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Let's Talk About Healthspan

Apr 26, 2025

When I ask most people what their primary goal is for developing healthier habits or their main motivation for seeking out my services, the responses often focus on relatively short-term objectives. Rarely do these goals align with the timeframe or scope we consider when discussing healthspan. This is completely understandable—small, immediate goals help build the habits and momentum necessary to pursue a long and healthy life. In fact, these short-term goals often contribute to the broader objective of healthspan, which is what I want to focus on today.

What is Healthspan?

First, let's define healthspan. Healthspan refers to the length of time a person lives in good health, free from chronic diseases or disabilities. It emphasizes a high quality of life across all aspects: physical, mental, and spiritual. While mental and spiritual health are vital components of healthspan, I will focus on the physical aspects today, as these sit squarely within my realm of expertise.

Key Physical Components of Healthspan

When considering the physical aspects of healthspan, several key areas stand out based on decades of research:

- VO2 Max

- Lower Body Strength

- Grip Strength

- Fiber Intake

- Protein Intake

1. VO2 Max and Cardiovascular Fitness

VO2 Max—or maximal oxygen uptake—is a measure of the maximum volume of oxygen your body can consume per minute during exercise. It serves as a proxy for cardiovascular fitness.. Research has consistently shown that higher VO2 max levels are associated with reduced risk of all-cause mortality, making it a crucial focus for extending healthspan.

Multiple studies have demonstrated the strong link between VO2 and positive health outcomes. For instance, a landmark study published in the Journal of the American Medical Association found that men with a VO2 max below 27 mL/kg/min had a mortality risk almost five times higher than those with a VO2 max above 37 mL/kg/min. Similarly, a study in the European Heart Journal showed that each 3.5 mL/kg/min (equivalent to 1 metabolic equivalent [MET]) increase in VO2 max was associated with a 15% reduction in all-cause mortality risk among older adults .

Higher VO2 max levels also correlate with a lower risk of cardiovascular disease. Research published in the Circulation journal found that individuals with a VO2 max in the top 25% of their age group had a 50% lower risk of developing heart disease compared to those in the bottom 25% . This relationship highlights the importance of maintaining high cardiovascular fitness for long-term health and disease prevention, while improvement in cardiovascular fitness is not only linked to reduced mortality but also enhances overall functional capacity and quality of life.

With VO2 tied so closely to quality of life, incorporating strategies to increase VO2 max are essential. All forms of aerobic exercise, including high heart rate weight training, when prescribed appropriately, can lead to increases in VO2. Specific strategies can theoretically shorten the time it takes to increase an individual’s VO2, but this depends on the anatomy of that individual. Maintaining a high VO2 max into older age can help ensure greater endurance, reduced fatigue, and a lower risk of chronic conditions, ultimately supporting a longer, healthier life.

References

2. Balance, Proprioception, and Squat Strength

Maintaining balance and proprioception—the body's ability to sense its position and movement in space—is crucial for overall mobility and reducing the risk of falls, especially as we age. Strength training, particularly exercises that enhance balance and stability like squats, plays a vital role in preserving these abilities. Research shows that improving balance and proprioception can significantly reduce fall risk and contribute to extending healthspan.

Falls are the leading cause of injury and a leading cause of mortality in older adults. According to the Centers for Disease Control and Prevention (CDC), falls are responsible for more than 95% of hip fractures and are the most common cause of traumatic brain injuries in older adults . Improving balance and proprioception through targeted exercises can help mitigate these risks. A study published in the Journal of Gerontology found that balance training reduced fall rates by 37% in older adults participating in a structured program compared to those who did not participate.

Squat strength serves as an important indicator of lower body strength and functional mobility. Squats target the major muscle groups in the legs and core, which are essential for maintaining balance and performing daily activities. Strong leg and core muscles contribute to stability and reduce the likelihood of falls and injuries.

Research has shown that squat strength is closely linked to balance and mobility in older adults. A study in the Journal of Strength and Conditioning Research found that older adults with higher squat strength had a 42% lower risk of falls compared to those with weaker lower body strength. The study also showed that each 10% increase in squat strength was associated with a 12% improvement in balance performance when measured by various standard balance tests .

Finally, a meta-analysis published in the British Journal of Sports Medicine indicated that strength training, including exercises like squats, improved overall physical function by 25% and significantly reduced the risk of falls by 30% among older adults .

Beyond preventing falls, maintaining squat strength ties to functional independence even further. A study in the Journal of the American Geriatrics Society found that individuals with stronger lower body muscles, as assessed by squat strength, were more likely to maintain independence in daily activities, such as rising from a chair, climbing stairs, and walking. Living independently is the central goal when focusing on healthspan.

Improving balance, proprioception, and squat strength is essential for reducing the risk of falls and maintaining mobility, for everyone! But, especially for us as we age. By incorporating targeted strength training exercises that focus on these areas, individuals can enhance their physical resilience, support independence, and ultimately extend their healthspan.

References

3. Grip Strength and Overall Physical Health

Grip strength is more than just a measure of hand and forearm strength; it serves as a powerful indicator of overall health, functional capacity, and longevity. Research consistently shows that grip strength is strongly correlated with a variety of important health outcomes, including the risk of chronic diseases, mobility limitations, and even mortality.

Several studies have highlighted the predictive value of grip strength for mortality. A comprehensive meta-analysis published in The Lancet examined data from over 140,000 participants across 17 countries and found that each 5 kg decrease in grip strength was associated with a 16% increase in the risk of all-cause mortality . This association was independent of other factors such as age, sex, and body mass index, indicating that grip strength is a fairly accurate predictor of mortality risk on its own.

In another study from the British Medical Journal, researchers followed nearly 400,000 participants over a four-year period and found that lower grip strength was associated with a higher risk of cardiovascular disease, respiratory disease, and cancer mortality. Most notably, individuals with the weakest grip strength had a 20% higher risk of cardiovascular mortality compared to those with the strongest grip.

Grip strength also plays a crucial role in maintaining functional independence. A study published in the Journal of the American Geriatrics Society found that older adults with higher grip strength were significantly more likely to maintain independence in daily activities, such as rising from a chair, carrying groceries, and climbing stairs. For each 1 kg increase in grip strength was a 4% reduction in the risk of functional limitations over a three-year period associated with it.

Additionally, a study in the Journal of Aging and Health found that older adults with stronger grip strength were more likely to have better overall physical performance, including balance, gait speed, and lower body strength . This suggests that grip strength is not only an indicator of hand and forearm strength, but also reflects the overall muscular strength and coordination that are necessary for maintaining mobility and preventing falls.

Grip strength is also tied to the risk of developing chronic diseases. A study published in Diabetes Care reported that lower grip strength was associated with a higher risk of type 2 diabetes. Participants in the lowest quartile of grip strength had a 50% higher risk of developing diabetes compared to those in the highest quartile. Finally, research published in the American Journal of Preventive Medicine found that low grip strength was correlated with an increased risk of metabolic syndrome, a cluster of conditions that includes hypertension, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. Participants with the weakest grip strength had a 31% higher risk of metabolic syndrome compared to those with the strongest grip.

Grip strength is an easily measurable indicator of overall health, functional capacity, and longevity. Maintaining or improving that grip strength through regular strength training is important, especially as we age. When we do, our physical resilience, functional independence, and, ultimately, our healthspan.

References

4. Fiber Intake and Digestive Health

Fiber is a type of carbohydrate that the body cannot digest, but it plays a crucial role in creating a healthy gut biome. We get our dietary fiber from plant-based foods: fruits, vegetables, whole grains, legumes, nuts, and seeds. It comes in two forms: soluble fiber, which dissolves in water and can help lower blood cholesterol and glucose levels, and insoluble fiber, which does not dissolve in water and helps promote regular bowel movements, while providing pre-biotic material.

A significant body of evidence supports the link between higher fiber intake and reduced mortality risk. A large-scale meta-analysis published in the Lancet reviewed data from over 58 clinical trials and observational studies involving more than 4,600 participants. The study found that individuals who consumed the highest amounts of fiber (at least 25–29 grams per day) had a 15–30% decrease in all-cause and cardiovascular-related mortality compared to those with the lowest fiber intakes. The researchers also noted a dose-response relationship, meaning that higher intakes of fiber were associated with even greater reductions in risk to the upper recommendation.

Fiber intake also ties closely to cardiovascular health. A study in the Journal of the American College of Cardiology found that for every 10 grams per day increase in fiber intake, there was a 10% reduction in the risk of cardiovascular events, such as heart attacks and strokes. Soluble fiber, in particular, has been shown to reduce levels of LDL cholesterol, which is a key risk factor for cardiovascular disease. Another study in the British Medical Journal reported that individuals who consumed the highest amounts of fiber had a 24% lower risk of developing coronary heart disease compared to those who consumed the least.

Higher fiber intake is also associated with a reduced risk of type 2 diabetes. A comprehensive analysis of prospective cohort studies published in the PLOS Medicine journal found that individuals with the highest fiber intake had a 25% lower risk of developing type 2 diabetes compared to those with the lowest intake. The study highlighted that for every additional 8 grams of fiber consumed daily, there was a 15% decrease in the risk of type 2 diabetes. This protective effect appears to be due to fiber's ability to improve insulin sensitivity and regulate blood sugar levels.

Fiber plays a crucial role in maintaining gastrointestinal health by promoting regular bowel movements and preventing constipation. A study published in the World Journal of Gastroenterology found that fiber has been shown to support a healthy gut microbiome by serving as a prebiotic—providing food for beneficial gut bacteria, which in turn produce short-chain fatty acids (SCFAs) that have anti-inflammatory effects and promote gut health.

Unfortunately most people do not consume enough fiber. The average daily fiber intake in the United States is around 16 grams, while the recommendation of 25 grams for women and 38 grams for men, is suggested by the Institute of Medicine.

Fiber is an often overlooked part of our diets and goes well beyond digestive health to reduced risks of cardiovascular disease, type 2 diabetes, and certain cancers. Regularly getting in a decent amount of fiber is a simple, but powerful strategy for enhancing longevity and quality of life.

References

5. Protein Intake and Muscle Maintenance

Protein is one of the three macronutrients affecting our body's structure, function, and regulation of tissues and organs. As we age, keeping our protein intake high enough becomes increasingly important for preserving muscle mass, strength, and overall health. That intake may increase to overcome the resistance to muscular anabolism and conveys a variety of health benefits including: reduced risks of sarcopenia, improved bone health, and enhanced metabolic function.

Maintaining muscle mass and strength is, as we mentioned earlier, important for healthy aging, and protein is central to this. Sarcopenia, the age-related loss of muscle mass and strength, affects up to 50% of individuals over the age of 80, contributing significantly to frailty, disability, and reduced quality of life. A study published in the American Journal of Clinical Nutrition found that older adults who consumed higher amounts of protein (at least 1.2 grams per kilogram of body weight per day) had a 40% lower risk of developing sarcopenia compared to those with lower protein intakes (less than 0.8 grams per kilogram). We also know that protein intake is essential for muscle protein synthesis, which is the process of the body repairing and building muscle.

People often do not realize that protein is also critical for maintaining bone health. A study in the Journal of Bone and Mineral Research found that higher protein intake was associated with a 20% reduction in the risk of fractures in older women, especially when combined with adequate calcium intake. The study emphasized that dietary protein helps maintain bone density by providing the necessary amino acids for collagen synthesis, a key component of the bone matrix. Another study published in the Osteoporosis International journal showed that each 10-gram increase in daily protein intake was associated with a 14% reduction in the risk of hip fractures among older adults. Further reducing all-cause mortality associated with falls.

Protein intake also has an impact on metabolic health. A study in the American Journal of Clinical Nutrition demonstrated that a relatively high-protein diet (approximately 25-30% of total caloric intake from protein) resulted in greater weight loss and improved body composition when compared to a lower protein diet (approximately 15% of total caloric intake from protein) .

Adequate protein intake can also improve insulin sensitivity and help regulate blood glucose levels, reducing the risk of type 2 diabetes. A meta-analysis published in Diabetes Care found that individuals who consumed higher amounts of protein had a 25% lower risk of developing type 2 diabetes compared to those with lower protein intakes. Protein has a very strong effect on satiety signals and reduces overall calorie intake, which reduces the levels of glucose and improves the body's ability to manage blood sugar.

Proteins are composed of amino acids, nine of which are essential and must be obtained through the diet. The amino acids profile of those proteins are an important thing to consider. Animal-based proteins: meat, fish, eggs, and dairy, are considered "complete" proteins because they contain all essential amino acids in adequate proportions. Plant-based proteins, found in beans, legumes, nuts, and grains, are “incomplete” proteins missing one or more essential amino acids, but can be combined to create a better amino acid profile. A study in the Journal of the Academy of Nutrition and Dietetics found older adults who consumed a combination of animal and plant-based proteins had better muscle strength and physical performance compared to those who consumed primarily one type of protein. This suggests that a varied diet is always essential and might offer the best benefits for healthspan.

Adequate protein intake is crucial for maintaining muscle mass, bone density, and metabolic health, especially as we age. By ensuring a sufficient and balanced intake of high-quality protein, individuals can support muscle maintenance, reduce the risk of fractures, and improve metabolic function, contributing to a longer and healthier life. Making sure you consume a variety of protein sources can help maximize these benefits.

References

The Challenge Ahead: Obesity and Healthspan

Now, for a more sobering reality check: the majority of Americans are clinically overweight, and projections indicate that by 2040, an outright majority could be clinically obese. This trend is concerning, as obesity is associated with a higher risk of numerous chronic diseases, reduced life expectancy, and increased healthcare costs. Current predictions suggest that life expectancy for future generations may decrease compared to their parents, primarily due to lifestyle-related health issues. Addressing these challenges requires honest effort and a commitment to promoting healthier habits without political distractions.

We Control the Future

In summary, while short-term goals are important for building the habits necessary for a longer, healthier life, understanding and focusing on the key physical components that contribute to healthspan can help us live longer, and better. By prioritizing cardiovascular fitness, strength, balanced nutrition, and weight management, we can all take meaningful steps toward extending our healthspan and enhancing our quality of life. This means spending more time doing what we enjoy most—exploring the world and showing younger generations that age brings wisdom without sacrificing strength and skill.

Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new health regimen, particularly if you have pre-existing medical conditions or concerns.

‹ The Case for Daily Mobility

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Ready to

stop starting over?

If you're done with quick fixes and want a real plan built around your life — I’m here for it. No pressure. Just progress, built step-by-step.