Your Longevity Blueprint: Part 1 — Eat Your Way to Better Health

Photo Credit: University of Delaware

The pursuit of longevity has been documented since the dawn of written history. A famous example is Emperor Qin Shi Huang, who longed for eternal life and dispatched his ministers on quests to find an elixir of immortality. However, regardless of the mechanisms the body possesses to resist infection, moderate oxidation and glycation, or repair DNA damage, none are sufficient; our biological systems simply cannot keep pace with the wear and tear.

While the maximum potential human lifespan is approximately 120 years, a more realistic goal—moving past the myth of immortality—is to live out a full biological span of ninety to one hundred years. The emphasis here is on the quality of life: remaining mentally and physically functional until the very end. As the saying goes, "You can't control the wind, but you can adjust your sails.

Your Longevity Blueprint: Part 1 — Eat Your Way to Better Health

8 Health Tips for Extending Your Healthspan

The following eight health tips are designed to help you reach your longevity goals:

1. Eat Your Way to Better Health
2. Maintain Mental Vitality
3. Nurture Your Relationships
4. Prioritize Essential Sleep
5. Manage and Reduce Stress
6. Connect with Your Community
7. Lead an Active Life
8. Practice Preventive Care

In this article, we will focus on the first tip, "Eat Your Way to Better Health," and will cover the remaining topics in future installments.

Mediterranean cuisine - The recipe for a long and healthy life? | DW Documentary (YouTube link)

How to Eat Your Way to Better Health  

A plant‑forward eating pattern can help reduce inflammation and support overall wellness. Focus on variety in fruits and vegetables, choose healthy fats, and limit highly processed foods. Pair these habits with regular physical activity and seek professional guidance for personalized needs. For evidence‑based frameworks, explore Dr. Li’s Eat to Beat Disease, Mediterranean‑style diet resources, or AICR recommendations.^[1-9]

Anti-Angiogenic and Cancer-Protective Foods

• Eat foods with Naturally-Occurring Antiangiogenic Substances: Foods like berries, green tea, soy, tomatoes, garlic, turmeric, and dark chocolate contain compounds (e.g., lycopene, EGCG, curcumin) that inhibit angiogenesis in lab/animal studies. Human evidence links higher intake to lower cancer risk (e.g., soy and breast/prostate; tomatoes and prostate). Strongest for overall plant-rich diets.

Antioxidant-Rich Foods

• Eat Antioxidant-Rich Foods: Antioxidants combat free radicals, reducing oxidative stress linked to aging, Alzheimer's, and cancer.
• Columbia study on anti-Alzheimer's foods (tomatoes, cruciferous/dark greens, fruits, nuts, fish): Plausible; observational data ties these to better cognitive health via reduced inflammation/DNA damage.
• Treat yourself to Chocolate (flavanols for heart/brain): Moderate dark chocolate (70%+ cocoa) linked to improved endothelial function and lower CVD risk.
• Go crazy for Cinnamon, spice up Your Life, Eat Curry (turmeric/curcumin): Turmeric's curcumin has potent anti-inflammatory/antioxidant effects; lab/human studies show benefits for heart health, potential cancer prevention, and reduced inflammation. Cinnamon may aid blood sugar control.

Superfoods and Specific Recommendations

• Top 10 Food Synergy Super Foods & Try Dr. Perricone's Superfoods (Acai, Allium family, barley, beans/lentils, buckwheat, green foods, hot peppers, nuts/seeds, sprouts, yogurt/kefir): Perricone's list (2000s anti-aging focus) overlaps with evidence-based foods high in EFAs, fiber, antioxidants. Acai has antioxidants but no superior evidence; alliums (garlic/onions) linked to lower cancer/CVD risk.
• Try Garlic for your heart: Strong evidence; allicin lowers blood pressure/cholesterol.
• Drink Tea (Green Tea): EGCG is antiangiogenic/antioxidant; linked to lower CVD/cancer risk.
• Put Vinegar in Everything: Limited evidence for blood sugar control and minor anti-inflammatory effects.

Healthy Fats and Oils

• Eat Good Fats (Avocado, Omega-3s): Supported; reduces inflammation, supports heart/brain health.
• Go for Olive Oil (2-2.5 tbsp daily for heart, blood pressure, free radical scavenging): Robust evidence from Mediterranean diet studies; monounsaturated fats/polyphenols (oleuropein, hydroxytyrosol) lower CVD risk, LDL oxidation, and inflammation.

Dietary Patterns and Habits

• Eat a Low-Glycemic Diet: Prevents blood sugar spikes; linked to lower diabetes, obesity, heart disease, and cognitive risks.
• Eat more Plant-Based Diets & Plant-based vs. Animal-based Diets (Dr. Hiromi Shinya's "You are what you eat"): Shinya emphasizes gut health/enzymes via plants; plant-heavy diets consistently show lower inflammation, CVD, and cancer risk.
• Eat Organic, Local and Seasonal Foods: Organic may reduce pesticide exposure; local/seasonal often fresher/nutrient-dense, but evidence for superiority is mixed.
• Eat several Smaller Meals: Mixed; some studies link frequent smaller meals to lower CRP/inflammation vs. large meals (post-meal spikes). Others show no difference or benefits from fewer meals (e.g., intermittent fasting).
• Take Folic Acid: Folate (from food) aids cognitive function/DNA repair; Dutch study supports better scores with supplementation.

Things to Limit or Avoid

• Avoid too much Caffeine & If You Drink Too Much Caffeine: Valid; excess (>400mg/day) causes anxiety, insomnia, high BP, dependency. Moderate is safe/beneficial.
• Know the dangers of Meat: Processed/red meat linked to higher colorectal cancer (observational); plant-based displacement of fiber-rich foods may explain much risk.
• Cut down on Sugar: Strong evidence; excess drives obesity, diabetes, inflammation, metabolic syndrome.
• Count Calories & Eat less live longer: Calorie restriction extends lifespan in animals; human evidence (e.g., Okinawa) links lower intake to longevity via reduced inflammation/oxidative stress.

References

1. Eat to Beat Disease (Dr William Li)
2. How to Prevent Cancer: 10 Recommendations (American Institute for Cancer Research)
3. Comprehensive Overviews and ReviewsThe Mediterranean diet and health: a comprehensive overview (2021) by Guasch-Ferré M, Willett WC.
4. Modern vision of the Mediterranean diet (2022) by Kiani AK et al.
5. Mediterranean diet and health status: Active ingredients and pharmacological mechanisms (2020) by Schwingshackl L et al.
6. Mediterranean Diet (StatPearls overview, updated regularly) by Daley SF et al.
7. The Mediterranean Diet and Cardiovascular Health (2019) by Martínez-González MA et al.
8. Classic and Foundational PapersMediterranean diet pyramid: a cultural model for healthy eating (1995) by Willett WC et al.
9. Definition of the Mediterranean Diet: A Literature Review (2015) by Davis C et al.

Evaluating Liver Health: Understanding FIB-4 Calculation and Interpretation

Liver Disease Stages

Cleveland Clinic encourages proactive screening for MASH (metabolic dysfunction–associated steatohepatitis), a progressive form of fatty liver disease previously known as NASH.^[1]

MASH currently affects an estimated 5–7% of U.S. adults, and its prevalence is projected to increase to about 7.9% by 2050, driven largely by rising rates of obesity and type 2 diabetes, according to studies published in Diabetes Care and by the American Liver Foundation.^[2]

What is FIB-4 Screening?

MASH occurs when excess fat accumulates in liver cells, causing inflammation and cellular damage. Unlike many medical conditions that rely on a single screening test, MASH lacks a universal diagnostic tool.

“The most effective approach is a two‑step screening strategy,” notes Dr. Laique.

1. Calculate the Fibrosis‑4 (FIB‑4) index: This is performed using routine blood tests.
2. Follow-up with VCTE (FibroScan): If the FIB‑4 index is elevated, vibration‑controlled transient elastography is used to assess liver fat levels (categorized as mild, moderate, or severe) and liver stiffness, which indicates the degree of fibrosis (scarring).

Fibrosis-4 index

The Fibrosis‑4 (FIB‑4) index is a simple, non‑invasive score derived from routine blood tests to estimate the risk of advanced liver fibrosis (scarring) in people with chronic liver disease—particularly MASH. It helps identify patients who may require further evaluation, such as advanced imaging (e.g., FibroScan) or referral to a specialist, while also ruling out low‑risk cases without the need for invasive procedures like liver biopsy.

FIB‑4 is recommended as a first‑line screening tool by organizations such as the American Association for the Study of Liver Diseases (AASLD), especially for individuals at higher risk, including those with obesity, type 2 diabetes, or metabolic syndrome.

Role in MASH Screening

• Why use it? MASH can progress silently to cirrhosis. Early detection of fibrosis allows interventions (lifestyle changes, weight loss, or emerging drugs like resmetirom) to halt progression.
• Screening process: In high-risk patients (e.g., type 2 diabetes, obesity), calculate FIB-4 from routine labs. If ≥1.3 (as mentioned in contexts like Cleveland Clinic resources), proceed to non-invasive imaging like FibroScan to measure liver stiffness and confirm fibrosis.
• Advantages: High accuracy for excluding advanced disease; reduces unnecessary referrals/biopsies.
• Limitations: Less accurate for intermediate fibrosis; can miss some cases in obese/diabetic patients. Often paired with other tests (e.g., ELF or NAFLD Fibrosis Score) for better precision.

Consult a healthcare provider for personalized calculation and interpretation, as values depend on individual labs and risk factors. Regular re-testing can track changes over time.

How is FIB-4 Calculated?

The formula uses four routine lab values:

• Age: Patient's age in years
• AST: Aspartate aminotransferase level (elevated in liver damage)
• ALT: Alanine aminotransferase level (often higher in fatty liver)
• Platelets: Platelet count (low counts suggest advanced fibrosis due to portal hypertension)

Notes:

• IU/L (International Units per Liter) and U/L (Units per Liter) both mean units per liter, and in clinical lab tests—such as AST, ALT, and ALP—they’re used interchangeably. One IU equals one U for these enzyme assays.
• ×10³/µL and ×10⁹/L are equivalent units for platelet counts—the numerical values stay the same.  For example, a range of 150–450 ×10³/µL (150,000–450,000 platelets per microliter) is identical to 150–450 ×10⁹/L in SI units.

These values are commonly available from standard blood tests, making FIB-4 cost-effective and accessible in primary care.

Interpretation of FIB-4 Scores (for MASH/NAFLD/MASLD)

Cutoffs vary slightly by guideline and population, but common thresholds for ruling out or identifying advanced fibrosis (typically F3-F4 stages) are:^[3]

FIB-4 Score	Risk Level	Interpretation	Next Steps
<1.3	Low risk	High negative predictive value (~90-95%); advanced fibrosis very unlikely.	Routine monitoring; no immediate further testing needed.
1.3–2.67	Indeterminate/intermediate	Possible fibrosis; further assessment required.	Proceed to second-line tests (e.g., FibroScan/vibration-controlled transient elastography for liver stiffness measurement).
>2.67	High risk	Likely advanced fibrosis (positive predictive value ~80%).	Refer to specialist (hepatology/gastroenterology); consider additional imaging or biopsy if needed.

Important Notes:

• Some sources use a lower low-risk cutoff (<1.45) or higher high-risk (>3.25), originally from hepatitis C studies, but for MASH, 1.3 and 2.67 are more commonly applied due to better performance in fatty liver populations.
• Age adjustment: FIB-4 performs best in ages 35–65; it may overestimate risk in older patients (>65) or underestimate in younger ones.^[6]

Source: AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease^[8]

References

1. Understanding Your MASH Test Results
2. Estimated Burden of Metabolic Dysfunction–Associated Steatotic Liver Disease in US Adults, 2020 to 2050
3. Use of the FIB4 Index for Non-Invasive Evaluation of Fibrosis in Nonalcoholic Fatty Liver Disease 
4. Fibrosis-4 (FIB-4) Index for Liver Fibrosis (Online Calculator)
5. FIB-4 (Fibrosis-4) Calculator
6. Age as a Confounding Factor for the Accurate Non-Invasive Diagnosis of Advanced NAFLD Fibrosis
7. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease
8. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease