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Mechanism

Supplementation

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Hello,

I received a PM today asking me about supplementation.  Unfortunately I am punting on this one except to speak in a few broad brush strokes.  At this time I don't plan on going into my own practices in any detail.

Why?  Many reasons actually but among them lower quality of evidence for supplementation , and they vary much depending on the individual, his/her circumstances, in some cases genetics, and always on goals.  I will leave it to the thought leaders in this domain at least for now (cf- Attia).  

Broad themes:

  •  A whole foods based diet ( ie with either no or minimal refined or processed foods ), and moderate in calories, trumps all
  • Biomarkers are helpful for a baseline  to see if you are on the right track ( search the Drive Podcast and other materials by Peter Attia ) remember Peter Drucker's wisdom: what gets measured gets managed.
  • Genetics are usually only modestly helpful but increasingly so, especially when they are can point you in the right direction which you won't know unless you get it checked.  For example, it would be great if everyone got their Lp(a) tested but if you have an LPA variant it is more likely to nudge you to double check.  Biomarkers trump genes, but for a quick cheat sheet, get Rhonda Patrick's Genome Analysis Tool.  For more in-depth DIY, pursue https://promethease.com/ or equivalent ( n.b., it is now part of the MyHeritage family ).   Just remember these are secondary in importance compared to your actual biomarkers and you usually can't read too much into it.
  • Know your nutrients - keep a food diary and put through cronometer as a ballpark gauge, adjust accordingly.
  • For basic vitamins the strongest consensus is around vitamin D and B12 ( check your levels!), followed by calcium and iron ( these depend on individual and diet - for example the latter menstruating women at higher risk for anemia - check your serum iron and ferritin).  Iodine and selenium are third tier, then the others noted in various guides ( see below).  Some would hedge with a multivitamin anywhere between daily and once a week - this is a matter of philosophy as much as it is science outside of a specific rationale ( e.g. selenium levels are lower in soil in Europe compared to in the U.S., so context matters).  After that, others.  I agree with Michael not to go beyond several hundred fold of RDA at the most unless you know what you are doing and have a target ( e.g. vitamin D is a good exception).

 

I don't necessarily agree with every aspect of the guides, but they provide a solid foundation and you should understand the science that leads you to agree/disagree as you move down form the top concerns ( e.g. vitamin D, B12 +/- calcium/iron/iodine, etc.).  

So called "Anti-aging" supplementation.  This is discretionary and very personal - not only the interpretation but also every individual's risk/benefit analysis even when we can agree on the science.  Therefore, for most I would devote 99.99+% energy on reasonable permutations - even if we don't agree with 100% of it - major national and international nutritional guidelines with some attention to these two threads, again most of which is pretty reasonable:

and

Will further CR extend healthspan / lifespan further: (a) yes and (b) despite the premise of the 2nd post above I think yes, probably at least modestly so, but I provide the 2nd link as a reminder: know where to focus your energy - an overall sound dietary and lifestyle strategy ( sound nutrition, exercise and structural maintenance in all its forms, sleep, stress-management, a sense of purpose, community and engagement, etc).

Hope that helps a little.  My philosophy here is self-sufficiency and scientific nutritional and health literacy.  Continuing education.  Keep learning.  

Health is the greatest wealth and I suggest for starters - if for nothing else to support good causes - becoming a “supporting” member of: 

1) https://peterattiamd.com/subscribe/ and 

2) 

https://www.foundmyfitness.com/subscriptions/new?amount=10

These are the two resources that at this time, May 2020, I would encourage others to support.

If you are passionate about life extension - as many on this forum are - read on.  My personal passion is not the traditional definition of longevity, but of "healthspan"   I agree with the "geroscience hypothesis" that research in the former is one of the most powerful ways to contribute to advances and gains in the latter.

If you also agree, consider also additionally "supporting" - this can be monetary, advocacy, volunteering or via other means - 

1) NIH funding in general, including for the NIA in particular, including basic science in biogerontology / geroscience.   The NIH is generally underfunded but I would argue especially the National Institute on Aging, and particularly in fundamental research.

2) Support fine organizations such as https://www.sens.org/get-involved/donate/ and https://www.lifespan.io/how-you-can-help/ These two emphasize a damage-repair or "SENS" paradigm.  I  feel some legitimate investment of resources equilibrium is required between this approach and more traditional strategies ( refer to an excellent balanced summary by  João Pedro de Magalhães here: http://senescence.info/sens.html ) .  As the SENS approach is comparatively less funded and relies more on personal donations and private investors, I would get familiar with it;

"Reason" ( yes, that is his name) has an excellent newsletter to stay up-to-date with some of these developments here: 

https://www.fightaging.org/

Be well,

Mechanism

 

PS / Epilogue: don't keep too fixed on one mindset - keep an open mind focused on ever-evolving evidence and personal experience. 

For example, even since my post here:

I continue to experiment with different variations and permutations of various diets, and monitor the impact on biomarkers and other outcomes of interest ( these are associative by nature given the absence of controls so minimizing known variation while reproducing the same interventions at other times and conditions partially mitigates this).

 For example I have pursued trials of additional every other day (EOD) fasting variants of SFD with similar results - though SFD has the isocaloric edge for peak ketosis other biomarkers, other variants can yield similar results with commensurate postprandial exercise, dialing back further net-CHO and/or calories, etc.  
 

The bottom line is that there are countless  equally efficacious ways to achieve essentially the same targets, so don't lose focus that it is the the overall diet quality ( see above ) and overall lifestyle that far and away determines the overall path to health.  Being consistent where it counts, adapting to the medical literature and your own biomarkers and other pertinent metrics including subjective wellbeing and sustainability , and focusing on the most impactful and evidence-based principals ( see above re: diet quality) is where your energy should be most devoted.  There are many roads to Dublin.

Edited by Mechanism

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Thanks Mechanism,

This answers my question.  Incredible comprehensive approach to maximize healthspan & lifespan!!

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