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outlive - Coggle Diagram

- - - - E.g. Carbs > Glycogen (storage form of glucose) > store in muscle (75%), store in liver (25%). Roughly 1600 calories total
        = roughly 2h vigorous endurance excericse
    - - cytokines (e.g. IL-6)
        dying fat cells secrete inflammatory
        cytokines into blood stream
        (e.g. IL-2 plays role in immune response
        = amplifies activity of white blood cells to
        fight infection)
    - - DEXA (body composition - e.g. visceral fat)
        see: https://www.training-and-diagnostics.ch/
      - CT angiogram (better, higher resolution) than regular calcium scan on blood vessel calcification
    - - OGTT (Glucose Tolerance Test)
  - - - 100mg/dL /5.1%
    - - e.g. Cholesterol
        
        essential to life
        needed to produce: cell membranes/hormones &
        acids for digesting food
        
        cells synthesize own colesterol (most of what is needed,
        ownly very little percentage absorbed by food)
        20% of cholesterol stored in the liver (=cholesterol repository)
        eggs not a problem
        
        lipid = not water soluable =
        cannot dissolve into plasma like glucose/sodium =
        cannot travel freely
        charted around by lipoproteines
        
        HDL/LDL carry Cholesterol
        HDL/LDL carried by Apolipoprotein
        (APOA for HDL, APOB for LDL (and others))
        HDL returns excessive LDL to liver = remove from body
        
        not related to diatary cholesterol
      - APOE (shuttles cholesterol around the brain and body)
      - LDL / HDL (Low/High Density Lipoprotein)
        = amount of fat relative to the protein
        LDL = more lipids, hdl more protein
      - APOB (shuttles LDL, VLDL, Lp(a))
        
        strongly associated with cardiovascular disease
        
        APOB signature the problem for atherosclerosis
        
        reduce carbs = reduce triglycerids
        reduce saturated fats
        
        target 30-40mg/dL
        
        Lp(a) is hereditary / genetic
        calcium score on CT aniogram will be very high
        for age
        high level destructiv to aortic valve
        
        ketogenic diet lowers triglycerids
        but usually increase in saturated fats
        this could increase apoB for some people
        
        monosaturated fats (nuts, olive oil, avocados)
        do NOT have effect of increasing apoB!
        = fat with better limpid profile
        = recommendation: consume up to 60% fat from these sources
        
        APOB related with high amount of saturated fats (e.g. ketegenic diet). Monosaturated fats (e.g. avo/olive oil, nuts) do NOT have this effect
      - e.g. triglycerides (energy stored in fat cells as triglycerides)
      - Lipoprotein = partly Lipid (inside) and partly protein (outside)
        protein = vessel that allows to be transported in plasma while
        carrying water insoluble cargo of lipids (e.g. cholesterol, triglycerides, phospholipids, vitamins and other proteins)
      - apolipoprotein = enwraps lipoprotin
        = provides structure, stability, solubility
      - APOE (Shuttles HDL)
      - Lipid Management
        / Lipid lowering drug
        
        Food/Diet
        
        Monosaturated fats good: Avo/Olive oil/nuts
        
        Triglycerides constribute to apoB particles = reduce triglycerides via dietary interventions
        EPA can help (fish oil), e.g. 4g via drug called Vascepa
        
        Drugs
        
        Statins
        
        inhibit synthesis of cholesterol = liver increases LDLR, clearing more LDL out of blood circulation
        
        side effects (about 5% of persons): muscle pain / disruption in glucose homeostasis / all reversible when drug consumption stopped / deploy early and often if can be tolerated!
        in muscles (and also liver)
        
        Rosuvastatin (Crestor), lower apob to 20/30mg/dL
        
        bempedoic acid (Nexletol)
        
        modulates different pathway, especially in liver
        should not have muscle soreness
        higher cost
        
        ezetimibe (Zetia)
        
        Blocks absorption of cholesterol in the GI tract (gut)
        pairs well with statins
        
        PCSK9 inhibitor
        
        upregulate LDL receptors
        attack protein called PCSk9 that degrades LDL receptors
        = improve the liver's ability to clear apoB
        (statin + pcsk9 inhibitor = most powerful pharmacological tool against apoB)
        PCSK9 inhibitor typically reduce Lp(a) by about 30%
        
        Think APOB Clearence, lay men terms = cholesterol lowering
        e.g. via activation of LDL receptors in the liver which absorb cholesterol from bloodstream
    - - e.g. FOXO3
    - - ALT (Alanine Aminotransferase) (Liver enzyme)
        
        30IU/L men
        19IU/L women
        
        job: promote break down food into energy
      - uricase (helps clear out uric acid)
    - - c-reactive protein
        
        popular (but poor) marker of arterial inflammation
- - - - highly correlated with obesity & hyperlipimedia
      - caused by more fat entering liver than exiting
    - - NAFLD + inflammation
      - nonalcoholic steatohepatitis
    - - Convert stored glycogen back to glucose + release into bloodstrream as needed to maintain steady blood glucose level =
        glucose homeostasis
        healthy adult 5g of glucose circulating in bloodstream (teaspoon) all the time, lasting only a few minutes (muscles/brain)
        (7.5g = diabetis) => highly regulated
- - - - Calcium score should be 0 for 30 year old
      - calcium score 6 for a 55y old
- - - - killing cells pretty easy, but
        colateral damage high
      - Mustard Gas from World War 1 was "first" version
      - Noncancerous cells that devide frequently
        mouth/gut/hair follicles/nails
        side effects for these cells like hair loss
        when doing chemotherapy
      - CR (caloric restriction) during chemotherapy
        turns down insulin and PI3K pathway
        (not possible to starve cancer), but type2 diabetes
        feeds it!
    - - Immune system programmed to distinguish
        "self" from "non-self"
      - immunotherapy = any therapy that atries to use patients immune system to fight an infection or other condition
      - cancer = teach immune system how to recognise
        and kill our own cells that have turned cancerous
        = "bad self" from "good self"
      - Rosenberg tried: IL-2 cytokines / T cells based therapy = genetic mutation to teach them how to kill patient specific tumor (called CAR-T) / checkpoint inhibitor (=help make cancer visible to immune system) / ACT (adoptive cell transfer) = add additional T cells = anticancer drug per patient
      - when it works it works, unlike chemotherapy
- - - - frontal and vascular dementia affect the frontal lobe,
        responsible for executive functions such as
        
        attention
        
        organization
        
        processing speed
        
        problem solving
      - Alzheimer Disease (AD) predominantly affects hyppocampus and temporal lobes:
        
        memory
        
        language
        
        auditory processing (forming and comprehending speech)
        
        also affects parietal lobe:
        
        processing and integrating sensory information
      - Parkinson resulting partly from deficiency in producing dopamine
        
        manifests as a movement disorder (primarily)
        
        ("movement reserve" such as with athletes help to resist/slow down parkinson)
        
        Excersise shown to delay parkinson