Monday, June 20, 2016

Review of Stop the Clock: The Optimal Anti-Aging Strategy by P. D. Mangan

Last year I reviewed economist Art De Vany's New Evolution Diet book, which is a 5/5 with good thoughts on paleo, low-carb, and power law effort distribution, and has his choice quote, "bread is the ultimate poverty food – it exists only because grain is cheap, easy to grow and is less perishable than other foods." 

Remember the key takeaway from De Vany was that early humans would have been exposed to practically no foods capable of triggering a massive insulin release, and each insulin spike puts wear on the body, and also lessens the insulin sensitivity of adipose tissue, which sets up an unpleasant positive feedback loop of metabolic syndrome.

Another excellent source for staying current on anti-aging/health/supplementation/diet research is P.D. Mangan (twitter/website), who also puts out short books from time to time like Stop the Clock

Mangan is helpful because he is synthesizing all the latest research and results on this stuff. A couple examples: many men are suffering from excess iron, and the beneficial antioxidant hypothesis is giving way to a phytochemical hormesis hypothesis.

Here are some examples of Mangan's thinking on diet:

  • Low carb: The better results on low-carb were likely due to two things, in my opinion. One is that insulin levels dropped. Insulin helps drive fat into cells, and lower insulin levels allow fat cells to release fat to be burned. The other reason is probably better compliance. This low-carbohydrate diet was unrestricted in calories, i.e. all-you-can-eat, therefore the participants on this diet were unlikely to get hungry and grab the nearest food available. The participants on the other, calorically restricted diets may have been much more likely to get hungry and cheat.
  • Fasting: The first treatment that Dr. Jason Fung uses for his diabetic patients is fasting, and by all accounts quite successfully. The treatment described in the paper was not fasting, but at 600 calories a day, was pretty close. All of this shows clearly that diabetes is a disease of over-nutrition, caused by too many or the wrong kind of calories, when those calories are not burned by exercise.
  • Protein leverage hypothesis: [H]umans and animals closely regulate the amount of protein in their diets, with the average human consumption of protein being around 15% of calories. The idea is that if available foods are low in protein, more food will be eaten until protein requirements are satisfied. If foods are relatively dilute in protein, containing, say, less than 15% protein overall, then more calories need to be consumed to make up for the lack of protein. If higher protein foods are eaten, then less calories are consumed and weight loss or maintenance follows.
Here are some hypotheses from Stop the Clock that you may not have heard before. Again, Mangan is not a primary researcher but he is an excellent synthesizer of research.
  • A theory of aging: "aging means a breaking down of capacity for renewal", caused by three main processes; an increase in oxidative stress, an increase in inflammation, and a decrease in autophagy.
  • Exercise (weightlifting to build muscle, not "cardio") is important because muscle strength is inversely correlated with cancer. [study]
  • Antioxidant supplementation may be harmful, blunting free radicals from exercise prevents beneficial adaptation from exercise. [study]
  • The high carb, low fat government nutritional recommendations were immensely destructive. Saturated fat is good for you.
  • The risks of obesity and adiposity to health have been underestimated. Flawed studies that use BMI at time of death instead of all time high BMI understate the risk. [study]
  • Low carbohydrate diets can quickly reduce insulin and blood glucose levels [study]
  • Coffee is an incredibly rich source of potentially beneficial phytochemicals.
Ultimately, Mangan's formula is pretty similar to De Vany's and consists of: building muscle with weightlifting, eating a low carb diet high in dietary phytochemicals, and practicing intermittent fasting.

5/5 for Mangan overall. I find it best to just follow him on Twitter and keep up with his blog that way. The books are good to buy and give away to friends or family who want to get healthier.


CP said...

When [Barry] Sears’ books started coming out in 1995, he was crucified because high-carbohydrate diets (generally recommending 10 percent of calories coming from fats, 15 percent from protein and 75 percent from carbs) still had a hold on the sports nutrition community and, as a matter of fact, the medical community, from the American Heart Association to the U.S. Surgeon General to the makers of the Food Guide Pyramid. They collectively trumpeted that to fight obesity you had to minimize or eradicate fat from the diet.

But Sears argued that a high-carb/low-fat diet left you feeling unsatiated and lethargic. Pigg’s anecdote about eating a stack of pancakes and finding himself both tired and hungry is an example of what Sears said was the body’s hormonal system working against you.

But Sears wasn’t given much of a chance to present his case. Since the medical establishment was so firmly entrenched in the idea of a high-carb/low-fat/low-protein diet, mainstream journalists were armed with quotes and documentation to paint Sears as a greedy snake oil salesman, as Jessica Seigel did in a 1997 story for Los Angeles Magazine. “Sears claims that his diet, which calls for roughly twice the fat and protein recommended by the USDA, regulates the body’s supply of insulin,” she wrote. “According to Sears, reducing levels of this crucial hormone makes the body burn fat faster and eliminates destructive food cravings. Medical research, though, has not linked insulin levels to weight gain in healthy people, and increasingly confirms that eating fat makes people fatter.” [...]

My personal experience with a high-carb, low-fat diet—my six months eating a vegan diet in which I paid little attention to the amount of protein and fat I was taking in—produced unwanted results. Despite running 50 miles a week at the time, a blood workup showed signs that I was becoming dangerously insulin-resistant. Or, in other words, pre-diabetic. Because my diet was constantly prompting a spike in insulin levels—insulin being a hormone that prompts the body to either use glucose for energy or store excess glucose in the liver and muscles—I was exhausting the system and a backlog of glucose was piling up in my blood, further taxing my hormonal system and creating a state known as hyperinsulinemia. Since it’s when insulin levels go down that the body starts tapping into stored body fat as energy, I had also enabled a fat-trapping mechanism within and I was recording a weight much higher than I should have been.

CP said...


"One general mechanism of action of phytochemicals that is emerging from recent studies is that they activate adaptive cellular stress response pathways. From an evolutionary perspective, the noxious properties of such phytochemicals play an important role in dissuading insects and other pests from eating the plants. However at the subtoxic doses ingested by humans that consume the plants, the phytochemicals induce mild cellular stress responses. This phenomenon has been widely observed in biology and medicine, and has been described as ‘preconditioning’ or ‘hormesis.’"

CP said...

Antioxidant hypothesis vs phytochemical hormesis hypothesis:

"During the past 5 decades, it has been widely promulgated that the chemicals in plants that are good for health act as direct scavengers of free radicals. Here we review evidence that favors a different hypothesis for the health benefits of plant consumption, namely, that some phytochemicals exert disease-preventive and therapeutic actions by engaging one or more adaptive cellular response pathways in cells"

Unknown said...

Great review. I've read a couple of his books and agree he's legit.

Walter said...

Have you read Why We Get Fat by Gary Taubes? It sounds like they mostly agree. I used to eat too much sugar and refined carbs but switched to a low-carb diet a couple years ago and now and I feel a lot healthier and more energetic.

PD said...

hey cp.

i am diabetic, type 1 insulin dependent, and the modern management of type 1 diabetes is to use the hormone insulin to offset carbohydrate intake, ie i eat 50g of carbs . This method has the strongest correlation for control over blood glucose, so that is why it is used. Fat can impact blood sugar levels and can also change absorption of insulin. The foods, that maybe you would not expect to impact blood glucose, but diabetics always have an issue with are pizza, watermelon, chips. Glycemic index is actually important as well, because the speed the carbohydrates get absorbed is important for blood glucose management, insulin's path of absorption and time need to match the food, if not blood glucose spikes faster than the insulin works.

I would caution on the term pre diabetic, for type 1 diabetics it basically means your blood glucose levels are high, has nothing to do with diet and everything to do with your body not producing insulin anymore. For type 2, if you are running 50 miles a week i doubt one would start developing type 2 diabetes.

What i can say is low carb diets do reduce the need for insulin and can help reduce high glucose spikes. eating low glycemic carbs would also have this benefit. A lot of high fibre foods are also low glycemic. i have found low carb diets to be really hard to sustain, if you exercise you are always hungry - four hour body or paleo diets would be examples. the medical community, pre discovery of insulin, used to use low carb diets, but it would mean the patients would live a little longer, nothing materially better. The discovery of insulin changed all that, diabetics routine live for 60+ years as diabetics because of insulin's discovery.

The point behind this is i think there is a ton of misinformation out there. People would be better off going to a diabetic session and seeing a registered dietitian. Most adults don't exercise enough and eat too much. Certain diets are beneficial/make it easier (4 hour body, etc), but eating balanced diets like a diabetic would is probably the best answer.

Diabetic research on this topic is well funded, the science community performs measurable and accurate studies, and too boot you can test blood glucose levels that will show you how the metabolic rate of the individual is performing. healthy individuals you can't do this. The human body is an incredible filter for all the noise in diets.

CP said...

PD, we're talking about type 2 not type 1.

CP said...

Some important new Mangan thinking:

* avoid vegetable oils and especially industrial Frankenoils (soybean & "canola" oils)
* therapeutic phlebotomy to reduce iron levels
* statins seem like bad news
* soy is bad news
* low T is bad news

The bad oils are everywhere. Really difficult to avoid. You almost have to cook everything yourself to avoid them.

Chipotle, for example, has pretty good ingredients but they are putting rice bran oil in a lot of stuff - WTF:

Scary to think what most breakfast places are cooking eggs in.

Here's a crazy one - food is fortified with iron mined by Rio Tinto:

CP said...

Boy do statins really seem like bad news!

High RORs for ALS and ALS-related conditions span many statins, in a setting in which ‘negative’ randomized and population-based studies cannot exclude causal occurrence (due to expectation of bidirectional effects on relevant mechanisms). Given the seriousness of this condition, the apparent excess reporting of ALS on statins warrants attention. When patients develop an ALS-like condition on a statin, a possible connection should be considered. This study does not address the impact of statin withdrawal. However, until better evidence is available, prompt statin withdrawal should be considered [44], given (1) the observational relations between higher cholesterol levels and both longer survival and slower progression in patients with ALS [58, 59]; (2) known mechanisms by which this may be causal [45]; (3) reports (though rare) of arrest and even reversal of ALS-like conditions with statin withdrawal [33, 44]; and finally (4) the important context that estimated median expected life extension with statins is minimal [87].

CP said...

Speaking of Chipotle: