Lifespan and Healthspan: How to Maximize Both

Lifespan: The total number of years you live.

Healthspan: The total number of years you live in good physical and cognitive health; years lived with a high quality of life, functional capacity, and level of independence.

Current populations on average have a decade gap between lifespan and healthspan (morbidity gap). Addressing the gap between is paramount amongst high-income countries where medicine has extended our lifespans considerably, though it is up to us to implement good habits so that we may use and enjoy these years to our fullest potential.

Acknowledging the Gap

A 2024 study compounding results from 183 World Health Organization member countries showed that as global life expectancy grew 6.5 years from 2000-2019, the gap between healthspan and lifespan also grew from 8.5 years to 9.6 years, with women having a 2.4 year wider gap.1 This morbidity gap actually extended to 10.7 years as of 2023, with high-income countries (United States, Australia, Canada) have even larger gaps than the average by ~3 years.2

As life expectancy grows with better medicine and technology, most people are spending the final decade of their life in poor health with either chronic disease, frailty, or cognitive collapse. Having healthy habits and taking preventative measures before decline accelerates is critical to age with dignity and grace. I’d rather spend the last years of my life doing fun things with loved ones under my own liberty rather than necessitated to visit doctors and hospitals all the time. Live long with grace.

Closing the Gap

Fortunately, most things that extend your healthspan also extend your lifespan. You cannot choose when and how you die, but you can shift the probability of living long and healthy by making good decisions all the time. Here are a few of the methods that maximize your probability of having a long healthspans and lifespans, with minimal gap in between:

Resistance Training

Lean muscle mass contributes significantly to metabolic health since muscle uses a lot of energy to maintain itself, absorbs a lot of glucose from the blood to keep levels stable, and is the core contributor to your functional capacity. Muscle mass begins to decline at a rate of roughly 3-8% per decade after the age of 30,3 and this decline accelerates up to 3% per year after age 60.4 This loss of muscle associated with aging is called sarcopenia, and resistance training, i.e., lifting weights, bodyweight exercises, resistance bands, and weight-lifting machines, can mitigate and reverse this decline; growing muscle even during your later years.

With consistent resistance training, you can retain your muscle mass and even grow muscle mass through every decade of your life. Though granted that during your 70s, 80s, and beyond muscle mass growth slows down and the primary focus of your training becomes maintaining what you spent your youth building. It is never too late to start. Beginning your first resistance training program even into the twilight decades is a phenomenal way to maintain physical and metabolic shape.

Another risk factor of aging that resistance training addresses is frail bones. Your bones are in constant renewal, breaking down old weak bone and building up new strong bone. After the age of 50, the rate of breakdown supersedes the rate of buildup, meaning your bones can become thin and brittle. Taking up resistance training puts pressure on your bones stimulating them to build up density.

Thus resistance training is vital for both your bones and your muscles to retain function and formidability for as long as you live. How much exercise you need to reap these benefits is detailed here.

Cardio

In 2023, 32% of deaths were caused by heart disease.7 That’s 19.1 million people, 52,400 deaths each day! Heart disease is caused by high blood pressure, high LDL ‘bad’ cholesterol, alcohol, smoking and inadequate physical activity all contribute to heart disease.9 Eating too much sodium, insufficient potassium, and being overweight are additional lifestyle choices that also contribute, as well as chronic stress, poor sleep, and aging.

Cardiovascular exercise, as the name implies, is imperative for your heart and blood vessels. VO2 max, the maximum amount of oxygen your body can use during intense exercise, is among the strongest predictors of all-cause mortality (including cardiovascular mortality).

Similar to muscle, VO2 max declines at a rate ~10% per decade starting in your 30s. A lower VO2 max is correlated with a higher risk of all-cause mortality, and even increasing your VO2 max a little (by 1 MET; metabolic equivalent of task is the energy required to burn 1 kcal per kg each hour), may reduce risk of all-cause mortality by 13%.10 The better your body is at using oxygen the longer you will live (God willing).

To build your VO2 max, cardio is the way. More specifically, aerobic-base cardio and high-intensity interval cardio. Aerobic-base cardio is conversational-pace. Walking, hiking, jogging, cycling, etc. at a comfortably effortful pace. A good rule of thumb is to do 80% of your weekly training as aerobic-base training to build foundational energy production and movement mechanics. With the foundations established, your body can then employ its capability at higher intensities.

The remaining 20% of your cardio training time is spent on high-intensity intervals. Bouts of near-max level effort for 2-5 minute rounds. A good protocol for VO2 max specifically is the 4×4 method. 4 minutes of pushing uncomfortably hard (90-95% your maximum heart rate), 3 minutes easy recovery, and repeat 4 times total. Doing these workouts are absolutely brutal though stellar for your body.

An alternative style of training called SIT training (sprint interval training) can also reliably and significantly increase your VO2 max.12 SIT training consists of max-level bouts (95-100% of your maximum heart rate) for 20-30s bouts, recovering for 2-4 minutes, and repeating for 4-6 rounds.

By increasing your VO2 max, you increase your cardiovascular fitness and therefore are a more functional individual all through life.

Nutrition

There are a few nutritional factors to keep in mind in closing the morbidity gap. First up, you need sufficient protein. Protein provides the building material to sustain your muscles. Alongside resistance training, you need 1.2-2.2 grams of protein daily per kilogram of bodyweight. Take more protein (1.6-2.2g/kg) if you’re actively putting on muscle and take relatively less (1.2-1.6g/day) if your maintaining what you’ve already built. Sedentary individuals need a minimum of 0.8g/kg daily to mitigate atrophy but being sedentary retains the morbidity gap. Being active and taking more protein to feed your muscle is the better approach.

Eating whole, nutrient-rich foods is another component of the nutrition equation. Nutrient deficiencies cause a whole host of additional problems affecting your healthspan to be avoided. Good habits to ensure you’re getting sufficient nutrition include getting bloodwork in regular intervals to check for nutrition as well as tracking your nutrition with food journals and/or tracking apps (I personally use chronometer). Keeping record of your diet quality is the first step in making better nutritional choices over time.

Fasting is the final component of nutrition we shall discuss regarding closing the morbidity gap. Fasting, voluntarily abstaining from food for extended periods of time promotes autophagy. Autophagy is the recycling of your cells, getting rid of old and damaged cells to keep the good ones. The recycled cells are repurposed for use as energy or building material. Fasting promotes autophagy because it deprives the body of energy and essential nutrients so the body makes better use of what it already has. The morbidity gap gets addressed by promoting good habits of moderation and temperance.

Good fasting protocols include 16:8 fasts (eat 8 hours a day e.g. 9am-5pm, then fast the rest of the day and overnight), omad (one meal a day; only eating in a 1-2 hour eating period and fasting the rest), and alternative day fasting (eat one day and fast the other). These are good ways to promote improved insulin sensitivity and weight management, though it is not recommended to fast excessively to the point of malnutrition. Fasting more than 72 hours requires strict medical supervision.

Sleep

Sleep is when the brain recovers, keeping the brain clean, and regulating hormones. Getting 7-9 hours of sleep daily prepares your body and cognition for optimal performance daily.

Chronic sleep deprivation is a key contributor to the morbidity gap as it is associated with cognitive decline, cardiovascular disease, type 2 diabetes, and dementia. Sleep lays upstream of the day. The better the sleep quality, the better the day will be.

Getting a good nights rest regularly is vital for sharp focus, clarity, and decision-making. Promoting sleep comes down to a few simple rules:

  • Exercise regularly. Workouts deplete energy allowing you to rest deeper. One caveat is that you must finish your workouts a few hours before bed. Workouts are stimulating and having one too close to bedtime can delay sleep onset. Finish a few hours before.
  • Eat dinner 3-4 hours before bedtime. Digestion raises your heart rate and heats your body. Sleep prefers cool environments and calm heart rates.
  • Go to bed and wake up at the same time daily. This sets your circadian rhythm (your body’s internal clock) to make you sleepy at bedtime and energetic at wakeup time. Getting bright sunlight within the first few minutes of waking up fortifies this schedule.
  • Avoid alcohol and caffeine. Stimulants keep you up and do more harm than good.
Cognitive Care

Stress activates cortisol, the stress hormone designed to give you energy in times of danger, wake you up in the morning, as well as manage blood sugar, blood pressure, and lower systemic inflammation. When too much is produced through chronic stress, these normal functions go haywire, contributing to poor sleep, overeating as a coping mechanism, metabolic disregulation, and slower exercise recovery. Healthspan drastically declines as a direct response to chronic stress.

Chronic stress is caused by external factors including career/financial worries, relationship trouble, and dissonant environments, as well as internal factors including trauma and negative thinking patterns. None of these causes is dealt with easily. Incremental and consistent changes must be applied with intent for improvement. Here are a few of the best ways chronic stress can be lessened:

  • Regular exercise, hearty nutrition, good sleep. Things already discussed within this article. The interconnectedness of all these aspects of longevity highlights how every decision made regarding your health impacts all relevant domains. Good decisions compound and accumulate to transformative results if given enough time.
  • Mindfulness practices such as journaling and meditation. Deceptively simple yet significantly effective. Giving yourself time to reflect and look inward can calm the waters within. Putting thoughts into words is fantastic in making sense of your internal dialogue.
  • Spending time in uplifting social circles. Even if your current environment pulls you down, there are many communities both online and in-person you can join and belong in. Human connection is one of the strongest driving forces of behaviour.19 Everything we do is for each other.
  • Participate in hobbies you enjoy or find purpose in. Have long term goals of what you want to accomplish or contribute to the world. This way your energy can be directed towards something useful and productive. Could be art, science, engineering, comedy, etc. Something that fulfills you. Maintaining this outlook is crucial especially in later years to find value with life.
Track Your Progress

Awareness is the first step to lasting change. Measurement tells you if you’re getting better and by how much. What you choose to measure, e.g., exercise duration, nutrition, sleep scores, etc., creates an internal bias where you sacrifice effort and other options to improve the thing you’re measuring. This is known as Goodhart’s law.

To ensure Goodhart’s law is applied for beneficial purposes, recall the intention of why you’re measuring in the first place. To close the morbidity gap, we must care for each aspect of health mentioned in this article. Exercise, nutrition, sleep, and good thinking.

References

  1. Centers for Disease Control and Prevention. (2024a, December 2). Heart disease risk factors. https://www.cdc.gov/heart-disease/risk-factors/
  2. Centers for Disease Control and Prevention. (2024b, May 15). About sleep. https://www.cdc.gov/sleep/about/
  3. da Silva, A. C., Mapa, V., Ferreira-Júnior, J. B., de Oliveira, E. C., Becker, L. K., Rosse, I., & Coelho, D. B. (2024). Progressive strength training can reverse sarcopenia stage in middle-aged and older adults regardless of their genetic profile. Archives of Gerontology and Geriatrics, 117, 105182. https://doi.org/10.1016/j.archger.2023.105182
  4. Dattani, S., Spooner, F., Ritchie, H., & Roser, M. (2023). Causes of death. Our World in Data. https://ourworldindata.org/causes-of-death
  5. Garmany, A., & Terzic, A. (2024). Global healthspan-lifespan gaps among 183 World Health Organization member states. JAMA Network Open, 7(12), e2450241. https://doi.org/10.1001/jamanetworkopen.2024.50241
  6. Hong, A. R., & Kim, S. W. (2018). Effects of resistance exercise on bone health. Endocrinology and Metabolism, 33(4), 435–444. https://doi.org/10.3803/EnM.2018.33.4.435
  7. Mandsager, K., Harb, S., Cremer, P., Phelan, D., Nissen, S. E., & Jaber, W. (2018). Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open, 1(6), e183605. https://doi.org/10.1001/jamanetworkopen.2018.3605
  8. News-Medical. (2026, July 21). Global study reveals widening gap between lifespan and healthspan. News-Medical.Net. https://www.news-medical.net/news/20260721/Global-study-reveals-widening-gap-between-lifespan-and-healthspan.aspx
  9. Shabkhizan, R., Haiaty, S., Moslehian, M. S., Bazmani, A., Sadeghsoltani, F., Saghaei Bagheri, H., Rahbarghazi, R., & Sakhinia, E. (2023). The beneficial and adverse effects of autophagic response to caloric restriction and fasting. Advances in Nutrition, 14(5), 1211–1225. https://doi.org/10.1016/j.advnut.2023.07.006
  10. Strasser, B., & Burtscher, M. (2018). Survival of the fittest: VO₂max, a key predictor of longevity? Frontiers in Bioscience (Landmark Edition), 23(8), 1505–1516. https://doi.org/10.2741/4657
  11. Volpi, E., Nazemi, R., & Fujita, S. (2004). Muscle tissue changes with aging. Current Opinion in Clinical Nutrition and Metabolic Care, 7(4), 405–410. https://doi.org/10.1097/01.mco.0000134362.76653.b2
  12. World Health Organization. (2024, August 7). The top 10 causes of death. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  13. Yamagishi, T., & Babraj, J. (2019). Active recovery induces greater endurance adaptations when performing sprint interval training. Journal of Strength and Conditioning Research, 33(4), 922–930. https://doi.org/10.1519/JSC.0000000000002787
  14. Yang, Q., Li, D., Xie, H., Ji, H., Lu, J., He, J., Qin, Z., & Sun, J. (2021). Effects of sprint interval training on maximal oxygen uptake in athletes: A meta-analysis. The Journal of Sports Medicine and Physical Fitness. Advance online publication. https://doi.org/10.23736/S0022-4707.21.12815-4
  15. Yale Medicine. (n.d.). Chronic stress. Yale School of Medicine. https://www.yalemedicine.org/conditions/stress-disorder
  16. Epik. (2025, July 30). Stress: Impact on health, aging and longevity. https://epik.care/en/stress-impact-on-health-aging-and-longevity/
  17. Francis, R. (2025, March 3). VO₂ max and how it can predict longevity. Harrison Healthcare. https://harrisonhealthcare.ca/vo2-max-longevity/
  18. Harvard Health Publishing. (2026, February 23). Age and muscle loss. Harvard Medical School. https://www.health.harvard.edu/exercise-and-fitness/age-and-muscle-loss-YAQZ7EMP
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