PatrickDB wrote: ↑Fri Jan 19, 2018 4:58 pmspeaking from experience, I think dealing with the sleep thing is necessary and sufficient.
I would agree it's probably the single most important part of any change for health (whether measured by T or anything else). But these things tie together. I trained one guy, his regular breakfast was a white bread roll with chicken loaf and mayo.
I said: "Set the alarm fifteen minutes earlier, have oats."
"Hey I do nightshift! Every minute of sleep matters!"
"I'm a parent, I get it. But here's the thing... didn't you say you're taking metamucil?"
"Yeah."
"You're a 30yo guy taking metamucil. Do you agree this is not normal? Now, when you're constipated, is it harder to get to sleep? Do you sometimes wake feeling uncomfortable and needing to go? If you had more fibre, do you think you might find things flow better? And maybe, okay, 15 minutes less sleep at the end, but maybe you'd get to sleep more easily, and your sleep would be better-quality?"
So he tried it and found he didn't need the metamucil, and his sleep was better. So I think these things tie together.
I agree you're one of the most useful and informed posters here. But some coaching or teaching experience makes you understand how your words come across - people are looking for any excuse to avoid doing what they need to do. The metamucil guy was a doctor, by the way, so it's not like he didn't know this stuff already - but he did need someone to tell him to do it. So rather than say, "X is all that matters" (which is what "necessary and sufficient" means, really, and could lead to people regularly eating KFC before going to bed early), you'll find yourself saying, "X is the most important thing, but even if Y and Z don't help much by themselves, they certainly won't hurt, and they'll help X, too. So focus on X, but try to do Y and Z, too."
All this detailed science matters, a lot. But it's the 80/20 rule once again. It's like the USA's
National Weight Control Registry. They've done stacks of studies and learned a lot and found some interesting things that need further study. But... the people who lost weight and kept it off,
"Most report continuing to maintain a low calorie, low fat diet and doing high levels of activity.
78% eat breakfast every day.
75% weigh themselves at least once a week.
62% watch less than 10 hours of TV per week.
90% exercise, on average, about 1 hour per day."
Apart from the "weighing yourself" bit, most of those changes are stuff most people would intuitively understand are good things to do anyway; much the same applies to many of the AoM guy's recommendations for T.
Some relatively simple changes can make a big difference to people's lives. I don't think you need to be an endocrinologist to figure that out.
Now I have to go eat those two cups of vegies I didn't have at lunch.