I AM MORE INTERESTED IN HEALTHSPAN than lifespan. I wouldn’t like to live too long with severe dementia. Today’s essay explores eight healthy habits that might add decades to your life.

Here are the lifestyle tools I use to expand my health- and lifespan:

1. I stay physically active.
2. I don’t smoke.
3. I manage my stress.
4. I do not drink alcohol excessively.
5. I maintain good sleep hygiene.
6. I avoid opioids.
7. I try to maintain positive social relationships.

Today, I want to examine a new study that illustrates the power of these eight lifestyle interventions to extend lifespan when adopted by midlife.

I Turned 60!

Earlier this year, I turned 60. While I always focus on my health and well-being, this turn into my seventh decade has me more focused on maintaining good health.

On a recent trip to Madrid and Seville, I observed the lives of our European counterparts.

Fruits had more pop to them. Desserts seemed far less sugary than those here in the States. And social interactions abounded. What can I learn from our friends across the pond?

I am fascinated by the last observation. Groups of men, families, and women all seemed to gather in the evening constantly. We joined in, dining between 10 and midnight.

First, here are some observations of William Shakespeare:

Crabbed age and youth cannot live together:
Youth is full of pleasance; age is full of care;
Youth like summer morn, age like winter weather;
Youth like summer brave, age like winter bare.
Youth is full of sport, age’s breath is short;
Youth is nimble, age is lame;
Youth is hot and bold, age is weak and cold;
Youth is wild, and age is tame.
Age, I do abhor thee; youth, I do adore thee;
O, my love, my love is young!
Age, I do defy thee: O, sweet shepherd, hie thee,
For methinks, thou stay’st too long.

A New Study Linking Lifestyle and Lifespan

Before we explore the new study examining the relationship between lifestyle and longevity, some caveats are in order.

The study I will present is observational, making it impossible to establish causality. While the researchers attempted to control for confounding factors, we should interpret the findings carefully.

Scientists analyzed data from over 700,000 enrollees in the Veterans Affairs Million Veteran Program MVP. This program aims to help researchers evaluate how lifestyle, genes, military experiences, and exposures impact health and well-being.

The team presented its findings at Nutrition 2023, the American Society for Nutrition annual meeting in Boston, Massachusetts (USA).

The data was from 2011 to 2019 and featured U.S. military veterans ages 40 to 99. Over 30,000 individuals died during the follow-up.

8 Habits That Might Add Decades to Your Life

The researchers examined all-cause mortality. They calculated longevity for male and female veterans separately.

Those who adopted all eight habits had a one-eighth reduction in the chances of dying compared to those adopting none of the habits.

Put differently, men adopting all eight habits at age 40 would be predicted to live 24 years longer (on average) than men who adopted none. Women adopting all eight habits by 40 would live 23 years longer.

8 Habits That Might Add Decades to Your Life — Not So Fast

When I first saw headlines about the study, I became excited about increasing my lifespan by 24 years.

On closer evaluation, the results are less impressive. I am comparing myself to someone on opioids who smokes and drinks excessively. That 24 years suddenly seems less impressive.

However, this finding resonated more with me:

Adding just one healthy behavior to a man’s life provided an additional four-and-a-half years. Adding a second tacked on seven more years, and three additional habits appeared with 8.6 extra years.

As additional lifestyle changes increased, so did the benefits for men.

For women, lifespan also increased by adding healthy behaviors. For example, one healthy behavior added 3.5 years to a woman’s life. Adding two added eight years, and three appeared linked to a 12.6-year increase.

The study reveals an association — not a cause-and-effect relationship. Moreover, given the focus on U.S. military veterans, the findings may not apply to all.

Ranking the Lifestyle Choices

The study ranked the eight lifestyle behaviors by their influence on longevity.

1. Exercise. Physical activity is the most important behavior to improve your health. Adding this behavior dropped death risk by nearly one-half (46 percent) compared with non-exercisers. This finding jibes with results from other studies. I ask my patients to walk 30 minutes daily, five days weekly. Add in two days of resistance training, too. I use regular walking as the base of my fitness routine. After my vision-threatening pituitary tumor scare, I re-focused on physical activity.
2. Opioids. Drug overdose and opioid misuse remain a serious public health crisis in the United States. This epidemic includes heroin, prescription opioids, and synthetic opioids such as fentanyl. Drug overdose deaths from prescription and illicit opioids have sharply increased since 1999. Over 300,000 people have died from them nationwide in the last 15 years. That’s about 55 people per day. Not getting addicted to opioids was the second most important contributor to a longer life, dropping early breath risk by a whopping 38 percent.
3. Never using tobacco. This lifestyle maneuver dropped premature mortality risk by nearly a third (29 percent). I would parenthetically note that quitting smoking at any point yields significant health benefits. Your primary care clinician can help you quit tobacco.
4. Managing stress. Stress management is something that I have recently focused on. The study showed managing stress reduced early death by just over one-fifth (22 percent).

More Lifestyle Choices

5. Eating a plant-based diet. I am not a vegetarian or vegan but follow a healthy plant-based approach, such as a Mediterranean diet. Have you considered upping your whole grains and leafy green vegetables?

6. Avoid binge drinking (four or more standard drinks daily). Avoiding excessive alcohol is easy for me, as I do not particularly enjoy alcohol (the occasional cup of sake notwithstanding).

7. Getting a good night’s sleep. I aim for seven to nine hours nightly, although, to be truthful, I am lucky to get seven. Numerous studies associated poor sleep with bad health outcomes, including premature mortality.

8. Being surrounded by positive social relationships. With age, I find myself pruning away negative (including toxic) folks from my life. I have a core group of supportive friends and family. I know that social isolation is associated with a significantly higher chance of dying early.

My Take on Lifestyle, Longevity, and Healthspan

One of my takeaway messages is that benefits are available even if we cannot adopt all eight healthy habits.

The available data hints that adopting healthy habits when we are older yields smaller gains in life expectancy but is likely still provides value. The earlier you start, the better. But even if I make changes in my 60s, I should get some benefits.

I have long advised my patients to eat well and to get regular physical activity. This study helps to quantify the gains associated with adopting healthy habits.

Finally, while an expert committee evaluated the abstracts chosen for Nutrition 2023, this process is less valuable than a peer review process required for publication in a scientific journal.

Healthy habits can improve overall quality of life, reduce the risk of chronic disease, and increase happiness and well-being.

The study reminds us that we can meaningfully impact our life- and healthspan by adopting simple lifestyle maneuvers. What can you do better?

Paying better attention to my sleep hygiene has paid huge dividends. With sufficient sleep, I am more productive, a safer driver, more energetic, and (here, my nurse Melissa and my wife might agree) less grumpy.