Global Longevity Consulting

21 years.

That's yours to gain.

The gap between optimal health and doing nothing has been measured — across 61 lifestyle factors, in landmark peer-reviewed studies. It comes to 21 years of life. Protocol 21 exists to help you close that gap, one evidence-based framework at a time.

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21 Years — By Category
21 modifiable years
fully reversible with lifestyle change
Exposures (tobacco, alcohol)
5.5 yrs
Physical Activity
4.0 yrs
Nutrition
3.5 yrs
Biometrics
2.5 yrs
Mental Health & Social
2.0 yrs
Sleep
1.5 yrs
Labs & Biomarkers
1.5 yrs
Based on Li et al. 2018, GBD 2019, Ding et al. 2016, Holt-Lunstad 2015. Category budgets anchored to composite epidemiological studies.
Board-Certified MD
61 Evidence-Based Factors Assessed
Data-Driven, Lifestyle Optimization First
No Long-Term Contracts
Available Globally
100% Confidential & Secure
The Science

Where 21 years comes from.

We translated hazard ratios from landmark epidemiological studies into years of modifiable life — anchoring each category to the best composite evidence available. These aren't estimates pulled from a single paper. They're calibrated against Li et al., GBD 2019, and Ding et al.

5.5 yrs
Exposures
Tobacco, alcohol, benzodiazepines, sleep aids, and medication overuse. The single largest modifiable domain.
4.0 yrs
Physical Activity
Steps, aerobic activity, strength training, sitting time, and sauna — anchored to Ding et al. 2016 (Lancet).
3.5 yrs
Nutrition
20 dietary factors — from legumes and olive oil to sodium, processed meat, and sugar-sweetened beverages.
2.5 yrs
Biometrics
BMI, blood pressure, grip strength, gait speed, VO₂ max, balance — measurable fitness markers tied directly to mortality.
2.0 yrs
Mental Health
Depression, social isolation, loneliness, marital status, and sense of purpose — all with meaningful all-cause mortality data.
1.5 yrs
Sleep
Duration and REM quality. Anchored conservatively given overlap with mental health and physical activity.
1.5 yrs
Labs & Imaging
HbA1c, insulin resistance, lipids, apoB, CRP, RDW, uric acid, vitamin D, and CAC score.
0.5 yrs
Supplements
Currently limited to glucosamine (HR 0.85). Modest but real. Kept conservative without RCT confirmation.
Sources: Li et al. 2018 (Circulation) · GBD 2019 · Ding et al. 2016 (Lancet) · Holt-Lunstad et al. 2015 · Cappuccio et al. 2011 · Bhaskaran et al. 2018 (Lancet). Category budgets reflect composite epidemiological estimates, not the sum of independent hazard ratios — which would overestimate due to shared risk pathways.
The Process

Simple. Personal. Ongoing.

No 12-month lock-ins. No vague wellness plans. A focused, educational partnership built around your actual life.

01

The Baseline

You complete a detailed lifestyle and health history questionnaire, along with providing recent lab data. Everything is reviewed before we meet, so our first conversation is focused entirely on analyzing your baseline.

61-factor lifestyle assessment
Educational biomarker analysis
Personalized longevity score
02

The Blueprint

A 90-minute one-on-one deep dive. We map your longevity bottlenecks, identify where your biggest lifestyle gains are, and build a concrete, prioritized educational framework — not a generic checklist.

Risk stratification by domain
Custom optimization strategy
Written roadmap delivered
03

Ongoing Optimization

Regular strategy sessions to track progress, adjust targets, and stay on course. Messaging access between sessions to help you implement your framework.

Sprint-based strategy sessions
Direct messaging access
Cancel anytime
Dr. Nicholas Cohen, MD
15+
Years Clinical
NYU
Med School
82nd
Airborne Div.
Dr. Nicholas Cohen, MD

Health optimization, engineered for the long term.

Board-certified in Family Medicine and Lifestyle Medicine, Nicholas Cohen, MD trained at NYU School of Medicine and Case Western Reserve University. Before his medical career, he served with the U.S. Army Rangers at the 82nd Airborne Division — an environment that forged his systematic, data-driven approach to operating under pressure.

After 15+ years in traditional clinical practice, he founded Protocol 21 to focus entirely on the proactive strategies that matter most: identifying physiological bottlenecks early and building the habits that compound over decades. He recognized that true health optimization requires ongoing, dedicated strategy rather than brief, reactive medical interventions.

He views longevity not just as a clinical science, but as a daily practice. Outside of his consulting work, you'll find him field-testing his own protocols — whether analyzing his wearable recovery data, pushing limits on the climbing wall, or making turns on the mountain.

Board-Certified MD Longevity Strategy U.S. Army Veteran Data-Driven Global Consulting
Common Questions

Good questions deserve honest answers.

Absolutely not. Protocol 21 is an educational and health optimization consulting service. We do not provide primary care, diagnose medical conditions, or prescribe medications. Think of this as a specialized layer of proactive longevity strategy that you will execute alongside your primary care physician.
No. Protocol 21 operates strictly as a health and wellness consulting service, which falls outside the traditional medical insurance model. Because our services are educational and not clinical, we do not provide superbills for out-of-network medical reimbursement.
No. Because Protocol 21 provides wellness consulting rather than establishing a formal physician-patient relationship, all strategy sessions are conducted via secure video call and are available to clients globally.
You complete a comprehensive health and lifestyle inventory — including our 61-factor longevity assessment — and share any existing lab work. That data is reviewed before our Deep Dive, a dedicated 90-minute strategy session to map your longevity bottlenecks and build a personalized framework. You leave with a written, actionable plan to discuss with your primary care team.
No. The ongoing partnership has no long-term contracts. You continue because you're gaining valuable insights and seeing results — not because you're locked in. Cancel at any time with no penalties.
While Protocol 21 does not provide medical treatment, you are consulting with a board-certified physician with 15+ years of clinical experience. This means your optimization strategy is built by someone who deeply understands the underlying science, complex biomarkers, and human physiology. We combine the depth of medical knowledge with the ongoing, personalized strategy that traditional healthcare settings simply aren't structured to provide.

Let's find out where your 21 years are.

Book a free 15-minute discovery call. We'll talk about your goals, your biggest gaps, and whether Protocol 21 is the right fit. No cost. No commitment.

Free · 15 minutes · No obligation
Secure video call
Honest conversation, no hard sell