How the Framingham Heart Study Works

April five. We're gonna be in St. Louis on May, in Cleveland one, and then of course we're gonna wrap this summer up on June at the Gothic Theater in Colorado. So go to s Y s K live dot com for all of your information and ticket needs. Welcome to Stuff you Should Know from how Stuff Works dot com. Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant, There's guest producer Noel all of Nature, Wild and Free. This is where you long to be. Stuff

you should know. So let's go ahead and admit that we just did a rare retake of like the first four minutes of the show. Yeah, and I still reused the Madonna lyric joke. That's fine, but we have to recreate the rest of the previous four minutes. No, I don't think so. I think we should just kind of let it flow. I was just I was saying to myself, By God, that Madonna jokes getting in there. All right, Well, maybe just a quick recap. Noel's dressed up and looks great.

He's it's because he's a snappy dresser. Uh. We mispronounced words in the UK and got laughed at. And now we're talking about the Framing Him heart Study. That's right, which we h. I don't know what podcast it was on, but years ago we called it the Farmington hard Study. Um, every time we said it, we said Farmington's did we really? Yeah, you don't remember that. No, I mean that definitely sounds like us, but I don't remember it. Yeah. Yeah, that's why I made that joke when you first came in

about the Farmington Heart Study. Okay, yeah, we said it was years ago. It was one of our earlier couple of years and we said the Farmingtons Hearts Study probably twelve times. Yeah. Back in the day, the standards used to be its head lower. Yeah, because we were low hanging Fruit podcast. It was us Zyberglass was Ricky Gervais and Jesse Thorn, and then Adam Curry was out there somewhere and probably Adam Corolla. Sure, yeah no, but no one else we had. There were eight podcasts. That was it.

That was all you had to choose from, So you better like at least one of them. Do you know how many there are? Now? I just saw today? Uh no, do you like you have an actual number? Well, I mean it's a it's an even number, so it's probably not exact. But the latest hot pod newsletter said that there are roughly three podcasts. Oh my god, that's nuts. I know, man alive. That's pretty impressive, and probably only

like five of those are good. Well, we we went from that was mean, we went from eight to three fifty thousand and how many years? Ten? We're still hanging strong, we are. That's great. That's what happens when you say things like Farmington ten twelve times. He's long gone. Yeah, he pronounced everything perfectly like guys washed up now yea, So the reason we're talking about framing him, which, by the way, yeah, yeah, it's gonna be tough to say it the same way every time, but it's framing Ham

is the city of Massachusetts. I don't get the Framingham as opposed to framing him Yeah, ok, yeah, the h is a hard age or soft aged like, Whereas if this were in Scotland they would just say you're right, which is again why we were laughed at Manchester that it's Germany sorry, right, which is landlocked. So again we're talking about Framingham, Massachusetts, a very small town these days.

In two thousand and seventeen, I think the census, well that the population estimate was something like seventy residents, not a not a huge town. I think that qualifies as a small, dinky town. Still. Yeah, but it's a suburb of Boston, which is a huge metropolis. Sure it is, um, but it is aside from being a suburb of Boston, it is in its own right, uh, an internationally renowned tiny town. Not because it's like a place where the circus used to hang out during the winter, or because um,

they have some amazing kind of fudge. Right, Farmingham, Massachusetts is on the map because that town back in the day, actually two times over that town. Just I did that they were going to present themselves as as test subjects, study participants, for some of the most important studies ever carried out in the history of medicine. Yeah. What one of the largest and certainly most influential longitudinal studies ever

performed in medicine. Yeah, it's called the Farming hum Or farming Ham Heart Study, the Framingham Oh my god, was that an accident? Yes, Oh boy, The Framing hum Heart Study. Yeah, which you know, we've we've had challenges, as has the medical community in research community throughout study history, of being frustrated with like bad studies and poor sample sizes. This one is really set the standard. Yeah, it's it's the gold standard for anything that has anything to do is

studying cardiovascular disease. And as we'll see it basically is everything we you and I, just Joe Schmo walking around on the street know about cardiovascular disease basically came out of this study. Um. And even before that, there was another study that the town participated in that helped lick tuberculosis, which was which was appropriate because you know, framing framing him. Yeah,

I got it right. Is in Massachusetts, which is part of New England, which was part of the vampire panic area, which, as you remember, was the result of tuberculosis. So it's it was appropriate that that little town contributed to humanity in that way as well. Yes, so should we hop in the way back machine? Oh yes, all right, let's set the dial. Let's load up the flux capacitor with

Miller heavy beer and banana peals. Miller heavy. Yeah that's what he used, nice, I think so, yeah, okay, that's that's at the end with the more modern version right right of the Dolorean. Yeah. I think he used some sort of plasma waist incenterator. Yeah. Uh so, let's let's set the dials for um, the World War two era. We're not gonna be super specific here, No, sometimes we rolled the dice in the way back machine. Let's see

what happened. Just say, spit us out anytime in the nineteen forties, not in Europe or the South Pacific, that's right. So in the nineteen UM here was a scene in the USA, and I guess all over the world is we did not know a lot about and all this stuff seems so second nature now and like duh about heart disease, But we didn't know a lot about heart disease back then, and it was sort of just accepted that once you reach a certain age, like, yeah, your heart just may take you out. Nothing we can do

about it. Might as well not research it. And there's certainly no preventative medicines for your to ensure that health. No, certainly not like they could try to treat it or whatever. But most of the time, once you came down with UM, one of the cardiovascular diseases, you UM, you were a goner. YEA of us deaths we're due to CBD, right, And so there was a confounding factor that led to this huge increase. There are actually two of them. One is

as far as percentages go. The cardiovascular disease deaths lurched forward in the mid early mid twentieth century because what used to be the big killers, which were infectious diseases which we now consider highly treatable. They used to kill everybody, right, And as we started to treat them thanks to the discovery and use of penicillin and antibiotics, those things fell into the background and and by by extend mention or by proxy, cardiovascular disease was basically bear naked out there

statistics wise. Suddenly something that was just kind of like a secondary problem was now that the leading cause of death in the United States and in the West. I believe, yeah, because I guess people were living routinely, living into their fifties and sixties, maybe for the first time, I don't know, Yeah, and they were saying, my god, I'm so glad I get these extra couple of decades of eating raw steak and smoking cigarettes at the dinner table. Grass. That is

so nasty. It's a it's a true story, though. I saw my grandpa do it with my own eyes, smoke at the table. Now. Actually, my grandpa was one of the He went the other way. He was like like subscriber number three to Prevention magazine and yeah, into like coffee animas and all sorts of weird st He was big time healthy guy. Is that what led your dad to become the herbal Elviots? I think that that had some had to have had something to do with it, for sure. Luckily my dad didn't carry on the family

tradition of coffee animos down to me. So um alright, So by of death or cardiovascular everyone's dying now from their heart because they're living longer because they're not dying of TV and their thirties and forties and then the second big thing that happened that you teased was President Roosevelt. Uh started to get really he got cardiovascular disease. He started to get really high blood pressure. Uh. This was

compounded by UM. Now we understand that stress and anxiety can compound these things, and he certainly had no shortage of that UM as president. And you know Winston Churchill of all people, when he says he seems to be a very tired man. If Winston Churchill was saying that, then you're in trouble. Yeah, because he wasn't the picture of health. No, he certainly wasn't. But apparently f D made him look like he was fresh as a daisy. So FDR had high blood pressure when he went into

the White House to begin with. But by the time rolls around right after the Yalta UM conference where they divided Europe up between what Great Britain, the United States in UM, Russia the Soviet Union, right. Um. He died a couple of weeks after that, at age sixty three. He had a stroke from hypertension, which is another word for high blood pressure. And boy, oh boy, did he have high blood pressure like off the charts. Chuck, Yeah, three hundred, when when he died he had three hundred

over one. One more time, three hundred over one. So I went and look that up. I'm like, even without looking it up, I know that's high, but how high is it? So? Ideal is between ninety over sixty and one over eighty. That's how deal blood pressure. Anything over one eighty over one twenty is what's called a hypertensive crisis. And the chart tells you to go to your doctor immediately for that if you have anything over one eight over. FDR had three over one. Yeah, and I mean his

doctor said, I predict he's a very sick man. I predicted will be dead within a few months. And he was running the money, right Churchill's doctor. Yeah, FDR Zone doctor was like, here, take this digitalis You'll love that. Churchill's guy, Yeah, okay, yeah. At the y'all take conference. I guess he just travels with I would think, so, I thought, I mean, I would imagine all those guys would travel with their doctors, you know, just just for fun, like what kind of pills you got today? Yeah, and

again I'm watching The Crown now. I talked about that in the TV h well, in the episode but when we talked about it and John listcal As Winston, Churchill is grow great. What he's awesome? When he and FDR like half two part ways after the y'all to conference, does he punch FDR in the face and say O, FDR hasn't actually he hasn't been in it. Okay, well look for that scene coming up. Yeah, but it's crazy. Churchill's all over the place. He had the Gary Oldman

movie and then there were dual Churchill movies. Brian Cox was on another one. Oh, he's in it's quality. He's great, although his Hannibal lecture was it was fine until Anthony Hopkins got his hands on that role. Yeah. The rare case where the second actor totally owns the role usually like the first actor. Will you know, just probably by the fact that the first Although I liked Um, What's the to Live In Diane l A's guy's name who was the lead guy in Manhunter? William Peterson. Yeah, I

liked William Peterson's character. That's a great movie more than Um Edward Norton's version. Oh, in Red Dragon, because Red Dragon and Manhunter they're based on the same book. Yeah, yeah, it's the same thing. Yeah, yeah, you're really right. William Peterson a way better than Edward Norton in that role, but Jodie Foster better than all of them, is closed, Yes, yeah, all of them put together. Man. I just watched the end of that again the other day, and oh, you're

gonna appreciate this. Uh. Emily was in the other room, um, in the bathroom or something, I can't remember, and she didn't know what. I turned it on and I passed it right at the moment of the Penis Tuck Buffalo Bill when he had his arms out in the Jesus Christ post and Emily came in and just got in bed and looked up and was like, oh my god, what a great movie that was. Had everything, the perfect race Rain did everything, had Jodie Foster, Anthony Hopkins, and

a Penis Tuck scene. We should probably take a break, all right, We're off the rails here, are you ready? Yes? Break starting now? Okay, Chuck. So we were talking about Penis tux right. FDR famously did that at the Yalta conference.

Oh my god, so he you know the reason the reason FDR's death from hypertension really factors into the stories because it was extremely public, okay, And what FDR basically did without using these last words, he basically said he pointed at at modern medicine and said, I beseech you, and then keeled over right, So modern medicine was like, who us, we don't know what we're doing when it comes to cardiovascular disease ease. And shortly thereafter, the framing

him heart study was born. No, you can almost coming. The framing of heart study was born because Harry Truman signed the National Heart Act, which is probably the thing that he's most famous for. Its president. Yeah, and that included and that included five thousand dollars in the form of a grant for this study for twenty years to cover twenty years for the study. And um, I think initially Public Health service physician Uh Gilson or Gilkin Metters uh said, it sounds like you messed that up, but

you didn't. I think you hit it right on the head. Gilson Metters. It matters sounds like a weird you think it'd be meadows or something. It sounds like you're drunk and saying meadows. Uh. And this was the original quote, which is actually a pretty good mission statement for the study. Their mission was to study the express and of coronary artery disease and a normal or unselected population, and to determine the factors predisposing to the development of the disease

through clinical and laboratory examined long term follow up. So there you have it. Not bad, it's got a clinical ring, it's got a it's concise. You can dance to it. Yeah, exactly. So this this framing Him heart study was a heart study before it was set in framing him. And they

went to framing him for a number of reasons. One they said, well, this is a pretty pretty standard UM middle America, middle class UM community, at least of the kind that we pay attention to in this day and age, right, meaning it was almost entirely white people, which will see as a huge criticism of this study that UM the study directors over time have tried to work on. But um, they said, aside from the the the complete and almost complete and utter of UM diversity. Yes, in this study,

it's a pretty good slice of America. It's a small town, most of the people their middle income. It's it's got a big enough population. At the time, this is the nineteen forties or something like twenty eight thousand people that we could get a pretty decent, like random sample of the population going. But the town itself is small enough. There's only like two hospitals and in time there would only be one hospital that we can actually easily keep

track of the people in this town. And it's not too far from Boston University, which would win the contrast to UM carrying out the study on behalf of the National Heart Institute. Well, yeah, and they had also, like you said, earlier, proven that their game for this kind of thing by participating in that uh to what was called tuberculosis how down or something. Ye had a name. It did have a name. It was called the Framing Him Tuberculosis Demonstration. There would be like watch this, no,

but it could be on a Saturday night. It was the hold Down. So that, yeah, the whole town had was not the whole town, but the town had gotten behind being UM test subjects or study participants for a whole other study about thirty years before the Heart study began. So they were already kind of like there. Their healthcare providers were already like aware that this stuff was going on. And at the time, apparently healthcare providers like your general practitioner.

That was like the end all be all of your health. That person was meant to know everything about you and everything about disease and how to treat you. And that was that. There weren't any longitudinal studies, There wasn't any preventative medicine, There wasn't any national hard institute, there was nothing like that. It all came down to your general practitioner.

So it was really important that the general practitioners and the healthcare providers in the town of Framing Them were on board this kind of thing, because they could very easily have seen this as encroaching on their turf, but

they didn't. And I think the Framing Him study directors and the people who carried this actual study out deferred to the general practitioners in the town as far as like giving advice from the findings and and keeping up with the the like outside medical findings or even the stuff they were finding from the study. They didn't directly give it to the study participants. They gave it to their doctors, and then the doctors would tell the study

parts participants, so they were kept in the loop. So there was a there was a a symbiotic relationship that was forged. Yeah. I thought that was interesting that they just kept the research like they weren't there to offer medical advice. They were literally just collecting research. But I do wonder if some of the times they would say, hey, uh, gp of Mr Donaldson, you really need to get him

in like next week. Yeah, like really yeah, like he It's kind of like I guess how Churchill's doctor saw Roosevelt, right, Like, I know we're not supposed to give advice, but my advice to you is to call this guy up and say, maybe you should come in a little earlier than next spring, right,

or go up your malpractice insurance. So we did say that it wasn't super ethnically diverse, which um didn't phase them too much at the time, And it really hit home to me just how like just how white probably every major study had been up until this point without even like thinking it was a problem, which is being like, I don't know, there's a great study. They're like, well, you know, he didn't include any black people, and they just it probably just didn't even occur to them at

the time. I don't know if it didn't occur to him. I I think that it was mostly that's who their clientele was. I think that that's probably who was being studied because that's what America catered to at the time, or who America catered to, I should say at the time. I don't know that that much has changed these days, unfortunately, but I think it was vastly more pronounced back then. Well I think they I think they're way more inclusive now and and probably have to be to get research

grants these days. I would think, oh, yeah, yeah, yeah, yeah, yeah, for sure. No, I'm saying America as a whole being like catering to Yeah, hear you, But that did change in and framing him after World War Two. Apparently there was an influx of a more diverse population after the war at least, right, and I think by the Good Lord was that the nineties when they added the new cohort. Well we'll get to the cohorts, Okay, well, anyway, sure

we'll spoiler alert. They added they made the study population more diverse. One thing that is in the credit of the study designers is that they included women at a about which was totally unheard of it's in any kind of medical study at the time. Because again, not only did they cater to almost exclusively white people in America at the time. They catered almost exclusively to white men

at the time. Yeah, and I think also women. I think heart disease probably still has a stigma of like, yeah, men have heart disease, uh more than women do, right, Like, what are you a trucker lady? How do you have heart disease? Go back, go back home, get out of my doctor's office. Yeah, you dummy. Yeah, which is not the case, right, No. But the weird thing is is

what they found from the study. Just overall, they found that the stuff that they've come up with, which we'll talk about in a second, is really good at predicting things for like white guys, for cardio vascular disease for white guys. But even though women were very um clearly represented in the study, they've actually found that the same

predictors don't work for women. So it's kind of led to a separate study of women and how they suffer from cardiovascular disease, because they definitely do, it's just under different circumstances it appears than men. Yeah, it's pretty interesting.

So let's talk about the beginning of the study, right, Yeah, So they recruited people between the ages of thirty and fifty nine initially because that is the window where you might develop c D d UM and they they thought by recruiting people in this range, they would also get a certain amount of people that are already have this uh appearing like these symptoms appearing right. They didn't though.

Actually it turned out that they had to actually go recruit people who had cardiovascular disease already and put them into this study themselves, I think, because people probably that maybe we're on that track, don't volunteer for studies like this. Well. They also it wasn't a very random sample, especial at first because they initially got participants through um word of

mouth at like civic groups and clubs. So so the presence of a social network or a certain type of social network, we just kind of does away with randomness right out of the gate. And they ended up recruiting other people outside of like these groups and civic civic clubs and all that, who initially formed a large part

of the study. UM cohort to make it a little more random, and I guess they were successful because it seems like the idea of it being not very random or not very representative sample of the whole um isn't really discussed any longer. So I guess they took care of it by the inclusion of the additional I think like seven people. Yeah, so they the idea was that you would come in every two years to give um your medical history updated, to get updated, to have your physical,

to get you all your labs done. And they thought at the time like, there's probably they were smart enough to know that there's probably not one thing this causing CBD. So collecting all this history from all these people over time, and initially it was going to be twenty years, but as you will learn, it's still going on today, which is amazing. Um, they can really get a robust sampling of people and time from kind of all walks of life once they started being more inclusive. Yeah, and they

can watch the disease develop or not develop. And since they do like a really they did a phenomenal baseline exam and Chuck, actually, I saw and the very original inception or conception of the study was that they were going to do a baseline exam and then a second follow up three to five years later and that was it. But luckily they had the foresight to be like, no, no no, no, let's keep this thing going and keep a rolling. Baby,

I'm feeling hot, right. So they were by doing this baseline exam and saying, you know, do you smoke, how much read meet you? How much do you drink? How much exercise do you get? How often do you go parasailing? Like? Um, like how many kids do you have? What were your parents medical histories? Like? By getting this really great baseline exam, they had an idea of all the different factors that could come into play when it comes to cardiovascular disease.

And then with these follow up exams every two years, they would find people as the as they got the disease or didn't get the disease, and then they could go back and look and say, well, this person has cardiovascular disease and they smoke and they have diabetes, and uh, their parents had a stroke. They're dead at a stroke and they just had a stroke. So they started to see from all of this data, it was basically like you know how data, big data is just enormous right now.

That's basically what the Heart Institute did in Boston University just went and set up camp in this town and they started collecting as much data as they possibly could, and then they set about sorting through it and publishing papers based on the finding. Yeah, and you mentioned the cohort earlier there, and I'm just gonna go ahead and say, each of these cohort names is a great band name. All of them a blanket. That's a blanket, great band name. Statement.

So the initial you said when they went out and got another seven forty people, who and those are the people who had the early signs of CBD. Yeah, they were included in there. Okay, that's the Framing Him Cohort. That's everybody. That's the first group. Okay, all of the first group combined was the Framing Him Cohort. That's a that's kind of an emo folkey band. Then in seventy one they said, you know what, these people are having kids.

So what would be awesome is if we started studying these children and their lifetimes and they were known as the Offspring Cohort. So that's like an offspring cover band. Okay, that's terrible. I thought, it's not bad. What what was offspring? I don't even know. Oh, remember you got to keep them separated. I do remember that song that was had

a couple of good songs. Yeah, and I think the guy, if I'm not mistaken, and I'm not thinking of Milo from the Descendants, Um, this was the guy from Offspring went on to get like a PhD in like biochemistry or nuclear physics or something really impressive. Interesting, Yeah, I was. I'm so I have no idea about any of that genre, whatever that genre is. I'm not sure what that is either.

The Offspring were kind of their own thing. Yeah, but isn't it a part of just the whole Like what was that tour like the Vans Warped Tour and that all that stuff. I know nothing about any of those bands. I'll bet they were on Warped Tour now that you mentioned it. They were not definitely not a part of what was Lilith Fair No, no, but ironically they did go to a couple of dates just as audience member probably so. Alright, So the Offspring cohort were the kids.

That was about fifty of them, and then they included their spouse is um which was a big deal because, like I said, adding the kids allowed to look for hereditary functions as far as CBD goes. And then the spouses just gave that extra layer of examination when they weren't related, right, Yeah, so it's almost like a built in control group as far as um looking at hereditary stuff goes. Right. And then that was also like I've seen it remarked on, man, my brain is a little

broken to day. But um, the having adding the kids as a second cohort was was just a stroke of genius because even before they had any idea that we were going to be able to easily examine genes and d n A, they they started building this this study data that can be mined now for genetic stuff thanks to these guys foresight by adding this offspring cohort. That pretty cool. Uh. The first omni cohort first of three, those are all three good band names. And this was

when they started getting that diversity. They said, hey, maybe we should sort of officially include this and break this out. So that was made up of about five hundred people of Native American descent, African American descent, Hispanic, Indian, Asian, and Pacific islander right first. And I guess second and third omni cohorts, And that was that's surprising to me that it took that long when they knew out of

the gate that it wasn't representative of America as a whole. Yeah, I mean it's that's not to say that they didn't have any of those people in the study, but they officially recruited more. Isn't that right? That's my impression. Yeah, okay, Yeah, I don't know that the original cohort was entirely white, but I from what I understand, it was so so majority white that it was not representative of of America

population wise. And by the way, Omni Cohort that's obviously a E d M band that would probably tour with like the Crystal Method or something like that. Uh. And then finally the third generation Cohort or Gin three, which is their album title, that started in two thousand two, and I think they're expected to shut that one down next year. That I thought was really weird. Why shut

any of them down? Might not be like, we're gonna follow you to the grave, man, Yeah, we might even dig you up in ten years after you're dead in case we figure out something new to do with you, you know. Yeah, And these are kids who had at least one parent in the offspring cohort? Is that right? Okay? And then there's another one called the offspring spousal cohort, the new offspring spouse cohort. Right, that's a that's just

a weird one. Yeah, they're getting a little meta. Yeah, So, um, the new offspring spouse cohort is made up of spouses who, for whatever reasons, weren't part of the original offspring cohort and have at least two kids in the Gen three cohort? Is that correct? It gets a little wonky, But but the point is is they're like adding more and more

people in the town. As the town's getting bigger and as the town's getting more diverse, they're they're making the study reflect this population more and more with the hopes that it's going to reflect America more and more. And they again this the study designers and and directors have always known that this isn't just like a perfect snapshot of America. Um, there's always been criticisms of it, and UM, I don't know, you want to take a break before we get into those, Okay, we will do that right

after this. Okay, so I said, we're going to get into criticisms, but first we should probably talk about some of the successes, right yeah. And like I said earlier that so much of what we learned from this UM today seems just so brainless. But it's important to remember that before this, I mean, you still even though you think, like, yeah, you smoke cigarettes, you're going to increase your risk of

heart disease. It seems like such such a second nature thing to know now, But until you have actual scientific proof, you can't say something like that. And this study gave us a lot of these things that we take for granted now as obvious and proved them came out of this study in particular, And and cigarettes was a big one.

I read in this article. I can't remember where it came from, Chuck, I sent to you where um they were talking about how one of the reasons why cardiovascular disease spiked in the forties was because they were giving free cigarettes out to all of the g I s during World War Two. They had like an endless supply of free cigarettes over there, and that they think that directly led to a rise in the in depths from cardiovascular disease. So, but no one knew for sure. Some

people probably suspected. Every once in a while a newspaper would quote them. They would be called a crack potter and by somebody else in the in the article, and that would be that. Right. So these guys went to town like establishing a link between smoking and cardiovascular disease. They tried very very hard to um connect diet in cardiovascular disease and had very mixed results, so much so that some of their early work in that realm was

just went unpublished. For the most part, they just kind of were like, uh, we'd don't understand this, so we're not gonna include this. But some of the other ones were stroke. Like, um, if you have cardiovascular disease, are at a much higher risk for stroke. Nobody knew that conclusively before. Yeah, they confirmed that things like cholesterol and blood pressure abnormalities increase your risk. UM, irregular heartbeat, atrial

fibrillation increases your risk five times menopause. Yeah, that was a that was a big one, super big one. Um, here's here's one, Like, seriously, this was figured out in this study that um, physical activity decreases your risk for cardiovascular disease, while lower physical activity and obesity increases your risk. Like again, this is stuff that we're like, of course, who doesn't know that, well, American in the world didn't

know that until Framing a Heart Study actually published its results. Yeah, here's one that. Um, if you're in your forties and you go to get a physical, there's a pretty to get a chance. At some point after your labs, your doctor will talk to you about your f R S score. You're Framing Him risk score. It is still widely used today as the standard. And that is the very sad moment where your doctor says you have this much of a percentage risk of of developing heart disease within ten

years from this state. They tell you have a hundred and three risk. You say, well, what can it go up to and they say a hundred Yeah, that's not good. Um, so there's the Framing HUM risk score is based on a bunch of different risk factors. And by the way, the term risk factor was coined from the Framing Him

Heart study, So that's another thing it gave to the world. Uh. Your risk factors are based on your age, your gender, total cholesterol, HDL cholesterol, whether you have diabetes or not, whether you smoke or not, and your systolic blood pressure. You put all this together, each of those gets a score. You can come up with a really really good indicator of whether you're going to come down with a cardio

of vascular disease in ten years. If you're a white guy, um, to a lesser extent, if you're an African American guy, to a much lesser extent, if you're a woman of I think any um ethnicity. Do you get a piscol every year? I try to. It's been Oh it hasn't been a year yet. I'm just under a year right now, but I need to find a new doctor. Are you. Uh how's your cholesterol? It's great man? My family dude?

Oh yeah, is that it runs high? Well? I mean I certainly do don't do myself any favors with my weight in my diet, but me, my brother, and my sister are all on cholesterol medication. Oh is that right? Statens? Is that what it's called? And and my brother like is in great shape, and so's my sister. So it's ah yeah, I mean it's just a totally Bryant family tradition, just naturally high cholesterol. Huh. Well, I mean my dementia runs in my family, so I'm toast one way or another.

Oh yeah, I mean it's basically you look at your family history and spin the big wheel. What's gonna kill me? Right, It's like common medical science, finally care for mine. Let's go with that one first. Well, thank god for statins there, you know now my cholesterol is great. So I since I went last went to the doctor, I've begun to introduce butter into my diet way more than I ever

had before. But I love yes, of course, Um like a really if it has like a picture of an Amish person on the cover of the package, go with that butter butter. Yeah, And I actually I read a taste test on maybe rancor or something like that of butters and apparently the ones that are like a pound really don't taste much better than like Carrie gold that you get at the grocery store just about any grocery store. So I found like that's good. I'm not really missing

out on anything. Um, I'll just eat more cheese butter and just like a little bit of butter on some bread is a really like delightful little treat um ten times a day. So I'm actually really interested to see what my cholesterol is like this year. I'm I'm basically

just performing a test on myself right now. Well, and they've learned so much in the past like ten years or so about good fats and bad fats and low fat foods really not being all they're cracked up to be, because then they're packed with other things that are bad for you, especially high freak toose coins from Yeah it's good, we go with a good uh local butter called banner butter. Mm hmm, it's it's good and you know, who knows if it tastes a better, but it's it's locally made,

so that's always nice. Is it made from those doomed goats across the street from you know, we just fed them yesterday though, did you did you go? I'm so sorry for what's going to happen to you know we. I don't think they're doomed. I think they are are being raised again and sent to Jamaica. Not for food for what for for milk and cheese to raise people's spirits. Well, they certainly do that, those goats playing. But yeah, it's not like every goat has to be eaten to have worth. No,

I agree. I'm just saying they're also milked in there cheese. We save all our Emily is a juicing theme now. So we have a lot of um green scraps now, so we just save them all and then about two times a week we'll we'll take the kid over there and feed the goats and it's pretty fun. They bray at us now when we leave our house. Oh yeah, they're like, can't you bring that over here? Pretty boomed? Yeah, they love it. So you guys have green scraps. Let me give you a little piece of advice to pass

along to Emily. One word, but I'm going to pronounce it like to Vita mix. Oh dude, we've had a a mix for like ten years. Is that what you use? Yeah, you should have scraps. You gotta throw all that stuff in there so you get the fiber too. Now we we don't throw like the butt end of the celery stalk in there. Okay, all right, stuff like that. I got to because you know there's like there's like juicers that just extract the juice and leave all of the fiber.

I thought that's what you were talking about. No, no no, no, we well we do two things. We have the Vita mix for a lot of the green smoothies and stuff. But then we are also juicing some of the stuff and uh, we'll give those the juice scraps to the goats. But we we do both like every morning now with some sort of green juice and smoothie. Okay, so you do have like a juice or juicer than two? Right? Yeah? Yeah, okay, I have another piece of advice for you. You're gonna

love this one. Get yourself some good mescal it's so hard to find these days. Juice, some cucumber, yeah, you're doing that. A little bit of lime juice which you don't need to run through the juicer, and then some sort of sweetener and thank me later. And and then mescal. Yeah, oh yeah, much as you like, because then we've been drinking the vodka. Uh with her fresh juices fail. Yeah, that goes really well with the two. This is this

is a different, This is something different. You know. The mess cow really stands out with the cucumber, makes it pop. Yeah, give it a shot. All right, are we gonna let's bring this homeless up torturing all these poor people who are still listening. I think we got off track with butter and goats, so f rs is what we were talking about. Oh, here's another one. For you. Uh, they've just some little ancillary things they've learned over time, because

it's not just about CBD. They've learned about things like um depression and stress and anxiety, sleep apnea for one, increasing a risk of stroke. And then they gave a really uh ingenious thing when they just said, hey, we've got all these people over this big chunk of time, so why don't we start seeing if people will give us a little bit of brain matter upon death and

we can start looking into things like Alzheimer's and dementia. Yeah, and they've actually found recently, at least in the framing and population, dementia's going down, which hopefully means that it's going down in the larger population as well. But yeah, they have all this study data and they say, well,

let's start mining it for other diseases as well. And it's becoming not just a gold standard for cardiovascular disease, but for like other neurological diseases as well, and eventually, almost certainly it will become the gold standard for genetic investigations into diseases as well. Yeah, And like we've been talking about the lack of diversity over the like, basically this is really good results for white dudes. They have since over the years included other calculators for minority groups.

For women, Uh, the f risk calculator is for British minority groups. The Reynolds Risk score has been developed for women. Uh. And I think a couple of others too, where they've tried to take all this data and then tailor it to a specific group. They've also found that people who go on vacation to have lower incidences of cardiovascular disease. So remember to vacate at least twice a year. Uh. What else? Oh that thing about dating people who look

like you? That was interesting. Yeah, I guess they saw that in the initial cohort, a lot of people, a lot of married couples looked alike. And they think that people were preferentially seeking out people about their height, their weight, um, maybe their hair color, who knows, but that that's largely gone away in the second and third cohorts. I also read an article that UM said that they found that

human evolution is still going on. They're noticing that each generation of women is slightly shorter, slightly pump plumper, and I'm talking like a tenth of an inch shorter and something like a half of a pound heavier, but that they this is traditionally tied to UM being able to easy more easily UM have live births, another way to put his having kids, because a lot easier to have kids, right,

is wrong with me? Um? So they think that this is like as they're seeing in in framing evolution still in place, which very much contradicts what a lot of people have long said, which is humans took ourselves out of evolution a while back when we started intervening in medicine and things like that. So that just the this cool pictures of humanity that this is provided. It's pretty sweet,

pretty pretty great study. Actually it is, and hopefully this will be I know they had a little trouble getting extended funding at one point, and they had some private institutions that stepped up, some kind of unusual ones like Oscar Meyer, and I believe that one of the cigarette companies, right, and then Nixon eventually he got out the checkbook and wrote him a big fat check, probably probably the thing that he's most known for his president too, I think,

so continuing the framing Him heart study, I read that he got out the checkbook or or twisted the arm of the National Heart Institute. Um, because one of the early champions of the Heart Study was Nixon's personal doctor, and that's how it all went down. He's like, turn your head and cough and give us fifty million dollars. You got anything else? Nope, Well, we could probably just talk about framing him for days, but we're gonna stop now.

I would urge you to go read I'm not even sure when it was written, but a CBS Sunday Morning article from maybe like the early two thousand's about framing him and the Heart Study, and it really just kind of gives you a picture of the people there. And then I also saw when that was critical of it that was pretty interesting, called framing him follies on something called protein power dot com. Um, just go read them both. You'll enjoy it. Uh. And since I said you'll enjoy it,

it's time for listener, ma'am. I'm gonna call this follow up on the beach near the Hearst Castles a couple of week to go. We talked about the when I went and I thought I didn't think there are Walrus's. I just couldn't remember what they were, and they are, in fact elephant seals. I said they were sea lions. That was wrong. Oh that's right, you did say sea lions. Well that's right. Um. Hey, guys, listen to the show on Walrus's and Chuck referred to the beach near Herst Castle.

They call it Piedras Blanca's Elephant Seal Rock Rookery. I think it's funny that you had mentioned that because for our honeymoon last June, my husband and I stayed in Oceano for a week near Pismo Beach, and one of our activities for a day was to go to Hearst Castle and Elephant Seal Beach. Of course, hers Castle was amazing. I still haven't been in there. I need to check that out. Uh. You know that one party scene at in Billy Madison was filmed at Hurst Castle. Yeah, I

never saw that. Still. Um. Getting to see the architectural history and artifacts that reside there were great. But the beach, unfortunately, on that particularly, was pretty quiet. I think it was a nap time by the time we got there, because most of them are sleeping or adjusting and going back to sleep. Well, it's still fun to see him. It's not like they're out there with with the beach ball.

Like in cartoons, it's fun. It's fun to be overpowered by their stench when you're down wind of that massive elephant. That uh. There were a few males that started an altercation, but that ended pretty quickly and wasn't all that noisy. I think the most interesting thing on that day, besides seeing them up close, he was watching them sleep in

the water. First, I got a little nervous because I wasn't sure if they were alive, but after several minutes of watching one of them, it moved once the waves pushed it close enough to the rocks. However, if you do suggest people to go there, please tell them to be aware there are no feeding of the squirrel signs. There was a group of preteens that didn't regard the sign and literally got chased by a big, fat squirrel. It was hilarious to watch, but a little scary. Thanks

for the show. I hope you're doing well. Keep up the work. And that is Morrigan body and Morgan actually just emailed back when I told her she was going to be on and said, o MG, no way for exclamations. Thanks smiley face emoji, and then she inserted I guess her or previous surname Morgan Meyer's body. Okay, way to go, Morgan. Thanks for the emojis and the exclamation points to all

for it. If you have a story you want to straighten us out with, you can tweet to us at josh um Clark or at s Y s K podcast. You can also go on to Facebook dot com slash Charles W. Chuck Bryant. You can also visit Facebook dot com slash stuff you Should Know. Send us an email to Stuff Podcast at how stuff Works dot com, and join us at our home on the web, stuff you should Know dot com. For more on this and thousands of other topics, is it how stuff Works dot com