Aging gracefully with a boat?

[Hippocampus]

Much of this harkens back to the Covid threads.

Correlation does not prove causation.
Correlation does not prove causation.
Correlation does not prove causation.

Americans make the most expensive pee in the world. Outside a prospective, double blind controlled clinical trial there is NO evidence any supplement is of any benefit. In clinical practice I’ve seen more disease produced by supplements then cured or prevented. Choose wisely on your diet and lifestyle. Have fun using turmeric in your Indian food, decreasing beef intake, or following a Mediterranean diet. There’s some evidence to support things like that and it’s fun. But in the face of a decent diet and absence of a lab documented deficiency there’s no proof that any supplement is of benefit. Realize your decision to do so is belief not science.

 

[backinblue]

Much of this harkens back to the Covid threads.

Correlation does not prove causation.
Correlation does not prove causation.
Correlation does not prove causation.

Americans make the most expensive pee in the world. Outside a prospective, double blind controlled clinical trial there is NO evidence any supplement is of any benefit. In clinical practice I’ve seen more disease produced by supplements then cured or prevented. Choose wisely on your diet and lifestyle. Have fun using turmeric in your Indian food, decreasing beef intake, or following a Mediterranean diet. There’s some evidence to support things like that and it’s fun. But in the face of a decent diet and absence of a lab documented deficiency there’s no proof that any supplement is of benefit. Realize your decision to do so is belief not science.

In my own experience, I have to agree 100%. It's easy to believe the ads and reviews. I've tried to self-treat a few symptoms using supplements and food choices. In the end, they didn't help and in fact potentially did more harm by delaying medical treatment.

 

[Tator]

Sorry if I wasn't clear. I meant to ask if any of my fellow cruisers had a implanted pacemaker/ defibrillator.

Tator

 

[Art]

Art, I don't think I agree with that last, because it depends where. The example of what you were subjected to in your post...

https://www.trawlerforum.com/forums/s3/aging-gracefully-boat-58137-5.html#89

...borders on malpractice, and is an example of a lot of what is not good about the US health system, even though most living there think it's the bees knees.

You were absolutely right to insist on a stress test, better still a stress echo, before anyone shoved 'stents' into any of your coronary arteries, and I too am pleased you held out.

The process and investigations they put you through, and the associated costs, (the reason they did that), let alone the risk they were prepared to expose you to, when clearly all you had was modest hypertension (BP) was a scandal, frankly, and it disappoints me medical colleagues anywhere could stoop to such.

Sadly however, experience of patients of my own, developing a medical issue while in the states, and the costly overkill of investigations they racked up in the process, tends to suggest it was not an isolated incident.

Peter - Kaiser Permanente is known as the "Preventative" king of health institutions. There are two in my family for which Kaiser preventative medicine and surgeon-operation procedures has time and again saved their lives. Otherwise they would most likely/surely be dead.

Saying that, I must wonder how many persons [of lesser chutzpah than I] would have simply rolled over and let the incorrectly doctor recommended procedures go forward to completion. BTW - I had also asked for an echo cardiogram test but was so successful in the stress test that I let that pass.

In closing I will say: The ongoing surveillances they performed on me for a day and a night were appreciated by me as all the results further exemplified my overall good health.

And... although the detail depicted costs on paper came out to some $24K... the bill I paid was under $300 +/-; medications included. I can just imagine what the total would be if the next stage of stint introductions had occurred. Therefore, what you say regarding legal over-steps...???!!!

 

[Hippocampus]

Like in anything doing due diligence is never wasted. Problem I faced as a provider is same I face when hiring techs to work on my boat. So have been on both sides of the equation. On the receiving end I’m a dilettante. I don’t know what I don’t know. My encounter with the provider is usually my first contact. I have no track record and an inadequate knowledge base to judge their work. But I’m able to judge their credentials and experience to some degree. I study, ask and learn so don’t come to the table totally ignorant. I could care less about their personality (bed side manner). The encounter (end of day) is whether they know their stuff and do a good job. Doesn’t matter if it’s a electronics tech, a plumber, surgeon or diagnostician. There’s a job to do. Did they do it and do it well. On the provider side how you develop the interaction will effect how well you get a history that will determine how easy it is to achieve a correct differential diagnosis. It will also effect patient compliance. So at a transactional analysis level personality (bed side manner) is important is achieving your goal. But some misconstrue bedside manner for competence. So with the boat techs is important they understand I’m intending to do blue water. There’s no tow service and once 200m out no SAR to speak off. The option of let’s try this and you come back if it doesn’t work doesn’t exist. Same with neurologic disease. More impressed by neurosurgeons who know when not to cut then those who are less discriminate. You get one shot at it. Do it once do it right.

 

[koliver]

Backing away slowly...avoiding eye contact...

Just looking at my drawings of my clock. Bigger numbers now, but they still look the same, except some of the older ones have numbers going up to almost 24, some only to 12, what is that about? Still have minutes numbers followed by seconds. What do you mean by "two hands"?

 

[MurrayM]

There appears to be some meat on the bone of this whacko coconut oil - ketone - alternative fuel supply for the brain when it's ability to use glucose is failing - idea:

(Broken into paragraphs by me)

Abstract

Brain glucose uptake is impaired in Alzheimer's disease (AD). A key question is whether cognitive decline can be delayed if this brain energy defect is at least partly corrected or bypassed early in the disease. The principal ketones (also called ketone bodies), β-hydroxybutyrate and acetoacetate, are the brain's main physiological alternative fuel to glucose.

Three studies in mild-to-moderate AD have shown that, unlike with glucose, brain ketone uptake is not different from that in healthy age-matched controls. Published clinical trials demonstrate that increasing ketone availability to the brain via moderate nutritional ketosis has a modest beneficial effect on cognitive outcomes in mild-to-moderate AD and in mild cognitive impairment.

Nutritional ketosis can be safely achieved by a high-fat ketogenic diet, by supplements providing 20–70 g/day of medium-chain triglycerides containing the eight- and ten-carbon fatty acids octanoate and decanoate, or by ketone esters.

Given the acute dependence of the brain on its energy supply, it seems reasonable that the development of therapeutic strategies aimed at AD mandates consideration of how the underlying problem of deteriorating brain fuel supply can be corrected or delayed.

https://nyaspubs.onlinelibrary.wiley.com/doi/full/10.1111/nyas.12999

 

[SteveK]

Not surprised.
Years bygone before lab produced medicine, it was made from products of nature.

Holistic medicine is a whole-body approach to healthcare. It aims to improve health and wellness through the body, mind, and soul. Usually, holistic medicine combines traditional medicine and complementary and alternative medicine (CAM)

 

[Nick14]

There appears to be some meat on the bone of this whacko coconut oil - ketone - alternative fuel supply for the brain when it's ability to use glucose is failing - idea:

(Broken into paragraphs by me)

https://nyaspubs.onlinelibrary.wiley.com/doi/full/10.1111/nyas.12999

I spent my career in drug development (legitimate medicinal pharmaceutical products, not street corner), including several attempts at Alzheimer's Disease. It's not that hard to show a transient, modest improvement in cognitive functioning. Caffeine has shown modest short-term improvements in certain aspects of cognitive functioning. For years it showed the most significant "improvements" of anything studied. But that certainly doesn't make it a cure or treatment for dementia.

There are so many foods or natural products that purportedly 'help' some disease or condition, and an infinite number of anecdotal reports. I completely agree with @Hippocampus. Unless something has been studied in a randomized, double-blind controlled clinical trial and subjected to statistical analysis, it's not possible to definitively say if it works or not.

There are indeed a number of medicinal products that have origins in plants. In most cases, the effect of the natural product is very mild. Most of the time, the bona fide pharmaceutical that is derived from a plant source is an optimized derivative or concentrated active ingredient.

As others have said, the placebo effect can be very strong. It's often been joked that the most powerful effects often seen are with placebos. But in the end, biology rules. With degenerative disorders such as Alzheimer's Disease, transient improvements are often just that - transient. It's hard for a positive attitude to overcome tissue death.

As others have also said, moderation is important. There are some 'vitamins' and 'nutraceuticals', that if consumed in massive quantities, can cause harm. Always check with your physician.

 

[MurrayM]

Hi Nick,

Very good point. The original article I read years ago echoed what you are saying.

The doctor who's husband fell ill discovered the ketone theory through patent search applications and research funding requests. Money is being spent and research is being done. She decided to 'go straight to the source' (coconut oil) because more concentrated forms weren't available.

 

[Hippocampus]

There remains so much which is unknown in nutrition, and medicine in general. We need to accept that and not substitute belief, conjecture or case reports for actual knowledge. Several examples:
For some years I worked at the Framingham Heart Study. That study started the ball rolling on cholesterol and lipids as regards stroke and M.I.. The epidemiology was correct but didn’t take in to account the details of lipid metabolism as for the original cohort study that knowledge had yet to be developed. Understanding HDL (happy) and LDL (lousy) was unknown. The original food pyramid the USDA developed was therefore unsophisticated in comparison to our current knowledge.
You need to accept good science is right at the time of development but is in a state of constant refinement. Where we are now is like Galen talking about humours. We are just starting to understand the details of metabolism and the relationship to food intake. Don’t subject yourself to bleeding unless you have p.vera nor cupping nor purging. Do listen to good science not pseudo science or conjecture.

Was involved in a study on Vitamin E and Parkinson’s disease. Underlying bench science was compelling. That family (vitamin E is a family not a single chemical) is a good antioxidant. However, a careful prospective clinical trial showed no benefit. Of interest there’s science to suggest E supplement decreases life expectancy in lung cancer and increases incidence. Similarly cigarette smoking decreases risk of Parkinson’s disease. What seems logical occasionally isn’t. Until something is proven it isn’t proven.

Same with aspirin. Unless you have a defined risk profile taking low dose aspirin increases your risk of death and morbidities.
Same with dietary restrictions. Severe restrictions of fat/cholesterol intake in the developing brain can hurt kids.
Same with oil soluble vitamins. Too much is as bad if not worst than too little. Talk to people with pseudo tumor cerebri.
Same with fish oil. Hg is a toxin.
A chemical is a chemical. Source is irrelevant. K+ is K+. Doesn’t matter if you’re getting it in a IV, pill, tomatos or bananas. Only difference is bioavailability depending upon which potassium salt and mode of delivery. This hype about “natural “ or organic is just that. A chemical moiety is a that moiety with the effects of that moiety regardless of origin. Willow bark works like the ASA it contains. Foxglove the digitalis. But we know so little about herbs spices and historical cures. Truly an area requiring further study.

 

[MurrayM]

Also:

- if Dementia and Alzheimer’s begin years before the first obvious symptoms start,

- a major contributing factor is the brains inability to use glucose effectively,

- the brain can use ketones while it’s ability to use glucose diminishes,

- then it seems plausible that ketones may at least delay onset.

I’ll keep putting coconut oil on my PB&J sandwiches and muffins because it’s just so darned nummy!

Also drink coconut milk for the same reason (nummy) and because it just seems weird to drink milk sucked from the teat of another animal, not that adults drinking human milk wouldn’t be equally odd.

 

[backinblue]

Correlation does not prove causation. Wise words and reminds me of an example that some might find interesting.

It's been shown that the incidence of skin cancer is greater in those that use sunscreen than in those that do not. You could make the assumption that you can lower your risk of skin cancer by not using sunscreen. If you look at the bigger picture, you find that those that don't use sunscreen are not exposed to the sun as much as those that do. They are not as active and not outdoors as often, therefore they don't bother with sunscreen and rarely get skin cancer. Correlation does not prove causation.

 

[MurrayM]

Well, I suppose if one is inclined to wait for the sweet discombobulated cognitive acuity of a potato, doing nothing is a great game plan.

 

[SteveK]

It's been shown that the incidence of skin cancer is greater in those that use sunscreen than in those that do not.

Really, I guess that explains why I do not have skin cancer.
Never use it, too icky. Well maybe one time on the beach until a blast of wind blew sand and had to go for swim to wash it off.

I will be trying out the coconut oil supplement, pill form. If I believe then it will work. Do not have time for studies. If it does not work, well I drank less to offset cost so my liver will be happy.

Is that correlation?

 

[backinblue]

Good thinking! I conclude then that coconut oil reduces the likelihood of liver disease! lol

 

[FF]

"Unless something has been studied in a randomized, double-blind controlled clinical trial and subjected to statistical analysis, it's not possible to definitively say if it works or not."

The hassle is this style of study costs big bucks and takes years.

A drug company would not profit , even if it worked , from the sale of a natural OTS product.
So why spend those big bucks? The stock holders might revolt!

 

[Hippocampus]

FF the major cost center for healthcare in the US is Medicare. Anything that decreases that constant drain is of great interest. Although many with reason view politicians below personal injury lawyers and used car salesmen they aren’t stupid. Therefore there remains great interest in driving those costs down. Although it doesn’t get much press many trials are directly funded by the federal government not by big Pharma. I was involved in several including the licensing trial for tPA to treat stroke. Similarly beyond NIH other agencies fund trials including Agriculture, FDA, and DARPA. The feds do keep an eye on academia. Much of the funding there is also directly or indirectly from the feds. You can be sure if anything showing real promise to prevent or delay AD or other neuro degenerative disease came up they would be all over it. The direct and indirect costs in conjunction with loss productivity of family caregivers is a huge number. The feeling Pharma has the ability to block advances in this field isn’t borne out by my personal experience. Pharma itself has great interest in therapeutics but “an ounce of prevention is worth a pound of cure” and the feds know this.

For well over half a century neurologists have been using the ketogenic diet to treat epilepsy. This predates the discovery of effective anti convulsive drugs and dates back to the era of bromides. Brain has no ability to survive on anaerobic metabolism. It can only survive on aerobic via the Krebs cycle. This is a miserable highly difficult diet to maintain. It’s still in use so have some experience on what it means at a Human level. Ketones can enter the Krebs cycle but glucose is the preferred substrate. The limiting factor in converting ADP into ATP isn’t that substrate except in extraordinary circumstances but rather O2 and the electron chain. The idea that adding ketones to a normals diet would increase brain metabolism was popular some years ago. Same with coconut oil. Now in the era of refined neuropsych testing, PET and fMRI imaging one has the ability to get objective measurements. Unfortunately it hasn’t been borne out.
The majority of brain degenerative disease can be thought of as being failures of getting the garbage out. You constantly make intracellular garbage as your cells metabolize doing their jobs. For AD it’s amyloid precursor protein, amyloid and Tau protein, for Parkinson’s its alpha synuclein, for frontal temporal dementia it’s tau. It’s normal to make this stuff. You only get into trouble when you make more than you can get rid of. Both the rate of production and clearing is in large part dependent on your genetics but for sporadic AD also dependent on lifestyle issues. To date the list of lifestyle issues is virtually identical to the list for atherosclerosis and other mixed degenerative illnesses ( inflammation, collection of an unwanted metabolic substrate etc.). Although there are strongly genetic forms of AD (presenilin1 and 2) there are genetic risk factors as well ( apo E4) for the sporadic form. Unfortunately to date there’s no magic bullet. The same old same old applies. Everything in moderation (food, etoh, regular exercise) and exercise your brain as well. Learn new stuff. Personally take no supplements. Try to eat wisely. Don’t drink much. Stay active and engaged. Fortunately I picked the right parents. Dad died mid 80s and mom mid 90 s both sharp as a tack. No family history in first nor second order relatives. Worry about other stuff.

 

[Nick14]

"Unless something has been studied in a randomized, double-blind controlled clinical trial and subjected to statistical analysis, it's not possible to definitively say if it works or not."

The hassle is this style of study costs big bucks and takes years.

A drug company would not profit , even if it worked , from the sale of a natural OTS product.
So why spend those big bucks? The stock holders might revolt!

I spent a few decades working in the pharmaceutical/biotechnology industry, and agree you're right in that most pharma companies would not generally be interested in funding expensive clinical trials unless there was the possibility for a financial gain for them. Otherwise, why would they do it? It would be a breach of fiduciary responsibility to spend money that would not have a possibility of yielding a financial return to shareholders.

However, pharma companies often come up with their own 'twist' on things, with a proprietary formulation, dosage form, dosage strength, or even just 'packaging'. There's a whole world of companies out there (and investors who back them) whose whole business models are based on finding new uses for already approved substances, and taking advantage of the faster and less expensive regulatory paths available.

There are also the 'nutraceutical' companies, some of which are (IMHO) shady, but others who spend money again for their own brand to be able to promote uses others do not. There are also non-profit patient advocacy groups for diseases that sometimes provide funding for clinical work.

As @Hippocampus said, many clinical studies are funded by the NIH, often with investigators at universities, particularly in situations where there is little commercial incentive for a for-profit company to spend money. There are many smart, dedicated, motivated people at universities eager and anxious to find new treatments for a range of diseases. If anything was thought to be truly promising, it could be expected to be studied more thoroughly in such trials.

The alternative to basing therapeutic decisions on real data is wishful thinking. It's not possible (or wise or safe) to take a whole lot of crap in the hope that something might have a beneficial impact on a condition. At best you're just wasting money and peeing it out; at worst, it could be causing harm. There's no shortage of experiences with things that were initially thought might be helpful, but later studies showed were either ineffective or possibly even harmful (most recently a spate of purported 'cures' for COVID, like hydroxychloroquine among others).

 

[Vashon_Trawler]

There is so much variation in how people age. I see a lot of very capable older adults at my marina and many share one thing in common--they keep the weight off and stay fit. Boating is physical, so you need to take care of your body if you want to enjoy boating as long as possible.

 

[backinblue]

Thanks Nick. In my opinion and personal experience, I think the real harm in alternatives and supplements is not that they cause harm in themselves, but they may cause a person to delay traditional medical treatment while they try and hope that something else might work. That delay can allow a condition worsen resulting in a more aggressive or invasive treatment. In some cases, it can be a fatal mistake.

 

[Hippocampus]

True B but as previously stated personally seen more pathology from supplements and bizarre diets than prevented.

 

[Art]

There is so much variation in how people age. I see a lot of very capable older adults at my marina and many share one thing in common--they keep the weight off and stay fit. Boating is physical, so you need to take care of your body if you want to enjoy boating as long as possible.

Build Masonry! Then workout in your own gym!!

Stay Fit! Make much $$$!! Go Boating Thereafter!!!

 

[Codger2]

Am i on the wrong thread about "Aging Gracefully With a Boat.?" Talk about "thread creep!

 

[Vashon_Trawler]

Build Masonry! Then workout in your own gym!!

Stay Fit! Make much $$$!! Go Boating Thereafter!!!

Good for you! You look great. I see many boaters (not always older) struggling to get around their boat. They'd be so much better off if they weren't carrying a sea turtle around their waist! No wonder they have difficulty crawling around the engine room. My wife and I work very hard to stay fit for the health benefits and to enjoy better our activities. One of our boat neighbors is in his mid-70s and seems to work non-stop. It is quite impressive (for any age).

 

[SteveK]

The last couple of years I haven't been as gung ho with my maintenance. Part of it has been some health issues but it's also been a change of attitude. The maintenance is becoming more of a physical challenge and I dread crawling around in the engine room. I've owned the boat since 2007 and been boating all my life. My neighbour had to sell his boat because he was careless in lifting a battery when he shouldn't have and suffered an injury. But he was in his 80's I'm only 68. When do you sell your boat?

Post #1
IF we all think about the age of those posting in this thread, this forum then we can agree that the average life left is about 10 years.
Why derail Aging gracefully with a boat by talking studies that can take 10 years and be inconclusive.
Seriously. Correlation does not prove causation. Who cares! Party poopers.
Just washed down 2 caps of coconut oil, feeling great.
Making a plan for the haul out.

Live and let live.

 

[foggysail]

My attitude today may change later. I plan to keep my boat even if it turns into a dock queen. It is an on the water place to go to. I enjoy most of the amenities found at home with Directv, large TV's, heat and AC when docked. I completely enclosed both the helm and rear deck to be able to enjoy even rainy days.

So far I can handle things even though well into my 80's. The things that I cannot do, I will pay someone else to get them done.

 

[backinblue]

True B but as previously stated personally seen more pathology from supplements and bizarre diets than prevented.

I was not disagreeing with you, just relating my own very personal experience and learning the hard way, but luckily not too hard as I am still here!

 

[Nick14]

@backinblue, thanks. I've also seen tragedies of people trying to self-medicate their disease with some sort of pseudoscience nonsense (because they either didn't trust 'big pharma', or didn't want the side effects of many oncological agents). It never works out well. While it's important to maintain a healthy positive attitude, the 'power of positive thinking' and placebo effects are no match for rapidly multiplying cancer cells or degenerating neurons. The realities of biology always win in the end.

@Hippocampus, my middle-aged whacky sister-in-law gets herself into medical trouble about once every year or two with her latest bizzaro diet. She gets these absolutely insane ideas completely unfounded in any science about the latest 'thing' she should be eating to ward off the effects of aging. It always ends the same way, with her being chastised by her physician followed by a regimen to get her health back in order. Remarkably, she doesn't seem to learn from these experiences, and the pattern continues with the next diet whackiness.

 

[backinblue]

Some of these things are hard to avoid since they are nonstop on TV ads and all over the internet. Weight, prostate issues, aging, arthritis, sexual iissues, brain power, building muscle, increasing HGH and testosterone, etc, etc. There are many magical natural pills and diets for all of these of these, just take your pick! I also know people who will never go to a doctor because they just google their symptoms and are sure they have it all figured out.