Roy Walford died at age 79 of ALS, and there are studies showing both excessive exercise and low-calorie diets (drivers of calorie restriction) increase the risk of ALS, for example: https://www.thelancet.com/journals/lancet/article/PIIS0140-6... https://www.neurology.org/doi/10.1212/WNL.0000000000007861 https://www.thelancet.com/journals/ebiom/article/PIIS2352-39...

I can't believe people are still beating this drum. There's no evidence calorie restriction (beyond not being fat) actually significantly (ie more than a few years) extends human lifespan, let alone can consistently get you to 100 (or even 120, like Walford speculated). And if it did work, we'd probably know already just by looking at existing centenarian populations. And even the best animal studies (where, unlike 99% of the garbage mouse studies, the control group isn't allowed to eat itself into obesity) don't paint an impressive picture: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832985/

> Our data indicate that under our laboratory conditions, CR does not improve mean survival in rhesus compared to CON monkeys despite clear improvements in overall health and function. Our finding contrasts with previous reports5, 19 and suggests that study design, husbandry, and diet composition are important factors for the life-prolonging effect of CR in a long-lived NHP, similar to what has been shown in rodent studies40–42. It will be valuable to continue to compare findings from on-going monkey CR studies to dissect mechanisms behind the improvement in health that occurred with and without significant effects on survival.

Like eating less :)

If the solution was easy, then we wouldn't be so gullible, we'd have a much harder time believing it works.

This is a key point. Lots of people follow fasting type diets for cultural/religious reasons. Those groups are not over represented in existing centenarian populations.

Circumstantial evidences does not prove an effect, but if the effect is real then you would expect to see lots of circumstantial evidence that is compatible with the effect. Right now there’s nothing to even suggest that calorie restriction increases lifespan in humans.

> In the United States supercentenarian status is predicted by the absence of vital registration. In the UK, Italy, Japan, and France remarkable longevity is instead predicted by regional poverty, old-age poverty, material deprivation, low incomes, high crime rates, a remote region of birth, worse health, and fewer 90+ year old people. In addition, supercentenarian birthdates are concentrated on the first of the month and days divisible by five

https://www.biorxiv.org/content/10.1101/704080v2.abstract

However, where I live in Hong Kong, they eat a lot of fish, vegetable and low amount of trash food, and live very old. But they're also very rich in general so hard to be sure of the cause.

What culture/religion were you thinking of ?

Ghee on the other hand is expensive and is accessible to a tiny fraction of the population.

It's such a delicate balance to maintain that without significant investment into monitoring, you're better off just consuming substantial amounts of complete protein and proper omega fat ratios + complex carbs. No need to overcomplicate things for the greater population.

Except restriction of essential amino acids, as well as the total amount of protein, was consistently shown to improve health markers and longevity in many animal models, as well as in human epidemiological studies. It's not even news, the first evidence for methionine restriction in rodents dates to the early 90s.

I can't figure out what motivates some people to go online and assert their baseless suggestions with so much authority.

https://www.cell.com/article/S1043-2760(14)00127-1/fulltext

https://www.thelancet.com/journals/ebiom/article/PIIS2352-39...

https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/nya...

https://www.cell.com/cell-metabolism/pdf/S1550-4131(23)00374...

First things first, different groups of humans have different protein requirements (pregnant women, elderly, athletes, sedentary non-active adults etc) so generalizations in nutrition science are always dangerous.

Secondly, the studies you cited have been experimental on yeast and mice, but observational and correlational with humans - nothing conclusive about how a practical reduction in methionine and leucine in the real world for real humans would work, and how it would affect them long term. Those are two completely different scenarios, with the former being highly controlled studies of non-human species.

Thirdly, even if methionine reduction did positively affect lifespan/healthspan, the reality is that most people are simply not equipped to take on such a dietary change, leading to more harm done than good.

The reality is that, yes, many animal foods contain much more methionine than plant based. However, you also have to consider that if regular people tried to switch to plant-based (aside from lacking general education about plant-based diets), in order for them to consume sufficient amounts of protein from plants, they'd end up consuming a lot more calories (not only fibre but other simpler carbs) due to the higher calorie-to-protein ratio. This, especially if they don't live very active lives, would contribute to weight gain, all the while them thinking they're being healthier by being plant-based.

I understand that these are promising studies that have been around for a while, and I was a vegetarian for 5 years before switching back to omnivore due to becoming more disillusioned by the vegetarian diet, especially as I was trying to build muscle while on veggie+fasting, and failing.

But context matters, real world conditions matter.

Correlational/observational studies don't mean shit because they cannot possibly account for the diverse lifestyle practices of the participants living in the real world, try as they might.

Hence why I'm advocating for people to simply consume more protein, because, even though there might be benefits to restricting certain AAs, a lot of other implications to this dietary change might be overlooked, causing more harm to the health long term.

Let me know if I'm missing something crucial.

It's true that conclusive lifelong human trials with appropriate controls are not available; but neither will they be, they're impractical.

The mechanistic basis for the health benefits of protein restriction is established to be conserved across species; they key aspects are mTor suppression, reduced IGF-1 levels and a shift from anabolic hypertrophy to catabolic autophagy.

This now famous study [1] showed that people in a large cohort who shifted to plant foods did manage to achieve lower mortality rates, perhaps challenging your assumption about the ability of the "regular person" to plan an effective diet that restricts protein.

In contrast to your experience, I am obtaining all micronutrients on a plant-based, whole foods diet, at under 1.5kcal/day; I drink one pea protein shake, for a total of 1.4 * bw. I'm happy with this, it's a form of "dietary restriction with optimal nutrition", but I'm not looking to increase muscle mass, because anabolic hypertrophy is detrimental to my longevity goals. I do exercise regularly and strength continues to increase, albeit modestly; this is consistent with a recent human trial that showed dietary restriction can lead to loss of muscle mass, yet without loss of strength.

[1] https://pubmed.ncbi.nlm.nih.gov/27479196/

I could literally eat this every day of my life and be either obese or underweight.

Anecdotally, I'm nearly 50, and for the last decade people have been commenting on how young I look. All my younger siblings have loads of gray hair, and I've only got a few; my mother even asked me if I dyed my hair (I don't!).

Possibly it's just genetics or something else (like not having a child to take care of until a few years ago); but also possibly it's because I've been regularly doing fasts for religious reasons since I was in my late 20's. I typically aim to do a 36-hour fast once a week (eat dinner on Sunday, eat breakfast on Tuesday); and I've done a number of week-long fasts as well.

There are loads and loads of benefits to fasting, and the potential for a longer, healthier life is one of them.

This is 100% the main reason. There are a few studies in this direction showing e.g. that raising a kid ages you faster than smoking or being obese. The physical and mental stress accumulated over so many years is insane.

1. Over the course of a week, you eat X calories and burn Y calories, where X < Y

2. At any given point in time, is your body burning glycogen or fat?

If you stop eating Sunday after dinner, then by Monday noon your body is out of glycogen and starts burning fat until Tuesday morning after you've had breakfast. If you simply listen to your body and eat until you're sated rather than full, you'll naturally have a slightly larger breakfast on Tuesday, but by lunchtime you'll have your full complement of glycogen again. Then work out and eat like normal.

> If nothing else youd be binge eating to catchup, which has its own drawbacks

The vast majority of animals on this planet go through "boom / bust" cycles: periods where there's lots of food and periods where there's less. The same was true for the vast majority of humans until a century or two ago. Obviously repeatedly losing and gaining 100 pounds is problematic, but losing and gaining 10 pounds over the course of a year, or 1 pound over the course of a week, is perfectly normal from a historical perspective.

What's very unusual from an evolutionary perspective is never going through the "bust" cycle where we live off our fat reserves. That's why intentional fasting is both easier and healthier than you'd think -- because just like exercising, our bodies are actually designed for it, and suffer when we don't get it.

You need to consume less calories to have longest maximum achievable age (again, not proven in humans).

You need to move more to have longest achievable healthy age (this is much better documented).

Personally, I prefer to be healthier for longer even if it means I will live shorter in absolute terms.

I am running every day which hopefully will help me have denser and more robust bones and joints and tendons. And I am lifting weights so that I still have some muscle into old age when they inevitably start to shrink. Core muscles are important to prevent fragility as we age.

It’s the “strain” on the body by the excess fat that counts (heart pumping / clogged arteries etc)

So, let’s say someone over consumes 500 calries per day, or 3500 per week which is a 1lb of fat. Over one year that’s 52lbs or 3.7 stone - over 6 years that’s 300 extra lbs. There are very very few people who consume even at that level.

Over a 60 year lifetime there is not a lot of wriggle room if we think calries restriction is the way to go

I suspect it’s part of the “food is a class issue / some people are genetically disadvantaged / social taste as gatekeeper of power “ morass

I calculated, that my obesity amounted to 1 teaspoon of sugar extra, every day.

Our bodies are excellent, miraculous regulating machines if they can stay within those tolerances regardless of what kind of shit we put in.

The bad news is, for everybody who wants to lose weight, that we have much less free will when it comes to eating than we think. To lose weight long term we need to fix whatever caused the regulating machinery to malfunction as we can't really eat less (over long term).

(Also weird the use of word regulator for finance and other NGOs - but do they really adjust? What would a regulator that said “wow we are making too much profit this quarter, let’s slow down a bit boys we must be taking steam out of the rest of the economy”)

First is realising you want to get healthy to reduce weight. Not reduce weight to get healthier.

Understanding what causes disregulation which is mostly caused by and part of metabolic syndrome, which in turn is mostly insulin resistance. Almost every overweight and every obese person has some level of insulin resistance. Just because they are not officially classified as diabetic is because medical establishment needs binary definitions. I like to think diabetes typically starts early in childhood with a wrong diet but it takes decades for the accumulated damage to the body to start gaining weight and then can take some more decades for this in turn to cause diabetes.

How to fight this? Well... undoing insulin resistance is the way to go.

I started classified as prediabetic and currently have absolutely stellar scores on any measure like HBA1C, fasting/fed blood glucose, etc.

How I improved my insulin sensitivity:

* cut off all sugar, sweet or sweetened drinks, and most carbs (I still eat carbs, just much less of them). This also tends to help with hunger.

* Cut almost all snacking. If I need to snack, I have alternative snacks that do not raise blood sugar (fresh vegetables, fatty/protein snacks like beef jerky, etc.)

* Intermittent fasting -- I try to maintain short eating window throughout the day. Usually about 4-6 hours.

* Sometimes keto diet / longer fasts -- While I don't like the idea of staying on keto diet permanently, I think doing it from time to time exercises certain important chemical pathways. So is a water fast.

* Running in the morning in fasted state. Really forces body to get good at burning fat, promotes more and better mitochondria.

* Exercise after meals, especially if the meal contains carbs. Taking a walk right after a meal has clearing effect on blood glucose -- the muscles producing energy for movement are much more eager to clear blood sugars making it as if insulin is more sensitive. It is a trick, but if you do it every day the body does not care, from its point of view it uses X amount of insulin and it causes Y amount of sugar cleared.

* Never eat naked carbs. Carbs should always be accompanied by fat and protein which causes digestion to take longer time and effectively lowers maximum blood sugar levels.

* Better sleep and less stress -- stress causes the body to release cortisol which raises blood sugar levels which causes insulin. You want less stress if you want to lose weight. Running increases stress, unfortunately, but I think it is good tradeoff.

I actually lost 20kg over 6 month, roughly following this advice. Not strictly, like I would be more lenient on weekends with carbs & booze, and have sugar, like a small dark chocolate, but only at night (to avoid further craving and consumption the whole day). I avoided the exercise as it made me unbearably hungry.

I recommend this 100%

Your day to day metabolism is not that precise, nor are calorie counts on packaging.

What I mean I calculated that amount of extra fat I gained over so many decades and divided it by the number of days and converted to amount of teaspons of sugar.

Hi, why do you say this? I mean I was a glutton (and still am), but I have been able to reduce the amount of food eaten by skipping dinner as a way of eating less. I've been at it for 2 years now, not long term maybe but medium term and I have no intention of stopping given the benefits I'm having.

And honestly? With those habits changed, I'd say I basically don't notice the difference. I'm not dieting now, and it's actually taken some effort to stop losing weight (which I just had a look at my calorie tracker app and realized accounting for thermic effects probably explains why 2750 naive calories is closer to 2275 if I'm targeting 120-150g of protein per day since now I chase muscle gains because it turns out I can get them).

Basically I eat better, and more frequently, then I did and enjoy it more. Which is to say: my bad habits were just unfulfilling, and as soon as I actually held myself accountable for the effects, the changes in my diet were all improvments in my overall quality of life.

A 500cal surplus is quite a bit though, so if you set that you’d probably gain 20 lbs over time assuming you kept everything else equal.

But over a 6 year period, you would definitely accumulate 300 pounds of extra weight this way.

What is this based on? The evidence I’ve seen is calorie restriction and exercise both increase one’s healthspan.

So over long periods of time, you consume almost exactly as much calories as you use.

The only way to consume less calories over your lifetime is to use less calories over your lifetime. And for this you need to move less.

So "calorie restriction" is opposite from higher activity levels (exercise).

Outside elite athletes, most people burn a significant minority of calories on physical activity [1]. Again, we have actual research around calorie restriction + exercise.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6003580/

All people have a huge static component to the calories that are used by our bodies. But this component is pretty much the same for all people. Our livers, our hearts, our brains are all constructed the same and use the same amounts of energy.

Where our bodies differ for the static component is based on our activity levels. Our Basal Metabolic Rate is higher when we have active lifestyle and tend to be lower when we are sedentary.

So, again, to use less energy you have to move less because regular exercise will increase your BMR or (depending how you think about it) prevent it from dropping.

You can't have low basal metabolic rate AND be regularly exercising.

We have evidence time-restricted feeding reduces basal metabolic rates [1].

> to use less energy you have to move less

Most of us carry a lot of fat, particularly around the organs, that makes all sorts of processes from physical activity to the mundane inefficient. The point of calorie restriction, nutrition and exercise is to cut out that inefficiency. We have strong evidence it can be done. Per the article and reams of research.

[1] https://pubmed.ncbi.nlm.nih.gov/27737674/

The only catch is that the truly extreme cases have a notably higher energy requirement to stay alive (more tissue needs more energy), which could skew their numbers a bit to have somehow resembled a more active person.

We know calorie restriction + exercise works in mice. So this isn’t a thermodynamic problem. We in tech tend to think from first principles; calories in = calories out seems obvious. The problem is it’s misleadingly simplifying—there is a lot in between that is significant.

In any case, I don’t think this is therapeutically inclined. It’s simply hinting at an underlying mechanism we may be able to exploit.

Primarily because of improper muscle activation, and from their body weight making the exercise more intense.

Athletes increase their cardiovascular and metabolic throughput (i.e., allowing them to burn even more calories and thus work even harder), and repeating an activity increases muscle control, allowing more coordinated and balanced movements (e.g., keeping themselves and external weights balanced without erratic, wasteful compensatory movements). They might also have a diet that absorbs better, as athletes try to absorb absurd amounts of calories.

A larger person does have a higher base energy consumption, although this is not caused by inflammation - it's just that any tissue need energy. If this was not the case, even just a few kilocalories overeating would cause unbounded growth - instead, energy requirements for a person lie on a curve, and slight overeating for one body weight just means that you reach equilibrium at a slightly higher body weight, with any combination of food intake + activity + body composition having some (although possibly absurd) body mass equilibrium. Of course, being morbidly obese does introduce high risk of certain diseases that have an energy cost and waste (e.g., mismanaged diabetes and sugar in urine), but I consider that somewhat separate.

Caries in = calories out is a thermodynamic problem. Thermodynamics account for inefficient processes. If you take fewer calories in, it always means that your body will be doing less or taking its energy from elsewhere. The body has plenty of ways to do this, including reducing base metabolism at certain costs. The sheer number of backup plans the body has available for any particular function is fascinating, but they are generally all costlier than the primary ones.

However, do not let that deter you from exploring this further. Collecting data on health outcomes of human behaviors is almost impossible without massive datasets - can't exactly cage people up in labs to test them.

Not arguing it doesn't. Just that using thermodynamics to understand human metabolism is akin to trying to grok flight through Newtonian mechanics. You can do it. But mostly by working backwards from higher-level principles.

The evidence for that disconnect is this thread. CACO leads people to believe you can't decrease your calorie consumed and burned without also increasing physical activity levels. Yet that's empirically incorrect. Not because thermodyanmics doesn't apply. But that it applies in mechanisms so complex that starting from first principles doesn't work until you have the roadmap.

> slight overeating for one body weight just means that you reach equilibrium at a slightly higher body weight

Studies observing the effects of calorie restriction see improvements in a variety of biomarkers. That slightly-higher weight comes with higher inflammation, higher CVD frequencies and other nasties.

Based on my personal experience, whether you exercise or not you are still going to be miserable when on caloric restriction.

But when you are exercising your portions do not get so small. In fact, you could be eating exactly the same and if you add walking about 10km (6 miles) every day, you are putting yourself in a significant calorie deficit of about 600 kcal (adult male, regular height, a bit overweight).

While it does not matter where 600kcal deficit comes from from thermodynamic point of view, it makes dieting easier:

* The food portions have the size you are used to. Your stomach is used to about this kind of food. At least some satiety signals are going to be the same as before you started dieting.

* Exercising will preserve muscle mass. We have a mechanism where if the body needs to access stored energy it will spare the muscles that are being exercised. This is how bodybuilders are cutting -- during cutting phase they are reducing their fat without building new muscle but are still exercising. This exercising is necessary so that the body burns fat preferentially rather than going for muscle protein.

* Exercising seems to prevent most or all of BMR drop from calorie restriction. Normally, if you just reduce your calories without much activity, the body will start conserving energy in various ways (for example I felt cold on hot days which was super interesting feeling). If BMR drops, you need to reduce your food intake even further to ensure the same level of calorie restriction. And if you do not do this you might find that a) you have reduced your calorie intake and b) you are not losing weight. Terrible place to be in. Activity prevents that from happening.

Over the period of six month from May 2023 to October 2023 I logged:

* 2497km of combined walks and runs (about 80% walks and running the rest), about 13.6km a day on average

* 384h of activities (for about 2h 7m daily average)

* about 6.5km/h average activity speed. I walk at about 6km/h normally (sometimes faster, sometimes slower), some of the activity time is probably walking into groceries or standing in a queue for a coffee and some of the activities are runs.

* 709k steps in May * 775k steps in June * 792k steps in July * 808k steps in August * 713k steps in September * 618k steps in October

For a total of 4.4M steps in 6 months or about 24.2k steps a day, on average.

* as an interesting note, Garmin estimates that my activities burned 180 thousand kcalories which translates to 20kg of pure fat or about 23kg of adipose tissue (I have maintained my weight during that period, though). Hard to say how accurate this is.

So, yes, it is feasible. Though quite time consuming. I switched my entertainment needs to consuming audiobooks and whatever informational/educational content I could put my hands on that would be even remotely useful.

Again, you're missing the other side of the comparison implied by "restriction"—restricted from what? You can't just avoid calories entirely.

From baseline. Which for almost every person is higher than is healthy.

> can't just avoid calories entirely

Who said this? Even the title says “eating less” not “starve and die.”

Why not just say "eat baseline calories"? Assuming everyone is overweight is weird.

This is like saying “everything in moderation.” What’s moderation? The whole point is drawing the new baseline.

> Assuming everyone is overweight is weird

Again, straw man. Nobody said as much. What is suggested by the research is we eat and expend more calories than is efficient.

And at every step, they hear that they surely eat too much.

Curious to see research showing eating disorders are driven by misguided pursuits of health.

> Increasing amount of population eats significantly less then they need and are terrified of eating more

"The overall incidence rate of anorexia nervosa is considerably stable over the past decades," though it's increasing "among younger persons (aged <15 years)" [1]. ("For bulimia nervosa, there has been a decline in overall incidence rate over time.")

Meanwhile, obesity is increasing globally [2].

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500372/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859313/

And yes, eating diaorders among young people are on the rise, both in boys and girls. When people complain about social media and mental health of young people, that is the primary concern.

Plus, you can have eating disorder and be fat, while your body lacking whole host of nutrition.

"Orthorexia nervosa is not listed in the offical ICD-11 and DSM-V classifications of mental disorders" and "there is still no officially accepted definition of ON, or standardised criteria of its diagnosis" [1]. As such, it's difficult to characterise its prevalence.

You said "eating disorders are on the rise." That's not true outside a narrow cohort, and among them, there is no evidence it's driven by misguided pursuits of health. What we do have evidence of is increasing obesity.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160773/

Note that this is the least traumatic way of calorie usage.

But monitoring calorie intake vs expenditure really does make a difference. I went through multiple cycles of controlled 10kg+ weight gain and loss, and I must say that just by walking extra couple miles a day while enforcing the calorie limit can make all the difference.

What doesn't work for weight control is just doing more sports - this is easily compensated by hunger.

Because their bodies compensate by eating more and they are surprised they are not losing weight and they think that exercising does not work.

Which is completely wrong way to look at it. You want to get healthier to lose weight not lose weight to get healthier. And exercise is one of the best ways to help you get healthier even if it does not directly and immediately lead to losing weight.

If you combine calorie deficit, a body that is in dire need of energy, high fasting insulin leading to inability to reach into fat stores, underdeveloped mitochondria making burning fat even more difficult, your result is body that prioritises burning protein for fuel.

If you exercise not only the body gets signal to preserve the tissue and muscles that are being loaded, but also keeps building mitochondria that are necessary to effectively burn more fat.

I would hope people exercise to a limited extent anyway, to the extent their bodies will try retain a baseline level of muscle-stength needed day to day.

As you've read on my other comment, I lost 20kg over 6 months on a low carb, low sugar, higher protein diet. I started gyming about 4/5 months in and I personally attribute this gyming with a chain-reaction that led to me putting the weight back on and am now in a much worse position health wise, even muscle wise. This all due to practical reasons, such as increased appetite which upset the hard-fought dietary and hunger equilibrium I reached.

Exercising too is I'm sure definitely better but I feel is way more difficult and sets many, on the weightloss journey, up to fail.

Regular exercise causes people to be hungry and compensate for the additional activity. That's normal.

But I probably am feeling and healthier than I would if I wasn't running.

As an example, my body got rid of all the skin folds. I should have flappy loose skin around my belly and I should have old looking skin on my face. Instead my body, being much healthier than if I was just restricting calories, is able to break up and use that extra tissue and got rid of all that skin naturally.

I learned that a doctors evaluating people who lost significant amount of fat can guess pretty correctly at the method the person used to lose the weight just based on how their skin looks like.

I went down from 93kg to 78 and then from 90kg to 78. I didn't go for low carb or sugar, just ensured enough protein and overall calorie deficit. Right now I am just carefully float around 80 kg.

This, and moderate excercise (kettlebells, some weightlifting, walking) made things relatively easy as I just made sure I stayed in an overall deficit.

One more point: it's the running weight average matters, not daily measurements.

i don't know where you pulled the data about 10k steps, but even if it was accurate, it would depend a great deal on how much weight. At my weight, running (!) for 30 minutes burns a mere 200 calories.

I switched to weight lifting, walking a lot and some kettlebell training for weight control after running for many years. Running is great but in my case resulted in joint and back problems.

One surprising thing about walking vs running is that running doesn't burn all that much calories compared to the effort it requires. While I can integrate walking into my daily routine (15-30 minutes in the morning, at lunch time and in the evening), running needs at least 1.5-2 hours per day.

[1] https://www.omnicalculator.com/sports/steps-to-calories

> most of the calories burnt are just so the body can maintain itself (basal metabolism), not from the exercise!

When reporting how many calories are burned through exercise, people usually count what is in addition to being at rest/sedentary. But the total reported by this calculator includes the basal rate. That's why it's so high.

Which is to say, it's too simplistic a model to talk about "breathing twice as fast" as explaining what's going on.

I'm curious about nighttime vs daytime breathing. I was under the impression that sleeping person breaths deeper than resting person. At least you can tell the exact moment somebody falls asleep because they start to breath deeply and loudly.

Between junk calories and inefficient metabolism from a sedentary lifestyle, almost everyone has this surplus in their energy balance.

The conclusion should be:

1. Eating less leads to better body composition and less internal organ strain in general.

2. Reasonable amounts of physical activity leads to better calorie utilisation and improved body composition.

3. It is absolutely possible to both eat less and do more sports.

4. Both eating less and doing more sports can damage the body. Say, running can damage one's joints, and undereating leads to muscle loss.

As in most things in life it's the balance that is important to get right, not just blindly following statistical insights that are mostly useless on an individual's level.

It is not (just) a correlation.

There is direct relation between what your body needs as energy and what calories are in your food. It is true for each and every single person, not just statistically over entire population.

Our bodies are physical entities that follow physical laws of conservation of energy. Because we can't create energy from nothing, every calorie expended as heat or work has to be consumed.

The only way to eat less calories is to expend less heat and work.

Calorie restriction compared to what? You need calories to live.

Regular stress is causing things to get stronger.

Running every day can be not good for the knees, if you increase the volume too quickly without giving the joints and tendons necessary time to strengthen up, if you suddenly introduce too much stress (try to sprint when you have never done it before), if you don't sleep well or give time for them to recover, if you have bad diet or if you are sick for some reason and your body has impaired ability to recover.

I've been running every single day no exceptions for almost 8 years, including marathons and a half marathon at least once a year. Most of my runs are slow, all of them are run with small steps and fore/mid foot strike.

Stomping around the track huffing and puffing is not the way to do it, but when done right it is absolutely wonderful for the body.

Running properly is part of the way to avoid injury.

I had 3 knee surgeries over the years and have arthritis in that knee and actually running with OA seems to be an ok thing to do, which seems to correlate with my experience that my knee pain is less when I run than when I don't.

As usual, there's lots of nuance and it depends on the person and the situation!

Is that universally true? Not every system in our body is so anti-fragile.

I walk a lot, but whenever I tried running, I had immediate problems with both joints and inflamed muscle. My guess is "too many hard surfaces". We are definitely not naturally adapted to pavements and asphalt.

But training in an uneven terrain will, over time, strengthen your other muscles and tendons that do not get much workout on pavement. It is important to understand if you want to move to running in uneven terrain you have to reduce your volume initially, pretty considerably, to give time to adjust.

As to your problems with inflamed muscles and joints -- I have some experience with this I can share.

First is that your aerobic capacity develops much faster than your joints and tendons, especially if you are older. It takes years of regular running to get your joints and tendons to be able to accept daily high mileage running.

There is no other way than to start small (say 1-2 miles every other day) and slowly, slowly build it up and react every time you have any problems (by stalling your build up to get time to catch up).

Connective tissue reacts best to high, non-repetitive loading. The fastest way to improve your tendons and knees is to start lifting heavy shit. That's why all pro runners are also going to the gym to lift weights. Not because they want to build muscle (you don't want muscle especially in legs because you need to move that mass back and forth) but because it strengthens joints and tendons and makes your legs more resilient to stress. Also, stronger core muscles help maintain good posture throughout long run preventing injuries.

Personally, I found walking is an excellent supplement to running. Walking long distances regularly will also strengthen things with less chance for an acute injury. I have even started walking with a loaded backpack (read up on rucking).

I keep having small injuries here and there. The difference is that I am currently running 70km a week on average (7-10km on most week days, 10-21.1km on Sundays). My leg muscles are hard as rocks and my Achilles tendons are twice as tough as before (based on the increased cross section based on the images I have). It is much harder to evaluate load capacity of my knees (I don't have images to compare) but it is easy to see If I just started running 10k every day (even if I was able to do it aerobically) I would probably blow my knees in less than a month.

Additionally, I suffer from torn ACL and before I started running my knee was kinda lose which made even walking a bit difficult (constant popping sounds, pains, etc.) Thanks to running and strength training the stronger muscles and other tendons took the slack off my knee and I pretty much forgot that there is anything wrong with it. I just need to pay attention to not get carried off too much and start doing some stupid shit like playing soccer or basketball which would definitely be a bad idea. As long as my activity has controlled moves like running or hiking in not too difficult terrain, I am fine.

Joints are not something you can recover easily once they are damaged.

It can decompose for example muscle and other connective tissue (which actually is quite important to be healthy), but it does limit ability to build tissue.

Lesson from bodybuilding crowd is that you need to eat protein with every meal if you are serious about building anything. They want to build muscle but it really extends to all tissues of our body.

I have nothing against veganism and vegetarianism. It is a lofty goal.

But strictly on health standpoint, no amount or kind of plant food can (currently) beat healthy whole animal tissue (you should really eat more than just meat and also not all animals are same way healthy to eat).

Now, this doesn't mean there can't be better plant-derived foods in the future. A protein is a protein is a protein.

The problem with plant based protein is they come in wrong concentrations, wrong combinations, they are missing some stuff or they have extra things that make protein more difficult to absorb. If we can fix these points, we can have healthy plant based diets.

But really the main benefit of meat is that you get close to the right concentrations of everything by very definition. If you eat whole animal, that is. We have evolved to eat meat and only evolved to eat plants to supplement some small things (mainly vitamin C and to eat fructose and alcohol to get fat for the winter).

With this, any stupid person can eat relatively healthy diet. You just put a steak in your mouth and you are 80% of the way there.

On the other hand eating healthy diet on plants is a difficult task requiring planning and diligence that I think half of the population is simply not equipped with brain power to execute correctly.

We evolved as opportunists and generalists. Humans are capable of taking nutrition from plants or animals.

> and only evolved to eat plants to supplement some small things

I believe this is backwards. There are examples of hunter-gatherer societies with meat-dominant diets, but more typically hunter-gatherer diets were/are predominantly plant-based. In most environments hunting was a less reliable source of food and more opportunistic.

> But really the main benefit of meat is that you get close to the right concentrations of everything by very definition.

Not really. Maybe if you were eating chimp... but chickens have very different compositions to cows, pigs, salmon or polar bears.

> You just put a steak in your mouth and you are 80% of the way there.

It really isn't that simple. For example, it is well established that excessive red meat consumption raises the risk of colorectal cancer and other bad things.

Well yes but no. Large brains were largely made possible by the fact we mastered fire (mostly to cook meat). Look at gorillas, they eat plants and spend most of their waking life to forage for food. Having even larger brains means that foraging would be impossible to sustain a modern human's constitution.

Just did a quick search and found this paper, which suggests an average rate of compensation of 28%, but notes that it varies significantly: https://www.sciencedirect.com/science/article/pii/S096098222...

In it Herman Pontzer investigated the daily calorie burn of different lifestyles: hunter-gatherers, farmers, and office workers. Studying the Hadza tribe in Tanzania, he discovered that their calorie expenditure was surprisingly similar to that of Americans and Europeans.

Results suggest that increasing activity won't impact total energy expenditure. But without exercise, the energy spent by bodies on other things like stress, inflammation, etc.

If you are in a serious deficit for a long time it can be harmful. But the more immediate worry is getting the right things at the right times.

According to this article:

https://www.nytimes.com/2018/02/23/sports/olympics/cross-cou...

>A typical elite cross-country skier will burn about 30 calories a minute during training–by comparison, a 155-pound person on an elliptical machine burns about 11 calories a minute.

On the rowing machine, I can get up to about 500 to 600 Calories in 45min to 1 hour. But I also feel like most people would not work out hard enough to burn 10 calories per minute, especially if we are talking about older people.

You can't exercise off calories. The difference in burning rate vs consumption is far too high for most cases.. I always thought the exercise that helped age better, was largely that the diet remains constant..

My weight lifting doesn't burn many calories, but I typically burn 2000-3000 calories a week running. This is close enough to my basal metabolic rate that it is calorically equivalent to fasting one day per week. This is more exercise than is typical, granted, but it does suggest that one can exercise off calories and it doesn't take all that much time to make a dent.

I will say, this kind of caloric burn ups my appetite and I'm not trying to lose weight, so I eat more to compensate.

Some people hear "one mile burns roughly a soda", look at the numbers and assume that weight loss through exercise is not going to work for them or anyone. These people give up way too easy.

One would most certainly require more calories if he/her started training.

If you're an olympic athlete swimming 10 miles a day, you need more calories.

If you're the typical American walking or jogging even for an hour, you burn basically a can of Coke or two.

This is 1/4 as much as 10 hours and is a significant proportion of my basal metabolic expenditure.

On a more typical day, I may run closer to an hour and be closer to 600-700 calories. I'd still call this significant.

You can burn significant calories exercising, but the exercise is probably kind of unpleasant.

Not necessarily. Consider the calories you're burning carrying around fat or being inflamed or from a higher resting heart rate.

Burning calories by eating/exercise is largely what kills us, but exercise can help keep our heart running when it otherwise might’ve failed due to congestive heart issues, or diabetes, etc. Death from metabolism means you avoided the other stuff.

Not sure about food though. I don't feel any different.

But reading article the conclusion seems to be that we simply do not know enough about how this all works. Giving absolute ranges of calories also seems like the wrong approach. There are differences in sex, in height in activity levels etc. etc. etc.

Would someone on a 2000 calorie diet who was moderately active fare better than someone on a 2500 calorie diet who was more active? I do not think we have the answer to that.

As for the science, my understanding is...excess calories = excess glucose = insulin-response, which is associated with inflammation.

A good book I read on it recently is, The Intermittent Fasting Revolution by Mark P. Mattson https://www.amazon.co.uk/Intermittent-Fasting-Revolution-Opt...

Aerobic exercise of course means more caloric expenditure, which you should totally compensate, but that's not hard for regular folks who train, only for extreme athletes

If you enjoy exercising, you get to do something you like, which on top of that increases your (healthy) lifespan. Win win.

I suppose feeling better overall (physically and mentally) makes it easier for me to have a more rational relationship with food.

https://help.archive.org/help/how-do-i-donate-to-the-interne...

Not sure maximum age is what you want to optimize for unless there is more data.

Fewer calories doesn't mean starvation. We have evidence time-restricted feeding decreses fat mass without compromising musculature or strength while reducing inflammation [1]. Curiously, while "resting energy expenditure was unchanged," basal metabolism did go down.

I don't think the solution is everyone time-restricting their feeding. But there is something here that suggests a broad quality-of-life improvement for many Americans.

[1] https://pubmed.ncbi.nlm.nih.gov/27737674/

REE was the proxy for basal metabolism. They measured respiratory ratio which decreased, but that's not BM just (should) reflect what macros are being burned

Of course this is only for optimizing - not relevant for almost anyone except elite athletes, I believe.

If one is actively working on building muscles there's already a pretty concerted effort to the whole goal, adding some protein supplement to that is much easier than carefully planning your breakfast, lunch, dinner, and snacks to reach your daily intake needs.

There is also a limit to the rate at which you can assimilate amino acids which is why all things being equal spacing out the protein throughout the day is more optimal.

I understand your point but it feels to me a little bit of soapboxing.

Being more optimal only really matters at a very high level of athleticism goals, if one is at the point where they need to optimise their protein intake windows they'd already know about it given that reaching such high level requires a lot of nutrition knowledge.

I'm stating this because there's a tendency on Hacker News comments to overoptimise everything. Yes, there are optimal ways that can give an edge for people requiring that edge but most people here are just normal people who shouldn't at all be caring about that, the tendency to min-maxing will just become an obstacle.

It's not just about anabolic window timing though. In fact, my point in using the word optimal is about the opposite of how you are approaching it above. For the majority of HN audience that fall outside of the switched-on bodybuilder/diet planning over-optimiser type, a restrictive TRF window simply makes it more difficult to get all the protein that one could benefit from. I'm not talking about optimising to the point of diminishing returns; the simple heuristic "don't skip breakfast but have one with protein" can have a significant benefit to the dietary macronutrient composition for many people with no other effort. Because even if they know two scoops of whey after or eating a second chicken breast for dinner might be a good idea, it doesn't always happen because there are more hedonic choices.

1g of olive oil will give you around 9kcal, when I used to track all my daily intake it was around 100+kcal for a tablespoon of olive oil. Peanut/other nuts butter provide a little less calories per gram but add protein to the mix.

Time-on-earth is easy to measure, but not obviously a good measure. EG, is time-on-earth a better metric than total calorie consumption? Doesn't feel straightforward to me.

The truth is that both schools of thought are correct. You can and will lose weight by eating junk calories as long as you are eating in a deficit[1]. You can also eat a strict paleo diet of whole foods and gain weight - anecdotal, I have done it.

I have been consistently and (very) gradually reducing my body fat percentage over the course of a year by eating mostly-healthy foods and calorie counting (the alleged worst way of tracking food). I still eat a fair amount of junk food but limit it to one day a week.

Bottom line: quality of food has very little to do with weight loss, calories determine weight loss. Quality of food will influence body composition but body composition !== weight.

[1] https://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor...

And since we're in the western world of medicine, the answer is of course, pills. Which is disappointing because the first question I would ask is do you need to calorie restrict constantly to get the same benefits?

If I restrict for three days a week, eat normally the other three, then add a relative "cheat" day between the two, am I possibly getting most of the same benefit anyways?

Anecdotally, I do eat this way, under the logic that our ancestors would have had similar calorie consumption patterns based around the "boom and bust" cycle of hunting, and since I've adjusted my diet I've been incredibly happy with what I perceive to be it's positive impacts on my weight and levels of energy.

Anyways.. I don't think our first instinct should be to go "off label" for an answer.

Unfortunately, we are more slaves to our bodies than one would think.

The calories you eat are almost exactly the same as what you burn.

And if you do not believe, try dividing the extra weight of a person by the number of days they lived to see how little extra calories they consumed over their lifetime.

Only a tiny imbalance is enough for a person to get overweight but it also means that it is really, really hard to eat any more or less than one is actually using for energy.

The biggest contributor to how much calories we actually use for energy (and based on above: consume), is our metabolic rates and activity. And metabolic rate does not differ a lot between people, the only thing that differs significantly is activity level.

So when somebody says "eat less calories to live longer" what they really are saying you should be less active.

Resting metabolic rates decrease in obese people, and stay lowered even if they lose weight.

Combine that with leptin resisance and it really is no wonder why it's so hard to lose weight once you have it and more than 90% of attempts persistently fail. This is why I do not like armchair "pills don't solve everything" takes, because in the case of semiglutide, it does help a lot getting over the leptin resistence induced permanent hunger feeling, just like Metformin improves insulin resistence.

It very much depends on how you lost weight.

You can be losing weight while maintaining high BMR. They key is to maintain high activity level and be able to eat to satiety regularly.

If you just cut calories consumed the body will try to defend from perceived starvation by cutting on activity and metabolic rate. You become sluggish, you feel cold even on a hot day, etc.

But you can also cut average calories consumed in relation to caloric requirements by moving a lot and practicing intermittent fasting where you eat to satiety from time to time (once a day, once every other day, etc.)

> (...) and it really is no wonder why it's so hard to lose weight once you have it and more than 90% of attempts persistently fail. This is why I do not like armchair "pills don't solve everything" (...)

I had two attempts at losing weight. I lost over 70 pounds both times. After the first time I regained it all within couple of years. For the second time I decided to rethink entire process and treat it as an engineering problem.

My results is that, to lose weight permanently, one has to learn new habits and essentially become a person that person that deserves lower body weight.

Which is what I did, I learned to eat better (cut all sugar, soft drinks and most carbs), stop snacking, restrict feeding hours, add activity every day throughout the day (running every morning, taking walks in the evening, sprinkling the day with small activities like buying groceries rather than driving to a mall once a week, etc.) It works.

However, what the parent is asking is whether we know that the longevity effect is due to persistently low calorie intake (which will result in lower body weight, so that an equilibrium can be reached that's sustainable at that lower caloric intake), or if instead it might be sufficient for the body to receive intermittent signals of caloric deficit. Personally I don't know the answer to that question; I'm not sure if it is yet known.

His main reason was that such traditional dietary practices are likely to be more reliable and beneficial than modern fads, which lack long-term evidence.

I generally find this logic unconvincing. Our ancestors lacked access to modern scientific knowledge and had far shorter average lifespans than us. Here are some examples of things that our ancestors didn't do: (1) perform CPR on cardiac arrest victims, (2) treat cancer with surgery / drugs, (3) engage in studies to determine which foods are healthier than others, (4) sterilize food products to avoid infection.

In my opinion it's a fallacy to assert that because pre-historic humans behaved in a certain way, that that way is superior. Pre-historic humans did the best they could with the tools they had and the environment they faced at that time. Gorging on a huge meal every few days made a lot of sense when the alternative was potential starvation. The priority at that time was surviving the next day/week/month, not living 80+ years. Modern humans can do better with more advanced tools and an environment containing a very different set of challenges to deal with.

It's also a fallacy to assume that natural > artificial in all cases. While there can often be some truth in that, there's no reason to think that we can't optimise what nature provides, or that we shouldn't try to do that.

GP wasn't talking about eating what his ancestors ate but eating in a way that they ate (boom and bust).

> Are you aware that animals in captivity generally live way longer than animals in the wild?

Are you aware that benefits mostly extend to species whit short life spans, high reproductive rates and high mortality in the wild? That is mostly because being in a zoo offers protection from the things that get these mammals with fast paced lives killed in the wild. Senescence is barely delayed in those mammals and in mammals with slower paced lives there is no effect on senescence and in some senescence starts earlier in captivity.

The rest of your post isn't worth addressing.

Ah yes, eating in the way they ate, it suddenly makes so much sense /s

> The rest of your post isn't worth addressing.

But this is my point. Why not? Why are people picking this one thing (food) to be "more like our ancestors" and not any of the countless other variables? And why is wanting to be like our ancestors even a thing given that they probably had hard lives that would basically be considered poverty by our standards?

It certainly does make more sense than what you said.

> But this is my point. Why not? Why are people picking this one thing (food) to be "more like our ancestors" and not any of the countless other variables?

It seems that you are surprised that people are talking about food on a thread about food. People are also picking those countless other variables, they are just aware of things like context.

> And why is wanting to be like our ancestors even a thing given that they probably had hard lives that would basically be considered poverty by our standards?

It isn't wanting to be like our ancestors. It is about being healthy.

Part of his protocol is caloric restriction coupled with very specific exercise and intermittent fasting. According to his published health data he is extremely healthy! His YT channel [1] is also pretty interesting, if mildly cult-like.

[0] - https://protocol.bryanjohnson.com/ [1] - https://www.youtube.com/@BryanJohnson/videos

1. He seems to have an awful lot of referral links - $60 for a bottle of olive oil? 2. He has not posted why is his regime like that - e.g. "Here is a paper about iron deficiencies, so I'm taking an iron supplement". 3. 90% of his website is "look at how dense my bones are", "look at how healthy my liver is" - bro I just wanted to see the actual regime, and you can't even post that.

Overall I think he's legit, but also weird. It could be "rich guy weird" or "on the spectrum weird", doesn't really matter. Either way, I'm mostly taking him seriously now, with caveats.

The biggest caveat being, of course, that it's a study with a sample size of 1. A very in-depth study, but the applicability is limited. For example if you look at the list of supplements, there are quite a few which are obviously there because he's a vegan.

This is also related to why his protocol isn't explained in detail - it's ongoing and result-based. He may try something, see if it works, and stick it in the protocol. Supporting studies are useless for this modus operandi - he's not trying to convince you that particular supplement is good for you. All he's doing is risk-benefit calculations for his particular case. Which means that yes, he'll have a bunch of stuff which maybe work for everybody, or maybe work for him, or maybe random noise just made them look like they work for him but are actually useless. Or worse, stuff which can be actively harmful, but he was lucky or just very healthy otherwise and didn't see the damage.

This is clearly a man who wants a cult-like mentality to form around him.

If he were just going ridiculously in-depth with his self-research and being open and honest about this, I'd actually admire him a lot, but it's all the grandiose talk about "Zeroth principles thinking" and "Aligning with what the 25th century would want" together with implying his detractors must be weak, scared and lacking in self-control that turns me off heavily.

Personally, I have taken few things from his routine and double-checked it with other sources and more importantly found much cheaper products/things locally than the ones that are advertised (even though, most of them are fine anyways such as in Skincare he uses standard Cerave stuff).

Do note that this is -one- guy trying basically everything that seems plausible. It would likely result in frequently switching up things that are not researched well.

His website is full of "look at my amazing results!", which makes for good marketing talk but does not good science make and is not good nor helpful for people who are trying to separate what works from what doesn't - but is great for Mr. Johnson' budding supplement business's baseline.

Any you feel comfortable sharing?

Looks like just another scam artist to sell stuff

Personally, I try not to throw out accusations about people when I'm this unfamiliar with their background. I'd encourage you to consider a similar habit :)

How does that background translate to any kind of scientific competence? Because his website is heavy on the buzzwords and the Silicon Valley "glorious future"-talk and remarkably light on anything resembling responsible science.

He clearly doesn't want to advance knowledge about longevity, he wants to be the world's top longevity marketer and salesman. It's just a business long shot to him. And yes, that is perfectly congruent with his background.

It seems that Jobs is way more successful than him. Should we follow his fruit diet?

https://www.youtube.com/watch?v=kw2H_j81_50&t=75s

What is he doing?

For non-invasive skincare he does daily face-wash, moisturizing creams (face and body), application of creams containing Vitamin C, E, B3 and more. Personally, it is enough to apply some moisturizer (for face and body) and UV-protective cream. If you want really smooth/clean face then you can look into getting some retinol/retinoid - the stronger the better the effect as long as your skin can tolerate (so requires experimentation). Stick to proven brands such as Cerave, Eucerin and few other big ones.

For more invasive procedures he does microneedle and laser procedures. Both operate on principle of basically causing controlled damage on the skin to force your body to repair it. I used to have some stretch marks that were repaired using CO2 laser. Before trying to do any of this - consult your local dermatologist if you have something that bothers you on the skin, however. These procedures can be costly, requires after-care and obviously should be performed by certified professionals.

He also does microbotox injections to clear any pores. In my opinion this is now veering off more to cosmetic enhancement with fillers and the like.

https://www.google.com/imgres?imgurl=https%3A%2F%2Fnetstorag...

1. First of all is that he talks significantly more about the supposed results of his program than he does about why his program is like that or even what does his actual program consist in. You will notice that nowhere at all is the actual "program" explained or even described in its entirety. As has been mentioned, all of his content is about "wow, look how amazingly strong I am" or "wow, look at my amazing metabolism" but none of it is actionable content beyond telling people to buy his shit.

2. Speaking of "telling people to buy his shit", once you get beyond the amazingly extensive wall of "wow, look how amazing my results are", his website looks remarkably like every single other unproven supplement peddler out there. I am looking at his website right now as I write this and the number of supplements he sells himself has, in fact increased greatly. He has gone from the $60 olive oil which was his original product to a branded line of spreads, drink mixes, and whatever else to the point that he's starting to look a lot like the Liver King (https://www.youtube.com/watch?v=BKpmAGZQetc), if more "creepy 50 year-old trying to look like a teenager" than Liver King's "creepy 50 year-old trying to look like a jacked piece of salami"

3. While I admire Mr. Johnson's willingness to self-test unproven treatments supposedly in order to figure out if they actually work for himself, his website is remarkably light on warnings on which treatments are actually unproven and which might actually carry some level of danger. The amount of warning on unproven and unlicensed therapies in his website amounts to a single footnote very well hidden under a gigantic wall of "wow, look how amazing my test results are and how impressive my wall of supplements is!"

4. Speaking of his test results, early on Mr. Johnson actually used to talk about challenges, things that went wrong or even just "not so great". As time went on, it's all rah-rah "look at how amazing I am! My measurements are better than an Olympic athlete!!". And while I truly do hope Mr. Johnson's (unexplained, just-so) protocol is just that great, it does seem a lot like peddling his olive oil and whatever else would suffer if he were to say that anything he did was anything beyond perfect.

5. Oh god, the "philosophy" parts. I really want to talk as little as possible about this one, because it's all vapid bullshit and even talking too much about it helps it spread - in fact Mr. Johnson is well-known for actively courting Twitter drama as a way to strengthen his brand. (It should be a well-known fact by any human being living in the 21st century that controversy will make grifters stronger in the short run). His rant on how he is somehow going from "First Principles thinking" to "Zeroth principle thinking", which is "the base of genius" can compete with anything written by any "motivational guru" who talks about "quantum healing" to large audiences... Including a part where he says that anyone who doubts him and his protocol must be weak, miserable, scared of being left behind, afraid of change, and lacking self-control. Wow.

6. Now, let's look at what all this high-minded philosophical talk builds up to. Well, it seems that somehow Mr. Johnson's protocol will help you resist "corporate profiteering at your detriment" and also stop us from "destroying the biosphere" by "aligning us with what the 25th century would value". Huh. Ok, seems pretty great. How can we get there, Mr. Johnson?

    It would have been hard to predict the books that would be written with the introduction of the printing press; or what the internet would enable. The same principle applies to what the human race can become when paired with the torrid wave of technological and scientific progress. We can take baby steps as we work on stretching our imaginations: 

    Week 1: drink the Green Giant (GG) daily.
    Week 2: GG + Super Veggie (SV) daily.
    Week 3: GG + SV + Nutty Pudding (NP) daily.
    Week 4: GG + SV + NP + supplements daily.

I rest my case.

At the extreme end there's Angus Barbieri:

https://www.diabetes.co.uk/blog/2018/02/story-angus-barbieri...

And not, like, adults being obsesssed with low calories lifeatyles themselves on all adults forums.

I suppose it is just a case of balance.

I sure am on one end of the bell curve, apparently. People don't seem like risk takers and play it safe (from my biased perspective). 'Try anything once' doesn't seem like a mantra that people actually do take to heart. "Live a little" gets proverbial blank stares. "Spend your money, what's the point in it otherwise?!" gets a concerned shuffle, then no action, from elderly relatives. "The world is your oyster!" results in no holidays being booked despite them opining the need or want for one. Well, from this very opinionated view, there are a lot of people playing it safe and hiding in their boxes, letting their resources go unused. But to each their own, if people are comfortable and happy and society is utilitarian.

Book a skydive, indulge in fancy unhealthy food for once, get a flight somewhere! Last night I bought tickets to a dance festival in Albania. I just need to get to Corfu by June to get my boat trip. Next week I am going to wander around the English countryside for a week. I think in Feb I will get the train to the Netherlands. I might wander EU for a bit. Meanwhile I have a friend that is miserable, stuck in an apartment, unwilling to spend the gold pot she sits upon, but wishing she could join me. The gold pot will go to charity in her will though at least.

Anyway, I suppose it is not in my nature to do Calls to Actions like this, but I found myself writing this because the person that I am replying to reminds me that IMO there is a bias in the other direction in the Overton window and in literature. It all feels very boring and safe to me. It's too longevity based and not quality based. I don't think Instagram trends are a counter-example - If anything I think they reinforce my point (that people will satiate their desire for things by watching someone else do it instead of themselves).

Or you could enjoy being more health along the way. Do you prefer decaying slowly from heart disease and diabetes, or going out with a stroke while jogging in your 80s? It's all a trade off.

There will be pill form for Wegovy to match Rybelsus, or it may be collapsed into that single brand name differing only in dosage. The issue is the US profits on semaglutide are excessive. It, along with metformin, are the two most important medications to increase public health and reduce disease in relatively healthy populations. Perhaps the Defense Production Act could be enacted to manufacture generics of the most expensive and most QALY-positive medications.

It's only available in two EU countries (Denmark and Germany), and availability is patchy, and they are no longer accepting any new patients because of chronic shortages.

It will take several more years for everyone to have enough. It's like 155mm production - seems easy on paper, takes years and billions in reality, and we have to deal with chronic shortages and ridiculous 20x prices in the meantime.