Four tools for managing cardiovascular disease risk
Cardiovascular Disease kills But longevity technologies help manage risk
In this post, we present you with four immediately actionable ways to ASSESS your risk
If you’re like us — you’re excited about the imminent increases to our healthspan that longevity technologies will soon offer us. However, if you want to stick around long enough to take advantage of all of the soon-to-be available lifespan and healthspan boosting technologies, you need to make sure you don’t die in the process!
But how will you die? Probability states it will be one of the four deadly killers
Atherosclerotic coronary heart disease is the single leading cause of death of men and women in the United States [Source: Medscape]
Ever since science effectively cured infectious disease through antibiotics, vaccinations and the like, there has been a distinct shift in what kills humans to the four deadly killers, which are considered ‘age related diseases’.
These are — cardiovascular disease, neurodegenerative disease, metabolic disease and cancer. If you manage to escape the most likely causes of death as a young person, which are largely accidental death (mostly car accidents), homicide or mental illness related (suicide) — then it is most likely that one of those four deadly killers will end your life.
But here’s the good news — there’s a growing body of immediately actionable longevity technologies that you can engage with to offset your risk of dying of these diseases.
In a series of posts on the topic, we’ll cover a few key resources at your disposal for managing your risk for each of these four categories.
First-up, cardiovascular disease.
Deadly Killer #1 — Cardiovascular disease
Heart attack, stroke, thrombosis, heart failure — the chances are overwhelming that you have lost someone important to you in your life to one of these causes.
It is often seemingly sudden, but in most cases, the acute cause of death by cardiovascular disease has been brewing for a very long time — decades even.
From A to D, the progression of atherosclerosis. At A: healthy aorta with no disease. D: an abundance of plaques and ulcerations.
The term ‘cardiovascular’ encompasses disease of both the heart and blood vessels, which is driven by the build up and eventual displacement of plaque that accumulated in the arterial wall in a process called ‘atherosclerosis’.
It’s not our role to explain all of the mechanisms of this disease.
Instead, we’ll focus on four actionable tools you can work with your doctor to obtain access to, which will help you assess your risk profile and detect any elevated risk of an acute event (e.g. heart attack, stroke) at an early, treatable stage:
1. Action 1 - Test your ApoB (“A-PO-B”)
Stop using your LDL-C as your only risk assessment tool (The “LDL” value too commonly called the “bad” cholesterol), and add tracking of your ApoB.
ApoB is a particular type of molecule attached to the types of lipoproteins carried by your LDL (and VLDL) that are the most likely to enter the arterial wall and lead to plaque formation.
You need to know *how many* of these atherogenic particles you have present in a given volume of you blood — this drives your risk.
Your ApoB value is influenced by diet and lifestyle and can be controlled with pharmaceutical intervention and possibly through certain forms of supplementation.
Learn more about ApoB at Healthline.
Self-order your own Apo-B test (+other cardiovascular markers)!
No doctor required!
HealthLabs.com (USA) - Single Test
UltaWellness (USA) - Panel
I-Screen (Australia) - Panel
2. Action 2 - Do you have elevated Lpa (”L-P-little-A”)?
Lpa is another cardiovascular disease bad guy that may be in your bloodstream.
Lipoprotein-a is a particle which carries cholesterol, fats and proteins and is made by your body, and how much of it you make is inherited.
Elevated levels of Lpa increase your risk of a heart attack or stroke as they are known to cause atherosclerosis.
You certainly need to know if you carry the genetic risk factor, and the earlier the better (i.e. get this test done as early as possible)!
Levels of Lpa don’t change much over one’s lifetime, so testing it once is enough in most cases!
Know your Lpa status, and better know your risk, and whether or not you should modify your diet, lifestyle and treatment options.
Learn more about Lpa from the lipoprotein-a foundation
Self-order your own Lp(a) Test
No doctor required!
HealthLabs (USA) - single test
UltaWellness (USA) - Panel (includes ApoB)
i-Screen (Australia) - Panel (includes ApoB)
3. Know your Coronary Artery Calcium scan score
Coronary artery calcium (CAC) scans are created by using computed tomography (CT) scans, which are a type of X-ray scan, to detect the presence and quantity of coronary artery calcification (the warning signs of atherosclerosis).
A CAC test reveals both the location and quantity of calcium located in three of the main coronary arteries. The scan provides a score which represents your risk.
The lower the better! This score will change over time, and is known to increase with age, so it is important to record it regularly (in a manner that balances the downsides of the X-ray radiation — ask your doctor what’s best for you).
Atherosclerosis is a disease of ageing, and that means your risk is increasing over time. If you are aged 50 or above and have never had one — work with your doctor to get one performed.
Read more about CAC scores in our interview with Health Nucleus Medical Director Keegan Duchicela.
4. Track your inflammation with C-Reactive Protein (CRP)
At its roots, atherosclerosis is known to be intimately connected with inflammation.
In fact, it is often damage to the arterial wall that attracts the formation of plaque in the first place.
This damage occurs over time, and is known to be increasingly likely with high blood pressure and high blood glucose levels.
CRP is a very common and relatively low cost blood test that can be easily ordered up by your doctor, and should be tested annually at the very least.
High levels of CRP are indicative of increased risk of cardiovascular disease, and once again can be influenced by changes in diet and exercise.
If you have the option, go for the high-sensitivity CRP (hsCRP) test if possible!
Self-order your own hsCRP Test
No doctor required!
HealthLabs (USA) - single test
UltaWellness (USA) - Panel (includes ApoB & Lpa )
i-Screen (Australia) - Panel (includes ApoB & Lpa)
Take Action!
Everything that we have discussed in this post encompasses longevity technologies that are available to you NOW.
Ultimately, it is up to YOU to demand access to these technologies, in one way or another. No one is going to do that for you.
If you are aged 50 or older, the importance of getting each of these tests performed is exponentially more important with each decade of life!
Follow us on Twitter for the latest! @longevity_blog
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FDA DISCLAIMER
This information is intended for educational purposes only and is not meant to substitute for medical care or to prescribe treatment for any specific health condition. These products are not intended to diagnose, treat, cure or prevent any disease.
What's My Age Again? Quantifying Biological Age with Three Free Online Tools
“How old are you?”
It’s a common question, and one that we often use in early conversation with acquaintances of all sorts. I’ve noticed just how common a query it is, because I’ve turned it into a fun guessing game, where I reply - “Well, how old do you think I am?”. People will often take a few moments to look at my face, and spurt out their guess without much hesitation. I’ve been casually keeping track of the responses, and the median age is currently 27 (range 24 - 30, 15 responses) - not bad for a 34 year old.
This fun little guessing game starts to beg a deeper, biological question. The difference between how old we look (we might call this one’s aesthetic age) versus our actual chronological age, varies from person to person. Looking at my classmates from high school or college over the years has been quite remarkable in this regard - many of my male classmates are now balding or have grey hair, others seem to have many wrinkles or sagging facial features already, many are overweight or obese - but a select few are trim, fit, glowing and youthful in appearance. So onto that biological question - are there measurable differences between people of the same chronological age that may shed some light on the seemingly different rates of aging I observe across my peers?
For a great, layperson explanation of the epigenetic ageing process, and what to do about it - Grab yourself a copy of “Lifespan” by Dr. David Sinclair
Well, fairly recently, the answer to this question has become a very clear yes. Enter the concept of biological age - where measuring representative variables in human biology have yielded remarkably accurate answers to this tricky question. There are several methods of approach, but by far the most widely discussed and accepted in the scientists exploring this topic are methylation clocks, which track changes in methyl groups in the epigenome. The epigenome is the system that controls how our genome is expressed, and this is known to change as we age. Later this year, I have plans to test and review several different biological age tests, including methylation clocks and other tools for tracking the epigenome and telomere length.
Given this emerging field of science, and new technologies that are following it, I have spent much of my recent longevity research efforts exploring the tools that are available to biohackers and wellness enthusiasts like myself for quantifying biological age. Today, I’ll share three different online tools that you can leverage, and share my results with you.
Biological Age Tool #1 - Phenotypic Age
[EDIT: Alternative direct download for spreadsheet hosted at the above link]
“Phenotypic Age” was first discussed in two separate studies, which you can find here (study 1 and study 2 -< note that Steve Horvath is one of the authors, who has pioneered the methylation clock work mentioned above). Phenotypic Age is calculated based on 9 biomarkers and measured chronological age using a cohort of 11,432 adults (a range of 20-84 years old). I was first introduced to this tool by Dr. Michael Lustgarten, who also blogs on longevity related topics, and was recently able to test out this tool for myself, thanks to the 15 vials of blood I gave at NextHealth.
Using the results from my Total Baseline test, and the excel spreadsheet located here (EDIT: some readers have reported the spreadsheet link is not working, so here is an alternative direct download) , I was able to enter the following information to reveal my phenotypic age. This includes information about the shape and size of my red and white blood cells, inflammation (C-reactive protein), albumin (protein in blood plasma) and creatinine (a byproduct of muscles and measure of kidney performance).
My biological age: 22 years old. That’s 12 years younger than my chronological age of 34! Hey - I must be doing something right :)
Biological Age Tool #2 - AgingAI
Another group of researchers who have pioneered biological age tools are the team at Insilico Medicine, developers of the ‘AgingAI’ tool. In fact, I considered Alex Zhavoronkov (CTO of Insilico) one of the world’s leaders in advocacy for longevity technology research, and if you are interested in this space, he is someone you should certainly follow.
AgingAI uses an artificial intelligence approach to biological age estimation, which is significantly more complex and technical than the linear model used in the phenotypic age tool. This approach employs deep neural networks and was trained on more than 60k data points (read more about the details here). In my view, this tool is inherently more subjective in that due to the machine learning approach employed, it will be biased toward chronological age more strongly than the phenotypic age model (simply put - the neural networks are trained against chronological age as ‘the answer’).
Using the results from my NextHealth Total Baseline I was able to complete both the AgingAI 2.0 and AgingAI 3.0 Tests. For those of you interested in replicating this with your own Total Baseline test, here are a few tips:
be sure to select “US” for the sample metric at the top
you won’t have a value for “Lactate dehydrogenase”, so I recommend using the median value of the reference range
“Basophils” is “Basos %”, “Eosinophils” is “Eos %”, and “Lymphocytes” is “Lymphs %”
in your Total Baseline report
And my results? AgingAI 2.0 guesses I am 30 years old. AgingAI 3.0 guesses 32 years old. Pretty close on both counts! And I suppose it is good news it knows I am a male (LOL).
Biological Age Tool #3 - RealAge by ShareCare
Not everyone will have the blood test results on hand to use both of the above tools (but you can likely get them if you find the right medical doctor! Also, read-on below, as it appears you can order these online via “Walk-in Labs”). So I wanted to make sure I included an age test that did not require a blood test. This one is arguably not truly a biological age tool, but I’ll place it in that category based on the amount of biological data it ingests through its questionnaire style approach (it does collect cholesterol numbers for example). Co-created by “Dr. Oz” and Mike Roizen, this tool boasts that is has been completed more than 43M times.
An example question from the RealAge survey tool
I appreciated this test for its accessibility and its candour. What I mean by the latter point is that it asks many questions that clearly gauge youthfulness through emotional and psychological data points (really digging into whether or not you still have that quintessential ‘zest’ for life or not!). It also provides a wide array of follow-up tools that directly target your RealAge score, and can help you improve it, including a ‘dashboard’ tool that will let you track your behaviours and give you tailored advice (and I am sure it will use your data to make money somehow!).
This test reported a ‘Real Age’ (biological age) of 28 years old.
Should you complete a Biological Age test?
If you’re interested in maximising your longevity, it’s important to establish a baseline. This means, to establish where your overall health and wellness are at NOW, so that you can make changes to your diet, lifestyle, supplements and other input variables, and then re-test to determine how you’re faring with your own longevity strategy.
In my view, biological age tests are an ideal choice of baseline testing, as they are designed to comprise the overall impact of many different factors and are specifically dedicated to measuring aging. However, there is a rapidly growing list of options for testing, including checking your telomere length (of white blood cells), DNA methylation clocks (e.g. DNAge), and more broad spectrum epigenetic tests (check out Chronomics for example). So selecting which test to use comes down to a few key parameters, in my view:
Representativeness of the test to your overall health & wellbeing (Does the age test capture the most representative biomarkers of aging?)
Affordability (Are you able to routinely repeat the measurement based upon its cost?)
Accessibility (Do you need a doctor to work with you to get the test? Is it available in your country/region? Can you order it online?)
As a part of my commitment to the purpose of this blog (supporting you in generating your own longevity strategy), I am preparing a review of several of the biological age tests available on the market, for publication on this blog later this year. By working with the providers of these tests, I’ll share my results with you, and compare and contrast the (1) representativeness, (2) affordability and (3) accessibility of each approach. In this post, we got off to a solid start, so let’s close today by summarising these three factors for the above biological age tests in a succinct tabulated format. I will be sure to update this table as I evaluate additional options in the future!
![Costing estimates produced with “Walk-in Labs” [1], [2], [3]. My total baseline test cost $999USD.](https://images.squarespace-cdn.com/content/v1/534cff75e4b0ce1c16de5321/1578708035056-NQBT0PVSD7FSR14BJDYH/Aging+Tests+Matrix+v1+January+2020)
If you enjoyed this post, be sure to read my coverage on epigenetic age testing company Chronomics
Want to test & improve you biological age? Longevity Blog recommends GlycanAge
Our Founder Nick used these kits to improve his biological age by 6 years, just by changing his diet. Read more about that here.
If you’d like a more robust and accurate biological age test than the free options above, GlycanAge is a great place to start!
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RT @rebeccavziegler: The cryonics payoff matrix. Choose wisely my friends. https://t.co/l1rzsmOC2w -
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Immediately Actionable Insights via Micronutrient Testing
Considering a micronutrient test? Do these two things first!
Want to take a micronutrient test? Order your own without a doctor!
Micronutrient test results are in!
Imagine my excitement as the moment finally arrived - the comprehensive results from my 15 vials of blood and four detailed blood tests arrived in my inbox. After 4 weeks of waiting, the mountain of data arrived and the real fun of digging through it for actionable insights began. To get started, I’d like to share with you three immediately actionable insights I gained from my micronutrient blood test.
Micronutrient Test for Glutamine (Actionable Insight #1)
Huffing and puffing my way towards my cardio goals (I plan to run my first 10km race this year) sure leads to a lot of SWEAT. Much more than I’ve personally been used to. I’ve established a solid routine where 6 days/week, I am up early in the morning getting in a vigorous walk of 5k+ steps or run workout (trail runs, endurance training - follow me on Strava). However, unbeknownst to me, that SWEAT was taking with it a critical micronutrient needed for the success of many different bodily systems - Glutamine.
Glutamine is an amino acid that plays a critical role in the synthesis of proteins, which has impacts for many bodily systems. In fact, it is the most abundant amino acid in the human body. This being the case, it is also abundant in a wide variety of our food choices - including meats like beef, chicken and fish, dairy products, eggs, and many vegetables (leafy greens, carrots, cabbage, beets).
After a deep dive on all the best options, I opted for this L-Glutamine powder from California Gold. They also offer a capsule form. Save 10% and support the Longevity Blog with code EYU021
But my levels were low, as in rock-bottom low, and that had many knock-on effects to my neurological function, gastrointestinal barrier, my liver performance, my joint health, my skin vitality and my mitochondrial function. Just check out the useful summary graphic provided in my report (the one with the multiple indicator “gauges”, note that you can click on the image to see the full size)
Low glutamine is simply put - bad news. For a young and healthy person looking to optimise his wellbeing and longevity, this was certainly limiting my performance. For some perspective on just how low my levels were, check out the reference ranges in the next image. The ‘Serum’ levels (what was detectable in my blood liquid - not the actual cells) was only 23.6 nmol/mL! Thankfully, the amount in my white blood cells (WBC), which is an indicator of long-term micronutrient availability was in the normal range, but the serum level was nonetheless quite problematic.
Needless to say, I jumped on a high quality glutamine supplement from my brand of choice (California Gold - save 10% and support Longevity Blog with code EYU021 ) within a few days. I immediately enjoyed a noticeable improvement in my gastrointestinal health, with knock on effects to the health of my skin (less acne breakouts) within just a few days. The bottom line here - this was incredibly valuable and highly actionable information that was available to me through this micronutrient test.
Micronutrient Test for Chromium (Actionable Insight #2)
My glutamine levels weren’t the only important micronutrient that was critically low, as my intense levels of exercise and SWEAT were also depleting an important mineral - Chromium. Further research revealed that Chromium is commonly deficient in athletes for this reason.
Chromium plays a very important role in metabolism, and is directly involved in the breakdown of fats and carbohydrates. With respect to fats, it stimulates the synthesis of cholesterol and fatty acids. For carbohydrates, it is involved in the regulation of insulin. It also is involved in the metabolism of some amino acids. Once again - very important!
I took a pretty picture for you! Chromium Piccolinate to the rescue!
Dietary sources of chromium include broccoli and green beans (which I eat daily!), meats like beef and poultry, and fruits like apples and bananas (which I regularly also enjoy). However these dietary sources are still relatively low.
This makes chromium supplementation a well-informed choice for me and for anyone else who is moderately active (or wants to better manage their insulin levels, e.g diabetics), which is the second immediately actionable insight I garnered from my NextHealth micronutrient test. I turned to my vitamin supplier of choice - Thorne for a Chromium Piccolinate supplement, but later pivoted to the cheaper version from Now and take it twice a week with my Vitamin C and B-vitamin complex to improve absorption. Just like with the Glutamine options on iherb - use the discount code EYU021 to save 5% and support the Longevity Blog!
Micronutrient Test for Vitamin K1 (Actionable Insight #3)
There are two forms of the fat-soluble vitamin K needed by the body - K1 and K2. These are important for blood clotting, regulation of calcium (particularly bone metabolism) and cardiovascular health. Vitamin K also plays a role in mitochondria producing energy for your cells.
It also turns out, that despite plenty of dietary intake of Vitamins K1 and K2 in my vegetable rich diet, my micronutrient testing revealed critically low amounts of Vitamin K1 in my blood serum. Additionally, despite my 100mcg/day supplementation of K2, it was also fairly low. This clearly made supplementation of Vitamin K1 (and continued supplementation of K2) the third immediately actionable insight gained from my micronutrient testing at NextHealth.
Conclusion - Micronutrient Testing is a Valuable, Actionable Tool
There is so much more that I gained from my micronutrient testing that I hope to share with you in upcoming posts (be sure to subscribe to the Longevity Blog!), including my Omega 3/6 balance, copper-zinc ratio and antioxidant levels. However, even without these added benefits, I believe the outcome of my first micronutrient test is clear - regular assessment (I’m guessing every 6-months) of one’s micronutrients provides actionable insights that can be used to improve your health and optimise longevity.
I’d like to close with my sincere thanks to NextHealth for living up to their mission as a Health Optimisation and Longevity Center, and making is simple, straightforward and affordable to access this resource. I’ll certainly be back for my next micronutrient test in 2020!
Follow-up Post: Considering a micronutrient test? Do these two things first!
READY TO Test Your Micronutrient Status?
We’ve found three valuable DIY options for you! No doctor required!
HealthLabs USA)
UltaWellness (USA)
I-Screen (Australia)
-
RT @rebeccavziegler: The cryonics payoff matrix. Choose wisely my friends. https://t.co/l1rzsmOC2w
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My rate of aging: 0.79 It’s the new street cred What you got? https://t.co/aHzWHAfCnD https://t.co/L3rZC4QFN2
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It’s official - I’m co-producing and hosting a new #longevity docuseries, and will begin shooting in a few months… https://t.co/wLGqRrBfbp
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“The #longevity segment opened my eyes to the groundbreaking advances in biotechnology, health, and wellness. The i… https://t.co/F8YB7PAeMW
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I’m completely mindblown by what AI has done over the past 3-6 months, and it continues to accelerate… https://t.co/hh0JslucRg
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RT @BradStanfieldMD: Avoid These Popular Supplements (shout out to Professor Matt Kaeberlein @mkaeberlein & Professor Brian Kennedy… https://t.co/cy9CXldgUS
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Who are influential persons in #longevity who are of Asian, African American or other “minority” group in the US?
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-
I built and exited my first company today A big moment in my entrepreneur journey What’s next? All in on… https://t.co/5oTo3IjSyN
FDA & TGA DISCLAIMER
This information is intended for educational purposes only and is not meant to substitute for medical care or to prescribe treatment for any specific health condition. These blog posts are not intended to diagnose, treat, cure or prevent any disease, and only may become actionable through consultation with a medical professional.
Why I Just Gave 15 Vials of Blood at NextHealth
Visiting NextHealth in Los Angeles to See and Experience Proactive Healthcare in Action
I’m coming off a real high having just been to LA and San Diego over this past week and not just because I had my face bathed in some awesome infrared radiation with a “Light Stim” (see this IG post and be sure to give me follow 😉). No, I’m jazzed because I FINALLY visited NextHealth in Century City, LA - and let me tell you, it was a life changing experience!
What is NextHealth?
NextHealth refer to themselves as a “Health Optimisation and Longevity Center” - as you can imagine, I fit quite squarely into their market segment (I am trying to Biohack my way to a vibrant, healthy, long life after all). They do everything from cryotherapy to dermatology and IV vitamin infusions to blood testing.
Why Did I Visit NextHealth?
This time I was out for blood 💉!!
NextHealth offers a few blood test products that I was very interested in for supporting my longevity journey. These are:
And then, upon further digging into some other options during my visit to the site, I decided to also add on:
My Motivation: Get Feedback and Optimise
There is simply no way to start to introduce all of the different things that will be covered by the above blood tests, those are quite extensive! But I do have a select number of things that drew me to these blood test options, by blood test product they are:
Total Baseline:
I was very interested in my NMR spectroscopy results so I can better understand what the particles sizes make up my LDL cholesterol
I am in my early 30s and undertaking many ‘hacks’ to keep my testosterone high - are they working? (dutch test hormone data!)
Micronutrient Testing
I have an aggressive supplement regimen (30+ supplements a day and climbing), and micronutrient testing will help me adjust the levels of supplementation very accurately
Genomic Fit
I am interested in optimising my diet and athletic performance (going for a sub-20 minute 5K at the moment) and ‘Genomic Fit’ will give me some actionable info on this
Food Sensitivity Testing
Figuring what foods you are sensitive to (different from being allergic) is very difficult to do with dietary testing alone, and I can tell I still have some foods in my diet that give me inflammation - what are they? I must know so I can ban them and protect my gut lining!
All Up I Gave 15 Vials of Blood in the Name of Science
“It’s less blood than it looks like”, Ashley, the gorgeous phlebotomist let me know. “We’re almost done”
Good, cause I was totally light-headed already.
“Yeah, I passed out once when I gave about 30x vials for a scientific research study”, I let her know. “But don’t worry, I totally gave that nurse a heads up that I was on my way out”, I joked.
She just laughed and smiled re-assuringly (and probably thinking “God, don’t let this guy fall over on me…”). Thankfully Nick stayed conscious this time, and just like she promised - the blood draw was over quite quickly.
And might I say - it was an exceptionally professional job done on the blood draw, complete with a comfortable chair and warm-up blanket over the arm to kick it off. A smoother experience than I have had in many hospitals!
While I’m Waiting for the Blood Test Results…
I am not going to get my blood results back until early December, so this story is far from reaching its conclusion. In fact that visit to NextHealth was so life-changing, I easily have 10-15 more blog posts I’d like to write about it.
One thing is for sure, I will have plenty of material to work with. I once again am going to find myself with a stack of amazing health data to dig through! It is my plan to walk through some key lessons I learn from those blood results in upcoming blog posts, so be sure to subscribe to the blog if you’d like to see what happens!