How Tracking Your Health Metrics Can Help You Live Longer

Zahi Fayad practices what he preaches. As a professor of radiology and director of the biomedical engineering and imaging institute at Mount Sinai, Fayad is leading a study investigating how our health data can be put to better use to help us live healthier, and by extension, longer. At his lab in New York City, he recently showed off his current go-to digital health devices (which rotate as new gadgets become available): an Oura Ring and a Garmin watch. He also uses an ECG strap to measure his heart rate every day, and occasionally pops on a continuous glucose monitor to keep track of his glucose levels.

Fayad is convinced that the trend of collecting more health data, on a more continuous basis—which the explosion of wearables made possible—will revolutionize health care. Keeping on top of risk factors for chronic diseases such as heart disease, diabetes, and obesity could help not just doctors but all health-conscious consumers identify when these conditions are beginning and potentially avoid them altogether.

In the lab, his team is developing better, more flexible, and inconspicuous patches to monitor health metrics—think Band-Aid-like patches embedded with sophisticated sensors that can pick up deeper vibrations from the opening and closing of valves in the heart, for example. Fayad shared his vision for how health care is changing, as well as how we can take advantage of technology to ensure that we not only live more years, but that we’re healthier and able to enjoy them more.

This interview has been condensed and edited for clarity.

How did you get involved in longevity research?

My interest has always been in trying to better understand lifestyle exposures on the body—specifically, initially, on the cardiovascular system. As we started to evolve in terms of what else we should look at, we started to think about how things get modulated through the immune system and the connection to the brain. When we looked at all the lifestyle exposures—diet, exercise, sleep, and stress—how do we start to study them? It’s hard to put them all on the table.

Eight-plus years ago, we initiated a research program with different projects that the National Institutes of Health funded. We focused on people with exposure to chronic stress or a traumatic event. We wanted to understand how the cardiovascular system and immune system were modulated by stress, so we created a platform to try to tease out what was happening. My background is in imaging, and imaging is a great tool to probe the body in multiple organs and understand their connection.

I was interested in not only chronic stress but, as a whole, all of the other exposures we experience. As the field evolved, people started to talk about not only chronic disease, but about healthspan and longevity. I said to myself that it wasn’t enough to study chronic disease. We needed to understand what health is in general.

How do you define health?

When you look in [scientific] literature, we know very little about health. We understand disease, but we don’t understand health. I wanted to start expanding the platform with the technology we now have, so it included not only imaging methods, but also things related to digital health, such as wearable devices, or sensors that have exploded [in popularity] during and after COVID. We started to integrate these technologies one by one.

And finally, because I am an exercise enthusiast, I started to stay on top of measurements we can do with imaging and digital health to understand the effect of strength on the body. Strength is one of the measures that will carry over as a surrogate marker for aging as people get older.

All of this data is collected in a project you call the digital twin study. Can you describe what the digital twin project involves?

The idea came initially from NASA as they were putting out rockets in the Apollo program. They needed to have a way to launch that rocket, so they created a digital twin of the same rocket here on Earth. That way, if they ran into a problem, they could figure out what went wrong and what to do.

They do the same thing with planes. A [plane] has over 30,000 sensors to track everything it does, from taking off to landing. All of that information is beamed back in real time to Earth to a station so they can maintain safety but also maintenance.

I started to think, why not carry out these digital twin tools for humans? But you need a lot of information to create a twin. Going to the doctor once a year and doing all of the lab testing will give you a very cross-sectional view of your health. Basically, you’re still missing the other 364 days. You cannot build a digital twin out of that. You need continuously updated information. Once you have that—let’s say blood measurements that you do at home on a quarterly basis—that information can feed into a digital twin.

Continuous monitoring [of health metrics] at home, like heart rate, body temperature, and O2 saturation, is now possible with the latest wearables. We need that continuous update. It doesn’t have to all be real time, but we need the information as frequently as possible so we can create this view of this physical entity in digital form.

What can we do with a digital twin?

Once we have all of that health information in digital form, we are able to do simulations. Now that I understand a person’s health trajectory based on the information collected, the idea is, can I predict what might happen to you in a year, or three years or five years? Once I see changes in your trajectory, the digital twin can be interrogated to say, how can I correct that?

Simulations are cheap. I can do billions of simulations to try to manipulate the factors affecting somebody’s health—say, for example, with a different diet. Would that have any effect on your trajectory? We could do the same thing with exercise, sleep, and other mental health factors.

The digital twin becomes a tool for us to create these agentic agents. Now I have multiple agents, each one of them optimizing different lifestyle factors, from diet to exercise to sleep and stress. I can give you specific information in the morning or on a weekly basis to try to optimize them.

Now suddenly, you have in your pocket multiple doctors or multiple people giving you specific recommendations.

Could a digital twin be used to help prevent disease?

I’m looking to intervene before you get to the level of having, say, a heart attack. I’m an engineer by training, so I have a bunch of data points, and they give me a curve that is the trajectory of somebody’s health. Let’s say you are stable, stable, stable, then suddenly start seeing a small dip in some measurements. That dip is presymptomatic, by the way—you’re not sick, or you don’t have any symptoms. But even if you don’t have a heart attack yet, your body is secreting things in the bloodstream related to cancer, heart disease, and even cognitive changes.

I can now see these dips. That’s when I want to intervene. I want to try to predict small changes and, ultimately, alter them.

You recently launched the digital twin study and equipped people with a swag bag of health devices. Can you talk us through what you’re measuring and why?

Let’s start with what we give them so they can do monitoring at home, or continuously. We chose the Oura Ring because we tested it, and people don’t mind wearing the ring continuously, compared to a watch. It gives us information on physical activity, sleep, heart rate variability, O2 saturation, estimated VO2 max, and body temperature.

We also give people a blood pressure cuff so they can measure their blood pressure at home. We ask them to measure it twice a day, in the morning and afternoon, and do it two days a week. We have access to the data through a connection to our own digital health app.

We give them a weight scale, too—I use it myself.

Another device we provide is a continuous glucose monitor. It gives us estimated glucose values, and we ask them to wear it for two weeks and repeat that quarterly.

For respiratory function, we send them home with a spirometer to measure lung function; it gives us three different measures of lung capacity, and they use it once a week.

To measure the air quality and environment in which people live, we have a silicon band that is chemically treated and analyzed here at Mount Sinai to give us an idea of exposure to pesticides and anything else in the environment. We do this for two weeks twice a year. After wearing it for two weeks, they send it to us, and we give them a report on the types of exposures they might have.

Then there is a device that measures particles in air. It looks like a [computer] mouse and is something you put on the table to capture certain particles in air.

We also do two types of blood analyses on a quarterly basis. One is a cartridge with a small lancet that we ask people to use on each shoulder. The samples are studied for proteomics, which gives us information on immune proteins. We also analyze metabolites and lipids.

Finally, we do blood markers, a whole series of them involving lipids, triglycerides, HbA1C, and hormones. These are done via a finger prick onto a dry blood card that people send into our labs.

The study participants also come in once a year for a health visit. We test muscle strength and grip strength, and take a sample for whole genome sequencing. We also take stool and saliva samples to measure their microbiome [the bacteria that normally live in and on the body].

Each of the study recipients also receive an annual MRI, which is different from the scans that doctors generally use for screening. This is a multi-organ scan where I collect information on brain volume, grey matter, body composition, heart, lungs, kidney, liver, and pancreas.

The digital twin study sounds like it would be popular with participants. How many people are you following so far?

We purposely kept it intimately small, and it’s in its early stages. We can’t scale up yet because of the cost it takes us to do all measurements. Ultimately, we may learn that not all of these measurements are as sensitive or useful, and we may therefore take them out. But first I want to put in everything, then little by little as I learn, take things out.

Right now, we have the money to do at least 20 people. By the end of this year and next year, we should be able to scale to more than 100 people. I would like to do 10,000 people, but that would cost billions of dollars.

How do you think studies like yours, combined with digital technology, will change health care in five or 10 years?

To be bold, I think that the way the hospital will change is that we are going to see the hospital at home. And physical locations like Mount Sinai will be the place people come to do interventions. I really think everything in the future is going to be reliant on things you can do remotely. Little by little, we are starting to see the explosion of sensors become specific to biomarkers that we are interested in—like for diabetes or heart health. Being able to measure them frequently will help you see early changes. It will be a new way to analyze biomarkers and understand them. We are prototyping some—I’m working on sweat markers for inflammation, for example. I think that’s the next generation.

We are also going to see the integration of physiological, molecular, and imaging sensors, like putting an ultrasound on a patch. Then you are suddenly measuring your heart with an ultrasound automatically. We’re not talking science fiction—there are [already scientific] publications in most of these areas.

Digital technology is going to change the whole delivery of health care. We are focused on healthspan more than lifespan. In the U.S. now, the average lifespan is 79 for males and 83 for females. People start degrading in health after age 60 or 65. What we want to do is to be able to push that as much as possible. If I am able to take people at 60 and not extend their life, but make them live their years in better shape, I will be very happy.

This article is part of TIME Longevity, an editorial platform dedicated to exploring how and why people are living longer and what this means for individuals, institutions, and the future of society. For other articles on this topic, click here.

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