Recognize exercise as the single most impactful factor for extending both lifespan and healthspan, surpassing nutrition and medication in its potential to reduce all-cause mortality and improve quality of life.
Create a ‘Centenarian Decathlon’ by identifying specific physical activities and daily living tasks you want to perform in your last decade (e.g., walking 3 miles in an hour, getting off the floor with one hand) and train deliberately to offset age-related decline.
Strive for a VO2 max in the top 2.5% for your age group, as this level of fitness is associated with the lowest all-cause mortality risk, a five-fold reduction compared to the least fit individuals.
Aim for the highest possible VO2 max in your 40s and 50s to create a larger reserve, buffering the inevitable age-related decline (which can be reduced from 10% to 5-6% per decade with consistent training) and maintaining functional capacity into later life.
As you age, especially from your forties and fifties, add strength, circuit, and agility training to your routine to combat the decline in skeletal muscle strength and frailty, which is crucial for preventing falls and maintaining independence.
Actively avoid inactivity, as even short periods of bed rest can cause significant physiological decline equivalent to decades of aging. Engage in any form of physical activity, from low-grade movement to intentional workouts.
Implement a high-intensity interval training protocol of four minutes of all-out effort (e.g., on a bike or running) followed by four minutes of complete rest or very light recovery, repeated four times, to efficiently increase your VO2 max.
Structure your exercise regimen with a polarized approach, alternating between ‘hard’ days of intense, structured workouts and ’easy’ days focused on active recovery to promote recuperation and loosen muscles.
If you are previously untrained or older (60-70 years), dedicate 3-6 months to ‘pre-training’ at a moderate intensity (e.g., 80% of time at conversational pace) to build a foundational fitness level before introducing hard interval sessions.
To prevent orthopedic issues, fatigue, and other load management problems, limit your hard training sessions to no more than five or six every two weeks, allowing adequate recovery.
When performing intervals, start at a sustainable pace where initial discomfort is minimal. Aim for consistent effort, with the most suffering concentrated in the last 90 seconds, and finish without needing to bend over, indicating optimal exertion without overdoing it.
During intense interval training, learn to ‘manage your suffering’ by maintaining rhythm, tempo, and form even as discomfort increases, pushing your limits while staying relaxed.
Incorporate at least 10-15 minutes of light physical activity daily, such as purposeful walking, gardening, or taking the stairs, as this provides substantial health benefits like improved insulin sensitivity and better vascular function.
Use a jump rope as a versatile exercise, even when traveling, to improve cardio, coordination, and foot reactivity, which are important for preventing falls.
Perform simple bodyweight exercises like pushups, planks, and pull-ups to maintain strength and functional fitness, which are accessible and effective.
Direct your training efforts towards improving cardiac output (heart rate multiplied by stroke volume), as it is the primary physiological driver of oxygen delivery and overall VO2 max.
On easy training days and for general physical activity, rely on your Rating of Perceived Exertion (RPE) rather than strictly tracking metrics like heart rate recovery or variability, focusing on the overall feeling of effort and recovery.
Implement strategies for accountability in your exercise regimen, such as training with a partner, using a device, keeping a diary, or simply tracking your progress, to maintain consistency and motivation.
For a hard day, perform a circuit of strength exercises (e.g., 25 squat thrusts, 1 minute jump rope, static wall sit to failure, drop sets for major muscle groups) followed by intense cycling intervals (e.g., 8x3-minute ladders with increasing watts, no rest between ladder steps).
For an easy day, engage in 30-40 minutes of light cycling or rowing, focusing on active rest to promote recovery and loosen muscles, rather than aiming for a significant training effect.
Set a specific long-term goal to maintain a VO2 max of 30-31 mL/kg/min into your 80s, which is a level that ensures you can perform virtually any reasonable activity without limitation.
For individuals who are unwilling or unable to exercise, consider a ‘poly pill’ strategy (e.g., low-dose statins, blood pressure medications, metformin) as a potential public health approach to reduce risk factors, though exercise remains the preferred method.
If you have recovered from COVID-19 (especially if vaccinated and had a breakthrough infection), consider donating convalescent plasma within 2-3 weeks of recovery (and up to 3-6 months) to help immune-suppressed patients.
Advocate for or participate in a ’national open gym movement’ to provide accessible facilities and opportunities for unstructured play and physical activity for children and communities, addressing the decline in such opportunities.
Utilize available spaces in your workplace, such as long hallways, to walk for 30-40 minutes at lunchtime with colleagues. This provides physical activity, social engagement, and can improve productivity.