The Ultimate Velvet Rope
On genomics, longevity, and who gets to know first.
Everyone has noticed, and everyone has a theory. The commentary runs across social media in a permanent loop: red light therapy, peptides, NAD infusions, methylene blue, cold plunges, rapamycin, berberine, continuous glucose monitors, sleep tracking, mouth taping, infrared saunas, grounding mats, beef tallow, seed oil elimination, and about 40 other things cycling through feeds daily, each with its own passionate constituency and its own before and after. A whole layer of people, not just the names everyone knows but the executives, the partners, the senior people adjacent to serious wealth, look noticeably different than they did 10 years ago, more energy, visibly healthier, younger in a way that reads as systemic rather than cosmetic, and the internet is running a permanent open investigation into why.
I have an expanded take. The most consequential advantage may not be the intervention everyone can see. It may be the information most people still do not have.
Earlier this month, Mayo Clinic drew attention to a study published this spring that received little mainstream attention. Researchers used whole-genome sequencing in 484 seemingly healthy people and found that 1 in 8 carried a medically actionable genetic finding they did not know about, involving risks such as hereditary breast and ovarian cancer, Lynch syndrome, cardiomyopathy, long QT syndrome and amyloidosis, findings that routine care would not typically have uncovered. It received little pickup, possibly because 484 people is a small cohort and the 1 in 8 finding is higher than estimates from larger population studies. But even the conservative estimate is enormous.
Before I use the 1/8 to do some math, some context:
A 2023 synthesis by Eric Topol of large population studies across the US and Iceland found roughly 1 in 25 people carrying actionable findings they didn’t know about, using stricter gene lists and much larger sample sizes than Mayo used. That figure is more statistically robust than what Mayo found in 484 people, whose cohort was drawn from biobank volunteers, which may limit how broadly its prevalence estimate can be generalized. These are real limitations and I’m not dismissing them.
The reason I believe the direction of the Mayo number anyway is what is happening to the category itself. The American College of Medical Genetics and Genomics first published a list in 2013 of 56 genes for which certain unexpected findings identified during clinical sequencing should be reported back to patients because action could be taken. That secondary findings list is now at 84 genes and continues to be updated. Its expansion does not prove that Mayo’s 13 percent estimate applies across the general population, but it points in the same direction: the category of medically actionable genomic information is still growing. On top of that, variants currently sitting in a gray zone may be reclassified as more data accumulates, with computational tools increasingly helping researchers interpret them. There are also categories of risk not counted in these figures, including the cumulative effect of hundreds of common variants that individually mean little but together may matter significantly. And genomic datasets have historically overrepresented people of European ancestry, leaving important gaps in what can be interpreted accurately across populations. The field is not approaching a final answer, every year it finds more.
Use the conservative 1 in 25 figure only as a scale exercise, not as a validated global prevalence estimate, and apply it to a world population of roughly 8.3 billion people: you get about 330 million people carrying an actionable finding they do not know about. Apply Mayo’s 1 in 8 and you get roughly 1 billion. Neither number captures the full future scope of genomic risk detection, because the definition of what is medically actionable continues to expand. Getting there requires testing far more people than the number who ultimately receive an actionable finding, because you do not know who they are until you look. And those numbers understate the clinical reach, because many findings trigger testing and prevention decisions across entire families.
The people I started with, the ones the internet has 40 theories about, may or may not be using any particular protocol. But many people with access to concierge medicine, executive health programs and longevity clinics are already operating in a different kind of medical system, one designed to identify risk before symptoms appear, interpret findings quickly, and coordinate action around them. That advantage is not always something you can see. A person who learns they carry a hereditary cancer risk may choose intensified surveillance or risk-reducing surgery. Someone with an inherited cardiac risk may begin monitoring or treatment before a first event. The advantage is not necessarily looking younger. It is getting information early enough for it to change the outcome.
Whether or not that is what social media is seeing, the divide itself is real. The most important line just may not run between people who can afford peptides and people who cannot. It may run between people whose future risk has already been made visible, and people still waiting for disease to reveal it.
I came to this question through BRCA1. Learning that I carried a pathogenic variant, and making the decisions that follow from knowing, changed how I see this entire landscape. Once you have lived inside predictive medicine, it is difficult not to notice how unevenly access to that knowledge is distributed.
The commercial world has already done the math on what this data is worth.
In a separate initiative, Mayo Clinic and Regeneron Pharmaceuticals announced in 2019 a collaboration to sequence 100,000 DNA samples from consented research participants. Mayo would receive genomic data for research, Regeneron would retain sequence data for its drug-discovery work. No money changed hands, the currency was the data itself. When 23andMe went bankrupt in March 2025, Regeneron bid $256 million to acquire its assets, including access to genetic and related data tied to more than 15 million customers. They were eventually outbid by TTAM Research Institute, a nonprofit founded by Anne Wojcicki, the co-founder of 23andMe, which completed the acquisition for $305 million in July 2025. But the bid told you something: a company that already has more than 3 million sequenced exomes, along with collaborations involving Mayo Clinic and UK Biobank, looked at access to millions more people’s genomic data and said it was worth a quarter of a billion dollars.
The protective infrastructure is not moving at the same pace. Direct-to-consumer genetic testing companies generally are not covered entities under HIPAA, which is why 23andMe customers’ genetic records did not carry the same federal privacy protections that apply to health records held by covered medical providers. The Genomic Data Protection Act, a bipartisan bill giving Americans the right to delete their genomic data and destroy their biological samples, was introduced at the end of 2024, stalled when Congress adjourned, reintroduced in March 2025, and as of this writing remains in committee. Introduced twice, stalled twice.
Demand for this kind of access is going to grow, and the social media noise may already be an early signal. Millions of people cycling through every possible explanation for what they’re seeing because they want to understand it, and many of them want in. A meaningful portion of the data that made these advances possible came from people who participated in research programs, hospital biobanks and consumer genetic testing without fully understanding what their contribution would eventually produce or who would benefit first.
People knowing things about their health before disease announces itself, and being able to act on that knowledge, is what medicine is supposed to do.
That is what is behind the velvet rope: not immortality, and not guaranteed health, but the chance to know what may be coming before it arrives. The question is how long it takes for everyone to get there, and what rules govern the data in the meantime.
The Mayo Clinic PREDICT study was published online in Genetics in Medicine on March 24, 2026, and publicized by Mayo Clinic on May 14, 2026. The American College of Medical Genetics and Genomics secondary findings list is currently at 84 genes and is updated regularly. The 1 in 25 figure reflects a November 2023 synthesis by Eric Topol of four independent large population studies. The Genomic Data Protection Act, S.863, was introduced March 5, 2025, and remains in the Senate Committee on Commerce, Science, and Transportation as of May 2026.