The neuroscience of eating behavior and obesity. Author of The Hungry Brain. Founder and director of Red Pen Reviews. Neuroscience PhD, University of WA.
Seattle, WA
Joined April 2011
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Stephan J. Guyenet retweeted
👉Just published in @NEJM: STAREE Trial
☝️At last, robust randomized evidence on statins for primary prevention in older adults.
🔹 9,971 adults ≥70 years, without cardiovascular disease, diabetes, or dementia
🔹 Atorvastatin 40 mg vs placebo
🔹 Median follow-up: 5.9 years
🔹 Baseline LDL-C: ~127 mg/dL NEJMoa2607314.pdf
👉Key findings:
🔹 30% reduction in major cardiovascular events
HR 0.70 (95% CI 0.61–0.82; P<0.001)
🔹 NNT = 37 over 5.9 years
🔹 MI: HR 0.57
🔹 Coronary revascularization: HR 0.57
🔹 Benefit was also observed in participants ≥75 years
👉Importantly:
🔹 No increase in dementia (HR 1.03)
🔹 No significant effect on all-cause mortality
🔹 No improvement in overall disability-free survival
🔹 Serious adverse events were similar between groups.
☝️Bottom line:
Age alone should not be a reason to withhold LDL-C lowering. Even in healthy adults ≥70 years, lowering LDL-C translates into substantial cardiovascular benefit.
@society_eas
@nationallipid
🔗nejm.org/doi/full/10.1056/NE…
Stephan J. Guyenet retweeted
Unfortunately, influencers can make exaggerated claims on social media with zero supporting evidence and still attract a substantial following. Even more unfortunately, it’s the general public that ultimately suffers from the spread of this misinformation...
Stephan J. Guyenet retweeted
Vaccines for cancer!! And malaria!! I've been a critic of Harvard's shortcomings over the decades, but it's vital to keep things in perspective: Harvard has 13 schools and 2.4K faculty, many doing life-saving and world-improving research. Not just Harvard: the American research university is one of humanity' greatest achievements. news.harvard.edu/gazette/sto…
One of the most obvious reasons why obesity is not a state of "internal starvation":
It's associated with ectopic fat accumulation in lean tissues like muscle, liver, and pancreas.
Adipose tissue does not excessively "trap" fat in obesity -- quite the contrary.
The evidence suggests that chronic exposure of lean tissues to excess energy substrates (fat, glucose) is the primary cause of insulin resistance.
Elevated intramuscular fat in endurance athletes is not a marker of excess energy exposure -- quite the contrary.
"Energy overload" isn't a viable explanation for the origins of insulin resistance. The "Athlete's Paradox" proves this.
A muscle biopsy from an overweight person with type 2 diabetes will reveal a high level of muscle fat. However, a similar biopsy from an insulin-sensitive endurance athlete reveals just as much muscle fat.
Stephan J. Guyenet retweeted
Excellent review paper by Roy Taylor on his journey to verifying the cause of type 2 diabetes. Aptly titled: "Aetiology of type 2 diabetes: an experimental medicine odyssey" (PMID: 40316731).
I wanted to share two quotes from the conclusion, because there still seems to be a tremendous misunderstanding of this disease among both scientific and layperson communities.
"The original destination of this experimental medicine odyssey was to identify the cause of type 2 diabetes and now this can simply be stated. If a person develops type 2 diabetes, they have accumulated more fat than can be tolerated by their own genetic constitution."
"There is a single environmental, modifiable cause. Type 2 diabetes only develops if an individual has eaten more than they require over a long period. However, there are two important stop–go stages, both determined by the lottery of inheritance. Diabetes appears only when fat can no longer be stored safely under the skin... Even if fat spills over into ectopic sites, diabetes will only occur if there is also genetic susceptibility to fat suppression at the level of the beta cell... Even if full genetic susceptibility is present, the writing is clearly on the wall: no positive energy balance, no diabetes."
We've confirmed it's an unpopular point of view 😁
Nevertheless true.
Added fats like oil and butter increase calorie intake and body fatness in a variety of species, including humans.
doi.org/10.1093/ajcn/46.6.88… doi.org/10.1016/j.cmet.2018.… doi.org/10.1093/ajcn/67.3.50…
Stephan J. Guyenet retweeted
My ancestors buried half their children. All mine are alive. My ancestors' house had a dirt floor. Mine is wood. I have indoor plumbing, I have hot water, I have never in my life hauled a full bucket half a mile and I probably never will. Do you know how rare it is, in human history, for small children to wear shoes? Mine have multiple pairs. I can speak to my relatives who live thousands of miles away, for free, at any time. Video, if we want video. With machine translation, if we speak different languages.
The original Library of Congress had 740 books in it. I have more than that. If I run out of books in my home my local public library has 350,000. If I want to take a hundred books with me on vacation, they all fit on a device that fits in my purse.
I have heat in the winter and AC in the summer and a washing machine and I have never, ever, ever had to scrub a dress clean by hand in the stream. I can look up recipes from more than a hundred different countries and I've tried dozens of them. I ride a clean and modern train across my city for $4, or take a robot taxi if I'm out too late for the train. I donate $40,000 every year to the cause of getting healthcare to the world's poorest people and even after the donations I never have to think about whether I can afford a book, or a pair of shoes, or a cup of coffee.
There is a great deal more to fight for, of course. I hope that our descendants will look back on our lives and list a thousand ways they're richer. Maybe we ourselves will do that, if some of the crazier stuff comes true.
But the abundance is all around you and to a significant degree you aren't feeling it only because fish don't notice water.
I switched my personal AI subscription from ChatGPT to Claude today.
Anthropic (Claude parent company) has repeatedly shown that it cares more about responsible, ethical, and safe use of AI than the other leading AI companies.
These uses of AI are widely understood to be unethical and dystopian at this time.
Anthropic is denying access to them at the cost of hundreds of millions of dollars in US government contracts.
Restricting these uses is a really low bar that only Anthropic cleared.
Hi all -- I've decided to step back from X.
X has a lot of value, but I increasingly see the cost/benefit balance as poor, both for myself and for society.
I'll still pop in occasionally.
I'd like to see a platform that has room for all voices, structurally favors connection and truth over conflict and propaganda, and has prosocial ownership.
I think that's what this country and the world needs right now.