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P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
@Mangan150
Aug 27, 2019 • 6 tweets • 2 min read • Read on X
A few of you asked me if I could "translate" this thread into simpler terms so that others could better understand. So here goes.
Some arteries are free of atherosclerosis, even when others - in the same person - are loaded with it. Why?

If we can understand that, we can better understand what *really causes atherosclerosis, and hence, coronary artery disease.
The arteries that don't develop atherosclerosis lack "vasa vasorum", which is a separate blood supply to arterial walls.

Yes, some arteries require their own blood supply.

ahajournals.org/doi/full/10.11…
Ischemia - tissue death due to lack of oxygen - of the vasa vasorum leads to atherosclerosis.

This seems to be linked to PVAT - perivascular adipose tissue, the fat tissue that lines arteries.

ncbi.nlm.nih.gov/pubmed/21910690
Insulin resistance can cause dysfunction in this fat, leading to inflammation.

This could explain why insulin resistance leads to atherosclerosis.

ncbi.nlm.nih.gov/pubmed/15910955
There's more, but to summarize, atherosclerosis comes from the outside in, not from the inside.

Insulin resistance, obesity, and aging all lead to inflammation of PVAT, which leads to atherosclerosis.

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More from @Mangan150

P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
Dec 29, 2025
As 2025 comes to a close, here's what you need to know about setting your 2026 health goals:

92% of adults have poor metabolic health.

And most are focused on the wrong metrics.

Here's the deal: Image
The most powerful predictor of chronic disease risk isn't your BMI, your weight, or your cholesterol.

It's your waist size. And you can measure it right now at home with nothing but a piece of string. Image
The Formula: Measure your waist at its widest point (around your belly button, not your pants size, since these are fake). That number should be no more than half your height.

Example: At 70 inches tall, your maximum reasonably healthy waist is 35 inches.Image
Read 5 tweets
P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
Dec 29, 2025
Here's how I never workout for more than 60 or 70 minutes per week…

And why 99% of people should do the same: Image
First things first, why should you listen to me on this topic?

I'm a 70 year old former microbiologist. For the past 15 years, I've been working with clients 1-on-1 as abody transformation coach.

So far I've helped 1600 men and women get lean, fit and strong in minimal time. Image
Before we get into it, let me be clear:

I am NOT saying that you should train for 60-70 minutes per week and then sit on your rear end the rest of the time.

As such, we need to distinguish between exercise (training) and activity.
Read 21 tweets
P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
Dec 27, 2025
I’m turning 71 next year, and I have 12% body fat.

If you want to lose 20, 30, 50 or 100 pounds in 2026…

What you don’t want to be doing is doubling down on willpower and discipline.

Here’s what to do instead: Image
The smart way to do self-improvement isn’t to sacrifice more, more, more.

In fact, the best thing you can do, as you reflect on what didn’t work for you in 2025 is to ask:

If I wasn’t allowed to, once again, rely on willpower…
What would I be thinking about instead?

How would I approach things differently if I wasn’t allowed to sacrifice all my free time?

What would have to be true if I refused to attempt a “bootcamp”, and needed to find a forever sustainable approach?
Read 4 tweets
P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
Dec 10, 2025
The 3 practical ways to get healthier:

1. Getting leaner
2. Getting fitter
3. Getting stronger

Here’s what I mean by that:
Getting leaner means losing weight.

But more specifically, it means losing fat while protecting against muscle and bone loss.
Getting fitter means improving exercise capacity.

It’s also referred to as “improving cardio” or increasing endurance.
Read 7 tweets
P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
Nov 5, 2025
A short guide for new readers:

The number 1 cause of chronic disease, including heart disease, many cancers, Alzheimer's, dementia gout and (almost) anything you care to name, is poor metabolic health.

Let me explain:
Poor metabolic health is most commonly visible to the naked eye based on 2 factors:

-Excess body fat (being over fat, no matter the BMI)
-Low muscle mass (being under muscled, again, no matter the BMI)
The official term for poor metabolic health is insulin resistance.

My shortcut is this: the opposite of poor metabolic health = being lean and fit.
Read 5 tweets
P.D. Mangan Health & Freedom Maximalist 🇺🇸 Profile picture
Sep 26, 2025
Top 4 metabolic health and body composition levers, in no particular order:

1. Resistance training
2. Nutrition optimization
3. Cardiovascular training
4. Sedentary-busting physical activity

Here’s why:
Resistance training is by far the most predictable way to:

1) Protect against muscle and bone loss that would otherwise happen as one ages

2) Build new muscle

New other form of training, no sport or physical activity is anywhere near as effective.
By nutrition optimization, I mean being intentional about what, how and when you eat.

I can craft arguments for and against different diets and ways of eating.

The most unambiguous fact is that it’s better and easier to be lean and fit if you mostly eat real whole food.
Read 6 tweets

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