2024 LC Thread: Name That Tune

Quick story about me/my health, and exercise:

Up until about two years ago I was in peak physical condition for a person my age (I’m 51 now). For several years I ran between 3-5 miles just about every day. Many 100+ mile months in a row during that time. Over the years that I was running regularly I had a bunch of setbacks - illness and injury mostly. Fighting my way back from those times was hard, but I was always able to grind back - sometimes quickly, sometimes slowly. About two years ago I hit a rough patch - I’d get out on the road and my legs just felt heavy and I’d have low energy in general. I put my head down and just kept going, confident that I’d come around like I always had. Not only did that not happen, but it got worse, and harder and harder to get out there at all. I started lifting more and running less, and put on weight. So that made running even harder, as you’d imagine. And then I hurt my shoulder and lifting wasn’t really an option anymore either. My energy was at an all-time low, and it’s pretty much been that way since.

As I’ve posted, I now know I have sleep apnea. I don’t know if that’s what caused the energy ebb in the first place or if I developed it after putting on weight, but that’s the deal now. When I was in my peak running shape I was around 220 lbs (I’m 6’3"), I’m now around 255. I know that losing weight is a key to improving apnea, so I’m fighting hard to do so. I did a few weeks of a meal delivery service (Factor) and am now doing my own meal prep. That 255 number is down seven pounds from a month ago.

All of this to say that I’m going to see my doctor tomorrow to ask about the semaglutides. My thinking is that I need to get the momentum headed in the right direction so that I can keep it going under my own power. And if weight loss can fix/improve the apnea to the point I don’t need a machine, then that would be amazing.

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There has only been a surplus of food in the modern era, and that unprecedented surplus is solely the result of the capitalist hellscape. Nearly every good thing the world has now (as well as many bad things) is the result of capitalism. Like individual health, the world runs on actual incentives not good intentions.

I would say don’t be afraid to be a bit stern with your doctor about semaglutide. Also, you should check out orangetheory. Their treadmills are top notch and the workouts are low impact.

Btw, another “hack” I use is nicotine lozenges bought from Costco for the last 15 years. It’s lame that I haven’t quit nicotine addiction, but removing the smoke is a major plus for overall health. I haven’t quit because I used to drink about once a week and would always smoke when drinking, but COVID lockdown and semaglutide have significantly reduced my drinking, so maybe I’ll eventually be able to kick my lozenge habit.

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Fair, I was too broad with my language because I’m talking specifically about obesity, which is a modern epidemic. Unless you all think that increased obesity in western countries actually goes hand in hand with reductions in malnutrition, with the same cause, so we can’t decrease malnutrition without also increasing obesity.

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Also, food cost is now like 10% of income, when it was like 60% 150 years ago. And it’s not just Western counties. Obesity is becoming epidemic in every country with a developed economy, especially the middle east and including China.

My personal belief is that it’s not just free access to food and bad food but sedentary lifestyle of the modern world that reinforce one another to create the current mess, which, all things being equal, is still preferable to actual food scarcity.

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Kind of. You could live a perfectly healthy life, but if you live in an area where malaria is endemic, you can’t healthy lifestyle your way out of it.

Lots of people have genetic or other conditions that don’t have a much to do with their lifestyle. Like if you’ve got psoriasis or rheumatoid arthritis, how are you going to healthy lifestyle your way out of that?

You can strive as much as you want, but there is some shit you just can’t fade My friend’s dad died of a really rare, highly malignant brain tumor. He was a thin vegetarian who exercised regularly. I don’t know the details, but I think in his case there just weren’t any good treatments available. But someday there may be and in that case, the pharmaceutical assist is something I think everyone in his spot would take.

I agree with this.

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There’s a ton of data to show that strength/muscle mass and VO2 max are the biggest predictors (that you can control) of a long healthy life, and nothing else really comes close. Except stuff like don’t get hooked on crack, etc.

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How does this fare vs. obesity. Obese people will have more muscle mass than non-obese people because they have to lug all of that weight around?

I think the presumption is non-obese, relatively healthy person who doesn’t do any resistance or cardio training vs. a person of roughly the same weight and build who does those things regularly in their 40s, 50s, 60s, 70s, 80s, etc.

I would put “don’t become morbidly obese” in the “don’t get hooked on crack” category. Visceral fat is a known killer.

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What about metrics associated with heart disease like high cholesterol levels? I’ve seen the Peter Attia videos where he makes those claims, but I still have a hard time believing I can eat whatever the hell I want with impunity provided I’m strong and have good cardio.

I don’t think that’s what’s implied. He’s not saying you can do tons of super unhealthy stuff just because you train hard. The general premise of the show is that the listener is at least interested in being healthy into old age, if not actively working towards that goal. People who are looking for that one weird trick that will let them eat a large pizza for dinner every night aren’t really his audience.

He’s talking about stuff like supplements and other supposed longevity boosters being a rounding error compared to strength and cardio training.

Or say a basically healthy diet with cheats every now and then vs. some insane super strict diet. I think he would say that the gap in outcomes between those two diets is much less than the gap in outcomes between someone who exercises and someone who’s sedentary (everything else being equal).

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New SciAm article on semaglutide.

The U.S. clinical trial registry shows that thousands of studies on GLP-1 receptor agonists are underway now. A large, multi­year study that showed sema­­glutide reduced risk of heart attack and stroke by 20 percent helped Wegovy gain FDA ap­proval as a treatment for cardio­vascular disease earlier this year. Weight reduction most likely played a large role in heart health, but re­searchers are also finding convincing early evidence that GLP-1—and the drugs—may reduce inflam­mation when bound to receptors. That observation is now opening up the drugs to clinical trials for diseases that seem less obviously related to metabolic disorders, including Alzheimer’s, Park­inson’s, depression and even cancer.

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This is actually what I think.

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I’ve been on Ozempic and it’s helped.

I tend to go in patches. A few good months where I lose a few KGs, then a few bad months where I put it all back plus some more.

Post Ozempic, I’ve stabilised, but have been mostly in bad months in terms of effort so that’s a win. If I can strong 6 months of effort together, I should get back to a healthier weight.

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I’d say you’re taking some real liberties with the categorization there. Those things are not the same at all.

They’re both very detrimental to your health and something most people have some control over.

When was capitalism invented? Money and markets and banking go back at least 5000 years. The first company was 1800 years ago. The first joint stock company was 670 years ago. In 1865, in the USA, a prosperous country at the time, life expectancy was 35, which is about the same as it was during the Roman Empire and at the high end of hunter gatherer groups.

Either capitalism took its sweet time, or other things were the major factors.

Hmmm, Das Kapital was published in 1867 and that’s about when life expectancy took off.

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Also the year Frank Lloyd Wright was born. Could be significant.