Obesity is a major risk factor for most of the chronic diseases responsible for premature death.

But so is being 'Under Muscled'.

The combination is known as OLLMM - Obesity Low Lean Muscle Mass

This is a major issue.

🧵👇

/1
Obesity is responsible for 12% of deaths in Europe & United States.

In other countries, it is higher.

/2
25 % of Europeans &
37% of US Adults

Are obese.

You thought it was worse didn't you? But see the next point.

In the 1970s the average was about 10%

/3
Including those who are both Overweight & Obese.

Europe - 58%
United States - 68%

In the 1970s, both were about 40%.

/4
The combination of Obesity with Low Lean Muscle Mass (OLLMM) is not good.

United States ~ 16%

In those with Pre Diabetes - 20%
In those with Diabetes - 35%

These are hallmarks of poor health & are associated with significantly increased risks over time.

/5
Appreciating that these factors are very serious markers of poor health is critical.

In the group with OLLMM:

- 71% believed their health was either Good/Very Good/Excellent.
- 6.8% in the Excellent Category.

/6
While many complex factors lead someone to being both:

Overweight &
Under Muscled

It is crucial that they are recognised as the serious health risk factors they are.

We routinely gloss over both & do not highlight their significance.

Both can be readily addressed.

/7
We have recently made huge leaps forward in managing obesity with GLP-1 inhibitors medications.

But increasing muscle mass is unlikely to be something a medication can influence (Happy to be proved wrong).

Resistance Training is the solution to Low Muscle Mass

/8
Resistance Training is a powerful tool.

Benefits include:

⬇️ All-Cause Death up to 27%
⬇️ Cardiovascular Death by 19%
⬇️ Cancer Deaths by 14%

Lift Heavy Things!

/9
Always think re risk:

Normal weight or Over Weight?
Low Muscle or Adequate Muscle Mass?

Getting both right will make a huge difference.

/10
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More from @Paddy_Barrett

Jan 7
When I check a patient's blood pressure, I will be honest; it's mostly for show.

Here's why

🧵👇

/1
I hear this at least once a day:

"I have white coat high blood pressure. It's only high when my doctor checks it.".

With more than 50% of adults over 45 having high blood pressure:

I'm not so sure.

/2
For these patients, I take the KGB approach.

"Trust. But verify".

We need more data. Verified. In a real-world setting.

Hence the at-home blood pressures.

This is what I tell them.

/3
Read 12 tweets
Jan 4
I hated running.

Then I learned about Zone 2 training and exercising to specific heart rate zones.

It changed my life.

Here's why.

🧵👇

/1
Those who are very fit versus unfit have a five-fold less chance of dying over a 10-year period.

There is practically nothing in medicine that can generate that type of difference.

But why does exercise have such a huge benefit?

/2
Insulin Resistance is a key risk factor for the 3 leading causes of death:
- Cardiovascular Disease
- Cancer
- Dementia

Exercise is a key factor in reversing insulin resistance.

Insulin Resistance = ⬇️ Mitochondrial activity.

Mitochondria are the powerhouse of your cells
/3
Read 18 tweets
Jan 1
Psst...

Did you know there is an app on your phone that can tell you A LOT about your risk of dying prematurely?

Want to know what to look for?

🧵👇

/1
Whether you have an iPhone or an Android phone, there is a 'Health' App that tracks many of your health biometrics continuously over time.

Your metrics today are useful, but the average over the last year is even more insightful.

Have a look at yours & see where you stand.

/2
Resting Heart Rate

Compared with a resting heart rate of 45 beats per min, the higher your resting heart rate, the greater the chance of dying from ANY cause.

The risk is most significant when resting heart rate is >90 bpm

Regular aerobic exercise ⬇️ resting heart rate

/3
Read 9 tweets
Dec 31, 2022
As a Cardiologist, here are some of the biggest mistakes I see patients make.

🧵👇

/1
Thinking that their HDL Cholesterol will protect them.

Often referred to as 'Good' cholesterol (Not my words).

Very high HDL cholesterol >2.5 mmol/l or >100mg/dl is likely harmful!

Pay more attention when it is low rather than high.

/2
Thinking about cardiovascular risk far too late in life.

The time to start thinking about risk is in your 20s, 30s & 40s.

Not your 60s, 70s & 80s.

Plaque in your arteries starts accumulating from childhood.

The earlier you act the better.

/3
Read 8 tweets
Dec 21, 2022
More than heart disease or cancer, people often fear dementia the most.

But 40% of Dementia can be prevented by focusing on specific risk factors.

Here's how.

🧵👇

/1
Dementia is the 4th leading cause of death in Europe and the United States.

Science has made tremendous progress in preventing and treating cardiovascular disease and cancer.

When it comes to dementia, almost all of the trials in this area have been failures.

/2
What causes dementia, particularly Alzheimer’s dementia, may also be based on potentially fraudulent research.

Amyloid plaques in the brain are thought to be the main reason a person develops Alzheimer's dementia, but this may not be the case.

/3
Read 18 tweets
Dec 19, 2022
As a cardiologist here are 5 books I regularly recommend to patients.

🧵👇

/1
Man's Search For Meaning.

Having spent 4 years in Nazi concentration camps, Viktor Frankl reminds us that all of our freedoms can be taken from us except the right to "choose one's attitude" on what to do next.

Our lives may be imperfect, but we can still choose.

/2 Image
The Second Mountain

The first half of your life is generally about ambition & success.

The second half is about something different.

It's about using that success as a platform to give back to others.

It's about connection with others & our deeper needs.

/3 Image
Read 12 tweets

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