Young adults are experiencing unprecedented levels of fatigue, often linked to lifestyle choices that prioritize ambition and constant activity over rest. This article explores the habits of individuals in their 20s and early 30s, examining how behaviors such as late-night workouts, excessive screen time, and poor dietary choices may be contributing to premature aging and chronic tiredness. It also investigates the potential for targeted lifestyle adjustments to improve health and well-being.

Tommy's Pursuit of Excellence and the Toll of Fatigue

Tommy, a 25-year-old undergraduate studying financial technology, exemplifies the drive for achievement common among his peers. He is actively pursuing multiple internships to enhance his employability, noting that "studies say that if you're coming out with only one internship when you graduate, you're already losing out to like 50% of the population." His current internship involves improving AI for regulatory compliance, a demanding role that requires constant learning.

This demanding schedule, coupled with an hour-long commute, leaves Tommy "dead" by the time he reaches home. To cope, he engages in evening runs and consumes oily, deep-fried foods, which he finds "reassuring." After returning home around 11:00 p.m., he dedicates time to working on his resume and coding skills to remain competitive.

Tommy's fatigue is exacerbated by his late-night "doomscrolling" habit, often extending to 3:00 a.m. He explains that "starting work has actually like made doom scrolling like become worse." This behavior, characterized by continuous engagement with digital content, activates the brain's dopamine reward system, similar to gambling. This cycle leads to poor sleep and compromised cardiometabolic health. Tommy observes a decline in his social energy, noting, "I used to be what they call like a party animal in the weekends... I just realized I'm getting so tired and don't have like the energy to go out once before."

Professor Dean Ho's Approach to Health Re-engineering

Seeking answers, Tommy consults with Professor Dean Ho, a biomed engineer specializing in digital medicine. Professor Ho, who has personal experience with fatigue and a self-described "re-engineering" of his own regimen, aims to help participants make "micro adjustments."

For Tommy, initial recommendations include adjusting his afternoon coffee break 30 minutes earlier and reducing sugar intake. The professor also suggests moving his phone outside the bedroom, a proposal Tommy finds challenging due to the phone's centrality in his life: "a phone is our everything. How am I going to survive in this kind of new environment?"

Nicole's Ambitious Lifestyle and Sleep Debt

Nicole, who recently turned 30, balances a full-time job, a part-time master's degree, frequent gym visits, and wedding preparations. She admits to a history of "sleep debt" since her teenage years at the Singapore Sports School, where she juggled cross-country training with academics. This has led to habits like repeatedly snoozing her alarm, which once caused her to miss a crucial client meeting.

Nicole's current sleep deprivation, averaging "about like 3 hours a day" during her wedding preparations, leaves her "functioning on adrenaline." She acknowledges the unhealthy nature of her habits, stating, "I don't think I can go on for any longer... it does affect other things like my fitness and also other aspects of my mental health, my ability to like remember important details."

Professor Ho's initial advice for Nicole focuses on shifting her sleep time 10-20 minutes earlier each week. He also notes that her late-night workouts, often finishing around 9:00 p.m., may impact her sleep quality.

Nazel's "Work Hard, Play Hard" Mentality and Health Concerns

Nazel, 32, adheres to a "work hard, play hard" philosophy, attempting to offset an unhealthy diet with regular exercise. His evenings are filled with day trading on the US stock market, active socializing, and occasionally waking up at 3:00 or 4:00 a.m. to watch his favorite football team, Manchester United.

The chronic lack of sleep has led to migraines and irritability, particularly after lunch. Nazel admits to consuming oily, home-cooked Malay food, despite knowing its unhealthiness. He also smokes "a pack a day," using it as a stress reliever and a social activity with his father.

Professor Ho proposes that Nazel reduce his smoking to three-quarters of a pack per day, a suggestion Nazel finds difficult, leading to increased anxiety. The professor also commits to making a similar personal adjustment by abstaining from French fries.

Medical Assessments and Early Findings

For six weeks, participants wear smartwatches and continuous glucose monitors. Professor Ho's team analyzes this data to illustrate how daily choices impact health. Initial medical tests reveal concerning results for some. Tommy's health screening indicates potential high blood pressure, prompting the nurse to ask if he felt "giddy." Professor Ho notes that high blood pressure in a 20-year-old is uncommon and potentially reversible by treating the underlying cause.

Tommy's dietary changes include switching from muffins and fried chicken to grilled chicken with less sauce and more vegetables. He finds the grilled chicken "sustainable" and uses his phone to track his glucose levels, a previously unavailable tool.

The Impact of Late-Night Glucose Spikes and Dietary Choices

Professor Ho observes that Tommy's glucose data shows spikes occurring late at night, which can disrupt sleep. Tommy's late dinners, sometimes followed by large desserts during social gatherings, contribute to this. While Nicole finds it difficult to forgo these late-night activities, she considers ending friend gatherings earlier.

Nazel also begins sleeping earlier, around 11:30 p.m., and has reduced his intake of fried food and cigarettes. However, Professor Ho expresses concern about elevated inflammation markers, potentially linked to Nazel's past habits. Blood tests reveal that Nazel's numbers "more closely reflect those who might be in their 50s or maybe even 60s."

Addressing Inflammation and Cardiovascular Risk

The high inflammation markers in Nazel's blood tests raise concerns about his risk of heart disease. Professor Ho explains that chemicals in cigarettes promote inflammation and damage blood vessels, akin to "rusting your pipes." Nazel acknowledges that exercise alone was not sufficient to maintain cardiovascular health and is motivated to improve his numbers.

Reducing smoking is identified as a key area for Nazel. While initially resistant to reducing his intake from a pack a day, he eventually agrees to aim for a reduction. Professor Ho also commits to quitting smoking alongside Nazel.

The Effect of Evening Exercise on Sleep

The participants' habit of exercising at night is noted to affect sleep quality. Professor Ho explains that late workouts can lead to a higher resting heart rate, making it harder to wind down. To address this, Tommy swaps his weeknight runs and late suppers for walks after an earlier dinner, allowing him to "end my days much earlier" and sleep sooner. He reports feeling more energized in the morning, though work stress still impacts him. Professor Ho recommends deep breathing exercises for Tommy to manage work-related stress.

Nicole is challenged to move some workouts to the morning, but struggles with waking up. She notes that morning workouts, when achieved, make her feel "more accomplished to start the day." However, the time required for showering and preparing for work after a morning workout presents a logistical challenge.

Nazel has incorporated morning workouts twice a week, reporting increased happiness and energy. He has also reduced his cigarette intake, finding that improved sleep offsets the mood impact.

Overcoming Sleep Challenges and the Role of Light Cues

Nicole continues to struggle with waking up, often snoozing her alarm. Professor Ho suggests using a smart bulb that gradually increases light in the morning to signal wakefulness. Nicole finds this helpful, reporting feeling "less tired" and "less groggy."

Nazel's earlier bedtime has enabled him to exercise before work and wake up more easily. He reports feeling happier and having more energy. His father has also been inspired to reduce his smoking, creating a "family effort."

The Ripple Effect of Healthier Habits

Professor Ho emphasizes the importance of community and social influence in lifestyle changes. He notes that healthier habits can inspire others, creating a "ripple effect."

At a group gathering, participants share their experiences. Tommy, unable to attend in person, participates virtually. The group shares a meal while monitoring their glucose levels, observing individual responses. Nicole reflects on how her family's late-night activities may have influenced her own habits. She realizes her self-worth has been tied to her busyness, a notion she now questions.

Sustaining Progress and Addressing Persistent Habits

While participants see improvements, some habits remain challenging. Nicole acknowledges that "there's just a lot of those habits that are just very sticky and tough to change." Professor Ho advises against being overly critical and suggests focusing on gradual progress.

Nazel, despite feeling generally healthy, acknowledges the long-term effects of chronic sleep deprivation. He commits to prioritizing rest, even if it's just one night a week. Nicole finds the process of change takes time and willingness to make sacrifices.

Tommy has significantly reduced his screen time and is preparing his own meals, viewing this as a future routine. He continues to monitor his blood pressure, a persistent concern. He has also developed an interactive chatbot to track his health data.

Significant Health Improvements and Future Outlook

Nazel's follow-up blood tests reveal significant improvements. His inflammation markers have dropped by 80%, and his homocysteine levels, another indicator of cardiac risk, have decreased by 30%. Professor Ho attributes these gains to Nazel's lifestyle adaptations, stating, "When you take care of your biology, your biology takes care of you." Nazel expresses relief and happiness, noting that even seemingly impossible changes, like reducing smoking, became achievable with support.

Professor Ho highlights that these improvements signify "unlocking the youth, the resilience that you have." He emphasizes that the participants' journeys offer hope and demonstrate that real health gains are possible through consistent effort.

The program concludes with participants reflecting on the importance of community, friendship, and mutual support in their health journeys. They acknowledge the challenges but are inspired by the positive impact they have had on each other and the potential to influence others. The participants celebrate their progress, recognizing that while the journey continues, their efforts have yielded meaningful results.