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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#121
post #92
post #77

Earlier quoted context omitted.

Not all things labeled "processed foods" are bad, it seems. There are enough scientists that say the distinction is often hypocritical (example from an article: a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing). Sugar, fats, and lack of fiber make factory-food unhealthy, they say. Others add that we can't feed the growing metropolitan areas without…

WRT the carrot cake, I will say that while there is only a minimal physical difference, there is a practical difference. Making a carrot cake at home is a commitment, and most people won't frequently go to the trouble except on special occasions... But one from the grocery store can be acquired casually and without effort, and it's easy to eat a lot more of something when it requires no effort.

Every time I cook (and thats quite often) I put a bit different ingredients that some factory would put in since they are the cheapest variant.

Some stuff is BIO, cream or coconut milk are lower fat version, or carrots are are without residual pesticides. Less salt since we use less salt, and taste buds quickly adjust so its still adequately salty, a better mix of herbs and spices so taste is.. simply better, more refined. We use with much less sugar, the same as for salt above (if you eat sweet stuff sparingly then even mildly sweet stuff tastes amazingly, just don't go from one extreme to another).

Re: Ticker: Don't die of heart disease

#122
post #107

I am not a statin skeptic--or rather, I don't want to be a statin skeptic. I've done the research and it makes sense to me, but I still feel some social and psychological pressures to reject statins. When I see that it is widely accepted that ApoB is better to measure than LDL-C, but the industry continues to measure LDL-C, but not ApoB, I wonder why. It makes me skeptical. When I see that the purpose of statins is t…

https://jamanetwork.com/journals/jamainternalmedicine/fullar... Meta-analysis conclusion: This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.

A meta-analysis that only includes 11 studies on statins is immediately suspect.

There have been a lot of studies on statins. If a meta-analysis comes along and only cherry picks a couple of them, something is up.

Re: Ticker: Don't die of heart disease

#123
post #108

The primary thing I did was ask a cardiovascular surgeon in my network to send the lab requisition form to a lab. This is the gate for much of this stuff, even if you pay out of pocket. If someone knows a simple “pay and play” testing service that would be fantastic. Most doctors recommend against these and against the full body MRI one can get because they believe you’ll always find things you don’t expect and that…

I got all the same labs through Function Health. That’s the standard pay-to-play these days, but there are others.

Perfect. Looks like everything I’d get from Ulta for $800 but for much less. The self serve model is great. Thank you.

Re: Ticker: Don't die of heart disease

#124
I was a bit distracted by the capitalization of the word "Advocate". Both when used as a noun and a verb. Peculiar.

But a great article with really great suggestions. Too bad there's not better medical care by default but good to hear that we can take control.

Re: Ticker: Don't die of heart disease

#125
post #81
post #69

Earlier quoted context omitted.

> lots of variety of veggies and fruits, little meat This is wrong. Our bodies evolved to rend flesh and eat meat. They are optimized by millions of years of evolution to process and run on meat. The biochemical pathways of carb-heavy diets put more oxidative stress on the body.

This is wrong. Our bodies evolved to eat a diverse omnivorous diet and complex carbs + the antioxidants present in vegetables and fruits are anti-oxidative.

This is wrong.

Humans have eaten complex carbs only for the last 10k years since agricultural revolution. Before that, outside of a small part of Africa, there physically wasn't enough carbs available to say that they made any substantial amount of our diet.

Most ancenstral carbs were uber high in fiber, and very low in glucose (starch) and fructose.

Re: Ticker: Don't die of heart disease

#126
post #51
post #16

Earlier quoted context omitted.

“Stress” is so abused and nebulous that it’s impossible to define. Nearly every condition is worsened by “stress” but there’s no way to measure it. And there’s no conclusive way to manage stress either. Medication, psychotropics, self medication, meditation. Nearly all of those are more broadly abused and yet stress “worsens”. One person may run an intense soup kitchen 15 hours a day and feel little stress, and anoth…

Fortunately, as you mention in your last sentence, stress is introspectable. How exactly stress corresponds to biomarkers doesn’t matter if your desire is to lower it. The issue is that many of us don’t pay attention to how we keep our body & mind throughout the day, or do so on a very superficial level. So strain on the body can accumulate for a long time. “Stress management” is a lifetime skill. It doesn’t come in…

it’s bad in the way of “don’t think about elephants” makes you think about elephants.

“Try not to stress” or “reduce stress” – but how to do that? Stress itself is nebulous, and the countermeasures are inconclusive.

Think of the last time you were angry or frustrated. Did your spouse telling you to “calm down” fix the problem?

Re: Ticker: Don't die of heart disease

#127

I might just be tired, but this seems highly repetitive. The author mentions friends in the field and concierge doctors multiple times in as much as I read. Feels like the whole thing could be shortened to just say "here's the tests you run, the drugs you might take, the lifestyle changes you should consider".

It’s also demonizing doctors and the healthcare system a bit too much for my liking. I’m located in Europe, so I may have a slightly different view, but my doctors clearly care and discuss with me about prevention, risks, tradeoffs, … They praise the methods of the „good“ doctors and stamps the others as driven by financial gain. Who says the expensive ones are any better in this regard? Who says they are more or les…

In the US my best doctors produce out of date advice about obvious things, have a very distinct gap between "everyday" (stuff they actually see) and "incredibly rare" (stuff unique enough to be a case study they heard about) in their knowledge/understanding and rarely advise things that require me to be a proactive and rational person (because they don't serve these often), so they'll spend two seconds being like "diet and exercise" without a discussion on how that'd work or what adjustments I'd actually make (leaving me to do this research myself) and then suggest a prescription (because even their least proactive patient will probably take a pill). They'll wait until things become a disorder before addressing them (or discussing with me how to address them).

The worst will basically laugh me out of their office for daring to belong to a marginalized identity or failing to already have the health knowledge I'm there trying to gain from them.

Maybe I have awful luck... but I have very little faith at this point. The most effective relationship I had was with a hack who was willing to just prescribe whatever I asked him for and order whatever tests I asked him for (I think most of his patient base were college students seeking amphetamine salts).

Re: Ticker: Don't die of heart disease

#128
post #107

Earlier quoted context omitted.

https://jamanetwork.com/journals/jamainternalmedicine/fullar... Meta-analysis conclusion: This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.

A meta-analysis that only includes 11 studies on statins is immediately suspect. There have been a lot of studies on statins. If a meta-analysis comes along and only cherry picks a couple of them, something is up.

> There have been a lot of studies on statins

Financed by who?

Re: Ticker: Don't die of heart disease

#129
post #77

Earlier quoted context omitted.

Not all things labeled "processed foods" are bad, it seems. There are enough scientists that say the distinction is often hypocritical (example from an article: a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing). Sugar, fats, and lack of fiber make factory-food unhealthy, they say. Others add that we can't feed the growing metropolitan areas without…

>a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing). Actually they are not. "Practically" is carrying a lot of weight there. The factory baked cake will have a lot more extraneous ingredients and usually has a larger quantity of sugar and fat. Similar to how restaurant food generally has a lot more salt and fat than home cooked food.

Yep just a glance at the ingredients shows obvious differences. Other issues I've seen studies about include contaminants from conveyor belts, and for many snack foods, processing into smaller particles, effectively making them partially pre-digested.

Re: Ticker: Don't die of heart disease

#130

Key Takeaway: Get a CT or CTA scan, and if you can afford it go for the CTA with Cleerly. There is a reason that we don't recommend getting imaging for everyone, and that reason is uncertainty about the benefit vs the risks (cost, incidentalomas, radiation, etc, all generally minor). Most guidance recommends calcium scoring for people with intermediate risk who prefer to avoid taking statins. This is not a normative…

A CIMT scan is another option. It uses ultrasound to measure carotid artery wall thickness.
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