Food as Medicine
As a physician practicing nutritional and functional medicine for 30 years on real patients, using food as medicine, Mark is humbled by the diversity of human biology and the need to personalize nutritional recommendations. However, a few universal principles exist that can guide the right diet for you.
- Focus on quality. 2. Make food as medicine the guiding principle for everything you eat. 3. Personalize your diet to fit your metabolism, genetics, and preferences.
Eat lots of plants.
About three-quarters of your plate should be covered with veggies. Aim for deep colors. Stick with mostly non-starchy veggies. Winter squashes and sweet potatoes are fine in moderation. Choose organic and regenerative when possible.
Lighten up on fruits.
Low-glycemic fruits are best, so stick with berries, kiwis, and watermelon. Enjoy sweeter fruits only occasionally, such as grapes, melons, and higher-glycemic-index fruits. Always eat the whole fruit and avoid fruit juices. Think of dried fruit as candy and keep it to a minimum. When in doubt, get a continuous glucose monitor to track your body’s response to different fruits.
Load up on foods with healthy fats.
Whole foods such as nuts, seeds, olive oil, avocados, pasture-raised eggs, and small wild fatty fish such as sardines, mackerel, herring, anchovies, and wild salmon contain good fats. For oils, use extra virgin olive oil (at low or no heat), avocado oil (for higher-heat cooking), and organic virgin coconut oil
Add nuts and seeds. They help with weight loss, diabetes, and heart disease and provide minerals, protein, good fats, fiber, and more. Almonds, walnuts, pecans, hazelnuts, macadamia nuts, and pumpkin, hemp, chia, and sesame seeds are all great.
Think of meat and animal products as condiments.
Not as a main course (which should be colorful vegetables). Servings should be palm-sized. Plant-based meals are fine as long as the protein comes from whole foods, not processed powders, bars, or fake meat. However, to get adequate protein for muscle synthesis as you age, you will need to supplement with animal protein and/or amino acid supplements or vegan protein powders with added amino acids.
Buy animal products that have been regeneratively raised, grass-fed, or organic when possible. They are nutritionally better for you and they are better for the planet. They are also rich in phytonutrients from all the wild and diverse plants the animals consume. Choose pasture-raised eggs. They are an affordable source of protein and vitamins—including B12, which you can’t get from a vegan diet—minerals, antioxidants, and more.
Eat fish that is low in mercury and toxins, high in good fats, and wild-caught or sustainably raised.
Sardines, herring, anchovies, mackerel, and salmon all have high omega-3 and low mercury levels. Check out Seatopia (seatopia.fish) or the Environmental Working Group’s Consumer Guide to Seafood (ewg.org) for those that are sustainably harvested/raised and low in toxins.
Eat only whole grains.
Not whole-grain flours and avoid gluten, especially from American dwarf wheat. Since all grains boost blood sugar, only eat ½ cup to 1 cup per day, and choose low-glycemic, gluten-free grains like black rice, quinoa, teff, buckwheat, or amaranth. Try heirloom grains like Himalayan Tartary buckwheat or ancient forms of wheat like einkorn, emmer, or farro.
Lentils are best. Stay away from big starchy beans as staples. Beans contain fiber, protein, and minerals, but some people don’t digest them well, and the lectins and phytates in beans can inhibit mineral and protein absorption. If you digest beans without a problem, then up to 1 cup a day is okay.
Avoid sugar and other foods that spike blood sugar and insulin.
Such as flour, refined starches, and carbohydrates. Treat sugar in any form as an occasional treat. Your body can’t tell the difference between a bagel and a bowl of sugar once it gets below your neck. Liquid sugar calories (from soda, energy drinks, sweetened teas, even fruit juice, etc.) cause increased hunger, obesity, and death. Stay away.
￼ Eliminate most grain, bean, and seed oils. That includes canola, sunflower, grapeseed, and especially corn and soybean oil. Small amounts of expeller or cold-pressed nut and seed oils like sesame, macadamia, and walnut oils are fine to use as condiments or for flavoring. Avocado oil is great for higher-temperature cooking.
Calorie Restriction Mimetics: Hacking Starvation
The one thing proven in longevity science is that eating fewer calories and triggering the starvation response in the body has significant long-term benefits on health and longevity. But in the search for ways to hack calorie restriction long term without being miserable and hungry, losing muscle and bone density, reducing sex hormones and libido, and slowing wound healing, scientists have found many roads to Rome. Luckily, there are ways to mimic calorie restriction without starving yourself.
- Time-restricted eating narrows the eating window to 8 to 12 hours. You can do this daily or three or four times a week depending on your health and weight. For example, you can finish dinner at 7 p.m. and have breakfast at 9 a.m. (a 14-hour fast). There should be at least 12 hours a day of not eating between dinner and breakfast.
- Intermittent fasts of 24 to 36 hours or even fasts of three days to a week periodically are another option. Even a weekly 24-hour fast can trigger a deep cleaning.
- Fasting-mimicking diets. Valter Longo, a leading longevity researcher at the University of Southern California, has developed a fasting-mimicking diet shown to be effective in extending life in animal models, and in weight loss, improving insulin resistance, cholesterol, dementia, autoimmunity, and response to chemotherapy and radiation in cancer patients. It is a plant-based diet of 800 calories per day for five days and can be done monthly or quarterly.
- Ketogenic diet. Another potential way to activate your longevity pathways is through a ketogenic diet: 70 to 75 percent fat, 20 to 25 percent protein, and 5 percent carbohydrates. For those who have severe metabolic disease, such as type 2 diabetes, a longer-term ketogenic diet has completely reversed type 2 diabetes in 60 percent of people and has gotten 90 to 100 percent off medication and insulin. For people with insulin resistance (about nine in ten Americans), a short- or longer-term ketogenic diet can quickly reverse metabolic dysfunction and improve your cholesterol profile.
The Young Forever Supplements for Longevity
You may wonder why we need vitamins now if humans evolved for 200,000 years without supplements. If you lived like our ancestors and hunted and gathered your own wild food, including mushrooms and 800 different species of wild plants rich in omega-3 fats, phytonutrients, vitamins, and minerals; if you ate organ meats, bone marrow, and wild fish; if you spent your days half-clothed outside in the sun; and if you were never exposed to environmental toxins or chronic stress and slept 8 to 9 hours a night, waking and sleeping with the sun—then, no, you would not need nutritional supplements. If that describes you, skip the supplements. For the rest of us, supplements are essential insurance against our nutrient-depleted diet, toxic environment, and high-stress lives.
think of nutritional supplements in two ways: first, as the foundational nutrients everyone needs for life; second, as specifically targeted supplements based on your unique needs (genetics, age, lifestyle, testing, and imbalances in the core biological networks or systems). A good multivitamin and mineral, vitamin D3, omega-3 fats, magnesium, and support for methylation (special forms of folate, B6 and B12, and other methylation nutrients) are essential for everyone. And given our gut-busting life, a good probiotic is also important. Not all supplements are created equal. They are unregulated, so it is critical to choose supplements that undergo rigorous manufacturing according to good manufacturing practices and independent / third-party testing for purity and potency, contain the most bioavailable and active forms of nutrients, and are free of fillers, additive, dyes, and preservatives. Do you really need a vitamin made with blue dye?
Core Supplement Plan
Vitamin D3, 2,000 to 5,000 IU a day with vitamin K2 (including MK-7 form), such as Vitamin D Supreme by Designs for Health.
EPA/DHA (omega-3 supplements), 1 to 2 grams a day. Dutch Harbor Omega from Big Bold Health is cold processed, which prevents oxidation of the fats and preserves active anti-inflammatory compounds called resolvins; take 2 softgels a day.
Multivitamin and mineral. Getting a complete array of all the micronutrient vitamins and minerals is important to optimizing your metabolic functioning. This should include all the B vitamins in the correct forms for methylation, such as 5 methyl-folate instead of folate, or methylcobalamin instead of hydroxycobalamin, or pyridoxal-5-phosphate instead of B6. Mark recommends Multi t/d, 2 a day, by Pure Encapsulations or Polyphenol Nutrients by Pure Encapsulations; take 3 per day.
Additional methylation support. You may need extra support for methylation if a high homocysteine level (over 10 mcmol/L) is indicated on your Young Forever Function Health Panel. For extra methylation support, Mark recommends Homocysteine Supreme by Designs for Health; take 2 per day.
Magnesium glycinate or citrate, 200 to 600 mg a day to support sleep, relaxation, and muscle function (45 percent are deficient in magnesium). Mark recommends magnesium glycinate for those who do not have constipation and magnesium citrate if you tend to be constipated. Both are available from Pure Encapsulations; take 2 to 4 capsules a day.
Probiotics to support a healthy microbiome. Probiotic 50B by Pure Encapsulations is a good basic probiotic; take 1 a day. Some people may need more specialized probiotics depending on their unique needs.
Lifestyle Practices: Exercise, Sleep
The joke is that if you don’t move, you won’t. The good news is that you will get the most dramatic gains in health and longevity when you go from doing nothing to doing something, like a 30-minute walk a day. However, if you want to achieve maximum benefits, you must focus on three key aspects of fitness: 1. Aerobic conditioning (to optimize your VO2 max). 2. Strength and muscle mass and function. 3. Flexibility and agility.
Thankfully there are so many options for keeping the body moving, and some of them are more like play than what you think of as exercising. Think biking, swimming, dancing, skiing, and tennis, for instance.
If you don’t exercise at all, just start walking. If you want to optimize your VO2 max and fitness, then do more vigorous exercise three or more days a week, such as jogging, biking, tennis, dancing, rowing, or using a treadmill or elliptical machine. This gets your lymphatic system moving.
If you want to optimize even further, start a high-intensity interval training (HIIT) program, where you push yourself to your max capacity, as if you were running from a tiger, for 45 to 60 seconds, followed by a 3-minute slow walk or light jog. Doing a few cycles for 30 minutes three times a week can have dramatic benefits, including increasing your metabolism, losing weight, and boosting your VO2 max.
Preserving muscle, building muscle, and optimizing muscle function are the keys to the fountain of youth. How do you do this? Put your muscles to work. Try weight lifting, resistance bands, and body-weight exercise. If strength training is new for you, then it’s best to work with someone experienced like a trainer, so you learn how to correctly perform the exercises and avoid injury. It is never too late to start. Ideally do three strength-training days each week to build and maintain your muscles and increase your mitochondria, which in turn will increase your energy, fat burning, and longevity.
Flexibility and Agility
Just like the Tin Man from The Wizard of Oz, we tend to rust as we age and need some lubrication. Flexibility and agility are key to staying active and pain-free. Yoga is the most effective therapy for helping older adults stay functional and pain-free.
A twelve-week intervention incorporating classical yoga postures, breathing exercises, and meditation was associated with positive changes in the levels of biomarkers of cellular aging including 8-OH2dG, a product of DNA damage; oxidative stress markers; and telomeres. It also improves neural connections, memory, and inflammation. Not bad for a little stretching!
Optimizing Sleep for Longevity
Here’s how to restore your natural sleep rhythm. It may take weeks or months, but using these tools in a coordinated way will eventually reset your biological rhythms.
Practice the regular rhythms of sleep. Go to bed and wake up at the same time each day. Use your bed for sleep and romance only, not reading or television. Create an aesthetic environment that encourages sleep—use serene and restful colors and eliminate clutter and distraction. Create total darkness and quiet. Consider using eyeshades and earplugs.
Get grounded. Electromagnetic frequencies can impair sleep. Mark recommend turning off Wi-Fi and keeping all your electronic devices away from your bed. Create a charging station in a common area of your home and encourage all your family members to “check in” their devices before bed.
Eliminate blue-light exposure for 2 to 3 hours before bed. Avoid computers, smartphones, tablets, and television 2 hours before bed. Avoiding blue-spectrum light after the sun goes down helps your brain reset for sleep and increases melatonin. Ideally use blue-blocker glasses after sunset, a simple hack that pays sleep and health dividends.
Avoid caffeine. It may help you stay awake during the day, but it interferes with your sleep. Write down your worries. One hour before bed, write down the things that are causing you anxiety and make plans for what you might have to do the next day to reduce your worry. It will free up your mind and energy to move into deep and restful sleep.
Take a hot Epsom salts and aromatherapy bath with lavender oil. Raising your body temperature before bed helps to induce sleep. A hot bath also relaxes your muscles and reduces physical and psychic tension. By adding 2 cups of Epsom salts (magnesium sulfate) and 10 drops of lavender oil, you will gain the benefits of magnesium absorbed through your skin to relax your muscles as well as the cortisol-lowering effects of lavender.
Avoid medications that interfere with sleep. These include sedatives (these are used to treat insomnia but ultimately lead to dependence and disruption of normal sleep rhythms and architecture), antihistamines, stimulants, cold medication, steroids, and headache medication that contains caffeine (such as Fioricet).
If after trying these strategies you still struggle with sleep, please see a functional medicine practitioner who can determine whether things like food sensitivities, thyroid problems, menopause, fibromyalgia, chronic fatigue syndrome, heavy metal toxicity, stress, or depression is interfering with your sleep. You can find one at the website of the Institute for Functional Medicine (ifm.org). Consider getting tested for sleep disorders such as sleep apnea. Getting good sleep is essential for your health and longevity.