Diet, Lifestyle, and Longevity—The Next Steps?

Nearly 50 years ago, Keys^1,2 recognized the enormously divergent rates of heart disease around the world, even after adjusting for differences in age. Although coronary disease was and remains the leading cause of death in the United States and many developed and developing countries, it was almost nonexistent in the traditional cultures of Crete and Japan.¹ Rates of cancer at various sites also differ enormously—up to 100-fold—in different populations.³ The rapid changes in rates of many of these diseases over time and studies that show increases in chronic disease rates among migrants from traditional to Westernized cultures demonstrate that relatively swift changes in disease rates cannot be attributed solely to genetic differences between populations.⁴ Instead, they are likely due to differences in lifestyle, with dietary factors and physical activity the leading candidates.