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0 sats \ 0 replies \ @gmd 13h \ parent \ on: America’s Comeback vs. Germany’s Stagnation econ
Yeah some real kool-aid being drunk here. TBD how our economy responds to these new policies, half of which seem half baked. Ports are empty, negotiations seem to have stalled as countries look for workarounds to avoid us due to uncertainties. Praying I'm wrong.
Thankfully we're not as dumb as Germany.
Statins have been generic since forever, there is not much big pharma profits to be made there any longer.
It's really hard to quantify "enormous health benefits". Much of what we do has a significant placebo effect. You will see a lot of plant zealots make similar claims (I am skeptical). If you've lost significant weight that's awesome. Otherwise most people <50 are mostly healthy to begin with. Having more energy doesn't necessarily mean you live longer.
I would say if you are one of the "hyper responder" that sees your cholesterol levels skyrocket, it might be worth reconsidering the diet or re-evaluating benefits or intervention (even if that means trying more fiber). While cholesterol might turn out to be more correlation than cause of cardiovascular disease, in every other disease phenotype (familial hypercholesterolemia, etc) that shows markedly elevated cholesterol levels we see rapid progression of cardiovascular disease.
tbh i haven't heard any really good defense from the authors, but only following peripherally. burying the primary outcome is just basic corruption as a purported scientist.
I encourage patients to look into keto especially those who are obese and diabetic- I was a big fan when I first heard about this study and was really hoping to be able to more enthusiastically advocate for it.
Yup same article. Surprised it has not been retracted yet from what's a rather large journal. Controversy continues to unfold on twitter...
Interesting... do you need to watch the other Z-nation series to get into it? Those don't seem great..
Generally most retailers don't charge fees specifically geared towards credit cards. Instead they have increased their prices to account for credit card fees, knowing that people want to use credit cards for the convenience. So if you use a credit card with rewards (2-5%) you get something back. If you don't you get nothing.
In the US the added prices are pretty much built into the system. If you don't use a credit card with rewards you are basically subsidizing 2-5% for the rest of us that do.
In addition (it's a fun hobby for me) I'm doing the sign-up bonus churning which nets me ~$2-4k/year in tax-free bonuses.
Doctor's generally don't make any money from these scans unless you own an imaging center which is rare. It's a difficult 10x longer conversation to convince a family they don't need a CT and you are often met with scorn.
Combine that with ridiculous malpractice settlements ($29M here) that demand perfection beyond standard of care you are too often forced to pull the trigger on the donut of truth.
Rewatching the Last Kingdom.. Uhtred would have been saddened to see his hard fought land given away like this.
I don't understand why people don't use common sense. The US has succeeded because of selective immigration of people with American values. You don't just let in unvetted people that refuse to integrate and hope they become productive when they can collect welfare instead.
It's just not practical or possible. When you are expected to see 30-40 patients a day, older patients come in with a list of 10 things they want to talk about, you have to negotiate them down to the top 2-3 items, reconcile meds and refills, redirect and listen to them ramble about irrelevant nonsense and suddenly you're all out of time and you have a waiting room of patients who are upset you are running late (and then demand more of your time in return).
PCPs are just fighting to stay afloat in clinic. There's a reason my PCP always bugs me to schedule an appointment every year- she knows I'm younger, fit an healthy and it's an easy booking for her.
The loudest voices on social media are young people <50 who want to talk about how amazing their secret sauce is for staying healthy, but the reality is you generally don't need a doctor when you're young (outside of women's health issues). Don't get fat is all most of what you need to hear, which is advice that can be given by anyone. They don't see the 90% of other health issues that physicians actually deal with as patients get older.
Maybe... maybe not lol.
I would say if you follow a low carb diet and you are part of the minority that shows a sky-high spike in LDL, you might need to weigh things a little differently.
There are in fact cardiologists who eat low carb... they would recommend potentially increasing your fiber intake, consider a statin, etc.
Curious do you have any fat friends or family? The reality is that it is very hard to get people to change their lifestyles, and most people don't want to hear it. Furthermore you don't need to see a doctor to get this advice. Any half-decent gym-bro can tell you the 80% you need to succeed. Most people already know what to do- it is very simple but very hard.
Many people can lose weight for a short period of time, the difficulty is keeping the weight off over a prolonged period of time. What we hear on social media is the echo of young influencers and virtue signalers, but the reality for most is they are older, have jobs, kids and all kinds of life stressors. When you have 15 minutes to see a patient and they want to talk about W, X, Y, Z it's very hard to insert a lecture about lifestyle stuff they don't want to hear about and probably won't follow anyway.
There is no shortage of patients, only a shortage of cardiologists and most other physicians. This has led to the proliferation of dangerously undereducated NPs.
The main issue is that they claimed one result from the study while the data behind the buried primary end-point they tried to hide showed the opposite. It's not conclusive but it's a certainly a negative data point for keto enthusiasts.
I had heard about this study years ago and was hoping for the opposite result so that I could more enthusiastically endorse the keto diet.
My priors are that life is too short to restrict yourself to any particular diet, especially when the evidence base in nutrition is generally incredibly poor. Anything/everything in moderation - less is more.