What we know about the secrets to aging well, according to a longevity researcher

Editor's Note: This is an excerpt from WBUR's weekly health newsletter, CommonHealth. If you like what you read and want it in your inbox, sign up here. 

Throughout history, humans have looked for the secrets to eternal youth and beauty. For better or for worse, they remain elusive. But there are some people who live very long lives – and stay surprisingly healthy and vital while doing it.

Dr. Eric Topol, a cardiologist, scientist and author, has coined a name for these apparent lottery winners: “super agers.” He even wrote a book about them.

So… what’s the secret to living long and aging well?!

That’s a question my colleague Deborah Becker asked Topol during a recent episode of WBUR’s On Point. Here are a few of her top takeaways:

1. Immune health may be key to healthy aging. 

Topol studied more than 1,400 “super agers” — or "the wellderly" — who reached their 80s with no chronic medical conditions.

That achievement is astounding when you consider that federal statistics show 93% of Americans have a chronic disease by age 65 — everything from cancer and heart disease to obesity and arthritis. According to the World Health Organization, the average American has just one healthy birthday after age 65.

One of the keys is a healthy immune system, and part of that means taking steps to avoid or reduce inflammation.

The research suggests you should try to get seven hours of sleep (the optimal amount varies by person), but Topol said deep sleep is what’s crucial for warding off inflammation in the brain, which increases the risk for conditions like Alzheimer's and other neurodegenerative diseases.

He also recommends a mix of strength, balance and aerobic training. That advice you’ve heard about 10,000 steps per day? It's not a number backed by research. In all likelihood, you don't need that much, according to Topol. In fact, he said "weekend warriors" (those who get in their big workouts on weekends) are still benefiting. (This may be music to many a busy person’s ears!)

And when it comes to diet, he said to consume a mostly plant-based diet.

"The Mediterranean diet, of course, would include not just plants, certainly, salmon, seafood," Topol said. "But emphasizing fruits and vegetables. And so it's fine to have occasional red meat and things that we know are pro-inflammatory, but they shouldn't be a core part of a person's diet."

2. There's an emerging scientific blueprint to help prevent many age-related diseases 

The biggest threats to healthy aging are essentially three main categories of chronic disease: cardiovascular, neurodegenerative and cancer.

Topol said we’ve been “reactive” to chronic diseases, instead of focusing on prevention. Part of the prevention playbook relates to lifestyle, things like sleep and exercise. But part of it is also scientific advances that allow us to monitor and target these diseases.

“We've never been able to prevent them because we didn't have the tools to do that,” he said. “But that's completely changed now.”

He’s talking about tools like artificial intelligence and preventive screenings such as looking at a person’s polygenic risk score and using multi-cancer early detection. Topol argues we should do that instead of screening everyone for certain cancers based on age alone. Topol said mass screenings detect only 14% of cancers in the United States. We now have “realistic and promising” ways, he said, to identify risks early on and take steps to address them.

“So all three, heart disease, cancer, neurodegenerative, specifically Alzheimer's or Parkinson's, they take 20 years or longer to incubate in our body. So we have a long runway to work with,” he told Deb. “And we now have proteins, genes, and biomarkers to be able to detect who is at high risk and to get all over those individuals regarding surveillance and prevention.”

Precision medical forecasting, Topol said, will be the path forward. Not only will it help identify risks, but people might be more likely to make different choices about exercise, diet and lifestyle if they know they personally will benefit.

3. Beware of people trying to profit from longevity claims

There are people out there spending massive amounts of money to slow down the aging process. There's also a lot of "pseudoscience," according to Topol.

When it comes to supplements, the evidence doesn't support a lot of them, he said, including the latest fads of NAD+ and senolytics. (There’s work being done on senolytics, but those drugs are not what’s marketed to consumers right now, Topol said.) He suggests taking extreme caution around influencers and longevity companies, especially when they stand to make a buck.

"Sleep, diet and exercise. They're basically free or very low cost," he said. "That's where the evidence lies."

You can find more details and listen to Deb’s full interview with Topol here.