Emergency hospital during influenza epidemic, Camp Funston, Kansas (1918). Original image from National Museum of Health and Medicine. Digitally enhanced by rawpixel.
I’ve seen a lot of viral illnesses the past six weeks or so: COVID. Bronchitis. Sinusitis. And of course, the flu. This is the time of year when people get sick with all kinds of sniffles, sore throats, coughs, chills, and aches. Understandably when people are sick, they want to get better as quickly as possible. Ergo, many patients who test positive for flu will ask me for Tamiflu.
Happy New Year! This is the time of year when many people make resolutions, with getting fit being amongst the most common. Of course, research shows that most people quit their new year’s resolutions by around March. So this year, I’d like to suggest you take a different approach: rather than giving yourself overly ambitious goals in the gym, instead learn to bake some very modest but high-yield habits into your life.
While this may not sound as sexy as committing to some kind of “beach body” program, the fact is that with exercise, a little goes a long way. A very long way. To this end, I’d like to highlight two threads of research for you.
If, like me, you came of age in the 1980s and 1990s, you probably don’t remember a time when you weren’t warned to stay out of the sun. The message for the past few decades has been that sun exposure = skin cancer, and that if you absolutely have to go out during daylight hours for more than a nanosecond, to please not do so without first donning sunscreen and a full suit of body armor.
It’s true that excessive sun exposure can cause skin damage and increase the risk of skin cancers. But there’s (pun intended) a wrinkle to this. And that is that limiting sun exposure might also increase your risk of getting lots of other diseases, including heart disease and virtually every other known cancer. I’ll discuss some data about this in a moment, but first I want to just share some thoughts about sun exposure in general:
I’ve been meaning to review this study for some time now. A few years ago, a cardiologist at the University of Texas by the name of Dr. Ben Levine conducted a study that ought to be on the minds of anybody who is interested in living a longer and healthier life.
Dr. Levine and his colleagues put middle aged adults (around age 50) who were previously sedentary but otherwise healthy on an exercise protocol for two years, and performed various tests on their hearts before and after the study. They found that after two years, the subject’s hearts had effectively reverted back to those of a 30 year old’s. In other words, exercise made these people’s hearts age in reverse by almost twenty years.
In my last post, I reviewed some of the background on how and why cholesterol came to be viewed as a risk factor for heart disease, and how this creates a clinical conundrum for those who go on a low-carb diet and see a big rise in their LDL (the “bad”) cholesterol but see every other aspect of their health improve. I discussed how there is a paucity of research on this particular population of patients and, hence, a lot of controversy about this topic. Then I introduced the work of Dave Feldman, a software engineer and internet personality who has been leading a grass roots research effort into this very topic. And I reviewed how Dave has proposed that maybe – just possibly – the metabolism of people on low-carb/keto diets is so different from that of a person following a more typical diet that cholesterol simply doesn’t behave the same way in their bodies, and hence the research we have until now suggesting that high cholesterol is a risk factor for heart disease might not apply to them.
I’m going to spend the rest of this post discussing a fascinating study that Dave and his colleagues just published which attempts to shed some light on this question. But first, let me stress that all of this remains theoretical, and – spoiler alert – we still do not know if having severely high levels of cholesterol due to a low-carb/keto type of diet is safe. One study does not a fact make, and most doctors would advise continued caution in this area. And while I do feel that the obsession on cholesterol and its treatment has had some real downsides (by emphasizing a laser focus on this one risk factor, while far more important risk factors such as metabolic syndrome/insulin resistance get ignored), it’s only fair to admit that there are still many, many, papers out there showing that – on a population level – there is a strong link between elevated cholesterol and cardiovascular disease risk. Please keep that in mind as you read the rest of this.
