4 ms·

I wish we put more energy into preventing Alzheimer’s and sharing what we know. There’s a lot known about populations that barely get it and lifestyles that hav

by mfer 4y ago

I wish we put more energy into preventing Alzheimer’s and sharing what we know. There’s a lot known about populations that barely get it and lifestyles that have reduced occurrences of it. There’s just no/limited money in prevention

icegreentea2 4y ago
Prevention through life style changes is difficult to implement on a population scale - money doesn't quite have anything to do with it. See how successful we are at treating obesity/diabetes through "lifestyle intervention" on a population level, despite the much much clearer connections.
- _cenw 4y ago
  One of the biggest problems is that such talk about "lifestyle interventions" usually comes with a motivation killing lack of empathy and the treatment model clearly doesn't work for everyone, be it because they can't starve off hunger with it or it simply doesn't work despite adherence. It doesn't really matter, the diet failure rate speaks for itself. I've experimented a lot with my diet and slowly figured out which food combinations work and do not work for me. And it is much less intuitive than anyone would assume. I used to eat a certain kind of junk food that is on the "definitely bad for you" list and I would always lose weight on it. I know it's still bad in other ways, but it made me question why I was trying so hard and still failing, while some junk food made it effortless. It's something that the "calories in calories out" crowd really loves to dismiss outright.
  - mfer 4y ago
    I don’t buy fad diets. I also learned that places a western diet goes there are increased healthcare costs. Learned this reading about studies in Barons (which is really for investors). I changed my diet. Eat a lot of food. Am regularly full. My numbers are all great. I feel better than I have in a long time. And I eat the types of food the people who live the longest (on average) and have the best long term vitality do. It wasn’t easy but I’m delighted now
    - yehudalouis 4y ago
      Same. Eating a massive caloric surplus at the moment while lifting 6 days per week (3600-4200 calories/day) -- eating about 60% animal protein, vegetables, and dairy. Rice/pasta on occasion. Don't really try and stop myself if I want to splurge on the weekends: ice cream, maybe some pizza, etc. Bloodwork is fantastic currently.
      - mfer 4y ago
        The problem with bloodwork is it doesn’t look at artery build up. Heart disease is the #1 killer on the US. Our numbers can look great on the way to atherosclerosis
- mfer 4y ago
  Do we try to treat/prevent diabetes? The CDC doesn’t tell people about any link or to lose weight if they are obese. I know multiple people being treated for type 2 diabetes. Few of their doctors have talked with them about weight or obesity being linked. The general solution in the US is to be regular on diet so your insulin done can be regular. I do know one person who was recommended to change their diet and weight. In a matter of months he was no longer a diabetic. I told other diabetics about it and they didn’t believe me. We, as a society, try to keep people on regular insulin and monitoring instead of trying to cure or minimize type 2 diabetes.
  - nradov 4y ago
    Virta Health has been able to put type-2 diabetes into remission for many patients through dietary interventions. https://www.virtahealth.com/reversediabetes https://www.virtahealth.com/reversediabetes
tasty_freeze 4y ago
My guess is such a study would end up recommending what is already known to be good for our health. Yet most people refuse to do it because it takes effort. Exercise your body and your mind. Keep your weight in check. Don't smoke. Don't drink much. Eat a variety of foods and avoid junk food. Once you've done those, then maybe there is some supplement that might squeeze out a little more benefit. It reminds me of cycling "weight weenies" -- people who obsess every gram on their bike frame, eg spending 3x for their caliper brakes because it uses an alloy that saves 20g. Yet most of them are 30 lbs/15kg overweight. They should lose the weight and only then worry about a few hundred grams from their bike frame. Additionally, losing that weight would pay all sorts of dividends unrelated to biking.
- deleted 4y ago
  [deleted]
alwillis 4y ago
> There’s just no/limited money in prevention Hard disagree. If I know I’m in at high-risk for Alzheimer’s, I will spend money to help prevent it. Unfortunately this is a growing market; anyone who’s watched a parent or grandparent with Alzheimer’s, it’s a no-brainer.
- mfer 4y ago
  The issue is that preventing it doesn’t really cost. Lifestyle change isn’t something VCs can make a big return on. Whole population groups prevent it without taking any drugs. Where is the money to be made? Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. We know how they live and what they eat. Groups have been studied in the US who are similar and they get really low rates of Alzheimer’s compared to the surrounding population. The changes people need to make for this just aren’t those you can get a high rate of return on.
  - alwillis 4y ago
    > Where is the money to be made? Drugs are the most obvious. I'm personally familiar with the drug Gleevec, the multi-billion dollar blockbuster drug for Chronic Myelogenous Leukemia, which only about 4–5,000 people get in the US each year. Compared to heart disease and the more well-known cancers (breast, lung, colon), this is a rounding error. When it launched, the cost was $10,000 for a 30-day supply in the US. Novartis' annual revenue for Gleevec was $4.7 billion dollars before it became a generic drug after patent expiration [1]. The number of people in the US who get CML per year is 5,000; the number who get Alzheimer’s is 100 times that—500,000. I'm not suggesting revenue of 100x of $4.7 billion to a comparable drug for Alzheimer’s; but 10x isn't out of the question. Due to the COVID pandemic, Alzheimer's disease dropped from the sixth to the seventh-leading cause of death across all ages in the United States. This is big market. > Lifestyle change isn’t something VCs can make a big return on. It's much more complicated: Having at least one APOE e4 gene increases your risk of developing Alzheimer's disease two- to threefold. If you have two APOE e4 genes, your risk is even higher, approximately eight- to twelvefold. But not everyone who has one or even two APOE e4 genes develops Alzheimer's disease. Sure, there are lifestyle issues at play, combined with genetics. At some point, this will get figured out and there will certainly be a way for investors to make a lot of money on "the cure", testing, diagnostics and the required intellectual property. If these blood tests pan out, the next step will be wearable devices (like glucose monitors) to test for Alzheimer’s markers or including that tech in a future Apple Watch or other future device. As an example, Apple has already bought several health-tech startups [3]; if a startup develops Alzheimer’s tech Apple can incorporate into it's ecosystem, they'd be ripe for an acquisition. > Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. False—the rate of Alzheimer's is growing globally. It's 50 million people now; at current rates, it will exceed 152 million by 2050 [2]. Like many diseases of old age, people are getting it at increasingly earlier ages. For example, we used to call Type 2 Diabetes "adult onset Diabetes"; that term is quickly fading in relevance since children get Type 2 Diabetes pretty often these days. The theory from David Sinclair that diseases of old age, including Alzheimer’s, are the result of a lifestyle the promotes premature aging, people who are genetically at increased risk for Alzheimer’s (by having at least one APOE e4 gene) will continue to get it at earlier ages. [1]: https://en.wikipedia.org/wiki/Imatinib#Economics https://en.wikipedia.org/wiki/Imatinib#Economics [2]: https://www.brightfocus.org/alzheimers/article/alzheimers-disease-facts-figures#:~:text=Alzheimer%27s%20is%20on,related%20dementia.21 https://www.brightfocus.org/alzheimers/article/alzheimers-di... [3]: https://www.beckershospitalreview.com/healthcare-information-technology/apple-s-health-it-acquisitions-a-timeline.html https://www.beckershospitalreview.com/healthcare-information...

by mfer 4y ago

icegreentea2 4y ago

Prevention through life style changes is difficult to implement on a population scale - money doesn't quite have anything to do with it. See how successful we are at treating obesity/diabetes through "lifestyle intervention" on a population level, despite the much much clearer connections.

_cenw 4y ago
One of the biggest problems is that such talk about "lifestyle interventions" usually comes with a motivation killing lack of empathy and the treatment model clearly doesn't work for everyone, be it because they can't starve off hunger with it or it simply doesn't work despite adherence. It doesn't really matter, the diet failure rate speaks for itself. I've experimented a lot with my diet and slowly figured out which food combinations work and do not work for me. And it is much less intuitive than anyone would assume. I used to eat a certain kind of junk food that is on the "definitely bad for you" list and I would always lose weight on it. I know it's still bad in other ways, but it made me question why I was trying so hard and still failing, while some junk food made it effortless. It's something that the "calories in calories out" crowd really loves to dismiss outright.
- mfer 4y ago
  I don’t buy fad diets. I also learned that places a western diet goes there are increased healthcare costs. Learned this reading about studies in Barons (which is really for investors). I changed my diet. Eat a lot of food. Am regularly full. My numbers are all great. I feel better than I have in a long time. And I eat the types of food the people who live the longest (on average) and have the best long term vitality do. It wasn’t easy but I’m delighted now
  - yehudalouis 4y ago
    Same. Eating a massive caloric surplus at the moment while lifting 6 days per week (3600-4200 calories/day) -- eating about 60% animal protein, vegetables, and dairy. Rice/pasta on occasion. Don't really try and stop myself if I want to splurge on the weekends: ice cream, maybe some pizza, etc. Bloodwork is fantastic currently.
    - mfer 4y ago
      The problem with bloodwork is it doesn’t look at artery build up. Heart disease is the #1 killer on the US. Our numbers can look great on the way to atherosclerosis
mfer 4y ago
Do we try to treat/prevent diabetes? The CDC doesn’t tell people about any link or to lose weight if they are obese. I know multiple people being treated for type 2 diabetes. Few of their doctors have talked with them about weight or obesity being linked. The general solution in the US is to be regular on diet so your insulin done can be regular. I do know one person who was recommended to change their diet and weight. In a matter of months he was no longer a diabetic. I told other diabetics about it and they didn’t believe me. We, as a society, try to keep people on regular insulin and monitoring instead of trying to cure or minimize type 2 diabetes.
- nradov 4y ago
  Virta Health has been able to put type-2 diabetes into remission for many patients through dietary interventions. https://www.virtahealth.com/reversediabetes https://www.virtahealth.com/reversediabetes

tasty_freeze 4y ago

My guess is such a study would end up recommending what is already known to be good for our health. Yet most people refuse to do it because it takes effort. Exercise your body and your mind. Keep your weight in check. Don't smoke. Don't drink much. Eat a variety of foods and avoid junk food. Once you've done those, then maybe there is some supplement that might squeeze out a little more benefit. It reminds me of cycling "weight weenies" -- people who obsess every gram on their bike frame, eg spending 3x for their caliper brakes because it uses an alloy that saves 20g. Yet most of them are 30 lbs/15kg overweight. They should lose the weight and only then worry about a few hundred grams from their bike frame. Additionally, losing that weight would pay all sorts of dividends unrelated to biking.

deleted 4y ago
[deleted]

alwillis 4y ago

> There’s just no/limited money in prevention Hard disagree. If I know I’m in at high-risk for Alzheimer’s, I will spend money to help prevent it. Unfortunately this is a growing market; anyone who’s watched a parent or grandparent with Alzheimer’s, it’s a no-brainer.

mfer 4y ago
The issue is that preventing it doesn’t really cost. Lifestyle change isn’t something VCs can make a big return on. Whole population groups prevent it without taking any drugs. Where is the money to be made? Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. We know how they live and what they eat. Groups have been studied in the US who are similar and they get really low rates of Alzheimer’s compared to the surrounding population. The changes people need to make for this just aren’t those you can get a high rate of return on.
- alwillis 4y ago
  > Where is the money to be made? Drugs are the most obvious. I'm personally familiar with the drug Gleevec, the multi-billion dollar blockbuster drug for Chronic Myelogenous Leukemia, which only about 4–5,000 people get in the US each year. Compared to heart disease and the more well-known cancers (breast, lung, colon), this is a rounding error. When it launched, the cost was $10,000 for a 30-day supply in the US. Novartis' annual revenue for Gleevec was $4.7 billion dollars before it became a generic drug after patent expiration [1]. The number of people in the US who get CML per year is 5,000; the number who get Alzheimer’s is 100 times that—500,000. I'm not suggesting revenue of 100x of $4.7 billion to a comparable drug for Alzheimer’s; but 10x isn't out of the question. Due to the COVID pandemic, Alzheimer's disease dropped from the sixth to the seventh-leading cause of death across all ages in the United States. This is big market. > Lifestyle change isn’t something VCs can make a big return on. It's much more complicated: Having at least one APOE e4 gene increases your risk of developing Alzheimer's disease two- to threefold. If you have two APOE e4 genes, your risk is even higher, approximately eight- to twelvefold. But not everyone who has one or even two APOE e4 genes develops Alzheimer's disease. Sure, there are lifestyle issues at play, combined with genetics. At some point, this will get figured out and there will certainly be a way for investors to make a lot of money on "the cure", testing, diagnostics and the required intellectual property. If these blood tests pan out, the next step will be wearable devices (like glucose monitors) to test for Alzheimer’s markers or including that tech in a future Apple Watch or other future device. As an example, Apple has already bought several health-tech startups [3]; if a startup develops Alzheimer’s tech Apple can incorporate into it's ecosystem, they'd be ripe for an acquisition. > Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. False—the rate of Alzheimer's is growing globally. It's 50 million people now; at current rates, it will exceed 152 million by 2050 [2]. Like many diseases of old age, people are getting it at increasingly earlier ages. For example, we used to call Type 2 Diabetes "adult onset Diabetes"; that term is quickly fading in relevance since children get Type 2 Diabetes pretty often these days. The theory from David Sinclair that diseases of old age, including Alzheimer’s, are the result of a lifestyle the promotes premature aging, people who are genetically at increased risk for Alzheimer’s (by having at least one APOE e4 gene) will continue to get it at earlier ages. [1]: https://en.wikipedia.org/wiki/Imatinib#Economics https://en.wikipedia.org/wiki/Imatinib#Economics [2]: https://www.brightfocus.org/alzheimers/article/alzheimers-disease-facts-figures#:~:text=Alzheimer%27s%20is%20on,related%20dementia.21 https://www.brightfocus.org/alzheimers/article/alzheimers-di... [3]: https://www.beckershospitalreview.com/healthcare-information-technology/apple-s-health-it-acquisitions-a-timeline.html https://www.beckershospitalreview.com/healthcare-information...