hormonal replacement therapy and breast cancer risk / thromboembolic risk
Dear Peter and team, as I reviewed the literature I realized that the WHI released in 2014 an update of their original results with a longer follow-up : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963523/ In this update, the invasive breast cancer risk (absolute risk) in the estrogen + progesterone group is an increase of 3.8 cases/1000/year, which is greater than what Peter usually says in his podcasts (1 case per 1,000 women). Dementia risk is also increased with the combined therapy by 2.3 cases/1000/year, and thromboembolic/cardiovascular risk by 1.2 + 1.9 cases/1000/year The importance of these numbers are obviously subject to individual values and preferences in the face of a reduction of 5.1 fractures/1000/years, however, if we think that HRT will be maintained for years/decades safety issues (not only breast cancer risk but CVD risk) start to be disturbing, and need to be better clarified I do acknowledge the fact that the WHI used equine oral hormones, which can contribute to their safety thromboembolic findings, however, I also urge Peter to update his discourse aiming at keeping the trustworthiness he conveys: I would say it is either conveying more objectively the risks seen in the WHI or bringing more robust objective data to counterpoint what has been seen in the WHI Thanks!
Non-fatal Healthspan Conditions
I've been listening to your podcast and reading your book. It seems to me that the focus on the top causes of mortality naturally leads to increases in lifespan -- and as a byproduct, increases healthspan. This is great! As a next step, people might want to focus on conditions that decrease quality of life in the later years, but won't necessarily kill them. I'm thinking of things like poor sexual health, gum disease and tooth loss, arthritis, etc. It's easy to find mortality tables; is there anything equivalent for morbidity? Are there studies that look at what non-fatal conditions decrease quality of life the most for people in their last decade or two? And then, of course, what should one do to try to postpone or avoid these things as much as possible. I'm sure exercise/nutrition/sleep are right up there, but what else?
climate change and health
Exposure to air pollution ( 2.5 particles as well as ground level ozone increase the risk of heart attack and stroke. This has been shown to be causally related. Millions of deaths are directly caused by air pollution. Longer pollen seasons, extreme heat and wild fires are all related to climate change.Climate change is limiting our health span and life span. Unfortunately this tends to be unfairly distributed to those individuals in lower socio-economic communities. I think you need to have guest with expertise in what individuals should do to protect themselves from pollution. When to stay indoors, hepata-filters, best times to exercise and avoid harm. It would be great to educate your audience on the amount of harm that is done from climate change and the importance of reducing fossil fuels, for the health of everyone.Pollution may well trump all of your other Horseman.:)