How Aging Research Is Changing Our Lives

> If you have no symptoms then what on earth would you have to talk about with your GP twice a month?

I feel like this illustrates my point quite nicely. I'm not sure, but the addition of "on earth" makes your sentence sound incredulous and rhetorical rather than a genuine question, more of a statement that without symptoms there can't possibly be anything to discuss. Are you by chance under 30?

The definition of whether something's wrong when I visit the doctor is how much pain there is. When they ask what's wrong they always give me a green xerox of a questionnaire that has me circle the number between 1 and 10 rating my pain level. If that number is less than 5, they schedule differently. Non-emergency may mean 2-3 weeks before I get a visit. If it's 1 or 0, they start asking if you really need to see the doctor at all and start giving you online resources.

Ever do any maintenance on your car or your computer when nothing's wrong with it now but you guess might be later if you don't? I have. Ever change oil or free up some disk space? Have you ever optimized some code before you actually measured a performance problem? I have. What are the reasons that we would ever do that or talk to anyone about it before there are actual symptoms?

Have you ever googled a health question to see what other people are doing? I have and I happen to know that Google's index has a lot of content that answers minor and major health and medicine questions. The existence and popularity of health advice online and websites like WebMD suggests you might be underestimating how many people would enjoy the chance to chit-chat with their doctor more often, just to ask stupid questions.

Have you ever just been curious about how things in your body work? Sometimes I know what to do with my body, I just want to learn why it's doing something, and learn it from somebody who went through training. For some topics, I'd rather skip the part where I google it and try to sift through the 90% of bullshit online where people just make up stuff, and talk to someone I trust instead.

I do get the feeling you might be making assumptions about what I said and what kind of questions I was talking about. I'm not sure what you're imagining, but I probably would run out of questions like "how many calories should I eat?" and "should I exercise?" pretty quickly. The body has a lot of moving parts though, and once you have a few surgeries, once you're over 40 and weird things start to happen, once you get curious about why some part of your body isn't doing exactly what you expect, you might end up wanting to ask your doctor some questions about your joints & muscles, or about your esophagus & stomach, or the health of your children, or your hair & eyesight, or your skin or toenails, or whether your family history about this or that is likely to affect you.

I've only just turned 40 and I suppose to be fair, when I was younger I might have felt the same way you do. But my body is changing and my desire to stay on top it is increasing. I've always been fairly healthy, and I know what to do to stay healthy, but in the last decade my body reacts differently to exercise than when I was younger. I've hit a couple of joint issues going to the gym that compromise my ability to do certain exercises. In the last 5 years I've hit some knee problems when running that compromise my ability to run longer distances. I've done minor damage my neck and back mountain biking and skydiving. I'm starting to experience side effects from the surgeries I've had in my life. My digestion is changing and I can't eat all the same food I used to without "adverse" effects. I would love to get regular advice on how to tune myself given the problems I have, often from a sports doctor, but like I said I don't seek appointments for every question that pops into my head because our medical system doesn't really support education and regular preventive care.

Eric Verdin is spot on, in my opinion, we have sick care, not health care.

The level of evidence for most of these recommendations is quite low. That doesn't make this bad advice. In fact, most of it is probably good advice. But it does explain why the GP's physician is not going to be discussing this in detail.

> I've hit a couple of joint issues going to the gym that compromise my ability to do certain exercises. In the last 5 years I've hit some knee problems when running

The running and lifting communities do an ok job giving people basic safety training, but the way people do these repetitive motions over and over and over for years without variation will frequently lead to injuries in the long term. It's still a net gain for health, but there's something about just the intention to be "a runner" or "a lifter" that sets you on a path to injury.

The alternative is movement practices that span a much wider range of motions. Tai Chi is a good example. Yoga probably is not, based on the way your average teacher will teach it (goal-oriented, fast, and repetitive).

But really if you want to limit your exposure to injury, you need to learn to be active all day long, to find exercise and resistance in everything you do, learn to read which activities your body needs more of, and go seek them out, and learn how to heal from things you're doing too much of.

Runners World can't really advise you on that because if it's not running it's not really on topic.

Of course. The problem is that trials when your effect size is small are expensive. A trial looking at longevity outcomes for young healthy people would require decades of follow-up. The expense would be enormous, and the results would come generations later. Really have to hope you've asked the right questions.

Statistically people will still die. I imagine a life insurance actuary could provide an expected life span if all medical causes of death were removed. I doubt it would be more than a thousand years.