I just replied to an EA member who raised the question "What is the most cost-efficient way to convert money into personal health?" so I thought I'll share it with you.

I'm pretty biased as a social psychology student, but some measures translates to health (physical and mental) better than cigarettes...the measure that was most correlated with longetivity was relationships and friendships (quantity and quality. It says Longest Study On Happiness but it's not only happiness, it's also longetivity).

So I guess find an affordable social hobby where you can meet new and good people.

Dancing, singing, martial arts (Capoeira is very social), ball games, off course, volunteering (socially). For me it's improvization. :)

And even cheaper (but as far as I remember, less effective than socializing, still more effective than not smoking) - avoid long sitting. Sitting is deadly. Stand up and make a little walk every once in a while.

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Thank you so much for writing this. It’s really important to take care of one’s health and so I’m glad you bring this up.

Of course, social relationships are important, but the recent talk about the loneliness epidemic (/ depression) is there for a reason-it’s just quite hard for people to establish satisfying social relationships and I don't think anyone has quite cracked it yet. Quitting smoking, alcohol, salt, and sugar is also hard–they are quite addictive. The jury on sitting seems to still out [1, 2, 3, 4] - it might be that exercise can effectively eliminate associations with ill-health.

If you factor in time costs, willpower and other constraints, then I think the below are better ways to effectively improve your own health.

Disclaimer: this is not medical advice, please consult your doctor before doing any of this. Also, this is based on experiences of a socio-economically-privileged, abled-bodied male.

  1. One-off behaviors that have long-lasting effects:
    1. Example: routine vaccinations and vaccination refreshers. You need to get the DPT and MMR vaccine during childhood and also need a refreshers during adulthood. There might be other vaccinations that might be effective for some people such as the HPV vaccine or meningitis.
    2. (Non-elective) surgeries
  2. One-off behaviors or purchases that create semi-permanent lock-in. Examples:
    1. Annual reminder for doctor’s / dentist appointment
    2. Signing up for a gym as close to your home/work as possible (beware of trivial inconveniences)
    3. Signing up with for psychotherapy
    4. Setting an annual calendar reminder to September to get a flu shot
    5. (Fitbit) scale to track your weight
    6. Noise-cancelling headphones to reduce hearing damage
    7. Eye-mask to improve sleep
    8. Better/private health insurance
  3. Remove negative health behaviors. As a rule, it’s often more effective/easier to remove negatives (not doing bad things) from one's lives than adding positives (doing good things).
    1. For example, you can’t outrun a bad diet: drinking 500 excess calories by drinking a liter of soda is much easier than doing an hour of exercise.
    2. Smoking/drinking less alcohol is more effective and easier than exercising
    3. Cancel addictive media that encourages sedentary behavior and reduces sleep
  4. Taking supplements and medications. The benefit-cost-ratio can be very high: you just need to remember to take the pill and do it, which might improve your health by quite a bit. Many people in advanced economies have micronutrient deficiencies such as iron, Vitamin D, insufficient fiber, etc.
  5. Health behavior change through listening to audiobooks might be very effective. Kick back and relax, while a professional audiobook narrator with an authoritative voice whispers affirmative, encouraging, actionable, scientific, focus-group tested, carefully edited prose right into your ear for 10 hours straight. In my experience, audiobooks can really hit the point home—all the behavior change, none of the eye clamps. You can get them for free with an audible trial. For health:
    1. “The Ultimate Guide to Fasting” and “The Obesity Code” by Jason Fung
    2. “The easy way to quit smoking”, "The Easy Way to Control Alcohol" by Allen Carr
    3. “Why we sleep” - for better sleep
    4. “Cognitive Behavioral Therapy: Techniques for Retraining Your Brain” for mental health
  6. Relatedly, learning about health might have a high value of information, if it makes you aware off unhealthy behaviors you could easily change (for instance, lifestyle risks for cancer)
  7. Weight loss: being overweight is one of the biggest causes of ill-health in advanced economies. I found water fasting to be really effective.
  8. Improving sleep (humans sleep a third of their life, so it scores very highly on importance).
  9. Exercise: If you want to optimize for health, keep it very short (<30 mins) because you’re quickly hitting diminishing returns, but do it more often. In the gym, do 20 mins of 1) low impact high-intensity interval training cardio (e.g. elliptical) and 2) do 1-2 exercises resistance/weight training with focus on safe and easy versions of the big compound lifts ((front) squats, Romanian deadlift, overhead press, dips, chin-ups). Increase weight slowly but steadily so that you to become strong, but stop increasing the weight when you reach your bodyweight to reduce injuries. Learn some bodyweight exercise for days you don't go to the gym.

Lately, I’ve been wondering whether this is a lot of effortful micro-optimization and whether not bigger things in life are not much more effective. For example, moving to a healthier city/country with better public health/ less air/noise pollution. Thoughts on this?

Even lower barrier for exercise is a treadmill desk or recumbent stationary bike, both of which allow reading and computer work.

Quitting smoking, alcohol, salt, and sugar is also hard–they are quite addictive.

For most people, cutting salt intake is harmful, not helpful. Salt isn't new to human diets, and it isn't a matter of addiction; it's just a necessary nutrient.

Sugar can be harmful, but only insofar as it crowds out other calorie sources which are better. When people try to cut sugar, they often fail (and mildly harm themselves) because they neglect to replace it.

I agree that, if sustained throughout the lifecourse, then moderate consumption of salt and sugar is not harmful. I wrote this sentence with metabolic syndrome in mind - this affects very many people as they get older.

On salt: I agree that salt is essential and not new to human diets, and that for the majority of people reducing sodium by a lot is harmful.

However, many people have high blood pressure and should avoid excessive sodium consumption [see study, study]. Also, many scholars argue that salt can be described as addictive [see 'Salt addiction hypothesis'] and some implicate it in making food hyperpalatable (also see 'The Hungry Brain' by a former OPP consultant).

On sugar: the WHO recommends a reduced intake of free sugars throughout the lifecourse.

Not sure what you mean that people harm themselves (you mean that they mess with their basal metabolic rate? I think this is only happens in extreme cases, not when, say, just cutting out sugar sweetened beverages). Thinking about this in terms of the reversal test, recommending increasing sugar intake (which is happening anyway) does not make sense to me on average.

Were you under the impression that I was disagreeing with the sodium-reduction guidelines because I was merely unaware that they existed? This is an area of considerable controversy.

Were you under the impression that I was disagreeing with the sodium-reduction guidelines because I was merely unaware that they existed?

No, my model of your view is that you were aware of the guidelines, but believe that sodium-reduction guidelines are on net harmful. Am I correct?

Both too little and too much salt is bad, but based on two the more recent meta-analyses I linked above, that deal with this controversy in the Ioannidis article you linked, I think the WHO salt reduction guidelines are on net good.

As a rule, public health messaging should be tell people to watch their salt intake to reduce their blood pressure, because:

  • average salt consumption is much higher than the WHO recommends
  • it will likely increase due to profit motives absent policy interventions
  • many more people with high blood pressure will benefit than people with low blood
    pressure would be harmed because they adapt a very low sodium diet on the basis of sodium reduction guidelines
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