Rational Health Optimization

by jacob_cannell7 min read18th Sep 201078 comments

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MedicineWell-being
Personal Blog

Possibly Related To: Diseased Thinking, Thou Art Godshatter

There are 8760 hours in a typical year.  A typical 30-year old will spend about 2900 of those hours sleeping, around 160 of them impaired or incapacitated by illness and will experience perhaps 2000 hours of peak mental function.

As one ages, the fraction of hours spent sleeping decreases slightly, but eventually the annual hours of peak mental function declines as well, and the annual hours spent ill increases nonlinearlly until one eventually makes that final hospital visit.  

There is a hope that medical technology, accelerated via a Singularity, will advance to the point where we have full mastery over biology and can economically repair organ and cellular damage faster than aging accumulates it.  There is sufficient evidence to put a reasonable bet on that happening by mid-century.

But for most of us that still leaves an unnaceptably high risk of death in the cumulative years between now and then.  Cyronics enrollment offers a further hope, but in practice probably only results in a modest improvement in long term survival odds after full discounting for the technical risks and uncertainties.

In the end it all comes down to a die roll.  Wouldn't you like to get an extra +1 or two?

With a simple evolutionary health optimization, one can:

  • achieve perhaps a 10% increase in peak mental hours per year
  • slow aging and prolong expected lifespan by at least ten years (before considering future medical advances)
  • significantly reduce chance of death before mid-century
  • shift body weight to a healthier equilibrium, increase attractiveness, general mood and happiness

Evolution and Health

Our bodies are the collective result of countless layers of mindless complex adaptations, evolutionary godshatter from a bygone history.  The current sub-species or races of humans today are just a small sampling of a much larger space of genetically related human ancestors who roamed the earth for hundreds of thousands of years before the modern era.  Our modern genomes are a wide and highly irregular sampling of this diverse set of historical adaptations.

For most of that time the earth was considerably colder and very different than it is today - we currently live in a warm peak between large glaciations.  These wide climate swings created complex dynamic patterns of shifting ecological niches.  At glacial peaks, sea levels were over 100 meters lower than today and most of the terrestrial world was connected, allowing large waves of nomadic migration in giant mammals.

Again and again tribes of homo sapiens with increasingly advanced technological hunting cultures expanded out of Africa, where humans originated and the ecosystems had more time to co-evolve.  The farther humans migrated out of Africa, the more they encountered megafauna unadapted to human hunting, and the more they became specialized technological apex predators.

By roughly 10,000 BC nearly all the terrestrial megafauna outside of Africa was extinct.  Shortly thereafter early agricultural centers began to spring up in several megafauna-depleted regions; nascent civilizations in the making - only to fail and rise again.  In the ten thousand years or so since these first large-scale farming experiments, the homo sapien genome has had limited time for any new novel adaptations.

This historical observation leads to a simple but suprisingly powerful top-level belief.  Our genome is optimized for genetic fitness functions that no longer exist; an evolutionary environment from the paleolithic era.  Thus all else being equal we should expect significant deviations from that environment to have negative effects more often than positive.

Evolution is near-sighted.  In thou art godshatter, Eliezer Yudkowsky asks:

Why wasn't a concept of "inclusive genetic fitness" programmed into us, along with a library of explicit strategies?  Then you could dispense with all the reinforcers.  The organism would be born knowing that, with high probability, fatty foods would lead to fitness.  If the organism later learned that this was no longer the case, it would stop eating fatty foods.

One answer is that explicit linguistic conceptual knowledge is much more complex and developed long after simple reinforcement strategies.  The other perhaps more obvious answer is that explicit conceptual strategies are inherently serial and are thus extremely computationally limited in the slow but massively parallel human brain.  Every day our brains are unconsciously evaluating vast quantities of probabilistic inferences tied to simple reinforcers in an attempt to maximize our inclusive genetic fitness and spread our genes.

Regardless of whether or not we are interested in maximizing genetic fitness, we can now use our advanced conceptual knowledge of evolution, genetics, and health to identify and map out the hidden assumptions of the numerous ancient programs in the genome, how they can go wrong in the novel modern environment, and how we can best trick these adaptive systems back into their optimal operating modes.

Evolution had no incentive to optimize for environments significantly different than those it encountered, and the web of complex interdependent genetic programs that maintain our bodies have numerous subtle minor failure modes, most of which are not fully understood.

A key insight is that the web of hormones, metabolism and gene expression are highly complex and inter-related, and one gets full benefit only by correcting the majority of the deviations.  If this is done then one can significantly reduce the chance of succumbing to the diseases of civilization

What are some of the modern environmental deviations?

Exercise

Hunter-gatherers were certainly not sedentary, but probably had an average daily activity level still below that of today's professional athletes.  It's pretty clear though that they spent a good chunk of time walking and running.  The effects of exercise on health have been fairly well studied.  Of interest to pragmatic instrumental rationalists is that only mild exercise is required.  Studies have shown that the main longevity boost is somewhere around 2 to 5 years and requires just 100 to 300 calories of exercise per day. [1]  Suspected mechanisms involve cortisol regulation, endorphins, and triggers that activate cellular repair.  Sex may be the most efficient form of exercise for the calorie budget.

Diet

Our ancestors ate a variety of foods with significant geographic and temporal variation.  But if you sum the typical average over a swath of ancestors, it is believed to have consisted largely of lean game meat, offal, fish, nuts, higher-fiber vegetables, low-sugar fruits, shellfish and insects.  At the macro-level the diet would be more balanced between protein, fat and carbohydrate, significantly different than the high carbohydrate and low protein modern diet.

Modern humans today eat a diet that is superficially super-good - it consists of the foods blind evolutionary adaptations thought we needed more of . . . ten thousand years ago.  Our taste buds are primed to favor foods that are rich in calories overall and high in ancient rarities such as sodium and certain fats.

We now have specific evidence for a whole range of health problems associated with the modern diet: excess calories and caloric density, high glycemic index causing excessive insulin production and spiking (mainly via over-abundance of concentrated starch and sugar), imbalanced omega 3 / omega 6 fatty acid profile and imbalanced sodium/potassium profile.

The exact mechanisms are complex and not fully understood, but in general this diet will cause one to put on weight and is linked longer term to an entire cluster of diseases - largely the metabolic syndrome and cardiovascular disease.

A simplified paleo-diet solution:

  • eliminate high fructose corn syrup and sugarey drinks in general.  They are empty extra calories that will not contribute to satiation.  The sugar/insulin spikes accelerate some metabolic aging processes.
  • reduce or eliminate the starchy foods: bread, pasta, potatoes, and rice.  Replace with real vegetables - the kind that actually have high micronutrient content and high fiber content. 
  • shift meat preferences towards the healthier fat spectrum: prefer fish, then grass fed beef, chicken, beef, pork
  • limit fried foods and vegetable oil
  • generally avoid processed foods, favor nuts and berries for snacks
  • switch to lower sodium salts
  • supplement vitamin D (more on that later), omega 3's, and vitamin B and potassium to suit diet

Night

Nights would overall be much darker than they are today (unless one lives in some remote wilderness), and that darkness would start much earlier.  Campfire light is considerably different than modern artificial illumination.

Even small amounts of light can block melatonin production.  Thus modern human's sleep cycle is completely unoptimized.  We don't get enough bright sunlight in the day, and we get far too much light at night.  The evidence suggests that melatonin/sleep imbalance can effect everything from mood to the immune system to aging itself.

Interestingly enough, human melatonin production may be optimized to ignore campfire light (from wikipedia):

Production of melatonin by the pineal gland is inhibited by light and permitted by darkness. For this reason melatonin has been called "the hormone of darkness". Its onset each evening is called the Dim-Light Melatonin Onset (DLMO). Secretion of melatonin as well as its level in the blood, peaks in the middle of the night, and gradually falls during the second half of the night, with normal variations in timing according to an individual's chronotype.

It is principally blue light, around 480nm, that suppresses melatonin, increasingly with increased light intensity and length of exposure. Until recent history, humans in temperate climates were exposed to few hours of (blue) daylight in the winter; their fires gave predominantly yellow light. Wearing glasses that block blue light in the hours before bedtime may avoid melatonin loss. Kayumov et al. showed that light containing only wavelengths greater than 530 nm does not suppress melatonin in bright-light conditions. Use of blue-blocking goggles the last hours before bedtime has also been advised for people who need to adjust to an earlier bedtime, as melatonin promotes sleepiness.

 

Melatonin can be supplemented at night, but I also intend to outfit my apartment with blue-filtered lights, or perhaps try blue-filtered glasses. I have noticed that sleep is also more effective when one wakes up slowly to bright daylight.

Sunlight

Paleolithic hunter-gatherers would spend most of the day outside in the sun.  Even with clothing, skin sun exposure would be vastly higher than the average today.

In some sense most terrestrial vertebrates are partially solar powered - plants are not the only creatures to use solar energy directly.  Unless you are currently taking 5000 IU of vitamin D3 per day the odds are you probably are vitamin D deficient.

"Vitamin" D is perhaps a misnomer.  I can do no better than quote from the  Vitamin D council [2]:

Technically not a "vitamin," vitamin D is in a class by itself. Its metabolic product, calcitriol, is actually a secosteroid hormone that is the key that unlocks binding sites on the human genome. The human genome contains more than 2,700 binding sites for calcitriol; those binding sites are near genes involved in virtually every known major disease of humans.

Current research has implicated vitamin D deficiency as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.

What does Vitamin D do at all these  gene expression sites?  We don't really know yet.

However it is clear that D is somehow involved heavily in immune regulation and brain development.  Interestingly enough, almost all of the modern diseases of civilization are either inflammatory diseases or are immune regulated, including cancer, cardiovascular disease and Alzheimer's, just to name a few. 

A number studies show that vitamin D deficiency (the default state of most of us today) increases overall rates of cancer by perhaps 50% or more - roughly double the cancer risk of smoking  [3a] [3b].  

An interesting quote from that article:

One of the researchers who made the discovery, professor of medicine Robert Heaney of Creighton University in Nebraska, says vitamin D deficiency is showing up in so many illnesses besides cancer that nearly all disease figures in Canada and the U.S. will need to be re-evaluated. "We don't really know what the status of chronic disease is in the North American population," he said, "until we normalize vitamin D status." (emphasis added)

I'm not aware of any other supplement, drug, or food that has this level of cancer protection.  Indeed drug companies have been working on patentable vitamin D analogues for years.  This is the sad state of our medical industry.  The reality is most of us today are deficient - and our cancer rates are thus abnormally elevated.  But we don't need an expensive new vitamin D derived drug to reduce cancer incidence.

Low vitamin D levels are also  linked to metabolic syndrome  and thus weight gain and diabetes.  Abdominal fat in particular is linked to a cluster of diseases, including cancer, and higher vitamin D levels in the blood are linked to lower weight, and strangely - higher educational status.

It also may boost intelligence;  deficiency has been linked to cognitive decline  with age.

And finally, vitamin D defeciency fits the epidemic profile of autism, and has been proposed as a cause of this disorder[4].

Another role of D may be as a form of summer/seasonal signalling hormone, and could explain the apparent link between VDDS, metabolic syndrome, and weight.  

If you are low on vitamin D, your body is perhaps stuck in some eternal state of fall or winter, suppressing high-energy or risky endeavors and attempting to put on fat.  You are thus not getting the full mileage of your genome.

Light in general has benefits beyond vitamin D.  Did you know that total light exposure has a measurable effect on mood?  In fact  bright light therapy  is a treatment for numerous psychiatric disorders.

References/Notes:

1. Statement on Exercise: Benefits and Recommendations for Physical Activity Programs for All Americans, from the American Heart Association

2. My father founded the Vitamin D council in 2003 and is a tireless promoter and advocate for D.  So I may have some bias, but at this point perhaps it's just an inside view, because D's health effects are now widely known and little of this is as controversial as it was just 5 years ago.

3. From this  article, which specifically summarizes an important  D cancer intervention trial.

4.  Autism and Vitamin D, JJ Cannell, Med Hypotheses. 2008;70(4):750-9. Epub 2007 Oct 24. (see comments below about this controversial journal)

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Readers may wish to note that Medical Hypotheses is not a peer-reviewed medical journal, as is often assumed. Medical Hypotheses is often known for publishing wild conjecture, such as the notion that AIDS does not exist or is not related to HIV.

I won't get into other criticisms, but this post has a high ratio of errors in the areas in which I am non-ignorant. This makes me more reluctant to trust the claims in areas in which I am ignorant.

9jacob_cannell11yDid I state the vitamin D/autism link as fact? I used the word 'may' to indicate uncertainty - and I find it interesting but I myself am skeptical. Nothing on this website is peer-reviewed either, do you take that to automatically indicate that every post is riddled with errors? What errors specifically? Is posting a link to a paper in Medical Hypotheses an error? I was not very knowledgeable about the journal beforehand, and after investigating after your post, I have updated and see that as it's entire purpose is to publish wild conjectures more or less, we should take everything there with a grain of salt. That being said, from at least the little I have read about it, it seems to me that there should be a place for conjectures outside of the mainstream. We have plenty of journals that follow the normal process of full review by senior scientists. We should question whether having only that system is optimal for generating knowledge. Please consider that much of the highly valued material on this website would be considered by outsiders to be wild conjecture far outside of the scientific mainstream. Does that stop you from reading here? And finally, I suspect you may be somewhat misrepresenting Medical Hypotheses in one attribution, at least in comparison to it's Wikipedia entry. A paper intending to show there is "yet no proof that HIV causes AIDS" seems to me different than your notion of "AIDS does not exist or is not related to HIV". You also fail to mention that Medical Hypotheses withdrew the articles. You are accusing me of erring in areas in which you are non ignorant. Where? Could you please clarify?

Since higher social status seems to increase life expectancy I have wondered if there is a way of "tricking yourself" into thinking your status is higher than most people would believe. Perhaps, for example, if you have little hope of having a prestigious career you could devote lots of time to becoming a respected leader in World of Warcraft. Or might it even be enough to become the ruler of a virtual kingdom in which you are the only non-computer player?

On the other hand, you'd probably waste far more time pressing the same button over and over again in World of Warcraft, then you could hope to gain in increased lifespan even if that trick worked. The question is whether there's an efficient way of tricking your brain into believing you have high status.

6hackerkiba11yWhy would this be? Higher social status seem to me to be correlated with greater wealth and the ability to buy expensive health food.
5James_Miller11yMuch of the social status boost to life expectancy might not be due to wealth. The "'Hierarchy Effect,' ...states that being lower in the social hierarchy independently impacts health through increases in the release of stress hormones. This has been shown fairly well in animal studies where researchers monitor the levels of stress hormones in primates and have found that being nearer the top reduces the overall level of stress hormones"' http://longevity.about.com/od/researchandmedicine/a/hierarchy.htm [http://longevity.about.com/od/researchandmedicine/a/hierarchy.htm]
6jacob_cannell11yI wonder how one dissociates the cause and effect in animal studies. Healthier animals are more likely apriori to advance up the social hierarchy. Nonetheless, it does make sense that social mammals could employ different strategies based on social rank. If you are at the top, you have more access to food and mates and a higher benefit to longevity. If you are at the bottom and have zero access to mates, longevity doesn't help your genes much, and your genes have an incentive to employ riskier strategies that could sacrifice longevity.
1NancyLebovitz11yWith those studies, I wonder how much is a sort of abstract being lower in the hierarchy, or having to give out submission signals, and how much is objectively worse conditions-- fro example, greater risk of physical assault or (for humans) less access to sunlight.
5NancyLebovitz11yI've seen one claim which I haven't been able to verify that eccentrics are healthier than other people. If true, is it just that it takes pretty good financial security to pull off being eccentric? Doing what you please means you optimize your environment for yourself? It's not that high status is good for you, it's that low status is bad for you?
2mattnewport11yBy what objective criteria does one distinguish an 'eccentric' from a regular person?
1[anonymous]11yA lot of it is produce availability, walkability, gym membership, and avoiding the stresses of poverty. Controlling for all that and getting a pure effect of hierarchy on longevity is incredibly hard. I haven't read Alain de Botton on income inequality, but as I understand his evidence has been somewhat discredited.

Vitamin D deficiency may also have something to do with multiple sclerosis-- incidence of the disease is positively correlated with latitude-- that's a just a maybe, though-- there are plenty of other theories.

Stephan Guyenet's blog is my favorite on diet from the kind of perspective presented in this post. It's wide-ranging with regular critical discussion of research, with links to the sources. (My layman's opinion.)

2jacob_cannell11ythanks, it looks good so far, adding it to my google reader.

This is really interesting; thank you. I'm curious what your sources on diet (which I would like to see more of) say about variety in the dietary needs of modern humans. Even if you discount the extremes (totally sedentary people and professional athletes), people may for example put on muscle and fat very differently from one another due to both genetic differences and lifestyle choices. Would any common variations that you know of--for example, regularly getting more exercise than recommended, or having a genetic tendency for a skinny or fat body type--alter your advice?

By the way, there's a typo in the diet section: "potassium to suite diet."

7jacob_cannell11yThe diet issue is complex, you can find plenty of info on the paleolithic diet on wikipedia and the web - one extensive source is beyondveg [http://www.beyondveg.com/cat/paleodiet/index.shtml]. It just so happens that in about every case where we have specific evidence for some dietary problem, the paleo-diet does not have that problem. There certainly are genetic differences and variations in the gene pool, but they are details in the story. For example, the particular genetic tweak that allows one to digest lactose (milk sugar) is a caucasian gene. Some particular races who have no recent history of agriculture do very poorly on modern diets. So there are some recent adaptations to agriculture - to wheat and higher glycemic diets. But these tweaks are probably more complex than the lactase gene. For example, there are a huge number of genes that influence weight, but most of them do not directly code for weight. We can expect much of the variation to be in these complex metabolic cycles that involve many factors. Variations in insulin response could cause some people to gain weight much quicker on high glycemic diets, for example. Vitamin D receptor variability could play a role. It is really complex. So it's not nearly as simple as 'skinny' or 'fat' body type. One person could have a naturally skinny body type - but only on a paleo diet. Another could have a skinny body type on a high-carb western diet, but only because they also have a reduced absorption of fats. Another could be skinny regardless. There are so many variables. It is never as simple as just genetics. It is genetics and diet. The safest route, the default strategy, should just be to revert to a paleo diet and lifestyle in at least minimal form. My post outlines a way one can get most of the paleo benefits for low cost. From what I have read, health benefits of exercise itself level off after about 300 calories burnt per day - equivalent of perhaps 30 minutes or so of running. Naturally there m
3Relsqui11yThank you for the thorough response. For what it's worth, I was curious about this because I bicycle a minimum of about two hours per week, usually more, depending on how busy I am. I don't do it for exercise, I do it for transportation, so the question was less "is this a good idea?" than "should I be taking this into account when making dietary decisions, and if so, how?"
2hackerkiba11yMy sleep optimization so far is to sleep when tired and wake up when not. So far that give me the waking time to be 8:00 pm to noon depending on how I sleep. This was both a subjective boost and actual performance. I have not been too tired to often to get the blinking eyes and other effects of sleep deprivation. This of course, enabled me to drive safely.
1[anonymous]11yIndividual variety in nutrition and response to food and exercise is really interesting, and it seems to occupy a weird gray area between science and craft. I'd like to learn more about this. One example I've seen (more from the fitness/nutrition community than the scientific community) is that people respond differently to carbohydrates -- I think it's variation in insulin response. Try eating a big meal of pancakes and syrup. Some people will feel sluggish soon after; some people will be energized. Some people are always mildly unwell on a high-carb diet: tired, hungry, gastric distress. Some people do fine. (I'm in the mildly unwell camp, only I didn't know it until I experienced what it was like not to be mildly unwell.)

the web of hormones, metabolism and gene expression are highly complex and inter-related, and one gets full benefit only by correcting the majority of the deviations

This smacks of superstition. This package-belief boosts serves to add fake certainty, distracting from the need to justify each part of the package.

That is, I need to see evidence for this package-claim - until then, I reject it. Show a benefit to following each part of the program vs. not, either in context of following all (or a core majority of), or none, of the others.

5jacob_cannell11yI should have worded it differently. The idea comes not from some known interaction between the different mechanisms, but the unknowns. For example, until fairly recently, typical medical advice included recommendations such as : eating a lower fat, lower cholestrol diet, staying out of the sun and using sun screen, etc. This advice was based on sound specific knowledge at the time. Compare that advice to general paleolithic diet/lifestyle advice and we now know of a large number of specific failings in that older advice. They all stem essentially from a fundemental rationality error in over-estimating our knowledge of health, and underestimating our ignorance. So I didn't mean to imply the full benefit was from some known set of interactions, but rather the full benefit comes from all the unknowns - there is still great deals of uncertainty about many of the interactions between sunlight, vitamin D, weight, metabolism, cancer, etc etc. In the face of all this uncertainty, the general evolutionary principle has proven to have a timeless advantage in expected outcome. However, this doesn't mean that strong specific evidence for benefits from specifc un-paleolithic behaviours shouldn't be considered. For example, it's pretty clear that brushing your teeth and flossing is good for health, even if it's strictly speaking, unpaleolithic. Perhaps the web-connection I was referring to is just as simple as summer vs winter behaviour, and our lack of sunlight and vitamin D is causing a perpetual metabolic winter (with associated weight gain and metabolic syndrome and a host of other weak disease associations). Perhaps so, but we don't really know yet.
3Jonathan_Graehl11yWhat I asked for (demonstrate the benefit of each suggestion in turn, against some baseline of none/some/all of the other paleo suggestions) in no way requires that the interactions be known. The hypothesis "don't expect to see great benefits except when you follow a plurality of these paleo-story inspired advices, because of UNKNOWN interactions between them" sounds crazy. Where's the evidence? Isn't it more likely that some of the program is definitely helping a lot, and other parts aren't, and you aren't sure which parts are working, so the lay person may want to maintain them all rather than experiment? From my point of view, it looks like some paleo-lovers choose to believe the improvements are super-additive just because it excites them. I'll assume the improvements are independently additive (not sub- or super-), and that some of them are great, and others not. I welcome evidence about what works, even if it's just "the whole package taken together is effective in this study."
3jacob_cannell11yI don't find that they are "super-additive", and my position is actually very close to yours. There may be some unknown interactions, but it's more we don't know which specific parts have which benefits, and overall it's safer to follow most of it. For example, getting natural sunlight (while avoiding burning), is probably better than taking vitamin D supplements. I don't know this for sure, but I'd bet that way at least slightly. I suspect that there are some interaction effects as well, but that's not the main reason I was saying you get the most benefit from enacting everything.
2Jonathan_Graehl11yYour starting point for "let's try this set of practices as a bundle" is somewhat reasonable: we should expect to be optimally calibrated for the ancestral evolutionary environment - except for things like genes allowing for efficient digestion of dairy and wheat have spreading dramatically over the last 10k years. So, to the extent that it's really true that we're optimally calibrated for exactly the AEE and the daydreamed bundle of practices really gets us something like it (in all the right ratios), then you should pattern your life exactly after it. Also: not everything needs to be "just right" because we have some self-regulatory or alternative-synthesis mechanisms that allow us to live in quite different environments and through lean times. And of course, I assume that life expectancy was significantly less in the AEE - but obviously you hope to suggest only the positive practices. I guess my point is: since we don't know exactly what parts of the AEE we're tuned (with low tolerance) for, and we don't know exactly how to most effectively live by some modern analog of the AEE, it's best to try and find by science the optimal level of each practice (while holding all other aspects in the best-known-so-far range). And, as always in such things, you can do what makes you feel happier in the near term by haphazard personal experimentation, while hoping that research will warn in time of any hidden long term damage you're doing.
1Jordan11yYes. This is the underlying guiding principle. But it begs the question, What is the best-known-so-far? Clearly the standard American diet is far from it. Clearly less modern diets have benefits over modern ones (and vis a versa!). There are many traditional diets known to have very low levels of diabetes, stroke, and heart disease (the predominant diseases of western civilizations), and which fly in the face of modern nutrition. Why aren't these diets considered the best-known-so-far? No one is arguing that a paleo mantra should replace science. People are arguing that the currently accepted theories are grossly wrong, and are offering a new hypothesis.

Thanks for outlining a health program that will help out solving many health problems that are related to our modern lifestyle. I am afflicted with cohn's disease, fat related issue, diabetes, etc.

I have only begun with a rigorous running routine. I scouted out the location of the college gym and did research on weight training so I can burn more calories.

Now, I have diet information and others to work with. The biggest diet challenge will probably be about eliminating high corn fructose. They're prevalent everywhere.

It's going to be hard, but it's going to be worth it.

4jacob_cannell11yIf you aren't already getting adequate vitamin D, I recommend that highly - taking a daily 5000 IU supplement is much easier than exercise. Of course, you want to exercise as well. I've found that exercise is a very inefficient method of weight loss. Dietary change is much easier. Exercise is important for health, but it is not effective unless you also change diet. My 'natural' weight varies from around 160 to perhaps 200 when I shift from a paleo diet to eating whatever I want (lots of junk) - in either case I am never consciously caring about how much I eat, just varying what I eat.
2hackerkiba11yChanging the diet will be a huge challenge since it is my parents that have the money and thus control of the food budget. So another objective is to make enough money so I can spend on the right kind of food myself.
1Jonathan_Graehl11yI've been taking roughly that much vit D (4000 IU) on days when I'm not getting sun. I mildly recommend it.

Be careful about reading health books. You may die of a misprint. -Mark Twain

No, I trust this information but reading health advice on the internet or getting it from the media gets confusing. The biggest problem is that it's all about what information is more novel or interesting, and not what is actually more practical. I would like to see all this information gathered into whatever is the most efficient way that can be backed up by scientific evidence, not "this just in, a new study shows that consuming large amounts of X is actually good for you."

Unless you are currently taking 5000 IU of vitamin D3 per day the odds are you probably are vitamin D deficient.

From what I understand, the vitamin D 'bucket' can store more than a day's worth, so you could also take 15000 IU every 3 days. Does anyone know if this wouldn't work?

2ChristianKl6yAt this point we don't know enough about vitamin D to answer that question. There are reports of people who found that taking Vitamin D in the morning is better for them than taking it in the evening. That suggest that timing matters.
0jacob_cannell9yYes, we appear to have stockpiling adaptations for D3. "Stoss therapy" is built around this principle.

Thanks for writing this up. I'm in the middle of re-hauling my goal system and trying to set up healthy habits and finally start truly exercising, motivated by my true goal - experience the world for as long as possible. This gathers a lot of information into one place, and I'd be grateful if you either updated it or continued to post new information - especially given knb's criticism. Please don't be discouraged by it - update beliefs, then update the post :)

1jacob_cannell11yJudging by the karma of knb's critique (which I still think is barely topical) It seems like many people would like the post more overall if it didn't have that one citation, which was pretty tertiary to the main article's point. I'll take your advice, and at some point either update it as I get new evidence or write a follow up. I'd proper change the citations to make them more relevant to the main points. For instance, one big study of vitamin D found that levels within a certain range (higher than our current norm) were associated with reduced mortality, and levels too low or too high increased mortality. I've only seen one big study that shows little effect of vitamin D, and that was for cancer, although it only found a negligible effect for overall cancer mortality, even though colorectal mortality in particular was significantly reduced. I may overstated the cancer effect of vit D. Another wierd thing is that sun exposure doesn't seem to reliably correlate with measured vit D blood levels. One suspected culprit is soaps washing off the vit D in sebum before it can be reabsorpted. I'm not sure if this has even been studied much in humans yet.

One simple step is the James Bond Shower. Turn the water on hot, then switch to cold right before you finish.

[-][anonymous]6y 0

this was an unhelpful comment, removed and replaced by this comment

0Lumifer6yAre you actually growing your food, training for a marathon, practicing Alexander/Feldenkrais, etc.?
2[anonymous]6ysd

Perhaps the Open Thread would be a better place for this comment, but I'm interested in suggestions for a scale.

Based on the large number of proponents of a "Paleolithic" diet here on Less Wrong, I've decided to take it seriously enough to try it for a while. So far (slightly less than a week) I'm not enjoying it at all, but I'd like more quantitative feedback. Over the past five months (the way I was previously eating), I've maintained a pretty steady dw/dt = -0.8 kg / week, but my current scale is broken, and so I can't compare that to what I'm trying now.

1mattnewport11yBased on your user name I guess you might like the scale I use, the Withings WiFi Body Scale [http://www.withings.com/]. It measures weight, body fat percentage and calculates BMI and uploads the data to their website via WiFi so you can track your progress without having to manually enter any data. You can also export the data easily from the site if you want to do further analysis and there is an API for linking the data to other web services. As for a reasonable expectation of weight loss, 1.5-2.0 lbs a week is commonly given as a sustainable target and that matches my experience. On my first serious attempt to follow the diet I lost 45 lbs in around 6 months and then as I became increasingly lax over the following 2 years I regained around 15 lbs. In the last 4 weeks since I've been following it more strictly again I've lost around 6 lbs.
0datadataeverywhere11yI haven't previously had a scale that measured body fat percentage. Are you happy with the accuracy and precision of that aspect of the Withings scale? It is something that I would like, because weight, while easy to measure, is for me mostly a heuristic for measuring body fat. Like I said, over the last five months I've lost 18 kg, which I'm happy with, and matches the middle of the range you gave. My current scale didn't break dramatically; it still reads, but I've noticed that now stepping off, grabbing a 3kg object, and stepping back on sometimes results in the exact same reading, while stepping off and stepping back on without grabbing anything sometimes results in a 2kg gain. I calibrated it when I first got it and was satisfied that it was accurate to within 0.1 kg, so I don't actually know when it broke, but sometime recently. In the meantime, sticking to this diet will be difficult if I don't have any positive reinforcement, like continuing to see my weight decline.
0mattnewport11yFor weight, the accuracy and consistency of the scale seems in line with other scales I have used in the past. I have not attempted to calibrate it against a known accurate scale however. I find with this scale and previous scales I have used that my weight commonly fluctuates by up to 3lbs from day to day so I tend to focus mostly on a moving average as a measure of my progress (the Withings tracking web app displays a trend line which serves for this purpose). The accuracy suffices for my purposes but I don't know how good it is in absolute terms. For body fat, I treat the reported figure mostly as a rough long term indicator of a positive or negative trend but I don't put much faith in the absolute figure reported or the day to day fluctuations which can be quite large. You can see the kind of information you get from the scale here [http://www.withings.com/en/utils/graph?userid=79428&publickey=bf911c09f87903d4&massUnit=lb&forcedisplay=fm] (note - I've not tried this public sharing feature before so I'm not sure it will work for you). The period without data in August was my summer vacation where I also back-slid some. A friend recommended a local body-scanning service which appears to provide accurate body fat percentages. I intend to use it to get an idea of how accurate the figures are. My understanding is that body fat measuring scales of this type (work by passing an electric current through your body) are a useful indicator but not very accurate compared to scans or water tank measurements. Having a continually updated graph online is quite effective for me as a positive (and occasionally negative) reinforcement mechanism.
0datadataeverywhere11yReinforcement seems to be vital. With my current scale, I eventually broke down and wrote a script to display graphs of the moving averages of the high and low, since the numbers themselves didn't really mean anything to me. Clunky, but similar to the graph you displayed (it did work). Thanks for all the information. I'm debating whether all the features are worth the price, but it is the kind of thing I want.
3mattnewport11yI did something similar with Excel the first time I seriously tried paleo. After manually updating it religiously for a while I thought 'someone should make a WiFi enabled scale that automates this process'. Fortunately someone did :)

reduce or eliminate the starchy foods: bread, pasta, potatoes, and rice. Replace with real vegetables - the kind that actually have high micronutrient content and high fiber content.

Paleo is based on assumption that diets of agricultural era and modern diets are anything alike - they're not!

Agricultural era diets were based on around cereals, potatoes, etc., and we had thousands of years to adapt to them.

Modern diet are based on vegetable oil and sugar, and they're destroying everyone's health. I mean it by vegetable oil and sugar - these two categori... (read more)

0ChristianKl6yThousands of years is not much in evolutionary terms.
0satt6yThough still long enough to adapt [http://www.scientificamerican.com/article/african-adaptation-to-dig/] to a shift in diet.
0mattnewport11yPaleo dietary recommendations are in complete alignment with mainstream dietary advice on the value of reducing sugar intake and caloric intake from (most) vegetable oils. Where they differ is in what the better choice is to replace them as calorie sources. They are also in agreement about eating lots of fresh vegetables and fruit so really the major difference is whether to substitute grains or animal fats for the calories lost by cutting out sugar and vegetable oils.
2taw11yAll paleo I've seen bundled together post-agricultural food like sugar and vegetable oil with agricultural food like potatoes and cereals as if there was no difference. It's difficult to be more wrong than that. Oh, and I've seen paleo advocating "healthy" vegetable oils, as if we didn't had too much of them already. A more pragmatic reason is that it's nearly impossible to go paleo these days, while it's entirely straightforward to shift back to agricultural era eating patterns (replace sugary drinks with milk, beer, and water; replace margarine and vegetable oil with butter; stop avoiding bread, rice, and potatoes; check pre-made food you purchase for excess vegetable oil and sugar added). Not that paleo diets as recommended [http://en.wikipedia.org/wiki/Paleolithic_diet] have really much factual basis.
0mattnewport11yYou must have been looking at some very abbreviated summaries or second hand information then. Not all vegetable based oils are created equal. Lumping them all together ignores a lot of relevant nutritional information and research findings on health effects. I assure you it is not.
0taw11yI'd definitely lump them together, ignore any distinctions, and strongly recommend avoiding all of them. People eat such ridiculous amounts of vegetable oil now compared with any time in the past, that until it gets reduced to reasonable level such fine distinctions are only distracting. Effects of unrefined sugar differ somewhat from effects of refined sugar too - still, the only sensible thing is to cut both.
0mattnewport11yI mostly do but I'll sometimes use olive oil for salad dressings or low temperature sauteing and coconut oil for higher temperature frying. I prefer butter or lard for low / high temperature frying respectively though. Yeah, sugar's pretty bad in most of its forms. I don't worry too much about sugar intake in the form of raw fruits and berries (which I eat a lot of) though.
1taw11yI took time to calculate how much Paleolithic, Neolithic, and Industrial is eaten in every country, and how it is changing [http://t-a-w.blogspot.com/2010/09/neolithic-counter-revolution-in-diet.html], enjoy.
1taw11yI doubt these sane uses would account for even 20% of amount of vegetable oil people consume these days. And there's nothing terribly wrong with using small amounts of sugar of any kind - it's the ridiculous amounts of it that are the main issue.

Aside from the ridiculous (See: Autism and Vitamin D):

So I should get exercise, moderate sunlight, eat healthy omega-3's and vitamin D's (also moderately) and not fried obesity food, and sleep in a dark setting?

Of the 2000 hours of peak mental function per year claimed in the first paragraph, how many are wasted on trendy speculation and obvious repetition?

2Apprentice11yWell, he's saying something a bit more specific - he's recommending a paleo (or at least low-carb) diet. That's not really the mainstream health recommendation.
4ewbrownv11yThe trouble with this sort of recommendation is that it would take a large-sample double-blind longitudinal study to generate even weak evidence that the proposal actually increases longevity, and performing such studies isn't remotely feasible. So instead people are tempted to adopt lifelong 'longevity' programs based on speculation and studies that are too weak to generate any meaningful weight of evidence. Rationally, the expected return on investing time in such programs is severely negative - you'll defintely invest significant time and energy trying it out, and the odds of hitting something that works by pure chance (which is all you're really going on) is infintesimal. For instance, this 'paleo diet' business relies on the idea that eating the same thing our ancestors did in 10,000 BC will make us live longer. But our ancestors lived much shorter lives than we do, we have only weak evidence about what they ate, and anyway 600 generations is more than enough time for evolution to re-tune the human digestive system. So we're left with no particular reason to think this idea is even worth investigating, let alone that the specific recommendations will accomplish anything.

The trouble with this sort of recommendation [low- carb and paleo diets] is that it would take a large-sample double-blind longitudinal study to generate even weak evidence that the proposal actually increases longevity, and performing such studies isn't remotely feasible.

This is not true at all, and blindly worshipping the double-blind study like this will prevent you from learning anything. Dietary studies, with few exceptions, cannot be blind since people know what they're eating. But people can easily observe what effects diets have on them, as long as they're keeping the right quantitative data. Weight isn't the right variable to be tracking, since it can't distinguish fat from muscle, and many studies went astray that way. But tracking exercise reps, body fat percentage, energy levels and various interesting blood tests are all feasible, useful and actually done. A simple observational study plus an understanding of biochemistry is sufficient to justify a dietary preference, so long as certain known traps are avoided.

I won't mix claims about the goodness or badness of particular diets in here, but I'd like to say that the questions are answerable, and some diets are better than others in general. Individual biochemistries vary in ways that interact with possible diets, but those interactions can be understood, and many of them are understood, so it's wrong to point to individual differences as though they make diet inherently mysterious.

0NancyLebovitz11yIs body fat percentage a good surrogate for health?
0[anonymous]11yObesity correlates with several chronic diseases, and so body fat percentage must as well. There are certain diseases where elevated risk is directly associated with fat specifically (I remember seeing something where heart disease is affected by abdominal fat in particular) so at least sometimes fat matters, and not just mass. Note that it doesn't necessarily imply any kind of causality. I think "health" is a nebulous concept anyway -- in my book, you are "healthy" if the physical state of your body allows you to do what you want to do.
5jacob_cannell11yThis is simply not so. If specific studies show improved longevity from specific dietary changes, it is quite reasonable to infer combining multiple specific beneficiary changes will also result in a benefit. Skepticism is warranted, but the idea that eating whatever you want is actually better for your longevity is just bogus. There is no control group. The hypothetical diet/lifestyle of our evolutionary ancestors is the closest to a control, but it no longer exists. You need to pick what experimental group you want to be in. Yes, because of a mountain of specific evidence which supports this hypothesis (omega 3, sodium, vitamin D, reduced calories, more fruits/veggies, etc etc) On average, yes. But based on what we know from hunter-gatherer tribes, a fraction probably lived to ripe old age, and these luckier/healthier specimens would tend to have more offspring. Regardless, just because we have eliminated most of their causes of death does not mean we have not also reduced our health in other ways. Not really. We have reasonably good ideas about what they ate. This is not a great length of evolutionary time, although it is enough for some strong selection effects for neotany changes such as prolonging lactase production and increased robustness for ceral grains. Nobody is saying that we don't have some neolithic adaptations - of course we do. But that doesn't mean they have had enough time to hit equilibria, or those equilibria are optimal for longevity. Also, some of the more profound effects are far more recent, such as the omega 6 shift, artificial illumination, and sunblock which have occured in just a handful of generations - a blink of an eye.
3jimrandomh11yNot quite. It's based on the idea that eating a specific list of foods will make us live longer. The bit about that being what ancient humans ate is probably both untrue and irrelevant, but we have direct data on the effects of the specific foods, so the existence of an additional, invalid argument which has gotten undue attention should not affect our judgment.
2jacob_cannell11yWhat part about "what ancient humans ate is probably both untrue and irrelevant"? I mean we don't know exactly what range of foods they ate, but we have pretty good ideas. The important point here is that the evolutionary diet/lifestyle theory correctly predicted a large swath of specific effects, now validated. Undue attention? You might as well argue against evolution.
1[anonymous]11yAlways keep in mind that you may see improvements in health outcomes simply from being the kind of person who deliberately starts a diet she believes is healthy. (The same phenomenon that makes all kinds of education experiments perform well because the most motivated parents and children sign up.)
1jacob_cannell11yOf point of fact, I do think there is a limit to the amount of time spent researching/thinking about diet longevity issues that one can justify on strict utilitarian grounds. On the other hand, one could say the same about most of what one thinks about or discusses. With health there definetly is some gain for the mental effort.

There is a hope that medical technology, accelerated via a Singularity, will advance to the point where we have full mastery over biology and can economically repair organ and cellular damage faster than aging accumulates it. There is sufficient evidence to put a reasonable bet on that happening by mid-century.

Downvoted for Kurzweilian faith and weasely wording of prediction.

3Kutta11yIt is not Kurzweil, it is rather Aubrey De Grey's pretty good execution of a "weak inside view" analysis. Longevity escape velocity, as he calls it. I have my own minor complaint about the "accelerated via the a Singularity" part, which is markedly not part of De Grey's analysis (assuming that the OP really wrote the above paragraph with De Grey in mind and not someone else).
2jacob_cannell11yYes I was hinting at longevity escape velocity, which doesn't depend on a Singularity per se, but a Singularity - meaning a vast increase in effective intelligence and computation - undoubtedly has a high probability of achieving longevity escape velocity, amongst other things. I happen to believe the odds of achieving that escape velocity anytime soon without a vast increase in effective intelligence and computation are very low.
0Vladimir_Nesov11yThat.
4jacob_cannell11yAhh I can see why you might take objection to that - Singularity can be a vague term. Nonetheless, it does describe a range of future scenarios which I do believe there is sufficient evidence to warrant as quite possible, without considering specifics - it's actually good in this case to use a term that wraps a diverse set of related futures together.
-1PhilGoetz11yI wouldn't have used it, because the term "singularity" makes me think of a sign saying "STOP: No humans beyond this point."
1jacob_cannell11yHow do you get "Kurzweilian faith" out of "reasonable bet"?
1wedrifid11yIs the ' probable, mid-century' part what you are dismissing as Kurzweilian faith? If so, I'm in agreement. (Along much the same lines as we discussed with respect to HP:MoR.)
5jacob_cannell11yUmm I actually I didn't use the word 'probable' - I said "reasonable bet". Do you think this justifies the term "Kurzweilian faith and weasely wording"? In terms of expected benefits, even with low odds the Singularity can be a good bet that one should take into consideration in any future projections. I think it is irrational not to consider it. Belief that a Singularity is extremely unlikely this century is just another belief in a set of future scenarios that one could assign the adjective 'faith' to.
6wedrifid11yFull agreement and retraction!
-1[anonymous]11yCan't we just say "please don't use the term singularity so casually" instead of downvoting?