Exercise is probably the single best way to extend lifespan. You need to exercise like your life depends on it. Because it does. Here's why. 👇🧵 /1

300 mins + of weekly activity has been consistently shown to Reduce the likelihood of: - An early death - Cardiovascular disease - Dementia The list goes on and on and on. And on and on and on.

300 mins + of weekly activity has been consistently shown to Reduce the likelihood of: - An early death - Cardiovascular disease - Dementia The list goes on and on and on. And on and on and on.

Why you need to train muscle power: – First thing to decline with age – Best predictor of falls – Linked to dementia risk – Drives independence – Easy to train, hard to regain Start now. Not later.

Always curious and full of energy, Beagles turn every walk into an adventure 🐾🎉.

Why you need to train muscle power: – First thing to decline with age – Best predictor of falls – Linked to dementia risk – Drives independence – Easy to train, hard to regain Start now. Not later.

Switching to a potassium based salt has been shown to: ⬇️ All Cause Death 11% ⬇️ Vascular Death 13% ⬇️ Major Cardiovascular Events 11% Small change. Big difference.

What determines if you need a statin? – Your Non-HDL-C level – Your plaque burden – Your long-term risk – Your tolerance for risk. This is a data question. Not a vibes question.

That's a wrap! If you enjoyed this thread: 👋 You can join over 35K others on my weekly newsletter Or you can sign up for my Free 5 Day Course On Preventing Heart Disease. Links in the Bio Above ☝️

Medications are also an important part of plaque regression But if you are not optimising all your lifestyle factors You are likely leaving benefits on the table. /14

So, if you have plaque in your coronary arteries, the evidence is clear. - Regular exercise ⬇️ plaque volume. ✅ - Good nutrition (Not just a DASH diet, I suspect) changes plaque composition to safer, more stable plaque. ✅ - Stopping smoking ⬆️ cap thickness ✅ /13

A key takeaway from these studies is to recognise that these lifestyle approaches were used ALONGSIDE standard medical therapies including: Aspirin Cholesterol Meds BP Meds These approaches should not be seen as a substitute for good medical therapy. /12

Smoking Cessation Although there are no randomised trials Observational studies have shown that in those who stop smoking Cap thickness increases, which is good. Smokes were more likely to have the more vulnerable TCFAs - Thin Cap Fibroatheromas. /12

The DISCO Trial was a randomised trial of the DASH diet to ⬇️ plaque. This was a low fat plant based diet with lower sugars. Overall plaque went ⬇️ in the control group but not in the intervention group. Non Calcifed plaque ⬇️ in both groups but more so in the diet group. /11

Nutrition A study in the 90s looked at a multifactorial intervention to ⬇️ plaque including: Low Fat Low Sugar Vegetarian Diet Smoking Cessation Stress reduction Exercise And plaque volumes did ⬇️. But... With so many parts, it's hard to say if it was the diet alone. /10

Similar reductions have been seen with moderate intensity steady state exercise. The key takeaway here is not to focus on the type of exercise But that exercise, in general, regresses plaque. And has been shown to significantly reduce the risk of future heart attacks. /9

Exercise 6 months of twice-weekly HIIT based exercise has been shown to reduce plaque volume by 1.4% That might not sound like a lot But.. A 1% reduction in plaque volume has been assoc with a 20% reduction in events. /8

In summary, the best outcome for plaque is to: - Decrease in size - Change from non calcified to calcified - Develop a thick fibrous cap. All of these components influence the risk of future heart attacks. But how do lifestyle factors impact these plaque features? /7

Cap thickness refers to the part of the plaque separating the plaque and the inside of the artery. TCFA's or Thin Cap Fibroatheromas are thought to be more vulnerable & likely to lead to a heart attack. In general, the thicker the cap, the better. /6

There are multiple ways of describing plaque depending on the imaging test used: - Calcified, Non Calcified, Mixed (A combination of the two) - Calcified, Fibrous, Non-Calcifed (Fibrofatty + Necrotic Core plaque) In general, the less non-calcifed plaque, the better. /5

The degree of obstruction is a key metric as it objectively quantifies the size of a plaque and whether the plaque has decreased in size over time. One of the primary metrics used in studies of plaque regression is plaque volume or plaque area. The less plaque, the better. /4

To understand plaque regression, you must understand some key concepts about plaque to appreciate the studies we will discuss here. There are multiple ways of describing coronary plaque: 1. The degree of obstruction 2. Plaque composition 3. Thickness of the plaque cap /3