Thank you Dr. Yang! And as far as birthday wishes go, I think this one is a sure fire "granted." I'm more a pie or brownies person, but make exceptions for tiramisu and anything dense and chocolate.
Thanks Cheryl! I confess that I exaggerated A LOT, but only to poke fun at myself and my low fuss podcast. I'll have another one out soon, and will keep it short!
Noted your comment about your birthday this weekend. I will be 85 on Saturday, 27 April, so we may have the same birthdate. I try to eat well, exercise (walk/weights), limiting drinking alcohol to around 3 drinks per week, and I quit smoking when I was 65. I see my cardiologist twice a year, and am so far relatively healthy.
Happy birthday! It really is a great time of year to have a birthday in my experience, with the rebirth of the world in spring cancelling some of the sense that we are older, right?
Looks like you are a case in point approaching 85 with most of these boxes checked. Wishing you a safe, healthy, and happy 86th year :)
Excellent comment, and I've added a little mathematical disclaimer to the post which (correct me if I'm wrong!) explains that each of these risk factor buckets can overlap with the other, and so a fountain of youth cannot be discovered by hitting all 4!
Wouldn't that be grand?
Here is the wonky HR stuff from the original paper just so you know I'm not that cognitively impaired yet:
"Adhering to a Mediterranean diet (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88), moderate alcohol use (HR, 0.78; 95% CI, 0.67-0.91), physical activity (HR, 0.63; 95% CI, 0.55-0.72), and nonsmoking (HR, 0.65; 95% CI, 0.57-0.75) were associated with a lower risk of all-cause mortality (HRs controlled for age, sex, years of education, body mass index, study, and other factors). Similar results were observed for mortality from coronary heart disease, cardiovascular diseases, and cancer. The combination of 4 low risk factors lowered the all-cause mortality rate to 0.35 (95% CI, 0.28-0.44)."
I have several friends and relatives with diabetes and other health issues who gladly take meds rather than changing their behavior one iota. Their ciggies, fast food, and sedentary binge-watching are things they just will not give up.
It makes me sad that many of these factors like smoking, fast food, binge watching are all engineered to take advantage of addictive physiologies and reward systems in our brains. At some point many people just give in completely, and it's a long lift out of that well once you've fallen into it.
Exactly. There’s a sense a doom in them about these habits - “I wish I could stop, but …” There’s always a “but.” Even knowing we’re all being played. It is sad.
My dear skinny friend, they make 6” cake pans. You can make a cake with them by halving a regular recipe. If there are 3 in your family, I think you could risk having a small birthday cake 3 times per year unless you just abhor sweets. I use chocolate ganache made with coconut milk for frosting as the less disgustingly sweet option for frosting. Happy Birthday!
Hee hee. Skinny was an insult before age 25, but ever since then I gladly accept it as a compliment! Thank you for the birthday wishes, and a good cake is divine I'll grant you that. I miss Miel Patisserie in Marlton/Phillly, that was some inspired baking.
I've been playing with Claude.Ai a bit, and so while I don't have time to confirm the complete accuracy of its response to your question, I think it looks good at first glance!
"There is some evidence that dark chocolate, particularly with a high cocoa content like 88%, may provide certain health benefits due to its rich content of flavanols and other beneficial plant compounds. However, the research on whether it specifically reduces all-cause mortality (death from any cause) is limited and inconclusive.
Here's a brief overview of what we know so far:
Flavanols in dark chocolate have antioxidant and anti-inflammatory properties, which may help protect against certain chronic diseases like heart disease and diabetes.
Some studies have found an association between moderate dark chocolate consumption and a lower risk of heart disease, stroke, and cardiovascular mortality. However, these studies are observational and cannot prove causation.
A few small clinical trials have suggested that dark chocolate may have beneficial effects on blood pressure, insulin sensitivity, and endothelial function (blood vessel health), which are risk factors for cardiovascular disease.
There is very little direct research on whether dark chocolate intake reduces all-cause mortality specifically. One large observational study found no significant association between chocolate consumption and reduced all-cause mortality.
Any potential benefits of dark chocolate likely depend on the dosage, frequency of consumption, and an individual's overall diet and lifestyle.
So in summary, while dark chocolate may provide some health benefits due to its nutritional composition, there is currently insufficient evidence to definitively conclude that it reduces all-cause mortality. More high-quality research is needed in this area."
Happy upcoming birthday, Ryan, and many more to come (particularly as I am confident you adhere closely to the risk-reduction specs)! It may amuse you to know that a friend of ours had her 95th birthday this past Monday. We were charged with bringing the cake😎. We chose a carrot cake, however, lest you think this even approximated a healthy choice, it turned out to be a layer cake and the layers and outer frosting were cream cheese! I was interested to observe that our friend ate only a small portion, another friend scraped aside the cream cheese, while on the other hand, others thought the frosting the very best part. All are pretty good overall in their eating choices, so a splurge for the 95th hopefully didn’t do too much harm.
Amused indeed! Would make for a cute scene in movie. And thanks for the birthday wishes. I like cream cheese icing much better than the stuff you get out of a can/packet, and I'll eat pretty much any home made cake, ice cream, dessert! Smallish portions except on birthday, and I feel disgusted by the ingredients in stuff like Philly product Tastykake. As a kid I used to love their peanut butter chocolate Kandy Kakes:
CONFECTIONERY COATING (SUGAR, HYDROGENATED PALM KERNEL OIL, COCOA PROCESSED WITH ALKALI, COCOA POWDER, WHEY POWDER [MILK], SOY LECITHIN, SALT, ARTIFICIAL FLAVOR), PEANUT BUTTER (PEANUTS, CORN SYRUP SOLIDS, HYDROGENATED VEGETABLE OIL [RAPESEED, COTTONSEED, SOYBEAN], SUGAR AND SALT), SUGAR, ENRICHED BLEACHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMINE MONONITRATE, RIBOFLAVIN, FOLIC ACID), WATER, NONFAT MILK, EGGS, SOYBEAN OIL, CONTAINS 2% OR LESS OF EACH OF THE FOLLOWING: HIGH FRUCTOSE CORN SYRUP, EGG YOLKS, MODIFIED CORN STARCH, LEAVENING (SODIUM ACID PYROPHOSPHATE, SODIUM BICARBONATE, MONOCALCIUM PHOSPHATE), SOY LECITHIN, SALT, MONO-AND DIGLYCERIDES, NATURAL AND ARTIFICIAL FLAVOR, PROPYLENE GLYCOL MONO- AND DIESTERS OF FATS AND FATTY ACIDS, XANTHAN GUM, LACTYLIC ESTERS OF FATTY ACIDS, CALCIUM SULFATE, CINNAMON, NUTMEG, POTASSIUM SORBATE (TO RETARD SPOILAGE).
Thanks for the heads up about Huberman. These studies give hope, and these interventions are so much more fun than taking a medication and dealing with side effects. I do have one piece of dark chocolate every evening, it signals that I am done eating for the day. Marty and I just c@me back from a nice walk at the waterfront. I love carrot cake but I’ll skip the spinach frosting. 🤢
I haven't actually listened to Huberman, but I hear of his stuff through some of my younger male patients especially, and then I read the Slate article (another substack md wrote) and was sad to learn of the predictable questionable science and products. And yes, the part that gave me hope about these studies was that making improvements can help at any age studied, so it's not all or nothing missed the boat sort of calculus.
A walk on the water front sounds great, wish I could easily join you guys... but I have to work on this spinach frosting recipe some more!
Happy Birthday, Ryan. Thank you again for your column and your good advice. I try (mostly) to eat a balanced, Mediterranean style diet, and limit my beloved glass of Italian wine or champagne to not more than three modest glasses a week. Creaking along at 86! I do not follow my Scottish grandmother’s recommendation of “a teaspoon of good scotch in my morning tea”, but I cannot help recalling the words of an aged African-American former iron-worker interviewed years ago by the Oakland Tribune on his 100th birthday with the usual question of to what did he attribute his great age. His response: “You gotta be made of good dirt!”
Hi Mary, and may your balanced diet and beloved glass continue to serve your health well, and perhaps more importantly, continue to be a source of pleasure! I drink less now than I used to and each glass is a true pleasure, so if it ends up hurting me in the final analysis then I suspect it will be just one of thousands of potentially negative variables I’ve enjoyed over the years.
Such a humble truism - you gotta be made of good dirt!
I’m sure he was strong like the iron he worked and from the tumultuous racial struggles he lived through during his long lifetime.
Happy early birthday, Dr. McCormick! May any birthday cake you choose to indulge in be more appetizing than the AI-generated ones in the post!
Thank you Dr. Yang! And as far as birthday wishes go, I think this one is a sure fire "granted." I'm more a pie or brownies person, but make exceptions for tiramisu and anything dense and chocolate.
Congratulations on Jawn #1's success!! Well-deserved.
Thanks Cheryl! I confess that I exaggerated A LOT, but only to poke fun at myself and my low fuss podcast. I'll have another one out soon, and will keep it short!
Noted your comment about your birthday this weekend. I will be 85 on Saturday, 27 April, so we may have the same birthdate. I try to eat well, exercise (walk/weights), limiting drinking alcohol to around 3 drinks per week, and I quit smoking when I was 65. I see my cardiologist twice a year, and am so far relatively healthy.
Happy birthday! It really is a great time of year to have a birthday in my experience, with the rebirth of the world in spring cancelling some of the sense that we are older, right?
Looks like you are a case in point approaching 85 with most of these boxes checked. Wishing you a safe, healthy, and happy 86th year :)
Well, have fun with your birthday old boy!!
One nit pick
adhering to a Mediterranean diet reduced the risk of all-cause mortality by 23%
moderate alcohol use by 22%
physical activity by 37%
nonsmoking by 35%.
Adds up to 117% , Curious Case of Benjamin Button?
You said 65% combined, what's up with that? (LOL)
Excellent comment, and I've added a little mathematical disclaimer to the post which (correct me if I'm wrong!) explains that each of these risk factor buckets can overlap with the other, and so a fountain of youth cannot be discovered by hitting all 4!
Wouldn't that be grand?
Here is the wonky HR stuff from the original paper just so you know I'm not that cognitively impaired yet:
"Adhering to a Mediterranean diet (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88), moderate alcohol use (HR, 0.78; 95% CI, 0.67-0.91), physical activity (HR, 0.63; 95% CI, 0.55-0.72), and nonsmoking (HR, 0.65; 95% CI, 0.57-0.75) were associated with a lower risk of all-cause mortality (HRs controlled for age, sex, years of education, body mass index, study, and other factors). Similar results were observed for mortality from coronary heart disease, cardiovascular diseases, and cancer. The combination of 4 low risk factors lowered the all-cause mortality rate to 0.35 (95% CI, 0.28-0.44)."
I didn't doubt your cognitive astutement. I was just joking. It an old joke.
I have several friends and relatives with diabetes and other health issues who gladly take meds rather than changing their behavior one iota. Their ciggies, fast food, and sedentary binge-watching are things they just will not give up.
It makes me sad that many of these factors like smoking, fast food, binge watching are all engineered to take advantage of addictive physiologies and reward systems in our brains. At some point many people just give in completely, and it's a long lift out of that well once you've fallen into it.
Exactly. There’s a sense a doom in them about these habits - “I wish I could stop, but …” There’s always a “but.” Even knowing we’re all being played. It is sad.
My dear skinny friend, they make 6” cake pans. You can make a cake with them by halving a regular recipe. If there are 3 in your family, I think you could risk having a small birthday cake 3 times per year unless you just abhor sweets. I use chocolate ganache made with coconut milk for frosting as the less disgustingly sweet option for frosting. Happy Birthday!
Hee hee. Skinny was an insult before age 25, but ever since then I gladly accept it as a compliment! Thank you for the birthday wishes, and a good cake is divine I'll grant you that. I miss Miel Patisserie in Marlton/Phillly, that was some inspired baking.
Does Dark Chocolate , the 88% variety , reduce all cause mortality? Just asking for a friend .
Hi Michael. I know that "friend", too ;)
I've been playing with Claude.Ai a bit, and so while I don't have time to confirm the complete accuracy of its response to your question, I think it looks good at first glance!
"There is some evidence that dark chocolate, particularly with a high cocoa content like 88%, may provide certain health benefits due to its rich content of flavanols and other beneficial plant compounds. However, the research on whether it specifically reduces all-cause mortality (death from any cause) is limited and inconclusive.
Here's a brief overview of what we know so far:
Flavanols in dark chocolate have antioxidant and anti-inflammatory properties, which may help protect against certain chronic diseases like heart disease and diabetes.
Some studies have found an association between moderate dark chocolate consumption and a lower risk of heart disease, stroke, and cardiovascular mortality. However, these studies are observational and cannot prove causation.
A few small clinical trials have suggested that dark chocolate may have beneficial effects on blood pressure, insulin sensitivity, and endothelial function (blood vessel health), which are risk factors for cardiovascular disease.
There is very little direct research on whether dark chocolate intake reduces all-cause mortality specifically. One large observational study found no significant association between chocolate consumption and reduced all-cause mortality.
Any potential benefits of dark chocolate likely depend on the dosage, frequency of consumption, and an individual's overall diet and lifestyle.
So in summary, while dark chocolate may provide some health benefits due to its nutritional composition, there is currently insufficient evidence to definitively conclude that it reduces all-cause mortality. More high-quality research is needed in this area."
If I hear of a dark-chocolate (80/90%) clinical trial that’s looking for volunteers, I’m signing up.
I find dark chocolate particularly good for my mental health😄
To point out about confounding factors that may play into this, still a positive benefit and , besides, it's chocolate!
Happy upcoming birthday, Ryan, and many more to come (particularly as I am confident you adhere closely to the risk-reduction specs)! It may amuse you to know that a friend of ours had her 95th birthday this past Monday. We were charged with bringing the cake😎. We chose a carrot cake, however, lest you think this even approximated a healthy choice, it turned out to be a layer cake and the layers and outer frosting were cream cheese! I was interested to observe that our friend ate only a small portion, another friend scraped aside the cream cheese, while on the other hand, others thought the frosting the very best part. All are pretty good overall in their eating choices, so a splurge for the 95th hopefully didn’t do too much harm.
Amused indeed! Would make for a cute scene in movie. And thanks for the birthday wishes. I like cream cheese icing much better than the stuff you get out of a can/packet, and I'll eat pretty much any home made cake, ice cream, dessert! Smallish portions except on birthday, and I feel disgusted by the ingredients in stuff like Philly product Tastykake. As a kid I used to love their peanut butter chocolate Kandy Kakes:
CONFECTIONERY COATING (SUGAR, HYDROGENATED PALM KERNEL OIL, COCOA PROCESSED WITH ALKALI, COCOA POWDER, WHEY POWDER [MILK], SOY LECITHIN, SALT, ARTIFICIAL FLAVOR), PEANUT BUTTER (PEANUTS, CORN SYRUP SOLIDS, HYDROGENATED VEGETABLE OIL [RAPESEED, COTTONSEED, SOYBEAN], SUGAR AND SALT), SUGAR, ENRICHED BLEACHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMINE MONONITRATE, RIBOFLAVIN, FOLIC ACID), WATER, NONFAT MILK, EGGS, SOYBEAN OIL, CONTAINS 2% OR LESS OF EACH OF THE FOLLOWING: HIGH FRUCTOSE CORN SYRUP, EGG YOLKS, MODIFIED CORN STARCH, LEAVENING (SODIUM ACID PYROPHOSPHATE, SODIUM BICARBONATE, MONOCALCIUM PHOSPHATE), SOY LECITHIN, SALT, MONO-AND DIGLYCERIDES, NATURAL AND ARTIFICIAL FLAVOR, PROPYLENE GLYCOL MONO- AND DIESTERS OF FATS AND FATTY ACIDS, XANTHAN GUM, LACTYLIC ESTERS OF FATTY ACIDS, CALCIUM SULFATE, CINNAMON, NUTMEG, POTASSIUM SORBATE (TO RETARD SPOILAGE).
~
Carrot cake any day!
OMG, talk about ultra-processed food! And re the cake, yes, Golden Girls, here we come! Have a wonderful, wonderful birthday!
Happy Birthday Ryan,
Thanks for the heads up about Huberman. These studies give hope, and these interventions are so much more fun than taking a medication and dealing with side effects. I do have one piece of dark chocolate every evening, it signals that I am done eating for the day. Marty and I just c@me back from a nice walk at the waterfront. I love carrot cake but I’ll skip the spinach frosting. 🤢
I haven't actually listened to Huberman, but I hear of his stuff through some of my younger male patients especially, and then I read the Slate article (another substack md wrote) and was sad to learn of the predictable questionable science and products. And yes, the part that gave me hope about these studies was that making improvements can help at any age studied, so it's not all or nothing missed the boat sort of calculus.
A walk on the water front sounds great, wish I could easily join you guys... but I have to work on this spinach frosting recipe some more!
🤣
Happy Birthday & keep doing what you do.
It's working.
Thank you 🙏 and will do!
Happy Birthday, Ryan. Thank you again for your column and your good advice. I try (mostly) to eat a balanced, Mediterranean style diet, and limit my beloved glass of Italian wine or champagne to not more than three modest glasses a week. Creaking along at 86! I do not follow my Scottish grandmother’s recommendation of “a teaspoon of good scotch in my morning tea”, but I cannot help recalling the words of an aged African-American former iron-worker interviewed years ago by the Oakland Tribune on his 100th birthday with the usual question of to what did he attribute his great age. His response: “You gotta be made of good dirt!”
Hi Mary, and may your balanced diet and beloved glass continue to serve your health well, and perhaps more importantly, continue to be a source of pleasure! I drink less now than I used to and each glass is a true pleasure, so if it ends up hurting me in the final analysis then I suspect it will be just one of thousands of potentially negative variables I’ve enjoyed over the years.
Such a humble truism - you gotta be made of good dirt!
I’m sure he was strong like the iron he worked and from the tumultuous racial struggles he lived through during his long lifetime.