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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#81

Post by cd4plus »

echelon wrote: post #69
dust42 wrote: post #63

Long story short care about your health. If you don't do already, maybe now is a good time to start. What you put into your body: no processed food, cook yourself, lots of variety of veggies and fruits, little meat, little alcohol. What you do with your body: regular exercise, low stress, enough sleep. What you do with your mind: good social environment, good relationships. And an apple a day keeps the doctor away!

> 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.

Re: Ticker: Don't die of heart disease

#82

Post by mac-mc »

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-date stuff.

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC3241518/

Re: Ticker: Don't die of heart disease

#83

Post by safety1st »

carbocation wrote: post #56

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…

Right.

Hang on a second.

This guy is making a big big claim.

The central point of his article is that he went to a doctor who followed the guidelines, tested him and found he wasn't at risk for heart disease.

But then he went to another, very expensive concierge doctor, who did special extra tests, and discovered that he was likely to develop heart disease and have a heart attack.

Therefore he is arguing that THE STANDARD GUIDELINES ARE WRONG AND EVEN IF YOU DO EVERYTHING RIGHT AND YOUR DOCTOR CONFIRMS IT YOU MAY BE LIKELY TO DIE OF HEART DISEASE ANYWAY, SO ONLY THE SPECIAL EXTRA TESTS CAN REVEAL THE TRUTH.

I want a second opinion from a doctor. Is this true? Is this for real? Because it smells funny.

Re: Ticker: Don't die of heart disease

#84

Post by tgv »

echelon wrote: post #69
dust42 wrote: post #63

Long story short care about your health. If you don't do already, maybe now is a good time to start. What you put into your body: no processed food, cook yourself, lots of variety of veggies and fruits, little meat, little alcohol. What you do with your body: regular exercise, low stress, enough sleep. What you do with your mind: good social environment, good relationships. And an apple a day keeps the doctor away!

> 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.

Vegetables aren't "carb-heavy". And we don't need to recreate blindly the circumstances evolution had to adapt us to. E.g., our bodies evolved when the population was much smaller, but I don't think you want to argue for mass extinction.

Re: Ticker: Don't die of heart disease

#85

Post by wocram »

js2 wrote: post #68

> Sticking to a Mediterranean diet that is light on carbohydrates and saturated fats is almost always the safest bet. Almost every health diet is some permutation of this. A permutation that's currently making the rounds in the press (even though the original research is from 20 years ago) is the "portfolio diet": https://jamanetwork.com/journals/jama/fullarticle/196970 https://www.ahajournals.org/doi/10.1161/CIRCULA…

This is a lot of words to say eat a plant-based/vegan diet.

Re: Ticker: Don't die of heart disease

#86

Post by Scubabear68 »

cogman10 wrote: post #13

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".

Somewhat related, one of my thoughts was “what if these concierge doctors just keep running tests until they find something, anything, to justify their fees”?

Re: Ticker: Don't die of heart disease

#87

Post by mac-mc »

If you dig into research and follow the low-risk experiments that people do online to reduce their Lp(a), you can find techniques and evidence to do so. It doesn't have to be an impossible-to-fix issue.

I like this list of experiments by Greg Muschen: https://x.com/gregmushen/status/1924676651268653474

Re: Ticker: Don't die of heart disease

#88

Post by callmeal »

tgv wrote: post #77
dust42 wrote: post #63

Long story short care about your health. If you don't do already, maybe now is a good time to start. What you put into your body: no processed food, cook yourself, lots of variety of veggies and fruits, little meat, little alcohol. What you do with your body: regular exercise, low stress, enough sleep. What you do with your mind: good social environment, good relationships. And an apple a day keeps the doctor away!

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.

Re: Ticker: Don't die of heart disease

#90

Post by bwfan123 »

lbrito wrote: post #42

I don't like this kind of content. The author might have a personal motivation for it, but for the general public, it's just more mental load. We are all going to die one day. When I was younger, I would fret over this kind of article. Great, one more thing I have to worry about. Now I just mostly ignore it. It's impossible otherwise. If I dedicate hours and days and months to all the heart best practices, what about…

> We all know the good practices. Don't be a dumbass

In theory yes, but in practice we are all dumbasses to some extent.

I used to have your attitude until I saw a friend die of a heart attack at an early age - and it appeared to me that he would have survived if he had an indication. So, now I have changed my attitude to one of more data does not hurt.

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