00:02So, this is vitamin D and calcium supplementation to prevent falls and fractures in older people.
00:09It's been recommended for many years, but over the years, the evidence supporting that
00:15has got weaker and weaker.
00:17So maybe 40 years ago, there were studies which showed there were benefits in terms
00:20of fracture prevention and fall prevention.
00:22The idea in vitamin D is not just that it might strengthen bones, but also may strengthen
00:27muscles to prevent you falling over.
00:29So that was a theory.
00:30But over time, the trials have failed to actually support that recommendation.
00:37So now a group, and those studies have been criticized.
00:42So a group published in the British Medical Journal have brought this up to date, looking
00:48at something like 69 studies, 150 odd thousand people in trials of vitamin D and calcium supplementation
00:55to prevent bone fractures and falls and shown that basically doesn't work.
01:01So these and the caveat here is these are people who are otherwise healthy, don't necessarily
01:06have a risk factor for falls and fracture.
01:08So there's a weakness because aged care residents have not necessarily been included in many
01:14of these trials.
01:15But the evidence is such that you shouldn't rely, if you've got a risk factor for falls,
01:23you should not rely on vitamin supplementation or calcium.
01:26And there is a bit of a risk theoretically in calcium.
01:29Some people who just take calcium supplements may be at more risk of a heart attack, particularly
01:34if you've got existing coronary heart disease.
01:36And so you're much better taking your calcium in food because it goes along with other factors
01:43in your food, which help it to be absorbed and metabolized rather than in pill form.
01:48So the bottom line here is, you know, you shouldn't be lulled.
01:52It's not necessarily there's going to do you any harm being on vitamin D and calcium, but
01:57it may lull you into a false sense of security that I'm going to be OK when exercise strength,
02:02muscle strengthening, balance exercises and those sorts of things, and also high-ish impact
02:08exercises to strengthen your bones, along with a calcium rich diet, are going to be much
02:14better for you.
02:15OK, all right.
02:16Let's talk about, you know, the longevity craze.
02:18You and I have spoken about this over years.
02:21We know it's taking the world by storm, many people by storm.
02:25And a lot of these people who buy into it to get these expensive full-body MRIs to tell
02:30them what's going on in their body, are they worth it?
02:34Well, the problem with them, first of all, it's going to cost you $3,000 to $3,500, there
02:40abouts, to have one of these full-body MRIs.
02:42And the problem with them is that these MRIs pick up, well, there are several problems.
02:48One is these MRIs can pick up lumps or shadows that mean absolutely nothing.
02:55But you then go on a trail of multiple investigations, maybe even surgeries, to find out what these
03:02lumps are, and you find out that they're nothing.
03:04So you've gone through more expense, the health system's gone through more expense, because
03:09you might have spent $3,500 on the scan, but those subsequent tests are actually on the
03:15public purse, whether that's through health insurance or Medicare.
03:20So that's one problem, and you could actually come to harm from those tests.
03:24Now, some people might say, well, I'll take that on myself.
03:26I'm prepared to take that risk.
03:28The other problem with these MRI scans is that if you've got a specific risk for, say,
03:34pancreas cancer or bowel cancer and so on, you actually want to have a very specific scan
03:39or test done, looking for that abnormality, because the MRI might not be so specific that
03:46it's going to find a real problem in your pancreas or bowel.
03:49And the third problem is, just like the vitamin D and calcium story, is it lulls you into a
03:55false sense of security.
03:56You could have a clear MRI scan one day, and a week later, you turn up with cancer.
04:02It's not a guarantee that you're free of disease.
04:05So, with all that added up, if you're going to do it, you should do it with your eyes open
04:10and your wallet open as well.
04:12Because some people might say, going back to that first problem, that, sure, you might
04:16not find anything, but in some cases, you may.
04:19And there will be the occasional person who will find something that otherwise wouldn't
04:24have done so, and treating it early would make a difference.
04:28But it's fairly random.
04:29It's rare.
04:30And, you know, and if you're going to institute this population-wide, then we can't afford
04:37it as a healthcare system, all the people who are going to flow through for unnecessary
04:41testing.
04:42But, yeah, there is a small chance of benefit.
04:45And, again, if people want to accept the risk of everything else around, and of false reassurance,
04:50then fine.
04:52But do it with your eyes open.
04:53No man's one.
04:54You're welcome.
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