Longevity in Stories
Dr. Sataporn Wangthitikul, MD — Longevity & Aesthetic Medicine Physician, Layan Life by Anantara
The gap nobody plans for
Almost everyone who comes to see me wants to live a long time. Very few have thought about the shape of those years. That distinction turns out to matter more than the number.
A 2024 analysis of all 183 WHO member states put a figure on it. Worldwide, people now spend an average of 9.6 years of life burdened by disease — the distance between how long we live and how long we live well — and that gap has widened by roughly 13% since 2000. It is larger in women than in men, by about 2.4 years (Garmany & Terzic, 2024). We have become good at extending life. We have been much less good at extending the useful part of it.
The window is midlife, not old age
The instinct is to deal with this later. The data says otherwise. A 2025 study in Nature Medicine followed more than 105,000 adults for thirty years, starting when they were in their late thirties to sixties, and asked a harder question than “did they survive?” — it asked whether they reached seventy free of major chronic disease, with cognition, physical function and mental health intact. Only 9.3% managed it. The single strongest dietary predictor was adherence to the Alternative Healthy Eating Index in midlife, associated with 86% greater odds of ageing well at seventy (Tessier et al., 2025).
Read that number carefully. It isn’t a promise. It’s an association across three decades, which is precisely the point — the interventions that decide how your seventies look are the ones you’re making now, in your forties, when nothing feels urgent.
The number I pay most attention to
If I could track one measurement across a patient’s life, it would be cardiorespiratory fitness. In a Cleveland Clinic cohort of 122,007 adults, those in the lowest fitness band had roughly five times the all-cause mortality of the fittest group, an effect comparable to or greater than smoking, diabetes or coronary artery disease — and there was no upper limit to the benefit (Mandsager et al., 2018).
Nothing else in preventive medicine has quite that shape. It is also, unlike your genome, something you can change in twelve weeks.
Measure first, then plan
We can now do better than guessing. Plasma proteomics allows organ-level ageing to be estimated separately — your heart may be running older than your kidneys — and accelerated organ ageing carries a 20–50% higher mortality risk, with an accelerated heart signature associated with a substantially higher risk of heart failure (Oh et al., 2023).
So a longevity plan, at least the way we build one at Layan Life, isn’t a supplement list. It starts with measurement — bloods, body composition, VO₂max, metabolic and hormonal markers — and turns that into a small number of things worth changing, reviewed on a schedule. Most of the work is unglamorous. That is usually a sign it’s the right work.
References
Garmany, A., & Terzic, A. (2024). Global healthspan-lifespan gaps among 183 World Health Organization member states. JAMA Network Open, 7(12), e2450241. https://doi.org/10.1001/jamanetworkopen.2024.50241
Mandsager, K., Harb, S., Cremer, P., Phelan, D., Nissen, S. E., & Jaber, W. (2018). Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open, 1(6), e183605. https://doi.org/10.1001/jamanetworkopen.2018.3605
Oh, H. S.-H., Rutledge, J., Nachun, D., Pálovics, R., Abiose, O., Moran-Losada, P., Channappa, D., Urey, D. Y., Kim, K., Sung, Y. J., Cruchaga, C., Montine, T., Henderson, V. W., Mormino, E., & Wyss-Coray, T. (2023). Organ aging signatures in the plasma proteome track health and disease. Nature, 624(7990), 164–172. https://doi.org/10.1038/s41586-023-06802-1
Tessier, A.-J., Wang, F., Korat, A. A., Eliassen, A. H., Chavarro, J., Grodstein, F., Li, J., Liang, L., Willett, W. C., Sun, Q., Stampfer, M. J., Hu, F. B., & Guasch-Ferré, M. (2025). Optimal dietary patterns for healthy aging. Nature Medicine, 31(5), 1644–1652. https://doi.org/10.1038/s41591-025-03570-5
