LONGEVITY

ROADMAP
Become Young at Any Age

WORKBOOK
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ROADMAP
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30 Days to Aging Backwards

WORKBOOK

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DISCLAIMER

This publication contains the opinions and ideas of the author. It is intended to provide helpful and informative

material on the subjects addressed in the publication. It is provided with the understanding that the author and

publisher are not engaged in rendering medical, health, psychological, or any other kind of personal professional

services in the book. If the reader requires personal medical, health, or other assistance or advice, a competent

professional should be consulted.

The author and publisher specifically disclaim all responsibility for any liability, loss, or risk, personal or otherwise, that

is incurred as a consequence, directly, or indirectly, of the use and application of any of the contents of this guide.

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30 Days to Aging Backwards

WORKBOOK

TA B L E O F C O N T E N TS

Welcome to The Longevity Roadmap: 30 Days to Aging Backwards Workbook.......................... 4

How to Use This Workbook................................................................................................... 6
Tracking Your Progress...........................................................................................................7
How’s Your Healthspan?...............................................................................................7
7 Keys to Aging Backwards Overview.................................................................................... 11
Key #1: Reduce Inflammaging............................................................................................... 13
Key #2: Keep Your Hormones in Check.................................................................................32
Key #3: Fuel Your Energy Powerhouse................................................................................. 43
Key #4: Feed Your Beneficial Bugs....................................................................................... 53
Key #5: Keep Your Cells Clean.............................................................................................61
Key #6: Protect Your Vehicle................................................................................................72
Key #7: Nourish Your Spirit.................................................................................................. 81
The 30 Days to Aging Backwards Plan................................................................................. 107
Aging Through the Decades............................................................................................... 117
Concluding Remarks.......................................................................................................... 119
References and Resources.................................................................................................120
Credits............................................................................................................................. 132

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WELCOME TO THE LONGEVITY ROADMAP:

30 DAYS TO AGING BACKWARDS WORKBOOK

I like to say that aging is in the hands of the “ager.” Aging does not have to mean getting old.

That’s why I put together my new docu-series, The Longevity Roadmap: How to Slow Down Inflammaging, Step into Vitality,
and Become Young at Any Age.

I plan to live to be 120 and do it well. That means staying active, sharp, strong, energetic, and engaged at every age. With
the emerging research on longevity and the right mindset, I believe that’s possible.

In this workbook, I break down all of the research my colleagues from The UltraWellness Center and I shared with you
throughout the series into easy-to-follow action items. This is where you start reversing aging in your own body, today.
Some of our most simple, everyday habits have immense opportunity to impact the way we age—this Longevity Roadmap
Workbook will be your guide to preventing chronic illness and supporting a long life of vitality.

By focusing on healthspan as opposed to just lifespan, we’re able to extend our years of feeling great and living fully—
instead of extending our years and struggling through the last of them.

We can do that through addressing the root cause of inflammation; balancing hormones; caring for the microbiome;
eating a longevity-promoting diet; focusing on community; supporting lean muscle mass and staying active; asking our
doctors the right questions and getting the right tests; and practicing self-care through multiple lifestyle choices like good
sleep practices (and much more). There is so much exciting new science in these areas that can literally turn back the signs
of aging and lead to more youthful years ahead; I’m going to walk you through it.

There’s also incredible research available specifically for avoiding the diseases associated with aging, like cardiovascular
disease and cancer. As always, it’s not just one part of the body we need to focus on. We need to support all of our
systems as a whole. In doing so we optimize our energy production on a cellular level and stimulate our bodies’ natural
resilience. That includes creating a stronger immune system, something we’ve seen is especially important for those in
their later years of life during the coronavirus pandemic.

Using Functional Medicine combined with the emerging science of Regenerative Medicine allows us to promote vitality
and longevity—we get the best of both worlds. And it’s important to note that genetics are not our destiny and we can
change our genetic expression using these action items. If you’ve feared you’re in for the same fate as your parents or
grandparents, think again. Your genes load the gun, but your environment pulls the trigger. This is good news. It means
that your daily behaviors control your health more than anything else.

Despite your chronological age, you have the ability to change your biological age. I just turned 60 last year and have the
biological age of a 39-year old. I have seen that number come down using the very methods laid out in this workbook. I
can’t wait to share them with you.

Are you ready to feel younger every day? Let’s get started!

Mark Hyman, MD

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A Note About Medication

Even though I believe that medication will not solve the root cause of most illnesses, taking medications are required in many
situations. Medication can be life-saving. If you are on medication, please work with your doctor while following this program.
I do not recommend getting off of any medication without working with your doctor.

A Note About Following this Program

Participation in 30 Days to Aging Backward is completely voluntary, and before starting this plan, you are agreeing to
participate for wellness informational purposes only. Nothing presented, stated, or suggested in this workbook shall be
considered medical advice, and all information shall solely be considered general wellness information. Please understand
and acknowledge that any specific information or changes to your diet, lifestyle, medication, or overall health should be
discussed with your primary care provider and not be based solely on information presented, stated, suggested, or learned
in the Longevity Roadmap docuseries or in this workbook.

Who this Program is Not For

This plan is not meant for anyone under the age of 18. There are many aspects of this plan that can be helpful such as eating
a whole foods diet; however, children and anyone under 18 should not implement any part of this program without working
with a doctor.

If you are currently under the care of a doctor for a serious medical condition, please do not follow this program without the
approval of your doctor.

This program is not recommended for anyone who is pregnant, nursing, or actively trying to conceive.

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HOW TO USE THIS WORKBOOK

It often takes achieving our most vibrant health for us to realize just how unwell we were in the past. Follow the
sections listed below to gauge your current healthspan so that after the 30 Days to Aging Backwards Plan, you can
see just how far you’ve come.

Section One—The Assessment:

● First, complete the “How’s Your Healthspan?” quiz, starting on page 7.
‒ Make sure to make careful and honest assessments.
‒ Retake the quiz following the 30 Days to Aging Backwards to check your progress.

Section Two—The Overview:

● Next, review the 7 Keys to Aging Backwards Overview, starting on page 9.
‒ This section breaks down the seven areas I believe are the most important when it comes to longevity
and healthspan.

Section Three—The Keys:

● Then, dive into each Key, starting on page 13. Each Key includes:
‒ An in-depth before-and-after quiz to identify how much attention that particular Key may need.
‒ An explanation of why I believe each Key is important for longevity.
‒ A step-by-step action guide containing items you can start today to radically improve your health.
‒ A list of tests you can request your health practitioner can run, if you suspect dysfunction.

Section Four—The Plan:

● Finally, jump into the 30 Days to Aging Backwards Plan, starting on page 89, which covers:
‒ My Three Pillars to Age in Reverse.
‒ An extensive “What to Enjoy/What to Limit” foods list.
‒ Tips for success on the plan and a daily habits schedule.
‒ Step-by-step instructions to increase your healthspan and age backwards.

Section Five—The Decades:

● Take it up a notch by checking out this section, starting on page 117.
It will walk you through specific areas to focus on as you age.

Section Six—The References and Resources

● Dig even deeper in this section, starting on page 120, which includes:
‒ Where to find a Functional Medicine and mental health practitioner.
‒ My favorite longevity and mindset books and podcasts.
‒ Pegan diet recipes.
‒ Recommended gadgets and apps.
‒ A list of all the supplements listed in the workbook.
‒ All references mentioned throughout the workbook.

It’s never too late to improve your healthspan and stay young at every age.

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TRACKING YOUR PROGRESS

You’ll never know how far you’ve come until you reflect on
where you’ve been. Take this “How’s Your Healthspan?” RATING SCALE
quiz before and after your 30 Days to Aging Backwards
Plan. Think about these questions and assess yourself
objectively; try to be as honest as possible. 0 = Never or almost never have the symptom

1 = Occasionally have it, effect is not severe

2 = Occasionally have it, effect is severe

3 = Frequently have it, effect is not severe

4 = Frequently have it, effect is severe

HOW’S YOUR HEALTHSPAN? BEFORE: AFTER: DIFFERENCE:

I WAKE WITH ACHES AND PAINS

I HAVE A HARD TIME GETTING OUT OF BED IN

THE MORNING/NEED TO NAP IN THE MIDDLE OF
THE DAY

I NEED COFFEE/TEA TO FUNCTION

I STRUGGLE WITH SKIN ISSUES

I EXPERIENCE HAIR THINNING/LOSS OR

BRITTLE/DRY HAIR

I GET FREQUENT HEADACHES/MIGRAINES

I OFTEN FORGET THINGS EASILY

I SOMETIMES FEEL DEPRESSED OR ANXIOUS

I HAVE BEEN DIAGNOSED WITH DIABETES OR

PREDIABETES
I EXPERIENCE ENERGY PEAKS AND DIPS
THROUGHOUT THE DAY

I HAVE LOW SEXUAL DESIRE/FUNCTION

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HOW’S YOUR HEALTHSPAN? BEFORE: AFTER: DIFFERENCE:

I AM NOT ABLE TO DO SOME OF THE THINGS
I WISH I COULD DO (I.E. PLAY TENNIS, HIKE A
MOUNTAIN, ETC.)

I FEEL NEGATIVELY IMPACTED BY STRESS

I FEEL OUT OF BREATH EASILY OR WHEN

WALKING UP STAIRS
I OFTEN HAVE BLOATING, GAS, ACID REFLUX
AFTER EATING
I HAVE IRREGULAR BOWEL MOVEMENTS (LESS
THAN 1 PER DAY OR MORE THAN 5 PER DAY)

I CRAVE SWEET FOODS

I WAKE FREQUENTLY THROUGH THE NIGHT OR

REQUIRE THE USE OF SLEEP AIDS

I USE STATINS

I HAVE PHYSICAL REACTIONS TO STRESS AND

ANXIETY

TOTAL

KEY
0-20: You’re on track to age in reverse! If you scored low, it’s all about maintaining the vibrant health and lifestyle
to have a strong healthspan. Keep up the good work!
21-40: There are some areas that could use some attention—some minor adjustments to your diet and lifestyle will
show improvements here!
41-60: It’s likely that your healthspan isn’t in tip top shape. But, there are some manageable diet and lifestyle
suggestions that can make a huge difference.
61-80: Your healthspan could use some serious attention, make sure you’re working with a doctor or Functional
Medicine practitioner for one-on-one direction to help get you back on track.

RESULTS
How was your score? Were you surprised by the quiz results? So often, we get stuck in routines and neglect to
take the time to assess our health. We accept aches, pains, fatigue, and excess weight as inevitable, or we ignore
them entirely. It’s not until we sit down and seriously assess our own health that we realize we don’t feel youthful,
energized, or amazing. So, if you’re surprised by your quiz score, you’re not alone. Keep reading.

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7 KEYS TO AGING BACKWARDS OVERVIEW

HEALTHSPAN
How Is Your Healthspan?
When was the last time you were excited to jump out of bed in the morning? Or had the energy to do all the ac-
tivities you’d like to do? How about the last time you had no joint pain, didn’t rely on prescriptions, or had clear
thoughts and cognition all day long? To be honest, most of us are barely getting by. Many people don’t realize that
true, vibrant health really can exist.

So many of us drag ourselves out of bed in the morning, glug several cups of coffee, experience fatigue, mental
blocks, energy drains, and a little fluff around the midsection. We spend all day looking forward to bedtime, then
experience restless sleep at night, and repeat day after day. That is NOT vibrant health. That is surviving, but not
thriving.

We seem to accept aches and pain, loss of energy, memory issues, and loss of mobility as inevitable signs of aging.
We view crossing “over-the-hill” as a new normal full of:
● Hearing loss
● Joint pain
● Memory troubles
● Increased diseases
● Poor digestion
● Frequent night wakings
● Loss of mobility
● Muscle loss
● Fatigue

And even if you’re feeling okay right now, when we view the diseases associated with aging, the statistics1,2,3 paint
a pretty grim picture:
● 6 in 10 Americans currently suffer from at least one chronic disease.
● 4 in 10 have more than one chronic disease.
● In a few years, 83 million Americans will have 3 or more chronic diseases.
● By 2030, it’s projected that 50% of the adult American population will be obese.
● By 2030, it’s also projected that Americans 65 and older requiring nursing home care will increase to
1.9 million.
● By 2050, Americans living with Alzheimer’s disease could more than double to 13.8 million.
● By 2050, Social Security and Medicare expenditures will increase from a combined 8.7 percent of gross
domestic product today to 11.8 percent.
● We spend about 90% of our lifelong healthcare dollars in the last 2-3 years of our lives. These are long,
painful, expensive deaths.

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Improving Your Healthspan

We are living longer, but we are NOT living better.

Longevity is not just about extending lifespan. No one wants to live to be 120 if our health, energy, and function
peak at age 40 and steadily decline until we’re bedridden. However, it does not have to be this way. There are
simple and easy things you can do every day to help make your healthspan equal to your lifespan—to make your
golden years even better than your adolescent years.

The good news is that you aren’t alone and there is help. The bad news is that you aren’t likely to find the help you
need in a conventional doctor’s office. This is because we have been looking for the answer to healthspan in the
wrong places.

You see, the solution to your healthspan probably won’t be found by using more pharmaceutical medication or
using drugs to treat the symptoms of one disease or another. There aren’t any magical pills that bring immortality
and we can’t find the fountain of youth by mechanically or chemically extending the amount of years in a lifespan.
In other words, the answer isn’t about making us live longer. It’s about making us live better.

My guess is that if you have come to this program you are suffering from one of the signs of aging outlined above.
It’s likely you’ve been looking for answers—perhaps desperately searching for them—for many years.

The Keys to living a youthful, vibrant, and healthy life can be found in my 7 Keys to Aging Backwards. When these
key systems are out of balance, your body breaks and you may suffer from a long list of disorders associated with
aging, from depression to dementia, from Alzheimer’s to diabetes, from brain fog and memory loss to joint aches
and pains, from fatigue to muscle loss, and everything in between. But it doesn’t have to be this way. Getting old
does not have to equal getting sick and slow.

When you rebalance these systems, your body will heal itself. And it doesn’t take years to do it. You can rebalance
the 7 Keys and begin to age backwards within a matter of weeks.

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THE 7 KEYS TO AGING BACKWARDS

In medical school, I was taught all about how to identify symptoms, categorize the disease, name it, and match
pharmaceutical treatments to manage it. I was never taught about treating the underlying cause of disease or what it
takes to create vibrant, energetic, lifelong health.

The 7 Keys are based on the most crucial areas of life that contribute to wellness. I use Functional Medicine princi-
ples—the biggest revolution medicine has seen in the last 100 years—to improve your whole-body healthspan and
create vibrant health. These Keys allow us to take a personalized approach based on the specific areas in the body
that have the biggest role in disease, aging, and health.

By addressing these 7 Keys (which is what I am going to teach you to do in this program), your health will get a
major makeover. If you’re tired of experiencing less than optimal health, struggling to get out of bed in the morn-
ing, desperately wanting to stay young as long as possible, or wondering what your golden years will look like, or
worse: dreading them, pay close attention to these Keys. This workbook lays out exactly what you need to know to
feel young at every age.

Here is a brief introduction to the 7 Keys to Aging Backwards. In the next section, I will go into greater details about
each of them.

Key #1: Reduce Inflammaging

Inflammation is at the root of many (some would argue all) chronic conditions. Our modern diets and lifestyles
have created an environment of chronic inflammation. While life-saving and extremely important in acute situations,
inflammation and inappropriate immune response can wreak havoc on our health. Balancing your immune system
and cooling off chronic inflammation is essential to creating optimal health.

Key #2: Keep Your Hormones In Check

Your hormones help you maintain great health and keep you happy, focused, and calm. They control everything
from your stress response through the adrenal glands, to your blood sugar balance through the pancreas, to your
thyroid hormone through the thyroid gland, to your sexual behavior and function through the reproductive organs.
Hormones also control growth, muscle tone and mass, mood, longevity, and so much more.

Key #3: Fuel Your Energy Powerhouse

Life is energy. When no more energy is produced in your cells, you die. The process of extracting energy from the
food we eat and the oxygen we breathe is the most essential process to life. Your mitochondria are microscopic
organelles found in your tissues that generate energy to keep you alive. Keeping those metabolic engines running
smoothly and protecting them from harm are essential for health.

Key #4: Feed Your Beneficial Bugs

The more we learn about your holobiome, or all of the beneficial bacteria living on and in us, the more we under-
stand the immense benefits of feeding, supporting, and optimizing our good bugs. Beneficial bacteria help you
digest, absorb, and assimilate foods, protect you from invaders on your skin, in your digestive tract, your nasal
passage, your lungs, and literally everywhere on your body, and they keep your immune system healthy.

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Key #5: Keep Your Cells Clean

Our bodies are equipped with a very sophisticated detoxification and cleaning system. However, we are over-
whelmed with insults from every direction. Toxins are everywhere: in our air, water, food, skincare products, medi-
cations, furniture, cars, and so many other parts of daily life. The toxic burden in the 21st century is overwhelming,
and often our bodies can’t keep up. This leads to dis-ease. It’s crucial to clean up your cells and support your natural
detoxification systems.

Key #6: Protect Your Vehicle

Your body is the vehicle that transports the organs, tissues, and cells that make you “you” all throughout your life.
Just like a car or truck, regular maintenance and use is important to keep the vehicle running smoothly. Daily move-
ment keeps your body young and active. Incorporating fun, exercise, and movement into your daily routine sets the
foundation for a vehicle that keeps running for decades.

Key #7: Nourish Your Spirit

Studies show that having a strong sense of purpose in life is associated with a longer, more fulfilling lifespan.4,5
Nourishing your spirit through purpose, building community, finding support and love, a sense of empowerment,
and connection all help to enhance your healthspan. It’s so easy in our modern society to be overwhelmed by
stresses like social isolation, overwork, negative news, disconnection, comparison, and media addiction. You can’t
live a long, fulfilled life with an empty spirit.

I know the truth of these Keys, both as a doctor and a patient. I have scoured the medical literature and reviewed
thousands of scientific articles in search of this information. As I turned 60 recently, I am dedicated to making my
remaining 60 years even better than my first. (Yep, I plan to live until I’m 120, and live well.)

So, how about you? Let’s get started.

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THE 7 KEYS DEEP DIVE

KEY #1: REDUCE INFLAMMAGING

Our immune systems are sophisticated and complex. They work feverishly (excuse the pun) to keep us safe, healthy,
and protected. In an ideal world, we would only experience very short bouts of stress (like being chased by a pred-
ator), have minimal toxic exposures, get an abundance of sunlight, fresh air, and movement, and would be rolling
around with our children and animals in the soil all day.

Unfortunately, in our modern times, we commonly experience long-term, chronic stress. We are cooped up indoors
for the vast majority of our days and have relatively limited access to the beneficial bacteria found in our soils, animal
dander, and natural environment.

While we have adapted to many of these changes, when our systems are overloaded by insults from every direc-
tion, like chronic stress at work, financial worry at home, raising children in a mono-culture as opposed to a village,
devices and information at our fingertips, and toxins all over the place, our bodies just can’t keep up.

On one end of the spectrum, our immune system might hyper-respond to all of these insults, potentially leading
to an autoimmune condition where the immune system attacks its own body. And on the other end, it might be so
fatigued from the constant exposures, it simply quits.

One of the most important features of the immune system is its ability to cause inflammation. Inflammation gets a bad
rap, but it is crucial to our survival. In an acute accident, a laceration from cutting slippery tomatoes, for example,
our body’s normal-functioning immune system springs into action. The platelets in our blood band together forming
a clot at the laceration site to stop any excess bleeding. These platelets release cytokines, which signal the next line
of defenses in our immune system to scan our body for any signs of infection and respond accordingly. This rush
of platelets and cytokines can cause the area to feel warm and swollen—that’s inflammation, and in scenarios like
this, it serves an essential function.

Any germs that enter our body through the dirty knife will require different immune cells to fight them off, called
neutrophils and macrophages. Luckily, we have these cells across the entire body, always at the ready to jump into
action. These cells react by “eating” invaders, shooting antimicrobial proteins at them, catching them, collecting
them, and/or disposing of them.

Our immune system also includes T-cells and B-cells, located in the lymphatic system. These cells act as defenders
and aid in the removal of unwanted invaders. A principal role the T and B cells play is in “remembering” these
invaders so that should we encounter them again, our adaptive immune system is already equipped and ready.

The reason inflammation gets a bad rap comes from when we experience chronic, low-grade inflammation. Things
that cause our immune system to react include infections, toxins from our environment or food, eating an inflamma-
tory diet, chronic stress, micronutrient deficiencies, inactivity, or altered gut function. Any time we are experiencing
one of more of these insults, our immune system creates inflammation.

Have an intimidating boss? Tight deadlines? Financial worries? What about exposure to exhaust? Pollution? New
car or carpet? What about new furniture? Do you know the ingredients in your shampoo? Do you drink out of
plastic bottles? The list goes on, but it’s easy to see that a lot of things you might not be aware of can be insults to
your immune system and result in low-grade inflammation in your body. Did you answer “yes” to many of them? It’s
entirely possible that you have long-term, chronic inflammation.

In addition to toxic inputs and situations, serious long-term chronic inflammation can stem from another invisible
source, and it’s something you can affect 3 or more times every day: blood sugar.

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Understanding Blood Sugar and Insulin’s Role in Your Body

In order to understand how the foods you eat can cause inflammation, we need to take a deep dive into exactly how
blood sugar and your hormones insulin and cortisol interact in your body. To get started, we need a brief overview
of digestion and metabolism—what happens when we eat food.

All foods consist of elements called “macronutrients”—most people are familiar with proteins, fats, and carbohy-
drates. Proteins are a type of macronutrient found in meats, lentils, beans, and other foods that break down into
amino acids and are used by your body to help repair and support muscles.

Fats are a type of macronutrient found in meats, oils, nuts, seeds, and foods like avocados and coconuts. Fats from
these foods break down into different structures of fatty acids, each that perform different, extremely important tasks,
such as supporting healthy inflammation levels, effective cell-to-cell communication, and cell membrane integrity.

Carbohydrates (carbs) can be found in fruits, vegetables, grains, and sugars and break down into glucose, the
term for sugars in your bloodstream. Most foods are a combination of all three macronutrients, which is a good
thing. However, for this Key, we will mostly focus on foods that are carb-heavy, meaning, they don’t have as much
protein or fat.

When you eat a balanced food or meal, such as an avocado, your body digests the food, breaks it into smaller
bits of fats (fatty acids), proteins (amino acids), and sugars (glucose, fructose, galactose, etc.). Those smaller com-
ponents are sent throughout your body to be used in processes that create the fuel you need to perform activities,
concentrate on tasks, remember important details, maintain excellent cellular communication—basically everything
you need to do to function. This is a very good thing.

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When you eat a food that is very carb-rich, such as a piece of cake, your body digests the food and breaks it into
smaller bits of sugars (glucose) that are shunted to your bloodstream. Insulin is secreted from your pancreas to
direct your cells to take up the glucose to be used as fuel or stored as fat if there’s too much glucose available. The
carb-rich food can cause your blood sugar levels to spike because your body digests carbs very quickly and can
send a huge wave of glucose into your bloodstream.

Your body maintains restrictive levels of blood sugar because without some glucose, some cells will die, and with
too much, cells can be damaged and no longer functional. Too low or too high of blood sugar is extremely stressful
to our bodies, so it’s imperative to our health that our blood sugar stays within range.

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These blood sugar extremes are literally life or death to your cells and your body. During periods of uncontrolled
blood sugar levels, your body does NOT prioritize focus, mental clarity, vitality, vibrant skin, proper weight, muscle
structure, hormonal balance, fertility, etc. Your body has one priority: to survive. And as you can imagine, it would
be taxing on you mentally, emotionally, and physiologically to constantly be in a state of “Will I die today?” Think
about how the deep inner workings of your body would feel in this reactive state day in and day out.

When you consume a carb-rich meal, initially, your blood sugar levels rise dramatically. Because this is a life or
death situation for your cells, it is imperative to remove glucose from your blood quickly and effectively, and insulin
is very good at its job. So good, that it diverts the glucose so quickly, it causes your blood sugar levels to crash.
Ever noticed feeling quite sleepy about an hour after eating a carb-rich meal? That’s why.

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One problem with blood sugar crashes is that our body responds by releasing
the stress hormone cortisol (remember: when blood sugar is too high or too Note:
low, it is extremely dangerous for our body). Cortisol isn’t inherently bad. In
Chronic stress from things
fact, it is very beneficial to help regulate blood sugar levels, stabilize blood
pressure, and store memories. Cortisol is a steroid hormone regulated by the like a demanding job,
sympathetic “fight-or-flight” nervous system. It’s responsibility in blood sugar unsupportive relationships,
regulation is to tell your liver to make more glucose when blood sugar levels financial or health worries,
get too low. It also plays a part in prioritizing functions like shunting glucose
or anything that causes
to the brain and muscles for rapid use. This is useful when you’re in immediate
danger, as well as helpful for curbing functions less important for short-term emotional unrest also elevate
survival—when your cortisol is high, your body does not prioritize things like cortisol.
proper digestion, reproduction, or fighting inflammation.

Clearly, this isn’t helpful unless you’re in immediate danger. So, every time you experience a large blood sugar
fluctuation, your body is also experiencing the stress of frantically directing glucose, activating its fight or flight
response, producing insulin and cortisol, and storing excess sugar as fat. Imagine that happening with every meal.

Luckily, this is something you can control by prioritizing the foods you eat. More on this later.

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Insulin Resistance, AGEs, and Inflammation

If this cycle continues over time, your cells begin to become less sensitive or even immune to insulin signaling. They
literally tune it out. If this happens and then you consume a carbohydrate-containing food, you’re left with increased
blood sugar circulating in your bloodstream and a non-responding insulin-signaling pathway, which causes your
pancreas to produce even more insulin—we call this insulin resistance. This situation can result in dangerously high
blood sugar and insulin levels.

This is a big deal when it comes to healthy aging and longevity. In fact, high blood sugar contributes to increased
levels of advanced glycation end products, aptly shortened to AGEs, which are compounds that contribute to ox-
idative stress and inflammation in the body (and you guessed it—accelerated aging!). Without getting into all the
chemistry of it, the short explanation is that AGEs can form as a normal part of metabolic pathways in the body, from
the spontaneous non-enzymatic reaction that combines certain kinds of sugar molecules with the amino groups of
proteins or lipids from fats. One major source of both inflammation and increased AGEs is chronically elevated
blood sugar caused by insulin resistance.

We also get AGEs through diet, for example by cooking sugars with protein or fat at very high heat. That means that
sugary BBQ sauce smothered over your chicken thighs is causing some real damage. The browning on a crust of
bread or sear marks from the grill are also signs of the reaction that produces excess AGEs.

AGEs are a major concern because they are irreversible once formed. And it’s a dangerous cycle—more AGEs,
equal more inflammation, which increases AGEs, and the cycle continues.

Not only do AGEs have a major correlation with inflammation, but they have also been found to make many chronic
conditions worse, including diabetes, cardiovascular disease, neurodegenerative diseases.1 They are toxic mole-
cules that create reactive oxygen species (ROS) and cause cell death, organ damage, and mitochondrial dysfunc-
tion. AGEs are counterintuitive to healthspan and longevity.

Luckily, there are simple ways to reduce your AGEs and the most important one is to balance your blood sugar. You
can also make sure you’re consuming plenty of natural antioxidants, in the forms of whole vegetables and occasional
fruit, and you can make sure you’re not eating charred, heavily grilled, or sugar-coated cooked or fried foods, like
BBQ. Low, slow, moist cooking methods, and acidic marinades help to offset the production of AGEs, especially
for meats. I go into steps to reduce your inflammaging later in this key, and all steps are helpful to reduce your
AGEs as well.

Insulin Resistance, Metabolic Syndrome, and Inflammaging

Because chronic excess blood sugar gets stored as fat, it’s common to see obesity or extra weight go hand-in-hand
with insulin resistance, but not always. It can also cause a condition I refer to as “skinny-fat,”2 where the excess fat
is stored around the vital organs. An individual like this may not look overweight, but the stored visceral fat can be
even more dangerous than subcutaneous fat, which is visible fat stored under the skin.

Those experiencing diabesity and insulin resistance tend to have quite high inflammation levels and most likely have
metabolic syndrome. Metabolic syndrome is a term for someone who has high blood glucose and insulin levels,
dyslipidemia (cholesterol and triglyceride numbers that are out of range), elevated blood pressure, high C-reactive
protein (a marker for inflammation), and obesity or increased waist-to-hip ratio.3

Metabolic syndrome is problematic because having it means that you are at increased risk for heart disease and
atherosclerosis, diabetes, Alzheimer’s and dementia, obesity, and chronic inflammation.4 And, I believe there are
many more people with metabolic syndrome than we recognize. In fact, only 12% of the US adult population is
metabolically healthy.5 That means, about 9 in every 10 adults either have metabolic syndrome, or are well on their way.

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Most likely, they’re already experiencing one or more symptoms, including many that I’ve mentioned in Key #1 on
inflammaging: increased blood sugar and insulin, elevated cortisol and stress, excess fat and toxin storage, high
AGEs, high inflammation, and a decreased healthspan because of it all.

That also means about 9 in every 10 US adults likely has chronic inflammaging. Do you?

Do You Have Inflammaging?

Inflammaging isn’t necessarily something that will wave RATING SCALE
obvious red flags on your annual physical exam, but it
definitely has a bunch of sneaky symptoms you need to 0 = Never or almost never have the symptom
be aware of. Most of us have experienced, or are current-
ly experiencing, serious inflammaging, though we might 1 = Occasionally have it, effect is not severe
not recognize the signs because a lot of these signals are
brushed off as “normal aging.” Do you have inflammag- 2 = Occasionally have it, effect is severe
ing? Take this quiz to give you an idea.
3 = Frequently have it, effect is not severe

4 = Frequently have it, effect is severe

HOW’S YOUR INFLAMMAGING? BEFORE: AFTER: DIFFERENCE:

I WAKE WITH ACHES AND PAINS

I NOTICE STIFFNESS AND/OR PAIN IN MY JOINTS

I NOTICE SWELLING IN MY BODY

I GET SICK WITH A COMMON INFECTION (COLD,

FLU, ETC.) OFTEN
I EAT GRILLED, CHARRED, AND/OR BBQ FOODS
OFTEN

I GET FREQUENT HEADACHES/MIGRAINES

I HAVE BEEN DIAGNOSED WITH DIABETES OR

PREDIABETES
I HAVE A HIGH FASTING GLUCOSE (>80 MG/DL),
INSULIN (>5 µIU/ML), OR HBA1C (>5.5%)

I FEEL FATIGUED

I EXPERIENCE DEPRESSION

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HOW’S YOUR INFLAMMAGING? BEFORE: AFTER: DIFFERENCE:

I HAVE LOW SEXUAL DESIRE/FUNCTION

I AM NOT ABLE TO DO SOME OF THE THINGS

I WISH I COULD DO (I.E. PLAY TENNIS, HIKE A
MOUNTAIN, ETC.)
I OFTEN EXPERIENCE GI ISSUES (I.E.
CONSTIPATION, DIARRHEA, ACID REFLUX, ETC.)
I HAVE A HARD TIME INTENTIONALLY LOSING
(OR GAINING) WEIGHT
I GET FREQUENT INFECTIONS (SINUS
INFECTIONS, URINARY TRACT INFECTIONS, EAR
INFECTIONS, ETC.)

I HAVE A HARD TIME SLEEPING ALL NIGHT

I GET MOUTH SORES

I HAVE SKIN IRRITATION, RASHES, ERUPTIONS,

BLEMISHES, ETC.

I FEEL DIZZY SOMETIMES

I EXPERIENCE DRY EYE

TOTAL

KEY
0-20: Your inflammaging levels are great! Keep up the good work!
21-40: You could use some attention on inflammaging—some minor adjustments to your diet and lifestyle will show
improvements here!
41-60: Your inflammaging levels need some attention, make sure to pay attention to this section.
61-80: Your inflammaging is severe, make sure you’re working with a doctor or Functional Medicine practitioner for
one-on-one direction to help support healthy inflammaging.

RESULTS
How’d you do? And more importantly, how do you feel? If you scored higher than a 40 on this quiz, it’s likely
that you are experiencing pain, swelling, stiffness, brain fog, and other symptoms that are typically associated with
“normal” aging. However, it’s not normal and there’s something you can do about it. Keep reading!

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Conventional vs. Functional Approach

Conventionally, as we age, it’s considered “normal” to have joint pain and stiffness, brain fog, trouble remembering
things, vision and hearing loss, immobility, and general slowing down. However, in the Functional Medicine world,
many of the signs considered “normal aging” are actually unresolved inflammation and something that can be both
addressed and improved in many, if not all, cases.

Unfortunately, conventional medicine tends to follow an approach I like to call the “pill for every ill” style of medi-
cine. Got pain and stiffness? Here, take an NSAID. Blood sugar too high? Take Metformin. Cholesterol high? Here’s
a statin. None of those approaches address the cause of pain and stiffness, high blood sugar, or cholesterol.

Inflammation comes from things in your diet like sugar, gluten, processed carbohydrates, dairy, and food sensitivi-
ties. It comes from unregulated blood sugar and insulin resistance. Even without a diabetes diagnosis, prediabetes
and metabolic syndrome are rampant. In your lifestyle, things like chronic stress, poor sleep, inactivity, and lack of
community and solid relationships can contribute to increased inflammation.

In Functional Medicine, we always ask, “Why?” Why are you experiencing joint pain and stiffness? Why is your
blood sugar unregulated? Why is your cholesterol a concern? This helps to identify the root cause of your inflam-
maging so we can create an individualized protocol including dietary guidance, helpful supplements, stress-reduc-
ing activities, a movement plan, and/or sleep hygiene practices depending on your specific situation. An individu-
alized root cause approach can make a significant impact on inflammation and inflammaging.

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5 Steps to Reduce Inflammaging and Feel Better Today

Inflammation is at the root of every chronic condition—it is pervasive and affects nearly everyone. It is crucial to
address, but there are simple, practical, and doable steps you can take today to make a significant impact quickly
and effectively.

Step 1: Eat Inflammation-Busting Foods

The first step for improving inflammation is to focus on the things that contribute to healthy inflammation levels and
support the immune system.

INFLAMMATION-BUSTING FOODS TO ENJOY

WHY EAT NON-STARCHY WHY EAT

WHAT TO EAT: WHAT TO EAT:
VEGETABLES? FATTY FISH?

Veggies are loaded with The more vibrantly colorful, the Fatty fish, like wild- Try to incorporate low-
phytonutrients, polyphenols, better. Make sure to eat a rainbow caught salmon, contain mercury fish at least
and fiber that help to balance of veggies every day—try to get beneficial omega-3 once per week:
blood sugar, provide your every color, and eat organic, if fatty acids6 including
cells with fuel, support your possible. Leafy greens, peppers, docosahexaenoic
● Salmon
detoxification organs, and onions, radishes, and cucumbers acid (DHA) and ● Sardines
allow your biochemical are just some of my favorites. eicosapentaenoic ● Anchovies
pathways to run efficiently— Mushrooms, like shiitake, reishi, and acid (EPA). These are ● Mackerel
all things your immune turkey tail are great to support the important to keep your ● Herring
system requires to function immune system. omega-6 to omega-3 ratio
appropriately. around 1:1 to 2:1, which
● Bass
Starchy veggies are also loaded is ideal. If this ratio gets ● Shellfish like oysters
with beneficial phytonutrients, but too far out of proportion, and mussels
can affect your blood sugar. Try to you can end up with
stick with the most nutrient-dense inflammation. EPA and
varieties, like sweet potatoes, yams, DHA are also great for
and squash. Limit to ½ cup per day. your heart, brain, skin,
nerves, and joints.
For more info on why to eat
organic, make sure to check out Key
5—Keep Your Cells Clean.

WHY EAT WHY EAT

WHAT TO EAT: WHAT TO EAT:
WHOLE FRUITS? NUTS AND SEEDS?

Fruits are an amazing source Stick with low-glycemic fruits like: Nuts and seeds are ● Walnuts
of antioxidants, polyphenols, great sources of protein, Brazil nuts
Berries
●

and other phytonutrients, healthy anti-inflammatory

●

Green apples
● Cashews
which quell the free radicals ●
fats, and beneficial fiber.
and reactive oxygen ● Kiwi
● Almonds
species that contribute ● Consider high-glycemic fruits an
● Macadamia nuts
to inflammation and can occasional treat ● Hazelnuts
damage your cells. ● Avoid fruit juices ● Pecans
● Pistachios
● Chia seeds
● Flax seeds
Note: Peanuts are
technically legumes
and often loaded
with mycotoxins and
molds, make sure to eat
organic or limit intake.

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INFLAMMATION-BUSTING FOODS TO ENJOY (CONT.)

WHY EAT WHY EAT

WHAT TO EAT: WHAT TO EAT:
QUALITY PROTEIN? HEALTHY FATS?

Pasture-raised, grass-fed, ● Locally-raised, grass-fed beef and Your body is made up of Stick with whole-food
or wild-caught are non- pork trillions of cells. Each cell fats:
negotiable when it comes Pasture-raised chicken/eggs is made up of different
Avocados
●

to animal protein. Animals types of fats. In order to

●

● Wild-caught fish Nuts

raised in their natural ensure proper cellular ●

environments have much ● Organic beans and legumes communication, integrity, ● Seeds
higher omega-3 fatty acid and function, your diet ● Chia and flax seeds
and conjugated linoleic acid NOTE: If you’re vegetarian/vegan, must be abundant in
make sure you soak your beans/ ● Pasture-raised/
(CLA) levels—both of which healthy fats. Your cells grass-fed meats*
are beneficial to support legumes, aim for organic when require fats to properly
healthy inflammation levels. possible, and include plenty of transport cholesterol,
● Wild-caught l
Conventionally raised meats healthy fats in each meal to balance which is essential for ow-mercury fish
contain much higher levels your blood sugar. repair of your cells, ● Grass-fed ghee
of omega-6 fatty acids, hormone synthesis, and butter*
hormones, and toxins that and nerve insulation. ● Coconut*
cause inflammation; avoid Fats are also needed ● Olive oil
whenever possible. for proper immune ● Avocado oil
response, healing, and
clotting. And of course, *See Pegan Fats section
your brain is mostly fat, on page 95 for an
so keeping your brain explanation on why
healthy and sharp as you these fats may not be a
age requires a variety of good fit for everyone.
healthy fats.

WHY EAT WHY EAT

WHAT TO EAT: WHAT TO EAT:
GUT-HEALING FOODS? HERBS AND SPICES?

70% of our immune system Fermented foods like: Many herbs and spices Add unlimited fresh
resides in our gut. Our gut are some of the most and dried herbs and
health is deeply linked with
● Natto nutrient-dense foods that spices to your meals:
our inflammatory and immune ● Sauerkraut can not only enhance
response. Having poor gut ● Tempeh the flavor profile of
● Turmeric
health often means having ● Unflavored yogurt and kefir your foods, but also ● Ginger
increased inflammation contain very potent anti- Rosemary
Lacto- fermented foods and
●
●
and decreased immune inflammatory properties, Thyme
pickles ●

protection. The overuse of like curcumin, quercetin,

Kimchi ● Cinnamon
antibiotics in our bodies and piperine, and others.
●

livestock, our ultra-processed ● Miso ● Garlic

diet, toxic overloads, and ● Cayenne
lack of diversification in our Prebiotic foods (food for our good ● Black pepper
diets has destroyed our guts. bacteria) like: ● Basil
Eating gut-healing foods is Jerusalem artichoke
● ● Sage
crucial for supporting our
immune system and a healthy
● Onions ● Oregano
inflammatory response. ● Garlic ● Parsley
● Leeks ● Cayenne
● Asparagus ● Saffron
● Acacia fiber ● Mint
● Green banana flour ● Cloves

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Step 2: Remove Inflammatory Foods

The second step for improving inflammation is to eliminate the things that contribute to inflammation.

INFLAMMATORY FOODS TO LIMIT

WHY LIMIT WHY LIMIT
WHAT TO LIMIT: WHAT TO LIMIT:
DAIRY? SUGAR?

Not only are roughly 75% ● Cow’s milk and cream Consuming sugar has been ● All sweeteners
of the population lactose ● Cheese shown to damage your intestinal ● Artificial sweeteners
intolerant, but dairy also lining, disrupt your beneficial
● Sweetened yogurts and ● Sugar alcohols
contains other inflammatory gut bacteria, and decrease your
kefir Cane sugar
properties that can cause immune function. It contributes to ●

gas, bloating, acne, ear ● Ice cream diabetes and insulin resistance, ● May use minimal
infections, and congestion, ● Sour cream is associated with heart disease amounts of natural
among other signs of and obesity, and can negatively sweeteners like
inflammation.7 Almost impact your brain function. The honey and pure
everyone can benefit from verdict is out: sugar is no good. maple syrup
significantly reducing dairy. ● Oh, and NEVER
drink your sugar!

WHY LIMIT
WHY LIMIT
REFINED GRAINS
WHAT TO LIMIT: FOOD WHAT TO LIMIT:
AND PROCESSED
SENSITIVITIES**?
CARBOHYDRATES?

All grains are primarily ● Limit pretty much anything Consuming foods you are Avoid any food that
made up of carbohydrates, you can find in a bag, a sensitive or allergic to can causes symptoms. If
and while there are some box, or a fast food joint. contribute to leaky gut and you are unsure about
that are better than others, ● Avoid all grains if inflammation, and sometimes the a specific food, try
the majority of grains are you have diabetes, symptoms are easy to miss.8 I avoiding it for 2
consumed in the form of prediabetes, autoimmune discuss leaky gut much deeper weeks and then add
grain flours—think pastas, conditions, or if you in Key #4, but it’s important it back. We find that
breads, bagels, cakes, scored 41 or more to understand that consuming many people are
crackers, pizza, ramen, on the How’s Your foods that cause acute allergic unknowingly sensitive
etc. These flours can spike Inflammaging? Quiz. If reactions, with symptoms to corn, soy, wheat/
blood sugar exactly the same you scored less than 40, I of anaphylaxis, diarrhea, grains, dairy, eggs,
as table sugar and cause still recommend avoiding shortness of breath, etc. or sugar, alcohol, and/
elevated blood sugar, insulin gluten-containing grains chronic sensitivity reactions, or caffeine. If you’re
resistance, inflammation, and grain-flours. with symptoms of itchy skin, interested in sensitivity
weight gain, and have been headaches, brain fog, bloating, testing, see the section
associated with increased risk etc. can cause inflammation, an on testing options in
for heart diseases, diabetes, immune response, and damage the section, Want to
metabolic syndrome, and to your gut. If you recognize Dig Deeper at the end
others. you’re sensitive to a certain food, of this Key.
it is imperative that you avoid that
food and work to heal your gut.

** Want a program dedicated at uncovering these sensitivities, balancing blood sugar, and reducing your inflammaging?
I highly recommend my 10 Day Reset.

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Step 3: Move Daily

Exercise has been shown to help modulate inflammation. Even as little as 20 minutes of light exercise or 7 minutes
of high-intensity interval training (HIIT) can have significant effects on your immune system and inflammation levels.
Even if you don’t hit the gym, try to find a way to incorporate movement into your day.9,10

Things to try:
● Go for a 20 minute walk first thing in the morning.
● Play a sport. Play catch with your kids, take up frisbee golf or club Note:
golf, play tennis, shoot some hoops, take up skeet shooting, archery, Take it up a notch by turning
or surfing. it into a Gratitude Walk. A
● Invest in a standing desk, treadmill desk, or under-desk elliptical. Gratitude Walk is where you
● Pick up an outdoor hobby. Try gardening, landscaping, hiking, bird mentally list all the things
watching, photography, fishing, hunting, canoeing, or kayaking. you’re currently grateful for.
● Invite friends to join a group exercise class. Most gyms and facilities Try not to repeat the list from
offer a range of group classes, from stationary biking in a theater, to day to day and you’ll be amazed
zumba, to chair yoga. There’s anything from dance classes, to light
at how much you have to be
stretching, to group weight training. You’re way more likely to stick
with an exercise routine if you have an accountability-buddy. grateful for and how much
● Have FUN! You don’t need to visit a gym to incorporate daily better you feel!
movement.

Step 4: Mind Your Mind

Short bursts of stressful experiences are beneficial to overall health. It helps keep your immune and cardiovascular
systems in tip top shape. When stressful experiences extend into a chronic experience, our systems can become
worn out and fatigued. Our cortisol levels become dysregulated and can contribute to hormonal imbalances (see
Key #2 for more information on a deep dive into hormones). When our systems, hormones, and stress are out of
balance, it can lead to chronic inflammation,11,12,13 as well as a slew of other dysfunctions, like poor digestion, sleep
issues, skin inflammation, brain fog, heartburn, blood sugar imbalance, and many others. Check out Key #7 for
more information on mindset practices, but something you can incorporate today is to watch this 14-minute TED Talk
on “How to Make Stress Your Friend” with Kelly McGonigal.

Step 5: Supplement Wisely

The basis of any healing protocol should be whole, real food. However, with the genetic modification of foods, long
transport and storage times, monoculture farming methods, and depletion of our soils, food is not as nutritious as it
once was. Gut health, stomach acid, and digestive enzymes can affect nutrient absorption too. So, supplements can
be beneficial and necessary in some situations. I always recommend supplementing with a high-quality multivitamin/
mineral as a basis of your program. Once you’ve covered your bases, there are some supplements that can be
very helpful for supporting an appropriate immune response and inflammation level. Here are my top 5 to reduce
inflammation and support the immune system:

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Vitamin D
Up to 90% of the population has inadequate intakes of vitamin D and around 40% are deficient.14,15,16 Vitamin
D, which works closely with magnesium (that around 50% of the population is deficient in), is a steroid
hormone and is absolutely critical for proper immune function. It activates the innate immune response,
important for immediate threats, infections, reactions to viruses, etc. It also plays a role in mediating the
adaptive immune response and helps support healthy inflammation levels. It’s important for supporting bone
health, improving mood, reducing cancer risk, and reducing severity of illnesses, including respiratory
illnesses. It’s best to have your blood levels tested; ideally your vitamin D should be between 40 and 60 ng/
mL. I find that most people do well between 1,000 and 5,000 IU daily.***

Fish Oil
Fish oil is an excellent source of EPA and DHA. These are long-chain fatty acids that have been shown
beneficial to support healthy levels of inflammation, as well as brain, heart, and joint health, among other
things.17 While there are plant sources of omega-3 fatty acids, like flax seeds, soy, evening primrose, borage
seeds, and walnuts, they are considered medium-chain fatty acids, called α-linolenic acids (ALA). It’s been
shown that long-chain fatty acids are biologically active and the conversion of ALA to DHA or EPA in humans
is inefficient,18 so a high-quality fish oil is the best source. I find that most people do well with 1,000 to 2,000
mg of omega-3s daily.***

Curcumin
Curcumin is one of the biologically active properties of turmeric—the popular spice used in Indian dishes.
Curcumin has powerful antioxidant and anti-inflammatory properties and has been shown beneficial in
mitigating inflammation and oxidative stress in various chronic conditions.19,20 I find that most people do well
with 600 mg to 1,000 mg daily.***

B-Complex
Your B-vitamins are crucial for supporting metabolism, immune function, and overall health.21 They are
important for keeping your mitochondria healthy and supporting brain, immune, heart, and bone health. And
unfortunately, things like stress, poor diet, environmental toxins, and genetic polymorphisms cause a majority
of individuals to be deficient in at least one B-vitamin.

HTB-Rejuvenate
This is a specialized blend of phytochemicals that help support immune function, activation, and rejuvenation,
as well as metabolism, and muscle mass. This blend was formulated based on the scientific evidence that
Himalayan Tartary buckwheat has in supporting and rejuvenating the immune system. The HTB-Rejuvenate is
loaded with rutin, quercetin, hesperidin, luteolin, and diosmin, which are key factors in immune support.

*** These are basic supplement ranges. You may need more or less, so make sure you are working with a practitioner to
determine your current levels and recommended dosage.

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Want to Dig Deeper?

When it comes to testing, it’s important to understand something fundamental to Functional Medicine: there is a
big difference between “normal” and “optimal.” When medical professionals determine the “normal” ranges for
many lab tests, it’s based on a general population. Unfortunately, our general population is metabolically unhealthy.
In fact, only 10% of people are considered metabolically healthy. So, if you want optimal health, you want your test
results to be optimal, not just “normal.”

Interested to learn where you stand in the inflammaging spectrum? There are a ton of very useful tests that you
can use to help determine your inflammatory response, many of which can be run by your doctor. This section will
outline various tests your doctor can run, along with the “normal” and “optimal” ranges. I’ll also include tests that
Functional Medicine practitioners can run as well, though keep in mind these are usually not covered by insurance. You
don’t have to do all of the tests to understand where you’re inflammaging is at, even one or two can be very helpful.

Conventional Testing
Fasting blood sugar: This is a snapshot of your blood sugar in time. Like we said on Day 3, this is not the best
measurement for metabolic disease. Instead we want to look at HbA1C and fasting insulin (see below) to gather
more information about how you metabolize sugars.
● Normal 65-99 mg/dL
● Optimal 70-80 mg/dL

Fasting insulin: If someone is moving towards diabetes, then the first marker to elevate is insulin, not blood sugar.
After insulin has been elevated for a prolonged period of time THEN we will see a rise in blood sugar levels. Thus,
fasting insulin and an insulin response test is essential if you are concerned about preventing metabolic dysfunction.
And given that 1 in 2 people have diabesity, this is something you should be concerned about.
● Normal: 2.6−24.9 μIU/mL
● Optimal: <5 μIU/mL
● Optimal 1 hour and 2 hours post sugar challenge: <30 μIU/mL

HbA1C: HbA1C is a measure that calculates your average blood sugar over the last 6 weeks. This is a better indi-
cator of your body’s metabolic health than a single measure of blood sugar because it gives us more data points.
Your body should be able to regulate your blood sugar tightly—not allowing it to fall too low or go to high.
● Normal 4.8% - 5.6%
● Optimal 4.8% - 5.5%

Total cholesterol: This is the total amount of cholesterol and is not specific to the type of cholesterol. This number
doesn’t tell us too much because it lumps together HDL and LDL and it doesn’t differentiate between the particle
characteristics.
● Normal: 100-239 mg/dL
● Optimal 150-200 mg/dL

HDL: This is considered the “good cholesterol,” though that’s not the whole picture. It can be protective against
heart disease and can be raised with exercise and eating certain healthy fats.
● Normal men: 40-50 mg/dL
● Normal women: 40-50 mg/dL
● Optimal men: >50 mg/dL
● Optimal women: >60 mg/dL

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LDL is considered the “bad cholesterol,” though it’s not inherently “bad.” LDL particle number is a better measure
for heart disease. We can also look at whether the LDL present is oxidized and whether it is small and dense (more
problematic) or big and fluffy (less problematic).
● Normal: <100 mg/dL
● Optimal: <100 mg/dL

LDL particle number: This is the number of particles that are in your blood. We can compare this to LDL-C (LDL)
which is the amount (weight) of the LDL in the blood. This measurement is more important when considering risk
factors for heart disease than the LDL measurement found on a standard lipid panel.
● Total particle count optimal: <1000 nmol/L
● Small dense LDL particle number (sdLDL) optimal: <400 nmol/L

Oxidized LDL: This is the amount of LDL that is damaged. Oxidized LDL increases the risk for heart disease
compared to non-oxidized LDL because it forms plaques that can narrow our vessels and increase our risk for heart
attack and stroke.
● Normal: <70 U/L
● Optimal: <60 U/L

Triglycerides: Triglycerides are fatty acids that participate in fat storage, and elevated triglycerides are associated
with carbohydrate intolerance. Thus having high levels of triglycerides might mean that you need to cut out processed
carbohydrates from your diet.
● Normal: <150 mg/dL
● Optimal: <70 mg/dL

Triglyceride to HDL ratio: This ratio tells us about your sensitivity to insulin, the hormone that is responsible for
regulating our blood sugar levels. Thus in addition to fasting insulin levels we can also look at this ratio to see if
insulin resistance is a reason for your symptoms.
● Optimal <2
‒ A measurement greater than 2 suggests insulin resistance

C-Reactive Protein (CRP): CRP is a general inflammatory marker. hsCRP is specific to cardiovascular health but
normal CRP is not specific to any system. Instead, it just tells us that there is inflammation somewhere. Low-grade
inflammation is a sign of chronic disease and should be addressed. Your doctor needs to dig deeper to find out
where an elevation is coming from.
● Normal: 0.0−4.9 mg/L
● Optimal: <0.7 mg/L

hsCRP: High-sensitivity C-reactive protein is a cardiac-specific inflammatory marker. If it is elevated it suggests an

increased risk for cardiovascular disease. If you have high cholesterol as well as high inflammatory markers, like
CRP, then it is more concerning than just elevated cholesterol by itself.
● Normal: <3.0 mg/L
● Optimal: <0.7 mg/L

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Homocysteine: This is a general inflammatory marker, similar to CRP. It is also a marker of B12 and folate status,
and gives us an insight to our ability to methylate. If this marker is elevated, then looking at causes for inflammation,
as well as your MTHFR status, can be helpful.
● Normal: 0−15 μmol/L
● Optimal: 6-8 μmol/L

APOB: This is an advanced cardiac marker found on LDL cholesterol. It is a marker for cardiovascular disease, but
is better when looked at as a ratio (see below).
● Normal: 52−135 mg/dL

APOA1: This is an advanced cardiac marker found on HDL cholesterol. It is a marker for cardiovascular disease,
but is better when looked at as a ratio (see below).
● Normal Men: 101−178 mg/dL
● Normal Women: 116−209 mg/dL

Ratio of APOB to APOA1: This is a more accurate risk predictor for cardiovascular disease then APOA1 or APOB
alone.
● Optimal: <0.8

Fibrinogen: Fibrinogen is a measure of blood flow and clotting risk. Fluid blood flow is important in preventing
cardiovascular disease because when we form clots we are more likely to have a stroke. Adequate blood flow is
needed to maintain all of our vital organs!
● Normal: 193−507 mg/dL
● Optimal: <300 mg/dL

Lp(a): This is a marker of cardiovascular risk linked to genetics, and may be even more problematic than LDL. If
you have a family history of heart disease and your lipid panel shows elevated LDL, then this is a must-order test.
Lp(a) has more to do with genetics than it does with diet, however there are natural therapies that can lower Lp(a)
and reduce your risk of ever developing heart disease in the first place. One of the therapies that has been found
to reduce Lp(a) is niacin, a B-vitamin.
● Normal: <75 nmol/L
● Optimal <30 nmol/L

Carotid Intima media thickness test (CIMT): If you have elevated cardiovascular measurements for the markers
above, then getting a CIMT will give you even more information about your actual risk. This test looks at whether you
have plaque in your arteries, which causes narrowing and increases your risk for stroke/heart attack. Many facilities
offer this test, and it can often be done at health fairs for a reduced rate as well.

Apolipoprotein E (ApoE): ApoE is a genetic marker for metabolic disorders and Alzheimer's. ApoE is also a
helpful marker if you are curious about a high-fat ketogenic diet. This is because people with the ApoE4 allele do
not always respond well to a high-fat diet, and especially to saturated fat. This population also does not respond well
to statin therapy. They typically respond better to a moderate or lower fat diet or other types of fats. But remember,
genetics load the gun, environment always pulls the trigger.
● ApoE2 = protective allele
● ApoE4 = increased risk for Alzheimer's
‒ ApoE3/4 (2-3x risk)
‒ ApoE4/4 (12x risk)

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Sedimentation Rate (sed rate, ESR): This is a general inflammatory marker. It just tells us there is inflammation
somewhere, potentially from an infection, physical injury, autoimmune disorder, toxicity, or other causes of inflammation.
● Normal Male: 0 to 50 years: 0−15 mm/hour, 50 years and older: 0−30 mm/hour
● Normal Female: 0 to 50 years: 0−32 mm/hour, 50 years and older: 0−40 mm/hour
● Optimal: <20 mm/hour

ANA: This is a general autoimmune marker. It does not tell you what type of autoimmunity is present but just that
there is an autoimmune process taking place.
● Normal: Negative

Rheumatoid Factor (RF): This is a marker for autoimmunity that is associated with rheumatoid arthritis, an auto-
immune condition of the joints. A negative value does not rule out the possibility of rheumatoid arthritis—in these
cases, a Cyclic Citrullinated Peptide Antibody test should be run (CCP antibody).
● Normal: negative

Cyclic Citrullinated Peptide Antibody: This is a more specific test for rheumatoid arthritis when compared to RF.
● Normal: <20 u/ml

White Blood Cell Count (WBC): This is how many white blood cells your body is making. Our immune system
can be thought of as an army. Chronically low levels of WBC tells us that your immune system is not sending enough
troops out. This can be an early sign of autoimmunity or infection.
● Normal: 4.5-11 x 103/µL
● Optimal: >5.5 x 103/µL

Functional Testing

Continuous Glucose Monitor

One of the easiest ways to track how foods affect your blood sugar is by asking your doctor for a continuous glu-
cose monitor. They are easy to use and relatively painless, and they provide real-time feedback.

NMR LipoProfile by Labcorp or Cardio IQ Report by Quest Diagnostics Lab

Either profile will tell you your normal cholesterol results along with LDL particle size and number, Apo(a), and CRP
values.

Omega-3 Index Complete by Omegaquant

More than 98 percent of Americans are deficient in omega-3 fats. Omega-3 fats help balance out omega-6 fats and
regulate our body’s production of anti-inflammatory and inflammatory molecules.
● Normal: 2.9-12.9%
● Optimal: 8-12.9%

Advanced Immune Testing: IGeneX, Labcorp, Quest

If your immune markers come back suboptimal, then further testing can help identify the cause. Your doctor can test
for Lyme, Epstein-Barr virus, or cytomegalovirus (CMV) through most large conventional lab companies. These are
chronic infections that may be the root of an immune imbalance.

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Celiac testing (conventional lab companies): Celiac disease is serious autoimmune disease that can be treated
with a gluten-free diet. These tests can help identify celiac:
● IgA antigliadin antibodies
● IgG antigliadin antibodies
● IgA antiendomysial antibodies
● Tissue transglutaminase antibody (IgA, and IgG in questionable cases)
● Total IgA antibodies
● HLA DQ2 and DQ8 genotyping for celiac disease (used occasionally)

Comprehensive Stool Analysis from Genova Diagnostics

Stool samples can tell us not only if we have an imbalance in our gut bugs, but also about the level of inflammation
present in the digestive tract. Many chemical markers in stool can be analyzed to give a picture of the ecosystem.
Markers for acid-alkaline balance, as well as cultures of various bacteria, yeasts, or parasites can often pinpoint the
sources of inflammation and be linked to many diseases.

Wheat/Gluten Proteome Reactivity & Autoimmunity: Array 3 from Cyrex Labs

Gluten/wheat sensitivity is when someone experiences low-level inflammation due to these foods. This can manifest
through a variety of symptoms (headache, brain fog, fatigue, etc.) and can be experienced well after the food is
consumed.

Gluten-Associated Cross-Reactive Foods and Foods Sensitivity: Array 4 from Cyrex Labs
If you have gluten-sensitivity then eliminating gluten might not be enough. This is because gluten and other foods
have similar chemical structures, so for example, someone with gluten-sensitivity may also have a corn or coffee
sensitivity.

Intestinal Antigenic Permeability Screen: Array 2 from Cyrex Labs

This test looks for “leaky gut.” Sometimes our gut can become leaky due to chronic inflammation, bacterial imbal-
ances, and eating the wrong foods for our bodies. Zinc and glutamine are repairing nutrients that the gut needs to
heal and recover.

Food Sensitivity Test Array 10: Array 10 from Cyrex Labs

This test looks at how your body's immune system responds to 180 different foods. And it is different from other
food sensitivity tests because it uses the specific form of the food that you actually eat. This is important because all
foods have different protein structures, and when they're cooked, you may react to a cooked version versus a raw
food or vice versa.

Edifice Health formerly known as Iuvebio

The iAge® test helps determine your inflammatory age.

Conclusion
Inflammaging is an enormous topic, but I placed it as the first Key because it is crucial to address before you address
any other areas. If you have chronic inflammation, you’ll struggle to balance your hormones, keep your mitochondria
functioning optimally, have a healthy gut microbiome, incorporate daily movement, or even focus on your spiritual
health. Make sure you know your status and are taking steps (even small steps) daily to support your immune system
and inflammation levels.

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KEY #2: KEEP YOUR HORMONES IN CHECK

Your hormones are like a symphony. Each hormone acts like a different instrument in the orchestra, interpreting a
signal from the conductor and then responding appropriately. They all work together. However, what would it sound
like if one instrument was too loud and another too quiet? Or if one was playing a different song entirely or totally
out of tune? That’s kind of what happens in our body when our hormones are out of whack. Everything else tends
to fall apart.

In this Key, I’ll start off by walking you through the major hormones related to aging. Then, you can take my Do You
Have Imbalanced Hormones? Quiz to see where you stand. In the section 3 Ways to Support Your Hormones, I’ll
cover things you can do to help support balanced hormones. Please note, hormone imbalance can be tricky to treat;
if you suspect serious hormone imbalance, it’s a good idea to work with your practitioner for testing and therapy
options to get you back on track.

Your Hormones and What They Do

Insulin and Cortisol

I covered insulin and cortisol in depth in Key #1 but wanted to include a brief description here since they are very
important hormones for longevity.

Insulin is made in response to consuming foods containing carbohydrates, which break down into sugar (glucose)
during digestion and metabolism. Insulin directs the glucose to be used as fuel or stored as fat. If blood glucose
gets too low, cortisol is released to signal the body to increase glucose levels in the blood. Too much blood sugar,
insulin, and/or cortisol is extremely stressful for your body and can cause increased inflammation, diabesity, and
insulin resistance, which can all contribute to the destruction of the thyroid gland and negatively impact thyroid
hormone production.

Thyroid Hormones: Thyroxine, Triiodothyronine, and Thyroid Stimulating Hormone

Thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating hormone (TSH) are super important to our overall
health. Your thyroid is the conductor of your metabolic symphony. In response to TSH signals, it takes iodine from
your foods combined with the amino acid tyrosine and converts it to the thyroid hormones T4 and T3. While the
majority of thyroid hormone found in your body is T4, T3 is the active form, much more potent, and the one that
actually affects your cells. This process largely occurs in your liver and gut, so it’s important those organs are func-
tioning well and that detoxification is working properly. Melatonin made during sleep is also needed to help convert
T4 into T3.

Hunger Hormones: Leptin and Ghrelin

Leptin is made by your adipose (fat) cells in response to stored fat levels. If your body has high levels of leptin, your
brain recognizes that you have plenty of stored fat and sends the signal that you are no longer hungry. However, if
you have low leptin levels, your brain believes you need to store more fat and signals that you need to eat.

Ghrelin is primarily made in your stomach. Ghrelin signals your appetite, hunger, and fat storage. It also plays a role
in glucose metabolism and energy homeostasis, among many others.

When your leptin or ghrelin hormones become unbalanced, you may experience inappropriate hunger or satiety,
fat gain, increased blood sugar levels, prediabetes and type II diabetes, inappropriate melatonin signaling, and
poor sleep.

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Human Growth Hormone

Human growth hormone (HGH) is essential for physical growth and appropriate body mass. It is secreted in the
anterior pituitary, found in your brain, and controls growth in children and helps maintain stature in adults. HGH is
important for stimulating the breakdown of triglycerides and keeps excess fat from being stored, helps build protein
and muscles, and plays a role in helping maintain blood sugar levels within non-threatening levels. HGH declines as
we age and with it we see a decrease in muscle mass, libido, energy, and increase in fat storage. Certain lifestyle
interventions, such as balancing blood sugar, exercising, and practicing intermittent fasting, can help to improve
production.

Sex Hormones: Progesterone, Testosterone, Estrogen

Estrogen is found in the highest quantities in women, but men also make estrogen. Formed primarily in the ovaries
or testes, estrogen is important for women’s menstrual cycles and for bone formation and health, blood clotting, skin
and hair, mood, sex drive, and reproductive function. Estrogen levels increase with puberty and decrease with age.

Progesterone is produced by the ovaries and adrenals in women and the testes and adrenals in men. While pro-
gesterone is found in much higher quantities in women, it is important for men as well and helps support nerve
relaxation, reproduction, ovulation, pregnancy, and sperm count and quality. It also allows the body to calm down,
relax, and sleep. Progesterone is required to form testosterone.

Testosterone is also produced by both men and women, though men tend to have much higher levels. It’s import-
ant for sperm production, motivation, sex drive and libido, muscle mass, bone health, exercise recovery, and to
strengthen adrenal glands (important for cortisol regulation). It’s also neuroprotective. Low testosterone levels have
been associated with obstructive sleep apnea for both men and women. Testosterone production decreases with
age and menopause, but should never be depleted entirely.

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Do You Have Imbalanced Hormones?

Often, signs and symptoms of hormone imbalance are RATING SCALE
ignored. They range from mild to debilitating but can
often improve with the right interventions. Because your 0 = Never or almost never have the symptom
hormones are so intertwined, when you experience one
type of hormone imbalance, you’re likely to experience 1 = Occasionally have it, effect is not severe
more. The first step is to identify if hormone imbalance
is affecting you—take this quiz to get a good idea. And 2 = Occasionally have it, effect is severe
when in doubt, check with your doctor for blood tests.
You can find more information about what’s available in the 3 = Frequently have it, effect is not severe
Want to Dig Deeper? section in this Key.
4 = Frequently have it, effect is severe

DO YOU HAVE IMBALANCED HORMONES? BEFORE: AFTER: DIFFERENCE:

I EXPERIENCE MOOD ELEVATIONS AND DIPS

I HAVE ACNE

I HAVE IRREGULAR BOWEL MOVEMENTS (< ONE

OR > FOUR PER DAY)

I HAVE DRY SKIN

I HAVE A HARD TIME LOSING WEIGHT

I AM SENSITIVE TO TEMPERATURE EXTREMES

I HAVE BEEN DIAGNOSED WITH DIABETES OR

PREDIABETES
I HAVE A HIGH FASTING GLUCOSE (>80 MG/DL),
INSULIN (>5 µIU/ML), OR HBA1C (>5.5%)
I HAVE IRREGULAR MENSTRUAL CYCLES
OR EXPERIENCE PMS (IF APPLICABLE) OR
EXPERIENCE EXCESS FAT STORAGE IN THE
BREAST AREA (FOR A MALE)
I EXPERIENCE HAIR LOSS OR THINNING
(INCLUDING EYEBROWS AND EYELASHES)

I EXPERIENCE FATIGUE

MY HANDS AND FEET ARE FREQUENTLY COLD

I HAVE A LOW SEX DRIVE

I EXPERIENCE POOR SLEEP OR INSOMNIA

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DO YOU HAVE IMBALANCED HORMONES? BEFORE: AFTER: DIFFERENCE:

I GET HEADACHES

I EXPERIENCE INFERTILITY

I CAN GET “HANGRY” IN BETWEEN MEALS

MY MOOD IS SIGNIFICANTLY IMPACTED BY THE

TIMING OF MEALS

I EXPERIENCE BRAIN FOG

MY HANDS ARE WHITE AND/OR CLAMMY

TOTAL

KEY
0-20: Your hormones are likely balanced
21-40: Your hormones could use some attention—some minor adjustments to your diet and lifestyle can make
improvements here!
41-60: You might consider meeting with a doctor to consider testing for your current hormone levels. You’ll
definitely want to pay attention to this key.
61-80: Your hormones might be unbalanced or you might be experiencing an underlying condition. Make sure
you’re working with a doctor or Functional Medicine practitioner for one-on-one direction and testing.

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Conventional vs. Functional Approach

Unfortunately, testing for hormone levels can be complicated. In fact, your body as a whole is quite complicated
(surprise!). Each organ, tissue, and cell in your body functions both individually and holistically as a unit. You can’t
just treat a single organ without affecting the rest of the body.

Take your thyroid, as an example. Your thyroid is a butterfly-shaped gland located in your neck. It produces the
hormones T3 and T4, important for energy production and metabolism. Your thyroid receives a message from your
pituitary gland, in the form of thyroid stimulating hormone (TSH). This stimulates the production of the T3 and T4
hormones, as the name implies. If your brain senses low levels of hormone, it can increase this TSH message to
encourage your thyroid to produce more hormones.

Unfortunately, it’s not as simplistic as it sounds to deduce that high TSH equals insufficient thyroid function. As
mentioned in Key #1, the test result ranges are based on the average (subjectively unhealthy) person and are not
necessarily based on optimal levels. Additionally, your blood levels of TSH may be different than your tissue levels,
so your blood may test “normal” but the tissues, where it’s desperately needed, may be inadequate. Relying solely
on a TSH test doesn’t show the whole picture.

To take it a step further, there are many different causes to thyroid dysregulation. Chronically elevated cortisol levels
from long-term stress, blood sugar imbalance/insulin resistance, or sometimes pregnancy, can negatively affect your
pituitary gland causing a decrease in TSH signaling and subsequent thyroid-like symptoms. However, there’s nothing
actually wrong with the thyroid in this example.

Or, for some people, things like chronic stress, elevated cortisol, chronic inflammation, a poor gut microbiome,
or others can cause your T4 to under-convert to active T3, again meaning the thyroid gland is functioning fine with
“normal” TSH levels, but still experience signs and symptoms of hypothyroid.

And there are other causes of thyroid dysfunction or abnormal test results as well. So it’s easy to see that relying on
a single testing method based on an overall unhealthy testing curve is not sufficient.

That is why the functional approach to testing and treating hormone dysregulation takes many factors into account,
looks at multiple different tests, uses a personalized approach, and most importantly: addresses the root cause.
Using the thyroid example, in Functional Medicine, we would likely look at: TSH, total T3 and T4, free T3 and T4, re-
verse T3 (which helps identify your toxic load), and thyroid antibodies (which helps identify autoimmune thyroiditis)
at a minimum. This helps to give a much more accurate look at your thyroid function.

Functional Medicine also takes into account your personal life—your mental and spiritual health, your stress levels,
your activity and exercise, your weight, your energy levels, your diet, your genetics, your history, etc. The one-
size-fits-all approach to medicine and healthcare just does not work. Each person is unique, it’s important that your
protocol is just as unique to you.

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3 Ways to Support Your Hormones

#1: Balance Blood Sugar

I think it’s pretty clear at this point how crucial having balanced blood sugars is. Not only can blood sugar spikes and
dips directly affect hormone levels, but this type of stress causes inflammation and can disrupt nearly every system
in your body. If you remember from Key #1, chronic inflammation is at the root of nearly every chronic disease and
one of the main causes is unregulated blood sugar and insulin resistance.

But this is really great news. There is SO MUCH you can do to help support healthy blood sugar levels. Even if you’re
already diagnosed with diabetes or insulin resistance, you can still make dietary modifications that can significantly
help blood sugar. I’ll dive into this much deeper in my 30 Days to Aging Backwards Plan, but if you’re wanting to
start today, and I suggest you do, try to do these three things:

1. Eat 2 servings of veggies with every meal.

2. Make sure you have a serving of quality protein with every meal.
3. Include a serving or two of healthy fats with every meal.

#2: Eat Healthy Fats1

Every cell in your body utilizes fats to keep healthy. On the exterior of each cell is a dual-layer of lipid molecules,
called the lipid bilayer. Within this lipid bilayer are different proteins, channels, and molecules of cholesterol. These
molecules are essential for cellular integrity, communication, and replication. In fact, your hormones are formed
from fat and cholesterol.

Healthy fats play a role in supporting healthy levels of inflammation and your immune response, and are needed
for your body to utilize the fat-soluble vitamins, A, D, E, and K, all of which are needed to synthesize hormones.

Nutrient deficiencies, fatty acid imbalances, and not enough healthy fats can lead to hormone dysfunction, so make
sure to include 1 to 2 servings of healthy fats with each meal and snack.

Examples of a serving of healthy fat:

● Extra virgin olive oil, avocado oil, macadamia oil, walnut oil, almond oil (1 tablespoon)
● MCT oil (1 to 2 tablespoons a day)
● Avocado (½ to 1 avocado)
● Fatty fish like sardines, mackerel, herring, black cod, and wild salmon (4 to 6 ounces);
aim to include these 3 to 4 times per week
● Nuts and seeds (2 to 3 handfuls); all are okay except peanuts
● Olives (¼ cup)
● Grass-fed butter or ghee (1 tablespoon)*
● Organic coconut milk (¼ cup)*
● Extra virgin coconut oil (1 tablespoon)*

*See Pegan Fats section on page 95 for an explanation on why these fats may not be a good fit for everyone.

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#3: Prioritize Self-care

Every one of your hormones are impacted when you experience stress.2 If your stress is acute, only lasting a few
seconds or minutes, these impacts are easy to recover from. However, if you experience long-term chronic stress,
your hormones can take a major hit.

Prioritizing self-care and making time for reflection, relaxation, and mindfulness can support healthy hormone lev-
els. Studies have shown that interventions like meditation and mindfulness can significantly lower cortisol levels.3,4
So, make sure you’re taking time for you.

Here are some examples of ways to prioritize self-care:

● Commit to meditating for 5 days. Apps like the Calm meditation app have guided meditations
of different lengths.
● Pick up an old hobby or try something new
● Start a garden
● Join a yoga studio
● Go on a walk with a friend
● Write your thoughts in a journal
● Keep a notebook by your bed and write 3 different things you’re grateful for every day.
Try not to repeat anything!
● Take a bath
● Video call with a friend
● Start an exercise and strength training routine (exercise not only releases your feel-good neurotransmitters
serotonin and dopamine,5 but resistance training has been shown to help mitigate age-related testosterone
decline.6 It’s a form of both self-care and hormone support!)

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Want to Dig Deeper?

There’s a lot you can learn from tests that are largely covered by insurance. It’s always a good idea to know where
you currently stand. Always keep in mind that it’s important to check your results against “optimal” levels if you’re
striving for optimal health.

Conventional Testing
Men’s Hormones
Testosterone (total): This is the main male hormone for brain health, motivation, optimal energy, heart health, and
more. It is estimated that 39% of men over the age of 45 have low testosterone. Why such a huge percentage? Well,
diabesity is a leading contributor to this because elevated insulin levels decrease testosterone levels and can cause
an increase in estrogen levels in men. As your belly fat goes up, your testosterone goes down and so does libido
and sexual function. Basically when your consumption of sugar and starch go up, your sex hormones get messed
up—both for men and women in slightly different ways.
● Normal: 264-916 ng/dL
● Optimal: >500 ng/dL

Free Testosterone: The majority of testosterone is bound to sex hormone binding globulin (SHBG). Free testos-
terone is the amount of testosterone that is actually able to produce its effect on the body because it is not bound
to a protein carrier.
● Normal: 20-50 years old: 7.2-26.5 pg/mL
‒ > 50 years old: 6.6-24.0 pg/mL
● Optimal >15-25 pg/mL

Sex Hormone Binding Globulin (SHBG): This is the protein that binds testosterone (making it unusable).
● Normal:
‒ 20-49 years: 16.5−55.9 nmol/L
‒ >49 years: 19.3−76.4 nmol/L

DHEA: DHEA is the precursor to testosterone. We need this hormone for optimal energy levels. If DHEA is low it
can indicate that your adrenal glands, which are responsible for responding to stressors, may not be functioning
optimally.
● Normal 71.6-530 μg/dL
● Optimal: 200-530 μg/dL

Estrogen (estradiol): Estrogen is an important hormone for both men and women, though it is often demonized
in men's health because some men have too much estrogen. However, normal levels of estrogen are essential to
maintain balanced hormones and a happy brain. Estrogen becomes elevated in men due to diabesity, and insulin
can actually increase the conversion of testosterone into estrogen, which can add to the fatigue and sexual dysfunc-
tion that is already prevalent in insulin resistance. Too much estrogen causes man boobs, beer belly, loss of hair on
chest and limbs—basically turning a man more into a woman!
● Normal: 7.6−42.6 pg/mL
● Optimal: 20-40 pg/mL

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Luteinizing Hormone (LH): LH causes the production of testosterone in men and stimulates the release of an egg
in women.
● Normal: 1.7−8.6 mIU/mL

Follicle Stimulating Hormone (FSH): FSH is responsible for the production of sperm in men and develops the
follicles in the ovaries of women.
● Normal: 1.5−12.4 mIU/mL

Women’s hormones between days 19-21 of menstrual cycle

Day 1 = first day of bleeding (first day of a women’s period)
Because womens’ hormones wax and wane depending on where they are in their natural cycle, it’s important to test
female hormones at a consistent day during the menstrual cycle. Otherwise, the results may be skewed and not give
an accurate snapshot.

Progesterone: Progesterone is a female hormone that is calming (reduces anxiety) and prepares the uterus for
pregnancy. Some women have normal values of progesterone but have too little progesterone when compared to
the amount of estrogen they produce, which is why we want to look at the ratio of estrogen to progesterone.
● Normal: 1.8−23.9 ng/mL
● Optimal: >5 ng/mL

Estrogen (estradiol): Estrogen is a female hormone responsible for female sex characteristics, memory, and heart
health. While it is essential, women can have too much estrogen due to suboptimal detoxification pathways, or con-
stipation—both of which are how we clear estrogen from the body.
● Normal: 43.8-211.0 pg/mL
● Normal postmenopausal: <6.0−54.7 pg/mL
● Optimal: 80-200 pg/mL

FSH: FSH is responsible for developing the follicles in the ovaries of women. In polycystic ovary syndrome (PCOS),
FSH can be low, so low that ovulation and conception can't occur, which is why women with PCOS have infertility.
● Normal (d 19-21): 1.7-7.7 mIU/mL
● Normal postmenopausal: 25.8-134.8 mIU/mL

LH (see above)
● Normal: 1.0-11.4 mIU/mL
● Normal postmenopausal: 7.7-58.5 mIU/mL

DHEA (see above)

● Normal: 41.2-432 μg/dL
● Optimal 200-432 μg/dL

Testosterone: Testosterone is responsible for male sex characteristics in men, but is also essential in women’s
health. Testosterone ensures that we have optimal energy levels, motivation, muscle mass, and a healthy sex drive.
● Normal 20-49 years: 8−48 ng/dL
● Normal >48 years: 3-41 ng/dL
● Optimal: 60-80 ng/dL

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Free testosterone (see above)

● Normal: 0-4.2 pg/mL
● Optimal: >0.5 pg/mL

SHBG (see above)

● Normal 20-49 years: 24.6−122.0 nmol/L
● Normal >49 years: 17.3−125.0 nmol/L
● Optimal: 16.5-80 nmol/L

Thyroid Panel

Thyroid stimulating hormone (TSH): This is the most commonly run test to check for thyroid disease.
1 in 5 women and 1 in 10 men have low thyroid function. Common signs of hypothyroidism are cold hands
and feet, trouble losing weight or weight gain, brittle hair and nails, dry skin, constipation, being tired all of
the time, having trouble getting up in the morning, and brain fog or memory issues or depression. These
symptoms warrant a thyroid panel to see if this gland is not kicking out the fuel it should be.
● Normal 0.45-4.5 μIU/mL
● Optimal 1.0-2.0 μIU/mL

Free T3 (fT3): This is the active thyroid hormone that actually exerts its effect on the cells. It is responsible
for energy production, hormone production, regulating bowel movements, and so much more.
● Normal: 1.81−4.06 pg/mL
● Optimal: 3.2-4.4 pg/mL

Free T4 (fT4): T4 is the majority of the thyroid hormone that is produced. It must get converted to active
thyroid hormone (fT3) in order to have any effect in our body. If fT4 is normal but fT3 is low, then you are
not converting properly and might require supplementation with nutrients to help this process along.
● Normal: 0.82-1.77 ng/dL
● Optimal: 1-1.5 ng/dL

Thyroid Peroxidase Antibodies (TPO antibodies): 90% of the individuals who have hypothyroidism
have autoimmune hypothyroidism (Hashimoto’s disease). TPO is one of the markers for Hashimoto’s. It
is important to know the cause of hypothyroidism because you treat it differently from non-autoimmune
hypothyroidism.
● Normal: 0−34 IU/mL
● Optimal: 0 IU/mL

Anti-thyroglobulin antibodies: Another marker for autoimmune thyroid disorder (Hashimoto’s).

● Normal: 1-115 IU/mL
● Optimal: 0 IU/mL

Reverse T3: Reverse T3 is like the brake that stops your thyroid hormone production. Sometimes there are
good reasons for higher reverse T3 but often it's because something's wrong. Unfortunately, toxins, stress,
inflammation all increase levels of reverse T3, which blocks your thyroid. Even if the regular thyroid tests
appear normal, high levels of reverse T3 mean your thyroid is not really working properly.
● Normal: 9.2-24.1 ng/dL

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Functional Testing
DUTCH Test by Precision Analytical or Essential Estrogens by Genova Diagnostics
Both of these tests look into downstream breakdown products of hormones and tell you a lot more about what's
happening with your hormone metabolism. These are measured using urine, not blood, and are used for assessing
HPA axis function: These tests can help you determine whether chronic stress and high cortisol are causing pituitary
dysfunction, under-conversion of T4 to T3, or thyroid hormone resistance.

Cortisol Test: Cortisol is a hormone that is produced by your adrenal glands. It is responsible for waking you up in
the morning and responding to stressful situations. The adrenals are two small glands that sit on top of your kidneys
and they produce cortisol as well as the reproductive hormones above. These glands are one of our first responses
to stress, and in chronic stress your adrenals get fatigued, your energy plummets, and it becomes difficult to man-
age your life. You could feel tired and wired, all at the same time. You might get palpitations or feel anxious or have
trouble sleeping. You might crave salt. You may get dizzy when you stand up. You might have low blood pressure.
You might even have sugar cravings, because your body can’t regulate your blood sugar properly. All these are
clues that you could have adrenal problems.

To test cortisol, it is best to test it at multiple time points throughout the day to ensure that your levels are normal AND
that you have a normal pattern of cortisol release (highest upon waking, and lowest before bed).

Companies who test cortisol measurements throughout the day using saliva: Adrenal Stress Hormones-Salivary by
ZRT Laboratories, Adrenocortex stress profile by Genova Diagnostics, Adrenal Stress Index by Diagnos-Techs

Conclusion
Your hormones regulate your internal symphony. Hormone imbalance can present itself in a multitude of ways, from
cold extremities, to acne, to headaches, to irregular bowel movements, due to how interconnected your hormones are.
Working closely with a practitioner is key when treating hormone imbalances, so if you suspect that your hormones
could use extra support, check with your doctor regarding testing options or contact a Functional Medicine doctor
near you through www.ifm.org.

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KEY #3: FUEL YOUR ENERGY POWERHOUSE

Mitochondria are those little organelles found in every cell in your body that you probably remember your middle
school teacher referring to as the “powerhouse.” They are absolutely crucial to preserving your healthspan, creating
energy, breathing, and overall survival.

Reactive Oxygen Species

Each one of your 30+trillion cells has hundreds to thousands of mitochondria,
with concentrations highest in tissues that require the most energy, like your Note:
brain and heart. These mitochondria convert the food you eat and oxygen This section on mitochondrial
you breathe into energy called adenosine triphosphate, or ATP, that your function is a bit science-heavy.
body uses to drive nearly every biochemical process. One by-product of this
I kept this section to the basic
reaction is the creation of a small amount of the free-radical reactive oxygen
species (ROS). premise because topics like
sirtuins, telomeres, AMP-
Some ROS is normal and needed for cell homeostasis, but as we age,
kinase, and mTOR are central
mitochondrial quality and quantity naturally decline. Mitochondria end
up producing less ATP and more ROS, which contributes to damage and to mitochondrial function and
inflammation that can snowball throughout the body. Ideally, your mitochondria longevity, but are extremely
would function optimally to create energy until they are replaced by new, complicated with new research
young mitochondria. Instead, we see that with aging and certain diseases,
emerging daily. If you’re
mitochondria can slowly decline in function, mucking up your cells.
interested in digging deeper,
Telomeres check out my References
It’s been shown that mitochondrial function can decrease for a number of and Resources section for
reasons beyond aging. One potential cause could be the shortening of recommended readings.
telomere length. Telomeres are the end caps on your chromosomes—often
likened to the hard plastic shells on the tips of shoelaces. They are protective
against DNA damage, and as they become shorter (which happens naturally with each replication and unnaturally
through things like toxin exposure, chronic inflammation, etc.) they become less protective and are associated with
age-related diseases and a shortened lifespan.1

Sirtuins
Another cause of decreased mitochondrial efficiency is the decline of sirtuin (SIRT) enzyme activity.2 Sirtuins are a
class of enzymes found in the mitochondria. There are several subtypes of sirtuins, but much of longevity studies
focus on SIRT1 and SIRT3. SIRT1 acts on certain pathways that help increase insulin production, support brain health
and cognition, and mitochondrial function in your muscles.3,4 SIRT3 is essential to help keep ROS levels balanced in
your cells and support and protect your liver. If ROS overwhelm your cells, they can cause damage leading to a mul-
titude of chronic diseases, like cancer, insulin resistance, obesity, reduced immune function, and cognitive decline.

Senescent Cells
Another link between mitochondrial function and aging comes from types of cells in your body called senescent
cells. Normally, when cells get old or no longer functional, they die through a process called apoptosis. In senescent
cells (sometimes referred to as zombie cells), they become old and non-functional, but don’t actually die.5 Instead,
they leak massive amounts of inflammatory compounds. In fact, the many mitochondria in senescent cells become
dysfunctional creating large amounts of ROS, which contribute to inflammation, cellular damage, and aging.6

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AMP-Activated Protein Kinase

And another target of research regarding mitochondria and longevity is the AMP-activated protein kinase (AMPK)
enzyme, which is found throughout many of your tissues. The AMPK is activated during certain “good” stresses
(called hormesis), like exercise, which signal your body to increase fuel (ATP) production in your muscles.

AMPK is a target of longevity research because when it is activated, it is involved with mitochondrial biogenesis,
among other benefits, like angiogenesis, and protecting against insulin resistance, inflammation, and fat storage.7 As
we’ve learned already, these are some of the keys to improving health span and living more vibrantly.

Mammalian/Mechanistic Target of Rapamycin

Finally, another area of focus regarding aging and longevity is the mammalian/mechanistic target of rapamycin
(mTOR) process. mTOR is important for regulating cell growth, protein synthesis, mitochondrial dysfunction, cell
senescence, and more.8 It also plays an important role in nutrient sensing, and responds to signals like insulin. In-
sulin activates the mTOR pathway which can lead to nearly every hallmark of aging. Though the full pathway is quite
complicated, the key takeaway with mTOR is keeping your blood sugar and insulin balanced can help reduce the
activation of mTOR and improve your mitochondrial function.

Aside from the natural aging process, there are other things that send mitochondrial function in a bad direction, like
smoking, stress, lack of sleep, environmental pollution like mold and smog, and eating a diet rich in refined sugar
and flour that causes blood sugar imbalances and insulin resistance.9

However, the good news is that there’s a lot you can do to support healthy mitochondria. There’s things you can do
to clear out the old and sluggish mitochondria and to support building new, robust mitochondria. This is easily one
of the most important things you can do to extend your healthspan.

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How Powerful is Your Powerhouse?

Your mitochondrial function decreases as you age, but RATING SCALE
unfortunately, we find that most people experience in-
appropriate mitochondrial slowing independent of age. 0 = Never or almost never have the symptom
In fact, around half of the population experiences some
sort of mitochondrial sluggishness prior to the natural 1 = Occasionally have it, effect is not severe
decline with age. Luckily, there’s a lot you can do to
support your mitochondria, but it’s important to start with 2 = Occasionally have it, effect is severe
an idea of where you currently stand.
3 = Frequently have it, effect is not severe

4 = Frequently have it, effect is severe

HOW POWERFUL IS YOUR POWERHOUSE? BEFORE: AFTER: DIFFERENCE:

I HAVE ACHY JOINTS

I HAVE A HARD TIME GETTING OUT OF BED IN

THE MORNING

I EXPERIENCE POOR SLEEP

I FEEL VERY FATIGUED THROUGHOUT THE DAY

I FEEL OLDER THAN MY ACTUAL AGE

I EXPERIENCE BRAIN FOG/TROUBLE

CONCENTRATING
I NOTICE PAIN IN MY BODY (NOT ASSOCIATED
WITH AN INJURY)

I EXPERIENCE WEAKNESS

I SUSPECT OR HAVE BEEN DIAGNOSED WITH

ARTHRITIS

I GET FREQUENT NOSE BLEEDS

I HAVE SPIDER VEINS

I STRUGGLE WITH BLOOD SUGAR IMBALANCE,

PREDIABETES, OR DIABETES

I NOTICE LOOSE SKIN OR WRINKLES

I HAVE SLEEP APNEA

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HOW POWERFUL IS YOUR POWERHOUSE? BEFORE: AFTER: DIFFERENCE:

I GET FREQUENT HEADACHES

I FEEL WEAK

I HAVE EXCESS FAT STORAGE

I NOTICE A DECREASE IN MUSCLE MASS

I EXPERIENCE MEMORY LOSS, LIKE FORGETTING

NAMES OR WHERE I PUT MY KEYS

I HAVE HIGH LEVELS OF INFLAMMATION

TOTAL

KEY
0-20: Your mitochondria are in tip top shape!
21-40: Your mitochondria could use some attention—some minor adjustments to your diet and lifestyle can make
improvements here!
41-60: You might be experiencing some level of mitochondrial dysfunction. You’ll definitely want to pay attention
to this key.
61-80: Your mitochondria may need some serious attention or you might be experiencing an underlying condition,
make sure you’re working with a doctor or Functional Medicine practitioner for one-on-one direction and testing.

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Conventional vs. Functional Approach

The conventional world doesn’t put much emphasis on supporting your mitochondria unless you have a genetic
condition causing total mitochondrial disease. It’s reasons like this why Functional Medicine is so important here.
There are many well-meaning doctors who simply haven’t been taught the importance of supporting your mitochon-
dria (similarly: most medical schools teach one or less classes on nutrition and zero on environmental toxins and
toxic overload.)

In fact, take a look at the use of statins for example. People are prescribed statins to help lower their cholesterol,
which we already learned is not what we need to focus on when it comes to heart disease. Statins interfere with the
HMG-CoA reductase pathway, which is to say that they decrease this reaction from happening, which decreases the
formation of cholesterol in our body.

However, this same pathway also synthesizes ubiquinol (coenzyme Q10, CoQ10) and dolichol (used in protein
synthesis). CoQ10 is required for your mitochondria to create energy. It is also a powerful antioxidant. So, statins
decrease the production of cholesterol and CoQ10. However, rarely do you find a conventional doctor who will
recommend a statin and a supplemental CoQ10. This is unfortunate since people who use statins commonly com-
plain of severe fatigue, weakness, and inflammation, largely caused by the reduction in the production of CoQ10.

This is not to say that doctors are bad and no one needs statins. Almost all doctors are very well-meaning, they just
weren’t taught about looking for the root causes of disease. Similarly, statins are needed for certain individuals—they
can save lives. It’s mainly a problem when they’re used as a band-aid for people with increased heart disease risk
instead of getting to the root cause and focusing on their diet, exercise, and lifestyle.

In Functional Medicine, we approach your mitochondria as a top priority. If your mitochondria are lagging, so will
nearly every other aspect of your health. If we suspect your mitochondria are in need of attention, we make sure to
include all aspects of supporting your mitochondria into your protocol.

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4 Non-Negotiables to Mitochondrial Health

There are many different stressors that negatively affect your mitochondria and many interventions that can signifi-
cantly support your mitochondria. However, I like to focus on 4 non-negotiables for mitochondrial health. These are
4 things that I recommend to my patients, do myself, and always prioritize.

Non-Negotiable #1: Eat. Real. Food.

And be intentional about it.

You’ve heard me say it before, and I’ll say it again (and again and again). You must eat whole, real food. If man
made it, leave it; if nature made it, eat it. Eating natural foods as close to how they are found in nature as possible
is absolutely paramount when it comes to not only supporting your mitochondria, but your overall health. You can’t
out-exercise a bad diet, nor can you out-live a bad diet.

Focus on eating healthy fats. Fats like avocados, nuts and seeds, coconut and MCT oil, olives and olive oil, macada-
mia oil, and pasture-raised meats and eggs help support your mitochondria. Not enough fats or the wrong type of
fats (like trans fats, fats from conventionally raised meats or fried food) can cause your cells to become brittle and
weak and they wreak havoc on your system, causing chronic inflammation.

Try intermittent fasting (IF) and/or calorie restriction (CR).10,11,12,13,14 There are
many ways to practice IF and CR, most of which are fairly easy. I am a big Note:
advocate for time-restricted eating, as a method of IF. This is where you eat
If you are pregnant, trying to
the normal amount of calories you would in a day, but limit it to a short eating
window, usually within 10 or less hours. So, for example, if you eat breakfast at get pregnant, have blood sugar
9 am, you’d make sure your last meal of the day was 7pm or earlier. dysregulation, or hormonal
imbalances, intermittent
There are studies to suggest that people benefit from IF while having an eating
window of anywhere between 8 and 12 hours, or even periods of fasting from fasting might not be for you.
24 to 48 hours once a month or once a quarter. By practicing an extended Be sure to check with your
pause from eating, your body has a chance to rest and recover from the bar- doctor or Functional Medicine
rage of foods, chemicals, and functions typical in a day. Your body responds
practitioner before making any
to these periods by increasing fatty acid oxidation (using fats for fuel), be-
coming more insulin-sensitive, clearing out old mitochondria, and increasing dietary modifications.
mitochondrial biogenesis—all really good things when it comes to increasing
healthspan.

Periods of calorie-restriction, about 40% less or fewer calories than normal, and intermittent fasting/time-restricted
eating have been shown to increase your sirtuin pathway (improves mitochondria), your FOXO pathway (enhances
your autophagy, or clearance of dead and damaged cells), and your Nrf2 pathways (increases your antioxidant
defenses). They can decrease your overall inflammation, fasting insulin levels, and blood pressure, while improving
your oxidative stress, sleep, and muscle-building. Hello, longevity!

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Non-Negotiable #2: Move, Seriously.

Exercise is so important for your overall health. It can help prevent telomere shortening, reduce stress and inflam-
mation, and help clear out ROS and other pro-oxidants. I love high-intensity interval training (HIIT) because there are
great studies showing the efficacy of this for so many areas of health: weight and fat loss, muscle building, cardio-
vascular improvement, stress relief, toxin-clearing, and improvements in sleep and blood sugar control, all using a
routine that’s usually less than 10 minutes. That’s extraordinary!

My favorite HIIT exercise is the 7-Minute Workout that you can do at home. When it’s this short and effective, there’s
really no excuse to not exercise a few times per week.

If you can, I also encourage you to include 2 to 3 strength training days each week as well. These are usually longer
than 10 minutes per workout, but strength training is what helps build and maintain your muscles and increase your
mitochondria, which in turn will increase your energy, fat burning, and longevity.

If you don’t have a current exercise routine, I recommend finding a plan that you will stick to. Download the 7-Minute
HIIT Workout, buy a gym membership to encourage you to actually go, invite a friend on a walk, or start a move-
ment hobby like gardening or hiking. Small or big, any addition of movement into your current routine can do your
mitochondria good.

Non-Negotiable #3: Get Light, But Not Just Any Light

Our ancient ancestors had some major natural advantages that our modern societies have no choice but to succumb
to. It’s rare that we look at our ancient ancestors’ advantages when they clearly had so many disadvantages—lack
of healthcare, lack of technology, lack of stable housing or protection against predators, lack of education, etc.
However, one major and distinct advantage was actually the lack of electricity and technology. I know this sounds
contradictory, but stick with me here.

Our modern times are flooded with artificial light from electricity, building lights, computers, TVs, tablets, phones,
alarm clocks, etc. and also significantly lacking in natural sunlight. Our circadian rhythms are closely tied to the nat-
ural cycle of the sun. This rhythm is a natural, internal process that regulates our sleep-wake cycles. Sleep involves
quite a bit more than simply closing your eyes, turning off your brain, and opening your eyes again in the morning.

There’s an entire internal “ecosystem” at work within your body that is closely connected with your environment to
help produce the hormones and neurotransmitters needed to either help you fall and stay asleep at night or help you
wake and stay motivated during the day. This ecosystem is almost exclusively regulated by light exposure.

Basically, light goes into your eye, hits your retina, and then is transmitted to the suprachiasmatic nucleus and on to
the pineal gland. This is an area of the brain where serotonin is synthesized into melatonin based on the light/dark
signal. If light is hitting this area, melatonin synthesis is suppressed and cortisol production is ramped up. If light is
not hitting this area, melatonin is formed and cortisol is suppressed.

Melatonin is a hormone produced in response to darkness and controlled by norepinephrine—part of the parasym-
pathetic “rest and digest” nervous system. It helps signal your body to feel sleepy, fall asleep, and stay asleep. It is
also a potent antioxidant and has many implications for your overall health.

Cortisol is a hormone controlled by your sympathetic “fight or flight” nervous system and is released in response to
stressors. It is what fuels the rush of adrenaline that allows you to respond and move quickly, especially beneficial if
the insult is life-threatening. It also responds to light exposure and is supposed to be at its highest levels first thing in
the morning to help you wake and feel motivated to take on the day and any time you experience a stressful situation.
Unfortunately, your body can’t tell the difference between a lion chasing you and a stressful job, so cortisol can be
chronically elevated, and you can see why this could be an issue.

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It’s clear that we want our cortisol highest in the morning to give us fuel,
motivation, and focus, and we want our melatonin highest at night to encourage Note:
restful sleep. And since light exposure boosts cortisol and inhibits melatonin,
In addition to when and what
getting exposed to light first thing in the morning and throughout the early day
is possibly the most important thing you can do to help regulate your circadian type of light exposure impacts
rhythm. I want to stress here: all sources of light affect these pathways. That your mitochondria, research
includes sunlight, lightbulbs, computers, TVs, smart phones, tablets, etc. indicates that exposure to near-
So how does this all tie in with your mitochondria? Your body requires restful, infrared light could support
deep, and adequate sleep to both create new mitochondria as well as clear out mitochondrial function and
the old, fatigued mitochondria. Lack of sleep can cause your mitochondria to energy production.15 Check
become sluggish and one of the easiest and most effective “hacks” for sleep
the References and Resources
is to get bright light first thing in the morning (ideally from the sun) and turn off
all electronic signals and artificial light at night. (Natural sunlight also increases section for our favorite infrared
your vitamin D levels, which your mitochondria love!) sauna recommendations.

Non-Negotiable #4: Try Supplements for Added Support

The foods you eat today are not as nutrient-dense as they once were. Food should always be the foundation of your
health regimen, but with the depletion of soils, travel distance and packaging of produce, loss of heirloom species,
and introduction of monocropping and genetic modifications, our fruits and veggies are not as nutritious as they
once were. Even with the perfect diet, you may be lacking in certain nutrients. Plus, our uber-stressed lifestyles, ex-
posure to toxins at every turn, access to less-than-ideal foods, and interference of many medications with our nutrient
pathways means that we need more nutrients than ever before.

If you suspect mitochondrial dysfunction or are just looking to support your mitochondrial health, I have 5 favorite
supplements that are mitochondrial all-stars—you can take one or all, but always double check with your doctor first.
● Ubiquinol (Coenzyme Q10)
Your mitochondria use CoQ10 to produce energy,16 and unfortunately, as you age, the production of CoQ10
declines. It also declines with chronic stress, toxin exposures, and certain medications. To help support your
mitochondria, I find most people do well with 100 to 200 mg ubiquinol daily.** (Note: Ubiquinol is the
active form of CoQ10 and more expensive. You can find ubiquinone for a bit cheaper, but that’s the inactive
form. Consider this information when making your decision.)
● Alpha Lipoic Acid (ALA)
Alpha lipoic acid is a powerful antioxidant that helps neutralize free radicals and ROS, supports fuel produc-
tion in your muscle mitochondria, and supports stabilized blood sugar levels. I find most people do well with
600 to 1,200 mg daily.**
● Resveratrol
Resveratrol, a major polyphenol found in red wine, is a powerful antioxidant that helps protect and promote
mitochondrial biogenesis. I find most people do well with 40 to 200 mg daily.**
● Epigallocatechin-3-Gallate (EGCG)
Commonly called green tea extract, EGCG is an antioxidant polyphenol that targets mitochondria to support
biogenesis and quell ROS.17 Surprisingly, EGCG has also been shown to create oxidative stress purposely
and situationally to combat cancer cells. I find most people do well with 225 mg daily.**

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● L-Carnitine
L-carnitine has been shown to carry activated fatty acids into the mitochondria for fuel production, remove
toxic fatty metabolites, and regulate mitochondrial function. It’s also been shown to support cardiovascular
health. I find most people do well with 600 to 1,200 mg daily.**

**These are basic supplement ranges. You may need more or less, so make sure you are working with a practitioner to determine
your current levels and recommended dosage.

Next-Level Supplementation
These are totally optional but promising in the realm of biohacking your mitochondria. Check with your doctor be-
fore incorporating any of these supplements into your routine.
● Nicotinamide adenine dinucleotide (NAD)
NAD is a coenzyme required by your mitochondria to make energy. Your body also uses NAD to generate
ketones, keep stable blood sugar overnight, for nerve communication, and proper muscle function. It’s an
extremely important coenzyme to protect and repair your cells18—all of which are crucial for longevity and a
long healthspan. You can also find this in the form of nicotinamide riboside (NR) or nicotinamide mononu-
cleotide (NMN).
● Nrf2 activators
The Nrf2 pathway regulates the production of the master antioxidant, glutathione, as well as superoxide dis-
mutase (SOD). It also is important for your detoxification pathway to help keep your cells and mitochondria
clean and can help downregulate inflammatory factors. Nrf2 activators include sulforaphane (an extract from
broccoli), pterostilbene, curcumin (the active ingredient in turmeric), and green tea extract (EGCG), among
others.
● Sirtuin activators
Sirtuins are important to protect your cells from oxidative damage and help maintain telomere length. Of
course, they are also important for keeping your mitochondria functioning optimally. Fisetin, resveratrol, and
quercetin are all sirtuin activators.19
● Pyrroloquinoline quinone (PQQ)
PQQ is an amazing antioxidant, up to 100x as powerful as vitamin C. It stimulates your mitochondria to in-
crease in number and efficacy, which equals more energy for you.

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Want to Dig Deeper?

Unfortunately, there aren’t many tests available that your doctor can run. You can check your cardiometabolic stress
test, which is VO2 max, to see how these systems are functioning, and this can give you an idea of your mitochon-
drial function.

Functional Testing
Oxidative Stress Analysis: This test is used to test the oxidative stress markers and antioxidant reserves. This also
tests glutathione and glutathione peroxidase levels.

Coenzyme Q10 (CoQ10): This is an essential nutrient for your mitochondria to make energy. CoQ10 is formed
from cholesterol, so people taking statins are likely deficient in this nutrient. It’s essential for heart health because
our hearts contain some of the highest levels of mitochondria. But the serum CoQ10 test is definitely not the most
comprehensive one to get for mitochondrial function. There is another test that includes CoQ10 levels and so much
more. So if your doctor will order this test for you then there is no need to do a seperate CoQ10 measurement. The
most important test for mitochondrial health is the organic acids test (OAT).
● Normal: 0.37−2.20 μg/mL

Organic Acids Test (Organix) by Genova Diagnostics

The organic acids test not only looks at mitochondrial function, it also examines how well our bodies are able to
detoxify, B-vitamin status, as well as whether you may have dysbiosis. Dysbiosis is a term that we will talk about in
the gut testing section—it is when the bacteria in your gut are not in balance.

Conclusion
Your mitochondria are crucial for your survival—you literally can’t live without them. However, how well you live, how
much energy you have, how well your cells communicate, and how well your organs function can vary depending on
how well your mitochondria are functioning. So much of the longevity research is deeply intertwined with functions that
rely on mitochondrial health: sirtuin activation, mTOR inhibition, activation of AMPK, telomere length, healthy inflamma-
tion and immune function, and the list goes on. These microscopic organelles hold the key to healthy living, be sure
to take good care of them.

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KEY #4: FEED YOUR BENEFICIAL BUGS

Your microbiome and holobiome include all the beneficial bugs that live in and on you. Your skin is teeming with
them, your gut is loaded with them, every inch of your body is covered in them, in fact, every time you poop, about
half of your waste consists of these organisms.1,2 But this is a very, very good thing.

Your microbiome consists of bacteria, viruses, fungi, and protozoa and as long as these organisms are all in a
particular balance, with the “good” outweighing the “bad” varieties, these little critters are literally what keep you
alive. They all play a crucial role in helping digest and assimilate your foods, keep your immune system healthy and
functioning, protect you from infections, help remove toxins, and even help synthesize essential vitamins. In fact,
scientific research suggests that your mitochondria actually evolved from bacteria.3

These microscopic microbes have many important roles, but one of the most important when it comes to longevity is
preserving your gut lining. Ideally, your digestive system should be a fairly closed, end-to-end system, only allowing
for the needed and necessary nutrients to pass out of the digestive system. The food you eat should travel through
your digestive system, extracting out only the nutrients and leaving everything else to be excreted as waste.

In fact, this is a pretty important function of a healthy digestive system: the abil-
ity to fully digest food, direct and utilize specific nutrients in the bloodstream, Note:
and leave everything else to be discarded. Antibiotics (and all
medications, for that matter)
The only thing that separates your digestive system from your bloodstream is
can be life-saving in certain
the lining of your gut and stomach. This lining acts as a barrier to selectively
allow certain crucial nutrients to pass into your bloodstream through what are situations; I am not anti-
called “tight junctions” but does not allow other things to cross. That’s also antibiotic. I am however,
where the majority of your bacteria are found, and for good reason too. anti-unnecessary or over-used
antibiotics. Unfortunately,
For anyone who’s had food poisoning, after experiencing the extreme dis-
comfort in your stomach caused by the harmful bacteria or virus, you could antibiotics are being used in
imagine how detrimental it would be if that got into your bloodstream. So this many unnecessary situations,
intestinal lining that is teeming with beneficial bacteria with the purpose of for things that should be treated
keeping harmful bacteria, viruses, etc. restricted to the digestive tract is very
using other methods, like acne
important. Unfortunately, there are things in our modern lifestyle and diets that
can destroy our beneficial bacteria and cause our tight junctions to become or illnesses caused by viruses.
not so tight. Antibiotics are prevalent in
conventional meat and dairy
This is a big problem, because damaged tight junctions can allow toxins, systems, which causes them
unwanted substances, harmful bacteria or viruses, or other particles into your
to wind up in our meat, milk,
bloodstream that would otherwise be neutralized and discarded as waste. We
call this “leaky gut.” And not only can harmful bacteria or viruses pass through and water. In addition to
damaged tight junctions, but so can food proteins. When this happens, the destroying our gut microbiome,
immune system, which does not expect to find food proteins in the blood, unnecessary antibiotics are
responds by launching an attack. This can result in a full-blown autoimmune
creating antibiotic-resistant
attack or can trigger allergies or sensitivities which can all lead to widespread,
chronic inflammation. Have you ever suddenly become allergic to a substance strains of bacteria, and that's
you’ve consumed for years? a deadly issue.

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Leaky gut has been associated with nearly every chronic condition: autoimmune diseases, diabetes, inflammatory
bowel disease, multiple sclerosis, asthma, celiac disease, and even common conditions, like acne and rosacea,
headaches, and fatigue.

Things like antibiotics, certain medications, environmental toxins, conventionally raised meats, glyphosate and other
chemical pesticides, antibiotics, sugar, lectins, and certain proteins found in gluten, like zonulin and agglutinin are
all known to damage your tight junctions and can lead to leaky gut.

Also, remember that 70% of your immune system is found in your gut and your gut bacteria make about 90-95%
of the serotonin,4,5 your “feel good” neurotransmitter, in your body. In fact, gut health has been implicated in many
neurological disorders including depression, anxiety, autism, and others, through the gut-brain axis. Poor gut health,
especially leaky gut, can lead to a multitude of unwanted downstream effects.

As much as I’d love to tell you that it’s a “perfect storm” situation that can lead to leaky gut, there’s a fairly straight-for-
ward equation that can lead to this.

LEAKY GUT FORMULA

BACTERIAL + TIGHT JUNCTION = INVITATION FOR

DISRUPTER DESTROYER LEAKY GUT
● Antibiotics ● Gluten (zonulin) Bacterial degradation,
● Nutrient-poor diet ● Alcohol cellular damage, and opening
of tight junctions can allow for
● Sugar ● Agglutinins
unwanted substances to enter
● Fiber-poor diet ● Sugar alcohols the bloodstream
● Not enough prebiotics ● Cortisol
● Certain medications ● Certain medications
● Mono-diet (lack of diversity) ● Nutrient deficiencies
● Stress ● Prolamins
● Saponins
● Gliadin
● Stress

It’s quite likely that leaky gut or bacterial imbalance affects nearly every one of us. But, let’s find out.

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How Beneficial Are Your Bugs?

There are companies out there that make testing your RATING SCALE
gut bacteria easy and something you can do from the
comfort of your own home. However, you don’t have to 0 = Never or almost never have the symptom
purchase a testing kit to know your gut health. There are
some telltale signs that may indicate that your gut could 1 = Occasionally have it, effect is not severe
use some attention. If you are interested in testing, there
are some suggestions in the Want to Dig Deeper? section 2 = Occasionally have it, effect is severe
of this Key.
3 = Frequently have it, effect is not severe

4 = Frequently have it, effect is severe

HOW BENEFICIAL ARE YOUR BUGS? BEFORE: AFTER: DIFFERENCE:

I HAVE IRREGULAR BOWEL MOVEMENTS
(< 1 OR > 4 PER DAY)

I GET BLOATING, GAS, INDIGESTION

I OFTEN GET HEARTBURN FOLLOWING MEALS

I NOTICE GURGLING IN MY STOMACH

I EXPERIENCE STOMACH ACHES AFTER EATING

CERTAIN FOODS
I HAVE SKIN ERUPTIONS, LIKE ACNE, ROSACEA,
ECZEMA, ETC.

I GET HEADACHES

I HAVE FOOD ALLERGIES

I HAVE SEASONAL ALLERGIES

I GET SMELLY GAS

I BURP FREQUENTLY

I OFTEN NEED TO CLEAR MY THROAT

I HAVE BEEN DIAGNOSED OR SUSPECTED TO

HAVE AN AUTOIMMUNE CONDITION

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HOW BENEFICIAL ARE YOUR BUGS? BEFORE: AFTER: DIFFERENCE:

I HAVE A HARD TIME LOSING WEIGHT

I HAVE ACHY JOINTS, STIFFNESS, PUFFINESS

I GET BRAIN FOG OR MEMORY LOSS

I HAVE CRAVINGS FOR SUGARS

I HAVE HORMONE IMBALANCES

I HAVE CHRONIC FATIGUE OR FIBROMYALGIA

I GET MOOD IMBALANCES

TOTAL

KEY
0-20: Your gut is doing great!
21-40: Your microbiome could use some attention—some minor adjustments to your diet and lifestyle can make
improvements here!
41-60: You might be experiencing some level of bad bacterial overgrowth. You’ll definitely want to pay attention to
this key.
61-80: You might be experiencing leaky gut or an underlying condition, make sure you’re working with a doctor or
Functional Medicine practitioner for one-on-one direction and testing.

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Conventional vs. Functional Approach

As we’ve noticed from the other Keys, this one rings true too: conventionally, most doctors tend to ignore or
downplay the importance of gut health. Luckily, as we are starting to see the damage caused by unnecessary use of
antibiotics, doctors are becoming more aware of the importance of your gut health and careful about prescribing
unnecessary antibiotics. Unfortunately, though, most are largely untrained when it comes to identifying and treating
leaky gut and what it takes to support gut health.

In Functional Medicine, we tend to agree with Hippocrates who said, “All diseases begin in the gut.” Many metabolic
and chronic conditions can arise from unhealthy gut microbiomes, so in Functional Medicine, we focus testing
and treatment on making sure your gut is thriving. This means we aim to make sure your gut has more beneficial
microbes than detrimental ones (there will always be some “bad bacteria,” it’s actually a good thing—just as long as
there’s more good than bad). We also want to see that there’s a great variety of different strains of bacteria and that
these bugs are abundant. If any of those qualifications aren’t met, it opens the door for a leaky gut.

Most Functional Medicine practitioners follow a similar protocol, we call it the 5Rs:
● Remove: First, we identify if you have an unbalanced gut microbiome or possibly leaky gut and remove the
overgrowth of bad bacteria as well as the external causes of poor gut health, like toxins, foods that cause
damage, unnecessary antibiotics, etc
● Replace: Next, we add in the good stuff, like a whole-foods, Anti-Aging Pegan diet, and digestive enzymes
to aid in digestion and support your gut.
● Reinoculate: Next, we reinoculate your gut with beneficial bacteria through probiotics, prebiotics, resistant
starches, fiber-filled foods, and fermented foods that your microbes love.
● Repair: Next, once your gut microbiome is thriving, we can focus on healing your gut lining, using things
like L-glutamine, omega-3 fatty acids, and bone broth.
● Rebalance: Finally, the fifth R is all about rebalancing your lifestyle to help your gut stay healthy. This includes
meditation and mindfulness practices, having a life/work balance, and making time to play.

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4-Step Bacteria-Your-Way-to-Longevity Protocol

Here, I lay out four things you can do today to support your gut-health and microbiome. It’s fairly simple: Out with
the bad, in with the good. Whenever you’re making changes to your current regimen, it’s important to pay close
attention to your body. For example, if you start adding in high-fiber foods or supplements and your body responds
with changes like extreme bloating or gas, it might be a sign that you have a type of small-intestinal bacterial
overgrowth (SIBO). If that's the case, you’ll definitely need to work with a doctor to get your bacteria sorted out.

And even if you don’t experience negative symptoms, it’s important to note positive symptoms, like increased
energy, consistent bowel movements, skin improvements, etc. Always celebrate the wins—it keeps you “on-track”
and motivated to keep up healthy lifestyle changes.

Step 1: Identify
Identify if your microbiome is out of balance. You can do this by taking the How Beneficial Are Your Bugs? quiz
from the beginning of this section or by checking out some of the at-home testing listed in the Want to Dig Deeper?
section. It’s best to know, not guess.

Step 2: Include Biome-Builders

Promote a vast and diverse microbial community by including biome-builders, like:
● Fiber. Aim for at least 25 grams of fiber daily from your organic vegetables (not processed grains). Consider
including an additional 10 or more grams of a powdered acacia gum fiber supplement.
● Veggies. Eat an abundance of polyphenol-rich veggies daily. Aim to fill your plate ¾ with non-starchy
veggies for every meal. Try to eat organic whenever possible, or follow the EWG’s Clean Fifteen or Dirty
Dozen produce list.
● Prebiotics. Include plenty of prebiotic foods: Jerusalem artichoke, garlic, onions, leeks, dandelion greens,
jicama, chicory root, asparagus.
● Probiotic foods. Include plenty of probiotic foods: Sauerkraut, kimchi, pickles, fermented soy, unsweetened
yogurt or kefir, miso, natto.
● Probiotic supplements. Take the right probiotic supplement (work with your practitioner to determine
which is right for you): Consider a low or no-histamine probiotic. That means avoiding histamine-creating
strains like Lactobacillus casei, lactobacillus reuteri, lactobacillus delbrueckii (bulgaricus) and taking the neutral
or histamine-blocking strains: Streptococcus thermophilus, lactobacillus rhamnosus, bifidobacterium infantis,
bifidobacterium longum, lactobacillus plantarum
● Digestive enzymes. Add in a digestive enzyme supplement to help properly break down foods while you’re
repairing your gut.
● Bone broth. Include grass-fed bone broth for a gut-healing boost.

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Step 3: Avoid Biome-Busters

If possible, avoid or reduce the things that cause your good bacteria to become unbalanced or damage your gut, like:
● Alcohol
● Sugar
● Gluten
● Glyphosate (eat organic, when possible)
● Non-steroidal anti-inflammatory drugs (NSAIDs)
● Unnecessary antibiotics
● Unnecessary steroids
● Acid blockers

Step 4: Try My Gut Healing Shake

This shake combines prebiotics with polyphenols, a therapeutic combination that is especially effective at supporting
the growth and proliferation of the bacteria Akkermansia muciniphila. Not only does Akkermansia support the health
of the gut by producing a protective mucus layer as well as short chain fatty acids, it may also protect against
metabolic syndrome and improve blood sugar regulation.
● 1 scoop of ImmunoG PRP by NuMedica (this is bovine immunoglobulins aka colostrum)
● 1 scoop of acacia fiber (a prebiotic)
● 1 tablespoon of organic pomegranate concentrate (I use Lakewood organic) or powder
● 1 tablespoon of organic cranberry concentrate (I use Lakewood organic) or powder
● 1 teaspoon of organic matcha green tea powder
● 1 scoop of collagen powder (you can also drink bone broth)
● 1 capsule of MegaSporebiotic (or your favorite high-potency probiotic) Open the capsule to empty the
probiotic powder into your shake.

Blend all ingredients together. Enjoy daily or as directed by your health practitioner.

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Want to Dig Deeper?

Unfortunately, there aren’t many options to test your microbiome that most doctors will run or insurances will cover,
unless you’re experiencing certain symptoms. However, if you do suspect SIBO, your doctor can run a breath
hydrogen test that is pretty accurate and very easy to do.

Your doctor can also run your C-reactive protein test, as mentioned in other Keys, which is helpful because your
body’s inflammation levels can tell you a lot about your gut health. Though, I would not rely on this as the only test
you do when determining your gut health.

There are at-home microbiome tests you can do. Look into Viome as one of the most comprehensive reports.

Functional Testing
Comprehensive Stool Analysis from Genova Diagnostics
Stool samples can tell us not only if we have an imbalance in our gut bugs, but also about the level of inflammation
present in the digestive tract. Many chemical markers in stool can be analyzed to give a picture of the ecosystem.
Markers for acid-alkaline balance, cultures of various bacteria, yeasts, or parasites, and short-chain fatty acid levels
can often pinpoint the sources of inflammation and be linked to many diseases.

Array 2: Intestinal Antigenic Permeability Screen from Cyrex Labs

This test looks for “leaky gut.” Sometimes our gut can become leaky due to chronic inflammation, bacterial
imbalances, and eating the wrong foods for our bodies.

GI Effects from Genova Diagnostics

The GI Effects® Comprehensive Stool Profile is an advanced stool test that provides immediate, actionable clinical
information for the management of gastrointestinal health. Utilizing cutting-edge technologies and biomarkers, this
test offers valuable insight into digestive function, intestinal inflammation, and the intestinal microbiome.

GI Map from Diagnostic Solutions

The GI-MAP (Microbial Assay Plus) is unique in the field of comprehensive stool testing. It relies exclusively on
quantitative polymerase chain reaction (qPCR) technology to detect parasites, bacteria, fungi, and more, by targeting
the specific DNA of the organisms tested.

Conclusion
Your gut is the gateway to your healthspan and longevity. Even if you have the perfect diet and exercise routine, if your
gut health is poor, your health will suffer. By identifying if this is an issue for you, including the biome-builders and
removing the biome-busters, you can support a diverse microbial community. You’ll notice benefits in all areas of your
health, from mental and emotional boosts, physical flexibility, enhanced digestion, and improved energy. You really
can’t go wrong by healing your gut.

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KEY #5: KEEP YOUR CELLS CLEAN

Our bodies are equipped with sophisticated detoxification and cleaning systems. However, the toxic burden in the
21st century is overwhelming our systems with insults from every direction—our bodies can’t keep up. This leads
to illness, shortens our healthspan, and decreases our lifespan. It’s crucial to clean up our cells and keep them
protected.

From the air we breathe, to the water we drink, the products we put in our skin, to the food we eat, the medications
we take, the chemicals in our furniture, carpets, paint (you get the picture), toxins are everywhere. In fact, did you
know that even vegetables take up heavy metals from the soil, which can be stored in your body when you consume
them? Now, I’m absolutely not telling you to avoid vegetables, in fact, the opposite. Vegetables help boost many
of our toxin-clearing capabilities, in addition to the beneficial micronutrients, polyphenols, and phytochemicals that
keep us young. I mention this to impress how overloaded our systems can get.

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Don’t lose hope—there’s a lot you can do to avoid and help your systems detoxify from these insults. The first rule of
thumb is: Avoid toxins when possible. The second rule of thumb is: Don’t stress over small exposures (stressing can
make matters worse). And the third rule of thumb is: Support your detox systems to help clear toxins when exposed.
But first, let’s look at how overloaded (or not) your system currently is.

How’s Your Toxic Burden?

Having excess, unwanted toxins stored in our system RATING SCALE
is detrimental to our health. Toxins are largely stored
in our fat cells, so carrying excess fat goes hand-in- 0 = Never or almost never have the symptom
hand with having excess toxins. Toxins interfere with
our mitochondrial function and cellular integrity and 1 = Occasionally have it, effect is not severe
communication; they muck up our brain, interfere with
our hormones, disrupt our guts, cause our organs to be 2 = Occasionally have it, effect is severe
overloaded, dysfunctional, and more. It’s a big deal. BUT
there’s a lot you can do to help. First, let’s find out where 3 = Frequently have it, effect is not severe
you stand in the realm of toxic-burden.
4 = Frequently have it, effect is severe

HOW’S YOUR TOXIC BURDEN? BEFORE: AFTER: DIFFERENCE:

I GET FREQUENT HEADACHES

I CARRY EXTRA WEIGHT/FAT (NOTE: THIS IS NOT

ABOUT PHYSICAL APPEARANCE—VISCERAL FAT
FOUND AROUND ORGANS OF INDIVIDUALS OF
ANY STATURE, INCLUDING SLIM-APPEARING
INDIVIDUALS, IS JUST AS DANGEROUS AS
SUBCUTANEOUS FAT)

I STRUGGLE WITH BLOOD SUGAR IMBALANCE

I GET HANGRY

I EXPERIENCE DIZZINESS

I EXPERIENCE FATIGUE

I HAVE TROUBLES SLEEPING, FALLING ASLEEP,

OR STAYING ASLEEP
I WAKE FREQUENTLY BETWEEN THE HOURS OF 1
AND 3 AM1,2

I HAVE AMALGAM DENTAL FILLINGS (MERCURY)

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HOW’S YOUR TOXIC BURDEN? BEFORE: AFTER: DIFFERENCE:

I DRINK FROM PLASTIC

I USE TEFLON

I USE PLASTIC STORAGE CONTAINERS

I HAVE NEW CARPET, FURNITURE, OR

MATTRESSES

MY CAR IS NEWER THAN 5 YEARS

I DRINK EXCESS ALCOHOL (>7 DRINKS PER WEEK

OR >3 DRINKS IN A SINGLE SETTING)
I DON’T KNOW WHAT'S IN MY SKIN CARE
PRODUCTS
I HAVE POOR DIGESTION (INCONSISTENT
BOWEL MOVEMENTS, ESPECIALLY
CONSTIPATION, BLOATING, GAS, ETC.)

I USE DEODORANT CONTAINING ALUMINUM

I HAVE SKIN ISSUES (ACNE, ECZEMA, PSORIASIS,

ITCHY OR DRY SKIN, ETC.)
I HAVE SINUS ISSUES (POST-NASAL DRIP, RUNNY
NOSE, FREQUENT SINUS INFECTIONS, ETC.)

TOTAL

KEY
0-20: Your toxic load is low!
２1-40: Your toxic load could use some attention—some minor adjustments to your diet and lifestyle can make
improvements here!
41-60: You might be experiencing some toxic burden or laggy liver/detox organs. You’ll definitely want to pay
attention to this key.
61-80: You might be experiencing toxic overload, liver/detox issues, or an underlying condition. Make sure you’re
working with a doctor or Functional Medicine practitioner for one-on-one direction and testing.

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Conventional vs. Functional Approach

Conventionally, many well-meaning doctors insist that our current detoxification systems are enough to keep us safe.
And while our systems are sophisticated and well-functioning, they are not far enough evolved to protect us fully
from the toxic burdens we encounter from every direction. These systems functioned really well in the time of our
ancestors when the invention of man-made chemicals and toxins were nowhere to be found. But unfortunately for
us, evolution is much slower than the on-going advancements that continue to increase our toxic burden.

Luckily, running a liver and kidney panel is fairly easy and readily prescribed by conventional doctors, and this can
be helpful in determining your current detoxification capacity.

Functionally, we take toxic exposure very seriously. We have testing methods to determine your level of heavy
metals, liver function, mold exposure, and toxic capacity. It’s important to understand how toxic the body is, what
kind of toxins you’re dealing with, and where those toxins are stored. Then we can follow a protocol to remove these
toxins first from your cells, and then from your body. This two-step process is important because if you skip either
step, you’re left with toxins in your cells or circulating throughout your body.

Here’s the basic approach I take to handling toxins:

● Identify and remove toxic inputs. I listed the primary forms of toxic exposure above and in the next
section, 3 Focus Areas to Make Your Life Less Toxic. Reducing your exposures is absolutely essential if you
want to rebalance your detox system.
● Fix your gut. Gut imbalances are a key source of toxins for many. I talked all about this in Key #4.
● Get moving. This helps your blood and lymphatic circulation do its job, essential for getting toxins out of
your body. I talk about this more in Key #6.
● Get your liver and detox system working. If your detoxification system isn’t working properly, this is a
serious problem and needs to be addressed.
● Detox your mind, heart, and spirit. This is just as important as detoxing your body, and it’s an area few of
us ever think about as a source of toxins. I talk more about this in Key #7.

In the next section, I lay out my top focus areas for supporting your detoxification systems.

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3 Focus Areas to Make Your Life Less Toxic

This topic can feel daunting. When we look at all the places we find toxins, it can feel overwhelming to make
changes to reduce this load. I want to emphasize that every little bit helps. If you can switch out a single thing
each week or month, it will add up. And the more small steps you take to reduce the toxins in your life, the less
overwhelming it will feel. Just take it one day and one item at a time and stick to it.

Note:
If you suspect a serious toxic burden, I highly recommend that you work
with a practitioner to help detoxify your body. This can be a complicated
process and certain side-effects sometimes occur, so it is best to work
with someone for a personalized protocol. You can work with my team
at The UltraWellness Center or find a Functional Medicine practitioner
near you.

Focus Area 1—Identify and Remove Toxic Inputs

POTENTIAL TOXIC
WHAT’S THE PROBLEM? WHY? BETTER ALTERNATIVE
SOURCES

Personal Care Products ● Triclosan These chemicals ● Use the Environmental

including: ● Fragrance are associated with Working Group’s
Shampoo allergies, reproductive Skindeep App to
Retinyl palmitate/retinol
●
●
concerns, interference help identify problem
● Conditioner ● Formaldehyde/formalin with hormones, ingredients and safer
Soap and body wash toxic accumulation, alternatives.
Toluene
●
●
microbiome imbalances, Stick with plant-based
● Deodorant Dibutyl phthalate (DBP)
●
●
and others. Much of products
● Face cream and ● PEG what you put on your
moisturizer skin absorbs into your ● Aim for organic
● Polyethylene bloodstream and makes
● Sunscreen ● Find non-nano barrier
● Parabens its way to your organs in sunscreen (zinc oxide)
● Lotion a matter of seconds—
● DMDM hydantoin ● Use non-aluminum
● Shaving cream and the additive effect
Oxybenzone deodorant (like Native
Feminine hygiene
●
of these chemicals is
●
brand)
products ● Diazolidinyl urea/ potentially deadly.3
imidazolidinyl urea ● Look for brands
● Hair styling products with Vegan, Cruelty-
● Ceteareth free, and Organic
● Makeup
● Aluminum certifications

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Focus Area 1—Identify and Remove Toxic Inputs (cont.)

POTENTIAL TOXIC
WHAT’S THE PROBLEM? WHY? BETTER ALTERNATIVE
SOURCES

Dental Amalgams Mercury Mercury amalgams Find a biological dentist

“silver fillings” (extremely in your area to see if
popular to fill cavities) your amalgams should be
can cause mercury removed
vapors to be released https://iabdm.org/
during chewing. At
high levels, mercury
can damage your
brain, kidneys, or
more. Mercury can be
neurotoxic

Plastics, including: ● Bisphenol A (BPA) BPA can leach into ● Glass

● Water bottles ● Bisphenol S (BPS) the things it touches. ● Stainless steel
This is made worse by
● Baby bottles ● Bisphenol F (BPF) duration and extreme ● Solid wood
● Baby pacifiers temperatures, like ● Sustainably-sourced
freezing food in a plastic and made bamboo
● Aluminum can liners
container, or heating in
Cash register receipts
● Medical-grade silicone
●
the microwave. BPA is an
● Plastic toys endocrine disruptor by ● Rubber
mimicking hormones. This
● Epoxy paint and can cause a multitude of
coatings reproductive issues, cell
damage, development,
and behavior to only
name a few. BPS and BPF
(often found in “BPA-
free” plastics) have also
been shown to have
just as much endocrine-
disrupting effects.4

Non-stick Cookware ● Teflon These man-made ● Stainless steel

● Perfluorooctanoic Acid chemicals can leach into ● Pure ceramic
(PFOA) your foods and remain in
your body for a very long
● Polyfluoroalkyl time. They have been
substances (PFAS) associated with certain
cancers, disruption in
hormones, and fetal
development.5

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Focus Area 1—Identify and Remove Toxic Inputs (cont.)

POTENTIAL TOXIC
WHAT’S THE PROBLEM? WHY? BETTER ALTERNATIVE
SOURCES

Chemicals Found In Your ● Volatile Organic These chemicals leach ● Look for items labeled
Home, includes: Compounds (VOCs) into your air and dust and Low- or No-VOC
● Mattresses including: circulate indoors. They ● Use wool as a natural
Polyurethane or have been associated flame retardant material
● New furniture ●

with lower IQ, cancers,

polyester in crib in crib mattresses
● New car mattresses hyperactivity, impaired
memory, endocrine ● Find used furniture that
● New carpets Organohalogen have off-gassed much
●
disruption, low-weight
● Infant car seats flame retardants babies, headaches, of their chemicals
● Paint (halogenated) in toys, fatigue, respiratory ● Use an air filter
mattresses, furniture irritation, among others.6,7
● Toxic mold ● Find non-toxic
● Polybrominated mattresses
● These can circulate diphenyl ethers flame
causing your air to retardants (PBDEs)
become toxic as well

Non-organic Food ● Heavy metals Studies show that Opt for organic when
● Pesticides, like non-organic foods possible. If not possible,
glyphosate (including conventionally follow EWG’s Clean
raised meats) have Fifteen:
● Antibiotics higher levels of toxins, ● Avocado
● Synthetic hormones chemicals, artificial ● Sweet Corn
hormones, antibiotics, (try to find non-GMO)
and heavy metals. ● Pineapple
● Onion
● Papaya
● Sweet peas
● Eggplant
● Asparagus
● Cauliflower
● Cantaloupe
● Broccoli
● Mushrooms
● Cabbage
● Honeydew melon
● Kiwi
And avoid the
Dirty Dozen
(find these organic only):
● Strawberries ● Spinach
● Kale ● Nectarines
● Apples ● Grapes
● Peaches ● Cherries
● Pears ● Tomatoes
● Celery ● Potatoes
● Hot peppers

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Focus Area 2—Treat Heavy Metal and Toxic Burden

The idea here is to move stored toxins out of the fat cells and then get them out of your body. As you may already
be quite familiar, there are only a few ways things can exit your body: poop, pee, sweat, and breath. So, this focus
area is all about how to move toxins from your fat cells to your liquid, solid, or gas waste.

1. Exercise Often
a. It’s been shown that exercise and movement can help increase lipolysis, the breakdown of fat cells,
which can help release stored toxins.8

2. Sweat Via Exercise or Sauna Daily

a. Sweating through exercise or sauna use also helps with moving those toxins from your fat cells
out of your body.
b. Your skin is your largest elimination organ, the more you sweat, the more detox ability you have.9,10,11

3. Have Consistent Bowel Movements

a. If you’re not pooping frequently, you’re not releasing toxins. In fact, you’re likely making it worse—
your poop is quite toxic by itself, and when it’s stuck in your colon, those toxins can reabsorb.
No good!
b. Eat plenty of fiber through consuming 2 servings of non-starchy vegetables with every meal, adding
a tablespoon or two of flax or chia seeds daily, and/or adding in a powdered fiber supplement, like
my favorite acacia fiber.
c. To help ensure you’re having regular bowel movements, make sure to incorporate daily movement,
drink plenty of water (discussed next), and consider taking Natural Calm, a gentle magnesium
supplement that can help encourage consistency.

4. Drink Adequate Water

a. Drinking water helps to flush toxins out of your kidneys. It also
helps with encouraging regular bowel movements. I encourage Note:
you to aim to drink at least ½ your body weight (pounds) in Chelators are also very effective
ounces daily. at removing toxins and heavy
b. If you weigh 170 pounds, try to drink a minimum of 85 ounces of metals. However, I do not
water each day. Increase to 1 ounce per pound body weight if recommend doing this on
you sweat often.
your own. It is important to
c. Don’t forget electrolytes to keep your cells appropriately hydrated.
work with a physician if you
My favorite is E-Lyte—add a capful
to each glass of water and drink throughout the day. are wanting to use chelation
therapy.
5. Help Bind Toxins Using Natural Binders
a. Activated Charcoal: This has been found to bind to heavy metals
and other toxins making it easier to remove them from your
body.12,13 (Note: activated charcoal can bind to nutrients as well,
so try to take them away from your meals and supplements.)
b. Chlorella: This is a type of single-celled algae found to not only help
bind and rid toxins, but also can help support gut and immune health.

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Focus Area 3—Support Your Natural Detoxification Systems

There’s so much you can do to support your natural detoxification systems. Here’s a simple list:

a. Focus on a Whole Foods Diet.14

i. Try to eat organic when possible. If not possible, try to stick with the EWG’s Clean Fifteen and
Dirty Dozen lists.
ii. Incorporate tons of fiber-rich, prebiotic, cruciferous veggies, including: broccoli, cauliflower, cabbage,
Brussels sprouts, bok choy, broccoli sprouts,15 spinach, and dandelion greens, among other veggies.
iii. Use lemon, which is great to protect the liver.16 Sometimes, I’ll start my day with a giant glass of fresh-
squeezed lemon water.
iv. Green tea is loaded with antioxidants and helps boost production of detoxification enzymes.17
v. Garlic, turmeric, and herbs like cilantro, parsley, basil, and others help enhance detoxification and
protect DNA from damage;18,19 and they make your food taste delicious!
vi. Beets and berries, especially blueberries, are loaded with antioxidants and powerful toxin-fighting
polyphenols.20

b. Try Supplements
i. Glutathione is our body’s master detoxifier and antioxidant. It helps protect cells, support the immune
system, and removes toxins from the body.
1. In some cases, IV glutathione therapy may be needed. Ask your doctor if IV glutathione
is right for you.
ii. N-acetyl-l-cysteine (NAC) is a powerful free radical scavenger and supports tissue levels of glutathione.
iii. Alpha lipoic acid (ALA) is an antioxidant that helps support liver function and energy production in the
muscles.
iv. Selenium is required for synthesis of glutathione. It can be found in foods like Brazil nuts and meats,
but this is an excellent supplement that incorporates selenium with ALA and NAC.
v. Zinc is crucial to support the body’s defense and immune system.

Note:
A note about toxic inputs: I recommend switching out your products as you run out.
Almost out of your shampoo and conditioner? Replace them with an organic product.
Do you have a plastic container that is stained and falling apart? Replace it with glass.
Use the Environmental Working Group as a helpful resource for finding cleaner products.

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Want to Dig Deeper?

Conventional Testing
Aspartate aminotransferase (AST): This is a blood test liver function test that can indicate if there is liver
damage occurring.
● Normal: 0–40 IU/L ● Optimal: 0–25 IU/L

Alanine aminotransferase (ALT): This is a blood liver function test that can indicate if there is liver damage occurring.
● Normal: 1–44 IU/L ● Optimal: 1–26 IU/L

Gamma-glutamyl transpeptidase (GGT): This is a blood test liver function test that is specific for toxin exposure
and for fatty liver. This value can be elevated in people with diabesity, drug exposures, excess alcohol intake, and
for many other reasons.
● Normal: 1–65 IU/L ● Optimal: 1–29 IU/L

Functional Testing
Oxidative Stress Analysis
This test is used to identify oxidative stress markers, antioxidant reserves, glutathione, and glutathione peroxidase levels.

Organic Acids Test (Organix) by Genova Diagnostics

The organic acids test looks at how well your body is able to detoxify. It measures specific compounds including
sulfates, pyroglutamate, and orotate and can identify a problem with your detox pathways or if you're exposed to toxins.

Mycotoxin test by RealTime Laboratories

Another cause for inflammation and immune system disturbances is toxic mold sometimes found in older
buildings and homes.

Urine Toxic Metals by Doctor’s Data

The Toxic Metals urine test is used to easily and accurately identify levels of heavy metals.

Mercury TriTest by QuickSilver

This test measures both organic mercury from fish, also known as methylmercury, which is mostly what you find in
your blood, as well as inorganic mercury which comes from dental fillings or pollution.

Conclusion
While it’s true that toxic exposures are unavoidable and overwhelm our natural detoxification systems, it’s also true
that there’s a lot we can do to reduce our toxic exposures and boost our detox systems. By making small changes and
modifications, little steps can add up. It’s impossible to be completely toxin-free, but we can work to limit incoming
insults and help fortify our body for those inevitable invaders.

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KEY #6: PROTECT YOUR VEHICLE

I think most people can agree that our physical bodies are awfully important to our existence and longevity. And for
the most part, the body you’re given is the only one you get, so it’s important to take care of your vehicle—the thing
that transports your vital organs and houses everything that makes you, you.

So how does science say you protect your vehicle? It should come as no surprise that there’s three main factors that
play a significant role in physical health—diet, mindset, and movement. So let’s look at the research.

Diet
The most well documented correlations between diet and longevity, health, Note:
and disease prevention come from the Mediterranean diet, which focuses Almost all nutritional and
on healthy fats like olive oil, whole grains, legumes, and low protein. The dietary research is based on
ketogenic diet (which is heavy in fats, moderate in protein, and low in carbo-
cohort observational studies
hydrates), Paleo diet (high in protein, moderate in fats, low in carbohydrates),
and vegan/vegetarian diets (heavily reducing or eliminating meat and animal and few-to-no long-term,
products) have also been studied. randomized placebo-controlled
trials—the gold standard
The Mediterranean diet has shown correlations with increased lifespan and
for scientific research. The
healthspan,1,2 but so have the ketogenic diet,3,4,5 the Paleo diet,6 and the veg-
an/vegetarian diet,7 though not as well-studied. So, I took the best parts of reason for this is that it is
all of those diets, the parts with the strongest scientific research, and created quite difficult to force a large
what I light-heartedly refer to as the “Pegan” (Paleo+vegan) diet. This means group of individuals to follow
eating plant-rich, nutrient-dense, whole foods with plenty of healthy fats, quality
specific dietary guidelines
protein, and as many polyphenols as your stomach can hold.
for an extended period of
I’ve followed the Pegan diet for years and recommend it to many of my pa- time and trust that they
tients, friends, and loved ones. I’ve done the research and compiled it into my follow it strictly. So, we are
book, Food: What the Heck Should I Eat? and shown what a delicious way of left with many observational
eating it is in my follow-up cookbook, Food: What the Heck Should I Cook?
studies. To give an idea of
(Then, I expanded on the importance of our food system in my book Food
Fix.) Keep your eyes out for my new book, Pegan Diet, coming out February observational studies, it’s
2021 for an even more extensive breakdown of the Pegan diet. I believe an largely a questionnaire
individualized approach to diet and longevity is important for everyone, and that people respond to
I also believe that the Pegan diet is a very good starting point. I talk all about
periodically. This works well
the details of this diet in my 30 Days to Aging Backwards Plan. Stay tuned.
to gather information over
Mindset longer periods of time for
I talk all about spiritual health in Key #7, but it worth mentioning here that larger groups of people. The
part of protecting your vehicle includes your mindset, and you simply cannot downside is recollection-style
ignore it. Focusing on negativity has been shown to shorten lifespan,8 whereas data collection is proven quite
being psychologically well, practicing stress-management, and nourishing your
unreliable and subjective. Do
spirit has shown to increase telomere length, lifespan, and most importantly,
healthspan.9,10 you remember what you ate 2
months ago? It’s all to say that
studies surrounding diet should
all be taken with a grain of salt.

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Movement
When it comes to exercise, it’s hard to dispute the evidence. Countless high-quality research has shown the benefits
of exercise on every facet of health and longevity.

Exercise has a direct correlation with improving heart and cardiovascular health, decreasing the risk of heart dis-
ease, and improving outcomes of those with heart disease.11,12,13

Exercise has been shown in preventing certain types of cancer, improving outcomes during treatment, and also
preventing recurrence of cancer.14,15

It has been shown extremely beneficial in treating diabetes, helping to stabilize blood sugars, improving outcomes
and management of diabetes, improving inflammation, and improving insulin-sensitivity.16,17,18,19,20

Exercise helps in supporting a healthy and diverse microbiome,21,22 reducing chronic inflammation,23 supporting
mitochondrial health and biogenesis,24,25 helping balance hormones,26,27 keeping your body strong as you age,28,29
and increasing overall happiness and satisfaction with life.30,31,32 It can improve every aspect of life.

And the research is just as compelling when we talk about longevity pathways specifically. Exercise has been shown
to protect your telomeres33,34,35 and has been associated with increased telomere length, helps mediate metabolic
effects of AMPK,36,37 activates sirtuins,38 and improves longevity and healthspan overall.39,40,41

The science is there. Want to live to be 120? Improve your healthspan? Reduce your risk for chronic diseases?
Or simply feel better or happier? All of the above? Move.

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Does Your Vehicle Need a Tune-Up?

Can you physically do everything that you’d like to do? RATING SCALE
That’s the main question here. If you wanted to go play
tennis or hike a mountain or go ice skating, could you? 0 = Never or almost never have the symptom
Protecting your vehicle means taking care of your body
so that you can do the things you truly want to do, even 1 = Occasionally have it, effect is not severe
as you age. So, let's take your vehicle in for a check-up.
2 = Occasionally have it, effect is severe

3 = Frequently have it, effect is not severe

4 = Frequently have it, effect is severe

DOES YOUR VEHICLE NEED A TUNE-UP? BEFORE: AFTER: DIFFERENCE:

I HAVE A HARD TIME SWITCHING POSITIONS
(GOING FROM SITTING TO STANDING OR VICE
VERSA)
I CANNOT STAND FROM A SEATED POSITION ON
THE FLOOR WITHOUT ASSISTANCE
JOINT PAIN INHIBITS ME FROM DOING PHYSICAL
MOVEMENTS

I EXPERIENCE PHYSICAL LIMITATIONS

THERE ARE THINGS I’D LIKE TO DO, BUT

PHYSICALLY CAN’T

I GET OUT OF BREATH EASILY

I HAVE BEEN DIAGNOSED WITH DIABETES OR

PREDIABETES

I SIT FOR MOST OF THE DAY

I HAVE BEEN DIAGNOSED WITH OSTEOPENIA,

SARCOPENIA, OR OSTEOPOROSIS
I NOTICE GASTROINTESTINAL UPSET AFTER
EATING CERTAIN FOODS

I CONSUME FOODS CONTAINING ARTIFICIAL

SWEETENERS OR ARTIFICIAL INGREDIENTS

I CONSUME PROCESSED CARBOHYDRATES

(FOODS OFTEN FOUND IN BOXES OR BAGS:
CEREALS, PASTAS, RAMEN, POP TARTS, ETC.)

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DOES YOUR VEHICLE NEED A TUNE-UP? BEFORE: AFTER: DIFFERENCE:

I FEEL LIKE MY WEIGHT INHIBITS ME FROM
DOING THINGS I’D LIKE TO DO

I FEEL LONELY

MY FEELINGS OF DEPRESSION OR SADNESS ARE

HEAVY

MY INNER-THOUGHTS TEND TO BE NEGATIVE

I AM OVERLY HARD ON MYSELF

I FEEL ANXIETY OR DEPRESSION IN PHYSICAL

LOCATIONS, LIKE MY STOMACH OR HEART

I HAVE ELEVATED BLOOD PRESSURE

I HAVE ADDICTIVE HABITS (I.E. SMOKING,

ALCOHOL USE, SOCIAL MEDIA OVERUSE, ETC.)

TOTAL

KEY
0-20: Your vehicle is functioning well!
21-40: Your physical body could use some attention—some minor adjustments to your diet and lifestyle can make
improvements here!
41-60: You might be experiencing some physical limitations that are keeping you from truly enjoying life. You’ll
definitely want to pay attention to this key.
61-80: You might be experiencing some serious physical limitations or an underlying condition, make sure you’re
working with a doctor or Functional Medicine practitioner for one-on-one direction and testing.

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Conventional vs. Functional Approach

Conventionally, there are a lot of ways to test your body, your bone strength, adipose tissue around your organs
(called visceral fat), your muscle score, cardiovascular function, and others. This is helpful to give you an idea of
where you stand physically, as far as testing is concerned.

Functionally, we do a full body assessment as part of our standard office visits. Many practitioners will watch you
walk, assess your posture, your gait, and your emotional state. We look at your skin texture, nail health, eye clarity,
even your tongue. Often, poor health is reflected outwardly, we just tend to ignore it most of the time. For example,
have you ever noticed vertical lines in your toe or fingernails? Or what about ridges along the edges of your
tongue? These can be signs of certain conditions that most conventional doctors ignore.

Functional doctors also deeply assess your diet, ensuring that you are eating in a way that supports health and
longevity. If you have a prior diagnosis, we will also assess how food can play a role in treatment. We do a deep
dive into every symptom you might be feeling and ask you to pay close attention to when you experience symptoms
and the foods you ate around that time.

Functional Medicine doctors also look into your spiritual health. We understand that if you’re feeling lonely, lost, or
hopeless, you’re very unlikely to find optimal health. Your mind is very powerful and we take the time to assess how
your mindset is helping or hurting your body.

And, of course, we also take the time to educate about how to make improvements to your movement, your diet,
and your mental health.

How to Move Youthfully at Any Age

For this Key, I’m going to focus on things you can incorporate into your daily routine to add more movement. I think I
made my point pretty clear that exercise is an absolute non-negotiable if you want to feel better, age slower, lengthen
your lifespan, prevent disease, and increase your healthspan. So, why is it so hard to stick with an exercise regimen?

I have a few ideas about this: I think for some people who don’t currently have a routine, it can feel overwhelming
thinking of going from 0 days of exercise per week to 5. I get it, that feels overwhelming. I also know, as a person
with a very, very full calendar, the idea of adding one more thing can also feel overwhelming. Some people might
not know where to start or maybe have tried a gym routine in the past but hadn’t noticed a “difference.” Whatever
your reason, I wanted to create this plan to make it impossible not to succeed. I am bringing in some advice from
some experts in the field of making habits stick, Jim Kwik, author of Limitless and BJ Fogg, author of Tiny Habits.

I’m also making two movement plans: one, called the Will-Do Movement Plan, for someone who currently does
not have an exercise routine and one, called the Move More Movement Plan, for someone who does but wants to
maximize their results and exercise intentionally for longevity and healthspan.

Will-Do Movement Plan

The Will-Do Movement Plan is for you if you don’t currently have an exercise routine or struggle to maintain a
consistent schedule. This is a 3-step plan that might sound overly simplistic. And it is, but that’s the point. I don’t
mention the gym, how many days to exercise, how long to lift weights, or anything that might sound too big if you’re
currently overwhelmed or don’t know where to start. But it is important that you start. So let’s decide today to follow
my 3-step movement plan.

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Step 1—Make Up Your Mind

Decide. Today, decide that no matter what, you are going to start a movement
routine. Write it down, tell your friends and family, and ask them to hold you
accountable. If your mind is wishy-washy about something, your actions will be, too.

If it helps you, write out sticky notes with your commitment

and list why it’s important for you to make these changes
and post them everywhere. Are you deciding to focus
on your physical health because you want to play
with your grand and great-grandchildren as long
as possible? To reverse a diagnosis? To become
stronger? To run a marathon? To live longer and
better? To prove that you can? Whatever the reason,
write it down and remember it daily.

Step 2—Commit to the Smallest Step Possible and Stick to It

My good friend Jim Kwik says, “Ask yourself: What is the smallest thing I could do today to achieve progress towards
my goal?” For example, if your goal is to read a book every month, the very smallest step might be committing to
reading one word every day. Make it something so easy, simple, and doable that there’s no way you CAN’T do it.

Want to go to the gym? Commit only to putting on your exercise shoes. That’s it. You
can do that right? Want to wake up early to go for a walk? Commit to set your alarm
clock, and that’s it. Want to start riding your bike after work? Commit to putting on
your helmet, and that’s it. And do it. Do those easiest, most simple commitments, and
celebrate when you do (check out Step 3 for more on celebrating yourself).

Why am I asking you to commit to doing next-to-nothing? Because the likelihood that
you stop at that one thing is very low. If you can find the motivation to read one single
word in your book, it’s extremely likely that you’ll keep reading. One sentence, one
page, one chapter. But here’s the kicker. If you commit to something small and that’s all
you do—great! You did it! Did you commit to put your shoes on and you put them on and took them right back off?
That’s awesome! Don’t beat yourself up; you literally made progress towards your big goal. Do it again tomorrow,
and the next day, and the next. So, focus on the easiest and most simple step you can take toward your goal, do it,
and then celebrate.

Step 3—Celebrate EVERY Accomplishment

As motivation researcher BJ Fogg puts it, “When you do a behavior and feel a positive emotion about it, your brain
pays attention. It essentially thinks, ‘Wow, that felt good. I want to do that behavior again!’ ...Emotion creates habit.”

I know it can seem silly to celebrate yourself, especially if it’s something “small.” But I want you to think about how
we teach children how to walk, to talk, to use the potty. We celebrate-the-heck out of everything they do towards
that goal. I mean, we parents freak out with excitement for them. (My children are long-grown now, but I remember
screaming, “You pooped in the potty!” like it was yesterday.)

They love it, we love it, and they have an amazing time reaching a major milestone. There is absolutely no reason
why you shouldn’t approach yourself with the same grace, patience, and support as you do with a small child.

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The more you celebrate wins, the more you fall in love with the process, the more likely you are to work harder, and
the more satisfied you’ll be overall. Why? Because it feels good to be proud of yourself.

That’s how you get started. You make it easy, impossible to fail, and fun. You remind yourself why it’s so important
to you and celebrate yourself every day.

So what do I want you to do for the Will-Do Movement Plan?

1. Decide.
2. Commit to something so small you can’t not do it. And do it.
3. Celebrate every action.

Move More Movement Plan

The Move More Movement Plan is for you if you currently have an exercise routine
or gym membership and are wanting to structure your daily routine to emphasize
longevity and healthspan. As with the Will-Do Movement Plan, make sure to mind
your mind. Commit to continuing your routine and taking it to the next level. Buy
yourself a sticky note pad, write down your goals, post them everywhere.

And as with the Will-Do Movement Plan, make sure

you celebrate every accomplishment. Even if
you’ve been keeping up an exercise routine for years,
the more fun and joy you experience, the younger
you look and feel, so let’s take it up a notch and get
moving!

Step 1—Basic Exercise Structure

Aim for a 7 to 10 minute HIIT routine Mondays, Wednesdays, and Fridays. I love
Seven, the 7-Minute App you can do from home or a gym.

Aim for a 30 to 60 minute resistance training session on Tuesdays, Thursdays, and Saturdays. Consider a routine,
like this one from our team’s fitness coach, Adam Cobb, or Pure Barre, a full body barre workout.

Step 2—Make It Fun

Instead of a gym workout, or in addition to, pick up a movement-based activity. The more fun, the better.
● Join a softball league.
● Register for a Color Run, Tough Mudder, or Insane Inflatable 5k. Bring friends.
● Join a regular dance class. (Build your relationship by taking a ballroom class with your partner.)
● Do a community sunrise yoga class.
● Commit to a long-term challenge, like the 52 trail challenge, where you commit to hike a new trail each week
of the year. Bring friends.
● Play an instrument? Join or form a band and practice regularly.
● Pick up hockey.
● Try rollerblading.

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● Buy a trampoline.
● Go for a swim or walk against the flow in a lazy river.
● Join a Ninja Gym.

Step 3—Take It Up a Notch

Incorporate movement all throughout your day. Some examples:
● First thing in the morning, aim to go for a 15 to 20-minute walk outside.
● Always take the stairs.
● Find a coffee shop that is walking distance from your office and visit daily.
● Take a “stairs” break at work—If you need a mental break, instead of skimming social media, try walking or
jogging up and down a few flights of stairs.
● Get a standing desk.
● Get a walking desk.
● Get an under-desk elliptical.
● Have walking meetings, whether in person or via tele-or video conferencing.
● Take a bike ride after work.
● Walk around the block during your lunch hour.
● Take advantage of your workplace’s wellness incentive program (if yours doesn’t have one, volunteer to start
one). Challenge a coworker to join you in the program.

Want to Dig Deeper?

There are a ton of super useful tests that your doctor can run to help give an idea of your physical health. Most or
all are covered by insurance, so I highly recommend getting a full work-up.

Conventional Testing
DEXA scan: The dual energy X-ray absorptiometry (DEXA) scan is a type of x-ray that can determine your bone
density.

Heart Rate: This shows how fast your heart is working and is a reflection of your cardiovascular health and
stress. Your heart rate can also tell you about your thyroid health: a low or high heart rate may be reflecting an
underactive (slow heart rate), or overactive (fast heart rate) thyroid gland.
● Normal: 60-100 beats per minute
● Optimal: 60-80 beats per minute

Blood Pressure: Your blood pressure is the resistance your heart is pumping against. You want it low enough so
it doesn’t damage your vessels, but high enough that it can get blood to your brain and limbs.
● Normal: less than 130/80
● Optimal: 110/60-129/79

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Functional Testing
Heart Rate Variability (HRV): This reflects the complexity of your heart rate and the health of your autonomic
nervous system, which controls all the subconscious processes of your body such as digestion, heart rate,
breathing, etc. It’s healthy to have a lot of variability in your heart rate. In other words, ideally, your heart rate isn’t
a steady 72, but instead is 69, 71, 68 ½, 73, and so on. It varies from beat to beat. Your doctor may not run this,
but you can find apps that work with your tracking device that can help track HRV.
● Ideal: high HRV

Waist-to-Hip Ratio: This is a better measure of metabolic risk factor (i.e. your risk of cardiovascular disease,
diabetes, etc.) compared to weight or body mass index (BMI) alone. Your waist-to-hip ratio tells us more about
your body composition—how much of your body is fat versus muscle/water.

How to:
● Measure your waist:
– Measure midway between the last rib you can feel and the top of the iliac crest (the topmost bony ridge of
your hips). This is roughly where your belly button is.
● Measure your hips:
– Measure the widest part of your hips a few inches below where your belt goes (these bony protuberances
of the thigh bone are known as the greater trochanters)
● Divide your waist measurement by your hip measurement:
– waist/hip= waist to hip ratio
● Optimal Women: <0.8
● Optimal Men: <0.9

Conclusion
Take care of your body and it will take care of you. It’s hardly worth trying to increase your lifespan if you are physically
tired and weak. By starting now, no matter your age, increasing your movement can significantly improve your health
today and sets the stage for a healthier, more active tomorrow. Whether it’s through sports, resistance and strength
training, play, or hobbies, any type and amount of movement is beneficial. Start small, but never stop.

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KEY #7: NOURISH YOUR SPIRIT

I think we are programmed to brush off the idea of taking care of our spirit and mental health. Our fast-paced
society, our full calendars, our many extracurricular activities, building careers, raising families, taking work home,
etc. has made self-care and mental status low priority. However, I’m here to tell you that you cannot live a healthy,
happy, fulfilled life while neglecting to nourish your mind and spirit.

This looks different to everyone, and I’m not necessarily talking about religious beliefs. Nourishing your spirit
includes focusing on uplifting thoughts, believing in your own worth, valuing yourself and others, prioritizing self-
care, cultivating community and meaningful relationships, practicing healthy stress management techniques, finding
support, and practicing religion or spirituality if that speaks to you.

Nourishing your own spirit is especially tough for the natural givers—those that dedicate their lives to helping
others. It is not second nature to think of taking care of themselves, but it’s just like the flight attendants remind us on
every flight: In an event where the cabin loses pressure, you must put the oxygen mask on yourself before helping
someone else with their oxygen mask. Why? Because if the oxygen saturation on the plane gets too low and you’re
not equipped, you’ll lose consciousness and really won’t be able to help others. The best, and only sustainable way
to help others, is to prioritize your own spirit. By making sure your own cup is filled, you’ll be able to fill others’
cups, tenfold, than if you're continually running on empty.

Spiritual health isn’t “woo-woo,” either. There is a ton of empirical research that indicates self-care, mindset, and
community help improve all factors of health and longevity.

It’s been shown that practicing self-compassion can significantly help people improve their health behaviors, like
quitting smoking, exercising, eating healthier/overcoming eating disorders, practicing self-care, and overall well-
being.1,2 Self-compassion is also associated with improving physical symptoms,3 mental health, outcomes, and
glycemic control in patients with diabetes,4,5 and resiliency against certain cancers as well as improved mental health
in those with cancer.6

Social connections, community, and strong relationships have been associated with increased lifespan, improved
mental health, and improved physical markers like blood pressure, waist circumference, body mass index, and
inflammation.7 Social relationships are shown to improve health and longevity,8 help mitigate the negative effects of
aging,9 and help you to live longer.10

Mindset, another feature of spiritual health, is also scientifically important. Research shows that people who ruminate
over repetitive negative thoughts tend to have decreased lifespans and poorer physical and mental health,11,12 and
that those who focus on positive thoughts and future goals and rewards have better well-being and physical health.13

Having a sense of purpose is associated with overall well-being, improved physical and cognitive health, reduced
depressive symptoms, and slower aging.14

In fact, psychological wellbeing is even associated with increased telomere length and slower telomere attrition15
whereas chronic stress is associated with decreased telomere length, accelerated cellular aging, and increased
oxidative stress.16

So, taking care of yourself, practicing self-love and self-compassion, working on a growth mindset, building
relationships and community, and having a sense of purpose are not only “not woo-woo,” but are crucial to living
a fulfilling, long, healthy life.

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How’s Your Spirit?

Are you feeling empty? Like you’ve given all you can RATING SCALE
give? Are you envisioning negative future events and/or
ruminating on the past? Are you feeling lonely regardless 0 = Never or almost never have the symptom
of if you’re around a lot of people or not? Or, are you
hopeful for the future? Building lasting relationships, 1 = Occasionally have it, effect is not severe
sharing in life’s joys and creating memories with others?
Do you feel worthy? Nourishing your spirit is more than 2 = Occasionally have it, effect is severe
yoga and meditation, it’s knowing that you’re worthy, worth
it, and important. Let’s find out how burdened your spirit 3 = Frequently have it, effect is not severe
is so we can work to introduce freedom.
4 = Frequently have it, effect is severe

HOW’S YOUR SPIRIT? BEFORE: AFTER: DIFFERENCE:

I FEEL HOPELESS ABOUT THE FUTURE

I FEEL LIKE I HAVE NO CONTROL OVER WHAT

HAPPENS IN MY LIFE
I FEEL LIKE DISEASE AND AGING ARE PART OF
GROWING OLD
I FEEL SADDENED OR DEPRESSED AT THE
THOUGHT OF GROWING OLDER
I DON’T HAVE TRUSTED FRIEND(S) THAT I CAN
TURN TO FOR ADVICE AND SUPPORT

I DON’T FEEL SUPPORTED

I DON’T KNOW MY PURPOSE IN LIFE

I CONSTANTLY WORRY ABOUT THINGS BEYOND

MY CONTROL
MY EMOTIONAL FEELINGS HAVE PHYSICAL PAIN
AND/OR MANIFESTATIONS
I DON’T TAKE TIME FOR MY OWN HOBBIES OR
SELF-CARE
I FEEL LIKE I PUT MORE EFFORT INTO
RELATIONSHIPS THAN THE OTHER PARTIES

I FEEL UNFULFILLED IN MY CAREER

I DON’T FEEL MOTIVATED TO MAKE CHANGES IN

MY LIFE

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HOW’S YOUR SPIRIT? BEFORE: AFTER: DIFFERENCE:

I AM OVERLY HARD ON MYSELF WHEN I MAKE A

MISTAKE

THE VOICE INSIDE MY HEAD IS USUALLY

NEGATIVE

I FOCUS ON THINGS THAT ARE GOING WRONG

MORE THAN THINGS THAT ARE GOING RIGHT

WORRY AND ANXIETY INTERFERE WITH MY LIFE,

SLEEP, RELATIONSHIPS, ETC.

I DON’T TAKE TIME FOR MYSELF

I COPE WITH NEGATIVE THOUGHTS OR

FRUSTRATIONS USING UNHEALTHY HABITS
LIKE ALCOHOL, DRUGS, OVEREATING, OR
AVOIDANCE TENDENCIES

I DON’T FEEL WORTHY OF “GOOD THINGS”

TOTAL

KEY
0-20: Your spirit is nourished, keep it up!
21-40: Your spiritual body could use some attention—some minor adjustments to your diet and lifestyle can make
improvements here!
41-60: You might be experiencing some emotional and spiritual limitations that are keeping you from truly enjoying
life. You’ll definitely want to pay attention to this key.
61-80: You might be experiencing some serious emotional or spiritual set-backs. Make sure you’re working with
a psychologist, doctor, or Functional Psychiatrist for one-on-one direction—see my Resources section for my
recommendations.

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Conventional vs. Functional Approach

As with all Keys I’ve covered, this one is no different. In Functional Medicine,
we include spiritual health in whole-body health. We don’t believe that mental Note:
struggles can be solved by simply finding the pill to match the ill. We believe Pharmaceuticals are absolutely
that there’s underlying causes to emotional upset, whether it’s releasing past
necessary in certain situations.
trauma, freeing yourself from limiting beliefs, learning how to focus on growth
mindset, or coaching to help focus self-talk on worthiness and support. We Do not stop any medications
don’t treat the brain as an organ detached from the rest of the body. What without working directly with
you do to your body, you do to your brain, and vice versa. your doctor or psychiatrist.

Overall, spiritual health in conventional medicine is an afterthought. I believe Many Functional Psychiatrists
some caring physicians take the time to check in on emotional health, which help patients using functional
is amazing. I don’t necessarily think that they are equipped to guide you approaches in conjunction with
through healing past trauma, releasing limiting beliefs, or helping you build
important drugs. This section is
friendships and community. That’s just a bit out of most of their wheelhouses.
not anti-medication. You need
And to be honest, some of it may be beyond many Functional Medicine to do what’s best for your mind,
practitioners too. We all know the extreme importance of fueling your spirit
spirit, and body, while working
and will take significant time and emphasis into making sure you’re supported
spiritually and emotionally. However, we also understand that our training is closely with your mental health
largely not in trauma-relief, manifesting, or meditation, as much as we believe specialist.
in these healing modalities. For this, we recommend our Functional family:
Functional Psychologists and Functional Psychiatrists.

These practitioners take a whole body approach to your spirit as well. They will look at your diet, your lifestyle and
exercise, your physical health, and other areas, to help support your emotional healing and vibrant spiritual health.
They work very closely with us to ensure that all of your healing needs are met. Yes, we literally talk to each other to
ensure your care is individualized to your needs and that we are all on the same page. This is very important when
you’re on your healing journey. Just as we can’t treat the brain as an individual entity, we can’t treat spiritual health as
an independent entity either. What you do to your spirit, you do to your body, and vice versa.

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5 Practices that Support Your Spirit

Healing from trauma, serious life events, or complicated struggles like chronic depression, anxiety, and others
requires support from a qualified professional. These steps and tips are intended for taking your spiritual health to
the next level to live a longer, healthier, and happier life, and not necessarily to heal. If you are in need of more
serious healing, please work closely with a practitioner to receive one-on-one support. Refer to the Resources and
References section of the workbook for some recommended mental health practitioners.

Practice 1—Gratitude
Practicing gratitude improves your well-being. It has been shown over and over again that focusing on the things
you’re grateful for enhances your life views, satisfaction, and well-being.17,18,19,20 You simply feel better the more you
focus on abundance.

Try this:
● Get a gratitude journal, app, or notes list for your phone. Record three things that you’re grateful for at the
end of each day. Try not to repeat anything on your list for a year.
● Volunteer at a nursing home, retirement community, soup kitchen, meals on wheels, etc. Serving others helps
instill gratitude.
● Ask others what they are grateful for.
● Share gratitude for your friends and loved ones. If you haven’t tried this before, think of something really
impactful that someone else has done for you. Why was it impactful? How did it make you feel? Make sure
to let that person know. And, try to let them know every time you feel grateful for someone else.

Practice 2—Self-Care
You can’t pour from an empty cup.

Try this:
● Pick up an old hobby or try something new. Make time to do this at least once per week or more.
● Get a massage.
● Take a bath.
● Schedule meditation into your daily calendar.
● Drink your morning coffee outside.
● Wake up early to exercise, read, meditate, practice gratitude, enjoy your hobby, take a walk, or even enjoy
your favorite show.
● Listen to uplifting podcasts. Our team favorites: The Doctor’s Farmacy Podcast, The Broken Brain Podcast
(I’m a little biased!), Unlocking Us Podcast with Brene Brown, and Ten Percent Happier Podcast with Dan Harris.
● Try a creative outlet: take a dance class, try photography, take an online design class, try ceramics or
pottery-making, invite friends to a paint and sip event, take a stab at writing a book, write poetry, practice
an instrument, take up woodworking. Even if you think you’re not creative, almost everyone finds joy in
expressing themselves in some way. Find yours.

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Practice 3—Community
Friends help celebrate your accomplishments, comfort you during struggles, cheer you on to achieve your goals,
and support you along the way. Building strong relationships with your friends, loved ones, family, and even
coworkers is so important because knowing that we’re all in this together feels good. Knowing that you’re not alone,
that you are supported, and that you are valued embodies an important fact: you are special, worthy, and worth it.

Would you like to make new or more friends? Try this:

● Talk to a new parent at your kid’s event.
● Ask to join someone sitting alone at a coffee shop or restaurant.
● At a work function, church, gathering, or spouse’s event? Start a conversation with someone you’ve never
talked to before.
● Try a Meet Up.
● Go to a class (yoga, pottery, dance, etc.) alone and start a conversation with someone.
● Call a friend you haven’t talked to in a while.
● Go through your phone and text someone you hardly know but felt a connection with.

Want to make your current friendships stronger? Try this:

● Be direct with your communication.
● Tell them what you need.
● Ask them what they need.
● Share your gratitude for them.
● Check in on them.
● Approach your communication out of love.
● Try the Soft Starter approach from the Gottman Institute for tough conversations.
● Acknowledge when they’ve helped you, but also if they’ve hurt you.
● Make sure they know they can come to you if you’ve wronged them.

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Practice 4—Sense of Purpose

When we are small, one of the most common questions we get asked is, “What do you want to be when you grow
up?” It’s exciting to think about the endless possibilities. For many of us, at some point, we succumb to the “work
to live, live to work” mentality and forget our dreams. For most of us, we require steady income to provide food
and shelter for our families—but that doesn’t mean that we should give up on our dreams. When we lose sight
of the goals and aspirations that we have, we also lose sight of the ambition, enthusiasm, motivation, and joy that
comes from realizing a goal. We find ourselves in mundane routines and easily fall victim to becoming neutral to
our passions. However, your life’s dreams, goals, and work are much bigger than that. Of course, I’m not saying
quit your job or make a drastic life change irresponsibly. I’m saying your dreams are worth the effort and you need
to be intentional with your sense of purpose in life.

Not sure what your purpose is? Meditate, journal, and/or think about these questions:
● Think about a time in your life when you felt the most fulfilled, what were you doing?
● If you had unlimited money, what would your life look like?
● If time and money were no object, what would you do with your time?
● If you could become a master at one skill, what would it be?
● What are you doing when you’re the happiest?
● What did you do that caused you to feel the most accomplished?
● What project did you work on that you’re the most proud of? What was it about this project that piqued your
interest?
● What have you always “wanted to do?”

Have you realized a dream but aren’t sure how to pursue it? Try this:
● Write it down. Post it everywhere—on your fridge, on your computer, on your mirror, on the book you’re
reading, on your cabinet doors, on your steering wheel, etc.
● Tell your community. Tell your crew your goals. Ask them to hold you accountable. Ask them to check in on
your progress.
● Prioritize your dreams. Instead of saying “I’m too busy,” try saying, “It’s not a priority.” That feels different.
So, make it a priority.
● Wake up an hour early to take steps towards this goal or dream.
● Work through the roadblocks, and there WILL be roadblocks.
● Check in on your dream. Revisit it often. Does it still give you joy? Does it still fuel you? Do you need to
evolve it or change it?
● Ask for help. People love helping others. But, they can’t help if they don’t know how. So tell them. Do you
need a connection with a publishing agency? Ask around, it’s likely that someone you know, or someone
they know, can help. Do you need public speaking lessons? A connection to the movie industry? Financial
assistance? What do you need to accomplish your goals and dreams? Ask for help.

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Practice 5—Mindset
Our minds are hard-wired to fixate on negative thoughts.21 It’s called the negativity bias and evolutionarily, it kept us
alive. If you encounter a life-or-death situation, your brain stores as much information about that event as possible
so that should you encounter it again, your brain already recognizes the warning signs and can react appropriately
to save your life. This works really well when stumbling into a bear cave. This does not work particularly well
when experiencing a tough conversation with a superior, or experiencing the ebbs and flows of relationships, or
maneuvering through self-discovery and self-confidence. By focusing on negative things, two main consequences
happen: 1. Our mind continues to fixate on the negative things and looks for more negative things to confirm the
first negative thing; 2. We miss out on the positive things.

So, how to break this cycle? Try this:

● Become aware. Start noticing your thoughts and pay close attention—especially to the repetitive ones.
Notice where they stem from and why you’re ruminating on them. If they are not serving you, ditch them.
When you notice a thought like this, think of the most recent thing to bring you joy or make you smile. Choose
to focus your mind on something that lifts you up.
● Practice mindfulness. I highly recommend downloading a guided meditation app, like Calm or Insight
Timer, and dedicating a few minutes every day to practicing mindfulness. Our minds are very powerful, but
they are easily manipulated to focus on negative and destructive thoughts—and one destructive thought leads
to another. It takes practice to identify when we get hung up and know how to change course. Committing
to practicing mindfulness daily can help.
● Practice gratitude. See Practice 1—Gratitude for tips.
● Read. There are some amazing resources to not only reframe your mindset, but show you the power of your
mind and how your thoughts can guide you to heal or harm. I recommend Limitless by Jim Kwik, The Universe
Has Your Back by Gabrielle Bernstein, The Power of Your Subconscious Mind by Dr. Joseph Murray, and
The Untethered Soul by Michael A Singer.
● Listen and learn. The more you learn and understand why your mind gravitates towards negative thoughts
and how to reframe your thinking, the easier it will be to reset your mindset. There are a ton of helpful
podcasts out there, but some of my top recommendations are: The Broken Brain Podcast with host and my
business partner Dhru Purohit featuring Peter Crone and his episode featuring Dr. Yashar Khosroshahi, and
The Doctor’s Farmacy podcast featuring Gabrielle Bernstein
● Remember, you are not your thoughts.

Conclusion
Your spiritual, emotional, and mental health are just as important as your physical health. What you put in your mind is
just as important as what you put in your body. In order to live your best, longest, fullest life, focusing on self-love and
self-care, forgiveness, community and solid relationships, positive mindset, sense of purpose, and gratitude are the fuel
your spirit needs. When you think better, you feel better.

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THE 30 DAYS TO AGING BACKWARDS PLAN

Well, you’ve made it to my 30 Days to Aging Backwards Plan. So far, we’ve talked about my 7 Keys to Longevity. We
discussed inflammaging and how inflammation is at the root of nearly every chronic condition. We talked about all
of the hidden sources of inflammation and how to support your immune system for health.

We talked about how intertwined your hormones are to every organ system. Every biochemical pathway in your
body relies on appropriate hormone signaling, so we discussed how to know if your hormones are unbalanced,
what causes hormone disruption, and how to support healthy hormone levels. We stressed the importance of your
mitochondria, which is a funny choice of words since stress is one of the mitochondria-killers. We talked about the
things that cause your mitochondria to become sluggish and how to fuel your powerhouse and support the biogen-
esis of new, energy-producing machines.

We highlighted the billions of microbes that live in and on our bodies and how extremely essential they are to our
existence. We talked about how the damage caused to our guts can open the gates to leaky gut syndrome. But more
importantly, we talked about how to create a diverse and healthy internal ecosystem.

We talked about the barrage of toxins we encounter multiple times a day, every day. We talked about the damage
toxins can cause, despite our sophisticated detoxification systems. We laid out how to help reduce toxin load and
how to support our detox systems. We talked about our physical health and how crucial movement is to staying and
feeling young. We laid out two no-fail movement plans to get you moving more, hurting less, and feeling great.

And we talked about spiritual, emotional, and mental health. We talked about how negative self-talk can be detrimen-
tal to our physical well-being. And we laid out 5 practices to nourish your spirit.

So now is the time to put it all together into my 30 Days to Aging Backwards Plan. This plan incorporates all 7 Keys
into a step-by-step plan to get you feeling more youthful using my Three Pillars to Age in Reverse.

The Three Pillars to Age in Reverse

If you’re familiar with my work at all, you’re probably surprised to have gotten this far into the workbook and not had
an extensive section focusing on food. Well, look no further! The basis, the most important, the absolute non-ne-
gotiable and first Pillar in the 30 Days to Aging Backwards Plan is: Eat for Life. Food is medicine. It’s the cheapest,
easiest, and most effective medicine on the planet and if you want to feel younger and live longer, you need to
prioritize eating for life.

Pillar two is: Do The Work. Listen, I’m not going to say that it’s easy to overhaul your health for longevity, but I will
say it’s worth it. This Pillar includes steps to increase movement, support your immune system and mitochondria,
reduce toxins and support your detox systems, and support your hormones. But, it’s also about putting in the effort.

And the third Pillar to Age in Reverse is: Enjoy Your Journey. I’ve mentioned before, but the more you focus on
negativity, how hard challenges may be, or how difficult it is to make changes, the more difficult your experience
will be. You are setting yourself up to fail. However, if you celebrate every victory, find joy in every win, and find
gratitude for every moment, not only will you succeed, but you’ll love the journey along the way.

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Pillar One: Eat for Life

Food is medicine. I always say, if you put crap in your body, you’re going to feel like crap. How many times have
you experienced a food hangover where you felt bloated, fatigued, gassy, and overall gross? I know, some greasy,
fried food tastes delicious. However, nothing tastes as good as experiencing vibrant, youthful health feels. It’s just
not worth it.

My Anti-Aging Pegan diet, introduced in Key #6, is based on whole, real foods. Anti-Aging Pegan foods are nutrient-
dense and loaded with the phytonutrients, polyphenols, and antioxidants to help keep you young. A longevity diet
is anti-inflammatory, blood sugar and hormone balancing, gut-healthy, and full of fuel for your mitochondria—just
like my Anti-Aging Pegan recommendations. It is not a trend or a fad, it is how I eat for life, and you should too.

How to Eat Anti-Aging Pegan:

● Eat mostly plants. More than half of your plate should be covered with veggies. The deeper the color, the
better. Stick with mostly non-starchy veggies. Winter squashes and sweet potatoes are fine in moderation.
Choose organic and regenerative when possible. Use the Dirty Dozen and Clean Fifteen guide by the
Environmental Working Group to choose the least contaminated fruits and vegetables and save money.
● Go easy on fruits. I find that most of my patients feel better when they stick to low-glycemic fruits and
enjoy others as a treat. Stick with berries, kiwis, and watermelon, and watch the grapes, melons, and higher
glycemic index fruits. Think of dried fruit as candy and keep it to a minimum.
● Eat more foods with healthy fats. Start with fats in whole foods such as nuts, seeds, olive oil, avocados,
pasture-raised eggs, and small wild fatty fish such as sardines, mackerel, herring, and wild salmon. For oils, use
extra virgin olive oil (at low or no heat), avocado oil (for higher heat cooking), and organic virgin coconut oil*.
● Eat more nuts and seeds. They have universally been shown to prevent and reverse disease; help with
weight loss, diabetes, and heart disease; are great sources of minerals, protein, good fats, fiber, and more.
Almonds, walnuts, pecans, macadamia nuts, and pumpkin, hemp, chia, and sesame seeds are all great.
● Think of meat and animal products as condiments or, as I like to call them, “condi-meat”—not a main
course. Vegetables should take center stage, and meat should be the side dish. Servings should be palm-
sized per meal. Plant-based meals are fine as long as the protein comes from whole foods, not processed
powders, bars, or fake meat. I often make three or four vegetable side dishes for each meal.
● Choose regeneratively raised animal products whenever possible. They are better for you and help
drawdown carbon from the atmosphere and reverse climate change.
● Eat pasture-raised eggs. They are rich in vitamins, minerals, antioxidants, protein, and more. They are also
a cheap source of high quality and bioavailable nutrients including B12, which you can’t get from a vegan diet.
● Eat wild-caught or sustainably raised or harvested low-mercury, high omega-3 fish. If you are eating
fish, you should choose low-mercury and low-toxin varieties such as sardines, herring, anchovies, mackerel,
and wild-caught salmon, all of which have high omega-3 and low mercury levels, and they should be wild-
caught or sustainably harvested or farmed. Check out www.cleanfish.com or the Environmental Working
Group’s guide on fish to learn which fish are sustainably harvested/raised and the lowest in toxins.

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● Eat only whole grains (not whole grain flours) and avoid gluten. All grains can increase your blood
sugar. Stick with small portions (½ to 1 cup per meal) of low-glycemic, gluten-free grains like black rice,
quinoa, teff, buckwheat, or amaranth.
● Eat beans. Lentils are best. Stay away from big starchy beans as staples. Beans can be a great source of
fiber, protein, and minerals, but they cause digestive problems for some, and the lectins and phytates they
contain can impair mineral absorption. Moderate amounts (up to 1 cup a day) are okay.
● Stay away from sugar. Or anything that causes a spike in blood sugar and insulin production—sugar, flour,
and refined starches and carbohydrates. Think of sugar in all its various forms as an occasional treat. Your
body can’t tell the difference between a bagel and a bowl of sugar once it gets below your neck. I tell people
to think of sugar as a recreational drug. You use it for fun once in a while, but it is not a dietary staple. Liquid
sugar calories (from soda, energy drinks, sweetened teas, even fruit juice, etc.) cause increased hunger,
obesity, and death. Stay away.
● Stay away from most vegetable, bean, and seed oils. That includes canola, sunflower, corn, grapeseed,
and especially soybean oil. Small amounts of expeller or cold-pressed nut and seed oils like sesame,
macadamia, and walnut oils are fine to use as condiments or for flavoring. Avocado oil is great for higher-
temperature cooking.
● Avoid or limit dairy. Dairy today is not what it used to be. Conventional dairy is bad for the environment and
not well tolerated by most people. Dairy has been linked to inflammation, cancer, osteoporosis, autoimmune
conditions, allergic disorders, digestive problems, and more. I recommend avoiding it, except for the
occasional grass-fed dairy from yogurt, kefir, grass-fed butter, ghee, and even cheese if it doesn’t cause any
problems for you. Try goat or sheep products instead of cow dairy. And always go organic and grass-fed.
● Stay away from pesticides, herbicides, antibiotics, hormones, and ideally GMO foods. Choose foods
raised or grown in regenerative ways, if possible. Also, no chemicals, additives, preservatives, dyes, artificial
sweeteners, or other junk ingredients. If you wouldn’t find it in your kitchen for cooking, you shouldn’t eat it.
Polysorbate 60, red dye 40, and sodium stearoyl lactylate (also known as Twinkie ingredients), anyone?

*See Pegan Fats section on page 95 for an explanation on why these fats may not be a good fit for everyone.

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DR. MARK HYMAN'S

PEGAN FOOD PYRAMID

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*See Pegan Fats section on page 95 for an explanation on why these fats may not be a good fit for everyone.

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Pegan Fats
There is a subset of people who experience something we are only recently becoming aware of and researching
further. We call this subset a “lean mass hyper responder (LMHR),” and these individuals typically show a similar
pattern where they have an athletic, lean build, are typically quite active, and eat a fairly low carbohydrate, high fat
diet. We are finding that when these individuals eat a lot of saturated fats, some notice unusual cholesterol patterns.1
We actually don’t know enough yet to indicate if these surprising cholesterol patterns are concerning or not, but I
created a special “Pegan Fats” list because LMHRs may consider skipping certain fats that I normally consider healthy.

To help determine if you fit into this category, you can check out cholesterolcode.com for more information. You
can also ask your doctor to run an NMR lipid test (discussed in “Want to Dig Deeper?” section from Key #1) to
get a good idea of your cholesterol and lipid levels. I also find that listening to your body is key. Some people
feel amazing consuming coconut oil and other saturated fats, whereas others find they need to stick with fats like
avocado and olive oil. Your body is your smartest doctor.

PEGAN FATS

ENJOY RESEARCH FIRST LIMIT

● Organic extra virgin olive oil ● Butter from pastured, ● Vegetable oil
● Organic avocado oil grass-fed cows or goats ● Soybean oil
● Walnut oil ● Grass-fed ghee ● Canola oil
● Almond oil ● Organic, humanely raised ● Corn oil
● Macadamia oil tallow, lard, duck fat, or ● Grapeseed oil
chicken fat
● Unrefined sesame oil ● Safflower oil
● Coconut oil or MCT oil
● Tahini (medium chain triglycerides)
● Sunflower oil
● Flax oil ● Sustainable palm oil
● Peanut oil
● Hemp oil (Look for Certified ● Vegetable shortening
● Avocado, olives, Sustainable Palm Oil) ● Margarine and butter substitutes
and other plant sources of fat ● Anything that says
● Nuts and seeds "hydrogenated” or
“partially hydrogenated”
● Anything fried

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Longevity Superfoods
My Anti-Aging Pegan diet is all about eating the foods that give you life, nutrients, and nourishment, and skipping
the foods that don’t. When it comes to longevity, there are some superstar foods that really shine. Want to feel young
at any age? Eat these phytonutrients often:

LONGEVITY SUPERFOODS

PHYTONUTRIENT PHYTONUTRIENT
SOURCE BENEFIT
TYPE CATEGORY

CAROTENOIDS Lutein and Zeaxanthin ● Cooked spinach ● Antioxidant

● Kale ● Anti-inflammatory
● Turnip greens ● Selectively taken up by
● Dandelion greens the macula
● Collards ● Vision health
● Mustard greens ● Filters blue light2

Lycopene ● Tomatoes ● Cancer prevention

● Watermelon ● Nrf2 activation
● Anti-inflammatory3

α-Carotene and Orange, red, and yellow ● Antioxidant

β-Carotene pigmented plants, ● Cancer prevention
especially: ● Cardioprotective2
● Carrots
● Pumpkin
● Sweet potatoes
● Cooked spinach
● Papaya

CURCUMINOIDS Curcumin ● Turmeric ● Anti-inflammatory

● Neuroprotective
● Anti-tumor
● Antioxidant
● Nrf2 activation
● Glutathione
biosynthesis4

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LONGEVITY SUPERFOODS (CONT.)

PHYTONUTRIENT PHYTONUTRIENT
SOURCE BENEFIT
TYPE CATEGORY

GLUCOSINOLATES/ Isothiocyanate Cruciferous vegetables, ● Anti-cancer

ORGANOSULFUR especially: ● Anti-inflammatory
COMPOUNDS ● Brussels sprouts ● Antioxidant5,6,7
● Garden cress

● Mustard greens

● Kale

● Turnip

Sulforaphane/ ● Broccoli sprouts ● Anti-cancer

glucoraphanin ● Broccoli ● Anti-inflammatory
● Antioxidant
● Anti-aging8

Indole-3-carbinol Cruciferous vegetables, ● Anti-cancer

especially:
● Brussels sprouts
● Garden cress
● Mustard greens
● Kale
● Turnip

POLYPHENOLS/ Anthocyanins Blue, red, purple ● Anti-cancer

FLAVONOIDS pigmented plants, ● Antioxidant
especially: ● Anti-diabetic
● Blueberries
● Cardioprotective
● Black raspberries
● Vision health
● Purple potatoes
● Neuroprotective9
● Blackberries
● Cherries
● Currants

Flavanols (Catechins, ● Black tea ● Antioxidant

Epigallocatechin gallate ● Green tea ● Anti-aging
(EGCG)) ● Oolong ● Anti-cancer
● White tea ● Repair DNA damage
● Dark chocolate ● Cardioprotective10

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LONGEVITY SUPERFOODS (CONT.)

PHYTONUTRIENT PHYTONUTRIENT
SOURCE BENEFIT
TYPE CATEGORY

POLYPHENOLS/ Flavonols (Quercetin, ● Onion ● Antioxidant

FLAVONOIDS (CONT.) Fisetin, Rutin, Kaempferol) ● Spinach ● Anti-cancer
● Dill ● Activates AMPK
● Kale ● Inhibits mTOR
● Arugula ● Glutathione
● Watercress biosynthesis11,12
● Cowpeas
● Chili peppers
● Strawberries
● Apples

Parsley Anti-inflammatory
Flavones (Apigenin)
●
●

● Celery
● Cognitive support
● Onions
● Anti-diabetic
● Oranges
● Anti-cancer13
● Chamomile
● Thyme
● Oregano
● Basil
● Herbal teas

Flavanones (Hesperetin) ● Lemons ● Antioxidant

● Oranges ● Anti-inflammatory
● Neuroprotective
● Enhances the Nrf2
pathway14

Isoflavones** (Genistein) ● Soybeans ● Antioxidant

● Tofu ● Anti-inflammatory
● Natto ● Anti-cancer15
● Legumes

CHLOROGENIC ACIDS 5-O-caffeoylquinic acid ● Coffee ● Antioxidant

● Anti-diabetic
● Cognitive support
● Detoxification

STILBENOIDS Resveratrol ● Berries ● Antioxidant

● Red grapes ● Anti-cancer
● Blueberries ● Cardioprotective
● Red wine ● Activates AMPK
● Protects against AGEs16

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LONGEVITY SUPERFOODS (CONT.)

PHYTONUTRIENT PHYTONUTRIENT
SOURCE BENEFIT
TYPE CATEGORY

PHENOLIC ACIDS Benzoic acid and Mushrooms, especially: ● Antioxidant

Cinnamic acid ● Cordyceps
● Activates Nrf2 pathway
● Reishi
● Activates sirtuins
● Oyster Mushrooms
● Protect mitochondria
● Shiitake
● Anti-cancer
● Lion’s Mane
● Anti-diabetic17, 18
● Maitake
● Chaga
● Agaricus blazei Murrill
● Antrodia cinnamomea
(AC)

Oleuropein ● Olives ● Anti-cancer

● Olive oil ● Antioxidant
● Cardioprotective
● Anti-inflammatory
● Neuroprotective19,20,21

FATTY ACIDS Omega-3-fatty acids ● Fatty fish ● Anti-inflammatory

Docosahexaenoic ● Fish oil ● Cardioprotective
Acid (DHA) and ● Fish eggs ● Cognitive support
Eicosapentaenoic Acid ● Salmon
(EPA) ● Sardines
● Krill
● Krill oil

Lauric acid ● Unrefined coconut oil ● Anti-inflammatory

● MCT oil ● Supports the
● Breastmilk microbiome
● Neuroprotective22,23,24

Caprylic acid ● Unrefined coconut oil ● Anti-inflammatory

● MCT oil ● Neuroprotective
● Palm oil ● Cardioprotective
● Blood sugar
balance25,26,27,28

**Isoflavones are classified as phytoestrogens and may not be a good fit for everyone. Be sure to check with your doctor before
incorporating foods high in isoflavones into your diet.

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Recipe-Free Cooking
I almost never follow recipes. I love opening my fridge, taking an inventory of whatever I have on hand, and throwing
it all together to see what new flavor combinations I can create. I call it Recipe-Free Cooking, and it takes a lot of
pressure off of meal prep. It can take some practice, so I’ve created some helpful resources you can use to cook
Anti-Aging Pegan recipe-free. To keep things simple, you can also tweak your current favorite recipes by swapping
out ingredients for foods on the Approved list or you can follow the basic templates below.

So, here’s a quick guide for how to cook recipe-free the Anti-Aging Pegan way:

The general formula is this:

Step 1: Fill your plate ¾ full with colorful, non-starchy veggies.
Step 2: Include a 4 to 6 ounce serving of clean protein (like pasture-raised steak or organic tempeh),
Step 3: Make sure you have healthy fats (like olive oil, grass-fed butter, or ½ avocado).

Example of an Anti-Aging Pegan plate:

● 1 oven-baked salmon fillet
● 1 cup lightly steamed broccoli, drizzled with olive oil
● 1 cup asparagus lightly sautéed
● Season all with sea salt and pepper

Here are a few templates for recipe-free meals that provide endless possibilities:

BER R Y-A NY T HI NG SM O OT HI E
Choose one from each column

Unsweetened Frozen berries Fat Greens Optional add-ins Instructions

dairy-free milk ½ cup 1 tablespoon 1 handful 1 tablespoon
8 ounces

Almond milk Blueberries Avocado Kale Cacao powder Blend all

Cashew milk Blackberries Almond butter Spinach Cacao nibs ingredients
together until
Hemp milk Strawberries Coconut butter Beet greens Cinnamon
smooth and
Macadamia nut milk Raspberries Sunflower butter Chard Vanilla creamy. Add a
Coconut milk Mixed berries Pecan butter Ginger few ice cubes if
Flax milk MCT oil (fresh or ground) desired.
Turmeric
(fresh or ground)

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QUIC K AND E A SY SUPE R SA L A D

Choose one from each column
Greens Veggies Protein Aromatics Fat Acid Instructions
2-3 cups Unlimited 4 to 6 ounces 1 tablespoon 1 to 2 tablespoons 1 to 2 tablespoons

Kale Peppers Wild-caught Fresh parsley Avocado Fresh lemon juice Toss all
Spinach Radishes salmon Cilantro Extra virgin olive oil Fresh lime juice ingredients in
Sardines a large bowl.
Red leaf lettuce Cucumbers Basil Macadamia oil Red wine vinegar
Arugula Fennel Cooked Oregano Nuts or seeds Balsamic vinegar
pasture-raised
Mix of above Mushrooms Mint Apple cider
chicken or
Tomatoes Green onions vinegar
turkey
Roasted Grass-fed Red onion
beets beef Shallots
Broccoli Hard-boiled
sprouts eggs
Broccoli
Cauliflower

K ITC HE N SI NK ST I R-FRY
Choose one from each column
Fat Aromatics Protein Veggies Garnish Instructions
2 tablespoons 1 to 3 1 pound 6 cups ¼ cup
tablespoons

Avocado oil Yellow onion Grass-fed beef Broccoli Fresh lime juice Heat oil over medium heat. Add
Grass-fed butter/ Fresh garlic Pasture-raised Peppers Coconut aminos onions and sauté 2 to 3 minutes
ghee chicken or until onions are translucent, then
Fresh ginger Mushrooms Balsamic vinegar
turkey add garlic and/or ginger and
Coconut oil Carrots Chopped sauté another 2 minutes.
Organic tempeh cashews or
Cabbage
almonds Turn heat to medium-high. Add
Cauliflower protein and sauté until golden
Cilantro
Celery and cooked completely through,
Broccoli sprouts this will depend on what kind of
Eggplant
Bok Choy cut you use.
Brussels Add vegetables and continue
sprouts stirring and cooking for 5
minutes, until heated through
but still crunchy.
Divide into 4 bowls, add garnish,
and serve.

Note: You can easily turn this Kitchen Sink Stir-Fry into a delicious and hearty soup by following the steps listed
above, then adding 2 quarts of pasture-raised chicken or beef stock or bone broth and cooking for about an hour.

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How to Choose Quality Foods

Despite what many diets have preached over the past several decades, finding good health and a happy weight
is not a matter of calories in and calories out. 300 calories from an avocado does not have the same effect on
your health as 300 calories from jelly beans. There are different macronutrients (fat, protein, carbohydrates) and
micronutrients (vitamins, minerals, antioxidants, phytochemicals) at play here.

Bottom line: Focus on real, whole food, on quality, and give up calorie counting. Your body will take care of the rest.
Here are some tips to make sure you’re saying YES to real whole foods and avoiding processed foods.

1. Know Your Ingredients: Don’t eat anything that contains ingredients you wouldn’t have in your own pantry.
You wouldn’t cook with things like carrageenan or MSG. If you see ingredients you don’t recognize on a
label, avoid that food.
2. Go Organic: When possible, try to eat as much certified organic foods as possible. It can get quite pricey,
so you may want to follow The Environmental Working Group’s Dirty Dozen and Clean Fifteen. This is a list
of foods that shows you which fruits and veggies should be purchased organic because they contain more
pesticides and which ones are safe to buy conventionally.
3. Say No to GMO: There’s just not enough information out there about what GMOs (genetically modified
organisms) are doing to our health. Take the precautionary principle and avoid them.
4. Say Yes to Grass-fed: The “grass-fed” or “pasture-raised” designations mean the product is from an animal
that was raised eating its natural diet and foraging outdoors. This is the type of animal protein you want to
consume. Look for the American Grassfed, Certified Grassfed, or 100% grass-fed designations.
5. Purchase Conscious Fish: Always go for wild-caught or sustainably harvested seafood. Look for the
Certified Sustainable Seafood, Certified Responsible Fisheries, or ASC Certified certifications. And be sure
to stick to the low-mercury varieties; in general, wild-caught salmon, mackerel, anchovies, sardines, and
herring.
6. Protect the Environment, Animals, and Workers: Look for Fair Trade Federation, World Fair Trade
Organization, RainForest Alliance, and Certified Humane certifications.
7. Eat the Rainbow Daily: The color of a plant signals different beneficial compounds within it, with each
color group representing naturally protective and healing substances:
● Red foods are heart healthy: tomatoes, bell peppers, strawberries, raspberries, pomegranate.
● Yellow foods are great for skin and eyes: yellow peppers, yellow summer squash and orange bell
peppers
● Green foods support detoxification: spinach, leafy greens, kiwi, zucchini, cucumber, kale, asparagus,
broccoli, Brussels sprouts, bok choy, arugula
● Orange foods help prevent cancer: orange peppers, carrots, pumpkin, acorn squash, sweet potatoes
● Blue-purple foods are great for longevity: eggplant, blueberries, blackberries, beets, red cabbage
● White foods help boost your immune system: cauliflower, mushrooms, garlic, radish, turnips, leeks,
onion, cabbage

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All About Cooking

There are a few simple cooking rules to always keep in mind. These help ensure your foods are nutrient-dense and
abundant in flavor.

Use the Right Fats

For drizzling: olive, sesame, flax, hemp, almond, walnut, and macadamia oils.
For cooking: avocado oil, coconut oil, grass-fed butter, and ghee.

Lower and Slower Is Better

Focus on lower-temperature, slow cooking for meat—such as baking, poaching, and stewing—as well as methods
that embrace moisture, like cooking in a slow cooker.

Soak for Better Digestion

Nuts, seeds, grains, and legumes are all healthy, whole foods, but they can be made more easily digestible by
soaking them overnight prior to cooking.

Avoid Boiling, Unless it’s Soup

When vegetables are submerged in water and boiled, certain nutrients, like B-vitamins and vitamin C, leach into
the water. If you toss that water, you toss the nutrients. Making soups or stews is also a good option because you
consume the nutrient-rich liquid the vegetables cook in.

Simple Cooking Techniques for Vegetables

There are lots of hacks to make healthy cooking take less time and energy. Here are some simple veggie-preparation
techniques.

How to Steam
● Add water to a saucepan fitted with a steamer basket, but be careful that the water doesn’t rise up into the
basket.
● Bring the water to a boil.
● Place chopped veggies into the steaming basket, cover the pan, and steam for 4 to 8 minutes, depending
on the vegetable and your desired level of tenderness.
● Remove the veggies from the basket, add favorite seasonings, and drizzle with some kind of healthy oil, such
as extra virgin olive oil, walnut oil, or hemp seed oil.

How to Sauté
● Add 1 to 2 tablespoons of cooking fat (coconut oil, avocado oil, ghee, or grass-fed butter) to a skillet.
● Turn heat on to medium/medium-high.
● When the pan is hot and oil is melted or shimmering, add chopped veggies and sprinkle with any desired
spices.
● Cook for 5 to 7 minutes, stirring occasionally, until your desired level of tenderness is reached. Sprinkle with
sea salt and black pepper to taste.

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How to Roast
● Preheat the oven to 425°F.
● Toss chopped veggies in about 1 teaspoon cooking oil for every 1 cup of vegetables to coat.
● Add your choice of dried herbs and spices and toss well to coat.
● Spread the veggies on one or two baking sheets. Take care not to crowd them.
● Pop your baking sheets in the oven. Stir every 10 minutes, until the veggies are fork-tender, around 20 to 40
minutes.
● Once done, remove from the oven and sprinkle with sea salt and pepper to taste.

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Pillar Two: Do The Work

This Pillar is important. I don’t want to set fictional expectations—as nice as it Note:
would be, it’s unlikely that you can change absolutely nothing and expect to I’ve gone through a couple
have great improvements in your healthspan. If you want something to change, very serious health crises, the
you need to be willing to put in effort. most recent being within the
So, what’s the “work?” past couple of years. It was
so serious, I literally thought I
This includes: following through with the food plan, taking steps to mitigate
inflammation, supporting your mitochondria, reducing toxic inputs, supporting was going to die, I couldn’t get
your detox systems, taking steps to support balanced hormones, incorporating out of bed, I couldn’t remember
daily movement, focusing on mindset. Basically, putting all of the 7 Keys into things from 5 minutes prior, I
action. was extremely fatigued, I was
The plan incorporates a low-inflammatory, hormone-balancing, mitochondria- basically wasting away. And at
supporting diet, and includes daily movement and mindset support. If you that time, the thought of putting
follow the plan, you’re well on your way to supporting health and longevity. any sort of effort into anything,
And it all begins with a commitment. Choose and decide that you’re going to
follow through. no matter how little, seemed
impossible.
I highly recommend grabbing a friend and accountability partner to go through
the 30 Days to Aging Backwards Plan with you. It’s more fun to have someone
in it with you—you can compare experiences, challenge each other, and raise But, I am here to tell you that
each other up. It’s easy for us to be hard on ourselves, but easy to support and even the smallest step will pay
lift others. So, grab a friend, and get started. off. I am now experiencing the

I’ve made suggestions for ideas on incorporating movement and mindset into best health I have felt in my
each day, but feel free to mix it up and make it work for you. Revisit Keys #6 and entire life. It was hard; I had
#7 for more ideas of movement and spiritual support to find the best fit for you. to decide that I wanted to live,

So, start today. Decide. Commit. Follow through. heal, and repair. It was not
easy, but it was worth it. So, if
you’re experiencing any level
of illness that is making you
feel unable to put for energy
or effort, I’ve made a gradual
plan, Easing In, just for you.
Even if the Easing In plan feels
overwhelming, just choose one
thing to focus on for as long as
it takes until you feel ready to
take on another.

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Pillar Three: Enjoy Your Journey

Have you ever helped teach a young child a new skill, like taking their first steps, using the potty, or learning the
alphabet? Part of their success is sharing in your immense joy and excitement. The more excited and encouraging
you are, the more likely they are to step out without your hands. And, the more likely they are to have a giant smile
on their face.

We as parents are extremely good at really amping up our kids and celebrating them when they’ve accomplished
a big task or goal. But, we as adults are extremely poor at doing this for ourselves. Why? Because, as we get
shaped by our surroundings and begin to learn that the world asks for a lot more responsibility and a lot less
celebration. Accomplishing things becomes the expectation and we are hard on ourselves if we don’t hit the mark.
We experience disappointments left and right and find it easy to get sucked into a routine of completing tasks just
to complete them. That can make it really hard to get excited to put in the work.

However, just imagine what it would feel like if every time you did something, like went on a walk or followed a short
guided meditation, someone was standing there cheering for you, saying “Yes! You did it! You are amazing! There
is nothing you can’t do!” That would feel amazing, right? You’d want to do it again, and again, and again. It feels
good to be supported.

Now, imagine that every time you thought about doing something, like taking a walk or following a guided meditation,
but didn’t, someone was standing there still cheering for you. Saying, “You are still amazing, you are still worthy,
you are doing the best you can!” You’d feel supported, loved, accepted, and much more likely to try again. Be that
kind of cheerleader for yourself.

Enjoying your journey is about finding the joy and support in the process. It’s about learning a new way to cheer
yourself on, celebrate your victories, and show yourself compassion when you miss the mark. It’s about paying close
attention to how good your body feels when you fuel it with life-giving foods. It’s about noticing how energized
you feel, how much more you smile throughout the day, about how grateful you’ve become, and even how your
relationships grow. And, really, about focusing on exactly what you want for your life, how you want to feel, how
you want to spend your time. We have a limited amount of time on this earth. What do you want to do with yours?

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The 30 Days to Aging Backwards Plan

I’m splitting my plan into the Easing In and Jumping In plans. When I’m making major life changes, what works
best for me is to Jump In head first; I want to rip the band-aid off and go all-in. However, I know that approach isn’t
a good fit for everyone.

The Easing In plan is made specifically for those that want to take things gradually. It’s an approach where you focus
on one thing at a time, all adding up to living better. If you like to take things step-wise, this plan is for you.

The Jumping In plan throws you in head first. It asks you to make major changes all at once, to overhaul your kitchen,
your routine, and your mindset in one fell swoop. If you like to rip the band-aid off, this plan is for you.

Both plans are great. Both plans are effective. It’s not a matter of which one is better, it’s a matter of which one is
the best fit for you. And no one knows you better than you. Are you a mix of both? Feel free to apply whichever
plan most resonates with you and mix it up. There are no right or wrongs here; all progress is a step in the right,
youthful direction.

Here are some tips to help get you started:

Tip 1: Keep Weekday Meals Simple. On your busiest days, stick with my Recipe-Free Cooking guidelines and
templates. The goal is to fill your fridge with nutrient-dense foods and then take the thinking out of preparing them.
Keep things simple. On your less busy days, visit my Recipes section under References and Resources in this
workbook for links to some of my favorite Pegan recipes to try.

Tip 2: Try Something New. Think you dislike broccoli? Now is the time to test out a new way to prepare broccoli.
Keep an open mind and try something new—you might be surprised to find your newest favorite vegetable!

Tip 3: Make Extras. Anti-Aging Pegan left-overs can save the day when you’re in a pinch, short on time, inspiration,
or motivation, or overly busy. If you find a recipe you love, double it. Cook once, eat twice (or more)!

Tip 4: Keep These Items in Stock:

● Olive oil (great for drizzling on ● Ground cinnamon/your favorite spices
your salads and veggies) and seasoning, salt, pepper
● Avocado oil (great for cooking) ● Frozen berries
● Unsweetened almond, cashew, hemp,
● Raw nuts and seeds
macadamia, or coconut milk ● Unsweetened nut butter

Tip 5: Prepare for a Food Emergency. It’s bound to happen at least once: you are in a situation where you aren’t
prepared with an Anti-Aging Pegan meal. It’s a good idea to always be prepared. Have some Anti-Aging Pegan
snacks readily available in your panty, your car, and with you at work. Then, when you run into a situation where
you’re facing a food emergency, you can feel prepared. Here are a few ideas:
● Hard-boiled egg ● Nut butter packets
● Veggie sticks with hummus or guacamole ● Grass-fed beef jerky (sugar-free)
● Nuts and seeds

So, here we go...

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Are You Easing In?

Implementing too many changes at once can be overwhelming for some people, and we want you to have the tools
to be successful. The Easing In plan is for you if you’d like to take things stepwise and gradually. I’ve created a
4-week plan to follow. I’ve also created a template in the next section that you can use to schedule your days based
on the weekly plan.

Week 1
Week 1 Food:
For week 1, reduce the amount of sugar, sweeteners, artificial sweeteners, honey, syrup, etc. that you
consume. Aim to limit to one serving per day or less. Consider making ingredient swaps to your normal
routine from the Approved Foods list, but make reducing sugar your priority for this week.

Week 1 Work:
For week 1, put a notebook by your bed and write down one thing that you are grateful for each night. Try
not to repeat any item.

Week 1 Enjoy Your Journey:

Make sure to give yourself a pat on the back every day that you limit your sugar to one serving or less and
write a gratitude entry in your journal. Make sure to give yourself grace—even if you didn’t make that mark,
still be proud of yourself for trying. Making big changes can be hard, but they are impossible if you always
dwell on the obstacles or missteps. You’re doing great!

Week 2
Week 2 Food:
For week 2, try to reduce your sugar intake to zero, and also add in reducing your dairy consumption. Aim
for one serving or less per day. Remember, dairy includes cheese, milk, yogurt. You can swap out milk with
unsweetened coconut or cashew milk, try your recipes without cheese or find an almond cheese substitute,
and even try out an unsweetened coconut yogurt.

Week 2 Work:
For week 2, in addition to your daily gratitude entry, try to keep all electronics off for the first 10 minutes
of your day. No emails, no texts, no apps, no news—just for 10 minutes first thing. Enjoy your coffee while
watching the sunrise, take a short walk, stand outside and breathe fresh air, or hop right in the shower.
Whatever you choose to do, try your best to avoid any electronics each morning, just for the first 10 minutes.

Week 2 Enjoy Your Journey:

Take time to reflect on how you feel when you limit your morning intake of social media, news, and emails.
Does it feel freeing? Or anxiety-inducing? Do you feel more refreshed starting your day without the input of
negative information, or do you feel disconnected? Don’t judge your thoughts, just notice them. It’s okay if
this is very hard for you, it’s also okay if you struggle, or even if you aren’t able to wait the full 10 minutes.
Go easy on yourself!

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Week 3
Week 3 Food:
For week 3, in addition to consuming no sugar or sweeteners, try to eliminate dairy entirely, and also reduce
the amount of processed carbohydrates you consume. Try to stick with one serving or less per day. Substitute
the processed carbohydrates you normally consume (like pasta, bread, bagels, cereal, etc.) with veggies and
protein. Try a zucchini noodle with marinara sauce instead of pasta. Try eggs instead of cereal or bagels. Try
an almond flour bread instead of grain flour bread.

Week 3 Work:
For week 3, in addition to your daily gratitude entry and your 10-minute device-free mornings, try to add
in a 5-minute guided meditation to your day. This can be during your 10 minutes in the morning (the one
exception to using devices), during your lunch, during a work break, or right before bed. Work it into
anywhere you have 5 minutes. Do you commute to work? Stream the guided meditation on your ride (just
don’t close your eyes if you’re driving!).

Week 3 Enjoy Your Journey:

You are making significant progress! Even if you feel like you’ve stumbled, no one is perfect. Be gentle with
yourself, make a U-turn, and get back on track. Forgiveness and self-compassion is at the center of finding
joy in your journey. It’s not always going to be easy to celebrate yourself and you’re definitely not going to
love every minute of it. But, be proud of every step along the way. In fact, be MORE proud if you have made
a small misstep and then got back on track. That’s a huge accomplishment!

Week 4
Week 4 Food:
For week 4, in addition to no sugar/sweeteners and no dairy, try eliminating your processed carbs, and
reducing your intake of processed foods to one serving per day or less. Processed foods would be almost
anything you can find in a bag or a box, most fast food, most pre-prepared items. The goal at this step is to
get all meals each day to have 2 servings of vegetables, one 4 to 6 ounce portion of quality protein, and
one or two servings of healthy fats—all whole food sources. An example would be a 5-ounce serving of wild-
caught salmon, one cup of steamed broccoli, one cup of roasted cauliflower drizzled in olive oil for dinner,
or two eggs with sautéed spinach, diced peppers, and tomatoes for breakfast.

Week 4 Work:
For week 4, in addition to your daily gratitude entry, your 10-minute device-free morning, and your 5-minute
daily guided meditation, add in daily movement for 20 minutes. Try a 20-minute brisk walk first thing in the
morning or a walk over your lunch break. Try a yoga class, go for a swim, take the stairs at work, go for a bike
ride, or play an outdoor sport. It doesn’t have to be vigorous, just aim to include movement. If you already
have an exercise or movement routine, try to increase it by 20 minutes or an additional activity each day.

Week 4 Enjoy Your Journey:

Celebrate each win. At this point, you’ve likely made some major strides towards your goals and you’ve also
likely hit some set-backs. But look at how far you’ve come! Be proud of your progress, stick with it, and give
yourself a little celebration dance every time you follow the diet or work plan.

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EASING I N W E E K LY T E M PL AT E

Food Food Food Food Activity to Activity to Activity to Activity to

to Limit to Limit to Limit to Limit Include Include Include Include

WEEK 1 Limit: Write down

sugar, 1 thing
sweeteners, you’re
artificial grateful for
sweeteners, each night.
honey, Try not to
syrup, etc. repeat.

WEEK 2 Avoid: Limit: dairy Write down Keep all

sugar, products, 1 thing electronic
sweeteners, cheese, you’re devices off
artificial yogurt, grateful for for the first
sweeteners, sour cream, each night. 10 minutes
honey, half and Try not to of your day.
syrup, etc. half, cream, repeat.
etc.
WEEK 3 Avoid: Avoid: Limit: Write down Keep all Include a
sugar, dairy processed 1 thing electronic 5- minute
sweeteners, products, carbohy- you’re devices off guided
artificial cheese, drates, grateful for for the first meditation.
sweeteners, yogurt, breads, each night. 10 minutes
honey, sour cream, pastas, Try not to of your day.
syrup, etc. half and bagels, repeat.
half, cream, cereals,
etc. etc.
WEEK 4 Avoid: Avoid: Avoid: Limit: Write down Keep all Include a Include a
sugar, dairy processed processed 1 thing electronic 5- minute 20- minute
sweeteners, products, carbohy- foods, you’re devices off guided movement
artificial cheese, drates, fast food, grateful for for the first meditation. activity.
sweeteners, yogurt, breads, foods that each night. 10 minutes
honey, sour cream, pastas, you find in Try not to of your day.
syrup, etc. half and bagels, a box or a repeat.
half, cream, cereals, bag.
etc. etc.

Make sure to take things one week, and one day at a time. Try to swap a vegetable with whatever food you’re
recommended to limit each week. Now is a great time to try out a new vegetable or food. Make a commitment to
this plan, ask your friends for help, and be proud of your accomplishments. It’s time to start feeling younger!

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Are You Jumping In?

If making significant changes in one fell swoop resonates more with you, this is the plan for you. I recommend
that you dive in, stick with it, tell your friends and have them hold you accountable, and practice self-compassion if
you hit roadblocks or setbacks. Always be gentle with yourself and take a U-turn to get back on track. I’ve made a
template you can use if it helps to have a visual schedule for the plan, you can find it at the bottom of this section.

Food:
For your entire 30 days, starting on day 1, cut out all forms of sugar (read your labels, sugar is hidden everywhere),
all grain flours and any sources of gluten, all dairy, any fruit juices or liquid calories (this includes artificial or zero-
calorie sweeteners), alcohol, soy, corn, peanuts, processed carbohydrates, and vegetable oils.

You might be tempted to binge on all the pantry items you currently have lying around that don’t fit this plan, prior to
starting. I’m not a fan of this approach—it’s counterproductive to your goal! I’m also not a fan of food waste. If your
pantry or fridge has a bunch of non-Pegan foods, consider donating them to your local food pantry or soup kitchen.

Follow my Approved Foods list for a more extensive guide to which foods to eat and which to avoid, but here’s the gist:

Enjoy:
● As many non-starchy vegetables as you want in all meals or snacks. Get in the habit of filling 75 percent
of your plate with non-starchy veggies. The more color, the better!
● High-quality protein from grass-fed beef, wild-caught salmon, pasture-raised poultry and eggs, etc.
● Gluten-free grains (such as quinoa, black rice, and buckwheat) in their whole-kernel form.
● Nutrient-dense, starchy vegetables such as sweet potatoes and winter squash, in moderation.
● Low-glycemic fruit such as apples, pears, berries, kiwi, or pomegranate, in moderation.
● Beans and legumes (except peanuts); shoot for lower glycemic options like lentils and black beans.
● Have one to two servings of healthy fat with each meal, like olive, avocado, or coconut oil.

Avoid:
● All forms of sugar, but especially avoid foods with added sugars. If you must sweeten, try using coconut
sugar, maple syrup, or honey, and do it yourself so you know exactly how much you are getting.
● Inflammatory beverages, like alcohol and coffee. One cup of coffee a day and one glass of wine or
alcohol three to four times a week may be okay for some people. Just pay attention and notice how they
make you feel.
● Liquid sugar calories such as soda or juices, unless you are making fresh-squeezed green vegetable
juices, which are fabulous.
● All artificial sweeteners.
● All fast food, junk food, artificial and refined foods.
● Refined grains, flours, and sugar.

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Work:
1. Stick to it. Write down your goals on sticky Mark’s Movement Routine:
Monday, Wednesday, Friday, I
notes and post them everywhere. Tell your have a 60-minute gym session
friends and family about your goals and ask with my personal trainer.
them to keep you accountable. Tuesday, Thursday, I do
the 7 minute HIIT workout.
Every day, I go on at least
2. Create a gym and movement routine. Model one 20-minute walk—usually
it after my recommendations in Key #6. Write it first thing in the morning. On
down, tell your friends, stay accountable. Saturdays and Sundays, I
dedicate my movement time to
play—I love tennis, hiking, and
3. Create a mindset protocol. Meditate, do even surfing. I like to mix it up,
yoga, download a mindfulness app, find a but I always play and have fun.
mindset podcast to subscribe to. Try to keep
all electronic devices off for at least 10 minutes Mark’s Meditation Routine:
first thing in the morning. Having a news, social Every morning, before my
media, and negative information-free time to coffee or my morning walk, I
meditate for 20 minutes. Then,
start your day helps to set you up for a positive
I’ll go on my morning walk. If
mindset instead of the barrage of negativity we I’m walking alone, I’ll listen
tend to set up our days with. Mindset is crucial, to my favorite uplifting (or
don’t skip this. science-heavy, depending on
my mood) podcast. I find a lot
4. Consider some health-promoting supplements. of peace and mindfulness while
I always recommend some staples: I cook, so I consider making
meals for my wife and I part
of my mindset routine, and I
● A high-quality multivitamin/mineral: Find one that contains optimal
do this most nights a week. I
amounts of the full range of vitamins and minerals in their correct also like to schedule calls with
forms to help fill nutritional gaps. either my friends, mentor, or
life coach so that I always stay
● Magnesium: About 75 percent of us are deficient in magnesium,
accountable. And most nights,
which plays a part in over 300 enzymatic reactions in our bodies. I include a second 20-minute
● Vitamin D3: More than 80 percent of the US population has meditation session. It helps me
relax and clear my mind before
insufficient levels of vitamin D, the sunshine vitamin. Research sleep—I know this helps me to
shows vitamin D deficiencies contribute to a wide range of rest fuller, deeper, and longer.
problems, including dementia.

Some of my favorite longevity supplements are:

● Probiotics: Stick with ones that are histamine-mitigating and avoid
the histamine-causing strains (see Key #4 for more on this).
● CoQ10: This is what helps your mitochondria to make energy.
While our bodies produce it, the amount made decreases as we
age and depending on factors like medications, genetics, and
overall mitochondrial health.
● Glutathione. The master antioxidant. It helps with our detoxification,
cellular integrity, energy production, and boosts immunity.
● Resveratrol. This poly-resveratrol product helps support blood
vessel health, enhances your sirtuin activity and normal inflammatory
response, and it helps support your liver function and detoxification.

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Enjoy Your Journey:

Celebrate every accomplishment you’ve made. Every time you stick with the meal plan, every meditation session, every
time you complete a gym session or movement activity, every time you practiced mindfulness, ate a veggie, or skipped
a dessert. Do you have a natural “cheerleader” friend? Ask them to keep you accountable and ask them to help you
celebrate your wins. In fact, ask them to join you! You’re more likely to accomplish your goals with a team.

Also, be gentle on yourself. Making major change can be challenging, but if you find yourself off track, practice self-
compassion and self-kindness and take a U-turn to get back on track. No matter how many roadblocks or setbacks you
might experience, the more gentle you are with yourself and practice self-love, the more likely you are to get and stay
on track.

You might consider an app that helps you celebrate wins and track your progress, like Confetti. It takes only a few
seconds to track each day. It keeps things simple but also gives you some accountability. Even if you don’t hit the mark
every day, every time you can check something off, celebrate and remember the progress you’re making to live better,
younger, and longer!

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30 Days to Aging Backwards Example Schedule

Here I’ve listed times and activities that you can follow for your 30-day plan. This is an example, but you can follow
it exactly if that is helpful. I filled in Monday with a full example but left some areas for the rest of the week empty
for you to fill in with what works for you.

MON TUE WED THU FRI SAT SUN

20-minute 20-minute 20-minute 20-minute 20-minute 20-minute 20-minute
brisk walk brisk walk brisk walk brisk walk brisk walk brisk walk brisk walk
6 am with guided with guided with guided with guided with guided with guided with guided
meditation or meditation or meditation or meditation or meditation or meditation or meditation or
podcast podcast podcast podcast podcast podcast podcast
Breakfast: Breakfast: Breakfast: Breakfast: Breakfast: Breakfast: Breakfast:
eggs+
8 am sauteed
veggies
Movement Movement Movement Movement Movement Movement Movement
Break: Break: Break: Break: Break: Break: Break:
10 am Go up/down 4
flights of stairs
Lunch: Lunch: Lunch: Lunch: Lunc: Lunch: Lunch:
Leafy green
salad with
canned pas-
ture-raised
12 chicken,
noon avocado, ¼
cup diced al-
monds, ¼ cup
diced pep-
pers, drizzled
with olive oil
Movement Movement Movement Movement Movement Movement Movement
Break: Break: Break: Break: Break: Break: Break:
take a walk
around a
12:30 block or two.
pm Listen to a
short guided
meditation
during your
walk.
Movement Movement Movement Movement Movement Movement Movement
Break: Break: Break: Break: Break: Break: Break:
Do 5 to 10
2:30 squats,
pm lunges, or
high knees
to get your
blood flowing

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MON TUE WED THU FRI SAT SUN

Dinner: Dinner: Dinner: Dinner: Dinner: Dinner: Dinner:
Baked
wild-caught
salmon
with 1 cup
of steamed
6 pm broccoli and 1
cup of roasted
carrots
drizzled in
avocado
oil, salt and
pepper
Movement: Movement: Movement: Movement: Movement: Movement: Movement:
Go for a
7 pm bike-ride or
sunset walk
Wind-down, Wind-down, Wind-down, Wind-down, Wind-down, Wind-down, Wind-down,
turn off turn off turn off turn off turn off turn off turn off
electronics/ electronics/ electronics/ electronics/ electronics/ electronics/ electronics/
use blue use blue use blue use blue use blue use blue use blue
blocking apps blocking blocking blocking blocking blocking blocking
8:30
or glasses. apps or apps or apps or apps or apps or apps or
pm Enjoy a non- glasses. glasses. glasses. glasses. glasses. glasses.
electronic Enjoy a non- Enjoy a non- Enjoy a non- Enjoy a non- Enjoy a non- Enjoy a non-
device activity electronic electronic electronic electronic electronic electronic
device device device device device device
activity activity activity activity activity activity
Gratitude: Gratitude: Gratitude: Gratitude: Gratitude: Gratitude: Gratitude:
Use your Use your Use your Use your Use your Use your Use your
notebook notebook notebook notebook notebook notebook notebook
or journal to or journal to or journal to or journal to or journal to or journal to or journal to
9:30
write down 3 write down 3 write down 3 write down 3 write down 3 write down 3 write down 3
pm things you’re things you’re things you’re things you’re things you’re things you’re things you’re
grateful for grateful for grateful for grateful for grateful for grateful for grateful for
that day. Try that day. Try that day. Try that day. Try that day. Try that day. Try that day. Try
not to repeat. not to repeat. not to repeat. not to repeat. not to repeat. not to repeat. not to repeat.

10 pm Sleep Sleep Sleep Sleep Sleep Sleep Sleep

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What Happens After the 30 Days?

Keep it up. You’re likely in a good routine and groove, and really starting to feel more youthful and vibrant. Like I
said, this way of eating and nourishing your spirit is lifelong. I don’t recommend fad dieting or short-term meditation.
I recommend eating and supporting your spirit for life.

You can add in some of the “Limit/Avoid” foods for special occasions or in rare instances, and do make sure you
enjoy it. No guilt allowed.

I always say, if what you’re doing makes you feel amazing and experience vibrant, youthful health, keep doing it.
If not, change.

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AGING THROUGH THE DECADES

In the Longevity Roadmap docu-series, our experts mentioned different focus areas depending on what decade of
life you’re in. I found this information very helpful and wanted to summarize it for you here.

20s and 30s

If you’re in your 20s and 30s, focus on creating and maintaining a good routine. Make sure you’re incorporating all
features of my 7 Keys to Aging Backwards and the Three Pillars to Age in Reverse. That includes taking care of your
blood sugar, hormones, mitochondria, diet, exercise, mindset, and emotional wellbeing. Start a self-care focus now.
It’s easy to get tunnel vision on big changes in life as most people in these decades are going through schooling,
marriage, starting families, building careers, and self-care is often put on the back burner.

Make sure you have a solid sleep routine and are not over caffeinating during the day, binge drinking at night, or
sacrificing sleep while working through these big changes. And definitely don’t smoke, try to minimize your expo-
sure to smoke and pollutants, and take steps to reduce your toxic exposures.

40s
If you’re in your 40s, self-care is of utmost importance. People in this decade are well into their family and career
lives and are often juggling multiple schedules, work deadlines, home maintenance, spousal relationships, and child
nurturing. It can be very, very busy. So busy, that it’s easy to put everyone else’s needs and schedule before yours.
Now is the time to prioritize yourself. Make sure you find what fills your cup and practice it often.

Do you like relaxing baths? Yoga classes? Meditation or stress reduction techniques? Catching up with a friend
over coffee or Zoom call? How about hobbies like gardening, landscaping, or home repair? Some things that work
for one person don’t work for another, so try out different forms of self-care and find (and stick with) the ones that
resonate with you.

50s
If you’re in your 50s, we focus on body fat and body composition. It’s important to identify if you have too much
weight around the midsection or are gaining too much subcutaneous or visceral fat. Now is the time to really focus
on resistance and weight training. By strengthening lean muscle mass, you can help to reduce some excess (and
potentially dangerous) weight, increase physical strength, and improve insulin sensitivity.

Getting into a good gym or exercise routine in your 50s is crucial to help set up the next several decades for
strength and agility instead of weakness and fragility. Now is the time to set the stage to ensure you can keep doing
the things you love as long as you want.

60s
If you are in your 60s, we bring it back to self-care. It’s easy in this decade of life to start to ruminate on the end
of life (though you could very well have many decades remaining to enjoy). It can be easy to fall into the “aging is
inevitable” mindset here, a lot of people struggle to enter their 60s. So really focusing on taking care of yourself
and surrounding yourself with things you enjoy is crucial.

Make sure you are continuing your hobbies and physical activity. Prioritize a healthy diet and sleep routine. Make
sure you still include weight and resistance training to keep your bones and muscles strong. Make sure you do what
you need to take care of yourself so that you can continue doing things you enjoy.

(I just turned 60 and feel stronger and more energetic than I ever have. I love being 60!)

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70s, 80s, and Beyond

If you are in your 70s or 80s+, it’s all about movement and exercise. As we get older, strength training becomes
more and more important. At this age, the fall risk and serious complications from falls increase dramatically and
can be fatal. The best way to reduce the risk of falling and injury is to keep your body strong.

You can practice resistance training using your own body weight, through light yoga or Pilates, or using weights.
Even if you’re over the age of 70, you can still build muscle and keep physically strong. Make sure you’re consuming
enough quality protein to support your muscles. Now is the time to keep moving.

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CONCLUDING REMARKS

The scientific study and research surrounding longevity is a very exciting frontier. Researchers are learning new and novel
ways to address aging every day. In fact, researchers are starting to approach aging as a disease instead of something
that is inevitable. This opens up the possibilities of finding a treatment for aging. This is a real possibility in our lifetime.

I’m not saying that becoming immortal is in our future, but I am saying that we are making massive strides towards living
way better, way longer. That’s a big deal.

We have a lot of that information at our fingertips right now. There isn’t a magic pill, nor a fountain of youth. Unfortunately,
it’s not that easy. But fortunately, there are so many things you can do today to improve your tomorrow. Every step you
take can add up to significant progress.

The more we learn about things like sirtuins, mTOR inhibitors, telomeres, and so many other emerging pieces of science,
the more able we are to enhance longevity and live better, longer. And while there’s still a lot to learn and discover, we
already know there are definitive things we can do to make that happen.

You can work to reduce inflammaging, you can help fuel your mitochondria, you can support your hormones, feed and
protect your beneficial bugs, incorporate movement and exercise into your life, and nourish your spirit and mindset. You
have the power. There’s so much you can do.

Thank you for taking this ride with me. I am fascinated, intrigued, and quite obsessed with learning everything I can to live
my fullest, most vibrant, energetic, and colorful life as possible. Will you join me?

Mark Hyman, MD

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REFERENCES AND RESOURCES

Resources
Find a Functional Practitioner

General Health
● The UltraWellness Center
– You can become a patient of The UltraWellness Center and work with the experts featured in The Longevity
Roadmap docu-series. The UltraWellness Center offers a variety of testing and treatment options, telemedicine
options, a highly-knowledgeable staff of nutritionists, IV therapies, and extensive follow-up.
● Institute for Functional Medicine
– The Institute for Functional Medicine is one of the most trusted sources for Functional Medicine certification.
You can use their database to locate Functional Medicine practitioners anywhere in the world. IFM Certified
Practitioners are listed first in the search results, given their extensive education in Functional Medicine. All
practitioners in the network have attended IFM’s five-day foundational course, Applying Functional Medicine
in Clinical Practice (AFMCP), and are also current IFM members.
● Parsley Health
– At Parsley, they’re redefining primary care with a root-cause, whole person approach and a focus on data,
technology, and real doctor-patient relationships. Parsley was founded by Dr. Robin Berzin, under the
belief that medicine should put nutrition, wellness and prevention on the front lines of health care, while
simultaneously making care smart and data-driven to meet our needs in today’s world.
● International Academy of Biological Dentistry and Medicine
– The IABDM is a network of dentists, physicians and allied health professionals committed to caring for the
whole person – body, mind, spirit and mouth.

Psychiatry and Mental Health

● Amen Clinics
– Amen Clinics are outpatient health care clinics that provide mental wellness strategies to patients of all
ages. They offer patient-first experiences and customized solutions to an array of behavioral and psychiatric
conditions.
● Hope Integrative Psychiatry
– Hope Integrative Psychiatry offers a comprehensive assessment of the impact of genetics, temperament, early
childhood experiences and trauma, current behaviors and lifestyle, along with a deep inquiry to assess your
unique strengths, belief systems and coping style. A holistic formulation is developed that pieces together all
these relevant factors into a narrative that is comprehensible, manageable and meaningful. This formulation
forms the basis of your personalized treatment by a team that is uniquely designed for you to accomplish
your transformation and complete recovery efficiently.

Longevity Books
● Lifespan: Why We Age—And Why We Don’t Have To by David A Sinclair, PhD
● Super Human: The Bulletproof Plan to Age Backward and Maybe Even Live Forever by Dave Asprey
● The Longevity Diet: Slow Aging, Fight Disease, Optimize Weight by Valter Longo, PhD.
● Glow15: A Science-Based Plan to Lose Weight, Revitalize Your Skin, and Invigorate Your Life by Naomi Whittle

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● The Longevity Paradox: How to Die Young at a Ripe Old Age by Steven Gundry
● Your Longevity Blueprint by Dr. Stephanie Gray

Mindset Books
● Limitless by Jim Kwik
● Tiny Habits by BJ Fogg
● The Universe Has Your Back by Gabrielle Bernstein
● The Power of Your Subconscious Mind by Dr. Joseph Murray
● The Untethered Soul by Michael A Singer.

Podcasts
● The Doctor’s Farmacy Podcast with Dr. Mark Hyman
● The Broken Brain Podcast with Dhru Purohit
● Unlocking Us Podcast with Brene Brown
● Ten Percent Happier Podcast with Dan Harris.

Specific Podcast Episodes

● The Doctor’s Farmacy Podcast featuring Gabrielle Bernstein
● The Doctor’s Farmacy Podcast featuring Dr. Jim Gordon
● The Doctor’s Farmacy Podcast featuring Dr. David Sinclair
● The Doctor’s Farmacy Podcast featuring Peter Attia
● The Doctor’s Farmacy Podcast featuring Valter Longo
● The Broken Brain Podcast featuring Peter Crone
● The Broken Brain Podcast featuring Dr. Yashar Khosroshahi
● The Broken Brain Podcast featuring Dr. John Amaral
● The Broken Brain Podcast featuring Dr. Rick Hanson
● How to Make Stress Your Friend TEDTalk by Kelly McGonigal
● Aseem Malhotra Pioppi Diet documentary

Recipes
● Find original Pegan recipes here
● Visit my website for many nutritious recipes
● 10 Day Reset, free version
● Food: What the Heck Should I Cook? Cookbook by Dr. Mark Hyman

Gadgets
● Sunlighten - Infrared Saunas
● Joovv - Red and Infrared Saunas
● chiliPAD - Temperature-controlled mattress pad
● Lumen - At home breath-test to track your metabolism

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● Vitamix - One of the highest-quality blenders on the market

● HeartMath - A technology to help release stress, find balance, and build resilience

Apps
● Calm - Guided meditation
● Insight Timer - Guided meditation
● Confetti - Progress tracker
● Seven - 7 Minute Workout
● Twilight - Red light blocker for devices
● Skindeep - Skincare ingredient database

Supplements Mentioned in the Workbook

● A high-quality multivitamin/mineral
● Acacia fiber
● Activated Charcoal
● Alpha Lipoic Acid (ALA)
● B-Complex
● Chlorella
● Curcumin
● Digestive enzyme
● E-Lyte
● Epigallocatechin-3-Gallate (EGCG)
● Fish Oil
● Glutathione
● HTB-Rejuvenate
● L-Carnitine
● Magnesium
● MegaSporebiotic
● N-acetyl-l-cysteine (NAC)
● Natural Calm
● Probiotics
● Resveratrol
● Ubiquinol (Coenzyme Q10)
● Vitamin D
● Zinc

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References

7 Keys to Aging Backwards Overview

1. Close to Half of U.S. Population Projected to Have Obesity by 2030. Harvard T.H. Chan School of
Public Health. https://www.hsph.harvard.edu/news/press-releases/half-of-us-to-have-obesity-by-2030/.
Published 2019. Accessed July 21, 2020.
2. Mather M, Scommegna P, Kilduff L. Fact Sheet: Aging in the United States – Population Reference
Bureau. Prb.org. https://www.prb.org/aging-unitedstates-fact-sheet/. Published 2019. Accessed July 21,
2020.
3. Scommegna P, Mather M, Kilduff L. Eight Demographic Trends Transforming America’s Older Population
– Population Reference Bureau. Prb.org. https://www.prb.org/eight-demographic-trends-transforming-
americas-older-population/. Published 2018. Accessed July 21, 2020.
4. Alimujiang A, Wiensch A, Boss J et al. Association Between Life Purpose and Mortality Among US Adults
Older Than 50 Years. JAMA Netw Open. 2019;2(5):e194270. doi:10.1001/jamanetworkopen.2019.4270
5. Gordon M. What’s Your Purpose? Finding A Sense Of Meaning In Life Is Linked To Health. Npr.org.
https://www.npr.org/sections/health-shots/2019/05/25/726695968/whats-your-purpose-finding-a-
sense-of-meaning-in-life-is-linked-to-health. Published 2019. Accessed July 21, 2020.

Key #1
1. Byun K, Yoo Y, Son M et al. Advanced glycation end-products produced systemically and by
macrophages: A common contributor to inflammation and degenerative diseases. Pharmacol Ther.
2017;177:44-55. doi:10.1016/j.pharmthera.2017.02.030
2. Hyman, M., MD. Why “Skinny Fat” Can Be Worse than Obesity. DrHyman.com. https://drhyman.com/
blog/2015/07/16/why-skinny-fat-can-be-worse-than-obesity/. Published 2015. Accessed July 21, 2020.
3. Saklayen M. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep. 2018;20(2).
doi:10.1007/s11906-018-0812-z
4. Roberts C, Hevener A, Barnard R. Metabolic Syndrome and Insulin Resistance: Underlying Causes and
Modification by Exercise Training. Compr Physiol. 2013;3(1):1-58. doi:10.1002/cphy.c110062
5. Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National
Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord. 2019;17(1):46-52.
doi:10.1089/met.2018.0105
6. Haghiac M, Yang X, Presley L et al. Dietary Omega-3 Fatty Acid Supplementation Reduces Inflammation
in Obese Pregnant Women: A Randomized Double-Blind Controlled Clinical Trial. PLoS ONE.
2015;10(9):e0137309. doi:10.1371/journal.pone.0137309
7. Trivedi M, Hodgson N, Walker S, Trooskens G, Nair V, Deth R. Epigenetic effects of casein-derived
opioid peptides in SH-SY5Y human neuroblastoma cells. Nutr Metab (Lond). 2015;12(1). doi:10.1186/
s12986-015-0050-1
8. Fasano A. Leaky Gut and Autoimmune Diseases. Clin Rev Allergy Immunol. 2011;42(1):71-78.
doi:10.1007/s12016-011-8291-x
9. Metsios G, Moe R, Kitas G. Exercise and inflammation. Best Practice & Research Clinical Rheumatology.
2020:101504. doi:10.1016/j.berh.2020.101504
10. Bartlett D, Willis L, Slentz C et al. Ten weeks of high-intensity interval walk training is associated with
reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a
pilot study. Arthritis Res Ther. 2018;20(1). doi:10.1186/s13075-018-1624-x
11. Punder KD, Pruimboom L. Stress Induces Endotoxemia and Low-Grade Inflammation by Increasing Barrier
Permeability. Frontiers in Immunology. 2015;6:223. doi:10.3389/fimmu.2015.00223
12. Rodiño-Janeiro BK, Alonso-Cotoner C, Pigrau M, Lobo B, Vicario M, Santos J. Role of Corticotropin-
releasing Factor in Gastrointestinal Permeability. Journal of Neurogastroenterology and Motility.
2015;21(1):033-050. doi:10.5056/jnm14084

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5. Childs BG, Baker DJ, Kirkland JL, Campisi J, Deursen JM. Senescence and apoptosis: dueling or
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Key #4
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Key #5
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Key #6
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23. Suzuki K. Chronic Inflammation as an Immunological Abnormality and Effectiveness of Exercise.

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Key #7
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