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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.

#259 – Women’s sexual health: Why it matters, what can go wrong, and how to fix it | Sharon Parish, M.D.

I can’t tell you how many women soldier on either avoiding sex or in pain because they don’t either know or feel validated to seek treatment.” —Sharon Parish

#258 – AMA #48: Blood pressure—how to measure, manage, and treat high blood pressure

If you care about your brain, if you care about your heart and if you care about your kidneys, you need low blood pressure. I think we can say that as confidently as we can say almost anything in medicine.” —Peter Attia

#257 ‒ Cognitive decline, neurodegeneration, and head injuries: mitigation and prevention strategies, supplements, and more | Tommy Wood, M.D., Ph.D.

If you’re trying to maintain a basic set of cognitive functions, [it is important] to actively work on ways to increase headroom, increase absolute capacity throughout the lifespan. Because at some point capacity will decrease, but you want to push that out as far as you can.” —Tommy Wood

“The cholesterol paradox”: a catchy phrase for an idea with no substance

A recent study reported that hypercholesterolemia is associated with reduced mortality, but it falls short of upsetting conventional wisdom

#255 ‒ Latest therapeutics in CVD, APOE’s role in Alzheimer’s disease and CVD, familial hypercholesterolemia, and more | John Kastelein, M.D., Ph.D.

“One of the things that is so dangerous about this disorder is that the plaque that you get in FH is a soft plaque.” —John Kastelein

#252 ‒ Latest insights on Alzheimer’s disease, cancer, exercise, nutrition, and fasting | Rhonda Patrick, Ph.D.

My perspective has shifted as any scientist that’s following data should… When new data comes out, you have to reassess things.” —Rhonda Patrick

#251 – AMA #46: Optimizing brain health: Alzheimer’s disease risk factors, APOE, prevention strategies, and more

The bottom line here is the earlier you were diagnosed with type 2 diabetes, the higher your risk of dementia.” —Peter Attia

Putting out the fire on the gas stove debate

A study published this winter raised concerns over gas stoves and childhood asthma, but we have many options for eliminating the excess risk.

#247 ‒ Preventing cardiovascular disease: the latest in diagnostic imaging, blood pressure, metabolic health, and more | Ethan Weiss, M.D.

If everybody got truly optimal medical therapy, if we didn’t have barriers to using all these tools in everybody, I think this disease would largely be controlled.” —Ethan Weiss

More hype than substance: erythritol and cardiovascular risk

A newly-published study caught public attention by reporting an association between the common sweetener erythritol and increased risk of heart attack and stroke, but there’s more to the story.

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