Chapter 1: What is the main topic discussed in this episode?
Welcome back, everyone, to the School of Greatness. Very excited about our guest. We have the inspiring Dr. Michael Greger in the house.
Good to see you, sir. So glad to be here. Welcome.
This is exciting. This is exciting. Your research has been really out there in the mainstream a lot lately. A lot of documentaries. Your books have been blowing up. And the most recent one, How Not to Age, The Scientific Approach to Getting Healthier as You Get Older. I'm really fascinated by because most people don't think they can actually get and improve their health the older they get.
They just feel like they have to deal with chronic pain, illness, disease. They have to take medications to just maintain a level of ease. So is it actually possible to stop aging or even reverse aging with foods as we get older?
Diet appears to be the most critical element. And that's really what the book is about, this kind of good news 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 diet and lifestyle.
Really?
only about 25% based on studies of identical twins, only about 25% of the difference in lifespan between people is due to genetics. Really? So for what we can do over the majority of which we have some control, we can look to, for example, you know, these blue zones, these areas around the world with exceptional longevity and kind of look at the Venn diagram and what they're all doing.
According to the Global Burden of Disease Study, the largest systemic analysis of risk factors in history, the number one cause of death in these United States is the American diet. Really? Bumping tobacco, smoking to number two, cigarettes now only kill about a half million Americans every year, whereas our diet kills many more. Come on.
So, but that's good news, because that means we have the power. Right. It's never too late to start eating healthier, to stop smoking, to start moving. So, I mean, it's really a positive message that I was excited to learn when I finished the book.
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Chapter 2: How can diet reverse aging?
So by slowing down the aging process, then we can reduce the risk of many different diseases at the same time, the stroke and the dementia and cancer, heart disease, which rise exponentially with age. Really? So something like, you know, having a high cholesterol can increase your odds of having a heart attack or number one killer of men and women by as much as 20-fold. But an 80-year-old...
has 500 times the risk of having a heart attack compared to a 20 year old. So age. But I mean, of course, the reason we focus on things like cholesterol is because it's a modifiable risk factor. But what if the rate of aging were modifiable, too?
And so that's what I really cover in the book. So what would the five main keys be to aging better?
Yeah, so Diet number one. And so if you look at these blue zones, they all center their diets around whole plant foods. So they're minimizing the intake of meat, dairy, sugar, eggs, junk, maximizing the intake of fruits, vegetables, legumes, beans, split peas, chickpeas, lentils, nuts and seeds, herbs and spices, basically real food that grows out of the ground.
These are really our healthiest choices. That would be number one. Number one, diet. So number one, diet. So that accounts alone for about half of the difference in lifespan between blue zones and the rest of the world.
What is the average blue zone age at death versus the average... you know, age of death of non-blue zones. Right.
It's about 12 to 14 years. 12 to 14 years difference. Difference. So women 14, men 12 years longer, and so have up to 10 times the rate of so-called centenarians, those that get triple digits, live to be 100 or older, And it's not just about, you know, adding years to your life, but life to your years.
These people are active, so they're at 100, and they're enjoying their lives or participating in life. And so what's the point of living longer if you can't do it, you know, with vibrancy, with vitality, right? And so in this country... I mean, even our lifespan is going down.
So actually, the peak of life expectancy, 2014, in the United States, started going down every year since, even before COVID shaved a few years off our lifespan.
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Chapter 3: What are the leading causes of death related to diet?
No, so what else? Smoking versus vaping. Well, the concern, the primary concern about vaping is the nicotine addiction will lead people to smoke. And so it's safer than smoking. But because people who vape tend to smoke that, unfortunately, you know, these kids getting addicted to nicotine can face a lifetime of cigarette addiction and then die.
dramatically cut their life short from something like lung cancer smoking so so yeah so it's really remarkably you know 80 of the way there is the simple basic common sense lifestyle behaviors i know it's a big book and i go into all the details don't want people to get kind of lost or intimidated, it's really the basics.
So, you know, a decade of life is possible just through not smoking, not being obese, exercising, even like 20 minutes a day, five servings of fruits and vegetables, really basic stuff. Now, you want to go beyond that? You want to tweak those 20%? I've got, you know, hundreds of cool things you can do in the book. But let's not lose sight of the real core tenets.
So you can imagine some smoker was like, oh, look at this fancy supplement I'm going to take. I'm like, no, no, no. Let's back up. It's not going to minimize the smoking. Right, right. So that's important to emphasize. In fact, the conclusion of the book, I'm like, all right, let's step back. Let's put this all in context again. It's really the core, basic tenets.
And then, yeah, there's all sorts of cool new science out there that you can tweak around the edges, but I don't want people to get lost, really.
Wow. Okay. And what about fasting? Because you mentioned fasting briefly, and I know you have a section in the book about intermittent fasting and fasting, but also I think there was a quote in your book that's, you know, fasting can have benefits, but if you fast too long, you die. Right.
Right. It is the ultimate in unsustainable diet. Right. Meaning guaranteed to kill you if you do it long enough. You can't say that about any diet. So there's all sorts of interesting intermittent fasting regimens. So one thing that fasting does is it... boost something called autophagy, which is kind of this house cleaning process within the cells. Killing the zombie cells, right?
Oh, that's a separate, that's a whole separate thing, but this is more inside the cell, the accumulation of debris that contributes to the aging process.
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Chapter 4: What lifestyle changes can add years to your life?
And we can boost autophagy with exercise, or with fasting. We can fast or go fast. Unfortunately, it doesn't really ramp up until 36 to 48 hours of fasting, which really is too long to go unsupervised. Normally, your kidneys dive into something called sodium conservation mode, such that people can fast literally for months on water only, but
If that response breaks down, then you can suffer a serious electrolyte abnormality, which only manifests with vague symptoms like dizziness or fatigue that could go unnoticed until it's too late. Really? So that's why one really should only fast. If you're fasting over a day, it really should be done under medical supervision. They can do urine tests. They can do blood tests.
Just to make sure everything's going to plan. Uh-huh. Otherwise, you can run into really serious stress.
Do you feel like doing a 24-hour fast is okay for people to do on their own?
So, although we're not going to get that boost and not toughening that short of a time, and you often hear, like, even a few hours, like, time-restricted feeding... You know, decreasing the feeding window daily, we can improve autophagy. That's in rodents.
Unfortunately, rodents have these really high metabolisms such that they can lose massive amounts of their body weight in literally a day or two. In a few days, it can be fatal. But unfortunately, that doesn't translate into humans. Really? We really only get this boosting in autophagy. After two days. Really, yeah, two days.
And then we're concerned about that being done outside of kind of medical supervision. Interesting. Is there benefit to doing the intermittent fasting, would you say? Okay, so, but there is some, certainly, there's so many different types. I'm talking about the pros and cons of each. So there's alternate day fasting and 5-2 fasting, 25-5 fasting, mimicking diet. Mimic fasting, yeah, yeah.
Right, all that. There's all sorts of it. And there's pros and cons of each. I think the best, kind of the bottom line, the best evidence is around early time-restrictive feeding, meaning... collapsing one's daily feeding window to at least 12 hours or less, but critically important, that window is early rather than late. So if anything, we're skipping supper, not breakfast.
And in fact, we're trying to cram as many calories earlier in the day as possible. The exact same food eaten in the morning is less fattening than the exact same food, same number of calories eaten in the evening. Come on. Causes less of a blood sugar spike, causes less triglycerides. If you're going to eat junk, If you're going to eat a donut or something, do it in the morning.
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Chapter 5: What are the five core foods for longevity?
military did these experiments. The Army did the first experiments where they actually took people and gave people 2,000 calorie meals, a single 2,000 calorie meal, the exact same meal, either as breakfast and fasting the rest of the day or as supper.
And they found these remarkable differences, the exact same food, exact same calories, different amount of body fat, different amount of metabolic implications of just that single tweak. It's because of chronobiology, the remarkable impact that our circadian rhythms have on our biology. We typically only think of our circadian rhythms when we're jet lagged.
Like, that's the only time we're even thinking about, you know, our bodies. But that's just kind of a symptom of this really deep underlying... Most of our biological processes, our biochemistry, our enzymes, actually go on this clock. And so it really matters. There's this really... devastating literature about pesticide suicides.
In India, that's a common way for people to commit suicide, but in manners, whether they survive, whether they do it in the morning or in the evening, because their body's better able to handle it in the morning, better able to detoxify Because of our circadian rhythms, you're much more likely to survive a poisoning attempt. Wow.
And this is just how powerful, it just suggests the power of our circadian rhythms. Really fascinating. I dived deep in my How Not to Diet book where I was talking about weight loss. And that entire field, fascinating. Never learned about it in medical school. Wow.
Now, for those that don't know, what is the circadian rhythm and what do we need to know about it to optimize our life?
Yeah, so our circadian rhythm is the kind of daily rhythm, almost 24-hour rhythm. So even if you're put in a bunker with constant lighting, your body will still, you'll have this cycle as if you were, even though you have no cues from the outside, you have no watch, you have no idea what time it is, you'll start getting sleepy at kind of the same time you normally get sleepy.
You wake up about the same time you normally sleep. But in that kind of environment, you can do these laboratory experiments on people where it's like, okay, what if we put you on a 27-hour cycle? So we put the lights on, right? But then we just stretch it a little bit, and it totally messes people up. Wow. It really undercuts our biology.
We were so meant to, because then all of a sudden it's chopping it through. And so it was these kind of experiments that really showed up. And so what we see is we see these shift workers. Or working late nights. Right. So, well, if you're only working late nights, that's a problem in and of itself. But it's the people that are shifting. So they're doing the late nights.
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Chapter 6: How does meal timing affect longevity?
You always keep a can of beans in the fridge. You can just throw a spoonful onto anything basically. Wow. Yeah, in fact, someone at a talk was like, I just take white beans mashed into my oatmeal. I'm like, never heard of that. But he's like, can't even taste it. I'm like, okay, yeah, great.
I mean, look, you know, and what's nice about a healthy breakfast is that regardless of what you do the rest of the day, you know, God knows what kind of, you know, what bowl of candy is on your co-worker's desk or what donut shop you're walking by or God knows what stress is going to, you know, take you down the wrong path. At least you have a good foundation here. Interesting.
Well, anyway, so that's number one on the list. Okay, number one, legumes. Okay, now, so these are, they identify the top five foods that associate with the longest lifespan. Now, legumes rule the roost on a per serving basis, but actually on an ounce per ounce basis, nuts rule the roost. are associated with the longest lifespan compared to any other type of food out there.
What are the three best nuts? There's really only one. There's really only one that pulls ahead. That's walnuts. Now, see, normally, when I say, like, you know, eat, you know, cruciferous vegetables or something, they're like, which one's best? I'm like, whichever one you'll eat. You like broccoli, eat broccoli. You like bok choy, eat broccoli.
Like, you know, look, whatever one you'll get into your face, that's it. But with nuts, wild nuts really do pull ahead, and that's because they have more omega-3s than other nuts, they have more antioxidants than other nuts, and they're the only nuts shown to acutely improve artery function within a matter of hours.
And so, in fact, in the PREDIMED study, which is this large randomized controlled trial over years of thousands of individuals, although mixed nuts certainly did lower cardiovascular disease rates, it was the walnuts that appeared to be the most critical part. And we do want to get unsalted nuts. I know that's not as delicious. Unsalted. Why unsalted?
In terms of dietary risk factor for death, excess sodium intake is the way. So I've been talking about this. Oh man, but salt is so good. It tastes so good on something. I know, I know. Look, so in terms of things we're missing out on, right? It's the legumes. But in terms of stuff we're getting too much of. Salt. There's lots of horrible things in our diet. There's sugar, there's trans fat.
Okay. But sodium, salt intake, is the number one dietary risk factor for death on planet Earth. It is the single worst thing about humanity's diet. But there's good news. What about like Himalayan salt or something? They're all salted the same. I know. But this is pink. This is from the Himalayas. This is rainbow colored. This has got a few minerals in it or something. No, no, no, no.
No, it's all bad. Oh, no. But a little bit? Can you have a little bit? Well, so we want to stick under 1,500 milligrams a day. That's the American Heart Association recommendation. And to do that, and most of it, and people are like, I don't add a lot of salt. Most of our sodium intake comes from processed foods. 70% of sodium intake is not the salt we add in the kitchen or the dining room.
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Chapter 7: What is the potassium salt switch and its benefits?
switching to a 50-50 blend of regular sodium chloride and potassium chloride. And there was a 40% drop in cardiovascular disease death rates within a matter of years in the reduced sodium group. In fact, their life expectancy at age 70 between the two groups was 14 years. Come on.
Meaning that just by switching to half potassium salt, for which you wouldn't even be able to taste the difference, they effectively made themselves 10 years younger when it came to the risk of premature death. So something that, so there's no downside. There's no, okay.
So now if you go with, I'm encouraging people to actually try to switch to full potassium salt rather than the 50-50 blend, but then you do actually taste the difference. There's this bitterness to potassium salt that you don't get otherwise. It's more apparent in some foods than others. Some foods you really can taste the difference. But any amount that we can cut down.
And the only other caveat is you need to have kidneys good enough to get rid of the excess potassium. And so if you have kidney disease or if you have diabetes, just because diabetes is such an increased risk of kidney disease, it's so damaging to the kidneys.
Even if you don't know you have kidney disease, if you have diabetes, you should first get your kidneys tested before switching to potassium salt. Mm-hmm. And, you know, if you're over 70, our kidney function does tend to decline over time. So even if, as far as you know, your kidneys are fine, if you're over 70, I would go super simple test.
You can just get your kidney function tested and just make sure your kidneys can handle the extra potassium. But then if you give them the all clear, your kidneys are good, then you can get all the saltiness you want. You can add extra, right? You can make your popcorn as crazy, right? Tears to your eyes salty and with no harm. Wow. No harm.
So that's one of the really one of the simplest tweaks in the book. And it's like the leading cause of dietary risk factor for death, like the worst thing we could possibly eat. And there's a simple fix to it. Like I'm too bad there wasn't like a potassium donut or something. We just switch over and totally fine. But that was one of the rare things is like,
Super easy to do. So explain that one more time. So if we have more potassium salt first, then we can have salt?
No, so we're swapping out. So instead of shaking on sodium chloride, we're shaking on potassium chloride.
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Chapter 8: Why are whole plant foods superior to supplements?
There's a bunch of different brands.
And you can have as much as you want.
And you can have as much as long as your kidneys are okay. Okay, got you. Right, you can have as much as you want. And so you can go to any grocery store. Wow. In the salt aisle, there's all these salt substitutes, and it says potassium chloride. And there's some 50-50 blends. If you want to start there and move, it's certainly better than adding pure sodium salt. Interesting.
I'm going to try that.
Yeah, yeah. I'm going to try that.
And the studies show.
Oh, right. And not just it's associated with, but these interventional trials, these randomized control trials, blinded, they don't know who's in which group until they break the code at the end. They say, oh, my God, significantly less death and disability in the group just cutting down on the sodium. Eating the same things. Eating the same things.
One single tweak, just switching over what kind of salt they're using. Amazing.
That's incredible.
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