Michael R

There's quite a bit on this, specifically on AD, including multiple studies in transgenic AD mouse models and reductions in Abeta in nonhuman primates (PMID 17183154). That's certainly true in some cases, like the Morris water maze, but there are plenty of other studies that don't involve physical condition at all — the extreme case being a standard contextual memory test that measures whether the mice freeze up when exposed to a stimulus they (should) have learned to associate with a coming shock. Your memory of the literature is failing you — perhaps because you quit CR 😉 . Steven Spindler proved that this wasn't true if CR was done properly in 2004: https://www.pnas.org/doi/full/10.1073/pnas.0305300101 ... and has subsequently been independently confirmed in numerous other studies by other groups, such as: https://doi.org/10.1016/j.cell.2020.02.008 https://doi.org/10.1109/IEMBS.2007.4352809 https://doi.org/10.1093/cvr/cvq273 https://doi.org/10.1038/s42255-019-0121-0 I certainly agree that CR is much riskier when started in older adults, and granted that CR is already an experimental and risky intervention when started in young people, starting it at advanced ages would have to be considered very carefully indeed. Additionally, today there are numerous pharmacological options with a lower level evidence than CR but still good evidence as potential anti-aging interventions that don't have as many known risks to older adults.

Obviously, this was a high-risk, older group; however, there's room for improvement by further reducing sodium intake and starting younger.

That's a reasonable question. However, there's evidence that high-salt diets not only increase BP in the near term, but are major drivers of the age-related increase in BP — so even if your BP is low now, eating a lot of salt might set you up for higher (thus, more damaging ) BP later on. There's additionally some evidence for direct negative effects on angiotensin II signaling etc, but that's a bit too mechanistic to hang hats on. Yes — and that high sodium intake is thought to be the reason for their disproportionately high risk of stroke (granted otherwise-low CVD risk factors, high fish intake, and expectedly-low MI risk), and for their higher contribution of vascular dementia vs. AD in the West.

The subjects increased their energy intake from baseline by 79 Cal on the Med diet, but decreased it by 500 Calories on the vegan diet. Consistent with that, the subjects were weight-stable on Med, but lost 6 kd (13.2 lbs) on the vegan diet. The metabolic changes are consistent with weight loss. It's not clear that there was any specific effect of the diet being either low-fat or vegan, let alone the specific presence or absence of EVOO. Also, "Participants were asked to use extra virgin olive oil instead of other fats or oils" on Med, but no food was provided or specific brands endorsed in the study: presumably they thought they were buying EVOO, but who knows what they were actually consuming (or if, were it EVOO, it contained decent levels of phenolics). And most importantly, there were no hard outcomes in this study, whose presence is a major strength of PREDIMED.

It's indeed a high bar to clear (though, in fact, few foods can meet it and it's arguably too high: what's your justification for eating zucchini, for instance?), but EVOO has quite successfully passed it, as documented earlier.not just from risk factors but from actual events, as documented near the beginning of this thread.

Edward has put the issue well: assuming it translates, you enter into a slower-aging mode on CR, so the earlier you start, the biologically younger you'll be at any age going forward. If CR slows your aging rate 20% and you start at 36, then at age 86 chronologically you'll be 76 biologically; if you wait until age 50, you'll be biological 79 at chronological 86 — three years older, and three years closer to age-related death (and have 3 years less to benefit from any real anti-aging therapies that are developed late in the game). This figure is now rather old and thus omits some of the newer and better studies, but: Merry BJ. Molecular mechanisms linking calorie restriction and longevity. Int J Biochem Cell Biol. 2002 Nov;34(11):1340-54. Review. PMID: 12200030 [PubMed - indexed for MEDLINE]. Data are derived from 24 rodent lifespan studies.

No wonder SCIENCE is scorned! Otherwise-intelligent people believe what they read in highly-slanted, dishonest low-fat vegan blogs instead of actually reading the scientific papers those blogs falsely claim to summarize. I addressed this "crappy control diet" nonsense in my major post on extra-virgin olive oil and health, including PREDIMED: begin at "And the results can't be argued to be the result of a crappy control diet" etc.

Hi Tom, First, this appears to be your first post: welcome. Yeah, I have the same problem with copper. I've had no real success lowering it, and I do think this is an issue — see my thread on supplementation for vegetarians/vegans. I use the quite imperfect solution of supplementing a full RDA of zinc (as picolinate, which appears to be superior tho' it's not clear; citrate may also be a very good choice). I also get close to 3x RDA of iron, but I don't worry about that too much: it's all 'vegan' iron, its bioavailability is low, and I get blood tests to ensure that my iron stores are low-normal. The latter is the main thing (which everyone should be doing anyway): get tested annually for (at least) ferritin, and at least once and occasionally thereafter do Transferrin and Iron-binding Capacity (TIBC, UIBC), to make sure your iron stores are low-normal. (If you've been genetically tested, you may know about Wilson's disease and hemochromatosis, respectively).

Dean, I've just come across this thorough and masterful demolition job, following a link I've just seen today via Iporuru. Very good work; thanks!

Meanwhile, you evidently are "satisfied" by tiny, non-randomized and sometimes non-controlled studies involving low-fat diets with no hard outcomes and often confounded by things like smoking (Ornish, Esselstyn (sp) etc). It is a puzzlement.

... an 'objection' covered in my original post, of course ...

A narrow metabolic study involving a single administration of , ~1.18 g/kg oil (=88.5 g of oil in a 75 kg adult person, ≈6.6 tablespoons) of a canola oil (not even refined olive oil, let alone high-phenolic fresh EVOO) can't be held up against a mountain of high-quality prospective epidemiology and two large-scale randomized controlled clinical trials — particularly when that body of evidence specifically shows the benefit of EVOO in preventing and ameliorating the course of diabetes. Please stop wasting time with this shite.

This reasonably narrow question got spun off into a whole discussion about the healthfulness of EVOO per se, with a bunch of random half-relevant assertions and data points ... please see here on EVOO as supreme health food (my post of July 3 — I would expect the main thing Gordo originally had in mind when linking the thread) and stop making assertions on lower-grade evidence. Closer to the core question, see my post on EVOO freshness, storage, and cooking.

This seems pretty strong evidence against BAT being an important driver of retardation of aging by CR, since (despite one odd one-off study) it's well-established that more severe (in some cases up to ≈55%) CR is dose-dependently more effective than less severe CR. This certainly makes sense. It's also a reminder of something I've said before and should get more care in this thread: that mere induction of genes is an inadequate indicator of fat browning. There should be data on the target proteins, and preferably on the actual phenotype of the fat and/or experimental subject. Dean, it would help if you would tare down your list to things that at least meet this criterion, and preferably tag off those shown effective in humans. That's certainly one possibility, although there are many others. And anecdotally, I'm of course extremely slim, doubt I have more than a tiny shred of BAT on my skinny ass (or subscapula ;)), but when actually put to OGTT rather than surrogate markers, I have excellent glucose tolerance — and that, when there's a rationale for which I probably ought to be tested with a lower dose of glucose to be metabolically meaningful. [1] Aging Cell [28 Mar 2019, 18(3):e12948] DOI: 10.1111/acel.12948 Long-term caloric restriction ameliorates deleterious effects of aging on white and brown adipose tissue plasticity. Corrales P 1 , Vivas Y 1 , Izquierdo-Lahuerta A 1 , Horrillo D 1 , Seoane-Collazo P 2 , Velasco I 1 , Torres L 1 , Lopez Y 1 , Martínez C 1 , López M 2 , Ros M 1 , Obregon MJ 3 , Medina-Gomez G 1 (PMID:30920127 PMCID:PMC6516146) --------- [2] Aging Cell. 2012 Dec;11(6):1074-83. doi: 10.1111/acel.12010. Epub 2012 Oct 24. Aging leads to a programmed loss of brown adipocytes in murine subcutaneous white adipose tissue. Rogers NH(1), Landa A, Park S, Smith RG. DOI: 10.1111/acel.12010 PMCID: PMC3839316 PMID: 23020201 [Indexed for MEDLINE] -------- [3] Age (Dordr). 2010 Mar;32(1):97-108. doi: 10.1007/s11357-009-9118-z. Epub 2009 Nov11. Effects of long-term calorie restriction and endurance exercise on glucose tolerance, insulin action, and adipokine production. Fontana L(1), Klein S, Holloszy JO. DOI: 10.1007/s11357-009-9118-z PMCID: PMC2829643 PMID: 19904628 [Indexed for MEDLINE]

If you spend a moment looking at the thread subject and the line of discussion, you'll see that these interventions are intended to increase brown adipose tissue mass and/or activity, "for increased health and longevity" — not strength and muscle mass gain.strength and muscle mass gain. I'm aware of no evidence that testosterone injection will affect any of this. Can you point to any? Indeed, barring any other changes, effective interventions on this front might well modestly decrease strength and muscle mass, simply because of energy balance. Your post might giv epeople the impression that you're here to sell steroids; if so, you need to revise your marketing analysis 😉 .

I don't think anyone ever suggested that dilute vinegar or peroxide was any good for either microbes or pesticides: I use these less than I used to, but I use them at full off-the-shelf potency, with a misting spray bottle or (rarely) by swishing during immersion. (I don't do this with things like berries, however, as it's hard to get the taste out and they sometimes exacerbate damage to the fruit).

Good God, McCoy! You're a beast!

All: in a post in another thread, I noted: Certainly, both the epidemiological evidence within Mediterranean countries where olive oil is used in meaningful quantities, as well as now large-scale clinical trials, demonstrate that plant-based MUFA, and especially real extra-virgin olive oil (or, though less celebrated, canola) reduces cardiovascular events and mortality, likely total mortality, and mortality from some cancers. A recent report supports this specifically for CVD risk, without even narrowly specifying olive oil (let alone high-phenolic EVOO):

You're being unreasonable here in all kinds of ways, including notably foregoing a well-established benefit for a purely hypothetical risk (which is like a caricature of the precautionary principle, which is to be cautious in the face of preliminary evidence of risk). But as regards the above: again, in a typical year the vaccine is roughly 59% effective. How "dramatically" could it improve? I suspect that Karl has already dug much of this up, but on the subject of vaccine effectiveness: I've posted separately about the Dreem headband, an auditory closed-loop system for enhancing slow-wave sleep (SWS):

Another Reminder that BMI is a Shitty Measure of Anthropometry Another problem with the BMI epidemiology is that it poorly captures the actual anthropometry of individuals: is this BMI 23 person lean and fit, or is s/he loaded with visceral fat related to South Asian heritage? Is this BMI 27.5 person bearing fat inside and out, or is he Lebron James? This study is one of several to instead look at measures of (or more directly linked to) body fat than simple body weight, and one of the few that does so while also having genuinely long-term followup (eliminating the problem of the long period of weight loss preceding death from diseases of aging) and looking at true never-smokers (rather than ex-). Lo and behold, less and less fat is good, all the way down: ... and here are the data for men for BMI in lifelong nonsmokers and in people without pre-existing comorbidities: References 1: Iliodromiti S, Celis-Morales CA, Lyall DM, Anderson J, Gray SR, Mackay DF, Nelson SM, Welsh P, Pell JP, Gill JMR, Sattar N. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J. 2018 May 1;39(17):1514-1520. doi: 10.1093/eurheartj/ehy057. PubMed PMID: 29718151; PubMed Central PMCID: PMC5930252. https://academic.oup.com/eurheartj/article/39/17/1514/4937957

So first: Karl bounced his fasting-as-natural-mTOR-inhibitor-so-see-PMIDs 29997249 & 25540326 idea: at the time, I thought (and still think) it's damned clever, but thinking more on it I'm not sure how to operationalize it,nor run a feasible clinical trial without a whole bunch of prior work. The problem is that while we have evidence that people on chronic CR have inhibited mTOR signaling (PMID 26774472 — consistent with the mice — as usual ;) ), I'm not aware of any good data on the time-course of mTOR suppression in different tissues upon initiation of fasting, let alone the more specific intermediates you'd want to see to replicate the mice (improved HSC function leading to increased production of naïve T-cells). Longo reported (PMID 26094889) that after a cyclical 5-day fasting-mimicking diet, "Although not significant, the percentage of [mesenchymal stem and progenitor cells (MSPC)] in the peripheral blood mono-nucleated cell population showed a trend (p = 0.1) to increase from 0.15 ± 0.1 at baseline to 1.06 ± 0.6 at the end of FMD, with a subsequent return to baseline levels after re-feeding." So without further work, I don't know that it'd be worth it to try this: conceivably, if you do it too soon or too late, you might miss the potentially beneficial shifts in MSPC output (and thence hypothesized increase in naïve T-cells), or the energy deficit or other metabolic changes might counteract such a benefit. Subjects in Mannick's first trial were administered everolimus "0.5 mg daily, 5 mg weekly, or 20 mg weekly... for 6 weeks ... and, after a 2-week drug-free interval, were given a 2012 seasonal influenza vaccine", and a similar protocol in the second, ± resTORbio's BEZ235/RTB101. Second: I strongly urge people to get the flu shot. Aside from the general principle that some risk reduction is better than none (added on, of course, to all the other stuff you may do to protect yourself), at next to no risk (vide infra), and the fact that vaccines may work better in us (based on PMIDs 26774472 (mTOR inhibition in chronic human CR) and PMID 2071828), whereas CR folk may be at greater risk if they do contract flu (discussed many times before — studies by Christine Gardner and others), and the fact that neither the individual trials nor the meta-analyses capture the benefit of the residual immunity from being vaccinated one year that carries over into subsequent years — aside from all that, folks are forgetting that the individual vaccinee isn't the only person at risk. By lowering your own risk of the bug taking hold in you, you're reducing the risk of transmission to others, including the vulnerable immunosenesced elderly, young children (who are at elevated risk of serious flu-related complications), people with immune deficiencies (HIV/AIDS, congenital disorders, people who have just had their bone marrow ablated for cancer, etc etc). Each of us needs to step up to protect all of us. Yeah: there is prior work, but it's all in mice, alas. The incentives are not well-aligned for clinical trials of dietary supplements, alas. Because we track side-effects in clinical trials, silly ;) . Gordo listed them; they're quite minor.

... if there is zero cadmium in the rest of your diet, which is certainly not the case. Per this report, eg, the median intake of Cd in France is already 0.3 μg/kg/d for adults. And you probably get more Cd than average. Per the ASTDR, "age-weighted mean cadmium intakes of 0.35 μg/kg/day for males and 0.30 μg/kg/day for females were calculated for U.S. nonsmokers. In general, vegetables, particularly leafy vegetables such as lettuce (0.051 mg/kg) and spinach (0.124 mg/kg), have the highest concentrations of cadmium; the concentrations of cadmium in all vegetables ranged from 0.001 to 0.124 mg/kg (FDA 2010; Morrow 2001). Peanuts, soybeans, and sunflower seeds have naturally high levels of cadmium (Morrow 2001); the mean concentration of cadmium in legumes and nuts ranged from 0.001 to 0.054 mg/kg (FDA 2010). People who regularly consume shellfish and organ meats (liver and kidney) have an increased risk of cadmium exposure, as these organisms tend to accumulate cadmium (Elinder 1985a). " It's a regulatory decision, not in the legislation, if you meant that literally. In the link I gave, they link the regulation. See 3.2.7, "Specific cocoa and chocolate products".

First, the EU are happily on top of this, and have established limits for cadmium specifically in cacao and cacao products, on top of the maximum levels for cadmium in foods generally that have existed since 2001. Starting on January 1, 2019: (a mg/kg is the same as a ppm, for all intents and purposes). Additionally, Prop 65 legal settlement is also about to bring in a de facto new industry standard for lead and cadmium in chocolate in California, and therefore likely in the USA. "The settlement establishes complex requirements regarding investigation of both the natural and man-made sources of lead and cadmium in chocolate, as well as evaluation of feasible measures to reduce such levels. This work is to be undertaken by a committee of experts chosen by the initial parties to the settlement, pursuant to a fairly aggressive timetable which can be modified if circumstances so warrant. The expert committee, which must conduct its work on a “consensus basis” rather than by majority vote, also is required to determine the concentration of lead and cadmium in chocolate products, above which a warning is required." But if no conclusion is reached, some default limits will go into effect, depending on the percentage of cacao solids: for products ≥95%, these would beset at 0.800 ppm for Cd and 0.200 ppm for Pb by 7 years after the December 2017 settlement date. https://grimaldilawoffices.com/proposition-65-settlement-may-establish-new-industry-standard-lead-cadmium-chocolate/ I've gone around and asked a variety of suppliers of organic cacao nibs for CoAs for cadmium and lead in their products, to varying degrees of success — and with some questions about the entire process. In brief: I contacted six companies and asked them for CoAs for cadmium and lead in their products. One got back to me with a CoA immediately; three got back to me within 36 hours; one said they would get me a CoA, but dragged the process out over three days and ultimately only provided summary information from 2016; and the last one said they would send one after confirming that I was not a competitor, but have not followed up and don't seem to be answering the phone. Nuts.com, from whom I've been buying nuts and other products for many years now, were extremely disappointing: I asked them for a CoA, and they initially sent me a booklet on all their quality procedures, including internal GMP and customer complaint procedure. It's good that they have this, but it was not at all what I asked for. I pressed them on this, and was told that "Due to recent changes in our policies and procedures, we do not provide COA's for orders under a certain price point. ... The document you received should contain all the information required by law including our letter of guarantee. In addition, all of our customers are welcome to conduct their own 3rd party testing [!!}" It shouldn't matter if I'm ordering a pound or a metric ton: a responsible and transparent company conducts testing on every batch of raw material that they order, match source material with the lot numbers for their product as sold to consumers, and provide CoAs on request. Viva Naturals was quite transparent: customers asked questions on their Amazon page in 2015 (twice) and 2017, and in all cases they responded (with specific numbers in 2015, and with their general standard in 2017). I emailed them to ask for a CoA and was promptly sent one: it was a third-party CoA with the lab disclosed as well as a clear published method ICP-MS (AOAC 2013.06), with Cd of 0.53 ppm and Pb of <0.02 ppm. I also got good results from Terrasoul: asked about Cd by a customer on their Amazon page, they said " We extensively test and 3rd party lab test for heavy metals. These results are available upon request by contacting us through our site." I did so, and was indeed sent a third-party CoA, with method specified (though only to say it was ICP-MS), and similar reasonably low levels (though nominally slightly higher than the forthcoming EU or Cd — again, see below before freaking o): Cadmium (ICP-MS) 0.824 ppm, Lead (ICP-MS) <0.005 ppm. I should note that they advertise this to be Criollo cacao, which is supposedly tastier, but has also been reported to have lower phenolic levels than other cultivars. By phone, Super Good For You Foods said that their Cd and Pb levels were present only at very low trace levels, but initially refused to send a CoA, on the basis that doing so would reveal their supplier and thus threaten their business. This may be revealing in itself, since the most likely reason a supplier would be on a CoA would be if the CoA were supplied by the supplier, rather than done by an independent lab hired by the purchasing company. After a bit of back-and-forth, they agreed to send me a CoA with the supplier name blacked out. It took a while, for some reason, but they did get back to me by the end of the next day with a CoA — of sorts. The document is clearly not an original, but a summary document, which is not that big of a deal if you are willing to trust that they didn't just make it up. It also says "A representative sample from the lot listed below was used for this analysis," but then under "LOT #" says "Sample"! But it's dated for April, so it's at least current, and the actual information seems good: it has all the info you'd expect to see on a CoA (other than the circular-reasoning lot number) and some that you wouldn't necessarily expect but are nice to see. In terms of the subject of this post, they report 0.320 ppm Cd and 0.027 ppm Pb, both by ICP-MS (specific methodology not referenced). Wilderness Family Naturals was a bit of a shaggy dog story. They openly list on their own website: Raw Certified Organic Cacao Nibs, Fermented 3/21/2016 Arsenic <0.049 ppm Cadmium 0.689 ppm Lead <0.049 ppm Mercury <0.02 ppm Raw Certified Organic Cacao Nibs, Non-Fermented 3/21/2016 Arsenic <0.049 ppm Cadmium 0.689 ppm Lead <0.049 ppm Mercury <0.02 ppm These are not bad numbers, but they're two years old — and they're giving the same numbers for two different products, which is either an error or, um, well ... So I phoned and asked for current CoAs for both. When I didn't hear back almost 48 h later, I emailed them to follow up. The next day, they sent me links for two files. Unfortunately, they were links to their Slack workspace, which is of course an internal site for which you need an administrator-authorized login, which I didn't have and which I'm sure they'd not've given me. I pointed this out, and their rep apologized and sent me a single image file — with the exact same information already on their website! Pressed on the point, I got "Our most current heavy metal testing for nibs can be found on the website in each product's respective page. This is the only information that we can provide at this time ." Finally, I looked at Raw Food World. A (former?) vendor had given the following two inconsistent replies to customer questions: * * * * * * * * * * * * * What is the cadmium level and when and who tested it? A: We had it tested against the other top raw cacao products on the market and ours had the lowest lead and cadmium there is. By EcuadorLiving on December 27, 2015 Q: If the lead and cadmium levels are low why is the california warning sticker on the package? these are the best cacao nibs i have ever had. i would ha A: This is known as Proposition 65 label required by law. By EcuadorLiving on July 18, 2017 * * * * * * * * * * * * * Of course, if they actually had "the lowest lead and cadmium there is," they wouldn't need a Prop 65 label. Their own website's product page says "it has a very low lead count, unlike many other cacao products on the market today", but nothing about cadmium, and nothing quantifying what a "a very low lead count" is. Despite this, they have a defensive page on Prop 65 with a lot of the usual whining, including the somewhat disingenuous statement that "Proposition 65 contains a unique "citizen lawsuit" provision. That means private citizens can file lawsuits against businesses they claim aren’t fully complying with the law—regardless of whether or not that’s true." Of course, citizens can file lawsuits whether or not their claim is well-founded (and some such suits are indeed poorly-founded), but you only *win* if you have good evidence on your side. In any case, there's an image on the page that seems to show their cacao nibs to have low lead levels compared to some other foods, though it's per serving side rather than per gram: A serving is 28 g, so this seems to suggest something like 1 mcg/28 g = 0.036 mg/kg. The Prop 65 "safe harbor" levels (No Significant Risk Levels (NSRLs) for Carcinogens and Maximum Allowable Dose Levels (MADLs) for chemicals causing reproductive toxicity ) are 15 mcg and 0.5 mcg/d, respectively: it appears that even one serving of this product puts one above the MADL, though one would have to take in significant amounts from other sources to reach the NSRL (though other risks for lead exist other than these two). So, yes, they need a warning label. They proved to be difficult to reach by phone: they were usually either on the phone or only had voicemail, and it's a generic voicemail message at that. When they finally responded, they assured me that they had very low Cd & Pb in their product. To send me a CoA, however, they wanted me to contact them via their online form with an email address (rather than just asking me for such), after which they said they would email me a form to certify that I was not a competitor, upon receipt of a signed copy of which they said they would send a CoA. Now, if they have the data and it's not sky-high, why would it matter if I was a competitor? And why put anyone — especially a potential customer, but even a competitor — through so many hoops? If they have über-low heavy metal levels (in which case, again, they wouldn't need a Prop 65 label), they ought to be proud to send it to anyone who asks: "Take that, Natural Foods Wonderland!!!" Days and days later, after additional emails and voicemail messages, nothing has been forthcoming. One more. I didn't contact them, but in response to a customer asking "What is the cadmium and lead levels in the bean and are they less or more than in the powder?", Healthworks didn't actually address the question, but directed them to a gernal statement about cadmium being naturally present in cacao and "at levels low enough for safe consumption according to the U.S. food and Drug Administration's guidelines." They were a bit more transparent but still defensive when asked "Why does this product have california proposition 65 safety warning. are ingredients not listed to require the prop65?" Reply: "Companies are required to place a warning label on any product ... if it exceeds the level that the State has established as risk free for a list of over eight hundred chemicals. ... The lead standard in California is more stringent than what is required at the U.S. Federal level, and by ... Canada and the European Union. A lot of research is being done on why chocolate products can contain high levels of cadmium and sometimes lead. Cadmium is a naturally-occurring element that can be present in soil. This means traces of it will be transferred to crops. Nevertheless, we do routinely have our products tested for heavy metals to make sure they are within the limits set by the FDA." However, customer reviews for Healthworks say "Consumer lab has just published it's review of cacao products and out of the 41 products they reviewed, Healthworks cacao powder had the 3rd highest levels of cadmium at 24.9 µg per serving." (By kgmedicine on July 17, 2017) and "ConsumerLabs tested these and found high levels of cadmium- 24.9 mcg cadmium per serving (1.8 mcg per g)! ... This is why Healthworks Organic Cacao comes with a Prop65 warning, and other cacao nibs such as Viva do not." (Narrowrd on March 15, 2018) The Problem with ICP-MS A significant fly in the ointment of all of this is that the ICP-MS methods that are apparently widely used for this purpose are apparently not very reliable: For now, I think it's best to take people having done ICP-MS testing as a sign of someone trying to do the right thing, and that the stuff probably is reasonably good if it comes in the ballpark of the EU standard, but to basically laugh off differences of a few tenths of a ppm between suppliers (which you should probably do anyway, since they're all done at different labs and only one of my three 'hits' above actually tell you they're using a published methodology). ... And the Usual Greger Mendaciousness I see that Greger has once again taken the opportunity to mislead his readers on a subject of interest (in this case, cadmium exposure) in order to sell them on a vegan diet. He says From reading that, you'd think he was talking about a study that had actually tested "exposure," and that their study involved some semblance of “a real situation.” in fact, this was an in vitro "digestion" model with colorectal adenocarcinoma cells. He also asserts that "Researchers have concluded: “Even if a vegetarian diet contains more lead and cadmium than a mixed diet, it is not certain that it will give rise to higher uptake of the metals, because the absorption of lead and cadmium is inhibited by plant components such as fiber and phytate.” Now, the fact that the quote says "it is not certain" but Greger says "Researchers have concluded" already tells you he's trying to frame something as a more definitive claim than the researchers themselves were making. This might not be that big a deal: sometimes researchers will find evidence of X, but be cautious about drawing a firm conclusion because of the limits of their study (for instance, an associational finding that they don't want to claim is causal without actual controlled experimental data). But that's not what was going on in this case. Here, when the scientists wrote "Even if a vegetarian diet contains more lead and cadmium than a mixed diet, it is not certain that it will give rise to higher uptake of the metals, because the absorption of lead and cadmium is inhibited by plant components such as fiber and phytate," it wasn't intended as even a tentative conclusion: it was the hypothesis that they were testing — and their results failed to support it! "There was a large inter-individual variation in faecal elimination of lead and cadmium during both the mixed-diet period (range 14 to 118, median 31 micrograms Pb/day; range 4.5 to 21, median 12 micrograms Cd/day) and the vegetarian diet period (range 19 to 136, median 42 micrograms Pb/day; range 6.1 to 24, median 14 micrograms Cd/day). There was a tendency towards increased faecal elimination of lead and cadmium following the change to the vegetarian diet, but the differences were not statistically significant." To be fair, there is some evidence that veg(etari)an diets may lower Cd body burden: here and here. On the other hand, in a study in Norway, while "Vegetarians had lower levels of Hg and Sb compared to omnivores ... [with] No differences ... between vegans and vegetarians", the vegetarians' blood cadmium levels were the same or possibly higher than omnivores (1.7 vs. 1.5 nmol/L blood, NS).

I agree, not high priority. [...] Controversies remain, but the emerging scientific consensus seems to be that Lp (a) is an independent and likely causal risk factor for CVD and CAVS. (My last name is not "Ray"). The question isn't whether Lp(a) is causally involved (tho' I don't think there's actually a consensus on that point either), but whether the test both meaningfully adds information about risk, and that steps taken lower measured Lp(a) values reduce risk — and that it adds incremental value to what can be determined and acted upon from established risk factors. There is certainly no consensus to that effect: neither the American Heart Association, nor the Canadian Cardiovascular Society, nor the European Society of Cardiology, or the American College of Cardiology, nor the US Preventive Services Task Force have thus far endorsed it as a primary screening test. The European Society of Cardiology guidelines say: Similarly, the Canadian guidelines suggest that "Measurement of Lp(a)might be of value in additional risk assessment in individuals with a family history of premature vascular disease and familial hypercholesterolemia." The American Heart Association/American College of Cardiology joint Guidelines say that ... and the USPSTF says: Now, only the European guidelines are very recent (USPSTF is from 2009), and all of these guidelines will be revised in future as more evidence accumulates — but as of now, the consensus is that Lp(a) is not a useful test for low-risk or asymptomatic adults.

All: I would get fasting insulin and glucose in addition to HbA1c. IGF-1 is important for people on CR, but you need to combine it with IGFBP-3. Hcy is important if you're vegan; as Mech indicates, your folate intake is likely fine if you eat a lot of veggies. Zinc is important for veg(etari)ans, but like most minerals, measuring serum levels tells you nothing about functional status. Similarly, serum calcium and magnesium are uninformative. Serum selenium levels may be useful for Europeans, who often have low Se intake, tho' they're generally useless for North Americans, whose Se levels are almost always adequate. "Lipid" (by which I take it Sibirak means "lipoprotein") particle size is at best a surrogate for LDL particle number, as explained here . If your insulin, fasting glucose, HbA1C, LDL-C and (especially) triglycerides are in the average range, you likely don't need any of these tests; if you're going to get one, get either apoB or NMR LipoProfile (LDL particle number), but not both — and then track the same value over time. HDL particle number/size are not ready for prime time. Adiponectin, lipoprotein (a),and apolipoprotein A1, and fibrinogen are all expensive, fancy-shmancy tests, of little use to most people: I certainly wouldn't put them on the high priority list without some specific reason to do so. You can ignore DHEA-s: it was on the CRS list originally because of some early data from the BLSA and the nonhuman primateas suggesting that it might be a biomarker of aging, but that's all fallen apart. IF you're on CR (I take it you're not, McCoy) and are male, testosterone is a good idea, but you really want testosterone by LC/MS-MS: Life Extension offers LabCorp's test #070038 for $48, but you can't order it online: have to call in and ask the blood lab for it. If you're on CR, get T3 and rT3 in addition to TSH.