Who wants to hear Tom rant about diet? Obviously. That's why I put all this in here: My bet, my insurance, what I'm mad about, and what I think I'm learning. You can take it or leave it, I don't mind. But you can't say I didn't tell you, I didn't share what I learned. So here you go.

Why? It started with a lifetime of nightmares (I just thought I deserved them), and gets worse. Yes, I'm motivated.

A Diet Bet

You can't not bet, pal. Whatever you do, it's a bet.

My diet, such as it is, is: (keto × vegan) − simple carbs (for nighttime headaches) + anchovies (for brains).

• Breakfast: oatmeal, blueberries, banana.
• Lunch: a pile of cashews, or a spinach salad on a good day.
• Dinner: Falafel, anchovies, hummus, olives and balsamic vinegar. Occasionally: kale chips.

See?: Little or no sugar, flour, rice, or corn. No meat, milk, or eggs. I know, it's eating to live, and barely. But just consider the alternative, realistically.

Supplements: cheap insurance.

• Magnesium, 500mg/day, because everyone is low in Mg and being low causes Alzheimer's, heart disease, anxiety, etc.
• Vitamin D3, 7500IU/day, which controls 800 of the 20,000 human genes and is low for most people, especially people out of the sun, which is all of us. Reduces inflammation, prevents osteoporosis, prevents artery calcification, and protects against viruses too including the flu and better responses to Covid.
• Vitamin K-2 which activates bone construction, deactivates bone destruction, and regulates calcium deposits in the arteries. Works with Vitamin D in calcium regulation to reduce plaques in the arteries and maintain bones. K-2 is not the same as K-1 which comes from veggies and noone is deficient in. Everyone is deficient in K-2 which comes from fermented soybeans. In Japan where they eat this nasty natto stuff, no osteoporosis, but in Western Japan where they don't, lots of broken hips.
• Multivitamin. Because who knows. It's a minimum, so: fine. But the problem is,
  • Multivitamins include the RDAs (recommended daily allowance) for essential vitamins and minerals. That means 2x the amount that if the mice in the lab don't get that much, they die. (SM: Survival minimum. SM*2=RDA). So the doctors figure, at least 2x will probably keep you from dying right away from scurvy (vit C) or pellagra (vit B-3) or etc. There's 14 vitamins, 14 minerals: if the mouse doesn't get the minimum, the mouse dies (sooner than from old age).
  • But nutritional requirements for optimum health are many more in number and quantity and linked by a logical dependency graph not by a linear combination.
    • So (A) the list is longer, maybe twice as long (estimated by Rhonda Patrick and Dr. Ames)
    • And (B) the amounts required to be useful are more than the survivable minimum.
    • But most of all (C) some (longevity-enhancing) functions will ONLY be taken up if the higher-priority (immediate-survival) functions are FULLY satisfied.
      It's not like if you consume half the RDA then half your needs are met: No! If you consume half the RDA then half the needs ON ONE BRANCH of the tree of needs are met. The other branches will make you live better, or longer, or have stronger bones, etc., but they get ZIP if you don't COMPLETELY meet the needs of the most important short-term need first.
      (This is called "Triage theory" according to Dr. Ames.)
      Since the RDA is based only on immediate survival functions, the optimum health allowance, let's call it the OHA, is potentially a lot more than the SM or the RDA. We have no idea how much more, or when we'll stop adding chemicals to the OHA list.

• Fish oil for the Omega 3 fatty acids which need to not be too low. Because I met a professor from Israel studying honey bees who said stupid vs smart bees eat low vs high amounts of Omega 3's, and and so he takes 3g/day. Why not? It's not like he'll die, when you take 3g of Omega 6's in your small McDonalds french fries.
• Vitamin B3 aka Niacin for many benefits (reference)
• Vitamin E, an antioxidant. Not too much please.
• Rosuvastatin to lower cholesterol, post stent. I disproved lipitor (ask me how), and also hated it. If you dislike lipitor, ask for a change. Don't be bashful.
• Mini aspirin (80mg/day), post stent blood thinner, because my cardiologist prescribed it.
• Alpha Lipoic Acid (600mg/day) and Acetyl L-Carnitine (500mg/day). Shown by J. Ames to improve mitochondia (ALA) and lower mitochondrial oxidation (ALC).
  
• Resveratrol. 500mg/day by Micro Ingredients. Argued for by Singler.
• Medium Chain Triglycerides from coconuts (~1 tablespoon/day. Because the brain runs on ketones not carbohydrates, and MCTs don't need chemical modification to go to the brain unlike Long-Chain or Short-Chain Triglycerides. So MCTs are brain food.

Other fads I'm looking out for include

• blanched broccoli sprouts, for its high sulphorophane, for anti-inflammation, anti-aging, anti-cancer. Sulphorophane activates the NRF-2 pathway which itself controls 3-5% of cellular proteins, particularly the turning on genes for anti-oxidant enzymes.
• Rapamycin. Apparently Rapamycin has been shown to extends life for yeast, flies, worms, and mammals. Inhibits mTOR (mechanistic Target of Rapamycin) (by definition) which "regulat[es] cell growth, survival, metabolism, and immunity". Maybe it regulates nutrient sensing, maybe that's good.

Diet Chickenshit

Is it people, or is it their doctors, that are the most gutless, when the doctors won't tell them to just eat falafel, oatmeal, stirfry, and salads, instead of batter fried meat on cheese plus dessert, so that they would maybe not die so much of cancer and everything else? I heard it's because the doctors think everyone will just ignore them. Fine, go ahead and frickin' die. That's what you prefer? Wow. Apparently you have to go to the non-idiot line at the doctors office and say No, you don't prefer McDonalds to Life Itself and you're actually willing to reconsider a couple diet choices. Then *Maybe* they'll break down out of their standard-American-diet-locked customer mode and tell you, Hey that's actually good because you'll probably not die so young of cancer and heart disease and stuff because of that. But SSHHHH, don't tell anyone because it's a secret, not because it's actually a secret, but because some of the people around here are chickenshit and so we seriously can't even talk about it, or we can't even talk seriously about it. Now you tell me, who is it, the people, or the doctors?

Diet Suggestions!

Okay. So, well, milk is evolutionarily correct too, obviously, so I tried a cream and bacon type of keto diet, but after a year my cholesterol was 300 and shortly after that I had to have a stent installed in my heart in order to not die. So I'm good with healthy fat (if I could figure out what that might be). For the last couple years, it's keto + vegan - simple carbs + anchovies. Lots of olive oil. Kale, when I can find a way to tolerate it (baked into chips with balsamic and olive oil, yes! Or fresh in bits on falafel with some olives: it's tolerable. Plus balsamic.

Here: My nutritionist said to try intermittent fasting. No late night snacks, and a late breakfast, gives your system 14 hours to run in ketosis and clean out the day's bluck. Longevity, okay? Study up, friend, the science is actually starting to come in! And please educate me, too; I don't know everything (for sure), or anything, (possibly).

Below are notes from Dr. Peter Attia's talk, "Reverse engineered approach to human longevity", on youtube. To live longer means to delay chronic disease. Consider the genetic contributors to longevity; we have documented about dozen among centenarians. (Among the dozen longevity genes, only the thyroid mutation doesn't have an evident chronic disease relationship.) For some examples Attia mentions:

• Hypoactive ApoC-III: which leads to lower triglycerides and ApoB which relates to CHD.
• Hypoactive PCSK9; which leads to much more LDL receptors on the liver, they clear ApoB-bearing particles out of circulation with great precision, where ApoB is what you need to understand to assess cardiovascular disease risk.
• ApoE2 > ApoE3 or ApoE4 genes; these being what regulate peripheral and central lipid metabolism and cholesterol
  ApoE4 is the evolutionarily ancient type and was best for parasitic infection.
  People who have the ApoE2 variant have much less Alzheimers (20x less than ApoE4 carriers)
  
• Less GHR: which seems to protect from cancer.
• Lower IGF1: which seems to protect from cancer.

See how all these are tied back to the main chronic diseases: cardiovascular, cancer, and neurological decline, which along with accidents cause 80-98% of deaths.

So perhaps the genotypes can be mimicked.

To control CVD we need to jointly target lipoproteins, inflammation, and endothelial function. E.g., low dose methotrexate reduced cardiac mortality.

Alzheimers: NIH will not even fund research including the word "prevention", but the Cornell Alzheimer's Prevention Clinic has got us on the track of managing it better for sure.

That's his argument for longevity as a focal point for science, medicine, and lifestyle.

II: Widely across species (1) caloric restriction (CR) and diet restriction (DR) makes yeast, flies, worms, mammals all live longer. The NIH vs U Wisconsin rhesus monkeys showed only that calorie restriction helped longevity only if you ate a crappy diet (the UW one). And (2) Rapamycin (mTOR) extends life across all these. It works on a protein called TOR, which has to do with growth/non-growth, Both of which related to nutrient sensing. Also DAF2 in C elegans can be tweaked to >2x longevity and also sharpen the decline at the end, and its job is something like IGF1 in humans.

III: Human nutrition density is an evolutionarily recent event. We likely have not evolved proper nutrient sensing for this new nutrient-dense context; autophagy is our friend; senescence needs to be understood as cells poison others to advance aging, though necessary against cancer; inflammation with its many causes needs regulated.

IV: Tactics: Nutrition should be optimized so that: carbohydrates make your average glucose low (85mg/dL) with a standard deviation of <15mg/dL, which leads to low insulin AUC (integral of insulin over time) proxied by continuously measureable blood glucose. I.e., aim for perfect glucose homeostasis. Agnostic w.r.t. paleo or vegan or whatever. Just keep glucose low and not very variable. For some people this is a high or a low number, and dependent on exercise and sleep. proteins aim for a barely positive nitrogen balance. Not protein wasted, for muscle mass matters, but not so much that it's too much with excess amino acids . We need homeostasis in muscular system. Too much and too little are bad. Fat is the balance by amount. Sat, Mono unsat, polyunsaturateds may differ. Exercise: Observe the lifespan impact of the metabolic advantage of exercise. We can put glucose (glycogen) away quickly into the liver (limited capacity) or into the muscle (potentially a large sink for glycogen), so muscle mass is very helpful. With insulin resistance in the lower body muscles it tends toward the diabetes. It's hard to have diabetes with a lot of muscle. Avoid exercise-preventing injuries. Lower back pain can bring morbidity. Do heavy strength training. Do heavy hip hinge exercises like squatting dead-lifting and rowing, even until your blind demented 90's. Get the II-B muscle fibers activated at the end of the effort scale. Interval train too next priority.

Sleep: underappreciated but key. Sleep is a highly conserved behavior, doesn't go away, evolved before neurons. E.g., Lack -> testosterone drops, perhaps because slow-wave (delta) sleep, where pituitary puts out FSH & LH which make testosterone. Hippocampus is sensitive to sleep disturbances which consolidate memories. Lack of sleep exacerbates effective glucose dispoal. So improve glucose disposal by correcting sleep.

Diet and supplments etc., it's empirical: you have to measure a lot and cycle through to find the right diet which for 80 people there will be 70 different optimized diets.

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