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Avoiding Heart Disease

blog.harjtaggar.com

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Re: Avoiding Heart Disease

#51

Post by patmcc »

claudiusd wrote: post #33
tansey wrote: post #30

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 lon…

I love your analogy, but I think you drew the wrong conclusion. Doctors don't have an incentive to prevent you from getting sicker any more than your mechanic has an incentive for keeping your car out of the shop. Why would your doctor read the latest research on preventing disease when he can make a tidy profit from treating your disease? Now this isn't to say that doctors are bad people who want to make you sick...…

I think another big problem is the generic advice (eat better, exercise more, don't smoke, etc.) is incredibly effective, but doctors routinely see huge numbers of their patients not doing it at all, so why would they bother researching for more specialized advice?

Re: Avoiding Heart Disease

#52

Post by eshvk »

mhurron wrote: post #42
gabemart wrote: post #21

Earlier quoted context omitted.

> Quinoa is 14% complete protein, and chia is almost 17% Quinoa provides 3.8 grams of protein per 100kcal of energy [1]. Boneless skinless chicken breast provides 18.8 grams of protein per 100kcal of energy [2]. A weightlifter who wished to consume 100 grams of protein per day would have to eat 2632 kcal of quinoa, vs. 532 kcal of chicken breast. [1] http://ndb.nal.usda.gov/ndb/foods/show/6383 [2] http://ndb.nal.usda…

http://breakingmuscle.com/nutrition/how-to-build-muscle-mass... Just as a quick look to see details as to what would be required. Quinoa is hardly the only source of non-meat protein. Now, yes that does include a lot of protein shake stuff, that's not that unusual for most weightlifting diets. That's also a vegan diet, so you might be able to add eggs, cheese and milk to that diet and cut back on the powder in the me…

Most of the protein shake stuff would not solve the issue for a vegan diet. Most of the protein shake stuff is made from Whey or Casein or egg whites which IIRC are not vegan. There is pea protein or hemp protein but my quick googling tells me is high carb and low protein and can easily throw you off your calorie limits.

Re: Avoiding Heart Disease

#53

Post by dragonwriter »

bdesimone wrote: post #34
aaron695 wrote: post #15

> I've been wondering though why didn't I have this level of discussion with my doctor? 1. For starters doctors are good but not super people. The amount of time you can allocate yourself can mean you win via quantity over quality. 2. Tragedy of the commons. Tests that might help you don't necessarily help society. Tying up a machine that helps people with cancer hurts society but might have a benefit to yourself. Wh…

1. Doctors are people like any other. But they've spent years specializing in evidence based medicine. They aren't perfect. No. But they are the best we have. 2. The far bigger problem is doctors order tests that wouldn't change treatment but rather help avoid malpractice. 3. The quote -- every time I read it -- makes me laugh because it's so disingenuous. My wife had a week of dietary training in med school. You kno…

> Doctors are people like any other. But they've spent years specializing in evidence based medicine.

Evidence-based medicine [1] as a norm is actually a surprisingly new thing. Assuming that because someone is a doctor they've "spent years specializing" in it is probably optimistic.

[1] http://en.wikipedia.org/wiki/Evidence-based_medicine

Re: Avoiding Heart Disease

#54

Post by palidanx »

rosser wrote: post #9
eshvk wrote: post #6

Earlier quoted context omitted.

The issue is that doctors give you muddled advice too. I had my blood test done last year and I was told that I should cut down on eating any meat and switch to a plant based diet. He also vaguely told me to do more exercise. Yet, I eat incredibly lean food, albeit high protein mainly because I weight lift. I also run 4.5 miles every other day. He couldn't go into more detail apart from this general warning. I could…

The claim that you can't get sufficient protein for pretty much any level of exercise from a plant-based diet is utterly specious. For example, quinoa is 14% complete protein, and chia is almost 17% — also complete protein — with an Ω3-to-Ω6 ratio of around 3:1, almost exactly the inverse of beef. Source: I'm a vegetarian, and I pay scrupulous attention to this stuff.

See Page 4 for alternative plant based protein amounts

https://drive.google.com/file/d/0B4anS4KxXuQdUlo3NEtUZ0xROFU...

Re: Avoiding Heart Disease

#55

Post by DanBC »

bdesimone wrote: post #4

> Am I missing other major downsides to taking a more proactive approach to managing my own health? Are there other things I should consider looking at to get a complete picture of my health? A potential downside is the tendency is to shift from being proactive about your health to diagnosing (or worse -- treating) yourself based on independent research. I get that it's tempting to fire up google scholar, pubmed, upt…

There's also a risk of becoming hyper-aware of stuff that just doesn't matter.

Your heart tends to just do it's thing. But if you concentrate on it you might start noticing weirdnesses. These probably aren't your heart, but now you're anxious, so you think about seeing a doctor. But you don't want to waste the doctor's time, so you look around on the Internet to see what it is. And now you're really worried even though you know you don't have any of those things. So you go and see a doctor, and sure enough you don't have anything wrong.

Except now you caught some cold / flu bug from someone in the waiting room.

Re: Avoiding Heart Disease

#56

Post by caycep »

tansey wrote: post #30

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 lon…

The big professional associates generally put out a set of consensus guidelines that are aimed at giving "physicians in the trenches" a (relatively) easy interface as to "best practices" in terms of preventative medicine and risk reduction.

That being said, this is a matter of separating the noise from the signal in the population which is quite hard. AFAIK, and I am probably missing a few, but the only real long term modifiers are aspirin, low blood pressure, and high fiber/low cholesterol/low glycemic index foods. Everything else - there isn't enough data to separate noise from signal except for a few specific cases (someone found a gene polymorphism or mutation to something specific, i.e. the risk of blue converse sneakers or something like that)

Re: Avoiding Heart Disease

#57

Post by euphemize »

eshvk wrote: post #47
euphemize wrote: post #14

Earlier quoted context omitted.

Was thinking the same. Also >The advice to "eat well and exercise" didn't seem particularly insightful ...but it actually makes a world of a difference. I think this is the most important advice and people tend to discard it as generic and useless - the truth is that it's very hard. Being active isn't a big deal, but for a week? For a full month? Full year? Full decade? Being consistent in eating well and exercising…

The problem is that most people don't know what "eating well" and "exercising" really means. I will take myself as an example. When I graduated from grad. school in December of 2011, I was 270 lbs which at 5'10" is fucking fat. I had some idea that I needed to eat less. I remember going to a nutritionist and a doctor back in school. She gave me some vague ideas that were taken from the pyramid scale about how I shoul…

yep. there are tons of factors to take into account (genetic, economical, etc.), but doing this right often means changing lifestyle altogether.

congrats on the change :)

Re: Avoiding Heart Disease

#58

Post by memset »

claudiusd wrote: post #33
tansey wrote: post #30

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 lon…

I love your analogy, but I think you drew the wrong conclusion. Doctors don't have an incentive to prevent you from getting sicker any more than your mechanic has an incentive for keeping your car out of the shop. Why would your doctor read the latest research on preventing disease when he can make a tidy profit from treating your disease? Now this isn't to say that doctors are bad people who want to make you sick...…

Do realize that doctors are required to do continuing medical education (CME [1]) to maintain their license? Not to say that the system is perfect, but it is false that doctors do not do some sort of continued study in their field (mandated or not.)

Doctors most certainly have an incentive to keep their patients from getting sicker. One of the ways we evaluate quality of care is incidence of morbidity. How often does this patient continue to return to the hospital? This is a huge risk to physicians, in the form of a lawsuit.

It isn't like there is any shortage of patients who require care. There are so many ways that hospitals encourage doctors to do bad things to make a buck, but preventing preventative care would not be the first thing I'd target.

[1] http://en.wikipedia.org/wiki/Continuing_medical_education

Re: Avoiding Heart Disease

#59

Post by seancoleman »

I can really empathize with Harj. I have a paternal history of high cholesterol, my grandfather recently having bypass surgery. Using WellnessFX I discovered that I have an extremely high Apo B level, nearly twice the upper limit of the low-risk range. Thinking my first test was an anomaly, I was retested over the course of several months with consistent results of less than 3% variation.

Using this data, I've modified my diet and am seeking medical advice to reduce to a normal range. My cholesterol levels are all normal. I eat healthy (a seemingly subjective measure) and exercise regularly. My doctor said I am in perfect health at my recent annual physical.

I'm privileged to be able to afford private blood testing. Apo B data is within everyone's grasp, yet it seems so under-utilized.

Re: Avoiding Heart Disease

#60

Post by maerF0x0 »

euphemize wrote: post #14
WizzleKake wrote: post #7

> Generic advice to eat well and exercise is not as effective as having a specific number you're trying to improve on e.g. lowering your ApoB count. What. No. If you need to work on a number, why don't you try improving the number of minutes you spend doing cardiovascular exercise per week?

Was thinking the same. Also >The advice to "eat well and exercise" didn't seem particularly insightful ...but it actually makes a world of a difference. I think this is the most important advice and people tend to discard it as generic and useless - the truth is that it's very hard. Being active isn't a big deal, but for a week? For a full month? Full year? Full decade? Being consistent in eating well and exercising…

iirc High end athletes (not sure if ~500 minutes /wk counts) die younger due to accumulated byproducts of metabolism and accumulated damage/wear across the body.
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