8/19/2026
This is the sixth piece in my series about Eric Topol's book, Super Agers: An Evidence-Based Approach to Longevity.
After discussing ultra-processed foods, sweeteners, salt, carbohydrates, protein, fat, caffeine, alcohol, and red meat, Topol turns to the other side of the equation: What should we actually eat?
Good Food
1. A healthy diet is strongly associated with a longer healthspan and lower disease risk.
Large, long-term studies consistently associate healthy eating with a 15–20% lower risk of cardiovascular disease, as well as lower all-cause mortality, cancer and neurodegenerative diseases.
There also appears to be a dose-response relationship: the more consistently people eat healthy foods, the lower their risk of several major chronic diseases.
Topol's healthy eating list:
Fruits and vegetables
Legumes such as beans and lentils
Whole grains
Nuts and seeds
Olive oil and avocados
Fatty fish such as salmon and tuna
These are mostly whole or minimally processed foods, with plenty of fiber and healthy fats.
Olive oil, for example, has been associated with about a 20% lower risk of all-cause mortality, and consuming at least 7 grams a day was associated with a 28% lower risk of dementia in one large observational study.
Nuts and seeds are another interesting example. Despite being calorie-dense, eating a handful regularly has been associated with about a 20% lower risk of cardiovascular disease. Interestingly, nut consumption has also been associated with less obesity and weight gain rather than more.
So calories alone don't tell us whether a food is healthy. Food quality matters.
2. Fiber is one of the stars of the story.
Topol recommends roughly 30 grams of fiber a day, adjusted for age, sex, and body size.
A large body of research has associated high-fiber diets with lower risks of:
heart disease
type 2 diabetes
colon cancer
overall mortality
Fiber slows digestion, reduces blood-glucose spikes, helps regulate cholesterol, and supports a healthier gut microbiome.
One fascinating finding he mentions is that a high-fiber diet can actually reduce the number of calories absorbed by the body. In one randomized trial, participants eating a high-fiber diet absorbed more than 100 fewer calories per day, with some people absorbing more than 400 fewer.
In a memorable phrase, Topol describes it as “pooping calories instead of absorbing them.”
This is almost the opposite of the ultra-processed-food diet.
Ultra-processed foods tend to be easy to digest, highly palatable, and calorie-dense, while fiber slows digestion and helps regulate the metabolic response to food.
3. The Mediterranean diet: the best-supported dietary pattern.
Of all the dietary patterns Topol discusses, the Mediterranean diet has perhaps the strongest overall evidence behind it.
It emphasizes:
olive oil
vegetables
fruits
legumes
whole grains
nuts
fish and seafood
while reducing red and processed meat, sweets, and highly processed foods.
Evidence from large observational studies and several randomized trials—including the PREDIMED trial and the Lyon Heart Study—has associated the Mediterranean diet with lower risks of cardiovascular disease, diabetes, cancer, neurodegenerative disease, and overall mortality.
In older adults, a Mediterranean diet has also been shown to favorably affect the gut microbiome, reduce inflammation and frailty, and potentially support cognitive function.
Topol even discusses a “green Mediterranean” diet, which adds more plant-based foods while further reducing meat. A small randomized trial found improvements in LDL cholesterol, inflammation, blood pressure, and weight, although it was too small to establish long-term health outcomes.
So far, however, Topol doesn't claim that we have found a diet that is definitively better than the Mediterranean diet.
4. Taurine: promising, but not proven.
Taurine is an interesting example of how longevity research can move beyond established dietary advice.
Taurine levels appear to decline with age, and lower levels have been associated with diabetes, hypertension, abdominal obesity, and inflammation.
Animal studies are particularly intriguing. Taurine supplementation has been associated with improvements in mitochondrial function, DNA damage, inflammation, cellular senescence, and other markers of aging.
In aged rhesus monkeys, six months of taurine supplementation produced several promising improvements in health markers, including fasting glucose, bone density, and markers of mitochondrial, liver, and immune function.
Taurine-rich foods include shellfish, dark poultry meat, milk, yogurt, cheese, and peanuts. It is found in very few plant foods.
But an important caveat:
Promising animal research ≠ proven anti-aging treatment in humans.
We don't yet have randomized human trials demonstrating that taurine supplements extend healthspan.
5. Choline: important for the brain.
Choline is an essential nutrient involved in several important brain functions.
Good food sources include:
egg yolks
fish
meat
milk
soybeans
mushrooms
broccoli and other cruciferous vegetables
The recommended daily intake is about 550 mg for men and 425 mg for women.
For most people eating a varied, whole-food diet, getting enough choline shouldn't be particularly difficult.
There are some intriguing findings suggesting that higher choline intake or supplementation may benefit cognitive function in older adults. But once again, Topol emphasizes that randomized trials are needed before we can draw firm conclusions.
The bigger picture
Healthy aging is about establishing a dietary pattern that consistently gives the body the right inputs.
Eat more:
vegetables, fruits, legumes, whole grains, nuts, seeds, olive oil, and fish. Get plenty of fiber.
Eat less:
ultra-processed food, added sugar, sugary drinks, processed meat, and excessive alcohol.
And don't become obsessed with any single nutrient while ignoring the quality of the overall diet.
Don't ask only, “How many calories, grams of protein, or grams of fat am I eating?” Ask, “What kind of food am I putting into my body?”
For healthy aging, food quality and overall dietary pattern may matter more than chasing nutritional extremes.
