best way to Target visceral fat
Dexa results as follow Visceral fat obesity 190Cm/sq for 100kg body weight & 176CM height - 1300Gms of Visceral fat in Dexa FMI = 14.0 42.6% total body fat - so mostly visceral but still a fair bit subcutaneous Everything else is clean - ZERO calcium in heart All Lipid markers at least 30% below the "optimal" level HBA1C 4.9 Clearly this visceral fat will cause issues & while I can go full keto to cut down total body fat over the next 3-6 months is there a more urgent medical intervention I should be discussing with my doctor
Early- Calorie Restriction vs Building Muscle
As we are going the Early Program, I am struggling with a nutrition question. While I have yet to obtain a DEXA (planning on it!), I anticipate that my lean muscle mass is insufficient for my age. I also have approximately 20-25% body fat at the moment. I am also using Layne Norton's Carbon app to assist with calorie and macro targets to meet my goals. What I have discovered, however, are what feels like competing interests between calorie restriction to drop weight and energy needs for building muscle. For reference, I am 5'11" and 203# currently and am lifting three times per week with the anchor exercises being bench press, deadlift, and squat. On alternative days, I am doing zone 2 work for 45 min with zone 5 work once weekly for 20 minutes. Any insight or direction on how to manage calorie restriction/fat loss vs muscle growth in the effort to succeed in the centenarian olympics would be greatly appreciated!
Not a question, but here's what I hand to new doctors, thanks to my experience with the Drive/Early/Outlive
The Parable of the Three Mechanics Once upon a time, there was a man who loved his car very much. It was a 2011 Ford Mustang, and he had bought it second-hand. It had 125,000 miles on the odometer and it hadn’t been well cared for. He wanted to improve its condition and make it last as many years and as many miles as possible. The First Mechanic He drove to the nearest garage and asked the mechanic to inspect his car. He told him that he loved his car and that he wanted to do whatever he could to make it last. The mechanic looked at the car and shrugged. He said, "It's not a special car. It's just a regular Mustang. It hasn't been treated very well up to this point. It has some scratches, some dents, some rust. It's not worth much. Just keep driving it until it dies. There's nothing you can do to make it last longer. Oh, and why are you even here? It isn’t broken." The Second Mechanic He decided to try another mechanic. He drove to a different garage and asked the mechanic to inspect his car. He told him the same thing: that he loved his car and that he wanted to do whatever he could to make it last. The mechanic looked at the car and nodded. He said, "I can see you like this car. But you have to follow the standard maintenance guidelines. The Ford engineers who designed the car are the true experts. They have the benefit of seeing the data for every car they've ever made. They know what's best for your car. Just follow the owner's manual and the recommended service schedule. Don't deviate from the standard. That's the best way to make your car last." The Third Mechanic He decided to try one more mechanic. He drove to another garage and asked the mechanic to inspect his car. He told him the same thing: that he loved his car and that he wanted to do whatever he could to make it last. The mechanic looked at the car and smiled. She said, "It's a beautiful car. It's a Ford Mustang. It's a legend. It has a lot of character. But you have to be willing to do what it takes. Are you sure you are willing to do what it takes?" The man said, "Yes, I am. Tell me what I need to do." The mechanic said, "Well, you need to do more than just follow the standard guidelines. You need to go above and beyond. You need to do things that most people don't do. You need to change the oil more frequently, use the best quality oil and gas, avoid driving too fast or too slow, operate the clutch correctly, rotate the tires regularly, protect the paint and the upholstery, and many more things. It will cost you more time and money, but it will make your car last longer and perform better. It will make your car happy. And it will make you happy." Their reaction saves me a ton of time.
Can Apo B be too low (using statins & PCSK9i)? PCSK9i drove my Apo B to 16 and LDL-C to 8!
I am a 70 year old male, very fit and athletic, with a CAC score of ~1200 and some family history of heart disease. I’ve been taking 40 mg Crestor (“maximum legal dose” of statins, as I like to say 😜) for the last 15 years but my annual CAC scores (I’m a data nerd) continue to increase at an average of 5% per year (which is much slower than before the Crestor!). I recently asked my cardiologist to add Repatha to my meds (based largely on what I’ve learned from your discussions with Dayspring and Sniderman). I just got back the results of a blood test taken a few weeks after starting Repatha and that stuff really works. My LDL-C went from 37 to 8(!) and Apo B from 49 to 16. Here is a summary: Crestor Crestor+Repatha Apo B 49 16 Total 110 87 LDL C 37 8 HDL C 61 68 VLDL C 12 11 Trigly 48 36 Obviously, my lipids looked pretty darn good BEFORE the Repatha, but given the continuing increase in CAC, apparently not good enough. Is there any danger of having LDL-C of 8 and Apo B of 16? Should I stop the PCSK9i? Or perhaps reduce the Crestor? Or is lower better even to this extreme?