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Lifestyle interventions to increase longevity

121 Post author: RomeoStevens 28 February 2014 06:28AM

There is a lot of bad science and controversy in the realm of how to have a healthy lifestyle. Every week we are bombarded with new studies conflicting older studies telling us X is good or Y is bad. Eventually we reach our psychological limit, throw up our hands, and give up. I used to do this a lot. I knew exercise was good, I knew flossing was good, and I wanted to eat better. But I never acted on any of that knowledge. I would feel guilty when I thought about this stuff and go back to what I was doing. Unsurprisingly, this didn't really cause me to make any positive lifestyle changes.

Instead of vaguely guilt-tripping you with potentially unreliable science news, this post aims to provide an overview of lifestyle interventions that have very strong evidence behind them and concrete ways to implement them.

A quick FAQ before we get started

Why should I care about longevity-promoting habits at a young age?

First, many longevity-promoting lifestyle changes will increase your quality of life in the short term. In doing this research, I found a few interventions that had shockingly large impacts on my subjective day-to-day wellness. Second, the choices you make have larger downstream effects the earlier you get started. Trying to undo years of damage and ingrained habits at an advanced age really isn’t a position you want to find yourself in. Third, extending your life matters more the more you believe in the proximity of transformative tech. If the pace of technological improvement is increasing, then adding a decade to your life may in fact be the decade that counts. Missing out on life extension tech by a few years would really suck.

Isn’t longevity mostly just genetics?

That's what I believed for a long time, but a quick trip to wikipedia tells us that only 20-30% of the variance in longevity is heritable.

What sort of benefits can I expect?

The life satisfaction of people who remain independent and active actually increases significantly with age. Mental and physical performance are strongly correlated, meaning maintaining your body will help maintain your mind. The qualitative benefits for life satisfaction of many of these interventions can be so dramatic that it is hard to estimate them. The gulf in quality of life between people maintaining good habits and those who do not widens with age.

How were these recommendations generated?/Why should I believe you?

This post summarizes studies at the intersection of having large effects, large sample sizes, and being well-designed in terms of methodology. The cutoff for an intervention being “worth it” is somewhat subjective given that there is often only a rough estimate of the overall effect sizes of various interventions in comparison to one another. CDC mortality statistics were used to determine the most likely causes of death in various age brackets. The list of things that kill people balloons significantly as you get towards the less common causes of death and I have limited research time. Individuals who face unusual health circumstances should of course be doing their own research and consulting health professionals.

This brings me to my disclaimer:

This post is not intended to diagnose, treat, cure, or prevent any disease. No claim or opinion on these pages is intended to be, nor should be construed as medical advice. Please consult with a healthcare professional before starting any diet or exercise program. None of these claims have been evaluated by the Food and Drug Administration. Suggestions herein are intended for normal healthy adults and should not be used if you are under the age of 18 or have any known medical condition.

Alright, let’s dive in.

 

Things that will eventually kill you

CVD

At the top of our list is cardiovascular disease, or CVD, causing the plurality of all deaths by far. We will break down the controllable components of CVD in terms of lifestyle interventions.

Smoking

This doesn’t need much of an explanation. Responsible for the majority of lung cancers, respiratory diseases, and a huge contributing factor to CVD. Buying an e-cig for yourself or people you know who smoke are possibly the single cheapest intervention for adding years to life. E-cigs have very high success rates in getting people to quit smoking and are absurdly cheap. You can spend under $10 and add 14 years to someone’s life. I buy them just to give away. Recommended products: 12.

Alcohol

Some controversy over possible benefits of small amounts, but large amounts definitely bad. Avoiding alcoholism is a whole subject I won’t tackle here.

Blood Pressure

Second to tobacco in effect size. Blood pressure is one of the things most people ignore. It is extremely cheap and easy to start monitoring your blood pressure, and there are things you can do if you find it to be high. You want your blood pressure to be about 120/70. If you are higher than this there are some simple things you can do. The first is to exercise and eat fish every week, especially salmon. There are also a few supplements that have been found to be helpful.

A quick note about my criteria for inclusion for supplements: I am extremely dubious as to the benefit of most supplements. Study after study shows that most of them are a waste of time and money. The fish example given above is a good illustration. You might ask why you can’t just take fish oil pills. Well it turns out that fish oil pills suck, and you’d need to take approximately 9 times as much to have the same effect as eating fish, at which point they’d have dangerous blood thinning effects. So when I recommend a supplement it has to meet a pretty stringent list of requirements.

1. Large effect seen in multiple randomized controlled trials.

2. Therapeutic dose is a tiny fraction of the toxic dose, or no toxic dose able to be identified because it is so high.

3. Side effects comparable to placebo.

4. Dose size is commensurate with an amount it would be reasonable to ingest in natural form.

So basically I weight any downside risk very heavily given the spotty track record of the general reference class of supplements.

So what passes these criteria for blood pressure?

1. CoQ10, large effect size in multiple studies

http://www.ncbi.nlm.nih.gov/pubmed/14695924

2. Flavonoids/anthocyanins, these compounds are present in things like dark chocolate, fruits, and teas.

http://ajcn.nutrition.org/content/88/1/38.short

3. Garlic

http://www.biomedcentral.com/1471-2261/8/13/

I have personally had success lowering my blood pressure from the 140’s to the 120’s with these supplements keeping my exercise levels constant.

Blood lipids (cholesterol)

Here the conventional recommendations appear to be wrong, or at least somewhat misguided. First, some theory. Blood lipids are composed of a variety of substances, but for our purposes we will stick to the ones tested for in blood panels and how to interpret these numbers. A typical blood panel will report LDL, HDL, and Triglycerides. The simple story of “high LDL bad” does not accurately reflect risk of CVD. The most powerful predictor of CVD in terms of blood lipids is the Triglycerides to HDL ratio.[1][2][3][4][5] The higher the triglycerides and the lower the HDL, the greater the risk. This relationship holds independent of LDL levels, which are usually the focus of cholesterol discussions with health practitioners. As it turns out, there are actually two types of LDL, and distinguishing between them is something not usually performed on a blood test. The reason for the prolonged confusion arises from the correlation between a poor HDL:Triglyceride ratio and prevalence of the unhealthy type of LDL. As a result, potent cholesterol lowering drugs are over prescribed. For people with a healthy ratio of triglycerides:HDL, a total cholesterol between 200-220 (traditionally considered “high”) is actually  correlated with lower mortality,[6] and aggressive lowering with drugs resulted in worse health outcomes. This is not to say that statins (cholesterol lowering drugs) are not useful. On the contrary they seem to be highly helpful for patients recovering from a cardiovascular event, but they have shown no benefit for people with no history of problems.[7] Statins have serious side effects[8] and should not be taken lightly. Be skeptical.[9]

So how does one go about lowering their triglycerides and raising their HDL? Again, exercise and eating fish are awesome here. Excessive fructose intake raises triglycerides, and this relationship is worsened by high BMI. Fiber and resistant starch from fruits, vegetables, and tubers has a positive effect. Intermittent fasting has also shown promising effects here.

BMI/Obesity

There are some controversies here I don’t really want to get into the details of as it is a complex subject. I do want to mention that health interventions should not have an excessive focus on whether one is losing weight. Many of the interventions discussed here have significant effects (for example on insulin sensitivity, c-reactive protein, and fasting blood glucose) even when body composition does not change. Getting BMI below ~27 should be a priority however, as it has wide ranging effects across all other interventions.

Nutrition

This is a big subject, and we’re not even going to attempt to go into detail. This section will focus on the largest high level features of a diet that have positive or negative impact. Processed meat consumption has the single largest negative effect on health. It is shockingly bad, even if you already suspected as such.[1] In contrast, a bit of red meat has actually been found to be neutral. It seems to be that many earlier studies claiming harm from red meat did not adequately separate out the huge effect size of processed meat. Fish and nut consumption appear to be a grand slam for CVD in particular and also just for overall health.[2][3] Pescetarians live significantly longer than vegans,[4] lending support to fish consumption. Outside of specific foods, common micronutrient deficiencies have been indicated in everything from cancer, to immune system suppression, to poorer physical and mental performance, to sleep problems, greater inflammation, and even depression. Really there’s too much material there to cover, there are just pages and pages of studies.

There’s also the bad news that multivitamins mostly don’t do anything. There has not been found an alternative to eating a variety of nutrient-dense whole foods. Though vitamin D supplementation appears to be quite beneficial. Another LW user, John_Maxwell_IV, and I are trying to make this easy with our startup MealSquares.

Blood donation

The studies related to this have some methodological issues but overall the effect size is so large, and the cost and risks so low, that it is worth inclusion. Several studies have indicated that, for men, regular blood donation results in a massive reduction in heart attack.[1][2][3] Other studies have found no such relation.[4] There are also additional health benefits to blood donation.[5] These are just some of the studies on this subject, but on balance after reviewing the evidence, I can say that donating blood once a year is almost certainly worth it if you're a man.  Donating too often is probably bad for you though.

Exercise

This topic is large enough that I am separating out my actual recommendations into another post and purely discussing the health benefits here. Exercise is probably the single most important lifestyle intervention. Even minimal amounts of exercise have very large impacts on longevity and health. We’re talking even walking 15 minutes a day causing people to live longer. Even ignoring quality of life you are looking at a 3-7 fold return on every minute you spend exercising in extended life,[1] perhaps even exceeding that if you are making optimal use of your time. Exercise has a positive impact on pretty much everything that contributes to mortality. I don’t really know how to convince you, the reader, that the future actually exists and that future you will be incredibly angry or sad that you didn’t put in a small effort now for a better life later. But everyone has already told you this your whole life. So I’m going to contrast it with the inverse. Most of the activities that we associate with fun and leisure involve some aspect of physicality, even if it’s just walking around with friends. Losing access to these activities as can and does happen to people represents a massive decrease in quality of life. If you are reading this and you are young, you are able to simultaneously ignore your body’s need for exercise, and demand performance of it when necessary to enjoy yourself. This will not remain true forever. Exercise has a protective effect against exactly the sorts of degenerative injuries that deprive people of their freedom of movement and activity.[2] I don’t care if you start with an exercise habit of one pushup a week, but you must do something.

Let’s move on to some relevant considerations assuming you want to exercise. What sort of exercise should I be doing? Several studies have indicated that endurance athletes enjoy the greatest improvements in longevity. I would agree with this but caution that often the groups in such studies with the best health outcomes are those that do engage in resistance training as well. Soccer and other team sport players, for example, often perform resistance training as part of their overall conditioning. This seems to be overlooked because they do not perform it at the same level of intensity as athletes in the power sports. Long distance skiers and bikers also generally train lower body strength moves at an impressive level compared to the general public, even if it is a level significantly below that of power athletes (e.g. here is an example of a training regime for a competitive skier). My point is simply that you shouldn’t read a study that says “endurance athletes live longer” and assume that all you need to do is run. Strength training also has significant effects on insulin resistance, resting metabolic rate, glucose metabolism, blood pressure, hormone balance, joint health, organ reserve, depression, increases in HDL, reduction in back injuries, sleep quality, and a variety of harder-to-quantify quality of life improvements.[4][5][6][7][8] I go to the trouble to cite resistance training so heavily because I feel that the benefits of cardio are generally well-understood, but I regularly encounter the idea that resistance training is only for people who want to look like a gross bodybuilder.

Hopefully I have established that one should do both endurance and resistance training. Program specifics will be included in the other post as well as info on when benefits taper off.

Edit: Exercise post is up here.

Stress

Stress affects almost every system in your body. It increases disease risk by acting as an immunosuppressant. It directly impacts blood pressure, sleep problems, skin conditions, anxiety, depression, and even heart problems. Chronic untreated stress is often considered a causal factor in many other ailments people are medically treated for. Stress often goes untreated because alleviating it is seen as low priority. Whatever we are doing right now is worth a little stress. This can be true, but over a longer time horizon failing to learn better ways of managing stress really harms us. To confront stressors you must confront ugh fields. Non-productive coping mechanisms are the norm here: procrastination, abuse of substances including food, sleeping too much, blame as a curiosity-stopper etc. Simple strategies for dealing with low level stressors include things such as meditation, gratitude journaling, reflecting on and updating goals, or even just paying other people to deal with a recurring source of stress. Two previous LW posts have excellent advice in this area: How to Be Happy and Be Happier.

If you are depressed and don't know where to start on getting help please take a look at Things that sometimes help if you're depresed.

Supplements that impact stress include

1. Rhodiola Rosea: http://www.sciencedirect.com/science/article/pii/S0944711310002680

2. Ashwaghanda root, which shows promise for chronic anxiety: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/

Sleep

Chronic insomnia is a massive source of stress for many people and poses a huge mortality risk. In one study, people who got chronically less sleep had 3 times the mortality risk as people who slept well![1] You cannot afford to not start optimizing your sleep. It is important that your sleeping place be a quiet, dark, cool environment. You can use simple methods to improve each of these parameters. Forehead cooling has shown great promise in clinical trials.[2] You can accomplish this with a gel pack that is cool (not ice). Even small LED lights in your room impact sleep quality because the melatonin production system is very fragile and sensitive to light.[3] Get tape and cover lights. Try orange glasses to prevent blue light from destroying your endogenous melatonin production after 10pm. Regularize your sleeping and eating schedules. Expose yourself to bright lights in the morning to calibrate your circadian rhythms. Afternoon/early evening exercise is beneficial in making you sleepy. Melatonin pills work for many, but make sure you start with 75mcg (cut these into fourths), rather than the 3mg most pills come in. A teaspoon of raw honey before bed helps prevent some people from waking multiple times throughout the night.

Consider reading this excellent info from Yvain on sleep apnea, especially if you snore excessively or feel very tired even after a full night's sleep.

Cancer

Almost all of the risk factors for cancer have some overlap with CVD, meaning most of the advice above works for cancer too, but there are a few additional considerations worth discussing.

Cancer and UV exposure

One of the surprising results of my research was that conventional wisdom appears to be wrong here. There is not a simple relationship between UV exposure and increased cancers. Specifically, while increased sunlight exposure is correlated with higher incidence of skin cancer, it appears that it is also correlated with a decreased risk of 5 other cancers that are far less survivable.[1] This is a straightforward trade off, getting sun exposure wins by quite a lot. Shade your face to avoid photodamage to your skin and macular degeneration of your eyes.

Breast cancer and testicular cancer

Redacted, see Vaniver's comment here.

Floss

No, seriously. Not flossing is way more lethal than you think.[1] You should also see a dentist regularly, even if you have to pay for your own insurance. (It's surprisingly cheap, e.g. Delta Dental offers plans for under $100/yr; lots of people don't make use of their plan and subsidize the treatment of those who do use theirs). Losing teeth greatly increases your chances of infections over time.


Things that will kill you right now

Avoidable medical errors

Avoidable medical errors might be the second leading cause of death after CVD.[1] This makes a hospital visit possibly the most dangerous thing you can do, especially if you are young. In general, you should not assume that medical staff are competent. Triple check dangerous prescriptions. If you don’t know whether a prescription is dangerous, assume it is. Ask medical staff if they’ve washed their hands (yes, this is actually still a major problem). Sharpie on yourself which side of your body a surgery is supposed to happen on, along with your name and what the surgery is for (seriously). Keep your own records, especially if you have serious medical issues; error rates in medical documentation are ridiculous. Medical equipment is generally cleaned by custodial staff with no medical training who often don't know how a particular device works. Have someone you can call in an emergency who knows about all of this.

While we're discussing medicine, I'll throw in a couple low cost recommendations that give me peace of mind, even if an emergency situation is unlikely. The first is that the Red Cross has created an android/iphone app covering first aid with extensive pictures and videos helping you through the situation. The second is quickclot which can stop severe bleeding much faster than traditional techniques.

Unintentional poisoning

This is mostly acetaminophen poisoning resulting from their mandatory inclusion in pain killers to prevent abuse. Also people misdosing themselves with legal and illegal drugs. Be careful, this outweighs traffic accidents in accidental deaths. Adding the 24 hour emergency poison control line number (1-800-222-1222) to your phone is something you can do right now. It is also worth knowing that SOP for acetaminophen poisoning is high dose NAC, which is freely available on amazon in the US (h/t Tara).

Traffic accidents

Michael Curzi has a great post on this I won’t attempt to reproduce here: How to avoid dying in a car crash. It is definitely worth updating your model of what behaviors are dangerous in a car.

 

Summary of interventions

  1. If you know people who smoke, getting them to vape is the single largest impact you can have on their lifespan.

  2. Pay attention when in your car.

  3. CONSTANT VIGILANCE when dealing with the medical profession and drugs.

  4. Exercise: very high return on first few units of effort, some cardio and some resistance training is best.

  5. Blood donation every 12-24 months for men.

  6. Buy a blood pressure monitor and do blood pressure reduction interventions if needed.

  7. Eat fish, nuts, eggs, fruit, dark chocolate. Supplement Vitamin D3.

  8. Work towards a healthy weight.

  9. If you are losing sleep/are stressed, try one small intervention at a time, and don’t get discouraged.  These interventions are the hardest but potentially the most rewarding. Supplements for stress, anxiety, and sleep are somewhat subjective and vary more in reported efficacy than others; self-experimentation is recommended.

  10. Floss (and see a dentist).

 

Closing

Don’t worry too much. Don’t get down on yourself about health.  This creates an ugh field making you less likely to take action.  The process of becoming healthier is going to make you feel stupid sometimes. This is a marathon and not a sprint; standard habit forming rules apply. Trying to fix 10 things at once is highly stressful! Do not do this! Discuss things that worked for you and didn’t work for you in the past with yourself and with others and come up with a plan. Don’t publicly commit to your plan in the comments, this makes you less likely to do it. Oh, and feel free to argue with me or request more sources.

 

Comments (376)

Comment author: RolfAndreassen 27 February 2014 06:03:28AM *  0 points [-]

the highest plurality

Excellent post, so naturally I nitpick the language... anyway, 'plurality' means "largest fraction but not a majority". So "highest plurality" is redundant.

On the subject of exercise: What intensity are we talking about for the endurance? Is it sufficient to bicycle, or do you need to work up a lot of sweat?

Comment author: RomeoStevens 27 February 2014 06:19:56AM 2 points [-]

I have a whole post on optimizing exercise parameters, it will probably go up friday.

Comment author: CAE_Jones 27 February 2014 06:06:05AM 1 point [-]

I am considering writing a program that will launch this page in my web browser every few hours.

(While most of these interventions are things with a surprisingly high cost in terms of stress, the one I like the least but am least stressed about is the recommendation to eat more fish. I am not a fan (nor much of an enemy) of fish. I will gladly save any recommended recipes that manage to include fish and all its benefits without making it overly obvious that I'm eating fish. I could always try and self-modify so that I no longer treat fish as pretty far down the preferred meat hierarchy, but using it in something more desirable in general sounds way more fun. Bonus points if it's something well balanced.)

Comment author: RomeoStevens 27 February 2014 06:18:35AM 1 point [-]

You can get sashimi delivered to your house frozen for around $25 a pound.

Comment author: atorm 27 February 2014 12:52:02PM 2 points [-]

That seems really expensive.

Comment author: Alejandro1 27 February 2014 02:22:51PM *  1 point [-]

Here is a very simple recipe for fish that doesn't feel like fish. I made it yesterday :). In addition to being simple, it is easily tweak able/optimizable for your tastes and dietary needs. All quantities are rough approximations:

Throw in a pot 1 onion (chopped), 4 celery sticks (chopped), 1 potato (diced), 2 cod fillets, and 2-3 cups of watered tomato sauce. (The one I use is a super-simple homemade one: 2 tablespoons tomato paste, 2 tablespoons olive oil, 2 cups water, 1 tablespoon sugar, and salt and pepper to the taste). Bring to the boil and simmer until cooked. (I do it in a pressure cooker, where it takes 20-25 minutes. In a normal pot it would take longer and you probably need to use more water). And there you have it. The defining taste is the celery in tomato sauce; the fish (which breaks down) and the potato are just white chunks in it giving the feelings of protein and starch without changing the taste. Makes 3-4 servings.

Comment author: NancyLebovitz 27 February 2014 03:37:51PM 0 points [-]

What do you want concealed about fish?

Would small bits of fish cooked in a strong-flavored sauce be enough to make the experience less fishy?

Comment author: ephion 27 February 2014 03:40:00PM 3 points [-]

Have you had a seared tuna steak? Cooked properly, it's one of the tastiest things I've ever eaten.

Comment author: Alicorn 27 February 2014 10:18:02PM -1 points [-]

I like to drown my slab-in-the-oven type fish in hollandaise sauce, or garlic, or both. Ceviche is surprisingly easy and can be full of non-fish flavors, especially if you use a mild (sushi-grade) fish and plenty of avocado and onion and put it on nice crackers.

Comment author: roystgnr 27 February 2014 10:26:49PM 0 points [-]

If you refer to "fish" rather than a particular species (or at least to "red fish" vs "white fish"?) then I have to wonder which varieties you've tried. There are significant enough differences between tuna, cod, salmon, and tilapia, for instance, that I would not be surprised to find a person whose liked/disliked any combination of the four.

Comment author: [deleted] 28 February 2014 09:46:40PM 1 point [-]

If you refer to "fish" rather than a particular species (or at least to "red fish" vs "white fish"?) then I have to wonder which varieties you've tried. There are significant enough differences between tuna, cod, salmon, and tilapia, for instance, that I would not be surprised to find a person whose liked/disliked any combination of the four.

Do all kinds of fish have the same health effects, BTW? What about molluscs and crustaceans?

Comment author: juliawise 01 March 2014 02:27:52AM *  5 points [-]
Comment author: Oscar_Cunningham 27 February 2014 08:42:20AM 1 point [-]

Could you use the standard font and fontsize please?

Comment author: John_Maxwell_IV 27 February 2014 09:54:56AM 1 point [-]

I standardized a bunch of the formatting. Will try to do more visual polish in the next few days.

Comment author: Gunnar_Zarncke 27 February 2014 10:30:33AM 28 points [-]

I wondered what "processed meat" means exactly and looked it up in one of the studies:

“Red meat” was defined as unprocessed meat from beef, hamburgers, lamb, pork, or game and excluding poultry, fish, or egg; “processed meat” was defined as any meat preserved by smoking, curing, or salting or addition of chemical preservatives, such as bacon, salami, sausages, hot dogs, or processed deli or luncheon meats, and excluding fish or eggs; and “total meat” was defined as the total of these 2 categories.

I also looked up "resistance training" but it is not clear exactly what is meant. I have to assume that it is streangth training.

I recommend adding this post to the boring advice repository

Comment author: Antiochus 27 February 2014 02:55:23PM 0 points [-]

Looks like I'm going to have to rethink my lunches.

Comment author: [deleted] 27 February 2014 03:18:47PM 3 points [-]

So is ground beef that is wrapped in a package like this usually processed or unprocessed meat?

Comment author: mare-of-night 27 February 2014 03:45:39PM 8 points [-]

Where I've heard the term used, it'd be unprocessed. As someone who can't eat the usual meat preservatives at all for health reasons, I can tell you for sure that typical plastic wrapped hamburger meat isn't preserved with anything (which, based on the examples, would probably be the reason why processed meat is bad for you).

Comment author: Gunnar_Zarncke 27 February 2014 04:13:42PM 0 points [-]

I think it counts as unprocessed.

Comment author: CronoDAS 27 February 2014 11:43:22PM 0 points [-]

So a McDonalds hamburger is "unprocessed" meat, then?

Comment author: taryneast 28 February 2014 09:47:39AM 0 points [-]

Does the hamburger incorporate salt?

Comment author: Gunnar_Zarncke 28 February 2014 01:24:58PM 2 points [-]

If the beef were created and processed freshly then yes. But as I understand McDonalds the "beef" of the hamburger arrives heavily pre-processed at each "restaurant" and I'd bet that it incorporates salt, artificial smoke, heating, flavoring and what not.

Comment author: juliawise 01 March 2014 02:05:41AM 2 points [-]

Their website says the ingredients are beef, salt, and pepper.

Comment author: Gunnar_Zarncke 01 March 2014 09:50:08AM 2 points [-]

It appears that the beef patties indeed do not contain additives: http://designtaxi.com/news/353751/McDonald-s-Reveals-How-Its-Beef-Patties-Are-Made/

Comment author: Gunnar_Zarncke 27 February 2014 10:33:20AM 0 points [-]

The section "How to actually form new habits" is small and doesn't fit in well. I recommend removing it or making it into a separate post or add it as a comment. There are some posts on this topic already that might be referenced roughly falling into the How To Actually Change Your Mind category.

Comment author: Gunnar_Zarncke 27 February 2014 10:41:53AM 0 points [-]

Very good post.

How I plan to act on it:

  • reduce processed meat further (but not unprocessed meat)

  • consider adding some restance training to my exercise (once I figure out which fits best and needs no weights etc.; probably http://en.wikipedia.org/wiki/Bodyweight_exercise )

  • check my blood measures with you info in mind

  • consider yearly blood donation

  • More exposure to sun

I already ordered an e-cig to give to an acquaintance.

Comment author: [deleted] 27 February 2014 03:26:13PM *  3 points [-]

OP said that you shouldn't publicly commit to your plan because it makes you less likely to do it. Can I ask why you decided to do so anyway?

Comment author: Gunnar_Zarncke 27 February 2014 04:17:14PM 0 points [-]

because it makes you less likely to do it.

Why do you think so? From procrastication and other advice I took it that publicly committing to a plan makes you more likely because or social pressure. What did I get wrong?

Comment author: [deleted] 27 February 2014 05:31:58PM 0 points [-]

Derek Sivers has argued that "announcing your plans to others satisfies your self-identity just enough that you're less motivated to do the hard work needed".

The page includes links to studies, but I haven't read them yet

Comment author: [deleted] 27 February 2014 05:37:53PM 7 points [-]

Why do you think so?

It's slightly counterintuitive, but studies say that this is what happens. I'll just paste a few paragraphs from the article linked by OP:

Tests done since 1933 show that people who talk about their intentions are less likely to make them happen.

Announcing your plans to others satisfies your self-identity just enough that you're less motivated to do the hard work needed.

In 1933, W. Mahler found that if a person announced the solution to a problem, and was acknowledged by others, it was now in the brain as a “social reality”, even if the solution hadn't actually been achieved.

NYU psychology professor Peter Gollwitzer has been studying this since his 1982 book “Symbolic Self-Completion” (pdf article here) - and recently published results of new tests in a research article, “When Intentions Go Public: Does Social Reality Widen the Intention-Behavior Gap?”

Four different tests of 63 people found that those who kept their intentions private were more likely to achieve them than those who made them public and were acknowledged by others.

Once you've told people of your intentions, it gives you a “premature sense of completeness.”

You have “identity symbols” in your brain that make your self-image. Since both actions and talk create symbols in your brain, talking satisfies the brain enough that it “neglects the pursuit of further symbols.”

A related test found that success on one sub-goal (eating healthy meals) reduced efforts on other important sub-goals (going to the gym) for the same reason.

Comment author: TylerJay 27 February 2014 05:56:31PM 0 points [-]

I'm confused here too... Commitment and Consistency pressure are well-researched and documented phenomena...

Comment author: [deleted] 01 March 2014 10:30:23AM 0 points [-]
Comment author: ephion 27 February 2014 03:45:48PM 2 points [-]

Why avoid weights? They're the most efficient and effective way to do strength training. Bodyweight exercises are OK but they fairly quickly top out on any benefits, unless you get rings and other gymnastic equipment.

You can get a barbell and 300lbs of weights for under $300 used, with which you can do deadlifts, overhead press, and barbell rows. That's a complete, full body routine of scalable difficulty which will last you for quite some time and requires no other equipment.

Comment author: Gunnar_Zarncke 27 February 2014 04:24:43PM *  1 point [-]

Why avoid weights?

Because they take space, are no fun, cannot be combined with useful activity and often encourage too simple movement patterns.

The only weights I'd consider are those to be worn on arms and thighs and can be continuously worn and are combined with all movements.

Comment author: ephion 27 February 2014 06:43:28PM *  9 points [-]

You appear to possess some misconceptions about weight training.

they take space,

A stack of plates with the barbell stored vertically takes 0.2m^2 (~2sqft). Here's a picture of a 330lb set for demonstration; wine bottle and keyboard for scale. I have a lot more equipment than just the barbell, but that's because I do powerlifting and it's a hobby.

are no fun

This is a matter of perspective and preference. I find weight lifting to be extremely fun, especially the sport of powerlifting. Furthermore, it has no bearing on the fact that weight training is the most effective and efficient means of getting stronger.

cannot be combined with useful activity and often encourage too simple movement patterns.

The deadlift, overhead press, and row are three of the most fundamental movements a person can do. In sports science terms, these are highly general movements, which means that increasing strength in these movements will have positive carry over to every other physical pursuit that uses similar movements. Runners use the deadlift to improve their running speed, for example, and throwers use the overhead press to improve their throwing distance. Your assertion that they can't be combined with useful activity is incorrect, as they are useful activity. And they don't encourage too simple movement patterns, as they increase the strength of all movement patterns.

I would agree that weight training can be an ineffective choice, if you limit your exercises to machines and single-joint isolations and use too many sets/reps with too little resistance. If you deadlift, overhead press, and barbell row for 3 sets of 3-5 reps 3 times per week and progressively add weight, then you'll get strong much faster and with less time spent exercising than on any no-equipment routine.

Comment author: waveman 28 February 2014 11:08:44AM *  3 points [-]

I would agree with this. I have found weightlifting ("Starting Strength" program is a good place to start) tremendously beneficial in real life applications. Eg helping my brother dig trenches at his house, lifting things into the car, my back problems have gone away, I am a lot more flexible and agile etc. Also my blood pressure is a lot better (117/77 this morning).

Key points:

  1. Full body compound exercises. Not "curlbro" isolation exercises.

  2. Weights not machines (I tried machines and found that specific muscles got big but I did not gain real world strength).

  3. Progressive increase in load.

  4. Sufficient rest days. For health purposes 1-2 workouts a week is quite sufficient. It will not get you "toned for summer" in minimum time but you will get good benefits.

  5. Good form - do the lifts properly. And allied to this, do not rush. Newbie gains are good for 6-8 months and then you will slow down no matter what you do. If you take your time you will avoid injury. Lifting weights is one of the safest forms of exercise statistically.

  6. Sufficient nutrition - a nutrient rich diet with sufficient protein and other nutrients.

Unfortunately most personal trainers have minimal training and often give bad advice. You need to do some research.

Comment author: [deleted] 01 March 2014 10:15:40AM 0 points [-]

A stack of plates with the barbell stored vertically takes 0.2m^2 (~2sqft).

What about the bench?

Comment author: ephion 03 March 2014 02:05:19PM 1 point [-]

You don't need a bench. Overhead pressing (and push pressing for intermediate trainees) is sufficient to develop pushing power, and is a better movement for balanced shoulder strength and posture. If you really want to develop the chest muscles, then you can do floor press for most of the same benefits without purchasing a bench.

Comment author: Lumifer 03 March 2014 04:54:48PM 1 point [-]

A stack of plates with the barbell stored vertically takes 0.2m^2 (~2sqft)

Storage isn't the real problem. You need, for example, a floor which will survive 300+ lbs of steel dropped onto it from more than six feet. Lifting weights without a spotter or a rack is risky, especially for beginners.

The deadlift, overhead press, and row are three of the most fundamental movements a person can do.

Weightlifters keep on saying that, but I see no sense in this. Why in the world, say, an overhead press is a "fundamental movement"?

If asked about highly general fundamental movements, I'd probably say run, climb, swim.

Comment author: brazil84 03 March 2014 02:29:42PM 2 points [-]

Why avoid weights?

For what it may be worth, I avoid weights because I want something I can do every day, any time, anywhere. Because I know that if I miss one day, there's a good chance I will fizzle out.

So I do pushups, crunches, and pullups. I have a pullup bar at work which fits into the door frame and the same thing at home. But sometimes I do pullups on the subway or on one of the many scaffoldings in NYC.

Using weights might very well be superior in some respects but for me the main thing is consistency.

Comment author: Gunnar_Zarncke 27 February 2014 10:44:39AM *  0 points [-]

I missed a section on sugar (even if it just says that this is not covered or e.g. link to http://lesswrong.com/lw/je5/critiquing_gary_taubes_part_3_did_the_us/ )

ADDED: And a sentance about caffeine.

Comment author: RomeoStevens 27 February 2014 04:02:52PM 0 points [-]

While average sugar consumption is certainly too high, a lot of nutrition concerns seem to be overblown for how large their actual effect size is. Of course, hopefully increased fruit consumption is having a substitution effect on other sugars in the diet.

Comment author: waveman 28 February 2014 11:21:03AM *  3 points [-]

Downvoted so I should say why.

  1. Citation required.

  2. When I saw Professor Lustig's talk (http://www.youtube.com/watch?v=dBnniua6-oM) and followed up the literature I personally cut my sugar intake from average (almost all from fruit by the way) to low. Consistent with his claims, my cholesterol (particularly LDL), triglycerides, and inflammatory markers fell dramatically, to the point that my doctor told me this is good but we don't want cholesterol any lower.

The authorities recommend limiting sugar intake. One issue is that modern processed foods are full of sugars, in part to make "low fat" foods tolerably palatable, so you are probably getting more than you think. Even some canned sardines I bought the other day has added sugar. Also be aware of the various euphemisms for sugar (HFCS, fructose, sucrose, etc).

inb4 I have no citation.

Comment author: Lumifer 28 February 2014 06:33:50PM 2 points [-]

I personally cut my sugar intake from average (almost all from fruit by the way) to low. Consistent with his claims, my cholesterol (particularly LDL), triglycerides, and inflammatory markers fell dramatically

It is pretty clear there is WIDE individual variation in response to low carbs.

Low-carb and paleo forums are full of people who eat none or very little sugar and their lipid panels horrify mainstream doctors. See e.g. this or this.

Comment author: RomeoStevens 28 February 2014 08:45:54PM *  3 points [-]

My physical and mental performance improved when I went from VLC to a more moderate 150ish grams a day. My HDL, Triglyceride, and c-reactive protein numbers are great, and my total cholesterol is 220, which is right in the middle of the lowest risk group. We see pretty much every hunter gatherer group using tubers extensively, along with some fruit, as a carb base.

Comment author: Lumifer 28 February 2014 08:57:58PM *  2 points [-]

As far as I know going VLC will (typically) push both your LDL and HDL numbers up and will drastically lower your trigs. CRP is an inflammation measure, not part of the lipid panel.

We see pretty much every hunter gatherer group

You mean "We see pretty much every tropical hunter gatherer group". The Inuit/Eskimos obviously don't.

Comment author: RomeoStevens 01 March 2014 12:54:40AM 0 points [-]

The Inuit are a fairly large outlier in dietary makeup.

Comment author: RomeoStevens 28 February 2014 08:47:06PM 2 points [-]

Very low LDL is predictive of greater mortality, not less.

Comment author: jaibot 27 February 2014 11:16:27AM 8 points [-]

Are there any decent vegetarian substitutes for fish?

Comment author: ephion 27 February 2014 03:38:55PM 1 point [-]

For which respect? Tempeh is a great source of vegetarian protein and micronutrients, as fermentation removes all the nasty stuff from soy. Algae supplements have a good bit of the n-3 fatty acid DHA and EPA, but are extremely expensive with average prices being $60/mo for the recommended 2g EPA/DHA per day. Contrast this with $8/month for fish oil of the same power.

Comment author: RomeoStevens 27 February 2014 04:00:46PM 9 points [-]

No. If you are a vegetarian for moral reasons consider how your personal consumption impacts suffering on the margin and maybe consider at least drinking milk.

Comment author: jaibot 28 February 2014 01:56:59PM 2 points [-]

Is it that we don't know what makes fish so effective, or we do know and can't get it any other way?

Comment author: ephion 28 February 2014 03:34:31PM 3 points [-]

The main benefits of fish are high protein content and most of the fats are essential omega-3 fatty acids, including the protective EPA and DHA which are mostly unavailable in plant form. The omega-3 fatty acid ALA, which is available in many plans, only gets converted at a rate of 2-10%. If you wanted to get 2g/day of EPA+DHA, you'd need to consume 20-100g of ALA, or 37-186g of flaxseed oil.

Comment author: jaibot 28 February 2014 04:47:03PM 1 point [-]

What about algae oil?

I'm also looking at krill oil. My vegetarianism is approximately Peter-Singer-When-He-Still-Ate-Mussels (http://www.wesleyan.edu/wsa/warn/singer_fish.htm), and I'm pretty sure Krill are simple enough that there's no disutility in consuming them, but I'm having trouble finding anything definitive.

Comment author: RomeoStevens 28 February 2014 08:39:50PM 3 points [-]

I have a general heuristic in my diet of "if you need to process ten thousand of something to get the amount you want to eat, don't do that."

Comment author: juliawise 01 March 2014 02:10:08AM 4 points [-]

What about yeast? This seems like a silly heuristic.

Comment author: RomeoStevens 01 March 2014 04:05:50AM -1 points [-]

I'm not at all confident eating lots of yeast is great for our gut bacteria.

Comment author: trist 01 March 2014 07:06:04AM -1 points [-]

Perhaps the reference is to "nutritional yeast", which are all dead, and won't impact your gut bacteria aside from being provided with more nutrients.

Comment author: zedzed 27 February 2014 01:56:06PM *  7 points [-]

(edited to add sources) (edited to add music-nerdery)

Reviewing my notes from Wiseman, I can add the following recommendations for stress:

*Listen to classical music. Actually, if you check the study, only major, baroque music was helpful. I recommend the Brandenburg concerti.

*Spend at least 30 minutes outside on warm, sunny days.

*Laugh at least 15 minutes a day.

*Source: Music can facilitate blood pressure recovery from stress.

*Source: A warm heart and a clear head. The contingent effects of weather on mood and cognition.

*Source A correlational study of the relationship between sense of humor and positive psychological capacities

*Source The Effect of Mirthful Laughter on the Human Cardiovascular System

<music nerdery>

(background: I've trained in classical cello for 11 years. What follows has an inferential distance of 1 for me, and an inferential distance of quite a lot for a layperson. You should probably move along)

If you check out the music study, you'll notice that it talks about "classical" music, while I'm specifying "major, baroque". Here's why.

Classical and baroque music are different. Colloquially, "classical" refers to old music that typically gets played by violins and pianos and flutes and stuff. If you're versed in music history, "classical" refers to music from the classical period, which has certain defining characteristics that make it quite distinct from other periods, like the baroque period, much like heavy metal and blues quite distinct genres with their own defining characteristics.

The original study used Spring by Vivaldi and Canon in D by Pachelbel as "classical" music. If you're a layperson, these are perfectly representative pieces of classical music. If you're a music nerd, these pieces will tell you a lot about the effect of major, baroque music on blood pressure, but generalized to classical music is analogous to saying something like "all vertices of a square form right angles, thus the vertices of all quadrilaterals form right angles."

Baroque music is different from classical is different from jazz. We know (major, baroque) works and jazz doesn't; everything else is different enough I'm sketched out about generalizing from baroque to that. Here's why I'm fine with generalizing from (Vivaldi, Pachelbel) to (major, baroque), but not to the rest of classical.

Baroque music is noticeably lighter than more contemporary music because of (the bows, lack of endpins, use of harpsichord instead of piano, gut instead of metal strings, smaller ensembles, different wind instruments, fewer types of brass instruments, less overpowering brass instruments).

Also, baroque music tends to use just intonation, whereas more contemporary music tends to use equal temperament, and the music tested. This may be important because JI sounds better, even if it's less flexible. (Physically, JI sound waves a low-reducing integer ratios of each other, whereas ET sound waves form ratios of powers of the twelfth root of 2 of each other, so instead of having 3:2, you have 1:2^(7/12))

I specify major because it's more consonant (physically, in major and minor JI, sound waves reduce to low integer multiples of each other; in major, they tend to reduce more, so instead of having 5:4, you have 6:5).

So, until somebody goes out and tests Mozart Symphony no. 40, you're overstating your case if you claim the study I cited extends to anything beyond major, baroque music. Fortunately, all of the Brandenburg concerti are major and written by Bach, the preeminent baroque composer.

</music nerdery>

Comment author: [deleted] 27 February 2014 03:30:51PM 4 points [-]

*Laugh at least 15 minutes a day.

Does it matter which kind of laughter? Is laughing with others a lot better than doing it alone? Is schadenfreude laughter as good as any other kind of laughter?

Comment author: Emile 27 February 2014 03:43:14PM 3 points [-]
Comment author: jobe_smith 27 February 2014 03:44:13PM 3 points [-]

That's a good question. What if it turned out that laughing maniacally after committing an act of villainy was the healthiest of all? Would that change people's views about altruism?

Comment author: zedzed 27 February 2014 03:45:08PM 3 points [-]

People who spontaneously use humor to cope with stress have especially healthy immune systems, are 40 percent less likely to suffer a heart attack or stroke, experience less pain during dental surgery, and live four and a half years longer than average... Participants’ blood flow dropped by about 35 percent after watching the stress-inducing films, but rose by 22 percent following the more humorous material.

Comment author: benkuhn 27 February 2014 04:52:39PM *  2 points [-]

Are you referring to the "Mozart Effect" studies? That's what I found in the book (or at least the parts of the preview that were accessible), but Mozart is actually classical, not baroque. The effect seems to be small and specific to one particular type of task, according to this Nature meta-analysis:

Rauscher et al. 1 reported that listening to ten minutes of Mozart's music increased the abstract reasoning ability of college students, as measured by IQ scores, by 8 or 9 points compared with listening to relaxation instructions or silence, respectively1. This startling finding became known as the 'Mozart effect', and has since been explored by several research groups. Here I use a meta-analysis to demonstrate that any cognitive enhancement is small and does not reflect any change in IQ or reasoning ability in general, but instead derives entirely from performance on one specific type of cognitive task and has a simple neuropsychological explanation.

As a side note, if you're going to cite studies it would be great to continue Romeo's trend of actually linking to the relevant studies, since there's not enough info in your comment to find the ones you're referring to and I don't own Wiseman. I don't really trust Wiseman (or pop-sci books in general) to interpret findings with anything remotely resembling rigor.

Comment author: zedzed 27 February 2014 05:38:40PM 3 points [-]

See edit.

Thanks for suggesting I put in sources. It didn't occur to me, but it really should have.

I generally don't trust pop-sci either, but Luke recommended Wiseman repeatedly, and since I trust Luke, I see Wiseman as a way of getting useful results without the work of reading all the science myself, much the same way I just give to Givewell's recommended charities rather than evaluate them myself. I could, but they have a comparative advantage, and I'm guessing you'll agree doing the verification is expensive. If there's a flaw in this reasoning, I'd appreciate a head-ups. Thanks!

Comment author: benkuhn 28 February 2014 12:28:29AM *  4 points [-]

For clarity, I don't trust Wiseman since I've never read anything and my prior for pop-sci is low. Luke's endorsement is a positive update to his credibility.

Fully verifying is expensive, but spot-checking is cheap (this post took me about 10 minutes, e.g.). Similarly, most people barely check GiveWell's research at all, but it still matters a lot that it's so transparent, because it's a hard-to-fake signal, and facilitates spot-checking.

Re: music--it looks like you were referring to a different study on the benefits of listening to music than the one I found in Amazon's preview of Wiseman. "Listen to classical music <to reduce blood pressure when stressed>" would have been another high-VoI addition to the OP.

Further studies indicate that "self-selected relaxing music" has the same effect, and that it's probably mediated by general reduction of SNS arousal. This suggests that (a) if you're doing an SNS-heavy task, like difficult math, you may not want to listen to music at the same time; (b) anything else you would expect to move you around the autonomic spectrum should work the same way (e.g. meditation). On the other hand, neither of the studies asked subjects to do anything while listening to music, so it's unclear whether the effect would stay visible. A possibly interesting meta-analysis is here. If doing anything while listening to music makes the effect go away, then I would guess that meditation or the autonomic-spectrum navigation that CFAR teaches is a more efficient way to reduce blood pressure.

I don't know if Wiseman went into any of those in his book, but my take-away is to do some research before installing any new habit.

Comment author: Will_Sawin 28 February 2014 02:54:30PM 1 point [-]

Difficult math is SNS-heavy?

Comment author: benkuhn 01 March 2014 04:17:41AM 1 point [-]

At least according to Val, activating System 2 requires SNS activity.

Comment author: Error 27 February 2014 03:18:37PM 0 points [-]

Melatonin pills work for many, but make sure you start with 75mcg (cut these into fourths), rather than the 3mg most pills come in.

Why is it important to use the lower dose? (I started using 3mg pills after reading recommendations here, and they work excellently)

Don’t publicly commit to your plan in the comments, this makes you less likely to do it

This one surprised me. It's the exact opposite of advice I've seen elsewhere here on social precommitments.

Comment author: mare-of-night 27 February 2014 03:48:25PM 5 points [-]

I remember seeing another LW member comment that over-the-counter drugs tend to get sold in too-high dosages because people who don't know how to dose (most customers) assume the strongest is best, and the stores stock the versions that are selling best, leading to doses that are too high for the typical user being the most commonly sold ones. I don't remember where the original comment was, unfortunately.

Comment author: Error 27 February 2014 04:03:51PM 1 point [-]

That makes sense but doesn't actually answer my question. The phrasing implied (to me) that either the smaller dose works better or that the larger has more side effects, without specifying which. I've tried 1mg pills and they didn't seem to work as well, but I'm not sure if that was placebo talking or not.

Comment author: RomeoStevens 27 February 2014 04:06:40PM 2 points [-]

For many smaller doses do work better than larger doses, though I don't have the cite handy. Better to start too small and work up than the other way around IMO. When I took large doses I had negative side effects.

Comment author: Douglas_Knight 27 February 2014 07:32:29PM 0 points [-]

Does the word "cite" mean that you have seen a controlled study claiming that smaller doses are more effective than large doses, and not just anecdotes?

Comment author: RomeoStevens 27 February 2014 11:04:51PM *  0 points [-]

Yes. or at the very least there were issues with side effects and tolerance building.

Comment author: fubarobfusco 28 February 2014 11:57:29PM 0 points [-]
Comment author: mare-of-night 27 February 2014 10:17:48PM 0 points [-]

This makes sense. I don't know the answer, though.

Comment author: NancyLebovitz 27 February 2014 03:43:43PM 8 points [-]

Sunlight leads to less cardiovascular disease. (nitric oxide)

Sunlight leads to less cardiovascular disease Vitamin D.

And see if you can have someone in your life who can advocate for you in medical matters if you're not in good enough shape to advocate for yourself. (Anyone know if deeply incompetent medical care is as bad a problem in countries which aren't the US?)

Comment author: Gunnar_Zarncke 27 February 2014 04:28:04PM 19 points [-]

Judging from the votes and quality couldn't this go to Main? At least with minimum further streamlining?

And if not why not?

Comment author: RomeoStevens 27 February 2014 05:03:52PM *  18 points [-]

Over the last year I have become dramatically better at instilling habits in myself. I posit two main reasons for this. The first is understanding the habit formation process, as summarized by Kaj Sotala here. The second is learning to create plans that are more robust against random failure. I used to model myself as a coherent agent with some set amount of willpower to expend on the various things I found unpleasant. More recently, I model myself as a bunch of sub-agents with different goals. The subagent that tends to make plans for what I’m going to do this week is NOT the same sub-agent that will actually have to do these things. So now I make plans that can take into account a low motivation sub-agent being in charge. Sometimes this is as simple as a part of your plan that says “IF you don’t want to go to the gym THEN you will go to the gym anyway.” Yes, seriously. Sometimes it is making the activation costs of a particular action easier by removing friction from your process. Sometimes it is modeling my future self as an idiot who can’t stop eating cookies and doing things like preemptively throwing cookies away.

How would I actually go about forming a new habit? Let’s use flossing as an example. Trying to remember to floss after I brushed didn’t work. At all. So I had to start strategizing. My sub-agents didn’t have sufficient motivation to care. So I started reading up on the benefits of flossing and looking at images of flossed vs unflossed surfaces in a mouth. This created enough of an emotional connection that I started feeling like I really needed to floss. But I still forgot. Remembering to floss after I brushed was still not working, so I changed it. I put the floss in my room. That way it was available over a much longer period of time in the evening. IF I forgot to floss THEN I would floss in the morning. I thought about positive things while flossing, longevity and building effective habits and having clean teeth. After a few weeks, flossing was finally a habit. I didn’t have to think about it anymore and was able to start working on a new habit.

Comment author: LucasSloan 28 February 2014 12:37:30AM 1 point [-]

The first is understanding the habit formation process, as summarized by Kaj Sotala here.

Link?

Comment author: RomeoStevens 28 February 2014 03:29:24AM 0 points [-]

fixed.

Comment author: AndekN 01 March 2014 09:59:00PM *  4 points [-]

Let’s use flossing as an example. Trying to remember to floss after I brushed didn’t work. At all. 

I had the same experience for years. Every six months or so I would read an article like this one reminding how important it is to floss, visit a dentist or something similar. Then I promised to myself that from now on, I'd floss daily. And then I'd forget to actually do it.

After reading The Power of Habit (the book Kaj Sotala summarised in his article linked above) I realised that just trying to remember would never work. Instead, I needed to create a cue. I did this by placing the floss in front of my facial cleanser. Then, every evening when I reached for the cleanser (this already was a habit for me), my hand would hit the floss. That reminded me to floss and only after flossing I would clean my face. And it worked. I don't have to think about flossing anymore: after a month it had become a habit and now, after six months or so it's starting to feel weird that there was a time I didn't floss every day.

Comment author: framsey 27 February 2014 05:11:24PM 1 point [-]

What do you think of the health effects of too much sitting? That seems to be a hot topic recently. http://www.mayoclinic.org/sitting/expert-answers/faq-20058005

Comment author: RomeoStevens 27 February 2014 05:45:06PM 3 points [-]

Breaking up long sitting periods with stretching and walking around is a safe bet, but the studies are actually less clear than the editorials on them would lead you to believe.

Comment author: D_Malik 27 February 2014 06:20:19PM 7 points [-]

On eating more fish: How worried should I be about mercury poisoning? Is it worthwhile to carefully select fish for low mercury content?

For instance, one guy on /r/fitness reports that 2 cans of chunk light tuna a day gave him mercury poisoning; while you're not recommending that much fish, I'd expect that health detriments appear long before full-blown mercury poisoning.

(I'm not expecting you in particular to tell me this, I just want to know if someone on LW has already done this research.)

Comment author: aelephant 27 February 2014 06:33:51PM 3 points [-]

I would recommend against eating canned food to limit your exposure to Bisphenol A.

I would also not eat tuna every single day for such an extended period of time!

Comment author: taryneast 28 February 2014 09:51:08AM 0 points [-]

supporting data ?

Comment author: aelephant 01 March 2014 06:32:08PM 4 points [-]
Comment author: RomeoStevens 27 February 2014 06:35:07PM 2 points [-]

Oh yeah, salmon is easily the best for health benefits AFAIK. I should include this in the post.

Comment author: Prismattic 28 February 2014 01:05:17AM 7 points [-]

Must be wild salmon, not farmed salmon. The difference in Omega 3/6 ratio is immense.

Comment author: [deleted] 02 March 2014 03:21:16PM 0 points [-]

Is tuna all right if I have a hard time getting salmon? I can get tuna salad at the grocery store or tuna sandwiches for lunch comparatively easily, but salmon can be expensive here.

Comment author: RomeoStevens 03 March 2014 05:20:53AM 1 point [-]

Tuna has among the highest mercury content per serving IIRC.

Comment author: [deleted] 03 March 2014 06:38:07AM *  1 point [-]

I was going to recommend kipper, but this says it's not that much better than tuna. It's still better, at least in terms of mercury.

This PDF says canned sardines have 1 gram EPA+DHA per 100g, whereas herring has slightly more and tuna is all over the place.

Not very good evidence for kipper vs. sardines (I buy kipper just because I can't stand sardines, though I'll look out for salmon now that it's been mentioned), but either looks to be preferable to tuna.

Comment author: LucasSloan 28 February 2014 12:36:49AM -1 points [-]

The health benefits of fish outweight the health detriments of mercury until way beyond the level of consumption you're likely to get to.

Just eat fish.

Comment author: Lumifer 28 February 2014 01:17:34AM 10 points [-]

The health benefits of fish outweight the health detriments of mercury until way beyond the level of consumption you're likely to get to.

Supporting data..?

Comment author: juliawise 01 March 2014 02:19:10AM 3 points [-]

For pregnant women, these days they're recommending oily, low-mercury fish like salmon, herring, and sardines. Chart

Comment author: TylerJay 27 February 2014 07:05:24PM 6 points [-]

Great article. Lots of really good information. A few questions:

Well it turns out that fish oil pills suck, and you’d need to take approximately 9 times as much to have the same effect as eating fish, at which point they’d have dangerous blood thinning effects.

Does anyone have a link to this full study? I'd like to see the full data. The abstract is confusing. It says you would need " two- and ninefold higher doses of EPA and DHA, respectively, if administered with capsules rather than salmon," but it's not clear which numbers you need to multiply by those factors... The amounts in the 100g of salmon or the amounts in the 1 or 3 fish oil caps? If it's the amount in the 3 caps, then that comes out to 900mg EPA and about 2700mg DHA, which is about 3 and a half grams. That's achievable in 6 high-quality caps and doesn't seem like it's at a level where you'd be in any danger of blood thinning... Do you have a good resource I can read to get more information on the blood thinning effects and when they might be dangerous?

I noticed you didn't really include anything on the fat content of a diet and its effects on CHD and Lipid Profile. As I understand it, omega-6 fatty acids are harmful in the amounts that most people in Western countries eat, even when not oxidized. On the face of it, this study appears to suggest that in CHD patients, bringing the omega-6 to omega-3 ratio down to 4:1 was associated with a 70% decrease in total mortality. I think it's likely that the omega-6 : omega-3 ratio is important and that supplementation of omega-3 likely achieves many of its benefits by bringing this ratio back into balance (since people typically have very low omega-3 intake). Reducing intake of omega-6 from seed oils like corn oil, soybean oil, and sesame oil seems likely to have similar beneficial effects.

On that note, really the only thing that jumped out to me about your meal squares is the high PUFA content. If you ate 5 servings to reach 2000 calories, you'd be getting 18g of PUFA, most of which is omega-6 and not much is EPA/DHA which are likely the only omega-3s your body can actually use effectively. It not being oxidized is definitely an important factor, but omega-6 is inflammatory and (as far as I can tell) negatively affects blood markers even without being oxidized before you eat it. Besides that though, I'm really impressed with it. Good luck.

Comment author: RomeoStevens 27 February 2014 11:02:12PM *  2 points [-]

We're going to be replacing our current sunflower seeds with high oleic acid versions which will bring us down to under 5% of calories from PUFA.

Do you have a jailbroken version of that study anywhere? That's a really large effect, and the best evidence against PUFA yet if true.

Comment author: TylerJay 28 February 2014 03:34:26AM 1 point [-]

I don't, unfortunately. I thought it looked really high as well. The wording of the abstract seems to indicate that it was an observational/epidemiological study, not an RCT, but you can never really tell from the abstracts.

Comment author: Mqrius 03 March 2014 12:35:52PM 1 point [-]

My university has access to the paper. I've got it hosted on my server, but you're only allowed to download it if you have legal access through your university as well. If you have legal access, feel free to click this link:

http://forecast.student.utwente.nl/Lesswrong/The%20importance%20of%20the%20ratio%20of%20omega-6%20omega-3%20essential%20fatty%20acids.pdf

Comment author: Mqrius 03 March 2014 12:52:37PM *  1 point [-]

The maximum total energy from PUFA has been a discussion point with DIY Soylent makers as well. The final consensus was that it should definitely be below 10%, and possibly below 4%. The 4% figure comes from The perfect health diet, which uses this as a source:

Angela Liou Y, Innis SM. Dietary linoleic acid has no effect on arachidonic acid, but increases n-6 eicosadienoic acid, and lowers dihomo-gamma-linolenic and eicosapentaenoic acid in plasma of adult men. Prostaglandins, Leukotrienes and Essential Fatty Acids 2009 Apr;80(4):201–6, http://pmid.us/19356914.

I've also got a copy hosted at http://forecast.student.utwente.nl/Lesswrong/ but only download that if your university or company legally gives you access to Elsevier content.

For the discussion and links to other relevant papers, see http://discourse.soylent.me/t/optimal-micronutrient-ratios/5049/52 and further posts

For my Soylent, I ended up getting most fats from macadamia oil (mostly Omega-9 aka MUFA) and MCT oil (Medium-chain saturated fat), since they don't have any negative effects associated with them. Correct me if I'm wrong.

Comment author: James_Miller 27 February 2014 07:18:19PM 5 points [-]

Examine.com is much less positive about CoQ10 writing "all the noticeable effects (more vitality) could potentially be placebo. It is very much a faith buy and the costs if you take it in the wrong manner (without a fatty transport) could be quite high financially."

Comment author: RomeoStevens 27 February 2014 11:00:38PM 3 points [-]

mean decrease in systolic pressure over 8 studies of 16mm Hg kicks the crap out of a lot of interventions, including some prescription ones.

Comment author: PeterDonis 01 March 2014 04:09:55AM 0 points [-]

Are there any theories about the mechanism involved here? I've done a fair bit of Googling about this but haven't found any discussion of underlying mechanisms, only the statistics. I know that CoQ10 is critical in the metabolic cycle that produces ATP, and therefore is involved in energy production everywhere in the body; but I'm not sure how to get from that to the specific result of lowering blood pressure (rather than something more general like "feel more energetic").

Comment author: RomeoStevens 01 March 2014 08:06:28AM 0 points [-]

The fact that blood pressure is an independent predictor of mortality would imply it affects, and is most likely affected by, a lot of metabolic processes.

Comment author: CellBioGuy 28 February 2014 05:03:23AM 2 points [-]

From my own looking around I would recommend adding CoQ10 if you are on statin anti-cholesterol medications. They interfere with its recycling within your body, and while there's a reason that the active part of CoQ10 is called 'ubiquinone' (its in EVERYTHING that was once alive) its plausible that levels might drop enough to mess with higher metabolic levels if you are on these drugs. Source: anecdotal evidence and a recent study that seemed to show that statin drugs cause people to stop getting cardiovascular benefits from aerobic exercise.

Comment author: AlexSchell 27 February 2014 09:10:55PM 3 points [-]

I can't donate blood where I live. Perhaps I should look into good old-fashioned bloodletting.

Comment author: octopocta 27 February 2014 09:16:05PM 3 points [-]

I'm very surprised that there is no mention of a low-dose aspirin regime here. Low dose aspirin can greatly reduce chances of stroke, heart attack, and cancer. The main caveat is that there is increased chance of bleeding or stomach ulcer, the latter of which can be avoided by taking with food.

Comment author: RomeoStevens 27 February 2014 11:04:30PM 7 points [-]

I looked into the numbers and it's a wash for people under 45. The risks are greater than often presented, likely because the marketing is targeted at people at heightened risk who really do need to be convinced to take it.

Comment author: D_Malik 27 February 2014 10:04:48PM 3 points [-]

Also relevant to longevity are supplements for reducing the cognitive decline that comes with aging, such as piracetam.

Comment author: brazil84 27 February 2014 11:53:03PM 4 points [-]

I was pretty surprised about blood donation. My intuition is screaming that it must be one of those correlation/causation things where unhealthy people are discouraged from donating blood, but on the other hand, the researchers are all surely very well aware of this issue and must have taken steps to correct for it.

Anyway, have you thought about typically sub-clinical viruses like cytomegalovirus? I recall reading that a CMV infection cuts a few years from your life expectancy. I don't have research to back it up, but I think it's a good idea to avoid having intimate contact (e.g. casual sex) with lots of people.

Comment author: Lumifer 28 February 2014 01:19:33AM 9 points [-]

I was pretty surprised about blood donation.

Males tend to have iron overload which is bad for you. The easiest way to fix it is to bleed on a regular basis.

Women don't have that problem.

Comment author: maia 28 February 2014 04:42:39AM *  1 point [-]

Hmm. Do the studies account for this?

Also, that would mean women on medication that stops their period also might have this problem.

Comment author: Vaniver 28 February 2014 05:07:12AM 3 points [-]

Also, that would mean women on medication that stops their period also might have this problem.

Indeed; also post-menopausal women.

Comment author: CellBioGuy 28 February 2014 04:58:37AM 2 points [-]

Wouldn't necessarily call it iron overload, but definitely higher levels.

Hmmm... as someone who is a carrier for hemochromatosis (thanks 23andme!) perhaps I should consider this more than the average person...

Comment author: Lumifer 28 February 2014 05:52:58AM 1 point [-]

Wouldn't necessarily call it iron overload

I thought it was a pretty standard term.

Comment author: CellBioGuy 28 February 2014 07:26:14AM *  3 points [-]

Yes it is, but generally for rather more clinically significant levels. The difference between men and women exists but is much much smaller than the difference you get from, say, hereditary hemochromatosis. Ordinarily I hate nomenclature quibbles but labelling the normal state of half the population as a pathology seems out of place.

Comment author: Lumifer 28 February 2014 06:21:27PM 1 point [-]

Well, nobody claims all males suffer from iron overload.

On the other hand, the correlation between blood donation and mortality seems to suggest that there is a nontrivial amount of people (very likely males) with "clinically significant levels" who are probably not aware of that fact.

Comment author: khafra 28 February 2014 06:22:08PM *  12 points [-]

Those of us disqualified from donating blood should probably try to get into some form of exercise that involves a lot of blood loss; like skateboarding over sharp rocks, fencing with un-foiled blades, or taunting apex predators in their natural habitat. A new Ev-psych explanation for why men engage in this sort of activity more than women!

Comment author: Nornagest 28 February 2014 06:58:07PM 3 points [-]

Huh, a plausible longevity argument for Mensur fencing. Never thought I'd see that in the wild.

(Snark aside, I imagine it'd be rather difficult to find a hobby that reliably takes a pint of blood a year and doesn't kill or seriously injure you.)

Comment author: Lumifer 28 February 2014 08:40:16PM 11 points [-]

I imagine it'd be rather difficult to find a hobby that reliably takes a pint of blood a year and doesn't kill or seriously injure you.

Pet leeches :-P

Comment author: Vaniver 28 February 2014 05:06:47AM *  6 points [-]

I don’t care if you start with an exercise habit of one pushup a week, but you must do something.

Beeminder Beeminder Beeminder. Having an email reminder to exercise, and a penalty for not doing so, has been tremendously helpful for me- I now actually lift weights three times a week, as compared to just when I remembered to do so on my own.

Comment author: Prismattic 28 February 2014 05:18:00AM 3 points [-]

My workplace has a gym. I generally scarf my lunch at my desk and use my actual lunch hour at the gym. This pretty much guarantees that I will go work out at a more-or-less set time every weekday. Between this and a weekly judo class, I typically exercise 6 days a week, without really having to remember anything. (Downside/tradeoff -- less socialization, which, like exercise, reduces stress)

Comment author: shokwave 28 February 2014 07:04:26AM 4 points [-]

Counterpoint: Beeminder does not play nice with certain types of motivation structures. I advocated it in the past; I do not anymore. It's probably not true for you, the reader (you should still go and use it, the upside is way bigger than the downside), but be aware that it's possible it won't work for you.

Comment author: taryneast 28 February 2014 09:59:04AM 2 points [-]

Yeah. Beeminder doesn't work for me either - nor do most online punishment-based motivators.

My problem with it is that it doesn't punish you for failing to do the thing you need to do. It punishes you for failing to record the fact that you did the thing you need to do.

So if you're time-poor (like me) and still managed to do the thing... but didn't have time to go online and tell beeminder that you did the thing... you still get punished. :(

Comment author: [deleted] 28 February 2014 09:36:05PM 0 points [-]

Have you checked out their Android and iPhone apps? Also, I think if you have a US cell phone number you can add data via SMS.

Comment author: TimFreeman 28 February 2014 06:10:01AM *  6 points [-]

I have experienced consequences of donating blood too often.The blood donation places check your hemoglobin, but I have experienced iron deficiency symptoms when my hemoglobin was normal and my serum ferritin was low. The symptoms were twitchy legs when I was trying to sleep and insomnia, and iron deficiency was confirmed with a ferritin test. The iron deficiency symptoms went away and ferritin went back to normal when I took iron supplements and stopped donating blood, and I stopped the iron supplements after the normal ferritin test.

The blood donation places will encourage you to donate every 2 months, and according to a research paper I found when I was having this problem essentially everyone will have low serum ferritin if they do that for two years.

I have no reason to disagree with the OP's recommendation of donating blood every year or two.

Comment author: [deleted] 28 February 2014 09:34:14PM 2 points [-]

The blood donation places will encourage you to donate every 2 months,

IIRC, where I am they don't even allow you to donate blood if you've already done so in the past three months or, if you're a fertile woman, in the past six months.

Comment author: Yvain 28 February 2014 07:06:26AM *  25 points [-]

This is good stuff!

One addition I would make to your "sleep" section: between 5% and 10% of Americans have moderate or severe sleep apnea, mostly undiagnosed. Untreated sleep apnea more than doubles mortality through a combination of cardiac problems, stroke, and maybe a cancer-promoting effect as well. There are well-known effective treatments for sleep apnea and it is kind of dumb not to get them.

The main symptoms of sleep apnea are excessive snoring, and feeling very tired during the day even if you slept a normal amount the night before. It is most common in obese and older people but sometimes happens in normal-weight and younger people as well. If you think you might have this condition, probably your highest-priority longevity intervention (after quitting smoking, if you do that) is to go to your doctor and get it checked out.

Comment author: RomeoStevens 28 February 2014 08:20:38AM 1 point [-]

Thanks! I believe it was you who pointed out that longevity is only 20-30% genetics that sent me down this rabbit hole to begin with.

Comment author: TylerJay 28 February 2014 04:40:30PM 1 point [-]

If I remember correctly, Yvain argued for a salt intake lower than 1500mg / day, whereas on your meal squares page, you made an argument for having 3000mg / day. Wy do you think you disagree on that one?

Comment author: RomeoStevens 28 February 2014 08:28:44PM 2 points [-]

Differing takes on which evidence is more valid. Many studies say reducing salt is healthy. A few studies say it is unhealthy, and point to the fact that all the other studies actually say "salt reduces blood pressure" and that it turns out that in this particular case the reduction was not correlated to overall mortality. It would seem that reducing salt has detrimental effects that outweigh the blood pressure effect.

Comment author: [deleted] 02 March 2014 04:12:36AM 0 points [-]

Should people with hereditary low blood pressure ignore most of this advice / do the opposite?

For example it seems processed meats --> increased salt intake --> increased blood pressure --> increased mortality, which doesn't apply to people with low blood pressure.

Comment author: RomeoStevens 02 March 2014 04:18:14AM 0 points [-]

The causal pathway is not necessarily (in fact almost certainly not) exclusively via blood pressure, so I wouldn't do this.

Comment author: [deleted] 02 March 2014 07:15:51AM *  0 points [-]

What proportion of it is through blood pressure and could you elaborate on what the rest of the causal pathway is? Trying to decide whether it's worth cutting down on processed meats even though it may result in less protein intake overall (because I can't be bothered cooking / preparing non-processed meats).

Comment author: RomeoStevens 03 March 2014 05:22:16AM 2 points [-]

I wouldn't venture a quantification. Whey protein and eggs?

Comment author: Jonathan_Graehl 28 February 2014 07:28:47PM 1 point [-]

I snore when I'm very tired and sleeping on my back (when my jaw relaxes down in that position it's harder to breathe even through nostrils). Any cheap advice for that (besides don't do it)?

Are there harmless allergy meds that would be worth taking for better sleep when I have mild nasal congestion from seasonal pollen etc?

Comment author: Eliezer_Yudkowsky 28 February 2014 08:09:35PM 2 points [-]

CPAP (auto-adjusting pressure) didn't work on me. What else is there?

Comment author: Eneasz 28 February 2014 09:12:28PM 0 points [-]

UPPP

Not terribly expensive. The recovery is painful. But the pain is temporary, and the improvements are amazing. It was a major turning point in my life, and I'd strongly recommend it to anyone who is considered a good candidate (consult your specialist)

Comment author: Yvain 01 March 2014 01:11:00AM 3 points [-]

Complicated. I think I'm seeing you tomorrow night, I'll talk to you then rather than demand your medical history on a public forum.

Comment author: Qiaochu_Yuan 28 February 2014 10:37:08PM 7 points [-]

feeling very tired during the day even if you slept a normal amount the night before.

Crap. Alright, I sleep alone so I don't know if I snore or not, but I can test this with an iPhone app. Thanks for giving me the push I need to do this (I had briefly considered the possibility of sleep apnea before but didn't see any easy next actions).

Comment author: shminux 28 February 2014 07:48:24AM *  1 point [-]

I wonder if farmed salmon, presumably full of colors and antibiotics, has the same beneficial effect as wild.

Comment author: ephion 28 February 2014 03:48:28PM 6 points [-]

A quick google search indicates that salmon farming has become much better in recent years, and might surpass wild salmon soon. Most of the information on fatty acid profiles that I can find is from 2008, before these advances. The chart on this page indicates that farmed salmon has much more fat with a smaller proportion of omega-3. The total n-3 is close (1.8g farmed vs 1.7g wild), but if most of the extra fat is n-6, then you're not doing much for fixing the 3:6 ratio.

Comment author: waveman 28 February 2014 11:27:18AM *  3 points [-]

Interesting that there is not much discussion in the comments about weight loss, which is very hard as we all know. And not much discussion about cholesterol either for some reason.

I would just like to point out that Body Mass Index and cholesterol are not very good predictors of risk and that there is some evidence that waist/hip ratio may be a better metric to track.

https://www.mja.com.au/journal/2003/179/11/waist-hip-ratio-dominant-risk-factor-predicting-cardiovascular-death-australia

Comment author: Jiro 28 February 2014 03:19:31PM 1 point [-]

Is body mass a good predictor of risk for people who know that they are not in an obvious category where body mass is expected to be a poor predictor? That is, if you exclude the bodybuilders and limit its use to relatively average-appearing people, is body mass then useful?

Comment author: ephion 28 February 2014 04:15:36PM 2 points [-]

The best metrics are body fat percentage or fat-free mass index.

For what it's worth, even vaguely muscular people are going to blow apart the BMI scale. I'm 5'10" and 190lbs at around 13% body fat. My normal weight range according to BMI is 130-173lbs. If I got down to that without losing any muscle mass, I'd be 5% body fat, which is severely underweight. I was completely sedentary before weight training, and I've only been training powerlifting for 1.5 years with moderate results (ie, I'm not quite as strong as most high school football players).

Comment author: RomeoStevens 01 March 2014 01:13:44AM 2 points [-]

even vaguely muscular people are going to blow apart the BMI scale

I disagree, it's fairly hard for people to get much above BMI of 28 while lean. You are likely underestimating your BF, have you done a bod pod or other immersion test?

Comment author: ephion 03 March 2014 03:05:37PM 1 point [-]

I haven't. I use calipers and visual estimation compared to DEXA confirmed images. Calipers, if taken at face value, report me to be at 8-10% BF which is definitely too low. Visually, I currently look like pictures of guys in the 13-15% range, so I add 5% to the calculated result. Even at 16% BF (the highest estimate I can get), I'd be around 7% BF with a BMI of 24.8. That's underfat yet very close to overweight.

Comment author: Lumifer 28 February 2014 08:37:59PM 6 points [-]

Is body mass a good predictor of risk

BMI is a horrible metric that was never intended to be used for evaluations of individuals (it was supposed to be used for evaluation and comparison of whole populations), is known to scale wrongly with height and basically should just be ignored.

Comment author: [deleted] 02 March 2014 03:23:05PM 1 point [-]

While you are technically correct, that shouldn't function as an excuse to let oneself get overweight. My BMI was just measured a couple weeks ago to be 23.7 (between 18 and 25 is "normal"), and even after you account for the fact that I carry some muscle thanks to a year of strength training, I'm still visibly chubby and the nurse told me to lose weight. I agree with her on this.

Comment author: Creutzer 02 March 2014 03:28:26PM 5 points [-]

But what you're doing is exactly ignoring the BMI: the BMI is supposed to be normal, but you think you should lose weight.

Comment author: [deleted] 02 March 2014 04:22:06PM 1 point [-]

Yes, that's my point. However, I'm abnormal: the most common use of ignoring BMI is to let oneself remain overweight against the evidence of its health detriments.

Comment author: Lumifer 03 March 2014 04:24:55PM 0 points [-]

While you are technically correct, that shouldn't function as an excuse to let oneself get overweight.

That's a non sequitur.

To quote you from another post

the most common use of ignoring BMI is to let oneself remain overweight

You don't know that. Asserting an opinion and describing reality are two different things.

Comment author: [deleted] 03 March 2014 04:35:00PM 1 point [-]

You don't know that.

I have not run a statistically significant experiment, no, but I have simpler never heard of anyone even ignoring their BMI when it's a reason to eat more and exercise less. You could say that I have more than a completely baseless prior but less than a completely well-evidenced posterior.

Comment author: Lumifer 03 March 2014 04:58:45PM 1 point [-]

I have simpler never heard of anyone even ignoring their BMI when it's a reason to eat more and exercise less.

Huh? You're making no sense.

The great majority of people ignore their BMI because they don't care. A notable number ignores their BMI because they have better metrics. I ignore my BMI because I think that it's a silly number that tells me nothing that I don't already know.

Comment author: Jonathan_Graehl 28 February 2014 01:40:01PM 0 points [-]

I don't know anything about testicular cancer, but are self-exams useful for breast cancer? I know that the data argues against mammogram-everyone-annually + the ensuing unnecessary surgeries caused by not-harmful tumors or other false positives - no increase at all in life expectancy and presumably there's a significant psychological (and $) cost.

Comment author: RomeoStevens 01 March 2014 01:15:23AM 0 points [-]

I'm not sure. I didn't research this very extensively. If you've already done the legwork it sounds like great material for a post, since it involves making correct tradeoffs based on probabilities.

Comment author: Vaniver 01 March 2014 01:24:03AM *  6 points [-]

Breast self exam is not recommended by the Susan G. Komen foundation, neither recommended nor discouraged by the Memorial Sloan Kettering Cancer Center, and the National Cancer Institute reports no benefit but an increase in biopsies of benign tumors.

Testicular self-exams have not been studied enough for recommendations to be made, according to the American Cancer Society.

Comment author: Pablo_Stafforini 28 February 2014 02:10:11PM *  2 points [-]

This is a useful post. Thank you for writing it.

You claim that "Eggs and whole milk are very nutrient dense." I think that's quite a controversial statement. Here are the nutrition facts for 100 Calories of whole milk and spinach:

Comment author: ephion 28 February 2014 03:27:44PM *  7 points [-]

I've downvoted your post due to use of a misleading graphic (EDIT: Downvote retracted after your reply). The graphic is comparing low fat milk, not whole milk, while whole milk has much more nutrition than low fat milk. Additionally, nutrient density can refer to both nutrients/calorie, nutrients/volume, and nutrients/price. All are important measures. Spinach wins on nutrients/calorie, but the other two, not so much.

Whole milk, for example, has 124IU of Vitamin D while the chart only lists 2.4 IU, which approximates the 1% fat figure from Google's nutrition information.

This is what 200 calories of whole milk looks like. This is 200 calories of eggs. This is 100 calories of spinach.

Spinach has little protein (0.9g/serving), while eggs and milk both contain 8g and 7g per serving. This extremely important number is missing from the chart. A cup (30g) of spinach (standard serving size) contains 7 calories, so you'd need to multiply your numbers in the charts by 0.07 to get the expected nutrition per serving of spinach. A serving of whole milk (8oz/244g) is around 148 calories, so we'd need to multipy by 1.48 for a serving:serving comparison. Doing this, the differences in nutrient content are much smaller for most nutrients, and milk 'winning' several of them.

A gallon of whole milk (16 servings) costs ~$3 in my town, and a 10oz bag of spinach (roughly 9 servings) costs ~$2. The price per calorie, per gram protein, and for most micronutrients is smaller for milk than spinach.

Spinach is, of course, great to eat and very healthy. But so are milk and eggs. That they compare so favorably to your chosen food when using more realistic comparisons supports "milk and eggs are nutrient dense."

Comment author: Pablo_Stafforini 28 February 2014 04:30:09PM *  4 points [-]
  • I originally used whole milk in my graph, but later removed it because the data was for fortified milk. (Clearly, in assessing the nutrient density of a food, one should exclude whatever nutrients are added in supplement form by manufacturers.) I have now found data for unfortified whole milk, and have updated my original comment with a graph displaying nutrition data for that type of milk.

  • Whole milk does not contain significantly more vitamin D than low fat milk does. The figure you quote corresponds to fortified whole milk, which for the reasons mentioned in the preceding bullet point should not be used in this context. And even if we used both fortified whole milk and fortified low fat milk, it would also be false to say that former contains significantly more vitamin D than the latter does.

  • Nor is the nutrient content of whole milk higher than that of low fat milk; if anything, the opposite is the case. Here's an isocaloric (100 Cal.) comparison of the nutrient content of whole milk and low fat milk:

  • According to Wikipedia, "Most commonly, nutrient density is defined as a ratio of nutrient content to the total energy content." That source also provides other definitions, while noting that they are less commonly used. But none of those definitions include the two alternative definitions you provide yourself. Nor have I seen those definitions used in journals or respectable discussion groups, like the Calorie Restriction Society mailing list. I think it's unfair to claim that my graph is misleading--and downvote me accordingly--for relying on the most commonly accepted definition of that expression, instead of using definitions which are rarely if ever used by knowledgeable authorities.

  • Everything else you write might support your argument if price or volume were relevant metrics for assessing the nutritional density of foods. It doesn't support your argument under adequate definitions, and sometimes provides extra support for my own position (for instance, 100 Calories of spinach contain (much) more, not less, protein than 100 Calories of whole milk).

Comment author: fubarobfusco 28 February 2014 05:12:27PM 2 points [-]

Clearly, in assessing the nutrient density of a food, one should exclude whatever nutrients are added in supplement form by manufacturers.

Most of the milk I see for sale is fortified with vitamins A and D. I would want studies regarding milk's health effects to report on the same sort of milk that I can buy in a store.

Comment author: Pablo_Stafforini 28 February 2014 05:17:41PM *  0 points [-]

I think that for the purposes of assessing the claim in question ("Eggs and whole milk are very nutrient dense"), unfortified versions of those foods should be considered. Otherwise, we should also regard cereals and many other foods as "very nutrient dense", simply because manufacturers decide to fortify them in all sorts of ways. (And I note that it's generally not a good idea to obtain your nutrients from supplements when you can obtain them from real food instead.)

In any case, even if we used data for fortified milk, it would still be false, in my opinion, that "whole milk is very nutrient dense." Vitamin D levels make a minor contribution to overall nutritional density.

Comment author: shokwave 02 March 2014 12:26:31AM *  0 points [-]

I suspect the real issue is using the "nutrients per calorie" meaning of nutrient dense, rather than interpreting it as "nutrients per some measure of food amount that makes intuitive sense to humans, like what serving size is supposed to be but isn't".

Ideally we would have some way of, for each person, saying "drink some milk" and seeing how much they drank, and "eat some spinach" and seeing how much they ate, then compare the total amount of nutrients in each amount on a person by person basis.

I know this is not the correct meaning of nutrient dense, but I think it's more useful.

Comment author: Pablo_Stafforini 02 March 2014 02:14:14AM *  0 points [-]

I think the best we can hope in this context is to have a number of distinct and precise metrics--like nutrients per calorie, nutrients per dollar and nutrients per bulk--, feed these to intuition, and decide accordingly. In other words, when it comes to food, I think we should make decisions according to a "rational" rather than a "quantified" model, given the difficulties of coming up with adequate definitions of a "serving size". Your approach wouldn't work, I believe, because how much people eat of a given food often depends on the presence or absence of other complement and substitute foods.

Comment author: Jiro 02 March 2014 07:38:45AM -1 points [-]

Googling quickly brings up http://www.cnpp.usda.gov/Publications/NutritionInsights/insight11.pdf

Serving size is defined as follows:

  1. Amount of foods from a food group typically reported in surveys as consumed on one eating occasion;
  2. Amount of foods that provide a comparable amount of key nutrients from that food group, for example, the amount of cheese that provides the same amount of calcium as 1 cup fluid milk;
  3. Amount of foods recognized by most consumers (e.g., household measures) or that can be easily multiplied or divided to describe a quantity of food actually consumed (portion);
  4. Amount traditionally used in previous food guides to describe servings.

While the amount of food people would eat is not the only factor used, it's a major one.

Comment author: [deleted] 28 February 2014 09:55:40PM 0 points [-]

Why should I care what someone's semi-arbitrary idea of what a serving is is?

Comment author: Jiro 28 February 2014 11:40:48PM *  0 points [-]

Because people eat by servings, not by fixed numbers of calories. Comparing by semi-arbitrary servings isn't perfect, but it's better than not comparing by servings at all, and you haven't offered any serving sizes that you believe are better, so semi-arbitrary is the best we have.

Comment author: Nornagest 01 March 2014 12:31:11AM *  2 points [-]

Servings are fine for candy bars, but they're almost totally meaningless if we're talking about fungible ingredients like spinach; those are going to be used in all sorts of ways, almost all of them different from whatever the relevant regulatory body had in mind. (Milk and eggs are a bit less so since they're often consumed in quanta of one egg or a glass of milk, but neither one's exactly an uncommon ingredient.)

I'm not sure there's a perfect way of comparing nutrient density under these circumstances, but volume is probably what I'd go for; you can only fit so much on a plate, so ingredients generally displace each other on a volume basis. For leafy greens in particular I might use cooked volume, since they usually cook way down.

Comment author: [deleted] 01 March 2014 03:29:29PM 1 point [-]

Because people eat by servings, not by fixed numbers of calories.

Who eats 30 grams of spinach and then stops?

Comment author: Jiro 01 March 2014 07:46:58PM -1 points [-]

That doesn't mean that people don't eat by servings, it means that 30 grams isn't a good serving size.

Furthermore, since we're comparing different foods, the fact that 30 grams may be too small is compensated for by the fact that the serving size for milk is a cup, which is also too small.

Comment author: Jonathan_Graehl 28 February 2014 07:24:49PM 0 points [-]

Fair point, but how long does it take to eat+digest (cooked or uncooked) 100 calories of spinach compared to 100 calories of whole milk? How much does it cost? Etc.

I agree that you shouldn't count the vitamin-fortification of milk as part of the value unless it turns out that milk is an especially good transport for what's added to it.

Comment author: Pablo_Stafforini 28 February 2014 07:59:41PM *  0 points [-]

Fair point, but how long does it take to eat+digest (cooked or uncooked) 100 calories of spinach compared to 100 calories of whole milk? How much does it cost? Etc.

Yes, I agree those are relevant considerations. I'd just keep them separate from the issue of nutrient density.

Comment author: RomeoStevens 28 February 2014 08:37:29PM *  2 points [-]

Two points that came up in my research:
1. whole milk and eggs are associated with significantly lower mortality for vegetarians, and somewhat lower mortality for the general populace.
2. fruit has twice the effect of vegetables on mortality risk per serving.

I am basically highly dubious of the proposition that we are supposed to munch on leaves all the time. Past and extant hunter gatherer groups eat tubers, fruit, and nuts as their plant material. We simply don't see these groups pursuing leafy greens as a significant calorie source.

Comment author: Lumifer 28 February 2014 08:46:18PM 2 points [-]
  1. fruit has twice the effect of vegetables on mortality risk per serving.

Huh?

I rather suspect fruit here is working a proxy for something else (maybe wealth).

Nutritionally, the major difference between fruits and vegetables is that fruits have MUCH more sugar. In particular, fructose which doesn't have a sterling reputation, to put it mildly.

Comment author: RomeoStevens 28 February 2014 08:52:29PM 3 points [-]

http://jn.nutrition.org/content/136/10/2588.short
http://www.neurology.org/content/65/8/1193.short

Yup. Surprised me a bit too when I first saw it. Fructose effects are not linear. The liver has some ability to process a certain amount of fructose every day, it is going well beyond this limit that is harmful. 5 servings of fruit is probably going to be 30-50g of fructose, which has been proposed as the approximate amount we can process.

Comment author: Lumifer 28 February 2014 09:01:37PM *  0 points [-]

Yup.

Yes, I understand there are studies. That doesn't make me trust their conclusion. I don't have time to dig into these papers right now, but I wonder how well they controlled for e.g. socioeconomic status and latitude.

Comment author: Nornagest 28 February 2014 09:18:06PM *  3 points [-]

Wealth doesn't look likely to me -- vegetables aren't a lot cheaper than fruit where I live, unless we're talking potatoes and such, and those usually aren't counted as vegetables in these analyses.

I would be interested in what fruits and vegetables are respectively displacing in the diet. If a lot of these people are eating fruit for dessert instead of e.g. cake, or for breakfast in place of Pop Tarts, then dramatic longevity effects wouldn't surprise me but also wouldn't be an unqualified endorsement of more fruit for everyone.

Comment author: Lumifer 28 February 2014 09:38:06PM 3 points [-]

vegetables aren't a lot cheaper than fruit where I live

Carrots, cabbage, onions, squash -- not cheaper than fruit?

But yes, I don't think it's purely a matter of money but may be a matter of culture as well.

I would be interested in what fruits and vegetables are respectively displacing in the diet.

Yep, a very good point.

Comment author: Nornagest 28 February 2014 10:10:14PM 2 points [-]

Carrots, cabbage, onions, squash -- not cheaper than fruit?

I just looked these up on Safeway's online store for my area, and found carrots at about 80 cents a pound, cabbage at a buck a pound, onions at about 56 cents and squash at about a dollar. (You can squeeze a bit more out of some of these if you're buying in 10-pound increments, but I consider that impractical for individuals or small families.) Compare to cheap apples at $1.09 a pound, grapefruit at $0.66, or bananas at about $0.85.

Fruit does go a lot higher -- if you're buying berries or tropical fruit, you can easily be spending five or six bucks a pound. But if you're mainly looking for frugality, you have plenty of options in each category. I expect this to be skewed a bit by season, too -- there aren't many cold-season fruits.

Comment author: brazil84 28 February 2014 06:58:13PM 2 points [-]

By the way, it seems to me that we need to think in more detail about the relationship between happiness and stress. For example, I have pretty high-stress job (I am a litigation attorney) but at the same time it's a lot of fun most of the time and I am reasonably happy with it. How many more years could I expect to live if I were a trust fund baby?

A few studies have been done on the relationship between retirement age and longevity. As I recall, the best studies seem to show little or no relationship once you eliminate consideration of individuals who retire early for health reasons. It occurs to me that stress or lack of stress can cut both ways. If you have a sense of purpose in life it can make you feel happy. But once you have a sense of purpose, things will invariably come up which frustrate your objectives in large and small ways. Which is stressful. On the other hand, if you are completely apathetic you will be free from stress. But you won't have any sense of purpose or meaning.

Comment author: RomeoStevens 28 February 2014 08:25:57PM 5 points [-]

My understanding is that how you respond to stress is a better predictor than total amount of stress.

Comment author: brazil84 28 February 2014 08:41:41PM 5 points [-]

My understanding is that how you respond to stress is a better predictor than total amount of stress.

That raises an interesting question. Just from simple observation, it's clear that a lot of people respond to stress by engaging in unhealthy behaviors like binge eating, excessive alcohol consumption, etc. So if stress is correlated with health problems, perhaps the causation is indirect.

Comment author: RomeoStevens 01 March 2014 01:11:53AM 6 points [-]

We do have some reasons to expect direct causation such as inflammation and immunosupression.

Comment author: brazil84 01 March 2014 10:06:05AM 0 points [-]

As it turns out, there are actually two types of LDL,

Of course there are. For pretty much every X which is associated with human health, closer investigation will reveal that there are two types of X -- "Good X" and "Bad X."

Comment author: RomeoStevens 01 March 2014 10:29:29AM 0 points [-]

Sure "healthy" and "unhealthy" as a demarcation gives the reader no info, but I already felt like I was delving into details a bit too much. I didn't want to turn it into a paper on the wonderful world of blood lipids.

Comment author: brazil84 02 March 2014 12:17:27AM 0 points [-]

Yes, I wasn't criticizing your essay so much as making a general observation.

Comment author: timujin 01 March 2014 10:56:31AM 5 points [-]

Get tape and cover lights. Try orange glasses to prevent blue light from destroying your endogenous melatonin production after 10pm.

I have always been confused about this one part. Seems like this is the place to ask, for once.

Where do these exact o'clock figures always come from when people are talking about sleep optimizing?

I mean, 10pm by which clock? Certainly, the position of arrows on my watches does not influence melatonin production. Is it calibrated by amount of daylight? But in the area I live in, 10pm can be a middle of the night or not-even-sunset, depending on time of the year, and the number given is a constant and doesn't depend on calendar. Is it calibrated by biological 'internal clock'? But it has different settings in different people. I go to sleep at 2am (and feel sleepy and dizzy if I don't) and wake up at exactly 9am with no alarm clock. Does the advice still apply to me? Does it assume some sort of 'normal' internal clock settings? Then what are they and why is it never explicitly mentioned? Please, help me resolve this confusion. Where did the numbers come from?

Comment author: RomeoStevens 01 March 2014 11:08:21AM 0 points [-]

completely arbitrary. You want to be doing it at a consistent time several hours before you want to be asleep.

Comment author: timujin 02 March 2014 09:31:40AM 0 points [-]

That's cool, but I am still curious about from whence exactly you got the number.

Comment author: [deleted] 01 March 2014 05:43:04PM *  0 points [-]

It seems to be that many earlier studies claiming harm from red meat did not adequately separate out the huge effect size of processed meat.

And here I've been thinking getting the chicken sandwich at Subway or eating smoked turkey sandwich meat was healthy. [Edit: Because of this post, I will not be doing that anymore.]

But I am not really convinced that eating red meat can be healthy. It seems safer to keep it as an "occasional indulgence." Edit: That first link was not clear. Here's another.

Comment author: Xodarap 01 March 2014 06:36:41PM 2 points [-]

Ovo-lacto vegetarians live significantly longer than vegans

Where does it say that the difference is significant? The only mention of this I see in the cited paper is table 7, and the CIs there overlap a great deal. (And it goes on to say that the numbers should be "interpreted with caution because of the uncertainty of the dietary classification of subjects in the Health Food Shoppers Study".)

Comment author: RomeoStevens 02 March 2014 03:17:25AM *  -1 points [-]

A lot of these studies point to the same small amounts of data. This article for example discusses a new study that again reanalyzes the Adventist study data http://www.nleducation.co.uk/resources/reviews/vegetarians-live-longer-and-healthier/

We don't really have anything better though. And what little evidence we have points towards ovo-lacto and pescatarians having better health.

Comment author: Xodarap 02 March 2014 05:26:35PM *  1 point [-]

And what little evidence we have points towards ovo-lacto and pescatarians having better health

Um, the article you linked seems to say that vegans are healthier:

  • Vegan All-cause mortality: HR 0.72, 95% CI 0.56-0.92
  • Pesco All-cause mortality: HR 0.81, 95% CI 0.69-0.94
  • Lacto-ovo All-cause mortality: HR 0.91, 95% CI 0.82-1
  • [Meat eaters presumably have an HR of 1]

The difference might not be significant, so I don't know that we would call this conclusive proof. But it seems like if you're going to lean one way, it would be towards vegans being healthier.

Especially since "animal products are bad" is a much simpler model than "animal products are bad, except for these few exceptions."

Comment author: RomeoStevens 03 March 2014 05:19:54AM 0 points [-]

I guess I completely failed to discuss that the studies I linked to do not constitute the entire set of studies I drew from for the recommendations. I will expand on some of the points when I have time.

Comment author: [deleted] 02 March 2014 03:13:40PM 0 points [-]

Ok, so basically, I need to floss more and drive less recklessly (when I drive at all, which is rarely). But other than that, I'm doing good at targeting longevity.

steeples fingers

Eeeeexcellent. Everyone who claims to aim for immortality or personal happiness but doesn't exercise, turn in your rationality card right now.

I can't claim any super-insightful techniques for actually building good habits and making good decisions, personally. My main technique is just to make a decision by putting myself in the shoes of future-me and asking what he's going to care about more.

Comment author: Eliezer_Yudkowsky 02 March 2014 05:53:09PM 0 points [-]

I clicked through to your recommendation to floss and saw an associational study with a set of control variables. This is such a horribly bad sign that it makes me doubt the rest of your post.

Comment author: RomeoStevens 03 March 2014 05:16:15AM *  6 points [-]

Floss does have the weakest evidence going for it, hence its position last on the list. It stayed above the "worth it" line due to the low cost and risk. I also believe it has an impact on quality of life even if the mortality effect turns out to be small. I do need to add a discussion of this to my post at some point.

Comment author: ChrisHallquist 03 March 2014 03:11:00AM 1 point [-]

How much have you looked into potential confounders for these things? With the processed meat thing in particular, I've wondered what could be so bad about processing meat, and if this could be one of those things where education and wealth are correlated with health, so if wealthy, well-educated people start doing something, it becomes correlated with health too. In that particular case, it would be a case of processed meat being cheap, and therefore eaten by poor people more, while steak tends to be expensive.

(This may be totally wrong, but it seems like an important concern to have investigated.)

Comment author: RomeoStevens 03 March 2014 05:13:02AM 1 point [-]

My process is to collect a list of confounders by looking at things controlled for in different studies, and then downgrading my estimation of evidence strength if I see obvious ones from the list not mentioned in a study. This is probably not the best way to do this but I haven't come up with anything better yet.