Outlive – by Dr. Peter Attia
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We know, we know; this diet, that exercise, don’t smoke or drink, get decent sleep”—a lot of books don’t go beyond this level of advice!
What Dr. Attia offers is a multi-vector approach that covers the above and a lot more.
Themes of the book include:
- The above-mentioned things, of course
- Rethinking medicine for the age of chronic disease
- The pros and cons of…
- caloric restriction
- dietary restriction
- intermittent fasting
- Pre-emptive interventions for…
- specific common cause-of-death conditions
- specific common age-related degenerative conditions
- The oft-forgotten extra pillar of longevity: mental health
The last one in the list there is covered mostly in the last chapter of the book, but it’s there as a matter of importance, not as an afterthought. As Dr. Attia puts it, not only are you less likely to take care of your physical health if you are (for example) depressed, but also… “Longevity is meaningless if your life sucks!”
So, it’s important to do things that promote and maintain good physical and mental health.
Bottom line: if you’re interested in happy, healthy, longevity, this is a book for you.
Click here to check out Dr. Attia’s “Outlive” on Amazon today!
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How to Eat to Change How You Drink – by Dr. Brooke Scheller
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Whether you want to stop drinking or just cut down, this book can help. But what makes it different from the other reduce/stop drinking books we’ve reviewed?
Mostly, it’s about nutrition. This book focuses on the way that alcohol changes our relationship to food, our gut, our blood sugars, and more. The author also explains how reducing/stopping drinking, without bearing these things in mind, can be unnecessarily extra hard.
The remedy? To bear them in mind, of course, but that requires knowing them. So what she does is explain the physiology of what’s going on in terms of each of the above things (and more), and how to adjust your diet to make up for what alcohol has been doing to you, so that you can reduce/quit without feeling constantly terrible.
The style is very pop-science, light in tone, readable. She makes reference to a lot of hard science, but doesn’t discuss it in more depth than is necessary to convey the useful information. So, this is a practical book, aimed at all people who want to reduce/quit drinking.
Bottom line: if you feel like it’s hard to drink less because it feels like something is missing, it’s probably because indeed something is missing, and this book can help you bridge that gap!
Click here to check out How To Eat To Change How You Drink, and do just that!
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How To Gain Weight (Healthily!)
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What Do You Have To Gain?
We have previously promised a three-part series about changing one’s weight:
- Losing weight (specifically, losing fat)
- Gaining weight (specifically, gaining muscle)
- Gaining weight (specifically, gaining fat)
There will be, however, no need for a “losing muscle” article, because (even though sometimes a person might have some reason to want to do this), it’s really just a case of “those things we said for gaining muscle? Don’t do those and the muscle will atrophy naturally”.
Here’s our first article: How To Lose Weight (Healthily!)
While some people will want to lose fat, please do be aware that the association between weight loss and good health is not nearly so strong as the weight loss industry would have you believe:
And, while BMI is not a useful measure of health in general, it’s worth noting that over the age of 65, a BMI of 27 (which is in the high end of “overweight”, without being obese) is associated with the lowest all-cause mortality:
BMI and all-cause mortality in older adults: a meta-analysis
Here was our second article: How To Build Muscle (Healthily!)
And now, it’s time for the last part, which yes, is also something that some people want/need to do (healthily!), and want/need help with that.
How to gain fat, healthily
Fat gets a bad press, but when it comes to health, we would die without it.
Even in the case of having excess fat, the fat itself is not generally the problem, so much as comorbid metabolic issues that are often caused by the same things as the excess fat.
So, how to gain fat healthily?
- Obvious but potentially dangerously misleading answer: “in moderation”
- More useful answer: “carefully”
Because, you can “in moderation” put on less than one pound per week for a few years and be in very bad health by the end of it. So how does this “carefully” work any differently to “in moderation”?
The key is in how we store the fat
Not merely where we store it (though that’ll follow from the “how”), but specifically: how we store it.
- When we consume energy from food in excess of our immediate survival needs, our body stores what it can. This is good!
- When our body is receiving energy from food faster than it can physically process it to store it healthily, it will start shoving it wherever it can instead. This is bad!
This is the physiological equivalent of the difference between tidying a room carefully, and cramming everything into one cupboard in 30 seconds just to get it out of sight.
So, you do need to consume calories yes, but you need to consume them in a way your body can take its time about storing them.
We’ve written before about the science of this, so we’ll share some links to that in a moment, but first, here are the practical tips:
- Do not drink your calories. Drinking calories tends to be the equivalent of injecting sugars directly into your veins, in terms of how quickly it gets received.
- See also: How To Unfatty A Fatty Liver ← this is highly relevant, because the same process that results in unhealthy weight gain, results in liver disease, by the same mechanism (the liver gets overwhelmed).
- Eat your greens. No, they won’t provide many calories, but they are critical to your body not being overwhelmed by the arrival of sugars.
- See also: 10 Ways To Balance Blood Sugars ← the other 9 things are also helpful for not putting on fat unhealthily, so using these alongside a calorie-dense diet can result in healthy fat gain as needed
- Get more of your calories from fats than carbs. Fats will not overwhelm your body’s glycemic response in the same way that carbs will.
- Again this is about getting calories while not getting metabolic disease. See also: How To Prevent And Reverse Type Two Diabetes as the advice is the same for that, for the same reason!
- Consider going low-carb, but even if you choose not to, go for carbs with a low glycemic index instead of a high glycemic index.
- For reference, see: Glycemic Index Chart: Glycemic index and glycemic load ratings for 500+ foods
- Need healthy fats in a snack? Enjoy nuts (unless you have an allergy); they will be your best friend in this regard. As an example, a mere 1oz portion of cashew nuts has 157 calories.
- See also: Why You Should Diversify Your Nuts
- Need health fats for cooking? Enjoy olive oil, as it has one of the healthiest lipids profiles available, and is a great way to increase the calorific content of many meals.
Lastly…
Be patient, enjoy your food, and stick as best you can to the above considerations. All strength to you.
Take care!
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What Grief Does To Your Body (And How To Manage It)
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What Grief Does To The Body (And How To Manage It)
In life, we will almost all lose loved ones and suffer bereavement. For most people, this starts with grandparents, eventually moves to parents, and then people our own generation; partners, siblings, close friends. And of course, sometimes and perhaps most devastatingly, we can lose people younger than ourselves.
For something that almost everyone suffers, there is often very little in the way of preparation given beforehand, and afterwards, a condolences card is nice but can’t do a lot for our mental health.
And with mental health, our physical health can go too, if we very understandably neglect it at such a time.
So, how to survive devastating loss, and come out the other side, hopefully thriving? It seems like a tall order indeed.
First, the foundations:
You’re probably familiar with the stages of grief. In their most commonly-presented form, they are:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
You’ve probably also heard/read that we won’t always go through them in order, and also that grief is deeply personal and proceeds on its own timescale.
It is generally considered healthy to go through them.
What do they look like?
Naturally this can vary a lot from person to person, but examples in the case of bereavement could be:
- Denial: “This surely has not really happened; I’ll carry on as though it hasn’t”
- Anger: “Why didn’t I do xyz differently while I had the chance?!”
- Bargaining: “I will do such-and-such in their honor, and this will be a way of expressing the love I wish I could give them in a way they could receive”
- Depression: “What is the point of me without them? The sooner I join them, the better.”
- Acceptance: “I was so lucky that we had the time together that we did, and enriched each other’s lives while we could”
We can speedrun these or we can get stuck on one for years. We can bounce back and forth. We can think we’re at acceptance, and then a previous stage will hit us like a tonne of bricks.
What if we don’t?
Assuming that our lost loved one was indeed a loved one (as opposed to someone we are merely societally expected to mourn), then failing to process that grief will tend to have a big impact on our life—and health. These health problems can include:
As you can see, three out of five of those can result in death. The other two aren’t great either. So why isn’t this taken more seriously as a matter of health?
Death is, ironically, considered something we “just have to live with”.
But how?
Coping strategies
You’ll note that most of the stages of grief are not enjoyable per se. For this reason, it’s common to try to avoid them—hence denial usually being first.
But, that is like not getting a lump checked out because you don’t want a cancer diagnosis. The emotional reasoning is understandable, but it’s ultimately self-destructive.
First, have a plan. If a death is foreseen, you can even work out this plan together.
But even if that time has now passed, it’s “better late than never” to make a plan for looking after yourself, e.g:
- How you will try to get enough sleep (tricky, but sincerely try)
- How you will remember to eat (and ideally, healthily)
- How you will still get exercise (a walk in the park is fine; see some greenery and get some sunlight)
- How you will avoid self-destructive urges (from indirect, e.g. drinking, to direct, e.g. suicidality)
- How you will keep up with the other things important in your life (work, friends, family)
- How you will actively work to process your grief (e.g. journaling, or perhaps grief counselling)
Some previous articles of ours that may help:
- How To Keep On Keeping On ← this is about looking after general health when motivation is low
- The Mental Health First-Aid You’ll Hopefully Never Need ← this is about managing depression
- How To Stay Alive (When You Really Don’t Want To) ← this is about managing suicidality
If it works, it works
If we are all unique, then any relationship between any two people is uniqueness squared. Little wonder, then, that our grief may be unique too. And it can be complicated further:
- Sometimes we had a complicated relationship with someone
- Sometimes the circumstances of their death were complicated
There is, for that matter, such a thing as “complicated grief”:
Read more: Complicated grief and prolonged grief disorder (Medical News Today)
We also previously reviewed a book on “ambiguous loss”, exploring grieving when we cannot grieve in the normal way because someone is gone and/but/maybe not gone.
For example, if someone is in a long-term coma from which they may never recover, or if they are missing-presumed-dead. Those kinds of situations are complicated too.
Unusual circumstances may call for unusual coping strategies, so how can we discern what is healthy and what isn’t?
The litmus test is: is it enabling you to continue going about your life in a way that allows you to fulfil your internal personal aspirations and external social responsibilities? If so, it’s probably healthy.
Look after yourself. And if you can, tell your loved ones you love them today.
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The Insider’s Guide To Making Hospital As Comfortable As Possible
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Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
This is Dr. Chris Bonney. He’s an anesthesiologist. If you have a surgery, he wants you to go in feeling calm, and make a quick recovery afterwards, with minimal suffering in between.
Being a patient in a hospital is a bit like being a passenger in an airplane:
- Almost nobody enjoys the thing itself, but we very much want to get to the other side of the experience.
- We have limited freedoms and comforts, and small things can make a big difference between misery and tolerability.
- There are professionals present to look after us, but they are busy and have a lot of other people to tend to too.
So why is it that there are so many resources available full of “tips for travelers” and so few “tips for hospital patients”?
Especially given the relative risks of each, and likelihood, or even near-certainty of coming to at least some harm… One would think “tips for patients” would be more in demand!
Tips for surgery patients, from an insider expert
First, he advises us: empower yourself.
Empowering yourself in this context means:
- Relax—doctors really want you to feel better, quickly. They’re on your side.
- Research—knowledge is power, so research the procedure (and its risks!). Dr. Bonney, himself an anesthesiologist, particularly recommends you learn what specific anesthetic will be used (there are many, and they’re all a bit different!), and what effects (and/or after-effects) that may have.
- Reframe—you’re not just a patient; you’re a customer/client. Many people suffer from MDeity syndrome, and view doctors as authority figures, rather than what they are: service providers.
- Request—if something would make you feel better, ask for it. If it’s information, they will be not only obliged, but also enthusiastic, to give it. If it’s something else, they’ll oblige if they can, and the worst case scenario is something won’t be possible, but you won’t know if you don’t ask.
Next up, help them to help you
There are various ways you can be a useful member of your own care team:
- Go into surgery as healthy as you can. If there’s ever a time to get a little fitter, eat a little healthier, prioritize good quality sleep more, the time approaching your surgery is the time to do this.
- This will help to minimize complications and maximize recovery.
- Take with you any meds you’re taking, or at least have an up-to-date list of what you’re taking. Dr. Bonney has very many times had patients tell him such things as “Well, let me see. I have two little pink ones and a little white one…” and when asked what they’re for they tell him “I have no idea, you’d need to ask my doctor”.
- Help them to help you; have your meds with you, or at least a comprehensive list (including: medication name, dosage, frequency, any special instructions)
- Don’t stop taking your meds unless told to do so. Many people have heard that one should stop taking meds before a surgery, and sometimes that’s true, but often it isn’t. Keep taking them, unless told otherwise.
- If unsure, ask your surgical team in advance (not your own doctor, who will not be as familiar with what will or won’t interfere with a surgery).
Do any preparatory organization well in advance
Consider the following:
- What do you need to take with you? Medications, clothes, toiletries, phone charger, entertainment, headphones, paperwork, cash for the vending machine?
- Will the surgeons need to shave anywhere, and if so, might you prefer doing some other form of depilation (e.g. waxing etc) yourself in advance?
- Is your list of medications ready?
- Who will take you to the hospital and who will bring you back?
- Who will stay with you for the first 24 hours after you’re sent home?
- Is someone available to look after your kids/pets/plants etc?
Be aware of how you do (and don’t) need to fast before surgery
The American Society of Anesthesiologists gives the following fasting guidelines:
- Non-food liquids: fast for at least 2 hours before surgery
- Food liquids or light snacks: fast for at least 6 hours before surgery
- Fried foods, fatty foods, meat: fast for at least 8 hours before surgery
(see the above link for more details)
Dr. Bonney notes that many times he’s had patients who’ve had the worst thirst, or caffeine headache, because of abstaining unnecessarily for the day of the surgery.
Unless told otherwise by your surgical team, you can have black coffee/tea up until two hours before your surgery, and you can and should have water up until two hours before surgery.
Hydration is good for you and you will feel the difference!
Want to know more?
Dr. Bonney has his own website and blog, where he offers lots of advice, including for specific conditions and specific surgeries, with advice for before/during/after your hospital stay.
He also has a book with many more tips like those we shared today:
Calm For Surgery: Supertips For A Smooth Recovery
Take good care of yourself!
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The Sun Exposure Dilemma
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The Sun Exposure Dilemma
Yesterday, we asked you about your policy on sun exposure, and got the above-pictured, below-described, set of answers:
- A little over a third of respondents chose “I recognize the risks, but I think the benefits outweigh them”
- A quarter of respondents chose “I am a creature of the shadows and I avoid the sun at all costs”
- A little over a fifth of respondents chose “I recognize the benefits, but I think the risks outweigh them”
- A little under a fifth of respondents chose “I’m a sun-lover! Give me that vitamin D and other benefits!”
All in all, this is perhaps the most even spread of answers we’ve had for Friday mythbuster polls—though the sample size was smaller than it often is.
Of those who added comments, common themes were to mention your local climate, and the importance of sunscreen and/or taking vitamin D supplements.
One subscriber mentioned having lupus and living in Florida, which is a particularly unfortunate combination:
Lupus Foundation | Lupus & UV exposure: What you need to know
Another subscriber wrote:
❝Use a very good sunscreen with a high SPF all the time. Reapply after swimming or as needed! I also wear polarized sunglasses anytime I’m outside.❞
…which are important things to note too, and a lot of people forget!
See also: Who Screens The Sunscreens? (on fearing chemical dangers, vs the protection given)
But, onto today’s science for the topic at hand…
We need to get plenty of sun to get plenty of vitamin D: True or False?
True or False, depending on so many factors—to the point that many people get it wildly wrong in either direction.
Whether we are getting enough vitamin D depends on many circumstances, including:
- The climate (and depending on latitude, time of year) where we live
- Our genes, and especially (but not only) our skintone
- The clothes we wear (or don’t)
- Our diet (and not just “how much vitamin D do we consume”)
- Chronic diseases that affect vitamin D metabolism and/or requirements and/or sensitivity to the sun
For a rundown on these factors and more, check out:
Should I be getting my vitamin D levels checked?
Notably, on the topic of whether you should stay in the sun for longer to get more vitamin D…
❝The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed (which could be just a few minutes, in a sunny climate) is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.❞
In contrast, she does also note:
❝During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D.❞
See also: Vitamin D & Calcium: Too Much Of A Good Thing?
We can skip the sun and get our vitamin D from diet/supplements: True or False?
True! However, vitamin D is not the only health benefit of sun exposure.
Not only is sunlight-induced serotonin production important for many things ranging from mood to circadian rhythm (which in turn affects many other aspects of health), but also…
While too much sun can cause skin cancer, too little sun could cause other kinds of cancer:
Benefits of Sunlight: A Bright Spot for Human Health
Additionally, according to new research, the circadian rhythm benefits we mentioned above may also have an impact on type 2 diabetes:
Can catching some rays help you fight off type 2 diabetes?
Which way to jump?
A lot of it depends on who you are, ranging from the factors we mentioned earlier, to even such things as “having many moles” or “having blonde hair”.
This latter item, blonde hair, is a dual thing: it’s a matter of genetic factors that align with being prone to being more sensitive to the sun, as well as being a lesser physical barrier to the sun’s rays than dark hair (that can block some UV rays).
So for example, if two people have comparably gray hair now, but one of them used to have dark hair and the other blonde, there will still be a difference in how they suffer damage, or don’t—and yes, even if their skin is visually of the same approximate skintone.
You probably already know for yourself whether you are more likely to burn or tan in the sun, and the former group are less resistant to the sun’s damage… But the latter group are more likely to spend longer in the sun, and accumulate more damage that way.
If you’d like a very comprehensive downloadable, here are the guidelines issued by the UK’s National Institute for Health and Care Excellence:
NICE Guidelines | Sunlight exposure: risks and benefits
…and skip to “At risk groups”, if you don’t want to read the whole thing; “Skin type” is also an important subsection, which also uses your hair and eye color as indicators.
Writer’s note: genetics are complicated and not everyone will fall neatly into categories, which is why it’s important to know the individual factors.
For example, I am quite light-skinned with slightly graying dark hair and gray-blue eyes, and/but also have an obscure Sámi gene that means my skin makes vitamin D easily, while simultaneously being unusually resistant to burning (I just tan). Basically: built for the midnight sun of the Arctic circle.
And yet! My hobbies include not getting skin cancer, so I tend to still be quite mindful of UV levels in different weathers and times of day, and make choices (schedule, clothing, sunscreen or not) accordingly.
Bottom line:
That big self-perpetuating nuclear explosion in the sky is responsible for many things, good and bad for our health, so be aware of your own risk factors, especially for vitamin D deficiency, and skin cancer.
- If you have a predisposition to both, that’s unfortunate, but diet and supplementation at least can help with the vitamin D while getting modest amounts of sun at most.
- Remember that you can only make so much vitamin D at once, so sunbathing for health benefits need only take a few minutes
- Remember that sunlight is important for our circadian rhythm, which is important for many things.
- That’s governed by specific photoreceptor cells, though, so we don’t need our skin to be exposed for that; we just need to be able to see sunlight.
- If you’re going to be out in the sun, and not covered up, sunscreen is your friend, and yes, that goes for clear cold days under the winter sun too.
- Most phone weather apps these days have a UV index score as part of the data they give. Get used to checking it as often as you’d check for rain.
Stay safe, both ways around!
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Laugh Often, To Laugh Longest!
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Putting The Abs Into Absurdity
We’ve talked before about the health benefits of a broadly positive outlook on life:
Optimism Seriously Increases Longevity!
…and we’re very serious about it, but that’s about optimistic life views in general, and today we’re about not just keeping good humor in questionable circumstances, but actively finding good humor in the those moments—even when the moments in question might not be generally described as good!
After all, laughter really can be the best medicine, for example:
From the roots
First a quick recap on de-toothing the psychological aspect of threats, no matter how menacing they may be:
Hello, Emotions: Time For Radical Acceptance!
…which we can then take a step further:
What’s The Worst That Could Happen?
Choose your frame
Do you remember when that hacker hacked and publicized the US Federal no-fly list, after already hacking a nationwide cloud-based security camera company, getting access to more than 150,000 companies’ and private individuals’ security cameras, amongst various other cyber crimes, mostly various kinds of fraud and data theft?
Imagine how she (age 21) must have felt, when being indicted. What do you suppose this hacker had to say for itself under such circumstances?
❝congress is investigating now 🙂
but i stay silly :3 ❞
…the latter half of which, usually rendered “but I stay silly” or “but we stay silly” has since entered popular Gen-Z parlance, usually after expressing some negative thing, often in a state of powerlessness.
Which is an important life skill if powerlessness is something that is often likely.
It’s important for many Gen-Zs with negligible life prospects economically; it’s equally important for 60-somethings getting cancer diagnoses (statistically the most likely decade to find out one has cancer, by the way), and many other kinds of people younger, older, and in between.
Because at the end of the day, we all start powerless and we all end powerless.
Learned helplessness (two kinds)
In psychology, “learned helplessness” occurs when a person or creature gives up after learning that all and any attempts to resist a Bad Thing™ fail, perhaps even badly. A lab rat may just shut down and sit there getting electroshocked, for example. A person subjected to abuse may stop trying to improve their situation, and just go with the path of least resistance.
But, there’s another kind, wherein someone in a position of absolute powerlessness not only makes their peace with that, but also, decides that the one thing the outside world can’t control, is how they take it. Like the hacker we mentioned earlier.
Sometimes the gallows humor is even more literal, laughing at one’s own impending death. Not as a matter of bravado, but genuinely seeing the funny side.
But how?
Unfortunately, fortunately
The trick here is to “find a silver lining” that is nowhere near enough to compensate for the bad thing—and it may even be worse! But that’s fine:
“Unfortunately, I didn’t have time to do the dishes before leaving for my vacation. Fortunately, I also forgot to turn the oven off, so the house burning down covered up my messy kitchen”
Writer’s personal less drastic example: today I set my espresso machine to press me an espresso; it doesn’t have an auto-off and I got distracted and it overflowed everywhere; my immediate reaction was “Oh! I have been blessed with an abundance of coffee!”
This kind of silly little thing, on a daily basis, builds a very solid habit for life that allows one to see the funny side in even the most absurd situations, even matters of life and death (can confirm: been there enough times personally—so far so good, still alive to find the remembered absurdity silly).
The point is not to genuinely value the “silver lining”, because half the time it isn’t even one, really, and it is useless to pretend, in seriousness.
But to pretend in silliness? Now we’re onto something, and the real benefit is in the laughs we had along the way.
Because those worst moments? Are probably when we need it the most, so it’s good to get some practice in!
Want more ways to find the funny and make it a life habit?
We reviewed a good book recently:
The Humor Habit: Rewire Your Brain To Stress Less, Laugh More, And Achieve More’er – by Paul Osincup
Stay silly!
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