Calorie Restriction, Exercise, And Longevity: Luigi Fontana, MD PhD

With Mike Lustgarten

Love the dig at Attia around 21:00


“What is disgusting is that there are a lot of people out there that they claim to be experts of longevity, health and they say a lot of stupid stuff, exercise is the most powerful anti-aging intervention… we have… no evidence whatsoever.”


Also liked what he said about olive oil in his Sicilian grandmother’s day. A one-liter bottle would last the family of four a whole month. That comes out to about 8.3 g per person per day. Less than 2 teaspoons per day.


That’s great! I’ve always felt that pouring a lot of olive oil on food was crazy (unless a person has trouble eating enough calories. I don’t have this “problem“).


Yeah, it makes no sense to dump a bunch of 9 kcal/g substance of dubious nutritional value on your food. What a waste of calories. The main benefit is that it is fairly low in saturated fat as opposed to many alternatives. Regarding all that chasing after polyphenols, one can get many more olive polyphenols per kcal from green olives than from any olive oil. Castelvetranos are pretty good.

I suspect the healthiest diets are not as high in fat as what they are currently promoting.

But, having lived a very low fat (still whole foods, though) lifestyle for about six weeks in my early 30s (six weeks was as far as I could take it), I understand why truly low-fat whole foods plant based diets–the ones that reverse heart disease-- are not and will never be popular. It’s because they are torture.

Since then, I’ve relaxed somewhat on my fat intake and my diet as a whole. I do use olive oil, but drip drip instead of glug glug. I use nuts and seeds, but sparingly. The rest of my kcals come from foods that are not overtly high in fat. I cheat sometimes, too.


Luigi has a blind spot of pharma. That people who advocate for pharma drugs like statins are paid off is not a good argument. Statins are generic and cheap, there is no money in it. The coming CETP inhibitor and the current PCSK9 inhibitors seem like great lifespan increasing drugs too.

Rapamycin and Acarbose are also pharma drugs, if they work.


People on plant-based, whole foods, very high fiber, calorie restricted diets need neither statins nor acarbose unless they are genetically extremely unfortunate.

(not saying I need nothing–I do need digestive enzymes at age 60)

I am not even sure that rapamycin has an added benefit with such a diet, but I am hedging my bets with a low dose. Although, truth be told, it’s probably overkill in my case.

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I don’t think Michael Lustgarten or Bryan Johnson’s LDL is low enough to be optimal. Inhibiting PCSK9 or possibly CETP in the future could help with that.

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Michael thinks he will die sooner if he cuts back on the sardines. He’d probably do fine with 2-3x a week instead of daily.

Bryan’s diet isn’t really all that high in fiber. 70 lb of vegetables a month sounds like a mountain to most people but to many vegans–probably the ones who get the most benefit from their diets-- it is child’s play. In my heyday (late 30s-early 40s) I did 5 kg/day at 105 lb bodyweight.

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There is a limit how low you can lower LDL with diet, I don’t think if Michael decreased his sardine intake or Bryan increased his fiber intake it would decrease. There are ancestral factors limiting us and the only way around it to say “No!”. Only people who are born in perfect health are unwilling to modify themselves pharmaceutically.


Authoritarians having a go:

Lustgarten spots someone buying a can of Pringles



Excuse you. No money in it? Just statins:

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btw do you know if Luigi Fontana takes rapamycin?

I really enjoyed this interview, he is so insightful and down to earth. I bought both his books yesterday. :sweat_smile: Cookbook has some pretty good recipes on first glance. It is really similar to what I normally eat except I add some cheese, milk products like mozz or ricotta, yogurt… and eggs to my diet. Do you know what his protein recommendations are? I eat around 1,6g/kg protein per day which comes to just over 100 g… but I believe he advocates low protein diet? 0,8-1g/kg? I was indoctrinated by “bro science” that you can not keep muscle mass if CR(ON) if you don’t eat enough protein… maybe I need to revise this…


10% of kcals before age 65. 20% of kcals after age 65.

Edited to add, I think their rec is that no more than 30% of the protein should be animal.

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It struck me like a bolt of lightning when he said the rats that died of starvation in CR experiments were “perfectly healthy”. They died of too much autophagy.

Not too little and not too much (“U shaped curve”) applies to everything?


Sorry, I can’t help myself. :sweat_smile: :rofl: :joy: :sweat_smile: :rofl: :joy:


I don’t understand how people can eat like Lustgarten.
Taking a multivitamin and a statin or something, seem much more interesting. And on top of that rapamycin. Can still continue to eat in a way that someone likes, which can include pringles. There is little to no downside, you just basically have to take some pills. If someone has trouble with their weight - there are pills for that too nowadays.


My Crestor cost me about $5 a month right now.

10 mg Rosuvastatin on Costplusdrugs costs $5.90 for one month, if you take half that’s very low cost.
I don’t know how they’re making 1 billion a year. But they’ve earned it.

You are so data driven when it comes to studies on causality and here you fail big time. Lipid lowering medicines are one of the most profitable medicines. Do you know how much of this money went into marketing? Do you have any idea how marketing works in medicine?

Like in all drug segments, the drugs are highly profitable while you’ve got the patent protection. Once thats gone and it goes generic, the profits are like any highly competitive business; low.

Typically new drugs are patented soon after the are discovered, but then it takes a number of years to do the clinical trials to validate the drug works and the side effect profile is acceptable. The result is that the “patent life” of a drug, from a revenue-producing standpoint is typically 13 to 15 years. This is when the Pharma company’s legendary profit margins are maximal.

You are missing the point I was trying to make. Sure drugs are more profitable while patented but that doesn’t mean they are worthless or not profitable after the patent expires. In case of statins they still bring billions in revenue and since most of the marketing and was done when they were most profitable they are selling by itself now. Doctors are “indoctrinated”, they are part of insurance and national guidelines… when patents expire same companies go and develop another class of drugs for the same purpose and the cycle continues.
And marketing in medicine is really strong. Not just that you get monthly visits from company representatives, but also they are paying directly or indirectly a lot of medical research, conferences etc. They lobby insurance and national health policies. Pharma interests are everywhere and one need to take this into consideration. I am not saying just cause it is pharma you need to stay away, but some due diligence is always in order.