Eating like a "blue-zoner" can help people live longer, healthier lives. Photo / 123rf
The doctor and author Michael Greger, 51, shares his rules for life.
The vast majority of premature death and disability is preventable,” says Michael Greger bluntly, over Zoom from his treadmill desk. “We have tremendous power over our health, destiny and longevity.” The American doctor and author and his team of 19 have spent three years wading through more than 20,000 research papers, unearthing hundreds of surprising diet and lifestyle tips for a new book, How Not to Age.
Who knew, for example, that a teaspoon of ground lettuce seeds could be a sleep aid? They contain the hypnotic lactucin, a substance with sedative properties. Or that mushrooms can help stave off an unpleasant whiff that comes with ageing? “There’s this distinctive body odour of the elderly due to a chemical we start producing as early as 40,” explains Greger, 51. “Ain’t that wild?” It has a “grassy, greasy” smell resulting from the oxidation of omega-7 fats emitted from our skin. According to a Japanese study, it is worth eating plain white button mushrooms to combat this.
Greger’s overriding message is that the choices we make in the supermarket aisle are key. “Based on studies of identical twins, only about 25 per cent of the difference in lifespan between people is down to genetics. Diet is the most important predictor of lifespan,” he says.
His grandmother inspired his focus on what he calls “lifestyle medicine”. “I was just a kid when she got sent home in a wheelchair to die,” he recalls. Aged 65 she was diagnosed with end-stage heart disease, “but then she heard about this guy, Nathan Pritikin, an early lifestyle medicine pioneer”. He established the Pritikin Longevity Center, then based in Santa Barbara, and promoted a plant-based diet. “Thanks to a healthy diet she was able to enjoy another 31 years. I just want to do for everyone’s family what Pritikin did for mine.”
Greger studied at Tufts University School of Medicine, in Boston, in the 1990s and briefly practised as a GP, specialising in nutrition before becoming a lecturer and the bestselling author of How Not to Die (2015) and How Not to Diet (2019). He also runs the website nutritionfacts.org.
A vegan, Greger practises what he preaches — hence the treadmill desk. “I could turn it on, but I don’t want to make anyone motion sick,” he says with a laugh. He reckons he walks 22km a day at it. He is “incredibly slow. I don’t get my heart rate up.” Researching his latest book inspired him to start walking up the 18 flights of stairs in his apartment building and take up resistance band training for “lower limb strength and balance training for preventing falls”.
“When the research is sufficiently compelling I incorporate it into my own life,” he says. He is also evangelical about sleep, “particularly on the road, during respiratory infection season, to keep my immune system up when I’m hugging hundreds of people in a book line”.
Here are some of his tips for a longer, healthier life.
Greger is an advocate of the “blue zones” diet favoured in longevity hotspots — the places around the world where people have the longest lifespans on average. They were named after the colour a demographer used in a global “heat map” of mortality and include Sardinia in Italy and Okinawa in Japan. The guidelines stipulate a 95-100 per cent plant-based diet (fruit, vegetables, wholegrains and legumes such as chickpeas and lentils for protein), a limited amount of fish, dairy and eggs, and a “retreat from meat”— blue zone centenarians only eat 60g or less meat about five times per month.
Greger has a breakfast of oat groats with cranberries, cocoa powder, nuts and seeds at 8am. Lunch at midday might be a seaweed salad. After his supper of wholewheat pasta with pesto or macaroni with kale and hummus at 4pm he avoids food for the rest of the day, triggering a cellular recycling process called autophagy. This is when the body breaks down and reuses old cell parts so cells can operate more efficiently. Timing is important: “You want the window earlier rather than later — because of our circadian rhythms, food eaten in the morning is less fattening than the same food eaten in the evening.”
If the blue zones diet sounds like a step too far, consider having lots of greens. One Harvard study identified five lifestyle factors associated with cutting in half the risk of dying over a period of 12 years for men and women in their sixties and seventies. Beyond non-dietary measures such as not smoking and walking an hour or more a day, eating green leafy veg almost daily was the sole dietary factor that could be relied upon.
“From this age our ability to extract vitamin B12 from food declines and the consequences can be devastating,” Greger says. “A deficiency can lead to disorders of the blood, gut, brain and nervous system.” He also takes a daily dose of dried Indian gooseberry powder (amla), black cumin, pippali or long pepper, turmeric and ginger powder.
As we age our sense of taste may decline, leading older adults to oversalt their food. One way to counter this is by removing the coating that can block taste pores on the tongue. Better yet, swap out the salt for savoury salt-free seasoning and add years to your life. Excess salt can increase blood pressure, boost pro-inflammatory cells implicated in autoimmune disease and affect our microbiome. Greger cites a study of more than half a million people aged 50: those who added salt at the table appeared to have a reduced life expectancy — two years lower for men, one and a half for women — compared with those who didn’t.
Resistance exercise is considered the most effective strategy to prevent age-related muscle weakness, treat muscle loss and improve physical function. “I’ve started taking these resistance bands around with me so I can do strength-training exercises on the road,” Greger says.
With age our sex drive declines, but Greger refers to a study that showed that women who smelt the aroma of neroli oil (distilled from the flowers of the Seville orange) twice a day for five days saw a significant increase in sexual desire compared with those who sniffed a control oil. You might want to take the results with a pinch of salt-free seasoning as aromatherapy trials are so subjective, but as Greger says, “there’s no downside” to giving it a try. For men, he says those who often have orgasms tend to cut their risk of premature death in half. He advises men to stop smoking and lose weight to keep up their libido. Regular aerobic exercise can help with erectile dysfunction. At least 40 minutes of moderate to vigorous aerobic exercise four times a week for at least six months is recommended for recovery (but avoid prolonged cycling). Certain supplements can help too. “The most beneficial is Korean red ginseng, which can significantly improve erectile dysfunction.”
Hot flushes are experienced by up to 85 per cent of European and American menopausal women, compared with just 15 per cent in Japan. (The Japanese language doesn’t even have an exact term for hot flush.) Some experts believe this may be due to the soy in their diet, which contains phytoestrogens, a natural substance with oestrogen-like properties. Citing more trials, Greger says about two servings of soy foods a day can reduce hot flush frequency by about 20 per cent more than a placebo and severity by about 25 per cent.
“Berries are the fruit associated with the longest lifespan,” Greger explains, “presumably because of the anthocyanin pigments that benefit cognitive function, decrease inflammation and improve blood sugar, artery function and cholesterol.” These are also contained in savoury sources such as red or purple cabbage and purple sweet potato, and in hibiscus tea. As for nuts, these are “associated with the lowest risk of premature death compared with any other food group —and walnuts edge out all the competition. This is the only nut shown to acutely improve artery function, and it has the highest antioxidant and omega-3 levels.”
How Not to Age by Michael Greger (Pan Macmillan) is available to buy now.
Written by: Audrey Ward
© The Times of London
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