Health Goals: The 9 Habits for Longevity

In this article, we focus on the science of longevity. We examine the leading causes of death including cancer and metabolic syndrome. We look at what we lose with age, such as brain matter, Heart Rate Variability, and Deep Sleep. Finally, we introduce the 9 habits for longevity incl. Sleeping 7 hours per day, Meditation Practice, Intermittent Fasting, Strength Training, and getting at least 10,000 steps each day.

Want to live forever? Or at least longer than average? In the absence of any specific health goal, this seems like a perfectly sensible general framework to guide your lifestyle choices.

The Datasets of Death

If we rely strictly on scientific evidence to guide us, then there are only three relevant longevity datasets available: leading causes of death, centenarians, and animal models. The first is pretty obvious, so we can start there and work backwards to extract strategies to keep living long and healthy.

Leading causes of death

If we look at WHO published data from recent decades, we can isolate a few key groups of mortality to focus on. By far, the biggest leading causes of death are non-communicable diseases, often called chronic age-related diseases, including cardiovascular diseases (e.g. myocardial infarction and stroke), cancer, neurodegenerative disorders (e.g. Alzheimer’s), chronic pulmonary diseases and diabetes. In addition to these, mental health disorders, such as depression and anxiety, are rapidly growing causes increasing morbidity and mortality due to suicides.

Metabolic syndrome

This is a term for metabolic mayhem, which increases your risk for heart attack, stroke and diabetes The signs include abdominal obesity, high blood pressure, high blood sugar and/or insulin resistance, and abnormal blood lipids (low HDL and high triglycerides). Often fatty liver disease is also present. The risk factors for metabolic syndrome include poor diet, low physical activity, sleep disturbances, and excessive alcohol use. The good news is that you can reduce your risk of metabolic syndrome - and increased mortality - by following healthy habits! Smoking also causes heart disease. So if you didn’t stop at cancer, then stop here! For non-smokers, the traditional theme was around saturated fat and cholesterol. Today’s research paints a broader theme around metabolic health and lipids, but there is no silver bullet as of yet.

Cancer

It remains the bogeyman, despite decades of well-funded research. One thing is for sure: stop smoking. If you’re smoking, you clearly don’t care about longevity. Obesity is the second biggest preventable cause of cancer after smoking. Excess body fat is associated with at least thirteen types of cancers, including breast, thyroid, liver, pancreas, kidney, stomach, colon, ovary and womb. The rest of the picture around cancer is murky, with increasing support for the metabolic theory of cancer, i.e. cancer as a result of bad mitochondria mishandling glucose and lactate. We’ll come back to those later.

Neurodegenerative disease

While the first two are the staples most know about and feat, the one that is actually growing is neurodegenerative disease, namely Alzheimer’s and Parkinson’s disease. The problem is mainly around plaque accumulating in the brain tissues, which slowly degrades function until dementia and death occur. A very active area of research, but again, the jury is still out, sadly. Fundamentally though, it is a cellular metabolic malfunction of some kind, as amyloid plaque is itself produced by brain cells.

Suicide

Tragically, suicide is a leading cause of death, and most often associated with severe depression. Causes for depression can include bad genes, brain chemistry imbalances, and chronic stress. To keep with the theme here, there are also correlations between depression and metabolic syndrome.

Accidents

To round off the horror show, the final major category is accidents. While the word itself indicates some type of bad luck has to happen, we can in fact avoid many deadly causes of accidents. Besides wearing a seatbelt, you should make sure to never text while driving to keep the odds on your side. Poisons are in the mix, and a good rule of thumb is to only take medicine prescribed by your doctor. Finally, falling is a major cause of death by accident. Maintaining muscle mass and range-of-motion into advanced age can make all the difference in those few split-second moments, walking down stairs or getting out of the shower, where you either laugh it off or end up hospitalized.

What we lose with ageing

The next source of information we can use to clarify what ageing means is people that are still alive, but doing better than average. The two mainstream use-cases are the centenarians, i.e. people who lived to at least 100 years, and the so-called Blue Zones, i.e. specific communities where people are especially healthy. The Blue Zones also contain their fair share of centenarians. In fact, there’s a lot more of them around these days, above 300,000 on last count. Enough to study, then. While most are lucky in the gene pool draw, we can also understand what changes happen in humans and how they relate to living longer than average.

Immune Function

With aging, the immune system becomes less effective and imbalanced in two ways. The first line of defence, i.e. the innate immunity, fails to resolve quickly after initial infection and the senescent immune cells continue to secrete more inflammatory cytokines. This contributes to chronic, systemic inflammation which is associated with many metabolic diseases (e.g. diabetes and heart disease). The second line of defence, adaptive immunity, which remembers and fights against particular viruses and bacteria, loses its efficiency with aging, since the number of naive T cells decrease over time and the ability to produce antibodies attenuates. Consequently, older people become less able to mount effective immune responses to new infections, and vaccinations provoke weaker responses and therefore, provide less protection. The good news is that exercise is an effective way to boost your immunity as it helps to preserve the levels of naive T cells. Muscle tissue provides protection for naive T cells to not become exhausted when fighting against chronic viral infections. Recent studies have shown that skeletal muscle can produce several proteins called myokines that reduce inflammation and maintain immune function with aging.

Brain matter

-5% per decade after the age of 40. I probably don’t need to elaborate why you might want to keep your brain matter intact. It just seems like a good idea. While disease, infection, and injury often result in cerebral atrophy, there is also a natural decline with age. How do you keep it? Eat better. Sleep more. Exercise more. Beneficial effects of exercise on neurogenesis and cognition to the aged brain are mediated by circulating factors from liver.

Muscle mass

-5% per decade after the age of 30, and up to 2% per year from age 50! The leading cause being down-regulation of hormones that build and maintain muscle, like testosterone. Well, who cares about abs at 80? Looking good at the beach is only a side-benefit of muscle mass. It’s also the leading consumer of glucose in your body, and therefore at the heart of metabolic health. When you really have nothing but toothpicks left, you also lose total mobility. Walking stick. Rollator. Wheelchair. Deathbed. The research on loss of mobility and mortality is gruesome. So don’t squat for the mirror, squat for the future. However, even at the age of 75-80 years, maintaining or increasing daily activity levels can prevent or attenuate the muscle strength declines with age.

VO2Max

-10% per decade after the age of 30. While most people have never heard of it, this has traditionally been the #1 metric for cycling nerds. It simply describes your body’s ability to consume oxygen. More is better, because it indicates higher potential output, as your muscles require oxygen during exercise. Therefore, it is often used as a single metric to indicate overall cardiovascular fitness.

Heart Rate Variability

-10% per decade after the age of 30. If you’re not familiar with HRV, then read all about it here. In short, low HRV is an indicator of overall frailty, and an accurate predictor of mortality for intensive care patients. Like muscle mass, you don’t want to run out of HRV, and it’s better to have extra. Unlike muscle mass, HRV isn’t just a function of exercise. More bicep curls will not boost your HRV. In fact, too much exercise can burn out your HRV. As an indicator of autonomous function of the central nervous system, HRV is also impacted by hormones, sleep rhythm, and your emotions.

Deep and REM Sleep

-5% per decade after the age of 20. Increasingly, besides quantity, we are finding out about the different phases of sleep and their functions. For example, deep stage sleep and Rapid Eye Movement (“REM”) sleep induce active recovery mechanisms in our body. Things like clearing up amyloid plaque that causes dementia. Balancing out growth hormone and cortisol levels. Memory encoding and consolidation. Losing those abilities doesn’t seem like a great idea. Aging is also associated with decreased ability to maintain sleep (increased number of awakenings and prolonged nocturnal awakenings), reduced nocturnal sleep duration, and decreased deep sleep (slow wave sleep).

Underlying drivers for ageing

The problem with the first two datasets is that they don’t really explain why we age on a cellular level. Given ethical limitations, the only way to do this is with animals like worms and mice that don’t live very long and can be dissected for analysis. The only caveat here is that animal research doesn’t always exactly translate to humans. However, they provide us hints of how mammalian aging can be delayed: with genetic, dietary and pharmacologic approaches.

Hormones

The balance of growth and death within our cells is what keeps us alive as long as we do. Hormones like IGF-1, growth hormone, insulin, and cortisol battle it out constantly throughout our lives. The main thing we can do to control this balance is intake of foods, as proteins and glucose in particular boost growth factors. We need them, of course, to stay alive, but too much increases the risk of metabolic syndrome, cancer and diabetes. We wouldn’t wake up from sleep without cortisol, but with aging, cortisol levels increase and this leads to increased adiposity (especially abdominal obesity), loss of muscle and bone mass, impairment of the immune system, and diseases such as hypertension, diabetes, depression and dementia. Balance is key to hormone health. The good news is that exercise can reduce the impact of high cortisol - or stress - on immunity.

Metabolism

The powerhouse of the cell, the mitochondria, are bacterial in origin but very central to our continued existence. They convert glucose from the food we eat into the basic energy currency of the body (ATP), with lactate as a byproduct. Depending on the energy needs, oxygen can be used by the mitochondria to boost ATP production. Increasingly, research is linking malfunction of mitochondria to a variety of age-related degradation and disease. When we get older, our metabolism slows down due to several reasons, one of them being decreased physical activity and muscle mass. Muscles burn more energy than adipose tissue, so to counteract the slowing metabolic rate with aging, keeping the muscles active is the solution. If one is on the path from physical inactivity to developing obesity and eventually diabetes, the metabolism becomes even more sluggish and inflexible. Metabolic flexibility means how your body can handle different nutrients (glucose and fat), for energy. People who are physically active - and especially throughout the day - are able to utilize energy from fat easily, or switch between different energy sources (glucose or fat) more efficiently than people who are physically inactive and/or have developed metabolic disease already.

Stress

Short-term acute stress can be good for us, in that it produces positive adaptations when we recover from bouts of exercise. Long-term chronic stress has no benefits. In fact, it’s all bad. Since any form of stress runs through our central nervous system, it is connected downstream to all the major systems in the endocrine system (hormones) and the immune system. It can literally wreak havoc all over the body, increasing the risk of everything from cardiovascular disease to depression, which in itself predicts excess risk of future heart attack. All ways to accelerate ageing and death. People with positive mentality (positive affect, life satisfaction, optimism, hope, self-esteem), are more likely to improve their diet quality and reach better outcomes (e.g. abdominal circumference) in intervention programs for metabolic syndrome.

Healthy Habits for Longevity

So what we want to do to maximize longevity is to build habits that support those key drivers. Why habits, you ask? Short answer: trends and diets come and go, so do hobbies, but habits stick. You are your habits, no more, no less. Long answer: read here. So, what are the right healthy habits for longevity?

NOTE: If you use Healthzilla, and choose the Live Forever goal, you will automatically get recommended all the right healthy habits!

Now, the list below might seem rather daunting. But it does reflect the current state of research around what keeps us healthy for the longterm. Remember, longevity isn’t just about lifespan, but mostly about healthspan, i.e. being able to enjoy life into advanced age, not just survive.

NOTE: If you start the 100-Day Challenge in Healthzilla, you will get the exact weekly targets for each of these healthy habits!

#1: Sleep 7 Hours, 7-days a week

Targets: hormones, stress, brain matter, deep & rem sleep

Newsflash. We were designed, by evolution, to sleep 8 hours. Why? Our planet just happens to rotate every 24 hours, creating alternating phases of light and dark. Evolution, if anything, is sparing. It doesn’t do luxury. So if nature insists on 8 hours, why do we fight it? There is no reason. Sleep deprivation in animal studies is just a horror show, and many studies have been reproduced in humans.

Why EVERY night though? Well, science says that the average quantity isn’t enough. Sleeping 12 hours on Sunday morning doesn’t cut it. Consistency is half the battle. If you don’t allow sleep deprivation to accumulate, there’s no need to sleep in!

#2: Walk 10,000 Steps, 5-days a week

Targets: metabolism, stress, heart rate variability, deep & rem sleep

Stillness and sitting are not good for you, that much is known. Physical inactivity is on the rise, and correlates with increases in lifestyle and metabolic disease. While more isn’t necessarily better, 10,000 steps seems to have become an acceptable number and corresponds to a decent amount of daily activity.

If you can divide your steps throughout the day to shorter bouts of walking, it may not feel as daunting a task as a single long walk - and it may even be better for your health. This is because the frequent bouts of physical activity provide a great benefit to your metabolic flexibility, i.e. glucose & fat metabolism. Metabolic flexibility means how your body can handle different nutrients (glucose and fat), for energy. People who are physically active - and especially throughout the day - are able to utilize energy from fat, or switch between different energy sources, more efficiently than people who are physically inactive. While you would ideally incorporate this into every day of the week, other forms of exercise complement a total weekly routine.

#3: Meditation Practice, 5-days a week

Targets: stress, hormones, heart rate variability, deep & rem sleep

Many longevity studies find characteristics like social relationships and spirituality to correlate with living long and healthy. It is a common misconception that the hard data attitude of western science often looks down upon these aspects, as that stance has gradually changed over the last two decades. Psychological wellbeing lowers the risk of cardiovascular disease, and thus, is considered an independent factor promoting cardiovascular health. The research on benefits of meditation and mindfulness based practices is adding up. It helps to keep our emotions in check, and manage our stress levels by lowering levels of stress hormones and inflammatory markers. Chronic and acute psychological stress is associated with increased levels of stress hormones, inflammatory markers and with depression. The chronically elevated stress hormones (e.g. cortisol) and abnormal inflammatory response predispose to high blood pressure, glucose and insulin levels, and thus, increase the risk of cardiovascular diseases and diabetes. Chronic stress is also an important risk factor for depression and anxiety. in particular can lead to disastrous health situations incl. depression and heart disease, so meditation is a universal shield for a wide range of health risks. Feel free to make it a daily practice, but let’s at least cover the working week with a morning 10-minute meditation. You DO have the time!

#4: Intermittent Fasting, 5-days a week

Targets: metabolism, hormones

Fasting is an ancient art, that has become increasingly popular in the last decade. Trendy, even, if not eating can be a dietary trend. The benefits are wide-ranging, from better metabolic health to appetite and calorie control, in addition to potential cellular level prevention against many cancers. The easiest way to start is simply to skip breakfast before working days, and even save some money doing it. We’ll allow you to keep brunch for weekends. You’re welcome!

#5: Strength Training, 2-days a week

Targets: muscle mass, hormones

Now we get into the heavy lifting part, literally. Rather than go all-out in one form of exercise, the current research indicates the best strategy is to cover all the bases. If you had to pick one, then strength training is a good place to start. You only need enough stimulus, and the goal here isn’t massive biceps but sustainable muscle mass and bone density. Two sessions of lifting heavy things, safely, will do the job.

#6: Cardio Training, 2-days a week

Targets: metabolism, vo2max, brain matter, stress

While basic cardio training isn’t all the rage these days, research shows that longer bouts of slow cardio training is the best way to stimulate the mitochondria. Why does that matter? Well, that’s the powerhouse of all your cells, so you want more and better mitochondria. The sweet spot is Zone 2, which many wearable devices and fitness apps can track automatically for you. Up to 60 minutes twice a week is the recommended dose. One low-impact modality is uphill walking on a treadmill. Just put on a good podcast or Netflix, and the miles will breeze by.

#7: HIIT Training, 1-day a week

Targets: vo2max, metabolism, brain matter, stress

To mix things up, some intense cardio to get your heart rate up near its maximum capacity is a good idea, just not too often. Even one dose a week of intense cardio intervals will do wonders. You’ll find many programs and apps that offer HIIT programs, from brutal 4-minute Tabata intervals to more traditional 4x4 intervals.

#8: Mobility Exercise, 1-day a week

Targets: accident prevention, muscle mass

Mobility, stability, functional strength, pilates, or yoga. Call it what you want. It’s still underrated. Today, many professional athletes are incorporating these forms of exercise into their regimens, because they must avoid injury. So do the rest of us. If we don’t take care to keep our bones, muscles, and joints in alignment and balance, we will have issues. Bad backs. Sore knees. For most people, that is what growing old is about. But it doesn’t have to be. Mobility isn’t something you do when things break. You have to do it now when the going is good, to keep it going good for the longterm! A little goes a long way, starting from zero. You can even incorporate elements of mobility into your existing gym warmup routines.

#9: Measure your Heart Rate Variability, 7-days a week

Targets: stress, heart rate variability, depression, longevity

You can only manage what you measure. For a long life, we have to keep stress in check. We need to recover from acute stress from our many workouts during the week. We need to keep chronic stress down. Heart Rate Variability (“HRV”) is how we measure stress! Greater autonomic dysfunction, as reflected by decreased HRV, is a plausible mechanism linking depression to increased cardiac mortality in post-MI patients.

The good news is that measuring HRV is easy these days. Several wearable devices like Apple Watch and the Oura Ring measure it automatically. If not, Healthzilla has a free Stress Scan that measures HRV from your fingertip using your smartphone camera. More so, Healthzilla helps you interpret the data into a daily Stress Score, to guide your choice of habits to work on each day.

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Join the 100-Day Live Forever challenge?

If you want to start measuring all these habits now, and working towards the levels cited in this article, then just download the app, set your goal as Live Forever, and navigate to the 100-Day Challenge. Once you start, the app will start from your current level of activity for each existing habit, and gradually introduce new habits. From there, each week you’ll be prompted to do a little bit more each week, until you reach the target levels. That’s an easy way to kickstart the right habits for longevity!