00:03:49 – Information and Medicine
00:06:03 – Nutrition Facts
00:07:03 – Environmental Mismatch
00:18:25 – Nutrition Nerd
00:28:03 – Role in Longevity
00:32:03 – Pathways of Aging
00:38:31 – Mineral Sunscreen
00:43:38 – Air Pollution
00:46:25 – Modeling Good Behavior
00:56:59 – Nicotine
00:58:42 – Swan Study
01:01:16 – Nutritional Facts
01:16:53 – Lifestyle Medicine is Growing

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Show Transcript:

[00:03:49] Gabby: And I’m so curious, um, when you went to school and I want to talk about your grandmother, did you think that in a way you were going to be using kind of? Information and medicine and performance to get people to try to comply like you have this unusual knack for sort of delivering your information that I thought, oh, I wonder if he thought about this when he was younger that this is how it was going to show up.

 [00:04:16] Michael: Uh, no, I mean, I certainly went into this because of my grandmother, but, but the, the, thankfully the knack, my, the Venn diagram of the knack and what I was interested in doing in my life seems to have crossed over. But, uh, yeah, they, they, the drive came first, and the knack is just, you know, gravy on the side.

 [00:04:38] Gabby: So maybe you can share, because I think when you have people who are Data driven and scientific, um, but a lot of this you’ve gone into because of something that your grandmother went through. Maybe you can share the story. Cause I think, I think it’s really powerful.

[00:04:53] Michael: Yeah, I was just a kid when my grandma was, uh, sent home in a wheelchair.

To die. She was diagnosed with end stage heart disease. She already had so many bypass surgeries that you basically run out of plumbing at some point. Confined in a wheelchair, crushing chest pain, there’s nothing more they could do. 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. Talks about Frances Greger, my grandmother. They wheeled her in. And she walked out. Though she was given a medical death sentence at age 65 thanks to a healthy diet, she was able to enjoy another 31 years on this planet until age 96 to continue to enjoy her six grandkids, including me.

So that’s why I went into medicine. That’s why I practice lifestyle medicine, why I started the website nutrition facts. org, why I wrote the book How Not to Die, why all the proceeds from all my books are donated directly to charity. I just want to do for everyone’s family. What Pritikin did for my family

[00:06:01] Gabby: and I want to talk about nutrition, uh, nutrition facts.

If for people listening, you have an insane number of videos. Everything is for free. Um, you know, these are well produced, well thought out videos. So, I want to direct people’s attention and you also have things in category. So, if people have a specific kind of, if it’s gut health or, Hearing or sight or things like that.

You’ve really, you, you really covered a lot of that and you, your two previous books, you mentioned one, how not to die and how not to diet. Um, and your latest book, how not to age. Um, you know, I’m, I’m curious just off the top. And I, I think I asked people this a lot. What is it that keeps us? Cause we do have the information out there.

What keeps us? Are we fighting our biology in compliance with our environment? Is there this mismatch? Like, what do you see that keeps people from first not even being able, you know, to kind of get into this conversation? Because I do find that part fascinating.

[00:07:03] Michael: Absolutely, is what we have is environmental mismatch.

So, becoming overweight, which is normal, 70 percent of Americans are overweight or obese. Becoming overweight is really a normal, natural reaction to an abnormal, unnatural environment where we are just bombarded by ads for fast food and junk food and candy. We’re, we’re, we’re surrounded by this sea of excess calories drowning.

In a sea of excess calories, um, with the sugary, salty, fatty foods, um, constantly being, being shoved in our faces. The battle of the bulge is a battle against biology. Um, and so the industry, I really found the processed food industry has found a way to kind of hook into our natural biological urges and kind of turn it against us.

Um, and they don’t appear to have our family’s health.

[00:08:00] Gabby:  Front of mind, your plant based. But even within that, now we’ve been kind of been made to be scared of, Oh, this, the soils and the, and pesticides and the glyphosate and things like that. I just love to know as you’re not as just you, the person, as you’re navigating your food systems, and obviously you’re really informed about, you know, what you can peel, what not to what really is good to avoid and things like that.

What’s just your daily practice of how you’ve put together your nutritional life? Because we’re going to get deep into the science and the nutrition, but I just love to hear as a human being how you think about it because you’re busy, how you travel, just how you navigate it.

[00:08:46] Michael: Yeah, I mean, it’s really about how taking a step back, getting proper context and having priorities, right?

What’s really the most important thing? And so, for example, in How Not to Die, I talked about this modeling study that looked at the pesticides issue, for example, and suggested that if half of Americans ate a single more serving of fruits or vegetables every day, we would every year prevent 20, 000 cases of cancer.

That’s how powerful produce is. But because they were talking about conventional produce, pesticide laden produce, the additional pesticide burden on the American public would cause 10. cases of cancer. So overall, we would just prevent 19, 990 cases of cancer, right? So that gives you a sense of the tremendous benefit of fruits and vegetable consumption versus the tiny bump in risk.

Now you say, wait a second, why not have all benefit, no risk, choose organic? Great, but we should never let concern over pesticides. Prevent us from stuffing our faces with as many fruits and vegetables as possible. You

[00:09:50] Gabby: know, 20 years ago, I have a friend named Paul Cech and he said to me, Listen, you and I could both sit all day long at the computer working.

And there are negative impacts of that. He’s like, but if, if you’re healthy and your immune system is. pretty fortified, the actual negative impacts of that are going to be less on you. So sometimes I feel like, um, you know, a lot of these chronic illnesses or just our carrying extra weight opens the door for actually more punishment from these things than maybe if we had the ability.

Like, I really appreciate, not that you have a stress-free attitude about it, but that it’s like, hey, we can’t worry about the things we can’t worry about because that really does paralyze us. But it’s, what are the good choices we can make to make that, that doorway narrow and just fortify ourselves the best that we can and sort of leave it at that.

I feel like that feels like your approach. Yeah.

[00:10:41] Michael: And it’s, uh, no pun intended, low hanging fruit. Right. I mean, that’s, it’s really about, you know, I mean, and, you know, it’s important to realize that, you know, look, it doesn’t matter what we eat on our birthdays, holidays, special occasions. It’s really a day to day thing that adds up.

And, you know, I know, I mean, people look at my books and they’re just, you know, it’s so easy to get lost in the weeds because there’s so much information, but I really want to emphasize that one need not make drastic changes. The, uh, even basic common-sense lifestyle factors can literally mean a decade of healthy life difference in life expectancy.

And we’re talking about not being obese, regularly exercise, not smoking, eating more fruits and vegetables, right? So, these simple things, 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 tremendous power. Over our health destiny and longevity, and that the vast majority of premature death and disability is preventable with a healthy enough diet and lifestyle.

[00:11:43] Gabby: Do you think w if you had someone who was really behind the eight ball, like coming in, not having a lot of experience, w you know, do you encourage them on the movement side to kind of couple up with somebody and you know, kind of have somebody that you’re either walking with or exercising or taking that class with and on the food. I’m just curious how you give them the baby steps to, to start. It really

[00:12:06] Michael: depends on their psychology. I mean, you really got to get to know, I mean, in primary care, you can really get to know your patients really kind of understand. Some people want to go all in. They’re black and white thinkers and like, you know, it’s no such thing as moderation.

You give them a little bit, you know, and they just know themselves enough that they really got to jump in feet first. Other people. Um, probably the majority of people. It’s really about, you know, starting slow. You know, people, you know, can’t imagine, you know, a life without, you know, whatever pepperoni pizza or whatever.

I’m like, no, no, no, no. Let’s give me three weeks. Let’s just start a little free sample. Let’s, you know, you could eat anything for three weeks. You could eat nothing for three weeks. Let’s just, let’s try three weeks, see what happens. And with the hope of, by the end of those three weeks, And, you know, I have the luxury of being able to take labs before and after, but, you know, at the end of those three weeks, your own body is telling you how good you feel.

So, uh, you know, sleep better, energy, better digestion, less painful periods, whatever it is, your own body is telling you so you can kind of feel. That’s enough time when you actually feel the difference and enough time for your cholesterol to plummet, your blood sugars to get better. You’re, I mean, so, um, and so, I mean, that’s one way to do it.

It’s like, okay, let’s just try it and then look, you know, Knowing even if you don’t decide to start eating this way in the back of your mind, you know, you could do it wasn’t probably as bad as you thought or as hard as you thought And you discovered some new foods along the way that you can start incorporating in your life.

That’s one way to do it in fact, there’s a wonderful program called 21-day kickstart. org by the physicians committee for responsible medicine starts at the first of every month completely free Hundreds of thousands of people have done it. It’s in a bunch of different languages. Encourage people to go there, sign up.

You kind of join a little social media group and you get daily, daily like recommendations and recipes and support. Um, and again, it’s just trying to give you a taste of how you don’t know how good you’re going to feel until you give it a try. Yeah.

[00:13:55] Gabby: And I don’t think any slice of pizza. Ever taste as good as feeling good.

I mean, I think we get to that trade off place where we go, Oh, wait, it’s, I’m not giving up anything. I, this is better. And, and I really appreciate that that 21 days is it’s not that long. I always, I always encourage people like. Could you just have like a floating faith for 30 days until you, you feel that that change yourself?

So how not to die is a, is an extraordinarily complete book. Um, you really went all in on that and, and same with how not to diet. Um, because you realize that nutrition is sort of the, the one that kicks our butt. Um, but now you have how not to age. And I have to tell you as is, you know, I’ve probably been my entire adult life in, in kind of the pocket that’s eaten and moved.

And, and so of course, what’s the next it’s slow aging. It’s it, that is kind of the, the interesting topic. I’m just curious, you know, cause you’re not talking about, Hey, live. Live forever. It’s sort of like let’s live and move and be as healthy and vibrant and independent as we can. And then, you know, move on to the next.

But I’m just curious for you doing this work. Um, people are talking about reversing. My favorite is halting. I don’t know. Is that a thing? Uh, the process altogether and just kind of what are your thoughts on the conversations of the progress that science has made in these areas. Um, and what are the, you know, what are the conversations that are being had?

Because I think when you’re practically you go, Oh, come on, you can’t stop aging. It’s just a natural process. So maybe we could just start there. Sort of your definition of that.

[00:15:41] Michael: Yeah, well, you know, going into the book, I didn’t really know what to think. I mean, there are those, you know, like, uh, you know, Ray Kurzweil that, you know, thinks that it’s just right around the corner, some biotech advance is going to finally kind of figure out aging and, you know, they make a compelling case that there’s really nothing.

That we shouldn’t be. I mean, the fact that, for example, you know, a fertilized egg turns into the most complex thing in the universe, the human brain. I mean, the fact that that is a thing should make, like, slowing down, stopping, reversing aging, like, nothing. Comparatively, I mean, biology is just so amazing.

Um, and so, I mean, there’s nothing, we just, we just got to figure it out. And there’s been tremendous strides made in laboratory animal models. And so, we can, we can manipulate certain, um, uh, so called model species and get, you know, 50%, 60 percent increase in lifespans. Unfortunately, most of that has yet to translate into human beings.

Um, and so a lot of that is really just extrapolating out. We do have, you know, short term interventional trials. We can randomize people to different kinds of diets and lifestyles, and we can, and now we have these kind of biological aging clocks, ways to estimate not just your kind of chronological age, your calendar age, but whether or not over time you’re, you’re aging slower or faster than Uh, in terms of kind of the breakdown of one’s organ systems, um, then one would expect just based on the calendar year.

And so, we can test short term interventions, randomize people to, you know, a caloric restriction, for example, for two years and see if you actually slow the pace of aging. And doing that you can, there are a list of things that have been found to be useful in terms of slowing aging and they’re also associated with decreased risk of age-related diseases, which would make sense.

Um, and so we really kind of get the best of both worlds, not only kind of adding years to your life, but life to your years. Um, this concept of health span, the, the number of years lived in health, um, being critically important. Um, and so I, so I ended up, you know, kind of, uh, covering those kind of across the board, in addition to, you know, all the stuff I knew people would be interested in, the cosmetic stuff, the how do you, you know, preserve your skin and, you know, all those kind of things.

Um, uh, I really wanted to create kind of the most comprehensive anti-aging book. Um, uh, that exists today.

[00:18:14] Gabby: So, what did you, what surprised you? What did you incorporate in your own practice that you, when you really got into the science, you thought, Oh, I’m doing this? Like, what are some of the things that really showed up for you?

 [00:18:25] Michael: So much. I mean, basically I learned as much as anybody else when I do these books. It’s not like I was, you know, taught much of this in medical school. In fact, some of the big discoveries, like a whole chapter on micro RNAs, which is this complicated, it didn’t even exist when I graduated. It was discovered after I graduated from medical school.

So, um, so, I mean, I, that’s one of the reasons I do it selfishly is because I love, I mean, I’m just a big, you know, nutrition nerd and, you know, love dabbling into all this stuff. And then to be able to, you know, share it with everybody else. Um, uh, is, is, is, is my true delight in life, but so much surprised me.

So, for example, um, uh, surprised at what I found about exercise, sleep, red wine, resveratrol, NAD, vitamin D supplements, fish. Um, uh, uh, protein restriction, these micro RNAs, list goes on and on. Lots of things I changed in my own life. I thought I was eating healthy and I was, but, um, you know, all of a sudden, I’m, you know, spicing my foods with something called papali, which is this long pepper.

You can find like Indian spice stores has something called paper lung. You mean, which is a. so called senolytic compound, which gets rid of these so-called inflammatory zombie cells in your body. Start eating wheat germ. That’s something my mom used to feed me when I was a kid. Little did I know mom was right all along.

Wheat germ has something called spermidine in it, which activates autophagy, which is kind of your house, internal house cleaning, getting rid of cellular detritus, which contributes to the aging process. Strawberries have something called phycetin. Um, that has remarkable benefits, really not found anywhere else concentrated, um, in our food supplies.

If you don’t eat, uh, fresh freeze dried or frozen strawberries every day, you’re just not going to get it. Um, I’m eating, um, I’m growing my own mushrooms. I, I have, I grow my own broccoli sprouts. That was from a previous book, but now you can grow oyster mushrooms. Who knew that you could grow moist mushrooms in your house?

How cool is that? Cause mushrooms are something called ergothioneine, so called longevity vitamin, again, not found really anywhere else, except in kind of the. fungal kingdom. One of the reasons why I’m eating more tempeh, which is this like, uh, fungi fermented whole soy food. Um, again, ergothioneine, spermidine, all these things.

I didn’t know about any of this. Um, and it’s been fun to just, you know, kind of see way to think of ways I can kind of incorporate some of these healthiest of healthy foods into my daily routine.

[00:25:50] Gabby: Forgive me, you said micro, macro, micro RNs. What was that? Micro RNAs. Yes. Can you, can you break that down for me?

[00:26:00] Michael: Yeah. So micro RNAs are, uh, it’s hard to do it justice. It represents a cross kingdom communication pathway between plants and animals that we can kind of use to our advantage, providing both kind of a reminder and mechanism for the importance of exercise and centering one’s diet around unprocessed plant food.

Um, uh, and so it’s just a, a layering of information. Um, in a way that we, uh, we, that really challenges what’s called the central dogma of biology, where one stretch of DNA leads to one messenger RNA leads to one protein. That’s what we were all taught in high school biology and even in graduate school.

Um, but it turns out, Oh, way more complicated than that. You know, about 90 percent of our DNA is so called junk DNA, which we thought was just kind of evolutionary schmutz that just kind of built up, that our body just didn’t do anything about it, kind of akin to dark matter in the universe. But then we realized, oh, guess what?

90 percent of our DNA isn’t just sitting there doing nothing. It’s making these micro RNAs, which, um, manipulate our messenger RNAs, um, and regulate protein production. And we can use that kind of to our advantage. And in fact, Broccoli RNAs communicate with our, can, can manipulate our genetic expression and so can, you know, bovine milk RNAs manipulate our, our gene expression.

And there’s this constant war between little micro RNAs in, in pathogens trying to suppress our immune system and our immune system releasing micro RNAs to suppress their pathogenicity. It’s just a remarkable story. I had never heard of any of this before. And I had. a lot of fun with that chapter. Um, uh, and so there’s lots of kind of highfalutin, science kind of things, but I really do try to break it down.

Like, okay, what does this actually mean in terms of concrete day to day grocery store type decisions?

[00:27:53] Gabby: What you mentioned that something about you were surprised about something about sleep. I would think that you had covered that and understood that. What, what, uh, turned up that, Oh,

[00:28:03] Michael: you know, what was surprising about sleep is that, uh, the, it’s role in longevity is surprisingly controversial.

Um, and so while sleep it’s, uh, it’s, it’s, it’s not, it’s beyond, uh, without a doubt, it can, you know, decrease risk of like, you know, automobile accidents, not being sleep deprived, it can improve our immune function. You can actually drip rhinovirus into people’s noses. Um, uh, and which is the cause of the common cold.

And if you’re getting less than five hours of sleep. five times more likely, um, actually coming down with a cold than if you got seven or more hours of sleep every night. Um, and so, uh, there was a hundred percent infection across the board. I mean, you literally got virus dripped in your nose, but, um, you’re five times less likely to show any signs of the cold.

 Your body, your immune system is just that much better at, at, you know, at, at crushing the virus before it even causes any problems. And so, what would expect with these kinds of benefits that we would actually see a difference in terms of longevity? But unfortunately, sleep doesn’t appear to affect cardiovascular disease, and that’s really the number one killer, kind of, by far in this country.

Heart disease, number one killer, both men and women. And so, if something doesn’t affect heart disease, it’s really hard to make a change in terms of all-cause mortality. I mean, even something like, even if we cured cancer, the overall life expectancy cured all cancer would only go up about three years because if you don’t die of cancer, you die of a heart attack or a stroke or something else.

Another one of these age-related diseases. That’s why the prospect of slowing down the aging process could potentially reduce the risk of all these different age-related diseases at the same time. Is it, is?

[00:29:39] Gabby: it fair to say that, you know, these variables, whether it’s chronic inflammation, excess weight, insulin resistance, that these, there’s sort of a handful of variables that actually can just.

If we can Focus on those that whether it was heart disease or Alzheimer’s or anxiety that it would, there was, there’s a real chance it would. avoid or kind of cure a lot of that stuff. I think we, we see all of those things and get overwhelmed, but I, I feel like if we go back to focusing on these few variables that you, you know, you keep addressing in, in all of your books, actually, that then it’s the chance to avoid all of it.

And so instead of being confused by the noise, If we got to bed and ate, you know, better foods and had, you know, connection with each other and things like that, that, that would most likely take care of a lot of these things.

[00:30:37] Michael: If that really explains why, I mean, it’s almost kind of too good to be true.

Like, wait a second, how could, how could a heart healthy diet be a brain healthy diet and a kidney healthy diet and a liver healthy diet? Like why? I mean, it’s almost, in fact, that’s how you, that’s how you kind of sniff out pseudoscience is if like somebody’s supplement like cures everything, you know, this kind of panacea is like, Oh, you always got to be, Oh, you got to get a little skeptical.

But it’s some of these factors that you mentioned that underlie so many chronic diseases like inflammation, many diseases, even something like type two diabetes has an inflammatory component. So, Oh, no wonder. in anti-inflammatory diet and lifestyle regimen is going to impact so many different things, right?

Because high blood pressure plays a role in so many different causes of death, not just, uh, you know, strokes, heart failure, kidney failure. And so, no wonder reducing sodium, reducing salt intake. Oh, has benefits kind of across the board. No, you know, all our organs need nutrients, need oxygen, need to get rid of waste.

So of course, an artery healthy diet is not just a heart healthy diet, but kind of, you know, helps with even, you know, low back pain and all these other things, which seem to be unrelated, uh, but can. You know, but can, but can kind of tie together. That’s why, for example, obesity, um, is, is obesity can contribute to so many different, uh, causes of death and disability because of the inflammation, um, uh, and oxidation that are higher in those with excess body fat.

[00:32:03] Gabby: And I, I guess I just bring that up because I think it is overwhelming if people, especially if they’re starting out and it’s like, no, actually just stay focused on the, those, these pillars that you’re talking about in your books. Maybe we can get a little more specific, um, can you just break down, actually, for people the actual pathways to aging so that they can get a sense of, you know, what they’re putting their arms around?

 [00:32:27] Michael: Yeah, so that’s the first part of the book, where I identify the 11 kind of most promising pathways for kind of slowing the sands of time, ending each with, you know, practical recommendations for diet and lifestyle. Um, uh, so that includes boosting the anti-aging enzymes and hormones. Um, like AMPK, FGF 21, um, sirtuins, telomerase, and then suppressing the pro aging hormones and enzymes like mTOR and IGF 1, decreasing inflammation, oxidation, uh, uh, senescence, um, while, uh, preserving autophagy, artelomeres, and kind of slowing what’s called the epigenetic clock.

Um, again, I know these all kind of sound kind of all science y, but really do try to make it, you make kind of doable practical suggestions for how we can manipulate each of those.

[00:33:17] Gabby: Right. And I appreciate that because it makes it when people, because it does, there are so many variables, but you do identify these, these pathways. Let’s talk about autophagy because It’s, it’s hard to get into. It’s confusing. I think for a lot of people, uh, maybe you can just explain what autophagy is and what happens, um, when you can get into autophagy. Yeah,

[00:33:42] Michael: so, autophagy is considered the primary system for cleaning the body from the inside out, clearing away kind of the cellular debris that contributes to the aging process.

And so, there are some food components that suppress the autophagy like acrylamide, which is concentrated in potato chips and french fries, while there are others like spermidine and the antioxidants in coffee that can help your cells kind of take out the trash. Um, so to boost this anti-aging pathway, recommend 60 minutes of moderate to vigorous aerobic activity.

20 minutes was found not to boost autophagy. It takes full 60 minutes. The reason I don’t recommend caloric restriction or fasting to activate autophagy because it really takes um, 48 to 72 hours to really ramp up autophagy. That’s really too much. That’s too long to fast without kind of medical supervision.

Um, and uh, and so, you know, when you hear things about, oh, time restricted feeding, activating autophagy after a few hours of not eating, that’s in rodent models. Rodents have much higher metabolisms. In people, it takes a lot longer. Um, so 60 minutes of, uh, ideally daily, at least moderate aerobic activity, minimizing your intake of french fries and potato chips, trying to get 20 milligrams of this spermidine, uh, substance, which, uh, is in mushrooms and peas and tempeh and wheat germ.

And drinking three cups a day of regular or decaf coffee, um, is associated with, uh, with lower cancer rates, significantly longer life, and we think it’s because of the primary antioxidant in coffee, um, uh, activates this autophagy

[00:35:15] Gabby: process. You know, we’d be remiss because, you know, how a lot of people could be motivated by beauty. And you do even talk about how autophagy can be powerful for the… The skin, the senescent cells, and I believe, right, is, is this, are these things connected? Well, I mean,

[00:35:33] Michael: uh, anti-aging skin interventions almost entirely center around sun protection. Ninety percent of facial aging is due to exposure. To the sun.

Um, and so, um, and we have these, you know, uh, these great randomized controlled trials where you can actually randomize people to use sunscreen, um, to increase your sunscreen uses and actually slow down, um, the rate of aging. You know, you have independent objective observers looking at, uh, you know, photographs, um, after years of being using more or less sun protection.

And you can actually see, um, within just a year or two, the difference, um, in skin aging. So really daily. A facial moisturizer with sunscreen is kind of the gold standard for, um, anti-aging skin care. And then there’s all sorts of other things I talk about, like topical niacinamide and vitamin C and caution people about, uh, tretinoin or all trans retinoic acid.

Um, uh, but, you know, I go through all the, you know, Botox and, you know, the alpha hydroxyl acids and basically, you know, covering everything. But it really does come down to this kind of boring, you know, uh, we got to protect our skin from the sun. And do

[00:36:44] Gabby: you, because we do basically eat our sunblock on some level, do you direct people to a certain type of molecular size? I mean, is there a conversation around that?

[00:36:57] Michael: Oh, uh, fantastic question. Yeah. So, there’s actually this kind of sunscreen from the inside out. So, beta carotene, lycopene, the red pigment in tomato products actually, um, provide some baseline level of sun protection. So, you actually do these studies where they pay people enough to actually burn there.

Butts for so they do it on the butt so then they don’t walk around these bright these bright red squares Um, but you know, you can you can you know, use the same up radiation dose you can get significantly less redness after being randomized to eating more processed tomato products like tomato paste or eating more, um, you know, sweet potatoes and carrots and cantaloupe things with that that orange beta carotene now the level of Um, sunscreen is insufficient to, you know, it doesn’t approach that of something like sunblock, but it’s there all the time, you know, so you forget to use it and it’s everywhere, all the hard to reach places and stuff.

So, it’s really kind of a complimentary strategy. Um, so you have this kind of low-level protection all the time. And then, you know, when you’re exposed, particularly to midday sun between, uh, you know, 10 and 2, then, um, you know, you want to have the hat on and the sunglasses and ideally, um. Uh, some block of at least, um, uh, 15 for anti-aging and a SPF of 30 is recommended for skin cancer.

[00:38:14] Gabby: Right. And I just want to remind people to get, I would, I mean, sometimes I know it’s too thick for a lot of people, but they’re getting really quite good with it with their tinted, uh, sunblock’s and they have ones that are. you know, sort of more zinc based so you aren’t absorbing all the toxins. You

[00:38:31] Michael: want right mineral sunscreens, mineral sunscreens, right?

Titanium dioxide and zinc oxide. Those are the only ones considered right now by the Food and Drug Administration to be safe. All the chemical sunscreens on the market, they were withdrawn their so called, uh, generally recognized as safe status was withdrawn because little did, we know more of these chemicals are actually absorbed into our system than we thought of before.

And so, the safety testing has not been done. And so, we’re left with these mineral sunscreens and you’re right. It can leave that residue, but there’s micronized versions where it’s less of an issue though on darker skin and you still kind of get some. Um, of that residue, but it’s, um, until that safety testing is done.

These are really the only sunblock’s that we can recommend. Yeah. I

[00:39:16] Gabby: mean, part of my job was being out in the sun for a long time and I was always really diligent about protecting my skin, but I still. know that, uh, you know, there’s been a level of exposure. Um, really, I’m just curious. Cruciferous aren’t those also good, right? For, um, a low level, just a little boost in, uh, some protection. I feel like I’ve heard

[00:39:42] Michael: cruciferous vegetable. What can cruciferous vegetables not do? I mean, they’re most, uh, I mean, I talk mostly about cruciferous vegetables in terms of boosting detox pathways within the, the liver and the, and the air on the airways in terms of combating air pollution.

Um, and then there’s the nitrates and greens that have their own properties in terms of, uh, artery protection and maintaining muscle mass. And yeah, dark green leafy vegetables, particularly cruciferous, those broccoli or cabbage family vegetables like kale, collards, et cetera. Um, in fact, that kind of makes it into my so-called anti-aging eight, which are the things I really encourage people to go out of their way to, uh, to, to get into their daily routine.

[00:40:21] Gabby: Can we, can we bounce over to that? Can we talk about your anti-aging?

[00:40:25] Michael: eight? Sure, sure, sure. That, so that’s, uh, you know, it’s kind of, um, meant to highlight specific foods and actions that, uh, have the potential really for the best opportunities to slow aging, improve longevity, to kind of complement my daily dozen checklist of the healthiest of healthy foods. I encourage people to try to fit their daily diet, which I recommended in How Not to Die. It’s a free app, iPhone, Android, um, that people can kind of, you know, little daily checklist. Um, uh, just to motivate people, inspire people to include some of these healthier foods in terms of anti-aging foods.

According to data from the Global Burden of Disease Study, so this is the largest systemic, um, study of risk factors in history funded by the Bill and Melinda Gates Foundation, found that the largest life expectancy gains would be expected from eating more legumes, which are beans, split peas, chickpeas, lentils.

So, if there was one thing we could do to boost in our diet, it would be, you know, beans or lentil soup or hummus. Um, uh, all the blue zones have as their primary source of protein, some kind of legume. This is presumed to be because they’re concentrated sources of prebiotics, the fiber and the resistant starch that feed them.

Probiotic good bacteria in our gut, like lactobacillus and bifidobacterial, that make the beneficial postbiotics, um, like butyrate and acetate. And that’s where the magic happens. That is what reduces inflammation and boosts our immunity and improves muscle strength in frail individuals. Um, and so, uh, so, so, so I encourage people to eat legumes every day, somehow incorporated into their lives.

 So, legumes rule the roost as the on a per serving basis, though on a gram for gram, ounce for ounce basis, nuts actually are associated with the lowest risk of premature death compared to any other food group out there. Um, so it’s like the healthiest snack you could possibly eat. I encourage people to eat a palm full of walnuts a day.

Walnuts are probably the healthiest nuts. You can overdo nuts in terms of their oxalate content, increasing risk for kidney stones over a cup a day. Um, but, um, and really doesn’t appear to be any additional benefit of more than an, uh, an ounce of nuts, uh, three to five times a week. So, um, no need to, to overdo it.

And then dark green leafiest. earn their place, the anti-aging aid, as the vegetable most associated with longer lifespan, uh, can improve age related declines, the nitrates, age related declines in muscle and artery function and actually slow our metabolic rate, which is something that we used to only think was, um, possible with caloric restriction, but instead of walking around starving all the time, you can just eat a big salad.

And then you have that sulforaphane in the cruciferous, um, vegetables, um, which, as I mentioned, improve, uh, Uh, uh, immune function and a boost detoxification, detoxification enzymes in our liver, um, which helps with, uh, kind of industrial pollutant exposure and our airways, um, which helps with, you know, diesel exhaust and depending where we live cuts down on air pollution, which is a leading killer of humanity.

 [00:43:34] Gabby: Wait, wait, don’t jump off that yet. Say that again.

[00:43:38] Michael: Yeah. Air pollution, um, is considered the seventh leading cause of death of humanity. Um. Yeah, isn’t that? And so, I mean, the, uh, you know, I mean, look, we can, you know, not everyone can move and go to some place that has cleaner air. And even if you do move, all of a sudden now we have wildfires everywhere, which have their own problems in terms of air quality.

Um, and so then the question is, well, what can we do? So, there’s certainly, we’re going to have HEPA filters in our house and, um, uh, and we can. Um, eat cruciferous vegetables. And so there’s these amazing studies where they give people broccoli sprouts versus alfalfa sprouts Which is kind of like the placebo and they drip diesel exhaust into people’s noses And I forget I think it was like the equivalent of being on an la freeway for like 20 hours straight or something and Then you just measure the amount of inflammation, um, in their noses, um, and you see significant drop in inflammation for those who would be needing the broccoli sprouts for just a few days versus alfalfa sprouts.

You can do the same thing with dripping influenza virus in people’s noses and you can see significantly less virus induced inflammation, significantly lower viral counts, um, really tremendous properties. Oh, and you’re not stuffing broccoli up your nose. It’s just that it’s so boosts your ability to detoxify.

Of these compounds, not just in our liver, which we always knew about. So, for example, you get less of a of a caffeine buzz if you’ve been eating broccoli than if you don’t eat broccoli because it’s so revs up your liver to, to, uh, to rid itself of, of caffeine. Um, same thing, like if you’re going to, you know, if you’re going to go, you know, you’re going to go to a barbecue on the weekend, you’re going to be exposed to these, you know, polycyclic aromatic hydrocarbons in the grilled meat, eat some broccoli.

And there’s significantly less, you know, carcinogens flowing through your system. It also works for smokers, um, decreases the number of carcinogens in their system. Of course, not as much as not smoking at all, but, um, but yeah, so yeah, I have a whole, that was another kind of surprise in the book, a whole chapter on air pollution.

Um, particularly a problem, uh, China has a huge, um, problem with, with air pollution. Um, in fact, it was estimated that during COVID, when everything was locked down, they actually, COVID actually saved more lives than it killed because it decreased air pollution rates. How crazy is that? Uh, so many fewer people were dying from heart attacks because the air was cleaner because the cars weren’t on the road.

Um, which kind of gives you a sense, but it’s something we don’t even really kind of think about, but there’s something we can actually do about it.

[00:46:25] Gabby: I love that. Okay. So, I cut you off. So now we move. And actually, I thought you were going to say, have them when you’re going to barbecue because people were drinking alcohol and made me think of the liver, but you’re talking about, Oh,

[00:46:35] Michael: I’m just talking about, yeah, we can talk about alcohol. Um, unfortunately not in my anti-aging eight. Yes.

[00:46:43] Gabby: No, of course. I don’t, I, yes, we can get into that. So, you go to, we talked about berries. I cut you off. Sorry.

[00:46:48] Michael: Berries. No, but right.

[00:46:50] Gabby: So, so you love berries.

[00:46:54] Michael: Exactly. So, uh, berries, uh, earn their place as the fruit, most associated with a longer lifespan. Um, I talked about the benefits of something called Amla, which is dried Indian gooseberry powder, which is this.

Type of powdered berry, which has these remarkable properties used a lot in Ayurvedic medicine. And then the anthocyanin pigments, these bright, you know, like purple pigments that are found in berries that have benefits. That’s where we think the benefits are coming from in terms of cognitive function, eyesight, inflammation, blood sugar, artery function, cholesterol control.

These anthocyanin pigments found in berries get cleared from our system though in about six hours. So, I recommend dosing at every meal. So, you could have berries for like dessert at every meal or hibiscus tea has the same berry anthocyanins that that bright red like red zinger kind of tea. Um, there’s also savory sources of anthocyanins like purple cabbage or red cabbage, um, and like purple sweet potatoes also have them.

So, there’s ways you can incorporate it in your meal, but I do encourage, that is part of my, my berries bit. And then, you know, the rest of the anti-aging includes, uh, uh, boosting the enzyme cofactor known as NAD. I talk about something called xenohormesis, the micro RNAs, caloric restriction, protein restriction, something called methionine restriction, which is a particular amino acid, which is actually probably the single most powerful thing we can do is methionine restriction for, um, anti-aging.

 [00:48:18] Gabby: What is that when you, what is, when you, for the layman, what does that mean and how does one do that?

[00:48:22] Michael: So, um, it turns out basically, and this is another huge surprise, when it comes to protein and aging, less may be more. Reducing protein intake, meaning restricting intake down to recommended levels, is the only thing I could find that could actually block all 11 pathways of aging.

Uh, it turns out there’s no benefit, uh, to adding extra protein to older men and women in terms of muscle mass, muscle strength, muscle performance. Instead, the excess protein that most Americans get causes a drop in the pro longevity hormone FGF21, a worsening of the age accelerating enzyme mTOR. So, we should try to stick to the recommended, um, protein intake, which is 0.

8 grams per healthy kilogram body weight. Comes out to be about 45 grams a day for the average height woman, 55 grams for the average height men. And the, and the benefits really are coming from not restricting protein across the board, but a specific amino acid called methionine. Um, and if you don’t want to restrict protein, you can shift protein sources to lower methionine sources, uh, which tend to be, uh, plant sources.

So maybe one of the reasons why legumes are so beneficial is that they are the lowest methionine concentrated source of protein. Um, and so you can either, you can achieve. Methionine restriction by cutting food across the board, like caloric restriction, just eating less of everything, or just restricting protein or keeping and maintaining your protein intake, but just shifting from more animal sources towards more plant sources.

 [00:50:00] Gabby: I love that. So, I could see where people, you know, get confused because, you know, we have these conversations about the importance of protein and the importance of muscle, especially as you get older and the benefits of that. Um, and so I guess what I I’m always trying to navigate is the conversation of.

Real food, um, a variety, variety of colors. Um, move your body, you know, get hugged, hug somebody like you have somebody to call, like you’ve got a connection. Um, and sleep you mentioned, and, and is there any other component when you talk about, and you do talk about the blue zones and the things that you, you sort of learned from those groups?

Um, you know, is there, is there anything else from the blue zones outside of those things that we just mentioned that, uh, showed up consistently that was important for the, for the, uh, life span?

[00:51:05] Michael: Yeah, I think you really nailed the most important thing, diet and beverages, and then exercise, sleep, stress, social ties, and then weight control, which you can tie into kind of fold into diet. But that was kind of the, that was, that’s kind of the other piece of the blue zones.

[00:51:21] Gabby: Yeah, I, uh. I have to ask, I know this is very separate, uh, you, you mentioned in your family that heart disease, did you have, is this right? You had a lot of heart disease. It’s connected to your family.

[00:51:33] Michael: Everybody. Number one cause of death for men and women. I, it’s hard to imagine anybody’s family that doesn’t have a lot of heart disease in the family. But, um, that is, uh, yeah, I mean that, that certainly did, uh, strike my, uh, strike, strike my grandma.

[00:51:50] Gabby: Is you as somebody who, No, so much. Are you able, you know, we always joke an expert, somebody who lives a mile away? Are you able to impact, I mean, obviously your grandmother’s story was very impactful, but are you able to impact, um, your immediate group of family and people who know you and knew you when you were like a little kid who was, you know, running around like a lunatic? Are you, and if you are, because I, I dance with this in my own life?

Even young people, kids, things like that. How do you present it? The invitation to these ideas?

[00:52:25] Michael: Yeah. Well, my immediate family had been very successful. Everybody’s on board, not so much with the extended family, but I think that it’s just less, less, uh, you know, I have less, less contact with them and look, it took a long time.

Um, but I think the most important thing is just role modeling good behavior. So, in terms of, uh, affecting like what kids eat, what’s the most important thing? Um, I mean, the social science studies are what does the parents eat? It’s not enough to just do as I say, not as I do, but that’s what they’re looking to.

So, role modeling healthy behaviors, being always open to answer questions, being non-judgmental, non-preachy. I’m just coming from a real source of. You know, you know, I did all this work. You’re welcome to, you know, everything’s free online, you know, if you have any questions, never hesitate to reach out to me, anything I do to help you or your family, you know, it’s just very, very, um, and then just kind of being that resource.

And then inevitably. What happens? We get diagnosed with, you know, high blood pressure. We get diagnosed with prediabetes. You hear somebody, a friend, a dear friend, all of a sudden get some terrible diagnosis. Um, and you know, reaches out and then, you know, you can just, you know, kind of just, just be a resource and just realize that, you know, it’s your body, your choice.

You want to smoke cigarettes? You want to go bungee jumping, you want to not wear your seatbelt, you know, you know, it’s up to each of us to, you know, make our own decisions, uh, you know, uh, but we should, as to how to eat, how to live, but we should make these choices consciously, really educating ourselves about the predictable consequences of our actions.

And so that’s where my, I feel my role comes in, if you’re interested in, you know, what people in your situation doing X, Y, and Z would expect to experience X, Y, and Z. And if that. collides with your own goals in life, you know, then, you know, I can help, you know, move that kind of risk profile. But, you know, as, as far as I’m concerned, as soon as everybody knows, then I’m retired, then I’m on a beach somewhere like that, that my job is done.

Right. It’s not that I’m trying to, I, I, it’s not that I’m trying to change anybody’s diet or lifestyle, it’s just I want to, to, to combat the kind of the, the c the com corruption and commercialization of nutrition where you have these huge industries just trying to muddy the waters, confuse people so they’ll just throw up their hands and eat whatever crap’s put in front of them.

Um, and, you know, but as long as people are doing it. With kind of fully informed consent like people understand if I do this, I understand that this isn’t good for me. Uh, and look that’s I have nothing. I have nothing against that It’s the person who’s been convinced That this kind of bad behavior is actually good from like the tobacco industry did a half century ago, where the AMA, the American Medical Associate was saying smoking on average is good for you, not just neutral, but actually good for you smoking in moderation.

Right. I mean, and so, you know, it took, it took decades for, you know, this mountain of evidence, um, to finally come to light and smoking went. Up, up, up every year of the last century till 1964, then basically fell every year since in perhaps the greatest public health victory of the last century. What happened in 1964?

The evidence didn’t change. We had studies going back to the 30s linking lung cancer to smoking. What changed was the Surgeon General’s report. Just this public acknowledgement from the powers that be that, oh yeah, it turns out smoking’s not good for you. They cited 6, 000 studies. You’d think maybe after the first 5, 000, it could give people a little heads up or something, but that’s what it took to, you know, push back against this industry.

I think we’re in a very similar situation today where we have this mountain of evidence implicating some of these worse foods, some of these ultra-processed foods, yet still, um, uh, you know, the, the kind of stranglehold these companies have here in the beltway over, you know, food policy and over, you know, the dietary recommendations has yet to kind of, you know, to, to be solidified, but we don’t have to wait until the powers that be tell us to eat healthier.

Um, we can take control of our own lives and own families lives and take these common basic, uh, you know, uh, you know, steps to improve our health and longevity prospects.

[00:56:59] Gabby: Yeah. And I think that’s important. I just have a quick curiosity question. Um, nicotine in its pure form is, isn’t, is there not data suggesting that there are Its sort of some cognitive, positive, uh, lines between pure nicotine and your brain.

[00:57:18] Michael: Decreased risk of Parkinson’s disease.

[00:57:21] Gabby: Okay. I just, I just, cause sometimes I think people, and I mean, obviously all the cocktail of the things that they put in cigarettes and the vaping things, it’s a nightmare. So, I, I guess I just want to peel that out because again, I think people get all this information, but they don’t spend enough.

They don’t slow down and really kind of, or have time, who has time to kind of get in there. So, I just, I just wanted to make that delineation. What, what about, um, you said something about resveratrol and wine. Did, were you surprised about something in that, that you learned?

[00:57:51] Michael: Oh yeah. No, so far. So, you know, I went into this thinking that, you know, a number of supplements would kind of rise to the level of, of recommendation.

You just hear so much out there. Um, but almost all of them kind of fell by the wayside. Resveratrol is one of them. There’s a double-blind randomized placebo-controlled study of resveratrol versus placebo found a tripling of brain shrinkage. So, three times the brain tissue loss in the resveratrol group compared to the placebo group.

That’s all I needed to recommend against it. Ironically, the resveratrol company funded researchers tried to spin it as, Oh, it’s because it decreases inflammation. Your brain was inflamed. It was all swollen. And then the resveratrol kind of made it smaller, but no one was buying it. Um, and so I would encourage people to stay away from resveratrol.

[00:58:42] Gabby: Okay. I have just a couple quicker questions because I can’t help myself. You, and I’m, this is, I’m moving away a little bit from this book, but it is connected when you, you’ve, you’ve shared about hot flashes and that maybe it’s not totally necessary. You know, I, I myself am middle aged and I haven’t really experienced, occasionally there’s some hot nights.

It’s like you get a moment, but nothing crazy, but I’m always getting people talking to me about this. And you talk about, um, forgive me, swan, um, Oh, the swan study. Yes. The swan studies. So, you’re sort of saying, Hey, because I think half of it, if you think about it, cause placebo alone has a 20 percent and you know, like, Hey, this’ll work for you.

People go, yes. Conversely, we’ve, we’re all buying into, well, I’m this age now, so this has to happen. And what I, what I really like is you have this gung-ho kind of energy, let’s go. But it is reminding people, it’s like, what are we buying into in the belief? And one of those things was, Hey, this is not inevitable, right?

 [00:59:46] Michael: That’s, I mean, that’s one of the things that came up over and over again, really in all my books, is this concept that, you know, the, the, you know, cognitive decline, inevitable, blood pressure rising with age, inevitable, you know, uh, you know, types of diabetes or heart disease get worse, worse, worse, and you die.

There’s no reversing it. There’s no stopping it. There’s no slowing it. Um, there’s this, this kind of inexorable decline is really been the, uh, you know, for, for many of these symptoms until you start looking around the world. And you say, wait a second. There are populations that aren’t dying from heart disease, don’t have rheumatoid arthritis, literally millions of people, and they don’t have varicose veins, and they don’t, like, these are all things that, well, we just thought this is what happens when you get older.

And one of the things is, and one of the things are those. hot flashes. So, for example, in Japan, there isn’t even a word for hot flash in the Japanese language. Um, that’s because they’re so rare. And, indeed, Japanese Americans have significantly lower um, rates of both vaginal dryness and um, the so-called vasomotor symptoms, like the night sweats and the hot flashes.

Um, we think it may be uh, tied to soy food consumption. They tend to, so Japan has the highest soy food um, consumption on average. Um, uh, and, um, and so there are things we can actually do. And so also, um, uh, fennel creams and fenugreek seeds also would significantly reduce high flesh enzymes. There’s a whole chapter on kind of preserving your hormone balance and, and talk about, um, the pros and cons of something like hormone, uh, treatment therapy, um, versus some of these more natural approaches.

[01:01:16] Gabby: Yes. And you go deeper into this on nutritional facts. org. So if people want to dive deeper.

So, whether it’s just recovering your mood, your mental health, you know, so many things are connected to trying to get that good night sleep. And I know a lot of us struggle with it. I struggle with it. And if you sleep less than six to seven hours per night, it really is linked to so many, it reduces white blood cell count.

I mean, we don’t think about that kind of stuff. And this protects our body against illness and disease. For me, it’s getting cold. Fighting viruses and you got, you know, cold season. We really need to try to rest and sleep is a foundation of so many tentacles of our health. They have an incredible offer for you today.

NERF2 hearing. I, I just wanted to ask you about folic acid. I thought this was also incredibly fascinating. So cool.

[01:05:23] Michael: So cool. Yeah. So, yeah, so this is a study in, in Scandinavia found that you could randomize people to folic acid supplements and have a significantly lower loss, um, uh, age related hearing loss.

Now, the wrinkle is that this is a country that does not have folic acid supplementation of their grains. So, for example, in the United States, by law, you know, bread has to, you know, you know, has to have folic acid added to it. Um, and so because the grain supply is fortified here in the United States, it’s possible that levels of folic acid are sufficient such that taking extra folic acid would not actually have this remarkable beneficial effect.

Um, though, You know, uh, I mean, I thought a lot of people are decreasing their intake of refined grains, which is a good thing may not be eating lots of greens and beans, which is the most concentrated sources of folate, the natural form of folic acid. Um, and so this is something we can do, ensure we’re getting at least 400 micrograms of folate into our diet.

So, I talk about how many lentils that is, how much spinach that is, um, because for a number of reasons, and one of which is age related hearing loss, which need not occur. There are these rare populations that don’t suffer loss of hearing with age. Isn’t that amazing? Mind blowing. And so, then it’s like, well, what is it about these cultures?

And so, they’ve looked. So that was one supplement. And then, um, there’s actually a study where they randomized the famous Finnish mental, um, hospital study with actually randomized, um, groups of patients to different levels of saturated fat in their diet and had a reversal of age-related tearing loss and the lower saturated fat.

So, um, there are things we can do, the kind of, we have the power, the whole, the book is filled with a lot of good news. Like, there is actually things that we can do about things that we may have presumed to just kind of, uh, come along with the aging process.

[01:07:14] Gabby: So, in, in just wrapping this up, and I know you’re not, um, you know what, I’m going to actually use you as a resource right now.

I have a question that just came up and I’m sorry, I just had it. If your brain is kind of, it’s mostly made of cholesterol, correct?

[01:07:28] Michael: Mostly made of fat. Fat. Sorry. Right. So yeah, it’s about a third DHA, a specific time of fat by weight, by dry weight.

[01:07:36] Gabby: Yeah. And so sometimes I was just curious because we, I think about this when people are taking a lot of medications to diminish certain things, sorry, like cholesterol medicine and things like that.

But then there’s sort of this line to a lot of Alzheimer’s or cognitive decline. I just, I guess. What I appreciate about these books, uh, whether it’s how not to diet, how not to age, how not to die, um, these are also big opportunities to, to not maybe have. You’re not fixing, you’re, you’re actually going to the root cause versus the symptom.

And then people take these medications that then I feel like they, it’s potentially could give you a myriad of other things that you either pay immediate or later for. Um, and your books are very specific about things that you can do to support your health. Um, and so I guess I, I, do you find in your practice.

It’s interesting how they’ll buy into the medications.

[01:08:44] Michael: It’s, it’s completely understandable though, because we have in most, I mean, uh, you know, big pharmas who, uh, who funds much of, of medical training, both posts, both postgraduate medical training and a medical school. I mean, you can ask your doctor when the last time they were taken out to dinner by big broccoli, it’s probably been a while, right?

Um, uh, and so, I mean, I think it’s natural that we, that we, Uh, that doctors come out with this kind of focus, yet these so-called lifestyle drugs, which are really the cash cows of big pharma, right? You don’t make money, you know, saving someone’s life with a 10-day antibiotic course. You make money by selling people a drug that they take every single day for the rest of their lives.

Um, like these blood pressure lowering drugs, blood sugar lowering drugs, cholesterol lowering drugs, osteoporosis drugs. Um, because instead of treating the cause, Yes. Um, you are just trying to kind of slow down the rate at which your diabetics go blind and lose their kidney function, lower limbs, etc. Um, and if you don’t treat the cause, then indeed, these drugs can be lifesaving.

I don’t want to, I mean, if you are unwilling or unable, Yeah. To, to change your diet. In fact, just this last week, um, they, that, uh, that, uh, the big, uh, you know, Zempik trial just came out, um, found decreased all cost mortality in those randomized to injecting with these weight loss drugs versus injecting with placebo.

Um, so if you are, it’s so, uh, it’s kind of like bariatric surgery, if you’re unreliable or unwilling, then there actually is. Um, benefit to some of these kind of last resort options, but we can also treat the cause. Um, and it’s not just, well, you know, isn’t it just easier to take a pill? People underestimate, but physicians and patients like overestimate the benefit.

Of these pills. So, for example, let’s take statin drugs. So, statins even in the best-case scenario, which is secondary prevention, meaning you’ve already had a heart attack trying to prevent your second heart attack. Um, and so we, uh, since you’re extremely high risk, you get the biggest benefit. The absolute risk reduction is really only 2 percent over six years in that scenario.

Um, someone in that scenario would have, uh, uh, their 6 percent risk of having a heart attack in the next 6 years go down to 4%. Uh, now, of course, that’s advertised as a 33 percent reduction in heart attacks, which is technically correct. But you realize it’s really just a 2 percent absolute risk reduction, meaning, um, it only helps 1 out of 50 people, 98 percent of people aren’t going to see any benefit.

Um, and so when you actually tell people that, most people aren’t willing to take these drugs because they just don’t see sufficient benefit. But if everybody agreed to do that… We’d have a lot more death on our hands. On a population scale, these drugs help, but on an individual person by person scale, we could have much more potential to actually benefit our own individual lives with treating the cause, um, and lowering, you know, cholesterol naturally, um, uh, with the dietary change.

[01:11:41] Gabby: So, Dr. Greger, uh, do you, I guess the part for me that always mystifies me as part of the conversation is people don’t feel good. And a lot of people not only don’t feel good physically, but they’re impacted emotionally. And, and it makes sense. The computer has gotten banged around right through the way we eat and our lifestyle and everything else.

How do we get people to the place? That we can get the computer in the right place to make the best decisions, because when I see what you hear these stories and you have compassion, because what you realize is a lot of times people can’t even get there. They can’t even get to the place emotionally to make the better choice.

So, in that scenario. So, you know, what’s the way to support, support them? Is it that 21 day, hey, just give it 21 days? Like, what is it? So,

[01:12:36] Michael: yeah, I mean, so you, there’s a number of different ways. I like the 21 day because we really want to get people to, if you just have, I mean, you can also start people very slowly start adding healthy foods to their diet in hopes of it’ll start kind of naturally kind of pushing out some of the less healthy options.

So, you know, let’s have an apple a day, you know, apple before lunch and dinner, you know, and then, then come back.

[01:12:57] Gabby: But what did you say? You eat like 30. 30 percent less or something like that.

[01:13:02] Michael: If you didn’t absolutely remarkable. Right. So, no, no. So, right. So, eating an apple before meal cuts 200 calories out of that meal.

So typical meal, right. So, one apple for meal has, can it, Negative 200 negative calorie preloading, really remarkable facts. Um, it can also be done with Paris, can also be done basically with water, can be anything with less than 100 calories per cup. Um, uh, and so, and you can actually randomize people to these very simple interventions like drinking water before meals and have significantly improved weight loss.

So, kind of simple things. And the hope is once you start seeing a little improve. Um, even if it’s just kind of numbers, you know, it’s like, well, you know, based on your numbers, recommendations that you start a statin drug, or you start this, or you’ve just been diagnosed with pre diabetes. And it’s like, there’s two different directions we can go.

We can do this, and here’s the pros and cons and the side effects, like statin drugs, increase your risk of type 2 diabetes. Um, all the, all the cholesterol lowering does increase it, and so it’s like, ugh, so, you know, you’re kind of balancing. Now, look, you know, diabetes may be just killer number six, heart disease killer number one, so it’s the benefits still outweigh the risk.

But what if we could actually do something that helped with both? Decrease the diabetes risk. and decrease heart disease risk. We can do that with diet and lifestyle changes, but of course, it’s up to everybody. And, but once they start feeling a little efficacy, once they start losing a little weight, once they start feeling a little better, you know, some people like have like this chronic indigestion and they just think this is normal.

It’s just normal to feel all, you know, bloated and gross after a meal. And then all of a sudden, they start eating and then all of a sudden, wait a second. No one told me that, you know, and so again, it’s their own, it’s no longer me, the doctor, wagging my finger. It’s their own bodies telling them that there’s a healthier way.

[01:14:48] Gabby: So, in ending this, um, and I know you’re not giving people, you know, telling them what to take for other, for other things that you love. I’m just going to list them, and people can dive in. You love vinegar, garlic, black cumin, ginger, green tea, spicy pepper, or cayenne pepper. And you suggest, Hey, Let’s not eat past 7 p.m. So, if, you know, these are things that you love on the supplementation side. Are there things that you just feel for, for most people are important? Oh,

[01:15:18] Michael: absolutely. So, for example, the National Academy of Medicine says that at age 50, everybody across the board needs to take a B12 vitamin B12 supplement or eat vitamin B12 fortified foods.

It’s not kind of a well-known recommendation, but that’s critical. Women of childbearing age need to make sure they get enough folate or folic acid. If you’re an alcoholic, there’s a whole list of supplements that you need. So different people have different recommendations. You’re not getting enough sun exposure.

You may need sufficient vitamin D, particularly if you’re at a latitude that the sun’s rays are at such an angle during the winter months, you’re not going to make enough no matter kind of how much you go outside. Um, so there are certainly. Um, things that people can take, I mean, a lot of the so-called supplements that they really aren’t supplements.

So, people, you know, like things like turmeric. So, a quarter teaspoon of turmeric a day, you can actually just take in capsules if you don’t like the taste of like curry powder or whatever. Um, and so it’s not really a supplement, it’s just a whole food just packaged in a certain

[01:16:14] Gabby: way. Lastly, if someone was interested, like there’s people who want to go and help, genuinely help, like you do, and you co-founded a founding member of the fellow of the American College of Lifestyle Medicine.

Um, I’m just curious. You know, what is, is this sort of more of a practice? Can someone go there or learn more? Cause I do think people are sort of saying, Hey, I do want to help or be in medicine and be a doctor, but I want to be in health, not in sick care. They want to be in healthcare for real. Um, I love it.

Is that, is that what was behind, you have a lot of energy. I tell, I don’t know how, I was like, wow, Dr. Greger has done a lot of stuff.

[01:16:53] Michael: This is, this is, you’re talking about what I’m passionate about. So, it’s kind of hard to, um, so look, the American College of Lifestyle Medicine. So, lifestyle medicine is the fastest growing medical specialty in the United States.

We just had the annual, uh, annual conference in Colorado. Thousands of practitioners show up. You know, there’s problems with reimbursement. The system really isn’t set up. to, you know, doctors aren’t paid for counseling people how to take better care of themselves, for example. So, there’s a lot of changes that really need to be done on a system level, policy level, but lifestyle medicine is like preventive medicine, but instead of using diet and lifestyle just to prevent disease, also to treat, potentially reverse it.

Some of the most exciting things happening in medicine or happening in lifestyle medicine encourage anyone, whether you’re a medical student, um, uh, or, or, you know, uh, you went to med school a long, long time ago. Um, uh, people have kind of just. Yeah, you know, it’s really frustrating practicing primary care these days because our patients just tend to get worse, worse, worse than they die.

And then all of a sudden, that spark of why we all went to medical school in the first place, because we actually want to help people, right? I mean, if you just wanted to make money, you’d go work on Wall Street or something. People go into medicine because they care about people, yet that kind of empathy that gets kind of beaten out of them through the medical training, and we kind of left on the other side just as pill pushers, but we can kind of reignite that spark that really drew us all into medicine, actually have that kind of hands on, you know, jump out of the wheelchair kind of moment where our patients actually get better.

It’s the most beautiful thing, um, and that, uh, and so I, I encourage people to check it out. Um, and, uh, yeah, it’s, uh, it’s, it’s the most exciting thing happening in medicine, as far as I can, I can tell at the moment.

[01:18:36] Gabby: Well, I can’t think of a better way to end it. Um, thank you so much, uh, Dr. Michael Greger. And the latest book is How Not to Age, but I do encourage people if they want to get even a different foundation of learning.

How not to die and how not to diet and again the nutritional facts. org. You have so much information on there and um, I really appreciate you and I can’t wait to see what you’re going to do next. Thank you

[01:19:03] Michael: Looking forward to it. Thank you so much. Keep up the good work

[01:19:08] Gabby: Thank you for listening to this week’s episode. If you want to learn more, there is a ton of valuable information on my website. All you have to do is go to Gabrielle Reese. com or head to the episode show notes to find a full breakdown with helpful links to studies, research, books, podcasts, and so much more. If you have any questions, please feel free to reach out and send them to at Gabby Reese on Instagram. And if you feel inspired, please subscribe. I’ll see you next week.

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About Dr. Michael Greger