#11

Andrew Steele has agreed to chair the debate.

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#12

What exactly are you two disagreeing on? Under that definition of biohacking, Brad Stanfield would be biohacking by taking rosuvastatin, finasteride, etc.

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#13

In terms of his 5 points I disagree with the idea that non-diabetics should not use CGMs. I have used a CGM myself and have an HbA1c under 5 (lowest was in fact 4.18%).

I am neither here nor there on Wim Hof.

I think he is essentially right on the anti-oxidants.

Autophagy is a key priority. I prefer his eating strategy of a large breakfast. I think the evidence points to better glucose handling.

However, intermittent fasting with a large breakfast might be useful.

I think the Metformin research had a selection bias.

3 Likes
#14

I think we/you want to and it is crucial to have the debate at the level of his headline statement more than about those 5 points and have him agree or not to key biohacking principles

Ie we can’t let him get away with the “…I am against biohacking” part just because he throws up some specific strawman like antioxidants XYZ

Key principles that are I think are key for good “biohacking”

  • while clinical trials are valuable, they are not perfect - (i) they are generally only done to detect averages, (ii) they slow and can often lag wealth of scientific and medical, understanding and (iii) many clinical trials that should happen don’t because of eg what is not/no longer patented, want is not optimal for the biopharma industry, etc

  • each person is individual and is often far from identical to the average information from clinical trials (that exist) and may often need intervention that there has - nor may never be - a clinical trial for

  • a doctor has in general very limited amount of time to think about each individual patient and to process massive amounts that a biohacker might be obtaining - while a smart, educated, and especially if dedicated biohacker can spend days and weeks on each and any decision they are considering

  • the amount of data that a health conscious biohacker can obtain through time across blood work, functional tests, wearables, imaging, etc, etc, has sky rocketed and in many cases goes way beyond what a clinical trial can afford to look at

  • while careless, uninformed use of a medication, supplement or sleep, exercises and diet practices, is not a good form of biohacking, each of the three last points above provide a context where biohacking has a good potential to improve a persons health state

  • such good biohacking needs to be data based (both scientific and medical literature) and collecting large amounts of the key relevant N=1 bloodwork), need to carefully consider risks/reward, needs to react to the N=1 data in a objective way

  • such “biohacking” is not really more than applying the scientific method to the individual - and when the individual is not someone like Bryan Johnson or Peter Attia’s patients who cannot afford 100s of thousands for an MD to guide them, the person themself takes on the responsibility to learn, digest and evaluate large amounts of info, gather key data and make decisions

—— above can be built out more, but think you get the direction

Perhaps people can add to it and help you prepare.

—-

I think the above is the most important to get rights - if you have these frameworks and principles down right you will repent “good forms of biohacking” in an excellent way and it will be tough for Brad to disagree with a lot of the core premises

—-

Other things that might help also

  • does he agree that off-label use of medicine can be done by a well educated and informed MD. How come - that is not based on a clinical trial right? Are the reasons for that not similar to the reasons why good biohacking can be risks/reward positive?

  • does he agree that the vast amounts of medical science go far beyond anything that a MDs education comes close to covering and that a dedicated person can in many ways - though not in all ways - rival the understanding that any doctor they can access would be able to apply if that doctor only can spend a limited amount of time with the patient

  • what are a humans rights to decide what to do with their time, resources and body?
    Should we be allowed to go ski off pist, parachute, drive a motor cycle? Should we be allowed to eat crappy food, not exercise, should we be allowed to fast? If so, should we not be allowed to lower our cholesterol more than current guidelines say if we feel the medical rationale is a positive risk/reward? Should we not be allowed to take acarbose before a meal? Who should have the right to say that a well informed individual cannot decide him or herself to take rapamycin?

  • how the knowledge for good biohacking can increase the world’s understanding and feedback into main stream medicine, eg Matt K’ paper on the survey of rapa users, or how Nobel prize winning medicinal advances where initiated that way as you mentioned above

11 Likes
#15

This is such a particularly good post that it needs more than just “like” as an option. I am in the process of agreeing with Andrew Steele a form of agenda, but I need to make sure that I include a lot of this where possible.

To be honest:
a) I think Brad Stanfield’s statement “I am against biohacking” is really clickbait rather than a well thought out position.
b) The debate will continue in any event.

However, it is very clear that self-experimentation has a long track record of being good science and has the ability to be sensitive to the individual test subject that a clinical trial is not.

7 Likes
#16

Here’s a paper posted here by @RapAdmin last year that might be helpful to this discussion.

My reaction to Stanfield is [yawn]. He isn’t really speaking about people like us who are carefully self-experimenting and testing biomarkers over time to assess benefit, forever tweaking and improving toward the “optimal” program for our personal genome / epigenome / life history / personal preferences.

He is talking about the Silver Bullet seekers who won’t improve their lifestyle and instead are being lead around by Influencers in pursuit of the “one true, hidden secret” to health. These people are not biohackers, they are ignorant people who haven’t yet caught onto how to really self improve. We can help them 1 by 1.

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#17

I think Stanfield is addressing the crowd that could endanger themselves through reckless or ignorant behaviour.

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#18

Aren’t we all biohacking every time we take a supplement, prescription drug, undergo a procedure, or get an injection? The difference between mainstream drugs/procedures and biohacking is a matter of degree, not kind: the degree of proof, reliability, and safety.

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#20

Debate serves no purpose except Stanfield’s. You just bit the bait.

Sorry. Wrong button. That was in reply to the John Hemming.

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#21

It was my idea. I think it is worthwhile promoting the idea that people have agency and are capable of making their own decisions about health

Furthermore I also wish to promote the XPrize team because I will be looking for people aged 65-80 to participate in this particular approach.

4 Likes
#22

How many hours between the last and the first meal?

#23

I dont have an evidence based answer to this.

#24

From my experience as a physician I can tell you that most patients don’t know how to interpret and more importantly how to use the data to make meaningful changes in therapy. I have used CGM for a little while, mainly out of curiosity and to estimate glycemic loads of the meals I prepared. I made some small adjustments, however that was based on the recommendations of the CGM manager - avoid sugar spikes at certain levels etc. Of course those parameters are not scientifically validated in terms of clinical outcomes. Given the extremely high cost of CGMs and questionable value of actionable data I agree with Stanfield. Remember Stanfield is very well versed in outcome based clinical studies AND has a ton experience with real patients. Setting up studies to created outcomes does not always translate well to real world experience. Studies have exclusion and inclusion criteria, incentives, etc… unlike actual clinical practice. This is why I tend pay more attention to well read up clinicians (like Attia or Stanfield) vs pure researchers.

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#25

You can employ the same eating window, just adjust it so that the first meal is in the morning (say 8 am). The last will be late afternoon (6 pm, if the window is ten hours).

Walter Longo wrote about it. There are many studies, if you search for intermittent fasting and circacian rhythm.

Brad Stanfield himself has a video reviewing one such study. That study is below:

Here we show that eTRF (early TRF) was more effective than mTRF (midday TRF) at improving insulin sensitivity. Furthermore, eTRF, but not mTRF, improved fasting glucose, reduced total body mass and adiposity, ameliorated inflammation, and increased gut microbial diversity.

We performed a randomized controlled trial to compare the effects of eTRF (eating during a period of no more than 8 h between 06:00 and 15:00, and fasting for the rest of the day), mTRF (eating during a period of no more than 8 h between 11:00 and 20:00.

eTRF could be 6 am 2 pm, or 7 am to 3 pm.

The last meal is too early for me. My last meal is at 6:30 pm.

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#26

My last meal is 6 - 6:30 pm and I have coffee at 9 am and breakfast at 10 am. May be my interval is too long?

#27

I used to start at 11 am, even 12 noon, when I forgot to eat. But there is some opinion that skipping breakfast may have cardiovascular effects. Walter Longo may have also opined as much. So I tried having some yogurt (Siggi’s, 5 grams carbs 100 calories) at 8:30 am. But the blood glucose went up a bit. So I went back to 11 am. As a compromise, I take a tablespoon of EVOO (about 100 calories) at 8:30 am There is also the 3 grams (12 calories 4.3 per gram) of glycine with the morning tea. I do not know if that counts as some breakfast. But I subjectively feel better this way.

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#28

Even a cup of black coffee at 8 am elevates my glucose 5-6 points. Because of that I now measure BG before I have coffee, and again 1 hour after breakfast.

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#29

I found it useful
a) To know what is going on
b) To see the changes from one year to another.

I don’t think it is worthwhile continuously wearing a CGM, but I am pleased to have some form of baseline as well. In fact between one year and the other my glucose handling improved (given the same or very similar meals).

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#30

Great, now what does that mean clinically?

#31

What kind of effects?