Which Longevity Protocol Wins? Lifestyle vs Medicine vs Biohacking

Hey, welcome back to the channel. Today we have a special video. I'm going to be ranking things in Matt Kaberlein's longevity bracket, where you have different interventions listed out. They compete with each other and we see which one comes out on top. So here's what it looks like. We have a total of 64 different interventions and yeah, they're going to be competing with each other. You can also vote. You can also follow through this same bracket. I'm just recording it for the channel, giving my own thoughts and opinions about it, give some commentary about this. So yeah, I'll put the link in the description where you can fill it out yourself. So without further ado, let's get started with the lifestyle bracket. Essentially things related to more lifestyle. And here we have not smoking versus the Italian grandpa lifestyle. Actually, I was one of the committee to submit these interventions and I submitted the Italian grandpa lifestyle, inspired by this meme online about the Italian grandpa who smokes and doesn't do anything for his health and lives a long time. I actually made a video about it as well, looking at the evidence to those claims. And the truth is that the Italian grandpa who doesn't take care of his health, who smokes, who doesn't exercise, eats a regular diet, they might live to the age of, let's say, low 80s, 82, 85, if they're healthy. But it's a myth that they actually live to the age of 100 without doing anything. The amount of people who live to the age of 100 while smoking is extremely small. There's only like 1% of the Sardinian centenarians who are actually active smokers. So there's a lot of misconception about this style of living. And if you compare it to not smoking at all, then for sure not smoking is significantly more important to your overall health when it comes to longevity. Next, we have sleep optimization and a high fiber diet, 25-30 grams a day. Now, sleep optimization can mean a lot of things. It's beyond just the regular basics of sleep, beyond the record of sleeping seven to eight hours. Sleep optimization is more about tracking your sleep, using different supplements to improve your sleep, trying to get basically 100 sleep score with your sleep tracker. And I think that sleep is something that you don't need to have 100% optimized. There's no linear benefits to that. You need to have, yeah, the seven to eight hours of sleep, consistency with your sleep cycles, sufficient amount of deep and REM sleep, not waking up several times throughout the night. So beyond just healthy sleep, sleep optimization itself has little to no evidence that it would be actually more important. Whereas a high fiber diet, I'm going to put high fiber here because people will benefit a lot more from a higher fiber intake compared to trying to get 100% sleep score, for example, based on the evidence. Next, social connections and abstinence from alcohol. I'll say social connections. So based on the evidence, you don't need to be 0% alcohol or zero alcohol intake. Closer to zero is better than moderate alcohol consumption based on the evidence. But let's say if you drink a few drinks per week, not more than two drinks per night, then that your liver can handle and your body can also recover from. So there's a certain amount of unhealthy things your body can do within a 24-hour period or within a week without harming your health. And alcohol is one of those things. Whereas with social connections, that is actually one of the more consistent findings about longevity, that people who live longer have healthy social connections and good relationships. Next, healthy body composition slash low visceral fat or plyometrics training. Now, plyometrics training is super underrated when it comes to health or living longer. Because with age, you see a disproportionately bigger decline in vastic muscle fibers. So you become slower. Older people are very rigid and slow, not only with less muscle, but also in terms of speed. So it is super important to do some form of plyometrics training. I think it's very underrated. But if you compare it to healthy body composition, which is having lower body fat, especially lower visceral fat, then this obviously is a lot more important in terms of the hierarchy. So I'm going to put healthy body comp here. Next, VO2max optimization or HIIT and a sense of purpose. Now, this is also kind of interesting matchup, since trying to optimize your HIIT can be a sense of purpose in terms of having certain goals and trying to pursue those goals, if you have certain VO2max goals. But again, yeah, looking at the broader evidence, then people with a sense of purpose, with a meaning behind their life, they tend to live longer. And it's very interesting that it appears to be something like top-down that with a sense of purpose, your brain is more motivated to do healthy things and follow healthier habits as well. Of course, if you are trying to optimize your VO2max, then you're also doing other things probably to improve your health, because to have the best VO2max, you need to be lower body weight, eat a healthier diet, sleep enough, etc. But I'll put sense of purpose here for the sake of this bracket. Obviously, both can be important, but it appears the sense of purpose over the course of decades is a bit more important. Mediterranean-style diet versus keto diet, I think there's no argument about that. The Mediterranean-style diet tends to be with more evidence, and I think most people will see better blood work as well on the Mediterranean diet. High-quality nutrition versus zone 2 training. Overall, nutrition is more important compared to regular zone 2 training. You can get away with not doing zone 2 training, but if you're at least eating a decent diet, you don't need to be 100% perfect with your diet, but at least a decent diet, you'll harm your health. And lastly here, we have strength training versus moderate alcohol consumption. I think, again, strength training is by far more important to do rather than being a zero alcohol, if that makes sense. You can be otherwise healthy, and if you don't drink more than two drinks per week, in my opinion, then you can maintain pretty good health and longevity. But if you don't do strength training, then you're going to pretty much wither away eventually. All right, so now moving up with the brackets, we're heading towards the semifinals soon. So, not smoking versus a high-fiber diet. That's kind of an interesting match-up. I would say not smoking is a lot more important than a high-fiber diet, although if you're smoking and you eat a high-fiber diet, you're probably going to have slightly better health outcomes than smoking and not eating a high-fiber diet. I just don't think that it's going to make up for smoking overall. Then we have social connections and a healthy body composition. Now, this can be quite conflicting in a sense. Could you be a gym cell completely obsessed bodybuilder with perfect physique and low visceral fat, but at the same time with bad social connections, suffering from depression or loneliness, etc.? So I think comparing healthy body composition and social connections is very tricky. First of all, there are some older individuals who do develop unhealthier body compositions. They can still live quite a longer time, but at the same time, we all know a jolly uncle or jolly grandfather who's happy with the life of the party, but they still get a heart attack in their 60s or 70s. So no one is immune to a heart attack if you have a bad body composition, but at the same time, no one is also immune to the negative consequences of social isolation and loneliness, no matter how introverted or independent someone thinks they are. So I'll put social connections here just because empirically, or at least I think subjectively, people would see the opposite, that people with good healthy connections tend to fare a little bit better. With healthy body composition at the older ages, it does appear that being slightly chunkier does protect against falls to a certain extent, but that's because people don't have muscle. So the extra body fat is acting like an extra cushion, which people with muscle wouldn't need, if that makes sense. If you have good muscle, then you don't need extra body fat, even at the elderly age, but if you don't have the muscle, the extra body fat does appear to protect something. Next, we have sense of purpose and Mediterranean diet. Well, I mean, you don't need an exclusive Mediterranean diet to live a longer time, or that's not the only diet you can follow. It appears to have the most evidence and it's a safe bet to follow, but you can follow an Okinawan diet, a Japanese diet. There's a Nordic diet that's becoming popular with a lot of seafood and whole grains. So, yeah, I mean, you can structure different diets. So I'll put the sense of purpose instead of the diet. And high-quality nutrition and strength training, I'll put strength training, because with strength training, you can also get a lot of leeway with your nutrition. If you're exercising, you have muscle, you lift weights, then you don't need to be as strict with your diet, because you'll have better body composition, just thanks to the training. You have better insulin sensitivity, better blood sugar regulation, so you can eat a little bit of lower-quality diet and not suffer in terms of your body composition and your metabolic health. So strength training definitely makes it easier to stay healthier with regards to your blood markers and body composition. And now the winners of this bracket, the lifestyle bracket, what's the best lifestyle interventions? Not smoking versus social connections. Well, I'll say social connections or, I mean, yeah, I mean, if you smoke, but you're hanging out with friends and family, I mean, you'll still get cancer and get a heart attack, right? So I'll put not smoking. That's, for sure, a lot more important in my opinion. A sense of purpose and strength training. So I'll put a sense of purpose here. I think that's a bit more important than a strength training component, although doing strength training, it can be a subcategory of having a purpose, right? You're trying to get stronger and increase your lifts or something like that. All right, before I actually compare these two, I'm going to finish the other brackets first, so we'll get a final showdown of the half finals. I want to take a quick break to invite you to my online community, Youthspan Society. Youthspan Society is a longevity community on school, and it's the place to be if you want to keep learning from me and hang out with other people who are interested in extending their lifespan and anti-aging. We have over 10 courses in the library about things like VF2Max, strength, liver health, visceral fat, sleep, HIV, as well as skin anti-aging, nutrition, and fat loss. More courses and masterclasses will be added throughout the year. Each course breaks down the topic into actionable steps and outlines the optimal range for dozens of biomarkers. The community also has weekly live group calls, and you can just post things on the dashboard for me and everyone else to respond to. Don't know where to start? Start with the 7-day longevity kickstart challenge, and then move on with the 30-day one. All of that for $0.60 per day for the standard membership or $1.30 if you opt for the premium. You can also start off with a 7-day free trial to see if it's a good fit for you or not. Link in the description. Moving on with the medicine bracket, so things related to certain medications and pharmaceuticals. First, we have blood pressure optimization and B-complex optimization. Out of blood pressure and B vitamin status, I think blood pressure is significantly more important. Hypertension accelerates brain aging. It increases risk of heart disease, one of the biggest risk factors for heart disease, kidney disease as well. For sure, keeping your blood pressure in check is more important than supporting methylation, although it's important, but it's not as important as the blood pressure. PCSK9 inhibitors versus metformin. PCSK9 inhibitors are a lipid lowering drug and they target LpA, which is the only drug that reliably lowers LpA, so that can be pretty important for cardiovascular disease risk reduction. Metformin is a diabetes drug and also appears to lower risk of cancer and heart disease in diabetics, so I think metformin is the obvious winner here. It has a lot longer track record. It's more wider in terms of the effect, so I'll put metformin here. SGLD2 inhibitors versus male hormone optimization. SGLD2 inhibitors being diabetes drugs and they are actually better than metformin. They have fewer side effects and they don't appear to lower testosterone, unlike metformin, for example. It's actually an interesting matchup with male hormone optimization. Male hormone optimization being things like taking some testosterone boosters, like Tongkat Ali, maybe taking TRT, hormone replacement therapy, and trying to make sure that your testosterone is on the upper higher end of the reference range, for example. This question doesn't address women, obviously, but I would say male hormone, for general health purposes, is more important. If you optimize your hormones, which entails doing some sort of exercise and keeping your body fat slightly lower, then you don't inherently need SGLD2 inhibitors. Next, we have maintaining oral health and bisphenates. Bisphenates are drugs that help to slow down bone loss. With oral health, there is an interesting relationship between your Alzheimer's risk and other heart disease risk as well. The mouth bacteria, as well as your teeth, they are influencing the rest of the body, especially can cause systemic inflammation. I'll put oral health. I think that's more important than drugs for bone loss. Next, we have GLP-1 agonists and low-dose aspirin. Aspirin is not effective for primary prevention of heart disease, but it is effective for secondary prevention, so people who already have had heart disease or heart attack, for them, it can be useful, but it's not effective as primary, so complete prevention. It has some side effects for increased risk of bleeding, so for elderly people, they need to be especially careful with that. Low-dose aspirin typically doesn't come with that increased risk or that not as big of a risk, whereas GLP-1s, they do have some side effects, but they have broader systemic health benefits, reduced body fat, better metabolic health, et cetera. I'll put GLP-1s here because they're just more effective as pharmaceuticals. Female hormone optimization and PDE5 inhibitors, an interesting matchup since PDE5 inhibitors, they're used for erectile dysfunction and sexual health for elderly men, but there's this research that they could also be good for cardiovascular benefits, and using these PDE5 inhibitors is associated with lower risk of Alzheimer's and heart disease, but for females, female hormone optimization is quite important because after menopause, they have significantly lower estrogen, pretty much close to zero, and that increases risk of heart disease. After menopause, it increases risk of frailty, bone loss, and there's this interesting research recently that hypothesizes that one of the reasons women have higher Alzheimer's, independent of the fact that they just live longer, there is the element of the loss of estrogen that increases the risk of Alzheimer's. Vitamin D optimization versus proactive healthcare. Well, proactive healthcare obviously entails optimizing your vitamin D as well to a certain extent, and vitamin D is just a single component to this. Next, we have vaccination versus captopril, so blood pressure medication. Now, of course, this can be very controversial. It's a very interesting matchup. For elderly people, they have very poor immune system. They see immunosenescence, and in the context of that longevity, the vaccination does help with their risk of infections, etc., reducing at least the risk of common cold. Other viruses, more like these traditional vaccinations, routine vaccinations, captopril, blood pressure medication. As we said, blood pressure is quite important. Now, it doesn't matter what I actually write here because proactive healthcare is the opponent in the next round. Proactive healthcare immediately will beat both of these things, so it doesn't really matter what I say here. We can put either vaccination is context-dependent or the captopril is context-dependent. Vaccination is broader use for elderly people, quite useful, but it doesn't matter because I'll put proactive healthcare here anyway. It's better than both of them. Next bracket, blood pressure versus metformin. I would say metformin has broader use case and targets overall metabolic health. By doing that, you can also improve blood pressure, whereas with blood pressure optimization, there can be some side effects. Very low blood pressure can increase the risk of falls in elderly people. The blood pressure medications are with quite a few side effects compared to metformin, which isn't side effect-free, but it is a bit more smaller side effects. Then we have male hormone optimization and oral health. I'll put male hormone optimization here over oral health. Actually, I'll put oral health because I think that appears to be more bigger of a driver of long-term risk of Alzheimer's than hormone optimization. Yes, with poor hormones, male hormones, low testosterone, you can experience higher risk of body fat and higher risk of other health ailments, frailty, low muscle mass, etc., but testosterone is not a pro-longevity hormone that much. It doesn't appear to make men live that much longer, and other androgens appear to shorten male life expectancy. I wouldn't say that it's the absolute biggest importance to try to min-max your testosterone and androgens. But GLP-1s and female hormones are just that big of more powerful of drugs, and that has a bigger long-term effect in terms of when we're talking about body fat and metabolic health. What's going to win here? Is it metformin and oral health? I would put oral health. Yeah, quite interesting, actually. I think maintaining good oral health, flossing, just not eating foods that disrupt the oral microbiome, things that would lead to bleeding gums, etc. Those things have quite an interesting direct relationship with inflammation in the brain, neuroinflammation, and systemic inflammation throughout the body. So definitely important to keep your oral health in check. Here, GLP-1s versus proactive health care, I'll put proactive health care. This involves things like taking regular blood work, preemptively taking care of your health before you get sick, and preemptively tracking things to a reasonable degree. So you can consider it like a medium-tier biohacker approach, or a health enthusiast approach, or a healthy user bias type of approach. All right, which one's going to win here? I'll do those brackets later once we finish the other two. All right, moving on with the geroscience bracket. So science of biological aging and longevity. Calorestriction slash intermittent fasting versus GSK2126458. So this is an experimental mTOR inhibitor that was the most potent lifespan extending molecule in the Ouro Biomedical's One Million Molecule Challenge, where I had a podcast with Dr. Ben Blue as well, and we discussed. So this is the molecule that had the longest life extension in these roundworms. So a very experimental model, obviously doesn't necessarily apply to humans yet. But yeah, apparently it's more potent than rapamycin in inhibiting mTOR and extending lifespan in the roundworms, at least. So compared to calorestriction, I'll put for humans, I think there's more evidence for calorestriction at the moment. And you could be taking an mTOR inhibitor, but if you're overweight, then it's not going to be that impactful. Spermidine versus epigenetic reprogramming. Well, the evidence for spermidine is quite weak, especially in human research. So I'll put the epigenetic reprogramming. So this is the Yamanaka factors. It's been shown to reverse aging and extend lifespan in experimental models. In humans, it's not yet available, but it is a bit more promising compared to spermidine, which is just like a generic supplement and with very weak evidence for any health benefits in humans. Alpha-ketoglutarate and glycine, I'll put glycine. So glycine, both have been seen to extend lifespan in mice. With alpha-ketoglutarate, it actually is a bit bigger effect than glycine, but glycine has more consistent evidence. There's more evidence that it has lifespan extending effects. And it plus has a lot of other auxiliary benefits like metabolic health, lower blood sugar, collagen synthesis, sleep, liver health, visceral fat. So with alpha-ketoglutarate, it's not there. There's very little evidence in humans or very few clinical trials in humans. There's some bone density studies with calcium alpha-ketoglutarate and some wound healing studies, but no other clinical trials. Parabiosis TPE, so total plasma exchange, this is the newest trendy thing in this longevity biohacking scene, where you exchange your plasma and parabiosis is the idea of exchanging blood, so getting young blood. There's some of these mice studies where the parabiosis, they connect the older mouse to the younger mouse with a circulatory system and the older mice appear to get healthier from the younger mice blood, which sounds like a sci-fi story, but in animals it does work. At least there's some evidence there for it. With a total plasma exchange, it's a bit of a weaker evidence for humans, but arguably it helps to take out toxins from the plasma. I'm just interested that the parabiosis probably has a bigger effect on human longevity than the total plasma exchange, in my opinion, although both haven't been studied that extensively in humans. Their matchup is astaxanthin. It's an unfair matchup since astaxanthin is just a supplement and the parabiosis probably has greater effects, at least it has been done so in the mice. Astaxanthin also has mice life extension data, but it's just a generic supplement, it can only take you so far. So I'll put parabiosis here. I think out of the TB, then parabiosis could have bigger potential. ACCARBOS, which is a diabetes drug and IL-11 inhibition, so IL-11 inflammatory molecule and pretty much using a drug to suppress the inflammation. Now, of course, both can have some benefits, but out of the research, then ACCARBOS has a lot more research compared to IL-11 inhibition. That's a tinib plus quercetin and TRMM protocol with human growth hormone. So the TRMM protocol is an experimental protocol that has been used in humans to rejuvenate the thymus gland, which controls your immune system, and with age the thymus shrinks. So supposedly using this growth hormone will help to rejuvenate the thymus gland. I think so far the evidence hasn't shown that it does so, and it has growth hormone, DHEA, and metformin. So metformin is there to counteract the increased blood sugar from growth hormone or the increased insulin resistance from chronic growth hormone use. So I mean, it's a very interesting and possibly could work, but currently I think the evidence is very limited. It would work. Dasatinib and quercetin are senolytics in mice. They've shown life extension data. They're not the most potent senolytics. Fisetin, I think, has the biggest life extension effects in animals, but dasatinib and quercetin are the most common senolytics, and there's no human clinical trials on these senolytics yet either. So yeah, I mean, both are kind of in an equal footing in terms of the hallmarks. If you look at the geroscience perspective, what is more important, clearing out these senolytic zombie cells or helping to rejuvenate the thymus gland, then arguably if we were to fix, if we were to be able to rejuvenate the thymus gland, that would have a bigger dent on human lifespan than the senolytics, I think. Because yeah, it's a big concern. It's a big issue that the thymus gland shrinks during aging, and that's the reason why older people have weaker immune system. That's a big part of it. So yeah, I mean, I'll put the senolytics because I think the senolytics target the broader aspect of biological aging. So if you potentially slow down biological aging before you experience the thymus gland shrinkage, I mean, it's going to happen quite early in life already, slowly, over time. But if you can put a slowdown to that, then that could be quite impactful. But yeah, I'll put senolytics in this matchup. Next, urolithin A and NAD precursors like NR and NMN, definitely NAD precursors, because urolithin A has quite a weak evidence, especially the mitopure studies on humans. They're very misleading, in my opinion, plus the effects are very small. With NAD precursors, NR and NMN, the effects are also quite small. They're not massive. But the idea of upregulating NAD in the context of biological aging, I think, is more impactful than urolithin A, which, yes, it could upregulate the process of mitophagy, the mitochondrial clearance of old, worn-out mitochondria through autology. But the evidence that it would do so is quite limited in humans, whereas there's plenty of evidence that NAD precursors do raise NAD in humans. Plus, they have some other benefits, mostly lower inflammation and some possible metabolic health benefits and exercise performance benefits. But the effects are quite small in that area. But the same with urolithin A, the fitness benefits are very small and very inconsistent. The last matchup of here is rapamycin and cerebrolysin. Rapamycin being the most famous longevity drug in history, the most consistently been shown to extend lifespan in animals. It's used in organ transplantation patients to suppress the immune system. But they use it differently there. They use it chronically for a short period of time, whereas in the longevity space, people microdose or take smaller doses of rapamycin and they don't take it all the time to avoid the chronic suppression of the immune system. And the cerebrolysin is a peptide that has brain benefits. There's a few human trials on cerebrolysin, if I'm not mistaken. So there's that advantage. Personally, if I had to choose right now, which one would I take right now? I would take right now cerebrolysin because in my current stage of age and health, I would be more interested in preserving the brain health due to the limited research, human research on rapamycin. I would be interested in seeing the results from the dog aging studies where they use rapamycin and see what the effects are there. That would inform me if I'm going to give my own dog rapamycin, possibly me as well. That will influence my decision moving forward, but I don't necessarily need the rapamycin right now. So cerebrolysin versus rapamycin. For most people, cerebrolysin probably has a bit more meaning in the current situation. Unless you are someone who is very old, then the rapamycin could also be a reasonable choice. But looking at the other comparisons, I think it doesn't really matter which one I take because I'm predicting the calorie restriction probably will be the winner of this bracket here. So I guess we'll move on with the quarterfinals, calorie restriction versus epigenetic reprogramming. I'll put good old calorie restriction since it's just related to lifestyle. There's very little evidence for epigenetic reprogramming right now. And calorie restriction, we know it works. So of course, there's the caveat that excessive calorie restriction, if you get frail, if you become malnourished, yes, that can shorten your life. But calorie restriction without malnutrition, without sarcopenia, without frailty is definitely very powerful for healthy aging. So making sure that you're slightly on the lower body fat side with adequate muscle and adequate strength and otherwise good health and nutrition status. Glycine versus parabiosis. So I'll put glycine because I think glycine, it's a safer bet and more consistent research than the parabiosis, although the effect size from parabiosis could potentially be higher. But I wouldn't say no to this 5% life extension from glycine, as you see from some of these mouse studies. Akkarbose versus endolytics. I'll put Akkarbose. So way more research, way more meaningful target as well, which is the metabolic health. Energy precursors versus cerebroglycine. Probably cerebroglycine because, yeah, as I said, the effect size from energy precursors is quite small. Yeah. All right. So these are the winners of the Geroscience. We'll do the half finals soon. And the final bracket of the showdown is the biohacking bracket. We have optimization of metabolic health versus circadian rhythm optimization. So I think metabolic health is more important. Obviously, both are super important. But let's say if you have shift work, then you're not going to be optimizing your circadian rhythm that much. But if you optimize your metabolic health, you're going to be better off still than not optimizing it. So I think the metabolic health in terms of the hierarchy is more important. Although, if you optimize your circadian rhythms, your metabolic health could also improve. It's just that if you're overweight, but you sleep well, you have perfect circadian rhythms, then it's not going to save you from being obese, if that makes sense. High quality multivitamin versus psilocybin. I'll put multivitamin just to cover the essential vitamins and minerals. HRV optimization versus healthy processed food. I think healthy processed food is processed food that is otherwise with good ingredients, good macros, good micros. So healthy protein bar, healthy protein powder. Now, I'm going to say HRV optimization is more important because that involves exercise, that involves sleeping well, stress management, etc. Yeah, but the healthy processed food concept just means that it doesn't have extra added sugars, extra added fats, doesn't have any sketchy ingredients. Sona versus Brian Johnson's blueprint. So again, this is a bit of an unfair matchup since Brian Johnson's blueprint involves sleep, diet, exercise. I think he also does Sona. So it's an unfair matchup in that sense. But because I want to make it a fairer matchup, I'll say Brian Johnson's blueprint in the sense that being, I guess, more very diligent and strict with your lifestyle, pretty much follow the opposite of the Italian grandpa lifestyle, as you remember from my video. There's the spectrum. On one end, you have the very health-obsessed biohacker, which Brian Johnson can represent in this scenario. And on the other hand, you have the life burner who just drinks and does alcohol. The Italian grandpa is somewhere in the middle. And Brian Johnson, on the other hand, I don't think you need to be the Brian Johnson to have good health and longevity. It's more about just getting 80% of the things right, maybe 90%, 95% or something. You don't need 100% optimization. But I still think that Brian Johnson's blueprint will be winning over the regular Sona just because of the idea of trying to optimize things a bit more than just beyond the regular Sona. Next, we have regular sexual activity and hyperbaric oxygen chamber. Regular sexual activity is, I think, more important for sure. It's good cardiovascular exercise plus the emotional and mental health component and the social connections as well, which we discussed earlier. Creatine versus blood filtration atheresis. Blood filtration is different from the total plasma exchange. Plasma exchange, you exchange a plasma with a blood filtration and atheresis, you filter the blood. So you shoot it through a filter, you take out the blood, you shoot it through a filter, you get the purified blood back in. So that could have quite significant health benefits, especially in the modern world with exposure to toxins, etc. So you remove heavy metals, different pathogens, microplastics etc. Whereas a creatine is a very generic supplement. I don't think it has any lifespan data from animals either, so it's not going to make you live longer. It can only improve your fitness and strength and body composition. Next, environmental toxin avoidance versus clotho gene therapy. Clotho gene therapy being for Alzheimer's and dementia risk. There's some potential there versus environmental toxin avoidance. So this is not drinking from a plastic bottle, filtering your air, filtering your water. Of course, you can take it to extreme, you can wear a face mask outside to avoid air pollution, etc. I don't know exactly how extreme you would go with it, but just the basic environmental toxin avoidance, not drinking from plastics, water filtration, reverse osmosis water filter, air purifier, not having plastic bed sheets made with polyester, etc. So not living next to a factory with heavy metals in the air. So I'll put toxin avoidance compared to the clotho gene therapy, which is still quite experimental or new. Omega-3 optimization versus NAD sublingual. So omega-3, way more evidence that it works, way more important as well than NAD. There you go. Next, we have metabolic health versus multivitamin. Metabolic health by far more important. HRV optimization versus blueprint. Yeah, so in my video with Matt, I said blueprint would win this because blueprint involves trying to optimize HRV. But as I understand, Brian's own HRV isn't that excellent. It's not bad, but it's not optimized or it could be better, which is interesting because stress and anxiety does lower HRV. So if you are worried too much about trying to optimize your HRV, then it could backfire in that sense. But I think blueprint involving more things than the HRV, you shouldn't get obsessed with the HRV because it's only one marker and it's not the most important biomarker to get obsessed about. So I put blueprint because with blueprint, you're probably focused on a lot of other biomarkers that matter a bit more than HRV. Name your favorite blood marker that could potentially be more relevant than HRV. Regular sex versus blood filtration, I would say regular sex is more important. So with a toxin exposure, you can get very neurotic about it. You can get very obsessed with avoiding toxins and trying to filter the blood. But how bad they really are is to be determined. So I think, yes, you should try to minimize your exposure, but you shouldn't. Most people don't probably need to filter their blood on a regular basis unless you're going more towards this hyper optimization route of things. Whereas with regular sex, you get a lot of these other mental health benefits. Toxin avoidance and omega-3s, I would say toxin avoidance is probably a bit more important than omega-3s. Although omega-3s, there is some research that smokers with a higher omega-3 index have lower mortality than smokers with a low omega-3 index. So omega-3s could potentially make up for some unhealthy habits and unhealthy, I guess, activities. Smoking being also a form of toxin exposure. But yeah, I mean, it wouldn't really matter because the regular sex would win both of these. Regular sex would win the toxin avoidance and omega-3s, in my opinion. So yeah, there we go. All right, so now we're heading into the final brackets. Who's going to win out of these eight? First up, we have not smoking versus a sense of purpose. Now, I think not smoking is way more important than the sense of purpose. You'll hear some anecdotal stories of people who smoke and live to 100, but it's a very small minority. It's a 1% chance pretty much for people who live to the age of 100 to be smokers. And no amount of purpose, having any purpose, is going to overcome that risk. It's definitely one of the more important things. Oral health versus proactive healthcare. I think proactive healthcare is way more impactful since it targets many systems. And yeah, it is going to be also involving some aspect of oral health optimization and going to the dentist on a regular basis. Next, we have calorie restriction versus a carbos. I think calorie restriction is more impactful. First of all, calorie restriction has been seen to extend lifespan more in animals than a carbos. And yeah, that's pretty much it. And there's also more evidence in humans, in otherwise healthy humans or slightly overweight humans, to improve certain blood markers. Blueprint versus regular sex. I guess many people would consider these things to be on the opposite side of things because being hyper-focused on your biomarkers, etc., can reduce your success in the daily market or in your marriage life, unless you're married to a health freak or a biohacker, if that makes sense. I mean, you could make it either way. Blueprint could be better in certain situations if you have a decent social life. If you maintain decent social life, then Blueprint is better. I mean, just having regular sex isn't going to be more powerful than making sure that you have good metabolic health and sleep optimization, etc. But the issue is that Blueprint doesn't have evidence that you need to be 100% strict. So we still need to keep in mind the idea that Blueprint, in this context, entails trying to be 100% perfect with your lifestyle, which I don't think is the case that there's evidence for that. So I'll put regular sex here because I think there's more evidence that people with better social relationships and just good mental health and social connections do appear to do better, whereas there's no evidence that having a 100% perfect optimized lifestyle would do better. You could make the argument that, yes, this is better, but we need to frame it within reason that we can't say that Blueprint involves being 80% optimized with your life, because it would be an unfair matchup, if that makes sense. The Blueprint here in this competition has to be that you're trying to get 100% perfect the way Brian Johnson does it. So testing your food for heavy metals before you eat it, making sure that everything is perfect. So that's the context. All right, so these are the winners. Who's going to go into the final round? Not smoking versus proactive health care. Well, arguably, if you smoke but you have good health care, you go to the doctor, you get regular MRIs, you see if you get cancer early, you do colonoscopy or you do blood tests, etc., you're very proactive about your health care, that could be better than not smoking. You can get away with smoking if you're testing things early, cracking things early and intervening early as well, using different medications to counteract smoking risk. But of course, it's a very tight competition. I think that smoking is definitely one of the most important things to avoid, or at least the surest things. It has the biggest likelihood of contributing to your longevity if you avoid smoking. Then calorie restriction and regular sex. Again, kind of opposite ends of the spectrum, since many people would report that they see a loss of libido or loss of sexual desire if they are calorie restricted. And of course, in the extreme examples, you can definitely attest to that. The desire for food is way more important than the desire to reproduce for an organism, if that makes sense. Although the reproductive desire is also quite high up in the list of priorities. But food, air, water, food, those are the most important things for an organism. But we're not talking about starvation or we're not talking about fasting, extended fasting and just not having food, famine. We're not talking about serious famines. Calorie restriction being having slightly lower calorie intake so that you would have better body composition and lower visceral fat, better blood work, those kind of things. So let's say 10 to 15% calorie restriction, moderate calorie restriction without malnutrition, without frailty. So that's the way to do it right in research. So I'll put calorie restriction for that reason. And plus, you can have regular sex while being calorie restricted. So it doesn't entail that you would lose total interest. Otherwise, we wouldn't have any humans at all throughout history since calorie restriction has been the norm throughout human history. And the final matchup is proactive healthcare versus calorie restriction. Which one is more important? I would say proactive healthcare, having good access to medical support, medical services, being able to test things regularly. That is by far, I think, out of all things here, the most important things for the regular person to do. Calorie restriction, from the lifestyle intervention side of things, is the biggest priority for people to follow. So it's not that you need to be on a calorie restriction, it's just that the calorie restriction ends in good metabolic health, lower body fat, lower visceral fat. And it also has the evidence from neuroscience that it actually targets different hallmarks of aging, and it actually extends lifespan. It's actually the longest lifespan extension in animals has been achieved with regular calorie restriction, so the non-genetic lifespan interventions. It has extended lifespan of mice by 65%, which is the longest in history, and it was achieved something like 45 years ago. We haven't had a breakthrough in 45 years in terms of actually extending lifespan in animals beyond the 65%. And it was achieved with good old regular calorie restriction, which just means that you don't want to be obese and you don't want to have even overweight. You don't want to be even overweight. You want to be either normal weight or slightly leaner than that, which you achieve with calorie restriction. Moderate calorie restriction without malnutrition, without frailty. You need to be still doing resistance exercise, and you need to be eating a nutrient-dense diet. You can achieve that with a moderate calorie intake. It doesn't mean that you count calories, but you need to be on the leaner side of things. And the proactive healthcare, having the health insurance is a big part of it. Whenever you get an emergency accident, you have good health insurance that's going to save your life. People died to bacterial infections on a regular basis even 100 years ago, so you want to avoid that. And good proactive healthcare, dental care, blood work, routine scanning, consultations with experts in the field, etc. Just being proactive about your healthcare, trying to prevent disease, and catching it in the infancy stage. Catching a cancer in its early stage is infinitely more likely to make you survive than catching the cancer in a stage four, stage three, whatever, stage two cancer even. So yeah, the earlier you catch things, the earlier you detect that you have heart disease, Alzheimer's, or cancer there, or diabetes, then the bigger likelihood you'll survive. So that's the idea behind this, and that is the most important thing I think people can do to meaningfully extend their lifespan. So there you have it. This was the bracket. And yeah, if you are interested in doing it yourself, I'll put a link in the description where you can fill it out yourself, give your own opinions on the topic. Again, this is kind of just a fun little silly competition. It's not supposed to be super serious. Of course, people have different opinions on the matter. This is my take on it, my analysis based on my research on this for many years. And yeah, you can check it out in the description. If you want to learn more about how to improve your biological age and overall healthspan without spending hours at the gym, without spending thousands on supplements, and get yourself to top 1% of health without obsessing about it, then check out my online community Youthspan Society. It's where you can learn more detailed programs and protocols from me. Link in the description.