- Add RBC indices (especially MCHC) and heavy metal screening (e.g., lead) to the routine blood tests

- Air quality: measure lead, carbon monoxide, and particulate matter levels to assess pollution exposure risks for cognitive health.

Include hippocampal volume assessments via advanced MRI sequences and evaluate gamma band EEG changes to monitor the impact of 40 Hz audiovisual stimulation on neurogenesis and circuit plasticity.

Additionally, incorporate a daily 40 Hz audiovisual stimulation session of approximately 20 minutes to support hippocampal neurogenesis and circuit plasticity.

Add a measure of cerebral metabolic rate of oxygen (CMRO2) via advanced MRI protocols (e.g., T2-relaxation under spin tagging), and incorporate an accelerometry-based fatigability index (e.g., Pittsburgh Fatigability Index) to evaluate brain energetics and fatigue risk in older adults.

Add advanced clonal hematopoiesis (CHIP) gene panel testing to measure known driver genes (e.g., SF3B1, JAK2, TET2, PPM1D, DNMT3A), repeated every 2-5 years for risk stratification and to monitor expansion rates that could increase leukemia and mortality risk.

Consider periodic clonal expansion monitoring for postmenopausal women, incorporating baseline or repeated testing for CHIP driver mutations given the strong association between faster growth rates and increased risk of cytopenia, leukemia, and all-cause mortality.

Include imaging to assess rectus abdominis muscle infiltration (myosteatosis) using standardized CT or MRI, given recent findings linking abdominal myosteatosis to declines in processing speed.

Consider splitting the daily Vitamin C intake into multiple servings to maintain stable intracellular ascorbic acid levels, based on research demonstrating GLUT10’s role in AA homeostasis.

- RBC ascorbate levels (to monitor intracellular ascorbic acid status)

Additionally, incorporate multi-tissue proteomic profiling (e.g., muscle, liver) to identify tissue-specific pQTL variations for deeper genotype-phenotype associations.

- Purasomes XCELL (per recommended dosage) to support skin telomere length and reduce skin aging.

Include MRI-based elastography (MRE) to evaluate brain tissue stiffness, given that mechanical cues significantly affect neuronal metabolism and autophagic function.

Include environmental modifications to reduce exposure to sedentary triggers (e.g., standing desks, fewer comfortable lounges) and set frequent reminders or alarms to encourage movement, helping offset the higher mental effort required to avoid sedentariness.

Additionally, adopt Sparse-Seq to measure 5mC and 5hmC levels at base resolution while maintaining cost-effectiveness. This method offers less variability than mass spectrometry-based methods for global epigenetic quantification.

- Incorporate region-based GMV (GMVN) and Brain Entropy (BENN) network analyses to capture additional aspects of brain function and improve predictions of cognitive and emotional outcomes.

Include ultrafast MREG recordings during sleep to assess CSF flow velocity changes and pulsation power, correlating with EEG-verified sleep stages.

- Implement single-molecule bacterial DNA methylation analysis in stool samples to monitor epigenetic phase variation (ePV) in gut microbes, especially when antibiotics or probiotics are introduced.

Consider adding TSPO-PET imaging to measure microglial activation status, given microglia’s critical role in tau-driven neurodegeneration.

Add a measurement of the Neurocognitive Efficiency Score (NES) by combining reaction time data with EEG-based global field power (GFP) for a ratio of cognitive work to neural energy expenditure.

Add a daily multi-strain Bifidobacterium probiotic supplement to synergize with existing prebiotics, enhancing host-specific carbohydrate metabolism and gut health.

Consider allowing lentils (and other starchy foods) to cool after cooking before reheating or serving, to increase resistant starch and support beneficial Bifidobacterium growth.

Include Bifidobacterium strain-level stool testing to monitor co-evolutionary and functional adaptations in carbohydrate metabolism.

Regular ECG monitoring analyzed by AI algorithms to detect electrolyte imbalances, particularly hyperkalemia.

- Integrate advanced AI tools like Brainfound for enhanced analysis of brain MRI and CT imaging.

Include periodic autoantibody profiling using PhIP-Seq for early detection of non-small cell lung cancer (NSCLC).

- Gut microbiome analysis focusing on Bifidobacterium abundance

Add periodic measurement of NLRP3 inflammasome-related biomarkers (e.g., IL-1β, IL-18) in blood to assess neuroinflammation risk relevant to AD.

Add single-nucleus RNA sequencing of hippocampal tissue to evaluate the presence and transcriptional profiles of immature neurons for insights into healthy aging and AD resilience.

Add advanced metaproteomic analysis (uMetaP) to stool and gut samples for a deeper functional assessment of host-microbiome interactions and potential drug targets, especially for monitoring and preventing inflammatory conditions.

Niacin (as Nicotinic Acid) 100 mg

Abdominal artery calcification (AAC) screening to evaluate progression of vascular calcification

Add advanced regional volumetric analysis focusing on hippocampal subfields (especially CA3) and anterior/intralaminar thalamic nuclei to detect early morphological changes related to AD.

Consider periodic MR-based volumetric assessments of hippocampal and thalamic subregions, as AD-related changes can be more pronounced in females. This can help detect early shifts in brain architecture for timely interventions.

- HbA1c (Glycated Hemoglobin)

- LDL Cholesterol levels

- Blood pressure measurements

- Blood Pressure: Regular monitoring, focusing on systolic BP in women and diastolic BP in men

- Regularly monitor blood pressure, focusing on detecting any decline in systolic BP.

- Apply WHITE-Net deep learning framework to MRI scans for accurate detection of white matter hyperintensities (WMH).

- Comprehensive plasma proteomics to analyze circulating protein levels and identify individual factors influencing them

> Note: I am vegan by choice, excluding the collagen peptides. Based on new evidence that the source of dietary protein significantly impacts immune response, digestion, and barrier function, consider adding or rotating a variety of plant-based protein sources (e.g., soy, pea, brown rice, yeast) to promote beneficial gut microbiota interactions. Feel free to add meat of your choice if desired.

Additionally incorporate Garmin’s Stress Score (GSS) to assess daily mental stress; the new study confirms GSS correlates with HRV metrics (e.g., RMSSD), offering a validated, accessible way to monitor stress.

Include serum microRNA expression analysis (specifically miR-1301-3p, -431-5p, -501-5p, -519a-3p, and -18a-3p) to assess correlation with VO2peak.

Incorporate progressive muscle relaxation techniques and slow stroke back massage to reduce blood pressure, alleviate stress, and enhance sleep quality.

- RHR, HRV (using standardized measurement protocols), VO2Max

Add specialized imaging for muscle architecture (e.g., advanced 3D MRI or ultrasound) to evaluate myofiber structure and function, facilitating the potential use of 3D-printed scaffolds and regenerative approaches for volumetric muscle loss (VML).

- Proferrin 10.5 mg** (use only if measured iron levels indicate deficiency, as iron overload may accelerate ferroptosis)

Add regular assessment of serum iron, ferritin, and transferrin saturation to monitor iron status and prevent iron overload that could exacerbate ferroptosis.

Include a serving of pomegranate (e.g., ½ cup of seeds or ~150 ml of 100% juice) daily to incorporate Urolithin A and help mitigate SASP/DAMP-related inflammation.

Include the use of bacterial-to-host (B:H) read ratio from stool metagenomic data as a straightforward proxy to quantify absolute gut bacterial biomass, allowing longitudinal tracking of treatment responses (such as antibiotics) and recovery.

- Genetic testing for variants in LINC01122 and KCNA5 associated with preserved cognitive function

- Bimanual coordination tests: in-phase and anti-phase tapping tasks to measure number, frequency, and average interval of taps

- Work on strength training, cardio, balance, flexibility, and coordination.

- Measure carotid Lumen Diameter (cLD) via carotid ultrasound

- APOE genotyping

| **Folate (as Calcium L-5 Methyltetrahydrofolate)**   | 800 mcg DFE        | 200%           |

| **Vitamin B6 (as Pyridoxine HCl)**                   | 5 mg               | 294%           |

- Include homocysteine levels measurement in blood tests

- Folate (400-800 mcg daily)

Include alveolar imaging or Lrg1 biomarker testing to monitor potential fibrotic changes in pulmonary capillaries and overall lung regeneration capacity.

Include measurement of sleep spindles (via EEG) to assess local cortical excitability during NREM sleep

Additionally, incorporate daily mindfulness or relaxation techniques to mitigate stress since heightened stress disrupts GABAergic signals in the amygdala, interfering with healthy GnRH pulses and menstrual function.

Additionally, establish consistent stress-reduction practices (such as mindfulness, breathing exercises, or yoga) to help maintain balanced GABAergic function in the amygdala, thereby supporting healthy reproductive hormones during pregnancy.

Include measurement of proteomic aging clocks, specifically the Cancer-specific Proteomic Aging Clock (CaPAC), using proteomic assays such as SomaScan.

- Weight, body fat, muscle mass, muscle quality, body water, BMI

Interpret muscle mass and muscle quality measurements in a sex-specific manner, as age-related muscle mass loss is more pronounced in males, while muscle quality decline is greater in females.

#### Considerations for males:

- As age-related muscle mass loss is more pronounced in males, prioritize resistance training to preserve muscle mass.

- Incorporate progressive overload to stimulate muscle growth.

- Ensure adequate protein intake to support muscle synthesis.

Incorporate exercises that enhance muscle quality, such as neuromuscular training, balance, and coordination exercises, to counteract the greater age-related decline in muscle quality observed in females.

Include lipid profile measurements: total cholesterol, LDL, HDL, triglycerides, ApoA, and ApoB

Gly-Low supplement** (to help lower MGO-induced glycation stress).

Include regular measurement of Methylglyoxal (MGO) and MGO-derived hydroimidazolone (MGH-1) levels in blood to monitor glycation stress.

Consider adding transcranial ultrasound stimulation (TUS) to target deep brain structures like the hippocampus, using MRI-based modeling for precise focal stimulation and potential improvements in sleep, emotion, and cognitive functions.

- Shiitake, Maitake, or King Trumpet Mushrooms, 50 grams. Pair these mushrooms with black lentils to enhance beneficial gut microbial synergy supporting cardiometabolic health.

- NR (450 mg) or NMN (500 mg)** focusing on muscle-specific benefits where feasible, acknowledging that tissue-focused NAD modulation may elicit enhanced anti-aging effects compared to whole-body approaches.

If feasible, measure muscle tissue NAD/NADH ratio (e.g., via biopsy or advanced imaging) to assess tissue-specific changes in redox metabolism.

Add a measurement of HPC mitochondrial transfer rate (using methods similar to iMSOD-mito) to evaluate mesenchymal-to-hematopoietic mitochondrial delivery and HSPC quiescence as part of our regenerative therapy tracking.

- Ground Flaxseeds, 1 Tbsp

- Hemp Seeds, 1 Tbsp

- Genetic testing including APOE genotyping

- Biofluids (blood, stool, urine, saliva)

- peripheral blood markers, including measurement of plasma lipid species such as CE 18:3, TG 56:5, TG 56:4, CE 22:6, TG 51:3, and TG 54:2.

Incorporate breath-based meditation practices like Sudarshan Kriya Yoga (SKY) to improve heart rate variability, sleep quality, and mental health.

Integrate multi-organ imaging and proteomic analyses focusing on the brain-heart-eye axis, including patterns of structural covariance (PSCs), imaging-derived phenotypes (IDPs), and proteomic data, to identify cross-organ phenotypic associations and improve disease prediction.