A few what ifs regarding article: Coronary atherosclerosis is a silent killer, but we have tools to stop it
Peter Attia and staff, Big fan of the weekly articles and podcasts. Your's is the only health-related podcast I listen to. A few what ifs to consider about this research and article: The research poses great points and how they indicate ApoB as the molecular cause of heart disease rather than simply LDL itself. And your article describing the research was excellently written. The takeaway, if I understood it correctly, could be construed that pretty much anyone over age 45 or so would do well to be on some type of lipid lowering drug. However, your article begins with the question: Despite everything we know about the causes of heart disease and the available drugs to eliminate it, why is heart disease still the leading cause of death? If we were to consider a parallel hypothesis/question: Despite the fact that statins and other lipid lowering drugs are the most prescribed drugs in the world, why then is heart disease still the leading cause of death? Two possible answers: 1. Not enough people, especially those with no clinically significant risk factors, are taking advantage of available drugs. 2. Although statins and other lipid lowering drugs indeed lower lipid levels, lower lipid levels alone do not prevent the development of heart disease nor prevent death from it. The answer to this question cannot be, Well you also have to exercise and eat right. You have said in previous podcasts, diet and exercise will not lower ApoB, and at some point pharmacological intervention is the only means to significantly lower ApoB. A few what ifs to consider if we want to dig deeper into the statistics: 1. What if the CDC National Center for Health Statistics, for an entire year, took all those whose cause of death was heart disease and then recorded who was and who was not on a lipid lowering drug. 2. What if we analyzed everyone in the USA over the age of say, 90, 95, 100 or 105, and again looked to see who is and who is not on a lipid lowering drug. If the takeaway of the research is true, we will see a high percentage of these seniors on lipid managing drugs. Although likely very difficult to obtain, these data would uncover whether or not the above statement is true- i.e. more people would do well to be on lipid lowering drugs.
Daily Protein with One Kidney
I recently donated a kidney and the nephrology team recommends the standard dietary intake of 1 gram of protein per kg of body weight. Obviously that is much lower than Dr. Attia's daily recommended amount; however I cannot find anything on the site indicating those living with one kidney should adjust their protein levels. Thank you.