For those who’ve heard of billionaire Bryan Johnson, you’ve possible encountered the phrase “bio age testing.”
Johnson, the topic of the Netflix documentary Don’t Die, says he’s on a quest to realize the bottom doable “organic age” (also called bio age).
He reportedly spends hundreds of thousands every year on anti-aging remedies—dozens of each day dietary supplements, weekly acid peels for his pores and skin, injections to spice up collagen manufacturing, hyperbaric oxygen remedy, and plasma infusions extracted from his 17-year-old son’s physique.
To find out what’s working, Johnson has undergone quite a few checks to evaluate his bio age. Johnson says these checks present his age is now 5.1 years youthful than when he launched into his anti-aging quest.
Apparently, he’s getting older in reverse.
Granted, not everybody’s shopping for it. A New York Occasions exposé, for instance, claims Johnson’s organic age, in actuality, has elevated by 10 years.1
Nonetheless, Johnson’s “don’t die” campaign is gaining traction.
Bio age checks are a frequent subject on in style podcasts by Peter Attia, Joe Rogan, and Andrew Huberman. Google “bio age testing” and also you’ll see dozens of advertisements for mail-order blood or urine testing kits that declare to disclose your organic age, tempo of getting older, and extra. With costs tumbling into affordability, it’s pure to surprise…
Do you have to or your shopper join bio age testing?
In that case, which check is greatest? Simply as importantly, what do you have to do with the knowledge?
On this story, you’ll study:
What’s your bio age?
Your organic age (bio age) refers to how your cells operate. It’s not essentially the identical as your chronological age, which refers back to the variety of candles in your birthday cake.
For instance, let’s say Chang, a 50-year-old man, works at a desk, spends his free time in entrance of the TV, lives in essentially the most polluted metropolis on the planet, eats a sweet bar for lunch, and smokes. Then again, Jabari, a distinct 50-year-old man, hits the gymnasium a number of instances per week, lives within the mountains, doesn’t smoke, relishes his 5 servings of veggies a day, meditates, and spends most evenings in his backyard.
Genetics apart, you’d be smart to wager that Jabari’s bio age is youthful than Chang’s.
How do these checks measure bio age?
Bio age testing kits measure a number of organic markers of getting older, also called biomarkers.
For instance, some checks deal with the dimensions of your telomeres, the protecting caps on the ends of chromosomes. Others measure DNA methylation, a physiological course of that chemically alters DNA.
As soon as an organization isolates and measures these markers out of your blood or urine, it plugs the bio knowledge right into a method that calculates your bio age.
Nonetheless, in the event you see a health care provider with any regularity, you’re possible already monitoring some biomarkers of getting older. For instance, biomarkers corresponding to blood stress, levels of cholesterol, and blood glucose will help predict your threat of future heart problems, a number one reason behind untimely demise.
What’s the purpose of biomarker testing?
Biomarker testing will help you monitor your wellness proactively reasonably than ready for illness signs to seem.
For some, it additionally serves as a motivator. For those who study you could have the bones of somebody 20 years older, this will provide the nudge you should begin power coaching persistently.
As well as, biomarkers present goal knowledge, permitting you to trace and consider varied health-related actions quantitatively. By monitoring your blood stress, you may study that constant train helps, however your late-afternoon power drink does the other.
5 FREE biomarker checks
You don’t should be a billionaire (or perhaps a millionaire) to trace biomarkers of getting older.
On this part, we’ll cowl a number of massively underappreciated, scientifically validated checks you should use to achieve perception into your bio age—for FREE.
Earlier than scientists developed high-tech blood-based bio age checks, researchers used these free checks to calculate the tempo of getting older within the individuals they studied.
FREE biomarker check #1: Get off the ground
People who find themselves fitter and stronger are likely to stay longer.2
That’s as a result of muscle tissue do extra than simply transfer us round. In addition they secrete anti-inflammatory substances, assist to control blood sugar, sluggish mobile getting older, defend the liner of the arteries, and extra. All this helps scale back the danger of age-related ailments, corresponding to kind 2 diabetes, hypertension, and coronary heart illness, a phenomenon we discover in our article, The New Science of Muscle.
Associated to power, your capability to steadiness can also be key. For those who’re middle-aged or older and might’t stand on one foot for at the least 10 seconds, your threat of dying within the subsequent seven years is double that of somebody who can stand for longer, in accordance with a examine of 1,700 individuals.3
The Sitting-Rising Check (SRT) is one method to assess each power and steadiness on the identical time.
Folks with low scores on this check have the next threat of dying from heart problems, in accordance with a 12-year examine of 4,200 adults between the ages of 46 and 75.4
▶ measure it
Decrease your self to the ground together with your legs in a crisscross place. Then, together with your legs in the identical place, stand again up. As you stand, discover in the event you should use part of your physique—hand, shin, knee—as leverage.
To attain your self, begin with 10 factors. Then, for every physique half you used to face, deduct some extent. Subtract a half level in the event you grew to become unsteady or misplaced your steadiness.
Understand that this (and different checks) function a proxy in your health. A low rating signifies that your steadiness and coordination, muscle power and energy, and mobility might all require some consideration.
FREE biomarker check #2: Squeeze a ball
Just like the SRT check, your grip power gives perception into your general health. If the muscle tissue in your arms are weak, the muscle tissue all through your physique usually tend to be weak, too.
Poor grip power also can predict future muscle weak spot. In a single examine, individuals with a weak grip have been extra prone to stroll slowly and be unable to rise from a chair, full rigorous house responsibilities, or climb a flight of steps 25 years later.5
Low grip power has additionally been related to:6
- Low bone mineral density
- Elevated threat of falls
- Poor dietary standing
- Despair
- Poor sleep, cognitive operate, and/or high quality of life
- Elevated threat of coronary heart illness, most cancers, and untimely mortality
In response to one examine, grip power was a greater indicator of longevity (or lack thereof) than blood stress.7
▶ measure it
Seize an ordinary tennis ball, and squeeze as exhausting as you’ll be able to, for so long as you’ll be able to.
For those who can handle 15 to 30 seconds earlier than your grip fatigues, you’re doing wonderful. Ninety seconds places you effectively above common—something over 90 ranks you solidly within the upper-third percentile.
For those who’re beneath 15, take into account that this check can also be only one indicator of your general power. (And squeezing balls to enhance grip power with out coaching the remainder of your physique is unlikely to make vital enhancements in your general well being and health.)
A hand-held dynamometer—obtainable to be used at most occupational therapists’ and a few gyms—also can check grip power. (For those who’re keen to shell out some money, you should buy your personal for someplace between $100 and $500.)
FREE biomarker check #3: Stand on one foot
A capability to steadiness on one foot for an prolonged interval will help scale back your threat of falls, one of many main causes of injury-related demise amongst older adults.
As well as, many alternative bodily programs—the eyes, interior ear, skeletal muscle tissue, and mind—should work collectively that can assist you keep upright.
Circumstances like diabetes, coronary heart illness, and most cancers can all have an effect on steadiness. Consequently, an lack of ability to face on one foot can function a warning signal for eroding well being and health.8
▶ measure it
Stand close to a wall or chair for security. Maintain your eyes open and arms in your hips. Then, elevate your dominant leg and begin timing your self. As soon as you place your foot down, cease the clock. Repeat the check together with your non-dominant leg.
After getting your instances, evaluate them to the next averages, from a examine out of Duke College, to see how you probably did in comparison with your age-matched friends.9
| Age | Seconds on one leg (males) | Seconds on one leg (females) |
|---|---|---|
| 30-39 | 59 | 56 |
| 40-49 | 56 | 55 |
| 50-59 | 42 | 48 |
| 60-69 | 40 | 38 |
| 70-79 | 27 | 25 |
| 80+ | 13 | 11 |
FREE biomarker check #4: How you are feeling
Generally you already know why you’re drained, such because the morning after binge-watching the previous couple of episodes of a thriller. When you atone for your sleep, the weariness lifts.
That’s not the identical factor as fatigue, which describes persistent exhaustion that worsens over time and interferes with life. Along with feeling bodily drained, somebody who’s fatigued feels mentally uninteresting and emotionally exhausted.
Consider fatigue as an early signal that one thing’s off, particularly in the event you don’t know the trigger.
Let’s say you’ve already dominated out the same old suspects like an excessive amount of caffeine, dehydration, an excessive amount of alcohol, remedy negative effects, continual stress, or an excessive amount of or too little train. What’s left is probably going a sleep problem or a creating well being drawback corresponding to anemia, weight problems, despair, most cancers, or diabetes, to call a number of.
For those who’re 60 or older, fatiguability—or how worn out you are feeling after an exercise—also can predict longevity.
In response to analysis out of the College of Pittsburgh Medical Middle, the upper somebody scores in fatiguability, the upper their threat of demise sooner or later.10 Different analysis has linked excessive fatiguability with declines in gait pace, strolling capability, and different checks of health.11
▶ measure it
To measure fatigability, use a instrument referred to as the Pittsburgh Fatigability Scale. Utilizing a 0 (no fatigue) to five (excessive fatigue) scale, fee how fatigued you assume you’d really feel after finishing the next actions:
| Exercise | Period | Rating (0 to five) |
|---|---|---|
| Leisurely strolling | half-hour | |
| Brisk or quick strolling | 1 hour | |
| Mild family exercise | 1 hour | |
| Heavy gardening or yard work | 1 hour | |
| Watching tv | 2 hours | |
| Sitting quietly | 1 hour | |
| Reasonable-to-high depth power coaching | half-hour | |
| Taking part in a social exercise | 1 hour | |
| Internet hosting a social occasion for 60 minutes | 1 hour | |
| Excessive depth exercise | half-hour | |
| Add all scores: | ||
For those who rating lower than 15, you’re doing effectively. Scores between 15 and 24 are a warning signal. Something 25 and above is considered extreme, and price mentioning to your healthcare skilled.12
FREE biomarker check #5: Physique composition
Regardless of in style perception, each too little and an excessive amount of physique fats can affect well being for the more severe, as we discover in our infographic, Is physique fats good or unhealthy for you?
| An excessive amount of fats raises the danger for: | Too little muscle raises threat for: |
|---|---|
| Coronary heart illness | Coronary heart illness |
| Hypertension | Hypertension |
| Most cancers | Most cancers |
| Fatty liver illness | Stroke |
| Insulin resistance | Insulin resistance |
| Sort 2 diabetes | Sooner mobile getting older |
| Irritation | Irritation |
| Joint misery | Despair and nervousness |
| Sleep apnea | Falls and lack of steadiness |
Your muscle mass additionally performs a task, which is why somebody’s physique composition issues greater than their weight.
The gold commonplace strategies that estimate physique composition—underwater weighing, air displacement (Bod Pod), and dual-energy X-ray absorptiometry (DEXA)—definitely aren’t free.
Nonetheless, a current examine decided {that a} good old style (and low-cost) tape measure can present a comparably correct estimate of physique composition.13
▶ measure it
To make use of a tape measure to maintain observe of your physique fats proportion, measure:
- The widest a part of your neck
- The narrowest a part of your waist (For some individuals, this can be on the navel. For others, it could be barely above the navel)
- The widest a part of your hips
Make sure the tape is comfortable however not so tight that it cuts into the pores and skin. After getting your measurements, plug these numbers—alongside together with your age, intercourse, peak, and weight—into our FREE Physique Fats Calculator, which is able to take it from there.
Physician-approved biomarker checks
Relying on the place you reside on the planet, the next checks might not be free. Nonetheless, as a part of routine preventative care, your insurance coverage may cowl them.
Physician-approved check #1: Blood panel
In case your major care physician recommends yearly blood work, it’s for good motive.
By retaining tabs on a number of blood markers, you’ll be able to see in case your well being is trending towards kind 2 diabetes or coronary heart illness, each main causes of untimely mortality.
Many blood markers can be influenced comparatively shortly (inside 6 to 12 weeks) by means of life-style adjustments, complement protocols, or medicines. This makes them sensible instruments for monitoring whether or not varied life-style or medical modifications are working.
▶ measure it
For those who’re not already doing so, contemplate having the next blood markers examined yearly. Then, discuss to your well being care skilled about what your numbers imply. They may use the next numbers, alongside together with your blood stress, to calculate a heart problems threat rating.
| Blood marker | Optimum vary |
|---|---|
| Complete ldl cholesterol | < 200 mg/dL* |
| LDL | < 100 mg/dL for these with out coronary heart illness < 70 mg/dL for these with a historical past of coronary heart assault or stroke |
| HDL | > 60 mg/dL |
| Triglycerides | < 150 mg/dL |
| Alipoprotein B (Apo B) | < 133 mg/dL (males) < 117 mg/dL (females) |
| Lipoprotein (a) | < 30 mg/dL |
| C-reactive protein | < 2.0 mg/L** |
| Fasting glucose | < 100 mg/dL |
| Hemoglobin A1C | < 5.7% |
*Milligrams per deciliter of blood
**Milligrams per liter
Physician-approved check #2: Bone density
When researchers examine wholesome super-agers aged 90 and older, sturdy bones are one among their defining options.14
Which may be as a result of, like muscle tissue, bones are stay organs that secrete substances which may be useful to general well being and longevity.15
For instance, bones secrete osteocalcin, a hormone that performs a task in bone transforming. When osteocalcin circulates within the physique, it’s thought to play a task in all the things from serving to muscle tissue to supply ATP to regulating mind neurotransmitters.
Due to these diverse roles, it’s thought that, as bones put on away, osteocalcin ranges drop, contributing to many age-related well being issues, together with diabetes, low muscle mass, and cognitive points.16 17 (No less than, that’s the speculation. Most of this analysis has been achieved on mice.)
Osteocalcin apart, lack of bone density can, after all, result in fractures, which might improve your threat of demise for as much as 10 years after a break.18
It’s particularly necessary to maintain tabs on bone well being in the event you’re in any of those high-risk classes:
- You’re feminine and went by means of menopause earlier than age 45.
- You’ve been sedentary most of your grownup life.
- You’re taking medicines corresponding to diuretics or stomach-acid blockers, that are linked with an elevated threat of osteoporosis.
- You’ve gotten a historical past of nicotine use or extreme alcohol consumption.
- You’ve gotten a medical situation, corresponding to diabetes or thyroid illness, that raises your threat.
- You’ve gotten a household historical past of osteoporosis.
▶ measure it
Twin-energy X-ray absorptiometry (DEXA) scans are a kind of X-ray that measures the quantity of bone mineral content material packed right into a sq. centimeter of bone.
Insurance coverage typically received’t cowl these scans for individuals youthful than 65 until there’s a documented threat of creating osteoporosis. Out of pocket, the common price is about $300.
While you obtain your DEXA outcomes, you’ll see a T-score that represents how your bone density compares to the common bone density of a younger grownup with peak bone mass. A T-score of +1.0 to -1.0 means you could have regular bone mineral density for somebody your age. Something beneath -1.0 means you may need osteopenia (low bone mineral density) or osteoporosis (porous bones which might be vulnerable to fracture).
Industrial bio age checks
In case you have some cash to burn, you’ll be able to study an terrible lot about your physique.
Right here, you’ll discover a fast run-down on a number of the extra high-tech checks you will get and what they’ll let you know.
Nonetheless, earlier than we get into the small print, we need to level out a number of caveats:
▶ Organic age can range over time, and by organ. Somebody might undergo a interval of accelerated getting older—saying, throughout a interval of intense stress—then their fee of getting older might sluggish as they focus extra on restoration. Moreover, organs can age at completely different charges. For instance, somebody with coronary heart illness might have a comparatively older coronary heart than their kidneys. (Not all checks measure particular person organ age, but it surely’s changing into extra frequent.)
▶ Industrial checks received’t all the time precisely replicate the adjustments you’re making. Till extra analysis helps the reliability of those checks, consider your behaviors over remoted check outcomes. For those who’re consuming extra fruits and veggies, exercising extra persistently, managing stress, and in any other case slaying the wholesome life-style division, don’t sweat your outcomes. Deal with doing the issues we all know enhance well being.
▶ If an organization pairs your check outcomes with a tough promote for a proprietary and costly complement protocol, be cautious. It’s higher to share and focus on your outcomes with a trusted well being skilled than take well being recommendation from a profit-seeking stranger over the web.
Industrial check #1: DNA methylation
DNA methylation is a organic course of that chemically alters DNA. As a result of the speed of methylation accelerates with getting older, it may be used to estimate somebody’s organic age and life expectancy, finds analysis.19 20 21
The Horvath Clock and DunedinPACE each measure particular biomarkers that can be utilized to raised perceive somebody’s methylation fee. Scientists developed these checks to assist different scientists examine how varied life-style elements, environmental exposures, and medicines have an effect on getting older. They didn’t develop the checks as a method for the common individual to pinpoint their organic age. (Which hasn’t stopped firms from promoting DNA methylation testing kits to the general public.) They price about $300.
For those who determine to get one among these checks, take into account your outcomes received’t provide you with an entire image of your well being and longevity. Growing older sometimes happens at various charges all through the physique. Your liver may age sooner than your coronary heart or mind, for instance. So in the event you measure DNA methylation in your blood, that’s all you already know about. Put one other method, a DNA methylation check isn’t an alternative choice to your annual wellness checkup or blood work.
Industrial check #2: Telomere evaluation
Telomeres—the protecting caps on the ends of chromosomes—put on away with age. The size of a telomere can predict what number of instances a particular cell can divide earlier than dying.
Abnormally brief telomeres are related to a number of genetic ailments. Because of this, when physicians suspect somebody may need inherited a genetic illness, they’ll order a particular kind of telomere check—the flow-FISH check—to measure the telomere size in all of the cells in a blood pattern.22 23
It’s extra debatable whether or not telomere checks can predict getting older in wholesome individuals.
Simply as importantly, the telomere check marketed to the general public, generally known as the qPCR telomere check, isn’t utilized in analysis or drugs. These $100 checks are wonderful in the event you’re merely curious—simply don’t base well being and health choices in your outcomes.
Industrial check #3: VO2 Max
For years, solely elite athletes cared about VO2 max, which describes the utmost quantity of oxygen that your physique can use throughout train.
Extra not too long ago, nevertheless, some specialists have urged that VO2 max can function a measure for athletes and non-athletes alike to trace the speed at which their our bodies are getting older.
Folks with excessive VO2 max have a tendency not solely to be extra bodily match but in addition much less prone to develop coronary heart illness, diabetes, most cancers, or stroke.24 25 26 27
In an observational examine that adopted the well being outcomes of 5,107 Danish males over 46 years, males with above-average V02 max throughout center age lived a median of 5 years longer than males with below-average V02 max. Every unit improve in VO2 max was related to a 45-day improve in longevity. The researchers urged VO2 max might extra precisely predict all-cause mortality than excessive ldl cholesterol, weight problems, hypertension, and insulin resistance.28
You may consider V02 max as a canary and your getting older physique as a coal mine.
As you age, your chest wall turns into extra inflexible, the muscle tissue that encompass the lungs weaker, and the oxygen-carrying blood vessels calcified and fewer elastic. The center additionally squeezes with much less power, max coronary heart fee drops, muscle mass and power decline, the mitochondria in cells and muscle tissue lose their effectiveness, amongst different variations.
Along with elevating your threat for a lot of completely different ailments, these adjustments also can have an effect on VO2 max, which tends to say no 10 p.c per decade beginning round age 30.29 30
Previously, the one method to reliably measure VO2 max was in a health lab.
You’ll put on a metabolic masks and a coronary heart monitor when you ran or cycled to exhaustion. The masks collected your expired carbon dioxide and monitored how a lot oxygen you sucked into your lungs. This lab-based testing continues to be essentially the most correct method to measure V02 max in addition to different key health metrics corresponding to:
- Max coronary heart fee, or the very best variety of instances your coronary heart can beat per minute throughout train
- Ventilatory threshold 1, or the purpose throughout train when the physique switches from primarily utilizing fats for gasoline to utilizing a mixture of fats and glucose or glycogen (saved glucose) for gasoline.
- Ventilatory threshold 2, or the purpose the place your physique strikes away from cardio metabolism (which makes use of oxygen) to anaerobic metabolism (which doesn’t use oxygen).
- Tidal quantity is the quantity of air inhaled or exhaled throughout every breath
Relying on the place you reside, you may be capable to get your VO2 max examined for round $150.
Nonetheless, in the event you don’t have entry to a VO2 max clinic, three considerably much less correct choices exist.
▶ The 1-mile stroll check
Put on a coronary heart fee monitor as you stroll one mile on a flat floor, corresponding to a treadmill or working observe. As quickly as you full the mile, file your coronary heart fee and stroll time. Then, plug it into the next method to calculate your VO2 max:
132.853 — (0.0769 × Weight) — (0.3877 × Age) + (6.315 × Intercourse) — (3.2649 × Time) — (0.1565 × Coronary heart fee)
If that looks like an excessive amount of math, it’s also possible to use a free on-line instrument.
▶ The smartwatch check
Many smartwatches will estimate your VO2 Max for you based mostly on data the watch gathers out of your exercises, intercourse, and age. In comparison with in-office testing, sensible watches can over- or underestimate V02 max, particularly in people who find themselves very off form or extraordinarily match.31
Due to this, you don’t essentially need to use your sensible watch measurement to find out your present state of well being. Nonetheless, it can show you how to to see developments. For instance, does your VO2 estimate drop after a number of weeks of skipping your typical spin class? In that case, that’s good data to have.
▶ The PR check
Health efficiency correlates with longevity. For those who’re getting sooner at working a sure distance or can go an extended distance than earlier than, you’re getting fitter and rising your possibilities of residing a protracted, wholesome life.
One method to check this: the 12-minute run check, also called the Cooper check. (This can be a validated method to estimate VO2 max—and exhibits a couple of 90 p.c correlation with lab-based measurements.)
Right here’s the way it works:
Run as quick as you’ll be able to on a flat floor, corresponding to a treadmill set at a 1 p.c incline or working observe, for 12 minutes. After 12 minutes, file your distance. Then, plug it into one of many following formulation to calculate your VO2 max.
| Distance in Miles | Distance in Kilometers | |
|---|---|---|
| VO2 Max = | (35.97 x distance in miles) – 11.29 | (22.351 x distance in kilometers) – 11.288 |
In lieu of doing math, it’s also possible to use a free on-line calculator.
change your organic age
Attempt to consider the knowledge you collect about your physique as simply that—data.
It’s not an ethical judgment of who you might be as an individual.
Simply as importantly, it’s not a everlasting scenario.
- For those who’re weaker than different individuals your age, you’ll be able to develop stronger.
- In case your ldl cholesterol or blood glucose ranges are excessive, you’ll be able to take steps to decrease them.
- In case your physique is getting older sooner than your birthdays, contemplate exploring key life-style adjustments which will assist flip the scenario round.
You’ve gotten choices. Nonetheless, most individuals make two huge errors in terms of longevity-related life-style adjustments.
Mistake #1: Ignoring evergreen, big-impact methods
It’s the easy, boring, “I’ve heard this one million instances earlier than” well being practices that, when achieved persistently, add as much as a protracted, wholesome life.
We’re speaking about issues like…
- Consuming extra minimally processed meals and fewer ultra-processed meals
- Consuming extra brightly coloured fruits and veggies
- Transferring your physique repeatedly
- Getting sufficient relaxation and sleep
- Having fun with neighborhood, time in nature, and different actions that make life significant
- Conserving alcohol consumption average
- Not utilizing tobacco
- Carrying sunscreen
- Flossing
And that’s only a partial record.
In response to hundreds of research, individuals who follow these and different high-impact methods not solely stay longer, but in addition stay higher. They’re stronger, happier, and fewer prone to spend their later years disabled or in ache.
(For those who’d prefer to see the place you stand in terms of huge impression well being and longevity methods, take a look at our FREE Longevity Evaluation.)
Nonetheless, in terms of well being, health, and longevity, many individuals pursue choices with minimal impression (at greatest). They attain for the newest, stylish complement reasonably than taking steps to stop smoking, as only one instance.
Right here’s the factor: Huge rock methods require adjustments in conduct. If each day bodily exercise have been as simple as popping a tablet, walkers and cyclists would clog up the streets in your neighborhood.
(It’s exactly this motive why so many individuals want the help of a licensed well being coach who has undergone coaching within the science of conduct change.)
Mistake #2: Not turning knowledge into motion
The information gathered from biomarker getting older checks may give you a way of management.
Nonetheless…
Knowledge, in isolation, doesn’t result in an extended life.
Gathering knowledge with out altering your conduct is like checking your reflection within the mirror, seeing spinach wedged between your incisors, and leaving it there.
It’s essential take away the spinach for the mirror test to be worthwhile.
Biomarker testing is identical.
For those who don’t use your bio knowledge to tell conduct change, you’re losing your time and cash.
Take into account your biomarker knowledge as a baseline or place to begin.
Then, use it to evaluate whether or not varied life-style adjustments or medical interventions are shifting you nearer to your purpose of residing an extended, more healthy life.
References
Click on right here to view the knowledge sources referenced on this article.
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