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Comment by olewhalehunter | Hacker News Reader

There is a ton of information of healthy living, the basic level of health you mentioned, emphasizing fitness and lifestyle choices, is taught in most physical education classes through primary education to high school, but phys ed has been gutted since the 1960s, kids are staying inside more, and now even schools sell sugar drinks and high sugar meals. The role of the homemaker is now a cultural taboo, resulting in less home cooked meals and more fast food, so the standards for what constitutes edible food is shit, and for similar cultural reasons people are delaying childbirth beyond the window of fertility which results in poorer genetic and physiological outcomes for their children.

The combined total of the entertainment industry (keeping you on the couch for money) and the healthcare industry (money made from complications of staying on the couch), is something like a whopping 1/4th of US GDP.

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> There is a ton of information of healthy living

Where is this "ton of information on healthy living" and what level of evidence do you have for it?

I don't doubt that there is a set of things that people can do to be healthy. I do not think that there is much information about what those steps are. Again, there is plenty of writing on the topic, but little information.

We do, and it's called the Framingham heart study.

It's a landmark, decades long (began in 1948) research study that revolutionized health guidelines and what factors in death and heart disease.

Sure, the Framingham Heart Study is one of the most famous long-lasting observational studies, now on its 3rd generation of participants. But, for one, it's an observational study, not an interventional study. Two, it's in Framingham, a white-predominant Boston suburb. Three, what actionable health advice do you understand from the Framingham that I haven't summarized above?

I would be delighted to learn that there is a trove of actionable, research-backed information about healthy living that we aren't taught in medical school, residency, or cardiology fellowship. My patients would benefit if I could provide them with this information. I don't think it exists, but if it does, who can point me to it?

I suppose this is pretty subjective and depends on your level of knowledge on the issues, but I feel that healthy living is more or less a solved problem from a "what to do" standpoint. The main problem is breaking people of unhealthy lifestyle habits while educating them on healthier habits (see books like Power of Habit for habit formation and modification).

I don't have links handy (edit: apparently I have a few) but just from reading over the years, it seems that the highest impact things you can do (that you have direct control over) to avoid the diseases of aging (both physical and mental degeneration, as well as the usual lifestyle diseases like diabetes and heart disease) while increasing or at least maintaining one's quality of life include (1) regular strength training, (2) endurance training, (3) avoiding processed foods and eating significantly more vegetables, (4) minimizing visceral body fat levels, and (5) always be learning something new (particularly relevant for lowering risks for cognitive degeneration).

For more specific and actionable advice:

1) Every able-bodied adult should invest anywhere from 6 months to 2 years of dedicated strength training to build muscle mass and strength. The benefits are numerous and well-documented (e.g., https://en.wikipedia.org/wiki/Strength_training, http://startingstrength.com/article/science-medicine/barbell...). A somewhat arbitrary floor recommendation would be to maintain a level of strength that allows you to deadlift twice your bodyweight and accomplish 20 pull ups in a row. This is a non-trivial level of strength that requires training, but is achievable for most people with intelligent (but not necessarily complicated) training. Any competent strength coach can take you there. Reading the book Starting Strength by Rippetoe would be my recommendation of where to start.

2) The benefits of endurance training are similarly well-documented (e.g., https://fivethirtyeight.com/features/the-5k-not-the-marathon...). The actual modality doesn't matter, but the only thing I know anything about is running so I'll stick with that. Rowing or swimming or hiking would also be great. A non-trivial goal to try and hit would be a level of fitness that allows you to run a 5k in ~20 minutes or less. If you search r/running, you'll see that this is surprisingly achievable as well. You simply have to work your way up to anywhere from 30-50 miles per week of running at a conversational pace. A good place to start would be Couch to 5K followed by Bridge to 10K. Then follow the 10% rule for weekly increases in mileage. The Running Order of Operations linked in the r/running sidebar has great recommendations. (Other tips would be to make sure you're running slow enough; the conversational pace tip is one metric, but another is to make sure your heart beat stays below 180-[your_age]. Running the first few months with a metronome app going in the background at 180 bpm and trying to sync your steps to it and trying to minimize how loudly your steps are will also minimize the impact forces and help you run more efficiently.)

3) Nutrition is filled with a bunch of contradictory advice, but there are some pieces of advice I like that seem unlikely to change in the future. In terms of what to eat, Michael Pollan's "Eat food, not too much, mostly plants", is a great place to start. Another person I encourage people to look up is Rhonda Patrick. She's a researcher who summarizes a lot of research about nutrition and its interaction with physiology and genetics. If you follow Pollan's advice of avoiding processed foods and eating more plants, you'll be much better off. But if you know the current state of your nutrition (e.g., based on what you're eating, how your weight is changing from week to week, blood panels to check for nutritional deficiencies, etc.), then Patrick's advice to get at least 100% of your RDA of various micronutrients will serve as a great framework for how to modify your diet further. Sites like Cronometer.com or NutritionData can compare your current diet and show you the likely distribution of your nutrient intake based on your diet and allow you to model what the addition or subtraction of various foods would do to that distribution. For example, you might find that you're regularly deficient in choline, and mucking around on Cronometer might show you that the addition of 2-4 eggs to your daily diet would resolve that.(Other really useful resources include Wikipedia and examine.com)

4) The strength and endurance recommendations above are made much simpler if you aren't overweight. But instead of chasing abs (not that there's anything wrong with that), I'd recommend trying to get leaner until you've minimized the amount of visceral body fat you have. Visceral body fat is something that has a lot of evidence suggesting it's connected to several disease states (http://www.health.harvard.edu/staying-healthy/abdominal-fat-...), so minimizing it gives you a non-vain metric and motivation for getting leaner that should increase your health along a variety of objective metrics. Now you can't spot reduce fat, so the only way to reduce visceral body fat is to lose body fat in general (genetics determines at what point in your fat loss journey your body decides to dip into your visceral body fat stores for energy). The sidebar in r/fitness and r/loseit have more information on this improving body composition, but the main points are to maintain a caloric deficit (https://examine.com/nutrition/what-should-i-eat-for-weight-l...) and eat enough protein (aim for 1 gram of protein per pound lean body weight; https://examine.com/nutrition/how-much-protein-do-i-need-eve...).

5) Anyone who's done any time dipping into the research on the diseases of cognitive decline (e.g., Alzheimer's) will know that, in addition to diet and exercise, one of the most important things you can do to lower one's risk is to maintain a life-long habit of learning new things. By that I don't mean trivia or a Wikipedia page per day (though there's nothing wrong with that), but the learning of things that require you to really work for improvements. I'm talking about stuff like music and playing instruments, foreign languages, pure mathematics, chess, go, art, dance, etc. You have a lifetime so you don't have to choose just one, just make sure it requires you to put in the work and struggle a bit for improvement. Coursera's Learning How to Learn course would be an excellent place to start for the "how" of this, and your own interests will probably lead you to the "what". (For languages, I'd recommend the book Fluent Forever.)

The only other major factor that seems to really contribute to long-term health is something that isn't entirely within your control, but you should still put a lot of effort into it: regular interactions with people you love like family and friends. If you don't have those, try and go out of your way to expose yourself to more people so that you can find your people.

Other things in research that have been getting more attention include things like meditation and practicing gratitude, but their benefits aren't as objectively measurable as the above, though they're probably well worth investigating and putting time in to.

Oh, and make sure you prioritize getting sufficient amounts of high quality sleep. HN has had conversations in the past about this.

In general, "use it or lose it" seems to be a universal law when it comes to one's mind and body.

What you are describing is a level of fitness that maybe 1% of the male population have at a young age. It is not realistic to keep that level throughout a full life. And it is probably unconstructive to try.

Most people don't know how and never try, which is why it's so rare.

At least as far as the strength goes, maintenance only requires 2 workouts per week of perhaps an hour apiece.

The body was meant to be used. And people assume it's less capable than it is, even in old age, but there are people who only started training late in life that have exceeded my strength recommendations.

I had that level of fitness for many years, until I did a startup at 40. Now I am trying to get it back at 59 thru a progressive calisthenics program. I can't even do ONE pull up at this point, but I am getting closer!

Bravo! That's a more or less perfect distillation of what I consider to be the things I should be doing to stay fit and healthy: Exercise a lot, live on fresh vegetables, sleep well and push your mental capacity so that it 'hurts' to understand something new.

The level of evidence for most of these recommendations is quite low. That doesn't make this bad advice. In fact, most of it is probably good advice. But it does explain why the GP's physician is not going to be discussing this in detail.

One of the best short but to the point set of suggestions I have seen. All known but it helps to reinforce them frequently! Thanks.

There is plenty of traditional knowledge, for example in India, related to yoga, ayurveda, medicinal plants, diet, meditation, celebrating various phases of life, etc. But most of it has passed on orally (for about 3000+ years) and is finding finding broader global acceptance only in the last 100 years.

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