My Top Six Anti-Aging and Life Extending Interventions

by Nils Osmar. Updated April 6, 2022

Life Extension is not the same as anti-aging. They can occur together, but one can also occur without the other.

Interventions that are anti-aging may improve the quality of life, but not necessarily us live longer. Interventions that are life-extending may not heal all of the effects of aging, but can still add years to our existences.

Life extension is about living longer.

This is obvious, but let’s think about it for a moment.
Therapies can be considered life extending if they extend either the median or maximum lifespan. But this doesn’t necessarily mean that they reverse the aging process.
For example, some medical treatments (such as hooking people up to machinery to replace the functions of failing organs, or pumping them full of antibiotics because their immune systems are no longer effective at fighting diseases) are clearly life extending, but they’re not reversing aging. Their result can sometimes be to keep people alive for years or decades in a decrepit state, stuck for long, lonely stretches in nursing homes waiting for death (not an existence many of us would want).
Interventions like these can be useful under some circumstances, but because they’re extending life without reversing aging, the result is not one that I personally would be interested in.

Anti-aging is about slowing, stopping and reversing the process of aging.

Again – this is obvious – but let’s look at what it means.
Aging isn’t just getting wrinkles and grey hair; it’s a process of gradual collapse that can go on for years or decades and can effect all of our tissues and organs.
For example, our eyesight tends to go downhill as we age. So anything that reverses age-related degradation of our eyesight could be considered anti-aging – even if we don’t end up living longer as a result
We tend to lose muscle as we age. So approaches such as weight training while taking certain nutrients that build muscle can be considered anti-aging. (Again, this doesn’t mean we’ll live significantly longer if we exercise. But it’s still valid because it is reversing aging.)
Approaches that increase sex hormone levels and restore our other biomarkers to those of youth are similarly anti-aging.
I would consider compounds that extend the health-span to of great value, even if they don’t add years to our lives. Ones that also extend the lifespan are also of interest. Ones that do both are of particular interest.

Anti-aging can be tested…

Interventions that reverse signs of aging can be tested both in animals in in humans. (It’s easy to see whether a particular therapy is restoring eyesight, restoring immune function or reversing sarcopenia.)
But life extension can’t be tested directly in humans. It would take longer than a typical human lifespan to do a really accurate test, then another couple of lifespans to verify the results. So the argument, “Yeah, but it hasn’t been proven to extend lifespan in people” is a little silly unless we want to wait centuries for definitive proof before trying anything.
We can, though, do studies in (short-lived) animals to identify interventions that make mammals (like people) live longer. This will give us a hint about whether they might turn out to work similarly in people.

Best of both worlds

Interventions that extend lifespan (in animals) while reversing aging (in both animals and people) do exist. The most promising ones (in my opinion), in order of importance, are:

Number 1: Eating a high-nutrient diet

We need nutrients to sustain health. There’s disagreement about how much of some of them we need – i.e., whether it’s better to eat 1 gram of protein per pound of body weight, or 0.3 grams per pound – but there’s no question that we need some dietary protein.
There are dozens of diets to choose from. To me, one of the top contenders from both an anti-aging and life extension point of view would be an Acciarolin diet. The people in Acciaroli are 75 times more likely to reach the age of 100 than people anywhere else in the world (and more than 30 times more likely to live to 100 than people in the s0-called “blue zones”). And a huge number of people there who reach 100 go on to reach 110.
They reach these ages in a state of almost perfect health, suggesting that their diet is also anti-aging. Heart disease and dementia are almost unknown. The people in the village are very sociable and are sexually active into their 90s or older.
The top staples in their diet include anchovies; sardines; the herb rosemary (in great quantities); and the meat from rabbits and chickens that they grow themselves. Like others in the Mediterranean area, they also eat a varied diet with lots of cruciferous vegetables, legumes and beans. But their results blow the usual Mediterranean diets out of the water.)
By comparison, people in the blue zones appear to be 2 times more likely to live to be 100 than folks elsewhere in the world. Would you rather have 75 times the odds of reaching 100 or 2 times?
In response to the argument that the Acciarolins’ extreme longevity may be genetic – that could definitely be a factor. But the same could be said of long lived populations anywhere. It’s odd to me that some people enthusiastically embrace the very minor “life extension” in the “blue zones” (which is often accompanied by ill health and higher rates of dementia), often totally ignore the far greater longevity of the Acciarolins.
And remember, what we eat and our lifestyle choices can also activate our genes. So the separation between saying “it’s just genetic” and “it may relate to their diet” is a somewhat artificial one.

Number 2: Exercising

As Peter Attia has put it, exercise blows most other anti-aging interventions out of the water.
The most effective kinds in relation to reversing or slowing the aging process appear to be HIIT and resistance training.
To be clear, there’s no evidence that exercising will increase the maximal lifespan. It won’t help us live past 120. But it does increase health-span, and is one of the most promising approaches for reaching our “maximum” lifespan (if there turns out to be a maximum) in a state of ideal health.

Number 3: Fasting and time-restricted eating

Fasting (in animal studies) has been shown repeatedly to increases both the lifespan and healthspan. So has calorie restriction.
Fasting is of course a form of calorie restriction. But its effects go deeper than (for example) the effects of the CRON diet. Fasting induced autophagy, which cleans our cells, and prolonged fasting induces apoptosis (the removal of senescent cells) and stem cell regereration. There’s no evidence that the CRON diet does either of these things.
To me, fasting makes most sense when done in combination with eating an Acciarolin diet or some other diet high extremely high in the macronutrients and micronutrients that support health and life.

Number 4: Taking rapamycin along with metformin

Taking rapamycin is often held out as the gold standard. There’s evidence that it’s far more effective than most of the other supposed life-extending compounds on the market.
The most potent combination of pharmaceuticals I’ve read about is the combination of rapaymyin with metform. The combination brought more than twice the lifespan increase of rapaymcin alone. See article.
Note: I’m not currently taking either rapamycin or metformin. I’m cautious because of the possible side effects, and I’m getting good results from my protocol without taking them. But if I ever feel like I’m slipping, I may considering taking them together at that point.

Number 5: Taking alpha keto-glutarate

AKG has been shown in animal experiments to extend health-span; compress morbidity; and extend lifespan. The life extension is not as great as that observed in animals given rapamycin, but more than most other compounds available as supplements.
Since it compresses morbidity, which rapamycin does not, I consider it just as important as rapamycin.

Number 6: Taking sirtuin activators and NAD+ boosters.

Sirtuin 1 has a role in DNA repair. But sirtuin 6 activation is associated with far greater longevity. We can activate SIRT6 by doing very prolonged (ten day) water fasts, or taking SIRT6 activators such as fucoidan and cyanidin
All sirtuins are NAD+-dependent, so it makes sense to me to take them in combination with NAD precursors such as NMN, NR and niacin)

This isn’t a comprehensive list, but it’s where I’d personally start if I were just beginning this journey. I’m doing many additional things, such as taking supplements to restore my testosterone and glutathione and nitric oxide to youthful levels. You can read about my tire enprotocol on this page. But the ones I’ve written about above seem to me to be among the most important ones to focus on.