Intermittent fasting vs time restrictive eating
Peter recently said on a podcast (and i may have misunderstood), that intermittent fasting is not eating for 24 hour period and TRE is eating windows. Is there literature to support this information? Is there a change in the definition of both?
Dental health
Dear Peter I would love to hear your thoughts on dental health and its relationship to overall health / longevity. Is there any scientific evidence that root canal can lead to disease elsewhere in the body? Thank you for being such an engaging and invaluable source of information on health and longevity.
What's the tolerable amount of light while sleeping?
We often talk about the importance of sleeping in a dark room. But how much list is allowed? Not a single ray of light? A little light below the door from another room is fine? Is light ambient light from the outside (moon, stars, kind of city lighting) ok when sleeping windows opened?
Robbing Peter to Pay Paul
Question: At what threshold are you discontinuing lipid lowering agents in your patients? Do you think lipid lowering agents are an effective modality in stimulating behavioral change? Why do you think traditional lipid lowering agents statins/PSCK9 are more effective at lipid lowering and improving longevity vs HRT/Stress reduction/Nutritional interventions/Exercise? Assumptions and background: You are an analytical thinker and will be open to these questions given your goal is to best improve patient care. Currently you have the assertion radical (<5%) primary prevention lipid lowering interventions (medications) are justified in order to prevent cardiovascular disease. Your justify this as CVD is the number one cause of death globally. HRT causes a ARR 50-60% reduction in CVD mortality vs 2-3% with statin therapy - see Neil Rouziers work. ALLHAT/ALLHAT-LLT and Sweedish Study - both non-industry funded trials show no net reduction in mortality vs standard of care for statins used for primary prevention. Analogy to your current practice: Why don't we just do radical mastectomies on women and medically castrate men immediately after puberty to prevent breast and prostate cancer. Recommendation to change your thinking: start doing muscle biopsies on patients treated with statin therapy continuously for 2 years vs controls. Disclosures: none Sources: ALLHAT, ALLHAT-LLT, No connection between the level of exposition to statins in the population and the incidence/ mortality of acute myocardial infarction: An ecological study based on Sweden’s municipalities
Stopping GLP-1 and/or Metformin
The recent AMA on GLP-1s and Metformin was an eye-opener. I am taking both for weight management and working with a physician on it. Is it better to come off the drugs slowly or just go cold turkey - e.g. - Increasing time between shots or reducing dose size or both? - Taking Metformin ER in the evenings only v.s. during the day?