A small update about what I’m tracking.
I recently bought a Body Cardio Withings scale to track body composition, and more importantly, arterial stiffness via pulse wave velocity (PWV). There are at least 2 small studies that validate the accuracy of this scale when it comes to the gold standard for PWV, here is one of them:
This has proven useful to me so far, and that data along with Garmin (VO2max estimation) has shown me that my curent training is currently lacking, and I either need to start adding more intensity, or more duration. I’ve opted for more intensity because I need to start at serioulsy improving my VO2max anyway.
I’ve also decided to ditch my use of acarbose, and instead add intermittent use of empaziflogin (Jardiance). Part of it is that I’ve been at a weight plateau for the last 6-9 months. The other part is for the potential longevity and cardiac benefits.
There are 2 things that I find interesting with empaziflogin. First, that one study shows that even intermittent use over a long period confers some benefits.
The intake rate of empagliflozin was 96.7 ± 7.2% for the regular group and 45.7 ± 7.0% for the intermittent group. Interestingly, ΔHbA1c was identical in the two groups (-0.64 ± 0.19% and - 0.65 ± 0.17%, respectively). Body weight decreased (-2.72 ± 0.52 and - 1.50 ± 0.45 kg, respectively) and diabetes treatment-related QoL increased significantly from baseline in both groups. Energy intake, however, decreased significantly only in the intermittent group (-221.0 ± 108.3 kcal/d)
The second thing is that empaziflogin use changes your gut microbiata (after just 4 weeks!) and plasma metabolites (after 3 months).
After the 3-month treatment period, empagliflozin increased the levels of fatty acids, fatty acyls, organic acids, phosphosphingolipids, and other metabolites such as maslinic acid but reduced the levels of amino acids and derivatives, lipids, vitamins, sugar alcohols, and other metabolites such as uric acid […] We found a significant increase in the sphingomyelin and capric acid levels and a decrease in glycochenodeoxycholate, cis-aconitate, erythritol, and uric acid in the empagliflozin group but not in the metformin group
We found that the richness (observed ASVs) and diversity (Shannon index) of the gut microbiota significantly increased in the empagliflozin group but not in the metformin group . The aPCoA of Bray-Curtis distance demonstrated that the gut microbiome of the patients showed a significant shift after 4 weeks of empagliflozin treatment and then remained relatively stable
The clinical benefits of both empagliflozin and metformin are related to altered plasma metabolites; plasma metabolite alterations, in turn, are associated with changes in the gut microbiota of patients. Empagliflozin modified plasma metabolites and gut bacteria related to clinical parameters, including blood glucose levels, inflammatory factors, and CVD-related factors, whereas metformin treatment was associated only with changes in blood glucose levels and body weight-related modifications in plasma metabolites and gut bacteria.
The above tells me that potentially, I could dose empa the following way to get most of its benefits:
- take it faily for 1 month. This would results in potential weight loss, and also in enriching and diversifying my gut microbiata
- take it intermitently after 1 month, maybe once a week. This would at least lead to weight maintenace, and more importantly help maintain gut microbiata diversity.
It’s an open question how long those change to the microbiome stay after being on empa for some time, but to me it points to another another criterion I’ll start using for anti-agin intervention: the frequency of the dosage. The less frequent, the better. We still don’t know what the optimal dosage of rapamycin is, but seems like at most once a week is a good start. It could be that once a month is also OK, who knows. Other interventions that last a long time:
I finally feel confident enough about my understanding of gut microbiome testing to order one. I plan to do one soon, while still on rapamycin, and a couple more when I start using empa.
