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Evidence Based Longevity (EBL)
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How every grade on this site is decided.

Separating what the longevity industry claims from what human randomized evidence actually supports.

New to reading research? Research basics explains the kinds of study and why a randomized trial counts most, in plain language.

No animal data enters a grade.

No affiliate revenue changes one.

Below is the method, the rule set, the evidence flags, the evidence pyramid, the grade tiers, the FAQ, the evidence log and the founder, in that order.

Conflict of Interest Policy

Grades assigned independently of affiliate relationships.

Evidence grades on EBL are determined independently. No supplement brand, affiliate partner, or commercial relationship influences any grade on this platform. Grades are assigned before any commercial relationship exists. If a graded product later becomes available through our Fullscript dispensary, the grade does not change. The editorial process and the commercial process are structurally separate.

The EBL Method

Six steps. In this order. Every time.

Human trials tell you what may work. Your measurements show what changed.

Steps 1 and 5 are the loop. The markers read at baseline are the markers read again, on the interval the literature uses.

The six rules

No exceptions.

01. Human RCTs Randomized controlled trial: people are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect. only

Mechanistic and animal data is labeled separately and never enters a grade. A supplement with 500 mouse studies and 0 human trials is Grade D. Period. The hardest rule to hold, and the most important.

Grade D has two routes, and they are not the same news. Route 1 No human randomized trial has been run, so the record rests on animal or mechanistic evidence only. One of the two routes to the lowest letter on EBL's scale. is the case above: no human randomized trial has been run, so the supplement is untested, not disproven. Route 2 Human randomized trials have been run and did not show benefit on the stated outcome. One of the two routes to the lowest letter on EBL's scale. is a supplement that human randomized trials have tested on the stated endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. and found no benefit, marked TESTED, NO BENEFIT, or found the treated group did worse than placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received., marked TESTED, HARM FOUND. A Route 1 entry may still turn out to work once someone tests it. A Route 2 entry has been tested and did not. Both routes, and which records sit on each →

02. Absolute risk The actual chance of an event in a group. A fall from 2 percent to 1 percent is a 1-point absolute reduction, even though it is a 50 percent relative one. + NNT Number needed to treat: how many people must receive a treatment for one of them to benefit, compared with the control group.

We show what the trial actually moved, not the relative-risk headline. "Reduces heart attack by 25%" is useless without baseline rate. For binary clinical outcomes we report absolute risk reduction and NNT or NNH where they can be properly estimated, together with the population and the time horizon, because both change the number. Continuous outcomes are reported with the appropriate absolute or standardized effect measure instead.

03. Dose and form must match

A grade applies only to the dose and chemical form studied. "Magnesium" is not one compound, glycinate, oxide, and threonate have different pharmacokinetics. A grade for one form does not transfer.

04. No affiliate influence

EBL earns no commission on any supplement it grades. Not on a Grade A, not on a Grade C, not on anything in between. Supplements ordered through the practitioner dispensary pay EBL nothing, and the practitioner margin is passed to the reader instead. Commission arises only on device hardware and diagnostic testing, which EBL does not grade as products. Where a paid device sits under a graded therapy, the product says so beside its buy link, and the letter can move only through a logged review naming the evidence. No grade has ever been set, raised or lowered by a commercial relationship.

The money behind the trials is disclosed, not hidden. A trial paid for by the company that makes or sells what was tested still counts. But when the trials a letter rests on were all paid for commercially, or were all run from inside the organization that develops, sells or teaches the intervention, the page says so beside the letter.

05. Observational Research that watches what people already do rather than assigning a treatment. It can show that two things travel together, not that one causes the other. ≠ Grade A

Cohort studies An observational study that follows a group of people over time and compares what happens to them., registries, and epidemiological data can support a grade, they cannot be the primary basis for one. The primary citation for any Grade A or Grade B claim must be a randomized controlled trial People are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect.. Observational evidence can inform context, long-term safety, plausibility and external validity, but it never independently carries an EBL letter. Grades rest on randomized human evidence. 2026 device restructure: device grades now attach to the modality at its studied protocol, not to brand products. Infrared sauna is capped at Grade B because its cardiovascular-mortality signal is observational (Finnish cohort data) rather than RCT; only its surrogate and functional endpoints have trial support. Cold water immersion is Grade C on the same principle, its evidence being limited and biomarker-only. Products such as Sunlighten, HigherDOSE, Plunge and Ice Barrel carry no letter grade; they are judged on how faithfully they deliver the studied protocol. See the graded modalities →

06. What the endpoint has to be

The quality of a trial does not decide the ceiling. The endpoint does. Surrogate biomarkers A measurable sign in the body, such as a blood test value, used to track a condition or the effect of a treatment. and self-report cap at Grade B, however large, well-run or replicated The same finding reproduced by a separate research group. A result seen once can be chance or bias; a replicated one is harder to explain away. the trial is. A perfectly executed trial that moves only a blood marker or a questionnaire score cannot reach A.

Grade A requires one of three things. A hard clinical endpoint An outcome that matters directly to a person and is counted without judgment, such as death, heart attack, stroke or fracture., meaning mortality, major adverse cardiovascular events or fractures. An objectively measured function, meaning something an instrument records rather than a person reports: dynamometer grip strength, measured VO2max, polysomnography sleep latency. Or a validated outcome scale scored by a clinician blinded to treatment, such as the Hamilton depression scale or a clinician-assigned mucositis grade: the patient does not fill it in, and the person scoring it does not know which treatment the patient received.

A surrogate marker A lab value or measurement used in place of the outcome that matters, such as LDL cholesterol standing in for heart attacks. Moving a surrogate does not always move the outcome. is a proxy for an outcome, not the outcome. Lowering a number is not the same as preventing an event, and the history of medicine contains drugs that improved the marker and harmed the patient. Replication raises confidence in a result; it does not convert a surrogate into an outcome.

Grade A also needs the result repeated. On top of the endpoint above, the effect must replicate across independent research groups. A single positive trial that nobody has repeated stays at C, however good the trial was.

How grades are assigned

How a grade is assigned.

  1. 01Literature search. PubMed for human RCTs within the past 15 years. Foundational older trials kept if they remain primary evidence. No preprint servers.
  2. 02Endpoint classification. Hard outcome (mortality, MACE Major adverse cardiovascular events: heart attack, stroke and cardiovascular death counted together as one trial outcome., fracture) · biomarker (HbA1c A blood test that reflects average blood sugar over the previous two to three months., LDL-C Low-density lipoprotein cholesterol, the cholesterol fraction most closely tied to plaque in the arteries., BMD) · mechanistic (gene expression, in vitro). Hard clinical outcomes, objectively measured function and biomarker or surrogate endpoints can all contribute to a grade, and the endpoint type sets the ceiling: biomarker and self-report endpoints cap at Grade B.
  3. 03Replication check. Replication across ≥2 independent research groups is necessary for Grade A but not sufficient; the endpoint must also qualify under Rule 06. A single positive trial without independent replication is a C, however large or well conducted it is. A systematic review A review that searches for every study on a question using a method set in advance, then assesses them together. is accepted as evidence of replication only when the trials it pools are themselves independent. A review can document replication; it cannot create it. If the underlying evidence is one trial and its own extension, a review of it is still one trial. Two trials paid for by the same manufacturer still count as replication when they are separate trials. Each replicating trial's funder is recorded with its relationship to the question: the maker of the product tested, the maker of a comparator, a competitor, or another commercial interest. A different company is called a competitor only when that relationship is established, never because it is a different company. When no replicating trial is free of commercial funding, the record names each funder and that relationship beside its letter.
  4. 04Conflict-of-interest screen. Industry funding is disclosed, not applied as an automatic penalty. Each trial is judged on its design and results. When every replicating trial was commercially funded, the record names each funder and its relationship to the question beside the letter (Rule 03). Funding alone does not raise or lower a grade.
  5. 05Annual review. Every graded record is reviewed at least once a year, and a new trial is reviewed when EBL finds it. Every change appears in the Evidence Log.
Reading the chips

What each evidence flag means.

Every supplement and device card carries a small set of methodology chips that describe the underlying evidence, what kind of study, how many sites, whether it has been independently replicated, whether the funding source is industry. The chips don't change the letter grade; the grade already incorporates these signals via Rules 03–05. The chips just make the reasoning visible. Click any flag below to see every catalog item carrying it.

Strength signals

Evidence you want to see.

✓ Meta-analysis A study that pools the numbers from several trials into one combined estimate.

Pooled across multiple RCTs

A systematic review that statistically combines results from several randomized trials. The strongest tier of clinical evidence, captures consistency across populations, doses, and research groups in one effect size How large a difference the treatment made, as distinct from whether the difference could be detected at all..

Grade impact: Required for Grade A under Rule 03, alongside the endpoint condition in Rule 06. A single trial cannot replicate itself; what must be reproduced is the finding, by an independent group.

See · supplements → | See · devices →
✓ RCT

Randomized, controlled human trial

At least one randomized trial in humans, typically blinded and placebo-controlled, with a hard or biomarker endpoint. The minimum bar for any Grade A or Grade B claim per Rule 01.

Grade impact: A single positive RCT without independent replication supports Grade C. Grade B requires replicated randomized evidence on a qualifying biomarker or surrogate: an established stand-in for a clinical outcome, not a blood level of the supplement itself. Grade A requires replication AND a qualifying hard, objectively measured or blinded clinician-rated endpoint under Rule 06.

See · supplements → | See · devices →
Methodology caveats

Signals that affect or cap the grade.

⚠ Observational

Cohort or case-control data

Population studies, no randomization, no controlled intervention. Captures association, not causation. Confounding by indication and healthy-user bias are baked in.

Grade impact: Per Rule 05, observational evidence provides context, safety information and long-term association data but never independently earns an EBL letter, regardless of effect size. The May 2026 audit downgraded 4 devices on exactly this rule.

See · supplements → | See · devices →
⚠ Pilot

Small, exploratory trial

Typically n<50, often open-label Everyone in the trial knows which treatment they are receiving, so expectations can shape the results, especially for symptoms people report themselves. and single-arm. Designed to test feasibility and generate hypotheses, not to prove efficacy. The signal-to-noise ratio is low; effect sizes inflate.

Grade impact: Pilot data alone supports Grade C at best. A pilot plus an independently replicated RCT can support Grade B.

See · supplements → | See · devices →
⚠ Single-center

One site, one population

Trial conducted at a single research site or with a single investigator group. Population, dosing protocol, and outcome assessment may not generalize beyond that one context.

Grade impact: Acceptable for Grade B. Grade A requires multi-site replication per Rule 03 and a qualifying endpoint per Rule 06.

See · supplements → | See · devices →
⚠ Not replicated

One trial, no independent confirmation

A landmark RCT exists, but no second research group has reproduced the finding. Treat as provisional, the literature is one positive replication away from solid, or one negative replication away from retraction.

Grade impact: Per Rule 03, a single positive trial without independent replication is a C, however large or well conducted it is. Replication across ≥2 independent groups is required for Grade A, alongside a qualifying endpoint under Rule 06.

See · supplements → | See · devices →
⚠ Sponsored evidence

Manufacturer-funded or proprietary

Primary trial data comes from studies funded by the device or supplement manufacturer, or relies on proprietary endpoint metrics that independent groups can't easily replicate. Industry-funded trials are not invalid. Under Rule 04 the funding is stated beside the evidence so it can be weighed; it does not by itself move a grade.

Grade impact: The letter is set by the trials' design and results. When only industry-funded trials exist, the funders are named beside the letter rather than the letter being lowered automatically.

See · supplements → | See · devices →

Flag coverage expands as the catalog grows. An item with no chips means we haven't completed methodology tagging for it yet, not that it has no underlying evidence. Use the letter grade as the canonical signal; chips show the work behind the grade.

The five tiers of evidence quality

What we trust, and what we don't.

Why we skip animal data

Of 53 landmark preclinical cancer studies, 47 could not be reproduced by independent laboratories (Begley & Ellis, Nature 2012; PMID 22460880). Preclinical findings are unreliable before translation into humans is even attempted. EBL labels Tier-5 evidence so you can see the mechanism, but it never enters a grade. This rule alone changes the outcome on more than half the supplement industry.

The four-grade scale

A · B · C · D, what each grade means.

Four steps from D to A. D: no human trial shows benefit, either none was run or trials found no benefit or harm. C: human trials exist but are small, mixed or unrepeated. B: a good trial with support, often on an established stand-in number such as blood pressure, LDL or HbA1c. A: repeated trials on real outcomes such as deaths, heart attacks, fractures, measured function or blinded clinician scoring. Self-reported results and stand-in numbers cannot go above B.
The four letters at a glance. The full definitions below govern. Opens full size in a new tab.

Why another site may grade the same supplement differently: grading rules differ from site to site. EBL grades each use separately, at the dose, form and population studied. An A requires a replicated result on a hard clinical outcome, an objectively measured function, or a validated scale scored by a clinician blinded to treatment. Results resting only on biomarkers or self-report cap at B.

Frequently asked

The questions that come up most.

Is EBL affiliated with any supplement, device, or testing company?

Not in the sense the question usually means. EBL has no equity, employment, or editorial agreement with any supplement manufacturer, device maker, or testing lab, and earns no commission on any item that carries a letter grade: not a supplement, not a protocol, not a medication, not a device modality.

Supplements ordered through the Fullscript practitioner dispensary pay EBL nothing. Readers without a membership are routed to a no-profit account and members to a full-pass-through account, and in both cases the margin that would ordinarily go to the practitioner goes to the reader instead. Commission is possible on ungraded items only. That is device hardware, where a specific product is described by its delivery specifications and never carries a letter, because the letter belongs to the therapy and the therapy is not for sale; and diagnostic testing, where no laboratory, test or testing product carries a letter either. Where a testing relationship exists it is named on the page that relies on it, and it is listed in the disclosure.

No commercial relationship has ever set, raised or lowered a grade. Grades are documented from the published human trial evidence before any commercial conversation takes place. See the full FTC §255 disclosure for the current partner list and the editorial-independence statement.

Why do some supplements I see recommended everywhere get a low grade here?

Because the supplement industry has a significant marketing-to-evidence gap. Resveratrol is heavily marketed based on compelling animal data, the human translation has been disappointing. Vitamin C megadosing has an enormous cultural footprint, the RCT data for longevity endpoints is weak. Our grades follow the evidence, not the marketing.

Can a Grade A supplement still be wrong for me personally?

Absolutely. Grades reflect population-level evidence, not individual responses. A Grade A supplement can interact with your specific medications, be contraindicated for your conditions, or simply not produce the expected response in you. That's why EBL emphasizes testing before and after.

How often are grades updated?

Every graded record is reviewed at least once a year. A new trial that bears on a graded use is reviewed when EBL finds it, whatever journal it appears in, and can move a grade inside the year. Every change is logged in the Evidence Log.

Is this medical advice?

No. EBL is educational content only. Nothing here constitutes medical advice. Nothing should be started, stopped, or changed without your physician. Especially medications. The Physician Discussion Sheet exists specifically to help that conversation.

Why is there a kosher angle on EBL?

Halachic nuances (capsule shells, fermentation substrates, kitniyot, gelatin sources) are real and not typically addressed by supplement manufacturers. Kosher Longevity is the dedicated sister resource. EBL surfaces it via a filter when it's relevant to a supplement you are looking at.

Public record of grade changes

Every change. Every date. Every reason.

No. 357 · October 2026 · new-record
Whole-food plant-based diet enters the graded corpus at Grade B

The plant-based diet page carried a Grade B with no record behind it and no citation. It now has a graded record. A meta-analysis of 30 randomized trials found vegetarian and vegan diets lowered LDL cholesterol by 0.30 mmol/L against omnivorous diets (Koch et al., Eur Heart J, 2023; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 37226630), and a meta-analysis of 7 trials found HbA1c 0.40 percentage points lower in type 2 diabetes (Guest et al., Adv Nutr, 2024; PMID 39415400): both Grade B, on established surrogates. Heart attacks, strokes and mortality are Grade D: no randomized trial has tested the diet on its own against them, and the Cochrane review found none of its trials reported a cardiovascular event (Rees et al., Cochrane Database Syst Rev, 2021; PMID 33629376). Against other healthy diets, the LDL difference was small or absent.

PMID 37226630 →PMID 39415400 →PMID 33629376 →
No. 356 · October 2026 · correction
Late dinner before sleep added as an ungraded record: one small trial, not graded

The nutrition page's meal timing entry had no citation. It now cites Gu et al. (J Clin Endocrinol Metab, 2020; PMID 32525525), a randomized crossover A trial design in which each participant receives both the treatment and the comparison, one after the other, and serves as their own control. trial in 20 healthy adults in which a 10 p.m. dinner raised overnight glucose compared with a 6 p.m. dinner, and sleep architecture did not differ. One small trial of one meal carries no letter.

PMID 32525525 →
No. 354 · October 2026 · added
Zinc: progression of age-related macular degeneration added at Grade C

AREDS (Age-Related Eye Disease Study Research Group, Arch Ophthalmol, 2001; PMID 11594942) found zinc 80 mg with copper, combined with antioxidants, slowed progression to advanced macular degeneration in 3,640 adults with signs of the disease; zinc alone reached significance only in the higher-risk group. One trial, not independently repeated against placebo, is C. The record's top letter does not change.

PMID 11594942 →
No. 353 · October 2026 · added
Vitamin D3: prevention of depression added at Grade D Route 2

VITAL-DEP (Okereke et al., JAMA, 2020; PMID 32749491) randomized 18,353 adults aged 50 and over to 2,000 IU a day or placebo for a median 5.3 years, with depression as a primary endpoint The one outcome a trial names in advance as its main test. Results on other outcomes carry less weight., and found no difference in depression or mood scores. One large null trial on the endpoint it was built for is Route 2, as on other single-trial rows, so this use enters at D. The record's top letter does not change.

PMID 32749491 →
No. 352 · October 2026 · correction
Cocoa flavanol supplementation added as an ungraded record: primary cardiovascular endpoint missed

The nutrition page's polyphenol entry had no citation. It now cites COSMOS (Sesso et al., Am J Clin Nutr, 2022; PMID 35294962): 21,442 older adults, 500 mg of cocoa flavanols a day for a median 3.6 years, with total cardiovascular events not significantly lower and cardiovascular deaths lower as a secondary outcome. One trial that missed its primary endpoint carries no letter.

PMID 35294962 →
No. 350 · October 2026 · correction
Genetic testing to choose diet or supplements added: Grade D, tested and no added benefit

Gene-test panels sold to choose diet changes and supplements now have a record. The largest randomized trial of the idea, Food4Me (Celis-Morales et al., Int J Epidemiol, 2017; PMID 27524815), gave adults in seven European countries personalized nutrition advice with and without their genotype; the genotype added nothing beyond advice based on diet alone. D on Route 2. Gene testing to guide medication choice is a different question and is not graded on this record.

PMID 27524815 →
No. 349 · October 2026 · added
Omega-3: DNA methylation clocks added at Grade C

A post hoc analysis of 777 adults aged 70 and older in the DO-HEALTH trial (Bischoff-Ferrari et al., Nat Aging, 2025; PMID 39900648) found 1 g/day of omega-3 slowed three of four DNA methylation clocks by about 3 to 4 months over 3 years. A methylation clock is not an established stand-in for a clinical outcome and the finding has not been repeated, so the row enters at C. The record's top letter does not change.

PMID 39900648 →
No. 348 · October 2026 · new-record
Oat beta-glucan for LDL cholesterol enters the graded corpus at Grade B

Meta-analyses of randomized trials, 28 trials (Whitehead et al., Am J Clin Nutr, 2014; PMID 25411276), 58 trials (Ho et al., Br J Nutr, 2016; PMID 27724985) and 13 trials in adults with raised cholesterol (Yu et al., Nutrients, 2022; PMID 35631184), find 3 g/day or more of oat beta-glucan lowers LDL cholesterol, and a randomized trial found the effect depends on molecular weight (Wolever et al., Am J Clin Nutr, 2010; PMID 20660224). LDL is a surrogate, so B is the ceiling. The high-cholesterol condition page previously listed oats under a soluble-fiber row whose evidence was psyllium only; oats now have their own row.

PMID 25411276 →PMID 27724985 →PMID 35631184 →PMID 20660224 →
No. 347 · October 2026 · added
NR: early Parkinson disease added at Grade D Route 2, harm found

NOPARK (Brakedal et al., JAMA, 2026; PMID 42848371), a phase 3 randomized trial of 410 people with early Parkinson disease, found that those on nicotinamide riboside 1,000 mg/day for 52 weeks did worse than placebo on the primary rating score and on non-motor symptoms. This use enters at D with the TESTED, HARM FOUND badge. The record's top letter does not change.

PMID 42848371 →
No. 346 · October 2026 · added
Ginkgo: dementia prevention added at Grade D Route 2

Two large randomized trials of the standardized extract, GEM (DeKosky et al., JAMA, 2008; PMID 19017911) in 3,069 adults aged 75 and over and GuidAge (Vellas et al., Lancet Neurol, 2012; PMID 22959217) in 2,854 adults with memory complaints, did not prevent dementia or Alzheimer's disease. Prevention now has its own row at D, tested and no benefit. The rows on symptoms in people who already have dementia, and the record's top letter, do not change.

PMID 19017911 →PMID 22959217 →
No. 345 · October 2026 · added
Folic acid with B vitamins: major cardiovascular events added at Grade D Route 2

HOPE-2 (Lonn et al., N Engl J Med, 2006; PMID 16531613) and NORVIT (Bønaa et al., N Engl J Med, 2006; PMID 16531614) lowered homocysteine An amino acid in the blood that rises when vitamin B12, folate or B6 are low. without lowering heart attacks or cardiovascular deaths, and a Cochrane review of 15 trials (Martí-Carvajal et al., Cochrane Database Syst Rev, 2017; PMID 28816346) found no effect on heart attacks or deaths. This use enters at D, tested and no benefit. The separate first-stroke row and the record's top letter do not change.

PMID 16531613 →PMID 16531614 →PMID 28816346 →
No. 344 · October 2026 · added
Vitamin E: major cardiovascular events added at Grade D Route 2

The record graded cancer prevention only. HOPE (Yusuf et al., N Engl J Med, 2000; PMID 10639540), the Physicians' Health Study II (Sesso et al., JAMA, 2008; PMID 18997197) and the Women's Health Study (Lee et al., JAMA, 2005; PMID 15998891), three large randomized trials, did not lower major cardiovascular events, so heart protection now has its own row at D, tested and no benefit. The record's top letter does not change.

PMID 10639540 →PMID 18997197 →PMID 15998891 →
No. 343 · October 2026 · added
Vitamin D3: all-cause mortality added at Grade D Route 2, and diabetes prevention at Grade C

The completeness check found two endpoints the record did not grade. All-cause mortality: D-Health (Neale et al., Lancet Diabetes Endocrinol, 2022; PMID 35026158), 21,315 older Australians, found no reduction, and a pooled analysis of 52 trials (Zhang et al., BMJ, 2019; PMID 31405892) agrees, so this use enters at D, tested and no benefit. Progression from prediabetes to diabetes: D2d (Pittas et al., N Engl J Med, 2019; PMID 31173679), 2,423 adults, was not significant, while a three-trial pooled analysis by the same group (Pittas et al., Ann Intern Med, 2023; PMID 36745886), which includes a prescription vitamin D analog, was positive. Results that disagree are C under the written definition. The record's top letter does not change.

PMID 35026158 →PMID 31405892 →PMID 31173679 →PMID 36745886 →
No. 342 · October 2026 · correction
Vitamin D3: two more large null trials added to the cardiovascular and fracture rows; both stay at D

A completeness check against the large vitamin D trials found two the record did not cite. ViDA (Scragg et al., JAMA Cardiol, 2017; PMID 28384800), 5,110 adults given monthly high doses, found no reduction in cardiovascular disease. DO-HEALTH (Bischoff-Ferrari et al., JAMA, 2020; PMID 33170239), 2,157 adults aged 70 and over, found no effect on nonvertebral fractures. Both agree with the existing rows, so both letters hold at D.

PMID 28384800 →PMID 33170239 →
No. 341 · October 2026 · correction
REMS ultrasound bone densitometry added as an ungraded measurement: agrees with DXA on a single scan, driven largely by typed-in age and weight

REMS bone scans were sold direct to consumers at a longevity conference, so they now have a record. Like DEXA, the scan is a measurement and carries no letter. Cortet et al. (Bone, 2021; PMID 33278653) found it classified osteoporosis close to DXA, and Chan et al. (Osteoporos Int, 2026; PMID 41872364) found the typed-in age and weight explained most of its result.

PMID 33278653 →PMID 41872364 →
No. 340 · October 2026 · correction
Carotid ultrasound added as an ungraded measurement: small added value for predicting heart attack and stroke; repeat scans not supported

Carotid scans were sold direct to consumers at a longevity conference, so they now have a record. Like DEXA, the scan is a measurement and carries no letter. Den Ruijter et al. (JAMA, 2012; PMID 22910757) found intima-media thickness added little to standard risk factors across 45,828 people, and Lorenz et al. (Lancet, 2012; PMID 22541275) found change between two scans did not predict events.

PMID 22910757 →PMID 22541275 →
No. 339 · October 2026 · correction
Exogenous ketones added: Grade C for blood glucose after meals and heart failure hemodynamics; performance, migraine and blood pressure tested without benefit

Ketone drinks were sold at a longevity conference by a sponsor, so they now have a record. Falkenhain et al. (Adv Nutr, 2022; PMID 35380602) found single doses lower blood glucose across 43 trials, and Berg-Hansen et al. (Circulation, 2024; PMID 38533643) found higher cardiac output in heart failure over two weeks: C, measured markers. Brooks et al. (Int J Sport Nutr Exerc Metab, 2022; PMID 35042186), Putananickal et al. (Cephalalgia, 2022; PMID 34541914) and Marcotte-Chenard et al. (J Diet Suppl, 2024; PMID 38145410) found no benefit on endurance, migraine or blood pressure: D on Route 2.

PMID 35380602 →PMID 38533643 →PMID 35042186 →PMID 34541914 →PMID 38145410 →
No. 338 · October 2026 · correction
Beetroot and glutathione: product forms that are not the graded form are named and kept out of the letter

Two products sold at a longevity conference sit near graded records without being the graded form. Lozenges combining nitrite with plant nitrate now appear on the beetroot record as a separate form, with their three trials (Zand et al., Nutr Res, 2011; PMID 21530799; Houston et al., J Clin Hypertens, 2014; PMID 24962851; Bryan et al., Am J Med, 2023; PMID 37356641), not counted in the beetroot letter; the only trial on a clinical outcome was null. Glutathione now states that its grade is for the oral form: a transdermal form did not raise plasma reduced glutathione in the one trial comparing routes (Kern et al., Med Sci Monit, 2011; PMID 22129897). Letters unchanged.

PMID 21530799 →PMID 24962851 →PMID 37356641 →PMID 22129897 →

The 20 most recent of 357 dated changes. Every change, dated →

Full Evidence Log →
Founder and Editor

EBL is founded and edited by Arnold Sandlow, D.C., a California-licensed chiropractor and A.B.A.A.H.P. Diplomate with 27 years in private practice and a further 20 years of independent study in longevity science.

Doctor of Chiropractic, licensed in California · Diplomate, American Board of Anti-Aging Health Practitioners (A4M) · 27 years in private clinical practice · 20 years of continued longevity-science immersion since retiring from active practice · Published author (chapter, Pain Management textbook, 6th edition).

Arnold Sandlow, D.C. holds an active license to practice chiropractic in California, issued by the California Board of Chiropractic Examiners, and current through May 2027. Status is verifiable directly with the state at the Department of Consumer Affairs license search. EBL is owner-operated and editorially independent.

Background

Twenty-seven years in private clinical practice before retiring from active practice. Since retirement, has remained continuously immersed in the longevity and nutrition science literature through professional conferences, board-level work, and independent study.

Career and credentials
  • Doctor of Chiropractic (D.C.) · licensed by the California Board of Chiropractic Examiners, active status, current through May 2027 (verify with the state)
  • A.B.A.A.H.P. Diplomate · American Board of Anti-Aging Health Practitioners (American Academy of Anti-Aging Medicine / A4M, conferred 2000, current)
  • Former Diplomate, American Academy of Pain Management · conferred 1989 (organization closed mid-2010s)
  • Former Fellow and Diplomate, American Association of Integrative Medicine · conferred 2000 (organization closed mid-2010s)
  • Chapter contributor · Pain Management textbook, 6th edition (Enhancing Adrenal Function)
  • Former Independent Medical Examiner (IME) and Qualified Medical Evaluator (QME) · State of California, 1992-2009
  • Former Founding Full Professor, Department of Anti-Aging Studies · University of Integrated Studies (one-year appointment, 2000; institution since closed)
  • Former Board of Advisors member · American Academy of Pain Management, 1998-2009

EBL holds itself to the same evidence standard it applies to the products it grades. The California chiropractic license is verifiable with the state at the link above. The remaining entries are accurate as documented, and several name organizations that have since closed, which makes them unverifiable by any public registry; documentation for those is available privately on request.

Why EBL exists

After 27 years watching patients spend money on supplements with no meaningful human evidence while ignoring drug-nutrient interactions that were quietly depleting their B12, magnesium, and CoQ10, plus 20 more years of full-time immersion in the longevity literature since retiring from active practice, the need for a medication-first, evidence-first resource was obvious. Most longevity platforms exist to sell products. EBL exists to grade them.

What makes EBL different

"Medication first before supplementing" is EBL's core differentiator. Most longevity sites assume a healthy, unmedicated adult. Most supplement users are not that person. Checking medication interactions and nutrient depletions A fall in a nutrient's level caused by a medication, for example through reduced absorption or increased loss. before building a stack is clinical thinking, not a feature.