#226: Michael Greger, MD -How Not to Age
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Dr. Michael Greger is back with a barnburner of a new book, How Not to Age: The Scientific Approach to Getting Healthier as You Get Older.
We know none of us love the idea of feeling older, but it doesn’t mean getting sicker.
As we say here at PLANTSTRONG, we do have a powerful influence on our aging process with what we eat – and the 13,000 studies that Dr. Greger cites in his new book show us that, once again, it’s plants for the win!
Today, Dr. Greger shares some of this research and a slew of great advice to improve your longevity and healthspan, and keep you feeling vibrant for years to come.
Dr. Greger's book covers multiple strategies for slowing the aging process and offers practical advice based on the overwhelming evidence and research. With so much misinformation in the anti-aging industry, his goal is to separate fact from farce and provide readers with reliable information.
Rip and Dr. Greger discuss the details of preserving various aspects of our health, including bones, teeth, circulation, hair, vision, immune function, and more. They also touch on Dr. Greger’s Anti-Aging 8 -foods like nuts, greens, and berries that can improve your longevity.
As he says, this new book will not only add years to your life, but life to your years.
Episode Highlights:
0:00:41 Introducing Dr. Michael Greger and his new book
0:10:49 How Not to Die: A Three-Year Journey
0:14:06 Your Best Regimen: A Whole Food Plant-Based Diet
0:16:28 Dr. Greger’s Recommended Beverages: Coffee, Green Tea, Water
0:19:17 Exercise: Aim for 90 Minutes of Moderate Activity
0:25:31 Maintaining a Healthy Lifestyle to Preserve Function and Longevity
0:27:27 Decreasing periodontal disease with a plant-based diet
0:30:25 Preserving vision with dietary changes and supplements
0:33:21 The importance of vitamin B12 and the surprising truth about vitamin D3
0:35:46 The Anti-Aging Eight: Legumes, Nuts, Dark Green Leafy Vegetables, Berries and more!
0:38:03 Tongue Scraping and Prebiotics: Activating Nitrate-Activating Bacteria
0:40:32 The Impact of Protein Intake on Health and Cancer Risk
0:45:06 The Benefits of Spermidine and Ergothioneine in Wheat Germ and Mushrooms
Order How Not to Age
About Michael Greger, MD
A founding member and Fellow of the American College of Lifestyle Medicine, Michael Greger, M.D., is a physician and internationally recognized speaker on nutrition. His science-based nonprofit, NutritionFacts.org, offers a free online portal hosting more than 2,000 videos and articles on myriad health topics.
Dr. Greger is a sought-after lecturer and has presented at the Conference on World Affairs and the World Bank, testified before Congress, and was invited as an expert witness in Oprah Winfrey’s defense in the infamous “meat defamation” trial. A graduate of Cornell University School of Agriculture and Tufts University School of Medicine. Dr. Greger is also an acclaimed author. How Not to Die, The How Not to Die Cookbook, and How Not to Diet became instant New York Times Best Sellers. More than a million copies of How Not to Die have been sold. All proceeds Dr. Greger receives from the sales of his books and speaking honoraria are donated directly to charity.
Episode Resources
NutritionFacts.org Website - https://nutritionfacts.org/
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Full Transcription via AI Transcription Service
0:01] I'm Rip Esselstyn and welcome to the PLANTSTRONG Podcast.
The mission at PLANTSTRONG is to further the advancement of all things within the plant-based movement.
We advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands, promotes, and prescribes plants as a solution to empowering your health, enhancing your performance, restoring the environment, and becoming better guardians to the animals we share this planet with.
We welcome you wherever you are on your PLANTSTRONGjourney, and I hope that you enjoy the show.
Introducing Dr. Michael Greger and his new book
[0:42] He's back! That's right, the man, the myth, the legend, the hero who can walk 14 miles a day on treadmills while simultaneously citing hundreds of recent studies.
The doctor who can churn out books faster than a speeding train.
Yes, he's Superman. Our Superman.
Dr. Michael, put it to the test!
Gregor, and he is here with us today to celebrate and discuss the launch of his new book, like how not to age.
When Dr. Greger started digging into the medical research on aging, he discovered the profound impact that diet has on combating the effects of aging and chronic illness.
Look, I know none of us loves the idea of feeling older, but getting older doesn't mean getting sicker.
And as we say here a lot at PLANTSTRONG, we can have an enormous influence on our aging process with what we eat.
And the 13,000 studies that Dr.
Greger cites in his new book show us that once again, it is plants for the win.
[2:01] Today, Dr. Greger and I talk about his research and a slew of anecdotes from how not to age to improve your longevity, healthspan, and keep you feeling vibrant for years to come.
Please welcome to the PLANTSTRONG Podcast, Dr. Michael Greger.
All right, Dr. Michael Greger. In the house, ready to rock and roll and do this.
In the house, almost in the flesh, not quite.
[2:33] Man, it is so good to see you. I take it you're at home right now on the treadmill?
I am at home on the treadmill, and you know, if that pesky TSA would let me get a good security, I could have it everywhere. Wouldn't we love that?
[2:51] So you, you just don't know how to sit still, do you?
I mean, I think since 2015, you've now written four different books, how not to die, how not to diet, how to survive a pandemic.
And then most recently, this puppy is hot on the presses, how not to age.
And I love what you say here at the top, the scientific approach to getting healthier as you get older, because most of us don't think that that's possible, but you're here to tell us that we can, right?
I'm here to tell you that we have tremendous power over our health destiny and longevity.
The vast majority of premature death and disability is preventable with a healthy enough plant-based diet and lifestyle. That's the good news.
It's fantastic news. Now, your dedication in and how not to die was to your grandmother, Frances Greger.
Your dedication and how not to age was to your great aunt Pearl.
Why? What did she mean to you? Oh my God. Yeah, yeah, yeah.
She, I mean, she's, you know, it's nice to be able to sit down with relatives and ask them, you know, so how was the 1918 pandemic for you?
[4:06] She was a little girl back then, but yeah, yeah, no. It's inspirational, you know, I mean, why, you know, learn about history from books, when you can get it straight from the source?
Yeah, yeah, it's funny, my mom and dad actually grew up as next door neighbors.
And so I have both sides of my family readily accessible anytime I go back to New York.
That's beautiful. So why did you decide to write How Not to Age?
Well, you know, my aim was to create the most comprehensive anti-aging book ever written covering every possible strategy for slowing the aging process for the longest, healthiest life based on the best available balance of evidence.
And I wrote it because there's just this mess of misinformation out there.
You know, it reminds me a lot of How Not to Diet, the weight loss book.
You know, I mean, both the diet and anti-aging industries are, you know, of these multi-billion dollar behemoths, and with so much money in the mix, the temptation to promote products purporting all sorts of preposterous claims is apparently irresistible.
[5:23] And so, even an educated layperson seeking just like basic practical advice in either arena, living longer or living lighter, is faced with just this inscrutable barrage of pills and potions, even as a physician with the luxury of, you know, to be able to wade through the peer-reviewed literature on the topic, it's really been a challenge to kind of separate the naked truth from kind of, you know, the emperor's garb.
But, you know, look, every time I ran into an impasse like that, I'd be like, look, That's what makes this work so much more important.
If it took me years to sit through all the science, I'm afraid the casual observer would just have little hope in kind of separating facts from farce.
[6:13] Well, it seems that the age old gerontology debate is, do we die from aging or do we die from disease?
Do you feel like you were able to put that to bed at all? Oh, yeah. So that was interesting.
I talked about that in the introduction, where there's no such thing as dying from old age.
So there was 14,000 consecutive autopsies.
And in every single case, centenarians died from disease, even though they were seen to be perfectly healthy, even by their physicians before death, when you actually cut them open up, They all died of disease, most commonly heart disease, the most common cause of death, not only of centenarians, but of men, women in general.
[6:55] And so you say, well, wait a second, if we're all dying from disease, then why wasn't my book, How Not to Die, all the anti-aging book anybody needs, right?
Because it was just first half of the book, it's just 15 chapters, each of the 15 leading cause of death, talk about the role of diet, may play in preventing, arresting, and reversing each of them. So what else is going on?
But then the other side of the debate is aging is a risk factor for all of these age-related diseases, like the cancers, and dementias, and heart disease, et cetera, such that even if we were to cure all cancer from the face of the earth, our life expectancy overall would only go up three years. Why?
Because if you don't die of cancer, is going to drop dead of a heart attack or some other age-related disease.
So yes, those with high cholesterol can have up to 20 times the rate of heart attacks compared to some with lower cholesterol, but an 80-year-old has 500 times the risk of having a heart attack compared to a 20-year-old.
So age plays a role. So if we are able to slow down the pace of aging.
[8:12] Then we may be able to reduce the risk of all these diseases across the board.
So that was really the promise that drew me into the book. And I was so excited to find all sorts of real practical, easy ways that we can target these 11 pathways of aging.
[8:31] You actually, I think it's in the introduction, you say that.
Not very many people have the luxury of dying, or I should say aging successfully.
I think the number, the percent was 18%.
That's not very good. Right. And I mean, those criteria, I don't know if you look at those criteria, but it's like, you know, being able to stand unassisted, right?
Like that's a great theory. Or, you know, being able to walk a quarter of a mile, right?
And so, you know, there are definitions of function and it's pretty kind of a pretty low bar, but that definitely does bring this concept of healthspan, not just lifespan.
It's not just about adding years to your life, but life to your years.
You know, it's funny when asked if people wanted to, they were given a multiple choice.
How long do you want to live? The choices were 85 years old, 120, 150, or indefinitely.
And to my surprise, what did most people choose? 85.
[9:30] Like what? Why are you short-chaining yourself? of ah, but then they changed the wording to be like how long do you wanna live in guaranteed physical and mental health?
Oh, then all of a sudden, boom, indefinitely. Most people switch to, well, I wanna live as long as I wanna live.
And so that really brings this, brings the health span, that period of life spent in good health free from chronic disease and disability.
And what's the point of living longer if you can't live it vibrantly?
And so here in the United States, we're living longer, we were up until 2014, but we're living sicker.
So more years in disability, even though technically more alive for longer.
Then 2014, life expectancy peak in the United States started to decline, such that we're raising the first generation of Americans living shorter lives than their parents.
And then COVID hit, shaved another two years off.
And so we could use a little help here. I hope my book will play a small role in that.
Oh yeah, and you have an inordinate amount of citations in this one compared to your How Not to Die and How Not to Die. How many do you have?
So yeah, it ended up 13,000. So I thought How Not to Die was 3,000.
How Not to Die: A Three-Year Journey
[10:49] And then How Not to Die came out with 5,000. Now 13,000. Took me three years to write the book.
I had no idea there was so much in the aging literature.
And so next time, I do this every time. I'm like, OK, next time I'm going to give myself more time to write this book.
But I don't know. But yeah, I'm planning on taking a whole extra year for the next book just because I don't want to run into the same problem I did, where it's just absolutely overwhelmed by the science.
And I just can't stand the thought of missing anything.
You know, I mean, I want, I really want it to be absolutely comprehensive.
Like you can look up any supplement, any, you know, function, any, anything, or look, I want to preserve my hearing.
I want to preserve my bones. I want to preserve my whatever I want to have it all in there.
So yeah, it was quite the project. I'm really proud of how it came out.
Are you already thinking about what your next book is going to be?
Oh yeah. Yeah, we're starting it in June 2025.
[11:46] Wow. And it's gonna be on cancer survival. Oh my goodness gracious.
So this book is broken up into four parts.
Can you kind of outline for the audience what those four parts are?
And then I'd love to dive in just a little bit into each one. Sure, sure, sure.
Yeah, so part one, I identify the 11 most promising pathways for slowing the sands of time, each ending with kind of practical proposals for targeting them naturally with diet and lifestyle changes.
So basically we're boosting the anti-aging enzymes and hormones like AMPK, FGF21, SIRT1, scolomerase, suppressing the pro-aging enzymes and hormones like mTOR and IGF1, all the while decreasing glycation, inflammation, oxidation, senescence, while preserving autophagy, artelomeres, slowing the epigenetic clock.
I know these all sound kind of like, you know, a lot of science-y sounding terms, but I really do try to break it down into, you know, kind of understandable, doable, practical takeaways.
[12:49] Then part two delves into, you know, the secrets of the longest, healthiest living populations around the world.
So, you know, based on studies of identical twins, only about 25% of the variability in lifespan between people has to do with genetics, has to do with our genes.
So what can we do over the majority, which we may have some control?
You know, the media loves stories about your hard-living veterinarian to 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? So I talk about the blue zones.
[13:27] And then part three is where I get into the nitty-gritty.
What can we do to preserve your bones, bowels, circulation, your hair, hearing hormones, your immune function, joint health, your mind, your muscles, your sex, life, and skin, teeth, vision, finally, your dignity and death. I have chapters on each of those.
Ending up, finally, part four of my anti-aging eight kind of checklist to complement the Daily Dozen, highlighting specific foods and behaviors like nuts, greens, berries, having potential to offer really some of the best opportunities for slumming aging and improving longevity. Dr. Justin Marchegiani Yeah.
Regimen: Whole Food Plant-Based Diet
[14:06] So what I'd love to dive into some questions with you right now on regimen.
So, you know, the optimal anti-aging regimen, and maybe just a couple then on preserving function.
And then I'd love to go through the top, your eight.
Dr. David Jockers Let's do it. Dr. Justin Marchegiani Great. So on the regimen, obviously diet is huge. But what is your, What did your research lead you? Is it in fact a whole food plant-based diet? Is it fair to say that?
So, absolute diet, most important, according to the Golden Burden of Disease study, the largest study of disease risk factors in history, funded by the Bill and Melinda Gates Foundation, number one cause of death, both in the United States and around the world, is humanity's diet.
[14:54] And so, also found to be the most important factor in terms of longevity of the blue zones.
There certainly are other factors like exercise, smoking cessation, weight control, stress, social connection, et cetera, et cetera.
And I talk about all those in the book, but it really comes down largely to diet.
And so there's been 150 dietary surveys within the Blue Zones to kind of find out what's the Venn diagram.
Like what do they all, they're all disparate geographic locations, but what are they all doing that seems to be kind of this common denominator.
And so the Blue Zones organization pulled together all these dietary surveys to come up with a list of 10 Blue Zone food guidelines.
You can look up Blue Zone's food guidelines, but here they are.
Number one, eat 95 to 100% plant-based.
So at least 95% plant-based, that's the foundation. Number two, reduce the intake of processed foods.
Number three, daily dose of beans, right?
At least one, two servings of legumes every day, the healthiest source of protein.
Four, best beverage is water. Five, best snack is nuts. Six is reduce your intake of fish.
Seven, reduce your intake of eggs. Eight, reduce your intake of sugar.
Nine, reduce dairy. 10, reduce meat consumption. I would add an 11, which is reducing intake of sodium.
[16:11] But that's really the core. So we're talking about a diet centered around whole plant foods, you know, foods as grown, you know, from fields, not factories. those are our healthiest choices.
So you mentioned water there as the beverage.
Beverages: Coffee, Green Tea, Water
[16:28] What does your research yield when it comes to things like, coffee, caffeine, alcohol, those things.
[16:37] Oh yeah, so what is the best beverage? Second is green tea, other healthy beverages, but surprisingly coffee, both decaf and regular coffee, associated with significantly longer lifespan, decreased cancer rates, and then I highlight in terms of herbal teas, chamomile, hibiscus, and green or red rooibos, while telling people to cut down on milk, sugary beverages like soda, and alcohol.
Unfortunately, the only safe intake of alcohol is zero because of its carcinogenic nature.
[17:11] I know that Dan Buechner is kind of a fan of a little bit of, you know, or so it appears, red wine, but I don't really buy that one.
Well, look, I mean, it doesn't matter what you eat on your birthday, holiday, special occasions, right?
It's the day-to-day stuff that really adds up. And look, if you're going to eat something or drink something that's less than optimal, then, you know, at the very least, absolutely savor it, get the best stuff out there, you know, and just really, you know, really enjoy it and, you know, do it as little as possible and, you know, kind of make it a special treat rather than the day-to-day.
You know, I mean, what, you know, the remarkable research your dad showed was that we have this immense capacity for repair in our body.
So as long as we're not stabbing ourselves with a fork three times a day, we really should have the capacity to heal unless we're really kind of in serious straights.
And so, you know, when someone's like, oh, you know, social drinking or whatever.
[18:16] For that matter, social smoking, some people can pick up one or two cigarettes a year at a party and just never become addicted.
And there's just no signs in the world that's going to show that they actually have something like lower, you know, higher lung cancer rates than someone who doesn't smoke at all.
The reason we say don't smoke at all is because we're afraid that one cigarette's going to lead to two and then all of a sudden you're smoking a half pack a day.
And similarly with food, I mean, the reason we say, you know, we really shouldn't, you know, you know, no oil.
It's not that a drop of oil is going to kill you, but it's like, oh, you put the one drop on, you have it in the house and all of a sudden you're drizzling it, you know, and, and going in the backyard and chugging it or something.
So it's really kind of like a psychological, it's just easier often for people to just like not have things in the house, control their environment.
[19:04] But if someone really is able to like have a bottle of wine and it just sits there and they whip it out when company comes over a couple of times a year, it's not something that I think is gonna perceptibly change someone's health.
Exercise: Aim for 90 Minutes of Moderate Activity
[19:17] Let me ask you about exercise. Obviously you're doing it right now as we're as we're doing this this podcast uh what did your research yield as far as how much, daily, weekly, what should we be aiming for? Yeah, so the longevity benefits appear to, the associated benefits appear to increase at least up to 90 minutes a day of moderate intensity activity or 45 minutes of vigorous activity.
It's possible that benefits continue to accrue, there's just not a lot of studies of people actually doing more than that.
But, having said that, it's important for people to realize that any amount of exercise is better than none. So, they shouldn't be intimidated.
And that even 15 minutes of walking a day is associated with significantly lower risk of premature death.
And so, and look, that's the just talking about the potential longevity piece.
[20:15] You know, exercise has been proven to improve muscle mass and strength and balance, mobility, decrease the risk of falls, enhance mood, cognition, depression, improve artery function, erectile function, insulin sensitivity, you know, kind of on down the list.
And so there's just an overwhelming body of evidence about that science that basically exercise is medicine.
How long are you going to be exercising today on that treadmill?
I am, these days I'm averaging about 14 miles a day.
[20:50] 14 miles. So how many hours does that come out to?
Oh, well, it's really slow. I'm going like two miles an hour.
So I'm really not even getting my heart rate up. It's not so much exercise as not being inactive.
So prolonged sitting for six hour more a day increases risk of all cause mortality, even if you then go out to the gym after your desk job.
And so it's not just about exercising. It's about not being inactive, not allowing blood to pool in your lower limbs for extended periods of times with impairs the endothelium, impairs your artery function, and appears to be the reason why you increase risk of death.
And if you do have to sit, I've got a lot of videos how, you know, taking, you know, hourly breaks and going up and down just a few flights of stairs can maintain your endothelial function.
So it doesn't take much, but we don't like that prolonged sitting.
But yeah, in addition, we also want to do, get our heart rate up and do the resistance exercise and the balance training, particularly in the lower limbs to lower risk of falling.
Well, like right now, I'm standing right now.
Great. Fantastic. So, you like it.
Absolutely.
So, right. So, that will, I mean, just your postural muscles will squeeze that blood up from your calves.
And even if you're sitting down, you can kind of fidget, you know, with your calves.
Anything that kind of keeps the blood moving was a good thing.
Yes, standing desks are great.
[22:16] Well, so if you're, yeah, that's incredible. So you're going to be, you're going to be walking for six to seven hours today.
That's- Oh yeah. I mean, I just walk while I work.
I know. And it's people, I mean, it seems like a lot, but when you're doing it, like you'll be on a call walking and then it's like, you know, 45 minutes goes by and it's just like flat, you know, you don't even recognize, it just kind of becomes kind of second nature for a while.
In fact, it's kind of weird working, not walking. I mean, eventually it's just like, you just get kind of used to it.
Weight Control, Plant-Based Diet, and Anti-Aging Regime
[22:46] Yeah. Let's talk about weight control for a second because obviously this country, you know, most of us are overweight or obese and you identify weight control as a important part of kind of how not to age.
What would you like to say about weight control? Yeah.
You know, obesity is correlated with accelerated declines in both physical and mental functioning and a radically reduced life expectancy.
But thankfully, there are interventional trials showing that weight loss can significantly reduce the risk of premature death.
The ideal BMI, body mass index for longevity is kind of on the low side, 20 to 22 is probably the best for the longest lifespan.
But even independent of BMI, a larger waist is associated with a shorter life, that visceral fat. so we want to have our waist circumference at least half our height or less.
[23:44] And you know, even at the same number of calories, a plant-based diet, killing more weight, lots of slimmer waist, even without calorie constraints, found to be the most effective diet for weight reduction today.
So that's one of the benefits of plant-based diet is part of an anti-aging regime.
Dr. Justin Marchegiani What about stress? it seems like a lot of people these days are in stress mode and you recommend stress management under the kind of, optimal anti-aging regimen, what are some things people should do, can do?
Dr. Snyder Well, first thing, you don't need to stress about stress. Why?
Because increased stress, although it is associated with increased mortality, it's not the stress itself.
Stress does not appear to be an independent risk factor for shortening lifespan.
Why do people who are stressed live shorter lives? Because when When we're stressed, not only do we eat more, but we tend to eat worse foods, high in sugar, fat, calories.
Stress can also increase substance use, tobacco, alcohol, illicit drugs.
[24:51] But thankfully, a healthier diet appears to be able to trump a stress for cardiovascular and overall mortality.
And so, the same thing with social connectedness.
So people who are lonely without social connections tend to live shorter lives, but it's all mediated through lifestyle. control for lifestyle factors, you don't get a decreased lifespan for bereavement, stress, and things like that.
The reason why people who are stressed and lonely live shorter lives is because they're drinking more, they're smoking more, they're eating worse diets.
And so, as long as we maintain our lifestyle, the stress and lack of social connection is not going to cut our lives short.
Maintaining Lifestyle to Preserve Function and Longevity
[25:31] I'm gonna I'm gonna pivot now to to preserving function.
And obviously, you talk about the mind, you talk about bones and muscles.
I want to ask you about teeth. I'm fascinated with people's teeth and their oral hygiene.
And how many people, especially as they get older, they just, it seems to kind of fall off the radar and they got gingivitis and their teeth are like yellow.
And I'm like, Oh gosh. So what did, what did you find? Like as far as when it comes to.
Yeah, no, there's some really, yeah. I'm glad you bring that up.
Some interesting takeaways. And it's something that you don't hear a lot about, right.
But there is a link between periodontitis and premature death and dementia.
Um, uh, it's periodontitis is inflammation of the tooth supporting structures in your jaw.
So, tooth loss alone can impair cognitive function.
[26:22] And so, I talk about that. In terms of the best mouthwash, rather than using an antiseptic chemical mouthwash, something like chlorhexidine that destroys the good bacteria on your tongue that activate nitrates in dark green leafy vegetables, green tea is the healthiest mouthwash.
Is cheaper, it's safer, it's better.
[26:42] In terms of avoiding cavities, added sugars are the primary cause, leading to a recommended 3% cap on total daily intake of free sugars, which is basically very, very little.
And some other things, due to a small radiation risk, I encourage people not to get a routine dental x-rays unless it would actually, there's some specific reason your dentist wants them that will actually influence diagnosis and treatment.
Otherwise, they're just doing it for like an insurance reimbursement.
It's not actually going to mean anything.
And you say, well, yeah, but they put the little lead apron on to protect your organs. Yeah, all organs except one, your brain, kind of important.
Decreasing periodontal disease with a plant-based diet
[27:27] In terms of what we can do to decrease periodontal disease, low saturated fat diet, high fiber diet, centered around plant foods, has been shown to be the best.
A specific foods that have been found to improve oral health?
In general, like one of the best plants, tomato paste.
You can randomize people to tomato paste, see significant improvements in gingivitis and leafy greens.
Because of those nitrates, leafy greens also improves our oral health.
[27:55] I would warn against something called oil pulling, which can increase your risk of something called lipoid pneumonia, not recommended.
The one thing that we are more at risk for, so those who are eating plant-based diets tend to have better oral health in general.
But with one exception, we are eating more acidy foods and beverages, like we're eating fresh fruit, for example.
And so it's important to immediately rinse your mouth with water after consuming an acidic food or acidic beverage like hibiscus tea or eating citrus or something. Why is that?
It's because it dissolves the enamel off of our teeth.
And so you say, okay, well fine, and after I eat an orange, I'll just brush my teeth.
No, that's the worst thing you can do because brushing your teeth when your enamel is in a softened state can actually exacerbate enamel erosion.
So what you want to do is actually wait a half an hour after eating something sour before brushing your teeth.
But just to meet, all you have to do is just rinse your mouth out with water after, because a lot of foods and beverages that are sour are really healthy, but we just need to rinse our mouth with water afterwards just to rinse the natural acids off of our teeth So it maintains our enamel.
[29:11] Wow Flossing before brushing is better than brushing before flossing.
We got to randomize control trials to show that and How about the water pick?
Oh, yeah, that's interesting. I was just looking at the research into the into the water pick so if the if the same amount of time, it's works as well as flossing the problem is is people don't use it long enough and so, you but if you use it as long as you would normally floss then it is considered equivalent to flossing in terms of being able to get rid of plaque between teeth i'm always amazed when i i become a big fan of the um of the water pick how effective it is removing just about everything that that the flossing didn't take care of.
Oh, I mean, yeah, no, no, so yeah. Do you take one on the road?
You got one of those portable ones too?
I do, I do. Yeah, yeah, yeah, yeah. Yeah, yeah, big fan.
[30:17] Yeah, and so the science is good. So the science is good. So you can get, I mean, you can use either, but yeah, the science is there.
Preserving vision with dietary changes and supplements
[30:25] All right, let's do one more when it comes to preserving function, and then I wanna drop down to your eight, okay? you're anti-aging eight.
And so that is, let's talk about vision because obviously who wants to age into their hundreds if they can't see that well, right?
I mean, it's a little bit of a drag. So what do you say about vision?
[30:48] Yeah, well, good news across the board, the risks of the top four causes of vision loss, which is macular degeneration, diabetic retinopathy, glaucoma, and cataracts can be, the risk can be reduced with dietary change.
And, where does it all come down to?
Dark green, leafy vegetables, best sources of lutein and zeaxanthin, these are these two pigments.
That protect the retina from light damage and, therefore, reduce the risk of macular degeneration.
You can also find these compounds in yellow corn, goji berries, and avocados, but number one, dark green leafy vegetables.
And, interestingly, chopping and steaming greens, as well as eating them with some source of whole food fat, like avocado, a few halves of walnuts, or something, can actually improve the bioavailability because lutein, zeaxanthin, are fat-soluble compounds, so you want to make sure they're absorbent to your system.
Saffron, which is a spice, can improve visual acuity in those with age-related macular degeneration.
If you already are afflicted, saffron can help.
[31:54] In terms of preventing diabetic retinopathy, the best thing to do is treat the cause and reverse type 2 diabetes with a healthier diet in the first place.
In terms of glaucoma, greens to the rescue, yet again, as well as regular exercise, can decrease the increased pressure within the eyeball, which can cause this condition called glaucoma, which involves the degeneration of your optic nerve.
[32:20] And then in terms, if you already have glaucoma, how can you slow the progression of the disease? Black currants, which is a type of berry, ginkgo biloba, and a type of B3 called nicotinamide can help.
For cataracts, the consumption of dark green leafy vegetables as well as vitamin C-rich foods are associated with lower cataract risk.
But antioxidant supplements don't appear to help, and yet there's a stepwise drop in cataract risk as our diet gets more and more plant-based.
Once you do have cataracts though, there's no reversing it beyond cataract surgery, but it is relatively safe and simple procedure, but hopefully we can prevent it in the first place.
[33:07] You, you mentioned supplements there, in your research, is there any supplement that you recommend that we take that can, that can be helpful?
The importance of vitamin B12 and the surprising truth about vitamin D3
[33:21] So vitamin B12, critically important, both for anti-aging and in general for those, not just eating plant-based diets, but at age 50, the National Academy of Medicine, which is what determines the recommended daily intakes, says age 50, everybody across the board, regardless of what you eat, needs to take a vitamin B12 supplement or eat vitamin B12 fortified foods every day.
And so that's probably the most critically important thing.
And then there's certain circumstances in which I recommend various supplements for, you know, if you're an alcoholic, there's a list.
If you're trying to get pregnant, if you are pregnant, those with skin cancer, there's a particular supplement that helps. Um, but, uh, so, but in terms of across the board, um, just a vitamin B12.
What, so, so what's, what did your research yield on a vitamin like D3?
Oh, so that was actually a big surprise. So I thought I'd be going into this recommending everybody take a vitamin D3 for longevity.
Um, but the latest meta-analysis shows no decrease in all-cause mortality in randomized controlled trials. So, I mean, just because people with higher D3 levels tend to live longer, well, they're probably actually, they're outside exercising, getting more sun.
[34:38] But when you actually randomize people to vitamin D3 or placebo, you actually don't get an extension in lifespan, but you do reduce the risk of cancer.
And so, but the reason why that doesn't translate into improved lifespan is because it has no effect on cardiovascular disease, which is by far our leading killer.
[34:59] But, okay, what if you're a plant-based eater, right?
Then, I mean, if you're eating healthy enough, cardiovascular disease, right, you kind of check that off the list.
And so, then you move down to killer number two, which is cancer.
So, is it possible that in plant-based eaters, taking vitamin D, making sure you have optimal vitamin D with supplementation, would that actually lead to an increase in life because it does decrease cancer incidence?
Possible. It hasn't been put to the test, but I think that's a reasonable extension, although for the general population, vitamin D supplements aren't going to mean a difference in lifespan. Okay.
Let's move into the anti-aging eight.
The Anti-Aging Eight: Legumes, Nuts, and Dark Green Leafy Vegetables
[35:46] So is this in any particular order as far from one to eight or do you just list eight?
Well, yeah, it depends kind of what you're kind of shooting for.
So, for example, on a serving by serving basis, legumes, beans, split peas, chickpeas, lentils have the largest life expectancy gains, According to the Goldberg and Zee study, that's what all blue zones center their diets around as a chief source of protein.
[36:14] And so, you know, any kind of beans, lentil soup, hummus, that kind of thing.
And it's presumed to be because they're the most concentrated sources of prebiotics, the fiber and resistant starch that support the growth of our probiotics, the good bacteria like the bacillus and bifidobacteria that produce the postbiotics, the benefits of postbiotics like butyrate and acetate that decrease inflammation and boost immunity and improve muscle strength in frail individuals, etc.
So but that's on a serving-per-serving basis.
[36:45] But on an ounce-per-ounce basis, nuts are actually associated with the lowest risk of premature death compared to any other food group.
One half to one ounce, like a palmful of walnuts a day, I would recommend walnuts are the best. You can certainly overdo it, and I talk about how one shouldn't extend beyond that.
And then dark green leafies, the only thing that can rival nuts is dark green leafy vegetables.
Earn their place in the anti-aging eaters, the vegetable most associated with a longer lifespan.
[37:17] The nitrates in greens can improve the age-related declines in muscle and artery function.
Slow our metabolic rate, something we only thought possible with caloric restriction, But instead of starving all the time, all we have to do is eat a big salad every day.
And then, hey, if you get those cruciferous vegetables, the broccoli family vegetables like the kale, the collards, the bok choy, then you get the sulforaphane in the mix and that improves the immune function, boosts the detox enzymes in our airways, in our liver.
Uh, Barry, do you dream about green leafies at night?
Oh my God. If I, if I, I, I, you know, some people count the sheep.
I count the grass that the sheep is eating.
That's the, There you go. There you go.
Tongue Scraping and Prebiotics: Activating Nitrate-Activating Bacteria
[38:03] All right. So, so number three is, The greens come up over and over. Yeah. Yeah.
Basically every chapter really comes down to greens.
Of course you have to maintain the nitrate activating bacteria on your tongue.
So we're not using, you know, antiseptic mouthwash, alcohol-containing mouthwash.
[38:21] Speaking of oral health, tongue scraping actually improves the growth of these nitrate-activating bacteria.
So there's things we can do, as well as feeding them with prebiotics, more nitrates.
So the more we eat greens, the more we foster the growth of these greens-eating bacteria on our tongue, which activate the nitrates, open up our arteries, have all these other beneficial effects.
Before we go on to berries and xenohormosis and some of those things, I just want to make sure that we talk about protein restriction because this, as we know, this culture is fascinated with or has a love affair with protein.
And I want you to talk about protein and how you think we should be restricting it, not increasing it.
Yeah. So that was kind of a surprise looking into the books.
When it comes to protein and aging, less may be more.
The most important thing we could do—in fact, the only thing I could find that could block every single one of the 11 stages of aging— is something called methionine restriction, restricting a particular amino acid, which can be done one of three ways.
[39:29] Caloric restriction, meaning you eat less of everything, and you just end up with less methionine.
Or you can keep your calories the same, but just reduce protein, and that'll reduce methionine intake. or you can keep your protein intake the same and just switch from animal sources to plant sources, which tend to have significantly lower methionine.
But for people who are continuing eating animal products, they need to be reducing their protein intake, restricting down to recommended levels, to boost NAD and improve immunity and decrease oxidative stress and inflammation and insulin resistance to cancer-promoting hormone IGF-1.
There's no benefit to adding extra protein to the diets of older men and women in terms of muscle mass, muscle strength, physical performance.
Instead, all that excess protein is just going to get you a drop in the prolongevity hormone FGF21, a worsening of the age-accelerating enzyme mTOR.
So sticking to the recommended intake, which is 0.8 grams per healthy kilogram body weight, that's 45 grams a day for the average height woman.
55 grams a day for the average height man.
The impact of protein intake on health and cancer risk
[40:32] It's not as important if you're eating plant-based, because then you're already having that methionine restriction, regardless of what your protein intake.
Though at sufficiently high protein intakes, you can get a bump in IGF-1.
So I would not go out of the way to add protein powders or protein shakes to one's diet that's more than enough protein in whole, healthy plant foods.
And you get high enough protein, even if it's plant protein, you can get a bump in IGF-1, insulin growth factor 1, and increase your risk of certain hormone-sensitive cancers.
I want to say something, and then you tell me if this is correct.
So in the randomized controlled trials, there was no indication that increased protein added, or was it contributed to muscular strength?
You cannot emphasize that enough. Now, so this is in older men and women.
Older men and women, There's no difference in terms of muscle mass, muscle strength, and muscle performance.
And this is with people, normal, healthy, older men and women.
Those with sarcopenia, meaning with accelerated age, related muscle loss, still doesn't help.
[41:41] Whether or not you add it to resistance exercise doesn't help, of course.
What does help? What does increase muscle mass, performance, and strength?
That resistance exercise itself, whether or not you add extra protein.
Um, so yeah, critically important to maintain muscle mass with age is doing that resistance exercise like the weight training, um, and then combined with balance training, um, and particularly, uh, weight in our, uh, lower limbs to maintain our balance, to protect our bones from falls.
Um, but, uh, What about the younger population, people between 20 and 50, do you think the increased protein and exercise is helpful?
So, adding protein to, so, right, if you look at younger populations, 95% of the randomized control trials, there have been 26 trials to date, and 25 out of 26, fail to show any significant increase in lean body mass, but there's enough of a trend in that direction.
The limited impact of increased protein intake in younger populations
[42:41] Across all of them that if you do a meta-analysis, you can tease out perhaps a 0.3 kilogram increase over 13 weeks of an extra 40 grams of protein a day when added to a resistance training program.
And so that's not a lot, right? So that's less than a pound over 13 weeks.
And that's just talking about lean body mass. Lean mass can be water retention, can be liver or kidney swelling.
There's actually not a great correlation between changes in lean mass measurements and the gold standard, which is muscle mass measured on MRI.
And so any of the statistic geeks out there, it's an R of 0.49, which is a pretty weak correlation.
And so even in younger populations, you don't see, I think people overestimate the impact of adding extra protein.
And then when you get to the older populations, it just zeroes out across the board. Wow.
So as far as that methionine restriction that you were after for, you know, to age successfully, you say that I think the highest source of methionine in a plant, and I'm sorry, in an animal-based protein is fish. Is that correct?
So highest across the board for any protein is fish. Fish, I think eggs is the second worst.
[44:05] And then the only kind of relatively low-methionine source of concentrated protein are the legumes.
Um, uh, and so that's why I, so no wonder why that's the cornerstone of blue zone diets around the world historically, um, no wonder associated with the longest life expectancy gains in the global burden of disease study legumes.
And so like, there's one thing we could do, you know, legumes for longevity hummus for health.
Um, these are, these are really the, uh, healthiest sources of concentrated protein. So when we talked it and you were part of our plant stock just a couple months ago.
I asked you I said What were some of your takeaways?
Like what are you incorporating into your life now that you weren't before you wrote this book and you said one of them was Wheat germ you were adding wheat Because of what?
Cut it with you got to cut it with your ground flax seeds everything put flax seeds I put a little wheat germ on Why we turn because? Oh, spermidine!
The benefits of spermidine and ergothione in wheat germ and mushrooms
[45:06] Spermidine to boost autophagy, this internal house cleaning process, which gets rid of cellular debris that contributes to the aging process.
Yeah. And so other great sources of spermidine, tempeh and white button mushrooms.
[45:23] Peas, but yeah, wheat germ is the most concentrated source.
Yeah. And you're also consuming, I think, more mushrooms.
Is that correct? Oh, yeah. In fact, you can make your own oyster mushrooms at home, just like you sprout broccoli sprouts at home on your window.
So you can make oyster mushrooms. Totally awesome.
In fact, you don't even have to cook them. It's one of the few mushrooms that you can eat raw.
[45:47] And yeah, so and why? Not only because of the spermidine, because the ergothione, which is this longevity vitamin, really only found in fungi.
And so, you know, if you're not eating mushrooms, not eating tempeh, you're not getting it out. Wow, and then strawberries, aren't you doing something with strawberries?
Oh my god, I'm doing strawberries like crazy!
Yeah, yeah, because of Fisodin, which is an anti-synolytic compound.
Yeah, so, you know, I've always liked, well, blueberries, I'm more antioxidant, so if I'm gonna choose something to put on my oatmeal, I'm using blueberries.
But yeah, now that I realize that you really can't get a more concentrated source of this Fisodin stuff, I've started to use both fresh, freeze-dried, and frozen strawberries more.
In fact, you see me at conferences, I have these little packets of just freeze-dried like strawberry powder that I can just add to, you know, hotel oatmeal wherever I am to get a extra dose of nutrition where on the road.
So tell me where are all the proceeds of this little bad boy going?
That, that big bad boy, Jesus, that thing.
Supporting GiveWell charities and organizations in practice
[46:53] So I encourage people to support GiveWell charities.
GiveWell is kind of like a charity evaluator, Founds a kind of what's the what's the kind of best bang for your buck in terms of improving health around the world, And also I donate to a lot of organizations that actually put this work into practice You know, it's all the information in the world is useless unless there's people in the trenches actually doing something with it And so that's why a group like balanced which is actually has these pro-fiber programs in for school children, That's the kind of stuff, all this greener by default.
They're the ones that got the public health hospitals in New York City to, you know, have default plant-based options, healthy foods in the hospital.
What a concept, what a great way to role model health.
So this is a kind of like, you know, kind of, you know rubber hits the road kind of organizations is where the money goes to.
Hey, last question, and then I'm going to let you go. And that is, how long do you think it'll be?
Your best guesstimate, at the rate that things are moving with technology and AI and everything, before we will have an option as human beings to basically live to 150 or 200, if we so want?
Ah, well, you know, that depends on us, right? That depends on whether we're going to be.
[48:14] You know, taking our taxpayer money and subsidizing cheap feed crops and dollar menu burgers in the sugar industry, or whether we're putting it into, you know, the right kind of research that's not just going to reward these cash cows of the drug industry, which is these lifestyle drugs.
I mean, you know, the last thing, I mean, you know, it's like, that's where the money is made. You don't make it saving people's lives with 10-day antibiotic courses.
You make money by giving people drugs they have to inject themselves every week for the rest of their lives to lose weight or take every day to reduce their blood sugars, blood pressures, or cholesterol instead of actually treating the underlying cause.
So how about more research into that primary prevention?
You're not going to get it from the private sphere, so we really need to push our public officials to take that public money and to put it not just a way to do R&D, to get privatized into new drug patents, but to do really the research that's necessary to inform people about the power they have with simple diet and lifestyle changes to maximize their diet and lifestyle.
And we have those tools right now. No more research necessary, right?
And we can get literally decades of extra life expectancy just doing some of the really important minimums. So how about we start there before we, you know, we need to put four more millions into biotech. All right.
[49:41] Man, Michael, you just never cease to amaze me. Seriously, this is so wonderful.
So everybody, How Not to Age, it's available, Amazon, wherever you wanna buy your books, go and get it.
You will not believe what an incredible read it is. All right, Michael, until next time, peace out, keep it playing strong.
Thank you so much. Boom! Boom!
[50:09] How Not To Age is out now and I'll be sure to link it up in the show notes along with Michael's website, nutritionfacts.org.
He is definitely a one of a kind, isn't he?
And if anyone can excite me about aging, it is definitely Dr.
Michael Greger. Although a little caveat, my parents are also incredible shining examples of vibrancy and they really excite me as well.
As always, thanks so much for listening and sharing these episodes of the PLANTSTRONG Podcast with your friends and family and together let's decide not to age along with always keeping it PLANTSTRONG. See you next week.
[51:01] Thank you for listening to the PLANTSTRONG Podcast. You can support the show by taking a quick minute to follow us wherever you listen to your favorite podcasts.
Leaving us a positive review and sharing the show with your network is another great way to help us reach as many people as possible with the exciting news about plants.
Thank you in advance for your support. It means everything. The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin, and Wade Clark.
This season is dedicated to all of those courageous truth seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth.
Most notably, my parents Dr.
Caldwell B. Esselstyn Jr. and Anne Crile Esselstyn.
Thanks for listening.
