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kpfleger

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  1. One more with evidence of making flu vaccine more effective: ginseng: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659611/ (but also a study just in mice) Still, add this to AHCC and Rapamycin (and maybe fasting/CR). And probably sleep around the immunization is important too though I haven't seen a study on that, but intuitive given the other reading on sleep and immune system. Note: Timing is different for each of these. Eg, AHCC was given for a few weeks after immunization vs. Rapamycin was given for weeks but stopped 2 weeks before vaccination.
  2. I believe the science showing immune boosting of healthy sleep (equivalently the immune compromising of lack of sufficient sleep) is more compelling than for cold exposure, and probably more compelling than for exercise, so I'd put the list as healthy diet & sufficient sleep, then moderate exercise, then if you want to include it (not a topic I've dived into personally yet) cold exposure. Eg, see the sleep book I recommended IIRC in another thread recently: Why We Sleep by Walker. But it's probably easy to find primary studies too.
  3. I read a bit about why it didn't work in previous years. The short version is that it has live but weakened viruses, multiple strains. They have to carefully balance the strains so that some don't get outcompeted in the body and thus not provide protection by not being present in sufficient number for an immune response to be learned. For a few years one of the strains got out of whack and outcompeted some or all of the others. They think they've fixed this and the CDC is convinced this year based on data so far, but the AAP is not convinced and wants to wait until the data is more numerous and so these 2 orgs recommendations don't agree on this form of the vaccination this year. But even AAP agrees that the mist is better than not getting either form.
  4. You are entitled to your value judgement of course, but I am surprised to find this sentiment. (A) I disagree and think that flu shots are worth it in the same way that wearing seatbelts and having insurance is worth it. Small expected benefit (because benefit unlikely) but much much smaller negatives (statistically hard to distinguish from zero). (B) To the extent that you believe the studies about rapamycin, AHCC, or other things making the vaccine more effective, this clearly changes the balance of pros/cons from studies just looking at taking the vaccine the normal way. (C) It is the job of the CDC, the AAP, etc. to review all the studies and make recommendations. While the groups sometimes differ on the details (like whether to recommend the nasal spray version), they all strongly recommend most people to get the flu vaccine. Multiple different groups of scientists have reviewed many studies and surveys. Do you think all these bodies have all been captured by corporate interests? (D) The main numbers in the very link you cited seems to disagree with your point. In more detail: A year ago a relative emailed out a link expressing anti-flu-vaccine opinion, so I Google'd around a bit and this was my summary at the time: ------------------ There is a lot of anti-vaccine stuff out there in general (not just for flu shots specifically) and for the other (non-flu) vaccines the weight of the evidence is so strongly in favor of vaccination that it is sad that so much negative is written about them as to make it seem like there is still an actual debate. Flu vaccines are different in that the benefits are very clearly less strong. But because of the amount of mis-information out there about vaccination in general, whenever anything comes up about vaccines/immunizations I always try to start with as unbiased of a Google query as I can think of that tries to get at the underlying scientific evidence. So for this I typed the following into Google: science OR evidence flu OR influenza shot OR vaccine OR vaccination risk benefit FWIW, I read through the first 10 results. The summary seems to be that there is some debate about the magnitude of the benefit. It's clear that it's much less of a benefit than vaccines that almost completely prevent really bad diseases. And some reasonable sounding things claim little to no benefit. But almost none of that material suggests any significant negative---1 exception for pregnancy but with lots of cautions, and 1 link mentioning febrile seizures but at a really low chance, so no mention of any scientifically credible worry for older kids, adults, or elderly. And lots of credible stuff suggesting the benefit though small still clearly greater than zero. ------------------ Now I didn't re-do that search in late 2018, but I'd be surprised if the results flipped. As for the 2018 Cochran paper you cited, it's main conclusion is "Healthy adults who receive inactivated parenteral influenza vaccine rather than no vaccine probably experience less influenza, from just over 2% to just under 1% (moderate-certainty evidence)." Reducing the chance by half with no downside mentioned seems pretty compelling to me. Also, to me the big value of the flu shot isn't actually avoiding the flu, it's making it much less severe if it should occur and thus significantly decreasing the chance of nasty secondary infections or other more severe consequences. The article mentions hospitalizations (and notes of the reduction in them that "the CI is wide and does not rule out a large benefit") but there are less severe complications of flu that are probably more common, such as secondary lung infections. These can be more than annoyances---they can cause lasting damage. Certainly antibiotics are not uncommon (and probably more common than hospitalization) and these of course damage one's gut microbiome. I wish the review had presented statistics on the reduction in antibiotic need for secondary infections. This is the main reason I like to get a flu shot. For those of us with low WBC this is an even more compelling rationale. One could conceivably believe as a result that flu shots are thus more important for those on CR. But again, if we have ways of making the flu shot more effective by creating a better immune response, then the balance of the statistics of these previous studies shifts in favor of vaccination. Thus, the original reason for my post that started this topic.
  5. Tis the season to think about flu shots. What's the optimal practical stuff one can do to optimize effectiveness? A few early studies have shown improved immune response to influenza immunization in humans by taking rapamycin around the time of the vaccination. There has been enough work to think that the effect is real, but not enough for optimal dose, timing, etc. to be confidently worked out, nor enough for this to have translated to standard-of-care in common clinical use yet, especially given rapamycin's other negative side effects. CR and fasting hit many of the same pathways as rapamycin, so it is reasonable to hypothesize that maybe temporarily entering CR or doing some fasting around a flu shot might also help optimize immune response and effectiveness of the shot. I think there has been no direct work testing this yet. Would love to hear people's opinions or any pointers if there has been respectable work on this that I don't know about. Should one fast before and/or after a flu shot, or enter CR / deepen CR around it? There has been science recently on fasting vs. feasting's differential effects on infectious agents depending on whether the infection is viral vs. bacterial, essentially backing up the old saying to "feed a cold, starve a fever", except the general version would be feed a virus, starve a bacterial infection. That doesn't exactly square with fasting or downregulating mTOR for a viral vaccination. The reconciliation seems to be that the eating in the face of an infection didn't affect the immune response itself. The additional glucose allowed cells to fight a viral infection better than without the glucose. Since the flu shot is inactivated, no cells actually get infected so no benefit to more available glucose. This suggests that possibly the best thing to do is fast near the flu shot but eat more if you actually get the flu (regardless of whether you had the shot). Separately from the above, AHCC seems to have some evidence that short-term use around a vaccination improved immune response. Matt covered this in his AHCC post (nice post Matt). But this seems to be based on a single paper published in 2013 and maybe earlier work. I don't see much work since then and clearly the intervening 5 years haven't caused this to be a widespread recommendation. I haven't search Google scholar for more recent papers citing this one to see what recent thoughts are on this study, but that's a next obvious thing to try. Certainly AHCC seems to have some other good work showing that it helps the body during certain kinds of infections, or even treatments like chemo. Michael Rae pointed out to me once that it is commonly used for people with low neutrophil WBC counts (neutropenia), but it did nothing for me personally to increase my WBC when I tried it for 6-9 months. So perhaps it helps taking around the flu shot, and perhaps it would help to take it if one were actually fighting a flu. Anything else? And what do people think of this list so far? Should we fast and take AHCC around the flu shot but then eat a lot and take more AHCC if we nonetheless later get a bad flu? And then stop eating again but take more AHCC if we get a secondary bacterial infection after the flu, such as bronchitis? (But alas, one can get viral or bacterial bronchitis and consumers and individual clinics/doctors don't yet have good tests to distinguish the type of infectious agent I think, though there are people working on this. Fever by itself I think is not a reliable indicator, though maybe it is decent for just a chest infection if the flu has cleared up?)
  6. kpfleger

    Cadmium contamination in cacao products

    There are no cocoa powders that have a better flavanol to bad metals ratio than the Navitas Naturals nibs. In particular note that the Navitas Naturals powder has much more cadmium than the nibs. So you'd be much better off crushing the nibs yourself. (Of course, if you really like crushing, you could maybe crush a 100% bar that has even less cadmium.) There was one powder that had low cadmium, but it had high lead, so that's no help. Even without paying or having a login, you can read the teaser page about the report here: https://www.consumerlab.com/reviews/Cocoa_Powders_and_Chocolates_Sources_of_Flavanols/cocoa-flavanols/ There is some info in the teaser page, and there is an 11min video that explains some of the basic topics like what levels of flavanols are therapeutic and what levels of cadmium are bad. The video does also talk a bit about dutching chocolate and how that can allow for darker % but lowers flavanols. The video mostly doesn't talk specific brands but does mention Aduna Super-Cacao, which had the highest flavanol and flavanol/cadmium ratio in their chart, but the ratio is still worse than the Navitas Naturals nibs, and the video discusses how there is a reformulation of that product that decreases the flavanols so they don't recommend it.
  7. I continue to be disappointed that none of Longo's work that I've noticed has results stratified by BMI or any correlates such as various blood markers (CRP, etc.). In most cases the control rodents are ad-lib and the control humans are on average normal people in our culture who on average eat pretty close to Standard American Diet---i.e., both species of controls are not particularly healthy. And given Rhonda's readership/listenership, I continue to be disappointed that she doesn't press him on the question of how much benefit is there to someone who already does a bunch of what she recommends in terms of healthy lifestyle. How much benefit is there to FMD or IF for those with a BMI of say 22.5 who eat a mostly whole-foods, plant-based diet whose biomarkers are mostly good (eg most of the way to Fontana's profile of CR even if not all the way in CR)? I buy that there are some benefits for cancer avoidance to getting glucose super low and ketones up temporarily every now and then, but it's hard to swallow any all-cause mortality overall quantification of benefits of any variants of fasting with controls that are to my mind artificially unhealthy. I get that those controls are appropriate if you are trying to help the majority of typical Americans, but I assume that for the community of these forums and for Rhonda's followers a different baseline should be considered. Now I haven't dug into the details of all of Longo's work or all work on various forms of fasting and time-restricted eating, so if someone knows of some data that compares to healthier baseline controls, I'd love a pointer. BTW, this is a broader disappointment I have with Rhonda's interviews that applies to other topics as well (and is feedback I have only just recently shared with them). For example, I wish she had pursued the question of how much benefit saunas / heat-therapy provides relative to a similar amount of sweating exercise as the control rather than just sitting around. I assume that there is some overlap in the pathways mediating the health-positive effects of saunas vs exercise and thus that the addition of sauna use would not be purely additive on top of the more basic healthy lifestyle factors (good diet + exercise + sleep + not smoking) at the level indicated by most of the studies (whose controls probably don't achieve even that basic mix of healthy lifestyle).
  8. kpfleger

    Cadmium contamination in cacao products

    Note that CL has updated their flavanols/chocolate/cadmium report (probably paywalled; I paid). The top says, "last update 9/12/18". Cacao powders generally seem to have more cadmium than nibs. By lucky chance the nibs that they tested that had the best flavanol to cadmium ratio was what my family has been using anyway, Navitas Naturals (so maybe this got better since the 2014 report) and for the double-win my favorite dark chocolate, Endangered Species 88%, did the best of bars (excluding a 100% bar) and had an even better flavanol to cadmium ratio than the Navitas Naturals nibs, though with the disadvantage of some sugar.
  9. Since posting this I have read the excellent book, Why We Sleep by Matthew Walker. Highly recommended. And available as an audiobook. One of the best books on health relationship to any aspect of lifestyle that I've ever read. Better than any single book on nutrition/eating (including CR) that I've ever read, and I've read many more on that area of lifestyle. Similar for exercise. He specifically says in this book that the sleep recommendations of the National Sleep Foundation and CDC of 7-9 or 7+ are time-in-bed recs and that modern hunter-gatherers actually sleep 6-7.5 hrs/night. That CDC page cites a couple published studies (that I did not dig into). I now try to spend 8-9 hours in bed in order to get 6.5-7.5 hours actual sleep. [My sleep efficiency seems to hover around 80% based on my Emfit QS and on my Garmin Forerunner 235 after correlating it with my old Basis Peak (which I trust more for sleep than the Garmin and which agreed with the Emfit) when switching from the Peak to the Fr235.]
  10. I quick Google Image Search for the query sleep mortality shows the widely reported U-shaped curve, with optimum near 7 hours. Has anyone dug into the studies that have examine this to focus on how sleep duration of the subjects was collected? Or has anyone looked into this enough to find which such studies specifically differentiated between hours spent in bed vs. hours spent actually sleeping as determined by some kind of sensor? My expectation and vague memory is that some fraction of these studies use self-reported sleep durations. Even if all the various watches, clips, ballistocardiography, smartphone-on-mattress, etc. sensors are not perfect at measuring sleep stages, I think some of them are decent approximations for total time spent in a sleeping state vs. awake (though they vary, eg my Emfit QS seems much better at realizing how long it takes me to go back to sleep after getting up in the middle of the night than my Garmin FR235). In my case, I seem to only spend an average of about 80% of my time between going to bed and finally waking actually sleeping. So this makes a big difference in terms of where the optimum is for hrs/night. Eg, if I try to hit 7hrs/night real sleep, then I'm at nearly 9hrs/night in bed, but maybe the studies are actually just reporting associations with in-bed time. I haven't had a chance to dig into the studies myself, so I figured I'd ask if anyone else has looked at any of them in enough detail to know, or found any that specifically used a trustable sensor to determine actual sleep time in the subjects. Karl
  11. It's great to see another good epidemiological study on lifestyle and long-term health, and great for it to get press as yet another reminder to people, most of whom are doing many of the wrong things, but I found the talk in some places of the new study's results being surprising to be very poor scholarship. These new results are very consistent with previous results, many of which were nicely collected and described for a lay-audience in Jeff Novick's classic Triage Your Health post. This is just yet another reminder. As for Michael being the only one to be actually working to solve the problem, I commend Michael for doing so much but for the rest of us don't think you can't help. Everyone can donate what to SENS. I do. There are other things people can do to help if you have extra time or money or good contacts or other things to bring to the table.
  12. kpfleger

    NAD supplement?

    This was a good thread and NAD+ is important, so I want to follow up with some things I've just learned. After not paying any attention to the whole world of NAD, NM, Sirtuins, resveratrol etc. due to all the disappointments in the area, I saw a great talk last week by Eric Verdin (long time researcher in the area and current head of the Buck Institute) summarizing a lot of stuff and making an important point. High level summary: NAD+ is generally good and as Michael says NR supplementation to increase NAD+ has much better evidence recently that it did some years ago. However, CD38 is a substance that breaks NAD+ and CD38 increases with age. This seems to be a major reason why NAD+ declines (see paper below). Though NR supplementation helps recover the NAD+, it doesn't do anything about the CD38 so the degree to which NR can help is limited. CD38 inhibitors would solve the problem a level back and should be better than NR supplementation. Candidates to do that are actively being worked on. So watch this space. Here's a 2015 review by Verdin on the area, though I didn't read it to see how similar it was to the talk: REVIEW NAD+ in aging, metabolism, and neurodegeneration Eric Verdin Science 04 Dec 2015: Vol. 350, Issue 6265, pp. 1208-1213 DOI: 10.1126/science.aac4854 full PDF found via Google Scholar: http://verdin.buckinstitute.org/s/2015-Science-review.pdf Another big researcher in the area is Chini. Here is a paper that shows that CD38 causes the NAD decline with age: CD38 Dictates Age-Related NAD Decline and Mitochondrial Dysfunction through an SIRT3-Dependent Mechanism DOI: http://dx.doi.org/10.1016/j.cmet.2016.05.006 http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30224-8 And a shorter intro that summarizes that message from the beginning of the special issues the above paper was part of: Why NAD+ Declines during Aging: It’s Destroyed DOI: http://dx.doi.org/10.1016/j.cmet.2016.05.022 http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30244-3 For more maybe try searching Google for cd38 inhibitor....
  13. This thread started with a claim that prolonged fasting isn't that useful due to a bunch of reasoning about autophagy. I'm surprised no one brought up cancer yet in the thread, especially given the several mentions of Seyfried. Surely there are other claimed benefits from fasting besides cleaning up cellular junk via autophagy. One of them clearly is the effect on cancer due to cancer cells and non-cancerous cells having different needs for and frailty in the face of glucose & ketones. I don't think there is widespread scientific agreement on the exact dose-response of fasting or ketones effects on tumors, and thus probably not a clear case that longer than 24-hr fasts have statistically significant increased benefit over <24hr fasts, and certainly ketogenic greater-than-zero calorie consumption may achieve some of the same goals w.r.t. cancer without technically being a fast, but I think there is enough evidence that fasting should be seen as potentially helpful with cancer and thus no discussion of what fasting durations are best is complete without addressing cancer as well as autophagy.
  14. kpfleger

    WBC: how low is too low?

    Thank you for the link, but in that study, neither the control nor CR groups had WBC drop below normal range. FYI, Chronic Idiopathic Neutropenia in Adults (CINA) is sometimes used as the medical phrase for when neutrophils are chronically low with no particular known cause. If it's your neutrophils that are low, you could Google it. Many people seems to live that way just fine. If they are too low, there is a substance that you can take to raise them and some people need to be more careful about going on antibiotics quickly in the event of bacterial infections. If it's the lymphs that are low, I assume there is a name for that and a chronic idiopathic version there too, but haven't Google'd it.
  15. I wrote a document exploring some of the data available on the issue of how low is too low for WBC, a topic that has come up here before. If anyone has any other studies to suggest that bear on the issue of health outcomes for WBC levels < 3.5, please send me the links. Thanks. Here is the document: https://docs.google.com/document/d/1lTA6105wJ4MNMRMmXZrEKYK5X2UXkRRwFmaGuixfz0I/edit?usp=sharing Joel Fuhrman likes to advocate that lower WBC is almost always good and reassures people eating his (CR-like) dietary style who have below-normal WBC that that is okay (it is "normal" for healthy eating). I looked at all 8 studies he has cited to defend this position as my starting point for the document, also looking at a link about lower WBC in vegans in general. Then I added one study Dean P. had pointed out on these forums. I have not gone through these forums comprehensively to find all relevant studies, nor done general lit searches, so if anyone knows anything else that should be included, I'm happy to stick it in. Thanks! Karl
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