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A Medical Mystery of the Best Kind: Major Diseases Are in Decline

nytimes.com

141–150 of 152 posts

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#141
post #75

Earlier quoted context omitted.

Yes those drugs. Hard to say conclusively, but the failure of most of CETP inhibitors is troubling news for the hyperlipidemia theory. Meaning possible hyperlipidemia has multiple causes and in and of itself isn't bad. AKA Cause A results in hyperlipidemia. Cause B results in hyperlipidemia. Cause C results in hyperlipidemia and arterial plaques. Cause D results in hyperlipidemia.

Numerous lines of evidence, including randomized controlled trials, single gene studies, and Mendelian randomization studies, are not consistent with your interpretation. Multiple agents that reduce cholesterol, including ezetemibe and statins, reduce cardiovascular disease outcomes and death. Multiple cholesterol-related genes, including HMGCR, LDLR, APOB, PCSK9, and ANGPTL3, contain variants which influence both LD…

> reduce cardiovascular disease outcomes and death.

Only in small selected populations.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#142
post #98

Earlier quoted context omitted.

> Smoking rates are only decreasing in developed nations. Except Japan when selling tobacco is still a very healthy business and there is no cancer prevention whatsoever. Lobby has been super effective down here.

When you say no cancer prevention whatsoever I think you are referring to just lung cancer. I do not know much about their national lung cancer recommendations but I do know that Japan has actually had a very robust GI cancer screening history compared to the US. This is partially due to their incidence of gastric cancer being much higher than in the US.

Yup, and the main reason for having so much GI cancer is basically alcohol abuse. Salarymen going to drink several times a week with colleagues and having always a beer on your table at home certainly does not help. Korea has the exact same problem, and very high Gastric Cancer rates as well.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#143
post #129

Earlier quoted context omitted.

Also the legality of abortion (Roe v Wade, 1973) could be a contributing reason. The drop in crime came about 18 - 20 years after abortion was declared a constitutional right. Most crime is caused by teenagers and young adults. What affect started in 1992,1993 that is still happening today?

In my country abortion laws were changed to much stricter 19 years ago, while everything else changed like in most developed countries. Crime dropped significantly, and is on the low-medium end in European Union, from high-end in early nineties. So I think abortion is irrelevant, and it's mostly lead and general quality of life issues.

Is it still legal in your country? It was illegal in the US prior to 1973.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#144
post #135

Earlier quoted context omitted.

"In his own studies of smoking, Stebbins has shown how the tobacco industry has turned to markets in the developing worl to make up for loss in sales first in the United States and subsequently in parts of the European market. Governments in developing nations often do not have the ability to limit tobacco marketing and, usually in need of financial help, they are open to introducing taxable commodities to their citi…

This is an area where I see the free market causing great harm. How can a population contend with greedy, money-rich corporations who wage huge psychological and legal campaigns? It's very one-sided. In the US, science and the people's own best interest are seldom enough. The government must have some balance of power to regulate corporations that are otherwise happy to abuse their fellow humans and distort culture a…

I can safely agree with you on these points, and it's probably the biggest argumentative weapon feminism has: many of the big problems that need to be dealt with require a "retreat" to a more innocent and child-like state of curiosity about our value systems.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#145

Earlier quoted context omitted.

Smoking rates are only decreasing in developed nations. Globally it's increasing by ~1% each year.

The study is talking about wealthy (e.g. developed) nations this doesn't apply.

I was just replying to his comment. It's a "mainstream" idea that people like to repeat, but it's simply untrue.

It's like a stock phrase: "Smoking is actually going down, you know! People really are getting smarter/healthier/happier/whatever."

It's just false.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#146

Earlier quoted context omitted.

"In his own studies of smoking, Stebbins has shown how the tobacco industry has turned to markets in the developing worl to make up for loss in sales first in the United States and subsequently in parts of the European market. Governments in developing nations often do not have the ability to limit tobacco marketing and, usually in need of financial help, they are open to introducing taxable commodities to their citi…

That's a photo, of a rate of growth, two decades and half ago. At least in Brazil, smoking rate is much lower than what it was by then.

It just shifts around from place to place.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#147
post #129

Earlier quoted context omitted.

In my country abortion laws were changed to much stricter 19 years ago, while everything else changed like in most developed countries. Crime dropped significantly, and is on the low-medium end in European Union, from high-end in early nineties. So I think abortion is irrelevant, and it's mostly lead and general quality of life issues.

Is it still legal in your country? It was illegal in the US prior to 1973.

Only in saveral cases (rape, threat for the mother's health, I think that's all).

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#148

Earlier quoted context omitted.

That's a photo, of a rate of growth, two decades and half ago. At least in Brazil, smoking rate is much lower than what it was by then.

It just shifts around from place to place.

Where to?

The world is finite, if you are pushed out of enough places, it's game over. All the poor and developing countries together sill don't have as much buying power as the developed countries. If you take the developing countries out, what's left isn't much of a market anymore.

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#149

It mentions statins as something obviously good but is there any evidence they're actually beneficial? I thought cholesterol was good now?

LDL cholesterol and triglycerides are harmful. Higher values of those cause higher risk of coronary artery disease and earlier death. HDL cholesterol ("good cholesterol") appears to have no effect, at least the scalar quantity that we measure with current lab tests. Statins reduce risk of death in proportion to their reduction of LDL cholesterol, so most likely this effect is a consequence of decreased LDL cholestero…

Not sure why you say HDL has no effect. Ratios of "bad" to "good" markers have been shown to be much better predictors of risk than any one number on its own, even LDL.

https://www.youtube.com/watch?v=YRFRRqe0vrE&t=924s

You should also take a look at the latest risk calculator derived from the Framingham Heart Study. It's basically a multivariate regression of various risk factors against CVD risk. Total cholesterol and HDL are inputs, while trigs and LDL aren't used. They do of course factor into total cholesterol, but the researchers specifically stated that "The use of low-density lipoprotein cholesterol did not improve model fit or performance."

http://circ.ahajournals.org/content/117/6/743.long

Re: A Medical Mystery of the Best Kind: Major Diseases Are in Decline

#150

It mentions statins as something obviously good but is there any evidence they're actually beneficial? I thought cholesterol was good now?

LDL is still "bad" and HDL is still "good", but that means in your blood, not your diet. The evidence linking dietary cholesterol and saturated fat to cardiovascular disease is weak.

Dr. Peter Attia provides an excellent summary of the topic here: https://www.youtube.com/watch?v=nhzV-J1h0do

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