'Super Agers' thrive through lifestyle, not genetics, says Dr. Eric Topol

Dr. Eric Topol’s new book argues that exercise, diet, sleep, and community—not miracle drugs or genetics—are the real drivers of healthy aging.

Illustration by Yifei Fang

By Novanka Laras and Hayu Andini

More than half of American adults live with at least one chronic illness such as heart disease, diabetes, cancer, or neurodegenerative disorders. By age 65, the majority have developed two or more such conditions. And among those lucky enough to reach 80, it’s a rare feat to arrive without some form of illness. Yet, a group of exceptional individuals—the so-called “Wellderly”—has defied this trend, maintaining robust health well into their later years.

In 2008, scientists at the Scripps Research Institute in San Diego launched a study to better understand these healthy aging outliers. They sought 1,400 individuals over 80 who had never been diagnosed with major chronic diseases. Spearheaded by cardiologist Dr. Eric Topol, the initiative aimed to find genetic markers linked to healthy aging. But the results surprised them: there was little in the DNA that explained their success. Instead, a pattern of shared behaviors began to emerge—one that would ultimately reshape how we understand the science of aging.

Beyond genetics: Lifestyle leads the way

In his new book Super Agers, Dr. Topol lays out the conclusions drawn from the study and more than a decade of further research. The key message? A healthy aging lifestyle matters far more than genetics. The Wellderly participants were generally leaner, exercised more often, and maintained active, socially engaged lives. Most had a positive outlook, strong support systems, and daily routines filled with purpose.

These findings shifted Dr. Topol’s focus. Instead of solely hunting for genetic causes, he turned his attention to how behavior and environment influence both longevity (how long we live) and healthspan (how long we live well).

Exercise: the miracle medicine

Dr. Topol is unequivocal about the benefits of physical activity. “Nothing surpasses regular exercise for promotion of healthy aging,” he writes, calling it “the single most effective medical intervention that we know.” He adds that if a drug could offer the same benefits as exercise, it would be hailed as a groundbreaking medical discovery.

And it’s never too late to start. Topol cites the example of Richard Morgan, an Irishman who began exercising in his 70s with a rowing machine in his garden shed. By his 90s, Morgan had won four world championships in indoor rowing—an inspiring testament to the power of movement at any age.

Diet and sleep: underrated allies in aging well

While there’s ongoing debate about what constitutes the ideal diet, Dr. Topol emphasizes one certainty: the worst culprits are ultraprocessed foods. Hot dogs, sugary snacks, and other heavily modified items trigger systemic inflammation, contributing to nearly every major age-related disease.

Sleep, too, is a cornerstone of the healthy aging lifestyle. Though the optimal amount may vary, seven hours per night appears to be a common target. However, Dr. Topol is skeptical of popular sleep aids, noting that melatonin supplements, magnesium, and high-tech beds often underdeliver when tested rigorously.

Social ties and nature: more than feel-good remedies

The book also explores lesser-appreciated factors such as community, optimism, and even hobbies. Loneliness, Dr. Topol argues, poses a severe threat to health, on par with physical illness. He cites studies showing that spending time in nature, engaging with music, and nurturing human connections can deliver tangible health benefits.

Touch, conversation, and shared activities can all play protective roles in aging. These elements, Dr. Topol contends, aren’t just emotionally fulfilling—they’re biologically beneficial.

The promise and pitfalls of new medications

In discussing pharmaceutical developments, Dr. Topol acknowledges the potential of new weight-loss medications like Ozempic and Zepbound. While primarily designed to curb appetite, these drugs also reduce inflammation—an effect that may help slow the aging process, independent of weight loss.

However, he remains wary. The cost of these medications could reinforce social inequities, and their long-term use raises ethical and medical concerns. “It’s conceivable that most people will be taking these drugs in the future,” he writes, “but the implications of lifelong use remain unclear.”

The rise of anti-aging hype—and its dangers

Super Agers takes a firm stance against the booming anti-aging industry. Dr. Topol derides the “longevity lifespan circus,” criticizing pricey wellness centers that offer intravenous drips and dubious supplements. Some clinics, he notes, charge up to $50,000 a week for supposed anti-aging treatments.

His skepticism extends to so-called “carnival barker scientists” who peddle supplements with bold claims but little scientific backing. Despite widespread enthusiasm for vitamins and nootropics, Dr. Topol argues that clinical data supporting their effectiveness is sorely lacking.

He points out that even medications like metformin and rapamycin, which have shown promise in influencing cellular aging, aren’t yet ready for mainstream use. For now, the most reliable route to healthy aging remains rooted in behavior, not pills.

Tech solutions for aging: real potential or just noise?

As a champion of medical technology, Dr. Topol does see promise in selective screening tools, especially when powered by artificial intelligence. He criticizes the growing trend of full-body MRI scans marketed to affluent consumers as being more fear-based than evidence-driven.

Dr. Topol is particularly unimpressed by “biological age” tests, which use molecular markers to estimate how old your body is. While flashy, he argues they offer little actionable insight. Instead, he supports the development of organ-specific age measures, which could guide more personalized and preventive healthcare in the future.

Writing style: dense but authoritative

Readers familiar with Dr. Topol’s blog and podcast Ground Truths will recognize his voice—detailed, deliberate, and steeped in science. At times, Super Agers reads like an academic journal, especially when compared to more accessible works like Dr. Peter Attia’s Outlive. Still, Topol’s commitment to evidence-based claims makes his book a valuable contribution to the conversation around healthy aging.

His insistence on grounding claims in peer-reviewed science offers a vital counterbalance to the hype-filled discourse that dominates much of the anti-aging world. As he explains, the stakes are simply too high for anything less than rigorous truth.

Lifestyle remains the best medicine

While new tools and therapies continue to emerge, Super Agers reminds us that the keys to a longer, healthier life are largely within our control. Exercise, balanced eating, quality sleep, social engagement, and time in nature remain the most powerful and proven strategies. These behaviors form the foundation of a healthy aging lifestyle—one that may not come with flashy marketing but delivers where it counts.

Dr. Topol’s work underscores a fundamental truth in medicine: sometimes, the simplest interventions offer the biggest impact. In a world captivated by quick fixes and miracle solutions, Super Agers serves as a sober, evidence-backed reminder that longevity is built day by day, choice by choice.