Three Numbers That Actually Tell You Where You Stand

Epigenetic clocks and biological age panels are the wellness industry’s newest anxiety product. They cost between $200 and $500, spit out a single number — “your biological age is 38 but your chronological age is 45” — and send you into either celebration or despair. The problem is that these numbers only weakly correlate with real health outcomes in middle-aged people, change too slowly to guide any decisions, and create a false impression that aging is a single number you can fix with a protocol ^[1].

There are three different types of epigenetic clocks, and understanding the differences shows why none of them are ready for individual use. The Horvath clock measures chemical markers at 353 spots on your DNA and was built to predict chronological age, not health. It’s remarkably accurate at telling you how old you are — which is information you already had. The PhenoAge clock was trained to predict death from any cause and is more clinically useful, but it relies on routine blood markers (albumin, creatinine, glucose, and so on) that are more informative on their own than the DNA component adds. The DunedinPACE clock measures how fast you’re aging rather than your current biological age, and it’s arguably the most useful of the three — but it still only changes over months to years, far too slowly to tell you whether your new exercise routine or sleep fix is actually working.

The core problem isn’t the science. The underlying patterns are real and interesting. The problem is usefulness. By the time an epigenetic clock changes in a meaningful way, you could already have measured the actual outcome directly. You could have tested your VO2 max, checked your ApoB, calculated your HOMA-IR — and gotten feedback you can act on today.

There are three numbers that actually tell you where you stand. They’re cheap, they’re actionable, and they change within weeks of making a change.

ApoB — your cardiovascular ceiling. This is the single most predictive blood marker for the artery disease that remains the leading cause of death as people age. If your ApoB is above 90 mg/dL at age 45, your blood vessels are accumulating damage even if your standard LDL cholesterol looks fine ^[2]. And the response to treatment — lifestyle changes, diet changes, and medication if needed — can be measured in weeks, not years.

Fasting insulin — your metabolic trajectory. A level above 8–10 µIU/mL with otherwise normal blood sugar means your body is pumping out extra insulin just to keep glucose under control. This is the earliest measurable sign of metabolic aging, and it shows up 5 to 10 years before blood sugar problems typically appear. It also responds to treatment — two resistance-training sessions a week plus a 12-hour overnight fast can lower fasting insulin by 20-30% in 8 to 12 weeks.

VO2 max — your functional ceiling. This is the single best predictor of death from any cause in middle-aged and older adults, beating every blood marker in head-to-head comparisons ^[3]. It measures your aerobic fitness directly — not a stand-in, not a loose correlation, not a DNA pattern that may or may not track with an outcome. It tells you where you stand compared to people your age, and whether your training is actually working. VO2 max improves with consistent aerobic training at any age, and the change shows up within 4 to 6 weeks of a structured program.

These three numbers together cost roughly $100 to measure (ApoB: $30-50, fasting insulin: $20-40, an estimated VO2 max via a submaximal test: $0-50). A single biological-age panel costs $200-500. For the price of one epigenetic test, you could run all three of these instead, get results you can actually act on, and still have money left over.

Counterpoint: aren’t epigenetic clocks validated by research? Yes, for certain specific uses — predicting death in terminally ill patients, identifying accelerated aging in people with chronic disease, and studying how interventions affect large groups of people. The DunedinPACE clock, for example, has shown that people with a faster pace of aging have worse physical function in their 40s and 50s ^[1]. But at the individual level, the effect is small enough that knowing your score doesn’t actually change what you’d do about it. You wouldn’t treat someone with a “biological age of 40” any differently from someone with a “biological age of 48” — you’d still work on their ApoB, fasting insulin, and VO2 max either way. The clock adds information that doesn’t change the decision.

Every dollar spent on a DNA-based aging test would be better spent on a DEXA scan and a max aerobic test. The simple numbers work. We just don’t like how simple they are. We want a single number that tells us whether we’re winning, and the epigenetic clock offers exactly that — which is precisely why it’s worth being cautious about. It creates the illusion that aging is a fixed score instead of an ongoing, changeable trend.

Bettering Me recommends knowing these three numbers before spending a single dollar on a biological-age panel. The epigenetic clock tells you how old your DNA looks. ApoB, fasting insulin, and VO2 max tell you how your body is actually functioning right now — and what to do about it. One is entertainment. The other three are information you can use this week.

Disclaimer: This post is for inspiration and education, not medical advice. Everyone’s body is different, so please check with your doctor before changing your diet, exercise, or lifestyle routine. By using these tips, you agree to do so at your own risk.

References

^[1] Bell CG, et al. "DNA methylation aging clocks: challenges and recommendations." *Genome Biology*. 2019;20(1):249.. DOI: https://doi.org/10.1186/s13059-019-1824-y

^[2] Sniderman AD, et al. "Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review." *JAMA Cardiology*. 2019;4(12):1287-1295.. DOI: https://doi.org/10.1001/jamacardio.2019.3780

^[3] Myers J, et al. "Exercise capacity and mortality among men referred for exercise testing." *NEJM*. 2002;346(11):793-801.. DOI: https://doi.org/10.1056/NEJMoa011858

Kurt Greiner

Kurt is a digital strategist and IT professional blending emerging technology with practical application to help businesses and individuals streamline their digital presence. His current work focuses on the intersection of intentional living and technological resilience, exploring how individuals can leverage modern tools to navigate the second half of life with purpose.