Getting all the plastic snaps off the back of the monitor was the single longest part of this... very annoying. I miss easy to repair devices.

• Aim: improve desk-focused life by improving the desk-focused body via powerlifting.
• Issue: long desk hours drive posture pain, back issues, and RSI patterns.
• Ergonomics alone stays reactive; strength work builds resilience.
• Safety: over 18 and medically cleared.
• Baseline: years of posture-related back problems and recurring physio visits.
• Principle: prevention beats repeated fixes after flare-ups.
• Powerlifting fit: heavy barbell work gives high return for limited gym time.
• Analogy: lifting acts as a contract test between brain intent and body reality.
• Core novice arc:
  • Rapid linear loading: about +2.5 kg (~5 lb) each gym session at the start.
  • Timeline: months to ~1 year of fast progress; early gains are "newbie" gains.
  • Capacity: within ~1 year, reach ~80% of long-term lifting capacity.
  • Mechanism: early progress is skill and proprioception, plus some muscle.
• Primary lifts for desk-work damage:
  • Squat: neutral neck, shoulders back/down, braced core, pelvis-to-legs linkage.
  • Squat point: with correct mechanics, knee ligaments take no stress in the lift.
  • Press/bench variants: build upper-back and shoulder strength against rounding.
  • Deadlift: train posterior chain and safer picking-up mechanics for the back.
• Simple template (Starting Strength-style novice focus):
  • Train ~3x/week with squat, press, and deadlift as the base.
  • Work sets: 3 sets of 5 reps per lift, with ~1 minute rests between sets.
  • Session length: ~30 minutes; most time is rest between heavy sets.
• Recovery rules:
  • Heavy weights need rest days; daily training breaks recovery.
  • Eat, sleep, rest; add a little weight next session; watch body feedback.
• Long-run view:
  • Consistency matters more than perfect program details.
  • Complexity can come later; the basic barbell lifts compound over time. References
• [00:01] I Didn’t Start Weight Lifting Because I Wanted to Be Strong — https://www.thecut.com/2022/02/casey-johnston-didnt-start-weight-lifting-to-be-strong.html
• [00:01] Starting Strength: Basic Barbell Training, 3rd edition — https://aasgaardco.com/store/books-posters-dvd/books/starting-strength-basic-barbell-training/
• [00:15] A Physical Education — https://www.grandcentralpublishing.com/titles/casey-johnston/a-physical-education/9781538773253/

• Salt restriction is common blood pressure guidance; obesity drives salt sensitivity.

Guideline target

• U.S. guideline target is ≤2.3 g sodium/day; some long-term cohorts link lower sodium with higher BP.

Body-fat → brain → kidney chain

• Adipose tissue functions as an endocrine organ; leptin rises with fat mass and raises blood pressure.

Hypothalamus control

• The hypothalamus coordinates sympathetic tone, hormones, thirst, and kidney sodium handling.

Obesogenic diet triggers the sequence

• A high-sugar/high-fat diet causes obesity; leptin rises; hypothalamic microvasculature remodels before BP rises.

Gliovascular remodeling mechanism

• Leptin signaling in brain tissue drives HIF1α and VEGF, increasing vessel density and thickening basement membranes near the BBB.

Kidney consequences

• Higher sympathetic output plus altered renal signaling reduces sodium excretion, expanding volume and raising BP.

Human anchor: congenital leptin deficiency

• Severe obesity without leptin links to low/normal BP, separating fat mass from hypertension when leptin is absent.

Human anchor: salt sensitivity trial

• NEJM crossover: 15 g salt/day vs 1 g/day, 2 weeks each; only obese participants lower BP on low salt.
• Salt sensitivity falls with body-fat percentage; below ~30% body fat, salt sensitivity approaches zero.

Interpretation

• Obesity creates a salt-sensitive phenotype; salt becomes a lever only after adiposity-driven reprogramming.
• Salt resistance protects from obesity-related BP rise; salt restriction mainly helps salt-sensitive, higher-adiposity states.

Reversibility

• In mice, weight loss reverses hypothalamic vascular remodeling and lowers BP.

Practical takeaways

• Target the fat–leptin–hypothalamus–kidney axis; use sodium targets as a secondary, phenotype-specific tool.

References

• [00:00] Salt vs. Fat: Rethinking the Root Causes of High Blood Pressure — http://staycuriousmetabolism.substack.com/p/salt-vs-fat-rethinking-the-root-causes
• [01:40] Dietary Guidelines for Americans, 2020-2025 — https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf
• [01:50] Low Sodium Intakes are Not Associated with Lower Blood Pressure Levels among Framingham Offspring Study Adults — https://doi.org/10.1096/fasebj.31.1_supplement.446.6
• [02:48] Obesity-associated hyperleptinemia alters the gliovascular interface of the hypothalamus to elevate arterial pressure — https://doi.org/10.1016/j.cmet.2021.04.007
• [11:05] The Effect of Weight Loss on the Sensitivity of Blood Pressure to Sodium in Obese Adolescents — https://doi.org/10.1056/NEJM198908313210905

• New guidelines use a short, consumer-focused format compared with prior editions.
• The earlier grain-heavy pyramid is inverted; red meat, butter, and whole milk are emphasized.

What to focus on: the visual pyramid

• The cornucopia-style graphic is the largest visible change and signals priority foods.
• Animal foods are placed centrally after earlier “eat sparingly” messaging.

Chronic disease reality and why macros must change

• 88–93% of U.S. adults are metabolically unhealthy; a single universal diet has not worked well.
• Carbohydrate reduction (especially grains) plus less added sugar is linked with chronic-disease reversal.
• More fat and more protein replace those carbohydrates in the low-carbohydrate approach.
• Low carbohydrate eating is named for chronic disease in the guidelines.

Keto: what this means for keto adaptation and keto resistance

• Keto and low carb are commonly tried “new year” options, alongside carnivore.
• The pyramid is not ketogenic, but it shifts macronutrients toward lower-carb, higher-fat patterns.
• Low carb is treated as a legitimate option, reducing institutional and social opposition.
• The remaining “<10% saturated fat” rule conflicts with common keto food choices.

Protein: higher targets and why

• Protein guidance rises from 0.8 g/kg (ideal body weight) to about 1.2–1.6 g/kg.
• More protein supports satiety, illness avoidance, and muscle-building across the body.

Grains and sugar: a quieter reversal

• The 1980 grain target (6–11 servings/day) drops to about 6–7 servings/day.
• Reducing grains and added sugars is treated as compatible with better health outcomes.

Whole milk and schools

• Whole milk returns; policy shifts allow whole milk without counting it against saturated-fat limits.
• The goal is whole milk back in schools.

Saturated fat: the unchanged ceiling

• The <10% saturated-fat cap remains, with limited supportive evidence cited.
• Removing that cap would have been the highest-profile change; keeping it limits the reform.

Red meat and cancer: the “WHO” legacy and why it persists

• A WHO-convened group labeled processed meat as cancer-causing and red meat as probable/likely.
• That classification influenced guidelines and headlines, while clinical-trial evidence was not included in the core review.
• Processed meat remains stigmatized even as the new pyramid elevates red meat generally.

Implementation and expected pushback

• Pushback is expected from major institutions (e.g., American Heart Association) and legacy stakeholders.
• Public lived experience and grassroots pressure are described as drivers of change.

Origin story and trust collapse

• A low-fat, whole-grain identity once dominated personal nutrition choices.
• Research for The Big Fat Surprise revealed weak evidence, entrenched bias, and conflicts of interest behind fat restrictions.

References

• [00:00] Dietary Guidelines for Americans, 2025–2030 — https://cdn.realfood.gov/DGA.pdf
• [00:00] The Big Fat Surprise — https://www.simonandschuster.com/books/The-Big-Fat-Surprise/Nina-Teicholz/9781451624434
• [00:08] The Nutrition Coalition — https://www.nutritioncoalition.us/about
• [00:09] Redesigning the Process for Establishing the Dietary Guidelines for Americans — https://doi.org/10.17226/24883
• [00:22] Whole Milk for Healthy Kids Act of 2025 (S.222; Public Law 119-69) — https://www.congress.gov/bill/119th-congress/senate-bill/222/text
• [00:25] IARC Monographs Volume 114: Red Meat and Processed Meat — https://www.iarc.who.int/iarc-monographs-volume-114-evaluation-of-consumption-of-red-meat-and-processed-meat/

• Sports and exercise medicine focus; work expanded from athletes to public metabolic health.
• Metabolic syndrome in 30s despite low-fat diet, sodium counting, heavy exercise, high carbs/sugar intake.
• Metabolic syndrome defined by 3 of 5: central adiposity, low HDL, high triglycerides, high blood sugar, high blood pressure.

Plant only vs carnivore

• Plant only diet benefit often comes from leaving heavily processed “SAD” eating.
• Research comparisons often use a low baseline and exclude plant-only junk-food intake.
• Many nutrition studies group “red meat” together with junk food and other confounders.
• Food-frequency questionnaires are a core data source, with major recall limitations.

Carnivore

• Carnivore movement includes high-profile advocates; diet sits at the extreme end of dietary change.
• Pure carnivore marked as extreme; question raised about maintaining optimal health on it.
• No research cited that proves optimal health on pure carnivore is impossible.
• People on pure carnivore can be extremely healthy; early support is largely anecdotal and observational.
• Personal contacts and patients on carnivore show very good health; some reversed chronic issues after switching.
• Population and historical patterns (Maasai, Inuit, other cultures) include predominantly animal foods with minimal plant food.

Animal foods, growth, and brain nutrients

• Cross-country child stunting aligns with low animal-food intake; economics and availability drive intake.
• Ecuador intervention: giving children one egg per day prevented pathological stunting.
• Red meat, dairy, and eggs support child growth and development via nutrient density.
• Developing brain needs DHA; plant omega-3 converts poorly to DHA; algae is a potential exception.
• Dietary DHA availability links to cognition and measured IQ differences in children.

Evidence quality

• Study design and confounding control determine reliability; avoid cherry-picking supportive papers.

Cholesterol, LDL, and carbohydrate damage

• Excess carbohydrate drives damaging changes to LDL; LDL level alone is a weak signal without metabolic context.
• Older-adult evidence synthesis: 19 cohorts; LDL inversely associated with all-cause mortality in 16 cohorts.

Practical blood tests and interpretation

• Triglyceride:HDL ratio and HbA1c are practical, widely available predictors of cardiovascular risk.
• HbA1c reflects average glucose exposure via sugar attachment to red blood cells over ~120 days.
• Lab “normal” ranges mirror population distribution and can drift as population health worsens.
• Liver enzymes help flag metabolic dysfunction; interpret toward optimal health, not the average.
• Homocysteine can reflect malabsorption and B-vitamin/folate insufficiency.

Fatty liver, connective tissue, and pain

• Fatty liver raises matrix metalloproteinases, increasing connective-tissue breakdown and arthritis pain risk.
• Early weight loss often comes from the liver and reduces these enzymes.
• Around 10% body-weight reduction links to ~30–50% pain reduction in obesity-related arthritis.

References

• [00:12] Eggs in Early Complementary Feeding and Child Growth: A Randomized Controlled Trial — https://doi.org/10.1542/peds.2016-3459
• [00:43] Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review — https://doi.org/10.1136/bmjopen-2015-010401

• Brain and mental illness as brain-energy failure with mitochondria at the center.
• Metabolic syndrome, insulin resistance, and obesity drive neurologic and psychiatric decline; Alzheimer’s as “type 3 diabetes”.
• Stress and environmental load trigger migraine and other brain symptoms.

Clinical observation and clinical blind spots

• Subtle changes in mood, outlook, and behavior can precede recognized neurologic or psychiatric syndromes.
• “Clinical simultanagnosia”: item-by-item medicine misses the whole-person metabolic pattern.

Ketogenic / low-carb as a main lever

• Dozens of large weight-loss cases with rapid functional improvement; goal is brain-function recovery.
• Ketogenic metabolism overlaps with mitochondrial resilience, inflammation control, and neuroplastic support.
• Target conditions include epilepsy, headache disorders, cerebrovascular disease, multiple sclerosis, depression, and other psychiatric disorders.

Evidence and examples named in the talk

• JAMA 2018 risk-factor data: diet among the leading contributors to mortality and disability burden.
• Mild cognitive impairment: a blinded randomized controlled trial of a ketogenic medium-triglyceride diet improves Trail Making, verbal fluency, and naming, with higher cerebral metabolic rates.
• Multiple sclerosis: a positive pilot study is already available.

Comorbidity and system wiring

• Psychiatric diagnoses cluster; a “P factor” concept and multi-million-person data show strong cross-disorder risk links.
• Vagus-nerve pathways and noninvasive vagus nerve stimulation converge with metabolic approaches across headache and psychiatric domains.

Historical and anthropological notes

• Banting’s “Letter on Corpulence” anchors an early low-carbohydrate precedent.
• The Horus mummy findings include coronary-artery calcification; atherosclerosis is not exclusively modern.

Information growth and data reliability

• Medical knowledge growth outpaces clinician bandwidth; research reliability concerns remain.
• Clinical practice uses structured handouts, reading lists, and performance criteria to drive adherence.

References

• [00:04] Brain on Fire (10th Anniversary Edition): My Month of Madness — https://www.simonandschuster.com/books/Brain-on-Fire-%2810th-Anniversary-Edition%29/Susannah-Cahalan/9781451621389
• [00:07] The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States — https://doi.org/10.1001/jama.2018.0158
• [00:07] Letter on Corpulence, Addressed to the Public — https://www.gutenberg.org/files/57545/57545-h/57545-h.htm
• [00:07] Brain Energy — https://www.simonandschuster.com/books/Brain-Energy/Christopher-M-Palmer/9781637741580
• [00:32] Atherosclerosis in Ancient Egyptian Mummies: The Horus Study — https://doi.org/10.1016/j.jcmg.2011.02.002

Obscura VPN: censorship-resistant multi-hop design

What Obscura is for

• Reliable VPN connectivity in restrictive networks; daily-use UX; reduced reliance on any single party.

Base architecture

• Two-hop tunnel: client -> Obscura ingress -> Mullvad WireGuard egress; user traffic exits on Mullvad IP space.
• Ingress uses QUIC/HTTP/3-style traffic shaping so blocking looks like blocking major web services.
• Egress is standard WireGuard, so the last hop stays fast and widely audited.

Why QUIC fronting

• WireGuard handshakes are fingerprintable; DPI can block or throttle them.
• QUIC blends into common web traffic; the Great Firewall cost to block QUIC is high.
• Obscura can fall back to a “compatibility mode” using a plain WireGuard first hop when needed.

MASQUE and iCloud Private Relay relationship

• Apple’s iCloud Private Relay uses a similar two-hop relay idea with a second-party egress; Obscura generalizes the concept for arbitrary traffic.
• MASQUE (CONNECT-UDP / HTTP Datagrams over HTTP/3) provides a standardized way to tunnel UDP inside HTTP/3; Obscura built this stack in Rust/Go.

Trust separation and key handling

• Obscura cannot decrypt user packets after the QUIC layer because payloads are encrypted to Mullvad’s published WireGuard server keys.
• Users can verify the active egress via Mullvad’s connection-check page; correlation is possible only if parties collude.

Privacy stance

• “No logs” comes from architecture: ingress lacks plaintext visibility; egress is Mullvad; both sides are separated by design.

Client and platform support

• Native apps focus on macOS/iOS; WireGuard configs exist for other platforms with the same multi-hop path.
• Split tunneling is hard to do safely; per-URL routing can leak DNS/traffic patterns; work ongoing for safer patterns.

Comparisons

• Tor and decentralized VPNs target stronger anonymity but have exit-node trust and performance limits; Obscura targets everyday throughput with censorship resistance.
• OpenVPN is complex to audit; WireGuard’s smaller surface makes auditing more tractable.

Performance and operations

• Front hop adds overhead but keeps connections stable under loss and censorship; bare-metal performance aimed near line speed.
• Payment options include Lightning; Monero planned; Obscura pays Mullvad for egress capacity.

References

• [00:04] Bitcoin Core — https://bitcoincore.org/
• [00:04] Reproducible Builds — https://reproducible-builds.org/
• [00:05] WireGuard: Next Generation Kernel Network Tunnel — https://doi.org/10.14722/ndss.2017.23160
• [00:06] iCloud Private Relay Overview (Dec 2021) — https://www.apple.com/icloud/docs/iCloud_Private_Relay_Overview_Dec2021.pdf
• [00:06] QUIC: A UDP-Based Multiplexed and Secure Transport (RFC 9000) — https://doi.org/10.17487/RFC9000
• [00:11] iCloud Private Relay security — https://support.apple.com/en-sg/guide/security/secad8ce3233/web
• [00:12] MASQUE Working Group — https://datatracker.ietf.org/wg/masque/about/
• [00:13] HTTP/3 (RFC 9114) — https://doi.org/10.17487/RFC9114
• [00:14] Proxying UDP in HTTP (RFC 9298) — https://doi.org/10.17487/RFC9298
• [00:15] HTTP Datagrams and the Capsule Protocol (RFC 9297) — https://doi.org/10.17487/RFC9297
• [00:20] Mullvad Servers — https://mullvad.net/en/servers
• [00:25] Collateral freedom — https://en.wikipedia.org/wiki/Collateral_freedom
• [00:29] Mullvad Connection check — https://mullvad.net/en/check
• [00:31] Tor Project — https://www.torproject.org/

• Serious mental disorders have a metabolic component, including impaired bioenergetics.
• Ketogenic metabolic therapy uses dietary carbohydrate restriction to induce nutritional ketosis.
• Mitochondrial function and brain energy metabolism connect metabolic and psychiatric conditions.

Historical and evolutionary context for ketosis

• Fasting can induce nutritional ketosis.
• Long-duration fasting is used as historical precedent for ketosis-based treatment.
• A shift from traditional diets to modern processed diets is linked to a higher metabolic disease burden.
• Ketosis is positioned as a backup metabolic pathway when glucose availability is low.
• “Cancer without sugar the tumor can’t really grow” is stated.

History of ketogenic diet in neurology

• Early ketogenic-diet work at the Mayo Clinic is referenced.
• Wilder is referenced for early ketogenic diet use in epilepsy.
• A report is referenced in which ~75% of infants with refractory epilepsy stopped “fitting” on a no-sugar/no-carbohydrate diet.
• Expansion of antiepileptic medications is linked to a decline in ketogenic diet use.
• Ketogenic therapy is extended (in scope) from epilepsy to cancer, dementia, and psychiatric contexts.

Metabolic–psychiatric overlap in schizophrenia and psychosis

• Insulin shock/coma therapy is referenced as historical psychiatric treatment.
• Insulin shock therapy observations include higher insulin dose requirements in schizophrenia.
• A 2019 Harvard/McLean sibling study is referenced for insulin resistance in psychosis.
• Insulin resistance is linked to psychotic disorders in sibling/unaffected-family findings.
• Antipsychotic metabolic side effects are separated from intrinsic metabolic abnormalities in psychosis.

Metabolic–psychiatric overlap in bipolar disorder

• Historical observations are referenced for metabolic abnormalities in bipolar disorder.
• Kinal (2014) is referenced for insulin resistance in the brain in bipolar disorder.
• Insulin resistance is linked to bipolar disorder in the brain-focused study reference.

Mechanistic model: mitochondria, metabolism, and neurotransmission

• Mitochondrial dysfunction is used as a unifying model for diverse mental disorders.
• Ketosis is linked to altered glutamate/GABA system behavior.
• Ketosis is linked to reduced hunger and reduced carbohydrate cravings.
• Ketosis is linked to reduced inflammatory markers and oxidative stress markers.
• Glucose monitoring is used to evaluate metabolic shifts during intervention.

Prior clinical evidence and case reports referenced

• Chris Palmer case studies are referenced for psychiatric symptom changes on ketogenic diets.
• An open-label Stanford trial is referenced for ketogenic intervention in schizophrenia with an enrollment count in the low 20s.
• Judy Ford is referenced in connection with the Stanford work.
• Albert Danan (France) is referenced for psychiatric ketogenic work and engagement with Stanford work.
• A seminar paper is referenced with Iain Campbell and Ali Hon (Edinburgh).

North Queensland RCT: design and population

• A randomized trial compares ketogenic metabolic therapy with a guideline-based comparator diet.
• The comparator diet is the Australian Guide to Healthy Eating.
• The ketogenic intervention is a “well formulated ketogenic diet” aligned with a Volek protocol.
• Recruitment focuses on stable community patients rather than acute inpatient populations.
• Diagnosis eligibility includes schizophrenia and bipolar disorder.
• Vegetarian participants are eligible and vegan participants are excluded.
• Exclusion criteria include active substance use and other clinician-determined contraindications.

North Queensland RCT: delivery, adherence, and safety workflow

• Diet support includes weekly sessions of approximately one hour, predominantly face-to-face with some phone sessions.
• The intervention focus is diet change rather than medication change.
• A multi-disciplinary team supports delivery.
• Home cooking and supermarket shopping are required for participation.
• Participant expectations include effort and structure, with no “magic” solution.

North Queensland RCT: measurements

• Continuous glucose monitoring is used, including a 2-hour pre-dinner measurement timing rule.
• Blood ketones track ketosis, with a target range of ~0.5–3 and observed peaks around 4–5.
• Weight and body composition are tracked.
• Physical activity is tracked with a wearable device.
• Sleep is tracked with an Oura ring.
• Psychiatric rating scales include PANSS.
• Daily self-reports include mood and energy ratings via visual analog scales.
• Cognitive measures and biomarkers (including stool samples and hair cortisol) are included in the protocol.

Reported trial experience and preliminary outcomes

• Both diet arms produce some weight loss.
• The ketogenic arm is preferred by some participants relative to portion-control guidance.
• The comparator arm is experienced as difficult by some participants.
• Anecdotal reports include reduced anxiety and increased social engagement during ketosis.
• A case example includes long-standing auditory hallucinations resolving during the ketogenic period.
• Interim analysis is pending at the time of the talk.

References

• [00:02] The effects of ketogenic metabolic therapy on mental health and metabolic outcomes in schizophrenia and bipolar disorder: a randomized controlled clinical trial protocol
• [00:13] Impaired insulin signaling in unaffected siblings and patients with first-episode psychosis
• [00:19] Ketogenic diet intervention on metabolic and psychiatric health in bipolar and schizophrenia: a pilot trial
• [00:45] Metabolic Mind: Home

• Claude Haiku 3.5 (duck.ai)
• ChatGPT (openai)
• Google AI Mode (deep dive)

• Llama 4 Scout (duck.ai)
• GPT-OSS 120B (duck.ai)
• GPT-4o mini (duck.ai)
• GPT-5 mini (duck.ai)
• Google Search AI Overview
• MS Copilot
• Perplexity

Core thesis

• Atherosclerosis: arterial wall injury + inflammation + oxidative stress + microbial burden.
• Oxidation of lipoproteins: a required step for foam-cell formation and plaque growth.
• Dental plaque and coronary plaque: biofilm similarity with different locations.

LDL and diet–heart hypothesis

• High LDL levels: no compelling evidence for causal heart-disease linkage.
• Older cohorts: highest LDL strata with longest survival in 16/19 prospective cohorts (systematic review; >68,000 participants).
• INTERHEART: 72.1% of myocardial infarction cases with LDL <130 mg/dL.

Randomized diet trials with omega-6 linoleic-acid substitution

• Corn-oil supplement after myocardial infarction (1965): higher mortality and recurrent heart attacks in the corn-oil arm versus controls.
• Sydney Diet Heart Study: omega-6 linoleic acid substitution; higher all-cause and cardiovascular mortality.
• Minnesota Coronary Experiment: cholesterol reduction without mortality benefit; higher mortality signal in subgroup analyses.

Infection and biofilm biology

• Transient bacteremia: toothbrushing and eating.
• Periodontal pathogens: bloodstream access with vascular seeding and endothelial dysfunction.
• Porphyromonas gingivalis bacteremia model (pigs): recurrent IV challenge; coronary and aortic atherosclerosis lesions versus saline controls.

Thrombosis and microbial DNA

• Arterial thrombus: bacterial DNA present in 58% of samples.
• Streptococcus viridans: 42% of 121 thrombus specimens after sudden cardiac death.
• Von Willebrand factor: lowest 20% levels with 41% lower sudden cardiovascular presentation risk.

Oxidative stress triggers

• Hyperglycemia spikes: oxidative products persistence ~3 days; ~9× longer than spike duration.
• Tobacco smoke: large acute cardiovascular risk amplification.

Oxygen exposure in myocardial infarction

• Supplemental oxygen above ~94% saturation in non-hypoxic myocardial infarction: larger infarct size (~35%) and increased recurrent infarction signal in-hospital.

Coronary stenting versus medical therapy

• Stable coronary disease: coronary stenting strategy without outcome advantage over medical therapy in large randomized trials (2,287- and 5,179-patient trials).

Mitigation themes

• Insulin resistance reduction: dietary sugar and fructose reduction as a primary lever.
• Aged garlic extract + statin therapy: coronary calcium score progression 22.2% (placebo) versus 7.5% (garlic) over 12 months.
• Oral hygiene focus: hydroxyapatite toothpaste as a plaque-control option.
• Environmental oxidants: “forever chemicals” (PFAS) and chronic exposures as additive oxidative load.

References

Papers/Reports Named

• 00:04 — Yusuf S, et al. INTERHEART study (Lancet, 2004). https://doi.org/10.1016/S0140-6736(04)17018-9
• 00:05 — Ramsden CE, et al. Sydney Diet Heart Study recovered data (BMJ, 2013). https://doi.org/10.1136/bmj.e8707
• 00:06 — Ramsden CE, et al. Minnesota Coronary Experiment recovered data (BMJ, 2016). https://doi.org/10.1136/bmj.i1246
• 00:05 — Rose GA, et al. Corn Oil in Treatment of Ischaemic Heart Disease (BMJ, 1965). https://doi.org/10.1136/bmj.1.5449.1531
• 00:12 — Brodala N, et al. Porphyromonas gingivalis bacteremia induces coronary and aortic atherosclerosis in pigs (ATVB, 2005). https://doi.org/10.1161/01.ATV.0000167525.69400.9c
• 00:22 — Stub D, et al. AVOID trial: oxygen in STEMI without hypoxia (Circulation, 2015). https://doi.org/10.1161/CIRCULATIONAHA.114.014494
• 00:41 — Boden WE, et al. COURAGE trial (NEJM, 2007). https://doi.org/10.1056/NEJMoa070829
• 00:48 — Budoff M. Aged garlic extract retards progression of coronary artery calcification (J Nutr, 2006). https://doi.org/10.1093/jn/136.3.741S
• 00:50 — Lustig RH, et al. Isocaloric fructose restriction and metabolic improvement in children (Obesity, 2016). https://doi.org/10.1002/oby.21371
• 00:43 — Pessi T, et al. Bacterial signatures in coronary thrombus aspirates (Circulation, 2013). https://doi.org/10.1161/CIRCULATIONAHA.112.001254

Surveillance, timing, and predictability

• Influenza deaths rise and fall in a consistent seasonal pattern.
• Peak weekly influenza deaths occur about 1–3 weeks after the shortest day of the year.
• Southern hemisphere timing mirrors the northern hemisphere; Australian peaks occur about 1–3 weeks after June 21.
• UK surveillance values at the timepoint shown: influenza A positivity 0.5%, influenza B positivity 0.1%, all influenza positivity 1.9%, influenza hospital admissions 0.6 per 100,000, influenza deaths 0.0 per 100,000.

Latitude and solar exposure relationships

• Latitude alignment matches the seasonal rise and fall of influenza and influenza-like illness.
• A Europe-wide timing relationship is tied to the day when UVB falls below 34% of equatorial UVB; correlative constant 0.9993.
• Temperature and humidity are not aligned with the timing relationship in the Europe analysis segment shown.

Sunlight, influenza, and pandemic timing example

• Higher sunlight is associated with lower influenza incidence in the US sunlight analysis segment shown.
• The fall 2009 H1N1 period is the main driver in the sunlight–influenza relationship segment shown.
• 2009 influenza activity increased in late summer/early fall despite warmer ambient temperatures.

Solar radiation and COVID-19 mortality relationship

• Higher solar radiation is associated with lower COVID-19 mortality in US, England, and Italy in the segment shown.
• The COVID-19 mortality association is independent of a vitamin D pathway in the segment shown.

N-acetylcysteine (NAC) trial result

• A 262-subject multicenter randomized placebo-controlled trial used NAC 600 mg twice daily for 6 months.
• Among infected participants in the trial segment shown: symptomatic illness 25% with NAC vs 79% with placebo.
• NAC is over-the-counter in the segment shown.
• Influenza kills tens of thousands of people in the United States in the segment shown.

References

• Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment — https://doi.org/10.1183/09031936.97.10071535
• Sunlight and Protection Against Influenza — https://doi.org/10.1016/j.ehb.2020.100942
• Ultraviolet A radiation and COVID-19 deaths in the USA with replication studies in England and Italy — https://doi.org/10.1111/bjd.20093
• Autumn COVID-19 surge dates in Europe correlated to latitudes, not to temperature-humidity, pointing to vitamin D as contributing factor — https://doi.org/10.1038/s41598-021-81419-w
• Influenza-associated mortality in Australia, 2010 through 2019: High modelled estimates in 2017 — https://doi.org/10.1016/j.vaccine.2021.11.019
• A geographical approach to the development of hypotheses relating to Covid-19 death rates — https://doi.org/10.32794/mr112500132 ... Server is misconfigured, but it should get fixed "eventually"
• Weekly US Influenza Surveillance Report: Key Updates for Week 53, ending January 3, 2026 (CDC) — https://www.cdc.gov/fluview/surveillance/2025-week-53.html
• National flu and COVID-19 surveillance report: 8 January 2026 (UK) — https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2025-to-2026-season/national-flu-and-covid-19-surveillance-report-8-january-2026-week-2