Prof Luigi Fontana (University of Sydney)

Title: Promoting healthy longevity through lifestyle medicine: biological and behavioural mechanisms

Abstract:

Chronic diseases are often perceived as an unavoidable consequence of genetics or chance. Yet converging evidence shows that a large proportion of cardiometabolic disease, type 2 diabetes, and many cancers is preventable, and that the years lived with disability can be dramatically reduced through mechanism-focused lifestyle interventions. Modern healthcare has excelled at prolonging survival after disease onset, but too often this extends years characterized by multimorbidity, polypharmacy, reduced independence, and escalating costs.¹

This lecture synthesizes human and translational evidence showing how lifestyle medicine can extend healthspan by targeting fundamental biological pathways that drive aging and chronic disease risk.^2-4 Key interventions include optimizing diet quality and energy balance (e.g., a Mediterranean-like, minimally processed, fiber-rich dietary pattern), regular endurance and resistance exercise, and avoidance of smoking and harmful alcohol use.^{1, 5}

Importantly, the effectiveness of these interventions in both clinical trials and real-world settings depends on adherence and long-term compliance, which are influenced by psychological and behavioral factors that remain incompletely understood. I will briefly discuss how improving health literacy—particularly through education—may help shape health behaviors and strengthen prevention. Finally, I will outline how integrating lifestyle medicine into proactive, personalized care can reduce disparities and support sustainable healthcare systems while aligning human and planetary health goals.^{6, 7}

Key references:

1.         Cagigas ML, Twigg SM and Fontana L. Ten tips for promoting cardiometabolic health and slowing cardiovascular aging. Eur Heart J 2024; 45: 1094-1097. DOI: 10.1093/eurheartj/ehad853.

2.         Green CL, Lamming DW and Fontana L. Molecular mechanisms of dietary restriction promoting health and longevity. Nature reviews Molecular cell biology 2022; 23: 56-73. 2021/09/15. DOI: 10.1038/s41580-021-00411-4.

3.         Cagigas ML, De Ciutiis I, Masedunskas A, et al. Dietary and pharmacological energy restriction and exercise for healthspan extension. Trends Endocrinol Metab 2025; 36: 521-545. 20250502. DOI: 10.1016/j.tem.2025.04.001.

4.         Fontana L, Partridge L and Longo VD. Extending healthy life span—from yeast to humans. science 2010; 328: 321-326.

5.         Tosti V, Bertozzi B and Fontana L. Health benefits of the mediterranean diet: metabolic and molecular mechanisms. The Journals of Gerontology: Series A 2017; 73: 318-326.

6.         Cheng K and Fontana L. Investing in value-based primary care: a pathway to sustainable healthcare. Eur Heart J 2024 20240710. DOI: 10.1093/eurheartj/ehae404.

7.         Fontana L, Fasano A, Chong YS, et al. Transdisciplinary research and clinical priorities for better health. PLoS medicine 2021; 18: e1003699. 20210727. DOI: 10.1371/journal.pmed.1003699.

Bio:

Luigi Fontana is an internationally recognized physician scientist and one of the world’s leaders in the field of nutrition, metabolism and healthy longevity in humans. His pioneering studies on the effects of dietary restriction in humans have opened a new area of nutrition-related research that holds tremendous promise for the prevention of age-related chronic diseases and for the understanding of the biology of human aging. 

Professor Fontana is the Leonard P. Ullmann Chair of Translational Metabolic Health at the Charles Perkins Centre, where he directs the Charles Perkins Centre Royal Prince Alfred Clinic and the Health for Life Research, Clinical & Educational Program. He is also a Professor of Medicine and Nutrition in the Faculty of Medicine and Health at the University of Sydney and a Clinical Academic in the Department of Endocrinology at the Royal Prince Alfred Hospital.

Professor Fontana was a Senior Scientist at the Italian NIH (ISS) and a Professor of Medicine and Nutritional Sciences at Washington University in St.Louis (USA), and co-director of the Longevity Research Program at Washington University.  Fontana graduated with highest honors from the Verona University Medical School (1994), where he completed his internship and residency in Internal Medicine (1999). He also received a Ph.D. in Metabolism and Clinical Pharmacology from the University of Padua Medical School (2003).

Professor Fontana has published over 180 manuscripts in prestigious journals including Science, Cell, New England Journal of Medicine, JAMA, BMJ, CA Clinical Journal cancer, Nature Reviews Mol Cell Biol, Cell Metabolism, Lancet Diabetes Endocrinol, Circulation, Journal American College of Cardiology, and PNAS ; 96.4% of his papers are in the top 10% most-cited journals (Google scholar total citations >39,000; h-index 90).  He has been invited to present his work at international conferences and top medical schools and research institutes around the world, including Harvard University, Cambridge University, Yale University, Universitè Paris “Pierre et Marie Curie”, Max Plank Institute of Aging, Baylor College of Medicine, Buck Institute for Research on Aging, Spanish National Cancer Research Centre, National University of Singapore among others.

Dr. Fontana’s is the recipient of several prestigious awards, including the 2009 American Federation Aging Research (AFAR) Breakthroughs in Gerontology Award and the 2011 Glenn Award for Research in Biological Mechanisms of Aging, the 2016 Vincent Cristofalo Award of the American Federation Aging Research, 2021 Vice-Chancellor’s Awards for Excellence of the University of Sydney, 2022 Honorary Member of the Italian Association of Hospital Gastroenterologists, 2022 Ordinary Non-resident Member of the Italian Academy of Medical and Surgical Sciences of the National Society of Sciences in Naples, and 2023 Ordinary Non-resident Member of of the Italian Pontanian Academy of Naples (founded in 1458). He was a Scientific Member of the Board of Directors of the American Aging Association (2014-2019), and since 2016, he is the Editor-in-Chief of ‘Nutrition and Healthy Aging’ and Associated Editor of ‘Geroscience’.

Professor Fontana believes that the time has come for a change in the conversation about chronic disease to a refreshed and repurposed model of health care, which emphasizes the power of mechanism based prevention and education to change potential to actual outcomes. Fontana is also an environmentalist. He wrote several highly-cited perspective articles and book chapters with Daniel Kammen, Walter Willett and Nicoletta Batini on the beneficial role of efficient use of energy and food in promoting human, environmental, and planetary health, and sustainable economic development. Fontana and colleagues believe that it is possible to substantially enhance human and environmental health, societal wealth and well-being, but this requires a profound transformation in the way we live, and a new prevention- and environment-centred healthcare, agricultural, industrial and economic system. They argues that most of the knowledge and technology to transform the world and begin a new industrial revolution already exist today. We only need to relinquish the idea of producing more energy, food, and other products at lower cost in favor of a new paradigm that opts for less but high-quality energy, food and materials for a healthier life and environment. They also claims that “both individual and societal wealth, happiness, and well-being do not depend merely on the acquisition of material goods and on economic growth, but are powered by our physical and psychological health, the quality of life and the richness of our social relationships, and foremost by the health of the environment that supports all life on earth, our Natural Capital that must be preserved”.

Major Media attention

• Quoted in The New York Times, “Food for Holiday Thought: Eat Less, Live to 140?” by David Hochman, by David Hochman, Nov 23, 2003
• Profiled on a NHK special documentary “Challenge the aging: You can live longer”, 2004
• Quoted in The Washington Post, “Seeking the Low-Calorie Fountain of Youth: Severely Restricted Diets May Slow Aging Process” by Rob Stein, May 4 2004.
• Quoted in Science “Lean, Hungry, and Healthy” by Constance Holden, Apr 23 2004(Science 2004;304:514)
• Quoted in New Scientist “Eat less and keep disease at bay” by Anil Ananthaswamy, Apr 24, 2004 (New Scientist 2004;182:2444)
• Featured in the Korean documentary “Secrets of Living, Aging, Illness and Death ” by Mia Lee (Korean Broadcasting Systems), 2005
• Quoted in The Times of London, “Eat less — and live to 130” by David Mattin, Oct 3, 2005
• Profiled in an Italian TV documentary on nutrition and longevity “Calorie restriction and aging” by Piero Angela (“SuperQuark” series), 2005
• Quoted in The Wall Street Journal, “Reducing Your Daily Calories by 40%: The Science Behind ‘Starvation’ Diets”, by Tara Parker-Pope, Jan 31 2006.
• Quoted in The Washington Post, “High Protein Diets May Boost Cancer Risk” by Steven Reinberg, Dec 7, 2006
• Featured in the BBC4 documentary “Live longer: Caloric restrictions and ageing of the heart”, 2007
• Quoted in Newsweek, “Never say die”, by Anne Underwood, Dec 12 2008.
• Quoted in The New York Times Magazine “The Calorie-Restriction Experiment” by JON GERTNER, Oct 7 2009.
• Quoted in the Los Angeles Time, “Permanent diet may equal longer life” by Karen Kaplan, July 9, 2009
• Quoted in the Time Magazine, “Health Checkup: How to Live 100 Years – Eat Less, Live Longer?”, by Bryan Walsh, Feb 11 2010.
• Quoted in New Scientist “Eat less, live longer?” by Laura Cassiday, Jun 3, 2010
• Time Magazine – “9 Healthy Snacks That Prevent Overeating”, by Markham Heid, Aug 11, 2016.
• Featured in the BBC2 Horizon documentary Eat, Fast & Live Longer by Michael J. Mosley, 2012
• Featured in the ABC ‘Catalyst’ documentary “Staying Younger For Longer” by Jayne Parker, 2019
• Featured in the ABC ‘Catalyst’ documentary “The Truth about Fasting”, 2021