7 ms·

> almost all of the high quality, science based writing I've read indicates that the mainstream healthcare system's view on cholesterol is wrong. My understand

by Swizec 11y ago

> almost all of the high quality, science based writing I've read indicates that the mainstream healthcare system's view on cholesterol is wrong. My understanding is that a doctor's first job is to be risk averse. That's why they shy away from bleeding edge research and knowledge, and choose instead to rely on proven ways. Their job isn't so much to be right as it is to not be wrong. If that means keeping you suboptimally alive, but still healthy, then so be it. Better than try to optimize and risk worsening your state.

DiabloD3 11y ago
The problem is, there is no research stating that lowering dietary cholesterol leads to lowered blood levels and the reversal of fatty liver disease. There is research stating that fatty liver disease exists due to long term over-production of cholesterol in the liver, caused by low dietary cholesterol, and increasing dietary cholesterol can lead to the reversal of fatty liver disease; and such research isn't really cutting edge, much of it is around a decade old now. The FDA has reversed course on this, and is no longer hammering its anti-cholesterol drum.
- Swizec 11y ago
  > much of it is around a decade old now Has your doctor done any research/training about cholesterol in the last 10 years? I'm being snarky. But I think it's important to consider the lifecycle of doctor careers. If you go to a liver or cholesterol specialist, then I'm sure they will be up to date with even findings from the last year. But I wouldn't expect a GP to be up to date on what every field within medicine has decided in the last decade after years and years of back-and-forth. It's almost like asking a computer scientist to know both the difference between Angular and React, and how to rewrite COBOL mainframe code into Lisp. The actual job of a computer scientist is writing proofs in Coq and understanding the difference between lexical and context-free grammars.
  - copperx 11y ago
    > The actual job of a computer scientist is writing proofs in Coq I was with you, but then this analogy went too far.
  - scott_s 11y ago
    You have a misinformed view of what a "computer scientist" is; I have never written a Coq proof, but I think my publication record buys me the label "computer scientist". (I recognize you were probably usually your specific examples as examples of a kind, but it's that kind which I think is misinformed. You probably think a "computer scientist" must necessarily be a theoretician, which is not the case.)
  - Joof 11y ago
    I think you would be saved by rephrasing to indicate a particular computer scientist. People are getting overly pedantic.
    - Swizec 11y ago
      It's okay. That's how engineers and computer scientists work. The idea of "generalization" and "hyperbole" and "caricature" is often lost on us. This is primarily why my technical blogging has slowed down significantly. Writing for an audience that cares more about details than The Point (tm) is often annoying.
      - copperx 11y ago
        Actually, to nitpick on the details, it's both. We care about the details AND the point. The details sometimes take you to The Point. For example, I on your original post, I was trying to figure out if you meant "Computer Scientists are theoreticians" through the details. If you're not going to outright say something straight to the point, the details better be clear so that one can understand the implication.
        Swizec 11y ago
        That's the thing, there were no details, it was a caricature. I've never heard of a person rewriting COBOL into Lisp in 2015. But I do personally know people who write Coq proofs and care about differences between strengths of various grammars. Maybe that's the problem - that part came too close to reality and triggered people's spidey senses.
        deleted 11y ago
        [deleted]
  - Joof 11y ago
    I think you would be saved by rephrasing to indicate a particular computer scientist. People are getting overly pedantic.
- carapat_virulat 11y ago
  But most anti-cholesterol diets lower animal fat intake, not dietary cholesterol intake. Is this supposed not to work? I had high cholesterol for years, I didn't take it very seriously because I'm otherwise healthy and I was eating healthy, but when I decided to take care of it I got it from around 210mg/dL to something like 140mg/dL just by changing all my meat/cheese to low fat alternatives as my doctor said. I am a big eater though, so maybe it doesn't make as much a difference for people that don't eat so much.
  - sliverstorm 11y ago
    There were two suspected causes of high blood cholesterol- 1) dietary saturated fat (e.g. beef) 2) dietary cholesterol (e.g. chicken eggs) Classical anti-(blood)cholesterol diets recommend avoiding both.
epalmer 11y ago
> My understanding is that a doctor's first job is to be risk averse. That's why they shy away from bleeding edge research and knowledge, and choose instead to rely on proven ways I think it is more a matter of relying on what other doctors are doing and as well what they think their patients will tolerate. I asked my cardiologist and primary care doctor before going on a well formulated low carb diet. they were both in favor of it but noted that they don't recommend these types of approaches, not because they don't work, but because people don't tend to stick with it. In 3 months I lost 30 lbs (got a way to go still). My primary said that I have not indication now of prediabetes while I did prior to my diet. For me I decided to take control of what I can in my health. Keep in mind your MMV.
- TeMPOraL 11y ago
  > For me I decided to take control of what I can in my health. But you did that cooperating with your doctors, which is how it should look. The problem with people taking charge of their own health is usually that they completely reject medical professionals altogether because they "know better". It makes exactly as much sense as when a manager decides not to hire a programmer, but instead buys himself a JavaScript book, because "how hard can this programming stuff be anyway?", or "the programming establishment still uses this old Ruby stuff, they don't know JavaScript is the state-of-the art solution!". Knowing better than your doctor can lead to tragic consequences. Since we're in story-sharing mode: just last week my brother's friends saved the life of a guy who was after surgery that involved installation of stents, but for some reason didn't take the prescribed anticoagulants - he just kept the prescriptions stored in his bag and went happy about his life. He slipped up and admitted to taking no drugs on a checkup in the hospital. According to the doctor who was leading his case, he was hours from dying when they figured out what's going on.
  - dualogy 11y ago
    > It makes exactly as much sense as when a manager decides not to hire a programmer, but instead buys himself a JavaScript book, because "how hard can this programming stuff be anyway?" Hey, worked out splendidly for Derek Sivers!
  - 11y ago

by Swizec 11y ago

DiabloD3 11y ago

The problem is, there is no research stating that lowering dietary cholesterol leads to lowered blood levels and the reversal of fatty liver disease. There is research stating that fatty liver disease exists due to long term over-production of cholesterol in the liver, caused by low dietary cholesterol, and increasing dietary cholesterol can lead to the reversal of fatty liver disease; and such research isn't really cutting edge, much of it is around a decade old now. The FDA has reversed course on this, and is no longer hammering its anti-cholesterol drum.

Swizec 11y ago
> much of it is around a decade old now Has your doctor done any research/training about cholesterol in the last 10 years? I'm being snarky. But I think it's important to consider the lifecycle of doctor careers. If you go to a liver or cholesterol specialist, then I'm sure they will be up to date with even findings from the last year. But I wouldn't expect a GP to be up to date on what every field within medicine has decided in the last decade after years and years of back-and-forth. It's almost like asking a computer scientist to know both the difference between Angular and React, and how to rewrite COBOL mainframe code into Lisp. The actual job of a computer scientist is writing proofs in Coq and understanding the difference between lexical and context-free grammars.
- copperx 11y ago
  > The actual job of a computer scientist is writing proofs in Coq I was with you, but then this analogy went too far.
- scott_s 11y ago
  You have a misinformed view of what a "computer scientist" is; I have never written a Coq proof, but I think my publication record buys me the label "computer scientist". (I recognize you were probably usually your specific examples as examples of a kind, but it's that kind which I think is misinformed. You probably think a "computer scientist" must necessarily be a theoretician, which is not the case.)
- Joof 11y ago
  I think you would be saved by rephrasing to indicate a particular computer scientist. People are getting overly pedantic.
  - Swizec 11y ago
    It's okay. That's how engineers and computer scientists work. The idea of "generalization" and "hyperbole" and "caricature" is often lost on us. This is primarily why my technical blogging has slowed down significantly. Writing for an audience that cares more about details than The Point (tm) is often annoying.
    - copperx 11y ago
      Actually, to nitpick on the details, it's both. We care about the details AND the point. The details sometimes take you to The Point. For example, I on your original post, I was trying to figure out if you meant "Computer Scientists are theoreticians" through the details. If you're not going to outright say something straight to the point, the details better be clear so that one can understand the implication.
      - Swizec 11y ago
        That's the thing, there were no details, it was a caricature. I've never heard of a person rewriting COBOL into Lisp in 2015. But I do personally know people who write Coq proofs and care about differences between strengths of various grammars. Maybe that's the problem - that part came too close to reality and triggered people's spidey senses.
      - deleted 11y ago
        [deleted]
- Joof 11y ago
  I think you would be saved by rephrasing to indicate a particular computer scientist. People are getting overly pedantic.
carapat_virulat 11y ago
But most anti-cholesterol diets lower animal fat intake, not dietary cholesterol intake. Is this supposed not to work? I had high cholesterol for years, I didn't take it very seriously because I'm otherwise healthy and I was eating healthy, but when I decided to take care of it I got it from around 210mg/dL to something like 140mg/dL just by changing all my meat/cheese to low fat alternatives as my doctor said. I am a big eater though, so maybe it doesn't make as much a difference for people that don't eat so much.
- sliverstorm 11y ago
  There were two suspected causes of high blood cholesterol- 1) dietary saturated fat (e.g. beef) 2) dietary cholesterol (e.g. chicken eggs) Classical anti-(blood)cholesterol diets recommend avoiding both.

epalmer 11y ago

> My understanding is that a doctor's first job is to be risk averse. That's why they shy away from bleeding edge research and knowledge, and choose instead to rely on proven ways I think it is more a matter of relying on what other doctors are doing and as well what they think their patients will tolerate. I asked my cardiologist and primary care doctor before going on a well formulated low carb diet. they were both in favor of it but noted that they don't recommend these types of approaches, not because they don't work, but because people don't tend to stick with it. In 3 months I lost 30 lbs (got a way to go still). My primary said that I have not indication now of prediabetes while I did prior to my diet. For me I decided to take control of what I can in my health. Keep in mind your MMV.

TeMPOraL 11y ago
> For me I decided to take control of what I can in my health. But you did that cooperating with your doctors, which is how it should look. The problem with people taking charge of their own health is usually that they completely reject medical professionals altogether because they "know better". It makes exactly as much sense as when a manager decides not to hire a programmer, but instead buys himself a JavaScript book, because "how hard can this programming stuff be anyway?", or "the programming establishment still uses this old Ruby stuff, they don't know JavaScript is the state-of-the art solution!". Knowing better than your doctor can lead to tragic consequences. Since we're in story-sharing mode: just last week my brother's friends saved the life of a guy who was after surgery that involved installation of stents, but for some reason didn't take the prescribed anticoagulants - he just kept the prescriptions stored in his bag and went happy about his life. He slipped up and admitted to taking no drugs on a checkup in the hospital. According to the doctor who was leading his case, he was hours from dying when they figured out what's going on.
- dualogy 11y ago
  > It makes exactly as much sense as when a manager decides not to hire a programmer, but instead buys himself a JavaScript book, because "how hard can this programming stuff be anyway?" Hey, worked out splendidly for Derek Sivers!
- 11y ago