Why This Book:  I work pretty hard – at least harder than most without being obsessed with it – to build a foundation of health, wellness and fitness that will allow me to live well and pursue my adventures well beyond middle age.  I wrote a piece on longevity in my Bob’s Corner Blog a few years ago which peaked my interest. I read this book while attending a total immersion program in health, wellness, and fitness in Virginia Beach, also intended to increase health and wellness. 

Summary in 4 Sentences:  This is a book about nutrition and the gut-biome – Gundry makes the convincing case that our gut biome, or microbiome – the bacteria that lives in our stomachs and small intestines – is a fundamental source of our health, wellness, or alternatively, our disabilities and maladies.  He argues that certain foods make our “gut-buddies” happy, others make it difficult for them to to their jobs, or help the bad bugs in our gut thrive or make it possible for bad nutrients to pass through the stomach lining and activate our immune system to attack them, which over time, is the source of much our inflammation, arthritis, and degeneration of our physical and mental capabilities.  He argues – again rather convincingly – that a diet that takes care of our gut-buddies and excludes or severely limits foods that support our bad bugs and/or can get thru our stomach lining, will extend health, well-being and life.  He tells us which foods to eat, which to avoid, how best to fast occasionally and why, and gives a whole chapter on meal plans and recipes for longevity enhancing dishes. 

My Impressions:  Fascinating book, easy to read, convincing and inspiring. Gundry is a well known cardiologist who has become something of a nutritional expert. His book The Plant Paradox was an opening salvo (I haven’t read it) in his efforts to explain and  improve people’s diets.   His focus is on the microbiome – our gut and stomach lining.  He writes for the lay person, but most lay people will not be familiar with some of the biology and the names of some of the enzymes and molecules which he uses to explain his arguments – but he makes it easy to overlook that. This book expands and explains the role of dietary consideration in explaining longevity, health span and wellness with a different approach – taking care of our microbiome means taking care of our long term health.  His explanations are convincing and he makes it interesting and even fun – and includes a lot of surprises.  

His recommendations are consistent with much of what I’ve heard from other nutritionists, and are very consistent with Michael Pollan’s simple seven word guide to healthy eating:  Eat Food, not too much, mostly plants. “Eat food” means eat primarily fresh – not processed, packaged, or canned food.  His recommendations will not be controversial with most nutritionists or doctors, though he does argue against the Keto and protein focused argument for more meat and saturated fats.  

What is different (for me) about his approach is the focus on the microbiome, how critically important it is to our health, how broad ranging and impactful the effects of a healthy (or unhealthy) microbiome can be, and how our diet should take care of it.  Some may argue with some of his recommendations, but the biggest question for most people will be: How important is my LONG TERM health to me, and what changes and inconveniences am I willing to put up with in order to invest in it?  Long term health is like a lot of things that are truly good in life – it requires discipline to invest in delayed gratification.  To attain long term health and wellness requires a willingness to endure some short term discomforts and give up some impulsive short term pleasures (junk food, fast food, sweets, easy, fast calories.)  Like working out when I might prefer more comfortable alternatives – like eating, drinking, watching TV. 

He argues that heart disease is largely an auto-immune disorder, brought on by inflammation caused by a diet which promotes inflammation.  He says that cholesterol is NOT the enemy – it is Triglycerides and  he gives an argument that only a cardiologist could give.   He has a whole chapter on memory and brain health and ties that again, to our microbiome and reducing inflammation in the brain. He offers some novel ways to maintain brain health in addition to diet – he argues that our last meal should be four hours before we sleep so that our body’s resources and blood are available to heal and take care of the brain at night while we sleep, instead of digesting our meal.  He argues for intermittent fasting, and occasional fasts or fasting mimicking diets to give the brain and the body an opportunity to cleanse themselves of dead and inefficient cells in the absence of calories.  He clearly believes that over time, dementia and Alzheimers can be significantly reduced if not defeated by a healthy diet that takes care of the brain and reduces inflammation.

He believes that the epidemic of cancer can also be traced to a diet which does not support a strong and healthy microbiome.  He writes that, “The standard Western diet promotes cancer growth at every turn.” p115

He also offers lifestyle changes and challenges to promote longevity and longer health span, to include a simple daily 5 minute exercise program, sleep advice, advice on timing on eating and fasting, as well as an abundance of recipes that follow his plan. He also gives specific guidance on supplements – some of which I’ve never heard of or are probably hard to find.  

He has a section on the 7 deadly myths about longevity – and he debunks them. He’s carefully studied the people in the Blue Zones and found that they largely live on plant based diets, not much meat, lots of healthy oils, regular exercise outdoors, and damn little sugar and simple carbs.  He says, “It’s very simple: if you want a healthier microbiome (and therefore a healthier brain and body), eat plenty of olive oil!” p157

He has many lists and explanations of foods we should eat to support our microbiome and many that we should avoid – quite a few of which conventional wisdom has taught us are good and healthy. But he disabuses us of some this outdated wisdom we got from our grandmothers.  In his arguments though, he gives explanations based on molecules, enzymes, activating inflammation,  gut biome response.  For example, he says “Consumption of dairy products is not conducive to a long life and health span” P90  

A very limited list of his Dont’s and Do’s is below. His complete list is on pages 225- 233 of his book: 

SOME FOODS TO AVOID/minimize:                        SOME FOODS TO EAT PLENTY OF

• Animal protein (some is permitted)                       * Olive Oil
• Any dairy products from cows                                 * nuts and seeds
• anti-biotics                                                                  * cruciferous vegetables
• wheat and all grains                                                   *Avocados/guacamole
• most breads                                                                * Extra dark chocolate
• simple carbs                                                               * Purple sweet potatoes
• sugar                                                                           * Red wine (some; not “plenty of”)
• Ripe Fruit (too much sugar)                                    * Coconut/MCT oil
• Egg whites                                                                  * Spinach
• Rice brown or white                                                   * Black Pepper
• soy products                                                               * Green vegetables
• Most artificial sweeteners                                          *Stevia 

I really liked this book, but to follow all of his guidance would be a full time job and would require giving up some things I am unwilling to give up entirely – but I can certainly significantly reduce how much of them I eat (for me, that’s a pretty long list, and includes key lime pie, ice cream, pizza).  He gives a number of examples of unwell people who’ve switched to and followed his program strictly and had pretty remarkable results, significantly reducing and even eliminating their “co-morbidities.”  

I’m pretty healthy now, but he has convinced me to make a number of changes to my diet that won’t be too hard, but could make a lasting difference – especially in reducing inflammation and improving brain health. As I get deeper into middle age, and in a few years will be knocking at the door of old age, I’m willing to invest more in maximizing my health span and agility to be able to continue to be healthy and physically active to extend my health span and enjoy life into my 90s. I’d recommend this book to anyone who is willing to sacrifice a few short term pleasures and start making investments in their own longevity and life and health span.  The Longevity Paradox may not be a comforting read, but it is convincing.