Bryan Johnson’s Blueprint Protocol

Why Johnson takes it: Boost NAD+ for DNA repair, energy and cellular aging — Blueprint protocol

What the evidence says: Human RCTs (Yi 2022; Yoshino 2021) confirm NMN raises blood NAD+ and, in one trial, improved muscle insulin sensitivity in prediabetic women — but these are short-term surrogate outcomes. No trial shows reduced mortality or extended lifespan. Johnson cut NMN to 6 days/week, itself reflecting the thin outcome data.

Why Johnson takes it: High-polyphenol fat; anti-inflammatory, cardiovascular — Blueprint protocol

What the evidence says: The PREDIMED RCT (Estruch 2018) found a Mediterranean diet with extra-virgin olive oil cut major cardiovascular events ~30% versus control, and cohort meta-analyses (Martinez-Gonzalez 2022) link higher olive-oil intake to lower CVD and all-cause mortality. Among the strongest evidence in the stack, though PREDIMED tested a whole dietary pattern.

Why Johnson takes it: Vascular function and blood flow — Blueprint protocol

What the evidence says: The COSMOS RCT (Sesso 2022, ~21,000 participants) found cocoa flavanols did NOT significantly reduce total cardiovascular events (p=0.11), but reduced cardiovascular death ~27% in a pre-specified secondary analysis. One large RCT with a modest signal confined to a secondary endpoint.

Why Johnson takes it: Anti-inflammatory; cardiovascular and brain health — Blueprint protocol

What the evidence says: In VITAL (Manson 2018), marine omega-3 (1 g/day) did not reduce the primary composite of major CV events or cancer, though secondary analyses showed fewer myocardial infarctions. Trial results overall are inconsistent (REDUCE-IT positive, STRENGTH null), with no longevity benefit for generally healthy people.

Why Johnson takes it: Immune, bone and hormonal health — Blueprint protocol

What the evidence says: VITAL (Manson 2018) found 2,000 IU/day did not lower its primary endpoints of cancer or major CV events. Secondary analyses suggested reduced cancer mortality and autoimmune disease, while fracture trials were null. Good RCT evidence, but the longevity case is modest and clearest in those deficient.

Why Johnson takes it: Directs calcium to bone, away from arteries — Blueprint protocol

What the evidence says: Observational data (Geleijnse 2004, Rotterdam Study) tie higher K2 intake to less coronary heart disease, and small MK-7 RCTs (Naiyarakseree 2023) improve arterial stiffness in specific patients. Largely observational and surrogate-endpoint; no RCT shows a hard-outcome benefit in healthy adults.

Why Johnson takes it: Enzymatic cofactor; blood pressure, sleep, metabolic — Blueprint protocol

What the evidence says: A meta-analysis of RCTs (Zhang 2016) shows magnesium produces small but real blood-pressure reductions (~2 mmHg systolic), and low magnesium status is observationally linked to higher CVD. Benefits are modest and most relevant to those with inadequate intake.

Why Johnson takes it: Immune function and hormone production — Blueprint protocol

What the evidence says: The best zinc RCT evidence (Cochrane, Singh 2013) is that zinc shortens common-cold duration — an immune effect, not a longevity outcome. Zinc is essential and deficiency harmful, but supplementation in replete adults has not been shown to extend lifespan, and excess can impair copper status.

Why Johnson takes it: Lower cortisol and stress — Blueprint protocol

What the evidence says: Multiple RCTs and a meta-analysis (Arumugam 2024; Lopresti 2019) show ashwagandha reduces perceived stress and cortisol versus placebo — a reasonably replicated effect. But it supports stress reduction, not longevity; no trial links it to lifespan, and long-term safety data are limited.

Why Johnson takes it: Blood pressure and lipids — Blueprint protocol

What the evidence says: Meta-analyses (Saadh 2024; Fu 2023) show garlic modestly lowers blood pressure and some metabolic-syndrome markers. Effects are small and confined to surrogate endpoints; no RCT shows garlic extends human lifespan.

Why Johnson takes it: Anti-inflammatory and metabolic support — Blueprint protocol

What the evidence says: A meta-analysis of RCTs (Maharlouei 2018) found ginger produces modest improvements in body weight and metabolic profile in overweight subjects. Evidence is limited to short-term surrogate endpoints, with no longevity data.

Why Johnson takes it: Neuroprotection; population longevity signal — Blueprint protocol

What the evidence says: The longevity rationale rests on Zarse 2011: an ecological correlation between higher drinking-water lithium and lower mortality across Japanese municipalities, plus lifespan extension in C. elegans. There is NO human randomized trial of microdose lithium for longevity — hypothesis-generating evidence only.

Why Johnson takes it: Antioxidant; heart and prostate — Blueprint protocol

What the evidence says: Observational meta-analyses (Li 2014; Cheng 2017) associate higher lycopene/tomato intake with lower stroke and CVD risk. The data are epidemiological and confounded by overall diet quality; randomized outcome trials are lacking, so any longevity benefit is unproven.

Why Johnson takes it: Mitochondrial energy; cardiovascular — Blueprint protocol

What the evidence says: In chronic heart failure, Q-SYMBIO (Mortensen 2014) showed CoQ10 300 mg/day reduced major cardiovascular events and mortality, and KiSel-10 (Alehagen 2015) found selenium+CoQ10 lowered CV death in elderly Swedes. But these benefits are in heart-failure or elderly/deficient populations, so extrapolation to healthy-longevity dosing is uncertain.

Why Johnson takes it: Induce autophagy (cellular cleanup) — Blueprint protocol

What the evidence says: Observational data (Han 2024, UK Biobank) link higher dietary spermidine intake to lower mortality, and spermidine robustly induces autophagy in animals. Human evidence is observational plus small cognition trials; no RCT demonstrates a longevity outcome.

Why Johnson takes it: Joint health; observed mortality signal — Blueprint protocol

What the evidence says: Large cohort studies (Li 2020, UK Biobank) find regular glucosamine users have ~15% lower all-cause and CV mortality — an intriguing but confounding-prone observational signal. No randomized trial has tested glucosamine for mortality, so causality is unestablished.

Why Johnson takes it: Replace age-related taurine decline — Blueprint protocol

What the evidence says: The headline study (Singh 2023, Science) showed taurine extended lifespan ~10-12% in mice and improved healthspan markers in worms, mice and monkeys, with human cross-sectional data showing taurine declines with age. But the human evidence is purely correlational — no human trial shows taurine extends life. A definitive human RCT is still needed.

Why Johnson takes it: Glutathione precursor; antioxidant — Blueprint protocol

What the evidence says: A small randomized trial of GlyNAC (Kumar 2023) improved glutathione, oxidative stress, mitochondrial function and physical function in older adults over 16 weeks. A promising but small, biomarker-based study with no longevity endpoint, and NAC's broader clinical-outcome evidence is mixed.