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What is health optimisation?

An introduction

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Health optimisation: unveiling the path to enhanced lifespan, healthspan, and vitality

Many of us hope not just to live longer, but to truly flourish as the years pass, maintaining our mental sharpness, energy, and physical abilities. But how can we achieve this? By blending ancient wisdom with modern science, health optimisation becomes an accessible goal.

What is health optimisation?

Health optimisation isn’t a mere buzzword – it’s a paradigm shift. At its core, it’s about a holistic, all-encompassing approach that binds the intricate facets of health into a unified goal.

The essence of health optimisation lies not just in adding years to life, but more importantly, life to those years. It seeks to magnify the healthspan – the span of one’s life spent in good health – not just the lifespan. But to truly understand its potential, we need to view health not as a static state but as an ever-evolving continuum. A continuum where the peak represents enhanced energy, unwavering cognitive function, and the physical capacity to embrace life to its fullest.

It isn’t just about dodging diseases – it’s about flourishing.

“Optimisation is the compass guiding us toward a better existence. Seek the better, for in that pursuit, we enrich our life with vitality.”

– Jabe Brown

Health optimisation is a journey

Health optimisation is best described as a journey, where every intervention, lifestyle change, and therapeutic decision converges to one primary objective: an enhanced state of holistic well-being. It’s about tapping into the inherent potential of our bodies and minds to function at their optimal, given the right set of conditions and care.

What sets health optimisation apart is its focus on the individual as a whole, tracked and measured by data, using the latest scientific understanding, and lab testing, on health and longevity. This approach integrates physical, emotional, cognitive, and even genetic facets of health. The ambition? Comprehensive benefits that resonate across all dimensions of well-being.

Beyond group data – the power of individualisation

No two individuals are the same, and neither should be their health optimisation strategies. This isn’t about generic recommendations; it’s about personalised solutions tailored to individual needs, backgrounds, and aspirations.

In an era of big data, health insights are undergoing a revolutionary transformation. Gone are the days when the best recommendations were made based on broad population studies. Today, we have the capability to delve deep into individual-specific data. From understanding genetic predispositions to capturing the nuances of metabolic health, the health optimisation strategy is data-driven, precise, and most importantly, personal.

“We’re in the age of n=1 medicine, where data holds the key to personalised paths of wellness.”

– Mark Payne

Health and ageing: a complex web of interconnections

In our pursuit for optimal health, the road leads us, again and again, to the shores of ageing. Ageing, as a biological process, is fascinating, as it is both a root cause for declining health, and is accelerated as a consequence of suboptimal health choices.

If we were to consider risk factors for diseases, from chronic conditions like cardiovascular diseases to neurodegenerative ailments like Alzheimer’s, ageing would emerge at the forefront. Simply put, the longer we live, the greater the risk of chronic diseases, and the more we’re exposed to environmental, metabolic, and other epigenetic factors that impact the function of our cells. Moreover, this isn’t just about individual diseases; it’s about a general decline in vitality, cognitive function, and physical capacity.

Inflammageing: fast-tracking ageing through lifestyle

Ageing is a natural process, but our modern lifestyles can effectively put it on the fast track through inflammageing.

Chronic inflammation, driven by poor dietary choices, sedentary habits, and unmanaged stress, is a key factor in accelerating ageing. This internal inflammatory state not only paves the way for myriad diseases, but also compounds the effects of ageing.

Can we live forever? Understanding longevity

While true biological immortality might be a stretch, slowing down, halting, or even reversing certain aspects of ageing are tangible goals being studied. Noteworthy here is the work on animals like hydras and certain jellyfish, which exhibit biological immortality, providing intriguing insights into the possibilities of longevity.

The 11 hallmarks of ageing

To truly grasp ageing, it’s essential to understand its fundamental drivers. The 11 hallmarks of ageing provide a framework:

  • Genomic instability: Damage that accumulates in the genome over time

  • Telomere attrition: Shortening of telomeres, the protective end caps of our chromosomes

  • Epigenetic alterations: Changes that affect gene expression without altering the DNA sequence

  • Loss of proteostasis: Reduced ability to produce, fold, and breakdown proteins

  • Deregulated nutrient sensing: Impaired sensing and response to nutrients

  • Mitochondrial dysfunction: Deterioration in the function of mitochondria, our cellular powerhouses

  • Cellular senescence: Cells losing their ability to divide and function

  • Stem cell exhaustion: Decline in the regenerative potential of stem cells

  • Altered intercellular communication: Miscommunication between cells, leading to inflammatory states

  • Extracellular matrix stiffening: Makes tissues stiffer and less functional

  • Dysregulated circadian rhythms: Disrupted sleep and activity patterns that affect health

Understanding what causes ageing provides us the therapeutic targets to slow down and reverse certain ageing processes.

Notable negative impact factors accelerating ageing

  • mTOR activation: While essential for cellular processes, unchecked mTOR activation can accelerate ageing and increase disease risk

  • Sedentary lifestyle: A lack of physical activity has a cascading negative effect on metabolic health, cardiovascular function, and neurocognitive health

  • Poor diet: Diets rich in processed foods and lacking in nutrients can induce inflammageing and exacerbate metabolic disorders

  • Chronic stress and inflammation: Prolonged stress affects the endocrine system, potentiates inflammation, and can hasten cellular ageing

 

Positive modulators: paths to graceful ageing

Two of the better known pathways we can use to help slow ageing, are:

  • AMPK: Known as the ‘longevity enzyme’, AMPK activation can counteract many negative ageing processes, and is linked to increased lifespan

  • Sirtuins: These proteins protect against cellular stress and are associated with longevity. They’re activated during caloric restriction, – a known lifespan-extending intervention – and in other circumstances of hormesis

Hormesis is a positive biological response to perceived adversity. Think of it like the body calibrating and fine tuning itself when you push the envelope. Examples include, cold and heat exposure, caloric restriction, and exercise.

“I believe humanity is on the cusp of the next frontier in our evolution: the ability to directly engineer our biology and our minds, to improve who we are as a species.”

– Bryan Johnson

Measuring age: beyond chronological time

While true biological immortality might be a stretch, slowing down, halting, or even reversing certain aspects of ageing are tangible goals being studied. Noteworthy here is the work on animals like hydras and certain jellyfish, which exhibit biological immortality, providing intriguing insights into the possibilities of longevity.

One of the most profound realisations in modern health science is that our age isn’t merely dictated by the number of candles on our birthday cake. There’s a more intricate story behind each wrinkle, every laugh line, and every silver strand of hair. This story is told by our biological age, which can differ significantly from our chronological age.

Biological age vs. chronological age: What’s the difference?

Chronological age refers to the exact time elapsed since our birth. Short of time travel, it is irreversible.

Biological age, on the other hand, reflects how our cells and tissues have aged and how much they’ve deviated from their original, youthful state. Factors influencing this age include genetics, lifestyle, exposure to environmental toxins, diet, exercise, stress, and more. Two individuals with the same chronological age could have very different biological ages depending on these factors.

Cutting-edge techniques for measuring biological age

While the notion of biological age isn’t new, our capability to quantify it with precision, is an outcome of advanced scientific techniques. Some of these groundbreaking methods include:

 

  • Epigenetic Markers: Epigenetics refers to changes in gene activity without alterations to the underlying DNA sequence. Certain epigenetic modifications, primarily DNA methylation patterns, change predictably with age. By assessing these, we can determine an individual’s epigenetic age, providing insights into their biological age. Horvath’s Clock, a multi-tissue predictor of age, was one of the pioneering models in this area

  • Telomere Length: Telomeres are the protective caps at the ends of our chromosomes, and their length can indicate cellular ageing. As cells divide, telomeres shorten, and once they reach a critical length, the cell can no longer divide and becomes senescent, or dies. Therefore, measuring telomere length provides an indirect measure of a cell’s age and its remaining lifespan

  • Metabolomics: This is the comprehensive study of metabolites, the small molecules present in our cells. Changes in levels and patterns of these metabolites can serve as markers for ageing. As we age, there are alterations in metabolic pathways, and recognising these can provide clues about our biological age

  • DunedinPACE (Dunedin PoAm Composite of Accelerated Ageing): Emerging from research out of the Dunedin Multidisciplinary Health and Development Study, the DunedinPACE is a newer tool capturing a person’s pace of ageing. Instead of focusing on any single marker, this method combines multiple measures from different organ systems to create a composite reflecting a person’s rate of biological ageing. Individuals with an accelerated pace may be biologically older than their chronological age, putting them at a heightened risk for age-related ailments and diminished cognitive and physical capabilities

Why biological age matters for health optimisation

Our biological age is more than a curiosity. It’s a beacon of our health status and potential longevity. A younger biological age relative to chronological age often correlates with:

  • Reduced disease risk

  • Enhanced physical and cognitive function

  • Longer healthspan

For individuals and practitioners engaged in health optimisation, monitoring and influencing biological age is incredibly powerful, and empowering. It shifts the focus from merely preventing disease, to enhancing vitality and function at every age.

In our clinic, we proudly offer the TruAge test – a state-of-the-art assessment that evaluates a comprehensive set of epigenetic markers, and telomeres, to give a detailed picture of cellular health and how it correlates with your chronological age.

Pillars of longevity and health optimisation

Health optimisation isn’t just about adding years to our life, but adding life to those years.

“If you want to live longer, you have to live longer without chronic disease, rather than live longer with chronic disease.”

– Peter Attia

One of the most profound examples of longevity and health optimisation are the centenarians residing in the ‘Blue Zones’ – regions globally where people live exceptionally longer and healthier lives. Commonalities among these long-living individuals include a plant-centric diet, regular physical activity, robust social engagement, stress-reducing practices, and a sense of purpose.

While we have learned a lot from the study of these Blue Zones, we are now in the age of n=1 medicine, where optimisation interventions typically fall into one of the below four pillars:

Nutrition

Nutrition is pivotal. Instead of a one-size-fits-all approach, the focus is on personalised dietary plans based on genetic profiles, metabolic rates, nutritional biomarkers, and food sensitivities. For instance:

 

  • Certain genes like FTO may influence one’s predisposition to obesity. APOE variants can affect cholesterol metabolism, and DAO relates to histamine intolerance

  • Supplements such as NAD, NR, CoQ10, and lutein play crucial roles in supporting cellular energy production and overall physiological health. Some of these nutrients are delivered intravenously, a superior delivery of nutrients in comparison to traditional forms of supplementation like pills, to maximise absorption

  • A holistic health approach also focuses on minimising toxins. This means sourcing clean, organic foods, using purified water, and employing safe cooking practices and cookware to ensure toxin exposure is minimal

Sleep

The rejuvenating power of quality sleep cannot be overstated. Personalised sleep strategies can be crafted based on potential genetic markers like the CLOCK gene. A deeper understanding of chronobiology – the study of internal clocks – is essential. Sleep deprivation can elevate risks of various diseases, diminishing health and longevity.

Embracing biohacking tools can be a game-changer. Devices like Oura and Whoop provide insights into sleep patterns, to then track, modify, and refine sleep routines for enhanced sleep quality.

“Sleep is the single most effective thing you can do to reset your brain and body for health.”

– Andrew Huberman

An optimal sleeping environment is key, which can include the use of HEPA air filters, humidifiers, blackout blinds, thermoregulating mattresses, and red lighting.

Sleep enhancing supplements include: Magnesium, glycine, taurine, tryptophan, theanine, GABA, B6, zinc, ashwagandha, zizyphus, and various other herbs.

Exercise and hormesis

Hormesis, a biological response where moderate stressors lead to increased resilience and better health, is a critical aspect of optimising health. Exercise is a form of hormetic stress, and its benefits can be maximised when tailored to one’s genetic predispositions. For example, SNPs in ACE can influence endurance capabilities, and ACTN3 can determine muscle composition and strength traits. Interestingly, exercise acts as a DNA methylation adaptogen, impacting our genes in a way that promotes health.

Additionally, practices like cryotherapy and sauna expose the body to controlled stress, offering hormetic benefits. Certain molecules, such as NAC and resveratrol, emulate these hormetic effects, further amplifying health outcomes.

Stress tolerance

A long, fulfilling life requires a balanced mind. The key here being: balance. A life with no adversity is not a fulfilling one, equally so is a life overly filled with adversity. Optimal is an oscillation between survival and revival, with balance over time, like a well-balanced see-saw.

Happiness and life satisfaction can subjectively be measured using a validated scale called PERMA – Positive Emotion, Engagement, Relationships, Meaning, and Achievement.

Heart Rate Variability (HRV) acts as an objective, trackable, measurement of one’s exposure and resilience to stress, using wearable devices, to assess how you respond to the way you live. The hand of cards we are dealt can have a profound impact on how we deal with stress and adversity: our genes. Genes that can impact stress tolerance include MTHFR, COMT, BDNF and MAO. We can’t change our genes – yet – but understanding them allows us to compensate for them in the way we live. Nature is not destiny.

With adaptogenic herbs like ashwagandha and rhodiola, meditation, mindfulness practices, strategic breathing exercises, and binaural beats, we can harness and enhance our innate stress tolerance capabilities.

Optimising goes far beyond the four pillars, but it is impossible to optimise without a solid foundation, so these fundamentals are just that; fundamental.

Personalised health blueprint: functional testing and beyond

In a world where health and wellness advice often comes in the form of broad generalisations, the notion of ‘personalised health’ offers a paradigm shift. Instead of following generic guidelines, the roadmap to optimal health is tailored precisely to an individual’s unique physiological, genetic, and metabolic profile. This comprehensive, personalised approach is what we do at our clinic.

Functional testing: The cornerstone of personalised health

Functional testing isn’t merely about identifying a disease or health issue. It’s about offering a profound insight into the myriad factors influencing an individual’s health, to then create a personalised blueprint for the optimal way of living for ultimate wellness.

At our clinic, we leverage a multitude of cutting-edge tests to map out this health blueprint:

Biological age tests

The dichotomy between chronological age (how old you are in years) and biological age (how old your body acts and feels) is revealing. Tests like MyDNAge and TruAge allow us to gauge where a patient stands in terms of biological ageing, providing a glimpse into their cellular health and longevity potential.

Genetic profiling

Our genes are the blueprint of our physiological functioning. Through genetic profiling, we can identify genetic predispositions that can influence everything from metabolism and nutritional needs to risk factors for certain conditions.

DNA methylation profiles

DNA methylation is a biochemical process that can influence gene expression. Understanding this profile can shed light on potential health risks and provide valuable information for preventative strategies.

Food sensitivity assessments

With tools like the KBMO Food Inflammation Test, we can pinpoint specific food sensitivities that might be triggering inflammation or other health issues.

Comprehensive health status array

To truly understand one’s health, we assess a broad set of markers, including:

 

  • Micronutrient levels to pinpoint deficiencies or imbalances

  • Comprehensive lipid profiles that go beyond standard cholesterol measurements to give insights into cardiovascular health

  • Essential fatty acid analysis

  • Hormonal profiles for understanding metabolic health, energy levels, and more

  • Evaluation of detoxification enzymes, offering insights into the body’s ability to process and remove toxins

  • Fasting insulin for metabolic health insights

  • Antioxidant status, indicating the body’s defence against oxidative stress

  • Plus, assessments of gut health, including bacterial and fungal dysbiosis, and screening for toxic heavy metals

The benefits of a personalised approach

With this wealth of information at our fingertips, we can design a health plan that is not only reactive (addressing existing issues) but also proactive (preventing potential future problems). It means that interventions, whether they’re dietary changes, lifestyle modifications, or specific treatments, are precisely targeted to your needs.

Longevity-enhancing molecules and strategies

For as long as humans have been self-aware we have dreamed of immortality. The quest for longevity and optimal health has now taken us on a journey deep into the molecular and cellular levels of our body. Over time, various molecules have been identified that play critical roles in cellular repair, energy production, and anti-ageing processes.

Some of these molecules are naturally produced within the body, while others can be acquired through diet, supplementation, or medication. In this section, we’ll delve into some of the most influential molecules associated with longevity enhancement.

  • NAD (Nicotinamide Adenine Dinucleotide): A crucial coenzyme found in all living cells, NAD is vital for energy production and repairing damaged DNA. It plays a central role in cellular metabolism and is known to decrease with age. Strategies that boost NAD levels, such as the use of its precursors, NMN and NR (Nicotinamide Riboside), are believed to counteract various ageing processes

  • Spermidine: A polyamine compound found in small quantities in certain foods, spermidine has garnered attention for its potential autophagic effects, essentially helping cells ‘clean out’ their waste products. This cellular housekeeping can lead to improved cell function and longevity

  • Berberine: Often compared to antidiabetic medication metformin in its effects, berberine is a natural compound found in various plants. It’s known for its anti-inflammatory and antioxidant properties and its ability to activate the AMPK enzyme, promoting healthy metabolic function

  • Quercetin: This flavonoid, found abundantly in fruits and vegetables, boasts powerful antioxidant and anti-inflammatory properties. Quercetin is also believed to promote cellular health by enhancing the autophagic process – the removal of damaged or dysfunctional cells

  • Urolithin A: A derivative of compounds found in berries and pomegranates, urolithin A positively influences the health of mitochondria – the powerhouses of our cells. It has been shown to stimulate mitophagy, a selective recycling of mitochondria, which can promote cellular health

  • Curcumin: Derived from turmeric, curcumin is celebrated for its potent anti-inflammatory and antioxidant properties. It has the potential to improve brain function, combat degenerative processes, and enhance longevity

  • EPA (Eicosapentaenoic Acid): an omega-3 fatty acid, which plays a role in reducing inflammation

  • DHEA (Dehydroepiandrosterone): DHEA is a hormone that diminishes with age, and is associated with physical and cognitive health

  • NAC (N-Acetylcysteine): A precursor to glutathione, a powerful antioxidant in the body, NAC plays a role in detoxification, reducing oxidative stress, and supporting respiratory health

  • Calcium Alpha-Ketoglutarate: This molecule is involved in the Krebs cycle, an energy-producing process in cells. Recent studies suggest it can reduce levels of inflammatory factors and extend lifespan in certain organisms

Being truly optimal means looking at molecules like these, however, it’s essential to approach these molecules with knowledge and guidance, understanding that each individual’s needs and reactions may differ.

At Melbourne Functional Medicine, we remain at the forefront of these discoveries, continuously integrating evidence-backed molecules and strategies into our holistic approach to health optimisation.

Nootropics for cognitive enhancement

Cognitive enhancement is more than just brainpower; it’s about sustaining mental energy, honing focus, and nurturing resilience against cognitive decline. Examples of nootropics are:

  • Phosphatidyl nutrients: Phosphatidyl nutrients such as serine, choline, and inositol play key roles in brain health, cell signalling and neurotransmission. Choline in particular is often considered for its nootropic effect

  • DHA: The primary fat building block of the brain. Your brain is only as good as what it is built with

  • Gingko Biloba: Long used in traditional medicine, gingko is renowned for its potential in boosting memory and cognitive function by promoting blood flow to the brain

  • Bacopa Monnieri: This adaptogenic herb has shown promise in enhancing memory, reducing anxiety, and protecting the brain from oxidative stress

Tailoring nootropics to genetics for high performers

For high performers, cognitive enhancement is the main game. But like most aspects of health, a one-size-fits-all approach is far from optimal. Enter the world of genetic tailoring, where understanding our genetic makeup can guide our choices in nootropics, ensuring that we’re not just taking a scattergun approach, but strategically enhancing our cognitive faculties based on our very DNA.

COMT (Catechol-O-Methyltransferase)

The COMT gene is responsible for an enzyme that degrades dopamine, a key neurotransmitter associated with mood, motivation, and alertness. Variants in this gene can affect dopamine levels in the prefrontal cortex, impacting cognitive functions like attention, planning, and working memory. Depending on one’s specific COMT genotype, certain nootropics may be more beneficial. For instance, individuals with a slower variant might benefit from substances that raise dopamine levels.

B3AR (Beta-3 Adrenergic Receptor)

This gene is related to the body’s response to adrenaline and can influence both physical and mental performance. Certain nootropics may help individuals with specific B3AR gene variants to manage stress better or stay alert during critical periods.

ANKK1 (Ankyrin Repeat and Kinase Domain Containing 1)

This gene interacts with dopamine receptors in the brain. Variants here can affect reward processing, which is critical for motivation and pleasure. Understanding one’s ANKK1 genotype might guide choices in nootropics to enhance motivation or combat feelings of fatigue.

BDNF (Brain-Derived Neurotrophic Factor)

BDNF plays a role in neuron growth and synaptic plasticity, which is essential for learning and memory. Those with certain variants might experience improved memory retention or faster learning with specific nootropics that boost BDNF or work synergistically with its pathways.

GRIN2B (Glutamate Ionotropic Receptor NMDA Type Subunit 2B)

This gene is involved in synaptic plasticity and memory. Variants in GRIN2B might influence how well someone responds to nootropics that modulate the glutamatergic system, which can be critical for enhancing memory and overall cognitive function.

CACNA1C (Calcium Voltage-Gated Channel Subunit Alpha1 C)

Related to calcium channels in neurons, this gene can impact various cognitive processes. Nootropics that modulate calcium channels might be particularly useful for individuals with specific CACNA1C genotypes, enhancing focus and clarity.

In essence, our genetics lay the foundation for how we think, feel, and perform. By understanding our unique genetic makeup, we can tailor our approach to nootropics, ensuring that we’re not just amplifying our strengths but also bolstering our weaknesses. For high performers, this genetic insight is invaluable, offering a competitive edge in a world where every fraction of cognitive enhancement counts.

Tracking and refining: the path forward

In the quest for health optimisation, the ancient adage, “What gets measured gets managed,” holds profound relevance. The drive towards enhanced lifespan, healthspan, and overall vitality is not a one-off endeavour, but rather, an ongoing journey. Just as a ship’s captain adjusts the vessel’s course based on wind and sea currents, one must adapt and refine their health strategies based on continuous feedback.

The imperative of tracking

Progress, if not measured, remains intangible. In the realm of health optimisation, tracking isn’t merely an act of recording but of elucidation – it brings clarity, offering insights into what’s working, what’s not, and how one might pivot for better results. This continual feedback loop is the bedrock upon which sustainable and effective health optimisation is built.

Wearable devices: the pioneers of modern health analytics

A range of wearable devices are now on the market, with some of the most popular being:

 

  • Continuous Glucose Monitors (CGMs): By providing real-time blood sugar data, CGMs offer invaluable insights into how diet, activity, stress, and sleep influence glucose levels. For those keen to understand and manage their metabolic health, this tool is nothing short of revolutionary

  • Oura Ring: A marvel in sleep tracking, the Oura Ring captures detailed data on sleep phases, heart rate variability, body temperature, and overall readiness. Such data is indispensable for anyone aiming to enhance sleep quality and, by extension, cognitive and physical performance

  • Whoop Band: Beyond just a fitness tracker, the Whoop band measures strain, recovery, and sleep, providing a holistic overview of one’s daily performance. It’s an athlete’s companion, but also an essential tool for anyone keen to push their physical boundaries responsibly

The power of subjective feedback

While metrics and numbers bring objectivity to the table, it’s vital not to overlook the significance of subjective feedback. To date, no device can capture how one feels in their body or mind. This internal self-awareness – how one feels after a particular meal, the rejuvenation after a good night’s sleep, or the mental clarity after a bout of meditation – is invaluable.

It serves two critical functions:

  • Personalisation: No two individuals are identical, and personal experiences can guide bespoke modifications in one’s health strategy

  • Validation: At times, positive changes in subjective experiences precede objective metrics, serving as early indicators that one is on the right track

The path forward in health optimisation is iterative, requiring both an astute awareness of self, and the leveraging of advanced tools to gather data. By seamlessly blending subjective insights with objective analytics, one can craft and refine a health journey that’s both fulfilling and efficacious.

At Melbourne Functional Medicine, we empower our clients to take the reins of their health journey, equipped with the best tools and a profound understanding of themselves. The horizon of optimal health beckons, and with the right tracking and refinement, it’s well within reach.

Crafting a future of optimal well-being

The goal of health optimisation goes beyond just adding years to life; it’s about enriching those years with vitality, clarity, and strength. To tread this path towards optimal wellbeing, a personalised roadmap is indispensable. Personalised approaches in nutrition, stress management, sleep, and exercise dictated by your genetics is essential, resonating with your distinct needs and goals.

Here at Melbourne Functional Medicine, we’re more than just a clinic; we’re your partners in this journey. We’re committed to using our expertise, resources, and dedication to guide you, every step of the way, towards becoming the best version of yourself. Let us illuminate the way.

“We’re not born with a fixed genetic blueprint that determines our fate. We have within us the ability to live longer & healthier lives if we choose to.”

– David Sinclair

Take charge of your health destiny

Find out how the team at Melbourne Functional Medicine can help you find the healthiest version of you.