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walkitoutReading Greene's book, I was struck once again about how people responded to the lessons of Framingham. Pharma made drugs to address the identified risk factors: high blood pressure, high cholesterol, smoking etc. All these drugs were intended for use _after_ dietary changes had failed to get the desired improvement. While quitting smoking is mentioned in some cases, the idea that quitting smoking would have a big effect on all the numbers seems to have been underemphasized or maybe not understood at all. Certainly everyone was shocked at the immediate and lasting drop in heart attacks in Massachusetts and elsewhere when smoking was banned in restaurants and bars, which is a strong indication that whatever the research said or didn't say, no one really viscerally understood what that would mean in practice. Chalk some of that up to the tobacco industry, but I'm betting there was a whole lot of something else going on, too.
The sheer lack of mention of exercise as the medical science developed hand-in-hand with the drugs is startling. Today, of course, I consistently feel that we pay too much attention to BMI and/or weight and not enough to waist circumference -- and we really don't pay hardly any attention to how adding even small amounts of low-intensity exercise can improve numbers.
I did a little googling, and once again, I'm annoyed at how little this has been researched. I know why -- there's no easy big money to be made out there by proving that the right kind and amount of exercise is as good as taking a statin -- but it is sad nonetheless.
It's particularly sad when you realize that everyone seems to be taking drugs for cholesterol and high blood pressure (sometimes in the same pill), and at least in some formulations, both of these increase the risk of problems in the liver and/or rhabdomyolosis. And on top of it, it's far from clear what the win is in these drugs for women anyway, in terms of hard outcomes.
The sheer lack of mention of exercise as the medical science developed hand-in-hand with the drugs is startling. Today, of course, I consistently feel that we pay too much attention to BMI and/or weight and not enough to waist circumference -- and we really don't pay hardly any attention to how adding even small amounts of low-intensity exercise can improve numbers.
I did a little googling, and once again, I'm annoyed at how little this has been researched. I know why -- there's no easy big money to be made out there by proving that the right kind and amount of exercise is as good as taking a statin -- but it is sad nonetheless.
It's particularly sad when you realize that everyone seems to be taking drugs for cholesterol and high blood pressure (sometimes in the same pill), and at least in some formulations, both of these increase the risk of problems in the liver and/or rhabdomyolosis. And on top of it, it's far from clear what the win is in these drugs for women anyway, in terms of hard outcomes.