domain:vinayprasadmdmph.substack.com?q=domain:vinayprasadmdmph.substack.com?page=0
guajalote
9m 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.
hydroacetylene
12m ago
Uh, what do you think a ‘government’ is other than the biggest, strongest gang?
pigeonburger
13m ago
The universal root of horror is not death or pain, it's powerlessness. For women it tends to be loss of social power. For instance, desperately pleading to someone for help only to be ignored or dismissed, or being unable to exert any influence on others. That second one is what a lot of this "suburban 50s" genre is playing to.
Turniper
16m ago
Pretty sure it was this one: https://exploringegregores.wordpress.com/
BurdensomeCount
Apparently "BIPOC" is a racial slur now.
24m ago
There is no good reason to ever watch or read anything made after 2012 and doubly so after 2016. There's enough great material to last you a lifetime from before then.
Ben___Garrison
Voltaire's Viceroy
25m ago
I haven't seen any evidence that puberty blocker hormone prescriptions are down or anything of the sort.
Is there any data on this anywhere? The way you're wording this is a bit sus, making a claim without evidence, but implicitly demanding evidence of a specific kind for any rebuttal.
FCfromSSC
Nuclear levels of sour
42m ago
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Innocent black men are routinely killed by corrupt police in large numbers, and the murders are covered up.
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Donald Trump is a Russian Asset, controlled through Kompromat.
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The Russians hacked the 2016 election
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Brett Kavanaugh is a rapist, and the Republican machine helped him cover it up.
It seems to me that these four fit your definition of "conspiracy theory", do they not?
hydroacetylene
45m ago
Monasteries in the late Middle Ages, mostly.
These were well known for obesity.
hydroacetylene
47m ago
It’s a civilizational horror of mediocrity. A deracinated and atomized people always, from every perch, know deep down that they don’t matter. In the Anglosphere you aren’t born someone unless you happen to be born into the British royal family; to not make something notable of yourself is to be no one.
In other societies- the ones humans are designed to live in- everyone is someone. Male or female, slave or free, old or young- there is a role, a set of marching orders from the top of society to the bottom, and it is no great sin to be average at whatever your role is. In the Anglosphere, to be average is to be so bad as to not have a role, not have a spot in society.
This may have gotten worse over time, but it is not a new problem- the plot of It’s a Wonderful Life is about Mr Bailey despairing at being no one and being convinced that he is some one. Further back, Great Expectations was already deconstructing the trope with Pip heading off to become someone.
ThenElection
53m ago
Not quite a suicide and more "nothing to see here, just bad luck," but the crash of the airplane carrying Lin Biao.
The official story: Lin Biao was planning a coup against Mao, but once he realized it was going to fail, he hopped on a plane with his family to flee to the Soviet Union. Unfortunately, he forgot to put any fuel in it, so it ran out of fuel early on and crashed in Mongolia.
There are some conspiracy theorists who find this suspicious.
urquan
57m ago
I am fascinated by this genre of "horror" (loosely described) having such a hold on women.
Heck, I'm surprised horror-qua-horror has such a hold on women! All the people I know who are into horror movies are women. Not to mention True Crime!
It seems like women are either really not into horror, or they're really, really really into horror.
daguerrean
59m ago
Agreed, I think the anger at Aloy is often misidentified, even by the people that are angry themselves. She’s just a 5/10, and there should be a place in media for people that aren’t attractive, there’s really nothing objectionable about her in isolation. The issue is that she’s a product of a movement that doesn’t just seek to establish representation for unattractive women but also seeks to abolish representation of attractive women: see replacing Lara Croft.
Lizzardspawn
1hr ago
Some riff on Tzatziki is the best - semi-strained yoghurt, plenty of lemon juice, garlic and dill, salt to taste. You look for naturally lactofermented yoghurts, with nothing added, on the tangier side.
srf0638
1hr ago
One I remember was about consumption in New York
I don't have a link handy, but I seem to recall it being demonstrated to my satisfaction that what the Fire in a Bottle guy and the Slime Mold Time Mold guy were presenting as evidence of high historical calorie consumption failed to account for food wasted rather than eaten. Like annual production divided by number of people or something.
vorpa-glavo
1hr ago
I just think the picture is at a bad angle. In this picture, Aloy looks fine. She's not a supermodel or anything, but she looks like a woman.
vorpa-glavo
1hr ago
I think this is why cultural products from the more feminists countries, such as the US, feature mannish-looking women, acting in a masculine manner.
I don't want to get too bogged down in the object level discussion of Aloy, but I think her having peach fuzz is a defensible choice. In our world, there are products to remove such hair. But Aloy is living in a post-apocalyptic world in 3040, isn't she? It's not hard to believe at all that grooming habits have changed, and women with peach fuzz just leave it as is.
Honestly, this kind of thing is something that takes me out of a lot of media. While we know that the Romans were big about hair removal, we also know plenty of ancient societies that weren't, and it's always strange to see "cave man" media where the women look like they stepped out of a modern Instagram photo, with shaved legs and armpits. I think a lot of creators across time have been cowards, unwilling to contend with the fact that humans are all, men and women, hairy apes.
Bartender_Venator
1hr ago
They expected one of us in the wreckage, brother.
WhiningCoil
1hr ago
I mean, you can clearly also see she has Ron Perlman's jaw. Which as it turns out is actually a disorder?!
daguerrean
1hr ago
1950s suburban nightmare
I am fascinated by this genre of "horror" (loosely described) having such a hold on women. I truly don't understand it. Don't Worry Darling, Revolutionary Road, Stepford Wives, Jeanne Dielman. To me it's reminiscent of a corresponding male genre that expresses existential horror at the idea of a boring office job (Fight Club, Office Space, The Matrix).
Lazuli
1hr ago
Week 13 thread live: https://www.themotte.org/post/1268/weekly-nfl-thread-week-13
07mk
1hr ago
However, I don't think that changes the fact that Republicans really have become the party of choice for conspiracy theorists that have very little grounding in reality.
This seems like a strange comment in the wake of an election in which one of the most commonly talked about theories about why the Democrats lost as much as they did is that the electorate rejected their embrace of a massive conspiracy theory that has very little grounding reality, i.e. CRT, "wokeness," identity politics, social justice, etc. I think it's more accurate to say that Republicans have become the party of choice for low status conspiracy theorists that have very little grounding in reality.
100ProofTollBooth
Dumber than a man, but faster than a dog.
1hr ago
but part of that problem is that Americans are just so unhealthy
Couldn't agree more. If you strip away chronic maladies that are directly due to poor lifestyle choices, you get rid of 50% of medical spend annually right there. If you then also exclude last two years of life care, you're at something like 90% of medical spend annually. And these two things interact. Getting old sucks, but it shouldn't be particularly painful or burdensome - but it is because people are getting obese first, then developing metabolic syndrome, and then getting old. Modern medicine and ethics keeps them alive, albeit with drastically reduced quality of life, pretty much up until the whole body just gives out.
Eventually, social security, medicare, and medicaid are going to run out of money. And, as this thread discusses, we're playing with the idea of a fundamental medical care shortage a la the NHS in Britain. If we don't grow our way out of this / come up with some seriously amazing medical technology innovations, I have two predictions:
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The cohabitation with an elderly parent will become ubiquitous in American society outside of the top 5%. For the top 5%, assisted living and retirement communities will become even more opulent and lavish then they are now. The wealthy elderly will become bizarrely hedonistic.
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There will be a large scale campaign for legalization of assisted suicide. It's already happening as a movement in the USA and they're already doing it in Canada.
I hate both of these things, personally. But I still believe they will happen. Getting wealthy in the next 50 years will be as simple as staying healthy, getting and staying married, staying employed (at pretty much any wage level that isn't working poverty), and caring about your children and family. Individualism will claim at least a third of society, perhaps more.
Celestial-body-NOS
🟦 All human beings are equal, **even when they aren't.**
1hr ago
Feminism as a concrete social movement is about advancing the material and social interests of women (or at least, the interests of a certain subset of women). It's not about "giving people the freedom to explore their identities" or "recognizing the complexity of every human" or any claptrap like that.
Until men or other women disagree with it, whereupon they retreat to "Feminism is simply the radical notion that women are people!" (This is why it is helpful to replace the symbol with the substance; yes, I Am Once Again Asking You To Read The Sequences.)
Not a conspiracy theory, just a retarded belief.
Are there (a significant amount of relevant) people who believe this?
This also seems like a strained framing, a lot of blue tribers believe that Brett Kavanaugh is a rapist (unlikely but unknowable) and believe that Republicans don't care about it because they hate women/whatever (wrong, Republicans just don't believe he is a rapist).
2 and 3 are one point stretched into two. But it's true that Russiagate stuff is definitely conspiratorial thinking, but it's miles more believable than QAnon (so is the Stop the Steal stuff, for whatever that's worth).
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