One figure shows why this definition matters. In Türkiye, according to the 2023–2025 life tables of the Turkish Statistical Institute (TurkStat, TÜİK), life expectancy at birth is 78.5 years. The same dataset puts healthy life expectancy at birth at 58 years. That gap of roughly 20 years means the average person spends the last quarter of their life living with one or more chronic diseases. Closing that gap is exactly what longevity medicine is about.
Türkiye | Years |
|---|---|
Life expectancy at birth | 78.5 |
Healthy life expectancy at birth | 58 |
What does longevity mean? Lifespan vs. healthspan
Two ideas are kept apart here. Lifespan is the total number of years you live. Healthspan is the part of that time spent free of serious disease or dependence on others. Longevity medicine focuses on the second, because living to 85 and spending the last 15 years bedridden is not the long life most people have in mind.
Scientists no longer see ageing as a single process. The "hallmarks of aging" framework, updated in the journal Cell in 2023, describes 12 interconnected mechanisms, from DNA damage and mitochondrial dysfunction to chronic low-grade inflammation and disrupted gut flora. What they share is that each one underlies age-related diseases such as heart disease, type 2 diabetes, cancer and dementia. Slowing ageing therefore means postponing all of these diseases at once.
Longevity vs. anti-aging vs. healthy ageing
The three terms are often used interchangeably, but they aim at different things:
Approach | Focus, timing and tools |
|---|---|
Anti-aging | Focuses on appearance, skin and hair. Usually starts once signs appear; assessment is visual and the tools are cosmetic and aesthetic procedures. |
Healthy ageing | Aims to preserve function in later life. Usually comes up after 60; daily living activities are monitored, and rehabilitation and social support are the main tools. |
Longevity medicine | Aims to delay age-related disease. Ideally starts in your 30s or 40s; progress is tracked with blood tests, fitness measurements and imaging, and the core tools are a lifestyle plan and screening. |
Skin care can be part of longevity: sun protection lowers the risk of skin cancer. But treating wrinkles does nothing for your heart attack risk. That is what sets longevity apart from anti-aging: it looks at what is happening inside.
Is longevity determined by genetics?
"Everyone in our family lives to 90" may be partly true, but genes matter less than people think. Twin studies in Denmark showed that about 20–25% of the variation in lifespan is explained by heredity. A 2018 analysis of family-tree data covering more than 400 million people suggested the share is actually below 10%; earlier estimates were inflated because spouses tend to share similar lifestyles.
In short, most of how long we live comes down to choices we make every day. That is the good news. If your family history includes early heart attacks, diabetes or certain cancers, treat that genetic risk not as fate but as a reason for earlier and more frequent check-ups.
What is biological age? What do longevity tests measure?
Your chronological age is your date of birth. Biological age describes how much wear your body shows relative to that age. Of two people born in the same year and now 50, one may have the blood vessels and muscles of a 40-year-old and the other those of a 60-year-old.
One point needs to be clear: no single test accurately measures biological age on its own. Some of the "find out your biological age" kits sold online give results that differ by years for the same sample sent to different labs. In the clinic, the more reliable route is to read together several measurements with proven power to predict risk.
Measurement | What it shows · Strength of evidence |
|---|---|
Blood pressure | Vascular ageing, risk of stroke and heart attack · Strong |
HbA1c, fasting glucose, insulin | Glucose metabolism, prediabetes · Strong |
LDL, ApoB, Lp(a), triglycerides | Risk of atherosclerosis; Lp(a) is a genetic risk that only needs measuring once in a lifetime · Strong |
eGFR, creatinine | Kidney reserve; also linked to cardiovascular risk · Strong |
VO2max / exercise stress test | Cardiorespiratory capacity; one of the best predictors of mortality risk · Strong |
Grip strength, walking speed | Muscle loss (sarcopenia) and frailty · Strong |
Body composition (DEXA) | Distribution of muscle, fat and visceral fat; bone density · Strong |
hs-CRP | Chronic low-grade inflammation · Moderate |
Epigenetic clock | Estimated rate of cellular ageing · Still at research stage |
Telomere length | History of cell division · Weak, little individual value |
The first seven measurements in the table can be done with a standard check-up and simple physical tests. Expensive epigenetic tests may add interesting information, but for someone with high cholesterol, uncontrolled blood pressure and no weekly exercise, that test should not be the first step.
7 evidence-based habits for a long, healthy life
Harvard researchers followed more than 120,000 people for over 30 years and looked at five simple habits: not smoking, keeping a normal weight, at least 30 minutes of activity a day, moderate alcohol intake and a good-quality diet. Those who kept all five lived on average 14 years longer after age 50 (women) and 12 years longer (men) than those who kept none.
At age 50 | Remaining life expectancy |
|---|---|
Women | 29.0 years with no healthy habits; 43.1 years with all five (+14 years) |
Men | 25.5 years with no healthy habits; 37.6 years with all five (+12 years) |
Research in recent years has added two more to these five: muscle strength and social connection.
1. Measure and improve your fitness
Cardiorespiratory fitness, the ability of your heart and lungs to deliver oxygen to the body, predicts mortality risk even better than smoking or diabetes. In a study of exercise tests from 122,000 people, those in the lowest fitness group had about 5 times the risk of death of those in the highest group. The World Health Organization recommends 150–300 minutes a week of moderate-intensity activity (a pace at which you can talk but not sing). Adding short, hard intervals that leave you out of breath on one or two days a week is the fastest way to raise VO2max.
2. You don't need 10,000 steps
A pooled analysis of 15 studies found that the drop in mortality risk levels off at around 6,000–8,000 steps a day for people over 60, and around 8,000–10,000 steps for those under 60. Going from 3,000 to 7,000 steps does far more good than going from 10,000 to 15,000.
3. Stop muscle loss early
After your 30s you lose some muscle mass each decade, and the rate speeds up after 60. In the PURE study, which followed 140,000 people in 17 countries, every 5 kg drop in grip strength was linked to an approximately 16% increase in mortality risk. That is why strength training at least two days a week, with weights, resistance bands or your own body weight, is recommended for everyone, not just gym enthusiasts. People with joint problems can start a safe programme under the guidance of physical therapy.
4. Sleep: regularity matters more than hours
Adults are advised to sleep 7–9 hours a night. But research shows that a bedtime that shifts from day to day also raises cardiometabolic risk. Keeping your weekday and weekend bedtimes within a one-hour window is a good start. If you snore, feel sleepy during the day or wake up with headaches, you may need an assessment for sleep apnoea at a sleep disorders centre; untreated apnoea is closely linked to high blood pressure and heart rhythm disorders.
5. Smoking: the single biggest gain
Smokers lose at least 10 years of life on average. The good news is that those who quit before 40 avoid about 90% of that excess risk. In a longevity plan, no supplement or test comes close to the effect of this one step.
6. Cut down on alcohol
The idea that "a glass of red wine a day is good for the heart" has been largely called into question in recent years. Current data show there is no safe lower limit for alcohol and that cancer risk rises even with small amounts. If you drink, drink less; if you don't, there is no health reason to start.
7. Don't stay isolated
An analysis of 148 studies found that people with strong social relationships were about 50% more likely to survive over the follow-up period. That effect is comparable in size to quitting smoking. If you are dealing with long-lasting loneliness, depression or chronic stress, support from psychiatry or psychology is an essential part of a longevity plan. The shifts in dopamine and cortisol balance under chronic stress have knock-on effects on sleep, appetite and blood sugar.
The longevity diet: what to eat and what to limit
There is no single programme that deserves the name "longevity diet". The eating habits of long-lived populations and large clinical trials point to the same thing: a mostly plant-based, minimally processed diet close to the Mediterranean pattern. In Spain's PREDIMED trial, people on a Mediterranean diet supplemented with olive oil or nuts had about a 30% lower risk of heart attack, stroke and cardiovascular death. Turkish cuisine, with its olive oil vegetable dishes, legumes and yoghurt, already overlaps heavily with this model.
How often? | Foods |
|---|---|
Eat often | Vegetables and fruit (5+ portions a day), chickpeas, lentils, beans, bulgur, oats, whole grains, olive oil, walnuts, almonds, oily fish twice a week (omega-3), yoghurt and kefir (probiotics) |
Eat in moderation | Red meat (1–2 times a week), cheese, butter, eggs, honey, grape molasses, rice, pasta, coffee (2–3 cups a day) |
Limit | Processed meats such as sausage and salami, sugary drinks and fruit juices, packaged snacks, desserts heavy in white flour and sugar, fried foods, trans fats, alcohol |
Protein deserves special attention. To prevent muscle loss, healthy adults over 65 are advised to eat 1.0–1.2 grams of protein per kilogram of body weight a day; for a person weighing 70 kg that is roughly 70–85 grams. In kidney disease this target changes, so your needs should be set with a nutrition and dietetics specialist.
Intermittent fasting and calorie restriction extend lifespan in animal studies. In humans they have been shown to help with weight loss and insulin sensitivity, but they have not proven clearly superior to a conventional diet with the same calorie intake. If it suits you, it can be a useful tool, but on its own it is not a longevity strategy.
Supplements: When a deficiency has been confirmed, B12, vitamin D or iron supplements make a real difference. There is no strong evidence that supplements taken "just in case", without a deficiency, extend life.
Longevity treatments without enough evidence yet
Longevity is one of the fastest-growing areas of healthcare, and that growth has brought expensive treatments with weak evidence. If a clinic offers you any of the following, you have every right to ask which human studies it is based on.
Treatment | What is known and what is not |
|---|---|
NAD+ supplements / IV drips | Raise NAD+ levels in the blood. Not shown to change lifespan or disease risk in humans. |
Metformin (in people without diabetes) | Safe and effective in diabetes. Not proven to slow ageing in healthy people; the TAME trial has not yet reported. |
Rapamycin | Extends lifespan in mice. Safe dose and long-term benefit in humans are unclear; it can suppress the immune system. |
Stem cells, exosomes | Approved for some blood and immune disorders. No proven benefit for ageing; unapproved use carries a risk of infection and tumours. |
Ozone, chelation, IV vitamins | Limited use in specific medical conditions. Not shown to extend life in healthy people. |
Hormone therapy | Appropriate for true deficiency or menopausal symptoms. No proven "rejuvenating" effect when there is no deficiency. |
This does not mean the field is worthless; some studies may genuinely change direction in the coming years. But for now, what gains a healthy 45-year-old the most years is still keeping blood pressure, cholesterol and blood sugar under control, staying active and quitting smoking. Decisions on hormone treatment, such as oestrogen or testosterone, should always be made after assessment by a specialist in endocrinology, gynaecology or urology.
A longevity roadmap by age
Which tests to have and when depends on your family history and risk factors. The table below gives a general framework; your personal plan should be drawn up with your doctor.
Age | Priorities and recommended checks |
|---|---|
30s | Laying the foundation: muscle mass, fitness, sleep routine. Blood pressure, lipid profile, fasting glucose; Lp(a) once in a lifetime; cervical screening for women. |
40s | Catching metabolic risks early: annual check-up, HbA1c, fatty liver, mammography for women; exercise stress test if at risk. |
50s | Cardiovascular and cancer screening: colonoscopy, PSA discussion for men, bone density (for women after menopause), eye and hearing tests. |
60+ | Preserving independence: grip strength, walking speed, fall risk, cognitive screening, vaccination schedule, medication review. |
If you want a more detailed look at your heart and vascular risk, the Heart and Lung Health Check-Up Programme is a good fit; for a general starting point, our general check-up programmes for women and men are a sensible option. For protecting your heart in everyday life, see our article 7 tips for heart health.
Which department should you see for longevity?
Longevity is not a separate specialty; it is an approach in which several departments work together. The starting point is usually internal medicine or the check-up unit. Depending on your results, care may continue with these departments:
Cardiology: cholesterol, blood pressure, exercise stress test and cardiovascular risk
Endocrinology: insulin resistance, thyroid, hormone balance
Nutrition and dietetics: personalised nutrition and protein plan
Neurology: memory complaints, dementia risk
Physical therapy and rehabilitation: muscle strength, balance, joint health
Sleep disorders centre: sleep apnoea and insomnia
Let's work out together where you should start: at the first consultation we review your family history, existing test results and lifestyle, and choose the tests that make sense for you. You can book an appointment online or browse our check-up packages.
Frequently asked questions about longevity
What does longevity mean?
Longevity literally means a long life. In medicine, it describes a preventive, measurement-based and personalised approach to health that aims to extend the years lived in good health (healthspan) rather than lifespan alone.
What is the difference between longevity and anti-aging?
Anti-aging deals mainly with visible signs of ageing, that is, skin and appearance. Longevity measures cardiovascular, metabolic, muscle, brain and immune health and tries to delay the onset of age-related diseases.
How is biological age measured?
No single test shows biological age with certainty. In the clinic, measurements such as blood pressure, HbA1c, ApoB, kidney function, grip strength, VO2max and body composition are assessed together. Epigenetic clock tests are valuable for research, but on their own they are not enough to base treatment decisions on.
Are longevity tests reliable?
It depends on what the test measures. Tests such as the lipid profile, HbA1c, Lp(a) and exercise capacity reliably predict disease risk. Epigenetic clock and telomere length tests can give different results from one lab to another, so results should be interpreted with a doctor.
What is the longevity diet?
There is no single longevity diet. The strongest evidence comes from the Mediterranean diet: mostly vegetables, legumes, whole grains, olive oil, nuts and fish, with limited processed meat, sugar and ultra-processed foods. Getting enough protein also matters for preventing muscle loss in later life.
At what age should you start with longevity?
It is never too late to start, but the biggest gains come from changes made between 30 and 50, before risk factors turn into disease. Even people who adopt healthy habits at 50 have been shown to gain 12–14 years of life expectancy.
How much do genes determine longevity?
Twin studies show that about 20–25 percent of lifespan is explained by heredity; a more recent analysis of millions of family records put that share below 10 percent. In other words, lifestyle and environment account for most of it.
Do NAD+, metformin or rapamycin slow ageing?
These substances have shown promising results in animal studies, but there is no completed clinical trial showing that they extend life in healthy people. Using prescription drugs for the purpose of slowing ageing is not recommended.
What tests are included in a longevity check-up?
It varies with age and risk factors, but it usually includes a full blood count, fasting glucose and HbA1c, lipid profile, ApoB and Lp(a), liver and kidney function, thyroid, vitamin D and B12, blood pressure, ECG and exercise stress test, body composition and age-appropriate cancer screening.
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