Your Top Five Tools for Longevity

The conversation around longevity is growing – and for good reason. We're living longer, but the goal is not just a longer life – it’s a healthier, more vibrant one. As interest in longevity explodes, the strategies being shared are just as varied. Some are accessible and familiar, like reducing sugar or managing stress. Others, like cold plunges or the off-label use of medications such as metformin, are more extreme or experimental.

While it's tempting to turn to the latest supplement or headline-making trend, the real foundation for longevity is built through sustainable lifestyle practices. These core strategies have the power to improve energy, reduce disease risk, and help us thrive well into older age.

Here’s how I think about creating a strong foundation for lifelong health, starting with these five essential tools.

1. Optimizing Your Metabolic Health

Metabolic health refers to how efficiently your body converts food into energy, and it's central to virtually every aspect of your long-term health. A healthy metabolism helps regulate blood sugar, blood pressure, and cholesterol levels. When these markers are in balance, you're less likely to develop chronic diseases such as cardiovascular disease, diabetes, cancer and neurodegeneration.

What does this look like in practice?
Personally, I focus on organic vegetables, fresh herbs, and well-sourced animal protein, once or twice daily. That said, I also work with patients who follow vegetarian, ketogenic, or other dietary preferences. Food is deeply personal – it’s not just fuel, but also culture, connection, and joy, so I like to remain flexible in my approach to nutrition with clients. But I believe there are fundamentals of nutrition that can help us all improve our metabolic health.

  • Prioritize protein with every meal: Protein promotes satiety, preserves lean muscle mass, and helps regulate blood sugar. A general target is around 1.6–2.2g of protein per kilogram of body weight per day, though individual needs vary.

  • Focus on whole, minimally processed foods: Processed foods are often loaded with refined sugars, seed oils, and additives that disrupt metabolic health. Center your diet on non-starchy vegetables, low-sugar fruits (like berries), healthy fats (avocados, nuts, olive oil), high-quality proteins, and legumes.

  • Minimize glucose spikes: Stable blood sugar supports steady energy, mood, and cognition. Eat fiber, fat, and protein before carbohydrates, avoid “naked carbs” (carbs without accompanying protein or fat), take a short walk after meals, and even use a continuous glucose monitor (CGM) for personalized insights.

  • Stay hydrated: Hydration isn’t just about water. Minerals like sodium, potassium, and magnesium are essential for metabolic function. Be sure to drink enough water and add electrolytes to your water, when needed.

Helpful markers to track metabolic health and optimal ranges:

  • Fasting Glucose: 70–85 mg/dL

  • Fasting Insulin: 3–7 µIU/mL

  • Hemoglobin A1c: <5.3%

  • Lipid Panel:

    • Triglycerides: <80 mg/dL

    • Apolipoprotein B <90

While these are helpful targets, cholesterol values should be interpreted in context, especially Apolipoprotein B. Advanced markers like Lp(a), CRP-hs and homocysteine, offer a more complete picture of cardiovascular risk.

  • Blood Pressure: <120 mmHg systolic and <80 mmHg diastolic

  • Waist Circumference:

    • Women: <31.5 inches (80 cm)

    • Men: <37 inches (94 cm)

2. Using Exercise as Medicine

Exercise is one of the most powerful tools for improving health and longevity. It benefits metabolic and cardiovascular health, increases insulin sensitivity, builds muscle, reduces inflammation, and supports cognitive function. Exercise also boosts brain-derived neurotrophic factor (BDNF), which helps brain cells grow and thrive. High-intensity interval training (HIIT) enhances this effect by increasing lactate, offering neuroprotective benefits. 

Helpful markers to assess and guide fitness goals:

  • VO2 Max (cardiorespiratory fitness): VO₂ max, a key measure of how efficiently your body uses oxygen during exercise, is one of the strongest predictors of overall health. Improving VO₂ max through aerobic training and HIIT enhances endurance, metabolic efficiency, and heart health. Tracking your VO₂ max over time, using a smart watch or a lab-based test, can offer valuable insight into your fitness and longevity trajectory.

VO2 Max Reference Chart for Women

Table reproduced from Mandsager et al., 2018 (doi:10.1001/jamanetworkopen.2018.3605).

 

VO2 Max Reference Chart for Men

Table reproduced from Mandsager et al., 2018 (doi:10.1001/jamanetworkopen.2018.3605).

  • ALMI (Appendicular Lean Mass Index): Muscle mass is a critical predictor of longevity and overall quality of life. Maintaining and building muscle through resistance training as we age reduces the risk of numerous diseases and significantly enhances our well-being. The Appendicular Lean Mass Index (ALMI) measures muscle mass in the arms and legs relative to height, providing insight into how your muscle mass compares to others of the same age and gender. A higher ALMI is associated with a longer healthspan and improved quality of life, making it an essential factor in aging well.

ALMI Reference Chart for Women

Table reproduced from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176161.

 

ALMI Reference Chart for Men

Table reproduced from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176161.

3. Lowering Inflammation

Chronic inflammation is a silent contributor to many age-related diseases, including heart disease, cancer, and cognitive decline. Reducing systemic inflammation is one of the most effective things you can do to support longevity.

How to lower inflammation:

  • Eat a nutrient-dense, anti-inflammatory diet: Emphasize colorful vegetables and fruits (especially berries, leafy greens, cruciferous veggies), omega-3-rich foods (like wild-caught salmon, sardines, walnuts, and flaxseeds), and anti-inflammatory herbs (turmeric, ginger, garlic). Choose organic when possible to reduce pesticide load.

  • Avoid processed foods and added sugars: These promote inflammation through oxidative stress, insulin resistance, and gut dysbiosis. Focus on whole, unprocessed foods and limit sugary drinks, refined carbs, and packaged snacks.

  • Reduce exposure to environmental toxins: Choose non-toxic cleaning products and natural personal care items (free of parabens, phthalates, and synthetic fragrances). The Environmental Working Group Skin Deep database is a great source for finding healthy personal care products. Avoid heating food in plastic containers, and opt for glass or stainless steel food storage containers when possible. Use a water filter to reduce exposure to heavy metals and endocrine disruptors.

  • Manage stress levels: Chronic stress increases cortisol and promotes inflammation. Support your nervous system through daily practices like breathwork, meditation, journaling, or spending time in nature.

  • Prioritize restorative sleep: Poor sleep increases inflammatory markers like CRP and increases insulin resistance. Aim for 7–9 hours of quality sleep each night, and maintain a consistent sleep-wake cycle.

  • Move your body regularly: Physical activity has potent anti-inflammatory effects, especially when done consistently. Even moderate-intensity movement—like walking after meals—can lower inflammation over time.

  • Optimize vitamin D levels: Vitamin D plays a key role in immune regulation. Spend time in the sun (safely), and supplement if needed to maintain optimal levels (typically 50 to 70 ng/mL).

Markers to monitor inflammation and optimal ranges:

  • CRP-hs (C-Reactive Protein, high sensitivity): < 0.3 mg/L 

A general marker of systemic inflammation. Elevated levels are associated with increased cardiovascular risk.

  • Homocysteine: 6–8 µmol/L

Elevated homocysteine is linked to inflammation and oxidative stress, with levels above 11 being associated with increased risk for cognitive decline, cancer and cardiovascular disease. Can be influenced by B-vitamin status (especially B6, B12, and folate).

4. Staying Proactive with Cancer Screening

While there’s still much we don’t understand about cancer, early detection offers the best chance for effective treatment. Prioritizing regular screening is one of the most powerful steps you can take.

Recommended screenings (based on individual risk factors):

  • Colonoscopy: Starting at age 45 (or earlier if high risk), and repeated every 10 years (or sooner depending on the findings).

  • Mammogram or Whole Breast Ultrasound: As recommended by your provider, typically beginning at age 40. Mammogram is the gold standard for breast cancer screening. Whole breast ultrasound can add another layer of screening and may be alternated with mammograms.

  • PSA (Prostate-Specific Antigen): Begin testing around age 50, or earlier based on family history.

  • GRAIL Galleri Multi-Cancer Early Detection Test: This blood test screens for a signal shared across 50+ types of cancer, many of which are not typically screened for in routine exams (like pancreatic, ovarian, and liver cancer). The test analyzes cell free DNA to detect early cancer signals, often before symptoms appear. It is most appropriately used in addition to, not as a replacement for, standard screenings (e.g., mammogram, colonoscopy). It is currently recommended for adults 50+ years old, or younger individuals with elevated cancer risk.

While no blood biomarker is perfectly predictive, regular screening, combined with a healthy lifestyle, is your best defense.

5. Supporting Your Cognitive Health

A sharp, healthy mind is essential for aging well. Many of the strategies we’ve already discussed – nutrition, exercise, and inflammation reduction – also support brain health. But there are a few more targeted approaches that can help combat cognitive decline and boost brain function as we age.

Additional approaches that may support cognitive function:

  • Ketogenic or higher-fat diets (for some individuals): Studies suggest that a ketogenic diet may improve brain function by providing an alternative energy source (ketones) that the brain can utilize, especially in individuals at risk for neurodegenerative diseases like Alzheimer's. However, it’s important to take into consideration other aspects of your health, such as your lipoprotein levels, so that you can tailor this approach to you. Taking exogenous ketones (i.e., ketone supplements) is a good option for many people who want to support brain health while eating more of a Mediterranean diet that is only moderate in fat intake.

  • Targeted supplements for brain health: Key nutrients can help protect brain function and slow cognitive decline. Consider:

    • Omega-3 fatty acids (EPA & DHA) for improving memory and overall cognitive function.

    • Phosphatidylcholine for cell membrane repair. (I like the BodyBio brand PC, which is available on Fullscript.)

    • B vitamins (especially B6, B12, and folate) to support brain health, particularly in older adults.

    • ProdromeNeuro and ProdromeGlia when more targeted support is needed. Prodrome plasmalogen precursor supplements, ProdromeNeuro and ProdromeGlia. Plasmalogens are an important component of our cell membranes, essential for function, particularly in the nervous system. They are also potent antioxidants and have anti-inflammatory benefits, thus supporting repair and maintenance of our cell membranes (and thus cell function) promoting overall health. Perhaps most importantly, plasmalogens are critically involved in nerve function, being indispensable in supporting neural processes and overall well being. Here's the link to try the supplements! 

  • Meditation and mindfulness practices: These techniques have been shown to enhance neuroplasticity (the brain’s ability to reorganize and form new neural connections), reduce stress, and improve emotional regulation. Even a few minutes daily can have long term benefits for cognitive health.

  • Prioritize sleep: Never underestimate the power of quality sleep! It’s during deep sleep that the brain removes waste products and consolidates memories. Aim for 7–9 hours of restorative sleep each night to support cognitive function. If you struggle with sleep, there are a number of techniques and supplements we can use to improve your sleep.

  • Social engagement and mental challenges: Keeping your brain active and engaged through social interactions, puzzles, reading, or learning new skills can enhance cognitive resilience. Studies show that individuals who stay mentally and socially active tend to have a lower risk of cognitive decline.

To assess cognitive function:

  • CNS Vital Signs: This is a computerized neurocognitive assessment that evaluates memory, processing speed, attention, and more. It’s an excellent way to track cognitive function over time and can help identify early signs of decline.

Final Thoughts

There’s no magic pill for longevity, but there is a powerful framework built on the habits we practice daily. Rather than chasing trends, I encourage you to focus on what’s proven to make a meaningful difference: improving metabolic health, exercising regularly, eating an anti-inflammatory diet, getting quality sleep, prioritizing preventive screenings, and partaking in mindfulness practices.

Small, consistent changes often yield the biggest long-term rewards.

If you're ready to take a personalized approach to your longevity journey, all of these powerful tools are integrated into my Longevity Membership. I’d love to guide you every step of the way. Click here to learn more and schedule your free consultation today!

Amy Nett