Getting your baseline
Is this guide relevant to you? What is your current lifespan? Are you in perfect health, or at high risk of disease?
There are many powerful ways to understand where you currently stand, and how urgently you should focus on your health, or which areas need the most improvement. Tools like the Health Score in Gyroscope can provide the most precise and daily changing estimates of these metrics. There are also many common tests and correlations that can reveal your current risk factors.
Risk factors for early death
Through hundreds of years of research and observations, many correlations have been found to mortality rate (that means chance of death). That doesn’t mean that these things necessarily cause people to die, but may be strong indicators that something is not working optimally.
Let’s look at these by each organ system...
Muscular & skeletal systems
Having strong muscles & bones are essential for longevity, for many reasons. There are some simple tests which can estimate this and show whether your muscular system puts you at risk...
Ability to do push-ups
The number of push-ups you can do (if any) is a strong indicator of your physical fitness and longevity. This simple test can give you a benchmark of how you are currently doing compared to the population. The expected amount depends on age and gender. The good news is these metrics can be rapidly improved if you’re not currently happy with where you rank.
There is a predictive link between grip strength and other signs of aging such as bone mineral density, fractures, cognition, depression, hospitalization risk, and all-cause mortality. Grip strength is a simple and helpful tool for identifying older adults that are at risk for poor health status and accelerated aging.
This is a very simple test to do that doesn’t require any special wearables. Sit down, and then try to stand up without using your hands. Lacking the strength or flexibility to do this successfully can signal a reduction in strength and expected longevity.
Squats improve strength and flexibility in the legs, which is also highly linked to longevity. It may seem very simple, but falling when older is very dangerous and hard to recover from if not physically fit.
A trial from the European Journal of Preventive Cardiology in 2014, revealed that people, aged 51 to 80, who could get up from a squat-like position without using their hands, were less likely to die within the next six years than those who couldn’t pull themselves up.
One of the most standard tests of aerobic fitness is VO2max. This can be measured through various exercises like cycling or running. It can be measured in a lab, or estimated automatically in Gyroscope as part of your Health Score if you do these types of workouts wearing a heart rate monitor.
One study tested midlife VO2 max of over 5,000 males and followed participants for 46 years. They found that participants in the highest five percent range of VO2max lived about five years longer than those in the bottom five percent.
Another study tested the VO2 max of 59,000 adults, a follow-up six years later showed that participants that had a lower VO2 max were more likely to have a shorter lifespan.
You won’t be able to change your VO2 max overnight once you’ve aged, but can start to invest in it now to start getting these protective benefits. You can track your VO2Max and see how it is trending from the heart section of Gyroscope.
Metabolic & Digestive System
How you digest food and produce energy affects every single cell in your body, since they all need a steady flow of energy to survive. Problems with this complex metabolic system can often be first noticed with imbalances in body fat or symptoms like insulin resistance.
Hip to waist ratio
A simple way to estimate bodyfat is by waist to hip ratio. This is less precise than other methods, but can be done quite easily with the simple technology of a measuring tape or piece of string.
An observational study of 54.000 adults around age 60 showed that men and women with an higher body fat percentage had more risks of death in the following 4-7 years than those with a healthy bodyfat percentage.
A more personalized metric than BMI or hip-to-waist ratio (which are good for population-level analysis but not quite precise enough to say how you specifically are doing, since it assumes a statistically average body) is to look at bodyfat percentage. This metric measures what percentage of your total mass is stored bodyfat. There are many ways to measure this, which vary in accuracy, precision, cost, and difficulty. An estimate from standing on a wifi scale is generally good enough once many measurements are averaged together, though some may want to do a DEXA scan or try other methods to get a more detailed score. The most simple and cheap method is to simply look in the mirror and estimate it.
Visceral fat amount
Measuring bodyfat percentage is a useful indicator, but there are different types of bodyfat. The most problematic type is called visceral fat, the kind of fat usually found around the abdomen in humans. This number is harder to measure without complex imaging like an MRI, but tracking your waist to hip ratio can help clue you in as to where your levels might be.
Visceral fat increase metabolic problems like type 2 diabetes and heart diseases, increasing your preventable mortality risk and decreasing longevity *.
Insulin resistance is often accompanied by obesity, but not always. Someone could have low bodyfat but still have unhealthy glucose levels, dangerous levels of insulin resistance, or even type 2 diabetes.
A more clinical measure of blood sugar and insulin resistance can come from include checking your glucose levels. Common times are after fasting (expected to be low) or after eating something sugary (expected to not stay high for hours). If your insulin and metabolic systems are functioning properly, then glucose levels should not stay high.
Fasting glucose levels associated with the lowest mortality were 80–94 mg/dL (regardless of sex and age). Prediabetes (100–125 mg/dL) was associated with higher mortality. You can easily check these at home with a simple $50 monitor. It is not painful and doesn’t require needles! If you’re interested in doing this, all the instructions can be found for free at glucose.guide
Another way to measure your glucose stability or insulin resistance risk is by checking A1c levels, which represent an average of the last few months. This can be done by your doctor, and is often part of a standard annual blood test — so you may already have the data somewhere in your medical system.
A study that analyzed the data of over 7,000 people noted that an HbA1c >8.0% was associated with an increased risk of all-cause and cause-specific mortality (aka death). Perhaps even more important, participants with undiagnosed diabetes and HbA1c >6.5% had a 1.3 times greater risk of all-cause mortality compared with participants without diabetes and HbA1c 5.0–5.6%.
We stay alive by breathing oxygen into our lungs, and then distributing by pumping blood cells to all our cells. From birth to death, our heart is constantly beating and doing this important task. We only have one heart, and for the most part once it stops we die. Even when we are sleeping and resting, the heart needs to keep going, and can never take a break! If you stop to think about it, this is really an amazing feat.
Resting Heart Rate
Resting heart rate is one of the simplest and most useful way of measuring your physical fitness.
Your heart is constantly beating, but as you can imagine, letting it slow down and rest at least a bit will be important if you want it to stay beating for many more years. Conversely, if it is always maxed out and remains beating quickly even at night, it’s not going to be great. This metric is easy to see by checking your sleep score every morning, simply by wearing a hear rate monitor at night.
There is a remarkable correlation between resting heart rate and lifespan. If there was just one number to look at, this would probably be it. The most optimal range is around 40-50bpm. while the risk of mortality increases 30% to 50% for every 20 beats/min increase at rest.
Lower is generally better, though you can get a more personalized analysis of how you rank through your Health Score or by talking to your doctor. If you look at your history over time, you can often notice your resting heart rate increase or decrease from changes like losing bodyfat, starting an exercise routine or reducing stress.
Lung capacity and aerobic fitness is strongly correlated with longevity, and health in general. One simple but powerful test to measure how well you are breathing — managing your CO2 and O2 levels — is the BOLT test (Body Oxygen Level Test). It needs no special devices or wearables, and requires just a clock.
Many people with limited fitness or incorrect breathing habits may have a bolt score of only 10-20, even if they exercise frequently. With practice and training (including techniques like breathwork), your BOLT score and blood oxygen management can be improved dramatically, leading to a much better healthspan.
Blood Oxygen Saturation
Another way to measure your oxygenation status is through oxygen saturation percentage. This should generally be at around 99% or 100%. Some devices like the Apple Watch are starting to measure this in the background, and those metrics can be seen now in Apple Health.
Cholesterol and LDL levels
Cholesterol levels are another well known measure of your heart disease risk, though often misunderstood.
Cholesterol is not evil. If you had no cholesterol in your body, you would instantly die. Your brain and organs are made out of a lot of cholesterol! However, certain unhealthy habits — especially a sedentary lifestyle with highly processed foods — can increase it to problematic levels. These metrics are generally tracked by your doctor, and often checked as part of an annual physical.
There are conflicting opinions on what exactly constitutes good or bad cholesterol levels, but in general the markers of HDL and LDL (often simplified to “good” and “bad” types) can be used to estimate your heart disease risk and understand how well your lifestyle has been optimized.
Other lab tests
There are many other common tests that you or your doctor can order, like ALT (to measure liver health) or EGFR (estimated glomerular filtration rate) for kidneys, etc. to keep an eye on all of your organ systems.
They can be useful indicators of how you are doing — is everything fine, or do you need to devote more attention to your health, especially a particular organ system? However, since they change gradually and are measured so infrequently, it may be useful in your daily routine to focus on leading indicators like resting heart rate or bodyfat levels, which provide faster feedback.
Since they don’t change overnight and are also checked infrequently, starting with other more actionable metrics like bodyfat percentage and resting heart rate is generally a good idea. As those improve, other internal metrics like cholesterol or insulin resistance also generally go in the same direction.
The Brain & Mental Health
One of the most important but most overlooked organ is the brain. It is at the core of your experience, and influences all aspects of your health to extreme degrees that are just now starting to be understood.
Having a positive mindset and manging stress and anxiety are an important part of both physical and mental health. There are many possible reasons for this, which are still being researched and better understood, including affecting our neurotransmitter levels and hormone levels.
There are many important chemicals like cortisol that affect all aspects of our physiology, so our daily thoughts and feelings can have a significant impact on health and longevity.
Stress or anxiety is a complex topic, but one way to make it more concrete and understandable is through the metric of heart rate variability. At rest (like when sleeping, measured by your Sleep Score) this can be an indicator of whether your nervous system is in a sympathetic or parasympathetic state. Measurements of your HRV can be easily found in each night’s Sleep Score in Gyroscope, along with the interpretation for what that means.
There is a psychological survey called “Adverse Childhood Events” — having a high score there is unfortunately correlated with higher mortality risk. This doesn’t mean everyone with a challenging childhood will die, but does indicate that there is significant damage that may need attention. People with a moderate to high score on these tests may highly benefit from therapy and other mental health support in order to restore maximum longevity.