Category

Biomarkers and Testing

16 evidence-based articles

Your birthday measures time; biomarkers try to measure how your body is actually aging. Experts writing in Cell in 2023 noted that the field still lacks agreed standards for what makes an aging biomarker reliable, and set out a framework for defining and validating such markers before they are used in trials and clinics.1

Some measures already rest on strong evidence. In 122,007 adults who had treadmill tests, lower cardiorespiratory fitness was linked to higher long-term mortality with no observed upper limit of benefit, and the extra risk of low fitness was comparable to or greater than that of smoking or diabetes.2 For heart disease, genetic studies, cohorts and randomized trials covering more than 2 million people consistently show that LDL particles cause atherosclerotic cardiovascular disease, which is why the lipid tests in this section matter.3

The articles below explain what each test measures, how to read results against standard reference ranges and guideline cut-offs, and where the evidence is still thin.

Reading path

Read in this order: the essentials first, then the detail, then the reviews that test popular claims.

Start here

  1. The Complete Longevity Lab Testing Guide: What to Test, When, and What the Numbers MeanWhat to test and when, from routine panels to ApoB, Lp(a) and HbA1c, and how to interpret the numbers at different ages.
  2. ApoB: The Cholesterol Number Your Doctor Probably Is Not OrderingWhy ApoB counts the particles that drive atherosclerosis, how it differs from LDL cholesterol, and which targets and tests are worth discussing.

Go deeper

  1. Fasting Insulin and HOMA-IR: The Biomarkers That Catch Metabolic Disease Decades EarlyWhy fasting insulin and HOMA-IR can reveal insulin resistance years before glucose rises, how to test them, and what the numbers mean.
  2. Lp(a): The Genetic Cardiovascular Risk Factor Most People Have Never Heard OfWhat lipoprotein(a) is, why levels are mostly inherited, who should be tested once, and the treatments now being tested to lower it.
  3. Coronary Artery Calcium Scoring: What Your Score Means and When It Is UsedWhat a coronary artery calcium score measures, who should consider the scan, and how the result can change decisions about statins and prevention.
  4. VO2 Max Testing: How to Measure Your Cardiorespiratory FitnessHow VO2 max is measured in a lab, on a treadmill or by wearables, how accurate each method is, and what your result means.

Evidence checks

  1. Continuous Glucose Monitoring for Non-Diabetics: What Your Blood Sugar Does All DayWhat a continuous glucose monitor shows in people without diabetes, how to read the spikes, and whether the data is useful for long-term health.
  2. The Wearables Guide: What to Track, What to Ignore, and How to ChooseWhich health metrics from wearables are worth tracking, which are noise, and how to choose a device for sleep, fitness and heart data.

Sources

  1. 1Moqri M, et al. "Biomarkers of aging for the identification and evaluation of longevity interventions." Cell. 2023;186(18):3758-3775. PubMed · DOI
  2. 2Mandsager K, et al. "Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing." JAMA Netw Open. 2018;1(6):e183605. PubMed · DOI
  3. 3Ference BA, et al. "Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel." Eur Heart J. 2017;38(32):2459-2472. PubMed · DOI
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Brain and Cognition (8) Cellular and Mitochondrial Health (8) Epigenetics and Aging (10) Exercise and Performance (10) Hormones and Peptides (4) Longevity Supplements (13) Nutrition and Fasting (17) Research and Clinics (24) Sleep and Circadian Biology (7)
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