- If you made a dietary change (e.g., more fiber and less saturated fat), the tests tell you whether it actually worked.
- Statins are dosed based on the LDL or ApoB reduction you need. The most powerful statins cut cholesterol by 50%, but at higher doses the risk of side effects does go up.
- Other medications like PCSK9 inhibitors and ezetimibe exist, and whether to use them depends on the other numbers. For example, PCSK9 inhibitors have a secondary benefit of lowering Lipoprotein(a), and statins and GLP-1s have a secondary benefit of lowering inflammation.
- If blood pressure, HbA1c, etc is high, then there's a slightly different set of diet advice and a very different set of medications. For example, lowering blood pressure through diet is mostly about reducing sodium and increasing potassium.
Behavioral changes can only do so much to lower ApoB. It is a meaningful marker and may trigger additional workup. It may also signal that you should at least consider a statin.
ApoA is completely out of your control and will not change with behavioral modification.
So, no, you're incorrect that these tests are superfluous and all you need to say is "diet and exercise". Besides, even if that was always the answer to these results, you should still have a baseline to see if behavioral modification is doing anything.
"Why not just skip the HbA1c tests? After all, you know they'll give you insulin. Just start taking it."
Do you think everyone with poor blood test indicators is aware of how unhealthy they are? How quickly they need to reverse course? Or do think there might be some possible validity to discussing your results with an actual doctor and understanding how acute your symptoms actually are? Do you think there are no side effects to statins and everyone should just be on one at all times, forever? Do you think there might be some value, for those patients, in discussing GLP-1s? Or nah, everyone can just like, go run 10 miles tomorrow because some 20 year old in SV said so?
I'm always deeply confused by people who think all medicine is "just repeat whatever ChatGPT said as if it's profound, like, duh - I'm smart and invincible and can't quite figure out that other people aren't me", in spite of them not knowing anything about medicine in the first place.
Because for the same behavior, risks are going to be very different on the other side. In my family, for instance, we need significant interventions to get a reasonable risk due to all the bad genetic factors. In my wife's family, not so much. So knowing how serious the risk seems much better than just handing statins to absolutely everyone.
They haven't really, it just seems like it, and for that you can blame better distribution.
When I was growing up movies were watched in cinemas. It was a big event and we saw maybe 5 a year.
Over time more start appearing on TV, but those tended to be a bit older, but also cherry picked the good ones. (I don't live in the US).
PayTV didn't appear until mid 80s. They had more movies, but again tended to cherry pick. VHS meant we recorded the ones we wanted to see.
All these things together meant we tended to watch "good" movies.
Hollywood of course were making lots and lots of movies we never saw, or had and way to see. The bad stuff simply didn't have a channel to the world.
The arrival of Video Stores changed that. Suddenly the mediocre (and worse) had an outlet. And trust me, there was plenty of rubbish in there. But there was still a cost to distribute.
Today, distribution cost is zero. If Netflix commission a movie it'll get onto Netflix. Regardless of the result. Some really good stuff, most mediocre, lots of real rubbish.
Repeat for Amazon, Disney, Hulu, et al.
Overall movies haven't gotten worse. Objectively production values are higher. But your access to mediocre and bad movies has increased.
Judging past output though introduces survivor bias, which in turn makes comparison to today misleading.
No way. It is not sampling bias. Big budget movies have gotten worse script wise compared to the 90s and 00s.
The scene workers have gotten better though. And there are a lot of good movies being made still, but not by the mainstream industry that used to really deliver.
Well, my kids like old movies, they just didn't had a chance to watch them. We are rewatching old stuff like Alien, Terminator, etc. and they are surprised how good those movies are. Last night we watched movie "Kiss Me, Stupid" 1964, kids loved it.
I believe this first sentence to be true, but I'm skeptical about the last sentence.
For a while in the oughts I taught a film history class, though, and even 2 decades ago the kiddos thought anything in black and white, much less with no sound or with subtitles, was literally unwatchable. I'm okay with the idea that the students' tastes in media are legitimate, though I have my own tastes and think they are differently-informed.
And further, I dunno if "silly jokes and narrative in favor of spectacle" are new. Think Keystone Cops and Busby Berkley.
I like Battleship Potemptkin and Citizen Kane as much as the next person, but that's not all of what was popular.
Paring the thousands of films from the 80s down to a list of 10 does a lot of work to make that looks like it was better, when in fact I was in middle school and I could literally go see a movie for 75c. I remember some really bad ones, and I am certain I've forgotten a lot of bad ones.
I also have problems making a list of good films from the last decade, but I think that's because I got burnt out and stopped watching long-form video mediums when I left my PhD program. I am not sure I have seen 10 long form narrative works in the last 5 years.
> I like Battleship Potemptkin and Citizen Kane as much as the next person, but that's not all of what was popular.
Funnily enough, those happen to be two movies I didn't enjoy beyond their historic relevance.
I'm not saying that spectacle and one-liners are bad - movies like that are included in my list for 1984. It is when you substitute good writing with funny lines and have spectacle instead of a compelling narrative that I see a problem.
because why should my electric light scheduler be in the business of inspecting my passwords and furthermore involving third parties in inspecting my passwords?
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