Cardiologist Eric Topol is one of the leading medical researchers in the world. A founder of the Scripps Research Translational Institute in La Jolla, Calif., Dr. Topol is also the author of a New York Times bestselling new book, “Super Agers: An Evidence Based Approach to Longevity.”
I recently sat down with Topol to discuss his book’s insights into slowing down, or turning back, our aging clocks to become more like super agers — or who he calls the “Wellderly” — people who live well into their 80s and 90s without any chronic illness or disease.
A comprehensive answer to that question requires reading his book, written for a lay audience curious about the latest (and upcoming) scientific breakthroughs in longevity medicine. But in our hour-long conversation, Topol discussed several do’s and don’ts for anyone seeking to make 80 the new 50.
1. Do: Strengthen your immune system
If there is one main thesis to Topol’s book, it’s that healthy aging is a function of a strong immune system, which can defend against diabetes, cancer, heart disease and other chronic conditions. “I keep saying to myself that old thing about the economy: ‘It’s the immune system, stupid,’ you know?” Topol told me. “Because it really is.”
He suggests focusing on habits that support and build immune health:
- Regular strength and resistance training builds strong immune systems and is the single best way to extend lifespan and, importantly, health span.
- Keep a Mediterranean-style diet that maximizes whole foods, colorful vegetables, lean meats, olive oil and minimal dairy, and minimizes ultra-processed food.
- Get deep, restorative sleep — crucial for supporting your body’s immune function.
- Maintain so-called “lifestyle+” factors, like spending time in nature, avoiding environmental pollution like food-borne plastics and airborne toxins, and maintaining strong friendships and a regular social calendar.
I’ll go deeper into some of these specific strategies, like sleep and nutrition, below. But the common denominator is supporting a robust immune function, Topol said.
“We should be having immune system testing as we get older,” he said, “because it is the reason why aging can hurt us.”
2. Don’t: Limit your medical care to only what your insurance covers
Most employer-provided health insurance programs cover only the minimum annual tests to gauge basic heart health and disease risks, cholesterol level and hormone health. “Standard medicine is missing out, leaving too many unsolved questions about a person’s risk,” Topol said. “Just do the tests based on a person’s risk; the yield is much higher.“
He recommends a few lower-cost, specific tests to help personalize medical care and guide preventive strategies that can help flag potential disease risks that most insurance-covered tests do not:
- Polygenic Risk Scores (PRS): Often costing fewer than $50, these tests provide validated risk estimates for common cancers (e.g., prostate, breast, lung, colorectal, melanoma) and other diseases. Use this test alongside other health data, like family history and routine blood tests, to provide a more comprehensive risk assessment.
- DEXA scans: Typically costing less than $100, this is a relatively inexpensive and useful tool for monitoring changes in body composition, such as muscle and fat mass, or older adults concerned about muscle loss.
- Sequencing your genome: For about $200, this process can help determine which, if any, cancers you may be most predisposed to. This is a test you need to take only once, for lifelong knowledge. Caveat: Unfortunately, most of the validated datasets for genomic cancer risk are still for people of European ancestry only.
3. Do: Nourish your “gut-brain axis”
In “Super Agers,” Topol writes at length about the bidirectional communication between gut hormones and the brain, and calls it critical to healthy immune function. Gut hormones are chemical messengers made by special cells in the digestive tract that help control digestive functions. They communicate with the brain through the bloodstream and the vagus nerve, which runs through the throat and vocal cords and connects the gut and brain.
“I’m pretty well-convinced now that the gut hormone story is the most extraordinary thing I’ve ever seen in medical intervention,” he told me. “Because the gut hormones talk to the immune system, and they talk to the brain, which is mission control for the immune system.”
“It isn’t just the microbiome, it’s the gut’s hormone production,” he said. “The way to a person’s brain and to healthy aging, it likely will be through their gut.”
Here’s how to nourish the two-way communication along the so-called gut-brain axis:
- Maintain a strong and diverse gut microbiome: Consume a variety of whole foods (meat, grains, legumes, dark leafy greens), and minimize ultra-processed foods (i.e., anything with a long list of ingredients you can’t pronounce). Foods with active macrobiotic cultures like yogurt, kimchi, sauerkraut and kombucha are great for building healthy, diverse gut bacteria.
- Stimulate and strengthen your vagus nerve. Care for it via deep-breathing exercises that engage the diaphragm. Singing, humming, laughing and even gargling stimulate the vagus nerve, and cold-water exposure can activate it and enhance its tone.
4. Don’t: Sleep too little — or too much
We all know that getting enough sleep is critical to health and specifically to healthy aging, and many doctors rightfully call Americans’ chronic lack of proper sleep a public health crisis. But there’s another side to the sleep story, Topol said, admitting his own surprise: According to plenty of clinical research, for people in their late 30s and older, getting more than seven to eight hours of sleep was associated with greater mortality risks, he said.
“The principal finding was that about seven hours is the optimal duration of sleep,” he writes in his book. “Every one-hour-a-night increase in sleep duration above that seven- to eight-hour threshold is associated with 12% higher risk of total cardiovascular disease.”
To improve sleep function, Topol recommends maintaining a consistent bedtime and waking schedule, and avoiding eating or drinking alcohol for a few hours before sleep.
5. Do: Use AI to answer health aging questions — but with caution
The convergence of AI with advances in biomedical data — such as genomics, microbiome analysis and digital health monitoring — create a transformative force that can radically improve disease prediction, prevention and personalized care, Topol told me.
For consumers, AI is a powerful tool, he said, that can still be grossly mistaken, sometimes. So with caution and vigilance for AI “hallucinations” that provide flat-out wrong information, here’s how you can use it to help you age with strength:
- Leverage personal health data: Consider feeding consumer AI apps like Claude (Anthropic), Gemini (Google) and Perplexity your anonymized data from wearable devices, mobile health apps and at-home testing kits for real-time feedback and personalized recommendations. Maintaining proper digital privacy means scrubbing personally identifying information like your name, address and social security number from any documents you upload to AI platforms. (Assume personally identifying data you provide an AI system may be captured by the company that owns it.)
- Make AI your personal food and beverage analyst: The more specific you can get about which foods you consume and how much, the more AI can give you an accurate idea of how balanced your diet is compared to nutritional standards. I’ve done this and received eye-opening feedback. Always ask the AI system what nutrition standards it’s using, and don’t be afraid to challenge results that don’t sound right. (Some AI can be good at admitting when it’s wrong.)
- Ask AI for non-technical explanations of emerging longevity trends, treatments and scientific breakthroughs. For instance, ask Perplexity, “Why are doctors so excited about GLP-1s now?” What it replies may well surprise you.
