The healthy human lifespan is much more complex than a Mozart symphony. It took billions of years of evolution for it to reach the current state of near-perfection. We cannot expect a simple supplement to make something that’s almost perfect even better, so we cannot expect that we will live healthier and longer lives just by drinking orange juice.

Although humans and most other organisms become dysfunctional in old age, growing older can actually bring improvements as well. For example, New York marathon winners are typically in their thirties, and many of the top finishers are in their forties.

Over millions of years of evolution, the lifespan of an organism will tend to get longer if its ability to generate healthy offspring also increases. Aging and death may be programmed so that organisms could age on purpose and die prematurely if it were advantageous to the species—to avoid overcrowding, for example.

People who live longer would need more energy to perform more maintenance (DNA repair, cellular regeneration, etc.). People who live longer would need to get better at utilizing energy to increase protection against aging and maintaining normal function for longer.

By monitoring the age at which people are diagnosed with different diseases, we know that aging itself is the main risk factor for cancer, cardiovascular disease, Alzheimer’s, and many other diseases. The probability that a twenty-year-old woman will develop breast cancer within the next ten years of her life is roughly 1 in 2,000. The risk is 1 in 24 for a seventy-year-old woman—that’s an increase by almost a factor of 100.

Curing cancer or cardiac disease today would increase the average lifespan by only a little over three years.

Longevity Diet in a nutshell

Most popular diets and the experts behind them fail to take into consideration the most important reason to adopt a diet in the first place: living to a very old age and “dying healthy.”

“Among the longevity factors within your control, what you eat is the primary choice you can make that will affect whether you live to 60, 80, 100, or 110—and more important, whether you will get there in good health.

• Follow a pescatarian diet. Aim for a diet that is close to 100 percent plant- and fish-based, limiting fish consumption to two or three portions a week and avoiding fish with high mercury content (tuna, swordfish, mackerel, halibut).
• Consume low but sufficient proteins. Consume 0.31 to 0.36 grams of protein per pound of body weight per day.” “That comes to 40 to 47 grams of protein per day for a person weighing 130 pounds, and 60 to 70 grams of protein per day for someone weighing 200 to 220 pounds.
• Minimize bad fats and sugars, and maximize good fats and complex carbs. Your diet should be rich in good unsaturated fats, such as those found in olive oil, salmon, almonds, and walnuts, but as low as possible in saturated, hydrogenated, and trans fats. Likewise, the diet should be rich in complex carbohydrates, such as those provided by whole bread, legumes, and vegetables, but low in sugars and limited in pasta, rice, bread, fruit, and fruit juices, which are easily converted into sugars by the time they reach the intestine.
• As extra insurance, take a multivitamin and mineral pill, plus an omega-3 fish oil soft gel every two or three days. Purchase these products only from reputable companies, where quality control ensures appropriate supplement content and stability.
• Eat a variety of foods from your ancestry. To take in all the required nutrients, you need to eat a wide variety of foods, and it’s best to choose from foods that were common on your parents’, grandparents’, and great-grandparents’ table.
• Eat twice a day plus a snack. ”Unless your waist circumference and body weight are in the normal or low range, it is best to eat breakfast and one major meal plus a nourishing low-calorie, low-sugar snack daily.
• Observe time-restricted eating. Another common practice adopted by many centenarian groups is time-restricted eating, or confining all meals and snacks to within eleven to twelve hours or less a day.
• Do not eat within three to four hours of going to sleep.
• Practice periodic prolonged fasting: People under age sixty-five who are neither frail nor malnourished and are free of major diseases should undergo two periods of five days a year in which they consume a relatively high-calorie fasting-mimicking diet, or FMD.

Fast-Mimicking Diet (FMD)

The mere fact that fasting is historically common to most religions supports the idea that fasting is not a fad diet, but part of our history and evolution.

If we consider fasting as the period necessary to switch from a primarily sugar-burning mode to a fat-burning mode, then only periods of abstention from food lasting two or three days or more can be considered fasting.

When to do an FMD Fast:

• Once a month for overweight or obese patients with at least two risk factors for diabetes, cancer, or cardiovascular or neurodegenerative disease
• Once every two months for average-weight patients with at least two risk factors for diabetes, cancer, or cardiovascular or neurodegenerative disease
• Once every three months for average-weight patients with at least one risk factor for diabetes, cancer, or cardiovascular or neurodegenerative disease
• Once every four months for healthy patients with a normal diet who are not physically active
• Once every six months for healthy patients with an ideal diet (see chapter 4) who engage in regular physical activity”

Day 1

• 1,100 calories
• 500 calories from complex carbohydrates (vegetables such as broccoli, tomatoes, carrots, pumpkin, mushrooms, etc.)
• 500 calories from healthy fats (nuts, olive oil)
• 1 multivitamin and mineral supplement
• 1 omega-3/omega-6 supplement
• Sugarless tea (up to 3 to 4 cups per day)
• 25 grams of plant-based protein, mainly from nuts
• Unlimited water

Days 2–5

• 800 calories
• 400 calories from complex carbohydrates (vegetables such as broccoli, tomatoes, carrots, pumpkin, mushrooms, etc.)
• 400 calories from healthy fats (nuts, olive oil)
• 1 multivitamin and mineral supplement
• 1 omega-3/omega-6 supplement
• Sugarless tea (up to 3 to 4 cups per day)
• Unlimited water
• The above components can be divided between breakfast, lunch, and dinner, or they can be taken as two meals and a snack.

Day 6 - Transition diet

• For 24 hours following the end of the five-day FMD, patients should follow a diet based on complex carbohydrates (vegetables, cereals, pasta, rice, bread, fruit, etc.), and minimize the consumption of fish, meat, saturated fats, pastries, cheeses, milk, etc.

Recipe For Longevity

Mice given a low-protein, high-carbohydrate diet lived the longest but also displayed improved health. Mice on a high-protein, low-carbohydrate diet lived the shortest and had the worst health, despite the effect of the diet on weight loss

We have shown that even periodic use of a low-protein, plant-based diet can reduce many markers or risk factors for aging and diseases in subjects ages twenty to seventy

A Mediterranean diet with high levels of olive oil or 30 grams a day of nuts (walnuts, hazelnuts, almonds) was associated with reduced cardiovascular events and mortality.

Areas of the world known to have the highest prevalence of centenarians—Okinawa, Japan; Loma Linda, California; small towns in Calabria and Sardinia, Italy; and in Costa Rica and Greece—all share diets that are (1) mostly plant-based with lots of nuts and some fish; (2) low in proteins, sugars, and saturated/trans fats; and (3) high in complex carbohydrates coming from beans and other plant-based foods. Most of these centenarians ate only two or three times a day, ate light meals in the evening, and were in many cases done eating before dark.

If you take 100 centenarians, you get 100 different elixirs of longevity.

Emma probably had the right genes, which can increase by manyfold the chance that someone will live to 100. Her mother had died at 94, her sister at 102, two other sisters had reached 98, and her brother passed away at 90.

Having just one parent who lives past the age of 87 reduces your chances of getting cancer by 24 percent.

In general, those who reach age one hundred in good health have stayed active or very active into old age.

Making it to 110 in good health, in my father’s case, is less about social connections and great friendships and more about simple things, like that long-forbidden chocolate bar. In the case of Salvatore Caruso, who watched my father grow up, it was about competition. He wanted to be the oldest man in the world. When I informed him that someone in Sicily was older, he said: “I have to beat him.” And he eventually did.

Thoughts on the Western Diet

Because everyone eats, everyone feels he or she knows enough about food and health to give advice. Would you fly on an airplane that you had personally designed?

Why would you be willing to make key decisions that affect whether you and your loved ones will get cancer, diabetes, cardiovascular disease, and many other illnesses based on the silly idea that one should “eat in moderation”? What does that even mean?

“Moderation” is relative. Consider the following daily menu: a glass of milk, two eggs and bacon, a small steak, a slice of cheese, some carrots, some pasta, a chicken filet, a salad with ranch dressing, a piece of cake, and two soft drinks. To many people, this represents eating in moderation. Yet this is the type of diet that has made the United States one of the world leaders in obesity and related diseases.

Between 50 and 90 percent of US adults do not get enough vitamin D, E, magnesium, vitamin A, calcium, potassium, or vitamin K. At the same time, several recent articles indicate that dietary supplements containing excess vitamins and minerals are ineffective in preventing major diseases and delaying mortality.

A plate of pasta and cheese can weigh just 12 ounces and be very unhealthy, full of bad-quality calories. Or it can weigh more than double that amount, about 1.5 pounds, and be very healthy, full of high-quality calories—provided you cut down the pasta and cheese to modest portions and add plenty of vegetables and legumes and a generous splash of olive oil.

We have known for nearly one hundred years that when mice are fed about 30 to 40 percent fewer calories, they live longer and develop half the tumors and other diseases when compared to the groups of mice receiving a normal-calorie diet.

American seniors ate ten times more meat, poultry, and eggs and three times more fruit, but far less fish, half the vegetables, and one third of the grains that the Okinawans did.

Activity

In Okinawa, I heard stories of fishermen who never retire, and I watched a woman in her nineties dance with a large bottle on her head, something she did many times a week. When she wasn’t dancing, she enjoyed playing traditional Japanese musical instruments.

What physical activity is best for healthy longevity? The one you enjoy most, but also the one you can easily incorporate into your daily schedule and the one you can keep doing up to your hundredth birthday and beyond. Many Okinawans practice martial arts, especially a dance-inspired version of tai chi. The type of exercise you choose isn’t important. What’s important is working all your body parts until you breathe rapidly and sweat for five to ten hours a week.

• Walk fast for an hour every day. The goal of walking for an hour a day can easily be achieved. For example, pick a coffee shop or restaurant fifteen minutes from your work and make a point of going there twice a day.
• Ride, run, or swim thirty to forty minutes every other day, plus two hours on the weekend. The best way to achieve this goal is to have both a stationary bike and a road bike. When you can, ride outside; when you can’t, use the exercise bike in high gear
• Use your muscles. Humans evolved as a species that walks, runs, climbs trees and hills, and uses a variety of muscles all the time. Now people use elevators and escalators instead of stairs, drive instead of walk, use dishwashers and washing machines instead of washing dishes and clothes by hand, buy food instead of growing it, and hire people to do even minor repair work around the house instead of fixing things ourselves.
• Take the stairs instead of escalators and elevators.
• On the weekend, walk everywhere, even faraway places (avoid polluted areas as much as you can).
• Do moderate exercise for 2½ to 5 hours a week, with some of it in the vigorous range. Most of the beneficial effects appear to be caused by the first 2.5 hours of exercise, making the additional exercise optional.
• Use weight training or weight-free exercises to strengthen all muscles.
• To maximize muscle growth, consume at least 30 grams of protein in a single meal one to two hours after a relatively intense weight-training session.”

Those who exercised less than 150 minutes at moderate intensity or 75 minutes at vigorous intensity per week had a 20 percent reduced risk of mortality compared with those who did not exercise. Mortality was reduced by 31 percent in those who exercised for more than 150 minutes a week at moderate intensity or for more than 75 minutes a week at vigorous intensity. And the risk of dying was reduced by 37 percent in those exercising more than 300 minutes a week at moderate intensity or 150 minutes at high intensity