Lately I've been thinking about how to define what I actually do, and I feel like promoting longevity is a good way to put it.
Although this article is about supplements and nutrient reference values, I want to open up the broader topic of slowing down aging (aging healthily) as a thread that runs through everything I'm working on. Since Western medicine doesn't treat aging as a disease, a lot of people don't realize that the health decline associated with aging can actually be slowed down or even avoided. The gradual deterioration of physical and mental capacity as we age is considered normal in our society, almost expected. There's also a widespread attitude that an aging population is basically a burden on a developing society.
In my experience though, old people don't actually want to sit around doing nothing. Like everyone else, they want to feel useful and contribute to society, not spend their retirement in front of the TV quietly fading out of the world.
Training new workers is expensive, and old people by definition have the most life experience to share and the most potential to create value. So the goal should be helping people age healthily, with their full health and mental faculties intact.
My motivation isn't to just live as long as possible. Having experienced a fair amount of illness for my young age, I don't want to repeat that as I get older. My goal is to be in at least as good health at 100 as I am right now.
But how do you make that happen? Lifelong prevention work. Definitely not the whole solution, but part of it is getting enough nutrients throughout your entire life.
Our dietary recommendations and daily reference values for nutrients & supplements are designed with one goal: preventing acute diseases. But "preventing disease states caused by vitamin deficiency" is not the same thing as promoting optimal health and slowing down aging.
Your body needs roughly 40 different micronutrients to function optimally. If your diet doesn't provide them, it can lead to various health problems, or in extreme cases, death.
As the word micronutrient implies, your body needs these in very small amounts. Every nutrient, element, and vitamin has a recommended daily amount, and the purpose of that number is to prevent disease states caused by vitamin deficiency.
The recommended daily allowance (RDA) is mostly determined through cooperation between the US, Canada, and some European countries. While the RDA itself doesn't have legal force, it's used by organizations like the US Food and Drug Administration to put together legal standards called DRVs (Daily Reference Values), which healthcare institutions and practitioners then follow.
But the problem with recommended nutrient amounts and taking supplements to meet them is multi-layered:
Despite established standards, nutrient deficiencies are very common even among people who consciously take supplements.
It's traditionally accepted that the way these recommended amounts are determined excludes a portion of the population who may develop deficiencies even while following the recommendations.
Since the standards can't account for everyone's genetic peculiarities and don't properly account for the actual biological differences between men and women, these recommended amounts are a pretty broad-brush approach.
The first step in setting recommended daily amounts is the EAR, or The Estimated Average Requirement study. The goal of this research is to figure out how much of a given nutrient you need to consume so that 50% of the population has enough of it (and the other 50% doesn't). Then they do some statistical dark magic and the recommended daily amount is set 2 standard deviations above the study result. This guarantees, in theory, that 97.5% of the population gets enough of that particular nutrient if they follow the recommendations.
The full process is different for each nutrient, and multiple experiments and studies are conducted to arrive at the final values.
It's going to get a bit sciency from here, but bear with me, it helps you see the full picture.
For example, to arrive at the new 2015 reference values for vitamin C, 6-month depletion-repletion trials were conducted.
First they needed to create a vitamin C deficiency in the test subjects. To do this, the men participating in the study were given less than 5 mg of vitamin C per day in their diet, until it was decided that continuing further wasn't safe. Then they began replenishing vitamin C stores, with a different amount for each participant.
During the study, they observed that if you plot the body's vitamin C absorption on a graph, it follows an S-curve typical of a sigmoid function. This means that when someone's vitamin C stores have been depleted, for example 30 mg per day isn't enough to raise plasma levels.
In that situation you need to consume about 100 mg of vitamin C per day until your plasma levels reach 100 mg. Below the 100 mg plasma threshold, the body holds on to all the vitamin C you consume, but once you cross that 100 mg threshold, the body starts excreting small amounts.
According to this particular study, the maximum bioavailability of vitamin C was 200 mg, after which bioavailability began to drop and the body started excreting vitamin C in large amounts.
Based on this, the scientists who conducted and published the study recommended that the daily recommended amount be set at 200 mg. But that's not what happened. The regulatory bodies set the RDA at 90 mg, which fell just below the 100 mg excretion threshold.
This example, and really all the other recommended daily amounts too, leaves a question hanging in the air: if nutrient recommendations are set with the goal of preventing acute diseases, then how much of all these micronutrients do you actually need throughout your entire life if your goal is healthy aging and promoting optimal mental & physical health?
Many enzymes need various micronutrients to prevent short-term, potentially fatal diseases. But there are also enzymes that need micronutrients to keep away aging-related problems, like DNA damage.
If your body only has enough micronutrients to prevent vitamin-deficiency disease states, how do you think your body uses them? To repair DNA damage that might not mean much until 50 years later, or does everything go toward keeping you alive right now so you can pass on your genes and reproduce?
Nutrient needs also vary biologically. Using vitamin C as an example again, animal studies have found that the difference in vitamin C requirements between two animals can be as much as 10-fold. The same thing shows up in humans through the historically observed phenomenon that, due to biological variability, only half of sailors developed scurvy. True, you don't need a lot of vitamin C to prevent scurvy, but if you consume only a sufficient amount, how does that affect all the other important vitamin C functions, mechanisms, and its role as a cofactor?
Triage is the patient prioritization system used in healthcare, where patients are sorted into categories based on how urgently they need help, according to their condition and the potential threat to their life and health.
American biochemistry and molecular biology professor Bruce Ames has also described an evolutionarily developed biological triage mechanism in humans. According to this theory, most recommended daily nutrient amounts are too low, and optimal RDAs should take into account the amounts needed for all biological functions in the long term as well.
When our bodies develop micronutrient deficiencies, according to Dr. Ames, the body uses them to promote short-term survival (and reproduction). In that case, the processes that deal with preventing long-term problems, like DNA repair, which might not matter for another 50 years, get pushed to the background.
This kind of biological triage in turn raises the risk of developing chronic diseases in the long run. Every time our bodies don't have enough micronutrients, we pay for it in the long run with DNA damage. If the goal is longevity and optimal healthy aging, all micronutrient needs have to be met throughout your entire life.
Triage theory also explains how a modest but chronic deficiency in some nutrient can develop into a degenerative disease associated with aging, like cancer, immune function disorders, cognitive decline, cardiovascular disease, and stroke. Conversely, optimizing micronutrient intake reduces the risk of developing aging-related chronic diseases.
Over millions of years of human evolution, micronutrient deficiencies were very likely to occur. This is well demonstrated by the fact that all the minerals necessary for life aren't equally distributed across different regions of the world. Dietary patterns and food availability also fluctuated significantly.
The theory that nature may have developed an internal nutrient-prioritizing system fits logically with the consensus that natural selection favors short-term survival for the purpose of reproduction over long-term health promotion.
Dr. Ames' triage theory is also supported by the already well-studied inter-organ triage systems. For example, in iron deficiency, the body first draws iron from the liver, not the heart. If the body started taking iron from the heart, you'd die. A side effect of this process is, again, DNA damage, which in the short term, in a life-or-death situation, doesn't play a huge role, but 20 years later it could develop into cancer.
If your body is in a constant state of nutrient deficiency and your mitochondria can't do their job and your body is suffering from chronic DNA damage, you can't expect to age well.
Despite recommended amounts and the explosive growth of nutritional science, micronutrient deficiencies are extremely widespread. According to a study conducted by the US Centers for Disease Control and Prevention (CDC), in adults who don't take supplements, deficiencies exist for vitamins D and E in 96% of the population, vitamin A in 58%, and vitamin C in 48%.
[2026 update: These statistics refer to dietary intake inadequacy — the percentage of adults whose food intake alone doesn't meet the Estimated Average Requirement (EAR). This is not the same as clinical deficiency measured by blood tests, which is much lower (e.g., ~10% for vitamin D, <1% for vitamins A and E). Both metrics matter: inadequate dietary intake creates long-term risk even before clinical deficiency appears. Current NHANES data (2024) shows similar dietary intake gaps: 94.3% for vitamin D, 88.5% for vitamin E, 43% for vitamin A, 38.9% for vitamin C.]
In adults who do take supplements, these deficiencies drop to 25% for vitamin D, 5% for vitamin E, 3% for C, and 2% for A.
You can draw a few things from these results: first, most Americans' diets have a massive gap in essential nutrients. Second, despite consciously taking supplements, a large portion of the population still has deficiencies. And third, there's a clear connection between taking supplements and a reduction in those deficiencies.
Out of a sense of duty I should mention, this doesn't mean you should start swallowing multiples of all kinds of supplements and vitamins. Definitely not. Note also that most substances have maximum amounts (upper limit values) that are worth paying attention to. The magic of any substance is in the dosing, and too much of a good thing can be dangerous or even fatal.
This whole situation also demonstrates the disconnect between regulatory and scientific institutions. Because of this, I unfortunately can't share specific guidelines on how much of anything you should actually be taking. It's all individual and depends on your situation and condition.
The smartest move is to work with a high-level functional medicine doctor (very hard to find in Estonia), or do very thorough research yourself. Whatever you decide, be careful and use common sense. Also remember that the better you understand what you're doing, the better results you'll get doing it. And that doesn't just apply to supplements.
Although I mentioned in my first article that the benefits of caloric restriction are strongly established scientifically, don't forget that the best source of all nutrients is always real (and homemade) food. [2026 update: Caloric restriction remains well-supported for lifespan extension. Other interventions being investigated include time-restricted eating, optimizing mitochondrial function through lifestyle factors (exercise, cold exposure, sauna), and pharmaceutical approaches like rapamycin and GLP-1 receptor agonists. The functional medicine view generally favors lifestyle-based longevity interventions over pharmaceutical ones.]
Also, the attentive reader may have noticed that above I referred exclusively to men in a few places. The problem is that women's recommended amounts are often adjusted based on values set for men, because women are exactly like men, just smaller and without a penis (that was sarcasm).
Often, practicing doctors aren't even aware of such biological differences, which is why female patients frequently don't experience the same success following a doctor's treatment plan as men do.
When it comes to nutrient consumption, reality may be quite different. Men are generally, so to speak, nutrient wasters. Women, on the other hand, are more efficient at using most nutrients than men. But since their biological purpose is to 3D print new smaller humans, they have greater needs for certain other nutrients.
But to wrap up on a slightly brighter note. Medicine is becoming increasingly personalized, and the future vision is that nutrient requirements will be determined individually. Imagine, for example, that at your local pharmacy they just take a pinprick of blood and based on the results recommend possible improvements to your diet or offer personalized supplements. That would be true preventive medicine.
But until that bright future arrives, prevention is every citizen's own responsibility. It's irresponsible to rely on patching symptoms with pills prescribed by your family doctor. And at the end of the day, when it comes to aging well, the main thing is to damage your entire biological system as little as possible throughout your life.