We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
A healthy distrust of experts, especially government experts, is a good trend. Government "expertise" is always contaminated by politics (eg the Ethanol scam). Caveat emptor.
As the threat of communicable diseases receded, public medicine began to turn its attention to treating and preventing health problems that weren’t germ-caused, such as chronic heart disease and strokes, the death rates for which seemed to be soaring after World War II. Some observers cautioned that the apparent increase might be the result of diagnostic advances, which had improved doctors’ ability to detect heart ailments. This possibility, however, failed to deter the press and advocacy groups like the American Heart Association from declaring the arrival of a frightening epidemic.
That is a major but unknown scandal. Think of all of the gullible Americans who avoided "red meat" and "animal fat" over a generation, for no reason at all.
Please do not tell me that you can lose fat by exercise alone. It doesn't happen. Exercise is great, but not for fat loss although many people find that strenuous exercise reduces appetite.
Bone weakness is mainly seen in post-menopausal women. It isasymptomatic until a bone breaks and you face a real problem. When men have it, it tends to be at least ten years later than women, on average.
You do not need to appear frail to have bone fragility, but osteopenia is one component of what we term "frailty" - vulnerability to things breaking. While being underweight is one risk factor, being heavy is not a protection. Vit D deficiency and inactivity are other factors, along with bad habits, unlucky genes, and a life style lacking in daily resistance exertion.
Hip fractures are one of the common presentations of previously-undiagnosed bone weakness. Contrary to common belief, people do not "fall and break their hip." It is usually the opposite: their femur just fractures from weakness, causing them to fall. People with bone weakness, though, are more prone to any bone fracture anytime they fall or have an accident.
Diagnosis is usually via a routine Bone Density Scan or after a fracture.
Prevention and Treatment: Besides getting some sunshine daily (not just on your face) and taking Vit D along with a good diet, the prevention and treatment for bone weakness is strength training. The medicines for osteoporosis are problematic and often ineffective. Cardio exercises - things like walking, running, swimming, etc. are not effective in building muscle or bone strength. (It is not unusual for runners to be weak-muscled - or for weight-lifters to be unable to run a mile. Balanced fitness means strength, a little cardio, and calisthenics for athleticism but only the strength component is relevant here). Some full-body calisthenics might be helpful (eg squats, farmer's walks, push-ups, step and press) but what really helps is moving heavy weights against gravity with all the muscles you can engage for a couple of hours each week.
That works because muscle stress and muscle growth put the good kind of stress on the bones to which they are attached. This naturally stimulates bone development. Bone-ligament-muscle is a functional unit. Weight training can not damage your bones. Quite the opposite.
For strength training for post-menopausal women, I recommend working towards multi-muscle-group exertions like barbell or goblet squats, bench press, deadlifts, assisted pull-ups, military press, leg press, etc with ever-increasing resistance. The uninitiated should not do these things without an experienced and savvy trainer with some nutritional sophistication. Being overweight is no obstacle to strength training, but a low BMI is a major obstacle to strength-building and requires remediation.
Bone weakness aside, any non-casual fitness program should include strength training, some cardio, and calisthenics. In addition, a nutritional plan that supports your conditioning goals.
Posture is complicated, because it involves habit, training, psychological attitude, and muscle strength. Further, good posture makes you more presentable and makes you look more confident even if you do not feel that way.
Medically, good posture helps prevent back problems.
Computer monitors, age, shame and shyness, muscle atrophy, and general slovenliness are the enemies of good posture: shoulders back, head up, no slouch, belly tucked in, etc. Look good, not proudful but self-respecting.
I hate sunscreen. I at least should use it on my nose when I expect to be outdoors for hours, but I often forget to.
In recent years, Americans have become so heliophobic that they become Vit D deprived, raising the risk for many diseases. My dermatologist told me that many American kids are now Vit D-deprived due to excessive sunblock use. Oral Vit D is an unreliable source. Your skin produces sufficient Vit D via exposure to the UV rays in natural sunlight for about an hour per week (assuming your body is not mostly covered up).
Nobody wants skin cancer, but the scary one is the rare but dangerous Melanoma. It seems to be associated with sunburn. Do dark-skinned people get Melanoma? Yes.
Can you get sunburned on cloudy days? I did an experiment on myself last week. After 4 hours of kayaking on a hazy day with thin clouds, I got semi- scorched. Can You Still Get A Sunburn When It’s Cloudy Out?
I think it makes sense to get some time in unprotected sun but if you are going to be outside all day nude or in a bathing suit, spray the stuff on after that and use a hat. It can't hurt.
In the crematorium, will you sizzle nicely or will your corpse burn down the funeral home?
We recently posted about abdominal muscles and abdominal wall fat, but fat of course is widely-distributed on the body. It's not all subcutaneous. Much of the excess fat you have is intramuscular and most of it is stored amongst your guts in the large packets of soft lard which produce the belly.
The human body is a sponge for carbs. It is designed to be a prepper for the next famine. If you have ever assisted with surgery on a heavy person, those giant yellow blobs of adipose clinging to the organs and intestines mean trouble. They ooze a slippery oil that make it difficult to hold onto a tool and get in the way of everything you try to do. Disgusting. Surgeons hate working on heavy people because of that. It pisses them off but they deal with it. Risky, though.
But, with the first incision when the yellow subcutaneous globules billow up and flow out onto your skin, they will say things about you that you would not like to hear. It's one reason they knock you out first. Handling all of that goo in my youth helped motivate me to stay fit in middle age.
Around 15% body fat is considered good, athletic fitness for men, and about up around 19-23% for women. Women naturally carry somewhat more fat in their hips, butts, and boobs. Less than 19% in women is for under-30 year-olds, body-builders, the naturally-skinny, and if it gets too low, those with eating problems. No need for expensive tests to assess yourself. Just compare your image below the fold, from here.
As government and other medical bureaucracies impose themselves on medical practice, their temptations are to create "practice guidelines" for their practitioner subordinates.
I resist the underlying idea of one-size-fits-all, or even the idea of a tyranny of "best practices." Each patient is unique. Furthermore, most areas of medicine are in constant controversy and dispute, with new ideas always emerging. For one example, the nutritional bureaucracies are about 20 years behind the times.
I have seen plenty of people poorly-served because of fear of rules or of law suits.
A "healthy diet" above and beyond the basics cannot be defined and never will be defined because adequate nourishment can be obtained in so many ways. Much of the science of nutrition is dubious and, anyway, nobody reading this website is in any danger of being malnourished. Overnourished, more likely. Americans probably pee out more vitamins and minerals in a week than malnourished African kids get in a year.
In other words, Americans are the last people in the world who ought to fetishize the idea of "healthy" food. That is probably why we are the only people who do.
The nutritional science which has the most value involves diseases of malnutrition, which are absent in the Western world. The knowledge that has general applicability concerns the roles of protein, carbs, and fats in the diet, perhaps the role of vitamins, and the new information about how people become fat.
Furthermore, some foods are disparaged as unhealthy for no reason. Consider steak and burgers, ice cream, and so forth. People say "Eat fruits, greens, and vegetables." Why? They are just sometimes-tasty fillers with minimal nutrients but which can be fun to eat if done right. Is orange juice "healthy"? Depends what you mean. It's flavored sugar water and some people prefer it to plain water. Is chocolate "bad for you"? Of course not. It is wonderful food.
People talk about what foods are "nutritious." In the Western world, that is an absurd notion. Lots of guys in the NBA were raised on Frosted Flakes, Doritos, hot dogs, Coke, MacDonalds, and school lunch slops. Highly nutritious. The only people who should eat brown rice and whole wheat bread are people who prefer the flavor. The only people who should pay any attention to nutrition are parents of growing kids, people who are overweight, and athletes and others with heavy physical work.
In the prosperous Western world, you are not what you eat - so people ought to eat what they like and what they can afford and ignore the health marketing hype and ignore the health superstitions. I can tell you why our family meals consist of what they do: Tradition, preferences, and nothing more.
Modern investigators find it hard to accept the fact that groups exhibiting superb physical development and perfect health ate liberally of the very dietary component that modern nutritionists have demonized: Saturated animal fat.
The deterioration in physiological function normally associated with aging is, in fact, caused by a combination of reduced physical activity and the aging process itself. By maintaining an active lifestyle, or by increasing levels of physical activity if previously sedentary, older persons can maintain relatively high levels of cardiovascular and metabolic function, including ˙VO2max (Kohrt et al. 1991), and of skeletal muscle function (Rogers and Evans 1993). For example, Fiatarone and colleagues (1994) found an increase of 113 percent in the strength of elderly men and women (mean age of 87.1 years) following a 10-week training program of progressive resistance exercise. Cross-sectional thigh muscle area was increased, as was stair-climbing power, gait velocity, and level of spontaneous activity. Increasing endurance and strength in the elderly contributes to their ability to live independently.
The saddest part of the story is how quickly training gains are lost during periods without regular (meaning 3+ days/wk) strenuous activity. There is measurable decline in cardio functioning and muscle strength in weeks, and training gains can be lost in a few months. Use it or lose it. That is just how it is after age 30 or 35.
Physical fitness, like mental fitness, is a life-style choice.
In Western civilization, self-exposure is often a daunting process. I mean physical as well as psychological exposure. Self-exposure requires courage and trust, but fortunately it is rarely called-for.
In public, we cover ourselves up literally and metaphorically. We put our best foot forward, if sober. The only real exception is at the beach where everybody wears highly-exposing underwear and our flaws are out there for all the world to see.
My topic is shame, whether about our physical or our psychological beings. Most of the time, shame is not neurotic but a healthy human response to exposure of our flaws, imperfections, and general instinct for privacy. We all have all sorts of dirty laundry. We are all on some spectrum between shame-paralyzed and shameless. The extremes are problems.
What sorts of things are often on many peoples' shame/privacy lists?
Physical self must be exposed sometimes: physical exams, weight, strength, physique, dentist(!), beach, sexual encounters, excretory fuinctions
Psychological exposure: Our private thoughts, fears, fantasies, mental flaws and weaknesses. Sometimes we will cautiously expose these to close friends or to shrinks.
Other personal attributes: Money, personal habits and home, rotten behavior, political views, failures, public performances, job status, childrens' difficulties, etc.
Intimacy means showing aspects of our unadorned selves to somebody else. It is not something to be done lightly because our private selves are not necessarily appealing to others (note the expression "TMI").We know that better than anybody, hence shame.
Caveat: Sociopaths are quite good at faux intimacy for purposes of ingratiation and manipulation.
Mitochondria are complex little buggers which live in our cells almost like little bacteria. They are the cell's, and thus the body's, power source (they burn sugar and only sugar but, only if necessary, the body will convert body fat or body protein into sugar for them to burn). They have their own DNA which is separate from your personal DNA.
"mtDNA" is only inherited from the mother, which is why we know that all living humans are descendants of one woman, Mitochondrial Eve. That is quite remarkable.
In recent years, the identification and understanding of Mitochondrial Diseases has been progressing. Most of these diseases are disabling or fatal: What is Mitochondrial Disease?
Unless you give yourself 4 or more hours in the gym daily like an anorectic, no. For practical purposes, it is of no use for that.
All exercise which fatigues and stresses the body is good for mental health, fitness, and vitality, and it probably slightly raises calorie-burning and is better than sitting, but exercise alone can never help you lose 10 lbs of belly lard. It's wishful thinking.
Distance running, like any extended-time cardio (eg swimming, elliptical, rowing, bike, etc), procures no health or fitness benefits. Worse, distance running damages the body, often permanently.
If you must use running for the cardio component of a fitness program, two to four quarter-mile or even half-mile sprints per week is plenty. Treadmill sprints are kinder on the joints than a road. The comparable anaerobic sprint approach applies to any cardio exercises. For cardio, it is the spurts of max. intensity that matter, not time wasted.
(I am reminded to add that, for those over 75 or 80, aerobic cardio is great and much better than sitting.)
The best-organized and rational program I have seen is the New Atkins.
If you want to look good, have maximum vigor, and save your joints, back, and heart, it's a good tough program which will shrink your belly, your stomach, and your appetite.
Once you reach your target, the plan focuses on maintenance. Not easy in a world of temptation.
They are physiologically correct in general, and especially in noting the trivial effect of exercise on fat loss. Exercise is for strength and vitality for white-collar and otherwise sedentary people, but not for fat loss. Lose fat, exercise better, get stronger, feel better, and fight aging.
Medically, each pound of spare adipose tissue over-stresses your heart, and your knees and hips. Not good. Also, strong and thin is good for sex.
If you just don't care, that's fine too. It's a free country. Very few have the self-discipline needed to do hard things persistently and obviously many people do not care very much about how they look or feel.
I have no problem with overweight people. I just assume that other things are more important to them than physical fitness, and they are right about that. It is not for everybody.
It's not really new news, but getting fat at some point in life does seem to alter some physiologic processes for the long term. It seems to retrain the body for a high-caloric life, for a fat life; resets some homeostatic buttons including altering or almost eliminating satiety signals for some period of time.
Despite the interesting physiology, I feel the article overstates the thesis and minimizes the role of human agency, human choice. Resisting temptation, calculating consequences, etc. is what makes us different from other animals. For those who have been heavy at some point in life, though, that is more challenging. Mind over matter.
Moral of the story: Don't "let yourself go" because you may live to regret it.
I think of it as physician-eased dying, and I see no important moral issues in the topic at all. Anesthesia and analgesia are among the handful of categories of mercies which modern medicine has to offer and to deny the comfort these tools can offer terminal patients seems sadistic and immoral to me.
I read this short piece, Death and the Psychiatrist, and do not feel that it was worth publishing (or linking, except as an example of a weak essay). Of course, I saw plenty of dying during my medical training. There are many ways to die, but the worst one is to die in agony and terror. Nobody needs that.
It seems common enough these days to see terminally-ill patients tortured by heroic medical efforts. I hate to hear about this. Physicians, of all people, should know when to let go even if families do not. Hope is not a plan.
When your 104-lb body is packed with cancer and wracked with pain, would you chose one more round of chemotherapy, or hospice care where you would be gently eased out of it all, floating on a sea of morphine?
There's a belief gaining popularity that when patients seem to be nearing death's door, doctors should back off from aggressive medical care and let them die in peace. Providing "heroic" care has become a negative, and many doctors are stepping back from it. According to a 2011 study,[1] 42% of primary care physicians believed they were overtreating patients.
And yet some patients—even when debilitated by metastatic cancer, brain injury, or old age—still want to keep on fighting. They don't want the doctor to give up on them, and there are many documented cases when that extra boost has saved their lives.
But for how long, and with how much medical misery?
It's a complex dilemma, but the Brits figured it out. Offering opiates for patients with severe pain. it seems to me, is more worthwhile than worrying about the few who become serious addicts.
No surprise there. When government pays for something, there are usually political angles to it. The only consolation is that nobody but a nitwit would follow government guidelines for anything more than income tax forms. If you can understand them.
Mitochondria are complex little buggers which live in our cells almost like little bacteria. They are the cell's, and thus the body's, power source (they burn sugar and only sugar but, only if necessary, the body will convert body fat or body protein into sugar for them to burn). They have their own DNA which is separate from your personal DNA.
The best-organized and rational program I have seen is 
It's not really new news, but getting fat at some point in life does seem to alter some physiologic processes for the long term. It seems to retrain the body for a high-caloric life, for a fat life; resets some homeostatic buttons including altering or almost eliminating satiety signals for some period of time.