A Journey of Mindfulness--the Remaking of Life in Midstream.

[IlliniDave]

2024 January Review.

I'm still not completely caught up with my financials. The stash was flat for January, up by 0.1% or so. Spending was okay although I probably got all the way up to and likely exceeded my annuity income level due to needing a crown replaced too soon after it was originally fitted for insurance to cover.

I'm having a lot of fun with my Oura ring so far. By the end of the month I'll have some more precise summaries but some interesting things I've learned are:

-During sleep my heart rate reliably drops to between 43-50 bpm with full night averages usually in the 50s.
-During sleep my breathing regularity (measured by fluctuation in dissolved oxygen in my blood) ranges between "good" and "optimal".
-My overall sleep score usually ranges from "fair" to "good" (one instance of "needs attention" and no instances of "optimal").
-During the day my heart rate averages (up to 6 readings binned in 30 minute windows and averaged) when I'm not physically active tend to run from 59-67 bpm
-My daytime stress score measures in the "stressed" range less than an hour/day, often 0-15 minutes. The rest of the time I'm about 50/50 between "engaged" and "relaxed", and hit "restored" as often as stressed.

Caveat is that for the roll-ups like sleep quality and daytime stress, I don't have a great handle on what data drives the scores. So I haven't figured out precisely what I'm being told nor how to exploit it in a way that's beneficial to me.

A number of things on the personal front emerged in January, and looking back I let my physical fitness activities slide quite a but. My body weight is hovering around in the upper 170s still.

High priority goals for February are:

-Get back to 6 workout days per week.
-Clean up my nutrition a little more and have less than 2 off-plan days for the month
-Try to watch at least 3 health/fitness related podcasts/week for the month.
-Design a matrix of experiments to see if I can tease out any lifestyle factors that measurably affect my Oura sleep scores. I'll probably have an update talking more about sleep in a week or so.

I've also received quite a bit of dating advice here recently. I don't think I'll exploit it this month, but I'll let it simmer on the back burner until that day comes.

Still have tons of health challenges in my extended family, which saps time and energy, and makes me feel guilty for not joining them as I appeared destined to do a year ago. The frustrating thing is no one believes me when I tell them what I did (i.e., in order of importance, eat much better, increase physical activity, and liberal use of supplements).

[IlliniDave]

Another month has gone by.

No precise financials to report. The stash is up about a percent and getting back to being very close to it's all-time peak hit during the waning months of 2021 without much in the way of new contributions over the last year, just my HSA contribution. Intuitively I think ongoing spending is at a reasonable level, but it will take a while to get the numbers together. I've been exceptionally bad about keeping up with the books, and maybe I'm entering a new phase where I just dispense with all of that.

I'm still having fun with the Oura ring. I'm learning it's not a great device for tracking workouts precisely, it attempts to track things in a more holistic way. I've been using it as feedback to try to dial in my sleep better. Comparing the last 10 days of February to the last 10 days of January my average sleep score is up 7% but I don't know what that means precisely.

An interesting observation is that as I became increasingly more active over the last month, both my "readiness" scores and "resilience" scores have gone down a little. I tend to do exercise stuff during the morning, which in turn tends to keep my heart rate somewhat elevated through the day and my daytime physiological stress levels in the "engaged" range (below stressed and above relaxed) a large fraction of the time. I feel good so am not worried about it, and I think it's maybe an artifact of having started the data record during a very sedentary stretch.

Some other things I've always wondered about is that the ring tells me my February average minimum overnight resting heart rate is 46, which is within the generally accepted range of 40-50 for a good number. Also my nighttime breathing regularity ranges from good to optimal, with optimal occurring slightly more often than good, especially towards the end of the month.

Weight is hanging in there in the mid-upper 170s. I still want to trim a little off of that.

I've spot checked blood pressure with my home device and it seems to be pretty good but not great. As I start to stack more active days and time outdoors I'm hopeful it will improve.

I'm still careful with my nutrition while experimenting with things within the general guidelines I follow. Lately I've been upping my animal protein. It's a topic of debate in the metabolic health/longevity space, but I'm beginning to be swayed by the camp that argues it's not the life shortener some make it out to be, and I'm getting into the age group where muscle mass becomes correlated with healthspan, and animal protein is the most straightforward way to do that. Also, I just feel better overall when animal protein makes up a larger fraction of my intake.

I've been on the phone a lot with hideout neighbors and other contacts up in the woods starting to put together a plan for the season there. After a series of longish winters up there (as measured by how long ice lasted on the lake, which recently has been early May) this year's has been exceptionally mild and it might be among the earlier ice outs recorded in the area, which in the vicinity seem to have generally occurred in 2012. I'm considering heading up a couple weeks earlier (mid-may rather than early June) if the spring is mild as well.

[IlliniDave]

Some unexpected observances.

My Oura risn isn't optimized for being a fitness tracker, but it does give me better information than I was getting without it. I've been surprised by some of the stuff.

-I noticed my heart rate gets higher during strength training than is does during my HIIT workouts on the rower even though the latter leaves me feeling quite thoroughly spent where the former does not.

-The more active I've become with increased time outdoors as the weather moderates has caused my Oura daytime stress (physiological) to increase and my resilience score to steadily decrease. Today I fell into the adequate range from solid for the first time. I need to get on their website to better understand what it's telling me with those scores. I'm thinking maybe things are a little wonky because I started wearing the ring in the dead of winter at my most inactive time and on the heels of my worst nutritional stretch through the holidays, which could mean some of the baseline profile it established for me was not representative of me most of the year. Maybe that's wishful thinking.

I am of the habit of reading for a while in bed prior to going to sleep. I figured out that a) the ring can somehow determine pretty accurately when I get in bed (no idea how, because I usually transition from just sitting in front of the computer watching podcasts or netflix to getting in bed to read. And it counts the time it detects me getting in bed and detecting when I'm asleep (which it also does with eerie accuracy) against my sleep score as 'latency', which it apparently counts as difficulty in falling asleep. I also figured out I can edit the sleep data and crop my reading time off, so last night I paid attention to when I put the lights out and adjusted it this morning and got a 10% upward bump in my sleep score.

I also went back to using my blue-blocking glasses in the evening. I have all my screens set to lower blue spectrum light between sunrise and sunset, as well, but the glasses really do seem to make a difference for me as far as the score goes. They are sort of a PITA but at least there's a reason to put up with the inconvenience. I'll need another week or two before I can quantify the difference, and it's not huge, but every little bit helps. Suboptimal sleep is known to lower insulin sensitivity which is my primary concern in the short run, though I think it's safe to say that good sleep ripples through ones being in a holistically good way.

I started taking an NO supplement, the only one I'm aware of that has some amount of evidence for it's efficacy in raising NO levels. I'm also experimenting with being fluoride-free. All the tap water in the two places I live is well water, so it was just a matter of finding a fluoride-free toothpaste. I'm also giving stopping use of "disinfecting" mouthwashes. The goal is to protect my oral microbiome (which among other things is important for endogenous NO production). I intend to keep it up until my next dental checkup and re-evaluate depending on the results. No is very important in metabolism which is the initial thing I'm trying to optimize, but (and it might be placebo) I do feel like it makes a small marginal difference in workouts/activity. I have good reason to think I didn't have a severe NO deficiency, but it's a fact of life that endogenous NO production wanes with age, and I'm interested in optimization rather than content with adequacy.

[jacob]

-I noticed my heart rate gets higher during strength training than is does during my HIIT workouts on the rower even though the latter leaves me feeling quite thoroughly spent where the former does not.

-The more active I've become with increased time outdoors as the weather moderates has caused my Oura daytime stress (physiological) to increase and my resilience score to steadily decrease. Today I fell into the adequate range from solid for the first time. I need to get on their website to better understand what it's telling me with those scores. I'm thinking maybe things are a little wonky because I started wearing the ring in the dead of winter at my most inactive time and on the heels of my worst nutritional stretch through the holidays, which could mean some of the baseline profile it established for me was not representative of me most of the year. Maybe that's wishful thinking.

I am of the habit of reading for a while in bed prior to going to sleep. I figured out that a) the ring can somehow determine pretty accurately when I get in bed (no idea how, because I usually transition from just sitting in front of the computer watching podcasts or netflix to getting in bed to read. And it counts the time it detects me getting in bed and detecting when I'm asleep (which it also does with eerie accuracy) against my sleep score as 'latency', which it apparently counts as difficulty in falling asleep. I also figured out I can edit the sleep data and crop my reading time off, so last night I paid attention to when I put the lights out and adjusted it this morning and got a 10% upward bump in my sleep score.

I used to have a smartwatch but I found that once I understood how the scoring worked, I'd start gaming it, so I gave it away. For example, "sleep score" depends on how often the accelerometers are triggered when you toss and turn. Thus I perfected the art of turning in bed without moving the watch-arm much and bam... instantly better sleep scores Goodhart's Law is strong with this one. Jacob's Corollary to Goodhart's Law would be that you can either measure XOR know how the measurement works and what it means, but it's best to avoid doing both. Case in point, I have a severe case of white coat syndrome when it comes to BP, because fearing getting a high result triggers the fear factor which in turn leads to a high BP measurement. It's not the white coat as much as it's the measuring device. Only way around it is to measure 10-20 times until I get bored with the process and distracted.

Don't read on lest you violate the Jacob's Corollary. Maybe it doesn't apply to you.

If you could measure your blood pressure as well, you'd probably find it to be sky high during strength training. Think of it as an engine with the heart being the fuel pump. If you floor the gas in order to accelerate fast, the pump will pump harder. Likely you feel more spent with the HIIT, because you did more total work with HIIT than when lifting. However, with lifting your maximum power was higher except it likely didn't last as long.

The "resilience" score (terrible name) essentially tells you how "race ready" you are; how spent you are from yesterday's workout. It's normal to dial down the daily exercise before a big race. If you work out hard right up to the day before the race, your results won't be as good. Conversely, giving it a rest will allow you to perform from a rested state. "Rest score" would be a better name. Being in better shape means that normal effort is less exhausting and thus has less effect on depressing the "rest score". OTOH, if you rested all the time, you'll get out of shape and thus normal effort will be less easy thus also depressing the rest score. This is the main reason why athletes to periodization planning out when to peak.

[IlliniDave]

I used to have a smartwatch but I found that once I understood how the scoring worked, I'd start gaming it, so I gave it away. For example, "sleep score" depends on how often the accelerometers are triggered when you toss and turn. Thus I perfected the art of turning in bed without moving the watch-arm much and bam... instantly better sleep scores Goodhart's Law is strong with this one. Jacob's Corollary to Goodhart's Law would be that you can either measure XOR know how the measurement works and what it means, but it's best to avoid doing both. Case in point, I have a severe case of white coat syndrome when it comes to BP, because fearing getting a high result triggers the fear factor which in turn leads to a high BP measurement. It's not the white coat as much as it's the measuring device. Only way around it is to measure 10-20 times until I get bored with the process and distracted.

Don't read on lest you violate the Jacob's Corollary. Maybe it doesn't apply to you.

If you could measure your blood pressure as well, you'd probably find it to be sky high during strength training. Think of it as an engine with the heart being the fuel pump. If you floor the gas in order to accelerate fast, the pump will pump harder. Likely you feel more spent with the HIIT, because you did more total work with HIIT than when lifting. However, with lifting your maximum power was higher except it likely didn't last as long.

The "resilience" score (terrible name) essentially tells you how "race ready" you are; how spent you are from yesterday's workout. It's normal to dial down the daily exercise before a big race. If you work out hard right up to the day before the race, your results won't be as good. Conversely, giving it a rest will allow you to perform from a rested state. "Rest score" would be a better name. Being in better shape means that normal effort is less exhausting and thus has less effect on depressing the "rest score". OTOH, if you rested all the time, you'll get out of shape and thus normal effort will be less easy thus also depressing the rest score. This is the main reason why athletes to periodization planning out when to peak.

Lol, I completely understand the temptation to game the device and inflate scores meaninglessly.

The ring has both a "Readiness" score and a "Resilience" score. My just-enough-to-be-dangerous understanding is that Readiness is more of a short term thing--how active you were the prior day, and how much you've rested/recovered in between active periods. Something that sounds a lot like "Rest Score" you posit. Resilience is a longer-term thing that looks over longer time frames (didn't even start reporting until I was wearing the ring for a month). So in my case since I now have many more "active" days than "rest" days (and those are usually so-called active rest) which leads the rings algorithm to conclude I'm not recovering to my longer-term baseline which was rooted in a very sedentary period. That's my working hypothesis, anyway.

I get gigged nightly for restlessness during sleep, and haven't tried gaming it yet. I don't have much competitiveness driving this (with my yesterday self or with other people), so I'm disinclined to just manipulate the scores in a meaningless way. I want to get decent quality data to inform behavioral/lifestyle changes that have efficacy. Another thing I get gigged for is that I probably average around 6.5 hr sleep per night, been that way a long time. I don't feel like I have the low branch symptoms of sleep deprivation, but I am below the norms in terms of sleep time.

Actually, I have a blood pressure cuff down in my workout area. It's what I used last year to measure my heart rate post workout, or between phases. I just never paid any attention to the BP reading. Tomorrow is the next day I both row and do strength work so I'll check that. I would expect it to be somewhat higher maybe, but not too much unless my blood vessels are super stiff, because the exercise should be triggering release of NO which if I have decent vascular health should be telling my arteries and vessels to relax/dilate. Given a fixed volume of blood that should increase flow and offset some of the increased pumping energy that if restricted would cause increased pressure. Interesting experiment!

[IlliniDave]

If you could measure your blood pressure as well, you'd probably find it to be sky high during strength training. Think of it as an engine with the heart being the fuel pump. If you floor the gas in order to accelerate fast, the pump will pump harder. Likely you feel more spent with the HIIT, because you did more total work with HIIT than when lifting. However, with lifting your maximum power was higher except it likely didn't last as long.

Unfortunately something went wrong and I didn't capture the high resolution heart rate data with the Oura ring during my workout period, so I had to go with what the cuff was telling me to keep the data somewhat consistent.

109/71 59 bpm--properly taken pre-coffee morning BP reading (seated/still for 5 min/proper arm elevation/posture)

130/79 57 bpm--pre workout, suboptimal conditions (recently moving around, caffeine in system, up and down stairs, compromise posture)

128/74 95 bpm--post rower HIIT (within 20 seconds of completion), suboptimal conditions (recently moving around, compromise posture)

114/73 114 bpm--post strength training (bands, body weight, within 20 sec of last set) suboptimal conditions (recently moving around, compromise posture)

107/73 73bpm--Ten minutes after the workout was done (proper reading, seated still for 5 minutes, proper posture and cuff elevation).

Dunno what all that means precisely, but that's the data.

When I do this again (Sunday is my next day for both rower and strength) I'm going to try doing the strength work first then the rower HIIT. It occurred to me this morning that the peak HR might just be a cumulative thing, and whichever I do second will always show the higher HR.

[jacob]

If you can somehow figure out how to take a BP measurement during exercising, you'll see much higher numbers. A maximum effort lift can very briefly send it up to 250/110 in a healthy person. This is why record setting power lifters may experience nosebleeds. The BP is high enough to burst the flimsy blood vessels in the nose.

[IlliniDave]

If you can somehow figure out how to take a BP measurement during exercising, you'll see much higher numbers. A maximum effort lift can very briefly send it up to 250/110 in a healthy person. This is why record setting power lifters may experience nosebleeds. The BP is high enough to burst the flimsy blood vessels in the nose.

Ah, I don't have the technology for that, but I can believe it. Large muscle group contraction will certainly constrict blood flow. And there's also the reaction to that--I very often had to take a knee after a near max dead lift to avoid injury should I pass out (often came close but never did pass out) as all the blood flows back into the recently contracted muscles leaving the old noggin in a deficit. I misunderstood what you meant yesterday.

For an old dude who was in poor metabolic health not much over a year ago, I'm pretty happy with those numbers. I don't know that they have huge significance, but BP soaring with just a little exertion (like getting out of a chair and walking to the fridge) is a really bad cardiovascular sign. I never descended to that point, but some superficial evidence that I've moved away from that makes me think all the trouble I take to keep my body working decently is worth the inconvenience. That I can also feel like I'm sticking it to BigPharma makes me feel good too. Had I just capitulated I'd have been on statins, BP meds, and diabetes meds for over a year now.

[IlliniDave]

Warning: this one is mostly just using journaling to reflect on some aspects of where I've come in the past year in hopes of generating seeds of ideas for honing my lifestyle regimen for the months ahead. It's apt to be a dull read.

I decided to go back and look at some numbers from a year ago. On 3/8/23 I weighed in at about 192 lb vs 175 now. Last year I was working my way down from 213 lbs post holidays vs about 182 lbs post holiday weight this year. Last year losing weight was a top priority but this year it's really not. I keep tabs on it because it is convenient, but I have a high degree of certainty that just keeping to my nutrition plan will put me in a pretty good place on the scale. I had a goal last year of getting down to 165ish then gaining 5-10 lbs back during heavy strength training. I quit recording weight measurements early last May at the time of my checkup, and I was down around 176 +/- at that time. The lowest weight I remember seeing prior to migrating to the hideout was around 173 lbs. I don't have a scale there. From the time I got back in the fall until holiday fattening began my very infrequent weigh-ins put me in the mid-upper 170s, so not much different than where I've been most of this year once I shed the water weight from sketchy eating over the holidays. I'm confident I never got down below 170, much less 165.

That's not to say I truly plateaued. Despite my weight remaining fairly steady over the last 9 months (holidays excepted) using non-numeric metrics like how my clothes fit and to a lesser extend what the mirror tells me, indicates that my physiology is still changing. It appears that I've continued to drop a little visceral fat (belt notch test) and reduction in subcutaneous fat is more visible of late. Some of the latter observation might be tied into my efforts to cultivate robust autophagy, and gradual recycling of excess skin. And these observations are contextual--I'm pushing 60 so phrases like "lean and mean" when it comes to appearance do not apply.

A year ago my morning BP reading was 114/71 62 bpm, today it was 104/64 55 bpm. I don't think there's a whole lot of significance to the difference in the actual BP numbers. There's enough day-to-day variability in those that a single data point doesn't necessarily mean much. Last year I was measuring daily, more sporadically this year. What I can say is that I see no indication that my BP has gone back up to or towards may late 2022 levels of 140s over 90s. The heart rate number does indicate a change. Thanks to Oura I've got a superabundance of heart rate data. Last March my early morning readings were generally in the lower-mid 60s and now are consistently in the upper 50s. Technically that puts me in the bradycardia range but it's not something I'm worried about at this time. I don't have the conditioning of an endurance athlete by any stretch, though I've probably improved year-over-year. But once I get up and start moving around in earnest my HR spends most of its time in the 65-75 range unless I'm doing some sort of activity geared towards physical fitness, and down in the 60-65 range (occasionally I'll dip to 58-59) when I'm relaxed during the day at least 2-3 hours out from a workout. On another resting heart rate scale that's more geared for measuring fitness than medical diagnoses, I vary between "better than average" and "very good" for the age cohort I'll be exiting in 2 months.

I've also seen fairly dramatic improvement in lower leg circulation.

On the truly subjective front, I feel substantially better on a day-to-day basis. That's kind of woo-ish and there's almost certainly some measure of placebo effect and confirmation bias going on. But I think there's value even in having an unscientific sense of ongoing well-being. What's better? Ongoing gut health (many minor issues I'd long accepted as normal are no longer the norm), physical energy is higher, mental energy is more consistent, and I have less susceptibility to "feeling" stressed (mental/emotional). I think the replacing of an ongoing amount of worry/stress with a stronger dose of well being is a big part of the reason why I'm having such a hard time convincing myself the effort required to maintain my old level of financial bookkeeping is warranted. Altogether it adds up to a higher degree of confidence in what I feel like I can take on--mostly physically but to a small extent mentally as well. Some of that is probably due to being 2.5 years out from retirement without a bevy of black swans descending on me, but I think improved physiological health is a big contributor.

The reason I did some review/reflection was to spur some brainstorming on the topic of where to go between now and departure for the hideout. "Just keep doing what you're doing," was the last bit of medical advice I received. And I don't think that would be a bad approach, just one that's not all that satisfying to me. I'm bereft of ideas at the moment, so I'll just let my subconscious chew on it while I go about my day and see if some ideas don't come up.

[J_]

Yes, go on. And read further. There are a bunch of (American) medical skilled specialists on nutrition (not connected to the “industry). See @Oey recently.
You will not become a youth anymore. But you will be a very fit person to grow old unhindered by bodily restrictions.

[mooretrees]

Can you write more about the dramatic changes in your lower leg circulation?

Also, I enjoy reading about your medical experiences, not boring at all!

One area I am focusing on is rehabbing myself and problem areas. For me that is the hips, ankles and so on. I’m guessing you have some areas that need attention? Maybe mobility and flexibility could be next pursuits? Whatever you choose, it’s always interesting to read about.

[IlliniDave]

Yes, go on. And read further. There are a bunch of (American) medical skilled specialists on nutrition (not connected to the “industry). See @Oey recently.
You will not become a youth anymore. But you will be a very fit person to grow old unhindered by bodily restrictions.

Yes to that! I am pretty well immersed/read (from a layman's perspective) in most of the leading-edge nutrition/healthy aging/metabolic health/general fitness ideas emerging over the last few years. That inludes MD's of numerous specialties and and biomed researchers from around the world. My 2024 goal is at least two podcasts per day in the subject areas I mentioned above. Lately I've been devouring Ben Bickman's "Metabolic Classroom" series. Dry and technical but I think I have the "do this, don't do that" side of things pretty well dialed in so I'm shoring up my under-the-hood understanding to help me with common sense testing of new ideas I run across from a more "popular media" perspective, as well as those I'm currently implementing.

Eventually my body will give out, but if I can buy myself a few extra years of healthspan I'll figure it's all worth it.

[IlliniDave]

Dilemmas and Guilt.

I've been fascinated by what I've learned over the last 15 or so months when it comes to the chronic lifestyle diseases (obesity, Type II diabetes, dementia, hypertension, vascular disease, heart attack, stroke, and many cancers). I'd long bought into the conventional wisdom that they were largely caused by age and were unavoidable, that the knobs available only had minimal impact, and eventually nearly everyone's fate would be to try to stretch out the golden years briefly through increasing dependence on pharmaceuticals until those options were no longer enough.

Although I'd seen hints of it in the past the big paradigm shift for me was being confronted with the increasing evidence that most of the chronic conditions bucketed as the consequences of aging probably are due to the same small set of root causes. "Metabolic disease" serves as an umbrella term. Under the umbrella the most common culprits seem to be insulin resistance, cellular/mitochondrial dysfunction, and leaky gut (a little controversial). Almost by definition IR is a form of cellular dysfunction. Leaky gut is believed to have roots in gut microbiome dysbiosis. It's cousin, "leaky gums", has a finger in the pie too ("bad" oral bacteria are sometimes observed in diseased hearts, e.g.). The newest branch of information I've been consuming involves the role of nitric oxide in systemic health. Both oral dysbiosis and IR contribute to lack of NO production. NO is well known for it's role as a vasodialator and role in blood pressure regulation, but insufficient NO results in hypoxia throughout tissues and organs (which in turn causes problems at the cellular and mitochondrial level). It's a complex system and sorting out the chickens from the eggs is challenging.

My conclusion (i.e., the concluson of the school of thought I find most compelling) is that the best solutions for the cluster of maladies is:

1. Thoughtful approach to food/nutrition (keep the liver functioning, avoid excess insulin, promote healthy microbiomes)
2. Be active/get exercise
3. Avoid things like unnecessary antibiotics (including antiseptic oral hygiene products)

Of course approaches to nutrition get quite a lot of debate. For the record I'll repeat that I'm a minimally processed whole food omnivore. Trial and error has led me there and I'm still experimenting to find what seems to be optimal to me. I think as long as a person avoids highly processed carbohydrates, excess sugar, excess starchy foods, and seed oils that require a trip through a chemical factory to be palatable, that covers most of it. From there carnivore, keto, vegan, or in between can probably all be made to work, though non-omnivores might benefit from some strategic supplementation (in my way of thinking, omnivores can benefit too, and I am an aggressive supplementer).

Okay, that was just a preamble to organize my thoughts a little. Now the dilemma ...

My dad is going through cognitive/memory decline. He's 84 and pretty much dependent on me and one of my sisters to ensure food gets into the house. His beliefs on nutrition are rooted in the original food pyramids (he was a scientist and, well, science!) and what was conventional wisdom in the distance running community back in the 1980s. Essentially that carb loading is the key to fitness and health. As his mind has declined he's becoming more and more of a grazer. There's some fascinating research I came across that describes some facets of dementia (in thos case primarily Alzheimer's) as a primitive foraging instinct run amok. It's rooted in comparing parts of the brain that are undamaged by the disease with parts that are. Anyway, I'm getting off track again.

When it comes to dementia it seems like the best arguments for causes that can be made implicate insulin resistance and mitochondrial dysfunction, and grazing sugar and high glycemic/refined carbohydrates is probably the worst thing a person can do if they want to avoid or manage it. It's likely that putting my dad on a keto regimen with intermittent fasting would be the best way to buy him time.

But the my softheartedness kicks in. His life/world have shrunk to the point that he really has very few options for things that give him pleasure. He thinks keto is nonsense. And while I'm genuinely concerned about his health, I also want him to enjoy his remaining years. He's an 84 yo widower and I just don't have the backbone to tell him, "No, Dad, you can't have Oreos or donuts or pretzels anymore. Here's a can of sardines and an avocado." One of the difficulties is he has almost no self control any more (ties into the foraging function of the reptile brain run rampant). Any sort of junky snack foods I bring him are gone in less than 24 hours, and that's on top of the ~1.5 lbs per day of mandarin oranges he puts away, toast with at least 2 meals per day. When I buy them he'll wolf down a "party size" bag of popcorn or pretzels in 12 hours (i.e., by the end of the day). We've tried rationing out his 'treats' but he'll tear the house apart to find the mother lode. In his mind all that stuff is perfectly healthy because low saturated fat.

And even though I Know better, I still get the stuff since it's about the only thing that he'll say he wants. He'll eat other things, but only reluctantly when his preferred forage is not on hand.

It's certainly the path of least resistance for me to just get him what he wants and let him have the short-term enjoyment of satisfying his addiction. But I have these lucid moments in the grocery store where I feel like a complete lazy heel for buying him stuff that other than an isolated holiday celebration or similar, I wouldn't put in my mouth if you paid me to. And therein lies the dilemma--should I in essence just make him comfortable or should I intervene in a heavy-handed way that may (or may not) make the most of his remaining time. Being a parent to one of your parent's can really suck, as some of you know.

[Smashter]

That's so tough. If I was in your shoes I think I'd let him eat what he wants to be happy in the moment. I think he'll just resent you otherwise. But I could also see myself giving it one try to see how it went.

When my grandpa's dementia got bad he also became a sugar fiend. He'd guzzle 64 ounce orange soda bottles with ease, and I never knew him to be much of a soda drinker before. Strangely, it was also the period in his life when he was the nicest, after being a monumental pain in the butt to many people in his life for basically his entire adulthood. My Aunt, his main caretaker, would joke about how she wouldn't be such a messed up person if this kind and gentle version of my Grandpa had raised her.

[Henry]

-should I in essence just make him comfortable or should I intervene in a heavy-handed way that may (or may not) make the most of his remaining time.

You actually think a few sunshine seeds are going to change the trajectory at this point? That The Illinois Dave's 11th Hour Resurrection Diet is going to derail death? This is only a dilemma for you, not for him and not for reality. He's 84 and experiencing dementia. It's deckchairs on The Titanic. Give the old man his Oreos and let him live his remaining cognizant days enjoying being the stubborn fuck he is. The last act I had with my father was feeding him a piece of syrup laden butter smudge piece of pancake on his deathbed. It probably killed him but I'm sure it tasted better than that shit coming out of the tube.

[bostonimproper]

Your post about your dad reminds me of my mother-in-law. She’s in her late 70’s and has had food issues her whole life (as in, very picky eating, no spices, only a few “safe” foods), and her diet at this point has winnowed down to sweet baked goods and yogurt drinks. She’s also showing early signs of dementia. My spouse and I have talked about if there’s anything we can do to broaden her diet and help her eat healthier, but we’ve decided not to push the issue. She’s very set in her ways in terms of food and at this point in her life, when she’s already experienced the loss of many friends and starting to lose her agency, scolding her for her dietary choices seems like it’d be both a futile and alienating gesture when what she needs most is comfort and connection.

[EdithKeeler]

I can relate to the parent and food thing. My mom’s in a nursing home and hates the food. The food isn’t quite as bad as she thinks it is, but her tastes have changed and some dementia is creeping in. She’s 87 years old, and she asks me for certain things—the latest things are ketchup (like, has used an entire bottle in 2 weeks), caramel cream candies and rice pudding. A few weeks ago it was ham salad, week after week.

I try to give her whatever she wants. She’s 87, stuck in a nursing home, and food is one of the last few things that give her pleasure. It may knock a year off her life, but… is that the worst thing? And… it’s also kind of a fight when I suggest less candy, etc. I just let her be and give her what she wants.

[Scott 2]

It's been interesting to see your experience with the Oura ring. I've often considered one.


Are you familiar with the term Orthorexia?

https://en.wikipedia.org/wiki/Orthorexia_nervosa

Applying strict food standards to your elderly father with dementia could approach that territory.


With that said - I think it's reasonable to head off acute problems. Party size bags of pretzels are obviously a bad idea. I wonder if quality for quantity substitutions could help there. The entire situation is challenging. Stepping up is not easy. Your Dad is fortunate for your care.

[IlliniDave]

That's so tough. If I was in your shoes I think I'd let him eat what he wants to be happy in the moment. ...

That's more/less the approach we've taken, though I have changed my shopping strategy. In the past we'd try to limit the number of shopping trips we make for him by buying him a whole week's worth of groceries at once. But recent;y that would mean a whole weeks worth of junk food treats would get eaten in a single day. We've gently pointed that out to him and he's done a little better (he really does know he shouldn't do that, and a year ago he wouldn't). But now I just make more incremental trips to the grocery to limit the amount of that kind of stuff that's in the house at any given point in time.

[IlliniDave]

You actually think a few sunshine seeds are going to change the trajectory at this point? That The Illinois Dave's 11th Hour Resurrection Diet is going to derail death? This is only a dilemma for you...

Maybe so. But there is evidence that dietary/nutritional interventions can slow the progression of some cognitive diseases. I'm doing them for myself, and feel a little hypocritical as the person 95% responsible for the type of food that gets into his house when bringing him stuff to eat that, as I said, I wouldn't consume if someone paid me to. Even though he's my parent rather than I his, I still feel a sense of responsibility.