Welcome to the latest issue of The Longevity Newsletter, bringing you longevity news, breakthroughs, and evergreen truths to help you live longer and look younger.

Today, we have a heart-healthy reason to reach for a third cup of coffee … a groundbreaking anti-aging peptide for your skin … the latest research on doubling the life of your cat … and plenty more. Let’s dive in.

LONGEVITY LIFESTYLE

3 cups of coffee a day keeps the heart doctor away

New study finds that consuming a moderate amount of caffeine a day may protect your heart from multiple diseases

What's the news: Consuming about 3 cups of coffee, or 200-300 mg caffeine, per day might help to reduce the risk of developing type 2 diabetes, coronary heart disease, and stroke.

Why should we believe it: This news is based on new research published a little over a week ago in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

The researchers looked at over 350,000 individuals, their coffee- or tea-drinking habits, and their health.

The results?

• Moderate caffeine consumption was better for the heart than no caffeine or light caffeine consumption

• Caffeine consumption helped at every stage — both to prevent heart diseases and to slow its progression

Why this is a big deal: Many studies have revealed the protective effects of coffee, tea, and caffeine consumption, especially in reducing the risk of a single heart disease.

This new study reveals consuming caffeine can reduce the risk of developing two or more heart diseases simultaneously.

And considering that over 75% of those over 60 have some form of heart disease, and that heart disease alone kills millions of people around the world each year, it’s a relief to know that an effective, safe, and natural treatment such as caffeine can help prevent the development of additional heart diseases.

So what specifically can you do now: The study says "3 coffees a day." The reality is that a tall Starbucks coffee has 235 mg, and probably all you need for the best results, and not clear that more caffeine will help your heart, rather than just leave you jittery and unable to sleep.

IRREVOCABLY PERSONAL

The all-female skincare company, OneSkin, discovers groundbreaking anti-aging peptide for the skin

The CEO of OneSkin, Carolina Reis Oliveira, PhD, showing off her breakthrough skincare product

Who we're talking about: Entrepreneur and scientist Carolina Reis Oliveira. Oliveira has degrees in stem cell biology, tissue engineering, and immunology, and is the founder and CEO of anti-aging skincare company OneSkin.

And the news is: Oliveira recently sat down with Peter H. Diamandis on his podcast, Moonshots, to discuss how her company developed the groundbreaking peptide, which the company claims is the first ingredient scientifically proven to reduce skin's biological age. 

Why this is a big deal: OneSkin claims it’s OS-01 peptide clears out our skin's "senescent cells" — aged cells that produce inflammatory signals which contribute to skin aging. Clearing out these cells would dramatically strengthen skin and reduce or possibly even reverse wrinkles.

And it's not just cosmetic either...

Since the skin is the largest organ in the body, lowering the inflammation of our skin through interventions such as the OS-01 peptide can have an indirect benefit on the rest of our body - something Oliveira discusses in more depth in the interview with Diamandis.

So, what specifically can you do now: If you'd like to find out more, and decide if this is something you'd like to invest in, then the recent interview that Oliveira did with Diamandis might be worth a look.

AROUND THE WEB

IN OTHER NEWS…

Longevity startups are being funded more than ever, while older adults are accounting for an unprecedented share of the population.

The right ventricle ages differently from the left, which may unlock new insights into improving heart health.

Scientists map out the genome of the Greenland shark, which can live up to 400 years, to pursue clinical benefits that may be applied to humans in the future. 

Taking Melatonin is linked to a reduced risk of developing age-related eye disease.

AROUND THE WEB

AROUND THE WEB

GOOD FOR THE CATS

Scientists in Japan may be able to double the life of our feline friends

AROUND THE WEB

Cats worldwide wonder if this new treatment could finally give them 10 lives

What's the news: Dr. Toru Miyazaki, an immunology specialist, has developed a treatment targeting chronic kidney disease (CKD) in cats, potentially extending their lifespan from 15 years to 30 years.

Why should we believe it: Fueled by his love of casts, Dr. Miyazaki has tirelessly pursued the development of a new treatment to reduce kidney failure in cats, which, if successful, could potentially double their lifespan. 

So, what does this mean for cats and their human owners (and hounds like me): Clinical trials on cats are still underway, but the new treatment will potentially be available in 2025. 

And who knows, maybe these breakthroughs will open up new research for extending the life of us hardworking hounds, and humans like you, too. 

In the meantime, take your cat for regular checkups at the vet, give them plenty of water and wet food, and keep their weight in check to reduce kidney failure. 

- The Longevity Hound

Welcome to the latest issue of The Longevity Newsletter, bringing you longevity news, breakthroughs, and evergreen truths to help you live longer and look younger.

Today, we have a weight loss drug that may reduce death … demands from Putin to increase life expectancy … an attack against a green supplement from Bryan Johnson … and lots more. Let’s dig in.

ON THE HORIZON

Weight Loss Drug Ozempic Shown to Reduce Deaths Caused by Infection [New Study]

Ozempic may have more benefits than previously known

What's the news: The popular weight loss drug Ozempic produced a significant reduction in non-cardiovascular deaths, particularly those caused by infection, including from COVID-19.

Why should we believe it: A The Journal of the American College of Cardiology (JACC) published a new study exploring the impact of semaglutide - the anti-obesity medication used in drugs such as Ozempic - for treating cardiovascular deaths, non-cardiovascular deaths and death from COVID-19.

The researchers looked at 17,604 adults, aged 45 or older, who were obese or overweight. The scientists treated these folks with either 2.4 mg of semaglutide or a placebo over 3 years.

The results, for the patients who got the semaglutide:

* 19% lower risk of all-cause death

* 23% lower risk of non-cardiovascular death

* 34% reduction in risk of dying from covid-19

Why this is a big deal: Previous research conducted through the SELECT trial had already found that semaglutide lowered inflammation and risk of cardiovascular disease and heart failure. 

This new study revealed additional anti-death benefits from semaglutide for non-cardiovascular causes, which even the lead author of the study found surprising. 

So what specifically can you do now: There's mounting evidence that weight loss drugs like ozempic benefit health and act as longevity drugs. And while exercise and a healthy diet are still the most proven and significant ways to slow down aging, it's worth keeping ozempic in mind — or even talking to your doctor about it.

IRREVOCABLY PERSONAL

Putin demands scientists develop treatments to "save 175,000 lives" by 2030 while average life expectancy in Russia falls

Putin is putting the pressure on his top scientists to boost the lifespan of Russian citizens

Who we're talking about: Russian president Vladimir Putin. At 71 years of age, Putin is quickly nearing the life expectancy of the average Russian, which is 73.2 years.

And the news is: Putin’s government has sent a surprise letter to Russian research institutes urging them to come up with new longevity interventions. 

The letter specifically mentions rejuvenating the immune system, reducing the burden of cellular aging, and new technologies for preventing cognitive disorders.

One Russian doctor who received the letter in June said they were surprised that physicians were asked to work on the proposals with such urgency.

He said, "We were asked to urgently send all our developments, and the letter arrived, let's say, today, but everything had to be sent yesterday. To be honest, this is the first time in my life that I've encountered this.”

Will Putin’s letter lead to Russian longevity breakthroughs? Putin seems desperate and motivated to come up with fresh solutions. 

I wrote in a previous newsletter how Vladimir Khavinson, Putin’s longevity guru, died at age 77 on January 6th, 2024. Putin is currently 71 years old. Not only is he feeling the weight of his country’s longevity status, but he’s concerned with his own. 

Whatever comes of this initiative, I’ll sniff out the details and bring forward any breakthroughs that can benefit us all. 

CONSUMER AWARENESS

Bryan Johnson goes to war against Athletic Greens

Athletic Greens is under fire from the tech millionaire biohacker who takes 100 supplements a day

What’s the product: The powder supplement from Athletic Greens, AG1, which boasts a formula of over 75 vitamins and minerals as well as prebiotics and probiotics that’s “designed to replace multiple supplements.”

What’s the problem: Bryan Johnson posted a new video to his YouTube channel breaking down several problems with AG1. 

• Problem #1 - it’s overpriced. Bryan claims he could make the bag for $10 but AG1 costs about $99. 

• Problem #2 - the army of influencers pushing AG1. Bryan is bothered by the fact that many if not most influencers are pushing this health product merely for the generous commissions they’re paid without evaluating its effectiveness. 

• Problem #3 - Pixie Dusting. Instead of providing you with the dosage amount AG1 used in clinical trials (which shows good results), they package a much lower dose for you and I which is insufficient for receiving the claimed benefits. 

What’s the point: Bryan raises a few fair criticisms of AG1 and it may be worth your time to consider an alternative supplement if you’ve been using it. But it’s worth noting that Bryan sells his own supplements, including in the YouTube video linked above, so he’s hardly a disinterested consumer advocate. 

This is a reminder to do your own due diligence when it comes to any supplement. 

IN OTHER NEWS…

AROUND THE WEB

Keto Diets May Help Cognitive Function in Alzheimer’s - but with a few caveats

Restoring facial fat using microneedles is a prickly topic - and these anti-aging enthusiasts take a stab at the best path forward. 

The anarchist collective producing DIY versions of expensive pharmaceuticals at a tiny fraction of the cost - this is the rise of pirated medicine

what we’re reading

“Why Aging Comes in Dramatic Waves in Our 40s and 60s”

“Life moves pretty fast. If you don't stop and look around once in a while, you could miss it.”

What we’re reading: A recent Scientific American article titled, Why Aging Comes in Dramatic Waves in Our 40s and 60s breaks down new research published in Nature suggesting that our bodies don’t only experience gradual changes, we’re also hit with sudden and sometimes large changes on a molecular level at age 44 and 60, respectively. 

I’m sure you can recall when you realized that partying the same way you did in college isn’t nearly as fun anymore, especially the next morning. 

This new study attempts to understand why changes such as these occur at specific ages. 

It’s one of the few studies that focused on middle-aged participants and involved such comprehensive biological sampling. 

Let’s see the bad news: People in their 40s and 60s display more muscle loss and weakness, inefficient metabolism of substances such as caffeine, a weakened immune response, and a greater risk of developing type-2 diabetes among other worrying findings. 

However, the study’s results aren’t ironclad: No participants were followed for longer than 7 years, so it’s impossible to measure all the changes that could occur across a lifetime. 

Participants in the study may have aged faster relative to others of the same age in the broader population. 

Numerous factors contribute to “age-related shifts” in a person’s health, from stress to race to socioeconomic class and more. 

Plus, this study sampled a relatively small number of people, all living in California’s Palo Alto area, which makes the data less representative of the broader public.

So, why is this study worth discussing, and what’s the good news? If we can better understand how age-related diseases develop over time and at specific ages, we have a better shot at mitigating or reversing them. 

One reason why folks in their 40s may experience certain declines in health is a decline in physical activity around that age. If you need another reason to exercise regularly for life, this is it. 

That goes for all the positive lifestyle changes we advocate for at The Longevity Newsletter. 

A noted age-related researcher at the University of Pittsburgh, Aditi Gurkar, commented on this study by observing, “diet and exercise can accelerate aging—or slow it down.”

Old news?

Perhaps, but it’s a helpful reminder that while getting older is inevitable, experiencing certain diseases isn’t. 

This study and future studies may prove that our biology undergoes similar changes, but we’ll be empowered with the knowledge to maximize our longevity at each stage of life.

- The Longevity Hound

Dr. Jeffrey Gladden, thinking about how to make 100 the new 30

Dr. Jeffrey Gladden, MD, is a board-certified cardiologist with a medical diploma from Temple University. Today, he runs a longevity clinic, Gladden Longevity, out of Irving, TX.

Gladden is the "coach" to 3 of the top 20 Rejuvenation Olympians, as per the latest results on the Rejuvenation Olympics absolute leaderboard. What's more, Gladden is a top Rejuvenation Olympian himself.

According to biological tests, Gladden, who is 69, has the body of a 30-40 year old man. As a result, he currently sits at position 20 on the Rejuvenation Olympics absolute leaderboard.

I sat down with Dr. Gladden to find out what exactly he is doing to get such rejuvenation results for his clients and for himself. The answer, it turns out, is quite a lot. Here are the details.

John Bejakovic:

I guess the first thing that I'd like to know is, who comes to you? So who are these people? What's their motivation? And what's their current health status?

Dr. Jeffrey Gladden:

Yeah, it's a great question. You know, people come to us for really two different reasons. And the way I think about it is it depends on the questions that they're asking. So people can come in asking the question, "Hey, I want to live young for a lifetime. How do I get back to age 30? How good can I be? How do I live well beyond 120?"

These are questions, if they're asking those questions, they come to us because we have the ability to actually assess where they are, and actually help them live young for a lifetime. So this has been very exciting work.

Other people come to us asking a specific question, like "I just got diagnosed with cancer," or "I just had a concussion or just had a stroke, or my blood pressure is out of control, or I hurt my knee or my shoulder, can you help me?" So some people come in with a much more focused sort of question, based on a pain point that they're having.

So people either come in because of a pain point, or because of an aspiration, or it could be a combination of the two. So those are typically the people that come in.

John Bejakovic:

What's the ratio of one to the other? What percentage are in the optimizing group, and what percentage are dealing with a pain point?

Dr. Jeffrey Gladden:

Most people come to us to optimize. But I will tell you that everybody that comes to us to optimize also has something else to fix, right? Everybody's dealing with something. And so you know, what we try to do is make ourselves accessible to the people that just have something to fix.

It's like, "I've gone to three doctors, I can't get my shoulder right." I met with a guy this past weekend. He had a shoulder replacement surgery, he's been doing his doctors, he's now having numbness and tingling weakness in the arm. It's like, "Can you help me?"

Yes, we can likely help you here. But first, we have to actually see the studies related to your arm and the nerve conduction study to see what's actually going on. And then from there, I'm quite sure we can help you. Which is really one of our main tenants is we can't really help anybody until we understand where they are, right?

So we don't we don't just start throwing things at people, we actually really do a deep dive to unravel where they are in terms of what cards are they holding. What are their genetics? What are their predispositions? And then where are they in the game that they're playing?

If the game is "I want to live young for a lifetime," well, then how old are you? And how many different mosaic of ages are we going to measure for you? So we give you a scorecard and give you a sense of where you're at?

If you're coming in because you have a bad knee, okay, well, let's get the past history of everything that went into that knee. Maybe there's a family history of joint issues, maybe there's some genetics that actually played into joint disease, and autoimmunity and things like this. And so once you start actually unraveling that, then you get much better solutions for these people. And so that's our approach. It's very thoughtful before we take action.

John Bejakovic:

Do you have a standardized, let's say, onboarding process? Or is it case by case, where it entirely depends on who comes in and what their situation is?

Dr. Jeffrey Gladden:

We have a standard process. The content is what changes. The categories remained the same. The content inside the categories can change.

So if I have a if I have a 30-year-old woman comes in because she's having difficulty getting pregnant, and she wants us to help her with that, that's a different set of questions than a 65-year-old person that wants to, you know, not only sell this company but start three more and have another 30 years of great impact on the planet. Those are two different questions.

So the process remains the same in terms of understanding who the individual is, what are the pain points, what are the aspirations and then doing the dive into that area. What are the genetics, what are the what are the metrics around the health of this organ system or the system as a whole.

And then from there, once you really understand the cards somebody's holding, and where they are in their particular game that they're playing, I'm gamifying this a bit, then we can actually start to come up with really intelligent, very thoughtful answers, where we can elegantly provide the best solutions and use this as few stones to hit as many birds if you will.

The problem I see with lots of clinics is that people come in with a problem and they have a solution and they throw the solution at the problem. In our world, we have all those solutions. But we just don't know which one is right for you until we actually understand what your the nature of your problem because every problem requires something a little bit different.

John Bejakovic:

In order to make sure that we don't go too broad with this interview, let's pick a specific patient who comes in to see you. Maybe we can walk through what that patient would actually be like.

Dr. Jeffrey Gladden:

So the ideal client for Gladden Longevity would be somebody who, at some point in time, started to face their own mortality. They've gone through enough of the aging process.

We work with people in their 30s and 40s, 50s, 60s, 70s, even 80s, right. But typically, someone will get to a point in their life where they don't feel like they want to or can't do what they want to, they may not look like they want to.

And at that point, they have a decision to make. Either, “I'm gonna accept this as the ‘aging process’ and acquiesce to that and go down that road,” or “No, I don't want to go down that road. I want to live young for a lifetime. I actually want my youth.”

So our ideal avatar is somebody who wants to live young, wants to be young. And typically, that translates into somebody that also wants to have a big impact on the world. And access opportunity, big opportunities as they come along.

So our ideal avatar is typically someone that's an entrepreneur or business owner, or an executive who really loves what they're doing. And the biggest fear they have is that they only have another five years to do it, or another 10 years to do it before they feel their health is going to start to crumble, and they're going to lose that ability to make that contribution that they want to make.

And people are also tied into this aspiration because of commitments to family. It's not just about the global world, right? They want to be there for the grandkids, they want to snowboard with their great grandkids, they want to do these things.

And so, when people come to us with those aspirations, we really believe that this is we're the first generation to not have to go down the same glide path of aging that everybody else went down.

We feel like we can take those people and do the deep dive. What are the cards you're holding? What are your aspirations? Where are you in the game? What are your metrics of aging? Where do you measure over 60 different metrics of ageing?

People talk about a single biological age. We're talking about measuring many, many, many biological ages that you have so that we get a really clear understanding of how well is your brain working right how well is your muscular system working. And we break it down into four different circles of areas.

The first is life energy. We want to understand where are you with related to what we call the life energy circle, which has to do with mindset. Are you married to your questions or are you married to your current answers? Are you a binary thinker? Or are you a quantum thinker?

Binary people are thinking about trying to get to an answer. Quantum thinking people are actually looking at a whole sphere of possibilities and trying to get to the best solution.

So we find that people that are quantum thinkers, people that are married to their questions and not their current answers, they have this growth mindset because of that, and this ability to adapt and grow. Those are perfect people for us.

Because to work with us, you're stepping outside the confines of traditional sickcare, you're moving into a new paradigm, right?

I've worked with a guy for a number of years here who owns an oil company, and he's doing great. We've helped him through a knee replacement, we helped him get rid of an infection. And he had another knee replacement when he first came to us. He's made tons of progress.

But he says, "When people ask me what I'm doing now, because I look so good, I don't even bother to tell them. I don't even bother to tell them anymore."

Because you have to be willing to step outside what most people would even consider normal to get these kinds of results. And so our avatar is somebody who in that life energy circle, who has a drive to be different than the people around them.

And then in that life energy circle are also things related to mental health. So anxiety, depression, PTSD.

Everybody has had trauma in their lives. And we all end up living in reaction to that trauma in one form or another. And that anxiety, depression, fear, etcetera, has a big toll on our bodies. It has a big toll on our biology, not just our psychology, but our biology.

And so being able to help people unravel those knots to understand what were the traumas. Why did they occur? How did you perceive them?

Being able to heal those traumas, and then being able to transcend those traumas, to the point where you become grateful for everything that happened, there is nothing bad that ever happened to you, because it all brought you to this moment, getting people to walk through those steps are really transforming their lives and their perspective on their own life.

And what's happened becomes very, very important because it has such a major impact on biology. It makes our life better, but it also de-stresses the system tremendously.

So then making sure people have great relationships, understanding what great relationships are. I wrote about all this extensively in the book 100 Is the new 30: How playing a symphony of longevity will enable us to live young for a lifetime.

So looking at relationships. And then looking at things like spiritual health, right? Every study that's ever been done shows that people that feel connected to something greater, do better. They live longer, they're happier, they recover better in the ICU. Study after study after study.

So where are people in terms of their own spirituality? We're not interested in religion, per se, but spirituality is very powerful.

And then, you know, this idea of wisdom, ow much wisdom are people developing? And the reason wisdom is important is because when we make great decisions for other people, as well as ourselves, as well as the community, as well as the nation, as well as the planet, when we make those wise decisions, we feel so good about what we're doing. We feel so connected. And that also pays big dividends back to us.

And then one of the other things that's super important is feeling safe. A lot of people don't feel safe. And I think that all anxiety, all depression, fear, anger, most of those things, if you if you really start to dissect it back, peel the onion, back at the center of it is not feeling safe. And so then the question goes, Okay, well, then how do I feel safe?

Well, the first thing, you have to realize that there's nothing external to you that can ever make you feel safe. There's no amount of money, there's no position, there's no set of relationships, all of that can be taken away. History has shown us that everything can be taken away. So how do you ultimately feel safe?

There's another thing here about self love also, right? A lot of people are hard on themselves, they beat themselves up, they don't have unconditional love for themselves. So unconditional love for yourself is an inside job and making yourself feel safe is an inside job. And we help people walk through this and and develop these areas to where they actually change their perspective on life who they are, how they go through life.

It's transformative for them. It's really cool. And and having a sense of purpose and feeling worthy of all this. A lot of people will go around feeling, "Well, I'm not worthy. Why should I invest dollars into myself? Maybe I should give that to the church or give it to this school or whatever."

And yet, people are worthy. And what we love is that our people, as they feel so much better and act so much younger, their ideas flow, they start new companies, new businesses, their contributions to the world go up and up and up. It's a really spectacular return on investment for them.

So that is life energy. Then we go through a whole longevity circle, where we break down all the metrics related to the drivers of aging, the hallmarks of aging that people have heard about.

We're up to 16 hallmarks now. I won't rattle them all off here, but I wrote about it extensively in the book. And we have ways to measure most of those at this point in time. Not all of them. But all but about three or four.

And then there's then there's health, the health circle, so all the different organ systems, brain, heart,liver, kidneys, hormones, thyroid, muscle, bone, eyes, ears, gut, all of it. Everything is looked at in there so we can understand what's going on.

And then when it comes to performance, that's the last circle. Our goal is to be fast, agile, strong, quick, balanced, with great cardiovascular endurance and great recovery and flexibility. So if you're going to be if you're going to have that level of performance, then you have to train for that, right?

When you're 18, you can go for a run and lift some weights, and you're pretty good to go. But that's not how it is anymore. Every decade, you have to keep changing the way you work out.

You know, if people are married to the way they work out, like, "This is what has always worked for me in the past," okay, that's great. But you know what, as you go through life, making some modifications here will get you even better results. And train your nervous system better.

Most people confuse working out with training their muscles. What they're really doing is training their nervous system. The muscles come along for the ride. But you're really training your nervous system to be fast as well, strong, quick, balance.

When you start lifting a weight, for example, the first thing you're strengthening is actually the nervous system, the nervous impulses, not the muscle itself. So you're really training the nervous system.

And then being able to access flow states and things like this, where you can go into a state of flow, which is like meditation, basically an action, and you can live your life from that space. We have we have people that just just skyrocket through things that were holding them back, when you put all these pieces together.

So we're really married to this question of, how good can you be? How much contribution can you make? How many opportunities can you access?

And so our ideal client is someone with whom that message resonates. That would be our ideal client.

John Bejakovic:

So when you were talking about the the first circle, about life energy, it got me wondering, how do you actually work with people? So they come in for a consult. They do some tests. But this sounds like it's a very ongoing feedback system. Just walk me through how you would actually work with somebody who comes and says, "Make me as good as I can be." What does that look like?

Dr. Jeffrey Gladden:

So there are different surveys that we use for people, We can do different surveys to tease out things around the anxiety or depression or fear or trauma or things like that. So we can sort of tease those things out via some of the surveys that we give.

In addition, some of it's just very conversational. Just talking with someone, right? If I was asking you, it'd be like, well, let me let me understand better how you're thinking about this or feeling about there. So explain to me what what's happened. So it becomes conversational, where we really get to know the individual, right.

And then we can work with therapists of different varieties, whether it's PT for your shoulder, or whether it's a psychotherapist for your psycho-spiritual wellbeing.

And then we have technologies we can use to augment brain function and decrease anxiety and decrease depression and things like that. So there's different technologies that we use for that as well as different supplements.

And, and then ideas about self love and feeling safe. Those are ongoing conversations. Those those are the kinds of conversations at first you have to be asking the question, "How do I feel safe? How do I give myself unconditional love?"

Once you start asking the right questions, then we have continued conversations about how to do that. I had a couple of nice conversations with people last Friday around these very topics. Some things have come up in their life that are challenges.

And so when the challenges come up, it's like, "Well, I'm now back reading your book again, section one about life energy, because I'm finding it very inspiring."

And I said, "That's great. Let's talk about that. Tell me a little bit about what you're thinking and feeling here." And then from there, I was able to coach them around. "Okay, well, I'm seeing where you are. Now, this was the next things I would start to think about. And I would start to implement it in this particular way."

And that rang very true for the individual, for both of them, actually. And so we we try to allow people to take action and steps that they can. You can't take too big of a leap in these areas, but it's conversational. And so over time, that's how we work to optimize it.

John Bejakovic:

Got it. Okay, when I prepared the questions that I wanted to ask you during this call, I had a number of standard categories of longevity interventions, things like diet and exercise.

Now that we're talking, I'm not sure to what extent it makes sense to ask you about those because it sounds like what you do is very customized to individual people based on what their needs are, what their test results show.

That said, does it make sense? Can you go through these categories? Can you give me recommendations that you've seen work?

Dr. Jeffrey Gladden:

So let me just tee this up for the audience here. You know, if you have these four circles, right?

There's a circle around all the other circles. That's the life energy circle. Inside that circle is a Venn diagram of the other three circles, where they overlap with each other.

And there is no doubt that exercise and hormetic stressors, like saunas and cold plunges, and things like meditation, and things like eating the proper foods that are good for your system, and the variety of foods that are good for your system, maintaining nutrient good nutrient status, exercise, eating on a regular basis, but exercising in a way that's good for you on that particular day, that never goes away. That's always going to be central and core to this whole longevity equation.

But it's not enough. It's not enough. And so everybody that had exercised, ate better, slept better, decreased anxiety, learned to meditate, they all got older, too, right? They all got older, and they all passed away.

So we know that you can accelerate the aging process if you don't pay attention to that. And we know you can decelerate it if you do pay attention to it. But it doesn't solve the equation.

And part of the problem is that people have this perception that aging is linear. They think, "It's another year, I'm a year older, I'm not that much different." If they think they're in a linear process. But they're actually in an exponential process. Aging is an exponential problem. It accelerates so much more between ages 63 and 78.

Stanford data shows that the aging protein released into the blood is just massively increased over this time span. And so aging is anything but linear. And when you have a strategy of lifestyle, optimizing lifestyle, that is actually a great strategy, but it's a linear strategy to an exponential problem. And it will never crack the code.

So what you need is an exponential strategy for an exponential problem. So that includes all the lifestyle pieces, but then you also have to have all the longevity pieces, right?

Where you're going at the actual drivers of aging, you have to tease that apart, where is somebody relative to those hallmarks of aging, and help them move those back in time. Because those are independent. And sure diet and exercise has some impact, but there's more to be done there.

And then in addition to that, there's performance. Many people sort of take for granted their performance. It's like "Yeah, I work out."

"Okay, well tell me what you do."

"Well, I'm doing this and I'm doing that and I have a trainer, we do this."

And then it's like, "Okay, well that sounds great. Let's do some fitness assess assessments and see what see what things look like."

So we measure them for VO2 max and anaerobic threshold. How in shape they are, how good is their cardiovascular system? Because when you have a high VO2 max, which is your basically your body's ability to pump blood, how much blood can you pump every minute, you live longer, you're stronger, you're healthier, you get less cancer, less heart disease, less dementia. So having a high VO2 max is something to train for. And yet most trainers are not training for this right.

Then how do you deal with muscle loss as you age right? This becomes a more intricate problem. But there are solutions when you start to put hormone therapy with the right supplements with the right kind of training and the right days in the right sequence with the right peptides, you can actually build muscle at any age, you can build bone density in any age.

But you have to deconstruct the problem before you construct the solution is what we found. So, we really want to have people that are optimizing performance or optimizing the hallmarks of aging, then optimizing the health pieces, which includes the lifestyle pieces, but then that life energy circle, having that equanimity, having that sense of calmness, and peace, because stress just sabotages the biology.

We all know this. So you have to have all of that, when you put all that together with one other piece, which is basically constructing and architecting the environments that you reside in to support the mission. That's the fifth circle, let's call it.

We all live in four environments. We live at home, we live in the office, we live on business travel, and we live on vacation. And architecting each one of those environments to support the mission so that it's as effortless as possible, to do your workouts, to get the good sleep you need, to access the food that you need. Making those environments work for you, instead of trying to work against you becomes really important.

You know, we have people that that come in and say, "I was doing great. I was doing fantastic. I'm making all kinds of progress. And I went to Italy for three weeks, and the wheels came off."

So you see, if you're not intentional about this, where you're really architecting all these environments... my idea of going on a vacation is to come back stronger than when I left. Not weaker than I left. So that's kind of how I think about it.

John Bejakovic:

A lot of the stuff that gets talked about in terms of longevity is either very exciting, scientific research that's not really ready to be applied to humans yet, or there's a lot of lifestyle advice that's been around for a long time that's maybe gotten incrementally updated, but it's not drastically different from what we knew, let's say, 5 years ago, 10 years ago, maybe even 20 years ago.

In between that, I heard you mention different interventions that people might not know about, that are cutting-edge longevity treatments, that go beyond diet and exercise, and that are pointing towards things that are coming in the future. Can you tell me some of the stuff that you do with your patients that fall into that category?

Dr. Jeffrey Gladden:

Yeah. So let's just focus on the longevity piece for a second. We're gonna bypass health and performance and just focus on those hallmarks of aging. So, you know, we have to measure telomere lengths, and there are ways to really lengthen telomeres also, that we're working with.

We have ways to measure the age of someone's immune system. You may have heard that immuno-senescence is a big problem, that when the immune system ages, it can no longer recognize foreign invaders or cancer cells. And so doing things to actually reboot the immune system, make it younger, less senile, so to speak, and then increase its activity, in appropriate ways.

We have strategies for all that — different supplements, different peptides, different protocols. But again, we measure directly to see where somebody is, before we do anything.

And then, we can look at changing DNA methylation ages. A lot of this is done through lifestyle changes for the most part. And you can significantly impact your rate of aging by lifestyle changes. Glycan age is another age that we measure, which has to do with endogenous blood sugars that are attached to antibodies. These are sugars that your body makes. It's not sugars that you're eating. Sugars modify proteins for different functions, so that protein can function in different ways.

And there are patterns of these sugar attachments to antibodies that basically are associated with aging or with youthfulness. And it's possible for people to be decades younger and all these areas right.

And then we have panels that will look at inflammatory markers that typically go up with with aging and things like klotho. We can measure klotho. Klotho is a protein that when it's elevated, it decreases cardiovascular aging, maintains brain health, maintains kidney health, etc.

So things like this we can measure. We can look at DNA damage, we can look at other markers associated with with senescence cells and the accumulation of senescence cell burden.

And then we've actually developed another test, a transcriptomic and proteomic tests, looking at how DNA is transcribed and what proteins are made from it, that can look at things like cancer risk potential, what's the body's ability to handle inflammation and oxidative stress currently? What's happening with telomere shortening actively? Not what are their lengths, but are their ongoing processes that are shortening them?

You know, things like this. What's the senescent cell burden? How are the mitochondria doing? We have access to all of these through different lenses. So we can look at many, many of these hallmarks. So when you do that, then you can construct therapies. Of course, lifestyle will be involved. But there are things that go well beyond that.

For example, we can do plasmapheresis, where we remove old plasma from people, which in and of itself, has been shown to rejuvenate the body. Also because we're in Texas, we can couple that with the young plasma. So we can take out old plasma, put in young plasma, right now, that has the rejuvenating impact on its own as well.Those youthful factors in the young blood, like GDF11, will have an impact on the body in a positive way.

And then we also can use regenerative products like different kinds of stem cells and exosomes and PRP and things like this, that when you start to sequence these things, you get the best results.

For example, if you're just going to use stem cells, let's say, well, a stem cell going into an older individual doesn't actually do nearly as much as it can. If you first clean out the old stuff, put in good new stuff, then add the stem cell products and the exosomes, and then add in signaling peptides, that will actually help orchestrate everything to move forward.

When you do that, and combine it with lifestyle, now you're really getting changes, right? So this is really exciting. And then we can use something called brain frequency to actually rejuvenate people's brains, whether it's it's been from anxiety, depression, stroke, head trauma, PTSD, even addiction can be addressed this way.

So this is a transcranial magnetic stimulation device that measures the electrical strength of the electrical impulses of the neuron. So where they're weak, we can stimulate it with the magnet to actually strengthen that those neurons. So it takes 20 to 40 sessions. But over that period of time, the brain is tracked by an EEG every 10 sessions, we can see the brain getting stronger.

So these are cutting edge things. We can deconstruct dementia. We've been helping people enhance their cognitive abilities, their hormone function or sexual function. We have people that come into us on five blood pressure medicines, and six months later, they're on one medication and some supplements.

And the reason is because we've unraveled a knot first, what's actually going on with them? What are the cards that they hold? And where are they in the game?

And next thing you know, we have clues as to basically how to go about this in a more elegant fashion. And we get them back under control. It's very exciting work. We'd love doing this kind of stuff.

John Bejakovic:

Absolutely. Actually, I guess that we've covered a lot of what I wanted to cover. It really sounds extremely comprehensive. And it sounds like this is not something that people can be doing at home, and it's a good reason to come talk to you.

But that said, if somebody is at home, if they are looking to optimize their longevity, if they're not ready to come and work with you, do you have any advice to them beyond what they're reading about supplements and diet and exercise?

Dr. Jeffrey Gladden:

Yeah. I think grabbing a copy of the book 100 Is The New 30 would be really a great start. You'll find there's so much actionable information that I've put into that book. We're really trying to democratize the information. Of course, you don't have the benefit of actually working with somebody to deconstruct it for you. But you are getting lots of useful information. So that's number one.

Number two is we do have a supplement shop also where we sell supplements that we know are good and generally good for basically everybody or most people. It's broken down into different categories of things, whether it's gut health or brain health or cardiovascular health or immune support or GI tracts support gut support. So people can go in there and read about the supplements that we have, and make choices there.

And then the last way to actually access us, apart from reaching out to us, would be to go to the podcast, the Gladden Longevity podcast. I think we're coming up on 240 shows or something like that. So there's really a wealth of information in there on many topics that people would enjoy. So those are ways to access it from more of a generic standpoint, if you will.

But if people are really interested, like, you know, I've got a lot to live for, I really want to accomplish a lot in my life, and I'd like to invest in myself, then they can reach out to us on the website, and we can reach back out.

I will tell you that to work with us, to do all that initial testing is probably going to be the better part of $40 to $50k to get it all done, if someone's just, let's say, 65, to 80. Because they've got a lot going on, it has to be understood. But I will also say that everybody pays for it pre-tax. There are ways to run this through an HSA or a business or different ways you can talk with your accountant about it.

So let's say you're in a 40% tax bracket, if you're in California, maybe it's 50%, I don't know. But all of a sudden, if you take that and you've cut it in half, the return on investment is is so dramatic for the dollars that you actually put in. So we feel like it's an amazing value, quite honestly.

John Bejakovic:

And do people only work with you by flying into Texas and working with you directly? Or how does it keep going if if somebody's not from there?

Dr. Jeffrey Gladden: 

Great question. So medically, legally, we have to see somebody in the state of Texas to establish a physician-patient relationship. So they do need to come to Texas for us to be able to do that. And they usually come and spend two or three days with us to get all the testing done up front, and we go through results with them at that point.

And then from there, we can do a lot of it via Zoom. We do love it if they can come back in six to eight weeks when we get all the tests back, so we could spend another day with them kind of going through everything, showing them stuff, having them practice something so that when they go back home, they don't have to start implementing everything.

And we make it bite size, right? Like we're not going to try to fix everything at once. Let's start here, or move our way through it as we go through a year.

So when people do that initial assessment, that's kind of the launch module. That's really where we get all the basic testing, what cards you're holding, where are you in the game, and then make the initial recommendations.

Then people have an option. They can say, "Great, I'll take it from here, I really appreciate it." Or, "I'm gonna go work with my local doctor." Or, "No, I love the way you guys think. And I love the technologies you can give to me that I can't get elsewhere. I want to work with you."

At which point we'll sit down and build out a plan based on understanding now what they really need and build out a plan for the rest of the year basically, and do some things that way.

Dr. Dian Ginsberg, age 59, clearly overflowing with energy

Who we're talking about: Dr Dian Ginsberg, MD. Ginsberg started out as a gynecologist and obstetrician, but she has gradually became more and more interested in functional medicine. Today, she heads the Ginstitute of Functional Medicine, which uses personalized medicine to help patients "reclaim their optimal health."

And the news is: Ginsberg, who is 59 years old, is currently no. 11 on the Rejuvenation Olympics relative leaderboard and no. 4 on the absolute leaderboard.

She has managed to drastically reduce her speed of aging from her starting point, and she is now among the top rejuvenation athletes in the world. In other words, whatever she is doing, it's working, at least for her.

Why this is a big deal: Lifestyle interventions such as sleep, diet, and exercise are still the most significant and proven longevity therapies we have. But that's starting to change. And clinicians like Ginsberg are at the cutting edge of new longevity therapies, with the best data on what really works in real human beings.

So what's next? If you'd like to hear about some of Ginsberg's cutting edge work, she gave a talk at RAADfest last year. She discussed case studies of her patients who significantly reduced their speed of aging using available and yet cutting-edge longevity therapies. You can find that video here.

Various rabbit friendly foods, lettuce among them, contain flavonols such as quercetin and kaempferol

What's the news: Flavonol intake is tied to significantly lower levels of all-cause mortality.

Why should we believe it: This news is based on a new study published two weeks ago by scientists in China. They looked at 11,679 U.S. adults who were closely followed over a 20-year period.

The scientists looked at the type and amount of foods in these subjects' diets, and used this to estimate intake of specific food compounds known as flavonols. Results:

• Total flavonol intake was tied to a 36% lower risk of all-cause mortality

• Total flavonol intake was also tied to a lower risk of mortality due to cancer (by 55%) and cardiovascular disease (by 33%)

• A specific flavonol known as myricetin was tied to a 66% lower risk of mortality due to Alzheimer's disease

Why this is a big deal: This is a cross-sectional study, so it doesn't prove causality. But it fits with other cross-sectional studies that have shown that low flavonol diets go hand in hand with higher cardiovascular disease, higher frailty later in life, and increased risk of cancer.

So what specifically can you do now: You can get different flavonols in onions, apples, grapes, tomatoes, kale, broccoli, blueberries, blackberries, raspberries... you probably get the idea. In other words, "get your flavonols" is really a restatement of the old advice to eat your fruits and veggies.

That said, if you suspect you don't get enough flavonols in your diet, then supplements are an option. A May 2023 study found that daily supplementation with 500 mg of flavonol-rich cocoa extract restored memory in a large group of adults who ate low-flavonol diets. My guess is it might be good for health in other ways, too — maybe even for staying alive longer.

We might soon have pharmaceuticals to preserve muscle as we age — something that was once thought impossible

What I'm reading: A new article in Nature Biotechnology titled, After obesity drugs’ success, companies rush to preserve skeletal muscle.

Background: Over the past few years, we've gotten several effective and massively popular weight-loss drugs like Ozempic and Mounjaro. Such drugs cause loss of both fat and muscle. The first is good. The second is not.

The good news: A number of clinical trials are under way to test pharmaceuticals to preserve muscle mass that follows obesity treatments.

Previously, muscle loss was thought to be an issue that doesn't respond to drugs. And yet, we now have several promising phase 1 and phase 2 studies for drugs that not only preserve muscle but also improve fat loss — since more muscle makes it easier to lose fat.

Why this is a big deal: These new drugs won't just help people who lose weight via drugs like Ozempic. They also will apply to age-related muscle loss, which is both caused by aging and which also contributes to aging via frailty, limited mobility, lower energy. One Phase 1b study in bedridden patients aged 65+ showed significantly reduced muscle loss.

So, what specifically can you do now: Considering the success of weight-loss drugs like Ozempic and Mounjaro, interest in muscle-preserving drugs is suddenly high. It's likely we will see pharmaceutical solutions for this problem in the next few years.

In the meantime, the best advice to preserve your muscle is old and familiar. Practice resistance exercise, and eat enough protein. These two lifestyle decisions will keep you stronger and healthier until exciting new therapies arrive.

Matt Kaeberlein and David Sinclair, apparently not very impressed by each other

Who we're talking about: David Sinclair, a leading longevity researcher at Harvard University, and Matt Kaeberlein, a leading longevity researcher at the University of Washington.

At one point, Sinclair and Kaeberlein were both working in the lab of the same professor at MIT. It seems that their scientific differences, and maybe even some bad blood, stem from that time.

What's the news: In a tweet yesterday, Kaeberlein announced he is resigning from The Academy for Health and Lifespan Research, a professional body of longevity researchers that has Sinclair as President. Kaeberlein wrote:

How we got here: The spark for this was Sinclair’s claim last week that a brand of dog supplements, sold by a company he co-founded with his brother, reverses aging in dogs.

Kaeberlein doesn't believe these claims are supported by the data. While he has accused Sinclair of exaggeration and hype before, he has never done so in such direct language, and with such a dramatic gesture.

Why this is a big deal: Both Sinclair and Kaeberlein are established figures in longevity research. Both are associated with prestigious universities. Both publish their research in top, peer-reviewed scientific journals.

Where they differ is in their attitude towards marketing, hype, and showmanship when it comes to pushing the field forward — and making money in the process.

So what's next? The drama is unfolding, and Sinclair hasn’t responded publicly yet. Meanwhile, the research pushes on.

Kaeberlein, along with his work on rapamycin and human longevity, continues to head the Dog Aging Project, designed to understand and improve the effects of aging in dogs.

On the other hand, Sinclair, among his many other ventures, recently announced that trials of epigenetic age reversal would start in humans in 2025. One way or another, it's exciting days in the longevity field.

A weight-conscious macaque eats a green banana, an unappetizing source of resistant starch

What's not news: Resistant starch helps weight loss.

Why we should believe it: Evidence has been piling up for years. Most recently, a new study published this Monday by scientists in China showed that 8 weeks of resistant starch supplementation led to 2.8kg in weight loss, with no other change in diet or exercise habits. A placebo supplement created no weight loss.

Previous studies have hinted that resistant starch helps weight loss in various possible ways. Maybe it's via lower insulin levels, the release of gut satiety peptides, or enhanced fat oxidation. This new study provides a different explanation. It shows that resistant starch reshapes the gut microbiome in ways that create weight loss.

So, what can you specifically do now: If you'd like to lose weight easily and naturally, you can supplement with resistant starch. The present study used 40 grams of maize-derived resistant starch each day.

Another, probably healthier option, is to simply introduce more beans and legumes into your diet. Beans and legumes are a natural source of resistant starch. Unlike other sources of resistant starch, such as green bananas, uncooked oats, and cold rice, beans and legumes fit well into many meals and diets. And as Dan Buettner has been pointing out for years, they are a staple of Blue Zones eating patterns.

Harvard genetics professor George Church, one of the co-founders of Rejuvenate Bio

What's the news: Old wild mice live longer and stronger with OSK reprogramming.

Why should we believe it: This news is based on a new study published earlier this month by scientists at Rejuvenate Bio, a startup spun off from Harvard's Wyss Lab.

The scientists treated 124-week-old mice (equivalent to 77-year-old humans) with OSK. That's a treatment made up of 3 of the 4 rejuvenating Yamanaka factors that won the 2006 Nobel Prize. Results:

• Treated mice lived 109% longer than control mice (142 weeks vs. 133 weeks)

• Treated mice showed "significant improvement in frailty scores"

Why this is a big deal: OSK has already been shown to be a powerful rejuvenating intervention. But it was previously used with genetically modified mice, and with younger mice. This study shows significant results in wild mice, and in mice that had already accumulated a lot of mileage.

So what's next: Rejuvenate Bio recently signed a partnership to develop a "one-shot" gene therapy for dog osteoarthritis. That therapy uses a different technology than the one described in this study.

With this proof of concept of OSK in old wild mice, a trial in dogs seems like a likely next step. And beyond that? Let's hope for similar results in humans soon.

David Haase, MD, the “coach” the the #1-ranked Rejuvenation Olympian

Who we're talking about: Dr. David Haase, a double board-certified physician. Haase received his medical degree from Vanderbilt University School of Medicine and did his residency at the Mayo Clinic. Since 2003, he has headed MaxWell Clinic, a functional medicine clinic in Nashville, TN.

And the news is: One of Haase's patients at MaxWell Clinic, Dan Sullivan, is currently #1 on the Rejuvenation Olympics absolute leaderboard. Sullivan is 78 years old and is aging just 0.71 biological years for every chronological year. Whatever Haase is doing to Sullivan, it's working.

Why this is a big deal: As I've written before, scientists are making big progress teasing out the many complex mechanisms of aging on the molecular, genetic, and epigenetic levels. But what do all these results mean if you want to slow down or even reverse your biological age today?

Clinical practitioners, who work with actual people, have the best insights on that. And according to the Rejuvenation Olympics results, Haase is right at the top of that clinical practitioner group.

What's next? MaxWell Health offers 3 and 12 month programs for patients. In case you're interested, you can find more details here. And if you're not looking for a full-on longevity clinic, Haase also has a YouTube channel where he regularly posts news, shares advice, and holds webinars.

Exercising for longevity just comes easier to women

What's the news: Women get the same exercise benefit as men with half the work.

Why should we believe it: This news is based on a new study set to be published next Tuesday by scientists at Cedars-Sinai Medical Center. The study tracked a massive group of 412,413 adult participants. It looked at all-cause mortality and self-reported exercise habits. Results:

• Men who exercised 300 minutes per week reduced their risk of death the most, by 18%.

• Women got the same 18% reduction in mortality from just 140 minutes of weekly exercise.

• Women continued to get additional benefit up to the 300-minute mark.

Why this is an interesting result: This is an observational study. It cannot prove cause and effect. But it fits into what we already know — that regular exercise reduces mortality. It's just that some of us have it a little easier than others.

So what specifically can you do now: Exercise. This new study is not an excuse to cut down your exercise, but a motivation to start. Particularly if you're a woman — and even if you're a man — any amount of exercise will help you live longer and look younger.

Long walks for better brain health — it’s never too early to start

What I'm reading: A Wall Street Journal article from earlier this month titled, The Clinics Treating Dementia Symptoms Before They Start.

The gist of the article is there in the title. Various new clinics, typically in famous hospitals like Cedars-Sinai, are offering testing and recommending interventions to stave off dementia. Most patients at these clinics are in their 40s to 60s. Some clinics take patients as young as 18.

Why this is a big deal: If things keep going as they are now, rates of Alzheimer's are expected to double in a few decades. On the other hand, 40% of dementia cases are believed to be preventable by simple lifestyle interventions, such as reduced alcohol consumption, less air pollution, and more exercise.

Lifestyle interventions are largely what these clinics seem to offer at the moment. Chrissy Goodman, a 51-year-old patient at Cedars-Sinai’s new clinic with no signs of cognitive impairment, was told to take longer walks with her dog and to cut down on sweets.

But what about new treatments? We now have new drugs that can slow the progression of Alzheimer's. These drugs might even prevent the disease indefinitely if started early enough. Plus, we just got a new test that can accurately predict dementia a decade in advance.

Unfortunately, I didn't see any mention of these exciting new developments in the article. But if these cutting-edge tests and drugs do come to a clinic, I suspect they will come to one of these clinics first. If you'd like to find out more about them, the WSJ article is worth a read.

Chris Masterjohn, PhD, smiling about his very slow pace of aging

Who we're talking about: Chris Masterjohn, a PhD in nutrition sciences. Previously, Masterjohn worked as a professor at Brooklyn College. Since 2017, he's been writing online about the intersection of nutrition and health.

Why this is a big deal: Lots of people write online about the intersection of nutrition and health. But in my opinion, few do it with the scientific rigour that Masterjohn does. He often has contrarian takes — because he digs into the research more deeply than others do.

And the news is: Masterjohn seems to be stepping into the longevity influencer world. He recently wrote about holes he sees in Bryan Johnson's Blueprint protocol. He criticized calorie restriction as a longevity intervention. And he's made the claim that low levels of alcohol actually improve longevity.

Masterjohn has also taken the Dunedin PACE test for the speed of aging. His result came back at 0.66 biological years for every chronological year. If he can repeat this result over two more tests, he will be near the top of the Rejuvenation Olympics leaderboard.

What's next? Masterjohn shares his surprising longevity takes via an email newsletter. It's one of the few in the health space that I take the time to read regularly. If you'd like to do the same, you can subscribe to it for free.

USC professor Valter Longo, the inventor of the fasting mimicking diet

What's the news: Fasting mimicking diet reduces biological age by 2.5 years.

Why should we believe it: This news is based on a new paper published this past Tuesday by scientists at Yale and USC. The scientists took 100 healthy participants, aged 18 to 70. They split them up into two groups.

One group, the control, ate a normal diet. The second group followed the fasting mimicking diet (FMD) for 5 days a month. They repeated this for three months, and ate a normal diet otherwise. Results:

• The FMD group showed reduced insulin resistance and other prediabetes markers

• The FMD group had lower fat in the liver and improved indicators of immune system age

• The FMD group lowered their biological age by 2.5 years, independent of weight loss

Why this is a big deal: FMD is a simple 5-day diet. It's designed to provide the benefits of fasting without completely restricting calories. Previously, scientists showed that FMD reduces body fat, blood pressure, and cancer risk.

The current study adds a new data point. It shows us that FMD actually reduces biological age, independent of weight loss.

So what specifically can you do now: If you want to try FMD, there are two ways to proceed. One is to order an all-in-one meal package from L-Nutra. That's a company started by Valter Longo, the USC professor who invented FMD.

The other way is simply to create your own fasting-mimicking diet. The principles behind it are described in detail in chapter 6 of Longo's 2018 book, The Longevity Diet.