Your book has only six rules, starting with “Don’t be a schmuck”. What does that mean?
There are lots of things in life that have unreasonable risk, and you should not be doing them. We obviously know about smoking. While vaping may be safer than smoking, that doesn’t make it safe. We need to think about that.
You’re stepping into the firing line about vaccines and guns – tell us about that.
I think what [Health and Human Services Secretary] Robert F. Kennedy junior is doing on vaccines is horrible. It doesn’t recognise how dreadful these infectious diseases were, or how much your grandparents probably couldn’t wait to get their kids vaccinated against polio, then measles and all the other illnesses that we got vaccines for. One of the consequences of the success of the vaccines is that we don’t see these diseases. When it comes to gun ownership, this is data-driven. If you own a gun to protect yourself, you are two times as likely to die by a gun than your neighbour. Why? Because most gun deaths are by someone you know, a relative or a friend. The number one cause of kids’ death now is guns, because guns are stored at home. They’re loaded, they’re not stored in a safe place, there are no locks. I think the data supports gun restrictions, which leads to people living. I’m a doctor and people living is my primary goal.
Why does your chapter about cultivating relationships come before diet, exercise and sleep?
There’s a myriad of studies that show people who have more and richer social interactions actually live longer. A lot of people think: “Oh, this is psychological. It’s in the head.” Well, it is in the head, but that doesn’t make it psychological. Interacting with people decreases cholesterol and cortisol (stress hormones) and lowers our heart rate, lowers blood pressure. These are physiological impacts. Not having friends, being socially isolated, that’s the equivalent of smoking 15 cigarettes a day.
You write that “ice cream improves people’s health.” Say what?
I still like ice cream – gelatos, specialty ice creams – and they’re dairy products, which are quite good for you. They give you protein and other nutrients and vitamins and can lower the risk of heart problems. If you eat ice cream once a week, twice a week, it can be fantastic. My wife’s grandmother, who lived to 101, used to have a scoop of ice cream every day. She would say: “There’s always a little room for ice cream.” Assuming you eat nutritiously, don’t consume a lot of ultra-processed foods and don’t have a lot of empty calories like sodas, it can be fine.
Tell me about the chapter called “Expand your mind.”
[It’s about what] hell is for most people – the body’s okay, the heart’s working, the kidneys are working, but the brain is not. You could go on for years, but it’s not living as we imagine it. So how do you keep the brain functioning, knowing that there is going to be cognitive decline, that neural connections are going to decrease? There are two key elements. One is cognitive reserve – do you start with a high level of brain functioning? We’re in a moment where people are obsessed by the economic value of a college education. That’s one way of looking at it. But there’s also a cognitive value to an education. Actually reading Dostoevsky, not just the AI [artificial intelligence] summary, is important to your brain. It makes connections and the more connections you have, the better. Then there is keeping your brain active. We know that cognitive decline begins in the late 30s, early 40s, and really goes down once people retire. And the best way of countering that, besides exercise, eating well and socialisation, is staying mentally engaged. Go to book clubs or volunteer at a library or in schools. Take up new hobbies, actually committing yourself to them.
What do you say to people who hate exercising?
Not getting any exercise is dangerous. What you can do is not make it exercise, not make it “go to the gym”, not make it “I’m going to go out for a seven-mile run”. You can hike with someone else, so it’s more of a social activity. In the winter, 20 minutes a day of doing yoga or riding an exercise bicycle is going to do you well.
What about alcohol? I find the current guidelines confusing.
From a physical standpoint, drinking alcohol is probably not a good thing. It’s bad for your liver and it’s associated with increased risk of at least seven cancers. There may be a group of men over 55 who are high risk of cardiac disease where some alcohol is protective, but that’s the bottom line. On the other hand, 65% of the population drinks. So how to do it in the best way? Well, probably three to four drinks a week is what you should be aiming towards, not more. That goes for men and women – that division is mainly based upon weight, and I wouldn’t spend one extra brain cell worrying about that. Three to four drinks a week. You shouldn’t be drinking five drinks in an evening. You shouldn’t be drinking alone.
You have a good sense of humour – should that be the seventh rule?
A hundred per cent. Having fun in life, looking forward to things – you’ve got to think about something new all the time. I think exuberance is a secret of life because it’s enjoyable, it’s intellectually challenging. You can do it with other people. And what could be better than that?
