We're all aging. I want to slow it down as much as you do. But this trial shows small, likely spurious effects on imprecise surrogate markers with no connection to clinical outcomes. Get your micronutrients from food.
Full write-up: buff.ly/n9fUjcV
The study, in Nature Medicine:
[LINK: buff.ly/dzmvQ8e]
The authors test this. They ask: does the cognitive benefit from multivitamins in COSMOS-Mind work through epigenetic clock changes? Answer: no. No significant mediation. If vitamins help your thinking, this isn't the pathway.
Even if real: is changing DNA methylation the same as "slowing aging"? Blood pressure predicts stroke and treating it helps. Grip strength predicts frailty but squeezing a stress ball doesn't. Which kind of surrogate are epigenetic clocks?
The authors say they didn't correct for multiple comparisons because the clocks are correlated. But they're not THAT correlated. And even with correlated outcomes, you need to control false discovery. We have ways to do this. You can't just test everything and pick the winners.
The two "hits": multivitamin slightly reduced PhenoAge and GrimAge increases at year 2. The PhenoAge difference was ~0.4 years over 2 years. That's 0.08 standard deviations. (0.2 SD is a minor effect typically).
The study tested 2 supplements x 5 clocks x 2 time points = 20 hypothesis tests. No single primary outcome. Of 20 tests, 2 crossed p<0.05. With 20 tests you'd expect 1+ false positive by chance. You'd see 2+ about 26% of the time. These are the real results.
We only have one calendar age. But we have LOTS of epigenetic clocks, all trained differently, and they don't agree with each other nearly as well as you'd hope. The scatterplots of one clock vs another look like shotgun blasts.
Quick primer: epigenetic clocks measure methyl groups that accumulate on DNA over time, like dust on a mantel. Algorithms use these patterns to estimate your "biological age." The gap between biological and chronological age has been linked to disease and death.
For this sub-analysis, 958 participants had DNA methylation measured at baseline, year 1, and year 2. The question: does a multivitamin or cocoa extract slow "biological aging" as captured by epigenetic clocks?
This comes from COSMOS, a 2x2 factorial trial of cocoa extract and Centrum Silver in 21,000+ older adults. If the name rings a bell, it's the Mars-funded trial testing whether cocoa prevents heart disease. The primary result was negative.
"A daily multivitamin slows biological aging." That's the headline from a new Nature Medicine paper. From a randomized trial! But when you actually read the data, the vitamin is doing just about nothing. Thread.
Wellness influencers mislead with biological plausibility all the time. Recognize the signs!
New episode of Wellness, Actually today (saunas, cold plunges, and more): wellnessactually.fm
with @ProfEmilyOster.
This week, on the Wellness, Actually podcast Emily Oster and I talk #peptides! Including the (infamous) "wolverine stack" as promoted by no less than Joe Rogan.
I have... concerns.
wellnessactually.fm
8/ I wrote about this in much more detail in my weekly Medscape column — link below.
🔗 buff.ly/5gU16Mm
If this thread was useful, give it a repost. Muscle isn't just for aesthetics — it might be the most underappreciated longevity factor we have.
7/ Clinical takeaway: as we push cardiorespiratory fitness for older adults, we should equally prioritize building muscle mass and quality.
You can measure it with a grip dynamometer. Or, like me, just glance at that interosseous muscle. It's my "rule of thumb".
6/ The authors' explanation resonates with me: muscle is a RESILIENCE marker.
Aging brings unpredictable illness, hospitalizations, injuries — each one strips away muscle. Having more gives you more to lose safely. More tread on the tire.
It's a buffer against the inevitable.
5/ But WHY? Could it just be inflammation?
They checked CRP — benefit persisted after adjustment.
Reverse causation (sicker = weaker at baseline)? They excluded women who died within 5 years. Results held.
It may be that the muscle itself is the protective factor.
4/ Chair stands told the same story. Women completing 5 stands in <11.1 sec were 34% less likely to die than those taking ≥16.7 sec — again, independent of activity level and cardio fitness.
Muscle strength is its own survival factor.
3/ Over follow-up, 1,964 women (36%) died.
After accounting for physical activity AND cardiorespiratory fitness, women in the top quartile of grip strength were still 35% less likely to die than those in the bottom quartile.
Dose-response effect too.
2/ Here's what surprised me: muscle strength, physical activity, and cardiorespiratory fitness were only weakly correlated.
Grip strength vs. physical function? r = 0.24
Grip strength vs. light activity? r = 0.09
These metrics are NOT measuring the same thing.
1/ Lamonte et al. studied 5,472 women ages 63-99 in JAMA Network Open.
They used hip-mounted accelerometers (no self-report!) to objectively measure physical activity, grip strength for upper body, and timed chair stands for lower body.
buff.ly/FpgAh9n
OK we know exercise saves lives. We know muscle strength predicts survival. But is it the muscle itself that's protective — or just that stronger people move more?
A really elegant new study finally disentangles this (in women at least). Thread 👇
So excited for "Wellness, Actually" - a new podcast with
@profemilyoster.bsky.social. Weekly, we take on a wellness topic and (gasp) actually read the literature to separate fact from BS. Check out episode 1, "What's the deal with declining sperm counts?" today.
wellnessactually.fm
What if wellness influencers actually knew how to read a medical study? 🤔
New podcast. Me. @ProfEmilyOster. The ACTUAL data on wellness trends so you can stress less.
Listen to Wellness, Actually wherever you get your podcasts:
open.spotify.com/show/5igTryE...
podcasts.apple.com/us/podcast/w...
Full breakdown (with the data) in my column this week: buff.ly/hEeFEgc
So in the end, whether the noise is white, blue, brown or pink, silence, it turns out, is golden.
One finding that concerns me: the authors warn against using broadband noise for newborns and toddlers. REM sleep makes up about 50% of a newborn's sleep and is essential for neurodevelopment. If pink noise suppresses REM, that might not be a risk worth taking. (11/13)
The earplugs only started failing at the highest noise level tested (65 dBA), a level that exceeds 99% of bedroom noise events measured in a prior field study. For the real world, earplugs had it covered. (10/13)
But guess what DID work? Earplugs. Plain old foam earplugs.
On earplug nights, sleep was statistically indistinguishable from the silent control night. Same deep sleep. Same REM. They recovered 72% of the noise-induced deep sleep loss. (9/13)
