> Generic advice to eat well and exercise is not as effective as having a specific number you're trying to improve on e.g. lowering your ApoB count.
I'm not so sure this is a wise approach.
I won't say that numbers aren't important, but it's worth noting that in many cases, doctors still don't know what particular measurements actually mean in practical terms because cause versus correlation is so hard to figure out in complex systems like the human body.
As an example: the general consensus has been that "good" cholesterol (HDL) has a protective effect and that those with lower HDL levels are at risk. You can have an LDL of under 150, low triglycerides and your cholesterol ratios can be stellar, but if your absolute HDL number is low, there's a good chance your doctor will talk to you and, at a minimum, recommend ways that you might be able to bring your HDL level up.
One common approach of doing this has been to use niacin, yet a 2011 clinical trial involving the use of niacin in an attempt to increase HDL levels in a high-risk population failed to produce the hoped-for risk reduction despite the fact that the niacin did increase HDL levels[1]. A larger, more recent study had a very similar outcome[2].
One logical possibility is that the HDL level reflects some other underlying factor which controls for risk and doesn't itself have the ability to influence risk. If this is the case, a higher HDL number may confer little to no protection unless it is the product of some other natural process.
I think the OP is referring to the fact it's much easier to focus and improve on specific items than it is to follow some nebulous generic advice. "Lose weight" is much less effective than "Exercise 30 minutes per day and eat 2200 calories per day".
What seems to be likely regarding cholesterol in general is that it has been greatly over focused on to the detriment of more likely culprits like sugar and refined foods. Of course, the cynic might say you can't take a pill made by Pfizer to lower your sugar and refined foods like you can to lower your cholesterol.
I think the parent comment's argument is that improvement on specific items isn't well correlated with "better health". Even interventions aimed at specific metrics have shown to have no or negative consequences. For example, niacin in the AIM-HIGH trial.
I'm not so sure this is a wise approach.
I won't say that numbers aren't important, but it's worth noting that in many cases, doctors still don't know what particular measurements actually mean in practical terms because cause versus correlation is so hard to figure out in complex systems like the human body.
As an example: the general consensus has been that "good" cholesterol (HDL) has a protective effect and that those with lower HDL levels are at risk. You can have an LDL of under 150, low triglycerides and your cholesterol ratios can be stellar, but if your absolute HDL number is low, there's a good chance your doctor will talk to you and, at a minimum, recommend ways that you might be able to bring your HDL level up.
One common approach of doing this has been to use niacin, yet a 2011 clinical trial involving the use of niacin in an attempt to increase HDL levels in a high-risk population failed to produce the hoped-for risk reduction despite the fact that the niacin did increase HDL levels[1]. A larger, more recent study had a very similar outcome[2].
One logical possibility is that the HDL level reflects some other underlying factor which controls for risk and doesn't itself have the ability to influence risk. If this is the case, a higher HDL number may confer little to no protection unless it is the product of some other natural process.
[1] http://www.nih.gov/news/health/may2011/nhlbi-26.htm
[2] http://health.usnews.com/health-news/news/articles/2013/03/0...