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Wellness Wednesday for November 20, 2024

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

Jump in the discussion.

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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 She and her doctor are working off what I understand to be outdated thinking on the subject.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?

The Number Needed To Treat for statins is about 138. 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.

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. But from what I'm aware of, eggs have swung from being unfairly maligned to being good for you.

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.

Is there a better formula besides just looking at LDL? Certainly HDL, Trigylcerides, and blood pressure would be relevant. Are there any downsides to statins?

I tried one of those cardiac risk score things, and it said my 10 year risk of a cardiac event was about 1.5%, below the 5% threshold in which statins would be advised. That didn't feel super comforting. I know people like Peter Attila recommend statins to most of their patients. But he also recommends aggressive prostate screening which has not been shown to increase life span, so he may have a harmful "do something" bias.