Avoiding Heart Disease

One thing I have recently become aware of, after my doctor ordered a test, is checking for mutations in the MTHFR gene. It's an enzyme which deals with how we process folate into its active form and is important in many pathways

Supposedly the C677T mutation increases your risk for heart disease. There is also another one, A1298C that is very common but no consensus on how it may effect health. I also matters whether you you have one or two copies of the mutations.

Some recommend supplementing with methylated B vitamins to offset the any negative health effects, but I'm still soaking this in and am not sure what the consensus is it yet.

Fred Kummerow seems like a credible authority on the subject of heart disease:

"My findings indicate fried foods, powdered egg yolk, excess vegetable oils, partially hydrogenated vegetable oils and cigarette smoke as the greatest culprits in heart disease." http://www.futuremedicine.com/doi/full/10.2217/clp.13.34

I think the OP is referring to the fact it's much easier to focus and improve on specific items than it is to follow some nebulous generic advice. "Lose weight" is much less effective than "Exercise 30 minutes per day and eat 2200 calories per day".

What seems to be likely regarding cholesterol in general is that it has been greatly over focused on to the detriment of more likely culprits like sugar and refined foods. Of course, the cynic might say you can't take a pill made by Pfizer to lower your sugar and refined foods like you can to lower your cholesterol.

For those interested in getting a much more comprehensive look at their blood, along with a consultation from a doctor to help you better understand the connections, check out http://www.wellnessfx.com/

(I haven't tried it out myself yet, but I'm planning to next year - I'm in no way affiliated with them, but definitely seems like a great idea)

I tend to think of doctors as mechanics. Often when something breaks on my car, the explanation is "it's an old car, that happens eventually." And when they talk about it after fixing it, it's usually "Toyota's a good brand. Take care of it and you'll get another 100k miles from that engine." If I took my car to my mechanic with nothing wrong and asked what I should be doing to make sure the transmission lasts as long as possible, they will give me some generic intuitive advice, but they have no real insight because they are not in the business of maximizing the lifetime of healthy cars.

Doctors are kind of the same way. They see patients who have problems and need them fixed. If you walk into a doctor's office and say your family has a history of heart disease and you're concerned, they'll run a standard diagnostic to see if there is a problem. If there isn't, they'll give you generic advice. Outside of that, they are not really likely to have much insight into how to prevent heart disease in your specific case. Maybe you'll get lucky and the doctor will have recently read a relevant paper.

This seems to me like a problem that you're better off having answered by a medical researcher rather than a physician in the trenches. Researchers are the ones who are taking the long view on outcomes in patients. Keeping with the same analogy, you're probably better off talking to a mechanical engineer at a car company about maximizing the life of your currently healthy transmission.

Also, I generally see this as a problem that will be best addressed by machine learning researchers collaborating with medical researchers. Then again, I'm an ML PhD student working on health applications, so I'm biased. :)