Longevity · Lifestyle

The longevity stack that's already proven

The supplement market sells $39–$1,000/month of NAD+ on biomarker promises. Meanwhile four unglamorous interventions carry mortality evidence no capsule has ever produced. Buy these first; they're mostly free.

Evidence-cited per our editorial policy · educational, not medical advice · 3 min read

1. Cardiorespiratory fitness — the strongest signal in the file#

In a cohort of over 120,000 patients (Mandsager et al., JAMA Network Open, 2018), higher treadmill-measured fitness tracked with lower long-term mortality — with no ceiling detected: the extremely fit did best of all. Association isn't causation, but no biomarker interventions come close to this gradient. Zone-2 cardio plus some hard intervals is the whole prescription.

2. Strength training — 30 to 60 minutes a week#

A meta-analysis in the British Journal of Sports Medicine (Momma et al., 2022) associated muscle-strengthening activity with 10–17% lower all-cause mortality, with benefits appearing at just 30–60 minutes per week. Muscle is also the organ that decides how you age functionally — see the same logic in our GLP-1 muscle playbook.

3. Sleep — the dose the meta-analysis agrees on#

Pooled cohort data (Cappuccio et al., Sleep, 2010) shows a U-shaped curve: both chronically short and chronically long sleep track with higher mortality. Seven-ish hours, kept consistent, outperforms every sleep gadget sold to optimize around not doing it.

4. Protein and not smoking — the non-negotiables#

Adequate protein defends the muscle the training builds (the same Morton et al. meta-analysis our diet guide cites), and smoking remains the single most reliable way to shorten a life in the entire literature. Nothing in a dropper bottle offsets either.

So where do NAD+ and the supplement stack fit?#

As the experimental layer on top — never instead. Our NAD+ price table ships with its evidence caveat for a reason: precursors reliably raise the blood biomarker, and the controlled trials so far show little consistent clinical benefit. If the basics above aren't in place, a $73/month NMN subscription is optimizing the paint while the foundation settles. If they are in place and you want to experiment with eyes open — that's what honest price tables are for.

Cost of the proven stack: sneakers you own + $30 of dumbbells or a gym membership + going to bed on time + protein at the grocery store. Versus $39–$1,000/month for the unproven one. The market inverts the evidence because the evidence is unpatentable.

Watch and listen#

Independent third-party material we found genuinely useful. Embedding is not endorsement, we have no relationship with these creators, and any commercial conflicts we know of are labelled. Video players load only when you press play, though the still image comes from Google; a podcast embed loads its player when it scrolls into view. What that means for you.

NAD and NAD precursors: help or hype?

Peter Attia, MD · with Matt Kaeberlein, PhD, biogerontologist · 2021-09-17

Two credentialed people examining why the NAD+ evidence is thinner than the marketing — the honest counterweight to this market.

disclosureAttia runs a paid membership and has supplement-industry ties; he sells no NAD+ product and is skeptical here.

Potential Risks of NAD Supplements

Peter Attia, MD · with Iñigo San-Millán, PhD · 2022-04-02

The risk side of NAD+ supplementation, rarely covered by sellers.

disclosurePaid membership; supplement-industry ties.

Sources#

Educational content built on the cited literature — not medical advice, and observational mortality data describes populations, not your prescription. Exercise programs and supplements both deserve clinician input if you have existing conditions.