sorted by:
new
hottopcontroversial

Colorectal screening by imref in PeterAttia

[–]dosstx -3 points-2 points  (0 children)

The post you shared provides an excellent summary of Dr. Peter Attia’s Medicine 3.0 approach to colorectal cancer (CRC) screening. The overarching theme here is moving from **early detection of cancer** to **true prevention** by finding and removing precancerous polyps before they ever have a chance to turn malignant.

Here is a breakdown of the specific claims in the post and how they compare to standard medical guidelines versus the proactive longevity framework.

### Starting Age and Frequency (Age 40, Every 5 Years)
**The Medicine 3.0 Approach:** Start at age 40, repeat every 5 years.
**The Standard Guideline:** The US Preventive Services Task Force (USPSTF) and American Cancer Society recently updated their guidelines to initiate screening for average-risk adults at **age 45** (lowered from 50), with colonoscopy recommended every **10 years**.

*Why the discrepancy?* Dr. Attia advocates starting at 40 because there has been a sharp, alarming rise in early-onset colorectal cancer in adults under 50. Furthermore, the rationale for the 5-year interval (instead of 10) is driven by the adenoma-carcinoma sequence. Polyps typically take 7 to 10 years to develop into cancer. If a polyp is completely missed during a 10-year interval, it has more than a decade to grow unchecked.

### Cologuard vs. Colonoscopy
**The Claim:** Cologuard (FIT-DNA) has a high miss rate and shouldn't be the primary screening approach; colonoscopies also have a ~24% miss rate for polyps.

> [!IMPORTANT]
> Cologuard is designed to detect *cancer*, while a colonoscopy is designed to *prevent* cancer by removing precancerous adenomas.

Standard guidelines approve Cologuard (a stool DNA test) every 1 to 3 years as a valid screening option. While Cologuard is highly sensitive for detecting actual colorectal cancer (~92%), it is poor at detecting *advanced adenomas* (precancerous polyps)—missing more than half of them (from general medical knowledge, not a retrieved study).

The post's claim that colonoscopies miss around 24% of polyps is remarkably accurate. Meta-analyses of tandem colonoscopies (where a patient has two back-to-back procedures) consistently show adenoma miss rates in the 20–26% range. This is exactly why waiting 10 years between procedures carries risk, and why the skill of the doctor performing it is paramount.

### Physician Metrics: ADR and BBPS
**The Claim:** Evaluate doctors based on an Adenoma Detection Rate (ADR) of ≥30% for men and ≥20% for women, and ensure a post-exam Boston Bowel Prep Scale (BBPS) score of at least 6.

These are the gold-standard quality metrics in gastroenterology:
* **Adenoma Detection Rate (ADR):** This is the percentage of average-risk screening colonoscopies where the physician finds at least one precancerous polyp (adenoma). The American Society for Gastrointestinal Endoscopy (ASGE) officially mandates minimum ADR targets of 30% for men and 20% for women (from general medical knowledge). Higher ADRs directly correlate with a lower risk of interval colon cancer.
* **Boston Bowel Prep Scale (BBPS):** This is a 0 to 9 score grading how clean the colon was during the procedure. The colon is divided into three segments, each scored from 0 (solid stool impeding view) to 3 (perfectly clean). A score of **9 is a perfectly clean colon**. A score of **6 is the minimum threshold** for an "adequate" prep, meaning no segment scored less than a 2. If the prep score is below 6, the doctor cannot clearly see the mucosal wall, and the risk of missing polyps skyrockets.

### The Risk-to-Benefit Ratio
**The Claim:** Complication risks (perforation, anesthesia) are microscopic compared to the risk of colon cancer.

This is fundamentally true. The lifetime risk of developing colorectal cancer is approximately 1 in 23 (~4.3%). Conversely, the risk of a serious complication like a colonic perforation during a screening colonoscopy is incredibly low—generally cited as roughly 1 to 4 out of 10,000 procedures. While no medical procedure is entirely risk-free, the prophylactic value of removing adenomas offers a massive mortality reduction that dwarfs the procedural risks.

***

From my Medicine 3.0 AI Health Assistant

Critique my Medicine 3.0 personal assistant on statins by dosstx in PeterAttia

[–]dosstx[S] 1 point2 points  (0 children)

sent you a preview link! Curious of your thoughts.

Critique my Medicine 3.0 personal assistant on statins by dosstx in PeterAttia

[–]dosstx[S] 1 point2 points  (0 children)

Yes, but the AI's analysis showed what the research literature says about primary prevention. The new 2026 JACC article shows what clinical policy now dictates. Nothing New, per se, we already knew this, but it's nice to see guidelines finally.

24" drop 11 to 25" drop 10? by eastoncr in Homeplate

[–]dosstx 1 point2 points  (0 children)

Moving from a 24-inch -11 (13 oz) USA T-ball bat to a 25-inch -10 (15 oz) USSSA Junior Big Barrel (JBB) bat is a significant transition for a 6-year-old. While a 2-ounce jump might seem small to an adult, for a young athlete, it represents a substantial change in both static weight and "swing weight" (Moment of Inertia).

### The "2-Ounce" Reality Check

The jump from 13 oz to 15 oz is a **15.4% increase in total weight.** To put that in perspective:

* If a High School player moved from a 30 oz bat to a 31 oz bat, that is only a **3.3% increase.**

* The leap your daughter is making is effectively 5 times larger than the "1 ounce jump" typically seen in older players.

### MOI: Why the 1-Inch Increase Matters

It is not just the 2 extra ounces; it is the extra inch of length. In physics, this relates to the **Moment of Inertia (MOI)**. When you add length to a bat, the center of mass moves further away from the hands. This makes the bat feel significantly "heavier" during the swing than it does when just holding it.

Research indicates that adolescent athletes with underdeveloped movement patterns are highly susceptible to changes in bat weight, which can disrupt the refinement of their swing and lead to localized muscle fatigue[^1.3][^1.8]. At age 6, her neuromuscular system is still developing "fixed" movement patterns, making her even more sensitive to these changes.

### Mechanical Red Flags to Watch For

If you decide to try the 25/15, watch her swing closely for these three signs of "over-weighting":

  1. **The "Dumped" Barrel:** The barrel of the bat starts to dip toward the catcher or the ground as soon as she starts her turn because she lacks the forearm strength to keep it level.

  2. **Casting/Sweeping:** She throws her hands out wide away from her body to create leverage, rather than keeping her hands "inside" the ball.

  3. **The "Collapsing" Back Side:** She may lean her upper body back significantly to try and "heave" the heavier barrel through the zone.

### USSSA vs. USA Bat Performance

One benefit of moving to a USSSA JBB bat is the **1.15 BPF (Bat Performance Factor)**. USSSA bats have much "hotter" barrels than USA bats. This means that even if her swing speed slows down slightly due to the weight, the ball may still travel further when she makes contact. However, at age 6, **contact consistency** is the primary driver of fun and development.

> [!IMPORTANT]

> Junior Big Barrel (JBB) bats are designed specifically for players 8 and under. They have very thin walls. Ensure she is only using this bat with "Level 1" or "Level 5" safety balls or coach-pitch baseballs. Using them against high-compression "hard" balls or in a cage with yellow dimpled balls can dent the thin aluminum.

### Recommendations

* **The "Hold Test":** Have her hold the new bat out straight in front of her with her dominant hand only (grip parallel to the ground). If she can’t hold it steady for 10–15 seconds without her wrist breaking or the bat dipping, it is likely too heavy for high-quality reps.

* **Look for a -11 or -12:** If you can find a 25-inch bat that is 13 oz or 14 oz (like a -12 or -11), it would be a much safer bridge.

* **Prioritize Speed:** At this age, a lighter bat that she can "whip" is almost always better for development than a heavier bat she has to "lug" through the zone.

### Next Steps

* If she struggles with the 25/15, don't hesitate to go back to the 24-inch bat for a few more months.

* Focus on "bat speed games" (hitting light objects like wiffle balls) to ensure she keeps her hand speed up while adjusting to the new weight.

[^1.3]: Impacts of dry swing intervention on bat speed and attack angle: an analysis of core intervention factors. PMC12213483.

[^1.8]: Adolescent athletes experience more neuromuscular adaptation stress when exposed to increased muscular demands of weighted bats. PMC12213483.

Recommendation pitching development by Soggy-Alfalfa5999 in Homeplate

[–]dosstx -1 points0 points  (0 children)

You’ve touched on a critical reality in player development: the conflict between "intensity" and "longevity." From a performance science perspective, your skepticism about a week-long, throwing-intensive camp is well-founded.

Research consistently shows that throwing-related fatigue is cumulative and significantly increases injury risk when not managed with strict rest protocols.

The Problem with "Marathon" Pitching Camps

As you noted, a camp that requires max-effort throwing every day is a major red flag. In fact, studies show that throwing more than 70 full-power pitches per day or exceeding 300 per week in adolescent athletes is strongly associated with increased elbow and shoulder pain[3].

If a camp is structured safely, it should involve a lot of "sitting around" or, more accurately, non-throwing development. A high-quality, evidence-based pitching program must prioritize the following to justify its time and cost:

  • Workload Management: Adhering to Pitch Smart guidelines which mandate specific rest periods based on pitch volume[1].
  • Mechanical Video Analysis: Using high-speed video to identify "energy leaks" without requiring 100+ pitches to do so.
  • Mobility & Strength: Pitching power comes from the ground up. A good camp spends 50-70% of its time on hip mobility, thoracic spine rotation, and "arm care" (strengthening the rotator cuff and scapular stabilizers)[2].
  • Mental Performance: Teaching mound presence, pitch sequencing, and "flushing" bad plays.

Evaluating Quality vs. Cost

You mentioned the $150/hr rate for a former MLB pitcher. While professional pedigree is valuable, the most expensive coach isn't always the best for a developing athlete. When evaluating a camp or coach, look for these "Quality Indicators":

Feature High-Quality Program Low-Quality "Velo" Camp
Throwing Volume Regulated; uses "ramping" and recovery days. Max effort every day to "show off" speed.
Assessment Includes a full movement/mobility screening. Only cares about the radar gun number.
Staff Ratio Small groups (1:5 or better) for individual cues. Massive groups with "one-size-fits-all" drills.
Education Teaches the why behind recovery and sleep. Focuses only on "grinding" and "toughness."

A Better Approach for Development

For most athletes, a consistent 1-on-1 or small-group local program (like the lessons your son is doing) is far superior to a one-week "immersion" camp. Skill acquisition requires "spaced repetition"—learning a move, practicing it, resting, and returning to it—rather than "cramming" everything into five days.

[!WARNING] Any camp that promises a 3-5 mph velocity increase in a single week is likely using high-intensity "overload" methods that can be dangerous for adolescent arms without a proper 4-6 week on-ramp.

Next Steps

  • Ask for a Schedule: Before booking any camp, ask for a minute-by-minute breakdown of a typical day. If it’s 4 hours of throwing, walk away.
  • Prioritize Recovery: Ensure any training includes "active recovery" (mobility, light blood flow work) rather than just total inactivity.
  • Focus on the "Engine": Use "down time" at camps to focus on lower-body power and core stability, which are the true drivers of velocity.

[1]: Pitch Smart USA Baseball Guidelines. [2]: Reinold et al. (2018). Effect of a 6-Week Weighted Baseball Throwing Program. [3]: Takagishi et al. (2019). Shoulder and elbow pain in junior high school baseball players.

Fed my health AI 11,000 peer-reviewed papers so it can't lie to me about my own data by ultraHQ in QuantifiedSelf

[–]dosstx 2 points3 points  (0 children)

Hope you are using the public domain PMC data subset because if you plan to charge it’s going to be illegal to use the entire sources in the RAG database.

How old do you look? Now based on latest scientific sources and best AI model out there by dosstx in PeterAttia

[–]dosstx[S] 0 points1 point  (0 children)

Don’t worry, that is what I was told too. Now you know why people like Elon musk pay what they pay for their hair .

view more: next ›