guajalote
8d ago
The Number Needed To Treat for statins is about 138.
I believe her LDL is around 135.
I would suspect that given standard monetary values of QALY and DALY in the West, it would be a net positive given how damn cheap drugs are.
Assuming they actually prolong life. My understanding is that "statin clinical trials have shown marginally significant benefits on mortality" at best over 5 years, and there's no good evidence they reduce long-term morality. That's why I came here to ask the question, I'm curious if there's newer or better evidence to support their effectiveness. If they don't work, then we're just risking side-effects for no gain.
As for eggs, I have more or less given up on attempting to understand nutritional science, there's hardly a more cursed and confounded field on the planet.
I get that nutrition is hard to study, but do you really have no opinions about this topic as a doctor? Shouldn't lifestyle changes be the first line of treatment for this sort of thing? If you had to recommend the optimal diet to a patient with high cholesterol, what would it be?
I ask this because my mother is something of a health nut and will follow credible diet and lifestyle advice religiously. When her doctor told her to cut out red meat, butter, and eggs, she completely eliminated these things from her diet. If a doctor told her eating nothing but unseasoned boiled potatoes was the key to lower cholesterol, she'd eat nothing but unseasoned boiled potatoes. On the other hand, her doctor has not told her to avoid things like processed sugars or margarine, so she still eats plenty of that stuff.
So I'm interested in trying to set her up with the best evidence-based diet and lifestyle interventions possible. Since she is going to religiously follow some sort of diet program regardless, it may as well be the best possible program.
Finances willing, I'd put very many people on GLP-1 agonists, so if granny could do with losing weight and not just cholesterol, that's my recommendation.
She is not at all overweight, goes on long hikes/jogs daily, skis, bikes, and is otherwise very physically active for a 70 year old.
guajalote
12d ago
List it as free on craigslist or nextdoor or a similar site and someone will come take it.
guajalote
12d ago
What's the latest thinking on addressing high cholesterol? My mom has high cholesterol (70 years old, active, not overweight, otherwise in excellent health). She and her doctor are working off what I understand to be outdated thinking on the subject. For example she is avoiding healthy foods like eggs with high cholesterol content, but my understanding is the latest studies suggest no clear link between eggs and high cholesterol. It seems like the latest consensus is to avoid red meats, sugar, and processed foods. Her doctor has also suggested statins, but my understanding is that there isn't much if any evidence to support their effectiveness. What do the doctors of the motte suggest for an otherwise healthy person with high cholesterol?
guajalote
28d ago
The squirrel only bit the guy after they entered the house and tried to take the squirrel, which should have never happened to begin with.
guajalote
28d ago
I think he is making an argument. It's a bad argument in my view, but it's an argument accompanied by some sort of reasoning. Not going to win a quality contribution award, but not in violation of the rules either IMO. He is inviting a discussion and responding.
guajalote
28d ago
So should we burn down murderers' houses? What's the point of destroying property as punishment for a "crime" (which in this case is not actually a crime and which no one has been convicted of yet)?
guajalote
28d ago
Even if the owner murders babies I don't see how that justifies killing the squirrel. Seems like an unrelated issue.
guajalote
28d ago
I completely agree. Laws ultimately rest on the threat of violence and there should be as few of them as possible.
guajalote
28d ago
Driving safely while going 10mph over the speed limit is a behavior the state should condone.
guajalote
28d ago
It "makes sense" from the government's perspective to do what you're describing. It "makes sense" from society's perspective to do what I'm describing.
guajalote
29d ago
The government regularly ignores well-documented violations of the law, particularly where those violations are non-violent (e.g. speeding, immigration, drugs). Given that the government doesn't have the ability to enforce all the laws all the time, it makes sense to deliberately ignore inconsequential violations and focus on consequential ones.
guajalote
29d ago
It's one of the biggest libertarian "viral moments" I can remember. Not only is it terribly authoritarian, it's a ridiculous inversion of priorities and waste of resources. We can start talking about euthanizing squirrels over "rabies" concerns after the government has successfully euthanized every rat in NYC. And treating a squirrel as some kind of dangerous exotic pet makes zero sense. There's a long American tradition of owning pet squirrels; Warren Harding had one named Pete living with him in the Whitehouse. This whole thing is just quintessentially un-American.
guajalote
1mo ago
Because it's a joke that's been done many times with different islands as the punchline. I've heard the same joke with Australia or the UK as the punchline.
guajalote
1mo ago
Of course they are different but the logic that it's ok to ban things as long as they lack "valid uses" (according to whom?) is seemingly applicable to both.
guajalote
1mo ago
Guns have valid uses, recreational drugs have less of a claim
What valid use does this website have? It's largely recreational and a drain on user's productivity, a bit like weed. Should the government ban the Motte?
guajalote
1mo ago
The fact that "there are situations where your choices are limited exactly on these grounds" is not a justification. The government limits my liberty in many unjustified ways.
guajalote
2mo ago
Yes, there is a line where prohibition makes sense, but I don't think any human society comes close to crossing that line when it comes to alcohol. This is especially true given that alcohol has proven its ability to coexist alongside the development of advanced human societies over the course of several millennia.
Thanks, I guess I was slightly off, it's more like dozens per year. Still far more deaths than the total number of US school shooting deaths over the same time period (131 killed and 197 wounded in active shooter incidents at elementary and secondary schools from 2000 to 2020).
guajalote
2mo ago
Let's assume for the sake of argument that alcohol prohibition reliably reduces the murder rate in the long run. This is worth taking into account, but it's hardly conclusive of whether we should have alcohol prohibition. Reducing the speed limit on all roads to 25mph will reliably reduce traffic deaths; outlawing TVs and bookshelves over a certain size will reliably save the lives of several hundred young children each year who are killed when furniture falls on them; not to mention all the lives that would be saved by banning candles and fireplaces; etc. Personal liberty has a great deal of value and I think we should be skeptical of prohibitions even if the data suggests they are "good" for people.
guajalote
2mo ago
Write more, edit yourself more, and find someone who is a strong writer to help you edit your writing. Be merciless and aggressive with the editing. "Kill your babies." Also, read the works of people who are strong writers in the style you want to achieve and emulate them.
guajalote
2mo ago
The smart attack is to outflank him from the populist side by out-promising him in a vague way. Whatever Trump says he'll do (on the economy, immigration, whatever) she'll do even more and better. "I'll do even more and give you more free stuff."
This approach doesn't appeal to me personally at all, and probably doesn't appeal to the type of person who is coaching Kamala for the debate, but it appeals to the average voter and Trump would have a hard time rebutting it.
guajalote
3mo ago
Isn't this a fully general argument that applies to everything? "People are too stupid to make good decisions, so the government should make those decisions for them!" And yet despite the fact that many people are very stupid, the government almost always seems to do a worse job at making decisions than those "stupid" people did. It's the same intuition that leads people to think communism is a great and flawless idea that "just hasn't been implemented properly." It's important to judge policies by how well they work, not how good they sound.
guajalote
3mo ago
The incentive will arrive as soon as people start saying "I'll believe it when I see the negatives."
Thanks, I really appreciate you taking the time to share your thoughts.
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