Which lifestyle factors influence your biological age the most?
Exercise is the most powerful brake on biological ageing. A Mediterranean diet, good sleep and less stress also help, but the evidence for these is more indirect.
Of all lifestyle factors, physical exercise has the strongest evidence base. Physical activity slows cellular ageing processes and extends healthy years of life. Progressive resistance training, in which you gradually increase the load, is the most well-supported approach for older adults: it preserves muscle mass and reduces muscle loss, frailty and bone loss. Programmes that combine aerobic training, strength, balance and flexibility with cognitive exercises also improve mental fitness and lower the risk of falls1,2.
Nutrition is the second pillar. The Mediterranean diet and caloric restriction have beneficial effects on metabolism and may slow biological ageing and cardiovascular disease. The evidence here is primarily associative: studies show associations, not hard cause and effect. Individual supplements and nutrients show inconsistent results. A dietary pattern rich in protein, fibre and unsaturated fats also promotes the diversity of gut bacteria, which contributes to better immune function and muscle performance3,4.
On the other side are factors that accelerate biological ageing. Prolonged sitting, sleep problems, a high-fat diet and persistent stress disrupt how the body processes nutrients and increase the risk of cardiovascular disease. Smoking, alcohol, UV radiation and air pollution accelerate ageing through free-radical damage and telomere shortening. This shows up as wrinkles and loss of skin elasticity, but it is also measurable at the cellular level5,6.
Sleep and mental health receive less research attention, but are relevant. Poor sleep is associated with faster biological ageing and a higher risk of cognitive decline. In women who experienced childhood trauma, a combination of an unhealthy lifestyle and symptoms such as depression, anxiety and insomnia was found to accelerate biological ageing further, as measured by telomere length. In men in the same group, this association was not found7.
Biological age can also be measured using epigenetic clocks, which estimate how old your body is biologically based on patterns of DNA activation. Diet, physical activity and educational level are all associated with this measure, although the direction and strength vary by factor. Biological ageing is therefore influenced by multiple lifestyle factors simultaneously and cannot be fully controlled by any single change4.
All claims are based on the provided studies (PMID 39743381, 34836334, 37944707, 39604792, 34203776, 38704685, 28202822). The evidence for exercise is the strongest and is likely causal; for nutrition and the remaining factors it is largely associative.