Ten Things Proven To Make You Live Longer

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Patients often come to me seeking advice about what they can do to live longer. The number of things that have been proven to extend life, however, remains shockingly small. What follows are things that have enough support in the scientific literature that I generally recommend them (though the strength of the evidence varies even with these):

  1. Take simvastatin (brand name Zocor). That is, if you have coronary artery disease. (This is one of those drugs that doctors joke should be put in our water supply.) A landmark trial called the 4S Study (click on the “Look Inside” button to read the article) showed that people with heart disease who take simvastatin will reduce their risk of dying from any cause by 30% (relative risk).
  2. Take ACE inhibitors if you have heart failure. Though we’ve known for decades ACE inhibitors make such patients live longer, studies also show a shocking number of such patients aren’t taking them. (This is the other drug that doctors joke should be put in our water supply.)
  3. Wear oxygen if your PaO2 (partial pressure of oxygen in your blood) is below 55 mmHg, as in severe emphysema. Lots of people want to wear oxygen for lots of reasons, but the only good reason to do so is if you PaO2 is below 55. And then you should do it not so much because it will make you feel better (it may do so, interestingly, by improving your energy, but strangely not by making you feel less short of breath), but because it will prolong your life.
  4. Get regular Pap smears (and mammograms). The interval for screening Pap smears isn’t the same for all women, but it too increases the likelihood of living longer. So does mammography (though the age at which to begin screening mammograms remains controversial).
  5. Get screening colonoscopies. Like Pap smears, how often you should get one varies depending on your baseline risk, but it too has been shown to decrease the likelihood of death. Screening exercise treadmill tests, on the other hand, the most frequently requested screening test, has been shown in otherwise low-risk individuals not to increase lifespan and should be avoided: the risk of false positives (that is, the test says you have coronary disease when you don’t) in low-risk individuals is higher than the likelihood of true positives (this turns out to be especially true for women) and only exposes patients to unnecessary invasive testing like cardiac catheterizations, which have very real risks.
  6. Exercise. Most of us already know that exercise makes us healthier. Some may also believe it makes us live longer. Those who do are probably right, though it depends on who’s doing the exercising. Statistically speaking, middle-aged men who exercise will live longer than middle-aged men who don’t. Statistically speaking, elderly women will also live longer than elderly women who don’t. Middle-aged women probably will live longer than middle-aged women who don’t. Elderly men, interestingly, won’t live longer than elderly men who don’t.
  7. Assume responsibility. In both elderly men and women, however, simply being made to feel a sense of responsibility has been found not only to improve daily functioning but also to increase lifespan. In a study of nursing home patients by researchers Ellen Langer and Judith Rodin, residents on one floor were given a plant for which they themselves were expected to care (the experimental group) while residents on another floor were given a plant for which their nurses would care (the control group). After three weeks, 93 percent of residents in the experimental group showed an overall improvement in socialization, alertness, and general function; in contrast, for 71 percent of residents in the control group functioning actually declined. And in a follow-up study eighteen months later, half as many of the residents who’d received plants for which they were expected to care by themselves had died as the residents who’d been given plants for which their nurses cared.
  8. Learn to be optimistic. A former resident of mine, Hilary Tindle, just recently published a book, Up: How Positive Outlook Can Transform Our Health and Aging, summarizing the research on optimism and aging, which shows that optimists live longer than pessimists. For a discussion about how to become more optimistic, see my own book, The Undefeated Mind, chapter 4.
  9. Train yourself to view aging as a positive. Studies show that people who have positive self-perceptions of aging have a strong will to live and that having a strong will to live actually seems to increase longevity.
  10. Be happySo much easier said than done, of course. Happiness, however, doesn’t seem just correlated with longevity. It actually seems to cause it.

Next Week: The Effective Use Of Silence, Redux

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  • I have to say I’m really surprised to see medications listed first on your list, and to no where see reference to a healthy diet (which so many of us seem to lack).

    Have you reviewed the literature to determine just how many chronic conditions could be addresses by whole foods and a much greater reliance on a plant-based diet?

    I sense a slow-moving cultural change in this direction (thankfully), and would think you could be at the forefront of helping with this shift.

    I’m really surprised this seems to be anathema to physicians. To me it seems (now) to be so obvious, and so wonderfully under everyone’s control, I would have expected to see it as #1 on your list.

    Steven: By no means does my excluding a healthy diet from this list imply that I think a healthy diet is unimportant. But as far as I know, no direct evidence exists that eating one particular diet causes people to live longer than any other. I’d be pleased to see such studies if they exist.


  • Thanks Alex,

    But honestly, I’m disappointed that you would not recommend a WFPB (whole foods, plant-based) diet, and make it number one—especially for middle-aged folks who have more time to rescue themselves from poor lifestyle choices. Exercise, in my opinion should be number two…for all ages, especially swimming for older folks who may have joint issues. The last four items on your list should be moved up, and the drugs should be at the bottom.

    We have more power to heal ourselves than Pharmaceutical Companies (who fund most of these studies directly or indirectly) want us to believe.


  • It’s also important to note that the scarcity of studies on the efficacy of eating a WFPB diet in disease prevention is directly related to who stands to make money off the results of these studies. I expect medical doctors and other healthcare providers to be at the frontline on this by demanding that such studies be funded and carried out.



  • Alex:
    Just a note to let you know I’m a huge fan of your column and book. Thanks for sharing your wise perspective; I always enjoy reading what you have to say.

    Jan: You’re so nice to say so. Thanks!


  • Well said Steven and Melissa. I have to agree with the whole food plant-based diet (or as we call it a lifestyle). My husband had a massive heart attack at age 36 that required 5 stents in one artery (a full metal jacket as they called it). The same artery then closed completely, but his heart grew another artery which saved his life at the time (they told him he had a bypass from God). For 8 years he was taking a handful of pills a day. He watched Forks over Knives and immediately started his whole food plant-based diet. After 3 months he was off all his medication and felt better than he ever did in his life. Now a year and a half later his cholesterol is at 160 and his blood pressure is great. That new artery that was a blessing but only very narrow is now fully functioning. He just had an appointment with his cardiologist today and was told for the first time since his heart attack that he didn’t need to be seen for a year (he has been going every 6 months since his heart attack) and, to top it off, the doctor told him his transformation was incredible and he wished all his patients would do what he did.

  • Agreeing in principle with Steven and Melissa. I also think that the lower number of many of the recommendations shows a dependence upon external sources for our own responsibilities. Listing “Assume Responsibility” as #7 seems, to me, to undermine all the other previous recommendations. You cite a study in a “nursing home”; however, common sense seems to say that we need to assume responsibility for even calling for an appointment for a screening test. We are, after all, when all is said and done, the only ones who can take the first step, no matter what that is, to make improvements or manage the outcome and results of our life and the actions we take within its bounds. The medical and pharma community, while perhaps considering themselves more knowledgeable than the rest of us regarding our health (illness) conditions, does not have the ultimate responsibility for living our life to dying to it. The obesity situation is really, truly not up to them, but might just require all of us to sign up to be more aware, pay more attention to, make more responsible decisions about our own health, life, and continuing responsibility for ourselves and others. We are never independent if we place the burden of our lives upon the shoulders of others; we perhaps need to reframe our picture of them as partners or co-collaborators in helping all of us to have more genuine happiness and health in our lives.

  • Denise, your husband’s story should be the advertisement we see ad nauseum during the evening news, on billboards leading into cities, on full-page ads in magazines and newspapers, on posters in doctors’ offices—essentially, everywhere we currently see an ad for a prescription drug. Can you imagine how the country (and the world) would be different if this were so? So much in our western medical establishment would have to change to allow center stage for this message. Your husband’s doctor has more power than simply wishing all his patients would adopt a WFPB diet.

    Thanks for sharing your story. It’s very important.


  • Hi Alex,

    Since you asked, here’s a pointer to a physician that seems to spend all of his time scouring medical research for the benefits of a healthy diet.



  • I agree with most of these, though the mammogram comment is open to debate, maybe over promised re: lives saved. Thanks for the discussion. I’d maybe add don’t smoke and don’t become obese, the two leading causes of preventable death in the US. For a discussion of these see: https://drpullen.com/leadingpreventablecausedeathamerica

    Dr Pullen: Agreed on all counts.


  • Alex,

    Dr. Gabe Merkin’s weekly ezine is chock full of current, international studies that support a whole foods/plant food diet/lifestyle as a means to a healthier, longer life.

    Denise—congratulations to your husband for his successes.