Mitochondrial decay, (a decrease in membrane potential, respiratory control ratio, cardiolipin, and cellular oxygen consumption, and an increase in oxidant by-products) appears to be a major contributor to aging and associated degenerative diseases.

Oxidative damage to DNA, RNA, proteins, and lipids in mitochondrial membranes is a major consequence of this decay, resulting in functional decline of mitochondria, cells, and organs. Feeding the mitochondrial metabolites acetyl carnitine and lipoic acid to old rats rejuvenates the mitochondria and improves brain and other function.

The degenerative diseases accompanying aging, such as immune dysfunction, cancer, cognitive decline, and stroke, might be delayed by an inexpensive intervention. About 40 essential micronutrients are required for metabolism and include minerals, vitamins, amino acids and fatty acids. Micronutrient inadequacy (2 standard deviations below the RDA) is unusually widespread in the U.S. population (especially in the poor, children, adolescents, the obese, and the elderly) because of high consumption of calorie-rich micronutrient-poor unbalanced diets.

Most of the world's population, particularly the poor, has inadequate intake of one or more micronutrients. Societal concern is low because no overt pathology has been associated with these levels of deficiency, e.g. 56% of the U.S. have intakes below the EAR for Mg and almost all African-Americans for vitamin D. My triage theory explains why the pathology is insidious.

When a micronutrient is inadequate, nature selects for a rebalancing of metabolism, that ensures survival of the organism at the expense of metabolism whose lack has only longer term consequences. I propose that during evolution micronutrient shortages were very common, e.g. the 15 essential minerals, which are not distributed evenly on the earth.

The consequences of this homeostatic response are, for example, DNA damage (future cancer), adaptive immune dysfunction (future severe infection), and mitochondrial decay (future cognitive dysfunction and accelerated aging). Much evidence supports this idea that micronutrient shortages accelerate aging.