The Best Biomarkers For Longevity, According To Experts

Human longevity has reached new heights. During the 20th century, lifespan in high-income countries increased by about 30 years due to public health and medicine advancements, according to a 2024 analysis in Nature Aging.In the U.S., the average life expectancy climbed to 78.4 in 2023—75.8 for men and 81.1 for women, per the Centers for Disease Control and Prevention.

Still, the analysis in Nature Aging suggests a dramatic increase in life expectancy is unlikely in the 21st century. Instead, strategies to slow down biological decline and improve quality of life in midlife and beyond are top of mind. Longevity researchers study the ways biological, environmental and lifestyle factors impact health span—the time you spend in good health—rather than just lifespan, which refers to how many years you live.

Biomarkers are used to gain information about an individual’s aging process, including their current health status and predisposition for diseases. Understanding a person’s future risk allows health care providers to recommend lifestyle and medical interventions that may slow down the biological aging process by improving overall wellness. Here are the top biomarkers that influence health span, according to experts.

What Are Longevity Biomarkers?

“Biomarkers are simply anything we can measure that provides quantifiable information about a biological process,” says Michael Doney, M.D., a longevity expert and executive medical director at Biograph, a preventive health and diagnostic clinic. Biomarkers provide insights into age-associated chronic diseases, such as heart disease, diabetes, dementia and cancer, which are responsible for the vast majority of morbidity and mortality, he says. Research notes that biomarkers may come in the form of genes, proteins, polysaccharides and more.

In the longevity and wellness space, the term has come to mean anything we can measure that provides information about your current health status and future health risks, adds Matt Kaeberlein, Ph.D., a longevity expert and chief executive officer of Optispan, a longevity health tech platform.

Biomarkers are measured in your body through laboratory tests, such as blood or urine, or on your body using wearable data and biometrics, adds Jim LaValle, a registered pharmacist, board-certified clinical nutritionist and chief science officer at Life Time, a chain of athletic country clubs.

How Do Biomarkers Influence Longevity?

Research in Heliyon from 2023 notes that the body creates biomarkers either by organs that are dealing with disease (such as tumors) or by the body in response to the presence of disease.

“Just like a car dashboard displays warning lights before something goes wrong, biomarkers can give you an early signal that something in your body might need attention,” says Dr. Kaeberlein. For example, they help detect existing pathology or disease so it can be treated and optimally reversed, he explains.

Biomarker results help identify early physiological imbalances, quantify biological age and guide targeted interventions that restore metabolic, hormonal, immune and mitochondrial efficiency (the conversion of food to energy within cells), notes LaValle.

“Rather than treating disease after it appears, biomarker optimization allows you to shift the aging trajectory toward resilience, repair and slower biological decline,” he says.

Key Biomarkers for Longevity

Considering a combination of biomarkers can provide a powerful snapshot of your current health status and health span trajectory, says Dr. Kaeberlein. The best biomarkers help predict long-term health outcomes that can be modified through intervention, he adds.

“My focus is on maximizing health span—the time spent in good health—rather than just lifespan (how long you live),” he says. “Slowing biological aging helps both, but health span is what truly matters to most people.”

Moreover, it’s challenging to identify a universal set of longevity biomarkers, stresses Dr. Doney. That’s because the significance of a specific biomarker depends on a person’s age, sex, genetics and lifestyle, in addition to clinical data, he says.

That said, several key categories of biomarkers can provide meaningful insight into long-term health.

1. Cardiovascular Markers

Lipid profiles measure the levels of fat in your blood, including total cholesterol, low-density lipoprotein (LDL, often referred to as “bad” cholesterol), high-density lipoprotein (HDL, known as “good” cholesterol) and triglycerides. A standard lipid panel, conducted via a blood draw, will measure these levels.

While traditionally used to estimate the risk of heart disease, lipid profiles can be used as a metabolic aging biomarker in longevity medicine, says LaValle. Elevated LDL levels are associated with an increased risk of heart disease, while higher HDL levels can help protect against it. The test provides insight into how much stress and inflammation there is in your blood vessels to gauge your overall health and aging, adds Lavalle.

2. Metabolic Markers

Regular testing of metabolic markers helps evaluate blood sugar regulation and long-term cardiometabolic risk, notes LaValle. Cardiometabolic risk refers to a group of health issues—abdominal obesity, insulin resistance, high blood pressure, unhealthy cholesterol levels and atherosclerosis (hardening of the arteries)—that raise heart disease and type 2 diabetes risk. Tests for metabolic markers include:

• Fasting glucose and fasting insulin tests, measured via a blood test, requires fasting for at least eight hours and assesses how well the body regulates blood sugar and insulin levels. Elevated levels can indicate insulin resistance, a precursor to diabetes.
• Hemoglobin A1c (HbA1c), also called a glycated hemoglobin or A1c test, measures the average blood glucose level over the past two to three months, explains Lavalle. “It reflects how much glucose in the blood has attached to hemoglobin—the protein in red blood cells that carries oxygen,” he says, adding that since red blood cells live about 120 days, HbA1c tests provide a long-term view of glucose control.

3. Inflammatory Markers

“Blood-based tests like high-sensitivity C-reactive protein (Hs-CRP) may help identify chronic, low-grade inflammation tied to heart disease, dementia and other age-related conditions,” says Dr. Doney.

Chronic inflammation, even at a low level, is linked to cancer as well as cardiovascular, autoimmune and other chronic diseases. Inflammatory markers include:

• High-Sensitivity C-Reactive Protein (hs-CRP) measures hs-CRP, a protein produced by the liver in response to inflammation. “It rises rapidly within hours of tissue injury, infection or systemic inflammation and returns to baseline when inflammation resolves,” notes LaValle. In terms of longevity, hs-CRP links inflammation to aging and the progression of chronic disease, he says.
  Homocysteine (Hcy), an amino acid, is broken down by B vitamins in the body. Elevated levels signal that Hcy is not being broken down properly, which can cause it to build up in your arteries, potentially causing arterial damage and increased risk of blood clots, which raises the risk of heart attack, stroke and other heart diseases.
  Neutrophil-to-lymphocyte ratio (NLR) measures systemic inflammation via standard complete blood count. NLR is emerging as one of the most accessible blood-based indicators of “inflammaging,” the chronic, low-grade inflammation that accelerates biological aging, according to LaValle.

4. Aerobic Capacity

Cardiorespiratory fitness results, measured through VO2 max testing (maximal oxygen consumption), can provide powerful insights into the risk of chronic disease and all-cause mortality, says Dr. Dorey. Improving aerobic fitness can enhance cardiovascular health and potentially longevity.

VO2 max testing assesses the maximum amount of oxygen the body can use during intense exercise. The more oxygen your body is able to use, the more energy you’re able to produce. Typically, participants exercise on a treadmill or bike while breathing into a device to measure their current fitness level.

5. Body Composition and Performance

“Measurements of visceral fat mass, lean mass, strength and power are associated with metabolic health, mobility and quality of life as we age,” notes Dr. Doney.

Dual-energy X-ray absorptiometry (DEXA) scans bone density, muscle mass and fat distribution in the body via a quick, noninvasive procedure. It sends dual low-power X-ray beams through the body to distinguish bone, lean mass and fat.

6. Hormonal Health

“Sex hormones play a central role in longevity,” says Lavalle. Declines or imbalances in testosterone, estrogen, progesterone and dehydroepiandrosterone (DHEA) are strongly associated with biological aging (which refers to how fast your cells are aging as opposed to your chronological age), he says. While hormonal panels vary, they are blood tests that measure sex hormones like testosterone, estradiol, progesterone and DHEA. They identify deficiencies so that treatments such as hormone therapy (HT) can be implemented as needed.

How To Interpret Longevity Biomarker Tests

To obtain the deepest understanding of biomarker data, tests should be obtained and interpreted within a clinical context, such as a practice specializing in precision preventive health and diagnostics, according to Dr. Doney. The key, he says, is understanding which results matter to build a personalized plan that extends health span (rather than fueling data overload).

Seek the guidance of a health care provider who understands your health goals and concerns and acts as a partner on your journey, adds Dr. Kaeberlein. “Request a full laboratory wellness panel that includes cardiovascular, metabolic, inflammatory and hormonal markers, tailored to your specific health concerns,” he advises.

Routine comprehensive blood panels and physical assessments can help track your biomarkers over time, adds Dr. Kaeberlein. That way, you can proactively manage your health with lifestyle and medical interventions based on the latest results.

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Practical Action Steps To Improve Longevity

While lifestyle factors including nutrition, exercise, sleep quality, relationships and stress management have a significant impact on improving health span, medical intervention (treating existing medical conditions with medication), will also play a role for most people, says Dr. Kaeberlein.

“For example, hormone therapy is a medical intervention guided by biomarkers that has a huge impact on health span for many people,” says Dr. Kaberlein. Similarly, cholesterol- or blood pressure-reducing medications can help lower the risk of heart disease, and blood sugar regulation medications can help control type 2 diabetes.

The bottom line? “Regular biomarker testing can detect existing disease or predisease and predict areas where problems are likely to arise in the future,” notes Lavelle. By utilizing these insights, individuals can implement lifestyle changes, seek appropriate medical interventions and ultimately shift their health trajectory toward greater longevity.

Credit: Forbes.com