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By making healthy lifestyle choices, you can self-engineer genetic alterations to prevent disease and boost longevity.

Take a moment to visualize your favorite place in the world that requires you to walk up an incline. Maybe it’s the Spanish Steps in Rome or the Potala Palace in Tibet. Or maybe it’s a serene hill in your local park. Or the top row of your favorite team’s stadium.

Now imagine that you’ve reached the summit. Take a look down at the other folks trekking toward you. You will see two kinds of people.

First, there’s the spry set. These are the bouncy beings that kangaroo from the bottom to the top. They’re smiling, laughing, barely breaking a sweat, and fully enjoying the journey. They’re excited about reaching the destination and—despite the fact that it takes some effort—can’t wait to experience what awaits when they arrive.

Second, there’s the group that’s struggling. Those who have to stop and catch their breath 10 times on the way up. Every. Step. Takes. So. Much. Out. Of. Them. Huff. Puff. Are. We. There. Yet?

You’re probably more like one of these groups than the other. What’s the difference between them, besides their speed and the ease with which they travel? It might be their size or age, yes. It’s most certainly their overall health.

But you know what it’s less likely to be? Their genes endowed at birth. Instead, it’s their lifestyle choices.

The Great Age Reboot is the name my co-authors—Peter Linneman and Albert Ratner—and I gave our new book, published by National Geographic. The “great age reboot” is also our term for the transformation we see dawning: breakthroughs in health and medicine that will let us live longer and live younger; advances that will exponentially change our society, our economy, and our future.

To prepare for the great age reboot, you have to be willing to change—not only to get and stay healthy but also to have enough health to repair yourself when repairs are needed. There is certainly a fantastic future ahead. But to enjoy it and relish your longevity, you will need to be a genetic engineer now. The upside? You will literally get to change your family medical destiny—if you want to.

In the United States about 40 percent of premature deaths—defined as occurring before age 75—are related to lifestyle choices, behaviors we can change. Lifestyle and genetics are intertwined, in that your lifestyle choices influence the ways that many of your genes function—and thus how your body functions.

Studies of human gene expression show that if you choose to make certain lifestyle changes, you can influence whether your genes are “on” or “off.” In fact, your choices can influence an estimated 1,200 of the 1,500 genes that are on and probably can influence the other estimated 21,000 that are off.

For example, after implementing changes to their physical activity, stress management, and diet regimens, men were able to turn off genes associated with prostate cancer growth and turn on a gene that produced a protein that causes cancer cells to self-destruct. The same principle applies for colon and breast cancer: Lifestyle changes switched on genes that fought cancer and turned off genes that promoted it.

You have the ability to change how your body works and reacts—and ultimately how healthy you are and how long you may live. You should build a strong foundation now.

Science tells us that by the time you are about 60 years old, 75 percent of your health outcomes are determined by your choices. That’s genetic self-engineering: Each healthy act switches on youth-promoting genes and switches off genes that cause you to age. This process is the result of millions of years of evolution. Good choices (and the proteins that are developed because of them) beget more good proteins, and the activation of bad genes begets more bad and destructive genes being turned on.

You have the ability to change how your body works and reacts—and ultimately how healthy you are and how long you may live. We’ll give you three main reasons your pursuit of optimum health and youth through lifestyle choices is an imperative.

You should build a strong foundation now.You probably know people who’ve survived a horrific disease, accident, or surgery—and it was said that their preexisting physical and mental strength fortified their bodies for battle and made them better equipped to endure stresses. That’s true with the recent COVID-19pandemic: Over 80 percent of COVID-19 deaths were among people older than 65, and severe cases are more likely for those with preexisting conditions, such as obesity, diabetes, heart disease, chronic lung disease, and immune dysfunction.

The same thinking will apply when we’re talking about longevity—that is, healthy choices will help prevent chronic disease and set you up for a long life. The better your physical shape, the higher the chances that new antiaging procedures will “take” at a high level, with fewer complications. Stronger at the start means stronger throughout the entire race and all the way to the finish.

It’s unclear how many reboots you’ll get.Perhaps in a utopian 25th-century world, there will exist some dressing-room-like catacomb that allows you to walk into a booth, press a few buttons, and erase every cigarette you’ve smoked, every couch you’ve potatoed, every potato you’ve ever fried. But for the foreseeable future, it’s far more likely that your reboot chances will be limited. Your ability to maximize their effectiveness will depend on your commitment to improving your biology through proven means: nutrition, physical activity, sleep, not smoking, and stress management.

No matter what happens, your brain needs you. The human brain remains the final biological frontier. So even if science ultimately allows us to correct our cells, genes, and other mechanisms that make our bodies work, when your brain goes, you will too. To maximize the promise of a longer-lasting youth, it’s imperative that you self-engineer your DNA switches to protect your brain—and the steps are the same as those you can take to protect the rest of your body.

The actions outlined below have been shown to have the most influence over your biological function. You’re not going to behave perfectly all the time. Your longevity depends more on the aggregate of what you do most of the time. How can we collectively get to better decisions?

We are in a peak period for access to information and have the most medically advanced health industry of all time. Yet two-thirds of Americans are overweight or obese, and millions will die or become ill from choice-related health problems, including heart disease, lung cancer, stroke, diabetes, and dementia (yes, the data show that healthy lifestyles are associated with a 60 percent reduction in the risk of developing dementia).

Finding the right way to motivate ourselves to make better lifestyle choices is not easy, and we Americans have very effectively exported our bad habits to almost every other developed country. However, we do have some data about what has worked. Several factors are common among people who successfully make positive lifestyle changes:

They achieve “normals”—our term for satisfactory health metrics or health and wellness behaviors—on six indicators.* The healthiest bodies are the ones that meet the goals set by the six key indicators listed below. That’s why our barometer for health success is “6 Normals + 2”—normal scores on those six indicators plus two other factors: seeing a primary care physician and ensuring your immunizations are up-to-date.

*Six key indicators of good health

Six key indicators of the optimal health status that promotes longevity:

• Blood pressure of less than 120 mmHg systolic and less than 80 mmHg diastolic
• BMI (a measurement of height-to-weight ratio) of less than 27 or, better, a waist-to-height ratio of 0.40 to 0.55
• LDL cholesterol (a risk factor for heart disease) of less than 70 mg/dL
• Fasting blood sugar (associated with diabetes) of less than 106 mg/dL
• Urine free of cotinine (an indicator of tobacco use)
• Completion of a stress management program

They use technology. The marketplace is full of all kinds of trackers that provide real-time feedback about our health choices. You can track steps, minutes of activity, heart rate, calories, sleep quality, and much more. While not everyone needs or likes these aids, technology can provide an excellent form of motivation by establishing benchmarks and goals. And it can help you try to reach those goals, especially when combined with the encouragement of a coach. The human touch is key to making the technology meaningful and the changes sustained.

They leverage financial incentives. It’s a basic human reaction: Significant financial incentives have always been a driver of behavior change. Much of the burden of establishing those incentives comes down to how our government and industries reward employees who stay or get healthy. You can improve your financial situation with better health, starting with lower medical costs, higher work productivity, a longer career, and less worry about the impacts of pandemic diseases too.

They have a buddy, or several. You need a built-in ecosystem with your own tribe—a community of people who support one another in pursuit of their goals. It can come in many forms: one person, a small group of people, or a large tribe with lots of people pursuing the same goals. Many of us may experience some combination of those supporters during the evolution of a wellness journey. Having a partner (or partners) in your pursuit of behavior change is the variable that most predicts success.

They do the little things that matter. Going into a hip replacement at age 59 and again at 64, co-author Peter Linneman was fit, did physical therapy before the surgery, and actively stuck with it after surgery; as a result, he was able to quickly and fully recover. Peter’s physical therapist noted that the scenario for most patients is to go into the surgery weak and ignore the post-op therapy. They blow it off, perhaps thinking it’s really not that important. This is the way a lot of us think about health: Why bother with the little things? Will they really matter that much? Yes! Every little decision adds up, and even more as you live longer.

Science is about to offer you the Garden of Eden. A chance not just at prolonged life but at prolonged youth—or rather, and even better, prolonged youthful years.

But taking advantage of it will be up to you.

Michael Roizen, M.D., is the chief wellness officer emeritus at the Cleveland Clinic, a professor at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, and author of four number one New York Times best-selling books.

This story appears in the October 2022 issue of National Geographic magazine.