Broken US Healthcare System

[JasperL]

Agreed. Public funds spent on healthcare must be limited and the least cost effective medical tests and treatments ought not be paid for. Doing everything medically possible to keep very old and seriously ill people alive a bit longer does more to harm society than benefit it. If people want everything possible to be tried to keep them alive even for another day or two they ought to be using their own money and not asking others to pay for what should be viewed as selfish behavior.

The trick is knowing when a given treatment might keep someone alive for just another day or two, versus something that might keep them alive for years longer. My dad died of prostate cancer. One what day did getting chemo/radiation and trying to put the cancer in remission become selfish? I watched him through that process and I'd love for you to tell me the day this desire to live and defeat cancer became selfish, and a personal failing on his part to continue and expect Medicare to fund. When should he have given up and just died already?

 

[RealityChecker]

And you ignored the cites showing you are wrong.

"Men with prediabetes were randomized to eTRF (6-hr feeding period, with dinner before 3 p.m.) or a control schedule (12-hr feeding period) for 5 weeks and later crossed over to the other schedule. eTRF improved insulin sensitivity, β cell responsiveness, blood pressure, oxidative stress, and appetite. We demonstrate for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF’s effects are not solely due to weight loss."

One small short term study does not refute anything I stated so you are wrong about me saying something wrong. RC

The subjects here lost no weight at all - they just restricted eating to an 18:6 IF diet.

True, and they saw some favorable changes in some metabolic markers. But IF has also been associated with increase in serum LDL-C and serum triglycerides and those metabolic markers are associated with more deaths from cardiovascular disease. More here: https://wou.edu/chemistry/home/stud...hemistry-bites/the-intermittent-fasting-diet/

Also, yes, IF is generally most useful to the obese and the #1 goal for someone obese is to get the weight off and keep it off. So your suggestion here is IF only works when people are successful in losing weight and keeping it off. Well, if people use IF to lose weight and keep it off, that's fantastic, awesome, an ideal outcome! That's where calorie restriction diets fail, nearly everyone.

The preponderance of evidence does not show IF aids weigh loss over the long term in people. I stated most of the benefits of IF are largely due to weight loss. However, the evidence that IF alone leads to weight loss is far from proven. Clearly time restricted eating in animals can lead to weight loss if the time they are allowed to eat is short enough. Diets that depend on will power to limit calorie intake when people are hungry fail. They fail because using will power to fight a potent biological drive like hunger is not likely to work. Try using will power to reduce how much you pee. You can fight that urge for a while but eventually the biological urge overcomes one's will to limit how much they pee. If the goal is to pee less then reducing fluid intake or sitting in a sauna and sweating could allow one to pee less without having to fight the urge to pee. Likewise, diets that have people consciously restrict calorie intake despite increasing hunger almost always fail. And in the most determined calorie counting dieters they promote eating disorders. You seem to be unable to grasp the need for increasing satiety per calorie to enable reducing calorie intake without having to consciously restricting calorie intake. RC

 

[RealityChecker]

The trick is knowing when a given treatment might keep someone alive for just another day or two, versus something that might keep them alive for years longer. My dad died of prostate cancer. One what day did getting chemo/radiation and trying to put the cancer in remission become selfish? I watched him through that process and I'd love for you to tell me the day this desire to live and defeat cancer became selfish, and a personal failing on his part to continue and expect Medicare to fund. When should he have given up and just died already?

How would I possibly know when his illness and prognosis reached the point where his quality of life was no longer good enough to justify even more efforts to keep him alive. My brother has had prostate CA for some time now but has been told if his PSA level increases above 1.0 (he had his prostate removed so the rising PSA means their are prostate cancer cells growing elsewhere in his body). He has been told he now qualifies for Pet Scan to look for those metastasized prostate CA cells. If it shows them then he can get radiation to kill any CA tumors they can find. However, Medicare pays for just one Pet scan to look for those metastasized clumps of CA cells. Why not unlimited PET scans and radiation treatments? The older someone is the less Medicare will pay for medical interventions that cost a lot but offer little benefit. So we already have some rationing of cost ineffective medical care. Countries with socialized medicine have even more restrictions to high cost interventions. Prostate CA kills far fewer men in Japan than in the US. But Japanese Americans have about the same high death rate as do white Americans. Africans have a far lower rate of death from prostate CA than do white Americans but African Americans have an even higher death rate than white men. Modern Western style diets promote prostate, breast, colorectal, pancreatic, and many other types of cancer. If you do not want to end up with prostate CA like your father and my brother then adopting a healthier diet and lifestyle makes more sense than paying for even more aggressive medical interventions to keep people alive when the odds are they have little or no quality of life time left.

 

[JasperL]

One small short term study does not refute anything I stated so you are wrong about me saying something wrong. RC

Did you read the NEJM paper? It's a summary of the many studies showing a benefit of IF. You've ignored all of them, claimed they don't exist. You are in fact wrong based on the evidence, which you pointedly have NOT been citing!

True, and they saw some favorable changes in some metabolic markers. But IF has also been associated with increase in serum LDL-C and serum triglycerides and those metabolic markers are associated with more deaths from cardiovascular disease. More here: https://wou.edu/chemistry/home/stud...hemistry-bites/the-intermittent-fasting-diet/

I'm not really sure why you cited what looks like a term paper by someone clearly non-expert in the field. There's also this meta analysis in 2020:

Effects of intermittent fasting and energy-restricted diets on lipid profile: A systematic review and meta-analysis

To the best of our knowledge, no systematic review and meta-analysis has evaluated the cholesterol-lowering effects of intermittent fasting (IF) and e…

www.sciencedirect.com

Conclusions​

Relative to a non-diet control, IF and ERD are effective for the improvement of circulating TC, LDL-C, and TG concentrations, but have no meaningful effects on HDL-C concentration. These effects are influenced by several factors that may inform clinical practice and future research. The present results suggest that these dietary practices are a means of enhancing the lipid profile in humans.

So at best/worst the evidence is inconclusive about the effect on cholesterol.

The preponderance of evidence does not show IF aids weigh loss over the long term in people.

You've cited exactly zero, nothing, nada, zilch of this 'evidence.'

I stated most of the benefits of IF are largely due to weight loss. However, the evidence that IF alone leads to weight loss is far from proven. Clearly time restricted eating in animals can lead to weight loss if the time they are allowed to eat is short enough. Diets that depend on will power to limit calorie intake when people are hungry fail.

Apparently you've read nothing about IF or fasting in general. For longer fasts - days - hunger all but disappears after just a day or so - literally. On day 2 or 3, most people aren't hungry at all. Many, including me, in fact can do IF without hunger, which is why it works for so many of us.

Here's a cite, since you're not offering any, with the study's conclusions. eTRF is 'early time restricted feeding' - i.e. IF. I'm assuming you know what ghrelin does. Lower levels means less hunger.

Early Time-Restricted Feeding Reduces Appetite and Increases Fat Oxidation But Does Not Affect Energy Expenditure in Humans - PubMed

Meal-timing interventions facilitate weight loss primarily by decreasing appetite rather than by increasing energy expenditure. eTRF may also increase fat loss by increasing fat oxidation.

pubmed.ncbi.nlm.nih.gov

Results: eTRF did not affect 24-hour energy expenditure (Δ = 10 ± 16 kcal/d; P = 0.55). Despite the longer daily fast (intermittent fasting), eTRF decreased mean ghrelin levels by 32 ± 10 pg/mL (P = 0.006), made hunger more even-keeled (P = 0.006), and tended to increase fullness (P = 0.06-0.10) and decrease the desire to eat (P = 0.08). eTRF also increased metabolic flexibility (P = 0.0006) and decreased the 24-hour nonprotein respiratory quotient (Δ = -0.021 ± 0.010; P = 0.05).

Conclusions: Meal-timing interventions facilitate weight loss primarily by decreasing appetite rather than by increasing energy expenditure. eTRF may also increase fat loss by increasing fat oxidation.

You:

Likewise, diets that have people consciously restrict calorie intake despite increasing hunger almost always fail. And in the most determined calorie counting dieters they promote eating disorders. You seem to be unable to grasp the need for increasing satiety per calorie to enable reducing calorie intake without having to consciously restricting calorie intake. RC

I've not counted a single calorie since starting IF. I eat a good dinner until I'm full. If that took 1500 calories, that's what I'd eat. I don't think it is that much, but I really don't have any idea, because I've never tried to count or estimate calories for even a single meal. And I won't be noticeably hungry until sometime tomorrow afternoon. That's why IF works, for me and others.

 

[skeptic llc]

Well it was not really a great answer and unlike JasperL I actually am an expert on diet and nutrition. Oprah maintained a healthy weight a long time while actually consuming a healthy diet that had a low calorie density, plenty of fiber, very limited beverage calories, and ate only when hungry and until comfortably full. Penn Gillette lost even more weight eating only plain potatoes when hungry and until comfortably full. Oprah now following Weight Watchers guidelines, which perhaps coincidently came about after Weight Watchers expert sat in on my "Biology of Weight Control" lecture about 15 years ago. And the rocket scientist (literally) who recommended Penn go on the potato diet came up with that approach after watching me dismantle wannabe nutrition experts on LinkedIn discussion groups. Contrary to popular mythology potatoes are not fattening but are a high satiety per calorie food. Hell if potatoes were fattening all the Irish peasant whose diet consisted of about 90% potato calories would have been overweight and far more likely to have survived the potato famine when their main food source was largely wiped out by a Mexican fungus that arrived in Ireland in 1945 and spread rapidly wiping out more and more subsistence farmers who mostly survived on potatoes alone.

Of course, French fries, potato chips, and Pringles are fattening because they are calorie dense and low in fiber and far more prone to be eaten when not hungry than a plain baked or microwaved potato (or sweet potato), which was all Penn ate when is lost 100lbs and dramatically improved his very high BP and dyslipidemia that were likely to have killed him had he not stopped eating a typical American diet full of fattening foods. Importantly Penn lost that weight without counting calories and eating a potato whenever he was hungry. Potatoes are a high satiety food so do not promote obesity. Food For Thought

You should argue with Jasper, not me, I'm clearly outgunned on this topic.

 

[Bodi]

With nearly half of the Federal government's budget going to healthcare it seems to me if we are to deal with government spending and the Federal governments growing debt one obvious place to reduce our growing national debt would be to figure out ways to reduce spending on healthcare or more specifically medical care. The US spends far more than any other country on healthcare and yet there are dozens of countries that spend far less than the US does on medical care and yet the people in those countries live longer and arguably healthier lives than do Americans on average. Marty Makary, MD has a new book titled "The Price We Pay" in which he shares his perspective on what he believes are the main problems with the US healthcare establishment. He shares his perspective on problems with the US healthcare system in this 5 minute video. I believe Dr. Makary makes some good points in this video and a discussion on the points he makes may be a good place to start a discussion about how Americans become healthier and live longer, while at the same time reducing the high cost of our current healthcare system. Here's a link to Dr. Makary's video: https://www.prageru.com/video/overm...tm_medium=email&utm_campaign=campaign_2438143

I thought poorly of universal healthcare around the world and bought the hype of the USA system for 35 years while I grew up there... I thought the USA healthcare system was pretty good... until I moved to New Zealand. Then I realized just how shit and unfair and expensive the US system was.

 

[Bodi]

Yes socialism works best with small homogeneous countries. It works worse the bigger it gets.

That is ridiculous. A system is a system. It is either effective or it is not effective. The USA's is not effective. It is not like it is even close, actually.

 

[bave]

That is ridiculous. A system is a system. It is either effective or it is not effective. The USA's is not effective. It is not like it is even close, actually.

Actually there is an enormous amount of data showing that smaller and more homogenous countries do far better when it comes to social programs and policies. Generally speaking people are far more ok with paying taxes and making sacrifices to help people they feel are similar to them and have an impact on their community. The best example of this is charity fundraisings after a disaster. Look at how much money is raised per capita nearby compared to further away.

 

[RealityChecker]

Did you read the NEJM paper? It's a summary of the many studies showing a benefit of IF. You've ignored all of them, claimed they don't exist. You are in fact wrong based on the evidence, which you pointedly have NOT been citing!


I'm not really sure why you cited what looks like a term paper by someone clearly non-expert in the field. There's also this meta analysis in 2020:

Effects of intermittent fasting and energy-restricted diets on lipid profile: A systematic review and meta-analysis

To the best of our knowledge, no systematic review and meta-analysis has evaluated the cholesterol-lowering effects of intermittent fasting (IF) and e…

www.sciencedirect.com

Apparently you've read nothing about IF or fasting in general. For longer fasts - days - hunger all but disappears after just a day or so - literally. On day 2 or 3, most people aren't hungry at all. Many, including me, in fact can do IF without hunger, which is why it works for so many of us.

Here's a cite, since you're not offering any, with the study's conclusions. eTRF is 'early time restricted feeding' - i.e. IF. I'm assuming you know what ghrelin does. Lower levels means less hunger.

Early Time-Restricted Feeding Reduces Appetite and Increases Fat Oxidation But Does Not Affect Energy Expenditure in Humans - PubMed

Meal-timing interventions facilitate weight loss primarily by decreasing appetite rather than by increasing energy expenditure. eTRF may also increase fat loss by increasing fat oxidation.

pubmed.ncbi.nlm.nih.gov

I've not counted a single calorie since starting IF. I eat a good dinner until I'm full. If that took 1500 calories, that's what I'd eat. I don't think it is that much, but I really don't have any idea, because I've never tried to count or estimate calories for even a single meal. And I won't be noticeably hungry until sometime tomorrow afternoon. That's why IF works, for me and others.

The N Engl J Med article by Dr. Mattson is a commentary or an opinion about how intermittent fasting (IF) might work even if calorie intake is not reduced. It is speculative. The evidence is so far mixed and not really convincing. There is little doubt the de facto IF seen in calorie restricted rodents works primarily by reducing total calorie intake in these animals. Calorie restriction in rodents has been known to significantly increase longevity since the 1930s compared to animals fed the same diet ad libitum. Dr. Mattson points out that when you feed rodents less food once a day (as Dr. McCay did back in the 1930s and many other research have done since then with many different species of animals that this calorie restricted animals generally eat their restricted food intake in just a few hours. So Dr. Mattson is speculating that some of the metabolic benefits of calorie restriction may result from going most of the day with nothing to eat. That is a plausible hypothesis but very difficult to study, especially in free living human subjects. Of course, it is likely the calorie restricted rodents were hungry most of every day. And if they had access to food they would certainly have eaten the same amount as the control animals. So my point is that people who maintain a lower body weight over time consume fewer calories by consuming a diet composed of less fattening foods and drinks. Fattening foods and drinks are fattening because they have a low satiety per calorie.

Now I have discussed this research with the late Dr. Roy Walford and his colleague Dr. Richard Weindruch when he too was at UCLA back in the 1990s and working with Dr. Walford. I have been following this research for more than 50 years. So I find it amusing you think it is a topic I know little about. Have you heard of the CR Society International? The challenge for people on CR (calorie restricted) diets is chronic hunger. So most of the people consuming limited daily calories do so primarily by consuming largely high satiety per calorie foods. Are you familiar with National Weight Control Registry (NWCR). The NWCR follows people who have lost and kept off 30 or more pounds for over a year. I believe the average success story in the NWCR was about 60lbs and they had kept it off for a bit more than 5 years on average. If you look at these successful (at least compared to most people who try to lose weight and keep it off) dieters have adopted a diet composed largely of higher satiety per calorie foods. And the Okinawans were once the best documented longest lived human population. Was it genes? Nope, because once their kids developed a taste for American fast foods (built initially for the US military personal there) they started getting fat and developing type 2 diabetes at even higher rates than Americans. So while Okinawa still has far more people living to 100y or more they have largely stuch with their traditional diet composed largely of high satiety foods that most grew themselves. https://www.bluezones.com/exploration/okinawa-japan/

 

[jonny5]

Yes, people are free to not get medical care they could just die instead.

Exactly.

 

[JasperL]

The N Engl J Med article by Dr. Mattson is a commentary or an opinion about how intermittent fasting (IF) might work even if calorie intake is not reduced. It is speculative. The evidence is so far mixed and not really convincing.

You're either lying or you didn't read the article. It's an extensive review of the vast literature showing benefits of IF. If it's her "opinion" it's backed by 80 cites to the literature.

So Dr. Mattson is speculating that some of the metabolic benefits of calorie restriction may result from going most of the day with nothing to eat. That is a plausible hypothesis but very difficult to study, especially in free living human subjects.

Great, you read the first paragraph. And she isn't speculating - she cited the research.

Studies in animals and humans have shown that many of the health benefits of intermittent fasting are not simply the result of reduced free-radical production or weight loss.2-5 Instead, intermittent fasting elicits evolutionarily conserved, adaptive cellular responses that are integrated between and within organs in a manner that improves glucose regulation, increases stress resistance, and suppresses inflammation.

And there is this:

In humans, intermittent-fasting interventions ameliorate obesity, insulin resistance, dyslipidemia, hypertension, and inflammation.33 Intermittent fasting seems to confer health benefits to a greater extent than can be attributed just to a reduction in caloric intake.....In two other trials, overweight women (approximately 100 women in each trial) were assigned to either a 5:2 intermittent-fasting regimen or a 25% reduction in daily caloric intake. The women in the two groups lost the same amount of weight during the 6-month period, but those in the group assigned to 5:2 intermittent fasting had a greater increase in insulin sensitivity and a larger reduction in waist circumference.20,27

Maybe you should catch up on the research! Those results are not her opinion.

Now I have discussed this research with the late Dr. Roy Walford and his colleague Dr. Richard Weindruch when he too was at UCLA back in the 1990s and working with Dr. Walford. I have been following this research for more than 50 years. So I find it amusing you think it is a topic I know little about.

That sounds about right - stuck in the 1990s as far as the state of the current research. Maybe that's why you've cited nothing that indicates IF doesn't work for weight loss, insulin sensitivity, and other health benefits.

Have you heard of the CR Society International? The challenge for people on CR (calorie restricted) diets is chronic hunger.

Fasting, including IF is different than calorie restriction diets. They have different impacts on insulin levels, which is key, and on hormones affecting hunger and satiety. I cited one of those studies showing IF reduces feelings of hunger. Fasting for more than a day literally eliminates feelings of hunger for most people - no hunger at all.

So the problems of calorie restriction diets are well known. Yes, people are hungry, in part because when you restrict calories per meal, your metabolism slows, burns less, so you need to continually eat less and less to keep losing weight. At the start maybe your base metabolism was 2100 calories. After a few months of calorie restriction, it might be 1700 or 1800. So you have to cut out 300-400 calories per day, just to maintain your current weight!

Fasting, and IF is different, at least for many people. The studies do NOT show IF reduces metabolism beyond that explained by actual weight loss. Traditional fasting in fact BOOSTS metabolism, so that person burning 2100 calories at rest on average might be at 2200 after 3 days of fasting, making weight loss easier, not harder.

So most of the people consuming limited daily calories do so primarily by consuming largely high satiety per calorie foods.

Not with IF - I cut calories by limiting when I eat. That pretty much automatically cuts my daily calories since I am not going to gorge on an 1800 calorie dinner.

 

[Peter]

Exactly.

I honestly have no idea if you're being serious?
Are you advocating that people who can't afford medical treatment should not get it?

 

[RealityChecker]

You're either lying or you didn't read the article. It's an extensive review of the vast literature showing benefits of IF. If it's her "opinion" it's backed by 80 cites to the literature.

Great, you read the first paragraph. And she isn't speculating - she cited the research.

Studies in animals and humans have shown that many of the health benefits of intermittent fasting are not simply the result of reduced free-radical production or weight loss.2-5 Instead, intermittent fasting elicits evolutionarily conserved, adaptive cellular responses that are integrated between and within organs in a manner that improves glucose regulation, increases stress resistance, and suppresses inflammation.

And there is this:

In humans, intermittent-fasting interventions ameliorate obesity, insulin resistance, dyslipidemia, hypertension, and inflammation.33 Intermittent fasting seems to confer health benefits to a greater extent than can be attributed just to a reduction in caloric intake.....In two other trials, overweight women (approximately 100 women in each trial) were assigned to either a 5:2 intermittent-fasting regimen or a 25% reduction in daily caloric intake. The women in the two groups lost the same amount of weight during the 6-month period, but those in the group assigned to 5:2 intermittent fasting had a greater increase in insulin sensitivity and a larger reduction in waist circumference.20,27

Maybe you should catch up on the research! Those results are not her opinion.

That sounds about right - stuck in the 1990s as far as the state of the current research. Maybe that's why you've cited nothing that indicates IF doesn't work for weight loss, insulin sensitivity, and other health benefits.

Dr. Mattson's article is a review article. BTW you referred to him as "she" and "her" so not sure why you believe Mark Mattson is a woman, but I have met him and he is a man).And his co-author Rafael de Carbo is also a man. Perhaps as many on the progressive left you also suffer from gender confusion?

Drs. Mattson & de Cabo are providing an argument in that N Engl J Med article as to why they believe more research is needed into the impact of time restricted eating or intermittent fasting on health and longevity. Not all surprising given that is a area on research both are familiar with and hoping to get more funding for future studies. What, if any, impact various strategies for time restricted eating or IF have are likely mediated largely by reduced calorie intake. Nothing in that review article by Mattson and de Cabo refute my expert opinion. Indeed, I suspect both these researchers share my opinion. You cut and pasted this quote from the article:


"In humans, intermittent-fasting interventions ameliorate obesity, insulin resistance, dyslipidemia, hypertension, and inflammation.33 Intermittent fasting seems to confer health benefits to a greater extent than can be attributed just to a reduction in caloric intake....." MM The rest of their quote suggested based on two small short term clinical trials in women that even without significant weight loss fasting for 2 days a week appeared to have some additional favorable metabolic effects.

FYI - Your lame ad hominem insults only make it appear you inability to have civil debate with someone who certainly knows far more about this topic than you do. Again your lack of desire to learn from those who likely know far more about the topic than you do seems par for the course for zealots and not those interested in determining what is and is not most likely true.

 

[JasperL]

Dr. Mattson's article is a review article.

Correct - it cites 80 sources. That's way beyond an article stating her "opinion." She cites the studies backing her opinions up. It's how that works.

You on the other hand have cited nothing that IF is ineffective.

Drs. Mattson & de Cabo are providing an argument in that N Engl J Med article as to why they believe more research is needed into the impact of time restricted eating or intermittent fasting on health and longevity.

You're lying again, or didn't read the paper. They cited dozens of studies showing the benefits. The primary purpose of the paper is cataloguing the many benefits. Of course they suggest more research, because there's always more to learn, but that's NOT the point of the paper. Of course more time is needed to see if IF has the same impact on longevity for humans as it does for rats or mice. But that's because it's a relatively new method and we simply cannot speed up time to see what happens over 30 or 40 or longer years.

Not all surprising given that is a area on research both are familiar with and hoping to get more funding for future studies. What, if any, impact various strategies for time restricted eating or IF have are likely mediated largely by reduced calorie intake.

Again, the authors cite studies showing the benefits are independent of reduced calories or weight loss. You've citing NOTHING to contradict those studies. And even if the benefits are tied to calorie restriction, that's not a downside of IF. For many people like me it's an easy, painless way to restrict calories, doesn't apparently lower our base metabolic rate, and the metabolic switching encourages burning our fat stores better than diets that simply restrict calories but still allow feeding all day, which keeps insulin levels elevated all day. That's what the research shows. Of course if the goal is to lose weight, then reducing calories is part of IF, and the real hope is that this works for obese people better than calorie restriction diets that we KNOW fail the vast majority, in part because of the lowering of base metabolism. As I pointed out, long fasts BOOST metabolism.

Nothing in that review article by Mattson and de Cabo refute my expert opinion. Indeed, I suspect both these researchers share my opinion. You cut and pasted this quote from the article:

"In humans, intermittent-fasting interventions ameliorate obesity, insulin resistance, dyslipidemia, hypertension, and inflammation.33 Intermittent fasting seems to confer health benefits to a greater extent than can be attributed just to a reduction in caloric intake....." MM The rest of their quote suggested based on two small short term clinical trials in women that even without significant weight loss fasting for 2 days a week appeared to have some additional favorable metabolic effects.

Right. What's your point? The results show the benefits are NOT tied to weight loss.

FYI - Your lame ad hominem insults only make it appear you inability to have civil debate with someone who certainly knows far more about this topic than you do. Again your lack of desire to learn from those who likely know far more about the topic than you do seems par for the course for zealots and not those interested in determining what is and is not most likely true.

I'm reading the most current research. You're misstating that research, lying about what that research shows. You've repeatedly mischaracterized the NEJM article, and haven't yet cited any research that finds IF doesn't have the benefits claimed. All you've done is make claims backed by nothing.

So who should I believe? Experts writing for the NEJM or you, rando internet guy, who cited at one point what looks and reads like a term paper for a freshman college class?

 

[Bodi]

Actually there is an enormous amount of data showing that smaller and more homogenous countries do far better when it comes to social programs and policies. Generally speaking people are far more ok with paying taxes and making sacrifices to help people they feel are similar to them and have an impact on their community. The best example of this is charity fundraisings after a disaster. Look at how much money is raised per capita nearby compared to further away.

Thank you but I never argued otherwise...

 

[RealityChecker]

Jaeger19 posted this statement by me:
"So most of the people consuming limited daily calories do so primarily by consuming largely high satiety per calorie foods." RealityChecker

To which he responded with this:
"Not with IF - I cut calories by limiting when I eat. That pretty much automatically cuts my daily calories since I am not going to gorge on an 1800 calorie dinner." Jaeger19

Your personal experience is hardly convincing evidence. I have tried IF for many months years ago myself when it first became a bit of a fad. I typically went 16 to 18 hours each day fasting. It had little or no impact on what I ate and my weight did not change (although unlike you I was not overweight to begin with). Nor did it impact any of my metabolic risk factors, which were all pretty low to begin with. Of course, before retiring in 2018 I had plenty of clients who had tried various forms of IF. Those who were in the habit of eating fattening foods in the evening often lost weight, but reviewing how IF impacted their overall diet it was likely most, if not all, of the health benefits some saw was largely due to consuming fewer calories. Of course, being less hungry seemed to be due to reduced their intake of calorie dense or low satiety per calorie foods. So there is no convincing evidence that IF leads to weight loss or more importantly reduces hunger. It is clear that people who eat large volumes of food over time stretch out their stomachs. How do you think those people who win eating contests can cram down that much food in a short period of time? So eating 1,880+ calories at a single meal would tend to get easier over time.

There is still much we do not know about various types of time restricted eating. But as a long weight loss strategy its efficacy remains to be established. Does IF have any health benefits independent of weight loss? Again the data are conflicting because long term tight control of food intake by free living subjects is very difficult to maintain over the long term. So at best claims that IF alone in the absence of a change in what people eat is healthier than simply eating healthy high satiety per calorie foods remains to be proven.

 

[JasperL]

FYI - Your lame ad hominem insults only make it appear you inability to have civil debate with someone who certainly knows far more about this topic than you do. Again your lack of desire to learn from those who likely know far more about the topic than you do seems par for the course for zealots and not those interested in determining what is and is not most likely true.

Why did you snip this part without comment? It's why I am being critical of your debate methods - I don't think you want to have a civil debate, not when you ignore the claimed benefits of fasting, including IF, without comment. I typed that because you conflated fasting with traditional calorie restriction diets, but they are different, especially for some of us on hunger. For longer fasts, the research clearly shows hunger virtually disappears after a day or two - gone. Those are CRITICAL differences.

Fasting, including IF is different than calorie restriction diets. They have different impacts on insulin levels, which is key, and on hormones affecting hunger and satiety. I cited one of those studies showing IF reduces feelings of hunger. Fasting for more than a day literally eliminates feelings of hunger for most people - no hunger at all.

So the problems of calorie restriction diets are well known. Yes, people are hungry, in part because when you restrict calories per meal, your metabolism slows, burns less, so you need to continually eat less and less to keep losing weight. At the start maybe your base metabolism was 2100 calories. After a few months of calorie restriction, it might be 1700 or 1800. So you have to cut out 300-400 calories per day, just to maintain your current weight!

Fasting, and IF is different, at least for many people. The studies do NOT show IF reduces metabolism beyond that explained by actual weight loss. Traditional fasting in fact BOOSTS metabolism, so that person burning 2100 calories at rest on average might be at 2200 after 3 days of fasting, making weight loss easier, not harder.

 

[JasperL]

To which he responded with this:
"Not with IF - I cut calories by limiting when I eat. That pretty much automatically cuts my daily calories since I am not going to gorge on an 1800 calorie dinner." Jaeger19

If you're going to quote someone, use the quote function. You're misstating who said what.

Your personal experience is hardly convincing evidence.

Correct! That's why we have studies and they back up my personal experience. Feelings of hunger go DOWN with fasting. Etc...

I have tried IF for many months years ago myself when it first became a bit of a fad. I typically went 16 to 18 hours each day fasting. It had little or no impact on what I ate and my weight did not change (although unlike you I was not overweight to begin with). Nor did it impact any of my metabolic risk factors, which were all pretty low to begin with. Of course, before retiring in 2018 I had plenty of clients who had tried various forms of IF. Those who were in the habit of eating fattening foods in the evening often lost weight, but reviewing how IF impacted their overall diet it was likely most, if not all, of the health benefits some saw was largely due to consuming fewer calories.

So you're saying in your experience IF is not beneficial to someone lean and with normal or better metabolic risk factors. Great. You're not the person IF is geared to help. What matters for this debate about obesity, diabetes, etc. is whether it works for those overweight and Type 2 diabetics or pre-diabetics. They are the targets.

And, again, you talk as if consuming fewer calories somehow discredits the claims of the benefits of fasting including IF. For most of us, it works because restricting calories is simple, easy, painless, with less hunger than other options.

Of course, being less hungry seemed to be due to reduced their intake of calorie dense or low satiety per calorie foods. So there is no convincing evidence that IF leads to weight loss or more importantly reduces hunger.

Other than the studies, there's no evidence at all.

It is clear that people who eat large volumes of food over time stretch out their stomachs. How do you think those people who win eating contests can cram down that much food in a short period of time? So eating 1,880+ calories at a single meal would tend to get easier over time.

But why would I try? More importantly, do the studies show people gorge on a 18/6 diet? Can you cite the studies?

There is still much we do not know about various types of time restricted eating. But as a long weight loss strategy its efficacy remains to be established. Does IF have any health benefits independent of weight loss? Again the data are conflicting because long term tight control of food intake by free living subjects is very difficult to maintain over the long term. So at best claims that IF alone in the absence of a change in what people eat is healthier than simply eating healthy high satiety per calorie foods remains to be proven.

It's not really hard. IF is basically what humans have done for thousands of years. We are designed to go long periods without eating. The new pattern of 6 or 8 or 10 or 12 feeding periods a day is brand new. A 16/8 IF is roughly 3 meals a day, then no snacks after dinner. A 'typical' pattern of breakfast, lunch and dinner can be easily done on a 14 fasted, 10 feeding diet. That's versus the more common American diet of maybe 16 or 17 feeding, and 7 or 8 fasting. We've reversed the fasting and feeding. Maybe that's why insulin levels stay high, encouraging fat storage, preventing fat burning?

 

[RealityChecker]

Why did you snip this part without comment? It's why I am being critical of your debate methods - I don't think you want to have a civil debate, not when you ignore the claimed benefits of fasting, including IF, without comment. I typed that because you conflated fasting with traditional calorie restriction diets, but they are different, especially for some of us on hunger. For longer fasts, the research clearly shows hunger virtually disappears after a day or two - gone. Those are CRITICAL differences.

Fasting, including IF is different than calorie restriction diets. They have different impacts on insulin levels, which is key, and on hormones affecting hunger and satiety. I cited one of those studies showing IF reduces feelings of hunger. Fasting for more than a day literally eliminates feelings of hunger for most people - no hunger at all.

So the problems of calorie restriction diets are well known. Yes, people are hungry, in part because when you restrict calories per meal, your metabolism slows, burns less, so you need to continually eat less and less to keep losing weight. At the start maybe your base metabolism was 2100 calories. After a few months of calorie restriction, it might be 1700 or 1800. So you have to cut out 300-400 calories per day, just to maintain your current weight!

Fasting, and IF is different, at least for many people. The studies do NOT show IF reduces metabolism beyond that explained by actual weight loss. Traditional fasting in fact BOOSTS metabolism, so that person burning 2100 calories at rest on average might be at 2200 after 3 days of fasting, making weight loss easier, not harder.

Not sure what you are referring to. Calorie restriction and weight loss have long been known to reverse insulin resistance, lower fasting insulin levels, and weight loss generally lowers elevated BP, lowers serum cholesterol (even though fasting for 3 to seven days has been shown to increase serum cholesterol levels) and triglycerides, and has many other likely metabolic effects that most researchers believe are likely to improve health and perhaps even slow aging a bit.

Fasting for 3 or more days does reduce hunger, which is certainly very different from IF and calorie restricted diets that do not generally reduce hunger. So not sure why you mentioned fasting reduces hunger when IF does not generally do so. You clearly believe it did in your case but most research suggests IF does not impact satiety per calorie. W know you can increase satiety per calorie by reducing calorie density of the overall diet, by reducing beverage calories, and by consuming more dietary fiber from minimally processed foods.
Even so there is no doubt for the most part IF and calorie reduced diet producing the same weight loss produce similar beneficial metabolic effects. I have not stated here that IF might have some modest beneficial effects independent of calorie restriction but that claim is based on very limited research. So your suggestion that IF has proven favorable metabolic effects independent of what was consumed remains unproven. So body weight is not reduced unless calorie intake is reduced except with surgical removal of stored fat deposits. Even surgical removal of body fat has some transient metabolic benefits. The problem is when fat stores are reduced via calorie restriction, IF, or surgery you generally see a increased hunger.

Both IF diets and calorie restricted diets have largely the same metabolic effects. Of course, while weight loss has more health benefits than harms (especially for obese people) it is hard to maintain. And eating less when hunger has increased and metabolic rate slowed down is why most people regain lost weight no matter how achieved.

We know girls (mostly) with anorexia nervosa that eat very low calorie diets over the long term often end up with many serious health problems and many will literally starve themselves to death if not treated. So how might we increase longevity without having to fight hunger? My best guess is to alter what you eat so it provides more satiety per calorie. Maybe consuming less protein and especially protein from animal sources. The evidence is increasing that most of the benefits of calorie restriction may due in large part to a lower protein intake. High protein diets over the long term appear less effective for slowing aging. Indeed, Dr. de Cabo's Rhesus monkey study found calorie restricted monkeys did not live longer, but he fed them a high protein diet. By contrast, Dr Weindruch calorie restricted diet did appear to slow aging in Rhesus monkeys.

Bottom Line: There is still a lot we do not know about the long term health benefits and perhaps aging benefits of reducing calorie intakes and/or lowering protein intake in humans.

 

[jonny5]

I honestly have no idea if you're being serious?
Are you advocating that people who can't afford medical treatment should not get it?

Of course, at least at the federal level. If states want to have universal healthcare, they can do what they, though I would oppose it in my state. Why should healthcare be any different than food, housing, furniture, entertainment. If you need something, you work for it.

 

[RealityChecker]

Of course, at least at the federal level. If states want to have universal healthcare, they can do what they, though I would oppose it in my state. Why should healthcare be any different than food, housing, furniture, entertainment. If you need something, you work for it.

Agreed. The Federal healthcare bureaucracy has already proven it is way too corrupt to be involved in healthcare. Over the past 5+ decades we have seen the cost of healthcare go from about 5% of GDP, where it had remained for the prior 5 decades before LBJ's not-so-great socialization of healthcare via the creation of Medicare and Medicaid), to about 18% of GDP today. . At least when the states get involved they can each try different approaches and the once associated with greater health benefits and/or lower costs will eventually displace those that are less productive. It is a lot easier to hide the failure of Federal government failures than it is to hide failures at the state and local level.

 

[jpn]

Let's start with the biggest hurdle. The fact that america needs a socialist health care provider system.

The US has the least "socialist" health care system among the developed nations. That's why it's the most expensive while delivering mediocre results.

All other developed nations have far more "socialist" health care delivery systems, pay far less per capita, get as good or better results, and manage to provide it to every one of its citizens as a basic right.

The rational conclusion is that we need more "socialism" in our health care, not less.

 

[jpn]

Why should healthcare be any different than food, housing, furniture, entertainment. If you need something, you work for it.

Because becoming seriously ill would bankrupt the average citizen? Could that be it? Ya think?

 

[jpn]

The Federal healthcare bureaucracy has already proven it is way too corrupt to be involved in healthcare.

As opposed to what? The pharmaceutical industry? Yeah, no issues there. Regular Boy Scouts, they are.

 

[jonny5]

Agreed. The Federal healthcare bureaucracy has already proven it is way too corrupt to be involved in healthcare. Over the past 5+ decades we have seen the cost of healthcare go from about 5% of GDP, where it had remained for the prior 5 decades before LBJ's not-so-great socialization of healthcare via the creation of Medicare and Medicaid), to about 18% of GDP today. . At least when the states get involved they can each try different approaches and the once associated with greater health benefits and/or lower costs will eventually displace those that are less productive. It is a lot easier to hide the failure of Federal government failures than it is to hide failures at the state and local level.

And I totally get why the socialists want universal healthcare as a national right. While I oppose that, my main problem is that they didnt get consent according to the law before imposing it on the us. If they get 3/4 states to empower the federal govt with the power to provide healthcare, then so be it.