Only 6.8% of adults have optimal cardiometabolic health

Is it even possible to walk places in California? It seems like everything would take hours to get to or would take hiking over hills and highways.

There also is the the mental trap of what I call "car think" which happens to me whenever I have a car readily available. Distances that were no problem walking creepingly become unimaginable as the (contestable) comfort of a readily available car gets normalized. I can only imagine that this effect gets worse when it's your own car with "sunk cost" as part of the equation. I'm always happy when I get back to "city normal". Walking is awesome.

Sounds like veiled classism rather than anti-walking. They would probably be against living in a RV and travelling the US.

My next-door neighbor here in California seemed kind of shocked when I told her I walked to the movie theater. It's 2 miles away, with a safe sidewalk.

When I lived in a more car-centric city in the US, I used to get honked at while walking. It was a thing in this city to honk and/or yell at pedestrians. I’m not sure what the thinking behind that sort of behavior is.

Ive had people throw cans and shout at me while walking. Never understood why. Your comment brings it together for me after so many years. I wasn't homeless, just didn't have a car at the time and was used to walking long distances where I came from.

Large scale changes rarely have a single cause, and there is a real lag before different habits turn into health issues.

Median age increased from 35.3 in 2000 to 38.6 today.

I suspect an increase in using computers both at work and home has played a role.

Urbanization has increased from 79% in 2000 to 83%, among everything else I think fewer people are doing yard work.

It hasn't.

> A majority of infrastructure in the US makes it extremely hard to be healthy

This is a copout.The only hard thing about being healthy is having the discipline to do so. Certainly more than 6.8% of people have the means to have healthy diet and they choose not to. There are definitely extreme cases of poverty where it would be difficult (which people who are well above that will use as an example to make themselves feel better about their choices) but I'd argue it's still very reasonable to be able to lead a very healthy lifestyle.

We're fat as hell because we live a life of extreme abundance.

Not only that, spend some time in Vietnam. Walk? Are you stupid? People will jump on a scooter to go 2 blocks.

A combination of brutal heat and lack of pedestrian friendly routes means almost no one walks.

They’re pretty healthy though. Lots of veggies and being fat is bad.

We could try that too!

From an outsiders perspective: Yeah. As new developments are zoned in such an awful way as to mandate driving anywhere.

if you have money, it's a lame excuse.

food deserts are real.

not having enough free time to exercise is real.

Yes and no, people get stuck in economic traps of paying for things they didn't really need, and those can eliminate all free time. Also, there really is a large group of americans that still work multiple jobs and can't afford healthcare, thats a thing. Some of those are physical jobs, but many are not.

Maybe, but many people in the world are able to stay healthy without having to make the time commitment or discipline of regular explicit exercise. It just falls out of living their regular lifestyles.

Exactly. Environment design can alter behaviors. If there’s a grocery store near me but no sidewalks, I have to cross a huge intersection, and there’s sketchy spaces — that’s not a good pedestrian experience at all.

Yeah, most people who say parts of a city are "too dangerous to walk around" are overblown, especially in major cities. There are a few cities with a few areas where you probably don't want to be walking around if you don't know the area and the people. But, 90% of the time it's just that it's an immigrant area and people are afraid of difference.

Feeling safe is just as important as actually being safe.

I think you partially addressed that already with the privilege part. I know my city has rough areas that definitely have an increased risk of getting mugged, robbed or just jumped for no reason. Knowing that is enough to keep me from going around there unless I have a reason.

I grew up in a bad neighborhood in the US and this is what it meant for us: hearing gun shots every other night, experiencing drive by’s at school, frequent helicopters looking for someone, swat team locking down our neighborhood and evacuating everyone, break-ins multiple times, being threatened at knife point by a random stranger, people putting our dumpsters on fire. Lack of opportunity because everyone around us is poor and in the same situation. No sidewalks, roads in bad condition, shitty schools.

We weren’t part of the problem, we were just kids. But it’s easy to get pulled in when you grow up like that. There’s a big difference between visiting or driving through and growing up in such a place where you feel like you always had to watch your back. Because you spend more time in such a place, it increases your chances of bad things happening.

But it also meant, playing around the streets with the neighborhood kids, great food, neighbors giving each other things like food and essentials, a sort of camaraderie that we had each other’s back. Not everything was bad. However, you never feel truly safe.

Beyond “grabbing a bite to eat“ being a very different level risk than going out to physically exhaust yourself on foot daily, violent crime per capita in the us is several multiples higher than it is in Australia on average, and it’s not remotely evenly distributed. The place most commonly cited as the most dangerous in Australia is Rockhampton in Queensland and the only numbers I could find were from 10 years ago— 2 murders per 100k, and apparently that’s dropped considerably. By contrast, St. Louis Missouri has about four times as many people and their murder rate is about 68 per 100k. St. Louis has about the same number of murders per year as Australia on a whole. I am quite certain that your experience in a rough neighborhood in Australia is not representative of many of our rough neighborhoods here.

I've discovered that being a pretty big white dude is a large part of why I feel safe in a lot of places that my friends don't.

Being a big dude means people are less likely to start something.

Being a white dude means people don't really even notice you unless you're starting something.

Call it privilege I suppose.

There's a selection bias in your comment. In the case where something did happen to you, you wouldn't have written it.

I imagine this affects many parents. I would love to know how many parents successfully manage this (or, perhaps, success is simply defined as raising your kids well)?

You're working against millions of years of evolution. If a cave man is given the options of 4 foods, the cave man who eats the most calorifically dense food is more likely to live and have energy through the next lean time than the cave man who eats the leaves. It sucks but that's just how we're evolved and it's shockingly hard to "trick" those sense with fake sugar etc.

Some people do seem to make it work though, going for a run with the baby (Thule strollers etc) or later on together with the kids. It's awesome to see and it still gives me hope but I have the feeling that some kids are just much easier to handle from the moment they are born. Nothing to be mad about. Just something to accept while celebrating the absolute wonder of them being with you including your survival of yet another day (without eating yet another cookie).

A salad will do it except the tasting like a pizza part. Pretty damn good compromise.

Intermittent fasting works for me, one coffee in the morning, lots of water, tons of dinner. Always on my feet, standing desk, cleaning constantly:)

> gave you energy [...] and had no calories.

What does this even mean :-D

Dude.

Buy caulipower brand pizza (either the pepperoni pizza or the cheese and add your own slice two of pepperoni.

Let thaw for 20 min.

Bake at 425 for 9 min.

Checks all the above.

She wasn't clueless. She just said that in her experience, nobody actually takes her advice to exercise and change their diet seriously and they wind up on statins.

Why is a vegan diet better for diabetics? Sugar is vegan after all...

Being vegan or not is mostly irrelevant to diabetes. Research has shown that the most effective way to put type-2 diabetes into remission is with carbohydrate restriction. That can be done with or without eating animal products.

https://www.virtahealth.com/research

There's a big difference between "mostly vegetarian" and vegan diets, especially when it comes to cholesterol, due to the eggs, milk, and whatever else it let through in that "mostly".

edit: form those disagreeing, please let me know the flaw in my statement.

Ask your doctor.

Definitely talk to your doctor but if you're highly endurant and do high-cardio exercise, it's not abnormal to have resting heart rates between 40 - 50 or even lower.

If you're fit exercise is a pleasurable activity, and the side effects of feeling better and looking better are pretty awesome too.

I'm not sure about GP, but about a decade ago I decided to stop being fat and lazy and started playing soccer, running, and later doing BJJ and some strength training (cannot seem to stick to weightlifting, but bodyweight works well for me). After that change, I slept less, but better, and had more energy throughout the day and into the night. I got more time back by being in shape than I lost from the exercise to get me there. And I was spending time with friends when I was exercising anyways (friends from before I started exercising) by joining their soccer team, going for runs and hikes and rafting trips with them, and similar things.

At work I became more productive because I wasn't struggling through half the day feeling fatigued and worn out, or pushing into a panic attack from all the caffeine needed to keep me conscious. Outside of work, despite (and as mentioned in many cases because of) the exercise I spent more time with friends and family. And I probably bought more than 2 years at the end of my life. I was on track for a heart attack in my 40s the way I was going.

I think that the bigger impact is improved quality of life when you’re old. Having a higher baseline health after 70 allows you to enjoy your later years much better. You may not live much longer but it’ll more likely be a longer period of relatively good health with a steep decline at the end as opposed to a long gradual decline where you’re able to do much less for a long period

> also means you're spending x times more of your productive years exercising

I'd strongly recommend finding some sort of physical activity that you enjoy, rather than seeing as a chore.

Exercise is a long term investment though. Life really is easier when you're fit. And all the gains you get in your younger years cannot be easily done when you're older especially for muscle mass.

This specific amount of cardio fitness is probably not strictly needed. Given the choice I believe most people should chose more strength training. But at any given time, being able to pop out at least a 5km run or equivalent is probably a good place to be.

There are four aspects to this:

1. Weight: I've been 50+ lb heavier than I am now and I, personally, hated it. It makes everything harder and that only gets worse with age;

2. Fitness: this one is (IMHO) less extreme than weight differences but if you can't walk up a flight of stairs without getting winded that's going to impact your life in negative and real ways;

3. Health: when you're young this is less of an issue but as you get older being overweight and/or unhealthy becomes a more significant risk factor for many health problems. Heart disease, strokes and a host of others;

4. Quality of life: getting fresh air, sunlight and exercise is generally good for your state of mine. At least, it's good for mine. It can help put thing sin perspective (professional and personal) and improve your mood.

YMMV

As far as time goes, this was a big motivator for IF for me. As in, the effort of preparing (or even buying) meals annoyed me. It's one of the big things I appreciated about working in tech: the free meals. Not for the quality necessarily but primarily for the convenience. I don't have to plan for (many) meals.

Treating eating as a leisure activity can be a trap too like some people have weight issues because they like food and end up treating it as a reward, which reinforces the cycle.

I prefer to think of food as necessary fuel.

But how much time do you spend on food?

Quality of life is usually better for those who exercise and that becomes particularly evident as people age. But either way it's literally just like a totally false tradeoff - the time I spend with people hasn't been at all compromised by exercising and you can even exercise with other people too (e.g. friends at the gym, beach, going for a run with partner etc.)

I think if you've made the choice to just not exercise you should be honest about why instead of inventing non-problems like exercise significantly reducing time spent with family and friends. I literally don't know anyone who has ever raised this as a problem. Maybe if you're exercising as an Olympic athlete...?

My understanding is the HDL-to-LDL ratio is important. I can't say for sure other than my doctor says my values are excellent.

Well that indeed sounds amazing. Great that you are already feeling better.

Because of my past, I'm often contacted by recovering ex-vegans in my area. I immediately get them started on the carnivore diet and within a week or two, most will come back, often with tears in their eyes, to tell me that they finally begin to feel normal again, really a joy to experience.

That doesn't actually explain anything, though. What is "optimal" in each of those categories and why is that level optimal as opposed to any other one?

So was the ice business, not to mention the salt business, the ice cartel and the salt cartel were dominating but the person who invented the refrigerator put them both out of business in one swoop and managed to subtract all their wealth/ status from them.

In this case there is also the incentive to solve it if anything out of selfishness given that everybody at some point develops cardiometabolic problems

It seems to me that the vast bulk of their business is made possible by the fact that our alternative is to dramatically improve our diets, sleep, and exercise regimens.

Studies seem to show that each of these often have meaningful effects on preventing, stopping and even reversing common diseases.

This is all really hard for people to do, though. There’s a lot working against us. It’s hard to see why we should do it at the individual level — it’s hard to believe these changes will make a meaningful difference.

But you’re right that there’s no financial incentive there. Not at all. There is for each of us, and here in Canada there is an incentive to reduce medical spending, but pharmaceutical companies stand to gain nothing and lose so much.

It’s hard to imagine this changing much, but what a difference it would make. Life could be so much different for so many of us.

Sure, current leading pharma companies will keep making money if they don’t invent an obesity cure. But most people aren’t in the pharma business, and even most scientists with the relevant expertise aren’t pharma magnates. If there were some one-and-done obesity chemical that no drug company bothered to market yet, it would actually be a great act of charity to the industry for everyone to unanimously ignore that opportunity. Realistically, there are a bunch of also-ran pharma companies who would jump at the chance to be the exclusive seller of this miracle drug for 17 years until the patent ran out.

isnt there? as long as people jeep needing to be cured, you have business.

not as good of business as treating it, but still great business

Are seed oils some new health trend? I keep seeing people mention them in health discussions.

Do NOT consume seed oils. Go in your pantry and throw away anything that lists some kind of seed oil as an ingredient.

I don't consume any oils. Of course if I'm eating out or at someone's house it can be outside my control.

Right now I'm doing 30-40+ miles of running a week. It's on concrete and asphalt with extremely high humidity and I'm still attempting to adapt. Will be starting a strength training program soon because I'm kind of destroying my body.

In the past I've done a mix of treadmill and outdoors. I would like to get back to using a treadmill but don't have access to one right now.

Mostly whole food plant-based. I do eat a lot of candy and I will eat meat sometimes. Usually if I'm at dinner or at someone's house. I avoid all oils.

My exercise is more extreme on the cardio side and has been since high school.

Nope, but I'm not lean right now unfortunately.

Don't accept low t - see your doctor and if your doctor won't there are T-specific clinic in your area that will be happy to help.

Do you have any sources or additional info on the latter? How did you determine that aromatase is the culprit? Thanks.

Decrease in testosterone as you grow older may be cardio protective. It seems like it's currently unknown. Do you have your T levels tested every year?

> Yes, I am pretty proud of myself!

Congratulate your parents as well for the good genes.

> I also love candy, and will eat a lot of it while coding or studying. Never skimped on things like popcorn, triple butter please.

> I think the key is, you have to use absolutely everything you put in your body. If you are not building a stronger body with it, it's going to waste.

I mean I’m totally in the indulge in moderation crowd if only to enjoy life, but I am still at a loss how your two statements above are connected. How are you building a stronger body with the triple butter?

I know it's a hard argument to make, but what I mean is that if there were fewer gyms that would be a more developed culture of 5-minute exercises at home.

Sure, people can go to youtube and learn. Nobody is stopping them but at the same time nobody in their circle of friends is encouraging this.

Many people need to be convinced by example, and I actually see a lot of friends that would be in better shape if there were advice floating around in casual conversations on how to keep fit within a full schedule.

Gym culture has taken up the bulk of the public discourse space on keeping fit, and it's led to a polarized population.