Evidence-Based Fitness: You are going to die.

So there's been ANOTHER study on some food and mortality. Last time, it was red meat. This time, it's eggs. To be honest, I'm not even going to read it. (Ok, I lied. I read it. Who are we kidding?) It's not the first study on eggs. It won't be the last. And it definitely won't be the last study of its kind in terms of trying to link what is really a very small part of life to mortality.

Being in medicine (yes, even in plastic surgery) has taught me a lot of thing, but one sure-fire experience is death, and dying. Most people in our society get very limited exposure to death, and fewer to dying. Most of us will only experience death when family members or friends die, which hopefully isn't that frequent. Very few people have experienced dying--not many people sit with the dying anymore (in my experience). Some of us will personally face death prematurely, but recover, which may or may not change our view on life.

However, there's something to be said about being exposed to death and dying in a very intimate way as caregiver. A palliative care nurse, Claire Scott, who influenced me deeply early on before I even went into medicine once said, "Dying is the gift that the dead give to us." And part of that gift is the reminder that we all die eventually.

So how does this relate to studies on red meat and eggs?

Everyone has their own motivations for pursuing a lifestyle that has more fitness and better nutrition in it. But one prevailing theme, not usually explicitly stated, is (and I'm going to make up a word here), "life maximization". This theme is not only prevalent in motivations for pursuing exercise and various forms of nutrition, but in the study of nutrition and physical activity itself. Sure, the short-term goal is to lose weight; but the brass ring is to avoid an "early death". Whether you eat red meat, processed foods, or eggs has very little to do with whether you're going to lose that weight, but ultimately, those that choose to eliminate or add foods to their diets for reasons other than taste and personal preference are looking to maximize the number of years they have left (i.e. the prevailing theme of food as drug/medication)

Here's the thing: You don't know when you're going to die.

Alwyn Cosgrove's best quote, in my opinion, has nothing to do with fitness. I'm not going to try to actually quote it, but the gist of it is this: What if you only had 1 year left to live? How would you live differently? What about if you had 5 years left? 10 years? How do you know you don't?

I'm not advocating a "live your life like every day is your last," outlook on life (It's highly impractical, since if this was my last day, I definitely wouldn't need to do laundry.) If I see another "YOLO" meme, I will hurl.

Here's my main beef with long-term correlational mortality studies: The underlying assumption is that these events are not only bad, but preventable. I'm not talking about heart attack studies or stroke studies in which the subjects survive, but the ones where the subjects have heart attacks, or strokes and DIE. Or worse yet, the baffling, "All-cause mortality" variable. Somehow removing or adding a single food item or group increases or decreases ALL-CAUSE mortality (i.e. your chances of dying--from anything, including, but not limited to, being struck by a falling piece of space debris.)

If we accept the tenets that each of us has finite willpower to accomplish our goals, that our bodies do not differentiate between physical and non-physical forms of stress, and that death is inevitable and individually unpredictable, then we should all stop paying attention to long-term correlational mortality studies, because the very construct of all-cause mortality and its reduction is ridiculous. Any energy spent on following through on eliminating or adding said food item or intervention is energy taken away from that finite pool of willpower that could be used to live your life as opposed to attempting to circumvent death. Any stress caused by trying to keep said food item or intervention in or out of our lives is stress that is grounded on a faulty construct that death is avoidable and somehow controllable (or at least somehow predictable), and therefore, also ridiculous.

We know from decision analysis studies that people (when asked the question, as opposed to being in the situation itself), respond that they would be willing to trade off years of their life to have higher quailty of life. In general, people would rather have shorter, but higher quality lives. What's interesting about decision theory, is what's known as a mirror effect, where people, when faced with two alternatives, both of which involve losses, (one of which is a certainty, and the other is a gamble favouring the odds of losing even more than the other option) will tend to choose the gamble, even though the odds are stacked against them. This, in some ways, might explain why these studies can have such powerful effects on people as the perceived options are A) certain death and B) a gamble of a lower quality of life in exchange for the chance of not-death.

One of my favourite comedians, Margaret Cho has a bit from her "Notorious C.H.O" (oddly apt since that's also the abbreviation for carbohydrate), "? So how much time would I save if I stopped taking that extra second every time I look in the mirror to call myself a big fat fuck? How much time would I save if I just let myself walk by a plate-glass window without sucking in my gut and throwing back my shoulders? How much time would I save?" And it turns out I save about 97 minutes a week. I can take a pottery class."

No lifestyle decision comes without cost. Arguably, no decision at all comes without cost. However, when it comes to making life choices based on evidence, and the cost of these choices in the face of what appears to be a faulty gamble for death-avoidance, the trade-off might not be worth it. It might be better to take that pottery class.

Protect your willpower. It's all you have to reach your goals.

There have been numerous books written on how Western society compartmentalizes/hides from/shuns death and dying, If you're curious, might I suggest The Order of the Good Death, who I heard about on the CBC (Oh, GOD, I miss the CBC?) and of whom I am definitely a fan.

Oh, and if you haven't and it's culturally/religiously okay with you, sign your donor card. For both organ and tissue (if the option is there). And talk to your family about it (yes, there are cases where the card is signed and the family objects and then more people have to get involved)

Source: http://evidencebasedfitness.blogspot.com/2013/01/you-are-going-to-die.html

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