Tell me more about the different pillars. What kind of diet appears to help you live longer?
The data is really clear that restrictive diets don’t work because many of them are not well-balanced and people have a hard time being on them for a long time. That includes the keto diet and also veganism and vegetarianism. I love the Mediterranean diet for a number of reasons: it’s very balanced, it includes a lot of fresh vegetables and fruits.
Ultra-processed food should be avoided as much as possible and eating a lot of saturated fat from meat isn’t healthy. If you’re going to eat meat, eat low-fat meat that is organic.
The most important thing to avoid is sugar. Sugar is the enemy of healthy aging, especially fast carbohydrates like cereals and fruit juice. The reason is, they make your glucose levels spike, which triggers a disproportionate insulin response. The surge of insulin then causes your glucose levels to get too low, which triggers hunger and then you restart the cycle.
I would recommend that people use a continuous glucose monitor [CGM] to understand their own carbohydrate metabolism. I’ve argued that every high schooler should have a CGM for two weeks which can show them the impact on their blood sugar of what they’re eating. I do it from time to time to remind myself of the consequences of eating that ice cream.
How about physical activity and sleep?
There is still a lot to be learned about what an optimal exercise regimen might be for most people. We do know that sitting is worse than smoking in terms of risk, so I tell people to stand up between Zoom calls. Do some squats, move around the house, go grab a coffee.
Walking for 35 to 40 minutes a day has enormous health benefits. Just 20 minutes in the morning and 20 minutes at night will have a really profound effect on your health. You can get even more benefits if you start lifting weights, especially if you’re older. Also, balancing exercises and stretching.
As for sleep, we know that something like 70% of the population is not getting adequate sleep. Most people need seven or eight hours. Some people might tell you, oh, I only need six—and I can tell you that in 99% of those cases, they’re deluding themselves. Not getting enough sleep has a big effect on things like metabolism and inflammation.
What is your advice to people who want to experiment with drugs or supplements for longevity?
I think there are drugs coming in the future—maybe in the next five to 10 years—that will have a protective effect against the aging process. Those are coming, but they’re not here yet.
There are a number of physicians now specializing in this who really understand the risks and the consequences. This is not something that you want to just play with by yourself. I hear so many stories of people buying supplements on the internet and taking them, and then they show me their numbers, and as a physician and a scientist, it doesn’t take very long to realize they’re actually harming themselves.
Educate yourself. Listen to serious people. Avoid the hype. Remember that supplements are unregulated. The first question that you want to ask yourself when you buy a supplement is, who’s making it? How do I know that what’s on the bottle’s label is actually in the bottle?
My attitude is, let’s start focusing on the four pillars that can bring everybody to 95 in good health, which would be transformative to society.