A Minimalist Longevity Protocol

A friend reached out to me recently with an interesting question: "I am 36 years old, have 2 kids, and my goal is to be around for my family as long as possible. I do not intend to consume 50 pills worth of supplements a day, but I do want to undergo holistic screening and get recommendations. What would you recommend? What's the minimum effective dose?"

I've been biohacking for a decade while running a startup, and over the years I've distilled my longevity protocol to the bare minimum. I've written about my full protocol, lab testing panel, supplements, and workouts in the past, and this is an update on my thinking across all these areas.

Let's dive in. My current protocol has five components: data, sleep, diet, exercise, and supplements or Rx.

TL;DR: The Protocol

If you're too busy to read the full post, here's the minimum effective dose:

Screening & Data:

• Annual: Function labs, Ezra full body MRI
• Age-dependent: LDCT + CAC score (>35), DEXA + VO2MAX (twice yearly)
• Standard screening: colonoscopy (>45), mammogram (>40), pap smear (>25), skin check (>35)

Lifestyle:

• Sleep: 7+ hours nightly, cool bedroom (<70°F), blackout curtains
• Exercise: 3x weightlifting + 2x cardio weekly
• Diet: Mediterranean-style, 1g protein per lb bodyweight, limit red and processed meat to 1x/week
• Supplements: Vitamins B, C, D, omega-3, magnesium citrate/glycinate, creatine
• Rx: Statins or Repatha if LDL/ApoB > 120 or CAC > 400

Data

The four horsemen of chronic disease are currently cancer, heart disease, metabolic dysfunction, and neurodegenerative diseases. To avoid dying from one of these you must get high-quality data about your body, longitudinally over time. An Ezra full body MRI, low-dose chest CT, Function labs, and the standard of care screening procedures recommended above will cover these four diseases and much more.

Ezra is available at 115+ locations in 40 cities across the US, as well as in London, UK. Function is available at 2000+ Quest locations in the US. If you're in Europe / Asia you can use this biomarker template and get your blood tests with your local lab.

For wearables, I use a Whoop and an Apple Watch, mainly to track RHR, HRV, HR during workouts. I wear the Whoop 24/7 and it's great at tracking my sleep, strain, and recovery. I use the Apple Watch primarily to track HR zones during workouts. My wife wears an Oura ring and loves it.

Sleep

I used to prioritize exercise first, followed by diet, then sleep. This was backwards. Sleep is the foundation that makes everything else work, so getting enough high quality sleep has become my main priority. My current sleep optimization stack goes as follows:

• Eat dinner at least 3 hours before bed
• Blackout curtains
• Bedroom temperature <70°F
• Blue-light blocking glasses 1h before bed
• Eight Sleep for temperature regulation
• Melatonin when I travel across timezones

Diet

I've experimented with virtually every diet: keto for weight loss, vegan for reducing inflammation, variations of paleo for muscle gain, and more. After years of cycling through restrictive diets I've concluded that they simply aren't sustainable long-term; the constant restriction and rule-following becomes exhausting, and most people (myself included) eventually revert to old habits.

For the past couple of years I have been following a Mediterranean-style approach. It's not really a diet, it's a framework that reduces the intake of bad stuff and promotes consumption of good stuff. I focus on whole foods, fish, vegetables, nuts, dairy, fruit, and limit red meat to once weekly; I try to avoid processed foods altogether. In practice, my weekdays center around (some) meat, fish, dairy, and vegetables, with larger meals that include grains on weekends. I like cake!

Most of my nutrition is focused towards getting 1 gram of protein per pound of body weight while not being in a caloric surplus larger than 10% of my daily expenditure (~2200 calories). If my weight creeps up > 175lbs, I go on a 10% caloric deficit for a month or two to bring it back to my normal range (170-175 lbs).

Exercise

I have tried pretty much all exercise routines. Powerlifting, gym bro splits, cardio-heavy, plus Barry's, Soulcycle, and all their variations. Over time I've streamlined my protocol to something I can sustain without risk of injury or nervous system fatigue, that can be done in pretty much any gym, that builds muscle and cardiovascular ability: 3x weightlifting splits (upper / lower / upper) plus 2x cardio, each week.

Weekly schedule:

• Monday: Upper body (focus on chest, lats) + Zone 5 training
• Tuesday: Zone 2 cardio or tennis
• Wednesday: Lower body (squats, deadlifts)
• Thursday: Rest
• Friday or Saturday (depending on time): Upper body variation (focus on arms) + Zone 5 training. Zone 2 on the other day, if I'm feeling rested.
• Sunday: Long outdoor run

Most days I'll also try to squeeze in a 4 to 5 mile walk together with my wife. You should follow her on Substack, she's a much better writer than me.

You can find my weightlifting protocols here: Monday, Wednesday, Friday. Just copy these into your Hevy account and start using them. If you can, I recommend weightlifting with a coach. This is especially important if you haven't done much weightlifting before, to prevent injury.

For Zone 2 training I do a stationary bike, treadmill, or sometimes outdoor run at an easy pace, using Apple Watch or Polar strap to monitor HR zones.

For Zone 5 training I do 30 seconds on, 30 seconds off, 5-10 rounds. It's generally either on an assault bike, stationary bike, or treadmill. I have a love-hate relationship with the assault bike.

Supplements & Rx

I've tried most supplements on the market, and countless protocols (including taking ~50 pills / day). I was wrong on this one, and I now take just a handful of pills per day. The truth is that most of the supplements recommended by longevity folks will likely do no harm, but won't do no much good either.

My current protocol focuses on supplements with RCT-backed benefits for reducing all-cause mortality (though some effects are small): vitamin D, omega-3, magnesium citrate/glycinate, and creatine. I also supplement when my labs show a deficiency (had a B-vitamin deficiency recently, and had to use a methylated B-vitamin). I also take vitamin C for immunity, and sometimes Quercetin for allergies.

I have very high LDL / ApoB, and a family history of hypercholesterolemia, so I'm using prescription medication to lower my LDL. I used to take a statin (rosuvastatin calcium 5mg), but I switched to Repatha this year as it has a much better safety profile than statins when it comes to metabolic health. The only downside of Repatha is that it's administered as a bi-weekly injection and that it's expensive.

Things I've tried and stopped

• NAD supplements - No perceptible effect from oral NAD. Planning to try sublingual delivery instead.
• 3x/week full body weightlifting (squat, deadlifts, bench/overhead press every session) - too taxing on the body, joints, and nervous system for sustainable long-term training. High risk of injury if not done correctly.
• Keto diet - Made me feel terrible; not sustainable for my lifestyle and energy needs.
• Aggressive caloric deficits (>15%) - Led to constant irritability and muscle loss.
• Multi-day fasting - Too much muscle mass loss, counterproductive for longevity.
• Intermittent fasting - Energy crashes impacted daily performance and workout quality.

Summary

I've been on this protocol for a year and it works great, including during some very busy times. It's also excellent for those who travel a lot as the workouts above can be done in pretty much any gym, and you don't need a separate suitcase for all your supplements.

It will take just a few hours to set it all up (labs & scans appointments, ordering supplements, getting trackers, etc.). Once it's up & running it becomes pretty straightforward to maintain. Hope you find it useful.

To 100 healthy years!