If you’re living, you’re aging. That much we know for sure. But the good news is, how we age is increasingly within our control. These days, more and more of us are striving not just to live longer but to ‘age well,’ living free from disease, disability and physical limitations far longer than most of our elders did. The modern pursuit of longevity isn’t just a matter of adding years to life, but about adding life to those years. The goal? A vital ‘healthspan.’ 

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But keep in mind, traveling the longevity path requires a proactive effort on your part – it’s not a one-and-done deal. Nor is it about diving into the latest social media-driven wellness trend. It’s about creating a road map that combines health and longevity-promoting lifestyle habits with cutting-edge scientific innovations and treatment modalities to enhance quality of life and reduce the risks of disease and early mortality.

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So, how do we get there? In my practice, I use the Lipman Longevity Pyramid as a framework for cultivating optimal health, resilience and vitality for my patients for decades to come. 

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Think of longevity as a pyramid made up of four levels, each building on the other to create a strong foundation for lifelong health. Here’s how it stacks up:

Level 1 – FOUNDATION: Your longevity must-haves

In my diagram, we start at the base, the core lifestyle habits you must have in place if longevity is what you’re after —we’re talking the ‘significant six’ habits of good nutrition, regular movement, restorative sleep, connection, stress management and time-restricted eating. Without these elements well under control, the next three levels will be a wasted effort. So, think of this level as the non-negotiables, the “must-haves.” The foundational rules of the road in this stack of healthy habits look like this:

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1) Nutrition: As in, a diet built around nutrient-dense wholefoods, non-starchy vegetables, healthy fats and increasing amounts of protein as you age, to maintain muscle

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2). Movement: And plenty of it! Think, frequent movement  breaks throughout the day, a regular cardio routine like walking, jogging or high-intensity interval training (HIIT) for heart health; plus strength training to slow age-related muscle wasting and to maintain or gain muscle as well as bone strength

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3) Sleep: A no-excuses, no shortcuts, consistent 7–9 hours of quality sleep. Your optimal sleep hygiene should include regular exposure to daylight during the day; consistent sleep and wake times; sleeping in a cool dark room; reducing exposure to blue light from screens several hours before bed

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4) Stress Reduction & Mental Health: Giving your mind and body intentional time-outs with stress-tamers like meditation, yoga and breathing exercises; time in nature; and periods of digital detoxing

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5) Social Connection & Purpose: Strong relationships and a sense of community – call it social engagement -- blunt the effects of rapid agers like loneliness, depression and anxiety

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6) Time-Restricted Eating /Intermittent Fasting:  Great value for your longevity buck (especially for those over 45), delivering longevity benefits via boosted autophagy (the recycling of cells or cell parts); metabolic flexibility; stabilized blood sugar and enhanced cognitive performance

Level 2 – TESTING: Numbers that measure – and matter most

Next comes the knowledge-is-power level, which involves a combination of conventional and cutting-edge diagnostic testing with expert analysis of the data that’s generated. The right combination of tools in our toolbox will help us catch potential problems early on, and together, we’ll make the necessary adjustments. Later on, we’ll use these same tests to track your progress as your body responds to therapeutic and lifestyle improvements.  Remember -- what gets measured gets managed! And the numbers don’t lie. Some mix from the following stack of testing is extraordinarily helpful for pinpointing where you are on the wellness spectrum:

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• Blood Work: A simple and excellent way to measure extensive lipid and heart health markers, heavy metal, hormone and nutrient levels, and markers for metabolic function inflammation, and longevity. 
• Genetic Testing: Identifies genetic disease predispositions and weak metabolic pathways, helping personalize treatment and longevity plans
• Health tracking devices: Real-time tracking and monitoring of key physiological data with high-tech devices like Oura ring, Apple Watch, continuous glucose monitors, blood pressure monitors and heart rate variability trackers
• Body Composition: Scans to measure and analyze muscle mass, bone density, body fat and visceral fat levels

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A smaller group of people may need more specialized tests, which may include a combination of diagnostics such as:  

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• Cardiovascular Scans: such as a calcium score or Cleerly Angiogram
• Full Body Scans: like Prenuvo’s full-body MRI, or ultrasound scans
• Biological Age Tests: Popular with consumers but as a clinician I have found them to be inconsistent, not particularly accurate and not helpful.
• Microbiome and Gut Health Testing: Although generally not very accurate nor useful, in certain conditions, these tests can be helpful.     
• Brain Mapping: Making use of a variety of different technologies, to help with early detection of neurodegenerative diseases and picking up early cognitive decline. 
• Specialized Testing: for example, toxic burden tests, as well as more esoteric options like markers for mitochondrial function and cellular senescence.

Level 3 –THERAPIES: Treatments that support and sustain.

Moving up the pyramid, to the third level, we arrive at what might be called the ‘reinforcements level.’ Here, we’re emphasizing therapies like targeted supplementation, hormone optimization, and other treatments to help fine-tune our longevity efforts, based on each individual’s unique physiology and life situation. The options in this stack include health-optimizing therapies such as:

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• Supplements: To counter the hallmarks of aging, encourage optimal organ function and support longevity
• Hormone support: To prop up the hormones that decrease with age with bio-identical versions, for both women and men. In fact, I am now coming to believe that for those of us over 50, hormones probably fit in level 1, the Foundation.
• Vagal Nerve Stimulation: Devices that send electrical messages to the brain to calm down the nervous system and enhance mood and function
• Red Light Therapy: Ideally, professional grade, red light beds
• Physical Therapies: Including bodywork, massage, acupuncture, physical therapy
• Peptides: To improve cellular function in general and many body functions, including immune, cognitive, hormone, sexual, metabolic and mitochondrial function, which decrease as we age. They are also helpful with improving body composition by burning fat and increasing muscle mass, taming inflammation and repairing soft tissue.
• Pharmaceuticals: Strategic use of well-tolerated low dose prescription drugs to manage blood pressure and lipids if necessary, and using drugs like Metformin,  low dose GLP-1s and SGLT2 Inhibitors  for metabolic health and aging benefits. 

Level 4 – NEXT LEVEL TREATMENTS: Innovations – practically and intelligently applied.

Finally, at the top of the pyramid, we’re at the ongoing research and innovation level. Here too not everyone needs every therapy all the time. But, generally speaking, these are sometimes great ways to deal with both acute and chronic problems – and help patients to feel a whole lot better, often quite quickly. 

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• Sauna: All varieties, including red light saunas and dry saunas (though we’re especially partial to red light)
• Cryotherapies: Such as cryogenic chambers, ice baths, ice plunges, to manage recovery, pain and healing.
• Hyperbaric Oxygen Therapy (HBOT): To increase blood oxygen levels and speed healing
• Exosome Therapy: To aid cell growth and regeneration
• Stem Cell Therapy: A form of regenerative medicine which helps promote the repair of dysfunctional stem cells and helps generate new ones
• Plasmapheresis: A process that separates plasma from blood, removes extra antibodies, abnormal proteins, or other harmful substances from the blood and then returns the blood to the person receiving treatment.  

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BOTTOM LINE: The Lipman Longevity Pyramid is a visual representation of the idea that cultivating longevity is a life-long journey. It’s not about doing a few scattershot red-light sessions, a cold plunge or two and expecting longevity to follow. That’s not how it works. You simply must pay serious attention to getting your Foundation right, the non-negotiables, as they are the spring from which longevity flows. With the Foundation in place, we can custom-tailor an effective and comprehensive strategy that adapts over time to help you live longer and better! The Lipman Longevity Pyramid is a great way to help get you there.