The health and fitness thread about random things

[hellymedic]

Heard something interesting on the Toady show on R4 this morning.
They were discussing that heart age website thingy.   Presenter suggested that docs ask questions about family history of heart attacks in order to suggest genetic propensity to heart problems.   A leading cardiologist  said that the reason was also that poor lifestyle is also most likely inherited.

That may be obvious, but I'd never thought of that.

Up to a point, Lord Copper.

There has been a HUGE increase in obesity in the past 40 years, which can't be inherited. You only have to look at photographs of holidaymakers to see this. Our parents' and grandparents' generation had a less obesogenic environment and lifestyle, though may have smoked more (which is not really inherited).

[Cudzoziemiec]

Isn't there a genetic component to obesity? And within our generally prevalent obesogenic environment, some of us inherit a more particularly obesogenic lifestyle; if our parents ate junk food, drank, smoked and spent their time in front of the TV, we're more likely to so similar, which is surely Basil's presenter's point.

[ElyDave]

what I wasn't clear with on that is how some of the risk factors are used - for example it asks if you are diabetic, which I am, but not which type which to me is relevant to heart risk. It also asks no questions about levels of exercise which I thought odd. 

[hellymedic]

Insulin-dependent diabetes is still associated with increased risk of cardiovascular illness.

Sorry!

[mrcharly-YHT]

Heard something interesting on the Toady show on R4 this morning.
They were discussing that heart age website thingy.   Presenter suggested that docs ask questions about family history of heart attacks in order to suggest genetic propensity to heart problems.   A leading cardiologist  said that the reason was also that poor lifestyle is also most likely inherited.

That may be obvious, but I'd never thought of that.

Up to a point, Lord Copper.

There has been a HUGE increase in obesity in the past 40 years, which can't be inherited. You only have to look at photographs of holidaymakers to see this. Our parents' and grandparents' generation had a less obesogenic environment and lifestyle, though may have smoked more (which is not really inherited).

My grandad weighed 26stone. He died in his 60s from heart disease.
My gran died in her 50s. She was short and fat
My uncle died in his late 40s. He was 'stocky'.
My other uncle had his first heart attack at 60. He was the figure of a robin. Sticklike legs, corpulent body.

None were smokers.

[hellymedic]

I see doctors apparently use too much jargon.

This is easily done, especially when conferring with medical colleagues.

Please let me know if I ever use incomprehensible language.

I don't think I'm guilty though.

[hellymedic]

Heard something interesting on the Toady show on R4 this morning.
They were discussing that heart age website thingy.   Presenter suggested that docs ask questions about family history of heart attacks in order to suggest genetic propensity to heart problems.   A leading cardiologist  said that the reason was also that poor lifestyle is also most likely inherited.

That may be obvious, but I'd never thought of that.

Up to a point, Lord Copper.

There has been a HUGE increase in obesity in the past 40 years, which can't be inherited. You only have to look at photographs of holidaymakers to see this. Our parents' and grandparents' generation had a less obesogenic environment and lifestyle, though may have smoked more (which is not really inherited).

My grandad weighed 26stone. He died in his 60s from heart disease.
My gran died in her 50s. She was short and fat
My uncle died in his late 40s. He was 'stocky'.
My other uncle had his first heart attack at 60. He was the figure of a robin. Sticklike legs, corpulent body.

None were smokers.

'Apple' type fat distribution, by the sound of things, which is associated with many of the ills of obesity.

British waistline expansion suggests this is increasing.

Our family were either reasonably slim or pear shaped - my grandmother weighed 14 stone (~89kg) when I was six and lived to 101.

[ElyDave]

Insulin-dependent diabetes is still associated with increased risk of cardiovascular illness.

Sorry!

Yes, but is that in the statistical generality, where I've seen quite a few both obese and poorly controlled T1s, or due to the condition itself, in which case my fitness and good control (hbA1c <50, 98% of readings on target) counts for nothing.

[Kim]

I see doctors apparently use too much jargon.

This is easily done, especially when conferring with medical colleagues.

Please let me know if I ever use incomprehensible language.

I don't think I'm guilty though.

It's an interesting one that:  As a child of medics, I'm reasonably conversant with medical jargon and get thrown a bit when people don't understand what - to me - seem like normal English words.  In a way that I don't with all the computer jargon I've actively learned.

As ever, plain English is a Good Thing, and the problem with jargon is that you need someone who isn't fluent in it to spot it.

[chrisbainbridge]

All of the models are vast simplifications of population level statistics.

We could produce a model which asked you 1000 questions about your health and lifestyle and come out with a specific risk factor for you but we still do not have enough data to make it meaningful.

The good news for T1 diabetics is that they probably should still take an annuity on retirement!  The insurance company model will give you a low life expectancy and therefor a higher pension.  Your general fitness will let you enjoy the high pension for longer!

[arabella]

Isn't there a genetic component to obesity? And within our generally prevalent obesogenic environment, some of us inherit a more particularly obesogenic lifestyle; if our parents ate junk food, drank, smoked and spent their time in front of the TV, we're more likely to so similar, which is surely Basil's presenter's point.

I'm reading the Robert Lustig book about sugar atm which covers genetics vs environment in spades
he reckons most people could slim down if they ate right (environment) but some are doomed by genetics no matter how healthy they eat/live
in particular 'food deserts' - areas where you can't buy decent food, only sugared/processed stuff (apparently 80% of what you can buy in US has added sugar)
haven't finished reading/digesting the  book yet, mind

[DuncanM]

I filled in the form, but I don't know my bp or cholesterol.
It told me my heart age was 1 year above my chronological age. WTF? I have no other risk factors, so therefore I'm 1 year above?

[Kim]

I filled in the form, but I don't know my bp or cholesterol.
It told me my heart age was 1 year above my chronological age. WTF? I have no other risk factors, so therefore I'm 1 year above?

Rounding error?

[hellymedic]

I filled in the form, but I don't know my bp or cholesterol.
It told me my heart age was 1 year above my chronological age. WTF? I have no other risk factors, so therefore I'm 1 year above?

Rounding error?

Possibly their algorithm 'thinks' if you CnBA to get your BP or cholesterol checked, you have a higher risk of disease associated with elevated levels.

Take-up of these silly health checks is reduced in deprived areas and it's the deprivation that influences morbidity...

[mrcharly-YHT]

I filled in the form, but I don't know my bp or cholesterol.
It told me my heart age was 1 year above my chronological age. WTF? I have no other risk factors, so therefore I'm 1 year above?

Rounding error?

Possibly their algorithm 'thinks' if you CnBA to get your BP or cholesterol checked, you have a higher risk of disease associated with elevated levels.

Take-up of these silly health checks is reduced in deprived areas and it's the deprivation that influences morbidity...

Quote of the day
"Poverty kills. You can't fix poverty with Statins."

My brother is far from impoverished (he has a world-touring holiday about every 2nd year and co-owns 3 houses).
He lives on statins, tries to convince me I should join him. His BMI fluctuates between 30 and 35, it has been a while since he has seen his toes without bending over. Basically, he is in denial. To be fair to him, he did make a major effort to get his weight down from 115kg to about 95kg.

[DuncanM]

I filled in the form, but I don't know my bp or cholesterol.
It told me my heart age was 1 year above my chronological age. WTF? I have no other risk factors, so therefore I'm 1 year above?

Rounding error?

Possibly their algorithm 'thinks' if you CnBA to get your BP or cholesterol checked, you have a higher risk of disease associated with elevated levels.

Take-up of these silly health checks is reduced in deprived areas and it's the deprivation that influences morbidity...

Sure.  On the other hand, the only things they know about me are my BMI (22) and that I don't smoke or have family history. I suspect it defaults to the age of the participant and that's it's 1 year out is just a rounding error as Kim suggested, I just found it odd.
I should probably get one of those 40+ checks done, but that would mean organising it!

[DuncanM]

Ben Goldacre made a good point on twitter about the reactions to this. In all probability, the number of healthy people who will click it and decide they need a cholesterol check from their GP to allow them to get an accurate picture of their heart health (i.e. fill the form in better) will result in wasted GP time and unnecessary expense for the NHS. Not convinced it's been thought through...

[phantasmagoriana]

I filled in the form, but I don't know my bp or cholesterol.
It told me my heart age was 1 year above my chronological age. WTF? I have no other risk factors, so therefore I'm 1 year above?

Same here. Healthy BMI, answered no to all the risk factors, no BP or cholesterol results, yet my heart age is a year above.

Interestingly, I tried again, with exactly the same answers but using a different postcode (my old one, in York rather than Glasgow) to see whether it made a difference. That aged my heart by a year, so 2 years above my real age! I'd have expected the opposite, since Glasgow doesn't exactly have a healthy reputation...

[hellymedic]

Maybe having few 'lifestyle' adverse factors is so unusual in Glasgow that you get double longevity Brownie points!

[Ashaman42]

Ben Goldacre made a good point on twitter about the reactions to this. In all probability, the number of healthy people who will click it and decide they need a cholesterol check from their GP to allow them to get an accurate picture of their heart health (i.e. fill the form in better) will result in wasted GP time and unnecessary expense for the NHS. Not convinced it's been thought through...

On the other hand if some unnecessary tests also results in catching some people that could really be helped...

Sent from my SM-G930F using Tapatalk

[hellymedic]

Ben Goldacre made a good point on twitter about the reactions to this. In all probability, the number of healthy people who will click it and decide they need a cholesterol check from their GP to allow them to get an accurate picture of their heart health (i.e. fill the form in better) will result in wasted GP time and unnecessary expense for the NHS. Not convinced it's been thought through...

On the other hand if some unnecessary tests also results in catching some people that could really be helped...

Sent from my SM-G930F using Tapatalk

I don't know how many people on average need to be tested to find somebody who needs to be treated. The NHS doesn't like wasting dosh so it tends to test where there's a potential health/economic benefit. The diagnostic yield in unbidden subjects is likely to be low, hence 'unnecessary' tests...

[Ashaman42]

Ben Goldacre made a good point on twitter about the reactions to this. In all probability, the number of healthy people who will click it and decide they need a cholesterol check from their GP to allow them to get an accurate picture of their heart health (i.e. fill the form in better) will result in wasted GP time and unnecessary expense for the NHS. Not convinced it's been thought through...

On the other hand if some unnecessary tests also results in catching some people that could really be helped...

Sent from my SM-G930F using Tapatalk

I don't know how many people on average need to be tested to find somebody who needs to be treated. The NHS doesn't like wasting dosh so it tends to test where there's a potential health/economic benefit. The diagnostic yield in unbidden subjects is likely to be low, hence 'unnecessary' tests...

All very true. I don't know where the balance lies.

Sent from my SM-G930F using Tapatalk

[hellymedic]

Public Health doctors have mostly done the maths.

A pre-menopausal woman, with normal blood pressure, desirable weight, no diabetes, no symptoms and no family history of heart disease, will be VERY unlikely to have a cholesterol worth checking or treating.

Suspect the same is true for men under 40.

If you are on any regular medication, it might be worth asking for a cholesterol check the next time you see your GP, especially if you have any of the risk factors listed above.

[rafletcher]

Many pharmacies offer cholesterol tests. That’s what I would use. And at a surgery it’d most likely be the nurse that did th3 test, not a GP.

[hellymedic]

Modern British man must be even fatter than I thought.

We were ambling past a menswear shop in Christchurch earlier today and David thought he'd like some new shirts. He asked me what size he needed andI suggested 15" as the 15½" shirt he'd been wearing was too loose on the neck.

Shop had only ONE shirt in that size, which was unsuitable. Shop assistant measured David and agreed 15" was the correct size. Said she used to sell loads of that size in the past but there was no longer any demand.

David is not particularly thin and would appear to have a thicker neck than his taller brother.