Image Credit: Kristina DeMuth.

Even Modest Lifestyle Changes in Middle Age May Significantly Extend Your Life

In How to Reduce the Risk of Sudden Death, I discuss how public health workers tend to work in their own separate domains. The tobacco folks rarely talk to the alcohol, nutrition, or sexual health folks, “with no apparent recognition that, far from being unique and separate, the behaviours they all address comprise a typical Saturday night out for large sectors of the population. This also blinds us to the importance of individual empowerment. We beetle away at micromanaging specific behaviours and ignore the key message emerging from the public health evidence base—that for the first time in human history we now know how we can take a measure of control over our own health and longevity.”

So much control, as addressed in my video Turning the Clock Back 14 Years, that we may be able to effectively turn back the clock 14 years in terms of mortality. But whether the benefits observed in those studies are the result of good, life-long health habits or can be achieved by those who make changes later in life needed to be confirmed.

And it was. “People who newly adopt a healthy lifestyle in middle-age experience a prompt benefit of lower rates of cardiovascular disease and mortality.” Researchers found that a switch in mid-life—that is, in our late 40s to early 60s—to a healthy lifestyle that includes at least five daily servings of fruits and vegetables, maintaining a healthy weight, exercise, and not smoking results in a substantial reduction in mortality over just the next four years. This is surprising not only because the benefit appeared so quickly but also because the lifestyle changes were so modest. The findings emphasize that making the necessary lifestyle changes is extremely worthwhile, and it’s never too late to get with the program.

If we can get such dramatic benefits so late in life and in such a short amount of time, why can’t we just live lives of gluttony and sloth, and then just clean up our acts around 50 or so? Because it may be too late: Our first symptom can sometimes be our last.

Sudden cardiac death accounts for more than half of all heart disease deaths. Hundreds of thousands of Americans just drop dead every year. Sudden cardiac death is the first manifestation of heart disease for the majority of individuals, particularly among women, meaning they had no idea they even had heart disease until they were literally dying from it. For many, their first indication of the presence of coronary heart disease is their demise. That’s why prevention is the key.

So, does prevention work? Women who don’t smoke, walk a half-hour a day, aren’t overweight, and eat a prudent diet—defined in the study as greater than average fruit, vegetable, nut, whole grain, and bean consumption—had a 92% lower risk of sudden cardiac death. When it comes to sudden death, an ounce of prevention is truly worth more than a pound of cure, because there is no cure for dead.

Why hasn’t your doctor told you about this? Physicians May Be Missing Their Most Important Tool. The good news is that it’s Never Too Late to Start Eating Healthier.

For more on the field of lifestyle medicine, see:

Some other important videos about life extension:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

44 responses to “Even Modest Lifestyle Changes in Middle Age May Significantly Extend Your Life

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  1. I’ve got two off-topic questions I’d like to put out there:

    1. I don’t see Lima beans in legumes or in other vegetables of the daily dozen. What would you all consider them?

    2. I know that the only ‘endorsed’ supplements here are vitamin B12, algae derived omega 3’s and vitamin D if you can’t get enough sunlight. However, has anyone been keeping up on the research with nicotinamide riboside? Do you think it’ll prove beneficial in the long run or just another over-hyped, overpriced pill for those that don’t want to improve their health through nutrition and exercise?

    1. There are no long term studies of its safety or effectiveness in humans. So why take the risk?

      The amounts naturally contained in foods are thought to be tiny so who knows what long term ingestion of NMR in the huge quantities contained in supplements will do or whether the body can safely and effectively handle large amounts taken regularly over a period of months or years (let alone decades).

    2. There’s a bunch of different beans. It would be hard to list them all. Dr. McDougall likes limas, Dr. Barnard likes limas, I like limas…….

      How did humans survive without those nicotinamide riboside supplements for millions of years before the internet?

    3. You might enjoy participating in the online (free!) 2018 Food Revolution summit, that started today and goes through May 6th. Dr. Greger seems the opening presenter, along with many other luminaries from the WFPB camp.
      (Scroll down to see the full speaker lineup)

      Yesterday morning at 8 AM I listened to Dr. Greger doing the opening protestation with John Robbins, and working together the two of them did an A+ job. Together they had an almost choreographed synergy that hit the ball right out of the park. Each presentation remains available to listen to for free for 21 hours afterwards.

    1. Preisman- I found another example for you if how it’s never too late. In this video Dr. Greger goes over the research of how a plant based diet improve your heart and cardiovascular health at any age. Improving your vessel dilation, blood pressure, resting heart rate, and reversing atherosclerosis all refund the risk of death and disability of stroke, heart disease, and neurodegenerative diseases. I hope these help!

    2. I´m 76 and adopted whole food plant based 8 years ago. Before that followed vegetarian for 32 years. Got sick every year of the 32 with sore throats, cough, chest congestion. Once I gave up the dairy I haven´t gotten sick at all during these 8 years. My health has been getting better and better so now I´m able to speak at events here in Mexico.

    3. Well, I am living proof that starting to eat a WFPB diet at age 75 works! I changed my diet (from several years on a Mediterranean diet and walking 2 miles every day) after accidentally catching Dr. Neil Bernard’s PBS Program in 2010 about changing to a vegan diet.

      I had required three different angioplasty operations prior to that to open up arteries in both the left and right ventricular chambers, the last one in 2004 had greater than 90% blockage. It is so occluded that the balloon with stent over the ballon couldn’t get into position to expand properly, so they had to withdraw the whole probe assembly, remove the stent and reinsert the catheter with just the ballon. After some jabbing (amazing that you can watch this procedure on the monitor) they got it into position and expanded the ballon to flatten the plaque blockage. They then withdrew the probe, reattached the stent (⅞ inch length), reinserted the probe, expanded the stent, and finally withdrew the probe. While recovering in the hospital, it was discovered that I had partial paralysis in my left leg from a portion of the plaque that apparently broke off and lodged in my brain. Thankfully, it was minor and I was fine within 10 days.

      I had my annual, full panel, lipid workup the month after the angioplasty. This documented my family doctor’s report of “great” lipid panel results, although I was still taking statins, a beta-blocker. and blood pressure meds. He was so impressed that he tried to change to a vegan diet, but he didn’t maintain the effort. Within a few months my cardiologist agreed that I could stop taking all my prescriptions, which I have been able to continue for eight years, now at 82 years of age. I have continued to walk, working up to 3 miles per day outdoors, or 30-minutes indoor stair-stepping when raining here in the NW to comply with Dr. Greger’s video indicating that 7 hours/week of brisk walking provided the best mortality results.I still have more energy than I had at 60 years of age. The amazing thing for me, in addition to no more angina pain, is that I haven’t had a case of influenza since I started this diet eight years ago! Previously, I always came down with the flu once and sometimes twice a year.

    1. Michael,
      Yes, no cure for dead and I want to go at 100 mph till they turn off the switch. Not slowly sink into ill health in mid life only to be tortured by modern medicine till death. Saw too many of my patients go like this. Healthy,happy active,repeat..Healthy,happy active,repeat..
      Healthy,happy active,repeat..Healthy,happy active,repeat..Healthy,happy active,repeat..
      Healthy,happy active till your dead..


  2. I’m 70 years old and I’ve been following dr. Greger daily dozen for about a year now ,I take a B12 vitamin ,and sometimes I take that. Clam magnesium to sleep, but I have to testify to the Daily dozen it has improved my help immensely I’ve lost weight I feel good people think I’m sick some think I’m crazy but I can honestly say thank you dr. Greger

  3. How to lose weight in today’s hostile food environment.
    After my dad had his third heart attack his doctor strongly advised him to avoid SOS–sugar, oil and salt. Most prepackaged foods are full of those three ingredients. So my mother dedicated herself to making all my father’s meals studiously leaving out the SOS.
    He was able to lose 80 pounds in his 60’s. He looked more handsome than I had ever known him and he had to go out and buy a whole new wardrobe. He had more energy and was able to keep the weight off for years afterwards. Best of all he suffered no more heart attacks.
    He eventually died from the results of injury from a car wreck. He did have a bad habit of sleeping at the wheel
    Bottom line, yes it can be done but not when eating out at restaurants or consuming “prepared” food, read anything that comes in a crinkly bag or four color printed cardboard box, or anything that comes with a “nutritional label” which is the signature of all “prepared food.”
    Prepare all your own whole plant foods bought in the produce section of the store. Avoid all animal based food products which are by definition full of fats and cholesterol, high in salt and have no fiber. You need more fiber and less protein. Indeed, plants come with plenty of protein and you don’t need to eat animal source products to get enough of it. Best to avoid the bacteria load that comes with animal food products, cooked or rare. Your body has to deal with the bacteria carcases, dead or alive.
    I am struggling with losing the 40 pounds I gained when I quit smoking. It is a real challenge to avoid eating out and nibbling off tables of high fat, sugar and oily, salty snacks at social events.

    1. Frances,

      I love your story about your father.

      I love the concept of an SOS diet. Having a diet named for a cry for help sounds fitting.

      Sorry to hear about his passing.

      My younger brother is someone who works double shifts and has an hour long commute and has told me that he has fallen asleep at particularly long stop lights in the middle of the night sometimes.

      I have never fallen asleep while driving, but I have been so tired that I have stopped at a stop sign and waited for it to change.

      Working on dietary changes, but I am also aiming for sleeping now and then.

      Caretaking is what messed me up. Ten years of having people who had reversed day for night and I still fall asleep after 4 in the morning.

      I guess WFPB can’t protect us from every outcome.

    2. Hi Frances – I’m Janelle, a Registered Dietitian and also a Health Support Volunteer for Thanks for your comment! That is an incredible story you shared about your dad and the significant lifestyle changes he made to better his health. I understand the struggle you are having with losing weight, and I would encourage you to check out Dr. Greger’s Daily Dozen checklist ( You can download the app and use it as a helpful tool to better focus your eating on healthful foods that will be filling and satisfying. Bringing your own whole, plant-based foods to social events is another helpful tip that will guarantee you have something nutritious and delicious to snack on instead of the fat/sugar/oil/salt snacks that often fill the table! I hope this helps!

  4. What I liked the most from the turning back the clock video was that every level of improvement had a win.

    I have been losing weight again on WFPB, but with the 4 categories, the fact that my weight crept up after injuries and caretaking would disqualify me from benefit yet, but with the 3 categories, I get to have a 40% lower risk of dying from not smoking as my first category. Already a win!

    Then, I get to have a benefit just from being in the Top 40% of compliance with the wimpy Federal guidelines, so that brings me up to 50% lower risk of dying. Hooray. Win-win and that was before I went Whole Food Super Food all Vegan Mostly Whole Food Plant Based with a few veggie product packaged foods and a newly acquired weakness for blue corn taco shells. 50% is pretty good!

    Not sure if my dog walking at golf pace exercise counts all the way to getting the 82% improvement in benefit, but maybe I am 62% or 72% or something. Win Win Win and if I keep losing weight I get the 4th.

    1. Laughing, because I give myself an extra 10%, because I am going through Turmeric so fast that I have to find bigger bottles, now that I figured out how to mask it in things like tomato paste.

      Lentils mask everything. They have this miraculous absorption of flavors of all the spices property. I still get the nutritional benefits even if I can’t taste the spices, right?

  5. For some one who reads over 8000 medical/scientific journals annually (let’s see that’s about 666 amonth, maybe 22 a day; maybe11in the morning and another 11 in the evening…) and translates the medical/scientific literature for us! What I want to ask on his next podcast, question: does he have a “normal ” I Q yes or no. THANKS for the blog Dr. G and can’t wait for your book on fasting.

    1. I am laughing at the “normal IQ” concept.

      I say it, because looking at nutrition web-sites and Universities and Hospitals, there are an awful lot of “dumb-smart” people out there.

      I was pondering that a few days ago, when I made a comment about Bill Clinton and Steve Jobs both leaving WFPB, because one “dumb-smart” person or another confused them.

      What I can say about Dr. Greger is that, I have brain issues, but Dr. Greger has shown me the pictures and given the statistics and given information that I won’t even keep searching outside WFPB ever again. I might ponder Nutritional Yeast or Avocados or how many servings of nuts are in my glass of nut milk, but I could come here and thank Dr. Greger every single day for the rest of my life – even just for taking away some of the confusion, but how could I ever possibly thank him that I have zero fear of Diabetes and pretty low fear of Heart Disease and I was terrified of Alzheimer’s, but I have pictures so clear of blocked arteries and I have tools like pomegranate and getting rid of saturated fat. How could I ever possibly thank this man for being funny enough and sweet enough and having a good enough story about his grandmother that I didn’t just watch one YouTube video, I came to find out what else this man might say.

      Honestly, the How Not To Die series is all I needed to hear, for the rest of my life, but it has been months and I am still here learning things and that makes me want to say, thank you for reading all of those boring studies for me and for finding some non-boring studies, which are well-written and thank you for simplifying the confusing and for making me laugh.

      I am still waiting for the musical version of How Not To Die. Org rhymes with morgue is a hint for the theme song lyrics.

      1. And I know that saying all of that could even sound like I am stroking Dr. Greger’s ego or idolizing him, which is a particularly big Biblical “No No” but it isn’t that.

        Even this one entry. I feel so much more confidence. I went through my whole life not knowing even how to eat. I am laughing, because I had slowly crept up in weight and had done every kind of diet and always felt hungry, except on Atkins, but had my friend’s father die from that and heard bad things about it and didn’t know that author was Dr. Greger, but I stopped Atkins and went through menopause and stopped dieting, then tried to eat better, but stalled out weight wise and even getting rid of all the junk food and soda and fast food didn’t help, and now here I am effortlessly losing weight and not being hungry and it feels like I am eating the same foods, just with more of the fruits and vegetables, so it feels like this mystery.

        I am sure Dr. Greger’s family had to not have any idea how to thank non-doctor Pritikin.

        There really is a sense of overwhelm at WFPB that I can’t even explain to my family yet.

        It is like I want to ask, “How can this possibly be this easy for all of these diseases?”

        I can get a 40% less chance of dying, just by not taking up smoking. I wonder how many percentage giving up soda and Round Up added.

        I am even not adding salt and my family licked salt off their hands. I didn’t even go and look up that study to make sure I agreed. I am using so many spices and herbs that I don’t need salt and most things have a “no salt” version, so I figured, “Why not?”

        And I am laughing, because so many people come here to argue their pet topics and I just am so happy to find this easy way to do everything.

        1. And I am laughing even harder, because I did Spark People and that is this positive, encouraging web-site, which I am pretty sure recommends WFPB, but not in the right way at all and I am typing in every single thing I am eating and keeping track of calories and carbs and now I am just eating and watching funny videos and there I wasn’t losing weight for a few months of improved eating and now I lost 8 pounds in the past 3 weeks and I want to tell them, they are not putting the right information.

          1. And I didn’t mean to call the studies boring.

            I love the researchers and the people who fund the research.

            I watched Eating You Alive and whole families would die without the right answers.

  6. A few of my friends are adopting a ketogenic (keto) diet and some of them can even tell me what their specific ketone levels are throughout the day. Personally, I have embraced Dr. Greger’s daily dozen (plus) approach because it makes sense and seems to suit me just fine. However, I wanted to point some of those friends to, but was surprised to find no Dr. Greger videos or blogs “directly” addressing this subject. Am I looking in the wrong places? Thanks.

    1. Keto diets are by definition low carb and high protein and/or high fat diets. So you can search for ‘low carb”.”fat” and “protein”. But there is nothing here that tackles keto directly.

      Unfortunately, keto dieters live in their own world (or echo chamber as it has been called).where they reinforce each other’s beliefs. They may not be open to evidence or other ideas that contradict keto claims

      However, it is worth pointing out that there are no long term studies of the effects of long term keto diets. That said, David Katz though has outlined some f the major reasons for being wary of such diets

      Keto diets (KD) have however proved useful in treating intractable paediatric epilepsy but even there, under strict medical supervision, such diets can deliver serious adverse effects

      “RESULTS: The most common early-onset complication was dehydration, especially in patients who started the KD with initial fasting. Gastrointestinal disturbances, such as nausea/vomiting, diarrhea, and constipation, also were frequently noted, sometimes associated with gastritis and fat intolerance. Other early-onset complications, in order of frequency, were hypertriglyceridemia, transient hyperuricemia, hypercholesterolemia, various infectious diseases, symptomatic hypoglycemia, hypoproteinemia, hypomagnesemia, repetitive hyponatremia, low concentrations of high-density lipoprotein, lipoid pneumonia due to aspiration, hepatitis, acute pancreatitis, and persistent metabolic acidosis. Late-onset complications also included osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron-deficiency anemia. Most early- and late-onset complications were transient and successfully managed by careful follow-up and conservative strategies. However, 22 (17.1%) patients ceased the KD because of various kinds of serious complications, and 4 (3.1%) patients died during the KD, two of sepsis, one of cardiomyopathy, and one of lipoid pneumonia.”

      In fact, we know that low carb diets generally seem to be associated with higher mortality and are likely unsafe eg

      It is also worth noting that the World Health Organization has assessed the evidence and concluded that processed meat is carcinogenic and red meat is probably carcinogenic.

      And the fact is that no credible health authority anywhere on the planet recommends keto diets. The World Health Organization, the World Cancer Research Fund and the US Dietary Guidelines reviews of the available evidence all pretty much say that we should be eating more plants instead – vegetables fruits and wholgrains.

    2. Alex

      I just came across this newspaper article (below) discussing a Hravrd study which concluded that just giving up meat alone reduces the risk of premature death by a third

      In fact the lead researcher commented

      “That’s probably an underestimate as well as that doesn’t take into account the fact that obesity is important and we control for obesity.”

      This all seems like a pretty good argument for not going keto to me.

  7. Alex the search function on the site plainly sucks. Most key on words spoken in dialogue or in print by frequency but this here seems to have no such functional ability.

    That said here is a video on life span and animal protein as opposed to plant protein and the amino acid profile which may account for that…

    Appears if your friends are doing keto with a emphasis on animal protein or dairy protein this may be a reason for caution. Keto on a plant protein basis would seemingly have no such consequence.

    There are those who do keto on plant foods but they are very minor compared to those who use animals meat.
    I personally use more protein than most vegans but vegan sports nutrition is supporting that.
    Don’t follow the keto stuff but protein by my read as a enemy is mostly like this, found to be a read on animal diary protein, rather than all protein such as pea or soy. Our culture and science seems to combine the two as one usually. If you are eating high protein you must be eating meat and dairy….well no not really.
    More in athletics are doing it now so perhaps more vegan specific study on high protein will result.

    1. If your friends are athletes you will find more and more vegan WFPB peoples are out there. As to sports specific nutritional trend I would say it is the most growing literally on fire aspect especially in the UK.
      Athletes are going to WFPB for the enhancement in recovery following work outs.
      You find this presenting in strange places…two UFC fighters Nick and Nate Diaz use vegan type diets(with the exception of eggs) in training for fights. Strongman boxing, football, here and there more and more are going this way.

      The sundance film festival this year had a movie on this topic. Your friends could certainly do vegan keto. I personally think it has not the benefits claimed in other than a short term consideration but many seem to favor it. Vegan by my read would be way more healthful.

      1. In the video I mentioned I’m pretty sure the calculations on leucine were per caloric amount not amount per equal weight measured.

        1. To add if you are a younger person and your friends are as well..many take UFC fighters to be mainly espousing a keto diet as attested to by Joe Rogan and others.
          But keep in mind most all of the high level fighters are employing personal nutritionists, people with degrees who have sports nutrition as speciality, to frame their diets. If it was as simple as Keto none of that would be necessary.
          By my guess it is marketing to push UFC as being a mans man type of thing fighting hunting, seeking a demographic held by other sports such as football to draw in fans..but admittedly that is a personal conclusion.

          But hearing the Diaz brothers and others who the UFC do not favor(one Diaz brother was suspended for several years for pot) speak out against meat…I presume there is a tie in with sponsorship. Dana White perhaps he is actively courting meat sponsors but as stated do not know.
          The idea UFC is keto is not true certainly. But listening to Joe Rogan tell would think they were. And his site is a million plus. He draws sponsorship from hunter related corporation appearing many times in hunting magazines and media.

          1. Ron,

            I don’t even think Bambi could get hunters to go WFPB.

            Though, when I have watched the WFPB presenting documentaries, the “growing up on a cattle ranch” type stories from WFPB doctors is fascinating.

            Maybe sometimes they see the disease first?

            I am watching my friends have pain and disease and dis- ease meaning lack of ease as in a hard life.

            I am thrilled today though, because my cousin tried some of my gadgets and he had the same “less pain after one session” type of experience that I had. He hasn’t been able to walk or drive and it has been getting worse since the doctors kept pushing him away from fruits and vegetables and grains and toward meats with his stage 5 kidney diet.

            I am going to be fascinated with whether the MicroPulse ICES accidentally heals his kidneys, on top of getting rid of his pain. (It reversed kidney disease in cats) I had brought some of the gadgets over to him a year ago after I read that they used light therapy when elderly patients couldn’t have transplants and it improved kidney function and the Vie Light used research from Russia where IV laser reversed kidney disease. Their puts the light into the nasal passages and it may work the same. Basically, all the blood in the body goes through those nasal passages after a while. I can’t remember if it was 20 minutes or 40 minutes. The Russians did a 40 minute study either way.

            I found cold laser ones, too, but this is just about “Can I get your kidneys better enough so that you can eat your fruits and vegetables and not go on Dialysis?”

            Not sure, but his pain going away after 1 session is already motivation enough to try them out.

            1. And, no, it wouldn’t be accidental.

              I told him about the study.

              A year ago, he didn’t believe it and six months ago, he didn’t believe the WFPB, but now he is about to have to do dialysis for the rest of his life, so he is in the time period where he still has money, but probably won’t ever have money again.

              Good time to try the gadgets.

              1. Also, he never recovered from a stroke from 7 years ago and I want him to get brain plasticity with me.

                He has been so down and in such pain, lack of pain is my favorite part, but I believe in so many things, which could radically change him. Even faith and hope and positivity. I even love placebo effect for someone like him.

  8. Thank you Ron for taking the time to answer and your detailed response. I will definitely have them look into vegan keto. Enjoy your day.

  9. Today on The Food Revolution Summit it was about not eating chemicals.

    Andrew Kimbrell did an excellent interview on GMO, Carey Gilliam did an excellent interview on The Great Glyphosate Cover-Up and Vani Hari did an excellent interview on the hazardous chemicals and addictive flavors in food.

    And, yes, I chose the same word, “excellent” for all of them.

    Someday, there might be a study on getting rid of all these chemicals and how that “minor” lifestyle change might make a major difference.

  10. I ended up crying after listening to it.

    People have to fight to get people to not poison people.

    We are such an unhealthy country and I couldn’t use enough exclamatory punctuation if I even wanted to and honestly, I just feel sick about it.

    The thing is, I knew about pesticides and the fact that so many people are lying to get money.

    I didn’t know that WFPB organic would reverse diseases.

    I know that good doctors and good farmers and good government officials are blinded by their need to make a living. Most people would be. People end up on the wrong side of the mental tracks and don’t even believe in the other side exists.

    I know that I am typing this out in a symbolic room full of strangers who barely interact and even that, we are so desperately unhealthy all of it is so unhealthy.

    And those of you who were raised WFPB and interacting in deep, meaningful, authentic, passionate, kind-hearted, soul-filling conversations with people who would be there for you no matter what won’t even understand what I am talking about and I am going to say, “Good for you!”

    I will be glad for everyone who didn’t get perverted by this culture.

    Good for you!

    Almost everyone I know comes from junk food, abuse and worship of leisure time and it is so hard, because it is hard to get people to interact at a real level and connect and care about things. They care about ridiculously violent and perverted television shows and the right to eat junk.

    Not putting them down. It is just the reality. Half the marriages end in divorce. Parents spend less than 5 quality minutes with their kids. People are in debt through the roof and can’t stop spending.

    And, yes, I am posting this in a comment section of strangers and that is something that exposes me. I have lost the people I was the closest to from disease and death. I still love the ones who are left, but they can’t have this conversation with me yet.

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