Even Modest Lifestyle Changes in Middle Age May Significantly Extend Your Life

In How to Reduce the Risk of Sudden Death, I discuss how public health workers tend to work in their own separate domains. The tobacco folks rarely talk to the alcohol, nutrition, or sexual health folks, “with no apparent recognition that, far from being unique and separate, the behaviours they all address comprise a typical Saturday night out for large sectors of the population. This also blinds us to the importance of individual empowerment. We beetle away at micromanaging specific behaviours and ignore the key message emerging from the public health evidence base—that for the first time in human history we now know how we can take a measure of control over our own health and longevity.”

So much control, as addressed in my video Turning the Clock Back 14 Years, that we may be able to effectively turn back the clock 14 years in terms of mortality. But whether the benefits observed in those studies are the result of good, life-long health habits or can be achieved by those who make changes later in life needed to be confirmed.

And it was. “People who newly adopt a healthy lifestyle in middle-age experience a prompt benefit of lower rates of cardiovascular disease and mortality.” Researchers found that a switch in mid-life—that is, in our late 40s to early 60s—to a healthy lifestyle that includes at least five daily servings of fruits and vegetables, maintaining a healthy weight, exercise, and not smoking results in a substantial reduction in mortality over just the next four years. This is surprising not only because the benefit appeared so quickly but also because the lifestyle changes were so modest. The findings emphasize that making the necessary lifestyle changes is extremely worthwhile, and it’s never too late to get with the program.

If we can get such dramatic benefits so late in life and in such short amount of time, why can’t we just live lives of gluttony and sloth, and then just clean up our acts around 50 or so? Because it may be too late: Our first symptom can sometimes be our last.

Sudden cardiac death accounts for more than half of all heart disease deaths. Hundreds of thousands of Americans just drop dead every year. Sudden cardiac death is the first manifestation of heart disease for the majority of individuals, particularly among women, meaning they had no idea they even had heart disease until they were literally dying from it. For many, their first indication of the presence of coronary heart disease is their demise. That’s why prevention is the key.

So, does prevention work? Women who don’t smoke, walk a half-hour a day, aren’t overweight, and eat a prudent diet—defined in the study as greater than average fruit, vegetable, nut, whole grain, and bean consumption—had a 92% lower risk of sudden cardiac death. When it comes to sudden death, an ounce of prevention is truly worth more than a pound of cure, because there is no cure for dead.


Why hasn’t your doctor told you about this? Physicians May Be Missing Their Most Important Tool. The good news is that it’s Never Too Late to Start Eating Healthier.

For more on the field of lifestyle medicine, see:

Some other important videos about life extension:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Chlorella May Help Preserve Immune Function During High Intensity Athletic Training

Sedentary women who start walking briskly on a treadmill for 45 minutes a day for a few months may cut their risk of upper respiratory tract infections in half. How exactly does exercise improve our immune system?

Approximately 95 percent of all infections are initiated at the mucosal surfaces—the moist surfaces, like our eyes, nose, and mouth. These are protected by antibodies like IgA, which provide “an immunological barrier by neutralizing and preventing viral pathogens from penetrating the body through the mucosal surfaces.” The IgA in our saliva, for example, is “the first line of defense against respiratory tract infections such as pneumonia and influenza.” As you can see in my video Preserving Athlete Immunity with Chlorella, moderate aerobic exercise—even just 30 minutes in the gym three times a week—may be all it takes to significantly boost IgA levels and significantly decrease the risk of coming down with flu-like symptoms.

We’ve known for a long time that prolonged heavy exercise, though, may reduce resistance to infectious disease, manifested by an apparent two- to six-fold increase in upper respiratory tract infection symptoms for several weeks following marathon running.

Sport coaches are advised to monitor immune function, since illness could ultimately lead to a decrease in performance. Therefore, it may be necessary to take protective actions to minimize contact with cold viruses, for example. Athletes can’t get away with just washing their hands and wearing a mask, though, because upper respiratory tract infections are often triggered by reactivations of latent viruses already inside our bodies, such as Epstein-Barr virus (EBV). As soon as our immune function dips, the virus becomes reactivated. Researchers found that IgA levels drop the day before EBV comes out of hiding and causes a spike in symptoms. “These results suggest that the appearance of [upper respiratory symptoms] is associated with reactivation of EBV and reduction of [salivary] IgA during training.”

How can we preserve immunity in athletes? In Preserving Immune Function in Athletes with Nutritional Yeast, I discussed the efficacy of using a one-celled fungi—nutritional yeast—to boost the immune systems of athletes. What about a one-celled plant?

Researchers in Japan found that IgA concentrations in breast milk could be increased by giving mothers chlorella, a unicellular, freshwater, green algae sold as powder or compressed into tablets. What about other parts of the body? Thirty tablets of chlorella a day for a month increased IgA secretion in the mouth, too. But does that actually help in a clinically meaningful way? Researchers in Canada tried to see if they could boost the efficacy of flu shots, but a chlorella-derived dietary supplement did not appear to have any effect. They were using some purified extract of chlorella, though, not the real thing.

What about giving it to athletes during training camp? High-intensity physical activity and group living create an environment ripe for infection, and, indeed, the training was so intense IgA levels significantly dropped—but not in those given chlorella each day. So, chlorella intake may attenuate the reduced IgA secretion during athletic training.


There is a caveat to the use of chlorella. See Treating Hepatitis C with Chlorella and Is Chlorella Good for You? to make up your own mind about whether the benefits outweigh the risks.

Interested in some other ways to decrease your risk of upper respiratory tract infections? See:

For the cuddliest way to protect your immune function, see my Are Cats or Dogs More Protective For Children’s Health? video.

What else can exercise do? See:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Find Out If Your Doctor Is on the Take With Just Two Clicks

A long-time editor of a prestigious medical journal started his editorial on physicians’ conflicts of interest by describing a fantasy: “Doctors treat patients using simply the best evidence and their experience. They are not influenced by money or self-interest.”

“This is, of course, nonsense,” he wrote. There is a reason “pharmaceutical companies spend billions of dollars on the influencing, education, and entertainment of doctors around the world.”

As discussed in my video Find Out If Your Doctor Takes Drug Company Money, the vast majority of physicians in the United States take gifts from the pharmaceutical industry, and, ironically, cardiologists, whose practice centers around diseases that can largely be prevented and treated with lifestyle changes, receive the most payments of all. A previous compilation of surveys from the 1980s and 1990s found that, on average, doctors met face-to-face with drug industry representatives about once a week. Today, your family doctor may meet with drug company employees on average 16 times a month. There are only 20 workdays a month, so that’s nearly every day.

What does the public think about this? Only about half even appear to know what’s going on. Therefore, “if 83% of doctors receive gifts, it is likely that a significant percentage of patients are not aware that their personal physician receives industry gifts.” We’re not just talking about a token Viagra paperweight or soap dispenser. For marketing, pharmaceutical companies spend $15,000 per physician every year, making conflicts of interest one of the most pressing problems in American health care.

How do doctors feel about it? Most generally approve of the gifts. However, tellingly, physicians don’t want gift relationships made public. “Physicians’ disagreement that it is inappropriate to accept gifts, but their reluctance to disclose the gift relationship to the public, suggests that they must recognize that the public would not appreciate the practice.” To analyze how doctors resolve this contradiction, researchers conducted a series of physician focus groups. It turns out physicians use a variety of denials and rationalizations, including avoiding thinking about it, and denying responsibility. Physicians readily acknowledged the inherent conflict of interest, but this didn’t stop them. In fact, some complained that the gifts were getting more modest.

“We [doctors] tend to deny that we have any conflict of interest if a pharmaceutical company buys us a nice dinner. We tend to insist that it won’t affect our judgement in any way”—as if drug companies just like wasting money for the heck of it. Most physicians contend that their colleagues are susceptible to industry influence…but not them.

Though physicians don’t want these gift relationships to be public, that’s just too bad. Thanks to Republican Senator Chuck Grassley, the Sunshine Act was inserted into Obamacare. “For the first time, patients will now be able to see what, if any, financial ties their own doctor has with a drug or device maker.”

Doctors can’t hide anymore.

The Sunshine Act was designed to give patients some insights when choosing a provider, and law enforcement agencies can also use it see who’s getting money from industry to investigate illegal kickback schemes. Right now, it might just be embarrassing, but this could allow attorneys general to go after doctors to see the kinds of incentives they may be getting for writing a lot of prescriptions. The database is live right now at openpaymentsdata.cms.gov/search/physicians or, for a more user-friendly version, Propublica’s Dollars for Docs page. The drug industry spends billions trying to influence doctors, and, for the first time, you can see if your physician, or any physician, has their hand out.

Senator Grassley hoped this would help save our nation money. It could reduce healthcare costs if patients viewed such doctors as less trustworthy and chose doctors less in bed with industry. It could also change physician behavior: Physicians may want to avoid financial relationships with companies to guard against patient distrust or becoming the target of an exposé or investigation.

Or they could just try to cover it up.

The American Academy of Family Physicians advised physicians how to “avoid getting burned” by the Sunshine Act. For example, drug companies now have to report when they give doctors free meals valued over $10. So, should family physicians just stop accepting free food from drug companies? No way! You just have to give the drug sales reps the right head count to ensure that the meal cost dips below $10 per person.

The former long-time editor of the New England Journal of Medicine said it best: “Although the spotlight has been on the failure to disclose (or adequately disclose) financial relationships with industry, the problem with [conflicts of interest] is not the lack of disclosure but the existence of the conflict itself.” Rather than just disclosing them, the best approach to financial conflicts is to have none.


No wonder physicians undervalue lifestyle interventions! See The Actual Benefit of Diet vs. Drugs and Why Prevention Is Worth a Ton of Cure. Inundated by Big Pharma without so much as a free mug from Big Broccoli, Physicians May Be Missing Their Most Important Tool. And, even worse, sometimes the drugs can do more harm than good. See my video on How Doctors Responded to Being Named a Leading Killer.

Financial arrangements can affect prescribing behavior for more than just drugs. See my video Should We All Get Colonoscopies Starting at Age 50?.

PS: I have never knowingly accepted gifts from the pharmaceutical industry, but “knowingly” is an important caveat. If you search for my name in the Dollars for Docs database you’ll see I apparently accepted money from a vision care company five years ago. I was giving a continuing medical education lecture at an optometric physicians conference and unbeknownst to me they had the corporation pay for my travel and lodging.

In health,
Michael Greger, M.D.

PPS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: