I recently wrote an article discussing how increased fruits and vegetables can prevent mortality from cardiovascular diseases, yet not cancer.[1]
My conclusion was that cancer is best prevented by removing negatives from life, not necessarily adding positives. ie avoid anything from stress to pollution to sunburn to obviously smoking. Interestingly, organic food doesn't seem to matter in the cancer equation, given the data we have.
Yet there's one thing you can ADD to reduce cancer: exercise. Preferably moderately hard to strenuous.
"My conclusion was that cancer is best prevented by removing negatives from life, not necessarily adding positives."
I'm also skeptical that adding foods/vitamins/supplements will prevent cancer.
However, there is one area that adding things seems to be very beneficial, and that is adding things that promote regular bowel movements.
There have been studies of heavy coffee drinkers and their reduced risks of colon cancer. Everyone is looking for some mysterious phenol or antioxidant from the coffee as a magic elixir, but I think it should be obvious that coffee as a laxative is the agent here.
There's also the age-old rule of thumb: an apple a day keeps the doctor away. It's not the apple, it's the fiber.
When I was young the idea that high fiber reduces colon cancer risk was very high profile and based on pretty stupid studies. Later when more rigorous studies failed to find an association, no one noticed. It's like antioxidants and a host of other "eat this and you'll live forever" studies/stories.
> "My conclusion was that cancer is best prevented by removing negatives from life, not necessarily adding positives."
But diet is a complex system. So while there might not be any magical "direct" benefit from eating a certain fruit or vegetable, they could still produce a significant positive effect.
Perhaps the biggest contribution to preventing cancer that fruits and veggies make is to curb negative behavior. They might replace sugary foods or regulate cravings or satiate (all interrelated). And then, this could feed back into promoting positive behavior: more energy which encourages more rigorous exercise. Which boosts the subject's mood and increases their sense of well-being. Which feeds back into their dietary choices. Etc.
That's all well and good, but data on over 800,000 people really didn't show any statistically-significant fewer number of cancer deaths from fruit-eaters.
Obviously there's benefits, but I maintain that adding fruits and veggies to an otherwise awful lifestyle is akin to putting lipstick on a pig. Eat all the fruit you want -- if you smoke, you're not fooling your body.
>A bigger concern to me is that people might interpret these findings as assigning fault to people who get cancer. You don’t want to get into situations where you feel as if people don’t deserve help because they didn’t try hard enough to stay healthy. Much of cancer is still out of people’s control.
Although only one paragraph, I'm glad the author addressed this.
All of these tips and lifestyle changes are great but this doesn't make those of us with loved ones with cancer feel any better. By all accounts she has done everything to qualify as "low risk," but still got cancer.
It's still an odds game. Better odds don't guarantee anything. It's unfair, frustrating, and infuriating.
On the bright side, I hear from medical friends that being otherwise really healthy is helpful because the doctors can hit you a lot harder with treatments like chemo and expect you to survive it.
Lung cancer is most closely associated with smoking, but lung cancer can be caused by many air contaminants. Radon is the second leading cause of lung cancer, causing 21,000 deaths each year. About 2,900 of those people are non-smokers.[1]
Cancer can be caused by things other than mutagens though. There is a certain rate of transcription errors when cells divide, and these errors can build up in the same way mutations from radiation, etc. build up. Things that kill cells and force them to divide speed up cell division, and can cause cancer that way. For instance, acid reflux and drinking can both cause esophageal cancer.
You can also get cancer from just being extraordinarily unlucky.
I'd like to see a statistic that accounts for the fact that we all eventually die from _something_.
If we measure success only by how many people eventually die from a particular disease, then increasing life expectancy doesn't count as success at all.
Dying from cancer at the age of 90 should not be counted the same as dying of cancer at the age of 45.
So the statistic I want to see would count cancer free years.
The NHS in the UK uses the concept of QALYs to measure the effectiveness of interventions: Quality Adjusted Life Years.
If you have to avoid a certain activity, or take up a certain activity, in order to enhance your longevity, doing or not doing something you'd rather do (or not) may still affect your quality of life.
It's amazing just how badly this study was distorted by generalized clickbaitism. It chafed me sufficiently enough to put out a video on the subject at the time[1]. The hype really wasn't even necessary... the underlying findings were plenty interesting enough already: that there is an association between stem cell division rate of specific tissues and overall cancer risk. This, however, in no way implies that cancer is only due to bad luck.
Science ended up printing a follow-up actually clarify things, perhaps feeling themselves that the interpretation by the public at large got out of hand a little bit[2].
> In other words, this study argued that the more times D.N.A. replicates, the more often something can go wrong. Some took this to mean that cancer is much more because of “bad luck” than because of other factors that people could control.
> Unfortunately, this simple explanation is not really what the study showed. Lung cells, for instance, divide quite rarely, and still account for a significant amount of cancer. Cells in the gastrointestinal tract divide all the time and account for many fewer cancers. Some cancers, like melanoma, were found to be in the group of cancers influenced more by intrinsic factors (or those we can’t control), when we clearly know that extrinsic factors, like sun exposure, are a major cause.
as well, he only opens with that and aims to debunk the bad luck hypothesis by means of the other two studies. which again I personally have no idea about :)
> Over all, though, about 25 percent of cancer in women and 33 percent in men was potentially preventable.
This article is a rather optimistic spin on these numbers. I'd have said "a large majority of cancer cases--75% in women and 67% in men--were not preventable"
Oh, I don't know. On the one hand, part of me agrees with you.
On the other hand, when someone tells me that they've optimized a compiler and it can now compile 3% faster I get really excited and pull their repo, I don't turn around and say "you mean 97% as slow" and keep complaining about how long compilation takes and how nothing can be done about it. Show that there are steps you can take to cut it by 33% more than we currently know how and you'll be a god among programmers.
I agree with your basic point - but doesn't "3% faster" usually mean that it runs faster in all cases? So the "97% as slow" does not seem to be clear. Maybe it should be said as the improvement is not significant enough according to some numerical threshold?
I think it's closer to "I boosted conversion rates on our sign up page by 33%."
Sure, not every visitor signs up still, but some group of people found the new copy compelling enough to sign up - with no new, very expensive feature development.
> About 82 percent of women and 78 percent of men who got lung cancer might have prevented it through healthy behaviors.
Back of the envelope: ~20 percent of all cancer deaths are lung cancer deaths that wouldn't have happened without smoking. That leaves just 5-15% of cancer deaths being "potentially preventable" once you've given up smoking. (Here, I'm not distinguishing between cancer cases and cancer deaths; please point to better data if you have it.)
I'd wager less than 5% of cancer deaths are preventable if you neither smoke nor are overweight.
I think this article, and especially its headline, is highly misleading.
I think as a culture (speaking here in the US) we've made quitting smoking out to be much harder than it actually is. One of the problems with this massive marketing campaign saying things like "You can quit with help!", etc.. is it's focusing on how difficult it's supposed to be.
After 20 years or so of being a smoker, I just decided I didn't want to be embarrassed about the way I smelled in elevators anymore, and quit. I was a competitive cyclist, despite being a smoker, so it wasn't helping me in those social situations either.
When I did stop, it was hard for about a single day. Irritation and not being sure what to do with your hands are the biggest "withdrawal" symptoms you'll have from quitting. If I'd known just how easy it is to stop, I would have 10 years prior.
So yes, listen to the above poster. It won't kill you to quit, it will kill you not to. If you honestly think you can't, it's a very simple problem to solve. There are really only three components to quitting. Nicotine addiction (easy to taper off with substitutes like gums, switching to vaping with decrementing nicotine levels, etc), Habit (the act of smoking, vaping/e-cigarettes/gum chewing/going on walks instead can help replace this) and the social pressure, which is usually smoking with your smoker friends or partner. Fun fact, they all want to stop too, even if they don't say so. Get them to quit with you, and if one or more refuse or abandon, ignore them and be selfish with your health.
All that said - the "pain" of cold turkey lasts a day and all the anecdata that I've collected seems to make it the most effective way to stop.
The difficulty of quitting varies a lot from person to person. I knew a couple back in the nineties, where one partner was able to quit using the patch. It just worked for him, and was reportedly not that difficult. He was done with tobacco immediately, and done with nicotine entirely within the month.
The other partner tried everything. Cold turkey, gradual reduction, patches, gum, change of location plus each of those, the works. As you can imagine given the domestic situation, she had exactly the right kind of support. None of it helped for over a decade. She was finally able to quit for good around 2010, and just a month later discovered that it was too late. Smoking had already given her the cancer that would end her life.
That said, this story kind of agrees with you. The partner who quit is still alive, and quite healthy. It might be easy, or it might be the hardest thing you've ever done. No matter how hard it is, though, lung cancer is even harder.
I guess the point I was trying to make wasn't to brag that it was so great and easy for me to do, it's to say that maybe we have culturally made it seem harder than it is. The more press it gets the more the belief is reinforced.
We have tobacco companies still cranking out the same garbage, almost with the attitude that they are forced to keep making this horrific product because people are hooked on it. They keep taking our money, apologetically, as they kill us.
I stopped 6 years ago and have zero cravings. But I am curious how you define "cravings". Is it a physical sensation? Is it a mental "pull" when you see someone light one up?
It's associative. If I think about smoking I get a strong urge to do it. I stopped the first time I noticed the craving when seeing someone I did not know smoking and had the urge to bum a smoke.
Smoking is easy to quit for most people, and ridiculously hard for most smokers. When I was 17-20 50% of my friends smoked cigarettes and 80% of my friends quit by the time they were out of college a year or two without any problems. The remaining 20% of my friends couldn't quit for the world. They've tried quitting 20 different ways and never succeeded. I think the difference is some people are just wired for quitting smoking to be hard, but most people aren't. And the former population is way over represented among the smoking population.
I quit cold turkey after 7 years of smoking and I'm really glad that I did.
So with that I can say: the pain of quitting doesn't last only a day, it's good you didn't experience depression, I never had depression before or after that but I was clinically depressed for 3 weeks, I was apathetic about life in general, would wake up and not feel motivation to do anything, I'd do them anyway because it was a routine (eat, shower, work) but I really felt I'd never be happy as I was before.
It began to fade after the first week, during the second week I'd still feel urges to have a cigarette after a coffee or lunch, or just when I was bored. Third week was easier and by the end of the first month I was over the initial withdrawal symptoms.
But again: it's not "just a day", it's not really "omg, this is so easy, I'm over it". I had to constantly remind myself to NEVER had a drag, I got drunk during the third week and it was a pretty good feeling to deny a cigarette a friend wanted to share.
I was a 2 pack a day smoker during the last year of smoking, that might have impacted how much the withdrawal symptoms lasted or how strong they were.
It's on of the best things I've done in life, it also gave me a huge boost of confidence to do other stuff, my mindset nowadays is "I quit smoking cold turkey, I can do almost anything when I commit to".
It's not to say I didn't have urges.. doing something for almost 20 years, anything, is hard to let go of. But that nail biting aggravated irritableness lasted about a day for me.
Part of it may be that because of the whole bike racing thing, I had had several occasions where I'd been through weekend long periods I couldn't really get to smoke, or had to make due with patches or gums. I would also immediately light up when I got away from those friends. Those times, I'd also tried white-knuckling through weekends, been just as irritable, but it kept going for days like you said. When I mentally made the switch to not smoking anymore though, it was different, much easier than those 3 day weekends ever were.
I've heard lots of people say the same thing to me, once you do it, you know it's done. You're not just holding off for a few days or seeing how long you can go, you're just mentally done with it. Or maybe I just tricked myself and it worked. :)
Yeah that first time you quit is easy. Then something bad happens in life and you smoke because you're sad. Now you know how easy it is to quit so paradoxically you don't actually quit. You turn into a every-other-weekend smoker. Then after months or years of on-off smoking you realize that it's no longer as easy to quit as that first time. Now that one smoke is actually going to matter.
Also, nicotine has the highest capture rates of any drug (over 30%) and the third highest dependence rate (after heroin and cocaine). Startup founders with unbelievable amounts of determination may be able to just give it up and say it was "easy" (I said the same thing the first time I quit) but many people are not so gifted.
A lot of this impression about the difficulty of quitting smoking arose in the 1980s and 1990s. At the time, smoking was omnipresent and taken for granted. Nobody asked permission to light up any place. If you were a nonsmoker out with friends, you'd sometimes be left nearly alone by yourself when everyone went out to take a smoke break together. I never smoked, but I reckon that these social factors made it much, much more difficult to quit and to stay quit.
A critical mass was reached in the 2000s, though, and now the bulk of social pressure is on helping people quit and stay quit. Frequently it's the smoker who will be alone in the cold on their smoke break. & besides, we have effective smoking cessation drugs like Chantix (how my wife quit).
Back in the army you quickly realized that when taking a smoke break, the guy who didn't smoke was volunteered to fetch the truck or whatever. So you learned to smoke, to avoid extra duty.
The pain of cold turkey stopping and the hardship of quitting in general vary widely between individuals; and even to a lesser extent at different periods of time for the same individual, I think.
I once stopped smoking for ~3 weeks and I too found it easier than advertised, but not nearly as easy as you; also, the most problematic symptom for me was irritability (I was a complete irrascible bastard while stopping). And I know people for which it is very, very hard (cold sweats, migraines, etc. for two weeks).
As another anecdote, I've found that it takes about 3 days for me to pretty much lose all the physical addiction. That part is pretty easy as long as you can find a 3 day chunk of time in which you don't have stressful obligations and fill it with some activity (even if it's just binge-watching Star Trek or something).
After that, it's all habit. That takes closer to 3 weeks to break. Here I find it helps to create another habit, maybe buy a bunch of candy and eat one when you feel like a cigarette.
I've quit a couple of times (and I will do so again--for the last time, obviously) and my experiences are pretty much the same.
Best way I found to get over those 3 days is to be sick, drunk, hungover or all of those, coinciding with a strong urge to quit and running out of tobacco (or throwing it out) at the start of it.
And it's not easy. But it might be for some. But I wonder if the ones that can quit really easily are really the ones that need all this anti-smoking advertising, anyway? I mean they can just have a moment of clarity, realize the health risks and quit. Well good on you (I mean it). I'm glad there is all this negative pressure nowadays, means I will have to say "no" less often, and feel supported by it.
And even though I feel quitting is hard for me (compared to people who can smoke once every two months or so, or maybe never, just like that), when I hear these stories about people having physical withdrawal symptoms for weeks, that sucks, I feel for them and wish them strength too.
14 year ex smoker here. 1 week of sweating hell and tic tacs followed by 3 months of hell and tic tacs and now I'm a few years free :) Not easy but just requires certitude.
It's great that you had it easy. I didn't. When I quit nicotine about two years ago, I got kicked into a deep depression that lasted about 3 months (Worth noting: I had a history with depression). I developed panic attacks (and I had no previous history with those).
On the plus side:
1. I quit and stayed quit.
2. I'm mostly back to my old self. No more depression or panic attacks. Not now, and never again!
3. The whole experience cost me so much that I doubt I'll feel much temptation to use nicotine ever again.
I hear about this depression. I was the opposite. I felt artificially manic/high/excited about quitting I think. It wore off pretty quickly but I was super happy the first few weeks.
One trick that worked for me (pack+ a day smoker for 5+ years) was not exactly calling it "quitting". I had tried quitting a bunch of times, but every time I had a lapse in will power and had a cigarette, the justification to start again basically went "oh well, guess I failed quitting, time to go out and buy a pack."
When I changed my mindset to more of a "I just don't really smoke anymore." it was ok to have one every once in a while when I was out with friends and not feel like I failed. Now I'm basically down to only one cigarette a year or two when I'm with old friends, and I usually feel bad enough in the morning after it that I don't really have any desire to smoke again for a long time.
It's really different for everyone. So I'll put this out as a word of caution: my response to that one accidental cigarette has been (twice) that cravings increase over the next couple of weeks, then I was having one random shitty night, and feeling all "fuck everything", bought a pack at the night store, and was back at square zero.
Yesterday I promised myself to not buy cigarettes anymore nor ask anyone to do it on my behalf. This first step only requires tremendous willpower when visiting a store, as the dispensers are placed at checkouts so I must stand right next to them when I'm in the queue.
Focus on the smell. Make it long enough (about 24 hours) to notice other smokers smell. That is the smell of other people being repulsed by you. You smell like that in every elevator, every time you introduce yourself to someone, and no amount of gum or tooth brushing covers it up. You can't smell it while you smoke, but the rest of the world can.
It was enough to keep me dedicated knowing I could confidently talk to anyone after I quit without having to wonder if they were immediately put off by my smell.
People who still smoke always complain that ex-smokers are the worst and most judgmental about smoking, and it's 100% true. It's because we feel seriously ashamed of ourselves for being so stupid for so long, it comes out as assholishness sometimes.
Everyone uses that little trope, "like kissing an ashtray" but I find that untrue. There's a really weird acidity when you're kissing someone who's just smoked, like coffee-breath and garbage.
I dunno, they might need to get close and smell the breath, the smell of cigarettes to this day (from a distance) still makes me crave one, ever so slightly. Even after having quit 13 years ago (I quit in 2003). The only off-putting smell is in ashtrays or their breath/clothing. The actual burning smell though, that gets me to this day.
My Dad quit smoking when I was little, back in the days when people "chain smoked" (i.e. They used a lighter once a day, and just kept lighting new cigarettes with their butts). He credits his success with this tactic: He loudly told everyone he knew that people who can't quit smoking are pussies. Fear of total public humiliation was enough to keep him from relapsing, or so he claims. He never did relapse that I saw though. He also told us this story often enough that none of us kids ever touched a cigarette.
Goodluck. I just quit cold turkey a few years back and just refused to do it again. Now if I try have a drag of someone else's it tastes so vile that I can't see what I ever got from them. It can be done. Just do it!
I would think it only fair to put the burden of the health damage on the company who sells addictive products.
If you sell cigarettes and a customer looses part of the lung, you pay or behave to prevent.
If you sell alcohol and a customer drives a car in a crowd, you pay or behave to prevent.
If you are a narco and sell crack, you pay for the results.
The problem is not the unknown problems with those substances, its the fact that the producers are detached from the consequences of their actions.
By that logic, no individual is responsible for anything they ever do because just about everything is "addictive" or "habit forming" in some way. Your suggestion is terrible for a number of reasons, but primarily due to the shirking of personal responsibility that it promotes.
Should Hershey be required to pay medical costs for morbidly obese individuals because they eat a dozen chocolate bars a day? Sugar is a highly addictive substance, after all.
Should automobile manufacturers be required to pay the medical bills of every individual injured in a high-speed accident because driving very fast generally causes an adrenaline rush, which is addictive?
Stop making it someone else's problem. Start casting blame where it needs to be - on the individual(s).
Nobody is forced to start smoking, or start drinking, or start eating sweets, or drive recklessly, or to do this or that. I'm tired of the popular trend of infantilization that offloads the burden of one's own actions onto society/industry/government.
I think it would be a great start if we started to differentiate- some humans are capeable of this, but others are not. To just leave them to there suffering because they had a "choosing-chance" is just wrong. No pr-opaganda can explain the facts on the ground away, sorry.
Right and wrong are not objective units of measure, please don't be insulting by trying to state "facts" regarding something being "right" or "wrong".
As far as "leaving them to suffer" goes, there are plenty of ways for people to get help with just about every health condition and disorder that's lifestyle related. They simply require that the individual actually take responsibility for their own existence and reach out.
Who makes the decision that someone is "not capable" of caring for themselves, and at what level? Do you force them into a special program? Do you take away all of their other individual rights at the same time? Who decides what aspects of personal responsibility apply to which people? That's a very slippery, dangerous slope to tread. Smarter people than you, or I, haven't been able to come up with "the right" answer.
Nobody is forced to manufacture addictive products, advertise them in misleading ways, pay celebrities and filmmakers to use them conspicuously, or buy prominent product placement everywhere a person trying to quit has to go, either.
You are introducing irrelevant other ideas to distract from the core of the OP's argument, which while a bit excessive IMO, warrants an honest discussion, not hyperbolic overreaction.
Ugh, what a nasty little, finger-pointing, stone-casting society you seem to desire. Is there anything that you'd blame on society/industry/government, or is it always 100% the individual's fault?
Who said anything about throwing stones, or pointing fingers? Nothing in my post indicates that help should be refused to individuals who make poor decisions and then try to recover from them, just that, in a free society, the onus should not be solely on the head of "a higher authority" (govt, industry, etc) to be responsible for doing so.
The world you seem to desire would make cellphone manufacturers and service providers fully liable for accidents that happen when an idiot is using their phone and gets in a car wreck.
The individual chose to get into a car, and drive somewhere, and use a cellphone, all at the same time. This despite the fact that it is made abundantly clear that doing so impairs driving ability much like alcohol would, via advertisement and public notice and safety publications, in the news, and even by state law in some cases. You cannot prevent people from doing stupid things. You can, however, make them bear the repercussions of those stupid decisions.
The world you seem to desire is one where every device and tool is covered in thick layers of bubble wrap and warning labels and dozen-pages-thick usage contracts to indemnify the manufacturer.
The world you seem to desire is one where no criminal is punished for their actions because they were just "a victim of their environment and don't know how to do anything else".
And that is something that I cannot and will not agree with, ever, on a fundamental level. Personal freedom comes with personal responsibility.
If there's a tool designed in such a way that using it in an accidentally-slightly-incorrect manner will electrocute the person using it - sure, hold the manufacturer responsible.
But if there's a tool that does exactly what it's designed to do, but someone uses it for a completely different purpose in a completely different way than it was designed to do, and it electrocutes them - that's on the user's head.
> Start casting blame where it needs to be - on the individual(s).
Those are your words, my friend. Maybe I misinterpreted them. I didn't say individuals are 0% responsible. It's a mix, right?. Individuals deserve blame but also support. Companies deserve protection from inane lawsuits but also bear some responsibility.
> But if there's a tool that does exactly what it's designed to do, but someone uses it for a completely different purpose in a completely different way than it was designed to do, and it electrocutes them - that's on the user's head.
Sure. That doesn't apply to tobacco or sugar. We're using it in exactly the way the sellers intended. I don't know why you're stuck on the reckless driving example, when it doesn't really pertain to the general context of the article.
> I'm tired of the popular trend of infantilization that offloads the burden of one's own actions onto society/industry/government.
Sure. But my question stands. Do you think the society/industry/government ever bears >0% of the responsibility?
> Sure. That doesn't apply to tobacco or sugar. We're using it in exactly the way the sellers intended.
Moderate tobacco use, in some forms, moderately increases cancer risk. Moderate sugar consumption doesn't overtly increase the risk of heart disease or obesity.
Overuse of most tobacco products dramatically increases your cancer risk, just as overuse of sugar dramatically increases its associated risks.
My point stands that nobody is forcing you to start smoking tobacco or eating large volumes of sugar. Why do you want to push all of the responsibility away from someone who willingly undertakes an optional activity with known risks?
It's not like every widely-available tobacco product hasn't had 50% or more of its packaging plastered with "warning, cancer!" labels for the last 30-odd years.
Should tobacco companies be held responsible for objectively-false advertising and marketing? Yeah, if memory serves they got beat up pretty well for that by the government many years ago. When was the last time you saw an ad for cigarettes on TV? It's been quite a long time since I have. That problem has already been taken care of.
With sugars you might be able to make an argument about a lack of in-your-face warnings - but why should those be required? Moderate consumption is fine. Excessive consumption is where the problem starts kicking in. Various government entities are already kicking up a stink about sugar-heavy products, so I wouldn't be surprised if we got such warning labels in the future anyway.
> Why do you want to push all of the responsibility away from someone who willingly undertakes an optional activity with known risks?
Where did I say or even imply that? I just said it's less than 100% – but more 0%. You're obviously quite passionate and/or angry about something, some injustice you've seen or something. I feel like we're talking past each other and you want to have an argument just for the sake of arguing on the Internet. I'm not super interested in that.
I hope you have a wonderful rest of the day. Maybe we'll meet in person one day and debate the issue in a higher bandwidth medium. Cheers.
Good thing we don't write those apps to be addictive. Good thing we all have clean consciousness - else we might end up compulsively venting guilt by propagating aggressive libertarian ideology's.
Good things.
I program Robots for a living, and you know what - im guilty of those peoples lives going to hell when they are let go.
They are not guilty that they can not retrain at 40.
They are not to blame that there endurance might not be high enough to get a degree.
Its also not the CEO who employs me to do my job, which i just do. I could quit my job anytime.
Im guilty and thus must work hard, to even that guilt out.
I try my best to promote basic income and unshaming unemployment in my home country.
Individual responsibility, suddenly sounds less happy, does it? Sounds like hard work and shame.
You arguments sounds suspiciously like shirking responsibility's by idealizing other people. Imagine if a whole society would do that, what a catastrophe, could you even call that a society anymore?
My dad also quit a long time ago; he's really proud of it, because he just decided to quit one day and it worked, without ever relapsing and without very negative effects. Or so he says. I don't really believe all of it, but the point to take away seems to be that it's all about willpower.
I've quit 4 times. Last time I was sure and totally relaxed. When you know you want to quit, you will, it doesn't matter the technique used to quit, I felt I was about to quit with determination.
I believe in tested e-cigarettes and liquids to cut a chunk of chemicals. I wonder what other people do. Kick their ass into sport ? Reorganizing life ? more hobbies, more social life, more zen ?
The easiest way to break a bad habit is to replace it with another habit. Just make sure it's a better habit otherwise there was not much point was there?
This is great, and I think it should be fairly easy for everyone to follow in small measure at the very least. I'm not minimizing the struggles of those who can't control their weight or eating habits. I simply believe that people often pick something like a "diet" as their primary focus and then skip the workouts or continue to indulge in alcohol. I find it much easier to succeed when I attack the problem from more angles and try to make changes in all of these aspects to my routine. If one fails, I can still reap the benefits from the other changes I've made.
With hearts, you open up and you see clogged arteries, for example. It doesn't get much simpler than "too much fat is bad for your heart".
With cancer? It could be anything. And there are tons of different types, seemingly hitting all kinds of people, fat smokers and lean non-smoking vegans alike.
I've heard recently that the causality for heart disease actually goes the opposite way than everyone assumed. The body's response to inflamed arteries is to lay down a layer of fatty plaques to protect the arteries from further damage. The fat deposition is the effect of the inflammation, not the cause, and now researchers are trying to understand just what the real cause is.
...which just goes to show how complicated causation vs. correlation is in real science. It was a pretty obvious conclusion that clogged arteries would cause heart disease...except that it's both obvious and wrong.
> I've heard recently that the causality for heart disease actually goes the opposite way than everyone assumed.
This "Assumption" would be a good case study of the infection of common knowledge with charlatanism.
Better scientists than Ancel Keys already knew that polyunsaturated oils were not appropriate for human consumption. Soybean oil and Linseed oil were used to make paint & stain, because they're good 'drying oils'.
But Dr. Key's theory was picked up by the mass media and used to demonize butter, and to promote garbage like "I Can't Believe It's Not Butter"...
I think often the line between correlation and causation is not very clear except in textbook examples. Does poverty cause corruption, or corruption cause poverty? Maybe most of the actual phenomena could be feedback loops, vicious cycles etc.
Have you any (peer reviewed) evidence of this? There is a lot of Internet hype about "carbs are bad, fat is fine" these days and other conflicting health guidelines. I am not saying its wrong, but I would like to see some proper evidence of it.
> With hearts, you open up and you see clogged arteries, for example. It doesn't get much simpler than "too much fat is bad for your heart".
The fat clogging our arteries doesn't necessarily come from dietary fat.
A lot has changed when it comes to heart disease. For example, not even the USDA supports the claim that excessive dietary cholesterol is linked to heart disease anymore. Their new official stance is that you shouldn't worry about it at all, no upper limit, eat as much as you want.[1]
Contrast that with the last 50 years we've all spent having conversations and making comments about how dangerous egg yolks and meat are because of the cholesterol, and all the foods promoted for being cholesterol-free or low-cholesterol. Cocoa Puffs getting the American Heart Association checkmark on the box because they're low-cholesterol.[2]
It's very difficult to get good information on this because the food industry spends billions selectively funding research to muddy the waters and spread misinformation the same way tobacco companies did in the '50s and '60s. Their 2 biggest goals on this front are:
1. Defend refined sugar and carbohydrates against claims that they're unhealthy/toxic. These are the most profitable commodities because they're the most shelf-stable, they're easy to shape dye and flavor into just about anything, and they're extremely cheap because of food subsidies.
2. Promote the idea that our health and well-being as it relates to nutrition, is entirely determined by one's ability to balance calories in vs calories out. If that's all it is, then all of their products are exonerated from all negative health effects, and they can shift the burden of blame onto their own customers.
I'm all for personal responsibility and companies having the right to produce delicious junk food and consumers having the right to purchase and consume as much of it as they want, but I think we'd all be better off if the food industry stopped funding nutritional research.
I've been reading a few recent papers about cardiology, but I didn't find a lot, could you list some references ?
ps: I tried to get off processed food for raw veggies and fruit, but most cities are flooded with utterly shitty ones. It's still a huge increase in terms of health (sugar really is like a drug), but way suboptimal.
It's not my experience that cities have bad raw veggies and fruit (I've lived near Boston and in NYC). Be that as it may, if you cannot find raw produce, you may want to look for the frozen stuff. http://www.webmd.com/food-recipes/frozen-vegetables-are-hot
"Nutritionally speaking, frozen veggies are similar to -- and sometimes better than -- fresh ones. This makes sense, considering that these veggies are usually flash-frozen (which suspends their 'aging' and nutrient losses) immediately after being harvested. Frozen veggies were often picked in the peak of their season, too."
I have a fruit (blueberries, cherries, mango, banana) and greens smoothie almost every morning. The banana is the only thing that's not frozen. It seems healthy, although I admit, it's not low-carb.
Never heard of this, gonna give it a look. Maybe I live in a bad neighborhood, but the amount of barely edible oranges, apples, carrots .. It's like eating plastic. I take comfort in thinking that at least there's no additives.
I think it's a much simpler disease to understand.
Many forms of heart disease are easy to understand. My heart is blocked up with a fatty deposit because I ate too much junk food? Makes sense, I could stop doing that.
Some of my skin cells are dividing uncontrollably because I sat in the sun too long 20 years ago? And somehow it's spreading to totally unrelated organs? I don't get it.
Interesting article. I don't know that I'd take too much to heart given some of the obvious caveats the author has been nice enough to make explicit, but it sounds like I'd be hard pressed to argue the suggestions contained within.
For the tl;dr crowd:
- written by a physician
- people often think that heart disease is controllable by our actions whereas they feel that cancer is not
- > people can’t change many risk factors of heart disease like age, race and family genetics
- > A more recent study published in Nature argues that there is a lot we can do. [about cancer]
- > Using sophisticated modeling techniques, the researchers argued that less than 30 percent of the lifetime risk of getting cancer was because of intrinsic risk factors, or the “bad luck.”
- > [another study] identified four domains that are often noted to be related to disease prevention: smoking, drinking, obesity and exercise
- if you limit that stuff, and not meaning 0 smoking, but "having quit within the last 5 years", no more than 1 drink a day (women) or 2 drinks a day (men), your BMI is >= 18.5 and <= 27.5 (BMI is such a shit and antiquated metric, IMO, incidentally), and perform 150mins/wk moderate intensity excercise or 75mins/wk vigorous intensity exercise, then you're in the low risk group. so the barrier to entry is not super high.
HOWever:
> No study is perfect, and this is no exception. These cohorts are overwhelmingly white and consist of health professionals, who are not necessarily like the population at large. But the checks against the national data showed that if anything, these results might be underestimating how much cancer is preventable by healthy behaviors.
[...]
Optimistic conclusion, for a skeptical cheapskate like myself,
> As we talk about cancer “moonshots” that will most likely cost billions of dollars and might not achieve results, it’s worth considering that — as in many cases — prevention is not only the cheapest course, but also the most effective.
Hard to fault this article. I'm glad you posted it, thank you.
BMI is a tool for doctors to use, along with clinical judgement. No doctor is going to look at a lean, well muscled individual and tell them they're at risk for heart disease because their BMI is high.
BMI is something that fails in theory and works in practice.
I thought it was a tool for measuring large populations where the lean, well muscled outlier is heavily outnumbered/balanced out by their opposites. Either way though I agree that it's silly for individuals to try to apply it to themselves and then shit on the concept because it doesn't work like that.
That's correct. On a population basis BMI is useful, on an individual basis there's too much variation for it to be useful as more then a very loose guideline.
when you record someone's BMI and it gets thrown in a spreadsheet as patient 123456 has BMI 23.5 the doctor is no longer looking at the patient. perhaps it's good enough, i don't claim to be able to evaluate the methodology of the study (and perhaps using BMI simply results in more skeptical results, by leaving healthy people out of the low risk group, which I'm fine with - not sure this is true though). it really was an incidental note on my part, but i stand by it. i am a little surprised at how much we're talking about it, i guess it is bikeshedding, which is understandable, im not qualified to comment with authority on much of the material myself :)
What's wrong with BMI for something like this? It's such a simple measure and it seems to be useful for predicting health issues. From what I've read body fat percentage is what really matters, but accurately calculating that takes expensive equipment. http://www.nytimes.com/interactive/projects/cp/summer-of-sci... seems to indicate that BMI does a pretty good job, although it may be too generous on the high end.
> It's such a simple measure and it seems to be useful for predicting health issues.
It is good for predicting in general populations, but can easily fall apart with individuals. It doesn't take into account what the makeup of your mass is. Muscle is denser than fat, so a muscular man and a fat man of the same height and weight would have the same BMI, but vastly different health profiles.
>It is good for predicting in general populations, but can easily fall apart with individuals.
While it can "easily fall apart with individuals", the difficulty lies in finding an individual to measure that will make BMI fall apart.
And that's because the huge majority of us is of the kind of complexion and body type where BMI works well.
So, sure it can give false positives, but for a quite small fraction -- besides any other rough medical heuristic does the same (e.g. signs of having the flu can also be caused by 200 other reasons).
The "individual measure" you're looking for is body fat percentage.
A vastly more accurate proxy is waist circumference.
BMI was developed largely because the proxy data (height and weight) are so readily available, especially in databases. Few doctors take waist measurements, and doing so is slightly more complicated.
> the difficulty lies in finding an individual to
> measure that will make BMI fall apart
I'm 5'11 with a 36 inch waist. This gives me a waist-to-height ratio of 0.507, which has me just under or over the healthy cut-off, depending on who you ask[0].
I was 212lbs this morning, giving me a BMI of 29.6, which has me at the border of "Overweight" and "Obese Class I (Moderately obese)", and is high risk.
I don't think you'd think I was a weird shape if you looked at me.
I see how it is a bad measure for some cases, but I don't think that makes it a bad tool. It's like financial advice that says how much someone should save for retirement or spend on rent based on income. Someone with a normal job progression will probably be fine following it, but for doctors who take out huge loans and eventually have a huge increase in income it's not helpful and a more specific plan should be created. For BMI, most people should aim for the middle of the range and if they think there's a reason that they don't fit the scale then a doctor can be consulted.
Why do people keep bringing up this point. Even blood tests are not perfect tools but we still make use of them. There are always some false positives and negatives. It is a combination of all the available results that a doctor will use to make a determination. If your BMI is high but you look muscular, have normal BP and cholesterol and no other concerns, they may feel that you are in good health.
I think the sort of person to be incredibly muscular is probably also one of the most likely groups to get body fat measurements, and be educated about the limitations of BMI. Because that person is almost certainly a bodybuilder, serious athlete, etc.
The link you provided indicates that BMI is incorrect (when compared to body fat %) roughly 1 in 5 times. That's pretty high, IMHO and that is why many people have a problem with it.
Having known some weight lifters, they generally dislike BMI because they are typically considered 'obese' due to their unusually high weight in muscle, whether or not they are in good shape (typically they are).
Calipers are also $10 and measure body fat accurately enough for health purposes (body building may be an exception in this as well, but only in extreme cases).
>In fact, for most people BMI correlates quite well with adiposity. In one study researchers compared BMI to a more direct measure of body fat percentage using skin-fold thickness. They found that when subjects met the criterion for obesity based upon BMI, they were truly obese by skin-fold thickness 50-80% of the time (depending on gender and ethnicity). When they were not obese by BMI they were not obese by skin-fold 85-99% of the time. So BMI is a rough but useful estimate, good for large epidemiological studies where more elaborate fat percentage measurements are not practical.”
BMI is a surprisingly relevant metric for many things as it's a comparison between volume (weight) and surface area (height ^2). And yes, short people do have an inherent advantage there which for example possibly relates to how small dogs tend to live longer.
Because muscle and bone are denser than fat, and exist in higher proportion in fitter people, two people could easily have identical BMIs even though one is a powerlifter with 5% body fat and the other is mostly made of Cheetos.
Yes, but powerlifters with 5% body fat are far more rarer than Cheetos-munging fat people.
So the possibility of such false positives is not that high, making still a good heuristic. Not to mention: if one is a thin, mostly-muscle powerlifter type, they already know they are not obese...
BMI is a horrible metric because it doesn't take body composition into account. I can't believe I was once almost considered obese with a body fat of less than 5%. 5'10" at 200-210.
My BMI is 26+ and I run ~8 miles/day. It can be pretty far off for larger built people...
I clearly remember asking my gym teacher in middle school why my BMI suggests I was fat even though I clearly wasn't. He then proceeded to tell the entire class "he's a good example of someone who's labeled as fat, but isn't." Somewhat embarrassing.
My employer had one of those physical checkups for a lowered rate on insurance. I'm 5'10", 215 pounds[1]. The doctor sighed and said that he was required to tell me that according to BMI, I was obese and should consider losing weight. We had a good laugh about it.
My body-fat percentage is definitely not 5%, though. My guess is that it's around 14-15%. Everyone drastically underestimates how low their body-fat percentage is, and I am not a bodybuilder. I lift heavy and like pasta.
Your heart does not care if it's supporting fat or muscle it must pump blood for both. Further skin and colorectal cancer are both surface area and don't care about fat vs. mussel.
Metabolically muscle is worse as it needs more oxygen and fuel. Which is one of the reasons body builders can often die young from a heart attack.
Taller people tend to have larger hearts and wider artery's which makes a difference. It's pressure = flow rate / diameter of pipe ^ 2. So, as you gain weight your arteries can get wider or the pressure can increase.
Gaining weight increases skin, which is why skin reduction surgery happens for people that lose lot's of weight. GIS for skin folds.
Weight / height ^2 is a proxy for both it's far from perfect, but it's also really easy to collect.
It's not doctors who provide the most trouble, it's rules and regs coming from your health insurance or your job. There are plenty of stories about guys in the Army who can meet all their physical requirements but are getting dinged for having a BMI a smidge too high. Or if your job gives you a discount on health insurance for meeting certain standards, you may not qualify if your BMI is a bit high -- even if you're a champion athlete.
When I last went through a health screening with a qualified professional, I was congratulated on my great health and great cholesterol levels. However, on some online screening I had to do for health insurance around the same time, I was warned that my BMI is a smidge high and my cholesterol is 1 point higher than desired. The online screening did not take into account activity level, functional health, or the differences between HDL and LDL. When health or financing decisions are made algorithmically there are some real traps.
95 per cent of the targeted cancer cells die within two hours with new treatment that involves injecting a chemical compound, nitrobenzaldehyde, into the tumour and allowing it to diffuse into the tissue;
http://sakshipost.com/index.php/lifestyle/editor-s-picks/840...
Yea, no shit. This is pretty much common-sense advise by now. I was hoping for some new insights with respect to things like cell-phone usage, pesticides, low-carb diets, fasting or those so-called "anti-inflammatory" diets.
At least in my section of this world people don't feel out of control about cancer. Trying to avoid things that "give you cancer" seem to be normal, even in lesser educated groups. Can't imagine it's so different in the US.
Here's what it would take to really prove the causative effects claimed in the article: pick a bunch of random people and then force them to either drink or not, exercise or not, smoke or not.. etc. There's no way anyone is ever going to do this experiment, and I just find the claims made in the article somewhat dubious as a result. On the other hand, they are likely to be right (yes?) and probably it's better to make such claims than not to. But hey, if you are a sedentary type, if you smoke, if you drink, what is causing those behaviours? Just forcing some exercise doesn't change those deeper causes (what ever bio/emoto/chemico causes), and may very well make the person absolutely miserable or worse.
Obviously the easy way to prevent cancer is to just stop aging. We just need to unlock the means to micro-manage the cellular mitosis of all the trillions of cells in our bodies. Easy.~
I'm 6'0 and the last time I was under BMI 25 I was a triathlete. The only way I could be <25 would be to exercise 3 hours a day and eat 1200 calories. F-off and die
I did quit smoking though:
- Really wanted to
- Picked a good mental argument against it ($100k CAD over 20 years)
- Picked a quit date
- Patch + zyban + nicotene lozenges
If you live in British Columbia, the government will pay for your patches or lozenges (hint: ask a friend)
I'm 6'1 and I had a BMI of about 26 until recently - I was definitely pudgy. I also claimed that BMI was worthless until I dropped a few pounds and realised that it was right and I was just making excuses.
If you're an athlete, or a bodybuilder, or particularly tall or small, it won't necessarily fit you. but if you're of normal-ish stature (ie 5'4 to 6'3), and don't keep track of your weight, it's probably bang on.
I've had a BMI of 27 for most of my adult life. I used to do competitive sport and trained for sessions a week 45 weeks a year, I got to 40 and couldn't cut it anymore so I quit. My bmi stayed at 28... I looked at a photo of me at age 28 about eight months ago and compared myself to that. The photo showed muscle bulk and tone, the mirror showed a big belly. I've adopted what I call the beer, bread and biscuits diet (as in NO) and avoid alcohol four days a week altogether. I've lost six kg, six more to go!
I'm about 6'2 and very lanky. My problem has always been that I don't eat enough, and my doctors have told me all my life I need to consciously try to eat more (which I try to do) to gain weight. I don't really do any planned exercise but I don't have a car so I get some daily workout from walking/cycling. In short, I'm no fitness nut or bodybuilder.
Every time I've taken BMI, the result is that I'm "slightly overweight". That's bullshit. If I actually tried to eat less, I'd probably end up having health complications related to malnutrition.
So BMI is very much bullshit when applied to individuals. It might have some relevance for the average case, and therefore be useful for demographic comparisons of large groups.
BMI isn't really reliable on a individual level as it doesn't take body composition into account. Athletes are generally "overweight" according to the BMI cutoff.
That's generally untrue. Winning endurance athletes are almost all in the normal BMI range. You'll only see "overweight" (by BMI) athletes in certain sports such as weightlifting and (American) football which require huge bursts of muscle power for only a few seconds at a time. Those are also the athletes who unfortunately tend to gain a lot of fat and have many health problems once they retire from competitive sports.
If peak cancer years are two or more decades in your future, I'd argue that the best thing you can do today is donate to research programs that are likely to change the economic landscape of cancer research. You should also not get fat, not smoke, and all the other things that require no money, but research is much more transformative. You want the future to be no cancer, not less cancer.
Why economic transformation in cancer research? The cancer research community suffers from a high level strategy problem: the majority of treatments are only applicable to a small number of cancer types, out of the hundreds of known types, and the majority of new technology platforms under development will be just as expensive to adapt to a different type of cancer as to build in the first place. A much more efficient approach is needed, as there are only so many researchers and only so much funding in the world.
This is much on my mind because I'm helping to raise funds for one such project right now. It involves taking on the less well-supported but still necessary part of building a universal cancer treatment platform, one that can target all cancers. This could be built for about the same cost as one of today's highly specific single-cancer treatments. Obviously that is an immensely better path forward.
The approach is to block telomere lengthening: all cancers must lengthen their telomeres in order to grow, and abuse a small number of target mechanisms in order to do so. These mechanisms, telomerase and alternative lengthening of telomeres (ALT), are very fundamental to cellular biochemistry. If they are turned off, it is expected that there is no way for a cancer to evolve around that dead end. Many of today's cancer therapies, in addition to being very specific, also leave room for a cancer cells to evolve a different way of conducting business that renders them immune.
A number of research groups are working on sabotage of telomerase, but next to no-one is working on ALT. It is known that telomerase cancers can turn into ALT cancers, so it is probably the case that both doors have to be slammed shut to have a truly effective universal cancer therapy. So I'm helping a fundraiser to use an ALT assay to scan the standard drug candidate library for compounds that act to suppress ALT, something that should greatly advance that part of the field, both by identifying more lines of investigation, and by finding potential therapies for ALT cancers. Since ALT doesn't happen in normal cells, completely suppressing ALT should be a pretty safe treatment if an approach with limited side-effects can be identified. The telomerase blocking will need more work on compensating or targeting for other effects, since stem cells require it. But that is still a lot less work than producing one therapy per cancer type.
You see the argument for this approach to cancer as being less valid because in addition to making it, I have chosen to act on it? Strange thought process.
I don't run this research. It is a non-profit initiative. I have donated myself. I'm persuading other people to do so as well because I think it is a good idea, an important idea, and very necessary for the strategic reasons noted above. The benefit I'm going to get out of it is that my odds of surviving future incidence of cancer increase should it succeed. But then the same is true of everyone else.
A lot of cancer is self-inflicted such as smoking cigarettes. Even though they know smoking is bad for them and they've had relatives that have died from tobacco, teens continue to use it and become addicted to smoking.
In NYC, cigarettes cost $12-$14 per pack it is against the law to buy cigarettes until age 21. Countries that have universal healthcare such as Canada, UK, France all have tobacco taxes that exceed $5 per pack. Our US Federal tax is about $1.
The high cost of tobacco and the increase age for buying tobacco (now the same as drinking alcohol which is also 21) helps to prevent teens from becoming using and becoming addicted to tobacco.
I was thinking the other day you don't see very many or any smokers or obese people in old age homes do you?
The majority of my family on my father's side who are smokers have died of heart disease, strokes, lung damage.
Even at my workplace 9 of 10 people who died were smokers. I think the buddy system where they need to smoke in groups just enforces their denial.
I've seen the "scared straight" situation many times where a middle aged smoker suddenly decides to quit only to be diagnosed a month later with cancer. Only now it's e-cigarettes instead of quitting so they can still be addicted to nicotine but quit cigarettes.
I like to tell them there are worse things than cancer which has a possibility of a cure or surgery. My dad has IPF a scarring of lung tissue and there is no chemo or surgery to cut it out or slow it down. It occurs from many years of small amounts of lung damage in my dad's situation it was blue collar work welding, paint fumes, wood dust, grinding dust etc.
Exactly. If there was strong evidence for causality I would make a real effort to go vegan. But I suspect it's about being thin and having a high fiber diet, which doesn't require being vegan.
It's the ratio of plant protein to animal protein in the diet. So no you don't need to go hard vegan. But yes, it is the diet and there is hard evidence.
This is something I've had a great interest in for years and have read many studies where there is clearly correlation but so many obvious confounders that claims of casuality are just not supported by the data. If the summary of the sudy you linked is accurate (http://web.archive.org/web/20090223222003/http://www.nutriti...) it is an example in that they studied people with low fat and high fiber diets, but had no group of high fat and high fiber diet. So is it the fat or the fiber or both? They also made no attempt to distinguish between types of fats. So is it animal fat +/- fiber or any/all fats +/- fiber? Further, they talked about fat and fiber not protein. Ultimately they made no claims about casuality, only correlation. Given more recent reports of the effects on diseases of fiber-fed gut bacteria it might be that it's the fiber that's important.
My personal question is, does a high fiber ketogenic diet (high fiber, high fat, low carb) raise or lower cancer risk? I don't know of strong evidence either way.
Thanks for that link. It's an excellent analysis of the actual data from the study. I'm part way into reading it and right away the author has thrashed some of the claims of the original study. It appears that even some of the basic claims of correlation aren't even correct.
Added: Schistosomiasis infection is such a huge cofounder for colorectal cancer rates that it is ridiculous to have claimed dietary cholesterol from animal sources as the cause.
My conclusion was that cancer is best prevented by removing negatives from life, not necessarily adding positives. ie avoid anything from stress to pollution to sunburn to obviously smoking. Interestingly, organic food doesn't seem to matter in the cancer equation, given the data we have.
Yet there's one thing you can ADD to reduce cancer: exercise. Preferably moderately hard to strenuous.
[1] https://blog.priceplow.com/vegetables