Listen to this episode of Longevity by Design on Apple Podcasts, Spotify, and YouTube.
In this episode of Longevity by Design, host Dr. Gil Blander sits down with Dr. Terrie Moffitt, University Professor at Duke University. They explore the deep link between mental health, self-control, and the pace of biological aging, showing how early-life mental disorders can shape health decades later.
Terrie describes her work with the decades-long Dunedin study, which tracks health from birth through midlife. She explains how people age at different rates, even when born in the same year and place, and how the “pace of aging” can be measured using biomarkers. Terrie shares that fast agers show early signs of physical and cognitive decline, while those with strong self-control tend to experience better health, stronger relationships, and greater financial stability as they grow older.
The discussion reveals that treating mental health issues early in life could prevent chronic diseases and slow aging itself. Terrie makes a strong case for taking mental health seriously, both as prevention and as a path to a longer, healthier life.
💡 Name: Dr. Terrie Moffitt
💡 What they do: University Professor
💡 Company: Duke University
💡 Noteworthy: Known for her research linking early-life mental health to aging, and for leading the Dunedin Study on human development, self-control, and healthspan.
💡 Guest Company Website: https://psychiatry.duke.edu/profile/terrie-e-moffitt
Episode highlights:
[00:00:00]: Introduction
[00:00:36]: Overview of the Dunedin Study and Its Origins
[00:02:13]: Joining the Dunedin Study: Early Career and Risk-Taking
[00:04:35]: Transitioning the Dunedin Study to Aging Research
[00:07:52]: Dunedin Cohort Structure and Unique Features
[00:10:30]: Biological Samples and Longitudinal Data Collection
[00:10:52]: Concept of Pace of Aging vs. Chronological Age
[00:13:30]: Measuring and Modeling Pace of Aging
[00:14:45]: Validating Pace of Aging: Physical and Cognitive Effects
[00:16:27]: Environmental and Generational Controls in the Cohort
[00:18:25]: Early Onset of Aging Processes
[00:19:49]: Applying Pace of Aging to Other Populations
[00:20:59]: Making Pace of Aging Exportable: Epigenetics and Broader Use
[00:22:19]: Why the Longevity Industry Needs Pace of Aging Measures
[00:24:06]: Economic and Societal Impact of Extending Lifespan
[00:27:32]: Challenges in Changing Population Trends and Longevity Solutions
[00:28:07]: Testing Anti-Aging Interventions: Need for Surrogate Biomarkers
[00:31:28]: Surrogate Biomarkers and Clinical Trial Design for Aging
[00:32:04]: Self-Control as a Predictor of Health and Longevity
[00:35:11]: Self-Control in Childhood and Its Lifelong Impact
[00:36:39]: Mental Disorders and Their Link to Physical Health
[00:39:06]: Explaining the Mental Health–Aging Connection
[00:42:33]: Prevention Strategies for Healthspan and Mental Health
[00:48:59]: Population-Level Changes to Support Longevity
[00:56:01]: Rapid-Fire Questions: Behaviors and Habits for Longevity
[01:01:29]: Key Takeaway: Mental Health and Lifelong Impact
[01:02:44]: Closing Remarks and Episode Wrap-Up
Key Insights
Early Mental Health Shapes How We Age
Mental health issues that show up early in life can have a long reach, impacting physical health and the pace of aging decades later. People who struggle with mental disorders in childhood or young adulthood are much more likely to develop chronic health problems as they age. This link holds true even when controlling for access to healthcare, lifestyle, and environment. Preventing or treating mental health problems early could delay or even prevent diseases like dementia, diabetes, and heart disease. Addressing mental health in young people isn’t just about improving mood or behavior, it’s a way to support healthy aging for life. This insight points to a new angle for prevention: invest in mental health now to help people stay healthier, longer.
The Pace of Aging Isn’t Set in Stone
Aging isn’t just about counting birthdays. People age at very different rates—even among groups born the same year and raised in the same place. Biological aging, measured through changes in multiple body systems, can be much faster or slower than the calendar says. Some people stay biologically young for years, while others show early signs of physical and cognitive decline. These differences are measurable using biomarkers, and they matter: a faster pace of aging predicts poorer balance, memory loss, and even visible signs of aging. The good news is that lifestyle choices, like quitting smoking or improving sleep, can slow aging’s pace. Understanding and tracking your biological age opens doors to staying healthier and more resilient at any stage of life.
Self-Control Is a Lifelong Advantage
Self-control isn’t just about resisting temptation. It’s a skill that shapes long-term health, relationships, and financial security. People with strong self-control early in life are more likely to have good health, stable finances, and supportive social networks as they age. In today’s world, where food, stress, and distractions are everywhere, self-control is more important than ever. It helps people avoid risky behaviors, stick with healthy habits, and adapt to new challenges. Building self-control works like strengthening a muscle: it can be trained, supported, and reinforced by personal habits and smart policy choices. Even small changes, like better sleep routines or nudges that make good choices easier, can help everyone build more self-control for a longer, better life.
The Dunedin Study: A Unique Window Into Aging
The Dunedin Study follows over 1,000 people born in one city in New Zealand in a single year, tracking them from birth into their fifties. This rare, long-term approach allows researchers to see how early-life factors shape health decades later. The study’s strength lies in its high participation rate and the depth of data collected, including regular blood samples and health assessments. This design means findings reflect real changes across a whole population, not just a select few, and enables powerful insights about health, behavior, and aging.
“The cool thing about this cohort of children is that, among those still living, about 95% are still taking part after all these years. And that’s important because it means that the people who are in bad health, who have bad mental health, or who are aging fast have not dropped out along the way. So it is still fully representative of its original population, which is really important for this kind of research.”
Validating the Pace of Aging With Real-World Markers
The pace of aging is more than a theory, it’s validated by tracking real changes in study participants. Those who aged quickly, based on biomarkers, showed clear signs like poorer balance, faster cognitive decline, and older facial appearance by midlife. These external and internal markers confirm that some people experience biological aging much faster than others, even when they live in the same environment and have the same chronological age. These findings highlight the need to measure aging dynamically and act early to slow decline.
“We found that the fastest-aging study members had poorer balance at age 45. So we asked them to stand on one leg as long as they could. And those who were aging fast would not be able to do that. The fast agers also had more decline in cognitive function… We saw that the people with a fast pace of aging on those biomarkers were also declining cognitively over time. Then we looked at their faces… The people who were aging the fastest on the pace of aging score were rated as having older-looking faces at age 45.”
Building a Test to Measure Biological Age for Everyone
Most studies can’t track 20 years of biomarkers, so the Dunedin team developed a way to measure biological aging from a single blood sample using epigenetics. This advance lets researchers and clinicians estimate someone’s pace of aging without decades of data, opening the door for broad, practical use. With this tool, the longevity field can now test whether new therapies or lifestyle changes actually slow aging, and do so in a short time frame. It’s a shift from waiting for disease or death to using a dynamic, actionable health measure.
“So we needed an exportable version of the pace of aging that other researchers could use. So we began to work on that… The epigenetics part was the key for quantifying the pace of aging in other cohorts of people, and really in everyday people… So you could get the answer inside a year if you had a pace of aging measure.”
Practical Ways to Build Self-Control and Support Healthy Choices
Self-control helps people avoid risky behaviors and choose healthier options, but it’s not only a personal trait, it can also be supported by smart policy and design. Simple changes like delayed school start times, automatic retirement savings, or making healthy food more convenient can make good decisions easier and support self-control across a whole population. Even habits like improving sleep can make a difference. This approach shifts part of the responsibility from individuals to communities, showing that widespread change is possible with thoughtful policy and structure.
“There are some simple things you can do. One of the things you can do is sleep, sleep better, sleep more... Another thing is that a country could adopt more wearable devices. So if you have wearable devices, it’s really easier to monitor your own self-control… You can also try these nudge tactics that behavioral economists talk about. So they say you want to make it harder work for people to make a bad decision, and you want to make it easy and less effortful for people to make a good decision, so they don’t need their self-control to make a good decision.”
For science-backed ways to live a healthier, longer life, download InsideTracker's Top 5 biomarkers for longevity eBook at insidetracker.com/podcast
