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

[IlliniDave]

... Assuming aging is truly solved, then many of the physical accumulation problems that cause psychological changes in the elderly will be solved. The plaques will be cleared. The bloodflow maintained indefinitely. A twenty-year-old's rejuvenatory abilities working in a ninety-year-old body. It sounds crazy until you think about the advances that have been made in our lifetimes and extrapolate that out, then consider what AI will do to the trajectory...

Okay, yeah, I was thinking more along the lines of a single Methuselah in a sea of people of contemporary longevity and extrapolating an existence of someone in latter midyears (albeit in decent health all things considered), just a much, much slower rate of decline from there on out.

In the not-so-science-fictiony realm, epigenitic reprogramming sounds closest to what you're talking about. I of course am sketchy on the details, but apparently there are records of our prior epigenetic state that could theoretically be determined and used to periodically 'reset' the epigenome to say our 25-year-old state. I think the principle has been demonstrated to an extent with mice as far as reversing markers of aging.

One thing I've encountered recently while devouring podcasts related to cognitive issues of aging is that it appears plaques are neither here nor there when it comes to Alzheimer's--there are drugs that can remove plaques, but they don't seem to affect the disease or its progression and come with side effects. In addition not all Alzheimer's sufferers have plaque buildup, and plaques are observed in brains without Alzheimer's. Not surprisingly when it comes to me, I'm pursuing a school of researchers/clinicians who are approaching these cognitive diseases of aging as yet other manifestations of fundamental metabolic disorder, specifically as sort of insulin resistance of the brain essentially (and hence my inner conflict of being involved in my dad's current pro-insulin resistance nutritional regimen).

[IlliniDave]

I agree that the human psychological narrative would have to be significantly adapted. For instance, just the fact that it's beginning to seem more likely that neither of my kids will have kids themselves is significantly altering my take on my senior years. But also the fact that my soon-to-be 84 year old mother (whom I phenotypically and vice profile resemble) is actually doing better, has regained a good deal of mobility, than in recent years now that she's recovered from second hip replacement. Pretty likely she will make it to 90 in spite of being an incorrigible cookie eater, because her heart is in great shape according to recent testing. She also looks fairly young and unwrinkled for her age, likely due to never smoking, rarely drinking, and avoiding very much sun exposure.

That's good to hear about your mom--that she's doing well all things considered. I think the best thing we who aren't assured of having family close by to look after us is to keep moving and stretching. Among my dad's struggles I mentioned in a different topic is putting on/tying his shoes and putting on any sort of garment with sleeves. My shoulder mobility is already less than I would like (though resistance work with bands I use to target that has been noticeably rejuvenating). Interestingly, I can still at any moment stand up and not only touch my toes but touch the floor between them without any sort of "warm up". I can also drop into a heels-down (aka "third-world") squat (thanks, Crossfit!) on command. I should probably do more stretching to preserve those capabilities. My dad was still running marathons at my age, so it's not like he spent his midlife sitting on the couch with a six pack and bowl of chips. Yet we're all dreading the day someone has to start clipping his toenails for him. Maybe that's something his IHHC helper will do for him, lol.

[7Wannabe5]

I got two words for you: Mobile Podiatrist.

My frugal practice towards staying limber is not owning any furniture. My mattress is on the floor and my typing desk is a banker's box on the floor, so I'm frequently moving from Child's Pose to standing throughout the day, so I can still fluidly move my knees up towards my shoulders or my naval towards the floor. However, I am otherwise generally currently in terrible shape. I tend towards intermittently blowing up a in fine line between slender-curvy/curvy-curvy/voluptuous/fat manner similar to Kirstie Alley or Janet Jackson, but I'm having more difficulty than usual giving myself a hard prune back to fighting weight this yo-yo go round. Usually if I make "Get Back in Shape!" one of my top 2 priorities, I can make a significant improvement in around 3 months. Keeping it one of my top 2 priorities in a world full of unexpected problems and super-interesting new opportunities is much more difficult. i guess Erotic Capital Management Over Age 55 may also require some adjustments. (sigh)

[IlliniDave]

... Keeping it one of my top 2 priorities in a world full of unexpected problems and super-interesting new opportunities is much more difficult. i guess Erotic Capital Management Over Age 55 may also require some adjustments. (sigh)

Yes, that's a challenge I've had mixed success with. Basically, I had to make it my #1 ongoing priority and fit other things around it. Not just movement/exercise, but the whole regimen of nutrition + supplements + activity. The rationale I use is that I'm best able to deal with the have-tos and pursue the want-tos when my health is at its best. I'm blessed in the sense that a) health/fitness is a topic I'm generally interested in (if my rote memory was better I probably would have pursued biology rather than engineering), b) many of the things I like to do are physical activities and/or conducive to it. Fishing is one of the more obvious examples. I could have opted for an 18' bass boat with a bazillion HP motor (or a bankside lawn chair and a cooler) but instead went with a kayak.

The ability to get up off the floor is one a person shouldn't overlook, and it sounds like your lifestyle is ideal for preserving that. About the only time I go down to the floor and/or get back up is doing pushups or sit ups which I do only 5x/week.

[jacob]

The ability to get up off the floor is one a person shouldn't overlook, [...]

Also basis for the famous sit--rise test: https://www.today.com/health/sit-to-sta ... -rcna73986

[Slevin]

Also a heavily considered factor in the Okinawan blue zone (and the health of japans older population in general):

Older Okinawans are active walkers and gardeners. The Okinawan household has very little furniture; residents take meals and relax sitting on tatami mats on the floor. The fact that old people get up and down off the floor several dozen times daily builds lower body strength and balance, which help protect against dangerous falls.

[IlliniDave]

Also basis for the famous sit--rise test: https://www.today.com/health/sit-to-sta ... -rcna73986

I still score a 10 on that one. I try to remember to use it as my get down/get back up movement when I get down on the floor mat for body weight stuff. The only time I have trouble is if I am just wearing socks and try it on a smooth/slippery floor, like hardwood. I tend to use the side of my feet while cross-legged to push against the ground (rather than separating my legs the way I've seen other people do)

I guess per the article that barring death by misadventure, I'll have relatively good odds of making it to Medicare age, lol.

Weird random note, there's a turkey (hen) gobbling about 18 inches from my window, it's more of a purring sound than what the gobblers make. For about two weeks ending last weekend the males of the neighborhood rafter (about 12-14 birds) have been out in the streets displaying for the gals.

[IlliniDave]

Also a heavily considered factor in the Okinawan blue zone (and the health of japans older population in general):

Well, I've got the walking covered, and the purple sweet potatoes are a staple. I should probably focus on getting on the ground more often though. For many years I slept on a futon on a low platform bed (platform sat about 3" off the ground). I like to hope that body weight squats 5x/wk help fill the gap.

Sort of unrealted, but the elderly-iDave-getting-off-the-floor idea is what sold me on trying Crossfit--listening to Glassman talk about functional fitness and it's relevance to healthy aging, and one of the topics being retaining the strength to get off the ground. It was used as a "justification" for burpees among other things, lol.

[IlliniDave]

Some random nerdiness:

On sleep. When I first moved back to Illinois I just used a bed that was already set up in the room I occupy. It had a decent mattress, but one that was pretty old. A few weeks ago I finally swapped things around and put my better quality mattress on the bed. Over the next few weeks my Oura sleep score improved by about 8% on average. Then earlier this week I bought a pair of 625 nM red light bulbs for my bedroom lamps and started using them from evening twilight until lights out. I'd noticed my so-so quality blue blocker glasses seemed to make a small difference but not enough to tease a number out for. The bulbs seem to make a much bigger difference. It's only four nights so far, but one of them tied my previous best score and another exceeded it. The third and fourth were solidly above my average, giving another 6% jump over my better mattress average. So I'm thinking there's a there there. Can't say I can feel a difference but Between the mattress and red bulbs I've improved by about 14% since mid-January as measured by my average oura sleep score.

My resilience score is waning though, and the thing doesn't judge my recovery being any better than adequate even though I've been paying attention to recovery much more than I have historically. At first I sort of scoffed about it, but gradually over the last 2-3 weeks I've begun to feel it subtly. I'm uncomfortable scaling back my activity too much, but I'm going to try substituting one of my light days for a full rest day (actually started this week). To add context, I'm far from a workout warrior, I'm trying to leverage some biohacking (essentially making everything except my hikes/walks have a strong HIIT component) so it's about as opposite of Crossfit's paradigm as you can get while still borrowing some of the ideas. Mirror and belt tests tell me I'm slowly moving in the right direction, and hopefully doing it without lotsa cortisol.

I'm about a month out from annual wellness visit/labs with my MD, so another month of being very dialed in nutrition-wise then I can let my hair down some. Reminds me I need to get back into the habit of regularly checking my BP. Spot checks and general intuition have led me to not having much concern about it, but it would be good to get the data. (Might as well just do it--105/68, 57 BPM a moment ago).

[Scott 2]

Love the experimental approach to sleep quality and recovery. I wonder about meditation or zone 2 exercise for improving resilience score. If it's based upon HRV, that's often looking for more parasympathetic promoting activity in your day.

For sleep - I am currently trying a weighted blanket. Nothing quantitative - sleep tracking on my Garmin Forerunner 55 sucks. But anecdotally - I am sleeping deeper. If I get up for the bathroom, I do better at falling back asleep, especially in the early morning hours.

Now that you have the smart phone, have you tried a continuous glucose monitor? That's been my most successful quantified intervention. Even eating trash, my a1c is down 10% in the past year. We're talking multiple pints of ice cream per week, yet a 4.5% a1c. My HOMA-IR dropped more like 20%. Yes, I am relatively young and active. But I also tested the meals I eat on autopilot. I know they cause a minimal post-postprandial spike, in my body. The occasional insult is much easier to absorb, than chronic glucose volatility.

If it's compatible with your phone, I'd ask for a Dexcom G7 script. GoodRx pricing for a 3 pack should be under $200. Worth every penny, IMO. The trial does require tracking carbs per meal, but with a food scale and MyFitnessPal, that's relatively accessible.

[macg]

For sleep - I am currently trying a weighted blanket.

I am thinking about trying a weighted blanket - any recommendations on which one to try? Thanks!

[Scott 2]

I am thinking about trying a weighted blanket - any recommendations on which one to try? Thanks!

Two types. I ordered both from Target, anticipating easy returns. I'm still waiting on the 2nd.


1. Glass beads. Heavier. Warmer. Not machine washable, so you want one with a washable cover. I went with 20lbs:

https://www.target.com/p/48-x72-tempera ... A-79750159

2. Thick yarn. Lighter. Cooler. Technically machine washable, though easier said than done:

https://www.target.com/p/48--34-x72--34 ... A-81316868


There are "nice" versions of these that cost 2-3x as much. No clue if they are worth it. I figured this was a case of try the middle end product, if I wear it out, replace it with something premium. I'm gentle on my things and using a top sheet, so there's a good chance these are fine.

[macg]

Two types. I ordered both from Target, anticipating easy returns. I'm still waiting on the 2nd.


1. Glass beads. Heavier. Warmer. Not machine washable, so you want one with a washable cover. I went with 20lbs:

https://www.target.com/p/48-x72-tempera ... A-79750159

2. Thick yarn. Lighter. Cooler. Technically machine washable, though easier said than done:

https://www.target.com/p/48--34-x72--34 ... A-81316868


There are "nice" versions of these that cost 2-3x as much. No clue if they are worth it. I figured this was a case of try the middle end product, if I wear it out, replace it with something premium. I'm gentle on my things and using a top sheet, so there's a good chance these are fine.

Great thanks so much!

[IlliniDave]

Love the experimental approach to sleep quality and recovery. I wonder about meditation or zone 2 exercise for improving resilience score. If it's based upon HRV, that's often looking for more parasympathetic promoting activity in your day.

For sleep - I am currently trying a weighted blanket. Nothing quantitative - sleep tracking on my Garmin Forerunner 55 sucks. But anecdotally - I am sleeping deeper. If I get up for the bathroom, I do better at falling back asleep, especially in the early morning hours.

Now that you have the smart phone, have you tried a continuous glucose monitor? That's been my most successful quantified intervention. Even eating trash, my a1c is down 10% in the past year. We're talking multiple pints of ice cream per week, yet a 4.5% a1c. My HOMA-IR dropped more like 20%. Yes, I am relatively young and active. But I also tested the meals I eat on autopilot. I know they cause a minimal post-postprandial spike, in my body. The occasional insult is much easier to absorb, than chronic glucose volatility.

If it's compatible with your phone, I'd ask for a Dexcom G7 script. GoodRx pricing for a 3 pack should be under $200. Worth every penny, IMO. The trial does require tracking carbs per meal, but with a food scale and MyFitnessPal, that's relatively accessible.

Interesting on the blanket. I've found that tossing just a small fleece sherpa on top of my bedding qualitatively (i.e., no quantitative daya to support it) makes a difference, I'll have to try one that's more intended to provide weight.

Some of my walking probably falls into Zone 2, and the Oura app has a number of guided meditations and the like that so far I don't seem to get much benefit from them. HRV (and "HRV balance") is something Oura measures and frequently cites, but tbh I don't have a good intuitive understanding of what the significance of those are. I do most of the right things: exercise, eat well, good sleep, limit caffeine, with rare exceptions avoid alcohol, and make a good faith attempt to manage stress. Oura only gives me nighttime HRV numbers, and my nightly average tends to fluctuate between 40-60 ms which is on the low side of a normal range of 20-200, but not unexpected in my age cohort. Ironically it was higher when I first got the ring for the first few weeks before I got my fitness regimen restarted, in the 60-80 range. During a given night there is a lot of variation: Last night I ranged from down around 20 to a peak of 173 ms with an average of 60.

No, no CGM yet. I will mention that to my doc next month, something I'd really like to do essentially the same way you've approached it--to fine tune my eating. I'm getting down in a weight range I don't want to fall too much below, and once I get sufficiently close to my minimum target I'll be wanting to add a modest amount of lean mass back while being conscious of continuing to foster recovery from insulin resistance (takes decades to build up and years to unwind). My first step in that path is to ask my doc to order fasting insulin as part of my pre-visit labs. If she's willing to do that I'll take that as her being open-minded enough to let me conduct my science experiment. And depending on what the numbers are (at last check my A1C was a tad high (although still within the reference range the lab uses), it might even sell with the insurance company. But among the advantages of being sort of fatFIRE guy is being comfortable shelling out some $$ for something like this. My hope would be to figure out a plan to adjust my macros to increase carbs without derailing my quest for normal insulin sensitivity.

[Ego]

HRV (and "HRV balance") is something Oura measures and frequently cites, but tbh I don't have a good intuitive understanding of what the significance of those are.

Mike Lustgarten is working on a series on RHR and HRV.
https://www.youtube.com/watch?v=KiC3o6YXGB0

My HRV skyrocketed into the 80s for the month we were traveling, then plunged to the 50s the moment we returned home, before settling in the mid to upper 60s. It would be interesting to see if yours varied when you are in civilization vs at your cabin.

[Scott 2]

My first step in that path is to ask my doc to order fasting insulin as part of my pre-visit labs. If she's willing to do that I'll take that as her being open-minded enough to let me conduct my science experiment. And depending on what the numbers are (at last check my A1C was a tad high (although still within the reference range the lab uses), it might even sell with the insurance company.

Insulin test is very affordable. I'm getting that and fasting glucose on my annual labs, then calculating the HOMA-IR online. As a point in time measurement, it's not perfect, but I like the leading metric aspect.

Selling a CGM with insurance is very tough. Uncontrolled diabetes is the criteria. Typically to the point your are a candidate for an insulin pump. They view it as a recurring, several thousand dollar per year expense. Given the low cost of a trial, it's not a fight I chose to pick. My wife's concierge doctor didn't think she'd get insurance approval either.

My doctor was very open to these ideas. I do have a family history of diabetes and dementia. Insulin resistance ranks high in my list of medicine 3.0 concerns.

[IlliniDave]

Mike Lustgarten is working on a series on RHR and HRV.
https://www.youtube.com/watch?v=KiC3o6YXGB0

My HRV skyrocketed into the 80s for the month we were traveling, then plunged to the 50s the moment we returned home, before settling in the mid to upper 60s. It would be interesting to see if yours varied when you are in civilization vs at your cabin.

Thanks for the link, Ego. I'm planning to check it out this weekend. Both my nighttime and RHR and HRV seem to vary cyclically, but I haven't determined anything that seems to correlate with the movements. Oura seems to imply that higher/rising nighttime HRV is better. Higher nighttime HRV definitely correlates to a higher resilience score. I'll have to dig around but if Oura tracks daytime HRV it's not something the app emphasizes in the interface.

[IlliniDave]

Insulin test is very affordable. I'm getting that and fasting glucose on my annual labs, then calculating the HOMA-IR online. As a point in time measurement, it's not perfect, but I like the leading metric aspect.

Selling a CGM with insurance is very tough. Uncontrolled diabetes is the criteria. Typically to the point your are a candidate for an insulin pump. They view it as a recurring, several thousand dollar per year expense. Given the low cost of a trial, it's not a fight I chose to pick. My wife's concierge doctor didn't think she'd get insurance approval either.

My doctor was very open to these ideas. I do have a family history of diabetes and dementia. Insulin resistance ranks high in my list of medicine 3.0 concerns.

I'm thinking I'll ask her to add fasting insulin, LP(a), and homocysteine to the labs this go around. LP(a) would be a one off probably since what I think it points to is a genetic susceptibility.

That's sort of a bummer to hear about the CGM. I'll still bring it up with my doc. In my case I see it as likely a one-off or very intermittent thing, just want to get a sense of my personal food sensitivities when it comes to blood glucose.The trials are something I'll have to look into. I'd run across a program some organization is running that is basically a research project (in the US and UK) that will give you a CGM free for presumably agreeing to share the data with the project. Unfortunately I lost track of the link and haven't been able to find it.

Insulin resistance seems to be linked to more and more strongly to conditions in the metabolic disease cluster, so I think you're on the right track as it might be one of, if not the most important metric, to keep a handle on prior to it becoming an issue. Unfortunately I'd never even heard of IR until mine was advanced enough I started to have elevated fasting glucose. So unwinding it to the extent possible is at the very top of my list.

Just a general note not necessarily related to your post is that my resilience score has recently jumped back up. It's still below it's highest levels from late January (during peak sedentary iDave season) but above where it's been drifting over the last couple of months. As far as explanations as to why that is, I got nothing.

[Scott 2]

Interesting you prioritize the LP(a) and homocysteine tests. My heart health concerns are low, so I haven't paid careful attention to what one should prioritize.

I did a High Sensitivity CRP test this last go, only because all the books have talked about it. The result was boring. I have an ApoB test noted for next year, for similar reasons.

The concierge doctor had my wife test her Omega 3 levels, which my doctor couldn't order. We're taking the same supplement, so I decided that was close enough. He also requested a heart CT scan screening, which was like $50. I opted not to copy that, since my concerns are low.


It's hard to know what's worth it or not. With the blood tests, I kinda figure the needle is already going in, so why not? If I think the additional lab will be under a hundred bucks, I just ask. With my current insurance, many end up under $10.

[IlliniDave]

Interesting you prioritize the LP(a) and homocysteine tests. My heart health concerns are low, so I haven't paid careful attention to what one should prioritize.

...

It's hard to know what's worth it or not. With the blood tests, I kinda figure the needle is already going in, so why not? If I think the additional lab will be under a hundred bucks, I just ask. With my current insurance, many end up under $10.

My heart health concerns are low too, the LP(a) is really just to make sure I don't have a genetic susceptibility, and homocysteine when high can indicate arterial/clotting problems, which could be lurking either from past decades of degraded metabolic health or possibly the jab. Really this all leads to bolstering a decision to continue my practice of avoiding statins. Even though back in November my blood lipids were better than I can recall at any time in the past, I'm not sure if that was more of a fluke or if it represents a new normal. If they stay this low I might not get the constant suggestions to go on statins. I'm getting to the age where I'm liable to get sent off to get scanned for CAC score too, and having some adjacent information might be helpful with that.

Another thing I'm considering is signing up for one of the services like InsideTracker or Function Health to just bypass Medicine 2.0 and their hoops and biases that deliberately or not shield patients from information that could be used to pursue more optimal health. It's an investment on the order of $1K/yr I believe with either one, but you get a pretty impressive array of tests plus interpretation through a Medicine 3.0 lens. From a quick look at both, InsideTracker seems a little more geared towards fitness (and can incorporate Oura data into its app) and Function Health a little more geared towards Medicine 3.0. I'm leaning towards Function Health at the moment because it includes a broader array of testing, though it appears it's still in beta.

A difference between me and many others here is that I went through a considerable stretch of time with substantially degraded metabolic health, and although I've improved many of the low fruit markers (low fruit meaning easy to acquire in Medicine 2.0) I don't know whether I have residual damage/problems lurking beneath the screens intended to sell pharma products. Maybe it's the former engineer in me, but since I've opted to take control of my health I feel like I owe myself a robust palette of data to make and evaluate decisions. Worst case I get in such a program for a year or two and don't find anything useful/actionable from it and I've spent a couple $K for some peace of mind.