#382: The Prescription for Longevity: Diet, Exercise, & Lifestyle We All NEED To Try with Dr. Michael Greger Physician, Bestselling Author, & Nutrition Expert

One need not make drastic changes. It really isn't all or nothing. Even basic common sense lifestyle factors can mean literally living the difference of a decade of healthy life expectancy. And that's not smoking, not being obese, regular exercise, eating more fruits and vegetables. So it's really the basics that's really the core regimen. And it's never too late, never too late to start eating healthier, never too late to start moving, never too late to stop smoking. We really do have the power.

Come on this journey with me each week when you join me. We are going to chase down our goals, overcome adversity and set you up for a better tomorrow.

I'm ready for my close up.

Hi, and welcome back. I'm so excited for you to be back here with us this week. Okay, today we've got an incredible guest. He's a founding member and fellow of the American College of lifestyle medicine. Dr. Greger is a physician, New York Times bestselling author, and is internationally recognized speaker on nutrition, food safety and public health issues. He has lectured at the Conference on World affairs, testified before Congress, and was invited as an expert witness in the defense of Oprah Winfrey in the infamous meat defamation trial. I'm gonna get into that. In 2017, Dr. Greger was honored with the ACLM Lifestyle Medicine Trailblazer Award. He's a graduate of Cornell University School of Agriculture and Tufts University School of Medicine. His first book, how not to Die, became an instant New York Times bestseller. He has videos on more than 2,000 health topics. The amount of work that you have done is nothing short of shocking. And his new book, which we're going to get into today, is out December 5th. Dr. Grecker, so nice to meet you and thank you so much for being here today.

I'm so honored. Hopefully I can help inspire some of your viewers to live longer, better lives.

Yeah, well, you're inspiring this one right here. Okay, so first of all, what is this Oprah case? I don't even remember that happening. We break it down.

I don't remember the famous she had to move to Texas, battle off the rancher. So 21 states had what are called food disparagement laws where it's illegal to make so called unfounded comments against perishable food items. So she had on this rancher by the name of Howard Lyman who just talked about some of the kind of realities of modern agribusiness on how they feed the remains of cows from the slaughterhouse back to cows as a way of kind of like recycling, essentially and that would lead to the bovine spongiform encephalopathy, the mad cow epidemic. And but like, Oprah was just, like, just so shocked to hear about it. She's like, that's it. Never eaten another burger again. And so this cattle futures tumbled on the Chicago Mercantile Exchange that next week, because Oprah's not eating meat. Oh, my God. And so then some cattle ranchers sued her in Texas under one of these so called food disparagement laws, saying, wait a second, you can't make unfounded comments against perishable food items. And so they brought on me as an expert witness to basically argue that, no, these were indeed founded comments. Nothing was said, wasn't true. Right. You can say true things about food. But thankfully, she did not need my help. She actually won on First Amendment grounds that, look, you should be able to say whatever you want about anything, right? That's kind of our system. But in a strict legal sense, you can argue that she won the case. On the other hand, they dragged her through eight years of appeals, so it took her eight years to get her out of this legal mess. And so if you can drag one of the richest, most powerful people on the planet through the courts, ruin their lives, you know, it's like a message to anyone else, right, that look, if we can do that dope or we can do that with anyone. And so it had kind of this kind of gagging effect on free speech. Even though technically you could say stuff, it had a way of kind of cooling speech in this area. And so that's one of the reasons why you don't see more of those kind of exposes about food safety issues, because they're afraid of those kind of lawsuits.

Wow.

Oh, my gosh. Well, thank you for breaking that down for us because somehow I'm sure I knew about at the time, but I've forgotten about it. Little bit of media overload, I think, these days. Okay, so now you did not get into this business to specifically help Oprah Winfrey. In fact, I think you are working on making the world just a healthier place. Can you give us a little background into how you got into this work?

It was really all thanks to my grandmother. I was just a kid when my grandma was sent home in a wheelchair to die. Essentially, she was diagnosed with end stage heart disease. She already had so many bypass surgeries and basically run out of plumbing at some point. Confined in a wheelchair, crushing chest pain. Her life was over at age 65. But then she heard about this guy, Nathan Pritikin. One of our early lifestyle medicine pioneers. And what happened next is actually detailed in Pritikin's biography. It talks about Frances Greger, my grandmother. They wheeled her in and she walked out. Though she was given her medical death sentence at age 65, thanks to a healthy diet, was able to enjoy another 31 years on this planet till age 96 to continue to enjoy her six grandkids, including me. So that's why I went into medicine, why I practice lifestyle medicine, why I started the website nutrition facts.org why I wrote the book how not to Die, why all of the proceeds I received from all my books are all donated directly to charity. I just want to do for everyone's family what Pritikin did for my family.

So give us a little bit of insight into that because that sounds rather drastic that she was basically, they were thinking she was going to die and then she lived another 30 years by diet alone.

We didn't used to know that heart disease was reversible. We thought they just got worse. Worse, worse than you died. And Pritikin was reversing heart disease by the thousands. But unfortunately back then we didn't have what's called angiography. We didn't have this way of kind of X raying the arteries to see if anything was changing. So these were clinical diagnoses, meaning their symptoms got better. And since we didn't think heart disease was reversible, the medical community just said, well, if you got better, then you never really had heart disease in the first place. It wasn't until then. Dean Ornish stepped UP and in 1990 published the Lifestyle Heart Trial, the most prestigious medical journal on the planet. Proven for the first time in a randomized controlled trial using something called quantitative angiography. She could actually prove that you can actually reverse heart disease, open up arteries without drugs, without surgery, this healthy plant based diet and lifestyle program. And so really that was the big shift. Now my family knew about that forever. I mean, you know, but here it was in black and white, published in the best medical journals on the planet yet, basically crickets. So here we, we have the cure to our number one killer of both men and women. And yet, you know, the system wasn't changing. And to this day, hundreds of thousands of men and women continue to die from this preventable, arrestable, reversible condition. I said, wait a second, if the cure to a number one killer could get lost down some rabbit hole and ignored, or what else might there be in the medical literature that could help my patients, but just didn't have Like a corporate budget driving its promotion. Well, I made it my life's mission to find out. So that's how nutritionfacts.org came about. This is the resource I wish I had in medical training to be able to kind of sift through the misinformation mess that we have over the kind of corrupting commercial influence in the field of nutrition.

So what does that mean? It just means that is it pharmaceutical companies? Who is it that's holding this information back? Or why are people still not understanding that there are solutions readily available to.

Them in terms of medical training? Most doctors just never taught about the power that healthy nutrition can have in the course of illness. And so they graduate without this powerful tool in their medical toolbox. Now, there's also institutional barriers, time constraints, lack of reimbursement. In general, doctors simply aren't paid for counseling people on how to take better care of themselves. But drug companies do play a role in medical education and practice. You know, you can ask your doctor when the last time they were taken out to dinner by big broccoli. It's probably been a while.

It's so true. But that's so horrifying that people who literally have the potential to die because they're not making different decisions that are readily available to them, the information is there. Not only are they not aware of it, but they don't even know how to access it. Is that correct?

It's increasingly easier. I mean, and that was the dream of the Internet, right? Is that we would democratize information. No longer could there be these gatekeepers. So, you know, Back in the 1950s, the tobacco industry had a stranglehold on the medical associations, on the media. And so the American Medical association was coming out saying that smoking on average is good for you, actually beneficial in moderation, of course, but the media was telling people to smoke. Famous athletes agreed. But that was at a time where you really couldn't get. Even though there were decades of science linking smoking with lung cancer, they were published in medical journals, never really saw the light of day. But the hope with the Internet was all this information out there that's been lying, these dusty stacks could now get out because you didn't need a corporate budget for promotion. You didn't have ads on tv. If something's actually going to be saving lives, that alone could get it out there. And there's certainly some of that. You know, Wikipedia is a great example of this expansion of knowledge, this democratization of knowledge. At the same time, you know, with much of the kind of web 2.0 with this move of social media, there's been this medical misinformation, there's just been all these crazy conspiracy theories and so much muddying of the waters. To the absolute delight of these food corporations who want nothing more than you to just get so frustrated you throw up your hands and put it eat any kind of crap that's put in front of you. Even though there's clear consensus in the nutrition literature going back decades around the really the core tenets of healthy eating, like eat more fruits and vegetables, it's.

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Was just that simple. So how much of it is that people don't have the information? Or how much is it that they don't actually want to adhere to the direction that is available to them?

No, that's a fantastic question. In fact. So the controversy really isn't in the medical field is not so much about the science, but it is about compliance. So you know, when I talk to my fellow colleagues, no one doubts the science, but they're like, I can't even get my patients to stop smoking. There's no way they're going to eat like this. And so they don't even bring it up. And I think that's a really dangerous, patronizing attitude. They're like they make up their own mind whether or not to even bring this information to patients. And it's true, many patients are not going to do anything with it they just want a pill or they're not going to do anything. And look, that's totally up to them, but at least they should have the choice, right? And it's your body, your choice. You want to smoke cigarettes, you want to go bungee jumping, you want to, you know, not wear your seatbelt, right? I mean, see, it's up to each of us to make our own decisions as to how to eat and how to live, but we should make these choices consciously, right? Educating ourselves about the predictable consequences of our actions. And so that's where I feel my work comes in. It's like, okay, here's the pros and cons. And then it's up to you. Do what you want. I just don't want you to make decisions based on some propaganda from Coca Cola rather than the actual science.

Well, that's one of the reasons why I like your new book, how not to Age so Much, is it? You're not preaching at people at any point in the book. You must do this, you must do this. But you give different viewpoints. You back everything up with the science that you've done. And clearly you put a tremendous amount of work into this book. I mean, I wrote two books and nothing like this. I can't even. First of all, writing a book in itself, it's hard. But to do it, allowing for all these different perspectives, even to the point you just made. Not only do you share, yes, here are some of the food tips and tricks that will help you with this situation. You give a lot of different perspectives and options that it isn't just one way. What made you write this book and put so much work into it?

Look, some people are going to take this information and they'll make one decision. And other people learn this information, the exact same information, and be like you just have different values and decide to do something else. That's why I didn't want to prescribe anything, because how do I know? Just because I feel this way, just because I think it'd be worth it for me to do X, Y and Z every day, it may not be worth you and everybody has the right to make that decision up on their own. My aim with this book was really to create the most comprehensive anti aging book ever written, to really cover every possible strategy for slowing the aging process for the longest, healthiest life based on the best available balance of evidence. And really the good news is 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.

And so what do you say to the people that say, no, it's genetics. And I know what you say because I've already seen it in the booklet and there are so many people that say that. I have people say to me all the time, oh, you're blessed with great genetics. And I think, sure, but are you at the gym with me every morning at 6am and are you the one that decides to go to bed at 10 o' clock at night when there's plenty of other things I could do? I know firsthand that isn't always the case. But what do you say to people when they attribute everything to genetics?

Oh yeah, well, I mean, you just have to look at the science. So based on studies of identical twins who have identical genetics, the same DNA, only about 25% of the variation in lifespan between people is determined by genes. The question is, okay, well then what can we do to exercise control over the vast majority of which we have control? And that's really what I delve into in the book. And it's true, some people are blessed. They don't have to eat as healthy or work out as much as other people. But the people who do have bad genes, where these diseases run their families, well, that's no excuse. They just have to actually work harder than everyone else. They have to eat even cleaner diets. So it's not an occasion to throw up your hands. It's an occasion to really double down on healthy lifestyle choices.

And you've seen people with poor genetics be able to be very disciplined and have a powerful impact.

Oh, absolutely. In fact, something like, you know, Alzheimer's, you know, there's this Alzheimer's gene, APOE4, which can as much as quadruple one's risk of getting Alzheimer's disease. But lifestyle changes can actually trump that. So for example, there's something called the Nigerian paradox, where in Nigeria they have among the highest rates of this Alzheimer's gene anywhere in the world, just genetically, but actually have some of the lowest rates of Alzheimer's disease. How is that possible? It's because they eat these plant based diets that lower their cholesterol. And that's what APOE does. It's the primary cholesterol carrier in the brain. Basically, what's good for our hearts is good for our heads. And so by lowering cholesterol low enough, we can actually undermine the ability of this gene to actually increase our Alzheimer's disease risk.

Okay, so for anyone, and that's super interesting because Alzheimer's is so Widespread, especially here in our country. You hear so much about it, so many people afflicted with it, and so great to hear that there's healthy ways that people can address this. For people who are thinking, okay, how not to age. Because this is what I thought when I first heard about your book. I thought, oh, my face, how to get my skin to look better. What overview can you share with people right now that this book, while it does affect how you look, it isn't just about your skin.

I really had to add that stuff in because I knew people would be interested in kind of the cosmetics of it and really wanted to have such a comprehensive book and so do have a whole chapter on preserving skin. So that's kind of one. There's kind of four sections of the book and section three is preserving function. So preserving your bones and your vision and your hearing and your circulation, etc. And I do talk about skin, do talk about nails, talk about hair, things that people care about, but also wanted to talk about, you know, slowing the aging process itself for these age related diseases like dementia and cancer and heart disease. And thankfully, it's really the same kind of things. It's not like, oh, you have to choose between looking better or being better inside. The same things, you know, that are good for you on the inside are good for you on the outside. So it was really kind of a natural. It really naturally came together and they really kind of complement each other.

Well, that section of the book intrigued me because recently I've been noticing that more hair has been falling out of my head. So I went right to that part of your book and you actually said, I believe it was wheat germ is something that people could take.

Germ. Absolutely, yeah. Because of the spermidine. Yeah, exactly.

But so random. I've never heard anyone talk about that.

Oh, I know, I know. It's all about boosting autophagy, which is this kind of internal house cleaning system which helps our cells rejuvenate by getting rid of build up cellular debris that contributes to the aging process. And actually, hair follicles are one of the most active growing tissues in the entire body and so need a lot of this autophagy. And so that's why that's how this spermidine comes in. So the most concentrated source is wheat germ. You can also get some eating plain white button mushrooms, green peas. There's a number of sources if you, for whatever reason, don't like wheat germ.

Okay, so on that, we've just brought something else up about all of these cells that. Sensitic cells or I don't know.

Oh, senescent cells.

Thank you. Can you tell us a little bit about that?

Oh yeah. Cellular senescence is one of the 11 pathways of aging that I talk about in the book. It's the basic of the accumulation of what are called so called zombie cells. Basically considered one of the foundational hallmarks of aging. Most of our cells are only able to divide about 50 times before kind of stalling out, at which point they secrete these inflammatory compounds to signal to the immune system to basically to clear them out. Unfortunately, our body to remove these cells declines with age. So our tissues end up littered with them. And so they keep spewing this inflammatory mediators and that actually contributes to the aging process. Thankfully, we can prevent premature senescence by averting oxidative or free radical DNA damage and potentially help clear them out once they've already formed using these so called senolytic compounds. There are natural senolytic compounds. Quercetin, fisetin, piprolongumene. Quercetin is found in onions, apples, kale, tea and capers. The kind of the Mediterranean spice. And then phistin. Really only found one food, strawberries. So I encourage people to eat fresh frozen or freeze dried strawberries. And then this Piper longamine is found in a food in the black pepper family called long pepper or papali. That's how you'd buy it, like in an Indian spice store. And you can try seasoning your meals with that as one of the ways to block that particular aging pathway.

Another buzzword or something that I have been hearing a lot about that I didn't understand that you get into the book is the nads. Can you talk to us a little bit about.

Yeah, no, that's interesting. Yeah. So nad, which is essential co factor basically for hundreds of different enzymes in the body, including a number of anti aging enzymes like sirtuins. So boosting NAD levels has been shown to improve the health span and lifespan of a variety of kind of laboratory animal models. It's not clear if those benefits are actually ever going to translate into humans. So far there's been difficulty doing so. There's a number of NAD boosting supplements on the market with the whole Alphabet soup of names. There's na, na, M, nr, NMN on down the list. It really turns out that none of them have been demonstrated to be both safe and effective and perhaps better than kind of blindly overloading the system with these NAD precursors. The body seems kind of too smart to allow the Levels in our tissues to actually change when we take these by pill. So really I encourage people to go for the natural approaches for boosting nad, which is amping up this enzyme that makes NAD in the body called nampt. How do we do that? We can do that through exercise. The only known thing that can actually boost NAD levels in our muscles. And then the other half of it is trying to prevent excess NAD degradation by suppressing the overactivation of two NAD consuming enzymes, one called PARP1, one called CD38, basically involved in oxidation and inflammation. And so by decreasing that by eating more antioxidant rich foods, by eating anti inflammatory foods, you can naturally boost levels of NAD in our tissues and hopefully getting some of those benefits that we're seeing in the lab.

So you bring up the importance there of working out. Well, do you mean exercise in doing cardiovascular exercise or does that mean weightlifting? And how does that affect the body differently?

So both, so both can increase NAD levels in the muscles. And so for healthy aging, we not only want aerobic exercise, get our heart rate up, but we also want resistance exercise like strength training using bands. And finally, something critically important, particularly in older age, is balance training for fall prevention. So about 85% of age related fracture risk actually has nothing to do with our bone mineral density, really has to do with falls, preventing falls. And so we do that by strengthening our lower limbs through strength training as well as these balance training exercises can decrease bone the risk of osteoporotic fractures. 74%. Something that none of the, so called, you know, anti osteoporosis drugs have ever been able to shown to do. And that's just one of the benefits of exercise. You know, we tend to think of exercise as just, you know, improving muscle mass and strength and preventing falls. But people don't realize that exercise does so many other things in our body. Enhances cognition, improves mood, treats depression, improves immunity, artery function, erectile dysfunction, insulin sensitivity, overall quality of life. And so yeah, it's a critical component to any kind of optimal anti aging regimen.

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It's so funny because like anyone listening, there's certain things like some people just eat really healthy or know to always eat their vegetables and you know, have a great mix of fruit fruits in their Life. Some people know to get eight plus hours of sleep a night, aren't disciplined about. Some people love to work out. Well, whatever the pieces. And for me, I love working out. So of course I work out my whole life, you know, any and every day I can, my whole life. So that's no brainer. But to think about after, especially after digesting the information in your book, I know I'm not getting anywhere near the amount of nutrients and the right foods and you know, that can seem overwhelming. How do you advise people when they feel overwhelmed by one of these elements and how they can incorporate into their life?

Yeah, well, I think the most important thing to recognize is that one need not make drastic changes. It really isn't all or nothing. Even basic common sense lifestyle factors can mean literally living the difference of a decade of healthy life expectancy. And that's not smoking, not being obese, regular exercise, eating more fruits and vegetables. So it's really the basics that's really the core regimen. And it's never too late, never too late to start eating healthier, never too late to start moving, never too late to stop smoking. We really do have the power now. That'll get you 80% there. Now if you're interested in that last 20% working at the margins, all the little tweaks, you can do books like mine, you get just a wealth of all sorts of things. But let's not lose sight of really the core basics. I don't want people to get intimidated and be like, well, I could, you know, just not do anything. Even 15 minutes of walking a day is associated with significantly lower risk of premature death. Right. So any exercise is better than none. So yes, ideally, I mean, we have science suggesting that up to 90 minutes of daily exercise, moderate intensity exercise, you get accrual more and more benefits all the way, at least up to 90. And we only know 90 because there's not enough people to study that get more than 90 minutes of exercise every day. But I think the authorities, the reason they Recommend Only about 20 minutes a day is because they want to make it seem approachable, doable, non intimidating. And so look, just tell people the truth, any exercise is better than none. Absolutely. But look, there's benefits all the way up. So the more the better at these kind of moderate intensity levels. I'm a big proponent of just kind of laying it out there and then letting people pick and choose what works for them. Knowing that again, not black or white, you know, anything we can do, you know, on a daily basis doesn't Matter what we eat on our holidays or birthday special occasions, it's the day to day stuff that really adds up on a day to day basis. Really should try to eat healthy. And that's trying to center our diets more around the healthiest of healthy foods out there, kind of unprocessed plant foods.

So one of the other things that you brought up in the book that I thought was interesting and important to include is stress and relationships and how that impacts the body. Can you tell us a little bit about that?

Yeah. So those are two factors of the so called blue zones, these areas of exceptional longevity around the world they have more these centenarians people live over a hundred. So there's these hot spots of longevity around the world. And so the whole point is, well, let's look at the Venn diagram of like what do they all seem to do together? And so in terms of their diet, they all, you know, center as a primary source of protein, some kind of legume, beans, split peas, chickpeas, lentils. That's the cornerstone of all blue zone diets. You know, don't eat a lot of processed foods, sugary food, salty foods, all these things. And so we can get a sense of what a longevity diet might look like. But they also have other healthy lifestyle factors like regular movement. Even though they don't necessarily go to the gym, they're you know, out in the garden, they're active throughout the day, they're not sedentary, they're not sitting for six more hours a day like so much in the western world does. And they also weight control. They also tend to be kind of ideal BMI and stress reduction and social connectivity. Now for those of you who start to stress about their stress, it's important to recognize that stress does not appear to be an independent risk factor for premature death, but it's mediated through changes in lifestyle. So people who are stressed tend to eat more and tend to eat worse, as well as smoke more, drink more, more likely to do illicit substances. And so it's that. So if you actually adjust for those factors, you actually don't see people who are stressed living significantly shorter lifes. It's only through the changes in lifestyle. So if you can maintain your lifestyle despite the stress, you will not suffer the ravages of that stress in terms of any decrease in longevity. And the same thing with connectivity, social connection, loneliness, bereavement, stress, all associated with significantly shorter life, but mediated through the lifestyle changes. So the reason why, you know, people die soon after their spouses is all Of a sudden they turn to the drink, the don't eat a salsa that they used to be. And if you control for those factors, then it all kind of washes out. And so those are two very important factors, but they're dependent factors and they're not independent factors mediated through those lifestyle changes. So maintaining a healthy lifestyle can get you kind of through all the rocky phases of life.

Wow. So, I mean, it must have been some regards interesting to you as a doctor to see Covid happen in real time and be able to process the changes people went through. What are some of the things that you saw there?

What we saw predominantly was how critically important these so called comorbidities are, these pre existing medical conditions. And so what determined most whether someone would suffer severe course or even die from COVID was whether or not they were obese, whether or not they had heart disease, high blood pressure, diabetes. And so that's all good news because we can actually have control over those lifestyle diseases. And so my hope was that, okay, all of a sudden people are sheltering in place, staying at home. Now they have control over their environment. They're no longer walking past the donut shop, there's no longer a bowl of candy on your co worker's desk, you know, and you're at home, you know, you may have more control over your schedule. So what a perfect time to get an exercise regimen in. What a perfect time to clean out the pantry and just surround yourself by good food. Right. That was my little idealistic. You know, it's like now you can do it, right and really reduce your risk of having serious consequences. Unfortunately, that's not what people did. And they just started, you know, instacarting cookies or whatever. And unfortunately we lost about two years of life expectancy. Well, life expectancy peaked actually 2014 started to decline even before COVID thanks to the obesity epidemic. We're raising now the first generation of Americans that are going to live shorter lives on average than their parents. And then Covid comes along, really knocks our kneecaps out. And so there's a lot of work to do, but we really do have the power much control over our life expectancy and disability.

Why would it be that if our children now are going to lead shorter lives or have potentially shorter lives when they have more information that doesn't make.

Any sense, Wouldn't you think it right? Well, because, you know, all the information in the world has not stopped the obesity epidemic from continue to increase. We now 70% of Americans are overweight, obese, we Have a childhood obesity epidemic which is going to manifest its increased rates of type 2 diabetes. We're already seeing young children. We used to call it adult onset diabetes. Now we call it type 2 diabetes because it's no longer just starting in adulthood, it's starting younger because there's so much excess body fat on so many of our youth. And so that's why if the trends continue as they are, we're going to see these really kind of a public health catastrophe. But it's important to recognize that obesity is not some moral failing, right? The battle of the bulge is a battle against biology, right? Being overweight is a normal natural reaction to an abnormal, unnatural ubiquity of these sugary, fatty foods. We are just drowning in a sea of excess calories, being pummeled all day long by advertisements for fast food and junk food and candy. No wonder, right? We're in this situation. We are unfortunately the most profitable foods like brown sugar, water in a bottle, it's pure profit, are the least healthy foods. And the healthiest foods like fruits and vegetables are the worst investment, right? The food actually goes bad. You know, you want a snack cake that lives on the shelf, right? That's why you're never going to see an ad on TV for sweet potatoes or something. It's just the system is set up to incentivize all the wrong things, right? I mean, the head of Coca Cola doesn't want to see, you know, a childhood obesity epidemic. They just want to satisfy their shop shareholders for the next quarter. And how do you do that? You don't do that through healthy food. And any CEO that did would get instantly booted out and replaced by someone who could make shareholders money. How do you do it? You do it selling, you know, carbonated brown sugar water with taxpayer subsidized sugar industry. I mean, it's just pure profit. Unfortunately, these companies do not have the health of our families forefront in mind.

Clearly not. But when you just brought up 70% of population being obese, that shocking to me. Number one, I live in Miami, which might be a little bit different because it's very much an outside lifestyle. However, and I'm interested to hear your perspective on this. So many of my friends are on Ozempic or diabetes I believe, and have lost so much weight and are thinner than ever. What are your thoughts on like these one pill, one shot wonders, these weekly.

Injectable drugs like Ozempic, now there's a whole bevy of them that just got approved by the fda. I mean, I think good Options of last resort like bariatric surgery. I see them very similar to bariatric surgery where if you are unable or unwilling to treat the cause of your obesity and lose weight, then the benefits outweigh the risks because obesity is such a dramatic pull on our life expectancy and increases morbidity like osteoarthritis and diabetes on down the risk. So for example, bariatric surgery, you can randomize people, obese individuals to get bariatric surgery, which is actually a risky surgery. It's difficult to do those kind of surgeries and still they actually live longer than those in the control group that didn't get the surgery, despite the risk of the surgery because obesity is so devastating. And in fact, even in the bariatric surgery group they ended up obese. So they went from really obese to just a little obese, still live significantly longer than the control group that stayed really obese. And we would expect, although we don't know the long term consequences of these new drugs, even if they have some pretty significant side effects, it may very well end up in the wash that you would live longer on these drugs. Of course you'd have to take them every week for the rest of your life. But of course that's exactly what big pharma wants. I mean that's the cash cows of big pharma. It's not the life saving, 10 day antibiotic course that doesn't make money. It's these lifestyle drugs where you give someone, you know, blood pressure lowering drug or cholesterol lowering drug every single day for the rest of their life, or an anti osteoporosis drug every day for the. That's how you make money. But we can treat the cause that led to these diseases in the first place with diet and lifestyle changes that may be actually more effective than these drugs and just really have positive side effects.

It's just incredible when you hear it rationalized to you so directly that we still as a population continue to make wrong choices when the information is so right there. One of the things I loved about your book, how not to Age is you can literally find specific topics and go right to it. It's almost like a dictionary for your health.

Right?

Because I've been struggling personally with some inflammation in my Achilles which happens to any runner whatever, but I'm thinking there's got to be more here than maybe the right stretching. Because some people you'll just hear you're out of alignment or you're not stretching and you need more ice. And so then I began thinking, oh, that's the only issue that it could be until I was looking at your book and I started diving into inflammation and some of the simple solutions like tea. That was such a surprising hack to me that I gleaned from the book.

That's.

It's so helpful.

Yeah, yeah, yeah. No, we have tremendous influence. The book is kind of intimidating size wise, but you don't have to read it kind of start to finish, right? You're just like, oh, all I really care about is I'm losing my hearing. Okay, well, you turn to the. That chapter or, you know, whatever. So it's going to exist as a reference book to kind of always go back to that was really my kind of goal in doing it. But the downside of that is it looks kind of like, you know, oh my God, that's just too complicated kind of thing. But it's just little chunks on all the various different conditions. You think about all the conditions, age related conditions. Well, of course it's going to be a big book even if I spend, you know, just half a page on every one of them.

The way that it's laid out, it's very simple for anyone. I used it myself to be able to go in and search. This is the topic I'm curious about. And you can find the information very, very simply. It's laid out incredibly easily. Well, which to me, that's what's so useful for it. Because when I first got the book, I was thinking, okay, how do I approach it? And then just out of curiosity, I thought, well, let's go look at my issues that I personally have first to see. And then recently I haven't been sleeping enough. And so then I'm like, well, I should probably read more about the sleep chapter right now because I haven't been doing a good job on that. And I wonder what impact it's having on me. And then you start educating yourself and you start saying, oh, wait a minute, this isn't worth it to continue shortchange my sleep.

Isn't it interesting? And so, like simple things like wearing socks, they have randomized controlled trials and putting on warm socks improves your sleep. And I talk about exactly the mechanism by which that happens. But it's like, how cool that there's just these simple things and it's not like there's some big sock out there that can, you know, send out press releases about this kind of study. This kind of great science just gets kind of buried. There's just not a lot of kind of profit to be made because people will just buy your competitors warm sock. I mean, just the system isn't set up right unless you have kind of a branded, patented product like a drug. You know, there just isn't this financial incentive to really educate people about it unless you have some kind of gimmicky product. And so all this amazing science just gets completely lost. And so that's, I feel that's really my job is to dig through all that and bring out those things where. Yeah, no, the only people are going to profit off of it are you and me and our families. We're going to profit through our health.

Give us an idea, a day in your life of what your food choices, exercise choices, and sleep choices are like.

In terms of diet, which is probably the most important factor over which we have control. I encapsulated my eating recommendations in the Daily Dozen checklist of all the healthy foods. I encourage people to fit into their daily routine. And so there's a free app called Dr. Greger's Daily Dozen on iPhone Android. I talk about it in my book, How Not To Die. So basically, it's like I encourage people to eat dark green leafy vegetables every day. The healthiest vegetables, berries, the healthiest fruits, tablespoon of ground flaxseeds, quarter teaspoon of turmeric. On down the list. How much exercise? You know, again, just trying to inspire people to include some of the healthiest of healthy foods into their daily routine. And so then those are the specific foods. And then in terms of how do I actually make those into meals? I have a series of cookbooks. There's the How Not To Die cookbook, How Not To Diet cookbook. The How Not To Age cookbook will be out December 2024. So it's not going to be around for another year. But I do have a few recipes in the book. In terms of exercise, it's really more about just not being sedentary. So I'm actually on a walking treadmill now. Normally I'm kind of walking during interviews, but I've got complaints that make people seasick. So I turned off the treadmill. But just during the day while I'm working, I'm able to clock about 14 miles a day just going through my daily business. Yes, sleep is critically important. The best way is to go to bed early. And then basically whenever I wake up, it's like, even if for whatever reason I get woken up early, you know, at least I've, you know, kind of nailed it. It's like eating a really healthy breakfast it's like whatever happens during the day, you know, at least I got a foundation. So going to bed really early and thankfully I'm able to do that less. So on the road, it's a little more difficult. I usually come speaking late, kind of long book signing lines. But when I'm at home, I have control over my diet. You know, there's just not bad food in the house because I know myself and I know I could white knuckle it for a while and just eat healthy food. But you know, I'm gonna have a bad day and I'm gonna go for the things that I shouldn't be eating. So I just don't have that temptation. There's just no bad food in the house. And so look, I get hungry enough, I'm gonna eat that apple because it's like the best thing I got. You know, I don't have to choose between eating cookies, you know, so that's basically kind of my schedule when I'm at home, then on the road, you know, I do my best to try to eat healthy. It's tough.

I love that you share that with such honesty though, because, you know, it's funny, the other night there was a really bad storm in Miami and the noise is all night. I couldn't sleep. And it was one of the first times I had very, very little sleep. I felt terrible, unproductive. I had the worst day. The next day reminded me of having a baby. Literally that bad. You forget what it's like to have run on, no sleep. And then I started thinking about if this is what it's like in a big fashion. Imagine over time, if you're always short, changing your sleep two, four hours, whatever you're, you might not get hit with it that way, but over time, it's gotta impact you in such a big way. It's got to be terrible.

And many people live their lives like it. They don't know any different, right? And so that's why it's amazing when you change people's diets and, you know, they, you get these like, you know, they have this chronic dyspepsia or like, you know, upset stomach. They were like, I just thought it was normal to feel really crappy after a meal or whatever. Or, you know, it's normal to just drag your feet and be really tired and not, you know, difficult to get out of bed and stuff. No, no, no, normal, you know, healthy is normal. Your body wants to come back to health. If we're not stabbing with a fork three times A day or, you know, not giving it sufficient sleep. You know, there's these amazing studies where you can randomize people sleep deprived under five hours or at least seven hours of sleep, and then drip rhinovirus, drip, the cold virus in everybody's nose, nose. And you're five times more likely to actually come down with the cold in the sleep deprived group. And now there's 100% infection rate across the board. They literally had virus dripped inside their nose, but they were five times more likely to actually show symptoms. And the people that got enough sleep, their bodies were able to rid the virus before they even knew about it. Never even got a sniffle out of it. And so that just gives you a sense now it's unethical to do that kind of experiment with more serious viruses like, like influenza or something, but gives a sense of how much power we have. And this was just literally a week, a week of five hours of sleep was enough to so suppress the immune function. And we see similar effects with proper sleep and vaccine effectiveness. Yeah, we really underestimate the power we have over our health. You don't know how good you're going to feel until you give it a try. So I encourage people, let's do it for a few weeks, get enough sleep, eat healthy, exercise. And then at the end of those three weeks, and of course I have the luxury of being able to do labs before and after and can show them kind of the objective benefits. But their own bodies are telling them they're feeling better, they have more energy, better sleep, better digestion, less painful periods, whatever it is, such that instead of it's just a doctor wagging their finger in their face, their own bodies are telling them how good they're feeling. And even if they don't necessarily continue it, at least in the back of their mind, they'll know they have that power. It probably wasn't as hard as they thought it was. And so there's something they could always go back to. And so, but you know, unless you do that experiment, you don't know how good you can feel.

And the numbers that you see when you're doing this in a lab support you can see in real time.

Oh my God. Right? And so, you know, it's like when I give someone a prediabetes diagnosis, you know, you will now qualify for cholesterol lowering statin drug or your blood pressure is going too high and it's like, okay, we can do two things. We can give you a drug and here's the pros and cons. Or let's try three weeks. There's a great organization called Physicians Committee for Responsible Medicine. They have a 21 day kickstart program which is completely free at 21daykickstart.org it starts on the 1st of every month. Hundreds of thousands of people have done it. It's a bunch of different languages. You kind of start as like a little social media group and you get daily recipes and advice and you kind of support each other. And the hope is you just dive in completely for three weeks. You know, you can eat anything for three weeks. You can eat nothing for three weeks. You know, you really like, just let's try it like a free sample. Because it's hard for people to imagine lifelong changes, right? It's like, what, I'm not going to eat another pepperoni pizza? No, no, no, no. Just give me three weeks. Let's just try it. And so I encourage people to do that. It doesn't take much time. You can be an emergency room physician and still be able to just give people a URL, say sign up beginning of the next month and just let's just try it and see how you do. And you often find that even within those few weeks, you can so dramatically drop their cholesterol, they no longer qualify for drugs. Their blood pressure, you know, normalizes. The only caveat is that if you are already on blood pressure lowering or blood sugar lowering drugs, drugs, you have to do this in conjunction with your medical professional because your doc has to wean you off these drugs as your body gets better. Once you start treating the cause, your blood sugars and blood pressures can so rapidly normalize that you can find yourself over medicated, which can be dangerous. You can drop your pressures too low, drop your sugars too low. And so your doctor has to wean you off these drugs as your body gets better, literally starting within just a few days.

Wow, that is incredible. You mentioned something that just triggered something for me. You said, or eat nothing. Talk to us a little bit about fasting and intermittent fasting and the impact that has on the body.

That's actually the biggest chapter of my book, how not to Diet, which talked about weight control because there's so many different types of intermittent fasting, Alternate day fasting, 5.2Fasting, 25.5Fasting, mimicking diets, et cetera, et cetera. Really the bottom line, and there's kind of pros and cons across the board, but the bottom line is that early time restricted feeding is beneficial. So that means restricting your daily feeding window to 12 hours or less. But critically, it's pushed towards the morning rather than the night. So if you're going to skip any meal, you skip supper, not breakfast. We should try to shove as many calories earlier in the day as possible. Because of our circadian rhythms, our bodies are better able to deal with junky foods. If you're going to eat junk, you do it for breakfast. Because the exact same food in the morning is less, less fattening than the exact same food, exact same number of calories 12 hours later in the evening, and has less of a triglyceride bump and less of a blood sugar load. And so big breakfast. So making breakfast or lunch is the biggest meal of the day. Actually may be one of the reasons why the Adventists in Loma Linda, California, the last remaining Blue Zone, actually have the longest formally studied lifespan in history, is because they have this religious teaching to do that early time restricted feeding. That may be one of the reasons they live so long.

Wow. I mean, these are incredible hacks that anyone can implement right now to have profound difference in your health immediately. Within just the first couple of weeks as Dr. Krieger took us through. How can everyone find the book how not to age? And how can they find you?

So they can find me@nutritionfacts.org where all my information is free. There's no ads, no corporate sponsorship, not selling anything. Just put it up as a public service, as a tribute to my grandma. You can get the new book at your local public library. I don't get a penny from any of my books. All proceeds donated directly to charity. I just want everyone to enjoy the longest, healthiest life.

Dr. Greer, thank you so much for the work you're doing and thank you so much for this book. It's an incredible resource and I'm super grateful you created for us.

Oh, I'm so happy. Keep up the great work yourself.

All right, guys. Get the book. How not to age. Dr. Greger. And start changing your life today. See you next time.

Next week.

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