How to Live Longer

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According to research studies, there are four smart behaviors we all can do to help extend our health and lifespan. In this article,  Dr. Michael Greger, M.D., physician, author, and founder of, shares which lifestyle changes can increase our longevity.

Senior Man and woman exercising with bicycles outdoors, they are a couple

By: Dr. Michael Greger, M.D., FACLM

History of causes of death

Medical antropologists have identified several major eras of human disease, starting with the Age of Pestilence and Famine, which largely ended with the Industrial Revolution, or the state we’re in now, the Age of Degenerative and Man-Made Diseases.1 This shift is reflected in the changing causes of death over the last century.

In 1900 in the United States, the top-three killers were infectious diseases: pneumonia, tuberculosis, and diarrheal disease.2 Now, the killers are largely lifestyle diseases: heart disease, cancer, and chronic lung disease.3

Is this simply because anitbiotics have enabled us to live long enough to suffer from degenerative diseases? No. The emergence of these epidemics of chronic disease was accompanied by dramatic shifts in dietary patterns. This is best exemplified by what’s been happening to disease rates among people in the developing world over the last few decades as they’ve rapidly Westernized their diets.

What role does nutrition play in lifespan?

In 1990 around the world, most years of healthy life were lost to undernutrition, such as diarrheal diseases in malnourished children, but now the greatest disease burden is attributed to high blood pressure, a disease of overnutrition.4

The pandemic of chronic disease has been ascribed in part to the near-universal shift toward a diet dominated by animal-sourced and processed foods–in other words, more meat, dairy, eggs, oils, soda, sugar, and refined grains.5

China is perhaps the best-studied example. There, a transition away from the country’s traditional, plant-based diet was accompanied by a sharp rise in diet-related chronic diseases, such as obesity, diabetes, cardiovascular disease, and cancer.6

Why do we suspect these changes in diet and disease are related? After all, rapidly industrializing societies undergo multitudes of changes. How are scientists able to parse out the effects of specific foods? To isolate the effects of different dietary components, researchers can follow the diets and diseases of large groups of defined individuals over time.

fresh food at an asian market

Do vegetarians live longer?

Take meat, for example. To see what effect an increase in meat consumption might have on disease rates, researchers studied lapsed vegetarians. People who once ate vegetarian diets but then started to eat meat at least once a week experienced a 146 percent increase in odds of heart disease, a 152 percent increase in stroke, a 166 percent increase in diabetes, and a 231 percent increase in odds for weight gain. During the twelve years after the transition from vegetarian to omnivore, meat-eating was associated with a 3.6-year decrease in life expectancy. 7

Even vegetarians can suffer high rates of chronic disease, though, if they eat a lot of processed foods. Take India, for example. This country’s rates of diabetes, heart disease, obesity, and stroke have increased far faster than might have been expected given its relatively small increase in per capita meat consumption.

This has been blamed on the decreasing “whole plant food content of their diet,” including a shift from brown rice to white and the substitution of other refined carbohydrates, packaged snacks, and fast-food products for India’s traditional staples of lentils, fruits, vegetables, whole grains, nuts, and seeds.8

Health-promoting foods

In general, the dividing line between health-promoting and disease-promoting foods may be less plant- versus animal-sourced foods and more whole plant foods versus most everything else.

To this end, a dietary quality index was developed that simply reflects the percentage of calories people derive from nutrient-rich, unprocessed plant foods9 on a scale of zero to one hundred. The higher people score, the more body fat they may lose over time10 and the lower their risk may be of abdominal obesity,11 high blood pressure,12 high cholesterol, and high triglycerides.13

Comparing the diets of 100 women with breast cancer to 175 healthy women, researchers concluded that scoring higher on the whole plant food diet index (greater than about thirty compared to less than about eighteen) may reduce the odds of breast cancer by more than 90 percent.14

Sadly, most Americans hardly make it past a score of ten. The standard American diet rates eleven out of one hundred. According to estimates from the U.S. Department of Agriculture, 32 percent of our calories come from animal foods, 57 percent comes from processed plant foods, and only 11 percent comes from whole grains, beans, fruits, vegetables, and nuts.15 That means on a scale of one to ten, the American diet would rate about one.

We eat almost as if the future doesn’t matter. And, indeed, there are actually data to back that up. A study entitled “Death Row Nutrition: Curious Conclusions of Last Meals” analyzed the last meal requests of hundreds of individuals executed in the United States during a five-year period. It turns out that the nutritional content didn’t differ much from what Americans normally eat.16 If we continue to eat as though we’re having our last meals, eventually they will be.

4 steps you can take

What percentage of Americans hit all the American Heart Association’s “Simple 7” recommendations? Of 1,933 men and women surveyed, most met two or three, but hardly any managed to meet all seven simple healthy components. In fact, just a single individual could boast hitting all seven recommendations.17 One person out of nearly two thousand. As a recent past president of the American Heart Association responded, “That should give all of us pause.”18

The truth is that adhering to just four simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases.

Recommended lifestyle behaviors to live longer:

  1. Not smoking
  2. Not being obese
  3. Getting half-hour of exercise daily
  4. Eating healthier–defined as consuming more fruits, veggies, and whole grains and less meat

Those four factors alone were found to account for 78 percent of chronic disease factors. If you start from scratch and manage to tick off all four, you may be able to wipe out more than 90 percent of your risk of developing diabetes, more than 80 percent of your risk of having a heart attack, cut by half your risk of having a stroke, and reduce your overall cancer risk by more than one-third.19

For some cancers, like our number-two cancer killer, colon cancer, up to 71 percent of cases appear to be preventable through a similar portfolio of simple diet and lifestyle changes.20

Maybe it’s time we stop blaming genetics and focus on the more than 70 percent that is directly under our control.21 We have the power.

Open vegan tortilla wraps with sweet potato, beans, avocado, tomatoes, pumpkin and seedlings on a white background, top view, flat lay. Healthy vegan food concept.

Excerpted HOW NOT TO DIE: Discover the Foods Scientifically Proven to Prevent and Reverse Disease by Michael Greger. Copyright © 2015 by Michael Greger. Reprinted with permission from Flatiron Books. All rights reserved.

This article, How Not to Die, is also from Dr. Greger and his book.

For those of you new to the whole food plant-based lifestyle, we’ve created a FREE 7-Day Plant-Based Menu Planner to help you get started!

About the Author

Dr. Michael Greger MD

Dr. Greger is a physician, New York Times bestselling author, and internationally recognized speaker on nutrition, food safety, and public health issues. He is the Research Director for

A founding member and Fellow of the American College of Lifestyle Medicine, Dr. Greger is licensed as a general practitioner specializing in clinical nutrition.

He is a graduate of the Cornell University School of Agriculture and Tufts University School of Medicine. In 2017, Dr. Greger was honored with the ACLM Lifestyle Medicine Trailblazer Award and became a diplomat of the American Board of Lifestyle Medicine.

Three of his recent books— How Not to Die (with over a million copies sold), the How Not to Die Cookbook, and How Not to Diet all became instant New York Times Best Sellers. His latest two books, How to Survive a Pandemic and the How Not to Diet Cookbook, were released in 2020. All proceeds he receives from the sales of his books go to charity.

Resources for eating healthier


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  2. US Centers ofr Disease Control and Prevention. Leading causes of death, 1900-1998. http://www.cdc/gov/nchs/data/dvs/lead1900_98.pdf. Accesed April 29, 2015.
  3. Kochanek KD, Murphy SI. Xu J, Arias E. Mortality in the United States, 2013, NCHS Data Brief 2014;178.
  4. Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-210: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859): 2224-60.
  5. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84(2):289-98.
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  8. Singh PN, Arthur KN, Orlich MJ, et al. Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable disease in Asian Indians. Am J Clin Nutr. 2014;100 Suppl 1:359S-64S.
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  11. Mirmiran P, Bahadoran Z, Golzarand M, Shiva N, Azizi F. Association between dietary phytochemical index and 3-year changes in weight, waist circumference and body adiposity index in adults: Tehran Lipid and Glucose study. Natr Metab (Lond). 2012;9(1):108.
  12. Golzarand M. Bahadoran Z, Mirmiran P, Sadeghian-Sharif S, Azizi F. Dietry phytochemical index is inversely associated with the occurrence of hypertension in adults: a 3-year follow-up (the Tehran Lipid and Glucose Study). Eur J Clin Nutr. 2015;69(3):392-8.
  13. Golzarand M. Bahadoran Z, Mirmiran P, Sadeghian-Sharif S, Azizi F. Dietry phytochemical index and subsequent changes of lipid profile: a 3-year follow-up in Tehran Lipid and Glucose Study in Iran. ARYA Atheroscler. 2014;10(4):203-10.
  14. Bahadoran Z, Karimi Z, Houshiar-Rad , Mirzayi HR, Rashidkhani B. Dietary phytochemical index and risk of breast cancer: a case control study in a population of Iranian women. Asian Pac J Cancer Prev. 2013;14(5):2747-51.
  15. U.S. Department of Agriculture Economic Research Service. Loss-adjusted food availability. September 30, 2014. Accessed April 29, 2015.
  16. Wansink B, Kniffin KM, Shimizu M. Death row nutrition. Curious conclusions of last meals. Appetite. 2012;59(3):837-43.
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  18. Yancy CW. Is idea cardiovascular health attainable? Circulation. 2011;123(8):835-7.
  19. Ford ES, Bergmann MM, Krord J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition Potsdam study. Arch Intern Med. 2009;169(15):1355-62.
  20. Platz EA, Willett WC, Colditz GA, Rimm EB, Spiegelman D, Giovannucci E. Proportion of colon cancer risk that might be preventable in a cohort of middle-aged US men. Cancer Causes Control. 2000;11(7):579-88.
  21. Wahls TL. The seventy percent solution. J Gen Intern Med. 2011;26(10):1215-6.

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