Just traffic fatalities

Unlike chronic diseases such as cancer and cardiovascular disease, the “cure” for traffic fatalities will depend more on technology and policy than on medicine and health science. On the plus side, we as a society already have pretty clear evidence of effective strategies for improving the problem – e.g., stricter speed limit enforcement, restrictions on commercial and residential building along arterial roads, and mandates for safety features such as automatic emergency braking. On the minus side, we as individuals are very limited in our power to enact those strategies.

~ Peter Attia from, https://peterattiamd.com/the-epidemic-on-the-road/

The article is about traffic fatalities in the context of the COVID pandemic. I’m focusing simply on the fact that more than 40,000 people died in 2021 in traffic fatalities. Sure there are lots of causes, but you know what the single most easily implemented change is? Of course you do. Slow down. Me? You’ll find me doing about 5-over-the-limit on the highway (so people don’t literally shoot me) and usually a little below-the limit otherwise. Often with the cruise control set. How about you?

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I’m not being hyperbolic

Why is it so difficult to make choices that we know will be best for us in the long run?

~ Peter Attia from, https://peterattiamd.com/hyperbolic-discounting-friend-and-foe-of-goal-achievement/

Sorry for the titular word play. This should be read foremost to understand exponential versus hyperbolic decay, and then to understand how to get your future self to do what your current self wishes. Attia explains it in the context of imagining future rewards. It turns out that using one (to assess the value of future rewards) makes actual sense, and the other turns out to be how our brains work (because: survival drove evolution).

Snoring? No really, go read it. Because if you understand the two methods you can hack yourself by setting up your goals to play into your mind’s predilection to make the wrong value calculation. In effect, rather than set things up the way that makes sense which frequently leads to failure thanks to our brains, we set things up in a more complicated way to fake ourselves into getting where we want to go.

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Guilt and efficacy

Accepting that “accidents happen” requires an acceptance of limitations to the control we have over our own lives. The philosopher Bernard Williams describes the hazy area between intention and outcome, where factors outside of one’s control can influence the course of events and our reactions to them: “anything that is the product of the will is surrounded and held up and partly formed by things that are not.” This thought may be unsettling, but constitutes the first step in letting go of guilt and moving forward along the path of healing, both for those who have caused unintentional harm and for any who are struggling with trauma.

~ Peter Attia from, https://peterattiamd.com/how-do-you-move-forward-after-making-a-fatal-mistake/

I am lucky in that I do not have any self-assigned guilt of the magnitude Attia is describing in this article. (I was pleasantly surprised by this article, it being different than his usual hard medical science.) But I do have a life-crushing pile of self-assigned, paper-cut-sized guilt for countless things I see in hindsight that I could have done better: Why didn’t I learn some particular lesson sooner? How did I not see that situation as it was developing? What if I had let go of that thing sooner? Perhaps you have occasion to ask similar questions.

I’ve verified that there’s nothing I can do to change the past. (Perhaps you’ve also.) But I have learned to tack faster: I flippantly made a silly tall joke—”how’s the weather up there?”—to a very tall friend as we passed at a busy event. As the day, and the next day, wore on I realized I was repeatedly thinking that had been inappropriate. The next time I saw him, I told him so, “dude, my joke was inappropriate and I apologize.” Radical honesty, as it’s sometimes called.

And for the things which end up one way, for reasons beyond my control, I deploy one, two, or all three of: 50,000 years from now, what difference will it make? Did I do everything within my power, (aka the dichotomy of control.) Memento mori.

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Ya don’t say!

Another factor to consider is that this was a study in “lean” adults, and it is possible that results would be different if the investigators included people who actually need to lose weight.

~ Peter Attia from, https://peterattiamd.com/is-alternate-day-fasting-superior-to-calorie-restriction-for-fat-loss-in-lean-adults/

Some times I read stuff that is really disappointing. (This is one such case, don’t bother clicking through.) Attia’s content is almost entirely really good… no idea what happened here.

My BMI is currently above 33. Say what you will about BMI—but, please don’t, I know what you’re considering telling me—but I am over-weight. I should drop 20 pounds. Then drop another 20 pounds… and guess what. I still wouldn’t be down to a BMI where they’d let me into the study Attia was writing about. What— why would you do a weight-loss study on people whose weight is, (according to BMI,) normal?? Face palm.

Here’s what I know about alternate day fasting: It really works if you are fat, (like me.) Presuming your body can metabolize fat—caution, the average western diet down-regulates that ability to near zero… But presuming your body can metabolize fat, a day of not eating is pleasant. I’m serious. And then the second morning, 40+ hours of not eating, I’m actually hungry. Meanwhile, my body just used up thousands of calories of fat. Then I simply go back to eating. Anyway. That’s my experience.

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No no no no no

The power of saying no is not a new concept. In addition to Ric Elias, Jason Fried and Ryan Holiday have also spoken eloquently about it on the podcast. Most of us struggle with saying no. Saying no is simple, but it’s not easy. 

~ Pete Attia from, https://peterattiamd.com/the-power-of-no/

Over-Accepters Anonymous should be a thing. I would totally attend those meetings. …wait, did I just say yes to a hypothetical commitment? …omg I really do need OAA meetings!

The first phase of getting myself under control was to learn to say the easier no’s. Those were the things that I didn’t actually want to do or accept, but which I used to say yes to out of habit or from a sense of obligation. I’m not perfect with that yet, but I’m getting close. (Go ahead, ask me to commit to something.)

But the second phase is far harder. (Who said, “the first 90% of a project is far easier than the second 90%?“) It’s difficult to say no to things I would in fact like to do! Curiously, years ago I made flossing twice a day into a habit—I know, right? Flossing is supposed to be really hard to make a habit, but some how I pulled it off. Meanwhile, I still say yes to far too many things that I want to do.

Yes! …another blog post written.

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How to die sooner and get Alzheimer’s

Sleep is primarily seen as a neurological phenomenon, and yet when deprived creatures die, they have a puzzlingly diverse set of failures in the body outside the nervous system. Insufficient sleep in humans and lab animals, if chronic, sets up health problems that surface over time, such as heart disease, high blood pressure, obesity and diabetes. But those conditions are not what slays creatures that are 100% sleep deprived within days or weeks.

~ Corey Brickley from, https://www.quantamagazine.org/why-sleep-deprivation-kills-20200604/

I’ve said it many times here, and I will keep saying it: Sleep is the single most important thing. In your life. Literally. If you are not sleeping well, and long—like, 8 hours per night, long—you have a serious health issue; not sleeping well, and sufficiently is a serious health issue.

Listen to this podcast, Matthew Walker, Ph.D., on sleep – Part I of III: Dangers of poor sleep, Alzheimer’s risk, mental health, memory consolidation, and more.

Yes, insufficient sleep—not, “I don’t feel sleepy,” but not getting sufficient sleep—if you don’t feel sleepy… if you are not sleeping 8 hours… you have other problems which are affecting your sleep. Insufficient sleep has direct causal relation to Alzheimer’s. Scared enough to fix your sleep yet?

Listen to the podcast, then buy the book, Sleep Smarter. It’s an easy introduction to how to fix your sleep. Or, don’t sleep well, die sooner and get Alzheimer’s; it’s your choice.

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Warburg’s finding

In 1924 a scientist named Otto Warburg happened upon a counterintuitive finding. Cancer cells, even in the presence of sufficient oxygen, underwent a type of metabolism cells reserved for rapid energy demand – anaerobic metabolism. In fact, even when cancer cells were given additional oxygen, they still almost uniformly defaulted into using only glucose to make ATP via the anaerobic pathway. This is counterintuitive because this way of making ATP is typically a last resort for cells, not a default, due to the very poor yield of ATP.

~ Peter Attia, from https://peterattiamd.com/way-exploit-metabolic-quirk-cancer/

This is a simple introduction to the two methods our cells can use to get the energy they need to do everything; One way is efficient and one is not. It’s critical that our cells can switch between the two methods as circumstances change. The curious discovery made by Warburg is that cancer cells always use the inefficient method.

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Causality

Most obesity “experts” assume (erroneously) that the big equal sign between the blue and red terms implies a direction of causality.  In other words, they assume that an increase in fat mass (the blue side gets bigger), was CAUSED by the red number being bigger than the green number.

~ Peter Attia, from https://peterattiamd.com/revisit-the-causality-of-obesity/

Yes, physics always works. Yes, the First Law of Thermodynamics is always true. Yes, “calories in” always equals “calories out”. But that does not explain why we get fat. The equals-sign in the calories-in equals calories-out does not tell you anything about causality.

As with every single thing Peter Attia writes, you should go read this. Twice.

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Type 2 diabetes

The traditional approach—which is clearly not working—is to “manage” this chronic condition with medications and the ever-ubiquitous “eat-less-avoid-fat-exercise-more” lifestyle interventions. At best, this approach only slows down the progression of the disease.

~ Peter Attia from, https://peterattiamd.com/type-2-diabetes-reversible-scale/

Often the things I’m commenting on are “close to the ground” — things that are immediately actionable, or suggestions of things to go explore or do directly.

This one is different. Peter Attia sits in a certain niche — if you know of him, you are nodding knowingly — but this particular article is a neat attempt to zoom way out to think about wether the more “on the ground” sort of “do this”, “do that” personal direction is inherently scalable out to population-wide solutions to problems.

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Ketosis

To test the relationship between exercise and ketosis I decided to examine my blood levels of glucose, B-OHB, and lactate immediately before and after three different types of workouts on three successive days. This interplay is complex and no one knows “everything” about it, including the world’s experts (which I am not pretending to be). I’m going to try to balance a fine line in this post – I want to be rigorous enough to explore the ideas with substance but not too detailed to put you to sleep. I hope I am able to balance these forces adequately.

~ Peter Attia from, https://peterattiamd.com/the-interplay-of-exercise-and-ketosis-part-i/

The more I read about the human body, the more fascinated I become. One of the big dietary changes I started long ago was to just “try to eat fewer refined carbohydrates.” Less cookies, breakfast cereal, that sort of thing. And then I spun off into intermittent fasting and ketosis and on and on.

But this guy, he’s gone way WAY farther down the rabbit hole. This article is a superlative dissection of ketosis, fuels (carbohydrate, protein, fat), wattage, workouts and … well, the best part is after all of it, there’s no strong conclusion. It’s just this wonderful exploration of how one person’s body performed under a bunch of circumstances.

Anyway. File this one under: Human body = amazing.

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