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Michael Greger — How Not to Age

How Not to Age: The Scientific Approach to Getting Healthier as You Get Older (book cover)

When Dr. Michael Greger, founder of, dove into the top peer-reviewed anti-aging medical research, he realized that diet could regulate every one of the most promising strategies for combating the effects of aging. We don’t need Big Pharma to keep us feeling young―we already have the tools. In How Not to Age, the internationally renowned physician and nutritionist breaks down the science of aging and chronic illness and explains how to help avoid the diseases most commonly encountered in our journeys through life.

Physicians have long treated aging as a malady, but getting older does not have to mean getting sicker. There are eleven pathways for aging in our bodies’ cells and we can disrupt each of them. Processes like autophagy, the upcycling of unusable junk, can be boosted with spermidine, a compound found in tempeh, mushrooms, and wheat germ. Senescent “zombie” cells that spew inflammation and are linked to many age-related diseases may be cleared in part with quercetin-rich foods like onions, apples, and kale. And we can combat effects of aging without breaking the bank. Why spend a small fortune on vitamin C and nicotinamide facial serums when you can make your own for up to 2,000 times cheaper?

Inspired by the dietary and lifestyle patterns of centenarians and residents of “Blue Zone” regions where people live the longest, Dr. Greger presents simple, accessible, and evidence-based methods to preserve the body functions that keep you feeling youthful, both physically and mentally. Brimming with expertise and actionable takeaways, How Not to Age lays out practical strategies for achieving ultimate longevity.

A founding member and Fellow of the American College of Lifestyle Medicine, Michael Greger, MD, is a physician, New York Times bestselling author, and internationally recognized speaker on nutrition, food safety, and public health issues. He has lectured at the Conference on World Affairs, testified before Congress, and was invited as an expert witness in the defense of Oprah Winfrey in the infamous “meat defamation” trial. In 2017, Dr. Greger was honored with the ACLM Lifestyle Medicine Trailblazer Award. He is a graduate of Cornell University School of Agriculture and Tufts University School of Medicine. His first book How Not to Die became an instant New York Times Best Seller. He is also the author of The How Not to Die Cookbook, How Not to Diet, The How Not to Diet Cookbook, and How to Survive a Pandemic. He has videos on more than 2,000 health topics freely available at, with new videos and articles uploaded every day. All proceeds he receives from his books, DVDs, and speaking engagements are donated to charity.

Shermer and Greger discuss:

  • low trust in medicine and public health post-Covid
  • why we age and die
  • Is aging a disease?
  • No one dies from old age?
  • lifespan, vs. healthspan vs. life expectancy
  • longevity escape velocity
  • leading causes of death: heart disease, cancer, stroke, dementia
  • aging in the Paleolithic vs. Civilization
  • how to determine causality in aging science: genes, environment, diet, and luck
  • dietary and nutrition fads in history
  • the diet and anti-aging industry: multibillion-dollar behemoths: $88 billion US, $292 billion worldwide
  • diet and beverages
  • What centenarians eat?
  • Mediterranean Diet
  • Okinawan Diet
  • Red, White, and Blue Zones
  • plant-based eating
  • meat, dairy, eggs, etc.
  • lifestyle
  • exercise
  • weight control
  • sleep
  • stress
  • the Anti-Aging 8: nuts, greens, berries, prebiotics and postbiotics
  • cholesterol and statins
  • vaccines: shingles, flu, etc.
  • brain supplements
  • sunscreen
  • sunglasses and UV
  • alcohol
  • Alzheimer’s and dementia
  • social ties, friendships, and marriage.

Excerpt from the Book

Even if all forms of cancer were eliminated, the average life expectancy in the United States would only go up about three years. Because dodging cancer would just mean delaying death from something like a heart attack or stroke. If one age-related ailment doesn’t get us, another will. Rather than playing “whack-a-mole” by tackling each disease separately, progress in decelerating aging could address all these issues simultaneously.

How long do you wish to live? 85, 120, 150, indefinitely (2/3 said 85) 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.” Studies have found the prevalence of multimorbidity, the coexistence of multiple chronic diseases, ranges between 55 percent and 98 percent among older individuals. By age eighty-five, more than 90 percent may have at least one disease and, on average, about four diseases. And just like 85 percent of cancer patients tend to overestimate their survival, so, too, do those with other chronic diseases. Those suffering from heart failure or chronic obstructive lung diseases like emphysema are about three times more likely to die within the subsequent year than they predicted.

A twenty-year-old in 1998 could expect to live about fifty-eight more years, while a twenty-year-old in 2006 could look forward to fifty-nine more years. However, the twenty-year-old from the 1990s might live ten of those years with chronic disease, whereas now it’s more like thirteen years. So it feels like one step forward, three steps back. The researchers also noted that we’re living two fewer functional years—that is, years we’re no longer able to perform basic life activities, such as walking a quarter of a mile, standing or sitting for two hours without having to lie down, or standing without special equipment.

In terms of life expectancy, the United States ranked down around 27 or 28 out of the 34 top free-market democracies. People in Slovenia live longer than we do. That was in 2010, down from ranking 20th in 1990. More recently, U.S. life expectancy dipped to 43rd in the world and is expected to drop to 64th by 2040, despite spending trillions on healthcare a year, more than anyone else around the globe. The problem isn’t healthcare access. The Mayo Clinic estimates that nearly 70 percent of Americans are on prescription drugs. The problem is that those trillions in healthcare spending aren’t addressing the root cause. The leading risk factor for death in the United States is what we eat. It’s the food. The standard American diet is just to die for. Literally.

According to one industry group, 60 percent of Americans sixty-five and older are pursuing anti-aging interventions, yet, according to the director of the Institute for Biomedical Aging Research, in almost all instances, these interventions are not supported by science. They sound like they are, though. Scientific breakthroughs exploited by the sensationalist press have long been opportunistically repackaged by profiteers.

“Simply put,” the American Academy of Anti-Aging Medicine’s official response to the criticism read, “the death cult of gerontology desperately labors to sustain an arcane, outmoded stance that aging is natural and inevitable.”

The odds of living to age one hundred have risen from approximately one in twenty million to as high as one in fifty. Why do some make it to their hundredth birthday but others don’t? It’s not just a matter of picking better parents. Studies following identical twins suggest that no more than 20 to 30 percent of the variance in lifespan is explained by gene inheritance.

This episode was released on December 16, 2023.

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