Eating ice cream and paths to a healthy, fulfilling life, according to Penn expert Ezekiel Emanuel
In his newly released book, titled "Eat Your Ice Cream," the Penn health policy expert and oncologist outlined his six evidence-based wellness rules.
University of Pennsylvania health expert Ezekiel Emanuel’s casual conversations often evolve into impromptu medical consultations.
People ask Emanuel — an oncologist, bioethicist, and health policy scholar who helped write the Affordable Care Act — how to live healthier.
He said that “incessant asking” inspired him at a time when both information and misinformation are booming in the wellness space.
His new book, “Eat Your Ice Cream: Six Simple Rules for a Long and Healthy Life,” landed on bookshelves in January. He uses the pages to argue that the goal of life should not be to simply live the longest, but rather to lead a healthy and fulfilling life.
The Penn professor, who has antique maps in his office and has taught a course on Ben Franklin, weaves in his appreciation for history throughout the book. Emanuel’s advice also addresses contemporary issues such as vaccines and vaping. And he shares personal family stories involving his father (to whom the book is dedicated).
In one of his favorite anecdotes, he describes looking for a cheap car to buy with his bar mitzvah money. Thinking he found a great deal on a Volvo, Emanuel and his brother bought the car, brought it home, and realized it couldn’t go in reverse.
“My father says, ‘You guys are schmucks!’” he recalled.
That became the first of his six rules: “Don’t be a schmuck — avoid self-destructive risks.”
The Inquirer spoke with Emanuel about tips for living a healthy life in a conversation lightly edited for length and clarity.
Why do you think wellness has become so big?
People feel like the world’s topsy-turvy. They’re not controlling it. It is controlling them. They want to assert control over the world, and one way they can do it is through wellness.
What have people gotten wrong about wellness?
Spending 10 hours a week on wellness, like some people recommend, is crazy. Just insane. You should not do that. You can spend two or three hours a week, get all the benefit you need, and focus your time on other things — your family, close friends, having a successful career, making the world better, making Philadelphia better. Those are the things that matter.
What does your first rule (Don’t be a schmuck) mean?
The first rule is, really, take reasonable risks, but not unreasonable risks.
The most dangerous thing most of us do in everyday life is turn the ignition on in our car. Driving is actually quite dangerous over a lifetime. And you have to compare the risk you’re willing to take to the risk of driving. I try to organize a chapter laying out unreasonable risks like BASE jumping [an extreme sport in which a person parachutes from a dangerous height]. Why is that so stupid? Well, look at the data. I try to make that assessment much more quantitative.
What is your second rule?
The importance of social relations.
It doesn’t get emphasized by almost anyone in the [wellness] field, and it’s vastly the most important for longevity, for health, and for happiness. We’ve got tons of data. There’s more than 3 million people who’ve been studied on the relationship between loneliness, social isolation, and ill health.
If you look at the Harvard Study of Adult Development, which started in the late 1930s, the single most important predictor of a long, healthy life with the fewest comorbidities is the number and quality of your social relationships.
Overall, a professor at Brigham Young University has summarized that being socially isolated is ‘like smoking 15 cigarettes a day.’
Tell us about your last four rules.
The third one is stay mentally sharp. If the body’s working fine, but cognitive decline has set in, that would be hell to me. I don’t want to live like that.
There are only a few people like Ben Franklin where it does not appear to decline at all. One of the things actually I learned after I finished the book is Franklin was the oldest person (aged 81) at the Constitutional Convention in 1787. He was still very nimble with his mind, able to put things together, to craft compromises and things.
Some of it’s obviously genes, but some of it’s also things you can do — what you can eat, how you exercise, your retirement, your strategies, social interaction, challenges, etc. The brain is a lot like muscle in that either you use it or you lose it.
The last three rules are the typical: eating well, exercising, and sleeping advice.
Are there things that you’d want the media to emphasize more when talking about wellness and health?
There are two really fundamental things on the ‘to do’ side for eating.
One is you should eat more fermented foods. Whether it’s yogurt or cottage cheese or aged cheeses or kimchi. It’s very important for the microbiome. In Philadelphia, one of our treasures is Di Bruno Bros. cheese shop. They have 200 cheeses on display. Go and get some cheese. It’s really good.
The other is that more than 90% of Americans don’t get enough fiber in their diet every day. You need to eat more fruits and vegetables. I start out every day by merging these two. This morning, I had a bowl of berries, or some kind of fruit, with yogurt, granola, and oats. I also added hemp hearts, which are high in protein, good fats, omega-3s and omega-6s. Then add a salad at dinner, and you pretty much have enough fruits and vegetables.
Can you explain the title of your book, “Eat Your Ice Cream"?
Ice cream is good. Dairy products are associated with higher height, especially if, early in life, you eat a lot of dairy. Second, [dairy consumption] is also associated with a lower risk of colorectal cancer, which is all in the news these days.
And most importantly, it’s about joy. It’s fun. Who doesn’t like ice cream? But it’s important to get good ice cream, not stuff with emulsifiers and fillers and all of that.
Have a little joy. It goes a long way toward making life lovely.