"Get busy living or get busy dying." That famous line was written by Stephen King in 1982 and popularized in the 1994 film The Shawshank Redemption, but the sentiment might be top of mind as we tear the cellophane from our 2024 calendars and take stock of our lives. Research tells us that resolutions don't work—yet many of us still make them—and those lists often make us feel worse when we abandon our frantic self-improvement goals before the end of January. That said, the new year is an excellent time to think about whether our habits and behaviors are moving the needle toward living or dying.
According to the Centers for Disease Control and Prevention (CDC), heart disease has been the leading cause of death in the United States since 1950, and the World Health Organization reports that 16 percent of the world's total deaths are the result of heart disease. When it comes to longevity, heart-healthy behaviors are only part of the longevity puzzle, but if we do the things that lead to a healthy heart, we'll undoubtedly be healthier overall.
Researchers from Harvard University's T. H. Chan School of Public Health collected data over 34 years and came up with five key lifestyle factors for improving longevity: healthy diet, regular exercise, healthy weight, no smoking, and moderate alcohol intake. In addition, the Harvard study found five additional longevity factors—having a life purpose, social connections, brain stimulation, improving sleep quality, and intermittent fasting.
"It's quite clear that many of the heart conditions I treat can be ameliorated if not avoided by focusing on 'the basics,' namely eating healthy, getting an adequate amount of physical activity, and achieving a healthy weight," says Benjamin Schaefer, MD, a board-certified cardiologist with offices at the Heart Center in both Kingston and Rhinebeck. "While this may sound simple, it also represents the most challenging part of my job," Dr. Schaefer says. "Taking a pill every day is easy, but lasting changes in behavior is hard."
We asked Dr. Schaefer and other local experts to comment on the 10 lifestyle factors for longevity and how to implement them into our daily lives.
Top Five to Stay Alive
Healthy Diet
Dr. Schaefer says many patients ask what to eat for a healthy diet, and he recognizes that the public is overwhelmed with information, so they wonder about the benefits of keto, paleo, or low-fat eating plans. "This is not an easy answer," he says, "But the best medical evidence probably exists for the Mediterranean diet, which is near par with taking cholesterol-lowering medications to prevent heart disease."
Regular Exercise
The Harvard study defined regular exercise as at least 30 minutes of moderate to vigorous activity per day, which is the bare minimum for lowering the risk of conditions such as heart disease, hypertension, diabetes, osteoporosis, certain cancers, and cognitive decline that increase with age. In their Physical Activity Guidelines for Americans, the Department of Health and Human Services recommends 150 to 300 minutes weekly of moderate to vigorous activity and two days of strength training. Those looking to improve mobility and balance can also include yoga, tai chi, or other balance-training exercises.
"Not only is it becoming evident that physical activity can prevent heart disease, and likely will affect longevity, it helps regenerate the lining of the blood vessels, prevents dementia, and helps maintain weight loss," Dr. Schaefer says, adding that only 20 percent of Americans meet the physical activity guidelines.
If you're new to incorporating regular exercise into your life, you don't want to jump into long-distance running or heavy lifting. "If it feels bad, stop," advises Ben Hendrickson, a certified strength and conditioning specialist with over 20 years of training experience. "You should listen to your body and stick with the process long enough to see results, and as you get more fit, you can push yourself more," Hendrickson says.
Hendrickson trains clients one-on-one, and he also offers group training classes through Root Strength, his studio in Kerhonkson. "Pushing yourself with other people makes it more accessible," Hendrickson says of his group classes, which include high-intensity interval training (HIIT) workouts and "fire and ice," which is a HIIT workout followed by a sauna and cold plunge.
Healthy Weight
Although some people maintain a healthy weight without a healthy diet or regular exercise, most of us must be mindful of what we eat and how frequently we move our bodies. The obesity epidemic began in the United States nearly 50 years ago, and is attributed to the advent of ultra-processed foods and an increasingly sedentary culture.
The Harvard study originally defined a healthy weight based on body mass index (BMI), and said the optimal was between 18.5-24.9, but recent research finds that BMI alone is a poor metric for measuring health.
Not Smoking
Smoking falls into the category of "preventable death," and the CDC reports that smoking is responsible for more than 480,000 deaths per year in this country, which includes approximately 41,000 deaths resulting from exposure to secondhand smoke. "As a nation, we've made great strides in reducing smoking, but quitting is very hard, and while behavioral therapy and medications can help, I think we need to do more as a medical community," Dr. Schaefer says.
"Similar to primary prevention measures, care for tobacco-cessation therapy is underfunded, and ironically, you can get reimbursed to counsel somebody to quit smoking cigarettes, but not cigars, smokeless tobacco, or vaping," Dr. Schaeffer says. "Many people can cut down on smoking but not quit, and I make a point of congratulating them for their harm-reduction efforts."
Moderate Alcohol Use
"Alcohol consumption is a controversial topic," Dr. Schaefer says, adding that there's no ambivalence in the medical community about heavy alcohol use, which is bad for your heart, liver, brain, and many other aspects of your health. "More and more research is pointing to the harm of even small amounts of alcohol on your health, but further research is fraught with problems, he says. "From a heart perspective, I usually tell patients that if they do drink, one drink per day is unlikely to cause harm to the heart unless they are prone to developing arrhythmia such as atrial fibrillation."
But There's More...
We can't emphasize enough the importance of eating a healthy diet, maintaining a healthy weight, and engaging in regular exercise while limiting alcohol and nicotine, but the additional five factors Harvard identifies in the study shouldn't be minimized. Of all of them, social connection is probably the most important.
Last May, Surgeon General Dr. Vivek Murthy released an 80-page report titled "Our Epidemic of Loneliness and Isolation." Dr. Murthy didn't pull any punches in the report's introductory letter, where he wrote: "Loneliness is far more than just a bad feeling—it harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death."
One good thing about the additional five factors for longevity is that you can combine some of them and potentially stack them with one (or more) of the five key lifestyle factors. For example, brain stimulation can be achieved by sitting home alone doing a crossword, but a person could add a social component and meet friends for a live game of Scrabble. Even better, engage in brain-stimulating conversation while walking with a friend. You can even add on cooking a healthy meal or eating together in a restaurant.
If you're not convinced that getting together with friends or strangers can prolong your life, think again. "The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity," Dr. Murthy wrote.
Sleep quality is another factor that leads to increased longevity. However, many circumstances can disrupt our sleep, with overactive minds at the top of the list. "Minds are often busy telling stories in our efforts to perceive patterns and make sense of the world, and insomnia can be exacerbated by stress," says Nina Smiley, PhD, director of mindfulness programming at Mohonk Mountain House.
Smiley explains that when we can't fall asleep or when we wake up in the middle of the night, we can get wrapped around the story "I'll be a total wreck tomorrow!" making slumber even less likely, leaving us in a loop of stress, exhaustion, and worrying about our performance when we're running on empty. "Mindfulness meditation helps us observe with deep awareness what is happening inside and outside ourselves in a gentle, non-judgmental way, supporting the ability to bring compassion for self and others into everyday life," Smiley says.
Overeating too late, especially heavy foods, can also interrupt our sleep. Intermittent fasting—when you abstain from eating for a set amount of time, typically 12 to 16 hours—is on Harvard's list of additional factors that lead to increased lifespan, and is another excellent longevity hack.
Both sleep quality and intermittent fasting have been proven to reduce systemic inflammation, which reduces the risk of Alzheimer's disease and other forms of cognitive decline, as well as inhibiting the development of chronic disorders such as obesity, diabetes, cardiovascular disease, and some cancers. In addition, studies have found that intermittent fasting improves insulin sensitivity, lowers blood pressure, decreases LDL cholesterol, and leads to weight loss. If you only implement one of these longevity suggestions, intermittent fasting is a solid place to begin.
Control the Controllables
Much of life is out of our control, and genetics may factor in your longevity, but controlling your mindset is one way of working with what you have. Two recent studies show that optimism is linked to longevity and well-being, and Katie Peterson, LCSW, a Hudson Valley-based therapist who sees clients virtually, says there are easy-to-implement ways to increase optimism. Instead of getting overwhelmed by a long list of goals, Peterson suggests asking: "What do I want to feel like?"
Do you want to learn something new? Do you want to engage more with your community? Do you want to implement new eating or movement plans? "The word 'should' does nothing good for our mental health," Peterson says, "But asking ourselves how we want to spend our time and who we want to spend time with is a great way to move in the direction of feeling good."
"Many people struggle post-pandemic with what they even want to do," Peterson says, "But learning new things is a great way to increase presence, and getting out and trying a new hobby is also a great way to engage with others who are also learning something."
Many of us work from home now, which can be isolating, and we may also have gotten into the habit of streaming fitness classes because it's convenient, though that convenience has a cost.
Whether it's yoga, dance, knitting, storytelling, or some other item on your to-do list—the moral of the story is to get out there and give it a shot. You'll never be worse off for improving your diet, moving your body, engaging with your community, or getting a solid night's sleep, and you may just feel better and prolong your life.
