The Longevity Paradox: How to Die Young at a Ripe Old Age

In Loma Linda, California—one of the world’s best-known “Blue Zones”—I had encountered many healthy centenarians. Nevertheless, I was singularly unprepared to meet Edith. She exemplified a seeming paradox: chronological old age wrapped up in an implausibly youthful, vital physical form.

Edith told me she had attended one of my recent speaking engagements and that I reminded her of someone else she’d heard speak about nutrition more than seventy years ago, when she was just 20 years old. That person was the nutritionist Gayelord Hauser, whose advice she’d been following to the letter ever since. She’d bought and read each of his books, adopted his dietary protocol, and stuck to her guns even when her husbands (she buried two in her time, including one who was a doctor) had told her she was crazy. After a lifetime of following Hauser’s advice, she was still fit as a fiddle.

I couldn’t believe my good fortune in meeting her. I peppered her with questions, wanting to know more about what exactly she’d learned from Hauser and how she’d maintained her health and vitality for so many years. Though I became her doctor and remained so until the day she passed, I can say for certain that I learned more from her than she learned from me. She showed me that the longevity paradox I’d imagined—the ability to die young at a ripe old age—was indeed a possibility that was available to us all.

As I gained more insight into Edith’s (and, by extension, Hauser’s) nutritional practices, I took a deep dive into the research of longevity and discovered another paradox that defines aging—that nonhuman ancient genes actually have the power to keep us young. How is this possible? Buckle up—we’re about to embark on quite an adventure.

In The Plant Paradox, I asked you to hop into an imaginary time machine and take a journey with me back 450 million years, to a time when plants were the only life-forms on Earth. They ruled the land for about 90 million years until insects showed up and started eating them. That was a tough time for the plants, but they were not about to go down without a fight. Plants are amazing organisms that can transform sunlight into matter, a feat we have yet to master. They weren’t going to let a little thing like the sudden appearance of millions of tiny predators stop them from growing and reproducing, so they developed complex defense mechanisms to protect themselves. These included chemical compounds that poisoned, paralyzed, or entrapped their predators and others that made them sick or disoriented. In The Plant Paradox, I argued that many of the health crises we humans are facing today are a result of unwittingly consuming those plant compounds. (If you haven’t read that book, don’t worry—it’s not a prerequisite to reading and understanding anything and everything that follows here!)

Now I want you to climb into a new time machine with me and go back even further, to a time long before even plants existed: about 3 billion years ago.

We would find ourselves in a vast empty space where the only living things are bacteria and other single cells that can grow and divide without oxygen. In fact, as hard as it is to believe, oxygen is often deadly to these single-celled organisms. As a prelude to something you’ll read more about later, these organisms could thrive on what we consider a toxic gas called hydrogen sulfide. But something important is happening in the atmosphere: oxygen levels are rising. These bacteria evolved in an anaerobic (oxygen-free) environment. To them, oxygen is lethal, and the world is suddenly becoming a very dangerous place.

Like all living things, these bacteria, which belong to the class of organisms called prokaryotes, have a biological imperative to survive and pass on their DNA, so they come up with a very clever plan to protect themselves in this hostile new environment. They hop inside other single-celled organisms and make a deal that will dramatically change the course of life on Earth. In exchange for food and a stable, protected home, the bacteria will give their host cell extra energy to fuel its functions and survival. It was that arrangement that resulted in the advanced cells, called eukaryotes, which constitute the cells of algae, fungi, plants, and all animals, including you and me.

Now let’s get back into our time machine and zoom forward to the twenty-first century. What if I told you that in the present day, these engulfed bacteria still reside in your cells? As the saying goes, truth is often stranger than fiction. The engulfed bacteria are called mitochondria, and their job is to use the oxygen you breathe and the calories you eat to create energy for all of your cells. But not every type of bacteria made the same deal with those single cells all those billions of years ago. So what happened to the rest of them? As the bacteria in the cells created energy and enabled them to evolve into increasingly more complex creatures, oxygen levels in the atmosphere continued to rise. The remaining bacteria escaped the deadly oxygen by moving into the animals’ colons, which resembled the anaerobic environment in which they’d thrived for billions of years.

Would it be too “out there” to suggest that bacteria actually created animals, including humans, so they could avoid oxygen and live safely on Earth? And talk about “out there”; suppose I told you that the bacteria in your gut keep in close contact with their relatives, the mitochondria inside your cells, in order to communicate with them about how things are going on the “other side”? We’ll discuss all of this and more in the pages that follow.

Now, you may be asking yourself, what does any of this have to do with longevity? In a word, everything. Because as your bacteria’s home, what happens to you depends on what happens to them. It may be hard at first to accept the fact that your fate is in the hands of the trillions of bacteria that live inside, on, and around you. Here’s the thing: you’re not actually who you think you are. The real you—or, more accurately, the whole you—includes all those bacteria, and the “you” that you are familiar with is actually only a small part of the whole. In fact, 90 percent of “your” cells are not actually human cells at all. They are the cells of bacteria, viruses, fungi, and worms that live on you and inside you, commonly referred to as the microbiome, or as you astute Plant Paradox readers know, your holobiome.

So your longevity is paradoxically tied to the fate of these ancient organisms—the oldest parts of you have the power to help keep you young. It all goes back to the bacteria’s need to survive and pass on their DNA. Your body is essentially a condominium for your microbiome or, as I like to call them, your bugs. You are their home. And as you’ll soon learn, if you provide a nice, hospitable home for them, they will be exceptionally good tenants. They’ll keep the utilities running efficiently, the plumbing in tip-top shape, and even the exterior paint fresh. On the other hand, if you feed them foods they do not thrive on, allow squatters to move in and take over, and let the foundation rot, they’ll give up and let the rest of you decay right along with it. Our relationship with our bugs has always been, and continues to be, symbiotic; in other words, their health is dependent on you and vice versa. You take care of them, and they’ll take care of you—for the long term.

In addition to being made up of 90 percent foreign cells, we humans are comprised mostly of foreign genes. Believe it or not, 99 percent of all the genes that make up “you” are bacterial, viral, and protozoal genes, not human genes at all. Humans actually have very few genes, and the ones we do have are virtually identical to those in our primate cousins, chimps and gorillas. In fact, the popcorn you may be eating as you read this (that was a test; you wouldn’t dare eat corn after reading The Plant Paradox, would you?) has 32,000 genes, while you have a measly 20,000.1 How can that be? you say. Corn has more genes than we do? We’re so much more complex than a dumb plant! Okay, fine, maybe corn’s got us beat, but surely we have the most genes of any animal, right? Wrong! The water flea, Daphnia, has the most genes of any animal, coming in right behind corn at 31,000.2

If we humans have so few genes, how did we become so complex? What makes us different from other animals? In a word: bacteria. When humans evolved, our bacteria changed, and it was our bacteria, rather than our genes, that made us human.3 As shocking as it may seem, most of what has happened to us, and what will continue to happen to us in the future, is determined by the state of the bacteria in our gut, mouth, and skin. So let’s stop focusing on taking care of the 1 percent and start paying closer attention to the 99 percent of the genes that make up you.

You might be feeling a little bit uncomfortable with the idea that we don’t have full control over our own bodies. But in actuality, the opposite is true. When we learn how to be a good host to our microbes, we can gain a lot of control over how well we will age and how long we will live. Your fate does not lie in your genes at all—it lies in your microbiome, and many of your daily decisions about food and personal care products influence how happy or unhappy they will be in their home. Paradoxically—and here’s the point to remember going forward—whatever happened to your parents or grandparents, your Ancestry.com or your 23andMe results contribute very, very little to your fate and longevity. Much more of your fate resides with the trillions of organisms living in and on you.

Those microbes have invested a great deal in their condo—they want it to stay in good shape for a long time. Their survival literally depends on you, and yours on them. We know this from experiments with germ-free mice (which are born without contact with the bacteria that would normally populate their gut), which live shorter lives and are more susceptible to disease than mice with normal bacteria, because without communication from those germs, their immune systems never develop properly.4 Your microbes (or “gut buddies,” as I like to call them) are there to help you. You are in the driver’s seat of your health and longevity if, and only if, and when, and only when, you give over your fate to them—the other you, or the unseen you within.

In the following pages, I’m going to give you a complete guide to the care and feeding of your gut buddies. In fact, I’m going to give you a veritable Google Maps tour of the entire neighborhood that your holobiome inhabits. The problem is that, like all neighborhoods, yours has its share of bad guys. And if you’ve been following a standard Western diet and lifestyle, chances are that those bad guys have taken over. They’ve broken down the all-important gut border wall that separates your other inhabitants from you, put their own needs first, hijacked the supply lines, and deprived your human cells of food and critical information to keep things humming along. And your poor gut buddies, with danger lurking on the streets, have gone into hiding.

But here’s the good news: if you starve out the bad guys and throw the good guys a lifeline, the good guys will reemerge, reinforce the border, and revitalize the neighborhood. What’s more, those good bacteria will start asking you for more of what they need to succeed.

Your gut bacteria are not only largely in charge of your health and how well you age—they also influence your behavior. With the mapping of the human microbiome in 2017, we’ve discovered that complex animals such as humans, who have fewer genes than plants and fleas, have uploaded most of their information processing to what I like to think of as our “bacterial cloud,” which has vast computing power over our fate and health. Since this genome has so many genes and divides and reproduces incredibly rapidly, your holobiome has immense power to tell “you,” your immune system, and the organelles in your cells how things are going in the outside world. Though the genome of a bacterium is only one-tenth of a human cell’s genome, National Institutes of Health (NIH) researchers recently showed that the microbiome contributes 8 million unique genes to human bodies. This means there are 360 times as many bacterial genes as human genes within you or me!5 Since bacteria replicate (divide) so quickly and have that much genetic “computing power,” our gut buddies are capable of almost instantaneous information processing and communicating, even to the point of influencing our thoughts and actions.

I’ve been gratified and a little amused through the years when my junk-food addicts or meat-and-potatoes guys come back to see me after a couple of months on my Longevity Paradox program and tell me that they’ve started to crave salads and other green things. They are shocked by their own behavior, which is now being remotely manipulated by a new set of microbes, their gut buddies, which are sending a loud and clear message to take care of their home. You will see this principle in action throughout this book: give your gut buddies what they want, and they will return the favor.6 Best of all, the bad bugs that are responsible for your junk-food cravings will leave the building and finally stop torturing you.

Now, perhaps you’re thinking, how is it possible that bad bugs have taken over if humans are living longer, healthier lives than ever before? Not so fast. There are a lot of misconceptions about aging that we will soon address, and the first and foremost is that we’re doing better than ever in terms of longevity. Yes, the average life expectancy has increased over the last five decades. In 1960, the average life expectancy of American men was 66.4 years; by 2013, it was a full ten years longer.7 For women, the average ages were 73.1 and 81.1, respectively. But much of this extended life span can be attributed to the fact that we’ve developed vaccines, antibiotics, and hygiene protocols to beat the main causes of a shortened average life span, namely infectious diseases that disproportionately affected young children. Perhaps we’ve come to an end in terms of what modern advances can accomplish. Sadly, life expectancy has now declined for the last three years!8 And never forget, people have lived into very old age since recorded time. One of my favorite documented cases is that of Luigi Cornaro, whose treatise How to Live 100 Years, or Discourses on the Sober Life chronicled his 102 years of living in the 1400s and 1500s! (And never fear; his “sober” life included a prescription for a daily ration of 500 milliliters—about two-thirds of a bottle—of red wine.)

Today we’re starting to see both a decreasing life span and a horribly reduced health span, the length of time people maintain full function. Most people now see their health begin to decline at age 50.9 Yet we’ve gotten very good at extending our life span with a host of medical procedures, drugs, and treatments. So we’re living longer, but we’re not living better. This, dear reader, is another paradox of aging, and it’s probably why you picked up this book. This paradox has become so pervasive that many of us assume we’re meant to spend the second half of our lives in a state of steady decline. We think it’s somehow normal to be on several prescription medications, undergo invasive surgeries, and require joint replacements. In many cases, we even plan ahead for it—moving our bedrooms to the first floor of our homes as a preemptive measure even when we can still climb the stairs, for example, as if there were some sort of deadline on stair climbing! Tell that to the Sardinians, who regularly live to over 100 and climb the hilly pastures until their final days.

As a heart surgeon, I have done my part to extend the lives of tens of thousands of individuals. I’m proud of the fact that I’ve helped so many people live longer lives, but I quit my job as professor and head of cardiothoracic surgery at Loma Linda University School of Medicine when I learned that much of what I’d been taught about health and longevity—information that many leading doctors still believe is true—was simply wrong.

For the past nineteen years, I’ve been treating my patients with a combination of nutritional therapy and conventional medicine, and over and over I’ve seen incredible results. When my patients treat their gut buddies right, they are able to dramatically increase their life spans. As my patients and regular readers know, I’ve seen dramatic reversals of diseases that many doctors still believe are irreversible, changes that we can track with sophisticated blood work and that my patients can feel and see. Many of these changes are directly linked to alterations we’ve made to their gut bacteria.10^,11

Between the results I’ve observed in my patients, my analysis of an enormous amount of recent research on the gut biome, and my own studies of the world’s longest-lived communities, I now know that your gut bacteria to a great extent influence both how long you’ll live and how well you’ll live. And with the help of my amazing patients, I’ve put together a program that will drive out the bad guys and make the good guys feel safe and happy in their home so they’ll be compelled to completely revitalize their neighborhood both inside and out.

Some elements of the Longevity Paradox program may be familiar, such as eating lots of certain vegetables and getting the right amounts of exercise and sleep, while others, such as tricking your body into thinking it’s winter year-round to stimulate your stem cells and spacing out your meals to “wash” your brain at night, are brand-new. These strategies have helped my patients lower their blood pressure and cholesterol markers, significantly reduce symptoms of arthritis and other joint issues, resolve MS, lupus, and other autoimmune conditions, improve heart health, and slow or reverse the progression of cancer and dementia—not to mention lose weight and look decades younger! And they accomplish this without starving, eating twigs, counting calories, or putting in hours at the gym.

It doesn’t matter how old you are, how old you feel, or how sick or healthy you may be right now. As on all of the best home-makeover shows, renovations happen quickly when the people in charge have the right materials and are motivated to get the job done. If you follow my plan, within just a few weeks you’ll have more gut buddies and far fewer squatters, and you’ll start to see and feel a difference in your energy levels, in your lack of symptoms of many of the most common diseases of aging, on your skin, and on the scale.

So let’s start transforming your body into the most desirable oceanfront suite on the market for your gut bacteria. They’ll be sure to thank you with a long and healthy life.