My 7 Point To-Do List for Aging Well – and Slowly!

One of the most frequent questions I get from my patients is: “How do I slow down aging?” I get it. Nobody wants to look, and more importantly, feel like they’re getting old. And by “getting old,” they mean losing the spark, sparkle and wrinkle-free skin they may have taken for granted in their twenties and thirties. What I tell them is, if you follow a few basic anti-aging rules, you’ll help take care of the wrinkles on the outside of you as well as the wrinkles on the inside – as in dysfunctions in the way your metabolism, cardiovascular system, immune system and your brain work. In other words, the big things that can take big bites out of the quality and the quantity of your years.

Granted, human physiology has a lot of moving parts but I’ll keep it simple here, and break down your To Do list into 7 basic rules for healthy aging. My advice? Get started now to start slowing your aging roll. Here’s where to start:

Rule #1: Eat Smart  

It’s not rocket science. Fill up most of your plate with plant foods, good nutrition that comes from the earth, not the flavor factories of the big processed food corporations. The stars in the plant category are the non-starchy veggies – think leafy greens, broccoli, peppers, onions and the like. In one tasty package, they contain health-enhancing vitamins and phytonutrients and hardly any calories. Why is that so important? A lot of what we think of as aging, especially in the middle decades, is really metabolic aging. The all-too-common scenario: with all the increased family and work responsibilities of middle age, we spend more time sitting (often in front of a screen) and less time moving the body. That means we’re burning fewer calories and the fast-digesting carbs (think sugar and grains) we eat are more likely to get stored by the body as fat instead of being burned by the muscles.

And so, begins what can easily become a downward spiral: fat collects around the middle and infiltrates the liver and other organs (I’m talking “visceral fat,” the really bad stuff), blood sugar goes up, and you develop insulin resistance. You’re well on your way to metabolic syndrome, at high risk for both type 2 diabetes and cardiovascular disease. And the same fatty plaque build-up that can clog up coronary arteries can do the same to the much smaller blood vessels in the brain, leading to “vascular dementia” as well as increased risk for Alzheimer’s. Think of all these bad outcomes as forms of accelerated aging that you can nip in the bud with a healthy lifestyle. The first line of defense?: a diet rich in non starchy veggies with liberal amounts of healthy protein, that stops the “middle-aged spread” (and, more importantly, the underlying metabolic damage) before it takes root.

Rule #2 Feed Your Gut Wisely

Ancient medical systems, like Ayurveda and Chinese medicine, often looked at the gut as the locus of both health and sickness. Western medicine evolved along different lines and tended to think that whatever bad things happened in the gut stayed in the gut. By now, thankfully, the Western scientific approach has caught up with the ancients, and has embraced the idea that the gut is frequently the source of inflammation that is the root cause of many, and maybe all of our most serious chronic diseases. If our good gut bacteria aren’t being well-fed (by us, of course), they won’t be able to produce enough of the organic compounds that protect the lining of the gut wall. The result can be “leaky gut” syndrome, where metabolites of bacteria (postbiotics), or bacteria themselves, escape from the gut into the bloodstream, triggering systemic inflammation that can manifest as anything from skin eruptions to fatigue or brain fog. Also, a gut depleted of a diversity of useful bacterial strains won’t be able to adequately help the gut’s own immune system distinguish between genuinely toxic invaders from otherwise harmless food components that come down the pike. The result: an immune system overreaction that sets in motion inflammation that can trigger symptoms throughout the body. Ignoring your gut is an all-too-effective way of feeling old before your time.

The solution couldn’t be simpler. Feed the helpful bacteria what they need to thrive, and they’ll crowd out the bad guys. That means lots of prebiotics, that is the fiber found in abundance in the veggies I just described. To make sure you are getting enough prebiotics from your veggies, don’t toss the stalks and stems, eat them. Other excellent sources include seeds and nuts. Legumes are another choice. They’re higher in carbs (of the slower-digesting variety) but if you can handle the carb load, they’re way healthier than the simpler carbs that often fill plates, like grains and potatoes. How else to feed your gut well? Develop a taste for fermented foods, especially fermented veggies like sauerkraut and kimchi, which contain their own bacteria, ready and able to help your resident gut bacteria do its thing.

PRO TIP: It’s always best to get your prebiotics and probiotics from food, although both come as supplements too, both in capsules and powders. If you are going to resort to supplements for either, I prefer supplementing with prebiotics, in particular resistant starch, as choosing the right probiotic for your microbiome is difficult.

Rule #3 Move More, Age Less  

How to keep your “metabolic aging” under control?  Eat a nutrient dense diet and then burn those calories by firing your muscles and moving your body. But there’s more to it than that. Let me take this opportunity to explode the myth that the only kind of movement that counts is intense and structured “exercise.” I’ve counseled too many patients who burn themselves out three or five times a week at the gym, stressing their systems more than building them up, and then spend the rest of their waking hours glued to computer screens. All that sedentary down time is washing out much of the health benefit of the work-outs. Look, if training hard for fitness sake brings you joy, then go for it, sensibly. But know that, whether you “exercise” or not, it’s the regular, sometimes spontaneous, ways that we get up from the desk or jettison the car that help keep our metabolism, as well as our joints, on an even keel every day. I’m talking about a couple of short walks (or some flights of stairs) between Zoom calls, followed by a quick stroll outdoors to grab (a healthy!) lunch, then a post-dinner walk to stoke the metabolic fires after what for many is the largest meal of the day (though far better if it’s the smallest).

PRO TIP: If a post-meal evening walk isn’t possible, instead of dessert, top it off with a few minutes walking up and down stairs or around the house to help get the job done. What’s more, doing so, even for as little as two to five minutes after dinner, may lower blood sugar according to a 2022 study in the journal Sports Medicine.

Rule #4: Don’t Resist Resistance Training!  

Keep in mind though, movement isn’t just about aerobic or the slower-paced stuff for metabolism and cardio health, resistance training is essential to living well, and aging slowly. Build in daily breaks for some strength-building work, especially the body-weight resistance stuff, like push-ups, curls, planks and squats. If you don’t invest some time and effort in maintaining your muscles, the muscle-wasting that occurs in old age (sarcopenia) will be that much more severe. Same thing with working to keep your joints as flexible as possible, to preserve your range of motion over the long haul. “Motion is lotion,” as the physical therapists like to say.

The menu of good movement and strength-building choices is long and varied, but as they say, just do it. Whether it’s pumping a little iron, yoga, Pilates, or exercises using your own body weight, get into a regular groove with guidance from a trainer to get you started, or an on-line course. The truth is, a lot of what will determine how well we age in our senior years, our “healthspan” if you like, is the ability to navigate the world confidently and safely. The research shows that you can build up muscle size and strength at any age, and it’s not only good for your body, but protects your brain too. Not only is life more fun when you’ve maintained a good degree of strength and balance, you’re far less likely to take the fall that may put an untimely end to your “golden years.”

PRO TIP: Start with simple body-weight exercises, as you can do them almost anywhere: push-ups (modified push-ups, knees touching the ground, are fine), squats, lunges, etc. Or, invest in a set of weights and with, the help of a good exercise video (they’re everywhere on-line), come up with your own accessible routine. You can also try my 3-month guide to building muscle at any age.

Rule #5: Stress Less

The fact is, chronic high levels of stress is one of the great drivers of fast aging, and in an insidious way, as it joins forces with the other ageing-promotors we’ve been talking about and helps them pick up steam. On the metabolic front, chronic stress pushes up insulin levels and steers you toward insulin resistance. Meanwhile, it drives down the nighttime production of growth hormone, responsible for muscle growth and maintenance. On the cardiovascular front, high stress, which often manifests as elevated blood pressure, raises your risk of heart attack and stroke.

So yes, stress less, an important rule to set down. Here’s where to start: get a good night’s sleep. The health effects of chronic stress and lousy sleep are almost impossible to distinguish one bleeds into the other. If you’re stressed out, you’re liable to have trouble falling asleep and/or staying in the more restorative REM and deep sleep phases of the sleep cycle. And a bad night’s sleep means you’re beginning the day with elevated levels of cortisol, your primary stress hormone.

So, all the rules of good sleep, which my regular readers should be familiar with, apply here: maintain a regular sleep schedule and do your best to stay in tune with your natural light/dark circadian rhythms: “power down” in the evening with low light exposure and no screen time before (or in) bed — and in the morning, expose yourself to as much bright outdoor light as possible to keep your body clock in sync.  

PRO TIP: Among my favorite just-before bed downshifters to help quiet and ease mind and body: reading a relaxing book; shifting the lights in the bedroom to soft pink or amber bulbs; a few minutes of restorative yoga or meditation. Another simple and effective one: taking a hot shower, bath or sauna to let the cares of the day drain away — it’s exactly what the doctor ordered.

And then there are the things that you can do out of bed that will improve the in-bed experience. Moving the body throughout the course of the day is key here, tiring yourself out by the end of the day in a non-depleting way, lowering cortisol levels and setting yourself up for success between the sheets.

Another key is giving yourself some down time during the day to turn your rational/planning/working brain off and tune in to whatever you find particularly soothing, even if you only have a few minutes to spare. A walk around the block, a 10-minute powernap or 3-minute meditation will help you pop the stress bubble and help bring those stress levels down.

The challenge with a lot of lifestyle advice is that it always seems to be asking you to do more of something to achieve your health goals. Traditional Chinese philosophy would call that the yang, or active principle.  But let’s not forget the equally necessary yin, or receptive principle, whether you express that in a sitting meditation practice or doing a relaxed, mindful form of yoga or enjoying some unstructured time in nature. Really, it’s whatever speaks to you.

Rule #6: Rejuvenate With Autophagy

Autophagy can be likened to a cellular fountain of youth, delivering an impressive array of preventative benefits protecting us from dysfunction and disease. The autophagy process is in effect, the garbage collection and recycling system in your cells, that gets rid of old and damaged cells and strips them for parts to make new robust ones, which in turn helps protect your body from disease. Autophagy also helps control inflammation; regulates mitochondrial function; promotes neurological health; and boosts immunity to name a few, so turbocharging the process is a great way to help slow aging. To do it, try a few of these autophagy hacks:

  • Cold comfort Start your shower warm and finish with a rousing cold blast; or take a short outside walk deliberately underdressed (no blue lips or hypothermia please!). The cold will rev up the metabolism.
  • Time restricted eating Spacing out your meals, as little as ten hours and for a bigger effect, 16 hours between meals, is another booster, stimulating your metabolism to do more with less insulin, and upgrading the metabolic garbage pick-up.
  • Low-carb eating – it’s a healthy dietary stressor that encourages to burn more fat (instead of glucose)
  • High Intensity Interval Training – HIIT-type exercise, be it running, cycling, swimming, hill walking, etc., pushes the body harder, and the heart rate higher, for a relatively shorter time. And yes, it does promote autophagy, but no need to overdo it. For most people, two sessions a week, 20-30 minutes a week, is a sensible maximum.

Rule #7: Open Yourself Up To Other People

If you follow the guidance I’ve offered in my first five rules, there’s every chance you’ll age slower and be able to have more healthy years. With this last sixth rule, I’m asking you to step back and ask yourself: “To what end?” I’d submit that it’s to be able to experience more joy. And that, in large measure is going to be determined by your relationships with family and friends. There is a voluminous medical literature that has found that the number and quality of your social connections is an excellent predictor of health and longevity, as much as any of the purely physiological factors that we’ve already discussed.

So, I’m concerned that our collective COVID experience has frayed those connections as effectively as our already over-busy hi-tech lives. I’m thinking particularly of some of my senior patients who have seen their social circles shrink by attrition – they’ve lost a lot of friends. My advice to them is to be as pro-active as possible, to seek opportunities to reconnect with old ones and to make new ones. I have one patient who started a Friday morning walking group in her neighborhood. The word got out and now the group has grown to about fifteen regulars. And a special bonus for making younger friends, a great way to stay on your toes and slow your own aging process.

The other group that worries me are those younger folk who during COVID retreated behind the screen of social media. I’m seeing too many people falling into the trap of believing that social media counts as honest-to-god socializing. By its nature, the on-line apps offer up a “curated” version of life. The joy of other people is precisely that you get to experience their “un-curated” unpredictable spontaneous selves and they return the favor. Sure, it’s messier but that’s where the fun lies – and I encourage patients of all ages to seek more of it.