Epigenetic clock: A promising biomarker and practical tool in aging
How DNA methylation clocks estimate biological age, and how they can be used to judge whether an intervention is actually working.
Read it on PubMed
Every paper below is peer reviewed, published in 2020 or later, and is a review, meta-analysis or clinical guideline rather than a single small study. Each section includes at least one paper that pushes back, because a clinic that only cites the flattering research is not really reading the research. Every title links out to PubMed so you can check any of it yourself.
Longevity medicine is less about one intervention than about measurement. The papers here cover how biological age is estimated, what diet, exercise and heat exposure appear to do to the underlying mechanisms of aging, and where the science is still unsettled. We have kept the consensus paper arguing that aging biomarkers are not ready for routine clinical use, because that is the honest state of the field.
How DNA methylation clocks estimate biological age, and how they can be used to judge whether an intervention is actually working.
Read it on PubMedA plain overview of the biology of aging and the interventions under study to slow it, including metformin, rapamycin, senolytics and caloric restriction.
Read it on PubMedAcross 199 cohort studies and 20.9 million observations, higher cardiorespiratory fitness was consistently linked to lower risk of death and of most major chronic diseases.
Read it on PubMedIn a two-year randomized trial, healthy adults who cut calories about 25% showed a slower pace of biological aging on DNA methylation measures.
Read it on PubMedReviews how eating patterns, including Mediterranean, time-restricted eating, ketogenic and caloric restriction, may act on the underlying mechanisms of aging.
Read it on PubMedExplains the worn-out senescent cells that accumulate with age, and the two drug classes being developed to clear them or quiet them down. Still mostly pre-clinical.
Read it on PubMedReviews what regular sauna use does physiologically, and the cohort data linking more frequent use to lower rates of illness and death.
Read it on PubMedThe honest counterweight: a consensus paper on why aging biomarkers are not ready for routine clinical use yet, and what they still have to prove.
Read it on PubMedHormone therapy is one of the most misreported subjects in medicine. What the evidence actually supports depends on the formulation, the dose, the route of delivery, the timing and the patient, not on hormones as one undifferentiated category. These papers include the cardiology guidance, the reappraisal of the Women’s Health Initiative breast cancer findings, the testosterone safety data, and the ACOG position on compounded bioidentical hormones.
A clinical overview arguing that outcomes depend on the right formulation, dose, timing and patient, not on hormones as one undifferentiated category.
Read it on PubMedCardiology-led guidance on who should and should not use hormone therapy, written specifically around women who also carry cardiovascular risk.
Read it on PubMedCompares oral versus transdermal estrogen and different doses on cardiovascular markers, and states plainly that hormone therapy is not a heart-disease prevention treatment.
Read it on PubMedRevisits the WHI breast-cancer findings and explains why the randomized trial results differ from the observational studies people often quote.
Read it on PubMedThe caution piece: the ACOG position that compounded bioidentical hormones are not FDA-approved, carry compounding-specific risks, and are not shown to be safer than approved products.
Read it on PubMedA large UK evidence synthesis: in men with confirmed low testosterone, replacement improved sexual function and quality of life with no short to medium term cardiovascular signal.
Read it on PubMedUpdated pooling of placebo-controlled trials, finding no overall increase in cardiovascular events with testosterone therapy.
Read it on PubMedHow thyroid function shifts with age, and when mildly abnormal thyroid labs in older adults should and should not be treated.
Read it on PubMedAcross 58 studies and 3,508 people, structured stress-management programs measurably changed cortisol levels.
Read it on PubMedRegenerative medicine covers a wide range of quality. Some of it is well studied and some of it is marketed far ahead of its evidence. The reviews here compare PRP, bone marrow concentrate, prolotherapy, shockwave and corticosteroid head to head, and include the meta-analysis that found PRP only weakly better than saline placebo at six months.
The orthopedic surgeons’ academy review of PRP for knee arthritis, weighed head to head against steroids, hyaluronic acid, bone marrow concentrate, prolotherapy and exercise.
Read it on PubMedThe honest counterweight: pooled against saline placebo, PRP showed only weak benefit out to six months, and the authors question how clinically meaningful that is.
Read it on PubMedRanking knee injections at six months or longer, PRP came out on top, ahead of bone marrow concentrate, hyaluronic acid and corticosteroid.
Read it on PubMedAcross 27 trials and 1,779 patients with tendon problems, PRP beat corticosteroid injection on pain and function at mid-term follow-up. Long-term data is still missing.
Read it on PubMedWhat prolotherapy is, how it is thought to work, and the conditions with supporting evidence: tennis elbow, rotator cuff, plantar fasciitis, Achilles, arthritis, low back and SI joint pain.
Read it on PubMedGraded by evidence quality: shockwave therapy has a large effect for plantar fasciitis, but little effect for patellar and Achilles tendon problems.
Read it on PubMedWhat bone-marrow and fat-derived cell preparations actually contain, and why potency varies from patient to patient.
Read it on PubMedA primary-care review of which musculoskeletal conditions have the best evidence for PRP and which do not.
Read it on PubMedAcupuncture has a large evidence base of uneven quality, and reading it well means separating the conditions with consistent findings from the ones that rest on a handful of small trials. These papers include the map of 862 systematic reviews across 184 conditions, the JAMA review noting how little of that base is high certainty, and the joint oncology guideline that recommends acupuncture for specific kinds of cancer-related pain.
Mapped 862 systematic reviews across 184 conditions: clear positive evidence for ten conditions, possible benefit for 82, and not enough evidence to say for the rest.
Read it on PubMedThe honest counterweight: reviewed the whole acupuncture evidence base and found only a minority of conclusions rest on high or moderate certainty evidence.
Read it on PubMedPooling the reviews of reviews, the strongest and most consistent benefit in low back pain is pain reduction. Effects on disability and quality of life are weaker.
Read it on PubMedAcupuncture gave pain relief and functional gains that lasted three to six months after treatment ended, with a good safety record.
Read it on PubMedAcross 40 trials and 4,405 participants, acupuncture worked as migraine prevention and compared favorably with preventive medication at 12 weeks.
Read it on PubMedAcross 24 trials, sleep improved significantly after more than three weeks of acupuncture, which means it takes a course of treatment, not a single visit.
Read it on PubMed22 trials and 2,391 participants: acupuncture helped depressive symptoms both on its own and added to antidepressants, with a good safety profile.
Read it on PubMedReal acupuncture raised parasympathetic tone, the rest and recover side of the nervous system, measured by heart rate variability, more than sham acupuncture did.
Read it on PubMedReviews acupuncture for hot flashes and other menopausal symptoms, including safety, as an option for women who cannot or prefer not to use hormone therapy.
Read it on PubMedA joint guideline from the Society for Integrative Oncology and ASCO recommending acupuncture and related therapies for specific kinds of cancer-related pain.
Read it on PubMedGut health is where good research and marketing sit closest together. The papers here cover what the microbiome does across a lifespan, what fermented food and fiber measurably change, what intestinal permeability actually means, and why SIBO breath testing is less reliable than most clinics present it as.
How gut bacteria change across the lifespan, including the patterns that set the very long-lived apart from everyone else.
Read it on PubMedA 17-week randomized trial in which a high-fermented-food diet raised gut microbial diversity and lowered inflammatory markers. A high-fiber diet did not do the same.
Read it on PubMedPooled prospective cohorts confirming that higher dietary fiber intake tracks with lower all-cause and cause-specific death rates.
Read it on PubMedIn 1,425 people across 173 dietary factors, specific foods mapped consistently onto either pro-inflammatory or anti-inflammatory gut bacterial communities.
Read it on PubMedWhat intestinal permeability actually means, and how the fiber and the types of fat in a diet affect the gut barrier.
Read it on PubMedPooling clinical trials, probiotic, synbiotic and prebiotic supplements improved measured markers of intestinal permeability.
Read it on PubMedThe honest counterweight: argues SIBO is over-diagnosed, because the breath tests most clinics use disagree with the reference culture standard.
Read it on PubMedGut bacteria differ measurably in depression, and probiotics or synbiotics gave a modest reduction in symptoms over four to nine weeks.
Read it on PubMedThe East meets West bridge: acupuncture and moxibustion shifted specific gut bacterial groups, though results varied across studies.
Read it on PubMedEnvironmental exposure is a medical question before it is a building question. These papers cover the sensible clinical approach to indoor mold, what air filtration measurably does to particle levels and to blood pressure, and what the evidence supports on PFAS, phthalates and long-term air pollution. Ashara treats people, not buildings.
A medical-association review giving a step-by-step approach to indoor mold: remove the exposure first, test rationally, and be honest about what air sampling cannot tell you.
Read it on PubMed141 studies across 29 countries identifying the main sources of indoor pollution at home: smoking, gas appliances, household products, traffic-adjacent location and poor ventilation.
Read it on PubMedPortable air purifiers cut indoor fine-particle levels by 22.6% to 92.0% across studies. The health benefits follow from that reduction but are less directly measured.
Read it on PubMedAcross 10 trials and 604 participants, in-home air filtration lowered systolic blood pressure by roughly 4 mm Hg.
Read it on PubMedPractical, evidence-graded steps a person can take to lower the cardiovascular cost of air pollution, metals and pesticides: air cleaners, water filtration, exposure timing.
Read it on PubMedGrades the PFAS literature, the so-called forever chemicals, to separate the well-supported health associations from the weakly supported ones.
Read it on PubMedLinks phthalate exposure, common in plastics and personal care products, to thicker carotid artery walls and more arterial plaque.
Read it on PubMedAir quality, neighborhood greenness and chronic noise, and shift work were all associated with dementia risk.
Read it on PubMedLong-term exposure to PM2.5, PM10, NO2 and SO2 was associated with insulin resistance, with fine inhalable particles showing the strongest effect.
Read it on PubMedBring the article in with you.
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