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Evidence Based Longevity (EBL)
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Top Lists by Grade

The strongest-graded vitamins, minerals, plant extracts, amino acids, lifestyle protocols, devices and prescription drugs on the site, each with the endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. its letter applies to, and every supplement with a trial that found harm.

Each list ranks by EBL grade, highest first. A grade does not rank records within a letter, so when more records share the cutoff letter than the list has places, all of them are shown, in alphabetical order. Each letter applies to the endpoint shown under it, and only to that endpoint.

Top 3 vitamins

2 records share C for the last 1 place, and the grade does not order them, so all are shown, alphabetically within the letter.

  • BSelf-report
    Vitamin C (ascorbic acid)
    Supplement · Pooled reviews of randomized trials and large randomized trials
    Grade for: Common-cold duration with daily supplementation
    23440782 38082300 18997197
  • BHard clinical endpoint
    Vitamin D3
    Supplement · 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. + meta-analyses A study that pools the numbers from several trials into one combined estimate. (use-specific)
    Grade for: Fracture prevention, vitamin D3 with calcium, older adults living in institutions
    1331788 15886381 19797342
  • CSelf-report
    Benfotiamine
    Supplement · RCT (limited)
    Endpoint: Diabetic neuropathy measures
    41571333 23701274 15726875
  • CSurrogate biomarker
    Vitamin K2 (MK-7 / Menaquinone-7)
    Supplement · 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. (3-year, arterial stiffness)
    Endpoint: Arterial stiffness and coronary artery calcification
    25694037 15514282 42268593

Ranked from 8 records.

Top 3 minerals

4 records share C for the last 2 places, and the grade does not order them, so all are shown, alphabetically within the letter.

Ranked from 6 records.

Top 5 plant extracts

9 records share B for the last 5 places, and the grade does not order them, so all are shown, alphabetically within the letter.

Ranked from 21 records.

Top 3 amino acids and related compounds

  • AMeasured function
    Creatine Monohydrate
    Supplement · Meta-analyses + RCT
    Grade for: Muscle strength with resistance training in older adults
    Endpoint: Strength recorded by an instrument (one-repetition maximum or dynamometer), a functional endpoint
    12560406 11740307 34199420
  • BMeasured function
    Beta-Alanine
    Supplement · Meta-analysis of RCTs
    Endpoint: High-intensity exercise capacity
    27797728 22270875
CMeasured function Tied for the remaining 1 place, 10 records, alphabetically: Acetyl-L-Carnitine (ALCAR), Carnosine, Glycine, GlyNAC (Glycine + N-Acetylcysteine), HMB (Beta-Hydroxy Beta-Methylbutyrate), L-Citrulline, L-Tyrosine, NAC (N-Acetyl Cysteine), Taurine, TMG (Trimethylglycine / Betaine).

Ranked from 12 records.

Top 5 exercise, diet and lifestyle protocols

6 records share A for the last 5 places, and the grade does not order them, so all are shown, alphabetically within the letter.

  • AMeasured function
    Adequate dietary protein (1.2 to 1.6 g/kg/day)
    Protocol · Meta-analyses of randomized trials (Morton, Tagawa, Nunes) and randomized trials
    Grade for: Strength gains (one-repetition maximum) during resistance training, healthy adults
    Endpoint: Strength (one-repetition maximum) gained during resistance training, healthy adults
    28698222 26797090 35187864
  • AMeasured function
    Aerobic exercise (Zone 2) 150 min/week
    Protocol · Randomized training trials and a meta-analysis of them (VO2max The most oxygen the body can use during all-out exercise, a standard measure of aerobic fitness. gain) + prognostic cohort meta-analysis (Kodama, context only)
    Grade for: Measured VO2max after low-to-moderate intensity aerobic training, against no exercise
    Endpoint: VO2max, objectively measured
    18580415 17507344 41543030
  • AMeasured function
    Daytime napping (length and timing)
    Protocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies An observational study that follows a group of people over time and compares what happens to them. and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letter
    Grade for: Alertness and cognitive performance in the hours after an afternoon nap, healthy adults; Cognitive performance during a night shift after an on-shift nap; Memory retention after an afternoon nap
    Endpoint: Alertness and cognitive performance on objective tests (reaction time, attention lapses, sleep latency, task scores) in the 1 to 3 hours after a nap
    16796222 11007448 12220317
  • AHard clinical endpoint
    Mediterranean diet + extra-virgin olive oil
    Protocol · Randomized controlled trial (PREDIMED)
    Endpoint: Major cardiovascular events (PREDIMED)
    29897866 38431146 31981007
  • AMeasured function
    Resistance training 2–3×/week
    Protocol · Meta-analysis of randomized trials
    Grade for: Muscle size and strength, progressive overload
    Endpoint: Objectively measured muscle size and strength
    32740889 35228201 37491419
  • AMeasured function
    VO₂max training (Zone 2 + intervals)
    Protocol · Randomized training trials and meta-analyses of them (VO2max gain) + prognostic cohort meta-analysis (mortality)
    Endpoint: VO2max, objectively measured
    38878596 41543030 42730846

Ranked from 18 records.

Top 5 devices and therapies

6 records share A for the last 5 places, and the grade does not order them, so all are shown, alphabetically within the letter.

  • AMeasured function
    CPAP for obstructive sleep apnea
    Device or therapy · Randomized trials and meta-analyses of CPAP against usual care, sham A fake version of a procedure or device used as the comparison, so participants cannot tell which one they received. CPAP or inactive control
    Grade for: Daytime sleepiness measured by the maintenance of wakefulness test, in moderate to severe sleep apnea with daytime sleepiness
    Endpoint: Objectively measured daytime wakefulness in moderate to severe obstructive sleep apnea
    27571048 31839558 26914592
  • AMeasured function
    Neuromuscular Electrical Stimulation (NMES) after Knee Replacement
    Device or therapy · Randomized controlled trials + meta-analysis of randomized trials
    Endpoint: Early quadriceps strength and mobility after total knee replacement, compared with usual care (dynamometer strength, timed up-and-go)
    22095207 32610358 28610968
  • ABlinded clinician rating
    Photobiomodulation to Prevent Oral Mucositis
    Device or therapy · Randomized controlled trials + meta-analysis of randomized trials
    Endpoint: Severe (grade 3 to 4) oral mucositis during head and neck radiotherapy or chemoradiation and stem cell transplant, graded by blinded clinicians
    24044799 22884841 22502814
  • AHard clinical endpoint
    Stool-based colorectal screening (gFOBT and FIT)
    Device or therapy · Randomized trials of the screening strategy, by test
    Grade for: Colorectal cancer mortality, guaiac FOBT (gFOBT)
    Endpoint: Colorectal cancer mortality (hard endpoint An outcome that matters directly to a person and is counted without judgment, such as death, heart attack, stroke or fracture.), graded separately by test
    24047060 42254696 39028667
  • A
    Transcranial Magnetic Stimulation (TMS) for Depression
    Device or therapy · Randomized controlled trials + meta-analysis of randomized trials
    Endpoint: Response and remission in treatment-resistant major depression on blinded clinician-rated scales (HAM-D, MADRS)
    17573044 20439832 25655160
  • ABlinded clinician rating
    Transcutaneous Vagus Nerve Stimulation
    Device or therapy · Randomized sham-controlled trials and meta-analyses, by use
    Grade for: Postoperative cognitive dysfunction in older adults having major surgery
    Endpoint: Postoperative cognitive dysfunction in older adults having major surgery, on the Montreal Cognitive Assessment
    42339645 42104979 42456197

Ranked from 22 records.

Top 3 prescription drugs used for longevity

2 records share B for the last 1 place, and the grade does not order them, so all are shown, alphabetically within the letter.

  • AHard clinical endpoint
    Semaglutide
    Prescription · Randomized controlled trials
    Endpoint: Cardiovascular death, heart attack and stroke in people with cardiovascular disease or type 2 diabetes
    37952131 27633186 33567185
  • AHard clinical endpoint
    SGLT2 inhibitors (empagliflozin, dapagliflozin)
    Prescription · Randomized controlled trials
    Endpoint: Cardiovascular death, heart-failure hospitalization and kidney-failure progression
    26378978 31535829 32970396
  • BSurrogate biomarker
    Retatrutide
    Prescription · Randomized controlled trials (phase 2 and phase 3)
    Grade for: Body weight in adults with obesity; HbA1c in adults with type 2 diabetes; Apnea-hypopnea index in adults with obesity and moderate to severe obstructive sleep apnea
    Endpoint: Body weight and HbA1c
    37366315 37385280 42250575
  • BSurrogate biomarker
    Tirzepatide
    Prescription · Randomized controlled trials
    Grade for: Apnea-hypopnea index in adults with obesity and moderate to severe obstructive sleep apnea
    Endpoint: Apnea-hypopnea index in obstructive sleep apnea with obesity; onset of type 2 diabetes in prediabetes
    39536238 41406444 38912654

Ranked from 8 records.

Supplements with a trial that found harm

Every supplement whose record lists a randomized trial in which the supplement group did worse. Drawn from the records; a new harm finding added to a record appears here at the next build.

  • DHard clinical endpoint · Tested, harm found
    2-HOBA (2-Hydroxybenzylamine)
    Supplement · Randomized controlled trial
    Grade for: Atrial fibrillation recurrence after catheter ablation
    Endpoint: Atrial fibrillation recurrence after ablation
    Harm found: Atrial fibrillation recurrence in the 28 days after ablation, on treatment (93 adults randomized, 82 analyzed, undergoing atrial fibrillation ablation; 750 mg three times daily against placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received.) 40709466
  • DHard clinical endpoint · Tested, harm found
    Beta-Carotene (supplemental)
    Supplement · Randomized controlled trials (harm found → D 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.)
    Endpoint: Tested at scale for cancer prevention in six large trials. Beta-carotene alone raised lung cancer in male smokers (ATBC); beta-carotene with retinyl palmitate raised lung cancer and death in smokers and asbestos workers (CARET, stopped early); in mostly non-smoking physicians and women it did nothing. A harm finding in smokers, a null in everyone else.
    Harm found: Lung cancer incidence; total mortality (29,133 male smokers aged 50 to 69, Finland, beta-carotene 20 mg/day alone, 5 to 8 years (ATBC)) 8127329
    Harm found: Lung cancer incidence; death from any cause (18,314 smokers, former smokers and asbestos-exposed workers, beta-carotene 30 mg/day plus retinyl palmitate 25,000 IU/day, a combination, mean 4 years (CARET)) 8602180
  • CMeasured function
    NR (Nicotinamide Riboside)
    Supplement · Randomized trials, mostly null on clinical outcomes; one unreplicated positive
    Grade for: Six-minute walk distance in peripheral artery disease; Blood NAD+ Nicotinamide adenine dinucleotide, a molecule cells use in energy metabolism. Its level falls with age in some tissues. concentration in healthy and clinical adults
    Endpoint: Six-minute walk in peripheral artery disease; blood NAD+; cognition and insulin sensitivity tested without benefit; early Parkinson disease tested with harm found
    Harm found: MDS-UPDRS parts I to III total score (primary) and Non-Motor Symptoms Scale score (410 randomized, 393 analyzed, phase 3 double-blind Neither the participants nor the people assessing them know who received the real treatment until the trial ends. placebo-controlled trial) 42848371
  • DSurrogate biomarker · Tested, harm found
    Pterostilbene
    Supplement · Randomized controlled trial
    Grade for: LDL cholesterol in adults enrolled for raised cholesterol
    Endpoint: LDL cholesterol in adults with raised cholesterol
    Harm found: Lipids: LDL cholesterol rose 17.1 mg/dL on pterostilbene alone; blood pressure fell as another endpoint (80 adults with high cholesterol, 6 to 8 weeks, four arms) 25057276
  • CSurrogate biomarker
    Resveratrol (Trans-Resveratrol)
    Supplement · Small randomized trials, mixed; pooled risk factors null; one training trial with harm
    Grade for: Metabolic markers in obese men
    Endpoint: Metabolic markers in obese men, mixed; exercise training adaptations in older men, blunted
    Harm found: Training gains in maximal oxygen uptake, mean arterial pressure and blood lipids (27 inactive men aged about 65, randomized to resveratrol or placebo alongside 8 weeks of high-intensity training) 23878368
  • BSelf-report
    Vitamin C (ascorbic acid)
    Supplement · Pooled reviews of randomized trials and large randomized trials
    Grade for: Common-cold duration with daily supplementation
    Harm found: Death or persistent organ dysfunction at 28 days (composite) (872 adults with sepsis receiving vasopressors in intensive care, 50 mg/kg intravenously every 6 hours for up to 96 hours (LOVIT)) 35704292
    Harm found: Death within 28 days, a secondary outcome; the primary outcome of death or persistent organ dysfunction at 28 days was also higher but not significantly (risk ratio 1.28, P = .06) (238 adults with deep burns over 20 percent or more of the body, 50 mg/kg intravenously every 6 hours for 96 hours (VICTORY)) 42267875
  • DHard clinical endpoint · Tested, no benefit
    Vitamin E (supplemental alpha-tocopherol)
    Supplement · Large randomized trials and pooled reviews, no benefit, harm signal in one trial
    Grade for: Major cardiovascular events
    Harm found: Prostate cancer incidence (Healthy men, 400 IU/day all rac-alpha-tocopheryl acetate, planned 7-12 year follow-up) 21990298

Build cf48ea3, November 2026