A Real-World Evidence Study Evaluating the Effects of the Human Optimization Project Protocol on Methylation Biomarkers and Health-Related Quality of Life in Women

Inclusion Criteria: * Women aged 35 to 60 years, English-speaking, and residing in the United States * Must own an Oura Ring with an active membership and a minimum of 30 days of baseline data * Willingness to comply with all study procedures, assessments, lifestyle considerations, and follow-ups for the study duration * Medically stable with no significant health changes in the past three months Exclusion Criteria: * Current use of GLP-1 receptor agonists (e.g., semaglutide, liraglutide), SGLT2 inhibitors (e.g., canagliflozin, dapagliflozin, empagliflozin), insulin, metformin, thiazolidinediones, acarbose, alpha-glucosidase inhibitors, or any investigational drug or supplement within the past 30 days * Current use of NAD+ precursors (nicotinamide riboside, NMN, niacin, NAD+), supplements containing active ingredients already in the HOP Box formulation, high-dose vitamin B12, berberine, alpha-lipoic acid, or other glucose-lowering supplements * Confirmed diagnosis of Type 1 or Type 2 diabetes, known liver disease (hepatitis, cirrhosis, NAFLD), kidney disease (including CKD or renal impairment), active or recent cancer (within past 5 years, excluding non-melanoma skin cancers), or severe psychiatric/mood disorders (bipolar disorder, schizophrenia, or major depressive disorder requiring hospitalization or intensive psychiatric intervention) * Known allergy, hypersensitivity, or intolerance to any active or inactive ingredient in the intervention * Participation in any other …