#433 SUPERPODCAST of Protocols for Diet, Exercise, Sleep, and Supplements

Siim Land (0:00)

Happy end of the year. 2024 was a pretty good year for me. I published my new book, The Longevity Leap, that took me ages to write, and it's very comprehensive. And I also learned a ton in the realm of diet, exercise, nutrition, supplements and blood work. So in this special episode of the podcast, I'm gonna bring it all together. I'm going to replay some of the best podcast clips and the best videos that I published this year. So you can consider it to be like a longevity masterclass, a cover or the major most important aspects of the fundamentals like diet, exercise, sleep and some supplements. In addition to me, you'll also learn from some of the experts like Dr. Gil Carvalho, Dr. Greg Potter, Dr. Alexis Ortega and also Dave Pascoe. I want to start this super podcast with the nutrition section. First I'll play you a video called My Evidence-Based Longevity Diet.

Food is what keeps us alive and what we eat can determine how long we will live. To be honest, in my opinion, food has much less of a role in longevity than people like to think. What's more important is your blood work because that reflects your inner health. Food is just a means to achieve better blood work and other biomarkers. Some foods are better than others in achieving this, which is where the confusion stems from. In this video, I'm going to outline you my personal evidence-based longevity diet. I'm going to outline you the macros and foods that I eat. I understand that it's going to generate a lot of conflicting opinions in the comment section. A lot of people are going to say, you're not supposed to eat that, you need to eat this food. It's just so many different conflicting opinions out there. You can spare me those comments. This is my evidence-based longevity diet, and I have the blood work and other biomarkers to back it up. So if you want to learn it, then make sure you watch until the end, because I'm going to outline you the entire formula. I'm going to start with the most controversial micronutrient in longevity, which is protein. It's often thought that eating protein accelerates aging and increases your risk of cancer. Indeed, protein restriction is linked with increased lifespan in animal studies, but it's not more powerful than regular calorie restriction. There's limited evidence that protein intake shortens lifespan in humans. However, there are also risks associated with low protein intake, such as frailty and hip fractures. So, with protein you want to kind of get enough to support bone density and muscle mass, because both of them decline with age and increase the risk of mortality. The biggest irony would be to diet to a hip fracture because you're on a low protein diet, and you're thinking that it's going to extend your lifespan. However, there does appear to be some age-dependent effects on protein and longevity. Dietary protein intake in the elderly is associated with higher lean muscle mass. A 2023 study on protein intake in the elderly people over 85 found that a higher protein intake was linked to lower mortality risk. The highest quartile of protein intake, over 19.1% of total calories as protein, was linked to a 56% lower risk of mortality than the lowest quartile, less than 14.7% of total calories as protein. So, if you are older than 85, then the higher protein of over 19% of calories from protein appears to be more beneficial and it does reduce the risk of mortality, mostly because of reducing the risk of frailty and sarcopenia. But what about people who are younger than 85? A 2023 meta-analysis of 14 prospective cohort studies in adults without cardiovascular disease, 18% or more of total calories from protein, wasn't associated with increased cardiovascular disease death, stroke or myocardial infarction. Another 2020 systematic review and meta-analysis of 32 prospective cohort studies, with over 715,000 participants, found that a higher protein intake was associated with a lower risk of all-cause mortality, with the lowest risk found at 15-25% of total calories as protein. So most of the evidence suggests that a protein intake of 15-25% is associated with a lower risk of mortality. We don't have data about people consuming higher than that, but a protein intake of 20-25% is already considered to be high protein. However, the percentages of how much protein you eat matter much less than how much you weigh. Given the fact that protein is supposed to support muscle maintenance into your elderly years, you want to eat just enough, but there's no need to go beyond that. A 2018 meta-analysis of several studies discovered that the maximum benefits of muscle mass are observed at an intake of 0.8 grams per pound per day, or 1.6 grams per kilogram per day of lean body mass. There's no benefits eating more than that, but if you're eating less, then you're leaving gains on the table. So I'm aiming for the 1.6 grams per kilogram per day of lean body mass, which for me is around 120 grams of protein per day. On some days, it might be higher than that, but I rarely go below that. There's no additional benefits of going above the 1.6 grams per kilogram of lean body mass, but if you're eating less than that, then you are missing out on some of the potential gain for muscle growth. So what kind of proteins do I eat? I'm not a vegan, I'm not a carnivore. I eat a pretty good balance of animal and plant-based proteins with an emphasis on fish, dairy and plant proteins. I do eat meat, but not very often and usually it's game meat. There are also controversial opinions about animal protein and plant protein. In epidemiological studies, meat consumption is often linked to higher mortality and plant protein is linked to lower mortality. The same 2020 meta-analysis of 32 studies found that exact phenomenon. Over 10% of total calories coming from animal protein was linked to a slight increase in mortality risk and over 5% of total calories from plant protein was linked to a decreased risk. My animal protein percentage is probably 15%, but my plant protein percentage is also around 10%. And there is also one critical nuance that determines the outcomes that is related to fats that I'm going to cover later. There are also studies finding that unprocessed meat consumption isn't significantly associated with all-cause mortality or cardiovascular disease. So it's hard to say that eating meat is going to increase the risk of heart disease or cancer in otherwise healthy people because the risk associations aren't that strong and they're mostly epidemiological. But it does appear to be that plant proteins have benefits if you compare them to animal proteins and they yield greater risk reduction. Here, too, there appears to be some age-dependent effect with animal protein being linked to a lower risk of mortality among the elderly people. The reason is because old people are at a higher risk of malnutrition and frailty, which could be counteracted by animal protein intake more easily. That's because old people are very bad at eating. They subconsciously under-eat, they forget their meals, and they don't have the appetite to eat. This is called the anorexia of aging. There are also studies among elderly people finding that plant-based diets are linked to reduced frailty as long as they get enough calories and protein. So the determining factor in all of this appears to be malnutrition and frailty. If you get enough calories and if you get enough protein and you maintain enough muscle tissue, then it doesn't really matter what kind of a diet you follow as long as you are meeting those requirements. I personally base my protein and all my food intake based on my biomarkers. The link between animal protein intake and mortality in epidemiological studies is thought to be due to increased risk of heart disease and cancer. The main biomarkers that are affected by animal protein intake and that they are linked to this increase in heart disease and cancer are your blood lipids and IGF-1. There are many others, but these are the main ones. IGF-1 or insulin-like growth factor 1 is a growth factor that promotes muscle growth but is also implicated in cancer and type 2 diabetes. However, both high over 200 ng per milliliter as well as low, less than 100 ng per milliliter of IGF-1 are associated with increased risk of cardiovascular disease, cancer mortality and overall death. The high IGF-1 is linked to mortality because of cancer and low IGF-1 is so because of frailty and muscle loss. My IGF-1 levels are on the lower end and around 100 and I haven't seen them above 120 in my blood work. So based on this, my cancer risk is very low and I'm also not in the risk of frailty or malnutrition. What about heart disease based on the lipids? Cholesterol isn't the most important lipid for assessing cardiovascular disease risk. Even the main health organizations and guidelines acknowledge that the bigger risk factor are lipoproteins, specifically APO-B or APOLIPOPROTEIN-B. It's one of the most atherogenic particle that's thought to be causally linked to heart disease. Normal APO-B levels are considered below 120 mg per deciliter. High APO-B over 140 mg per deciliter is significantly associated with increased risk of old cause and cardiovascular disease mortality. The optimal APO-B for preventing atherosclerotic cardiovascular disease is below 90 mg per deciliter and below 70 mg per deciliter in those with higher risk. The risk of cardiovascular events related to APO-B is higher in younger than in older individuals. So, if you're someone who's younger than 40, then for cardiovascular disease prevention, it's better to have your APO-B low. My recent blood work showed that my APO-B levels were 77 mg per deciliter, which is in the low-risk category. Of course, there are many other markers that are associated with increased risk of heart disease, such as inflammation, hemoglobin A1c, blood pressure, blood sugar levels, etc. But they're also optimal for me. Next, let's talk about fats because they're relevant to proteins. For normal physiological functions, it's recommended to get at least 15% of your daily calories from dietary fat. That's going to be about 20 to 30 grams for most people. However, this doesn't appear to be optimal from an all-cause mortality perspective. In the 2017 PURES study done on people from 18 countries across the world, the lowest mortality was seen at a fat intake of 35.3% of total calories. That's a pretty moderate amount of fat and for most people, it's going to be somewhere between 50 to 70 grams a day. There are also studies finding that men eating 40% of calories as fat have higher testosterone than those eating 20% of calories as fat, but there are no additional benefits beyond 40%.