The importance of play
I'm a 46 year old science teacher trying to stay active and healthy so that I can compete with y'all in the centenarian olympics! *And be a fun playful dad for my little kids. What’s your take on PLAY as we grow older - as part of being healthy and for longevity? Seems like no one talks about it, and esp in USA, hardly any adults still play sports. We seem to view it as just a kid thing. Clearly injuries are a downside - I feel like if I only lifted and did zone 2 and 5, I would never get injured. Maybe that'd be a good thing. But I still play beach volleyball at a pro/semi-pro level, and I try to play as many sports as possible - tennis, pickleball, basketball, etc. Any thoughts on why it’s ignored so much? Also, how the training fits into your framework? Meaning, is 3 hours of beach volleyball in 95 degree FL heat zone 5? Tons of sprinting and jumping on sand, but breaks between points. There are definitely social and cognitive benefits of play. Just wondering if the injury potentials or taxing nature (and other potential negatives) outweigh the goods.
Statins and Artery Calcifcation
I would love to hear some analysis and commentary on the effects of statins on calcifying coronary arteries (et al). Statins are known to "promote" this, for good or bad, and I'm curious how this impacts ASCVD risk. i.e. studies using CAC as a risk factor don't seem to control for long term statin use. e.g. a 40 year old with a CAC score of 100 using aggressive statins since their 20's would have a higher risk than a 40 years never statin user with a CAC of zero (but might have more vulnerable plaques).
Intensive vs standard BP / glycemic control in T2D patients
Hi Peter & al, In AMA episode on blood sugar and CGMs, you discussed the importance of BG control and the impact of variability / peak / hyperinsulinimia. In a review article of RCTs and CVD epistemology, Farnaroff et al. discuss how "common sense" interventions (based on mechanistic data and observational research) can lead to spurious correlations and inefficacious interventions. One example given is intensive vs normal glycemic and BP control interventions in T2D patients: "In patients with diabetes mellitus, observational studies, consistent with common sense, showed associations between higher blood pressure and worse glycemic control and worse cardiovascular outcomes (70,71). However, when patients with diabetes mellitus were randomized to intensive (<120 mm Hg systolic) or standard (<140 mm Hg systolic) blood pressure control and to intensive (hemoglobin A1c <6%) or standard (hemoglobin A1c 7% to 7.9%) glycemic control, intensive blood pressure control did not reduce the risk of cardiovascular events, and intensive glycemic control lowered the risk of MI but increased the risk of mortality (72,73). Both intensive treatment strategies caused a higher likelihood of adverse events compared with standard therapies." Appreciate your thoughts and insights on these findings. doi: 10.1016/j.jacc.2020.05.069
Inhibition of nonalcoholic fatty liver disease in mice by selective inhibition of mTORC1
These scientists were able to selectively inhibit mTORC1 just in the liver with good results. https://www.science.org/doi/epdf/10.1126/science.abf8271 What are the implications for those of us without such selectivity (short of waiting for pharma to come up with something that works similarly)?