Drop Dead Healthy

by A. J. Jacobs

  I see this project as a crash course in my own body. I’ll be a student of the strange land inside my skin. I’ll try out diets and exercise regimens. I’ll test drugs and supplements and tight-fitting clothes. I’ll experiment with the most extreme health advice, because, as I learned in my year of living biblically, only by exploring the limits can you find the perfect middle ground.

  At the end of the project, I probably won’t keep up all my healthy behaviors, but I’ll keep a bunch. I’ll find the ones that work best. And that, I hope, will keep me alive long enough to teach my kids how to be healthy.

  The Warm-up

  As with any physical endeavor, you need to warm up. You can’t just start doing squats and eating kale without knowing what’s what.

  First thing I did was to assemble a board of medical advisers. I don’t have an M.D. After my name, but—through luck and persistence—I do have access to the best health minds in the country. It’s a somewhat ad hoc group, but varied and esteemed and far more knowledgeable than I.

  I’ll be getting advice from Harvard professors and Johns Hopkins researchers, from top-of-their-field doctors and from fitness trainers with biceps like cantaloupes. My aunt Marti will weigh in. She is the single most health-minded person in America, and has a mail-order business that sells powdered blue-green algae supplements and organic hand sanitizers. She lives in Berkeley and will be giving me a distinctly Californian point of view.

  When I called her to tell her about the project, she was thrilled at first, then appalled. “You’re doing a project on health and you’re calling me from your cell phone?” She went on to lecture me on its brain-frying dangers. And for calling too late, since staying up at night disrupts my circadian rhythm.

  I’ve been devouring health books and magazines and blogs. I’ve read at least fourteen articles on the benefits of blueberries. I’m steeped in my omega-3s and flavonoids. I know a lat from a delt, fructose from sucrose, HDL from LDL. I know that you should eat a lot of the Indian spice turmeric, as it fights cancer. Also that you should avoid the Indian spice turmeric, as it might contain dangerous levels of lead. One or the other.

  The research so far has been fascinating, often confusing—but heartening overall. Admittedly, I’m saddled with twenty-three pairs of chromosomes I can’t change, at least not yet. But there’s so much I can control. An estimated 50 percent of our health is determined by behavior. Our well-being is an accumulation of hundreds of little choices we make every day—what to eat, drink, breathe, wear, think, say, watch, lift, and smear on our skin.

  My timing is lucky as well. This is a good era in which to pursue total health. We’ve had more medical advances in the last thirty years than, arguably, in the last millennium.

  But I also have to be careful. I’ve spotted an astonishing amount of what even I—with my currently limited expertise—can tell is quackery. You’d think that with the steady march of science, the dubious health advice would have faded since the days of “Dr. Hammond’s Nerve Medicine and Opium Blend.” Not so.

  Thanks to the Internet, just about any quarter-baked idea ever conceived still gets traction. Case in point: trepanning, a practice that dates back to 6500 BCE and involves drilling a hole in the skull to let out evil spirits.

  I did an Internet search. And guess what? It’s still around. Check out the International Trepanation Advocacy Group. Its website features images of green-tinted brain scans next to doctors in white lab coats writing complicated math equations on boards. Apparently, this is not your caveman’s trepanation. No, this is totally scientifical drilling of holes in your skull.

  Now, quackery can be interesting and even important. (For instance, one of the leaders of the 1773 Boston Tea Party riled up the protesters by claiming that tea was hazardous to the health; so our very country is founded on absurd medical claims.)

  But I want this project to be an evidence-based makeover. I want to separate the hard science from the squishy claims. I’ve got to be wary of the Latest Study Syndrome. Our brains are unduly drawn to whatever yesterday’s study revealed—Look at that! Bacon IS healthy—especially if the conclusion is surprising and counterintuitive and delicious. Each study needs to be weighed against the mountain of existing data. I want to focus on the meta-analyses. Or better yet, meta-analyses of meta-analyses. I’ll be seeking second opinions, but also third, fourth, and eighth opinions. I’ll be consulting the Cochrane Collaboration, which sounds like a shady international conspiracy but is actually a nonpartisan group that reviews medical studies.

  The trick, though, is to avoid quackery at the same time as maintaining childlike enthusiasm for innovation. Because cutting-edge medical science veers into the surreal. It’s a world where mice live twice as long when they’re on the verge of starvation, and where electromagnetic pulses to the brain can temporarily improve memory and creativity.

  I read a quote from Carl Sagan that I printed out and put on the wall above my computer. It will be my guide:

  What is called for is an exquisite balance between two conflicting needs: the most skeptical scrutiny of all hypotheses that are served up to us and at the same time a great openness to new ideas.

  The Battle Plan

  What does it mean to be maximally healthy? Courtesy of the World Health Organization’s definition of health, I’ve broken it down into three parts:

  1. Longevity

  2. Freedom from disease and pain

  3. A sense of emotional, mental, and physical well-being

  If I can have those three, I’ll be ecstatic. It’d be nice to get a six-pack, but it’s not my top priority—unless I decide I need shredded abs for emotional well-being, as many magazines seem to imply.

  I’m going to quantify my progress as best I can. Granted, the longevity part will be tough to measure, unless I happen to die during my project. Which would be embarrassing but would certainly provide some closure. But the other two, thankfully, are testable.

  To quantify how badly off I am at the project’s start, I visited a clinic in Rockefeller Center called EHE, short for Executive Health Enterprises.

  The website boasts of the company’s illustrious history: EHE has been doing preventive medicine since 1913. The founding chairman of its board? Former president William Howard Taft. Which, frankly, isn’t the first name that comes to mind when you think of healthy living. This is a man who got stuck in the White House bathtub and had to be lifted out by four government employees.

  But still, EHE is a classy joint filled with reputable doctors, free fruit salad, and fancy clientele from law firms and banks. It offers a top-to-bottom physical and a full report card on your body. I went one morning, and it took three hours and involved six vials of blood, forty-two tests, six nurses, and eleven horrific minutes on a treadmill.

  Here’s what they found:

  Height: 5'11”. Weight: 172 pounds. Body fat percentage: 18. Total cholesterol: 134 (it used to be over 200, but I’ve been taking Lipitor for three years). I’m myopic. I have abnormally low hematocrit, which means the percentage of red blood cells is depressed, which could explain my fatigue. I have a heart murmur and elevated liver enzymes.

  Far from perfect, but not terrible. Overall, I should be grateful I don’t have any debilitating diseases. Just the usual American sloth-related maladies.

  Though I should mention this was just the first test. In the coming months, I will submit myself to dozens of additional exams and find out an alarming number of other things wrong with me. Among them: sleep apnea, depleted iron, deviated septum, collapsed nostril, precancerous skin growths, and, particularly embarrassing for someone who works at a men’s magazine: low testosterone. But I’m getting ahead of myself.

  As my start date approached, I realized just how overwhelming being maximally healthy is. It will consume my every waking hour, and my sleeping ones, too.

  I need some structure. Taking a cue from the digestive system, I’ve decided to break my project down into smaller, bite-size chunks. I will imp
rove my body one part at a time. I will attempt to have the healthiest heart and the healthiest brain. But also the healthiest skin, ears, nose, feet, hands, glands, genitals, and lungs.

  I know all the body parts are all linked on some level. But I want to lavish some individual attention on each.

  And where to start? Since diet is such a huge part of health, I’ve chosen the stomach as my jumping-off point. The first part will be about what to put in my Buddha-like belly.

  Chapter 1

  The Stomach

  The Quest to Eat Right

  I’VE MADE A LIST of more than a hundred diets. The Mediterranean diet. The USDA diet. The Michael Pollan eat-what-your-grandparents-ate diet. The Blood-type diet. The Paleo diet. The Okinawa diet. Veganism. Raw foodism. Not to mention the more outré ones, like The Cookie Diet. The Rastafarian diet. The Master-Cleanse diet.

  I want to try them all. Well, maybe not The Taco Bell Drive-Thru Diet (it exists). But most of the others. Eventually, that is. The thing is, studies show that if you switch habits too rapidly, the changes don’t stick. So my plan is to wade into my new diets slowly, like my five-year-old son entering a chilly pool.

  Which is how I’ve decided on my first dietary reforms: more chocolate, booze, and coffee.

  “Salud,” I say to Julie as I pour a cup of Starbucks Gold Coast on my first morning.

  That night, our friends Paul and Lisa—who are visiting New York from D.C.—come over for an informal Thai dinner. Before the meal, as we wait for the delivery guy, I hand out glasses of Pinot Noir, and dig out a Toblerone bar from the fridge.

  “So when does your health thing start?” Paul asks.

  “It started today,” I say, breaking off a triangular chunk.

  Paul gives me a questioning look.

  “He also had two cups of coffee this morning,” says Julie. “That’s his new health plan: chocolate, coffee, and wine.”

  “All very good for you,” I say.

  “Huh. Sounds like you’re really committing yourself to this project,” says Paul.

  “How about heroin?” asks Lisa. “I hear that it’s loaded with antioxidants.”

  Everyone has a good laugh.

  Clever. But Paul and Lisa have to acknowledge, science is on my side. Consider:

  • As the Mars Corporation gleefully and regularly points out, dark chocolate is, in fact, loaded with antioxidants and has been shown to cut the risk of heart disease and stroke. It also might be good for the eyes: According to at least one study, chocolate improves contrast sensitivity.

  • A bunch of studies has shown that alcohol is good for your heart in judicious amounts (one glass per day for women, one to two for men) and that moderate drinkers live longer than both teetotalers and heavy drinkers. That includes drinkers of beer or liquor, not just the highly trumpeted red wine, though red wine does contain the much beloved resveratrol, which might have age-resistant effects.

  • Coffee lowers the odds of several types of cancer (bladder, breast, prostate, and liver) as well as Alzheimer’s. It has some downsides (more than two cups can cause sleeplessness and raise cholesterol), and isn’t quite as healthy as its cousin green tea, but drunk in moderation, coffee’s benefits outweigh the risks.

  Sadly, I do understand my Vice Diet won’t lead me to everlasting health. Chocolate, alcohol, and coffee are outliers. In general, food that tastes good is bad for the body. As Jack LaLanne liked to say: “If it tastes good, spit it out.”

  Which is a bizarre situation. Evolution has betrayed us here. The human body—as miraculous as it can be—is in many ways a malfunctioning machine, a biological version of a 1978 Ford Pinto.

  If evolution worked perfectly, healthy food would taste delicious and unhealthy food would make us gag. On Halloween, kids would fill their pails with quinoa and cauliflower. Dairy Queen would sell millions of bok choy Blizzards.

  The problem is, we live in a modern world, but we’re stuck with caveman taste buds. When our ancestors roamed the plains, our preferences actually did make sense: Our tastes aligned with healthy foods. We evolved to like sugar because it’s in fruit. And fruit—which is rare in the wild—is high in nutrients, fiber, and calories. We evolved to like salt because the body needs salt to retain water. Salt—also rare in the wild—was an occasional lifesaving treat.

  But then we figured out how to extract sugar from plants and put it in pastries and Frappuccinos. We mined salt and stuck it in our soups and burritos and neon-orange cheese snacks. And in large quantities, sugar and salt are not so good for you at all.

  We also started to live longer. We cured a lot of infectious diseases, but this presented a new problem. Foods that were healthy in the short run—like those loaded with fat to allow the caveman to survive the famine until the next kill—turned out to be damaging in the long run.

  My question is, can I reprogram myself to love healthy food? And can I figure out how to prepare and buy healthy food that doesn’t taste like a roll of double-ply Bounty?

  The answer, it turns out, is yes. Sort of. But not yet.

  Right now I’m still comforting myself with my holy trinity of chocolate, coffee, and booze—three of the rare foods that are both tasty and healthy.

  At least somewhat healthy. The more I research, the more I realize the situation is complicated. Consider chocolate. What’s really healthy is the 100 percent cacao chocolate. No sugar, no butter.

  I click onto rawcacao.com and order a bag. The mouthwatering write-up says it’s “certified organic, raw, low fermentation, nonfumigated, fair traded, strict farming standards, training and equipment provided, fair wages, profit reinvestment plan, purity testing.”

  My bag of certified-organic-raw-low-fermentation-etc. chocolate arrives three days later. I take a pinch of the sprinkle-size nibs and pop it in my mouth. I can taste the chocolate I know from Hershey’s Kisses, but it’s faint and muffled, like a clock radio stuffed under a heap of pillows. Mostly I taste the bitterness.

  “What’s that?” Julie asks, walking into the kitchen for a snack.

  “Natural chocolate,” I say.

  Reflexively, I offer her the bag. She takes a handful and puts it in her mouth.

  I probably should have mentioned the tastes-like-detergent part, but, well, it happened so fast. Also I was curious to see her reaction.

  A second. Two seconds. There it is: the same face she made when our friend showed us an Internet video of two women violating several cultural and hygienic taboos.

  Taming the Portion

  In my quest for healthy eating, I know I’ll have to do better than my Vice Diet. But I still haven’t committed to veganism or Atkins yet. I’m still too overwhelmed by choices.

  I do, however, notice that there’s one thing almost every nutritionist agrees on: We eat too much damn food.

  We have a size problem. You can see it in the puberty-like growth spurt of portion sizes. In 1916, a bottle of Coca-Cola was 6.5 ounces. Today, it’s 20 ounces. A hamburger used to be about 300 calories. Now you can enjoy Hardees’ Monster Thickburger with 1,420 calories, not counting fries. (The average man should eat about 2,500 calories a day.)

  So I’ve decided to split up my food reforms. First, I’ll deal with quantity. Then I’ll take on quality.

  How to eat less? One idea is to suppress my appetite. I’ve read reputable studies saying a glass of water before a meal reduces the average number of calories people consume. Same goes for cayenne peppers. And an apple. And a handful of walnuts. So that’s my breakfast this morning: cayenne peppers, water, an apple, and walnuts.

  I won’t be hungry for days! Or at least until 10 a.m. when I get the urge to snack again.

  I’m going to need some professional help. Which is why, on a Sunday afternoon, Julie and I drive to a house in secluded hilltop Westchester.

  I’m here to meet the leaders of the Calorie Restriction movement. You might have heard of CR, as it’s called. It’s the most extreme diet you can find that isn’t technically a psychologica
l disorder or human rights violation.

  The idea is that if you live on the edge of starvation, you will increase your life span. If you can survive on 30 percent fewer calories a day—say 1,750 instead of the usual 2,500 for an adult male—you’ll slow down your metabolism and be free of disease. You can easily break the century mark, maybe even the 120 mark or more.

  It’s not an insane notion. Actually, there’s a good amount of scientific data behind it, going back to a Cornell University study in 1934. Researchers were able to double the life span of mice when they fed them extremely low-calorie diets. Similar results have been found for worms, spiders, and monkeys.

  Scientists still aren’t 100 percent certain why calorie restriction lengthens animal life spans. One theory is that the famished animals produce fewer cell-damaging free radicals. Another says that their bodies sense starvation and switch into a defensive state, slowing their metabolism.

  Does it work on humans? Studies are under way, but it’s too soon to tell. The prospect, though, has attracted thousands of Calorie Restrictors, folks who weigh their food on digital scales, plot precious calories on spreadsheets, eat two meals a day, and treat their mouths like an exclusive SoHo VIP club where only the most deserving morsels can enter.

  The house is perched on a steep hill atop a series of perilous turns that leave Julie frazzled. “If they want to live forever, they might want to move to a safer street,” she says. Julie drops me off, and drives away to visit some friends nearby. She says I can fill her in later.

  A man answers the door. He’s Paul McGlothin, the director of research for the nonprofit Calorie Restriction Society, and coauthor of the how-to book The CR Way.

  He’s skinny, but not the POW skinny I was expecting. More like lead-singer-of-an-emo-band skinny.