Longevity Fitness Quotes

Repetition, volume, and longevity will twist and turn a myth, a lie, into a commonly accepted way of doing things.

I have heard it said that if you tell a lie often enough, loudly enough, and long enough, the myth will become accepted as a fact. Repetition, volume, and longevity will twist and turn a myth, or a lie, into a commonly accepted way of doing things. Entire populations have been lulled into the approval of ghastly deeds and even participation in them by gradually moving from the truth to a lie. Throughout history, twisted logic, rationalization, and incremental changes have allowed normally intelligent people to be party to ridiculous things. Propaganda, in particular, has played a big part in allowing these things to happen.

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed. Similarly, there’s no billing code for putting a patient on a comprehensive exercise program designed to maintain her muscle mass and sense of balance while building her resistance to injury. But if she falls and breaks her hip, then her surgery and physical therapy will be covered. Nearly all the money flows to treatment rather than prevention—and when I say “prevention,” I mean prevention of human suffering.

This study found that someone of below-average VO2 max for their age and sex (that is, between the 25th and 50th percentiles) is at double the risk of all-cause mortality compared to someone in the top quartile (75th to 97.6th percentiles). Thus, poor cardiorespiratory fitness carries a greater relative risk of death than smoking.

The longevity genes I work on are called “sirtuins,” named after the yeast SIR2 gene, the first one to be discovered. There are seven sirtuins in mammals, SIRT1 to SIRT7, and they are made by almost every cell in the body. When I started my research, sirtuins were barely on the scientific radar. Now this family of genes is at the forefront of medical research and drug development. Descended from gene B in M. superstes, sirtuins are enzymes that remove acetyl tags from histones and other proteins and, by doing so, change the packaging of the DNA, turning genes off and on when needed. These critical epigenetic regulators sit at the very top of cellular control systems, controlling our reproduction and our DNA repair. After a few billion years of advancement since the days of yeast, they have evolved to control our health, our fitness, and our very survival. They have also evolved to require a molecule called nicotinamide adenine dinucleotide, or NAD. As we will see later, the loss of NAD as we age, and the resulting decline in sirtuin activity, is thought to be a primary reason our bodies develop diseases when we are old but not when we are young.

One way to track your progression in zone 2 is to measure your output in watts at this level of intensity. (Many stationary bikes can measure your wattage as you ride.) You take your average wattage output for a zone 2 session and divide it by your weight to get your watts per kilogram, which is the number we care about. So if you weigh 60 kilos (about 132 pounds) and can generate 125 watts in zone 2, that works out to a bit more than 2 watts/kg, which is about what one would expect from a reasonably fit person.

This is another area where my thinking has changed over time. I used to prioritize nutrition over everything else, but I now consider exercise to be the most potent longevity “drug” in our arsenal, in terms of lifespan and healthspan. The data are unambiguous: exercise not only delays actual death but also prevents both cognitive and physical decline, better than any other intervention. We also tend to feel better when we exercise, so it probably has some harder-to-measure effect on emotional health as well. My hope is that you will understand not only the how but the why of various types of exercise, so you will be able to formulate a program that fits your own personal goals.

Vitamin D3 boasts a strong safety profile, along with broad and deep evidence that links it to brain, metabolic, cardiovascular, muscle, bone, lung, and immune health. New and emerging research suggests that vitamin D supplements may also slow down our epigenetic/biological aging.29, 30 2. Omega-3 fish oil: Over the last thirty years or so, the typical Western diet has added more and more pro-inflammatory omega-6 polyunsaturated fatty acids versus anti-inflammatory omega-3 PUFAs. Over the same period, we’ve seen an associated rise in chronic inflammatory diseases, including obesity, cardiovascular disease, rheumatoid arthritis, and Alzheimer’s disease. 31 Rich in omega-3s, fish oil is another incredibly versatile nutraceutical tool with multi-pronged benefits from head to toe. By restoring a healthier PUFA ratio, it especially helps your brain and heart. Regular consumption of fatty fish like salmon has been linked to a lower risk of congestive heart failure, coronary heart disease, sudden cardiac death, and stroke.32 In an observational study, omega-3 fish oil supplementation was also associated with a slower biological clock.33 3. Magnesium deficiency affects more than 45 percent of the U.S. population. Supplements can help us maintain brain and cardiovascular health, normal blood pressure, and healthy blood sugar metabolism. They may also reduce inflammation and help activate our vitamin D. 4. Vitamin K1/K2 supports blood clotting, heart/ blood vessel health, and bone health.34 5. Choline supplements with brain bioavailability, such as CDP-Choline, citicoline, or alpha-GPC, can boost your body’s storehouse of the neurotransmitter acetylcholine and possibly support liver and brain function, while protecting it from age-related insults.35 6. Creatine: This one may surprise you, since it’s often associated with serious athletes and fitness buffs. But according to Dr. Lopez, it’s “a bona fide arrow in my longevity nutraceutical quiver for most individuals, and especially older adults.” As a coauthor of a 2017 paper by the International Society for Sports Nutrition, Dr. Lopez, along with contributors, stated that creatine not only enhances recovery, muscle mass, and strength in connection with exercise, but also protects against age-related muscle loss and various forms of brain injury.36 There’s even some evidence that creatine may boost our immune function and fat and carbohydrate metabolism. Generally well tolerated, creatine has a strong safety profile at a daily dose of three to five grams.37 7.

If you increase your muscle strength and improve your cardiorespiratory fitness, you have also reduced your risk of dying from all causes by a far greater magnitude than you could achieve by taking any cocktail of medications.

My point is that if you really stop to consider the kind of aerobic fitness that most people actually need in the course of their lives, it basically boils down to being really good at going slow for a long time, but also able to go hard and fast when needed. Training and maintaining a high level of aerobic fitness, and doing it now, is essential to preserving this range of function in your later years.

The goal of this new medicine—which I call Medicine 3.0—is not to patch people up and get them out the door, removing their tumors and hoping for the best, but rather to prevent the tumors from appearing and spreading in the first place. Or to avoid that first heart attack. Or to divert someone from the path to Alzheimer’s disease. Our treatments, and our prevention and detection strategies, need to change to fit the nature of these diseases, with their long, slow prologues.

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed.

Thus, poor cardiorespiratory fitness carries a greater relative risk of death than smoking.

A person who smokes has a 40 percent greater risk of all-cause mortality (that is, risk of dying at any moment) than someone who does not smoke, representing a hazard ratio or (HR) of 1.40. This study found that someone of below-average VO2 max for their age and sex (that is, between the 25th and 50th percentiles) is at double the risk of all-cause mortality compared to someone in the top quartile (75th to 97.6th percentiles). Thus, poor cardiorespiratory fitness carries a greater relative risk of death than smoking. That’s only the beginning. Someone in the bottom quartile of VO2 max for their age group (i.e., the least fit 25 percent) is nearly four times likelier to die than someone in the top quartile—and five times likelier to die than a person with elite-level (top 2.3 percent) VO2 max. That’s stunning. These benefits are not limited to the very fittest people either; even just climbing from the bottom 25 percent into the 25th to 50th percentile (e.g., least fit to below average) means you have cut your risk of death nearly in half, according to this study.

of menopause—not to mention a potentially increased risk of Alzheimer’s disease, as we’ll see in chapter 9. Medicine 2.0 would rather throw out this therapy entirely, on the basis of one clinical trial, than try to understand and address the nuances involved. Medicine 3.0 would take this study into account, while recognizing its inevitable limitations and built-in biases. The key question that Medicine 3.0 asks is whether this intervention, hormone replacement therapy, with its relatively small increase in average risk in a large group of women older than sixty-five, might still be net beneficial for our individual patient, with her own unique mix of symptoms and risk factors. How is she similar to or different from the population in the study? One huge difference: none of the women selected for the study were actually symptomatic, and most were many years out of menopause. So how applicable are the findings of this study to women who are in or just entering menopause (and are presumably younger)? Finally, is there some other possible explanation for the slight observed increase in risk with this specific HRT protocol?[*3] My broader point is that at the level of the individual patient, we should be willing to ask deeper questions of risk versus reward versus cost for this therapy—and for almost anything else we might do. The fourth and perhaps largest shift is that where Medicine 2.0 focuses largely on lifespan, and is almost entirely geared toward staving off death, Medicine 3.0 pays far more attention to maintaining healthspan, the quality of life. Healthspan was a concept that barely even existed when I went to medical school. My professors said little to nothing about how to help our patients maintain their physical and cognitive capacity as they aged. The word exercise was almost never uttered. Sleep was totally ignored, both in class and in residency, as we routinely worked twenty-four hours at a stretch. Our instruction in nutrition was also minimal to nonexistent. Today, Medicine 2.0 at least acknowledges the importance of healthspan, but the standard definition—the period of life free of disease or disability—is totally insufficient, in my view. We want more out of life than simply the absence of sickness or disability. We want to be thriving, in every way, throughout the latter half of our lives. Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system

It was uncanny: this exotic molecule, found only on an isolated scrap of land in the middle of the ocean, acts almost like a switch that inhibits a very specific cellular mechanism that exists in nearly everything that lives. It was a perfect fit, and this fact still blows my mind every time I think about it.

turns out that peak aerobic cardiorespiratory fitness, measured in terms of VO2 max, is perhaps the single most powerful marker for longevity. VO2 max represents the maximum rate at which a person can utilize oxygen. This is measured, naturally, while a person is exercising at essentially their upper limit of effort. (If you’ve ever had this test done, you will know just how unpleasant it is.) The more oxygen your body is able to use, the higher your VO2 max.

For example, a thirty-five-year-old man with average fitness for his age—a VO2 max in the mid-30s—should be able to run at a ten-minute mile pace (6 mph). But by age seventy, only the very fittest 5 percent of people will still be able to manage this. Similarly, an average forty-five- to fifty-year-old will be able to climb stairs briskly (VO2 max = 32), but at seventy-five, such a feat demands that a person be in the top tier of their age group.