An MD On What The Longevity Movement Got Wrong & The Habits That Actually Keep You Well
We've been sold a simple deal: the more you measure, the healthier you get. HRV, glucose, sleep stages, ApoB, VO2 max—pick your metric, then measure it.
I've been tracking my health metrics for years, so I was excited to ask oncologist and health policy leader Ezekiel J. Emanuel, M.D., Ph.D., MsC, which numbers are actually worth tracking when he came on the mindbodygreen podcast. I expected a debate about tiers of data, but the conversation took a different direction when I learned he doesn't track daily health metrics at all. His new book, Eat Your Ice Cream, makes the case that the habits you repeat matter far more than what you record.
Why he doesn't track anything
"I don't actually track anything," Emanuel told me during our conversation. His argument? If you're doing things right, you're doing it for years and decades, and nobody wants to spend decades logging numbers.
For some people, data genuinely motivates. His wife, an MIT grad, is one of them, and he's all for it if that's what works. But for plenty of others, tracking mostly generates worry. Am I sleeping enough? What's my VO2 max today?
Instead, he uses a much older feedback system. "I just listen to my body," he said. He eats well, exercises, protects his sleep, and knows within hours of waking up whether he's on track. When he's short on exercise or eating poorly, he feels out of sorts. That, he argues, is a better signal than chasing optimization through a quantitative readout.
The markers he thinks are worth knowing
Emanuel is quick to say he is not anti-data,. He isn't a fan of wearable fitness trackers, but was quick to supporting getting lab work done. He's a firm believer in standard screenings that monitor disease risk, like mammograms, pap smears, and HPV vaccinations.
We also discussed how to monitor cardiovascular health. Emanuel says knowing where your cholesterol stands is important, especially if it needs adjusting. He also recommends testing Lp(a), but only once since it is determined by genetics. If you're older and dealing with a cholesterol issue, he also said it's worth getting a calcium score.
In terms of testing, this list is pretty measured. He recommends getting a handful of tests, but only when necessary. No need to create unnecessary anxiety.
Willpower fatigues, habits don't
Lots of people blame themselves and their lack of power for an inability to keep up with a healthy lifestyle, but Emanuel argues willpower is not the way to achieve optimal health.
"Willpower easily fatigues," he told me. "If you have to expend willpower every time you do something, you don't begin to make it a habit or to enjoy it, you will give it up."
He uses New Year's resolutions as an example. Most resolutions run entirely on willpower, whether it's not drinking or sticking to a diet, and 80 to 90% of them are abandoned by the end of February. He argues willpower can get you over the initial hump and carry you for about four to six weeks, but taking action to create a habit three to four times a week is what genuinely makes something stick.
What his own habits actually look like
Emanuel's routines are the proof of concept, and I was struck by how unglamorous they are. No fancy tools or diets—just healthy habits he enjoys.
- Yoga every morning: He wasn't doing it 10 or 15 years ago, but it's become a routine. When he skips it, he can feel it in his muscles.
- A fixed breakfast: Eggs for protein with one piece of toast, plus a bowl of berries with yogurt, chia seeds, and hemp hearts. The meals packs giber, protein, and good fats. When his breakfast isn't structured, Emanuel doesn't enjoy it as much.
- A salad at dinner, nearly every night: This is a habit his mother started in the early 1960s, meaning he's had a salad almost every day since childhood. He credits this with getting him far more fiber than most Americans get, which he calls the single biggest deficiency in the American diet.
None of these habits requires discipline anymore because they are a part of his daily routine. He's arranged his schedule around these things, so they're not decisions.
Why the ice cream is the point
As I recounted to Emanuel, the title of his book hooked me before I read a single word. As a dad of two young girls, ice cream with my daughters is a treat, not a cheat, and 10 years from now they may want nothing to do with me and ice cream. I'd rather be present for it. Emanuel said this outlook perfectly captured his thesis.
"Rarely does a single person go and buy ice cream," he said, saying most people come in groups, making it an enjoyable social event. When wellness is built on self-denial and punishment, Emanuel does not see it lasting. That's why he thinks the wellness industry has left out a key pillar of health: sociability and connection.
He recognizes most people consider joy and social relationships to be psychologically important, but he goes further. "It's biologically important," he says.
Social interaction releases oxytocin and dopamine and lowers stress hormones, while loneliness and social isolation increase genes associated with inflammation and cardiovascular disease. He doesn't just want social fitness listed alongside diet, exercise, and sleep, but put ahead of them. This spans deep connections with close friends and family, to the casual ties we tend to dismiss. He points to a large body of research showing that even introverts feel happier when they act more extroverted.
The takeaway
What Emanuel hears most often from readers is a sense of relief that they don't have to 'max' or biohack to achieve their health goals. Most of what he prescribes is closer to age-old motherly wisdom than modern longevity science. He wants you to eat well, move your body, sleep, stay mentally sharp, keep people close, and avoid stupid risks.
And he reminds us that behaviors you enjoy or automate will outlast the ones you have to force. If you're choosing where to start, choose the version of the habit you'd still be glad to repeat in five years.