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“I'm talking to you from the land of old,” says Joan Price, 79, as we tuck into the topic of vibrators.

“The land of ‘young,’” I say reflexively, adding that she looks amazing.

“No, no no!” The author of The Ultimate Guide to Sex After 50 catches me, sharply. “We think of youth as the goal, but how about celebrating who we are now? Then we have more of a chance of going through our later years happy, zesty, and able to problem-solve.”

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She has a point. If you’re always craning to see yourself in the rearview mirror, you’re not looking forward to what you’ll become. And that, experts would say, is the first step to kicking ass as you age.

Longevity is the word on everybody’s lips these days, but it isn’t just about adding more years. Over the last century, our life spans have doubled, thanks to advances in medicine, agriculture, and sanitation. The problem now? We are spending many of those extra years in hospitals and doctors’ offices, sick with heart disease, cancer, diabetes, and Alzheimer’s, conditions that typically start around 60. So the question today isn’t so much how to live longer but how to live longer well. It’s the health span we’re after—figuring out how to push off these diseases so we have more time for leisurely sex, as Price would have it, or sailing down the Nile, or being the last person on the planet to pick up pickleball.

One day, we might just pop a daily pill. Scientists are hot on the trail of “gerotherapeutic” drugs that prevent the aging diseases. A leader in the field, Nir Barzilai, MD, director of the Institute for Aging Research at the Albert Einstein College of Medicine, is launching a major study on metformin. It’s a drug originally developed from the French lilac that’s cheap, already in wide use to treat diabetes, and known to help prevent death from heart disease, cancer, and cognitive decline. One of the hallmarks of aging it affects is a process called autophagy, which slows as we get older—the cells’ garbage disposal that clears out and recycles the junk, which accumulates in diseases like Alzheimer’s. (“By the way, if you were a mouse, we could take care of you already,” Barzilai says.)

There are other promising candidates, including SGLT2 inhibitors, also for diabetes, and an immunosuppressant used in organ transplants called rapamycin. But Barzilai believes metformin has the best shot of getting FDA approval as a gerotherapeutic—and that would mean cracking a regulatory impasse, because the agency doesn’t consider aging a disease. If his four-to-six-year trial successfully does that, it could pave the way for a blizzard of pharmaceutical development. But he’s not waiting for results. He started taking metformin seven years ago and is already seeing effects, he says: “I’m 67 and my EKG age is 58.”

In the meantime, there’s a lot we can do without drugs. Barzilai studies centenarians for clues to why they get diseases 20 or 30 years later than normal people—in fact, 30 percent have nothing major wrong at age 100. They definitely have some genetic help, “but exercise, nutrition, sleep, and social connectivity can play a huge part,” he says. “As a scientist, I can’t prove it—there are no controlled studies; it’s all association—but for me, the evidence is overwhelming. People who check a lot of those boxes are in better health for longer.”

Ready for a full-body scan? We went to the top minds in the field for this head-to-toe, research-packed guide to stretching your health span.

Brain

Forget IQ. The hot new concept in business circles is LQ (learnability quotient)–your desire and ability to keep picking up new skills. This is not only crucial in workplaces, where Web3 and ChatGPT nip at the heels, but also for what longevity experts recommend for staying sharp as words start sticking on the tip of your tongue and absorbing new information takes a few extra beats. There’s nothing wrong with crossword puzzles (or sudoku and brain training apps), experts say, but you only get better at doing those games. It’s much more effective to lean in to your LQ. Take up the banjo, learn to read recipes in Italian, and go on more vacations—travel is a great way to perk up those synapses, especially if you do the trip planning.

Also at the top of the list: Move your body, says Vonetta Dotson, PhD, a neuropsychologist at Georgia State University, author of Keep Your Wits About You, and founder and president of CerebroFit, a one-stop shop for cognitive care. Research shows that exercise sparks neurogenesis and rebuilds myelin, the brain’s insulation that helps transmit messages along the nerve cells, which starts to wear away as we age. Even getting up for 10 minutes and dancing your heart out in your living room can give you a spritz of mental clarity, says Dotson. So will getting your z’s. During sleep, the brain appears to go through a rinse cycle where cerebrospinal fluid washes out toxins—the kind that have been shown to attack memory in Alzheimer’s patients.

Just as critical is spending time with friends. Emotional connections are like Miracle-Gro for the brain, per research by Joel Salinas, MD, a behavioral neurologist and researcher at NYU Langone Health and chief medical officer at Isaac Health. If you’re under 80 and not genetically predisposed to dementia, he says, loneliness triples your risk for it. In fact, the surgeon general has declared loneliness a public health epidemic in America because it (along with social isolation) is associated with about a 30 percent increased risk of heart disease and stroke. He says that spending just 15 minutes a day with someone you care about, making sure you’re 100 percent present, and finding ways to help someone else all reduce that risk. This will sharpen your brain, too—but especially if the caring goes both ways. “People with a lot of emotional support are much more likely to have higher levels of brain-derived neurotrophic factor,” says Salinas, referring to a substance that’s essential to learning and memory.

Laura Carstensen, PhD, founding director of the Stanford Center on Longevity, says you get an extra bump by hanging out with people of different generations. In one of her studies, using virtual reality, people who looked in the mirror at images of themselves as they would appear at an older age reported that they would save more for their retirements. “It’s hard to make changes like eating healthy and exercising for something abstract,” she says. “We’re much more motivated if we connect with ourselves in the future.” In real life, being with older people prompts us to think about whether we’d like to be like them or not. And younger generations inspire us with their energy and voracity to learn (and we have so much to teach!), reminding us to keep those qualities going in our own lives.

Eyes

In your 40s or 50s, you’ll probably start using readers. Grab an extra pair of shades, too, to make sure you’re protecting your eyes from UV damage. And if you’ve been blowing off yearly eye doc visits, no more. Catching problems like macular degeneration and glaucoma early can slow or prevent them from robbing you of vision; and if your eyes are miserably dry courtesy of menopause, prescription drops and other treatments can help. The other threat a good exam can thwart? Driving accidents. Research by Cynthia Owsley, PhD, a professor of ophthalmology at the University of Alabama at Birmingham, found that age-related changes—like slower visual processing speed and a shrinking field of vision, which don’t show up on a DMV test—significantly increase your chances. “Just by having your cataracts removed and replaced with intraocular lenses,” Owsley says, “you reduce your crash risk by 50 percent.”

Teeth

They’ll make you pay (literally) if you ignore them. Keep your dentist appointments, and whip out that floss.

Neck

If you work at a computer, you probably know about tech neck. It’s that hunch that settles in like an uninvited in-law, pushing your shoulders into a perpetual forward slouch, and no doubt (okay, anecdotally) causing “turkey neck” as the skin in front sags. It’s not a good look. Worse, it can be painful and bring on tension headaches. The quick fix: Pop a book or two under your monitor so your head is looking straight at the screen, and get up and walk around often to let your body stretch out. Long term, body-awareness techniques like Pilates, yoga, tai chi, Alexander technique, and Feldenkrais Method can change bad posture patterns and maintain good alignment, while teaching you to read your body like music for a less painful future, says Kate Hamel, PhD, professor of kinesiology at San Francisco State University.

Shoulders

These complicated joints are super vulnerable to injury as you age, especially the rotator cuff and tissue around it. Tennis, golf, and softball are some of the biggest culprits, along with chores like cleaning your gutters, says Tamara Huff, MD, an orthopedic surgeon in Columbus, Georgia. Shoulders can also start aching from good old osteoarthritis, which starts to creep in everywhere around the 40s and 50s (thanks again, menopause). She highly recommends strengthening the muscles around your upper back, including the traps, with stretches and exercises, which can go a long way toward prevention. But sometimes you need surgical help. “What’s really cool about the shoulder,” Huff says, “is if we get a hold of things early enough, there are so many things we can do to repair it.”

Back

Low-back pain is the number one cause of “years lived with disability.” That’s the dire (and stiffly phrased) declaration from a recent global Lancet study. “As we get older,” says Harvey Smith, MD, a spine specialist and associate professor of orthopaedic surgery at the Hospital of the University of Pennsylvania, “we get shorter because our discs—the soft cushions between the bones—start to collapse.” As they collapse, they bulge outward like a car tire going flat, and sometimes end up pinching a nerve, which can cause pain either in the lower back or radiating into the butt and down the legs. The best way to protect yourself is doing things already on your list—exercise, lose weight, and for the love of God, quit smoking (cigarettes particularly can lead to spinal degeneration). But also add some targeted strength training [see Core]. And make sure you keep rotating your torso, says Kate Hamel, the kinesthesiologist. “You should be able to sit in your chair and, without moving your bottom, turn to see 180 degrees in back of you,” she says. If you do end up with chronic backaches, Smith says physical therapy, cognitive therapy, acupuncture, and chiropractic adjustment can all help, with surgery as a last resort.

As for those excruciating random moments when–snap!–you bend down and can’t stand up again? Those spasms, says Smith, are a warning: You overdid it. Don’t move me! “The body goes to great lengths to protect your spinal cord with all those nerves.” If a couple days of rest, ice, gentle stretching, and ibuprofen don’t help, or if the pain is going down the arms to the legs, check in with the doctor; it could be a disc tear or herniation, or something else. To prevent future spasms, do more core strengthening and—sorry, ladies, you can’t outrun them—Pilates or yoga.

Heart

It’s a fact. Of all the things that are likely to kill you, heart disease is number one. Fortunately, there are also a lot of ways to dodge that stat—and they also help the rest of your body stay healthy. So take a few beats:

“Exercise is the most potent intervention we have in avoiding or delaying chronic diseases, including heart disease,” says Peter Attia, MD, author of the new book Outlive: The Science & Art of Longevity (as he wolfs down a wild venison stick one day before a hilly hike while lugging a weighted backpack, an activity called rucking.) His Rx for fitness is about half cardio and half strength training. Low-intensity activity like walking or cycling—easy enough where you can talk but hard enough that you can’t jabber a mile a minute with your girlfriend—improves your mitochondria, the mini power plants of your cells. But to stay functionally younger, Attia says, you’ve got to push your VO2, a measure of oxygen intake at the hardest you can exercise, which is especially important for heart health. And you do that with bouts of high- and low-intensity activity, like alternating four minutes of fast running with four minutes of easy jogging. When it comes to strength training, which also boosts bone density and metabolism, Attia has two pointers: To avoid injuries, focus not just on the lift or pull or climb, but also the return to where you started. “People hurt themselves falling off the curb, not stepping on it,” he points out. And if life gets in the way of your workout, just do a few push-ups or stand as much as you can: “Something to tax your body a bit,” he says. “It takes much longer to build muscle mass than to lose it.”

In more exciting news, it’s official: Sex is good for your heart, and not just metaphorically. A study out of Michigan State University found that physical pleasure and emotional satisfaction from sex seem to protect women from cardiovascular risks, particularly high blood pressure. (Unfortunately for the guys, the same doesn’t hold true—go figure.) [See Vagina.]

Hands

As kids or single 20-somethings, we studied the lines on our palms to see how long we would live. As adults, we just have to clench them. Hand grip is one of the biggest indicators of how long we’ll be healthy as we get older, according to Attia. Not that this means you should walk around with those little grip-squeezer gizmos, he says. But if you do have trouble grasping things, you likely need overall strengthening. Note to self: Get to that fitness plan.

Breasts

In case you missed it, the U.S. Preventive Services Task Force now recommends all women start mammograms at age 40. Also, we now know that changes in breast density can be a warning sign. Density generally decreases with age, but subjects who lose it more slowly have higher odds of developing cancer. Since you can’t feel this with a self-exam (which you’re doing diligently, right?), it’s even more important to never skip a screening.

Core

Ah the core…it’s kind of like Oz, a distant place with mysterious powers. Actually, says Dorian Cervantes, a Pilates-trained instructor at Obé fitness, the core is a very real group of muscles that wrap around your trunk to stabilize the pelvis and spine. “It’s not a six pack—if you want aesthetics, fix your diet,” she says. “This is your center, your powerhouse.” Aside from Pilates and yoga, which go right for those muscles, Cervantes recommends exercises like “dead bug” and “bird dog” and planks. Adding a few of these core strengtheners into a 10-minute prehab before a workout can save you from injury. “Because, I tell you what,” says Cervantes. “Pickleball is really getting people. I mean, people are getting messed up! As you get older, you can’t just throw yourself into things!”

Gut

As we age, digestive problems pile on, so what we eat becomes even more important. With acid reflux, for example, the muscular valve that opens to pass food from the esophagus weakens and doesn't shut all the way, allowing stomach acid to splash back up. “And unlike your hamstrings, we can’t take it to the gym!” says Christine Lee, MD, a gastroenterologist at Cleveland Clinic. Irritable bowel syndrome, a grab bag of constipation, diarrhea, gas, and bloating, has all kinds of causes, including the medications you may now be taking for high blood pressure and cholesterol. (Probiotic-rich fermented foods like sauerkraut, yogurt, and kimchi are worth a try, says Lee, but are no magic bullet.) Then there’s diverticulosis, which is sneaky. Half of Americans over age 60 have it, but most don’t know it. Imagine it this way, says Lee: Your colon starts out as a pristine highway, but by your 40s and 50s, it inevitably starts getting potholes. That’s diverticulosis, which only tends to show up incidentally when you have a colonoscopy (when, not if—because you must start at age 45). If you’re diagnosed, you’re lucky. It gives you a chance to up your fiber game, because “the potholes get impacted with stool and infected or inflamed and in danger of bursting. That’s when it’s diverticulitis with an i,” says Lee, “and this is usually diagnosed in the ER.”

Lots of fiber is, in fact, a key component for what some recent studies show is the optimal way to eat for longevity. In a walnut shell: Go Greek. If you switch to the Mediterranean diet from the typical Western one in your 60s, as a woman you can expect eight extra years of life; do it in your 20s, and you get more than a decade. We’re talking tons of veggies, nuts, whole grains, some fish—more specifically, 45 to 60 percent of calories from nonrefined complex carbohydrates, 10 to 15 percent plant-based protein (a bit more as you get older), and 25 to 35 percent plant-based fats, according to research in the journal Cell.

That study also recommends “intermittent fasting,” an idea that’s catching on in longevity circles. Experts have long been tantalized by caloric restriction, which involves slashing your intake by around 25 percent, because it remarkably seems to slow aging. No one is suggesting this, fortunately, but you get some of the benefits by doing it moderately, says the study’s coauthor Valter Longo, PhD, director of the Longevity Institute at the University of Southern California’s Leonard Davis School of Gerontology. Based on the research, he recommends fasting between 11 and 12 hours a day by going without lunch or eating dinner early. “Don’t skip breakfast,” and consult your doctor first, he says.

Vagina

Do you really need a sex life? It may be good for the heart, but menopause, with estrogen doing its disappearing act, can leave your vagina high and dry (technically, thin and dry) and delete your desire like an old computer program. First, the physical: If lubricant or daily vaginal moisturizer doesn’t help, doctors can prescribe oral estrogen, depending on your other symptoms, or as a local topical cream, tablet, or ring. And Osphena is a nonhormonal FDA-approved drug for painful sex. Regular vaginal self-massage may also help.

As for libido, Price, from “the land of old,” stresses that feeling hot and bothered is only one kind of desire. You can also crave sex after you’re aroused. “Put yourself in a situation where you would enjoy it if you felt desire, and go ahead and get started,” she suggests. Try to relax and just feel the pleasure. As clichéd as they are, she’s an advocate for making sex dates with your partner—anticipation is an underestimated aphrodisiac. A prime time is after exercise but before eating, because increased blood flow can boost arousal.

What if you’re single? Even if you have a lover, vibrators are better than ever. As you get older, the general rule is “stronger and rumblier instead of buzzy,” says Price. A few of her personal faves? For clitoral stimulation, the Eroscillator (“get the ultra-soft fingertip attachment”) and the Womanizer (there are several models with sensuous air pulses). For penetration, she’s all about the Kurve, which has treble and bass options for different vibes. “It’s worth it to spend more on good-quality materials because this is going up against your genital skin,” she says. “You don’t wanna be putting chemical-laden jelly toys there.”

Hips

Crazy but true: If you are over 50 and fracture your hip, you have a one-in-three chance of dying within a year. Bone density test, anyone? (With some loss, it’s definitely time to hit the weight-bearing exercise and get more calcium and vitamin D; if it’s significant, your doctor will discuss drugs to treat it.) The more immediate problem is usually arthritis, which can cause a deep pain in the groin when you cross your legs or get out of the car. Tamara Huff, the Georgia orthopedist, says she starts by having patients switch their workouts to gentle motion. Walking, swimming, and cycling are great; yoga and Pilates, too. “The worst thing you can possibly do is stop moving,” she says. “That’s actually a death sentence to your joints.” But if you’re still in pain, hip replacements are life-changing. You can be out of the hospital—and walking—the same day of surgery.

Knees

“Knees are the ones that tell on us the fastest,” says Huff. “They take all the force.” Aside from injuries like meniscus and ACL tears, basic aging really gets to them (arthritis again). Doing a few specific exercises—like stretches, straight-leg lifts, and hamstring curls—every day to strengthen the muscles around the joints can go far to keep you out of pain, and if you’re overweight, losing even a few pounds should make a difference. Like with painful hips, switching your workout to low-impact cycling and swimming, or even running on packed dirt versus pavement, can help. If you love your squats (definitely not knee-friendly), do a modified version against the wall with a wide stance, and instead of going deep, stop partway down and do pulses.

But as with the hips, a knee replacement can make you feel like a new person—and you can be in and out the same day. More and more people in their 40s and 50s are having them done, although it’s tricky. The implants last only 15 to 20 years, says Huff, but waiting until your pain is severe means a poorer outcome. Bottom line: Don’t wait to get a consultation. A study in The New England Journal of Medicine showed that for people who very much need knee replacements, the subject just doesn’t come up with their doctors—and it happens three times as often in women as in men. “You want to make sure you see an orthopedist,” says Huff. “It doesn’t mean you have to have the surgery.”

Feet

Last but not least: “You have 26 bones, 33 joints, and four layers of muscles in each foot, 10 muscles in total,” says Irene Davis, PhD, president of the American College of Sports Medicine, who has long researched the lowly appendage. She has one message: “Free your feet!”

Go barefoot at home, and try wearing “minimalist shoes”—anything you can roll up, like ballet flats, flip-flops, and sneakers without midsoles, Davis says. Start with short walks, and if you’re sore, skip a day; it can take a while to adapt, but this will make them strong and nimble. Non-custom insoles or taping can be useful while healing from foot injuries, but only temporarily, she says—one study showed that wearing them for 12 weeks reduced muscles in the foot 10 to 17.5 percent. For the bane of the sole, plantar fasciitis, she says you can often just use over-the-counter orthotics and rest (try rolling on a frozen water bottle for the pain), and when it’s better, start walking slowly. Simple foot exercises can help prevent future episodes and are great for anyone to restore strength and dexterity and significantly improve balance. (The “doming” move, where you pull the large joint of the big toe toward the heel while creating a dome under your foot, is a good one you can do sitting at your desk or in line at the grocery store on one foot, says Davis.) If you’re attached to your pumps or strappy heels, pull them out for special occasions. That’s what she does; otherwise it’s usually flip-flops. “I gotta walk the walk,” she says. “No pun intended.”

And with that, let’s all kick off our shoes and stride toward a healthy future. “Having 30 extra years, on average, to live has got to be among the greatest accomplishments in human history,” says Stanford’s Laura Carstensen. “So what do we do differently? Number one, recognize the opportunity, and don’t let it pass by!”

Any content published by Oprah Daily is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. It should not be regarded as a substitute for professional guidance from your healthcare provider.

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