Part I - Personalized Healthspan Coaching: Background Context
Project Type
Research
Date
May 2024
Location
College Station, TX
This case study is the first section in an independent study I completed under the mentorship of Dr. Mark Benden through the school of Public Health during my final semester at Texas A&M.
The goal of this case study was to understand the factors contributing to the length of one's healthspan, and to develop a knowledge base from which approaches to increasing healthspan could be individually designed. These research goals were met through:​​
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A literature review of over 50 academic papers
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Studying the work of medical doctors and healthspan experts
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Listening to 100+ hours of interviews with top professionals in the field
The Problem:
The average American lifespan is getting longer, but the average “healthspan” is shorter than ever.
Healthspan -- the period of an individual's life characterized by optimal physical and mental health, free from chronic diseases and disabilities
Chronic diseases and autoimmune disorders are globally increasing due to rising obesity rates and sedentary lifestyles.
This trend affects individuals of all ages, leading to physiological consequences and a higher risk of conditions that cause mortality risk to rise and decrease quality of life.
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The Challenge of Age-Related Decline:
As life passes, everyone can expect to see declines in capability in several areas of life. This is a natural part of living.
This rate of decline can be decreased, or in some even cases even reversed using a focused intervention strategy.
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Learning about these trends can feel uncomfortable, but it’s important to understand what's at stake to take action.
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These areas of risk are most crucial to understand:
Lean Mass, Muscle Mass
Research indicates a decline in muscle mass of 3–8% per decade after age 30, with rates increasing steeply after age 60 to 70 and varying based on factors like sex, age, and lifestyle habits.
Balance, Stability
~One-third adults aged 65 and above experience at least one fall annually. 10% result in serious injuries, often attributed to vestibular system degradation as well as declines in hip strength and bone integrity. About half of hip fracture patients ever regain their pre-injury mobility.​
Age-Related Declines
In:
Bone mineral density decreases by 1–3% per year with age, leading to increased osteoporosis risk. Peak density is typically achieved in the early 20s, as noted by Dr. Attia in Outlive.
Bone Density
Research suggests a linear relationship between cognitive decline and blood flow to the brain. Those with cardiovascular disease history were found to have a higher incidence of​ Alzheimer's disease.
Brain Health and Cognitive Function
Oxygen Utilization Capacity
Research indicates an age-related decline in VO2 max of roughly 10% per decade between ages 25 and 50, and up to 15% after age 50.
The 4 Horsemen:
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Another important idea is that of the 4 Horsemen, as popularized in Dr. Peter Attia's book, Outlive.
They are the four diseases that kill the vast majority of those living in industrialized nations.
Metabolic disease (i.e., NAFLD, NASH, IR, T2D, hyperinsulinemia)
Neurodegenerative
disease
(i.e., Alzheimer’s disease)
Cancer
Atherosclerosis (i.e., Cardiovascular disease, Cerebrovascular disease)
Less
Mortality Risk
More
The Strategy:
Any comprehensive plan of attack for this problem will need to prioritize two central goals:
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Delay the onset of chronic disease (The Four Horsemen).
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Maintain the highest quality of life possible, using scientifically backed strategies to slow the natural effects of aging and increase healthspan.
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There are many resources available for learning about approaches for each of the areas listed above, and the field is growing by the day. However, following are some major points to get started.
Optimizing Lifelong
Oxygen Utilization Capacity
As this diagram shows, VO2max has an outsize impact on one's abilities. It performs as a cap on aerobic physical capacity.
The good news is that the evidence shows that this decline can also be slowed! The “starting point” matters, but the "slope" of the curve can still be changed at any point.
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The relationship between power output during zone 2 exercise (heart rate around 65% of maximum value) and VO2max exercise is visualized in the diagram below. The higher one's capacity for power output while in zone 2, the greater their cardiac capacity. The higher their VO2max power output, the greater their cardiac capacity.
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Both of these values can be increased with training, but the width of the "base" of the triangle supports the limits of what is possible aerobically. This is why training zone 2, though far less intense, is so important for improving overall aerobic fitness.
Recommended Training Plan:
NOTE: If this is the start of a fresh effort to become more aerobically fit, experts recommend individuals begin with a training focus for 6 months on zone 2 exercise before beginning work to increase VO2max.
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Average daily activity goal:
26 minutes
"Take-Out" Reflections
The Most Powerful Tool to Increase Healthspan.
Exercise emerges as the most powerful tool in addressing age-related declines, impacting both the length and quality of life. It is by far the most important factor in increasing quality of life and reducing the rate of age-related decline. One caveat to this statement: mental health also has a profound imact on quality of life, and it stands out as the only area of potential age-related decline in which marked improvement is seen in a variety of older individuals.
The Way the Race is Run Matters More Than Current Fitness.
Despite perceptions of younger individuals being naturally fitter, older individuals may exhibit greater overall fitness due to resilience and adaptability over time.
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Personalized Health Goals vs. Generalized Goals DO Make a Difference.
People are generally more likely to adopt lifestyle change for personal reasons than for educational awareness, and their goals mean more to them if they are individualized and specific to their own needs.
To learn more, move on to Part II to read about what this looks like in people's lives!
You can also reach me directly using the Contact page.