A longevity protocol built only on what the evidence supports

Ranked on: the strength of human evidence and the size of the effect on mortality and function. Nothing here is ordered by cost, novelty or commercial value — which is why the expensive items are last.

1. 01

   Cardiorespiratory fitness

   Largest single effect

   VO₂max is consistently among the strongest modifiable predictors of all-cause mortality in large cohorts, and the difference between the lowest fitness category and the next one up is where most of the benefit sits. Practically: zone 2 aerobic work most weeks, with some higher-intensity intervals. If you do one thing on this list, do this one.

2. 02

   Resistance training

   Protects the thing that fails first

   Muscle mass and strength decline from midlife and predict independence, fall risk and mortality. Resistance training is the only reliable way to defend them, and it becomes more important with age rather than less. Two to three sessions a week covering the major movements is sufficient.

3. 03

   Blood pressure and ApoB

   Cheap to measure, treatable

   Both are modifiable, both have decades of outcome evidence, and both are frequently ignored by people spending thousands on longevity supplements. Measure them, and if they are elevated, treat them — usually with medication that has better evidence than anything else on this page.

4. 04

   Sleep

   Underrated because it is free

   Short and fragmented sleep tracks with metabolic dysfunction, cardiovascular risk and cognitive decline. Consistency of timing does more than any supplement marketed for sleep. If sleep is genuinely disordered, that is a clinical problem worth investigating rather than supplementing around.

5. 05

   Protein adequacy and body composition

   Enables everything above

   Adequate protein supports the muscle that resistance training builds, and matters more with age as the anabolic response blunts. This is also where GLP-1 medications need care: substantial lean mass is lost alongside fat unless training and protein are deliberate.

6. 06

   Creatine monohydrate

   The one supplement that earns its place

   Hundreds of human trials, consistent effects on strength and lean mass, growing cognitive data in older adults, and a cost of a few dollars a month. It supports the second item on this list, which is why it ranks above compounds with far better marketing.

7. 07

   Everything else in a bottle

   Optional, at best

   NAD⁺ precursors, taurine, spermidine and the rest sit here — not because they are worthless, but because their human evidence covers biomarkers and short-term function rather than outcomes. Treat them as considered experiments once the items above are genuinely handled.

• Check interactions first. The most common real-world harm from a longevity routine is a supplement meeting a prescription, not a compound being ineffective.
• Match the dose to the trial. A product below the studied dose does not inherit the study's evidence, whatever the label cites.
• Change one thing at a time. A protocol assembled all at once cannot tell you which part worked.
• Decide in advance what would make you stop. An open-ended protocol with no exit condition is a subscription, not an experiment.