Dr. Greger’s Anti-Aging Eight
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Dr. Greger’s Anti-Aging Eight
This is Dr. Michael Greger. We’ve featured him before: Brain Food? The Eyes Have It!
This time, we’re working from his latest book, the excellent “How Not To Age”, which we reviewed all so recently. It is very information-dense, but we’re going to be focussing on one part, his “anti-aging eight”, that is to say, eight interventions he rates the most highly to slow aging in general (other parts of the book pertained to slowing eleven specific pathways of aging, or preserving specific bodily functions against aging, for example).
Without further ado, his “anti-aging eight” are…
- Nuts
- Greens
- Berries
- Xenohormesis & microRNA manipulation
- Prebiotics & postbiotics
- Caloric restriction / IF
- Protein restriction
- NAD+
As you may have noticed, some of these are things might appear already on your grocery shopping list; others don’t seem so “household”. Let’s break them down:
Nuts, greens, berries
These are amongst the most nutrient-dense and phytochemical-useful parts of the diet that Dr. Greger advocates for in his already-famous “Dr. Greger’s Daily Dozen”.
For brevity, we’ll not go into the science of these here, but will advise you: eat a daily portion of nuts, a daily portion of berries, and a couple of daily portions of greens.
Xenohormesis & microRNA manipulation
You might, actually, have these on your grocery shopping list too!
Hormesis, you may recall from previous editions of 10almonds, is about engaging in a small amount of eustress to trigger the body’s self-strengthening response, for example:
Xenohormesis is about getting similar benefits, second-hand.
For example, plants that have been grown to “organic” standards (i.e. without artificial pesticides, herbicides, fertilizers) have had to adapt to their relatively harsher environment by upping their levels of protective polyphenols and other phytochemicals that, as it turns out, are as beneficial to us as they are to the plants:
Hormetic Effects of Phytochemicals on Health and Longevity
Additionally, the flip side of xenohormesis is that some plant compounds can themselves act as a source of hormetic stress that end up bolstering us. For example:
In essence, it’s not just that it has anti-oxidant effect; it also provides a tiny oxidative-stress immunization against serious sources of oxidative stress—and thus, aging.
MicroRNA manipulation is, alas, too complex to truly summarize an entire chapter in a line or two, but it has to do with genetic information from the food that we eat having a beneficial or deleterious effect to our own health:
Diet-derived microRNAs: unicorn or silver bullet?
A couple of quick takeaways (out of very many) from Dr. Greger’s chapter on this is to spring for the better quality olive oil, and skip the cow’s milk:
- Impact of Phenol-Enriched Virgin Olive Oils on the Postprandial Levels of Circulating microRNAs Related to Cardiovascular Disease
- MicroRNA exosomes of pasteurized milk: potential pathogens of Western diseases
Prebiotics & Postbiotics
We’re short on space, so we’ll link you to a previous article, and tell you that it’s important against aging too:
Making Friends With Your Gut (You Can Thank Us Later)
An example of how one of Dr. Greger’s most-recommended postbiotics helps against aging, by the way:
- The mitophagy activator urolithin A is safe and induces a molecular signature of improved mitochondrial and cellular health in humans
- Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health in a randomized trial in middle-aged adults
(Urolithin can be found in many plants, and especially those containing tannins)
See also: How to Make Urolithin Postbiotics from Tannins
Caloric restriction / Intermittent fasting
This is about lowering metabolic load and promoting cellular apoptosis (programmed cell death; sounds bad; is good) and autophagy (self-consumption; again, sounds bad; is good).
For example, he cites the intermittent fasters’ 46% lower risk of dying in the subsequent years of follow-up in this longitudinal study:
For brevity we’ll link to our previous IF article, but we’ll revisit caloric restriction in a main feature on of these days:
Fasting Without Crashing? We sort the science from the hype!
Dr. Greger favours caloric restriction over intermittent fasting, arguing that it is easier to adhere to and harder to get wrong if one has some confounding factor (e.g. diabetes, or a medication that requires food at certain times, etc). If adhered to healthily, the benefits appear to be comparable for each, though.
Protein restriction
In contrast to our recent main feature Protein vs Sarcopenia, in which that week’s featured expert argued for high protein consumption levels, protein restriction can, on the other hand, have anti-aging effects. A reminder that our body is a complex organism, and sometimes what’s good for one thing is bad for another!
Dr. Greger offers protein restriction as a way to get many of the benefits of caloric restriction, without caloric restriction. He further notes that caloric restriction without protein restriction doesn’t decrease IGF-1 levels (a marker of aging).
However, for FGF21 levels (these are good and we want them higher to stay younger), what matters more than lowering proteins in general is lowering levels of the amino acid methionine—found mostly in animal products, not plants—so the source of the protein matters:
For example, legumes deliver only 5–10% of the methionine that meat does, for the same amount of protein, so that’s a factor to bear in mind.
NAD+
This is about nicotinamide adenine dinucleotide, or NAD+ to its friends.
NAD+ levels decline with age, and that decline is a causal factor in aging, and boosting the levels can slow aging:
Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
Can we get NAD+ from food? We can, but not in useful quantities or with sufficient bioavailability.
Supplements, then? Dr. Greger finds the evidence for their usefulness lacking, in interventional trials.
How to boost NAD+, then? Dr. Greger prescribes…
Exercise! It boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:
Skeletal muscle NAMPT is induced by exercise in humans
Another study on resistance training found the same 127% boost:
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The Alzheimer’s Gene That Varies By Race & Sex
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The Alzheimer’s Gene That Varies By Race & Sex
You probably know that there are important genetic factors that increase or decrease Alzheimer’s Risk. If you’d like a quick refresher before we carry on, here are two previous articles on this topic:
- Genetic Testing: Health Benefits & Methods (about personal genomics and health, including Alzheimer’s)
- The Surprising Link Between Type 2 Diabetes & Alzheimer’s (about the APOE-ε4 allele that is implicated in both)
A Tale of Two Alleles
It has generally been understood that APOE-ε2 lowers Alzheimer’s disease risk, and APOE-ε4 increases it.
However, for reasons beyond the scope of this article, research populations for genetic testing are overwhelmingly white. If you, dear reader, are white, you may be thinking “well, I’m white, so this isn’t a problem for me”, you might still want to read on…
An extensive new study, published days ago, by Dr. Belloy et al., looked at how these correlations held out per race and sex. They found:
- The “APOE-ε2 lowers; APOE-ε4 increases” dictum held out strongest for white people.
- In the case of Hispanic people, there was only a small correlation on the APOE-ε4 side of things, and none on the APOE-ε2 side of things per se.
- East Asians also saw no correlation with regard to APOE-ε2 per se.
- But! Hispanic and East Asian people had a reduced risk of Alzheimer’s if and only if they had both APOE-ε2 and APOE-ε4.
- Black people, meanwhile, saw a slight correlation with regard to the protective effect of APOE-ε2, and as for APOE-ε4, if they had any European ancestry, increased European ancestry meant a higher increased risk factor if they had APOE-ε4. African ancestry, on the other hand, had a protective effect, proportional to the overall amount of that ancestry.
And as for sex…
- Specifically for white people with the APOE-ε3/ε4 genotype, especially in the age range of 60–70, the genetic risk for Alzheimer’s was highest in women.
If you’d like to read more and examine the data for yourself:
APOE Genotype and Alzheimer Disease Risk Across Age, Sex, and Population Ancestry
Want to reduce your Alzheimer’s risk?
We have just the thing for you:
How To Reduce Your Alzheimer’s Risk: It’s Never Too Early To Do These 11 Things
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Basic Baked Tofu
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One of the main criticisms of tofu is that it is tasteless. Well, so is flour, but you’re not supposed to eat it plain, and the same goes for tofu. It’s a blank canvas that you get to decide what to do with—not to mention, it’s a canvas that’s very high in protein, and is a complete protein too, containing all essential amino acids. Anyway, here’s a starter recipe that elevates tofu from “nutrition” to “nutritious tasty snack”!
We were going to do a fancier recipe today, but considered that it might be judicious to cover this basic element first, that can be incorporated into a larger recipe later, a bit like we have done with recipes such as our Tasty Versatile Rice, and Plant-Based Healthy Cream Cheese (amongst others).
You will need
- 1 block of extra-firm tofu; these are quite standardized in size; it should be about 12oz; don’t worry if it’s a little more or less.
- 2 tbsp arrowroot powder (or potato starch if you don’t have arrowroot)
- 1½ tbsp extra virgin olive oil
- 1 tbsp nutritional yeast
- 1 tsp black pepper
- ½ tsp MSG or 1 tsp low-sodium salt
- Optional: ½ tsp garlic powder
- Optional: ½ tsp ground turmeric
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 425ºF / 220ºC.
2) Press the tofu for about 15 minutes (to remove excess moisture), using a tofu press if you have one. If you don’t, then here is an example product on Amazon, or alternatively, you can go with the time-honored tradition of cutting the tofu lengthways into slabs, and wrapping it in a lint-free kitchen towel or muslin cloth, and pressing it with heavy books. We don’t recommend pressing for more than about 15 minutes, as you are going to bake the tofu so you don’t want it too dry going in.
3) Cut the tofu into cubes. Size is up to you, but half-inch cubes are very respectable.
4) Combine the tofu cubes in a big bowl with the oil and seasonings, including the nutritional yeast but not the arrowroot powder or potato starch yet. You will need to toss them gently (very gently; they are fragile!) to combine.
5) Add the arrowroot powder or potato starch, and again toss gently to combine. We do this last, because it would stop the other things from sticking properly if we did it earlier.
6) Arrange the tofu on a baking tray lined with baking paper, in a single layer so that the cubes don’t touch. Bake for 15 minutes, turn them over, and bake for a further 15 minutes on the other side. They should now be golden and crisp, but if they’re not, just give them a little more time.
7) Serve as a snack, or set aside for whatever else you’re going to do with them in a larger more complex recipe.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Tofu vs Seitan – Which is Healthier?
- Plant vs Animal Protein: Head to Head
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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Viruses aren’t always harmful. 6 ways they’re used in health care and pest control
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We tend to just think of viruses in terms of their damaging impacts on human health and lives. The 1918 flu pandemic killed around 50 million people. Smallpox claimed 30% of those who caught it, and survivors were often scarred and blinded. More recently, we’re all too familiar with the health and economic impacts of COVID.
But viruses can also be used to benefit human health, agriculture and the environment.
Viruses are comparatively simple in structure, consisting of a piece of genetic material (RNA or DNA) enclosed in a protein coat (the capsid). Some also have an outer envelope.
Viruses get into your cells and use your cell machinery to copy themselves.
Here are six ways we’ve harnessed this for health care and pest control.1. To correct genes
Viruses are used in some gene therapies to correct malfunctioning genes. Genes are DNA sequences that code for a particular protein required for cell function.
If we remove viral genetic material from the capsid (protein coat) we can use the space to transport a “cargo” into cells. These modified viruses are called “viral vectors”.
Viruses consist of a piece of RNA or DNA enclosed in a protein coat called the capsid.
DEXiViral vectors can deliver a functional gene into someone with a genetic disorder whose own gene is not working properly.
Some genetic diseases treated this way include haemophilia, sickle cell disease and beta thalassaemia.
2. Treat cancer
Viral vectors can be used to treat cancer.
Healthy people have p53, a tumour-suppressor gene. About half of cancers are associated with the loss of p53.
Replacing the damaged p53 gene using a viral vector stops the cancerous cell from replicating and tells it to suicide (apoptosis).
Viral vectors can also be used to deliver an inactive drug to a tumour, where it is then activated to kill the tumour cell.
This targeted therapy reduces the side effects otherwise seen with cytotoxic (cell-killing) drugs.
We can also use oncolytic (cancer cell-destroying) viruses to treat some types of cancer.
Tumour cells have often lost their antiviral defences. In the case of melanoma, a modified herpes simplex virus can kill rapidly dividing melanoma cells while largely leaving non-tumour cells alone.
3. Create immune responses
Viral vectors can create a protective immune response to a particular viral antigen.
One COVID vaccine uses a modified chimp adenovirus (adenoviruses cause the common cold in humans) to transport RNA coding for the SARS-CoV-2 spike protein into human cells.
The RNA is then used to make spike protein copies, which stimulate our immune cells to replicate and “remember” the spike protein.
Then, when you are exposed to SARS-CoV-2 for real, your immune system can churn out lots of antibodies and virus-killing cells very quickly to prevent or reduce the severity of infection.
4. Act as vaccines
Viruses can be modified to act directly as vaccines themselves in several ways.
We can weaken a virus (for an attenuated virus vaccine) so it doesn’t cause infection in a healthy host but can still replicate to stimulate the immune response. The chickenpox vaccine works like this.
The Salk vaccine for polio uses a whole virus that has been inactivated (so it can’t cause disease).
Others use a small part of the virus such as a capsid protein to stimulate an immune response (subunit vaccines).
An mRNA vaccine packages up viral RNA for a specific protein that will stimulate an immune response.
5. Kill bacteria
Viruses can – in limited situations in Australia – be used to treat antibiotic-resistant bacterial infections.
Bacteriophages are viruses that kill bacteria. Each type of phage usually infects a particular species of bacteria.
Unlike antibiotics – which often kill “good” bacteria along with the disease-causing ones – phage therapy leaves your normal flora (useful microbes) intact.
Bacteriophages (red) are viruses that kill bacteria (green).
Shutterstock6. Target plant, fungal or animal pests
Viruses can be species-specific (infecting one species only) and even cell-specific (infecting one type of cell only).
This occurs because the proteins viruses use to attach to cells have a shape that binds to a specific type of cell receptor or molecule, like a specific key fits a lock.
The virus can enter the cells of all species with this receptor/molecule. For example, rabies virus can infect all mammals because we share the right receptor, and mammals have other characteristics that allow infection to occur whereas other non-mammal species don’t.
When the receptor is only found on one cell type, then the virus will infect that cell type, which may only be found in one or a limited number of species. Hepatitis B virus successfully infects liver cells primarily in humans and chimps.
We can use that property of specificity to target invasive plant species (reducing the need for chemical herbicides) and pest insects (reducing the need for chemical insecticides). Baculoviruses, for example, are used to control caterpillars.
Similarly, bacteriophages can be used to control bacterial tomato and grapevine diseases.
Other viruses reduce plant damage from fungal pests.
Myxoma virus and calicivirus reduce rabbit populations and their environmental impacts and improve agricultural production.
Just like humans can be protected against by vaccination, plants can be “immunised” against a disease-causing virus by being exposed to a milder version.
Thea van de Mortel, Professor, Nursing, School of Nursing and Midwifery, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Seven Principles for Making Marriage Work – by Dr. John Gottman
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A lot of relationship advice can seem a little wishy-washy. Hardline clinical work, on the other hand, can seem removed from the complex reality of married life. Dr. Gottman, meanwhile, strikes a perfect balance.
He looks at huge datasets, and he listens to very many couples. He famously isolated four relational factors that predict divorce with 91% accuracy, his “Four Horsemen”:
- Criticism
- Contempt
- Defensiveness
- Stonewalling
He also, as the title of this book promises (and we get a chapter-by-chapter deep-dive on each of them) looks at “Seven principles for making marriage work”. They’re not one-word items, so including them here would take up the rest of our space, and this is a book review not a book summary. However…
Dr. Gottman’s seven principles are, much like his more famous “four horsemen”, deeply rooted in science, while also firmly grounded in the reality of individual couples. Essentially, by listening to very many couples talk about their relationships, and seeing how things panned out with each of them in the long-term, he was able to see what things kept on coming up each time in the couples that worked out. What did they do differently?
And, that’s the real meat of the book. Science yes, but lots of real-world case studies and examples, from couples that worked and couples that didn’t.
In so doing, he provides a roadmap for couples who are serious about making their marriage the best it can be.
Bottom line: this is a must-have book for couples in general, no matter how good or bad the relationship.
- For some it’ll be a matter of realising “You know what; this isn’t going to work”
- For others, it’ll be a matter of “Ah, relief, this is how we can resolve that!”
- For still yet others, it’ll be a matter of “We’re doing these things right; let’s keep them forefront in our minds and never get complacent!”
- And for everyone who is in a relationship or thinking of getting into one, it’s a top-tier manual.
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Pear vs Prickly Pear – Which is Healthier?
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Our Verdict
When comparing pear to prickly pear, we picked the prickly.
Why?
Both of these fruits are fine and worthy choices, but the prickly pear wins out in nutritional density.
Looking at the macros to start with, the prickly pear is higher in fiber and lower in carbs, resulting in a much lower glycemic index. However, non-prickly pears are already low GI, so this is not a huge matter. Whether it’s pear’s GI of 38 or prickly pear’s GI of 7, you’re unlikely to experience a glucose spike.
In the category of vitamins, pear has a little more of vitamins B5, B9, E, K, and choline, but the margins are tiny. On the other hand, prickly pear has more of vitamins A, B1, B2, B3, B6, and C, with much larger margins of difference (except vitamin B1; that’s still quite close). Even before taking margins of difference into account, this is a slight win for prickly pear.
When it comes to minerals, things are more pronounced; pear has more manganese, while prickly pear has more calcium, iron, magnesium, phosphorus, potassium, selenium, and zinc.
In short, both pears are great (so do enjoy the pair), but prickly pear is the clear winner where one must be declared.
Want to learn more?
You might like to read:
Apple vs Pear – Which is Healthier?
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Mammography AI Can Cost Patients Extra. Is It Worth It?
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As I checked in at a Manhattan radiology clinic for my annual mammogram in November, the front desk staffer reviewing my paperwork asked an unexpected question: Would I like to spend $40 for an artificial intelligence analysis of my mammogram? It’s not covered by insurance, she added.
I had no idea how to evaluate that offer. Feeling upsold, I said no. But it got me thinking: Is this something I should add to my regular screening routine? Is my regular mammogram not accurate enough? If this AI analysis is so great, why doesn’t insurance cover it?
I’m not the only person posing such questions. The mother of a colleague had a similar experience when she went for a mammogram recently at a suburban Baltimore clinic. She was given a pink pamphlet that said: “You Deserve More. More Accuracy. More Confidence. More power with artificial intelligence behind your mammogram.” The price tag was the same: $40. She also declined.
In recent years, AI software that helps radiologists detect problems or diagnose cancer using mammography has been moving into clinical use. The software can store and evaluate large datasets of images and identify patterns and abnormalities that human radiologists might miss. It typically highlights potential problem areas in an image and assesses any likely malignancies. This extra review has enormous potential to improve the detection of suspicious breast masses and lead to earlier diagnoses of breast cancer.
While studies showing better detection rates are extremely encouraging, some radiologists say, more research and evaluation are needed before drawing conclusions about the value of the routine use of these tools in regular clinical practice.
“I see the promise and I hope it will help us,” said Etta Pisano, a radiologist who is chief research officer at the American College of Radiology, a professional group for radiologists. However, “it really is ambiguous at this point whether it will benefit an individual woman,” she said. “We do need more information.”
The radiology clinics that my colleague’s mother and I visited are both part of RadNet, a company with a network of more than 350 imaging centers around the country. RadNet introduced its AI product for mammography in New York and New Jersey last February and has since rolled it out in several other states, according to Gregory Sorensen, the company’s chief science officer.
Sorensen pointed to research the company conducted with 18 radiologists, some of whom were specialists in breast mammography and some of whom were generalists who spent less than 75% of their time reading mammograms. The doctors were asked to find the cancers in 240 images, with and without AI. Every doctor’s performance improved using AI, Sorensen said.
Among all radiologists, “not every doctor is equally good,” Sorensen said. With RadNet’s AI tool, “it’s as if all patients get the benefit of our very top performer.”
But is the tech analysis worth the extra cost to patients? There’s no easy answer.
“Some people are always going to be more anxious about their mammograms, and using AI may give them more reassurance,” said Laura Heacock, a breast imaging specialist at NYU Langone Health’s Perlmutter Cancer Center in New York. The health system has developed AI models and is testing the technology with mammograms but doesn’t yet offer it to patients, she said.
Still, Heacock said, women shouldn’t worry that they need to get an additional AI analysis if it’s offered.
“At the end of the day, you still have an expert breast imager interpreting your mammogram, and that is the standard of care,” she said.
About 1 in 8 women will be diagnosed with breast cancer during their lifetime, and regular screening mammograms are recommended to help identify cancerous tumors early. But mammograms are hardly foolproof: They miss about 20% of breast cancers, according to the National Cancer Institute.
The FDA has authorized roughly two dozen AI products to help detect and diagnose cancer from mammograms. However, there are currently no billing codes radiologists can use to charge health plans for the use of AI to interpret mammograms. Typically, the federal Centers for Medicare & Medicaid Services would introduce new billing codes and private health plans would follow their lead for payment. But that hasn’t happened in this field yet and it’s unclear when or if it will.
CMS didn’t respond to requests for comment.
Thirty-five percent of women who visit a RadNet facility for mammograms pay for the additional AI review, Sorensen said.
Radiology practices don’t handle payment for AI mammography all in the same way.
The practices affiliated with Boston-based Massachusetts General Hospital don’t charge patients for the AI analysis, said Constance Lehman, a professor of radiology at Harvard Medical School who is co-director of the Breast Imaging Research Center at Mass General.
Asking patients to pay “isn’t a model that will support equity,” Lehman said, since only patients who can afford the extra charge will get the enhanced analysis. She said she believes many radiologists would never agree to post a sign listing a charge for AI analysis because it would be off-putting to low-income patients.
Sorensen said RadNet’s goal is to stop charging patients once health plans realize the value of the screening and start paying for it.
Some large trials are underway in the United States, though much of the published research on AI and mammography to date has been done in Europe. There, the standard practice is for two radiologists to read a mammogram, whereas in the States only one radiologist typically evaluates a screening test.
Interim results from the highly regarded MASAI randomized controlled trial of 80,000 women in Sweden found that cancer detection rates were 20% higher in women whose mammograms were read by a radiologist using AI compared with women whose mammograms were read by two radiologists without any AI intervention, which is the standard of care there.
“The MASAI trial was great, but will that generalize to the U.S.? We can’t say,” Lehman said.
In addition, there is a need for “more diverse training and testing sets for AI algorithm development and refinement” across different races and ethnicities, said Christoph Lee, director of the Northwest Screening and Cancer Outcomes Research Enterprise at the University of Washington School of Medicine.
The long shadow of an earlier and largely unsuccessful type of computer-assisted mammography hangs over the adoption of newer AI tools. In the late 1980s and early 1990s, “computer-assisted detection” software promised to improve breast cancer detection. Then the studies started coming in, and the results were often far from encouraging. Using CAD at best provided no benefit, and at worst reduced the accuracy of radiologists’ interpretations, resulting in higher rates of recalls and biopsies.
“CAD was not that sophisticated,” said Robert Smith, senior vice president of early cancer detection science at the American Cancer Society. Artificial intelligence tools today are a whole different ballgame, he said. “You can train the algorithm to pick up things, or it learns on its own.”
Smith said he found it “troubling” that radiologists would charge for the AI analysis.
“There are too many women who can’t afford any out-of-pocket cost” for a mammogram, Smith said. “If we’re not going to increase the number of radiologists we use for mammograms, then these new AI tools are going to be very useful, and I don’t think we can defend charging women extra for them.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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