NOVOS Webinar Series: Longevity Tests [video]

CEO Chris Mirabile, serial entrepreneur and biohacking expert hosted a webinar focusing on a range of tests to track your longevity progress. He discussed blood tests, DNA tests, epigenetic tests, wearables, and more! Toward the end of the webinar, he opened the floor to questions.

Full Transcript

Grace: Welcome everyone. We’re going to let a few people join in before I start speaking. All right, my name is Grace De Leon, I’m an associate brand manager at NOVOS, and I’ll be your host for today’s event. As we all enter, I would love to know what part of the world you’re calling in from. Feel free to type into the chat box where you’re currently located. Wow, we have a global audience today, I see people Zooming in from Canada, Spain, New York City. I’m currently in Nevada. All right, before I introduce our speaker, I have a few housekeeping items to go over. First off, I want to thank those of you who have already submitted questions. During the event you can submit more questions in the Q and A box. If you see a question you like, you can upvote it. At the end of the presentation, we will begin the Q and A. We will record and share this event, barring technical difficulties.

Okay, everyone, it’s time to get started. I would like to give a warm welcome to NOVOS’ founder and CEO, Chris Mirabile, a serial entrepreneur, brain tumor survivor, and the youngest winner of NYU Stern’s business plan competition. Chris is known for beating the odds, early success and failure shaped his business principles, but also taught him the value of living well. Determined to crack the code to longevity, Chris became a self-proclaimed citizen scientist, experimenting with supplements, diet, and exercise has enabled him to reverse his biological age by more than 30%. He created NOVOS, a nutraceutical company with some of the world’s top longevity scientists and MDs that help people take control of their health spans and lifespans. Welcome, Chris.

Chris: Thank you, Grace. Hello, everyone. So, I guess I’ll jump right in here. So, today’s webinar is about longevity tests, how you can track and improve your biological age using these tests. So, first is the disclaimer. This is not medical advice. Always consult with a professional health expert, ideally specialized in the areas that we’re talking about today. So, the agenda for today’s webinar is first an introduction. What are longevity tests and why should you consider testing? And then we’re going to go into all of these fancy words, the epigenomics, transcriptomics, proteomics, metabolomics, microbiomics, phenomics, telomeres, and then additional longevity relevant markers and practical application. So, by the time you’re done with this webinar, you’re going to know more about longevity and how to test it than practically anyone you know, including doctors, but I promise to keep it pretty high level. So, I’m going to share with you something that you probably already know.

For each year you’re alive, your chances to be affected by one or more health disorders increases and your risk of death go up exponentially after your first year of life, as you can see in this chart on the right, which is a logarithmic chart. So, this is actually not a straight line, it’s actually exponential. But this isn’t the full story. The charts that I just showed you, they’re based on chronological age, which is the time since your birth. But your biological age, which is the age of your cells, your organs, your body, that’s going to vary somewhat based on your genes, but predominantly based on your lifestyle. So, as this chart depicts, as you get older, your biological age can be further and further away from your chronological age. So, your chronological age being this 45 degree line here, you can vary above, which is bad, or below, in either direction. And we as a company specialize in leveraging science to reduce your biological age as far below chronological as possible. Essentially focusing on keeping you below the chronological age line in this area here.

So, for each year that you’re biologically older than your chronological age, your statistical probability for disease and death increases. Fortunately, though, the opposite is also true. For each year you’re biologically younger, your risk decreases. Specifically, your cellular and physical fitness will be impacted by your biological to chronological age ratio, the disease risk for cancer, heart disease, dementia, for Alzheimer’s, Parkinson’s, diabetes, sarcopenia. The list goes on. As such, your mortality risk is directly correlated to your biological age, and so is your physical appearance. And to that point, as part of the Dunedin study, which is a study that we’ll talk more about in a few minutes, researchers use computer software to merge the faces of the 10 biologically youngest, 10 closest to the mean, which is in the center, and 10 biologically oldest subjects in their study. Mind you, all of them were 45 years old chronologically.

And to further emphasize this, as you can see, the difference from the youngest to the oldest is stark. Despite these people all being the same age by the conventional definition of age, their superficial traits are illustrative of their internal biology. It is possible to be dramatically older or younger than your peers biologically. Now, most people tend to think that this is due to genetics, but that’s actually not the case. This is a slide that was in my last webinar about longevity lifestyle, but it’s worth repeating because it goes beyond genes. In fact, researchers have found that the nature part of the equation is only responsible for 20% to 30% of our lifespan, with a higher percentage being associated with exceptionally long lived people, these are people like centenarians and supercentenarians who live 100 or 110 plus years. For most of us though, lifestyle and environments, or nurture as people refer to it, will be responsible for closer to 80% of our lifespans and our health spans.

Now, since biological age is so important for health and lifespan, scientists have wanted to track it for decades, primarily to be able to measure the effectiveness of therapies and to extend healthy lifespan, because you can’t reliably fix what you can’t regularly measure. Only recently has that been made possible with advanced biomolecular technologies. Many of the biological age clocks have been created in the past decade or even sooner, but the field is very complex and has varying degrees of accuracy and precision. So, in the remainder of this discussion, I’ll attempt to bring some clarity to all of this. But before we go specifically into the categories of the clocks, you might be asking yourself, why should I care about these clocks in the first place? So, we at NOVOS believe that biological age clocks are the best, most powerful, and most efficient means to track your overall health and the effects of your lifestyle on your aging process. That would be even more effective than the blood test that you might get at an annual physical.

By first measuring your biological age, and then some adjunct markers, which we can also speak about this webinar, then evaluating your results and formulating hypotheses or lifestyle changes that you want to experiment with, then integrating those changes while making sure to minimize confounding factors, then finally measuring again, you have the proper feedback loop that you need to objectively ensure that the steps you’re taking for your health are actually improving for the longterm rather than leaving it to blind faith or only being short term focused at the expense of your longterm health.

So, the remainder of the discussion is divided into two parts. First, we’ll discuss the multiome, what it is, how it’s relevant to tracking your biological age. As complex of a subject as this is, just bear with me because I’m going to keep it high level and comprehensive. And then the second part of this presentation is going to go into longevity relevant markers, which you can measure at home. Many of these you can do immediately without any special equipment, you can do it behind your computer screens while I’m going through the webinar if you care to, and I’ll quickly explain what those tests are and their relevance to your NOVOS longevity journey.

So, what biological age clocks and relevant markers currently exist? This is going to be composed of seven sections. First is epigenetic clocks, then transcriptomic clocks, proteomic, metabolomic, microbiomic, phenomic, and then finally telomere length. And these are all aspects of what’s known as the multiome, which we can think of as layers with your genes being at the foundation of the multiome. But since your genes are hard coded and the majority of your longevity, as I mentioned earlier, is determined by your lifestyle, we’re going to start at the epigenome and epigenetic tests. So, epi, which means above or over based on the Latin derivative, the epigenome can be thought of as a layer above the genome that determines which genes are turned on and which genes are turned off. The genes on DNA are turned on and off by attaching and detaching what’s known as methyl groups.

You may have heard oftentimes about the idea of methylation. This is where it’s taking place. And these methyl groups are added to what’s known as histones. Histones are proteins where the DNA wraps itself around to stay compact and to protect itself from damage. And lifestyle and aging, about 70% or so up to 80%, determine your epigenetic expression, which genes are turned on or off, whether by intention or simply from errors caused by the aging process and related processes. So, epigenetic clocks look for patterns that emerge in the epigenome that correlate with age or aging outcomes. So, first generation clocks, they looked to correlate the outputs of the clock to your chronological age, and this is where you may have heard the name Steve Horvath or the original Horvath and Hannum clocks come from. This was back in 2011.

Then second generation clocks came out, and these integrated environmental variants like smoking, and they looked to correlate the outputs with morbidity and mortality as opposed to simply to chronological age. In 2018, you got clocks like PhenoAge and GrimAge, which are two powerful clocks, and we’ll talk a little bit more about PhenoAge soon. And then third generation clocks came out and they take into account longitudinal changes over time across 18 different biomarkers, for example, body mass index or cholesterol or hearing, or your subjective impression of your facial age and so on. And this was to measure how fast the subject is aging. And these came out, the most recent one is the DunedinPACE clock, which we’re going to talk about in the next slide, in 2022, so the newest of the epigenetic clocks.

So, the DunedinPACE clock was produced by Duke Professors Moffitt and [inaudible 00:11:53], and they led six researchers who built a database that took the international team more than 50 years to complete, and they tracked biological changes in 1,037 New Zealanders who are members of what’s known as the Dunedin Multidisciplinary Health and Development Study. This began when these people were born, in 1972, and it has one of the highest compliance rates of all studies of all time. And as part of this longterm study, researchers measured all different things, postural hypotension, DXA bone density, auditory tests, physical function, optic nerves, they look at white matter within the brain, dental imaging, they did 19 different blood labs, they measured IQ, many, many other things.

And all of these things can change based on your age and based on your lifestyle and biological age, of course. So, the DunedinPACE study, they took a four step approach towards developing what is now a simple DNA methylation metric, and they took these complex datasets, everything that I just mentioned across more than 1,000 people, which represents individual variation in their pace of biological aging. So, for step three in the process, called elastic net regression, researchers were able to refine the pace of aging into a measurement that is obtained from a single blood sample.

And the measurement is sensitive enough to changes in physiology that occur across multiple organ systems. And as you can see depicted here in this graph, the DunedinPACE has a significantly higher ICC, or correlation, than all other epigenetic clocks. And after consulting with more than a dozen different scientists in the field, we at NOVOS agreed with them that this is the most powerful biological clock currently available, more powerful and accurate than other biological clocks that you can currently find that are being sold. So, we made it a point to hold off on launching any biological test kits. We wanted to launch biological tests since we basically founded NOVOS, but we wanted to wait until we could include this in our offering, and so I’m happy to say that as of this month, NOVOS Age, which we just launched, is complete with the DunedinPACE clock.

Now, next, transcriptomic clocks. The next part of the multiome is the transcriptome, which is the protein coding part of the genome. So, this refers to, if you remember from high school biology class, RNA, so you have DNA and RNA. So, RNA are created based on the genes that are expressed, and they are intended to form proteins. So, the transcriptome is the precursor to the next step, which is the proteome, which deals with proteins. And compared to epigenetic clocks, there are no widely used transcriptomic clocks just yet. They might be more tissue dependent than epigenetic clocks, so that’s also something to consider, in other words, different organs might have specific considerations as opposed to the epigenome where you can measure it simply in blood. Nonetheless, they do show promise, and for example, micro RNA is related to many different diseases such as cancer and cardiovascular disease, hypertension, obesity, diabetes, a lot of the things that go wrong as we get older.

And so there is promise to be able to create a clock that can detect this or have a sense for this potentially being in your future based on your current health. So, next is the proteome, and the proteome is all proteins that are or can be created by a genome, cell, organ, or organism. And proteins have direct effects on our physiology. They’re created via the transcriptome’s coding instructions, so the RNA’s instructions then lead to the creation of these proteins. And these proteins significantly change their expression levels with age, and they represent functional products, unlike transcriptome changes which are not always associated with proteome changes. In other words, an RNA might exist, but it might not end up producing a protein that it intends to produce. And so that would then have a direct impact on your physiology, that it was not produced. Common longevity proteins that are associated with longevity include AMPK or AMP-kinase, mTOR, telomerase, which deals with your telomeres, and sirtuins.

And since it’s closer to the observable characteristics or traits of an individual than the genome or the transcriptome, the proteome has become an attractive target for researchers who study aging biomarkers. But, unlike epigenetic clocks, proteomic clocks are only price competitive for academics right now, and they have not really been validated in large study cohorts just yet, so they requires still more time and work and research before they’re ready for the general public. Next is the metabolome. So, the metabolome is the complete set of small molecule chemicals found within a cell, within an organ, or within you as an entire organism. And the human metabolome includes all small molecules found in the body, everything from lipids, which are fats, carbohydrates, amino acids, and peptides, which form proteins, nucleic acids, organic acids, biogenic amines, all of the vitamins, minerals, food additives, drugs, and cosmetics that you might be ingesting or putting on your skin and breathing in, contaminants, pollutants.

Basically any chemical that a human ingests in one way or another, that they metabolize or catabolize or anything that you come in contact with would be part of your metabolome. And molecules that are produced by the human body are known as the endogenous metabolome, so internal, endogenous, whereas those that are absorbed from external sources like from cosmetics or pollution, that would be exogenous metabolome, but also from healthy things like eating food, that would still be exogenous. As a final product of cellular metabolism, the metabolites may provide a more complete picture of biological processes than all of the other omic profiles that I mentioned before. But the metabolomic clocks have not yet seen correlations with chronological age that are nearly as high as the standards that have been set by epigenetic clocks. So, to that point, there aren’t currently any reliable metabolomic aging clocks. The technology is lagging considerably because of a unique challenge that these types of clocks have.

While the previous omic clocks that I mentioned, they have this finite set of building blocks like nucleotides and amino acids, metabolomics includes a large part of the chemical universe, I mean practically anything you come in contact with can be part of your metabolome, so that just makes it far more complex for scientists to wrap their hands around. Next is the microbiome. The microbiome involves many areas of the body, but the colon or the gut is what has been most focused on. The oral microbiome is probably going to be the next biome that scientists track. Now, the human gut microbiome, it’s a microbial community that lives in our digestive tract, and it is composed of bacteria, fungi, viruses, and then all of the genes of all these species. And researchers have found that the composition and diversity of these species can vary not only by diet and lifestyle and genetics, but also by your age.

And with this, scientists have been able to develop methods of predicting biological age based on the microbiological profiles of your gut microbiome. And in the 2020 paper, researchers used what’s known as a deeper neural network, a form of AI, to achieve results that were within 3.94 years of mean absolute error of chronological age, so that’s getting pretty close to chronological age. That’s quite accurate. It’s getting close to the standards set by epigenetic clocks. Now, certain bacteria have been identified as pro aging, while others are anti aging, and that’s one of the things that has been discovered through this process, for example, akkermansia is a pro longevity bacterial species.

And now microbiome clocks, they have a lot of promising potential, but as of now, all of them are corporate black box IP, so none of it has been subject to the validation in large cohorts of thousands of people or subject to scientific scrutiny like the academic process typically would, as we saw with the DunedinPACE clock, for example, so we hesitate to recommend any of them at this point since we can’t look into the science and the algorithms and the results behind these clocks.

So, next is phenomic clocks. The phenotype is something you’ll hear a lot about when it comes to longevity, and the phenotype is the set of observable characteristics of an individual resulting from the interaction of the genotype, so the genes, with the environment, for example, your pulse rate or your muscle strength or your height, your lung capacity, and so on. So, when it comes to muscles, for example, you have certain genes, and then by weightlifting or exercising, that’s your environment, that’s stimulating it, but everyone has slightly different genes, and the way that your muscles then developed would be your phenotype for specifically muscles. And when considered in relation to the multiome, it’s the final outcome of your genes plus the environment, so nature plus nurture equals your phenotype. And the well known phenomic clock is what’s known as the PhenoAge clock, I mentioned this one earlier. It’s a somewhat confusing clock because it’s a combination of an epigenetic clock and a phenomic clock.

So, I’m going to try to clarify this. It took me a little bit of time reading through the paper to finally understand this, but essentially the researchers ran an epigenetic analysis alongside a phenotypic and blood test analysis, and they looked at things like lymphocyte percentage and albumin and glucose levels. You can see them all over here on the screen. And then they used that information to create another clock that only requires those blood biomarkers plus chronological age to output a biological age and predictions of physical function. So, they ran the epigenetic clock and all of these other measures, they got the results, and then they were able to leverage these blood markers to create an algorithm that you can then simply enter these blood biomarker numbers and then get the output of what in theory the epigenetic clock would’ve told you.

Now, that’s a second generation clock when it comes to epigenetic clocks and then considering the phenomic clocks as well. A later generation, not yet published but soon to be published, phenomic clock, uses 50 times more data than the PhenoAge clock used, and it looks at organ systems from the immune system to cardiovascular, hepatic, brain, pulmonary, musculoskeletal, renal for your kidneys, and metabolic system. And the study utilized the UK Biobank data and longitudinal organ imaging, so longitudinal meaning over time, images of organs, and it finds that an organ’s biological age influences the aging of other organ systems, revealing what they call a multi-organ aging network.

So, for example, your brain age is most influenced by the biological age of your cardiovascular system, your pulmonary system, and your metabolic system. They also found that specific organ ages can predict 16 different chronic diseases, diseases of aging, and that accelerated body aging is associated with lifestyle and environmental factors, your telomere length, and predicts survival time when diagnosed, and the likelihood of you suffering from premature death. And this is a promising clock that we’re certainly keeping an eye on, but it’s brand new, so it will take some time for the scientific scrutiny.

Finally, we have telomeres. These are the end caps of chromosomes, and they protect the DNA and the caps get shorter, the telomeres get shorter, with each cell division, and therefore with age, your cells have divided more times as you get older. Now, there’s a wide range for chronological and biological age, so these tests, although once thought to be promising for a biological age clock, they have since not been found to be accurate enough since there is such a wide range depending on your age, but they are most predictive of morbidity and mortality once they become too short. There was a paper in 2017 I came across that suggested that telomere length of five kilobases is the, what they call, telomeric brink, which denotes a high risk, a high risk of disease or mortality. Shortening of your telomeres can be slowed by DNA protection and cellular protection.

If your cells are being damaged or your DNA is being damaged, it requires a new cell to be produced and your telomere is going to get shorter. And it can be lengthened via an enzyme known as telomerase, which I mentioned earlier, and this can be produced via specific foods and supplements or your body’s production of it can increase when you take in certain foods and supplements. For example, NOVOS Core contains lithium and magnesium and [inaudible 00:26:54], and these may be able to either lengthen or at least slow the shortening of telomeres. And the correlation with chronological age is negative 0.3, so that’s pretty small. But the point is that there is still a correlation. It is still present, so it’s a worthwhile biomarker. It’s just not worth looking at it as a biological clock like we’ve been mentioning.

Now, I’ll also briefly mention glycolics. I didn’t create an entire slide from this, but this is where glycan clocks have emerged from, and generally speaking, results from glycan tests, they haven’t had a very strong correlation to chronological age. I’ve come across extreme discrepancies with people who are chronologically, say, 55 years old, and then they have a biological age according to a glycan test of 20, which is just too extreme to really be considered realistic. So, at this time, we’re strongly in favor of the latest generation of epigenetic tests, for the sake of accuracy, precision, and the amount of research that has been devoted to the field, but of course we’re open minded to any evolution in the research behind glycan tests.

So, now for part two, that was all of the technical stuff, the most advanced forms of tracking aging and morbidity risk and mortality risk and so on. And now we’re going to talk about things that you can do yourself at home. So, we’re going to go over additional biomarkers that, since you can complete them at home, you can track them easily at very low cost. And although they’re less powerful than epigenetic tests, since they are free and they can reinforce your confidence in the results and they can also highlight anything that may be low probability, but anything that an epigenetic test might miss, then it can give you a clue into something you might want to look into related to your health.

So, experts agree, in fact, one of our scientific advisory members, Matt Kaeberlein, who’s famous for his work with rapamycin, I was talking to him about my own results and he emphasized that it would be ideal to validate these results of the biological age clocks with as much supporting evidence from real world physiological markers as possible. So, I’m going to present some of these now. The first is measuring your facial age. Researchers have been able to leverage AI and a dataset of more than 12,000,000 people’s faces to provide you with your face’s perceived age and your skin’s health with nothing more than taking a selfie with your smartphone. And as a public benefit corporation, we’re happy to provide this service for free to NOVOS visitors. So, if you go to novoslabs.com/faceage, you can take that selfie and get that report. And this is one of the things we encourage you to do once every month or two, making sure that the lighting conditions and your hydration and you slept enough and so on, and so keep everything as similar as possible across tests so that your results are as accurate as possible.

So, next is VO2 max. It’s a measure of your maximum amount of oxygen your body can utilize during exercise. And the best way to measure this is with expensive machinery that can measure your oxygen consumption during exercise, and you can see that in this odd photo of me strapped into all of this equipment at a lab in Prague where we officially did it. But you can also approximate this with devices like the Apple Watch or polar heart rate straps, anything that’s measuring continuously your heart rate while exercising, and then your smartphone, for example, I have an iPhone, Apple Health, which is standard on all iPhones, can then compute your VO2 max, and it’s not going to be as accurate as the official equipment, but for most of our needs, it’s close enough. And VO2 max is found to decline with age and it’s associated with cardiovascular and other health outcomes.

So, next is the sitting rising test. This is something you can do right now without any equipment. Be careful. But for this, you start with 10 points, and you cross your legs, then you move to a seated position, and after sitting, you need to try to stand up again and each time you use your hands, you use your knee, your side of your leg, et cetera, so everything here in this section labeled negative one, you’re going to deduct a point from those 10 points. And if you lose balance, you deduct a half point. So, if you score between three and a half and seven and a half, researchers have found that you’re two times more likely to die in the next six years than someone has scored between eight to 10. And if you score between zero to three, you’re five times more likely to die in the next six years.

So, the next is postural hypotension also known as orthostatic blood pressure. So, postural hypotension measures blood pressure and pulse rate when a patient is lying down for five minutes, then standing for one and three minutes. And a drop in blood pressure of 20 milligrams of mercury or greater or in diastolic blood pressure of 10 millimeters of mercury, or if you get lightheaded or dizzy, these are all considered abnormal. And postural hypotension is most common in people who are 65 years and older and can be indicative of a heart issue or an endocrine disorder, nervous system disorders, or more acutely things like dehydration or electrolyte imbalance, so those are things to consider as well, and make sure that you have enough hydration and electrolytes and so on, because that might influence your short term result rather than these more significant issues.

So, although factors beyond aging, including environmental noise, especially environmental noise, can impact our ability to hear, aging is a strong contributor as well. And speech and noise tests determine your ability to perceive different sounds in different forms of background noise and effectively measure your hearing loss. And there are online tests that you can use for this, and there’s also smartphone apps, like an app I came across called Mimi. There’s even Apple has their official research app that they partner with academic research labs for. And this illustration on the left is that use case, where you can actually enroll in a study where they use this type of test and check how your hearing is declining over time with your age. Next is a fun one called pulse wave velocity, but this requires a device, so pulse wave velocity, or PWV, it’s a measure of your arterial stiffness or the rate at which pressure waves move down your blood vessels.

And as the heart pumps, there’s this pressure wave that’s formed through the arteries, and with age or due to arterial wall health based on, for example, your diet or lack of exercise, these vessels can become stiffer and the speed that the waves move through the system increases. So, pulse wave velocity increases linearly with aging with a high degree of correlation, so higher velocity is worse. It’s somewhat counterintuitive, but you want the velocity to move slowly because that means that the blood vessels are very supple and elastic. So, PWV, it increases 6% to 8% with each decade of life and it’s most pronounced after you are 50 years old and beyond. So, you can measure this with certain models of the Withings brand scale. And with that same Withing scale, you can also measure your visceral fat levels. So, visceral fat, it can’t always be seen, but it’s the fat that wraps around your organs and your abdomen and it’s more likely to raise your risk for heart disease, Alzheimer’s, type two diabetes, stroke, it can lead to higher cholesterol numbers and ultimately a higher risk of mortality.

And visceral fat makes more proteins that cause inflammation to your tissues and organs, and it also causes narrowing of your blood vessels, so this can increase your blood pressure, but possibly even that pulse wave velocity that I just mentioned to you. So, visceral fat increases with age and obviously depending on how healthy you eat and exercise and so on, you can keep that down even though it will increase with age. Next is cognitive processing speed. So, this test, there’s one specifically that can measure your verbal memory, your visible memory, [inaudible 00:36:26] motor speed, your reaction time, your attention, executive function, and a whole bunch more. And researchers oftentimes use what’s known as the CNS vital signs test. It’s an online assessment. It’s, as far as I know, reserved for researchers, but there might be a way for you to be able to access it as well.

So, grip strength, this is a popular one. A lot of people have heard about this when it comes to longevity, because researchers have shown that a powerful grip also correlates to longevity. There’s a study of over 500,000 adults between 40 and 69 years old which correlated grip strength to their rates of healthy outcomes for diseases ranging from heart disease to respiratory illness and even cancer. And they found that a grip strength measurement of less than 57 pounds for men and less than 35 pounds per women was associated with, quote, “higher overall risk of death and higher risk for specific illnesses.”

So, each 11 pound increment of grip strength below these levels was associated with a 20% increase for a woman and 16% increase for a man for all causes of mortality, and specifically for heart disease, it increased it 19% for women in 22% for men, for respiratory disease, it was 31% for women in 24% for men, and deaths from all types of cancers increased by 17% for women in 10% for men. So, grip strength has counterintuitively been shown to be a better predictor of cardiovascular disease than even blood pressure and physical activity levels.

Test number 10 is appropriately named the 10 second one legged fence, I did that on purpose, and is a simple test that doesn’t require any equipment. So, the test requires that you just stand on one leg with your shoes off, barefoot, and balance on that one leg for 10 seconds. And if you’re unable to do this, your chance of death over the next seven years increases by 84% as compared to someone who can complete it. That’s probably the simplest of all of the tests.

So, next is FEV1, which stands for forced expiratory volume in one second, so this measures the volume of air that you can exhale in a single second and it’s measured by a device called a spirometer. You can purchase spirometers on Amazon or Google for as low as $25 for this more manual device, or well over $1,000 dollars for digital devices that are of course significantly more accurate. Now, FEV1 is a very powerful test. It’s the second and third largest predictor of biological age in an upcoming aging clock that Alphabet, Google’s parent company, Calico is one of their companies, found for females and males respectively. So, it’s been found to be more important in their experiments than even things like body mass index or the tests that I just mentioned, hand grip strength.

And then finally we arrive at something I’m sure many of you are curious about, which is blood tests. So, there are certain blood biomarkers that can be plugged into the pheno age algorithm that I mentioned before that can provide you with a biological age, though it’s going to be significantly less accurate than the third generation DunedinPACE clock. But those biomarkers are albumin, creatinine, glucose, C-reactive protein, lymphocyte percentage, mean cell volume, red cell distribution with alkaline phosphatase and white blood cell count. But then additional biomarkers that you might be interested in beyond the PhenoAge clock, but relevant to longevity and overall health, are of course HbA1c to get a three month average of your blood glucose calculations, ferritin for iron, which can accelerate aging and, little known fact, higher iron levels are directly and linearly correlated with cancer risk.

We wrote an article about this in one of our most recent blog posts, if you go to novoslabs.com/iron, you can easily access that article. LDL and HDL cholesterol and their ratios are important. Lipoprotein A and triglycerides are also important. There are many other tests, but those tend to be for digging into specific diseases and not necessarily for general longevity markers. So, a novel test that’s totally optional unless you have high blood glucose levels that you may have detected from your HbA1c test, it’s very popular right now, they’re called continuous blood glucose monitors or CBGs. And these will be able to show you continually how your blood glucose fluctuates over time and which foods are going to make it spike the highest and the area under the curve, so that space in the chart, that area under the curve is perhaps even the most important. And you can detect that and learn which foods to eat and which foods to avoid to improve your blood glucose, but this isn’t necessarily a longevity intervention unless you have high blood glucose levels.

So, wrapping up, I’m often asked by people, when’s the best time to start focusing on longevity? And there’s really no time that’s too early or too late. It’s like asking when is it too early to eat healthy or to exercise, and is it too late to eat healthy or exercise? It’s never too late. But there is a time that’s particularly ideal, and that’s going to be when you’re between 25 to 35 years old. It’s because at that point, as this chart shows, the chances of having a chronic disease of aging, although they’re low, the rate of prevalence begins to accelerate significantly. So, this is a really fantastic time for you to begin to focus on the biological causes of aging and integrating a NOVOS longevity journey into your lifestyle in an effort to slow down the biological aging process.

So, bringing it all together, you saw this at the beginning of the presentation, and as a reminder of what I mentioned, we believe it’s best to follow this three step process. So, first, measure your biological age with NOVOS Age and track as many of the adjunct markers that I mentioned as possible, and then based on these results, formulate a longevity plan that’s tailored to your particular needs and lifestyle requirements. Integrate that plan, make sure you document it to be able to refer back to it in the future, because I guarantee you’re going to forget the very specific details of your daily routine if you give it enough time. And then do everything you can to eliminate any confounding factors. We recommend that you test once a year for that reason, which I’ll get into in a couple of minutes. But finally, after enough time has passed, then measure again and repeat the process, and you’ll continually improve your scores, your results, and your overall health and slow down the aging process.

So, as a quick refresher, the most powerful, accurate, and precise way to measure your biological age is with the NOVOS Age kit. And that contains the DunedinPACE clock that I mentioned earlier, that Duke University and Columbia University researchers have created as a third generation clock, and it tells you literally at this point in time, at what rate are you aging? Are you aging 10% slower than a chronological year or 13% faster? Getting that gives you your speed, your rate of aging, at this moment. And then there’s epigenetic age clock, that is also included, so you can tell your biological age, and then telomere lent as well, which is something to keep an eye on to make sure it doesn’t get too short. Then consider adding these additional at home tests like Facial Age, which you can find at novoslabs.com/faceage, VO2 max, sitting and rising tests and others. And then finally, if it’s within your budget, consider a blood panel.

So, what steps do you take to integrate a longevity lifestyle into your routine? My last webinar, I covered this topic specifically, longevity Lifestyle, which if you search for NOVOS Longevity Lifestyle on YouTube or on our website, you can come across the video recording of this. And then of course, novoslabs.com has tons of scientifically referenced contents that can help you on your journey. So, to wrap it all up, we at NOVOS, we dug deep, as I hope you can see, into all of the topics that we presented in this presentation and considered all of the biological age tests that are currently available. And it’s only after we carefully analyzed the options and consulted with a minimally biased group of independent researchers that had no stake in these tests that we decided to offer the DunedinPACE clock to track your rate of aging as part of NOVOS Age.

We also included the epigenetic biological age test and a telomere length test that is measured via the epigenome, which there are multiple ways to measure telomere length, but this seems to be the best because it is more predictive of time to death and time to morbidity by measuring it via the epigenome than other means of measuring telomere length. And then finally, we believe NOVOS Age is the most powerful, it’s the most accurate, it’s the most comprehensive set of longevity biomarkers that are available in an affordable kit. So, we recommend that you test once a year, ideally on the same day, the same week, or the same month of the year, to minimize any confounding factors as much as possible., Because every season, your lifestyle changes whether you notice it or not.

And if budget permits, you can test more often than that, but just be very careful to track those confounding factors and log your lifestyle during those times. So, you can learn more about all of these topics and NOVOS Age if you go to novoslabs.com. And I’ll leave you with slowmyage.com is my personal blog where I go over my personal results for these types of tests and more, and also my personal lifestyle routine. So, with that said, I’ll open the floor of your questions.

Grace: Wow, Chris, thank you for that wonderful presentation, that was very insightful. We have a bunch of great questions in the chat or in the Q and A and we also had some great pre submitted questions, so I think we’ll start there. To start, people want to know why does NOVOS believe that the biological pace of aging is better than other tests with biological age?

Chris: So, I’d like to give an analogy to answer this question. So, if you are driving in a car and you’re on a very long journey, imagine a 50 year journey, you’ve accumulated a lot of mileage on that car. The distance traveled is essentially your biological age, it’s how many years you’ve been alive for. And this biological age is based on accumulated damage that builds up over time and is reflected in your epigenetic age, whereas your pace of aging as measured in the DunedinPACE clock is like the speed that you’re driving in that car. And you can press the gas or press the brake instantaneously and adjust the speed of your car. And so, to that point, the pace of aging is something that is far more responsive and is going to see changes from lifestyle interventions far more quickly than a biological age test will.

It’s also arguably the most important, because although you can look in the rear view mirror and see how old are you biologically, what’s most important is today and the future and what are you doing to slow down that pace? And if you slow it down enough, you may eventually get to the point where you have reversed your age, where you’re biologically younger than your chronological age. So, we see the pace of aging as being the most actionable test out there, not to mention, as I went over earlier, it is the most advanced epigenetic clock out there right now, I would argue even biological clock in general. And so it is a third generation clock, very accurate, it is one of the only, if not the only, clock out there that is based on a longitudinal dataset of people over a long period of time.

It’s definitely the longest running longitudinal dataset of more than 50 years. So, the accuracy that you get from a clock like this is beyond other clocks out there, so that’s why when you purchase NOVOS Age, we encourage you to focus 80% of your energy on the pace of aging clock. That’s what you should really hone in on. And it may be 10% to 15% is on your biological age and the remainder on telomere length, more as a check to make sure it’s not too short and to keep an eye on it over time to see if you’re either lengthening it or slowing down the attrition of the telomere length.

Grace: Great, thanks for sharing. We do have one question in the chat that asks how accurate are telomere tests?

Chris: So, I can answer that in a few different ways, so one way to interpret that question is how accurate are they at interpreting your biological age? And as I alluded to in the presentation, they are not particularly accurate, largely because of the wide range for a biological or chronological age in terms of length. In other words, if you look at it on the chart, it’s not this thin narrow line where everyone stays pretty close to their chronological or biological age, it’s actually thick.

And that means that somebody who’s 20 years old might have the same telomere length as somebody who’s 40 years old and they might both be perfectly healthy, and an epigenetic test might actually reveal that they are distinct ages biologically, but from telomere length measurements, it would not otherwise indicate that. So, that’s why, although there was promise for telomere length in the past, a lot of scientists were hopeful for it, and it is a key metric in some of these biological age tests to input into the algorithm, it is not on its own a reliable biomarker to determine your biological age.

In terms of another way to interpret the question, the accuracy of telomere measurements can vary depending on the specific telomere or set of telomeres that the analysis is looking at. That’s why we believe that the approach through which we’re detecting telomere length through the epigenome is actually more effective because it’s looking at, throughout the body, the effect of these telomeres and by application the telomere length, which is then more closely associated with things like morbidity, as I mentioned earlier, than directly measuring a single telomere, for example.

Grace: Great, thanks for sharing. Could you dive deep into our product suite and our recommended directions of use?

Chris: Sure. So, we’ve got three products currently. The first product is NOVOS Core, a product that we’re very proud of. I have it here. So, NOCOS Core is a drink mix with 12 different ingredients. It would be too heavy to fit into capsules, that’s why we made it as a drink mix. And you take a sachet of the powder and you pour it into your water and you drink it every day. We recommend that you drink it while having a meal or after a meal on a full stomach, it will slow down the absorption of it. And some of the more lipid soluble ingredients like fisetin will be absorbed better if you have a little bit of fat in your stomach when you’re eating or consuming NOVOS Core. If you want to be an overachiever, you can also split it up into two different meals, so I personally have it with my first meal of the day, and then I have a mid afternoon snack oftentimes, and I’ll have it between those two meals.

The second product is NOVOS Boost. This contains one very powerful ingredient, nicotinamide mononucleotide, or NMN for short, not M and Ms, as a lot of people say, but NMN. And this is best taken first thing in the morning. So, you can pop these on an empty stomach, you can do it while fasting as well, and that’s how we recommend you take this. And then when it comes to NOVOS Age, which we just released this month, the test kit that I’ve been referring to, this is what it looks like, and you pop it open and you have this nice instruction manual in here with all of the steps. And then it is a blood swab, so you would take some of that blood and you would smear it out onto this card. You can see this tiny little circle, you just want to smear your blood onto that card.

A lot of people ask, do you need to fill the whole thing completely, 100%? And the answer is no. You want to get as close as you can, but if you are filling up half or two-thirds, you’re going to be good to go. And we recommend that, although it’s basically pain free or close to pain free to prick your finger on the side, if you want to increase blood flow, if you’re having trouble, you can then move on to the center of the finger, and make sure you have warm hands, maybe exercise or put your hands under warm water, that’ll get the blood flowing. And then you should be able to pretty easily get enough blood to fill this tiny little circle.

Grace: Thank you for sharing that. We had a two in one response there because someone also asked in the Q and A, how do we use NOVOS Age? Is it a mouth swab, a blood test? So, thank you for that.

Chris: Sure, and I would very quickly just add that there are mouth swab tests out there and in terms of accuracy, we are all about giving you the most scientifically advanced formulations, tests and so on. And so that required blood, so a little bit more invasive, but well worth it for the sake of accuracy. If you’re spending money on this, you want accurate results.

Grace: That’s right. Regarding accuracy, we have a question in the chat that says, how reputable are the results from DunedinPACE tests? Meaning if you did five separate blood samples at the same time, how close would those results be?

Chris: That’s a good question. I don’t have a precise number for this. We could probably go through the literature and get a better idea or speak to the researchers directly, but it does have a low margin of error. And so that would imply that if you are doing multiple tests at the same time, that you’re going to get results within a couple of percentage points, probably 2% to 3% of each other. So, it does have one of the lower error rates compared to the other biological clocks out there, one of the lowest in fact, so I don’t have a precise number to answer right now, but that’s something we can get back to you with.

Grace: Thank you. We only have about a minute left, so we’ll finish up with one question, and that is, if you could only suggest one thing to increase your longevity, what would it be?

Chris: Well, I would love to say taking NOVOS products, but that would be somewhat disingenuous of me. I would say that the single most important thing you can do is absolutely free, and it comes down to, I’d love to include everything like sleep and activity and so on, but if I had to choose just one, I would go with your eating habits, particularly, of course, what you consume is very important, so the vitamins, the minerals, the macronutrients, and so on, but I would say the timing, so assuming everyone is eating relatively healthy, so we’ll just set that as the assumption, I would say integrating some fasting into your routine. So, you can start with time restricted feeding where you’re only eating for, say, a six or eight hour window, say 11:00 AM to 7:00 PM each day to start, and maybe make that an narrower in narrower as you go along, within reason, especially if you exercise. You don’t want to make it too narrow where you’re not getting enough calories in the day and you’re essentially starving yourself over the longterm.

That’s that’s not ideal either for lifestyle reasons and general health, but you can start with that and then make that into maybe a three or four or five hour eating window. And then ideally, you can also integrate prolonged fasting. So, maybe start with 24 hours. I personally every week go, most weeks, not all, Thursday to Friday, do 24 hours without eating, so dinner to dinner. And then once a quarter or once every six months, try to go as long as three days is the max I’ve done, 72 hours in a water only fast, I should say water plus electrolyte only fast. And that has been found to have profound benefits for your general health and your longevity. And it’s even been found, this is no medical advice whatsoever, but people with autoimmune disorders have found relief from symptoms when extending their fast, and many other things have been seen anecdotally, at least, from people who are challenging themselves with prolonged fasts.

Grace: That’s awesome. I’m currently beginning my own fasting journey. It’s about 2:00 PM Eastern Time and my stomach is starting to growl, so almost time for breakfast for me. All right, everyone, that is all we have time for today. Before we sign off, I wanted to let you all know that I did link a fasting blog in the chat for you to read up on. In addition, you can ask us questions at any time. If you go to our Instagram, you can click the link in our bio, it’s called NOVOS Ask Me Anything, and you can drop questions there.

If we didn’t get to your questions today, I recommend heading over there and putting your questions in that link in bio section. We plan on keeping this link up indefinitely so you can ask us any longevity, biohacking, and health and wellness related questions. We’ll do our best to answer these questions during events like today across social media, in email, and more. If you’re interested in learning more about how to live younger for longer, our blog, which we’ll link right now, is a great educational resource. That’s all I have on my end, Chris, did you have any last remarks?

Chris: Yeah, so I would just encourage everyone to take advantage of what we put out there for your consumption. We have lots of free resources at novoslabs.com. Now, we’re going to continue producing free resources, we are a public benefit corporation and it is part of our mission to extend humanity’s lifespan as much as possible. Our goal is to add a billion years to humanity. That’s more of a vision than a mission, but go to our website, take advantage of all of those free resources, interact with us, give us feedback of what you’d like to see more of. And of course, if you’re interested, try out NOVOS Core, NOVOS Boost, NOVOS Age, and embark upon your own longevity journey.

Grace: All right. Thank you, everyone. Have a good day. Bye.