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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:

  1. Avoid Overeating
  2. Eat Some Nuts
  3. Use The Spice Turmeric
  4. Eat Plenty of Healthy Plant Foods
  5. Exercise and Be Physically Active
  6. Don’t Smoke
  7. Keep Your Alcohol Intake Moderate
  8. Prioritize Your Happiness
  9. Avoid Chronic Stress and Anxiety
  10. Nurture Your Social Circle
  11. Increase Your Conscientiousness
  12. Drink Coffee or Tea
  13. 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

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How about mitigate risks: for example sports-related ( http://www.runnersworld.com/health/the-10-laws-of-injury-prevention), occupational ( http://www.blacklinesafety.com/6-workplace-injuries-can-mitigate/ ), driving safety ( seatbelt use, driving safety courses), etc.

 

Nice list though I would remove nuts as the data for benefits is not without controversy: https://youtu.be/UvYq6WTm258 /. https://www.drmcdougall.com/forums/viewtopic.php?t=6678 & expand the tumeric to include healthy spices & herbs ( maintaing emphasis on turmeric which has some unique potential anti-aging properties ).

 

I like your addition of preventative maintenance.

Edited by Mechanism

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Regarding "not overeating" unfortunately, people are not clued into the caloric content of food, so their estimates of how much is "too much" is skewed; for example even with all the publicity many folks don't cotton on to the fact that f.ex. Starbucks "coffee" concoctions can push 1000 calories per drink! I was at a party recently where a big discussion erupted over weight loss, and one woman was claiming that she kept a food diary and she never overate, in fact ate very little, but yet was massively overweight; upon questioning, I found out she doesn't count "drinks" and "condiments" in her calorie count - condiments being things like creams and honey and other stuff that she liberally dumped into her teas and coffees, oils that he drizzled over her salads, the pesto etc., etc., etc. So the issue is not only about giving tips, but giving info that is likely to be understood properly.

 

I like the Michael Pollan dictum about eating - very succinct for the lay public: "Eat food, not too much, mostly plants". But you can't leave it at just that, you need to unpack it a bit. What does "eat food" mean in this context - it means avoid "processed food", and in turn what is "processed" - does it come out of a box, or jar, or bottle, or can? Avoid. A soft drink is not "food" - avoid. If you must eat meat - avoid processed meat. Any processed food is usually nutritionally bad - avoid. And you need to stress all three elements, because people have an amazing ability to hear selectively - I've seen many "vegetarians" who by definition "eat mostly plants", who are quite obese, because they hear "mostly plants" and forget "not too much". So when I cite this quote, I usually stress the tripartite nature of it by saying: remember, to eat properly you need ALL three elements like the legs of a stool - if you have only two legs, or only one leg, the stool will fall - you need all three: Eat food AND not too much AND mostly plants - remember, all three! Otherwise people will do stuff like eat a mound of potatoes in one sitting, or a 3000 calorie "omelet". 

 

To your list I'd add:

 

1) Don't snack - ever. 

2) If possible, try to consume all your food within an 8 hour window - leave the rest of the hours with only non-caloric liquids: unsweetened tea, coffee black, no additives, water - no juices, no soft drinks etc. There was a study recently that showed higher breast cancer risks for women who had less than a 14 hour fasting period per every 24 hours.

3) Increase fiber in your diet - avoid "white" breads, "white" rice, highly processed or refined grains (remember: avoid processed - the less processed, the better)

4) If possible, try to spend some time every week in "green" areas: parks, woods, gardens etc. - this might also additionally spur you to find better ways of spending your spare time than sedentary behavior, TV watching, internet surfing, computer noodling etc.

5) If possible, try to find some quiet time every day: some place where silence reigns, where you can meditate (even as little as 8 minutes a day mini meditation before you go to sleep), where you can give your ears, other senses, and mind a rest. Every day.

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Tom,

 

Thanks for your input. All good additions, although bordering on the impractical for the general population - e.g. "Don't snack - ever".

 

I like the Michael Pollan dictum about eating - very succinct for the lay public: "Eat food, not too much, mostly plants".

 

Me too! In fact I used that sage piece of advice from Michael Pollan in my recent letter to the editor of Discover Magazine defending CR (and promoting the CR Society!) after they published an article that was critical of CR, as discussed here. Unfortunately I don't believe they ever published my letter (I'm a subscriber and have been watching for it...). 

 

But even among CR folks, Michael Pollan's advice of "Eat food, not too much, mostly plants" drew some criticism, as you can see from that thread.

 

Fortunately it was only Saul - who went off on another one of his delusional tyraids about some sort of vegan conspiracy, which he thought Pollan must be part of and which he seems convinced is spearheaded by Dr. Greger ...

 

But when it comes to communicating with rational human beings, Pollan's pithy synopsis of the best diet for health & longevity is hard to beat. You are right however - qualifications and explanations are almost always required.

 

Mechanism, I'll address your well-meaning but nevertheless somewhat misguided perspective in my next post...

 

--Dean

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Btw., I have read your dental care regimen, and I have some observations. It has always been my habit since childhood, to brush my teeth first thing in the morning, however, that was done with no thought behind it, until I spoke to a periodontist. That conversation changed my teeth brushing habits. According to the periodontist, the most important brushing of teeth is the "first and last". That is, before you go to bed, obviously, you must brush your teeth, so that periodontal disease bacteria don't have a chance to build calculus on your teeth, especially below the gumline - the damage is mediated by the metabolic acids released by the bacteria metabolizing the food left in your mouth if you don't thoroughly brush/floss your teeth. However, the bacteria do most of their acid damage in the first 20 minutes of when they get ahold of the food, so why is it bad to leave it all there for the whole night? Well, that's because the bacteria build a biofilm on your teeth and build a colony that eventually hardens into calculus pushing up the gum and starting the periodontal disease process. All those hours at night, without brushing, they are building the biofilm and establishing a coral reef of bacterial colonies. So, before you go to bed, you want to floss and brush - that's a given. But here is where the twist comes in - he said (paraphrasing from memory): "it is in some ways more important to brush your teeth before eating than after eating". Here is why: brushing your teeth disrupts the biofilm and flushes out a substantial portion of the bacterial colonies - do this just before you eat, and now there are fewer and more disorganized bacteria to immediately feast on the food you are consuming (remember: the greatest damage the bacteria do through their acidic metabolites is in the first 20 minutes) - because even as you eat and have not yet brushed after the meal, odds are that much more than 20 minutes have passed and a lot of damage has been done before you have managed to do any brushing post eating. So what would you rather have: an intact biofilm and bacterial colonies falling ravenously on the food you are eating and doing their worst damage before you have managed to brush after eating? Or would you rather disrupt the biofilm and flush the colonies alway right before you eat, so that they are in the smallest number and greatest state of disorganization when food comes to them - and then before they manage to organize again after being presented with food, you brush again! Now it is not practical to brush your teeth before every meal. However, it is entirely possible to brush your teeth not necessarily first thing in the morning, but right before the first meal of the day! So, my protocol these days is to brush right before my first meal of the day - walk out of the bathroom and go eat my meal pronto, so that as little time as possible is given to the bacteria to organize again and start a new biofilm. Then after the meal, I brush again. After dinner, I brush/floss/interdental brush thoroughly to give the bacteria as little to work with for the next 16-17 hours of non-eating. During this time, my saliva is remineralizing my teeth, so I don't want to disrupt that activity for the full 16-17 hours by unnecessary brushing (or 40 hours when I fast between 8 pm every Thursday until 12 pm Saturday). Then, I figure if any biofilm has managed to sneak by my evening brushing/flossing, I hit it again and eliminate it before my first meal.

 

Now, that's a lot of mind-numbing detail, so obviously that's not something I'd try to limit my advice to laymen by simply saying:

 

 

1) Brush your teeth right before your first meal of the day, then after it, and also make sure to brush/floss before going to bed (after your last meal).

 

A few other things that I have researched through PubMed, but don't have the citations on me at the moment (probably can hunt them down with time) follow, some of which can be turned into brief clear advice. In addition to a doctor, you should see a dentist at least a year, so:

 

2) See a dentist at least once a year 

 

Now, this must be seen in context, because of the following:

 

3) You should have your teeth cleaned at a minimum 2 times a year

 

From the research I've seen, I believe a Canadian study showed that the optimum number of times an ordinary person should have their teeth cleaned is 4 times a year. Of course, if you have special periodontal problems, it can be more, but it really should not be less than 2 times. Whenever I've had dental insurance, they'd cover teeth cleaning no more than 2 times a year - I'd reach into my pocket and pay for the extra 2, so that I ALWAYS have my teeth cleaned 4 times a year. Now, I split my teeth cleaning between my periodontist and my dentist, so that I alternate once at the dentist and next at the periodontist. I also always insist that the actual dentist and periodontist do the teeth cleaning (together with an assistant), because I want them to examine my whole mouth - that way they can spot not only incipient teeth problems and give me a full accounting of how I'm doing (with depth readings etc.), but also they are experienced in spotting other problems in the mouth: lesions, growths, signs and symptoms of other things (dentists are the biggest spotters of mouth cancer). So, when I say "see a dentist at least once a year", if you can contrive to have the dentist be your hygienist, you can "see" your dentist at least 2 times a year (or your periodontist).

 

A few more random things on dental hygiene: you should brush for at least 3 minutes. Any further removal of bacteria attenuates after a 3 minute session (according to a study I've seen). Electric toothbrushes are highly effective and convenient because you don't have to keep track of the time, instead you are alerted to how long you should spend on each quadrant of your teeth - and go for the full 3 minutes. So my brief advice:

 

4) Get an electric toothbrush and brush for 3 minutes a session.

 

From what I have read, toothpaste is a waste of time as far as effectiveness in bacterial removal - they add nothing, if anything, they slightly reduce the effectiveness of brushing in removing bacteria. What they do supply is fluoride - but for people who drink a fair amount of tea, this is unnecessary since tea supplies a ton of fluoride and most of the water is fluoridated anyhow. I personally do not use toothpaste, but I consume a LOT of tea, so I'm not worried about getting more through a few minutes of toothpaste exposure. But that's not advice I'd give to the layman.

 

Mouthwashes - can be effective (anywhere between 7%-13% more harmful bacteria are killed), but there are enough warning signs about cancer from exposure to various agents, including alcohol, for me to skip this. I don't use mouthwash - and anecdotally, when I have used in the past, I subjectively felt I did worse, on account of the bacterial balance being disturbed. Again, not advice I'd give one way or another to a lay person.

 

A limited window in which you consume food is generally conducive to dental hygiene.

 

The biggest factor in the destruction of your teeth is lack of saliva - dry mouth. You've seen the pictures of 'meth-mouth' - that's not due to drugs per se, but to the dryness they cause, which destroys the teeth. Saliva is your protective agent that remineralizes your teeth. I've seen reports of athletes who habitually breathe with an open mouth for hours on end while training (marathon running etc.) having worse dental health through dryness. So another piece of advice on that front:

 

5) Don't walk around, train, sleep etc., with your mouth open for hours on end. Keep your teeth bathed in saliva for as long as you can.

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Thanks Tom,

 

I do brush (with a Sonicare electric toothbrush) just before bed and soon after I get up in the morning, in addition to after my meal (with 30min in between for acid to dissipate). Perhaps I'll shift my morning brush closer to my meal to disrupt the biofilm.

 

Note I also gargle with my homemade mouth rinse (water, baking soda, xylitol, erythritol, & amla powder) several times throughout the day to make my mouth inhospitable to bacteria. Coincidently, I had my biannual dental checkup and cleaning last Thursday. The hygienist was very impressed with how little staining, plaque and tartar I had this time compared with last. I attribute it to the dental rinse, which I just started using consistently a few months ago after my last checkup, where the staining due to tea coffee  was much worse.

 

--Dean

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I use the Braun Oral-B Pro 5000 electric toothbrush. I've never been 100% clear on the "acid dissipation" idea - as I understand it, if you leave acid on your teeth, the mechanical brushing will abrade your enamel, and if you wait 30 minutes, the acid will dissipate, and then you can brush. But if that's the case, then why not simply flush the acid away by vigorously swishing a liquid in your mouth, or a more alkalic liquid for a few seconds. My wife always has a pot of chamomile tea ready in the refrigerator, and I just pour a mouthful into a glass and swish that around in my mouth (and then swallow) at the end of the meal, and immediately floss, and then use an interbrush which takes a few minutes, and then go directly to brushing (so about 15-20 minutes after a meal). I eat twice a day, so that's not that many chances for acid+brushing to destroy my teeth if any is left after my chamomile swishing.

 

Now, to complete the dental ritual description a final addition: I brush my teeth in the bathroom over the sink. It takes about 3 minutes (slightly more) - but I do my brushing while standing on one leg, slightly bent at the knee... it takes some muscle control and effort to do this for 3-4 minutes! Then at the next brushing, I do the same, but alternate the leg I stand on. So each leg gets a couple of sessions a day. This I do for 3 reasons: (1) practice balance (important, as falls for elderly are highly mortality connected) (2) I strengthen my leg muscles (3) I strongly strengthen my bones:

 

http://www.ncbi.nlm.nih.gov/pubmed/18974448

 

Clin Calcium. 2008 Nov;18(11):1594-9. doi: CliCa081115941599.

[Dynamic flamingo therapy].

[Article in Japanese]
Abstract

A long follow up study of one minute unipedal standing therapy 3 times in a day to prevent femoral neck osteoporosis that have started from 1993 was reported. The registration from July 1993 to March 2004 were 86 cases which measured the femoral neck bone mineral density (BMD) according to dual energy x-ray absorptiometry (DXA) (Hologic QDR 1000 and 2000) in a follow-up period. Average age at starting exercise was 67.9 years old. All cases were female who were registered in our university hospital. The result of unipedal exercise evaluated by the femoral neck BMD was described as follows : The increased cases of BMD were 15/24 (62.5%) post exercise 3 months, 15/37 (40.5%) post 6 months, and 12/21 (57.1%) post one year, 8/25 (32%) post 3 years, 7/13 (53.8%) post 5 years and 1/3 (33.3%) post 10 years. We have no fracture cases in which continued exercise in follow-up period. According to a randomized controlled study of unipedal standing balance therapy to clinically defined high-risk elderly individuals a therapy group reduced fall times by a significant difference than non-therapy group. We conclude that unipedal standing therapy is efficacious against femoral neck osteoporosis and fractures.

PMID:18974448 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/17142934

 

Clin Calcium. 2006 Dec;16(12):2027-32.

[Effects of unipedal standing balance exercise on the prevention of falls and hip fracture].

[Article in Japanese]
Abstract

To prevent hip fracture there are three methods: 1) falls prevention, 2) treatment of osteoporosis and 3) hip protectors. The improvement of the osteoporosis of the proximal hip demands nutrition involved medication as bisphosphonate and mechanical stress. Unipedal standing captures the 2.75 times weight load to the femoral head. Unipedal standing for one minute is equivalent to the amount of integral load gained through walking for approximately 53 minutes. Unipedal standing balance exercise in one minute 3 times per one day is useful to create the proximal femoral bone density and to prevent falls but is not statistically definition to prevent hip fracture. We believe daily unipedal standing balance exercise should contribute toward overcoming prevention of hip fractures.

PMID:17142934 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/17013734

 

J Orthop Sci. 2006 Oct;11(5):467-72.

Effects of unipedal standing balance exercise on the prevention of falls and hip fracture among clinically defined high-risk elderly individuals: a randomized controlled trial.

Abstract
BACKGROUND:

The aim of this study was to assess the effectiveness of the unipedal standing balance exercise for 1 min to prevent falls and hip fractures in high-risk elderly individuals with a randomized controlled trial. This control study was designed as a 6-month intervention trial.

SUBJECTS:

Subjects included 553 clinically defined high-risk adults who were living in residences or in the community. They were randomized to an exercise group and a control group.

METHODS:

Randomization to the subjects was performed by a table of random numbers. A unipedal standing balance exercise with open eyes was performed by standing on each leg for 1 min three times per day. As a rule, subjects of the exercise group stood on one leg without holding onto any support, but unstable subjects were permitted to hold onto a bar during the exercise time. Falls and hip fractures were reported by nurses, physical therapists, or facility staff with a survey sheet every month. This survey sheet was required every month for both groups.

RESULTS:

Registered subjects were 553 persons ranging in age from 37 to 102 years (average, 81.6 years of age). Twenty-six subjects dropped out. The number of falls and hip fractures for the 6-month period after the trial for 527 of the 553 subjects for whom related data were available were assessed. The exercise group comprised 315 subjects and the control group included 212 subjects. The cumulative number of falls of the exercise group, with 1 multiple faller omitted, was 118, and the control group recorded 121 falls. A significant intergroup difference was observed. However, the cumulative number of hip fractures was only 1 case in both groups. This difference was not statistically significant.

CONCLUSIONS:

The unipedal standing balance exercise is effective to prevent falls but was not shown to be statistically significant in the prevention of hip fracture in this study.

PMID:17013734 [PubMed - indexed for MEDLINE]

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Tom,

 

...as I understand it, if you leave acid on your teeth, the mechanical brushing will abrade your enamel, and if you wait 30 minutes, the acid will dissipate, and then you can brush.But if that's the case, then why not simply flush the acid away by vigorously swishing a liquid in your mouth, or a more alkalic liquid for a few seconds.

 

My understanding is that it isn't the acid per se, but that the acid softens the enamel, which takes time to re-harden. That's why you want to wait 30min after a meal to brush. BTW, I do flush my mouth with my alkaline homemade mouth rinse immediately after I eat, to lower the acidity of my mouth and begin the enamel-hardening process.

 

 I do my brushing while standing on one leg, slightly bent at the knee...

 

I like that idea - kill multiple birds with one stone! Similarly, I've lately taken to doing laps of my basement while brushing, to get in a few extra steps. But your practice makes even more sense - building balance & strength at the same time. I'm going to give it a try!

 

Thanks,

 

--Dean

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You're welcome, Dean. While you're at it, you might consider holding the brush with your non-dominant hand :). Interesting wrt. the acid - I'll have to give this more thought/research.

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Tom,

While you're at it, you might consider holding the brush with your non-dominant hand :). 

 

What are we - playing Twister here?

 

Seriously, I know where you are coming from with that advice. I suspect for me anyway there would be a tradeoff between the benefits of non-dominant hand brushing for brain health vs. reduced brushing quality / thoroughness. But once I master brushing while standing on one foot, maybe I'll give it a try with my non-dominant hand. 

 

--Dean

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You know what's funny? Those were my exact thoughts too when I just started out with the non-dominant hand - I was worried about quality of brushing. But - I turned that weakness into a strength. Here's how - after I gained confidence that I could stand on one foot, I upped the challenge by doing so with my eyes closed... that was scary, but eventually I got good at that. And there was an unexpected benefit - when I used my non-dominant hand, with closed eyes and aware of the consequences of a disastrous fall, not to mention bad brushing, I was hyper-aware of what I was doing - I was particularly careful to maneuver the brush thoroughly and with my eyes closed I seemed to pour myself into feeling exactly where it was that the brush was, and I could practically feel the new neural connectors being generated, and now I had a fresh awareness of where the brush is and also of spacial feeling and orientation while standing with eyes closed. I feel that such a challenge a few times a day is highly beneficial to keeping the brain engaged and being in the moment. I actually look forward to my brushing sessions, whereas in the past I used to think of it as a time-consuming chore. Anyhow, that's a one-rat report, and YMMV.

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Thanks Dean for the tips.  In addition to the research front I appreciate being clued in to forum etiquette, style, etc. issues - it can be like having the proverbial fly down, it's something you want to be aware of but present company may or may not feel comfortable chiming in.  So I'll try using the link feature with this post and see how it goes.

 

The threads and videos were helpful -- I agree with reading the primary studies and have observed that Dr. Greger however well-intentioned and chock full of interesting occasional obscure yet high yield gems of studies, does not appear to always analyze the studies he quote with the same critical rigor and analysis as Jeff Novick... and even Novick I don't always agree with.  

 

Regarding the studies you cited some of the studies had issues - for example breaking randomization ( i.e., breaking so called "intention-to-treat" analysis to go with actual practices ) while well-meaning post-hoc analysis of the predmed study has problems, and for the large prospective cohort observational studies residual confounding can be a notorious problem.  However the more data utilizing disparate methodology converging to similar conclusions, the more believable the findings, and the literature is getting more robust here even with some of the methodological flaws.  Some of the supportive basic science studies have been compelling and consistent with the above. 

 

Now assuming for the moment that we believe the above nut research findings hold true, a larger concern is to what extent their conclusions are clinically significant and applicable to the CRON community as opposed to the general population ( on etiquette if I can go on a tangent to ask - what acronym should I use - I recently discovered a thread between you, Saul, and possibly Michael R where there is a negative connotation with the words "crone" & "cronie" hence avoidance of the acronym expression "CRONie")?  I realize the original thread is focused on a general population and that has value, but I am also concerned with how this applies to our own diets and lifestyle.

 

Playing devil's advocate, Novick argues, besides methodological points on what the nuts displaced in the diet (such as simple highly refined, high glycemic index carbs that CRONs would not ordinarily consume), that if there is benefit, it would be incremental in a healthy low-BMI, etc. population.  In other words the CRON population may just be too darn healthy from other lifestyle choices to really benefit from any incremental increase in longevity or decrease in morbidity.  His elaborate stepwise argument can be found here:  

 

( hey I think my first link worked!  Thank you for the suggestion and guidance).  I think Novick's argument in that link is worth the full read -- interested in your thoughts....).

 

I'll add that lending credence to his hypothesis is that the Okinawa population resembles CRON participants a lot more than the general population, and in that population although there was nut consumption it was really minimal:  "Nuts were less than 1% of calories (the equivalent of 1/10 of an ounce a day) Oil was less than 2% of calories" ( Source here ).

 

One other point that I think deserves attention / addressing in this population.  A substantial proportion of the Okinawa population were deficient in one more more micronutrients and yet were very long-lived.  I was thinking this may have bearing in the thread on supplementation where I have been leaning towards a minimalist approach (aside from B-12, vitamin D, possibly iodine).  Fire away!  ;)xyz 

Edited by Mechanism

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Btw. on a related issue: are you an evangelizer for CR IRL (In Real Life)? When I first read Walford's book, back in the day, I was pretty enthusiastic about the validity of the diet and the possible benefits - and I offered unsolicited advice to people who would complain of various health problems that I saw as diet-related. With time, I stopped doing that, and these days I avoid the topic like the plague - which is not always easy, since my low BMI sometimes generates comments and questions, as do my various social behaviors (ordering food in restaurants, being "weird" about food when invited for dinner, lunch etc.).

 

The reasons are many, but perhaps the biggest one is that I am no longer convinced that CR actually results in longer lifespan. And this was before the monkey study. I've seen 2-3 years advantage bandied about, but I am not sure at all that it's not due to obesity avoidance rather than CR per se. Furthermore, I am not even sure about CR not being actually lifespan detrimental - what with the avalanche of studies and statistics about BMI and mortality; yes, I am aware of all the confounders, but study after study eventually seems to untangle a given confounder (like smoking, disease etc.). It's possible it has something to do with "reserves" in case of illness, but regardless, the outcome is what matters. Now, I don't fully believe that CR is actually life shortening (if initiated properly), but I can't 100% guarantee it is not. So I keep quiet.

 

I do CR because it makes me feel good - the same way someone may like junk food because it makes them feel good (see Warren Buffett). I feel more vital and sharp when I skip a meal, it gives me a rush - just as a hamburger might give someone else a rush. But I make no health claims. It's been a peculiar devolution of conviction for me. I started out with "CR will surely prolong lifespan in humans, as it has in all animals studied so far" to "well, it won't do so for higher mammals like apes and humans" to "well, but at least it will prolong healthspan" to "well, it won't prolong life, and probably not even healthspan, but what the heck, I like it, even if it loses me a couple of years"... which is no different from the guy who loads up on junk food - "shorter, but sweeter".

 

In short, I've pretty much lost faith in CR - or more accurately - I'm not counting on anything. I do it, because I like it. But that's no grounds for standing on a soapbox and evangelizing a lifestyle. So I avoid the subject - I make excuses and file it all under personal preferences when asked.

 

In fact, I demur from offering any health advice - as requested in this thread. I may share it with the few people who read this thread, but I would never IRL go ahead and say any of this to a real person out there. Health, diet and lifestyle are such a personal and touchy matter that I think it's a losing proposition to attempt to offer strong opinions, even when asked. I have come to regard any questions about how to improve health or diet or lifestyle as I regard questions about how to reach financial security. I offer no answers - if my advice is correct, someone can always wonder if had they invested their money differently they wouldn't have made even more, and if my advice turns out to be wrong, then I get all the blame. So I don't offer advice about health, or money - at most, for two life-long friends, I'll offer "this is what I do, but it works for me, and I can't say how it will work for you!". 

 

Therefore this thread, for me, is something I might do in the (weak) anonymity of the internet, but never in real life.

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Tom,

 

Years ago I too quit proselytizing CR in real life (IRL), for several reasons. First, as you noted - it doesn't work. I've found it much more effective (although much more gradual) to simply set an example. For example, my immediate family has come around to vegetarianism (although not yet veganism) based in large part on simply seeing that it's working well for me, and through their own reading of the literature, which I might occasionally, casually mention to them.

 

Second, I too have lost a lot of faith that CR will work significantly better to extending healthy lifespan than a much simplier, easier-to-follow, obesity-avoiding diet & lifestyle, particularly for those who don't have the discipline for serious, careful CR, and who would therefore be likely to quit and go back to their original, really-unhealthy lifestyle.

 

I too practice my unusual diet and lifestyle (I won't even call it CR) because I enjoy it, and I enjoy the challenge of it. Plus, I have some rekindled hope that the combination of net CR along with persistent cold exposure might actually be beneficial for health and longevity. But mostly I do it to explore a part of human possibility space that few have visited before, and see where it takes me...

 

That's why I opened this thread by characterizing the original article as something I'd share with someone who asks. I'm not in the business of offering diet or health advice unsolicited anymore. I get my fill of preaching (mostly to the choir) here on the CR Forums!

 

--Dean

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Mechanism,

 

You're getting the hang of this forum thing - congratulations and thanks for your continued efforts in this regard!

 

In reference to how to refer to those of us who do what we do here. I've taken to even avoiding the term CRON, for exactly the reason we're discussing - namely there is no clear consensus on what the ON part of that term means. Plus, at least if you ask Michael, it's the CR (i.e. calories, calories, calories) that counts, as long as one is getting adequate nutrition - and CRAN sounds even worse! What would we be then - CRANies?!

 

Instead I say we "practice CR", and that we are "CR practitioners" or "CR folks", or collectively as a group, the "CR community". Less than ideal, admittedly.

 

Regarding nuts. They are a case-in-point in why to avoid the term CRON. As I said, an argument could potentially be made that an adequate diet could be formulated without nuts, seeds or oils. Based on personal experience, such a diet would be difficult both to formulate and to stick to. And I'm strongly suggesting that it wouldn't be better than a diet that includes nuts and seeds. But I'm not denying it's possible to formulate a diet as good. 

 

The Okinawans are one piece of evidence to support this idea that really low fat can work, although I wouldn't claim it to be strong evidence, because the traditional OKies have so much else going for them that could explain their longevity. I certainly would not suggest that the fact that some of them were deficient in known essential vitamins and minerals (like B12) but that as a group they lived a long time as evidence that being deficient in essential vitamins and minerals may not be so bad. That is such a bad form of argument that it must have a specific name associated with it...

 

I don't think anyone can or should even try to argue the traditional OKie diet was optimal (there is that word again). Plus the fact that a few of them may have been deficient doesn't mean they all were, or that they were on average, or, importantly, that those who were deficient lived particularly long or healthy lives. 

 

In short, stick to the controlled science over anecdotes and epidemiological data when good science is available. There is good science available that tell us certain nutrients are essential, and to be deficient in them is bad news in general. Yes, there will always be exceptions (like George Burns), but it's foolish to expect you'll be one of them.

 

--Dean

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It's a form of so-called ecological fallacy. A good epidemiological analysis follows the individuals as the unit of analysis rather than the group as a whole - a common problem when comparing lifestyles & outcomes in country (or region) to country studies - and I agree, not the comparison to make. This reference was intended to draw attention to overall limited impact on the population as a whole. Agree with you 100% there though.

 

Given such low average nut consumption I think it probable ( would need to look at the probability distribution to say for sure ) that nuts are neither necessary nor sufficient for an optimal longevity diet and we can observe similar patterns across other indigenous populations.

 

As for low fat / high fat, in the case of added oil ( different than nuts where clinical data would be the best source) I am somewhat concerned regarding:

 

(1) endothelial lining damage with higher fat consumption, which apparently is dose dependent but I don't know off the top of my head whether there was a threshold effect / how realistic the monounsaturated oil doses given to green monkeys were ( are you familiar with this study)?

(2) Likewise Dr. Esselstyn frequently discusses endothelial dissruption following high fat meals.

(3) A very low fat diet is the only diet I am aware of that can reverse atherosclerosis ( Dean Ornish, etc.).

 

Now I can understand #3 being less likely a problem for the CR community with low BMI / great lifestyle and few problems with atherosclerosis, cholesterol, etc. with the lifestyle.... and as far as I know #3 has never been put to the test for a Meditaranian of better yet more Fuhrlman-like diet where there is plenty or lots of oil but mostly from nuts and seeds, so who knows how these diets would fare.

 

But for (1) & (2) above, even with low cholesterol, etc. in the CR and/or healthy lifestyle, non-obese, etc. community I wonder whether the higher dietary fat intake can be problematic - could for example temporarily impaired arterial perfusion disrupt even a small atherosclerotic plaque leading to an idiosyncratic cardiovascular event ( stroke, MI ), not to mention the free radical / oxidative hit from the circulating fatty acids from, for example, too much EVOO in a higher dietary fat diet? These can be quite a bolus hit to the vasculature, especially if you practice intermittent fasting with fewer but larger meals. What is your take ( anybody please fee free to also chime in and join the discussion here too , I think this is a pretty interesting area with lots of data and takes on the literature ) on the risks of a higher fat otherwise "optimal nutrition" CR community diet - what say you to concerns (1) & (2) for such a diet?

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Regarding increased inflammation with higher fat meals as well as increased endothelial dysfunction:

 

"What’s really intriguing is that high-fat meals increase inflammation even when calorie intake is restricted and weight is lost. In a study published in the Journal of the American College of Nutrition, a diet high in fat raised an inflammatory protein (CRP) in the blood by 25% despite the fact that the subjects lost weight. By contrast, CRP levels dropped by 43% when the subjects lost the same amount of weight on a low-fat, high-carbohydrate diet. (6)"

 

"

“Certainly, a single high-fat meal has been shown to impair blood flow in part because of acute damage to the endothelium, which may explain why angina is often much worse for several hours after each high-fat meal. A vital question scientists must ask is: ‘How much inflammatory damage do dietary fats cause, and, as a result, how much cardiovascular disease are they causing’?”

 

And also increased LPS:

 

"A study in the Journal of Lipid Research conducted at the University of Kentucky clearly demonstrated in animals that a high-fat diet promoted the absorption from the gut of lipopolysaccharides (LPS), toxic substances that are part of bacterial cell membranes. That’s troubling because high levels of LPS trigger immune cells to increase inflammation. (7)"

 

Noteworthy was that quote 1 above referred an already calorie restricted population... In this setting why take the risk of aberrations from a low fat diet?

 

Dean, I tried looking to use the link method you told me about but I am replying by iPhone & I do not see an option for this like I saw for my PC: https://www.pritikin.com/your-health/healthy-living/eating-right/1103-whats-wrong-with-olive-oil.html... I thought this full reference was quite provocative, very interested in your thoughts.

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Mechanism,

 

It's a form of so-called ecological fallacy.

 
Thanks! I knew it must have a name. Now I know it - ecological fallacy. It seems like a few nutrient-deficient Okinawans among an otherwise healthy (non-deficient) population is a good example.
 

Given such low average nut consumption I think it probable ( would need to look at the probability distribution to say for sure ) that nuts are neither necessary nor sufficient for an optimal longevity diet and we can observe similar patterns across other indigenous populations.

 

Yes - at least some studies show (see this post yesterday) that doesn't take much in the way of nuts to benefit. I also note from a link you posted that our mutual vegan friend Jeff Novick isn't nearly as nut-phobic as I was led to believe from the video you posted. Here is Jeff's (sensible) perspective on nuts, from this post to Dr. McDougall's forums: 
 
If you have seen my presentation, From Oil to Nuts and/or Nuts and Health, or have spent time in these forums, then you know my recommendations which I have taught for over 20 years, which are also taught at the McDougall program (and I taught at the Pritikin Program from 1998-2007 and at the E2 Immersions), are that for most everyone, the inclusion of 1-2 oz of nuts per day is fine. In the Nuts and Health talk, I even go up to 4 oz/day for certain populations in certain situations. A serving is 1 oz. So, that means, for most everyone, I am recommending 7-14 servings a week and for some populations, up to 28 servings a week.
 
He seems to be speaking for Dr. M. (or at least the program bearing his name...) as well, which is a bit surprising, but good to see. It seems that for both Jeff and Dr. McDougall (and especially Dr. Esselstyn & Ornish) their wrath is targeted at oils more than nuts. I too favor nuts over extracted oils, since the former is a whole plant food while the latter is not. But unlike those good doctors, I'll happily acknowledge that very carefully-sourced and stored, unrefined extra virgin oils (esp. olive oil) can serve as a big part of a very healthy diet. For me, nuts are just better since they are whole foods (with extra nutrients, like fiber), less prone to spoilage (although they need to be stored carefully too), easier to judge quality, and lb-for-lb cheaper than really high-quality oils, like Amphora EVOO
 
Which brings me to your question: 
 

As for low fat / high fat, in the case of added oil ( different than nuts where clinical data would be the best source) I am somewhat concerned regarding:

(1) endothelial lining damage with higher fat consumption, which apparently is dose dependent but I don't know off the top of my head whether there was a threshold effect / how realistic the monounsaturated oil doses given to green monkeys were ( are you familiar with this study)? 
(2) Likewise Dr. Esselstyn frequently discusses endothelial dissruption following high fat meals. 
(3) A very low fat diet is the only diet I am aware of that can reverse atherosclerosis ( Dean Ornish, etc.).

 

[Hint: Mechanism, there are handy formatting tools in the toolbar for making pretty numbered and bulleted lists, right next to the link tool I pointed you to yesterday]

 

Mechanism - I'm surprised, you still haven't learned. A simple PubMed search on "olive oil endothelial" brings up a ton of recent controlled trials showing polyphenol-rich olive oil benefits rather than impairs endothelial function in people and rodents. I won't post all the abstracts here, but simply point to a list of a few of them. Here is an even bigger list of recent human evidence showing nuts, especially walnuts, improve endothelial function in humans too, perhaps to a larger degree and more consistently than EVOO.

 

Most of these nut studies simply instruct subjects to eat nuts on top of their existing (likely pretty crappy) diet, and the subjects serve as their own control in a crossover design.  That's what makes these studies so relevant to this thread - "eat more nuts" is sensible advice you can give to non-health-conscious friends and family interested in a few, easy-to-follow tips.

 

We can argue until the cows come home about whether nuts (or good EVOO) will benefits folks who are already eating an impeccable, low-fat diet. I'd lean towards answering "yes", but I'm not sure there is compelling evidence one way or the other, and I wouldn't be shocked to learn my intuition is wrong and that such a study has been done. But if so, I haven't found it.

 

Finally, regarding your latest post (which came in while I was composing this one):

 

Regarding increased inflammation with higher fat meals as well as increased endothelial dysfunction:

 

Of course a typical high-fat meal or diet will impair endothelial function. But if you look carefully at those studies, you're almost certain to find that the fats employed in the "high fat meal" or "high fat diet" were not good quality nuts or EVOO.

 

--Dean

 

 

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I think there is an interesting divergence between EVOO and nuts in that I've seen it implied that you really need to consume quite a bit of EVOO to gain health benefits, somewhere north of 2 tablespoons, as seen in this post by MR. And to be fair, if you examine the original Mediterranean diets, those folks consumed prodigious quantities of olive oil, so if we're going off of that, then indeed, it seems you need quite a bit to get the benefits. Meanwhile, relatively small amounts of nuts already clearly seem to get you health benefits, so it must be about more than the FA fraction in them - after all, it would take a ton of nuts to get you 2 tablespoons of corresponding oils, so it can't be just the oils (can it?), otherwise correspondingly smaller amounts of EVOO (equal to the amount you'd get from 1 oz of nuts) would exhibit health bennies (and MR claims - not). Now, I consume about 1.5 oz of almonds a day, and I also take in EVOO (top rated EVOO of any given season as determined by Amphora Nueva, where I buy it exclusively) - but I don't take in more than about 1 tablespoon of EVOO (actually slightly less) - and according to MR, I am therefore extracting no benefits from my EVOO consumption... which is disappointing to learn. However, I find it extremely difficult to fit in all the "good for you" foods into my meager caloric allotment, and an extra tablespoon of EVOO with its massive caloric cost would be a huge disruption trying to fit in. On another note, regarding the "oils vs the source of oils" discussion, that was also my thought process when I decided, years ago, to supplement my EVOO consumption with a few green and black olives daily (literally, like 3) - with the idea that there are probably some beneficial phytonutrients I'm missing with just EVOO; I mentioned that on the list, and MR commented on that practice - unfortunately I don't remember what exactly he said (it was a long time ago!), but the upshot was that including actual olives in the diet is suboptimal compared to EVOO (I don't think it had anything to do with just the excess Na in the olives) - but apparently it must have been convincing, because I stopped eating olives as before (I still have them occasionally at parties and the like). The other oil I used to consume was flax oil, but that went the other way - I stopped with the oil, and switched to a tablespoon daily of freshly made flaxmeal (which I grind myself from flax seeds stored in my freezer). The original reason not to consume flaxmeal was the same (vascular dementia) as the strictures against consuming tofu. However, I have on balance decided that the pain-in-the-behind of obtaining guaranteed fresh flax oil was too much given the many additional benefits of other fractions within the flax seed (other than the n3 FA).

 

But that poses a bit of a conundrum. Why do such small quantities of nuts give health benefits if it takes more than 2 tablespoons of EVOO to obtain benefits? Something is wrong - either the oils in nuts are much more potent healthwise than EVOO, or the benefit is not down to the FA profile of the nuts but to other substances in the nut, or... who knows. 

Edited by TomBAvoider

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Thanks Dean, wonderful response...

  • ... and thank you for the tip on bullets!
First just a little aside: For the Okinawa studies I referenced, I wanted to note that I was intrigued to find that deficiencies were not merely "a few nutrient-deficient Okinawans," but really rather common: 2%, 45%, 27%, and 62% for vitamins D, B2, B12, and zinc. Certainly for B12 even 1% would be 1% too high (!!) but a 45%, 62%, and even 27% deficiency across such a long-lived population it does give pause for thought as even moderate declines in mortality for those deficient would be expected to significantly reduce the overall group survival curve. Nevertheless, there still is no good substitution for careful review of the longevity distribution curve, or better yet stratify by quartile or other measure of nutrient adequacy, and by nutrient as the implications would be very different across these micronutrients. In any case this was new to me, and I found this quite intriguing. We frequently discuss optimal nutrition which may be well above lower doses required to prevent specific disease states and this sounds optimal indeed. But how best to determine optimal. If we define this as 100% enzyme activity in all cells this may promote longevity or lower morbidity / higher quality of life. It is also possible 100% may not benefit individuals for these outcomes compared to say 80 given the many interacting biochemical pathways involved in health and longevity.

 

I was more familiar with the studies on the positive effect on endothelial function, originally from M Greger, as pertains to nut consumption, but not so much EVOO where I have seen data in both directions. Thank you for the citations and indeed, investigating now through a direct PubMed search, it indeed is evident that the Pritzkin link I supplied above references to the green monkey study, elevated CRP, anti-oxidant hit, etc. were cherry picked from a robust literature that has increasingly favored the well-sourced EVOO as anti-inflammatory as opposed to pro-inflammatory.

 

Interestingly enough, following this I looked into the LPS study, and reading its methodology, it appears they were using butter! I would have hypothesized there to be more bias with EVOO which has a powerful lobby behind it but whether it is entrenchment and reluctance to depart from a rigid dogma or other any of a number of motivations I cannot say, but needless to say the focus in that link was narrow and misleading, in this case generalizing from saturated fats to MUFA and PUFA as was implied by the reference.

 

A couple of months into discovering crsociety, this exercise underscores the pivotal role of consistent independent literature a priori, rather than merely targeted post-hoc analysis of studies. And while that is a self-evident proposition, it is all too seductive to initially turn to inferior shortcuts in a misguided approach to efficiency!

 

If we feel comfortable departing from low fat to a more Mediterranean type oil content diet based on the above data the next question is this - how high % fat can an ON diet have without adverse consequences -- some of us here are on ketogenic diets where up to half or more calories may be from oils rather than perhaps merely 10-35%

 

While short to low-intermediate term studies may suggest acceptability of higher fat diets, the long-term implications are less well studied, and there is some measure of avoidable risk extrapolating surrogate variables indefinitely into the future. One way to address this is to ask how much the %fat varies across blue zone cultures. The presence of blue zone cultures with substantially higher fat content ( that is, substantially higher than for the % at for a prototypical mediteranean diet similar to Sardinia's version at the time) would lend greater credence to a long-term higher % oil diet. In the absence of such cultures I pose the question: would it not be unreasonable, to be conservative, to keep the % calories from oil/fat at or under the percent witnessed by blue zones populations?

 

Addendum 5/4/16: for the Okinawa study above it is not clear ( could not aquire original study) whether the % deficiency represent percentage of population with the deficiency vs. average % deficiency for the population as a whole. Percentage of population deficient vs. average magnitude of deficiency are both important questions. Interesting in either scenario.

Edited by Mechanism

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Being the proactive sort, I thought I'd get the ball rolling a bit by setting out more of the context for the discussion. And so, a few points. First the FA quantity disparity between the nuts and EVOO recommended amounts for health benefits is even greater than what you'd get from nominal nutritional profiles, because while pretty much 100% of EVOO is metabolically available, that is not true for nuts - in fact, nuts are famously poorly digested and your extracted calories are nowhere near the amount stated in the nutritional profile. Therefore, the disparity of the tiny amounts of FA from nuts and the huge amounts of EVOO needed for benefits is even greater.

 

But let us take a brief look at the idea that perhaps the FA in nuts is more beneficial than the FA from EVOO. A hint of how that might work can be found in that MR post I referenced previously. To quote: "because they're essential fatty acids and that's what's good for you". The idea being that EVOO has no EFA (more accurately, there are only trace amounts of EFA in EVOO), but nuts definitely do have EFA and therefore much smaller amounts of essential oils are going to be much more significant healthwise than large amounts of non-essential FA.

 

However, there are two things to keep in mind. First - the fact that all nuts are pretty much equivalent when it comes to health benefits (at least when it comes to CVD)PMID: 26561616, brought to our attention by Al, and discussed by Dean in this thread here, and quoting Dean: 

 

"In other words, it appears its how much nuts you eat, not which type of nuts you eat, that determines the amount of benefit wrt CVD risk factors."

 

The second fact to keep in mind is that there is a tremendous heterogeneity of FA profiles across all the nuts studied (and I'm using the word "nuts" loosely, according to how they've been studied under "nuts", which can encompass tree nuts, seeds, legumes like peanuts etc.).

 

So, if all nuts bring health benefits and the nuts in turn all have wildly different FA profiles, how can it be that the FA are what are responsible for the benefits vs EVOO, since they're all different?

 

But let us tackle the EFA head on. Obviously, we can discard the long-chain FA such as omega-3 DHA etc. since they are not a factor in nuts. Confining ourselves to n3 and n6, which are both EFA, we immediately notice that most nuts are not a significant source of n3 (except walnuts) especially considering bioavailability of nut FA - there are only trace amounts of n3 in most nuts. Moreover we have studies that confined themselves to mostly peanuts (PMID: 25730101) discussed in this thread by Dean. And it showed that those whose consumption of "nuts" consisted almost exclusively of peanuts, still reaped all the benefits of "nuts in the diet". But peanuts have no n3 to speak of. So I think the case for n3 as an EFA supplied by nuts is not really valid (except maybe walnuts). Moreover, many nuts have not much in the way of EFA at all - instead their greatest proportion of FA is monounsaturated (see: EVOO!) like in the almonds I consume, or hazelnuts. Or take macadamia nuts, which are mostly mono and SFA, with only trace amounts of n3 and n6 not all that different in EFA amounts from EVOO. And yet, all nuts are pretty much equally beneficial in small amounts. The case for nuts doing their magic through EFA would have been stronger, if they supplied significant amounts of n3, but that is the one class of EFA they in practical terms (especially bioavailability) don't supply at all (with possible exception of walnuts) - because as is, most Americans for example, have wildly skewed ratio of n3:n6 in favor of n6, so what they really would need from nuts would be n3 instead of yet more n6. All in all, especially given the relatively trivial amounts of FA in general bioavailable from nuts when consumed as infrequently as 1 a week - it seems hard to believe a once weekly tiny amount of FA from nuts is responsible for the entire health benefit of nuts in the diet as has been documented. And documented even in people whose diet otherwise is not that of the healthy-diet folks as the study mentioned above (PMID: 25730101) showed.

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