Shift your approach to health from reactive (Medicine 2.0) to proactive (Medicine 3.0) by aggressively taking action to delay the onset of the “four horsemen” (atherosclerosis, cancer, neurodegenerative disease, and metabolic dysfunction) rather than waiting for diseases to set in. This involves making consistent changes over decades to compound benefits.
Recognize exercise as the most potent longevity intervention due to its profound impact on all-cause mortality, exceeding that of many disease conditions. Focus on improving cardiorespiratory fitness (VO2 max), strength, and muscle mass, as these metrics have the widest impact on lifespan and healthspan.
Invest in understanding your baseline health by getting key metrics like VO2 max and appendicular lean mass index (ALMI) via a DEXA scan. Use this data to drive personalized training and lifestyle adjustments, focusing disproportionately on areas where your metrics are weakest.
Understand and aggressively manage your risk of atherosclerosis, which is the leading cause of death globally. Measure ApoB (or non-HDL cholesterol as a surrogate) and aim for levels at or below the 20th percentile, especially if young, to reduce lifetime exposure and delay disease onset.
Measure your blood pressure accurately at home twice daily (morning/evening) for at least two weeks using a high-quality monitor and a strict protocol (sitting comfortably, legs uncrossed, not speaking for 5 minutes, cuff at heart level). Aim to maintain an average blood pressure better than 120/80, primarily using lifestyle interventions like exercise, weight loss, and sleep improvements before considering pharmacology.
Consider using a continuous glucose monitor (CGM) for a period to gain real-time insight into how diet, sleep, exercise, and stress impact your blood glucose and glucose variability. This tool can be powerful for behavioral change and understanding that optimal blood glucose is lower than what is considered merely “normal,” but avoid if you have a history of disordered eating.
Prioritize emotional health as it significantly impacts your ability to make and sustain lifestyle changes and can improve with age. Actively work on widening your “distress tolerance window” through practices like therapy, journaling, and checking in with supportive friends.
To combat destructive inner monologues, practice speaking to yourself with the same kindness and support you would offer a close friend who made a mistake. Say these supportive words out loud and consider an accountability partner (not a romantic one) to help ensure consistency in this practice.
Recognize adequate sleep as a fundamental determinant of healthspan and lifespan. Prioritize getting sufficient sleep, as it profoundly impacts blood sugar regulation, stress levels, and overall well-being.
Ensure you are consuming adequate protein daily, especially if you are focusing on strength training or managing body composition. This is a crucial recommendation for overall health and muscle maintenance.
Critically evaluate all health habits by considering their context, trade-offs, and opportunity costs (especially time). Avoid binary thinking about “good” or “bad” interventions, and instead, apply the right tool at the right time, understanding that extreme or unbalanced approaches can lead to unintended negative consequences. Aim for consistent “seven out of ten” effort rather than sporadic “ten out of ten” efforts.