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Thread: gaining weight and high blood pressure

  1. #21
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    Quote Originally Posted by Robert Santana View Post
    Most doctors believe things that their "pimp" told them to believe in medical school. The Harvard Guys say that "obesity kills" and the Cooper Institute guys say "not if you are fit." Here is a good question to ask at the individual level. Did your fat parent or grandparent have a heart attack and die?
    Well, it is true that graphing morbidity and mortality against BMI, you get a U-shaped curve. There is much debate about where the bottom of the U is, and why, but it is clear that at some point adding weight shortens your life. I think that people doing heavy resistance training are an interesting population that could illuminate this a bit. It seems obvious that someone who adds 20 lbs with a high protein diet and lifting heavy is improving their health, while someone who gains 20 lbs from sitting on the couch eating crab rangoons is not. BMI has its uses, but is unable to address this difference, and so its overuse is vexing to certain populations and to certain doctors who don't stay current or read carefully.

    BTW, I have spent the past 15 years or so in medical schools and academic medical centers, and have not heard anyone referred to as a "pimp." Except for one patient who turned out to be an actual pimp. I was very disappointed that he did not dress the part. I do know what "pimping" is in med school parlance, or course, but there are no pimps, and I think you underestimate most doctors' willingness and ability to change their practice and beliefs in the face of evidence.

  2. #22
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    Quote Originally Posted by jfsully View Post
    I do know what "pimping" is in med school parlance, or course.
    "Pimping" needs a pimp to take place.

  3. #23
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    It's probably better to be an endurance athlete than a power athlete if all you are concerned about is being the oldest person in the rest home. Some studies on retired athletes:

    Higher CVD mortality in the NFL than in the MLB. Mortality Among Professional American-Style Football Players and Professional American Baseball Players | Neurology | JAMA Network Open | JAMA Network

    Endurance athletes tend to have lower CVD mortality, power athletes higher: Increased life expectancy of world class male athletes. - PubMed - NCBI

    In the NFL, defensive linemen have double the CVD mortality of offensive, and a BMI over 30 also seemed to double the risk of heart attack (ie., >210lb for a 5'10" male, >250lb for a 6'4" male): Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. - PubMed - NCBI

    Former Finnish elite endurance athletes tend to have less CVD/diabetes, with power athletes having more, and having higher (disease-predictive) BMI after retirement: Prevalence of diabetes, hypertension, and ischemic heart disease in former elite athletes. - PubMed - NCBI

    Now, in all of these studies (and a bunch more -- they're pretty typical), elite athletes of whatever type are healthier than the general population. But that fact is not surprising, as they already have to be a pretty healthy specimen in the first place to be an elite athlete. However, what is interesting to me here, is that the same BMI correlation shows up within elite athletes as does for normal humans, and it is enough to shave years off of high-BMI athletes' lives. It is enough to make me think that a large amount (even 10-20lb) of extra muscle weight is not necessarily safe weight, if one's main concern is longevity and healthy aging.

  4. #24
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    Right, but if you, say, pimp our your car, that doesn’t mean people will call you a pimp. Or if barbell coaches tend to squat during training sessions, it doesn’t mean we would call them a “squatter.”

    For those wondering what we’re talking about, pimping is the practice of grilling a student with questions, usually continuing to get more and more obscure and specific until the student says they don’t know or gets one wrong, done in the presence of other students. It’s generally thought to be a humiliating and less effective teaching method, so it’s on the decline.

    But the noun “pimp” is not used to refer to the questioner. And to say that doctors believe what was said by “their pimp” doesn’t make sense, as pimping is generally done in clinical rounds, where the leader changes perhaps every week, if not every day. So in the heyday of pimping, a Med student would have dozens of “pimps” at a minimum. and nobody they could refer to as “their pimp.” And even in the same rounds, a senior resident could pimp a student and then in turn get pimped by the attending. When the pimpee becomes the pimper, who is actually “the pimp?” It’s not like medical training is a tight 2-person long-term apprentice-master relationship, except maybe in unusual situations. Yes, there is pimping, but nobody is actually called a “pimp.”

    So you used a bit of jargon out of context in what seemed to me to be an insulting-sounding way. So I clarified, so let’s move on.

  5. #25
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    The message was communicated so the context was just fine.

  6. #26
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    Quote Originally Posted by Robert Santana View Post
    The message was communicated so the context was just fine.
    The message I got was “doctors are whores” (ie they have a pimp), who don’t think for themselves (they just believe whatever some dude told them in medical school, and don’t question it for the next 20 years). And you are a sloppy thinker/writer (to demonstrate some inside knowledge of medical training you used Med school slang incorrectly).

    Messages received. I thought I had misinterpreted, but I guess not. Thanks for clarifying.

  7. #27
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    Quote Originally Posted by thras View Post
    It's probably better to be an endurance athlete than a power athlete if all you are concerned about is being the oldest person in the rest home. Some studies on retired athletes:

    Higher CVD mortality in the NFL than in the MLB. Mortality Among Professional American-Style Football Players and Professional American Baseball Players | Neurology | JAMA Network Open | JAMA Network

    Endurance athletes tend to have lower CVD mortality, power athletes higher: Increased life expectancy of world class male athletes. - PubMed - NCBI

    In the NFL, defensive linemen have double the CVD mortality of offensive, and a BMI over 30 also seemed to double the risk of heart attack (ie., >210lb for a 5'10" male, >250lb for a 6'4" male): Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. - PubMed - NCBI

    Former Finnish elite endurance athletes tend to have less CVD/diabetes, with power athletes having more, and having higher (disease-predictive) BMI after retirement: Prevalence of diabetes, hypertension, and ischemic heart disease in former elite athletes. - PubMed - NCBI

    Now, in all of these studies (and a bunch more -- they're pretty typical), elite athletes of whatever type are healthier than the general population. But that fact is not surprising, as they already have to be a pretty healthy specimen in the first place to be an elite athlete. However, what is interesting to me here, is that the same BMI correlation shows up within elite athletes as does for normal humans, and it is enough to shave years off of high-BMI athletes' lives. It is enough to make me think that a large amount (even 10-20lb) of extra muscle weight is not necessarily safe weight, if one's main concern is longevity and healthy aging.
    There is so much wrong here that I don't even want to address it.

    I would encourage anybody who reads this post to at least look at the summaries of the studies to see the flaws in methodology and logic that are typical in peer reviewed literature. (Sometimes the study methods are fine, but the results are presented in a way that leads people to believe unsupported conclusions)

  8. #28
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    Quote Originally Posted by Yngvi View Post
    There is so much wrong here that I don't even want to address it.
    Did I just get "REEEEEEEEE"'d at?

    Like muscle, height is great to have, but tall people die sooner than short people. Men are bigger and tougher -- and even leaner -- than women and also die sooner. We are all descended from gracile hunter gatherers who kicked the shit out of the more robust Neanderthal as they took over Europe (picking up no more than 2-4% of Neanderthal genes as they went). Living hunter gatherers, like the Kalahari San, are extremely lean and light compared to any modern population. Increased gracility has been the trend in human evolution ever since we became hominids.

    Today we shouldn't be surprised that packing extra weight onto that basic human frame you share with your grandparents and great-grandparents -- even if that extra is muscle -- leads to more metabolic stress against the entire system, and lowers longevity. What would be surprising if being 220lb and strong came with no cost at all. You don't get to have everything.

  9. #29
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    Could you be specific about the flaws/biases you feel call the CVD mortality claims of the 1st study (JAMA) into question?

  10. #30
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    Quote Originally Posted by m_sporkboy View Post
    Mine was like that, and one doctor decided to treat it, and another doctor kinda eyerolled when I told him that. So... yeah.

    My impression is it's not a medical emergency, but you should keep an eye on it.
    I learned the hard way to ask for the big boy cuff when your arms get to about 15” - I got to pay for a stress test and take time off work because staff at a top academic medical center wasn’t clear on this.

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