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Carotid Artery Ultrasound and Longevity   The opposite of longevity is death. If longevity is what we seek we must obsess about death, and those things that increase the risk of us dying.   #1 Killer – Cardiovascular Disease Cardiovascular disease is the biggest killer on the block claiming the lives of 1 in every 3 people worldwide. Almost 1 million people a year die from cardiovascular disease in the United States alone, often due to events like heart attacks and strokes. The main cause of cardiovascular disease is atherosclerosis.    Atherosclerosis  Thickening and hardening of the artery walls caused by the deposition of plaque (made of cholesterol, fats, other materials) into the blood vessel walls. Plaques can slowly grow causing occlusion of a blood vessel (stenosis). Plaques can also rupture, leading to blood clots (ischemic heart attacks, strokes, and other infarctions). Plaques can also break away from the walls, forming emboli (also causing ischemic heart attacks, strokes, and other infarctions).   Infarction: Obstruction of blood supply to an organ or region of tissue (usually from a blood clot or embolis)   Thickening of blood vessel walls, plaques, and restriction of blood flow can all be visualized using Carotid ultrasound. In the body, if blood vessel disease (e.g. atherosclerosis) is seen at one area, it is likely present in other areas as well. As such:   Carotid Ultrasound is a very important Longevity Metric.  For the complete blog post check out fullscope.org/blog or longetrics.org/blog

Visual Accuity and Longevity   Happy Halloween everybody! Hope everybody is dressing up, My kids are being Spiderman, Boba Fett, and a black cat. I am going out as Darth Vader. If you are new to parenting, you are probably also realizing that candy is an alcohol equivalent for children and they literally become “drunk” after several pieces of concentrated sugar. Sorry Mormon church…..concentrated sugar is a drug.  But enough about candy!   Today on Full Scope, we are going to talk about a very important Longevity Metric – Visual Accuity, or how clearly a person can see things.   For longevity metrics, we are going to look through 3 lenses 1.        Common-Sense: Does it make sense that a given metric would impact longevity 2.        Clinical: Do I see evidence that a given metric impacts longevity in my clinical practice 3.        Research: Do research studies demonstrate that a metric impacts longevity. So HERE WE GO Check out fullscope.org/blog or longetrics.org/blog for the complete post. To see how visual acuity is measured at Longetrics, check out our youtube channel Longevity Metrics @BillBrandenburgMD.

Health and longevity are measurable, quantifiable, and malleable. The first step toward health optimization is awareness. Awareness starts with measuring. Because:   “What gets measured gets managed”  -              Said by many, made famous by Peter Drucker (known for modern management theory) -              This idea is why I moved from primary care to longevity medicine. More about this at the end.   Welcome to Season 6 of Full Scope! This season is all about how to measure health and longevity. We are going to go over: -              All of the tests utilized at Longetrics to measure health and longevity in Your Longevity Report Card -              Videos of how to perform each test (https://www.youtube.com/@BillBrandenburgMD) -              A podcast and a blog about what each of these tests (the longevity metrics) means regarding a person’s health and longevity (+ some tips about how to improve them).   Saddle Up! Visit Longetrics.org/blog or fullscope.org/blog for the complete post

Your Longevity Report Card   Today on Full Scope, I want to talk to you about Longetrics comprehensive, longevity focused, health screening, Your Longevity Report Card.    Full disclosure, this service is how I make a living. As such, all of the recommendations and ideas in this podcast contain an inherent conflict of interest.    But, please understand, I have spent over 1-million dollars, tens of thousands of hours, and shouldered great risk to build this. Hopefully this podcast will be useful for: -              Patients considering Your Longevity Report Card or another comprehensive health screening. -              Medical providers building health screenings for their own practice -              Anyone thinking about how to optimize there health and wondering what strategies and diagnostics to think about.   Why Did I Build Your Longevity Report Card?  For the complete Blog post, visit Longetrics.org/blog or FullScope.org/blog

There is a buzz about longevity. Many people feel that we are on the brink of a lifespan revolution. There is talk of making living to 100 the new norm. But the reality is just the opposite.     So, I thought I should.   The truth: Life expectancy is actually declining. Since its peak in 2014, the average lifespan in the United State has declined about 0.5 years. This may not sound like much. But considering the trend has been consistent and represents the average of a population of over 300 million people, it’s a hug deal.  My big fear…..This is just the beginning and that this trend will continue.  Why? Because even though we have more and better medical technology than ever, our environment is increasingly unhealthy. The world has become obesogenic, diabetogenic, and addicted. This is crippling our ability to live long and live well. Figure 1: Life Expectancy from Birth (2003 – 2023) Visit Longetrics.org/blog or fullscope.org/blog for the complete post!

The hype around longevity is huge in 2025. Money is pouring into the space. Longevity Start-ups are launching. Big claims are everywhere. But is all the hype justified?   What can longevity medicine actually deliver now?    Let's start with some quotes: Listen carefully. These come from leaders in the Longevity space. Do these quotes/claims sound true? Do you believe they are possible? Dave Asprey: “Im going to live to atleast 180 years” Mark Hyman: “Im 63 years old, but my biological age is 43” David Sinclair: “Why we age, and why we don’t have to” Fountain Life: “Live 100 healthy years”   My Responses to these Claims Check out FullScope.org/blog or Longetrics.org/blog for the complete post! Thanks for listening! Bill Brandenburg, MD

Longevity Philosophy 5 Big Ideas That Will Deliver More Years NOW   The longevity space is filled with empty claims! For example: -              This supplement will extend your life (C15, spermidine, D3, fish oil, etc.) Truth:  No supplement has ever been shown to extend human life in all comers (outside of a nutrient deficiency). If your Longevity provider has you on a supplement subscription for life extension…..you are being played.    -              This drug, peptide, hormone will extend life Truth:  No drug, peptide, or hormone has ever been shown to extend lifespan in all comers in a human clinical research trial (outside of a specific clinical indication. E.g. hypertension [referred to as a mortality benefit]). Some commonly used “longevity treatments” like growth hormone, may even shorten life.   -              AI will revolutionize longevity and we are close to longevity escape velocity. Truth:  AI is revolutionizing data accumulation, handling, and analysis. However AI is yet to extend lifespan in humans at all. Until AI leads to any measurable life extension, this claim remains unproven. Until we can measurably slow aging (beyond proven lifestyle interventions), longevity escape velocity will remain in the realm of science fiction. Visit Fullscope.org or longetrics.org for the complete blog post.

Today we are going over the basics of DEXA. This will help patients understand the test and what is being measured. It will also help clinical providers understand this test better. Let's dive in!   The Basics DEXA stands for Dual Energy X-Ray Absorptiometry -              Xray machine used for analyzing body composition -              Great at telling the difference between bone, fat, and lean tissue (mostly muscle) -              Uses 2 xray beams of different energies for this, hence Dual (via subtracting attenuation coefficients….or something like that) -              Most studied and widely used tool for looking at bone density -              USPSTF recommends all women over age 65 get one -              But 65 is way to late to get your first DEXA. The Cliff of old age is already luming at that point. -              I recommend getting one in your 20s or 30s to get a baseline and to help plan for the future. This will give you decades to improve things like bone density or get more muscled. Check out FullScope.org or Longetrics.org for the complete blog posts.

Muscle is your bodies bank account. It is the currency of life. It is biological gold.   Quote: “I lift weights, and I lift weights for 1 reason, to be strong” – Arnold Schwarzenegger   Deadlifts Deadlift: Lifting a weight from the floor to hip level. We use this movement anytime we pick something up off the ground.  Everyone should know this movement. Everyone should be able to deadlift their body weight, full stop (ideally much more)   Max weight ever Deadlifted:  Visit longetrics.org/blog or fullscope.org/blog for the complete blog post.

Quote: “In movement, there is life” – Aristotle “Genius starts with the abs Max” – The Grinch   Muscle is your bodies bank account. It is the currency of life. It is biological gold.   Why Do People Need Nursing Homes? As a hospitalist I frequently have to place people in nursing homes . I estimate that the reason why >90% cannot live at home anymore…….NOT ENOUGH STRENGTH. Think: needs help standing, needs help walking, unable to go up steps, unable to lift a dinner plate, etc. Additionally, I have noticed that as soon as muscle goes, cognition follows. Want to maintain your independence as you age? Start by maintaining your physic (aka – muscle)   Most people are concerned about having enough money for retirement. But, what people should be concerned about is having enough muscle. No-one can give this to you. It must be earned over years and decades.   You cant just talk about it, you have to do it. – Arnold Schwarzenegger   Strength peaks in our late 20s and early 30s. After this it declines by about 1-2% per year in most people. This decline is accelerated in the last 1 or 2 decades of life as we literally wither away.   Functions of Skeletal Muscle -              Movement -              Posture, Stability, and Joint Health -              Metabolic Health  -              Neurological and Brain Health  -              Store of Nutrients and Protein -              Heat Production -              Circulation (particularly venous) -              Protection and Padding -              Communication (facial expressions, posture, gesturing, etc.) -              Attraction and Reproduction   Did you know:  The best way to prevent dementia is physical exercise. See https://www.longetrics.org/blog for the complete blog post

Quote: “The greatest wealth is health” - Virgil, Roman poet 2000 years ago   Higher VO2 Max = Much Lower Risk of Dying…….Get off your ass! Let's illustrate this point:   ICU Patient 68 year old man with diabetes type 2 presenting with weakness and shortness of breath found to have sepsis due to pneumonia. This man is critically ill with sepsis.  His vitals: Heart Rate 150 (100% of estimated max heart rate: 220 – Age) Respiratory Rate 54 breaths per minutes Sweating and looks exhausted.   This man is literally fighting for his life. Can you see why fitness matters so much? How long can he hold on? Many of us will have to fight for our lives in this way at some point. FITNESS REALLY REALLY MATTERS   The Gold Standard for measuring cardiorespiratory fitness = VO2 Max   What is VO2 Max VO2 Max = the maximum volume of oxygen that can be utilized per kilogram of body weight during maximal exertion   Most often Expressed as:  ml/kg/min (milliliters per kilogram of body weight per minute) [1ml = 1cm3]   This is the gold standard for measuring cardiorespiratory fitness in medicine, exercise science, and research.    Humans range from of VO2 max of 5 (bedbound) to 90s (elite endurance athletes) Hummingbirds VO2 max = 600 ml/kg/min Exercise training will improve VO2 Max So, I hope since listening to part 1 you have gotten “off your ass”   Check out Longetrics.org or Fullscope.org for the complete post!

Title: VO2 Max, Part 1   This is just the 101 course:   Quote: “If you don’t make time for exercise, you will probably have to make time for illness” - Robin Sharma, Attorney, Writer, Consultant   What is VO2 Max Perhaps the most important metric for longevity and health in 2024 V=Volume (actually volume per unit time in this case) O2= oxygen VO2 = volume of oxygen that can be utilized per unit time VO2 Max = the maximum volume of oxygen that can be utilized during maximal exertion   Most often Expressed as:  ml/kg/min (milliliters per kilogram of body weight per minute)   This is the gold standard for measuring cardiorespiratory fitness in medicine, exercise science, and research. The best way to measure VO2 max is with a cardiopulmonary exercise test (CPET test). This is performed by hooking a person up to a closed breathing circuit via a facemask and measuring both inhaled and exhaled O2 and CO2. Other methods for estimating VO2 Max also exist. We will discuss measuring VO2 Max more thoroughly in part 2.   VO2 Max Record Holders Check out Longetrics.org or FullScope.org Blogs for the complete post

Title: Health Report Cards   Quote:  “what gets measured gets managed” - unknown source   When you measure something you become aware of it and can objectively manage it. Potential Pitfalls: The right things must be measured. Measurement must be accurate.   What is a Report Card: - an evaluation of performance   Benefits of Report Cards:  - attempts to measure strength and weaknesses - allows for awareness of weaknesses (so they can be targeted and improved) - provides objective measures of performance normalized to the rest of the group (lets one know exactly how they measure up) - allows outsiders to evaluate and make decisions   Negatives of Report Cards - can hurt feelings (who f*****g cares, life is tough, competitive, and requires constant improvement) - can leed to discrimination (of course….people, companies, and things with bad reports should be discriminated against). Discrimination = pressure to improve - the wrong things are often measured or given too much importance. If not, you will manage things that don’t matter. Importance of asking the right questions. - the things measured may be wrong or inaccurate. This is a big deal! Measuring things inaccurately is probably worse than not measuring things at all - subject to the bias of those creating report cards. We all remember that teacher that just didn’t seem to like us…..   See the full post on the Longetrics.org blog

Title: Longevity Conferences (ARDD and Dublin Longevity)   Quote: “Its not what you know but who you know” Said by many across multiple cultures   Today we review: The Aging Research and Drug Discovery Conference in Copenhagen, Denmark The Dublin Longevity Summit in Dublin, Ireland   3 Plugs - keep moving until you find your place and your people - go to places where you can be useful and contribute - try not to lose what makes you, you along the way.    Hallmarks of Both Conferences - I highly recommend attending both of these events (and conferences in general) - Europe was a blast. People are out and about. The downtowns I went to were generally flourishing  - Work Hard Play Hard – Lots of lectures, lots of late nights at the bar - All Day Every Day - Leaders in the field of Longevity Research (highly research focussed) - Research Focused, Less Clinical (but still some clinical content) - Startups and Funding/Funders was a big focus - Eccentric Personalities - Lots of Fun! Met a lot of great people   See full blog post at fullscope.org and longetrics.org

Quote: “The best physician is also a philosopher” – Galen (Claudius Galenus)   Reflection is key! What can I do better and why am I doing it in the first place? Harness failures as the great teachers that they are and constantly improve.   Why this person is important: Roman and Greek Physician, Surgeon, and Philosopher (129-216 AD, 87 years). Used anatomy based care (from observing the corpses of dead gladiators) and this allowed him to outperform his piers.    Bags the Question: What are we not using right now in medical practice that will be obvious to future doctors that we should be using? - I think about bedside ultrasound in this light -I also think about capturing more exam data through photos, sound clips, and videos and then harnessing new technology and big data insights to learn things not previously known - photos, sound clips, and videos have so much more data than a written physical exam in a note.   Philosophy Take: Asking the right questions is the key In a changing world, answers, like epidemiology, are always changing. So in some ways all we will ever have are questions.   The Longevity Physician We are going to talk about medical providers and physicians in this discussion. But the ideas may be useful for multiple other disciplines within healthcare. Everything from coaches, to personal trainers, physical therapists, pharmacists, etc. There is plenty of room for everyone in longevity and it will take a village to solve aging.   See Fullscope.org for the complete post