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Gerontologist Michael Pessman discusses his article, “Why what you do in midlife matters most.” Michael explains why the ages of 45-55 are a critical window and final opportunity to build healthy habits that profoundly impact future aging. He highlights new research on “super-agers” and the power of strength training (reducing early death risk by up to 20 percent), the importance of community, and the proven benefits of a Mediterranean diet. Michael also explores the crucial role of a positive mindset toward aging and the concept of “gerodiversity,” reminding us that aging well is not a one-size-fits-all journey. Learn how intentional changes in midlife can lead to a longer, healthier, and more connected life.

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Transcript

Kevin Pho: Hi. Welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Michael Pessman. He is a gerontologist. Today’s KevinMD article is “Why what you do in midlife matters most.” Michael, welcome back to the show.

Michael Pessman: Thank you, Kevin. It is a pleasure to be here again.

Kevin Pho: All right. Tell us what your latest article is about.

Michael Pessman: Sure. I would be happy to. As you mentioned the title, “Why what you do in midlife matters most,” as a gerontologist, one of my main concerns is people living their longest life, their happiest life, and their most fulfilling life. I am constantly thinking about ways people can age well. As you know, modern medicine has made so many advancements. I have talked about this before. Statins, in particular, are keeping people alive much longer and much more able. Aging in place is a big thing. People want to be well to age in place in their house. In order to do that, there are certain things that need to be done.

Starting in your 40s can really determine how you end up later in life. I have a lot of friends in their 40s who do not think they need to go to a doctor every year. It is critical, as you know, since you are a doctor. Getting that blood work done to see if you need a statin or if your blood sugar is high and addressing those issues in your 40s can really affect your quality of life later in life.

Diving into some of that research, I find it very interesting. I like to be a voice to let people know that it is important in those 40s and 50s. I am 55 myself, so I take my own advice, Kevin, and follow my doctor’s results from my blood work. For example, I found out that strength training for just 30 to 60 minutes a week, once a week, can reduce early death by up to 20 percent. That to me seems amazing. This is a new stat that was in 2025. Personally, that motivates me. I can commit to 30 minutes, maybe even twice a week, so maybe I get an even higher percentage. I am just letting people know that I am very passionate about this article.

Kevin Pho: Strength training. We hear a lot about that from a lot of the health gurus. Tell us exactly what you mean by that. Does that necessarily require going to the gym? Can you just do strength training from the comfort of your own house?

Michael Pessman: That is a very good question, Kevin. You can do strength training just from your house. You can buy dumbbells, even 5 or 10 pounds, put YouTube on the TV for 30 minutes, find a free workout, and go to it. I work for a place called Mather in Evanston, Illinois, where we have Zoom classes. There is one called Better Balance. It is for older adults, but it is a workout.

I try to do it myself. I have to take a few breaks. As you know, maintaining balance in older ages creates optimal health. It prevents falls and issues with hips and knees and everything that can be complicated. Balance is very important. Regarding strength training, this is something that I have done. I have bought my own dumbbells. I have a gym in the building where I live, but I prefer to work out in my living room. I have YouTube on my Roku TV, and I am doing this myself. Again, it is not an intense workout. It is more than I was doing before. I do this 30 minutes twice a week, and it gets the blood flowing in ways that I do not get just by going downstairs or walking down the street. Something as simple as that can really add years onto the rest of your life.

Kevin Pho: You mentioned seeing your doctor regularly. You mentioned statins. You mentioned strength training. What else can we do in midlife to help us as we age?

Michael Pessman: I think connection is key. There is more and more research that having social connection is so important, not just isolating at home alone. Often, older adults feel that they want to do that, but getting out is crucial. Whether that be a religious activity or a hobby, it is important. Where I work, we run art classes on Zoom for older adults. Seeing people become friends who do not live in the same city and enjoy an activity that keeps their brain active and engaged is great. They create art that is amazing. I envision myself at their age doing that.

Look for opportunities like that. Look at your senior center in your area. They often have classes. Push yourself to get outside of the box to go do something that maybe you do not know anything about or to meet people and just get out of your house and make those social connections.

I also mentioned something in the article about diversity. It is that one size does not fit all in aging. This means aging is deeply individual. A person’s culture, race, gender, income, and language all affect the aging process. That means that different interventions will work differently for these categories. I am glad that aging research is being more inclusive and is considering all of these facts. I have talked about this before. For example, African Americans have a higher risk of dementia. We do not know why. So, they react to different treatments differently. Research should be geared towards them in different ways than other races.

Kevin Pho: How about diet? What kind of diet tips can you share with us?

Michael Pessman: Absolutely. The Mediterranean diet, hands down, has all the best research. Limiting fried foods is important. I myself am guilty of eating fried foods. I like french fries. I am trying to limit that to once or twice a week. Eating fish twice a week that is not fried, along with olive oil, is part of that Mediterranean diet. Nuts and vegetables have shown to be very effective, even for cognitive ability later in life.

Kevin Pho: Can you comment on protein? Protein is all the rage now. You read the news, and you just go to the supermarket. Everything focuses on the protein. You get protein-enhanced bread and protein-enhanced pasta. Tell us whether protein is important or not.

Michael Pessman: Absolutely, Kevin. That is in the article actually as well. Protein is a factor because it limits the carbohydrates, and it is recommended for older adults to get as much protein as possible. People are not getting as much protein these days as they have in the past. So, find any way that you can add it, especially if you like it. I bought some high-protein products myself, Kevin. I do not like some of the taste. It is kind of an acquired taste, but there are some that I do like. Stick to trying different options and sticking to your favorite ones. Make those meaningful decisions. As you are grocery shopping, look at some of the products like bread. There are certain breads that have more protein, and there is one that I do like a lot. Absolutely, yes. It is more filling. When you eat more protein, you are not as hungry, so it leads to weight loss.

Kevin Pho: How can someone actively cultivate a positive view of aging when there is so much in our culture that sends the opposite message? How can we cultivate that positive view?

Michael Pessman: That is a very good question. Perception is everything, right? How you perceive yourself as aging matters. I do address that a little bit in the article. I think personally surrounding yourself with people who are positive in your life is helpful. Surround yourself with people that will help you, people that you can give to, and do things that people find meaningful.

For example, go to religious services if a person finds that fulfilling. Make that effort. If you cannot go in person to do it, maybe do it online. A lot of spiritual places do offer the virtual option as well. Really pursue that. Spend time with friends. Make the effort to get together with family. Often, family lives far away, so you have to really plan in advance strategically for those visits.

Kevin Pho: One of the things you also mentioned is VR and some cognitive benefits from VR games.

Michael Pessman: Right. That is so exciting. As you know, I have worked in Alzheimer’s research before. It is very exciting. As a matter of fact, they have made a lot of advancements with some of the treatments with Alzheimer’s. There are new medications out. I have a family member who was diagnosed in June. Because this person was diagnosed early, they have an option. It is a medication, an IV drip once a month that is supposed to stop the disease for 10 years. We are going to see. Early diagnosis is very important with Alzheimer’s disease. The VR is something that is new, and it is very exciting. Some of the results are really promising. Anything that we can do to help the many people that are stricken with this disease is for the better.

Kevin Pho: As a primary care physician, I only have, as you know, 15 to 20 minutes, and I see a lot of people in that midlife stage. If I were to prioritize some of the advice that we are talking about today, what would you recommend first?

Michael Pessman: I would recommend asking if they have a social group that they are actively engaged with. If it is a male, maybe ask about a card game on a Friday night or a Friday morning breakfast club. I would ask if there are social things that they get out and enjoy on a weekly basis. Are there hobbies that they have? Thank goodness they are seeing you as a PCP. Thank goodness they are in the office. That is a wonderful thing.

I would also ask them about their diet. Maybe ask if they want some information about the Mediterranean diet as they age. That is recommended by so many really reputable institutions. I would just ask them about their family. Do they have family, or are they connected with their family? Do they have chosen family, perhaps? I myself have some chosen family members who are not blood-related, but I consider them family. Just get those details out of them during that visit.

Kevin Pho: We are talking to Michael Pessman. He is a gerontologist, and today’s KevinMD article is “Why what you do in midlife matters most.” Michael, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Michael Pessman: Sure. I want to emphasize that it does not take much effort in your 40s and 50s to ensure the later decades in your life are good. You can add years to your life by just making simple weekly changes to exercise, diet, and social connections.

Kevin Pho: Michael, as always, thank you so much for sharing your perspective and insight, and thanks for coming back on the show.

Michael Pessman: Thank you, Kevin. Have a good day.