As of today, no drugs, supplements or potions have been shown to extend your life, in spite of the fact that the internet is full of an incredible number of fraudulent life-extension products that provide no benefits while they steal your money. However, we do have overwhelming evidence that several healthful lifestyle habits can extend how long you live and improve your quality of life in your later years. These lifestyle factors have been associated with freedom from type-2 diabetes, heart and respiratory diseases, cancers, and other diseases that can make your life miserable.

A study of 116,043 European men and women, followed for 15 years, found that of 16 different lifestyle profiles, four were associated with the greatest disease-free life years (JAMA Intern Med, published online April 6, 2020):
• absence of obesity (BMI < 25),
• never smoked,
• exercised regularly, and
• drank no more than a moderate amount of alcohol.

Longevity and Quality of Life
In North America, the average man lives to age 76, and the average woman to age 81. Harvard researchers found that adopting five healthy habits could extend life expectancy by 14 years for women and by 12 years for men (Circulation, 2018;345:345):
• eating a diet high in plants and low in fats,
• exercising at a moderate to vigorous level for several hours a week,
• maintaining a healthy body weight,
• not smoking, and
• consuming no more than one alcoholic drink a day for women and two for men.

The team of Harvard researchers followed that study with another that found that by following a healthful lifestyle, women can extend their disease-free life expectancy after age 50 by 10 years, and men can add about eight more years (BMJ, Jan 8, 2020). Women who followed four out of five of the healthful lifestyle factors lived on average 34 more years without those diseases after age 50 compared to 24 years for women who said they did not follow any of the healthy habits. Men who reported fulfilling four or five of the lifestyle habits lived on average 31 more years free of disease after age 50 while those who adopted none of them lived on average 23 more years after age 50.

Longevity is determined by both genes and lifestyle, but genes are estimated to contribute only about seven percent, so lifestyle is much more important. Living with a person who practices a healthful lifestyle increases your chances of practicing a healthful lifestyle (Genetics, November 1, 2018;210(3):1109-1124), and parents’ healthful lifestyles can change their genes so that they pass on more healthful genes to their children (Epigenomics, Jun, 2011;3(3):267–277). This process is called epigenetic modification. Mothers who live to their 90s with a healthy lifestyle are far more likely to have healthy daughters who live to their 90s (Age and Ageing, Nov, 2018;47(6):853–860).

Alcohol Does Not Have Health Benefits
The authors of the European study found that those who took in 1-21 drinks a week had the most disease-free years. Next came non-drinkers, and as expected, those who took in more than 22 drinks per week suffered the most disease. However, other recent studies on alcohol consumption show that alcohol at any dose does not benefit health. One review of 45 studies found that the studies that associated moderate drinking with reduced heart attack rates were flawed (Journal of Studies on Alcohol and Drugs, May 2017;78(3):375-386). Studies designed to show that alcohol prevents heart attacks must have a control group of nondrinkers, but many members of the control groups were former drinkers who had given up alcohol because they were alcoholics, had heart, liver or kidney diseases, were diabetic, or had some other disease or condition that forced them to give up alcohol. When these unhealthy people are removed from the non-drinking control groups, the corrected studies show that even moderate drinking can shorten your life. Alcohol causes inflammation and oxidative stress that damages cells and increases risk for disease. There may be a threshold at which alcohol causes disease, but alcohol at any dose increases cancer risk and does not help to prevent heart attacks.

My Recommendations
Here are the major components of a healthful lifestyle:
• Diet: You should be eating primarily a plant-based diet with lots of vegetables, fruits, whole grains, beans, nuts and other seeds. Your main drink should be water; avoid fluids with calories, including fruit juices and adding sugar or cream to coffee or tea. I recommend that you avoid mammal meat, processed meats, fried foods and sugar-added foods. Restrict refined carbohydrates, particularly if weight control is an issue for you. That means everything that is made from flour or other refined grains such as bread, pretzels, bagels, spaghetti, macaroni, white rice, most cold breakfast cereals, and so forth.
• Exercise: Try to exercise for at least a half hour every day, and an hour is better. All exercise is beneficial, but increasing intensity at least once a week will help you even more. Resistance exercise to strengthen your muscles has been shown to help prevent heart disease and strengthen bones.
• Avoid smoke: Recent data show that you can shorten your life by breathing other people’s smoke (second-hand smoke) or even living in an environment where people have smoked previously (third-hand smoke).
• Avoid or restrict alcohol: Most doctors agree that men who take more than two drinks a day and women who take more than one drink a day, or have any pattern of binge drinking, are at increased risk for disease and premature death. I believe that no amount of alcohol has health benefits.
• Avoid overweight: The fat that kills is in your belly and around organs. Fat elsewhere is far less dangerous. Research shows that skinny people can be at high risk for heart attacks, diabetes and premature death if they store most of their fat in their belly (Annals of Internal Medicine, November 10, 2015), and the people who are at highest risk for premature death are those who have big bellies and small buttocks (J Bone Miner Res, July 2019;34(7):1264-1274). Your doctor can order a sonogram of your liver to see if you store too much fat there.