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Overview of Treating Patients for Longevity and Athleticism

Oct 06, 2025
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Austin Yeargan III MD-Orthopaedic Surgery/Molecular Immunobiologics

Treating patients to maintain longevity and athleticism involves a multifaceted approach that combines preventive strategies, lifestyle interventions, personalized medicine, and targeted therapies. The goal is to optimize healthspan (the period of life spent in good health) alongside lifespan, while enhancing physical performance, recovery, and resilience against age-related decline. This can include evidence-based methods drawn from sports medicine, functional medicine, and longevity research. Key principles emphasize early diagnostics, individualized plans based on biomarkers and genetics, and ongoing monitoring to adapt treatments.

Lifestyle Interventions

Lifestyle forms the foundation for promoting longevity and athletic performance, often described as the base of a "longevity pyramid." These strategies are accessible, cost-effective, and supported by robust evidence for reducing mortality risk and improving physical capabilities.

  • Exercise Regimens: Regular physical activity is essential for combating sarcopenia (muscle loss), improving cardiovascular health, and enhancing cognitive function. Recommend a combination of:
    • Aerobic exercises (e.g., walking, cycling, swimming) for 150–300 minutes per week at moderate intensity or 75–150 minutes at vigorous intensity to boost VO2 max, endurance, and reduce chronic disease risks. Incorporate high-intensity interval training (HIIT) to improve oxygen utilization and stamina.
    • Strength training 1–2 times weekly with progressive overload to build muscle mass, bone density, and metabolic function, which helps prevent diabetes and supports athletic power.
    • Stability and balance training (e.g., yoga, Pilates) to reduce fall risk, improve proprioception, and maintain functional independence, which is crucial for sustained athleticism in aging patients. These can add up to a decade to life expectancy compared to sedentary lifestyles, with even modest increases yielding benefits like lower all-cause mortality.
  • Nutrition and Dietary Patterns: Tailor diets to support energy production, reduce inflammation, and promote gut health.
    • Emphasize plant-based or Mediterranean diets rich in vegetables, olive oil, and moderate protein to lower BMI, hypertension, and diabetes risks.
    • Incorporate caloric restriction (10–25% reduction) or intermittent fasting (e.g., 5:2 diet or time-restricted eating) to enhance metabolic switching, improve insulin sensitivity, and extend healthspan.
    • Increase protein intake with age to preserve lean muscle, and monitor blood sugar to prevent metabolic disorders that impair athletic performance. For athletes, functional nutrition can optimize recovery and longevity.
  • Additional Habits: Encourage sauna bathing (associated with reduced stroke and dementia risk), cold water immersion for mood and recovery, and maintaining oral health to prevent malnutrition and sarcopenia. Limit alcohol consumption, as excess accelerates aging and increases disease risks like osteoporosis, which can hinder athleticism.

Supplements and Pharmacological Interventions

Supplements can address cellular aging and support athletic demands when lifestyle alone is insufficient. Always base recommendations on patient biomarkers and monitor for interactions.

Supplement/Therapy

Key Benefits for Longevity and Athleticism

Dosage/Administration

Evidence Notes

NAD+ Precursors (e.g., NR, NMN)

Boosts mitochondrial energy, improves endurance, recovery, and DNA repair; reverses age-related declines in performance.

250–1,000 mg/day orally or IV for maximum uptake; combine with vitamins for synergy.

Enhances aerobic capacity in runners and reduces fatigue in older adults.

Alpha-Ketoglutarate (AKG)

Improves sports performance, reduces biological age, enhances collagen synthesis for skin and joint health.

300–1,500 mg/day.

Can compress morbidity and extend lifespan in models; human studies show age reversal by up to 7 years.

Resveratrol

Antioxidant effects improve glycemic control, fat loss, and cardioprotection.

100–500 mg/day.

Benefits metabolic status in diabetes and heart disease patients.

Spermidine

Reduces CV disease risk, improves cognition, and extends lifespan.

7–25 mg/day from food or supplements.

Linked to cardioprotection in studies.

Senolytics (e.g., Fisetin, Quercetin + Dasatinib)

Clears senescent cells, reduces inflammation, and supports muscle function.

20–500 mg/day for fisetin; up to 1g/day quercetin.

Ongoing trials for age-related diseases; extends lifespan in models.

Probiotics (Gerobiotics)

Enhances gut microbiota diversity, reduces sarcopenia, and boosts immunity.

Strains like Bifidobacterium and Lactobacillus.

Improves muscle and cognitive health in aging.

Other agents like metformin (for mortality reduction) or rapamycin (for lifespan extension) may be considered for specific cases, but require careful monitoring.

Advanced Therapies and Personalized Medicine

Leverage next-generation tools for precision treatment.

  • Hormone Replacement Therapy (BHRT): Use bioidentical hormones to restore estrogen or testosterone levels, combating fatigue and maintaining vitality for athletic performance. Discuss risks like stroke or cancer, and tailor to patient needs.
  • Pharmacogenomics (PGx) and Genetics: Test for variants (e.g., CYP enzymes) to optimize drug responses, reduce side effects from NSAIDs or opioids, and personalize training based on performance genes (e.g., ACTN3 for power). This enhances recovery and extends career longevity.
  • Multi-Omics and Digital Health: Integrate genomics, proteomics, and metabolomics for molecular insights into performance and injury risk. Use wearables (e.g., Apple Watch, Oura Ring) for real-time monitoring of sleep, activity, and workload to prevent overtraining and track progress.
  • Regenerative Therapies: Consider hyperbaric oxygen for telomere lengthening and cognitive enhancement, photobiomodulation for pain relief, or stem cell therapies for tissue repair.

Implementation in Practice

Start with comprehensive assessments: biomarkers (e.g., glucose, VO2 max), genetic testing, and body composition scans. Develop individualized plans, integrating remote monitoring via apps or devices for adherence. Collaborate with specialists in sports medicine or functional integration for holistic care. Regular follow-ups ensure adjustments, with lifestyle changes prioritized before supplements or therapies. This approach can prevent up to 80% of premature heart disease and stroke while supporting sustained athleticism.