Everyone wants to live a long healthy life, but certain bad habits we pick up like too many late nights without proper sleep, eating excessive amounts of processed foods and not managing stress can impact your health in a very negative way. That said, it’s never too late to kick our unhealthy ways and adopt positive lifestyle changes that can add years to your life. Eat This, Not That! Health spoke with Endocrinologist Dr. Brian Fertig, M.D., F.A.C.E., Founder and President of the Diabetes & Osteoporosis Center who revealed five things to do that help you live longer. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

Dr. Fertig reminds us that “Nicotine is highly addictive, causing smoking cessation to be incredibly difficult, more difficult than it is for an alcoholic to stop drinking and is as addictive as heroin. The destructive impact it has on healthspan and lifespan  are widespread involving but not limited to: 1)the vascular system leading to heart disease, strokes, and leg amputations;2) lung disorders, including chronic obstructive lung disease (or COPD), bronchitis and asthma by damaging the airways; and 3) increased risk of many cancers, including the lungs, reproductive tract (cervix, and ovarian), gastrointestinal tract (esophagus, stomach, liver and pancreas), urinary tract (kidney, ureter and bladder), as well as well as mouth, throat and acute myelogenous leukemia (AML). There are other adverse effects of cigarette smoking as well, such as gum disease, tooth decay, darkening of the teeth and lungs and premature wrinkling of the skin.

Nicotine, in addition to being the addictive component of tobacco, is used as an insecticide which damages the nervous system of insects. It’s important to know that human and insect DNA is 60% exactly the same. That means our nervous systems share many of the same proteins, and therefore explains the neuroinflammatory effects of nicotine in the human brain, which in turn may lead to a host of neurodegenerative disorders such as multiple sclerosis, Parkinson’s, and Alzheimer’s disease, and even anxiety, depression and an exaggerated stress response. It also probably contributes to malignancies in the brain as well.6254a4d1642c605c54bf1cab17d50f1e

Among the roughly 7,000 chemicals in tobacco, there are about 70 known carcinogens. Some of the most toxic of these are polycyclic aromatic hydrocarbons (PAH’s), nitrosamines, a few of which are nicotine derived (although nicotine itself is not directly carcinogenic), and tar containing benzene and other cancer producing chemicals. Tar promotes gum and tooth decay, as well as darkening of the teeth and lungs. Black lung disease is most prevalent in coal miners. Arsenic and formaldehyde are also carcinogens in tobacco, the latter responsible for AML. Notably, while particular oxidizing chemicals are known to promote cancer forming DNA mutations, others are known, for example nicotine, carbon monoxide and the heavy metal arsenic, to promote vascular disease by oxidizing molecules of the blood vessels. It should be pointed out that inflammation is rooted in reactive oxygen species (ROS’s) from oxidizing chemicals. Inflammation and ROS’s amplify one another in feed forward fashion. However, it’s the ROS’s that are most fundamental to all forms of disease, and it’s the chemicals in tobacco that are oxidizing that make them dangerous.

The good news is that the hard work necessary to overcome cigarette addiction is well worth the effort. Vascular disease begins to improve immediately, and within 5 years the risk of a heart attack is significantly improved. By 10-15 years after smoking cessation the risk of cardiovascular events, such as a heart attack, heart failure, stroke and amputations is roughly the same as a non-smoker. The risk of cancer does not return to baseline, although there is a remarkable reduction in cancer risk compared to those who continue to smoke. Overall, smokers who quit by age 40 have a 90% decreased risk of dying from cigarette related diseases. It’s also inspiring that smoking cessation at age 60 carries a very significant risk of dying from cigarette related causes. Additional motivators to stop smoking include improved coloration of the teeth and nails, less gum disease and associated loss of teeth as well as improved fine facial wrinkling.

It must be appreciated how extremely difficult it is to stop smoking. It requires not only a determined will and goal oriented ambition to add years to life (lifespan) and life to years (health span), but a support system of family and friends, counseling (including available telephone quitlines), typically in addition to a willingness to supplement motivated behavior with one or more of the approved cigarette cessation medications, which include varenicline (Chantix), bupropion SR (Zyban) and a number of nicotine containing strategies (patches, lozenges and gum).”

“To imagine what a healthy diet is, think of the components of the Mediterranean diet,” says Dr. Fertig. “This diet consists of fatty fish (sardines, mackerel, herring, salmon, tuna fish (including canned), trout, cod, anchovies (in olive oil)), but also fish low in fat such as sea bass, crab, shrimp, and flounder. The fat in these fish are rich in healthy polyunsaturated omega 3 fatty acids. The diet also encourages olive oil (rich in monounsaturated omega 9 fatty acids from olives, avocados, nuts, and seeds), olives and other fresh fruits, berries, vegetables, nuts, seeds and fiber containing whole grains (for example buckwheat, barley, rye, and popcorn). The health benefits of the Mediterranean diet largely relate to its soluble fiber and nondigestible carbohydrates (“resistant starches” including legumes, whole grains, some vegetables, nuts), its healthy fat content, and the absence of refined and other non-nutritious dietary components.

The basic premise for why polyunsaturated omega 3 fatty acids and monounsaturated omega 9 fatty acids are healthy is that these get incorporated into the cell membranes of tissues increasing their fluidity. Conversely, an excess of omega 6 saturated fatty acids in cell membranes reduces it’s flexibility. In the latter case, for example insulin signaling is impaired leading to insulin resistance mediated disturbances and downstream chronic diseases, including diabetes, high blood pressure, lipid disturbances, cardiovascular disease, neurodegenerative diseases such as Alzheimer’s, and cancers. Dietary fibers are important for maintaining bowel pattern regularity, as well as allowing smoother absorption patterns of macronutrients such as sugars, to avoid swings in blood glucose levels.

Most important however is the intersection of these fibers with the gut Microbiota. This underscores the importance of the Microbiota composition and diversity in human health and disease. Healthy microbes outnumber the total number of cells of the body by a ratio of 4:1-> 10:1. Moreover, the human genome is less than 25,000 genes compared to the composite Microbiota gene pool of about 3 million. Humans do not have the genes to produce the enzyme to break down fibers, which rely on healthy microbes to do this task. The breakdown products of microbe digested fibers include short chain fatty acids (SCFA’s) which have many crucial effects on our physiology. These include: serving as an energy source for cells lining the large intestine, protective against colon cancer, improving insulin sensitivity, preventing weight gain by increasing satiety, and reducing inflammation in fat cells, the liver, other tissues and the brain.

Taken together, the Mediterranean diet reduces not only cardiovascular disease and mortality, but it reduces dementias and all-cause mortality by 75%. This is a greater reduction in mortality than has been demonstrated by every currently available pharmaceutical drug on the market combined.”

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Dr. Fertig explains, “It is very important to appreciate that a healthy body mass index is not just about body weight, and even body fat mass, but should account for muscle mass and fat storage capacity. That is, the greater the number of fat cells and the larger the size of these fat cells, the greater the storage capacity for fat. That is, one person with massive body fat and huge folds of pendulous fat may be so called ‘metabolically healthy obese,’ with normal insulin sensitivity in the absence of overfilled fat cell storage capacity and inflammation. Another person who appears relatively thin may have engorged insulin resistant fat cells spilling lipid into the circulation, causing high triglycerides and uptake into tissues systemically where fat storage damages the function of these tissues (e.g. the heart, skeletal muscle, liver, pancreas, and brain). In the former case, the body habitus tends to be skewed towards large thighs and buttocks, whereas in the latter case, the thighs and butt may be small with a mildly protuberant belly. Noteworthy is that ~25% of obese people are metabolically healthy. Unfortunately, the caricature of public opinion around body weight is misleading, and updated criteria measurement tools are needed. For the time being, markers of insulin sensitivity such as blood lipid and glucose levels, blood pressure and waist to hip ratio measurements should be followed, in addition to a healthy diet and active lifestyle.”

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Dr. Fertig states, “Moving of any type is important. Generally, 30 minutes of moderate activity 5 days a week will have significant health benefits. Resistive muscle training is also very important and has additional effects promoting weight loss than just caloric expenditure. Specifically, it leads to the release of a hormone from muscle cells that result in the transformation of fat storing white adipose tissue (WAT) to fat burning beige adipose tissue (BAT). The hormone mediating this effect, called Irisin, was discovered in 2012 by Dr Bruce Spiegelman from Harvard, who was the recipient of the prestigious Banting Award for the discovery. Surprisingly, there has not been widespread awareness of this. While resistive and aerobic exercise promotes muscle and CV fitness, it also improves metabolic efficiency of all tissues at the cellular level. Accordingly, this imparts a roughly 33% reduction in all cause mortality. It’s beneficial effects on tissues widespread throughout the body include improved bowel motility and blood pressure, lower heart rate, lower glucose, and lipid levels in diabetics and pre diabetics, improved depression, anxiety and cognitive scores, lower body weight, improved bone density and risk of hip fracture. Moreover, it reduces the risk of a host of cancers including esophageal, stomach, colon, breast, endometrial, bladder, kidney and lung.”

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According to Dr. Fertig, “The toxic stress response is inseparable to all metabolic and chronic disease. Not only does the prolonged perception of uncontrollable stress promote disease by disturbing immune function, gut Microbiota, and desynchronized circadian physiology within and between tissues, all of these stress effects result in inflammatory mediators that feedback on the brain, causing an exaggerated activation of the stress response. Social stressors are particularly toxic.  An important reason for this is that in addition to stressful conflict, it often isolates us from the support systems that are relied upon to promote resilience. To use a physics analogy, support systems spread stress over a wider mass.  A healthy body weight, diet, activity levels and cigarette smoking cessation all improve physiological health and inflammation, and consequently the stress response.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.