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How Exercise Might “Clean” the Alzheimer's Brain (scientificamerican.com)
390 points by extraterra on Oct 16, 2018 | hide | past | favorite | 209 comments

So, some biology 101:

The lymphatic system is powered in part by the circulatory system and in part by physical activity (aka "exercise"). Fluid from the blood, minus certain blood products, goes out into the tissues and becomes interstitial fluid. Muscle action dramatically increases the rate at which it gets returned from the tissues to the blood.

This is the mechanism by which the body cleans up most tissues. Except for the brain. The brain has a separate mechanism whereby lymphatic fluid (aka interstitial fluid) gets flushed out, taking wastes with it, only during sleep. This is a primary function of sleep.

Personal firsthand experience suggests that exercise is frequently followed by napping precisely because these are separate systems. Exercise may start this process by flushing out other tissues, but your brain won't get flushed of wastes until you sleep.

If you want to benefit from this research, you will need to have good sleep hygiene in addition to exercising. From what I gather, aerobic exercise is likely to do more good from the perspective of powering the lymphatic system than weight lifting.

Not to mention the fact that good sleep hygiene provides immediate payoffs as well. The single best thing I have done for my health was giving myself the gift of a regular sleep schedule and sticking to it. I perform better in every aspect of my life. Even if I feel like I have less time than I did before, I feel much better every day than I did when I was getting < 7 hours of sleep every day.

Interestingly, I feel I have more time that I did before, mostly because I'm mentally alert and more productive for more hours.

I couldn't agree more. I work a lot and long hours, but I almost always insist on getting 7 hours of sleep a day.

I am curious, what is consider good sleep hygiene academic wise.

In a nutshell setting aside 8 hours, going to sleep and waking at the same time even on weekends and holidays, refrain from stimulants and depressants 8 hours before bed.

Recommended reading: Why We Sleep

> From what I gather, aerobic exercise...

That was my impression as well after doing some research in this area a while back. Although I looked specifically at longevity and cardiovascular studies there was a peak benefit at about 2hrs per week after which virtually no more benefits were observed.

2 hrs a week of intensive aerobic exercise sounds like an easy to remember target if that's what research shows.

I wouldn't stop at two hours just because there's no additional benefit that manifested in a study on some super-specific outcome.

You probably care about other benefits as well.

Sure. But there are also risks associated with exercise; you want to minimize those too.

What constitutes "intensive"?

I finally got a heart monitor. So far, I get into "zone 4" for a few minutes every day. Zone 5? Not so much...

Mayo clinic says 70-85% of your max heart rate [1] counts as "vigorous". Not sure what the zones on your monitor are set at.

[1]: https://www.mayoclinic.org/healthy-lifestyle/fitness/in-dept...

That would mean heart rate around 126 to 153 for me, evidently. Which, actually sounds low. Which I guess is good for me? :)

I was using "zones" per the Strava app lingo. I rarely make zone 5, which would be 174+ heart rate. I spend a fair bit of time in the 160 range, though.

As an ultra runner I can tell you 130-150 is "vigorous" in medical literature. Actually for anyone over 30, maintaining 150+ is probably threshold and providing you different kinds of adaptation. Ideally you spend 80% of your training time in Z3. You use Z4 to train VO2 max and Lactate Threshold. VO2 max is not very trainable. Lactate Threshold is. Z5, once you are "trained" and can run in Z3 for extended periods of time (30+ minutes) is almost purely for speed work and learning to run faster. It helps develop coordination and push through barriers. It is mostly anaerobic, so some amount of intervals in Z5 is good. Z4 is longer tempo work and fast/hard intervals.

Marathons are meant to be run at the edge of Z3 so you avoid hitting your lactate threshold. Think of your ability to run in each zone as separate gas tanks. Your Z5 gas tank is very small. Your Z4 gas tank can be trained, but is still relatively small. Your Z3 gas tank is basically unlimited (ultra marathon pace, 50+ non stop miles possible for almost any healthy human). Cardio is not about suffering.

Most people should be fast walking to maintain Z3 rather than suffer it out in Z4 and Z5 when they are getting started.

Is it the same for biking as running? My hunch is I was silly and looking at distance when I thought I could get more out of cycling. That is, I know I can bike 30+ miles with fairly little effort. Running 2 miles near kills me. (Granted, some of that is hernia related. Fixing that, but not expecting it to be easy any time soon.)

Checking my last long bike ride, I see I maintained 120 heart rate for majority of it. Which means I spent most of the time in zone 2, and makes sense that would be easy to maintain. (Contrasted with my last commute, where I cover 270 ft of elevation in about 7 minutes, mostly at about 160 heart rate...)

A few years back when I was looking at Tour de France stats, IIRC a lot (most?) of those guys spend all day around 120 bpm too. The difference is that they are putting out pretty much twice the power that I do for that same effort.

And probably you too, given I have a hill around the same size on my commute that takes me around 7 minutes too.

https://www.strava.com/segments/622627 is the hill I'm talking about. Agreed that they are likely putting in much more power than I can at that heart rate.

My naive understanding is that I can push more time in higher heart rates and slowly pull up what I can do in the lower ones. That said, I'm just aiming to be consistently in the 6 minute time frame for that hill by next year. As things are, I'm quite winded if I hit the low 7 minute time frame. So, trying to pay attention to any methods I could use to make that better.

Yep, just a little steeper than mine: https://www.strava.com/segments/623328

AFAIK your 'naive' understanding is pretty right on. I subscribe to the philosophy of spending as much time as possible in the "sweet spot" (search on that term), which is toned down just a bit from the best effort you can do in an hour.

Yep. Cycling has some different terminology, but the basics of zone training are the same. How much time per zone, intervals, training cycles, it all works the same in terms of adaptation.

If you're just using a formula your heart rate zones could be quite far out.

For example, 220-age suggests my maximum HR is 178 and my threshold HR (85% of this) is 151, but in fact my max HR (determined empirically) is 188 and my threshold HR (based on an actual threshold test) is 162.

Thanks! I'll have to consider doing a test like you describe downthread sometime. Most of my biking is just getting home from work. And, well, that is only 20 minutes on the bike. Large hill, but still just 20 minutes.

The canonical running test is to run an all out 5K. You can then derive pretty simple training paces based on tables. See: Daniels Running Formula. Or any number of training calculators on the Internet. A 5K is a very good measure if your overall running fitness and a pretty good predictor of race performance from 10k to Marathon. It helps you set up good training paces. Then it just comes down to volume. When you find your HR creeping out of zone don't be ashamed to walk to chill it out.

I primarily do cycling to commute. That said, I've signed up for a 5k this Dec. Will make sure to wear my heart monitor and see how I do.

You can definitely go out too hard in a 5K, it isn't a 400, 800, or 1600M effort, but if you aren't hurting and questioning your life choices the last mile you weren't going hard enough :)

Mine's even more out... I'm a full 20 bpm higher than that formula would suggest. Mid-30s and still do over 200 bpm at the end of a 5K.

That Mayo Clinic page has another way to calculate target HR.

Target HR = RestingHR + (MaxHR - RestingHR) x 0.85

So, if your RestingHR = 70 :

Target HR = 70 + (178 - 70) x 0.85 = 162

How do you do a threshold test? Do you need a doctor?

For cycling, I do a long warmup then ride as hard as I can (uninterrupted) for 30 minutes and take the average HR for the last 20 of the 30 minutes. There are online calculators you can plug this value into to give you the 5 zones.*

I do a test every 3 months, as the zones can shift as you get fitter.

Running might use a different protocol, but the same principle applies.

* These days I base my training on a 3-zone system: low intensity, below aerobic threshold; medium intensity, between aerobic and anaerobic (lactate) threshold, and high intensity, above lactate threshold. This is the system preferred by researchers, as it's based on real physiological markers.

Translating the 3 zone system into the 5 zone: low intensity equates to zones 1-2, medium is zone 3 and zone 4 up to your (lactate) threshold value, and high intensity is everything above this, i.e. the top part of zone 4 and all of zone 5.

So 'vigorous' per the Mayo Clinic would be medium intensity on the 3 zone system.

Personally, I define vigorous exercise when I hit 95% of my maximum heart rate (220-age) non-stop for 30 minutes. 100% is doable but a bit too extreme. I think I've seen similar definitions in health literature.

I am pretty sure that is very extreme and 70-80% of MHR is fine to consider "vigorous", especially for someone who is untrained.

Worth noting that the various "max heart rate formulas" are just guidelines. Plenty of people routinely hit above their predicted rate, and plenty of people cannot get there.

Yeah, the "based on age" makes it tough. I would love for there to be something more prescriptive. That said, I suspect just trying already puts me in a decent position.

Weight training tends to be moderately cardiovascular. Not an out-and-out replacement for cardio, but your heart will be pumping hard at higher weights/reps. Same thing for a long session in a hot sauna. Just throwing some nearly-as-good alternatives out there for people who hate treadmills.

Just to throw in some new terms, weight training tends to be more anaerobic, where things like distance running are more aerobic (where oxygen provides most of the energy). It's not an either/or, but more of a scale progressing from aerobic to anaerobic. Lifting more weight is generally more anaerobic than lifting less weight. And the downside of anaerobic exercise is that you can generally only do it for short periods of time.

Since I don't have a Science subscription, I can only read the summary, and they do not explain what type of exercise they required the mice do. So if someone with access can clarify, please do. But from what I know of similar "cleaning out" studies, the exercise is generally distance running. So weightlifting for a short period of time is probably not going to give you the benefit this study refers to, even if you're burning the same number (or more) calories, because you didn't do it for as long of a period of time.

In particular, dead lifts wind me every time. After a set I feel like I just ran up a few flights of stairs. Other lifts not as much, but man I have respect for the dead lift. Works damn near every muscle in your body at the same time.

Yeah, it's not aerobic at all, unless you're doing 1 set of 100,000.

Gotta be more careful with your words. There's some component of aerobic metabolism in weightlifting, even if we colloquially think of lifting as anaerobic exercise. If you start breathing harder when you lift stuff, it's because your body needs more oxygen to provide energy to your body.

Technically you're correct (the best kind of correct!) but I don't know if I'd be under the opinion that somehow doing a 5x5 (or, whatever) of Deadlifts is going to positively effect your cardiovascular system in a training sense, to the point where doing separate cardio is unnecessary.

Depending on the exertion you put forth, a different energy system is going to be utilized by the body.

* Deadlifts: ATP Creatine Phosphate

* Cardio: Aerobic

I suggest you read Tactical Barbell and TB 2 the conditioning guide(search for PDF). Contrary to popular wisdom, the two systems are not independent of each other

No, I didn't say they were. The point being is that you're not going to get great aerobic conditioning from deadlifts when compared to any other specific aerobic activity, like running.

That shouldn't even pass the sniff test, yes? If you would like to test the theory, I'll run for 5 weeks, you deadlift, then we'll test our aerobic thresholds (or whatever else you'd like to do!) :)

I hate treadmills, but going for a bike ride or a walk is awesome. I don't know why people go to the gym to run...

Because it’s easy to set targets and measure them while in the gym, but it’s not easy to fit that kind of exercise into the day to day.

People often live too close to work for the bike ride to really be considered exercise, or too far, where they couldn’t feasibly fit it into their day.

I get it, doing exercise for free seems like a no-brainier, but not everyone’s life and exercise needs converge neatly to make it easy.

> easy to set targets and measure them while in the gym

The cost of the gym will pay for a GPS watch and heart-rate monitor pretty quickly.

But I understand that some places might be too high density or unsafe to run, or the weather is too hostile.

I'm fortunate enough to live 10km from work, so I switch up between running AND riding the distance.

Because the outside air is polluted and having to wear a air filter while exercising is unpleasant.

Because I have to watch out for traffic and pedestrians outside, and driving to a cycling/running path takes about 15 minutes anyway.

Because looking at healthy, fit people exercising gives me more motivation to get in shape.

Because I can devote more attention to my audiobooks than if I was exercising on the streets.

Because the gym is in my apartment complex, so I just go downstairs and walk 2 minutes to the gym.

There's another article on the front page that pollution increases the risk of either getting or accelerating Alzheimers, I forget which. Either way, if you live in a city, getting aerobic exercise out of doors is probably counter-productive when done for the purpose of cleaning your brain. In that case, indoors at a gym might be an option, if it's well ventilated and fresh air is filtered first.own.

You can watch TV on a treadmill, something that is much harder (and more dangerous) while running outside.

Sometimes the weather blows.

Probably for the same reason people go to the gym to exercise yet don't do any pushups at home: we pathologically avoid exercise, so we often must compartmentalize it away from our life to actually do it.

"This is the mechanism by which the body cleans up most tissues. Except for the brain. The brain has a separate mechanism whereby lymphatic fluid (aka interstitial fluid) gets flushed out, taking wastes with it, only during sleep."

I've been thinking about this myself and I theorize that this all comes back, full circle, to your heart.

That is, both bodily and brain lymphatic fluid flushing mechanisms are driven by circulation - and the more efficient and powerful your blood circulation is, the more efficient and cleansing your lymphatic flushing will be.

And thus, your brains lymphatic flushing, while not directly driven by exercise, still benefits greatly from exercise due to the improvement in total circulation.

I think circulatory health and blood health are hugely important, for a lot of things, for a long list of reasons. I also think total load on the system matters.

If your system has a backlog of built up wastes generally, that backlog is going to be a barrier to efficiency in any particular system.

Note long ago someone listed some papers about the relationship between exercise and circadian rhythm : https://www.reddit.com/r/workout/comments/9n6f6p/the_greates...

it might be related to your comment too

Bio 101 after 2015 got an update. Researchers found out about lymphatic vessels in the brain:


> aerobic exercise is likely to do more good from the perspective of powering the lymphatic system than weight lifting.

This is conjecture? I do hope its true though! A frequent debate I have with a friend is whether weight-lifting or running has better effects. He claims 1 hour of weight-lifting raises your metabolism by many multiples vs more aerobic exercise. Its always a bit hard to have these debates though since we are mostly armed with anecdotes and not facts.

I suspect the answer is always moderation - somewhere in between.

I'm fairly certain it's true.

But that knowledge comes from 17+ years of firsthand experience (aka "anecdata") and reading (where I may not be able to cite my source anymore because I read it eons ago for personal reasons, not to try to win an internet debate). So I qualified it in hopes of keeping people off my back about citations etc.

So if you need citations for some reason, you will need to find them on your own. You might start with googling info about the benefits of walking and sources on how the lymphatic system works.

This is something very new to me, thank you!

One question- what is it specifically about sleep? Have we figured that out yet? And when you say "only", you mean "only" or you mean 99.9% of time?

Thank you for explaining this - I learned something today!

Hear that Elon?

There is an awful lot of "might" in that article.

Not disagreeing with it on face value, mind you, but the actual research basically states that you can't just start exercising... you have to already been exercising (and not even all that much, like, ~5000 steps ~= 2 miles a day, some HIIT (less is more) + low rep heavy weight lifting one or twice a week) benefit from this.

So, all of us who are in our 30s now? The time is now.

Also, re: weight lifting, try to target all of your muscle groups right. Don't be the guy who skips leg day, don't be the guy who has a shitty core and is trying to squat 250+. Guys like Jeff Cavaliere are who to look at on how to do this right.

If you’re in your 30s a much better bet for your overall health and for keeping Alzheimer’s away is giving up on sugar, since there’s a strong link between Alzheimer’s and insulin resistance.

Exercise too does help a little with insulin resistance (but not enough to repair the damage done by a diet high in sugar), plus people that exercise tend to also eat healthy.

Much like we used to think dietary fat created visceral fat, and dietary cholesterol created blood cholesterol, we've been operating under the assumption that eating sugar is the primary cause of high blood sugar leading to insulin resistance. When you look at the glycemic index and glycemic load of foods, it's actually wheat that comes out on top. Cutting wheat out of your diet is likely to be much more effective at reducing your insulin resistance, and there are often a litany of other positive health outcomes as well.

Don’t know what the glycemic index says on sugar, but that’s not the whole story.

The story is that fructose gets metabolized differently than glucose and for example leads to accumulation of fat in your liver and then your pancreas and it’s all downhill from there, I.e. having a fatty pancreas is correlated very well with insulin resistance and prediabetes.

And then the problem with sucrose and HCFS are is that they have both glucose and fructose and the foods containing them have no fiber to slow down the digestion, so it’s hitting that liver hard, with that fructose being converted directly in fat deposits.

I do agree that wheat is bad too. Personally I’ve cut wheat from my diet.

But don’t look at the glycemic index alone as that’s an oversimplification.

Also let’s get one thing straight ... you cannot live without fat, no matter what fat we’re talking about and anybody that claims otherwise doesn’t know what he’s talking about. And you can die without salt. In these cases the debate has always been about quantity.

But you can live without putting another gram of sugar in your mouth for your remaining life. Although it’s pretty hard to do because sugar is in everything these days, including packaged bread because it extends shelf life ;-)

> Much like we used to think dietary fat created visceral fat, and dietary cholesterol created blood cholestero

Those have been debunked. You're running on that same assumption, correct?

> we've been operating under the assumption that eating sugar is the primary cause of high blood sugar leading to insulin resistance

That's called Type 2 Diabetes. I don't know if that's an assumption?

> When you look at the glycemic index and glycemic load of foods, it's actually wheat that comes out on top.

Wheat is glucose though, not fructose.

Cutting soda out of your diet is probably better than having a naked sandwich.

I would say that switching to whole wheat from white bread is a positive, though.

Sorry if I was unclear, but you seem to have completely misunderstood my post. I hardly know where to start with clarifying.

1. Yes, those have been debunked. That's why I said "used to".

2. Most people assume dietary sugar creates high blood sugar. I'm stating that, like saying dietary fat makes you fat, it sounds intuitive but may not be true.

3. Yes, wheat is glucose. Why do you mention fructose? I didn't.

Whole wheat bread will raise your blood sugar, just like white bread.

And possibly more than soda. http://quittingsugar.com/2012/07/11/bread-and-coke-smackdown...

> 2. Most people assume dietary sugar creates high blood sugar. > I'm stating that, like saying dietary fat makes you fat, > it sounds intuitive but may not be true.

Consuming excess amounts of fructose will (via complicated metabolic pathways) produce a lot of uric acid by your liver. That's what's causing hypertension. This shows the metabolic pathway diagrammed out:


Pretty interesting.

Is there a competing theory?

> 3. Yes, wheat is glucose. Why do you mention fructose? I didn't.

Glucose is not sugar; fructose is. They take different pathways when metabolized. It's true that lots of white bread has added sugar, but that's not the wheat. I would say that if wheat is a silent killer, France would be in big trouble, and they're not.

Hypertension? How is that relevant??

Glucose is absolutely sugar. Fructose and glucose are both simple sugars (table sugar is sucrose, a disaccharide composed of glucose and fructose).

The starch in wheat is made up of long chains of glucose, which again, is a sugar. It sometimes has added sugar as well. Both those facts are true for both white and wheat bread.

RE: France, are you kidding me? French people do get fat. https://en.wikipedia.org/wiki/Obesity_in_France

> RE: France, are you kidding me? French people do get fat.

Like most of the world that switches to a "western diet", France is not immune to it. They've got McDonald's and junk food there too.

That said France has been a "paradox", as noted since the 1980s, due to their low incidence of coronary heart disease or other chronic diseases, in spite of their high consumption of dietary fat and cholesterol.

Of course, the French diet is only a paradox due to the American dietary guidelines being dead wrong. And as they switch more and more to the American diet, of course, they stop being a paradox.

> Hypertension? How is that relevant??

Hypertension is another word for high blood sugar - that's what you were talking about. It's part of a larger related problem called, Metabolic Dysfunction/Syndrome

> Glucose is absolutely sugar.

Glucose is a complex carbohydrate. Sugar is not, it's a simple sugar.

Edit: As other's have pointed out, I am wrong: glucose is a simple carb - the fact remains that it is not fructose and still feel that this is important.

Fructose is metabolized in the liver via Fructolysis


Glucose can be utilized by almost every living cell on earth:


And that big difference is why taking in cals. via sugar is different than taking it in via glucose, even though, as you say, glucose is just a long chain of simplier carbs.

> RE: France, are you kidding me? French people do get fat. https://en.wikipedia.org/wiki/Obesity_in_France

Fat isn't necessarily unhealthy; Metabolic Syndrome is the underlying problem.

It's all interesting stuff, huh?

Hypertension is high blood pressure. Glucose is a simple sugar.

With respect, please do some fact checking before restating whatever you think you know outside your area of expertise.

Hypertension can be caused by many factors, including genetics, however there are indications that one of the biggest factors is sugar consumption and not salt, as was previously believed and still is to some extent.

I've been reading The Salt Fix (http://thesaltfix.com), it has references to many studies ... not sure what to think of it, but being confronted with a serious electrolytes deficiency lately and having the symptoms to go with it, I tend to believe it.

As a professional athlete, health is an area of my expertise. Desk jockying is the hobby.

Lots of different issues are related, and I'm not going to say there can be a simple way to make it all make sense - for example: what is the symptom, and what is the disease?

I'm trying to share what I know to help others, not to stroke my own ego. If I make mistakes in typing things out, I apologize. I never said I was a doctor, and I appreciate the feedback.

Glucose and fructose are both monosaccharides - also known as "simple sugars".

Sucrose, "table sugar", is a disaccharide of one glucose group and one fructose group.

"Complex carbohydrate" is ill-defined, but I guess could refer to polymeric saccharides, a classification which wouldn't apply to sucrose, glucose, or fructose. In any case, you'd need a strange perspective to see glucose as a "complex carbohydrate": it's only got six carbon atoms.

> Glucose and fructose are both monosaccharides - also known as "simple sugars".

Point taken.

The metabolism of the two are still, very different (glucose and fructose)

This thread has sunk into absurdity. I assume at this point that you are a hilarious troll, but in case you are actually serious: virtually everything you said is wrong on a basic level you could verify with Wikipedia or whatever.

I am being as honest as possible - I'm not a troll. Do trolls usually have 6+ year accounts?

But, I do try to study up on the subject, since I am an athlete. If I bobbled two things up: calling glucose a complex carb, and mixing up high blood pressure with high sugar levels, I believe I believe I have already apologized and conceded that I was wrong. If it isn't clear, take this post as doing that again.

>Glucose is a complex carbohydrate

Citation? Everywhere I look says that it is a simple sugar.

> 2. Most people assume dietary sugar creates high blood sugar. I'm stating that, like saying dietary fat makes you fat, it sounds intuitive but may not be true.

That is not what most people assume. In fact sugar has never been vilified properly, which is why diabetics are still prescribed diets with sugar, which is basically murder.

But btw — this is not an assumptions, you can actually measure it at home. I got a glucose meter at home, got it for self experimentation. Whenever I eat something with sugar in it, my blood glucose spikes and even stays slightly higher than my average for several hours afterwards. Whenever I'm eating meat or green veggies however, I don't get any glucose or insulin response (you can measure your insulin response by noticing a lower blood glucose than the baseline).

You can also understand if you're a diabetic or pre-diabetic too by the time it takes your blood glucose levels to come back to the baseline (the level you were at prior to eating). If it takes 2 hours, you're still insulin sensitive enough. If it takes 4 hours, you're a diabetic, or well on your way to becoming one.

Self experimentation is actually easy in this case, you don't have to guess ;-)

In fact T2 diabetes is not a disease of high blood sugar, although the health care industry is yet to fully acknowledge it. T2 diabetes is a disease of hyperinsulinemia (i.e. high levels of insulin in your blood), which creates a vicious cycle that can lead to high blood sugar as a symptom, due to developing insulin resistance, which makes your pancreas dump more and more insulin into the blood stream, until the pancreas is no longer able to keep up with the required load of insulin, very high blood sugar levels being the symptom. At some point the beta cells of the pancreas begin to die too. And if you lose the function of your pancreas, that's T1 diabetes.

Interestingly T1 diabetics can also develop T2 diabetes by injecting themselves with too much insulin. People without a functional pancreas (T1) and with high insulin resistance (T2) are essentially screwed.

This is why treating T2 diabetes by giving patients synthetic insulin shots is like giving them poison, the same poison that's been making them ill, treating the symptom and not the disease.

To treat T2 diabetes, or pre-diabetes (which is prevalent in half of the US's population by now), you have to stop your body from producing so much insulin.

Many doctors claim that T2 diabetes is a degenerative disease that can only get worse (if you give them poison as treatment, of course) and yet many T2 diabetics have reportedly achieved full remission, completely getting rid of their medication, by switching to low carbs diets. Assuming they still have a functional pancreas of course.


So yes, it's without doubt that dietary sugar creates high blood sugar and T2 diabetes, but the way it does that (via hyperinsulinemia) is not common knowledge or treated properly ;-)

But to make things clear — we are talking of sugar as in the generally understood sense of sucrose and HCFS, whose consumption has been out of control and rising since the end of WWII at least, with obesity and diabetes rates to match it. And we can agree that anything based on white flour has been a problem too.

We are not talking about eating fresh apples (although apple juice is a problem). And fruits too are damaging on diabetes, anything with a lot of carbohydrates becomes damaging, so we'd better ensure that we don't get there.

Cutting out the sucrose, the HCFS and even the white flour is not such a drastic change. A few years back people couldn't imagine living without cigarettes either.

My grandparents lived without any sugar in their diets (countryside folks), my grandfather was eating 10 eggs per day and lived to 99 years old, working his land until 95.

We're not disagreeing here, except I'd argue most people DO in fact still think (incorrectly) that fat makes you fat.

Have you measured blood sugar after ingesting bread, and compared it to ingesting pure sugar? It might surprise you to know that a typical serving of bread will cause your blood sugar to spike MORE than even a very large amount of sugar.

This might be simplistic thinking, but isn't this why exercise helps? The liver turns the fructose from the sugar into glycogen. Exercise consumes the glycogen before it has a chance to be overly abundant, which is what causes the harmful effects. So you can either avoid sugar altogether, or have sugar with sufficient exercise.

Yeah, you have a good point. When/while you exercise fructose can be more easily converted to glucose, to be used right away by the body (faster than glucose alone). That's what's meant by, "a higher metabolism"

Under rest, 30% of fructose is converted to fat by the liver.


The real reason to exercise (for health) is it improves your skeletal muscle insulin sensitivity - it's certainly not because you burn a ton of calories from the exercise,


As in my other comment, I see more benefit from cutting wheat than sugar. But to your question, keeping your blood sugar low, and then exercising, helps your metabolic flexibility, i.e. your body's ability to generate energy from fat. So the best answer is, do both.

I think simple carbohydrates are a much bigger silent evil than even alcohol and opioids.

Alcohol and opioids at least have a stigma, and most governments enforce marketing and public health information accordingly. Starch and sugar can never be appropriately demonized because they are "just food", and have some of the largest companies in the US behind them.

The advent of processed food has created 2 entire generations of obese, insulin resistant people. The marketing starts as young as possible, and it is normalized to not think twice about eating sugar all day.

I'm still trying to get over the fact that the FDA actually banned partially hydrogenated oil. Very surprising that they said no to the entire processed food industry in such a big way, to the benefit of consumers. I'm sure the food conglomerates went into it knowing they had other options like interesterified oils up their sleeves, though.

That doesn't implicate sugar any more than excess body fat. There is no established causality from sugar intake. It's just popular to slam on sugar and promote fat acceptance so sugar is the "obvious" demon.

Can you clarify what you mean? I might have misunderstood you. I was a little flabberghasted that you seemed to say that there's no causality between sugar and insulin resistance. Based on everything I've been reading in the past 10 years, there's very clear causality between insulinogenic foods, insulin resistance, and body fat. The mechanisms, I thought, were also very well understood.

Perhaps they're talking about Alzheimers specifically? If you frame Alzheimers as a disease of affluence (Which is a bit of a stretch, I'll admit), you could look to the same causes (like excess added sugar in industrialized diets)

There is a link between sugar intake and diabetes.

Some people also suggest Alzheimer is a 3rd form of diabetes. I read a study that nasal applied insulin actually helps Alzheimer.

So, no slamming of sugar, just some preliminary evidence that may want to ask yourself if you really need to drink a liter or 2 liters of coke per day.

I wonder whether taking Metformin defensively helps in any way to reduce the odds of Alzheimer's if you have metabolic syndrome.

But my brain runs on glucose !

Sugar is nutritious for people who have a healthy gut biome.




But sugar people are delicious! They're such sweethearts.

Sour Patch Kids for life <3

eats shoots and leaves

> don't be the guy who has a shitty core and is trying to squat 250+

I don't really get this advice. I compound lift and when I was lifting regularly I peaked at 145kg/320lbs. I've never done focused core exercises with any regularity, I just focused on good form/posture and a neutral spine. Perhaps compound lifting itself is enough to build the core strength you need for squatting? Obviously I wouldn't recommend other people leave it out, but it doesn't seem to have done me any harm.

It's a confusing statement. Squatting is a core exercise.

I've never performed a plank or crunch in the many, many, years I've been squatting and it's never been a problem. If you try any sort of slow steady progression you don't need to - things adapt to take care of themselves. I've put well over 500 lbs on the bar and never worried about my core.

"I've never performed a plank or crunch in the many, many, years I've been squatting and it's never been a problem. If you try any sort of slow steady progression you don't need to - things adapt to take care of themselves. I've put well over 500 lbs on the bar and never worried about my core."

In a perfect world, this is true - and I wish you continued good luck and health.

However, you should reflect on the mechanical advantages and levers that your body is capable of producing as it curves and flexes around a particular joint ...

500 lbs distributed nicely and evenly across all of your vertebrae works quite nicely ... but all you need is a little twist ... a little hiccup ... just two or three vertebrae coming into line instead of a gentle curve ... and you suddenly have multi-hundreds of pounds on one little lever.

Not to spoil it for you, but the squishy little disc loses.

I am a huge proponent of back squats without aids - like belts - for the purpose of developing natural core strength like what you have experienced, but it is very, very cheap insurance to work your abs/back/sides in addition.

> I am a huge proponent of back squats without aids - like belts - for the purpose of developing natural core strength like what you have experienced, but it is very, very cheap insurance to work your abs/back/sides in addition.

Belts are aids in that they allow you to literally flex your stomach muscles and valsalva to a great degree - they provide no intrinsic support, instead providing something to brace your own muscles against. This is literally the argument one makes for core work! I also agree - it's important to learn to be able to squat without a belt, and I largely will with the exception of my heaviest sets of the day. It helps you appreciate the assistance and work on your own unaided valsalva.

If you do slip into this catastrophic scenario you're visualizing, being able to hold a static plank for 3 minutes isn't going to help that - you haven't trained the muscle at all to do what it needs to do at that moment - stop being static and move. Having the sheer grunt power and experience of having hundreds of lbs on your back for years is what's going to save you, and I'd argue that there's plenty of muscle groups that you've built up over the years to keep you safe in just such a circumstance - your spine isn't floating in a vat supported only by abs. I've dumped the bar, failed lifts, things have slipped, but I've never slipped a disc because I am strong enough to survive the load.

Do accidents happen and people get hurt? Absolutely, but both runners and old ladies slip discs too.

Eventually this is going to catch up with you. It only takes 6 minutes every few days to train your core. Neglecting it WILL lead to injury, no matter how good your habits are under the barbell.

> Neglecting it WILL lead to injury

I would love to see some evidence of this. Here's Brian Shaw's workout routine. Without question one of the strongest men in the world, I see no dedicated core work:


Core work is not a bad thing, but it's not required.

My impression is that if you have good posture to begin with, you might just "lift right" off the bat. I have to do a ton of supplementary work to balance out my posture issues. And the progress is slower than people generally like to admit.

my posture has always been pretty terrible (until I got to higher weights and my posture has straightened out) so I'm not sure its that. Though I think squatting with a low bar and not moving up in weight until I was happy with my form may have helped to compensate for that.

Strange. From lifting I developed what seems to be pretty common: anterior pelvic tilt. My lower back muscles being tight would pull my hips back. This went away with some stretching. Also I stopped doing Yates rows which I think compounded that issue. I'm happy posture-wise but do get the sense my shoulders should naturally fall further back. I think shoulder droop is the hardest thing to get rid of if you work a desk job.

This might be an example what the GP meant about doing core work in addition to squatting. If your lower back is strong, your abs need to be strong too to keep things in balance.

Core strength matters, but the perpetual shortening of muscle strands is understated. If you're just standing on two feet, strong core won't keep your hips from being tilted back involuntarily, ime. Not how I got rid of the problem.

if you're working your lower back during squats, your form is incorrect and you're risking injury. Your spine should be neutral throughout the movement - the lifting force comes primarily from your quads and glutes.

Er, it's part of the posterior chain and squats will always target the lower back to an extent, both high and low-bar. Squats were one of Arnold's favorite lower-back exercises. No way you walk away from heavy squats without feeling it there.

to be clear, I meant working as in bearing load - of course your lower back will be active in stabilising your spine through the movement, as will your core. So you're going to feel that, especially if you're keeping tight. But your lower back shouldn't be generating the force necessary to lift the weight.

OK, we agree

Yes, you should not good-morning the weight.

But if you are low-bar squatting, your back isn't going to be completely upright, and so keeping a significant weight at a angle requires muscular contraction. Your back is going to get worked.

Hell, even high-bar isn't completely upright, and even if it was, you'll get tension there.

What stretches did you do to help with your APT? I think I have it slightly and would like to work on it.

I would stretch my hip flexors by lying on my stomach and grabbing one leg at a time by the heel, and also go into a super-low squat position while holding on to something for support, letting the low back really stretch. Another one was lying on my stomach, arms above me somewhat wider than shoulder width, and twisting from one side to the other. I'm not sure which of these helped most but between them my APT disappeared.

It could be that we are taking different approaches to do the same thing - you hold off on moving up in weight and repeat the exercises, whereas I hold off, repeat the exercise, and do supplementary glute and core work to avoid my spine curving too much in the "right" way.

yeah that makes sense. Either way is a "safety first" approach, which is the most important factor.

How did you evaluate your posture? Did you hire a trainer?

Not that I utterly disagree with what you write, but there is almost nothing you wrote mentioned in the article.

Yes, almost any exercise is better than none. The earlier in life the better. Good core is super important in, well, anything including sitting on the chair. Hiit I consider very good based on effects on me, but would like to see some long-term results and its definitely only for people already doing some regular training.

But where do you get the low rep info? This is good for only very specific exercise goals, mainly bodybuilding. Not something most people should strive for. Arnold type body looks great on photos, but is utterly impractical for normal life, super hard to reach and maintain. Low rep means you are close to your limits, which is area where injuries happen a lot, and wear on all parts of the body happens much more (muscles love it, but joints and connective tissue disagrees, and spine has a say in the topic too). Wear is something you are not aware of till its too late and all kinds of pain start to manifest.

Lighter weights, more reps(15-20), shorter stops between them (30-60s), and you not only gain much better results in stamina (what good is it to be able to lift 100kg 3x times and you're done, when you need to move apartment for example or do multi-hour hike/anything else). Muscles grow like crazy too, if you have weights just right. Its much easier to keep good form of exercise when you are not at your limit.

Low reps (<=5) maximize strength, you're not going to get Arnold muscles if your goal is strength. Bodybuilding emphasizes size > strength and is more in the medium reps range (8-10). Higher reps basically turn into cardio and joint stability work.

I really like this chart for references on rep range:


>Lighter weights, more reps(15-20)

I was with you until you got here. A typical high-rep range for compound work should be between 8-12. 12-15 for auxiliary work. Most lifters would consider a rep range of between 3-5 to be low-rep.

>and you not only gain much better results in stamina (what good is it to be able to lift 100kg 3x times and you're done, when you need to move apartment for example or do multi-hour hike/anything else

Heavy lifting actually trains both fast-twitch and slow twitch muscle fibers, as it takes your entire muscle to lift heavy. The reverse can not be said for higher-repetition lifting. I've never trained in the mentioned rep range and anecdotally am able to do multi-hour hikes/anything else just fine. I find that the running/biking crowd loves to perpetuate this myth and generally does so with use of the phrase "meat-head".

Since we do anecdotes here, a friend who is purely heavy lifter (squats, deadlifts, benchpresses etc), exactly in those low reps range, and pretty good at it. He is utterly useless in 2h+ hikes with 1000m+ elevation gains.

Glad you don't disagree that its more injury-prone to lift heavy. Of course its all good if one has perfect form, but technically its impossible to keep it 100% of the time. Again anecdotally I had various smaller tendon/ligament issues when lifting at my max, every few months I had to stop for a week or two to heal. Since switching to what I described, I can do exactly the same, but no injury at all for 4 years.

But all bodies are unique, I found what works for me and my goals long term, if different approach works for you, stick to it.

In the case of weight lifting, it's usually the mind, not the body, that leads to injury. Crossfit is probably the fastest way to injure yourself, followed by trying to lift more than you should. It's injury prone to make your body do more than it should, you can lift heavy and not do this. Similarly, it's quite easy to stay in the good form zone and still get a good workout. You aren't going to be Ronnie Coleman, but you'll be healthy.

And yeah, I hope no one is claiming that weight lifting trains your aerobic system.

>And yeah, I hope no one is claiming that weight lifting trains your aerobic system.

The issue is when people claim that weight lifting is detrimental to cardio-related activities, which is what OP seems to be insinuating.

>Since we do anecdotes here, a friend who is purely heavy lifter (squats, deadlifts, benchpresses etc), exactly in those low reps range, and pretty good at it. He is utterly useless in 2h+ hikes with 1000m+ elevation gains.

The difference is that I made a statement which is scientifically accepted as true, followed by an anecdote to support it:

"Heavy lifting actually trains both fast-twitch and slow twitch muscle fibers, as it takes your entire muscle to lift heavy. The reverse can not be said for higher-repetition lifting."

There's a reason why NFL running backs can run an entire game and still squat 600 lbs; basketball players are also some of the most active athletes but still put up huge lifting numbers. Reps in the 12-20 range do not increase muscular endurance any more than the 6-8 rep range. [1]


I generally agree, but in a regulation NFL game the running backs are typically only running for about 5 minutes total.

The study you linked does not support your claims.

Also, professional athletes do both high rep and low rep weight training. The high rep build the strength but the low rep build the endurance to use the strength.

>The study you linked does not support your claims.

It does support my claims - but that was not the purpose of the study so you'll actually have to read beyond the abstract to see it

>Also, professional athletes do both high rep and low rep weight training. The high rep build the strength but the low rep build the endurance to use the strength.

I agree - which is why I don't believe that heavy weightlifting is detrimental to one's ability to do multi-hour hikes.

> Since we do anecdotes here, a friend who is purely heavy lifter (squats, deadlifts, benchpresses etc), exactly in those low reps range, and pretty good at it. He is utterly useless in 2h+ hikes with 1000m+ elevation gains.

Kind of a false equivalence. Firstly, I'm not sure that long, arduous hikes are very relatable to e.g. moving around in old age, whereas doing a single squat is absolutely comparable to getting out of a chair for anyone. Secondly, my guess is that you'd be utterly useless if you had to carry a pack whose weight equalised the difference between your respective bodyweights.

Heavy lifting actually trains both fast-twitch and slow twitch muscle fibers, as it takes your entire muscle to lift heavy.

If that were true bodybuilders would do great at marathons and triathlons.

>If that were true bodybuilders would do great at marathons and triathlons.

It takes more than leg and back muscle to do great at marathons and triathlons. Aerobic development, VO2 max, lactate threshold are just as important. Further, you would want less weight (muscle mass) in the areas that are not required for your marathon. That's why many professional bikers and marathon runners intentionally neglect gaining upper body muscle.

Weight lifting won't train you to run a marathon, but it certainly isn't detrimental towards multi-hour hikes. Don't move the goal-posts on me :)

You have it backwards. Bodybuilding is mainly high-rep, often with isolating exercises for muscle hypertrophy. Obviously concessions are made to improve strength for size, but strength training is where you really see the focus on low-reps.

Low reps is more frequently used for powerlifting than bodybuilding. Body builders tends to use medium to high reps.

(And Arnolds body type is not possible without steroids, in any case)

You can just as easily get too close to your limits with high-rep work. In fact, if I've ever been injured doing something, it's been wear and tear from high-repetition strength endurance exercise. IMO neither is inherently mote dangerous than the other, you have to know your limits whatever the repetion range you work in.

>Arnold type body looks great on photos, but is utterly impractical for normal life

No one gets "buff" on accident. No one gets to the size where they have trouble fitting through a door on accident (and without drugs).

>Low rep means you are close to your limits, which is area where injuries happen a lot

High reps = more movement, and just like a hard disk drive, more movement means more chances for failure. The injury that sent me to the chiropractor was a warm-up ~125lb Deadlift that I did with impromper form. Weight does not correlate with Injury risk.

>what good is it to be able to lift 100kg 3x times and you're done, when you need to move apartment for example

The "joints and connective tissue" (tendons aka grip) you mentioned prior is exactly what gets trained on heavy reps, and takes a LONG time to develop.

> High reps = more movement, and just like a hard disk drive, more movement means more chances for failure. The injury that sent me to the chiropractor was a warm-up ~125lb Deadlift that I did with impromper form. Weight does not correlate with Injury risk.

You don't see any logical fallacy in your statement? If more movement = simply more risk, then ultra-trail runners would be all in wheelchairs in 5 years. What you load on yourself on top of your weight makes huge difference. Give those ultras 10kg backpack and they will be having all kinds of knee/ankle issues in very short time.

Doing deadlift warmup with cca 55kg seems ridiculously high, I am not surprised you eventually had an injury. Really buffed up guys in my gym start with cca 30 kg only after proper warmup of whole body via some other way (I do it same way, usually on elliptic trainer for 5 mins).

Joints and tendons get trained with whatever you do, bodyweight can still do the trick if done properly. You are right it takes horrible amount of time, also healing injury can take months easily. I prefer sport climbing for those, flexibility required is substantial, and overall the sport is awesome on every single level, especially on the rock outdoors.

Whatever works for you long term, stick to it. You should know your body better than anyone else. I know amount of load made a big difference in injury risk for me, going lighter but still almost till muscle failure I have lost 0 of the power, and gained tons of endurance. But that's just me.

All of the ultra-trail runners I've known have had significant injuries from overuse or falling on the trail. When you're exhausted at the end of a 50 mile race it's easy to trip over a root and blow out your knee. A single mistake is all it takes.

Just as note, for a trained adult male, a first set warming up for deadlifts with ~60kg is not uncommon.

A regular bar is ~20kg by itself.

> So, all of us who are in our 30s now? The time is now.

This is true for exercising regardless, TBH. The more you build up now, the less trouble you have maintaining it later.

I do ~12,000 steps/day and HIIT 3x/week but I have trouble incorporating weight lifting primarily because I can do the other two without needing a gym, which is very difficult (single dad, 2 kids, sole caretaker, 2 businesses). Any suggestions?

Dumbbells especially adjustable ones do not take a lot of space and they are not only for the upper body muscles. Squats with dumbbells especially bolgarian ones is a good way to get muscles on legs and it is enough to do it once a week as long as weights are heavy enough so you cannot do more than 8-12 repetitions. But I would advise to pay an instructor for first few times to get the proper technique to avoid mistakes leading to injuries.

I like Matt Might’s article on least resistance weight training: http://matt.might.net/articles/hacking-strength/

A quick summary: No gym, lifting is at home 3 days per week of 30 minutes each day. First form a habit, any kind of exercise will do. Sounds like you’re there. Once lifting, keep it compact and accessible, start with just a bench and adjustable dumbbells. He also only does a few minutes at a time, not a half hour block. Eat some protein.

This is fantastic, and also the trend I seem to be going towards. Lazy as possible with the most results. Makes sense for techies, eh. Thanks for the post!

If you can join a gym with an indoor pool and sign your kids up for swimming lessons then that will give you at least 30 minutes twice a week to lift.

Resistance bands, a pull-up bar and a TRX go a long way for a fraction of the cost and space of a gym. Not as effective as free weights (in my personal experience) for putting on a lot of new muscle, but still quite effective.

+1 to resistance bands. This has been life changing for me. Minimal space, fraction of cost, and I get to exercise in my home office, watching something useful (currently going through fast.ai videos). Double win.

Here's the ones I use [1][2].

[1] https://www.amazon.com/gp/product/B006O0GDMO

[2] https://www.amazon.com/gp/product/B01NH55SAK/

Kettlebells are absolutely great. You can unlock a full range of movements and do a full body work out with just a couple kettlebells.

This sounds like the ticket. Will look into it, thanks.

You can go a long way with just bodyweight exercises. I like the progressions by "ElDiablo".

I'm familiar with bodyweight exercises/calesthenics. I just don't feel my strength improving, though the flexibility is through the roof. I would like to be conventionally "strong" before I die, at least once!

If you don't feel your strength improving, you need to try harder exercises. Can you already do a one-legged squat? A one-armed push-up? A handstand pushup? A one armed pull-up?

Does it sound right that I think I'd need to lose more weight before I could do those? I'm 6'3" and "lumbering" is the right way to describe me. I only ever see small, light people doing those.

As with all bodyweight exercises, having less bodyweight makes them easier :). I'm 6'2" myself and always jealous of the 50kg asian dudes that can do all kinds of crazy things easily. However, I can do one-legged squats and one armed pushups and I'm working (for quite some time now...) on a press-to-handstand.

do you have space in your home for a set of dumbbells? You can lift plenty of weight using just those. A barbell is better if you have room for some basic equipment (flat bench, squat stand/power rack, rubber mats for deadlifts if you have a solid floor).


If you are squatting 250 you already have a strong core.

Does the literature actually suggest that skipping leg day causes Alzheimer's?

The internet loves lifting. Cool, but the kind of legs you get from walking a lot are fine too.

Agreed that walking is great. However, the positive bone-density effects of lifting are greater than those of walking [1].

>Both aerobic and resistance training exercise can provide weight-bearing stimulus to bone, yet research indicates that resistance training may have a more profound site specific effect than aerobic exercise.

[1] https://www.ncbi.nlm.nih.gov/pubmed/9927006

But does it actually prevent falls or make the elderly less likely to break bones?

I'm not sure, but mechanistically speaking that would make sense, wouldn't you think?

People thought that consuming more calcium would do the same thing.

> While there is a small effect of calcium supplementation in the upper limb, the increase in BMD which results is unlikely to result in a clinically significant decrease in fracture risk. The results do not support the use of calcium supplementation in healthy children as a public health intervention.


By that same logic, should consuming lots and lots of protein yield bigger, stronger muscles?

Or perhaps in both cases, the body must experience stimulus such that the tissues "know" they need to get at the necessary supplies coming in.

Why build muscles, or stronger bones, if the body overall never does anything to need them? It would be wasted motion from their point of view.

Anecdotal and will get downvoted, but I have WAY more energy when I eat sugar. And yes, I have cut sugar for up to a month at a time before. I never got the magical increases in energy people talk about.

I run circles around the meat eaters in my life. My latest change was replacing maple syrup with date sugar. I also started drinking matcha often. The change to a Whole Foods sugar made all the difference in the stability of my energy levels. Matcha also makes the caffeine buzz a lot more steady, manageable, and even calm. Changing out processed foods for Whole Foods might outweigh the carb/fat/protein differences. There’s still a lot to biology and nutrition we don’t know, in my first hand experience.

I really don’t see how a Whole Foods sugar has any different effect compared “normal” sugar...

This site claims that different sugars have different glycemic indexes. E.g palm sugar (from date trees) at 35 and brown sugar at 65. https://www.eatthis.com/sweeteners/

The way my doctor put it: science likes to think “a molecule is a molecule” and it’s possible to isolate out the benefits of a food in individual extracts. But that’s been shown to fall short of reality over time. Nutrition is still a largely misunderstood system. Sticking with Whole Foods (bad autocorrect) should be more predictable/reproducible.

I recently joined a gym ( industrialstrengthgym.com/ ). It has an emphasis on having a welcoming atmosphere and community.

When they asked me during orientation what my goals were, I said "Show up three times a week. I need to grow up, it is time to work out."

And that really is how I feel about the matter.

If you listen to Tim Ferriss' interviews and read his interview books ( Tribe of Mentors, Tools of Titans ), you will notice a pattern: MANY of these highly effective people MAKE time to have intense work-out sessions.

All of the research and knowledge we currently have about human health and successful aging points to regular weight training and cardio training as the secret sauce for having a healthy mind and body as you age.

Going to the gym and working out isn't about having a hobby or enjoying it. It's about being an adult and taking care of yourself.

So grow up. Get to the gym.

Disclosure: I am a member of the gym I mentioned above but have no other affiliation with the gym.

For what it's worth -- an anecdotal as tentative counterpoint: my mentor in my teenage years, an academic and just an excellent man, was an avid cyclist with a diet that supported said hobby. To the extent that he rode daily and would cycle from around lake Michigan every other year. He repaired and built ham radios in his basement, next to his de facto bike repair shop. He was a socialite and happily married. This is how he spent his days.

Yet he was diagnosed with Alzheimer's at 72, six months after mild symptoms started appearing. He passed less than two years later, and his personality & mind a year before that.

Just six years before that he was detailing vector calculus proofs with me at his dinner table.

I try not to be too cynical but I just can't help thinking of him and his bitter end when reading about these albeit preventative measures.

I'm not sure why you are so cynical, my Aunt died of Alzheimer's in her late 50s. Maybe all that activity, staying mentally and physically active, delayed your mentor's symptoms by 15-20 years?

Is it possible the onset would have been earlier without the lifestyle? 72 is late, isn’t it?

Depends on who is talking, my grandfather ate healthy and exercised nearly his entire life and lived to be 96 before he started getting Alzheimer's and died a few years later.

I think most people would consider my grandfather to be a near optimal outcome in terms of lifespan and keeping your mind nearly intact until you are very very old. The number you are citing isn't even average lifespan in US for instance (78 currently). If you take out most of the things which are out of our control from that average, or things which cause disproportionate amounts of negative entropy on your body and recalculate it (things like homicide, suicide, accidental death, people who smoke profusely, people who drink to excess, people with severe mental health issues, etc etc) the number is much much higher.

Yes, 72 is late onset. I don't understand why OP is cynical. There is a big difference between getting Alzheimer's at 50 and 72. If exercise and other measures give me an extra 22 years of productive life, I'll do them, whatever they are

No matter what disease you are worried about, it seems like you need to follow the same advice in your day to day life: eat better, smoke less, drink less, exercise more, sleep appropriately.

Don’t exercise too much. You wanna take the car out to have the motor running every once in a while but if your driving 200km/h everyday the engine is going to wear out prematurely

Indeed, overtraining is bad for you in all aspects, it even hampers training progress - it’s really good for nothing. I heard that you can avoid overtraining by keeping an eye on heart rate variability - if that is low, you are either over-stressed or overstrained, and should tread lighter. Some fitness trackers can measure HRV.

One thing I've been concerned with lately is the tradeoff between systems that strengthen with training and systems that degrade with use.

Most of my favorite forms of exercise (climbing, hiking, running) are pretty hard on my joints, along with several other risks like shin splints and pulley injuries. I know there's some capacity to strengthen tendons and ligaments, but I can't find decent data on what tradeoffs I'm making at what levels of activity. Replacing everything I do with swimming and intermediate-rep weight training would almost certainly offer a better tradeoff, but I want to at least work out what price I'm paying.

Their are workouts that strengthen joints up to a point and significantly reduce injuries. The trade off is you need to specifically focus on them and their are a lot of at risk joints.

More important in many ways is knowing what pain is a sign to immediately stop, and take time off to recover from. Taking a week or two off now can prevent significant long term issues.

Which is difficult for type a personalities !

That's my belief too. So much for modern times and progress.

Seems that brain physiology and health don't live in isolation but are integrally linked with aggregate body muscular physiology. In a Frontiers in Neurology report [1] a prolonged sedentary lifestyle (mouse model) resulted in a 70 pct reduction in neural stem cells compared to a free roaming control group. Specifically, leg-loading exercises (weights) result in the transmission of neurological signals which catalyze generation of healthy nerve cells. A summary of the first technical article appeared in Frontiers Blog [2] if interested.

[1] Reduction of Movement in Neurological Diseases: Effects on Neural Stem Cells Characteristics


[2] Leg exercise is critical to brain and nervous system health


Regular exercise with elevated heart rate improve circulatory health (vascular and lymphatic). Low carbohydrate real, organic foods improve vascular function and prevent insulin resistance in the organs. Fasting performs cellular cleanup in all portions of the body.

Our planet and thus our bodies are highly populated with viruses and bacteria. Our body is the best healthcare system we have and works continually to eliminate or quarantine harmful pathogens like Borellia (Lyme), Bartonella, Babesia, Erlichia, Chlamydia, malaria, epstein-barr, herpes, etc. The quarantined pathogens (from biofilms, bacterial starvation forms, etc) often reproduce during immune suppression and over time propagate across the body. Many of the 'deposits' in Alzheimers are composed of quarantined pathogens (lyme, chlamydia, etc) and fasting + diet + exercise can help minimize those.

Personal experience here: Incidentally, the non-Hodgkins Lymphoma symptoms of Wikipedia very strongly parallel Bartonella and Babesia symptoms. The immune suppression from those often raises viral antibodies to things like Epstein-Barr. Cultural/native medicines lacked microbiology, but had a much better understanding of the body as a whole just from visible physical and patient reported symptoms than most western medicine practice today. Most pathogen testing is poor due to low blood/urine density and most doctors are authoritatively ignorant and refuse to look at other markers like TNF-a, TGF-b, C3a, C4a, etc blood tests.

Steven Buhner has written a number of scientifically and medicinally based books on the bacterial/parasitic pathogens (he has a ton of references from China, Korea, Russia, Germany, India, and the US).

> organic foods improve vascular function and prevent insulin resistance in the organs

This is bullshit.

> Many of the 'deposits' in Alzheimers are composed of quarantined pathogens (lyme, chlamydia, etc) and fasting + diet + exercise can help minimize those.

This is also bullshit.

> Steven Buhner

He's a well-known crackpot.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949767/ and there is another study that I don't have the link to where autopsies on 100 Alzheimer brains showed a mix of spirochetes, chlamydia, etc in the deposits.

Buhner protocols have helped many tens of thousands of people with tick borne diseases and is widely used by a number of lyme specialists throughout the world.

If you feel healthier eating processed food containing higher levels of pesticides, herbicides, etc then please continue to consume them. Be the center of your own black hole.

> Low carbohydrate real, organic foods improve vascular function and prevent insulin resistance in the organs

Yes, low carb can reduce chronic hyperglycemia and thereby keep insulin resistance at bay. I wouldn't be surprised if there were vascular benefits from avoiding processed foods as well. What's with the cherry-picking in your quote?

And I don't know who Steven Buhner is, but you rarely see ad hominem arguments in such raw form on HN these days, not to mention an overall response that adds so little and in such a rude tone. Please try harder or go elsewhere.

GP took the time to write down a thousand words, and you just call bullshit, bullshit, and crackpot. Why don’t you convert your knee jerk reaction into an argument that we all can follow?

My Opa is struggling right now- mid 80s, thinking is getting very fuzzy, and he isn't exercising the parts (back) he needs to. It's causing his body to break down. The cartilage and disks in his ribcage and spine are collapsing, forcing him to hunch deeply (accelerating the degeneration) and crushing his lungs. If he had kept his back strong, it would have kept the stress off his tissues for decades. He would still be losing his sight, smell, and taste (horrible, for a chef), but maybe he would be less fuzzy.

My Opa is also the most hardcore motherfucker I've ever met. It's not that he didn't exercise. He still heaves around 80 lb bags of sand, he's building a goddamn cottage almost by himself, he's still almost immune to pain. He's the toughest man I know, and even on the days he has trouble with fairly basic spatial tasks he can multiply three digit numbers in his head faster than I can write them down. His short term memory is still better than mine. He's still smarter than me. He's so stubborn he keeps falling off ladders every week because despite how much he has lost he just refuses. to. give. up.

I can't understate how fucking scary it all is. The man is unstoppable when he puts his mind to something. Time has not worn down his will even a tiny bit. He breaks bones more often now, but he shakes it off, does the PT, and it's like it never happened. But even that isn't enough when age decides to take you. If your spine wilts, all the exercise and work in the world will not save you. When you can't sleep more than two hours at a time, what do you do? You can't force yourself to sleep. You just slowly go nuts, a little more each day.

Aging is the real process of senescence, not just of getting older. Dementia, weakness, and frailty all seem increasingly like symptoms of a larger bodily/immune system degeneration. The inability to exercise, the constant pain, the constant sleep deprivation- those things could give dementia to a young man too. You can stave off the bodily decay until you start aging, but not after. Some lucky few, the Jeanne Calments[1], seem to be basically immune to senescence. They follow the path you'd expect, of a body slowly wearing out. The rest of us eventually hit a point where our bodies suddenly start to break down, and things like exercise just no longer produce the same changes they used to. The systems that handle growth, repair, immune responses- they just stop.

I'm sorry if this is bleak, but it hurts to see him like this. I just spent a couple months helping him put up siding. He wants to finish that cottage so much. I hope it's not his swan song.

[1]: https://en.wikipedia.org/wiki/Jeanne_Calment

Don't be too scared - the way we die now is still much better than the vast majority of humans that have ever died, even in the throes of dementia. The transience of health (and, by extension, life) is the great tragedy of all sentient life. The transience is a brute fact, the tragedy is an emotional response. We understand the brute fact very well, but can't change it. We understand the emotional response very little, and yet we have the ability to change it significantly.

That is bleak. Yikes. Sometimes, though, it's good to face the reality that nothing is forever, including one's own mind.

I'm glad your Opa has you there with him though this stage.

"he can multiply three digit numbers in his head faster than I can write them down"

As in e.g. 365 * 128? Or 365 * 8? The latter is realistic, the former is a bit unbelievable. Even the latter is a violation of the "magic 7"[0].


That's a trivial detail of the parent's anecdote which may or may not have been exaggerated for narrative purposes and completely tangential to the point they were making. Given the subject matter it's pointless and a frankly bit insensitive to nitpick that IMO.

I am really interested in measuring working memory and how it relates to IQ, hence the details.

I admit to not taking emotions into consideration here.

If you actually were interested, you would have asked for details rather than simply attacking the anecdote as implausible.

That's not quite right. Remember that grouped numbers count as a singular number within some limits. For example, if I was trying to remember a phone number in my working set: 1-2-3 4-5-6 7-8-9-0 that would be too large, but if I group the numbers: 12-3 45-6 78-90 then now it fits. Of course, most adults will remember that number like this: 123 456 78-90

When you're multiplying large numbers you only need around 5 or 6 items.

The former- it's something of a party trick for him. Most people can chunk up to 3 digit numbers, so you really only need to remember 4 numbers (original two, result, and temp). When I was little people would try to beat him on a calculator, and rarely won.

His talent was mainly that he could factor super quickly, and had the times tables memorized up to some absurd level. So that just cut a lot of thinking out of the task.

Replying to you and vorpalhex at the same time. I can see memorizing multiplication tables for 2-digit numbers * 1 digit numbers, (0-99 * 0-9).

I am unsure about chunking for random large numbers though. Mnemonic champions chunk very large numbers (I don't have sources on hand), but normal people generally don't.

Not at all. I just did that one in my head while driving, though I'm not fast.

The original multiplicands are honestly the hardest to remember. Don't materialize all of the intermediate results, and you can stay within working memory. You'll need to chunk a little, but mostly only 2 digit numbers.

Personally, I use fingers to keep track of the 10s place, and work from left to right. Less overwriting that way, and you start with an underapproximation that you refine gradually, which means you can stop early when estimating.

@OP: where do you find all your links that you submit?

Are you just submitting your RSS feed here?

>there have been traces of evidence for exercise playing a preventative role in Alzheimer’s disease

It seems quite a weak correlation compared with the story 3 months ago "Alzheimer's risk 10 times lower with herpes medication" https://news.ycombinator.com/item?id=17540094

Maybe healthier / exercising people are better able to deal with viruses?

I do not know About exercise; there are other options too: fasting for several days ( 4-5) ; Your body will produce ketones as fuel for your brain and growth hormone will also be produced; both can be used to repair your brain. It is free and from ancient traditions

Am I wrong to be frustrated with the way this is phrased. I think something to the effect of, "Lack of exercise pollutes brain and promotes degeneration." is more informative of the finding.

Similar to "Time in nature heals you"...

I thought autophagy was what "cleans" the brain i.e. fasting or keto.

It is and it does. Water fasting is the quickest way to trigger autophagy. Depending on the person this will start around 12 - 18 hours of no caloric intake.

Buried lede: Major pharmaceuticals are giving up on Alzheimer's research...?!

why is this pop-science trash at the top of the front page???

Reading the comments, might be because of the lack of literacy on this topic in this venue

Then do educate us instead of posting passive-aggressive comments! This is hacker news, not biohacker news, it's not really surprising that most people here (including myself) are not very knowledgeable on the subject.

Raising literacy on a topic is beyond the scope a post on HN but observing that it is low is not.

Biohacker news is a subclass of hacker news and adhering to good SOLID rules esp Liskov sub principle it’s permissible to talk about that stuff here without breaking the interface contract

How about healthy people can do exercise while people with the early symptoms of Alzheimer's are kind of bad at it, but they just need to try harder and have their Medicare to pay people to help them flail around a little more gracefully and when their disease progresses we can just blame them for their disease because of their lack of exercise even though it's a bit hard for them to remember to exercise at that point.

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