Peer-Reviewed Science

How Eumaia Measures Biological Age

Every number in Eumaia is grounded in published research — not wellness trends. Here's exactly how we calculate biological age, which studies we rely on, and what our limitations are.

The PhenoAge Algorithm

Eumaia's biological age estimate is based on the PhenoAge algorithm, developed by Dr. Morgan Levine and colleagues at Yale School of Medicine and published in Aging (2018). The algorithm was trained and validated on over 11,000 participants from the National Health and Nutrition Examination Survey (NHANES III).

PhenoAge outperforms chronological age at predicting all-cause mortality, cancer incidence, disability, and multi-morbidity — making it one of the most clinically validated biological age clocks available from standard blood tests.

Primary Citation

Levine, M.E., Lu, A.T., Quach, A., et al. (2018). "An epigenetic biomarker of aging for lifespan and healthspan." Aging, 10(4), 573–591. doi:10.18632/aging.101414

The 9 Biomarkers

PhenoAge uses nine routine blood markers — all available from a standard metabolic panel and CBC — weighted by their contribution to biological aging:

Albumin (g/dL)

Liver function, nutritional status, longevity predictor. Declines with inflammation and poor nutrition.

Optimal range

> 4.4

Creatinine (mg/dL)

Kidney filtration efficiency. Elevated levels indicate declining renal function.

Optimal range

0.7–1.0

Fasting Glucose (mg/dL)

Metabolic health and insulin sensitivity. Chronic elevation accelerates cellular aging.

Optimal range

< 85

C-Reactive Protein (CRP) (mg/L)

Systemic inflammation — the #1 driver of accelerated biological aging across all systems.

Optimal range

< 0.5

Lymphocyte % (%)

Immune competence. Low levels predict infection risk and immune senescence.

Optimal range

25–40%

MCV (fL)

Red blood cell size. Elevated MCV indicates B12/folate deficiency or liver stress.

Optimal range

80–95

RDW (%)

Red cell variation width — a powerful, underappreciated marker of oxidative stress and inflammation.

Optimal range

< 12.5

Alkaline Phosphatase (ALP) (U/L)

Liver and bone health marker. Elevations linked to liver inflammation and accelerated aging.

Optimal range

< 80

White Blood Cell Count (K/μL)

Total immune activation. Chronically elevated WBC reflects systemic immune stress.

Optimal range

4–7

How the Calculation Works

The PhenoAge calculation involves two steps:

Step 1 — Phenotypic Mortality Score

The nine biomarkers are combined using a linear equation with coefficients derived from Cox proportional hazards regression on the NHANES dataset. This produces a "mortality score" that represents 10-year mortality risk better than chronological age alone.

lin_combo = −19.907 − 0.0336×albumin + 0.0095×creatinine + 0.1953×(glucose/18) + 0.0954×ln(CRP) − 0.012×lymphocyte + 0.0268×MCV + 0.3306×RDW + 0.00188×ALP + 0.0554×WBC

Step 2 — Convert to Biological Age

The mortality score is converted to an age equivalent using a Gompertz survival model — mapping the predicted mortality risk to the chronological age at which the average person would carry that same risk.

mortality = 1 − exp(−exp(lin_combo) × (exp(0.0076927 × 120) − 1) / 0.0076927)
PhenoAge = 141.5 + ln(−0.00553 × ln(1 − mortality)) / 0.09165

Results are clamped between 18 and 100 to avoid extrapolation artifacts. All coefficients are taken directly from the published paper and have not been modified.

Validation & Evidence

11,000+

NHANES participants used in training and validation

3.2 yrs

Average biological age improvement seen in lifestyle interventions (Fitzgerald et al., 2021)

p < 0.001

Statistical significance of PhenoAge vs chronological age in predicting all-cause mortality

6 systems

Body systems tracked: metabolic, immune, inflammatory, hepatic, renal, cardiovascular

Additional Supporting Research

Fitzgerald, K.N., et al. (2021). "Potential reversal of epigenetic age using diet and lifestyle interventions." Aging. doi:10.18632/aging.202913
Liu, Z., et al. (2020). "Phenotypic age: a novel signature of mortality and morbidity risk." EBioMedicine. doi:10.1016/j.ebiom.2020.102981
Belsky, D.W., et al. (2015). "Quantification of biological aging in young adults." PNAS. doi:10.1073/pnas.1506264112

Expert Scientific Panel

Eumaia's recommendations are informed by the published research of leading longevity scientists. These experts have not directly endorsed or partnered with Eumaia — we reference their public research and peer-reviewed publications.

Dr. Morgan Levine

PhenoAge, Biological Clocks

Yale → Altos Labs

Dr. David Sinclair

NAD+, Sirtuins, Epigenetics

Harvard Medical School

Dr. Valter Longo

Fasting Mimicking Diet, Longevity

USC Longevity Institute

Dr. Rhonda Patrick

Micronutrients, Sauna, Inflammation

FoundMyFitness

Dr. Iñigo San Millán

Zone 2, VO2 Max, Mitochondria

CU Anschutz

Dr. Matthew Walker

Sleep Science, REM, Circadian

UC Berkeley

Dr. Peter Attia

Longevity Medicine, Performance

Early Medical

Dr. Ben Bikman

Insulin Resistance, Metabolism

Brigham Young University

Dr. Eric Berg

Metabolic Health, Keto Protocols

Berg Institute

* Expert names and research are referenced for educational attribution only. No endorsement implied.

Honest Limitations

We believe in transparency. Here's what Eumaia cannot do:

  • PhenoAge is a population-level predictor — individual results carry inherent uncertainty (±3–5 years typical range).
  • We do not account for genetics. Two people with identical biomarkers may have different genetic aging trajectories.
  • Lab values fluctuate with hydration, recent meals, illness, stress, and timing of blood draw. A single reading is not definitive.
  • Eumaia is not a diagnostic tool and cannot diagnose, treat, or predict any specific disease.
  • Our intervention recommendations are based on population research — not clinical trials of your specific health profile.
  • VO2 Max, HbA1c, ApoB, and epigenetic clocks (DunedinPACE, GrimAge) would improve accuracy but require additional testing.

Medical Disclaimer

Eumaia is a longevity education and tracking platform. Content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified physician or licensed healthcare provider before making decisions about your health. The PhenoAge algorithm and all referenced research are used for educational purposes — Eumaia is not affiliated with Yale University, the NHANES program, or any referenced researcher.

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