Dr. Ashley Riskin BSc, MD, CCFPFunctional Medicine

Healthy aging should be everyone’s goal. It’s the goal to live long enough and be well enough to enjoy life on your own terms! For me, with a young family, I want to be around for a very long time. I want to see my kids grow up. But I also want to be healthy. And I know you do too. So let’s take a closer look at the tactical steps we can all take right now to give our improved longevity a research-backed boost.

The science suggests that it’s all about our tacticsLongevity is a functional combination of lifespan and healthspan. Lifespan is the length of our lives. Healthspan is how long we live in good health. The goal is to lengthen both; to enjoy a long and healthy life. So what should we do? In no particular order, the variables that we must tactically adjust to tip the scales of longevity in our favour include: what we eat, how we sleep, how we exercise, how we manage distress, what drugs and supplements we take, and our ability to learn new behaviours. The science is evolving rapidly and we know that our knowledge in these areas will change in coming years, and that recommendations must be specific to the individual person. But broadly speaking, here are some of the most actionable insights in some of the most critical categories.


The current state of nutritional research is not yet optimal and mainstream nutritional recommendations are lacking. The typical North American diet is perhaps the worst in human history. So any improvement on the nutrition front will be of benefit to all. Our individual macronutrient needs depend on our sleep, stress, exercise levels and, likely, the microbiome of our gut. Here’s what we know:

  • Carbohydrates: consider your daily intake. All carbs break down into sugar. Ultimately the goal here is to keep your glucose in a mid-normal range with the least number of spikes as possible. This helps keep insulin secretion in check and avoids the yo-yo’ing of insulin/glucose that can be detrimental.
  • Protein: think about your daily intake. We are learning that amino acids are involved in nutrient sensing pathways (longevity pathways) and that too much protein on a regular basis can be a problem. The trade off is that too little protein will ultimately lead to muscle wasting as we age. The take home message is that too much protein over time isn’t good and may be counterproductive.
  • Fats: there’s both good and bad fat. Good fats should play an important role in your nutritional intake. We now know that good fats aren’t to be feared like we once thought—even some dietary saturated and cholesterol rich fats have their place. But staying away from conventional vegetable oils and all oxidized (fried) fats is vitally important.
  • Diets: there are so many! Paleo vs keto vs vegan vs Mediterranean vs high-fat-low-carb (HFLC). Again, a general recommendation is not simple and always depends on how you personally utilize nutrients, along with some of the other factors already noted above. In general, the trend is certainly a move away from processed carbohydrates and toward increasing healthy fats, and to a quality over a quantity approach to protein.
  • Fasting: this is the removal of food for a specific period of time. And it appears to be one of the most profound interventions available to us today. As a rule, we should all strive to have longer periods of not eating within each day than we currently do. And we should consider implementing longer fasts (or modified fasts) on a somewhat regular basis throughout the year.


Often overlooked or just glossed over, sleep is one of our innate behaviours that is highly conserved—meaning after years of evolution, we haven’t been able to reduce the need for it despite it occupying roughly 1/3 of our lives. Obtaining adequate, restorative sleep must be viewed as non-negotiable. As we age, sleep tends to deteriorate and we should do all we can to address this. The impact of inadequate sleep on glucose, hormones (sex-hormones, cortisol, insulin and more) and memory is detrimental. In my medical practice, we’ve moved toward using sleep trackers to assist in quantifying patient sleep patterns, and to in-home screening to rule out obvious sleeping disorders.


The importance of moving your body cannot be overstated. We already know the facts on the benefits to immune function, mood, sleep and hormones.

  • From a lifespan perspective, exercise plays a key role in glucose disposal. Apart from the liver, which has a finite capacity to store glucose, we know that muscle plays a key role and has potentially much larger abilities to store glucose as glycogen. Exercising improves muscle mass which allows for better glucose disposal with less insulin requirements.
  • From a healthspan perspective, exercise leads to preservation of muscle mass and muscle stability as we age. Exercise also yields many structural benefits including injury prevention. And since aging without pain is a key goal, the bottom line is that exercise is imperative, not optional. Strength training, when done correctly, is possibly the most important focus.

Distress Tolerance

This is essentially mindfulness. Our ability to be resilient in stressful situations is important. Socially, we tend to be in a reactive state most of the time—always on edge and with constant low-grade stress. We didn’t evolve to be in this over-stimulated environment with constant texts, alerts, screens, traffic, bills and more!

Our autonomic nervous system views all of these stimulants as threats. And in reality, most of the over-stimulation is insignificant and won’t have any bearing on our survival, yet our bodies don’t know this, and we remain in a highly sympathetic (stressed) state.

Our challenge is to be still and be more present. We must seek new ways to be more mindful.

Other Compounds

Supplements, drugs and hormones can be a part of an overall longevity strategy.

  • Supplements: this is again very individualized and it’s challenging to make broad recommendations. However, as we age, certain cellular functions are lost, and some supplements are showing intriguing plausibility to counter this process. Specifically, supplements are attempting to address cellulary energy such as NAD, as well as a class of proteins called sirtuins that play a role in cellular aging. There are also novel compounds being developed to improve arterial health that warrant a look given the number one killer starts in our arteries.
  • Drugs: pharmaceuticals also have possibilities in longevity. Active research into drugs like rapamycin, and similar compounds, is ongoing for their effects on longevity. Metformin, a diabetic drug, is equally compelling. It appears to affect the nutrient sensing pathways, similar to a fasted state, and has been used in the longevity space frequently.
  • Hormones: many of our hormones decrease as we age and there is a reasonable argument to be made that replacing some, or all, can provide health benefits. This is most definitely individually focussed and medical history needs to be factored in.

The Take Home

Like it or not, time is ticking! So let’s make our collective longevity a simple and common goal.

The science of longevity is fascinating and evolving rapidly. And the notion that we can improve our healthspan and enjoy our lives for a longer portion of our time on this planet is finally attainable.

With careful screening, lifestyle modification and introduction of certain hormones, supplements and possibly medications, we can make impressive strides. The future looks long—and healthy!

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