More than 2,400 years ago, Hippocrates, the father of medicine, said, “The first responsibility of a physician is to prevent disease. If that be impossible, to cure it. If that, too, be impossible, to relieve pain.” As a physician and neurosurgeon, I’ve spent the majority of my life trying to surgically cure the brain and other organs afflicted by various diseases and trauma and relieve pain directly caused by poor choices and environmental factors.
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In fact, approximately 70 to 80 percent of diseases, including cancer, heart disease, stroke, diabetes (the most common cause of blindness, kidney failure and amputations) and Alzheimer’s disease are directly related to or caused by four factors:
- Poor dietary choices
- Insufficient physical activity or exercise
- Environmental toxins, such as smoking, excessive alcohol, pesticides, BPA, lead, mercury and others
- Poorly controlled emotional stress
It was only later in my professional career I realized that, as with the majority of physicians, I was doing very little (or nothing) to prevent disease. My entire life was devoted to “fixing cars,” or bodies after they were broken. I was doing nothing in terms of prevention.
My wake-up call came approximately 35 years ago when my father died of a heart attack at age 60. It was then that I determined that I wanted to avoid dementia, blindness, being a cardiac cripple, incontinence and other ravages of age while at the same time functioning at the highest possible level cognitively and physically. Overweight, inactive, overstressed and with horrible dietary habits, this meant I had to radically change my life if I were to accomplish my goal.
It’s been a continual, sometimes arduous, learning process to sift through the often-contradictory recommendations for good health. But I’ve succeeded in my goal so far: I remain blessed to continue to practice the art and science of neurosurgery, compete in Iron Man triathlons and enjoy my children and grandchild.
What I would like to do is share with you what has worked for me — my top 10 guidelines — for a longer and healthier life:
1. Follow the Mediterranean Diet
Choose animal proteins from fish (preferably low-mercury, sustainably caught and not Atlantic farm-raised) as well as lean cuts of free-range chicken, grass-fed cows and pigs. Eat a rainbow of fruits and vegetables, including the so-called “clean 15” with the least amounts of pesticides: asparagus, avocados, cabbage, cantaloupe, eggplant, kiwi, mushrooms, mangoes, onions, pineapples, sweet peas, sweet potatoes, beans and blueberries.
Other nutritious produce includes apples, celery, cherry tomatoes, cucumbers, grapes, hot peppers, nectarines, peaches, potatoes, spinach, strawberries, sweet bell peppers, kale, collard greens and summer squash. These are the so-called “dirty dozen,” meaning they are generally more contaminated with pesticides, so opt for organic or locally harvested when you can.
Buy whole-grain bread, cereal, rice and pasta. Prepare your meals with healthy fats like olive oil. And drink red wine in moderation; no more than one glass per day for women and two for men.
2. Practice Intermittent Fasting
Fasting is not for everyone, especially those with blood sugar problems or hypoglycemia. It’s not a diet but rather a diet pattern that involves skipping a meal and only eating between certain periods of time. Paradoxically, this can result in increased energy, increased processing of information and actually increased endurance.
Fasting triggers a dramatic increase in growth hormone, which is essential in maintaining health, fitness and longevity. By reducing insulin production, it primes the body for muscle growth, fat loss and a more uniform weight. Two to three times each week I skip breakfast and eat only between noon and 8 p.m.
3. Stay Active Most Days of the Week
“Use it or lose it” applies to the body as well as the brain. You don’t have to do triathlons to be fit. The minimum amount is 150 minutes each week, or two-and a-half hours. That’s about the same amount of time you might spend watching a movie. Thirty minutes of walking five days a week reduces the risk of diabetes by 40 to 50 percent.
Strength training with elastic bands, light weights or machines two to three times per week is essential as well. Aerobic activity increases the brain-derived neurotrophic factor (BDNF), called Miracle-Gro for the brain. BDNF increases the formation of new brain cells and brain connections. It’s also the best antidepressant -- it activates the same receptors as morphine and marijuana.
4. Avoid Environmental Toxins
Smoking tobacco and ingesting alcohol to excess go together like peanut butter and jelly. But they happen to be the two most deadly drugs in our country. They either cause or aggravate most of the major diseases, such as heart attacks, strokes, cancer, hypertension and diabetes.
Alcohol is also an anti-nutrient. It depletes vitamin A, all of the B vitamins, vitamin C, magnesium, zinc and essential fatty acids. It is also anti-job, anti-family, anti-pregnancy and, eventually, antisocial. Heavy metals like mercury are found in some tuna and other large fish, which is why they should not be eaten frequently.
Bisphenol A (BPA) is a chemical used to harden plastics. It’s also found in the lining of canned foods and water bottles. There’s concern that BPA may potentially have negative effects on behavior, pregnancy and the brains of fetuses and infants. Finally, there’s increased awareness of the dangers of medical X-rays, particularly CAT scans. Always question how information will be used if a radiographic study other than an MRI (which does not use x-rays) is recommended.
5. Control Stress
Prolonged chronic stress literally kills brain cells. It increases the hormone cortisol, which, when chronically elevated, leads to memory impairment, osteoporosis from loss of calcium in the bones and a suppressed immune system, which makes us susceptible to infections, depression and even cancer.
Those people in the world with the greatest longevity have very strong family units, pray frequently and have a strong belief system. Spirituality and religion are strong antidotes for depression and stress. The same holds true for meditation and yoga.
Doing “nothing” could be the very best thing you can do to enhance longevity and health. A review of 500,000 individuals revealed a 50-percent higher risk of developing or dying from heart disease when sleep dropped to five to six hours per night compared with seven to eight hours.
Other scientifically confirmed sleep benefits include improved learning through consolidation and strengthening of the emotional components of memory, longer life span, reduced inflammation, enhanced creativity, improved endurance and athletic performance, sharpened attention and lowered stress. Try to avoid large meals and vigorous aerobic exercise for at least two to three hours before going to bed. Melatonin is a natural sleep aid, which may be useful.
7. Rely on More Natural Anti-Inflammatories
Inflammation is at the heart of many of our common diseases, including cancer, heart disease, arthritis, obesity and hypertension. A few of the natural compounds used for thousands of years to reduce inflammation include fish oil and omega-3 fatty acids, curcumin (turmeric) and ginger.
We performed a study in patients with osteoarthritis and back or neck pain and compared therapeutic doses of fish oil (two to three grams per day of EPA/DHA) versus pharmacologic drugs like ibuprofen and other types of pain relievers. Almost two-thirds of the patients were able to discontinue the drugs and use fish oil instead as an anti-inflammatory.
Curcumin is a naturally occurring yellow pigment derived from the flowering turmeric plant. It has been used for centuries in Ayurvedic and Chinese medicine to treat digestive disorders, enhance wound healing and reduce inflammation. It regulates the same enzymes as pharmaceutical drugs, but without side effects. Ginger contains a potent anti-inflammatory compound called gingerols. Many scientific studies confirm its benefit in painful arthritis and gastrointestinal disorders. Laboratory studies show it may be protective against gastrointestinal cancer.
8. Eat Healthy Fats, Not Sugar
For years, we’ve been told to eat a high-carb, low-fat diet. Wrong! Due to its effects on hormones and the brain, sugar has unique fat-promoting effects. It is the leading cause of obesity in both children and adults. It’s addictive through its release of dopamine in the brain. That’s the same neurochemical released by morphine and heroin. It’s also related to a higher risk of cancer, fatty liver and diabetes.
Fat, on the other hand, is essential for the production of many of our major hormones, including progesterone, testosterone and estrogen. Our brain is mainly made of cholesterol and fat, which also constitutes a high percentage of the cellular membrane of every cell in our body. Fat has a positive effect on mood, reduces depression, enhances bone formation, decreases the risk of osteoporosis and leads to a better cholesterol ratio and reduced cardiac risk. Good fats include avocados, coconut, butter from grass-fed origin, raw nuts, organic eggs and grass-fed animal protein.
9. Increase Energy Production
Mitochondria are capsule-shaped structures in every one of the trillions of cells that make up our body. They are the energy source for the fuel (ATP) that powers all life functions. To improve how our mitochondria function, we need to increase something called nicotinamide adenine dinucleotide, or NAD+.
NAD+ enables the transfer of energy from the foods we eat to vital cell functions. As NAD+ declines, mitochondrial function becomes impaired. This results in many of the physical symptoms of aging, such as reduced energy, fatigue, tiredness and various diseases.
Nicotinamide riboside, a form of vitamin B-3, increases NAD+ levels and provides longevity benefits that promise to combat how we age. Laboratory studies confirm that nicotinamide riboside helps to switch “off” the genes of aging, extend life span, improve brain function and increase endurance while enhancing cellular energy. Regular aerobic exercise can increase NAD+. This may also be accomplished by taking nicotinamide riboside (NIAGEN®) available in capsule form.
10. Balance Your Life: The Square
Maintaining a healthy life balance is not only essential for happiness and well-being, it’s a tremendous boost to creativity and productivity. But what does life balance actually mean, and how do we achieve it?
After a few life “train wrecks,” here’s my advice: Draw a square with the words “work,” “family/social,” “spiritual” and “physical” written one per side. Now draw yourself in the square, making each line equivalent to how much time and effort you place on each of these areas on a daily basis. This simple model immediately illustrates where you need to find more balance in your life.
It’s surprising how little insight we have into the deficiencies until we graphically view it. We can survive with one line being shortened, but if it is too asymmetrical, we’re clearly in trouble emotionally, psychologically and, most likely, spiritually. The daily goal is to contemplate your square and make sure you touch each base as much as possible!
You may want to modify these guidelines according to your circumstances, needs and abilities, but ultimately these serve as a template upon which to begin the journey to longevity and wellness.
Joseph C. Maroon, MD, FACS is Professor and Vice chairman of the Department of Neurological Surgery and Heindl Scholar in Neuroscience at the University of Pittsburgh Medical Center. In addition to being a renowned neurosurgeon, he is a sports medicine expert, health and nutrition expert and Ironman triathlete.