If you consult most orthopedic bodies of authority, they are incredibly fatalistic about the prospects of adult joint cartilage, stating definitively that it does not regrow. In fact, they’ll usually throw in something about how it “can’t” regrow due to the fact that there is no direct blood supply. Umm... yeah, about that. No one ever said it needed a blood supply. Cartilage uses a diffusion process to obtain nutrients. It would be gone in a single month around the age of twelve if it couldn’t obtain any nutrients.
Beyond anecdote, studies already prove that joint cartilage does regrow: https://jamanetwork.com/…/jamainternalme…/fullarticle/410037 This includes hips, knees, shoulders and the discs between vertebrae in the spine. In fact, even the once-believed-to-be impossible disc herniation, it turns out, often spontaneously heals: https://www.sciencedirect.com/science/article/abs/pii/S1878875011004992 Cell turnover rates in the body are incredibly well understood. Anyone who insists that tissue has a one way ticket of no capacity to recover or heal is ignoring the entire subject of biology. There is only one situation which will irrevocably degrade joints, and it has nothing to do with age or injury or anything people tend to blame. Rather, joint tissue degrades via unloading: https://www.nature.com/articles/s41536-017-0016-1. That's right. When you stop putting pressures on cartilage, it has ZERO capacity to even maintain its current integrity, let alone get better. We've known this for a while, thanks to astronaut studies, wherein young, fit, perfectly healthy and athletic people "age" their bones, muscles, and other tissue the equivalent of 50 years from just a few weeks of weightlessness: https://phys.org/news/2010-08-astronaut-muscles-space.html. Even children whose legs are cast have loss of knee cartilage. It's a fully known phenomenon. This is why we have to load structures, especially when we fear they may have accrued damage and wearing. The loading restores them. Why? Because the MECHANISM. We understand the MECHANISM. Diffusion requires pressures. As we take away pressures (inactivity, decreased loading, etc.) we take away the known process to manage cartilage. As we add pressures (strengthening, movement, loading, etc.) we enable the diffusion process. Does this mean any old pressure will do? Of course not. Repetitive pounding on the same angle of the joint will likely outstrip the regenerative rate. Again, this is where controlled strength training defeats all other modes of exercise. You place pressures in a controlled fashion on the body at different angles, with variant tensions. Thus, diffusion. Whereas walking, distance running or cycling will tend to hammer the exact same spot over and over. And cartilage does have very slow cell turnover rates. So frequent high volume repetitive activity will likely degrade or accelerate joint degradation. We’d expect, therefore, to see a nice bell curve of joint degeneration based on activity. At one end (underuse) there will be a high incidence of cartilage loss, strength loss, and other musculoskeletal loss. At the other end (overuse) there will be a high incidence of cartilage loss. At the underuse end, we’ll find a rampant degeneration because inactive people will have other metabolic factors impeding the repair of all tissue. In the middle, we will find some asymptomatic people. Look it up. Every analysis confirms this expectation. Likewise, reducing body mass (specifically fat mass) will reduce the chronic overuse burden on joints. Thus, on summary papers, researcher look at this issue and find that weight loss improves joint defects: https://jamanetwork.com/…/jamainternalme…/fullarticle/410037. The individuals who have improvements in cartilage defects included some sort of physical activity, but not excessive repetitive activity. They still abided by diffusion, but didn't overwear the cartilage. They improved nutrition, such that cells can actually repair themselves.
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Since none of them have comprised the majority of American food and eating behaviors for at least the last 20 years. I think back to school lunches in the 80s, and it’s hard to recall a single protein-dense meal or really any meal where grains and plants weren’t the vast majority of the plate. Heck, even on Mac and Cheese day, I doubt the dietary fat content outweighed the carbohydrate content.
On the “report card” of American eating in the past two decades, researchers agree that carbohydrates always comprise over half of the nutrition (https://now.tufts.edu/…/report-card-diet-trends-low-quality… ). Always. Americans are more vegetarian on average than anything else. And most of those plant-derived foods are processed to death. And it’s been this way for a long time. The call to reduce our protein consumption and meat intake is a little at odds with the data. We may produce and buy a lot. But we don’t eat a lot. Keep in mind American food waste is out of control, clocking in somewhere around 40 percent (yes, that’s right - we throw away 40 percent of our food). People don’t eat protein, meat, fats, or real salt. I’ve been doing consults with gym-goers and would-be gym-goers for over 15 years. We’re talking tens of thousands of people. And most of them report back something like, “we maybe eat red meat once a week, chicken once or twice, and seafood once.” They’re talking servings, mind you. That’s like 4 servings of protein-dense food per week. They go on to describe their “healthy” eating habits: oatmeal, cereal, whole grain pastas, whole grain bread, etc. Where exactly is this massive overconsumption of real fats, real salt, and meats? As far as I can tell, only in healthy people. No, seriously. The only people I’ve ever heard in a consult report back a majority protein intake in their diets were fit. They were lean. They were healthy. They had optimal body fat percents and no CVD risk factors. Do our food industries produce too much fat, meat and protein? Maybe. But we don’t eat too much. Walk through a grocery store and show me the tiny butcher counter and the minuscule shelf with butter or ghee or oils on it. Now, show me the rows upon rows upon rows of cereals and pastas and overflowing boxes of potatoes and corn and an entire 2/3rds of the store dedicated to fruits, juices, snacks, etc. I mean, it's built into our Americana songs for crying out loud. We sing about amber waves of grain, not beef as far as the eye can see. The popular criticisms on American diet don’t look at the fact that our primary nutrients are plant-derived and carbohydrates. Thus, the common criticisms can’t be anything else but utter nonsense. In yet another medical study, we find type 2 diabetes entirely reversible: https://www.cam.ac.uk/…/type-2-diabetes-remission-possible-…
I applaud the effort, but I’m also sad that this is somehow news to people. Receptors in the body change daily and throughout our lives. You can always become more or less tolerant/sensitive to any compound, including sugar. We didn’t need hundreds of in vivo studies on symptoms to tell us this. More than half of all heart attacks occur in people with normal/low cholesterol: https://www.sciencedaily.com/releas…/2017/…/170412105837.htm
And, despite the fact that white females have almost 50% higher incidence of high cholesterol than white males (https://www.cdc.gov/cholesterol/facts.htm) males are twice as likely to have a heart attack: https://www.health.harvard.edu/…/throughout-life-heart-atta… From at least 1988-2010 Americans reduced their total cholesterol and LDL numbers: https://www.ncbi.nlm.nih.gov/m/pubmed/23073951/ Yet cardiovascular disease deaths have been on the rise ever since: https://www.mdmag.com/…/cardiovascular-disease-deaths-on-ri… . In-depth analysis of heart disease risk and cholesterol has repeatedly failed to verify cholesterol as a cause. Contrary to expectation, every time massive datasets are examined, most of the interpretation points the opposite direction: https://www.nhs.uk/…/study-says-theres-no-link-between-cho…/ That’s right. Lowering cholesterol ought to raise risk of heart disease. This would actually make more sense with the known biology, since cholesterol plays a vital role in controlling cardiovascular inflammation (the actual cause of heart disease), is a building block in every single cell of the body, and it’s the precursor to make every hormone that keeps us alive and lets us enjoy life. “But didn’t we find that lowering cholesterol lowers risk?”, you may ask. No. What we found is that people who are so scared to die that they take a statin may trend toward statistical risk reduction. That could be due to the fact that patients have accepted they are at risk and are concurrently taking OTHER steps to stop killing themselves with other lifestyle behavior changes. This is called sample bias or embedded causation. It may also have to do with the fact that statins are synthesized from fungus and exert antimicrobial properties similar to other antibiotics. Again, since most heart attacks occur in people with low or normal cholesterol, and since we know for a fact that plaque develops in unhealthy people even when they lower blood serum cholesterol, cholesterol is a red herring. Heart disease IS rampant atherosclerotic plaque buildup. We understand it pretty well. Immune function and dysfunction play a strong role. The antimicrobial properties of statins, therefore, are more explanatory for any possible benefit they may appear to have than the cholesterol-reducing impact. Just like with other antibiotics, patients may experience lower infection rate/duration/severity, creating a net reduction in total damage. Thus, in turn, we might expect less rampant plaque buildup. “But isn’t the atherosclerotic plaque made OF cholesterol?”, you may be thinking. In part. It’s also made OF calcium. Why aren’t we eliminating calcium? The damage to the blood vessel walls around the buildup is from white blood cells. Why aren’t we eliminating white blood cells? Plaque formation also results from cell leftovers. Why aren’t we getting rid of cell waste? In fact, this is the question on which you want to focus. There is a much more straight-forward correlation of heart disease for people who have persistent hypertension and diabetes or prediabetes. These people don’t clear the body of excesses, by definition. Ergo, accumulation (of lots of things, including plaque) results. “Isn’t one type of cholesterol different than another?”, you might ask. Precisely. Moreover, levels in your blood fluctuate within a day, because you make different amounts based on many changing factors. But you know what doesn’t fluctuate a whole lot? The amount of cholesterol and fat which ISN’T in the blood and isn’t in your food. Blood serum cholesterol and dietary fat intake represent an infinitesimally small percent of cholesterol and fats in the body. You could eliminate all cholesterol from the blood and there’d still be more inside that person than was removed. Every cell in the body is made from cholesterol. It’s everywhere. You could eliminate all fats from the diet and you’d still be confronted with the fact that the average American carries over 55lbs of excess stored fat. That’s over 25,000 grams. Eating 0 grams of fat versus 17 grams in your meal today won’t even be noticed by your body. There are tens of thousands of grams already inside you. Trying to reduce risk of plaque without dramatically reducing body mass is a fool’s errand. The final cause of death for everyone is adrenal crisis. It doesn’t matter if they’re shot and bleed out, stroke out, or age and tire out. The last thing that happens at death is the body is so damaged and defeated that we can’t summon adrenal output to keep other systems working and other cells alive. What is the precursor for adrenal output? Cholesterol. What keeps cells alive? Cholesterol. Without cholesterol, life doesn’t exist. That said, adrenal glands must increase output tenfold when we get an infection. So it may turn out that statins provide a net benefit, prolonging the life of adrenal health, in that their antimicrobial properties reduce infections. It’s a rather complicated cost-benefit evaluation, since statins also damage other organs. Regardless, the pseudoscientific canard about cholesterol and dietary fat from the 1960s has to go away. People dangerously accumulate plaque from unmanaged health and stress. People don’t dangerously accumulate plaque because of cholesterol and its natural healthy role of being a building block of life. In fact, the causal arrow goes precisely in the opposite direction: IN ORDER TO ADDRESS THE DAMAGE, the body increases its production of cholesterol to try to manage the damage. When an unhealthy body fails to synthesize hormones from cholesterol, guess what: there will be more unused cholesterol present in the blood. When the same unhealthy body fails to clear cell waste and energy, guess what: more will be present in the blood. Reducing cholesterol isn’t the answer. Managing health is the answer, which, in turn, will result in lower blood serum cholesterol. But that’s entirely beside the point. We want to reduce the accumulation of plaque. We want to build a healthy body that can clear plaques and rebuild damaged vessels. We don’t simply want to reduce the production of life-saving hormones. Pay attention. It’s not a coincidence that the exact same company (Pfizer) had the same best-selling cholesterol drug (Lipitor) the same years that it had the best-selling erectile-dysfunction drug (Viagra). We make testosterone and all of the steroidal hormones from cholesterol. Remember, many people successfully achieved lower cholesterol only to find that they are the majority of heart attack victims. Low cholesterol will kill you. Type 2 Diabetics Become Less Diabetic by Eating Less Carbs And Adding More Dietary Protein And Fat?11/5/2019 Brace yourselves. The natural condition in the body of gaining a resistance toward repeated overexposure to a substance can be improved by... wait for it... NOT repeatedly overexposing the body to that substance. I know. Shocker.
Yet another formal study is examining the reversibility of type 2 diabetes some 50 years after the mechanism was well understood: https://nexs.ku.dk/…/reduction-of-carbohydrate-intake-impr…/ People who’ve built a resistance to the impact of alcohol can regain sensitivity to it by reduction or abstinence. People who’ve gained a resistance to the impact of caffeine can regain sensitivity to it by reduction or abstinence. But people who’ve built a resistance to the impact of glucose or insulin? Nah. Why would cellular receptors, which are incredibly well understood, operate the same for type 2 diabetes as they do for absolutely everything else in biology? Am I right? Right? Hopefully you caught the sarcasm. Somehow people think diabetes research is new and hotly-debated even though we have Egyptian descriptions of it from over THREE THOUSAND years ago. Since at least the 1970s we’ve known that controlling blood sugar IS the therapeutic intervention for type 2 diabetics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014359/ What might be the most profound way to slow or stop the damage caused by uncontrolled blood sugar? Maybe... ... control it better. Yep. We needed a study to tell us that. Not a joke. Despite the overwhelming evidence and paper after paper showing incontrovertible proof that dietary interventions at the very least slow the progression of diabetes, we may as well add another to the pile. It’s not just a moving poem by Robert Frost, nor is it merely one of my father’s favorites. People tend to confuse it with the book by M. Scott Peck, and easily pass over it as a florid work of art, not one of the wisest commentaries on how to live. I would argue it’s probably the best consideration one might contemplate when thinking about healthy living and fitness.
Sociological laws push people into common and basic behaviors. Then people repeat them. And, therefore, people tend to interface with the same problems, challenges, and outcomes for life. But what about that road not taken? I hear people talk about themselves as an unmoving and non-growing entity, and I cringe. “I always,” they begin a sentence. I shudder. “I’ve always,” they say. I wince. “I never,” they boast. Ouch. Always and never? Well, you can replace yourself with a robot then. Humans can be dynamic if you’d like to join us. An automaton can occupy that static position of zero growth you keep talking about. People cling to labels in order to fool themselves into a delusion of permanence. Everything is impermanent, folks. And if you were to actually carry the same exact thinking and personality traits your whole life, what a sad and tiny life that would be. You’re a person, not a printing press. But I get it: it’s scary. Stepping into reality is anxiety-producing. It’s safer and more predictable to every day recreate a fictional narrative about who we’ve “always been.” You’ve haven’t ever been anything. Human beings aren’t products. They’re processes. There are so few cells in your body today which existed 10 years ago. And in 10 years this “self” you’re trying to convince us all about will be almost completely revised with different cells. You haven’t always been any one thing. You won’t always be any one thing. In the time it took you to get from that last sentence to this one, you are a different physical specimen. No, seriously. Hundreds of trillions of nucleotide changes just occurred inside of you. This isn’t opinion. This is scientific reality. But the ego doesn’t like science. It doesn’t enjoy the idea that every next moment is an opportunity to be someone else. So we choose not to be. We create incredibly complex sophistications to justify why we shouldn’t change, can’t change, won’t change. It’s the fates, the stars, the genetics, the “way I am.” The mere suggestion that we could be someone different is so destructive to the ego that people can feel themselves get hot when they hear the idea. Defenses rise. And before they let themselves ponder the implications, they’ve already written a formal treatise to substantiate their egos. No. The way we are is a human animal. And we can take the road not taken. There is no obligation to continue reinforcing for our egos that we must always do what we’ve always done, always be who we’ve always been, always get what we’ve always had. Plenty of people start other languages, instruments, skills, careers, late in life. There are people with autism who become great public speakers. There are outgoing people who get tired of social interaction and introverts who get worn out from solitude. Dali was no more an “artist” than you can be. Newton was no more a “thinker” than you can be. Healthy people become unhealthy all the time. Unhealthy people become healthy people all the time. I don’t disagree that people are generally the same and predictable. I just don’t believe that they have to be, because of hard evidence. That flimsy rule of “never-change” you’re trying to hold up needs only one single counter example to forever dismantle it. You know there are multiple counter examples. You know there are people who do change. You know in your heart of hearts that you have changed. I’m not saying anything you don’t already know. I’m just saying it again in hopes you will embrace it. It’s simple, really: take a road you’ve not taken. Achievements do make us feel good, usually, on average, all things being equal, if we look at the bright side, when things are going our way, while we carry a spirit of gratitude. You get the idea. We have to add caveats to make the statement true, because there are ample examples to the contrary. Your beliefs and comparisons dictate whether something gives you satisfaction.
When people goal set with regard to health or fitness, a great followup is, “why is that valuable to you?” You can get fit and then take it for granted. You can acquire wealth and take your ease of lifestyle for granted. You can become world champion and decide NOT to appreciate that accomplishment every day thereafter. We see exactly this varied response in studies on wealth and happiness: https://www.visualcapitalist.com/…/money-happiness-large.ht… I once coached a couple who could not perform 10 consecutive kneeling pushups when we met. Less than a year later, they each could do handstand push-ups. But all the while, including when this was a regular part of their repertoire, they both said the oddest response: “I don’t feel like I’m making any progress.” This went on for months. I dismissed it as a joke for a while. But then, it appeared to have a serious tone. It perplexed me. Both people got incredibly more athletic, way leaner, doing activities they couldn’t ever do. But they kept saying, “I don’t feel like I’m making any progress.” They couldn’t bow forward with a 45lb bar and any control when we met. Now, both were deadlifting 1.5-2 times bodyweight. Nonetheless, “I don’t feel like I’m making any progress.” So I asked, “compared to what?” I said, “what exactly is it that would confirm for you that you’re making progress?” With painfully disappointed tones, they replied, “well, you see, we still get out of breath.” Lol. Ah. Nonsense comparisons and expectations will do that to you. When you go hard relative to your ability, you will always get out of breath. I take Division I athletes and make them cry in about 3 minutes. The more athletic you are, the harder you can push, and the faster I can annihilate you. You may at first get out of breath jogging 3.0 miles per hour, because your max is 3.1. Two years later you’re still going to get out of breath when we go 9.0 miles per hour and your max is 9.3. Usain Bolt still gets out of breath when he runs 26 miles per hour. You see, objective and even relative improvements and achievements don’t correlate to appreciation unless your frame of mind is proper. The average American is losing a pound of skeletal/muscle/tendon/ligament/cartilage mass per year. People who lift buck this trend. But I’ve known people who are doing a great job bucking this trend and still quit investing in health and fitness, because they think health and fitness is losing 50lbs when they’ve only lost 5-10. Their comparisons are detached from science and reality. And I believe strongly that the same people would quit even if they’d achieved precisely their incorrect definition they contrived in their imaginations. You cultivate a spirit of gratitude; or you cultivate a spirit of malcontent. A spirit of malcontent cannot be overcome by any worldly success. Why does the US consistently rank so low in mental health and happiness when it’s so wealthy? For the same reason. It’s easy to take wins for granted. It’s easy to forget successes, advantages, progress. We fixate on how much better it “could be” or “once was”, and we’re sad, indignant, malcontent. I don’t disagree that there are things which should change. There are wrongs worth righting. There are health and fitness goals still out of reach. But if you cannot appreciate the abundance you have now (always thinking of it as so little, so insignificant, so what), then you will never appreciate more. You already have more. More “more” isn’t worth fighting for when you already aren’t grateful for “more.” Take the wins. Breathe in thankfulness. Revise comparisons. Then, progress is a natural phenomenon borne out of empowerment. Moreover, you’ll be in a frame of mind to actually be fulfilled by the progress, because, after all, there isn’t a linear correlation between the achievements and happiness anyway. More research concludes that only 4 nights of sleep impairment makes the body less physiologically capable of fat loss: http://www.jlr.org/content/early/2019/09/04/jlr.P094375
Hormones run the show. Some anachronistic luddites still talk about calories (some of which DOES matter). But it’s all about hormones. People with optimal hormone patterns eat more and move less. People with suboptimal hormone patterns can starve as much as they want and exercise as much as they can, and they’ll never fix the fundamental problem. For years I’ve tried to buck this trend. I have iron will. I know nutrition science backward and forward. I run crazy experiments. I’m a health and fitness professional. But in long stretches of extreme high work load and impaired sleep, my body CANNOT get lean. It doesn’t matter how great my program compliance is, how tight my nutritional and workout program are, I cannot supersede this biological law. No one can. Trust me. I believe in hard work. I know what it is to outwork and outwill every single person around you. But at some point, suboptimal stress management (including bad sleep) come a-knockin. You can’t outwork too much work. A handful of my peers still cling to this idea, talking about how they soldiered through high-stress periods of their lives and still got super-shredded or muscular. The same guys gave themselves autoimmune diseases in the process, having to have portions of their colons removed or some other severe issue. The irony is totally lost on them. "Unrelated," they say. No. Not unrelated. I am in agreement that you can try to push through and make the calories paradigm work; but there is a monumental cost. This is where some of the influencers and famous motivational speakers come up totally bereft of wisdom. Yeah. I get it. A lot of people could benefit from working harder. But not ALL people. Lack of sleep doesn’t scale. It has high associations with autoimmune disorders, rampant inflammation, neurodegenerative diseases, cancers, and cardiovascular risks. So, even if someone curtails sleep in order to achieve one thing (let’s say it’s a body composition goal), I have supreme skepticism about other areas of his health especially over the long term. A gain somewhere incurs a cost elsewhere. You can’t out-diet or out-exercise bad sleep. One of the largest studies on longevity (hoping to find a genetic explanation for how long we live) discovered that spouses, NOT RELATIVES, share more in common with regard to lifespan and risks of all-cause-mortality: https://www.genetics.org/content/210/3/1109
Species. Eye color. How much melanin your melanocytes produce. Sure. These are legit. There are quite a few high risk diseases which have a heritability component which has reliable research supporting it. But when we get into personality traits and lifestyle-caused disease, it’s really dicey trying to pin it all or even a fair margin on genetic heritability. Not only have most theories come up empty-handed on reproducibility, the attempts to reproduce outcomes have backfired. That is, the preponderance of evidence is in favor of “other than genetics” as causal. A lot of people have wanted DNA to be the be-all end-all explanation for all of life. In part, because people have a simple framework of nature-vs-nurture, they can’t really wrap their heads around a third, fourth, fifth causal set of options. Really, epigenetics and bacteriology tell us a lot about human health and behavior. Which switches get flipped and how our symbionts signal us play a massive role. That’s a few parts nurture and a few parts nature, which of course is not the way people wanted to think about it. Trying to boil anything down to nature versus nurture itself is a question-begging proposition that most people miss. These two things aren’t different or divergent. I’m reminded of a George Carlin bit where he destroys marketers who label foods as “natural”. He just eviscerates people who talk about “unnatural” ingredients. As he said, “EVERYTHING EXISTS WITHIN NATURE.” All that is in our universe is “natural”. It’s part of nature. Nurture is another way of talking about nature. Trying to pit them against each other is nonsense. The variable pieces of nature work hand-in-hand with the static framework of physical laws. There is no one or the other. But that hasn’t stopped those who want everything to be an impossibility outcome dictated by genes. The MAOa gene is a perfect example of people confusing themselves about how to interpret genetics research. Many carriers have no aggressive tendencies. But since some stats show an increased likelihood, we want to extrapolate that forward to mean people are genetically determined to be aggressive, determined, or violent. Then the debate devolves into whether or not we should give these people a pass when they commit violent crime. After all, they were genetically predetermined to be bad, right? Others on the flip side think sentencing should be harsher, since we have to get rid of these deviants who could never be rehabilitated and brought back into society. You can see where this is going. But we don’t even need to entertain this foolish debate, because no one has reproduced statistically significant MAOa research. And many authors have dismantled it altogether as an explanatory model: https://blogs.scientificamerican.com/…/code-rage-the-warri…/ Anything else behavior-wise we want to pin on genetics is fraught with danger too. It seeks to avoid personal responsibility. That very thought disempowers you. Now placebo is at play. And you make it true. Therefore, even if genetics were a true explanation of most personalities and behaviors, it wouldn’t make sense to believe in it. The belief is self-reinforcing. But we don’t even need to worry about that. Because, so far, linking genes as the sole cause for personalities and behaviors is pseudoscience. |
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