If you want to look forward to a long and healthy life, then according to current scientific insights, there are roughly seven basic rules that you could follow. We will explain them in this blog. If you’re bracing yourself for an information overload, relax. You already know a lot of what you are about to read below.
By Willem Koert
The turning point came in the late 1970s and early 1980s. Until then, biomedical sciences had concentrated entirely on the control, treatment and prevention of disease. Scientific attention was focused on factors that hindered normal functioning.
The scientific project had been successful. In the developed countries, more and more people were able to grow old. A new field of attention emerged: aging. Gradually, more and more scientists began to wonder whether and to what extent aging could be slowed down. Some progressive researchers have even gone so far as to regard aging as a disease and look for a cure. To this day they have not found that medicine, but they did make remarkable discoveries.
This blog post is based on the work of less radical researchers. These scientists followed large groups of people for years, determined their lifestyle and then used advanced statistics to find out which lifestyle increased the chance of a long and healthy life, and which lifestyle did not. In this vast body of research, the associations below come up again and again.
#1 Exercise
It’s unfortunate for anyone who hates exercise, but exercise is one of the two most important lifestyle factors that can help you reach a very old age while staying healthy. If we are to believe molecular studies, people who exercise a lot every day can live 9 years longer than people who exercise little.[1]
The magnitude of the effect of exercise is shown in a study published in 2015 in Clinical Interventions in Aging.[2] In this study, Brazilian scientists followed 1,378 people over 60 for 11 years. The Brazilians divided the study participants into 3 equally sized groups based on the amount of daily exercise. Of the men in the group that moved the least, 35 percent were still alive after 11 years, while in the group with the most exercise, 70 percent of the men were still alive.
It is not yet entirely clear what the optimal amount of daily exercise is. The answer to that question is probably different for every type of movement. High-intensity exercise, such as circuit training or strength training, appears to have a stronger anti-aging effect per 15 minutes than low-intensity forms of exercise. This is probably because high-intensity forms of exercise increase muscle mass. Especially at a higher age, muscle mass reduces the risk of death.[3] The more muscles people over 60 have, the older they can get.
It also seems that you don’t have to do high-intensity exercise for a long time for an optimal life-prolonging effect. Maybe it’s an hour a day, maybe even less.
If we look at low-intensity forms of exercise such as walking, cycling or working in the garden, the scientific studies are a bit more precise. According to a 2020 study published in JAMA, the longevity effect of these activities is optimal at about two hours per day.[4]
#2 No smoking
If you smoke but would like to reach old age in good health, consider quitting. Smoking has just as strong an effect on your life expectancy as not exercising, but in the opposite direction. In other words, all the years that you can gain by a lifestyle with a lot of exercise, you can lose again by smoking. According to a Korean epidemiological survey of 14,533 men, if you smoke, quitting smoking is arguably the best thing you can do to increase your chances of living a long and healthy life.[5]
According to figures from the Dutch Central Bureau of Statistics (CBS), smokers who smoke more than 20 cigarettes a day live 13 years shorter than non-smokers. Moderate smokers, who smoke less than 20 cigarettes a day, live 9 years shorter. Even smokers who only occasionally smoke a cigarette still lose 4 years of their life span.[6]
#3 Healthy diet
If you are to believe the health news from the mass media, nothing is as unhealthy as overeating and getting fat. That picture is not entirely in accordance with the facts. Indeed, a body composition with too much body fat is far from healthy. But the link between being overweight and death is not very strong, even in older age groups. According to a meta-study that Australian scientists published in 2014 in the American Journal of Clinical Nutrition, there is no such connection at all.[7]
A high-calorie diet is apparently less of a factor than health educators say. Much more important is the quality of the diet. According to the hundreds of epidemiological studies into the association between dietary quality and life span, the total amount of vegetables in a diet is especially relevant.
In second place comes fruit, although often mentioned in the same breath as vegetables. According to a meta-study that appeared in the BMJ in 2014, the optimal amount of fruit and vegetables is about half a kilo per day.[8] This intake maximizes the chance of reaching old age.
The longevity effect of a diet with sufficient vegetables becomes even greater the more varied those vegetables are composed.[9]
The joint effect of a good diet, not smoking and sufficient exercise is considerable. Researchers from the University of Cambridge have been able to calculate that people who do not consume alcohol excessively, exercise daily, eat sufficient fruit and vegetables and do not smoke can live 14 years longer than people without these characteristics.[10]
#4 Sleep enough and well
After exercise, not smoking and a healthy diet, sleep is probably the fourth factor that, according to recent studies, allows for a long and healthy life. Scientists have only recently begun to unravel the role of sleep for health, so the amount of knowledge is still limited. But what we do know is that if men chronically sleep less than 5 to 6 hours a day, the rate at which their cells age increases.[11]
In addition to the quantity of sleep, the quality of sleep is also important. In a University of Pittsburgh study, which followed a group of healthy men and women ages 58-91, people were more likely to reach old age if they fell asleep within half an hour of getting into bed. High sleep efficiency was also found to be important. A sleep pattern in which the men and women actually sleep at least eighty percent of the time that they are in bed increases the chance of a long life.[12]
#5 Social contact
Homo sapiens is a social creature. Lonely individuals not only experience more stress than individuals who are part of a social network, they are also more sensitive to inflammatory processes that affect tissues. This explains why in a study by the University of Texas at Austin, people over 60 who have regular contact with other people are 37 percent less likely to die than over 60s with little or no social contact.[13]
According to a study by the University of California, published in PNAS in 2016, contact with online friends also counts.[14]
#6 Avoid prolonged sitting
Much of the population of developed countries spends their lives sedentary. When they travel they sit in a means of transport, at work they sit behind a screen and at home they sit on a couch, also in front of a screen. If you are not physically active for an hour or more every day, such a sedentary lifestyle may decrease your life span.[15] “Sitting is the new smoking,” some health scientists say.[16]
Walking for half an hour every day, as health educators advise, does not eliminate the negative effect of sitting for hours on end. If you don’t exercise for at least an hour every day, you can make sitting less unhealthy if you get up every hour and then walk for two minutes.
#7 Supplementation
A seventh factor that brings longevity within reach is intelligent supplementation. There is a lot to tell about this, but we will save this for other blog posts.
1 Tucker LA. Physical activity and telomere length in U.S. men and women: An NHANES investigation. Prev Med. 2017 Jul;100:145-151.
2 Ramalho JR, Mambrini JV, César CC, de Oliveira CM, Firmo JO, Lima-Costa MF, Peixoto SV. Physical activity and all-cause mortality among older Brazilian adults: 11-year follow-up of the Bambuí Health and Aging Study. Clin Interv Aging. 2015 Apr 16;10:751-8.
3 Graf CE, Herrmann FR, Spoerri A, Makhlouf AM, Sørensen TIA, Ho S, Karsegard VL, Genton L. Impact of body composition changes on risk of all-cause mortality in older adults. Clin Nutr. 2016 Dec;35(6):1499-1505.
4 Saint-Maurice PF, Troiano RP, Bassett DR Jr, Graubard BI, Carlson SA, Shiroma EJ, Fulton JE, Matthews CE. Association of Daily Step Count and Step Intensity With Mortality Among US Adults. 2020 Mar 24;323(12):1151-60.
5 Rhee CW, Kim JY, Park BJ, Li ZM, Ahn YO. Impact of individual and combined health behaviors on all causes of premature mortality among middle aged men in Korea: the Seoul Male Cohort Study. J Prev Med Public Health. 2012 Jan;45(1):14-20.
6 Heavy smokers cut their lifespan by 13 years on average. cbs.nl, 15/09/2017.
7 Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr. 2014 Apr;99(4):875-90.
8 Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W, Hu FB. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. 2014 Jul 29;349:g4490.
9 Torres-Collado L, García-de la Hera M, Cano-Ibañez N, Bueno-Cavanillas A, Vioque J. Association between Dietary Diversity and All-Cause Mortality: A Multivariable Model in a Mediterranean Population with 18 Years of Follow-Up. 2022 Apr 11;14(8):1583.
10 Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2008 Jan 8;5(1):e12.
11 Jackowska M, Hamer M, Carvalho LA, Erusalimsky JD, Butcher L, Steptoe A. Short sleep duration is associated with shorter telomere length in healthy men: findings from the Whitehall II cohort study. PLoS One. 2012;7(10):e47292.
12 Dew MA, Hoch CC, Buysse DJ, Monk TH, Begley AE, Houck PR, Hall M, Kupfer DJ, Reynolds CF 3rd. Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosom Med. 2003 Jan-Feb;65(1):63-73.
13 Thomas PA. Trajectories of social engagement and mortality in late life. J Aging Health. 2012 Jun;24(4):547-68.
14 Hobbs WR, Burke M, Christakis NA, Fowler JH. Online social integration is associated with reduced mortality risk. Proc Natl Acad Sci U S A. 2016 Nov 15;113(46):12980-4.
15 Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009 May;41(5):998-1005.
16 Baddeley B, Sornalingam S, Cooper M. Sitting is the new smoking: where do we stand? Br J Gen Pract. 2016 May;66(646):258.