weapons of mass destruction€¦ · weapons of mass destruction. cardiologie centrum utrecht 450...

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Licensed to kill; a bad lifestyle

Bad diet kills?

11.3 M GBD Lancet 2013

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Weapons of mass destruction

Cardiologie Centrum Utrecht 450 newly referred patients/month

Helpful studie: better predictive biomarkers for heartfailure in

women UMC and NHS

Professor in Cardiology VUMC

Huang Dee: Nai Ching (2600 B.C. 1st Chinese medical text)

Oldest medical text

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

More fat: longer life

More carbs: shorter life

Yusuf, Lancet 2017

Fat confusing:

Interaction food industrie/science

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Intention gap

1992-2004:

check ups, cholesterol levels good exercise

2004: Acute coronary syndrome emergency bypass surgery No alarming symptoms beforehand

“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

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!

Lifestyle = disease

Heart infarct 80% Alzheimer 60%

Cancer 40% Diabetes 60-70% Lack

excercise, overweight,lack of sleep, stress, bad

diet, smoking

Obesity -> doubling diabetes

Aging -> more disease

NHS: 2011-2040 from 600.000 to 900.000 CVD patients

Hart- en vaatziekten in Nederland 2015 – Hartstichting

Lifestyle worsens

At population

level: disease is

an“inevitable

surprise”

alzheimer-cancer-

diabetes-CVD

alzheimer-kanker- diabetes-hartziekte

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Improvement

Lifestyle?

Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition

Gottesman R et al. JAMA 2017;317:1443-1450

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

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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