You can’t be financially independent without also learning how to be healthy. You need to make sure you’re around to enjoy it all.
This guide will share a very important topic any fat FIRE reader should know: longevity.
I will share the latest research on the goals, strategies, and tactics on how to be healthy and live forever.
Most of the research in this guide comes from Dr. Peter Attia. I hope this will inspire you to start thinking about your health in addition to your finances.
Disclaimer: FatfireWoman.com is not a medical advisor. All health opinions expressed by FatfireWoman.com are from the personal research and experience of the owner and are intended as educational material. It is very important that you do your own research, talk to a licensed medical professional before making any medical decisions.
Why Learn How to Be Healthy?
Why do we want to learn how to be healthy? Because life is finite.
Disease kills and it doesn’t discriminate.
It doesn’t care how rich, nice, or smart you are. And disease doesn’t care who you love or how much you mean to others.
Most of our great grandparents died in their 60s. Many of our parents plan to live into their 90s.
It’s entirely possible that many of us will celebrate 100th birthdays and break records to live beyond the 110s and into the 120s.
Don’t believe me? Read and you’ll find out how.
Why Live Longer?
Why do we want to be healthy and live forever?
It looks like a silly question but it’s important you answer this for yourself.
For me, wanting to live longer took a different meaning when I had my first child.
I want to pass down my culture to my grandkids. I want to explore and learn in my old age. And most of all, I can’t wait to see the technological development in the next 100 years.
Why do you want to live longer? Do you have a reason that propels you to learn how to be healthy and live forever?
How to be Healthy: the Goal
The goal of longevity is not only to live longer, but to also live fully.
What does this mean? It means we want to not only live into old age, but to still be able to do all the things we want to do at that old age.
Lifespan is the quest to live forever. Healthspan is the quest to be healthy.
Together, healthspan and lifespan determine longevity.
Here’s a graph that puts lifespan on the x-axis and healthspan on the y-axis.
Lifespan is simply how old that person is:
Healthspan is the quality of your life while you are alive.
But what exactly is “quality” when it comes to your health? Let’s dig into that a bit more.
Measuring “How to be Healthy”
We can think about the quality of your life in four parts:
Our goal is to optimize all four parts to achieve perfect quality.
The quality of your life heavily depends on a sharp and clear mind because our mind controls everything we do.
As you get older, your brain gets slower and deteriorates.
Eventually your brain may even succumb to a neuro-degenerative disease such as dementia or Alzheimer’s.
Without a healthy mind, you’ll have trouble doing the following:
- Completing everyday tasks
- Have self control
- Remember things
- React quickly enough to changes (such as while driving)
These things are generally called executive function, short term memory and processing speed.
Without them, people can die very quickly due to their inability to do everyday tasks without hurting themselves.
Alzheimer’s is an example of a neurodegenerative disease that can render the person completely dependent on others to live for the rest of their lives.
Our body can also deteriorate like our mind.
We are not talking about an elite athlete unable to run a marathon or do a split. We’re talking about slowly not being able to do the basic, necessary things in life.
Our body deteriorates in three ways:
- Losing muscle mass
- Losing functional movements.
- Physical Pain
Losing Muscle Mass
As we age, we lose our muscles. Yet we need to have enough muscle to do basic things like carrying something without falling over.
When we lose too much muscle, we could become so weak that we are more prone to injury and falls – you see this happen frequently to older people.
Muscle is also important because other than the liver, muscle is the only other part of your body that absorbs glucose.
This is why you rarely see diabetic people with a lot of muscles.
What’s worse, it’s harder to get muscles the older you get.
Older people become weak because they lose so much muscle mass that they eventually can’t hold themselves up and falls with a slight bend at the knees or trip at the feet.
Suppressing or stopping muscle decline due to aging is key to longevity
Losing Functional Movements
Similarly, we also need to preserve our functional movements to maintain quality of life.
A core functional movement to keep is the ability to hip hinge so if you drop something, you can squat perfectly to pick it up without breaking your back or straining your knees.
Sadly, there’re lots of studies that show that hip hinge starts to go away as early as once students start grade school.
The worst bone to break is the pelvic bone where the person can’t hip hinge correctly and falls to the ground.
The stronger the muscle and denser the bone density, the more likely this person can perform basic functional movements, and thus less likely to get an injury and be bedridden and die early.
And last but not least, a quality life means we want to be free of physical pain.
The reality is that if you are over 30 you probably experience some form of back pain. If you haven’t experienced it you will soon.
Some people have so much pain that they can’t function without medication.
Pain is inevitable with aging. But with proper training, we can delay it and lessen the pain.
Physical pain is not the only pain that matters. Let’s talk about emotions.
Humanity is connected with each other through suffering. We suffer because we are human. And we suffer because we love.
Your quality of life is very much dependent on your ability to tolerate suffering, that is, the emotional stress of living life.
Emotional distress can be both chronic and acute in nature. It can be a traumatic event such as abuse or death of a loved one, or the minor but chronic stress of driving in traffic.
The truth is people are born with different tolerance levels to suffering. Two different people could both be stuck in traffic but one experiences chronic stress while the other barely view it as coping.
For reasons we won’t get into here, some people just have an enormous amount of distress tolerance while others struggle to find their peace.
Those who can withstand emotional stress will certainly experience a higher quality of life.
The good thing is like exercise, you can learn to build up your emotional distress tolerance and ability to live through stress.
You can proactively learn to improve your emotional distress tolerance level by talking to a therapist.
Getting a therapy might change your life and greatly increase your quality of life. So invest in yourself and take the time to take care of your emotions.
Those who live a high quality life often live with purpose. This purpose can be as simple as being the best mother to your child or as ambitious as to change the world.
Further, those who live a high quality life often have social support – people to live for and live with.
Having a why to what makes your life worth living directly impacts your quality of life.
Insomnia is a sign of midlife crisis, and really, midlife crisis is the loss of meaning and direction in life.
How to be Healthy: Quality
Nobody has a perfect score on mind, body, emotion, and meaning.
Stephen Hawking, the famous Nobel Prize-winning physicist, had an extremely low-quality life on his body. He has ALS and cannot move or speak and must eat via a feeding tube.
But Stephen Hawking is vastly more satisfied with his life than most people with perfect bodies.
What Stephen Hawking lost in the body he more than made up in mind – having a mind so sharp that he taught us new things about the black holes.
Stephen Hawking probably also has a strong emotional tolerance for distress. And of course, his purpose in life is clear: advancing the field of quantum gravity and being an advocate to disabled people everywhere.
How would you assess yourself today, and what are you willing to do to take your quality of life to the next level?
The Strategy on How to be Healthy
When you are born, your healthspan starts out at a pretty solid place. Your healthspan improves as you grow up, get stronger, and develop emotional maturity and purpose.
Your quality of life peaks around 40 years old. For the first decade after 40, the downhill is barely noticeable.
But after 40, things start to go downhill.
And by the time you hit 65, your health decline starts to pick up pace.
Longevity is maximizing your lifespan (age) while delaying the rate of decline of healthspan (quality of health).
In your 40s, you can still eat junk food and not see much damage. But once you are nearing your 60s, it’s like the flood gate has opened and everything will start to break at once.
Once your health starts to decline, it’s very difficult and maybe even impossible to stop.
Longevity is a long-term game, you have to start as early as possible.
Why Have a Strategy on How to be Healthy?
Today, we spend a lot of money on drugs to live with chronic diseases and pain. We barely spend any money on disease prevention.
If you have a disease like HIV, you wouldn’t need to discuss strategy. Doctors would jump straight to the tactics of giving you a range of antiviral drugs for treatment.
Why? Because we don’t need a strategy for HIV, we already know how to best treat it. This is a success story in medicine.
But we can’t test our way into living forever.
We can’t do a clinical trial of children across their life to get a clear answer on how to be healthy and live forever.
All we can do is deploying strategies to delay the rate of decline of our healthspan.
Now, let’s delve into the three major strategies to longevity:
- Study of Centenarians
- Research on life extension in animals
- How molecules (cells) regenerate and grow
How to Be Healthy Like Centenarians
Centenarians are people over 100 years old; they are about 0.4% of our population.
We think if we can learn what makes them live for such a long time, maybe we can take their secrets to us normal people.
It turns out that the #1 important thing is genetics. Centenarians are actually no more likely to engage in healthy behavior than those who die early.
Longevity is highly under the influence of genes. But we can’t change our parents, so should us normal people just give up?
Why Do People Die?
If you take someone above 40 years old who does not smoke and is not suicidal, 80% of them will die from one of these 4 diseases:
- Blood clot to the heart (Heart Attack) or the brain (Brain Haemorrhage)
- Neuro-degenerative disease (Alzheimer’s)
- Accidental death, 80% of which fall into 3 categories
- Accidental poisoning (alcohol, drugs)
- Falling (irrelevant until you get to your 80s)
So unless you are suicidal (actually a major problem in our society) or a smoker, the above four diseases account for why 80% of us will die one day.
Is this how centenarians die? Because if we can spot differences in how normal people die differently, maybe we can learn about where we should focus on to extend life.
Why Do Centenarians Die?
It turns out that Centenarians die the same way as us mortals. With some exceptions:
- More Centenarians die of some sort of blood clot in the brain.
- Fewer Centenarians die of cancer
- Similar number of Centenarians die of neuro-degenerative disease
- More Centenarians die of pneumonia.
We learned that Centenarians are not immune to death. In fact, they get the same kind of chronic diseases everybody else dies from. They just get them much later in life.
Rest of us see early signs of the same diseases 20 years earlier, in our 60s.
The key to living longer is delaying the onset of chronic disease.
Delay the Onset of Chronic Diseases
A disease is like the interest rate; it compounds.
Just because somebody has a heart attack at the age of 69 does not mean that they were fine at the age of 68. They were definitely not fine and riddled with diseases, invisible but present, long before that heart attack occurred.
The question is: what could that person have done that is early enough so that the disease is not clinically evident by 69?
If we start trying to get healthy when diseases show up, it might already be too late. We need to start delaying the disease well before it becomes visible.
We need to delay the disease at its onset – the very beginning, before the beginning.
But how do we delay the chronic diseases at the onset? Let’s ask the Centenarians
Genes that Cluster in Centenarians
How are centenarians able to delay the onset of chronic diseases? We look to their genes to answer this question.
It turns out that centenarians tend to have the following
- Hypoactive apoC3.
- An inactive apoC3 gene tends to lead to lower triglycerides and ApoB (lower means good).
- Hypoactive PCSk9
- Inhibiting this gene allows people to more easily clear ApoB out of circulation.
- More likely to have AE2 over 3, 4
- With Ae2, the person has a 20x reduction in Alzheimer’s disease
- Less IGF1
- This gene promotes cancer development, so less of this protects us from cancer.
As you can see, some genes are tied back to diseases, and having a less active version of this gene makes you very lucky in the longevity lottery.
But if you didn’t get lucky with genes, you can still change your behavior to mimic what these genes tend to contribute toward.
And that’s where animal research comes in.
Insights on How to be Healthy from Animals
We can’t conduct longevity research on humans but we have conducted longevity research on many types of animals.
Simple organisms like yeasts and flies surprisingly share many common traits with humans, and of course, mammals like monkeys or mouse also share many common traits with us.
We want to find interventions that have consistently extended life in all forms of life, from yeasts, flies, to worms and mammals
If we have, these things are more likely to also work on humans.
From longevity research in animals, a few themes jump out.
Food Restriction Works
Research in animals found that some combination of calorie and dietary restriction seems to have an impact on longevity.
With calorie restriction, overeating leads to death more quickly. And consuming fewer calories than your metabolic needs tend to extend life.
With dietary restriction, restricting macronutrients, such as protein, sugar, rather than the amount of food we eat, also seems to help.
There is a famous NIH and University of Wisconsin 18-year study on monkeys that found that calorie restriction doesn’t really work if you are already eating healthy.
But the worse your diet, the more calorie restriction starts to matter.
This is why some people mimic calorie restriction using a method called intermittent fasting.
With dietary restriction, the clear finding is that too much sugar is bad for you, and too many carbs may also not be ideal.
If you are interested in learning more about fasting, here’s a great AMA from Peter Attia’s podcast about it.
One Drug Improving Survival
A lot of drugs have also been tested on animals to measure whether they extend life.
Only one drug has demonstrated consistently an advantage in survival. This drug is Rapamycin.
Rapamycin extends life across the spectrum. Another drug that’s coming up is metformin.
Rapamycin and metformin work on a protein called mTOR. Specifically, both drugs are mTOR inhibitors.
mTOR is a protein that plays a role in the growth and non-growth of cells. Inhibiting mTOR has been shown to have multiple anti-aging, anticancer, and anti-cardiovascular disease benefits.
In some ways, this drug does the same thing as fasting. Fasting restricts the growth of cancer cells at the macro level and Rapamycin and Metformin restrict at the micro-level.
We’ve done genetic experiments on yeasts, specifically a yeast called C. elegans has a longevity curve like humans.
The research of C. elegans found that modifying its genes can extend the lives of C. elegans by 2.5 times, or from 80 years to 200 years!
And the life of a C. elegan with its genes edited to perfection can live until 200 years old and has the quality of life at its peak the entire time until the day it drops dead.
Imagine us humans living like that!
Molecular Insights on How to be Healthy
Putting everything together, here’s how we understand aging and diseases:
- Nutrient sensing: our cell’s ability to detect and process glucose
- Autophagy: our cell’s ability to clean out damaged cells
- Senescence: our cell’s ability to poison other cells
- Inflammation: our cell’s ability to defend our immunity
Nutrient sensing is a cell’s ability to recognize and respond to what we eat, specifically, fuel substrates such as glucose.
We didn’t evolve to live the way we currently live, which is to eat so much nutrient-dense food high in glucose.
In fact, less than 0.1% of our genetic existence has been exposed to this amount of nutrient density!
Nutrient sensing is survival. It starts in the mouth with taste helping us make the decision to ingest good food and reject spoiled or poisonous food.
Then, our gut continues to monitor the food, including detecting and processing glucose.
What you eat impacts how cells breakdown, and there’s something about how cells breakdown that then either causes aging, cancer, or the lack thereof.
Autophagy is the body’s way of cleaning out damaged cells in order to regenerate newer, healthier cells.
When your cells don’t or can’t initiate autophagy, bad things can happen, from neurodegenerative diseases to diabetes.
So autophagy plays a very important role in living longer.
Fasting inhibits mTOR activity, which in turn activates autophagy. And this only begins to happen when you substantially deplete your glucose stores and your insulin levels begin to drop.
In mice deprived food, autophagy increases after 24 hours and this effect is magnified in cells of the liver and brain after 48 hours.
In humans, autophagy has been detected starting at 24 hours of fasting. Exercise together with caloric restriction through fasting can also increase autophagy in many body tissues.
This is not ready for prime time and not clearly helpful in humans. But In animal models, there are cells in the body that are poisoning other cells to advance aging.
When you knock these cells out, you advance longevity.
We know that cardiovascular disease is a highly inflammatory disease. The more we understand the science, the more we can modulate to reduce inflammation.
Many people have chronic inflammation.
Interestingly, autophagy helps regulate inflammation, increasing inflammation when the invader is present or decreasing inflammation by removing the signals that trigger it.
You see, everything is connected together in longevity: our behaviors cause glucose spikes, and we may experience chronic inflammation. Autophagy seems to be an effective way to lower glucose and reduce and regulate inflammation. And autophagy can be achieved through fasting.
So is fasting the only thing we need to do? No, there’s more. Read on to learn the top 8 tactics on how to be healthy and live forever.
Tactics on How to Be Healthy
We’ve said so much. So let’s dive into the tactics of how exactly are we going to extend life.
There are eight tactics:
- Manage distress
- Learn / unlearn behaviors
How You Eat
Try to keep carbohydrate consumption such that your daily average glucose is below 85 mg/dl.
You can buy a blood glucose monitor at any CVS store to measure your glucose. With one poke of a finger, you can understand your glucose level.
Try to measure your glucose first thing you wake up before you eat, and then one hour and two hours after you eat.
Most doctors think you are fine as long as your glucose is under 120 mg/dl. And people are only diagnosed with diabetes when their glucose exceeds 140 mg/L. Even then, the doctor puts you on some sort of insulin.
But if your morning glucose is above 120, you’ve been too high in glucose for a long time already.
The ideal state is to keep glucose at 85 mg/dl average with a standard deviation of less than 15 mg/dl.
Why the standard deviation? Because homeostasis is important. We not only want a low average, but we also want low fluctuations throughout our day.
What drives up glucose and makes it spiky? Carbohydrates. The worst kind of carbohydrates are straight up sugar. But carbohydrates from rice, bread, pasta, and potatoes can also drive up glucose!
So you can and should eat carbs, but you have to monitor and make sure you are not eating too much of it.
A typical good portion is actually 1/4 of a bowl of pasta or 1 slice of bread yet most people eat multiple times more per day.
The research says that you should consume a barely positive nitrogen balance.
A negative nitrogen balance means you’re malnourished. But too much of a positive is also not good.
Excess amino acids beyond what’s necessary to maintain muscular congruence might make diseases progress faster.
While you can measure your nitrogen balance with a urine test, you shoud make sure you eat enough but not too much.
Fat is the balance after carbohydrate and protein are adjusted for. It is dependent on how you partition fuel. And fat is the balance of mono, saturated, and poly-saturated fat.
Some fat is better than others. For many decades we thought fat is bad. So we bought a lot of fat free stuff.
But the latest research suggested that while too much fat is bad, some fat is better than others. Olive oil is a good fat, for example, and artificial trans fats and saturated fats are bad.
Today, I’d recommend that you avoid any fat-free stuff because in order to make that stuff taste good, many companies replace fat with sugar, which is even worse.
How You Exercise
Exercise is extremely important to maintain muscle mass and functional movement.
But there is a risk of over-exercising. Very serious athletes have a 7-10x higher risk of a heart attack.
Why exercise? The metabolic advantage of exercise is glucose disposal.
Glucose can only go to the liver or the muscle. The liver has a limited capacity but muscle has the flexibility to absorb more.
So the bigger you can store glucose in muscle, the more you can tolerate.
Muscle is also good for injury prevention. You want your type 2b muscle activated.
If you don’t like exercise, just do very heavy strength training like deadlifts or squats and rowing.
For people who like to exercise, you can do both strength training and interval training on a bike or treadmill or a HIIT workout.
A lot of strength training exercises depend on your ability to correctly hip hinge. What is this?
The hip hinge is limiting the movement of the entire system to have all flex be driven by the hip joint. The goal of a hip hinge is to have the spine stay neutral throughout the entire movement – and this requires your core to stabilize the spine.
Once you have some core stability, you can do more stuff, like lying on your back and pick up your butt, it’s sort of a functional deadlift.
Correctly doing hip hinge will allow you to do a correct deadlift, which is the most important strength straining you need.
But remember: learn the basics first. You want a deadlift to generate muscle on your hip and thighs, not to strain your back or your knees!
How you Sleep
Sleep is grossly underappreciated in our overworked society today.
Sleep is one of the most highly conserved behaviors that doesn’t seem to go away. If there is a way to out-evolve sleeping, we would’ve long evolved away from sleeping.
Sleep is wasteful and dangerous, and yet we continue to need it.
Sleep impacts your memory and testosterone level. And sleep deprivation hurts glucose disposal.
Lack of sleep, defined as six hours of sleep or fewer per night, can have serious consequences.
Sleep deficiency is associated with problems in memory, concentration, immune system, and may even cause us to die early.
Every disease that is killing us has casual to significant links to a lack of sleep. Alzheimer’s disease is linked to chronic undersleeping.
“You can sleep when you’re dead” is the worst advice because it can actually kill you.
Try to sleep 8 hours a day. It will extend your life.
How You Manage Stress
There are many techniques to distress tolerance, from cognitive behavior therapy, trauma counseling, family therapy, to MDMA-assisted psychotherapy.
Everybody has stress because Instagram lies. Everybody has anxiety on a daily basis.
Stress and anxiety are evolutionary traits that are good for us. In fact, studies have shown that a moderate amount of stress might even help with longevity! Though of course, too much stress can be toxic.
Some people can manage stress better than others. Your ability to understand and manage your stress will directly impact your health.
Stress will always be there, so don’t try to fight it or run away from it. Instead, learn to cope.
Seek help, talk to someone, and learn to live longer and thrive with stress.
What drugs you take
Should you be taking a drug to make your life better? Many of us don’t have a choice but to take medications.
But what about the drugs that optionally might enhance your health?
This is hard to say and since I am not a doctor, I won’t go into the details here.
Sometimes it’s better to follow doctor’s orders on medication. But other times it might be better to consider if all of that medication is necessary.
And sooner or later, we may be able to buy medicine specifically built for longevity.
What hormones you take
Same as above, I won’t go into details since I’m not a doctor.
But hormone therapy is sometimes used to treat menopausal symptoms and protect long-term health. But clinical trials also showed health risks.
Hormone therapy has been proven to prevent bone loss and reduce bone frastructure. This will help prevent someone from falling easily and breaking their bones easily, becoming wheelchair bound in old age.
And a person who has stopped walking will die very quickly compared to someone who can still walk a mile a day.
But hormone therapy has also been shown to increase the risks of major diseases from heart to blood to cancer. So consider carefully with a trained professional if hormone replacement therapy is right for you, particularly at the onset of menopause when your estrogen is depleted.
What vitamins you take
There’s been very limited research that multivitamins actually improve longevity.
There is some evidence that Vitamin D can help maintain calcium, which is vital for maintaining healthy bones.
There’s some evidence that vitamin D might help protect against becoming infected with, and developing serious symptoms of COVID-19.
We know, for example, that people with low vitamin D levels may be more susceptible to upper respiratory tract infections. One meta-analysis found that people who took vitamin D supplements, particularly those who had low vitamin D levels, were less likely to develop acute respiratory tract infections than those who didn’t.
I take this Calcium and Vitamin D pill three times a day. This is the highest quality calcium I’ve seen on the market and has really helped to reverse bone density loss in my parents.
Your ability to learn / unlearn behaviors
In order to be healthy you have to adapt quickly – continually unlearn old rules and relearn new ones.
Science is advancing rapidly and you can’t continuously optimize your health if you can’t manage to adapt to the latest best practices.
Unlearning is the process of realizing that something which we learned earlier is incorrect, admitting it and deciding to erase it from our behaviors.
When you resist learning new behaviors, the options available to you can narrow. Are you willing to run 3 miles a day to delay diabetes rather than starting insulin today?
The quicker you can adapt to change, the easier it is for you to fix the problem. Delaying correcting health becomes increasingly expensive until it becomes too late.
How to Be Healthy and Live Forever: Conclusion
I hope this becomes a framework from which you think about how to delay the onset of diseases.
Longevity depends on two things:
- How to be healthy (healthspan)
- How to be alive (lifespan)
Health is made up of many things, from the mind, the body, to your emotions and purpose in life.
In order to reach our goal of longevity, we can change our behaviors to mimic the genes of centenarians.
From controlled experiments on living organisms, we know that at the molecular level, the food we eat and the muscle we gain has a profound impact on how our cells regenerate and grow for the better or worse.
Autophagy, which can be triggered by fasting, maybe a way to lower glucose, slow down bad cell growth, and regulate inflammation.
The answers to how to be healthy and live forever are:
- Reduce carbohydrate intake and fast to keep glucose low and stable
- Build strength and muscle (learn to hip hinge correctly first)
- Sleep 8 hours a day
- Stress can be good, stress is necessary. Learn to cope with stress.
- Maybe, take drugs and hormones but only as a last resort and with a doctor’s approval.
- Preserve bone density mass, eat calcium and vitamin D.
- Be flexible to learn, unlearn, and relearn behaviors that iterate toward a just slightly better version of you every day.
I have no doubt that many people today can live past 100 years old if they adopt the right decisions and behaviors.
But it’s not enough to live for a long time, we also want to be able to do all the things we want to do, and live a life full of purpose.
Here’s to our quest on how to be healthy and live until we’re 120.
How to cope with negative emotions? Read: Why Am I Angry All the TIme? How to Control My Anger
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