Genes As Destiny

[TomBAvoider]

I recently had an opportunity to watch a film shot last year, which featured the comedian Jerry Lewis in a dramatic role. Well, Jerry Lewis just turned 90 this year, and watching that movie and his appearance in it, I was shocked and amazed at how good he looked considering - more than appearance however, I was amazed at how sharp and with-it he seemed... not at all gaga as so many folks in their very late 80's -90's are all too often. I live not far away from a retirement home, and I can tell you that there are plenty of folks in their 70's and even 60's in far worse shape, physically and mentally than what I saw of Jerry Lewis in that film.

 

Now, this by itself is not particularly noteworthy, as although hitting 90's is certainly a longer lifespan than the average male in the U.S., it is not exactly rare. No, what is remarkable, in fact verging on the inexplicable, is the fact that as long as I've lived, all I heard - and have seen - when it came to Jerry Lewis, were his innumerable and difficult health challenges. I remember very clearly when he looked very sick on TV as he was hosting one of his Muscular Dystrophy Telethons - bloated from steroids and unsteady in gait. But that was nothing new - he had severe morbidities going back to his thirties when he had his first recorded heart attack. The man has had many since and many quite severe. He's a prostate cancer survivor, diabetic, pulmonary fibrosis, life-long severe heart disease, incapacitating injuries, infections, history of painkiller addiction and the list goes on. Here is the wikipedia entry regarding his health:

 

(can't link to wikipedia - but google "Jerry Lewis")

 

Quote:

 

"Lewis has suffered from a variety of illnesses and addictions related both to aging and a back injury sustained in a comedic pratfall from a piano while performing at the Sands Hotel on the Las Vegas Strip on March 20, 1965.^[35][36] The accident almost left him paralyzed. In its aftermath Lewis became addicted to the pain killer Percodan for thirteen years.^[35] He says he has been off the drug since 1978 and has not taken one since.^[36] In April 2002, Lewis had a Medtronic "Synergy" neurostimulator implanted in his back,^[37] which has helped reduce the discomfort.

He is now one of the company's leading spokesmen.^[36][37] In the 2011 documentary Method to the Madness of Jerry Lewis, Lewis said he suffered his first heart attack while filming Cinderfella in 1960.^[38][39] In December 1982, Lewis suffered a serious heart attack. En route home to San Diego from New York City on a cross-country commercial airline flight he endured a minor heart attack on June 11, 2006.^[40] It was then discovered that he had pneumonia as well as a severely damaged heart. He underwent a cardiac catheterization and two stents were inserted into one of his coronary arteries, which had become 90% blocked.

The surgery resulted in a return of blood flow to his heart and has allowed him to continue his rebound from earlier lung problems. Having the cardiac catheterization also meant canceling several major events from his schedule, but Lewis fully recuperated in a matter of weeks. In 1999, his Australian tour was cut short when he had to be hospitalized in Darwin with viral meningitis. He was ill for more than five months. It was reported in the Australian press that he had failed to pay his medical bills; however, Lewis maintained that the payment confusion was the fault of his health insurer. The resulting negative publicity caused him to sue his insurer for US$100 million.^[41] Lewis has had prostate cancer,^[42] diabetes,^[36] pulmonary fibrosis,^[35] and a decades-long history of heart disease. https://en.wikipedia.org/wiki/Prednisone^[35] treatment in the late 1990s for pulmonary fibrosis resulted in weight gain and a noticeable change in his appearance.

In September 2001, Lewis was unable to perform at a planned London charity event at the London Palladium. He was the headlining act, and his band had taken to the stage, starting up their music while he was introduced, but he didn't appear, as he had suddenly become unwell, apparently with heart problems. He was subsequently taken to the hospital. Some months thereafter, Lewis began an arduous, months-long therapy that weaned him off https://en.wikipedia.org/wiki/Prednisone andenabled him to return to work. On June 12, 2012, he was treated and released from a hospital after collapsing from  hypoglycemia at a New York Friars' Club event. This latest health news forced him to cancel a show in Sydney.^[43]"

 

Certainly, older people can have all sorts of morbidities, but I have to think it's pretty rare to have had those morbidities essentially one's entire life - these are not trivial illnesses, we are talking heart disease so severe that it would result in a heart attack in one's mid-30's. The list of side-effect laden medications, such as Prednisone itself would spell doom for a lesser man. It's amazing and frankly bordering on the unbelievable. The very old are frequently divided into the "avoiders" (the ones who manage to avoid morbidities all their lives), the "postponers" (who compress all their morbidities into their very late age), and the "survivors", those who have managed to survive a morbidity of some kind. Even calling Jerry Lewis a "survivor" stretches the definition, given that he has survived not merely one major morbidity but a veritable catalogue of them - not merely severe heart disease, but cancer, diabetes, respiratory illnesses, and the list goes on. But that's not all. If you told me of such an individual at 90, I'd picture someone on life support, vegetating, completely out of it, living more in theory than in reality. But that is not Jerry Lewis - he's still working, and more - he appears to really be in good mental shape, and ambulatory. Is this a miracle or what? Defies imagination.

Here we are, tweaking and micro-adjusting minute elements of our lifestyles and subjecting ourselves to decades long iron regimens of diet, exercise and lifestyle - and there you have a fellow who lived a care-free lifestyle with an unimaginable collection of lifelong serious illnesses, merrily carrying on into his 90's. Meanwhile, some who have tried their best with enormous discipline and scientific insight - die decades earlier (Walford). Why even bother - it's clearly all in the genes. It is with a sense of great fatalism that I dutifully follow the strictures of a CRON life. I may do my best, but it really is down to the genes first and foremost.   

[Dean Pomerleau]

Tom,

 

Jerry Lewis is quite a survivor! I had no idea about all his health troubles. But generalizing from one or a few long- or short-lived (☹) individuals to the conclusion that :

 

Why even bother - it's clearly all in the genes. It is with a sense of great fatalism that I dutifully follow the strictures of a CRON life. I may do my best, but it really is down to the genes first and foremost.   

 

seems to me to be going too far. Case in point, this new review [1] of the role of genes vs. lifestyle for human longevity, suggests:

 

The genetic component of lifespan in humans has also been analyzed by comparing the age of death of monozygotic and dizygotic twins. This has allowed the estimate that about 25% of the variation in human longevity can be due to genetic factors and indicated that this component is higher at older ages and is more important in males than in females.

 

I don't consider 25% genetic determination to warrant the kind of fatalism you appear to espouse.

 

--Dean

 

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[1] Immunity & Ageing 2016 13:12

DOI: 10.1186/s12979-016-0066-z©  Passarino et al. 2016

 

Human longevity: Genetics or Lifestyle? It takes two to tango

 

Giuseppe Passarino, Francesco De Rango and Alberto Montesanto

 

free full text: http://immunityageing.biomedcentral.com/articles/10.1186/s12979-016-0066-z

 

Abstract

 

Healthy aging and longevity in humans are modulated by a lucky combination of genetic and non-genetic factors. Family studies demonstrated that about 25 % of the variation in human longevity is due to genetic factors. The search for genetic and molecular basis of aging has led to the identification of genes correlated with the maintenance of the cell and of its basic metabolism as the main genetic factors affecting the individual variation of the aging phenotype. In addition, studies on calorie restriction and on the variability of genes associated with nutrient-sensing signaling, have shown that ipocaloric diet and/or a genetically efficient metabolism of nutrients, can modulate lifespan by promoting an efficient maintenance of the cell and of the organism. Recently, epigenetic studies have shown that epigenetic modifications, modulated by both genetic background and lifestyle, are very sensitive to the aging process and can either be a biomarker of the quality of aging or influence the rate and the quality of aging.

 

On the whole, current studies are showing that interventions modulating the interaction between genetic background and environment is essential to determine the individual chance to attain longevity.

 

Keywords

 

Human longevity Genetics of aging Calorie restriction

[Sthira]

Here we are, tweaking and micro-adjusting minute elements of our lifestyles and subjecting ourselves to decades long iron regimens of diet, exercise and lifestyle - and there you have a fellow who lived a care-free lifestyle with an unimaginable collection of lifelong serious illnesses, merrily carrying on into his 90's. Meanwhile, some who have tried their best with enormous discipline and scientific insight - die decades earlier (Walford). Why even bother - it's clearly all in the genes. It is with a sense of great fatalism that I dutifully follow the strictures of a CRON life. I may do my best, but it really is down to the genes first and foremost.

Kind of a bummer here, these words. For me I find it fun and challenging to do my best to eat as healthy as I can for every single meal. Eat no junk, ever. It's counter-culture behavior amidst a sick society. And we never know who we may be secretly inspiring by living clean in the face of general crappiness.

 

And I guess I don't enjoy food very much in that gormet, foodie-addict sense that I see in many others. Is being a foodie synonymous with poor health and obesity? Also there's an ecological perspective here to keep -- eat well to help protect habitats, eat gently to protect animal rights and welfare, eat well to help limit pesticide runoffs into streams, lakes, oceans: we have higher, nobler reasons to tweak diet.

 

You may have overstated the genetics-will-fuck-you-anyway bit -- but I hear your argument -- why bother obsessing over every detail when we're just gonna fall apart and die on schedule anyway? Isn't that sorta de Gray's view?

 

Stay healthy for as long as possible is one goal, thumb your nose at genetics, give bad genes the middle finger by fighting as best as you can, and maybe just maybe we can hope new tech to delay disease WILL HURRY THE FUCK UP in its arrival.

[Dean Pomerleau]

Sthira,

 

Is being a foodie synonymous with poor health and obesity?

 

Yes - pretty much ☺. Take a look at this foodie's Quora answer to the question What is the most expensive meal you have ever eaten? Pay particular attention to the last photo in his answer, a portrait of him with the chef. Guess which is which (before looking at closely to see who's wearing the apron). Reminds me of Monty Python's Mr. Creosote (Warning: graphic content). One thin wafer anyone?☺.

 

...we have higher, nobler reasons to tweak diet.

 

While I do think eating healthy can also reduce the impact on the environment and certainly improve animal welfare, it isn't necessarily the case that doing what's right for our own health has the best overall outcome for the planet. Not that I advocate eating any kind of meat, but grass-fed beef has a bigger impact on the environment than cows raised on feed-lots. And closer to home, our choices about fruits & veggies don't always jibe with what's best for the planet.

 

--Dean

[Sthira]

Haha that exploding guy was funny! My favorite part was his giant heart still patiently beating away after the stomach food explosion!

 

And eating local, organic, plants-only, and no piggies, no cows, no gallus gallus domesticus is absolutely healthier "for the environment" than mainstream alternatives!

[TomBAvoider]

One of the world's richest men, Warren Buffett is 85 years old. That's certainly much longer than the average American or a denizen of any country with even the longest life expectancy. From what one reads, he expects to live for quite a while yet. He consumes about 2700 calories a day, of which 700 calories comes from drinking Coke - and he absolutely does not believe that the obesity epidemic should be blamed on calories such as from Coke and other soft drinks. His sole criterion of what to eat is whatever tastes good. I wonder if nutritionists would cite Warren Buffett as a model of how to reach at least 85 years old - milk shakes from Dairy Queen, almost a thousand calories a day from Coke and eat whatever makes you feel good at the moment. After all, it works for that bum, Warren Buffett. Genes as destiny - because if not, then nutrition science has it all wrong. Keep that in mind as you assess the tradeoffs between QOL and what you hope to gain from your CR lifestyle. 

 

http://www.reuters.com/article/us-berkshire-results-idUSKCN0XR0GT

 

"Buffett, who consumes 700 calories of Coke a day, said it seemed wrong to blame calories alone for rising obesity levels.

"I elect to get my 2,600 or 2,700 calories a day from things that me feel good when I eat them," he said. "That's my sole test."

[Thomas G]

Tom,

 

It's not all genes and lifestyle. Here's one factor that might also be coming into play in Buffet's favor: 

 

"The top 1 percent in income among American men live 15 years longer than the poorest 1 percent; for women, the gap is 10 years. These rich Americans have gained three years of longevity just in this century. They live longer almost without regard to where they live. Poor Americans had very little gain as a whole, with big differences among different places." "The Rich Live Longer Everywhere. For the Poor, Geography Matters." New York Times, April 11, 2016.

 

More on that three year gain for the 1% since 2000: "The gains in lifespan for the rich are the equivalent of curing cancer; the CDC estimates that eliminating all cancer deaths would increase average lifespans by 3.2 years." healthinequality.org

[Dean Pomerleau]

Welcome to the CR Forums Thomas!

 

Good point about health & longevity inequality. I actually talked here about the sad and growing gap between rich and poor when it comes to health & longevity. The interesting thing is that two of the factors driving this growing inequality are:

1. More healthy lifestyle options and better health choices on the part of the wealthy compared to the poor
2. Better access to good healthcare for the rich

 

In Warren Buffett's case, neither of these advantages appear to be operative. He clearly isn't making healthy choices when it comes to diet, and things are a little more interesting and ambiguous as to whether he's being optimally served by the juggernaut that is the US healthcare system.

 

In 2012 (at the age of 81) Buffet was diagnosed with early stage prostate cancer via a PSA test. From Mark Garnick, MD at Harvard Medical school:

 

Buffett’s PSA test set off a disastrous chain of events that will probably do the legendary money manager more harm than good. The high PSA result triggered a prostate biopsy. (On Twitter, cancer specialist Benjamin Davies of the University of Pittsburgh School of Medicine said “If one of my residents biopsied an 81yo (with no mets [metastases]) I would fire them on the spot.”) The biopsy showed some cancerous cells in the walnut-sized gland. And that is leading Buffett to a two-month course of radiation therapy.

 

If Buffett’s PSA level was very high, or had been increasing rapidly, or the biopsy showed highly abnormal, fast-growing cancer cells, radiation therapy is one of several reasonable options. But if his PSA is stable, his Gleason score (a measure of how closely cancer cells resemble normal ones) is low, and he isn’t experiencing any prostate-related symptoms, undergoing radiation therapy right now doesn’t make sense.

 

Although quite safe, radiation therapy isn’t a risk-free procedure. As we describe in Harvard Medical School’s 2012 Annual Report on Prostate Diseases, it has immediate side effects, such as fatigue and bowel problems. Over the long term, about 50% to 70% of men lose the ability to get or sustain an erection or experience rectal bleeding.

 

It's now four years later, and Buffett is apparently still doing ok. So maybe it was the right decision, and he was fortunate enough to dodge the potential negative side effects of radiation therapy for his prostate. But the side effects are personal enough that we are unlikely to find out...

 

It does appear to that Oracle of Omaha does grudgingly do a little exercise:

 

Back in 2007, Buffett told CNBC that his doctor had given him a choice two years before: "Either you eat better or you exercise." Buffett said he chose exercise, the "lesser of two evils."

 

Bottom line, sometimes "less is more" when it comes to traditional medical care. And the best course to pursue is prevention, rather than treatment. But given his Coke habit, that's a message Buffett doesn't seem to have received...

 

--Dean

[Thomas G]

Thanks for the welcome Dean. I'm a total n00b and have been lurking here for a few months, reading all of the recent posts, trying to learn as much as I can. I'm amazed by wealth of knowledge and experience on this forum. It's humbling and a bit intimidating.

 

A lot of that gap between rich and poor seems to be due to smoking, but that probably isn't all of it. I find this stuff really interesting. On the one hand we can say that smoking is a lifestyle choice that individuals have a remarkable amount of control over (at least at first). But it's clear that our choices are very heavily influenced by larger social and economic forces. How those two interact fascinates me.

 

In addition to smoking I'd be interested to see how stress plays into this widening gap. I'm sure there are certain stresses involved with managing billions of dollars, but I would gladly take that kind of stress instead of loosing sleep because you're unsure how to come up with rent next month.

 

I have high blood pressure. Among other factors I'm almost certain that my student loans are a major contributing factor. They are the last thing I think about before I go to sleep, and the first thing I think about when I wake up. Debt rules everything around me. So far I'm only aware of one study that looks at the effects of debt on physical health and sure enough they found that those with higher debt had "higher perceived stress and depression, worse selfreported general health, and higher diastolic blood pressure." My student loans have taken years off of my life, and that's partly why I'm interested in taking better care of myself and CR. If I can, I want to steal a few of those years back.

[Sthira]

Yeah I feel ya on those student loans, man, really really sucks. They kept telling us get education, get educated, get more, more edumacated, get even highereducateididumust -- and then whoops out pulled the rug of decent and humane living wage jobs. So it's freelance or die, and student loans hang there like evil, and how are we not supposed to be stressed again? Oh yeah, meditate and eat more cabbage and don't get too hammered...

 

Hey tho, for high blood pressure, nothing works better at lowering it than good ole free of charge ain't gotta pay nothin' fasting (!) Fasting is the cure for elevated b/p, man.