
Live slow, die old: Mounting evidence for caloric restriction in humans - discombobulate
http://geroscience.com/caloric-restriction/
======
ellyagg
There's a totally different way to live that also has mounting evidence, and
it's a way that sounds a lot more satisfying to me.

For awhile now, the "obesity paradox" has been a thing, where segments of the
population who are a little heavier than one would expect actually have the
best all-cause mortality rates.

Recently there's been some pushback on this "paradox", but the one I want to
call attention to is here:

[http://annals.org/aim/article/2499472/relationship-among-
bod...](http://annals.org/aim/article/2499472/relationship-among-body-fat-
percentage-body-mass-index-all-cause)

The problem with the obesity paradox is that it's been based on the flawed
BMI. In this study, they actually did DEXA scans of elderly women's body fat
percentage, and those with the highest BMI and lowest body fat percentage had
the best all-cause mortality rates.

This suggests plenty of calories plus strength training is in the running for
a longevity lifestyle. This makes sense intuitively and if one is familiar
with the panoply of beneficial physiological effects from exercise on the
human body. And, it would not come as a shock to find that increased strength
from greater muscle improves, e.g., balance and coordination to prevent
accidents in the elderly, nor that increased muscle mass provides a protective
tissue reserve for fighting disease without the concomitant downsides of
adipose.

~~~
gumby
Don't be faked out by BMI; it's no different from the Dow Jones Index
(something easy to calculate with pen and paper, or in your head), that gives
you a low-resolution signal at best. If you have a BMI of 50 (or 16) you have
problems, but you already knew that.

It's bizarre that people worship it, but then again, simplicity has always
beat having to think.

~~~
FabHK
Very nice analogy. What's the equivalent of the S&P 500 then? :-)

~~~
nradov
The equivalent is probably a 2D DXA scan with body composition report.
Supposedly it can measure the amount of bone, muscle, and fat in your body to
within 1% of actual values. Those scans are widely available for <$50.

BMI is still a pretty good proxy measurement. There's a very high correlation
between BMI and body fat content. People like to complain that BMI is useless
because a few weightlifters show up as "obese" but those are so rare as to be
statistically insignificant.

~~~
rangibaby
> People like to complain that BMI is useless because a few weightlifters show
> up as "obese" but those are so rare as to be statistically insignificant.

A good explanation I saw is that if you care what your BMI is you probably
aren't a weightlifter

------
crudbug
2016 Nobel prize was awarded to Yoshinori [0] for his work on Autophagy [1] -
Cells eating dead cells and auto-correcting body functions when there is lack
of calories/energy in the system.

Ancient philosophy also says about fasting 2 days a week. The Autophagy
process provides a scientific foundation for those claims.

[0]
[https://www.nobelprize.org/nobel_prizes/medicine/laureates/2...](https://www.nobelprize.org/nobel_prizes/medicine/laureates/2016/press.html)

[1]
[https://en.wikipedia.org/wiki/Autophagy](https://en.wikipedia.org/wiki/Autophagy)

~~~
amelius
> fasting 2 days a week.

I don't know about you guys, but if I don't eat breakfast and lunch, I get a
headache in the afternoon, and have serious problems concentrating, and very
little energy. My conclusion is that either I am doing something wrong, or
intermittent fasting only works if one stays in bed the whole day.

~~~
aedron
At least in the case of ramadan fasting, the difference is that you eat (and
drink) nothing at all from waking up until night. This way the digestion
system never gets started, the stomach kind of just shrivels up and you never
actually feel much hunger.

Incidentally, Islamic practice is to fast two days of the week too (outside of
the month of ramadan).

~~~
amelius
The stomach is not the problem. I can easily ignore it if I put my mind on
something else.

What I can't ignore is having a pile of work on my desk and absolutely zero
energy available to get it done.

------
jaggederest
As a counterexample, the Minnesota Starvation Experiment found a substantial
variety of negative effects from calorie restriction:

> Among the conclusions from the study was the confirmation that prolonged
> semi-starvation produces significant increases in depression, hysteria and
> hypochondriasis as measured using the Minnesota Multiphasic Personality
> Inventory. Indeed, most of the subjects experienced periods of severe
> emotional distress and depression.[1]:161 There were extreme reactions to
> the psychological effects during the experiment including self-mutilation
> (one subject amputated three fingers of his hand with an axe, though the
> subject was unsure if he had done so intentionally or accidentally).[6]
> Participants exhibited a preoccupation with food, both during the starvation
> period and the rehabilitation phase. Sexual interest was drastically
> reduced, and the volunteers showed signs of social withdrawal and
> isolation.[1]:123–124 The participants reported a decline in concentration,
> comprehension and judgment capabilities, although the standardized tests
> administered showed no actual signs of diminished capacity. This ought not,
> however, to be taken as an indication that capacity to work, study and learn
> will not be affected by starvation or intensive dieting. There were marked
> declines in physiological processes indicative of decreases in each
> subject's basal metabolic rate (the energy required by the body in a state
> of rest), reflected in reduced body temperature, respiration and heart rate.

[https://en.wikipedia.org/wiki/Minnesota_Starvation_Experimen...](https://en.wikipedia.org/wiki/Minnesota_Starvation_Experiment)

~~~
Jemmeh
_> From that Wiki: "Their meals were composed of foods that were expected to
typify the diets of people in Europe during the latter stages of the war:
potatoes, rutabagas, turnips, bread and macaroni."_

What an interesting study. Seems they had that limited selection of foods
though so it's not just about the calories in that case. I've seen a few
documentaries of people doing CRON (Calorie Restriction Optimal Nutrition) and
they focus on very nutrient dense foods. I think mostly fruit and veg. _Eat,
Fast & Live Longer_ is the documentary I saw most recently. Luigi Fontana,
M.D., Ph.D. talks about it and they visit someone doing the CRON diet and run
tests. Doc said he was very healthy.

[https://en.wikipedia.org/wiki/CRON-diet](https://en.wikipedia.org/wiki/CRON-
diet)

[http://optimal.org/voss/cron_overview.html](http://optimal.org/voss/cron_overview.html)

~~~
literallycancer
>they visit someone doing the CRON diet and run tests.

This is not very convincing. A blinded clinical study would be much better. I
guess it's not very practical though.

~~~
Jemmeh
As I mentioned, Luigi Fontana is in the film and he's big on researching
calorie restriction. Google shows he has been doing some studies on calorie
restriction though I'm not sure which one to point you at, I haven't gotten to
reading them yet since I just saw that documentary a few days ago.

I know know they've done a study with rats that's shown a link between CR and
longevity though and I can at least point you at that.
[https://www.ncbi.nlm.nih.gov/pubmed/21792819](https://www.ncbi.nlm.nih.gov/pubmed/21792819)

That said this is just something I've been reading about recently, still
looking into the topic so I don't have any real opinion on it yet.

------
leovonl
There is mounting evidence that fasting and a few dietary approaches (like the
ketogenic diet) are useful tools for dealing with a whole sort of issues, from
autoimmune diseases and generally any excessive inflammatory responses
(including CHD).

Calorie restriction OTOH is something that gives mixed results, and I suspect
it may be related to the diet adopted and how it is implemented (ie, LCHF vs
LFHC, fasting vs frequent small meals).

I suggest anyone interested in food/health to spend some time on google
scholar searching about these approaches, it's enlightening.

~~~
todd8
I'm not sure I would describe the available literature as "enlightening"; for
me at least, it's quite confusing. I'm just a computer scientist so it's hard
to sort through the often contradictory results and claims.

------
prodmerc
Wait just a minute. What if I don't want to live longer? What if I want to
live a shorter life full of energy?

Everyone is focusing on longevity when quality is probably more important. 120
years as a couch potato would be shit compared to 60 years of being active
every day (whether physically or mentally).

People are against TRT because it shortens lifespan, while completely ignoring
the quality of life improvements, which is just stupid.

Give me something to burn fast and bright, not slow and dim, thank you very
much.

~~~
svachalek
From what I read of the early caloric restriction studies on animals, it
tended to greatly increase the healthy adult portion of the lifespan rather
than adding a lot of geriatric time. That was the great hope for the human
version too, but all the accounts I've read do indeed sound miserable.

I'm curious about fasting though. It's very easy for me to believe that our
bodies are designed to go without eating for a while, much like we need to
sleep. In nature we wouldn't really have needed any prodding to miss some
meals so there wouldn't necessarily be a corresponding drive like thirst or
sleepiness. I haven't tried it but personally I've never suffered much from
missing a meal or two... seems like it wouldn't necessarily hurt quality of
life if you were used to it.

~~~
aedron
Also don't forget about possible spiritual benefits to fasting. It is no
coincidence that practically all spiritual traditions incorporate fasting.

------
nacc
I have a wild theory about longevity. For all the mammals, increased heart
rate correlates with lower life span [0]. But heart rate itself may just be a
measurement, and what's important is rate of metabolism - higher metabolism,
higher heart rate, lower life span. And vice versa.

If we very boldly assume these relationships are causal and predictive to
individuals, it follows lower energy consumption -> longer life. Caloric
restriction might be one way to do this.

However, with lower metabolism, stuff in the body tend to get older. This will
make them fail more easily, then you are likely to get sick, which will
shorten your life. Therefore the optimal strategy to maximum life expectancy
seems to be control metabolism (by exercise / calory intake etc.) to a certain
point where you are just unlikely to get sick, then stop.

[0] biology.stackexchange.com/questions/20489/is-there-any-relationship-
between-heartbeat-rate-and-life-span-of-an-animalH

~~~
bitL
Heart rate is genetic - some people like me and my family have increased
resting heart rate even while being athletic (one cousin was a table tennis
champ and other highly competitive swimmer, both have increased resting rate).
And our genes make us look young (20-30s) even in our 50s, as I can see on my
relatives. So different genotypes have different characteristics I guess.

~~~
sushid
That's interesting. Shouldn't professional athletes have a lower resting heart
rates?

------
coldcode
Interesting but is it worth living being hungry all the time? Are the extra
years (you might not get anyway due to illness or accident) on average worth
it to you the individual?

~~~
flyinghamster
My own anecdata: Late in 2014, as I turned 50, I stepped on the scale and saw
295 pounds. I knew I had long been overindulging, but I freaked and decided to
do something about it. As it was, it was starting to hurt when I walked.

First thing to go: snacks. I made a simple rule: don't keep snacks handy. It's
way too easy for me to graze. The other thing I did was to greatly reduce my
portion sizes. I found a couple of things: first, that if I still felt hungry
after finishing a meal, I didn't feel that way a few minutes later. I also
noticed that I didn't feel nearly as hungry in general as I thought I would.
Keep in mind that restaurant portions often are big enough for two, sometimes
three people. If I take half home, there's tomorrow's lunch or dinner. Win-
win.

Occasional treats are not a bad thing, but I won't let myself fall into the
trap of "oh, just one more bag of chips won't do any harm (lather, rinse,
repeat)."

The first summer, I broke out my long-dormant recumbent trike, fixed the
broken spokes, and got it back out for long rides, and I also rode a lot last
summer as well. During this time, I found that I needed to eat more to support
the rides, but I didn't gain weight, and my rides got faster through the
season - very noticeably so last summer. Once it got too cold to ride, I had
to readjust my eating habits again, but it still wasn't too difficult.

After 28 months of this, I'm down to 195. I'd like to get down to 170, but I'm
not going to go nuts trying to hit the target. As it is, my knees and feet are
very thankful, and I feel a whole lot better.

~~~
GrinningFool
I've dropped ~50 lbs in two years nearly the same way, or at least the same
net effect: a rather large breakfast every day, no lunch, and medium sized
dinner. No snacks during the day, though I often grab something later in the
eve. The gap might qualify as intermittent fasting, but I do drink coffee with
a fair amount of whole milk & sugar through the mid afternoon.

I am not eating any healthier, just less food.

For exercise, I started walking my dogs 4-5 nights a week in the evenings for
a few miles (think closer to speed walking than regular).[0] I stopped losing
weight when I stopped walking so often - the cold is getting to me this year,
will resume in the spring. I'm seeing no weight gain though, because I haven't
increased the amount of food I'm putting in.

Couple of things to add to your observations:

I've found that with time, a sensation of 'hungry' is just another sensation
that my body reports - it's not an imperative to eat. And as I've adapted to
reduced calories, this has largely faded.

For the periodic conference or social gathering, I'll and enjoy the excessive
amounts of food. For longer events this might cause an uptick of a few pounds,
but it settles back to the prior level within a week or two.

\----

[0] _I know - in the US I should put the period inside of the paren (or
quote). But that 's illogical. I refuse._

~~~
coldpie
First, congratulations on the weight loss. It's great that you're finding a
routine that works for you. I offer the following as a friendly suggestion if
you would like to take another step: please drop the sugar from the coffee.
Sugary drinks are hell on your body and especially on your teeth.

~~~
GrinningFool
Thanks - re: the sugar, I'm ... working on it. Some days more than others ;)
All told, it adds about 100 calories to my day so intake wise it's not a huge
thing... but you're right re: body & teeth.

------
reasonattlm
Of note, Geroscience is a new popular science of aging online magazine
supported by the Apollo Ventures investment fund, devoted to longevity science
startups. You should absolutely take a look at their site to see the sort of
sea change that has occurred for the perception of aging research in the
funding community:

[http://apollo.vc](http://apollo.vc)

They take a very Hallmarks of Aging view of the causes of aging, which I can
quibble with around the edges, but it is good to seem more people putting
their money into the game of building ways to treat the causes of aging.

The principals at Apollo became involved in this space and raised a fund both
because they are enthused by the field of therapeutics to treat aging and want
to see it succeed, but also because they recognize the tremendous potential
for profit here. The size of the market for enhancement biotechnologies such
as rejuvenation treatments is half the human race, every adult individual.

Publishing a magazine on aging research is a way to help broaden their reach
within the community, find more prospective investments, talk up their
positions, and raise the profile of the field as a whole, all of which aligns
fairly well with the broader goals of advocacy for longevity science. Many
hands make light work, and we could certainly use more help to speed up the
growth of this field of research and development.

------
anonu
You might live longer on a calorie restricted diet but you might just die of
boredom. Seriously, food is amazing. Why would you deny yourself so much of
it.

I'd be a bigger advocate of intermittent fasting. This has also been shown to
improve health and longevity.

~~~
tluyben2
> Seriously, food is amazing. Why would you deny yourself so much of it

You don't have to; I conditioned myself to enjoy all the excellent foods, but
to just take less of it. The quality is not in the quantity while I thought
all my life it was. There is no 'better' feeling eating an entire cake versus
taking 2 bites of the same cake. It took me 40 years to figure that out but
he.

The main trick was eating very very slow. Do not load the next spoon until
your mouth is completely empty. I noticed i'm absolutely full eating a
fraction of what I hammered down usually in a fraction of that time.

> I'd be a bigger advocate of intermittent fasting.

Yes, but stuffing myself in between, depending on your age, doesn't actually
work very well. I felt like shit doing that, did not lose too much weight and
my brain thought I needed that stuffing. Now I feel fit and healthy doing
fasting & eating slowly. Let's see how long I keep it up. I need less sleep
too.

------
memoryfab_com
I actually believe starvation and caloric deficiency has more correlation with
inflammation. When you introduce foreign sustenance (food) into your body, it
has to spend resources to work through it, absorb it and expel waste. The
higher the caloric count the more work it has to do and usually more
inflammation from working through it instead of working on recovery.

What studies (HMS,Johnhopkins) have shown is exercise (blood flow vital to
removing waste and in result inflammation) and sleep (recovery) is equally as
if not more important than diet.

These focus points are the same in fighting age related diseases: Alzheimers
and sleeplessness.

------
fast_throwaway
Dr. Jason Fung, a Canadian Nephrologist is an encyclopedic resource for the
impacts of calorie restriction and fasting. While he has a couple (really
good) books, the following presentation is a nice overview of his work,
findings and results of therapeutic fasting:

'Therapeutic Fasting - Solving the Two-Compartment Problem'
[https://www.youtube.com/watch?v=tIuj-oMN-
Fk](https://www.youtube.com/watch?v=tIuj-oMN-Fk)

------
thomk
Eat To Live, by Dr. Joel Fuhrman describes a diet that is low calorie high
nutrient and it's a very good, easy read for anyone who is interested. I
personally lost 70+ pounds on it:
[https://www.wikiwand.com/en/Eat_to_Live](https://www.wikiwand.com/en/Eat_to_Live)

Health = Nutrients/Calories!

------
wallace_f
Given the inconsistent, even capricious prescriptions coming from nutritional
science and medicine, here's three reasons I don't worry too much about
nutritional "science."

First, n anecdote:

1.) One year I decided to run a marathon, and joined a running group including
some elite runners.

One was a former state champion. In that particular year he'd run an Iron Man,
a marathon, and the Goofy Challenge. That is a big deal.

He was carved out of stone. At running clubs, women would surround him. They'd
paw at him, giggle as they pointed and touched this man body of steel.

After witnessing this for months, once at a pub I saw him order, IIRC: 2
hotdogs, a hamburger meal (with its own sides), and sweet potato fries, which
he washed down with several beers.

I was shocked. I asked if he always ate that way. He said he just eats what he
feels like eating, with one exception: added sugar.

So that's what I do. I eat what I feel like, with (3) exceptions. Small
portions, no added sugar, and limits on artificial flavours. I've seen great
results in energy, mind and physique. It appears my body is actually really
well tuned to tell me what it needs without me having to do anything at all--
as long as I follow those three rules.

2.) We need to be careful what we call actual science. If you can't rigidly
follow the scientific method and test your theory to see if it matches with
nature, it's not science.

3.) Nutrition is ridiculously important to our well being. It's more important
than sex, shelter, and ego. Our bodies have been evolving for millions of
years to learn how to tell us what they require. It's arrogant to declare
yourself to know better here without having hard scientific evidence of it.
That's what we're seeing now in the "scientific" literature. Butter is no
longer a heart risk. Eggs are now healthy. All of the sudden sugar is the
devil. Etc.

------
athenot
In a similar vein, there's the Greek version of the same thing:

\- [http://www.nytimes.com/2012/10/28/magazine/the-island-
where-...](http://www.nytimes.com/2012/10/28/magazine/the-island-where-people-
forget-to-die.html)

Discussion on HN:

\-
[https://news.ycombinator.com/item?id=4692598](https://news.ycombinator.com/item?id=4692598)

\-
[https://news.ycombinator.com/item?id=9025438](https://news.ycombinator.com/item?id=9025438)

------
sebringj
See about Roy Walford [http://www.walford.com/](http://www.walford.com/) for
the origins of this. He was able to experiment with humans in the biosphere
team.

------
stefap2
[https://en.wikipedia.org/wiki/Old_Tom_Parr](https://en.wikipedia.org/wiki/Old_Tom_Parr)

He existed and even thrived on a diet of “subrancid cheese and milk in every
form, coarse and hard bread and small drink, generally sour whey”, as William
Harvey wrote. … "On this sorry fare, but living in his home, free from care,
did this poor man attain to such length of days".

Thomas Howard brought him to London to meet King Charles I.

Parr was treated as a spectacle in London, but the change in food and
environment apparently led to his death.

~~~
vkou
Given the well-documented rarity of modern centenarians [1][2], it's highly
likely that Old Tom Parr did not live to be 150 years old - and is much more
likely that his documented age is due to errors in recordkeeping.

[1]
[https://en.wikipedia.org/wiki/Centenarian](https://en.wikipedia.org/wiki/Centenarian)

[2]
[http://www.nytimes.com/2010/08/15/world/asia/15japan.html](http://www.nytimes.com/2010/08/15/world/asia/15japan.html)

------
reasonattlm
Some of the more interesting recent research, from the perspective of evidence
for meaningful health benefits, and some degree of additional longevity in our
long-lived species.

Caloric restriction improves health and survival of rhesus monkeys
[https://dx.doi.org/10.1038/ncomms14063](https://dx.doi.org/10.1038/ncomms14063)

Will calorie restriction work in humans?
[http://dx.doi.org/10.18632/aging.100581](http://dx.doi.org/10.18632/aging.100581)

------
bikamonki
Meh, I'll just wait for the iHeart, the iKidney and the iLiver. Surly hope I
do not end up with an Android-powered brain b/c my insurance plan does not
cover the always reliable and reasonably priced AWS Cognito Plus, while I'm
definitely not rich enough to dream about the iBrain 7. Until then, the
triple-b diet will do: beer, burgers and bike to work.

------
grondilu
Yet as far as know longevity records among humans did not have any particular
diet, did they?

As caloric restriction is being more and more shown to be the only efficient
method to increase longevity, I suppose more and more people will try it and
soon enough we'll get to break records. Time will tell.

------
ziotom78
Interestingly, I read about this idea in «Corps et âmes» (1943), a marvellous
novel by Maxence Van Der Meersch (a physician). The wife of the main character
is able to recover from tuberculosis thanks to a diet with very low calories.

------
wcummings
A low-calorie _plant-based_ diet

>much of it from plant-based material like the Japanese sweet potato, their
staple food, in contrast with the rice-heavy cuisine of the mainland.

~~~
clock_tower
I get what the author's saying -- that white rice is pure carbohydrates, while
sweet potatoes are a healthier mix -- but it's phrased pretty strangely. What
exactly is rice, if not a plant?

~~~
geomark
Isn't glycemic index (GI) an important measure of the potential negative
effect of the carbohydrate? Some varieties of rice have a surprisingly high
GI. Jasmine rice, for example, has a higher GI than pure glucose, a sad fact
for me since it's the favorite rice where I live. Other types of rice have
much lower GI.

When it comes to sweet potato versus rice, cooking method makes a big
difference in GI: Jasime rice = 109, baked sweet potato = 94, boiled sweet
potato = 44 [1]

[1] [https://www.diabetesselfmanagement.com/blog/glycemic-
index-c...](https://www.diabetesselfmanagement.com/blog/glycemic-index-
confusion/)

------
hartator
I wonder what's the best way to apply this to daily life. Restriction at every
meal vs alternative day restrictiona vs fasting a few days every once in a
while.

------
Hambonetasty
Why the fuck would you want to do that? Being old sucks.

~~~
deleted_soon
I think the implication is that you age slower if you consume fewer calories.
So if you adopt CR then you might feel at age 50 how someone on a normal diet
feels at age 40, and at 100 you might feel as they do at 80.

~~~
rubber_duck
Having done it for short periods of time (months) it makes you feel like
you're 50 at 20 - drained and weak.

~~~
tluyben2
Interesting; I feel fitter and need less sleep. What exactly did you do? Maybe
it differs from person to person like many things, but i'm curious.

~~~
rubber_duck
When I want to lose fat I go low calorie high protein (below 2000kcal). I get
constant food cravings and I can't even get myself to do anything in the gym,
also have a hard time focusing at work. It was considerably better when I
wasn't lifting - then you get used to it (I still felt weak) - but weight
training + low calorie = very draining.

~~~
tluyben2
But 2000kcal is already well below a male doing normal things during the day;
so 2000 + gym with weights would drop that completely out. When I do weights I
try to shoot for around 2500 which already sucks compared to what I was used
to (which does affect performance but it feels the same so I think overall I
benefit?). But when just doing cardio I can go well below 2000 on a day or
just not eat at all (only tea + water) and feel sharp, I just choose not to
and just do days without any food.

I cannot imagine doing every day below 2000 and then going to the gym indeed.
That would definitely not be productive and painful, but doing days of weights
with 2500 max, other days around 2000 and then some days 0 works fine for me.

~~~
rubber_duck
Yea going really low calories and working out is really nasty - you visibly
start shaking during practice and start feeling really strange - I'm guessing
from lack of blood sugar. Will not be doing that in the future.

I'm trying something along those lines this month - I eat maintenance calories
and work out over the week (~3000) and then I eat ~1000 on the weekend (mostly
from coffe/milk/protein shake), but I want to do side projects on the weekend
- sometimes I can get in the zone and food doesn't even get on my mind, other
times I just feel like doing nothing when I haven't eaten.

------
beegeezuz
Live fast, die young. Quality over quantity. I'm bout dis life bitch.

