On Trusting Experts

In 2019, I had a lot of friends who encouraged people to "trust the experts." A common criticism they made was to denigrate people who had "done their research," which was usually maligned to be something like watching three hours of ideologically motivated YouTube videos. The basic idea was that "Karen" and her having "done her research" was no match for an expert's years of study and advanced degree.

2020, of course, put an end to that sort of argument, at least as far as I've observed. No need to rehash the details here. The so-called "experts" gave befuddling and contradictory advice on managing the COVID-19 crisis, and then shut down the country for a year or more while the global economy ground to a halt. It was a disaster. Importantly, many of these same friends I had stopped criticizing people for "doing their research" and instead started criticizing people for "trusting the experts." 

These friends of mine were always on the side of what I would consider to be "the truth." That is, when the experts were largely correct, so were my friends; when the experts were largely incorrect, my friends were great sources of better information. But on the moral issue of advising people to trust experts, they flip-flopped.

As for me, I never criticized people for "doing their own research," because that's precisely what I believe everyone should do. No one should ever take for granted the idea that the experts probably know what they're doing. One should always verify information; and the more controversial or the more widespread the impact of that information, the more important it is to verify it. This kind of attitude comes easy to a type 1 diabetic, because we diabetics often know more about our condition than most of the doctors in our communities. We certainly know more about our own bodies than the "experts." We are used to "doing our own research" and arriving at life-saving conclusions to better manage our lives and our blood sugar.

Today, many people (say, about half the country) still insist on "trusting the experts" or "following the science" or whatever the canard happens to be. This morning, I thought about a hypothetical scenario that might help them understand the value and importance of skepticism.

Imagine you're a woman who has recently gone to her doctor to get a prescription for birth control, for the first time. You fill the prescription and start taking the pill. Very soon, you notice that your body feels very different. In fact, it feels awful. You're really uncomfortable all the time and you're struggling to just be normal. So, you go back to your doctor. He tells you that this is a common set of symptoms and that many women take time to adjust to the birth control pill. He advises you to stick with it. So, you do.

But months go by, and your discomfort doesn't let up even a little bit. Every time you think about going back to the doctor, you remember what he said. Some days you figure that you probably just need a little more time to adjust. Other days, you shrug and figure that even if there is some kind of underlying problem here, going back to the doctor is pointless, since he'll probably just tell you the same thing again, anyway.

One day, you come across a website or an internet forum of some kind, where many women describe symptoms a lot like yours, and many of them insist that the problem went away when they switched to a different kind of birth control pill. You know it's not real medical advice, but the women all seem very emphatic, so you figure, what will it hurt to try a different pill?

You make an appointment with a new doctor, you tell her that you want to try a new birth control pill. She shrugs and says sure, you can try it. She writes you a new prescription, which you fill. You make the switch and, sure enough, your symptoms let up a bit, and then a lot, and then after a few weeks, you feel completely normal again. You're back to your old self.

If you've ever been through something like this - or know someone who has - then chances are, you already understand the value of being skeptical of "the experts." You have gained some familiarity with internet research and you have an informed opinion of which other patients to listen to, and which to take with a grain of salt. You have developed a more nuanced understanding of which kinds of risks are worth taking, and which are not.

In doing so, you have equipped yourself with the tools required to verify the information that the nation's "experts" are giving you, and you have come to a point where you feel confident in the kind of research you are willing and able to do on your own time. There should be more people like you in the world, and fewer people out there who blindly trust "experts" just because they're "experts."

Imagining Mars

I had a dream last night about something that I quite often dream about: the colonization of Mars. I love dreams like this because they always enable me to imagine things that I never would have imagined otherwise.

In this particular dream, Mars had been colonized and built upon to the following extent: There were good roads leading to a wide variety of businesses that existed in support of the primary economy of Mars, which I imagine to be extraction. In other words, it's most likely to me that life on Mars would revolve around mining, and to a lesser extent construction, and that all other businesses would serve to support those industries. There were shops and convenience stores, but they were sparsely stocked. There were bars and restaurants, mostly serving unappealing food like sandwiches, and also serving plenty of alcohol with which the Martian workers could "while away their time."

Interestingly, albeit unrealistically, buildings and cars on my Dream Mars were mostly open-air. Everyone had their doors open and their windows rolled down. Business establishments would generate their own oxygen, somehow, for patrons to breathe. People had grown accustomed to the difficulty of breathing the CO2 atmosphere of Mars as they made their way from Point A to Point B. My "host," the person in my dream who was showing me around the place, could generate oxygen in his car, too, but simply preferred the feel of the open air, just as all the other residents of Mars did. So, a good portion of my visit to Dream Mars was spent kind of suffocating as we traveled from place to place. It was frustrating for me, but my host assured me that I'd get used to it eventually. 

Obviously, such a thing would be impossible on real Mars. You'd only be able to last about as long as you could hold your breath. You'd need to find an enclosed building with breathable air as soon as possible, or else port your air with you in a space suit. But my dream wasn't a dream about what would happen if we plopped a bunch of present-day humans on present-day Mars using present-day technology. Instead, it was about the future.

*        *        *

A while back, I also thought of a similar sort of story. In it, human beings colonize Mars and exist there for hundreds of years before two major factions have an irreconcilable conflict, and the losing faction is banished from the colony. Ill equipped to survive the Martian landscape with whatever technology they could carry with them, and regularly exposed to the high solar radiation of the surface of Mars, this losing faction eventually, over time, evolves the ability to withstand high levels of radiation without suffering biological damage, and also the ability to breathe Martian air - or at least whatever middle-step the atmosphere of a partially colonized Mars might be like. 

The rest of this story revolved around the discovery of this very profound human evolution and its implications for the two Martian "factions." Would they separate permanently? Would they intermarry and cooperate? What would happen?

I'll have to actually write the book some day to find out.

*        *        *

The key feature of all of these dreams and ideas I have about Mars is that building up and maintaining a "bubble world" on the surface of the planet, where humans must always be encased in glass with a steady supply of oxygen pumped around, has always struck me as a terrible way of life, one that is only feasible in the very short run. In my mind, Mars is only inhabitable if it can be terraformed. A generations-long project would have to ensue, during which humans would have to discover a way for Mars to maintain a thicker atmosphere, and for that atmosphere to be made of nitrogen, oxygen, argon, and carbon dioxide, just as Earth's atmosphere is. In order to achieve that, humans would have to discover a way to convert the existing Martian atmosphere to something that it currently isn't. Humans would have to figure out a way to protect that atmosphere from the kind of solar radiation that would destroy it - and that means either manufacturing an electromagnetic field around the planet (since Mars isn't capable of generating its own), or somehow constructing a thick ozone layer, under which an even thicker breathable atmosphere would reside.

All of this, and we haven't even tackled the question of potable water yet. Bear in mind that these materials cannot simply be piped-in from Earth or elsewhere in sufficient quantities to maintain and grow a permanent human population. Conflicts of water rights are the kind of thing that we Earth-dwellers have started wars over. Can you imagine how much conflict there would be between the inhabitants of an environmentally fragile Earth and inhabitants of a terraformed Mars whose existence depends entirely on Earth's willingness to ship its limited water and air resources across the expanse of outer space? 

There are plot holes that a clever science-fiction writer can resolve, at least long enough to tell an exciting science-fiction story. However, to the best of human knowledge, there is no way to actually do this on Mars. If Mars will one day be habitable, we don't currently have the technology to do it; perhaps we don't even have the scientific knowledge to do it.

*        *        *

The primary reason we know we can't colonize Mars at any point in the foreseeable future is because there are vast, dead regions of Earth that human beings have killed and can't bring back to life. A couple of examples include the desertification of the Middle East and large patches of the ocean floor. If we can't build a farm on a plot of land that was farmed as recently as a couple of generations ago - if we can't keep part of a coral reef alive even though it isn't even dead yet - why in the world would we suppose that we can travel to Mars and render its barren soil fertile? (Keep in mind that the primary difference between barren and fertile soil is the presence of existing biological matter. Martian soil doesn't have any biological matter in it. How's it going to get there? Here's one way, but it requires clay from Earth.)

For the entirety of human existence, life has involved extracting resources from out environment and using them. Full stop. Every animal does this, but only human beings make the kind of technology that changes the environment in potentially catastrophic ways. We're the only animal that produces our own fire, for example, and fire can burn a forest down. We're the only animal that has ever managed to scrape the bottom of the ocean floor clean of all life. These are catastrophic changes. 

Don't get me wrong, I'm not a luddite. Humankind's ability to produce technology has created a world that our primitive ancestors would certainly have considered to be the work of sorcery. We have become gods in all but one respect: we've figured out how to produce civilization when given wilderness; we have yet to figure out how to produce wilderness when given civilization. It's a tough problem to solve.

If we don't solve it, though, we can kiss our dreams of inhabiting Mars goodbye. Even supposing that Mars proves to be uninhabitable and we go searching for other worlds to colonize, we'll never even reach those worlds until we've figured out how to produce enough nature aboard a spaceship to provide ourselves with food, medicine, water, and technology along the way. 

Nor is "environmentalism" the solution to the problem. Covering the surface of the earth with solar panels and windmills is no better for the land upon which they reside than is clear-cutting an acreage of forest. There is no way to reuse or recycle medical waste, and if we intend to heal the sick with medical technology, then we intend to perpetuate medical waste, too. There is only so much leeway we can get from "vertical hydroponic gardens" and other such green fantasies. 

No, the problem here is that we human beings simply don't know how to terraform. We don't know anything about it. We know a bit about gardening, and a bit about landfills, and a bit about leaving virgin landscapes untouched. But we know nothing about creating and maintaining a viable ecosystem capable of supporting human life forever. 

How truly odd that a species of ape that specializes in manipulating the environment around it in order to survive knows so little about manipulating the environment in order to survive.

Creatine Versus Mere Hydration

Here's a quick post about creatine.

Last year, after reading about some studies that found creatine consumption to be safe for diabetics, I decided to give it a try. Long story short, I subjectively determined that creatine helped me feel fresher and better-able to do my workouts. So, I stuck with it.

What does creatine do? Well, in so many words, it helps muscles retain water so that they have more ready access to ATP, i.e. energy during exercise. Because these muscles have more energy at-the-ready, every time a person exercises, each round of exercise does more good than it would under a status quo scenario. How much more good? Well, studies tend to show that body-builders who use creatine are able to build about 6% more lean muscle mass than non-users, and that the gains are real. That is, the 6% more mass doesn't go away when you stop using creatine, it appears to be a real gain.

On the label of every package of creatine, you'll see that the directions indicate that anyone taking creatine should drink extra water. That got me thinking, "Drink extra water and take this harmless substance, and you will retain more water" sure sounds a lot like, "Combine this placebo with a diet and exercise regimen to lose weight." In the latter case, the placebo obviously isn't doing the work, it's the diet and exercise that is helping a person lose weight. So, what if the former case is analogous? That is, what if creatine is a harmless placebo that evinces users to drink more water? What if you can obtain the same benefits of creatine merely by drinking more water?

I put the question to my social circle, and no one seems to be aware of any creatine studies that specifically controlled for water consumption. Never mind the fact that such a study would be extremely difficult -- every two human bodies are different and thus have different hydration requirements, so how exactly could water consumption be held constant for the purposes of the study?

If my reasoning is correct, then, at least on a personal level, athletes interested in creatine supplementation should start by increasing their water consumption and testing whether this gives them 6% more gains, plus-or-minus an acceptable error rate. If so, there is no point to taking additional creatine.

Of course, since creatine is cheap and virtually harmless, there will always be a "what if." What if good hydration improves athletic performance by a full 6%... And then creatine supplementation could increase it another 6%? Athletes who are interested in such things will always be keen on experimenting to see whether they can squeeze out a little better performance. And there are almost no downsides to using creatine.

Still, this line of thinking was enough to convince me to stop using it.

Is It Unfair To Be Born Faster Than Everyone Else?

NBC news reports:

The IAAF wants Semenya, Niyonsaba and other female athletes with high levels of natural testosterone to lower them — either through medication or surgery — to be eligible to compete in events from 400m to the mile at top track meets like the Olympics. The IAAF argues that female runners with abnormally high testosterone levels have an unfair advantage.

When is an advantage unfair?

Steroids are made from synthetic testosterone, which is why they call them ster-oids. The issue in this case seems to be that athletes who are born with naturally elevated testosterone levels are capable of building larger, stronger, more powerful muscles than other athletes.

It's true that steroids give athletes an unfair advantage. Steroids create the kind of athletic advantage that cannot be overcome by training alone. They're also hazardous substances that cause major health problems for users over time. The reason steroids are banned substances is because, if they weren't, all athletes would be required to permanently jeopardize their health just in order to be able to compete, let alone win. Officials don't want to foster a sports atmosphere in which medical intervention is the major determinant of elite competitiveness. That all makes sense.

But, in this case, we're not talking about any of that. We're talking about women who have naturally elevated testosterone levels. They didn't ask for elevated testosterone levels. They didn't aggravate their levels. They were simply born on the upper tail of the bell curve and found a way to make use of their natural hormonal profile: Train hard, and win races.

At the elite level, every advantage counts. It is probably true that an athlete with abnormally low testosterone levels will always lose to an athlete with abnormally high levels. In a cosmic sense, that might not be fair. It certainly comes down to pure, dumb luck. But in the sense of starting from a blank slate and rising to the upper echelons of competitive sports through hard work, isn't it impossible to call this "unfair?"

There are a few problems here. First, "normal" testosterone levels are not a static thing. We don't have testosterone records that go back 500 years, but I'm willing to bet that, just as humans have grown taller over time, so human testosterone levels have changed. So who's to say that the line drawn today is worthy of setting a competition policy on?

Second, elevated testosterone is something experienced by multiple athletes in the same competition. There is no evidence that these races have come down to "whoever has the highest testosterone levels on race day wins." Instead, there has simply been a trend showing that those who test high also tend to perform well. The correlation is clear enough, and perhaps also the causation, but there's still a lot more to it than hormones.

Third, if the IAAF can make a determination about how much is too much testosterone among women, does that mean they also plan on doing so for men? Or is "too much testosterone" only something that matters among women? If this rule applies to both sexes then the IAAF will have a lot to account for when they start demanding medical intervention for qualification. And if the rule only applies to one sex and not the other, despite the fact that both sexes make testosterone, it's impossible to see this as anything other than sex discrimination, even beyond the medical discrimination issue already being discussed.

And finally, what does it mean to become a great athlete if the very biological differences that give us an advantage over our competitors are outlawed from competition? Will the IAAF eventually decide that only people of average height be able to compete? Only those with average-sized hearts or average hemoglobin levels? Should people of above-average intelligence be banned under the argument that they can train smarter than all other athletes?

If the body an athlete was born with - naturally - disqualifies them from competition, then what if anything is fair?

How Soon Until I Notice Changes?

The first question from every fitness novice when they first start a new training program is, "How long will it take to see results?" The question comes from a good place, but hinges on what counts as "results."

What most people mean when they ask this question is usually something along the lines of, "The whole reason I started dieting and exercising was to make my body look more attractive; how long will it be before I notice that my body looks more attractive?" The answer to a question like that is entirely subjective. In truth, the question is unanswerable. No one else can tell you how long it will be until you've changed enough to notice it. Some people work out for years and never "notice" anything, no matter how much their bodies actually change. Other people swear they see a difference after just three days, even though no one else can see it. Who's to say what the truth is? The Beachbody people have the right idea in that they recommend doing a basic fitness test and taking comprehensive photos before starting every new workout program, and at various checkpoints along the way. Your eyes can fool you for a long time, but there is no arguing with photographic evidence. For people whose goals are mainly aesthetic, I recommend Beachbody's approach. Just take photos every 30 days or so and call it macaroni.

For people whose goals are non-aesthetic, or whose aesthetic goals are incidental to their non-aesthetic goals, the question runs a little deeper. It might begin with the bald, empirical question. "How long will it take before I run X seconds faster per mile?" "How long will it take before I can bench press my body weight?" "How long will it take before I'm ready to summit Mount Rainier?" These are good, specific questions whose answers are, unfortunately, uncertain. A sixteen-week training schedule will improve your race time, your bench press, or get you in better shape for a big expedition, but there is no guarantee that doing X, Y, or Z over the course of sixteen weeks will result in a particular improvement. That is, if you engage in a good training program, you'll improve, but there's no telling by how much you'll improve. You just have to keep at it until you reach whatever goal you're aiming for. And if your goal is to do something like summit Mount Rainier, then you might just have to give it a try and see if you're ready.

But that doesn't mean there won't be any observable changes. The truth is, exercise produces a lot of observable changes in a relatively short span of time, and most of these are changes people don't expect. Some they even possibly ignore completely or thoughtless attribute to other factors.

Let's talk about some of the changes you can see when you start to exercise.

Six weeks of exercise is enough to create a statistically significant difference in a patient's microbiome. If you ask me, though, two or three days is enough to observe microbiome changes. Pardon my bluntness, but after taking on a new and vigorous exercise regimen, you should notice changes to the frequency and consistency of  your stool in as little as a few days. Confirm this for yourself. The above link goes on to state, "Further, the genetic expression of the bacteria changed so the bacteria produced more short-chain fatty acids, which reduces inflammation in the body and enhances metabolism." This means that it's not just that your microbiome consists of new bacteria; there are also felicitous physical changes within the old bacteria.

One to two weeks of exercise is enough to notice your changing relationship to food. I don't mean that your diet will suddenly become successful or that your cravings will disappear. What I mean is that bad food like pizza and french fries will start to noticeably slow you down. Where you might have once had little problem with a night of greasy pizza, once you take on an exercise regimen, you'll notice that you need good fuel to keep your training up to snuff. The day after pizza night will feel like a total drag compared to the day after lentil soup with fish and vegetables. Again, don't take my word for it; confirm this for yourself. You'll see.

One to two weeks of exercise is also enough for you to notice that beer and serious training is almost completely incompatible. I first noticed this phenomenon while training in college. I noticed that I wouldn't make any significant progress during the first week or two of any training schedule unless I eschewed beer. If I did, everything would be fine. Now, one or two beers every now and then might be alright, but even those one or two beers is enough to make you feel sluggish the next day, ditto for spirits. Wine, by contrast, seems to have little impact on training, so long as you (I?) don't drink more than a glass or two with dinner. Part of this is dehydration: As you tear up old muscle tissue and rebuild it with stronger muscle tissue, your body craves water to feed that process. Still, if this were solely a matter of dehydration, all alcohol would impact the body differently, and it is clear enough to me that wine impacts things a little differently. Wine is known to aid digestion, especially the digestion of meat; perhaps that and the changes to your microbiome account for the difference. I don't know. Your mileage may vary here; try it and find out for yourself. All I can say is that I can drink moderate amounts of wine while training, but drinking any other kind of alcohol is like putting my muscles in a blender.

One week of exercise is enough to increase your insulin sensitivity. This I know firsthand for obvious reasons. Just yesterday I ate a meal with in excess of 45 grams of net carbohydrates, not counting the wine or the tomato sauce that surely involved at least another 10 grams. This is a dinnertime meal that would ordinarily correspond to three units of bolus insulin for me, but due to my increased insulin sensitivity, not only did I go low, but steeply low, dipping down to 50mg/dL of blood glucose for the first time in months; and that, too, after snacking on a few treats because I felt my diabetic body's telltale carb-craving.

Healthy people won't have to worry about hypoglycemia, of course. For you normals, insulin sensitivity is all-upside, no-downside. One week of training is enough to start the process.

A few days, possibly as little as two, are enough to change your sleep patterns for the better. After committing to daily exercise, you'll get more deep sleep and more REM sleep. You'll fall asleep faster, and you'll wake at a time that corresponds more closely to your circadian rhythm (unless, of course, your alarm clock doesn't line up to that). You might even notice that the total hours of sleep you need to feel well-rested decreases as your sleep quality increases. This is certainly true for me. Six to seven hours of sleep is perfectly adequate for me if I am training. Eight hours is what I need if I'm not training.

One week of exercise is enough to make you feel more energetic. This one is a bit of a paradox, since a lot of vigorous exercise will also tire you out. Somehow, though, physical fatigue hits you in a way that doesn't decrease your subjective "energy level." You can be tired from exercise without nodding off at your desk in the morning, which is a marked contrast from being tired from a late night or an extended happy hour. A "girls' night out" will have you in bed all day the next day; a long run will possibly result in a nap that afternoon, followed by a surprising readiness for the next adventure, whatever it is.

So, to sum up: How soon will you notice changes when you start a new exercise program? If you include changes beyond just what you look like in the mirror, then the answer is a highly encouraging two days at the minimum, and two weeks at the maximum. That's not a lot of time at all.

Competing Pardigms

As of this writing, the dominant theory on human health appears to be: Eat very little, limit carbohydrates, and do mostly strength training. Or, perhaps it would be more accurately summarized: ketosis and weight lifting.

Advocates of this approach recommend training your body to metabolize protein and fat in its resting state, so that you don't risk carrying a lot of body fat. While many people who follow keto-style diets don't have the whole story on why cardiovascular exercise is generally avoided by keto practitioners, the idea there is that, since cardiovascular exercise promotes fat matabolism, and therefore some fat storage, cardiovascular exercise is bad for losing weight. Besides, many will continue, weight lifting burns just as many calories and building more muscle mass means increasing your body's Basal Metabolic Rate (BMR). So, even though exercising doesn't hold a candle to dieting for weight loss, building more muscle mass is better than not building that muscle mass. Even if the BMR boost is small, it's still positive. Meanwhile, remaining in ketosis will take care of all that pesky fat tissue. Play your cards right, and you'll soon look like Ronnie Coleman, or so the argument goes.

(Never mind that Ronnie Coleman never actually ate like that.)

Under this paradigm, a person will eat mostly meat and vegetables, and very little of anything else, while doing some daily weight lifting. This is certainly a much healthier lifestyle than the average American is currently living, so if you're the kind of person to whom this lifestyle appeals, I say go for it.

Even so, I'd like to present you with a viable alternative that is at least as healthy, and possibly a lot healthier. That lifestyle can best be summarized as: do a lot of hard cardiovascular training, and eat a Mediterranean/DASH type diet consisting of lean meats, plant-based unsaturated fats, and whole grains. And don't go into ketosis.

The first reason I recommend this kind of lifestyle over the keto/weight-lifting lifestyle is because it is precisely the kind of lifestyle recommended by every doctor and dietician worth their salt. The second reason is because it is the only diet and fitness lifestyle that is consistently supported by scientific evidence.

But if that isn't enough to convince you, then consider a few more things.

Let's tackle the question of burning fat. A keto practitioner aims to burn fat and metabolize protein while his body is at rest. An endurance athlete, by contrast, aims to burn fat during exercise. The sweet-spot for this starts after twenty minutes of cardiovascular exercise and continues for up to about ninety minutes before tapering off. So, any cardiovascular activity you engage in that lasts between 20 and 90 minutes will primarily metabolize fat. If you have 45 minutes today, you can burn a bunch of fat cells and still eat fruit and drink milk and have a little pasta. There is no need to sacrifice pleasant and healthy food like blueberries and whole grain toast in order to burn fat off your body. You just need to spend between 20 and 90 minutes, several times per week, burning fat as fuel for exercise.

I grant that ketosis will enable you to do this while at a resting state. But the science of the matter is that you don't have to, and having that other option just might appeal to you. Especially if you like fruit.

What about increased muscle mass and an elevated BMR? Won't you have to give those up if you focus on cardiovascular exercise? No. The reason is because cardiovascular activities like running, swimming, and cycling still build lots of muscle; it just happens to be a smaller-yet-denser muscle tissue, compared to the hulky fast-twitch tissue required for weight lifting. In other words, endurance athletes still have more muscle mass and higher BMRs than sedentary people, even though their muscles appear smaller.

You might prefer the aesthetic appearance of a linebacker to that of a marathoner, and if so, more power to you. Lift weights. But, if you've been eschewing cardio exercise under the impression that you won't be as healthy as you will if you stick to weight lifting, then I have some good news for you: Do all the cardio you want, you'll still build muscle mass and enjoy a higher BMR.

A final important consideration here is the impact of cardiovascular fitness on longevity. As of my writing this, there is little evidence to support the notion that lifting weights extends your lifespan; but there is solid evidence in favor of the notion that cardiovascular health makes you live longer. So, if your goal is not only to lose weight and be healthy, but to live a longer life, cardiovascular exercise offers you something keto + weight lifting cannot.

So, which paradigm is for you? Burn fat while resting and never eat a carbohydrate? Or burn fat while exercising and eat tons of fiber? The choice is yours. I know what I've chosen.

Supplementing My Life Away

For a while now, I’ve been adding supplements to my diet, and I’d like to dedicate some space here to the supplements I’m taking and why.

I started taking a multivitamin some years ago. While I recognize that there is little evidence that these vitamins are actually absorbed, they don’t cost very much money, and I am a diabetic. Diabetic people don’t absorb vitamins very well. There are two ways to think about this: The first is that we diabetics have even less of a reason to take a multivitamin; after all, if “normal people” can’t absorb the vitamins in a vitamin pill, diabetics are even less likely to be able to do so. The other way to think about it is that, since I’m getting fewer vitamins from my food than “normal people do,” I should throw more vitamins at the problem in hopes that it does some kind of something for me. I chose the latter way of thinking about it, although I concede that the former is probably more logical.

For a long time, that daily multivitamin was all the supplement I took. Then, one day, a colleague of mine at work mentioned that he was taking milk thistle. He didn’t strike me as being the voodoo-hippie-supplement type, so I asked him about it. He said that milk thistle was good for your liver, and from this I gathered that my colleague started taking milk thistle as an insurance policy against his appetite for weekend partying. No judgement here, he was a virile twenty-something guy doing what virile twenty-something guys do. But it was enough to cause me to do some research on milk thistle. As it turns out, milk thistle is genuinely excellent for the liver. The data is pretty clear on that, it successfully lowers the primary marker for liver disease. I’m not a hard-partying twenty-something, but we diabetics, in addition to poor vitamin absorption, often suffer from liver failure. So, I started taking a half-dose of milk thistle daily as a preventative measure.

That brought me up to two daily supplements, but after a short while, that wasn’t enough for me. I started to wonder, if there are legitimate supplements out there, like milk thistle, what else might I be missing? I started to do some more research, ruling out all the useless supplements and getting curious about the ones that had data to back them up.

One supplement I discovered was called “phosphatidyl serine.” According to some research, there is some weak but not terrible evidence that phosphatidyl serine reduces the cortisol response in the body after exercise. If true, this would prevent my blood sugar from spiking after a hard workout. I bought a bottle and started taking it daily, but eventually looked at the ingredients list. There was only one ingredient: soy lecithin. After some additional research, I realized that the reduction in post-exercise cortisol was something that could be achieved by eating some protein; so the main benefit of phosphatidyl serine is that it’s a miniscule amount of protein.

So, I struck out there. But no big deal. It was a harmless health experiment.

Next on my list was glucosamine. Glucosamine is often prescribed to arthritic dogs, and since it’s over-the-counter, arthritic humans also sometimes take it. It’s not a cure for arthritis, not by a long shot, but it has strong evidence in its favor. That is, the evidence suggests that it very definitely does some good, but only a little bit of good. It’s also cheap and has no side-effects, so I bought a bottle and started taking one daily. This time, the experiment worked like a charm: I have literally not had tendinitis since I started taking glucosamine, despite increasing my exercise frequency and running perhaps more than I have in the previous ten years. To be fair, I don’t know for sure that glucosamine is what made the difference here. Maybe I somehow managed to improve my running form after 30 years of great form. Maybe. But my family is prone to arthritis, and my anecdotal experience suggests that the glucosamine is doing some good. So I’ll keep taking it.

The next one I thought I’d try was coenzyme Q10. Coenzyme Q10 is a coenzyme that the body naturally produces and that helps the heart do what the heart does. Some people have a medical issue wherein their bodies are deficient in coenzyme Q10, and for those people the CoQ10 supplement is actually a total solution. The supplement restores their CoQ10 levels and they return to living normal lives. For most other people, there is no harm in CoQ10 supplementation, but it’s not clear that anyone really benefits from it. I did some research and discovered that, at least epidemiologically, diabetics tend to have lower than average CoQ10 levels. So, when it went on sale at Costco, I bought some. I figured, there are no side-effects, the price is right, and it might do me some good. I’ve never had my CoQ10 levels checked, but I am diabetic, so why not.

Here's where things get interesting. After several weeks of daily CoQ10 supplementation, I observed a very small improvement in my blood glucose control. In addition, I simply felt better. Was this a placebo effect? Possibly. But when I go on vacation, I don’t take my CoQ10 supplements with me, and I always feel a little worse. Then I get back home to my supplements, and I start to feel better again. I repeat: this might be a placebo effect. But it’s working for me, so I’ve been keeping up with my CoQ10. It seems to give me a little more energy and… I don’t know… spry-ness, maybe? Virility? (Not like that, perv.)

Two days ago I started taking Niagen. Niagen is nicotinamide riboside, i.e. a form of vitamin B3. The thing about nicotinamide riboside is that, as it gets absorbed in the cell, it “activates” some genes associated with anti-aging. Every form of B3 activates genes in order to absorb the B3, but only nicotinamide riboside activates these specific genes. This much is factual. The speculative theory is that, by activating these genes, nicotinamide riboside actually gets the body to do “anti-aging stuff.” If true, it would prevent some cell aging, notably in the brain, but also in the body, thereby preventing cognitive decline, and also physical decline. People self-report that nicotinamide riboside supplements make them feel younger, look younger, perform at a higher level of athleticism, get better sleep, and many other things. I have no idea whether these claims are true. But I decided to try a bottle and see what happens.

Finally, today, I started adding creatine to my post-run protein shake. The benefits of creatine are thoroughly described elsewhere. The short story is that creatine really does cause muscles to retain more water, and thus improves their ability to absorb nutrients and create ATP during exercise. In the end, this causes people who exercise to get a little bit more out of their training sessions. The reason I had previously avoided creatine was that it was supposedly contraindicated for diabetics. According to more recent research, however, that’s not true.

Another cool thing about creatine is that it is associated with higher levels of insulin-like growth factor, which has anti-aging properties, and which also (as the name suggests) lowers blood sugar levels. So, I’ve been keen to try creatine, and today I finally did.

We’ll see where all this gets me.

I Have Two Things To Say

The first is, yes, I'm still here.

The second is, check out this awesome comment from a recent EconLog post:

I wish economists/sociologists would stop running a linear regression on ordinal outcome variables. A 0.56 decrease on a 4 point-scale doesn't mean anything because the scale is ordinal and saying such-and-such leads to a 0.56 decrease is treating it as cardinal. The reason why you can't do that is because a trust level of 2 does not reflect twice as much trust as a trust level of 1.

This comment demonstrates advanced understanding of statistics, the kind that wards off mistaken conclusions, the kind that I wish were more common among numerate people. 

Science Puzzle

From Gizmodo.com:

On November 14th, skygazers will witness the closest full moon, or “supermoon,” of 2016. But more excitingly, it’ll be the closest full moon since 1948—and we won’t get another one like it until 2034.

So it's been 68 years since an orbital perigee, but the next one will happen just 18 years from now? I can't think of why that might be. Does anyone out there know?

Fitness Tracking As Augmented Reality

For a long time now, I've struggled for the right words to explain why I like fitness trackers so much. It's not that I'm obsessed with the data, and I was already a fitness nut before I got any of this stuff. What is it about these apps that I find so engaging?

A few days back, I downloaded Pokemon Go and gave it a whirl for a few minutes. It was fun, but it also seemed to use a lot of data and battery power. I also didn't like how I had to keep my eyes glued to the screen, rather than walking around with my head held high, enjoying the scenery. After a quick walk around the neighborhood, I uninstalled the game.

But don't get me wrong: I saw the appeal. What could be more fun than going on a little treasure hunt, no matter where you are in the world? What's more literally engrossing than having your own surroundings become the location of a video game? It was cool.

Over the course of the next several days, I observed the tsunami of Pokemon Go virulence via social media. That was not as much fun, but whatever. People are talking about what is currently the most popular game out there. People talked about Angry Birds, Farmville, Cards Against Humanity, and etc., too. People talk about football basically non-stop. People like to talk about games, and more power to them.

But what I came to realize as I read the various social media posts and articles about this particular augmented reality game is that I already have an augmented reality game of my own, which I have been playing for years now. I'm talking about the "game" I play when I use my running watch / fitness tracker - currently the Microsoft Band 2.

Like a "true" augmented reality game, I go out into the world, and my game follows me there. I interact with the digital augmentation of reality via my wearable tech and collect points along the way. I can compete with my friends for these points, track my progress over time, improve my score, and so on. The only difference between my game and everyone else's is that mine is merely augmented information, as opposed to the augmented imagery of a true AR game. Augmented metaphysics, if you will.

The criticism you could offer here is that tracking your health data isn't actually a game. Fair enough, but it's as much of a game to me as anything else is. I don't spend a whole lot of time playing video games on my phone, but on the other hand, I'm always anxious to interact with my fitness trackers and data. 

Sleep, Insulin, And Wearable Tech

I woke up with extremely high blood sugar yesterday morning, which I fought to reduce all day long, to only partial satisfaction. And yet, there didn't seem to be any obvious reason why this would have been so. I had a very healthy, low-carbohydrate dinner the night before, took the appropriate dose of insulin, took my Levemir, had a really nice, low-stress evening full of great conversation with my spouse, and headed to bed at a reasonable hour. I slept through the night and had a nice dream.

What happened? Well, this happened:

Output from my Microsoft Health sleep dashboard

On this graph, orange represents time spent awake after clicking the "sleep" button on my Microsoft Band 2. Light blue represents light sleep, while dark blue represents deep sleep. As you can see, on Thursday I got plenty of sleep, but absolutely no deep, restful sleep whatsoever.

As we diabetics know, a lack of sleep causes the body to produce cortisol, which both raises blood sugar and increases insulin resistance. It's a double-whammy of increased blood glucose levels and a reduced ability to bring them down. My blood sugar was high all day yesterday, and now I know why.

To better manage my blood sugar, I should look into how to get the most out of the sleep I get, but that's a huge problem. A more immediate solution would be to simply check the sleep output from Microsoft Health and adjust my basal insulin intake accordingly: Less sleep should mean more insulin to get me through the day.

News pieces are still coming out about some of the design flaws in the Microsoft Band 2, and almost all of them are serious problems with the physical durability of the product. This is a real shame, because, as I have written elsewhere, the actual functionality of the Band 2 is basically the best of the best. By pure functionality, the Band 2 wins on virtually every metric you can throw at it. This thing can do almost everything you'd ever want a wearable fitness watch to do. The fact that such a powerful device breaks so easily is very disappointing. I guess there are reasons to look forward to the next generation of fitness trackers, after all.

Some Links

• The alligators have finally reached Dallas, Texas. No one knows how.
• Neanderthals cooked their meat and conducted rituals as far back as 176,500 years ago, long before homo sapiens existed.
• Yet another drug that holds the potential to reverse Type 1 diabetes. That doesn't help those of us who don't have any beta cells left, but still very cool.
• Compression gear - tight, spandex workout clothing - is scientifically better for endurance and post-workout recovery.
• I Sweet Talked again.

Space Race

Could anything be more Stationary Wavesy than an astronaut running a marathon in outer space?

British astronaut Tim Peake became the first man to complete a marathon in space on Sunday, running the classic 26.2 mile distance while strapped to a treadmill aboard the International Space Station. 

As part of the London Marathon, Britain's biggest mass participation race, the 44-year-old spaceman saw London's roads under his feet in real time on an iPad as, 250 miles below him, more than 37,000 runners simultaneously pounded the streets.

While this is undoubtedly a puff-piece, and possibly a PR stunt by either the organizers of the London Marathon, or the UK Space Agency, or both, I think it showcases an important step in the evolution of human society.

After all, Peake didn't just plod along on a treadmill, he viewed the marathon from an iPad. The article doesn't say that he completed the marathon "virtually," but how far away from that are we now? I can imagine little remote-control drones traversing the course in real-time as their treadmill-bound "pilots" control from afar.

No, I don't think this is the future of marathon running. That's not the significant thing here. The significant thing is the way in which our relationship to the world is changing. In essence, Peake completed a marathon via Skype. We're already working remotely and having video conference calls. My daughter spends a little time with her grandparents almost every morning via Skype. Slowly, but definitively, we are changing what it means to be "present."

I don't mean this as any sort of criticism, by the way. There is nothing to criticize. This is simply the direction we're headed. It's an amazing time, and it will be interesting to watch it unfold.

As for myself, I will never feel as good as I do when I'm running alone, in the mountains, with no electronic cameras or devices nearby. (Except perhaps for my fitness tracker.)

Some Links

For just $500, you can combine fitness tracking technology with a full-body scanner to get even more insight into how your body is changing as you exercise. This is not actually too rich for my blood, but I think I will wait and see whether the technology catches on first.

Science tells us the keys to an effective apology. (H/T Marginal Revolution) Faithful reader PR remarks that this is more reflective of society's current obsession with "science." After all, the findings are basically common sense.

This is probably an old article, but I wanted to gather some ideas for speed workouts I could try over the next few weeks, and its recommendations were really helpful. Note that the distances all work out to be about five kilometers. That's not a coincidence.

The sound you make when you laugh changes, depending on whether you are with friends or strangers.

Some Links

1. The evolution of Deepika Padukone. Interesting throughout.
2. My latest at Sweet Talk Conversation, on hermeneutics. Adam Gurri provides additional context.
3. David Henderson lauds Barack Obama. I would guess that this sort of politicking requires a great deal of experience, which explains why Obama failed to take advantage of similar opportunities in earlier diplomacy with the despots of Africa and Latin America.
4. Catherine Rampell on the soda tax, or as I have called it, making it illegal to be fat.
5. They were also discussing the ramifications of fat-versus-skinny on the Jason Ellis Show yesterday. I was going to link to it, but his show archives are only current up to February 6th. Watch that space for the 3/23/2016 show, and you'll be able to see how it dovetails nicely with link #4, above.
6. I need to write something about this totally awesome article on running form, but I haven't figured out how to say it better than she already said it. Read it now!

Bonus content! Here's some video footage I took of the storm cell that rolled in on me last night, with some commentary. Later on, the weather radar detected circular motion in the clouds and we had to take cover, but luckily it was a small storm that passed by uneventfully.