Category Archives: Longevity

Male Versus Female Longevity

Working on powerlines is dangerous and it’s mostly men who do it.
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Jim Goad is one of my favorite living cultural commentators. On par with a young P. J. O’Rourke, who died in 2022 at age 74. Last year Goad wrote a thoughtful and thought-provoking article on why women outlive men. A sample:

This disparity is not exclusive to the United States. In fact, it’s worse elsewhere. Worldwide, women outlive men by an average of seven years. According to a 2001 report, the only five countries on Earth where men outlived women were the flea-bitten open-air latrines we call Afghanistan, Nepal, Papua New Guinea, Namibia, and Zimbabwe. But a report from 2017 says there’s no longer any country on the planet where men outlive women.

It wasn’t always this way.

According to data from developed countries, men lived longer than women throughout most of the 1800s, only for the longevity stats to tip in favor of females during the 1890s — an advantage that women have held ever since. Women are supposedly more vulnerable than men to infectious diseases, but once male scientists got a grip on the microbes and brought those pesky critters to heel, women started living longer than men.

As far as I know, women have never thanked men for it.

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For another example of Goad’s work, check out his valentine, Why I Never Gave Up On Women.


  Steve Parker, M.D.

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10,000 Steps a Day: C’mon, Man! Is That Really Necessary?

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For perhaps 15-20 years, many health experts have recommended you walk 10,000 steps/day as important for maximizing your health and longevity. Depending on your stride length, that’s roughly 5 miles (8 km). When I walk my dogs 4 miles, it takes about 90 minutes, which is a big time commitment. Frankly, it’s often boring. But not for the dogs. So many fascinating odors!

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The good news is, you don’t need to walk the 10,000 steps in one fell swoop. Your walking around your residence and workplace throughout the day counts, too.

More good news. If you’re an older woman, maybe 4,400 steps/day is enough for a longevity benefit. In other populations studied, 6,000 to 8,000 steps/day was optimal.

I admitted a patient to the hospital a few days ago who told me her health insurer sends her a small check monthly if she meets their step goal. She’s saving them money via lower healthcare expenditures, and they’re sharing with her. I love it!

  Steve Parker, M.D.

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Which Diet (way of eating) Is Best for Health and Longevity?

Proper diet undoubtedly promotes healthier aging and longevity. But what’s the right diet? A meta-analysis diet studies proposes an answer. Or more accurately, answers, based on diet-related biomarkers linked to disease and aging. Half of the studies were done in Europe, the rest from North America and Asia. The February, 2023, article was published in Nutrients. You can read the entire article online.

“….the main goal of this systematic review was to perceive the quantity and quality of different diets or aspects in nutrition, how they could modulate biomarkers and prevent aging-related diseases, in order to enlighten new intervention strategies. Biomarkers that are linked to aging-associated metabolism, inflammation processes, cognitive decline, and telomere attrition were scrutinized in order to understand how these mechanisms could actually influence healthy aging. Moreover, it could provide information to future health professionals.”

The researchers conclusions:

“In conclusion, this systematic review demonstrated the necessity for individuals to improve their diets, to reduce the emergence and development of several comorbidities and promote healthy aging. Diets rich in vegetables, fruits, nuts, cereals, fibers, fish, unsaturated fats, containing antioxidants, vitamins, potassium, omega-3—and reducing red meat and ultra-processed food intake—could prevent obesity, CVD [cardiovascular disease], and inflammation, and promote favorable glycemic, insulinemic, and lipidemic responses. Moreover, the Mediterranean diet and ketogenic diet, or a combination of these diets (MMKD), and increasing consumption of vegetables and green tea catechins, could improve one‘s working memory and decrease destabilization of the brain network and the attention domain, preventing cognitive decline. Finally, the Mediterranean diet, supplemented with CoQ or virgin olive oil, or a low-fat diet, also rich in antioxidants, could help to decrease the prevalence of atherothrombosis [arterial blood clots], hepatic steatosis, diabetes, and telomere attrition, as well as prevent oxidative and DNA damage. These diets can enhance one‘s quality of life and increase life expectancy. Moreover, a putative panel of molecular markers would follow the impact of diet/nutrition alterations during aging.”

The biomarkers tested included C-reactive protein, telomere length, HOMA-IR (insulin resistance), cholesterols, fibrinogen, platelet activating factor acetylhydrolase in HDLs, glucose, white blood cells, apolipoproteins, adiponectin, leptin, visceral adiposity index, etc.

Diets mentioned in the article include DASH, modified Alternative Healthy Eating Index, Southern European Atlantic (SEAD), Baltic Sea (a Nordic alternative to the Mediterranean diet), Mediterranean, and ketogenic Mediterranean.

This article is pretty dense reading. For science nerds only!

I was gratified to see several mentions of the ketogenic Mediterranean diet. It deserves more attention from the general public.

Steve Parker, M.D.

PS: If you have my Advanced Mediterranean Diet (2nd edition), you already have the Ketogenic Mediterranean Diet. It’s there in addition to the traditional Mediterranean diet.

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U.S. Life Span Falling Behind Our Peer Countries

From NPR:

The average life expectancy for Americans shortened by over seven months [in 2021], according to new data from the Centers for Disease Control and Prevention.

That decrease follows an already big decline of 1.8 years in 2020. As a result, the expected life span of someone born in the U.S. is now 76.4 years — the shortest it has been in nearly two decades.

But we still have the best healthcare system in the world, right? Not if you judge it by life expectancy. From Health System Tracker:

Life expectancy in the U.S. and peer countries generally increased from 1980-2019, but decreased in most countries in 2020 due to COVID-19. From 2020 to 2021, life expectancy at birth began to rebound in most comparable countries while it continued to decline in the U.S. The CDC estimates life expectancy at birth in the U.S. decreased to 76.1 years in 2021, down 2.7 years from 78.8 years in 2019 and down 0.9 years from 2020. The average life expectancy at birth among comparable countries was 82.4 years in 2021, down 0.2 years from 2019 and up 0.4 years from 2020. 

Click the article links for potential explanations.

Steve Parker, M.D.

PS: Healthy diet, exercise, and weight management improve longevity. Let me help.

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Euthanasia Soon to Be A Leading Cause of Death in Canada?

From DailyMail:

Last year, more than 10,000 people in Canada – astonishingly that’s over three percent of all deaths there – ended their lives via euthanasia, an increase of a third on the previous year. And it’s likely to keep rising: next year, Canada is set to allow people to die exclusively for mental health reasons.

Only last week, a jaw-dropping story emerged of how, five years into an infuriating battle to obtain a stairlift for her home, Canadian army veteran and Paralympian Christine Gauthier was offered an extraordinary alternative.

A Canadian official told her in 2019 that if her life was so difficult and she so ‘desperate’, the government would help her to kill herself. ‘I have a letter saying that if you’re so desperate, madam, we can offer you MAiD, medical assistance in dying,’ the paraplegic ex-army corporal testified to Canadian MP


God gave me life. It’s up to God, not me, when it’s over. Over 40 years of practicing medicine, I’ve never had an patient ask me to “put them down,” like we would a cherished pet that was suffering during impending death.

Steve Parker, M.D.

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Two Dietitians Wonder What’s the Healthiest Way of Eating

A couple of dietitians did an massive literature review looking for evidence that diet has an effect on major health conditions such as obesity, diabetes, and cardiovascular disease. Sounds interesting, and similar to my own obsessive review done between 1995 and 2005. It bothers me that “hypertension” is misspelled in the abstract. For the researchers’ conclusions, you have to pay $27.95 USD.

Abstract from the Journal of the Academy of Nutrition and Dietetics:

Appropriate diet can prevent, manage, or reverse noncommunicable health conditions such as obesity, cardiovascular disease, and diabetes. Consequently, the public’s interest in diet and nutrition has fueled the multi-billion-dollar weight loss industry and elevated its standing on social media and the internet. Although many dietary approaches are popular, their universal effectiveness and risks across overall populations are not clear. The objective of this scoping review was to identify and characterize systematic reviews (SRs) examining diet or fasting (intermittent energy restriction [IER]) interventions among adults who are healthy or may have chronic disease. An in-depth literature search of six databases was conducted for SRs published between January 2010 and February 2020. A total of 22,385 SRs were retrieved, and 1,017 full-text articles were screened for eligibility. Of these, 92 SRs met inclusion criteria. Covered diets were organized into 12 categories: high/restricted carbohydrate (n = 30), Mediterranean, Nordic, and Tibetan (n = 19), restricted or modified fat (n = 17), various vegetarian diets (n = 16), glycemic index (n = 13), high protein (n = 12), IER (n = 11), meal replacements (n = 11), paleolithic (n = 8), Dietary Approaches to Stop Hypretension (DASH; n = 6), Atkins, South Beach, and Zone (n = 5), and eight other brand diets (n = 4). Intermediate outcomes, such as body weight or composition and cardiometabolic, were commonly reported. Abundant evidence was found exploring dietary approaches in the general population. However, heterogeneity of diet definitions, focus on single macronutrients, and infrequent macronutrient subanalyses were observed. Based on this scoping review, the Evidence Analysis Center prioritized the need to collate evidence related to macronutrient modification, specifically restricted carbohydrate diets.


Steve Parker, M.D.

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Dietitian Questions Healthfulness of the Mediterranean Diet

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Shana Spence, RD, wrote at Self.com:

The Mediterranean diet is constantly lauded in the nutrition world—in fact, U.S. News has named it the “best diet overall” for five years straight—but as a registered dietitian, I think it’s time to think about it a little differently: It’s time to dethrone the Mediterranean diet as being the very best way to eat.

Now, the Mediterranean diet—which emphasizes whole grains and plant foods such as fruits, vegetables, legumes, tree nuts, seeds, and olives, and limits red meat, sugar, and saturated fat—is not the only culturally based way of eating that’s been celebrated. The Japanese diet, rich in foods such as seafood, steamed rice, tofu, natto, seaweed, and pickled fruits and vegetables, has been promoted for its longevity-promoting aspects as well. But as scrolling through social media or even many news and health websites will show, it still doesn’t come close to the Mediterranean diet in terms of widespread recognition.

As an RD, I’ve noticed an overwhelming belief in our society that eating Mediterranean-style is just the way to go. So if your cultural foods don’t hail from one of the countries that make up that area, how does this make you feel?

Spoiler: Probably not so good—and that’s why I believe we need to rethink how we talk about cultural foods and ways of eating.


You know I’m a Mediterranean diet advocate. There are other healthy ways of eating. I’m an advocate of free speech and open debate. No censorship here! Read it and see what you think. I’m not sure what the “Japanese diet” is. I’ve written good things about the Okinawan diet as discussed in Dan Buettner’s Blue Zones books. Click for my review of Blue Zones.

Steve Parker, M.D.

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“Cellular Exercise” May Promote Longevity

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London researchers introduce the concept of “cellular exercise.”

Nutritional discipline and dietary restriction result in resistance exercise for our cells. Triggered by calorie restriction or physical exercise, our cells end up producing transcription factors that lead to protection against oxidation, inflammation, atherosclerosis, and carcinogenic proliferation. In the long-term, this results in longevity and a decrease in cancer, T2DM [type 2 diabetes], myocardial infarction, and stroke. Since centuries past, studies on humans, rhesus monkeys, and multilevel organisms have demonstrated the benefits of calorie restriction without malnutrition. Periodic fasting and calorie restriction show increases in regeneration markers and decreases in biomarkers for diabetes, CVD [cardiovascular disease], cancer, and aging.

The present review concluded that longevity can be increased through moderation of diet and exercise. Research shows that a concoction of the diverse diets modernly popularized— MED [Mediterranean], DASH, high-protein diets±—tempered by overall calorie restriction through periodic fasting or chronic calorie restriction, will provide protection against CVD, cancer, and aging. Exercise has also been shown to increase longevity in the general population, lower incidence of diabetes and cancer, and produce psychological benefits.

This review of research indicates that incorporating a moderate caloric restriction or fasting regimen could provide substantial benefits at low risk. Cellular exercise through calorie restriction and physical exercise can increase longevity and prevent the greatest killers of human society today—stroke and heart disease.


Caloric restriction is a form of hormesis. If interested, read more about it in free article from Journal of Physiological Anthropology.

Steve Parker, M.D.

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Leafy Greens Can Kill You!

Not sure if this is chicken or tuna salad with walnuts and grapes

Periodically there are outbreaks of illness caused by eating contaminated leafy greens. The contaminants are usually bacteria such as E coli and Salmonella. The illness is typically diarrhea, sometimes with belly cramps, nausea, and vomiting. And rare deaths.

Cathe Friedrich published an interesting article about this phenomenon. Here are a few bullet points (I haven’t independently verified):

  • Leafy greens such as lettuce are linked to 22% of food poisoning outbreaks over over the last 10 years
  • The riskiest leafy green is bagged, ready-to-serve lettuce

A few ways to avoid foodborne illness:

  • Avoid pre-packaged leafy greens
  • Avoid sprouts
  • Keep the produce refrigerated and dry
  • Consume before the expiration date

Click for leafy green food safety tips from the Canadian government.

Click for a harrowing story at Consumer Reports about E coli poisoning from romaine lettuce.

Consumer Reports article on the safest ways to eat salad.

Steve Parker, M.D.

h/t Jan at The Low Carb Diabetic

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Mediterranean Diet Reduces Cardiovascular and All-Cause Mortality

Caprese salad: mozzarella cheese, tomatoes, basil, extra virgin olive oil

Folks with diabetes have higher-than-average risk of dying from cardiovascular disease, such as heart attacks and strokes. So it’s good to know about dietary habits that enhance longevity.

Article

ABSTRACT

Background

Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and CVD [cardiovascular disease] mortality.

Objective

To examine the association between three diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality and non-fatal CVD events up to 19 years later.Design

Data on 10,009 adults (51.8 years; 52% female) from the Australian Diabetes, Obesity and Lifestyle study were used. A food frequency questionnaire was used to calculate DGI, DII and MIND at baseline. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% CI of all-cause mortality, CVD mortality and non-fatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status.Results

Deaths due to all-cause (n = 1,955) and CVD (n = 520), and non-fatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4 and 9.6 years, respectively. For all-cause mortality, HRs associated with higher DGI, DII and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15) and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24) and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and non-fatal CVD events.Conclusions

Better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, while a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean style diet and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.


Steve Parker, M.D.

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Filed under coronary heart disease, Health Benefits, Heart Disease, Longevity, Mediterranean Diet, Stroke