As evening approaches and most people wrap up their workdays, Dr. Ronald Primas is often just getting started. A concierge physician in New York City, he makes house calls for patients whose ‘work, travel, or medical situation makes a conventional appointment impossible.’ That means he’s available essentially around the clock. ‘I often go to bed around 1 a.m., or later when a patient needs me,’ he says. Despite that late bedtime, the 66-year-old internist has built a career around longevity, helping patients make everyday choices that support healthier aging.
Primas has practiced medicine for more than three decades. Trained as an internist, he now describes himself as a longevity physician. He tests patients to evaluate genetic health risks and designs personalized health plans based on the results. He still handles urgent care, but his focus since the 1990s has been preventive care, helping people build healthier daily routines to ward off chronic disease or age related decline.
“At that time, no one was using terms such as healthspan, biological age or longevity medicine,” Primas says. “We did not have wearables, genomics or [artificial intelligence]. Yet the principle was already clear: The trajectory toward chronic disease often begins years before the first symptom, and preserving function matters as much as treating illness.”
Today, he notes, “the science, tools and public interest have caught up” to that idea. Physical and mental health are often linked with success, and generally healthy people report feeling more productive at work. The industry has become crowded with buzzy biotech startups, billionaire funded ventures, expensive longevity memberships at clinics and gyms, and plenty of biohacking influencers on platforms like YouTube and TikTok.
Primas says he believes in the power of small habits. “Little tweaks that you do every single day add up,” he says. And he tries to practice what he preaches. “I can tell my patients until I’m blue in the face about what to do. Unless I lead by example, they’re really not going to pay attention to it. I try [to] tick all the longevity boxes that I can.”
A seven-day workout routine
Primas exercises seven days a week. His schedule includes strength training three times a week, high intensity interval training, a Norwegian four-by-four twice a week, and 45 minutes of zone two training twice a week. On weekends, he devotes time to stretching and balance work.
“I protect exercise time as I would an important clinical appointment,” he says. He typically trains in the evening after work. He also aims for a 20 minute walk after each meal, a simple way to break up sedentary time and potentially blunt the post meal rise in blood sugar. During the workday, he gets up and moves at least once an hour, often doing 10 to 20 bodyweight squats.
If a busy week prevents him from finishing a regular workout, he still does something shorter: a walk, mobility exercises or a few sets of resistance training. “Something is almost always better than nothing,” he says.
Sleeping eight hours, even with a 1 a.m. bedtime
Primas maintains a consistent bedtime, even if it’s late. “I don’t go to bed until like 1 a.m., maybe later than that, but I wake up around 9 a.m., so I’m in bed for eight hours and sleeping for about seven-plus hours a night,” he explains. He ensures quality sleep by keeping his bedroom completely dark, cold at 67 degrees or below, and comfortable.
A paleo-style diet with a time restricted eating window
Primas says he tries to follow the way our ancestors lived before agriculture. “I guess you can call it a paleo diet. I eat only whole foods. No grains, no dairy, no added sugar.” He gets fiber and calcium from root vegetables like parsnips, celery root, turnips and sweet potatoes. His protein choices include tuna, salmon and grass fed meat, always complemented with vegetables and nuts. He also eats fruits like blueberries, raspberries and blackberries.
At home, meals are simple and revolve around a reliable rotation of protein, vegetables, healthy fats and practical staples. “Eating well does not require elaborate cooking every night, or expensive fish or meat,” he says. He emphasizes minimally processed foods, including fresh or frozen vegetables, beans and lentils if tolerated, eggs, plain yogurt, canned salmon or sardines, frozen berries, nuts and olive oil. “The goal is not a perfect diet. It is a durable one.”
He also follows a time restricted eating schedule, having two meals and a snack within a window of six to eight hours daily, and stops eating at least four hours before bedtime. “You get your highest-quality sleep when you don’t eat too close to bedtime,” he says. He tracks his metrics on the Oura Ring and Biostrap wearables.
Brain health, stress management and social fitness
Primas says he doesn’t smoke. The plant based fats in his diet, such as avocados, walnuts, fish oil tablets and algae oil tablets, help support cell membranes throughout the body, including the brain. Fatty fish provides DHA, an omega-3 fat especially concentrated in the brain and retina.
He says exercise, especially high intensity interval training, is particularly helpful for the brain. It increases BDNF, a hormone that can stimulate the growth of neurons and increase neuroplasticity. “Anything is better than nothing,” he adds.
Quality sleep is another cornerstone. “Your brain does self-cleaning while you’re sleeping,” he says, explaining that chronic sleep deprivation can harm cognition, mood, metabolism and long term health. Sleep allows the brain to consolidate memory, recalibrate stress and immune signaling, and support restorative processes.
For stress reduction, Primas practices Qigong, a meditative movement, whenever he gets a chance. He also uses a device called HeartMath, which clips onto his ear and syncs his breathing with the technology.
He also stays socially active. “My wife and I have a lot of friends, and we hang out, do fun things together and take a lot of vacations. I try to protect time for my wife, family, friends and our dogs.” He says the goal is not to build a perfect, hyper-optimized life but to create a repeatable routine.
Lessons from a lifetime of social connection
Primas says the main lesson he has learned over the years is not to sweat the small stuff. “When I was younger, I used to pay attention to what people thought of me, and being judged, and all that stuff,” he recalls. “At this point, now that I’m older, I don’t care. But I wish I’d learned that when I was younger, and I try and pass that on my kids.”
What he reads for longevity insights
Although his work is preventive, Primas remains a board certified internist, so most of his reading involves journal articles. He recently bought Michael Fossel’s book, “Aging: How Aging Works, How We Reverse Aging, and Prospects for Curing Aging Diseases,” and Eric Topol’s book, “Super Agers: An Evidence-Based Approach to Longevity.” He hasn’t gotten to those yet. “I’m a nerd,” he says. “Mostly, what I do is just stay up-to-date on medical literature.”
This interview has been edited and condensed for clarity. Always consult with your primary care doctor before implementing any major changes that can affect your health.
Primas’s routine may be unconventional, especially with its late bedtime, but it reflects his belief that sustainable habits matter more than rigid perfection. As he puts it, “Little tweaks that you do every single day add up.” For him, the path to healthier aging is built on daily choices that are simple enough to stick with.
