ApoB number

I wasn’t saying that you shouldn’t try to live as long as you can, but to accept that there’s a limit to what you can do to prevent heart attacks or strokes. Both are survivable, and much more so if you are alert to their symptoms and get fast treatment.

There’s no way that I’d ever tell anyone to quit trying. My DNR and MPA basically say that if I can tell what’s happening to me, decide what I want to be done to and for me, and direct it, and I’m not a burden to those who would have to support me, then I want to continue to live.

I’m also in my 70s, never expected that I’d live longer than my father who died of T1D at 68 after blindness, lameness, multiple heart attacks and a stroke. We were both diagnosed at age 29. We had the same diets. He was stronger than I am, more active, smarter. We used the same insulins for all but his first years. Until early last year the only tech I used that he didn’t soon enough was a BGM.

The two medications I’ve been taking take to get slightly lower numbers that my doctor likes, now have multiple studies with statistics that show they aren’t beneficial in extending outcomes or quality of life. I’ve outlived several of my doctors, am now older than most of my current ones.

imo, Better information and learning to use it, not medicine, is what has preserved my health.

Medicine today is about suppressing symptoms, repairing damage, preventing infection, not curing disease. What’s known about the effects of what we can do as individuals to change our health outcomes is very limited, and all statistical, not scientific. For every person who believe that cardio exercize is life-extending, there are counter examples like Jim Fix who died at age 52 from a heart attack.

There were promoters of two radically opposed extreme diets. Both had “suggestive” evidence from limited studies. They theorized that low fat or low carb diets were healthier than the average north american diet. They took those two theories and pushed them to their limits, promoted their application. Both died in their early 70s, Dr Pritikin and Dr Atkins. They believed that if a little was better, then a lot must be a lot better.

What you have described you do is more than most people do, and from what we know about diet, nutrition and lifestyle on individual health, it is reasonable and into diminishing returns.

There are things you can do, but only you know how much of them you can.

Work for balance and moderation. There is more evidence that excess of any kind is harmful to health than there is that anything specific that isn’t a medicine or poison is helpful.

Think carefully about any changes you make. Make them small changes, one at a time, wait and pay attention to how the way you feel changes.

Try to optimize exercize. Keep your body flexible and stronger than you need to be to do what you must do, rest and don’t knowingly extend activity beyond the point where it hurts. It takes us longer to heal from injuries. If you haven’t been doing a physical activity freqintly, approach it cautiously to find your limits.

imo The most important things anyone can do to maximize their life are to stay mentally healthy and not become stressed over things beyond their control. Stress can make you ill, while an unstressed mind can make better choices between options.

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I agree and would not be quite as proactive in my heart care if I did not live countryside, roughly 85+ miles from the nearest decent hospital. I also travel globally to my offices and factories in very remote parts of the world where medical care and language challenges definitively interfere with receiving the urgent care required for a positive outcome from a cardiac event.

No, it has not been “demonstrated”.

What was found was a staistical difference between two groups of people, neither of which were following a protocol using self reported or inferred behaviors.

Believing that IF the difference could be duplicated the result would be the same isn’t a demonstration. You can’t demonstrate that something that didn’t happen would have happened if you hadn’t intervened. And the percentages are for general populations, not PWD nor persons over 65.

I appreciate availability of medical services. It’s why I chose to continue to live in an area that is decreasingly affordable, 12 mile from a first-class medical center.

I just did some research and found out that Nathan Pritikin died at 69, because he committed suicide. He had two forms of Leukemia and the treatment made him so miserable that he decided to end his life.

When his autopsy was performed the doctor in charge said that Dr. Pritikin had the heart and arteries of a very young person. He can not be compared to Dr. Atkins.

When Pritikin was in his 40’s he was diagnosed with severe heart disease. His cholesterol was over 290. He changed the way he was eating completely to a low fat mostly plant based diet and completely reversed his heart health.

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As we get older our bodies produce larger lipids because the machinery gets worn out, meaning our livers. You already eliminated all the animal fat and you limit all fat intake even vegetable fats. Iknow you also exercise. I really don’t know what else you could possibly do except for statins. You said you can’t tolerate them and neither can I. At some point ApoB rises with age and there really isn’t enough data to truly give age adjusted ranges.Also I really doubt the accuracy of these new lipid tests. People always want the next best test and the diagnostic companies will push for things and suggest they are significant. I’m not convinced . It’s also not one thing or another it’s an entire system working in concert. When it’s out of whack, like with diabetes, we want to make adjustments, but it could be normal variation besides there are no drugs to treat it thst I know of
You might need to accept your numbers and your health are really good and you are doing everything you can to be healthy

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Totally agree, but in the meantime may as well keep trying the latest new shiny object as it is only a matter of time before a better solution comes along, and if we don’t at least give it a shot, w will not benefit from it if it works.

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Well I do add chia seeds, flax seeds, and a walnut to my morning oatmeal and fruit, and I eat pumpkin seeds with my dinner, Also the garbanzo bean chocolate cookies also have some fat. It would be extremely hard to not eat any fat.

I have really lowered my lipid numbers a great amount without statins which I would take if they didn’t cause me to have a bit of neuropathy. I realize that my previously high LDL and HDL numbers helped cause me to need heart stents, so it makes sense, at least to me, to know the numbers. My internist doesn’t understand the VLDL number either and I have thought about calling the lab. I will probably just wait to see what my ApoB number looks like. If it is high all I can do is what I have been doing for the last 6 yrs. My echocardiogram in a couple of weeks, will give us information too.

I realize that there isn’t any more that I can do food wise to lower numbers, but I could always exercise more. I would rather read a book than exercise, but I can at least make sure that I put in at least an hr a day riding my exercise bike.

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It’s good that you questioned my response and did some research.

I see you misssed the point, that I wasn’t clear enough. The point was that you need to find balance and lower your stress.

These were not so much comparisions as illustrations of 3 champions of life extension practices who failed to reach your goal of living until age 80. There are people who did none of the things these men did, who you and I might regard as living unhealthy lives, who outlived these champions and may outlive us.

We don’t really understand why. We guess and hope, and ideally we have some solid basis for our effort. I try to avoid confirmation bias and look for strong evidence to support what I do.

That Jim Fix died of a heart attack having been an avid runner isn’t evidence that running causes heart attacks, is beneficial or harmful. It’s coincidental.

Nathan Pritikin had undergone treatment for cancer and then had leukemia, diseases and treament that disrupt the entire metabolism. That he was observing a chronic diet before long before he died is not proof that the diet caused his suicide, or the condition of his arteries.

Dr Atkins died of head trauma after a fall. That he was following a diet isn’t proof that the diet caused the fall , for him to gained 60 pounds or have had multiple ischemic heart attacks. It isn’t evidence that minimizing carbs is a bad idea.

These three men all had some evidence to support their beliefs, they all focused on one thing that they thought might improve their lives, then promoted that one thing. All three still died from the consequences of disease at a relatively young age despite trying not to.

We’re they wrong to try? I don’t think so. Everyone dies, but they all did something that made some other people think about what they were doing, what they might try. .

If you look at the aerobic exercize plans, the Atkins and Pritikin diets of today, and compare them to the original cocepts, they are all evolving through experimentation toward moderation.

Today aerobic exercizes are combined with anerobic, with intervals, recovery periods and nutrition. The modern Atkins and Pritikin diets share minimizing foods that wouldn’t be available today without extensive engineering. Atkins was suspicious of highly refined carbs, Pritikin of fats from intensively inbred farmed animals.

I believe that Pritikin was the most rational of the three. It might seem ironic that what he thought was harmful was the result of generations of engineering, because he was an engineer. But as engineers we are very aware of the limits of our knowledge, how our work can be misapplied, and unintended consequences.

Engineering is the application of science (what we know) to produce specific results that we believe are desireable. Farming and medicine are specialized forms of engineering. But engineering isn’t science. It’s a practical art of trial and error to find always sub-optimal solutions - compromises. There’s never enough time, knowledge or resources.

Nothing that an engineer, doctor, or athlete says or does should ever be treated as if they were golden bullets that will solve all your problems or magic shields that protect you; they all have limitations and unintended consequences. And nothing reported by the popular media should be accepted as completely true.

I have a plaque that reads “Moderation in all things - including moderation - is the key to happiness.”

best wishes.

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Taking quotes out of context but right here is a key point

Thanks to everybody for their thoughtful replies. In case I have confused anybody, I need to say that I really do enjoy my life and I am not particularly stressed. I am sorry if I led people to believe that I am. Because I do love my life, I am interested in getting excellent numbers and consider it a challenge. I also want to live my remaining years with as few complications as possible, so that my husband and I can continue to enjoy our lives for as long as possible.

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If you have a specific issue with your diet, activity or insulin that you are having a hard time improving to your satisfaction, it is more likely to get useful options for you to thik and and possibly try.

Although you may have gained an impression to the contrary, I’m not an opponent of Fix, Aktins or Pritikin. I just don’t believe in believing in anything, especially regarding health, that anyone else believes. Knowing what works reliably and imperfectly, even if you don’t believe it will, or understand why it works, is more useful.

The best approach l’ve found to get better heaIth is to start with useful metrics. I’m not fond of the A1c for management because I’m well below the very lax ADA and AACE targets. A1c doesn’t tell me or a doctor anything that can be used to make a specific lifestyle change.

The same is true of lab lipid test. They just check to see if somene is within the statistical range of “normal”. The medical approach to lipids not being in range is to target the symptoms with disruptives chemical or use a scentifically unfounded belief of cause and effect to suggest a gross dietary change.

CGM stats are better than either for improving my blood glucose level, and cardiac health.

They let me pick out one aspect of what I do that I think is the “worst”, make small changes to change it and see if it improves. I learned that changes in diet are more impactful on my health than execize is, and that a series of small over time are able to produce steady improvement and a more positive effect over time than a few large ones.

I’m a pragmatist. I don’t believe, I do. I need facts proof that something works, or at least multiple unbiased opinions, and if I can get empirical proof through careful experimentation, I will try to do so instead of relying on others. If something works, I’ll tweak it and keep doing so until it stops improving. Then I start a different experiment.

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I found this video to be very informative and thought I would share it. I am not sure I can make substantial changes in my ApoB numbers at 72 or even if I need to, but why knowing your ApoB number is important is explained here. I found this to be fascinating.

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Thank you so much for sharing. I hung onto every word of this video and it connected many of my missing dots connecting APOb to atherosclerosis. I have been following Peter Attia for a few years and he is an amazing interviewer and I am not sure how I missed this podcast when it came out. A big takeaway for us older folks is that for several decades we have been either outwardly or inadvertently damaging our main arteries with atherosclerosis and that at an early age (in our 30’s) that damage can be stopped. Once we reach our 60’s+ the damage has been done and non reversible so at best we can attempt to keep our risk level steady and not let it get any worse. Are there any options beyond how we are currently living our lives? I don’t know, but am in the process of chasing down any and all current options and will post anything I come up with.

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CJ, for me, switching to my low fat plant based diet 6 yrs ago, and adding a bit more exercise has made a huge difference in my particle numbers. They don’t even register on the graph, and my insulin resistance is 25, which is extremely low.

On the Bernstein low carb diet, my particle numbers were much, much higher. While very low carb eating works beautifully for Dr. Bernstein, it was really disastrous for my arteries.

Both very low carb and low fat plant based diets gave me very low A1c numbers. It is my belief that paying close attention to artery heath is just as important as excellent CGM numbers. So very glad to have found the Mastering Diabetes guys and so thrilled to have a CGM.

Also very glad that I am a personality type that allows me to follow a limited way of eating. I wish I had switched decades ago, when it would have prevented me from needing stents.

We live and hopefully learn.

I have been mixing up my diet, and after a daily avocado stint, I am now on a large bed of mixed greens, 4-5 oz of chicken breast, salad dressing 1.5 tbsp chia seeds. 1.5 tbsp pumpkin seeds, 1.5 tbsp sunflower seeds, a few spices, virgin olive oil, and vinegar. In a few weeks, I hope to know a lot more after my functional cardiologist has results from all my test and will let you know what she recommends for me and why she recommends it.

Artery health is certainly as important as excellent glucose control. Unfortunately, I only started on artery control 2-3 years ago, 40+ years past due.

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Hi Marilyn! Just an afterthought here. Summer before last I had a couple of episodes of strange but temporary memory loss, dubbed mini-strokes by my doctor. :scream: Nobody our age wants anything to do with these either!
The only treatment recommended was to take a 325mg aspirin daily, which I do. NBD, but the downside is that as a pump user, my sites, or any other little injuries, bruise like crazy.
Probably good for heart issues as well?

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Hi earthling!! I am so sorry to hear about your mini strokes. When I received stents, I was told to take a baby aspirin daily, which I have been doing for 13 yrs now. I also take a supplement called Nattokinase which a functional MD suggested I take to thin my blood. I have been taking that for about 8 yrs. I worry at times about internal bleeding, but so far so good.

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I think it depends on the type of stroke, ischemic strokes are prevented by using aspirin but hemorrhagic strokes would be worse. So there you go. Damned if you do damned if you don’t