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Triage theory and its application to health and performance.

With thousands of chemical reactions happening at any one time, your body is no simple machine. It demands a vast number of nutrients to carry out these processes and function at its best. Dr Bruce Ames’s realised this point with his Triage theory, proposing that the body requires a much more diverse range of nutrients than the traditional 30 essential micronutrients to function at its best. He suggests that when the body is deficient in a micronutrient, it will prioritise processes in the body required for short term survival, and proteins and enzymes involved in long term health will lose out on the allocation of nutrients. Looking at this theory through the scope of health and performance, we realised that if the body is deficient in nutrients, it will be starved of the raw ingredients it needs to function optimally during exercise.

What is Triage Thoery?

Due to a complex interaction of geological and environmental factors, periods of micronutrient deficiency were likely common throughout human evolution. It makes sense that the body would have mechanisms in place to maintain short term survival during such periods, even if it were deleterious to healthy ageing [1]. Throughout history, natural selection has been known to favour short-term survival over long term health if the two are in conflict. Selection for reproductive success early in life may involve trade-offs that shorten lifespan [2]. These mechanisms are witnessed across many species and seem consistent throughout nature.


The body places a higher priority on immediate function and survival than it does on longevity and health. In the case of micronutrient deficiency, this short term survival was likely achieved by allocating scarce micronutrients to enzymes in order of importance, whilst those involved in long-term health would lose out. In this case, a micronutrient deficiency could accelerate cancer, ageing, and neural decay but would leave critical metabolic functions such as energy production intact [1].


Similar mechanisms are not uncommon in the body. For example, when oxygen delivery to the tissues is inadequate, vital organ function is maintained by mechanisms that distribute blood flow primarily to the brain, heart, and adrenal glands. Non-vital organs will receive less blood flow, as they are not as essential to the immediate survival of the body [3]. Similarly, when the body experiences micronutrient deficiencies, organs such as the liver can lose out on the allocation of micronutrients first, before other more essential organs.


Triage theory proposes that during micronutrient deficiency, a rationing mechanism allocates vitamins and minerals to enzymes critical for immediate survival and reproduction. Proteins involved in protecting from future damage (such as DNA repair mechanisms) will be sacrificed in the order of priority. This could accelerate ageing and increase the risk of disease [4].


With this in mind, Dr Bruce Ames suggests categorising certain enzymes as survival proteins and longevity proteins. The dietary compounds needed for the function of longevity proteins are called longevity vitamins. The shortage of these vitamins could result in damage that, although not immediately apparent, may accumulate over time [4]. Confirmation of similar nutritional concepts has been witnessed before, such as foetal malnutrition having a high association with coronary artery disease in adulthood [5].


It is also worth noting that some nutritional compounds exhibit beneficial effects on metabolism and overall health, despite not being essential for survival. The importance of such compounds may not be adequately emphasised, as the consequences of their absence are not immediately apparent nor fully understood [1]. These include the likes of antioxidants, which, although not critical for our survival, help reduce the harm caused by oxidated stress and free radicals from the body.


Dr Bruce Ames references 41 different micronutrients with important functions in our overall health. He emphasises the importance of fulfilling your body’s requirement for them to achieve optimal health and longevity, minimising the long-term effects of nutrient deficiency. This includes vitamins, minerals, conditional vitamins, and putative longevity vitamins [4].

Applications for health and performance

Looking at this theory through the scope of health and performance, we realised that if the body is deficient in nutrients, it will be starved of the raw ingredients it needs to function optimally during exercise. Triage theory applies to health and performance for several reasons. It stands to reason that if the body is prioritising nutrient allocation for survival mechanisms, proteins and enzymes that optimise athletic performance may miss out. If a metabolic process can enhance performance but isn’t deemed essential for survival, it may not be prioritised in the case of nutrient deficiency.


Additionally, triage theory has obvious implications for general health and wellbeing. It is proposed that nutrient deficiency can accelerate aging and disease development, as processes that increase longevity are starved of the nutrients they need to function. As an athlete, health and longevity are both essential concepts in relation to performance. Staying healthy allows athletes to train and compete more often and at their best, which naturally benefits performance. Staying in good health will also increase the span of training and competition, allowing you to continue doing the things you love for longer.

The Radix solution

Here at Radix, we took Bruce Ames’s theory and expanded on it even more, adopting an obsessive and meticulous approach to giving the body everything it needs to perform. Using a science-based research process, our aim is to find any and all nutrients that impact health and performance and provide them through the highest quality products and ingredients. This forms the basis of RNA, which we use to increase the overall nutritional values of our products across a broad spectrum of 80+ nutrients. From macronutrients, micronutrients, pre and post biotics to a wide range of phytonutrients, our aim is to optimally support the metabolic performance of athletes’ bodies like yours.

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  1. Ames, B.N., Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. Proc Natl Acad Sci U S A, 2006. 103(47): p. 17589-94.

    1. Kirkwood, T.B. and M.R. Rose, Evolution of senescence: late survival sacrificed for reproduction. Philos Trans R Soc Lond B Biol Sci, 1991. 332(1262): p. 15-24.
    2. Polin, R.A. and W.W. Fox, Fetal and neonatal physiology. 2nd ed. 1998, Philadelphia: Saunders.
    3. Ames, B.N., Prolonging healthy aging: Longevity vitamins and proteins. Proc Natl Acad Sci U S A, 2018. 115(43): p. 10836-10844.
    4. Wyness, L., et al., Nutrition and development : short and long term consequences for health. 2013, Chichester, West Sussex: published by Wiley-Blackwell for the British Nutrition Foundation. p.