Longevity

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urge

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Most of us think long term I imagine. 10, 20, and 30 years down the line. All the schooling, investments, retirement accounts with deferred taxes….

What are you doing to increase your chances of being alive when your master plan comes to fruition?

I have heard of people doing metformin, glutathione, resveratrol…. and of course exercise.

What’s your concoction?
 
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Most of us think long term I imagine. 10, 20, and 30 years down the line. All the schooling, investments, retirement accounts with deferred taxes….

What are you doing to increase your chances of being alive when your master plan comes to fruition?

I have heard of people doing metformin, glutathione, resveratrol…. and of course exercise.

What’s your concoction?

Strength training and aerobic exercise, good diet, sleep.

Maybe intermittent fasting if you feel so inclined.

Rest is of dubious value at best, and side effects can be significant. There is no way that I’ll be holding in diarrhea from metformin all day just for a tiny chance that it extends my lifespan by a trivial amount.
 
Most of us think long term I imagine. 10, 20, and 30 years down the line. All the schooling, investments, retirement accounts with deferred taxes….

What are you doing to increase your chances of being alive when your master plan comes to fruition?

I have heard of people doing metformin, glutathione, resveratrol…. and of course exercise.

What’s your concoction?

Good amount of cardio a week. Try to do 150 min a week. Can be jogging, weighted vest with walking, hike etc.

Weight training 3 to 4 times a week. I follow the motto of training harder than last time, whether that's increasing reps/ weight/ slower reps etc. I developed basically tennis elbow when doing bicep curls with too heavy of a weight. Took months to heal. Learned my lesson on increasing weight slowly etc

Keep track of my blood pressure daily/weekly.

Keep track of my A1c regularly. I have a family history of diabetes. A1c is ~5.1 but I have noticed my fasting glucose is borderline so am keeping a closer eye on that. Wouldn't be opposed to starting a low dose of metformin.

Started crestor several months ago. My LDL was ranging from 105 to 120 and I couldn't get it to drop. Started 10mg of crestor and my LDL ranges from 50 to 70 now.

I wanted more aggressive lipid control. I am concerned about my lifetime risk for CAD in general based on racial and family risk factors.

Will likely get a coronary calcium score at some point.

A physician buddy of mine got a prenuvo MRI done. I've thought about that too even though technically there probably isn't a survival benefit. I get paranoid about pancreatic/renal masses.

Other than that, pray for some good fortune.

"Man plans, God laughs"
 
Simple thing is using a smart watch to track vitals and sleep. Noticed small things i would do would have a measurable impact. For example drinking coffee at what I thought wasnt that late in the day around 4 pm would get picked up on the sleep monitor with less hr variability and less deep sleep. Same with eating heavy right before sleeping.

Do a lot of people take statins for primary prevention? So much stuff on the internet not sure what to believe anymore.
 
- Resistance training: minimum two to three times per week, focusing on the major compounds like upper body presses, upper body pulls, lower body squats, and hip hinges like Romanian deadlifts.
- Cardio: a couple times per week, or at least getting around 10k steps per day.
- Diet: more importantly, controlling your calories.
- 1 g per lb. of lean body mass Protein
- a couple servings of fruits and vegetables per day.
- Consistent circadian rhythm.
- Sufficient sleep.
- Low stress.
- If you really have trouble controlling your appetite, maybe a GLP-1.
- All the other peptides are pretty bogus, especially BPC and the like, and those similar to it in that category.
- Just to emphasize, not all peptides are the same. People constantly group the GLPs with other peptides like BPC, but while they are all peptides, the evidence and effectiveness behind them are worlds apart. Be aware of the side effects of GLP-1s, such as anhedonia and gastroparesis, though, which sometimes take a while to resolve. Other peptides like retatrutide can elevate the heart rate and cause insomnia, but a peptide like retatrutide (triple agonist) also has glucagon receptor agonist benefits that improve basal metabolic rate and insulin sensitivity beyond just the weight and fat loss in controlled trials.
- With regards to keeping stress levels low, who you marry definitely impacts that.
- Keeping a good social life and staying socially active, preferably within a community involving activities that encourage meeting up regularly. That can be church, a very nice luxury gym, etc.
 
99.9% arent' doing the basics optimally like SLEEP, diet and exercise. Data suggest sleep is actually the most important for longevity believe it or not and our society with 24/7 engagment is making it incredibly harder to adhere to it. I spend hours a week on this topic im going to give the most basic highlights that ive learned.

Sleep: 7 hours ish ideal for longevity. over 8 or under 6 incr mortality according to the data. ideal bedtime is likely somewhere in the 930p-11p zone and waking up before 7a essentially following circadian rhythms. ive been a night owl all my life and this was the most difficult one to swallow but its true and i still fight it at times. Won't bore you on details but you max out your NREM sleep along with GH levels. Also for me if i sleep great much higher odds i will eat optimally and workout vs bad sleep and skipping the gym and/or getting cravings for bad food thanks to cortisol. last meal 3 hrs before bed, no blue light 1 hr min, i sleep in 65 deg temp with fan and black out blind with an air purifier running in the room. We dont understand sleep that great either so sticking to the circadian rhthym on how your designed to sleep is the safest bet.

Diet: Real food number 1. looks at blue zones but mediaterrean diet. Higher protein, lower carbs with ample veggies, EVOO for fats. If you do keto, you should cycle it as your mitochondria need to have metabolic flexibility and run on both efficiently. Lowering meat intake over time and limited etoh. wait 60-90 min after waking to have caffeine. If your sleeping well you wont really need it to get going.

Exercise: the 150 min/wk zone 2 is great but more research showing you need the HIIT 1-2x a week . Compound mov't 2-3x a week. Dont have an ego once your in your 40-50s joint health/tendons/ligament no need to max out and its more about maintaining the lifts and form quality. The sport with the most longevity benefits is tennis so learn or keep it up. get your VO2 max tested at some point. Do a Dexa periodically to track viceral fat/bone mass/muscle mass. The cancer scans may have a role too at some point. Work on flexibility early.

Mich: social interaction matters in a world thats more disconnected by the minute. U need to be the guy to call the other friends bc people have forgotten or get scared now to intiate things like in the past.

80-90% adherence to the above goes a long way. There are way too many peptides, mitochondrial agents, hormonal agents to discuss and i've only explored the mitochondrial ones ( nmn, tmg, coq10) and there is something to it but the base needs to be there and maybe hold off on the peptides/hormones few more years till more data on safety.

P.S. : Reach financial independence but work 1-2 days a week is also likely optimal cognitively. Sub 50 yo is the 4D move. More time to explore the above if your lucky to reach it.
 
Simple thing is using a smart watch to track vitals and sleep. Noticed small things i would do would have a measurable impact. For example drinking coffee at what I thought wasnt that late in the day around 4 pm would get picked up on the sleep monitor with less hr variability and less deep sleep. Same with eating heavy right before sleeping.

Do a lot of people take statins for primary prevention? So much stuff on the internet not sure what to believe anymore.

I think the statin use needs to be based on family and ethnic background.

I know of a couple of guys in their 40s and 50s who've already had an MI or chest pressure that prompted a cardiac work up and found CAD that required stents. Scary stuff.

The side effects are minimal to be honest and I'd rather have an LDL in the 50s than the low 100s.
 
Most of us think long term I imagine. 10, 20, and 30 years down the line. All the schooling, investments, retirement accounts with deferred taxes….

What are you doing to increase your chances of being alive when your master plan comes to fruition?

I have heard of people doing metformin, glutathione, resveratrol…. and of course exercise.

What’s your concoction?
I stopped spending nights in the hospital before the age of 40.
 
I think the statin use needs to be based on family and ethnic background.

I know of a couple of guys in their 40s and 50s who've already had an MI or chest pressure that prompted a cardiac work up and found CAD that required stents. Scary stuff.

The side effects are minimal to be honest and I'd rather have an LDL in the 50s than the low 100s.

This relates to a major aspect of health/longevity that I see neglected by a lot of physicians: keep up with age appropriate health screenings and get weird/unusual symptoms checked out.

I’ve encountered a surprising number of docs who let random symptoms slide for years until they built into catastrophic issues. One ignored significant gastric pain and heartburn for years, taking OTC PPIs…eventually they developed stomach cancer from the untreated H. Pylori ulcer that had been lingering all that time (thankfully this regressed after the H pylori was treated with abx). I know of another physician who was having chest pain intermittently, and one day in clinic it was especially bad…so he ran an EKG in clinic and it looked like a STEMI. He didn’t believe this, so he took his EKG machine home with him, got on his treadmill, and did another EKG which looked even worse…only then did he go to the ER.

Bottom line: don’t be stupid. Get issues checked out.

Also, keep up with the age appropriate cancer screenings. Oh, and get an actual colonoscopy…do not do cologuard or any of that nonsense. Colon cancer is becoming surprisingly common in young people. I’ve encountered a number of doctors on the younger end who are shying away from colonoscopies, doing cologard or whatever instead…”but I’m low risk”…no. Just get an actual freaking colonoscopy. It could save your life.
 
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This relates to a major aspect of health/longevity that I see neglected by a lot of physicians: keep up with age appropriate health screenings and get weird/unusual symptoms checked out.

I’ve encountered a surprising number of docs who let random symptoms slide for years until they built into catastrophic issues. One ignored significant gastric pain and heartburn for years, taking OTC PPIs…eventually they developed stomach cancer from the untreated H. Pylori ulcer that had been lingering all that time (thankfully this regressed after the H pylori was treated with abx). I know of another physician who was having chest pain intermittently, and one day in clinic it was especially bad…so he ran an EKG in clinic and it looked like a STEMI. He didn’t believe this, so he took his EKG machine home with him, got on his treadmill, and did another EKG which looked even worse…only then did he go to the ER.

Bottom line: don’t be stupid. Get issues checked out.

Also, keep up with the age appropriate cancer screenings. Oh, and get an actual colonoscopy…do not do cologuard or any of that nonsense. Colon cancer is becoming surprisingly common in young people. I’ve encountered a number of doctors on the younger end who are shying away from colonoscopies, doing cologard or whatever instead…”but I’m low risk”…no. Just get an actual freaking colonoscopy. It could save your life.


I think we do enough GI that we’re comfortable with screening colonoscopies. Myself and all my close friends and family have had them. I do have an anesthesia friend who’s college roommate, an electrophysiologist, died of colon cancer in his 50s last year.
 
I think we do enough GI that we’re comfortable with screening colonoscopies. Myself and all my close friends and family have had them. I do have an anesthesia friend who’s college roommate, an electrophysiologist, died of colon cancer in his 50s last year.

I’m a rheumatologist. So I don’t know how this usually plays out among anesthesiologists. But I can tell you that I’ve encountered PCPs and other IM sub specialists who are forgoing a colonoscopy in favor of cologard etc.
 
Reading..

Improves memory and possibly delays cognitive decline. Relives stress (and possibly lowers blood pressure). Boosts imagination and improves overall mood/ wellbeing.

Brain health is vastly underrated in these discussions. Regular reading is one of the best habits/ hobbies you can have IMO.
 
You gotta die of something. Eating, drinking, and screwing ain't a bad way to go.
It is amusing how many people are denying themselves many of the things they enjoy the most to live forever in a future that a majority of people believe will be a dystopian hellscape.

I do the basics, diet and exercise, and sleep well when not working. Unfortunately sleep disturbance will likely always be a part of anesthesiology.
 
It is amusing how many people are denying themselves many of the things they enjoy the most to live forever in a future that a majority of people believe will be a dystopian hellscape.

I do the basics, diet and exercise, and sleep well when not working. Unfortunately sleep disturbance will likely always be a part of anesthesiology.

Dont peeps have the option to not take call. My sibling can opt out of the call pool but its a 50-60k hit for the 1 or 2 overnight 12 hr shifts per month
 
Religious exercise routine from a young age (strength training for functional strength and hypertrophy - muscle mass is a glucose sponge, and as much cardiovascular training as you can stomach) . People tell me I look like I’m in my 20s but I’m in my 40s. I believe these are related.

Avoid as much carcinogen as possible (smoking, drinking, environmental exposures)

Eat as much whole plant food cooked at home at low temperatures , or not cooked at all, as much as you can stand.

Treat your dyslipidemia that doesn’t respond to diet and exercise with the most modern and effective medicine available (I’m on repatha)

Social activity and intellectual activity (always be learning something new and engaging with new people and people you already have formed a social connection with)

Sleep. This is my biggest issue. Lifelong sufferer of relatively severe sleep onset and sleep maintenance insomnia. I don’t sleep unless the circumstances are just right and I do frequently have to use medications that promote both onset and maintenance.
 
Prelipid aka red yeast rice
Fish oil bc it can’t hurt 🤷‍♂️
Exercise 2-3 times per week- squats, hanging leg raises, one legged exercises like lunges. Finish with assault bike 15-20 min
Therapy for mental stress - was actually surprised at how well this has gone. Never would have gone before
Salads frequently (daily if I can)
Protein 1g per lb or at least try to. Mainly chicken and protein shakes. Not ideal but it’s easy
Fiber supplements and fiber cereals
No EtOH - might go back to a glass now and then in the future.Abstinence for now, moderation in the future.
No smoking
Sunscreen, nightly adapalene gel and lotions for my vanity
Normal preventative healthcare check ups and lab work, colonoscopies, etc.
Water, I now drink 30+ oz before I even leave the house and it’s been life changing. Between that and the fiber I’m sh1tting like a God.

Every time I take overnight call, I feel like this has to be bad for me long-term
I was considering a GLP drug as well. I do have concerns about my vascular system just based on my father‘s medical issues. My numbers all look great and I would prefer for them to stay that way.
Please comment if you see a glaring issue here lol
 
Prelipid aka red yeast rice
Fish oil bc it can’t hurt 🤷‍♂️
Exercise 2-3 times per week- squats, hanging leg raises, one legged exercises like lunges. Finish with assault bike 15-20 min
Therapy for mental stress - was actually surprised at how well this has gone. Never would have gone before
Salads frequently (daily if I can)
Protein 1g per lb or at least try to. Mainly chicken and protein shakes. Not ideal but it’s easy
Fiber supplements and fiber cereals
No EtOH - might go back to a glass now and then in the future.Abstinence for now, moderation in the future.
No smoking
Sunscreen, nightly adapalene gel and lotions for my vanity
Normal preventative healthcare check ups and lab work, colonoscopies, etc.
Water, I now drink 30+ oz before I even leave the house and it’s been life changing. Between that and the fiber I’m sh1tting like a God.

Every time I take overnight call, I feel like this has to be bad for me long-term
I was considering a GLP drug as well. I do have concerns about my vascular system just based on my father‘s medical issues. My numbers all look great and I would prefer for them to stay that way.
Please comment if you see a glaring issue here lol
Statins are purified red yeast rice, just start a freaking statin and quit trying to be a hippie.
 
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Dont peeps have the option to not take call. My sibling can opt out of the call pool but its a 50-60k hit for the 1 or 2 overnight 12 hr shifts per month
Sure any individual anesthesiologist can opt out but people are always going to need surgery at night. While I’m not quite in the ‘medicine is a calling’ club, I do feel some obligation to take care of the community during off hours. It probably helps that I do peds so I’m never doing BS choles or other semi-elective nonsense at night.
 
Sure any individual anesthesiologist can opt out but people are always going to need surgery at night. While I’m not quite in the ‘medicine is a calling’ club, I do feel some obligation to take care of the community during off hours. It probably helps that I do peds so I’m never doing BS choles or other semi-elective nonsense at night.
I too feel some obligation to work off hours because if everyone has this attitude there wouldn’t be any emergency services for anyone . It should either be paid a major premium or everyone should be made to do at least some .
 
Also, keep up with the age appropriate cancer screenings. Oh, and get an actual colonoscopy…do not do cologuard or any of that nonsense. Colon cancer is becoming surprisingly common in young people. I’ve encountered a number of doctors on the younger end who are shying away from colonoscopies, doing cologard or whatever instead…”but I’m low risk”…no. Just get an actual freaking colonoscopy. It could save your life.

100%. There's some evidence that colon cancer is more prevalent in distance runners as well. More evidence needed.

 
100%. There's some evidence that colon cancer is more prevalent in distance runners as well. More evidence needed.

Yet more evidence that exercise is dangerous.

Also, despite current evidence against alcohol:
cliff-clavin-on-beer-reprint-of-a-classic-diatribe-from-chee-demotivational-poster.jpg
 
100%. There's some evidence that colon cancer is more prevalent in distance runners as well. More evidence needed.

More dehydration and constipation in runners maybe? Slower colon transit times?
 
Sleep. This is my biggest issue. Lifelong sufferer of relatively severe sleep onset and sleep maintenance insomnia. I don’t sleep unless the circumstances are just right and I do frequently have to use medications that promote both onset and maintenance.
Ironically, the sleep meds often make the symptoms worse.
 
Statins are purified red yeast rice, just start a freaking statin and quit trying to be a hippie.
Yeah I know that, I was just lazy. I started it on a whim and it’s easier to just order it at the touch of a button than it is to make an appointment and get some mid-level to prescribe it for me.
Rather than respond in a sassy manner, I will consider it the next time I go in for a check up
 
I too feel some obligation to work off hours because if everyone has this attitude there wouldn’t be any emergency services for anyone . It should either be paid a major premium or everyone should be made to do at least some .


Yeah ASC aint gonna reopen at midnight to take care of that bleeding postop tonsil.
 
Yeah I know that, I was just lazy. I started it on a whim and it’s easier to just order it at the touch of a button than it is to make an appointment and get some mid-level to prescribe it for me.
Rather than respond in a sassy manner, I will consider it the next time I go in for a check up
.... Fair
 
Reading..

Improves memory and possibly delays cognitive decline. Relives stress (and possibly lowers blood pressure). Boosts imagination and improves overall mood/ wellbeing.

Brain health is vastly underrated in these discussions. Regular reading is one of the best habits/ hobbies you can have IMO.
Keep your mind sharp.

I may go deaf from podcasts, but my brain will be brimming with worthless information and exponential neural connections at my death.

Which will occur at age 130 during WW4.
 
This is easy. Keep mind active. Exercise. Maintain good weight. Start a statin or repatha at a young age. Don't drink or smoke.