This seems like a critical update on what we know about the impact of vitamin D on cardiovascular health. Perhaps the highest value is that "unlike earlier vitamin D randomized trials that used standard doses, the TARGET-D trial personalized the doses based on the results of each participant’s blood test." (https://newsroom.heart.org/news/heart-attack-risk-halved-in-...)
Amazing work - as a clinician, being able to have wearable data be clinically useful would be game changing for our patients and for models of healthcare delivery.
We always talk about the Mediterranean diet as being one of the best for reducing mortality - interestingly a typical Mediterranean diet would have approximately "14g of vegetable fiber for every 1,000 kcal per day, which is more than double what is consumed every day in many industrialized countries" (https://pmc.ncbi.nlm.nih.gov/articles/PMC7190876/). Aside from its healthy fats, omega 3s, etc. there may be a big role here for the fiber in this dietary approach.
Lp(a) is a largely distinct risk factor from “ordinary” cholesterol and cannot be changed by diet or exercise.
Survey papers show practically no effective treatment (statins help all cause mortality in patients but do not lower lp(a)).
There are two (iirc) ongoing trials for new, effective drugs. But those are not available yet and will probably be prohibitively expensive, going by the advertisements that the companies run.
So yeah, get an Lp(a) test once (it doesn’t vary too much over time) and reduce your other risk factors, but don’t put too much hope into an easy solution to this specific cause yet.
It wasn't too long ago that evidence was mixed on benefits in this area: https://www.sciencedirect.com/science/article/pii/S096007602...
Nice find!
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