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Mechanism

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  1. Mechanism

    How sustainable is a CRON lifestyle?

    Hi April, Welcome back! I arrived to the scene after your time, but your reputation precedes you.... I for one would enjoy a fresh CR blog, especially one delving deeper in the literature ( more like Reason’s posts but more in depth) if that is your cup of tea. . On the note of spreading the word, I would add that if we ever hold a live CR meeting again, from what I hear about your CR-friendly culinary skill, I think if word got out that you may consider serving that famous pizza ( or any iteration of the infamous “binging brownies” circulating on the web) it would no doubt would sell out on the first day. 🙂
  2. Mechanism

    Supplementation

    Hello, I received a PM today asking me about supplementation. Unfortunately I am punting on this one except to speak in a few broad brush strokes. At this time I don't plan on going into my own practices in any detail. Why? Many reasons actually but among them lower quality of evidence for supplementation , and they vary much depending on the individual, his/her circumstances, in some cases genetics, and always on goals. I will leave it to the thought leaders in this domain at least for now (cf- Attia). Broad themes: A whole foods based diet ( ie with either no or minimal refined or processed foods ), and moderate in calories, trumps all Biomarkers are helpful for a baseline to see if you are on the right track ( search the Drive Podcast and other materials by Peter Attia ) remember Peter Drucker's wisdom: what gets measured gets managed. Genetics are usually only modestly helpful but increasingly so, especially when they are can point you in the right direction which you won't know unless you get it checked. For example, it would be great if everyone got their Lp(a) tested but if you have an LPA variant it is more likely to nudge you to double check. Biomarkers trump genes, but for a quick cheat sheet, get Rhonda Patrick's Genome Analysis Tool. For more in-depth DIY, pursue https://promethease.com/ or equivalent ( n.b., it is now part of the MyHeritage family ). Just remember these are secondary in importance compared to your actual biomarkers and you usually can't read too much into it. Know your nutrients - keep a food diary and put through cronometer as a ballpark gauge, adjust accordingly. For basic vitamins the strongest consensus is around vitamin D and B12 ( check your levels!), followed by calcium and iron ( these depend on individual and diet - for example the latter menstruating women at higher risk for anemia - check your serum iron and ferritin). Iodine and selenium are third tier, then the others noted in various guides ( see below). Some would hedge with a multivitamin anywhere between daily and once a week - this is a matter of philosophy as much as it is science outside of a specific rationale ( e.g. selenium levels are lower in soil in Europe compared to in the U.S., so context matters). After that, others. I agree with Michael not to go beyond several hundred fold of RDA at the most unless you know what you are doing and have a target ( e.g. vitamin D is a good exception). Let's make this simple - this is the CR Society so must reads: a) https://www.longecity.org/forum/topic/51743-michaels-quotidian-diet/ b) https://www.longecity.org/forum/stacks/stack/122-michaels-tiered-supplement/ ( hint Ron Put: you asked about glycine the other day, read this thread and comments closely). I don't necessarily agree with every aspect of the guides, but they provide a solid foundation and you should understand the science that leads you to agree/disagree as you move down form the top concerns ( e.g. vitamin D, B12 +/- calcium/iron/iodine, etc.). So called "Anti-aging" supplementation. This is discretionary and very personal - not only the interpretation but also every individual's risk/benefit analysis even when we can agree on the science. Therefore, for most I would devote 99.99+% energy on reasonable permutations - even if we don't agree with 100% of it - major national and international nutritional guidelines with some attention to these two threads, again most of which is pretty reasonable: and Will further CR extend healthspan / lifespan further: (a) yes and (b) despite the premise of the 2nd post above I think yes, probably at least modestly so, but I provide the 2nd link as a reminder: know where to focus your energy - an overall sound dietary and lifestyle strategy ( sound nutrition, exercise and structural maintenance in all its forms, sleep, stress-management, a sense of purpose, community and engagement, etc). Hope that helps a little. My philosophy here is self-sufficiency and scientific nutritional and health literacy. Continuing education. Keep learning. Health is the greatest wealth and I suggest for starters - if for nothing else to support good causes - becoming a “supporting” member of: 1) https://peterattiamd.com/subscribe/ and 2) https://www.foundmyfitness.com/subscriptions/new?amount=10 These are the two resources that at this time, May 2020, I would encourage others to support. If you are passionate about life extension - as many on this forum are - read on. My personal passion is not the traditional definition of longevity, but of "healthspan" I agree with the "geroscience hypothesis" that research in the former is one of the most powerful ways to contribute to advances and gains in the latter. If you also agree, consider also additionally "supporting" - this can be monetary, advocacy, volunteering or via other means - 1) NIH funding in general, including for the NIA in particular, including basic science in biogerontology / geroscience. The NIH is generally underfunded but I would argue especially the National Institute on Aging, and particularly in fundamental research. 2) Support fine organizations such as https://www.sens.org/get-involved/donate/ and https://www.lifespan.io/how-you-can-help/ These two emphasize a damage-repair or "SENS" paradigm. I feel some legitimate investment of resources equilibrium is required between this approach and more traditional strategies ( refer to an excellent balanced summary by João Pedro de Magalhães here: http://senescence.info/sens.html ) . As the SENS approach is comparatively less funded and relies more on personal donations and private investors, I would get familiar with it; "Reason" ( yes, that is his name) has an excellent newsletter to stay up-to-date with some of these developments here: https://www.fightaging.org/ Be well, Mechanism PS / Epilogue: don't keep too fixed on one mindset - keep an open mind focused on ever-evolving evidence and personal experience. For example, even since my post here: I continue to experiment with different variations and permutations of various diets, and monitor the impact on biomarkers and other outcomes of interest ( these are associative by nature given the absence of controls so minimizing known variation while reproducing the same interventions at other times and conditions partially mitigates this). For example I have pursued trials of additional every other day (EOD) fasting variants of SFD with similar results - though SFD has the isocaloric edge for peak ketosis other biomarkers, other variants can yield similar results with commensurate postprandial exercise, dialing back further net-CHO and/or calories, etc. The bottom line is that there are countless equally efficacious ways to achieve essentially the same targets, so don't lose focus that it is the the overall diet quality ( see above ) and overall lifestyle that far and away determines the overall path to health. Being consistent where it counts, adapting to the medical literature and your own biomarkers and other pertinent metrics including subjective wellbeing and sustainability , and focusing on the most impactful and evidence-based principals ( see above re: diet quality) is where your energy should be most devoted. There are many roads to Dublin.
  3. Mechanism

    Olive oil? Healthy or not?!

    Mike, I am going to stick my neck out a little here to break up a friendly debate 🙂 I like you was an olive oil skeptic. After re-cultivating the habit of being systematic appraising the evidence and reading the primary publications - something I was doing in other areas of medical care but not in this universe - I have come around to the conclusion that for 99+% of the population EVOO is compatible with optimal health, though it is neither necessary nor sufficient. Indeed, I would list among "Michael's Greatest Hits" the discourse that starts with this post: Nevertheless if I am truly reformed I would and certainly appreciate and encourage ongoing discourse as new evidence presents itself, and I think it is reasonable and appropriate to present new data and research findings. Science is a process, not a conclusion, and I appreciate your & Al presenting data as it emerges. Though I fully endorse Michael's criticism of the study in question - namely that there is little novel under the sun in the study in question and nothing that fundamentally undermines the overall EVOO evidence base with regard to actionable health optimization for our cadre here I also fully concede ( leaving aside the matter of genetics which is a whole other ball of wax ) that PREDIMED included there has never been a well-conducted RCT with a true apples-to-apples comparison of an extreme Esselstyn or Ornish version with an equally healthy higher-fat EVOO and/or nuts equivalent comparison. Though DIETFITS tried to reconcile low-fat vs high-fat ( doi:10.1001/jama.2018.0245 ), ultimately the spread between the two was too narrow to satisfy either side of the debate ( caveat: yes I am conflating low/high fat vs. EVOO vs. ketogenic a bit but I am working with the very limited higher quality trials data that we do have available). Given this state of affairs there is room for epidemiology ( Blue Zones - plagued with confounding by non-nutritional factors and problems with data quality and making inferences across non-controlled populations) and model organisms ( lovely controls and follow-up , yet alas mice are not little people with tails), and I concur with Valter Longo's reasonable appeal to identifying common themes across multiple different pillars ( categories of ) nutritional evidence including also centenarian studies, analogy to other complex systems / mechanisms of systems biology, etc. Though this holds no water at all, its always colorful to illustrate with personal examples and indeed, I have maintained detailed periodic biomarkers for years, including estoteric ones. Anecdotally, I transitioned over years from a low fat diet to a relatively high fat Mediterranean diet - both whole foods based and plant-centered unscathed. The only period when my fasting insulin rose above the very low single digits with comparable HOMA-IR ( while cholesterol have remained similarly near-optimal) was when the intervention was not an adjustment of the % macronutrients, but the total daily calories via meal size. Barring individual differences ( https://doi.org/10.1016/j.cell.2015.11.001 ), diet quality trumps all within the common range. My decision to edge towards higher fat was a personal one, albeit guided by my interpretation of less clear-cut data including basic science data, nutritional requirements / chronometer analysis, and yes even some interesting work at all levels on nutrient sensing pathways and intervention studies in rodents ( long term) and people ( short term, limited to surrogate variables). But from a big picture perspective, both diets were compatible with good health at least as far as nutritional epidemiology and personal biomarkers go. Outside that common broad range of reasonable options, there are other interesting phenomenon with a wider range of uncertainty and debate ( e.g., cancer risk and methionine & BCAA excess , ketogenic diets and metabolic syndrome and likely modest impact on some hallmarks of aging, etc). So given this science and limitations in its study for the foreseeable future, I anticipate the forum and others like it will always have lots of interesting fodder for discussion and debate.
  4. Mechanism

    Lost your marbles yet??

    When I feel sad, I remind myself what I am grateful for. I also try to remember I am a good person, that I care, and though I do not always succeed, I try my best, and that is all one can do. Making plans for something positive I can do - for the situation, for renewal, and especially for others also helps. Listening to and supporting and offering kindness in another’s troubles can provide perspective, gratitude, meaning, a sense of purpose and a positive direction. Sometimes space or distraction and getting through is what is needed - and is enough. I am sorry about your losses. You are capable and worthy, and deserve happiness which will come. You are not alone. The human condition is rough. We are in this together.
  5. Tom, I agree with this author that “using a population-wide average VSL standard for assessing COVID-19 policies is inappropriate insofar as such an average does not accurately capture the age distribution of expected COVID-19 decedents.” This was one of your points. When I was in grad school it took me a little time to wrap my brain around the QUALY - which is not a measure of economic impact of a lost life ( as you pointed out, a lost life can be net savings to society notwithstanding the tragedy - that is another matter ), but rather a societal willingness to lose $ per lives saved and moreover in systems with constrained resources it attempts to provide an objective paradigm for trade offs such as for determining the relative merit of investing in public health measure 1 vs. public health measure 2. Society needs some way to maximize good and comparable metrics are the best we have right now, as unfair as it feels to choose one protective program over another. I agree with you about the problems with VSL, i feel QUALY analyses are more suitable. If there is a better system than QUALY analyses ( not done in your cited study), I am not aware of it, but would be interested in learning and being enlightened. https://www.forbes.com/sites/theapothecary/2020/03/27/how-economists-calculate-the-costs-and-benefits-of-covid-19-lockdowns/#37b4207c6f63
  6. Last video I posted featuring Dr. John Ioannidis ( looks almost identical but it was "Episode 1") he had called for more data - Now (Episode 4) he has more data - some based on his own research and provides a - in my assessment - fairly balanced evaluation with his take on its implications, where we are, and considerations going forward. Worth a listen: #2 Dr. David Katz has been a controversial figure in the nutrition and health policy space. Regardless how you feel about him or his nutritional assessments, I found this thought-provoking, and he also raises some of the same questions with regard to the balance required in a cogent opening up / health mitigation strategy:
  7. Sadly you are probably right Todd: https://academic.oup.com/cid/article/46/10/1582/294025 The Interaction between Nutrition and Infection Peter Katona, Judit Katona-Apte Clinical Infectious Diseases, Volume 46, Issue 10, 15 May 2008, Pages 1582–1588, https://doi.org/10.1086/587658 The biggest advantage is the lower prevalence of older persons, but comorbidities, crowding and malnutrition are huge problems along with issues around hygiene and simple supportive measures in and outside the minimal or broken health care systems. The true extent will likely never be known due to anticipated limited testing. The best estimate would be comparing ( also imperfect) crude all-cause mortality data pre vs post Covid.
  8. Coronavirus’s ability to mutate has been vastly underestimated, and mutations affect deadliness of strains, Chinese study finds https://www.scmp.com/news/china/science/article/3080771/coronavirus-mutations-affect-deadliness-strains-chinese-study Very interesting study BrianA ( regarding the different virus variants, mutation rate, and potential virulence / CFR) the most novel of our recent posts and if confirmed the biggest game changer in implications so far. Mike - this is tricky stuff, and one of the greatest challenges- estimates for our models make all the difference - garbage in, garbage out. Thanks for the link. Drewab- though agree ( Saul) that greger info sadly suspect, I would not throw out the baby with the bathwater as he also brings in literature sometimes that is easy to miss - I just make sure to review the sources myself though this should always be the rule anyway. I do like his raising awareness of impact of factory farming at multiple levels - he means well and is doing mostly good. Was not aware of his ID background, thanks for the link. Gordo, Tom, Sibiriak, Dean, McCoy, Ron : I think we have consensus that opening in stages may be needed - the devil is in the details when/how WRT testing readiness. This was recently touched upon in this video interview @ Harvard CME ( their stuff is easily accessible to general public): https://postgraduateeducation.hms.harvard.edu/continuing-education/covid-19-resources-providers#April 16 ( see for others: https://postgraduateeducation.hms.harvard.edu/continuing-education/covid-19-resources-providers ) misc of interest: ##Risk factors in Wuhan inpatients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152876/ With the possible exception of age ( and even here I suspect biological age to trump chronological age, high correlation notwithstanding), I expect most CRSoc members to fare well.
  9. Hot off the press: Risk factors in Wuhan inpatients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152876/ with the possible exception of age ( and even here I suspect biological age to trump chronological age), I expect most CRSoc members to fare well.
  10. It was great meeting you today Drewab. These authors speculate that vitamin D deficiency related reduced immunity ( and activity level) may mediate part of the obesity-Covid adverse events association that we has discussed earlier today: https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22838 Merits further study.
  11. Great to see you @ the CR Meeting online Gordo. Here from your article:
  12. I just updated the URL, so if you check your PM , the link to the CrSociety Google Hangout should ( hopefully) work!
  13. The Google Hangout CRSociety get-together will be at 2pm EST ( New York Time) today, but I will come in early, probably around 1:30. For those with invited please check your PM box 1:30 or later for the updated URL so you have the right link ( the URL address will change then since the old one has expired ). If I missed you, please PM me - see you soon!
  14. I agree Gordo, I thought the same thing. The 15% you cite was from an essentially 100% sample of pregnant woman and the highest reliable source reported Covid percentage that we have seen domestically to date - and from NYC which has been among the hardest hit. From the New England Journal of Medicine (the highest impact U.S. clinical journal): https://www.nejm.org/doi/full/10.1056/NEJMc2009316 We have a long way to go before herd immunity is achieved. I have the same issues with the Knut Wittkowski video. This is in distinction with Dr John Ioannidis who in my estimation has been consistently balanced, nuanced, and data-responsive.
  15. Sibiriak, your video post was beyond words. A scary segment at multiple levels. At the same time, understandable that we are witnessing this at all levels: we are talking lives, jobs, freedom, social responsibility and core issues at the heart of our greatest needs and most deeply held values..... With so much at stake, and rather than sound bites and simple yes/no policy , we need a careful and nuanced science-grounded approach appropriately balancing the high stakes at all sides of this.
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