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Comment by dawhizkid | Hacker News Reader

Why do we keep looking for some magic pill and ignore diet and exercise, especially when we talk about cancer and cardiovascular disease? Expecting a pill to counteract a sedentary lifestyle and a diet high in sugar and carbs is lunacy.

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Diet and exercise have considerably higher costs than pills. Seems like that should be apparent.

I don't see it as lunacy. Some chemicals we put into our bodies kill us, some cure our illnesses, some keep us awake or put us to sleep. It's lunacy to believe that some can benefit our health?

Regardless, this isn't zero-sum. I don't think people are advocating for a pill to replace diet and exercise, but it seems obviously worthwhile to pursue other avenues of living a healthy life.

If you want to lose weight, spending hours in the gym is a waste of time if you change nothing about a bad diet high in carbs and sugar. I think the same goes with vitamins or supplments...if you change nothing about your lifestyle and are at risk of developing a cardiovascular disease taking a vitamin probably won't do anything. If you make significant lifestyle changes that are already proven, or at least more proven, to reverse symptoms of cardiovascular disease and then take certain vitamins as part of that change then the vitamins might have the impact of slightly speeding up the recovery time and/or slightly reducing the chance you'll be diagnosed in the first place.

Post body

There's a cost to exercise? Walking, running, and jumping jacks are free.

It still costs time.

You make time.

There's a cost not just in time, but also in willpower. There is some disagreement as to whether willpower is a finite resource or not, but if there is even a partial limitation, then coming up with that willpower needs to be taken into consideration.

Also, saying "you make time" is true in such a way that is of little value, as there are a multitude of things you can make time for, such as connecting with your friends and family, learning new skills, educating your children, and any of those can take up as much time as you have. Life is a balance of things where you try to minimize your regret, since there is just not enough time to do everything you want to do.

Exercise is very important. I wouldn't recommend looking at it as something that is optional. It's funny you mention willpower, as there is a book called "The Willpower Instinct" and the author claims that willpower is indeed finite and exercise is one of the best things that can lead to a greater amount of willpower over time. So exercise may be a short term willpower cost but if this author is correct, exercise would lead to a net gain in willpower over the long term.

Exactly. We all have the same 24 hours, how we we choose to prioritize is up to us. But I’m not interested in excuses of “I don’t have the time.” You MAKE the time when it comes to your health.

Why do you think so? If you accept the body as a very complex biochemical machine, then you should also accept that there are some changes you can introduce that impact the overall state. Take for example Myostatin: its an active ingredient that promotes the build up of muscular mass, and this does not require to do any physical activity. There are thousands of substances that significantly impact how you feel, sleep, and operate, so I am not sure why the answer to every problem should always be diet and exercise.

That's sort of like asking why we keep using antibiotics when you could just live in a bubble. Answer: Because not dieting and exercising is easier, cheaper, and more efficient.

Why can't we take supplements AND have a healthy diet and exercise.

I work indoors and there's not enough sunlight around to get enough vitamin D, especially this time of year.

False dichotomy. There are plenty of us who are doing plenty of exercise, who have adjusted our diets to remove cardiovascular risks, and yet are suffering from being dealt poor hands at genetic poker.

Us folk need all the help we can get.

I don't mean this to be combative, but what makes you assume it is genetics? The amount of conflicting and often known false "health" information out there makes it very likely that you just haven't tried the right change yet. Try cutting out polyunsaturated fats and using coconut oil for cooking. PUFA are broken down into toxic free radicals by lipid peroxidation. Long term exposure to these free radicals causes hormonal problems including thyroid dysfunction, insulin resistance and leptin insensitivity. Eliminating PUFA and upping your anti-oxidant intake is much easier than most other diet options as long as you cook for yourself. Unfortunately it is essentially impossible if you want to buy pre-made food as almost all of it contains "vegetable oil".

> Unfortunately it is essentially impossible if you want to buy pre-made food as almost all of it contains "vegetable oil".

“Vegetable oil”, as such, is almost never an ingredient in premade food, as it is a marketing term for plant-based oil as a standalone consumer product (even “vegetable oil” itself lists the actual specific oil or oils used, usually pure soybean oil) as ingredients.

Yes, the quotes are because the name is intentionally misleading, not to suggest you'll necessarily see it as an ingredient (although it is listed as such sometimes). Soybean, canola, corn, safflower, sunflower and cottonseed oils are the typical toxic "vegetable oils" that should be avoided.

>(even “vegetable oil” itself lists the actual specific oil or oils used,

Often it just provides a list of oils the company uses, and you have no idea which one or how much of which ones is in the particular container you're looking at. There's plenty of "soybean and/or canola oil" out there.

These pills are part of your diet.

Because magic pills don't require lifestyle changes, and lifestyle changes are quite difficult to do for many people.

The evidence suggests that "quite difficult" is actually closer to "practically impossible". It's not just willpower, it's social and economic also!

Show me a randomized control study of healthy people with lower all cause mortality from either diet or exercise, and I'll gladly change my ways.

Nutrition studies are very difficult, which is exactly how we get to a place where governments are pushing food pyramids telling everyone to eat mostly carbs everyday. I won't show you anything, other than articulating that I genuinely believe sugar is toxic, we should be eating fewer carbs, intermittent fasting makes me feel better, and 3 meals a day is unnecessary.

This comes across like the people who say, show me incontrovertible proof God does not exist and I will happily become an atheist.

Knowing, of course, it cannot be proven.

If you are actually of open mind, there are some natural experiments that have been done, e.g. see Blue Zones.

One of the largest observational studies done, the PURE study (large, epidemiological cohort study of individuals aged 35-70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3-9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires) includes statistically significant all-cause mortality data and is the best controlled for study yet.

Here are the abstract results: Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12-1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67-0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76-0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71-0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71-0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64-0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality. INTERPRETATION: High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

doi: 10.1016/S0140-6736(17)32252-3