How Not to Age

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Research Advisory Committee member, Dr Michael Greger, discusses his most recent book; How Not to Age.

I turned fifty in the process of writing How Not to Age, so the subject has a certain salience lacking from my last nutrition book, How Not to Diet, which covered weight loss. There is, however, a clear parallel between the two topics: both are tainted with the same corrupting influence of commercial interests. The diet and anti-aging industries are both multibillion-dollar behemoths. With so much money in the mix, the temptation to promote products purporting all sorts of preposterous claims is apparently irresistible.

Imagine if there was an intervention that didn’t just reduce your risk of the leading killers, but also arthritis, dementia, osteoporosis, Parkinson’s disease and sensory impairments. Because such risks tend to double every seven years, even just slowing aging to the extent that the average 65-year-old, for example, would have the health profile and disease risk of today’s 58-year-old would be expected to cut in half everyone’s risk of death, frailty and disability.

This is why I wrote How Not to Age.

My inspiration was the consensus document “Interventions to Slow Aging in Humans”. Its authors identified the most promising strategies for slowing aging, including the pharmacological regulation of the anti-aging enzyme and hormone, AMPK and FGF21 respectively, and the pro-aging enzyme mTOR and hormone IGF-1.1 As I looked through the list, I realized: every single one of these pathways could be regulated through diet.2,3,4,5 That became the opening section of How Not to Age.

In Part II, I delved deep into the behaviours that those in the five longevity hotspot “blue zones” around the world share in common. In constructing the optimal anti-aging regimen, I explored the best and worst foods and beverages. Is red wine deserving of its symbolic status for longevity? What about coffee? I covered the “longevity vitamin” ergothioneine, the vegetarian’s Achilles’ heel, and the best exercise and sleep routine for the longest, healthiest life.

Then, in Part III, I got to the nitty gritty. What can you do to preserve your bones, bowels and circulation? Your hair, hearing and hormone balance? Your immune function and joint health? Your mind and your muscles? Your sex life and skin? Your teeth, your vision and, finally, your dignity in death? There are chapters on each.

My Anti-Aging Eight was the final section of How Not to Age, an actionable checklist to complement the Daily Dozen I established in my earlier book How Not to Die. In the Daily Dozen, I compiled the healthiest of the Green Light foods - foods of plant origin from which nothing bad has been added and nothing good has been taken away - into a checklist of foods I encourage people to try to fit into their daily routines. I made it into a free app, Dr. Greger’s Daily Dozen, available for iPhone and Android, so that anyone and everyone can try to check off all the boxes every day and track their progress over time.

My Anti-Aging Eight was meant to expand on my Daily Dozen and highlight specific foods, supplements, or behaviours that have the potential to offer some of the best opportunities to slow aging or improve longevity: nuts, greens, berries, prebiotics and postbiotics, caloric restriction, protein restriction, xenohormesis and microRNA manipulation, and NAD+.

My aim for How Not to Age was to cover every possible angle for developing the optimal diet and lifestyle for the longest, healthiest lifespan based on the best available balance of evidence.

A midlife switch between the ages of forty-five and sixty-four to even just the barest of minimums – at least five daily servings fruits and vegetables, walking about twenty minutes a day, maintaining a healthy weight and not smoking -resulted in a substantial reduction in mortality even in the immediate future. We’re talking a 40 percent lower risk of dying in the subsequent four years.

There is so much we can do to extend our lifespan and our healthspan. A recent remarkable study of more than half a million participants, for example, found that those who salted their food at the table (in addition to whatever salt was used in cooking) appeared to have a twoyear lower life expectancy at age fifty compared to those who didn’t. So just swapping out the salt shaker for some savoury salt-free seasoning could potentially add years to your life.

Meta-analyses suggesting that you could add years to your life just by avoiding eggs or bacon, or by eating nuts every day or certain fruits? It just seems too good to be true. Regardless of the absolute magnitude of the effect, diet is understood to be the number one determinant of how long we live. We are what we eat.

The views expressed by our Research News contributors are not necessarily the views of The Vegan Society.


[1] Longo VD, Antebi A, Bartke A, et al. Interventions to slow aging in humans: are we ready? Aging Cell. 2015;14(4):497–510.

[2] Hu GX, Chen GR, Xu H, Ge RS, Lin J. Activation of the AMP activated protein kinase by short-chain fatty acids is the main mechanism underlying the beneficial effect of a high fiber diet on the metabolic syndrome. Med Hypotheses. 2010;74(1):123–6.

[3] McCarty MF, Barroso-Aranda J, Contreras F. The low-methionine content of vegan diets may make methionine restriction feasible as a life extension strategy. Med Hypotheses. 2009;72(2):125–8.

[4] McCarty MF. mTORC1 activity as a determinant of cancer risk—rationalizing the cancer-preventive effects of adiponectin, metformin, rapamycin, and low-protein vegan diets. Med Hypotheses. 2011;77(4):642–8.

[5] Ngo TH, Barnard RJ, Tymchuk CN, Cohen P, Aronson WJ. Effect of diet and exercise on serum insulin, IGF-I, and IGFBP-1 levels and growth of LNCaP cells in vitro (United States). Cancer Causes Control. 2002;13(10):929–35.

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