Health

Book review: The End of Alzheimer’s, by Dale E. Bredesen.

Alzheimer’s can be at least postponed for years in most people, and maybe fully cured.

The main catches: It only works if started early enough (and Bredesen only has crude guesses about what’s early enough), the evidence is less rigorous than I’d like, and it’s not a medical treatment, it’s a quantified self approach on steroids ketones.

My guess is that the book is roughly 70% correct. If so, that’s an enormous advance.
Continue Reading

Book review: Seasteading, by Joe Quirk, with Patri Friedman.

Seasteading is an interesting idea. Alas, Quirk’s approach is not quirky enough to do justice to the unusual advantages of seasteading.

The book’s style is too much like a newspaper. Rather than focus on the main advantages of seasteading, it focuses on the concerns of the average person, and on how seasteading might affect them. It quotes interesting people extensively, while being vague about whether the authors are just reporting that those people have ideas, or whether the authors have checked that the ideas are correct. Many of the ideas seem rather fishy.

I suspect that seasteading’s biggest need now is businessmen and/or VCs who can start cruise-ship-sized projects. Yet the book seems aimed more at creating broad, shallow support among ordinary readers than it is at inspiring competent entrepreneurs.
Continue Reading

Book review: Aging is a Group-Selected Adaptation: Theory, Evidence, and Medical Implications, by Joshua Mitteldorf.

This provocative book argues that our genes program us to age because aging provided important benefits.

I’ll refer here to antagonistic pleiotropy (AP) and programmed aging (PA) as the two serious contending hypotheses of aging. (Mutation accumulation used to be a leading hypothesis, but it seems discredited now, due to the number of age-related deaths seen in a typical species, and due to evidence that aging is promoted by some ancient genes).

Here’s a dumbed down version of the debate:
<theorist>: Hamilton proved that all conceivable organisms age due to AP and/or mutation accumulation.
<critic>: But the PA theories better predict how many die from aging, the effects of telomeres, calorie restriction, etc. Also, here’s some organisms with zero or negative aging …
<theorist>: A few anomalies aren’t enough to overturn a well-established theory. The well-known PA theories are obviously wrong because selfish genes would outbreed the PA genes.
<critic>: Here are some new versions which might explain how aging could enhance a species’ fitness …
<theorist>: I’ve read enough bad group-selection theories that I’m not going to waste my time with more of them.

That kind of reaction from theorists might make sense if AP was well established. But AP seems to have been well established only in the Darwinian sense of being firmly entrenched in scientists’ minds. It got entrenched mainly by being the least wrong of a flawed set of theories, combined with some poor communication between theorists and naturalists. Wikipedia has a surprisingly good[1] page on the evolution of aging that says:

Antagonistic pleiotropy is a prevailing theory today, but this is largely by default, and not because the theory has been well verified.

Continue Reading

I’ve substantially reduced my anxiety over the past 5-10 years.

Many of the important steps along that path look easy in hindsight, yet the overall goal looked sufficiently hard prospectively that I usually assumed it wasn’t possible. I only ended up making progress by focusing on related goals.

In this post, I’ll mainly focus on problems related to general social anxiety among introverted nerds. It will probably be much less useful to others.

In particular, I expect it doesn’t apply very well to ADHD-related problems, and I have little idea how well it applies to the results of specific PTSD-type trauma.

It should be slightly useful for anxiety over politicians who are making America grate again. But you’re probably fooling yourself if you blame many of your problems on distant strangers.

Trump: Make America Grate Again!

Continue Reading

I started writing morning pages a few months ago. That means writing three pages, on paper, before doing anything else [1].

I’ve only been doing this on weekends and holidays, because on weekdays I feel a need to do some stock market work close to when the market opens.

It typically takes me one hour to write three pages. At first, it felt like I needed 75 minutes but wanted to finish faster. After a few weeks, it felt like I could finish in about 50 minutes when I was in a hurry, but often preferred to take more than an hour.

That suggests I’m doing much less stream-of-consciousness writing than is typical for morning pages. It’s unclear whether that matters.

It feels like devoting an hour per day to morning pages ought to be costly. Yet I never observed it crowding out anything I valued (except maybe once or twice when I woke up before getting an optimal amount of sleep in order to get to a hike on time – that was due to scheduling problems, not due to morning pages reducing the available of time per day).
Continue Reading

My first year of eating no factory farmed vertebrates went fairly well.

When eating at home, it took no extra cost or effort to stick to the diet.

I’ve become less comfortable eating at restaurants, because I find few acceptable choices at most restaurants, and because poor labeling has caused me to mistakenly get food that wasn’t on my diet.

The constraints were strict enough that I lost about 4 pounds during 8 days away from home over the holidays. That may have been healthier than the weight gain I succumbed to during similar travels in prior years, but that weight loss is close to the limit of what I find comfortable.

In theory, I should have gotten enough flexibility from my rule to allow 120 calories per month of unethical animal products for me to be mostly comfortable with restaurant food. In practice, I found it psychologically easier to adopt an identity of someone who doesn’t eat any factory farmed vertebrates than it would have been to feel comfortable using up the 120 calorie quota. That made me reluctant to use any flexibility.

The quota may have been valuable for avoiding a feeling of failure when I made mistakes.

Berkeley is a relatively easy place to adopt this diet, thanks to Marin Sun Farms and Mission Heirloom. Pasture-raised eggs are fairly easy to find in the bay area (Berkeley Bowl, Whole Foods, etc).

I still have some unresolved doubts about how much to trust labels. Pasture-raised eggs are available in Colorado in winter, but chicken meat is reportedly unavailable due to weather-related limits on keeping chickens outdoors. Why doesn’t that reasoning also apply to eggs?

I’m still looking for a good substitute for Questbars. These come closest:

For most people, it would be hard enough to follow my diet strictly that I recommend starting with an easier version. One option would be to avoid factory farmed chicken/eggs (i.e. focus on the avoiding the cruelest choices). And please discriminate against restaurants that don’t label their food informatively.

I plan to continue my diet essentially unchanged, with maybe slightly less worry about what I eat when traveling or at parties.

My alternate day calorie restriction diet is going well. My body and/or habits are adapting. But the visible benefits are still small.

  • I normally do three restricted days per week (very rarely only two). I eat 800-1000 calories on those days (or 1200-1400 when I burn more than 1000 calories by hiking). On unrestricted days, I try to eat a little more than feels natural.
  • I have an improved ability to bring my weight to a particular target, but the range of weights that feel good is much narrower than I expected. My weight has stabilized to a range of 142-145 pounds, compared to 145-148 last year and an erratic 138-148 in the first few weeks of my new diet. If I reduce my weight below 142, I feel irritable in the afternoon or evening of a restricted day. At 145, I’m on the verge of that too-full feeling that was common in prior years.
  • My resting heart rate has declined from about 70 to about 65.
  • For many years I’ve been waking in the middle of the night feeling too warm, with little apparent pattern. A byproduct of my new diet is that I’ve noticed it’s connected to having eaten protein.
  • I’m using less willpower now than in prior years to eat the right amount. My understanding of the willpower effect is influenced by CFAR’s attitude, which is that occasionally using willpower to fight the goals of one of my mind’s sub-agents is reasonable, but the longer I continue it, the more power and thought that sub-agent will devote to accomplishing its goals. My sub-agent in charge of getting me to eat lots to prepare for a famine can now rely on me, if I’m resisting it today, to encourage it tomorrow; whereas in prior years I was continually pressuring it to do less than it wanted. That makes it more cooperative.

The only drawbacks are the increased attention I need to pay to what I eat on restricted days, and the difficulties of eating out on restricted days (due to my need to control portion sizes and to time my main meals near the middle of the day). I find it fairly easy to schedule my restricted days so that I’m almost always eating at home, but I expect many people to find that hard.

Mission: Heirloom is a cafe in Berkeley which is serious about paleo food. Their meat and eggs meet my ethical standards (no factory farmed animal products).

Their burgers are unusually tasty, and have a better texture than any other grass-fed beef I’ve tried.

They have a nice outdoor area in back – I recommend going there when it is warm outside.

The main drawback is limited variety in their entrees.

I wish there were more cafes like this.

I’ve recently noticed that dietary zinc/copper ratios may be important (e.g. may influence Alzheimer’s), and that my diet has had ratio which is too low (mine got down below 3 last year, when it should be more like 8 or 10).

The main contributors to lowering the ratio are chocolate, macadamias, and almonds. Each of those seems like a healthy food in moderation (i.e. as many nuts as I’d be willing to shell manually). But I often overeat them.

Animal products are about the only practical way to improve the ratio. Despite the stereotype of a paleo diet consisting of mostly animals, I’ve been getting most of my calories from foods that are fairly similar to what hunter-gatherers eat, while eating a below-average amount of animal products. Since that diet gave me more than the RDA for all nutrients except vitamin D, it seemed unimportant to eat more animals.

Oysters have by far the best zinc/calorie ratio. I find that adding oyster sauce to a stir fry is nicer than having whole oysters, but many brands have little oyster in them. Lee Kum Kee is a common brand that lists oysters as the first ingredient, so I’m using that regularly.

Should I take zinc supplements? I’m reluctant to trust nutrition from something that doesn’t resemble a whole food, but that would be the most convenient solution.

Alternate day calorie restriction seems to be one of the most effective ways of increasing my life expectancy, but it isn’t easy. I tried it about three years ago, but gave up because it interfered with my sleep. I started it again three weeks ago, and this time I seem to be adjusting to it.

One important difference is that this time I’m better informed about what it takes to adjust to the diet. I planned a strict induction phase of 7 down days (about 550 calories) and 7 up days (unlimited food), followed by a less strict pattern of 2-3 days per week on which I’m limited to around 1000 calories a day. (I ended up adding an extra up day after each of the first two down days, then switched to strict alternation for the remainder of the induction phase). The severity of the induction phase may be important at triggering adaptation to this kind of diet.

The second difference is that this time I’ve been obsessive about measuring my food intake to the nearest gram. I suspect that when I intended to eat 1200 calories a day in my prior attempt, I was actually getting at least 1400 calories and fooling myself into thinking I was following the diet. This time I’m using a good scale to weigh each serving.

After the first down day, I slept poorly (as expected), getting impatient for sunrise to bring me an excuse to get up for food. After about the fourth down day, waking with an empty stomach seemed normal enough that it doesn’t provide a motive to get out of bed, or to get food quickly when I do get out of bed. I hardly notice the feelings of hunger then, even though I ought to be hungrier than late in the previous day when I did notice some of the standard hunger feelings. My sleep isn’t quite back to normal, but it seems close to normal and improving.

I’ve been feeling full about 50% of the time. I felt noticeably hungry about 30% of the time at first, and now it’s more like 20% of the time. Hunger feels a bit less important now than it used to feel (i.e. it affects my attention less).

Weight loss wasn’t an important motive for changing my diet, but I hoped I would lose about 7 pounds. I lost at least 5 pounds by the end of the 5th down day (my weight fluctuated enough that it’s hard to evaluate it precisely). I couldn’t comfortably eat enough on the up days to make up for what I lost on the 550 calorie days, even when I became mildly alarmed at my rate of weight loss.

Then my weight rebounded within a few days, without any apparent change in my diet, to roughly what it was at the start. The obvious guess is that my metabolism slowed down to compensate for the reduced calories. I did feel noticeably colder in bed after down days. I also felt less mental energy, and when doing an easy hike on the day after the 6th down day I felt a need to take rest breaks that was unusual in that it wasn’t caused by anything like muscle fatigue.

During the induction phase, I practiced strict protein fasting (< 15 grams of protein per day) on down days due to guesses that protein restriction is more effective at causing beneficial metabolic changes, which might cause faster psychological adaptation. My results seem to provide weak evidence in support of this guess. My diet on down days was mostly sweet potato and lettuce, with modest amounts of other vegetables and sugar-free chocolate. This provided more bulk to fill my gut than is typical for this kind of diet, but that was likely offset by the lack of protein related satiety. I’m not restricting protein now that I’m out of the induction phase (although I expect to do so maybe once a month).

My heart rate variability mysteriously increased after the first down day, then declined to a much lower than average level after the fourth down day, and has fluctuated a lot since then (averaging somewhat below normal).

Why did I have enough willpower to get this far, when I probably didn’t have the willpower needed to do it right three years ago?

One factor is that I now consider the CFAR community to be an important tribe to belong to, so my sense of self-identity has changed to attach more importance to being able to make big changes to my life.

Another factor is having information that led me to be somewhat confident that by a specific, not too distant, date it would become a good deal easier.

A third factor is being more obsessive about measuring how well I was complying with the rules I set down.

The induction phase cost me a fair amount of productivity. For 17 days I wasn’t close to having enough willpower/ambition to start writing a blog post (and had similar problems with most other non-routine tasks). But now I feel that writing this post is easier than normal. It’s too early to tell whether that means I have more mental energy than before.

I don’t know how to get strong evidence about whether it is worth the effort. I seem to feel more self-efficacy. I now think I can set my weight to any reasonable target simply by changing my calorie target on 2 or 3 down days per week. But in order to be clearly worthwhile it needs to improve my long-term health. I won’t know that for quite a while.