#63 The Million Dollar Question: Which Health Predictions Actually Help You Live Longer?

Can you predict when “bad things” will happen to your health—and more importantly, can you do anything about it? In this episode, I break down which prediction tools actually help you live long and well (because you can act on them), and which ones are mostly expensive fortune-telling. Joined by cardiologist Dr. Anthony Pearson (author of The Skeptical Cardiologist), we dig into heart-risk calculators, dementia genetics, and why biological age clocks aren’t ready for prime time.Guest: Dr. Anthony Pearson, cardiologist and writer of The Skeptical Cardiologist (Substack)Key topics & takeawaysWhy “prediction” only matters if it changes what you do—and improves real outcomes.A red flag to watch for: is the person promoting the tool also selling the test, supplements, or “hacks” to fix it?A sobering reality check: even doctors’ YouTube claims often lack strong evidence (and the least evidence-based content gets more views).Heart disease risk equations: the gold standard in prediction because we can reduce risk factors (BP, LDL/ApoB, smoking, diabetes) and clinical trials show outcomes improve.But even good tools miss people: a study of <65-year-olds who had heart attacks found many were labeled “low risk” beforehand.Dementia genetics (ApoE): ApoE4 raises risk (especially E4/E4), but it’s not destiny. You can’t change genes—so the value of testing depends on whether it motivates healthy behaviors or creates anxiety.Biological age clocks: fascinating research, messy consumer product. Different tests disagree, repeat testing can vary wildly, and most importantly—no proof that “lowering” a clock improves health outcomes or longevity. My advice: save your money (for now).Links & resources mentionedWall Street Journal: longevity calculators for retirement planning: https://www.wsj.com/personal-finance/retirement/i-tried-answering-a-big-unknown-in-retirement-planning-how-long-will-i-live-9ef468dfEvidence behind doctors’ YouTube claims (JAMA Network Open): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2844038Example of strong claims vs broader evidence debate (Substack): https://substack.com/@drjasonfung1/p-182794806Framingham Heart Study overview (risk factors history): https://pmc.ncbi.nlm.nih.gov/articles/PMC4159698/Heart-attack patients labeled “low risk” by calculators (JACC Advances): https://www.jacc.org/doi/10.1016/j.jacadv.2025.102361Biological age clock reliability issues (comparison across clocks): https://pmc.ncbi.nlm.nih.gov/articles/PMC9586209/Call to action If you found this useful, please share the episode with a friend and leave a quick review on Apple Podcasts or Spotify. Want my newsletter on practical, evidence-supported ways to improve longevity? Visit drbobbylivelongandwell.com.And don’t forget to vote on what we should call this community: N of One Nation, Outcome Optimizers, Health Warriors, or something better.Send us Fan MailSupport the show📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com