Lifestyle habits like adopting a heart-healthy diet, exercising regularly, and getting plenty of sleep don’t just help lower the risk of events like heart attacks and strokes – they also may slow down biological aging, a new study suggests.

Unlike chronological age, which is determined by date of birth, biological age can be older or younger based on a variety of health measures. The study looked at whether eight modifiable heart health factors could slow biological ageing:

  • Diet
  • Exercise
  • Tobacco use
  • Weight
  • Cholesterol
  • Blood sugar
  • Blood pressure
  • Sleep

Among more than 6,500 participants in the study, people who did the best at managing these eight things to achieve optimal heart health had average biological ages about six years younger than their chronological age, according to preliminary findings presented at the American Heart Association (AHA) Scientific Sessions 2023.

“As heart health improves, biological ageing slows down,” says senior study author Nour Makarem, PhD, an assistant professor of epidemiology at Columbia University Irving Medical Center’s Mailman School of Public Health. “This is important because lower biological ageing is associated with a lower risk of death and disease, and a greater number of years of life lived in good health.”

By contrast, people in the study who had the poorest cardiovascular health were biologically about five years older than their chronological age.

“We show that the eight modifiable health behaviours and health factors that can lead to heart disease when sub-optimal can also accelerate the body’s ageing process,” Dr. Makarem says.

Life’s Essential 8 for Heart Health

All eight factors that researchers assessed are on the AHA’s Life’s Essential 8 checklist, which lays out things people can do to lead a heart-healthy lifestyle. It scores people on a 100-point scale, with higher average scores across all eight items indicating better cardiovascular health. You can check your score with the AHA’s online tool. These are the things people need to do for optimal heart health — and high scores — according to the AHA:

  • DietClosely follow a Mediterranean style eating pattern that includes whole foods, lots of fruit and vegetables, lean protein, nuts, seeds, and cooking with healthy oils like olive oil.
  • ExerciseAim for 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise each week
  • TobaccoAvoid all forms of nicotine – including e-cigarettes, as well as older forms of smoking like cigarettes and cigars.
  • WeightMaintain a body mass index (BMI) of 18.5 to 24.9.
  • CholesterolInstead of focusing on total cholesterol, aim to reduce harmful fats in the blood such as triglycerides and low density lipoprotein (LDL) cholesterol.
  • Blood SugarMaintain healthy blood sugar levels, which can be checked with blood tests showing so-called haemoglobin A1C levels, which reflect average blood sugar levels over about three months.
  • Blood PressureTry to keep blood pressure below 120/80 mmHg
  • SleepAdults should aim for seven to nine hours a night.

It’s Never Too Late to Improve Your Health
Knowing how well you’re doing at achieving these eight things can help you focus on the things you can improve, says Donald Lloyd-Jones, MD, chair of the writing group that drafted Life’s Essential 8 and a professor at Northwestern University’s Feinberg School of Medicine in Chicago.

“It’s never too late to try to improve your cardiovascular health score,” says Dr. Lloyd-Jones, who wasn’t involved in the new study.

“The earlier you start, the better for sure, but it’s never too late. We see benefits from improving cardiovascular health at every stage of life.”

People with low scores who aren’t sure how to start making improvements may want to start gradually and focus on health habits like how much they sleep or what they eat, Dr. Makarem advises. That’s because improvements to things like eating and exercise habits can lead to improvements in the other factors that matter, like blood pressure or weight.

“It is important to remember that progress is better than perfect, and to focus on making gradual changes in health behaviour,” Makarem says.