🐊ZK For Tre🐊

@jonatanpallesen Measurement artifact or real finding? Seems hard to believe on a pure prevalence basis that this degree of change could happen this rapidly

The proportion of high-IQ people in the world is declining fast.

This has become very sad, very fast. It’s clear you need this one, so good on you. Next time I’m at a conference, I’ll be sure to tweet vaguely about protein, and I’ll know that you will have a priori made a carve out for protein supplements— but not just any source… exclusively whey.

@ZKForTre Bro is wrong here too, per Gemini

Fiber is the counter-culture wellness target? I wasn’t aware big psyllium had established such a beachhead. Also, big psyllium has some prominent citations it would like to highlight.

@maxlugavere @ProFactchecker Did I ever use the term majority? Can you screen shot it?

@ProFactchecker @ZKForTre My tweet stands. And per Gemini, psyllium is not a majority share of the fiber market. So bro is wrong there too 😬

That anyone can type this out and not be able to think “damn, i am spinning” is a casualty of the social media age, but you definitely have been consumed by it. Notably, my response was rooted in one primary point— one which you’ve taken significant effort to not interact with at all to this point. I’ll let the people decide which case looks better here.

@ZKForTre You’re ignoring context and ignorant of the “expo” which is the largest wellness product expo in the world. Your ignorance on both counts is not my problem Foods today are fortified with fiber supplements left and right You’re always entertaining but this is next level 😆

We’re taking coaching evals from the McCarthy evangelist now? I’m sure that will work out fine.

We can waste both our time and break down the etymology of this particular spin if you want. Adjudicating absurdity on Twitter almost certainly is a waste of time even before the person doing it tries to suggest insanity from the counterparty. I feel perfectly secure in my characterization given that you said “most fiber supplements,” of which psyllium is literally the largest player. A pivot to referencing the wellness industry (let alone visiting an expo), as if that in any sane world forms any a priori assumption or framing is indeed absurd to any objective observer. If it makes you more comfortable to try to paint an obvious response that was delivered half in jest as literally the machinations of an insane person, more power to you.

@ZKForTre Is the "spin" in the room with us?

@maxlugavere I shouldn’t be surprised that people are willing to spin this much, but yet somehow I usually am. As you were.

@ZKForTre Definitely not hyper-niche at all when the original post referenced the wellness industry

@maxlugavere I don’t base my usage perceptions based on expos. That’s a fair, albeit hyper-niche, criticism.

@ZKForTre You weren’t at Expo West the past couple of years, I take it

@maxlugavere Weird choice to carve out the most popular case, but to each their own.

@ZKForTre Psyllium is great. As I said, “most”.

I’m going to try a new tactic outside of again pointing out how lazy, uninformed, and uncurious Rogan is: Can someone show me a non-MMA clip in which he has a well-formed, well-researched perspective and contributed meaningfully to a discussion? Any clip at all. Give me something.

Attacking Mark Carney in any capacity right now would be profoundly stupid

@Alexleaf Have really enjoyed your measured responses of late.

My last post about the nutrient inadequacy of ground beef received some interesting comments from the carnivore crowd claiming that the RDA is irrelevant for them. It's common enough that I thought it deserves a post on its own, because it seems that many of these people simply don't understand what the RDAs represent and are engaging in motivated and other fallacious reasoning. First, the RDA is a statistical estimate derived from the average requirement (EAR), set high enough to cover ~97–98% of the population and prevent deficiency. They’re not perfect. They’re not individualized. And they’re definitely not optimal. They are simply safe intake levels to prevent deficiency in nearly everyone. They definitely shouldn't be seen as the goal, so to speak. Protein is a great example of this, where the RDA (0.8 g/kg) consistently underperforms for improving muscle mass, metabolic health, and healthy aging compared with higher intakes. It's absolutely true that many people require less than the RDA value for a given nutrient. That's built into the statistics of the RDA. But again, the RDAs should be seen as a floor, not a ceiling. And yes, nutrient requirements can shift depending on countless variables. Higher protein intake increases demand for cofactors like B6. Lower PUFA intake reduces the need for vitamin E. Being athletic increases the requirements for certain minerals. The issue with the carnivore crowd, in general, is that they seem to just assume that their diet reduces requirements for nutrients. If metabolism is truly changing, requirements should plausibly shift in both directions, not just conveniently downward. It's entirely plausible that a carnivore or ketogenic diet influences nutrient requirements. It's a completely different metabolic state than the general population that was studied for determining the RDAs. But which nutrients, to what extent (magnitude), and in which direction remain unknown because that research hasn't been conducted (as far as I'm aware). So, if you want to claim that nutrient requirements on carnivore meaningfully change in a certain direction, the burden of proof is on you to show a clear biological mechanism, controlled data demonstrating altered requirements, and/or long-term outcomes showing no deficiency or functional decline. Without any of that, you aren't making a scientific argument, you are just trying to rationalize your preferred way of eating. It's ideologically motivated and intellectually dishonest. And you can point to people who claim to eat carnivore for long periods of time, but anecdotes aren’t data. Not only do we have no way of determining what these people are actually eating or supplementing, but there's no controlled investigation of health outcomes. Just saying "they are doing fine" is ridiculous, especially because short-term tolerance isn’t long-term sufficiency and the absence of overt disease does not equal optimal nutrient status. I strongly recommend reading about Bruce Ames' Triage Theory which discusses how, during conditions of nutrient shortfall, the body prioritizes processes needed for survival over those needed for long-term health. You can run suboptimal levels for years before anything obvious shows up. So, if you want to argue that a carnivore diet meaningfully changes human nutrient requirements, go for it. But do it properly. Show the mechanism. Show the data. Show the outcomes.

@Clarksterh @DrSamuelBHume I mean 217 is a step change in biomarkers quality for AD

@ZKForTre @DrSamuelBHume Better biomarkers would help immensely, particularly those that predicted speed of progression. (Ppl almost always give too little emphasis to biomarkers - but better biomarkers allow wildly cheaper and faster drug discovery and approval)

It’s worth considering that we’ve had a couple of treatments that move biomarkers but not disease endpoints now (including pTau217). Multiple interpretations of this, but given that it didn’t really help in MCI suggests that trying to save dying neurons requires much more aggressive treatments and much earlier interventions. Doing the studies to validate such approaches will be devastatingly difficult.

@masonat7 Gets into whether or not you think MCI is early enough to intervene (D and L). The obicetrapib mechanism certainly makes sense, but we’ve seen that tagline before.

@ZKForTre Agree treatment needs to be earlier to (hopefully) see better results. Donanemab and lecanemab have large/long trials in preclinical AD reading out in next few years. Seems like obicetrapib will also be tested in a preclinical AD population with APOE4 and elevated p-tau217.

Uncompensated care is not driven by treatment of non-citizens. It’s driven by emergency and hospital care of un or underinsured individuals who don’t pay for the care they receive (because they can’t afford it) and incomplete reimbursement from federal sources that has been made much worse by the current admin (anyone paying attention knows this was strongly predicted to happen, then the admin decided to uniquely punish Minnesota additionally). Using broad healthcare structural problems to denigrate immigrant communities is gross

@AlexMicheletti I’ll bet as much money at whatever odds he wants the Murray is the starter.

Wentz at QB1???? What #skol Murray doesn’t sign if he isn’t QB1

@nacholeber I will take every single dollar you are willing to bet that this isn’t the case and whatever odds you want Murray is the week 1 starter (assuming health)

I believe there will be a true QB competition. So as of right now I would guess the depth chart would be: Wentz Murray McCarthy May the best man win

Worth clarifying that these are hardly the worlds biggest movement in AD biomarkers, and the stock conclusion is probably just that oral Rybelsus isn’t enough of a hammer in the first place

Definitely agree. The plasma markers had huge variance, and I’m not sure how wise it is to put stock in those. Meaningful increases in gfap and NfL in the plasma is worth keeping an eye on, though. I’m not sure oral low dose interventions with GLP1s can really be considered a good intervention either way, tbh.

@ZKForTre Pretty modest biomarker moves in CSF, and interestingly went in the wrong direction in plasma. Not sure why that would be? Not surprised it had no effect.