Field guide
What the research actually says
94 interventions, from foundational behaviours to experimental compounds. Each entry describes what it targets, how it works, who it fits, and — where it applies — where it stands legally.
Behavioral
24-
Caffeine Timing Discipline
Cut caffeine 8 hours before sleep. Protects sleep architecture even when subjective sleep feels fine.
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Control Blood Pressure
Target 120/80 or lower. Sustained mild elevation does most of the lifetime damage.
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Daily Breathwork
Slow breathing, 5 to 10 minutes daily. Raises vagal tone and steadies sleep.
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Daily Stress Downregulation
5 to 10 minutes a day of structured downregulation. Lowers cortisol and blood pressure.
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Daily Sunscreen
SPF 30 to 50, every morning. One of the few aesthetic moves with hard outcomes.
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High-Intensity Intervals
Short threshold-or-above work, once a week. Pushes VO₂ max where zone 2 alone can't.
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Improve Glucose Control
HbA1c 4.8 to 5.3 percent. Most glucose problems are body-composition problems in disguise.
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Increase Daily Steps
8,000 to 12,000 a day. The cheapest mortality intervention in existence.
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Increase Fiber Intake
25 to 40 grams a day from whole food. The unglamorous lever that moves multiple risk markers at once.
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Increase Protein Intake
1.6 to 2.2 g/kg body weight. The lever that holds muscle as you age.
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Invest in Social Connection
Regular in-person time with people who matter. Mortality risk on par with smoking when missing.
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Mediterranean Dietary Pattern
Plants, fish, olive oil, modest grain. The dietary pattern with the most consistent mortality data.
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Minimize Ultra-Processed Foods
Keep ultra-processed food under 10 to 20 percent of intake. The single biggest dietary lever most people haven't pulled.
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Morning Light Exposure
10 to 15 minutes of outdoor light in the first hour after waking. Cheapest sleep upgrade available.
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Optimize Sleep
Fix sleep before anything else. Most "optimization" downstream of broken sleep is theater.
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Posture & Mobility Work
5 to 10 minutes a day. Cheapest lever for perceived age and injury prevention.
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Power & Plyometric Training
Sprints, jumps, swings. The fast-twitch fibers age the hardest if you leave them alone.
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Reduce ApoB
ApoB 80 mg/dL or lower. The single most consequential cardiovascular target.
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Reduce Excess Body Fat
Drop visceral fat first. Fixes lipids, blood pressure, glucose, and inflammation in one move.
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Reduce or Eliminate Alcohol
Less is better. No safe lower threshold for longevity has emerged from the modern data.
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Resistance Training
Lift. The most defensible move in the entire stack.
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Rigorous Oral Hygiene
Brush twice, floss daily, dental visits twice yearly. Cardiovascular risk lever in disguise.
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Stay Current on Vaccinations
The boring intervention with the largest effect size in adult preventive medicine.
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Zone 2 Cardio
Conversational-pace aerobic work. The most reliable way to raise VO₂ max.
Supplements
14-
Berberine
500 mg, two to three times daily. Functions as a weaker pharmacologic glucose-lowering agent.
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Caffeine (Performance Dose)
1 to 3 mg/kg before performance. Watch the sleep cutoff.
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Collagen
10 to 20 grams daily for joints, skin, tendons. Not a complete protein.
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Creatine Monohydrate
3 to 5 grams a day. Highest-evidence supplement in the muscle-and-strength category.
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Electrolytes
Sodium, potassium, magnesium around training in heat. Not a general-use supplement.
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Fiber Supplement (Psyllium)
Useful when whole-food fiber falls short. Psyllium is the studied form.
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Fisetin
OTC flavonoid senolytic. Lower risk than the prescription combination; thinner standalone human evidence.
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Glycine
3 grams before bed. Modest sleep benefit, low downside.
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Magnesium Glycinate
200 to 400 mg in the evening. Sleep quality, muscle relaxation, low cost, well-tolerated.
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NAD+ Precursors (NMN/NR)
250 to 1,000 mg daily. Strong mechanistic case, limited human outcome data.
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Omega-3 (EPA/DHA)
1 to 3 grams of combined EPA and DHA daily. Most useful if fish intake is low.
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Protein Supplement
Use to hit your protein target when food falls short. Not a substitute for whole food.
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Topical Vitamin C
Morning antioxidant. Supports collagen, pairs with sunscreen.
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Vitamin D
Supplement if levels are low. Test before high-dose supplementation.
Labs
9-
ApoB Testing
The single most actionable cardiovascular test. Every 6 to 12 months.
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ApoE Genotyping
A one-time genetic test that shapes Alzheimer's and cardiovascular risk interpretation for life.
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Epigenetic Age Test
DunedinPACE estimates how fast you're aging right now, not how old you are.
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HOMA-IR Panel
Fasting insulin and glucose together reveal insulin resistance years before glucose alone would catch it.
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Hormone Panel
Free testosterone, DHEA-S, estradiol, and SHBG together — the baseline for any hormone conversation.
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hs-CRP Testing
A single blood marker for systemic inflammation — the through-line connecting cardiovascular, metabolic, and aging risk.
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Lp(a) Testing
Test once. Genetically fixed. If elevated, the cardiovascular math changes.
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Thyroid Panel
TSH flags thyroid dysfunction that mimics fatigue, weight change, and mood issues.
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Vitamin D Testing
Confirms whether you actually need to supplement, and how much.
Assessments
6-
Cancer Screening
Stage at detection drives outcomes more than treatment intensity. Follow the schedule.
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Coronary Artery Calcium (CAC) Scan
Cheap, non-invasive, shows actual plaque. Once at 40 or earlier with family history.
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DEXA Scan
Gold-standard body composition and bone density. Annual baseline, or during active recomposition.
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Grip Strength Test
A 30-second dynamometer reading that tracks frailty risk years before it shows up anywhere else.
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Screen for Sleep Apnea
Snore, fatigued despite long nights, partner notices breathing gaps? Get the study.
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VO₂ Max Testing
Confirms your cardiorespiratory fitness baseline — the strongest single predictor of all-cause mortality.
Modalities
6-
Cold Exposure
1 to 5 minutes, a few times a week. Mood and alertness signal real. Longevity signal speculative.
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Hyperbaric Oxygen Therapy
Useful in specific medical indications. Hard to justify as a general longevity tool.
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Red Light Therapy
Reasonable for targeted skin and recovery use. Weak case for systemic longevity.
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Regular Sauna Use
3 to 5 sessions a week, 15 to 25 minutes hot. One of the few modalities with a real signal.
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Sensory Deprivation / Float
Useful for deep relaxation if it helps you stick with stress-management practice.
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Whole-Body Cryotherapy
Similar to cold exposure, more expensive, less evidence of incremental benefit.
Devices
2Compounds
33-
Statins
First-line ApoB lowering. The most studied class in modern cardiology.
Approved -
Tesamorelin
FDA-approved GHRH analog that reduces visceral fat — explored off-label for body composition.
Approved -
Ezetimibe
Second-line ApoB lowering. Stacks cleanly with statins when targets aren't met.
Approved -
Sermorelin
GHRH analog with the cleanest regulatory history of any secretagogue — pulsatile GH release, modern human data is thin.
Compoundable -
Bempedoic Acid
Statin alternative for statin-intolerant patients. Same pathway, one step upstream.
Approved -
Ipamorelin
Selective ghrelin-receptor agonist (GH secretagogue) — raises pulsatile growth-hormone release.
Gray zone -
CJC-1295
Long-acting GHRH analog — raises pulsatile growth-hormone release.
Gray zone -
MK-677 (Ibutamoren)
Oral GH secretagogue — reliably raises GH/IGF-1, but also reliably raises insulin resistance.
Gray zone -
PCSK9 Inhibitor
Injectable ApoB lowering. The most powerful tool in the class.
Approved -
ACE Inhibitor or ARB
First-line blood-pressure medication. Bonus protection for kidneys.
Approved -
BPC-157
Synthetic peptide fragment studied for tissue repair. Animal data promising; human evidence sparse.
Gray zone -
Dasatinib + Quercetin
Quarterly pulse-dosed prescription combination. Promising mechanism, thin human evidence, real side-effect profile.
Approved -
DSIP (Emideltide)
Delta sleep-inducing peptide marketed for sleep — no published human RCT.
Prohibited -
GHK-Cu
Copper peptide studied topically and systemically for skin repair and wound healing.
Gray zone -
GHRP-2
Growth-hormone-releasing peptide used for muscle gain — limited human evidence, unclear regulatory status.
Prohibited -
GHRP-6
Growth-hormone-releasing peptide, notable for appetite stimulation — limited human evidence, unclear regulatory status.
Prohibited -
GLP-1 Receptor Agonist
Semaglutide or tirzepatide. The most consequential pharmacologic intervention in modern preventive medicine.
Approved -
Hair Loss Treatment
Finasteride and minoxidil. The most effective interventions for androgenic hair loss.
Approved -
Hexarelin
Potent growth-hormone-releasing peptide — desensitizes with repeated use, unclear regulatory status.
Gray zone -
Humanin
Mitochondrial-derived peptide studied in animal aging models — no human clinical data yet.
Gray zone -
KPV
Tripeptide derived from alpha-MSH, explored for inflammation and gut healing — low risk, minimal human data.
Gray zone -
Menopausal Hormone Therapy
Estrogen with or without progesterone. Best evidence when started within 10 years of menopause.
Approved -
Metformin
500 to 2,000 mg daily. Old drug, long track record, possible longevity signal.
Approved -
MOTS-c
Mitochondrial-derived peptide studied for metabolic effects. Early-stage research, minimal human data.
Gray zone -
Rapamycin
Off-label, weekly, physician-supervised. The most plausible longevity drug currently in use — still experimental in humans.
Approved -
Retatrutide
Triple-agonist incretin in trials for weight loss — not yet FDA approved.
Investigational -
SGLT2 Inhibitor
High-value in diabetes, heart failure, or kidney disease. Not a general-population longevity drug.
Approved -
SS-31 (Elamipretide)
Mitochondria-targeted peptide with a narrow FDA-approved indication (Barth syndrome) — no longevity/aging human RCT yet.
Approved -
TB-500
Synthetic thymosin beta-4 fragment studied for tissue repair. Animal data promising; human evidence sparse.
Gray zone -
Testosterone Replacement (Clinical)
For documented deficiency with symptoms. Not a casual optimization tool.
Approved -
Thymalin
Thymic peptide studied for immune/longevity effects, mostly in older Russian trials — no rigorous modern human data.
Gray zone -
Thymosin Alpha-1
Naturally occurring thymic peptide explored for immune modulation — not a stimulant, a regulator.
Gray zone -
Topical Retinoid
Tretinoin or retinol nightly. Strongest topical for collagen and turnover.
Approved