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Comment by sparrc | Hacker News Reader

It's always strange to me how certain studies seem to gain so many upvotes on hackernews....a few thoughts:

1. This is a single study published in 2015, what does the wider literature say? Any dieticians or clinicians recommending anything from this?

2. The journal is EBioMedicine, which is not nothing but not exactly pre-eminent either.

3. This seems like just a common sense conclusion: "In Cox proportional hazard models, inflammation predicted all-cause mortality". So...people who die have inflammation? Wouldn't that be expected that people who are dieing are likely experiencing significant inflammation of at least one organ of their body?

4. In short, the conclusion of this paper seems like essentially "people who are dying are likely to die". Am I missing something here?

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I think you’re overthinking it.

Certain studies gain so many upvotes on HN because they generate interesting discussion, and may be worth storing in our favorites for sharing and/or future reference.

I almost always upvote articles when there is interesting discussion (or the potential for interesting discussion) related to the article. I very rarely (but do sometimes) upvote articles solely based on the content of the articles themselves.

Or rather, I’m much more interested in a collection of people’s thoughts vs. a single person’s thoughts.

On the other hand, isn't it a peer-reviewed journal? If we have to do the legwork of going around asking what other clinicians think of it, it has failed at its mission as a peer-reviewed journal.

You have a weird view of academia

Peer review only is the initial smell test, and don’t mean it’s actually true. Fraud for example can often pass peer review just fine. That said, it does catch errors and rejects a lot of junk which is why it’s considered important.

No, peer review is “there doesn’t seem to be an major errors and the thinking is reasonable”

>it has failed at its mission as a peer-reviewed journal

Peer-reviewed just means:

(a) a bunch of guys had a cursory look at the research, which they might or might not be able to follow (even basic math), and left some hasty criticism on low hanging fruits (or the personal pet peeves they always mention) to pretend they thoroughly read it, and accepted it

(b) Some scholar friends accepted this as a favor to other academic friends, who will backrub them when they submit their own research, and help each other pad their paper counts

And meta-analysis means:

I run across peer reviewed garbage on nih.gov all the time. I report them and quite rarely they are taken down. Others put more effort into this than me. They will publish nonsensical papers to expose the vulnerabilities. I am too lazy for that.

It looks like it is actually a meta-analysis: A study of several other studies, which has good points and pitfalls.

we combined community-based prospective cohorts: Tokyo Oldest Old Survey on Total Health (TOOTH), Tokyo Centenarians Study (TCS) and Japanese Semi-Supercentenarians Study (JSS) comprising 1554 individuals including 684 centenarians and (semi-)supercentenarians, 167 pairs of centenarian offspring and spouses, and 536 community-living very old (85 to 99 years).

One of the good points is that it tends to include data from a great many more people than most studies can include. One of the pitfalls is that it is challenging to combine data from multiple studies because they probably used different methodologies, were measuring different things, etc and this puts a lot of noise in the data and cleaning the data to get something useful and meaningful can be quite hard.

Meta studies can be a case of "garbage in, garbage out." But when they are done well, they can roll up a whole lot of information together to draw conclusions we simply don't have the resources to meaningfully study some other way.

I suppose emphasis is on this: "telomere length was not a predictor of successful ageing".

yet everyone in the comments is sounding off as if this scientifically proves their random anecdotes about fasting

What’s wrong with fasting, isn’t it likely to increase life expectancy. I certainly feel better from this attempt at Ramadan (not religious just interested to try it as flat mate is Syrian). What evidence do you have that fasting -> less inflammation -> better ageing is wrong?

Fasting is good when following recommendations. But people in West are very ignorant about the practice still. It's natural to be sceptical about foreign practices, until they become medicine.

> What evidence do you have that fasting -> less inflammation -> better ageing is wrong?

It’s wrong to frame the question as you did. The evidence should be provided to prove something, not disprove it. Is there enough evidence that fasting ultimately leads to better aging? If so, for which groups of people? Is there any underlying condition that negates the effect? That’s how science work, not the other way around.

>Is there enough evidence that fasting ultimately leads to better aging?

There never is any evidence than anything leads to better aging because longevity studies are notoriously expensive, hard to do, and prone to be inconclusive. like those diet studies that pinhole certain foods like chili peppers which supposedly reduce vascular disease.

https://newsroom.heart.org/news/people-who-eat-chili-pepper-...

"eating chili pepper has an anti-inflammatory, antioxidant, anticancer and blood-glucose regulating effect" Similar things have been said for fasting. But just like people who eat chili peppers in these studies, they differ from the normal population, most likely in more ways than just consuming chili peppers. even though there is significant consensus, like this article also affirms, that reducing inflammation might help you live longer.

You could test the theory more conclusively if you had 100.000 people participating in fasting over entire generations but you'd also have to account for changes in their diet as response to such insane study. I bet everyone would think longer and harder over shoving high-sugar foods in their mouths after explicitly consuming nothing for a period of time.

I guess we will see who is right once the studies are done. There is definitely proof that fasting reduces inflammation, if reducing inflammation helps with ageing is being worked on by people like David Sinclair at Harvard and others.

All the things I've listened to regarding health an longevity have a recurring theme - inflammation happens a lot in modern life - and it decreases your lifespan.

I think type 2 diabetes is basically an inflammatory disease. More and more people are "pre-diabetes", which is basically lifestyle moving them towards type 2 diabetes.

But inflammation is just the body's natural respond to disease. Claiming inflammation hurts you is like saying wet streets cause rain.

It might also be the body's natural response to a poor diet, or carrying too much weight.

Yes, you're more vulnerable to disease when you are living an unhealthy lifestyle. Shocker.

Please define "unhealthy". This is a higly ambiguous term, and its definition differs a lot between cultures and across time, therefore it is far from obvious what living an unhealthy lifestyle means.

Inflammation can be good or bad.

You really don't want a section of a nerve to be inflamed because the body is attacking the coating, for example. You do, however, want the skin surrounding the scratch on your leg to have some inflammation to help close the cut.

None of this means you should regularly take an anti-inflammatory drug nor does it mean that an "anti-inflammatory" diet or other preventative measures will help, either. I view some of this as the latest pseudo-science, at least in the hands of most folks.

This is slightly incorrect, because inflammation is not only triggered by "diseases". Inflammation indeed hurts the body. Some of the weapons it deploys, for example Neutrophil extracellular traps (basically, playing Spider Man with webs of DNA) make subsequent cadiovascular disease more likely. Others are just generally bad for the body or uncomfortable (fever, ratches, ulcers).

Chronic systemic inflammation is known to play a role in the development and progression of coronary heart disease and diabetes, and accelerate the transformation of the immune system into an aged state, which makes it more likely to develop immune system disregulations such as autoimmune diseases, and to cause cytokine storms when exposed to agents such a N1H1, Epstein-Barr or Covid.

The immune system consists of many moving parts coordinating each other via the exchange of signalling molecules, which results in a large distributed system with lots of unintuitive emergent behaviors. We are only just starting to understand what effects our everyday behavior has on the immune system, and what happens to it when we age.

What are the best ways to lessen inflammation assuming a person is presently in good health?

>1. This is a single study published in 2015, what does the wider literature say? Any dieticians or clinicians recommending anything from this?

Dieticians and clinicians seem to say all kinds of contradicting things all the time, for half a century...

Outside of physics, a single study with a surprising result is usually wrong.

Even in physics...

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