Yet these days many people ignore the many links between our minds and our bodies—our fight-or-flight response, our social hormones, the vagus nerve—and instead of investing in their relationships obsess about their diets and exercise. They skip gluten, load on turmeric, and religiously count their daily steps. Research shows, however, that a lot of this effort may be misplaced.
A FEW SUGGESTIONS TO BOOST YOUR LONGEVITY
To get a health-promoting increase of your social hormones such as oxytocin or serotonin, engage in more physical contact with others—kiss your partner more often, hold hands with your kids, hug your friends. Rub each other’s backs. Treat yourself to a massage. And don’t forget to look others in the eye—it may help raise oxytocin levels for both of you (and it works even if that “other” is a dog).
PART TWO
HOW YOUR RELATIONSHIPS AND YOUR MIND CAN PROLONG YOUR LIFE
4
DITCH GOJI BERRIES
Why Many Diet and Exercise Interventions Matter Less than You Think
IT WAS A SUNNY OCTOBER AFTERNOON in Vilamoura, a small town on the Mediterranean coast of Portugal. It was warm, bordering on hot, and the sweet scent of sun-heated olive groves lingered in the air. With my bare feet I could feel several fallen olives scattered in the grass. A yoga instructor, clad in purple leggings and a purple tank top, was telling the class to move to a downward dog. I followed her lead. I breathed in, I breathed out. In, out.
The days are well organized at the Longevity Cegonha Country Club in Vilamoura, especially if you are taking part in their longevity boot camp. After the yoga class there is Pilates, and later, a “Juices and Water Detox” workshop and a stretching class. The weekly schedule is loaded with exercise, from tai chi to jogging, and healthy eating courses. Each participant is offered personalized nutritional coaching and can access an infrared sauna, a salt room, and a steam room. The wellness area offers a “longevity ritual” (aromatherapy massage), reiki, and even a dodgy-sounding “epigenetic test” that is supposed to “provide clear information to help you implement a food regime that will optimize your gene expression for wellness.”
Everything in Vilamoura is centred on longevity—and I mean everything. In my room there was something called a “longevity soap” (according to the label) and a bag of some mysterious “longevity infusion,” a kind of herbal tea. I was at the resort to do research, so I dutifully drank the tea. It tasted horrible, and I thought that if this was what long life felt like, I wasn’t sure I wanted it anymore. The food at the resort’s restaurant was far more appealing, albeit devoid of salt. For breakfast I got coconut milk porridge, a whole wheat bun, a slice of melon, some cheese, scrambled eggs with arugula, and a glass of freshly pressed mango-raspberry juice—no sugar added, the waitress assured me. For lunch, I ordered a “longevity salad” (lots of arugula, some quinoa, sunflower seeds) and a “longevity drink,” which included cucumber and mint. Some boot camp participants, those on a detox program, got nothing but juice and soup. If you believe that eating well and exercising hard are the key to longevity, Vilamoura is certainly the place to be.
Yet the boot camp–goers of Vilamoura are certainly not alone in their obsession with nutrition and fitness—most Westerners these days seem to follow a similar philosophy. In their New Year’s resolutions, over 80 percent of Americans say they want to change their diet or exercise regimen. As many as 45 percent buy organic foods and 70 percent drink low-fat milk. More than half take various dietary supplements, spending on average $56 a month. Even though less than 1 percent of Westerners have celiac disease, almost one-third of Canadians, 10 percent of Britons, and over 40 percent of Poles now try to eat gluten-free. We load up on protein, chase superfoods, and worry about omega-3s. And about our weight, of course.
If there is one longevity-related fear that seems particularly prominent across the Western hemisphere, it’s that of excess pounds. According to one poll, most Americans think obesity is the most serious health concern faced by their country, and so they spend over $60 billion a year on weight-loss pills and slim-down diets. We seem truly obsessed with weight loss: just consider all the TV shows about it these days. There’s The Big Fat Truth, Extreme Weight Loss, and My 600-lb Life.
I, too, admit to be slightly obsessed with staying the same size: I dutifully weigh myself each and every morning and feel slightly anxious on holidays when I don’t have an easy access to scales. Here’s the thing, though. For many of us, a few extra pounds may not be such a big deal after all. Not only does excess weight shorten lives less than does social isolation, but in certain circumstances, it may not even shorten lives at all. In the last two decades, research has accumulated on something scientists have dubbed the “obesity paradox”: the fact that in many studies the plump and the pudgy come out better off in some aspects of health than do their slender counterparts. Take, for instance, advanced renal disease. If two patients, let’s call them Mr. A (a slim guy) and Mr. B (slightly overweight), both have serious kidney problems and end up on hemodialysis, Mr. B has higher chances of surviving than does Mr. A. For every unit increase in BMI (body mass index), the probability of making it through hemodialysis increases by 10 percent.
A similar obesity paradox has been observed in cardiovascular disease. Let’s say that instead of kidney problems, Mr. A and Mr. B end up with dodgy hearts. If the illness progresses to a full-blown heart failure, the slim Mr. A will be more likely to kick the bucket than Mr. B, whose risk of death could be even 12 percent lower than that of Mr. A.
The obesity paradox has been found in hypertension, in atrial fibrillation (a heart condition), and in lung-removal surgery. What’s more, chubby people may overall live longer than the skinny of the world. Yes, you heard it right. By now we have quite a few papers published in top journals suggesting that being a bit overweight can add years to your life. People with BMIs between 30 and 35, which is grade one obesity and above the normal BMI range of 18.5 to 24.9, are 5 percent less likely to succumb to the grim reaper than the lean. It’s only when your BMI tops 35 that your longevity potential starts to go considerably downhill.
One explanation for such counterintuitive results is that BMI is simply not a good measurement of how extra pounds affect health. If you are a classic “pear” shape, with relatively narrow waist but big hips, you may be far better off than an “apple” whose bulk accumulates in the belt area, even if your height-to-weight ratios are identical. Here is the reason: not all fat is created equal. A big belly, more scientifically known as “abdominal adiposity,” in general means having too much fat stored around the internal organs, and this particular type of fat plays a role in inflammation and insulin resistance. On the other hand, the jiggly subcutaneous fat that accumulates under the skin in your thighs or around your hips is of a less troublesome quality (that’s also the type of fat that helps women survive Donner party–type starvation).
Yet the issues with pear shape versus central chunkiness are still not enough to explain the obesity paradox. As for now, scientists are still unsure what the answer could be. Some suggest the paradox exists because people with weight issues tend to report concerns to doctors faster than do regular-sized folks. Others point to the properties of the fat tissue itself. For one, it can sop up toxins. Second, it can provide its “owner” with metabolic resources, which may be particularly needed in chronic disease—for instance in late-stage cancer. Obese people may also have altered levels of various substances circulating in their bodies, from cytokines involved in inflammation to some hormones—which could all play a role in the obesity paradox.
It appears that some of us, myself included, may be unnecessarily obsessed with the readings of our bathroom scales. What’s more, many popular approaches to weight loss may reduce longevity. Consider high-protein diets. Although the jury is still out on whether they help shed unwanted pounds in the long term, research shows that too much protein can damage kidneys and shorten lives—someth
ing early Arctic explorers, including Vilhjalmur Stefansson, knew about very well.
Stefansson didn’t look much like someone who had thoroughly explored the polar regions. With his slender build and longish hair, he more resembled a party-loving dandy than a tough adventurer who had lived for over a year on an ice pack. And yet his northern expeditions were what brought the Icelandic-Canadian his fame. It was also up north where he learned about the dangers of protein-loaded diets. In his writings, Stefansson described a phenomenon known across the Arctic as “rabbit starvation”—an illness caused by eating too much lean meat chock-full of protein, such as that of squirrels and rabbits. Here is what he recounted: “you are showing both signs of starvation and of protein poisoning. You eat numerous meals; you feel hungry at the end of each; you are in discomfort through distension of the stomach with much food and you begin to feel a vague restlessness. Diarrhea will start in from a week to ten days and will not be relieved unless you secure fat. Death will result after several weeks.”
Although these days few people base their diets on little but squirrels, in those with chronic renal disease—and that’s about 13 percent of the Western population—eating a lot of protein can accelerate the illness, so much so that scientists now advise against such diets in patients with chronic renal disease. What’s more, there is some evidence that high-protein diets may harm kidneys even in healthy people. Authors of a study that revealed worrisome changes in renal function in young men who were put on a protein-rich regime concluded that those who follow such diets should have their kidneys regularly checked for abnormalities.
Faulty kidneys aside, upping your protein intake may generally shorten your life. Very low-carbohydrate diets may elevate the risk of imminent death by as much as 31 percent. While gorging yourself on protein might be a bad idea as longevity goes, another common Western pastime, popping supplements, can bring with itself a whole other set of risks—even ones as serious as uncontrollable bleeding.
Beware of Supplements
A fifty-five-year-old Indian national living in Canada, let’s call him Mr. Gupta, needed a coronary bypass. He wanted to have it done in his homeland, so he travelled all the way to Punjab, India, to have the surgery. At first, the procedure seemed to go well, but as time passed things started to go downhill in the operating room—Mr. Gupta just wouldn’t stop bleeding. The doctors transfused one unit of plasma, then another. Several interventions later, the oozing finally subsided, but when the doctors checked the patient sometime after the surgery, they noticed his chest was covered in huge bruises—a rather disturbing photo of them can be now seen in a scientific paper the three cardiologists published in 2016 to document the case.
Later on, the doctors discovered the likely reason for Mr. Gupta’s mysterious bleeding: his supplement pills. Before the surgery, Mr. Gupta was in the habit of taking three over-the-counter omega-3 and oleic acid pills per day, and a garlic-thyme supplement twice a day. Considering the effects such products may have on platelets clumping together to form blood clots, the doctors concluded they’d found the likely culprits. Mr. Gupta finally recovered, but his doctors commented in their later journal paper that the case “highlights the dangers of some dietary supplements.”
Each year in the US alone there are an estimated fifty thousand serious adverse events connected to supplement consumption. In 2013, as many as 20 percent of cases of drug-induced liver injury were due to herbal and dietary supplements, up from 7 percent in 2004. What’s more, those patients unlucky enough to have a liver failure after taking herbal pills are much more likely to require a transplant than are those who have damaged their liver by taking prescription drugs.
One supplement that is now making the rounds of the internet as a cure-all miracle is an extract from a Pacific islands plant called kava. It’s supposed to work as a natural anti-anxiety medication, stop the growth of breast cancer tumours, treat depression, and protect you against Alzheimer’s disease. The claims are wild, with basically no scientific evidence to support them.
What we do have evidence of, though, is that kava can damage the liver. Health authorities in several countries including Canada, the UK, and France have reported at least twenty-five cases of liver toxicity, including liver failure, after ingestion of kava. Products containing kava have been banned in some of these countries, such as the UK, while Consumer Reports placed kava on its list of “15 Supplement Ingredients to Always Avoid.” Still, in some health junkie circles, kava remains highly popular. Across the US, well over a hundred specialized kava bars have opened in recent years, with more than fifty in Florida alone, offering juice-based and coconut water–based kava drinks.
So how can it be that something so innocuous-sounding as an herbal or dietary supplement can be so dangerous? First of all, about a quarter of supplements may have contaminants in them introduced in the production cycle—heavy metals, for instance, such as lead or mercury. Or pharmaceuticals. As of 2014, over five hundred supplements have been found to be tainted with pharmaceuticals, including amphetamine analogues or alprazolam (Xanax).
Second, we may simply not know how exactly the supplement works in the body. Prescription drugs have to undergo lengthy safety trials. Supplements don’t. They are also practically unregulated—in the US, the FDA does not review their safety before they end up in shops. In the European Union, supplements are considered a “foodstuff,” and their control is very difficult, especially considering that many of them are sold online. In Canada, “natural health products”—vitamins, minerals, herbal remedies, and so on—must be assessed for safety by Health Canada, but the process is primarily paper-based, and the evidence submitted by manufacturers doesn’t have to be particularly robust.
Another issue is that of drug interactions and side effects. Supplements are active substances and can interact with your prescription pills just the way regular pharmaceuticals do. And yet, one in six people who take prescription drugs also take at least one dietary supplement. To get into trouble you don’t even have to go as far as the futurist Ray Kurzweil, the very same one who downs metformin to boost his longevity, who takes about ninety other pills a day, including green tea extract, echinacea, and gentian root. Two wrong substances mixed together can be enough to cause problems. St. John’s wort, for example, can cause interactions with high blood pressure medications and with oral contraceptives.
Large, dangerous doses are also a common problem—both with herbal supplements and vitamins. Some toxic substances are basically poisons at high dosages yet beneficial to health in small quantities. This effect, known as hormesis, applies, for instance, to many phytochemicals, compounds that plants produce in order to kill or deter pests. Examples of phytochemicals likely known to many nutrition buffs include glucosinolates (behind the health benefits of broccoli) and tannins (red wine). Although it’s basically impossible to overdose on broccoli due to the physical limits of your stomach—I challenge you to eat more than two or three heads—phytochemicals found in supplements are another story. Some green tea pills sold online in the US, for example, contain a minimum of 274 milligrams of phytochemicals called catechins per pill. The label says you should take three of these a day, which would bring you to a dosage exceeding what the European Food Safety Authority considers a liver damage risk.
Same thing goes for vitamin pills. High doses of vitamin C have been linked to renal failure, and high doses of vitamin E to cancer. According to meta-analyses of studies, taking 400 IU or more of vitamin E per day can actually shorten your life, and so can beta-carotene supplements and vitamin A. Multivitamins aren’t much better, either. In a study of over eighty thousand American physicians, those who took multivitamin pills had a 7 percent higher risk of dying from cardiovascular disease than those who didn’t go for such supplements.
One reason for the damaging effects of vitamins may lie in the tricky workings of antioxidants in our bodies. Although often touted as quasi-miraculous substances that can
wipe up dangerous free radicals and prevent aging, in reality the antioxidants that we swallow as supplements have much less rosy effects on our cells. More and more research suggests that free radicals are an important part of the body’s repair mechanisms (that’s why exercise is good for you—it produces free radicals). If you dump too many antioxidants in a purified form into your cells, they may end up disrupting these important repair processes. What’s more, they can actually protect cancer cells from free radicals that are trying to get rid of the intruders. Just to be clear: this does not mean that antioxidants found in whole foods are bad for you. On the contrary. The reason for this goes back once again to the difference between mixtures of various naturally occurring compounds interacting with each other to your benefit (as in a carrot) versus purified components (vitamin pills).
If whole foods are much better for longevity than are supplements, maybe superfoods are super-good at boosting health? I decided to check it out. I ventured to a French equivalent of Whole Foods, Naturalia, about a twenty-minute drive from my house, taking with me a long list of supposedly extraordinary products advertised on blogs and in health magazines as superfoods. After spending far more money than I care to admit, I came home with a bag full of goodies. The next day was my superfoods day. For breakfast I whipped myself an organic Greek yoghurt with mixed berries, oats, and a generous sprinkling of goji berries, plus a cup of matcha and a glass of kombucha (fermented tea). Lunch was a kale and spinach smoothie with freshly pressed orange juice, fresh ginger, turmeric, and baobab powder. I also made myself a whole-wheat bread sandwich with chia seeds and ground flaxseed, topped with avocado and heirloom yellow tomatoes. I sipped some more matcha. For a snack, I had a beet and carrot smoothie with açaí berry juice plus two squares of dark chocolate—raw, of course. Dinner was Tuscan white bean soup with organic whole wheat pasta. And more kombucha. I was either going to turn into a superwoman or end up with a super-upset stomach.
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