R&R#8: My Personal Health Routine
It's important to know not just what the conclusions are, but how to get to them, to optimize your own routine.
Unsurprisingly, the wider longevity community is full of people who on average care a lot about their own personal health. Whether simply wanting to avoid diseases of aging for which there is a big lifestyle component, or alternatively as a concerted attempt to achieve Longevity Escape Velocity in tandem with advancing medical progress, people take to heart the goal of living a long and healthy life. And, people have a strong sense of wanting to take action rather than crossing their fingers. On top of this there is also a fraught relationship between some longevity advocates and the medical establishment, with the FDA often seen as too conservative and the medical establishment as a whole as misaligned (or even against) the goal of long life. Thus, the “biohacking” mindset is very common.
I have personally been very attentive to my own health since I was a teenager, with longevity being only one major driver. Overall, I went through a few phases of looking at the question of personal health.
1. From high school to around 27 I tried to do overall the right things but was relatively passive and didn’t take many supplements. Generally being a person who loves working out and defaults to a healthy diet, there wasn’t really THAT much that I needed to do until 25 for most of these points anyways.
2. Then, I fell into a rabbit hole of trying 50+ different supplements and multiple lifestyle changes in the unfulfilling third quarter of my PhD. Perhaps it was because my attention was longing for something to focus on and optimize in light of unsuccessful genetic screens in lab, or maybe just because I was finally feeling like my fitness was plateauing. Regardless, the obsession ironically led to oversensitivity, higher stress levels, multiple doctors appointments and problems being designed around answers. It was at this point that I mainly learned how NOT to approach personal health.
3. Subsequently, I got a concussion and had extended post-concussion syndrome and learned why the average person is REALLY driven to biohacking. During the 6 months between when I got my concussion and when I got prescribed a drug which actually majorly reduced the cognitive fatigue, I saw multiple doctors for ACTUAL important reasons and ended up being recommended magnesium, riboflavin and acupuncture from one of NYC’s top TBI neurologists (that is actually how poor the standard of care for PCS is). Thus, having a condition which makes everything in your daily life suck 50% worse whilst being understood less well than quantum chemistry, I stopped caring about purely theoretical optimizations to squeeze an extra 10% out of all relevant health parameters.
4. Finally, post 30 and after finding a few things that worked for me, I became relatively more conservative while understanding better how to test self-interventions. I’ve come to appreciate that, as a 33-year-old, I have plenty enough time to underline and reassess my goals and carefully apply the scientific method.
The points that I want to optimize, and what I do for them, are:
Physical fitness, the bread and butter for living longer and healthier.
a. Aerobic ability- ~4hrs a week of zone 2 aerobic exercise, including (in order of how common I do it) running, beat sabre, biking/stationary biking
b. VO2 max- Aim for 30 minutes a week at least at VO2 max level, would like to build to 1 hour. VR martial arts (Thrill of the Fight or Dragon Fist), hill/stair running, track laps (rare)
c. Strength- At least one but ideally two days with large muscle exercises (Deadlift/Squat/Bench Press/Abs, usually takes ~20-30mins), 1-2 days/week climbing + pullups/bench press
d. Flexibility/Stability- Climbing, yoga (I’m not consistent with this sadly).
e. Injury Avoidance- Not a single thing but more a mandate to think through things before I do them.
f. Overall, these are so that I can do fun things and do them well, and eventually achieve the “centenarian decathlon” noted by Peter Attia in his recent book “Outlive” (these were my primary fitness goals prior to reading the book as well so I was happy to see our views aligned so well). Or even more ideally, an actual decathlon.
Reducing stress/anxiety and maintaining mental health, equally important though I’m not going to profess to be wildly succeeding at this, these are just what I try to do giving I’m still treading water occasionally.
a. Meditation during/alongside yoga. It’s my new years resolution to be more consistent with this because I used to be more so before Lento. Usually I aim for 30 minutes total, can also do this when on planes/trains etc.
b. Do fun things! Especially nice that “fun things” for me has huge overlap with physical fitness
c. Generally trying to connect with people in meaningful ways, focusing on people I know well and trust/care for but also enjoying meeting new people
d. Sleep. Plenty of resources on doing this better, but ya it’s important. Also a thing I often fail at.
Cognitive ability, may help stave off neurodegeneration but also worth working on in its own right.
a. Visual attention/coordination/fast decision making – video games like beat saber, I often play with my friends/family
b. Verbal fluency – Language learning, I often do this while driving or waiting in an airport etc through podcast apps and also language exchanges. It forces you to consider the context of things intensely and do many things with slow thinking that you would normally do subconsciously
c. Strategic and applied intelligence- now mostly my work, I feel like its stimulating enough, though in the past I may have put Real-Time-Strategy here as well
d. Technical problem solving- Be curious and determined to make things work which are not straightforward (generally you get a lot of this in science, but it can be many things).
Eat right and get the right nutrients: Another thing I really agreed intensely with from Peter Attia’s recent book was that the healthier you already are/the more you exercise, the less you need to do some insane diet (i.e. don’t put a cast on an arm unless it’s broken).
a. What to eat- Macro balance is very personal IMHO. I do better on carbs, especially fruit/berries/oatmeal, I eat a lot of dairy, and I love pizza. I’m a vegetarian (not for health reasons) yet I make sure to get at least 100g of protein as I workout a fair amount and I’m larger (~190lbs). I don’t eat a lot of saturated fats or PUFAs.
b. When to eat- I don’t eat when I’m not hungry.
c. How much to eat- When I do eat I generally eat as much as I feel like because, coupled to my work out routine, I don’t gain weight that way. I am not naturally inclined to stuff my face. Also I don’t mistake stress-induced carb desires for hunger (though I also don’t totally restrict carbs in that case as they acutely lower cortisol).
d. Supplements- Many of these are nutrients that I’m missing as a vegetarian, some of which are linked to longevity such as taurine and maybe EPA/DHA, and some of which help with methyl metabolism such as B12/MTHF/creatine.
e. Medications- I’m not afraid to take medications lacking in side effects if I think I need them and a doctor agrees, relating to physical or mental health. If a drug makes the difference between you being constantly depressed or anxious (not necessarily personal experience just an example) to enjoying life, it’s a longevity drug both directly and indirectly IMO.
Looking good – Wearing sunscreen, having good hygiene and exercising a lot is largely enough at least up to age 50 for most people I feel. Does make sense to account for your personal skin type though, for example I have oily skin and hair and focus my minimal routine around that.
a. I may try OneSkin’s product at some point in a few years when I’m a bit older
There are several main principles I follow regarding optimizing my own personal health.
General:
ONLY TEST 1 INTERVENTION AT A TIME! This one should be a no-brainer, but people have a tendency to rationalize when they are in a mode of constantly reading about all the things that they could do and getting excited/hopeful. The time interval between adding interventions will vary based on what you are looking for, but in general it’s better to be conservative by thinking in terms of a few months rather than days/weeks.
The main exception is when you are testing something which is designed to have an immediate effect, for example a short acting nootropic, you shouldn’t have to wait for a month. But, you SHOULD avoid taking it right after starting some other longer-term intervention which could be a confounding factor, and take advantage of the short duration to get at least n=3 or greater before forming opinions
ALWAYS HAVE A DEFINED READOUT! This is equally as important as the first point, especially since your period of time to assess an intervention should be much longer than your short-term memory of your own feelings extends. Looking back will be a fishing expedition for minor changes in how you were feeling, most of which will be placebo in net favor of what you subconsciously want to be true about the supplement.
The best way to monitor your readout would most likely be to keep an excel sheet with all relevant parameters updated daily. But, most people will not manage that. Thus I think a journal updated every few days assessing your health will generally work. Health and fitness tracking apps like Strava or Daylio can also help, some of them even will export your data as excel or CSV.
Hard readouts such as blood tests are useful as well, but mainly if you have something really specific you are looking for. For example, taking a nutrition panel where you learn you are short on vitamin D, and then re-testing after adding a supplement. Usually (but not always) the types of reasons you would need to take a blood test would be things you can go to the doctor for and get insurance coverage for anyways.
For supplements and medicines:
Only get your information from resources which either are peer-reviewed, or heavily reference exclusively peer-reviewed papers. And, always seek a second opinion, including scrolling through PubMed. I think most biohackers in the longevity community are very science literate so they actually won’t have a problem with this one.
Work with a doctor if possible. A good PCP will help, not hinder, your efforts by giving you critical feedback, and you will be thankful a decade later when your medical records better reflect your efforts.
Accept that N=1 studies and case examples are useful for the participant alone. Anecdotal opinions and experiences from biohacker influencers provide just enough information to take over your thoughts and sway you out of being objective, and are especially useless given that said people tend to try dozens of new interventions per year.
On that note, sign up for a clinical trial if there is one available for the intervention you are trying! Trials for things like rapamycin and dasitinib + quercetin are ongoing, yet many biohackers choose to not participate. Want to contribute to something greater being built bottom up while also optimizing your own health? This is absolutely the best way. And, trials have carefully in-built methods of assaying success, optimizing the experiment for you as an individual as well.
Have a very high bar when it comes to supplements/medications proclaimed to extend lifespan which don’t have alternative readouts, as you will be taking them indefinitely based on theoretical promise. For me the ideal bar is a successful clinical study measuring composite endpoints for aging like the TAME trial. Other than that, maybe I will take rapamycin when I hit middle age, I honestly haven’t decided yet.
For lifestyle things:
Find ways to touch on multiple points with one activity. This will save time, also I think the average person can only focus on so many lifestyle things at once. Examples from my list above:
Climbing deals with whole body strength, flexibility/stability, and problem solving skills.
VR games give aerobic exercise (beat saber at higher levels) or VO2 max (Thrill of the Fight) along with visual attention/coordination/dexterity.
Yoga adds flexibility/stability, potentially aerobic/strength depending on thee type, meditation, and can add to injury prevention by strengthening small muscles and reducing stiffness.
Do things that are fun, and do them with other people if you can. This is killing two additional birds with one stone regarding mental health, and ensuring that you come back to doing something. Above all, whenever it comes to health-related things, I choose the path that feels the best to me since it’s the only way I’ll stick to it. Living a healthy lifestyle should not be 1-2 hours a day of extra chores. I do the exercises I enjoy, eat the healthy foods that I enjoy, etc.
For anyone reading, how do you approach personal health? Do you have a system like the one that I mentioned? What are your core pillars? Feel free to note in the comments below!