Weekend links for Saturday, August 17, 2017: post-apocalyptic Rio, money makes the Mediterranean diet work, DNA testing may not change behavior, and the folly of clean eating

A year later, the Rio Olympic sites are ruin porn. 

Is money the secret to making the Mediterranean diet work? 

To be fair: I don't know a lot about this literature at all, but I suspect that the same claim could be made of many interventions, dietary and otherwise, were the data known. The more money you have, the healthier you are in general. (link via kottke.org)

Knowing our DNA risk doesn't make us change our behaviors.

I need to investigate this further. The thrust of this article--that knowing our risky mutations doesn't make us behave any differently--flies in the face of some data I've presented in the past. 

Have we all fallen for "clean eating?"

I remain convinced that eating food that looks like food, in the Michael Pollan sense, is generally what we should all be doing. Like most ventures that people look to capitalize on, though, it has been taken too far: see the "influencers" in this article that actually make themselves sick with adherence to an irrationally vegetable-based, uncooked diet. (link via longform.org)

Links for Wednesday, August 2, 2017: death of the high-top, marijuana makes you stupid, and spending money only makes you so happy

Are high-top basketball sneakers on their way out?

True story: I bought 3/4 top sneakers for my senior year of basketball over the objections of my high-school coach, who wanted everyone in true high-tops. I stepped on another guy's foot on the first day of practice and broke my fibula. He took this as evidence I'd erred in my shoe choice. The evidence says otherwise:

"There's no science out there, that we have at least, that proves that a high-top shoe is more effective at reducing ankle injuries than anything else," says Kevin Dodson, Nike's senior design director for basketball footwear. 

Marijuana probably makes people do poorly in school, and it's not because they study less

So, with decriminalization and legalization of marijuana occurring nationwide, let's put the drug where it belongs: right beside tobacco and alcohol, two substances that, while not sinister enough to be made illegal, are clearly not good for you and should be mostly avoided.

Is the old adage to "Buy experiences, not things," wrong?

[this] helps us see the car-buyer’s true problem: not that he’s prioritising objects over experience, but that he’s pursuing the wrong kind of experience. He wants to receive a predictable, consistent daily dose of pleasure from owning a car. But that’s not how pleasure works: if the holidaymaker ends up happier, it’ll be because she got to enjoy anticipating the trip, experiencing it, then consigning it to memory, where it can be burnished until it’s perfect (or, if it went terribly, turned into an anecdote that’s even more fun). If our shallow materialist were to use his vehicle to pursue unpredictable, sociable and one-off experiences – like, say, a road trip with friends – he’d stand just as much chance of happiness.

So these new studies seem to indicate that it's not a simple matter of whether you buy things or experiences; it's a matter of what purpose the things you buy serve. If you buy a Faberge' egg (to use the example in the article) to simply put on a shelf in your office to be dusted, it's unlikely to make you any happier. If you buy that same egg to use in a game where it's passed around to close friends and family who are obligated to write a story about it and distribute it at Christmas, it may cause many people to be much happier. 

Super four-pack of links July 11, 2017: the five percent and healthcare money, video game addiction, exercise to prevent diabetes, activity inequality, and evil coconut oil

Super-user sounds great, right? Who doesn't want to be super at something? Only this video (in Memphis-style) refers to the 5% of Americans that account for ~50% of health care spending in a year.

To paraphrase the end of the video: "There's almost nothing insurance companies won't charge, and Americans won't pay." How do you keep yourself from becoming a super-user? Everything medical is a matter of risk, so don't believe anyone who tells you there's a rock-solid simple way to keep from falling into that 5%, at least temporarily. But overwhelmingly, if you can keep a steady job you don't hate, if you can abstain from smoking, if you can get even a small amount of daily exercise (more is better, obviously), if you can keep your alcohol intake to a minimum, if you can abstain from recreational drugs (this includes marijuana, obviously), and if you can choose to eat mostly plant-based foods in semi-sane quantities, you're gonna stay out of The Five Percent.

Dara Lind and Dylan Matthews join Ezra to talk about the updated travel ban, how Trumpism has translated into policy, and the impact that increasingly awesome video games have had on young men's work habits.

Links!

White Paper: Leisure Luxuries and the Labor Supply of Young Men

Peter Suderman's piece about young men playing video games instead of getting jobs

What does excess immersion into video games mean for young men?

I've tried to set the Weeds audio above to play at about the 46 minute mark. But if that doesn't work, fast forward to the 46 minute mark. Not because the discussion of what "Trumpism" is isn't interesting (it is), but because the discussion that follows helped me think more deeply about the problem of excess immersion into video games that young people, especially young men, are experiencing. I've blogged about this before, and I talked about it at a recent speaking engagement. We seem to be creating a generation of youths who are increasingly isolated in very immersive video games, and then they're growing up into increasingly isolated and lonely people, particularly after age 40. As Ezra Klein says in the piece: if this were a problem of drug abuse, I think we would be acting collectively to do something about it. That's an apt comparison, since game addiction and drug addiction seem to have some physiology in common. But since the solution to technological problems currently seems to be "more technology," we are kinda-sorta just plowing ahead and hoping that video games fix themselves. I'm not optimistic. I think we need to start introducing programs to help kids moderate their exposure to video games and increase their exposure to the world at a young age. Dylan Matthews, who generally defends the idea of video games as a pacifying technology for people who can't or won't work, ends with this quote: "When we're in our eighties, we're all gonna be doing, like, flight simulator stuff. That's, like, how we'll spend--or, VR stuff, at least--that's what retirement's going to look like." Yuck. No. No. No. 

A new meta-analysis shows that African-Americans who exercise may not derive the same protective benefit from type 2 diabetes as other races

(brief Healio write-up here)

 I'm not ready to sign on to this point; race is a very blunt instrument when it comes to genetics. As the cost of gene sequencing falls, I think we'll not only be able to tease out drug effects in people with specific genetic features; we'll be able to more precisely target interventions like physical activity. Maybe certain people in this collection of studies would have benefited more from strength training, while others needed more endurance-oriented activities. Maybe some would have benefited from a specific combination of drug and activity. We don't know the answers to these things now, but we will soon. 

Smartphone data shows that countries with the highest "activity inequality" are more likely to have large obese populations: 

More differences in activity within the population equals more obese people. 

So it isn't a surprise that the same investigators found that the higher the walkability of a city, the lower the "activity inequality":

Texas is not a place with a great deal of walkability. 

The cynical take on this study is something like, "Of course people who are inactive weigh more!" Fair enough. But the obvious policy implication of the study is that, to affect the activity level of the inhabitants of a city, the built environment must give opportunities for activity.

ADDENDUM (make it a five-pack): How coconut oil got a reputation for being healthy in the first place. I don't love coconut oil, but even if I did, I'd think of it like I think of butter: an ingredient to be used sparingly, mostly for flavor. 

Things you can control right now

There are a lot of things you can't control: the weather, the stock market, your neighbor's loud music. But many, many things are under your control, as pointed out by Lori Deschene. And how well you do at seizing control makes a huge difference in your health and happiness:

Right now, you can control:

1. How many times you smile today.

7. When you pull out your wallet for luxuries.

11. How often you notice and appreciate small acts of kindness.

17. The type of food you eat.

21. How much exercise you get.

22. How many times you swear in traffic. [I'd amend this to say that you can control how often you're in traffic at all. If you're swearing at traffic, chances are you are the traffic.]

27. The attention you give to your loved ones when you see them.

28. How much you enjoy the things you have right now.

41. Whether you formulate a new plan or act on your existing one. [this is my favorite]

44. Whether you smoke or drink. [unless you’re an alcoholic, in which case you are in control of whether or not you seek help from a qualified practitioner]

50. How much rest you get at night.

40 minutes

Who is the maniac posting here the last few days? 

What the hell is Double Arrow Metabolism? Doctors always think they know everything. And I don't like the looks of this guy. He was probably born skinny, and here he is trying to judge the rest of us for driving cars, smoking, eating processed foods, spending our money on whatever we want, and spending our free time on social media. Sure, maybe you can be healthy if you've got a good set of genes and luck into a doctor who's not a quack. But it's a roll of the dice. Life is hard, and this guy acts like we can all just "choose" to be healthy. Some of us have obligations! Kids at home, a mortgage to pay. So we get a little stressed out and watch some TV and maybe have a beer or two. Live a little for a change. So what? 

Yet some people live happily and healthily into their 90s, while the overall life expectancy is going down. Is it all just genetics, or is there something we can do to live longer and happier? Let's examine the thin grey line between being healthy and happy and being sick and depressed.

How thin is the line? How about 40 minutes a day?

Let's say you are holding your own, health-wise. On the Double Arrow Metabolism Wellness Index, you're a solid two or three. Then you decide that lying on your side for thirty minutes in bed each night flipping through your Facebook feed is more important to you than moving through space like you were designed to do. All the light from the screen blasting into your retinas throws off your sleep cycle, so you wake up in the middle of every night for ten minutes and raid the fridge to the tune of 200 highly-processed calories.

Then, since you couldn't sleep the night before, you wake up twenty minutes late and decide that you don't have time to make a sensible, non-cake-based breakfast at home.

Let's assume that you commute less than five miles to work, as a solid plurality of
Americans do. You're in a hurry and instead of biking, walking, or busing to work, you swing your fancy gas-powered wheelchair through McDonald’s on your way there and spend $5 on a meal that should have cost you less than $2. Let's be generous and say that this breakfast was no better and no worse than what you would've had at home (a generous assumption indeed). Say this routine (self-inflicted bad sleep, sedentary commuting, breakfast of processed crap, repeat) becomes a habit.

So that 40 minutes a day: 30 minutes of Gay French King scrolling Twitter or Facebook, then 10 minutes of late-night insomnia binging, all at the sacrifice of a more meaningful breakfast and commute, leads to this: 1400 extra highly-processed calories a week in food intake, 1148 fewer calories per week burned by missing your average 19.2 minute one-way cycling commute, $21 a week spent on food you didn't need and shouldn't have bought, and, at the current Federal rate of $0.52 per mile, $30 a week from gas-powered wheelchair driving. And, for the sake of being fair, let's say your fancy gas-powered wheelchair is a sensible car and not a gas-guzzling adult Tonka Toy:

Goodbye, one year's salary. I'll miss you.

If that's what you drive, these numbers would be far, far worse.

End result? One year later, if you started out at 150 lbs, you're now almost 60 pounds heavier. The extra $1440 you spent on your habit in that year, had you just put it in an indexed fund, would now be worth $1541.

And ten years later, if you really fell into a rut, that 40 minutes would have cost you $10,791! Your weight would eventually level out--we all hit our genetic max for obesity at some point--but you'd almost certainly have complications, like diabetes, heart disease, or sleep apnea.

And all this assumes you didn't even take on any credit card debt to pay for this, and assumes that the bad sleep you were getting didn't make your metabolic issues worse, and doesn't even take into account the $1184/year that your new diagnosis of diabetes cost you.

40 minutes a day to stay out of this swirling vortex. 40 minutes.

Freedom from the vortex

Maybe you’re sick. Not throwing up or coughing up blood or having a fever, at least not most of the time, but you’re on a few medications, probably for diabetes or blood pressure issues or cholesterol, and your doctor picks on you to change your diet or be more active whenever you see her. Your medications cost a couple hundred dollars per month, and every second or third time you visit the doctor she adds another one, or replaces an old, cheap medication with a newer, more expensive one.

And maybe you weigh a few pounds (or many pounds) more than you want to. You’ve tried a few diets, mostly Atkins-type stuff, or low-fat, or calorie counting, and you’ve lost weight a few times, but each time the weight eventually came back.

Maybe you’re tired all the time. You feel bad when you get up in the morning, you are fatigued and achy all day, and you don’t sleep well at night. Your doctor thinks you might be depressed, and you’ve tried a couple medications for it, but they don’t seem to help.

And maybe you worry about money. You spend a lot of it on medications, and you go through the drive-through a few times a month even though you promise yourself that you won’t, and you end up working longer hours than you want to because you need to make sure the bills get paid.

Maybe you worry about the environment. You worry that our habits are putting your kids’ futures at risk, and you worry about it, but you aren’t sure what to do. A couple of times you’ve clicked the button to buy carbon offsets when you flew somewhere, but mostly you just try to ignore the problem.

And maybe it hasn’t occurred to you that these are all different manifestations of the same problem. You read that right. There is a very good chance that your diabetes is just another manifestation of the same set of problems as your weight and your fatigue and your money issues and even climate change.

We’re gonna talk about how. This blog is about your health, but not in the way that you’re used to talking about it with your doctor. It's not about the “blood pressure, blood sugar, cholesterol,” kind of health that makes you feel like a gadget someone is tinkering with. It’s more about the “What do I look forward to when I get out of bed in the morning?” kind of health. Or the “What can I do today to make sure I’m happier tomorrow than I was yesterday?” kind of health. Health as freedom: freedom from false choices, freedom from medications (not all of them, but some of them), freedom from the, *ahem*, Bravo Sierra that passes for medical advice from celebrities and celebrity doctors. I’m talking to you, Dr. Oz.

You’re not going to see click-baity posts on this blog about some new supplement or cellulite-destroying cream. You’re going to see posts on how you can take control of your life back. I’m not talking about a life jacket to protect you from the evil, swirling vortex of drug companies, subsidized faux-food, and carbon-spewing cars and factories. I’m talking about the freedom of learning how to swim your way out of that vortex altogether, put your feet on dry land, and walk away. All those people wrapped in spandex and padding away on a commercial gym’s treadmill under creepy fluorescent lights: do you think they’re free? They sure don’t look like it to me. You, with dry feet, having sprung once and for all from the vortex and now walking one foot in front of the other toward a happier, healthier life: that’s what freedom looks like.

I intend to be your guide along this path to medical freedom. I want to teach you a new way to think about your health; a way that allows you to make decisions that are your own and that will get you out of the vortex. You know the last time you had a bad cold, and you felt guilty for taking all the healthy days you had before that for granted, and you wondered when you would finally feel normal again? Remember how you said to yourself that you’d never take a healthy day for granted again? Once you claw your way out of the vortex, you won’t. And it will be because you MADE that next healthy day. You will have made it yourself, with your own hands and feet and decisions. If you believe me, I’ll see you at the next post.