Notes from Outlive:
Sir Francis Bacon first articulated the scientific method in 1628.
It’s extremely difficult to tell the difference between a viral and bacterial infection. This difficulty results in millions of useless antibiotic prescriptions.
Studies are often mischaracterized. Especially the difference between relative risk and absolute risk. If a given intervention changes your risk of some cancer from 4/1000 to 5/1000, a headline might say your risk increases “24 percent”—that’s relative risk. But it’s only a .1 percent change in absolute risk. So if the intervention has other benefits, it’s still probably worth it.
“Hyperbolic discounting” is the tendency to choose immediate gratification over potential future gains, especially if those gains entail hard work.
Happiness reaches its nadir (lowest point) at age 47.
The oldest person ever to have lived was 122 when she died.
Natural selection doesn’t care if we develop diseases later in life, after child-bearing and rearing age. In fact, some diseases later in life might have genetic roots that confer benefits earlier in life. This is called “antagonistic pleiotropy.” e4 promotes immune response, for example.
APOE is a protein that does cholesterol stuff. It has three variants: e2, e3, and e4. Those with e4 have a much higher risk of Alzheimer’s. e2, on the other hand, seems to protect against dementia. e4 also associated with Parkinson’s and Lewy body dementia. Those of African descent have increased risk of Alzheimer’s. 2x as common in women than men. Exposure to oral contraceptives may increase Alzheimer’s risk. Close to 40% of those age 85 or older have Alzheimer’s.
FOXO3 is a gene that helps prevent cells from becoming cancerous. Being deprived of nutrients and exercise tend to activate FOXO3.
Rapamycin was discovered on Easter Island. It comes from Rapa Nui (the people) + mycin (antimicrobial agent). A scientist got defunded while working on it and had to smuggle it in a jar. It’s a miracle we found it.
Autophagy is cellular garbage cleanup. It is carried out by lysosomes.
Rapamycin helps clear senescent cells, older cells that have stopped dividing but have not died.
Alcoholics in the hospital get beer with dinner.
In 1979, the average American male weighed 173 pounds. Now it’s almost 200. More than 40 percent of the US population is obese. Another third is overweight.
Scientifically, “normal” typically means between the 2.5 and 97.5 percentile. So normal does not mean good.
A lean adult can still carry 10 kg of fat, which is 90,000 calories of stored energy.
Visceral fat is fat around organs. It’s much more harmful than subcutaneous fat.
You should get a DEXA scan annually. Visceral fat matters a lot more than total body fat.
Diabetes was at first a disease for the superelite, who could afford a luxury food known as sugar. Bach had it. Today, over 11 percent of US adults have type 2 diabetes.
Humans are bad at metabolizing fructose because we don’t have an enzyme called uricase, which helps clear uric acid. So uric acid builds up. For humans, calories from fructose often turn into fat. But fructose consumed from actual fruit is fine because it absorbs slower, with fiber and water. Fruit smoothies are a bad idea.
Insulin resistance = 12x risk of cancer, 5x risk of Alzheimer’s, 6x risk of cardiovascular disease.
If you stretched out all our veins, arteries, and capillaries, it would wrap around the earth more than twice (60,000 miles).
Cholesterol is a fat that is not water soluble, so it gets carted around in lipoproteins (the final L in HDL/LDL). HDL = high density; LDL = low density.
Most of the cholesterol we eat gets pooped out. Most of the cholesterol circulating in our body is produced by our own cells.
Half of all major cardiac events occur before age 65. In men, 1/4 occur before 54.
Endothelium = layer of tissue that lines all our arteries and veins. The endothelium can summon special white blood cells called monocytes (think Pac-Man) to break up clumps up cholesterol.
A third of 16 to 20 year olds already had plaques in their coronary arteries when they died.
You should test for apoB regularly.
Monounsaturated fats are good. MUFA. EVOO, avocados.
Cancer is second leading cause of death behind heart disease.
The mustard gas used in WW2 is a precursor to what we use for chemotherapy.
Lowering insulin levels could potentially help slow the growth of some cancers and reduce cancer risk.
A colonoscopy is great because it’s both a screening tool and a surgery. The endoscopist can remove polyps on the spot. Start getting colonoscopies at age 40, and every 2 to 3 years after that.
Top five deadliest cancers in the US: lung, breast/prostate, colorectal, pancreas, liver. 15% of lung cancers occur in people who have never smoked.
The only modifiable cancer risks are smoking, insulin resistance, and obesity. Maybe pollution but unclear.
Alzheimer himself died in 1951 at age 51 from complications of a cold.
There are gene variants associated with Parkinson’s: LRRK2 and SNCA.
Exercise is the only intervention shown to delay the progression of Parkinson’s.
The brain is 2% of body weight but accounts for 20% of energy expenditure.
People in lowest quartile of grip strength had 72 percent higher incidence of dementia.
People with hearing loss pull back from interactions with others. When brain deprived of inputs, it withers.
Flossing may help prevent Alzheimer’s by preventing systemic inflammation.
Sauna: 4 session per week, 20 minutes per session, 179+ degrees F. Can reduce Alzheimer’s risk.
77% of US population doesn’t exercise. Poor cardiorespiratory fitness carries a greater relative risk of death than smoking.
Endurance exercise helps memory. Endurance exercise generates a molecule called brain-derived neurotropic factor (BDNF) that improves health of hippocampus.
Zone 2: 2x/week, 30min/session at first —> “tremendous benefit.” Then he says 3 hours per week, or four 45 minute sessions, is the minimum required for most people to derive a benefit and make improvements, once you get over the initial hump of trying it for the first time.
VO2 max: 4 minutes at maximum pace, then 4 minutes easy; repeat 4x
Grip strength for males: half body weight in each hand (so full body weight) for at least 1 minute. Keep shoulder blades down and back. Men should be able to dead hang for 2 minutes.
Spine has three parts: lumbar (lower back), thoracic (midback), and cervical (neck).
Red meat is probably fine. There was a well-publicized 2017 study that said red meat led to 17% increase in colon cancer. But that’s not that strong of an effect. Smoking was 1000-2500% increase in lung cancer.
The #1 leading source of calories for Americans is a category called “grain-based desserts” like pies, cakes, and cookies. That’s the #1 food group.
Average glucose should be below 100 mg/dL, with standard deviation less than 15 mg/dL.
Bad sleep makes you MUCH worse at disposing of glucose.
Protein: if you eat too much, you just pee it out as urea. 1g per pound of bodyweight is good. Plant protein is there for the benefit of the plant, meaning it is largely tied up in indigestible fiber, and therefore less bioavailable. Whey protein is better and richer in available amino acids than soy protein.
Fat: saturated fat has more hydrogen atoms attached to its carbon chain. Trans fats have been banned by the FDA. Most everyone should take EPA and DHA supplements in capsule or oil form.
Japanese word for mindless eating: kuchisabishii (“lonely mouth”).
Sleep: It’s good because there’s no need for it evolutionarily, being in a state of unconsciousness, where we could easily be killed or eaten. So it’s doing something important. REM sleep helps learn new ways of moving the body, which is good for athletes and musicians. Trazodone and ashwagandha help sleep.
NBA/NFL/NHL teams that have to travel westward are at a circadian disadvantage.
23andMe tests for a common caffeine-related gene, how fast you metabolize it.
Don’t eat anything less than three hours before bedtime.
There is some research that experiencing the fractal geometric patterns in nature can reduce physiological stress.