What are your top 10 biomarkers to track for improving healthspan and longevity?

[RobTuck]

In other walks in life, I sometimes find it instructive to challenge myself to identify a sparse set of criteria.

Limiting the topic to vascular health, I think Apo(b) + Lp-PLA2 + hsCRP would capture most of the variance.

VO2max alone might do a pretty good job of tracking musculoskeletal health.

Has anyone here conducted an exercise to come up with what blood metrics they would track if the total number were limited to, say, five or even 10?

[desertshores]

Sure:

Albumin, Creatinine, Glucose, CRP, Lymphocytes, MCV, RDW, Alkaline Phosphatase, WBC, Cholesterol.

Why? All but the cholesterol are the ones on the Levine-derived spreadsheet calculator.
I am including cholesterol because many in the forum place a high value on this.

[RobTuck]

I like this list. Are you referencing LDL-C or total? It seems like the evidence is that the single metric Apo(b) will capture most of the variance of interest and it can play even of TC is relatively low.

[RobTuck]

I think Apo(b) is modulated by Apo A-1 and CRP but that kind of thinking makes for a bigger list.

[desertshores]

Judging from the responses on the various threads, LDC seems to be the favorite marker.
Though a lipid panel is fairly cheap. A lipid panel from Ulta Lab Tests is only ~$22
Chol/HDLC Ratio
Cholesterol, Total
HDL Cholesterol
LDL-Cholesterol
Non-HDL Cholesterol
Triglycerides

[RobTuck]

Being reminded of an adage from another era, “Sorry I didn’t have time to write a shorter letter,” I find it easier to come up with a list of 20-30 metrics that cover the issues than I do with five or 10.

The only thing I’m reasonably sure of is that the list should be derived from how much variance it accounts for in life- and health-span outcomes. This is an empirical question. But aren’t most of the models we see about what should and should not count based more on theory than fact? And isn’t any short list going to be dynamic; e.g., if your lipids are optimal (whatever that is), elevated blood pressure will account for a smaller proportion of the variance.

One underexplored contribution to knowing what we should measure and manage might be obtained by working backwards from individuals who have excellent conventional metrics and yet die young from an ASCVD event. How does that happen and why don’t our current metrics account for it?

[DeStrider]

Yes, ApoB and LDL are very important for men. 1 in 3 people globally will die from heart related issues (CVD). 2 out of 3 men will have heart and cholesterol problems. I also have a familial history with my grandparents and parents having heart disease issues. In order for Rapamycin to work for me, I have to jump the CVD hurdle first by keeping my ApoB and LDL low!

[RapAdmin]

The new Outside magazine article / interview with Peter Attia has some discussion on the functional biomarkers that he uses…

VO2 max measures the amount of oxygen your muscles can utilize at peak effort. It’s the benchmark of cardiovascular fitness because it’s a picture of how well oxygen moves through your system. You can’t game the results. It has also, somewhat recently, become a useful predictor of longevity. If some fitness is good, is more better? Apparently so. Numerous studies have found that higher VO2 max scores correlate with longer life.

…

My score tops out at 41.6, which strikes me as low, but Bennett says it’s actually pretty good for a guy my age. I’m quietly thrilled to see my report sheet include the word “excellent.” Still, I’m a bit short of the Elite category, which requires hitting 50 or above. In Outlive, Attia states that he wants his clients to aim for a VO2 max score in the Elite zone for their gender but two decades younger. In my case, that would mean a score of around 53, a daunting target based on what it took to hit 41.

That seemed highly improbable, but Bennett assures me I can get there, or close. And what, I ask, might it require? Something in the range of four to six hours of Zone 2 work, plus at least one Zone 5 interval session, per week, he says.

Zone 2 is the quasi-magical aerobic threshold, where it’s possible to burn fat as fuel more than you’re burning carbohydrates. Zone 2 is the kind of effort you can sustain for a long time. Zone 2 is pretty easy. I love Zone 2.

Zone 5 training is quite hard, but it’s mercifully brief. A popular Zone 5 workout involves four minutes of maximum effort followed by four minutes of recovery, done a total of four times. One of my big takeaways from testing is realizing how these zones actually feel. What I thought was Zone 2 was probably more like Zone 3 or even 4. My easy workouts have not been easy enough, I discover, and my hard sessions are not hard enough. I’ve been trapped in the middle, a metabolic no-man’s land.
…

I’d long thought of lifting weights as essential for athletic performance, regardless of your sport, but I hadn’t considered the impact on healthy aging. Not only does preserving lean muscle deliver metabolic benefits, but it also helps keep us mobile and stable. Falls are the leading cause of death after age 65—the fifth horseman.

Not surprisingly, given my cyclist’s approach to upper-body development, I fare less well at strength. The goal for the arm hang is two minutes. That doesn’t sound like much, but it’s surprisingly difficult. I don’t even make it to one minute.

The goal for the hex-bar carry is similarly challenging: carry your body weight—in my case 186 pounds—for 60 seconds. Once again I come up short. Not to worry, Bennett tells me. With a dedicated lifting regimen, I can meet these standards as well.

…

Fitness Institute of Texas website: FITNESS INSTITUTE of TEXAS

Online Fitness Progams: Get FIT - FITNESS INSTITUTE of TEXAS

“There is no short-term fix,” Blue Zones’ s Dan Buettner told me. “If you want to live longer, you have to think about things you are going to do on a daily basis for decades.”