Bryan Johnson, the technology entrepreneur who founded the online payment company Braintree, has become one of the most recognizable figures in the anti-aging trend. Among Generation Z (Gen Z), he is widely known as the “most measured man in history.” Through social media, Johnson documents daily biomarker monitoring, a strict diet and sleep regimen known as Blueprint, and the use of dozens of dietary supplements and hormone preparations. His stated goal is simple: “Don’t die.”

Johnson has become one of the public faces of the anti-aging trend, which aims to delay aging until science can eventually overcome it altogether. Longevity focused content has attracted a large following, particularly among Gen Z, where concerns about aging, long-term health, and quality of life have fueled growing interest in biomarker tracking, dietary supplements, and other strategies promoted to slow biologic aging.

However, how well do this increasingly popular longevity strategies stand up to scientific scrutiny? Current evidence suggests that although several emerging interventions influence biologic pathways associated with aging, the strongest evidence for maintaining long-term health and promoting healthy aging continues to support established lifestyle measures, particularly regular physical activity and adequate sleep.

The Strongest Evidence

Exceptional longevity appears to be largely influenced by genetics. Individuals who live beyond 100 years of age often show strong familial clustering, whereas lifestyle and environmental factors appear to have the greatest influence on achieving normal life expectancy and good health.

Among lifestyle interventions, regular physical activity has the strongest evidence of promoting healthy aging.

Regular aerobic and resistance exercises have consistently been associated with lower all-cause mortality, reduced cardiovascular risk, improved insulin sensitivity, greater muscle mass and bone density, better cognitive function, and lower frailty in older adults.

Several of these measures are incorporated into biological age assessment models, suggesting that regular physical activity may not only increase the likelihood of reaching one’s expected life span but also help delay biologic aging.

Sleep duration also affects long-term health. A 2010 meta-analysis found that both short sleep duration, defined as fewer than 5 hours per night, and long sleep duration, defined as more than 8 hours per night, were associated with higher all-cause mortality in prospective population studies.

Nicotinamide Adenine Dinucleotide (NAD+) Boosters

NAD+ boosters are among the most widely promoted anti-aging interventions on social media.

NAD+ is a coenzyme essential for mitochondrial function, DNA repair, and numerous metabolic processes. Because NAD+ concentrations decline with age, many proponents of anti-aging medicine believe that restoring youthful levels may slow age-related metabolic changes.

NAD+ treatment boosters typically involve supplementation with NAD+ precursors, such as nicotinamide riboside, nicotinamide mononucleotide, or niacin.

Although studies have consistently shown that these supplements increase circulating NAD+ concentrations, there is currently no evidence that they prolong life or reduce the clinical manifestations of aging.

Metformin

Metformin is another intervention that is frequently promoted within the anti-aging trend.

Among individuals with type 2 diabetes, metformin has been associated with lower mortality and reduced cardiovascular and metabolic risks.

Metformin activates signaling pathways similar to those triggered by calorie restriction and physical activity. Unlike exercise, however, metformin does not increase muscle mass, preserve bone density, or produce cardiovascular adaptations associated with regular physical training.

Moreover, no evidence has demonstrated that metformin prolongs the life of healthy individuals.

Takeaway

The pursuit of longer, healthier lives is not new, but social media has brought an anti-aging trend to a much wider audience.

Current evidence continues to support regular physical activity and adequate sleep as interventions, with the strongest evidence for maintaining long-term health and promoting healthy aging. Although NAD+ boosters and the off-label use of metformin influence biologic pathways associated with aging, neither has demonstrated proven longevity benefits in healthy individuals. Additional research is required before either approach can be recommended for anti-aging purposes.

This story was translated from Univadis Germany, part of the Medscape Professional Network.