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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.

#24 – Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more

“Use the correct terminology with everything.” –Tom Dayspring

#23 – Tom Dayspring, M.D., FACP, FNLA – Part IV of V: statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain

“This is what it ultimately comes down to – and it’s the way you practice – you’ve got to individualize everything.” –Tom Dayspring

#22 – Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins

“Here’s something that’s going to shock you: in an average person, anywhere from 30 to 60 percent of the cholesterol in that LDL particle arrived via an HDL particle.” –Tom Dayspring

#21 – Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation

“If you learn nothing else today, the first thing is, lipids, for the most part, go nowhere in the human body unless they’re a passenger inside a lipoprotein.” –Tom Dayspring

#20 – Tom Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology

“Illustrating things made me understand . . .  I just learned by illustrating.” –Tom Dayspring

Narrative glossary: lipids

A companion post for the podcast episodes with Thomas Dayspring, M.D., FACP, FNLA (October 15-19, 2018).

#19 – Dave Feldman: stress testing the lipid energy model

“I am on a journey of science, not of advocacy: I’m going to be quite a skeptic.”  —Dave Feldman

Transcript — The Drive — Dave Feldman

Transcript of episode 19 of The Drive with Peter Attia, released October 8, 2018.

Statins, Lp(a), and upcoming podcast guests

In other words, statins are not addressing the associated risk in patients with an elevated Lp(a), and this population represents about 25% of those with previous CVD or an indication for statins.

#18 – Richard Isaacson, M.D.: Alzheimer’s prevention

“Anyone with a brain is at risk for Alzheimer’s.” —Richard Isaacson

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