Perhaps we should not have been surprised. He was always on the go, ate healthy meals, never smoked, and enjoyed being with friends.

He always seemed calm and collected, so on his 101st birthday, I asked how he had managed his stresses — his ship, the Canberra, was torpedoed during WWII with the loss of many of his buddies, and he was nearly killed. He had lost his daughter to cancer when she was forty, and his wife to cancer when she was 67. Yes, he had grieved greatly, but somehow, he was resilient and came back strong each time. He had been very sad but lived through his grief and always appeared unperturbed. “Well,” he said, “I guess I just let stress roll off my back.”

Organs decline about 1% per year.

One of the most important things that happens with aging, sort of like a car, “old parts wear out.” Most organ functions decline by about one percent per year. Of course, there is great variation from person to person, year to year, organ to organ, but 1% is a pretty good average to consider. We usually think of a person being in their prime through at least age 60. In many ways, that is correct, but you may be surprised to learn that the 1% decline starts in early adulthood and continues throughout life, speeding up as we age. Fortunately, most of our organs have significant redundancy so that we can tolerate these declines without any appreciable impact. But eventually, the decline may get to the point where we have a functional impairment that can be serious or at least impair our day-to-day activities.

I recently turned 84. I don’t feel “old,” but I do know I can’t do everything I used to do, or at least not as quickly. My hearing is less; my vision is reduced. My muscle mass and strength are definitely much less than they were in the recent past. My balance is OK, but not as good as it used to be, and so on. It has been a set of changes that came slowly at first but are now progressing faster. I always enjoyed splitting wood for the fireplace. I kept a woodshed filled with wood split and logs drying for a year before splitting. As time went on, I realized that I couldn’t keep at it for as long before wanting to take a break. As one friend in his early 80s told me, “I was fine until about age 78, and then it seemed that the aging process was suddenly there and moving fast.” Those declines, developing “under the radar” for decades, had accelerated and become overt.

The 1% Per Year Decline, Author’s image

Hearing decline begins at about age 25 but is not noticed until much later. Many of you will need reading glasses by age 40, even though you have had excellent vision for years; cataracts may occur later. Balance starts its inevitable decline early, although it, too, will not be noticed until much later. Meanwhile, internal organs, including the heart, lungs, and kidneys, are slowly declining, and so too is brain function, especially cognition.

This normal aging process of old parts wearing out is universal and is progressive, but you can slow it and sometimes reverse it, at least partially. Let’s use bone mineral density (BMD) as an example. BMD is easily measured to demonstrate the sturdiness of our bones — how strong they are. We start life with cartilage rather than bones. As we grow from toddlers to children to teenagers, calcium and other minerals, along with a protein-collagen matrix, are laid down in our bones, and they become increasingly strong, reaching a peak around the age of twenty. Once that age and that peak are reached, it can’t go up any further — that’s it. Then there is a plateau, and at about age thirty to forty it starts to decline at a rate of about 1% per year. At age twenty, men’s bone mineral density is, on average, higher than women’s.

Nevertheless, for women as for men, the decline is about one percent per year. Menopause changes this; the rate of loss increases to perhaps three percent per year for a few years and then returns to the one percent average decline until reaching osteopenia and then osteoporosis. There are three important points to consider. If you live long enough, your bone mineral density will decline to a level where, if you fall, a bone fracture becomes more likely. Since women start at a lower level and because they have this increased loss of BMD during menopause, they’ll reach that fracture threshold in life earlier than men. Since women tend to live longer than men, in total, more women than men will have a fracture at some point in their lives. We might just say this is one of the risks of living longer.

But why will you fall? Because your balance mechanism is likewise declining, and your muscle mass and strength are not as capable of “catching” your fall. The three combine together in a very negative manner!

Muscle mass and strength decline in a similar fashion, resulting in what doctors call sarcopenia. Most people lose perhaps 30% of their muscle mass between ages 50 and 70, and the loss continues at an even faster rate thereafter. Older individuals who exercise find it takes more effort to maintain their muscle mass and strength, but regular exercise and good nutrition have a significant beneficial impact and slow the process considerably.

Cognitive function is another example; your brain loses some of its abilities as you age. Cognitive abilities and brain volume do not decline in lockstep but do have a clear relationship. A fascinating study published in the journal Nature in April 2022, pulled together 123,984 MRI scans taken at over 100 institutions from 101,457 individuals ranging from 115 days post-conception to 100 years of age — from fetuses to centenarians. At the age of three years, the brain had reached 80% of its maximum size. The gray matter, which consists of the actual brain cells, reaches its maximum by about age 6, whereas the white matter, the inner connections between brain cells, does not reach its peak until the late 20s. The decline in brain volume thereafter is slow but accelerates after about age 50. These changes can be seen in the figure, which shows the growth trajectories of gray and white matter. The charts show volume (in mm3) across age, beginning before birth and ending at about 100 years.

If you are over 65, you have probably noted that you can’t memorize as well, recall names as quickly, etc. When I was in medical school, memorization was relatively easy; not so today! This is normal. This loss of cognitive function over time should not be confused with the disease Alzheimer’s. Nearly everyone who lives long enough will suffer from some cognitive decline, but only some will develop Alzheimer’s. As with BMD, you reach your peak cognitive function around age twenty; it plateaus for about 10 years, then starts that slow decline. Given the great redundancy in your brain, it is not noticeable for some time. Eventually, you reach a functional threshold where your cognitive function begins to impair your ability. This becomes more apparent when an older person is engaged in highly technical activities, very fast-paced activities, or stressful situations (emotional, physical, or health-related). Those cognitive challenges are less apparent in highly familiar situations.

This 1% annual loss is normal. No, it is not an exact number, nor is it the same for every person or every organ, nor is it exactly 1% in the same person at all times. But 1% is a good proxy for what is happening throughout your body throughout adulthood and into your elder years.

Slowing the aging losses

Here are some suggestions to slow that steady decline in functions. If you start at age twenty with very strong bones (i.e., a high BMD), then you have a longer way to go down before reaching that level of potential bone fracture from a fall. Perhaps too late for you if you are older, but encourage your children and grandchildren to eat a good diet, play/exercise daily, preferably outdoors, manage their stress, and get a good night’s sleep. And for their brains, do just the same (quality food, plenty of exercise, sound sleep, and managed stress) as for their other organs. Then, continually challenge their brains with new learning. Those with more years of schooling will start out with greater reserves, so the 1% decline will take much longer to cause difficulties. Muscle mass and strength are similar. Encourage them to build it up now as a teen. No need to be a muscled bodybuilder, but regular exercise and a good diet will mean more strength at the start of that long decline.

Most people seem to accept that, with age, comes a decline in function. “That is just what happens when we get older.” They may not like it, but they do not realize that they can substantially modify the downhill course. You can slow this continuing loss of body functions, including cognitive decline, and you can start at any age. It is never too late. It is not hard to do, and it does not cost money, but it does take time and persistence. It is all about how you move, what you eat, how you manage chronic stress, get adequate sleep, avoid tobacco, not too much alcohol, plus challenge your brain and keep socially engaged.

Stephen C Schimpff, MD, MACP, is a quasi-retired internist, professor of medicine, former CEO of the University of Maryland Medical Center, and author of Longevity Decoded — The 7 Keys to Healthy Aging, and is co-author with Dr. Harry Oken of BOOM — Boost Our Own Metabolism

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In fact, isometric workouts are an excellent starting point for a healthier lifestyle because they require minimal resistance and can be performed at a lower intensity. As you become more self-assured, comfortable, and stronger, you can integrate more isotonic motions and weighted exercises, both of which are great ways to build strength and confidence. What are some ways isometrics can improve your body and mind?

1. Helps to preserve the strength of joints

Isometric exercises are more effective than traditional strength training in strengthening joints. Additionally, they can accomplish this without experiencing the discomfort commonly associated with other movements.

2. Causes a decrease in high blood pressure

An investigation conducted in 2023 showed that isometric workouts, particularly the wall squat, have the potential to be an efficient method for lowering blood pressure. By holding a squat position while leaning your back and shoulders on a wall behind you, you can do an isometric leg workout known as a wall squat (also known as a wall sit). The mechanism by which this affects blood pressure is not fully understood by researchers; however, they believe it may be related to the blood flow into and out of muscles when they contract and release.

In a study published in October 2023 in the British Journal of Sports Medicine, researchers combined the results of 270 clinical trials involving a total of over 15,000 participants. The effects of exercise on blood pressure were documented in each of the experiments, which lasted for a minimum of two weeks.

Exercising in various ways helped lower blood pressure, as expected. Isometric exercise training has been proven to be the most effective form of exercise, particularly for individuals with high blood pressure.

The pain associated with osteoarthritis can be excruciating, particularly when the joint is being moved through its full range of motion or when the patient is exercising. Individuals with osteoarthritis may benefit from engaging in isometric exercises to activate their muscles and maintain strength before adding additional resistance. This method is effective in reducing discomfort, increasing the range of motion, and enhancing function, according to research. How long should these muscles be held for the best results?

Beginners should hold for 3-10 seconds; experienced individuals, 30+ seconds. Cleveland Clinic Health Essentials suggests a gradual increase in exercise hold time, based on your body’s feedback and increasing strength.

Here are some isometric exercises. Remember to discuss this with your healthcare provider before any exercise, and begin slowly — do not attempt to proceed faster than your body can handle the exercise. Everyone will go at their own pace.

1. Phone calls and push-ups

You should position yourself so that you are arm’s length away from a wall and rest your palms flat against it at shoulder height. This should be done when you are standing and talking on the phone or waiting in line. Maintain this position while leaning forward slightly and engaging the muscles in your chest, shoulders, and core. This exercise helps ease stress and anxiety while also strengthening the upper body and improving posture.

2. Planks at the desk

By placing your hands on the edge of your desk and walking your feet back until your body forms a straight line, you may turn your desk into a useful tool for increasing your fitness level. This modified plank position should be held for thirty to sixty seconds.

In addition to preventing the detrimental consequences of sitting for extended periods, this workout targets the entire core, as well as the shoulders and arms. Besides removing mental fog and boosting attention throughout the workday, the concentration required to maintain good form serves as a form of mindfulness.

3. Commute glute squeezes

In any situation, whether you are sitting at your desk, in a car, or on public transportation, you can subtly clench your glute muscles and hold the contraction for ten to fifteen seconds before releasing it. As you perform this exercise, you will strengthen the largest muscle group in your body while also preventing the muscle weakness that can result from prolonged sitting. A meditative pattern can be created through the repetitive nature of squeeze-and-release, which helps reduce stress caused by commuting and promotes mental peace.

4. Calf Raises While Carrying Out Daily Tasks

Raise yourself up onto your toes and maintain the position for a few seconds before gradually lowering yourself back down when doing tasks like brushing your teeth, cooking, or doing the dishes. By strengthening the calves and improving circulation in the lower legs, this exercise is particularly beneficial for individuals who spend a significant amount of time sitting or standing for extended periods.

5. Abdominal Support During the Day

This invisible exercise involves gently drawing your navel toward your spine and maintaining that contraction while breathing normally throughout any activity you engage in. This is something you should practice while walking, sitting in meetings, or performing household or work duties.

A consistent abdominal bracing routine helps develop the deep core muscles, which in turn improve posture and support spinal health. In addition to enhancing bodily awareness, the conscious link between the mind and core muscles can also serve as a point of anchoring for maintaining presence and reducing stress throughout the day.

Isometrics are a great way to incorporate simple exercises into your daily routine, eliminating the need to go to the gym, use equipment, or take time out of your day. Each day includes exercise, allowing you to reap the benefits while going about your normal activities.

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“The fault, dear Brutus, is not in our stars, but in ourselves…”
— William Shakespeare, Julius Caesar.

That quote haunted me for years, long before I ever held a linear accelerator’s joystick or delivered radiation to a tumor curled around someone’s spine.

Back then, I didn’t fully grasp its relevance to my work.

Now, after decades in oncology, I see it with stark clarity.

Because here’s the truth:

Up to 42% of cancers are preventable — not through miracle drugs or genetic luck, but through modifiable, everyday choices.

This observation isn’t about blame.

It’s about power.

And it’s time we stopped whispering about it.

Even through the fog of risk, we can walk toward healing. 42% of cancers are preventable, and every step counts.

🔁 Why Cancer Isn’t Just Bad Luck: The Myth of Randomness

When patients hear “cancer,” the next question is often whispered:

Did I cause this?

It’s a painful, complicated moment.

I always remind them: no one deserves this, and no one gets cancer from one bad meal or missed screening.

But I also tell them we know that cancer is not a lightning strike.

Yes, some cancers come from sheer genetic chaos.

But others arise from a slow, silent drift, shaped by inflammation, environment, and habit.

🔁 Inflammation and Obesity: The Hidden Cancer Risks

You don’t see inflammation in the mirror. But it shapes your fate.

Low-grade, chronic inflammation — often fueled by excess fat, poor diet, poor sleep, and stress — is a known contributor to several cancers, including colorectal, breast, and liver.

Chronic inflammation in the etiology of disease across the life span – Nature Medicine

www.nature.com

We once thought of obesity as a cosmetic issue. Now we understand it as a biological amplifier of cancer risk:

• Fat cells release cytokines and estrogen-like compounds
• These can trigger DNA damage and tumor-promoting environments

I’m not judging anyone’s weight. I’m inviting a deeper understanding of how the body works — and how we can gently steer it.

Diseases desperate grown,
By desperate appliance are relieved,
Or not at all.”
— Shakespeare, Hamlet.

Sometimes, small daily shifts are our most potent medicine.

🔁 How Alcohol, Smoking & Diet Tip the Scales

If you asked me what four lifestyle changes would make the biggest impact on global cancer rates, I’d say this:

1. Stop smoking
2. Drink less alcohol
3. Eat more plants and fewer processed foods
4. Move

🥃 Alcohol

Alcohol is a group 1 carcinogen, the same class as tobacco and asbestos.³

It increases the risk for at least seven cancers, including breast and colorectal.

And even “moderate” drinking has risks, especially for those with other risk factors.

No level of alcohol consumption is safe for our health

. www.who.int. int.

🍽️ Diet

Ultra-processed foods cause inflammation, metabolic dysfunction, and now, higher cancer risk.

A 2023 study in The Lancet tied them to a 29% increased risk of colorectal cancer.⁴

It’s not about moral purity. It’s about stacking the odds in your favor.

Prevention Isn’t Perfection. It’s Daily Poetry.

When I talk to patients, I don’t hand them guilt. I hand them a possibility.

• A walk after dinner to quiet insulin spikes
• A decision to swap soda for tea
• A full night of sleep instead of doomscrolling

These things may seem small, but they are acts of devotion, not just to the body, but to the life it still wants.

Though this be madness, yet there is method in’t.”
— Hamlet.

Health is not about perfection. It’s about rhythm.

About small, quiet methods repeated until they shape destiny.

The Truth I Wish More People Knew

When people find out I’m a cancer doctor, they usually ask about treatments.

But the conversation I wish we had more often is this:

What can I do now, before the diagnosis, to change the story?

The answer isn’t sexy. It’s not a pill or a breakthrough headline.

It’s this:

Cancer isn’t always random. And your choices — however small — are not meaningless.

You deserve to know that.

A Gentle Invitation

I don’t write this to scare you.

I write it because knowledge is power, and silence is not protection.

Here’s the truth:

• Cancer is common.
• Up to 42% is preventable.
• That prevention is made of ordinary acts repeated with quiet courage.

What’s one habit you’ve changed for your long-term health? I’d love to hear.

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