Midlife Vascular Risk Burden and Dementia-Free Survival Years | Hacker News Reader

Midlife Vascular Risk Burden and Dementia-Free Survival Years

neurology.org

85 pointsbookofjoe82 comments

Yes. The time to fix your health is now. Any unhealthy habits put time on the biological clock, and they'll just get harder to undo later. This is true if you're 20, 40, or 60. Plaque even starts building up on the arteries of healthy teenagers. It all adds up.

But don't read this and panic or beat yourself up, that's a waste of energy. That's choosing the punishment instead of the fix.

Instead, quietly start doing one small healthy habit. If you stop, don't revert to self-punishment again. Just quietly get back to it. Stubbornly persist until you've won.

yep.

eat healthy food as much as possible.

walk. exercise. and SLEEP.

IMO developing good sleep hygiene is by far the most important habit to cultivate.

It has lots of benefits, but the most important one is it replenishes your willpower. If you're trying to develop other healthy habits, it's 10x harder if you haven't slept well.

It's also the easiest to implement, imo. But there is a tradeoff: fewer waking hours during your best years cognitively for more years when you're older...

Waking hours is both a quantity game and a quality game. I don't remember too much from the parts of my life where I was very sleep deprived

Poor sleep is a widespread problem and very few of those people are cognitively doing it intentionally as some sort of "tradeoff". The number of people "grinding on a startup" is tiny compared to the population of people who suffer from this problem. Instead it's caused by things like general anxiety, too much screen time before bed, or not having consistent sleep schedules. And other health related reasons that compound the problem.

You can add having a child to the list. Nothing has caused more disruption to my sleep as my son has done

Have some kids and tell me how easy it is. I havnt had an uniterupted sleep in 4 years

Orphanages are always an option

"eat healthy food as much as possible."

I usually stop, if my body signals me I had enough.

(might seem like pedantery, but I know some people do believe it literally, that it is healthy to just fill themself up with "healthy food", but it is not).

I think the commenter meant such that as much as possible of your diet consists of healthy rather than unhealthy food — NOT as great a quantity as you can take in.

I know, I took the literal meaning because I know some do live by that.

Fair enough! Just because I don't doesn't mean I shouldn't broaden my scope.

haha yeah I meant like choose to cook the chicken in your freezer with some veggies over going through the drive-thru

I just watched this video by a doctor, and his point was every one of his ER patients had a problem that was years in the making (except for 1, a little girl who swallowed a battery)

I Saw 120 Patients This Week. Here's Why They Were Actually Sick. https://www.youtube.com/watch?v=UiVKh97rJsg

It is a bit crazy that everybody seems to agree that diet and exercise are important, and yet it seems like society is hell bent on making those things very hard to do well.

I went to the mall recently (big mistake) and I had to get lunch at the food court. I don't think there was a single gram of fiber across the 10 or so restaurants. So much of America is drive-thru garbage. Yup -- you don't even have to stand up to get your Big Mac. You can endanger other people by eating it while you drive.

We tell people to get exercise and then force them to have 9-5 desk jobs that have a 45 minute car-commute each way. And what's so much worse is that people are paying a ton of money for that car that's slowly killing them. It's not entirely their fault though -- that's just the way our society is set up. Walkability is a luxury only the rich can afford.

Then, 20 years later you show up to the doctor and the standard course of action is to prescribe a bunch of medications. The doctor says "you should exercise more and eat better" and many people just don't.

So much is broken.

Exercise is taxing, and healthy food isn't as tasty or easy as junk food.

Humans are natural experts in min-maxing calories spent vs calories consumed. Then we solved food ~100 years ago and its been a kid in a candy shop ever since.

Gotta find exercise that is fun though. Don’t just try one thing and give up, it takes time to find what you enjoy.

I’ve been swimming for 15 years, but only got into bouldering 1.5 years ago. I tried running and cycling but it always felt like a chore so I could not stick with it.

The food problem is much harder to solve for IMO, even shops are designed to get you to impulse-buy junk. Although one minor tip is to do groceries when you’re full, not when you’re hungry.

> healthy food isn't as tasty

Mediterranean cuisine tasty and healthy. But it’s not as cheap as ultra-processed food.

The Mediterranean diet is tasty, but its supposed health benefits are mostly bunk; the whole "blue zone" longevity secret has far more to do with bad record keeping, pensions, and shoddy research than with diet.

"Ultra-processed food" is a vibes-level concept that is likewise more scam than science.

https://www.msn.com/en-us/health/mindandbody/the-real-secret...

https://www.harvardmagazine.com/research/harvard-ultraproces...

The alternative hypothesis is that their 100yo are healthy enough to scam the state out of their "120yo" parents' pension.

I've been in many of these miracle health countries and seen many 90yo walking around.

They all have some just–so story about a particularly awfully–tasting vegetable or drinking English gin every morning or whatever.

It most likely entirely genetic but we aren't ready to accept that we are what our genes are.

An important factor there is “walking around.” It’s a very healthy thing to do.

Agreed, but we don't need it to explain why people who lied about their age seem to live longer than average.

Except when you start eating real food made fresh from quality ingredients. Or sauces being cooked for proper times. There is so incredibly much more flavour to all of that food. It is seriously rewarding both from a nutritional point of view and a mental health side.

We really don’t need to eat so much as we do for the lives most of us lead. Yes, farmers doing heavy labour and cyclists riding the tour du France need to consume 3000 to 6000 kcal because that is the actual labour they perform.

Take small portions of high quality food that you enjoy. Pay attention to what you eat and how it tastes. They will last you longer both in appetite and in the mind.

I know junk food is almost the only thing obtainable on low budget and that is the real poverty. But not having the time to well prepare meals nor having the money to buy the proper ingredients and store them in a cost-effective manner. It is one of the costs of being poor. And it is a sad thing we have the world in that state while we have multi billionaires roving around as well.

A lot of healthy food is much more tasty because it's mostly plants, which is where almost all flavours come from. The trouble is a lot of the time it it's branded as healthy it won't have much salt or oil etc. They make it taste bad so you think it's good for you. But food consisting of mostly plants can be both healthy and delicious, you just have to prepare it like Indians or Italians.

There's no master plan, it's just that technology is making life more efficient, and more productive. It's also the downside of freedom: you're free to make bad choices too.

Should we ban cars to force people to hike uphill to work? It would mean people would have to live in smaller apartments in cities, and the workforce would have less talent. But we could do it.

Should we ban rich foods in the mall? Do we want to live in a world where the government forces healthy choices on people? Many would argue the downsides outweigh the benefits, and most of us live in democracies.

Society is not obligated to make the choices you want to make easier for you. That will never change, so you might as well focus on yourself and your own habits.

I'm not saying we should ban stuff.

I'm saying that we could enact policies that encourage better habits by default. For example, we don't have to build car-dependent suburbia. Car-dependency is a choice we made. We've largely outlawed the building of walkable cities through zoning codes. There are literally millions upon millions of people who are forced into car-dependent suburbia and stuck with 9-5 jobs where they have to spend 1.5 hours commuting. It's no wonder people find it difficult to exercise. Add kids into the mix and it becomes almost impossible to find the time to drive to a gym to exercise 5 days a week. Many of these suburban cities are openly hostile to people not in cars.

That whole thing I just described is a series of policy choices. We can't save people from themselves but we can encourage better lifestyle choices. People would walk more if there were more stuff to walk to. People would bike to work if it were made possible.

Also, honestly, a world with fewer cars would be a much better place.

People are ignoring climate change too even though they know about it. It’s hard to make good decisions over these long lifestyles, which is why pay as you go taxes or structured retirement savings as part of your paycheck work better than just telling people they should be prepared.

The kid dying is sad, but it could have probably been prevented if the batteries were coated with a bitter agent such as denatonium.

It's mostly luck and genetics, but good sleep matters.

My mother died from Alzheimer's at 77 but wrote down her symptoms as early as 60, a full six years before her diagnosis.

Prior to her diagnosis, she walked her dog two miles a day, had an ideal weight, ate organic, never drank or smoke, used her brain constantly, and enjoyed a happy social life.

The only problem I saw with her was she was a very light sleeper.

Her aunt also died from Alzheimer's and was super healthy when diagnosed too.

Meanwhile the 103-year-old lady at my mother's former care facility is still sharp as a tack and reads daily without needing glasses.

Are you aware of her APOE3/APOE4 status?

Nope.

I have one APOE4.

Her mother didn't get Alzheimer's until her mid-80s.

Previous studies have shown that heart health at 50 predicts brain health at 75.

This study is interesting in that it quantifies the benefit as 12.5 extra dementia-free years. People with 0 risk factors had 30 years of dementia-free survival, vs 17.5 years for people with all 3 risk factors measured.

The risk factors in this specific study are blood pressure, diabetes (HbA1c), and smoking. You could reasonably also include cholesterol/ApoB, inflammation (hs-CRP), and perhaps Lp(a) as potential risk factors.

You are going to die, and it's a painful ugly business.

The right to die humanely is the single most under-regarded and under-valued aspect of life hygiene.

Fortunately some jurisdictions are death wise enough to provide humane means that we can request from a health practitioner.

That cuts both ways though, and I have quite direct knowledge of how this has been misused in really gross ways. But that said, I would still bias towards more freedom than less, and hope that we can get a handle on the more extreme cases.

The importance of walking can not be overstated. Walking for 30 mins every other day will dramatically improve your life if you are sedentary. If you can't do 30 minutes, start with 15.

Lifting weights also helps.

I'd argue that if someone wants to go beyond walking into running or even jogging, they ought to get their strength up so they don't have blood sugar crashes or cramps. It's never a bad idea to gain some muscle.

And don't drink alcohol

I'm not a drinker, but I think we shouldn't be so strict about it. I usually have a drink once every few months or so, and frankly I don't really care about the impact it has on my health. I suspect it's so minuscule as to not matter at all in the scheme of things.

Same with eating deep fried food. Especially if it's a food that's otherwise quite healthy. A bit of hot oil isn't going to be your undoing. Just don't make these things a habit. Enjoy a bit of indulgence, but be honest with yourself: is this once per month thing becoming a once per week thing, or a once every few days thing? Daily? Don't do that. Recognize vice. But don't be so strict that you never allow anything remotely unhealthy. Humans aren't great at abstinence.

Having said that, there's a reason I don't drink more often and it's because it really is terrible for you. I agree, haha. Just, don't pretend you'll never do bad things ever again. Unless you have far more willpower than I do — that's entirely possible.

It is an issue of moderation. The problem is that the science says the only safe level is none and people are not so good at moderating. My current level is one beer a week. My goal is to scale that back to one a month.

Also stay out of the sun. Better yet, just do a treadmill inside. No skin cancer that way.

As long as indoor air quality is good

Had an uncle who swore by this. He died at 57 of ALS.

That obviously doesn't mean walking is bad, I just mean to point out that even those people who believe in it as a silver bullet, can be hit with something totally out of left field.

Life is really quite brutish and short. You can do all the right things, and die early. All the wrong things, and live a long time. Take care of yourself for sure, but also find a balance and enjoy your life.

You can do everything right and get taken out by an accident. So far I've dodged a loose trailer that came off next to me going the opposite direction, a rock dislodged by a marmot from the cliff above, two drunk drivers drifting towards me, a city bus turning towards me on an icy road, a few other left turning drivers who didn't see me in a crosswalk (I now carry a high intensity pulsing flashlight for crossing at intersections) and two near misses when a gust upset my glider.

I was almost taken out by two rogue kayaks being towed behind an oblivious truck driver.

If I get taken out, I want it to be while I'm saving kids from an angry bear, not something stupid like ^

>I was almost taken out by two rogue kayaks being towed behind an oblivious truck driver.

Wow! That's some luck!

Movie night suggestion: Final Destination 1 and 2

Fine. But walking is also just kind of nice and unobtrusive for most people. I'd understand if you were replying to someone telling you to do strength training, but I'd argue walking is just pleasant.

Almost nobody believes it's a silver bullet or perfect shield against disease.

It's an odds game. I don't encourage people to start going into the long tail of diminishing returns to improve their longevity at the expense of everything else, but low hanging fruit like going for a walk every day has a very high ROI in later life quality of life.

The construction of GP and your post in sequence implies you think walking is not enjoyable.

GP: Go walking.

You: Instead, find a balance and enjoy life.

Walking is very enjoyable. Try it! Bonus, you'll come up with some of your best ideas!

No walking sucks when you have bad knees, go biking instead, or rollerblading, or kayaking, or swimming, or whatever, just make a habit of being active every day.

Nobody thinks walking is a silver bullet, ie a cure all. It's a good preventative for the most likely cause of death (heart disease).

Nobody thinks of it as a silver bullet. They know they can still get cancer, or get hit by a car, or whatever else.

For those who are inclined, I recommend running instead (even if you think you aren't a runner)

My body has been completely transformed from 15 years of running. I'm 5'7" and 135 pounds at age 41. My face looks thin, I have a better body than most 20 year olds. I gave myself the best gift that I could possibly give myself.

If they could distill 15 years of running (5x per week) and put it in pill form, I truly believe it would be the most valuable thing medicine has ever created.

All it takes is 45 minutes per day for 5 days per week. And you can actually have fun while doing it! It takes a long time to get to that point but it's so worth it.

For those who are a bit intimidated by the thought of starting running, especially if you are a bit older, you don't need to run hard or fast. Slow jogging (zone 2) results in great cardiovascular improvements. Don't be afraid to start by alternating jogging and walking.

And if you can't spare 45 minutes 5 days per week, do it 3 days a week instead. Something is better than nothing.

The couch to 5k programme is now routinely recommended by GPs in the UK (and elsewhere), a very positive development in health care in my opinion.

https://www.nhs.uk/better-health/get-active/get-running-with...

All it takes? Omg, why not do it every day if you’re going to do it 5 days a week? 3 days a week sounds more reasonable.

I actually do run every day. I've only missed about 4 days so far this year. Anyway, 3 days of running per week is certainly better than 0.

> For those who are inclined

I'd actually recommend an incline treadmill. Roughly 10% grade 3mph will give you the same caloric burn as a run but will be significantly easier to perform and save your knees from the wear and tear of running.

The whole "running destroys your knees" thing is a very persistent myth. Running can cause temporary knee injuries, especially in beginners. In the long run it actually strengthens your knees. There has been quite a lot of research on this but unfortunately, it's still in the cultural zeitgeist that running is bad for your knees

Of course, every person is different. Anecdotally, my knees and hips are so much stronger now than they were 15 years ago after running over 20k miles.

Walking is great, and you should do it for reasons other than cardio/circulation health too (walk in nature, rest for eyes, ankle strength, socialising, touch-grass moment etc).

But if you're doing it primarily for health, there's one other thing I'd suggest.

High rep bodyweight squats and lunges.

If you build up to it very gradually there's no risk of hurting your knees. It's the best example of "motion is lotion". After a few months of daily squats, climbing stairs will feel effortless. I'm 40 and I can tell you you'll notice the difference.

A 100 squats at relaxed pace takes about 5 minutes for me. 10 mins for 150. 100 walking lunges in 10 mins. There's no hurry/competition. You can take your time to catch your breath. I've done 250 or so in 30 mins once every 2 or 3 weeks. But I feel that's not conducive to daily work. I get tired.

Once you get acquainted to this to the point where a 100 reps of squats/lunges don't make you sore the next day, or hurt the joints, then the heart rate you achieve from this will be similar to a relaxed zone 2 run.

And the health benefits are similar to walking. improved blood sugar and blood pressure.

My goal is to be able to do this for 20 to 30 mins twice or thrice a week. That might be some 300 to 400 squats.

I've been doing his way of training for a few years now, and I love it because this is what has be train consistently. not going to gym or tracks, or playing sports.

I like this, and recommend this over walking to anyone who can't seem to get the time to walk because it takes less time to get similar health benefit, doesn't need space/dressing-up/socialising/commute.

If you want info on this, kboges on youtube is the man. here are his amazing squat/legs related videos:

- https://www.youtube.com/watch?v=guG1LT7ejDU - he does 525 reps in one set. says it took him 20 mins

- https://www.youtube.com/watch?v=zWXToSCaq-Q - he does 100 constant tension squats in 2 mins

- https://www.youtube.com/watch?v=0euDDJu6GnQ - deep knee bends, aka hindu squats

- https://www.youtube.com/watch?v=TqNP_PiEalg - his take on squats busting your knees

ofc, not a doctor, dyor, listen for sharp pains etc and progress very slowly if you don't want to get hurt! you have your whole life to improve, so there's no hurry.

> Hypertension was defined as a systolic blood pressure of 140 mm Hg or higher, a diastolic blood pressure of 90 mm Hg or higher, or the utilization of blood pressure-lowering medications.

Whoever defined this, thank you for having common sense!

This stood out to me because there are so many lunatics defining it as 121/80 or even 121/70 with the backwards idea that the systolic is more important. Worse still is when they insist that something as low as 100/65 is optimal despite complaints of dizziness. All the while hammering home that you should chug a million gallons of water and deprive yourself of sodium. It's like they're trying to make people miserable.

The 120/80 benchmark isn't lunacy. Most people in the west have issues with hypertension because that's the direction it goes due to the common risk factors.

If you're at 135/85, and you're middle aged / younger, and your diet and lifestyle aren't already optimized, it's something you should probably care about, not look for the next highest rung on the ladder so that you can celebrate for being below it.

You're completely missing the point. There's a significant amount of people middle aged and younger with numbers something like 125/75. They may have that same blood pressure never change from about 20 years old until their 70s.

Elsewhere they'd be borderline normal, but "in the west" (really just the USA) they're considered stage 1 hypertension and it's anyone's guess what wild nonsense the doctor will tell them once that's in their chart.

It's a total circus. Covering your own ass and screwing the patient over by assuming the worst is not preventative medicine. Overprescribing medication would cause harm if the patient is too naive for their own good despite doing everything else right. Nobody in their right mind should listen to that kind of doctor or take the medication.

Sure, at the end of the day you have to do your own research and consider whether any medical professional is under- or overreacting. It's why a second opinion makes sense.

I have naturally higher blood pressure such that I'm usually 135/75 in the doctor's office. But I also run every day, I'm fit, and I have a dialed in diet. No doctor has given me flak for it.

But I also see this thinking turn into empty contrarianism that is also dangerous.

I know some keto/carnivore grifters say high blood pressure is fine and high blood cholesterol is fine and that you should actually double down on table salt and that as long as your a1c is good then nothing matters. Now people trying to navigate their numbers are even more confused.

I don't know much about keto/carnivore, but I think it might be worth picking apart the last thing you said.

There are far more people spreading misinformation about reducing dietary cholesterol and sodium because authoritative sounding organizations promoted it for so long.

The American Heart Association is paid by big pharma to talk out of both sides of their mouth. For decades they have strongly suggested that people consume less than 1500mg of sodium and minimize dietary cholesterol. In recent years they've been forced to admit that all that does is lead people to avoid better foods. Regardless, they still double down that the math makes sense on their old advice. They refuse to explain how.

The fact of the matter is dietary cholesterol has no impact on blood cholesterol, and most people need more than 1500mg of sodium to prevent low blood pressure and stay hydrated.

I have personally naively attempted to eat healthy by turning to salads, skipping dairy, and focusing on protein and carbs that contain lots of soluble fiber. I just ended up with severe constipation (too much fiber overall), vitamin deficiencies (animal products contain cholesterol), low blood pressure, and was getting dizzy and peeing all the time because I didn't think to get more sodium beyond seasoning.

What fixed it? Add the dairy back in (greek yogurt and cheeses), don't skip old school fortified breads/cereals (the OG ultraprocessed multivitamin), offal/organ meats, eggs, seafood, nuts, avocado, olive oil, etc.

It's one thing to say people have different bodies, but quite another to unwittingly support blatant lies.

The blood pressure-lowering medications was a kick in the crotch. I've had primary hypertension (i.e., doctors have no explanation for why) since I was a teenager playing fifteen hours of tennis a week with a low body fat percentage and healthy eating habits.

Nothing I've ever tried has fixed this, including scratch-cooking everything for months, no meat, no salt, for months. Distance running. Weightlifting. Lots of sleep. I literally don't even have to work the rest of my life and am in my 40s, so no stress, either. I guess I'm just screwed!

I must admit that I found it confusing that they lumped people with unmanaged hypertension in with those who were on meds to manage it. Those feel like separate groups. Does anyone here know more about this area, and why the combined group might make sense?

Blood pressure varies significantly throughout the day and is often measured incorrectly at doctors offices. It's a good idea to get a home cuff BP machine and keep track of it yourself after reading up on how to use the machine. Otherwise you might get recommended medicine incorrectly, or you could get a false sense of security.

If anyone wants to go down a rabbit hole, go search for topics around fructose corn syrup, visceral fat and artery plaque. It can play a substantial role in vascular health. I'm not a doctor but there's a bunch of studies posted online about this and my doctor also agreed when I asked him about it.

Avoiding fructose corn syrup is a really good idea. It's in a ton of sugary drinks. It really messes with inflammation in your body and your liver materializes it in a very similar way as alcohol. Basically both are bad and can cause similar issues.

For me personally I walk a few miles a day for 15+ years and I'm in ok shape. Cutting out Arizona iced tea (has a lot of fructose corn syrup) has made a material difference in how my body operates, I used to drink 1-2 cans a day for a while. Nowadays going 18 hours without food is no problem, I don't have mid-day tired spikes and I didn't change what I eat. I can't explain it but it feels like it reset something.

When I've been on vacation in other countries outside of the US for a few weeks, I noticed the same thing (less hungry, more energy, etc.) and a commonality there is I also didn't drink large amounts of fructose corn syrup. There's a lot of variables I'm sure but I can say I feel a difference for the better after stopping and I've now repeated these feelings when doing normal things locally.

The work of Dr. Rick Johnson is perhaps relevant. He links the effects of fructose on the mitochondria, which then affects the neurons in the brain, over time.

This hypothesis makes much more sense to me when you think to the associated diseases (diabetes, heart disease etc...)

You can get a overview of his research on this podcast (approx 75min): https://www.youtube.com/watch?v=59Oje6n2JLU

In the context of TFA, what hypothesis makes much more sense to you than what alternative?

TFA? Not sure what you mean.

The hypothesis (I'm paraphrasing) is the fructose severely downgrades the mitochondria (this is well established).

The part that is really interesting to me is that patients with alzheimer's have huge amounts of fructose in their brains (that's covered the in the podcast).

So, lots of fructose, mitochondria impacted, thus neurons degraded. Makes sense to me.

As far as alternative hypothesis, there aren't any good ones that I'm aware of.

TFA: https://news.ycombinator.com/item?id=19781756

Alzheimer's disease is a specific subtype of dementia; this article seems to be more focused on vascular dementia (or at least vascular risk factors) -- why I was curious about the relationship between e.g. smoking and fructose.

The association of fructose has been studied directly in the context of AD, and the hazard ratio is modest (and not necessarily dose-dependent) [0]:

> After adjustment for sex, age, MMSE at baseline, education level, SBP, treatment of hypertension, LDL, uric acid, prevalent diabetes mellitus, current smoking, alcohol consumption, dietary fiber intake, total energy intake, sugar in beverage, seafood, red meat, fried foods, animal fat, personal income, marital status, physical activity index, and BMI in the Cox regression model, participants with consumption of fructose more than 7 servings/week showed a higher risk of all-cause dementia and AD dementia (HR: 1.49, 95% CI: 1.14–1.84, P for trend < 0.001 for all-cause dementia; HR: 1.60, 95% CI: 1.22–2.01, P-trend < 0.001 for AD dementia) than subjects with no consumption for fructose. And the results remained comparable for participants with medium consumption of fructose (HR: 1.46, 95% CI: 1.30–1.79, for all-cause dementia; HR: 1.52, 95% CI: 1.14–1.91, for AD dementia) (see Table 2).

I haven't seen anything about the fructose content of brains of AD patients; do you have a (preferably non-video) reference / source?

[0]: https://www.sciencedirect.com/science/article/pii/S227458072...

I have always had a very low blood pressure, below what's considered "normal." I never feel dizzy when standing up, though. Is this still a risk factor for dementia?

This is a question for your doctor.

> Maintaining optimal midlife vascular health was associated with up to 12.6 additional dementia-free survival years,

Stay on top of your cardiovascular health. Even moderate diet and lifestyle changes can have a significant impact on the last decade of your life. These things compound over decades.

Being human, I think more about the number of dementia years than number of dementia-free years. Could having good dietary, sleep, and exercise habits result in living longer with dementia?

I've hard about cognitive reserve and how healthy lifestyle choices can build that. But I never read about ways to minimize the number of years you have to live with dementia. I wish I could sign an order that would grant me a dignified death once I'm deemed no longer fit to make that decision.

You're looking at this from the wrong angle. The dementia risk and longevity have overlapping factors. Lifestyle choices correlated with shorter lifespan are also correlated with earlier dementia onset. They're not perfectly proportional, but getting earlier dementia and also living shorter is lose-lose.

Technically there's an extreme version of this where someone's lifestyle is so bad that they're unlikely to live past 60, but the last 10-20 years of that life would not be fun.

> getting earlier dementia and also living shorter is lose-lose

That depends. I'd rather die at 70 after a year of dementia than live to 85 where the last five of those I have dementia. I want to minimize the number of years with dementia, not maximize the number of years without.

This is indeed a problem. My mom had excellent cardiovascular health (she walked hours a day, ate a mostly vegetarian diet, etc). She got Alzheimers at 65 and is now 82. She's been completely gone as a person for the last decade, but her body hasn't died yet. It's tragic.

Microplastics are a huge issue-- reducing your exposure is of the utmost importance imo. I go to a longevity clinic that tests, and was recommended this product MicroCleanse by Hazel's. Have seen a material reduction in level 2 build up.

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