Longevity for Parents - Part 1
Introduction
A quick warning before diving in, this post talks about parent loss and ageing parents. I realise this may be sensitive for some readers who may not want to read further.
I recently read Prince Harry’s autobiography (hear me out!), and what stayed with me most is how different his life could have been if his mum had been alive. She comes up a lot in the book, and it’s clear that he thinks about her often. His mother’s death shaped his life in both the unbearable grief of losing a parent at twelve years old and the loneliness of losing the one person who would always have been in his corner.
Becoming a parent has made me think a lot about longevity. I feel a responsibility to my son to be around as long as possible. I want to be the person who, when all else fails, he knows he can come back to and will be here for him. I also don’t want to burden him later in life. If he has young children, I hope he can focus on the joy of his young family and not have the stress of an ageing parent with health needs.
We can’t control everything; even the healthiest people can experience chronic and terminal diseases. That said, there is reasonably good research that can help us understand some of the key drivers of longevity and good health in old age. A Danish study of twins determined that only 20% of longevity is determined by genetics, while 80% is attributable to our lifestyles.
It’s worth being explicit that there are two separate things to optimise for when considering longevity. The first is how long one lives, and the second is how healthy one is in those years. Fortunately, the research shows that the longevity factors within our control influence both of these together. In other words, making the changes that promote a longer life also promote better health in our later years.
I’m a working parent. So whatever I need to do to improve my longevity needs to be something I can systemise into my family’s routine and not need to remember too much. It’s unlikely that doing a 3-hour workout every day or meal prepping that takes twelve hours will last very long. I want the highest ROI on my effort, which means I want to understand what I can do with the least effort to have the highest impact on my longevity.
Dr Waldinger from the Harvard Study of Adult Development summarises this question nicely in his TED talk: “What keeps us healthy and happy as we go through life? If you were going to invest now in your future best self, where would you put your time and your energy?”
Data:
Let’s start with what the data says. The best data we can use to understand the effect of interventions on health are randomised controlled trials (RCTs). The problem with looking for RCTs for longevity is that RCTs cannot run over the long time periods we would need to understand longevity outcomes like age at death or quality of life in later years.
In my research, the best data I have found is:
Long cohort studies: The longest study of adult health is the Harvard Study of Adult Development. This study has been running for over 80 years, tracking a cohort of the 1938 Harvard class and their descendants. In the 1970s, this study was paired with another cohort study following a group of men from inner-city Boston since the 1940s. These two studies combined resulted in over 700 participants in the study. In a cohort study, participants are assessed and interviewed over time so that researchers can pull out patterns from the data they receive. The challenge with this study is that it first started in 1937, so the type of lifestyle that individuals had at this time would be quite different to us today. Second, for a long time, the study only followed men. Lastly, since it is a cohort study over time and not an RCT, it is difficult to separate correlation from causation.
Studies of groups showing high longevity: The Blue Zones project has studied five communities with a high proportion of healthy centenarians to identify patterns in what these communities have in common. These communities are in Sardinia, Italy; Okinawa, Japan; Nicoya Peninsula, Costa Rica; Icaria, Greece and Loma Linda, California. Dan Buettner started the Blue Zones project in 2004 as a National Geographic expedition to explore ageing. Dan and his team have published their findings over the last 20 years and worked with communities to build the conditions for longevity in other communities. They have distilled what they have found in common across the five blue zones groups into 9 Principles for longevity.
RCTs and other studies using epigenetic markers: Scientists have developed what they call epigenetic markers, basically the features in the human body that are signs of ageing. For example, inflammation appears to have an accelerating effect on ageing. Scientists can do RCTs testing for the impact on these epigenetic markers to understand if an intervention improves outcomes. What we don’t know is how well these epigenetic markers actually contribute to longevity in isolation and, therefore, what the most effective interventions are.
Bryan Johnson has recently made headlines as acting as a ‘human guinea pig’, trying out everything that might contribute to lowering the rate of ageing. He has developed a plan called ‘Blueprint’ so anyone can follow it. It’s handy but also a bit ‘kitchen sink’ — it follows every possible intervention. For example, he takes 54 supplements every day. It is unrealistic for a working parent to follow and doesn’t differentiate between higher and lower leverage intervention. Still, it is a helpful summary of the latest science on what is effective from many RCTs and what epigenetic markers are important for longevity. He appears to have significantly reduced his rate of ageing and perhaps even begun to reverse some of the ageing he has experienced.
While each of the above sources has some flaws, using them together, we can identify some clear principles to apply to help us understand where to invest our time and energy for the highest impact on longevity.
Three principles for longevity
Principle One: Invest in relationships
The Harvard study found that the most significant single determinator of longevity and health in old age was whether individuals had good relationships across three dimensions – their immediate family, close friends and connections with their community. They showed that the number of friends you have is not important, but the quality is – warm, protective relationships help us live longer and that the effect is not just on our bodies' health but also that of our brains.
This Blue Zones project found the same thing. Every group that they studied had rituals that encouraged building and investing in their relationships. For example, the Sardinian group meet their friends for happy hour every day. The Okinawan group have a concept called “moais”, a group of five friends grouped together in childhood and committed to being friends for life. They also found that individuals in the Blue Zones prioritised family, often living close to or with parents and grandparents.
How you can systemise this:
The most effective way to systemise building relationships is to create rituals. Rituals are a set of actions or behaviour that we repeat regularly – just like the Sardinian happy hour. Rituals are an effective way to systemise investing in relationships for two reasons.
First, rituals eliminate decision-making and implementation work. For example, let's say you want to have a date night with your spouse. If you decide on a week-to-week basis whether or not you will have a date night, there is the cost of making the decision, coordinating together to find the right day and time, finding childcare for that night of the week and planning where to go. If you have a ritual of date night every Thursday with a regular childcare solution (granny, au pair, babysitter), the only work to execute on date night once it is set up to recur weekly is deciding where to go. Obviously, it doesn’t have to be weekly; it could be the first Thursday of every month or whatever works for you. The point is that if it’s on auto-pilot as a ritual, it's in the calendar for everyone and much easier to do.
The second is that friendships, in particular, need time to develop. Research suggests that casual friendships don’t emerge until you have spent 30-50 hours together. Good friendships are closer to 150 hours. The studies of best friendships show anywhere between 300 and 5000 hours are needed, which is probably why some of my best friendships were made at boarding school. In other words, good friendships will need repeated investments over time, which is precisely what rituals do.
If you create two rituals in your life for longevity, the two most important ones are:
Spousal rituals:
Our spousal relationships are the most important relationships that we have. Systemise making time for just the two of you each week in a ritual built into the fabric of your weekly routine. For example, Preet Anand and his wife do a date night every Thursday evening. My partner and I have two weekly rituals that include exercise: On a Friday morning, we work out at the gym and get a coffee at the coffee shop next to the gym together. We run and get breakfast together on a Saturday morning while our au pair watches my son. We both have these times blocked on our calendars and don’t have to make any decisions apart from which breakfast spot to run to on a Saturday.
For bonus points, read the 7 Principles for Making Marriage Work. Dr John Gottman’s work on building relationships is excellent. He covers why marriages fail, the skills needed to make a marriage work, and exercises to get better at them. It also creates a shared language between the two people to navigate conflict better.
Friend rituals:
The data suggests that a few friendships you consistently invest in as a group is most important when it comes to close friendships. Again, the best thing here is to create a ritual. This could be a regular dinner, lunch or happy hour with a group of people, but I’d challenge you to make it something you enjoy doing- something energising vs energy draining. I’ve found that some of my best friendships have come out of running. One of my friends and I have had a weekly run on a Thursday morning for (I think) about five years now. It has been a wonderful regular connection, and we both get to do something we enjoy while chatting.
If you create one regular spousal ritual and one regular friend ritual, you’ll make good strides in building the relationships that support your health and overall well-being.
Principle Two: Eat primarily plant-based, nutritionally dense food, and stop when 80% full
There is new information every week about what is and is not good for us. In the Blue Zones project, they found that most communities ate very little meat, just a few times a month. Their diets mainly consisted of vegetables, legumes (especially lentils), whole grains and often a high amount of fish. It is also worth noting that their diets contained very little processed food and minimal refined carbohydrates.
These diets follow the basic construct of the Mediterranean diet, and research into this way of eating started in the 1950s. The Mediterranean diet is high in vegetables, legumes, seafood, nuts, seeds, herbs and spices. Olive oil is the primary source of fat. Meat is included only in small quantities, and red meat very sparingly. Although only two of the Blue Zones communities are actually in the Mediterranean, the ones in Greece and Sardinia, the others have very similar fundamentals to their diets, being high in vegetables and legumes and low in meats and processed food.
I like the concept of ‘nutritionally dense’ as a rule to follow, as it is straightforward. A nutritionally dense food is a food that provides a lot of good nutrients for every calorie. For example, vegetables, nuts and lentils are very nutritionally dense. On the other hand, white rice, white bread and sugar are not nutritionally dense – they are ‘empty calorie’ foods that provide a lot of calories but not much else.
The last part of this principle is eating until 80% full. Recent research suggests that overeating is a cause of inflammation, and inflammation is linked with ageing. Most of us need fewer calories than we think. Eating until 80% full is an easy rule for the whole family to follow. Slowing down and eating mindfully helps a lot too.
Bryan Johnson, who I mentioned earlier with the Blueprint project, follows an intense version of this principle. He eats a fully vegan and calorie-restricted diet that is nutritionally dense – it has no refined carbohydrates, and every food included in his diet packs a nutritional punch. He eats just under 2000 calories a day, which is pretty calorie restricted for a man doing his level of exercise.
How you can systemise this:
Eat vegetarian regularly and replace meat in your diet with lentils and beans. I like to remove decisions from the equation, so having specific vegetarian days or a specific number of dinners a week that are vegetarian help make this part of the weekly flow. I also like to cook a big pot of lentils on a Monday that I can have for lunch throughout the week. Remove refined carbs and highly processed foods from the menu to ensure the diet stays nutritionally dense.
Eating until 80% full is a good family rule to have at the dinner table and helps everyone regulate their eating. Many small kids do this naturally; they lose interest in eating once they are satiated and want to leave the table. Provided your child isn’t having issues maintaining their healthy weight, helping them listen to their bodies when they are full can be encouraged.
Principle Three: Move often and lift weights
In the Blue Zones project, all the communities studied moved regularly and had walking as a part of their daily activity. Low-impact regular movement is essential for overall health, and some level of cardio is important for heart health.
Recent research also suggests that lifting heavy weights is a critical component of longevity. Without active use, we start losing muscle mass from our thirties onwards. Lifting weights can prevent and reverse this muscle loss.
Additionally, falls are a risk factor for rapid ageing later in life. Suffering a fall can put older adults on a higher ageing trajectory as their injuries can prevent them from doing their everyday activities. In the time it takes to heal, their bodies can atrophy to a lower level of health than before the fall. Lifting weights specifically targets the parts of the muscles that are important for us to prevent falling. This is a good explainer video on why lifting weights is critical for anti-ageing.
How you can systemise this:
General activity:
I’ll come back to this in a future newsletter, but the choice of where you live is one of the most important decisions you can make. People who live in dense, walkable neighbourhoods where they are generally walking to shops, school etc., have much higher activity levels than those who live in suburban areas and rely on cars to go anywhere.
Assuming that you’re not moving house just because of me writing this post (although if you are in the process of moving, please do consider walkability!), what’s the next best thing? Incorporating walking into your daily routine is highly effective, and monitoring your steps using your phone or smartwatch is an excellent starting point to see how you’re doing. The goal is 10k steps per day, and I can only do that if I incorporate walking calls into my workday.
It’s also highly beneficial to walk with a weighted vest – this is easy as a parent of small children, as a toddler in a backpack is a perfect weighted vest! So take your kiddo for a walk in your backpack while you still can.
Lifting weights:
The best option is to get a personal trainer to help you with a program that suits your specific strengths and weaknesses. Personal training also has the major benefit of ensuring you put training on your calendar and show up! Most personal trainers will be able to work out with you once a week and provide you with a plan for working out a few times a week on your own once you’re comfortable with the different exercises.
If you don’t want to work out with a personal trainer or it’s not feasible for you, Huberman has a good fitness program for optimal muscle development, and Bryan Johnson’s workout is here. You could follow either and do just as well. I still suggest starting with a personal trainer if weights are new to you because poor form or just moving the heavy weights could cause you injury, so it is better to do it supervised.
Conclusion
Ok, so you’re a busy parent, and I’ve just told you that you need to make time to go on dates, see your friends, walk 10k steps and work out multiple times a week so that you can live for a long time. Oh, and don’t eat too much.
The good thing about effective systems is that they compound. The best way to make these particular systems compound is to switch socialising over food to socialising over exercise or activity. Work out with your significant other, find a few buddies to lift weights with or do a regular morning walk (ideally as a group!), garden with a friend, or do regular Sunday morning hikes with another family and a toddler in your backpack. Obviously, you can always grab brunch after 😁.