Episodios

  • 98: Big Tech’s Vision of an Aging Population

    98: Big Tech’s Vision of an Aging Population
    Aug 26 2024
    Buck discusses the role of big Tech and the elderly with Keren Etkin, founder of TheGerontechnologist.com. Discussion includes the role of robots, implications for social interaction, as well as the additional opportunities for founders to take advantage of the coming geriatric storm. 01:04 Current Tech for Aging
    05:17 Tech for Social-Emotional Support
    09:03 The Driving Force Behind the Development
    12:00 The Impact of Increasing Longevity
    13:54 Affordability of Aging Tech
    17:08 Cyborgification
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    23 m
  • 97: Buck’s Boston Heart Cholesterol Balance Test

    97: Buck’s Boston Heart Cholesterol Balance Test
    Aug 19 2024
    Link to Buck's Results: https://drive.google.com/file/d/19BJaZNYwBxlPx4nR9695Q2NC3nNpgW6y/view?usp=sharing https://drive.google.com/file/d/1br1ikAJKmgKev9X3jkS7nUPdXpAqMzYd/view?usp=sharing Section 1: Overview of Cholesterol Metabolism Cholesterol in the Body: Cholesterol is essential for cell membrane integrity, hormone synthesis, and bile acid production.It is produced endogenously in the liver and absorbed exogenously from dietary sources. Endogenous Production: Cholesterol is synthesized in the liver through the mevalonate pathway.Key intermediates: Lathosterol and Desmosterol, indicators of cholesterol production rate. Exogenous Absorption: Dietary cholesterol is absorbed in the intestines along with plant sterols like Beta-sitosterol and Campesterol.These sterols compete with cholesterol for absorption, reflecting dietary cholesterol absorption levels. Section 2: Detailed Analysis of the Test Components Production Markers: Lathosterol: Precursor in the cholesterol biosynthesis pathway.Elevated levels indicate increased hepatic cholesterol synthesis (overproduction).Example: Lathosterol level of 329 µmol x 100/mmol in my study indicates hyperactive cholesterol production. Desmosterol: Another precursor in the synthesis pathway, contributing to total cholesterol production.High levels reinforce the diagnosis of increased cholesterol production.Example: Desmosterol level of 74 µmol x 100/mmol in my study supports elevated production. Absorption Markers: Beta-sitosterol: Plant sterol absorbed in the intestines, competes with cholesterol.High levels suggest increased absorption of dietary cholesterol.Example: Beta-sitosterol level of 120 µmol x 100/mmol indicates borderline absorption. Campesterol: Similar to Beta-sitosterol, reflects cholesterol absorption efficiency.Elevated levels indicate increased absorption.Example: Campesterol level of 113 µmol x 100/mmol within normal limits but suggests absorption could be a factor. Cholesterol Balance Score: Ratio of production to absorption markers.A higher score indicates predominant cholesterol production; a lower score indicates absorption as the main issue.Example: Score of 2.4 suggests overproduction is the dominant issue. Section 3: Clinical Implications and Treatment Strategies Frequency of Overproduction vs. Overabsorption: Common to see patients with either overproduction or overabsorption, but less commonly both.Overproducers: Significant portion of hypercholesterolemia patients, especially those with genetic conditions like Familial Hypercholesterolemia.Overabsorbers: Often have high-cholesterol diets or genetic predispositions. Treatment Implications: Overproducers: Statins are first-line treatment; they inhibit HMG-CoA reductase in cholesterol synthesis.Overabsorbers: Ezetimibe, which inhibits intestinal cholesterol absorption, can be effective.Combination Therapy: Considered for mixed dyslipidemia cases. Case Examples: Example of a patient with high production markers but borderline absorption: Statin therapy may be appropriate, with potential addition of Ezetimibe.Example of a patient who is a high absorber but not a high producer: Dietary changes and Ezetimibe might suffice without statins. Section 4: Physiological Mechanisms and Genetic Considerations Pathophysiology of Cholesterol Production: Overproduction may result from genetic mutations (LDL receptor or PCSK9) or conditions like insulin resistance. Pathophysiology of Cholesterol Absorption: Increased absorption could be due to genetic polymorphisms (NPC1L1 gene), leading to higher dietary cholesterol absorption. Section 5: Practical Application in Clinical Practice Incorporating the Test into Clinical Workflow: Integrate the Boston Heart Cholesterol Balance Test for patients with unexplained hypercholesterolemia or non-responders to standard therapy.Tailor treatment based on whether a patient is an overproducer, an over absorber, or both. Patient Communication: Explain test results in an understandable way, emphasizing personalized treatment plans.
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    22 m
  • 96: Cardiovascular Risk Management: Calcium Scores, Lp(a), and Colchicine

    96: Cardiovascular Risk Management: Calcium Scores, Lp(a), and Colchicine
    Aug 12 2024

    Buck shares his experience visiting a cardiologist and discusses his family history of heart disease. He explains the importance of coronary calcium CT scans and the significance of calcium scores. Buck also highlights the role of lipoprotein little a (Lp(a)) in cardiovascular disease and the potential for new medications to target and lower Lp(a) levels. He explores the use of low-dose colchicine as an anti-inflammatory treatment for coronary artery disease and atrial fibrillation.

    01:23 Understanding Coronary Calcium CT and Early Interventions
    02:48 Advanced Cardiovascular Testing and Treatments 06:01 The Role of Lipoprotein Little A in Heart Disease 13:42 Inflammation and Coronary Artery Disease
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    20 m
  • 95: What is Atherosclerosis and How to Prevent it

    95: What is Atherosclerosis and How to Prevent it
    Aug 5 2024

    This week's episode is about atherosclerosis, a condition that leads to cardiovascular disease. Buck explains the role of cholesterol and lipoproteins in the development of atherosclerosis. He emphasizes the importance of understanding this topic as cardiovascular disease is the leading cause of death. The conversation covers the different types of lipoproteins, such as HDL and LDL, and their association with atherosclerosis. Buck also discusses the significance of apolipoprotein B (APO-B) in measuring the risk of cardiovascular disease. He explains how APO-B can penetrate the blood vessel wall and trigger an immune response, leading to the formation of plaque and potential heart attacks. Buck recommends keeping APO-B levels below 60 milligrams per deciliter to reduce the risk of atherosclerosis. He also mentions the importance of testing for lipoprotein little A (Lp(a)) levels, as high levels of Lp(a) are a major risk factor for atherosclerotic cardiovascular disease.
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    19 m
  • 94: Intermittent vs Prolonged Fasting

    94: Intermittent vs Prolonged Fasting
    Jul 29 2024

    Buck explains the difference between intermittent fasting and prolonged fasting, highlighting the benefits and potential pitfalls of each.

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    28 m
  • 93: Alzheimer’s Disease vs Age-Related Cognitive Decline

    93: Alzheimer’s Disease vs Age-Related Cognitive Decline
    Jul 22 2024

    Buck interviews Dr. Ken Frumkin on his own journey of aging and cognitive decline.
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    20 m
  • 92: Gene Editing 101

    92: Gene Editing 101
    Jul 15 2024

    In this episode, Buck discusses gene editing and its potential implications for human health and longevity. He explains the basics of gene editing, including the structure of DNA and how genes are transcribed into proteins, then dives into the history and development of gene editing techniques, focusing on the game-changing CRISPR-Cas9 technology. He also explores the practical applications of gene editing, such as its use in treating sickle cell anemia and other genetic diseases, as well as the potential for human longevity, including targeting genes associated with aging and reversing epigenetic age.
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    27 m
  • 91: Ask the Doctor 07/08

    91: Ask the Doctor 07/08
    Jul 8 2024

    Topics include:

    00:25 Protein Intake for Longevity

    12:40 Tips to Improve Sleep Quality

    22:52 Is Robert F. Kennedy Jr. Controlled by a Worm
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    30 m