 There may be no such thing as dying from old age. From a study of more than 42,000 consecutive autopsies, centenarians— those who lived past 100— were found to have succumbed to diseases in 100% of the cases examined, though most were perceived even by their physicians to have been healthy just prior to death. Not one died of old age. They died from disease, most commonly heart attacks. If aging kills via diseases, why wasn't my book How Not to Die? All the longevity book anyone needs. In it, I ran through what we can do to prevent it, rest or reverse each of our 15 leading causes of death, starting with heart disease, not only the number one killer of centenarians, but of men and women in general, and projected to remain that way in the decades to come. But is it really? Unless the single greatest risk factor for most of our killer diseases is old age, one could argue that the leading cause of death is actually aging. The rate of death increases exponentially for age-related diseases, such as heart disease, cancer, stroke, dementia. So yes, in the same age bracket, having a high cholesterol can increase your risk of heart disease as much as 20-fold, but an 80-year-old may have 500 times the risk of having a heart attack compared to someone in their 20s. Yes, eating a plant-based diet may reduce the risk of dementia as much as 3-fold, but the difference in dementia rates between those older than 85, compared to younger than 65, is 300-fold. The reason we focus on things like cholesterol is because it's a modifiable risk factor. But what if the rate of aging was modifiable too? Instead of our current piecemeal approach of focusing on individual degenerative diseases, what about slowing down the aging process itself? I can remember as a nerdy kid, I wanted to cure cancer when I grew up, but even if all forms of cancer were eliminated, the average life expectancy in the US would only go up about three years. Why? Because dodging cancer would just mean delaying death from something like a heart attack or stroke. If one age-related ailment doesn't get us, another will. Rather than playing whack-a-mole by tackling each disease separately, progress in decelerating aging could address all these issues simultaneously. Imagine if there was an intervention that didn't just reduce your risk of the leading killers, but also arthritis, cerebrosis, sensory impairments. Even just slowing aging seven years, such that the average 65-year-old, for example, would have the health profile and disease risk of today's 58-year-old, would be expected to cut everyone's risk of death frailty and disability in half because such risks tend to double every seven years. That's why I wrote How Not to Age. The problem is the anti-aging field is said to be a fertile ground for con-scams and get-rich-quick schemes. As a former president of the Gerontological Society of America has written, there have been few subjects which have been more misleading to the uncritical and more profitable to the unscrupulous. Not only does the popular literature on the subject harbor a huge amount of misinformation, but most anti-aging scientists, widely known to the public, are said to be unscrupulous purveyors of useless nostrums, according to the editor-in-chief of a leading gerontology journal. It's easy to be swayed by charismatic gurus, but when it comes to something as life and death important as the health and well-being of ourselves and our families, we should rely not on anecdote, but on evidence. That's why I cite everything to the teeth, How Not to Die at about 2,000 citations, How Not to Die at 5,000, How Not to Age ended up with 13,000 citations, all of which I have hyperlinked for you online to access the original sources. My inspiration for writing How Not to Age was a consensus document entitled Interventions to Slow Aging in Humans, compiled by the top researchers in anti-aging medicine. The likes of Drs. Longos and Claire Fontana, A Veritable Who's Who, they were brought together to identify the most promising strategies to combat aging. They identified a list of essential pathways, for example, drugs that can block the hormone IGF-1, or drugs to block the enzyme TOR. As I looked through the list, I realized, wait, every single one of these pathways could be regulated through diet. That became the opening section of this book. The science of aging has been called the most dynamic and provocative in modern biology. An attempt to classify the theories of aging, published more than 30 years ago, identified more than 300 such theories, and the number has only grown since. In part one, identify the 11 most promising pathways for slowing the sands of time, ending each with practical proposals for targeting them each naturally, with suggestions for diet and lifestyle changes. Part two targets the optimal anti-aging regimen. The odds of living to age 100 have risen from approximately 1 in 20 million, to as high as 1 in 50. Why does some make it and others not? It's not just a matter of picking better parents. Studies following identical twins suggest that only about 25% of the variation in lifespan is explained by gene inheritance. The media loves stories about hard-living centenarians who attribute their longevity to some combination of lard, vodka, and their favorite brand of cigarette. But how do centenarians and super-centenarians, those over 110, really eat and live? What are the best and worst foods and beverages? What about red wine, fish, olive oil, coffee? I cover the longevity vitamin, ergothione, the vegetarians, achilles heel, and the ideal exercise and sleep routines. Then in part three, I get into that nitty gritty. What can we do to preserve our bones, bowels, bladder, and circulation, your hair, hearing, and hormone balance, your immune function, and joint health, your mind, your muscles, your sex life and skin, your teeth, your vision, and finally, your dignity and death? There are chapters on each. Did you know that 85% of bone fracture risk has nothing to do with your bone mineral density? I addressed that in the Preserving Your Bones chapter talking about the pros and cons of the new osteoporosis drugs, what supplements consider as well as more natural approaches to protect your skeleton. I discussed preserving your bowel function fittingly in chapter number two. I discussed solutions to the constipation epidemic, proper positioning, laxatives, fiber supplements. I also compared the six colon cancer screening strategies and ways to help prevent it in the first place, as well as bladder function, urinary incontinence, and prostate enlargement. In the circulation chapter, I discussed how having a normal cholesterol or blood pressure is not so good in a society where it's normal for people to drop dead of heart attacks and stroke. I covered statins and stents, and most importantly, treating the underlying cause of artery function failure. Preserving your hair refers to both color and volume. Why do we gray and lose our hair? And what can we do about it? I also covered drug supplements and surgeries, as well as dietary and topical treatments. In preserving your hearing, I break down hearing aids, earwax removal, and the fact that in some cultures, there's no such thing as age-related hearing loss. What can we learn from them to protect our own inner ears? In the hormone chapter, I investigate blockbuster anti-aging treatments like growth hormone injection, DHEA, the preservation of female fertility, menopausal hormone therapy, natural alternatives for symptoms like hot flashes, and the pros and cons of testosterone therapy for so-called male endopause. In the immunity chapter, I cover immune boosting foods to improve cancer surveillance and resistance to infection, examine the role of supplements like ginseng, vitamin D, and zinc, and help you decide whether to get vaccinated against the flu, pneumonia, and shingles. The joint chapter touches on back pain, but focuses on osteoarthritis, covering prescription and over-the-counter drugs, injections, knee surgery, topical treatments, inflammation dowsing foods, and supplements such as glucosamine and chondroitin. Preserving your mind takes on the dementia epidemic. I cover Alzheimer's disease, vascular dementia, the rapidly reversible causes of dementia, the controversial new drugs, so-called brain supplements like ginkgo, the role of aluminum, and chronic infections like HSV, and most importantly, what we can do to prevent, arrest, and even rewind cognitive decline. In preserving your muscles, I tackle what we can do to combat age-related muscle loss and frailty, addressing protein needs of older adults and supplements like creatine, as well as touching on essential tremor. Then, it's on to preserving your sex life. I discuss the best ways, natural and otherwise, to improve male and female sexual interest and function, talk about aging body odor, the best vaginal moisturizers and lubricants, and the role of herbs such as ashwagandha and makarut. I'll understand if you want to skip directly to this chapter. Then it's all about skincare. I cover the pros and cons of chemical peels, laser resurfacing, facelifts, botox, and filler injections, how we can prevent and treat wrinkles, both topically and from the inside out, by what we eat, what's the safest sunscreen, what's the value of facial moisturizers, alpha hydroxy acids, redinoids, collagen supplements, and anti-aging skin creams and serums. I also cover varicose veins and nail health, from brittle fingernails to fungal toenails, and the role of nail supplements like biotin. In preserving your teeth, I take a bite out of periodontal disease and tooth loss, cover oil pulling and fluoride, and detail the best mouthwash. In the vision chapter, I focus on dietary approaches to cataracts, glaucoma, and macular degeneration, including the role of lutein and zeaxanthin. And the final chapter in this section, preserving your dignity, offers the assurance that you can have control over your ultimate fate. The final section, Dr. Greger's anti-aging eight, is intended to be an actionable checklist to complement my daily dozen from how not to die. In addition to the wealth of recommendations throughout the book, this section is designed to highlight specific food supplements or behaviors that have the potential to offer the best opportunities to slow aging or improve longevity. My aim with this book was to cover every possible angle for developing the optimal diet and lifestyle for the longest, healthiest lifespan based on the best available balance of evidence.