The Atlas / Modalities
The interventions of the healthspan economy
What the field actually does, recorded one modality at a time. Each entry states plainly what it is, who it serves, and where the evidence stands, then links to the Atlas organizations that offer it.
Diagnostics & Assessment 5
Advanced bloodwork / ApoB
Advanced bloodwork is an expanded blood panel used in the longevity industry that adds markers like apolipoprotein B (ApoB), inflammatory markers, and metabolic indicators to a standard physical's bloodwork. ApoB counts atherogenic lipoprotein particles directly and is recognized by cardiology guidelines as equal to or more predictive of cardiovascular risk than LDL-cholesterol alone, making it well-evidenced as a clinical risk marker.
Hormone panel testing
Hormone panel testing measures sex hormones, thyroid hormones, and adrenal markers through blood, saliva, or urine to assess endocrine function, a clinically established and well-evidenced diagnostic method used in endocrinology for decades. In the longevity industry, it has split into two distinct commercial segments: women's menopause-focused hormone platforms and men's testosterone optimization platforms, plus standalone testing services.
Epigenetic age testing
Epigenetic age testing estimates biological age from DNA methylation patterns using algorithms such as the Horvath clock, GrimAge, and DunedinPACE. The clocks reliably correlate with chronological age and, in research cohorts, with mortality risk, but whether changing a clock score through intervention improves actual health outcomes remains unproven, making this an emerging rather than well-evidenced diagnostic.
Full-body MRI
Full-body MRI screening applies magnetic resonance imaging, a well-evidenced diagnostic technology, to asymptomatic adults seeking early disease detection. While MRI itself is well-established for indicated clinical use, screening healthy populations with whole-body MRI is not endorsed by bodies like the USPSTF and carries documented risks of false positives and incidental findings requiring uncertain follow-up, making this specific application an emerging and contested practice.
VO2 max testing / CPET
VO2 max testing, performed via cardiopulmonary exercise testing (CPET), measures maximal oxygen uptake during exertion and is one of the strongest predictors of all-cause mortality in exercise physiology research, in some studies stronger than smoking status. It is highly trainable through aerobic exercise and serves as the flagship biomarker in longevity medicine frameworks such as Peter Attia's, making it well-evidenced as a clinical and fitness marker.
Programs 4
Functional medicine
Functional medicine is a systems-based clinical framework that treats chronic disease as the product of interacting genetic, environmental, and lifestyle factors, using expanded diagnostic testing and personalized intervention to address underlying physiological imbalances rather than managing symptoms with a standardized protocol. It is well-evidenced as a clinical model, anchored by a 2019 Cleveland Clinic outcomes study, and is the most common clinical framework among Atlas-listed longevity providers.
Longevity Coaching
Longevity coaching is a specialized coaching discipline that translates aging science into individualized strategies for extending healthspan, the years of genuine functional vitality rather than managed decline. It draws on the hallmarks of aging framework, exercise physiology, metabolic health research, and sleep science. Evidence for the underlying lifestyle interventions is strong; the coaching service format itself is classified as emerging.
Executive health programs
Executive health programs are comprehensive preventive health assessments delivered by physician-led teams, typically in a full-day or multi-day format, combining advanced diagnostics with structured physician review and a written action plan. The underlying preventive medicine components (cancer screening, cardiovascular risk stratification, metabolic disease detection) are well-evidenced. The bundled executive health program format has not itself been the subject of randomized controlled trials.
Precision medicine / personalized medicine
Precision medicine uses an individual's genomic profile, biomarkers, microbiome composition, and other biological data to design prevention and treatment strategies tailored to their specific biology. In the longevity sector it is applied primarily to disease-risk stratification and early detection. Evidence is well-established in oncology and pharmacogenomics; evidence for healthy-aging optimization applications is classified as emerging.
Therapeutics 3
HRT / BHRT
HRT restores estrogen and progesterone in women experiencing perimenopause and menopause. After a sharp prescribing contraction following the 2002 WHI trial, subsequent re-analysis and the 2023 NICE guideline update established that for most women under 60 and within ten years of menopause onset, benefits outweigh risks. BHRT uses structurally identical hormones. The modality is well-evidenced and guideline-supported for the relevant population.
Rapamycin / sirolimus protocols
Rapamycin (sirolimus) is an FDA-approved immunosuppressant being used off-label at low weekly doses as a longevity intervention, based on its inhibition of the mTOR pathway and a robust lifespan-extension record in model organisms, including a landmark 2009 NIA study in mice. Human longevity trials are underway. The benefit and risk profile in healthy adults taking it long-term for longevity indications is not yet established. This is an experimental modality with no major medical body endorsement for longevity use.
Senolytics
Senolytics are drugs that selectively eliminate senescent cells, which accumulate in aging tissues and drive systemic inflammation through the SASP. The leading human research combination is dasatinib plus quercetin (D+Q), identified at Mayo Clinic. Early Phase 1 and 2 human trials have reported preliminary signals. As of mid-2026, no senolytics are FDA-approved for aging indications, and no standard clinical protocol exists outside of trial settings. The animal data is mechanistically compelling; human translation is in progress.
Lifestyle Optimization 3
Sleep optimization protocols
Sleep optimization protocols range from CBT-I, the first-line clinical treatment for chronic insomnia endorsed by the American Academy of Sleep Medicine, to device-based approaches targeting circadian alignment, thermal regulation, and closed-loop neurological sleep enhancement. The evidence base for sleep as a longevity variable is well-established. The commercial device segment is growing, though device efficacy claims vary and most products are not FDA-cleared for clinical use.
Strength training / resistance protocols
Resistance training builds muscle mass and strength through progressive loading, directly countering sarcopenia, the age-related muscle loss that is one of the strongest predictors of disability and mortality. Multiple meta-analyses confirm inverse associations between muscle mass and all-cause mortality. The evidence base is among the strongest available for any lifestyle intervention in longevity medicine, and the modality is foundational in performance-medicine and longevity clinic programs.
Zone 2 aerobic training
Zone 2 aerobic training is the exercise intensity band at roughly 60 to 70 percent of maximum heart rate where fat oxidation dominates and the primary training stimulus drives mitochondrial biogenesis. It is the aerobic training prescription central to Peter Attia's longevity framework and Inigo San Millan's metabolic research. The evidence base is well-grounded in exercise physiology, though RCT evidence in aging populations specifically is limited.