You Can Still Change Your Future Starting Today

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Episode Summary: In this episode, I explore whether it’s ever “too late” to change your health future—and why the science suggests that earlier is better, but later still matters. 

Can you still change your future? The answer is hopeful, but nuanced. Younger listeners may assume they have plenty of time, while older listeners may wonder whether the damage has already been done. In both cases, the evidence points to a more useful truth: some risks accumulate over time, some damage may be partly repaired, and many future outcomes can still be changed.

I begin with a personal update about using EMDR to address exercise-related fear. At 69, I’ve found that it has helped me feel more confident and enjoy intense exercise more. Would it have been better to try it decades ago? Probably. But that does not mean it was too late to benefit now.

The episode then walks through a five-part framework for thinking about health changes. First, some changes are best made early because damage accumulates. Blood pressure is a clear example: long-term cumulative blood pressure exposure in young adulthood has been linked with later cardiovascular disease risk, which is why “my arteries are keeping score now” is such an important message.  Glaucoma follows a similar logic: elevated eye pressure can silently damage the optic nerve, so early detection and treatment matter.

Second, some damage may be partly repaired. Smoking cessation is the clearest example. Lung cancer risk declines the longer someone has stopped smoking, although prior smoking risk does not disappear completely.  I also discuss the Lifestyle Heart Trial, where intensive lifestyle changes were associated with regression of coronary atherosclerosis and fewer cardiac events over time, while also noting that the study was small and required major changes that may not be realistic for everyone. 

Third, even when we cannot erase the past, we can still protect the future. The Diabetes Prevention Program showed that lifestyle changes reduced the risk of developing type 2 diabetes by 58% overall and 71% among adults over age 60.  The UKPDS also reminds us that early glucose control after diabetes diagnosis can have lasting benefits, especially for complications involving the eyes, nerves, and kidneys. 

Fourth, it is never too late to build certain capacities. Strength training is a powerful example. In one study of frail adults up to age 96, high-resistance training led to major strength gains and improved walking speed.  That does not mean we are trying to become bodybuilders at 90. It means we are training for independence, balance, confidence, and the ability to keep doing the things that make life meaningful.

Finally, timing may matter, but sometimes we do not yet know how much. Social connection is strongly tied to health and happiness, as shown in the Harvard Study of Adult Development, but we do not know exactly how much risk can be reversed by building new relationships later in life.  Sauna use has also been associated with lower cardiovascular and cognitive risk, but it is less clear whether benefits require lifelong use or can still meaningfully begin later. The practical question becomes: does this activity also bring you joy now?

Takeaways: Earlier is better, but later is not too late. Start by asking what part of your future you can still influence from here. Check your blood pressure, see your eye doctor, consider strength training, reconnect with a friend, or address a fear that has been holding you back. The goal is not perfection—it is progress, and there is still time for that.

Transcript

Is It Too Late To Change

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Maybe you're fifty-five or sixty-five and thinking, I haven't exercised much. My blood pressure hasn't always been controlled. My cholesterol has been a bit high. Why bother changing now? Isn't it too late? Or maybe you're younger and thinking I have plenty of time. I'll deal with this later. Today's episode asks both questions, and the answer is hopeful but nuanced. The young person's mistake is thinking they have plenty of time. The older person's mistake is thinking their time no longer matters. The science says both are wrong. Can you still change your future? Or is it too

EMDR And Exercise Fear At 69

SPEAKER_00 1:06

late? I'd like to start with a personal update, which directly relates to today's discussion. In a recent episode on stress, I talked about the technique of EMDR for anxiety. With EMDR, you may recall a fear while watching a ball move back and forth on a screen. It desensitizes you to the memory and the symptoms. As I shared, when I exercise intensely, I have a fear. Not just the normal discomfort of exercising, but a deeper feeling that something is wrong or that I won't be okay. So at age 69, I decided to try EMDR. And now, two months or so in, I can tell you, it really's helped me. Has it made exercise more enjoyable? Absolutely. Has it made me feel more confident? Yep. Would it have been better if I had done this 20 or 30 years ago? Probably. But was it too late to feel less fear and more joy? Absolutely not. And that got me to thinking about the saying you can't teach an old dog new tricks. Perhaps I'm part of the old dog here. Now, we actually do have three old dogs, three Vishlas, ranging from 11 to 13 years old. And I'm not entirely sure they want to learn the new tricks I want to teach them. Sit, stay, come. Apparently, those are negotiable. But are they still learning? Absolutely. They're learning increasingly creative ways to steal food from counters, sinks, and our kitchen drawers. So maybe you can teach an old dog new tricks, but but the dog may choose which lesson. And that led me to the real question for today. Yes, maybe we can still change or learn or adapt. But will it matter? Or will it change our future? If we start exercising later, control blood pressure or blood sugar later, build new friendships later, or learn new ways to manage fear and stress later, is it too late? Or is there still real benefit? Here's the punchline. So I'll give it to you, but hopefully you'll continue to listen. So as I said in the intro, there are two mistakes we should avoid. The young person's mistake is thinking they have plenty of time. The older person's mistake is thinking their time no longer matters. Well, the science says both are wrong. Now, I'm not going to run through the usual checklist of health advice and tell you to exercise more, eat and sleep better, reduce your stress.

A Five Part Timing Framework

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Instead, I want to explore a five-part framework to help you think about changes and what they might do for you. And then, and then you can decide what you actually want to do. So five parts to our framework and our discussion. Part one, in some cases, make changes as early as possible because damage accumulates over time. Part two, in other situations, undoing the health damage is still possible. Part three, even if we can't undo the damage, we can protect our future. As the saying goes, the past is the past. Part four, it's never too late to build certain capacities. And part five, finally, timing may matter, but sometimes we don't know how much. A quick thought for today. Do you want to get the most out of the podcast without taking notes? Make sure you're signed up for my newsletter. For every episode, I send out a summary that includes links to the clinical studies and now to a one-page PDF action item checklist. You can sign up right now by clicking the link at the bottom of your show notes or by visiting drbobbyvidence.com, drbobbyevidence.com. One other point I'd like to make before I dive in, and this applies to many episodes, and really, really how I think more generally, is both perhaps my greatest strength, but also a limitation. I'm pretty good at taking complex scientific issues and framing them in ways that are understandable for you and frankly also for me. I hope that helps you. But I am also mindful that when I simplify, I run the risk of oversimplifying. Today's episode is a perfect example. These five categories are not perfect silos. They're thinking tools. So use this framework as a way to think more clearly, not as a perfect map of biology. And finally, I try to be realistic and realize that not everyone is going to be me with the time and flexibility to focus on health. It's not always feasible to make a bunch of changes at any moment in life. Family demands, career pressures, financial challenges, pain can all shape what's realistic. So, so this episode is not meant to make you feel bad if you can't make those changes. It's meant to create a better question. Given your life right now, right now, what part of your future might you still be able to change? And how much will you gain from those changes? Then you decide you. Okay, let's start with the clearest reason not to wait to change your future.

Damage That Builds Over Years

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Part one. Start early because some damage accumulates. Some health problems are quiet for years. No pain, no obvious warning, no sense that anything's wrong, but the damage may still be accumulating. And all seems well until it isn't. As I say to Gail a lot. It's all good until it's not. And it's a very fine line between the two. Blood pressure is the model of addressing a health issue early. High blood pressure is not just a number at a single doctor's visit. It's really the impact of that pressure over time, which increases your risk for heart disease, stroke, and dementia. The problem with blood pressure is that it creates cumulative damage. Not just how high your pressure is today, but how high has that been over what time period? Years of high blood pressure can injure blood vessels, stiffen arteries, strain the heart, and damage our kidneys. That doesn't mean later treatment is useless, far from it. Lowering blood pressure later can still reduce cardiovascular risk, but late treatment will likely not undo years of prior injury. That's the crucial distinction. For younger listeners, for younger listeners, the message is not, I'll deal with my blood pressure someday. The message should be my arteries are keeping score now. I should do something today. For older listeners, the message is not, I waited too long, so why bother? The message is I may not erase the past, but I can still reduce what happens next. As always, does the evidence support this approach? Yes. In an interesting study, researchers followed 3,600 young adults, young adults for 15 years, and measured their blood pressure over those years and looked at how likely those folks were to develop heart disease. What they found is what you might expect. The folks at greatest risk were those who had high blood pressure for the most years. So the damage was cumulative. And because it's cumulative, getting it under control earlier in life is better. Here's another illness, a more subtle one, and one that isn't talked about enough, that follows the same general pattern, glaucoma, or elevated pressure in your eyeballs that can lead to optic nerve damage and blindness. Unfortunately, it's silent. And unless you test for it, you won't know until it's too late. Like blood pressure, studies have shown that treating it earlier is a lot better than waiting. See your eye doctor, get your eye pressure measured, and start early if there's something to treat. All right.

When The Body Can Repair

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Damage may have already started, but part two, part two, repair is possible for some things. Here's some good news. Some changes don't just slow future damage. They may undo at least some of the damage that has built up over time. Not perfectly or completely, but meaningfully. Let's talk about smoking. Now, smoking isn't interesting here because we need yet another reminder that smoking is harmful and causes lung cancer. And few of you likely smoke. It is not that quitting erases the past. Smoking is a great starting point since the evidence is pretty clear. And that evidence shows that quitting reduces some of the lung cancer risk. In a systematic review of 26 studies, the researchers found that stopping smoking reduced the risk of lung cancer for each five years since quitting. Quitting 10 years ago was better than continuing to smoke. 15 years of quitting beat 10 and 20 beat 15. So the body can repair some of that risk or damage. But I don't want to oversell it. Even quitting for 25 years still leaves us at significantly increased risk of cancer. Here's another example where repair is possible for our heart. This is incredibly hopeful, but I need to add, I need to add incredibly preliminary and needs a bunch of confirming studies. But here it is. In a popularly talked about study, patients with known coronary heart disease were randomized, randomized to an intensive lifestyle intervention or usual care. The lifestyle intervention included a very low-fat vegetarian diet, exercise, stress management, smoking cessation, and group support. So a lot of changes were expected of the participants. Not an easy regimen to follow. What did they find? After one year, the intensive lifestyle change group showed regression of coronary disease or some opening up of the arteries. While the control group got worse, following those patients for five years showed fewer heart attacks in the intervention group. That's that's incredible. Probably first of its kind findings. Heart disease may at least be partially reversible. Okay, before high-fiving everyone around you, take a breath, as I often suggest when you hear potential hype and ask about the study. How believable are the results? Can I actually do what those folks did in the study? Here's the problem with the study. It was tiny, tiny, with just 20 to 25 folks in each arm. And the lifestyle changes were huge in terms of manpower power by the study folks to support all of those interventions. Proponents of the study like to conclude that the results are clear that a very low-fat, vegetable-based diet led to the benefits. However, the data don't support that conclusion, is the patients had every intervention, not just dietary change. So we can't say which factor drove the potential improvements. Keep in mind the tiny size of the study, and that the results have not been replicated. And perhaps not replicated for good reason. It may be too good to be true. And asking folks to make that many changes at one time is a monumental effort by the study folks and the folks in the study. My take, you can reverse some disease, and smoking cessation is the poster trial. For heart disease, the study was really interesting, but not definitive, at least until it's repeated in a much larger way.

Protect Tomorrow And Build Strength

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Okay, part three, protecting the future. The past is the past. Although we'd like we'd like to believe that all damage can be reversed, that's not likely. But you can still reduce future damage. Blood sugar is an example. In a study, lifestyle changes reduce the likelihood of diabetes by 58% overall and by 71% among participants age 60 and older. That is a great, not too late finding. But once diabetes is established, the timing question changes. Now, treating earlier is a lot better than waiting. So any damage that might have been done can't be reversed, but we can limit future diabetes complications. In the UK PDS study, researchers followed newly diagnosed diabetics to see whether early glucose control had lasting effects. What they found was important, starting treatment as early as possible reduce many key problems of diabetes, especially in the eyes, the nerves, and the kidneys. The past may be the past, but tomorrow's problems aren't inevitable. Part four. It's never too late to build certain capabilities. Some changes, some changes don't repair old damage or slow future ones, but they can create new capabilities and possibilities. And it's never too late. Let's take exercise. You're not just exercising for today. You're training the future you. Starting exercise at 60, 70, or even later may not give you the body you would have had if you had started at 30, but it can still improve blood pressure, mood, sleep, balance, and mortality risk. And strength training is the perfect example. Older muscles still respond. Even, even really older muscles. Of course, it's not about becoming a bodybuilder. It's about being able to lift a suitcase, recover from a stumble hike, get off the floor, play with grandchildren as you get older, remain independent longer. Here's an optimistic study. Researchers measured strength and walking speed in 90-year-old and older folks, some up to 96. Then they began a strength training program with those old individuals. What did they find? Amazingly, strength gains averaged 174%, and walking speed improved 48%.

unknown 19:14

Wow.

SPEAKER_00 19:15

I thought perhaps 10% gains might be possible, but these amounts were huge. Now we don't know if those folks lived longer or were more mobile or happier, but the study clearly shows that it's never too late to build muscle capacity.

Benefits We Still Cannot Time

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Part five. Timing may matter, but sometimes we don't know how much. There are a few areas that we know improve our health. It just isn't clear how timing plays into it. Do we need to start young, or can we have similar benefits even if we start later? As I discussed in an early episode, social connections may be one of the most important determinants of a good life. The Harvard study of adult development showed that relationships in midlife are strongly connected with later health and happiness. Now, that's a powerful message for younger and middle-aged listeners. Don't wait until you're lonely to build connection. But here's the uncertainty. If someone is lonely at 70 and builds new relationships, then how much does that improve long-term disease risk or longevity? We don't really know. We'd likely be happier, it may improve our health, but the timing and amount of benefit aren't as clear as they are for blood pressure, smoking, or exercise. Similarly for sauna, folks who take saunas have lower risk of heart disease and stroke and cognitive decline. Listen to my earlier episode if you want details. But we don't know whether those benefits, those benefits require a lifelong use of them, as many folks do in Finland, or whether starting later brings lots of benefits as well. So how should we think about social relationships and so on? You can start earlier in life, great. If it's later in life, perhaps make your decision based upon whether those activities are truly enjoyable for you, unrelated to long-term benefits.

Wrap Up And Your Next Step

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Let's wrap up. So can you change your future? Yes. But the answer depends upon what kind of changes we're talking about. Some choices are best started early because risk accumulates and benefits grow. Some choices can undo risk, at least partly. Some choices may not erase the past, but they can protect tomorrow. And some choices are never too late. And for some choices, the honest answer is timing may matter, but we don't yet know how much. Let's come back to where we started. At age 69, I tried something new: EMDR for exercise related fear. Would it have been better if I had addressed it decades ago? Probably. But has it helped me now? Absolutely. So maybe the final question isn't simply, did I do everything right before now? The answer for most of us is probably no. The better question is, what part of my future, what part of my future can I still change from here? If you're younger, please don't conclude. Great, I can wait. That's the young person's mistake. Thinking you have plenty of time. If you're older, please don't conclude. I miss my chance. That's the older person's mistake. Thinking your time no longer matters. The science says both are wrong. Earlier is better, later is not too late, and joy is not something we age out of. So I'll leave you with this. What change might you make? Maybe it's checking your blood pressure or seeing the eye doctor. Maybe it's starting strength training, even gently. I didn't start real strength training until just a few years ago, and it's really helped. Maybe it's reconnecting with an old friend. Whatever it is, I'd love to hear from you. What part of your future are you trying to change? Send me a note and let me know.