What's the difference between lifespan and healthspan?

Lifespan counts years; healthspan counts the years spent independent and in good condition – and it's the latter that the serious longevity movement is actually about. Many people spend their final years with limitations; the big levers (training, diet, sleep, relationships) mainly extend the healthy time before that. It's less spectacular than “living forever” – and considerably more valuable.

Are longevity supplements like NAD boosters or resveratrol worth it?

The sobering short version: convincing human evidence is still missing for the prominent anti-ageing substances – resveratrol is now largely written off after disappointed hopes, NAD boosters are interesting but unproven. What's solid are the unglamorous basics: vitamin D if deficient, omega-3, magnesium, creatine, B12 from 50 or on a vegan diet. Stacking supplements before training and sleep are sorted means optimising the decimal point before the whole number. (This is not medical advice – discuss values and intake with a doctor.)

At what age is it worth starting on the big levers?

The earlier, the greater the cumulative effect – but there's no point at which starting stops being worthwhile. Studies on strength and endurance training show measurable improvements even in people past 80. Start in your twenties, and you build reserves over decades; start only at 60, and you still gain healthspan – just with less time for the effect to accumulate.

What's the biggest misconception in the longevity space?

That more complex, more expensive interventions are automatically more effective than simple ones. The evidence shows almost consistently the opposite: the five mundane levers – fitness, strength, sleep, diet, relationships – have the most robust evidence of all, while elaborate biohacking interventions (cold chambers, infrared suits, exotic blood tests) mostly rest on thin or absent human data. Complexity gets mistaken for effectiveness.

How do you measure your own progress on the big levers?

For fitness, VO2max is the most robust single value (we have a dedicated article on it); for strength, grip strength or a simple strength-endurance test like maximum push-ups. Sleep can be roughly tracked via time to fall asleep and how rested you feel, using a wearable if needed. For diet, a simple look at the proportion of unprocessed food on your plate is often enough. Relationships are harder to measure – here the simple question helps: how often in the last few weeks have you had real, undisturbed contact with people close to you?

Travel & Lifestyle · Longevity

Longevity: What Actually Works, According to the Evidence

Between ice baths and supplement stacks, one thing gets lost: research has long known the big longevity levers – uncomfortably mundane. An honest sort.

By Boaz Lichtenstein

Article image: Longevity: What Actually Works, According to the Evidence

The longevity wave has two faces. The loud one: billionaires with blood plasma protocols, supplement stacks of thirty capsules, biohacking conferences. And the quiet one, which is surprisingly uncontroversial in the research: the big levers for a long, healthy life are known, cheap and uncomfortably mundane. Sort through them, and you find it’s a short list – and almost nothing on it can be bought.

Key takeaways

Five levers carry the lion’s share of the evidence: cardiorespiratory fitness, muscle mass/strength, sleep, diet quality, social relationships.
Cardiorespiratory fitness (VO2max) is the strongest known single predictor of life expectancy – ahead of most classic risk factors.
Prominent anti-ageing supplements such as resveratrol or NAD boosters have no convincing human evidence so far.
It’s about healthspan, not just lifespan – the years spent independent count for more than the raw number of years.
Complexity is no proof of effectiveness: the simplest interventions often have the most robust evidence base.

The big levers, ranked by evidence

1. Cardiorespiratory fitness. No lab value predicts life expectancy as strongly as VO2max – the mortality-risk gap between poor and good fitness exceeds that of most classic risk factors, including smoking and diabetes. The way there is no secret: the aerobic base from Zone 2 training plus the occasional intense stimulus.

2. Muscle mass and strength. The second foundation: strength training two to three times a week correlates with 15 to 30 per cent lower mortality, and grip strength is one of the most robust age markers there is – muscle is an organ, not decoration. Combine the first two levers, and by today’s evidence you’ve covered the largest part of the trainable longevity effect.

3. Sleep. Chronically too little or irregular sleep damages practically every system longevity depends on – metabolism, cardiovascular health, immune defence, the brain. It’s the lever the biohacking scene most likes to work around with gadgets instead of actual bedtimes. Chronically short sleep (under six hours for years) is consistently associated in observational studies with elevated risk for practically every major age-related disease.

4. Diet quality – without dogma. The patterns of long-lived populations resemble each other: mostly unprocessed food, plenty of plants, enough protein in old age, little ultra-processed food. No single superfood shows up in the evidence – patterns beat ingredients.

5. Relationships. The most underrated point: social connectedness is one of the strongest predictors of health and satisfaction in old age in long-term studies – in the same league as quitting smoking. Loneliness is a health risk, not an emotional inconvenience, with an effect on mortality that in some analyses is comparable to that of physical inactivity.

The five levers compared

A rough overview of how strength of evidence, time investment and cost relate to each other:

Lever	Evidence strength	Time investment	Cost
Cardiorespiratory fitness	very high	2–4 hrs/week	low
Muscle mass/strength	very high	1.5–2.5 hrs/week	low
Sleep	high	no extra time, just priority	none
Diet quality	high	planning effort	medium
Relationships	high, often underrated	variable	none

Notably, none of the five strongest levers costs meaningful money – in the longevity field, the relationship between price and effectiveness is, if anything, inversely proportional. For comparison: an annual subscription to a private longevity lab with dozens of biomarkers can easily run into four figures – for the same amount, or less, you can fund a full year of strength training and running shoes, with an effect on actual lifespan and healthspan that’s many times better documented.

The Blue Zones view: what longevity regions have in common

The so-called Blue Zones – regions with an above-average number of very old, often still independent people, such as Sardinia, Okinawa or Costa Rica – are often sold as an exotic role model. Look closely, though, and they mostly confirm the mundane list: exercise there is built into daily life rather than outsourced to a gym (gardening, walking, stairs), the diet is predominantly plant-based and minimally processed, and social integration is structurally high – multigenerational households, stable communities, barely any isolation in old age. No place on the list owes its reputation to a supplement or a special diet. Blue Zones research isn’t methodologically uncontroversial, but the pattern it shows matches the rest of the evidence almost exactly: daily life and surroundings that automatically serve the five big levers beat any single deliberate intervention.

What’s NOT on the list – the most common misjudgements

Mistake 1: Prioritising supplements over behaviour. Taking thirty capsules while training irregularly and sleeping badly means optimising the sideshow. Mistake 2: Chasing exotic biomarkers. Epigenetic clocks and rare blood tests are interesting but rarely change the behaviour that actually matters. Mistake 3: Extreme diets as a longevity strategy. Radical calorie restriction shows effects in animals; in humans the evidence is thin and the risks (muscle loss, malnutrition) are real. Mistake 4: Overrating single interventions. One cold-chamber session a week doesn’t offset irregular sleep. Mistake 5: Dismissing relationships as “soft”. Track your training plan and diet meticulously while ignoring social isolation, and you overlook one of the strongest levers there is.

The order in which to tackle the levers

Stabilise sleep first. Without a solid sleep foundation, the other levers work less well – both training recovery and dietary decisions suffer from sleep deprivation.
Establish strength training. Two fixed sessions a week, even if they start small.
Build an aerobic base. Add Zone 2 sessions once strength has become routine.
Adjust dietary patterns, don’t overhaul them radically. Gradually increase the share of unprocessed food.
Actively maintain relationships. Schedule fixed, recurring social contact instead of leaving it to chance.
Optimise only after that. Treat supplements, tracking gadgets and biomarker tests as fine-tuning, not the foundation.

This order isn’t an arbitrary recommendation, it follows the logic of the levers themselves: sleep and diet are the base on which training can work at all – train exhausted and malnourished, and you build neither strength nor endurance at the expected rate. Flip the order and jump straight into intense training on poor sleep, and you risk overtraining and frustration in the first few weeks – a common reason well-meant New Year’s resolutions get abandoned again by February.

Why the hype booms anyway

The honest answer: the big levers demand behaviour, the hype sells shortcuts. An infusion is more convenient than training three times a week, a test is more exciting than going to bed earlier. The rule of thumb for anything new – from the cold chamber to the epigenetic test: first ask whether the five basics are in place. If not, any further optimisation is decoration. If they are, feel free to experiment – as a bonus, not a substitute. In the end, longevity is a portfolio with five large holdings and many small side bets. The art lies in not mistaking the side bets for the portfolio.

The limits of your own control

An honest view includes this: genetics, chance and the socioeconomic context someone grows up in also explain a substantial part of the differences in life expectancy – longevity isn’t a pure merit system where perfect behaviour automatically guarantees a perfect outcome. That doesn’t diminish the five levers, it places them realistically: they’re the largest part of what’s actually within your own control, not a guarantee against every risk. Accept that, and you also lose the temptation to blame yourself for a diagnosis because some lever was supposedly missing – while keeping the incentive to pull the levers that are genuinely within your influence.

The bottom line

The research on a long, healthy life has been stable in its essentials for years – and strikingly unspectacular: fitness, strength, sleep, diet, relationships. Hold these five positions in your portfolio, and you’ve already realised most of the controllable longevity effect before a single supplement even comes up. The most sensible next step is rarely a new test or a new product, but an honest stocktake: which of the five levers is shakiest for you right now? That’s where your time is best spent next.