# Anti-Aging: Myth or Science? What Really Influences Biological Aging

> Anti-aging is a billion-dollar market full of promises. Which of them are evidence-based and which are just marketing? An honest assessment.

The anti-aging market passed the 60 billion dollar mark in 2024. Creams with "revitalizing stem cell extracts", hormone cocktails for "rejuvenation", NAD+ supplements in every conceivable dosage. The promises are endless, the marketing budgets enormous. How much of it is actually science?

## What biological aging actually is

Biological aging is not a single process. In 2023, López-Otín et al. identified 12 "Hallmarks of Aging" in Cell, including telomere shortening, mitochondrial dysfunction, cellular senescence and inflammaging. No single intervention addresses all of them. But targeted protocols can influence several at once.

## What works, based on the evidence

**Caloric restriction / intermittent fasting ★★★★★:** The best-documented longevity protocol of all. It activates AMPK and sirtuins, inhibits mTOR and boosts autophagy. Intermittent fasting (16:8) achieves similar metabolic effects without permanent calorie reduction.

**Exercise ★★★★★:** Lengthens telomeres, stimulates mitochondrial biogenesis and promotes neurogenesis. 150-300 minutes of moderate endurance training plus 2 strength sessions per week. One of the most powerful anti-aging interventions available.

**HBOT ★★★★:** The 2020 Efrati study found +20% telomere length and a 37% reduction in senescent cells. No other non-pharmacological protocol shows comparable biomarker effects. It directly addresses telomere shortening, senescence and mitochondrial dysfunction.

**Sauna ★★★:** Laukkanen et al. followed 2,315 men over 20 years. 4-7 sauna sessions per week reduced cardiovascular risk by 63% and all-cause mortality risk by 40%.

**Sleep ★★★★★:** Chronic sleep deprivation accelerates all 12 Hallmarks of Aging. Sleep is the foundation on which every other intervention stands or falls.

## What does not work

**High-dose single antioxidants:** In studies, beta-carotene increased lung cancer risk in smokers. Meta-analyses showed a slight increase in mortality with high-dose vitamin E. NMN/NAD+ precursors: interesting data from animal models, but so far no consistent human longevity studies.

**Anti-aging creams:** They affect skin texture and surface hydration. They have no effect on cellular aging.

**Hormones without medical indication:** Testosterone, HGH and DHEA taken without a medical indication show no consistent longevity evidence. The risks can outweigh the potential benefits.

## The pragmatic protocol

Daily: 7-9 hours of sleep, an individualized diet based on your metabolic type, 30+ minutes of movement. Weekly: 1-2 IHHT or HBOT sessions, 2 strength workouts, 2-4 sauna sessions. Monthly: measure your biomarkers and adjust the protocol.

## Frequently asked questions

**What is the most important first step?**
Sleep and a diet matched to your metabolic type. Everything else builds on this foundation and becomes ineffective without it.

**Is longevity worth pursuing at 40?**
Yes. From 40 onward, targeted interventions deliver the largest measurable gains, because natural decline begins around that age. There is no such thing as "too late".

**Is longevity expensive?**
Sleep is free. Exercise is free. Intermittent fasting is free. IHHT from around CHF 90 per session is a targeted addition, not a basic requirement.

## Sources

López-Otín C et al. (2023), Cell - Hallmarks of aging: An expanding universe.
Efrati S et al. (2020), Aging - Hyperbaric oxygen therapy increases telomere length.
Laukkanen JA et al. (2018), JAMA Internal Medicine - Sauna bathing and risk of disease.
Miller ER et al. (2005), Annals of Internal Medicine - Meta-analysis: high-dosage vitamin E supplementation.

*Which longevity interventions are right for you?