weapons of mass destruction€¦ · weapons of mass destruction. cardiologie centrum utrecht 450...
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Licensed to kill; a bad lifestyle
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Bad diet kills?
11.3 M GBD Lancet 2013
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Weapons of mass destruction
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Cardiologie Centrum Utrecht 450 newly referred patients/month
Helpful studie: better predictive biomarkers for heartfailure in
women UMC and NHS
Professor in Cardiology VUMC
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Huang Dee: Nai Ching (2600 B.C. 1st Chinese medical text)
Oldest medical text
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atherosclerose starts early
Delay between cause and
effect
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Stroke and heart attack:
50% suddenly
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Politics and media: look at the
bird, not at the elephant
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Social gap = Gap in health
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Disease = business model
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Population: mainly interested in
sports and entertainment
No 4 Trending 2016
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More fat: longer life
More carbs: shorter life
Yusuf, Lancet 2017
Fat confusing:
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Interaction food industrie/science
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Intention gap
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1992-2004:
check ups, cholesterol levels good exercise
2004: Acute coronary syndrome emergency bypass surgery No alarming symptoms beforehand
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“Life is the cumulative effect of a handful of
shocks” Nassim Taleb
Disease at individual
level -> “Black Swan”
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Black Swan
Negative or positive
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Heart attack = Black Swan
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Heartinfarct
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Lifestyle
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90%?
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90% lifestyle!
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Lifestyle = disease
Heart infarct 80% Alzheimer 60%
Cancer 40% Diabetes 60-70% Lack
excercise, overweight,lack of sleep, stress, bad
diet, smoking
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Obesity -> doubling diabetes
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Aging -> more disease
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NHS: 2011-2040 from 600.000 to 900.000 CVD patients
Hart- en vaatziekten in Nederland 2015 – Hartstichting
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Lifestyle worsens
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At population
level: disease is
an“inevitable
surprise”
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alzheimer-cancer-
diabetes-CVD
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alzheimer-kanker- diabetes-hartziekte
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Improvement
Lifestyle?
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Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition
Gottesman R et al. JAMA 2017;317:1443-1450
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Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition
Willaimson et al. JAMA 2018 320(7):665-673 ;
25 yr old adults: better cardiovasculair fitness -
> better perfusion brain, more blood vessels,
less white matter lesions
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Diabetes: 3 times higher chance to
develop erectile dysfunction The American Journal of MedicineVolume 120, Issue 2, February 2007, Pages 151-
157
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Lancet 2017 Tsimane Indians Amazon: only 10% of heart disease burden compared to Western Countries
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Health = business model
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Superior doctors prevent the disease.
Mediocre doctors treat the disease before evident.
Inferior doctors treat the full blown disease.
Huang Dee: Nai Ching (2600 B.C. 1st Chinese medical text)
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