Professor Fontana, first of all tell us about your long term research related with the Calorie Restriction Society.
My interest in calorie restriction (CR, in short) started in the 1990s, during my last years of medical school in Verona, Italy. I did read some interesting papers by Drs Walford and Weindruch on the incredible life-extending effects of CR with optimal nutrition in rodents. After I finished my residency in internal medicine, I wrote to Dr John Holloszy, a giant in lifestyle medicine, and a few months later I moved to St. Louis to work at Washington University in his laboratory. There, I conducted a series of pioneering studies on the long-term cardiometabolic, hormonal and molecular effects of dietary restriction, fasting and exercise in humans.
For those who want to know more, I just published an easy-to-read book, entitled ‘The Path to Longevity – How to reach 100 with the health and stamina of a 40-year-old’, where I tell the story of my journey at the discovery of the secrets of healthy longevity.
What is Calorie Restriction Society?
Over the years, I have studied master athletes and people following different diets, including lacto-ovo vegetarians, vegans and CR practitioners. In particular, I tested men and women who were members of the Calorie restriction Society. These individuals, who call themselves the CRONIES (Caloric Restriction with Optimal Nutrition), firmly believe that CR will enable them to live far beyond the average human lifespan. All of the CRONIES we have tested are extremely smart, well-educated and responsible individuals (business owners, physicians, college professors, lawyers and other professionals, etc.) who are extremely well read and informed in the areas of aging and CR. Few of them are now my best friends.
Our readers would like to know about the breakthroughs you have obtained in Nutrition and Healthy Aging.
CR may slow, or even revert, the accumulation of molecular damage with age
Data from the CRONIES and other clinical trials that we have conducted at Wash U clearly demonstrated that moderate CR with adequate vitamin and mineral intake markedly improves human health and drastically reduces inflammation, oxidative stress and other metabolic factors implicated in the pathogenesis of the most common chronic diseases, such as type 2 diabetes, hypertension, heart disease and cancer. Accumulating data suggest that more severe CR may slow, or even revert, the accumulation of molecular damage with age and slow cardiovascular aging.
When we speak about ‘healthy aging’ most imagine an older person who must focus on a healthy regimen while the truth may be far from it. What would be your recommendations for the young.
Trillions of dollars are spent every year to treat highly prevalent illnesses, which are largely preventable by implementing the best healthy lifestyle practices. Modern medicine focuses on diagnosing and treating diseases (only after they become clinically evident) one at the time, mainly with drugs and surgery. The problem of this approach is that many age-associated chronic diseases begin very early in life and progress over decades of unhealthy lifestyles, which trigger a wide range of physiologic, metabolic and molecular alterations deeply influencing the initiation, progression and prognosis of multiple medical conditions. In my new book, I explain several tricks that everybody can use to prevent, or at least to slow, the incremental build-up of cellular damage leading to metabolic dysfunction and tissue degeneration, eventually culminating in multiple organ pathologies.
How important is fasting?
Accumulating data suggest that severe CR is not needed, other less drastic interventions such as intermittent fasting, time-restricted feeding, protein or selective amino acid restriction may recapture some of the beneﬁcial effects of severe CR in modulating specific anti-aging pathways. As I describe in the manual “The Path to Longevity” endurance and resistance exercise, high-intense interval training, mindful meditation, and some sleep and slow-breathing techniques are also important to maximize health and promote emotional, creative and intuitive intelligence and wellbeing.
Indeed, ‘What we eat and what we do shapes not only our metabolic health, but also our emotions, and how our brain processes information and creates thoughts and ideas. Our thinking and ideas influence our actions that in time become our habits. A collection of habits forms a large portion of our personality. We don’t have to reach far to see that our habits, health and personality ultimately decide our success in life and our degree of freedom and happiness’.
Most people, especially those who are on a fitness regimen tend to increase their daily intake of protein substantially. Is this necessary?
No, it is not necessary, and it might be even detrimental. Robust clinical data show that the synthesis of new skeletal muscle protein reaches a plateau when we consume about 30g of protein at each meal. All the excess is oxidised, but at the same time activates a key pro-ageing pathway, called IGF-1/mTOR. Consuming more protein than what is required, therefore, will not increase muscle mass, but will promote obesity, type 2 diabetes and cancer, and can accelerate the ageing process. Moreover, as I explain in the last chapter of my book excessive animal food consumption contributes to global warming, pollution of the air and water, topsoil degradation, antibiotic resistance and viral pandemics such as the recent one due to covid-19.
Are those who live on a plant based diet physically weaker than meat eaters? And are meat eaters healthier?
I wrote an entire chapter on the beneficial but also potentially harmful effects of vegetarian diets. It is difficult to summarize all these concepts in a couple of sentences, but remember that are no shortcuts, no special diets or magic pills that can replace the beneficial effects of a comprehensive healthy lifestyle. If someone were to tell you that by taking a pill and a few lessons, you would become an accomplished pianist or a black-belt Karate Sensei, would you believe him? It’s easy to take someone’s word for it when you’re not knowledgeable. Moreover, we should bear in mind that what we eat, think and do affects not only our wellbeing and degree of success in life but also environmental and planetary health, which in a vicious circle impacts our risk of becoming ill. Everything is interrelated.
Please tell us about biological age as opposed to chronological age.
Twenty percent of human centenarians do not develop any chronic illness before reaching 100.
Chronological and biological age are not synonyms. If you smoke, eat unhealthy food, live a sedentary life and you are exposed to pollution and other toxins, your biological clock runs much faster. On chapter 3 of my book, I talk about these important concepts. The good news is that extensive data from experimental studies have shown that it is biologically possible to live a very long life without experiencing a cumulative increase in nasty and debilitating diseases. Twenty percent of human centenarians do not develop any chronic illness before reaching 100.
Please tell us about your growing up years, your self motivation and those who inspired you in these areas where you have become a figure of authority.
Smart folks never stop learning
My interest in preventative medicine and healthy longevity started many years ago when I was a teenager. My maternal uncle Francesco, who is a scholar in Eastern philosophies, taught me that our body is a temple in which our inner self can develop and empower itself. Although I was still enjoying time with friends and girlfriends, I spent a substantial amount of time to read, contemplate and meditate. I also started to learn hatha yoga. Empowered with this holistic vision, I progressed through 6 years of medical school, 5 years of residency in internal medicine, and 4 years of a PhD in metabolism. Immediately, it became clear that the teaching, and also the standard medical practice, were completely focused on diagnosing and treating diseases. I knew I did not want to spend the rest of my life prescribing the latest cholesterol-lowering or anticancer medication, a better walker or incontinence device. But at the same time, I did not want to practice alternative medicine either, because its scientific basis was very poor at best. So, with the generous support of my mother Antonietta, I decided to start a scientific career to dissect, with rigorous experiments, the mechanisms regulating healthy ageing. And, here I am, still learning and enjoying every single day of my life.
Our readers are mainly the youth from different parts of the world who look up to trailblazers and achievers such as you.
‘Life is beautiful. Being born on this spectacular planet, and being able to travel, experience and enjoy the marvels around us and, most importantly, inside us, is a gift. The most important one!’
Smart folks never stop learning, because they know that this is the way to deeper insights and revolutionary changes. As I tell in my new book a healthy and balanced diet coupled with exercise and cognitive training, deep sleep and meditation can maximise our physical and mental health and wellbeing, and our performance and success in life. However, I firmly believe that the cultivation of our inner strength and resilience should be our ultimate goal. ‘If we can learn how to travel the paths of life with confidence, if we can master how to experience life without anxiety or fear, but with curiosity, creativity, trust, serenity, kindness and compassion we can achieve our true potential.’
Photos: From the Archive of Professor Luigi Fontana