What’s your health iceberg?

Using one of the most infamous shipwrecks to explain aging, he says that the Titanic didn’t sink because it was flawed, but because the crew saw only the tip of the iceberg, and the danger was too late. 

→ Healthy aging may work much the same. Many of us have hidden risks in our genome, blood, or environment that we don’t know exist until something goes wrong.

This general idea often resurfaced at the Summit, yet it’s becoming possible to identify your icebergs earlier. And when you know your unique risks sooner, you can advocate for your own health and make more decisions about your longevity.

One of the most surprising discoveries of 2026 is that genetics plays a larger role in longevity than estimates suggest…. Some estimates suggest around 50%. That number might sting, but many experts reiterate that your genes are not your destiny.

The way to control your iceberg seems to be pairing genetic insights—or practical insights from other biological and blood tests, and technologies—with everyday choices. And, when needed, therapeutics.

Let’s use cognitive health as an example, since Alzheimer’s is one of the most common and feared age-related diseases, with around two-thirds of all cases occurring in women.

How do you know if Alzheimer’s is part of your iceberg? One of the strongest known genetic risk factors is the APOE4. 

Still, APOE4 does not mean you’re destined to get Alzheimer’s disease. Instead, it can help you focus on areas of health worth paying more attention to.

Life stage also matters (*especially for women): At the Summit, experts suggested that the dramatic uptick in female Alzheimer’s risk at midlife might be hormonal.

During perimenopause and menopause, estrogen suddenly drops and:

That’s why Dr. Brizendine says a critical window for starting estrogen would be around ages 40 to 55— especially for women with a known Alzheimer’s risk. Several experts add that estrogen may support other age-related risks, such as heart disease, osteoporosis, and metabolic conditions.

And what if you’ve had breast cancer? Systemic hormone therapy is generally not recommended; however, for women with certain genetic risks (BRCA1 or BRCA2), the picture may be more nuanced, so the decision to start hormone therapy should be made with a doctor based on personal risks/benefits.

In many cases, long-term lifestyle habits can help reduce dementia risk.

Strength training: Studies show that strength training may slow brain wasting in the hippocampus, the part of your brain responsible for forming long-term memories, and increase brain volume. Because it’s linked to better mood and sleep, this might further contribute to long-term cognitive function.

Social health: Don’t discount social circle as a brain-boosting tool. As people age, they tend to fall into patterns of isolation that increase dementia risk, said Dr. Hamdani. Prioritizing meaningful connections lights up the brain areas that build “collateral circuits.” 

Nutrition: Focus on an anti-inflammatory, high-fiber diet with emphasis on polyphenol and antioxidant-rich foods. Think green leafy veggies, whole grains, berries, and nuts and legumes (specifically, walnuts).

Brain training/mental stimulation: Playing Sudoku is fine, jokes Dr. Hamdani, but new long-term research suggests that brain training for processing speed is linked to lower dementia risk. 

Sleep: Aim for at least 7 hours per night. Wearables are not fully accurate, but they may help identify long-term sleep patterns and reflect how different lifestyle and behavior choices impact sleep quality.

The response pattern may similarly be test → understand → act, with a few key differences depending on the risk.

Cancer: Testing for inheritable cancer risk may include BRCA mutations for breast or ovarian cancer, or MLH1/MSH2 for colon cancer. Knowing this can help you advocate for earlier screening.

Heart disease: Bloodwork can identify elevated Lipoprotein(a), a genetic risk for cardiovascular disease. LDL cholesterol and ApoB (a cholesterol-carrying protein) should also be tested, as ApoB might be a better indicator of risk than cholesterol.

Bone health: A DEXA scan is standard of care for many women at 65 and older, and men at 70, and younger adults with a single risk factor for osteoporosis (low bone density) may qualify for insurance, said Vonda Wright.

Despite what Instagram says, no single drug or treatment can fully prevent cancer or dementia, nor heart disease or osteoporosis, said Dr. Eric Verdin of the Buck Institute for Research on Aging, at the event.

The foundation for health is lifestyle, and some tools may help guide your choices:

Every healthy body has an iceberg or two, but none of them are guaranteed to sink your ship. What makes the difference is curiosity about your risks, your patterns, and your choices. Healthy aging isn’t about avoiding the icebergs, but seeing them early and steering away from them.

Get excited for a guided breathwork session to sooth your vagus nerve and stimulate your parasympathetic nervous system. Join the Livelong Women’s Inner Circle for even more events, Women’s Summit replays, and more

Ask LIV: We’ve added an AI-powered tool that answers your health and longevity questions.

On the Livelong Podcast^TM: Why your workouts stopped working. A conversation with exercise physiologist Dr. Stacy Sims.

Be on the lookout for future ways to get involved in our events.

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