You have not touched on the topic of statins in this review... is the consensus then that early statins is the only meaningful tool we have to delay cardiac events? and as such, should most people start medications prophylactically since disease begins early and progresses in all individuals regardless of screening/testing results? If anyone has any strong opinions on this topic please chime in...but I would love to hear from the experts :)
Raison d'être Is not to be missed as a driver of happiness, quality of life and humanity. Seen many with orthorexia and hung up on Imaging and clinical lab tests, biometrics and extreme physical performance goals, causing them unwarranted concerns and anguish besides avoidable injuries. Be sensible …. Don’t forget to live.
So clear, thank you! I keep wondering what a person actually does with "you have plaque at 32" when the advice afterwards is the same advice as before - eat well, move, don't smoke. That's a lot to carry with nothing new attached to it.
Important and excellent piece, thank you as always. You use a word I think applies perfectly: wrinkles. The human vascular system ages, just like all the others, and that means wrinkles. Conflating this with disease is, I think, an error. Clinical events, often fully detached from the aesthetic problem of wrinkles, are the only outcomes worth chasing. We aren’t there yet.
great data. I saw vessel disease in pathologist assistant school lab as early as 10 years old. I have had 2 Cac first at 52 =0 and second at 57= 23. no more imaging for me. I am doing the lifestyle interventions and listening to my body. I am sure my femoral ilacs are full of plaque.
Wellness Protecting & Disease Prevention Goal “Numbers”/Insights: (In the Walking Well & modified appropriately for health issues). These numbers are the basis for the motto: “The simultaneous prevention of multiple diseases.”
1. Non-HDL cholesterol: goal less than 90
2. Triglycerides: goal less than 100
3. A1C diabetes test: 5.5 or less at age 55, not above 6.2 at age 62 or older
4. Blood sugar: 90 at 90 minutes after a meal
5. Cardiac HS CRP: 1.0 or less
6. Blood Pressure: near 110/60
7. Less than 12% sodium in any one serving from any one container, at any one meal
8. PSA: 1.0 or less
9. TSH: 0.35-3.50
10. Hemoglobin: about 14
11. Lp (a): goal 15 or less
12. Homocysteine: goal 7 or less
13. Uric Acid: goal 5.5 or less
14. BUN: 12 or less
15. Magnesium: 2.1+: relates to diabetes prevention
16. Potassium: 4.1- 4.5
17. 25 hydroxy (OH) vitamin D3: 50-65 ng/mL
18. Percent body fat: 15-20% in men, 20-25 % in women: manifested as clear lines of definition/demarcation on the abdomen = “CLOD/D”
19. Virtually no one loses weight who eats more than occasional chicken, turkey, rice, sandwiches, cereal, and much fruit
20. If overweight, keep a diet diary of ALL you eat or drink that you should NOT: the diary should be empty
21. Eat foods (exactly) as they grow up out of the ground and in the field: G-V-B (grains, vegetables, beans, fruit, nuts, and seeds)
22. The Food Mantra: Fresh (fruits & vegetables), Whole & Unprocessed (grains & beans), Organic (all) and Fiber (all) at the 90+% level is the goal: 18-19 meals/week
23. If overweight, eat cooked vegetables and vegetable soups before any and all else ALL day long, even breakfast (not red or white potatoes). Intermittent fasting is recommended . Try to finish calorie intake within 9 hours after arising
24. In general, eat only out of a bowl
25. Individuals with the best of these values are vegan (no eggs, fish, fowl, dairy, or meat)
26. Tai chi, swimming, tennise, and resistance training: all exercise helps
27. Smoking cessation is best dealt with by a combination of support and medication Chantix, Wellbutrin (bupropion), and the nicotine patch/inhaler/gum/e-cigarette
28. Limit alcohol to 4 six ounce glasses of red wine (or beer or whiskey equivalent) per week or less.
29. Accept & deal with reality: wishing, wanting & hoping are like alcohol, only safe in small doses
30. For high blood pressure, purchase an Omron wrist blood pressure cuff; have it validated at your doctor’s office; check your blood pressure variously before, after, and in between meals
31. Many conditions are vastly improved with 100% avoidance of ALL wheat (rye), dairy, and processed soy other than tempeh or miso
32. Cologuard, colonoscopy, digital rectal exams, mammograms, thermograms as agreed upon
Do the 52-60% of younger adults with a POSITIVE CAC score greater than zero have a worse prognosis than those the test "missed?"
You have not touched on the topic of statins in this review... is the consensus then that early statins is the only meaningful tool we have to delay cardiac events? and as such, should most people start medications prophylactically since disease begins early and progresses in all individuals regardless of screening/testing results? If anyone has any strong opinions on this topic please chime in...but I would love to hear from the experts :)
Raison d'être Is not to be missed as a driver of happiness, quality of life and humanity. Seen many with orthorexia and hung up on Imaging and clinical lab tests, biometrics and extreme physical performance goals, causing them unwarranted concerns and anguish besides avoidable injuries. Be sensible …. Don’t forget to live.
Is it better to “do without so you can live longer to “do without “???🫤
So clear, thank you! I keep wondering what a person actually does with "you have plaque at 32" when the advice afterwards is the same advice as before - eat well, move, don't smoke. That's a lot to carry with nothing new attached to it.
Important and excellent piece, thank you as always. You use a word I think applies perfectly: wrinkles. The human vascular system ages, just like all the others, and that means wrinkles. Conflating this with disease is, I think, an error. Clinical events, often fully detached from the aesthetic problem of wrinkles, are the only outcomes worth chasing. We aren’t there yet.
great data. I saw vessel disease in pathologist assistant school lab as early as 10 years old. I have had 2 Cac first at 52 =0 and second at 57= 23. no more imaging for me. I am doing the lifestyle interventions and listening to my body. I am sure my femoral ilacs are full of plaque.
JM: This will be a help:
Wellness Protecting & Disease Prevention Goal “Numbers”/Insights: (In the Walking Well & modified appropriately for health issues). These numbers are the basis for the motto: “The simultaneous prevention of multiple diseases.”
1. Non-HDL cholesterol: goal less than 90
2. Triglycerides: goal less than 100
3. A1C diabetes test: 5.5 or less at age 55, not above 6.2 at age 62 or older
4. Blood sugar: 90 at 90 minutes after a meal
5. Cardiac HS CRP: 1.0 or less
6. Blood Pressure: near 110/60
7. Less than 12% sodium in any one serving from any one container, at any one meal
8. PSA: 1.0 or less
9. TSH: 0.35-3.50
10. Hemoglobin: about 14
11. Lp (a): goal 15 or less
12. Homocysteine: goal 7 or less
13. Uric Acid: goal 5.5 or less
14. BUN: 12 or less
15. Magnesium: 2.1+: relates to diabetes prevention
16. Potassium: 4.1- 4.5
17. 25 hydroxy (OH) vitamin D3: 50-65 ng/mL
18. Percent body fat: 15-20% in men, 20-25 % in women: manifested as clear lines of definition/demarcation on the abdomen = “CLOD/D”
19. Virtually no one loses weight who eats more than occasional chicken, turkey, rice, sandwiches, cereal, and much fruit
20. If overweight, keep a diet diary of ALL you eat or drink that you should NOT: the diary should be empty
21. Eat foods (exactly) as they grow up out of the ground and in the field: G-V-B (grains, vegetables, beans, fruit, nuts, and seeds)
22. The Food Mantra: Fresh (fruits & vegetables), Whole & Unprocessed (grains & beans), Organic (all) and Fiber (all) at the 90+% level is the goal: 18-19 meals/week
23. If overweight, eat cooked vegetables and vegetable soups before any and all else ALL day long, even breakfast (not red or white potatoes). Intermittent fasting is recommended . Try to finish calorie intake within 9 hours after arising
24. In general, eat only out of a bowl
25. Individuals with the best of these values are vegan (no eggs, fish, fowl, dairy, or meat)
26. Tai chi, swimming, tennise, and resistance training: all exercise helps
27. Smoking cessation is best dealt with by a combination of support and medication Chantix, Wellbutrin (bupropion), and the nicotine patch/inhaler/gum/e-cigarette
28. Limit alcohol to 4 six ounce glasses of red wine (or beer or whiskey equivalent) per week or less.
29. Accept & deal with reality: wishing, wanting & hoping are like alcohol, only safe in small doses
30. For high blood pressure, purchase an Omron wrist blood pressure cuff; have it validated at your doctor’s office; check your blood pressure variously before, after, and in between meals
31. Many conditions are vastly improved with 100% avoidance of ALL wheat (rye), dairy, and processed soy other than tempeh or miso
32. Cologuard, colonoscopy, digital rectal exams, mammograms, thermograms as agreed upon
Thank you for the information in this article.
Declining watts on the bike saddened me, but cycling remains a primary joy.