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Mechanisms of CR-Associated Impaired Glucose Tolerance

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Saul,

 

I wasn't making any statements about your % body fat.

 

the shape of my body is such that my BMI is high. 

 

Just out of curiousity, how much height have you lost since your peak?

 

--Dean

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Saul,

 

between 2.5 and 3" [of height loss].

 

Wow, that's quite a bit of lost stature. But Al has got you beat by a country mile, and he's 10 years your junior and struggling with other health challenges as well. And who can forget what happened to Warren, someone else who pursued CR with gusto into his senior years without careful nutrition tracking...

Your daily Forteo injections must be working for you. Keep it up.

As for the rest of us, let these be cautionary tales.

--Dean

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Losing height as he ages is why Saul continues practicing yoga. Not that "yoga" will help much with the drying up of spaces between vertebrae and the loss of bone, muscle mass, loss of fascia flexibility, etc etc that's the "natural" part of aging. But yoga practiced in an steady forthright manner ("sthira sukkha asana...") in an Iyengar style will help slow some kyphosis, which is inevitable anyway, until repair tech comes online. Guruji Iyengar is dead, of course, but not before far outliving expectations.

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Hi All!

 

Dr. Wittlin approved my glucose tolerance test.  I'll probably arrange to have it this coming Tuesday morning (after overnight fast).

 

I looked up the appropriate preparation for the test:  All sources(Mayo Clinic, etc.) say to eat my normal diet for several days before -- no refernce about consuming 300g of carbohydrate, for 3 days, prior to the test.

 

I put my usual diet through CronOMeter -- nowhere near 300g of carbs per day -- so I take the 300g of carbs for 3 days is something that Dr. Wittlin added, knowing that I'm on calorie restriction (300g of carbs is trivial for most people -- we're not most people).  My guess is that Dr. Wittlin's thoughts are that the usual glucose bolus applied to a fasting CRONnie is unreasonable -- that a CRONnie needs some acclimatization to the carb challenge, or else the test might show a false positive.  (So for example, Dean's failure of Luigi's glucose tolerance test might be one such example.)

 

So truthfully, I don't know whether to "just eat my usual diet", and maybe getting results similar to Dean's (but maybe not), or else eat enough fiber (psyllium husk?) to reach 300g of carbs (fiber counts as carbs). 

 

My guess:  Eat my usual diet.  That is Luigi's (and the Mayo Clinic's) usual GTT. 

 

(That way, I'll give some information, that might be useful to those members of the CR Society who have had a GTT from Luigi.)

 

I passed Luigi's GTT with ease.  But that was before I began restricting protein, which is probably why my IGF1 has gone down.  It's possible that lower IGF1 might make the beta cells in the pancreas "sluggish" (if I understand Dr. Wittlin correctly).

 

However, I'd like people's thoughts on this (many of you are much more knowledgeable in these matters than I am).

 

  --  Saul

Edited by Saul

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Do both, or two tests. On the first, eat your normal CR diet. On your second, eat the 300g of carbs for three days as Dr. Wittlin suggests (meanwhile, at the health club during spinning class, ask Dr. Wittlin to suggest what 300 g of the healthiest carbs would mean for you -- since you said above he's CR friendly).

Edited by Sthira

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Saul,

 

I put my usual diet through CronOMeter -- nowhere near 300g of carbs per day

 

Great to hear you crunched your diet through COM. So what is the big picture - i.e. total calories and your macronutrient ratios?

 

So truthfully, I don't know whether to "just eat my usual diet", and maybe getting results similar to Dean's (but maybe not), or else eat enough fiber (psyllium husk?) to reach 300g of carbs (fiber counts as carbs). 

 

I'll repeat myself with added emphasis, since you apparently didn't hear me the first time. 

 

DO NOT attempt to boost your carb intake by eating a boatload of extra psyllium husks or any other pure fiber sources. That would do nothing to improve your readiness for the bolus of glucose on the OGTT, and would likely really mess up your digestion. Why even bring it up again Saul? Is it that you won't believe that eating several hundred grams of extra fiber is a very bad idea unless you hear it directly from Michael?

 

On a related note - did you even read the post above which I spent over an hour composing in hopes of helping you?  You know, the one where I outlined the four scenarios?

 

If you had, it should have been obviously to your mathematically-astute mind that the only scenario where you can hope to learn anything useful is to take the OGTT without carb pre-loading. It's a long-shot that you'll pass, but you might, and if you do (like you did for Luigi) you'll know pretty definitively you've got nothing to worry about with respect to your glucose metabolism. And as you suggest, this strategy would tell the rest of us something too - contributing to the science of human CR. Of course if you fail the OGTT, it will be very hard to know which of the many possible reasons outlined in that post best explains your decline in glucose tolerance since Luigi's OGTT so many years ago.

 

However, I'd like people's thoughts on this (many of you are much more knowledgeable in these matters than I am).

 

When you say 'people', is that a euphemism for 'Michael'? Otherwise it seems like you've got all the evidence you need already to come to your own logical conclusion on how to proceed.

 

Michael really is in a difficult spot...

 

--Dean

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About my loss of height:  My youthful height was 5' 5.5".  This was measured when I was in High School -- buy I don't recall whether or not I was wearing shoes.  If I was, then my actual height would be about .5" shorter.

 

My current height (no shoes) is 5' 3.5".  It's remained at that number for the past several years.

 

I have a slight kephosis -- not enough to be easily noticeable (Dean, you saw me at CR IX -- so you probably can confirm that it isn't significant -- my wife certainly can! :)  Of course, my kephosis is a consequence of osteoporosis (dexa is improving, as a result of my taking Forteo daily).

 

Calorie restriction, of course, may encourage osteoporosis -- but in my case, I don't think that that was the leading cause.  In the past, the FDA warned against "overdosing" Vitamin D.  I have always been health conscious -- so I was very careful to limit my Vitamin D intake (carefully monitoring the foods that I ate to total my Vitamin D intake -- and DEFINITELY not supplementing Vitamin D.  I've lived in Rochester, (upstate) NY, since 1973 -- rated as being one of the WORST places to attempt using solar energy (we get Lake Effect clouds that block, or reduce, sunlight for much of the year).  So my daily intake of Vitamin D was way below 1000IU.  (I currently supplement 5000IU daily.)  This lack of adequate Vitamin D, I think, is one of the main causes of my osteoporosis.  Another is heredity:  My mother had severe osteoporosis.  Of course CR may, in my case, be a contributing factor, as well.

 

BTW, I don't regard a small height loss as being a matter of concern:  All of my family members are short (my oldest daughter is extremely short -- but she's in an MD/PhD program at NYU, soon to complete the PhD part [on MERS]; and she has made me a grandfather with a 9 mo. old grandson :)xyz , and is very happily married [and religious].  I forget her acutual height; must be around 5' or a little less).

 

Anyway, I do appreciate comments on whether or not to raise my carb consumption to 300g per day.  All sources say "No".  But I feel bad about it:  Dr. Wittlin said 300g of carbs for 3 days prior to the test day; I would be taking the benefit (the GTT) without fulfilling the suggestion; this poses a moral dilemma.

 

  --  Saul

Edited by Saul

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Saul,

 

Glad you scheduled your OGTT and congrats on becoming a granddad!

 

Dr. Wittlin said 300g of carbs for 3 days prior to the test day; I would be taking the benefit (the GTT) without fulfilling the suggestion; this poses a moral dilemma.

 

Just how useful (or 'immoral') an OGTT will be without carb pre-loading depends a lot on how many carbs you normally eat day-to-day. If you are eating a seriously ketogenic diet, your test results really could get screwed up by your body not being accustomed to metabolizing a lot of carbs / glucose. But since you (stubbornly and inexplicably) continue to avoid telling us what your diet actually looks like these days, we can't help you any further.

 

Good luck to Tuesday!

 

--Dean

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All:
 

I looked up the appropriate preparation for the test: All sources(Mayo Clinic, etc.) say to eat my normal diet for several days before -- no refernce about consuming 300g of carbohydrate, for 3 days, prior to the test.

I put my usual diet through CronOMeter -- nowhere near 300g of carbs per day -- so I take the 300g of carbs for 3 days is something that Dr. Wittlin added, knowing that I'm on calorie restriction (300g of carbs is trivial for most people -- we're not most people). My guess is that Dr. Wittlin's thoughts are that the usual glucose bolus applied to a fasting CRONnie is unreasonable -- that a CRONnie needs some acclimatization to the carb challenge, or else the test might show a false positive. (So for example, Dean's failure of Luigi's glucose tolerance test might be one such example.)

So truthfully, I don't know whether to "just eat my usual diet", and maybe getting results similar to Dean's (but maybe not), or else eat enough fiber (psyllium husk?) to reach 300g of carbs (fiber counts as carbs).

My guess: Eat my usual diet.



Anyway, I do appreciate comments on whether or not to raise my carb consumption to 300g per day. All sources say "No". But I feel bad about it: Dr. Wittlin said 300g of carbs for 3 days prior to the test day; I would be taking the benefit (the GTT) without fulfilling the suggestion; this poses a moral dilemma.


First, if your doctor were wrong, there would be no moral dilemma: the point of the GTT is to inform your clinical situation, not to fulfil the letter of Dr. Wittlin's recommendation for its own sake. The reason he is (rightly) advising you to get lots of carbs is to avoid a false positive — as you rightly understand. So, you should follow his advice and avoid a false positive ;) .

On the other hand, it will be very important to discuss whatever you actually do with him, so he reads your data in its actual context.

That said: you don't actually link any of your sources, but it's pretty clear to me that you're misreading them. Here for instance is what I expect is your Mayo Clinic source actually says:

 

 

It's important to eat and drink normally in the days leading up to the glucose tolerance test.

 

Now you're right that it doesn't say anything about consuming any particular am't of carb. But you're mistaking "eat and drink normally" for "eat and drink in the way that you, Saul, normally do." I'm quite confident that what they mean instead is "eat and drink like a "normal" person"/"eat and drink in a normal way".Neither you, nor I, nor Dean, nor any but a couple of curious watchers of the CR zoo amongst the readership here "eats and drinks normally" in this sense.

 

Remember, the sites you're citing are consumer-friendly sources: that is, they're aimed at a mass market of "normal" people. Certainly, it is not the case as you say that this Mayo source (again, you've not linked any of your sources) says you don't need to consume a "normal" amount of carbohydrate. And, if Mayo or others really did tell you to go ahead and keep eating your usual diet, they would be violating the actual procedures required by hospitals and others that actually run the test:

 

 

Australian Family Physician [The journal of the Royal Australian College of General Practitioners [≈Internists in the USA]]

The OGTT results can be affected by carbohydrate intake and duration of fasting preceding the test, the time of day the test is performed and carbohydrate intake or activity during the test.46 During the 3 days preceding the OGTT, 150 g of carbohydrate should be eaten (approximately ten 40 g slices of bread per day). The person being tested should then fast overnight except for water (eg. from 22:00 hours) and should not smoke or consume caffeine containing drinks, such as coffee.

 

 

Helen DeVos Children’s Hospital Pediatric Endocrinology  [NB: a children's hospital — little twelve-year-olds!]

 

Instructions for Oral Glucose Tolerance Test and Prep Diet

For three days before the test you should eat a high carbohydrate diet (150-200 grams). A copy of a samplediet is attached. It is very important that this diet be followed. The test results may not be accurate if you do not eat enough carbohydrates. ...

Glucose Tolerance Prep Diet
This is a test diet. Include the following foods in the proper amounts in your daily diet. Additional food may be eaten.

Follow this diet for 3 days prior to the test.

 

[I'll let you read it, but it's yer standard, starchy-carb laden American diet. They want to make absolutely sure you get those carbs into you].

 

 

ST. JOSEPH MERCY HOSPITAL
Clinical Laboratories

• Your Doctor/Nurse has asked that you have an Oral Glu cose Tolerance Test (OGTT).
• The OGTT measures your body’s ability to deal with an oral glucose (sugar) load.
• For the OGTT to be accurate, you will need to eat foods that are rich in carbohydrates for 3 days before the test. Your carbohydrate intake should be at least 150 grams each day.
• This booklet includes a list of commonly used carbohy drate foods and the average amount (grams) of carbohy drates in each.
• From the lists provided you can plan your daily intake of carbohydrates. A sample menu is planned for you.
• Remember, you should have a minimum of 150 grams of carbohydrates. It is okay to eat more than 150 grams.

 

[Again, check out their example foods: bread, breakfast cereals, muffins, carby fruits, potato chips, sweets, etc]

 

Cf. the Clinical and Translational Science Institute at UCLA, ICAN of Atlanta, the Beaumont Health System, a couple of consumer-oriented sites, etc. It appears that 300 g is excessive — 150 seems to be a pretty strong consensus — and they mean lots of "normal" carbohydrates, not loading up on celery and psyllium.

 

You don't have to eat all the crap they give as examples, but a couple of decent-sized sweet potatos, an apple, and some oatmeal are evidently in order.

 

Edit, 2017-05-11: I now note tha in the original Fontana study in which CR-associated IGT was discovered (PMID 19904628), "All of the study participants were eating more than 150 g of carbohydrate per day. ...

Carbohydrate restriction seems also unlikely as a possible cause for the glucose intolerance in the CR-IGT group, both because 150 g of carbohydrate appears to be sufficient to prevent impairment of glucose tolerance due to carbohydrate deficiency (Wilkerson et al. 1960; American Diabetes Association 2009) and because the CR-NGT group carbohydrate intake was similar to that of the CR-IGT group."

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Thanks Michael!

 

That was very helpful.  I imagine raw sweet potatoes should be alright?  (Of course, raw sweet potatoes will not be digested as well as mildly cooked -- or fully cooked; that might be cheating (and perhaps invalidating my test)?

 

I hate oatmeal.  Maybe Fiber One cereal?  That certainly will supply the carbs (but again, most of the "carbs" are insoluble fiber).

 

Perhaps I'm best with several sweet potatoes.

 

  --  Saul

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between 2.5 and 3".

From a yoga perspective, Saul, you're lucky to live in Rochester. One of the most formally-, classically-trained Iyengar teachers in the country, Francois Raoult, owns a beautiful studio called Open Sky Yoga Center on Arnold Park. I've studied with Francois, he's brilliant, and he'll definitely help you regain some lost posture.

 

Go!!!! http://www.openskyyoga.com/francois-raoult

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Fantastic!  Happily, CronOMeter has full nutritional information for raw sweet potatoes -- breaking down the carbs into starch, fiber and sugar.

 

I'll easily compute how much raw sweet potato to consume, to reach 150g of starch + sugar, and then weigh it out on my accurate kitchen scale: 2 lbs.

 

That's a lot to eat.

 

  --  Saul

Edited by Saul

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However, Luigi didn't require us to conume 150g of carbs, for 3 days, before testing us (as best as I can recall).  Both you and I passed with flying colors -- but Dean didn't.  Perhaps Dean's diet was extremely low in carbs?

 

(Also, I do remember that Luigi gave us black beans and yogurt to eat -- at least the black beans had some starch.)

 

  -- Saul

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Thanks Michael!

 

That was very helpful.  I imagine raw sweet potatoes should be alright?  (Of course, raw sweet potatoes will not be digested as well as mildly cooked -- or fully cooked; that might be cheating (and perhaps invalidating my test)?

 

I hate oatmeal.  Maybe Fiber One cereal?  That certainly will supply the carbs (but again, most of the "carbs" are insoluble fiber).

 

Perhaps I'm best with several sweet potatoes.

 

  --  Saul

 

No, silly! Remember, you're trying to make sure that you ARE exposed to the carbs: raw sweet potatoes and Fiber One are bad examples. Cook the sweet potatoes; eat a non-diet, non-Atkins cereal — and no sneaking Vector across the border from Canada.

 

However, Luigi didn't require us to conume 150g of carbs, for 3 days, before testing us (as best as I can recall).  Both you and I passed with flying colors -- but Dean didn't.  Perhaps Dean's diet was extremely low in carbs?

 

(Also, I do remember that Luigi gave us black beans and yogurt to eat -- at least the black beans had some starch.)

 

  -- Saul

 

Dean can fill us in, but I doubt he'd've been eating fewer carbs than us. IAC, Luigi had his dietitians crunch all our lead-in diets out and prepare all our foods: I'm sure they know what they're doing.

 

Yogurt — even plain yogurt — has carbs. Look at COM, or a label.

 

2 lbs of raw sweet potatoes supplies slightly over 150g of sugars + starches.

 

  --  Saul

 

No, it's 183 g. Don't subtract the fiber, and certainly not the sugar. Look at the carb counts in the example diets: they mean, roughly, "150+ g of total carbohydrate as present in normal foods"

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Saul,

 

First off - Michael is right (see I'm not always mean ☺). I was eating plenty of carbs at the time of my (failed) OGTT for Luigi. IIRC, I was eating about 2200-2300 kcal/day (40-50% of it carbs) around that time (in 2002), and weighted about 123 (BMI 18.5).

 

He's also right that I don't remember eating either black beans or yogurt during my visit to Luigi's lab as you suggested they fed us. He's also correct that the food we received while visiting WUSTL was customized for each of us individually according to what we told them our normal diet consisted of. Perhaps you were eating beans and yogurt at the time? I know they wouldn't have given me anything I didn't approve of, especially since I think I was probably a vegan by then (although it was right around that time that I saw the light, IIRC).

 

In fact, now that I think about it, I only ate their provided food on my second visit to WUSTL. During that first visit in 2002 (which included the OGTT), I "pulled a Michael" and brought all my own food with my in a cooler from home. In fact, several of my old food containers still have my name written on the lids, from when I brought them to WUSTL and kept them in the fridge on the metabolic ward. Yes I still have them. I'm kinda a pack rat... As I recall, the dietitian wasn't particularly happy with me. My 2-days of food took up most of their fridge...

 

But getting back to you. I've found your conversation with Michael, and your entire contribution to this thread, fascinating.

 

You were the only person out of the 30 participants in the CR Motivation Survey to give "habit / momentum" the top rating (i.e. "very important") for your motivation for continuing to practice CR. Recall the description of "habit / momentum" in the survey was:

 

 Many of us are creatures of habit, and habits are hard to break. Momentum keeps us going with our practice of CR, even when we have a sneaking suspicion that it may not be serving us (any longer).

 

I have to compliment you on your introspective sense and your willingness to acknowledge "habit" as an important driver for your continued practice of CR. Your attitude has really come shining through in your apparent revulsion to even adding some very healthy carbs as Michael suggested:

 

[Eat a] couple of decent-sized sweet potatos <sic>, an apple, and some oatmeal.

 

When Michael said "a couple decent-sized sweet potatoes"  anyone who wasn't irrationally afraid of carbs would have known he meant cooked sweet potatoes, especially after we've repeatedly told you not to count eating all indigestible fiber as satisfying Dr. Wittlin's recommendation to boost your carbs before your OGTT.

 

You resistance  (and I don't mean resistant starch ☺) is palpable. You are clearly a man of habit. Do you really think following your doctor's and Michael's recommendation of eating a few more healthy carbs for three days ahead of an important test of your health which you've requested is going to impair your health, perhaps shortening your life by reducing your lifetime degree of CR?! That's crazy thinking. 

 

One other things Saul. I know you continue to refuse to share your CRON-O-Meter nutrition data with us. I think it's irrational, but I can respect your desire for privacy.

 

But reading between the lines, are you really implying that you aren't even eating 150g (~600kcal) of healthy carbohydrates per day these days? What the heck are you eating? You've said your (nearly) a vegan who eats very little protein (apparently), and no grains, bread or pasta. Clearly you eat a lot of low-calorie vegetables, like celery (formerly?), cabbage and raw tomatoes. Those are mostly carbs, although relatively few per gram. But it wouldn't be impossible for you to get to near 1500kcal/day eating mostly raw vegetables. But in that case you'd be eating a lot of carbs. I've always thought of you as someone who generally avoided added fats, but maybe I'm wrong and you've changed it up over the years. Are fats (nuts, seeds and EVOO) where you are getting most of your calories from these days? Or maybe lots of legumes? You've never struck me as a big legumes kinda guy. But maybe I'm wrong. I'm just wondering, because between what you're saying and what I thought I knew about your diet from the past (e.g. you used to eat raw red peppers by the bushel), it just doesn't seem to add up.

 

In short, I'm just baffled, both by your stubbornness to follow good advice and add some carbs before your OGTT, as well as by what the heck it is you are actually eating...

 

--Dean

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Hi Dean!

 

 

 

You were the only person out of the 30 participants in the CR Motivation Survey to give "habit / momentum" the top rating (i.e. "very important") for your motivation for continuing to practice CR. Recall the description of "habit / momentum" in the survey was:

 

 

I must have checked the wrong box.  Accurate would be "health extension", "life extension", and "like my CR food", in that order.

 

(BTW, I ate two fairly large wife-cooked sweet potatoes, and about 1/2 cup of (a Wegman's clone of) original grape nuts cereal, with my mildly Neotame sweetened Chinese white tea for lunch (plus a lovely vegan salad with no dressing -- not many carbs in that).  

 

And there are the 2 lbs of raw Nappa cabbage that I ate for breakfast (about 18 gm carbs).

 

  --  Saul

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Hi ALL!

 

Well, following Michael's useful advice, I consumed ca. 150g of carbs for 3 days prior to the OGTT -- mostly from fully cooked sweet potatoes and the Wegman's clone of Grape Nuts cereal.  (0n on one day, two slightly cooked bananas and a nectarine.)  These are all foods that I don't usually eat.  And I had my OGTT yesterday.

 

I passed!

 

:)xyz

 

  --  Saul

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Saul my Man,

 

And I had my OGTT yesterday.

 
I passed!

 

Congratulations! As promised, I hereby officially eat crow:

 

fRQ2xU3.png

 

I can't tell you how hard it was to catch that sucker. ☺

 

Seriously Saul. Congratulations. You're a 79 77 year-old man. You are still an active freakin' math professor, still contributing valuable insights and research in your field. You've got great biomarkers, and it sounds like a very healthy glucose metabolism, despite a family history of diabetes. You do yoga, and exercise regularly. You've got a lovely wife, kids, and now grandkids. You're clearly doing a lot of things right.

 

It would be a lot easier for me to actually swallow that crow (rather than release him unharmed - boy are my jaws getting tired ☺) if we knew more about your diet and lifestyle.

 

You've been quite cagey, to the point that we know very little about what you eat day-to-day besides tomatoes replete with ambulating rodent feces (ever catch that mouse?), and a heck of a lot of cabbage. ☺ You say you practice "fairly severe" CR, which is the same rating Michael gave to his own CR practice. Bu your BMI is in the 20 - 22.5 range (i.e. the sweet spot I recommend), while his is less than 16. Al Pater, who is 10 years your junior, has a BMI of 18, up from much lower, and he isn't doing nearly as well as you are (no offense Al - we love you!).

 

You are quite an enigma Saul, and that is too bad. You're obviously doing something (probably lots of things) right, and I think people around here could learn a lot from you if you'd open up.

 

Unfortunately, I've got bigger fish to fry, and not farm-raised salmon from the Wegman's flagship store ☺. I regret that I don't have time at the moment to continue trying to tease those details out of you. Perhaps someone else will pick up the reins (reigns?) and steer this conversation in my absence.

 

Maybe I can pick your brain during our week in Costa Rica together - in the same cabin no less! Needless to say I'm really looking forward to it.

 

But in any case, keep up what you're doing, and see if you can find it in your heart to share your "secret sauce" with the rest of these schleps.

 

--Dean

Edited by Dean Pomerleau
Fixed Saul's age

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Hi Dean!

 

Crow isn't vegan!  It shouldn't be in your diet!

 

(BTW, I'm 77 -- not 79!)

 

Hopefully, there might be some get-together before Costa Rica.  Mechanism and Brian are planning some North-East get-together -- Brian seems to want Boston -- a bit far for me, even further for you, if you should decide to go.

 

Mechanism and I are trying to push Kripalu -- that's a 4 hour drive for me, and probably 5-6 for you, if you should decide to join such a get-together.  Boston, I think, would be closer for Brian -- perhaps Brian is currently living in Boston?

 

I'd love to introduce Kripalu to you and Brian -- most of their food is vegan and CR-friendly; and they're the largest yoga resort in the Western hemisphere.  I think it would make a wonderful sight for CR X -- but I haven't been able to convince David Stern.

 

Anyway, thanks for the heads up!

 

:)xyz

 

  --  Saul

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Dean, and all:
 

Saul my Man, ... you say you practice "fairly severe" CR, which is the same rating Michael gave to his own CR practice.


Er ... no, it isn't. As you quoted,
 

Here was Michael's comment from survey regarding his own CR practice:
 

I practice extremely RIGOROUS CR, but no free-living organism can voluntary <sic> adhere to "severe CR" of the sort imposed by rodents on 40% CR.


If I clicked a box to the contrary, it might have been because of the inherent ambiguity of the question, but I clarified that I make no such claim.
 

Bu your BMI is in the 20 - 22.5 range (i.e. the sweet spot I recommend), while his is less than 16.


But, of course, CR has nothing to do with your weight or BMI. My BMI was lower than Saul's when eating completely ad libitum (including in  university, when I was stuffing myself with pancakes and syrup and bagels and mac-&-cheese in the dorm cafeteria); that doesn't mean I was practicing CR at the time, nor was I a decade later when I was eating a very healthy diet ad libitum and still no lighter than I was at the time. ob/ob mice, LeBron James, hyperthyroids, etc etc.

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Congratulations Saul!

 

Not surprised, from what I know about you I attribute a fair amount to a combination of physical activity ( enjoyed our walks/hikes together @ Kripalu) including anaerobic component which has helped you preserve muscle mass, your low GI & primarily plant-based diet, adequate BMI ( not taking CR too far) and adequate protein ( low IGF-1. But not off the charts low your regular sushumi... vegans can get the protein and omega-3's another way so more than one road to Dublin). Of course this is by it's nature highly speculative, with the role of genes ( T2D family bx noted), luck, and the interactions amongst variables forever shrouded in mystery... but while we debate on etiologies & even serial introducing one new variable to your regimen and subtracting it serially would comprise very imperfect and limited data, I wanted to pass on my encouragement on your successes and on some of your great habits.

 

Leaving aside controversies ( abstinence from grains, etc.), wouldn't it be great if it was the Yoga Dancing! ???? A lower stress ( cortisol) life is not a bad thing with impaired glucose tolerance.

 

As OGTT is only one parameter so I hope everything else checks out too. I agree with Dean on the value of checking cron-o-meter as restricted calories especially and synergistically with less varied dietary patterns can have their quirks at a minimum. Also the less common the practice the more "new frontier" risk and potential peril along with the fuzzier surrogate data that go with it. Since not all of potential effects are well captured by the limited biomarkers in today's lab panels, and moreover nutrition science is in it's infancy and the interaction amongst even all presently known factors with low quality and absent peer-evidwed examination worthy of a AGI analysis ???? , I personally diversify & hedge via a very diverse diet diluting potential harm while optimizing potential healthful known and unknown nutrients and factors. But then you've seen my mega-salads in person Saul - it has been lots of fun & hope to see you again at the NE Meetup wherever that takes us.

 

Thanks for sharing your results, Way to go!

Edited by Mechanism

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