Very informative and well researched! I could not agree more that if we want to live long and live well, we should not wait to take care of ourselves. Not until we are 50, nor until we are 35. And it makes my mind spin when I see the number of obese people in the streets. I don't mean to judge anyone, but I am wondering if the people that live unhealthily or are obese (at any age) are aware of the risks and potential damage they are incurring? Anyways, thanks for a great post.
This is good stuff. The preventive approach is what I came to know about from Peter Attia's book Outlive. He calls is the centenarian marathon and it starts today by taking a walk instead of waiting till 50 to get a stent and what not. Keep up sir!
I never had a doctor express the slightest concern about heart disease when I was I my 30s and 40s. It’s always been something I’ve had to bring up. Most people will not be proactive so doctors really need to take the initiative during annual physicals, much more aggressively imo.
Paddy, I agree time exposure is huge and the majority of Americans are exposed to the most important independent risk factor for CVD for decades without knowing it, hyperinsulinemia. We have had data on insulin for decades…..N Engl J Med 1996; 334:952-958....so why the continued focus on glucose metrics. So why haven’t we become insulin centric? Insulin matters even with low apoB, with >3 fold increased risk. When you put high insulin with high APOB, risk is massively amplified.
In the lower insulin group, apob losses relevance but the study is old and we dont know what the OR for high apoB would be if insulin levels <5 (instead of <12 in the study), which is ideal.
Current consensus is that ApoB is the important INDEPENDENT causal vector. So that's the question that I believe needs resolving - independent, or mainly a great indicator that hyperinsulinemia is busting your chops, for decades, well before A1c rises.
appreciated the caution about the risk evaluation tools; the results need to be seen as a point for more query and not a hard stop e.g I'm good. Thanks
This post contains information I had not seen or even heard of before. I am stunned. Thanks for this.
Very informative and well researched! I could not agree more that if we want to live long and live well, we should not wait to take care of ourselves. Not until we are 50, nor until we are 35. And it makes my mind spin when I see the number of obese people in the streets. I don't mean to judge anyone, but I am wondering if the people that live unhealthily or are obese (at any age) are aware of the risks and potential damage they are incurring? Anyways, thanks for a great post.
This is good stuff. The preventive approach is what I came to know about from Peter Attia's book Outlive. He calls is the centenarian marathon and it starts today by taking a walk instead of waiting till 50 to get a stent and what not. Keep up sir!
I never had a doctor express the slightest concern about heart disease when I was I my 30s and 40s. It’s always been something I’ve had to bring up. Most people will not be proactive so doctors really need to take the initiative during annual physicals, much more aggressively imo.
Paddy, I agree time exposure is huge and the majority of Americans are exposed to the most important independent risk factor for CVD for decades without knowing it, hyperinsulinemia. We have had data on insulin for decades…..N Engl J Med 1996; 334:952-958....so why the continued focus on glucose metrics. So why haven’t we become insulin centric? Insulin matters even with low apoB, with >3 fold increased risk. When you put high insulin with high APOB, risk is massively amplified.
In the lower insulin group, apob losses relevance but the study is old and we dont know what the OR for high apoB would be if insulin levels <5 (instead of <12 in the study), which is ideal.
Current consensus is that ApoB is the important INDEPENDENT causal vector. So that's the question that I believe needs resolving - independent, or mainly a great indicator that hyperinsulinemia is busting your chops, for decades, well before A1c rises.
appreciated the caution about the risk evaluation tools; the results need to be seen as a point for more query and not a hard stop e.g I'm good. Thanks