Facial video photoplethysmography (vPPG): Use a smartphone-based contactless optical method to accurately monitor heart rate, as validated by recent research showing mean absolute errors below 1 bpm when averaged over 60 seconds.

RHR, HRV (including SDNN and lnRMSSD measured via facial video photoplethysmography [vPPG] as validated by Shen.AI Vitals technology), VO2Max

- Note: Consider front-loading a larger portion of your daily carbohydrates in the morning to align with natural circadian peaks in insulin sensitivity, potentially enhancing GLUT4 translocation and postprandial glucose uptake.

- When possible, schedule strength training sessions in the morning to take advantage of peak circadian insulin sensitivity, which may improve GLUT4 translocation and overall glucose uptake.

• Consider incorporating cysteine-rich foods or a vegan L-cysteine supplement (e.g., 500 mg daily) into your diet. This can support intestinal stem cell function and repair through enhanced Coenzyme A biosynthesis and IL-22 signaling, as indicated by recent research.

Atomic Force Microscopy (AFM) assessment of interfollicular stem cell (ISC) stiffness and dermo-epidermal junction (DEJ) stiffness to quantify skin mechanical properties and renewal potential.

Physical fitness - whoop + Polar; incorporate wearable-derived MX metrics for real-time analysis of physical activity intensity (focusing on M1-M30), which are shown to correlate with improved lower limb mobility and overall functional capacity.

Also, consider utilizing wearable accelerometer-based devices to monitor MX metrics (e.g., M1-M30) during exercise sessions. This cut-point free parameter provides insight into the intensity of your most active minutes, helping you fine-tune high-intensity bursts and ensure effective lower limb engagement, especially over time.

Consider limiting dietary iron intake by avoiding excessive consumption of iron‐rich foods and refraining from unnecessary iron supplementation. Regularly monitor blood iron levels, as emerging research indicates that a modest iron-deplete diet may activate beneficial oxidative stress response pathways linked to increased longevity.

Consider incorporating a daily intermittent fasting window after the final meal at 11 am. For example, restrict all caloric intake until the next morning (approximately an 18-hour fast). This approach is supported by recent findings showing that intermittent fasting reprograms chromatin accessibility in brain and muscle, leading to enhanced neuroprotection and muscle function.

- Eyes (include retinal ganglion cell layer thickness assessment via OCT to monitor retinal ganglion cell health and detect early glaucomatous neurodegeneration)

CDDO-EA (experimental triterpenoid) – dosage to be determined – intended to reduce caloric intake and improve insulin sensitivity in the context of a higher fat diet. This addition is considered for potential protection from hyperglycemia, hyperinsulinemia, and obesity as supported by recent research findings.

Add a CSF flow assessment using phase-contrast MRI to monitor glymphatic system function. Specifically, measure CSF flow in the perivascular spaces of the circle of Willis and middle cerebral artery. Use baseline parameters such as a Sylvian aqueduct flow of ~0.00700 mL/s and note that velocities in the circle of Willis and MCA are typically ~0.159 cm/s and ~0.198 cm/s lower, respectively. This measurement can help detect early neurodegenerative changes.

Consider incorporating a prostate cancer screening protocol for men aged 50-69 that uses combined PSA and Stockholm3 testing. This screening aims to improve specificity for detecting clinically significant prostate cancer while reducing the rate of benign biopsies and overdiagnosis.

DXA scan and CT analysis of the lumbar spine (with specific focus on L5 and S1 vertebrae) and adjacent muscle groups (e.g. psoas major, erector spinae, quadratus lumborum) should be performed annually to monitor bone mineral density and early muscle atrophy. This helps in detecting progressing osteoporosis and bone-muscle degeneration.

Include extraction of total gray matter, hippocampal, and ventricular volumes from routine brain MRI scans to support early dementia risk assessment and ADRD research.

- At least 4 Tbsp of diverse fermented foods (e.g., kimchi, sauerkraut, kefir, tempeh) to promote enhanced functional redundancy of the gut microbiota and support its resilience against neuropharmaceutical-induced alterations.

Consider adding plasma biomarker assessments (e.g., GFAP, NfL, p-tau217, p-tau231, and Aβ42/Aβ40 ratio) to complement neuroimaging markers for early detection of cerebral small vessel disease and Alzheimer’s pathology.

- Mood States: Daily mood assessment via passive sensing from wearable technology (e.g. FitBit data) using predictive algorithms for just-in-time interventions.

• Add targeted core stabilization and paraspinal strengthening exercises (e.g., back extensions, planks, bird dogs) to maintain axial muscle stability and counteract age‐related spinal sarcopenia.

- Blood Pressure: Monitor systolic, diastolic, mean arterial pressure (MAP) and pulse pressure on a regular basis (e.g., daily or weekly) using standardized devices.

Sleep Efficiency: Track night-to-night sleep efficiency using actigraphy or wearable devices as a digital biomarker. This measure can serve to assess cognitive function and help predict functional capacities such as safe driving, as indicated by recent research.

Consider adding a periodic contrast-enhanced cardiac MRI assessment focused on measuring myocardial extracellular volume (ECV) fraction as a surrogate for diffuse myocardial fibrosis, particularly in patients with or at risk for OSA. This addition will help monitor the cardiac remodeling benefits observed with OSA treatments such as CPAP or MAD.

Additionally, prioritize maintaining a healthy BMI (<25) by incorporating targeted weight management strategies. Regularly monitor your BMI and adjust your caloric intake if needed, as recent research indicates that obesity is associated with a higher likelihood of electrical cardioversion in atrial fibrillation, suggesting that achieving and maintaining a normal weight can improve cardiovascular outcomes.

- 1-4 Tbsp of fermented foods i.e. cabbage, kimchi, beets, etc. (preferably ensuring inclusion of Lactiplantibacillus plantarum-rich sources, as studies indicate that L. plantarum can acidify the gut and offer protection against enteric pathogens)

Sugar, junk food, fried food, ultra processed food, highly processed food, gums, high-fructose corn syrup, aspartame, sucralose, dairy, pasta, bread, hydrogenated oils, canola oil, corn oil, soybean oil, trans fats or alcohol.

Cerebrovascular Topological Analysis: Utilize topological invariants derived from cerebral angiography (such as Betti numbers and graph-based connectivity measures) to assess structural integrity, collateral circulation potential, and aneurysm susceptibility.

**Blood Glucose and Diabetes Risk Biomarkers:** Average blood glucose remains ~90 mg/dL; however, incorporate routine assessments of fasting plasma insulin, triglycerides, cholesterol, gamma‐glutamyl transferase, creatinine, platelet count, segmented neutrophil percentage, urine albumin, and urine creatinine. This multivariable data approach, as supported by recent research, can improve early detection of pre-diabetes and diabetes compared to relying on Hemoglobin A1c alone.

- Freshly squeezed lemon juice, 1 Tbsp

Blood Lipid Panel (Total cholesterol, LDL, HDL, Triglycerides)

Don’t get caught up and paralyzed in all the nuances and rabbit holes of exercise. Being active, in whatever ways you can, pays big for your health. For individuals with chronic lymphocytic leukemia (CLL), however, professional exercise guidance is especially important. Tailored exercise programs that address fatigue and insomnia can improve quality of life, physical functioning, and overall symptom management.

Additionally, consider incorporating a weekly Singing for Lung Health session as a low-intensity, enjoyable activity. This can serve as a maintenance strategy post pulmonary rehabilitation to help sustain lung benefits and improve overall quality-of-life and exercise capacity.

• Consider incorporating predominantly low glycemic index carbohydrates in meals to minimize postprandial glucose spikes, potentially reducing Alzheimer’s disease risk as suggested by recent genetic evidence linking 2-hour postprandial glucose with increased AD risk.

2-hour postprandial blood glucose and fasting insulin measurements

Sleep: HR, HRV, Deep, REM, Respiration Rate, Body Temp, Sleep spindle density (via polysomnography)

DEXA Scan for Bone Density: schedule periodic DEXA scans every 1-2 years to monitor bone mineral density, with a specific focus on detecting early osteopenia or osteoporosis in CKM patients.

Serum Vitamin D (25-hydroxyvitamin D) levels

Vitamin D: Monitor serum levels and consider increasing supplementation if levels are low, as vitamin D deficiency has been significantly associated with depression in young females.

• L-Serine, 1000 mg

Liver Enzymes: Regularly measure serum ALT and AST levels to monitor hepatic function and detect early signs of liver injury.

Consider evaluating serum PCSK9 levels as an additional biomarker for plaque vulnerability and cardiovascular risk. This measurement can help identify early signs of vulnerable plaque regions linked to inflammation and oxidative stress.

Continuous non-invasive blood pressure monitoring using a cuffless PPG-based chest patch device, validated against invasive arterial pressure measurements, to provide ongoing cardiovascular insights.

Additionally, for individuals with arthritis or chronic joint pain, integrate mental health support and tailored physical activity strategies. Monitor depressive symptoms and adjust exercise intensity accordingly to counteract the negative impact of pain, as research shows that addressing both pain and depression helps maintain functional independence.

Additionally, consider incorporating group or partner exercise sessions. Engaging in activities with others can enhance social connectedness, which the research paper identifies as a key factor in reducing intrusive distraction and promoting better mental health and well-being.

• Incorporate short bursts of high-intensity interval training (HIIT) specifically designed to increase fluid shear stress. This may stimulate TRPV4-mediated endothelial responses, promoting vascular relaxation and improved blood flow.

Consider incorporating sources of resistant starch and diverse fermentable fibers (e.g., cooled potatoes, green bananas, legumes) to help promote a resilient gut microbiome with enhanced fatty acid and TCA cycle metabolism (Archetype 2), as recent research indicates that such a profile is linked to greater microbiome stability and may counteract disease-associated shifts.

Note: In addition to the current 10% caloric restriction, consider implementing a periodic fasting protocol (for example, one extended fasting day or a fasting-mimicking diet cycle per week) to further stimulate autophagy pathways. Recent research on myosin misfolding in hypertrophic cardiomyopathy indicates that dietary restrictions can nearly reverse detrimental effects on muscle protein folding via insulin/TOR signaling modulation, potentially improving cardiac muscle health.

MIP & MEP are diaphragm measurements - maximum inspiratory (MIP) and expiratory (MEP) pressure scored at 155 and 117 cmH2O respectively, = to age 20 (maximum possible reduction) for both markers.

Add measurement of circulating Surfactant Protein D (SFTPD) levels to assess lung function, as recent MR research shows a causal link between SFTPD and respiratory health, offering a specific biomarker for early COPD risk evaluation.

Clinically monitor the pace of biological aging (e.g., using DunedinPoAm) in postmenopausal women—especially those with early menopause—and consider appropriate hormone replacement therapy to mitigate accelerated aging.

Measure the C-reactive protein to albumin ratio (CAR) as an inflammatory biomarker to assess chronic kidney disease risk, given that elevated CAR is associated with higher CKD prevalence.

Renal interlobar arteries resistive index (RRI) coming in at 0.46 (right kidney) and 0.49 (left kidney), equal to age 25. Additionally, include regular assessments of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (every 6 months) to monitor kidney function and help mitigate the rising risk of CKD-related heart failure.

Additionally, emerging evidence links low physical activity with a greater risk of chronic kidney disease. To mitigate this risk, consider incorporating an extra 10 minutes of brisk activity (such as walking or light aerobic exercise) several times throughout the day, especially if you have risk factors like hypertension or diabetes.

Blood-based DNA Methylation analysis (e.g., DunedinPACE) for monitoring epigenetic aging and IBD activity.

Add EEG-based assessment of multivariate phase-amplitude coupling (mPAC) during cognitive tasks to evaluate working memory and learning processes. This marker can help monitor age-related cognitive decline, as research shows older individuals exhibit lower mPAC compared to younger counterparts.

Biofluids (blood, stool, urine, saliva) and periodic blood-based liquid biopsy for serum miRNA profiling to enable early, pan-cancer detection.

Feel free to add meat of your choice.

Note: Based on recent research on sustainable diets, consider periodically assessing your eating habits using a brief EAT-Lancet Consumption Frequency Index approach. This tool separates foods into categories such as 'foods to encourage' and 'foods to balance and to limit' to help ensure your diet is both nutritionally robust and environmentally sustainable.

PDE5 inhibitor (e.g., low-dose Sildenafil 5 mg daily)*

Emerging research using FLight bioprinting of mini-muscles shows that small molecules like Repsox can significantly enhance muscle regeneration. Consider exploring, under proper medical supervision, the integration of repsox or similar regenerative therapies as an adjunct to your strength training regimen to potentially improve muscle recovery and resilience.

Circulating exosomal PCNA measurement in serum via liquid biopsy for early pan-cancer detection and monitoring.

> Note: I am vegan by choice, excluding the collagen peptides. Avoid adding red meat or other high choline/carnitine sources, as these can increase TMAO production which has been linked to valvular stress and early stages of aortic valve disease.

Include a periodic cardiovascular risk assessment using updated scoring algorithms (e.g., ASCVD, FRS, QRISK, SCORE) that are validated for your demographic. This additional evaluation can complement the existing heart imaging and biomarker measurements to further refine early detection and prevention strategies.

- Serum proteomics panel analysis targeting causal protein networks linked to future myocardial infarction risk, to provide an additional layer of cardiovascular and cardiometabolic health assessment

Consider incorporating one dedicated high-intensity interval training (HIIT) session per week specifically aimed at maximizing cardiorespiratory fitness. Research in adolescents has shown that higher fitness levels are associated with a lower future risk of depression and antidepressant use. Tailoring this session to safely push cardiovascular limits could provide additional mental health benefits.

- Calories: 2,250 (10% caloric restriction from RDA). Note: Consider personalizing this caloric target using Bayesian diet inference aligned with the Nordic Nutrition Recommendations 2023 to optimize blood marker outcomes.

- Protein: 130 grams (~25%). Note: Adjust protein targets as needed based on personalized analysis to optimize insulin and metabolic responses.

- Carbs: 206 grams (~35%). Note: Reevaluate carbohydrate levels with personalized recommendations informed by Bayesian inference and Nordic Nutrition Recommendations if blood markers (e.g., insulin) indicate the need.

- Fat: 101 grams (~40%). Note: Consider reassessing fat intake guided by personalized dietary inference to best match individual lipid profile and blood marker responses.

Serum T3 and T4 levels measured via immunoassay should be added to the measurement protocol. These tests will help detect thyroid dysfunction associated with early HFpEF, as identified in recent research.

Intrinsic Capacity Score: Composite measure integrating genomic data and phenotypic markers (e.g., muscle strength, heart function, neurocognitive performance, adipose tissue health, and tibial nerve function) to assess overall functional capacity in line with recent GWAS findings.

3D-Vectocardiography QRS-Loop Mapping: Incorporate advanced 3D vectorcardiogram analysis of the QRS complex using fixed-scale, octant-specific, and unit sphere representations for a more nuanced assessment of ventricular electrical activity.

- Injuries can create serious limitations, cause body imbalances, and—as recent research indicates—lead to metabolic alterations in joint tissues that may predispose to osteoarthritis, especially in females. Prioritize joint-protective strategies and proper recovery to mitigate these risks.

Addendum: Given emerging evidence of sex-specific metabolic responses in joint tissues following injury, it is recommended that female protocols incorporate regular joint health evaluations and consider joint-supportive strategies (e.g., low-impact exercises, enhanced warm-up routines, and potential joint health supplements) to help mitigate osteoarthritis risk.

Include an annual plasma proteomics panel analysis (covering ~2448 proteins) to calculate multi-organ ProtBAG. This test, integrated with existing phenotypic measures, will provide age bias-corrected insights into tissue-specific aging and improve disease/mortality prediction.

Consider adding Centella asiatica water extract supplement (dosage scaled from 1000 mg/kg/day in murine studies, adjusted appropriately for human use) with your final meal to potentially enhance REM sleep in males and reduce sleep fragmentation in females.

Calcium 1200 mg daily; Consider adding Centella asiatica water extract supplement (dosage to be determined) to help reduce sleep arousals and improve sleep consolidation in aged females.

Resting state fMRI network analysis of sensorimotor, vestibular, and anterior cingulate networks to assess network segregation as a biomarker for physical and cognitive function.

Consider incorporating cognitive dual-task training (for example, walking while performing a working memory exercise) to enhance sensorimotor and vestibular network engagement.

- Sleep: HR, HRV, Deep, REM, Respiration Rate, Body Temp; plus integrate polysomnography (PSG) analysis using the SleepFM foundation model to capture multimodal sleep embeddings that can predict future disease risk.

Add a dedicated neuropsychological assessment protocol focusing on differentiating mild cognitive impairment (MCI) from prodromal Alzheimer’s disease. This should include advanced cognitive batteries, targeted neuroimaging (e.g., PET imaging if available), and complementary biomarkers to improve early diagnostic precision.

Include plasma proteomics analysis for key cytokine and neurotrophic markers (e.g., DEFB4A, ECE1, XCL1, SLAMF7) in blood samples to monitor inflammatory and immune pathways linked to psychological wellbeing.

DNA Methylation Entropy: Regularly assess DNA methylation entropy as a biomarker of epigenomic stability, particularly in regions regulating the electron transport chain. This will help evaluate the effectiveness of nuclear maintenance processes linked to efficient mitochondrial energy production.

Note: I am vegan by choice, excluding the collagen peptides. Feel free to add meat of your choice.

Additionally, incorporate a Microbiome Enhancer Diet approach by emphasizing high-fiber, minimally processed whole foods (e.g., whole fruits, vegetables, legumes, and whole grains) to support beneficial gut microbiota, reduce energy absorption, and increase microbial biomass.

Ensure consistent meal timing to reinforce your circadian rhythm. For example, aim to complete your primary meals by early afternoon to support BMAL1-mediated metabolic regulation and improved glucose homeostasis.

Circadian Rhythm Monitoring: Incorporate actigraphy or similar devices to track free-running period and rhythm consistency, providing insight into circadian alignment.