The Melanie Avalon Biohacking Podcast Episode #276 - Dr. Michael Greger

TRANSCRIPT

(Note: This is generated by AI with 98% accuracy. However, any errors may cause unintended changes in meaning.)

Melanie Avalon:
Hi friends, welcome back to the show. I don't know if I've ever started a show with so much gratitude and smiles on my face as I have right now, the backstory on today's show. I am here with Dr. Michael Greger, who is a legend, friends in the health and wellness sphere. I have been following his work for years. I told him this last time, and I will explain about the last time, but probably about a decade ago, honestly, I was doing a nutrition certification program, and the requirement for the program was actually to watch DVDs made from nutritionfacts.org to learn all about the benefits of a plant-based diet in particular. They were super deep on the science of things and looking at studies, and that was my first exposure to Michael Greger's work. Since then, he has released so many incredible books, including many New York Times bestsellers, and I have read most of them. I read How Not to Die, I read How Not to Diet. He also has the How Not to Die Cookbook, and we are here today for his book How Not to Age, which honestly, friends, I talk about aging a lot on this show. This is the deepest dive I have read. It is massive. You could use it as like a weight for muscle building. It dives so deep into what actually causes aging, and then really, really deep into the role of diet in aging, and just literally, it goes through pretty much every ailment associated with aging, and how different dietary approaches affect it. It's just incredible. The other reason I'm smiling so much is I actually already had this interview with Dr. Greger a few months ago, and I don't even know what happened. For the first time in like how many episodes have I done of podcasting? Almost 600, 700 episodes. I did not hit record, so I lost it, and he is so kind to come back and do a take too. So Dr. Greger, thank you so much for all that you do. I am so excited to interview you again, and yeah, thank you for being here.

Dr. Michael Greger
I love the first one so much we couldn't lose it. Let's do it again. Hopefully it's a high bar though. I mean

Melanie Avalon:
I know, it's kind of nice that it's been a few months because I feel like I've kind of let it evaness from memory and so I can just kind of start afresh. But if I repeat myself, I apologize, but nobody will know except for us. So to start things off, a big question about, well, actually, I think this is how I started it last time and I will start it again this way because I think it's really important. So the title is How Not To Age and when I first saw that and when I first saw How Not To Die and How Not To Die It, the thought is like it's about not aging or not dying. But is that what you mean by that title?

Dr. Michael Greger
just in my earlier book, How Not to Die, it was not about living forever. It was not how to not die, but rather how not to die, as in prematurely in pain after a long chronic disabling illness. How Not to Age has a similar premise. The book's not about immortality, but rather how to age with grace and vitality rather than suffering from the ravages of infirmity and disease.

Melanie Avalon:
Exactly. So a little bit of a different transition there or a different perspective. And so this concept of aging, there are so many different theories and interpretations. You know, I've had people on the show like David Sinclair, who will say aging is disease. I've had people on the show who talk about reversing aging or, you know, reaching this point where we will reach immortality. I'm curious for you, do you think aging, is it a disease? Is it natural? Do our bodies naturally want to not age or is it just part of the natural process?

Dr. Michael Greger
Actually, you start out early in the book talking about the debate on whether aging itself is a disease, kind of one of the most contested questions in gerontology. Aging is, you say, well, it can't be a disease. It's natural, right? But yeah, but so is getting an infection, right? We call that a disease. You say, well, yeah, we can't call it a disease because aging is universal. But yeah, but everyone gets the common cold, too. It's interesting, if you ask people whether they think a variety of conditions classify it as a disease, you get this odd mix. Like, you know, alcoholism, alcohol dependence, is considered a disease. But nicotine dependence, smoking, not considered a disease, right? It's interesting, the general public is actually more likely to view aging as a disease than physicians, even though, God, you know, physicians love medicalizing everything. But medicine is kind of hesitant to label aging as an ailment. You say, like, well, why does it really matter? Well, the disease classification would lead to greater resource allocation for aging research. You know, just like this recent declaration that obesity is considered a disease, they're on obesity research, got a big boost in funding. Well, you know, aging is arguably, like, one of the most important unsolved problems for humanity, yet less than 0.1% of the National Institutes of Health budget is spent on understanding the aging process, even though aging really is like the leading cause of disease and death. But, you know, few medical textbooks even have a single chapter on the subject. It's been kind of relegated to, you know, this kind of limbo reserved for, like, you know, eccentric whims rather than really kind of serious scientific consideration. And, you know, you think, well, wait a second. You think big pharma, regardless, would invest in it. Because, like, talk about a blockbuster drug, right? Everybody, right? Everybody would be up for it. But why spend the money on research when it can just be spent on marketing all the unproven anti-aging products they already sell, right? Many of the leading lines of dietary supplements owned by drug companies. They're the ones selling the Cosmeceuticals, the age-reversed skin creams, all that garbage. It's Sanofi, big drug maker, even partner of Coca-Cola to come out with some beauty drink, quote, unquote, right? So they're already making money, hand over a fist, preying on the public's gullibility and desperation for anti-aging products. So it's like, why waste money on proving anything actually works? Because people are suckers. They'll buy it anyway.

Melanie Avalon:
And actually to that point, I would be super curious. So like, because you mentioned like a blockbuster drug for aging. I definitely think people, most people would be, would want that. I would be really curious though, because I always thought everybody wanted to live forever. Like I want to live forever. I thought that was just really common. But I ask when I asked a lot of people on the show, they actually don't. And when I ask people like in my life, they often don't. So for you, do you want to live forever?

Dr. Michael Greger
Well, you know, there was actually asked that question, I have it somewhere in the book, where people were given the choice of asked, how long do you want to live? I mean, multiple choice. Do you want to live to 85? 120, 150, or indefinitely. And to my shock, about two thirds, big majority, said they'd prefer only to live to 85. But when the question was reframed as how long do you wish to live in guaranteed mental and physical health, aha! Well, then the most popular answer switched to an unlimited lifespan, right? And that really brings up this concept of healthspan, which is the period of life spent in good health, free from chronic disease and disability. And so what's the point of living longer if we can't enjoy it vibrantly? And so that's why in my book, I not only talk about lifespan, but also talk about healthspan.

Melanie Avalon:
So it sounds like since you were shocked, you must have been like me where it's like, oh my

Dr. Michael Greger
God as long as I frickin want that's how long I got shit to do. I don't know about you, but more hours in the day and years

Melanie Avalon:
Sometimes I'll follow up with the second question about health span, and sometimes that changes their minds, but sometimes still people are like, well, it's like they don't know what they would do with that much time, but I'm like, there's so much to do. I just want to keep going.

Dr. Michael Greger
Ask them a day before they're going to die if they really want more time. Right now, they're like, oh, 85 seems so far away. But okay, ask me at 84, come on. Hopefully, you're living some sort of life where you got stuff that you want to do that you enjoy. There's other people that you can improve their lives. You can do suffering in the world. I mean, there's just so much to live for.

Melanie Avalon:
One quick, really specific question about aging. Well, first of all, so men versus women in aging, is there a big difference there? And in particular, because we're going to dive deep into diet, is there a difference in how men and women respond to diet and how that affects their aging? And I also am curious about women having children and aging, how that affects things. So two, lots of topics.

Dr. Michael Greger
Lots of topics. One of the biological constants in the world, one of the best validated data that we know, is that women live longer than men basically everywhere. It's been a really interesting research question. I talk all about all sorts of juicy theories in the book as to why that's actually the case. We're still not actually sure. In terms of different foods, well, there's certainly different conditions. Women experience menopausal hot flesh symptoms, obviously. Often, these so-called vasomotor symptoms such as hot flashes or flushes and night sweats and things, that's something men don't have to worry about. Women don't have to worry about prostate enlargement and prostate cancer. Women have to worry much more about breast cancer, certainly ovarian cancer, et cetera. There certainly are very gender-specific things, but overall, for the organs that they share in common, it's the same recommendation. It's the same heart-healthy diet, the same heart-healthy diet and lifestyle for men and women, liver-healthy, kidney-healthy. Otherwise, biology is very similar. I'm trying to think of any circumstances where ... I mean, there's obviously different foods, but that's ovary specific, talking about all the things you can do for menstrual cycles and things. But beyond those arenas, it's pretty much the same for both, although you have different size. What about soy? Oh, yeah. Well, soy is healthier for women than this for men, just because they get more benefit from it. Soy is certainly a very misunderstood bean, so I talk a lot about the benefits of soy. People don't understand there's actually two kinds of estrogen receptors in the body. They hear phytoestrogens in soy. They think, oh, estrogen's that bad. This guy can be breast cancer or worse than my breast cancer. But there's two types of estrogen receptors. There's phytoestrogens in soy bind to the beta receptors and our own estrogen binds to the alpha receptors. The effects of soy on different tissues depends on the ratio of alpha to beta. Estrogen has positive effects on some tissues, negative effects on others. For example, estrogen is good for the bones, bad for the breast. Ideally, we'd have some kind of what's called a selective estrogen receptor modulator to have estrogen effects on some tissues, but anti-estrogenic effects on others, and that's what soy fat estrogens do. So they lower breast cancer risk. That's an anti-estrogenic effect. At the same time, they reduce the menopausal hot flask symptoms. That's a pro-estrogenic effect. So with soy, you get the best of both worlds, but we should eat legumes, soy, and other beans, chickpeas, lentils, split peas every day.

Melanie Avalon:
With soy, does some of that depend on your gut bacteria and whether or not you produce?

Dr. Michael Greger
Oh yeah, juicy, equal. I love it. So cool. Yeah. So I talked about the microbiome chapter. Basically, some people's soy is good for you. Some people's soy is great for you. And that's because there's kind of an activation of compound soy by one's microbiome, but you have to have those activating bacteria. And so you just miss out on some of the benefits if you don't. The only population in the Western world with decent rates of equal production is those eating plant-based diets, presumably because we're basically feeding the bacteria that are making this transition. It used to be a lot of equal production in Japan since they have the highest soy consumption in the world, averaging I think two, about two servings of soy a day. But even they are starting to, their equal producers are starting to wither away. So the question is, how can we turn from non-equal producer to equal producer? And looks like the best advice we can give is to eat a diet centered round plants.

Melanie Avalon:
So those bacteria are ones that can be cultivated through a dietary choice. You don't have to be born with them.

Dr. Michael Greger
That is true, although we have not, there's yet to be an interventional trial to actually show the switch, so it looks like it just takes longer. And we see that a lot with the microbiome studies. In fact, that's why you see so much, I think, confusion in a lot of the microbiome literature, where some studies show one thing, other studies show another, and duration is really, duration and quantity are the two big things. So you'll see studies comparing like some like whole grain bread to white bread, and see no difference in some kind of outcome. And yeah, but like the difference in fiber, it was like five grams. And five gram difference, I'm not sure you're going to see in a limited time span. And you can actually do fiber supplement studies where, you know, 10 grams works, but five grams just doesn't. Another factor is duration. There's a breakfast cereal study where they randomized people to rice, recipes are all brand for breakfast, for a year. And for the first nine months, nothing happened, which is consistent with all the short term studies, where just that switch was not enough to sufficiently affect kind of the microbiome. But starting at month nine, and increasing through month 12, you saw significant improvements in, I think it was insulin resistance, long term blood sugar control. I mean, that is because, you know, it takes a while to shift the microbiome, particularly when you're making small changes, such that, you know, the more fiber you eat, not only is more the beneficial short chain fatty acids, the post-biotics created by our fiber feeders, but the more fiber feeders we create. And so it increases our capacity. So for example, if you give someone who's been just using like milkshake and cheeseburgers their whole lives, you give them a whopping dose of fiber, they only benefit a small amount from it because they just don't have enough fiber feeders. I mean, you can maximize out the production of those little few bucks you have, but it's growing the production of, you know, making an ecosystem down in your gut that facilitates, you know, where they can just count on, you know, the constant flow of nourishment that you can really grow your bifida bacteria and acidophilus and these other fiber feeders that have those knock on beneficial effects. And so you basically increase your machinery of fiber conversion capacity to those post-biotics that we really want by eating more fiber and then continue to eat more fiber. And so just continue to ramp up. But that's why a lot of these short term studies just don't show the beneficial effects you'd expect from increasing fiber intake.

Melanie Avalon:
I was actually thinking about that concept, not about those foods, but the concept of short-term versus long-term in particular and how we interpret data and what does it maybe say about causation and correlation. And the example in the book I was thinking about was you talked about how having, I think it was wine with like a cheeseburger or something could short-term reduce oxidative stress from the meal, but that long-term that didn't necessarily pan out. And then on the flip side, having, I think grape juice short-term didn't seem to do that, but might do long-term. And I was wondering if that was more about causation, correlation, and how do we interpret that if we have a situation where having some, you know, with the meal seems to have a beneficial effect in the moment, but how do we know if that is a long-term benefit or not?

Dr. Michael Greger
Oh, that's a good point. In fact, you know, those indigestible sugars, like raffinose and stachios, in those beans that you're getting rid of with the beano, these are actually what good gut bugs eat in part. And so you're actually, yes, starving your bugs of those particular compounds. So, look, you got to eat your legumes, right? It's the centerpiece of every single, you know, Blue Zone diet, area of exceptional longevity in history, centering their diets as the primary protein source, some kind of legume. So you got to have them in your diet. The only way you can do that is using something like, you know, at the beginning, until your gut bugs can adapt, then absolutely go for it. But it's not something that you should need to be on long term as your, your gut will adapt to it. Basically, what happens is you, your gas consuming bacteria are fostered by the gas producing bacteria, but there's a delay in that, in that middle period where you can have excessive gas and bloating. But that's just because you have yet to, you know, develop the bacteria on the other end that are consuming that same gas. But I mean, gas is showing fermentation works, you're fermenting fiber, right? When you know, you're making beer, you're making sauerkraut, it's those little bubbles show that stuff is happening. So that's a good thing as a gas production, but that is countered naturally by bugs in your gut that are like, Oh, methane is delicious. And they use it. But it takes a while for the higher gas environment to foster the growth of those gas consumers. So you get the optimal balance. So you can eat all the beans you want and not run the problems and net all the benefits.

Melanie Avalon:
So we're talking about so many things here that I think my audience in general tends to be a little bit skeptical of or lean away from because it is a lot of, well, paleo, keto, even carnivore people, things like soy and even legumes, people get hesitant about. So I have so many questions about this topic. And I personally, you mentioned the blue zones, I am so haunted by what is the ideal diet for longevity. Super curious, your take on some things that we talk about a lot on this show, probably with a slightly different perspective. So this is a good moment for me, where to start. So maybe one would be, because we've mentioned protein and you just mentioned like starting with protein in these diets, but legume-based, so plant-based protein. And in the book, you have this anti-aging eight list, which I am really excited to hear how you, actually, I'll ask you that really quickly because it's a big topic to come up with the eight anti-aging things. Was there a lot in the running? Like, did you have to narrow it down from like a hundred? Yeah, in fact.

Dr. Michael Greger
In fact, yeah, I think it was, I think we started at 13, something like that. What were some that didn't make the cut? Oh my God, I have to look at some of the earlier drafts. I think all I did in some cases is just kind of combined too, like so I combined xenoharmesis and... We have it right here.

Melanie Avalon:
and microRNA manipulation. Oh, is that the same chapter? I have it, yes.

Dr. Michael Greger
Oh, yeah. For example, those were two initially, and I just kind of put those together because it's kind of this cross-kingdom communication. Basically, the anti-aging is things that just came up throughout the book. So I go through in my part three where I talk about preserving your bones, bones, bladder, circulation, hair, hearing, hormone bones, immune functions, joint health, mind, muscle, sex, life, skin, teeth, vision, et cetera, et cetera. And things just kept popping up like greens all the time. Like, oh, you want to preserve your vision? Well, there's luteus and xanthin and all these other things. Oh, well, guess what? All of a sudden, the nitrates come up and nitrates and greens come up in the sex life chapter. Oh, all of a sudden, comes up in the brain chapter, even the muscles chapter, right? You can actually randomize people to eat spinach, see a significant improvement in muscle mass, muscle strength, muscle performance, spinach. Who would have thought? And so it's like, so that's how greens make in my anti-aging aid. It's like, okay, well, if there's one thing, it just hits so many different things at the same time, same thing with berries. It's just berries came up over and over, came up in cognition, came up in immune function, came up in joint health. Basically, just a way to kind of emphasize, underscore, these are some of the things that you can, with kind of one failed swoop, affect so many aspects of aging at one time.

Melanie Avalon:
What's really interesting, I just interviewed the researchers behind the MIND diet, which is one of the highest studied, if not the highest studied dietary approach for preventing cognitive decline. They also break down, you get more points for greens specifically and for berries specifically, and just berries, like you don't get points for the other fruits. It really makes me wonder in the entirety of the literature if findings would be different at all if it was always broken down by greens versus other vegetables and also by berries versus other fruit, because often it's lumped together like fruit and vegetables.

Dr. Michael Greger
Right. Right. And not just fruit and vegetables, but even fruit is a huge category. Vegetables is a cute category. So vegetables include some of the healthiest foods on the planet like kale and some of the like, you know, iceberg.

Melanie Avalon:
Although it's good for sleep, I learned in your book.

Dr. Michael Greger
Which is good for sleep, which is crazy. No, and it's actually relatively high in spermidine. I couldn't believe I saw it on the spermidine list. I was like, what? Iceberg, I shouldn't be so mad. I shouldn't diss iceberg. Look at it. Look at it go. Look at it go. But basically, so there's some components in our diet, like, say, vitamin C, found widely throughout the plant kingdom. And so basically, you could eat almost any plant, and you're not going to die a scurvy. But there are certain compounds only found in certain foods or certain classes of foods, like sulforaphane, in cruciferous vegetables. If you don't eat cruciferous vegetables, you're basically screwed. Now, there's, I think, this one mushroom that has it, moringa, which some tree in Africa has it. But basically, the only thing in the supermarket, you're going to get sulforaphane from, in cruciferous vegetables, broccoli, kale, cabbage, bok choy, et cetera. And so if you don't eat cruciferous vegetables, you are going to miss out on the benefits, even if you eat tons of other vegetables. Same thing with the lignans and flax seeds. Flax seeds have, like, 100 times more lignans than any other food. Sesame seeds are not bad, but basically, the most concentrated source by far, and you're basically not going to get a lot of lignans unless you are eating flax seeds every day. So that's, you know, goes on the daily dozen. And, you know, turmeric has this curcumin pigment that's really not found anywhere else, and saffron has things not really found anywhere else. And so that's why, you know, it's not enough just to eat plants, just not enough to eat fruits and vegetables, not enough to, you know, we should focus on the healthiest fruits, berries, the healthiest vegetables, dark green leafy vegetables, even cruciferous dark green leafies, just because they're not interchangeable. Now, there is something to be said about dietary diversity. So I talk about, you know, the 50 food challenge, talking about trying to get 50 different plant foods every week, that's because fiber is a catch-all term, which involves literally thousands of different molecules of these indigestible carbohydrates made by plants that can feed our good bacteria, but different fibers feed different gut bugs. And so if you want to have this variety, this richness in your microbiome, then eating lots of different foods can help get you there. And interestingly, some of the fiber supplements like psyllium, metamucil, isn't fermented at all by our good gut bugs, right? So they don't, they can't eat psyllium, so it can kind of bulk up stools for regularity, but doesn't have any of the other fiber benefits we would expect. And so that's why I always better to eat whole foods, a variety of whole foods, but there certainly are some foods that are better than others, we should go out of our way to eat them.

Melanie Avalon:
Question about the dosage with these foods. I'm curious, so I know at one point in the book you talk about olive oil being added to a meal and how at a certain threshold it was beneficial for preventing, I don't remember, something like negative effect from, I think, oxidation or something. And if you had too much olive oil, it actually had a pro-inflammatory effect. And I realize that's olive oil. I'm super curious, though, with something like spices, which seem to have a really potent, concentrated mechanism for potential benefits in the body, are the health benefits of spices xenohormetic? Or do they involve hormesis, meaning if we have too much of a spice, could it actually be a problem? And I'm selfishly asking this question because I eat so much turmeric and ginger. I don't just sprinkle it on. I'll have like half a spice jar. I'll have like half of that in one meal. Whoa! I'm wondering if I'm actually undoing the benefits.

Dr. Michael Greger
No. So, I mean, these are not hermetic. I mean, there are some healthy foods like actually cruciferous vegetables. That's a hermetic response. Your body does not like broccoli and will increase its defenses when you eat it. Same thing with green tea. Green tea actually has a pro-oxidant effect so powerfully that your body ramps up its antioxidant defenses such that actually, overall, you have improved antioxidant status in your body because you drink green tea. So that is certainly true of some things, and that's why you don't want to take green tea. Extra supplements, which run liver toxicity because you can get levels, you can get too high levels, and you can actually overdo cruciferous vegetables, but that's an absolutely humongous dose. I'm trying to think if the spices know. In fact, some of the beneficial effects of curcumin supplementation are done at doses which are really way higher than culinary doses. You can never get that kind of curcumin just eating turmeric. There are certainly studies that use like 18 milligrams of curcumin, which is easy to do and spoonful of turmeric, but others use such high levels that you're really not going to be able to get that otherwise. The only concern about drinking... Well, they haven't met me. And they haven't met you. Although turmeric has some insoluble oxalates in it such that if you are at risk for producing urinary kidney stones, oxalate kidney stones, I would not be eating half a jar of turmeric just for that reason. So I have a video about that. I forget exactly how much.

Melanie Avalon:
Like you said, it's not like it's a hormetic thing where you could No, no, no.

Dr. Michael Greger
And in fact some people are taking absolutely huge doses, I'm talking about cancer trials where they're doing grams of curcumin a day, which would just be like cups of turmeric.

Melanie Avalon:
Okay. Well, I think I would be an interesting person. Like I'm an interesting case study because I eat, I eat very simply. I only eat whole foods and I eat a ton of, well, you're going to look half of it. I eat a ton of, it's all whole foods, but it's very simple. So I eat a ton of like cucumbers and like I said, like spices. I need a ton of fruit, but I also eat a ton of lean animal protein. And that works really well for me. And we so curious your thoughts on all this because one of your anti-aging eight is protein restriction. And I think, I think it's a topic I've been perplexed by and haunted by for a long time because I hear so much and learn so much about the role of protein and the benefits of protein. And then we also hear about how low protein is anti-aging and methionine restriction, you know, is a good thing. And, but then for me personally, I'm eating, I do fasting every day as well. So I feel like that kind of maybe counters the IGF-1 and mTOR effects. But yeah, so I eat a ton of lean protein and my LDL is like 49, which Oh, nice. Gorgeous. It's interesting that you can eat high animal products and have low LDL. That must be really lean. Yeah, I don't add any, I don't add any fat. And then I eat, well, sometimes I will have like salmon, which is fatty fish. But what's the question there? The question in there is what are your thoughts on animal protein when it comes to aging? Maybe we can start there.

Dr. Michael Greger
Yeah, well, when it comes to protein aging, less, maybe more, right, reducing protein intake, meaning restricting protein intake down to recommended levels, is the only thing I could find that could help block all levels of the aging pathway. So it boosts NAD, improves immunity, decreases oxidative stress, inflammation, and some resistance, as well as the cancer-promoting growth hormone IGF-1. Surprisingly, there is no benefit to adding extra protein to the diets of older men and women in terms of muscle mass, muscle strength, and muscle performance. Instead, what the excess protein that most Americans get causes a drop in the pro-longevity hormone called FGF-21, a drop in testosterone, a worsening of the age-accelerating hormone mTOR. So we really should strive to stick to the recommended level of 0.8 grams per healthy kilogram of body weight, which comes out to be about 45 grams a day for the average height woman, 55 grams a day for the average height man.

Melanie Avalon:
Are those studies looking at, are they epidemiological data for people on high protein diets? Are they controlled trials?

Dr. Michael Greger
Interventional trials, you can randomize people to higher lower protein and you can affect their FGF21, IGF, their mTOR, easy, right? And the single greatest life extension you can do in a laboratory animal setting is methionine restriction. Probably, I mean, that was, if there was one thing, if you could only choose one thing in terms of longevity intervention, it would be methionine restriction, restricting the intake of this particular amino acid which is found concentrated in animal proteins. One of the reasons why legumes are the centerpiece protein for every single, you know, blue zone ever documented.

Melanie Avalon:
What happens after age 65?

Dr. Michael Greger
Now, at age 65, we really should probably bump that up to 1.0 grams per kilogram, but of course sticking to plant-based sources to prevent excess IGF-1 activation.

Melanie Avalon:
Okay, what do you think is happening when when I like bring on experts and they are saying There's a lot of negatives to low protein and that we really need protein to support muscle as our main organ and our metabolism Like why do you think there are these different ideas about protein?

Dr. Michael Greger
Oh my God, well, there's this massive protein marketing industry. God, you walk into a store, they have protein fortified water. If you want to sell something, you slap high in protein on, I'm surprised Fruit Loops doesn't have a big protein, not with protein, whatever. It's just a way to sell stuff. I mean, so there's just like ton, you know, the protein, you know, supplement market is just absolutely huge. And so there's just this like social, I don't know. I mean, but if you look at the literature, it's the entire longevity literature is like you go to like the, you know, Luigi Ventana, Volta Longo, it's cutting down on protein to live longer. I mean, the peer reviewed medical literature is very clear, but peer reviewed medical literature often does not have much contact with kind of like the blogosphere or whatever is happening in the kind of, you know, in the crazy, crazy marketing world. But the literature is really, I mean, that's like the one thing you see in the longevity literature, it is protein restriction. That's how you make everything from fruit flies live longer, the rats to live longer is like, you know, more. In fact, the benefits of calorie restriction may be from protein restriction. The benefits of protein restriction may be actually coming from the methionine restriction. You can replicate many of the benefits of caloric restriction, restricting everything you die just by cutting down methionine. I mean, it's really, yeah, I mean, so probably the most powerful thing we can do is it would be methionine restriction, which is basically can be done either by eating less food period, or by even, you know, restricting your protein down to recommended levels, or switching even if you keep the same amount of protein, you just switch from animal protein sources to plant protein sources, you can reduce your methionine because legumes have relatively low methionine levels compared to animal products.

Melanie Avalon:
Like I said, I'm so haunted by this. And I had Dr. Valter Longo on the show. And I asked, I told him the same thing about my diet. And I wanted to know if he thought by fasting every day, because I do one meal a day, if it was evening out. Was I having the fast? And was that countering the whatever, my inflammatory potential, IGF-1, mTOR, all the things with high protein? And he said, we just don't know. Well, I mean, for you, you can just

Dr. Michael Greger
You want to know what your idea of one is? You just measure what your idea of one is.

Melanie Avalon:
That's only been on one blood test that I've done, I should do it, I should do it again.

Dr. Michael Greger
I mean, so look, I mean, I don't know what kind of meat you're eating, but I think most people at your diet, they'd have high LDL. So that would be bad for them, but not bad for you. Your LDL is beautiful, right? So you can find out. So just because on average something happens, and so you make population recommendations, don't eat this, eat this, but if you eat Twinkies and all of a sudden your numbers all get better, eat Twinkies.

Melanie Avalon:
If I add plant fats actually, so if I do like high coconut oil, which I realize has saturated fat, then my LDL does shoot up. Oh, absolutely.

Dr. Michael Greger
as it's as bad as lard, right? I mean, et cetera. I mean, yeah. So yeah, any tropical laws, palm oil, pomegranate oil,

Melanie Avalon:
do the same thing. So many things here. Well, speaking of like funding and everything, there's a lot of controversy around the olive oil industry that a lot of funding went into making olive oil like the thing. Do you have thoughts on that?

Dr. Michael Greger
Well, of course the olive oil industry wants olive oil to be the thing. Just like the watermelon industry wants watermelon to be the thing. This is the Watermelon Promotion Board. Just there's the Walnut Commission. I mean, it's no surprise, but it's like, well, but who has the power, right? I mean, if you compare the Watermelon Promotion Board budget to the, you know, the Egg Council or the National Cattlemen's Beef Association, right? Or the Dairyman. I mean, you know, you can get a sense of where you're getting the kind of, you know, the crazy misinformation from, and who has the budget to muddy the waters by, you know, designing studies to have kind of preordained outcomes. And you kind of, you know, put your kind of thumb on the scale. And it's because these foods are, you know, profitable. Things, the ultra-processed food industry actually created by the tobacco industry back in the 80s when Philip Morris owned Kraft General Mills, and they started producing. They started making these products. They just flooded the zone with Kool-Aid, and they created all this stuff using the same tobacco industry scientists. And, you know, they, and they are, I mean, if you look at the nutrition literature, you're out huge industry backlash trying to, you know, to dismiss this whole ultra-process thing. Thankfully, the scientific community is holding strong. It's really one of the most exciting things to see happen in the nutrition community. And, but I mean, it's just tremendous. I mean, you should see the editorials. And I mean, that's just in the medical literature. I can only imagine what's happening out in the real world with companies trying to somehow argue that these foods aren't bad for you.

Melanie Avalon:
I think one of the most frustrating things is things like Coca-Cola or companies where they focus on exercise instead. So they like make exercise seem, I mean exercise is great, but they kind of like, they're like, look over here. Like, you know, like, don't look at the problem with like our sugar sweetened beverages instead it's that you're not exercising, that's the problem.

Dr. Michael Greger
Right, yes, you cannot outrun a bad diet, right, just because, you know, it takes an hour to burn the calories that you would get consuming in five minutes from something like Coca-Cola. And so, but yeah, no, no, so they funded this whole global energy balance consortium that was all Coca-Cola funded because they wanted to, right, to shift the societal conversation away from, you know, the crappy foods to, oh, you just need more, you know, it's all about sedentary lifestyle. But, if you look at, you know, the global burden disease study, the largest study in history of risk factors for disease of death and disability, number one cause of death in these United States is the American diet, bumping tobacco smoking, number two, cigarettes only kill about half a million Americans every year, whereas diet kills many more, physical activity is like seven, killer number seven. It's bad, I mean, not, I mean, you know, but, you know, what we put in our mouths, most important

Melanie Avalon:
Do you think, especially right now with Ozimpic and GLP-1 agonists and everything, where people are actually losing weight, what do you think will be the long-term effects of that? And if people are losing weight on still not so good diets, does it even matter? So like if they're just doing calorie restriction and they're eating less, but they're still eating, you know, processed foods, can they maybe get most of the benefits or do they really need to be following a whole foods-based diet?

Dr. Michael Greger
Oh no, how would we answer that question? You know how we answer that question? Bariatric surgery, right? So what does bariatric surgery do? So let's say, you know, you cut out most of your stomach, 90% of your stomach, right? And then you're, I mean, and then what are you eating? You're eating the same crappy diet, but you're eating one tenth the same crappy diet, right? Okay, so what happens? What happens to your cancer rates? Dramatic drop. What happens to your lifespan? Dramatic increase. What happens to cardiovascular disease risk? Goes down. Why? Because excess body fat is such, is so devastating to one's health, shaving, you know, six, seven years off your lifespan. I don't care if these drugs, you know, literally shaved years off your lifespan could still, you know, come out positive in the end if indeed they actually cured obesity, which they don't actually do. But if they did, then there'd be a different story. You know, bariatric surgery has a fatality rate on the operating table by one in 1,250 people. Don't make it off the table. Even though they're such high mortality, just because it's, you know, there's a risky patient population, it's major surgery. Okay, but even with that, you still live longer. Those at the same way to do bariatric surgery versus those that don't, because of the devastating consequences of obesity. So that's why, you know, so, you know, yes, they talk about how, yeah, ozepic, these GLP1 agonists increase your risk of thyroid cancer, probably increase your risk of pancreatic cancer, blah, blah, blah. You don't want cancer? Well, then you don't want obesity. That's what you don't want. Obesity increases risk of 18 different kinds of cancer. So if you lost enough weight, you get all the thyroid, you know, pancreatic cancer you want, you still get less cancer overall, still be less likely to die from cancer. Now, this is all assuming these drugs work. And unfortunately, what you see is they work short term, but then they stall out. So all the studies have been done after a year weight loss stops. So they have four year studies, been done so far. You know, they lose the, they have this dramatic weight loss, which stalls after a year, and then literally they don't drop a pound. So they're injecting drugs every single week for the next three years, don't lose a pound. And these are forever drugs. Why? Because if you stop taking drugs, all of a sudden that weight you initially lost will come raging back. But in every single major study done today, people on average started out obese and they ended up obese when the drug stopped working. So you start out obese and you end up obese. Now you're still less obese, but you're still taking these drugs, spending, you know, $1,000 a month every day for the rest of your life, every day every week for the rest of your life just to maintain your obese status. Otherwise you'll get more obese. And some people don't understand that. And so you have no more benefit in terms of weight loss, but you do continue to experience the risk side effects for short term, mostly gastrointestinal, long term, have these issues with thyroid cancer and bowel obstruction and pancreatitis and kind of on the list.

Melanie Avalon:
I'm super curious in the studies if it would be any different if they would separate it out by people and their food choices, what they're eating during the weight loss and or I'm really curious about the effects of a high protein calorie restricted diet to maybe support muscle and not have the inflammatory effects of the protein because it's calorie restricted. I just wonder if that's an approach like a lot of people do like this PSM app approach proteins very modified fast where they're basically eating just lean protein. Yeah, I don't know if you have thoughts on that concept.

Dr. Michael Greger
conserving protein during weight loss, conserving your muscle mass during weight loss is not about how much protein you're eating. I mean, if you have excess protein, your body just turns it into carbs and fat. I mean, you have no way to store protein. And if your body doesn't just make muscles because it wants to make muscles, make muscles because it needs to make muscles, why, because you're doing strength training, because you're doing resistance training. That's how you make more muscles. And so that, I mean, so resistance exercise is the best way to prevent the loss of muscle mass during weight loss, which typically is about 25%, 25% of people on caloric restriction, 20%, you know, whatever every four pounds you lose on the scale is actually lean mass. But actually for these osemic drugs, it's 40%, 40%. And that's why part of the osemic face reaction is not just loss of fat from the face, you're actually losing muscle from the face. And so, so what do you do? You need to exercise. Are these people doing strength training when they're being prescribed these drugs? Unfortunately, they're not, typically.

Melanie Avalon:
Going back to some of the things that you touched on in the food discussion, I love – okay, here's a question I'm haunted by is nitrates, nitrites, nitrosamines. So it's fascinating we talk about it in the book because we hear about the health benefits of these from produce, but also the potential for them to turn into cancer-causing compounds. And is it possible that that happens when you combine it with animal products, meaning could having produce actually become a cancer-causing compound in the right setting?

Dr. Michael Greger
Yeah, yeah, isn't that ironic? So people who are like doping with beet juice for athletic performance, if they're then having a meat meal, I mean, that nitrate is going back up forming nitrite in their mouth. It's being screened in their salivary glands. And when that nitrite hits the amines and amides in their stomach, because you just had the turkey sandwich for lunch, then you can actually create these nitrosamines. So that's why it's really only safe to do this kind of nitrate, you know, ergogenic nitrate strategy if you're eating plant-based diet, because the, you know, the vitamin C and other plant-based nutrients actually prevent that from forming. They don't have the amides and amines that create this problem. So nitrites are not carcinogenic, right? The nitrites that are added to cure meat. But what happens to the nitrites combined with the amides and amines in animal protein and create these nitrosamines and nitrosamines. Now those are carcinogenic, and which is the reason why cured meat, processed meat, bacon, ham, hot dogs, lunch meat, sausage is a known human carcinogen causes cancer in people, colorectal cancer, which is the number one cancer killer among non-smokers. Now red meat, like beef and pork, is just a probable cancer, probably causes colorectal cancer in people, but processed meat is considered a known human carcinogen, a so-called group one carcinogen.

Melanie Avalon:
When meat has like celery, what is it, like celery seed extract as celery juice.

Dr. Michael Greger
Yeah, fermented celery juice. Oh, slimy.

Melanie Avalon:
Slimy. Is that still gonna be a problem?

Dr. Michael Greger
Yeah, even the meat industry understands that this is really misinforming people. So basically, okay, so people understand that, oh, nitrates are, added nitrates are bad for you. Okay, so you will see, but you will look, go to the store, you'll see uncured pork, uncured bacon, uncured ham, no nitrites added. And then there's always an asterisk. Look at the asterisk. What does the asterisk says? It says, except that provided in fermented celery juice, or that added in seasoning or something. Okay, so what's in celery? Nitrates, right, vegetable nitrates. What, with that fermentation process, there are bacteria that fix the nitrogen and turn the nitrates into nitrites. So basically, they are adding what? Nitrites, but they just don't have to use the word, technically, so they can say no nitrites added, which is not true, because that's what's in fermented celery juice. I mean, it's outrageous, and so it would be expected to have the same effect, the same carcinogenic effect. And so it's just slimy. But what do you expect from an industry that's making a carcinogenic product? You expect them to be like, oh, we all of a sudden care about people's health. Outrageous, it's just a marketing point.

Melanie Avalon:
And so to double clarify, because you talked about this, but to really clarify. So if I have a animal based meal that is going to problematically create these nitrosamines, does that mean adding like eating celery with it actually creates a problem or you said, are there protective compounds that prevent that from happening?

Dr. Michael Greger
So it's between the nitrites and the animal-based meal. In the celery are nitrates. There are bacteria on your tongue that turn nitrates into nitrates. But when you just eat celery, very few of those nitrates are turned into nitrates. But what happens is your body then absorbs the nitrates and concentrates. It's in your salivary glands and then spews the nitrates onto your tongue because it knows that there are bacteria on there. They're going to turn into nitrites. And that is actually how you get this nitrogen oxide effect, which is the nitric oxide effect, which has this performance-enhancing benefits, not only increases blood flow, but actually improves your ability, your mitochondria, to extract energy from oxygen, get more energy from each breath, thanks to the nitric oxide, which comes from the nitrates, which comes from the nitrates originally from vegetables. Okay. That takes a few hours, right? So you eat your spinach salad or your beets or your beet juice, I think it was like an hour and a half before your 5K. Okay. And so that's time for the body to take it, absorb it, dump it in your salivary glands and let your bacteria do its magic. So it's not having the celery, so it's having the celery and then eating meat an hour and a half after the celery, not with the celery, but an hour and a half after it. That would be the problem.

Melanie Avalon:
So if you have them at the same time, does the timeline just not line up for that to happen?

Dr. Michael Greger
Yep, doesn't line up. So you're just mixing nitrates with amides and amines and nothing happens.

Melanie Avalon:
Oh, that's so interesting. Okay, that's complicated. Okay, and then what about you mentioned spermidine? I was really okay because spermidine I feel like is one of those supplements I kept hearing about about for quite a long time like oh, it's like this Anti-aging longevity wonder of a something and I was a little incredulous about it in your book You talked about this study where they looked at all these different foods and like the one thing that was the thing was spermidine I know I didn't say much information there out of all no

Dr. Michael Greger
Out of all food components, the one thing about one's diet, most associated with longevity over time with spermidine, beat out everything else. In fact, we talked about methanol restriction in terms of the most powerful intervention to expand lifespan, but in terms of what you can add, what's the greatest longevity ever for any molecule on kind of a safe list, there's some things that you don't want to take. But in terms of the database of all longevity associated compounds, and in the small subset with fewer side effects, spermidine has the longest life expectancy extension ever for any molecule. Amazing! That's why we got to eat wheat germ, but it's amazing that you knew about it. I had never even heard of spermidine. You're obviously kind of steeped in the longevity area, but before I sat down to write Hahnatej, I had never even heard of it. But oh my God, what? All of a sudden, I'm eating wheat germ. I never ate wheat germ before. I'm eating a lot more tempeh than I was before because it's so critically important to shoot for that 20 milligrams of spermidine today.

Melanie Avalon:
Yeah, honestly, your book made me take it more seriously. I was like, oh, I need to think about this. Although, wait, wasn't there also a story about the naked mole rat that related to spermidine? Am I?

Dr. Michael Greger
Oh yeah, that may be one of the reasons why naked roll rats have such extraordinary longevity is because they don't see the decline in spermating that you see in all other species.

Melanie Avalon:
So taking it as a supplement though versus getting it from your food, is there a big difference there?

Dr. Michael Greger
Well, see, but it's funny when you look at the supplements, it's just wheat germ in a capsule, right? When it says spermidine, it'd be actually looked at the list of ingredients. They're just putting wheat germ in a capsule and they're charging you like, you know, a 10,000% markup or something. It's literally just wheat, you're such as wheat germ. I mean, it's funny. I was so funny that I couldn't actually find the actual spermidine because there's no point. It's so concentrated. I mean, wheat germ, they're just like, well, just put wheat germ in a bill. All right, fine. If people want to take capsules of wheat germ, they're just, you know, wasting a lot of money.

Melanie Avalon:
I'm actually surprised there's not a spermating diet book yet that has people eat high spermating foods.

Dr. Michael Greger
I tell you, they just got to change the name or something. It was any other name. We got a branding problem. It's got a branding problem. But if it was any other name, it would absolutely be the huge thing, right? But it's just like no one wants to talk about it.

Melanie Avalon:
Isn't it called that though, wasn't it found in sperm originally?

Dr. Michael Greger
Yeah, so it was first discovered in spurts actually by Lee one up the guy invented the first microphone and not microphone, the first microscope, then the first microscope and all of a sudden could see things and no one else could see his first one to see sperm first one to see cells. And so he had all these slides of sperm, the semen sitting around us, you know, in his office as one does. And he found these crystals started to form. I evidently didn't have you know, he wasn't good about, you know, clean it up. And he's like, wow, what are these weird crystals? And that it was it was fermidin. And so only later, they would realize that fermidin is found throughout the body. In fact, it was later independently discovered as a compound, they called it nerding, because they found in nerves, and then they called another compound they found said, Oh, let's call this muscle mean a new, a new fancy compound found in muscles. Then only later do they realize, Oh, musculomean, that's just fermidin, nerdy, it's just fermidin. So, so the naming rights defaulted to the less palatable original, but it's actually found throughout the body was just discovered there. If they first discovered it in nerves, it would have called nerdy. And then when they then discovered it in semen, they'd be like, Oh, that's just nerdy and semen. But unfortunately, yeah, it all started that way.

Melanie Avalon:
Wow, okay, so it's not necessarily more concentrated in sperm than other places.

Dr. Michael Greger
Well, I mean, well, because spermidine is so important as a DNA protector, all your DNA in your body needs protection. But guess what needs extra protection is obviously your gamates, in terms of passing on your genes. So no, it's highly concentrated. Cosmo likes to run columns about how concentrated it is. But that's on like a per-calorie basis or something. But yeah, there's not as much as Cosmo would like you to believe.

Melanie Avalon:
similar concept where we're finding these, you know, really interesting molecules in the body that are doing things that we didn't realize. So we mentioned it earlier, microRNA. What is going on here?

Dr. Michael Greger
Oh my God, how cool is that? In fact, guess what? Two weeks ago, just won the Nobel Prize in Medicine. MicroRNAs. Wait, really? Yeah. This year, the 2024 Nobel Prize in Medicine went to the people that discovered microRNAs. And so it's like, I called it. I called it. This is a moment. Yeah, no, no. Very cool. Yeah, yeah. So microRNAs, I mean, so this is one of the areas that I had never heard of because it wasn't even discovered by the time I graduated medical school. So I like completed my training before the world even knew about it. Then they discovered it, and the discoverers just got the Nobel Prize. So I learned as much writing these books as many people do reading these books, just because, look, this is all new to me. It's not like I was taught about this in medical school. But anyway, so microRNAs represent a cross-kingdom communication pathway between animals and plants and us that we can use to our advantage and explains just some of the effects that different foods have on us that we normally had ascribed to all sorts of other things. But it's like, oh my god, no. These are modulators of gene expression that can be transmissible through food and a way that we communicate with bacteria and vice versa. We communicate with plants we eat and vice versa or the animals we eat. Really kind of extraordinary. So the reason that we have benefits from eating broccoli may not just be because I like the good stuff of broccoli. I like to find a nutrients for furfane. But because there are, these molecules actually affect the way our DNA is expressed. The reason it's so monumental is actually the challenge is the central dogma of biology, which is that DNA leads to, you know, Mr. RNA meets the protein, kind of one gene, one protein. That's just how it works. And 90% of the DNA was just junk because it didn't do anything. It was just like some kind of viral leftover or something, kind of the dark matter of the genome. Till we realized, huh, it's actually not. It's actually doing stuff. It's making these microRNAs, which then go and, you know, affect the transcription and function and production of proteins throughout the body. It's this incredible level, extra added level of complexity. And we can use it to our advantage through diet and actually explain some, the benefits of herbal medicines and all sorts of things. Absolutely amazing. I was just, it was one of my favorite things about that I learned in How Not to Age. And it's still such kind of early stages in terms of our understanding.

Melanie Avalon:
And so what is the difference between the micro-RNAs and plants versus animals? And when we take them in, do they reach our bloodstream? And also, does our body treat our micro-RNA differently if it's endogenous versus exogenous?

Dr. Michael Greger
Well, that's the thing. So, when we're talking about microRNA, they are micro, right? The first microRNA, 22 letters long, right? In the four-letter RNA alphabet, right? These are absolutely tiny, basic molecules. So, I mean, it takes like a stretch of, like to make a protein, it takes a stretch of DNA thousands of letters long, just to kind of give you a sense, right? So, thousands of letters long. Okay, but microRNAs, like only about 20 letters long. And so, there aren't that many ways to make microRNAs. And so, like there's, you can have a broccoli microRNA, which is literally the exact same sequence, the same word, right, in the alphabet. And so, your body cannot distinguish between a broccoli mRNA or a pig mRNA, and the one that's doing things within our body. And it's just because they're so basic. And the reason that it's exciting from research point of view, because we can make them from scratch. We can be like, oh, you know, we want to know if the broccoli microRNA is actually doing this thing. Well, we can literally make it from scratch chemically, create the microRNA, no broccoli associated with it ever, and give that to people and see if we can replicate the effects, just like we can replicate some of the damaging effects of bad, you know, microRNAs found, you know, like some of the bovine microRNAs in dairy. And so, it's just, it's not specific to aging. But microRNAs, we now regulate, are known as a major regulator of all cellular pathways. And so, it just makes sense because it's just something that is just the way our body works. But I talk about how, you know, the very first microRNA discovered was in C. elegans, this little round worm. And what did it do? Regulate lifespan. Very first microRNA, you know, you add a little extra, extends your life, cuts it down, and shortens your life. And it turns out the target of that microRNA was this, it's called DAF16, which is basically the worm equivalent of FOXO, which is, can confer like immortality to certain primitive animals. One of the most important genetic determinants of extreme longevity in humans. And so, basically, by blocking the repression of this longevity gene, the microRNA had this life-extending effect. So, from the very first discovery of microRNAs, it's all about lifespan and aging. And now, we just know it does so much other stuff.

Melanie Avalon:
It's so fascinating. You talk about how it could be a way that different parts of the body, you know, communicate with other parts of the body and I'd be really curious if they studied like the longest lived animals. Like I wonder if like jellyfish or going back to that naked mole rat. I wonder if there's stuff to learn from microRNA in them. What if we eat a jellyfish?

Dr. Michael Greger
It's difficult to study. I just got over saying how easy it is to study. But the problem is that there's such simple molecules that contamination is a real issue. Since everything, every living thing makes microRNAs, so every single bug, every single bacteria, every single food that comes in a lab, basically, is microRNAs, it's just contamination everywhere. It's like when they tried to start doing studies on lead. The reason it was so hard to nail down the lead contamination as a concern for brain damage is because the lead is everywhere. It's the lead is in everything. So it's very difficult to make a low lead control group just because it was so kind of... And so that's why... And so there's a lot of kind of spurious results that have been retracted from the literature where we thought microRNAs did something, but no, someone had just brought in a salad and just contaminated the bench. I mean, yeah, it's crazy stuff. So yeah, still kind of early stages, lots of cool controversy, but a lot of cool interventional studies where they're like, oh, this herb does this. Oh, this herb has lots of microRNAs. Let's just give the microRNAs and poof, you can actually replicate the herb's effects just with this little microRNA. So the way the herb was working was not because it had some cool final chemical or something. No, it was working by actually changing the way we express our genes through this communication pathway. Absolutely, so cool.

Melanie Avalon:
For the Nobel Prize, in what aspect just their work with microRNA?

Dr. Michael Greger
Just the discovery, their discovery. It was such a monumental thing to discover this whole field. Now, it still took them a while to actually get the Nobel, but you had to make sure that it really was a thing and that it was so important as we thought it was. But as the research developed to a point, they're like, oh my God, these people deserve a Nobel Prize and they just got it.

Melanie Avalon:
It's so, so interesting. Okay, a question that I started at the beginning and I don't think we answered yet, and it's coming back to the fertility. Women in fertility and having kids. I'm so fascinated by this because I don't personally think I'm ever going to have kids, and I'm wondering if that hurts or hinders my longevity potential.

Dr. Michael Greger
Oh yeah, wasn't that an interesting, interesting discussion in the book and it was kind of weird and counterintuitive if I remember. People that

Melanie Avalon:
I think it was I think it was that women who have children later live longer, but the kids don't live as long

Dr. Michael Greger
There's all the sorts of combat, so there was having more kids and less kids, and then having kids earlier and then later, and it did opposite things of the benefits of the kids versus the parents. I remember having to tease that out, and I forget how I would have to reread that section. But yeah, it was a really interesting thing, and then it was like, well, is it just the genetic ability to have lots of kids that's helping, or is it actually having the kids that does something good? Yeah, I forget that all, but it was fascinating.

Melanie Avalon:
However, women having children tend to live longer, but their kids don't live as long. I hear all different things because I ask that question a lot to people because I'm so interested by it and people seem to have different opinions. But also another fertility question. What are your thoughts on the potential reduced fertility rates in societies like Loma Linda?

Dr. Michael Greger
Oh, yeah, fast. Okay. Oh, so I found the found the section talking about so you have a portion of women having the first age after age 35 has increased tenfold, right? So having kids later. So women are having kids later in general, and that induces a longevity penalty on their children, as those born to older mothers don't tend to live as long. But women having children later tend to live longer themselves. For example, female centenarians four times more likely have children after age 40, those than women who died in their 70s. Now, that doesn't necessarily mean that delaying kids will make you live longer. Because for example, smoking is a co founder. However, then there's suggestion that, you know, some biological changes in pregnancy may actually have a rejuvenating effect, kind of like a parabiosis mechanism, like bathing the blood of babies, but none that can't count as battery sort of way. And so it turns out, so sift through the possibilities, researchers study the longevity of brothers of women who gave birth after age 45. And that of their wives, right? So the brothers with late fertile sisters lived longers, but their wives did not. So this suggests the genetic robustness cause rather than a rejuvenation effect. But the fact that the longevity benefit didn't extend the lives suggests it's not just like a co founder, like socioeconomic status or something. So it's just that women who have kids later are just have the genes that allow them to do that, which also allow them to live longer. And so there's no reason to delay kids.

Melanie Avalon:
basically, because they have the ability to have the kids later genetically, there's something there that's

Dr. Michael Greger
just, yeah, they're just more genetically robust that also happens to help longevity. So there's nothing we can do in terms of interventional, in terms of a modifiable risk factor.

Melanie Avalon:
I would just think because, and this is just me thinking about it sort of casually, but because the purpose of the female is seemingly to have children. I just wonder if not having children, then your body's like, you know, waiting still to have children. So maybe it's up regulating some anti-aging pathways. I don't know. That's what I tell myself, but yeah, it's really interesting. So what about the fertility with Loma Linda? And thank you for looking that up.

Dr. Michael Greger
Yeah, so there was a semen analysis at Loma Linda, right, so it was the only surviving blue zone on planet Earth, that raised a question about sperm quality. And so, for example, so the vegetarians had about 25% lower sperm count, still within normal range, but lower. And same thing with the vegans, though wasn't significantly so, but there's just fewer vegans in the study. But so overall suggests decreased fertility. And so, yes, it could just be a flu, blah, blah, blah. But I mean, they could actually make sense because there's just this evolutionary trade off between fertility and lifespan. God, we've known for over a century, right? So you could take a finely tuned laser and like destroy the gonads of, you know, roundworms, and they extend lifespan when they're not, you know, reproducing. The same thing with fruit flies, right? There's this priority between reproduction to survival, right? Once you're not reproducing anymore, you can take more of your resources and put it into survival. And boy, do we see that with spaying and neutering our pets. I mean, so sterilized dogs live about 20% longer than intact dogs, spayed female cats, 40% longer, neutered male cats, 60% longer. Your cat will live 60% longer neutered than unneutered. Talk about just a huge lifespan increase. And so it's like, well, wait a second. What about, what about eunuchs? And indeed, eunuchs seem to live about 25% longer than non-crast-rated men. In fact, we used to sterilize the so-called feeble-minded back in the 1950s, something that was actually proved by the Supreme Court as part of this kind of eugenics thing at the time, which Germans stole from us. And so we actually have these kind of natural experiments where these mental institutions where castrated men lived on average 14 years longer than men with their testicles intact in the same hospital. So again, this kind of, there appears to be this kind of reproduction survival trade-off. And for kind of in women, the later girls start their periods, the longer they tend to live. Each year later, associated with lower risk of dying from heart disease, cancer stroke. So the lowest mortality, really, if you don't start menstruating until like 15, that's really where the lowest is. Same thing with breast development, earlier breast development, increased breast cancer risk later in life. And you know, lower risk of cancer is kind of across the board. So a century ago, menarche, first menstruation was like 17. Now the average age is less than 12. Age of breast development dropped three months per decade over the last half century. Now we're down like nine or 10 years old. We have to keep changing the textbook definition of so-called premature puberty because all of a sudden it's like normal. And this may have to do with IGF-1, you know, because it depends how much meat you eat in terms of when you begin menstruating, but this could have something to do with some of the persistent pollutants and things. But yeah, it's just an absolute fascinating field. We, I do not recommend self-ecastration for, I feel like, you know, Brian Johnson is one scalpel away from his next experiment, but I really think we need more data before taking such drastic measures.

Melanie Avalon:
actually really relates to what we were talking about with the women. On the one hand, that might be in favor of not having children. Maybe. Just if there's this inverse correlation between fertility and aging.

Dr. Michael Greger
But you can be fertile and not use that for that.

Melanie Avalon:
Right. So what, so how does that line up? So how does infertility relate to longevity and how does fertile, but not?

Dr. Michael Greger
So, what would be interesting is if women undergoing early hysterectomies lived longer. That, I'm surprised we don't, like not just hysterectomies taking out the uterus, but typically when they take out the uterus, often they take out the ovaries if the woman doesn't want to get pregnant. And so it would be interesting if they lived longer. I'm surprised that those studies haven't been done, or at least I didn't run across them. I'm surprised,

Melanie Avalon:
but the infertility does correlate to longevity.

Dr. Michael Greger
Well, it depends on the cause. Right. So there's this presumption that the same kind of things that there's this seesaw effect, that things that are good for our longevity may be bad for our fertility and things that are good for our fertility are bad for our longevity, these kind of pleiotropic effects, where genes that get us to, that speed us towards puberty to increase our fertility may not be good. And so later on in life, but evolution doesn't care about later in life. It just wants us to pass along those genes. And so what may be good earlier on may be bad later. We see that with all sorts of things, from Alzheimer's risk to the mTOR thing. Yeah, so I mean, it's possible. So like, you know, caloric restriction is not good for reproduction, right? Kills your libido. Like the famous Minnesota starvation studies, they cut their calorie intake in half, completely lost their libidos. But, you know, that was severe calorie restriction in the context of nutrient insufficiency, which is not the way to do it.

Melanie Avalon:
Yeah, because it wasn't that calorie restricted, right? It was like cut in half, 50%. That's some severe calorie restriction. I guess when I think severe, I think people doing like 500 calorie diets, but I think it was like 1,300 or something.

Dr. Michael Greger
Right. So you can do a 500 calorie diet for a few weeks, but these people were looking like concentration camp victims because they were on this constant calorie restriction for months.

Melanie Avalon:
Okay, that's so interesting about the fertility. What about the slowed metabolism? Is that another one where it's kind of like a seesaw? Like we hear all the benefits. Right, right.

Dr. Michael Greger
So, you think about things that you always talk here about boosting metabolism. This is great because it boosts metabolism, right? Because you want to burn calories quicker, right? But the candle that burns twice as fast burns half as long. So, basically, what we want to do is actually slow down our resting metabolic rate in terms of longevity. And we can do that through, I don't even know if we're sure we can do that through a bunch of other ways. Plants. Plants, yeah, yeah. We do that through, you know, lots of nitrates and things. But would it make you, you know, more likely? So, you eat a lot of greens and all of a sudden your resting metabolic rate goes down? Does that mean you're going to gain weight easier? We're eating a lot of greens, probably not, right? But if you eat a lot of greens and Twinkies, you will gain more weight than if you just eat a lot of Twinkies.

Melanie Avalon:
Another, so I think your last anti-aging one on the anti-aging eight, I have to applaud you, because you mentioned earlier about how I'd heard of spermidine, you know, prior to this. So a big thing in the biohacking world is NAD and the debates about NR versus NMN. And I personally have been doing, I was doing NAD injections for a while. Now I do patches. Your overview of NAD in your book is the deepest dive I have experienced. I was really impressed. So I'm super curious where you land personally in the NAD debate and do you supplement NR or NMN or get, do I V NAD or what do you think about NAD?

Dr. Michael Greger
Yeah, that was a big question going in, and boy did it. It wasn't a mess. I mean, it's just huge, right? It's just this alphabet soup, right? There's N-A-N-A-M, N-N-N-R, N-A-D-N-A-D-A, just dropped a fan, blah, blah, blah, on the list. So basically, in short, so I go through the pros and cons of each one. All the, what, eights, precursors.

Melanie Avalon:
Wow, you had more than I even realized. I was like, whoa, who knew?

Dr. Michael Greger
Well, I mean, yeah, I mean, some just fail, you know, I mean, for all for kind of obvious reasons, or cause nasty side effects, blah, blah, blah. And don't make anybody money, right? You know, some something like niacin just absolutely dirt cheap. So you're never going to see an ad for it, or, you know, but so but the two ones you can't make money off of that you hear a lot about in our MMM in short, and our has been demonstrated be relatively safe, but not effective. And neither safety nor efficacy been established for MMM. In fact, blindly overloading the system with nad precursors may not be the best way to restore ad level since the body seems way too or at least the human body seems way too smart to allow such a kind of blunt incursion to affect tissue levels. So these supplements really just kind of a profit making distraction from more natural approaches. And I talk about look, there are ways I mean, so the nad, we really do want to boost nad levels in our tissues. The problem is there has never been a single study in normal human beings that don't have some weird muscular genetic muscular distance. There's never been a single study ever showing any nad precursor nad boosting supplement increasing tissue levels, you can increase blood levels. But increasing tissue levels happens in mice and rats, and they have these miraculous benefits showing if we actually could increase any levels in our tissues, it would have all these miraculous, but we don't have the miraculous benefits and our tissue levels don't go up, which makes sense. Okay, but there are actually ways we can increase nad in our tissues. And it's called exercise, right? So that's one way. So we boost nampt, which is the enzyme that actually makes nad. How do we do that? We do that through exercise. And then the two ways, the other two ways are to decrease excess nad degradation by suppressing the two mean nad consuming enzymes, parp1 and cd38, which are involved in reducing oxidation and information respectively. And so we just by reducing the amount of oxidative stress in our body, eating lots of antioxidant rich foods, and reducing production free radicals by you know, not standing in traffic and all there's all sorts of ways we can reduce our exposure to free radical generation, and eating anti an anti inflammatory diet decreases the need of these pro inflammatory enzyme and the DNA repairing enzyme to do their thing because there's less DNA damage. And so, but it's like, well, that's not very sexy exercise, you know, how are we going to make money selling exercise? This is bullshit. Yeah, it's just, you know, the, I think the failure really should be expected given the complexity of nad physiology. I mean, it's just so many multiple precursive production pathways, recycling routes, consuming enzymes, it's just, you know, it's just, I mean, maybe we'll come up with some way to do it eventually. But until then, we have exercise, reducing oxidation information.

Melanie Avalon:
Have you done an IV or anything? I have not done, no. Yeah, that doesn't feel good doing it. Oh really? Oh yeah, so yeah, the actual experience is like not fun.

Dr. Michael Greger
Is it, what do you experience?

Melanie Avalon:
So, I've done the shots and they make me feel like tight-chested and just really unwell for a little bit. So, what are they in general?

Dr. Michael Greger
you with, literally, like NAD, because NAD isn't really a stable molecule.

Melanie Avalon:
Yes, so the way you can get direct nad is through i am injections or the ivy and the drip i never did a drip because it's really expensive and i was like i don't pay that much money to feel really unwell for hours because it can take people hours to do it because. Because they have to do it so slow but it's kind of like if it's making you feel that way i don't know that that's a good thing you know maybe your body is a little bit intuitive.

Dr. Michael Greger
But then no, but that's what these studies show, is that your body's into it. Your body's not stupid. Your body sees all these end-to-end precursors like, screw this, right? And it just, unfortunately, some of the ways that it shunts them off, you know, leads to methyl depletion and all these other things, right? There's actually negative side effects of the byproducts from these excess precursors that your body has to get rid of. And that's been never exposed to in the past at those kind of levels. So you get the sirtuin suppression, methyl depletion. And so, yeah, I mean, so it's not just like, oh, yeah, maybe the research isn't in yet, but like, what's the harm? What do you mean, what's the harm? There's real potential. So I talk about the downsides of using this includes, you know, certain inflammatory conditions and infections, certain cancers. And so it's just, it's not worth it till we know more.

Melanie Avalon:
I will say I do love the patches, which are just straight NAD, and it's through the skin, and I've only experienced benefits from that. I don't get any of the negative feelings, and it's not the precursors, it's just the actual NAD.

Dr. Michael Greger
and NAD gets in the skin. I mean, it's a charged molecule. How's it going?

Melanie Avalon:
getting through the skin. Mm-hmm. You mix it yourself. It uses those ionopatches, I think, where it's, you're like, mix the saline, and then you mix the NAD, and then it's like on these two different charges, and you patch it to your skin. Wow.

Dr. Michael Greger
Wow. So, someone needs to make you some placebo patches and see if you can tell the difference. I love to do that. Well, no, there's a great, and it's one experiment because, yeah, I'm skeptical. But look, if you could, if you actually, you know, if you could get someone to make you some patches and you could tell them which is which, that would be juicy.

Melanie Avalon:
That's a good idea. I'm actually gonna reach out to them and see if they'll do that for me. That'd be amazing.

Dr. Michael Greger
Well, but then they just be proving them. Well, if they're really confident in their product, they should give it to you. And if they're not,

Melanie Avalon:
They're going to refuse. I'm literally going to email them after this, be like.

Dr. Michael Greger
Oh my God, they should write, I mean, they should be like, oh my God, our stuff is so awesome. Of course you're going to be able to see them.

Melanie Avalon:
difference. Right? Yeah. I'm not kidding. I'm going to reach out to them and see what they say. Well, this has been so fabulous. You're incredible. I cannot thank you enough for all the work that you're doing. I asked you this last time. Are you writing a new book now? I.

Dr. Michael Greger
I absolutely am, so How Not to Hurt is my next major book on lifestyle approaches to pain management. And I just wrote a book on ozimpic, which will be out by the end of the month, about an audiobook, soft cover, and e-book. By the end of the month, I'm doing a three-hour webinar on the subject next month with a lot of interesting nuance about these GLP-1 agonists.

Melanie Avalon:
Yeah, what's the book called, the Ozumpik book?

Dr. Michael Greger
It is called Osympics, I forget the subtitle. It's called Osympics, it's like pros, cons, and natural alternative, something like that. Awesome.

Melanie Avalon:
Well, thank you so much, Dr. Greger. I appreciate you so much. The last question I ask every single guest on this show, and it's because I'm so passionate about mindset. So what is something that you're grateful for?

Dr. Michael Greger
Oh my God, I'm grateful to do work that I love, that I feel that I'm good at, and that actually makes a difference in the world. Like that's the Venn diagram, right? I mean, you can imagine someone who's like an amazing pianist and they love playing piano, but it's like, okay, what are you actually doing for the world? I mean, that's cool. That's two out of three. That's awesome, right? It's better than being a really good piano player that hates playing piano, right? But if you could find something in life where you actually are good, you feel like you're better than most at it, and it actually brings you joy. And as the benefit actually reduces suffering in the world, oh my God, that's where you have to dedicate your life to. And I'm just so lucky that I just ended up being able to do that all day, every day, and so I couldn't be more thankful.

Melanie Avalon:
I love it so much. You are the best. Thank you so much. Hopefully you can come back again in the future for that pain book. That'd be really amazing.

Dr. Michael Greger
That'll be fun. Yeah, I'm really looking forward to writing it and seeing what's what's out there to help people

Melanie Avalon:
Yay, well have a good rest of your day. I appreciate everything you're doing so much. Thank you. Thanks so much. Keep up the good work. Thank you. Bye. Bye-bye.