Podcast Summary

Podcast: Feel Better, Live More with Dr Rangan Chatterjee
Episode: How To Live Longer and Better: The Secret to Super Ageing with Dr Eric Topol (#626)
Guest: Dr Eric Topol – Cardiologist, Professor, author of “An Evidence Based Approach to Longevity”
Date: February 18, 2026

Episode Overview

This episode centers on how we can extend our healthspan—the number of years we live in good health—rather than simply increasing lifespan. Dr. Eric Topol, a world-leading cardiologist and medical researcher, draws from his new book to explore the evidence base for adding 7-10 years of disease-free, healthy living by focusing on achievable lifestyle changes. The conversation covers why healthspan lags behind lifespan, the “lifestyle plus” model (incorporating social, environmental, and psychological factors), the profound impact of exercise, diet, and sleep, and how AI and individual health data will revolutionize prevention.

Key Discussion Points & Insights

1. Healthspan vs. Lifespan: The Core Problem

• The gap between healthspan and lifespan is roughly 15 years: Many spend their last years in poor health or with chronic disease.

  • [03:55] "Lifestyle like lack of exercise... obesity... poor diets... poor sleep health... environmental exposures... there’s a mixture of many different factors that play a role in compromising our healthspan." – Dr. Eric Topol

• Dr. Topol highlights alarming statistics:

  • 95% of Americans over 60 have at least one chronic disease (UK similar).
  • By age 65 in the US, 80% have two or more chronic diseases.
  • [09:44] "Our health span is relatively short and this gap is so, so expansive." – Dr. Eric Topol

• Key insight: The real goal is not merely living longer, but maximizing the number of years lived in good health, vitality, and independence.

2. The “Worlderly” Project: Genetics vs. Lifestyle

• Dr. Topol describes a project [06:30–09:44] assembling over 1,400 people aged ~89 with no chronic diseases and no medications.

  • Only a minor fraction of their healthy aging could be attributed to genetics.
  • The immune system emerged as a key differentiator—heavily influenced by lifestyle.
  • "It completely altered our perception that we’re stuck with our parents’ story for healthspan. It’s not true at all." – Dr. Eric Topol [09:03]

• Notable quote:

  • [06:12] "We should be focusing on healthspan or what we call the ‘welderly’... people who are 85+ and don't have cancer, cardiovascular disease, or neurodegenerative disease." – Dr. Eric Topol

3. The “Lifestyle Plus” Model

• Dr. Topol advocates for “lifestyle plus”:

  • Diet, exercise, sleep, and environmental toxins (e.g. air pollution, microplastics), social isolation, mindset.
  • [13:00] "My much broader definition is lifestyle plus... it adds environmental conditions, socioeconomic status, loneliness and social isolation..." – Dr. Rangan Chatterjee, quoting Topol

• "Most of the things we can do now are either free or eminently affordable and make a big difference... there are so many hucksters out there selling things that don't have any data." – Dr. Eric Topol [13:00]

4. What Really Makes the Difference? Basics Over Tech

• Despite his expertise in genomics and AI, Dr. Topol stresses that longevity success depends on the basics:
  • Movement, nutrition, sleep, and connection remain foundational ([14:50])
  • "None of that [tech advances] is going to be important without attention to these lifestyle factors." – Dr. Eric Topol

5. The “Big Three” Diseases & Prevention

• Cancer, heart disease, and neurodegeneration account for 85% of the healthspan/lifespan gap.
  • Each takes ~20 years to develop (a huge window for prevention).
  • All are linked by inflammation and immune dysfunction ([16:07])
• AI is poised to help us identify risk "20 years ahead" so preventive action can be tailored ([17:59]):
  • "That will be the singular biggest contribution of AI in medicine: helping us to find high-risk people and to help prevent diseases ultimately." – Dr. Eric Topol

6. Diet: Personalization, Ultra-Processed, and Protein

• Poor diet is linked to 22% of all deaths.

  • Ultra-processed foods, excessive calories, and unbalanced macros (protein/carbs/fat) are major drivers ([19:21]).

• Mediterranean diet has strongest evidence, yet personalization is key.

  • Each person's needs/microbiome/genome is unique ([22:57]).
  • "There is no one diet that's right for all people… The all people thing just doesn't exist." – Dr. Eric Topol

• CGMs and Data-Personalization:

  • Individual data empowers change. Dr. Topol discovered via a CGM that tortilla chips and pizza spiked his glucose, changing his habits ([30:10]).
  • "For me, other people I know can eat the same foods and they're totally flat… it's a very individual response."

• Time-Restricted Eating:

  • Even simple practice (e.g., 7 pm to 7 am fast) shown to help weight, health ([34:46]).
  • No clear evidence by sex; more research ongoing.

7. Exercise: Foundation for Disease Prevention

• If you choose one lifestyle factor, choose movement.

  • Exercise slows biological aging, is anti-inflammatory, fortifies immune health, and benefits all three major diseases ([41:56]).
  • "If you're gonna just pick one thing to concentrate on, this would be it." – Dr. Eric Topol

• Not just aerobics—include:

  • Resistance/strength training (muscle mass predicts successful aging)
  • Balance and good posture (crucial after 40; prevents falls, preserves independence)
  • Walking is vastly underestimated—recent study shows it’s a standout for health ([44:02]).

8. Mindset and Social Connection

• All the “welderly” or superagers had upbeat, positive personalities ([45:44]).
  • "The most common thread was that their disposition, they are upbeat, happy people." – Dr. Eric Topol
• Social isolation/loneliness is a powerful negative (increased risk for all aging diseases) ([86:55]).
• Hope and optimism—across blue zones and in dying individuals—reliably correlates with better health, less regret.

9. Environmental Toxins: Air Pollution, Plastics, Forever Chemicals

• Air pollution: Strong, proven driver of inflammation and major diseases ([49:28]).

• Microplastics: Italian carotid study—60% had microplastics in arteries; those individuals had much higher rates of heart attacks, strokes ([49:28]):

  • "That study to me cinched it... it does incite locally inflammation, as we've seen in the artery, and it accumulates in every part of the body..." – Dr. Eric Topol

• Forever chemicals (PFAs, perfluorocarbons):

  • Non-degradable, abundant in daily items (non-stick pans, cosmetics).
  • Industry knows the dangers but lacks regulation ([80:47]).
  • Democratizing action at the individual and government policy level is essential.
  • Both experts: control what you can (home environment), but broader change requires regulation.

• "Our storage and our reliance on plastic is just way out of control and at least part of it is under our control." – Dr. Eric Topol [60:29]

10. Knowledge & Individual Data Are Power

• Personal biomarkers drive change:

  • Dr. Chatterjee only acted on plastic exposure after seeing his own BPA levels ([62:11]).
  • Behavior change accelerates when people see their own risk data (as shown in Finnish heart disease polygenic score study [71:22]).

• Prevention (Alzheimer's example):

  • AI + early biomarkers (genomics, protein markers like P-Tau217, pace-of-aging clocks) allow for detection/behavior change decades before symptoms ([65:22, 68:04]).
    • "We’re going to go into an era of prevention that I am really excited about. Treatment is not the end all, it's prevention." – Dr. Eric Topol [91:42, 00:01]

• Screening Philosophy:

  • Mass age-based cancer screening is wasteful and often ineffective (false positives, anxiety, unneeded procedures).
  • Risk-based, personalized screening (using genomics, immune clocks, etc.) is vastly superior ([72:51–77:30]).

11. Audience Q&A Highlights

• Does stress/sadness cause heart issues? Acute and chronic stress can acutely damage the heart and increase disease risk ([84:38]).
• Best healthy upgrade? Exercise, with proper balance ([85:22]).
• Is it too late to change? Never too late, never too early. Even at 60+, major gains are possible ([85:42]).
• Blood tests for heart health beyond basics? Lipoprotein(a) will soon be critical; organ “clocks” (pace of aging) will become standard ([86:10]).
• Is lack of connection risky? Yes, loneliness and social isolation harm heart/brain health ([86:55]).
• Personalization in blood pressure? Targets must be individual; “one-size-fits-all” numbers are outdated ([89:11]).

Notable Quotes & Memorable Moments

• [00:01] Dr. Topol: "Let's accept that we're aging right, it's a biologic process. But let's not accept that we can't make a huge dent in age related diseases...Treatment is not the end all, it’s prevention."
• [30:10] Dr. Topol, on CGMs: "Some of my guilty pleasures would be like tortilla chips, and oh my gosh, I had a big spike... So I gotta cut down on that."
• [45:44] Dr. Chatterjee: "You point out in the book that [superagers] were remarkably upbeat... What is their approach to life?"
• [49:28] Dr. Topol (on microplastics): "The most compelling study to me was the one from Italy... those are the people that had a fivefold risk of heart attacks and strokes."
• [65:22] Dr. Topol: "You have at least the key genetic information... the proteins... a readout of each organ clock... biomarkers... ways to be twenty years ahead of your health arc. It’s like a health GPS."
• [91:42] Dr. Topol: "I have tremendous optimism that we’re going to prevent age-related diseases... With AI, multimodal AI and all these new layers of data, we’re going to go into an era of prevention that I am really excited about."
• [93:42] Dr. Topol: "No longer is there room for this defeatist attitude... We shouldn’t have this sense that we are stuck with our parents' conditions..."

Key Timestamps (MM:SS)

• 03:41 Healthspan vs. lifespan and why the “gap” matters
• 06:30 The Worlderly Project: can you age healthily without disease?
• 09:44 U.S. and U.K. statistics: chronic disease prevalence
• 13:00 “Lifestyle plus”—expanding what matters for aging
• 16:07–17:59 The Big Three diseases and prevention window
• 19:21–24:29 Diet, personalization, CGM insight
• 34:46 Time-restricted eating: practical application
• 41:56 Exercise’s powerful role across all major diseases
• 45:44 Mindset, optimism, and the “welderly”
• 49:28–52:02 Environmental toxins and plastic crisis
• 65:22 What the new era of prevention looks like
• 68:04 Alzheimer’s biomarker P-Tau217
• 72:51–77:30 Personalized and risk-based screening over age-based
• 84:38–90:35 Quickfire audience questions on stress, community, BP, and more
• 91:42–93:42 Dr. Topol’s message of hope and optimism for super aging

Takeaways for Listeners

• You’re Not Doomed by Genes: Lifestyle, immune health, and mindset trump genetics for healthy aging.
• Don’t Wait for Symptoms: The diseases that cut healthspan develop silently over decades—a huge opportunity for early action.
• Basics Still Count More Than Fancy Tech: Movement (especially walking), varied diet, good sleep, and social connection remain vital.
• Your Own Data Changes Everything: Whenever possible, use personal data—CGM, genomics, blood tests—to guide behavior.
• Environmental Health Is Personal Health: Minimizing exposure to pollution, plastics, and forever chemicals is increasingly urgent.
• Hope and Action Over Defeatism: It’s never too late, and the future of prevention is bright—with tools coming soon to detect and halt disease decades ahead of time.

Final Message

Dr. Topol urges listeners: "Let’s accept that we’re aging—but let’s not accept that we can’t make a huge dent in age-related diseases. Treatment isn’t the end-all—it’s prevention."

For those who want to take concrete steps, Dr. Topol’s book and this conversation are rich resources for inspiration, practical tips, and a message of hope that we can all become “super agers.”