How Not to Age Summary – The Aging Pathways

The book How Not to Age was published by physician and plant-based research, Dr. Greger, in 2023, following the release of his books How Not to Diet and How Not to Die. In it, he explains how aging works, via the eleven aging pathways, as well as how certain parts of the body age…and what we can do about it. 

Dr. Greger combed through thousands of studies on aging, to write this book, which is fantastic. But, it’s still a ton of information to get through. The print book is 640 pages long and it took me a solid three weeks to read, the first time around.

So, if you don’t have the time to read the book and you want to know some of the essentials, this is for you. Or, if you want to determine whether it’s worth buying the book, because you want to know ALL the details, this is also for you. 

I have Degenerative Disc Disease, which is a kind of accelerated aging of the spine. I also have complex PTSD, which is known to cause additional aging, if I remember correctly from the book What My Bones Know.

I suffer from obesity and have for most of my life (I’m working on it!). My father and maternal grandfather both died young,  from natural causes.

So, I have a vested interest in knowing how to age gracefully and reverse some of the damage I caused to my body from a lifetime of overeating and hardcore stressing out. When this book was released, I got my hands on a copy as soon as I could and I read it, word-for-word. 

Is this inclination skewed by his personal preferences and chosen lifestyle? One has to wonder. Still, if you’ve heard about the healing powers of a plant-based diet, this may help you understand how that works.

By the way, when I say “plant-based diet” in this post, I’m referring to a “whole food plant-based” (WFPB) diet. This is different from a vegan diet, which may or may not include copious amounts of vegan junk food and other highly processed foods, i.e. vegan meat, vegan cheese, Oreos, corn chips, TVP, soy protein isolate, peanut butter powder, etc.

A whole food plant-based diet is about sparing the environment and the animals, sure. But, the main focus is on health, wellbeing, and longevity.

In addition to plant-based food remedies, you’ll see other lifestyle recommendations that can help slow down the aging process.

They include certain types of exercise, supplements, etc. to either embrace or stay away from, if you want to slow the aging process and improve your quality of life. 

Have you ever seen a video of Dr. Greger filming from his treadmill desk? I love that he’s demonstrating a healthy lifestyle and he definitely walks his talk! 

This is admittedly long-winded, but I promise that it really is just the essentials. And, hey, I’m saving you at least a weeks’ worth of time. So, grab a cup of coffee or green tea and settle in, because if you care about aging gracefully, improving your quality of life, and extending your years, you’re going to want to read this. I’m just sayin’. 

Some ways to boost AMPK are High Intensity Interval Training (HIIT), reducing saturated fat – especially from meat, increasing your intake of fermentable fiber, and consuming at least 2 t of vinegar, per day. 

Autophagy is a method in which your body gets rid of old, damaged, and mutant cells. This is like taking the trash out, which makes your body more efficient and able to cope with stressors.

Fasting is the most commonly talked about way of inducing autophagy, that I’ve seen. But one would have to fast for longer than is safe to induce autophagy, so that method is not recommended. 

There are other ways to induce autophagy which are safer. They include:

• 60 minutes per day of moderate intensity exercise, i.e. brisk walking, swimming, or dancing
• drinking coffee – 3 cups per day – light roast is best
• consuming 20 grams per day of spermidine from foods
• activating AMPK
• suppressing mTOR
• avoiding fried foods

Dr. Gregor included a handy chart in the book, which includes both animal and plant foods. As is his bent as a plant-based doctor and researcher, he recommends getting your spermidine from plant-based sources. So, I’m going to list them, in order of most spermidine per 100 grams of food:

• chickpeas
• cauliflower
• yellow peas
• lentils
• popcorn 
• kidney beans
• potatoes
• pine nuts
• asparagus
• peanuts

Senescence is a process by which the body removes old cells. Some ways to induce senescence are by consuming foods high in quercetin (an antioxidant) and fisetin. 

Some of the best sources of quercetin are kale, apples, red onion, berries, dark grapes, broccoli, buckwheat, and green tea. 

The single best source of fisetin is strawberries, whether fresh, frozen, or freeze-dried. It’s currently summer where I live, so I’ve been gobbling up as many strawberries as I can afford to get my hands on.

Fisetin can also be found in apples, onions, and persimmons.

Your epigenetic age is also determined by your genetics. Fortunately, it’s something that can be decelerated with a healthy lifestyle. 

Another source of spermidine is bifidobacteria, which are sometimes used in the making of (plant-based) yogurt & kefir. They are also found in saurkraut, kimchi, and many probiotic supplements. 

A.G.E.S.

A.G.E.S. is short for advanced glycation end products, which lead to aging. The way to lower your consumption of them are by a) focusing on raw foods, b) choosing meats that are cooked by moist methods, such as stewing & boiling (ick), and c) avoiding meats cooked by high heat dry methods like barbecuing (probably the worst, sorry), baking, and broiling.

Glycemic Load

Unfortunately, A.G.E.S can be formed internally, as well, particularly by high blood sugar levels. One way to decrease production of A.G.E.S. is to by reducing your glycemic load, which is the blood sugar impact of the foods that you eat. It differs from the more commonly known glycemic index of foods, as it’s not about each individual food, but the overall blood sugar impact of a meal. 

Some ways to reduce your glycemic load are to focus on a plant-based diet rich beans, fruits, vinegar, less processed grains, and spices. Increasing resistant starches in foods like potatoes (by cooking and cooling for 24 hours) and avoiding sweeteners of all kinds are two methods by which you can decrease your glycemic load, per meal. If you overdo it (by eating sugary desserts or plowing through a buffet), it might be possible to lower your blood sugar by walking after a meal. 

There is a receptor to IGF-1 and those who have a mutation which blocks this receptor tend to live longer. Centenarians often have lower levels of IGF-1 in their blood. 

Ways to reduce IGF-1 are to avoid meat (especially chicken) and dairy products, fast, restrict calories, and not eat protein (whether from plants or animals) beyond the daily recommended allowance for your weight. Because plant proteins are harder to break down, due to their fiber content, getting your protein from plants (aside from soy) can help lower your IGF-1 levels. 

According to Dr. Greger, chronic inflammation raises blood levels of CRP (C-Reactive Protein), which is a major indicator of inflammation and part of what leads to inflammaging. 

“CRP levels rise as we age and are associated with reduced survival, poorer physical and cognitive performance, diminished feelings of vitality, and a range of age-related diseases, including Alzheimer’s, Parkinson’s, cardiovascular disease, diabetes, and chronic kidney disease.” 

– Dr. Gregor, p.80 ebook

Ways to reduce chronic inflammation are to:

• exercise regularly
• reduce your weight, if you are obese
• avoid junk food, smoking, alcohol, and drugs
• eat a whole food plant-based diet rich in fiber 
• avoid saturated fat, trans fat, and cholesterol
• protect your skin from the sun
• avoid animal products

So, to slow aging, it’s best to inhibit the production of mTOR. Some ways to do that are via 

• restricting calories
• restricting protein to recommended DA
• avoiding major sources of BCAA’s, i.e. poultry, eggs, dairy
• prioritizing plant-based proteins
• drinking green tea & coffee
• eating cruciferous vegetables

Doing all of the things that promote AMPK (mentioned earlier) can help to inhibit mTor, as well. According to Dr. Greger, they include engaging in high intensity interval training (HIIT), reducing saturated fat, eating foods with fermentable fiber, and consuming vinegar. 

There are other things that can be done to boost AMPK, as well. Notable dietician, Dr. Josh Axe, has a great article about AMPK, if you want to explore this topic, in further detail. 

These processes are constant, they go at an alarming rate, and they greatly contribute to aging. So, for the most graceful aging, it is helpful to avoid things that cause them and lean towards ones that inhibit them. 

Gregor points to the amino acid methionine as being a major cause of accelerated aging due to oxidative stress. Aside from pounding the protein, there are all kinds of bad lifestyle habits and environmental factors that contribute to oxidative stress, unfortunately. 

However, antioxidants (along with a healthy lifestyle) play a huge role in ameliorating oxidative stress. They are found mostly in richly pigmented plant foods. Have you ever heard the term “eat the rainbow” (and I’m not talking about Skittles, here)? That came about because the colors in foods are indicators of antioxidants. It’s as if Mother Nature was saying, “Hey, look here! Eat this!” when she created all of the amazing plant foods on our planet. 

Foods rich in antioxidants are legumes, whole grains, fruits, vegetables (minus iceberg lettuce), mushrooms, nuts, seeds, herbs & spices, coffee, tea, wine, chocolate, and edible flowers (i.e. hibiscus).

Pro tips: 

• If you can avoid it, don’t peel your produce. Instead, find ways to include the peels in your dishes. This is because most of the antioxidants are in the peels of your fruit and veg. 
• Choose whole grains, because much of the antioxidants live in the hulls and husks of the grains.
• The same goes for nuts and seeds.

Fun fact: 

Popcorn is considered a whole grain. Because you automatically eat the kernels (inside the puffed part) when you’re smashing it in your face, you’re getting a load of polyphenols, which are a class of antioxidants. 

To get the most out of it, skip the butter and hold way back on the oil and salt. The most healthful way to eat it is plain, but if you can’t do that, perhaps a light spray of avocado oil and a sprinkling of sea salt will do the trick. I sometimes like to put granulated garlic on mine, as well, if I’m feeling feisty. 

Boosting sirtuin activity has shown to increase lifespan. So, how can we do that? Caloric restriction and intermittent fasting are two ways, though one would have to go to rather extreme methods. 

Instead of starving yourself, there are much more pleasant ways to boost sirtuins, like consuming curcumin (best source is green cardamom), as well as the antioxidants quercetin, fisetin, and resveratrol. 

I talked about quercetin and fisetin, already, but let’s glance upon resveratrol. It can be found in certain types of produce, as well as products derived from them. Some examples are grapes (darker varieties), peanuts, cocoa, pistachios, dark chocolate (is anyone else getting hungry?!), blueberries, and cranberries. 

Red wine is popularly thought to be the richest source of resveratrol, but is that just marketing hype? According to Dr. Greger, one would have to consume an insane amount of red wine, in one sitting, in order to get any benefit from the resveratrol in it. Also, the toxic effects of alcohol negate any benefits that you would get from drinking wine. Sorry to crush your burgundy colored hopes.  

Also, make sure to get in your apple-a-day, as apples are known to activate SIRtuins, stimulate AMPK and autophagy, and suppress mTOR. Put the paring knife down, though! Remember that most of the good stuff is in the peels. 

How do you avoid suppressing SIRtuins? Keep your A.G.E.S. down. 

I started hearing talk about telomeres in my plant-based research, going back to 2019. Dr. Greger explains, in detail. At the end of each chromosome is a protective cap called a telomere. Telomeres can get chipped away by certain processes and telomere length is associated with biological aging.

Telomeres are considered to be a kind of fuse and advanced telomere shortening is associated with accelerated aging, shortened lifespan, and a whole host of horrific diseases. 

What to do about it? Here are ways to prevent the shortening of your telomeres:

– Abstain from drugs, alcohol, cigarettes, junk food, overeating, etc.

– Maintain a healthy lifestyle & keep stress levels down

– Decrease inflammation and consume antioxidants

– Eat a whole food plant-based diet

– Focus on folate-rich foods, such as beans and leafy greens

– Get adequate vitamin D 

– Do HIIT or endurance training

BTW, some of these suggestions are from Dr. Greger and some are from another source.

Are you wondering how you’re going to get all of these amazing plant-based foods in your body, as well as keep track of them? You’re in luck! 

Dr. Greger created a free app called “The Daily Dozen”. It’s a whole food plant-based checklist with categories of all the foods you “should” be eating, daily, for optimal health. 

Although I’m a Flexitarian, rather than a vegan (I eat animal products, sparingly), my diet is still plant-based. I use The Daily Dozen most days and I find if to be really helpful in focusing on the things that I want to be putting in my body, which helps to crowd out the junk. That was part of Dr. Greger’s intention with creating this app and it really works!

Dr. Greger was very clever in gamifying use of this app. He challenged a number of plant-based YouTubers to show how they use the app, in a “what I eat in a day” post.  They then had to nominate others, as well. 

These videos were really fun to watch and I learned a ton of useful tips, tricks, and info. I created a YouTube playlist that you can check out, below. I actually discovered “The Daily Dozen” by watching a video from one of my favorite plant-based YouTubers, Maddie at Let’s Eat Plants. That’s why you’ll see her video first. She takes things a bit further than just showing you one day’s worth of using the Daily Dozen. She shows you how to meal prep with it. Her video is tops, in my opinion, which is why it’s first on the list.