Many of us hope not just to live longer, but to truly flourish as the years pass, maintaining our mental sharpness, energy, and physical abilities.

Key takeaways

• Health optimisation is an integrated paradigm shift aimed at not just extending lifespan but enriching healthspan.
• Biological age, influenced by lifestyle and genetics, can diverge significantly from chronological age.
• Tracking through wearable devices like CGMs, Oura Rings, and Whoop Bands is crucial for providing actionable insights and forming a feedback loop essential for sustainable improvement and personalised health management.

Health optimisation: the path to enhanced lifespan, healthspan, and vitality

Many of us hope not just to live longer, but to truly flourish as the years pass, maintaining our mental sharpness, energy, and physical abilities. But how can we achieve this? By blending ancient wisdom with modern science, health optimisation becomes an accessible goal.

What is health optimisation?

Health optimisation isn’t a mere buzzword – it’s a paradigm shift. At its core, it’s about a holistic, all-encompassing approach that binds the intricate facets of health into a unified goal.

The essence of health optimisation lies not just in adding years to life, but more importantly, life to those years. It seeks to magnify the healthspan – the span of one’s life spent in good health – not just the lifespan. But to truly understand its potential, we need to view health not as a static state but as an ever-evolving continuum. A continuum where the peak represents enhanced energy, unwavering cognitive function, and the physical capacity to embrace life to its fullest.

It isn’t just about dodging diseases – it’s about flourishing.

“Optimisation is the compass guiding us toward a better existence. Seek the better, for in that pursuit, we enrich our life with vitality.”‍

– Jabe Brown, Founder, Melbourne Functional Medicine

Health optimisation is a journey

Health optimisation is best described as a journey, where every intervention, lifestyle change, and therapeutic decision converges to one primary objective: an enhanced state of holistic well-being. It’s about tapping into the inherent potential of our bodies and minds to function at their optimal, given the right set of conditions and care.

What sets health optimisation apart is its focus on the individual as a whole, tracked and measured by data, using the latest scientific understanding, and lab testing, on health and longevity. This approach integrates physical, emotional, cognitive, and even genetic facets of health. The ambition? Comprehensive benefits that resonate across all dimensions of well-being.

Beyond group data – the power of individualisation

No two individuals are the same, and neither should be their health optimisation strategies. This isn’t about generic recommendations; it’s about personalised solutions tailored to individual needs, backgrounds, and aspirations.

In an era of big data, health insights are undergoing a revolutionary transformation. Gone are the days when the best recommendations were made based on broad population studies. Today, we have the capability to delve deep into individual-specific data. From understanding genetic predispositions to capturing the nuances of metabolic health, the health optimisation strategy is data-driven, precise, and most importantly, personal.

“We’re in the age of n=1 medicine, where data holds the key to personalised paths of wellness.”

– Mark Payne, Functional Medicine Practitioner, Melbourne Functional Medicine

Health and ageing: a complex web of interconnections

Ageing, as a biological process, is fascinating, as it is both a root cause for declining health, and is accelerated as a consequence of suboptimal health choices.

If we were to consider risk factors for diseases, from chronic conditions like cardiovascular diseases to neurodegenerative ailments like Alzheimer’s, ageing would emerge at the forefront. Simply put, the longer we live, the greater the risk of chronic diseases, and the more we’re exposed to environmental, metabolic, and other epigenetic factors that impact the function of our cells. Moreover, this isn’t just about individual diseases; it’s about a general decline in vitality, cognitive function, and physical capacity.

Inflammageing: fast-tracking ageing through lifestyle

Ageing is a natural process, but our modern lifestyles can effectively put it on the fast track through inflammageing.

Chronic inflammation, driven by poor dietary choices, sedentary habits, and unmanaged stress, is a key factor in accelerating ageing. This internal inflammatory state not only paves the way for myriad diseases, but also compounds the effects of ageing.

Can we live forever? Understanding longevity

While true biological immortality might be a stretch, slowing down, halting, or even reversing certain aspects of ageing are tangible goals being studied. Noteworthy here is the work on animals like hydras and certain jellyfish, which exhibit biological immortality, providing intriguing insights into the possibilities of longevity.

The 11 hallmarks of ageing

To truly grasp ageing, it’s essential to understand its fundamental drivers. The 11 hallmarks of ageing provide a framework:

• Genomic instability: Damage that accumulates in the genome over time
• Telomere attrition: Shortening of telomeres, the protective end caps of our chromosomes
• Epigenetic alterations: Changes that affect gene expression without altering the DNA sequence
• Loss of proteostasis: Reduced ability to produce, fold, and breakdown proteins
• Deregulated nutrient sensing: Impaired sensing and response to nutrients
• Mitochondrial dysfunction: Deterioration in the function of mitochondria, our cellular powerhouses
• Cellular senescence: Cells losing their ability to divide and function
• Stem cell exhaustion: Decline in the regenerative potential of stem cells
• Altered intercellular communication: Miscommunication between cells, leading to inflammatory states
• Extracellular matrix stiffening: Makes tissues stiffer and less functional
• Dysregulated circadian rhythms: Disrupted sleep and activity patterns that affect health

Understanding what causes ageing provides us the therapeutic targets to slow down and reverse certain ageing processes.

Notable negative impact factors accelerating ageing

• mTOR activation: While essential for cellular processes, unchecked mTOR activation can accelerate ageing and increase disease risk
• Sedentary lifestyle: A lack of physical activity has a cascading negative effect on metabolic health, cardiovascular function, and neurocognitive health
• Poor diet: Diets rich in processed foods and lacking in nutrients can induce inflammageing and exacerbate metabolic disorders
• Chronic stress and inflammation: Prolonged stress affects the endocrine system, potentiates inflammation, and can hasten cellular ageing

Positive modulators: paths to graceful ageing

Two of the better known pathways we can use to help slow ageing, are:

• AMPK: Known as the ‘longevity enzyme’, AMPK activation can counteract many negative ageing processes, and is linked to increased lifespan
• Sirtuins: These proteins protect against cellular stress and are associated with longevity. They’re activated during caloric restriction, – a known lifespan-extending intervention – and in other circumstances of hormesis

Hormesis is a positive biological response to perceived adversity. Think of it like the body calibrating and fine tuning itself when you push the envelope. Examples include, cold and heat exposure, caloric restriction, and exercise.

“I believe humanity is on the cusp of the next frontier in our evolution: the ability to directly engineer our biology and our minds, to improve who we are as a species.”

– Bryan Johnson

Measuring age: beyond chronological time

Modern health science reveals that biological age, influenced by the potential to slow, halt, or reverse ageing, can significantly differ from our chronological age, offering a deeper understanding of longevity.

Biological age vs. chronological age: What’s the difference?

Chronological age refers to the exact time elapsed since our birth. Short of time travel, it is irreversible.

Biological age, on the other hand, reflects how our cells and tissues have aged and how much they’ve deviated from their original, youthful state. Factors influencing this age include genetics, lifestyle, exposure to environmental toxins, diet, exercise, stress, and more. Two individuals with the same chronological age could have very different biological ages depending on these factors.

While the notion of biological age isn’t new, our capability to quantify it with precision, is an outcome of advanced scientific techniques. Some of these groundbreaking methods include:

• Epigenetic markers
• Telomere length
• Metabolomics
• DunedinPACE (Dunedin PoAm Composite of Accelerated Ageing)

For individuals and practitioners engaged in health optimisation, monitoring and influencing biological age is incredibly powerful, and empowering. It shifts the focus from merely preventing disease, to enhancing vitality and function at every age.

Pillars of longevity and health optimisation

Health optimisation isn’t just about adding years to our life, but adding life to those years.

“If you want to live longer, you have to live longer without chronic disease, rather than live longer with chronic disease.”

– Peter Attia

One of the most profound examples of longevity and health optimisation are the centenarians residing in the ‘Blue Zones’ – regions globally where people live exceptionally longer and healthier lives. Commonalities among these long-living individuals include a plant-centric diet, regular physical activity, robust social engagement, stress-reducing practices, and a sense of purpose.

While we have learned a lot from the study of these Blue Zones, we are now in the age of n=1 medicine, where optimisation interventions typically fall into one of the following four pillars:

Nutrition

Nutrition is pivotal. Instead of a one-size-fits-all approach, the focus is on personalised dietary plans based on genetic profiles, metabolic rates, nutritional biomarkers, and food sensitivities. For instance:

• Certain genes like FTO may influence one’s predisposition to obesity. APOE variants can affect cholesterol metabolism, and DAO relates to histamine intolerance
• Supplements such as NAD, NR, CoQ10, and lutein play crucial roles in supporting cellular energy production and overall physiological health. Some of these nutrients are delivered intravenously, a superior delivery of nutrients in comparison to traditional forms of supplementation like pills, to maximise absorption
• A holistic health approach also focuses on minimising toxins. This means sourcing clean, organic foods, using purified water, and employing safe cooking practices and cookware to ensure toxin exposure is minimal

Sleep

The rejuvenating power of quality sleep cannot be overstated. Personalised sleep strategies can be crafted based on potential genetic markers like the CLOCK gene. A deeper understanding of chronobiology – the study of internal clocks – is essential. Sleep deprivation can elevate risks of various diseases, diminishing health and longevity.

Embracing biohacking tools can be a game-changer. Devices like Oura and Whoop provide insights into sleep patterns, to then track, modify, and refine sleep routines for enhanced sleep quality.

“Sleep is the single most effective thing you can do to reset your brain and body for health.”

– Andrew Huberman

An optimal sleeping environment is key, which can include the use of HEPA air filters, humidifiers, blackout blinds, thermoregulating mattresses, and red lighting.

Sleep enhancing supplements include: Magnesium, glycine, taurine, tryptophan, theanine, GABA, B6, zinc, ashwagandha, zizyphus, and various other herbs.

Exercise and hormesis

Hormesis, a biological response where moderate stressors lead to increased resilience and better health, is a critical aspect of optimising health. Exercise is a form of hormetic stress, and its benefits can be maximised when tailored to one’s genetic predispositions. For example, SNPs in ACE can influence endurance capabilities, and ACTN3 can determine muscle composition and strength traits. Interestingly, exercise acts as a DNA methylation adaptogen, impacting our genes in a way that promotes health.

Additionally, practices like cryotherapy and sauna expose the body to controlled stress, offering hormetic benefits. Certain molecules, such as NAC and resveratrol, emulate these hormetic effects, further amplifying health outcomes.

Stress tolerance

A long, fulfilling life requires a balanced mind. The key here being: balance. A life with no adversity is not a fulfilling one, equally so is a life overly filled with adversity. Optimal is an oscillation between survival and revival, with balance over time, like a well-balanced see-saw.

Happiness and life satisfaction can subjectively be measured using a validated scale called PERMA – Positive Emotion, Engagement, Relationships, Meaning, and Achievement.

Heart Rate Variability (HRV) acts as an objective, trackable, measurement of one’s exposure and resilience to stress, using wearable devices, to assess how you respond to the way you live. The hand of cards we are dealt can have a profound impact on how we deal with stress and adversity: our genes. Genes that can impact stress tolerance include MTHFR, COMT, BDNF and MAO. We can’t change our genes – yet – but understanding them allows us to compensate for them in the way we live. Nature is not destiny.

With adaptogenic herbs like ashwagandha and rhodiola, meditation, mindfulness practices, strategic breathing exercises, and binaural beats, we can harness and enhance our innate stress tolerance capabilities.

Optimising goes far beyond the four pillars, but it is impossible to optimise without a solid foundation, so these fundamentals are just that; fundamental.

Longevity-enhancing molecules and strategies

Many molecules have been identified in research to play critical roles in cellular repair, energy production, and anti-ageing processes.

Some of these molecules are naturally produced within the body, while others can be acquired through diet, supplementation, or medication. The most influential molecules associated with longevity enhancement, include:

• NAD (Nicotinamide Adenine Dinucleotide)
• Spermidine
• Berberine
• Quercetin
• Urolithin A
• Curcumin
• EPA (Eicosapentaenoic Acid)
• DHEA (Dehydroepiandrosterone)
• NAC (N-Acetylcysteine)
• Calcium Alpha-Ketoglutarate

Being truly optimal means looking at molecules like these, however, it’s essential to approach these molecules with knowledge and guidance, understanding that each individual’s needs and reactions may differ.

Nootropics for cognitive enhancement

Cognitive enhancement is more than just brainpower; it’s about sustaining mental energy, honing focus, and nurturing resilience against cognitive decline. Examples of nootropics include:

• Phosphatidyl nutrientsDHA
• Gingko biloba
• Bacopa monnieri

For high performers, cognitive enhancement is the main game. But like most aspects of health, a one-size-fits-all approach is far from optimal.  Available now in the performance toolkit is  genetic tailoring, where understanding our genetic makeup can guide our choices in nootropics, ensuring that we’re not just taking a scattergun approach, but strategically enhancing our cognitive faculties based on our very DNA.

Tracking and refining: the path forward

Progress, if not measured, remains intangible. In the realm of health optimisation, tracking isn’t merely an act of recording but of elucidation – it brings clarity, offering insights into what’s working, what’s not, and how one might pivot for better results. This continual feedback loop is the bedrock upon which sustainable and effective health optimisation is built.

Wearable devices: the pioneers of modern health analytics

A range of wearable devices are now on the market, with some of the most popular being:

• Continuous Glucose Monitors (CGMs): By providing real-time blood sugar data, CGM's offer invaluable insights into how diet, activity, stress, and sleep influence glucose levels. For those keen to understand and manage their metabolic health, this tool is nothing short of revolutionary
• Oura Ring: A marvel in sleep tracking, the Oura Ring captures detailed data on sleep phases, heart rate variability, body temperature, and overall readiness. Such data is indispensable for anyone aiming to enhance sleep quality and, by extension, cognitive and physical performance
• Whoop Band: Beyond just a fitness tracker, the Whoop band measures strain, recovery, and sleep, providing a holistic overview of one’s daily performance. It’s an athlete’s companion, but also an essential tool for anyone keen to push their physical boundaries responsibly

Jabe Brown is the Founder of Melbourne Functional Medicine.  A clinic dedicated to personalised healthcare and longevity services.  Find out how the team at Melbourne Functional Medicine can help you find the healthiest version of you.

Adapted from Jabe's original What is Health Optimisation? article.