How to prevent fragility as we age with Dhru Purohit

What actually helps you avoid frailty, stay strong, and live a long, healthy life

If you're navigating midlife, you've probably heard a thousand tips for aging well: walk more, eat more protein, build strength, get bloodwork. But what's truly worth your time, nd what’s just hype?

In this deep-dive conversation with Dhru Purohit, host of The Dhru Purohit Podcast, we break down and rank the top habits that influence longevity, based on what i see in practice every day. The ranking system is simple: S for “Supreme,” A for "excellent", down to F for "forget it".

A word about the rating: some things that are rated C may be helpful, they are just less helpful than things that are rated an A or B.

DEXA Scans: A Wake-Up Call for Bone Health

It’s easy to dismiss osteoporosis as something that happens “when we’re older.” But the truth is, the foundation for strong bones is built decades earlier.

“Osteoporosis can be viewed as a childhood disease in some regards… you’re building most of your bone density in childhood, teens, young adult years.”- Dr. Mary Pardee

A DEXA scan is a low-radiation scan that measures bone density — and it can reveal silent issues like osteopenia before a serious injury occurs. I emphasize this test is especially important if you're postmenopausal, underweight, have a history of eating disorders, or a family history of fractures.

“One in four women will die within two years of a hip fracture at the age of 90.”- Dr. Mary Pardee

Rank: S for the right person

VO₂ Max: The #1 Predictor of Longevity

VO₂ max, or your body’s ability to use oxygen during aerobic activity, is one of the most powerful predictors of lifespan.

“You get a 50% reduction in all-cause mortality if you go from a low VO2 Max to below average.”- Dr. Mary Pardee

The good news? You don’t need to test it to benefit from improving it. Dr. Mary does offer this test to all of her concierge patients in Los Angeles, but if you can't get this test done it doesn't mean you can't get the benefits.

You can build your VO2 max through cardio exercise — starting with low-intensity movement like brisk walking, and progressing to sprint intervals as your fitness builds.

Dr. Mary mentions an easy way to work on VO2 max: 1 minute all out sprint intervals (run as fast as you can for 1 min) followed by 1 minute of rest, repeat 5-10 times.

Rank: S

Strength Training: Your Lifelong Health Insurance

If there’s one non-negotiable habit for longevity, it’s lifting weights. Strength training does more than build muscle — it protects your bones, improves balance, prevents frailty, and extends your healthspan.

“Strength training. S. Easiest one we've done so far. I see strength as a cornerstone of quality of life as we age. Whether you're 35 or 75, it's never too late to start." - Dr. Mary Pardee

Rank: S

Tracking Workouts: Why Your Progress Might Be Stalling

Lifting weights is great — but tracking what you're doing is the next-level tool that most people skip.

“They’re just on a hamster wheel of repeating workouts and aren't improving" - Dr. Mary Pardee

I have seen it often: people go to classes or lift the same weights each week, never realizing they’re not progressing. Tracking helps ensure you’re applying “progressive overload” — the key to gaining real strength.

Rank: A

Grip Strength: Useful, But Not the Full Picture

Grip strength is often talked about as a longevity biomarker — but it’s not one you need to train directly.

“Grip strength is a proxy for total body strength."

I test it because it’s simple, but I am quick to caution that squeezing hand devices won’t lengthen your life. It reflects general strength, but doesn’t create it.

“We don’t want people to work on their grip strength. That is not gonna help you live longer.” We DO want people to work on their total body strength, which will help you live longer and have a higher quality of life AND will improve your grip strength".

Rank: C

10,000 Steps: Good, But Not a Gold Standard

Walking is one of the best forms of movement. But the 10,000 steps goal? That’s just a number.

“Most people just need to move more.”

I give walking a thumbs-up — especially if it helps people meet the recommended 300 minutes of activity per week.

Rank: B

Rucking Vests: A Niche Bonus

Wearing a weighted vest while walking or hiking can make movement more challenging — but it's a bonus tool, not a requirement.

“It doesn't have life-changing benefits in my mind... but it does have the ability to get you to a resistance level that pushes you.”

Helpful for increasing intensity on walks or hikes, especially if you're trying to avoid high-impact exercise.

Rank: B

Longevity Testing: Don’t Waste Your Money

Biological age tests that claim to tell you how old you “really” are?

I do not buy it.

“I think they’re a marketing thing. If you tested it using a bunch of different companies, you would get a bunch of different results. I don’t think they’re reproducible. They are a waste of money".

I give these tests a rare fail, noting they lack utility, consistency, and actionable insight.

“Save your money. … get a gym membership."

Rank: F

Lipid Panels: The Silent Risk You Shouldn’t Ignore

Heart disease remains the leading cause of death — and many people are in the dark about their risk.

“Heart disease is silent until it’s not.”

That’s why I recommend everyone get a yearly lipid panel, including Apo B if possible.

“Heart disease is something we know how to almost entirely prevent, so we should prevent it."- Dr. Mary Pardee

Rank: A

Calorie Tracking: A Short-Term Secret Weapon

If you’re trying to lose weight, even a short period of calorie tracking can be transformational.

“If you are overweight, tracking your calories is a go-to. Must.”

It doesn’t have to be forever, even two weeks can reveal hidden eating patterns and help you take control of your health.

“It’s a no-brainer in my mind. And it’s not fun… but it works.”

Rank: S (for those with weight to lose)

Macro Audits: Especially Protein and Fiber

You may be eating less protein than you think, and that can make it harder to build muscle or stay full.

I often have clients do a brief audit to assess protein, fiber, and saturated fat. For many, the numbers are eye-opening.

“Women, should consume, ideally more than 25 grams of fiber. Men closer to 35.”

Rank: A

Walking After Meals: Helpful, Not Essential

A post-meal walk has become a viral habit, but the timing isn't essential for most people.

For those managing blood sugar, it may offer benefits. But for most, overall movement matters more than the timing of the movement.

Rank: C ( remember a C does not mean it's a bad idea, I had to give it a rating and there were things I rated a B that I think are more important than the timing of exercise, any movement is GREAT).

Final Word

There’s no one path to longevity — but there are clear patterns: build strength, move often, measure what matters, and skip the fads.

For more evidence-based health insights and myth-busting content, subscribe to the Modrn Wellness podcast and follow @dr.marypardee on Instagram.

Follow Dhru Purohit

Instagram: @dhrupurohit

Podcast: DhruPurohitShow

Website: https://dhrupurohit.com/

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