Everyone wants to live longer. But living to 95 in a nursing home isn’t the goal.
Healthspan — the years you’re healthy, functional, and actually enjoying life — is what matters.
Here’s what the research shows actually moves the needle.
The Big Picture
Longevity research is exploding. But most “anti-aging” interventions are either:
- Promising in mice, unproven in humans
- Overhyped by people selling something
- Common sense dressed up as cutting-edge science
Let’s separate signal from noise.
Tier 1: The Unsexy Stuff That Actually Works
Exercise (Especially Strength Training)
The evidence: Exercise is the closest thing we have to a longevity drug. Period.
- Reduces all-cause mortality by 30-35% [1]
- Maintains muscle mass (sarcopenia is a primary driver of frailty)
- Preserves bone density
- Maintains metabolic health
- Protects cognitive function
The nuance: Both cardio and strength training matter, but strength training becomes MORE important as you age, not less. Muscle is the organ of longevity.
Minimum effective dose: 150 min/week moderate cardio + 2x/week strength training. More is generally better up to a point.
Sleep
The evidence: Chronic sleep deprivation is associated with:
- Increased all-cause mortality
- Higher rates of heart disease, diabetes, obesity
- Accelerated cognitive decline
- Impaired immune function
The target: 7-9 hours for most adults. Quality matters as much as quantity.
What helps: Consistent sleep/wake times, cool dark room, limiting alcohol and caffeine, treating sleep apnea if present.
Not Smoking
Obvious, but worth stating: smoking is still the single biggest modifiable risk factor for early death. If you smoke, quitting is the highest-yield longevity intervention available.
Moderate Alcohol (or None)
The “red wine is good for you” narrative has largely fallen apart. Recent analyses suggest:
- No amount of alcohol is “healthy”
- If you drink, less is better
- Previous studies showing benefits had methodological issues
Practical take: If you enjoy alcohol, moderate consumption is probably fine. But don’t drink “for your health.”
Maintaining a Healthy Weight
Obesity increases risk of basically every chronic disease. But:
- Being slightly overweight (BMI 25-27) might not be as harmful as thought, especially in older adults
- Muscle mass matters more than the number on the scale
- Yo-yo dieting may be worse than stable mild overweight
Focus on: Body composition (muscle vs. fat), metabolic health markers, and functional fitness rather than BMI alone.
Tier 2: Evidence-Based Interventions
Zone 2 Cardio
What it is: Low-intensity cardio where you can hold a conversation. Heart rate roughly 60-70% of max.
Why it matters: Builds mitochondrial density, improves fat oxidation, enhances cardiac efficiency without excessive stress.
Practical: 3-4 sessions of 30-60 min/week. Walking, easy cycling, light jogging.
Time-Restricted Eating
What it is: Limiting eating to a window (typically 8-10 hours).
The evidence: Modest but real benefits for metabolic health in some studies. May improve insulin sensitivity and reduce inflammation.
The caveat: Most benefits probably come from eating less overall, not the timing per se. If TRE helps you control calories, great. If it makes you miserable, skip it.
Cold Exposure
What it is: Cold showers, ice baths, cold plunges.
The evidence: Increases brown fat activation, may improve insulin sensitivity, reduces inflammation acutely. Long-term mortality data in humans is limited.
My take: Probably beneficial, but the magnitude is unclear. If you enjoy it, do it. Don’t force it.
Sauna
What it is: Regular sauna use (traditional Finnish style, 15-20 min at 80-100°C).
The evidence: Finnish studies show dose-dependent reduction in cardiovascular mortality and all-cause mortality with regular sauna use [2].
Mechanism: Heat stress triggers similar adaptations to exercise — improved cardiovascular function, reduced inflammation.
Practical: 2-4 sessions per week if you have access.
Tier 3: Promising But Unproven
Rapamycin
mTOR inhibitor that extends lifespan in every organism tested. Human trials for longevity are ongoing. Interesting, but not ready for widespread use.
Metformin
Diabetes drug with potential longevity benefits. TAME trial in progress. Might blunt some exercise adaptations. Jury still out for non-diabetics.
NAD+ Precursors (NR, NMN)
NAD+ declines with age. Precursors raise NAD+ levels. Whether this translates to meaningful longevity benefits in humans is unclear.
Senolytics
Drugs that clear senescent cells. Very promising in animals. Human data is early. Dasatinib + quercetin is the most studied combo.
What I Actually Do
Transparency time. Here’s my personal protocol:
Daily:
- 7-8 hours sleep (non-negotiable)
- Strength training 4-5x/week
- Walk 8,000+ steps
- Protein target: 1g/lb body weight
- No smoking (never have)
- Minimal alcohol
Weekly:
- 2-3 Zone 2 cardio sessions
- Sauna when available
Monitoring:
- Annual bloodwork (lipids, metabolic panel, hormones, inflammatory markers)
- Track strength and body composition
- Regular check-ups
Not doing (yet):
- Rapamycin, metformin, or other pharmaceuticals
- Extreme caloric restriction
- Expensive longevity supplements
The unsexy basics work. I’ll add more aggressive interventions when the human data is stronger.
The Bottom Line
- Exercise — especially strength training — is the highest-yield intervention
- Sleep 7-9 hours
- Don’t smoke, minimize alcohol
- Maintain reasonable body composition with adequate muscle mass
- Add Zone 2 cardio, sauna, and cold exposure if you’re optimizing
- Be skeptical of expensive supplements and unproven interventions
Healthspan is built through decades of consistent basics, not magic pills.
References
Arem H, et al. “Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship.” JAMA Intern Med. 2015.
Laukkanen T, et al. “Association between sauna bathing and fatal cardiovascular and all-cause mortality events.” JAMA Intern Med. 2015.
Questions about longevity protocols? Find me on Twitter @drmob.