There’s plenty of hard longevity strategies, those with fewer expected benefits, and those that require more effort or money. What would be your bare minimum longevity strategy that almost everyone will benefit from? For me it would be taking a cholesterol lowering medication.
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Exercise–At least 3 or 4 times a week depending on your normal level of activity. Expensive for the rich, but I think it pays back in many ways.
Vitamin D–Should test, also should use a Sperti lamp, but get into the high 40’s at least.
Avoid–smoking, alcohol, and sweets. Also fast, it helps to understand that your body can take it. You don’t need to eat if you’re fat.
On Cholesterol-- I just got my numbers back from the blood draw Dec 19. Lowest LDL ever tested in me and I was not that careful, even cut way down on my Niacin. What I did was alpha cyclodextrin before each meal. Maybe 9 cents worth. This is really easy to do and seems to work. N=1.
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You can save a surprising amount of money on food if you minmax for macros, micros and enough calories to keep your BMI between 18.5 and 20.
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FWIW
“Randomized double blind clinical trial on the effect of oral α-cyclodextrin on serum lipids”
6g per day was used in the above posted study
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Ok, I just rechecked remeasured the amount I was taking and it was only 2.2 grams per meal. That’s short. I’ll take 2 each meal from now on, I’ve had absolutely no side effects from this. It’s rare to find something that can get rid of the s LDL without wiping out all the LDL.
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Since you already have a CAC score above 0, wouldn’t it be more prudent to concentrate on driving your apoB and other risk factors to 0?
How much did your LDL decrease?
On 9-18…
HDL 78
LDL189
tg 82
On 12 19…
HDL 89
LDL 115
tg 75
also this was a more expensive test, so
sLDL 313
Apo B 90
I was really only on the cyclodextrin for a month or so.
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First, the common sense ones - within your own personal constraints, do your best to optimize (and at least meet the minimums) for sleep, exercise (cardio and resistance) and diet, minimize stress and test - blood pressure, blood tests. Focus on the basics, like the causes of metabolic syndrome - so - lipids, blood sugar and insulin resistance, blood pressure, BMI and inflammation (HsCRP). Then monitor and prioritize, work on anything outside the normal range and get it as optimal as is practical. Regular blood tests and watching your blood pressure tell you most of what you need to know, then good sleep and exercise…don’t get fat…and you’re 90% of the way.
For blood test markers, ApoB, HbA1c, HsCRP and then look at the Levine PhenoAge Calculator for what’s worth optimizing.
It’s not rocket science til you get to rapamycin… 
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@ng0rge Is quite right. I’ll just add on the next step which would be to control your biomarkers through proper medication. Some top longevity prescription medications you may consider are:
- Rapamycin
- Bempedoic Acid (or statins) + Ezetemibe for lipid control and CVD prevention
- SGLTi (Empagliflozin, etc…) for glucose control and longevity
- ARB (Telmisartan, etc…) for BP control and cognitive decline prevention
- Acarbose/Metformin for glucose control and synergistic effects with Rapamycin
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You’ve done a great job optimizing your markers and I’m working on the same. I have my rapamycin and acarbose but I need one more blood test before I start. The big thing I learned here is the importance of blood testing (and testing in general) to show you what goals to set. I wouldn’t have known about Lp(a) and that turned out to be my Achilles heel. My other markers were, not perfect, but normal, healthy. So, testing and correcting is my number one intervention. I come from an anti-pharma (alternative healthcare) background and have always been lean, active and healthy, avoiding taking even so much as an aspirin. But when I turned 70, I realized that it was a whole new ballgame, I started researching online and came around to the idea of trying metformin. Now I’ve just added atorvastatin and ezetimibe and have rapamycin on deck. But I can’t quite get away from what I learned from big media in the 60s - take one puff of marijuana and next thing you know, you’re a heroin addict. I’m on the slippery slope and headed downhill fast.
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I would try and get a PCSK9i and nuke that Lp(a) and apoB from orbit.
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You might be right and it’s not out of the question. I’m going one step at a time. I’ll do another blood test in 2 weeks and see. I’m also looking around for a CAC test and/or a CIMT test, as they would show the actual problem (plaque).
But just like the heroin problem above, injections really scare me, so that may be a bridge too far (like having a cage of tarantulas attached to my face).
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I use Repatha. The auto injector is super easy. Does not feel like an injection. Super quick. No pain. You don’t even really see any needle.
Does it feel like a tarantula bite? (on the face?)
PS - How’s your treatment going? Have you tested again for Lp(a)? and other lipids? And why haven’t you started rapamycin?
Praluent decrease ACM post-hoc, any reason for choosing repatha over it?
Did you notice any change in your blood glucose? My insurance approved me for Repatha but I’m afraid to try.
Haha. No, you seriously hardly feel it.
Doing bloodwork soon around Lp(a), Apo B and some of the advanced cardio related oxidation markers, so should know more in a few weeks.
It’s seemed better in some of the other metrics, but generally quite similar and cardiologist suggested we start with it.
At some point when I have time the next year or so, will get my head around all the latest and greatest on the data and decide whether to keep or switch and then will do so every two-three years (depending on what happens with other Apo B and Lp(a) meds too)
You could try at a half dose and monitor it carefully with blood work (and perhaps CGM).
My [Edit:] HbA1c is up slightly from 4.9ish to 5.2. Could perhaps also be that I’ve been doing a bit less cardio training and more resistance training where the former depleted glucose stores more I think.
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