Return to Africa

I’m flying to Africa next week with other family members. A total of 15 of us are going to revisit family connections from the past sixty years. We will be in Zimbabwe June 7-12 and Ethiopia June 12-17, 2018. It will be a trip filled with wonderful experiences as we rekindle many family memories.

I’m starting the newsletter with this announcement so you can follow us through my blog if you wish to do so. You may learn some fascinating things about Africa as well as about my family.

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Now, on to the wellness topic of the month.

The Longevity Diet

The Longevity Diet is a book by Dr. Valter Longo, published this year in the USA, but first published in Italy in 2016. Dr. Longo came to the United States from Italy as a guitar-playing teenager who majored in music with dreams of becoming a rock star. Yet he also wanted to learn the secrets of longevity because of his admiration for an aged grandfather. In college, he switched from music studies to become a science major. Thirty years later, he still plays the guitar, but his work as director of the University of Southern California (USC) Longevity Institute remains his great passion. He also leads the program on Longevity and Cancer at the Molecular Oncology FIRC Institute in Milan, Italy, where he combines studies of centenarians with research and epidemiological studies.

Dr. Longo makes it clear that it’s not simply longevity that motivates him and his work. What drives him is the goal of staying vibrant and youthful beyond the usual life expectancy. It’s more than adding years to life; it’s about making our lives vibrant throughout. That really resonated with me. It’s why I’m so passionate about healthy living.

During his three decades of research, Dr. Longo found that our bodies have an innate ability to regenerate their health at the cellular and molecular levels, but that constant consumption of the modern diet keeps these built-in mechanisms switched off, making us “prematurely vulnerable to disease and degeneration beginning in our thirties and forties.” With a focus on yeast cells in his lab, he learned that sugar activates two genes (RAS and PKA) that accelerate aging. It also inactivates factors in the cell that protect the cell against oxidation. Its overall impact is to make yeast cells age fast and die early. Yeast cells fed sugar die twice as fast as yeast given only water. It took over 20 years of additional research to show that the age-accelerating impact of sugar held true for more complex organisms like mice and probably humans. Other nutrients such as excess amino acids also have a premature aging impact.

His striking discovery was that the “health switch” can be turned back on rather easily. He writes that the difficult part has been to figure out a way to do this that is feasible and safe for everyone. Much of his book is about his research on how to do this.

The Fasting-Mimicking Diet (FMD)

Scientists have known for almost a century that laboratory mice fed a calorie-restricted diet live up to a third longer than the average mouse. This was found to be true for other animal species also. There have been hints that this might hold true for humans. Dr. Longo resolved to find out why calorie restriction worked at a cellular level. He then wanted to learn how to make such processes work in an acceptable way in humans.

Valter Longo_ PhD

Valter Longo_ PhD

Years of research on the effects of major calorie restriction and fasting in species ranging from yeast to mice helped Dr. Longo learn the answer to the first part of the puzzle. Severe calorie restriction initiated a process to take out damaged cells and/or damaged parts within cells. At the same time, it activated stem cells to stimulate regeneration of tissues and organ systems. The newly regenerated cells had all the characteristics of younger, more functional cells. This was why mice put on diets that restricted calorie intake had more youthful characteristics and lived significantly longer than normal mice.

The problem remained: Did this process happen in humans, and if so, was there a way to apply it to them in an acceptable way? His answer is yes on both counts. He found that fasts lasting from three to seven days started this healing process, and that repeated bursts of fasting made it effective for longer terms. Yet, humans don’t like to go on such fasting spells, and for many, it wouldn’t be safe to do so without expert supervision. Dr. Longo’s solution was to develop the 5-day fasting-mimicking diet (FMD).

This diet limits calorie intake to 800 calories a day, evenly divided between highly nutritious veggies and healthy fats (nuts and olive oil,) along with a multivitamin-mineral supplement and an omega-3/omega-6 supplement. The FMD plan excludes highly processed food and reduces calorie intake enough to initiate the healing process, but includes enough nutritious calories to be safe for healthy adults. It should not be tried by pregnant women, active athletes, or anyone ill or on medication.

The phrase “Intermittent Fasting” has been used by the media to characterize this type of approach to weight control and better health. Dr. Longo does not like this popularized phrase because it suggests that any kind of short intermittent fasting works. He says this is not a safe or effective way to approach fasting. He strongly recommends having a doctor’s approval and supervision with fasting if there is any kind of health or medical issue involved.

Many healthy adults find it hard to follow the FMD plan guidelines. Because of this, Longo developed a nutritious product he named ProLon. It incorporates all the food values of the FMD plan without the need for any other food or supplement intake. It removes all guess-work and provides all the nourishment a person needs while following a 3-day, 5-day, or 7-day FMD plan. A person should resume their normal diet after being on the FMD.

How often should a person go on the FMD? Ideally, this decision should be made jointly with a doctor or registered dietitian familiar with the FMD. Longo’s broad guidelines range from once a month for overweight patients who have two or more risk factors for diabetes or heart disease, to once every six months for healthy patients who follow an ideal diet regularly and who engage in regular physical activity. He has developed the “Longevity Diet” for people to follow who don’t have an ideal diet. In some ways, his longevity diet is similar to a Mediterranean diet. He says it’s an easy diet for most people to adopt.

There is much more in Longo’s book, but this summarizes his major themes. He goes on with more chapters in the book on the use and benefits of FMD in specific disease categories, including diabetes, cardiovascular disease, cancer, Alzheimer’s disease, and a number of inflammatory and autoimmune diseases. There are ongoing clinical trials for most of these diseases that show promising results, but patients should only get involved with these trials with the approval of their doctors. His last chapter, titled “How to Stay Young,” summarizes the results of his research in a few short pages.

My View of FMDs and The Longevity Diet

I approached this book with considerable skepticism. The concept of a fasting-mimicking diet seemed gimmicky to me, and the fact that a commercial product (ProLon) was promoted as a way to implement the FMD made me even more skeptical. When authors use their books to promote a commercial product they’ve developed, this sends cautionary flags flying in my mind’s eye. (To Dr. Longo’s credit, he makes it clear that he derives no personal profit from the sales of ProLon or from his book. All profits and royalties go to the Create Cures Foundation and to other non-profit research institutes.)

By the time I finished his book, Longo had convinced me of the value of his plan. He is a research scientist, not a medical doctor. He describes his careful scientific approach to the subject clearly, and his conclusions are well supported by his data. It took many years to develop all this data and to convince other scientists of their value. Many initially skeptical scientists became supportive colleagues as more and more labs replicated and confirmed his work. He also buttressed his lab findings with epidemiological field studies that correlated well with the work of other scientists. In recent years he has received a number of awards recognizing him for his research on aging and the biological mechanisms of aging.

My personal conclusion is that his research is solid, and that his periodic fasting-mimicking diet (FMD) and maintenance longevity diet have real value. The FMD is analogous to re-booting a computer that has become sluggish or poorly responsive. Simple re-booting often gets the computer back on track, and that is what the FMD seems to do biologically for human systems that have been thrown off kilter by unhealthy lifestyle patterns and diets. His research shows unequivocally that excess sugar and excess animal protein are very damaging to vital cellular life. The frequency needed for the FMD depends on how far patients stray from healthy lifestyles and eating patterns.

I don’t agree totally with every detail of his prescription for longevity, but my caveats are minor. They do not detract from the solid foundation for healthy living that he has established through his research. He has made major contributions to our understanding of disease and the aging process. I recommend his book and his longevity diet. Potentially, it can have a favorable impact on our unhealthy fast food culture.

Be Well!

Ed Dodge, MD, MPH

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