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Dean Pomerleau

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  1. Dean Pomerleau

    My random notes/stream of consciousness thread

    OK Guys, You got me. Inquilinekea is one of my bots. 🙂 But seriously. We've been discussing who is Alex K Chen (aka InquilineKea) and why he asks so many questions for years. Here is one example. There is even a thread about him that I started in 2016 on the admin/moderator board for these fora called "Mr. Questions - Alex K Chen (aka InquilineKea)". We concluded he is harmless, and very occasionally makes thoughtful contributions rather than just asking questions (e.g. here). He was even active on the CR mailing list back to at least 2012 before these fora were created (search "simfish" Tom). We've had it easy for the last few years since Alex went quiet here around 2017. But he's continued to ask lots of questions (and answer quite a few) on Quora. His Quora profile shows he has asked 62K questions since 2013. Here is a good one. He's also very active on Reddit. If he's a bot, he is a very good one, and he has got a very elaborate back story (see his Quora profile). I for one welcome our new AI overlords. 🙂 --Dean
  2. Dean Pomerleau

    Acarbose better than Metformin?

    Evidence? This appeared to be true in one of Luigi Fontana's early study of some of us [1], but that appeared to be mediated by the relatively high protein diets many of us were eating at the time and subsequently discontinued. I'm not aware of more recent evidence that most CR folks have elevated IGF-1. I for one do not. --Dean ----- [1] Aging Cell. 2008 Oct;7(5):681-7. Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans. Fontana L, Weiss EP, Villareal DT, Klein S, Holloszy JO. Abstract Reduced function mutations in the insulin/IGF‐I signaling pathway increase maximal lifespan and health span in many species. Calorie restriction (CR) decreases serum IGF‐1 concentration by ~40%, protects against cancer and slows aging in rodents. However, the long‐term effects of CR with adequate nutrition on circulating IGF‐1 levels in humans are unknown. Here we report data from two long‐term CR studies (1 and 6 years) showing that severe CR without malnutrition did not change IGF‐1 and IGF‐1 : IGFBP‐3 ratio levels in humans. In contrast, total and free IGF‐1 concentrations were significantly lower in moderately protein‐restricted individuals. Reducing protein intake from an average of 1.67 g kg−1 of body weight per day to 0.95 g kg−1 of body weight per day for 3 weeks in six volunteers practicing CR resulted in a reduction in serum IGF‐1 from 194 ng mL−1 to 152 ng mL−1. These findings demonstrate that, unlike in rodents, long‐term severe CR does not reduce serum IGF‐1 concentration and IGF‐1 : IGFBP‐3 ratio in humans. In addition, our data provide evidence that protein intake is a key determinant of circulating IGF‐1 levels in humans, and suggest that reduced protein intake may become an important component of anticancer and anti‐aging dietary interventions. PubMed PMID: 18843793; PubMed Central PMCID: PMC2673798.
  3. We touched on this topic earlier in this thread. I'll observe again that the state of the stock market often does not reflect the current state of the broader economy. I'm not saying we won't see a serious correction, especially if there is a big second wave in the fall. But there is a pretty good argument to be made that with the fiscal and monetary policies in place, this may simply be another case by which the system is rigged so the rich (capital owners) getting richer and the poor (labor class & small business owners) getting poorer. Part of it is that the stock market and the major indices are dominated by large companies (esp tech) and they are forward looking, with 90% of the value of stocks coming from the discounted future corporate earnings beyond the one year time frame. Equity investors believe that we will get past this and strong companies will weather this downturn, with many of them (e.g. Amazon or Costco) gaining market share when mom and pop stores go belly up. Here is Jim Cramer making this argument better than I can. It doesn't seem fair or healthy for our society, but contrary to your assessment Annik, it does make some sense. --Dean
  4. Thanks Gordo. Here is another interesting look at the timeline of deaths from covid-19 among different countries from ourworldindata.org: --Dean
  5. Dean Pomerleau

    Nuts and Mortality

    Al Pater posted the following prospective study [1] (thanks Al!) on the association between nut intake and mortality amongst a group of 20,000 middle aged Italians. It found that compared with people who didn't consume nuts, people who consumed them more than 8 times per month had about a 50% reduction in all-cause mortality risk during the 4 years of followup, largely due to reduced cancer risk. They found the nut eaters also had lower levels of inflammation. Not surprisingly, nut consumption was more beneficial for those who otherwise didn't adhere to a Mediterranean diet. More evidence that nuts are a very healthy food! --Dean ------------- [1] Br J Nutr. 2015 Sep;114(5):804-11. doi: 10.1017/S0007114515002378. Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study. Bonaccio M(1), Di Castelnuovo A(1), De Curtis A(1), Costanzo S(1), Bracone F(1), Persichillo M(1), Donati MB(1), de Gaetano G(1), Iacoviello L(1). Author information: (1)1Department of Epidemiology and Prevention,IRCCS Istituto Neurologico Mediterraneo,Neuromed,86077 Pozzilli,Isernia,Italy. Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation. We conducted a population-based prospective investigation on 19 386 subjects enrolled in the Moli-sani study. Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ. C-reactive protein, leucocyte and platelet counts and the neutrophil:lymphocyte ratio were used as biomarkers of low-grade inflammation. Hazard ratios (HR) were calculated using multivariable Cox proportional hazard models. During a median follow-up of 4·3 years, 334 all-cause deaths occurred. As compared with subjects who never ate nuts, rare intake (≤2 times/month) was inversely associated with mortality (multivariable HR=0·68; 95 % CI 0·54, 0·87). At intake ≥8 times/month, a greater protection was observed (HR=0·53; 0·32, 0·90). Nut intake (v. no intake) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet (MD). A significant reduction in cancer deaths (HR=0·64; 95 % CI 0·44, 0·94) was also observed, whereas the impact on CVD deaths was limited to an inverse, but not significant, trend. Biomarkers of low-grade inflammation were reduced in nut consumers but did not account for the association with mortality. In conclusion, nut intake was associated with reduced cancer and total mortality. The protection was stronger in individuals with lower adherence to MD, whereas it was similar in high-risk groups (diabetics, obese, smokers or those with the metabolic syndrome), as compared with low-risk subjects. Inflammation did not explain the observed relationship. PMID: 26313936 [PubMed - in process]
  6. Thanks Tom. This result appears to confirm the earlier finding that A-type blood increases risk of a bad outcome while O-type blood decreases risk. From the article: A lead SNP was also identified on chromosome 9 at the ABO blood group locus, and further analysis showed that A-positive participants were at a 45% increased for respiratory failure, while individuals with blood group O were at a 35% decreased risk for respiratory failure. The authors say that early clinical reports have suggested the ABO blood group system is involved in determining susceptibility to COVID-19 and has also been implicated in susceptibility to SARS-CoV-1. Meanwhile the big hydroxychloroquine for covid-19 treatment study in the Lancet was retracted today over questions about the data. The medical research community has made some unfortunate missteps during this crisis, undermining its credibility. Hopefully it won't spill over into the vaccine development effort. --Dean
  7. Thanks Gordo! Those results are somewhat encouraging. But I say only somewhat because of some of the limitations of the study. For example: These were tests of surgical masks, which aren't the cloth masks the CDC is recommending, although some of us are lucky enough to have access to surgical masks making the study more relevant. As you point out, the "coronavirus" patients in the study didn't have SARS-cov2, but one of the seasonal coronaviruses that we refer to as part of the "common cold" family. All the participants in the study were symptomatic and what we're mostly worried about is preventing asymptomatic / pre-symptomatic spread via mask wearing. Building on #2, most of the people tested were coughing quite a bit during the data collection sessions. For example, the coronavirus patients coughed a median of 17 times during the 30 minute collection session. Again frequently coughing people aren't what we're really worried most about. In the few sessions where the patients didn't cough, there was no virus detected in either the droplets or aerosols collected in the coronavirus patients: A subset of participants (72 of 246, 29%) did not cough at all during at least one exhaled breath collection, including 37 of 147 (25%) during the without-mask and 42 of 148 (28%) during the with-mask breath collection. In the subset for coronavirus [who did not cough] (n = 4), we did not detect any virus in respiratory droplets or aerosols from any participants. In the subset for influenza virus (n = 9), we detected virus in aerosols but not respiratory droplets from one participant. In the subset for rhinovirus (n = 17), we detected virus in respiratory droplets from three participants, and we detected virus in aerosols in five participants. This last point makes me question somewhat the relevance of these results for prevention of the spread of the SARS-cov2 virus, since it is thought that this virus is unusual in its ability to proliferate in large quantity in the throats of asymptomatic and pre-symptomatic individuals and then spread through respiratory droplets and aerosols generated while talking or simply breathing. If other viruses, including other coronaviruses don't seem to spread in the same way, it may be that surgical masks or especially cloth masks, won't be effective at preventing SARS-cov2 spread. Having said this, it seems intuitive to me that both cloth masks and more so surgical masks should provide some level of protection against the spread of SARS-cov2 and this study provides some evidence to support this intutition. So it seems to me wearing a mask should reduce the risk of transmission at least by a bit, so long as one doesn't engage in more risky behavior as a result of believing masks will dramatically lower your risk on contracting and/or spreading the virus, i.e. the well known phenomenon of "risk compensation". --Dean
  8. I learned quite a bit from this video from the head of UMinn CIDRAP group (Osterholm) on the almost total lack of evidence that cloth face coverings can effectively reduce virus transmission. He says that the gaps around the edges and the poor filtration mean that cloth masks (and to a somewhat lesser extent, surgical masks) will only (partially) stop respiratory droplets and will have little effect on aerosolized particles. Since asymptomatic transmission is likely driven more by the latter than the former (since droplets are generated mostly by coughing and sneezing when you are sick, at which time you should stay home), cloth masks won't help (much) and may hurt by giving the wearer or those they interact with a false sense of security, encouraging them to take more risks like ignoring physical distancing guidelines. He also discusses the unfortunate politicalizing of the mask issue and how politics and peer pressure has clouded decisions making on this topics, including at the CDC. --Dean
  9. Here is a neat interactive visualization of cases, deaths and tests by country. Here are two views - total deaths per million and total new daily deaths per million. The first shows how much Europe has dominated the total deaths per million and how North and South America (with UK, Kuwait and Sweden) are dominating the new cases per million. --Dean
  10. Here is the full text of the UMinn hydrochloroquine prophylactic study [1]. The accompanying review letter discusses some of the paper's limitations, but weirdly doesn't mention the lack of a zinc chaser: This trial has many limitations, acknowledged by the investigators. The trial methods did not allow consistent proof of exposure to SARS-CoV-2 or consistent laboratory confirmation that the symptom complex that was reported represented a SARS-CoV-2 infection. Indeed, the specificity of participant-reported Covid-19 symptoms is low,6 so it is hard to be certain how many participants in the trial actually had Covid-19. Adherence to the interventions could not be monitored, and participants reported less-than-perfect adherence, more notably in the group receiving hydroxychloroquine. In addition, those enrolled in the trial were younger (median age, 40 years) and had fewer coexisting conditions than persons in whom severe Covid-19 is most likely to develop,7 so enrollment of higher-risk participants might have yielded a different result. The trial design raises questions about the expected prevention benefits of hydroxychloroquine. Studies of postexposure prophylaxis are intended to provide an intervention in the shortest possible time to prevent infection. In a small-animal model of SARS-CoV-2 infection,8 prevention of infection or more severe disease was observed only when the experimental antiviral agent was given before or shortly after exposure. In the current trial, the long delay between perceived exposure to SARS-CoV-2 and the initiation of hydroxychloroquine (≥3 days in most participants) suggests that what was being assessed was prevention of symptoms or progression of Covid-19, rather than prevention of SARS-CoV-2 infection. So this study is far less than perfect and leaves open the possibility that hydroxychloroquine (plus zinc?) may still turn out to be an effective prophylactic against the virus. --Dean ------------ [1] The New England Journal of Medicine A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19 David R. Boulware, M.D., M.P.H., Matthew F. Pullen, M.D., Ananta S. Bangdiwala, M.S., Katelyn A. Pastick, B.Sc., Sarah M. Lofgren, M.D., Elizabeth C. Okafor, B.Sc., Caleb P. Skipper, M.D., Alanna A. Nascene, B.A., Melanie R. Nicol, Pharm.D., Ph.D., Mahsa Abassi, D.O., M.P.H., Nicole W. Engen, M.S., Matthew P. Cheng, M.D., et al. June 3, 2020 Abstract BACKGROUND Coronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are exposed, the standard of care is observation and quarantine. Whether hydroxychloroquine can prevent symptomatic infection after SARS-CoV-2 exposure is unknown. METHODS We conducted a randomized, double-blind, placebo-controlled trial across the United States and parts of Canada testing hydroxychloroquine as postexposure prophylaxis. We enrolled adults who had household or occupational exposure to someone with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure). Within 4 days after exposure, we randomly assigned participants to receive either placebo or hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 additional days). The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days. RESULTS We enrolled 821 asymptomatic participants. Overall, 87.6% of the participants (719 of 821) reported a high-risk exposure to a confirmed Covid-19 contact. The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was −2.4 percentage points (95% confidence interval, −7.0 to 2.2; P=0.35). Side effects were more common with hydroxychloroquine than with placebo (40.1% vs. 16.8%), but no serious adverse reactions were reported. CONCLUSIONS After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure. (Funded by David Baszucki and Jan Ellison Baszucki and others; ClinicalTrials.gov number, NCT04308668. opens in new tab.) DOI: 10.1056/NEJMoa2016638
  11. Looks like I may have been wrong in my recent prediction that hydroxychloroquine would turn out to be an effective prophylactic based on Trump starting to take it after talking with a researcher from UMinn who was running a trial to test the idea. Here are highlights of the now published UMinn study from an NPR article out just minutes ago. It doesn't look like the paper is yet available on the NEJM website. No Evidence Hydroxychloroquine Is Helpful In Preventing COVID-19, Study Finds Taking hydroxychloroquine after being exposed to someone with COVID-19 does not protect someone from getting the disease. That's the conclusion of a study published Wednesday involving 821 participants. All had direct exposure to a COVID-19 patient, either because they lived with one, or were a health care provider or first responder. To qualify, people had to be within a few days of their encounter with a COVID-19 patient and not have any symptoms of the disease themselves. Encounters meant being within 6 feet of a sick person for more than 10 minutes while wearing neither a face mask nor an eye shield or while wearing a face mask but no face shield. The volunteers received either a five-day supply of hydroxychloroquine, or a placebo. As Rajasingham and her colleagues report in the New England Journal of Medicine, 107 of the 821 participants developed disease; 49 in the group receiving hydroxychloroquine and 58 in the placebo group. That turned out to be a reduction in risk of 2.4 percent. That difference was not statistically significant, and "it's also not clinically meaningful," Rajasingham says. She would like to have seen a reduction of 30% or more before recommending hydroxychloroquine to asymptomatic patients. She says hydroxychloroquine can have serious side effects, although the side effects reported in this study were relatively mild. I'm not sure why the difference in the rate of infection between the two groups (49 vs. 58) is only a risk reduction of 2.4 percent - perhaps it was a result of adjusting for confounders. The article doesn't mention if participants were given zinc along with the hydroxychloroquine, so I think it safe to assume that they weren't. So perhaps there still is some hope for its effectiveness as a prophylactic. It will be useful to see the full published study to know the answer to these open questions. --Dean Update: This Business Insider article explains the 2.4%. It also provides more info on side effects, which were statistically higher (although mild) in the hydroxychloroquine group: The researchers tracked both groups, who routinely filled out online surveys about their health. Approximately 12% of people taking hydroxychloroquine got COVID-19 compared to 14% of the placebo group, according to a University of Minnesota press release. The difference was not statistically significant. However, one finding was meaningful between the two groups: those taking hydroxychloroquine had much higher rates of side effects. About 40% on hydroxychloroquine registered side effects compared to 17% on placebo. These were mild reactions — most commonly nausea, diarrhea, or vomiting — with no reported serious side effects.
  12. Dean Pomerleau

    Dean's Diet & Exercise Regime, Tips, and Motivation

    Sci-hub is your friend :-). Here are the tables from the paper in question [1]: The p-values are impressive in Table 2 due to the large number of people in the study (n=3355). But the magnitude of the difference in cognitive test scores between quartiles of IGF-1 appear quite small relative to the within-quartile variance. For example, look at the TMT-B test I've highlighted. The difference in average test score between the top and bottom quartile is ~5.5, but the within-quartile range is around +-15, indicating there is much more variation within quartiles than between the various quartiles of IGF-1. This suggests to me there are likely several factors that potentially contribute to having a low IGF-1. The speculation is that like with another growth-promoting hormone testosterone, there may be benign and potential even health-promoting reasons for having low IGF-1 and there may be other reasons that are associated with (or casually responsible for) poor physical and/or cognitive health - hence the wide within-quartile variance. But it is a speculation which we've discussed many times before in threads focusing on the potential pros and cons of high vs. low testosterone and/or IGF-1 including the ones I linked to in the post above. --Dean ----------- [1] Neurobiol Aging. 2015;36(2):942‐947. doi:10.1016/j.neurobiolaging.2014.10.035 Association of insulin-like growth factor-1 with mild cognitive impairment and slow gait speed. Doi T, Shimada H, Makizako H, et al. Abstract The decrease in serum insulin-like growth factor-1 (IGF-I) with aging is related to the neurobiological processes in Alzheimer's disease. IGF-1 mediates effects of physical exercise on the brain, and cognition has a common pathophysiology with physical function, particularly with gait. The aim of this study was to examine whether mild cognitive impairment (MCI) and slow gait are associated with the serum IGF-1 level. A population survey was conducted in 3355 participants (mean age, 71.4 years). Cognitive functions (attention, executive function, processing speed, visuospatial skill, and memory), gait speed, and demographic variables were measured. All cognitive functions and gait speed were associated with the IGF-1 level (p < 0.001). The association of IGF-1 with slow gait was weakened by adjustment for covariates, but MCI and the combination of MCI and slow gait were independently related to the IGF-1 level in multivariate analysis (p < 0.05). Our findings support the association of a low IGF-1 level with reduced cognitive function and gait speed, particularly with a combination of MCI and slow gait. PMID: 25467636
  13. All, I've been engaged in an off-forum Q&A dialog with a CR friend, and I figured some of you other crazies might appreciate reading about (and hopefully commenting on / criticizing) some of the details of my current diet & exercise regime, as well as tips & my motivation for them. If not, feel free it skip this post! I've only included my sided conversation, but I think from my answers it is pretty clear what the questions were. Feel free to ask for clarification on anything that's unclear. Regarding eating once per day. It's very hard, especially when just starting out on this regime, to eat once per day in the afternoon. It takes a lot of willpower. So I recommend, and always try myself, to wait a couple / few hours after waking before I eat, but then eat in the morning rather than waiting until afternoon, and definitely never try to grocery shop on a (very) empty stomach! For large scale chopped veggie storage, I use glass containers because I'm a bit paranoid about leeching from plastics. The glass jar I use is from Anchor Hocking. Turns out it is only 2gal. Here is a link. I believe both Target and Walmart have them as well, although I'm not sure about in-store availability. I chop my "chunky" veggies once per week, and store them in this glass jar, all mixed up, between layers of paper towels to absorb moisture and keep them fresh. I chop my "leafy green" veggies at the same time, throughly spin-dry them using salad spinner, and then store them in another containing between layers of paper towels to preserve freshness. Both go into my fridge, which I temperature control to maintain a very steady 34degF. Vegetable prep takes me just over one hour per week, but after many years I've got it down to an art/science. It used to take me about 2 hours. I find meditation and practices that cultivate mindfulness are helpful for fostering one's self-discipline. Other than that, I don't have much specific advice on that topic. I used to cook for my family when we were 4 rather than 3 . But now that it is just the three of us, and my daughter has an extremely busy schedule, my wife and daughter's eating schedule is pretty irregular. So they cook for themselves. I also found it hard to cook for them. Not because I was particularly tempted by the food I was making for them (although on occasion that too was the case), but more that I was conflicted by the opposing goals of cooking as healthy meals as possible for them, but also meals they would enjoy, and not waste by not eating. When practicing CR for a while, I've found you become extremely averse to wasting anything, but especially food. Plus I'm an ethical vegan. Both kids are (were) vegetarian, and my wife eats mostly vegetarian. But they enjoy quite a bit of dairy, which I had trouble buying/cooking for them for ethical reasons. Regarding exercise, I'll enumerate everything I do in a day, in order: [Get up at 2:45am - yes I'm kind of a early riser ] 4min - straight arm planking 2min - 100 body weight squats 10min - "10 minute abs" workout - Originally from YouTube video of that name, but after doing it several thousand times, I've got it memorized. . Video embedded at bottom. Warning - this will really hurt anyone not used to doing an ab workout, but her accent is strangely compelling... 20min - Jogging on treadmill at 4mph and 15% incline (very steep). 1.07miles, 200 kcal 120min - Stationary road bike. Modest intensity. HR around 95bpm. My Resting HR is about 45bpm. [breakfast - 1.5 hours] 10min - One mile run outdoors. Moderate pace . usually with my dog. 20min - Resistance training. 4day split to work all body parts on successive days, but giving each enough time to recover. Little rest between sets to keep it mildly aerobic. Pretty light weights. Pull-ups, pushups, light squats, triceps extensions, curls, shrugs, etc. All the standard exercises. Using dumbbells and body weight. 4min straight arm planking 2min - 100 body weight squats 2min - Ab Slide machine. Quite a good Ab exerciser 90min - Stationary road bike again. [Time now around 10:30am - Shower & 6min inversion therapy (to decompress spine and stretch back) & 20min power nap] [Puttering around for a while, light food prep, errands etc - 1-2 hours] 10min - One mile run outdoors. With dog. ~240min - pedalling at my bike desk while reading, surfing web, posting to CR forums [Off and on throughout afternoon evening - spend time with wife and daughter, especially when they eat dinner] 30min - brisk walk with my wife (and dog) [8:00pm - bedtime. 8:15 sound asleep] So in total I run for about 40min, do resistance training / calisthenics for about 45min, walk 30-45min, and then pedal for about 7h per day. On an average day, my Fitbit tells me I log about 45K steps (or step equivalents, including bike pedal revolutions), and about 23 miles. All of it at home, by myself (except if you count the mile walk with my wife and jogging with my dog ). I don't enjoy the hassle of working out with others at a gym. I don't seem to need the motivation of having other people around to exercise with. What motivates me to such extreme exercise? Hmmm... A few ideas: I like to eat, and to stay slim. Extreme exercise let's me do both. I'm exploring the possibility of getting CR benefits while eating lots of calories, but burning them off via lots of exercise and cold exposure. It makes me feel good. I like the endorphins, opiates, whatever makes exercise feel good. With my stationary bike and bike desk, I'm able to do other things while pedaling, like composing this message! I like being different from other people. I like pushing myself to extremes, to see what's possible. Pushing the envelope of human possibliity. I think exercising one's abilities and strengths is why we are here, and what makes life meaningful and significant. My biggest strength is probably self-discipline / conscientiousness. Exercising discipline strengthens the will. As Nietzsche said in Twilight of the Idols, "From life's school of war, what does not kill me makes me stronger." He was a big proponent of hormesis before it became fashionable. I hope being very different from others, and sharing my results, will enable people (like you!) to learn from my experiences and experiments, and figure out what might work best for them. Regarding sleep. I sleep for 6.5 hours per day (8:15pm - 2:45am) + a 20min power nap. Lately I've been sleeping like a baby, without my former problem of early waking (unless you count 2:45am as early ). I hope this is helpful. --Dean
  14. A while back I expressed concerned about the developing world getting hit hard by the virus. It appears to be happening, especially in South America with Brazil, Peru and Chile. New daily cases in Brazil are rapidly approaching the peak we saw in the US, which was just under 40K cases: Perhaps not surprisingly given their limited medical infrastructure, the number of deaths relatively to number of diagnosed cases is already nearly identical to that of the US (5.8%). This may be due to more diagnosed patients dying as a result of less-effective medical care or fewer cases being diagnosed due to limited testing. India and Bangladesh are also seeing a consistent rise in new cases: Fortunately the reported covid-19 deaths in both countries are relatively low. --Dean
  15. The Washington Post has an interesting article with a graphic showing changes in foot traffic to various types of businesses since early March both by state and as a national average. Here is the data from Georgia, which was one of the earliest states to reopen (late April) compared with the US average (dashed line): It looks like several types of Georgia businesses are seeing a slightly greater rebound in foot traffic than the national average. But everything except grocery stores, fast-food restaurants and barbers/salons are still way down both in Georgia and across the US. The recovery looks to be progressing rather slowly so far. --Dean
  16. Dean Pomerleau

    Brian May - "Very healthy" but "near death"

    I didn't notice it until you pointed it out. Maybe my eyes are going :-). I'll leave it that way to avoid ruining your clever quip. Except for the white hair I didn't think he looked too bad especially for someone who recently had a heart attack. But I'll grant you he doesn't look significant younger than his chronological age. From his seemingly upbeat attitude (although I know he does have a history of depression) and lack of physical disabilities, I suspect that like you, he doesn't consider himself to be "over the hill." That's why he was so surprised when he learned of his heart problem. I think it is gift of human psychology that allows us to "spin" all kinds of things to make life bearable - including our own self-image in the face of inevitable aging. Like your advice to Clinton on how to be resilient by not dwelling on the setbacks but instead finding positives ("well I've still got my health...") when things go pear-shaped in life. --Dean
  17. Dean Pomerleau

    Dean's Diet & Exercise Regime, Tips, and Motivation

    Hi Karen, Welcome to the CR Forums! Thanks for your questions. I'll try to answer them. Somewhere around 2005 - 2007. There is some discussion of my diet evolution earlier in in this very thread (which I'd forgotten!), but the best discussion of my protein history and motivation for reducing it can be found in the following discussion between Michael and me: The TLDR of the above thread is that back in the early days of the CR Society (early 2000s) both he and I used to eat a relatively high protein diet (~30% of calories - 30/40/30 "Zone Diet") until we participated in a human CR study by Luigi Fontana [1] which found that those of us who were following a high protein CR diet had a relatively high level of IGF-1, which has come to be though of as pretty pro-aging. For a discussion of the tradeoffs associated with high vs. low IGF-1, see this thread: Back to your questions: I've never noticed that protein per se was a big driver of my muscle mass. When I went on CR in 2001, I dropped about 45 lbs (172 -> 127, BMI 25.8 -> 19.0). During that drop I lost quite bit of fat, as well as muscle and bone mass. It's just something I accepted. I've always done a modest amount of weight training, and haven't changed that in an attempt to maintain extra muscle. I consider my muscle mass sufficient for health purposes and enough to avoid late-life sarcopenia. Because I'm once again exercising an unusually large amount (after a drop for while in 2017), I eat a lot of calories and despite being a vegan, my protein intake is more than adequate - in the neighborhood of 100g / day. I've never worried about it beyond trying to keep my protein intake from being too high (see above threads). If I'm getting enough high-quality calories from a variety of (vegan) sources I figure I'm getting sufficient protein. --Dean ------------ [1] Aging Cell. 2008 Oct;7(5):681-7. Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans.  Fontana L(1), Weiss EP, Villareal DT, Klein S, Holloszy JO. Author information: (1)Division of Geriatrics & Nutritional Sciences, Washington University School of Medicine, St Louis, MO 63110, USA. lfontana@dom.wustl.edu Comment in Aging Cell. 2009 Apr;8(2):214; author reply 215. Reduced function mutations in the insulin/IGF-I signaling pathway increase maximal lifespan and health span in many species. Calorie restriction (CR) decreases serum IGF-1 concentration by ~40%, protects against cancer and slows aging in rodents. However, the long-term effects of CR with adequate nutrition on circulating IGF-1 levels in humans are unknown. Here we report data from two long-term CR studies (1 and 6 years) showing that severe CR without malnutrition did not change IGF-1 and IGF-1 : IGFBP-3 ratio levels in humans. In contrast, total and free IGF-1 concentrations were significantly lower in moderately protein-restricted individuals. Reducing protein intake from an average of 1.67 g kg(-1) of body weight per day to 0.95 g kg(-1) of body weight per day for 3 weeks in six volunteers practicing CR resulted in a reduction in serum IGF-1 from 194 ng mL(-1) to 152 ng mL(-1). These findings demonstrate that, unlike in rodents, long-term severe CR does not reduce serum IGF-1 concentration and IGF-1 : IGFBP-3 ratio in humans. In addition, our data provide evidence that protein intake is a key determinant of circulating IGF-1 levels in humans, and suggest that reduced protein intake may become an important component of anticancer and anti-aging dietary interventions. PMCID: PMC2673798 PMID: 18843793
  18. Dean Pomerleau

    Brian May - "Very healthy" but "near death"

    Here is a video from a few days ago by Brian May talking about his recent health ordeal. It is nice to see he is doing much better after getting three stents to clear blockages in his coronary arteries. --Dea
  19. I did earthing for a while but eventually couldn't convince myself that it was beneficial either based on credible research studies or personal experience, so I gave it up. This sort of language from the paper you linked reinforces my skepticism: Earthing restores a primordial electric connection to the Earth lost over time because of human lifestyle. Earthing appears to correct what we call an “electron deficiency syndrome,”3 an overlooked and likely significant cause of multiple health disorders. --Dean
  20. Dean Pomerleau

    Nuts and Mortality

    Almond or other nut milks are very easy to make at home if you have a high quality blender like a Vitamix. Below is a video on the process. I'm not drinking it these days, but when I did I made my own. The nice thing is you can control how "creamy" it is by how long you blend and how much (if any) of the solids you strain out using a nut bag. You can also use your own sweetener (or not) and add vanilla (or not) for extra flavor. --Dean
  21. A while back we discussed the true rate of completely asymptomatic infections. It looks like my estimate of ~30% was a little low. A new (rather small) study from China published as a letter in JAMA found it to be around 42%. Those people whose complete course of infection was asymptomatic shed virus and hence were infectious for 8 days, compared with 19 days for symptomatic people. ASYMPTOMATIC SARS-CoV-2 INFECTION A Research Letter published in JAMA Network Open describes the characteristics of asymptomatic SARS-CoV-2 infections identified in Wuhan, China. The study compiled clinical data from 78 patients, representing 26 COVID-19 clusters—identified between December 24, 2019, and February 24, 2020—with known epidemiological links to known cases or exposure at the Hunan Seafood Market in Wuhan. Among these patients, 33 (42.3%) were asymptomatic throughout their infection. The asymptomatic individuals tended to be younger than symptomatic individuals—median age of 37 years, compared to 57 years—and a higher proportion of asymptomatic infections were in females—66.7% of asymptomatic infections, compared to 31% of symptomatic cases. Additionally, asymptomatic individuals exhibited a shorter duration of viral shedding than symptomatic cases—median of 8 days in asymptomatic individuals, compared to 19 days in symptomatic cases. --Dean
  22. I agree with Todd that the first wave isn't going away but is likely to persist throughout the summer. The model that has been most accurate is predicting that the US daily death toll will hover around 1000 throughout the summer, with a total US deaths by Sept 1st of about double what it is now (202K, 95% CI 125-346K). Here is the graph: It seems more likely than not that daily new cases and deaths will go up from there during the fall and winter months as schools reopen and people spend more time indoors, barring the discovery of effective prophylactics and/or treatments. --Dean
  23. To my reading this new preprint [1] from Rockefeller University seems less than reassuring about the immunity conferred by a previous infection. From the University's press release on the study: The majority of the samples they have studied showed poor to modest “neutralizing activity,” indicating a weak antibody response. However, a closer look revealed everyone’s immune system is capable of generating effective antibodies—just not necessarily enough of them. Even when neutralizing antibodies were not present in an individual’s serum in large quantities, researchers could find some rare immune cells that make them. The good news seems to be that nearly anyone can make neutralizing antibodies, at least in small amounts - so the researchers suggest a vaccine that could trigger the production of a large number of this type of antibody could be effective. But at the same time these results (i.e. "most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity") would seem to call into question how effective the antibodies created as a result of a previous infection would be at preventing a future infection, or for how long such protection might last. Maybe having just a few memory B cells with the right antibody would be enough to combat the disease upon another infection, once those b cells have multiplied. I'm not sure. And of course it's just a pre-print so should be taken with a grain of salt. --Dean --------- [1] Convergent Antibody Responses to SARS-CoV-2 Infection in Convalescent Individuals Davide F. Robbiani, Christian Gaebler, Frauke Muecksch, Julio C. C. Lorenzi, Zijun Wang, Alice Cho, Marianna Agudelo, Christopher O. Barnes, Anna Gazumyan, Shlomo Finkin, Thomas Hagglof, Thiago Y. Oliveira, Charlotte Viant, Arlene Hurley, Hans-Heinrich Hoffmann, Katrina G. Millard, Rhonda G. Kost, Melissa Cipolla, Kristie Gordon, Filippo Bianchini, Spencer T. Chen, Victor Ramos, Roshni Patel, Juan Dizon, Irina Shimeliovich, Pilar Mendoza, Harald Hartweger, Lilian Nogueira, Maggi Pack, Jill Horowitz, Fabian Schmidt, Yiska Weisblum, Eleftherios Michailidis, Alison W. Ashbrook, Eric Waltari, John E. Pak, Kathryn E. Huey-Tubman, Nicholas Koranda, Pauline R. Hoffman, Anthony P. West Jr., Charles M. Rice, Theodora Hatziioannou, Pamela J. Bjorkman, Paul D. Bieniasz, Marina Caskey, Michel C. Nussenzweig Abstract During the COVID-19 pandemic, SARS-CoV-2 infected millions of people and claimed hundreds of thousands of lives. Virus entry into cells depends on the receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S). Although there is no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-21–5. Here we report on 149 COVID-19 convalescent individuals. Plasmas collected an average of 39 days after the onset of symptoms had variable half-maximal neutralizing titers ranging from undetectable in 33% to below 1:1000 in 79%, while only 1% showed titers >1:5000. Antibody cloning revealed expanded clones of RBD-specific memory B cells expressing closely related antibodies in different individuals. Despite low plasma titers, antibodies to three distinct epitopes on RBD neutralized at half-maximal inhibitory concentrations (IC50s) as low as single digit ng/mL. Thus, most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective. doi: https://doi.org/10.1101/2020.05.13.092619
  24. All, I'm sometimes asked by friends and family who aren't quite as obsessive as I am about health & longevity for a few tips they might be able to adopt that might help them stay healthier longer but without "going overboard" like I do. Today I stumbled across an article that I think fits the bill really well, and that I'll point such people to in the future. It is titled 13 Habits Linked to a Long Life (Backed by Science) and it is from the website AuthorityNutrition.com, which I've never considered much of an authority on nutrition, but this article is quite good so I may have to reconsider... Here is the list: Avoid Overeating Eat Some Nuts Use The Spice Turmeric Eat Plenty of Healthy Plant Foods Exercise and Be Physically Active Don’t Smoke Keep Your Alcohol Intake Moderate Prioritize Your Happiness Avoid Chronic Stress and Anxiety Nurture Your Social Circle Increase Your Conscientiousness Drink Coffee or Tea Develop a Good Sleeping Pattern Each of the 13 is explained in clear, easy to understand language. The article describes the science to back up the recommendations, and has references for people who want to learn more. Finally, it's really brief for those with a short attention span. There are three additional items I can think of that I would add to the list: 14. Don't Sit Too Much (ref) 15. Practice Good Oral Hygiene (discussion, discussion) 16. Ask Your Doctor - Get regular medical checkups and recommended tests after age 50, or earlier if you've got risk factors (discussion) Anyone else have health and longevity "best practices" you would or do suggest to friends/family that aren't included on the list? --Dean
  25. I will take the vaccine once it has been tested for safety and (reasonable, i.e. > 50%) effectiveness, for reasons I outlined in my last post. But a vaccine that came out in Oct/Nov as you suggest wouldn't have been thoroughly tested. So I probably wouldn't take it in that time frame unless it was part of a clinical trial. In fact, I'd go further. I would volunteer for a clinical trial on safety and effectiveness of a vaccine candidate, or even a challenge trial (as I said before), if it would help accelerate getting the world to a safe and effective vaccine. --Dean
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