In looking for topics for this issue of the newsletter, I knew I wanted to include something related to new year resolutions and health. The term “healthspan” kept popping up, so I decided to talk with Katy Wallace, ND, about the concept. -Caitlyn Tompkins, Reader Editor
Tell us about yourself!
I am a licensed Naturopathic Doctor with seventeen years of experience using functional medicine and nutrition-based approaches to health. I authored the book The Body Tune-up, which describes a six-week food-based cleanse. It was not an easy journey for me to adopt this innovative and science-based approach, however. When I was younger, I worked as an ecologist and experienced chronic illness. I consulted medical doctors who suggested repeated antibiotic prescriptions for my chronic sinus problems. A friend suggested I see a naturopathic doctor, and I did. Ultimately, what I learned from her helped me to feel much better and I decided to make a career change and went to school to be a naturopathic doctor and worked at my ND’s clinic. In 2007, I began consulting for Willy Street Co-op offering Individual Nutrition Sessions and classes that are still offered today. I worked at Group Health Cooperative for a period and currently see people through my private practice, Human Nature, LLC.
We’ve been hearing about “lifespan” vs “healthspan” lately. What do each mean? What is the difference?
Lifespan is about how long your life is and the more years you have, the better. Healthspan, on the other hand, is about the quality of your life. It is how many years you experience reasonably good health and function. The point is that lifespan might not be very important if the quality of your life is poor, so healthspan is becoming more of a focus. To identify someone’s healthspan, for example, tests may be used to assess comprehensive wellness, including physical and cognitive function, beyond just the presence or absence of disease.
What can contribute to causing you to look or feel younger than your age?
In general, people feel and look younger in the absence of chronic inflammation. Chronic inflammation can be characterized by some of the following signs: fatigue, weight gain, joint pain, gastrointestinal issues, skin rashes, brain fog, or lack of mental clarity. There are many natural ways to address chronic inflammation to feel and look younger, and many of them are simple.
For example, drinking adequate amounts of water was shown to be correlated with less disease and healthy aging in a study published by the National Institutes of Health in 2023. Part of this benefit is from how hydration helps with reducing chronic inflammation.
Also, going outdoors and spending more time in nature was recently shown in a large study to be correlated with slower aging on a cellular level. The study was published in 2023 in the Journal Science of the Total Environment and it found that the length of peoples telomeres, an indicator of youthful cellular health and function, were increased in people who spent more time outdoors in nature. Other studies have indicated that time spent outdoors reduces inflammation for people, too.
There are major diet choices people can make to reduce inflammation. A big one is avoiding sugar and processed carbohydrates like baked goods and pasta. This is because these foods lead to blood sugar problems that promote chronic inflammation through the production of the hormone insulin. The amount of carbohydrates a person eats needs to be dialed into their level of activity and metabolism and for most people, this needs
to be adjusted as they age.
Another important dietary choice is to eat more omega-3 foods like fish, seafood and flax, grassfed and free-range meats, and butter and eggs from free-range animals. Numerous scientific studies show that having a healthier omega-3 to omega-6 ratio is key to controlling inflammation, reducing disease, and therefore leading to better healthspan. In my work with people, I regularly witness them experiencing less pain, less chronic digestive issues and an improvement in mental clarity with these changes.
What are some things that people in their 20s and 30s can do to help them later in life?
One of the most important things someone can do at this age is to learn how to handle stress well. A positive mindset and developing habits that help one manage stress will lead to well-being later in life. Meditation or mindfulness exercises can be helpful tools to practice. Also, the basic habits of exercise, healthy diet, outdoor activity, and good sleep patterns go a long way to improving how one copes with stress and the perception of stress which have a big impact on health.
Another piece of advice for young people is to cultivate body awareness such as knowing your body’s cues and changing habits based on them. If you learn to pay attention to your body, then you’ll develop lifelong habits that promote health rather than destroy it. For example, if you have sensitive digestion, you may be able to discern either alone or with the help of a functional medicine practitioner, which foods work for your body and which ones do not. Or in another example, if you’re paying attention, you’ll be able to tell what, if any, level of alcohol is okay. You’ll be able to tell when you are not getting as much sleep as you need and establish a new bedtime.
What are some things that people in their 40s and 50s can do to help them later in life?
Americans at this stage of life are often at the peak of their careers in a culture that devotes itself to work. Those in middle-age often care for children and then for their parents leading to less time and energy for friendships and personal interests. It’s well understood that strong social connections are foundational for a healthy life, and that it can be harder to establish those as we get older. I would encourage people in this group to prioritize social connections that bring them joy.
In our 40s and 50s, people begin losing muscle mass. This is a process that co-occurs with aging,
but it leads to many problems. The loss of muscle leads to a slowing of metabolism and thus weight gain or poor handling of carbohydrates in the diet, which in turn can lead to inflammation and diabetes for many. According to the CDC, diabetes most often develops in middle-aged Americans. An older person without diabetes will generally have a better healthspan because they will not experience nerve damage, vision problems, and kidney or cardiovascular illness, for example. This is one reason why progressive strength training that builds muscle is so important for this age group. The more muscle mass you have, the faster your metabolism. This makes balancing weight and blood sugar much easier and helps improve how energetic you feel.
Loss of muscle also exacerbates hormonal difficulties by allowing hormone levels to drop at a faster rate. The steady decline in hormones with age can lead to a decline in emotional and cognitive health. The more muscle, the better the hormone production.
One more benefit to building muscle is the more of it you have, the more mitochondria you have, which is key to reducing inflammation and slowing cellular aging. The mitochondria are components of our cells that produce energy, and help prevent or allow disease to develop. Many things help improve mitochondrial health such
as nutrition, heat and cold therapy, sunlight, proper hydration, and of course, strength training. With the one habit of strength training, you get multiple benefits.
What differences are there between what women and men should do?
I think the fact that there are several scientific studies showing that women make more of the stress hormone, cortisol, than men, affects how lifestyle interventions can be adjusted for the individual. For example, women’s morning cortisol levels are typically higher, and when facing a common stressor in research studies, women are shown to typically experience higher cortisol levels. High levels of cortisol in general are uncomfortable to live with, because they make us feel anxious and can lead to anxiety disorders. Couple this with the fact that an aging woman will likely experience a drop in progesterone and estrogen causing cortisol to be more dysregulated, and it becomes increasingly important to help women regulate cortisol for
better healthspan.
There are several lifestyle interventions that help manage cortisol such as adequate sunlight and sleep but how we eat is also critical. How we eat also plays a big role in our healthspan and so this is a case where there may be some differences in what women and men should do. Take intermittent fasting, for example.
Intermittent fasting, the practice of eating during certain hours each day, has been popular in recent years to achieve weight loss and blood sugar control. Some research says it has the potential to improve healthspan. However, I would say this approach should be attempted with some caution and adapted for the individual. When a woman fasts for too long on a regular daily basis for example, this can lead to higher cortisol levels and disrupt progesterone hormone levels. Dysregulated cortisol can lead to mental health disorders like depression. It may also lead to gut barrier issues, and chronic illnesses like autoimmunity and cancer, according to scientists. When intermittent fasting shortens the eating window to less than 10 hours, it may not work in the long term for women because of the higher cortisol levels women make when fasting. Therefore, intermittent fasting in this form may lead to dysregulated cortisol and its host of issues.
To balance cortisol levels, I suggest not fasting for longer than 14 hours at night and eating protein every 3-4 hours throughout the day. I repeatedly see this approach is very helpful for hormone balance in women I work with. Of course, some women will be less sensitive than others and may find that intermittent fasting for long windows works great for them. This is where individual hormone testing can be helpful.
Conversely, on average, men may do very well with intermittent fasting because they are not pre-disposed to higher cortisol levels. Of course, this will vary based on the individual.
It can be very helpful for both men and women to do hormone testing in their 40s and 50s when they might begin to experience the changes in hormone levels. Men naturally experience a drop in testosterone and may experience increases in estrogen from blood sugar swings. Changes to nutrition and lifestyle can often help raise testosterone and reduce its conversion to estrogen in men. Women experience a dramatic shift in hormones when going through menopause. There are natural remedies and hormone precursors available over the counter that are safe and effective ways for men and women to achieve hormone balance, in combination with good blood sugar control.
In terms of better healthspan, statistics indicate women need to be more mindful of habits that support healthy bone density and thyroid hormone levels. Emphasizing weight-bearing exercise, avoiding sugar, and eating adequate protein are approaches that help with bone and thyroid health. Men are prone to prostate issues with age. Focusing on proper blood sugar control using diet, sleep, and exercise can help prevent prostate problems.
Are there regional benefits related to healthspan? Does living in Madison/Dane County/Wisconsin have its advantages?
Living in a region or community where a healthy lifestyle is easy or accessible for you is key. The Madison area was ranked in the top 10 best cities for quality of life in 2024 by the US News and World Report. One of the qualities that contributed to the ranking was having the highest ratio of parks and playgrounds to residents providing ample opportunities to enjoy the outdoors. Our access to sustainable agriculture is health-promoting, as is the bike-friendly nature of our community, just to name a few.
Everyone’s heard about (if not experienced) New Year’s resolutions faltering within the first few months of the new year. Why do you think they falter, and how can we help keep them?
If you want to be successful with a resolution, then you have to make a plan. Next, you must follow through and stick to the plan. People fail in resolutions because they either don’t make a good plan, or they don’t stick to the plan and hold themselves accountable.
Some of the science around making resolutions shows that if you physically write them down with pen and paper, that helps with making a better commitment, so you might want to set aside some time to write down your resolutions as a formal statement to yourself. Also, make the plan as specific as possible: “I’m going to lift weights three times a week, on Monday, Wednesday, and Friday, in the morning after breakfast.”
The other big takeaway from scientific studies about new habits is that your brain will keep doing the habit if it feels rewarded. This can be as simple as positive self-talk after completing a workout, like “Yay, I did this!” or you can think of a tangible reward. For example, I worked with a client who went horseback riding as her reward for improving her diet over several months.
Another trick that can help is to tie the new habit into an existing habit. For example, if my resolution were to drink more water, I might make sure I have a glass of water every morning before or after I brush my teeth (existing habit). Or if my resolution were to lift weights at home after breakfast, I would put my workout clothes and shoes on first thing in the morning to help minimize the transition to the new habit.
Recording your new habit can also help. If you are keeping track of how much water you drink each day, then it becomes much easier to identify when you didn’t hit your goal of drinking three quarts of water that day, for example. Then, it can be more at the top of mind tomorrow that you need to focus on drinking water to reach your goal. The same might be done for hitting a protein or calorie target, or recording how many steps you take.
In this example, I would plan to log how much water I drank every day for the whole year to keep the plan going. At some point, you may not need to log the habit anymore because it just becomes who you are but for many people, the practice of keeping track of something helps keep the focus on it. These approaches are consistent with the old phrase “What is counted matters” meaning that if you are recording something you are doing, it will matter more to you, and that will help reinforce your plan to change your behavior to something positive.
Do you have a few health-related New Year’s resolutions you’d recommend?
Many people already have a natural break in eating overnight from supper to breakfast. I advise people to be more consistent with this habit and break from eating for at least 12 hours overnight to promote numerous health benefits. There is an increasing amount of research showing how changes to someone’s circadian rhythm in this way benefits healthspan. One of the benefits includes supporting more butyrate-producing bacteria in the gut and protection from increased inflammation and disease. A study presented to the European Society of Clinical Microbiology and Infectious Diseases last summer showed that having more beneficial butyrate-producing bacteria in the gut helped prevent hospitalizations due to infections. Avoiding eating overnight is a simple but helpful way to boost these beneficial microbes which may translate to better healthspan.
Progressive strength training for 3-4 days weekly would be another great resolution because it’s helpful for building muscle, hormone health, metabolic health, and mitochondrial health. Increased muscle activity also has the bonus of reducing inflammation according to a recent study out of Duke University. All of this will improve someone’s physical and cognitive healthspan.
Eating protein every 3-4 hours throughout the day is helpful for reducing inflammation from poor blood sugar control and helps reduce cravings for high carbohydrate foods that promote inflammation. It helps keep stress hormone levels under control and helps to build muscle and all its benefits. So, if your goal is to “eat better”, focusing on protein will be a game-changer.
People are often surprised by this one but going outside daily is important for circadian rhythm and healthy levels of neurotransmitters that contribute to mental health.
What didn’t we ask that we should’ve asked about?
If you want to focus on healthspan, you could order tests that help optimize health rather than showing absence of disease. For example, there are helpful tests for describing the gut biome and digestive capabilities, micronutrient status, hormone balance, or detailing someone’s levels of chemical exposure. At this time, we have many tools that can help us fine tune what is best for the individual’s healthspan. Furthermore, a growing number of studies also show that simple habits like going outside, being with friends and loved ones, adequate sun exposure, sleep and hydration matter more than we might give them credit for when it comes to healthspan.
We recommend consulting with your doctor or nutritionist before making changes to your diet or exercise routine.
