There may be a shortage of primary care doctors, but there is no shortage of celebrity doctors. I have tried fighting them, I have tried rationally engaging them, now I have decided to join them. This post marks the launch of my health and wellness empire. I call it: Life My Way! The Science and Art of Outhealthing your Friends and Enemies. I will refer to the strategy as OhFE, pronounced “Ooof” (my creative team is still working on that).1
Following my recommendations will guarantee a long life filled with health, wealth, and truly transcendent happiness. I’ll admit to Sensible Medicine readers that OhFE 1.0 has been created on the cheap because I still have a job that takes up a lot of time. Most of OhFE 1.0 is just modeled on how I live. Since I am a generally healthy, relatively happy, middle-aged person, OhFE 1.0 should be just fine. Once OhFE 1.0 starts generating vast sums of income, I will release OhFE 2.0 which will be highly focus-grouped, aimed at maximizing clicks, grabbing eyeballs, and moving product (including granola, dietary supplements, skincare products, and action figures).
Besides being a generally healthy, relatively happy, middle-aged person, my bona fides are solid. I graduated from medical school over 30 years ago. I think I had a lecture or two about nutrition. I learned nothing about exercise physiology, but I have read a few articles about it in the New York Times over the years. My wellness training involved at least eleven years of education seemingly designed to make me terrifically unwell and yet I am now pretty well, so… My expertise in longevity science includes knowledge that there have been no studies that show a longevity benefit, in humans, of any single intervention in any remotely unconfounded way.
Diet
Once, while vacationing in a blue zone, a wise woman told me, “You are what you eat,” so let’s start there. Many other celebrity doctors tell you what to eat and what to avoid. They are wrong. What follows is the only reasonable dietary advice.
You should eat when you are hungry. Do not overeat, it doesn’t take much to satisfy you. Avoid all processed food and eat meat. at most, once a week. (I suggest limiting meat more for the benefit of our planet and the animals than for your health.) Avoid anything that makes you feel bad. Avoid all liquid calories and artificially sweetened beverages – this includes fruit juices, smoothies, and the latest coffee adjacent drink from Starbucks. Water and unsweetened coffee or tea are your friends.
If you’d like, you can drink a glass of wine or a beer a couple of nights a week. I suggest this not because it has health benefits, it does not. Rather, if you have the money, physiologic wherewithal, and social supports that enable you to consume moderately, then you benefit from the confounders that make this habit appear beneficial in hundreds of studies funded by the wine and spirit lobby. (We plan a line of T-Shirts featuring the phrase “Be A Confounder” in the future).
This dietary advice should be adequate, but simple, common-sense suggestions are the stuff of medical practice and not empire building so let’s get specific. I find it easiest to avoid dangerous temptation by being obsessively regimented about eating.
Breakfast:
Steel cut oatmeal with pomegranate or sliced mango. On the weekend, I would suggest baked goods, ideally from a good local bakery.
For lunch, Greek yogurt or cottage cheese with cumin-tahini granola and pomegranate seeds or sliced mango.2
On weekends, skip lunch. A cookie at a good local coffee shop is advised.
Dinner:
Monday: Take out from a local Thai restaurant (this should be eaten while watching Antiques Roadshow).
Tuesday: Salad (homemade dressing only).
Wednesday: A Buddha-Bowl which consists of tofu sauteed in oil and garlic, roasted veggies, and a grain. We will eventually market this recipe with a trademarked, genetically modified super grain but first my team needs to weigh in on whether “Buddha-Bowl” is trademarked by the restaurant at which I first ate it or is culturally appropriation.
Thursday: One of a wide selection of pasta dishes (never involving pre-prepared sauces). These recipes will fill forthcoming OhFE cookbook. I will probably grace the cover but I will be unrecognizable after the cosmetic surgery and hair transplant that Netflix will fund after they buy the television rights. Pasta is a necessary part of a healthy and happy life. I am definitively pro-carb and pro-gluten. (I am also prosecco and profiterole.)3
Friday: Pizza, Chinese, Pho, Ramen, or Middle Eastern from a local restaurant. This should be eaten in front of a movie or a series with a beer. Until this empire takes, I plan to keep my day job and that leaves me sapped out by Friday night.
Saturday: Eat out. This might be the time to have some meat since someone else will cook it.
Sunday: I don’t know, leftovers? (Not to self, get the research team to brainstorm this.)
Exercise
You need to do 30-40 minutes of aerobic exercise every day. The exercise needs to be brisk enough that you would have trouble carrying on a conversation while exercising. Exercise cannot by skipped. It is a necessary bodily activity, same as eating and drinking. Vary your exercise to avoid injury. I suggest swimming, running, and biking. Adding on other activities such as Pilates, yoga, tennis, basketball, or even a bike ride to get that weekend cookie (be careful), is wonderful but does not take the place of your daily aerobic exercise.
I cannot overstate the importance of building exercise into your schedule.4 I am sure that one of the reasons that wealth leads to longevity (see below) is that people with fewer economic resources tend to have schedules that make daily exercise more difficult. They also live in neighborhoods whose built environment discourages exercise. Exercise benefits cardiovascular and mental health. It may bring diseases to light earlier. It teaches you to differentiate between normal and pathologic discomfort – which will, at very least, make things easier for your doctor.
Sleep
Sleep is critical. You cannot skimp on sleep without eventually paying a price. Unfortunately, not everybody is blessed with the ability to sleep well. Read about sleep hygiene and learn about how sleep changes as you age. If you are not sleeping enough, spend a couple of weeks sleeping as much as your body needs and then adopt the rhythm your body has found. If your sleep is fragmented, but you are spending a lot of time in bed, you might need a trial of sleep deprivation. If your sleep is fragmented and… – wait a minute, it seems like giving one-size-fits-all advice is impossible, but wait, that acknowledgment might affect profit. Never mind, let’s move on.
Be Happy
Yes, better health leads to greater happiness but, more and more, it seems clear that happiness lets you live longer and better. Having watched a medical practice worth of people age for 30 years, and despite data to the contrary, old age can be pretty depressing. Progressive disability and the loss of peers and family is an inescapable reality. Those who start out happy weather this storm better. Happiness is no guarantee of longevity (nor is the converse true) but when I consider the centenarians for whom I care, I would certainly rather be among those who tend toward hyperthymia rather than dysthymia.
How do you stay happy? Have friends. At least once a week, call a friend and see another for a lunch, dinner, or a beer (another reason for the confounded alcohol data). It is true that most of us don’t bowl anymore, so set up a book club or a film club, take a class, volunteer for a group activity. Make a list of the things that make you happy, look at it every now then, make sure you are making time to do those things.5
Be Rich
Poverty is a pretty good way to hasten your demise. Look at the maps of wealth and life expectancy in any major US city and the overlap delivers a pretty clear message. Most celebrity docs know this too, but their suggestions only help their own wealth and longevity. When OhFE 2.0 is released, we will earmark a percentage of our profits toward the purchase of lottery tickets. Winnings will be distributed to subscribers in $5M increments. This will attract press attention and mimic how much of health works – there is a lot of luck involved.
When I speak of “my team” or “we” I mean me. As my empire grows, I will hire people.
The recipe for this granola has been developed over years and has the interesting quality of being both delicious and disliked by most people with whom I have shared the recipe. One friend and colleague actually made a batch and then brought it to me after finding it inedible. To show my generosity at the start of my empire building, I share the recipe, for free, here.
I plagiarized this from the t-shirts sold at the Floriole, a lovely bakery and coffee shop in Chicago.
My wife insists this can only be accomplished by doing the exercise at 5:30 every morning. She is wrong and she usually doesn’t read footnotes.
I love lists and actually have this list on my phone. Just reading through it occasionally makes me happy.
The marketing has hooked me. I will buy the "Be A Confounder" T shirt.
You forgot to include the line of supplements marketed under your name priced ridiculously high. Besides that, you nailed it!!