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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#491

Post by exhilaration »

sn9 wrote: post #477
exhilaration wrote: post #378

Earlier quoted context omitted.

Thanks for posting this. I was able to plug in all the required values from my last checkup and blood work. Even EGFR was there, I've never paid attention to that before.

I learned about it on the Barbell Medicine podcast! They had an episode dedicated to it. Highly recommended to search their episodes for anything about health or fitness you've been curious about.

Nice, I just subscribed to their podcast. I'm an adherent to the Starting Strength / Mark Rippetoe school of thought but always looking to learn more.

Re: Ticker: Don't die of heart disease

#492

Post by array_key_first »

mac-mc wrote: post #82
Buttons840 wrote: post #58

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…

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

No, actually, you should improve your lifestyle and diet and also take statins.

Ever cardiologist ever will tell you that statins work best when you make diet and lifestyle changes. They tell you that, to your face. It's not a secret. This actually goes for A LOT of medications. Usually, medication + diet and exercise is better than medication alone. They also test medications like this.

Re: Ticker: Don't die of heart disease

#493

Post by array_key_first »

liveoneggs wrote: post #430
cthalupa wrote: post #403

Earlier quoted context omitted.

A single study showed a single statin reducing GLP-1 levels and ascribed it to gut microbiome changes that could be totally resolved with UDCA supplementation. If this even ends up being reproduced it at most says there is an easy fix for people taking atorvostatin and that it might be a concern with other statins, but this should be treated with the same health skepticism of any other single study finding. Not all s…

How many doctors are cycling through all the statin classes to find the least-bad option for each patient? (I'll rant about one guy I know.. was any of this related to statin over perscribing? who can know) Now that we have your LDL under management isn't it easier to just add metformin and gabapentin into the mix? I mean what are the chances you're not also put on a calcium blocker too? Now you've got brain fog and…

If you have metabolic syndrome (heart disease, diabetes, obesity, hypertension, liver disease etc) then yes, you will take many different drugs. Because these are all complex conditions that must be managed, and that will lower your quality of life and raise your mortality.

It sometimes seems like if you get one, you get the others. That's because all these diseases feed into each other.

Re: Ticker: Don't die of heart disease

#494

Post by array_key_first »

ericmcer wrote: post #246
adammarples wrote: post #195

Earlier quoted context omitted.

I think the article makes a valid point: stop worrying about 90% of the other stuff and focus on the thing that will almost certainly kill you - heart disease - for which there are easy diagnostic and preventative measures. I think they're arguing for a better allocation of resources, if anything.

Isn't the global population like 50% obese? What is your actual risk of dying from it if you are relatively in shape and in your 40s?

The bar for obesity is lower than a lot of people think. I have known many people who look good, have decent bodies, and are obese. Your fat distribution can be very misleading. Some people happen to hold fat very well.

Re: Ticker: Don't die of heart disease

#495

Post by array_key_first »

ponector wrote: post #307
Fire-Dragon-DoL wrote: post #252

Earlier quoted context omitted.

We don't know how to treat obesity 100% though

Are you joking? We do know how to treat eating disorders. Same as we know how to treat opioid addiction or alcoholism.

Yes, and that's why we have eliminated addiction.

Re: Ticker: Don't die of heart disease

#496

Post by array_key_first »

in_cahoots wrote: post #200
kqr wrote: post #158

Earlier quoted context omitted.

I had assumed "the MESA study population" was a particularly unhealthy bunch in terms of this measurement, meaning the 50th percentile puts one in the worst half of an already bad off group.

I don't know the exact details, but I thought the Framingham survey was just a cross-section of the population. So getting upset about a 50th percentile score makes no sense at a population level. A quick Google says that the Mesa study was actually of people without cardiovascular disease at the beginning of the study. So again, these conclusions don't make any sense to me.

I mean, how many people have cardiovascular events? I don't actually know, but 50% sounds right.

Re: Ticker: Don't die of heart disease

#497

Post by GrzegorzWidla »

>> Sticking to a Mediterranean diet that is light on carbohydrates and saturated fats is almost always the safest bet.

Majority of calories on a Mediterranean diet come from carbohydrates. I think the author meant “light on processed sugars (unless warranted by a high endurance training volumes)”.

Re: Ticker: Don't die of heart disease

#498

Post by GrzegorzWidla »

aldarion wrote: post #429
btilly wrote: post #235

Earlier quoted context omitted.

I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…

That is because dietary advice they give is actually bad. It mostly boils down to "limit calories while eating standard western diet" but that is impossible to follow long-term as SWD and similar (e.g. food pyramid) diets are nutrient-deficient. How many doctors recommend things like paleo diet, intermittent fasting and so on? Not many, I think - most simply focus on calories, combined with the advice that is either…

Nobody recommends western diet. It’s standard practice to recommend DASH or Mediterranean one.

Re: Ticker: Don't die of heart disease

#499

Post by GrzegorzWidla »

sn9 wrote: post #298
Fire-Dragon-DoL wrote: post #250

Earlier quoted context omitted.

If I'm not wrong, it takes 20 years to revert the damage of smoking. I don't think you need to care at 18, but the effects will be seen over the course of 20 years

Lots of the damage done can't be undone when it comes to heart diseaese. Notably risk goes up with the time spent with bad numbers, so the most leverage you have on affecting your lifetime risk is caring as early as possible. It's an area under the curve situation. Waiting until you start experiencing symptoms is putting a band-aid on an open wound compared to avoiding injury at all by focusing on high impact habits…

The article is fantastic with only one caveat. Recommending 1.6 g of protein per kg of body weight to people who are only meeting, not exceeding, physical activity recommendations is foolish. 1.6 if amount that one needs to build maximum muscle mass in the shortest possible time. Leading protein intake researchers (think people like Stu Philips) state that that recommendation is excessive for most people and he instead suggests 1.2 g for nearly everyone.

Re: Ticker: Don't die of heart disease

#500

Post by GrzegorzWidla »

ericmcer wrote: post #245
Waterluvian wrote: post #155

I’m sensing a potentially significant misallocation of resources. My mental model is that there’s a hypothetical quantification of not just your time and money, but your anxiety, attention bandwidth, mental energy, etc. I think, in some ways, the trick is being able to short circuit the entire journey represented by this website in favour of some form of, “I’m 40. I should be more mindful of heart disease. I should a…

Seriously there is too much shit to worry about to micro manage each facet, unless your like a Bryan Johnson billionaire with a staff. Beyond just heart disease & cancer taking you out entirely its: my eyesight is going, my hearing, every joint in my body could fail, my brain is slowing, etc. There is just way too much shit to do anything other than be like: sleep, exercise, eat better and don't drink too much.

There are roughly 5 areas of which combined cover 80+% of things you can control.

1. Exercise (aerobic and strength, doesn’t have to be much but more is better). 2. Diet (mostly whole foods, mostly plants, low saturated fat). 3. Prevention (regular check ups and following doctor’s advice). 4. Meaning / purpose (either being passionate about your job or having such hobbies outside of it). 5. Friends and community.

This isn’t too much. By many that’s the bare minimum for having a satisfactory life.

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