One of my many interest areas is human longevity – not just increasing lifespan, but increasing health-span as well (that is, the number of years that we enjoy good health which allows us to continue having awesome experiences and truly enjoying life, as opposed to just laying in a hospital bed or sitting in a chair in front of the TV in a nursing home.
To achieve that, there are some pretty fundamental things one can do – eat well, lift weights, do some cardio exercise, and improve one’s sleep – I’ll have whole posts on those topics another time.
But its important to know where you’re starting from – and there are some fairly simple and cheap tests that you can request from a doctor – tests that most doctors wouldn’t order automatically.
These tests give you an idea of where you stand with regard to cardiovascular health (avoid heart disease) metabolic health (avoid diabetes, etc.) and mental health (avoid neuro-degenerative diseases such as Alzheimers).
Here's what I got from reading Outlive, Dr. Peter Attia's book on longevity as well as listening to this podcast featuring Dr. Casey Means – her book Good Energy: The Surprising Connection Between Metabolism and Limitless Health is on my “to-be-read” list!
Dr. Attia’s First Commandment of Fitness is worth sharing – he says, “First, Do Thyself No Harm” – exercise and food are important, but eating the wrong food can hurt you – and so can doing too much or too heavy of exercise – if you injure yourself by training too hard, that will set you back. But where most people harm themselves is by not doing any exercise at all – which is important because Dr. Attia believes that exercise represents our “most powerful longevity drug” – it reduces all-cause mortality by 14% for people who exercise for about 90 minutes /week - regular exercisers live 10 years longer.
This is a reason to test your VO2max – which is a test of respiratory fitness, because poor respiratory fitness (low VO2max) is a greater risk of death than smoking.
An Oral Glucose Tolerance Test will let you know how well your body processes sugars – you should also get a DEXA scan annually – this is a full-body imaging that will show you how much bone mass, muscle mass, and fat you have in your body – and where it’s located.
ApoB and Lp(a)-P are blood tests – for apoB, a score of less than 60 is "good" – for Lp(a)-P, a score of less than 50 is good, and over 125 is dangerous... if you can’t get an Lp(a)-P test, Dr. Attia says that there is another test called Lp(a) Mass which is more common – it’s a "good but not great" test for which a score of 30 is considered normal. Finally there is the “Calcium scan” a CT scan of the heart which looks for calcium deposits in the heart arteries.
Another blood test is the APOE gene test for Alzheimer’s, which is twice as prevalent in women as in men. You can also ask for one or more of the tests for mild cognitive impairment (MCI) – these include the Short Test of Mental Status, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE).
If you find that you’re showing some degree of impairment, the good news is that it’s possible to strengthen our minds as well as our bodies to avoid the onset of more serious conditions. Dr. Attia notes that we know more about preventing neurodegenerative diseases than cancer. Unsurprisingly, diet and exercise are key – sleep is important too, and Vitamin D, Omega-3s, and B vitamins can all help.
Dr. Casey Means points out that “every leading cause of death in the United States, other than suicide is fundamentally in some way related to the immune system being on overdrive all the time” and says that immune overdrive is directly linked to metabolic dysfunction. Even neuro-degenerative diseases have a metabolic component, as Dr. Means observes that “Alzheimer's dementia (is) now being called Type 3 diabetes.”
“Indoors" is actually a very new concept in human history... we live on this spectacular planet with this spectacular star in the sky that literally is our life source - it creates hormones in our bodies, its photon energy is what helps define circadian rhythms - that photon energy is stored in the carbon-carbon bonds of plants that ultimately we eat - when we're 'doing metabolism', what we're really doing is liberating the sun's energy from carbon-carbon bonds, using our mitochondria to power our lives...
Mitochondria are the parts of our cells which convert the food we eat into the energy that our body uses to power our mind and our muscles – and Dr. Means says that - if the mitochondria is damaged because of our environment from factors like poor-quality food, lack of sleep, sedentary behavior, chronic stress, poor light hygiene, and environmental toxins, then our metabolic health suffers.
She says that 93 percent of Americans are in a state of metabolic dysfunction - only 7% can be considered metabolically healthy... and she recommends the following tests:
- HSCRP which is an inflammatory marker so High-Sensitivity C-Reactive Protein - 0.36 = ideal for least risk of disease
- Test for Vitamin D (40-60=good, 25=too low)
- ApoB (best predictor for heart disease)
- Fasting insulin – 2 = good, 30 = bad
- Fasting glucose - healthy range less than 100 milligrams per deciliter
- Triglycerides - less than 150 milligrams per deciliter
- Waist circumference - less than 35 inches for women or 40 inches for men
- Blood pressure - less than 120 over 80
- Hemoglobin A1c - less than 5.7%
- HDL above 40 for men or 50 for women
Once you’ve had these tests, what do you do with the information?
That comes back to looking at diet, exercise, and supplements – all of which represent topics for which a whole post is needed.
But it’s my hope that this gives you a good sense of what tests to request from your doctor, and what ranges you should be looking for to be able to judge if you are doing well, or need to improve your current lifestyle to optimize your health-span!
I'll be taking many of these tests myself in the weeks to come - and will do another post discussing my results and what I'll be doing to improve my own health-span. Meanwhile, I'd love to hear your thoughts in the comments! Are there any tests that you think I've missed here? Have you had any of these before - and if not, are you likely to try to take some of these tests based on what you've read here?
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