Reverse Aging - Dr. Max Sawaf by Fadi Rahhal

Itâ&#x20AC;&#x2122;s about

time

Protocols to add years to your life and life to your years Improve your memory and energy Look your best Decrease your stress Combat cardiometabolic disease and cancer

Dr. Max

Protocols to add years to your life and life to your years

Dr. Max

Disclaimer This publication contains the opinions and ideas of the author. Every effort was expended in making sure the medical information and recommended dosages are evidence based and are backed by the latest research and publications. However, medicine is not an exact science and new findings come to light every day. This publication is sold with the understanding that the author and the publisher are not engaged in rendering medical, health, or any other kind of personal professional services. Always consult with a qualified health care professional in matters related to your health. If you are currently taking any medications consult with your physician regarding possible modifications or potential harmful interactions. Choose an honest good physician who is staying up to date with the rapidly changing body of medical information. The author and publisher specifically disclaim all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, or “of using or applying the content in this book”. To the integrative age management physicians who identified my insulin resistance and motivated me to cut down on my sugar addiction To my conventional cardiologists who changed my life with their angioplasties To the thousands of patients who gave me a chance to reverse their cardio metabolic disease and trusted me to make them look as young on the outside as they felt inside To my wife of thirty years Rene and my five children Danny, Lana, Sammy, Omar and Karim Dr. Max Copyright© 2015 by Max Sawaf, M.D. All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior consent of the copyright owner. 2

Protocols to add years to your life and life to your years

Dr. Max

PREFACE

Reverse Aging is a prescription for better health developed from over thirty years of practical experience working with thousands of clients and patients. My colleagues and I developed the Integrated Health Management System™ to help clients in our Reverse Aging Centres return to a healthier and more active life style. I compiled the best and most up to date advice in reversing aging, cosmetic procedures, and lifelong weight management from many different disciplines, and now offer it to you. This book is so much more than “just another book on dieting,” or one more “anti-aging book.” Follow the advice in this book to restore your body to a trim and youthful appearance. Improve your memory, look your best, and avoid heart disease and cancer. I know all this is possible, because I did it. Following a life threatening encounter with cardio metabolic disease, I dramatically changed my lifestyle and added years to my life expectancy. This book can do the same for you. Many celebrities in Beverly Hills are using my formulas to live better younger. But you do not have to be a celebrity to start on this beautiful and inspiring journey. No matter what your background or age is and no matter how much you already know, I promise you this book can change your life and the life of the ones you love. It’s about time! Dr. Max

Protocols to add years to your life and life to your years

Dr. Max

Contents:

Reverse Aging – It’s About Time Chapter 1: My Story - How It All Began

Chapter 2: My Recovery

Chapter 3: What Is Cardio Metabolic Disease, Anyway?

Chapter 4: Cancer, Drugs’ Side Effects and Leaky Gut

Chapter 5: Integrated Health Management System

Chapter 6: Food as Medicine – Dr. Max’s Modified Paleo Diet

Chapter 7: Putting a Healthy Lifestyle into Action

Chapter 8: Hormones and the New Generation of Medicine

Chapter 9: Cosmetic Surgery – “A Thing of Beauty”

Chapter 10: How to Quit Smoking and Other Addictions

102

Chapter 11: Summary

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Protocols to add years to your life and life to your years

Dr. Max

Chapter 1: My Story - How It All Began “We’ll need to cut him open if it doesn’t work this time.”

I was lying on an operating table fully awake while my two handpicked cardiologists debated their next step. They were referring to the less invasive cardiac catheterization method of opening clogged arteries using a series of thin wire probes. The procedure apparently was not working as they had hoped, and they were about to saw my chest open. Great, I thought. After all my attention to diet and intermittent exercise, is the dreaded heart disease that struck my father at the same age now going to take my life? Having watched thousands of sternal bones sawed open when I worked at Boston University in the cardiac anesthesia department; open-heart surgery was my least favorite choice.1 My thoughts drifted to my children. I wondered if I would see them grow up and have children of their own. I would miss their graduations and weddings their whole lives! One of the cardiologists saying this would be his last attempt quickly brought me back to the moment at hand. We had discussed my three options before the procedure - restricted lifestyle with lifetime medication, cardiac catheterization, and open-heart surgery - and the last of them was rapidly approaching. As a physician turned patient, I had asked the cardiologists to include me in their conversation during the procedure. I stubbornly refused any kind of sedation (doctors can be very difficult patients), so I was fully awake while the debate continued. At the time of my diagnosis in 2008, open-heart surgery was much more invasive than it is now. It required sawing open the sternum, stopping the heart, and diverting the circulation through a pump. Heart surgeons today make a small incision and use a scope to guide their work.

Protocols to add years to your life and life to your years

Dr. Max

I was adamant about not wanting open-heart surgery, but I had signed the consent forms in case the cardiac catheterization process proved ineffective. There is always a danger of perforating the artery, and that can mean instant death or emergency open-heart surgery if the cardiologist makes the wrong move. While this is uncommon, the risks are much higher if the cholesterol plaque is long and hardened with a lot of calcium, as it was in my case. The cardiologists worked on me for an hour and a half using different tricks and finer wires. Just as they were about to call it quits, they were finally able to pass a wire through the clogged artery and open it allowing the blood to flow again. Once they were able to open the artery, they inflated a balloon to widen it. I immediately felt overwhelming chest pain - my heart muscle was suffocating from lack of oxygen - so they gave me intravenous nitroglycerin to relieve the pain. This caused a sudden splitting headache as a rush of blood flowed to my head and brain. I had often witnessed patients enduring this type of pain, but I was now experiencing it firsthand, and the patient/doctor relationship had suddenly flipped 180 degrees. I did not like being on the opposite side of the relationship, knowing I was completely at the mercy of my two relatively unknown colleagues no matter how great their credentials.. My whole life flashed before me and I began praying in earnest for God to get me through the ordeal. As the nurse placed the cold metallic defibrillator plate behind my shoulder blade, I knew things had just gotten very serious, very quickly. Shortly before my first meeting with the cardiologist, I learned that my love for bread was contributing to my fatigue and heart problems. Like most Americans, I had consumed enough sugar in my life to fill a good-sized train car. I certainly never saw that slow-moving freight train coming, and now I was riding a high-speed bullet train about to head off the track - and I was the only passenger on the train. My journey as a patient was spinning out of control, and I did not like the feeling. 6

Protocols to add years to your life and life to your years

Dr. Max

I had promised my wife, Rene, and our five children that I would fight this battle to save my life with everything I had, but I was no longer in control. I felt more helpless than I had ever been in my life. As a frequent speaker at anti-aging conferences, I understand that death eventually takes us all, but nothing had prepared me for the conversation playing out between the two cardiologists discussing whether to cut my chest open. Yet there I was, experiencing that real, scare-the-life-out-of-you pain and fear. I frequently coach my friends and patients to have their affairs in order at all times, because I see how quickly life plans change. I did not expect to face a life-threatening illness so early in my life. My father had coronary heart disease, so I was careful to take good care of myself by exercising whenever I could find time in my busy schedule, monitoring my cholesterol levels and maintaining what I thought was a healthy diet. His battle and my battle with coronary disease helped shape my life’s work. I dedicated my life to helping others deal with this and other life-threatening illnesses. As I lay on that surgery table, my thoughts went back to my commuting days, and I prayed for more time to fulfill my dreams. After many years of building a business, my family and I had a very nice lifestyle. I was in my mid-50s, and I could have easily retired to enjoy the fruits of my labor, but my near fatal incident caused me to rededicate myself to growing younger everyday by reclaiming my health and wellbeing while helping as many people as possible. “Max is the kindest and most driven person I have ever met,” Rene often tells our friends. “His mother told me he was harder to raise than all five of his siblings. He was an overachiever from birth, and his compassion for others was evident at an early age. He really cares about his family and his patients despite his hot temper. He is now on a mission to transform the practice of medicine and spread wellness among his friends, his patients, his peers, and his neighbors.” I also want to involve my children in the quest to find more ways to slow the aging process as I extend my research into integrative medicine. They are already helping me spread the word about early 7

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detection and the lifestyle and dietary changes that can extend their lives and the lives of their children. About a year before my diagnosis, I checked myself into an antiaging center in the Midwest. I was feeling unusually fatigued, I wasn’t sleeping, and I knew intuitively that something was wrong. The doctors determined that I had insulin resistance and recommended that I cut down on my addiction to bread. I did, but I was not as strict as I should have been. When the symptoms continued, I decided to visit a cardiologist, and that’s where my journey into coronary artery disease really began. It all started on a treadmill. The first thing a cardiologist does is to conduct a stress test to determine how long a patient can exercise without feeling fatigued. I lasted less than eight minutes. The cardiologist stopped the machine and declared that I was a walking time bomb. My arteries were at least 75 percent blocked perhaps worse. I argued that all my blood chemistry was well within normal limits. On top of that, I exercised regularly, and I had just lost 11 pounds. How could this be? He ordered immediate testing. I reluctantly agreed to undergo an angiogram.2 The test confirmed that I had complete blockage of the most important two arteries connected to my heart. I kept staring at the computer screen in disbelief. My cardiologist offered me three options: 1. Retire from my active lifestyle and take medications for the rest of my life. 2. Undergo cardiac catheterization and angioplasty in an attempt to open the left anterior descending artery, nicknamed by cardiologists as “the widow maker”. 3. Submit to open-heart surgery. An angiogram is the most accurate test to find out how much damage someone’s heart has incurred. In this test, a cardiologist injects a special dye into the blood vessels through a tiny hole in the groin.

Protocols to add years to your life and life to your years

Dr. Max

None of these options sounded particularly inviting now that I was the patient. Whatâ&#x20AC;&#x2122;s behind door number four? There was no way I was I ready to retire, and I was adamantly opposed to having my chest sawed open, so that left cardiac catheterization as the only choice. Thankfully, the cardiology team was able to stabilize me and did not need to use the defibrillator, but I went home the next day limping from the pain in my groin where they had inserted the wire and guided it into my heart. Back at home, my cardiologist advised me to take CrestorÂŽ to lower my bad lipids and to reverse some of the hardening of my arteries. I had to take aspirin and Plavix to keep my blood from clotting and closing my stents, something that happens frequently, especially in the first six to 12 months after a stent placement. I was truly depressed for the first time in my life. I would be taking medications for the rest of my life and would never feel like myself again. I had a business to run and a destiny to fulfill. It took a while, but I was eventually able to cut down on the Crestor dose and refocus my mind on being thankful to God that I had not suffered any irreversible damage to my heart muscle. At age 61 and seven years later, I now run 30 minutes on the elliptical machine at a level seven of difficulty while bringing my heart rate to 140 for ten minutes. I then follow with 45 minutes of stretching and weight training. Certainly a far cry from having chest pain and shortness of breath at age 56 after just eight minutes of being on a medium speed treadmill. I do so five times a week. I never felt more energized and more in control of my destiny. I also sleep much longer and deeper than before. I have dragged with me on this wellness journey hundreds of my friends and patients. I hope you join this train. The ride is hard in the first 8-12 weeks but then becomes truly rewarding and pleasantly addicting. Spontaneity is not in my nature. I have long believed it leads to mistakes, and mistakes are the harbinger of failure. I planned my entire life, including what I would eat, where I would go to school, and what type of medicine I would practice. 9

Protocols to add years to your life and life to your years

Dr. Max

I trained in general surgery at the University of Connecticut, continued my training at Boston University, obtained my board certification in anesthesiology, and completed fellowships in cardiac anesthesiology and critical care medicine at the University of Massachusetts. During my long commutes between home and hospital, I continued to develop my life plan. The more I learned about the practice of medicine, the more I realized that most people are unaware how much control they can have on their quality of life as they age. Recent medical evidence shows that 80% of chronic disease is related to three Fâ&#x20AC;&#x2122;s: Food (the amount of sugar and fiber we eat), Fingers (smoking, drugs, and alcohol), and Feet (too much sitting and lack of exercise and muscle mass). All other factors such as pollution, stress, lack of sleep and toxic relationships account for only 20%. The food processing industry includes fructose corn syrup and other toxic sugars in the vast majority of packaged foods leading to insulin resistance. It also removes most fiber from the packaged food to prolong its shelf life and to render it easy to cook and fast to digest. We must lean gradually towards a healthy lifestyle and prevent disease, or we shall go broke as governments and societies and shall lose our most precious wealth as individuals: our health and our freedom. As my practice evolved, I became very interested in developing ways to help my patients in a holistic manner. I saw how specialists focused only on one particular discipline while ignoring total patient care. At the anti-aging centers that I helped found, our approach is different. We assemble teams of specialists who focus on the patient as a whole person and look for ways to prevent illnesses before they happen. My current practice is all about preventing people from aging prematurely, and I am board-certified in pain management and in antiaging medicine. As a cosmetic surgeon, I always knew I could work miracles on the exteriors of wealthy and famous people, but now I actively coach patients to make the necessary lifestyle changes that can extend their lives. Coaching others is one thing, but facing my own mortality is another matter altogether. I have so many things yet to do. My family needs 10

Protocols to add years to your life and life to your years

Dr. Max

me. Many of my patients need me, and I must let others know what I have learned about slowing down the aging process. As a doctor, I am now dedicated to stopping our society’s propensity toward mass suicide. Our poor diets and sedentary lifestyles are shortening our lives, yet we individually and collectively ignore the warning signs. “Every man desires to live long; but no man would be old.” Jonathan Swift My personal story is a reflection of the pill epidemic affecting the USA, which was in turn created by the food-born epidemic of cardiometabolic disease. As a society, we are going backwards quickly, and we are playing with the most unbelievably harmful book of matches you can imagine. Our matches are sugar, sugar substitutes, simple carbohydrates, trans fats, and processed food, lack of exercise, cigarettes recreational drugs, prescription drugs, and alcohol abuse. They encourage our bodies to store and trap fat, and that trapped fat comes with a long list of inflammatory toxins and immune modulators that are killing us. Most people have heard that every 29 seconds, someone has a heart attack, and every 53 seconds, another American suffers a brain stroke. Contrary to popular belief, though, and according to recent research, the fundamental issue behind heart disease is not cholesterol. Cholesterol gets all the attention, but excessive sugar intake and high insulin levels are the real culprits that take so many lives every year. Saturated fat and excessive red meat is a distant second. According to the U.S. Centers for Disease Control and Prevention, more than 600,000 men and women die of heart disease each year - that’s one out of every four deaths. If we include stroke, caused by arterial plaque, the numbers are even higher. Anyone with cancer should seriously limit sugar intake as cancer cells use sugar to fuel their growth. Some even suggest that sugar may cause cancer. Refined sugar and high fructose corn syrup found in most bread, crackers, juices, carbonated drinks, deserts, tomato soup, ketchup and salad dressings are also behind the epidemic of Alzheimer’s (also called type 11

Protocols to add years to your life and life to your years

Dr. Max

three diabetes). Statistics tell the story, but you and I are more than statistics. We are living, breathing human beings who want to live as long as we possibly can. We are all at risk unless we make positive changes in the foods we eat and alter our sedentary lifestyles. Since my real-life encounter with heart disease, I have re-energized my efforts to educate everyone I can with a new approach to medicine. The existing medical system in America and all around the world focuses on reacting to disease rather than preventing it in the first place. This book is a call to action to the global medical community and to you, to get your lifestyle in order before it is too late. As a society, we are falling off a cliff, and it is time to take positive action. We can reverse aging through prevention and early detection or even reversing disease, balancing our hormones, using our own stem cells to regenerate our joints, decrease our pain, and improve our mobility. We can also look our best while avoiding the dreaded unnatural or operated look. For the first time in history, the current generation has a shorter life expectancy than the previous generation. Many teenagers and young adults are now dying of heart disease because of the modern Western diet. It is, in fact a food-borne epidemic. Diabetes has doubled worldwide in the last two decades, and obesity is a global pandemic. Cardio metabolic disease is the global epidemic of the 21st century, but we have tools available to reduce this trend toward shorter life spans. Most Americans base their daily diets on the U.S. Department of Agriculture food pyramid introduced in 1992 and updated every five years, but many nutritionists now question several elements of the pyramid, including the recommendation to drink plenty of milk and eat lots of bread. Previous nutritional studies masked a dangerous link between carbohydrates and chronic disease because the pyramid placed the unnatural, refined carbohydrates found in bread, sugar, and white flour in the same food category as raw fruits, vegetables, and whole grains.

Protocols to add years to your life and life to your years

Dr. Max

This belief that bread was a good thing almost killed me! In fact, the refining of carbohydrates represents the most dramatic change in human nutrition since we first introduced agriculture. One in three children born today will eventually develop diabetes, and children born after 2000 will have, for the first time in human history, a shorter lifespan than their parents will. Natural whole foods stripped of water and fiber result in food that can be stored longer and cooked faster, thereby creating addicting concentrated sugar crystals in a similar manner that producers treat coca and poppies plants to create opium and cocaine. They all share the attributes of a toxic addiction: cravings, tolerance, withdrawals, and dependency. Our addiction to sugar fixes is killing us. Sugar and life rehabilitation starts with awareness. I urge you to embrace this book and its lessons as a way to turn your life around and encourage others to do the same. This is not just another diet or a guide on how to lose weight the healthy way. This book is a clarion call for a dramatic new approach to medicine that can save thousands of lives - yours included. Fear of death is as old as recorded history, and I often wonder if the recent explosive interest in antiaging medicine and cosmetic procedures reflects that collective fear of death. During my recovery, I had plenty of time to think about my life and my unfinished efforts to inform others about how integrative and personalized care can extend lives. I also thought about how our society treats our senior citizens. There was a time when we revered our elders and valued their life experiences. Today, we put them out to pasture, medicate them into a near-catatonic state, and wait for them to die. It is a national disgrace - and a costly one, at that. I am truly astonished at the number of people dealing with heart disease and age-related illnesses - how they suffer through the agonizing decline of their bodies and minds. As they get sicker, doctors prescribe more medications until prescribing and taking pills becomes an obsession for both doctors and patients. Everyone wants a magic pill that cures all ailments. This seemingly endless cycle of taking pills for what ails us usually 13

Protocols to add years to your life and life to your years

Dr. Max

starts with a general practitioner recommending some basic medication for hypertension or a similar ailment. That pill leads to depression, so the doctor prescribes an antidepressant. That drug leads to erectile dysfunction, so the doctor prescribes Viagra®, and on it goes. As people age and doctors become their primary connection to legal drugs, the doctors prescribe more medicines - for osteoporosis, joint pain, arthritis, and muscular aches and pains. Patients start referring to their pills as “the big yellow one” and “the small blue” and “the one I take at 10 o’clock” and “the ones I take after lunch.” With multiple doctors involved, nobody knows what is working and what is not. One of those multicolored plastic pill-dispensing boxes begins to seem like a good birthday gift! Soon, people find their vision deteriorating so badly that they can no longer enjoy TV, their only source of entertainment and news. They lose their memories and can’t remember the date or recognize the place where they live. They can’t even recognize their kids or grandkids. Finally, as people approach their “golden years,” the cost of assisted care wipes out what is left of their savings and drains their children’s bank accounts, as well. They are now completely dependent on others and are such a physical burden that their children place them in a nursing home. With a picture like this, who wants to get old? My wife Rene and my daughter Lana like to watch reruns of Golden Girls, a popular television series from the 1980s. In the show, Dorothy continually threatens to send Sophia to Shady Pines when she “misbehaves.” Watch out Sophia, your time has come - such is the life of an aging person in our “modern” society. How did our health care system go so far wrong? In my early years as a physician, I respected the U.S. Food and Drug Administration as a trustworthy institution that had consumer interests in mind and was independent from the influence of big pharmaceutical companies. Most Americans trust the FDA as a government agency established to protect them from greedy drug manufacturers and food 14

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producers. Unfortunately, this is not the case. In his book On the Take, Jerome Kassirer, former chief editor of the prestigious New England Journal of Medicine, talks about the incredible influence and practical control the pharmaceutical industry has on the FDA and on the education of physicians in the United States. “Aside from the harm of such biases to patient care, participation in marketing sets a poor example for younger physicians, who are being seduced by industry every day with lunches, dinners, and gifts,” writes Kassirer. “Though physicians who engage in these activities often believe that company largesse cannot influence their objectivity, all evidence from psychological studies suggests that this is a naive belief. The public has become increasingly aware that doctors are making financial ‘deals’ with pharmaceutical, biotech, and device companies. People are beginning to lose trust that their doctors’ advice is for their benefit rather than for their doctors’ benefit.”3 Thousands of hard-working physicians are dedicated to their patients and refuse to take any financial gift that might affect their clinical judgment. However, the practice of medicine has changed from a physician-patient relationship based on trust, to a corporate and insurance driven model of high volume, less personal and more cynical relationship significantly driven by monetary considerations that may endanger your health. Financial deals also extend to purveyors of alternative approaches. Unfortunately, many anti-aging organizations and self-described alternative medical “experts” aggressively recommend unnecessary vitamins and supplements. Many of these alternative medicine practitioners regularly receive kickbacks from compounding pharmacies and endorse countless unproven products, services, and equipment. Such actions leave them open to justified criticism from drug companies, the FDA, and the medical societies whose practices they question. On the Take: How Medicine’s Complicity with Big Business Can Endanger Your Health, by Jerome P. Kassirer. 251 pp. New York, Oxford University Press, 2004

Protocols to add years to your life and life to your years

Dr. Max

As a nation - indeed, as a world - we cannot continue to pour money into ineffective ways of dealing with an aging population. As described in The Washington Post, a report “by a respected think tank ranks the United States dead last in the quality of its healthcare system when compared with 10 other western, industrialized nations, the same spot it occupied in four previous studies by the same organization. Not only did the U.S. fail to move up between 2004 and 2015 - as other nations did with concerted effort and significant reforms - it also has maintained this dubious distinction while spending far more per capita ($8,508) on health care than Norway ($5,669), which has the second most expensive system.”4 The report itself, issued by the Commonwealth Fund, states, “Although the U.S. spends more on health care than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients’ perspective, and based on outcome indicators, the performance of American health care is severely lacking.”5 There are better ways for our society to deal with aging. We need to start by recognizing that conventional approaches to health care don’t work. We must also understand how marketers slant the truth about the processed foods they urge us to consume and recognize the disinformation campaigns perpetrated by self-appointed health experts who are really just pushing harmful products. The sugar industry is using the same tactics that the tobacco industry used to oppress science and ridicule scientists who threatens their profits. We all realize that we need radical lifestyle changes to remain independent and stay productive. My mission with this book is to give you the information you need to reverse your path towards self-destruction. Thousands of so-called anti-aging centers have popped up in the United States, and many more are finding their way to other parts http://www.washingtonpost.com/news/to-your-health/wp/2014/06/16/once-again-us-has-most-expensive-least-effective-healthcare-system-in-survey/ 5 http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror 4

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of the world. Unfortunately, most of these centers concentrate exclusively on providing concierge medicine for hormone replacement and miss the point of integrative and preventive medicine. I believe that preventing; predicting, and reversing cardio metabolic disease is a good place to concentrate our efforts. Doctors trained in this new approach use lab tests to uncover when a patient is on a perilous yet reversible path to sickness well before disease strikes. They then work with nutrition specialists, lifestyle consultants, sports medicine practitioners, and experts in integrative and cosmetic medicine to develop programs tailored to each patient. The new age of personalized medicine also holds a lot of promise. Cardio metabolic care is a great place to apply what we are learning at the molecular level by using what biomedical scientists call â&#x20AC;&#x153;next generation sequencing.â&#x20AC;? We will discuss this further in future chapters. Take the lessons in this book to heart, and you can significantly improve the quality of your life and the lives of your children. You can also help others by letting them know how our existing lifestyles are killing us. I invite you on a journey to save your life and the lives of those you love. Writing as a patient, I share my own very personal encounter with death. As an alarmed citizen, I use my wake-up call to challenge conventional approaches to many illnesses. As a doctor, I offer you a road map for personal wellness, vigor, and health. Are you ready? Letâ&#x20AC;&#x2122;s continue with what led to the circumstances surrounding my very personal confrontation with heart disease. However, in the end, this journey is not about me. It is about changing our modern approach to health care, and most importantly, it is about how you can live better and longer.

Chapter 2: My Recovery During my recovery from surgery, my biggest fear was losing the ability to practice medicine and becoming a victim of long-term heart disease - wasting away, losing my drive, and becoming a burden to 17

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my family. None of us wants to live out our lives as a burden to our loved ones. We want to continue functioning as useful members of society for as long as we can, but we all see what happens to people as they age. Their skin sags, they gain or lose excessive amounts of weight, they lose their hair and their hearing, and they may even lose their sight and their memories. Far worse than the physical changes, they lose their sense of belonging, they lose their direction, and in the end, they lose their dignity. As death approaches, they withdraw into themselves to live out their last days in self-imposed isolation - waiting for the train. Most countries have either mandatory or voluntary retirement programs that encourage people to “check out” after age 65. Most European countries recently moved their mandatory retirement ages from 65 to 70, but that doesn’t change the fact that society no longer considers our elderly as worthwhile citizens of the world. This is truly unfortunate, because so many “senior citizens” still have a great deal to offer. If they do check out, their bodies and minds begin to deteriorate, and we lose both their personal and collective wisdom and experience. The deepest personal defeat suffered by human beings is constituted by the difference between what one was capable of becoming and what one has in fact become. - Ashley Montagu At the anti-aging clinics, I helped found, we focus on the patient as a whole person, and that includes the patient’s mind. Patients who smile and laugh with a constant positive attitude fare better than those who focus on the downside of aging. Attitude truly is everything. In our current health care system, patients rarely meet with a doctor for more than a few brief minutes. When they do get more time, the doctor focuses on symptom relief and writing prescriptions. How many times do they have to ask about my level of pain? 18

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In the anti-aging world, we call this phenomenon “fragmentation of care.” This symptom-focused treatment is a serious issue in traditional medicine. What happens is that each physician focuses on his or her own specialty - for example, the brain, the lower back, the prostate, the gut, or the liver - as the source of a specific complaint, with little regard for the patient as a whole person? Oxidation

Plaque deposition

Plaque growth/ vulnerable plaque

Plaque rupture

Acute coronary sydrome

Plaque

Rupture

Thickening

Blood clot

Myeloperoxidase Inﬂammation Calcium build-up

Vulnerable Plaque Stiﬀening wall

Source: Cleveland HeartLab

Introducing Integrative Medicine

My colleagues and I in the anti-aging clinics believe that we have moved to a more integrative approach that relies on a more thorough diagnostic phase designed to find the underlying causes of an illness or disease before rushing to the prescription phase. Our program begins with a comprehensive questionnaire that reviews a patient’s history from all perspectives - including nutritional, emotional, sleep and stress components - as well as asking about clinical symptoms, current medications, and any nonprescription supplements the patient uses. The diagnosis includes laboratory tests to check for any imbalance in thyroid, and stress-related hormones and to identify any food intolerances, osteoporosis, cardiac risk indicators, and the ability of the liver to carry out its very important role as the body’s detoxification factory.6 We also perform electrical brain mapping or Because more than 90 percent of the drugs humans ingest are recycled in one of the six major “recycling factories” in the liver, I recommend checking each patient’s genomic DNA map, which reveals drug sensitivities in these recycling factories.

Protocols to add years to your life and life to your years

Dr. Max

Electro-Encephalo-Gram (EEG) and computer testing to evaluate your memory and detect Alzheimer’s early. Our extensive services include training sessions to improve focus? for people suffering from Attention Deficit Disorder (AAD) instead of relying exclusively on drugs. Finally, we do a head-to-toe ultrasound, which often reveals early non-symptomatic cancers, as well as arterial and cardiac diseases, without exposure to radiation. Most people don’t realize it, but the body sends warning signals up to 10 or 20 years ahead of most disease conditions. Traditional physicians receive little or no training in preventative anti-aging protocol, so these early indicators often go unnoticed until it is too late. To make matters worse, Medicare pays only for treatments - not for cognitive and preventive activities. The future of medicine is in prevention and education. Most people want to live a long, productive, and independent life and then die quickly. Unfortunately, most insurance companies do not cover preventive tests. Should we allow bureaucrats and budget cutters to condemn us to slow and painful deaths that may keep us lingering for more than 20 years? In the past, a “complete physical” only included checking the patient’s blood pressure, running a few simple tests, and a cholesterol check. Today, a good truly thorough checkup is more individualized and much more comprehensive. A thorough annual physical is one of the best investments you can make in your health. You still need to watch your own back, though, because many physicians do not go beyond the obvious when presented with multiple “soft symptoms.” While many physicians dismiss symptoms such as weight gain, irritable bowel, migraines, or diminished sex drive, integrative teams recognize them as signs of premature aging. Before prescribing drugs, an integrative team recommends diet and exercise changes, along with stress reduction as a first course of treatment. Though most insurance programs do not cover charges for integrative medicine, we expect that their position shall change as they begin to understand both the patient benefits and the financial savings available from preventive care. 20

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Meanwhile, we can prevent and even reverse chronic disease with a new approach to personal health care. At the end of the day, we are responsible for our own health, and we need to recognize that doctors are advisors, not deities, and that health care centers are profitoriented businesses. Although most physicians care deeply about their patients, they have limited flexibility when choosing treatment options. This is where an integrative approach could change the face of medicine, allowing physicians to spend more time on diagnosis and less time writing prescriptions. Unfortunately, this canâ&#x20AC;&#x2122;t happen until insurance companies, pharmaceutical companies, and regulatory agencies change their attitudes toward patient protocol and treatment plans.

Preventing and Reversing the Chronic Disease Syndrome

As a society, we can prevent and reverse the chronic disease syndrome, but it will take a concentrated effort. Regulators and special interest groups need to compare the costs of the current model to a more prevention-oriented model and make changes that will encourage practitioners to spend more time in the diagnostic phase of health care. I think the drugs-first approach to healing does more harm than good. Some older patients tell me they actually avoid an annual physical because all the doctor does is suggest vaccines and recommend prescriptions for nonexistent problems. This is institutional medicine. Large medical institutions, pharmaceutical companies, and insurance companies now dictate what doctors can and canâ&#x20AC;&#x2122;t do when interacting with patients. They want everyone vaccinated for nonexistent problems, and they want doctors to prescribe more and more drugs. It is a systemic problem that is destined to get worse as the Affordable Care Act rolls out. Doctors have limited input to the process while institutions and the government control treatment plans, hospital admissions, and patient care. 21

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Yes We Are What We Eat

My colleagues and I at the anti-aging centers believe that the best medicine is often less medicine, and poor food choices are the worst medicine of all. We need to relearn the art of cooking. People in modern society eat more meals away from home than at any time in history. Eating out contributes to weight gain and exposes our bodies to excess inflammation and toxins. In an effort to make more money per customer, many restaurants pile on the food. Extra dollars, not nutrition, drive their idea of portion control. How often do we hear, “Did you save room for dessert?” As consumers, we need to resist Mom’s directive to clean our plates. Instead, we should ask for a doggie bag and take the rest of our dinner home for tomorrow’s lunch. Mom did not serve our dinner on three plates with the entree on an oversized platter that could feed a family of four. When eating out, be mindful to substitute rice, bread, and potatoes with a side of vegetables. Try a bowl of berries with a small amount of whipped cream instead of the oversized, sugar-laden desserts offered at most restaurants. When shall “How many spoons would you like with that dessert?” become an acceptable question? The good news is that cooking at home is making a big comeback all over the world.

Your Genes and Your Environment (Gene Expression)

Before we throw drugs at our chronic disease problem, we should get off our rear ends and onto our feet. One recent study says that adding a brisk half-hour walk to your daily schedule can add three years to your life expectancy. “Three years of extra life: It’s a very clear message that makes it easy to grasp what might be the consequences of a sedentary lifestyle,” said Dr. Oscar Franco, a researcher at Erasmus Medical Center in Rotterdam, Netherlands, who co-authored a study linking exercise to increased longevity.7 What could you do with three extra years of http://www.nbcnews.com/id/10039577/ns/health-fitness/t/exercise-can-add-yearslife-expectancy/#.VCrOgeZd0tc 8CosmeSurge and Emirates Hospital

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vigorous health? Many patients come to me knowing they have a genetic predisposition for breast cancer, diabetes, or Alzheimerâ&#x20AC;&#x2122;s disease. This does not mean they are automatically prisoners of their genes - unless they violate the laws of good nutrition, sensible hormone replacement, and stress reduction. Being born with bad genes is no different from driving on a highway full of traffic police. If we follow the rules of safe driving, the police will not stop us for driving under the influence, speeding, tailgating, or running traffic signals. In a similar way, if we exercise regularly, eat a proper diet, and have regular checkups, our genetic predispositions will have less impact on our long-term health.

Confessions of a Respected Physician

â&#x20AC;&#x153;We are healed of a suffering only by experiencing it to the fullestâ&#x20AC;?. - Marcel Proust Prior to discovering my disease, I was fully confident in my medical training and abilities. After all, I was board-certified in three different medical specialties, served as the chief of cardiac anesthesia in a 300-bed hospital in South Carolina, and was the founder of a major multidisciplinary pain management center in Long Beach, California. Additionally, I was a partner with the famous dermatologist Zein Obagi before moving to Dubai, where I founded and directed two hospitals and 11 centers for cosmetic surgery, cosmetic dermatology, and anti-aging medicine. My wife and I moved back to Beverly Hills in 2014, which put us closer to our three sons who were attending the University of Southern California and allowed me to become a part of an exciting new generation of medicine. Like most traditional American-trained physicians, I was a firm believer in the wonders of high-tech medicine that had become a standard for the rest of the world to follow. At the same time, I saw the utter confusion experienced by my fellow physicians in trying to cope with the well meaning but poorly executed Affordable Care Act, also known as Obamacare. I realized that many elements of the Affordable Care 23

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Act definitely needed improvement. For example, patients typically wait an average of 45 minutes just to see a doctor. Once the doctor appears, someone usually interrupts the appointment after about 24 seconds, the total consultation lasts about 11 minutes, and a medical assistant closes out the visit. The assistant schedules tests, such as magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, which an insurance clerk must then authorize. It is truly unfortunate that an insurance clerk with a high school education can now override a physician with eight to 10 years of training and 15 to 20 years of clinical experience in determining what tests a patient should have. Many physicians are disillusioned with the modern practice of medicine, where insurance companies rule their professional lives. These doctors work like robots and treat patients like numbers. Unfortunately, their biggest concern often becomes, “How will this look to a jury?” In this environment, patient-doctor trust is lost, and the practice of medicine is very stressful. Medicare reimbursements and insurance company payments are falling, and expenses and taxes are increasing. It is hardly surprising that, on average, doctors live nine years less than the rest of society and most doctors now tell their children to avoid medical school. Physicians receive training in disease recognition, diagnosis, and treatment, but they receive very little training in disease prevention for example, watching for lack of vitality, reduced energy, declining memory, or the consequences of stress. Doctors often ignore or discount these conditions, labeling them as chronic fatigue, fibromyalgia, depression, or some other “wastebasket diagnosis,” and move on to the next patient. The reality is that our bodies do not suddenly move from a state of perfect health to a disease state without going through a stage of suboptimal health. Our normally wonderful body repair mechanism fails to keep up with the onslaught of poor nutrition, hormone imbalance, and heavy metal toxicity. After futile attempts and now in 24

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crisis, the body finally gives in to disease. The future of medicine is about intervening before a patient reaches the crisis state.

How I Got Here

Country music legend Willie Nelson says his “heroes have always been cowboys,” and when I was growing up, most American boys idolized Mickey Mantle, Bart Starr, or some other sports hero. My heroes were my dad (who passed away in 1999) and our family doctor. I’ve wanted to be a doctor as long as I can remember. I was born in Damascus, Syria, and moved to the United States in 1979 to pursue my dream of becoming a doctor. Always a very active child, hyperactivity served me very well during my residency at Boston University. The life of a resident is even more grueling than what you see on television. Residents work all the time, the competition is incredible, and “survival of the fittest” takes on a completely new meaning. It took everything I had to make it through those years and hold fast to my dream. I became a doctor and a successful business owner. I developed medical practices in four countries, and my family was living the American dream. Everything but my heart ran like a fine-tuned sports car. We were at the top of the mountain, and the view was great! Sadly, the extreme working hours, the stress of long commutes, and the rising debts from starting a new practice in California took their toll. My dream life began to unravel when several longtime business partners betrayed my trust. The relationship became very toxic and added even more stress to an already difficult time in my family’s life. My constant travel even threatened my marriage, requiring Rene to raise our children on her own. Despite the many challenges, we eventually got our life back on track. However, at night, I would often toss and turn for hours. Eventually, I would get out of bed to read a medical journal only to realize that 25

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I could not remember anything I had read. This was very disturbing, because I was very proud of my memory. One particular morning, I woke up wondering if my drive for success was worth the price. I was 52 at the time and had more than enough money to retire and sail off into the sunset with my family. Did it really make sense to work so hard, endure sleepless nights, and add stress to our lives with more new business ventures? I realized that I was suffering from high-level stress-related burnout. My self-prescribed cure was to hit the gym and cut down on caffeine. I kept the gym routine going for three months despite feeling worse after each workout. To force myself to continue the dreaded routine, I prepaid my physical trainer a month in advance. Since I would rather die than lose the money, I continued to go, even though I had little time and even less energy. After several months of this routine, I decided to get a complete health checkup. The workup included a colonoscopy, an electrocardiogram, and conventional laboratory tests to check lipids, C-reactive protein, blood sugar, and electrolytes. I underwent bone density scanning to check for osteoporosis and had routine urine, kidney, and liver function tests. All my results came back normal except for my LDL cholesterol, which was high, and my vitamin D level, which was low. My colleagues said I was â&#x20AC;&#x153;pretty healthyâ&#x20AC;? while I pleaded with them that something was wrong. I had a new appreciation for my patients who expressed the same feelings of frustration. It wasnâ&#x20AC;&#x2122;t until a few years later that the failed stress test and subsequent angioplasties helped me realize that our traditional approach to medicine is severely broken. We clearly need better ways to predict and prevent Cardio metabolic and other diseases. I resolved to do something about it. I needed that same resolve in dealing with my arterial blockage. Although the original stent placement described at the beginning of the book opened the crucial left anterior heart vessel and saved my 26

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life, my right coronary artery was still blocked, and doctors could not open the artery with approaches available at that time. A big chunk of my heart muscle was still dependent on that right coronary artery what cardiologists call “right-heart dependent.” I continued to search for answers because the physical limitations imposed by having only a half-functional heart did not fit my lifestyle. As a high achiever and seeker, I wanted to get back to the lifestyle I had enjoyed before my blockage occurred. A few years later, I discovered that Marty Leon’s team at CornellPresbyterian Hospital in New York was developing a new approach for opening vessels. They pioneered a retrograde approach, in which doctors feed the catheter in the reverse direction of the blood flow - the exact opposite of earlier methods. A physician friend of mine in New York introduced me to Leon, who graciously rearranged his schedule to see me on very short notice. At that time, one of our sons was in his last year of high school and studying for his International Baccalaureate. I did not want my wife to leave him alone, so I updated my will and told her I was traveling to New York on business and would return in 10 days. Although no stranger to cardiac catheterization labs and intensive care units, given my previous experience with cardiac surgery, I was more than a bit apprehensive about the new procedure. An hour after the procedure my blood pressure dropped so low that I went into a cardiovascular shock as my blood pressure dropped rapidly, and I had the dreaded chest pain that signals a pending stroke or cardiac arrest. My life was again in the hands of a surgeon I barely knew, and I was no longer Dr. Max. As patient Max, I once again felt helpless and no longer in control of my own destiny. Attendants rushed me back to the angioplasty suite and Dr. Martin Leon’s team went back through my sore groin again to recheck my heart with a catheter, but they couldn’t find anything wrong. Apparently, my shock was due to being too sensitive to the sedation I received, which excessively dilated my blood pressure. As the blood pooled in my veins, there was not enough blood going 27

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back to my heart. During the retrograde procedure, they cut me on both sides of my groin, I developed a hematoma (blood collection), and I left the operating room with recurrent chest pain - post-traumatic pericarditis, in medical terms. I seriously wondered if the operation was successful, but Leon assured me I would be “better than ever” in a few weeks. Thankfully, he was 100 percent correct. Within three months after the operation, I was playing tennis for the first time in years. I felt great and ready to take on the world again. The Reverse Aging Diet that I followed during my recovery - which I will discuss later - eventually reversed my insulin resistance and kept my arteries as clean as a whistle. As I turn 61, I am in excellent health and enjoying the experience and wisdom that comes with aging. One of my favorite quotes about perseverance comes from Robert Louis Stevenson: “The saints are the sinners who keep on going.” I intend to keep on going as long as I am able. I no longer work as a full time cosmetic surgeon or anti-aging physician. I may do some procedures, but spend most of my time developing the Reverse Aging Centres, making sure our customers are very satisfied with our services. The practices under my charge have changed the lives of more than 300,000 people from all over the world, and I have plans to help in many more ways. While most of my peers are slowing down, I am picking up the pace. I practice what I preach and truly think of myself as middle-aged, even though, as I write this book, I am 61 year young. I follow a modified Paleo diet that should suit most people – as I will explain later- and go to the gym at seven in the morning for 60-90 minutes five days per week. Therefore, the advice I would offer to anyone facing a serious life challenge is this: Before giving up on your dreams, get a second opinion from a credible integrative physician that understands the benefits of lifestyle interventions?” Setting proper patient expectations is a very important part of the process at the Reverse Aging Centre. We avoid clients with 28

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unrealistic demands, who want to look like someone else, or who want just one more tweak to make them look perfect. We also stress that cosmetic surgery will only change their exteriors. New lifestyles will change their lives. We have patients who think that liposuction gives them a license to eat everything in sight. Unless we guide them to develop new habits, they are likely to continue to dig their graves with their teeth. We take our responsibility to alter patients’ lifestyles very seriously, and our per-engagement interview process includes counseling on what patients should do immediately following surgery to obtain their “new look.” For example, during the first month after liposuction, patients can’t exercise. Without proper guidance, they inevitably gain back much of the weight they have lost very quickly. It’s important for patients to understand that liposuction is not about weight reduction; it’s about removing localized fat deposits, such as those under the chin or in the hips or thighs. Now, before we investigate the chronic disease system in detail, allow me to summarize these opening chapters and let you know what to expect from the rest of the book. As a patient, I am thankful I survived, and I treasure every day. As a citizen, I believe our health care system is failing us. As a doctor, I remain hopeful that I can help you extend your life. My goal in writing this book is to rally others in support of fixing our broken health care system, challenging strong special interest groups to embrace a new generation of integrative medicine, and reversing the trend toward reduced life spans. “ I shall pass through this world but once. Any good, therefore, that I can do, or any kindness that I can show to any human being, let me do it now. Let me not defer or neglect it, for I shall not pass this way again”. - Author unknown

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PHYSICAL SYMPTOMS OF STRESS

EMOTIONAL SYMPTOMS OF STRESS

Recurrent evening headaches

Rushing around and driving fast

Neck and back pain

Nervous ticks or nail biting, scratching and picking

Dizziness

Playing it too safe â&#x20AC;&#x201C; not taking reasonable risks

Irritable bowel with diarrhea or constipation

Frustration

Indigestion

Forgetfulness

Frequent incomplete urination

Excessive worries

Blocked sinuses

Feelings of being overwhelmed or confused

Heart pounding (palpitations)

Loss of trust in people

Insomnia

Apathy or lack of passion

Drug use

Decreased self confidence

Teeth grinding

Irritability or excitability

Fatigue

Anxiety attacks

Weight change

Inability to listen attentively

Restlessness

Talking too much

Chapter 3: What Is Cardio Metabolic Disease, Anyway? The Killer Diseases in Developed Countries

This chapter on killer diseases is not meant to alarm you, but we must realize that our society is going backwards. After eradicating many of the diseases of our childhood, we are now battling two new killer 30

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diseases: heart disease and cancer. Nearly half of all deaths in the United States can be linked directly to one of these two diseases, and many of these deaths are preventable. After analyzing the causes of premature aging and death in developed countries, my colleagues and I developed a comprehensive and integrated approach to health care. In our research, we found three common beliefs that are just flat-out wrong: • Cholesterol is the fundamental cause of cardio problems. • Statins are a magic potion that fixes all ills. • Carbohydrates are good for us. This section demonstrates how wrong these assumptions are. There are serious ramifications for our society when we accept them as gospel. We need to focus on new paradigms and take corrective actions before the problems get any worse. By the way, if numbers bore you, please feel free to skip over the flagged sections because they are heavily focused on statistics. But trust that we did our research. I have included this information for those who want to see the proof.

The Research

In the beginning, my colleagues and I looked at how the World Health Organization and other international agencies focus on global killers such as lower respiratory infections, AIDS, malnutrition, malaria, diarrhea, tuberculosis, and pre-term birth.8 When we looked at global death rates, heart disease and cancer barely registered. However, when we looked at the statistics in the United States and other developed countries, we saw that heart disease and cancers kill more than a million people every year. Everyone should pay attention to these alarming statistics but also realize that we can reverse these trends. According to the U.S. Centers for Disease Control and Prevention, For more information, see http://www.who.int/mediacentre/factsheets/fs310/en/ index1.html 11http://www.cdc.gov/nchs/fastats/deaths.htm

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heart disease and cancers each killed almost 600,000 Americans in 2013.9 The CDC estimates that the totals for 2014 will be more than one million new heart disease cases and more than 1.5 million new cancer cases. The major diseases in developed countries include: • Heart disease • Cancers - including liver cancer, stomach cancer, breast cancer, colorectal cancer, blood-related cancers, and others • Lung diseases - including chronic obstructive pulmonary disease (COPD) and respiratory infections • Alzheimer’s disease and dementia The good news is that we have the means to delay - and in many cases, completely eradicate - these diseases in our lifetime.

Heart Disease: The Leading Killer in Developed Countries

In the United States and other developed countries, heart disease is the leading cause of death among both men and women. Cardio metabolic disease claims as many lives each year as the other seven leading causes of death combined. Someone in the United States dies from cardiovascular disease every 29 seconds. The Heart Foundation likens this to “a September 11thlike tragedy repeating itself every 24 hours, 365 days a year.”10 The Heart Foundation also notes that more people die of heart disease than of AIDS and all types of cancer combined and that by 2020, heart disease will be the top cause of death around the world. In 2014 alone, more than 920,000 Americans will suffer heart attacks, nearly half of which will occur without any prior symptoms or warning signs. Our blood vessels start aging the minute we are born. Autopsies on children who were victims of car accidents have proved this point. http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/ http://www.cdc.gov/nchs/fastats/deaths.htm

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Our challenge is to encourage anti-aging health strategies earlier in life. With these proactive strategies, we can reverse the trend. So letâ&#x20AC;&#x2122;s get started. METABOLIC SYNDROME

YES

Overweight â&#x20AC;&#x201C; Increased waist size

High Blood Sugar

High Triglycerides

Low HDL-Cholesterol

High Blood Pressure

Total CARDIO-METABOLIC DISEASE Old Thinking

New Thinking

Disorder of Fat Metabolism

Disorder of Sugar Metabolism

Plugging Up Of Pipes

Chronic Systemic Inflammation

Look At Cholesterol (Passengers)

Look at Lipoproteins (Cars)

LDL-C Best Predictor

LDL-P Best Predictor

Statins

Paleo Diet

Stents / Bypass

Intensive Lifestyle Intervention

Rx Symptom

Rx Cause

Sick Care

Health Care

You have Cardio metabolic syndrome if you marked yes to three or more.

Cardio Metabolic Disease Defined

As a direct result of my illness, I researched the relationship between heart disease and diabetes. At the time of my initial diagnosis, very few doctors directly connected the two illnesses. It is now very clear that cardio metabolic risk or cardio metabolic syndrome contributes to more than 28 percent of the deaths in the 33

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United States and other developed countries. In an article on metabolic syndrome, the National Heart, Lung, and Blood Institute, NHLBI, defines the syndrome as “a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.”11 Metabolic risks link directly to coronary heart disease. The risks listed below cause a condition where a waxy substance called plaque builds up inside the coronary arteries. As plaque hardens, it narrows the arteries and reduces blood flow. The NHLBI article identifies the following five conditions as metabolic risk factors: • An apple-shaped body or abdominal obesity - excess fat in the stomach • A high level of triglycerides - a type of fat - in the blood • A low level of HDL cholesterol - sometimes called “good cholesterol” • High blood pressure - which can damage the heart and lead to plaque buildup • High fasting blood sugar - also an early sign of diabetes The NHLBI and others stress that the risk of contracting heart disease and diabetes increases dramatically when a person has more than one of these risk factors. In my case, an excessive intake of carbohydrates caused the high blood insulin. My blood sugar was normal, giving me a false sense of security, but my glucose tolerance test told a different story. I ate too much bread, and because bread breaks down into sugar, my insulin levels were off the charts. I had insulin resistance, also known as pre-diabetes. Insulin is an inflammatory hormone, and it was turning all the otherwise harmless http://www.nhlbi.nih.gov/health/health-topics/topics/ms

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lipoproteins in my blood into harmful oxidized products - enough to block my arteries, thanks to my inherited “heart attack genes.” Someone who has metabolic syndrome, as I do, is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn’t have metabolic syndrome. Although I had lost weight, I was still overweight for my size and age. While my bad LDL was moderately elevated, my healthy HDL was low because of my love of bread and pasta and lack of exercise, and that increased my odds for heart disease and stroke. One of the biggest factors in cardio metabolic syndrome, though, is insulin resistance. Insulin resistance prevents the body from properly using insulin. Insulin is a hormone that helps move blood sugar into cells, where it creates energy. Insulin resistance leads to high blood sugar and links directly to obesity. This description of cardio metabolic syndrome fits me far too well! Sadly, I am not alone with this disease. Cardio metabolic syndrome will overtake smoking as the leading cause of heart disease by 2020, and it will be the global epidemic of the 21st century. The takeaway from my experience is this: As a protective measure, you should regularly ask your doctor to check for pre-diabetes. The time to reverse the diabetic destination is well before you permanently destroy 80 percent of your pancreatic beta cells, causing your insulin factory - otherwise known as your pancreas - to run out of gas. With the amount of sugar and bread we consume annually, the situation will get worse unless we raise public awareness, and make the necessary changes in our eating, and exercise habits. It’s no longer about just wanting to look good. It’s about saving lives. I discuss recommended dietary and lifestyle changes in more detail in the chapters ahead.

More on Sugar and Insulin

Until recently, refined carbohydrates were a vital part of the U.S. Department of Agriculture food pyramid. The pyramid incorrectly 35

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placed sugar and white flour in the same class as raw fruits, vegetables, and whole grains. New research, however, has determined that although carbohydrates in their natural form are healthy, the carbohydrates found in ultraprocessed white bread and similar products break down too quickly, and the sugar that results from this process is the real culprit behind cardio metabolic syndrome. This process of refining carbohydrates represents the most dramatic change in human nutrition since agriculture went corporate. Because they consume so many refined carbohydrates, one in three children born today will eventually develop diabetes, and children born after 2000 will have, for the first time in human history, a shorter life span than their parents will. Many teenagers and young adults are now dying of heart disease - a veritable food-borne epidemic - because of the modern Western diet. Diabetes has doubled worldwide in the last two decades. Obesity is a global pandemic. Cardio Metabolic Syndrome and the Cholesterol Myth Cholesterol has developed an inappropriately bad reputation, and the media hype around it has spawned a multibillion-dollar industry of cholesterol-free products. Along the way, though, we overlooked the dangers of cholesterol-free alternatives, which are often full of hidden sugars or - even worse - dangerous artificial sweeteners.

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MYTHS

FACTS

Fat, low fiber and red meat increase cancer

Science has proved this is false. Insulin promotes the proliferation of heathy and malignant cells. Low cholesterol is associated with increased cancer rates

Excessive carbs triggers insulin resistance and Cholesterol and LDL cause CAD and create small particles (LDL) that easily oxidize, linger longer in circulation and stick to the stroke inner wall of blood vessels High blood pressure High blood pressure and obesity are caused is caused by eating primarily by increased insulin too much fat and salt Ketones are different from ketoacidosis... Restricting carbs creates ketones that Protein and fat satisfy hunger while carbs trigger it suppress appetite Obesity is caused by too many calories and lack of exercise

Conflicting, confusing, or wrong advice often causes obesity. Politically, it is difficult for governments and advocacy groups to admit that they have been wrong for decades. Exercise is good for emotional eating and bone health and prevents muscle loss but has limited effects on burning calories. Exercise is key.

Chronic disease and obesity are mental states that can be cured by will power and drugs

Disease is spread primarily by agriculture (corn, wheat and rice is cheap enough to feed the billions). Trans-fats can last for years in packaged food. This diet turns on our ‘fat switch’.

Calorie in = Calorie out... A calorie is a calorie

Weight control should be a non-voluntary exercise. It is extremely hard to eat more than you need if you are not eating refined carbs. by eating the right diet like our ancestors did when they consumed 20 times less sugar. An average American consumes 26 teaspoons of refined sugar mostly hidden in bread, rice and pasta and juices.

You should rely on governments, hospitals, doctors and drugs to reverse disease and stay healthy

Prescription drugs are the fourth leading cause of death in the USA. Let knowledge and good food be your best medicine The more ‘conscious’ (aware) you are the longer you will live. 37

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Let’s Have a Jury Decide!

Perhaps the best way to explain how the industry paints the cholesterol picture as the bad person in cardio metabolic disease is to compare it to a murder mystery. We’ll create a mystery called The Case of Mistaken Identity, or What Really Causes Cardio Metabolic Syndrome, and appoint you as the foreperson of the jury. Cholesterol is the prime suspect in our case. Pharmaceutical companies and Madison Avenue advertisers are co-conspirators or accessories after the fact. Let’s look at the evidence a defense attorney might present to clear his client, cholesterol. • Seventy-five percent of the total cholesterol in our body is in our brain. Cholesterol is a major part of our hormones and cell membranes. It serves as a gatekeeper, policing what gets in and out of our cells. • Arteries are blood vessels that carry oxygen to vital organs such as the heart and the brain. Clogged arteries cause heart attacks and strokes. Plaque that accumulates on the inner walls of arteries is made up of various substances that circulate in the blood. • These substances are calcium, fat, cholesterol, cellular waste, fibrin, and other materials involved in blood clotting. In response to plaque buildup, cells in the artery walls multiply, which adds to the obstruction. The attorney for the defense looks directly at you and states, “Cholesterol is at the scene of the crime, but it is not killing people. It’s merely an innocent bystander.” A good defense lawyer either creates reasonable doubt or finds the person who actually committed the crime. In our case, let’s find out who is actually responsible for the crime. The real culprits in this case are sugar and insulin (triggered by juices, bread, rice, and candy), bad genes, cigarettes, hypertension, and 38

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other risk factors. Health professionals disparaged cholesterol for more than 40 years, but very few researched what actually causes metabolic syndrome. They simply repeated the pseudoscience perpetuated by the co-conspirators. Most physicians mean well but are unaware of the new scientific evidence just presented. Instead, they rely on unproven opinions, industry-sponsored research, and are influenced by trips to exotic places hosted by our co-conspirators. Unduly influenced by money and politics, they then unwittingly perpetuate these biased assumptions. I chose not to follow the crowd. I reviewed hundreds of large-scale studies involving thousands of patients from all over the world, and I read hundreds of diet and nutrition books. The evidence is indisputable: Sugar and insulin are the cause of cardio metabolic syndrome. There are dozens of bestselling books that detail this astonishing “cholesterol scam” perpetrated on the American public. The book with the best scientific evidence is Gary Taubes’ Good Calories, Bad Calories, which details the cholesterol swindle and is backed by hardhitting investigative research. Most diets based on the USDA recommendations suggest lots of fruits, simple sugars, rice, and bread in moderation. Lean and healthy people may get away with eating a limited amount of refined carbohydrates, but people battling diabetes or trying to lose weight are doomed if they follow the prescribed guidelines. There are hundreds of popular books and programs promoting instant weight loss, however most people eventually get tired of semistarvation and unsatisfying yo-yo diets. They don’t lose weight and get into even more trouble because of their erratic weight fluctuations. Again, overconsumption of sugar and refined carbohydrates is the fundamental reason so many Americans are overweight; it has almost nothing to do with cholesterol. I am not a researcher working on rats and rabbits. I have treated thousands of patients, and I have successfully reversed their heart disease, obesity, hypertension, and diabetes without them feeling hungry or deprived. In chapter 7, you will learn the secrets to an anti39

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aging regimen based on a healthy lifestyle that really works. Getting back to our trial, the attorneys for the prosecution now call their rebuttal witnesses and counter with documented studies attempting to prove their contention that cholesterol is indeed the perpetrator of the crime. Chief among their witnesses would be Ancel Keys, the father of the hypothesis that originally linked cholesterol with heart disease. Many people still believe that if they don’t consume animal products, their cholesterol will be low, protecting them from heart disease. What they fail to recognize is that most cholesterol comes from their body’s internal production, rather than from what they eat. Today, most mainstream cardiologists agree that less than 20 percent of the cholesterol in the body actually comes from diet. Many physicians have known this for a long time, and we are now encouraged that more people are seeing the cholesterol scare for what it is - a hoax! In our trial, the defense enters the following additional information into evidence: • Study after scientific study shows that countries with the lowest saturated fat consumption have the highest death rates from coronary artery disease (CAD), while countries with the highest intake of saturated fat, including Switzerland and France, have the lowest death rates from CAD. • In the Multiple Risk Factor Intervention Trial, 250 researchers studied 361,000 men in 28 medical centers. The researchers reported that when cholesterol consumption was cut by 42 percent and saturated fat was cut by 28 percent, there was no effect on heart disease. The defense presents even more statistics as “forensic evidence,” lulling the judge and jury into a deep sleep. Suddenly, the judge snores so loudly that he wakes the jury in time for all to hear the defense attorney state, “And in conclusion, Michel de Lorgeril, the lead researcher for the Lyon Diet Heart Study states, 40

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‘Cholesterol is harmless.” That’s all the judge needs to hear. “Members of the jury have you reached a verdict?” he asks. “We, the jury, find cholesterol not guilty on all counts,” replies the foreperson. “And further, your honor, we find sugar and carbohydrates guilty of the crime.” “Case closed,” states the judge. “Bailiff, next case, please.” Russell Smith and Edward Pinckney, a co-editor of JAMA, published one of the largest critical reviews of the cholesterol diet/ heart hypothesis in The Cholesterol Conspiracy. They showed that despite the fact that statins have lowered cholesterol levels for many Americans, there has been little or no associated effect on the number of fatal and nonfatal heart attacks. The marketing efforts for Lipitor®, Crestor®, Zocor®, and other statins, as well as the research sponsored by their manufacturers, have deceived physicians and patients alike. Pfizer’s Lipitor is the most prescribed cholesterol medication in the world, taken by 30 million people in the United States alone. Oh, what lengths they go to weave their sordid tale... In its advertising, Pfizer has boasted that Lipitor reduces the risk of heart attacks by 36 percent. However, a footnote to that advertisement clarifies the basis of this statistic, explaining, “In a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor.”12 This means that for every 100 people who took Lipitor for 3.3 years - the length of the study - three people taking the placebo and two people taking Lipitor had heart attacks. If Pfizer simply reported that information, nobody would have noticed. Nevertheless, using the 36 percent statistic changes the tenor of the story and makes Pfizer a lot of money. For more on how statisticians slant information to their http://www.businessweek.com/stories/2008-01-16/do-cholesterol-drugs-do-anygood

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advantage in the world of health care marketing, see “A Note on Statistics, Because Your Life Depends on Them” in chapter 4. With all the evidence in, here is the truth about statins: • Statins do not reduce overall mortality in women. • Statins do not reduce overall mortality in men who do not have existing heart disease. • Statins do reduce overall mortality in men with existing heart disease. That is why I take them.

Sugar Is the Cause of Cardio Metabolic Disease

Every book needs a villain, and this one is no different. The real culprits in cardio metabolic disease are clearly sugar and carbohydrates, so let’s add them to the docket. As I briefly mentioned earlier, the diagnosis of insulin resistance is critical to understanding how we get fat and develop cardio metabolic disease. Every time we eat sugary food, our insulin levels spike, resulting in a sharp drop in blood sugar. This triggers cravings for more sugar. Eating that sugar leads to another insulin spike, and on it goes. When this up-and-down cycle continues over time, our cells lose their sensitivity to insulin, so we need increased levels of insulin to move glucose into our cells. Doctors call this phenomenon insulin resistance, and it is the primary cause of cardio metabolic disease. Therefore, the real criminal is finally out in the open for everyone to see. Burning sugar as a primary fuel is not how our bodies normally work. Sugar is the body’s “turbocharged” fuel, and our bodies normally reserve it for urgent, “fight or flight” situations. Most modern diets include too many carbohydrates, so we rarely burn excess fat. Contrary to conventional wisdom, doctors should not use blood sugar levels to diagnose diabetes, because insulin resistance – pre-diabetes begins 10 to 15 years before blood sugar levels start to rise. By this time, 70 to 80 percent of the beta cells in the pancreas are already gone. 42

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Advanced lipoprotein studies allow doctors to catch diabetes earlier. They offer a “window” into the metabolic health of a patient long before health problems develop. More important, if we make lifestyle changes early enough, the results are better. With an LDL particle number under 750, a person is metabolically bulletproof. A triglyceride/HDL ratio of greater than three means the individual is insulin-resistant. Fat around the belly is another good indicator of insulin resistance. The most reliable and most accurate test for insulin resistance, though, is the two-hour glucose tolerance test. In this test, the patient drinks a sweet liquid containing a specific amount of glucose and then has blood drawn several times over the next two hours, so doctors can check the patient’s blood sugar levels at certain intervals. Thanks for bearing with me as I build the case for change. Next, we’ll look at some misconceptions about cancer how our integrated approach saves lives.

Chapter 4: Cancer Cancer Claims Second Highest Number of Deaths

“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.” - Sun Tzu, the Art of War Before we launch a campaign to defeat the second leading killer disease, we need to understand the enemy - not to alarm, but to inform - and make no mistake, this is a war against a formidable foe. The cancer cells in our bodies routinely build up defenses against the drugs we launch to combat them. For this section, pretend you are a major in the infantry. Most people don’t realize that majors and colonels are kind of the in-between people in the military. They have been in the military long enough to know that orders are orders but also long enough to know that many 43

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orders just don’t make sense. However, majors do not get to ask why; their mission is to “do or die.” For example, let’s say your body is craving sugar, but I suggest it is killing you. As a major, you might say, “Yes sir,” if I told you to stop consuming sugar, knowing that when you leave my office, you will chug a bottle of soda. I did much the same thing, eating loads of bread even though I knew it was bad for me. No doctor can order his or her patients to make the necessary lifestyle changes to extend their lives, so I will do my best to convince you, Major, how bad foods and poor lifestyles shorten lives and become silent killers. Are you ready to accept your promotion? Here is your first order: Go spend an hour or two in the waiting room of your regional cancer center. The room is full of emaciated baby boomers and others in wheel chairs waiting for their dose of chemotherapy. It is a sobering experience to see these once-vibrant souls slowly wasting away. The few with smiles on their faces are either not patients or have decided to rise above the cancer. They know that a positive attitude is critical to beating cancer. I’ve seen many people beat cancer over the years, encouraging me to help others win their personal battles by challenging the norm and waging war against these debilitating diseases. Malignant tumors - the type that carry cancer - kill more than 500,000 people annually in the United States, but cancer is not a single disease. There are more than 200 types of cancer, which can affect more than 60 different organs.13 Each type has different patterns of behavior, making cancer a complex disorder to understand and treat. People sometimes inherit abnormal DNA from their parents, but most DNA damage occurs from mistakes that happen while cells are http://www.businessinsider.com/top-causes-of-death-united-states-201111?op=1#ixzz3F7nCO6Km

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reproducing or from external causes such as cigarette smoking, too much sun exposure, environmental toxins, and poor diets. Recent research also points to stress as a direct and indirect contributor. One of the biggest challenges in treating cancer is that there are so many different types and they all behave differently. Lung cancer, skin cancer, gynecologic cancer, and pancreatic cancer vary widely and react differently to the available treatment protocols. The Human Genome Project, along with dramatic advances in biomedicine and nanotechnology, are allowing researchers to develop new treatments and protocols involving a wide array of technologies and techniques, including immunotherapy, nanotechnology, stem cells, robotics, and more.

Are You or Your Loved Ones at Risk for Cancer?

The first question people ask when diagnosed with cancer is “why” and “why me?” 80-90 percent of lung cancers, esophageal and pancreatic cancers and cervical cancers are lifestyle related and hence preventable. Brain cancers in children and young adults and blood cancers such as leukemia are manufacturing errors in DNA division and are not avoidable. They simply represent bad luck. Regular checkups and watching for early warning signs can catch many cancers before they spread. Early detection measures can often prevent cancers altogether and result in longer remissions when cancers are already present. I highly recommend pre-emptive cancer screening, but I also want patients to understand the risks associated with some types of screening measures and the downsides of screening too often. As with any procedure, it’s important to weigh the potential benefits against the possible risks. Here are some of the benefits of screening: • Early detection enables us to prevent many cancers from spreading. • Most tests are easy to do and have minimal side effects. • Screening tests are affordable and cost-effective. 45

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These are some of the risks of excessive screening: â&#x20AC;˘ Tests often miss cancers, leading to a false sense of security. â&#x20AC;˘ False alarms from tests that say cancer is present when it is not actually there lead to undue stress and additional - and potentially risky - tests and procedures. â&#x20AC;˘ CT scans and mammograms emit radiation, which can itself cause cancer. At my Reverse Aging Centers, my colleagues and I regularly screen patients using a head-to-toe ultrasound scan to check for cancers in the thyroid, breasts, lungs, liver, pancreas, uterus, ovaries, and prostate - all without radiation. We also recommend many other screening tests for the most common types of cancer.

Screening for Colon Cancer

Instead of waiting to see blood in your stool because cancerous cells have multiplied and spread, ask your doctor to schedule a colonoscopy, which can find and remove pea-sized polyps, which are precancerous tumors, before they become dangerous. There is a 90% chance of curing your colon cancer if found early. You have very little fighting chance if detected late. Colon cancer is the third most common cancer killer. Everyone between 50 and 75 should have a colonoscopy every 10 years. The test uses no radiation and physicians use twilight anesthesia. Patients in this age range should also have a fecal occult blood test and a fecal immunochemical test annually. Colonoscopies are just one example of the many tests that are available to catch cancers early. Unfortunately, some people inherit bad genes, which cause about 20 percent of cancers, and these cancers are not completely preventable. Even in these cases, though, early detection can prolong lives.

Screening for High-Risk Patients

For patients who are at a higher risk for cancer because of genetic conditions, obesity, or excessive weight gain or loss, we recommend 46

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lab tests to check for cancer biomarkers. For example, we can test for: â&#x20AC;˘ CA 125 linked to ovarian, lung, breast, and colon cancers. â&#x20AC;˘ CA 19-9 linked to stomach, bile, and pancreatic cancers. â&#x20AC;˘ CA 15-3 linked to breast cancer. There is no one-size-fits-all approach to cancer screening. Overtesting is good business for the medical industry but is ultimately just as bad as under-testing.

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Chapter 5. Lung disease and Dementia Chronic obstructive pulmonary disease (COPD)14 and other noncancerous lung-related illnesses strike more than 100,000 Americans each year. Together, they represent the third leading cause of death in developed countries. When you breathe, air travels through your airways into your lungs and on to millions of tiny air sacs. In a healthy lung, the airways are open, and the air sacs fill up and expel air quickly and normally. People with COPD have difficulty getting air through their airways, into, and out of their air sacs. COPD involves one or both of the following problems: Chronic bronchitis: Persistent cough with excessive mucus production caused by inflammation of the airways Emphysema: Damaged or collapsed air sacs In the United States, more than 24 million adults have impaired lung function, approximately 10 million have chronic bronchitis, and nearly 5 million have emphysema. Each year, more women than men die from COPD. In 2010, more than 70,000 women died of this disease compared to about 64,000 men. Most lung-related illnesses link directly to smoking and harsh environmental toxins. Many of the deaths from these illnesses are preventable with education and lifestyle changes.

For more information about COPD, see http://www.copd.com/about-copd/ and http://www.lung.org/lung-disease/copd/resources/ facts-figures/COPD-Fact-Sheet. html.

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Alzheimer’s Disease and Dementia

An old man goes to the doctor, and the doctor says, “Your test results came back, and I’m afraid I have some bad news. You have cancer, and you also have Alzheimer’s.” The old man replies, “That’s not so bad. At least I don’t have cancer!” Alzheimer’s disease is the sixth leading cause of death in the United States. According to the Alzheimer’s Association, more than five million Americans are currently living with Alzheimer’s, and 500,000 that’s one out of every three seniors - die each year from Alzheimer’s or some other kind of dementia. The association estimates that in 2013, more than 15 million unpaid caregivers provided approximately 18 billion hours of care worth more than $220 billion.15 Alzheimer’s takes an especially heavy toll on women. Nearly two-thirds sufferers are women. Early detection of Alzheimer’s disease is possible, and although no cure is yet available, there are medications and treatments that can relieve symptoms and slow the progress of the disease. Contact your physician if you or someone you know exhibits any of these early signs or symptoms:16 • Memory loss that interferes with daily life • Challenges in planning or solving problems • Difficulty completing familiar tasks • Confusion with time or place • Trouble with visual images and spatial relationships Smoking is the primary risk factor for COPD. Approximately 80 percent of COPD deaths are caused by smoking. Other risk factors for COPD include exposure to air pollution, secondhand smoke, occupational dusts, and chemicals; heredity; a history of childhood respiratory infections; and socioeconomic status. Occupational exposure to certain industrial pollutants also increases the risk for COPD. One study found that 19.2 percent of all COPD cases are attributable to work environment; for people who have never smoked, 31.1 percent of COPD cases are work-related.

http://www.alz.org/alzheimers_disease_facts_and_figures.asp http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp

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• Problems with speaking or writing • Misplacing things and being unable to retrace steps • Decreased or poor judgment and changes in mood or personality The risk factors associated with Alzheimer’s disease are age, family history, and genetics. Researchers hope the Human Genome Project will help uncover some of the mysteries associated with this disease. The treatment horizon promises many exciting developments, including new drugs and better targeting with immunotherapy. Clinical trials for a variety of potential new treatments are ongoing.17 Alzheimer’s is behind about 65% of severe memory loss or dementia and is related to sugar sticking to the walls of the nerve cells like super glue would. Vascular dementia is behind 20% of dementias and is caused by small lipid particles seeping under the inner lining of the blood vessels thereby suffocating the brain over years. Sugar is again the number one reason for lipids turning into the smaller and more dangerous variety.

http://www.alz.org/research/science/alzheimers_treatment_horizon.asp

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Chapter 6. Drug Sensitivities - Are You or Your Loved Ones at Risk? In our clinics, my colleagues and I regularly check the drugs and supplements our patients consume. We are forever uncovering situations where multiple doctors have prescribed different medications that should not be taken together. Adverse drug reactions and medical mistakes are the fourth leading cause of death in the United States - more common than breast cancer, AIDS, or traffic fatalities!! The burden to our health care debt is more than $200 billion annually. I prescribe drugs to my patients every day because I know they save lives, but physicians overusing their prescription pads for the wrong reasons often do more harm than good. The FDA takes more than 50 percent of newly approved drugs off the market because of serious adverse effects not detected before approval. However, drugs that do stay on the market also have potential harmful side effects. Doctors, nurses, pharmacists, and especially you, the patient, must pay careful attention to drug prescriptions and the delivery method, whether oral, topical, or injected. The liver detoxifies about 90 percent of all oral medications, but the five percent that it does not properly handle can cause many problems. That remaining five percent overwhelm the liverâ&#x20AC;&#x2122;s capacity to break down what it sees as foreign or chemically complex compounds. These compounds pass through the liver into the bloodstream and on to target organs. While pills are the most convenient and reliable way to take medications, they are the most taxing on the liver, which also has to do itâ&#x20AC;&#x2122;s job to deal with environmental pollutants, food additives, toxins, xeno-estrogens,18 caffeine, and many other foreign substances all day long. Xenoestrogens are estrogen-like substances that are not made by the human body. Many have been implicated in disruption of the endocrine system. For more information, see http://womeninbalance.org/2012/10/26/xenoestrogens-what-aretheyhow-to-avoid-them/.

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When possible, it is far better to use a topical cream or intramuscular injections to deliver medication, as these delivery mechanisms bypass the liver completely. About 50 percent of the chemicals in suppositories, whether vaginal or rectal, also bypass the liver. When using oral medications, it is sometimes possible to bypass the liver by placing the pill under your tongue for a few minutes. Check with your doctor about your body’s ability to absorb different types of medicines. The serious side effects from adverse drug reactions are now almost commonplace and accepted as part of the risk of doing business. This is truly unfortunate, because a little extra time and attention to detail could save many lives. Patients often complain to their physicians about new symptoms that they are experiencing, unaware that they are drug side effects. This problem compounds itself when physicians rush to treat these “new conditions” with additional medications, causing a cascade of side effects.

Avoiding Adverse Drug Reactions

Pharmacology books actually refer to medicines as “controlled poisons,” since many are potentially very harmful. Moreover, prescribed medications are only effective about 50 percent of the time, because they fail to account for individuals’ physical and genetic variations. Your DNA plays a crucial role in determining which medications work best for you. Even slight variations in DNA can affect how an individual responds or reacts to a given medication. Physicians should carefully document all allergic reactions and other negative side effects to prevent future problems. Many physicians are not aware of a very simple procedure that can prevent negative reactions from occurring in the first place. We can swab the inside of each patient’s cheek with a cotton ball and send it to a specialized lab to find out how each person’s liver handles different substances, such as painkillers, blood thinners, antidepressants, and caffeine. We only need to do this pharmacogenetic testing one time, and the information it provides enables us to 52

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prevent many negative reactions. The one-size-fits-all approach to prescribing medications assumes that my genes respond to medications just like yours do. This is obviously not the case, and the false assumptions inherent in this approach are behind the epidemic of adverse drug reactions and side effects. Is it any wonder that there are more than 30 antidepressants and 50 different blood pressure medications on the market? Doctors who use a one-size-fits-all or haphazard approach are costing all of us a lot of money and endangering lives. We know that medicines work best when they are compatible with our genes. With the cheek swab test, we are able to help our patients avoid serious drug reactions.

The Body as a Recycling Factory

As I mentioned earlier, the liver recycles most of the drugs entering our bodies. We have six other recycling factories: one that handles most antidepressants, another for anxiety drugs, a third for painkillers, and a few more for other substances. Each recycling factory plays an important role in keeping our bodies functioning normally. Everyone’s body recycles foreign substances differently, so heath care practitioners and patients must pay attention to what works and what doesn’t. For example, doctors in North America write the prescriptions for 80 percent of the codeine prescribed in the world. The typical American’s body works overtime recycling codeine. Nevertheless, some people get no pain relief from codeine, and others experience only nausea. For these patients, Bufferin® or Tylenol® may offer more relief with fewer problems. To further complicate the situation, one or more of your recycling factories may be more or less efficient than that of the “average” person. I ran pharmaco-genetic tests on myself and found out that my liver metabolizes the blood-thinning medication Plavix® very quickly. That meant I had to cut my dosage or switch to another blood thinner to avoid serious bleeding complications. 53

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Although pharmaco-genomic testing has been available since 2008 and Medicare will pay for it, only 15 percent of cardiologists regularly order these tests. This is surprising considering that most cardiologists routinely recommend taking PlavixÂŽ for a year following angioplasty.

Avoiding Drug Interactions

Talk to your doctor about the risks of taking your medications concurrently! Why? Because they compete for the same recycling pathways in the liver. As a result, the medications rarely perform as expected. You only need to have pharmaco-genetic testing done once in your lifetime to know how your liver handles a wide variety of drugs. There is no need to obtain updated genetic reports. However, each time you start, stop, or add a medication, your doctor can request an updated copy of your genetic report. With the results from the report, he or she can confidently select the best treatment for you without you ever having to take the DNA test again. When you go to a new doctor, or when your current doctor adds a new drug, the doctor should review your genetic report to check for compatibility and drug-handling issues. Avoid overburdening one particular recycling factory with too many drugs. Again, the doctor does not need a new genetic report; he or she just needs to consider the available choices with the existing report in mind.

The Dangers of Oxidative Stress

Oxidative stress refers to the imbalance between the bodyâ&#x20AC;&#x2122;s production of reactive oxygen species - the potentially damaging by-products of cellular energy generation - and its ability to repair the resulting damage. More simply, oxidative stress is damage done to cells when the oxidation process malfunctions. Oxidative stress is a natural part of the aging process but you may be speeding that process up! High sugar intake, exposure to heavy metals, and hormonal and nutritional deficiencies cause oxidative stress, which impairs endothelial nitric oxide levels and causes endothelial dysfunction, a well-established response to cardiovascular 54

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risk factors that precedes the development of atherosclerosis.19 The overconsumption of refined carbohydrates, including fast food and convenience foods, is the primary cause of this oxidative stress. Most people now understand that antioxidants help detoxify and clean the cell environment, but most still do not consume nearly enough healthy antioxidants in their daily diets. The Reverse Aging diet that I recommend includes high quality, nutrient-dense, alkaline-forming foods that are easy to digest when eaten in proper proportions. By implementing such dietary changes, we eliminate nutritional stress and help our bodies regenerate, ultimately slowing down the aging process. Our dietary choices contribute to how long the genes that control the rate of biological aging stay alive (AKA telomere testing). In other words, what we eat determines how long our genes continue to work normally and, therefore, how long we live. By returning to our Paleolithic roots, we can control the silent inflammation and oxidative stress that result from insulin resistance, leaky gut syndrome, and glycation. We can reverse Cardio metabolic disease and aging. Antioxidants are the key to controlling oxidative stress.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1993955/

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Chapter 7. Leaky Gut Syndrome Leaky gut syndrome, also known as intestinal hyper permeability, is a disorder associated with increased intestinal permeability and the loss of intestinal mucosal integrity. With leaky gut syndrome, the body reabsorbs harmful toxins that damage the tight junctions between intestinal epithelial cells. As a result, dangerous substances can leak from the intestines into the bloodstream. Most physicians have only recently recognized this potentially serious condition. Being “full of it” now takes on a completely new meaning, but it’s not very funny. Research demonstrates that gut bacteria are responsible for turning on the “fat switch” in our bodies. Sugar intake links directly to dyspepsia, gastro esophageal reflux disease, peptic ulcers, hiatal hernia, gallstones, Crohn’s disease, ulcerative colitis, and diverticulitis. Researchers have identified certain proteins - including gluten in wheat, rye, oats, barley, millet, rice, and sorghum; zein in corn; casein in dairy products; and proteins in some legumes - that can damage the lining of the gut. With a damaged gut, intestinal debris flows into the rest of the body. Other common toxins include fructose, alcohol, non-steroidal antiinflammatory drugs, stress, viruses, bacteria, parasites, antibiotics, cytotoxic drugs, and yeast. Yeast overgrowth often produces chronic fatigue and sugar cravings. Gluten can also cause inflammation of the brain and skin without abdominal symptoms. Overgrowth of any one of the more than 400 microbial species in the human gut can produce adverse effects. Excessive growth by undesirable microbes alters the body’s metabolic and immunologic status. This microbial imbalance, or dysbiosis, can turn genes on or off. Leaky gut syndrome and dysbiosis are often responsible for low-grade inflammation throughout the body. They can add to oxidative stress, cardio metabolic disease, autoimmune disorders, and many other chronic conditions. 56

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To prevent or cure leaky gut minimize refined sugars, vinegar, antibiotics, milk and cheeses and take, on a regular basis, food supplements containing at least several billion micro-organisms per tablet. Nutritional “Dysbiosis” Gut barrier Metabolic Low grade and Gut microbiota alteration endotoxemia inflammation. Nutritional and Genetic Obesity

“Dysbiosis” Gut microbiota

Gut barrier alteration

Metabolic endotoxemia

Low grade inﬂammation Insulin resistance Type 2 diabetes

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A Note on Statistics, Because Your Life Depends on Them There are three kinds of lies: lies, damned lies, and statistics. Benjamin Disraeli ‘Medicine is a science of uncertainty and an art of probability.’ – Sir William Osler

I appreciate your patience with some of the statistical data in this section, but I believe it is very important that we all pay attention to the disinformation campaign that is happening every day in our country. It is a tragedy, and knowing the truth can save your life! When I first entered medical school, my statistics professor recommended that I read the book How to Lie With Statistics by Darryl Huff. It made a lasting impression on me, and I highly recommend it. Most people and many doctors do not appreciate the difference between what Huff described as “relative risks” and “absolute risks.” Drug companies and the media cleverly use relative risks to impress people with their stories. Fundamentally, risk is about whether or not something is likely to happen. There are different ways to describe the same risk that can dramatically affect the way we perceive it. For example, some health care industry authorities report that “getting a CT scan as a child triples the risk of developing a brain tumor as an adult.” Phrased as a relative risk, this seems like an alarming fact. However, when we understand that the absolute risk of getting a brain tumor is so small (1 in 25,000), the relative risk (3 in 25,000) becomes almost meaningless. When presented with the smaller absolute risk versus the alarming relative risk, most parents are willing to consent to a recommended CT scan. The same facts presented in terms of absolute versus relative risk clearly yield different responses. We need to ignore the scare tactics of marketing companies and understand the difference between real information and information slanted to make a point. Here is another example: For patients who are at low risk of getting a heart attack, taking statins drops their risk of getting a heart attack by 36 percent and lowers their 58

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risk of stroke by 22 percent. On the surface, phrasing this information as a relative risk sounds impressive and convincing. However, when we tell patients that only one in 1,000 patients actually benefits from statins - the absolute risk - they are far less likely to endure the side effects and cost of unnecessary treatments. Finally, we know that chemotherapy rarely cures advanced solid cancers, except testicular and anal cancers, but is great for blood and lymph node cancers. Hospitals and doctors, though, often present information about a recommended procedure in terms of the relative risk, such as â&#x20AC;&#x153;a 50 percent reduction in mortality,â&#x20AC;? when the absolute risk is that the patient will most likely lives about two months longer while incurring more costs and negative side effects. Over time, even physicians start believing the medical industryâ&#x20AC;&#x2122;s statistical misrepresentations. Technically, they are not lies, but tell this to the poor patient who is spending his last few months with nausea, vomiting, heart failure, and hair loss from costly and highly toxic treatments. Pay attention to the data behind the data, and be skeptical about everything you put into your body and the procedures you have performed on it. It is your life, and all health care decisions are ultimately up to you. Be your own best advocate.

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Chapter 8. Integrated Health Management System Just as military leaders develop a battle plan with multiple lines of defense, your body has many lines of defense, too. You are the general in charge of your life, and a smoothly running immune system is your most important ally. When you weaken your lines of defense, your whole body suffers. Think for a minute about the color-coded Homeland Security Advisory System. The different colored threat-level alerts were supposed to help people know when they needed to be especially watchful. However, once the public received multiple â&#x20AC;&#x153;orangeâ&#x20AC;? alerts, the warnings started to become meaningless.20 This is unfortunate, because an alert public is a critical element in the war against terror. When your body is constantly under attack and is dealing with sugar overload, environmental allergies, and sluggishness due to lack of exercise, it also loses its readiness. Over time, the immune system loses its ability to fight infection. How our bodies contract disease and how we age are the direct results of what we eat, how much we exercise, the quality of our sleep and our mental state. If we eat the wrong foods, sit all day long, are sleep deprived and lead stress-filled lives, our immune systems are constantly on orange alert. When we continually ignore our bodiesâ&#x20AC;&#x2122; yellow and orange alerts, the pain level eventually rises to red. What should we do when these red-level pain alerts appear? Just as in war, the first mission is to understand the enemy - in our case, the source of the pain. How our bodies react to both internal and external threats is at the heart of the Integrated Health Management System, and the primary component of the system is a modified Paleo diet. Ask your doctor to help you find the right prescription for you, and http://www.wired.com/2009/09/threatleveladvisory

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recognize that not every prescription is a drug.

Components of the Integrated Health Management System

The Integrated Health Management System has evolved over many years and has two fundamental goals. The first goal is to offer you a tool kit for extending your life, and the second is to offer the framework for a better health care system in developed countries. I will first present a plan for each segment of the system and then a template for a new worldwide Early Death prevention-based health care management system. Heart Disease The Integrated Health Management SystemTM addresses the following areas:

• Inflammation and the immune system

• Nutrition

Diabetes Obesity Inﬂammation

High Sugar

• Testing for signs of trouble • Exercise • Genetics and glycation • Restoration of hormones • Advanced supplementation • Training the mind • Environmental toxins • Depression and stress Inflammation and the Immune System

Inflammation is the body’s first line of defense against physical harm and the infections that cause many of the diseases discussed in the previous chapter. The immune system responds to both internal and external stimuli with redness, swelling, pain, and malfunctioning cells 61

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that lead to heart disease and cancer. This redness - both internal and external - is like a red alert, and we need to pay attention. Research links inflammation to most chronic diseases. Aging itself appears to result from the cumulative effects of silent inflammation, or what some researchers call “inflamaging.”21 Scientists are now finding links between how the immune system responds to physical injury and the risk of contracting many of the diseases discussed in the previous chapter. Inflammation is behind many conditions, from hypertension and depression to obesity and diabetes. It is the cause of cardio metabolic syndrome, cancers, and many other diseases. The Integrated Health Management System specifically targets agerelated inflammation, or inflamaging. When your immune system is functioning normally - as in times of peace - you probably don’t even know you have one, but it is always on guard. In addition, just as Homeland Security issues an orange or red alert when terrorists threaten the country, when foreign substances threaten the body, the immune system issues a similar alert. Just as a highly trained Special Forces unit that covertly goes behind enemy lines to save the day, the body’s healthy immune system regularly handles inflammation, and most of the time, we don’t even know it is at work. In other words, with a healthy immune system, our bodies easily respond to both physical injuries and the internal inflammations that cause premature aging and chronic illness. However, when the immune system misfires in the face of an attack, it leads to heart attacks, colon cancer, Alzheimer’s disease, and many more health problems. Virtually all the risk factors for inflammation also lead to autoimmune dysfunction of the arteries and heart disease. A Time magazine cover article entitled “Inflammation: The Secret Killer,” states, “Instead of different treatments for heart disease, Alzheimer’s and colon cancer, there might be a single inflammation remedy that would prevent all three.”22 21 22

http://www.ncbi.nlm.nih.gov/pubmed/19109735 http://content.time.com/time/magazine/article/0,9171,993419,00.html 62

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The Integrated Health Management System, centered on a Reverse Aging diet, offers a comprehensive approach to dealing with inflammation and chronic illnesses. Armies always use the most advanced technology available. Modern warfare depends on drones and robotics controlled from Florida to fight battles in faraway countries. We have many advanced tools available to help our immune systems fulfill their mission. So what can we do to fix our immune systems? It begins with understanding how dramatically our food supply has changed in the last 50 years. When people first started farming, they grew natural foods on collective farms. The traditional family farm emerged in the late 19th century.

As the countryâ&#x20AC;&#x2122;s population grew, we needed corporate farming to keep up with the demand for food. Somewhere along the line in this shift in the way our food is produced, we processed out all the nutrients. What passes for food today is often nothing but chemicals and flavorings. COMMON INFLAMMATORY MARKERS MARKER

IDEAL

CRP-hs

Homocysteine

< 10

IL6

< 10

IL8

< 20

TNF

< 20

Fasting Insulin

HbA1C

LDL-P

< 750

Oxidized LDL

< 130

Food companies and retailers are starting to realize that more and more people value fresh produce, so they are strategically placing produce in the front of their stores. Unfortunately, most people walk right past that department to the frozen foods section to pick up frozen entrees or to the chips and soda aisle for snacks. 63

Protocols to add years to your life and life to your years

Dr. Max

A “snack” (formally a small bag of chips), has now become a family sized sack of grease-filled salted potatoes. Have you been to a state fair lately? Have you tried the fried dough or the deep-fried chocolatecovered pickles? The midway is a one-way street to heart attack city! The salt-laden, sugar infused, ultra-processed substances we feed our bodies today don’t even resemble the healthy, nutrient-rich foods our ancestors ate. Our digestive systems barely recognize the substances we now consume as food. Our bodies actually build up defenses against these substances and store the unrecognized excess substances as fat. The tremendous proportion of carbohydrate-based foods - especially those with high-fructose corn syrup - in the modern American diet results in a large increase in insulin production, which is the primary cause of cardio metabolic disease and aging. In contrast, fat and protein produce little in the way of insulin response. When the immune system misfires, the result is insulin resistance, oxidative stress, leaky gut, and glycation. I’ll discuss each of these in more detail later.

Nutrition

When attackers break through the first line of defense, the body, just like an army, needs a second line of defense - a fall-back strategy. If inflammation is the cause of the problem, then proper nutrition is the solution, and we need to build up this second line of defense. Proper nutrition can dramatically slow the aging process. Proper nutrition begins with eating the healthy foods included in a modified Paleo diet. Unfortunately, over the years, the message about what is healthy and what is not healthy has become as confused as the message at the end of a game of Telephone. Scientists have known for a long time that the damage caused by the oxidation process ties directly to free radical damage. According to the free radical theory of aging, organisms age because, as time passes, their cells accumulate free radical damage.23 23

http://geronj.oxfordjournals.org/content/11/3/298

http://www.theatlantic.com/ health/archive/2012/04/how-vegetable-oils-replaced64

Protocols to add years to your life and life to your years

Dr. Max

Of all the organs, the heart and the brain are the most susceptible to free radical damage, environmental damage, and premature aging. What’s good for the heart - that is, reversing cardio metabolic disease - is also good for the brain and most other organs. Fortunately, the organs of the body are also highly responsive to proper nutrition in the form of healthy foods, and the Reverse Aging Diet includes many foods that fight free radical damage. Beware the Modern Western Diet Special interest groups influenced the USDA food pyramid for many years. Unfortunately, large companies selling products kept that pyramid alive. No independent group monitored or ever published any actual results. The food pyramid’s recommendation of drinking three glasses of milk and eating eight slices of white bread and three sugarladen fruits per day does far more harm than good. The major cause of silent inflammation is the changes that have occurred in our food supply over the past 50 years. Fish, lean meats, nuts, select fruits, and vegetables are part of a menu that’s in harmony with our genetic structure, which has not changed for millennia. Our ancestors ate primarily from only two food groups: meat/fish and vegetables/fruits. Grains entered our diets relatively recently - about 7,000 years ago and animal husbandry to produce dairy foods developed even more recently. Most of our ancestors had little exposure to grains until about 1,000 years ago. For more on this subject, read Wheat Belly by William Davis. As the modern Western diet evolved, chemists developed highfructose corn syrup, vegetable oils, and hydrogenated fats to drive their profit margins up and keep food on the shelf much longer., all of which combine to drive the current health crisis. The average American today consumes more than 150 pounds of sugar per year; in 1700, average sugar consumption per year was just seven and a half pounds. That’s a 20-fold increase! Similar trends are animal-fats-in-the-american-diet/256155/ 65

Protocols to add years to your life and life to your years

Dr. Max

occurring in the Middle East, Asia, and many other parts of the world. Robert Lustig, a pediatric endocrinologist and author of the books Fat Chance and More, believes that sugar is far more toxic than alcohol and cigarettes combined. Because they pose such a threat to our national health, he says we should either ban or tax sodas, which he refers to as “liquid carbs.” Super sizing everything took the fast food industry to an entire new level and threw fuel on the health crisis fire. Many New Yorkers were reportedly outraged about losing their “Big Gulps” when the late New York City Mayor Michael Bloomberg tried to ban 64-ounce sodas. He may have lost to public outcry, but I believe he was on the right track. High-fructose corn syrup is primarily responsible for the huge increase in obesity, diabetes, and Cardio metabolic disease. The large amounts of sugar that most Americans consume in a normal day keep their insulin levels high, which makes and keeps them fat, which in turn accelerates chronic disease and aging. The debate is not about the absolute need to cut down on sugar and gluten intake. All experts agree that we are consuming way too much of both. The debate is about how much is too much. Many ardent supporters and opponents of the Paleo diet and other similar diets passionately believe in their positions. Here are a few examples of foods that deter cardio metabolic disease, cancer, and other illnesses: • Meats: Organically grown, grass-fed, free-range, and hormone free • Poultry, fish, and eggs: Wild or free-range • Fibrous vegetables: Asparagus, beets, peppers, cucumbers, and more • Leafy greens: Spinach, romaine lettuce, collard greens, etc. • Pseudo grains: Buckwheat, quinoa, wild rice • Seeds: Flaxseed, sunflower seeds, sesame seeds 66

Protocols to add years to your life and life to your years

Dr. Max

• Cold-processed oils and nuts: Olive oil, coconut oil, sesame oil, raw almonds, etc. • Water and green tea There are hundreds of antioxidants in salads, fresh garlic, fresh onion, mushrooms, beets, radish, calciferous vegetables, and pomegranate that reverse inflammation in our body. We cannot rely on pills to make up for junk food. How could the word junk be associated with food anyway? Why do we feed “junk food” to our children? Poisons served with toys that are contributing to the epidemic of obesity in children. French Fries represent some 90% of the vegetables consumed by many children today! One can of Coke® a day adds up to 15 pounds of extra weight per year. Fat around the belly is a factory of inflammation, accelerated aging and chronic disease. There is much more about these foods in the chapter devoted to the Reverse Aging Diet. I wonder if we could reverse the obesity epidemic by offering water or green tea in 64-ounce Big Gulp cups! Testing your nutritional status Consult with your physician about advanced testing that includes micronutrient tests, and then review those results to find which vitamins and minerals may be lacking in your diet. This is definitely not the time to fly solo, though! There are tests available for nearly everything you can imagine, and the results are not easy to understand, so work in partnership with your physician to figure out which tests are best for you and what to do with the results.

Testing for Signs of Trouble

If you ignore the mountain, doesn’t mean the mountain will ignore you too. -Tanveer Mazhar Just as armies use scouts and spies, we can help our immune systems by watching for signs of trouble and sending spies into our system to find potential threats. Step two in the Integrated Health Management System includes regular testing for signs of trouble. This includes personally monitoring our health and doing something about it. Ignoring the telltale signs of trouble is suicidal. 67

Protocols to add years to your life and life to your years

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Our bodies regularly send us warning signs when something is wrong. When we take non-steroidal anti-inflammatory drugs, steroids, or other drugs to mask the symptoms of pain, the problems don’t just disappear; they often get worse. Doctors have many ways to test for potential danger. Work with your doctor to test for trouble before it starts. A regular physical and periodic testing are cornerstones of the Integrated Health Management System. We regularly check patients for a variety of indicators of premature aging and use them as an early warning system. You can do the same by referring to the following list. • Excessive weight loss or gain and changes in blood pressure and temperature are nearly always signs of one problem or another. This is why nurses check and report a patient’s weight and blood pressure during every visit. • Snoring, feeling tired all the time, and dry mouth are signs of sleep apnea, a potentially serious sleep disorder. Sleep apnea causes high blood pressure and often leads to clogged arteries. • Inflamed or red eyes are early indicators of arthritis, and grayish eyes are often signs of blood related issues. • Dull or graying skin is a sign of kidney issues. As discussed earlier, the kidneys are responsible for flushing wastes and excess fluids from our bodies. • Discoloration, bumping, swelling, and other changes in the hands, feet, and toes may signal lung cancer, circulatory problems, and Alzheimer’s disease. • Loss of hearing, eyesight, and smell are all signs of some type of malfunction. Unfortunately, many people ignore these early warning signs, allowing diseases to progress further and faster than they should. An LDL number of say 110 composed mostly of dangerous small beach balls needs treatment, whereas an equal number of 68

Protocols to add years to your life and life to your years

Dr. Max

110 LDL particles made up of larger particles (beach balls) may need no treatment. The two reported lab numbers are equal in volume but not equal in danger. (Discordance between LDL-C and particle number, Journal of Clinical Lipidology, 5, 105-113 - 2011)

Exercise

Every military in the world understands the need for rigorous training. Sports teams develop regular training routines and build up their endurance for game day. Our bodies need regular training and exercise so they are ready for game day, too. In addition to rethinking what we put in our bodies, we all need to pay attention to the other lifestyle choices that we can modify. Mechanization, electronics, and home entertainment systems are great for the economy, but they lead contribute to sedentary lifestyles and fuel the obesity epidemic. Far too many people spend their days in front of computers, televisions, and electronic gadgets. I call this lack of movement “sitossis,” and it is killing us! I admit that I sit far more than I should, and I constantly look for ways to keep moving in my life.

Genetics Role the Aging Process

The Human Genome Project, which mapped all the genes in the human body, gave us the ability to read nature’s complete genetic blueprint for building a human being. Using this information, researchers are discovering new ways to leverage the role that genetics plays in the diseases discussed previously and in the aging process itself. Recent research has revealed that the aging gene regulates aging but also stress resistance, metabolism, and development. How the Aging Gene Works A study published in Nature showed that stimulating telomerase in mice could reverse aging. Telomerase is the enzyme that can increase the length of telomeres – the protective “cap” on the end of chromosomes. The longer the telomere, the younger the biological age. 69

Protocols to add years to your life and life to your years

Dr. Max

We now know that in humans, some foods found in the Paleo diet (in particular those high in omega 3), some supplements, exercise and stress reduction, all affect the increase in telomerase. Additionally, researchers have shown that after just six months of twice-weekly strength training, the biochemical, physiological, and genetic signature of older muscle turns back 15 to 20 years in a process known as gene shifting. All this research and other studies being published daily, support my belief that aging is genetically controlled. It also probably explains why older, more active individuals’ hearts are in better shape than those of their sedentary counterparts, enabling them to avoid agerelated disease altogether. By changing our lifestyles, we can influence our genes and reverse the aging process and reduce and eliminate diseases, including heart disease. Harnessing Epigenetics Genes may load the gun, but your lifestyle pulls the trigger. Julieanna Hever.24 Epigenetics is “the study of inherited changes in appearance or gene expression caused by the environment”. In other words, genes are not our destiny! They can be positively influenced by non-genetic factors such as the modified Paleo diet, exercise, toxin reduction, hormones, certain nutrients, and stress management to express themselves in a healthier way. Or negatively influenced: I inherited a “heart attack gene” from my father and my two uncles, but I triggered the blockage of my coronary arteries using the Middle Eastern habit of wrapping most of my food with bread. Healthy lifestyle and gene-activating nutrients up-regulate the mechanisms that produce lipoprotein patterns typical of very old people. These practices slow the aging process and lead to greater longevity. With all this promising research going on, genetic testing is becoming more valuable every day. This testing is now very affordable and is an important tool in the Integrated Health Management System toolbox. https://kindle.amazon.com/work/complete-idiots-guide-plant-based-nutrition/ B004HL387A/1615641017 35http://www.genome.gov/27532724

Protocols to add years to your life and life to your years

Dr. Max

We now measure your telomere length at our Reverse Aging Centres, which gives us an idea of your true biological age as opposed to your chronological or passport age. Even if genetic testing reveals killer genes, we can turn them off by avoiding high-carbohydrate diets, smoking, and other toxins. We can also help ourselves by switching to a Reverse Aging Diet with adequate nutrients, engaging in moderate exercise, and managing our emotional and mental health and declining hormones.

Restoring and Re-balancing of Declining Hormones

Just as traitors and turncoats can undermine an army, out-of-control hormones can cause lots of damage to the body. That’s why anyone who wants to live longer must understand the role of hormones in the aging process. Hormones are the “juice of life,” and we cannot enjoy good health unless we restore our hormones to optimal levels and more importantly bring them into balance. Unfortunately, some hormones have an undeservedly bad reputation, whether for political reasons or due to poor science. Both testosterone and human growth hormone received negative publicity after the United States lost to Russia in the Olympic Games many years ago. The Russians were using these substances to improve their athletes’ performance long before American physicians and sports authorities had heard of them, and there was no drug testing in sports at the time. The hysteria that has reigned ever since regarding hormone use among professional athletes has still not subsided, and that’s unfortunate because there are times when administering hormones safely is a good thing. Clearly, if a person has type 1 diabetes or an underactive thyroid, most physicians will recommend replacing the deficiency with insulin or thyroid hormone. More recently, due to the Women’s Health Initiative study released in 2002, there was again mass hysteria and concern about hormones - this time with regard to hormone replacement therapy (HRT) in menopausal women. This was a very poorly done study. Although it showed a slight increase in heart disease and breast cancer in women on HRT, there was in fact a lower overall mortality rate in the women 71

Protocols to add years to your life and life to your years

Dr. Max

on HRT due to a lower risk of colon cancer and reduced morbidity from hip fractures. A skilled therapist can quickly re-balance all of a patient’s hormones. Signals from hormones act on the endothelium and on processes within the endothelium to exert specific functions. After the age of 30, we lose about three percent of our hormones each year, so replacement strategies make a great deal of sense. If we fail to correct problematic hormone levels in people between the ages of 35 and 50, they cannot enjoy optimal health and avoid chronic disease, as they get older. Not everyone needs hormones, and since so many people in their 60s have low levels, these levels are “normal,” but they may not be optimal. Re-balancing hormones to their ideal levels allows older people to lead healthier and more robust lives. Safe hormone replacement when indicated has many other positive effects besides helping your libido. Vitality, mood, skin, weight, bones, memory, energy, sleep, and sense of wellbeing are all improved. Hormones can help reverse cardio metabolic disease. Consider the male sex hormone, testosterone. Testosterone is important for sugar and fat metabolism. Most men who are obese and have diabetes have little or no testosterone. Without testosterone, they cannot reverse their diabetes, lose weight, or build muscle. An under-active thyroid is another common problem. Routine blood tests could be very inaccurate in diagnosing hypothyroidism. Unless we correct the thyroid hormone balance, it is nearly impossible to lose weight. Many other hormones play an important role in reversing cardio metabolic disease. Environmental toxins, stress, and medications all negatively affect hormones. Several studies have shown that statins lower testosterone and cause erectile dysfunction as well as lower levels of oxytocin (the “love hormone”) and serotonin (the “happiness hormone”). 72

Protocols to add years to your life and life to your years

Dr. Max

There is also much misinformation and ignorance about menopause and andropause, or â&#x20AC;&#x153;male menopause.â&#x20AC;? A trained physician can replace your hormone deficiencies with natural, bioidentical hormones with no problems or side effects. Susan Somers, a leading advocate for women and bioidentical hormone replacement therapy, was amazed at the response when she asked nearly 2,000 menopausal women whether they would prefer sex or a smoothie. Most women put their hand up for the smoothie! This is because women, who make only 10 percent of the testosterone that men make, still need testosterone for libido. A little testosterone cream will revitalize most of these women. I have been on testosterone replacement therapy for seven years. When I switched to the Reverse Aging diet, and after losing a third of my body fat and building more muscle at the gym, I had to cut down on my testosterone dose to avoid pushing my blood levels into overdose territory. When you build muscle and lose fat, your body reverts to manufacturing its own hormones. If you want to live longer, learn everything you can about hormones. Safely administered, they add to your quality of life and delay the aging process. Take the test in the applicable table below. If you answer yes to three or more questions you may need hormones to optimize your health. AS A MAN OVER 35 1

Iâ&#x20AC;&#x2122;m often tired

I have fewer early morning erections

I have lost a lot of strength

My mind feels less sharp

I think about sex less often

My belly has much more fat

I feel sadder

My orgasms are less satisfying

My erections are less hard

YES

Protocols to add years to your life and life to your years

Dr. Max

I simply feel less confident

AS A WOMAN OVER 35 1

I get hot flushes

I have severe mood swings

I am less interested in sex

I donâ&#x20AC;&#x2122;t sleep so soundly

I have bone loss

I often feel tired

My vagina is dry

I am losing hair and getting wrinkles

I have urinary incontinence

My breasts are droopy

YES

Advanced Supplementation with Nutraceuticals

Even with the perfect diet, key nutrients such as omega-3 fatty acids and vitamin D are often missing. Advanced supplementation can fill the void and contribute to better overall health. There is mounting evidence that nutrients in the form of â&#x20AC;&#x153;nutraceuticalsâ&#x20AC;? may extend lives and delay the onset of many diseases. Proper nutrition, regular exercise, and supplementation with appropriate nutraceuticals for your condition can dramatically slow the aging process.

Training the Mind Improves Health

The grand essentials to happiness in this life are something to do, something to love, and something to hope for. -George Washington Burnap The best soldiers are the best thinkers. Instead of relying on brute force, they outthink their opponents. They understand the power of mind over matter, and in the same way we need to use our minds to help our immune systems. 74

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Just like a high-carbohydrate diet, stress is one of the primary causes of cardio metabolic disease. Both positive and negative emotions have a powerful impact on the human body. Negative emotional reactions cause a variety of health problems, including heart disease, high blood pressure, stroke, and even sudden death. A bad marriage, a bad job, or financial stresses are just as unhealthy as high blood sugar. Just as important, positive emotions, such as love, forgiveness, and compassion, contributes to good health. More than 4,000 years ago, Chinese physicians noticed that illnesses often followed periods of frustration in their patients’ lives. Many physicians in the Western world now share the view that emotions, life events, and coping skills have a very strong influence on health. New fields of medicine, such as psychoneuroimmunology and behavioral cardiology, recognize how important a healthy mind body connection is to better health.25 Psychoneuroimmunology studies the relationship of thoughts and emotions to brain chemistry and the immune system. Behavioral cardiology applies psychological and social factors to check and reduce cardiovascular risk. In addition to reducing recurrent heart attacks, these new fields help patients recover sooner by improving family support. Doctors also understand that poor emotional health and stress contribute to disease and aging. And the opposite is even more powerful. Can you think yourself well? “Absolutely,” say many doctors and researchers.26 Cave dwellers encountered stress once or twice a week when they faced a wild animal. We encounter some 35 stressful moments per day. Brain Health • Anger, hostility, and being a hot burner increases your risk of heart attacks. Reduce stress by avoiding toxic relationships and https://www.pritikin.com/home-the-basics/about-pritikin/how-pritikin-works/16healthy-mind-healthy-body.html#. VEGEseZd2cE 26 http://familydoctor.org/familydoctor/en/prevention-wellness/emotional-wellbeing/ mental-health/mind-body-connection-howyour-emotions-affect-your-health.html 25

Protocols to add years to your life and life to your years

Dr. Max

taking a yoga class to master using deep breath to control anger outbursts. Depression equally increases your heart attack risk. Exercise and being around positive people help. Seek comedy shows and movies since laughter is a great therapy as well. • Live below your means. The best things in life do not cost money. Love, on line learning, self-improvement efforts, volunteering for good causes, a stroll in a park, playing cards and listening to good music are just a few examples. • Live close to work and preferably in a walk-able community. Commutes waste time and fry nerves. Never mind long commutes to live in the bigger house with the bigger yard. • Regular flossing and dental cleaning decreases both heart disease and Alzheimer’s disease. Have your dental hygienist show you the proper way to floss. Wrong flossing techniques are common and cause more harm than good. Replace the oldfashioned strings and rolls of floss with flossers that you can use while driving or watching TV. Keep plenty around the house and floss several times per day.

Environmental Toxins Harm Our Bodies

Chemical warfare is the most dangerous form of warfare, and chemical toxins are the most dangerous threat to our bodies. William Rea, founder of the Environmental Health Center in Dallas and a recognized authority on environmental toxins, is the author of a fourbook series on chemical sensitivity27 and many other books on how the environment works against our bodies. He says that many common ailments are directly traceable to substances in our environment. Environmental factors can cause headaches, sinusitis, fatigue, joint aches, blood vessel abnormalities, asthma, chronic infections, and more. According to Dr. Rea, the “environment” involves all of our surroundings, including everything we breathe, eat, or touch. Substances such as pollens, molds, machinery, carpets, cleaning supplies, perfume, and smog surround http://www.ehcd.com/chemical-sensitivities/

Protocols to add years to your life and life to your years

Dr. Max

us daily and contain toxins that are detrimental to our health. As one example, letâ&#x20AC;&#x2122;s look at what exposure to heavy metals does to our bodies. According to the CDC, more than 25 percent of Americans have clinically toxic levels of heavy metals such as lead and mercury. The average personâ&#x20AC;&#x2122;s bone-lead levels are 1,000 times greater than they were 400 years ago. People with idiopathic cardiomyopathies - heart problems with no identifiable cause - may have 20,000 times more toxic metals in their bodies than people with healthy hearts. Environmental toxins can wreak havoc in the body, increasing oxidative stress, inflammation, hormonal imbalance, and insulin resistance, all of which contribute to cardio metabolic disease. A simple urine analysis can tell your doctor if you have heavy metal toxicity. Other environmental toxins include pesticides, radiation, chronic infections, organic hydrocarbons, and polyvinyl chlorides. These and many others take their toll over time. They are in the food we eat, the air we breathe, and the water we drink. Electromagnetic frequencies are yet another source of toxicity. If you are a man, just carrying your cell phone in your pocket significantly decreases your sperm count and testosterone levels. One way that you can lessen your exposure to environmental toxins is to avoid eating tuna, swordfish, shark, and sea bass, all of which contain relatively high levels of mercury. It takes 30 years for your body to get rid of a drop of mercury, which is toxic to the heart, brain, and immune system. Another step you can take is to pay attention to the way your food is cooked. Frying meat at high temperatures or grilling it on a barbeque releases compounds called heterocyclic amides (HCAs), which increase the risk of stomach and colon cancer. Understanding this is especially important for anyone following a modified Paleo diet, which is can be rich in meat. To reduce HCA production, turn the meat often to avoid burning it, peel away any burned parts, marinate the meat overnight so that it will not need as much cooking, or precook it in a 77

Protocols to add years to your life and life to your years

Dr. Max

microwave before frying or grilling it. If possible, you should also avoid living close to heavy traffic and overhead power lines to reduce your exposure to pollution-related toxins and electromagnetic frequencies.

Detoxification

Carbon released into the environment stays for thousands of years. The global concentration of carbon dioxide, the primary driver of global warming, has increased by 25 percent over the last 50 years. In another 25 years, the earth will warm up by an additional one degree. Average global CO2 levels have now crossed the 400 parts per million (PPM) milestone. When we hit the 450-PPM level, the Earth will become uninhabitable. In 2013, five oil companies - ExxonMobil, Chevron, BP, Shell, and ConocoPhillips - earned $93 billion in profits. They spend $400 million per day in lobbying expenses. For every dollar spent, they received $73,000 in tax breaks. We, the taxpayers, are subsidizing the pollution of our air, and the resulting environmental toxins are killing us! Our great military men and women protect these companies all around the world in wars that kill and maim our young soldiers. The recent drop in oil prices is probably here to stay and is a great break for our struggling poor and middle class but could be catastrophic for our environment. Solar energy is now five times cheaper than it used to be just seven years ago. Solar storing technology is now much better. Old bulbs create a lot of heat and burn out frequently because they are fragile. Light Emitting Diodes (LED) bulbs are now much cheaper, last for years and consume ten times less energy. Replace your old bulbs: you save money and help save the planet. The same applies to investing in insulating your house. Framework for the Integrated Health Management System

If you want to save the world, start with something you know and understand. Dr. Max 78

Protocols to add years to your life and life to your years

Dr. Max

There is fundamentally no reason our bodies should give out when we hit the magic age of 65 or 70. Our bodies and minds can thrive longer than we think, but we need to take care of them. We also need a new national attitude toward aging and the elderly. It is time for a dramatic change in how we approach health care in developed countries. Returning to a diet rich in wholesome foods - the Reverse Aging Diet - is a great place to start. We then need to stop depending on drugs as the healer of all ills. Doctors should reduce their use of their prescription pads and ask themselves, â&#x20AC;&#x153;Is this prescription really necessary, and is it in the best interest of the patient? Physicians can lead the way in developing a preventive-based health care system that includes healthy exercise programs and better public education about the value of lifestyle changes. They can also help to expose how special interest groups slant information to their advantage. What passes for food in our grocery stores is appalling. Marketers capture our youth before they are old enough to understand how the packaged foods they gorge on will eventually shorten their lives, and the toxins in our environment are the frosting on the cake. The deadly toxins in the air we breathe cause major illnesses and shorten our lives. I hope this manual alerts others to what I have known for a long time, and I pledge to continue raising awareness about these issues at every opportunity. The next chapter outlines a modified Paleolithic diet that is a great start for personal health. It also includes a new food pyramid based on healthy foods instead of the starch- and sugarladen foods originally recommended by the USDA.

Protocols to add years to your life and life to your years

Dr. Max

Chapter 9. Food as Medicine - The Reverse Aging Diet From Dallas, Texas, this flash, apparently official: “President Kennedy died at 1 p.m. Central Standard Time,” 2 o’clock Eastern Standard Time, some 38 minutes ago. -Walter Cronkite With these words, Walter Cronkite, in his black-rimmed glasses, became the most well known news anchor in history. I also remember him as the narrator of an educational series called You Are There. Our history teacher used the You Are There educational videos to break the monotony of memorizing dates and events. We always looked forward to hearing Cronkite narrate a special event from the past. I vividly remember his introduction to each show with the phrase, “Everything is the same as it was then, except” - and here he would pause for effect and then continue in his deep, broadcast voice - “you are there.” Imagine, if you will, Cronkite on a 13-inch black-and-white TV screen, narrating this special episode, “Tracing Our Paleolithic Roots.” FRIENDLY FRUITS Apples

Currants

Passion fruit

Apricots

Grapes-but not seedless ones

Peach

Avocado

Guava

Pear-firm, not ripe

Banana-greentipped only

Huckleberries

Plums

Blackberries

Kiwi

Pomegranate

Blueberries

Kumquats

Raspberries

Boysenberries

Lychees

Strawberries

Cherries

Mulberries

Tomato

Citrus-orange, grapefruit, tangerines

Nectarine

Cranberries

Papaya-green only 80

Protocols to add years to your life and life to your years

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KILLER FRUITS Dates*

Ripe pears

Dried fruits of any kind

Ripe papayas

Figs

Seedless grapes

Fruit leather/strips

Watermelon

Mangos

Ripe bananas

Pineapple

Raisins

Plantains Avoid these sugar and calorie bombs *Dates are often referred to as ‘Natures Fuel’. Upon consumption, glucose is rapidly converted into glycogen in the liver. Dates are best consumed shortly before, during or immediately after exercise. It is an ideal snack to fuel activity. Figs, dates, and pineapple for example are good sources of antioxidants but are too high in carbs. We can best get our antioxidants from dark vegetables, apples, berries, citrus and other friendly fruits.

Tracing Our Paleolithic Roots: You Are There MUSIC: “Way back in history three thousand years In fact ever since the world began There’s been a whole lot of good women shedding tears over a brown eyed handsome man”28 COMMENTATOR (Continuing from a previous episode on the modern diet): Now that you understand the problem, let’s look at how to slow your body’s aging process. The best way to get started is to go back to eating the foods our ancestors ate more than 10,000 years ago. Our ancestors ate mostly wild animals and plants in what we now call 28

http://www.oldielyrics.com/lyrics/buddy_holly/brown_eyed_handsome_man.html 81

Protocols to add years to your life and life to your years

Dr. Max

a Paleolithic diet, the cave dweller diet, or the hunter-gatherer diet. The term “Paleolithic” refers to the period of human history when cave dwellers first used stone tools, from about 2.6 million years ago up to about 10,000 B.C. In today’s episode, we join a cave-dweller family. Everything is the same as it was then, except you are there. Scene 1 The brilliant, late-afternoon sun slowly fades into the pink horizon casting a brilliant, yet calming glow over a crystal-clear lake while a family gathers around an open fire for the evening meal. CRONKITE (whispering so as not to disturb the scene): This is Walter Cronkite reporting to you from Qesem Cave29 in a small, hidden valley on the planet Earth. It is a fall evening in 10,000 B.C., and everything is the same as it was then, except you are there. Scene 2 (the next morning) CAVE DWELLER MOM: Ugh! Keeds un gree. CAVE-DWELLER DAD: Ergh! Me gah hunt. CAVE-DWELLER DAD hunts and kills a wild boar with his spear and picks some berries on his way back to the cave. The family eats for several days on roasted pig, fresh berries, and greens. Scene 3 Generations flash by on the screen.

A newly discovered hearth full of ash and charred bone in a cave in modern-day Israel hints that early humans sat around fires as early as 300,000 years ago - before Homo sapiens arose in Africa.

Protocols to add years to your life and life to your years

Dr. Max

CRONKITE: The cave dwellers and their descendants eat a hearty diet, are fruitful, and multiply through many generations until corporate greed decides processed grains are better for us than organically grown meat, fruits, and vegetables. Scene 4 (Modern times, 5:30 p.m., any day of the week) The camera slowly moves in on a modern-day office, where a female executive sits at her computer and dials the phone. MODERN-DAY MOM: (Humming as she dials) I can bring home the bacon, fry it up in a pan.30 (Talking on phone to MODERN-DAY DAD) I have to work late. Can you pick something up for dinner? They had pizza last night, so get something different. MODERN-DAY DAD (driving home from work): Iâ&#x20AC;&#x2122;ll grab a bag of burgers and fries or a bucket of chicken. CRONKITE: Flash, this just in from modern times. (Glances at viewers for effect and removes his glasses.) Letâ&#x20AC;&#x2122;s fast-forward to this modern-day Western diet. There is zero nutritive value in that bag of burgers or bucket of chicken. There are, however, enough preservatives to last more than 10,000 years with no spoilage. (We tried it!) We return you now to our studios and commentator Dr. Max. The Paleolithic diets of our ancestors consisted of a moderate amount of carbohydrates, protein, and fat. The macronutrient composition of those foods triggers an ideal hormonal response in our bodies with little inflammation. One of the cheesiest songs of all time adapted for a perfume commercial; see https://www.youtube.com/ watch?v=mWFhlVvYOno and http://guiltypleasures.quora. com/Im-A-Woman-Peggy-Lee-1963-Enjoli-commercial-1980s

Protocols to add years to your life and life to your years

Dr. Max

Our genes have changed little in the past two million years, and we are still ideally suited to this type of diet. The modern-day, Western diet now spreading throughout the world is primarily responsible for the global obesity epidemic and causes many of the diseases discussed earlier. It is imperative that we return to our original Paleolithic diet if we are to stay healthy and free of disease.

Introduction to The Reverse Aging Diet – a Modified Paleolithic Plan Initially discussed in the 1970s, the idea of a diet based on the Paleolithic era gained significant popularity.

In the late 1990s and early 2000s, Staffan Lindeberg, Mark Sisson, Arthur De Vany, Loren Cordain, and others published books and articles promoting the diet. Most of these books and authors advocate strict adherence to an animal- or vegetable-based diet. I started on my modified version of the Paleo diet or what I call the Reverse Aging Diet after my encounter with cardio metabolic syndrome. I now recommend the modified version to all my patients and to you as a proven way to combat chronic illness, improve hormone balance, maintain optimal weight and reverse the aging process. An overly strict diet is far too difficult to maintain, and people give up when they are not able to stay on these diets. The Reverse Aging Diet leads to better compliance and allows more people to achieve the results they want.

Reverse Aging Diet Basic Principles - “Here’s the Beef!” With more than 15,000 diet books on the market, what is so special about the Reverse Aging Diet? It is inspired by the original diet eaten by humans for more than 100,000 generations back. The popular press calls this the Paleo Diet. Our cave-dweller ancestors were far more likely to die from animal attacks than from the killer diseases of the 21st century that are diet related.

Protocols to add years to your life and life to your years

Dr. Max

The Original Basic Paleo Diet – Key Principles

• Begin with a diet containing moderate equal amounts of each macronutrient) of protein, carbohydrates, and fat. Much of the healthy food from the animal-based Paleo diet comes from grass-fed meat, organic poultry, fish, organic eggs, vegetables, and salads, complemented by friendly fruits (citrus fruits, berries and apples), pseudo-grains, and nuts (except the starchy peanuts). This is the ideal diet for most people to keep insulin levels below five mIU/L and slow the aging process. • Focus on “high net-gain nutrition.” People who eat a modern Western diet that includes excess carbs and processed foods use a significant amount of energy digesting the empty calories. High net-gain eating eliminates this excess work for the body. This means consuming nutrient-dense, enzyme-intact foods that are easy to digest. Intermittent fasting - one day a month without solid food? Or half days every week- optimizes the process. When you do this, you can forget about calorie consumption guidelines. • Eat vegetables raw, or cook them below 118° F or 48º C. Hightemperature cooking and excessive food processing destroys the enzymes and nutrients needed for digestion and converting food into usable fuel for the body. As with hormones, our bodies’ production of natural enzymes diminishes with age, so our diet must provide them. High-temperature cooking also creates advanced glycation end products. The body perceives these AGEs as invaders, and the immune system produces inflammation to combat them. • Eat green salads to counter the acidity produced by meat and balance your body’s pH level. Eating too many acid-forming foods causes weight gain. Low-grade metabolic acidosis produces additional free radicals and oxidative stress, which increases the risk for cardio metabolic disease. It also causes virus and bacteria growth. Interestingly, it is impossible for cancer to grow in an alkaline environment. One factor that raises the body’s pH level is the chlorophyll content of plants, which 85

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is vital for removing toxins from the blood. Most citrus fruits become alkaline once eaten. • Use cheese in moderation. Hard and semi-hard aged cheeses, such as Swiss, cheddar, and mozzarella, are OK, but avoid most commercial soft cheeses. Cheese is very acidic and can aggravate osteoporosis. On the other hand, cheese is a great source of calcium, which helps control abdominal fat. Instead of eating cheese with crackers, which contain sugar, try wrapping it in lettuce, or eat a cucumber or some cherry tomatoes with it, because vegetables neutralize the acidity of cheese. The dairy industry has done a great job marketing milk products as the best way to build healthy bones, but you can actually get calcium from all sorts of plant-based sources. Examples: kale, collard greens, tempeh, almond butter, and broccoli

Dr. Max’s Modified Paleo Diet - The Reverse Aging Diet When a patient is sick, treat with diet first - if that doesn’t work, then use medications -Hippocrates

The most powerful medicine you can consume is the food you eat. Pay special attention to the quantity and quality of the carbohydrates in that food. We are all going to age, but we don’t have to get old before our time. At about the same time that Walter Cronkite was hosting You Are There on television, agricultural companies discovered that they could step up dairy production, mass-produce a few grains, process them for easier packaging and shipping, load them up with preservatives, and pass them off as healthy. Over a few short decades, we have moved from a nutrient-dense diet that varied and changed based on location and season to a diet dependent upon a few starchy crops, meats, and poultry injected with hormones, and sugar-laden drinks. Eating a poor diet and living a lifestyle at odds with our genetic heritage is shortening lives and costing nations trillions of dollars each year. Hunter-gatherers appeared to suffer no obesity, diabetes, metabolic syndrome, heart disease, or cancer. 86

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Our cave-dweller ancestors regularly feasted on fat and protein, a macronutrient composition that triggers an ideal hormonal response in the human body. Our genes are very much like those of the family in the opening scene. They have changed very little in the past two million years. The Reverse Aging Diet, (a modified Paleo plan) is the perfect diet for us today, just as the Paleo diet was millions of years ago. The major reason for our current epidemic of silent inflammation is genetic discordance - our genes have not had time to adjust to our hugely increased intake of refined carbohydrates and adulterated vegetable oils. The human tribe is under attack from within! We spend trillions of dollars annually to defend against external enemies while the biggest threat to our species comes from our diets, our sedentary lifestyles, and our polluted environment. With a return to the food of our ancestors, we can restore optimal health, physical performance, and mental alertness. When we change what we eat at each meal, we need be far less concerned about how much we eat. A high-carbohydrate diet increases our insulin levels, makes us fat, and increases the inflammation that causes chronic disease and premature aging. No doctor or government agency prescribes the modified Paleo diet. Itâ&#x20AC;&#x2122;s derived from millions of years of evolutionary wisdom. Now more than ever, we need to take charge of our own health, become better informed, and partner with knowledgeable agemanagement doctors who can mentor us toward optimal health. With the lifestyle changes presented earlier and a switch to the Reverse Aging Diet, you can add years to your life and avoid diseases.

Animal- and Plant-Based Reverse Aging Diets

There are many versions of the Reverse Aging Diet, but the fundamental decision is whether to include meat. At my centers we believe in personalizing your eating plan to your health, hormone, and weight loss goals. I personally decided to include meat in my diet plan because it promotes muscle strength and reduces weight gain. I have reduced my body fat percentage from 27 percent to 13 percent with a diet that includes meat and a prescribed exercise plan. 87

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Dr. Max

You can halt and begin to reverse chronic disease with either a Reverse Aging Diet that includes meat or a Reverse Aging vegetarian diet. If you are overweight, reducing body fat is critical, but it is harder to reduce body fat or gain muscle on a plant-based diet because of the higher carbohydrate load. Legumes, for example, are dense in calories, half of which are from sugar, so use them in moderation. Eat fish two times per week and “whole” soy – not processed. Organic non GMO edamame, temphe and tofu. Body fat percentage is an excellent measure of metabolic function in the body. When your body fat is in the right range, all the important biomarkers normalize - including blood pressure, blood sugar, HbA1c, blood fats, uric acid, and inflammatory markers - and you begin to feel a new, healthy glow.

How I Approach My “Diet”

Here are a few key ideas that are helpful to keep in mind when changing your eating habits to incorporate The Reverse Aging Diet: • Change your mindset. I don’t think of myself as being “on a diet,” nor do I tell others that I am dieting. I eat the right foods every day and will do so for the rest of my life. I encourage others to do the same. I think of it more as an eating plan that complements my exercise and lifestyle plan. • Allow yourself rewards. Follow the basics of the diet presented here, but allow yourself two “reward meals” each week that include foods you love that are not included in the base diet. Two defined reward meals to look forward to will inspire you to stay on your plan. This is especially true in the first 3-6 months as you switch from consuming what the average American consumes - 26 teaspoons of sugar a day- to less than ten. • Don’t go overboard with “rewards.” Yes – enjoy two reward meals. No - don’t go crazy and eat lots of junk food. These rewards take the edge off the eating plan, making overall compliance easier to maintain. The need for rewards decreases with every year of being on this wellness-eating plan. 88

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• Exercise burns few calories. The real benefit of exercising is not in burning calories but in lowering your stress hormones such as cortisol and increasing your happy hormone dopamine, thereby fighting your biggest enemy: your stress induced or depression induced emotional eating. Remember, according to a New England Journal Of Medicine study, 45 min of brisk walking a day equals the anti-depressant effects of one Prozac per day®. So move it or you lose it. Not only you lose your marbles but also lose your sex life. Erectile dysfunction is a common problem related to diabetes. Exercise increases your metabolism and decreases insulin resistance in muscles, liver and brain thereby fights Alzheimer’s and cardio metabolic disease. • Pay attention to portion control. Eat one normal-sized plateful of food at each meal and nothing more. It’s important to be acutely aware of your portion sizes, because too much of even good foods can be harmful. Avoid second helpings and resist the urge to “clean your plate” in restaurants. Instead, take half of your meal home for your next day’s lunch. Stop eating before you are full and wait 20 minutes. You will be surprised that you feel full then. It helps to eat a lot of fiber especially salads. It is hard to eat more than you need unless you are spiking your insulin with refined carbs and skipping your fiber rich greens.

The USDA Killer Food Pyramid

According to The New England Journal of Medicine, children born today may be the first generation in the history of the United States with a lower life expectancy than their parents may. This is at a time when the United States spends twice as much per capita as any other country but is 37th in the world in terms of health outcomes.31 The reason this generation will have shorter life spans is the USDAapproved food pyramid discussed earlier. Agricultural companies, politicians, special interest groups, well-meaning but misguided physicians, and self-appointed nutrition experts have recommended this killer pyramid for more than 40 years. The New England Journal of Medicine, 2005

Protocols to add years to your life and life to your years

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The diet represented by the old pyramid killed millions as it recommended 45 to 65 percent carbohydrates and including eight slices of bread and three glasses of milk per day. The new FDA pyramid introduced in 2011 is a step in the right direction but is still too lax when it comes to sugar consumption. It treats bread, grains, and pasta differently than sugar when in fact they are the same. It is also recommends excessive amounts of milk. Plain organic yogurt would be much healthier and less likely to cause prostate and ovarian cancers. Keep protein intake to under 150 gm/day – excess protein converts to fat if taken in very large amounts

The Reverse Aging Pyramid Fundamentally Healthy Foods

As an alternative to the USDA food pyramid, consider the Paleo Reverse Aging pyramid. The following sections detail the elements of this healthy diet.

Animal-Based Reverse Aging Diet Meat, Fish, and Poultry Animal protein offers a good building block for our bodies. It repairs and restores tissues, improves immune and enzymatic functions, and optimizes hormone and body fat levels. Here is a guide to the animal-based modified Reverse Aging Diet: • Choose natural, wild, or grass-fed animals. • Eat red meat three times per week. • Eat fish at least two times per week. • Avoid fried, processed, and cured meats. • Avoid sweet dressings such as teriyaki sauce. Good red meat choices include: Beef filet, flank steak, stew meat, ground sirloin, round steak, jerky/ biltong, lamb, wild game, venison, bison. Organic, free range and hormone free poultry is another excellent source of complete protein. 90

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Eating whole chicken breast is better than eating processed lunchmeat. Good poultry choices are: Chicken, cornish game hen, duck, goose, turkey, turkey bacon, chicken cold cuts (not processed) and wild poultry. Good fish choices include: Shrimp, alaskan halibut, anchovies, freshwater bass, hawaiian fish such as ono, salmon, all shellfish, white fish, and perch. When it comes to fish, eat wild-caught fish and avoid farm-raised fish. Smaller fish have less mercury. Eggs Over the years, eggs developed a bad reputation for the wrong reason. In one recent study, people who ate eggs for breakfast consumed 20 percent fewer calories throughout the day and had a higher basal metabolic rate. This is the amount of energy the body expends at rest. Egg yolks offer choline, which protects the liver and increases fat loss. Betaine, formed from choline helps with mitochondrial function. Always use organic or â&#x20AC;&#x153;free rangeâ&#x20AC;? eggs rather than eggs from caged chickens.

Vegetarian-Based Reverse Aging Diet

If you donâ&#x20AC;&#x2122;t want meat in your diet, consider a vegetarian Reverse Aging Diet based on grains, greens, beans, and whole soy if you have no allergies. The optimal balance of these elements is approximately 50 percent whole grains, 25 percent greens, and 25 percent beans and whole soy. In addition, the Reverse Aging vegetarian diet includes weeds, seeds, roots, and fruits.

Protocols to add years to your life and life to your years

Dr. Max

Fibrous Vegetables WHERE TRANS-FATS ARE FOUND 95%

80%

Many Frozen Foods

75%

Snacks

70%

Cakes

40%

Most Supermarket Products

Fibrous vegetables are an important part of the Reverse Aging Diet. These include leafy green vegetables, broccoli, onions, garlic, mushrooms, and colorful vegetables. In addition to supplying carbohydrates, these vegetables are a rich source of vitamins, minerals, and phytonutrients.32 They also deliver a large amount of chlorophyll and fluid. Eating chlorophyll-rich leafy green vegetables and engaging in moderate exercise is the best way to create a biologically younger body. Good vegetable choices include: Asparagus, beets, bell peppers, bok choy, carrots, celery, cucumbers, daikon, jicama, green chard, green curly kale, green leaf lettuce, green oak leaf lettuce, kale, lollo rossa lettuce, mache, mizuna, mustard greens, pea greens, radicchio, red Belgian endive, red leaf lettuce, red mustard, red oak, leaf lettuce, red peacock kale, red romaine lettuce, red Russian kale, squash, tomatoes and zucchini. In addition, consider adding the following leafy greens to your diet: Arugula, baby red chard, baby spinach, beet greens, butter lettuce, collard greens, dandelion greens, dinosaur kale, frisĂŠe, gold chard, Romaine lettuce, Ruby chard, spinach, Swiss chard, tango lettuce, tatsoi, nagoya kale and white peacock kale. Phytonutrients are chemicals that plants use to protect themselves from threats such as bugs, germs, and fungi. Although not essential for human life, phytonutrients may help prevent disease and keep your body working properly. Source: http://www.

webmd.com/diet/phytonutrients-faq 92

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Sea Vegetables Sea vegetables, including seaweed, kelp, and other wild ocean plants, are among the most nutritionally dense foods in the world. They contain 10 times more calcium than cowâ&#x20AC;&#x2122;s milk and several times more iron than red meat. They are a rich source of naturally occurring electrolytes, easy to digest, and are rich in chlorophyll. In addition, they are alkaline-forming and supply the body with needed iodine. There are hundreds of antioxidants in seaweed. Here are some sea vegetables you may want to include in your diet: Agar, Arame, Dulse, Kombu, and Wakame.

The Killer pyramid

The killer pyramid, consisting of 4565% carbs recommended for the last 40 years by political and economic interest groups and misguided physicians and nutritionists. The 2011-revised pyramid is better but still recommends too much grain and

Reverse Aging Lifestyle Pyramid

Exercise, sleep, Hormone less stress, balance and No cigarettes brain health & less or no restoration alcohol or drugs Until the last 100 years, our ancestors ate two thirds of their calories from protein and a small amount of carbohydrates. The large increase in sugar and refined carbohydrates now account for 50 - 60% of calories consumed in the modern Western diet. We need to return to our original human diet and eat natural whole food in order to recover our health, balance our hormones, and maintain our optimal weight. Pseudo grains, Seeds, and Legumes Although referred to as grains, pseudo grains are actually seeds. Because they do not contain gluten, they are ideal for people who are on glutenfree diets. In addition, these foods are alkaline-based and easily dig 93

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Here are some examples of pseudo grains: • Amaranth: Composed of 17 percent protein, amaranth is rich in lysine, which is difficult to find in plant-based foods. Combine it with buckwheat, spelt, or Kamut. • Buckwheat: Buckwheat contains eight essential amino acids, including tryptophan, a precursor to serotonin, and a natural mood-elevator. It is best to select the unroasted form. Kasha is a roasted buckwheat that combines well with quinoa. • Quinoa: Composed of 20 percent protein, quinoa is high in lysine. It is important to rinse it well to eliminate the bitter saponin coating. • Wild rice: An aquatic seed rather than true rice, wild rice is more nutritious than traditional grains and not treated with pesticides. You can incorporate many healthful seeds into your diet. Here are some you may want to try: • Flaxseed: Of all plants, flaxseed has the highest levels of omega-3 fatty acids. Adding 10 grams of flaxseed per day to your diet allows your body to more efficiently burn fat as fuel. Flaxseed is also an excellent source of fiber and has antiinflammatory properties. Choose whole flaxseed rather than flaxseed meal, and keep it refrigerated in an airtight container. You must grind whole flaxseed or the seeds go right through you. Meal is fine if it is refrigerated. • Hemp: Many people are surprised to learn that hemp is a nutrient-rich food that contains all 10 essential amino acids. Edestin, found in hemp seeds, is an integral part of DNA. It is great for muscle and tissue regeneration and fat metabolism. You can buy hemp in several forms, including fresh hemp oil, hemp seed, and hemp protein powder. • Pumpkin seeds: Rich in iron, pumpkin seeds are tasty on their own or in a salad. If you are active, then you need more iron. • Sesame seeds: An excellent source of calcium, sesame seeds are great for sprinkling onto salads, cereal, pasta, and soups. 94

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You can grind them in a coffee grinder and store them in the refrigerator for up to three months. • Sunflower seeds: These popular seeds are extremely high in protein and are a good source of vitamin E as well as other vitamins and minerals. • Other seeds: All raw natural seeds are generally good sources of protein and fat, so they are an important part of the Reverse Aging Diet. Legumes Legumes are plants that have pods containing small seeds. Lentils, peas, and beans are all in the legume family. They are high in protein, fiber, and many vitamins and minerals. Yellow peas have an excellent amino acid profile. Soak and rinse them in fresh water, and then rinse them again after cooking. You can also add seaweed to them while cooking. Raw legumes are ideal for sprouting. Legumes can cause dysbiosis and leaky gut in some people, so watch for symptoms of bloating or other unusual reactions. Taking digestive enzymes can be helpful. While they are rich in antioxidants, they are also high in sugar. Eat them in limited amounts if you want to lose weight. Fruits - Consume With Caution The modern Western diet contains too much sugar, and many fruits add to the problem. In 1820, Americans consumed on average 15 pounds of sugar per year; in 1950, that amount increased to 120 pounds per year. Even after well-publicized dietary campaigns, sugar consumption is now up to 150 pounds per person per year. Fruits are very different from vegetables, although nutritionists often lump the two categories of food together. Fruits have more carbohydrates than vegetables. If you like juice, try juicing vegetables or dilute freshly squeezed fruit juice to reduce the sugar level. Only eat the “killer fruits” like tropical and sweet fruits once a week and in small amounts. Bananas are OK as long as they are greenish. 95

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If you are trying to lose weight, do not consume more than one or two friendly fruits per day and donâ&#x20AC;&#x2122;t drink fruit juice at all, because it causes a huge spike in insulin, just as sodas do. Most people donâ&#x20AC;&#x2122;t realize there is as much sugar in a glass of fresh juice as in a Coke. Friendly fruits are apples, citrus fruits, and berries. Fructose, which gives fruits their sweet taste, is the primary cause of insulin resistance. It contributes far more to AGEs, high blood pressure, high blood fats, and high uric acid than glucose. Fructose in nature comes with a lot of fiber. High fructose corn syrup is a toxin that turns into very small and dangerous lipoproteins that form arterial plaques. Remember, the body burns fat only after it exhausts the available carbohydrates, and excess carbs convert into fat. The modern Western diet includes far too many carbohydrates in the form of simple sugar and fruit. Although sugar is an excellent source of quick fuel for the body, use it cautiously, particularly if you have cardio metabolic disease. Cold-Pressed Oils and Nuts Oils come in a wide assortment, each with its own distinct taste and nutritional value. When you first start on the Reverse Aging Diet, you canâ&#x20AC;&#x2122;t taste these subtle differences because your taste buds want sugar and salt. After a few weeks, you will delight in the subtle flavors found in nuts and seeds. In the right amounts, high quality, cold-pressed, unrefined oils are healthy. The best oils are hemp, olive, pumpkin, and flaxseed. Switch from vegetable oil to olive oil, coconut oil, lard, ghee, and butter for cooking. Most oils contain the same nutrients as their underlying plant seed but in a more concentrated version.

Protocols to add years to your life and life to your years

Dr. Max

Most vegetable oils contain polyunsaturated fats, which cause tremendous oxidative stress on the body and are a major cause of heart disease. This is because polyunsaturated fats are the most sensitive of any foods to oxidation when heated. Therefore, it’s best to avoid energy bars, margarine, and all hydrogenated fats. Hydrogenated fats are the toxic trans fats that found in massproduced chips, crackers, doughnuts, muffins, cakes, cookies, fried products, and fast foods. Food producers add them to extend shelf life and enhance flavor. These trans fats are unusable by the body and are extremely toxic to the endothelium in blood vessels. Every two percent increase in trans-fat calories doubles a person’s risk for cardio metabolic syndrome. The Food and Drug Administration’s recent decision to phase out partially hydrogenated oils, the source of most trans fats in the U.S. food supply, as well as the banning of trans fats in restaurants in many areas, is hopefully the final nail in the coffin for this dangerous artificial ingredient in the American food industry. The FDA is making the change gradually to give manufacturers time to find less disruptive solutions to their business, but you shouldn’t wait. Get trans fats out of your diet today. Starchy Vegetables and Select Grains Eat starches in the form of starchy vegetables and unmodified grains in limited amounts. Starchy vegetables include parsnips, squash, sweet potatoes, turnips, and yams. Grains that you can eat on the Revere Aging Diet include the following: • Brown rice: Because producers process unaltered brown rice less than white rice, it does not cause such severe allergic reactions. Brown rice is high in manganese, selenium, and magnesium. Purple sticky rice and Thai black rice are other good alternatives to processed white rice. • Millet: Millet is one of the most easily digestible grains, and it is gluten-free. It is high in B vitamins, magnesium, and tryptophan. 97

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• Spelt: Food producers genetically alter and modify white flour beyond recognition. Spelt is an unaltered ancient grain that has 30 percent more protein than wheat and does not contain as much gluten as processed white flour. • Teff: This North African grain is rich in calcium, magnesium, boron, copper, phosphorus, and zinc, and it has twice as much iron as whole wheat. • Other select grains: You may also eat uncontaminated oats, sorghum, arrowroot, and tapioca.

Beverages

Water is an organic magnet, and at the same time a transformer, a receiver, and a transmitter. It is the mediator or accumulator of growth, which mediates life. - Viktor Schauberger The human body is 70 percent water by weight and 97 percent water by molecular percentage. Thus, it’s no wonder that pure spring water is the best thing you can put in your body. Don’t be fooled by the filtered water now marketed by the bottling companies. It’s the same water that comes from your tap and possibly even worse. They’ve just figured out a way to make money from it! Most people in developed countries are chronically dehydrated, and even mild dehydration slows down the body’s metabolism. Hydration is also a consideration in many disease conditions. Drinking just five glasses of water daily decreases the risk of colon cancer by 45 percent. A lack of water is also a major reason for daytime fatigue. Even mild dehydration triggers short-term memory loss and trouble with focusing on the computer or printed page. Mobile monitors often have a “water tracker” that can help you stay optimally hydrated. Both the quantity and quality of water you drink is important. Drink glass-bottled spring water whenever you can. Proper hydration has the added benefit of helping us eat less by giving us a more satisfied feeling. CARDIO-METABOLIC DISEASE 98

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Old Thinking

New Thinking

Disorder of Fat Metabolism

Disorder of Sugar Metabolism

Plugging Up Of Pipes

Chronic Systemic Inflammation

Look At Cholesterol (Passengers)

Look at Lipoproteins (Cars)

LDL-C Best Predictor

LDL-P Best Predictor

Statins

Modified Paleo Diet

Stents / Bypass

Intensive Lifestyle Intervention

Rx Symptom

Rx Cause

Sick Care

Intelligent healthcare

Here are some other healthful beverages you can drink in addition to water: • Coconut water: Electrolyte-rich coconut water is the original sports drink. • Green tea: Praised in Asia for centuries, green tea has a host of beneficial properties, including powerful antioxidant effects that help reduce cardio metabolic disease. • Rooibos: Also known as red tea, this drink originated in South Africa. It is similar to green tea and has excellent antioxidant and alkaline-forming properties. It does not contain caffeine, and brewing whole leaves is the best way to prepare it. • Yerba mate: Yerba mate is a South American plant similar to green tea. Rich in chlorophyll, antioxidants, and trace minerals, it is a good digestive aid and helps reduce cardio metabolic disease. Choose the wild harvest varieties. • Flavored water: These drinks are made by adding natural fruit extracts to water. They taste good, quench your thirst, and have a very low carbohydrate content. They are a safe beverage to drink if you have cardio metabolic disease.

Sweeteners - Are They All Bad? 99

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Americans depend on a variety of sweeteners to alter the bland taste of many foods, often not realizing that these sweeteners increase insulin production and make them fat. There are two types of sweeteners: those with calories and those without. Nutritive sweeteners provide four or more calories per gram, and non-nutritive sweeteners provide zero calories per gram. While nutritive sweeteners are less harmful than non-nutritive sweeteners, all sweeteners are very acidic, will raise your insulin level, and will make you fat. Therefore, optimal health requires keeping sweeteners of all types to a bare minimum.

Nutritive Sweeteners

In addition to adding flavor, caloric sweeteners also act as a preservative by maintaining freshness, thus contributing to product quality. Manufacturers use them in jams, jellies, and processed meats. In addition, nutritive sweeteners allow fermentation of breads and pickles, add bulk to ice cream, and add body to carbonated beverages. Many caloric sweeteners occur naturally, including those listed below. • Raw sugar: Evaporate the moisture from sugar cane, and raw sugar is the natural by-product. • Molasses: This thick, dark syrup is the residue of sugar cane processing. • Maple sugar: Derived from the sap of maple trees, maple sugar consists of sucrose, fructose, and glucose. • Brown sugar: Evaporate the moisture from molasses syrup, and brown sugar is the result. • Fructose: Also known as levulose or fruit sugar, fructose is a naturally occurring sugar found in all fruits. God always mixes it with a lot of fiber. I personally like God but you might consider “nature”. • Glucose: This sugar occurs naturally in fruits but in limited amounts. Be careful, though, because many manufacturers also 100

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refer to cornstarch as “glucose.” • Honey: Bees combine fructose, glucose, and water to make honey from the nectar they collect. Manufacturers create many other caloric sweeteners from sugarbased compounds. These include: • Confectioner’s sugar: Also known as powdered sugar, this is just finely ground sucrose. • Corn sweetener: Corn sweeteners, including corn syrup and cornstarch, are sugars made from corn. • Dextrose: Dextrose is glucose combined with water. • Invert sugar: This type of sugar is made by dividing sucrose into its two parts: glucose and fructose. Sweeter than sucrose and used in a liquid form, it acts as a preservative and keeps candies and baked items sweet. • Lactose: Also known as, milk sugar, lactose is the carbohydrate primarily found in milk; it contains glucose and galactose. • Maltose: Also called malt sugar, maltose is derived from grain, especially barley. Manufacturers ferment malt sugar for use in beers and breads. • Mannitol: Mannitol is a sugar by-product of alcohol production that is often used in dietetic food products because it has half the calories of sugar. It is not well absorbed and may have a laxative effect when eaten in large quantities. • Sorbitol: Sorbitol is a sugar alcohol produced from glucose. It is found naturally in certain berries and fruits. Absorbed more slowly than sugar, it appears in many dietetic food products but may have a laxative effect when consumed in large quantities. • Sucrose: This form of sugar consists of glucose and fructose and is made by concentrating sugar beet juice or sugar cane. Raw sugar, granulated sugar, brown sugar, confectioner’s sugar, and turbinado sugar are all forms of sucrose. 101

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• Syrups: These sweet liquids are a combination of maltose, glucose, and dextrose sugars made from various sources. While many are naturally occurring, they often undergo some form of chemical treatment before use as food additives. These include maple syrup, birch syrup, brown rice syrup, and agave syrup.

Non-Nutritive Sweeteners

Many people use non-caloric sweeteners in place of caloric sweeteners in an attempt to cut calories. Because these sweeteners have zero calories, many people think they are healthier than caloric sweeteners. They are wrong! Non-nutritive sweeteners are far worse for your health than nutritive sweeteners. They offer no calories and are generally sweeter than caloric sweeteners. In addition, manufacturers use chemicals to process all non-caloric sweeteners, and these chemicals remain in the sweeteners. Here are the most common non-nutritive sweeteners: • Aspartame: Two amino acids, phenylalanine, and aspartic acid, combine to make aspartame. Known by the brand names Equal and NutraSweet, it is 220 times sweeter than sugar. • Acesulfame-K: This artificial sweetener is in many processed foods. Marketed as Sunett or Sweet One, it is also available as a tabletop sweetener. Manufacturers combine it with other sweeteners, such as saccharin, in carbonated low-calorie beverages and other products. • Cyclamates: Cyclamates are 30 times sweeter than sugar. The USDA banned them after they caused bladder cancer in animals. • Saccharin: Marketed as Sweet’N Low, saccharin is 200 to 700 times sweeter than sugar. • Sucralose: Marketed as Splenda, sucralose is an artificial sweetener made from chlorine and sucrose. It is 600 times sweeter than sugar. • Stevioside: Marketed as Stevia, Truvia and Sun Crystals, stevioside is a derivative of the stevia plant, also known as sweet leaf. It is 300 to 400 times sweeter than sucrose, and it is gaining 102

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popularity because it lacks the gastrointestinal side effects of sugar alcohols. It is the least harmful of the sweeteners.

Avoid All Sweeteners

To control and normalize your insulin levels, you should avoid all sweeteners. Instead, try adding one tablespoon of acacia powder to your meals to supplement your daily fiber intake. It is a great and inexpensive prebiotic that helps you lose weight.

Conclusion

It takes two to three months to reprogram your taste buds. You may feel awful during the first few days without your addictive bread, soda, and pizza, but this will pass. Reading creates awareness. Awareness breeds motivation. Motivation gets you started. Habits keep you going. By adopting the Reverse Aging Diet, you will dramatically reduce your intake of refined carbohydrates, reduce inflammation, and restore the health of the endothelium lining in the blood vessels throughout your body. It is best to ease into this diet. When shopping, don’t be fooled by supermarket claims of gluten free products. Most of the gluten-free boxed or packaged foods contain super-starchy flours loaded with sugars. Food is your most important medicine! You can begin to reverse diabetes without medications in just two weeks.

Chapter 10. Putting a Healthy Lifestyle into Action

All this information may seem a bit overwhelming, but I assure you it is all very simple once you get started. I began implementing these principles into my life about six years ago and today it is the natural and obvious way to live my life. It won’t be long before it’s second nature to you as well. Before we start, allow me to share a few secrets - tried and true tricks - that will make your journey into the Reverse Aging lifestyle a little easier. Now, I’m not saying it will be effortless, because it will take 103

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commitment and work on your part, especially in the beginning. It comes down to how much you truly want to transform your life and how many years you want to add to your life. I can assure you of one thing. If you commit to following the Reverse Aging principles for at least one full month, you will have more energy and younger-looking skin with fewer aches and pains than you can imagine. “The journey of a thousand years begins with one step.” Begin by setting up your environment.

Set Up Your Home for Success

It makes a huge difference to have the whole family embrace a Reverse Aging lifestyle and certainly it makes a huge difference to have a partner or two commit to going to the gym with you five times per week. Many studies have shown that having support will increase your success. Before you even think about heading to the grocery store, you need to give your kitchen a complete overhaul. Grab the trashcan and start throwing away anything that contains refined carbohydrates. Remember, these are your enemy! They may taste good, but they are slowly killing you. So get rid of white rice, processed bread, dry cereal, pancake mix, and even pasta. If whole grain is not the very first ingredient (no, enriched grains do not count! And “whole wheat” is not whole grain), then it needs to go in the trash. Next, eliminate all vegetable oils (other than extra-virgin olive oil), fruit juices, and diet drinks from your pantry. Now, you should have plenty of free space for healthy foods, so let’s go shopping!

A Trip to the Grocery Store

The unfamiliar areas of the grocery store may seem daunting at first, but you’ll figure it out very quickly once you understand one basic premise. Items on the outside edges of the store are most likely to be good for you, but items in the central aisles are probably not. Think about it. The meat and fish department, the deli counter, the dairy section, and the produce areas are all around the perimeter. You need to exercise caution, however. Just because something is 104

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on the perimeter of the store, that doesn’t guarantee that it’s good for you. You still need to avoid high-sugar and high-starch produce items, such as bananas, figs, grapes, mangos, squash, corn, peas, and potatoes. Your goal should be to purchase a week’s worth of food in one trip, so you can avoid having to make a quick trip on another day to purchase a staple. Because we all know what happens when you head to the store to buy a gallon of milk: You end up leaving with not just that but whatever processed junk is on sale and displayed at the store entrance. Those darned marketing pros - they get you every time. OK, back to shopping. While you will definitely want to have specific meals planned out, it’s also important to have a solid supply of snacks on hand. After all, hunger pangs between meals are usually the times you end up eating processed junk, because it’s easy and fast. Here are a few of my favorite snacks. I think you will like them, too. • Oatmeal: Opt for the slow-cooking variety, because it’s rich in soluble fiber and will slow down the absorption of carbohydrates. Oatmeal is a whole grain – limit the amounts. • Protein powder: You can mix it with a variety of food items to give yourself an added boost of muscle-building, bodysustaining protein. Just make sure you choose a powder that is natural, like pea protein, instead of one of the chemical-laden varieties. • Nuts: This is about as easy as a healthy snack gets. Grab a handful of raw almonds, walnuts, cashews, or pistachios, and you will easily stay satisfied until mealtime. As a bonus, you’ll also get a strong dose of omega-3 fatty acids and protein.

Stock Up on Spices

Many people c find that a basic Paleo diet is boring. I have just one word for those people: spices.[1] In my Reverse Aging Diet these lowcalorie substances not only make food taste better, many of them also offer powerful healing and anti-inflammatory benefits. If you’re not using spices in your food, you’re missing out a on a world of flavor. Here are 105

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the spices I often cook with, along with their additional health benefits: • Cinnamon: Decrease LDL cholesterol, blood sugar, and triglyceride levels, reduces gum disease, and promotes healthy digestion. • Nutmeg: Helps ease anxiety and insomnia. • Cloves: Contain powerful antioxidant properties that relieve asthma and mouth pain. • Ginger: Not just for sushi; gives the immune system a boost and is anti-inflammatory. • Turmeric: Popular in curry; may explain why Indians have fewer incidences of Alzheimer’s disease. Highly recommended for systemic and local inflammation. • Red pepper: Contains capsaicin, which has anticancer, antiasthma, and anti-allergy properties; its strong flavor reduces the need for salt. • Black pepper: When freshly crushed, offers a boost of antioxidants. • Cardamom: Often used in Middle Eastern cooking; energizes and aids in digestion. • Cumin: Another great spice for improving digestion • Sesame paste: Also known as tahini; very high in calcium • Paprika: Offers antioxidants.

Pay Attention to Food Labels

You know that fresh food is always best, but sometimes life calls for some packaging. So how can you tell which packaged items are the best? The secret to healthy packaged food is right in front of you; it’s on the food label. Food labels contain all the information you need to choose the best options for you and your family. You just need to learn how to read them properly. First, it’s important to read the actual food label. It may seem obvious, 106

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but you wouldn’t believe how many people just scan the front of the package and take everything at face value. Food marketers aren’t stupid. They present their messages in a way that is technically honest yet extremely deceptive. For a perfect example, look at a bottle of juice that brags about having only 230 calories. Turn it around and read the label. It turns out that it has 230 calories per serving, and if you drink the entire bottle, you are consuming three servings - 690 calories. That’s a big difference. Next, you want to make sure the calories you consume are worthwhile. There is no room for empty calories in a healthy lifestyle. So how do you know if something is worth eating? Make sure it contains a decent amount of protein and fiber - at least three grams of each - and make sure the sodium value is less than five percent of your daily requirement.[2] Sodium is an essential nutrient, but too much can cause health problems. Depending on your age and health status you should aim to consume less than 1500 mg of sodium per day. 1500 mg of sodium equals about 3/4 teaspoons or 3.75 grams of salt per day. Most people today are eating much more than that. Our average intake of sodium is about 3400 mg, mostly coming from processed foods Food manufacturers often disguise sugar as sucrose, glucose, and corn syrup. Refer back to the section on sweeteners in the previous chapter for an extended list of many of the different names sugar can take.

Make Cooking Easier

Now that you’ve done your shopping, it’s time to get cooking. Before you say you just don’t have the time, let me reiterate one thing: If you don’t change your diet now, it will be you on the operating table next. Trust me. Did I ever think I would get the diagnosis I did at the age that I did, and see my life flash before my eyes? No, I certainly did not. So please, make cooking healthy meals a priority. Spend a little less time surfing the Internet or checking up on your friends on Facebook, and invest the time into your health instead. That said, cooking doesn’t have to be as difficult as you might 107

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imagine. It’s all right to take a few shortcuts. Here are some tips to make getting started a little easier: • It’s OK to buy precut, pre-washed vegetables. This will save you a lot of time and make you more willing to cook. You can do this with lettuce, mushrooms, carrots, and many other items in the produce aisle. • Choose one day per week to be your prep day. Spend a few hours washing and cutting your vegetables for the week and cooking any meat or beans you have on the menu. You can even make complete casseroles to have on hand for the busiest days of the week. • Involve the entire family in the cooking process. There is always something your kids can do to help, whether you are prepping everything at once or preparing each meal from scratch. Not only does this make your job easier, it also teaches your children about proper cooking and eating habits, so it’s a double win. • Remember that every change takes some getting used to, and converting to the Reverse Aging Diet is no exception. Approach this new lifestyle with patience and an open mind. Before long, you’ll be whipping up nutritious meals better than the chefs on TV will. The hardest part of a new lifestyle is getting started. After a few short days of healthy eating, however, you will notice that you have more energy and you suddenly don’t hurt as much. (No, it’s not a coincidence.) After a couple of months, you’ll notice that you need to buy new clothes because yours are too big. After a year, when it’s time for your annual physical, you will be amazed by the improvement in your diagnostic test numbers. You will have successfully reversed the effects of cardio metabolic disease.

Stay Safe When Cooking

If you are new to cooking, then you probably don’t know much about food safety, but don’t worry; you’re not alone. As great as healthy eating is, if you do it with reckless abandon, then you may actually do more harm than good. Always keep these tips in mind when preparing your meals. 108

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• Fruits and vegetables that feel soft are usually not fresh, so try to avoid buying or using them. • When washing your produce, there’s no need to use soap. To remove microorganisms and pesticide residue, Beware of Marketing soak your produce in a Scams clean sink or large bowl Look at the serving size full of cool water mixed and how many servings with about 10 percent you are actually consuming. vinegar. (That’s about a cup and a half of vinegar Fat won’t make you fat. per gallon of water.) Then, Make sure that sugar (in rinse thoroughly with tap its various forms) is not the water.33 This works best first ingredient! for items such as leafy greens and batches of berries. Use a spray bottle with three parts water and one part vinegar to wash individual items like apples or carrots. • Remove the outer leaves of lettuce and cabbage before eating, but don’t even think about peeling apples or pears - that’s where all the nutrients are. • Never put uncooked meat near your produce - unless you are particularly fond of salmonella. Make sure to store meat and produce in separate drawers in the refrigerator, and try to keep the meat at the bottom, in case any of the juices leak out. When cooking, always use separate knives and cutting boards for meat and produce, or wash them thoroughly before reusing. • To sanitize cutting boards, clean them with a solution of one teaspoon of bleach per liter of water. • Be aware of the harmful toxins emitted from plastic when it gets too hot or too cold. That means no putting hot drinks in plastic Anahad O’Connor, “The Claim: A Soap-and-Water Rinse Gets Produce Cleanest,” New York Times, October 4, 2010, http:// www.nytimes.com/2010/10/05/ health/05real.html?_r=0.

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containers, wrapping frozen foods in plastic wrap, or covering food with plastic wrap before microwaving. Similarly, avoid aluminum cans and Teflon coatings. • Do not boil your vegetables. Doing so diminishes their nutrient content, as many of the nutrients wind up in the water. Light sautéing is the best way to cook vegetables so that they retain their nutrients. You can also microwave them briefly in a covered dish with a very small amount of water - the water that clings to them after rinsing them is sufficient. This steams them quickly and helps retain nutrients.

Give These Recipes a Try

Now, you are probably wondering what you should cook. You will want to find recipes that are low in carbohydrates and gluten, as well as sugar-free and low on dairy products. Fortunately, there are still many. Finding your personal favorites all comes down to trial and error. The Internet is full of recipes, choose a few today and get started. Here are some of my favorites: Omelet This is one of my favorite breakfasts - and I even have it for dinner sometimes - because it’s easy and tastes great. All you need are eggs; your favorite vegetables and a little bit of butter or olive oil provided you avoid high heat. Gather your chopped vegetables (I prefer onions, mushrooms, broccoli and jalapeno) and sauté them for five minutes. 1. Crack a couple of eggs into a bowl and beat with a fork. 2. Add the eggs to the vegetables in the pan, and cook to your liking. 3. Once complete, season with allspice, black pepper, or even Tabasco sauce, and enjoy.

How to Prepare Different Salads in Less Than Five Minutes

If there is one thing I love, it’s a good salad. Not only are they easy and 110

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nutritious, there are so many different varieties, you’ll never get bored. If you don’t think you like salads, then I challenge you to try one of mine. Here are some tips: • Only prepare the salad when you are ready to eat it. You don’t want soggy lettuce, do you? • Use triple-washed mixed organic greens to save time, avoid pesticide residue, and obtain a major dose of nutrients. As an added bonus, they’ll usually stay fresh in the fridge for a week. If organic is too expensive in your area, you can use non-organic provided you let it soak for few minutes in water that contains white vinegar (one cup of vinegar for every ten cups of water). Then rinse it well and thoroughly drain it, • For a basic salad, simply add the juice from a lemon, a clove of crushed garlic; two teaspoons of olive oil, a sprinkling of black pepper, and a dash of salt, and you are done. • If you want some variety, try adding cherry tomatoes, sliced onion, feta cheese, celery, walnuts, etc. • For a more filling meal, throw on some turkey, chicken, tuna, grilled salmon, or shrimp. • Don’t rely on the same salad every day, or you will get bored very quickly. Instead, switch up your favorite add-ins, and don’t be afraid to try something different. Snacks As I mentioned earlier, it’s important to always have healthy snacks on hand to keep you from reaching for the nearest processed death trap. However, you should only have two snacks per day - one midmorning and one mid-afternoon is ideal - and you should try to avoid eating three hours prior to bedtime. The best snacks offer a combination of protein and fiber while still being tasty. Here are a few of my favorites: • Walnuts covered with a bit of stilton cheese • Vegetables dipped in hummus 111

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• Asparagus and prosciutto • An apple with a tablespoon of walnut butter • A bowl of berries • Nuts -any kind will do, but avoid peanuts because of their high fat content • A hardboiled egg - make them in advance; it doesn’t get much easier than grabbing one out of the fridge • Celery sticks with almond butter • A protein shake - choose natural, low-sugar options Dressings One of the best ways to spruce up a bland meal - other than spices, of course - is to use a condiment. However, most of the options available on store shelves are packed full of sodium, sugar, and fat, which is why I choose to make my own. Here are a few easy ones you can try making for yourself: • Reverse Aging mayo: Combine 200 ml of extra-virgin olive oil (EVOO),[6] a large organic free-range egg, two crushed garlic cloves, and one teaspoon of Dijon mustard, one tablespoon of red wine vinegar, and sea salt and fresh-ground black pepper to taste. Once blended thoroughly, you can keep it in an airtight container in the refrigerator for up to a month. • Simple balsamic vinaigrette: Whisk together one teaspoon of Dijon mustard, two tablespoons of balsamic vinegar, and sea salt and black pepper to taste. After combining these ingredients, slowly add in four tablespoons of EVOO and whisk until completely blended. • Lemon-tahini dressing: Blend together one tablespoon of tahini, one tablespoon of EVOO, the juice from one lemon, a pinch of garlic powder, and sea salt and black pepper to taste.

Limit Alcohol Consumption

Don’t act so surprised; you knew it was coming. There is very little 112

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room for alcohol in a healthy lifestyle. Not only is it loaded with sugar meaning it directly affects your body’s insulin levels and elevates your triglycerides- it also takes away your inhibitions and self-control when it comes to making healthy food choices. Think about it: How many times have you splurged on junk food while drinking? Paleo diets allow two servings of alcohol per day.[7] Personally, I think two servings per day is too much; it is unfortunate that alcohol is everywhere with an alarming number of socially accepted abusers, especially in colleges. If you must drink, vodka or tequila has less sugar for the same amount of alcohol as any other alcoholic drink, while dry red wine is second best because of its relatively low carbohydrate content and its antioxidant properties. Whatever you choose to drink, remember that your body views alcohol as a carbohydrate and as a toxin, so always have some sort of protein, such as cheese or nuts, to counteract the effects of your carbohydrate intake.

Tips for Dining Out

One of the most difficult times to follow a healthy eating plan is when you are dining away from home. In their effort to make more money per patron, restaurants pile on the food and tempt you with all kinds of extras you can do don’t need. Because I understand that dining out is an important part of socializing and building memories with your friends and family - especially when you are on vacation, I developed eight rules for dining out that will ensure you can enjoy restaurant meals without destroying your health. 1. Skip the bread. Don’t even let the server bring it to the table. 2. Choose your protein source from the entrée menu first. Then you will be able to decide if you have calories to spare for an appetizer or dessert. 3. Substitute vegetables for starchy side items. You will be surprised at how accommodating most restaurants are to such requests. 4. Order your dressing on the side. That is the only way to control 113

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how much goes on your salad. If you really want to cut back, simply dip your fork in the dressing before picking up the lettuce. 5. After ordering, try conversation to pass the time instead of feeling as if you have to be eating something. You may also want to sip on a glass of water with lime, mint, or ginger. 6. Once your entrée arrives, evaluate the portion size. If it’s bigger than the size of your palm, immediately ask for a to-go box, so you can set aside half of it for later. 7. Never eat more carbohydrates than protein. 8. It’s OK to occasionally splurge on a dessert, but when you do, do not eat any other carbohydrates during the meal, whole-grain or not. Plan ahead! Once the dessert arrives, take small bites and savor every one. When you get to the halfway point, offer the rest to your dining companions. I’m sure they will gladly oblige. Or – if they are on your support team, decide collectively to order tea instead!

Exercise is Medicine for the Soul

Studies also show that exercise buffers the side effects of stress and protects our telomeres from prematurely shortening, causing accelerated aging. Exercise burns very little calories. You need to run twenty minutes on the treadmill to burn just one chocolate chip cookie and 50 minutes to burn a blueberry muffin. It is not the few calories burnt that make a difference but the control of emotional eating and the increased metabolism. The big bonus to doing cardiovascular exercise is you activate your fat burning enzymes making you a more efficient fat burner 24/7. • Exercise lowers stress and hence decreases emotional eating and cortisol secretion. Walking is also good for the soul, it allows us to breathe in fresh air, and strengthens the muscles that atrophy on the couch. • Exercise is essential for reversing insulin resistance, which is the primary reason for inflammation, accelerated aging, and chronic disease. It’s also essential for preventing anxiety, depression, 114

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constipation, insomnia, Alzheimer’s disease, chronic fatigue, stress, osteoporosis, decreased libido, back pain, cardiovascular disease, diabetes, stroke, cancer and high blood pressure. • Exercise is good. Do it daily. Aim for at least 10,000 steps per day. Invest $10 in a pedometer to track your progress. Wearable devices such as the Fitbit® or Jawbone® are extremely valuable when used to compete with or motivate your friends or loved ones. • Carve out time to exercise. Make it ‘protected time’ and guard it fiercely against intrusion. It makes sense to think of exercise as a job requirement because without it you are less likely to be energetic or in control of your mood and emotions. Do you wake up every day and wonder whether to go to work? • We are not tired at the end of the day because we get too much exercise. We are tired because we do not get enough. To get energy you must spend energy. • Stretching for five minutes before and after weight lifting decreases the all too frequent muscle pain and stiffness especially during the first month of going to the gym. Never stretch until you have done some cardio to increase your body temperature and prevent injuries. Once you get in shape, the pain goes away and the fun starts in the form of better sleep and better energy. Do not ever stop exercising, as your muscles are de-conditioned in less than one week. Who needs to go through that pain again? • Exercise benefits everyone no matter how old they are. You do not have to go to the gym and you do not have to lift weights to realize health benefits. Walking thirty minutes a day is a great start. Certainly, you would benefit more with resistance exercises and weights. • Most Americans watch more than three hours of television per day. Limit your television time to two hours per day, and use the extra time to go for walks or to visit the gym. 115

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• Join a gym, sign up with a physical fitness trainer, and pay in advance. If possible, join a gym that is close to work or home or that you must drive by every day. Proximity counts for a lot. Getting there is half the battle. • Find a way to make exercise fun, whether it’s shooting baskets, running with a friend, joining a biking club, playing soccer, or some other companionable activity. • Schedule exercise for half an hour five days per week and increase as your fitness level and your schedule permit. - Turn off your phone during your exercise time, and do not allow anything or anyone to disrupt this personal time. • Thinking that you are too heavy to exercise is like saying you are too skinny to eat. Start low and go slow. You should leave the gym or your exercise area feeling rejuvenated, not worn out. ACE Body Fat % Chart Description

Women

Men

Essential fat

10-13%

2-5%

Athletes

14-20%

6-13%

Fitness

21-24%

14-17%

Average

25-31%

18-24%

Obese

32%+

25%+

In Short

Adapting the Reverse Aging lifestyle is a gradual process. It will take some getting used to, and some days will be harder than others. However, as time goes on, it will get easier. When you start exercising you burn fat and you build more muscle. Therefore, your weight may not budge but your belly shrinks. One pound of fat takes five times more space than one pound of muscle. So get off the damn scale as it demotivates you. Better yet, let us use our sophisticated and accurate InBody machine to measure your body composition: fat, muscle and water percentage. 116

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We use a bone scan to detect osteoporosis early. Bone scans are also by far the most accurate test for body composition including fat percentages. A bone scan emits negligible amounts of radiation: ten times less radiation than a dental X-ray and one hundred times less radiation than a chest X-ray. In the next chapters, we shall then look at whether stem cell therapy lives up to the hype. We shall then review the safest and most effective ways to make you look as good as you feel with the latest options of cosmetic services while avoiding the operated look. Finally we shall present an effective and short and simple manual to quit addictions to cigarettes, alcohol and drugs.

Chapter 11: The New Generation of Medicine Stem Cell Therapy: is it Hype or is there Hope?

Researchers are discovering new uses for stem cells every day and we are just scratching the surface on this new world of bioengineering. Before we discuss this new field in more detail, allow me to clear up a few misconceptions. First, there are several different kinds of stem cells that are used in medicine, including adult stem cells, embryonic stem cells, and stem cells harvested from umbilical cord blood and fetal tissue. Most of the controversy in this area surrounding stem cell use has to do with embryonic and fetal stem cells, because obtaining them may involve the destruction of embryos or the use of aborted fetuses. Our high tech, scientific anti-aging physicians do not use embryonic and fetal stem cells and we use only FDA cleared devices in our practice. Iâ&#x20AC;&#x2122;m not going to get into all of that, though, because those are not the kind of stem cells that are being used by anti-aging physicians. Anti-aging doctors extract stem cells directly from the person who is going to receive them. We can get these autologous cells from two sources. Bone marrow provides the highest quality stem cells, but the supply is limited. Fat contains more than enough stem cells, but the quality is subpar less effective. Sometimes, I combine the two to get 117

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the quantity I need while still maintaining a high quality.

SO HOW ARE STEM CELLS USED?

Most often, we use bone marrow stem cells to heal joint damage, while others are investigating the use fat stem cells to treat neurological disorders, such as Parkinson’s disease and Alzheimer’s disease. More than 900 published studies have shown the effectiveness of bone marrow stem cell joint injections, while the other uses are still in the research and development stage. What we do know is the treatments may heal orthopedic injuries, including those related to sports. Cosmetic applications go beyond using your stem cells and fat as permanent fillers in your face, breasts, or buttocks. Stem cells can improve the quality of your skin by increasing skin thickness, skin blood supply and skin collagen and elasticity. Severe acne scars and skin deformity following radiation to the breasts are just some of the exciting potential. Many plastic surgeons attack the use of stem cells derived from fat for lack of scientific medical evidence. “Hundreds of procedures in medicine never gathered the required medical evidence, yet doctors use them every day. Open-heart surgery for blocked coronaries is one example. New technologies are threatening the established correct spacing turfs amongst medical practitioners and big pharma with serious economic implications. No wonder they refer to these new inventions as “disruptive technologies!” No matter what your views are on stem cells in medicine, it’s important to adhere to the FDA regulations that permit only minimal manipulation of stem cells. If it’s not safe, we should not do it, period.[13]

WHY STEM CELLS HOLD A HUGE POTENTIAL

Stem cells have a regenerative power with unlimited potential. It is estimated that the proper alignment of the application could double human life expectancy. Within 15-25 years, it will not be rare to see people reaching 150 years of age and still enjoying good memory, good sight, and good mobility. If a body part starts to fail, we’ll be able to rebuild it such as the case with a failing kidney or a failing liver. 118

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Scientists are routinely cloning stem cells to create in - the Pitri Petri lab dish - small beating heart cells. The challenge that shall take years to overcome is how to make these cells communicate with each other to beat all in harmony and adjust their pumping force to a changing change blood pressure or body activity. There are many FDA sponsored clinical trials using stem cells to treat the once dreaded and un-treatable retinal degeneration that frequently leads to blindness, as we get older. This may sound like something out of a science fiction movie, but Iâ&#x20AC;&#x2122;m guessing it will be a reality - at least to some degree - within the next 20 years. We should all be saving and banking the stem cells of our children or grandchildren for future use. This could be the best 2500 USD that you would ever spend. Of course, youâ&#x20AC;&#x2122;ll still have to maintain the other aspects of your health by exercising regularly, limiting your sugar intake, choosing healthy foods, quitting smoking and balancing your hormones. These key principles will never go away, no matter how much medicine evolves. Healthy lifestyle prevents chronic disease while stem cell therapy could, in the future, fix failing organs caused by such diseases. This is our only hope to bring the cost of treating chronic disease under control. Otherwise, chronic disease shall bankrupt most industrialized countries within 15-20 years. The smart investment in the US biotech industry represents a very timely move. However, certain arcane FDA regulations are halting the potential progress as most regulators only care about covering their behinds and do not have an incentive to take the slightest risks. Japan, led by thousands of Kyoto University researchers, is moving much faster in that area medicine and biotech due to smarter and more progressive recently enacted regulations. I met with their team in December 2014 at the World Stem Cell Summit Congress in San Antonio and was profoundly impressed. We should not allow outdated regulations to stand in the way of innovation or we risk losing the technological race with billions, if not a few trillion, dollars at stake. Financial incentives do save lives. Britain passed a law in early 2015 that permits the use of a New York invented technology that allows for mothers who have genetic 119

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mitochondrial diseases to have their eggs manipulated so as to replace their diseased mitochondria with healthy ones from a donated egg. This is only the beginning and the more stringent US- FDA shall eventually allow the same once proven safe in Europe.

Chapter 12. Cosmetic Surgery “A Thing of Beauty” A study at the Pennsylvania University Hospital found that 85 percent of facelift patients felt better about themselves, were more relaxed in social situations, and had an improved sense of self-worth. A full 25 percent of the patients studied received salary raises, awards, or received promotions into their dream jobs — and they believed it was because of their new physical appearances. There are very good reasons for many people to explore the benefits of cosmetic surgery and especially as they get older, their skin sags and skin blemishes adversely alter their appearance. When people look good, they feel better about themselves and their whole outlook on life changes. They treat themselves better and treat others better. They smile more, they laugh more, and they bring joy into the lives of those around them. There are mountains of clinical evidence that support this feeling we observe every day with our patients. Yes, there are risks – there are risks with any surgery, and yes, sometimes people go too far and the results are less than expected, but in the end and for the majority of our patients, cosmetic surgery is a wonderful alternative.

Cosmetic Surgery Restores Beauty

Because plastic surgeons are scientists and artists, they have difficulty referring to each other in contrast to their colleagues in different medical fields. The majority pretend to be masters of some 62 different cosmetic procedures, hence that artificial “operated look” on so many patients in Beverly Hills, the heart of the Mecca for plastic surgery. The hyper-competitive environment created by a glut of general plastic surgeons make matters worse as most surgeons are not busy enough 120

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to be able to afford to refer to their colleagues. View this video to learn more about our team. Avoid the “operated on” look by following Dr. Max’s formula for a natural or REAL look: • Relevant References: Just because a surgeon did a good liposuction, surgery on your friend does not mean he shall do a good nose job or breast surgery on you. You want a specialist who performs more than five procedures per month in the specific area of expertise you require. At our Reverse Aging Centre in Beverly Hills for example, we assembled a team of eleven plastic surgeons each specializing in a different area of the body in order to maximize the chances of natural and predictable results. • Expensive: When it comes to plastic surgery and your looks, the least expensive option is usually a bad move! You get what you pay for here more than any other place in your life. Be especially wary of surgeons who are significantly below others performing similar procedures. They are the ones who statistically are more likely to produce the “just operated on” look you want to avoid. • Anatomy: Respect your anatomy: “if it ain’t broke don’t fix it.” Do not overdo it and see our story below on Scarlett to understand that sometimes plastic surgery can be too much of a good thing. Listen to your doctor and avoid shopping until you find one who will do what you want. • Lasers: Seek a surgeon with expertise in a variety of laser procedures. The best laser for you depends on your skin color, skin condition, skin sensitivity, budget and available down time. Avoid surgeons who have only one or two lasers (when your carpenter’s only tool is a hammer, everything looks like a nail to him). We can combine a variety of treatment modalities to address different imperfections all at once so that you receive individualized packages of treatments to suit your needs. Our goal is to give you the maximum possible benefits with minimal downtime or discomfort. 121

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Celebrities, patients living in the greater Los Angeles area, and international visitors alike trust our experienced team to help them achieve their cosmetic goals. Our treatment options can help individuals who are craving smooth wrinkle-free unblemished skin, fuller facial features, or plump yet natural looking lips.

Additional Perspectives on Elective Cosmetic Surgery

Like all elective surgeries, there are times when things don’t go as planned. We’ve all seen pictures of celebrities and others who have undergone so many procedures they almost look grotesque. Thankfully, these situations are rare and they dramatized by the every present media. Most people would be very surprised to learn how many people in the public eye choose elective surgery to improve their appearance. Yes, things can go wrong and occasionally they do. Any surgeon who claims a 100 percent success rate is being less than truthful. Does that mean complications are commonplace? No, they’re actually quite rare. Most of the unsuccessful procedures occur when surgeons are inexperienced or use outdated techniques. Other times, it’s because the patient didn’t follow all of the preoperative directions. As a surgeon, I always counsel my patients not to expect miracles. Yes, I can make them look and feel better, but I will not transform them into a movie star. I am careful to provide realistic images of how they should look following a procedure. Done correctly, cosmetic surgery is not about creating a “brand new you” with an entirely new look. This is not Reality TV or Hollywood. This is the real world. Our patients are real people who simply want to alter their appearance in a positive manner. Cosmetic surgery is serious business and we treat every single patient with the respect they deserve. It is about preserving the natural appearance of our patients while helping look and feel better. As long as you go into your procedure with realistic expectations, make sure to follow all of your doctor’s instructions — including quitting smoking, which you should do regardless — and choose a plastic surgeon with a proven track record, then there is a very high probability that your procedure will have the expected results. 122

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Cosmetic Surgery Is Changing

There are now several FDA-approved, noninvasive methods that promise smoother, younger-looking skin, a reduction in fine lines and wrinkles, and a more even skin tone. Laser surgery is safer, less invasive and has fewer side effects than traditional surgery. There are several different laser based techniques available and we usually present them all to our patients and provide guidance on what is best for each situation. However, nothing beats the effectiveness of surgery for advanced skin sagging.

Chapter 13: How to Quit Smoking and Other Addictions “Tobacco use is the single most preventable cause of disease, disability, and death in the United States. Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and another 8.6 million live with a serious illness caused by smoking.” Back in chapter four, we used a military analogy to wage a war on cancer. For our final chapter, we are again going to war and this time against the most formidable enemy ever invented by man. Even after all the negative press and the realization that tobacco use is deadly, cigarettes are responsible for over one-half a million deaths each year! This time around, you are a “private in this man’s army,” but the only one issuing orders is you. You have the right to decide, for the last time, to quit your habit and take control of your life. Make no mistake about it. This is a war, and your enemy has millions of dollars at their disposal. It is old-fashioned trench warfare and you are on the front lines. It is a personal war for every smoker hoodwinked as a teen-ager who is now unable to break this filthy, disgusting, and killer habit. “Get ‘em Hooked when they are Young and we’ll have ‘em for Life” Millions of teenagers start smoking because they think it makes them look “cool,” and they want to be in with their peers or look like a movie idol. They may look “cool,” but they start killing themselves from the 123

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first time they light up. Nothing does more to affect your health and appearance than this deadly habit. Even if you are not a smoker, please read this section and potentially apply to other addictions. You will also understand more about the dangers of second-hand smoking so you can help others quit the habit for the last time. Many of the suggestions for dealing with cigarette addiction also work with other kinds of addictions including gambling, sugar, caffeine, alcohol, cocaine, and other street drugs. Sadly, eighty per cent of smokers who quit, do so without being in any program - and studies show that 90 percent of these self-reliant quitters fail and go right back to square one. It’s the same rate of recidivism as with heroin. With a 90 per cent chance of failure without a program, you may wish to consider getting some help this time around. The battle against smoking and other addictions is harder to win when fought alone! Your line that “quitting smoking is easy, I’ve done it hundreds of times,” may get you some laughs at a party, but it is no way to live your life. I know because many of my friends finally quit for good when they get heart problems. However, I lost many others who never nknew they had a heart problem until they dropped dead.

Quit Your Addiction for Good – Do it Right this Time!

Private, if you want to improve your chances of quitting by tenfold, read the next few pages. The vast majority of my patients report that quitting when using my program was a lot easier than they had anticipated. They enlisted in the program with the understanding that we would help them and we delivered on our promise. Must truly successful people realized a long time ago, they can learn much more by listening and learning from others than by believing that they have all the answers. They learned that reinventing the wheel is foolish when someone else already figured that out. They spend their time looking for expertise rather than slogging away on their own. “That men do not learn very much from the lessons of history is the 124

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most important of all the lessons that history has to teach.” Aldous Huxley, Collected Essays They read about preventing illness and consult a doctor when they are sick. Business owners know when to consult a lawyer to keep them out of trouble with contracts and other legal matters. They hire a marketing firm to do the marketing, an ad agency to create the ads, an accountant to do the accounting - and so on. Ultimately, those who are most successful in life understand the importance of outsourcing. They seek assistance from specialists when necessary and value the advice they receive. Real men ask for directions! The same applies for saying goodbye forever to cigarettes. For once in your life, be a quitter and be proud of it. For those who have repeatedly failed to quit smoking and other addictions in the past, it’s comforting to learn that most people actually fail several times before stopping successfully. Don’t beat yourself up about it, your past failures are not proof that you are unable to quit. Instead, they are part of the normal process toward becoming a permanent non-smoker, non-gambler or getting off street drugs for good. For many, every failure to quit smoking causes a loss of faith in their ability to do so. Therefore, each time you try, it gets harder and harder to motivate yourself to set a date for the next attempt. The risk is that you begin to feel that all efforts are hopeless. Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time. Thomas A. Edison As your commanding officer, I urge you to fight a good fight and set your sights on the success you desire. My mission here is to restore your faith in yourself. You can quit. Even if you’ve failed several times in the past, understand that this is normal. You’re not alone. Get properly prepared, follow the guidelines and. Do it now. Do it right now! In analyzing the motivations behind this dangerous social addiction, when asked why people smoke, some might say, “I just like to smoke!” or “It’s my choice to smoke.” In reality, real choice is not part 125

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of the pattern. Tobacco companies have promoted the idea that smoking is a matter of personal choice. As I see it, there really isn’t as much choice as they have suggested to their customers. This is marketing hype to keep people addicted and in the hands of the ultimate enemy (the advertisers), it is the root cause of millions of deaths over the past fifty years.

Be True to Yourself – You Can Quit!

Ask yourself honestly, am I addicted to tobacco? Am I truly exercising free will when I light up? By telling smokers that smoking is a personal choice, the tobacco industry has helped to keep its customers in denial about the true extent of their addiction. The tobacco industry is the most formidable enemy you will ever face armed to the teeth with more ways to twist the truth than the snake in the Garden of Eden. It is Your Decision and You Must Take Control You may only be a lowly private, but you have the power to change your life. The most important step to take is the first step - admit you have an addiction. Admitting that you’re smoking more out of addiction than choice will help motivate you to proceed to the next steps - taking control of yourself and becoming a non-smoker. This admission will further serve you by helping you stay smoke-free later. In the months and years after you quit, when temptations to smoke occasionally overpower you - and they will - remind yourself, “I have an addiction and I’m powerless over tobacco.” Saying this to yourself in overwhelming moments of temptations will give you the strength to say no to ‘just one’ cigarette. Nicotine Make no mistake; nicotine is an addictive, mind-altering drug of the worst kind. Nicotine is a drug found naturally in tobacco. It is highly addictive - as addictive as heroin and cocaine. Over time, the body 126

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becomes physically and psychologically dependent on nicotine. Studies have shown that smokers must overcome both of these to be successful at quitting and staying cigarette-free forever. Nicotine adversely affects many body parts, including the heart and blood vessels, hormonal system, metabolism and brain. Absorbed throughout the body, nicotine is in breast milk and in cervix mucous secretions of smokers. Highly toxic, only 60 mg of pure nicotine (contained in two packs of cigarettes) placed on a person’s tongue would kill within minutes.

What’s the big deal about cigarettes anyway?

Nicotine produces pleasurable feelings that make the smoker want to smoke more. An unusual drug, in the morning nicotine works as a stimulant, whilst in the evening as a relaxant. As the nervous system adapts to nicotine, smokers tend to increase the number of cigarettes they smoke, hence the amount of nicotine in their blood. After a while, the smoker develops a tolerance to the drug, which leads to an increase in smoking over time. Eventually, the smoker reaches a certain nicotine level within and then smokes to maintain this degree. Existing within the sphere of a series of mini-withdrawal crisis, the smoker only feels normal or relaxed and able to concentrate when lighting a cigarette. Smoking is like wearing very tight shoes all day just to experience the joy or relief of removing them! When you finally quit, you will feel the pleasure of being relaxed and focused all the time rather than just when you are lighting up to get your fix. Nicotine Withdrawal If you light another cigarette, the nicotine is replaced and the empty, insecure feeling immediately disappears. It’s the feeling that smokers describe as pleasurable. When smokers try to cut back or quit, the absence of nicotine leads to withdrawal symptoms. Withdrawal is both physical and psychological. Physically, the body is reacting to the absence of nicotine in the bloodstream. Psychologically, when faced with giving up the habit, a smoker experiences wild mood swings and other behavioral changes. Dealing with these mood swings and behavioral changes is one of the 127

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first steps in gaining control over smoking and other addictions.

Withdrawal symptoms can include any of the following: • Depression

• Feelings of frustration and anger • Irritability • Trouble sleeping • Constipation • Nose congestion • Increased coughing in the first three days • Trouble concentrating • Restlessness • Headache • Fatigue • Increased appetite Like Post Traumatic Stress Disorder (PTSD), these symptoms are very real and they are debilitating to someone who is trying desperately to rid themselves of any addiction, especially smoking, drugs, or alcohol. Often, these uncomfortable symptoms lead the smoker to resume smoking cigarettes in order to boost blood levels of nicotine back to a level where symptoms recede. The same holds true for other addictions. If a person has smoked regularly for a few weeks or longer and then abruptly stops using tobacco, or greatly reduces the amount smoked, they experience withdrawal symptoms. Symptoms usually start within a few hours of the last cigarette and peak about two to three days later. These symptoms can last from a few days to several weeks. For hardened smokers, the addiction is usually half-mental and halfphysical - studies show, however, that the ratio varies with each individual. The physical portion of the addiction is to nicotine. As for 128

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the mental or psychological aspect, a smoker’s conscious mind says, ‘I will stop smoking - no problem.’ The unconscious mind, however believes that cigarettes give pleasure and that’s all it can focus on. The unconscious mind says, ‘Give me a cigarette - now!’ The FDA approved drug Chantex® includes a nicotine replacement additive that addresses physical nicotine addiction and a non-nicotine prescription to address the mental addiction. When combined with psychological preparation and relaxation techniques, withdrawal symptoms are much milder than stopping “cold turkey,”

Common rationalizations used by smokers or alcohol abusers

I’m under a lot of stress and smoking or drinking relaxes me. Naturally, you will feel more relaxed when you give your body a substance it’s come to depend upon. Recognize, however, that nicotine is actually a highly potent stimulant - it raises your heart rate, blood pressure, and adrenaline level. Most ex-smokers feel much less nervous just a few weeks after quitting. Most smokers are tenser and more easily irritated than non-smokers are. Alcohol may help you go to sleep but causes your body to release adrenaline in the middle of the night, resulting in poor quality of sleep. Again, this irritability is prevalent in most addictions. Smoking enables me to concentrate. During the withdrawal period, you will be tenser and find it harder to focus, but in the end, you will feel much better. Smoking actually deprives your brain of oxygen. I’ve already cut down. Cutting down is a good first step, but there’s a big difference in the benefits to you between smoking a little and not smoking at all. Besides, smokers who cut back often inhale more often and more deeply - negating many of the benefits of cutting back. After you’ve cut back to about seven cigarettes a day, it’s time to set a quit date. I smoke only safe, low-tar cigarettes. These cigarettes are still harmful. Carcinogenic substances and many smokers who use them inhale more often and more deeply to maintain their nicotine intake. 129

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The percentage of carbon monoxide intake often increases with a switch to low-tar cigarettes. It’s too hard to quit. I don’t have the willpower. Quitting cigarettes is hard, but it’s not impossible. More than 25 million people quit every year. It’s important for you to remember that many have had to try more than once - and try more than one method - before they became ex-smokers, but they have done it and so can you. I’m worried about gaining weight. Many people who consider quitting are acutely concerned about gaining weight. I get that! Most smokers who gain more than three to six kilos are eating more. Major weight gain (12kg) occurs in only 10 per cent of men and 13 per cent of women who quit smoking. Gaining weight isn’t inevitable; there are certain things you can do to help keep your weight stable. If you’re concerned about gaining weight, keep these points in mind: Quitting doesn’t mean you’ll automatically gain weight. When people gain, most of the time it’s because they eat more once they have quit. The benefits of giving up cigarettes far outweigh the drawbacks of adding a few extra kilos. Smoking adds the equivalent of 40kg of extra burden to the heart. You’d have to gain a very large amount of weight to offset the many substantial health benefits that a normal smoker gains by quitting. Watch what you eat! Plan menus carefully and count calories. Don’t try to lose weight - just try to maintain your pre-quitting weight. Have low-calorie low carb foods like celery, cherry tomatoes, broccoli and mushrooms, lentil soup, air-popped popcorn without butter, apples, and cucumbers on hand for nibbling. Chew a sugarless gum. Get back to exercising on a regular basis. Once you quit smoking, you have a lot more energy. Drink lots of water and avoid juices, fizzy drinks, alcohol, and caffeine. I don’t know what to do with my hands. That’s a common complaint. You can keep your hands busy in other ways - it’s just a matter of getting used to the change of not holding a cigarette. Try holding something else, such as a pencil, paper clip, or marble. Practice simply 130

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keeping your hands clasped together. If you’re at home, think of all the things you wish you had time to do, make a list and consult it for alternatives to smoking whenever your hands feel restless. Put a rubber band around your wrist so you have something to do with your fingers besides munching on candies. Snap it and feel the pain. It helps remind you that smoking is a terrible habit and was killing you!

It is War and You are Ultimately in Charge of Your Own Destiny

In his book ‘The Art of War’, Sun Tzu wrote hundreds of years ago that, “most battles are won before they are ever fought.” “In your personal war against cigarettes, dear private, this is the most important battle you will ever fight against the most formidable enemy you will ever encounter, and you must engage that enemy in hand to hand combat.” Going a bit further with our military analogy, think about how countries prepare for war and how they decide to launch an attack. Leaders gather information and intelligence about the enemy; “in country” operatives collect more information and send it forward to headquarters analysts. They consider United Nations’ resolutions, economic blockades, and other non-military activities. At the same time, they commence with psychological and media warfare, marshal troops along the border of the targets country as a show of strength, work to neutralize opposition within the targeted country and analysts pour over more details. Once everyone agrees that a military operation is necessary, commanding generals fix a date, and launch a strike mission. In our case for quitting our addiction, all the facts are in and the research is complete. It’s time to develop your plan and launch your attack. Here are the steps you need to take: • The Preparation phase • The Quitting phase 131

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• The Maintenance phase

The Preparation Phase:

1. Information and intelligence gathering – To win your war against addiction, become a sponge for information. Reach out to your physician, family, and friends. Most importantly, take charge of your own health by reading more about how to maximize your chances of success. Find a good quit smoking program and seek help for drug or alcohol and other addictions. 2. Psychological Warfare - Everyone knows that smoking is bad for you, but few appreciate how bad smoking really is. Part of quitting, is to get angry at the cigarette instead of thinking of it as your best friend. You should be able to recite by heart the bad effects of smoking on your health and on your family. Gag when you think about emptying ash drays. Cringe when you think what smoking did to your lungs and your ability to take a clear breath of fresh air. Internalize the stench of your clothes from years of smoking. Smoking is disgusting – Drill that thought into your head however you need to do it.

Cancer is the leading cause of death amongst women aged between 40 and 79 and men aged 60 to 79. Smoking can damage the DNA of different cells in the body. The damage is cumulative, irreversible and evidence of this damage can take decades to emerge as a cancer. Smoking is also the root cause for twenty-one separate cancers making it responsible for over forty per cent of all the deadly cancers. Lung cancer accounts for one third of all cancer-related deaths. By the time, a chest X-ray shows lung cancer, it has been present for at least five years and contains a billion cancer cells. Your likelihood of contracting breast cancer triples when you smoke. The same is true for bladder, esophageal and prostate cancer. There are 4,800 different chemicals in a cigarette and 60 of them cause cancer. Cigarettes cause cardiac disease, high blood pressure, as well as stroke. They can kill you if you are lucky or even worse; land you in a wheelchair for the rest of your life. 132

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What most people do not appreciate is that smokers may or may not get cancer or heart disease but every heavy smoker destroys his or her lungs. This in turn destroys the person’s quality of life so that the ability to exercise or even climb stairs becomes impossible. The ‘usual’ morning smoker’s cough is a sign of chronic bronchitis - infection of the bronchi and this eventually may lead to COPD. I ask my patients to do a simple breathing test that measures their lung function before they enroll in my ‘quit smoking’ program. After two months of quitting, their score improves by an average of thirty percent. Clearly, smoking is also a major factor behind asthma and allergies. Smoking also aggravates stomach ulcers and heartburn as it increases gastric acidity. Another little known fact is that the majority of people over eighty years old lose a lot of their sight due to the degeneration of the retina. Many eventually get Alzheimer’s and may not even recognize their own name or even their families. The likelihood of both of these terrible conditions doubles when you smoke. When you get older, your height shrinks and you get a hump on your back due to painless fractures of your spine caused by osteoporosis. The risk of fractures and osteoporosis increases significantly with smoking. Blood clots in the legs and poor wound healing after surgery particularly affect smokers. Smoking robs you of your beauty and is detrimental to your overall physical appearance. Lifelong smoking stains your teeth and nails, and decreases blood circulation resulting in the pallid look evident in most smokers. This decrease in circulation also damages the elastin fibers in your skin, creating sagging on your neck and face, your abdomen, breast, thighs and rear. Smokers have a higher incidence of impotence and a decrease in their sexual performance. They are in general, more stressed out than nonsmokers are.

Addictions Go Together Like Guns and Ammunition

The Michigan addiction research center revealed in 2005 that 87 per cent of alcoholics smoke cigarettes, compared to less than thirty per cent of the general population. While research showed that improved 133

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mental functioning is one of the immediate effects of nicotine exposure, chronic smoking however, had the opposite effect. Smoking predicted poorer performance on verbal and visual-spatial reasoning and lowered the IQ even more than chronic alcohol abuse. Smoking is often a precursor to illicit drugs Anathema to vitality and longevity, cigarettes cause accelerated aging. Chronological age refers to how old you are on paper while biological or ‘real age’ refers to how old your heart, bones, muscles, joint, brain, liver, kidneys, and immune system are. Shockingly, there can be a twenty-seven year difference between the two numbers... The first and most effective anti-aging step is to quit smoking. When you quit smoking, you start growing younger every year for the next ten years. Parents, celebrities, health professionals, and teachers who smoke set a bad example for children and ultimately the reason why so many kids first take up smoking. Smoking can be the first gate to alcohol and drug abuse as the child accepts that it is OK to harm your body instead of respecting this amazing and complex machine.

Second-Hand Smoke is bad for Children and Other Living Things!

When you retire from the army and smoking is behind you, beware of another leading cause of cancer and other deadly diseases – second hand smoke. Passive smoking from “second hand smoke” is dangerous to family members and friends because the smoke from the unfiltered cigarette end is eighty per cent more harmful than the filtered one that the smoker inhales. For every cigarette inhaled by the smoker, those in close proximity are inhaling a third of it themselves. Smoke penetrates clothes, draperies, and furniture. It’s even in the rugs on the floor. When a non-smoker walks into a supposedly “non-smoking” room in a motel, they can tell immediately someone has smoked in the room. This second hand smoke causes asthma, respiratory illnesses, and ear infections. It can 134

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even affect unborn children.

Great News - Smoking No Longer Socially Acceptable Thankfully, smoking is far less socially acceptable now than it was in the past. While these decisions are not based entirely on social acceptance, most workplaces have smoking restrictions. Some employers prefer to hire non-smokers too.

For all you smokers out there, friends may increasingly ask you not to smoke in their houses or cars. Public buildings, concerts, and even sporting events are largely smoke-free nowadays. Most communities are restricting smoking in all public places, including restaurants and bars. Like it or not, finding a place to smoke can be a hassle. Smokers may find their opportunities for dating or romantic involvement largely limited to other smokers, who only make up around a quarter of the population.

Smoking is a â&#x20AC;&#x153;Dragâ&#x20AC;? on Productivity and the Pocketbook In terms of productivity, smokers waste a lot of time consumed in the act of smoking and taking unproductive brakes.

Finally, smoking is expensive. Thousands of dollars are wasted buying cigarettes but more importantly, the cost paid to treat the major health problems that invariably affect the smoker later on is huge. There may also be a loss of earnings due to the frequent sicknesses reported by smokers - or worse, their early retirement due to smoking-related disabilities. Having the aforementioned list present in your head helps you decide to seek help, take action and view the cigarette as the enemy camouflaging itself as a friend that is a source of pleasure and calm. 1. Setting the dateÂ - There is no convenient date to quit smoking. Seventy per cent of smokers would love to quit but are afraid of gaining weight, going through the pain of withdrawals or are afraid of failure. Do not postpone quitting until you have less stress. There is always an excuse to postpone the decision. The best time is usually two to three weeks from the time you finish reading this chapter, when you should be mentally ready to quit. 135

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If you smoke less at home, then choose the quitting date on a weekend or vacation. If you smoke less at work then choose the beginning of the working week. Announce to all the people you know the magic date and ask them for their support. If your spouse is a smoker, it is essential that you quit together. 2. Two weeks before the date you have set up for quitting, you should: • Switch brands. Switch to a brand you do not like. Switching increases your success rate. A common strategy is to switch from menthol-flavored to non-menthol flavored or vice versa. Remember, you will be quitting soon and you want to sever this love-hate relationship gradually. • Start exercising. Most smokers suffer from a state of low energy and feel older than their age. Exercise is an essential tool to deal with the temporary increase in stress or depression of the first two to four weeks after quitting. Quitters who exercise four hours a week are thirty per cent more likely to succeed than those who do not exercise. Exercise releases dopamine, a substance that gives us a natural high the same way that nicotine does. Smoking speeds up the metabolism by 100 calories per day. This translates into four kg per year. You can get the equivalent calorie-burning benefits by lifting weights to build muscle. Every kilo of muscle burns 100 calories per day (the equivalent of twenty olives), while a kilo of fat burns only five (one olive). By gaining only one extra kilo of muscle, you make up for the loss of metabolism. In addition, weight lifting also reverses osteoporosis that will show up later in life due to smoking. Exercise also helps us sleep better, fights constipation and controls weight gain. So just do it! • Consider Chantex®. Smokers who have more than 1015 cigarettes per day would benefit from varenicline or Chantex® as this drug helps with withdrawal symptoms and 136

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cravings, leading to a doubling or tripling in your success rate. The drug does not contain nicotine but it does block the effects of nicotine from the tobacco. In rare cases, Chantex® triggers depression and suicide. Family members should watch for symptoms of depression. Few others may experience a worsening of their chest pains. It’s strange how some people are against using an FDA approved drug for a few months to get help with quitting but have no problem ingesting the 4,800 cigarette chemicals every day for years. You should start taking Chantex® about a week before you quit smoking and continue taking it for a total of 12 to 24 weeks. • Consider intravenous nutritional support. When indicated, I enhance the treatments for chemical dependency with a few sessions of intravenous vitamins such as the Myer’s cocktail and agents such as NAD+ and Glutathione that are beneficial in restoring brain health and weaning patients off their addictions. I use similar techniques for alcohol, cocaine and heroin addictions with appropriate FDA approved drugs on a temporary basis such as Naltrexone IM monthly injections (Vivitrol®), anti-seizure and/or anti-anxiety medications such as Xanax®. 1. Stress reduction strategies. Beside exercise, it is important to get plenty of sleep and cut down on coffee and other caffeinated drinks. Coffee increases your blood pressure and increases stress, making it harder to quit smoking. Do not stop coffee cold turkey, as you will get headaches and feel lethargic. Instead, change the size of the mug to a smaller one, mix half decaf and half regular, and add skim milk. A few days before quitting, you need to get nicotine replacement patches (a 10mg patch for each pack you smoke per day). You should start the patches the day you quit. Learn how to use deep breathing exercises to control stress, anger, and frustration. (Take a yoga class if you can.) Acupuncture, while effective in treating chronic pain, does 137

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not help in quitting smoking regardless of the claims of some practitioners. Book a visit to your dentist a day or two after the quitting date to clean your stained teeth and gums. Stock up the night before on sugarless gum and healthy snacks. The aim of the quitting game is to be prepared. Temptation is inevitable. The Big Day - the Quitting Phase • Get plenty of sleep • Throw away all cigarettes, lighters and other paraphernalia • Eat a good breakfast • Drink lots of water • Send your clothes to the laundry to rid them of cigarette stench, which can linger for a long time • Get a tooth cleaning or whitening session Keep very busy on the big day. Go to the movies, exercise, take long walks, go bike riding or to the gym. When you crave a cigarette, do deep breathing exercises. Distract yourself with the thought of how free you will be without cigarettes. Stay busy but avoid stress, and stay away from other smokers and things that make you want a cigarette. Keep your hands busy. Get plenty of sleep. Do not think that you will never have a cigarette, think that you will not smoke today. “One day at a time.” Deep breathing is perhaps the single most powerful and important technique to adopt. Every time you want a cigarette, do the following three times consecutively as needed: Inhale the deepest lung-full of air you can and then, very slowly, exhale. Purse your lips so that the air comes out slowly. As you exhale, close your eyes and let your chin gradually sink over 138

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onto your chest. Visualize all the tension leaving your body, slowly draining out of your fingers and toes, just flowing out. Learn to relax quickly and deeply. Make yourself limp. Visualize a soothing, pleasing situation and get away from it all for a moment. Concentrate on that peaceful image and nothing else. This is a variation of an ancient Indian yoga technique, and is very centering and relaxing. If you practice this, you’ll be able to use it for any stressful situation encountered in the future. It will be your greatest weapon during the strong cravings that are sure to assault you over the first few days. This deep breathing technique will be vital. • Remember that the urge to smoke only lasts a few minutes and will then pass. The urges gradually become further and further apart as the days go by. • Do your very best to stay away from alcohol, sugar and coffee the first week or longer, as these tend to stimulate the desire for a cigarette. Avoid fatty foods, as your metabolism will slow down a bit without the nicotine, and you may gain weight even if you eat the same amount as before quitting. Discipline about diet is very important now. No one ever said acquiring new habits would be easy! • Nibble on low calorie vegetables, apples, berries and citrus fruits. Chew a sugarless gum. • Stretch out your meals - eat slowly and wait a bit between bites. • After dinner, instead of a cigarette, treat yourself to a cup of mint tea or a peppermint candy. Get up from the table and brush your teeth or go for a walk. • Nicotine patches are associated with better patient compliance and hence, slightly higher success. However, people have the most success when they combine Chantex®, nicotine patches, deep breathing exercises, and physical exercise. You need 10mg of nicotine per day for every pack you smoke. 139

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• For the first few days, drink lots of water and fluids to help flush out the nicotine and other poisons from your body. • Go to a gym - sit in the steam room, exercise. Change your normal routine - take time to walk or even jog around the block or in a local park. • Ask for support from co-workers, friends, and family members. Ask for their tolerance. Let them know you’re quitting, and that you might be edgy or grumpy for a few days. If you don’t ask for support, you certainly won’t get any. If you do, you’ll be surprised how much it can help. Take a chance - try it and see! • Ask friends and family members not to smoke in your presence. Don’t be afraid to ask. This is more important than you may realize. Until you’re confident of your ability to stay off cigarettes, limit your socializing to healthy outdoor activities or situations where they prohibit smoking. If you must be in a situation where you’ll be tempted to smoke (such as a cocktail or dinner party), try to associate with the non-smokers there. • Write down ten good things about being a non-smoker - and then write out ten bad things about smoking. Actually, do this right now, before going any further. It really helps. • Don’t pretend smoking wasn’t enjoyable - it was. This is like losing a good friend - and it’s OK to feel a bit sad. Keep your spirit and motivation as you think of the eventual great benefits.

The Maintenance Phase and Avoiding Relapses

Just like in a war, the enemy is never truly defeated until they are dead and buried in the ground. You must take this war seriously and be prepared to fight the secondary battles when they come along. Know that most relapses occur in the first week after quitting, when withdrawal symptoms are strongest and your body is still dependent on nicotine. Be aware that this will be your hardest time, and use all of your personal resources - willpower, family, friends, and tips in these pages - to get you through this critical period successfully. Realize that the most successful ex-smokers quit for good only after 140

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several attempts. You may be one of those who can quit on your first try but if you’re not, don’t give up. Try again. Your chances increase with every attempt. The sooner you try again the better the success rate. Know that most other relapses occur in the first three months after quitting, when situational triggers - such as a particularly stressful event - occur unexpectedly. These are the times when people reach for cigarettes automatically, because they associate smoking with relaxing. This is the kind of situation that’s hard to prepare for until it happens, so it’s especially important to recognize it if it does happen. Here is perhaps the most encouraging information amongst all these points. In the period starting a few weeks after quitting, the urge to smoke will subside considerably. However, it’s vital to understand that from time to time, you will still be suddenly overwhelmed with a desire for ‘just one cigarette.’ This will happen unexpectedly, during moments of stress, whether negative stress or positive (at a party, or on vacation.) If you are unprepared to resist, succumbing to that ‘one cigarette’ will lead you directly back to smoking. Remember the following secret: in these surprise attacks - and they will definitely come - do your deep breathing and hold on for five minutes, the urge will pass. Remember that smoking is a habit, but a habit you can break. Never allow yourself to think that ‘one won’t hurt’ - it will. When it comes to a spouse or partner who smokes, don’t be a nag. Just three times a year you can ask your loved one – briefly and lovingly - to kindly quit. Surround your request with honest complements and make it brief, yet sincere.

America is the Leading Exporter of Addictions

Private, it is hard for me to tell you this, but as Americans, we are the leading exporters of death sticks and other killers of humankind. We are a nation of good people but we are also a nation full of addicts. The whole world is importing our lifestyle. It’s sad to say that one of our leading exports to the world is our addictions and we now see multiple American originated addictions springing up all over the world.

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It is now common to see people in other countries smoking cigarettes, eating sugar and salt laden snacks, drinking alcohol, caffeine drinks, watching television, texting on smart phones, and glued to social media while ingesting prescription drugs. People are frequently obsessed with sex, money, power, and work. Each of these things acts as a kind of drug, since each temporarily distracts your mind from your pain. This is not a very proud legacy for the greatest country in the world! We could convene another jury to prove America is the leading exporter of harmful addictions, but unfortunately the evidence is overwhelming and our arguments would never stand up in court. We are talking about both current pain, such as anger, loneliness or sadness, as well as emotional pain we’ve carried with us since childhood, such as unmet childhood needs, like an absent father or abusive mother. Addictions work as emotional crutches. By getting to the root cause of the problem, the need for the ‘addictive crutch’ subsides. Sometimes, life is painful. It’s supposed to be that way. All of us face grief, loss, and struggle but it’s because of these struggles that our characters are strengthened and defined.

Controlling anger and frustration

Letting out anger in reasonable, mild bouts as frustrating situations arise is acceptable, even healthy. This is better than letting it build up and later exploding in rage. It’s helpful and healing to verbalize feelings of frustration as you quit smoking, or any other negative addiction for that matter. Don’t worry; if you ask for support and tolerance, you’ll get it. Don’t isolate yourself, lean on others. If you want a hug, it’s OK to ask for one. Especially for men, showing vulnerability is a sign of strength. Some people view attending a support meeting as an act of fear and therefore, cowardice. This is not the case. Support groups are extremely helpful for those wishing to end addictions. So be brave and seek support from others. It’s a sign of a strong person. 142

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You can do it!

The Fallacy of ‘Responsible Drinking’ – There is No Such Thing!

Being in the military, you understand the power of the drink. How often have you heard things like “just one more for the road,” or “I only have a glass of wine with my meal in the evening to relax; it’s no big deal, because I am drinking responsibly.” Not too many years ago, the liquor industry launched a campaign to “drink responsibly.” This is actually just another underhanded way of keeping alcohol consumption in the public eye which appearing to be politically correct. The term ‘responsible drinking’ has no place in your vocabulary! Alcohol consumption spawns other addictions and increases your risk of contracting cancer and many other diseases. There is no safe minimum!

Alcohol and Carcinogens

Alcohol is the common term for ethanol, a chemical substance found in beer, wine, and spirits. Studies have shown that alcohol can contain around 15 carcinogenic compounds and clear patterns have emerged between alcohol consumption and the development of cancers. Following this, the conclusion of the 2014 World Cancer Report (WCR) is that absolutely no amount of alcohol is considered safe. The most important carcinogen is ethanol because when it metabolizes (breaks down) into acetaldehyde; it becomes very toxic and damages DNA and proteins. Each individual’s genes determine the rate ethanol metabolism in their body. It varies from person to person. Alcohol also increases the risk of cancer by impairing the body’s ability to absorb nutrients that may be associated with cancer risk. It increases the amount of the estrogen hormone in the blood. Increased estrogen levels cause breast cancer and generate reactive molecules that damage DNA and protein through increased oxidization.

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Alcohol contributes to over 200 diseases and injury-related health conditions, most notably alcohol dependence, liver cirrhosis, physical injuries, and cancers. Research cites alcohol as the risk factor for mouth, esophagus, pharynx (throat), larynx (voice box), breast, and liver cancer. In fact, alcohol-related liver disease is the primary cause of almost one in three liver transplants in the United States. In 2012 alone, 3.3 million deaths (5.9 percent of all global deaths) were attributable to alcohol consumption. These worrisome statistics increase every year. Alcohol addiction negatively affects our health, puts a heavy burden on our health care system, and is costing us all a lot of money every year. In 2006, alcohol misuse problems cost the United States $223.5 billion and approximately 17 million adults aged 18 and over had an Alcohol Use Disorder (AUD).

Misleading Information

Our enemies are masters at disinformation. Just like the tobacco industry, the “spirits” industry spews all kinds of nonsense into the media to misinform the public. It has been going on for 100’s of years and it will continue forever until we collectively put a stop to it. Despite several well-documented studies demonstrating how harmful alcohol is to the human body, there is still a public debate going on about the dangers of alcohol verses its potential benefit. Give me a break! Just like cigarettes, alcohol kills! As the mother who lost a child to drunk driving or the abused wife who is beaten daily by an alcoholic spouse. The Department of Health, The Royal College of Physicians and the House of Commons Science and Technology Committee publish articles recommending how much alcohol we should limit ourselves to per week. They would do better to recommend against it altogether. Dr. Jürgen Rehm, World Cancer Report Contributor and Senior Scientist at the Centre for Addictions and Mental Health in Canada points out that the National Cancer Institute (NCI) research found that there is no safe minimum and even light drinkers are at risk. “People often enquire about how much alcohol they can safely drink 144

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and what may be regarded as a health risk, but in reality there is no risk-free level of alcohol consumption” he said. The concerning fact that there are very few press reports relating to alcohol concerns, apart from celebrity drink driving cases was also highlighted. “I do not know why a beneficial link would be more important than a detrimental one, if the beneficial link overall is about one tenth of the detrimental link.” The risk-to-benefit ratio of drinking appears to be higher in younger individuals, and a shocking fact states that alcohol abuse is the leading risk factor for premature death amongst males aged between 15 and 59. People in this age bracket have higher rates of binge drinking, often resulting in dangerous consequences including serious accidents, violence, and other social problems. Research also indicates that alcohol use during teenage years could interfere with normal adolescent brain development.

A Drink and a Smoke: A Deadly Combination

Since we are taking on all comers, we may as well hit this one head on as well. Smoking is widely known to be a huge risk factor for cancer but combining smoking and drinking together can be a deadly mix, and the two often go hand in hand. There is a synergistic effect during tobacco smoking and alcohol consumption. Combining the two agents leads to much more serious problems over time. The highest risks of oral cavity, pharynx, larynx, and esophagus cancers occur in those who are both heavy drinkers and smokers, and avoidance of both could prevent a huge 80% of oral cancer cases and 90% of laryngeal cancer cases. To conclude, any level of alcohol intake increases the risk of developing an alcohol-related cancer, and that risk rises in accordance with the level of consumption. Many health care agencies have suggested adding a warning label mentioning cancer risks to all alcohol products in the same manner cigarette packages carry the warning today. Further educating the public about risks, controlling the 145

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affordability of alcohol through pricing and reducing the overall volume consumed, would vastly reduce social problems, cancer and mortality. Waging war against alcohol, tobacco, and drugs is both a public and a very private battle. I urge you to take up arms and join the fight. Quit smoking, alcohol and other addictions and then get involved to help others and to counter the massive advertising campaigns waged by these formidable enemies.

Weed: a friend or a foe?

I am in favor of decriminalizing the use of marijuana. The percentage of users in minority kids is the same as Caucasians yet they are three times more likely to be arrested and thrown in prison. The US accounts for 5% of the world population but has 25% of the world’s inmates. We are arresting 800 000 people a year for marijuana use. 50-100.000 people are in jail in the great USA due to weed at any given night. Many promising futures and careers are ruined especially in absurdly stringent states like Virginia. Having said that, kids experimenting with weed are at risk of becoming habitual users. Habitual use does slow down learning, memory and alertness. Drivers shall wrongly assume it is legal to drive once they do not feel high but a blood sample may get them a DUI even if they have not smoked a day or two. Cannabinoids are good drugs for older people on chemotherapy to treat their nausea and increase their appetite. However, the widespread new websites and apps claiming it is great for anxiety, depression, headaches and back pain are not backed by any science, but anecdotal unscientific stories. Sorry to the weed ambassadors “Cheech and Chong” but no apologies to Leafy.com. Weed is like alcohol, a bad vice. Education, awareness and further research are the way, but prohibition and criminalization is not. The principal contributor to loneliness in this country is television. What happens is that the family ‘gets together’ alone. Ashley Montagu It is harder than ever to befriend, influence or be their role model to our 146

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children as we juggle our busy schedule to fit theirs? And when we do meet, we cannot carry a meaningful conversation. That is true not only with our kids, but also with anyone, as we are constantly checking and texting with our smart phones.

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Summary

Thank you for reading/listening to the book and congratulations on finishing it. If you are to ready to transform your life and add years to your life span, here is a great way to start. Go back through the book with a highlighter in hand. Your goal is to move interest to understanding and then on to mastery. Mastery takes times but is well worth the effort. Become the master of your own destiny with a carefully developed health plan. Adopt one new habit at a time. Do not jump into wellness with both feet before you develop your overall plan. Avoid procrastination however, and do get started. Start now, not next month or next year. This is a complete lifestyle change, not just a temporary fix to a problem. Today is the first day of the rest of your life - really. I learned the hard way not to take my health for granted. Every decision you make has an impact. Donâ&#x20AC;&#x2122;t let another day go by where you arenâ&#x20AC;&#x2122;t being the best you that you can possibly be. Visit my website at www.revesreagingcentre.com where you can get free webinars and videos on how to prepare more than ten different delicious salads in less than five minutes, while shopping only once per week. Follow me on www.DRmax.TV Dr. Max

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Before and After Pictures

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After Fat transfer, a chemical peel and ThermageÂŽ

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After Clear + Brilliant laser facials

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Before and After Pictures

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Before and After Pictures

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After hair transplant

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Before and After Pictures

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Dr. Max, is the founder of the Reverse Aging Centres headquartered in Beverly Hills where he assembled under one roof some of the worldâ&#x20AC;&#x2122;s most recognized experts in plastic surgery, cosmetic dermatology, lasers, weight management, hormone re-balancing, chemical dependency, brain health restoration, genetic testing, and sophisticated executive check ups. Dr. Max trained in general surgery at the University of Connecticut program before completing his training at Boston University in anesthesiology. He then completed a fellowship in cardiac anesthesiology and critical care medicine at the University of Massachusetts. He is board certified in of anesthesiology, board certified in pain management and Board certified in Anti-Aging medicine. With his eleven Anti-Aging Centres around the world, Dr. Max helped more than 300,000 patients reverse the aging process. He is the author of the international best sellers Younger Every Day and Vitality for Life. www.reverseageingcentre.com