The COSMOS trial gives everyone the same pill and measures a whole-body average signal from blood samples. It can't tell you which vitamin drove the effect or where in the body it's acting. It's a limitation of what a broad systemic intervention can tell you. The more targeted work is happening at the tissue level.
In skin specifically, L'Oréal and UC San Diego looked at 1,000+ subjects in 2024 and found that bacterial diversity in the skin microbiome correlates directly with both chronological age and wrinkle depth. They're building these as actual measurable aging biomarkers. Unilever's 2025 study also showed that people whose facial microbiome had higher Acinetobacter and lower Staphylococcus aureus were read as biologically 5–7 years younger. Many other companies are also researching biomarkers for skin anti-aging, and now the longevity trend is being seen in the food industry as well.
Microbiome as a modifiable aging clock is where the real specificity is starting to come from. I work in this space, and we recently mapped where this research is heading. We also did a session exploring the underlying science if you want to go deeper: https://greyb.com/resources/skin-microbiome-beauty/
L'Oréal Study: https://www.frontiersin.org/journals/aging/articles/10.3389/... Unilever Study: https://academic.oup.com/bjd/article/193/Supplement_2/ii24/8...
From Harvard: https://news.ycombinator.com/item?id=47319478