Inside the Clinical Trials Reshaping Longevity Medicine
A clinical researcher at the Buck Institute walks through the wave of human trials now moving longevity science out of the lab and into people. From ketone drinks for frailty to a homelessness aging cohort and the ambitious PROSPER program built around intrinsic capacity, she shows how wearables, multi-omics and smart trial design could reshape how we measure and support healthy aging.
Overview
For 25 years the Buck Institute focused on the basic biology of aging; this conversation is about the moment that science began moving into people. The researcher describes how a single philanthropic donation funded the Buck's first-ever clinical study, a safety trial of ketone drinks in older adults, despite having no staff, protocols or infrastructure to start. That pilot's positive results unlocked NIH funding and grew into a program of seven studies, including TAKE OFF, a multi-site trial of ketones for frailty in 180 prefrail adults.
Other trials translate basic-science findings into humans, such as testing a glycation-lowering supplement in postmenopausal women at metabolic risk. A striking thread is her lifelong-exercise study, where even sedentary control participants score in the 80th to 90th VO2-max percentile, prompting questions about how much socioeconomic status, not exercise alone, shapes aging.
A companion cohort will, for the first time, measure biological aging in people experiencing homelessness. She also details data-heavy studies, the wearable-driven beta and TIME projects, that pair continuous sensors with deep multi-omics to map the human phenome. The conversation closes on PROSPER, an ARPA-H program aiming to define and measure intrinsic capacity and open an FDA pathway for treatments that support aging before disease appears.
Key quotes
5It doesn't have to be fancy. It just has to be compliant and safe and rigorous.
My mission for what we're doing at the Buck is to help basic scientists take these ideas and start to try them out in people.
If I don't see what I'm expecting to see, my conclusion will have to be that socioeconomic status more than exercise drives aging.
The idea would be to have an adult health curve, kind of analogous to the pediatric growth chart.
You really have to be pretty confident or pretty stupid to apply.
Key ideas
9Moving gerontology into people
After 25 years focused on the basic biology of aging, the Buck began translating that science into human studies, driven by a background in clinical research and a can-do mindset.
From a safety pilot to an NIH program
A small 12-week safety trial of ketone drinks in 30 older adults produced positive results and intriguing proteomic and immune signals, unlocking a large NIH R01 grant.
TAKE OFF: ketones and frailty
A 20-week, placebo-controlled, double-blind trial in 180 prefrail adults across the Buck, Ohio State and UConn tests whether ketones improve functional outcomes.
Translating basic science to the clinic
A glycation-focused supplement shown to reduce advanced glycation end products in mice is being tested in postmenopausal women with metabolic risk, with AGEs and MGO as the primary outcome.
Lifelong exercise and muscle organoids
Elite older athletes undergo deep phenotyping, and fresh muscle samples feed a 3D organoid system that keeps living muscle cells twitching for study.
The healthy-control paradox
Even sedentary controls score in the top VO2-max percentiles, raising the question of how much socioeconomic status and the ability to make healthy choices shape aging.
Exposures and biological aging
A first-of-its-kind cohort will measure biological aging in people experiencing homelessness, who often show geriatric syndromes decades early.
Wearables and the human phenome
The beta and TIME studies pair CGMs, rings and bands with deep multi-omics to map biorhythms and move diabetes detection upstream.
PROSPER and intrinsic capacity
An ARPA-H program aims to measure intrinsic capacity across physical, cognitive, psychological, sensory and vitality domains and open an FDA pathway for treating aging before disease.
Practical takeaways
7- 1
Ketones are promising but personal 8:30
Early trials suggest ketones may support aging, but the right product and dose likely differ from person to person, and this is still active research, not a recommendation.
- 2
Environment shapes aging too 27:30
Exercise matters, but socioeconomic status and the everyday ability to make healthy choices may play a bigger role in aging than we assume.
- 3
Think in terms of capacity 40:30
Framing health around intrinsic capacity across physical, cognitive, mood, sensory and vitality focuses on the presence of function rather than accumulating deficits.
- 4
Wearables reveal continuous signals 34:30
Everyday devices like CGMs, Oura rings and Whoop bands can surface high-resolution patterns in glucose, sleep and recovery over time.
- 5
Timing changes your numbers 38:00
Biomarkers can shift from morning to evening, so when you measure matters, and single snapshots tell only part of the story.
- 6
Consistency beats intensity 41:30
Lifestyle interventions tend to work only when people can sustain the behavior change, so adherence matters more than any single program.
- 7
Aging can be tracked early 40:00
The long-term vision is an adult health curve that flags changes before disease appears, so support can start earlier.
Topics & chapters
14Shifting to the clinical trial work
After a glucose anecdote, the conversation turns to the human clinical trials now underway.
Ketones bring her to the Buck
Ketone research and a partnership with John Newman drew her to the Buck's first clinical work.
Building a clinical program from scratch
With no staff, IRB or SOPs, a single donation funded the institute's first trial over about a year of setup.
First safety results and an NIH R01
A 30-person, 12-week ketone safety study produced positive results and pilot data that unlocked NIH funding.
TAKE OFF: ketones and frailty
A 180-person, multi-site, double-blind trial tests ketones for functional outcomes in prefrail adults.
Personalizing ketone dosing
Studies with Ohio State compare products and doses to learn how to give ketones to different people.
Glycation stress and postmenopausal health
A supplement that lowers AGEs in mice is tested in postmenopausal women with metabolic risk factors.
Lifelong exercise and muscle organoids
Elite older athletes undergo deep phenotyping, with fresh muscle feeding a 3D organoid system.
The unexpectedly fit control group
Even low-exercise controls score in top VO2-max percentiles, complicating the study's assumptions.
A geroscience lens on exercise
No one had run aging clocks or senescence markers on lifelong athletes versus non-athletes before.
Homelessness cohort: exposures and aging
A new cohort will measure biological aging in people experiencing homelessness for the first time.
Wearables to predict diabetes
The beta study pairs CGMs and other wearables with clinic tests to detect diabetes trajectories earlier.
The TIME study: mapping the phenome
An intensive study captures wearables, microbiomes and multi-omics to chart the biorhythms of the human phenome.
PROSPER and intrinsic capacity
An ARPA-H program aims to measure intrinsic capacity and open an FDA pathway for gerotherapeutics.