The Longevity Solution

by Jason Fung

  All types of blockages involve the same underlying damage to blood vessels and blood clots.

  Studies of tea flavonoids3 show significant improvements in endothelial health in both normal and diabetic populations. Flavonoids enhance the effect of nitric oxide (NO) a key molecule to relax blood vessels and lower blood pressure. Higher doses of black tea produce greater benefits. Researchers have noted similar benefits for flavonoids derived from chocolate and red wine.

  In green tea, the main flavonoids are the colorless and water-soluble catechins that contribute to some of the bitterness and astringency of green tea. One cup of green tea contains 90 to 100 milligrams of catechins, and the catechins are potent antioxidants, which may help the body protect against inflammation. Green tea contains much higher concentrations of catechins than black teas; the catechins in green tea account for up to 30 percent of the dry weight. Furthermore, green tea is particularly high in one type of catechin—EGCG, which is responsible for 50 to 80 percent of total catechins in green tea. Standard brewing does not fully extract the catechins, so studies often use enriched green tea extracts (which are green teas that have been enriched with supplemental EGCG). Cold brewed green tea is another potential solution for fully extracting the catechins.

  Catechins are absorbed in the intestine, but the presence of food significantly decreases their absorption. Consequently, drinking green tea on an empty stomach may increase catechin absorption. Because of the appetite-suppressing effects of green tea, some people might experience nausea. Hot brewed tea typically contains 70 to 100 grams of catechins. A cold brew crystal process (such as Pique tea crystals, https://www.picquetea.com) have about triple that amount of catechins per cup.

  The Benefits of Tea on Disease

  Various research studies have found that tea offers benefits for reducing the risk of various diseases, including cardiovascular disease, diabetes, cancer, and hypertension. The following sections describe some of the ways researchers have found tea to be beneficial.

  CARDIOVASCULAR DISEASE

  A large Dutch population study, called the European Prospective Investigation into Cancer and Nutrition (EPIC-NL)4 followed 37,514 participants over 13 years and found that tea drinking was associated with less heart disease. Those who drank more than 6 cups per day had a 36 percent reduction in the incidence of heart disease. A 2001 meta-analysis suggested an 11 percent reduced risk of cardiovascular disease,5 and the prospective 2002 Rotterdam study suggested that more than 375 milliliters per day (about 13 ounces or more) had a 70 percent lower risk!6

  The subjects in these European studies mostly drink black tea, but there is some evidence that green tea may be even more beneficial.7 A meta-analysis suggests that moderate green tea consumption (one to three cups per day) is associated with a 19 percent reduced risk of heart disease, and drinking more than four cups per day increased that benefit to 32 percent. The prospective 2006 Ohsaki study also showed that drinking green tea is associated with strong protection against cardiovascular disease.8 Over 11 years of follow up, the risk of death decreased by 15 percent, death from heart disease was down by 26 percent, and death from stroke was reduced by 37 percent, as shown in Figure 8.1.

  Fig. 8.1: Ohsaki study results

  There may be some important differences between the types of tea (green versus black) and the style of tea drinking. In North America, people often buy tea from the coffee shop, paying $1.50 or so for a tea bag and some hot water. If you drink six cups per day, as some subjects have done in some of these studies, you’d have to pay $9 per day.

  However, in Asia where people drink tea like water, a teapot full of tea leaves was steeped over and over again. Whenever a person is thirsty, they would pour some tea. At restaurants, it’s the same thing. When people go out for lunch in Hong Kong, yum cha literally means “to drink tea.” A pot of tea stays on the table, and the waiter keeps refilling it with hot water as needed for everybody to enjoy throughout the entire meal. At many homes, people do the same. Instead of getting glasses of water with dinner, the family might refill the teapot and drink some hot tea. In Asia, tea is the default drink throughout the day, and therefore you can easily drink six or eight cups a day without even thinking about it. North Americans might drink six to eight glasses of water instead, although that’s the best-case scenario. Many North American children drink sugary sodas or fruit juices instead.

  There’s another important difference in tea drinking traditions between the East and West. In Asia, tea is usually taken straight, without any added sugar or milk. In the United Kingdom, it is estimated that 99 percent of tea drinkers add milk to their tea. Does the added milk make a difference? The Caerphilly study9 from South Wales found no reduction in heart disease with increased tea drinking, in contrast to other studies mentioned earlier. Researchers speculated that milk blocked the absorption of flavonoids from the tea. Experimental evidence shows that the antioxidant effect of both green and black tea was completely inhibited by adding milk. Proteins in milk form complexes with polyphenols that might block absorption.10

  The benefits of drinking straight tea also extend to the prevention of stroke.11 A 2009 meta-analysis showed that people who drank three or more cups of tea per day had a 21 percent reduced risk of stroke. In addition to improving endothelial function and lowering blood pressure, tea contains theanine. Tea leaves have a high concentration of this amino acid, and dietary theanine comes almost exclusively from that source. Theanine easily crosses the blood-brain barrier and might help protect against damage from stroke.

  OBESITY AND TYPE 2 DIABETES

  Since 1977, obesity and type 2 diabetes have become a worldwide epidemic. Prevention and treatment strategies have become global priorities.

  Many miracle diet pills have come and gone. The notorious Fen-Phen, a prescription medication, was like the old street drug “speed” in that it caused weight loss by speeding up metabolism, but it also caused all kinds of heart problems. Fen-Phen could make you thin, but it also could kill you. Orlistat was another drug that blocked fat absorption. It caused weight loss, but it had some bothersome side effects like diarrhea from malabsorption of fat. The best advice for someone taking Orlistat was not to wear white pants. Then there was sibutramine, which caused weight loss, but side effects like heart attacks and strokes caused it to be discontinued.

  There were weight loss supplements that wouldn’t kill you, but they didn’t work. Green coffee bean extract, raspberry ketones, and grapefruit extract all come to mind. They sound great, but they all turned out to be pure hype.

  However, there’s one substance that seems to have stood the test of time: green tea. Traditional Asian medicine has touted the weight loss effects of green tea for thousands of years.

  A 2016 randomized trial showed that high-dose green tea extract (EGCG 856 milligrams) significantly reduced weight by more than 1 kilogram, and it also reduced waist circumference.12 In tea drinkers, the hunger hormone ghrelin also was significantly reduced by the catechins when compared to non-tea drinkers. Obviously, hunger control leads to easier weight loss.

  Hunger is one of the most powerful human needs, and controlling hunger is one of the keys to long-term weight loss. Most calorie restriction plans ignore this factor and pretend that willpower is more important. You can’t “decide” to be less hungry. You can temporarily ignore hunger, but when it persists day after day, it is impossible to ignore. Green tea, with its small effect on decreasing ghrelin, is a great complement to fasting, and both are important components of longevity. However, the dose of catechins used in the study would require you to drink twelve cups of hot brewed green tea per day.

  A 2009 meta-analysis also found similar benefits to green tea drinking, with an average loss of 1.31 kilograms of body weight.13 The catechins in green tea may help with weight loss by increasing the metabolic rate.14 A beverage containing green tea catechins and caffeine increased the daily energy expenditure by an average of 106 calories per day, or 4.6 percent. This effect wa
s likely due to both the catechins and caffeine in green tea. However, green tea performed 50 to 100 percent better than expected compared to caffeine alone. Other studies15 found an almost identical 4 percent increase in metabolic rate even in tests of half the amount of caffeine. It was noted in a Cochrane review16 that the benefits were not seen when brewed green tea was used; the results occurred only with the catechin-enriched tea.

  Oolong tea may also show this benefit, with studies demonstrating that consuming five 10-ounce servings per day for three days raises energy expenditure by 2.9 percent (about 67 calories) and fat oxidation by 12 percent.17 Oolong tea is semifermented and thus represents a sort of medium ground between green and black tea. It is very popular in China and Japan.

  Green tea promotes long-term weight loss by increasing basal metabolic rate, improving glucose uptake by muscle, and enhancing fat-burning in the liver and muscle.18 Although the effects on basal metabolic rate are not huge, we don’t win the battle for weight loss by creating a small caloric deficit; we win by improving the overall metabolic health of the body. Thus, although the difference of burning an extra 100 calories per day might not be very significant, an improvement in glucose and fat burning (and a reduction in hunger) is what makes the difference. It’s like taking out an old engine and putting in a brand-new V10 engine. You are a better fat- and glucose-burning machine. And fat loss is about enhancing your body’s metabolic machinery because that determines what your body does with the calories you eat (either storing them or burning them); it’s not about creating a small deficit of calories. All these beneficial effects make tea drinking a highly effective intervention for health.

  Because obesity and type 2 diabetes are closely linked, we might expect that the weight-loss benefits with tea and tea catechins also could translate into benefits for type 2 diabetes. Indeed, that appears to be exactly the case. A 2009 placebo-controlled trial19 showed spectacular results. Green tea enriched with 582.8 milligrams of catechins reduced hemoglobin A1C (a marker for three-month average blood glucose levels) by 0.37. That result is almost as powerful as some of the medications used today for treatment of diabetes. The waist circumference, which is indicative of the more dangerous abdominal fat, was reduced by 3.3 cm. Systolic blood pressure was reduced by 5.9 mmHg and diastolic by 3.0 mmHg; triglycerides improved by more than 10 percent.

  The 2006 Japan Collaborative Cohort Study for Evaluation of Cancer Risk20 followed more than 16,000 subjects and found that drinking green tea (six or more cups per day versus less than one cup per week) was associated with a 33 percent decreased risk for developing type 2 diabetes. Researchers found no association between consumption of black and oolong teas and the risk for diabetes. The MEDIS study21 of 1,190 elderly patients in Greece, Cyprus, and Crete also found that moderate (one to two cups), long-term (at least thirty years) consumption of green or black tea was significantly associated with lower blood glucose and 70 percent lower odds of having type 2 diabetes. Interestingly, almost all of the tea drinkers in the study were also coffee drinkers, which suggests additional benefits even on top of coffee consumption.

  Asians show consistently better results compared to Caucasians, which is perhaps a result of genetic differences. Catechins inhibit the enzyme COMT, which increases energy expenditure. Asians have higher rates of the high-activity COMT(H), so blocking it with green tea catechins would be predicted to show greater effects, explaining the racial difference. Weight loss for Asians averaged 1.51 kilograms, but only 0.8 kilogram for Caucasians. However, 0.8 kilogram is still a substantial benefit.22

  HYPERTENSION

  High blood pressure (hypertension) has been called the silent killer because it increases the risk of heart disease and stroke, yet there often are few symptoms. Traditional Chinese medicine believes that tea reduces blood pressure and modern studies confirm this assertion. A Norwegian study23 showed that drinking tea was associated with lower blood pressure even after twelve years of follow up. The effect was moderate (4 mmHg), but when this effect is combined with an improvement in endothelial function24 and is multiplied by millions of men and women over decades, the overall effect is huge, and the potential savings in both money and human suffering is massive. A Taiwanese study showed similar results.25 The study showed the same dose-response relationship, but it also showed that those who habitually drank tea for many years had lower blood pressures.

  Green tea may also have many of these antihypertensive benefits. A 2011 randomized trial26 showed a 5 mmHg drop in blood pressure. However, there also were improvements in cholesterol (lower LDL, higher HDL), insulin resistance, inflammation, and oxidative stress.

  CANCER

  There is inconsistent data on the effect of tea on cancer. According to the National Cancer Institute, “The results of these studies have often been inconsistent, but some have linked tea consumption to reduced risks of cancers of the colon, breast, ovary, prostate, and lung.”27 The main catechin in green tea, EGCG, has been shown to be an inhibitor of both mTOR and the PI3K growth pathway that is stimulated by insulin. Both pathways are overactive in many cancers, so regular drinking of green tea might help prevent cancers.

  Drinking tea may potentially improve cancer outcomes and reduce the risk for breast cancer.28 Breast cancer recurrence and colorectal cancer may both be reduced in regular green tea drinkers.29 The catechins in green tea might help prevent metastasis or induced apoptosis (programmed cell death). EGCG binds to the death ligand to activate the mitochondrial pathway. Once activated, the cell dies and never has a chance to become cancerous.

  Why Drink Tea?

  Because tea is so widely consumed, the potential for changing health is immense. Even if there exists only a small benefit for tea, when multiplied by billions of people drinking it multiple times per day, it can add up to substantial benefits for public health. There are substantial data suggesting benefits for weight loss and lower risk of heart disease, stroke, cancer, and type 2 diabetes. Tea contributes in many different ways to longevity and has been a part of human culture for many millennia.

  The bottom line is relatively simple. There are many potential benefits with virtually no risks, and the cost for this form of prevention is low. Drinking tea comes with a very high benefit-to-risk ratio, so the better question is “Why would you not drink tea?”

  The history of wine-making dates back more than 10,000 years to when it was discovered in Caucasia before it spread to Mesopotamia, Phoenicia, Egypt, Greece, and the Mediterranean.1 Wine was initially revered worldwide as a source of longevity and health, but later it became better known as a deadly toxin, and many countries banned it during Prohibition. In the last fifty years, the viewpoint has been shifting back in the direction of considering it to be a healthy habit to drink some wine. Science is only now catching up to what ancient civilizations long knew. In this chapter, we discuss the health benefits of consuming red wine and coffee and tell you how much of each beverage you should be consuming per day.

  Red Wine

  The Hunza valley lies in the Himalayan Mountains of northern Pakistan, 8,500 feet above sea level. The Hunza people, who are completely isolated from other civilizations by the surrounding mountain peaks, are famous for their longevity. In 1979, visiting scholars were astounded2 by several centenarians who ranged in age from 101 to 109 and were seemingly in perfect health. They had normal blood pressures, and electrocardiogram (EKG) testing revealed no recognizable atherosclerosis. They were agile for their age; not only could they walk and move about effortlessly but their favorite hobby was going out and working the nearby terraced fields. This lifestyle differs markedly from the elderly in the United States. If Americans are lucky enough to reach the age of 100, they’re often barely able to walk to the bathroom. There is some controversy about the Hunza citizens’ actual ages because there were no birth certificates, but they nonetheless had clearly managed to age gracefully.

  The Hunza prize the locally grown apricots and add them to their homemade wine, which is called H
unza-Pani (or “Hunza water”). Six of the remarkable centenarians said that they drank wine every day. At feasts, the Hunza freely drink their homemade wine. They consider it their secret for longevity and stress relief,3 and it could be yours too.

  RED WINE THROUGHOUT HISTORY

  “Wine is an appropriate article for mankind, both for the healthy body and for the ailing man.”

  —Hippocrates

  Wine has been part of human culture for thousands of years, not only as part of our diet but also part of our social and religious history. It predates Biblical times at least to the Neolithic period (approximately 10,000 BC), but it was almost certainly consumed much earlier. Alcohol was produced in practically every part of the world, differing only by what was used to make it. But was this elixir healthy, or was it harmful?

  Hippocrates, the father of modern medicine, believed that men should live on large quantities of “watered wine.”4 It was commonplace to mix wine with water to prevent overt intoxication. Sometimes wine was sweetened with honey. Hippocrates recommended wine as a disinfectant on wounds and even prescribed wine as a tranquilizer, an analgesic, and a diuretic.5 The ancient Greeks used wine as both food and medicine. They washed wounds with wine and used it as a medium for taking medicine.6

  The Greeks and the Romans believed the consumption of low doses of wine was beneficial to many aspects of health. The Greek physician Rufus of Ephesus, in the first century AD, wrote, “Wine is more praiseworthy for health than any other thing; however, anyone who drinks it must be wise, if he does not wish to suffer some irreparable ill.”7 This captures the essential dual nature of alcohol. In small doses, it can be highly beneficial, but it is toxic in large doses. In ancient Rome, Caesar ordered his soldiers to drink wine with meals to protect against gastrointestinal infections.