“We are living in an age where aging is becoming optional.”

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A 70-year old in so-called “perfect health” is much more likely to die than an obese, chain smoking 30-year old. “Wellness” won’t save you. Solving aging will.

This I wrote on X recently. And it’s true.

But, judging by some of the replies, it’s also remarkably hard for people to grasp.

One replied that you “wanna look and feel good getting there too chief.” Another wrote: “Yes, but quality of life for that 70 year old has been 30+ years of much higher quality and likely another 10+ higher than that 30 year old would experience for the rest of their life assuming they continue current habits.”

Let’s address these before getting to the real point of comparing the obese young person with the “healthy” older one.

Do we want to look and feel good as our days pass? Of course. That’s not controversial. But my post was not an argument against exercise, good nutrition, or avoiding cigarettes. I am not claiming metabolic dysfunction or smoking are harmless. We know they accelerate biological decline. Nor am I disputing that looking after yourself likely improves quality of life.

A third poster dismissed the comparison entirely as apples to oranges. And this is where it’s get interesting.

Because the comparison I made is deliberate. It isolates one variable: age itself.

We are used to comparing like with like - healthy 70-year-old vs unhealthy 70-year-old. That tells us lifestyle matters. And, again, yes, it does.

But compare across ages and something uncomfortable appears: aging is not just another risk factor. It is the background process that multiplies risk across nearly every major chronic disease.

This is exactly what biogerontologist Matt Kaeberlein’s slide below illustrates. It compares the relative-risk increase associated with roughly 30 years of aging - say 35 to 65 - with the risk multipliers from familiar villains like smoking, obesity, hypertension, or APOE status. And the aging bar dwarfs the others.

Not because smoking is trivial. Not because obesity is harmless. But because aging pushes risk upward across the board.

Cancer incidence rises steeply with age; advancing age is described by the National Cancer Institute as the most important risk factor for cancer overall. Alzheimer’s prevalence explodes with age, from roughly 5% in people aged 65–74 to more than 30% in those over 85. Annual mortality rates increase by several orders of magnitude between early adulthood and older age. The curve is not linear. It is exponential.

Smoking might double or triple risk for certain diseases. Severe obesity might raise risk substantially. But aging multiplies baseline vulnerability in a way that lifestyle factors simply do not match.

And this brings us back to the uncomfortable claim: the “healthy” 70-year-old is not biologically healthier than the obese 30-year-old.

They may be fitter. They may have better habits. They may have lower blood pressure or better glucose control than many of their peers. But their body is operating with reduced resilience.

Even if you do everything right, aging brings:

That list, by the way, is not exhaustive. These changes - the hallmarks of aging - lower the body’s capacity to absorb shocks. Recovery from infection is slower. Surgery carries higher risk. Cancer surveillance weakens. Vascular systems stiffen. The margin for error shrinks.

The younger person - even with bad habits - still benefits from youthful repair capacity, higher stem cell function, more robust immune responses, and greater physiological reserve. Their baseline odds of catastrophic failure are dramatically lower.

This does not mean lifestyle is irrelevant. It absolutely can delay decline and add disease-free years. It can shift you somewhat along the curve. But it does not flatten the curve. The odds remain stacked against the older person because the underlying biology of aging continues to operate.

And this, finally, is the real point: If we want a world in which a healthy 70-year-old truly is biologically healthier than the obese 30-year-old - not just impressive “for their age,” but genuinely more resilient - then behavior alone will not get us there.

The only path to that world is to change the biology of aging itself.

Not polish it. Not manage it. Not cope with it. We must change it. And, in the end, solve it.

That is why my comparison matters.