With my two daughters away at school, it was time to sell the old family Subaru. The car had served us through 12 years of road trips, errands, and driving lessons. I went to CarMax and filled out a detailed questionnaire about the vehicle: mileage, accident history, engine warning lights, and equipment condition.
CarMax runs its entire business on one idea. The company builds a quantitative longevity index for every car it considers buying. Getting that index right is the foundation of the business model.
The connection to medicine struck me before I finished the form. We’re living through a surge of interest in what people call “longevity medicine,” a phrase that means different things to different people. The concept touches on a universal human desire: to push back the forces of aging and live a long, productive life.
Much of the longevity industry is selling promises it can’t back up with data. At Banner Peak Health, where we bring disciplined evaluation to annual health assessments and preventive care, patients walk in with questions about biological age tests, rapamycin prescriptions, and NAD+ infusions. My answer catches them off guard.
Two Categories of Longevity Technology
When I think about longevity medicine, I divide the technology into two categories: diagnostic and therapeutic.
Diagnostic technology centers on the concept of biological age. A growing number of tools claim to measure how well a particular individual is aging: DNA methylation clocks, telomere length assays, and other physiologic biomarkers. Each one promises to tell you whether you’re aging faster or slower than your birth certificate suggests.
Therapeutic technology occupies the other side. This category includes the supplements, pharmaceuticals, and dietary protocols that people are either taking or selling to extend lifespan: rapamycin, NAD+ precursors, and extreme calorie restriction. I’ve covered making safe choices with supplements in a previous post, and that guidance applies to longevity products.
Both categories face the same fundamental problem: neither has produced the scientific proof needed to show it can help you live longer.
Why Biological Age Testing Falls Short
A diagnostic test has value only when it leads to a therapy that produces a better outcome for the patient. You can measure a person’s biological markers till the cows come home, but if those measurements don’t drive a treatment that helps the patient live longer, the diagnosis has no value.
This is the core issue with biological age clocks. They can track how you’re aging, but none has led to a therapy that helps you live longer.
I discussed a similar gap in a post on at-home hormone testing. The longevity diagnostic space is a bridge to nowhere: full of measurements, but without the data to connect them to longer, healthier lives.
Why Longevity Therapeutics Lack Proof
The therapeutic side of longevity medicine faces its own challenge. Generating valid science around lifespan is a major undertaking. Human beings aren’t laboratory mice with 18-month life expectancies, and running a study to determine whether a drug or supplement helps humans live longer takes decades.
What the science of longevity needs, and doesn’t yet have, is a validated intermediate endpoint for aging.
An intermediate endpoint is a measurable marker with a proven causal relationship to the outcome you’re studying. A good example comes from cardiovascular medicine: ApoB. We’ve covered how to lower ApoB in a previous post, and the science is clear: reduce ApoB, and you’ll reduce atherosclerotic vascular disease and live longer.
Longevity medicine doesn’t have an equivalent of ApoB. Without a validated intermediate endpoint for aging, we lack the methodology to evaluate the flood of supplements and drugs claiming to extend life.
The 10 Interventions Proven to Prolong Life
Setting aside the hype, the interventions with the strongest scientific backing for living longer are familiar.
The 10 most potent interventions, ranked by strength of evidence:
- Regular physical activity, including aerobic exercise and resistance training
- A healthy dietary pattern (Mediterranean, DASH, or plant-based)
- Maintaining a healthy weight
- Not smoking, or quitting
- Strong social connections and avoiding isolation
- Good quality sleep
- Cognitive engagement and mentally stimulating activity
- Limiting alcohol consumption
- Stress management and psychological well-being
- Controlling cardiometabolic risk factors (hypertension, diabetes, and elevated cholesterol)
We’ve covered several of these topics in previous posts. Exercise is the real fountain of youth, and the traditional medical approach to sleep is overdue for a rethink. We’ve discussed the latest on alcohol guidelines and why monitoring your hemoglobin A1C levels matters for metabolic health.
Notice what’s absent from this list: any high-tech biological testing or pharmacologic agent designed to extend your life. Not a single purpose-built “longevity” product appears. The interventions with the strongest backing are the same ones doctors have been recommending for decades: move your body, eat well, sleep well, stay connected to other people, and manage the conditions that shorten life.
How Banner Peak Health Approaches Longevity
The list above points to an uncomfortable truth. The longevity industry attracts enormous investment, and clinics across the country charge tens of thousands of dollars for proprietary biological age tests and supplement protocols. I have friends who run these clinics, and I respect their intentions.
But consider a thought experiment. You’ve spent tens of thousands of dollars at a proprietary longevity clinic. Now call that clinic at 4 p.m. on a Friday and tell them you have had worsening chest pain every time you climb the stairs and that you are worried.
In all likelihood, the clinic will completely disown the problem and direct you elsewhere despite a very real imminent threat to your “longevity.”
At Banner Peak Health, we do things differently. We’re committed to longevity, but science guides our approach, not profit.
We use continuous glucose monitors to give patients real-time feedback on how dietary choices affect metabolic health. We’ve built a parasympathetic rehabilitation program around the TruVaga vagus nerve device to help patients lower their stress load. We employ the Galleri test for early cancer detection to catch cancers before symptoms appear.
We use VO2 max as a diagnostic tool to guide athletic optimization. We work with Sleep Image technology to help patients improve their rest, and we partner with nutritionists and physical therapists to improve their diet and maintain physical fitness.
Every one of these technologies ties back to the evidence-based list. Each one strengthens a proven pillar of longevity. In upcoming posts, we’ll examine specific technologies and trends through this same lens: evaluating what works, what doesn’t, and what the science supports.
Today’s Takeaways
The longevity industry is booming, generating excitement and attracting enormous investment. But when I look at the data, the picture is clear: the most powerful tools for living longer are the same ones we’ve recommended for decades.
Move your body, eat well, and get quality sleep. Stay connected to the people around you, and control the medical conditions that shorten your lifespan.
At Banner Peak Health, we’ve built our practice around these fundamentals, in step with the evolution of concierge medicine toward evidence and prevention. We adopt new technology when the data supports it, not when the marketing hype peaks. We stay in relationship with our patients for the long haul: through annual physicals, acute crises, and the quiet daily work of living well.
The term “longevity medicine” is a fad. Our practice is not.
If you’d like to discuss how our approach can support your health goals, schedule a conversation with our team.
