Healthy Longevity

What is covered in this review: Human and primate studies provide strong evidence that healthful plant-based diets low in saturated fat and cholesterol play a critical role in preventing erectile dysfunction (ED), and that there is a shared etiology between vascular ED and atherosclerotic cardiovascular disease. Cholesterol feeding, including from fresh egg yolk has been used in thousands of experiments to successfully accelerate the development of atherosclerosis across mammals, birds, and fish of herbivorous, omnivorous, and carnivorous nature (Tables 1-6). Cholesterol feeding has been used to induce atherosclerosis in >20 species of nonhuman primates, including the chimpanzee, and these adverse effects have been observed even at very low intakes and in part independent of increases in LDL cholesterol (Tables 2-4). In primate studies, saturated fat from animal fats and tropical oils has also been extensively used to accelerate the progression of atherosclerosis and induce heart at...

What is covered in this review: Dairy foods are widely recommended to promote health but have been associated with an increased risk of premature death when substituted for healthful plant-based alternatives. Meta-analyses of prospective cohort studies found that substituting whole grains, legumes, and nuts with a 200-245 g/day serving of dairy foods, including yogurt, was associated with between a 12% and 28% increased risk of all-cause mortality. A meta-analysis of Mendelian randomization studies involving 119,787 participants presented here found that a genetically predicted 1% increment in energy from total dairy was causally associated with an 8% increased risk of all-cause mortality compared to other typically consumed foods (Figure 1). Genetically predicted dairy intake was causally associated with a 44% increased risk of all-cause mortality in a subgroup analysis in which dairy foods likely predominantly displaced healthful plant foods. A meta-analysis of prospective cohort stu...

What is covered in this review: Ketogenic diets are often promoted to improve body composition but were found to have a negative effect compared to a minimally processed, very-low-fat, plant-based diet in an inpatient feeding study. A meta-analysis of 15 crossover, inpatient feeding studies presented here found that isocaloric substitution of fat with carbohydrate resulted in a 21.6 g/day greater reduction in fat loss (Figure 1). Greater fat loss occurred during the lower fat diets even when there was a rapid and sustained decrease in insulin secretion during carbohydrate restriction. Inpatient feeding studies and a meta-analysis of 21 randomized controlled experiments demonstrate that minimally processed and fiber-rich sources of carbohydrate also lead to lower energy intake, explaining the discrepancies in studies examining ad libitum intake. Large “lifelong” Mendelian randomization studies demonstrate a causal and permanent effect of substituting carbohydrate with dietary fat and gr...