Test of Roadmap - How To Look Young & Feel Strong

For people aged over 18 years old

Contents

Introduction

Our health is the compass that guides us. It influences not just the length of our journey, but the quality of our experiences along the way. 

This roadmap is designed to be your trusted companion, offering clear and actionable steps to ensure you lead a life brimming with vitality and wellness. Whether your goal is to radiate youthful energy, build strength and resilience, or safeguard yourself against major health adversities like heart attacks, strokes, and cancer, this guide has you covered. 

Crafted from the latest clinical guidelines and research, the recommendations herein aim to empower you to nurture your body and mind from the inside out. So, as you embark on this transformative journey to holistic health, remember: every choice you make is a step towards a brighter, healthier future. Let's begin.

Diet

Diet is deeply personal, and what works for one individual may not necessarily work for another. While there's no one-size-fits-all 'best' diet, there are foundational principles that can guide us towards healthier choices. The food decisions we make profoundly influence our health and longevity. Recent 2022 data suggests that transitioning from a typical Western diet to an optimal one could potentially add over a decade to one's life.[1]

While this section offers guidance on the three primary macronutrients: protein, carbohydrates, and fats, it's essential to tailor these recommendations to your tastes, preferences, and individual needs. The goal is to provide a framework that you can personalize, ensuring a diet that not only nourishes your body but also resonates with your lifestyle.

Lean Protein

Protein plays a pivotal role in our body, from repairing tissues, building muscles, to producing enzymes and hormones. As we age, maintaining adequate protein intake becomes even more crucial to combat muscle loss, known as sarcopenia.

Why is Protein Important as We Age?

  • A 2022 meta-analysis revealed that older adults engaging in resistance exercise witnessed more significant strength improvements when their diet was supplemented with protein.[2]
  • Target a daily protein intake of 1.6g per kilogram of body weight.[3] For someone weighing 80kg, this equates to 128g of protein each day.
  • To put this in perspective, reaching this 128g target would require an 80kg individual to eat either 674g of chickpeas or 512g of beef. While this is just an illustrative example and not a dietary recommendation, it underscores how challenging it can be to meet daily protein requirements and suggests that many might fall short.
  • Distribute your protein intake evenly throughout the day, ideally every 3-4 hours, for optimal muscle protein synthesis.[4]

Sources of Lean Protein

  • Legumes: Beans, lentils, chickpeas, and peas
  • Quinoa: Unlike most plant-based foods, quinoa is a complete protein, making it a great choice for vegetarians and vegans.
  • Protein-Rich Vegetables: Some vegetables, like spinach, broccoli, and Brussels sprouts, have a decent amount of protein per serving.
  • Tofu and Other Soy Products: Tofu, tempeh, and edamame are all high in protein and are staples in many vegetarian and vegan diets.
  • Unsalted Nuts and Seeds: Almonds, walnuts
  • Fish and Seafood: Fish like salmon, tuna, and mackerel are not only high in protein but also rich in heart-healthy omega-3 fatty acids
  • Eggs: Eggs are one of the most complete sources of protein
  • Lean Meats: Chicken, and lean cuts of beef or pork. They also provide important nutrients like iron and vitamin B12.
  • Lean or Low-Fat Dairy: Greek yogurt, cottage cheese, and skim milk are high in protein.

For those struggling to meet their protein targets through food alone, consider adding a no-sugar protein powder to your diet. It's a convenient way to boost protein intake without added sugars.

Carbohydrates

Aim to consume mostly whole, unprocessed carbohydrates like fruits, vegetables, and whole grains, which provide essential nutrients and fibre. These complex carbs are digested slowly, helping to keep you feeling full and your blood sugar stable. Try to limit intake of processed carbs, such as white bread and pastries, which can lead to rapid spikes in blood sugar and are often low in nutrients.

  • Whole Grains: Foods like quinoa, steel-cut or rolled oats.
  • Legumes: Beans, lentils, and peas are high in fibre, protein, and various nutrients.
  • Vegetables: All vegetables are good sources of carbohydrates. This includes everything from starchy vegetables like potatoes to green, leafy vegetables like spinach and broccoli.
  • Fruits: All fruits, including apples, bananas, berries, and oranges

Fats

Prioritize the consumption of unsaturated fats,[5] which are found in foods like avocados, nuts, seeds, and extra-virgin olive oil. Try to limit your intake of saturated fats, which are present in foods such as fatty cuts of beef and full-fat dairy products. Most importantly, avoid trans fats, which are commonly found in many processed foods.

  • Avocados: These are rich in monounsaturated fats, and they're also high in fiber and potassium.
  • Nuts and Seeds: Almonds, walnuts, flaxseeds, chia seeds, and others are high in healthy fats and also provide a good amount of protein and fiber.
  • Fatty Fish: Salmon, mackerel, sardines, and trout are all high in omega-3 fatty acids, a type of polyunsaturated fat that's particularly good for heart health.
  • Extra-virgin Olive Oil: high in monounsaturated fats and is a staple in the heart-healthy Mediterranean diet.
  • Peanut Butter: While it's high in fat and calories, peanut butter has a good amount of monounsaturated fat. Just watch out for brands with added sugar, salt, or hydrogenated oils.
  • Chia Seeds and Flaxseeds: These seeds are not only high in fiber but also rich in omega-3 fatty acids.

Salt and Hidden Sugars: What to Watch Out For

Salt Intake:

Excessive salt consumption is linked to high blood pressure, which is a risk factor for heart disease, stroke, and other cardiovascular ailments. While our bodies need a certain amount of salt to function correctly, most people consume far more than the recommended daily limit. Here are some tips to reduce your salt intake:

  • Check Labels: Always read the nutrition label on packaged foods. You'd be surprised how much salt can be found in everyday items.
  • Limit Processed Foods: These often contain high levels of salt as a preservative.
  • Cook at Home: Preparing your meals allows you to control the amount of salt you use.
  • Use Herbs and Spices: Enhance the flavor of your dishes with herbs and spices instead of relying solely on salt.

Deceptive Sauces:

Sauces, dressings, and condiments can be a hidden source of both salt and sugar. Even those that might seem savory can contain unexpected amounts of sugar.

  • Homemade is Best: Whenever possible, make your sauces and dressings. This way, you know exactly what's going into them.
  • Read the Ingredients: Apart from checking the nutrition label, look at the ingredient list. Ingredients are listed in order of quantity, so if sugar or salt is near the top, that's a red flag.

Beverage Choices:

Liquid calories, especially from sugary drinks, can add up quickly and contribute to weight gain and other health issues.

  • Water is King: Ideally, make water your primary beverage. It hydrates without adding any calories or sugar.
  • Beware of "Healthy" Drinks: Even drinks labeled as "natural" or "healthy," like some fruit juices, can be packed with sugar.
  • Opt for No-Sugar Variants: If you're craving a soda or another sweetened drink, consider a no-sugar option. While they're not a health drink, they're a better choice than their sugar-laden counterparts.

Remember, it's not about completely eliminating certain foods or drinks but making informed choices and understanding what's in the products you consume.

 

Exercise

  • Exercise is a key component of a healthy lifestyle, contributing to both physical and mental wellbeing.
  • Ideally this should be done under the guidance of a personal trainer.

Here are some general guidelines to help you incorporate exercise into your routine:

  1. Regular Activity: Strive for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity each week, ideally spread across five days.
  2. Strength Training: Include strength training exercises at least twice a week. For optimal results, consider four to five sessions weekly. This can involve weights, resistance bands, or bodyweight exercises.
  3. Warm-Up and Cool-Down: Always start and conclude your workouts with a 5-10 minute warm-up and cool-down phase to prepare your body and aid recovery.
  4. Balance and Flexibility: Incorporate balance and flexibility exercises into your routine. Yoga and Tai Chi can improve your balance and flexibility, and they can also be good for stress reduction.
  5. Mix It Up: Variety in your exercise routine can keep it interesting and help you work out different muscle groups. Try to mix aerobic activities like running or cycling with strength training, balance exercises, and flexibility workouts.
  6. Gradual Progress: If you're new to exercise, start slow and gradually increase the intensity and duration of your workouts. It's better to do a little exercise regularly than to do too much too soon and risk injury.
  7. Active Lifestyle: Beyond structured workouts, integrate physical activity into your daily life, such as taking stairs or stretching during TV breaks.
  8. Listen to Your Body: Rest when you need to and don't push yourself too hard. If you feel pain, shortness of breath, dizziness, or nausea, stop and rest.
  9. Nutrition and Hydration: Fuel your workouts with a balanced diet and ensure you stay hydrated before, during, and after exercise.

Remember, it's always a good idea to consult with a healthcare provider before starting a new exercise program, especially if you have any chronic health conditions or you haven't been very active recently.

Progressive Overload

Understanding progressive overload is essential for effective strength training. This principle involves gradually increasing the stress on your body as you become stronger. Here's a safe approach:

  • Opt for weights that allow 15-20 repetitions before reaching failure.
  • Conclude your set 1-2 reps before reaching this point to minimize injury risk.
  • As you progress, adjust the weight to maintain the 15-rep threshold.
  • Aim for 2-3 sets per exercise for optimal strength gains, ensuring at least a 2-minute rest between sets.[6]
  • Engage in exercises with a full range of motion for maximum benefits.

Opposing Muscle Group Training

Balance your workouts by training both pushing and pulling muscle groups. This ensures even strength and flexibility development across your body, promoting good posture, functional fitness, and reduced injury risk.

Advanced – Periodizing Your Workout

For seasoned practitioners, "periodization" is a strategic approach to organize training over time, maximizing gains and minimizing overtraining risks. This method helps prevent plateaus, reduces overtraining risks, and optimizes performance peaks.

For instance, a 12-week program could be:

  • Weeks 1-4 (Hypertrophy Phase): Focus on muscle growth with lighter weights and higher reps (e.g., 3 sets of 15-20).
  • Weeks 5-8 (Strength Phase): Prioritize maximal strength with heavier weights and fewer reps (e.g., 3 sets of 8-12).
  • Weeks 9-12 (Power Phase): Incorporate explosive movements with even higher intensity (e.g., 3 sets of 1-5 reps).

Remember to always consult with a healthcare provider before starting a new exercise regimen, especially if you have health concerns or have been inactive for a while.

Sleep

Sleep is a vital part of maintaining and improving health. Good sleep hygiene can significantly enhance the quality of your sleep and, in turn, your overall health. Here are some sleep hygiene tips that can help you improve your sleep:

  • Establish a Regular Sleep Schedule: Aim to go to bed and wake up at the same time every day, even on weekends and days off. This regular rhythm will help your body establish a healthy sleep pattern.
  • Soak Up the Sun: Aim for at least 30 minutes of natural sunlight per day, particularly early morning sunlight, to help regulate your sleep patterns.
  • Sleep When Sleepy: Only try to sleep when you actually feel tired or sleepy, rather than spending too much time awake in bed.
  • If You Can't Sleep, Get Up: If you haven’t been able to get to sleep after about 20 minutes, get up and do something calming or boring until you feel sleepy, then return to bed and try again.
  • Limit Stimulants and Screen Time: Avoid caffeine or energy drinks past 9:30am and limit screen time before bed. Both caffeine and the blue light emitted by screens can interfere with your ability to fall asleep.
  • Limit Alcohol: Avoid alcohol for at least 4-6 hours before going to bed (ideally though, no alcohol at all). Although many people believe that alcohol helps them to get to sleep, it can actually interrupt the quality of your sleep.
  • Reserve Your Bed for Sleep and Sex: Try not to use your bed for anything other than sleeping and sex, so that your body comes to associate bed with sleep.
  • Avoid Naps: Try to avoid taking naps during the day to ensure that you are tired at bedtime. If you must nap, make sure it is for less than an hour and before 3pm.
  • Develop Sleep Rituals: Establish your own rituals that signal to your body that it's time to sleep, such as doing relaxing stretches or breathing exercises for 15 minutes before bed each night.
  • Consider a Bath/Shower Before Bed: Having a hot bath 1-2 hours before bedtime can be useful, as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again.
  • Keep a Sleep Diary: This can be a useful way of making sure you have the right facts about your sleep, rather than making assumptions.
  • Exercise Regularly and Eat Right: Regular exercise and a healthy, balanced diet will help you to sleep well. However, try not to do strenuous exercise in the 2 hours before bedtime and avoid large meals close to bedtime.
  • Create a Sleep-Friendly Environment: Keep your bedroom cool and dark. A cooler temperature (around 18-20 degrees Celsius) is conducive to better sleep. Use blackout curtains or an eye mask to block out light.
  • Maintain Your Daytime Routine: Even if you have a bad night's sleep and are tired, try to keep your daytime activities the same as you had planned. Don't avoid activities because you feel tired as this can reinforce the insomnia.
  • Manage Worries: Try to resolve your worries or concerns before bedtime. If you can't resolve them, try writing them down and setting them aside for tomorrow.
  • Check Your Mattress and Pillows: The foundation of good sleep is a comfortable bed. The life expectancy of a mattress is about 9 or 10 years for most good quality mattresses. Pillows only last around 2 years, as they start to accumulate dust mites.
  • Use a Sleep App or Recorder: If you suspect you might have a sleep disorder like sleep apnea, consider using a sleep app or a simple audio recorder on your phone to monitor your sleep. These tools can help you track your sleep patterns and record any noises you make in your sleep, such as snoring or gasping for air, which are common signs of sleep apnea. Remember, these tools can't diagnose sleep apnea, but they can provide information that you can share with a healthcare provider. If you have symptoms like excessive daytime sleepiness, loud snoring, or you stop breathing during sleep, it's important to consult a healthcare provider for a proper diagnosis and treatment.

Mindfulness & Meditation

Mindfulness is the practice of focusing your attention on the present moment and accepting it without judgment. It's about being fully engaged in whatever is happening around and within you, without being distracted or overwhelmed by what's going on. Mindfulness can be practiced in any moment of the day, whether you're eating, walking, or even doing chores.

Practicing mindfulness has been shown to reduce stress, improve focus, regulate emotions, increase self-awareness, and enhance mental health. It can also help reduce negative thinking patterns, improve relationship satisfaction, and increase resilience to adversity.

Meditation, on the other hand, is a more formal practice where you dedicate specific time to cultivate mindfulness or other mental qualities. There are many forms of meditation, including concentration meditation, loving-kindness meditation, body scan or progressive relaxation, and mindfulness meditation.

Regular meditation practice has been shown to have numerous benefits, including:

  • Reduced Stress: Meditation can decrease the levels of the stress hormone cortisol, leading to a more relaxed state of mind and body.
  • Improved Emotional Well-being: Regular meditation can lead to an improved self-image and a more positive outlook on life.
  • Enhanced Self-awareness: Certain types of meditation can help you develop a stronger understanding of yourself, helping you grow into your best self.
  • Increased Attention Span: Focused-attention meditation is like weight lifting for your attention span. It helps increase the strength and endurance of your attention.
  • Improved Sleep: A variety of meditation techniques can help you relax and control the "runaway" thoughts that can interfere with sleep. This can be particularly helpful for insomnia.
  • Decreased Blood Pressure: Meditation can also improve physical health by reducing strain on the heart. Over time, high blood pressure makes the heart work harder to pump blood, which can lead to poor heart function.

Remember, mindfulness and meditation are skills that take time to develop. Start with just a few minutes each day and gradually increase the time as you get more comfortable with the practice. There are numerous resources available, including apps and online courses, that can guide you through different mindfulness and meditation techniques.

Incorporating mindfulness and meditation into your daily routine can be a powerful way to improve your mental health and overall well-being. It's a simple, cost-effective tool that can make a big difference in your quality of life.

Young Skin

The skin, our body's largest organ, acts as a shield against environmental threats, including the sun's harmful UV radiation. Protecting the skin from excessive sun exposure is vital to prevent premature aging, hyperpigmentation, and skin cancer.

Step 1: Sunscreen

Daily sunscreen application is essential for skin health. Not only can it prevent skin aging, but some studies even suggest it can reverse some signs of aging. [7, 8] Remember, no sunscreen offers complete UV protection, so complement it with sun-protective clothing, shade, and avoiding peak sun hours.

Types of Sunscreens:

  • Chemical Sunscreens: These absorb UV radiation. Despite some reservations, current research affirms their safety (https://www.aad.org/media/stats-sunscreen).
  • Mineral Sunscreens: Containing ingredients like titanium dioxide and zinc oxide, these sunscreens reflect UV radiation. They're recognized as safe but might not shield as extensively as chemical versions.

Product Options:

  • Mineral Sunscreen: EltaMD - https://amzn.to/3YmgnIs
  • Chemical sunscreen: When shopping, seek out sunscreens listing Bemotrizinol (bis-ethylhexyloxyphenol methoxyphenyl triazine) as an active ingredient.

Step 2: Retinoid Creams

Retinoid creams are a powerful tool in the fight against skin aging. They accelerate the skin-building process by stimulating cells to produce collagen fibres and improving blood supply and nutrition to the skin.[9]

There are two main types of retinoid creams: adapalene and tretinoin. A large study in 2018 found that both creams significantly improved wrinkles and other signs of skin aging, with no significant differences between the two.[10]

However, it's worth noting that adapalene is generally the least irritating topical retinoid, while tretinoin can be more irritating.

The common concentrations of the creams are: tretinoin at a 0.05% concentration or adapalene at a 0.3% concentration.

Retinoid creams should be used at night. They can initially irritate the skin, so it's recommended to apply the cream every second or third night when you first start out, gradually increasing frequency as your skin adjusts.

Remember, always wear sunscreen when using retinoid creams as they can make your skin more sensitive to the sun.

Lastly, be cautious with retinoid creams if you're pregnant or planning to become pregnant, as they can potentially cause harm to the developing fetus. Always consult with a healthcare provider before starting any new skincare regimen, especially if you're pregnant.

Step 3: Collagen Peptide and Hyaluronic Acid supplements

Collagen is a vital protein that provides structure and elasticity to the skin, however it's estimated that adults over 80 years have 75% less dermal collagen in sun-protected skin than young adults.[11] Supplementing with 10-15g of hydrolyzed collagen can help rebuild it.[12, 13]

Similarly, Hyaluronic Acid is essential for skin health and decreases as we age. Fortunately, just like collagen, we can rebuild Hyaluronic Acid. Multiple human randomized controlled trials, including a non-sponsored, conflict-free study in 2021, have shown significant improvements in skin health with Hyaluronic Acid supplementation, including an 18.8% decrease in skin wrinkle depth.[14]

MicroVitamin contains 200mg of Hyaluronic Acid, which can be found here: https://drstanfield.com/products/microvitamin

Step 4: Vitamin B3

Vitamin B3 or Nicotinamide enhances skin barrier function, increasing hydration, and improving complexion.[15] It also improves complexion by reducing pigmentation, blotchiness, and redness associated with aging skin.[16]

It's beneficial to have a slightly higher dose than the daily recommended intake due to these effects.

Other tools

  • Lasers: Laser treatments stimulate collagen and elastin production, helping to reduce the appearance of wrinkles and improve skin elasticity.
  • Photodynamic Therapy (PDT): A light-based treatment that targets and reduces fine lines, wrinkles, and age spots.
  • Botox: An injectable treatment that temporarily paralyzes specific facial muscles, reducing the appearance of dynamic wrinkles.

Teeth

Maintaining good oral hygiene is essential not only for dental health but also for overall well-being. Here are some key practices to keep your teeth healthy:

  • Brushing: Brush your teeth at least twice a day, preferably in the morning and before bed. This helps remove plaque and food particles that accumulate on your teeth and gums. Use a fluoride toothpaste, which helps strengthen tooth enamel and reduce the risk of decay.
  • Electric Toothbrush: Consider using an electric toothbrush, such as the Philips Sonicare Series 2100 (https://amzn.to/3SWKS62). Electric toothbrushes can be more effective at removing plaque and improving gum health compared to manual toothbrushes. The Sonicare Series 2100, for instance, uses sonic technology to drive fluid between teeth, effectively cleaning those hard-to-reach areas.
  • Flossing: Floss at least once a day to remove plaque and food particles that your toothbrush can't reach. Regular flossing can prevent gum disease and tooth decay.
  • Mouthwash: Using an antimicrobial or fluoride mouthwash can complement brushing and flossing. It helps reduce bacteria, strengthen teeth, and freshen breath. However, it's not a replacement for brushing or flossing.
  • Regular Dental Check-ups and Cleanings: Visit your dentist or dental hygienist for a professional teeth cleaning every six months. Regular check-ups can help detect oral health problems early and keep your teeth and gums healthy.

Sunglasses

Protect your eyes from the sun's ultraviolet (UV) rays by wearing sunglasses that block out 99 to 100 percent of both UVA and UVB radiation. Overexposure to UV rays can lead to conditions like cataracts and macular degeneration.

However, it's beneficial to avoid wearing sunglasses in the very early morning. Exposure to morning light can help regulate your sleep/wake cycles and support overall health.

No Smoking and Limited (ideally no) Alcohol Consumption

Smoking and excessive alcohol consumption are two habits that can significantly impact your overall health, including your brain and sleep quality.

Smoking is harmful to almost every organ in your body, including your eyes. It is a leading cause of cancer and can damage your lungs, heart, and blood vessels. Smoking also decreases your body's ability to circulate blood effectively, leading to less oxygen and nutrients reaching your tissues and organs. This can result in premature aging and a host of other health problems.

Alcohol, even in moderate amounts, can have profound effects on your body and brain. It acts as a poison, leading to cellular stress and damage. It can negatively impact your gut microbiome, brain thickness, hormone balance, mood, and motivation. Alcohol also disrupts sleep, causing anxiety and headaches. Long-term alcohol consumption can lead to inflammation, stress, neurodegeneration, and an increased risk of cancer. It's also worth noting that alcohol can disrupt the balance of hormones in your body, including testosterone and estrogen.

Adult Vaccinations

https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html#table-age

Blood Pressure Below 120/80 At Home

Blood pressure is a critical aspect of overall health. It's the force that your heart uses to pump blood around your body, and maintaining it within a healthy range is vital for your wellbeing. High blood pressure, or hypertension, can lead to serious health issues, including strokes, heart attacks, vascular dementia, and kidney damage. 

Why Lower Blood Pressure?

Lowering blood pressure is important because it reduces the strain on your heart and arteries. This can significantly decrease the risk of life-threatening conditions such as:

  • Strokes: High blood pressure can cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke.
  • Heart Attacks: If high blood pressure is left untreated, it can lead to heart disease, which increases the risk of having a heart attack.
  • Vascular Dementia: This condition, which causes problems with thinking, speaking, and memory, can be a complication of high blood pressure.
  • Kidney Damage: The kidneys filter out waste from your blood using a network of tiny blood vessels. High blood pressure can damage this network, leading to kidney disease or failure.

Home Monitoring

Monitoring your blood pressure at home with an automated blood pressure kit is a good idea. It allows you to keep track of your blood pressure levels and notice any trends or changes. However, it's not necessary to check it excessively. Checking once every 2-4 weeks should be sufficient to get a trend. Ideally, at home, the blood pressure should be below 120/80.

Lifestyle Modifications

Achieving a healthy blood pressure can often be accomplished through lifestyle modifications, including:

  • Healthy Diet: As mentioned in the diet section, a balanced, nutritious diet can significantly impact your blood pressure.
  • Low-Salt Diet: Consuming too much salt can cause high blood pressure. Aim to limit your sodium intake.
  • Low or No Alcohol: Excessive alcohol consumption can raise your blood pressure, disrupt your sleep, and lead to other health problems. It's recommended to limit your alcohol intake or avoid it altogether.
  • Regular Exercise: Regular physical activity can help lower your blood pressure and keep it at a healthy level.
  • Good Sleep: Poor sleep or sleep disorders can contribute to high blood pressure.
  • Stress Management: Techniques such as meditation and mindfulness can help manage stress, a common contributor to high blood pressure.
  • Weight Control: Maintaining a healthy weight is crucial for blood pressure management. Newer GLP-1 therapies can help maintain a healthy weight if required.

For some people, these lifestyle modifications may not be enough to lower blood pressure to a safe level. In these cases, it's important to speak with a healthcare provider. They can help identify any underlying reasons for high blood pressure, such as kidney disease, hormonal disorders, or certain medications. If necessary, they can prescribe medications such as Angiotensin II receptor blockers (ARBs) to help manage your blood pressure.

Remember, managing blood pressure is a long-term commitment. Regular monitoring, a healthy lifestyle, and, if necessary, medication, can help you maintain a healthy blood pressure and reduce the risk of serious health complications.

Screening Blood Tests for Optimal Health

Screening blood tests are a cornerstone of preventive medicine. They can identify potential health issues before they become severe, guiding both treatment and lifestyle modifications. However, it's essential to approach these tests judiciously. Not every test is necessary for every individual, and the concept of pre-test probability should guide decisions.

Pre-test Probability

Before ordering a test, it's crucial to consider the pre-test probability. This concept refers to the likelihood that a person has the disease or condition in question before any tests are done. If the pre-test probability is very low, even a positive result might still mean the person doesn't have the disease (false positive). Conversely, if the pre-test probability is very high, a negative test might not rule out the disease (false negative). Ordering tests with a low pre-test probability can lead to unnecessary treatments, anxiety, and costs.

Recommended Screening Algorithm

18-35 years:

  • Full Blood Count (FBC)
    • Measures different components of the blood, detecting disorders like anemia, infection, and other diseases.
  • Lp(a):
    • Elevated levels are associated with an increased risk of heart disease. Testing once in a lifetime is typically sufficient as the levels are primarily driven by genetics rather than lifestyle.[17]
    • Ideal level: <60nmol/L (<30mg/dL)
  • Cholesterol Blood Panel
    • Essential for assessing cardiovascular risk.
    • Ideal level: LDL-c <70mg/dL (but lower for longer is best)
  • ApoB:
    • Provides a more comprehensive view of heart disease risk.
    • Ideal level: <60mg/dL
  • HbA1c: Measures average blood sugar over three months, diagnosing and monitoring diabetes.
  • Creatinine: Assesses kidney function.
  • Sodium & Potassium: Essential electrolytes indicating various conditions.

>35 years:

The tests are largely the same as for the younger age group, but with a frequency of every 5 years unless issues have been detected.

Additional Considerations:

Ferritin: While not routinely screened for every adult, it's essential for those at higher risk of iron deficiency. This includes premenopausal women, especially those with prior pregnancies or heavy menstrual periods, and individuals with conditions causing blood loss or iron malabsorption.

Hypothyroidism: Subclinical hypothyroidism is common, but most asymptomatic non-pregnant adults aren't routinely screened. However, individuals at increased risk for hypothyroidism, such as those with a goiter, history of autoimmune disease, previous radioactive iodine therapy, head and neck irradiation, family history of thyroid disease, or use of medications impairing thyroid function, should be screened.

Liver Function Tests: These aren't routinely screened unless there's a specific reason, such as alcoholism, obesity, family history of liver disease, autoimmune diseases, etc.

In conclusion, while screening blood tests are invaluable, it's essential to tailor them to individual needs, considering each person's unique health history, risk factors, and concerns. Regular consultations with healthcare providers ensure that the most appropriate tests are chosen, maximizing health benefits while minimizing unnecessary interventions.

Cancer Screening

Early detection of cancer can significantly improve the chances of successful treatment and survival. Screening tests are used to find cancer before a person has any symptoms.

The following is based on the American Cancer Society's guidelines:

Breast Cancer:

Age 40-44:

  • Women have the option to start annual mammograms if they choose.

Age 45-54:

  • Annual mammograms are recommended.

Age 55 and above:

  • Women can either:
    • Continue with annual mammograms, or
    • Switch to mammograms every 2 years.
  • Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.

Women should also know how their breasts normally look and feel and report any breast changes to a health care provider right away.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRIs along with mammograms.

Cervical Cancer:

Under Age 25:

  • Screening is not recommended as cervical cancer is rare in this age group.

Age 25-65:

  • Every 3 years, women should undergo:
    • A Pap smear, and
    • A human papillomavirus (HPV) test.

Over Age 65:

  • Women who have had regular cervical cancer testing with normal results in the past 10 years should stop testing.
  • Once stopped, testing should not be resumed.
  • However, those with a history of serious cervical pre-cancer should continue testing for at least 25 years after the diagnosis, even if it extends beyond age 65.

Colorectal Cancer:

Age 45-54:

  • Begin regular screening at age 45, as recommended by the American Cancer Society.
  • Opt for the stool-based FIT test.
  • Repeat the FIT test every 2 years.

Age 55-75:

  • Start getting a colonoscopy at age 55.
  • Repeat the colonoscopy every 10 years.
  • Continue regular screenings throughout this age range for optimal health.

Age 76-85:

  • Discuss with your healthcare provider whether you should continue screenings.
  • Your decision should consider your overall health, previous screening results, and personal preferences.

Age 86 and above:

  • It's generally advised to discontinue colorectal cancer screenings.

Lung Cancer:

Age 50-80:

  • Annual screening with a low-dose CT scan is recommended for individuals who:
    • Have a 20 pack-year smoking history, and
    • Currently smoke or have quit within the past 15 years.

If you quit smoking more than 15 years ago:

  • Screening is not recommended.

After Age 80:

  • Regular screenings are no longer recommended. 

Prostate Cancer:

Age 45-50:

  • Routine screening is not recommended for most men.
  • Men at high risk (e.g., those with a family history of prostate cancer or African American men) should discuss the potential benefits and risks of screening with their healthcare provider.

Age 50 and above:

  • Discuss the potential benefits and risks of prostate cancer screening with your healthcare provider.
  • If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.

Additional notes

Multi-cancer Early Detection Tests:

Multi-cancer early detection (MCED) tests have the potential to detect more than one type of cancer from a single blood sample. The blood is tested for DNA or proteins from cancer cells. If found, it might indicate the presence of cancer and potentially identify its origin.

MCED tests, such as the GRAIL Galleri test, are currently available by prescription. They are not meant to replace existing screening tests but might supplement them.

These tests are still under evaluation, and more research is needed to determine their effectiveness and accuracy. More details here.

Whole-Body MRI Scans:

Whole-body scanning with techniques like MRI, CT, etc., is sometimes marketed for detecting undiagnosed cancers. However, there's no evidence suggesting these imaging studies improve survival or the likelihood of finding a tumor in asymptomatic patients.

The risk of false-positive findings can lead to unnecessary testing, exposure to radiation, and additional medical costs.

Medical professional societies do not recommend whole-body scanning for individuals without symptoms. More details here.

Other Health Screening

Osteoporosis Screening

Dual-energy x-ray absorptiometry (DXA) scan

Women:

  • Age 50-65: Consider a DXA scan if risk factors for osteoporosis are present.
  • Age 65 and older: All women should undergo a DXA scan.

Men:

  • Age 50 and older: Consider a DXA scan if risk factors are present. Common risk factors include a previous fracture, smoking, excessive alcohol consumption, liver disease, and certain medications.

Supplements

Creatine Monohydrate 5g

  • The most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training.[18]
  • Possibly help enhance measures of memory performance.[19]

Omega-3 (DHA/EPA)

  • Supplementation is associated with 13% reduced risk of heart attacks according to a 2021 Mayo Clinic meta-analysis, with high GRADE certainty.[20]

 Low-dose Multivitamin & Mineral

  • Help reach your recommended daily intakes of micronutrients WITHOUT mega-dosing.
  • Daily multivitamin-mineral (MVM) supplementation for 3 years improved global cognition, episodic memory, and executive function in older adults.[21] 

Trimethylglycine 500mg

  • Reduce homocysteine levels.[22]
    • High homocysteine levels are linked with Alzheimer’s disease, however it is currently unclear whether lowering homocysteine will reduce Alzheimer’s disease rates.[23]
  • Possibly improve muscle performance during exercise.[24-26]

Hyaluronic Acid 200mg

  • Reduce skin wrinkles (by 18.8%) and the signs of skin aging.[14, 27-29]

Collagen Peptides 10-15g

  • Reduce skin wrinkles (by 8%) and the signs of skin aging.[12, 13]
    • There’s debate as to whether collagen peptides offer any further benefits for skin health compared to protein supplementation. In a 2020 trial of burn patients, one group had 36g of collagen daily while the other group had 35g of protein. The wound healing rate was significantly higher (Hazard ratio: 3.7) following supplementation with a hydrolyzed collagen-based supplement.[30] From that study, it appears that collagen peptide supplements have further benefits for skin beyond protein supplementation, however further research that specifically investigates skin wrinkles and the signs of skin aging is required.

Psyllium Husk

  • Reduce total cholesterol and blood pressure as per a 2016 Cochrane Review.[31]

References

  1. Fadnes, L.T., et al., Estimating impact of food choices on life expectancy: A modeling study. PLoS Med, 2022. 19(2): p. e1003889.
  2. Kirwan, R.P., et al., Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr, 2022. 115(3): p. 897-913.
  3. Morton, R.W., et al., A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med, 2018. 52(6): p. 376-384.
  4. Jager, R., et al., International Society of Sports Nutrition Position Stand: protein and exercise. J Int Soc Sports Nutr, 2017. 14: p. 20.
  5. Hooper, L., et al., Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev, 2015(6): p. CD011737.
  6. Spiering, B.A., et al., Maximizing Strength: The Stimuli and Mediators of Strength Gains and Their Application to Training and Rehabilitation. J Strength Cond Res, 2023. 37(4): p. 919-929.
  7. Hughes, M.C., et al., Sunscreen and prevention of skin aging: a randomized trial. Ann Intern Med, 2013. 158(11): p. 781-90.
  8. Randhawa, M., et al., Daily Use of a Facial Broad Spectrum Sunscreen Over One-Year Significantly Improves Clinical Evaluation of Photoaging. Dermatol Surg, 2016. 42(12): p. 1354-1361.
  9. Zasada, M. and E. Budzisz, Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy Dermatol Alergol, 2019. 36(4): p. 392-397.
  10. Bagatin, E., et al., Comparable efficacy of adapalene 0.3% gel and tretinoin 0.05% cream as treatment for cutaneous photoaging. Eur J Dermatol, 2018. 28(3): p. 343-350.
  11. Russell-Goldman, E. and G.F. Murphy, The Pathobiology of Skin Aging: New Insights into an Old Dilemma. Am J Pathol, 2020. 190(7): p. 1356-1369.
  12. Barati, M., et al., Collagen supplementation for skin health: A mechanistic systematic review. J Cosmet Dermatol, 2020. 19(11): p. 2820-2829.
  13. Kim, J., et al., Oral Supplementation of Low-Molecular-Weight Collagen Peptides Reduces Skin Wrinkles and Improves Biophysical Properties of Skin: A Randomized, Double-Blinded, Placebo-Controlled Study. J Med Food, 2022. 25(12): p. 1146-1154.
  14. Michelotti, A., et al., Oral intake of a new full-spectrum hyaluronan improves skin profilometry and ageing: a randomized, double-blind, placebo-controlled clinical trial. Eur J Dermatol, 2021. 31(6): p. 798-805.
  15. Bissett, D.L., J.E. Oblong, and C.A. Berge, Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg, 2005. 31(7 Pt 2): p. 860-5; discussion 865.
  16. Hakozaki, T., et al., The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer. Br J Dermatol, 2002. 147(1): p. 20-31.
  17. Kronenberg, F., et al., Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J, 2022. 43(39): p. 3925-3946.
  18. Kreider, R.B., et al., International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr, 2017. 14: p. 18.
  19. Prokopidis, K., et al., Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev, 2023. 81(4): p. 416-427.
  20. Bernasconi, A.A., et al., Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Mayo Clin Proc, 2021. 96(2): p. 304-313.
  21. Baker, L.D., et al., Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimers Dement, 2023. 19(4): p. 1308-1319.
  22. McRae, M.P., Betaine supplementation decreases plasma homocysteine in healthy adult participants: a meta-analysis. J Chiropr Med, 2013. 12(1): p. 20-5.
  23. Yu, J.T., et al., Evidence-based prevention of Alzheimer's disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry, 2020. 91(11): p. 1201-1209.
  24. Nobari, H., et al., Effects of chronic betaine supplementation on performance in professional young soccer players during a competitive season: a double blind, randomized, placebo-controlled trial. J Int Soc Sports Nutr, 2021. 18(1): p. 67.
  25. Lee, E.C., et al., Ergogenic effects of betaine supplementation on strength and power performance. J Int Soc Sports Nutr, 2010. 7: p. 27.
  26. Pryor, J.L., S.A. Craig, and T. Swensen, Effect of betaine supplementation on cycling sprint performance. J Int Soc Sports Nutr, 2012. 9(1): p. 12.
  27. Oe, M., et al., Oral hyaluronan relieves wrinkles: a double-blinded, placebo-controlled study over a 12-week period. Clin Cosmet Investig Dermatol, 2017. 10: p. 267-273.
  28. Kim, H., T. Moon, and N. Kim, Effect of hyaluronan on wrinkle. Food Style, 2007. 21(11): p. 42-46.
  29. WATANABE, M., K. MATSUI, and S. KONDO, Effects of low molecular weight hyaluronic acid by oral intake to beautify skin-placebo-controlled double-blind comparative study. 薬理と治療, 2015. 43(1): p. 57-64.
  30. Bagheri Miyab, K., et al., The effect of a hydrolyzed collagen-based supplement on wound healing in patients with burn: A randomized double-blind pilot clinical trial. Burns, 2020. 46(1): p. 156-163.
  31. Hartley, L., et al., Dietary fibre for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev, 2016. 2016(1): p. CD011472.