How to Age Well: 4 Evidence-Based, Big-Impact Strategies

By Casey On May 2, 2024

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None of us is getting any younger.

Take it from someone who’s old:

You don’t want to reach the Age of Senior Discounts with regrets about all the things you didn’t do to prepare your body and mind.

Fortunately, there’s a lot you can do, at any age.

In the following article, we’ll cover the best practices for aging well—preserving longevity, quality of life, and healthspan. They include:

The very short list of things you should avoid.
The much more detailed list of what you can do to get the most out of the time you have.
The most impactful way to combine a healthy life with a happy life.

Some are easy. Some take more effort. Many are common sense. All are supported by research, some of it going back decades.

But before we get into all that, we’ll start with something more fundamental.

Why do we get old?

Despite centuries of medical breakthroughs, everyone who’s been lucky enough to get old either has died or will die.

There’s a reason no one’s been able to find a loophole.

“Virtually all of our genes, and all of our vital systems, play a role in aging,” says biochemist Charles Brenner, PhD, chair of the Department of Diabetes and Cancer Metabolism at City of Hope National Medical Center.

Because there’s no “lone gunman”—no single gene that goes gray and takes everything else down with it—there will never be a single pill, potion, or practice to stop the process, let alone reverse it.

It doesn’t matter how much money goes into the search for an “off” switch.

“The anti-aging industry has been full of grifters for thousands of years,” Brenner says. “Overpromisers and underperformers.”

The modern roots of the industry go back to 1990, when a study in the New England Journal of Medicine showed promising results from administering human growth hormone to older men.¹

It was a small study—just 12 men received hGH, with nine comparable participants serving as a control group.

But the results “were sensationalized by the press in a number of exaggerated reports,” according to biologist Richard F. Walker, PhD.²

That was enough to jump-start an anti-aging “gold rush,” Walker wrote—one that was commercialized from the jump.

The money is bigger today, with tech billionaires investing crypt-loads of cash in life-extension startups.³

But the problem they keep running into remains the same, Brenner says:

In terms of lifespan, humans have already exceeded the intended “warranty.”

What he means is that humans evolved to satisfy five basic priorities:

Avoid predation.
Acquire food.
Attract a mate.
Together with your mate, turn food into babies.
Make sure your babies live long enough to produce babies of their own.

If we had stopped there, we would be similar to all other animals. We would live as long as we’re reproductively capable, and then we’d expire.

But in the 300,000 generations since hominids split off from the great apes, we doubled our life expectancy.

That allowed some of our ancient ancestors to become active grandparents, which was a huge evolutionary advantage.⁴

Life expectancy doubled again in the past two centuries, thanks to breakthroughs in sanitation, nutrition, medicine, hygiene, and public safety.

And yet, despite all those gains in average lifespan, there remains a hard cap on maximum lifespan.

That’s because the aging process begins at birth and never stops.⁵

Once you get past your growth stage, your body becomes progressively less capable of repairing tissues and maintaining vital structures and functions.⁶

Two systems in particular drive the aging process.

▶ The first is metabolism.

Your metabolic rate declines about 0.7 percent per year in your sixties and beyond. If you live to 95, your daily energy expenditure will be about 20 percent lower than it was in your late 50s.

That’s according to research from an international consortium of scientists who crunched four decades’ worth of metabolic data on thousands of participants of all ages.⁷

The problem isn’t just that elderly people lose muscle. Their remaining lean mass also burns fewer calories. That includes energy-hungry organs like the brain and liver. A slower metabolism means you’re more likely to store fat in your muscles, liver, heart, and other places it doesn’t belong.

Intramuscular fat, for example, is linked to lower strength and mobility, as well as elevated blood sugar and higher insulin resistance.⁸

▶ The second is cognition.

With advancing age comes a long list of declining cognitive abilities:⁹

You’ll remember things less accurately, and take longer to pull up the memories you retain.
You’ll struggle to learn new words, and to recognize and retrieve words you already know.
New skills will be harder to master. It will also be harder to use your current skills in complex sequences.

The combination of physical and cognitive decline means you’re less able to do what you know how to do, and less capable of adapting to your changing circumstances.

But while the process itself is inexorable, there’s a lot you can do to slow it down.

How to age well: 4 evidence-based strategies

If you asked an expert to make a list of healthy aging strategies, it would probably have two parts. You’d expect the “do this” section to be more substantial, as it is here.

But it’s on the other side of the list that you’ll find your first line of defense against physical and mental decline.

“What you don’t do is at least as important as what you do.”

That’s according to Brian St. Pierre, MS, RD, Director of Performance Nutrition for PN.

You can probably guess most of the potential life-shortening behaviors:

Overeating
Smoking
Drinking to excess
Using non-prescription drugs to excess
Excessive unprotected sun exposure
Inactivity

All those things—along with infectious diseases and environmental pollutants—are what Brenner calls metabolic insults.

They all stress your metabolism and make it more difficult for your body to repair itself. (That’s the focus of Brenner’s research at City of Hope.)

On the proactive side of the list, you’ll probably find aspirational targets like:

Get a minimum of 150 minutes a week of moderate-intensity cardio, and do some form of resistance exercise twice a week.
Get seven to eight hours of sleep a night.
Maintain a “healthy” body weight, defined as a body-mass index (BMI) between 18.5 and 24.9.

The problem is, very few of us have the energy or ambition to check every item on the list. Just 6.3 percent of Americans collect the entire set, according to a 2016 study by the U.S. Centers for Disease Control and Prevention.¹⁰

So, from a public-health perspective, you could say the glass is 93.7 percent empty.

Or, from a personal perspective, you could pick and choose which practices and behaviors will have the most impact on your own health—and, by extension, give you the best chance for a long, satisfying life.

Make those your “big rocks,” the things you value most and will continue doing as long as possible.

Healthy aging strategy #1: Move more and preserve muscle.

In studies going back to the last century, participants who increased their levels of physical activity lowered their risk of dying of any cause by 15 to 40 percent.¹¹

What does that mean?

Let’s look at one study:

Starting in the late 1970s, the British Regional Heart Study recruited thousands of middle-aged men. More than 3,000 were still in contact with the researchers 20 years later. By 2016, just over half of them had died, according to public records. ¹²

Participants who told researchers they increased their activity level were 24 percent less likely to die of any cause, compared to those who reported moving less.

Those who sustained modest activity levels were 17 percent less likely to die than the low-activity group.

Studies show even more powerful benefits when participants push themselves hard enough to increase their cardiovascular fitness.

Simply moving up from the lowest level of fitness—usually the bottom 20 percent of the study population—to a higher level significantly decreased the risk of dying of any cause in the following years.¹¹

Moreover, the protective benefit of cardio fitness appears to be linear. That is, the higher your fitness level, the lower your risk of dying during any particular window of time.¹³

You don’t need to lose weight to get the benefits of fitness

If you’re among the two-thirds of Americans with a BMI of 25 or above (full disclosure: I’m with you), you can mitigate any potential weight-related disease risk through exercise and diet.

Studies show, for example, that increasing your maximum aerobic capacity (a.k.a. VO₂ max), is consistently linked to lower all-cause mortality among participants classified as overweight and obese, even when they don’t lose weight in the process.¹¹

Muscular strength and muscle mass are also correlated with a lower mortality risk.

So is resistance training—the process of trying to increase your strength and size—especially when it’s combined with cardio exercise.^14,15,16

Finally, there’s walking speed. It’s one of the least known but most powerful predictors of who’ll live the longest.^17,18 Which makes sense: Walking at a brisk pace requires a mix of muscular strength, cardio fitness, balance, and mobility.

You can make all of the above as simple as this:

“Move every day,” says Stuart Phillips, PhD, director of McMaster University’s Physical Activity Centre of Excellence, where he works closely with older adults who live near the campus in Hamilton, Ontario.

“Without daily movement, you go downhill fast.”

The specifics don’t matter nearly as much as the fact you’re doing something.

Another benefit of exercise: The “virtuous cycle”

“On average, people tend to eat better when they exercise more,” St. Pierre says.

That doesn’t mean we eat less.

Although exercise does seem to have an appetite-regulating effect (especially among people with low to moderate activity levels), that changes as we crank up the duration and intensity of our workouts. Hunger rises, and we eat more.¹⁹

But even then, we at least try to make better food choices, and often succeed.

St. Pierre says we do that for both physiological and psychological reasons.

“Physiologically, exercise improves your brain health, including the parts of the brain that are highly involved in our thoughts, actions, and emotions,” he says.

Those improvements seem to reduce our desire for highly processed foods, and help us make healthier choices to replace them.

Psychologically, he says, our fitness pursuits tend to lead to a healthier meal pattern because we don’t want all that effort to go to waste. “And good habits tend to stack on one another in a virtuous cycle, as opposed to a vicious one.”

Healthy aging strategy #2: Upgrade your meal pattern.

A healthy diet, one based on minimally processed whole foods, also helps prevent many of the chronic diseases associated with aging, St. Pierre says.

Those foods include:

A wide variety of fruits and vegetables
Lean protein from both plant and animal sources
High-quality carbs (whole grains, beans and legumes, and tubers)
Fibrous fats (nuts, seeds, avocadoes) and extra-virgin olive oil and other cold-pressed oils

“The biggest thing to emphasize is the overall pattern,” he adds. “Whether you eat more carbs or more fats is a personal preference.”

Getting a variety of foods within each category is helpful. That’s especially true for fruits and vegetables. You’ll not only get an abundance of key vitamins and minerals, the water they contain will also help keep your body hydrated.

That’s important because, the older you get, the greater your risk of dehydration.

“It’s far more common in the elderly, due to medications and a reduced sense of thirst,” St. Pierre says. “And it can impact physical and mental health more profoundly in that group.”

Healthy aging strategy #3: Prioritize high-quality sleep.

Generally speaking, people who sleep less than seven or more than eight hours a night, and who go to bed and wake up at unpredictable times, are at higher risk for pretty much everything—obesity, diabetes, cardiovascular disease, and death from any cause.^20,21

Establishing a regular, consistent sleeping-and-waking routine is probably the most powerful way to improve your sleep quality. (Bonus: It also helps to start that routine before midnight.)

One of the most impactful strategies to use to encourage good sleep is to employ a nightly bedtime ritual.

Just like Pavlov’s dogs learned to salivate at the sound of a bell, your body can learn to wind down with a custom-tailored pre-sleep routine.

About 30 minutes to an hour before bedtime, wrap up any stimulating activities (working, doomscrolling, intense exercise) and switch to activities that promote physical and mental relaxation. For example, read, take a bath or shower, do a mini yoga routine, or watch a favorite show.

Dim the lights, and maybe lower the thermostat a few degrees.

If you’re the ruminating type, consider doing a “brain dump.” Take a few minutes to write out a list of whatever’s bugging you: Emails you need to send or reply to, calls you have to make, project ideas, creative thoughts, that thing you should have said to that person…

Whatever’s on your mind, get it out of your head and onto your list.

(For more advice on how to engineer an excellent night’s sleep, check out our infographic: The power of sleep)

Healthy aging strategy #4: Deepen your human connections.

There’s one more key to a long, healthy life.

It’s something you can’t get with exercise, nutrition, or sleep. It’s impervious to wealth, fame, or professional achievement.

Tech bros can’t buy it, big pharma can’t replicate it, and longevity hustlers can’t sell it.

Good relationships, it turns out, are the ultimate life hack.

That’s according to the Harvard Study of Adult Development, which began in 1938 and continues today with the descendants of its original participants—Harvard undergrads (including future U.S. president John F. Kennedy) and teenage boys from underprivileged backgrounds.²²

Robert Waldinger, MD, is the study’s fourth director. In his 2015 TED talk, he said it’s this simple:

“Good relationships keep us happier and healthier. Period.”

Participants who were most satisfied with their relationships at 50 were the healthiest at 80.

A 2016 study by Waldinger and his coauthors found that octogenarian participants who felt securely attached to their spouses—they believed they could count on them in life’s roughest moments—performed better on memory tests than those who felt less connected.²³

“Think about relationships as something akin to physical fitness,” said Marc Schulz, PhD, associate director of the Harvard study, in a recent podcast interview.

To function, they require not just time and energy. At critical moments you also need to reflect on what is and isn’t working for you and the other person. And that applies to all important relationships—family, friends, neighbors, and colleagues as well as life partners.

Put another way: If you want a longer life, it helps to have a life.

References

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