Living longer, beyond the basic protocols

So, I’m a big fan of Dr. Gregor “How not to die“, which is essentially how to fight the big killers of our day with a plant based diet. The premise is rather plausible. Whether you have a cultural aversion or proclivity towards plant based diets or not, the advice for heart disease, diabetes, kidney failure and cancer are all very similar- as if they were one disease. In Japan they call it metabo. The advices you get tend to be don’t smoke, drink booze or eat sugar/white carbohydrates. Eat a wide variety of plants, including whole grains, nuts, seeds, etc.

Now if you survive those on average you’ll live ~13 years longer. In other words, if you follow the protocol right, you die in your 90s instead of somewhere between your 60s and low 80s. To live longer than that without a protocol, you need parents you gave you an unusually excellent genetic structure.

So I now follow such a protocol and I’m reading up on what is going to happen. I should now avoid most typical health crises. [On a side note, I suspect that some countries full of bad habits like smoking and drinking live longer because their public health system helps people get past crises, e.g. surviving heart attacks through better CPR instead of better diet and exercise!] But how is the quality of life doing? Obviously no one wants 13 extra years of Alzheimer’s and disability. [I'm not talking about quality of life in the sense of the joys of smoking, getting drunk and eating meat at every meal- I'm okay with skipping those.]

There is some evidence that a plant based diet will help prevent some version of dementia, i.e. those cause by excessive metals (often derived from animal products), vascular dementias (where your brain vessels fail just like your heart vessels fail in heart disease).

Improving late life health starts to move us into some areas other than plant based diet.

Fasting/Calorie reduction strategies. This TED talk summarized the Fasting Mimicking Diet as a way to trigger alternate metabolic pathways that encourage old cells to die, be replace by new stem-cell derived cells. It appears to be a built-in means for all animals to respond to famine. Us humans can use it to trick our body into post-famine regeneration, except we use it to slow the rate of aging.

It is possible that plant based diets do the same thing as periodic fasting or lifetype fasting. A periodic fast denies everyone of possibly harmful foods, like candy and meat. [Thought experiment, what if our diet was cocaine, heroin and Taco Bell food-- any one week fast would give you body a chance to heal & you'd feel better, not because of fasting, but because you aren't eating cocaine and heroin and if that harm reduction was better than the benefit you got from Taco Bell food, you'd benefit from a fast. On the other hand, merely skipping healthy food might not have any useful benefit]

Also, a plant based diet will restrict your maximum intake of calories (plant based food is just less calorie dense and harder to binge on), restrict your methionine (a protein associated with accelerated aging), metals like copper & iron (insufficient and you are anemic, but too much and it accumulates in the brain- it is harder to overdose on plant based iron).

Heartbeat slowing. The best way to achieve this is by exercise. The downside is that any let up in your exercise protocol sends you back to your pre-exercise levels in about two weeks.

Sleep, Exercise. This is using a cardiovascular exercise program and extra sleep to fight dementia on the theory that dementia is caused when our brain can’t move waste out of our brains fast enough, because our circulation is bad or because we aren’t sleeping enough. Cerebral waste is only removed when your sleeping.

Falling. What kills 90 year olds, aside from dementia and the results of metabolic syndrome  [i.e. diabetes, CHD, etc] is falling in the shower. So if you think you will live to 90 and want to live to 99, you need to have a strategy in place to avoid falling. I notice in my own behavior everyday cases where I do something risky and stumble, but I don’t fall because I got quick reflexes. And if I did fall, I’d just get a bruise. I have to break this bad habit now because when I’m 90, I’m probably going have fully ossified bad habits, like not holding on to rails, standing on one leg in the shower, etc.

 

Sleep, Post 3

Last weekend I was down about 6 hours, gained three hours in the first part of the week and was down two hours again last night. So I’ve a sleep debt of five hours.

Each weekend, I suppose I could pay four hours of sleep debt (to bed an hour early and get up an hour late– five hours if nothing fun is happening on Friday). At best, I can pay off an hour of sleep debt a day on a workday, and that only if nothing really is going on– just gym, eat, sleep and minor errands.

So 9 hours a week of sleeping in can pay back the maximum sleep debt of 20 hours in about 2 weeks, which seems low compared to other estimates of several months.

Sleep- Part 2

Sleep tracking in practice
I put my sleep tracker onto my Kindle Fire. Bad idea, for two reasons. I use my android cell phone for my alarm clock, so it would have made more sense to put it there. If your alarm clock is also your sleep tracking application, you can skip half of the manual entries as you only need to log when you went to sleep. The other problem is that I try turn my Kindle Fire off, which takes forever when I just want to record a data point.

Also, any manual logging of sleep start time consistently overestimate how much sleep I get since it takes time to go to sleep.

More complicated ways to calculate sleep debt.
This calculator assumes you need to sleep for 1/2 of an hour for every hour awake (I think– that’s 8 sleep per 16 awake). So to pay off sleeping only 6 hours for two nights means sleeping more than just 4 extra hours over the next few nights because you need to sleep for the extra awake hours as well. It creates an interesting algebra problem, or it means sleep debt needs to be tracked on a spreadsheet, kind of like a mortgage amortization schedule.

Yawning.
First point of yawning should be a good measure of sleepiness, but boredom will confound the results. In my experiment so far, I’ve started yawning at 3PM, 3PM and 11AM. And yawning is contagious, so hanging out with tired people will trigger yawning that isn’t related to sleep debt.

Joe’s Goals
With Joe’s Goals you can mark up to 3 good things or 3 bad things happening on a day. That roughly corresponds to a typical increase or decrease in sleep debt– although sleep debt should only be recorded as decreasing up to 2 hours a day and only if there was a sleep debt (i.e. if you start out fully rested, you don’t get credit for sleeping in advance of the day you stay up late). I use Joe’s Goals for other goal tracking already, so this could be a good solution for sleep debt tracking.

Results. Unexplained anxiety is way down and ability to get work done is way up. That is the good news. The bad news is I’m too old to stay up late and not suffer the consequences.

Sleep

Either I’m getting old, or I’m just getting better and spotting oddities in how my brain works. I’ve never been able to nap. I lack the talent for it. So if I don’t sleep, I used to sleep in to compensate. Sleeping in, it appears, isn’t happening anymore. So while trying to figure out where this disconnected sense of anxiety was coming from, it took a long time to suspect sleep debt.

The symptoms of sleep debt are either obvious– falling asleep during the day and yawning– or not so obvious– free floating anxiety. And it appears causation goes in both directions– anxiety discourages sleeping and the body pumps itself full of anxiety causing neurochemicals to keep you awake when you’re overtired, creating a vicious cycle.

Ref. Sleep debt causes anxiety:
Reasons
Sleep Deprivation and Anxiety
Original research using brain imaging & experimental subjects that skipped sleeping for 35 hours.

Sleep Debt is real.
Sleeping for 6 hours a day for a 10 days will cause people to behave as if they had skipped an entire night of sleep. However at least one researcher is skeptical of the existence of sleep debt.

Curing a Sleep Debt
It takes months to fix a chronic sleep debt. Other articles on the next are less pessimistic, see below.

Measuring Sleep Debt
According to this article– sleep debt goes up to about 20 hours, can be paid off by only 2 hours a day– max. Also, if you have 0 sleep debt, you can’t sleep in today to earn the ability to stay up late tomorrow, i.e. you can’t bank excess sleep. According to this, if you sleep an extra hour a day, i.e. about 9 hours, a maximal sleep debt can be paid off in 20 days, ten if you can manage to sleep 10 hours a day.

Typically these provide for recording an entry a day, a start/stop timer, graphs and sleep debt calculations
Android Apps for Sleep Debt
Sleep Bot– I’ve got one data point in this app. Whoo!

Continuing to muse on how a programmer can help fight cancer

Reading about Senator Kennedy’s battle with brain cancer, and recent excitement in my own extended family, I learned most people are diagnosed with brain tumors only late in the process when they have seizure.  And more interestingly, the symptom is a headache.  Thinking that just any headache is a brain tumor is hypochonria of the worst sort, but the headaches of brain cancer follow a pattern:

Headaches linked to a brain tumor are often more painful in the morning and tend to improve throughout the day. The headaches, which can be accompanied by vomiting in the morning, may get worse with coughing or exercise or a change in position, such as kneeling. (MSNBC)

So I thought–the humble blog could capture that data.  I’m not the first to think of a headache log.

I would worry that while a headache log would catch a brain tumor early, there are probably a lot of other more likely diseases one should watch out for, like testicular cancer, breast cancer both detectible via self examination.  You’d think with all the porn on the internet there would be higher detection rates, but the most intensively inspected naughty bits are not owned by high risk populations.  Rectal cancer is much more common, but I’d rather not self inspect, thank you very much.

Is early detection the right strategy, can we just prevent it like we can prevent lung cancer by giving up the coffin nails? Outside of avoiding radiation, the risk factors for brain cancer aren’t related to choices you make.

Will early detection lead to excessive or dangerous false alarms?  Well, this website says in some places you can get an MRI for $160 bucks– cheap.

Will early detection actually make any difference?  Is brain cancer like Huntington’s Cholera, a disease you can diagnose early, but you can’t really do much about it?   Well, the 5 year survival rate for brain cancer is about 10%– higher or lower depending on the exact kind and your age.   Depending on the website you read, some websites seem to think early surgery helps– although 10% is a pretty small base to be expanding on.

So is this a worthwhile widget?  Would it work?

It seems like it could be implemented as a wordpress plug in or a facebook app.  I imagine an app that would ask you a question a day about interesting health events, like heachaches and then when you have a string of morning heacaches that go away in the evening, it would apply some probablities bases on epidimilogical data and then send you a link to a MRI center or give you a print out of your head ache log to take to the doctor.

If health is a public good–as some of the politicians in congress are arguing, the late Ted Kennedy among them, then it would make sense for the headache log to be public.  The more people who watch other people publicly keeping track of headaches– the more people would know what to look for.  And that would help get that 10% 5 year survival rate up better than just a few obsessive compulsive diarists knowing exactly when they got brain cancer.

Just don’t ever, ever, ever, ever, ever post in my facebook feed if you did a self rectal examination.  Really, I don’t want to know the good news.

Exercise Goals… hmm, what should they be?

So I’ve met my first goal of not dying young–I’m 36.  The next goal is shorter: not dying.

Goals work better if you go at them while staying true to who you are.  So a couch potato should be able to become one of those people that watch TV on a treadmill.  

So how can I get some technology into my exercise goals?

- Heart rate monitors.  Heart beats are easy to count.

- Pedometers. Steps are easy to count.

- Cybex weight machines are awesome and count repetitions, but only if you gym has that equipment

- GPS can measure how far you went.

And this feeds into that goals are supposed  to be measurable.

Well, enough blogging, time to go to the gym.  45 minutes seems like a good goal.

Vegetarianism: My advice for new vegetarians

Get enough calories, especially if one decides go go vegan. Ounce for ounce, vegetarian and vegan fare has fewer calories. This good if one is trying to lose weight, otherwise not. Iceburg salads don’t count as a substantial vegetarian meal.

Fake meat and fake milk are optional. The quality–in terms of taste–of fake foods is hit or miss. I suspect many people are discourage from becoming vegetarian because they figure they’ll have to eat fake meat to make up for the absence of real meat. Tofu is highly overrated in this regard. I find it easier to cook with seitan instead. The best ‘fake’ foods are homemade recipes which don’t try very hard to replicate the real thing, but do try to be good to eat.

Getting enough protein can be done by accident, but getting lots of vegetarian protein takes planning, say for pregnant women or weightlifters. Ounce for ounce, vegetarian and vegan fare really does have less protein. Somewhere in this blog I have a post about strategies for eating lots of vegetarian protein, but I’m too lazy to look & link it.

Beware of dietary perfectionism and isolationism. Having a strategy for staying socially engaged with the non-vegetarian world is probably as important as learning the new recipes. Flexitarianism, a word I’ve just invented maybe, is eating vegan when it is convenient to do so, vegetarian when being vegan is to difficult, and eating low on the hierarchy of sentient beings when it isn’t possible to be a vegetarian. Being flexible may sound unprincipled, but making no effort what so ever to consider the impact of diet one’s health and the surrounding world is doubly unprincipled.

[this started out as a comment on another blog that got too long]

Alanis Morissette: Hand in My Pocket

So I was listening to Alanis Morrisette on Lucy radio & she’s complaining about how uncertain she is about how she’s doing, then she says 

“Is that everything’s gonna be quite alright
I’ve got one hand in my pocket
And the other one is flicking a cigarette”

And I think, “How isolating!  How absurd!  Her health is going to go in the toilet, she’s going to be shunned by everyone, potential boyfriends, her family.”  I mean, no one in my family smokes– among my sisters and my self, only one person married a smoker, and the generation after that no smokers at all!

Tobacco doesn’t mean looking cool anymore.  Tobacco’s symbolism has shifted from a habit to a irrational act, irrational as rubbing glass shards into your eyes, licking red hot electric stove burners and gargling Clorox.  I mean, sure someone might look cool doing it, but why bother?

And worse yet, why would someone smoke when it has the social appeal of

“Is that everything’s gonna be quite alright
I’ve got one hand in my underwear
And the other one is flicking a booger”

Sadly, this blog entry is probably only going to attract readers from Alanis Morissette fandom, so I’ll point out that Regina Spektor, who is a singer who I do like, makes me do the same double take, like in “That Time

“Hey, remember that time when I would only smoke Parliaments?
Hey, remember that time when I would only smoke Marlboros?
Hey, remember that time when I would only smoke Camels?”

and I thought, “This isn’t here singing anymore, she’s singing on behalf of someone else, like if she was singing the love songs of 18th century whalers. Her voice doesn’t sound damaged enough for her to be a smoker”

Gym: Rehabbing the knee

I’ve been working on getting to the gym every other day.  Whilst walking across the parking lot, something broke in my knee, some tendon, ligament, string or rubber band that goes diagonally across the knee started to hurt and I could barely put weight on my leg.  Maybe it’s the PCL ligament. (If you suffer from sympathetic symptoms, i.e. medical student’s syndrome, don’t follow the link)  It is a diagonal and I didn’t fall when I hurt it, I just felt like I might.  

In any case, in an effort to stave off a vicious cycle of injury, dis-use, weakening and re-injury, I’ve been doing 15 minutes of leg work a day with 1/2 normal weights.  So far so good, but still, it’s been two weeks and I kind of wish the pain would just go away.