So, without further ado, may I present the founder and
director of NutritionFacts.org, Dr. Michael Greger. There may be no such thing
as dying from old age. From a study of more than
42,000 consecutive autopsies, centenarians—
those who live to be a hundred— were found to have
succumbed-to-disease in a hundred percent
of the cases. Though most were perceived,
even by their physicians, to have been healthy
just prior to death, not one,
“died, of old age.” They died from disease,
most commonly, heart disease. If aging kills via diseases, why wasn’t my book
How Not to Die all the longevity book
anyone needs? In it, I ran through
preventing, arresting, or reversing each
of our top 15 killers— starting with
heart disease, not only the #1 killer
of centenarians, but of men and women
across the board and projected to remain that
way in the decades to come. But is it really? Because the single
greatest risk factor for most of our
killer diseases is how old you are, one could argue that the
leading cause of death is actually aging. The rate of death
increases exponentially for age-related
diseases, such as heart disease,
cancer, stroke, dementia. So yes, within the
same age bracket, having a high cholesterol can increase your risk of
heart disease up to 20-fold, but an 80-year-old may have
five hundred times the risk of having a heart attack compared to a
twenty-year-old. Now, the reason we focus
on things like cholesterol is because it’s a
modifiable risk factor, but what if the rate of
aging was modifiable too? Instead of our current
piecemeal approach of focusing on
individual diseases, what about slowing down
the aging process itself? When I was a
nerdy little kid, I wanted to cure
cancer when I grew up. But even if all forms
of cancer were eliminated, the average life
expectancy in the U.S. would only go up
about three years. Why? Because dodging cancer
would just mean delaying death from a heart attack or stroke. If one age-related ailment
doesn’t get us, another will. So, rather than playing
“whack-a-mole” by tackling each
disease separately, slowing the
rate of aging could potentially address
all these issues simultaneously. Imagine if there
were an intervention that didn’t just reduce your
risk of the leading killers, but also arthritis,
osteoporosis, sensory impairments. Because risks tend to
double every seven years— like if the average 65-year-old
had the health of a 58-year-old? Slowing aging by
even just seven years could cut everyone’s
risk of death, frailty, and disability in half. That’s why I wrote
How Not to Age. The problem is that
the anti-aging field is said to be a “fertile
ground for cons, scams, and get-rich-
quick schemes.” As a former president of the
Gerontological Society wrote, there have been “few subjects
which have been more misleading to the uncritical and more
profitable to the unscrupulous.” Not only does the popular
literature on the subject harbor a “huge amount
of misinformation,” but most age-researching
scientists widely known to the public are said to be “unscrupulous
purveyors of useless nostrums,” according to the Editor-in-Chief
of a leading gerontology journal. When it comes to something
as life-and-death important as to what to feed
ourselves and our families, we should rely not on
anecdote, but on evidence. That’s why I cite
everything to the teeth. How Not to Die,
had about 2,000 citations. How Not to Diet,
5,000 citations. How Not to Age ended
up with 13,000 citations, all of which I have
hyperlinked for you online to access all the
original sources. So, you can
download the studies and read them
all yourself. My aim was to cover
every possible angle for developing the
optimal diet and lifestyle, for the longest,
healthiest lifespan— based on the best available
balance of evidence. My inspiration for writing the book
was a consensus document, “Interventions to Slow
Aging in Humans”, compiled by the top researchers
in the anti-aging field (the likes of Drs. Longo,
Sinclair, Fontana). They were
brought together to identify the most
promising strategies to combat aging. They identified a list
of “essential pathways,” for example, drugs that
can block the hormone IGF-1, or drugs to block the
pro-aging enzyme TOR. But I realized as
I looked at this: Wait, every single
one of these pathways could be regulated
through diet. That became the first
section of the book. The term “antiaging” has been much
abused in popular culture, attached to all manner
of unproven products and procedures, whereas the term
should really be reserved for things that can
delay or reverse aging by targeting one
of the established aging mechanisms, the so-called
Hallmarks of Aging, the common denominators
of the aging process like, for example, the buildup
of misfolded proteins that can be disposed of
through autophagy. See, at any given time, most of our cells
are producing and assembling more
than 10,000 distinct proteins, each of which can
become misfolded or damaged
at any time and require a
cleanup in aisle three. But during times
of nutrient excess, our body figures
why bother? We can just toss it in
the corner and make another. Having evolved in
a context of scarcity, our body expects to fall
on hard times any day now and can put off spring
cleaning until then. But these days, these lean times
hardly ever come; so, our cells just end up
continually hoarding junk. That’s where autophagy
comes from, from the Greek words
for “self-eating.” It’s a housekeeping
process by which defective cellular
components are broken down and scrapped
for spare parts. This doubles as both salvage
operation and quality control, clearing out some
of the damaged debris implicated in the
aging process, while renewing our cells
in a sort of cellular reset. As one review put it,
“The janitor is the undercover boss.” Our ancient ancestors often
went for several days without food; so, autophagy was
constantly being switched on. But these days, our cells no longer need
to clean out the corners for sustenance. And so, the tainted heaps
just pile higher and higher, which isn’t good, because autophagy is
essential for lifespan extension. It’s not only necessary, but sometimes sufficient
for increasing longevity. Self-digestion for
lifespan extension. Boosting autophagy
alone can boost lifespan, at least in mice, by an average of 12 percent,
and it also boosts healthspan. Unfortunately, our bodies’
ability to take-out-the-trash declines with age,
leading to this vicious cycle. Garbage builds up,
accelerating aging, which leads to more
garbage buildup. No wonder the drug
industry is so eager to pharmacologically modulate
autophagy to combat aging— but we can do it naturally. One way is
through fasting. Unfortunately, autophagy doesn’t
really maximally ramp up until after a day
or two of fasting, which may be too long
to do it unsupervised. Fasting more than 24 hours should probably only be done
under medical supervision, ideally in a
live-in clinic. In other words,
don’t try this at home. This is not just legalistic
mumbo-jumbo. For example,
normally, your kidneys dive into
sodium conservation mode, but should that
response break down, you could rapidly develop
an electrolyte abnormality that might only manifest
with non-specific symptoms like fatigue or dizziness, which could be easily
dismissed, until it’s too late. Thankfully, there’s another way
to activate autophagy. You can fast or go fast. Exercise induces
autophagy. As one of the
researchers said, “I’ve always known
exercise was good for you, but when we found that
it increases autophagy, I finally got a treadmill.” You have to do
enough, though. Autophagy is activated
after 60 minutes of moderate
intensity exercise, but only twenty minutes
fails to move the needle. What about diet?
Any foods to avoid? In 2021, we found
out acrylamide can inhibit autophagy, at least in cells
in a petri dish. Acrylamide is a toxin concentrated in French
fries and potato chips that’s formed during
the frying process. The fact that high acrylamide
exposure is associated with as much as double
the risk of premature death would be consistent with
an anti-autophagy effect, though diminished lifespans
among eaters of fatty, salty snacks isn’t exactly a revelation. You can’t know if
it's cause and effect, until you… put it to the test—
very nice! Before being asked to
eat a bag of potato chips every day for a month, study subjects were given
weeks of boiled potatoes mixed with the same amount
of fat and salt as the chips. Compared with the fatty
salty boiled potatoes, their C-reactive protein levels
shot up 50 percent on the chips, suggesting “chronic ingestion
of acrylamide-containing products induces a proinflammatory state.” However, deep frying
causes the formation of all manner of
“undesired food-borne toxicants;” so, we can’t be sure
it was the acrylamide. As one of the earliest
geriatric medicine textbooks presciently concluded
back in 1849, “frying…is an abomination.” If you just must
have your French fry fix, air-frying produces about
90 percent less acrylamide. Anything that can help? Starving yourself
“generates discomfort,” but there is something
that activates autophagy that many people
find comforting: coffee. At a human-
equivalent dose, both regular and decaf rapidly
induce autophagy within hours— in mice, and coffee can extend
the lifespans of some rats, but what about people? In humans, we only
have observational research, but to date
about 20 studies have followed more than
10 million people over time, and those drinking
3 cups (720 ml) of coffee a day had 13 percent lower risk of dying from all
causes put together. And decaf appears
to be just as protective; so, it’s not the caffeine. Coffee contains more than
a thousand bioactive compounds. The polyphenol chlorogenic acid is the most abundant
antioxidant in coffee; so, researchers started there,
and indeed, was found to enhance
autophagy in human cells. More than a hundred
coffees have been tested, and chlorogenic acid levels
vary by more than 30-fold. Interestingly, the major contributor
to this wide range is Starbucks, with its extremely low
chlorogenic acid content, thought to be because they
roast their beans so dark that they destroy it. Freeze-drying is okay, and brewed has
more than espresso. Paper filtered
is the best, because it traps the cholesterol-
raising compounds in coffee, perhaps explaining why
those drinking filtered coffee had even lower mortality rates
than those drinking unfiltered coffee. Any food components
that activate autophagy? Spermidine, the longevity elixir,
spermidine. Don’t be put off
by the name. Spermidine and its
byproduct spermine are actually found
throughout the body. When it was later independently
discovered in the brain and the muscles, they called it
neuridine and musculamine until they found out it was
all the same compound, and so, naming rights defaulted
to the less palatable original. Our body can
make it from scratch, but we can also boost levels
by eating spermidine-rich foods, which is good news because our spermidine
levels tend to decline with age, dropping more than half
by the time we reach our 50s. This decline is seen across
the biological spectrum with one
remarkable exception, naked mole rats, also known by their
more cuddly nickname: sand puppy, considered to be a
“non-aging mammal” without any visible
signs of aging and almost no decline
in physiological function over decades, or typical signs of aging,
like loss of fertility or muscle mass. Perhaps in part because they are able to maintain
their high levels of spermidine, something you also see
in human centenarians. To prove cause and effect,
extra spermidine was fed to animals and “Induction of Autophagy by
Spermidine Promotes Longevity,” increasing the lifespans of mice,
for example, by as much as 25 percent. In a database of more than
a thousand life-extending compounds, among the small subset
with the fewest side effects, spermidine has the largest
documented lifespan extension. Longevity can be improved
even when started late in life, kind of the human equivalent
of changing your diet when you’re already
in your fifties. Anti-aging effects were
found in the heart and kidneys, rejuvenating immune function,
delaying brain aging, and improving
cognitive function. Yeah, but that was in animals
like fruit flies and mice. I mean who cares if spermidine
cures flies of senior moments. What about in people? Hundreds of men and women
in their 40s through 80s were followed for twenty years, and after looking at 146
different components of their diets, the single most predictive
of longevity was spermidine. How much spermidine? Higher spermidine intake
is linked to lower mortality. Those who consumed
the most spermidine had a reduced risk of death
from all major causes, which is what we’d expect
from an anti-aging compound. Critically, this survival
advantage persisted even after controlling
for dietary excellence, meaning that it
wasn’t just because they were eating
healthier foods in general, but rather spermidine-
rich foods in particular. How big of an effect
are we talking? The reduction
in mortality risk between getting more than
12 mg of spermidine a day compared to
getting less than 9 was as if those eating
more spermidine were 5.7 years younger. It’s as if by eating
more of certain foods, they were effectively able
to turn back the clock nearly 6 years. The findings were
so extraordinary, the researchers sought
to replicate their results in a whole new
set of individuals and, indeed, arrived at
the same conclusion. This led some to propose that spermidine may
be an anti-aging vitamin. When we’re younger, we seem to be able
to make enough, but as we get older, we may need to start ensuring
we’re getting enough in our diet to maintain autophagy
into old age. Well, if spermidine is going to be
considered an anti-aging vitamin, where is that
vitamin found? Beans are said to have
the highest natural amounts, but I compiled a list of the
top spermidine sources, and pig pancreas beat out
bean burritos for the bronze. This is virtually every food averaging at least 2 mg
of spermidine per serving, with a fermented whole soy food
called tempeh leading the list, along with plain
white mushrooms. While some have suggested
the genetic engineering of spermidine-rich crops, there are already a plethora
of naturally spermidine-rich foods. As a certified dark
green leafy snob, I was begrudgingly impressed
to see lettuce score so high, though lettuce is so light, a 100-gram serving
would be about 3 cups, but even the spermidine in
little side salads could really add up. In the book, I spend a lot
of time going through the list, but the single most concentrated
source is wheat germ, with 2.5 mg of spermidine in just the 7 grams
in a tablespoon. It’s also the
cheapest source, costing as little as
two cents per milligram. You can’t get a lot
of pancreas for two cents. Does wheat germ
actually do anything? Let’s randomize people to
some dinner rolls and find out. A randomized,
double-blind pilot in which older individuals were secretly slipped
some spermidine in the form of wheat germ
baked into bread rolls vs placebo rolls with
wheat bran instead. And, those with mild dementia
improved way beyond all available antidementia
drug treatments so far. Admittedly, that’s
not saying much, but what’s the harm of sprinkling
a little wheat germ on your food? The latest Alzheimer's drugs
don’t appear to work at all. All you get for
your 56,000 dollars is a dramatically increased risk
of swelling or bleeding into your brain. When the FDA
approved it anyway, the head of the
American Geriatrics Society replied, “My head just exploded.” (Maybe they just got
slipped a dose of the drug). Anyway, lots of other
clinical spermidine studies, but just to wrap
up this section, autophagy is considered the
“primary system for cleaning the body” from the inside out. And, we can boost autophagy
with aerobic exercise, skipping fries and chips,
drinking coffee, and eating specific foods to reach a target of
20 mg of spermidine a day. I offer similar diet
and lifestyle takeaways for each of the other
10 anti-aging pathways, but don’t have time
to touch on them, because there’s still three
other major sections of the book. Part Two focuses on
the diets and lifestyles of the healthiest and longest-lived
populations around the world. The odds of living to a hundred have
risen from approximately 1 in 20 million to as high as 1 in 50. Why do some make it
and others not? It’s not just a matter of
picking better parents. Studies following identical twins
suggest that only about 25 percent of the variation in lifespan
is explained by genetics. So, what can we
do for the majority over which we may
have some control? The media loves stories
of hard-living centenarians who attribute their longevity to
some combination of lard, vodka, and favorite brand of cigarette, but how do the oldest and
healthiest really eat and live? That’s what we have
the blue zones for, areas of exceptional
longevity around the world, where there may
be ten times the rate of those reaching
those triple digits. (Named for the color a demographer
used in a global “heat map” of mortality around the world.) What lessons can we learn? The Blue Zones organization
distilled findings from more than
150 dietary surveys from the world’s
longest-living people to create a set of
ten food guidelines. The foundation of the
Blue Zones Food Guidelines, is making your diet at least
95 percent plant-based, avoiding highly
processed foods, emphasizing beans as the
healthiest source of protein, water as the best beverage,
and nuts as the healthiest snack. That’s the foundation. The final five guidelines
are to “Go easy on fish,” “Eliminate eggs,
“Slash sugar,” “Reduce dairy,”
and “Retreat from meat,” noting that blue zones
centenarians only eat about
two ounces (57 g) of meat or less about five
times a month. Historically, there’ve been
five recognized blue zones, but only one survives
and thrives to this day, the red, white, and blue zone: the Seventh-Day Adventists
in Loma Linda, California, with perhaps the
longest life expectancy of any formally studied
population in history. There are a number of shared
Blue Zone lifestyle characteristics: family coherence,
avoiding smoking, daily exercise,
social engagement, but plant-based nutrition appears
to be the principal component, alone accounting for about
half the difference in lifespan. No surprise, since the number
one risk factor for death in the United States
is the American diet. So, unsafe sex is bad.
Sedentary lifestyle? Bad. Alcohol and drugs—
especially tobacco. Bad. But cigarettes only kill about
a half million Americans every year, whereas our diet
kills many more. We are what we eat. Which is good news, because it means
we have the power. Changing from a more typical
diet to a more optimized diet starting at age twenty
would be expected to increase the
lifespan of women by about eleven years
and men by thirteen years. The largest life
expectancy gain would be made by
eating more legumes— in other words, more beans,
split peas, chickpeas, and lentils. So, if there was one
thing we could eat: Legumes for longevity.
Hummus for health! Then, comes whole
grains and nuts, and eating less meat. Now, for the few of you
who aren’t twenty anymore, not to worry. Starting to eat healthier
at age sixty, could still mean adding eight or
nine more years to your lifespan. Even starting as late as
age eighty could add years. Changing your
health destiny can start tomorrow
morning at breakfast. And it doesn’t take much. The NIH-AARP study
is the largest forward-looking study
on diet and health in history. Based on its six million
person-years of observation, replacing just three percent
of daily caloric intake from animal protein
with plant protein was associated with a
ten percent decreased risk of overall mortality
in both men and women. Just swapping three percent! Of all the animal protein sources,
eggs were found to be the worst. Swapping in three percent
of plant protein for egg protein was associated with
twice the benefit, twenty percent lower mortality
for swapping in a few British beans for breakfast instead. Harvard researchers found that
when it comes to premature death, processed meat was the worst,
followed by eggs. In essence, they found
that tuna salad may be better than
egg salad or a BLT, but a bean burrito
beat out the bunch. When it came to death
from all causes put together, plant protein beat out
every type of animal protein— including dairy,
fish, and chicken. A three percent swap
from chicken to chickpeas, or fish to falafel was linked to a six percent
decreased risk of premature death. But does eating healthy
actually slow down aging? Randomize
hundreds of women to a diet centered around
healthy plant foods, or exercise, or neither, and though the physical
activity failed, those in the plant-based
dietary intervention group had a significant slowing
of biological aging. Of course, it isn’t just about
adding years to your life, but life to your years. An unhealthy aging
index was devised to measure functional
impairments, vitality, mental health,
physical health. Substituting even just
one percent of calories from plant protein
for animal protein appeared to lead to significantly
less deficit accumulation. And substituting five percent
may reduce the risk of dying from the greatest deficit,
dementia. That may help explain why those
who don’t eat any meat at all may be up to three times
less likely to become demented. But again,
it’s not all-or-nothing. In fact, the worst thing
about humanity’s diet is neither animal nor
vegetable, but mineral: sodium. Here are the top five
fatal flaws of our diet. Millions of deaths may
be attributable every year to not getting enough
whole grains, not eating enough fruit,
not enough nuts and seeds, not enough vegetables. But the single deadliest
ingredient in humanity’s diet is something we
get too much of: and that’s salt, our number one dietary
risk factor for death. A recent whopping study,
for example, of more than a
half million people found that those who salted
their food at the table at age fifty appeared to have about a
two-year lower life expectancy compared to those
that didn’t. So, just swapping
out the salt shaker for some salt-
free seasoning or salt substitutes could
potentially add years to your life. How do we know
it’s cause and effect? Five kitchens at a
veterans’ retirement home were randomized into
two groups for a few years, offering meals salted either
with regular salt or, unbeknownst to them, a 50/50 blend of regular salt,
sodium chloride, with a salt substitute like these,
potassium chloride. The kind of salt was the only
difference between the meals, and cardiovascular disease death
rates plummeted by 40 percent in the folks getting the
reduced sodium blend. The new difference
in life expectancy between the two
groups at age seventy was equivalent
to that which would have occurred
naturally in 14 years, meaning simply switching
to even half potassium salt— for which you wouldn’t even
be able to taste the difference of— appeared to effectively make
people more than a decade younger when it came to the
risk of premature death. What do the likes
of the Salt Institute have to say about public
health recommendations to reduce sodium intake? In testimony before a
Congressional committee, the presumption
that healthier diets would cut healthcare
costs was challenged. “Indeed,” one processed
food defender testified, “healthcare expenditures increase
if the lifespan is prolonged.” If people eat healthier
and live longer, it could be
more expensive, noting that if tobacco
were banned, the increase in
expected lifespan would, “increase the cost of
care of old people.” Think how expensive
it would be if people started taking
care of themselves and didn’t, conveniently,
die on time. Ultra-processed foods, often packed with added
salt, sugar, and fat, consistently account for more than
50 percent of our dietary caloric intake. More than half of
our diet is junk. Not surprisingly, those foods are associated with
a greater risk of dying prematurely. So, just cutting back on
animal foods isn’t enough. Healthy plant-based
diets are associated with a significantly
lower risk of dying, but unhealthy plant-
based diets are not. In the Harvard cohorts, the more you minimize
meat, eggs, and dairy, the lower your
risk of death falls, but that’s only if you’re
eating healthy plant foods. If you, instead,
just pile on the junk, like chips and soda, you can increase your
risk of death overall— even if animal product
consumption remains low. Same in the Million
Veteran Program study: Healthy plant foods,
reduced their risk of death. But if your idea of a plant-
based diet is fries and a Coke, you’re not doing your
body any favors. Same with the risk
of cognitive impairment. Only healthy plant
foods reduce risk. The same with dementia
and depression. The same with frailty. Healthy plant foods good;
plant-based junk bad. That’s why Cornell Professor
Emeritus of Biochemistry, T. Colin Campbell, coined the term
whole food, plant-based diet. As a physician, terms like vegetarian or vegan
just tell me what you don’t eat. I mean, do you actually
eat vegetables? Professor Campbell’s physician
son and daughter-in-law tried putting a group of
vegetarians and vegans on a whole food,
plant-based diet. In eight weeks,
they lost ten pounds, dropped their LDL
cholesterol 15 points. In other words, vegans may benefit from eating
a little more plant-based, too. Now, meat is a problem. In terms of lifespan, eating a burger may
cut one’s life as short as smoking two cigarettes. So, if it wouldn’t
even occur to us to light up before-
and-after lunch, maybe we should choose
the bean burrito instead. There are certainly ways
to make meat safer, though. For example, one of the ways whole food,
plant-based diets can help is by reducing the
load of gerontotoxins, age-accelerating toxins, such as advanced
glycation end-products, also known as
glycotoxins, or AGEs, an acronym intentionally chosen
to emphasize their toxic role in age-related disease. AGEs occur
naturally in animals, but dry cooking methods can
generate 10 to 100 times more. When muscle cells
rupture under dry heat, highly reactive compounds
combine with blood and body sugars to form AGEs
within the meat. So, even without
cutting down on meat, you can significantly cut
down on glycotoxin intake, just by switching
up cooking methods. The safest ways of cooking
meat are moist methods, such as boiling, poaching,
steaming, stewing. Check out what happens
when people are randomized to a meal of fried or broiled
chicken breast and veggies— or the same meal with
the same ingredients— including the oil— but with steamed or
boiled chicken breast instead? That single high AGE meal
with the fried or broiled breast induced a profound impairment
of artery function within hours. The steamed chicken still
impaired artery function, but not as much as
the fried or broiled. So, we can eat
an “age less” diet by switching to moist
methods, for example, but dietary approaches are said
to have “zero commercial value” and hey, stewed chicken
may not be as tasty; so, why not
just take a drug to block AGE absorption
every time we eat? It does lower your
blood levels of AGEs. It’s just activated charcoal, like when people are
poisoned or for drug overdoses. I’m sure our AGEs
would also go down if we chased our chicken
with a little ipecac, too. What about fish? Unfortunately, our oceans have essentially
become humanity’s sewer. Everything eventually
flows into the sea; so, the consumption
of contaminated seafood has become
the main route of human exposure
to chemical pollutants. Yes, a variety of
foods are affected, but the number one
source of DDT? Fish. The number one source
of PCBs? Fish. Salmon is the worst
when it comes to PCBs, followed by canned tuna. Salmon also has the highest
levels of dioxin-like compounds. So, on the one hand, fish has long been viewed
as a healthy dietary component because of those
long-chain-omega-3’s, but on the other hand,
we’re so polluting our world that we’re now
seeing heavy metals, pesticides, flame retardants in fish,
forever chemicals, which may explain why,
despite their omega-3’s, there’s been a failure to consistently observe beneficial
effects of fish consumption. So, if we had
a time machine to go back before
the industrial revolution, that would be one thing,
but now, we have studies like this, where mice fed commercially
available farmed salmon fillets with common levels of
persistent organic pollutants were found to develop
insulin resistance, glucose intolerance,
abdominal obesity, fatty liver, chronic low-grade
inflammation. So, even just background
levels of pollutants that might be
presumed to be safe could completely counteract
the potential benefits of omega-3s, in particular,
leading to metabolic issues. For mercury,
it’s more about brain health. Hundreds of thousands of babies born
with brain damage every year, seemingly as a consequence
of their mothers consuming mercury-contaminated
fish during pregnancy, with the resulting
loss of intelligence estimated to cause billions of dollars
of lost productivity every year. In the aging literature,
there are cases like this: a man with progressive
memory loss tentatively diagnosed with
Alzheimer’s dementia. His friends and family assumed
he was nearing the end of his life. But a detailed
history revealed that he had consumed
swordfish once or twice a week. When the fish was
removed from his diet, his mercury levels fell,
and his memory bounced back. No more dementia. So, it seemed he didn’t
have Alzheimer’s after all, but rather mercury poisoning
from a handful of monthly meals of contaminated fish. You can see the same
remarkable reversals with hair loss. Here’s a common story: a perimenopausal woman
seeks help for hair loss. Blood tests indicate
elevated mercury levels. And no wonder, because she had
a diet high in tuna. But within two months
of stopping fish, her hair started
to grow back, and eventually her
hair regrew completely. So, doctors should consider
screening for mercury toxicity when they see hair loss, since there’s something
we can do about it. Instructing patients to
reduce fish intake could offer relief
of symptoms and uncover
dietary habits that may be a source of
heavy-metal-induced hair loss. (Though, admittedly, sometimes heavy metal
can lead to too much hair.) What about alcohol?
That’s from plants! Sorry to be Dr. Buzzkill, but alcohol appears to be humanity’s
7th leading cause of death and disability. The safest level
of drinking is none. But wait a second,
what about the famous J curve, where light to moderate drinkers
appear to have lower mortality rates than the teetotalers
at zero drinks a day? This, may just be an artifact
of the systemic misclassification of former drinkers
as lifelong abstainers. This leads to the so-called
“sick-quitter” effect, where the reason a person
may be a nondrinker is because drinking
made them sick, thereby making current drinkers
look good in comparison. It’s the same reason studies
can find higher mortality among those who
quit smoking compared to those
who continue to smoke. It’s not that abstention
led to poor health, but poor health rather
led to abstention. When researchers went back
and controlled for the error of misclassifying former drinkers,
the J curve disappeared. No more apparent benefit
to moderate drinking. In other words,
compared to true abstainers, the more alcohol,
the more disease, with no apparent protection
at low levels of consumption. Even red wine? Unfortunately, interventional trials show that
wine can cause inflammation within hours of consumption,
both red and white— significantly more than just
like drinking sugar water, and you get a surge of
fat in your bloodstream that you don’t get drinking
“dealcoholized red wine” (the same wine with
the alcohol taken out). What about just
taking supplements of the red wine
compound resveratrol? Oh, you mean the supplement found to nearly triple the loss of
brain tissue compared to placebo? No, thank you. The healthiest beverages
are probably water and tea. Increasing tea consumption
three cups (720 ml) a day may decrease the risk of premature
death from all causes by 24 percent. This applied to both
green and black tea, though green may
have a slight advantage. Part of this protection may be
a lower risk of dying of pneumonia. There have been five
randomized, controlled trials showing those
randomized to green tea are about a
third less likely to come down with
the flu, for example. Within just one hour of drinking
a single cup (200 ml) of green tea, we can significantly cut down on the rate of DNA
damage in our cells, because green tea significantly boosts
the activity of a DNA repair enzyme in our body that can
fix DNA damage. And within a month, drinking two small
daily cups (400 ml) of green tea can improve DNA resistance to
free radical damage in the first place, indicating that green tea has
significant genoprotective effects, or DNA protecting effects. Tons more about individual foods
and beverages in the book. But let’s move on to Part Three,
where I get into the nitty gritty. What can we do to protect our
bones, bowels, bladder, and circulation? Our hair, hearing,
and hormone balance? Immune function,
joint health? Our minds and our muscles? Sex life and skin? Our teeth, vision, and finally,
our dignity in death. Let me just share
a few quick pearls. For example, did you know that 85 percent
of bone-related fracture risk has nothing to do with
your bone mineral density? That’s just been drilled
into our heads by big pharma and a billion-dollar bone
density screening industry. Fractures are primarily due
to falling, not osteoporosis. So, it’s the age-related muscle
loss and impaired balance that may be breaking
most of our bones— which is good news, because there’s something
we can do something about it. Seven randomized
controlled trials found that strength
and balance training can cut fracture
rates nearly in half— and that’s just
during the trial. In the five years after this
one-year study ended, those who had previously
been randomized to the combined strength
and balance group, suffered 74 percent
fewer fractures. That’s far more effective than
osteoporosis drugs like Fosamax that can cause fractures—
atypical femoral fractures, in as many as
1 in 300 users. They are called “atypical,” because they occur
not after a fall or trauma but just during routine
activities, like walking, twisting at the hip,
or even just standing still. Thanks to the drug,
your femur, your thigh bone, the biggest bone in your body—
just cracks in half. Too cruel an irony from a drug
that’s supposed to protect your bones. This is what it looks
like on x-ray. Ouch! After bones, I talk about preserving
your bowel function in chapter number two. Randomize constipated
diabetics to either cookies containing
a tablespoon (20 g) a day of ground flaxseeds or flax-free placebo
cookies for 12 weeks and not only does the flax
improve constipation symptoms but resulted in an eight-pound
weight loss over placebo, 25-point lower
blood sugars, an astounding drop in hemoglobin A1c,
and 17-point lower LDL cholesterol. All for about 10 cents a day
of ground flaxseeds. For a head-to-head test
between flaxseeds and psyllium, sold as Metamucil, a third cookie group was added
with 10 grams of psyllium, and the flaxseed beat out the
psyllium for constipation relief, weight, blood sugars,
and cholesterol— and, is about four
times cheaper. Flaxseeds were also directly compared
to the prescription laxative lactulose and worked better as well. Bladder function! The prevalence of overactive
bladder syndrome increases with age, reaching about
one in three. No wonder bladder-relaxing drugs
are a multibillion-dollar industry, yet may only reduce
bathroom breaks by a half a pee a day
compared to placebo. But a quarter teaspoon (500 mg) a day
of dried cranberry powder worked nearly
four times better, about two fewer daily trips
to the bathroom over placebo, and that’s without any of
the drug’s side effects: dry mouth, constipation,
sedation, impaired cognition, rapid heartbeat,
urinary retention, and the visual disturbances
that lead almost two-thirds to stop taking the drugs, whereas cranberries
are just tangy. Urinary incontinence is a common
problem among older adults, particularly women,
thanks to childbirth. Systemic menopausal hormone therapy
like Premarin actually makes it worse, but local, vaginal
estrogen may help. What works five times better
than estrogen cream though? Kegel exercises,
pelvic floor exercises, as I detail in the section
“Jacked in the Box.” For men, urinary issues are more
an enlarged prostate problem, having to get up
multiple times at night, wee hours of the night. Cranberries to the
rescue there again. Even just an eighth of a teaspoon (250 mg)
a day of powdered cranberries can significantly improve
prostate symptoms. You can buy cranberry
powder in bulk at a cost of less than
a penny per day. What about
saw palmetto, the most common herbal supplement
used for prostate symptoms? Based on dozens of randomized,
controlled trials involving nearly 5,000 men:
no clinical benefits. But pumpkin seeds work. More than a thousand men with
prostate symptoms were randomized to either about a tablespoon (15 g) a day
of plain pumpkin seed kernels, a proprietary pumpkin seed
extract, or a placebo. The study was funded by the drug
company that made the supplement, but the supplement
totally flopped, while the pumpkin seeds
themselves worked. Pumpkin seed oil was pitted against
the leading drug for hair loss in women. A little less than a quarter teaspoon (1 ml)
applied to the scalp once a day versus a dose of the drug,
and they both worked, but the drug worked better. Rosemary oil, however,
may be more closely matched. A hundred balding men were randomized
to twice a day minoxidil like Rogaine versus a rosemary lotion. It took six months, but significant comparable improvement
in hair counts in both groups, with no significant difference
between the two. The rosemary lotion appeared
to work as well as the drug. If you want to
give it a DIY try, you can premix about 10 drops
of rosemary essential oil to each fluid ounce (30 ml)
of your favorite lotion and rub a quarter teaspoon (1.23 ml)
into your scalp twice a day. Cost-wise,
that much rosemary oil would come out to be
about a penny per week. Let’s move on from hair
highlights to hormones. I touched upon how
menopausal hormone therapy can increase the risk of urinary
incontinence, but that’s not all. If a thousand
postmenopausal women take the standard hormone
regimen for ten years, you’d not only expect 876
extra cases of urinary incontinence that they would not
have got otherwise, but nine more cases of
invasive breast cancer, eight more cases
of heart disease, probably 22 more
cases of dementia, 21 more cases of
gallbladder disease, nine more strokes,
and 21 more blood clots— though not a single
partridge nor pear tree. However, hormone
therapy is highly effective in decreasing
menopausal hot flashes. Is there any way to keep cool
without the clots and cancer? In the U.S., menopausal hot
flashes are considered inevitable, but there isn’t even a word
for hot flash in Japanese. This may be due to their
greater consumption of soy foods, but you don’t really know
until you put it to the test. Harvard’s Center of Excellence
in Women’s Health funded a randomized,
crossover trial of a half a cup (118 ml) of
unsalted soy nuts a day and achieved about a 40 to 45
percent reduction in hot flashes within two weeks compared
to the control group. Given that a plant-based
diet may also be effective for managing
menopausal symptoms, researchers decided to combine the two:
a plant-based diet plus whole soybeans. In fact, two randomized controlled trials
found that plant-based nutrition with a daily half cup (86 g) of
cooked whole soybeans can reduce the number of serious
hot flashes by 84 to 88 percent within twelve weeks. Overall, most randomized to
the plant-based bean group ended up free of
moderate-to-severe hot flashes compared to about 95 percent
still suffering in the control group. Lots of other
things can help. Whole fennel seeds, powdered into capsules
to pit them against placebo in a double-blind trial significantly
improved menopausal symptoms at a dose of just
a teaspoon (2 g) a day. Fenugreek may also help at a dose
of one and a half teaspoons (6 g) a day, though not as much as hormones,
but without the side effects. Though fenugreek can make your
pee smell like maple syrup, sounds like a bonus! The nice thing about
studying spices is that entire servings
can be stuffed into a pill, to pit them
against placebo. A quarter teaspoon (1 g) of
black cumin powder a day led to significant
improvements in memory and other tests of cognition within
nine weeks compared to placebo. Black sesame seeds— less than a teaspoon (2.52 g) a day
of ground black sesame seeds— stuffed into capsules
against placebo, drove down systolic blood pressures
by eight points within a month. If sustained, that alone could decrease
the risk of stroke by about a quarter. What else can we powder?
Strawberries! Osteoarthritis patients
were randomized to two ounces (50 g) of freeze-
dried strawberry powder versus a fake, strawberry-flavored
and colored placebo powder, and, compared to placebo, the real strawberries significantly
decreased constant pain, intermittent pain,
and total knee pain, and improved disability
and overall quality of life. Osteoarthritis is the most frequent cause
of physical disability among older adults, yet how do we treat it? Acetaminophen—Tylenol is
considered the first-line pain killer, but guess what:
it doesn’t work. I mean—it works, just not much better
than a sugar pill, but at least it’s not going
to make matters worse, like other things we doctors have
cooked up, like steroid injections, which actively worsen
joint deterioration and offer no greater
pain relief than placebos. Or arthroscopic surgery, which may end up
tripling our risk of ending up having to get
a total full knee replacement. I mean so, even if the strawberry
study is some total fluke, what’s the worst that can
happen, tastier smoothies? And less than a quarter of a teaspoon
(~1.25 ml) of ground ginger a day can beat out placebo
for joint pain. Researchers conclude
ginger, "therefore, is recommended as a safe
drug for these patients,” but by “drug” they just mean
a couple pinches of the ground ginger you can buy
at any store. There was even a
study on topical ginger— at least, when applied
to the scrotum. Paper-thin slices of ginger
applied over the inflamed testicles, and the researchers
were, on the ball, healing nearly three times
faster than the control group. There have been more than a hundred
randomized, controlled trials on ginger, shown to help with
nausea and vomiting and everything from
COVID to PMS. Heavy periods,
painful periods, migraine headaches,
multiple sclerosis, and the list goes on. Bottom line: “Mounting evidence suggests
ginger can promote healthy aging.” What about garlic? Clinically proven to protect against
those who vant to suck your blood. Literally. A hundred marines were randomized
to a clove a day or placebo, and those on garlic had
significantly fewer tick bites. Though sadly, garlic does not appear
to help against other bloodsuckers. So far, I’ve touched on
preserving your bones, bowels, bladder, hair,
hormones, and joints, but preserving your mind is
the largest chapter in the book, because dementia is one of our
most pressing public health problems and the most feared
condition of later life. There’s a common misconception
that we have no control over whether we
develop dementia, but the good news is that although
Alzheimer’s may be incurable, at least it is preventable. There is an
emerging consensus, that “what is good for our hearts
is also good for our heads,” because clogging of the
arteries inside the brain with atherosclerotic plaque
is thought to play a role in the development of
Alzheimer’s dementia. This is what our cerebral
arteries should look like: open, clean, allowing blood
to flow throughout our brain. This is what atherosclerosis
in our head looks like. Clogged with cholesterol,
closing off our arteries— clamping down
on blood flow. What kind of brain arteries
do you want in your head? Too much cholesterol in our blood is
unanimously recognized to be a risk factor for the development of
Alzheimer’s disease. Those with a total
cholesterol of 225 mg/dL or more may have nearly
25 times the odds of ending up with amyloid plaques
in their brain 10 to 15 years later. Cholesterol explains how the Alzheimer's
gene APOE4 ravages the brain. After all, APOE is the primary
cholesterol carrier in the brain. LDL cholesterol in those with
bad gene variants of APOE averages 40 points higher, but switch people to a
diet lower in animal fat and that cholesterol difference
can be effectively smoothed out. So, diet can trump genetics. This may explain the
so-called Nigerian paradox, where they have among the
highest rates of the Alzheimer's gene but some of the lowest rates
of Alzheimer’s disease. How is that possible? Genes load the gun,
but lifestyle pulls the trigger. The paradox may be explained
by their low cholesterol levels, probably because of their
diets low in animal fat. Human beings may
have evolved to maintain an LDL cholesterol
level of around 25 mg/dL, but the average in the Western
world is approximately 120 mg/dL. No wonder heart disease is
the leading cause of death in high income countries,
and dementia is killer #2. That helps explain why the
so-called Alzheimer’s gene is the single most important gene
when it comes to longevity, too. Which is good news, because even if we’ve been
dealt some bad genetic cards, we still may be able to
reshuffle the deck with diet. So, in terms of dietary guidelines
for the prevention of Alzheimer’s, we should center our diets
around vegetables, legumes, fruits, and whole grains. In other words, the dietary
pillar of lifestyle medicine: whole food,
plant-based, nutrition. Or even simpler, plants,
plants, and more plants. Any plants in particular? Note that the directors of Loma Linda’s
Alzheimer’s Prevention Program single out berries
and greens. Eating strawberries
and spinach can mitigate age-related
cognitive decline in rats, but what about in people? When the cognition of hundreds
of twins was followed over a decade, consuming the berry pigments in less
than a quarter cup (23 g) of blueberries a day or about a daily
cup (138 g) of strawberries was associated with slowed
cognitive aging by about four years, and nearly all of the randomized
controlled trials of blueberries and cognitive performance found
improvements in at least one brain domain, perhaps, because blueberry
consumption can improve blood flow to certain critical
regions of the brain. Now, the one study that flopped
mixed the berries with milk, and we know the
addition of milk prevents the artery
protective effects of tea and prevents the
bump in antioxidants that you’d normally get
eating dark chocolate and impairs
the absorption of the autophagy-activating
compounds in coffee. What about mixing
berries and cream? The antioxidant activity of blueberries
is not just impaired by milk. Check this out. Researchers found that the total
antioxidant capacity of our bloodstream (measured in two
different ways) shoots up within an hour of eating
a cup-and-a-half (200 g) of blueberries with water and remains elevated
five hours later. With milk, maybe one
would expect less of a bump? But in fact, they ended up even
worse than when they started. After eating a whole
bowl of blueberries, they ended up with less
antioxidant capacity in their body— because they ate
blueberries with milk. One reason greens may be referred
to as an anti-Alzheimer’s plant is because dark green leafy vegetables
can also improve blood flow in the brain in interventional trials. Randomize older adults
to the greens pigments found in about a cup (12 mg) a
day’s worth of cooked kale and see significant improvements
in complex attention, cognitive flexibility. And those randomized
to even just a half cup of kale’s worth of the cruciferous
compound sulforaphane got significant improvements in
processing speed and working memory. Here’s the rate of cognitive
decline in elderly men and women eating a serving a
day of green leafies, compared to those only eating
greens about once every ten days. Are you sitting down? “The rates of decline
among those who consumed 1 to 2
servings of greens a day was the equivalent to
being 11 years younger… .” So, now are you sitting
down to a big salad? Greens come up in
chapter after chapter. What’s the recommendation for preventing
age-related macular degeneration, our leading cause
of blindness? Or even treating it
in its earliest stages? Consume a diet high
in green leafy vegetables. We’re talkin’ two to
three servings a day, so at least greens at
every lunch and supper, with bonus points for sneaking them
into breakfast in, say, a green smoothie. In fact, blending greens
can triple the bioavailability of a key, vision-
protecting nutrient. The main reason greens make
it into in my Anti-Aging 8 though, is because of the nitrates in
a serving or two of cooked greens can slow our metabolic
rate for the same reason, a little shot of beet juice can help
free divers hold their breath longer, because it improves the
efficiency of our mitochondria, the little power
plants in our cells, allowing us to effectively extract
more energy from each breath. Another dietary intervention that has
a similar effect on slowing metabolism is calorie restriction. The candle that burns half
as bright burns twice as long. But instead of starving all the time,
you can just eat a big salad. What else can
greens do? In the Harvard Nurses’
Health Study, the consumption of leafy
greens appeared to protect against the
development of frailty, and when put to the test in a randomized,
double-blind, placebo-controlled trial, the equivalent of two
thirds of a cup (158 ml) of spinach led to a significant boost in
muscle strength, muscle quality, and muscle mass in
older men and women. A single cup (240 ml) of cooked greens
worth of vegetable nitrates significantly boosted maximal power
and velocity in quads so much it was “functionally equivalent, to acutely reversing the effects
of several decades of aging.” A single cup (240 ml)
of cooked greens! Of course, when most people think
about maintaining muscle mass into old age, they don’t think spinach,
they think protein. But if you put together all of
the randomized, controlled trials of adding extra protein to the
diets of older men and women, you find no evidence that adding protein
increases muscle mass or strength. Yeah, but what if you have sarcopenia,
excessive age-related muscle loss? Surely then,
protein helps, right? No. No significant effect on physical
performance or muscle strength. What does work?
Exercise. When it comes to
age-related muscle loss, it’s use it or lose it. But maybe exercise
plus protein? No. Protein supplementation
does not significantly augment the effects of strength
training in older adults. In fact, one of my Anti-Aging 8
is protein restriction. Why do longevity experts like Valter Longo
recommend people cut down on protein to live longer? Here’s what Luigi Fontana
wrote in his book. He’s the director of another
leading longevity research center. Excess protein may
not mass your muscles, but it will accelerate aging. How do you boost the
pro-longevity hormone FGF21? Dietary protein restriction. How do you suppress the
age-accelerating enzyme IGF-1? You do it through dietary
protein restriction. How do you suppress the
so-called motor of aging, mTOR? Dietary protein restriction. In fact, protein restriction was
the only intervention I could find that could slow down all
11 of the aging pathways, which is good news because
it’s easier to cut back on protein than it is to cut
back on everything and walk around
starving all the time. And, it may even
be easier than that. Most or all of the life-extending
benefits of protein restriction may be due to just restricting
particular amino acids like methionine. In that case, you could even
keep your protein intake the same but just swap sources, from animal proteins like meat
to plant-based sources like beans. So, in humans, methionine restriction can be achieved
using a predominately plant-based diet, which makes methionine restriction
feasible as a life-extension strategy. Of course, drug companies
look at this same data and think: What pharmaceuticals can we develop
to mimic these dietary interventions? Anything else to maintain muscle mass
other than greens and machines? How about cocoa beans! Older men and women randomized
to a single tablespoon (22 g) of regular cocoa
powder a day experienced a significant
improvement in muscle strength, muscle mass, and all four
tests of physical performance. And no, the study was
not funded by Hershey’s. Unfortunately, the tastiest
cocoa doesn’t work as well. The control groups here were given
the same amount of highly Dutched cocoa— alkalized cocoa, where some of the bitter compounds
removed in the Dutching process are the very flavonoids
responsible for the benefits. But natural cocoa is so good it can improve walking performance
in those with peripheral artery disease, not only by
improving blood flow, but, as muscle
biopsies showed, by improving
mitochondrial activity. This is consistent with improved
mitochondrial structure as well in biopsies taken
from people’s quads. Though this study was
actually funded by Hershey’s. What else can cocoa do? Increase the circulation
within our skin, boosting it 70 percent
within two hours, after less than a tablespoon. Do that every day and
within three months, you end up with significantly
improved skin thickness, density, and hydration,
but no change in wrinkles. However, keep it
up for six months, and you do see an
improvement in wrinkles, a significant decrease
of wrinkle depth, along with an improvement in
skin elasticity within 12 weeks— all by making your life
a little more chocolatey, by just adding some natural
cocoa powder to your daily diet. I put it in my oatmeal with some
canned water-packed tart cherries for a chocolate-covered
cherry sensation. What else can we
do for our skin? Well, there certainly
are other antioxidant, anti-inflammatory,
glycotoxin-free foods; so, when patients
inquire about a diet that might contribute
to younger-looking skin, evidence supports
a recommendation to follow a whole food,
plant-based diet. But the most important thing to
prevent skin aging is avoid the sun. Exposure to sunlight may account
for 90 percent of visible skin aging. That’s why
dermatologists agree there’s nothing more important
to slow the signs of aging than to protect your
skin from the sun. Check out this trucker, who spent years getting more
sun on the left side of his face through the driver’s
side window. So, the gold standard is considered
to be the use of sunscreens in the daytime and
“retinoids” at night. They’re talking about a prescription-
only form of topical vitamin-A, also known as
all-trans-retinoic-acid, or tretinoin
(sold as Retin-A), that has been widely proven
to improve skin appearance. The only problem is
that it may kill you. “Topical Tretinoin Therapy
and All-Cause Mortality”, a randomized controlled trial
had to be stopped early, because significantly more people
were dying in the retinoic acid group, compared to the
placebo-cream group. When applied topically, 1 to 8 percent is absorbed
into the bloodstream. Could it be
killing people? While the debate
continues as to whether the increase in deaths
was just some statistical fluke or a real biological effect, tretinoin continues to be banned
in Europe for cosmetic purposes. So, what can we use? Topical niacinamide,
also known as nicotinamide, is described as one of the best-studied
anti-aging skin cream ingredients (which is not
saying much), but it has been shown
to reduce yellowing, wrinkling, blotchiness,
and dark spots in aging facial skin, for example, significantly reducing
crow’s feet wrinkles around the eyes. This was a
split-face study in which 64 percent of the
niacinamide-side eye wrinkles had moderate or
marked improvement, compared to zero percent
of the placebo-side eyes. Topical vitamin C also offers similar
improvements over placebo in wrinkles, sallowness, and
skin tone or firmness. Unfortunately, vitamin C
is unstable in creams, turning an unsightly
brown when it oxidizes, limiting its shelf life. So instead, what the
skin care industry does, the skin care industry, they use the stable
vitamin C esters or derivatives, but there’s no evidence that these
compounds have comparable effects, likely because they’re
poorly absorbed and only minimally convert
to the active form. But the good news is you
can make your own. The 10 percent solution used in the study
retails for a ridiculous $127 an ounce (30 ml), but you can make a DIY solution
more than two thousand times cheaper by simply buying
ascorbic acid in bulk and mixing three grams
into 30 grams of water, at a cost of about
a nickel per ounce (30 ml). Drip a few drops into
the palm of your hand and use your fingertips to
apply it over your face, neck, and upper chest daily. (Just don’t get
it in your eyes.) And look, you can do the
same thing with niacinamide, which can be even
more ridiculously priced. But you can buy
it in bulk as well, at a 5,000 percent discount. I can go on and on,
and the book certainly does, but let me close out by
going back to the basics. From the anti-aging journal
Rejuvenation Research: “Finally, a regimen to extend
human life expectancy.” Was it some exotic new stem
cell treatment or gene therapy? No, it was a reference
to this Harvard analysis. More than a hundred thousand men
and women were followed for decades, and even just a few
basic lifestyle behaviors appeared to translate into 12 to 14
extra years for the average 50-year-old. Even at age 50, you may be able to add an
extra dozen years to your lifespan. Even at age 70, there could still be about
ten extra years on the table. And if you clean up
your life before 50, nearly 18 years may
be up-for-grabs, based on simple
common-sense behaviors. That’s the kind
of life extension extrapolating from some
of these lab animal experiments, but after decades of research and
hundreds of millions of dollars later, efforts to translate those results
into humans have largely been in vain. Yet, here we are
with human data suggesting dramatic life
extension is available to all of us. Right here, right now. The trillion-dollar pill that anti-aging
biotech has been promising us is here, it just effectively has to be administered
in the produce aisle and the gym. Turning back the clock,
not with a drug or a DeLorean, but just by eating and
living more healthfully. A midlife shift between
the ages of 45 and 64 to even the barest
of minimums, the barest of minimums. So, what are
we talking about? At least 5 servings of
fruits and vegetables a day, walking even just
20 minutes a day, maintaining a
healthy weight, and not smoking, can result in a substantial
reduction in mortality even in the immediate future. We’re talking a 40
percent lower risk of dying in the subsequent
four years. The researchers conclude that
making the necessary changes to adhere to a healthy lifestyle
is extremely worthwhile, and middle-age is
certainly not too late to act. You hold the power. OK. So, I was only able to
get to about 100 studies. Just 12,900 to go! For the other 99 percent,
you’ll have to wait for the book. But it’s available
for preorder now, and all proceeds I receive
from the sales of all my books are donated directly to charity. I just want you and your loved
ones to enjoy the longest, healthiest life. Thank you so much.
