Very Important Post
Great title to get you to read more....
I find it funny when I see “Most important post ever” as the headline on blogs/articles/posts/substacks. Who wants to miss reading about something so important? It’s a catch-22. If you click and read you might waste your time. But if you do not, you might miss something really really really important.
So I titled this post this way just to make a point. You get to decide what is important, not the world around you. You get to decide for yourself what you should do that moves you forward in life, without ever purposely harming anyone else. These two sentences are how I live my life and how I practice medicine, or shall I say how I practice Common Sense Health and Wellness.
All that being said, I do have an interesting blog/articles/post/substack for you today. I came across it this morning and found it so vitally important that I had to sit down with my unsweetened hot peppermint tea and start slowly typing this out. Slowly not because I am tired, as I took my Liquid VitD last night which always helps me sleep deeply and soundly, but because I almost failed typing in middle school.
Ready for the title of the article I read that got me motivated to write??
Have you ever seen so many long words in one title??
The article also came with a picture shown below.
I will try and be succinct now in simplifying for you.
The study was looking to find out statistically what are the most common risk factors for heart disease, especially in people under 55 years of age. The hope is we can look at this study and try to help prevent early heart disease by treating the risk factors.
If you look at the pic above, look at the numbers in each column.
Ex:
The first row is “Current Smoker”.
First column to the right is Incident CVD (Coronary vascular disease/Heart Disease) at age <55
The first number in the column gives you how much greater or lower risk for coronary vascular disease a person <55 would have if they were a current smoker.
So what does 1.49 mean?
Well 1.00 means no greater or lesser risk.
Less than 1.00 would mean a lower risk. If it was 0.90, it would mean a 10% LOWER risk. If it was 1.10, it would mean a 10% higher risk.
The actual number was 1.49, which means a 49% higher risk of CVD if you are a current smoker and <55 years of age.
Sooooo, if you smoke perhaps you want to reduce or eliminate it if you are concerned about coronary vascular disease. Of interest is that as you age while smoking still raises your risk, it does not raise your risk as much. This is NOT because smoking helps as you age, but more because there are so many other risk factors in coronary vascular disease as well other than smoking that increases your risk as you age.
Next I want you to look at the last column, the “p for interaction’ column or as others call it the “p-value”. This column is looking to see if the study data was truly clinically significant and not caused by other factors. In other words, how verifiable and accurate can you take the data?
Data scientists prefer the p-value to be less than 0.05. This would indicate a less than 5% chance that the data is not valid to be used. So when I look at research studies I always look for the p-value. The p-value can be manipulated in research but that is not a topic for today.
Now back to the pic of the data.
The p-value for the current smoker was 0.0006 which is well under 0.05 so the data appears to be valid. Soooo, current smokers do indeed have an increased statistical risk of CVD.
Now I am not writing this to pick on smokers. I do not like smoking as I do find it bad for many health conditions. But it is not illegal to smoke. It is also not illegal to run into a burning building and start deeply inhaling but I wouldn’t do that either.
Let’s now look at some of the other aspects of the data pic by first looking at the p-value. Let’s look at p-values > 0.05. These do not mean they are wrong, it just means the data can not prove they are a factor. There is not always a clear right and wrong, especially in data.
The p-value > 0.05 did NOT prove a relationship between the factors tested and CVD.
These clinical risk factors NOT proven in this study to increase CVD risk may be surprising to many of you. They include:
Current Alcohol drinker
Physical Inactivity
LDL cholesterol
Yep I just wrote it.
The study found LDL cholesterol, my fav topic is not proven by the data to be associated with CVD.
Where have you heard that before?
Perhaps by little ole me????
If you look at the % risk for LDL to see if it has much of an effect even disregarding the p-value, the increased CVD risk from LDL cholesterol is between 1-5%.
Now let’s compare LDL cholesterol risk to Diabetes risk for CVD.
LDL increases risk 1-5%
Diabetes increases risk 36-408% dependent upon your age, with the the greatest risk the younger you are.
Sooooo once again, to lower your risk of heart disease do ya think you should focus on lowering your LDL cholesterol or instead work on not becoming diabetic??
What are some of the other clinical risk factors for CVD? I will stick to only those that increase your risk by 50% or more.
Hypertension (High Blood Pressure)
Dyslipidemia
Metabolic Syndrome
Overweight or Obese
Systolic and Diastolic Blood Pressure Elevations
Look at the above list.
What do they all have in common?
Don’t rack your brains trying to figure this out.
I’ll be nice and tell you.
Hypertension, Dyslipidemia, Metabolic Syndrome, Overweight, Obese and Systolic and Diastolic blood pressure elevations are ALL associated with Chronic Excess dietary intake that overloads your body’s ability to handle the excess safely. This is especially true if the chronic excess intake is from processed foods, carbohydrates and fake fats such as vegetable and seed oils.
All the above clinical risk factors are from CHRONIC METABOLIC IMBALANCES usually caused from the diet already mentioned and to some lesser extent from activity levels.
If you have been in my practice and had our full Advanced Wellness Testing (AWT) and review, you may know this already. But for those of you who don’t I look at different systems of the body and try to help rebalance the systems so they work optimally both independently and together. The main systems I look at with you include:
Metabolic
Immune/Inflammatory
Nutrition
Hormonal
Gut
Vascular
then I look at individual organs
I usually end up stressing how to improve the metabolic system as I have found it so important in preventing CVD and other health issues. Now with the study above I have even more proof of why improving your metabolism can lower your risk of future CVD.
I think that is enough for today other than one last word on cholesterol. Dealing with cholesterol at my practice, the Institute for Medical Wellness (IMW) has allowed me to soon retire early. Why? Well I believe in saving $$ for retirement so when I started the IMW I decided to put away into retirement savings $1 every time someone asked me about their cholesterol. Well that has added up so you may soon see me or hear from me from some nice quiet, sunny and warm tropical island somewhere relaxing on the beach getting ready to have a nice Organic grass fed ribeye as a meal after playing tennis.
Ok.
The above was just a joke but a guy can dream.
Another one last thing.
Did you know cholesterol is a vital component of all your cell membranes and helps to keep the cell together almost like the glue that holds your skin together over your other body parts?
So without cholesterol we would perhaps look like…
Congratulations if you have made it this far, to the end of this “Most important post ever” .
As always comments and questions welcome.
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I always enjoy your emails. I see my health so much differently after coming to you for the last 11/2 years.
Thanks Doc….very helpful (and important!)