My Current Evidence-Based Anti-Aging Program

The Fountain of Youth by Lucas Cranach the Elder

My interest in anti-aging goes back as long as my interest in health and nutrition, but in the past year or so I’ve done a deep dive into the topic. I’ve just turned fifty, and I’d very much like to live at least another half-century. I have long lists of things I’d like to both accomplish and experience, and I’ll need time to do that. I became a father on the later side, so I’d like to be around for my daughter’s adulthood. And for the most part, on most days, I greatly enjoy being alive. Why end the party early?

In addition to those reasons, I had a series of health problems in my late forties that really shook me. I broke three bones in my foot, contracted a staph infection that required antibiotics, suffered from painful chronic gastritis, and battled terrible insomnia. A bout of prolonged stress was part of the issue; as I was experiencing some initial success in my new career as a fiction writer (selling my first stories, winning a contest, and selling my first novel to a mid-sized publisher), I was also feeling the new pressures and expectations that came along with those wins. Also during that period, my father-in-law got sick and died from cancer, my uncle succumbed to chronic pulmonary issues (after a lifetime of smoking), and other family members suffered from health issues of varying severity. My anxiety levels peaked and remained chronically high for months, which no doubt contributed to my health issues.

I researched and applied various nutritional, behavioral, and nutritional and herbal supplement remedies for my various ailments, as well as following conventional medical advice, all with mixed success. With a simple cast and good nutrition, my foot healed more-or-less perfectly (despite my careening around on my wheelie cart and falling multiple times). Antibiotics cleared up my staph infection within days, but the drugs did a number on my stomach (as did the stress). Prescribed proton-pump inhibitors reduced my stomach pain, but caused other digestive issues, and a couple years later my stomach is still recovering. My insomnia proved resistant to nearly every remedy I tried until I made some nutritional and cognitive adjustments.

During these health struggles, I wondered if there was a way to improve my general health, and to become more resilient and less fragile. I wanted to become antifragile — as Nassim Taleb puts it — a state where external stressors would make me stronger, not weaker (both physically and mentally).

If I could become biologically younger, slowing or even reversing some of my body’s natural and stress-induced aging, maybe this would make me less vulnerable to health issues, and perhaps fully or partially resolve my existing ones.

The experiment may be working. At fifty, after a year or so of experimental anti-aging protocols, most of my health indicators are in the green, I’m as physically strong as I’ve ever been, and on most days I feel energetic, motivated, and in a reasonably good mood.

Anti-Aging Goals

In order, my anti-aging goals are to:

1. Improve current health.
2. Increase health span (good physical, emotional, and cognitive health through middle age and into old age).
3. Increase longevity.
4. Decrease visible signs of aging (look younger).

I have no interest in adding twenty years to my lifespan if those additional years are spent in poor health, but I’m very interested in maintaining excellent health until my last months or weeks of existence. Feeling more youthful is great. Looking younger, if that happens, is just gravy.

How To Measure?

I track the following and consider them all to be important health measures (in no particular order):

1. Standard medical tests (blood lipid levels, blood pressure, hormone levels, disease markers, etc.)
2. Exercise capacity (endurance and strength).
3. Mobility and flexibility.
4. Sleep quality.
5. Emotional health (motivation, mood, anxiety/stress levels, capacity for joy and love and full spectrum of emotions).
6. Cognitive health (memory, capacity for focus, problem-solving, creativity, etc.)
7. Low levels of pain and inflammation (joint, gastric, nerve, etc.).
8. Body composition (high lean muscle mass, low fat %).
9. Skin health and tone (low inflammation, reduced wrinkles and age spots).
10. Acuity/sensitivity of eyesight, hearing, taste, smell, touch, etc.
11. Sexual health (sexual desire, strong erections, prostate health, etc.).
12. Generally looking younger, and feeling more energetic, more resilient, and happier.

My Current Anti-Aging Protocol

Lifestyle (in no particular order)

1. Dedicate 7-8 hours per night to sleep, at roughly the same time, and follow good sleep hygiene (reduced lights in the evening, no phone use in bed, etc.). Chronic sleep deficits are linked to metabolic issues, fat gain, and increased cancer risk, so this is non-negotiable. No burning the candle at both ends (with occasional exceptions for deadlines, fun times, and passion projects).
2. Walk 2+ miles per day, ideally 3+ miles. Walking an hour or more a day increases longevity. It’s easy to hit this target with a dog who goes a little nuts if she doesn’t get three walks a day. Also, after a long hiatus, I’ve been sucked back into Pokemon Go (gotta hatch those 10km eggs).
3. Do strength training and/or a high-intensity sport everyday. Athleticism is associated with a reduced risk of chronic disease and longer telomere length. Strength training in older adults is associated with huge drops in overall mortality risk. My strength training currently consists of body-weight exercises (pull-ups, chin-ups, push-ups, bar dips, crunches, etc.) and some dumbbell exercises (presses, rows, curls, squats, etc.). My current sport is racquetball (once or twice a week).
4. Eat a nutrient-dense, phytonutrient-dense, mostly whole-food, mostly plant-based diet. While other diets may be more effective for weight loss or addressing specific digestive concerns, the Mediterranean diet appears to increase telomere length and potentially increase longevity. For those who don’t mind a highly restrictive diet, the ketogenic diet has been shown to extend longevity in mice. I generally eat a low-carb version of the Mediterranean diet, with plenty of cheats for the sake of socializing, variety, and pleasurable indulgences.
5. Moderate exposure to stressors and toxins that have both potential health benefits and risks, such as alcohol and UV radiation (both of which reduce heart disease risk but increase cancer risk). Caffeine and intense prolonged exercise fall into this category as well.
6. Minimize exposure to toxins and pollutants that increase health risks (smoke, smog, lead, endocrine-disrupting chemicals, etc.).
7. Spend enjoyable time everyday with family and friends, and invest time and resources into maintaining relationships. Having a strong social network is so important to longevity that it’s probably worth cutting corners in other areas (maybe not getting enough sleep, inhaling some secondhand smoke, or drinking a bit too much) in order to maintain and enjoy your friendships.
8. Regularly consider and examine my life purpose and principles. Having a sense of life purpose is inversely correlated with mortality. It makes sense too; if you know why you want to stick around, your body will likely rise to the task.
9. Meditate regularly, and do what is takes to limit anxiety and chronic stress. Meditative practices increase telomere length and reduce markers of oxidative stress.
10. Heat-shock therapy. I take very hot baths and/or saunas at least once a week, ideally twice a week. The precise chemistry is outside of my understanding, but heat shock proteins persist in the bloodstream for some time after exposure, and provide a slew of anti-aging benefits.
11. Fasting and intermittent fasting. Moderate caloric restriction and periods of fasting appear to upregulate longevity-promoting sirtuin genes. Intermittent fasting increases autophagy, which may be protective against some forms of cancer.

Supplements (in no particular order)

1. Nicotinamide riboside (as Tru Niagen, abbreviated as NR). Currently I take a low daily dose of Tru Niagen: 1-2 caps (150-300mg) per day. NR increases NAD+ in humans and may improve cardiovascular function and other physiological process in ways similar to caloric-restrictive diets (but without the caloric restriction). I’m taking a low dose at the moment because it’s an expensive supplement and there still isn’t very much human research. I follow Chris Masterjohn’s advice to take NR with food, and to also supplement with TMG/betaine to compensate for increased demand for methyl groups. The following health changes MAY be attributable to NR: putting on about five pounds of lean muscle mass, resolution of insomnia. Disclosure: I own shares of Chromadex, the company that sells Tru Niagen.
   
2. Niacin (nicotinic acid, abbreviate as NA). Niacin also increases NAD+, activates sirtuins, and prolongs lifespan in roundworms. Unlike NR, NA is dirt cheap. While high daily doses are associated with an increased risk of diabetes, lower doses are likely safe, especially combined with a lower carb or slow-digesting carb diet. I take 100mg once or twice a day, which sometimes produces a mild flush for about twenty minutes. For me, niacin obliterates anxiety, improves baseline mood, and improves sleep quality. Niacinamide, which I’ve written about before, does the same thing without the flush, but also without the sirtuin activation (the sirtuin enzymes convert niacin into niacinamide).
3. Pterostilbene. I currently take 50mg of pterostilbene every other day or so. Pterostilbene is a polyphenol found in blueberries, similar in structure to resveratrol, but more difficult for the body to metabolize (so that its biological effects last longer). Pterostilbene activates sirtuins, reduces inflammation, and may have cognition-boosting effects. I’ve only been taking pterostilbene for a few weeks and I haven’t noticed anything dramatic. I have noticed slightly increased vascularity and a mild calming effect. I buy inexpensive pterostilbene from Swanson.
4. Quercetin. I take 250mg quercetin a few times a week. This is a low supplemental dose, but much higher than amounts found in quercetin-rich foods such as apples and onions. I take quercetin as a potential senolytic (a substance that destroys senescent “zombie” cells that significantly contribute to aging). Research regarding quercetin as a senolytic in humans is early but promising. I have also experimented with supplemental fisetin (another senolytic, found in strawberries), but quercetin is less expensive and better-researched. Supplemental quercetin combined with tea flavanoids also appears to bestow metabolic protections (reducing insulin resistance), at least in mice. The main effect I notice from quercetin is a slight drying of my sinuses and whitening of my sclera (the whites of my eyes), most likely due to quercetin’s antihistamine effect (very helpful when pollen counts are high). Quercetin also has gastroprotective properties via COX, and a host of other potential health benefits.
5. L-carnosine. Carnosine is a dipeptide consisting of beta-alanine and histadine. Supplementing with carnosine reduces glycation, protects against telomere shortening, may protect against Alzheimer’s disease, and increases longevity in mice. I’ve experimented with doses up to 1000mg per day, but I currently take 500mg every other day or so (less if I’m eating red meat, which is high in carnosine).
6. Creatine monohydrate. Creatine is mostly known as a weightlifter supplement, but this cheap, well-researched organic compound, which recycles ATP, also has neuroprotective and cognitive boosting effects. While I don’t take creatine regularly (larger doses disrupt my sleep), I sometimes use a few grams to boost physical or mental performance. Creatine appears to modestly boost lifespan in mice. Creatine supplementation should probably increase with age for maximum benefits.
7. Vitamin and mineral supplementation. While multivitamins are unlikely to increase lifespan, common deficiencies (such as vitamin D, zinc, and magnesium) can negatively impact health. I take vitamin D, vitamin K2, magnesium glycinate, zinc (OptiZinc brand), and the occasional multivitamin or B-complex. I sometimes take small amounts of vitamin C, but there is no evidence that large doses of antioxidants (such as vitamins C and E, and alpha lipoic acid) extend lifespan, and may even shorten it.
8. DMAE. DMAE, or dimethylaminoethanol, a compound found in small amounts in sardines and anchovies, has several interesting physiological effects, including clearing lipofuscin from skin cells when applied topically (to reduce age spots), as well as a cholinergic, acetylcholine-boosting effect to improve attention (some parents have successfully used DMAE as an alternative to ritalin for kids with attention disorders). I take DMAE a few times a week when I need to increase my focus and work capacity, but if I take too much my neck and shoulders get stiff (a known effect of excess acetylcholine). DMAE perhaps is better categorized as a neuromodulator than an anti-aging compound, but at least one older study shows significant lifespan gains in mice given DMAE.
9. Co-enzyme Q10. CoQ10 functions as an antioxidant, and is small enough molecules to enter the cell and support mitochondrial function. CoQ10 increases lifespan in mice fed PUFA-rich diets. CoQ10 levels tend to drop with age. I currently take 50mg a few times a week and have noticed an improvement in gum health since I added this supplement. Chronic, high-dose supplementation of CoQ10 is associated with a reduced response to exercise (and this appears to be true for most antioxidants; our bodies need a surge of free radicals to trigger positive adaptations to exercise), so less may be more with CoQ10 and other antioxidants (C, E, ALA, etc.).

Other supplements that I don’t take regularly, but may increase telomere length, include reishi mushroom and astragalus.

Anti-aging researcher David Sinclair takes the drug metformin daily to control his blood sugar and extend lifespan. I have experimented with berberine, which has similar effects, but I don’t currently take it regularly due to possible GI side effects.

Medicinal/Nutraceutical Foods

Including specific foods in the diet can slash disease risk and extend healthspan. This post is already too long, so I’ll get into more details and cite evidence in a follow-up post, but here are my Top 11 nutraceutical foods/food categories:

1. Matcha (cancer prevention)
2. Garlic (cancer prevention, cardiovascular health, immunity, selective antibiotic)
3. Berries (neuroprotective, eye health)
4. Herbs and spices (cancer prevention, cardiovascular health, neuroprotective)
5. Cacao (neuroprotective, cardiovascular health)
6. Pomegranate (cardiovascular health)
7. Hydrolyzed collagen (sleep and skin health)
8. Extra virgin olive oil (cancer prevention, cardiovascular health)
9. Mushrooms (neuroprotective, immunity, cancer prevention)
10. Non-starchy vegetables – cruciferous, leafy greens, alliums (cancer prevention, bone health, blood sugar control)
11. Nuts and seeds (cardiovascular health, blood sugar control)

What Health Fads Do NOT Contribute to Longevity (though they may have other benefits)

1. Fish oil
2. High-dose antioxidants
3. High-mileage running
4. The blood-type diet (or practically any other highly restrictive diet with lots of silly rules, with the possible exception of the ketogenic diet as noted above)

How to Design and Implement Your Own Anti-Aging Program

So far this post has been a bit of a info-dump as I’ve tried to share my own program. But if someone were to ask me, in simple actionable terms, how they could implement their own health improvement/life extension program, I’d recommend the following flowchart/action sequence, in order of probable helpfulness:

1. If you don’t have regular enjoyable social interactions in your life, make it happen. For health purposes, it appears quantity is more important than quality or “deep” relationships. It can be hard to make new friendships as an adult, but it’s not hard to join a jiu-jitsu or pottery class, or to join your local D&D Adventurer’s League — whatever floats your boat.
2. If you’re not exercising at least an hour a day, start (with walking making up the bulk of that, but some strength and endurance training as well).
3. If you’re not eating a nutrient-dense, phytonutrient-rich diet, start (either a gradual transition or a radical change, whatever works best for you), and correct any nutritional deficiencies.
4. If you’re not allowing yourself at least 7 hours of sleep and/or rest a night, start, and take steps to improve your sleep quality if you’re not sleeping well.
5. Experiment with other lifestyle practices that may improve health and increase longevity, such as meditation and saunas (see above).
6. Experiment with supplements that raise NAD+ and activate sirtuins (see above).
7. Experiment with supplements that clear lipofuscin, prevent glycation, increase telomere length, reduce cellular senescence, and enhance physical and/or mental performance (see above).

Keep in mind that I’m not a doctor and have no formal medical training. These are my ideas, speculations, and opinions, not medical advice.

I hope this post was helpful! Please feel free to ask questions or share your own experiences below.