I see merit on both sides of this culture clash, with the field of gerontology (the study of old age) struggling to retain hard-fought gains in public funding for basic aging research versus the more ambitious anti-aging crusaders who appear to more fundamentally question underlying assumptions.

To paraphrase Winston Churchill’s quote about democracy as a form of governance, the peer-reviewed medical literature is the worst way to establish facts about our health—except for all the others.

I promised the publisher a book with no more than about 600 pages, but when all was said and done, my manuscript was closer to 2,150 pages. Yikes. I didn’t want to lose any content, so my first stab at trimming was to put the 995 pages of citations online. here, there’s a web address (see.nf/citations) and QR code for the full list of searchable citations referenced throughout this book.

I just never want anyone to take my word for anything. I always strive to justify exactly how I arrive at each recommendation.

There may be no such thing as dying from old age. From a study of more than 42,000 consecutive autopsies, centenarians—those who lived at least to one hundred—were found to have succumbed to diseases in 100 percent of the cases examined. Though most were perceived, even by their physicians, to have been healthy just prior to death, not one “died of old age.” They died from disease, most commonly heart attacks.

In the United States, heart disease has been the leading cause of death every year since 1900, with the exception of 1918 when pandemic flu ruled the roost.41 (In contrast, as I detail in How to Survive a Pandemic, COVID only made it to number three.42

Because old age is the greatest risk factor for most of our killer diseases,45 one could argue that the leading cause of death is actually aging.

Eating a plant-based diet may reduce the risk of dementia as much as threefold,51 but the difference in dementia rates between those older than eighty-five compared to younger than sixty-five is three hundredfold.

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, such that the average sixty-five-year-old, for example, would have the health profile and disease risk of today’s fifty-eight-year-old, would be expected to cut in half everyone’s risk of death, frailty, and disability.55 This is why I wrote How Not to Age.

When asked, How long do you wish to live? and offered the choice of 85, 120, or 150 years, or indefinitely, about two-thirds said they’d prefer to live to be eighty-five. But, when the question was reframed as How long do you wish to live in guaranteed mental and physical health?, the most popular answer switched to an unlimited lifespan.

Only about 18 percent of people can be described as undergoing “successful aging.”

This raises the concept of healthspan, the period of life spent in good health, free from chronic disease and disability.

That is why this book addresses both lifespan and healthspan. What’s the point of living longer if you can’t enjoy it vibrantly? It is my sincere hope this book adds not just years to your life but life to your years.

I remain agnostic as to whether such a breakthrough is possible, but I hope this book will help regardless, whether you’re striving to live long enough to live forever97 or just trying to die young as old as possible.

My Anti-Aging Eight is the final section of the book, an actionable checklist to complement the Daily Dozen I established in my earlier book How Not to Die.

On the other hand, the lifespans of spouses sometimes correlate as much as—or even more than—those of genetic relatives.

In short, only about 15 to 30 percent106 or less107 of our lifespan appears determined by our genes, which means how we live our lives may determine the bulk of our destiny.

AMPK induces autophagy, which cleans house, sweeps away accumulated waste, and effectively institutes a sort of cellular reset.123

In see.nf/metformin, I talk about its interesting origin story and all the other upsides, including the mind-blowing revelation that diabetics placed on metformin may live longer lives than those who never got diabetes in the first place.

So, healthier individuals may not reap the benefits of metformin that we try to extrapolate from longevity studies on diabetics.

In short, barberries, which can be found inexpensively priced at Middle Eastern groceries in dried form, have been shown to successfully lower LDL cholesterol levels an average of fourteen points (mg/dL),175 as well as improve acne,176 artery function,177 triglycerides, blood sugars, and insulin resistance.

Black cumin is another plant traditionally used in Middle Eastern cuisines that can boost AMPK.

Another AMPK-boosting zinger is hibiscus,196 which delivers the tart cranberry-like flavor and bright red color of Red Zinger tea. Also known as roselle or jamaica, hibiscus tea has been enjoyed around the world for millennia as both a delicious hot or cold drink and an ancient medicinal remedy.

When we consume vinegar, the acetic acid is absorbed and metabolized, giving us a natural boost in AMPK at the dose you might typically get dressing a salad.212

Based in part on studies of human coprolites227—fossilized feces (paleopoo!)—our ancient ancestors may have consumed in excess of 100 g of fiber a day.

That’s more than five times that of the average American today.

In 1676, Antonie van Leeuwenhoek, the father of microscopy, was the first person in history to see bacteria. The following year, he saw his own sperm,308 and a year after that, in 1678, he discovered tiny crystals forming in the semen he had left sitting around.

Eight hundred men and women in their forties through eighties were followed for twenty years. Researchers looked at 146 different nutrients in their diet, and the component most predictive of longevity was spermidine.

Swedish researchers calculated that a healthy diet would include 25 mg of spermidine for women and 30 mg for men.

TOP SPERMIDINE SOURCES (MILLIGRAM PER 100-GRAM SERVING UNLESS OTHERWISE SPECIFIED)   1.   9.7 mg: tempeh351,352   2.   9.2 mg: mushrooms353,354   3.   9.2 mg: pig pancreas (1 oz)355   4.   8.2 mg: natto (1 oz)356   5.   6.1 mg: mango (one, 210 g)357,358   6.   5.9 mg: edamame359,360   7.   5.8 mg: green peas361,362   8.   5.7 mg: cheddar (aged one year, 1 oz)363   9.   5.5 mg: lentil soup (1 cup)364 10.   5.1 mg: soybeans365 11.   4.4 mg: lettuce366 12.   4.3 mg: polenta367 13.   4.3 mg: corn368,369 14.   3.8 mg: soymilk (1 cup)370 15.   3.8 mg: mussels371 16.   3.7 mg: broccoli372,373 17.   3.4 mg: cow intestine374 18.   2.9 mg: chickpeas375 19.   2.8 mg: cauliflower376,377 20.   2.7 mg: celeriac378 21.   2.6 mg: yellow peas379 22.   2.5 mg: wheat germ (1 Tb)380 23.   2.5 mg: french fries381 24.   2.4 mg: oysters382 25.   2.4 mg: lentils383 26.   2.4 mg: adzuki beans384,385,386 27.   2.3 mg: eel livers (1 oz)387 28.   2.2 mg: salad388 29.   2.1 mg: popcorn (50 g)389 30.   2.0 mg: kidney beans

Mushrooms take the silver. Interestingly, plain white mushrooms may have twice the spermidine content as “fancier” mushrooms like enoki or shiitake.

Soymilk, however, is a concentrated source411 and is presumably the only type of milk with significant levels at 3.8 mg per cup.

Give people a strain of probiotic Bifidobacteria, and you can increase spermidine levels in their stool.

DrugAge is an extensive online database472 of more than five hundred lifespan-extending compounds.473 Among the small subset with the fewest side effects, spermidine had the largest documented lifespan extension.

trying to consume at least 20 mg of spermidine by incorporating foods such as tempeh, mushrooms, peas, and wheat germ into your diet

Given the senolytic success of a quercetin cocktail, researchers started screening other flavonoids.537 In doing so, they found one that was nearly twice as potent: fisetin.

I run through all the landmark strawberry studies in see.nf/fisetin. In short, randomized controlled trials show that strawberries can improve cognition,547 cholesterol, inflammation,548 and osteoarthritis,549 as well as boost beneficial gut bugs, including Christensenellaceae,550 a newly discovered551 bacterial family found associated with longevity based on studies of centenarians and supercentenarians.

A third natural senolytic compound has been discovered: piperlongumine,553 found concentrated in a spice commonly sold in Indian grocery stores as pippali (Piper longum, also known as pibo in China and long pepper in Europe).554 I detail what it is and what it can do in see.nf/pippali. I was convinced enough to add it to my daily spice regimen alongside amla (see here), black cumin (see here), and turmeric (see here

In 1996, we learned that eggs aren’t the only cells that can undergo a complete reversal of aging. That was the year a sheep named Dolly was born.

In the Gene Expression Modulation by Intervention with Nutrition and Lifestyle (GEMINAL) study, Dr. Dean Ornish and colleagues took tissue biopsies before and after subjects adopted intensive lifestyle changes for three months that included a whole food, plant-based diet. Beneficial changes in gene expression were noted for five hundred different genes.

Using nonepigenetic estimates of biological aging, the control group continued to age at a rate of about one year per year, but in that time, the dietary restriction group only seemed to age by about one month. And they achieved this with only a 12 percent calorie restriction, which is like skipping just one donut a day.613

You don’t need a special kind of folate either. The folate in foods and folic acid in supplements and enriched foods are perfectly usable, irrespective of which gene type you have.

Randomized trials have also found that those taking folic acid supplements for more than three years are more likely to develop colorectal polyps.

meeting the 400 µg recommended daily allowance of folate, which could be achieved with about a cup of cooked lentils or edamame, a cup and a half of cooked spinach or asparagus, or two and a half cups of broccoli, for example

Diabetes can be diagnosed with an HbA1c of 6.5 percent or higher, meaning 6.5 percent or more of the hemoglobin in the blood has been glycated. A percentage of 5.7 to 6.4 gives a diagnosis of prediabetes, and less than 5.7 is considered normal.

Acarbose has been shown to lower blood AGE levels in diabetics by about 30 percent within twelve weeks.762 No wonder acarbose has been found to improve the healthspan and longevity of mice, increasing their maximum lifespan by about 10 percent. As drugs go, acarbose has an outstanding safety record.

Some grains—notably sorghum798 and millet—inherently contain resistant starch, resulting in a 20 to 25 percent lower blood sugar response compared to other grains, such as rice,799 wheat,800 or corn.

Now, potatoes aren’t like meat, which may actively shorten your life, but there is an opportunity cost to eating white potatoes, since every bite of a potato is a lost opportunity to put something even more healthful into your mouth that may actively make your life longer.

Cinnamon tea works even better, with nearly a 40 percent drop in glycemic response. Even regular unsweetened green tea cuts the glycemic impact by about 20 percent.

Chamomile tea and green tea appear to share the same mechanisms for blood sugar control: blocking the transport of sugars through the intestinal wall.

These days, shorter stature predicts a longer lifespan.861 In fact, this may help explain the gender differential in life expectancy. Men, on average, are about 8 percent taller than women and have about an 8 percent shorter lifespan.

Each additional inch in height is associated with about a 6 percent increased risk in dying from cancer.

At age sixty-five, we are a hundred times more likely to have a tumor than we are at age thirty-five, but if you don’t get a cancer diagnosis by a certain age, you may never get one.

Centenarians appear ten times less likely to die from malignant tumors than people in their fifties and sixties (4 percent versus 40 percent, respectively).

And, in terms of longevity, as we’ll explore in Part II, the two longest-lived formally studied populations on Earth, the Okinawa Japanese947 and the vegetarian Seventh-day Adventists in California, tend to eat soy foods on a daily basis.

The researchers explained that, compared to someone on a low-protein diet, the quadrupling of risk for cancer death from eating a diet rich in animal proteins during middle age is a mortality risk comparable to smoking.

Overall, the amount of life lost from each burger is estimated to equate to smoking two cigarettes.

To help slow this aging pathway, on a daily basis, consider: striving to stick to the recommended daily intake of protein of 0.8 g per healthy kg of body weight (0.36 g per pound), which translates to about 45 g a day for the average-height woman and about 55 g a day for the average-height man choosing plant-based protein sources whenever possible

Ideally, CRP levels in the blood are under 1 mg/L,999 but, in the presence of infection, it can skyrocket within hours up to 100 mg/L or more.

Researchers scoured thousands of such experiments and developed a scoring system called the Dietary Inflammatory Index.

That’s why acarbose can increase the level of good bugs like Bifidobacterium,1171 Lactobacillus, and Prevotella.

but taking the next step and switching to intact whole grains (groats) wouldn’t only give us more fiber but also sneak down a load of starch.

A type of fiber called beta-glucan in brewer’s, baker’s, and nutritional yeasts has been found to boost IL-10.

Simply swapping out a few servings a week of meat for beans, split peas, chickpeas, or lentils can lower your CRP, IL-6, and TNF-α by about a third within two months.

Here’s Dr. Fuhrman’s recipe if you want to try it yourself: half a pound of dark green leafy vegetables (such as baby kale), two and a quarter cups of blueberries, one banana, one tablespoon of unsweetened cocoa powder, one tablespoon of ground flaxseeds, half a cup of water, and half a cup of either plain or vanilla soymilk or unsweetened vanilla almond milk.

Ginger and garlic follow turmeric as the most anti-inflammatory foods in the Dietary Inflammatory Index.

One-eighth of a teaspoon of powdered ginger, which can cost a single penny, can work as well as the migraine headache drug Imitrex without the medication’s side effects.1289 Taking a third of a teaspoon up to a full teaspoon each day for a few days before your period was shown to significantly lessen menstrual pain and dramatically stanch heavy bleeding.

To help slow this aging pathway, on a daily basis, consider: reducing dietary and endogenous exposure to inflammatory AGEs (see the Glycation chapter) reducing senescent cell SASP inflammation (see the Cellular Senescence chapter) boosting autophagy to help clear out inflammatory cellular debris (see the Autophagy chapter) applying an emollient skin lotion avoiding pro-inflammatory food components, such as saturated fat, endotoxins, Neu5Gc, and sodium, by minimizing intake of meat, dairy, tropical oils, and salt (one lousy breakfast could double your C-reactive protein levels within four hours before it’s even lunch time1333) eating foods shown to be anti-inflammatory, such as legumes, berries, greens, sodium-free tomato juice or tomato paste, oats, flaxseeds, turmeric, ginger, garlic, cinnamon, cocoa powder, dill, green and chamomile teas, and other fiber-, anthocyanin-, and salicylic acid–rich foods mTOR

Most Londoners, for example, apparently didn’t even survive to age sixteen during the seventeenth century.

help slow this aging pathway, on a daily basis, consider: following all the steps to boost AMPK from here striving to stick to the recommended daily intake of protein, 0.8 g per healthy kg of body weight (0.36 g per pound), which translates to about 45 g a day for the average-height woman and about 55 g a day for the average-height man choosing plant-based protein sources whenever possible

Plant-based diets are said to make methionine restriction “feasible as a life extension strategy.”

Presumably, it’s not a coincidence that the few other mammals unable to synthesize their own vitamin C—such as guinea pigs, fruit bats, and some rabbits—are all strongly herbivorous, just like the great apes.1517 Data from human fossilized feces deposited in the Stone Age tell us that we may have been getting up to ten times more vitamin C and ten times more dietary fiber than we do today.

What about us? Sulforaphane can also restore Nrf2 activity in our aging tissues,

discuss the pros and cons in see.nf/lipoic. Bottom line? I would exercise caution until we have a better idea of its dosing safety window.

In C. elegans1776 and fruit flies, lifespan was extended at one dose but, at a higher dose, was dramatically cut short by up to 70 percent, raising a “serious concern” for taking NAc supplements.1777 More details in see.nf/nacse.

What’s the optimal intake? See see.nf/vitaminc for details, but the magic number appears to be about 200 mg a day.

To help slow this aging pathway, on a daily basis, consider: exercising restricting methionine intake by choosing plant-based protein sources and reducing overall protein intake to recommended levels activating Nrf2 defenses by eating green (cruciferous vegetables) and drinking green (tea) eating berries and other naturally vibrantly colored foods using herbs and spices, such as cinnamon, cloves, garlic, ginger, and marjoram avoiding added salt, sugar, and saturated fat– and cholesterol-rich foods

However, since that publication, more than 150 human clinical trials have been published.1850 I present the update in see.nf/resveratrolhealth. No impact on inflammation, cancer, cardiovascular disease, long-term frailty,1851 or death1852 has been found epidemiologically for dietary resveratrol exposure, and meta-analyses of randomized controlled trials of resveratrol supplements failed to find clinically1853 or even statistically1854 significant effects on systemic markers of oxidative stress, helping to explain the lack of apparent DNA protection.1855

The one study that looked at the greatest apple intake—half an apple a day compared to less than one apple in an entire month—found a 35 percent lower risk of dying early.

As a bonus, the same cardamom dose over two to three months can significantly improve markers of inflammation and oxidative stress,1911 and be a safe, cheap, convenient way to decrease the level of triglycerides in the blood by about twenty points (mg/dL).

To help boost this anti-aging pathway, on a daily basis, consider: elevating cellular NAD+ levels (see the NAD+ chapter) following the recommendations on AMPK activation (see the AMPK chapter) snacking on apples and experimenting with adding cardamom to meals not smoking avoiding foods high in AGEs (see the Glycation chapter)

The answer lies in an enzyme found in Methuselah. That’s the name given to a bristlecone pine tree growing in California’s White Mountains. When it was named, the tree was the oldest recorded living being. Today, it’s nearing its 4,800th birthday. For context, Methuselah had already been alive for centuries before construction of the Egyptian pyramids had even begun.

To help boost this anti-aging pathway, on a daily basis, consider: following the recommendations in the Inflammation and Oxidation chapters eating a high-fiber diet centered around whole plant foods choosing to drink tea or coffee over soda or milk eating cruciferous vegetables supplementing with 800 to 2,000 IU of vitamin D3 a day if your vitamin D blood level is under 20 ng/mL (50 nmol/L)

Worldwide each year, physical inactivity has potentially accounted for more than ten million years of healthy life lost, but what we eat may account for nearly twenty times that amount.

Among the findings, they determined that the number one killer of Americans is the American diet, bumping tobacco down to number two. Smoking now only kills an estimated half million Americans every year, whereas our diet appears to kill many more.

A microlife is one of the million half hours we may have left. Smoking two cigarettes or drinking two pints of beer, on average, would cost a thirty-year-old man one microlife, as would each day he is eleven pounds overweight.

But, even exercising for twenty minutes may add an hour (two microlives) to your life. So, for everyone who says they don’t have time to work out, exercising potentially gives a three-to-one return on investment. Give twenty minutes of your life to theoretically get sixty minutes of life.

What about meat? A single burger is associated with losing a microlife. Is eating a burger worth thirty minutes of your life?2132 So, in terms of lifespan, one burger appears to equal two cigarettes.

Each half-an-egg-a-day was associated with a 7 percent increase in all-cause mortality,2133 which would make one egg on par with one burger for reducing lifespan.

Alternately, you can frame it as a daily loss. Eating a sandwich with just two slices of deli meat like baloney or ham is expected to take off around one hour of your life.

So, breathing in secondhand smoke day in and day out increases your risk of lung cancer almost to the same extent that eating a single daily serving of processed meat increases your risk of colorectal cancer.

We started using tools during the Paleolithic period, which only goes back about two million years, but we and other great apes have been evolving since the Miocene era, which goes back about twenty million years.2155 So, our body evolved on mostly plants for the first 90 percent of our hominoid existence.

The American Heart Association’s recommended limit is 1,500 mg of sodium a day.2183 Care to guess what percentage of Americans exceed that? An incredible 99.4 percent.2184 The overwhelmingly vast majority of U.S. adults consume too much sodium and, at the same time, too little potassium, a mineral that lowers blood pressure. (Less than 2 percent of U.S. adults consume the recommended daily minimum intake of potassium.)

What about using potassium-based salt substitutes? Instead of flavoring our food with sodium chloride (salt), why not shake on some potassium chloride? A naturally occurring mineral salt, potassium chloride is obtained in the same way as regular sodium salt.

The conclusion, echoed by the World Health Organization2348 and the World Heart Federation,2349 was clear and unambiguous: “The safest level of drinking is none.”

The five generally accepted blue zones are the Nicoya Peninsula in Costa Rica, the island of Sardinia in Italy, Ikaria in Greece, Okinawa in Japan, and Loma Linda, California, in the United States.

The foundation of the Blue Zones Food Guidelines is “See that your diet is 95%–100% plant-based.” Vegetables are emphasized (especially leafy greens), along with fruits, whole grains, and legumes.

The list ends with “Retreat from meat,” noting that blue zones centenarians only eat about 2 oz or less of meat about five times per month.2393

And the population with perhaps the highest life expectancy in the world, the Loma Linda Adventist vegetarians, don’t eat any meat at all.

A paper titled “Legumes: The Most Important Dietary Predictor of Survival in Older People of Different Ethnicities” detailed a study in which researchers looked at five cohorts in Australia, Greece, Japan, and Sweden.

Of the food factors investigated, the only one found to have a consistent and significant association with a longer lifespan across the board was intake of legumes, whether it was Swedes eating their brown beans and peas, Japanese eating their soy, or Greeks eating their lentils, chickpeas, and white beans. The researchers identified an 8 percent reduction in risk of death for every 20 g increase in legumes consumed each day,2404 which is just about two tablespoons’ worth.2405

Legumes are not interchangeable, though. A Venn diagram of the phytochemicals found in lentils, beans, soybeans, and chickpeas shared only a 7 percent overlap, so we should strive for variety.

The way the disease is diagnosed and monitored is with the ankle-brachial index—the ratio of blood pressure at the ankle compared to the arm. If the index falls below 0.9, it indicates a clog in the flow of blood to your lower body.

Every ten-beats-per-minute increase in resting heart rate above about sixty-five beats per minute is associated with a 10 to 20 percent increase in the risk of premature death.

Dr. Stamler said as much about the Mediterranean diet on the occasion of his hundredth birthday.2483 The centenarian remained committed to his pioneering research2484 even after turning one hundred. We lost him on January 26, 2022, at the age of 102.2485

How did the traditional diets of more than 2,000 Okinawans break down? Only 1 percent of their diet was fish, less than 1 percent was other meats, and less than 1 percent was dairy and eggs, so it was more than 96 percent plants, with few processed foods.2550

Okinawa has had six to twelve times fewer heart disease deaths per capita than the United States, two to three times fewer colon cancer deaths, seven times fewer prostate cancer deaths, and five and a half times lower risk of dying from breast cancer.2554

And no wonder. The Center for Science in the Public Interest ranked sweet potatoes as one of the healthiest foods on the planet2558—and, one day, perhaps even off the planet, as NASA has chosen the sweet potato for space missions.2559

And purple sweet potatoes may be the best of the best.

The anthocyanins in red rice, black rice, and purple wheat have been shown to have anti-aging and/or life-extending properties in model organisms such as yeast, worms,2561,2562 flies,2563 and mice.

Regardless, miso is now a staple of my kitchen and cookbooks.

With seaweed consumption associated with better blood pressure control in both children2592 and adults,2593 researchers decided to put it to the test and found significantly lower blood pressures from 6 (but not 4) g a day for a month of dried wakame (the sea vegetable in seaweed salad).

For a comparison of the healthiest iodine sources, see my video see.nf/iodine. In short, I recommend the dark-green leafies of the sea. The recommended daily intake can be had in about two sheets of nori,2597 the seaweed used for sushi.

Of more than a hundred compounds measured in the bloodstreams of thousands of individuals, the one most associated with the lowest rates of disease and death was ergothioneine,2604 thought to function as a potent intramitochondrial antioxidant.2605 I review what it can do and the best way to get it in see.nf/ergo. In short, mushrooms and tempeh—a fungi-fermented soybean cake—are the only concentrated dietary sources.

Check out see.nf/garlic for a remarkable series of interventional trials showing that, compared to placebo, a quarter teaspoon of garlic powder can dramatically improve artery function2631 and slow the progression of atherosclerosis.

Randomized, double-blind, placebo-controlled trials have also found ginger to be effective for treating osteoarthritis,2648 premenstrual syndrome,2649 and menstrual pain;2650 preventing2651 and treating migraine headaches;2652 and reducing cholesterol, triglycerides,2653 blood sugars,2654 blood pressure,2655 excess body weight,2656 and signs of oxidative stress2657 and inflammation2658—typically for just pennies a day using the type of ground ginger you’d find at any grocery store.

But, if the person had been eating one and a half teaspoons of ginger powder a day for a week, oxidative stress–induced DNA damage drops about 25 percent, down to 8 percent of cells, which is similar to what’s been found in those fed the same amount of rosemary. Researchers also tested cumin, paprika, sage, and turmeric. The first three don’t seem to help in this regard, but turmeric worked best.

study participants consumed about an eighth of a teaspoon each day of the plain spice you can buy at any grocery store.

If we consume the equivalent of about three-quarters of a teaspoon of turmeric a day for a month, the activity of the catalase enzyme in our bloodstream may get boosted by more than 50 percent.

Okinawa-Inspired Smoothie I’ve been experimenting with a recipe for a delectable bright-purple smoothie that tastes like you are drinking a pumpkin pie. The sweet potato gives it an especially silky-smooth texture. There are a lot more recipes to come in my forthcoming The How Not to Age Cookbook, but to whet your appetite:

½ cooked then frozen purple sweet potato ¼-inch piece of turmeric root ¾ teaspoon matcha 1 cup unsweetened soymilk 1½ teaspoons ground flaxseed 1½ teaspoons wheat germ ¼ cup frozen cranberries ½ cup frozen strawberries 3 pitted dates ¼ teaspoon pumpkin pie spice Dash of cardamom Scrub one purple sweet potato under running water, then pierce it a few times with a fork. Microwave on high until it is fork-tender. When it is cool enough to be handled, cut it in half and freeze both halves. (You’ll use half for this recipe and the other half next time you’re craving this smoothie.) Place all the ingredients in a blender, and blend until smooth. 

Tips: To preserve my turmeric root, I cut it into quarter-inch pieces, then freeze. Also, since learning about spermidine (see here), I’ve been cutting my ground flaxseed with wheat germ, half and half, so I just scoop in one full tablespoon of my flax–wheat germ mixture. Also, please note that the amount of matcha (2 g) used in this smoothie can carry more caffeine than a shot of espresso, so you may not want to drink this late in the day.

Based on the best available studies with the longest follow-up, including an “unusually slim cohort” from the Oxford Vegetarian Study,2676 the ideal body mass index (BMI) for the longest life appears to be 20 to 22 (kg/m2).2677 Okinawans traditionally fell smack dab in the middle at a stable BMI of 21. Although

The fertility versus longevity trade-off may be one reason why spaying and neutering our pets can extend their lives. Based on a study of millions of dogs and cats,2715 sterilized male and female dogs live about 20 percent longer than “intact” dogs, spayed female cats live about 40 percent longer, and neutered male cats a remarkable 60 percent longer.2716

The later girls start their periods, the longer they tend to live.

A century ago, the age of first menstruation averaged as late as nearly seventeen,2732 but now the average age is under twelve.

Higher levels of IGF-1 are associated with earlier sexual maturity,2735 so it’s no surprise that kids eating more animal protein experience puberty significantly earlier; this effect is not seen with plant protein.

Which do you think is more effective? Asking patients to make large dietary changes or smaller ones? Paradoxically, diet studies have shown that recommending greater changes leads to greater changes, leading researchers to conclude: “It may help to replace the common advice, ‘all things in moderation’ with ‘big changes beget big results.’”2754 But, it needn’t be all or nothing.

Swapping in 3 percent of daily calories with plant protein instead of egg protein (found mostly in the egg whites) was associated with twice the benefit of swapping out meat protein, exceeding 20 percent lower mortality in men and women.

So, eggs appeared to be worse than red meat.

These days, “junk” is the predominant food group.2776 Corporations willfully engineer products to maximize eating for profit, and the industry will happily make all the vegan junk we’re willing to buy.

In order to distinguish between healthful and unhealthful vegan diets, Cornell professor emeritus in nutritional biochemistry Dr. T. Colin Campbell introduced the term whole food, plant-based diet.

If people just concentrate on decreasing their intake of animal foods, they may end up increasing their consumption of highly processed junk, like Coke and Wonder Bread.

In general, the dividing line between foods that promote health and those that promote disease may be less plant versus animal and more whole plant foods versus everything else.

The standard American diet only rates an eleven out of one hundred. According to U.S. Department of Agriculture (USDA) estimates, 57 percent of our calories come from processed plant foods, 32 percent from animal products, and only 11 percent from whole grains, fruits, beans, nuts, and vegetables.2804 In other words, on a scale of one to ten, the American diet only rates about a one. Why

In contrast, the potential lifelong damage of any pesticides on those fruits and vegetables has been estimated to only cut a few minutes off the average person’s life.2814 So, while there are many reasons people choose organic produce over conventional, concerns over pesticide residues should not discourage us from stuffing our faces with as many fruits and vegetables as possible.

Tobacco use is responsible for up to ten times or more greater mortality risk:2878 twenty excess deaths per thousand people each year for the heaviest smokers, compared to less than two such deaths for the heaviest sitters.

The share of adults who smoke declined from 42 percent in 19652881 to just 14 percent today.

Exercise is fantastic, but in terms of risk factors for death and disability in the United States, physical inactivity ranks down at number ten and eleven, respectively.2906 Globally, inactivity doesn’t even scratch the top twenty when it comes to years of healthy life lost.2907 A poor diet, as I’ve discussed, is by far our greatest killer, followed by smoking cigarettes.

Apparently not. The same mortality rates were found in identical twins whether they exercised vigorously or not.2916

I was shocked to learn that endurance athletes, compared with sedentary individuals, have been found to have worse atherosclerosis.

However, after ten weeks of intensive workouts and weight loss on the paleo diet, the participants’ LDL cholesterol levels actually went up.

The dosing works out to a whole raw jalapeño pepper or a half teaspoon of red pepper powder a day.

Alternately, there’s ground ginger. It increases weight loss (potentially through BAT activation2986) at a teaspoon a day,2987 which you can just stir into hot water to make ginger tea.

The largest studies in the United States2991 and around the world found that having a normal body mass index between 20 and 25 is associated with the longest lifespan.2992 When you put together all the best available studies with the longest follow-up, that ideal range can be narrowed down even further to a BMI of 20 to 22,2993 which is about 124 to 136 pounds for someone who stands five feet six inches tall.2994 You can use this unisex chart to see what your optimal weight might be based on your height:

Sleep deprivation is no joke. The magnitude of impairment from a week of five-hour nights is similar to that reported in people who smoke, have diabetes, or have coronary artery disease.

A quarter teaspoon of ground lettuce seeds beat out placebo in a double-blind trial for improving sleep quality.3073

No, studies in Nazi-occupied Norway,3086 Finland, and blockaded Sweden showed the rates plummeting, dropping down to as little as only about one-fourth the preceding rate.3087 Check out see.nf/worldwars to see what happens when meat, eggs, and butter are rationed,3088 and food shortages result in diets dominated by garden produce.3089 In reference to the Nazi occupation of Norway, an editorial in the Journal of the American Medical Association noted, “[S]tress has little or no effect if the diet is poor in animal fat.”3090

seven different doses of vitamin D found that elderly women randomized to the medium doses (1,600, 2,400, or 3,200 units a day) were significantly less likely to fall than those given either the lower doses (400 or 800 units a day) or the higher doses (4,000 or 4,800 units a day).