by H. Robert Silverstein, MD, FACC
This approach reduces the complexity and cost of healthcare: it is an important part of the human potential movement
The best clinical insights exceed so-called knowledge by at least 1 step
Physicians guess at every step, the best physicians have the best guessing rate
In the 2012 Arnold Schwarzenegger actually quite decent sci-fi movie ‘Total Recall’, Kuato the chief mutant tells Quaid (Schwarzenegger) ‘open your mind’: this is a request for the same in this completely different approach from the usual
It has been said that not managing your multiple risks is being in church, on your knees, and praying for a stroke or heart attack. For all (mis)behaviors, as in building a wall, which brick (behavior) is the most important (they all are equally important)?
As in the Bible, “ask and it shall be given unto you.” When it is stated that the ‘meek shall inherit the earth’, it is talking about longevity for the trimmest/lowest fat (meek) people who will remain alive in order to be able to inherit the earth. ‘You can never be too rich, have too many black shoes, or be too thin’
At every step and decision, it is the old radio and TV program, similar to Foxwoods, as the truth is ’you bet your life’
‘For the wages of sin’ … This was once said to a minister, ‘Christ did not die for our sins, we do.’ There was no debate
The discussion of genetic diseases such as diabetes, high cholesterol, heart attack, high blood pressure, cancer of the colon, … is explained by understanding this metaphor: How much sun bathing CAN an albino SAFELY do? The answer is obvious: ‘None’ because of a genetic weakness-no melanin. If there is no sunbathing, there is no risk to the skin of that albino. We are all biochemical albinos somewhere. The same applies regarding cholesterol, blood pressure etc. If people do not do certain things, those risks do not occur. You do not answer to me, you answer to your internal biochemistry’s ‘alert judge’ that is aware of everything you do: do things right and the judge leaves you alone and free without frequent doctor visits, co-pays, parking charges, surgeries/risk of complications, medicines, medication side effects, … : if you do things not correct for your biology, that judge will punish you putting you in the jail of medicine
If you have an enemy on the North, the South, the East and the West, which one do you want me to fight? (The answer is to address all risk factors, not just 1)
Why do water buffalos turn the wheel to bring up water for irrigation? There is a ring in their nose attached to the spokes in front of them: if they slow down, the ring PAINFULLY pulls on their nose. So, to avoid the pain, they keep up. That statement brings up the bothersome necessity for keeping a paper diet diary when trying to lose weight: it is like a ring through the nose of the water buffalo increasing one’s focus
An essay on the Preventive Medicine Center website www.thepmc.org is entitled ‘I don’t like brown rice vegetables and beans’ which is a true statement. I would much rather have 2 fried in butter eggs on Thomas English Muffins with turkey sausage for breakfast, a tuna cheese-melt or turkey BLT sandwich on ’wheat toast’ for lunch, and chicken tenders plus French fries for dinner: BUT I will have organic berries in organic rice milk with chopped up walnuts and almonds for breakfast, an organic lentil barley soup for lunch, and for dinner steamed vegetables covered with browned sesame seeds plus vegetable soup with a dessert of some cut up fruit in Pom Wonderful pomegranate juice: the price of freedom (eternal vigilance)
My high school football coach Robert Auble said it correctly: winners don’t quit and quitters don’t win. ‘Perseverance is everything‘
When the going gets stuff, the tough get going. What does the captain say when the ship is sinking: “Every man for himself.” In life, each person is responsible for themself and what comes thereafter. Think about the dedication, perseverance, determination of a 1650’s Pioneer who goes out to the edge of the wild Frontier, clearing the land, and facing all the weather-hostiles-childbirth dangers and mortality-crop failure obstacles but then having the freedom, satisfaction, and joy that comes from such determination, self-reliance, and cleansing effort
When it comes to the presence of diabetes, high blood pressure, high cholesterol, high triglycerides, and many other conditions it is both humorous and mostly true: ‘Always blame the patient’
It was a medieval riddle that was seriously debated: How many angels can dance on the head of a pin? Was it 1, 10, 100, 1000, more? Like the human body, how many things can possibly go wrong? The answer in both cases is ‘an infinite number’
Clint Eastwood in the movie ‘Magnum Force’ states an important truth that few pay attention to: ‘A man has got to know his limitations’: most disregard that, making high blood pressure, overweight, diabetes, high cholesterol, etc occur
In the well-done Bruce Willis Prohibition-crime movie ‘Last Man Standing’, a confrontation is unnecessarily provoked by 2 of Mr. Doyle’s gunners/henchmen. A bit later, Willis shoots the 2 of them with his 45s. Doyle comes by a couple of days later and offers Willis a job to which Willis responds he thought Doyle would be upset with him. Doyle responds: ‘It is the only cure I know for stupidity’ Think about that with regard to any issue you have
Get smart or get hurt. We tend to nickel and dime ourselves to death
Talk is cheap: The journey of 1000 miles begins, continues, and ends with a single step
Each action/decision could be the opening Pandora’s box (of multiple and long-lasting plagues). Be careful in your decisions/actions
The first law of gambling is the first law of pharmacology: Never get off a winning horse.
Doctors should approach the patient as guilty of multiple and various disorders until proven innocent and well
If you ask the wrong question, you will get the wrong answer. This often applies to many so-called ‘scientific’ studies
The powerful and correct phrase: KISS = keep it simple, stupid
Do not buy and bring home what you should not eat. Impulsive people care less about immediate risk and do not withhold action for a later greater gain = safety: This is comparable to spending your entire paycheck vs saving some. It is usual and often that you endure the pain of discipline/restraint with your forbearance in order to avoid the pain of your biology’s regret due to arrived disorders/diseases
We are drawn to what we should not, the very beginning of addiction and disease. Food is a powerful and addictive force. You are plenty educated, most are not plenty maturated
Shakespeare: ‘Diseases desperate grown by desperate means are relieved or not at all’
When addressing behavioral choices, what constitutes enough change? We tend to repeat our mistakes but as Liza Doolittle’s father said in the wonderful 1964 musical ’My Fair Lady “with a little bit of help.”
It is important to be accurate, not rigid: If meat (animal protein of any kind including fish, chicken, turkey, red meat, cheese, eggs, shrimp) is used, it should be used in small and diced amounts such as comparable to a spice and not as the center of the plate. If trim, this is a palm sized animal protein serving up to 5 times in 2 weeks = 5 of 42 meals
It is important to be accurate, not rigid.
Take your eyes off the problems and put them on the solutions. Obstacles are what you see when you take your eyes off the goal
Caldwell Esselstyn of the Cleveland Clinic said what is extreme is not a plant-based diet but is the 500,000 coronary artery bypass graft/CABG surgeries per year
An (ideally organic and) unprocessed whole foods vegan Liv-it (not a die-t) is lowest cholesterol, lowest saturated flat, lowest inflammation, lowest calorie, lowest simple carbohydrate, highest fiber. The best word to keep in mind about this is “field” meaning foods exactly as they grow up out of the ground and in the field being unprocessed in every fashion
Food choices affect life expectancy, the greatest longevity is mostly plant based
Inositol-requiring transmembrane kinase endo-ribonuclease
50% of those with a high atherosclerosis risk score will have a coronary calcium score of 0. 42% of ‘normals’ have atherosclerosis
Only 20% of atherosclerotic plaque is calcified: 80% is not calcified
75% of coronary events occur with a coronary calcium score of greater than 100
A 1% decrease in plaque volume results in a 20% decrease in major adverse coronary events. For every 39 mg/dL reduction in cholesterol there is a 25% decrease in risk. Depletion of plaque volume and cholesterol content is the goal: done by achieving a non-HDL cholesterol of 90 or less, triglycerides of 100 or less, BP 125/80 or less with an ideal of 110-115/60-70 on no medication, A1c of 4.4 or less up to age 44 and not above 6.2 at age 62 or thereafter
Tai chi results in less cognitive decline. First best exercise is swimming, second is cross-country skiing, third is tai chi, fourth is resistance training
Kawasaki disease may be a result of a high animal protein low fiber (low folate) diet.
Ozempic causes a 60% decrease in the inflammatory protein CRP/the SELECT study. Hunger is due to the agouti related protein neurons. There are 60 comorbidity associations with obesity. The exception to the rule: Winston Churchill smoked cigars like a furnace, was a heavy alcohol drinker, grossly overweight and lived to age 90. Don’t count on your getting away with it like he did
All drugs are poison including the ones I prescribe
Every cell in the body runs on carbohydrate (carbohydrate is only found in plant-based foods). Average American protein intake for adults is 100 g per day and should be about 56 for men and 46 for women. Americans have the highest protein intake of anywhere. Boxers require about 60 g of protein per day. The 1907 New York Times said that a high protein die-t causes an increased incidence of cancer. In Okinawa near Japan, protein intake is 10% of the largely plant based diet that includes sea vegetables.
In adults, mTOR should be limited but is increased by branched chain amino acids (BCAA), in particular leucine which is primarily found in animal protein and results in the aging pathway that is slowed by having less protein as a whole and more vegan protein which replaces leucine with glycine
US sodium intake per day is 3400 mg with a recommended 1500 mg. Reaming half a lemon + half a lime and using that juice at the table completely replaces the taste/need for salt. That’s all, folks