Drop Dead Healthy

Prologue

FOR THE LAST FEW MONTHS, I’ve been assembling a list of things I need to do to improve my health. It’s an intimidatingly long list. Fifty-three pages. Here’s a sample:

• Eat leafy green vegetables

• Do forty minutes of aerobic exercise a day

• Meditate several times a week

• Watch baseball (lowers blood pressure, according to one study)

• Nap (good for the brain and heart)

• Hum (prevents sinus infections)

• Win an Academy Award (A bit of a long shot, I know. But studies show Oscar winners live three years longer than non–Oscar winners.)

• Keep my apartment at sixty-two degrees, which makes my body burn more calories a day

• Buy a potted Areca palm plant (filters dirty air)

• Lift weights to muscle exhaustion

• Become an Okinawan woman (another long shot)

And on and on.

By the way, I’ve printed this list in nine-point Papyrus font, because I found a study that says hard-to-read fonts improve memorization.

I want to do everything on my list because my quest isn’t just to be a little bit healthier. My quest isn’t to lose a couple of pounds. My quest is to turn my current self—a mushy, easily winded, moderately sickly blob—into the embodiment of health and fitness. To become as healthy as humanly possible.

I’ve been intrigued by the topic of health and fitness for years. But the idea of devoting myself to the cause occurred to me during a recent vacation. It was supposed to be a relaxing week with the family in the Dominican Republic. Sand castles would be built. Boggle would be played. Soda would be ordered without ice.

Instead, I ended up in a Caribbean hospital for three days with severe pneumonia. I expected some jet lag, maybe a skittish stomach. But tropical pneumonia? That took me by surprise.

I’d read plenty about the importance of gratitude. So as I lay wheezing and shivering on my thin hospital mattress, I tried to find things to be thankful for. For instance, my hospital visit gave me the opportunity to learn new Spanish words such as “lung” and “pain” (pulmón and dolor, respectively). Also, roosters outside my hospital window woke me up every morning, which is marginally more charming than New York car alarms.

Neither of these observations helped much. But I found one big upside, a life-altering one. This experience was a seventy-two-hour-long memento mori. For one of the few times in my life, I was certain I was about to leave this world. Now, maybe this fear was melodramatic, but in my defense: If you were hooked up to an IV drip with a rainbow of unknown liquids (clear, yellow, blue, pink), if you saw doctors speaking in hushed tones while stealing glances at you, if you couldn’t breathe without wincing, if your mind was fogged in by viruses, you might think what I did: The only way I’m getting out of here is on a stretcher covered by a sheet.

My dread was more focused than any I’d ever experienced. Probably because of my three young sons. I want to be around to see them grow up. I want to be there for their graduations, their marriages, yes, but I also want to see them sing their first Led Zeppelin karaoke song and eat their first jalapeño pepper. I want to be around to teach them the importance of having compassion and why the original Willy Wonka is superior to the remake. I worked myself into quite a state by imagining all of the memories I’d never have.

The thing is, I’m forty-one. I can no longer take my health for granted. Catching pneumonia is just one sign that I’m deteriorating. My bones are becoming lighter and more porous. My muscles are shriveling. My brain is shrinking, my arteries narrowing, my coordination slowing. I’m losing 1 percent of my testosterone a year.

And I’m fat. Not morbidly obese. I’m what’s described as skinny fat. A python-that-swallowed-a-goat type of body. Which I’ve learned is the worst kind of fat. So-called visceral fat (which surrounds the liver and other vital organs) is considered much more dangerous than subcutaneous fat (the kind under the skin that causes cellulite). In fact, the size of your waistline is one of the best predictors of heart disease.

My wife, Julie, has been nudging me for years about my growing belly. She’s got a repertoire. She’ll refer to me as Buddha. Or she’ll ask, “So, when are you due?” When she wants to be especially subtle, she’ll just whistle the Winnie-the-Pooh theme song as she walks by.

She tells me she doesn’t care about whether or not I look fat. She says she just wants me to take care of myself so I’m around for a while. A couple of years ago, she sat me down at the dinner table, put her hands on mine, looked me in the eyes, and told me: “I don’t want to be a widow at forty-five.”

“I understand,” I replied solemnly. I pledged to join a gym, and at the time, I meant it. But inertia is a powerful force.

So I did nothing. I continued eating food packed with empty calories—lots of pasta and corn-syrupy cereal. There was a notable lack of anything green at my meals, not counting bottles of Rolling Rock. My exercise regimen was just as bad. I hadn’t done serious aerobic exercise since college. I got winded playing hide-and-seek with my sons.

And then I found myself in the hospital gasping for air. And so, right about when the nurse came into my room bearing a pill the size of my middle toe, I made a pledge: If I make it out alive, my next project will be about revamping my body.

I say “next project” because this book isn’t my first foray into radical self-improvement. Over the last decade, I’ve had a bit of a fixation. Studies show it’s healthy to have a purpose in life, and mine has been a relentless, well-intentioned if often misguided quest for perfection. Project Health will be the third leg of a triathlon devoted to upgrading my mind, my spirit, and my body.

Some quick context: The mind was first. After college, away from research papers and seminars, I worried my brain was slowly turning to the consistency of Greek yogurt (which is on my list of foods to eat, incidentally). I could feel my IQ gently ebbing away. So I came up with a fix: I pledged to read the entire Encyclopaedia Britannica and learn everything I could. It was an extreme measure, sure, but not without family precedent. I got the idea for this quest from my father, who had started to read our Britannica set when I was a kid but only made it up to the letter B, around “Borneo” or “boomerang.” I wanted to finish what he began and remove that black mark from our family history.

The alphabetical journey—which I chronicled in my first book—was painful at times. Including for those around me (my wife started to fine me one dollar for every irrelevant fact I inserted into conversation). And frankly, I’ve forgotten 98 percent of what I’d learned. But it was also an amazing experience. Uplifting, even. After eighteen months of reading about the sweep of history, I emerged with more faith in humanity. I read about all the unfathomably evil things we’ve done, but also all the mind-boggling good ones (the art, the medicine, the flying buttresses of Gothic cathedrals). On balance, it seemed the good outweighed the bad, if only by a sliver.

Having checked off the mind, I was inspired enough to work on my spirit. I chose this next because I grew up without any religion or spirituality at all. As I wrote in a book about this project, I’m Jewish, but I’m Jewish in the same way the Olive Garden is Italian. Not very. But my wife had just given birth to our first son, and we were grappling with what to teach him about our heritage. So I decided to learn the Bible inside out—by living it.

I chose to follow all of the Good Book’s hundreds of rules. I wanted to obey the famous decrees, like “love thy neighbor” and the Ten Commandments. But I also wanted to pay attention to the often ignored, lesser-known rules, such as “don’t shave your beard” and “don’t wear clothes of mixed fibers.” I wanted to see which would improve my life and which were not so relevant to twenty-first-century America.

It was another experience that was simultaneously profound and absurd, manufactured and life-changing. When the year ended, I shaved my Ted Kaczynski–like facial hair and started wearing poly-cotton blends again, but I’ve kept much from my biblical life. I try to observe the Sabbath, for instance, and to be grateful, and to avoid gossiping. “Try” is the key word here, especially on the gossip one.

Which brings me to the final quest, the last leg of the bar stool: Remake my body.

As with my other adventures, this one is fueled, in good part, by ignorance. I know astoundingly little about my own body. I know the small intestine comes before the large intestine. I know the heart is the size of two fists and that it has four chambers. But the Krebs cycle? The thymus? Presumably I read about them in the encyclopedia, but they are not in the 2 percent I retained.

And even more to the point, I don’t know what to eat or drink or the best way to exercise. It’s a bizarre situation. It’s like owning a house for forty-one years and being unaware of the most basic information, such as how to work the kitchen sink. Or where to find the kitchen sink. Or what this so-called kitchen is all about.

I see this project as a crash course in my own body. I’ll be a student of the strange land inside my skin. I’ll try out diets and exercise regimens. I’ll test drugs and supplements and tight-fitting clothes. I’ll experiment with the most extreme health advice, because, as I learned in my year of living biblically, only by exploring the limits can you find the perfect middle ground.

At the end of the project, I probably won’t keep up all my healthy behaviors, but I’ll keep a bunch. I’ll find the ones that work best. And that, I hope, will keep me alive long enough to teach my kids how to be healthy.

The Warm-up

As with any physical endeavor, you need to warm up. You can’t just start doing squats and eating kale without knowing what’s what.

First thing I did was to assemble a board of medical advisers. I don’t have an M.D. After my name, but—through luck and persistence—I do have access to the best health minds in the country. It’s a somewhat ad hoc group, but varied and esteemed and far more knowledgeable than I.

I’ll be getting advice from Harvard professors and Johns Hopkins researchers, from top-of-their-field doctors and from fitness trainers with biceps like cantaloupes. My aunt Marti will weigh in. She is the single most health-minded person in America, and has a mail-order business that sells powdered blue-green algae supplements and organic hand sanitizers. She lives in Berkeley and will be giving me a distinctly Californian point of view.

When I called her to tell her about the project, she was thrilled at first, then appalled. “You’re doing a project on health and you’re calling me from your cell phone?” She went on to lecture me on its brain-frying dangers. And for calling too late, since staying up at night disrupts my circadian rhythm.

I’ve been devouring health books and magazines and blogs. I’ve read at least fourteen articles on the benefits of blueberries. I’m steeped in my omega-3s and flavonoids. I know a lat from a delt, fructose from sucrose, HDL from LDL. I know that you should eat a lot of the Indian spice turmeric, as it fights cancer. Also that you should avoid the Indian spice turmeric, as it might contain dangerous levels of lead. One or the other.

The research so far has been fascinating, often confusing—but heartening overall. Admittedly, I’m saddled with twenty-three pairs of chromosomes I can’t change, at least not yet. But there’s so much I can control. An estimated 50 percent of our health is determined by behavior. Our well-being is an accumulation of hundreds of little choices we make every day—what to eat, drink, breathe, wear, think, say, watch, lift, and smear on our skin.

My timing is lucky as well. This is a good era in which to pursue total health. We’ve had more medical advances in the last thirty years than, arguably, in the last millennium.

But I also have to be careful. I’ve spotted an astonishing amount of what even I—with my currently limited expertise—can tell is quackery. You’d think that with the steady march of science, the dubious health advice would have faded since the days of “Dr. Hammond’s Nerve Medicine and Opium Blend.” Not so.

Thanks to the Internet, just about any quarter-baked idea ever conceived still gets traction. Case in point: trepanning, a practice that dates back to 6500 BCE and involves drilling a hole in the skull to let out evil spirits.

I did an Internet search. And guess what? It’s still around. Check out the International Trepanation Advocacy Group. Its website features images of green-tinted brain scans next to doctors in white lab coats writing complicated math equations on boards. Apparently, this is not your caveman’s trepanation. No, this is totally scientifical drilling of holes in your skull.

Now, quackery can be interesting and even important. (For instance, one of the leaders of the 1773 Boston Tea Party riled up the protesters by claiming that tea was hazardous to the health; so our very country is founded on absurd medical claims.)

But I want this project to be an evidence-based makeover. I want to separate the hard science from the squishy claims. I’ve got to be wary of the Latest Study Syndrome. Our brains are unduly drawn to whatever yesterday’s study revealed—Look at that! Bacon IS healthy—especially if the conclusion is surprising and counterintuitive and delicious. Each study needs to be weighed against the mountain of existing data. I want to focus on the meta-analyses. Or better yet, meta-analyses of meta-analyses. I’ll be seeking second opinions, but also third, fourth, and eighth opinions. I’ll be consulting the Cochrane Collaboration, which sounds like a shady international conspiracy but is actually a nonpartisan group that reviews medical studies.

The trick, though, is to avoid quackery at the same time as maintaining childlike enthusiasm for innovation. Because cutting-edge medical science veers into the surreal. It’s a world where mice live twice as long when they’re on the verge of starvation, and where electromagnetic pulses to the brain can temporarily improve memory and creativity.

I read a quote from Carl Sagan that I printed out and put on the wall above my computer. It will be my guide:

What is called for is an exquisite balance between two conflicting needs: the most skeptical scrutiny of all hypotheses that are served up to us and at the same time a great openness to new ideas.

The Battle Plan

What does it mean to be maximally healthy? Courtesy of the World Health Organization’s definition of health, I’ve broken it down into three parts:

1. Longevity

2. Freedom from disease and pain

3. A sense of emotional, mental, and physical well-being

If I can have those three, I’ll be ecstatic. It’d be nice to get a six-pack, but it’s not my top priority—unless I decide I need shredded abs for emotional well-being, as many magazines seem to imply.

I’m going to quantify my progress as best I can. Granted, the longevity part will be tough to measure, unless I happen to die during my project. Which would be embarrassing but would certainly provide some closure. But the other two, thankfully, are testable.

To quantify how badly off I am at the project’s start, I visited a clinic in Rockefeller Center called EHE, short for Executive Health Enterprises.

The website boasts of the company’s illustrious history: EHE has been doing preventive medicine since 1913. The founding chairman of its board? Former president William Howard Taft. Which, frankly, isn’t the first name that comes to mind when you think of healthy living. This is a man who got stuck in the White House bathtub and had to be lifted out by four government employees.

But still, EHE is a classy joint filled with reputable doctors, free fruit salad, and fancy clientele from law firms and banks. It offers a top-to-bottom physical and a full report card on your body. I went one morning, and it took three hours and involved six vials of blood, forty-two tests, six nurses, and eleven horrific minutes on a treadmill.

Here’s what they found:

Height: 5'11”. Weight: 172 pounds. Body fat percentage: 18. Total cholesterol: 134 (it used to be over 200, but I’ve been taking Lipitor for three years). I’m myopic. I have abnormally low hematocrit, which means the percentage of red blood cells is depressed, which could explain my fatigue. I have a heart murmur and elevated liver enzymes.

Far from perfect, but not terrible. Overall, I should be grateful I don’t have any debilitating diseases. Just the usual American sloth-related maladies.

Though I should mention this was just the first test. In the coming months, I will submit myself to dozens of additional exams and find out an alarming number of other things wrong with me. Among them: sleep apnea, depleted iron, deviated septum, collapsed nostril, precancerous skin growths, and, particularly embarrassing for someone who works at a men’s magazine: low testosterone. But I’m getting ahead of myself.

As my start date approached, I realized just how overwhelming being maximally healthy is. It will consume my every waking hour, and my sleeping ones, too.

I need some structure. Taking a cue from the digestive system, I’ve decided to break my project down into smaller, bite-size chunks. I will improve my body one part at a time. I will attempt to have the healthiest heart and the healthiest brain. But also the healthiest skin, ears, nose, feet, hands, glands, genitals, and lungs.

I know all the body parts are all linked on some level. But I want to lavish some individual attention on each.

And where to start? Since diet is such a huge part of health, I’ve chosen the stomach as my jumping-off point. The first part will be about what to put in my Buddha-like belly.