That is not a question that is simple, if by simple you mean not subject to different interpretations. Especially if your question is seen in the context of your whole original post and my response to it.
You listed eight interventions. At best - and this is being speculative and charitable - only one of them might affect some of your body systems. Possibly not even that single one.
Before we go any further, let me get one thing out of the way. This is the internet, and not a real life conversation, so it is easy to misinterpret tone. I am on your side. I am an ally. I - desperately - want you to be right. We are in the same boat. We are facing the same enemy. We only differ in how we assess the best means and prospects of fighting our common enemy. What I post, is only with the best intention of helping to illuminate the path forward, not to “win” an internet argument, or be a contrarian, or engage in pointless scoring. I’m passionate about the fight, and so I post with energy and at length, but only in service to the ultimate goal of improving health and lifespan. So before I go any further, I extend - metaphorically - my hand in friendship: we have no beef, only a common search for truth and solutions, peace!
The only intervention on your list that has a chance to prolong max lifespan in humans by slowing down aging, is rapamycin. It is highly speculative, because we must make a distinction between prolonging mean lifespan of a cohort and max lifespan, and in mice the strongest signal for life prolongation with rapamycin was mean lifespan, i.e. having more mice achieve “old age” than if there was no intervention. But for max lifespan, the only intervention that has been shown conclusively to work in more complex animals to slow down the aging process and thus prolong max lifespan, not just mean lifespan, is CR. And an intervention you notably - and perhaps ironically - have not listed in your collection.
Note one thing about extending max lifespan - the simpler the organism, the easier it is to have a dramatic impact. In a worm that has many fewer and less complex systems than higher animals, you can prolong lifespan by 300% with all kinds of interventions, drug, genetic, food restriction etc. In mice you can get about 50% or so (with CR - about 30% with rapamycin). In dogs, cats, cows etc., possibly by 10%-15% - we hope (hasn’t been proven yet). In monkeys and especially humans, currently we have no proof - none - that any intervention, including CR (one of the two monkey CR trials failed to extend max lifespan) or rapamycin or anything else can extend max lifespan.
So, in granting you that rapamycin might extend max lifespan, I am doing so without proof, out of hope more than anything else. I too am looking to take rapamycin, and obviously I would love for it to work. But there is currently no proof in humans - or even dogs.
All your interventions at best might improve healthspan. But as the recent mouse CR study concluded, lifespan and healthspan, though related, are not the same. Being in better health might let you achieve - at best - the full potential of your lifespan - but not beyond.
Shockingly, being currently in better health, might NEGATIVELY affect your lifespan, might shorten it, through a similar modality as antagonistic pleiotropy. This is not a mere theoretical possibility - this is something that is actively discussed when scientists argue over whether there’s a U curve with exercise. You might be fitter, and stronger, and have lower mortality risk, but it might come at the cost of a shorter life. We have seen proof of that in CR studies. Exercised animals are more robust, stronger than CR’d animals, but at the extreme edge of CR, those more fragile CR’d (“in worse health”) handily outlive those healthier stronger exercised non-CR mice. The longest lived were the non-exercising extreme CR’d mice (where introducing exercise shortened their lives, thus exercise was a strongly lifespan negative intervention). Which is why in that recent mouse study they have made such a strong point of decoupling healthspan from lifespan - because it is counterintuitive to most people, I mean what’s more natural, than to think that the healthier you are the longer you will live. But it’s just not so in animals like rats/mice at least. And likely in humans - healthspan and lifespan are loosely coupled and at points divergent and decoupled. Exercise has been shown to definitely square the survival curve - it will keep you healthy and you won’t die prematurely - but it will not, repeat, NOT prolong your life. We have seen that in CR studies too - and as the mouse study pointed out. Note one interesting thing about those statistics that folks like Peter Attia like to pull out about exercise - like the VO2Max you mention in your list of interventions - the higher the VO2Max, the lower your mortality risk. Same (up to a point) with muscle mass and other fitness markers. But what does it mean? It means you are healthier - you have better healthspan - and during that period of time, your chances of dying are lower, your mortality risk goes down. But what it does not mean is that you will live longer than is your physiological limit. What it means, is your odds of dying prematurely is lowered, not that the date of your death is postponed beyond your physiological limits, that you have slowed the rate of your aging by any percentage (as you are hoping in your interventions). To slow the rate of aging, to die later than your physiological limit, you need pharmaceutical interventions or better yet, genetic manipulation - with the possible exception of CR (in humans). None of your interventions - with the possible exception of rapamycin - prolong lifespan by slowing down the aging rate as you posit.
A few points about your interventions, they address healthspan, and so do prevent many premature failures of many systems. Absolutely true. But that is not what we were talking about we were talking about extending life by slowing down the rate of aging (your hope/claim) - and that is not affected by those interventions (rapa possibly excepted). One may even argue that perhaps - perhaps - some are even dangerous, like exercise (if beyond a certain point), and might shorten your lifespan (this is speculation: we don’t know that, and your regimen is not clear enough about the degree of intensity).
The reality is that these types of interventions, broadly speaking lifestyle, diet, exercise, sleep etc., are all at best going to allow you to age to your natural limit. They will prevent accellerated aging. Like you said in your last intervention: don’t do the stupid stuff like smoking. Smoking accellerates aging. A bad diet and a totally sedentary lifestyle will shorten your life. But doing all those things right, will not lengthen your life beyond its physiological limit (by slower aging), it will prevent the shortening of it. An exercised muscle is no aging slower (beyond its physiological limit), exercise is lowering the rate of accelerated aging - old people move less than young people and their muscles actually are subject to accelerated aging, and excercise is slowing accellerated aging, not basic aging, because your muscle tissues still age. And so on for all the other interventions - they slow the rate of accellerated aging, not basic aging. To affect the rate of basic aging you need CR, perhaps rapamycin - and ultimately other drugs and genetic interventions.
There is an additional wrinkle here with the interventions such as yours centered around lifestyle factors - there is a point beyond which they don’t get you any further. You only need to exercise so much to not die prematurely - if your physiological limit is, say 95, you’ll die at 95 if you merely exercised “enough”, and being fitter yet, will only allow you to lower your risk of mortality, i.e. make it more certain that you will actually reach that 95, but still not take you beyond 95. Same with diet - you eat “well enough” and it will let you reach that 95, and eathing “brilliantly” will not get you one second longer, though maybe you’ll have better healthspan during that period of time. Same with all those minute tweaks that we all make to our heath regimens, supplements and the like - that aged garlic supplement or some tiny change in your morning routine is not adding years to your life, though if lucky, adding life to your years as the saying goes. And it is in this spirit that I admire those super exercisers like Peter Attia (and you!), but I jog at my relaxed pace with occasional spurts of HIIT, and let those better than me athletes pass me by, and I smile, untroubled by my sloth. I reckon we’ll all reach the same finish line - our inherent physiological limits. Same with diet. I eat a very healthy diet, because I like how it makes me feel. But I realize that I could eat only adequately, and live just as long. And so I feel zero guilt about that occasional fancy meal, or cookie, or glass of wine, because that will not shorten my life by one second. You can have a good healthspan up to your 95, or you can have brilliant healthspan up to your 95 - the question is, are you willing to sacrifice a lot for that brillance - not me. Although, caveat, like with my diet, if you enjoy exercise (I don’t!), it’s not a sacrifice.
By the way, real life has verified that in spades. If super healthy eating, exercising etc., were really affecting the natural limits of our physiology, you’d find health nuts overrepresented among supecentanarians. Yet, that is not so. In fact, it is often the opposite - we see a lot of very, very bad lifestyle choices among them (like the recent 110 year old who smoked for 20 years and never exercised), tons and tons of them have very iffy diets - frankly bad diets. Because it is the genes that set the limit, and lifestyle factors at best let you affect your healthspan in that time. If your body is built for 115, you will hit that number in better or worse health regardless of your lifestyle (up to a point, obviously, no 600 pound weight!). And if built for 78, that’s what you will hit no matter how much of a health nut you are - "strange, he died so early, he was such a paragon of good lifestyle, “strange, diagnosed with cancer despite exemplary lifestyle”). Your interventions will not affect lifespan, only healthspan (at best!) - rapa a possible exception.
Bottom line: we need more than the interventions you listed. We need true anti-aging drugs in addition to drugs/interventions addressing our weakest links, and ultimately genetic interventions (sadly, not in our lifetimes).
