The conversation around human longevity used to focus on, not surprisingly, the idea of living for as long as possible. It was kind of a score-keeping mentality – she who lives longest wins. But in the past few years, the conversation has gotten a lot more interesting, and useful. Enter the ‘spans.’ About a decade ago, longevity-minded physicians began to more talk about the idea of the ‘healthspan’, the number of years a person could live without serious disease. After all, what’s the point of making into your nineties if a good portion of those later years are spent managing a chronic illness and, especially, losing your independence?   

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But healthspan still doesn’t quite capture how we actually experience our health. Most people don’t spend their days walking around asking, themselves, “Am I disease free?” Instead, they think, “Why do I run out of gas in the mid-afternoon?” Or “My work-out routines haven’t changed that much but now it takes me twice as long to recover.” Or maybe, “I feel like I’m struggling over tough work problems when I used to be able cut right through the complications.”

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What those questions should bring home is that truly being healthy isn’t just about sidestepping disease. It’s being able to function at something close to your maximum capacity – the way you did in your twenties or early thirties – in a whole range of different life arenas. A new concept, known as ‘peakspan’, has recently entered the conversation, and thrown down a challenge: how can we expand the number of years where most of our physiological systems are operating at about 90% of their youthful capacity. But in this one, I want to “set the table” by introducing you to the twelve individual “spans” – covering everything from energy to brain power to mobility to considerably more – which together, give us a clearer picture of peakspan. By breaking it down to twelve, you’ll get sense of the breadth of our human physiology (and psychology), and how it can best be harnessed to add up to one long robust life. Here’s what you need to know:

Let’s meet the ‘spans. 

Twelve ‘spans’ might sound like a few too many to keep straight in your head. But when you think about the mountains of data generated by your annual physical, it’s actually a very efficient way to organize what our bodies (and minds) actually do. And how, if we don’t make a concerted effort to push back, these “span” systems become increasingly susceptible to the gravitational pull of aging. 

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In brief: Energyspan reflects your day-to-day vitality. Strengthspan captures muscle and physical capability. Recoveryspan shows how quickly you bounce back. Sleepspan reflects depth and quality of rest. Cognitivespan includes memory, processing, and clarity. Metabolicspan tracks how well you manage energy and blood sugar. Hormonespan shapes mood, drive, and repair. Bonespan reflects structural strength. Immunospan reflects resilience to illness. Mobilityspan governs movement and range. Attentionspan shapes focus. Confidencespan reflects psychological stability and sense of agency.

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Think of them as your functional portfolio, a read-out on what’s working well and what’s not. The goal is not perfection, it’s self-awareness, recognizing strengths that need to be maintained and understanding which weaknesses need to be shored up. 

Timing the “spans”.

One thing that emerges from looking at human function as a collection of “spans” is that our different parts age at different rates. While it’s true that many of our systems begin their downward slide when we’re in our thirties, that’s not a universal metric, especially when we look beyond the purely physiological. For instance, our mental processing speed peaks early in our twenties, but our ability to enlarge our vocabularies and store of world knowledge grows through middle age. And what we’re calling here one’s Confidencespan – psychological resilience and emotional stability – doesn’t have an age upper limit at all. 

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The important point is, don’t wait for something to go obviously wrong. It’s always a good time to upgrade your lifestyle and, even if you’re convinced you’ve got yours wired, avail yourself select diagnostic tests (more on that later) to arrest any slide before it crosses the disease threshold and your primary doc pulls out the prescription pad. 

It’s all connected, for good and ill.

If you’re still wondering whether twelve spans are more than enough, know that our systems are interconnected so a behavior or a routine that affects one will affect most, if not all, of the others. That’s a good thing when it comes to healthy habits and a bad thing when it comes to the bad. Let’s start with the bad. 

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Poor quality or insufficient sleep wreaks havoc with hormones like growth hormone and testosterone which help build and restore muscle strength. (Think Strengthspan.) It will leave you listless, cognitively foggy and more prone to skipping daily activity and eating a crappy high-sugar high-carb junk-food diet. That all contributes to a metabolism heading south, insulin resistance and worst-case type 2 diabetes, which affects practically every cell in the body via the bloodstream. (A bunch of “spans” here – Sleepspan; Energyspan, Cognitivespan, Metabolicspan, Hormonespam.) 

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And, while we’re at it, let’s throw in alcohol, especially regular heavy imbibing. That delivers a blow to brain function, blood sugar, muscle recovery, and sleep quality. (Pretty much the same line-up of “spans.”) Sitting in the middle of this sad “span” story is inflammation which, when it’s consistently elevated, accelerates aging and contributes to multiple diseases.

Good news for “spans”.

Fortunately, when it comes to ‘spans’, the good news is very good. Any positive lifestyle change you make will begin to reverse the vicious circle I just described. Call it a “virtuous” circle. Remember, small changes can build on themselves and have outsize effects, rippling out in numerous positive directions. To get there, you you’ll need to practice the essentials: 

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• Sleep deeply and consistently. This is when your body repairs tissue, balances hormones, and clears waste from the brain. 
• Eat real food, that comes from nature, not a factory: veggies, healthy fats, and quality protein that helps build and preserve muscles. 
• Move. Strength training helps support muscle, metabolic health, and bone density. Moderate aerobic exercise supports cardiovascular function, energy production, and metabolic efficiency. Moving throughout the day -- walking, stretching, dancing – not only counts, its life-enhancing. 
• Unwind. Give your nervous system time, every day, to unwind, to reset, through simple practices like breathing, meditation, or just a quiet walk. Stress management supports recovery and attention. 
• Connect with others. Relationships and a sense of purpose are powerful drivers of both mental and physical health. 

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While over the years I’ve written about all these things before, what I love about the span approach is that now we’ve got a new way to think the health promoting behaviors I’ve encouraged patients to work on for decades – they all connect and enhance multiple “spans” all at once. 

Three easy — and powerful — “span” enhancers.

Working on your spans doesn’t have to be complicated. If you’re just getting started on upgrading your spans, start with these three: 

• Sleepspan: Same wake time every day, and that includes weekends. No screens before bed. Thirty minutes before, an hour or two? Figure out what you can manage. 
• Energyspan: Ten minutes of morning sunlight first thing in the a.m. It will reset your sleep/energy rhythms, aka circadian rhythm.
• Metabolicspan: walk at least 10 min after your largest meal of the day to tamp down post-meal sugar spikes. And if you want to take a speedwalk around the block, or do a quick set of squats after your other meals, so much the better.

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The idea is to test yourself, play around with what’s possible and what makes sense with your life without getting overwhelmed. Think baby steps and keep building on them.

Keep your eyes open.

OK, so, doing the right things is one thing, but being able to catch yourself when you’re slipping, is another key part of the story. A comprehensive survey of valuable health diagnostics is, of course, beyond the scope of this post. And different people will have different appetites for this kind of testing. But here’s a selection from the diagnostic menu that you should strongly consider so you and your doc can keep a closer eye on things and notice any oddities or blips before they become bigger issues. Consider trying:

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• Wearables like Oura, WHOOP, Garmin, or Apple Watch for sleep, recovery, and heart rate variability
• VO₂ max estimates from wearables or lab testing for energy and cardiovascular fitness
• Grip strength testing as a simple, powerful indicator of strength and resilience
• Blood work including fasting insulin, an extensive heart panel including Apolipoprotein B, LDL particle size and lipoprotein (a), hormone levels, nutrient levels and inflammation markers
• DEXA scans for muscle mass and bone density
• Continuous glucose monitors for short term insight into blood sugar control
• Simple mobility tests like sit-to-stand and balance assessments like the standing-on-one-leg test
• Online cognitive tests to track processing speed and memory

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By taking measurements at regular intervals over time, you can chart the “trajectory” of your health “spans.” Are you improving, holding steady, or declining? This information will allow you to plot the course of your health. That’s a smart way to enhance your odds of aging well.