Most of us carry a quiet belief about our health as we age. When illness arrives, we tend to say something like, “I guess it’s in my genes,” or “I was just unlucky.” It feels like the honest, modest thing to say. But a remarkable new report from the Oxford Longevity Project argues that this belief is mostly wrong, and that letting go of it may be the most hopeful thing you can do for your future.
The report, titled Living Longer, Better, brings together a biologist, a public-health pioneer, a practicing doctor, an immunology and nutrition specialist, and a 90-year-old who still runs 10Ks. Their combined message is simple and a little startling: for most of the diseases that shorten and spoil later life, how we live matters far more than the genes we inherited. By their estimate, at least 80% of the responsibility for our health in old age lies in our own daily choices.
Who is behind this?
The Oxford Longevity Project, or OLP, grew out of the Covid crisis of 2020 to 2022, when a small group of medical and scientific professionals, along with a few informed lay members, began meeting to wrestle with a single question: how can we best prepare to live longer, and better? It is an unusually varied group, spanning a wide range of ages, backgrounds, and expertise, which is part of what gives the report its weight.
The five contributors are Professor Denis Noble, a pioneer of systems biology who developed the first mathematical model of the heartbeat and is a noted critic of gene-centered biology; Sir Muir Gray, a public-health veteran of half a century who built NHS screening programs and first described the “fitness gap”; Leslie Kenny, an autoimmune-disease survivor and health coach who founded an Oxford-based nutraceutical company; Dr Paul Ch’en, an Oxford GP with a background in cancer immunology and a particular interest in prevention and lifestyle medicine; and Sir Christopher Ball, the group’s lay member, a teacher, philanthropist, and poet who, in his nineties, still runs and writes. To develop their thinking, the group convened a series of Oxford “Summer Summits” from 2023 to 2026.
Living Longer, Better, published in May 2026, is the project’s first “Age-less” report. Rather than smoothing every contributor into a single voice, it lets each member speak in their own chapter, making the strong agreement among them all the more striking. The report is deliberately written for a wide audience: aging adults and their families, doctors and those who train them, and policymakers and the media, with the shared aim of shifting our culture from treating sickness to actively creating health.
The science behind the optimism
For most of the 20th century, biology told a story in which genes were the master controllers and the rest of us were along for the ride. Professor Denis Noble, a pioneer of systems biology, explains in the report why that story proved incomplete. Genes do not act on their own. They are switched on and off, dialed up and down, by signals from our environment and our behavior, a field of study called epigenetics. In plain terms, the way you live sends instructions back to your biology every single day.
This is why two people with similar genetic profiles can age so differently, and why your DNA, except in a handful of purely genetic conditions, is a poor predictor of the common diseases of later life. As one of the report’s authors puts it, genetics may load the gun, but it is our choices that fire the bullets.
The diseases we fear most are largely preventable
The illnesses that worry us as we age tend to be the same handful: heart disease, cancer, dementia, the dangerous pairing of obesity and type 2 diabetes, autoimmune conditions, and the falls and fractures that so often steal independence. The report makes an important distinction here, one worth pausing on. A tumor is not the cancer itself; it is a symptom of a deeper disturbance at the cellular level. Treating symptoms matters, but preventing the underlying problem matters more, and prevention is far more within our reach than most people realize.
None of these conditions is primarily caused by infection, and only rarely by inherited genes alone. Overwhelmingly, they grow out of the way we live: what we eat, how much we move, how we sleep, how we handle stress, and the company and purpose we keep. That is sobering, but it is also liberating, because it means the remedy is largely in our own hands.
Remember to take your S-MEDs
If there is one phrase to carry away from the report, it is this homemade prescription: remember to take your S-MEDs. It is an easy way to hold the essentials in mind.
- S is for Sleep, regular and sustained, with no screens glowing in the bedroom. Sleep is described as the most undervalued health intervention available to us, and it costs nothing.
- M is for Mindset. Love your life and choose the life you love. Resist the daily pull toward gloom, comparison, and complaint, and live for today and tomorrow rather than dwelling on yesterday.
- E is for Exercise. Walk or run a mile a day, climb the stairs, and build strength. Strength, balance, and aerobic capacity are among the best predictors we have of staying independent and sharp.
- D is for Diet. Eat real food that is largely plant-based and minimally processed, with enough protein to protect muscle as you age. The report is blunt about ultra-processed foods, calling them a modern experiment with serious metabolic consequences.
- And the small s reminds us to reduce stress, which the authors place alongside smoking as one of the most serious threats to healthy aging. Add to all of this the obvious: avoid smoking, and minimize or skip alcohol.
Aging is not a single thing
Sir Muir Gray, who spent 50 years studying how people grow old, offers a clarifying idea. Much of what we blame on “getting old” is not biological aging at all. It is the result of three things layered on top of it: a slow loss of fitness, disease that was often preventable, and the corrosive effect of low expectations, what he calls ageism. The pure biological process of aging, he argues, does not itself cause major trouble until very late in life.
The encouraging consequence is that three of those four factors can be influenced. We may not be able to stop the clock, but we can dramatically change how we live the years by maintaining and building physical, cognitive, and emotional activity. What most people want is not simply more years, but more good years, with fewer spent dependent on others.
A word for women
The report devotes special attention to women’s health, calling it an opportunity hiding in plain sight. Women live longer than men but spend more of those extra years in poor health, and they make up roughly four in five centenarians. Hormones shape bone density, heart health, metabolism, mood, and immune function, yet hormonal health is often poorly managed. The authors argue that fears about hormone therapy, stirred up by headlines decades ago, were based on older formulations and an older study population, and that the real questions today are more precise: which hormone, at what dose, by which route, and for which individual woman. Their call is straightforward: that every woman deserves an informed conversation with a practitioner who understands the field.
Become the chief executive of your own health
Perhaps the most practical idea in the whole report is a shift in posture, from passenger to participant. Think of your health the way you think of a pension. You invest steadily over decades, the returns compound quietly, and it is never too soon to start. Responsible patients, the authors suggest, learn to read their own lab numbers the way a driver reads a dashboard, ask informed questions, and partner with their doctors rather than waiting passively for rescue.
This does not mean rejecting modern medicine, which remains indispensable. It means using it wisely, and recognizing that the greatest gains lie upstream, in prevention and daily habits, long before crisis arrives. Even our doctors, the report argues, need to rebalance toward preventing disease, not only treating it, so that we build a true health service rather than what the authors bluntly call a national sickness service.
The choice is yours
The hardest part is rarely knowing what to do. It is doing it, day after day, against the pull of old habits, the influence of those around us, and the lure of the next small pleasure. The authors are honest about this, comparing daily life to an ongoing marshmallow test in which we are forever choosing between an easy reward now and a greater reward later.
Their advice is to start small and let success build on itself. Take the stairs. Add more vegetables. Walk to the shop instead of driving. Protect your sleep. Tend your friendships. Pick one easy win this week, then another. You do not have to overhaul your life overnight, and you certainly do not have to be perfect. You only have to begin.
The deeper message of Living Longer, Better is ultimately hopeful. Your later years do not have to be a slow decline to be endured. They can be a new prime, with more freedom to invest in what gives life meaning. The science says much of that future is being written now, in the small choices of an ordinary day. The pen, encouragingly, is in your hand.
