Hormone replacement therapy
I’m surprised at the number of women I talk with who are not on HRT. HRT is so beneficial to so many women, I recommend it for all my clients, and I have a partner doctor you can use to order everything online. Here's a video conversation with my client Kathleen on this topic.

For men, it's more complicated. Taking testosterone has benefits, but the body compensates, so the benefits can reverse and cause problems later (it also completely shuts down your body’s natural ability to make testosterone). Yet testosterone replacement therapy can be done right and is beneficial for some men.

Women should have a good reason not to go on HRT, while men should have a good reason to start TRT. In both cases, watch carefully for any unwanted side effects and adjust accordingly. If you need a good doctor for this, ask me in our discovery call.

Get enough protein
The older we get, the more protein we need. You should be trying to get 1 gram of protein for every pound of lean-mass bodyweight daily. It's not easy. Aim for about 40-70 grams of protein per meal, depending on your body weight. I’m a believer in protein shakes that aren’t too sweet. They give you a quick 30 grams of protein. I prefer Rockin’ Protein Builder from Shamrock Farms, which has whey protein. Or get protein powder and make your own. Especially good after a hard workout.

I don't have time to go into all of it, but you'll find a lot more on the site on this topic, especially the videos.

What's up with LDL cholesterol?
The evidence connecting LDL cholesterol with heart attacks and stroke is very mixed. I hope to have a thorough update on this topic at some point. But what to do about it is quite straightforward. We know that soft plaque is far more dangerous than hard plaque. You can undo it by reducing insulin resistance and hard exercise. 

Should you take statins? 
I think most people will benefit from taking statins. Few people have side effects (if you do, stop taking them or switch the kind of statin). And the lowest dose is generally best. If you're on 20 mg, ask your doctor about going to 10. If you're on 40, ask about going to 20. If you don't like the idea, try red rice yeast, it's pretty much the same. 

Build bone
If you're not building bone, you're losing it. You can't build bone by walking and doing yoga. Runners and cyclists, even mountain bikers, don't have strong hips and spines. Everyone over 70 has a 25% risk of a fall each year, and 50 percent of falls result in a permanent reduction in the quality of life, leading to death. You build bone through resistance and impact training. Read The Osteoporosis Breakthrough to understand the basics. Resistance is pushing or carrying heavy weight, and impact is jumping and landing fairly hard. Two people in the world have an advanced bone-building program, and I’m one of them. I'll make a better video, but for now you can watch my very blurry video that goes into some of this. 

Build muscle
I’m a big fan of Peter Attia’s, and I want everyone to read his book, Outlive. He talks about the value of zone-2 exercise, which I agree with. Zone 2 is a pace that is hard but sustainable for at least a few hours. It’s faster than normal-pace walking, it’s like very fast walking at about 3 miles an hour. You should do that or its equivalent once or twice a week. But I can't emphasize the value of zone-3 and zone-4 exercise enough, even if you're in your 80s. This means going as hard as you can for 2-4 minutes in the pool, on the track, rowing machine, or even jumping up and down in your living room (YouTube videos are great for this). Hard. Like you can't do any more, and the last 30 seconds are very very challenging, and it takes several minutes to recover.

Use a stopwatch. If you ride a bike, pick a hill and always start at the same place and measure your time to the top, then keep trying to beat that time. In the pool or on a machine, it's easy. Always keep trying to beat your previous best time. I also like 2-4km of rowing - how fast can I row 4km at the hardest setting? 

Try ten flights of stairs (17 steps per flight is normal in a modern building) in under 90 seconds — without touching the handrails at all. Never touch handrails when doing stairs. Stairs are great, because you know exactly how far you're going, you can do them in any weather, all you need is a building with 10 floors. I'm 65. My record for ten flights is 70 seconds, but that's because I carry 50 pounds on my back up 13 flights three times a week. Can you beat me? If you're older or not as strong, adjust but still push. 

Zone 4 is maximum output, like sprinting 100 meters as fast as you can. I'm sprinting 100m in 21 seconds; my goal is under 20. What's yours? 

Whatever you do, establish your best time and keep trying to beat it. Do this for the rest of your life. A breath trainer will help. 

Don’t forget lifting heavy in the gym, using free weights, and rucking. If you’re not rucking, you should consider adding it to your routine. People who do a lot of walking, Pilates, and yoga don’t live longer than the rest of us. It’s the weightlifters and serious pushers who outlast everyone else. The average 70-year-old farmer will probably outlive the average 70-year-old citydweller by ten years or so.

Don’t get injured
It’s very important not to get hurt, and that’s why you want a longevity coach, not a gym trainer. You need to prevent injuries. The older we get, the longer it takes to recover. It’s much better to avoid injury in the first place. A few of us know how to do this — to keep you under your injury threshold yet still performing at the highest capacity that your system will allow. It starts gently but progresses, because stressing your bones, muscles, and heart will let you do more and more aggressive and agile movements over time, and that is the best way to stay strong and healthy as you age.

What? You have pre-existing conditions? We all have pre-existing conditions. We work with what we have, we strengthen what we can, and we find ways to move forward. I don’t want to make you into a prize fighter. I want to make you leaner, stronger, and more resilient than you are today. The only person you’re up against is yourself.