I have added it to the third place on the moment to test it out if it fits there or not.
I don’t really think it’s tricky.
If it’s something humans won’t die or become unhealthy without, but that they can use to extend their lifespan, then it belongs on the list. (Rapamycin, calorie restriction, etc.)
If it’s something that humans will die or become unhealthy without, then it should be considered “healthspan” stuff and doesn’t belong on the list. (Sleep, eating, exercise, etc.)
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It’s also pretty intuitive if you think about it . . .
Humans have been around in our current form for tens of thousands of years. If there was something as simple as a certain kind of food or sleep habits that extended our maximum possible lifespan, then we would have figured these things out many thousands of years ago.
The maximum possible lifespan for humans hasn’t increased with better nutrition and healthcare; it’s just the average lifespan that has increased, because more people are getting closer to the maximum possible age before dying.
It was absolutely possible for people to live to be 100 years old in ancient times, as long as they didn’t die from childbirth /disease /wars /famine /etcetera first.
The stuff that belongs on your list are the things that will increase the maximum age that humans will have the opportunity to live to . . . if they stay healthy and don’t get eaten by a bear or something.
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Perhaps 8 hours of sleep is overrated.
Though, rapamycin has increased my sleep time and my sleep quality.
“A new study looking at sleeping patterns in three traditional hunter-gatherer tribes suggests ancient humans were just as sleep-deprived as we are, averaging a little under 6.5 hours of shut-eye every night.” Actually NOVEMBER 02, 2015
“In some ways, the sleep in these traditional human groups is more similar to sleep in industrial societies than has been assumed. They do not sleep more than most individuals in industrial societies”
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This study appears to confirm your point.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694114/
Conclusion
Our results revealed that people who sleep more than 7.5 hours per night have decreased levels of the anti-aging protein klotho in their serum, thus being more at risk of aging-related syndromes.
Sweet spot seems to be 6.5 to 7.
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This is a hair growth formulation as was mentioned in the 17-alpha estradiol page. 17-Alpha Estradiol - Another Top Anti-Aging Drug
Nothing likely gets into the blood stream, and you don’t want to drink it.
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Really great summary of the differences, Phil!
If it’s something humans won’t die or become unhealthy without, but that they can use to extend their lifespan, then it belongs on the list. (Rapamycin, calorie restriction, etc.)
If it’s something that humans will die or become unhealthy without, then it should be considered “healthspan” stuff and doesn’t belong on the list. (Sleep, eating, exercise, etc.)
But exercise is probably something between these two ones?
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Does anyone have murine model longevity data for either:
“extracellular vesicles” https://www.freethink.com/health/young-blood-transfusions%3Famp=1
Or
Sea squirt plasmalogen
Eating sea squirts reverses signs of ageing in mice – new research
I think we don’t yet have any published data on longevity per se, but presumably studies of being done?
Does anyone have murine model longevity data for either:
“extracellular vesicles” https://www.freethink.com/health/young-blood-transfusions%3Famp=1
You might try asking Collin Ewald (or reviewing his publications)…
https://twitter.com/CollinEwald
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Related, new study:
Aging is associated with an alteration of intercellular communication. These changes in the extracellular environment contribute to the aging phenotype and have been linked to different aging-related diseases. Extracellular vesicles (EVs) are factors that mediate the transmission of signaling molecules between cells. In the aging field, these EVs have been shown to regulate important aging processes, such as oxidative stress or senescence, both in vivo and in vitro. EVs from healthy cells, particularly those coming from stem cells (SCs), have been described as potential effectors of the regenerative potential of SCs. Many studies with different animal models have shown promising results in the field of regenerative medicine. EVs are now viewed as a potential cell-free therapy for tissue damage and several diseases. Here we propose EVs as regulators of the aging process, with an important role in tissue regeneration and a raising therapy for age-related diseases.
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@Krister_Kauppi I really like this thread, thanks for starting it. I know you are hyper focused on longevity, as you should, but how do we account for the quality of life or health span balance when we talk about this subject? Are they two separate subjects or just assumed we are talking about both? Hormone replacement would be a good example of health span improvement and probably no to negative data on longevity. I am not trying to change the focus, just a comment:)
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They are both the same thing, you can’t extend your lifespan without increasing your healthspan also. There was a good podcast where Richard Miller, head of the NIA ITP program discussed this - I think it was in the Peter Attia podcast if you want to listen to it. In it he says the whole debate about whether to focus on healthspan vs. lifespan is a false dichotomy. They are one and the same. In all the lifespan research they’ve done they cannot increase the lifespan without increasing the healthspan.
I think it was this podcast:
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I don’t think exercise belongs in the longevity column at all, because it doesn’t extend maximum possible human lifespan. It belongs in the “healthspan” category.
Another way of looking at it: a perfect exercise regiment might allow someone to live into their 90’s . . . but it isn’t going to be the thing that pushes them beyond the already-established maximum natural lifespan of a human.
I’m also no expert and could very well not know what the heck I’m talking about. 
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Thank you. I will listen to it.
I understand the spirit of the point you are making through the scope of this site and passion of what we are all hoping achieve. In medicine, we have made great strides in improving longevity without improving healthspan. We have some of the most unhealthy people living longer than in previous generations. With the right medications and modalities we can keep hearts pumping, lungs breathing and systems flushing all to increase our longevity number without improving our healthspan. I agree that longevity and healthspan can be interconnected, but not in all cases and sometimes we pick one over the other.
From my memory, you decided that since testosterone did not have enough data on longevity that you opted not to include it in your own regimen. Many of the members here that agree with you on the longevity data and testosterone still take it to affect their healthspan. I think exercise will ultimately help improve longevity, but agree with @Krister_Kauppi that the data is currently lacking on a direct cause and effect.
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The first important thing everyone should do when it comes to longevity is to specify their goal. Longevity can for example be to live a healthy and good life with not so big life extension with a average length or little bit longer than the average length. Longevity can also mean radical improvement in life extension combined with good health etc. So there are many different types of longevity goals out there and this makes it hard to discuss things sometimes when we don’t first understand what the person has as a goal.
But as I see it healthspan and quality of life go quite good hand in hand with living over 100 years or radical lifespan extension. But there are interventions that only for example promote healthspan and guality of life and not so much that you will live over 100 years. And vice versa. So the interventions that I’m very interested about is the ones that makes me live extra long. I can sacrifice lite bit quality of life for achieving this. One simple example about this. When I for example met with Wim Hof (the ice man). He said that everyone hates the cold. Even him. So what does this mean? It means that in the moment of cold exposure the quality of life is not high. The same thing can be with different longevity interventions that people practice. It’s not fun to restrict calories often and do for example a extended fast for several days etc. The important thing is to find the level that fits you.
That was some quick thoughts in the topic. How do you view it?
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Yes, I fully agree, there are different buckets. I will try to create a image over this because it’s a important topic to get clarify 
I agree! I guess my long winded point was to consider adding a top 4 health span list that may not have evidence of longevity, but many people have found valuable in their journey.
@Krister_Kauppi - My list of 4 longevity - CR, Rapa, Acrobose/ Metformin, alpha-estradiol for men.
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“Can’t extend healthspan without extending longevity” is certainly the ITP view. An alternative view undercuts his work to some extent. But that is not a universally accepted view. I know Mayo had a study (dealing with reducing senescent cells?) in 2017 where the median lifespan was increased but the lifespan of the mice was not increased.
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Actually - I think Richard Miller said something similar but that “you can’t extend longevity without extending healthspan” - meaning that all the agents / drugs that extend lifespan also increase healthspan.
I think that the opposite is not necessarily all true - i.e. that all agents that increase healthspan don’t necessarily increase healthspan.
I think there are lots of agents that do increase healthspan - e.g. reducing risk of cancer, eg. for nrf2 promoters like sprouts, etc…
And yes - you are right, senolytics have in studies increased healthspan, but not lifespan.
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2 therapies I am intensely interested in for healthy longevity (but no studies on increasing maximum lifespan) are:
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Maintaining a healthy gut microbiome. I’ve written a paper titled The Microbiome Theory of Aging (currently in review for publication). To learn more, read my paper titled: Postbiotic Metabolites: The New Frontier in Microbiome Science, which can be found by searching for the terms PELTON TOWNSEND POSTBIOTIC. Also, here is a link for a free copy of a booklet I wrote titled: Dr. Ohhira’s Probiotics and Postbiotic Metabolites. Probiotics & Postbiotic Metabolites | Ross Pelton | The Natural Pharmacist
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PULSED ELECTRO-MAGNETIC FREQUENCY therapies. PEMF dramatically increase circulation in the 70,000 miles of micro-capillaries throughout the body and result in a substantial increase in mitochondrial ATP production. Dr. Kunlin Jin proposed The Microcirculatory Theory of Aging, which explains why improving microvascular circulation is critical for healthy longevity. Many PEMF devices are on the market. I own and recommend the BEMER brand. For more information about PEMF and BEMER, send an email request to me at: rosspelton70@gmail.com
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