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Sam Stephenson's avatar

I know very little about the technical end of your topic however found it interesting enough to want to learn. This may be something you could consider pursuing topic wise.. Presenting multiple sides in any conversation is great in my opinion and feel you did a great job of this. It is not lost on many that the general public is in pretty bad shape however there are many that would do more if they felt they could trust the information or guidance given to them. I appreciate your reply post and look forward to more writing.

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An Old Doc's avatar

Thanks for your feedback! I have always enjoyed physical activities & am competitive by nature. In med school we didn’t learn much about exercise physiology per se, but the overall systems biochem/physiology were taught. So I would dig around at the med school library (no internet, had to read PAPER & INK!), but there was another source as well...

My wife & I belonged to a gym during residency & worked out regularly. There people talked about “gym knowledge” & discussed ‘Muscle & Fitness’ magazine & the like. Workout plans & advice was based on very different authority - Ahnuld (Arnold Schwarzenegger) obviously knew the most because “look at him” & so the popular press went. But there WAS some knowledge. Supplement research was probably as reliable as Pharma research => highly variable: some truth, some distortion, some total fabrication.

I’ll stop there, but the same trends flow through sports, nutrition, Pharma, “self help” and every other bit of practical advice in the various forms of press. You see, a “how to build this” article is easily verified, but so much stuff internal to the body requires some trust in the source. What is actually TRUE...

... hence the title to this Substack channel or whatever we call them.

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Sam Stephenson's avatar

I was drawn to the article as a whole but have to say that the information about foods and nutrition was amazing. The details matter and i loved the part about Walnuts :)

IMO you wrote what was true for you and your experiences which included options and the truth as you experienced it. This , imo , makes all the difference as we know that there is not a one size fits all. There are several things within your article that are true and verifiable that are misrepresented in basic nutritional guides. I believe this will become far more important in the near future as are and will have to change.

Look forward to reading ( I wish it were Paper and Ink) more!

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An Old Doc's avatar

Thanks, I appreciate the encouragement. As I have told others: subscribe & send links to others. I do enjoy writing but it takes a lot of time, which I am glad to do if it is beneficial to people. Even responding to comments gives me “grist for the mill” to write other pieces. Living a long time, doing a lot of things, having a lot of interests, and enjoying the process of teaching does provide a good basis for writing here!

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Dani Richards's avatar

I appreciate your writing on this topic. I'm one of those people who has found it relatively easy over the years to be fit and healthy enough (I don't do extreme exercise but I'm just naturally active) -- but about 10 pounds have crept on which I'd like to lose. I've been looking into how to tweak my diet.

What are your thoughts on paying attention to reducing linoleic acid/PUFA as a strategy in general?

And -- glad to know about walnuts because I'd hate to give those up entirely.

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An Old Doc's avatar

Walnuts are atypical for nuts, in that they have significant amounts of omega-3 fatty acids (but still more 6 than 3). Actually that is another issue that I had with the webinar: the speaker said NO vegetable oils. He was too vague with this, but later was clearly talking about seed oils. My concern is that people might hear this as no olive oil, no avocado oil, etc.

The omega-6 fats are pro-inflammatory so I seek to minimize them. Realize that you are getting a mix of different oils in your foods, and you do need omega-6 FAs as well as 3. The issue is balance, of not heavily leaning towards the O-6 oils.

I will be writing more about exercise & fitness in the future, but given what you posted I might suggest you rethink exercise. All of us, especially as we get older, benefit from truly strenuous activities. Osteoporosis in women would be a rare occurrence if women did exercises such as squats. The axial loading (the force acting down from your shoulders down your vertebral column) stimulates an increase in bone density. Strength training also helps keep us mobile, increases metabolic rate, increases growth hormone release, etc. MANY positive benefits!

Another issue that seems to be happening more & more in women is subclinical thyroid disease. Sub-clinical means it isn't diagnosed, usually because the doc simply relies on "lab normal values" which are in a range. My late wife had her weight creeping up for no clear reason. In addition she was less tolerant of cold, her hair & nails grew slowly & were brittle, and things of this sort - ALL of which are symptoms of hypothyroidism. When her OB/GYN (her primary care doc) said "normal range" & dismissed it, I added a bit of thyroid to her daily routine. The additional weight dropped, her hair & nails improved, and she wasn't cold all of the time. The LAB said she wasn't hypothyroid, her clinical picture said she WAS.

The best approach is 'all of the above' - shift your eating patterns (timing) and components, commit to a bit of strenuous activity, and enjoy your life! Balance & contentment are important in our well being :-)

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Dani Richards's avatar

Hmmmmm..... exercise.... it is true that I lift heavy things frequently, and mow my own yard (manual push mower), and do such things as hiking/walking. And dancing. Occasional cycling (for fun, not exercise). I've tried running and going to the gym but it has never taken hold. You are right, though -- getting "older" (it will always be in quotes, maybe) I am more mindful that I should probably change it up and try again. :)

I have a longstanding interest in herbal medicine (North American, primarily) and striving for balance. Contentment, always! :)

Staying away from seed oils should not be too hard of a shift to make. I've gotten lazy, so this may light a fire.

I look forward to your future articles!

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An Old Doc's avatar

The underlying principle is that we are designed to adapt to new stresses, and compensatory mechanisms are what provide increase in strength & endurance. Lifting & carrying heavy objects is quite good. I remember a family friend, an older gentleman that worked with my dad when I was little. He retired & moved back to the family farm in another state. He described initially how hard everything was (and this was a guy who was pretty feeble as I remembered him), but over time things changed. He told my dad he no longer let down the rear gate on his pickup truck, he just threw the bags of feed up over the side! That is a great example of increase in both strength (to lift the bag high enough) and endurance (to do this repetitively) from hard work.

The thing is, continued improvement requires progressive overload. The guys throwing around a lot of weight in the gym are doing exactly that. There are different energy systems involved, different physiologic mechanisms to optimize. But the basic principle is pretty straightforward.

Quality of life is DRAMATICALLY impacted by this. My wife was going through chemo for a time (before we realized it wasn't helping) and she would LIFT WEIGHTS in the morning before chemo. Her veins were dilated and they never had any vascular access issues with her. She lived far longer than anyone expected, and was quite function until the final weeks.

And yes ... 'OLDER' is something we all must come to grips with :-)

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Dani Richards's avatar

that's a great illustration of your point -- I get it. And I've seen similar in people close to me. My mom had a stroke a few years back, and through physical therapy (challenges), she was able to recover significantly more than they told her she would. I will emphasize: it was not that she went to physical therapy, but that she took what she learned there home with her, and did more exercises at home. Another example: I have a relative to lived to be over 100. He only started to lose his independence in the last year. He stayed in his 3-storey home, went up and down stairs, went for walks daily, and just kept doing the ADLs. Just keep moving, don't stop.

I've also seen the opposite: another relative who is barely able to walk, is badly hunched over.... it is the result of years spent hunched over a computer. I think: whatever we do today is our gift to our future selves. We become whatever it is we create through today's behaviors and habits -- whether intentionally or not.

But you are saying something additional: push beyond (believe that you can, and then do it) because it will lay down a new groove or a new level that was not there before (advancing, rather than merely maintaining). I saw this in my mom, going way beyond what anyone expected she would be able to achieve.

I am very sorry for your loss, and it sounds though as though you and your wife were able to enjoy more of life and had more time together than you were probably led to expect. Cancer (and cancer treatment) sucks. :(

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