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Preventing Chronic Disease

One of the foundational lessons we can take away from studying centenarians — those who have lived to the age of 100+ — is that if you want to live longer, you have to live longer without chronic disease, not live longer with chronic disease. Unfortunately, our current healthcare system is primarily geared toward helping you live longer once you develop chronic disease. This, of course, is the opposite of the approach I take with my patients. 

Over 80% of deaths in people over 50 who do not smoke can be grouped into 4 main categories, what I like to call the four horsemen of chronic disease. These are: (1) atherosclerotic disease (comprised of cardiovascular disease and cerebrovascular disease), (2) cancer, (3) neurodegenerative disease (Alzheimer’s disease being the most common), and (4) metabolic disease (a spectrum of everything from hyperinsulinemia to insulin resistance to fatty liver disease to type 2 diabetes).

We have five main longevity tactics at our disposal to affect our longevity: (1) exercise, (2) sleep, (3) nutrition, (4) medications & supplements, and (5) distress tolerance. Below is a collection of podcasts and articles discussing how we can use these tactics to mitigate, prevent, and reverse chronic disease.

LDL-C & systolic blood pressure and lifetime risk of cardiovascular disease

Mendelian randomization and lifetime cardiovascular disease risk.

Qualy #53 – Screening for prostate cancer

Today’s episode of The Qualys is from podcast #39 – Ted Schaeffer, M.D., Ph.D.: How to catch, treat, and survive…

Qualy #46 – Rapamycin’s effects on cancer, cardiovascular disease, and neurodegeneration

Today’s episode of The Qualys is from podcast #09 – David Sabatini, M.D., Ph.D.: rapamycin and the discovery of mTOR…

Hormone therapy and breast cancer?

There are not many topics in clinical medicine more polarizing than hormone replacement therapy (HRT) for women suffering from menopausal…

Qualy #24 – What are the “ABCs” of Alzheimer’s prevention?

Today’s episode of The Qualys is from podcast #18 – Richard Isaacson, M.D.: Alzheimer’s prevention.

#69 – Ronesh Sinha, M.D.: Insights into the manifestation of metabolic disease in a patient population predisposed to metabolic syndrome, and what it teaches us more broadly

“The way we raise our kids early on might actually set a pattern for how much of an accelerated life, or how much of a stressed out nervous system they might have later on. . . a lot of the behavioral patterns that we’re instilling in our kids are kind of setting the foundation for insulin resistance and inflammation early on.” —Ronesh Sinha

Qualy #16 – How much does cognitive activity ward off cognitive decline?

Today’s episode of The Qualys is from podcast #18 – Richard Isaacson, M.D.: Alzheimer’s prevention.

What can you prove?

If that weren’t enough to set me off, consider the overall weakness of this study, and the choice of the word “proven” borders on journalistic manslaughter.

#66 – Vamsi Mootha, M.D.: Aging, type 2 diabetes, cancer, Alzheimer’s disease, and Parkinson’s disease – do all roads lead to mitochondria?

“We have 300 different forms of monogenic mitochondrial diseases. . .and these are terrible diseases and we need therapies for them. . .but it’s also our hope that studying some of them will provide insights into the common form of aging as well.” —Vamsi Mootha

Fasting and cancer

The purpose of the study was to find out if fasting could protect the intestines from high-dose radiation, which could allow for higher doses of radiation treatment in killing pancreatic tumor cells.

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