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Wellness Wednesday for June 26, 2024

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

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Culture war adjacent, but what drugs (if any) will Biden be getting before tonight's debate? Caffeine is the obvious choice, but many people are speculating that he's on something stronger. If so, what? Is it plausible that pharmaceutical intervention can give his mental acuity a short-term boost, or is it just shit-talking?

One surprising thing some politicians before campaigns is TRT. Higher testosterone levels can make you verbally quicker and wittier. Andrew Sullivan wrote about it back in the '00s.

Of course it can also boost your sex drive, which is probably why Anthony Weiner kept getting caught up in sexting scandals whenever he tried to run.

From discussion on X, I've come to the conclusion that Biden's symptoms are more characteristic of dementia with Lewy bodies (DLB) than Alzheimer's. DLB symptoms include higher peaks of lucidity than with Alzheimer's, but with more effects of motion characteristic of Parkinson's disease. So I asked ChatGPT:

For patients suffering from dementia with Lewy bodies (DLB), increasing alertness can be challenging due to the risk of exacerbating other symptoms. However, some medications may be used to help temporarily increase alertness and manage cognitive fluctuations:

1. Cholinesterase Inhibitors:

  • Rivastigmine (Exelon): This medication is often used in DLB to improve cognition and alertness. It helps increase levels of acetylcholine in the brain, which can enhance cognitive function.
  • Donepezil (Aricept): Similar to rivastigmine, donepezil can be used to improve cognitive symptoms in DLB patients.

2. Stimulants:

  • Modafinil (Provigil): Sometimes used off-label to promote wakefulness and alertness in patients with excessive daytime sleepiness or significant cognitive fluctuations.

3. Antidepressants:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like sertraline (Zoloft) or citalopram (Celexa) may help manage depression and improve overall alertness and energy levels.

4. Dopaminergic Medications:

  • Levodopa: While primarily used to treat parkinsonian symptoms in DLB, it may also help with alertness. However, it can sometimes worsen psychiatric symptoms like hallucinations and delusions.

5. Melatonin:

  • Melatonin Supplements: While not a stimulant, melatonin can help regulate sleep-wake cycles, potentially improving daytime alertness by promoting better nighttime sleep.

Caution:

  • Antipsychotic Medications: These are generally avoided or used with extreme caution in DLB patients due to the risk of severe adverse reactions and worsening of motor symptoms. If absolutely necessary, atypical antipsychotics like quetiapine (Seroquel) might be considered at the lowest effective dose.
  • Benzodiazepines and Other Sedatives: These should be avoided as they can worsen cognitive impairment and increase the risk of falls and sedation.

Summary:

Managing alertness in patients with DLB requires a careful balance to avoid worsening other symptoms. Cholinesterase inhibitors like rivastigmine and donepezil are commonly used and can be effective. Modafinil might be considered off-label for promoting wakefulness, while dopaminergic medications and antidepressants can also play a role under careful medical supervision. Always consult with a healthcare professional to tailor the treatment plan to the individual patient's needs and monitor for adverse effects.

It's plausible that he's using uppers on a regular basis. Low doses of any stimulant might be helpful. But it's not something that can be used for the first time on one important occasion, like a one time boost in a Vidya.

What are the downsides of using it on a onetime basis? Would you act erratic without a tolerance or any experience with using?

Maybe. Hard to say. I'd think with any drug I wouldn't want to do something high pressure on it without a good handle on its effects, and even for a lifetime performer like Trump you would want to practice how you play.

I bet that they are both taking a low dose of methylphenidate or Dexedrine. Methylphenidate would be a good choice since I don’t think it’s tested for on a standard 5 panel test.

No one is piss testing presidential candidates, so that's not a concern.

A brief update to the roommate situation:

I have decided that I will kick him out, but this will need to be delayed for a few (as in three) weeks while I conclude the lease on the old place he was living at: get the last of the stuff out, keys turned in, power turned off, etc. If I were to give him notice now there's a chance that he would try to move back in there and squat after the lease ends, in which case I could be held liable for having had an additional tenant living there off the lease, and I don't want to get sued. I don't think that he would do that, but I am afraid that he would and I'm not sure if that's reflective of the level of scumbag I've tolerated over the last few years or the level of paranoia/dread with which I approach interpersonal conflict. I am less afraid that he will pitch a fit and punch a bunch of holes in my walls or whatever, if only because he'll run out of breath in 30 seconds. I consider it likely that he will threaten to commit suicide but unlikely that he will attempt it in a violent enough fashion to succeed. He can say whatever he wants to his friends about what an asshole I am, but it doesn't matter because most of them are ~15 years older than I am and the ones that know both of us will understand why I am doing this.

It is my understanding that per my state's laws his living with me sans paperwork is considered an informal month to month lease that can be terminated without cause with 30 days written notice (which can be hand delivered by myself, no need to have it served). If he fails to vacate by then I can then sue to have him evicted. If worst comes to worst I will ask my landlord to have him evicted at whatever price that may cost (Conveniently, my landlord is an old lady who likes me, and she knows about this roommate, so I don't think she'll elect to evict both of us.). My worst case scenario resort is to exercise the fact that my lease is month to month at this point, so I could just move and leave him there to be evicted. I don't want to do that because I'm paying below market for a nice apartment in a great location but I'll do it if I have to.

Good luck.

How are you holding up morally/emotionally? Are you alright with kicking out your friend (or "friend", depending on how you see that by now and what friendship means to you)?

It's been rough (especially anxiety-wise, but this isn't my first rodeo there and I'm reasonably competent at dealing with it at this point in life) but I'm hanging in there and am calmer about the situation than last week. My job situation is not what I want it to be but is not an outright emergency (I can string together enough delivery and bartending shifts on top of it to keep the bills paid.) so I can backburn that problem while I get the roommate situation dealt with and have a backup plan there that'll open up in a few months.

I am dreading the process of kicking the roommate out (He may legitimately have nowhere to go due to having burned every bridge, and if that's the case or close to it I expect much wailing and gnashing of teeth.), but he has more than overstayed his welcome and done less than nothing with the frankly embarrassing amount of aid I've directly or indirectly sent his way. His health problems are unfortunate but his refusal to manage them is not my fault or responsibility (nor is his failure to find welfare or employment), and allowing him to stay here is tolerating an incorrigible leech at best and putting myself at risk of being conscripted into caregiving at worst. I really thought I could help this guy and all I wound up doing was enabling his self-destructive bullshit.

As far as friendship goes (and this is something I'm going to have to work on after this is over so that I don't find myself in a re-run of this situation), I had a bad habit through my 20s of picking up "friends" who really just appreciated my being useful and disappeared/drifted away when I quit loaning them money, fixing their car, etc. If the only thing you value in yourself is being useful then you'll develop a knack for finding people who will exploit this mercilessly, and this roommate is merely somewhere between grandfathered in from the past and the worst case of all of them. It has to end, and I am not obligated to let this guy stay at my place until he dies because of whatever went wrong in his life that isn't my fault.

To be honest, whatever pity or desire I had to help him at this point has been overcome by disgust, at him for his shameless freeloading and refusal to even try and get his shit together and toward myself for having tolerated it for so long. I will not let anger get the better of myself when dealing with him but I cannot and will not continue to tolerate this. This won't be an ultimatum or intervention, just a statement of fact: "You need to leave."

If the only thing you value in yourself is being useful then you'll develop a knack for finding people who will exploit this mercilessly, and this roommate is merely somewhere between grandfathered in from the past and the worst case of all of them. It has to end, and I am not obligated to let this guy stay at my place until he dies because of whatever went wrong in his life that isn't my fault.

Read your previous posts, you're making the right decision. Good luck.

I've seen your type before and I'm glad you have identified the problem. Many people are looking to exploit other people. The good news is that when people who have always focused on helping people focus on themselves they become dangerously competent.

You've got this man! Stand up for yourself! Get this guy out of your life, value your own!! Cut him out without mercy. Any kindness or wavering will be used as a splinter to reinfect you.

On Outrunning a Bad Diet

We've probably all heard the phrase, "you can't outrun a bad diet". There's certainly some wisdom embedded there, particularly for anyone that's just starting to get a handle on their weight and fitness - burning enough calories to significantly outstrip dietary intake isn't really an option for most people most of the time, and even if they do start burning quite a few calories, many people find it easy enough to outeat that burn rate anyway. Nonetheless, I find that the phrase irks me a bit, I think because people use it in a fashion that I think is stronger than what's consistent with either the general set of facts or my own personal experience. I've been thinking about this more lately for reasons I'll get to shortly.

As a bit of background, I'm a running enthusiast that picked the sport up in my late 20s when I had started to look at little doughy around the middle. After entering a couple races, I found that I really enjoyed the sport, wanted to be more competitive, and embarked on what's now a more than decade-long journey through the sport. Over that time, I've had ups and downs due to work schedule and injuries that resulted in my mileage fluctuating from a then-highpoint around 2200 miles back in 2015 down to about 1100 miles in 2020. Over the past couple years, I've been lucky enough to finally sort out both my work and injuries well enough to have set a new yearly mileage PR last year, knockout a great marathon training cycle to start 2024, culminating in a marathon PR to close the spring race season. During that time, I saw, "you can't outrun a bad diet" quite a few times on various message boards, and I'd quibble a bit with it on the basis that it sure seemed like controlling my weight had become a lot easier since I started my running life. Nonetheless, it was true that it fluctuated a few pounds and that I had to consider my calories a bit, so at least the weak form of the claim seemed true even for a consistent runner.

In the last couple months, that's changed. Now, I am outrunning a bad diet. After I bounced back from my marathon, I just started running every day with recovery days being slower and shorter rather than true rest. After finishing my morning run today, I'm at just a shade over 500 miles in 50 days, and the result is that I've lost a few pounds of fat. What's more, I'm seeing some additional muscular remodeling through both my torso and legs as I adapt to the consistently higher mileage. Going even a shade further, we got a dog and I'm walking more now too, with Garmin saying that my total movement per week is about 105 miles. I haven't made any conscious changes to my diet and haven't noticed any sharp increase in appetite, so without any dietary effort at all, I'm getting leaner.

To be clear, what do I mean by a "bad diet"? I think the first thing to note is that I kind of object to the term, I think most foods are fine in their proper time and place, and to the extent that food is "bad", it's contextual. Donuts are a terrible idea for diabetics, but there's nothing wrong with someone walking in from ten mile run and smashing a donut. At 140 pounds, I generally eat about 3000 kcal per day and I'm not at all particular about "eating clean". I drink too much beer (particularly big stouts and IPAs), I eat potato chips, I grill a lot of burgers, beef and onion fried rice is a huge go to, slow-cooker pork shoulder is great, cheese is definitely a go, fries or tater tots from the freezer are great, I'm happy to have pizza, and so on. It's not comically bad or anything, and I don't have a sweet tooth, but I just eat a lot of basically whatever I want.

So, is there any real point, any lesson to take away here, or am I just being a smug, pedantic asshole in saying that ackshually I outrun my diet? Well, admittedly there's more than a little of the latter. But really, I do want to note that I think people take the framing too far and undervalue exercise as part of maintaining a healthy weight. While it's true that a fat guy probably can't run enough to get skinny, the flip side is that a guy that isn't fat that takes up running or cycling really probably isn't ever going to get fat because of the way these sports change your relationship to food, giving you a real perspective on what you're eating and how much you need to eat for a given task. The metabolic impact is also crucial as easy aerobic work both burns fat directly and improves the capacity to use fat as a fuel for exercise. As with many other things, this isn't very helpful for digging out of a hole, but it's great for avoiding that hole in the first place.

I hate running and cardio in general, but my experience with physical jobs is that any kind of physical job massively affects my weight. My last job had me lose about 5kg in five weeks, and I've had times before where I've found it nearly impossible to gain weight while working.

It's also something that bothers me about CICO dogmatists - CO is a huge black box, and so it doesn't end up explaining or predicting weight change.

"You can't outrun a bad diet." generally refers to excessive calorie intake above all else, and while you might think/feel like you're consuming a lot at 3,000 kcals a day you've got to think bigger. A quick google search suggests that your average American (who is overweight if not obese) consumes 3600 calories a day, so you're eating less than the average American and probably in the top 1% among them for physical activity.

I promise you can't outrun my obese roommate's diet, which I've started to occasionally observe as the fast food trash clogs up my kitchen trashcan. Some bangers from the last week: Thursday's lunch was a 20 piece McNuggets, three double cheeseburgers, and two medium fries from McDonald's (about 2800 calories). He came home from the bar with a Taco Bell bag later that night. Saturday night's dinner was eight 3 cheese chicken flatbread melts from Taco Bell along with a 7.75 oz bag of potato chips (about 3900 calories in total).

A quick google search suggests that your average American (who is overweight if not obese) consumes 3600 calories a day

That is, um, more than I expected. I'm personally closer to OP, and thought my 2500-3000 calories was a lot, although admittedly I try to make it pretty healthy within that allotment. There have been times in my life where absurd volumes of low-intensity exercise (think through-hiking) have actually made it difficult to physically eat enough in a day to keep up, some of that is having to carry the food and not sitting down often to eat it. I hear the polar explorers of a century ago (and perhaps still today) were eating butter by the stick just to cram in enough calories.

That said, I think OP should worry about getting a sufficiently well-balanced diet: macros are important even for endurance athletes (who frequently need more carbs than weightlifters), and I've heard enough anecdotes about various micronutrient deficiencies that I try to balance things out a bit. But while running, especially longer races? Even the professionals there are consuming lots of sugar to maximize performance. I do recall an anecdote from a professional triathlete trying to explain to his dentist that he deliberately consumes about a gallon of sugary sports drink daily, because that can still cause issues for teeth.

I realize they're probably not unusual, but your roommate's diet as you describe it sounds terrifying.

But while running, especially longer races?

Affirmative - during the last marathon I ran, I downed a 100-calorie gel every half hour and took Gatorade at aid stations.

More broadly, I got to thinking about the whole thing precisely because I had arrived at a pretty homeostatic position with regard to diet and 40-50 mile weeks over the course of years and was surprised when my recent increase led to inadvertent (though not entirely unwelcome) fat loss. As dopey as it sounds, a cheeseburger actually is tolerably macro-balanced. Likewise, my go-to meals of rice with meat and onions are fairly balanced. As I get into the next training cycle, I'll generally pay more attention to specifics when I have structured workouts.

You have to remember that close to 10% of Americans are morbidly obese, and as with alcohol consumption the heavy users drag up the average (It's more dramatic with alcohol, but there are vastly more severely obese people than anorexics.). On that note, the "10th decile drinkers drink 10 drinks a day" is probably an overstatement, but 10th decile drinkers still likely consume far too much.

My roommate's diet is simultaneously infuriating (He's literally going to eat himself into being bedbound at this rate and that much fast food has to cost a ton of money.) and sad (Binge Eating Disorder is a thing.). I get that it's really easy to become overweight or obese (Otherwise most people wouldn't be one or the other.), but to get your BMI over 40 or 50 takes work (unless you're really short and inactive, I suppose).

My admittedly light reading into it is that a lot of the consternation about exercise not yielding particularly encouraging fat-burning benefits for the effort is really only relevant for high-intensity exercise. Returns diminish hard beyond zone 2, so the platonic ideal exercise for weight loss is high-volume but relatively gentle and non-strenuous. In fact higher intensities may even yield negative returns to the extent longer recovery time cuts into time you could just be back on the bike, or probably more realistically as a weight-loss prescription, cause unfit people to bounce off it as unpleasant.

Diet-wise, though, I think it's easy to project your normal onto others. I'm similarly pretty lax about what we cook (I barely flinched at the insane amount of butter one apparently needs to make a good syrup for crepes suzette a few days back) but on the other hand it is largely all cooked by us. We just never have oreos etc in the house or are in the habit of 'snacking' in general -- the idea of a midnight snack is a bit odd to me, but some people clearly do otherwise.

A medium coke at McDonald's is around 200 calories. Google tells me running 1 mile burns around 100 calories. So, if we focus purely on calories, to cancel out 1 coke requires running 2 miles. For an average out of shape adult, I'd assume that would take 25-30 mins. Skipping out on a soda is a whole lot easier than running extra 2 miles to burn it off.

I eat potato chips, I grill a lot of burgers, beef and onion fried rice is a huge go to, slow-cooker pork shoulder is great, cheese is definitely a go, fries or tater tots from the freezer are great, I'm happy to have pizza, and so on. It's not comically bad or anything, and I don't have a sweet tooth, but I just eat a lot of basically whatever I want.

I'm a lot like you. I also eat pretty much whatever I want. My only restriction is not eating carbs/sweets right before bed because that fucks up my sleep, but other than that I never restrict myself in anything. However, I never drink soda or eat fast food. It's just something that I rarely consider for my meals, probably because my family put big emphasis on home cooked meals when I was a child. But I'm most definitely an outlier. Many of my peers live off take out, fast food, frozen meals, quick grubs at Starbucks for lunch. They also don't exercise consistently. For people like that, if they ever decide to lose some fat, cutting out a couple things from each meal would put them at maintenance calories or slight caloric deficit. Or they would have to add an hour or two of physical activity per day. We both know which one would be easier for them.

I've been having similar thoughts for a bit, happy to be able to latch onto your post to discuss them. I think you are broadly correct, but that the common wisdom advice is the common wisdom advice for a few reasons:

Focusing on diet is good advice if you're in a hurry, or if you're already working out. At my age and size and weight and activity level, the basic calculators say I maintain weight at about 2,800 calories a day. That's pretty much my normal diet. I can cut 800-1000 calories a day with effort, but without suffering. I can cut 2000 calories a day while feeling it a little, but not dying or curtailing other activities. To burn 800 extra calories a day, I'd have to run something like eight miles (I'm going to use a simple 100 calories/mile number for simplicity). That will take a good runner an hour, it would take me at least an hour twenty or an hour thirty, and I'd be tired after. To burn an extra 2000 calories, well it's right in the username, it would take me close on five hours. A totally impractical quantity of time to spend in an otherwise full life.

Moreover, adding more than about two moderate miles a day to a full workout schedule is nearly guaranteed to interfere with squats, or kettlebell snatches, or whatever else I'm trying to do. For a sedentary person, anything bigger than a two mile walk (probably the equivalent 100 calories) is going to require effort and recovery. You've frequently discussed injuries in the WW threads, that shows right off how difficult it would be for you to add activity to burn additional calories.

So, in my mind, it's easy to cut 500-800 calories a day, on average. That's a pound a week. While it's easy to burn 100-200 extra calories a day. That's a pound a month.

Burning an extra 100-200 calories is going to get you a pound a month, give or take. Keep it up for a year, you're dropping ten pounds a year.

That's a lot in the grand scheme of things! If I was ten pounds heavier every year for the past five, I'd be fucking fat by now. And that's the case for a lot of people! If they took a two miles walk every day, 45 minutes of time, they'd be a lot lighter today.

But that's also mind-numbingly, unnoticeably slow. If I tried to do something today, in hopes of being lighter five years from now, that's tough for me. It sure ain't gonna help you get ready for that beach weekend. Where cutting calories, whether daily or in an IF format as I prefer, can get you ten pounds in two months, no sweat.

So in my mind, if someone is sedentary and fat and wishes to lose weight, the right move is to start by getting active, and then to move to diet. If one is already active, focus on diet.

The inverse is also undeniably accurate, that it's always possible to out-eat any workout plan, it is always possible to create a diet bad enough that it can't be outrun. I outweigh you by 50 pounds, I'd imagine that might be a difference between us: it's not difficult for me to imagine a dietary choice so brutal that no activity would save me. There's an all you can eat Sushi place on the drive back from the downtown courthouse, I could swing in there and with a few beers or sodas eat a marathon's worth of calories. I could sit down and house a half bag of oreos watching the Phillies, and not even think about it. I can power through half a pie when my wife makes one. Any Dairy Queen will happily sell me a thousand calorie Blizzard. Some degree of not-terrible choices must be made to even begin to keep a decent weight.

I also think that the viral memetic quality of "You can't outrun a bad diet" is in part a puritan strain in American culture that can't quite be exorcised. You can't be enjoying yourself, having fun, and getting good results. You must be suffering. Suffering is the only way to succeed. So don't think you can enjoy that donut and then pop in a podcast and take a pleasant jog or go climbing and burn it off. You can't do that! You must suffer!

In my experience, the main draw to addressing diet is either A: Culling excessive calorie intake and running a big enough deficit is a way to lose weight quickly, and it's easier to stay motivated when I see fast results. or B: My diet has become so bereft of nutrition that my lack of energy is interfering with my daily life (My job is fairly physical.).

I've bounced between "average overweight American" and "really fast weight loss" (My personal record is 25lbs in six weeks, starting at a BMI of 28.) more times than I can count, invariably prompted by something setting off my anxiety such that I totally lose my appetite (I suppose that being in a permanently agitated state might burn more calories than being calm, but surely not that many.). It's horribly unhealthy to have the majority or entirety of my calories come from Mountain Dew Voltage (If they made a sugar-free version I'd switch, but that's not what the Circle K is selling at 79 cents for a 44 ounce.) and alcoholic beverages (Oh, and you'll drink less and get more bang for your buck because the perpetually empty stomach and weight loss will wreck your alcohol tolerance. This can be dangerous when trying to have a fun night out.), but from the perspective of the scale it's almost amusing effective.

I'm actually kind of annoyed tonight because I went through the effort of acquiring a dinner that I was looking forward to/ meal prepping for the next few days and then barely ate any of it before getting too full to continue. I don't know if the stomach really shrinks after a few months of food restriction, being excessively tense tightens something around the stomach, or what, but when I get like this I have to force myself to eat at all or I'll go days without eating (By day three I'll hit a wall, run out of energy, and get really cold.). Oh well, I ate enough that the fat soluble vitamins should take, can refrigerate the leftovers, and I can always freeze the stuff I prepped.

My favorite bit of American puritanism (while not raised a churchgoer, I grew up in a churchy enough place that the values rubbed off on me) is that I refuse to take OTC anything to medicate a hangover. Hangovers are to be endured as penance for excess. With that, there is the very real thing that if you have anything like an excessive drinking habit you probably shouldn't touch Tylenol because combining liver killers is a bad idea.

I don't know if the stomach really shrinks after a few months of food restriction, being excessively tense tightens something around the stomach, or what, but when I get like this I have to force myself to eat at all or I'll go days without eating

Could be dyspepsia? Buildup of gas in the stomach, sometimes due to the output pipes getting clogged.

I think the body is just resistant to change. There are some major things that seem to alter the body:

  1. Caloric restriction (including intermittent fasting).
  2. Exercise.
  3. Non-caloric dietary choices (keto, sugar intake, vegetarianism, etc).
  4. Sickness / poisons (your body trying to save itself and expending lots of energy, also poisoning from taking too many drugs legal and illegal).
  5. Age.

Even making drastic changes in one area you'll be held back by the other things. But get drastic enough, and you'll still break through the effects of the other things. This can be seen in the extremes. Take in zero calories and you will lose muscle mass no matter how much you exercise. A severe alcoholic is on the path to liver failure and death no matter how good their diet and exercise are. Be Michael Phelps and swim miles every day and you can eat 5000 calories of sugar for breakfast and still look like a chiselled Greek statue. Be old enough and no amount of dieting, exercise, or healthy living will save your body.

The original advice is probably helpful in the sense of telling people to avoid trying to do a thing that is very difficult. I think outrunning a diet specifically is very hard, because as you've experienced injuries are not uncommon. I think people can hit a death spiral with running. Where they need to run a dangerous amount to burn off their excess calories and fat, that amount of running leads to injuries. While they are injured they still have the bad dieting habits so things get even worse before they can get back to running. Rinse and repeat until they learn that swimming is a superior sport for exercise.

Where they need to run a dangerous amount to burn off their excess calories and fat, that amount of running leads to injuries. While they are injured they still have the bad dieting habits so things get even worse before they can get back to running. Rinse and repeat until they learn that swimming is a superior sport for exercise.

FWIW, this part seems largely sorted over the last couple years. The main sources of prior injuries were classic stupidity - too quick of builds, too much high-intensity work, not recovering well, pushing through soreness. My current higher mileage has been generally well-tolerated in part because of a reduction in pace on easy days, shifting them from putatively easy to actually easy. Even though I academically understood the difference, it took running with genuinely fast guys in a club to really internalize that just going really slow greatly improves recovery. During the last training cycle, I peaked with a 290-mile month, then tweaked a calf muscle during a race and needed to ramp down for a couple weeks (replaced with a bunch of light cycling for base), but other than that, I've been pretty consistently healthy for quite a while now. The shift to focusing on high-quality recovery has been the big difference.

The death spiral point is interesting. As I get older, I realize over and over how much injury prevention and management is the long term key to fitness.

Amen to that, you can't do shit when a major joint is out of commission.

haven't noticed any sharp increase in appetite

This is what exercise seems to get for me. Yeah, burning an extra 300 calories means spending a whole hour on light exercise or half an hour on more vigorous exercise, but after I've done that I somehow don't feel like I'm missing 300 calories. I can initially drop 300 calories more easily (infinitely more easily! negative effort!) by skipping snacks or eating a lighter meal, but if I do that with real food or even junk food then I'm acutely aware of the absence until I make up for it (possibly with interest, eating too fast because I'm hungrier...). I think for most people the easiest low-hanging fruit is dietary, avoiding liquid calories, but once that's done exercise starts to look like a good deal very soon afterwards.

(this is just talking about weight loss - obviously if you're more directly worried about health and fitness then things like "replace junk food with healthier food" and muscle-building exercise are more beneficial sooner)

I think it's one of those things that's obviously not literally true but is true in a practical sense for most people trying to lose weight. See the spike in gym memberships at the beginning of the year; if you think that joining a gym is going to provide sufficient motivation for the amount of exercise required to not diet, then I have some swampland in Jersey to sell you. I get the impression that these people don't particularly enjoy exercise but are forcing themselves to because they know it's necessary. Contrast that with people like you and me who exercise more because we like it and who look forward to it and it's much easier to just knock off a 20 mile bike ride after work without really thinking about it. I recently had to take a group of 14 year olds on a 50 mile bike ride to finish a merit badge and these kids were clearly wiped out by the end. One said he'd never do that again. Meanwhile, I'd do that same ride on a random Saturday for recreation. Given that diet has a bigger impact on net caloric intake than exercise, saying that you can't outrun your fork is a good rule of thumb for most people.

What's the straight dope these days on probiotic supplementation post-antibiotic therapy? Already eat kimchi and will resume regularly eating yogurt when the congestion goes away.

Read me though this isn't specifically about post-antibiotic therapy.

I have known for a while that many people in western countries have eaten themselves sick, both by the amount and substance of what we are eating. Sugar is in everything (especially so in the US from what I have read) and the 'three meals a day' rule, along with the saying that "Breakfast is the most important meal of the day!", is just bullshit. Personally, I always hated when my mom forced breakfast on us as a kid. I had just woken up! A conspiracy of Big Cereal no doubt (not even joking here).

But it took another while to truly internalize this and making a change myself. I got a sweet tooth. I admit it. But it's not that I don't have good habits: I am moderately active and can easily run a 10k or even a marathon if given a few weeks to prepare and I am on my feet at work (although it is not further physically demanding that that), I do some light martial arts too. So there's already momentum towards improvement.

However, to be truly healthy I need to get my eating under control. Firstly, I don't eat as much anymore. I fast quite regularly nowadays. Mostly a day out of the week at the beginning of the week, as of writing I have tried to stretch the fast and I am seventy hours into one (only drinking water and/or juice). It's very counterintuitive because we learn that we need to eat constantly to feel energized, but it is almost frightening how much energy you have after not eating for 'merely' a whole day. The tiredness do come eventually. I can feel it in me now, for example.

I would like to know from the more fitness-oriented, the health-nuts and the culinary inclined on what I should break my fast with? I'm thinking a thick chicken soup with boiled broccoli and some light garlic bread. I aim to drink mostly water, from now on, but when not then freshly pressed orange juice and milk. Soda I have promised to cut entirely, with the exception of parties. Thought about also drinking raw eggs, but have yet to try it out. Any other meals I can prepare so that it doesn't get too monotone (preferably I would also still like to eat other meats than chicken)? Perhaps there's a good YouTube channel to follow?

Am I on the right track towards healthy dining at all, or am I going wrong somewhere?

I am exceptionally lazy about breakfast, beyond my typical laziness about food. So I usually just wolf down some yogurt. I do it for the sake of weight gain because I rarely get hungry before mid morning and could wait until lunch.

Yogurt with a bit of granola is the only way I can get some protein for breakfast, it's great.

To be more specific I usually have mine plain. I find sweetened yogurt disgusting,quite aside from the absurd sugar content, but greek yogurt is a bit hard to eat because it's so thick, and there are very few brands available that just do plain yogurt. But then I'm a plain eater.

The best diet is the one you stick with. Intermittent fasting works for some people, but I don't really see the point in going on long fasts every now and then.

Track your calories for a while. Every single thing you eat. There are plenty of apps with databases. You can just scan the barcodes etc. Gain some knowledge and overview of how many calories and grams of carbs/protein/fat/sugar/sodium you put in your body in an average week.

Cut soda and other sugary drinks entirely if you're serious about losing weight. Keep alcohol and snacks to a minimum.

Intermittent fasting works for some people, but I don't really see the point in going on long fasts every now and then.

I believe there is some evidence that certain cancers cannot survive without a continuous supply of glucose. So while your body will survive a fast quite easily, the cancer inside you won't. I'm not sure how well-studied and robust that result is.

When it comes to IF, some people claim it works for them, but the evidence is mounting that it's ineffective on average.

https://www.nytimes.com/2020/09/28/well/eat/a-potential-downside-of-intermittent-fasting.html

"A rigorous three-month study found that people lost little weight, and much of that may have been from muscle."

Fasting to kill cancer is intriguing, and I've heard it claimed once before. Presumably OP doesn't have cancer atm though. :)

I think IF helps some people with gaining more control over the intake. If you have all your caloric intake in two meals within 6 hours, you're less likely to cheat. It helps sets up a more disciplined lifestyle, I imagine.

Is continually deferring gratification a good idea?

I've got a lot of long, boring tasks to do. I've got some less long and more interesting activities I'd like to pursue.

Doing the boring tasks first will create the time and space to fully pursue the interesting activities free from the shadow of procrastination. Diving straight into the interesting activities would mean trying to squeeze them in around the boring tasks, and even if the boring tasks get ignored completely their incompletion will still have an effect on the fun pursuits. Toy example: you can't easily cook a delicious cake in a messy kitchen, and even if you did it would be more laborious and the result is having to eat the cake in what is now an even messier kitchen.

On the one hand the more I defer the gratification the more appealing the gratification becomes (a delicious cake in a pristine kitchen with friends and family and song and laughter). On the other hand the more I defer the gratification the more all I see is additional messy kitchens to be cleaned.

I suppose the sensible thing to do is to look back, reflect on and take some gratfication from what I've achieved already.

My rule of thumb, which has to be adjusted amd prioritized to some degree, is Do what you need to do before you do what you want to do.

As you might imagine, this possibly wouldn't work well for obsessive-compulsive types (I do not use that term with any accuracy), who might see an ever-expanding and never-ending list in their minds of things that need doing. But it generally keeps entropy at bay, keeps my sense of time efficiency fairly positive, and keeps my wife from having to do every goddam thing around the house. I also like to think modeling such behavior will be good for my sons, for whom lethargy and idleness sometimes seem to come naturally.

A suggestion that may seem unrelated: Get a plant, preferably a flowering or fruit- (or vegetable-) bearing plant. Look up how to tend it properly, including soil pH, pruning, watering, etc. Then start taking care of it. The process of continual vigilance, patience, and reward when it does bloom/bear fruit is I think instructive.

I pair up

  • Keep up with chores

with

  • Define chores narrowly

precisely to avoid the list of chores expanding every time I get two-thirds of the way down the list. It is vital to define chores narrowly enough that one can actually finish today's and have a little time left over.

I share your rule. It's only that I feel like I'm passing a point where I'm losing sight of what it was I wanted to do.

Propagating more plants is about halfway down my list. In fact I'm mere days away from discovering whether the seeds that I collected from my garden last year are going to come out with pink, white or blue flowers (come ooooon pink!). On the other hand maintaining and improving the (poorly planned) garden is one (slash many) of the tasks towards the top of the list - and those particular tasks have a tendency to cycle back and regenerate in short order.

I've found taking before and after photos of projects or documenting in other ways to be a good way of keeping some perspective on progress and avoid the feeling of being stuck in a perpetual "work in progress" stage.

Anyway, I texted a friend who I've been putting off catching up with until the weather improved. Drinking beer on a boat will be a nice change. Can't help feeling that it doesn't actually advance matters though. Ehh, trade offs. It's not like I was going to fix everything in one night.