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Coming up next on Passion Struck.
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In these countries, our most common and major diseases were universally rare, like heart disease.
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In the African population of Uganda, for example, coronary artery disease was almost non-existent.
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If you look at age-matched heart attack rates in Uganda versus St.
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Louis, out of 632 autopsies in Uganda, one myocardial infarction, and it was evidence of a healed myocardial infarction, so it wasn t even the cause of death.
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Yet, out of 632 autopsies in Missouri, same age and gender distribution, 136 myocardial infarctions, so 100 times the rate of our leading killer.
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In fact, they were so blown away, went back, did another 800 autopsies in Uganda, and still just that one small healed infarct out of 1,427 patients, less than one in a thousand, whereas here in the United States, heart disease is an epidemic.
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Welcome to Passion Struck.
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Hi, I m your host, Jon R. Miles, and on the show, we decipher the secrets, tips, and guidance of the world s most inspiring people and turn their wisdom into practical advice for you and those around you.
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Our mission is to help you unlock the power of intentionality so that you can become the best version of yourself.
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If you re new to the show, I offer advice and answer listener questions on Fridays.
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We have long-form interviews the rest of the week with guests ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes.
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Now, let s go out there and become Passion Struck.
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Hello, everyone, and welcome back to Episode 447 of Passion Struck.
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Consistently ranked by Apple, it s the number one alternative health podcast.
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A heartfelt thank you to each and every one of you who return to the show every week, eager to listen, to learn, and discover new ways to live better, to be better, and most importantly, to make a meaningful impact in the world.
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I am so excited to announce that my new book, Passionstruck, is a finalist for the Eric Hoffer First Horizon Award for Best Debut Book of the Year.
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And you can find it on Amazon or on the Passionstruck website.
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If you re new to the show, thank you so much for being here.
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Or you simply want to introduce this to a friend or a family member, and we so appreciate it when you do that.
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We now have episode starter packs, which are collections of our fans  favorite episodes that we organize in a convenient playlist that give any new listener a great way to get acclimated to everything we do here on the show.
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Either head over to Spotify or passionstruck.com slash starter packs to get started.
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In case you missed it, earlier this week, I interviewed psychologist, Emma Sapala and marketing expert, Neil Patel.
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In my interview with Emma, we discussed her roadmap to how you become psychologically sovereign, empowering you to break free from self-destructive beliefs and live life to the fullest.
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Also in this can t miss episode with Neil Patel, Neil reveals his secrets on the power of personal branding
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mastering audience engagement and the art of storytelling to build a lasting brand.
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We ll break down how Neil uses his setbacks as springboards and his systematic approach to becoming a powerhouse in personal branding and content creation.
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I also wanted to say thank you so much for your ratings and reviews.
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And if you loved today s episode or either of those others, we would appreciate you giving it a five-star review and sharing it with your friends and families.
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I know we and our guests love to see comments from our listeners.
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Today, we embark on a fascinating expedition into the realm of health and longevity guided by Dr. Michael Greger.
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Michael isn t just a physician.
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He s a New York Times bestselling author and a tireless advocate for public health.
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With a resume as impressive as it is extensive, he s graced prestigious platforms from the Conference on World Affairs to the halls of Congress, enlightening minds and championing the cause of wellness.
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Today, we re going to discuss his latest masterpiece, How Not to Age, a scientific approach to getting healthier as you get older.
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This groundbreaking work isn t just another book.
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It s a roadmap to defying the sands of time, backed by rigorous research and Dr. Greger s unparalleled expertise.
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This book is so extensive, it took me about three weeks to read it, but it was so well worth my time.
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From the secrets of centurions to the science of cellular rejuvenation, Dr. Greger unveils the keys to preserving vitality and embracing life to its fullest.
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Drawn upon the wisdom of the blue zones and the latest in nutritional science, he empowers us with practical strategies to unlock the fountain of youth within.
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And here s the kicker, Dr. Greger doesn t just present the evidence, he equips us with practical tools to implement these changes in our lives.
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Whether it s DIY vitamin C serums or incorporating quercetin-rich foods into our diets, the path to optimal health has never been more accessible.
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Get ready to be inspired, informed, and energized as we learn from the master himself.
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Thank you for choosing PassionStruck and choosing me to be your host and guide on your journey to creating an intentional life.
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Now, let that journey begin.
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I am absolutely honored and thrilled to have the one and only Dr. Michael Greger on PassionStruck.
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So excited to be here.
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Dr. Greger, we all have moments, I think, that define us.
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A defining moment for you was your personal experience with your grandmother s remarkable recovery from end-stage heart disease.
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Can you share with us a little bit about how her transformation influenced your perspective on the power of lifestyle interventions and promoting health and longevity?
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Absolutely.
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Yeah, that s how it all started with my grandma.
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I was just a kid.
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When my grandma was sent home basically in a wheelchair to die, she had this end-stage heart disease, so many bypass surgeries, she basically ran out of plumbing at some point.
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Confined in a wheelchair, crushing chest pain, her life was over at age 65.
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Then she heard about this guy Nathan Pritikin, one of our early lifestyle medicine pioneers, and what happened next is detailed in Pritikin s biography.
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It talks about Frances Greger, my grandmother.
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They wheeled her in, and she walked out.
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Though she was given a medical death sentence at age 65, thanks to a healthy diet, was able to enjoy another 31 years on this planet until age 96 to continue to enjoy her six grandkids, including me.
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That s why I went into medicine.
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That s why I went into lifestyle medicine, why I started this website NutritionFacts.org, why I wrote the book How Not to Die, why all the proceeds from all of my books are all donated directly to charity.
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I just want to do for everyone s family what Pritikin did for my family.
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I m going to speak to this a little bit because on this show, I have had a ton of medical professionals and a notable observation that surfaced regarding all of them is that when they go to medical school, there s a limited emphasis that s placed on nutrition in traditional Western medicine.
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Considering your background as a conventionally trained physician, what prompted your shift to focus on nutrition?
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Yeah, I mean doctors have a severe nutrition deficiency in education.
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Most doctors are just never taught about the impact health and nutrition can have on the course of illness, so they graduate without this powerful tool in their medical toolbox.
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Of course, there s also institutional barriers, time constraints, lack of reimbursement, and generally
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Doctors simply aren t paid for counseling people on how to take better care of themselves.
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Of course, look, drug companies also play a role in influencing medical education and practice.
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You can ask your doctor when the last time they were taken out to dinner by Big Broccoli.
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It s probably been a while.
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But from my personal story, I had seen it with my own eyes, and so I knew the power.
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of lifestyle, and then in 1990 the publication of Dr. Dean Ornish s Lifestyle Heart Trial proved it to the world, published in the most prestigious medical journal in the world, showed for the first time that you can open up arteries without drugs, without surgery, just a plant-based diet and lifestyle program
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and proved it with something called quantitative angiography.
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You can actually see the arteries opening up.
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We thought heart disease was irreversible.
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You just got worse, then you died.
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But first Nathan Pritikin showed that you can reverse heart disease, but he didn t have the proof in black and white.
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We didn t have that angiography technology.
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But then Ornis actually proved it.
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And look, this was 1990.
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So decades ago we proved that the number one killer of men and women
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can be prevented, arrested, and reversed with a plant-based diet, yet hundreds of thousands of people continue to die from this preventable, arrestable, reversible condition.
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That s why I went into nutrition.
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Well, thank you for sharing that.
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And you have created some incredible bestselling books.
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You mentioned How Not to Die, How Not to Diet.
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I wanted to ask you some questions about those before we go into your latest masterpiece, How Not to Age.
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I think the biggest question I want to ask is,
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If someone is here on the podcast today and they re dealing with cancer or some type of illness like that, what would be some of the most profound things that they could do right now if they wanted to positively intervene in stopping its growth?
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Well, first of all, the good news is that we have tremendous power over our health, destiny, and longevity, and that the vast majority of premature death and disability is preventable with a healthy enough diet and lifestyle.
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In terms of the single most important thing we could do is really tweaking our diet.
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According to the Global Burden of Disease Study, the largest systematic analysis of risk factors in human history,
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found that the number one cause of death here in the United States is the American diet, bumping tobacco smoking to number two.
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Cigarettes not only kill about a half million Americans every year, whereas our diet kills many more.
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But that s good news, because the power is then at the end of our fork.
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Okay.
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And if one of the types of cancers that is really increasing right now is pancreatic cancer, and it s soon to become number two on the list of taking the most lives from cancer.
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Do you have any insights into what is causing this rise with pancreatic cancer and specifically what you would do to someone who might be diagnosed with this with diet intervention?
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Yeah, pancreatic cancer is one of our most lethal cancers, though it would be hard to imagine it kind of bumping out killer number one, lung cancer, and then cancer killer number two, colorectal cancer, which really kind of far lead the field.
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But I do have, so if you go to nutritionfacts.org, I do have some videos talking about improving survival with pancreatic cancer with certain dietary interventions.
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However, by improving survival we re talking about
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extending, compared to the control group, life by a matter of months, not years.
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But still, that may be better than some of the kind of chemotherapy regimens we now have on the market, which may not improve quality of life or survival at all.
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Okay, well, thank you for that.
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In How Not to Age, you ventured into the realm of aging, and there ve been a number of books over the past year that have come out that have talked about longevity.
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There s been Lifespan, there s been Dr. Mark Hyman s book, Peter Atay s, Kara Fitzgerald s.
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What sets How Not to Age apart from those other books and your previous works?
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I really wanted it to be the most comprehensive anti-aging book ever published, covering every possible strategy for slowing the aging process for the longest, healthiest life, based on the best available balance of evidence.
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And so, I ended up with 13,000 citations.
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It took me three years.
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We have a team of 22 people working on it, churning through tens of thousands of papers.
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So, I really wanted it
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to really cover all the bases, really be kind of the reference book for this.
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I don t think any other resources really come close to the kind of comprehensive nature.
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So whether you re interested in targeting some of the aging pathways to actually slow the aging process, or just talk about preserving function, whether we re talking about bones, bowels, bladder circulation, ear, hearing, hormone balance, immune function, joint health,
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minor muscle, sex life, and skin, teeth, vision, etc.
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So some of the more kind of cosmetic areas, if you re just worried about your skin, or if you re worried about some of these more critical issues in terms of preventing, arresting, and reversing chronic disease.
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And so I really wanted to just cover everything.
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I don t think any other book has quite done that yet.
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Okay.
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And I just want to set this up for the audience because it s going to be impossible for me to go through nearly everything in your book, because when you originally wrote this, I think it was like 20,000 words and you got it to then down to 10,000 words and, or I probably have the statistics wrong.
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Order of magnitude off, but yes.
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But my point is, this is a very comprehensive book, and it s now about 600 pages, and it has some really incredible information in addition to what s in the book that the reader can go through and link out to as well.
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But the book is divided into four sections.
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The slow 11 pathways of aging is the first section.
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The second section is the optimal aging regimen.
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Third is preserving function.
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And fourth is your anti-aging eight.
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So I m going to approach this interview by kind of going through that pattern, but I m going to open it up with this question.
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Dr. Greger, there s a growing trend of older Americans, and I think people in many Western civilizations, where they re seeking out anti-aging interventions, with a significant portion of them investing in products and treatments that are touted by the industry.
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However, many of these interventions lack scientific backing.
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Can you share your perspective on this phenomenon and offer any guidance on how a person might navigate this landscape?
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Yeah, and that s really why I wrote this book, is really to cut through all that noise and nonsense.
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It reminded me of my last book on weight loss, on how not to diet.
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Both dieting and anti-aging are these multi-billion dollar industries, and with so much money in the mix, anyone seeking even basic, practical advice in either arena, living lighter or longer,
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is faced with the just inscrutable barrage of pills and potions.
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I mean, even as a physician, with the luxury of wading neck-deep through the medical literature, it s really been a challenge to tease out facts from afar.
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Look, if it took me three years to sift through all the signs, I m afraid the casual observer would just have kind of no chance.
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But the more difficult it was, the more valuable I realized this resource will eventually be.
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Well, thank you for that background.
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One of the things I wanted to ask you about is I think there s this notion we often hear about, I ve certainly have heard it throughout my whole life, that people want to end up dying from old age or that person died from old age.
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However, this concept of dying from old age
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may not be accurate as centenarians and others typically succumb to specific diseases rather than old age itself.
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What role do you believe that aging plays as the primary risk factor for the conditions many people face?
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Based on a study of 42,000 consecutive autopsies, centenarians, those that live over 100, were found to succumb to disease in 100% of cases.
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Though most were perceived, even by their physicians, to have been healthy prior to death, not one, quote-unquote, died of old age.
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They died from disease, most commonly heart disease, the number one killer of men and women in general, which is, again, great news because there s diet and lifestyle interventions that can prevent arrest and reverse it.
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And so, that s kind of a critical point to remember, though aging is a primary risk factor for many of our leading killers.
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So, for example, yes, having a high cholesterol can make you 20 times more likely to have a heart attack compared to someone with low cholesterol.
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An 80-year-old has 500 times the risk of having a heart attack compared to a 20-year-old.
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Now, the reason we talk about cholesterol
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is because it s a modifiable risk factor.
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But the question I raise in the book is what if aging was modifiable too, and then we could slow down the rate of kind of age-related diseases across the board?
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So, for example, even if all cancer was eliminated tomorrow, the average life expectancy in the United States would only go up 3 years.
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Why?
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because if you don t die from one age-related disease, you just die from another.
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The only reason you didn t die of a heart attack is because you were killed by cancer, but you were getting ready to die next month from a heart disease anyway.
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So instead of playing whack-a-mole by targeting each of these diseases, by slowing aging we can reduce the risk of heart disease, cancer, stroke, dementia, all these age-related diseases in one fail swoop.
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I love that approach and how you can deal with all of it because it s interesting.
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I have seen statistics where as much as two thirds of the population has one, if not two underlying conditions by the time most of us reach our fifties, which means that really 30 to 50% of your life, however you want to look at it, you re dealing with
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a chronic illness, which to me is sad and it s preventable.
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What is the most important thing a listener could do today if they wanted to change that perspective in their own life?
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I m glad you bring up that concept of healthspan.
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It s not just about adding years to your life, but life to your years.
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When asked how long people wish to live and offered a choice between 85, 120, 150, or indefinitely, most people, which surprised me, about two-thirds, said that they d only want to live to 85.
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When that question was reframed as, how long do you wish to live in guaranteed mental and physical health?
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Ah, then all of a sudden the most popular answer jumped to an unlimited lifespan.
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That raised this concept of healthspan, the period of life spent in good health, free from chronic disease and disability.
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What s the point of living longer if you can t enjoy it vibrantly?
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Unfortunately, here in the United States,
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We re living shorter and sicker.
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Life expectancy peaked in 2014.
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The United States has basically declined every year since, and that was before COVID kneecapped a couple years off our lifespan.
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And so we are raising the first generation
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of Americans to, on average, live shorter lives than their parents is primarily due to the obesity epidemic, leading to diabetes and other metabolic issues.
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And so, this is a critical time to have resources like this podcast to help people really take responsibility for their health.
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Again, there s tremendous power we can exercise over our health and longevity, but we need to intentionally choose to do it.
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Yeah, I love that you said that because this podcast is really about intentional choices and it s the micro choices that each of us make in the moments that fill out our day that end up changing our trajectory from either good or bad, from either the health span that you talked about to one that s filled with disease.
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So appreciate your perspective on that.
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So your book meticulously examines 11 pathways of aging.
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and it offers insights into how these processes can be slowed or disrupted.
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Can you go through perhaps two of them and how understanding their mechanisms can inform strategies for promoting longevity?
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Yeah, so that s part one of the book where I identify kind of the 11 most promising pathways for slowing the sands of time and engage with practical takeaways for targeting them naturally with diet and lifestyle.
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So boosting the anti-aging enzymes and hormones AMPK, FGF21, sirtuins, and telomerase, while suppressing the pro-aging enzymes and hormones mTOR and IGF-1, decreasing glycation, inflammation, oxidation, and senescence, while preserving autophagy, autelomeres, and slowing the so-called epigenetic clock.
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fancy-sounding scientific terms, but I really do try to break it down into the easily understandable, kind of doable, practical takeaways.
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So, just to take a few.
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So, autophagy, for example.
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is considered kind of the primary system for cleaning the body from the inside out, clearing away accumulated cellular debris that may be contributing to the aging process.
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And so, there s some food components that actually suppress autophagy, suppress this anti-aging pathway, like acrylamide, which is a toxin concentrated in potato chips and french fries, which is formed during the frying process,
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If you absolutely must have your French fry fix, air frying produces 90% less acrylamide, so that would definitely be the choice.
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There are some food components that actually boost autophagy.
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For example, chlorogenic acid, the primary antioxidant in coffee, which may explain why those drinking three cups of coffee a day have about 13% lower risk of dying from all causes put together compared to those who don t drink any coffee because of this autophagy-activating compound in coffee.
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Also, in foods,
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Something called spermidine, which out of thousands of life-extending compounds among the small subset with the fewest side effects, spermidine has the largest documented lifespan extension and is found concentrated in beans, legumes, so beans, split peas, chickpeas, and lentils, also found concentrated in white button mushrooms.
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Though the most concentrated source on a gram-for-gram basis, not on per-serving basis,
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is wheat germ, actually, and so I encourage people to add wheat germ to their daily diet to get their spermidine, which is considered an anti-aging vitamin because when we re younger we may be able to eat enough, but as we get older our levels of spermidine drop as much as 50% by the time we reach our 50 s, so we may need to start ensuring we re getting enough in our diet to ensure autophagy into old age.
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Two other ways to improve autophagy.
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One is water-only fasting.
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Unfortunately, it takes two to three days to really ramp up autophagy in human beings, and that s really too long to go unsupervised safely.
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But there s another way to activate autophagy.
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We can fast or go fast.
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Exercise induces autophagy.
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Though you have to do it enough, 60 minutes of moderate-intensity activity, like brisk walking, can boost autophagy based on muscle biopsies taken before and after, but only 20 minutes fails to move the needle.
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And so, those are some of the takeaways from my autophagy chapter.
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I don t know if there s any other.
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particular aging pathway you want to dive into, but I m happy to jump wherever you want to go.
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No, I wanted to ask you a further question on autophagy, because when I think about it, it s really your body eating itself.
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In fact, that s the Greek roots, right?
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Self-eating, right?
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Autophagy.
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And I do intermittent fasting every single day.
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Typically I fast for 16 hours and I eat during an eight hour window.
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Nice.
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I was recently listening to a podcast by Peter Thiel and he said that.
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From what he has researched, a topogy does not happen if you are fasting, unless you were fasting, he was saying, for four to five days before it kicks in, which to me would be very difficult for me to do on a routine basis.
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What is your thought on that?
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And what is your thought overall on intermittent fasting?
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Right, well, so Tia s right in that it takes days for autophagy to ramp up, although you should be able to get within two to three days, you can see, ramping up.
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But again, even that s too long to go without medical supervision, in my opinion.
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On the Internet, you ll hear autophagy activated within hours of not eating, and so they encourage people to do this kind of time-restricted feeding to boost autophagy, but that s all based on rodent studies.
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Rodents have much higher metabolism
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In fact, a couple days of fasting can be deadly for rodents, and they lose a huge amount of their body mass even just after a day of fasting.
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But in human beings, when you actually put it to the test, it does take days to ramp up.
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Thankfully, there s other ways to activate autophagy, like the aerobic exercise, which everybody should be doing anyway, along with these dietary tweaks.
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But there are other benefits to time-restricted feeding.
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In fact, in my book, How Not to Diet, the largest chapter
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on accelerating weight loss was indeed intermittent fasting, because there s so many different types.
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Alternate day fasting, 5-2 fasting, 20-5-5 fasting, mimicking diets, time-restricted feeding, etc., etc.
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Really the bottom line, although I talk about the pros and cons of each, is early time-restricted feeding has a variety of benefits.
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And so exactly like something you re doing, restricting your daily feeding window to 12 hours or less, 8 is even better, but critically important,
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It has to be earlier rather than later.
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If you skip any meal, you re skipping dinner, not breakfast.
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In general, we should try to squeeze as many calories earlier in the day as possible.
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Ideally breakfast or lunch would be the biggest meal of the day because of our circadian rhythms.
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The exact same food eaten in the evening is more fattening than the exact same food, exact same number of calories eaten in the morning.
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causes more of a blood sugar spike, triglycerides, etc.
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And so if you re going to eat junk, eat it in the morning, your body s just better able to handle it thanks to this really fascinating field of chronobiology, the effect our circadian rhythms have on our metabolism.
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Okay.
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And I happen to be researching some other podcasts you were on.
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And I heard you quote this study that was done about cardiovascular disease, where they were looking at people.
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I think it was in St.
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Louis and they ended up, I think, examining 600 patients who had died and how many of them had cardiovascular disease.
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And then they looked at the same amount of people in Africa.
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I think it was Gonda and
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I was hoping you might be able to share that because to me this illustration was just shocking between how people in Africa are eating and living and how we in the United States are.
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Yeah, it really goes back to, wait a second, where did Pritikin get this idea of reversing heart disease with this diet centered around whole plant foods?
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Well, it all goes back to this network of missionary hospitals set up by Western doctors in sub-Saharan Africa.
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which uncovered one of the most important advances in health, really according to one of the most prestigious medical figures of the 20th century, Dr. Dennis Burkitt, that the fact that in these countries our most common and major diseases were universally rare, like heart disease.
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In the African population of Uganda, for example, coronary artery disease was almost non-existent.
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You say, wait a second,
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Our number one killer, almost nonexistent, what were they eating?
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Well, they were eating lots of vegetables and greens, their protein almost entirely from plant sources, and they had the cholesterol levels to prove it, very similar to kind of modern plant-based eaters.
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And you say, wait a second, maybe the Africans were just dying early from something else, never lived long enough to have a heart attack.
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That s where that St.
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Louis study comes in.
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And so, if you look at age-matched
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Heart attack rates in Uganda versus St.
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Louis out of 632 autopsies in Uganda, 1 myocardial infarction, and it was evidence of a healed myocardial infarction, so it wasn t even the cause of death.
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Yet out of 632 autopsies in Missouri, same age and gender distribution, 136 myocardial infarctions.
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a hundred times the rate of our leading killer.
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In fact, they were so blown away, went back, did another 800 autopsies in Uganda, and still just that one small healed infarct out of 1,427 patients, less than one in a thousand, whereas here in the United States, a heart disease is
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In fact, atherosclerosis is a disease that begins in childhood by age 10.
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The arteries of nearly all children raised on the standard American diet already have what are called fatty streaks in the arteries, which is the first stage of the disease.
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These streaks then turn into plaques in our 20s, get worse in our 30s, and then can really start killing us off.
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In our heart, it s called a heart attack.
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In our brain, the same disease process can cause a stroke.
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And so, the earlier the better we can get to improve our diets, the better, but importantly, it s never too late.
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It s never too late to start eating healthier, never too late to stop smoking, to start moving,
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We really do have the power.
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So on this whole line of cardiovascular disease, one of the things that many Americans deal with is high cholesterol levels.
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And it s interesting because a lot of doctors will tell you to eat steel oats as a way to reduce it.
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But what are some of the examples that you would tell people to do if they wanted to reduce their cholesterol levels?
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Oh, steel-cut oats would be great, or even better, uncut oats, which are oat groats, what you have before you cut them two to three times to get steel-cut.
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It contains a lot of soluble fiber, which helps remove cholesterol from the body.
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The most important thing is the cut down on the three things that increase cholesterol in our bloodstream.
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One is saturated fat, which is found concentrated in meat, dairy, and processed junk.
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Number two, trans fats found in these partially hydrogenated oils, as well as meat and dairy.
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And then three, dietary cholesterol found concentrated mostly in eggs.
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The overall meat is the largest single intake in the United States just because people eat so much meat.
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And so that should bring, just reducing those three components that elevate our cholesterol, really should bring one s cholesterol down to where we want, which is if you don t have heart disease or diagnose heart disease, we really want a total cholesterol of about 150, LDL or so-called bad cholesterol down around 70.
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And that really is where the bell curve
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averages out.
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Now, because of genetic factors, you still may be high, even if you re cutting down all that junk, in which case you have to add to your diet foods that actively pull cholesterol from your system, and that s Dr. David Jenkins at the University of Toronto, the guy that invented the glycemic index, very prestigious researcher, developed this so-called portfolio diet, developing a portfolio of different foods that pull cholesterol from your body, so it s a strictly plant-based diet, but adding things like the oats, the soluble fiber foods, oats,
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slimy foods like oats and eggplant and okra, that kind of stuff, and also adding nuts for these phytosterols, and a variety of other foods.
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So, I encourage people to check that out.
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Now, beyond just dietary interventions, certainly quitting smoking will reduce your risk for cardiovascular disease, aerobic exercise.
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But the good news then, again, we have tremendous power over our risk of getting and dying from the number one killer.
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If that s the only thing a plant-based diet could do, reverse our risk of the number one killer of men and women, shouldn t that kind of be the default diet to prove otherwise?
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The fact that it is also so effective in preventing, arresting, and reversing other leading killers like type 2 diabetes and high blood pressure really seem to make the case for plant-based eating simply overwhelming at this point.
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Okay.
3
SPEAKER_00
And since we re on the topic of diet, let s talk about the second part of your book in it.
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You talk about both the Mediterranean diet and the Okinawan diet, which are two popular diets that many of the listeners might ve tried themselves.
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What are your thoughts on both of those?
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Oh yeah, well, so it turns out that based on studies of identical twins, only about 25% of the lifespan differences between individuals is due to genetics.
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So from what we can do over the majority of which we have some control, we can look to these blue zones, these areas of exceptional longevity around the world.
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where they may have up to 10 times the rate of centenarians, those reaching triple digits.
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And so two of those, as you mentioned, actually three of those, two in the Mediterranean and one in Okinawa, have been found.
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So Okinawa Japanese is the second longest-living formally studied population in the world.
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The only population living longer than that is actually the red, white, and blue zone, which is in Loma Linda, California, the seven-day Adventists, the vegetarian seven-day Adventists in Loma Linda, California, which actually live the longest compared to anybody.
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And it s actually the only blue zone that survives to this day.
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Unfortunately, all these other blue zones are really kind of historical artifacts of history.
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But were they all share in common?
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is that regardless of which of these five blue zones that have been documented, they all center their diets around whole plant foods.
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So, they re minimizing their intake of meat, dairy, sugar, eggs, salt, processed junk, and maximize the intake of fruits, vegetables, whole grains, these legumes, beans, split peas, chickpeas, and lentils, nuts and seeds, herbs and spices, mushrooms, basically real food that grows out of the ground.
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These are our healthiest choices.
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Yeah.
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I actually saw another program where one of your tips of advice would be before you eat a meal, perhaps start with an apple and a glass of water.
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SPEAKER_00
Oh, absolutely.
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That s in How Not to Diet.
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SPEAKER_01
Very cool.
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Yeah.
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This negative calorie preloading.
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And so eating an apple before a meal
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cuts down kind of average caloric intake by 200 calories a meal.
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You eat 200 calories less of the meal, you feel just as full eating 200 calories less.
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And so look, I mean an apple may only have 50 calories, right?
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So you basically, if you re eating an apple before a meal, the apple has like negative 150 calories, right?
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It s like drawing calories out of your body.
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Same thing with eating a low-energy density vegetable soup or something.
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By eating soup before a meal, you are going to feel just as full, cutting down on calories.
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You re going to have hundreds of calories sucked out of your body, veritably, and even just drinking water.
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So before a meal,
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has been shown, you can randomize people to drink water before meals or not, and you can get a significant acceleration of weight loss, and that s from a number of different mechanisms.
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But yeah, so negative calorie pre-letting is one of my so-called 21 tweaks of all the things that have been shown in randomized controlled trials to accelerate the loss of body fat.
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And I love it.
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And I think it s really interesting.
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I m just going to go back to blue zones for a second, because you mentioned the diet that they follow.
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The other thing that I think is pretty remarkable is there s two other things that I ve studied that they do.
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One is the concentration on the importance of relationships.
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and the connections that they have with each other in the blue zone.
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And the other one that really ties into this is that they have a profound sense of purpose in when they get out of bed, what they re doing in their life that brings them fulfillment.
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So it seems like it s
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this combination of the diet relationships and having this overwhelming sense of purpose that really helps as well to increase this age and healthspan.
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They also have regular daily exercise, tend not to smoke, so there s other factors, though diet appears to be the principal component, alone accounting for half the difference in lifespan between blue zones and the rest of the world.
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But I m glad you brought up about social isolation and loneliness, both associated with higher mortality rates,
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For example, marriage appears to carry a survival benefit, but the apparent detrimental effects of social disconnection and bereavement may be mediated by refraining from substance abuse like alcohol and tobacco.
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And when people are stressed,
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When people are lonely, they tend to eat more food, less healthy food, more likely to do illicit substances or alcohol, tobacco.
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And so that is much of the— which is kind of good news, meaning that as long as you re able to maintain your healthy habits, you can be stressed and lonely without it affecting your lifespan if you re able to maintain those healthy habits.
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But unfortunately, they tend to go together.
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And Dr. Greger, I want to jump to part three of the book called Preserving Function.
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And here you cover everything from preserving bones, bowel and bladder function, circulation, hair, hearing, immune system, joints, mind, muscles, sex life, et cetera.
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I wanted to just hit on a couple of these.
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So the first one, I think when a lot of people feel like they re aging,
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I think bone strength is one of the things that comes top of mind.
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So I was hoping you might be able to talk about how do you preserve your bones?
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Yeah, some of the takeaways from that chapter.
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First of all, stomach acid-blocking drugs like Prevacid, Prilosec, people often overuse for acid reflux can increase the risk of bone fractures.
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I don t think a lot of people know that.
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So can tobacco and heavy cannabis use, associated with increased fracture risk.
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These bisphosphonate drugs, like Fosamax, the most commonly prescribed drugs for osteoporosis, may help prevent hip fracture risk in high-risk individuals, but come with these rare serious side effects.
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So I encourage people to look at the pros and cons and see if it makes sense for you.
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Calcium supplements are actually not recommended for most individuals due to their poor efficacy and poor safety records.
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We should, however, strive to get 600 mg of calcium a day from calcium-rich
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Non-dairy food sources, and the reason non-dairy is because meta-analyses show high milk consumption not only does not appear to protect against hip fracture, but is associated with premature death, probably because of the galactose, which is a breakdown product of lactose.
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Inadequate sun exposure should consider supplementing their diets with 2,000 international units of vitamin D a day, the sunshine vitamin.
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Prunes, onions, tomatoes, and almonds, and large quantities of fruits and vegetables appear to have bone protective effects.
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However, alcohol, soda, and coffee, though evidently not tea, appear to increase osteoporosis fracture risk.
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Soy phytoestrogens may be safer than estrogen hormone therapy.
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For preserving bone, you can randomize people to soy milk or regular milk and see an improvement in bone mineral density.
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compared to the dairy milk group.
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And finally, though weight-bearing exercise can certainly improve bone strength, since most of the osteoporotic fractures are a function of falls, not bone density, fall prevention is the single most important intervention
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which is good news because we can actually do something about it.
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Primarily a combination of lower limb strength exercises and balance training can significantly reduce the risk of fractures.
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There s been seven randomized controlled trials showing that.
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So we really do have tremendous power over whether or not we re going to break your bones and all those deleterious consequences that follow from that.
4
SPEAKER_00
Well, thank you for that.
4
SPEAKER_00
And I think another important one is preserving your mind, which I think there s been a lot of discussion about Alzheimer s and dementia and its rise.
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And so I think this is a hot topic for many people.
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No, absolutely.
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In fact, it is the most feared condition of later life and tremendous public health challenges.
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In high-income countries, heart disease is killer number one.
4
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Dementia is killer number two.
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But, though Alzheimer s may be incurable, at least it is preventable, and that is the good news.
4
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Modifiable lifestyle factors outweigh the genetic component of Alzheimer s disease.
4
SPEAKER_01
Alzheimer s is related to the atherosclerotic plaque buildup in the brain.
4
SPEAKER_01
So the same dietary changes that can help with cardiovascular health can also help with cognitive health.
4
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In other words, what s good for the heart is good for the head.
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So normalizing blood pressures, for example, in hypertensive individuals can help prevent cognitive decline.
4
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Aerobic exercise.
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can improve brain function in both normal and cognitively impaired individuals.
4
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Part of that is by boosting something called brain-derived neurotropic factor, which can also be boosted by meditation, caloric restriction, reducing saturated fat intake, and eating high flavonoid fruits and vegetables, so that s these colorful fruits and vegetables like beans.
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berries, greens, and rye groats, also high in flavanols.
4
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Non-vegetarians have about 2 to 3 times higher risk of becoming demented.
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SPEAKER_01
So, maybe that s because of the saturated fat or oxidized cholesterol, some of the pollutants like DDT in the diet that may increase our risk of cognitive dysfunction.
4
SPEAKER_01
So, the best kind of dementia-deterring diet would be low in added sugars, low in added salt, low in saturated fat, animal products, processed foods, and high in those whole plant foods, particularly
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greens, beans, and berries for reducing our risk of dementia.
4
SPEAKER_00
OK.
4
SPEAKER_00
And I want to just cover one more that I think a lot of people worry about, and that is their sex life as they get older.
4
SPEAKER_00
So what are your tips there?
4
SPEAKER_01
In terms of sex life, something that I had never heard of before, there s a distinctive body odor of the elderly due to a chemical we start producing as early as age 40 called tunonanol, which has this unpleasant grassy, greasy kind of odor, which is caused by the oxidation of omega-7 fats, which are increasingly exuded from our skin as we age.
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But the good news is we can cut that odor by eating two things.
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One, mushrooms.
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Randomized controlled trials have shown mushrooms can help, as well as chlorophyll-rich
4
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dark green leafy vegetables.
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So in terms of smelling better as we age, which may have to do with romantic life.
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SPEAKER_01
In terms of function, sexual responses for both women and men are related to blood circulation.
4
SPEAKER_01
So again, dietary and lifestyle changes that are good for the heart, also good for the genitals.
4
SPEAKER_01
And indeed, men and women randomized to healthier diets can experience significant improvement in sexual function, and this may be due to the anti-inflammatory effects.
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SPEAKER_01
the blood vessel dilating compounds in certain fruits and vegetables like watermelons and beets, or lowering the phthalates and BPA exposure that we may find these plastics, chemicals that are found in a lot of processed foods.
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SPEAKER_01
In terms of sexual desire, there s a dangerous and ineffective drug prescribed for women called filceraban.
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SPEAKER_01
which should be avoided.
4
SPEAKER_01
Similarly, there s not enough safety data to prescribe testosterone for women to warrant FDA approval.
4
SPEAKER_01
However, what has been shown to help improve sexual desire in women, which is one of the main complaints with aging for women in sex life, is lavender and bitter orange aromatherapy may help.
4
SPEAKER_01
In terms of some mental testosterone can help low libido in men, though the risks likely outweigh the benefits.
4
SPEAKER_01
Thankfully, there are
4
SPEAKER_01
safe natural ways to boost testosterone with diet and lifestyle changes, such as eating less than a teaspoon a day of fenugreek seeds, avoiding obesity, avoiding sleep deprivation, and beer.
4
SPEAKER_01
Actually, beer lowers our testosterone levels.
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SPEAKER_01
The spice saffron can improve sexual impairment caused by these SSRI drugs like Prozac.
4
SPEAKER_01
Maca root can improve sexual desire in men and sexual function in women.
4
SPEAKER_01
Ashwagandha, another root,
4
SPEAKER_01
may improve some aspects of sexual dysfunction, but there s a risk of liver toxicity, so I actually encourage people not to use it.
4
SPEAKER_01
About half of postmenopausal women experience something called the genitourinary syndrome of menopause, first-line treatment of which are low osmolality vaginal moisturizers and lubricants, and I talked about the few brands that actually fit the bill in terms of safety.
4
SPEAKER_01
The second-line treatments are topical hormones,
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Intervaginal estrogens, DHEA.
4
SPEAKER_01
Vaginal estrogen is safer and more effective than to manage these vaginal symptoms than oral hormones, and oral DHEA doesn t appear to work at all.
4
SPEAKER_01
However, oral fenugreek and topical fennel creams can improve sexual symptoms in postmenopausal women.
4
SPEAKER_01
And finally, in terms of erectile function, smoking cessation
4
SPEAKER_01
Weight loss and physical activity can help with erectile function.
4
SPEAKER_01
Though one type of exercise, prolonged cycling, can actually make it worse because you re pressing on that pudendal nerve.
4
SPEAKER_01
Men should know about the drugs like Viagra can have both short-term and long-term adverse effects, and so you want to weigh the pros and cons.
4
SPEAKER_01
And though ginseng doesn t have any effect on female sexual dysfunction, Korean red ginseng can significantly improve erectile function in men.
4
SPEAKER_01
I think those are kind of the main takeaways in this sex life chapter.
4
SPEAKER_00
Okay.
4
SPEAKER_00
Well, thank you for sharing that.
4
SPEAKER_00
And the fourth section goes into your anti-aging eight.
4
SPEAKER_00
And these are things such as nuts, green berries, micro RNA manipulation, probiotics and probiotics, caloric restriction, et cetera.
4
SPEAKER_00
And I wanted to just go through a few of these.
4
SPEAKER_00
The first one I wanted to talk about because it s something that much of the audience might not be familiar with is xenohormosis.
4
SPEAKER_01
Oh, so interesting, right?
4
SPEAKER_01
So yeah, xenohormosis and actually microRNAs represent these kind of cross-kingdom communication pathways between plants and animals that we may be able to use to our advantage, providing both a reminder and mechanism for the importance of exercise and centering one s diets around these kind of unprocessed plant foods.
4
SPEAKER_01
Hormetic stress is the—hormesis is that which doesn t kill you, makes you stronger principle.
4
SPEAKER_01
Hormetic stress explains the health and longevity benefits of exercise.
4
SPEAKER_01
So exercise actually causes little micro tears in our muscles, actually causes damage to our body, but in our body s repair we actually end up better than we started out with, also can help
4
SPEAKER_01
the benefits of caloric restriction, as well as certain foods and beverages like broccoli and green tea.
4
SPEAKER_01
So, for example, green tea, you think of as an antioxidant beverage, is actually a pro-oxidant beverage, but it has overall antioxidant effects because it ramps up your body s antioxidant defenses.
4
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Same thing with broccoli.
4
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Our body sees broccoli as this invading compound and boosts our defenses, so we actually end up better off than we would otherwise.
4
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The xenohormesis comes in, and it s just like antioxidants,
4
SPEAKER_01
can be kind of commandeered from plants for our own benefit, so might these xenohormetic stress compounds like polyphenols, which can actually help affect by modulating this microRNA expression.
4
SPEAKER_01
So, there s been this kind of failure of kind of isolated phytonutrients in supplements to replicate the benefits of whole plant foods.
4
SPEAKER_01
And that may be due for a variety of things.
4
SPEAKER_01
Maybe people are overdosing on these supplements, or the lack of synergistic reactions between the thousands of different compounds in foods that are actually as grown.
4
SPEAKER_01
But there also may be this kind of manipulation of human gene expression by these xenomicroRNAs, again, a way in which there s this kind of genetic communication
4
SPEAKER_01
between plants and animals, which is a fascinating field.
4
SPEAKER_01
This is something that wasn t even discovered by the time I graduated medical school.
4
SPEAKER_01
It really challenges the central dogma of biology, but really helps explain why, oh my God, no wonder these foods are good for you, these foods are bad for you, because they actually affect the gene expression within our body.
4
SPEAKER_00
And I think another one that people might be interested in is the role of prebiotics and probiotics in supporting gut health and longevity.
4
SPEAKER_01
Oh yeah, oh, so fascinating.
4
SPEAKER_01
The problem historically with kneeling down
5
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this interaction was because foods that are good for our gut are good for us generally.
5
SPEAKER_02
So when you eat a lot of prebiotics, that which feed our healthy gut flora, where are the resistant starch, dietary fiber, where is that found?
5
SPEAKER_02
Oh my God, really healthy foods, right?
5
SPEAKER_02
So eating kidney beans or something.
5
SPEAKER_02
And so I said, wait a second, eating kidney beans helps health, but yeah, is there a microbiome interaction or not?
5
SPEAKER_02
Well, we didn t know until these fecal transplant studies come along where you can actually transplant
5
SPEAKER_02
the microbiome between people, between animals, doesn t actually prove cause and effect.
5
SPEAKER_02
And so you take mice that are genetically manipulated to have better exercise fitness, and you transplant their microbiomes to other mice, you can actually get an improvement in aerobic capacity, proving that, oh my god, even our microbiome even plays a role in our physical fitness.
5
SPEAKER_02
And so basically prebiotics, like the resistant starch and dietary fiber, feed our probiotics, which are the good bacteria themselves, the acidophilus, the bifidobacteria,
5
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that make beneficial postbiotics like butyrate and acetate.
5
SPEAKER_02
That s why probiotics are so good for us because they create these byproducts that are then absorbed through our colon wall, circulate throughout our bloodstream, cross the blood-brain barrier,
5
SPEAKER_02
and actually can affect our mental health as well, decreasing inflammation, boosting our immune function, etc.
5
SPEAKER_02
However, feeding the wrong foods can actually foster the growth of bad bacteria, which create toxic postbiotics like TMAO, this trimethylamine oxide.
5
SPEAKER_02
The bottom line is our health is inextricably linked to the health of our microbiome, and these fecal transplant studies prove.
5
SPEAKER_02
that a preponderance of health-promoting bacteria in the colons of centenarians may not just be kind of a biomarker, but actually an active promoter of healthy aging.
5
SPEAKER_02
You do fecal transplant studies, you feed mice the poop from a centenarian, and they actually live longer, proving that, oh my god, there s some longevity benefits of the microbiome.
5
SPEAKER_02
Intestinal dysbiosis, meaning having a bad mix of bacteria in the gut, may actually accelerate aging via leaky gut, but we can seal up a leaky gut with the short-chain fatty acids produced in response to fiber-rich diets, adequate zinc intake, reduced exposure to alcohol,
5
SPEAKER_02
and reduce exposure to these NSAID drugs like aspirin and ibuprofen, which can play havoc with our gut lining.
5
SPEAKER_02
And then we can prevent the dysbiosis, this bad mix of bacteria, in the first place by reducing unnecessary exposure to antibiotics, including antibiotic residues in typically industrially produced meat, reducing our intake of excess sulfur-containing amino acids like cysteine methionine,
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found concentrated in certain foods like dairy, decreasing our intake of certain artificial sweeteners and emulsifiers, which can interfere with our microbiome, as well as maximizing the intake of these fermentable carbohydrates like the fiber and resistant starch, which we can t actually digest, but so it makes it all the way down to our colon and creating this kind of prebiotic bounty for our good gut bugs.
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In terms of decreasing TMAO levels,
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That s reducing our intake of animal products and carnitine supplements.
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So, there s carnitine found in some kind of energy drinks.
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That s another thing that can create, that can foster the growth of these bad bugs.
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In terms of, well, why feed our good gut bugs when we can just take good gut bugs by eating probiotic supplements?
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Unfortunately, they have been generally found to have questionable safety, efficacy, and purity on the market.
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And so, really the best way to go about it is by eating prebiotics.
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With our good gut bugs eaten, they can be fruitful and multiply,
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and create an environment by which they can do well.
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In fact, we have randomized controlled trials where you give people, randomized people, the prebiotics of placebo and can significantly improve muscle strength in frail individuals, significantly improve exhaustion.
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And so, these prebiotics are found in these unprocessed plant foods.
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And then there s other prebiotics, which many people haven t heard of.
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Urolithins are found concentrated in certain foods like pomegranates that can help explain the health benefits of a diversity of whole plant foods.
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Well, I appreciate that whole perspective.
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And the other thing I like to tell people is through the work of Chris Palmer and others now, we re also seeing the link between gut health and mental health as well.
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Yeah.
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Fascinating.
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Absolutely fascinating.
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Right.
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So you can like the anti-inflammatory effects.
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You can decrease asthma attacks in individuals by feeding their microbiome.
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And you get this, the butyrate in the system, which suppresses the excess inflammation.
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Really remarkable effects.
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And we used to think our good gut box is just about digestive health.
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right?
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Reducing intestinal inflammation.
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But now we know that these compounds circulate throughout our body, across the blood brain barrier and can have effects really across the board.
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Okay.
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And then I had one last question for you.
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We talked about coffee a couple of times today.
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And the other thing I wanted to mention was red wine, because these are two things that people love.
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What s your thoughts on each in the role of promoting longevity?
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In my chapters in How Not to Die on liver disease, depression, and Parkinson s, I talk about the benefits of coffee for the liver, mind, and brain.
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Coffee drinkers do live longer and have lower cancer rates overall, although not for everyone.
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Coffee can worsen acid reflux disease, bone loss, and glaucoma.
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Otherwise, though, coffee is good for you, though every cup of coffee is a lost opportunity to drink something even healthier, which is a cup of green tea.
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So three cups of coffee a day associated with 13% lower risk of all-cause mortality, three cups of tea every day associated with 24% lower risk.
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So tea is better, though they work through entirely different mechanisms.
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The coffee is an autophagy-boosting effect, whereas the green tea is this hormetic antioxidant defense-strengthening strategy.
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So presumably both would be kind of additive, and so it s not kind of either-or, but you could kind of start out with coffee in the morning, switch over to green tea, and then switch over to decaf or herbal tea later on.
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I talk about the benefits of honeybush tea, rooibos,
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chamomile for their various anti-aging properties.
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But then in terms of alcohol, everyone agrees that heavy drinking, drinking during pregnancy, binge drinking, bad ideas.
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But there s been this controversy about moderate drinking.
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Those who tend to live the longest are not the abstainers who drink zero alcohol, but those who imbibe a few drinks a week.
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Unfortunately, this appears to be an artifact of the so-called sick quitter effect.
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which arises from the systemic misclassification of former drinkers as if they were lifelong abstainers.
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It s the same reason sometimes you see higher mortality rates among those who quit smoking compared to those who continue to smoke.
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Why?
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Because why did they quit smoking?
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Ah, they got sick.
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So, of course, no wonder those
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that aren t smoking, these quitters, these new quitters, have even worse health.
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So, it s not the abstention led to poor health, but rather the poor health led to abstention.
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So, when you go back and control for that sick-quitter effect,
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then unfortunately that so-called J-curve disappears, and there s just this kind of dose-response increase of more disease with more alcohol with no apparent protection at lower levels of consumption.
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So, according to the Global Burden of Disease Study of the World, Health Organization of the World, Heart Federation, the safest level of drinking is, sadly, none.
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Grapes, barley, and potatoes best eaten in their non-distilled form, and Johnny Walker, no substitute for actual walking.
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Well, thank you for sharing that.
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And where would be the best place the audience can go if they want to learn more about you and your work?
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Oh, they can go to nutritionfacts.org, where all my work is available free.
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There are no ads, no corporate sponsorships, strictly non-commercial, not selling anything, just put it up as a public service, as a labor of love, as a tribute to my grandmother.
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Well, Dr. Greger, thank you so much for joining us today.
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It was such an honor to have you.
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I m so happy to be here.
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Looking forward to coming back on after my next book, which will be on cancer.
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Oh, fantastic.
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Would love to have you back to discuss that.
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I thoroughly enjoyed that interview with Dr. Michael Greger, and I wanted to thank Michael, Flatiron Books, and Fortier for the honor and privilege of joining us on today s show.
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Links to all things Dr. Greger will be in the show notes at passionstruck.com.
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You re about to hear a preview for a special Passionstruck Podcast interview that I did with astronaut Steve Ballen, a true hero from the depths of the ocean to the reaches of outer space.
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We ll delve into the critical moments and the decisions that propelled Steve s career to another hemisphere.
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He ll share how he tackled self-doubt and the unexpected twists on his path to the stars from record-breaking spacewalks
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to seeing Earth s fragile beauty, Steve brings a fresh perspective on the highs and the lows of space exploration.
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I was literally on top of the space station.
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We were installing an antenna on top of the space station.
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And so I kind of clipped myself in and got my hands free and sat back and watched the world pass below me for about 25 minutes or so.
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And what struck me was the reality that what kind of civilization do we have that allows us, all these countries working
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together to put people in space, not just to go to space, but really to research and challenge ourselves and to explore and to really improve life on Earth.
6
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I grew up carrying buckets of cement for my dad.
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It was not anything I could conceive of to be
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sitting on top of the space station, installing an antenna.
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Sometimes I think we all have to stop and take a look, look around us, look at our environment, just look at the civilization we have, we re living in.
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It may seem in such turmoil on any given day, but really billions of people are living together and getting along.
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And that s remarkable.
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And I don t think we necessarily appreciate those aspects of it.
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We actually can solve problems when we all work together.
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We actually can
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take care of this incredible planet.
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We challenge ourselves to understand it and understand how to make it work.
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The fee for this show is that you share it with family or friends when you find something helpful or useful.
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And if you found this episode with Dr. Greger useful, then definitely share his advice on graceful aging with those that you love and care about.
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In the meantime, do your best to apply what you hear on the show so that you can live what you listen.
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Now, until next week, go out there and become passion struck.