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David Sinclair Profile picture
@davidasinclair
Jan 15, 2025 • 12 tweets • 4 min read • Read on X
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The largest and longest clinical trial comparing the effects of lifestyle changes vs. medicines on glucose control, inflammation, blood pressure & cholesterol over 24 weeks. The lifestyle changes won - hands down

Here's what they found...
tinyurl.com/yjev6dbtImage
The clinical trial was conducted in the Marshall Islands, which has the seventh-highest diabetes prevalence globally. There were 169 participants... Image
Image
The country’s high prevalence has been partially attributed to its increased reliance on imported foods, including white rice, refined four, sugar-sweetened beverages and canned meats... Image
A whole-food, plant-based lifestyle intervention plus moderate exercise (PB+Ex) was much more effective for improving glycaemic control than standard medicines. It also reduced the need for diabetes and cardiovascular medications... Image
Compared with medicines, the lifestyle change decreased HbA1c by an additional 14 mmol/mol (1.3%) at week 12 and 8 mmol/mol (0.7%) at week 24... Image
63% of those who changes their lifestyle and also took medicines reduced the dose or frequency of their glucose-lowering medications... Image
The diet+exercise group also had lower body weight, C-reactive protein and cardiovascular medication use compared with standard medical care.... Image
Here's the summary: Image
We all know a healthy diet + exercise is beneficial but this study clearly shows lifestyle changes can be even better than medicines in treating type 2 diabetes, and they improve cardiovascular health biomarkers as well 🥑🏃🏻‍♀️💪
The prescribed diet was high in fibre (35 g/4184 kJ), low in fat (20–25% of energy; saturated fat <7% of energy), moderate in protein (10–15% of energy) and low sodium...
During weeks 1–2, PB+Ex participants received 12 prepared meals/week and were instructed to consume no animal products & minimal ground grains & refined carbohydrates...
The PB+Ex group was instructed to do moderate intensity aerobic & resistance exercise 60 min/day during wks 1–2 and 30–60 min/day during wks 3–24 & counseled to walk 10–20 min before breakfast & after lunch and dinner (end)

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More from @davidasinclair

David Sinclair Profile picture
Feb 1
New "Cardiometabolic Clock" identifies biomarkers that associate with disease & early death:

1. HbA1c
2. Creatinine
3. Lymphocyte %
4. Urea nitrogen (BUN)
5. Red Cell Dist. width (RDW)
6. Pulse
7. Systolic blood pressure

Now you can calculate your CardioMetAge! Image
Heres the formula: 𝐶𝑎𝑟𝑑𝑖𝑜𝑀𝑒𝑡𝐴𝑔𝑒𝑃𝑟𝑒𝑑𝑖𝑐𝑡 = 0.831320 × 𝑎𝑔𝑒 + 19.5734 × log( 𝐻𝑏𝐴1𝑐 + 1) + 1.77394 × 𝑅𝐷𝑊 + 0.0760217 × 𝑆𝐵𝑃 + 6.18803 × 𝑐𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛𝑒 − 0.148076 × 𝑙𝑦𝑚𝑝ℎ𝑜𝑐𝑦𝑡𝑒 𝑝𝑒𝑟𝑐𝑒𝑛𝑡 + 0.218946 × 𝑀𝐶𝑉 + 0.105980 × 𝑝𝑢𝑙𝑠𝑒 𝑟𝑎𝑡𝑒 + 0.0603608 × 𝑃𝑃 + 0.636711 × 𝑈𝐴 + 2.40001 × log( 𝐶𝑅𝑃 + 1) + 0.0283277 × 𝑊𝐶 + 0.0754119 × 𝐵𝑈𝑁 − 101.454
Candidate measures tested in the model: Body composition, waist circumference, waist-to-height ratio, glucose, HbA1c, albumin, ALP, CRP, creatinine, blood urea nitrogen (BUN), UA, lymphocyte percent, mean corpuscular volume (MCV), white blood cell count (WBC), red cell distribution width (RDW), AST, ALT, HDL, triglycerides, total cholesterol, BP, pulse pressure (PP) and pulse rate.
Read 4 tweets
David Sinclair Profile picture
Jan 18
Amazing! Placing mice in low air pressure every other day slows hair loss, weight gain, osteoporosis & extends median lifespan by 12%. Ascribed to the killing of senescent, zombie cells

Could exercise, high altitude, or a drug have similar benefits? Let’s dig in🧵 Image
Firstly, hypobaric (low) pressure should not to be confused with hyper-baric oxygen therapy (HBOT), which is also studied by longevity researchers, though there may be overlapping hormetic mechanisms between the two @NaturePortfolio
I’ve always wondered if living at a high altitude is healthier, but the evidence is weak. Maybe it needs to be pulsed: high pressure -> low pressure -> high pressure -> low pressure to induce hormesis Image
Read 19 tweets
David Sinclair Profile picture
Jan 14
New study indicates that a decrease in nerve cell cholesterol caused by cortisol, inflammation & low SIRT1 activity may be a cause of major depression.

So, do statins exacerbate depression?

And since SIRT1 is NAD⁺-dependent, could NAD⁺ boosters treat or prevent depression? …🧵Image
Around 5–5.7% of adults worldwide experience depressive disorders at any given time. >280 million people! Image
Lifetime depression diagnoses in the U.S. have risen. ~29% report ever being diagnosed, up from ~20% a decade ago Image
Read 16 tweets
David Sinclair Profile picture
Jan 4
Cannabidiol (CBD) does amazing things. According to a new study it:

* Increases SIRT1 & autophagy ✅
* Decreases mTOR ✅
* Upregulates SOX2 & OCT4 ✅
* Preserves telomeres ✅
* Reduces inflammatory NF-kB ✅
* Slows stem cell aging ✅

🧵 Image
CBD, or cannabidiol, is the second most prevalent active ingredient in marijuana, with no effects indicative of any abuse or dependence potential
Mesenchymal stem cells (MSCs) are used to treat various degenerative diseases. Their therapeutic potential is limited by their aging in the dish as they are expanded in number. The researchers tested if CBD could help
Read 10 tweets
David Sinclair Profile picture
Oct 7, 2025
Statistically, you should not exist:

– Life-friendly universe: 1/10⁶⁰
– Earth + moon: 1/10⁹
– Multicellular life: 1/10⁴
– Intelligence & civilization: 1/10⁹
– Your genome: 1/70 trillion

You’ve already won the lottery 10 times in a row. Ignore small people & enjoy!
Equivalent odds: winning the Powerball jackpot 10 times in a row
Flipping 272 heads in a row
Read 7 tweets
David Sinclair Profile picture
Oct 4, 2025
DNA breaks from cosmic rays disrupt the epigenome and release virus-like retrotransposons. Not wild theory. Fact

X-rays and CT scans probably do too but no one talks about it
This study in 2008 was the first evidence for the information theory of aging in mammals - the idea that DNA breaks and other major stresses cause chromatin modifiers like SIRT1 to relocate, which disrupts the epigenome & changes the expression of genes in ways that cause aging Image
Just re-read this paper and I’ve realized it was 15 years ahead of its time. Still is
Read 4 tweets

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