Is the point of life just to avoid getting cancer?

[Dragline]

Well, this is interesting:

http://www.nytimes.com/2016/07/26/healt ... p=cur&_r=0

It suggests that whether the fat content of a particular individual is potentially dangerous is specific to the individual, which throws a bit of cold water on the value of absolute measurements such as BMI or even body composition itself. You'd be better off just measuring blood pressure, bad cholesterol and blood glucose it would seem.

[Ego]

Cancer is good? Hum. Not the examples I saw. But then again, at least one was a version of a fate-worse-than-death that jacob mentioned above.

This tread strikes me as a long convoluted rationalization.

We no longer live in a world where temptations are mostly beyond our reach. 24/7 I can have almost anything I am tempted to eat/drink/.... in a matter of minutes.

80/20 is, in my opinion, a disaster. By and large, we know what is bad. We know what is good. But we are encouraged by those who profit from it to shift items from the 20% category to the 80% category.

Couple that with the fact that the smarter we are, the better we are at convincing ourselves, with very complex justifications, that small bad things done consistently really aren't that bad. We are terrible at seeing the accumulated damage of the 20% in ourselves. We call it nature. Aging.

First do no harm.

[Toska2]

Oh. I thought it was to live a life so thorough that there is no fear of death.*


*Cancer is no longer a death sentence. Depending on other health markers I might find the cure too expensive. C'est la vie

[Dragline]

80/20 is, in my opinion, a disaster. By and large, we know what is bad. We know what is good. But we are encouraged by those who profit from it to shift items from the 20% category to the 80% category.

This simply represents a belief in certainty -- especially the idea that "we know what is good". That we are so smart these days we can conquer death just by a little more effort. In fact, we probably don't, at least for all genotypes. That's why nutrition and exercise are such debatable topics.

I think you may be missing the point. There is always uncertainty in health in that (a) we cannot anticipate every negative medical outcome that may befall us and (b) we may be doing things that we now think are healthy for us that actually might not be or might just be neutral/inneffectual. This means that at a certain point of "living the healthiest life we can conceive" only may get us, say a 2% improvement whereas the uncertainty factor may be 5-10% (the percentages are for illustration only). The idea is that the level of uncertainty exceeds the potential benefit such that the effort becomes useless other than any psychological benefits.

The upshot is that unless you are omniscient, you cannot live a "perfectly healthy life", but only some approximation thereof that may or may not prevent your early demise.

As the title of the new book says, "Ego is the Enemy". And yes, I'm just jerking your chain now with that last remark.

[EdithKeeler]

I've been thinking about this thread this evening. I just got back from my mom's house, where I go every Sunday, and usually several times during the week. She has Parkinson's Disease, a blood clotting disorder, and terrible, terrible arthritis. At 79 her quality of life sucks. Of her afflictions, probably the one thing she could have affected--to an extent, maybe--with lifestyle changes would have been her arthritis, but now with her co-morbidities, she's really kind of stuck at this point. The latest development is that she's pretty much lost the use of her dominant hand; I offered twice tonight to cut her meat for her and she refused, but it was painful for both of us--her to cut her steak and eat it, and me to watch. Although she's got a lot of problems, she's actually pretty healthy in terms of blood pressure, her arteries are very clear, per a recent procedure she had done related to something else, and fortunately she's had little mental slippage. But... she can barely walk thru the house with the assistance of a walker, and I think the time is coming soon where she's going to need help with bathing. She hasn't been able to drive the last 4 years, and her days are pretty much spent in front of the TV.

My dad, on the other hand, lived a pretty bad lifestyle. Smoked for years, probably 2 packs a day. Quit cold turkey at the age of 62, when he was diagnosed with kidney cancer, which probably resulted from the very significant amount of liquor he drank every day. He quit smoking, but kept drinking, even with one kidney, which I suspect made it that much harder to metabolize the booze. He died a couple months before his 80th birthday. He'd been diagnosed with a recurrence of the cancer, had been given a year to live, and died a month after the diagnosis. He'd played golf about four or five days before.

I know that given the choice ar my end of life, I'd sure rather go quick than slow. I don't care what kills me, I just don't want to do that slow spiral into less and less function, whether mental or physical, relying more and more on people to take care of my most basic needs of daily living. "Better to burn out than to fade away." I suspect my mom could live another 10 years or more, but I don't think they will be good years. My dad was vital pretty much up until the end.

[Ego]

I think you may be missing the point. There is always uncertainty in health in that (a) we cannot anticipate every negative medical outcome that may befall us and (b) we may be doing things that we now think are healthy for us that actually might not be or might just be neutral/inneffectual. This means that at a certain point of "living the healthiest life we can conceive" only may get us, say a 2% improvement whereas the uncertainty factor may be 5-10% (the percentages are for illustration only). The idea is that the level of uncertainty exceeds the potential benefit such that the effort becomes useless other than any psychological benefits.

Two things.

1) We do not control everything. Absolutely. We agree on that. We know that kale is good and sugar is bad. Your 20% is a purely arbitrary number. A very high arbitrary number. That's 73 cheat days a year. It is 1/6 of the food you ingest as "bad habit" food. Alcohol, mind you, has the same metabolic cascade as fructose. So telling people it's okay to have a few drinks a day (20%) is like saying it is okay to eat spoonfuls of fructose. It is not.

2) Again, the 2% and 5-10% above is out of thin air. That said, there is certainly a point of diminishing returns to healthy eating and exercise. But just because that point of diminishing returns exists does not mean it is wise to discontinue healthfulness at that point. You have to work harder to get additional gains. Those additional gains may mean the difference between, for instance, my 75 year old friend who cycled Alp d'huez on a long cycle tour of Europe recently vs. my previous 75 year old tenant who can no longer walk because of weight. 2% a year for 20 years is a big variance.

[Ego]

I know that given the choice ar my end of life, I'd sure rather go quick than slow. I don't care what kills me, I just don't want to do that slow spiral into less and less function, whether mental or physical, relying more and more on people to take care of my most basis needs of daily living. "Better to burn out than to fade away." I suspect my mom could live another 10 years or more, but I don't think they will be good years. My dad was vital pretty much up until the end.

Exactly. Me neither.



Which technique would be more likely to square the curve? Which would be more likely to lead to the typical long steady decline?

[BRUTE]

We know that kale is good and sugar is bad. Your 20% is a purely arbitrary number. A very high arbitrary number. That's 73 cheat days a year. It is 1/6 of the food you ingest as "bad habit" food.

brute has learned from experience that he can't do cheat days, basically at all. 80/20 is not nearly enough for meaningful results from him. currently he's at >90% over the last few months. unfortunately, this seems necessary to brute, and actually much easier than 80/20.

[Dragline]

We know that kale is good and sugar is bad. Your 20% is a purely arbitrary number. A very high arbitrary number. That's 73 cheat days a year. It is 1/6 of the food you ingest as "bad habit" food.

brute has learned from experience that he can't do cheat days, basically at all. 80/20 is not nearly enough for meaningful results from him. currently he's at >90% over the last few months. unfortunately, this seems necessary to brute, and actually much easier than 80/20.

What do you mean by "meaningful results" and what bearing does it have on your longevity that you can calculate?

I think these are two different things. It would be confused metrics to equate some measure of current physical health with the probability of getting cancer or contracting some other fatal disease or condition

[Dragline]

I think you may be missing the point. There is always uncertainty in health in that (a) we cannot anticipate every negative medical outcome that may befall us and (b) we may be doing things that we now think are healthy for us that actually might not be or might just be neutral/inneffectual. This means that at a certain point of "living the healthiest life we can conceive" only may get us, say a 2% improvement whereas the uncertainty factor may be 5-10% (the percentages are for illustration only). The idea is that the level of uncertainty exceeds the potential benefit such that the effort becomes useless other than any psychological benefits.

Two things.
1) We do not control everything. Absolutely. We agree on that. We know that kale is good and sugar is bad. Your 20% is a purely arbitrary number. A very high arbitrary number. That's 73 cheat days a year. It is 1/6 of the food you ingest as "bad habit" food. Alcohol, mind you, has the same metabolic cascade as fructose. So telling people it's okay to have a few drinks a day (20%) is like saying it is okay to eat spoonfuls of fructose. It is not.

2) Again, the 2% and 5-10% above is out of thin air. That said, there is certainly a point of diminishing returns to healthy eating and exercise. But just because that point of diminishing returns exists does not mean it is wise to discontinue healthfulness at that point. You have to work harder to get additional gains. Those additional gains may mean the difference between, for instance, my 75 year old friend who cycled Alp d'huez on a long cycle tour of Europe recently vs. my previous 75 year old tenant who can no longer walk because of weight. 2% a year for 20 years is a big variance.

No, we don't agree that kale is 100% good and sugar is 100% bad. That is the fundamental difference -- you appear to believe in certainty and I do not. Whether its 80/20 or 90/10 is not really the point -- the point is that there are diminishing returns on any course of future action as to health that are overwhelmed by uncertainty. Only if you have a belief in certainty would you contend that every last effort to maintain healthy habits will actually result in increased longevity. As I've said before in other threads, "almost nobody lives in the aggregate".

You will find people who "cheated" every day of their lives and lived to be 100 or more. This is simply a matter of probability.

The fractal nature of these distributions and the inherent uncertainty of them is a natural fabric of life. It even governs what we view as "art' as opposed to random flings of paint: http://discovermagazine.com/2001/nov/featpollock

As an analogy,wWhether you will die early or late may have as much to do with the arrangement of drops on a Pollack canvas (uncertainty) as it does with your habits (how he made the painting).

[7Wannabe5]

Sugar is not too bad for you if you have no tendency towards metabolic syndrome, as manifested by low normal blood pressure, very good cholesterol and blood sugar processing lab results, and an almost infinite tendency towards converting sugar ingested into metabolically inert fat stored on buttocks due to low exposure to testosterone in the womb. It's just the tending towards skinny shanks and high hard paunch (or disproportionately large breasts if female) geno/phenotype that really needs to avoid the sugar and alcohol and push the cardio. It is likely that I will outlive the men on this forum who are the same age as me, no matter what they do, because I am approaching 52, and I am still nominally fertile, and that gives me an approximately 5 year edge, which is hard to touch even with the very best lifestyle practices. My mother at 76, is quite overweight and has a huge butt, and no signs of diabetes or heart disease. She was nominally fertile into her late 50s. One of the older Polish women in my water aerobics class, same story. Huge butt, gave birth in her late 40s, shows up for class in scuba pants and bra with bare belly at age 78. She wears her hair very short and steel gray, and is quite overweight, but still looks pretty good and solid naked if you go for the big butt type. During a brief celibate period around 4 years ago, I started manifesting some symptoms of menopause, but found that they abated completely when I formed contract with a partner who was consistently available for sex 5 to 10 times/week. Unfortunately, I have now formed the opinion that there may be some correlation between men who are good to go 5-10X/week and men with whom it is impossible to share house space without going insane. Thus, my current attempt to procure life-sustaining vigorous sexual activity 6X/week by having 3 partners who are each available approximately 2X/week. Since, at least 2X/week, is the level of sexual activity best correlated with huge improvement in heart health statistics for older men, I feel like this should be a very mutually beneficial arrangement. I know that I am before my time with this practice, but somebody has to blaze the trail first, and not simply follow where others have already set their data points. The rest of you can feel free to carry on with your kale juice concentrate powered interval sprinting. I will meet you back here in the year 2046, and we can compare our results.

[ThisDinosaur]

It is a myth that nature is a benevolent Mother Goddess who will keep us healthy if we just eat the *right* foods and avoid the *wrong* ones. Nature is much more like a Lovecraftian Elder God; indifferent to us as individuals and as species. Sugar is one of the most fundamental components of metabolism. Too much kale may be toxic to the thyroid. Age related diseases, including cancers, may be brought on by free radicals naturally produced by normal, healthy metabolic processes that are an inevitable byproduct of being alive.

7Wannabe5 and vexed87 can BOTH be right about the onset of age-related cancers. The DNA repair mechanisms in multicellular organisms are a determinant of the slope of the line in the posted figure. Larger/longer-lived/late breeding organisms typically have more robust DNA repair mechanisms than smaller ones. This leads to chronologically later onset of cancers. It takes longer for a large animal to grow to sexual maturity. This leads to a selection pressure to either breed earlier or to delay onset of cancer-causing mutations. There is an equilibrium between these two pressures, which is why a two year old mouse can develop cell cycle mutations that take elephants several decades to acquire.

[Ego]

That is the fundamental difference -- you appear to believe in certainty and I do not. Whether its 80/20 or 90/10 is not really the point -- the point is that there are diminishing returns on any course of future action as to health that are overwhelmed by uncertainty. Only if you have a belief in certainty would you contend that every last effort to maintain healthy habits will actually result in increased longevity. As I've said before in other threads, "almost nobody lives in the aggregate".

Certainty. No, I am not certain. Probability. Yes! I am constantly tweaking what I do and what I don't do based on good science.

My goal is not to live forever. It is to live on the top line of this chart.

This tells you that applying a healthy 80/20 (healthy habit/unhealthy habit) kind of rule of thumb is probably the best strategy for most people.....

You are advocating 20% unhealthy habits. You are saying it is okay if 20% of things I do are things I KNOW ARE NOT GOOD FOR ME. 20% of my actions are things I know to be unhealthy.

This is a mental model justifying self-harm. Rationalizing. Enabling.

That unhealthfulness is amplified over a lifetime in much the same way compound interest amplifies money. It puts people on the lower line of the chart.

Decline is inevitable. That fact, the inevitability of decline, does not mean that we should stop striving for constant improvement.

As imperfect as we are, we should use what we've got at this very moment; the information, the genetics, the resources, the abilities, the strengths, the weaknesses .... everything that combines to make up who we are.... to get a little bit better today. Tomorrow things may change. And when they do we should factor in those changes.

First do no harm. The 20% is harm.

[Scott 2]

It's just a question of what kills you first. Death by cancer at 80 means you've avoided the other risks.

My hope is when I get there, I'll be happy enough with the life I lived, that I can go "oh, so this is how it happens..."

I make my choices with that in mind. I also see health as a resource to be consumed, facilitating that goal. If nothing wears out, then I drop dead, I haven't lived hard enough.

[BRUTE]

We know that kale is good and sugar is bad. Your 20% is a purely arbitrary number. A very high arbitrary number. That's 73 cheat days a year. It is 1/6 of the food you ingest as "bad habit" food.

brute has learned from experience that he can't do cheat days, basically at all. 80/20 is not nearly enough for meaningful results from him. currently he's at >90% over the last few months. unfortunately, this seems necessary to brute, and actually much easier than 80/20.

What do you mean by "meaningful results" and what bearing does it have on your longevity that you can calculate?

I think these are two different things. It would be confused metrics to equate some measure of current physical health with the probability of getting cancer or contracting some other fatal disease or condition

things like keeping metabolic syndrome under control and fixing sleep. these two are probably the biggest killers in the west right now, maybe except tobacco. most age-related diseases or degenerations seem to be influenced heavily by either.

[BRUTE]

It's just a question of what kills you first. Death by cancer at 80 means you've avoided the other risks.

My hope is when I get there, I'll be happy enough with the life I lived, that I can go "oh, so this is how it happens..."

I make my choices with that in mind. I also see health as a resource to be consumed, facilitating that goal. If nothing wears out, then I drop dead, I haven't lived hard enough.

that doesn't seem to be how it works. excluding things like accidents, most humans seem to die of the same diseases. some just get them earlier rather than later. very few humans seem to live happily until 80 and then suddenly die of cancer or heart disease. longevity seems to generally correlate with higher quality of life at old age. that's probably because most (all?) diseases of civilization have slow onset over decades, and most also have negative impact on quality of life years or decades before they kill. cancer, heart disease, diabetes, Alzheimers. stroke, brute isn't so sure.

this is why brute is a fascist when it comes to his diet, but also rides racing motorcycles, one of the highest risk activities most humans have access to. he can live (haha) with dying in a 160mph crash, but doesn't feel like living from 50-80 with terrible quality of life.

[Dragline]

This tells you that applying a healthy 80/20 (healthy habit/unhealthy habit) kind of rule of thumb is probably the best strategy for most people.....

You are advocating 20% unhealthy habits. You are saying it is okay if 20% of things I do are things I KNOW ARE NOT GOOD FOR ME. 20% of my actions are things I know to be unhealthy.

This is a mental model justifying self-harm. Rationalizing. Enabling.

That unhealthfulness is amplified over a lifetime in much the same way compound interest amplifies money. It puts people on the lower line of the chart.

Decline is inevitable. That fact, the inevitability of decline, does not mean that we should stop striving for constant improvement.

As imperfect as we are, we should use what we've got at this very moment; the information, the genetics, the resources, the abilities, the strengths, the weaknesses .... everything that combines to make up who we are.... to get a little bit better today. Tomorrow things may change. And when they do we should factor in those changes.

First do no harm. The 20% is harm.

The 20% might be bad habits, neutral habits or decent habits, actually. It doesn't really matter if there is an inherent factor of uncertainty that is of similar magnitude.

But this process actually does not work that like compound interest on a smooth curve for the individual -- the trajectory is generally far more jagged for the individual -- you are fine, and then suddenly you are afflicted. And death itself is ultimately binary. You only get smooth sickness/mortality curves when you aggregate many people and their habits. A few unhealthy habits do not necessarily lead to incremental declines in health; nor does maintaining 100% good habits guarantee success.

A good example of being lucky with uncertainty of aging might be Warren Buffett, who consumes five cokes a day and "eats like a six-year old." http://fortune.com/2015/02/25/warren-buffett-diet-coke/ Yet he is still going strong at 85 despite these bad habits and surviving prostate cancer.

On the flip side, you have someone like Steve Jobs who meticulously followed a vegan diet but yet was struck down with cancer before age 50 -- of course SJ did not help himself by not seeking conventional medical treatment right away, because he erroneously "thought" he could cure himself with "healthy habits" that he researched himself. This is another aspect of the uncertainty -- what you think you are doing that is good for you might not be at all or might just be ineffectual.

[Ego]

But this process actually does not work that like compound interest on a smooth curve for the individual -- the trajectory is generally far more jagged for the individual -- you are fine, and then suddenly you are afflicted. And death itself is ultimately binary. You only get smooth sickness/mortality curves when you aggregate many people and their habits. A few unhealthy habits do not necessarily lead to incremental declines in health; nor does maintaining 100% good habits guarantee success.

This is an interesting way of thinking. It seems you are saying that because none of us live in the aggregate, there is nothing we can learn from the aggregate.

Nobody is suggesting that it is possible to eliminate risk with good habits. I am suggesting that it is possible to influence risk. Squaring the mortality curves has been a cornerstone of those who specialize in disease prevention / health promotion for decades



The ideal trajectory for an individual is a square quality of life/age curve. A square curve (like the one you outlined) is NOT the typical trajectory. Most people experience a gradual decline in function as measured by a typical physical function assessment by their physician. They experience compounding-interest-like decline because they follow the thinking you are proposing. They believe it is inevitable. Unavoidable.

And I am glad you brought up Jobs because he is an excellent example. When they calculated tumor doubling times they found that he developed pancreatic cancer at age 24 and lived as long as he did and had a relatively high quality of life for most of his life because he had healthy habits.

Buffett is the largest investor in Coke, so no surprise there. I know you believe it is perfectly ethical to make money selling stuff that kills others. We disagree there as well.

[jacob]

Health and quality of life aren't necessarily the same. Consider for example, happy smokers. It used to be unfathomable to me why anyone would deliberately destroy their health, but I think I get it now. Same reason that people get into cars despite it having a negative statistical effect on their health: It increases their quality of life.

[BRUTE]

true for some things, not for others. jacob may ask sufferers of advanced stage diabetes with amputated legs and who lost their vision. or sufferers of stroke. or cardiovascular infarctions. or Alzheimers.

these are the diseases of civilization, and they do affect quality of life just as they do mortality.