By Mark Quirk MSc CertLM, Healthspan Coach and Registered Health Coach
Healthspan is the part of life we spend in generally good health—able to remain active, independent and engaged with the people and activities that matter to us.
We can't control everything that affects our future health, but we can influence a great deal. I organise those influences into six interconnected pillars: nutrition, movement, sleep, emotional health, relationships and meaning, and minimising harmful substances. Our physical and social environment forms the foundation beneath them.
These are not six rules to perfect. They are six areas we can assess, prioritise and strengthen over time.
It is easy to assume that our future health is largely predetermined by our genes. Genes certainly matter, and their influence varies between different conditions, but they are only part of the picture. For example, a 2016 review by Prof. Stephen M. Rappaport, using published data on identical twins, found that genetic factors are not the primary causes of later-life chronic disease [1]. Our health is also significantly shaped by our behaviour, experiences and surroundings, and these influences accumulate throughout life, for both good and ill.
So, let's start with a quick reference for the six areas...
| Pillar | How it supports healthspan | A starting point |
| Nutrition | Metabolic and cardiovascular health, body composition, energy, and gut health | Build meals around minimally processed foods, with plenty of plants and adequate protein |
| Movement | Fitness, mobility, metabolic and cardiovascular health, and independence | Move frequently, and combine aerobic with resistance exercise |
| Sleep | Recovery, cognition, and emotional regulation | Protect a consistent sleep pattern, and use active recovery such as gentle movement |
| Stress and emotional health | Resilience, behaviour, and wellbeing | Develop practical ways to manage, use, and recover from stress |
| Relationships and meaning | Connection, resilience, wellbeing, and engagement | Invest deliberately in supportive relationships and purposeful activity |
| Minimise harmful substances | Reduces avoidable health risks | Avoid smoking and keep alcohol within lower-risk limits |
Pillar 1: Nutrition quality, quantity, and timing
There is no single perfect diet. We only have to look around the world to see populations enjoying long lives while eating quite different foods—from traditional Japanese diets to the Mediterranean eating patterns of countries such as Greece, Spain and Italy.
That doesn’t mean all diets are equally good for us. Despite their differences, healthier dietary patterns tend to share important features: plenty of minimally processed plant foods, adequate protein, sources of healthy fats, and relatively few ultra-processed foods.
There is growing evidence that diets high in ultra-processed foods are associated with poorer health, particularly cardiometabolic health. But most of us already know, broadly speaking, that minimally processed foods are likely to be better for us. The real challenge is not simply knowing what we “should” eat; it is consistently putting that knowledge into practice.
Food packaging can make that harder. Claims such as “high protein,” “low fat,” or “supports bone health” may describe one characteristic of a product without telling us much about its overall nutritional quality. It is therefore helpful to look beyond individual marketing claims and consider where a food sits on the spectrum from minimally processed to ultra-processed. I describe this as food quality.
We can then combine quality with food quantity. This does not mean there is a single correct amount for everyone: how much energy and nutrition we need varies with our body, health, and activity.
The third consideration is timing. Our metabolism follows a daily rhythm, and our bodies generally handle food less effectively during the biological night. Regularly eating shortly before bed, or during the hours when we would normally be asleep, may therefore affect appetite, blood glucose, and metabolic health. So, timing complements food quality and quantity.
Over time, the combined pattern of what we eat, how much we eat and when we eat can influence our body composition, blood glucose, cardiovascular risk, energy levels, and gut health. Nutrition may also affect mood and psychological wellbeing. Getting these three elements broadly right - not perfectly, but consistently - can make a meaningful contribution to our healthspan.
Pillar 2: Movement, Fitness, and Strength
Our bodies function at their best when they get plenty of movement. That movement doesn’t have to be formal exercise, which, after all, is a relatively recent idea. Until comparatively recently, everyday life and work required most of us to move considerably more than we do today.
But we cannot escape the reality that far fewer of us need to move very much to earn an income, travel somewhere, find food, or complete everyday tasks. That makes it increasingly important to create opportunities for movement rather than relying on daily life to provide them.
We consistently see that fitter and more physically active people tend to develop the health challenges associated with ageing later and live longer. Maintaining muscle strength, balance and mobility also helps protect our ability to perform everyday tasks and reduces the risk of falls [2,3].
Perhaps just as importantly, being fitter and stronger allows us to continue participating in life on our own terms. That might mean remaining independent, doing our own shopping, driving, enjoying holidays, friendship, or being actively involved in the lives of our children, grandchildren or great-grandchildren. Fitness is not simply about performing well in a gym; it helps preserve our ability to do the things that matter to us.
If we assume that getting older means we should exercise less, the UK physical activity guidelines may be surprising [4]. For adults aged 19 and over the guidelines suggest being active every day, aiming for at least 150 minutes of moderate-intensity activity (increased breathing, able to talk but not sing), or 75 minutes of vigorous-intensity activity (breathing fast, difficulty talking). Plus, do activity to build strength on at least two days per week. For adults aged 65 and over, the guidelines additionally emphasise activities that improve balance and flexibility on at least two days a week. These activities can overlap with strength or aerobic activity rather than requiring completely separate sessions.
Activities can be combined, of course. Carrying heavy shopping bags, for example, could involve strength, balance, and some aerobic effort. Though we probably wouldn’t do activities like this frequently enough to meet our activity guidelines. So deliberate exercise helps us build the capacity when everyday life calls upon it.
So, move frequently, sometimes quickly, and sometimes with heavy things.
Pillar 3: Sleep, rest, and recovery
Sleep supports physical restoration, recovery, learning, and memory. Our sleep is regulated partly by an internal timing system, the circadian rhythm, which is synchronised with the 24-hour cycle of light and darkness. Sleep pressure also builds gradually while we are awake, helping us prepare to sleep.
If you’ve experienced the grogginess, daytime sleepiness or inconvenient wakefulness of jet lag, you’ll know how real the effects of being out of sync with your circadian rhythm can feel. A frequently changing sleep schedule can produce a milder form of this misalignment, even without travelling to another time zone.
But what if we struggle to sleep during our normal sleeping hours? It’s a widespread problem and understanding it usually means looking at the individual rather than assuming a single universal cause or solution.
You may already be familiar with common sleep-hygiene advice: keeping reasonably consistent sleep and wake times, creating a dark, comfortable bedroom, and reducing stimulating activities and bright light late in the evening. Screens matter not only because of the light they emit, but also because what we do on them can keep us alert or delay when we go to bed.
These approaches are generally sensible and can be helpful, although their effects are sometimes exaggerated. Many people who struggle with sleep are already trying hard to follow them, so being given another list of sleep-hygiene rules may not resolve the underlying difficulty.
Sleep problems can be influenced by physical health, pain, medicines, hormonal changes, breathing disorders, mental health, daily routines, and our relationship with sleep itself. Persistent difficulties therefore sometimes warrant assessment by a healthcare professional.
For chronic insomnia, cognitive behavioural therapy for insomnia, usually called CBT‑I, is the recommended first-line treatment. It goes beyond general sleep hygiene and helps people change thought and behaviour patterns that can unintentionally perpetuate sleep difficulties. Some principles are compatible with health coaching, while persistent or complex insomnia may require a suitably trained practitioner.
Sleep plays the central role in this pillar, but rest and recovery matter too. Being constantly busy can become habitual, and repeatedly failing to create opportunities to recover may contribute to accumulating physical and psychological strain. Rest often doesn't mean doing nothing. It could involve quiet time, gentle movement, time outdoors, an absorbing hobby or simply a temporary reduction in demands.
It also overlaps considerably with the other pillars. Inadequate sleep and recovery can affect our stress response, appetite and food choices, motivation to exercise, concentration, and relationships. Difficulties in those areas can, in turn, make sleep harder.
You get the picture: it’s a pillar for good reason. In health coaching, we look beyond generic advice to understand what is affecting your sleep and recovery, then identify realistic changes that fit the demands of your life.
Pillar 4: Stress and emotional health skills
Emotions help us notice what matters, prepare for action, and respond to opportunities and threats. Fear may encourage us to escape danger, anger can alert us to something that feels wrong, and joy can draw us towards people and experiences we value.
These responses are not limited to dramatic dangers such as meeting a lion. Modern stress is more likely to involve workload, uncertainty, conflict, financial concerns, caring responsibilities, or simply feeling that the demands placed upon us exceed the resources we have available.
In the short term, the stress response can be useful. It redirects attention and energy towards dealing with an immediate challenge. The problem is not that we experience stress; it's more often that demands remain high, feel outside our control, or are followed by too little opportunity to recover.
Emotion also influences how we think and the choices we make, including some choices that feel entirely rational. When emotions are intense, our attention can narrow towards whatever feels most important in that moment. That can help in an emergency, but it's less helpful when making decisions with benefits that lie further in the future.
We can see this in many health-related behaviours. Stress, sadness, boredom or frustration may affect what and how much we eat, whether we exercise, how well we sleep, how we use alcohol and how we respond to other people. Pleasant emotions influence behaviour too: food and drink, for example, are often connected with celebration, reward, and belonging.
This doesn’t mean that emotions are obstacles to good health or that unpleasant feelings need to be eliminated. Emotions provide useful information, although they don’t always tell us the whole story or point towards the action that will serve us best.
I often say that resilience is not the absence of stress or discomfort; there is no need for resilience when nothing feels difficult. Resilience is something we can develop through experience, support, and practice.
The aim is not perfect control over how we feel. It is to create a little more space between what we experience and what we do next, so that our responses more often support our health, relationships, and the life we want to lead.
Pillar 5: Supportive relationships and meaning
Humans are fundamentally social, although the amount and type of connection we prefer varies considerably. Some people thrive in larger groups; others prefer a small number of close relationships. What matters most is not simply how many people we know, but whether our relationships provide connection, trust, and mutual support.
Supportive relationships can help us cope with adversity, regulate stress, and stay engaged with life. Conversely, persistent loneliness and social isolation are associated with poorer physical and psychological health.
I include meaning in this pillar because it often comes through connection with or support of other people. It gives us a sense that our lives matter and that our actions have direction or purpose. Meaning doesn’t need to come from exceptional achievement; it can come from family, friendship, work, caring, creativity, faith, learning, contributing to a community, and doing something with impact beyond ourselves.
So, relationships and meaning can reinforce each other, but neither stays healthy automatically. Both may need time, attention, and deliberate investment, particularly during periods of transition such as retirement, bereavement, illness, or children leaving home.
The practical question is not whether we have an impressive social life or a grand life purpose. It is whether we feel sufficiently connected, supported, and engaged in something that matters to us.
Pillar 6: Minimising harmful substances
Some substances can undermine our health directly, especially when exposure is repeated over many years. Tobacco is the clearest example, but alcohol, recreational drugs, and the misuse of medicines may also affect long-term health, daily functioning, and relationships.
Smoking is one of the most consequential avoidable risks to health, increasing the likelihood of multiple serious diseases. Stopping smoking benefits health at any age, but quitting is not always easy. Appropriate treatment and support can make it more achievable, for example, through NHS stop-smoking support.
Vaping is not harmless and isn’t recommended for non-smokers. However, for adults who smoke, switching completely to vaping is likely to be substantially less harmful than continuing to smoke and could be used as a part of a longer-term quit strategy.
Alcohol is more complicated because its risks vary with the amount consumed, the pattern of drinking and individual circumstances. In general, drinking less means lower risk. UK guidance recommends that men and women don’t regularly drink more than 14 units a week, and that it is best to spread the alcohol across three or more days and include several drink-free days. This guideline aims to lower risk, not define a safe threshold, and choosing not to drink is also a healthy option.
Although they are not substances, potentially harmful behaviours can create similar difficulties. Gambling, for example, can become compulsive and harm psychological health, relationships, and financial security. Excessive use of digital media may also interfere with sleep, movement, relationships, and emotional wellbeing.
Recognising when something is causing harm and seeking appropriate support when change feels difficult are important health skills in their own right.
The foundation: Our physical and social environment
None of the six pillars exists in isolation. Our surroundings can make healthy choices easier or harder, from access to nutritious food and safe places to exercise, to working hours, financial resources, social norms, air quality, and the conditions in which we sleep.
Which pillar should you work on first?
You don't need to overhaul all six at once. The most useful starting point depends on your current health, priorities, circumstances, and what feels realistically changeable.
In one-to-one healthspan coaching, we assess where you are now, identify the areas most likely to make a meaningful difference and turn them into practical changes that fit your life. There is good evidence supporting each pillar, but deciding where to focus, and how to apply that advice in daily life, is rarely straightforward.
- Explore where you are now, including your current health status and how you live.
- Prioritise action steps from where you are now toward the goals of where you want to be.
- Invest your time and effort to meet those goals.
- And repeat.
Together, the intent is to improve your health and wellbeing for today and extend your healthspan for tomorrow.
Which pillar feels the strongest at present? And which one, if improved, might make the biggest difference?
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Frequently asked questions
References
1. Rappaport SM. 2016 Genetic factors are not the major causes of chronic diseases. PLoS One 11, 1–9. (doi:10.1371/journal.pone.0154387)
2. Lexell J, Taylor CC, Sjöström M. 1988 What is the cause of the ageing atrophy? J. Neurol. Sci. 84, 275–294. (doi:10.1016/0022-510x(88)90132-3)
3. Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. 2018 Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA Netw. open 1, e183605. (doi:10.1001/jamanetworkopen.2018.3605)
4. Physical activity guidelines: UK Chief Medical Officers' report. Updated, July, 2026.