Dr Ford Brewer - PrevMed

A mendelian Randomization is a new tool we have in understanding risk vs bias, confounding, or other relationships. We can't do a randomized clinical trial on whether obesity causes heart attacks. We can't "make" people obese at random, and we couldn't blind them or their docs even if we could. So how will we know whether obesity causes heart attacks or something else causes both? The same question comes up with hsCRP, one of the tests for CV inflammation. Mendelian Randomization helps us understand.

Mendelian randomization was first mentioned in the following article: https://pubmed.ncbi.nlm.nih.gov/2869248/

But it's attributed to Gray & Wheatley a few years later: https://pubmed.ncbi.nlm.nih.gov/1855097/

Obesity was found to be causative of heart attacks in this study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2714500

The miniseries on Sarcopenia was intended to raise awareness of the risk of loss of muscle mass ( Sarco = muscle, Penia = loss of), especially among those 65 & older. I think that happened. But is also tripped off a viewer debate about which is better: intensity vs repetitions. Here are some components of that debate.

This is another story from the FH ( Familial Hypercholesterolemia) Foundation site. You can find plenty of other stories and good information re: FH at the following link: https://thefhfoundation.org/

Mackenzie & the FH Foundation are challenging the insurance community for access to PCSK9s & other expensive new drugs. I understand that & think it's a debate that needs to happen. But I also think there's room for other challenges:

1. patients & lifestyle - this is by far the biggest determinant of health;

2. FH leadership & community - just like the majority of the healthcare provider community, needs to provide guidance that lifestyle & CV Inflammation are critical for FH patients as well;

3. The Preventive & Functional Medicine communities need to realize that - yes, lifestyle & CV inflammation are critical - but that doesn't mean doctors should abdicate their responsibility that comes with the fact that they are the ones that can provide access to medications. Patients with FH, just like patients with significant diabetes & other conditions, will often need medication support, no matter what's going on with their lifestyle.

Prolyl endopeptidase was discovered by Sabrina Diano at Yale in 2014. This enzyme measures the blood glucose level. This is done by the ventromedial nucleus in the hypothalamic area of the brain.

We orient to the brain, going from the cortex to the corpus callosum, thalamus, hypothalamus, and pituitary gland.

Ventromedial syndrome in mice causes obesity. The lateral hypothalamic syndrome causes decreased eating and underweight mice.

Discovering the brain's mechanism for measuring blood glucose and determining appetite can be critical to developing preventives and cures for diabetes.

The WatchPAT is a simple Pulse Oximetry device with an added sensor for airway movement. And the WatchPAT makers, like most biomedical device makers, say the science behind the device is impeccable. Well, re: pulse oximetry, that's true. Go to the Wikipedia site for pulse oximetry. It's now a standard, reliable component of medicine. Most pulse ox is immediate only. A major value of the WathPAT is giving you a recorded sleep episode showing pulse ox the entire time. My O2 sat, or blood saturation of oxygen, was great the entire night.

How about the sleep apnea sensor? I had some problems there. By one measure, I had an index of 8. By another, I had an apnea index of 23. The difference was a very high number of very short apnea ( less than 10 seconds). I actually interpret this as a probable improvement. This is due to the Invisalign braces I've used for 6 months. I can feel my teeth spread out and my tongue moving out of my airway and into my mouth.

There is a final component of the readout. It says I have REM ( rapid eye movement) sleep 1.5% of the time. I am very skeptical of the value of the REM sleep value from the Itamar WatchPAT.

Gene lost 52 pounds. He didn't see it as a big deal. He seemed at least as focused on his Insulin Resistance - and for good reason.

Continuous glucose monitoring vs. glucometers. Is it easy to do? What are the advantages and disadvantages? Is it cost-effective? How will it help you manage your blood glucose better? This video takes a deeper look into these questions to help you decide if CGM is right for you.

About John Lorscheider - John is a frequent contributor. He’s also a PrevMed patient. Like most of us, John’s family and personal history include significant cardiovascular risk.

John came from a technical background and spent his entire career in providing engineered fluid process systems and equipment to industry, as well as performing root cause failure analyses for his customers.

His own study and research made it clear he wasn’t getting the whole story about prevention from his docs. They just didn’t know. So he’s been in several roles of running prevention medical groups to help further the science.

I will do a brief series on saturated fats dietary recommendations. The original USDA MyPlate recommendations were based on Ancel Keys' Seven Nations Study. It showed increased heart attack and stroke risk for people living in nations with higher animal fat in their diet. Recently, many scientists have criticized Dr. Keys for cherry-picking data. The term "big fat lie" has been used again when Dr. Christopher Ramsden published a re-analysis of a similar study from the same research group. In fact, critical data were found unpublished. I'll cover this information and others in the upcoming series, BIG FAT LIES.

https://en.wikipedia.org/wiki/Seven_Countries_Study

https://www.scientificamerican.com/article/records-found-in-dusty-basement-undermine-decades-of-dietary-advice/

https://bjsm.bmj.com/content/51/15/1111

https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/

AREDs are Age-Related Eye Disease. It is a major cause of blindness and loss of sight. It really is prevented by supplements: Vitamins A, C, E, and Zin. These are very high doses, the kind you won't get in a routine multivitamin. Since eyes are derived from the same tissue as the brain, and biologically behind the blood-brain barrier, you have to wonder about the implications re: the meaning of this. Would antioxidant supplementation at this level protect the brain as well? This specific video is about the 10-year follow-up on the AREDs study population. Yes, it is still protected against AREDs. But guess what? It also protected against overal death. Hmm.

The original video on AREDs ( pt 1 ) is at the following link.

https://www.youtube.com/watch?v=SzghQN-E68I&t=0s

The European Urological Association just met in Barcelona. On March 18, 2019, Alexander Zlotta MD, director of Uro-Oncology at Mount Sinai Hospital presented a study of men with high PSA values (indicating the need for a prostate biopsy). They stopped spicy food, coffee, tea, alcohol & biking. The average decrease was 1.5 ng/ml. Over 1/3 of these men were able to avoid the biopsy.

https://www.medscape.com/viewarticle/910528

It was a small study. And there were many other considerations re: interpretation of this study signal.