How Not to Age by Michael Greger MD

Reviewed by E.B. Heath

Dr. Michael Greger’s latest book – How Not to Age – provides readers with trustworthy scientific research on how to get healthier as you age. Wild unsubstantiated claims are used to promote anti-aging products, often sponsored by vested interests producing skewed results. It is very hard for the general public to identify what is credible research. Understandably, this is upsetting for those in the medical profession who invest in solid studies.  For this reason, Dr. Greger is keen to show that his work is based on unbiased evidence, explaining: That’s why I cite everything to the teeth.  Dr. Greger’s material is dense, but instructive, and so worth the effort.  Knowledge is power, it also inspires a change.  What follows is a brief guide of a comprehensive work.

Greger refers to the three ways researchers plot an aging pathway: Does the factor worsen with age? If you amplify it, does it accelerate aging? And, if you dampen it, does it slow aging and thereby extend lifespan?   Part 1 details eleven factors in the aging process, and how each changes aging when accelerated or slowed.

‘Slowing Eleven Pathways of Aging’ is full of nerdy characters (factors) that populate a complicated who-dun-it.  Readers will be introduced to the gritty details about the good guys, bad guys and good guys gone bad.  It makes interesting reading, such as the enzyme, AMPK, colloquially known as the Fat Controller.  This enzyme flips the switch from storing fat to burning it, working alongside another factor, Autophagy, which gets rid of defective cellular components.  The trick is to activate AMPK and Autophagy to keep doing the job as the process slows down with aging.  This can be done by fasting or through exercise.  Readers will come to understand that calorie restriction and exercise, does a lot of heavy lifting in the anti-aging process.  But there are foods that may boost AMPK, such as Barberries, Black Cumin, Hibiscus and Lemon Verbena Tea, vinegar and fibre-rich foods. Autophagy is similarly motivated by these foods plus coffee, black percolated coffee.

Enter good guy gone bad, mTOR.  mTOR was great when we were young triggering growth.  But for the aging population, not so good, in fact bad.  This enzyme, along with acrylamide, found in carbohydrates exposed to high temperatures such as fried chips, works to deactivate Autophagy speeding up aging.  mTOR also resides in animal protein.  Needless to say, mTOR is armed and dangerous and should be avoided at all times.

Then there is Spermidine, a complicated character found throughout the body. It binds to DNA to stabilize the genetic code. And it activates Autophagy.  In the aging process Spermidine dissipates, thankfully it can be replenished from certain food sources.  Dr. Greger provides a comprehensive list of natural foods sources containing Spermidine.

Readers are then introduced to Zombie Cells, aka Cellular Senescence.  In the aging process, they pile up causing chronic systemic inflammation and diseases such as Alzheimer’s, Parkinson’s, osteoarthritis and even cancer.  Senescent cells can be eliminated by exercise and calorie restriction and by foods that contain flavonols, such as Quercetin in onions, kale, and particularly, apples with peel intact.  Greger refers to the old maxim, an apple a day keeps the doctor away, adding, and the mortician.  Fisetin, also from the flavonoid family, does much the same job only better.  Strawberries are loaded with Fisetin.  Pippali is a rather exotic character that fights cellular senescence, it can be found in a spice of the same name.

Epigenetics – ‘Genes load the gun, lifestyle pulls the trigger’ – this is such a motivating section.  The choice of lifestyle particularly a whole plant diet can make a big difference to the aging process.  Greger educates readers about glycation, oxidation, methionine, telomeres, sirtuins function, and Resveratrol, along with helpful food sources.  Research regarding the famed ketogenic diets reveal that they should be approached with care, or better yet, avoided, especially by diabetics.  In reading Part 1, readers will discover that we have more control than they think over the aging process.

Part 2.  ‘The Optimal Anti-Aging Regimen’ looks closely at the success or otherwise of various diets, and lists long-lifers around the world.  He goes into plant-based eating, which he reiterates is life-saving.  There are, of course, sections regarding exercise and weight control, and the importance of sleep and stress management.

Part 3. ‘Preserving Function’, here Dr. Greger provides information about many separate functions of the body: bones, bowel and bladder, circulation, hair, hearing, hormones, immune systems, joints, mind, muscles, sex life, skin teeth, vision and preserving dignity at the end stage of life.  He discusses various ailments pertaining to each function along with practical proposals for targeting them naturally.

Readers might note that vital information is provided in this section regarding drug and supplement therapies related to the above.  The possible side effects of drugs used to treat some conditions, osteoporosis drugs for instance, seem to be worse than the disease.  Real food, fruit and vegetables and herbs, might be a better option, at least worth discussing with GP.

Part 4, ‘Dr. Greger’s Anti-Aging Eight’ starts off by warning of the many scams, including the exaggerated claims of anti-aging supplements that do more harm than good.

Dr. Greger reiterates the World Health Organization recommendations for a healthy diet.  Meta-analyses of studies show that an additional daily serving of vegetables resulted in a 4% lower risk of premature death, 6 % for an additional serving of fruits, 8 % per for whole grains, 10% for a single daily serving of legumes, and 15% for a daily half serving of nuts.

Nuts are the first of the eight recommendations for healthier living.  Nuts are one of the very few foods that, just on their own, may literally add years to your life. Greger points out that nut butters do not have the same effect.  Just as important for Greger are leafy greens for boosting gut defences, detoxifying enzymes, muscle aging, and oral microbiome.  Berries rate high for antioxidants, cherries reduce inflammation, cranberries for bowel and bladder function.

The fourth anti-aging factor is Xenohormesis and microRNA Manipulation, which, apparently, represent cross-kingdom communication pathways between plants and animals.  Hormesis can be summed up as “that which doesn’t kill you makes you stronger”.  Plants that have been stressed, through drought or small doses of poison gain heightened bioactive compounds that can be passed on to those who consume them.  That was interesting.  But what came next was breathe taking.  And it’s complicated.  Readers will learn about newly discovered microRNA, a series of molecules that regulate every biological process (humans, plants, and animals), how each one works, and which ones work to increase or decrease aging, and what happens when we eat animal microRNAS.  There is a surprising synergistic effect when eating different foods together, such as raspberries and adzuki beans, which boosts their antioxidant power.

Dr. Greger follows with prebiotics and postbiotics, caloric restriction, and protein restriction.   Finally, rounding off the anti-aging eight is NAD.  An essential molecule in all species, and the most abundant in our body.  NAD declines as we age.  Over several pages he discusses NAD boosting supplements, and their potential adverse effects, before listing some natural approaches to boosting NAD.

Some of the information in How Not to Age is complicated, but at its heart the message is simple.  Lifestyle trumps genes.  By a long shot.

How Not to Age

by Michael Greger, MD

(2023)

Pan MacMillan

Paperback

ISBN: 978 152905 735 5

$39.99; 608pp

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