105: New Cholesterol Guidelines 2026: What Your Numbers Mean & What to Do

Cholesterol advice has been stuck in “it depends” for years, and we wanted something more concrete you can actually use. So we dig into the 2026 American Heart Association cholesterol guidelines and translate them into plain language: the new LDL cholesterol thresholds, what counts as borderline or high, and why having clear targets can make shared decision-making with your doctor, nurse, or PA a lot less vague. We also explain why non-HDL cholesterol can be a helpful “total bad cholesterol” goal, plus the HDL and triglyceride ranges that still shape overall cardiovascular risk. 

One update we’re especially excited about is the class one recommendation to check lipoprotein(a) at least once in adulthood. Lp(a) is largely genetic, doesn’t reliably drop with diet, exercise, or standard statins, and can raise heart attack and stroke risk even when the rest of your lipid panel looks normal. We walk through what the numbers mean, how common elevation is, and how this single test can change the intensity of prevention for you and prompt testing for family members. 

We also cover the new Prevent equation for 10-year risk, including how it accounts for factors like diabetes and kidney function, and why the risk category cutoffs have shifted. From there, we lay out the foundation of dyslipidemia treatment: heart-healthy eating, consistent physical activity, weight goals, smoking cessation, and limiting alcohol. And when lifestyle isn’t enough, we get practical about medications, including statins, ezetimibe, PCSK9 inhibitors, inclisiran, and bempedoic acid, along with straight talk about safety and the harm of online statin myths. 

If you care about prevention, family history, or simply want a clearer plan for your next lab review, this one is for you. Subscribe, share this with a friend who’s confused by cholesterol results, and leave a review with the one question you want your clinician to answer about your heart disease risk.

Transcript

Welcome And Why Guidelines Matter

SPEAKER_00 0:03

Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversation from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area.

SPEAKER_01 0:18

And I'm Nicole Rufo. I'm a nurse.

SPEAKER_00 0:20

And we are so excited you were able to join us here again today. So what are we going to talk about today, Nick?

SPEAKER_01 0:28

Today we're talking about something very exciting.

SPEAKER_00 0:31

So exciting. There is them.

SPEAKER_01 0:33

The new 2026 cholesterol guidelines. You heard it here first, people.

SPEAKER_00 0:40

And what they mean for the average person.

SPEAKER_01 0:42

Yes.

SPEAKER_00 0:43

Moreover. Like what might change when you have those conversations with your doctor, nurse, physician's assistant, whoever the heck is taking care of you.

SPEAKER_01 0:52

Whoever the heck's taking care of you.

LDL Cholesterol Thresholds Made Simple

SPEAKER_00 0:54

So this entire conversation is based off of the 2026 American Heart Association Guidelines. Um, we're gonna go over screening recommendations, risk thresholds, maybe some current treatment options. So it's a juicy one. So buckle up, um, and we'll try to make it exciting for you. So cholesterol is a waxy substance in your blood. While your body needs some cholesterol to function, definitely, too much of certain types of cholesterol can build up in your arteries and ultimately lead to heart attacks and strokes. Managing your cholesterol is one of the most important things you can do to protect your heart health. And so, one of the cool things about these new guidelines is that they better define actual thresholds for LDL cholesterol. And so the next part of what we're gonna do is we are going to talk about the thresholds for LDL cholesterol. This is very fun because it's like it's plain English, it's very obvious. People can understand this. So they define that optimal LDL cholesterol. That's the unhealthy one. Um, I try not to say this to patients, but I say it out here. L is for lard.

SPEAKER_01 2:10

You're welcome.

SPEAKER_00 2:11

Thank you.

SPEAKER_01 2:13

You don't tell your patients that I feel like they would remember it.

SPEAKER_00 2:16

Maybe. I don't know. I don't want to offend anyone.

SPEAKER_01 2:18

Um read the room on that one.

HDL Non HDL And Triglycerides

SPEAKER_00 2:20

Yeah, no, it's tough. And some people are wild cards. Um, so optimal is less than 100. Easy peasy. Less than 100 is optimal. Near optimal is 100 to 129. Still pretty good. So if we're basically under 130, you're doing pretty good. And that's what I've been talking to a lot of people about just from reading other cardiology literature recently. So now we get into like where risk is a little increased. Borderline high is between 130 and 159. Sort of a yellow flag to say, hey, maybe something's going on here. You should kind of think about making some adjustments. High is 160 to 189. That's what it is. High. That's what it is. And then very high, teeter-tottering on the not even teeter-tottering, the like probably a genetic problem is very high, 190 or above on LDL cholesterol. What also is cool is there's a new emphasis on non-HDL, basically saying all of the bad cholesterol, the total bad cholesterol. This number includes all of the harmful cholesterol types combined. And so your doctor will make a goal based on your overall risk, essentially for this one. HDL is the good cholesterol. We've talked about this before, but it's always good to keep these things in mind. For this one, the higher the better. H for healthy. 40 milligrams per deciliter or higher for men is something to think about as a healthy threshold. And 50 milligrams per deciliter or higher for women. The guidelines also recognize triglycerides as another type of fat that can be harmful if present in excess. They define normal as less than 150 milligrams per deciliter, and that's all these numbers, so I'm not going to keep saying the unit. They say borderline high is 150 to 199. High is 200 to 499, and very high is 500 or greater. Yes, no, I've seen that a bunch of times. Um, this one does move if you don't fast. So if you're fasting, you'll get a different number. This one is very related to the meals that you eat. And so practically, we'll get to how to fix that later in the episode. Does that seem fair?

SPEAKER_01 4:47

I think so.

Lp Little A One Time Test

New Prevent Risk Calculator

SPEAKER_00 4:48

It's cool that they actually give thresholds, especially about LDL. Um, the guidelines, the last ones were from 2018, and so they gave, they basically just said like risk assess the person and then figure out where you want to go based off like and lower their LDL cholesterol from there, which is vague and challenging to actually implement. Now, doctors, nurses, and PAs can align with patients and say, like, okay, this like this is obvious. We should try to get less than 100 or whatever your goal is that you set by your doctor. Because not everyone, some people need lower goals. All right, we're gonna transition to the next one. I'm gonna take this one and then Nikki's gonna hop in shortly after. One of my favorite Oh, goodness. Yes, one of my favorite things because I think it's just about marketing. And if you know anything about us, obviously we do this whole podcast, so we love to talk about things and make people aware of them. And so from a primary care angle, oftentimes we're the people ordering the labs that people get. And so there is one lab that ever since I've been a new attending, I've been thinking about a lot. And now it's prime time. It's a class one recommendation. It's the highest recommendation that you can have in the American Heart Association guidelines in 2026. I don't want to bury the lead anymore, but it was a dramatic thing to bring up lipoprotein little A. We talked about this before. We had a whole episode about this, but we're gonna give you some old information and also some updated contextualized information for you here today. LP little A is a special type of cholesterol particle that increases your risk of heart attack and stroke. Unlike regular cholesterol, LP little A is almost entirely determined from your genes. It's inherited from your parents. What I've been telling people is that it's like a birthmark, but invisible, like cholesterol. There are some key facts that I want to share with you. About one in five adults, 20% have an elevated LP little A. LP little A generally stays the same throughout your life and they don't change with age. Unfortunately, diet and exercise do not lower LP little A. Statins also do not lower LP little A significantly. And when all of the other cholesterol numbers are normal, having a high LP little A can still increase your risk of heart disease. And so here in March of 2026, the American Heart Association has finally come out and said that all adults should have an LP little A measured at least once in their lifetime. So, brass tacks, what do the numbers mean? Because you're gonna get numbers back, your doctor is gonna get back to you at some point, and it's gonna take a little while. But here's what the numbers mean. So these risk comparisons are comparing the number that we're gonna talk about to someone with an LP little A of 20. So normal is having an LP little A of less than 50 milligrams per deciliter. Elevated is technically considered above 50, and that would say compared to someone with a 20 milligrams per deciliter, that's about a 40% higher risk of heart attack and stroke. I've seen plenty of people who have it high between 80 and 180, and that about doubles the risk. And they draw a threshold, they have a nice, a nice figure. They draw the threshold, they have a nice figure, and they say very high is 180 milligrams per deciliter, and that is about four times the risk of heart attack and stroke. Now, I've had people who are in the 200s, I've had a woman with 330 on this. So, this is an opportunity where I think primary care and cardiologists can really team up to help these people where they have a family history. They're like, Yeah, my dad had a stroke, like a heart attack in his 40s. Oh my goodness, what does that mean for me? And if everything else is normal, and then you get this lab and it's elevated, it can be so important for that person. All right. So we're gonna transition again. I'm just so excited about this topic because it really does change so much about what I do day to day. Um, all right, so another big thing that changed is the calculator that we use to assess one's personal risk of heart attack or stroke in the next 10 or 30 years. There were old calculators. This is like a very nerdy behind the scenes thing, um, but it's important because the new calculator is called the prevent equation from the well, the calculator is derived from the prevent equations. And the calculation considers all of these things, which is much more comprehensive for someone's health. It chooses, you it looks at your age, sex, blood pressure, cholesterol levels, diabetes status, believe it or not, it wasn't in the old one. Kidney function, it wasn't in the old one. Whether you smoke, it was. And whether you've already taken cholesterol medication. There is also something called a social deprivation index where the zip code can go in there, admitting that people have different lived experiences if they live in different socioeconomic areas. This might be two in the weeds, but I'm going to share it anyway. Is that because the calculator works differently than the old one, they also changed the categories. They still use the old ones that we talked about on the show: low risk, borderline, intermediate, and high risk. But now they have different thresholds because the old calculator comes out with numbers differently and assesses risk differently. So they changed this in advance. Low risk is considered less than 3% chance in 10 years. Borderline risk is considered 3% to less than 5% now. Intermediate risk is considered 5% to less than 10%, and high risk is considered 10% or higher. And so your treatment goals now depend on your risk category, meaning that higher risk patients have more aggressive treatment targets. And you could be in one of these groups, like you haven't had a heart attack or stroke, that's called primary prevention, and you're being proactive and working on these things. Or if you have had heart disease, that's called secondary prevention. And ultimately, you are considered very high risk if you've had multiple heart attacks or strokes, or if you've had one event, plus you have other high-risk conditions like diabetes, kidney disease, or a high LP little a. Those are the big changes. Um, there are a couple things about kids that I want to mention is that there is an if there is an early significant family history in children, it is reasonable to check cholesterol levels at two to four years old. They also recommend, and I know your ears perked up over there, and they also recommend universal, and so does the American Academy of Pediatrics, universal lipid profiling for children between nine and eleven. And so I think that's awesome for family medicine because we see people in the continuum of someone's health and a huge opportunity to be able to make early relationships with people and keep them over time. So those are the two things. Well, I'm really jazzed up about this episode here.

SPEAKER_01 12:28

Um it's your favorite topic.

SPEAKER_00 12:30

It is one of them. Maybe second in medicine. Um's your first probably obesity.

SPEAKER_01 12:35

Oh, duh.

SPEAKER_00 12:36

And like behavioral health. Anyway.

SPEAKER_01 12:38

Oh, that's what I wanted to talk about. Actually, maybe next because I didn't finish watching it.

Lifestyle Foundations For Better Lipids

SPEAKER_00 12:45

So anyway, go ahead. Can you take us through the foundations of treatment? We're gonna switch from risk profiling, which has been super exciting, to stuff that we've talked a lot about on the show, but it's always worthwhile to revisit because spaced repetition helps learning. And we can't help but get so excited about these opportunities for healthy improvements for people to make. So I'm gonna stop talking and I'm hoping you can take us through the lifestyle changes that are the foundation of treatment for dyslipidemia.

SPEAKER_01 13:22

Yeah, I sure can. We love talking about lifestyle changes here at your checkup. All righty, what should we start with? Heart healthy eating, perhaps?

SPEAKER_00 13:33

Mahaps.

SPEAKER_01 13:35

Okay, we've said it once, we've said it twice, we've probably said it thrice. But heart healthy eating, we're eating more fruits, vegetables, whole grains, and our favorite legumes.

SPEAKER_00 13:49

Love a legume.

SPEAKER_01 13:51

We're having lean protein like fish, chicken, beans, and nuts. We are avoiding trans fats, which are found mainly in those processed foods. We're limiting our saturated fats, which are in things like red butter, red butter, red meat, butter, cheeses, and fried foods, and then limiting refined carbs and sugars.

SPEAKER_00 14:17

That sounds amazing.

SPEAKER_01 14:18

And we have an entire episode on this, I'm pretty sure.

SPEAKER_00 14:20

We absolutely do.

SPEAKER_01 14:21

So you should go listen to it if you haven't already.

unknown 14:28

Trying to get stuff.

SPEAKER_01 14:30

First lifestyle change, second one, of course. Something else we'd love to talk about is physical activity. And we have also said this once and said it twice and said it thrice.

SPEAKER_00 14:40

It's always you who says it too.

SPEAKER_01 14:43

For physical activity, we are aiming for at least 150 minutes per week. Not per day, it's not that dramatic. For over the course of seven entire days, just 150 minutes of moderate intense exercise. So something like going for a brisk walk, or alternatively, if you want something a little more vigorous, you can do 75 minutes again per week, not per day, um, of vigorous exercise. So, like running or cycling, something more high intense. And then also including strength training, um, at least two days per week for I mean, not even just your heart. It we also have episodes on this too.

SPEAKER_00 15:28

We do.

SPEAKER_01 15:30

Um, of course, um, a healthy diet and physical activity will lead to hopefully the goal of maintaining a healthy weight and even losing about five to ten percent of your body weight can improve your cholesterol levels. Um, another big one is don't smoke. If people are still doing that these days, um seems like they are definitely.

SPEAKER_00 15:56

Yep.

SPEAKER_01 15:59

Um, if you smoke, just stop. Which I realize it's a lot more difficult than just doing that. But you should really your doctor can help you if you need it's really for the betterment of everyone involved.

SPEAKER_00 16:17

It actually is probably the biggest risk factor for heart attack and stroke and like that, the unhealthiest thing that someone could do.

SPEAKER_01 16:26

Um, and then of course, limiting alcohol, which we we've been talking a lot about.

SPEAKER_00 16:32

We've been talking about in like in passing. Not we won't have like an exclusive alcohol episode. I think we're having a mounting little like we talk about it here, we talk about it there, but I'm with you.

SPEAKER_01 16:42

Yeah.

Statins Work And Myths Hurt

SPEAKER_00 16:44

Great, thank you so much. Oh my god, you're so welcome. Perfect. So if the lifestyle changes aren't enough, your doctor may recommend medications. Oh my goodness, statins are the most common and effective cholesterol lowering medications.

SPEAKER_01 17:00

Yeah, don't be a statin denier. Don't be weird.

SPEAKER_00 17:03

They let me say that again. They are the most common, safest, and effective cholesterol-lowering medications. What I'm gonna say is we now, in the effort to be like to get more FaceTime or ear time in front of people, something that I've been talking a lot more about is the heinous comments that are unscientific that come in Facebook posts, if you will, about statins. And people, statin deniers, have such strong, baseless claims that turn away or turn the average person to doubt. And you know, the statin denier won't take a statin and they never will, and that's fine.

SPEAKER_01 17:54

But and then they'll have a heart attack.

SPEAKER_00 17:57

Yeah, and they'll be at an increased risk of having a heart attack. But it's the it's the average person who I worry about because there's a lot of people who are either just like they don't know about it, they're ambivalent, and then I see them at best every three months, and so does anyone else in healthcare at best and consistently. And you get 20 precious minutes with the person who's prescribing this to you who knows that like it's probably the best thing for you in the right situation, and then you're online and seeing these comments. Nice pick on the puzzle piece there.

SPEAKER_01 18:34

That was a good one, right?

SPEAKER_00 18:35

That was a good one, and you see people talking about these unscientific claims that I hesitate to even give airtime to. And it's awful. I so hear it here.

SPEAKER_01 18:47

Also, if you're getting your medical advice from a Facebook page, um, maybe don't. Yeah. Like there are some good, but I think also a lot of it. Like, you need to look at who is oh my goodness writing the information that you are consuming.

SPEAKER_00 19:08

Definitely.

SPEAKER_01 19:09

Yeah, check your sources, people. Okay, anyway.

Add On Drugs For LDL

Diabetes Kidney Disease Pregnancy Considerations

Rapid Fire Statin Questions Answered

SPEAKER_00 19:12

Yeah, I I will give one. The one people talk about is concern of dem increased risk of dementia, which is not true. And I'll say it again, is not true. It's been studied, it's once again not true. And we have an aging population, and it's like saying the sun causes broken arms. And if the sun is out, the weather is probably warmer, more children are outside playing on scooters, bikes, playgrounds, what have you, breaking arms. It's like saying the sun causes broken arms when you say that statins cause dementia, which they don't. We have an aging population who accumulates a lifetime burden of vascular disease. We're gonna talk about hypertension later in like the next few weeks, and how hypertension is causally linked to dementia, but not statins. It's I've spent enough airtime talking about it, but I just really like look, that one is among so many of them where you get some people who just say that they're the devil in the comments, and look, you don't have to take it, but also stop carrying forward misinformation to other people who see this passively. Okay, gosh, this episode I look, team. I actually sat down and I was like, I don't want to do this today, but I'm jazzed up right now. We gotta get our way through this though. Common statins include a Torvstaden named Lippertor with the brand name, Rosuvastatin, brand name Crestor, Symvastaden, brand name Zocor, Pravastadin, Pitivastaden, and there is a little to-do about statin intensity, where there are high-intensity statins and low-intensity statins, you know, stuff like that. Um, that's more for like doctor thought. So then there's another medicine that your doctor might prescribe if you weren't able to get to the goals they set for you called azetamib or zetia. This blocks cholesterol absorption in your intestines. Um, it lowers LDL cholesterol by about 15 to 20 percent, and it also does not lower LPA. There are new medicines, these are injectables, and they work very well. They are called PCSK9 inhibitors. Um, they have big fancy names. Um, I'm gonna try here Alirocumab or Praluent. Um, it's an injection every two weeks. Evillocumab or Rapatha. You probably see commercials for that now. Injection every two weeks or monthly. These are very powerful LDL lowering agents by 50 to 60 percent. Um Top of people using statin. They may also capture a little LD LP little a lowering and could be helpful in this moment. There's also another one called enclycerin or lec lecVio. It's an injection given twice yearly, which is really convenient after the initial doses. It can lower LDL by about 50% and also captures some LP little A lowering. And another medicine called bempadoic acid, which is a pill taken once daily, and another option for someone if they can't tolerate statins. All right. So uh we talked a lot about LP little A, and there are emerging therapies, um, which I'm not going to try to pronounce, but they're coming because we know that this is a risk and it's real. So in the coming years, there will be hopefully new FDA approved medicines for actual LP little A lowering, which is very exciting. Okay. We are running along on this episode, but people can break it up if their attention span weights. Next, we're going to talk about some special conditions, special situations. Most people with diabetes aged 40 to 75 should take a statin. It's not medical advice, it's just fact. Even if cholesterol levels aren't very high, diabetes significantly increases risk of heart disease. This next one's new. That one's old. We knew that. I teach that to all my students. But this next one, if you have chronic kidney disease, stage three or four, cholesterol treatment ends up being especially important to you. And so the doctor will make, or nurse or physician's assistant will make adjustments based on your kidney function. But it's a do not pass go automatic in CKD three and four. The next one is that you're if you're over 75, you know, cholesterol treatments at this point are individualized based on your overall health, life expectancy, sorry, and preferences. If you're already on a statin, tolerating it well, and you're taking it like the vitamin for your heart and your mind that it is, go for it. Keep going. If you're done with it and you haven't had a heart attack and a stroke, you could probably talk to your doctor about it. If you're pregnant or planning for pregnancy, one could consider stopping, or probably should just do anyway. Stop statins one to two months before trying to conceive, or as soon as you know you're pregnant. And if you have familial hypercholesterolemia, you should probably just be on a statin. All right. And once you start the medicine, blood tests will be done probably every like month or 12 weeks to see how things are going. And if things are controlled, people will space it out as they see fit. All right, Nikki. We're bringing it home here. There are some common questions that people have that I wanted to say. Maybe we can go back and forth. I'll read the question, and maybe you can give the answer. Does that seem okay? Sure does. All right. So question one are statins safe?

SPEAKER_01 25:20

Drum roll, please. Yes. Statins are safe. I will say it again. Statins are safe. Statins are safe. And they are also among the most studied medications and are safe for most people. Serious side effects are very rare.

SPEAKER_00 25:44

And rare means rare.

SPEAKER_01 25:46

Rare means rare. Okay.

SPEAKER_00 25:48

What about muscle pain?

SPEAKER_01 25:51

Some people can experience some muscle pain or aches on statins. If that happens, just tell your doctor. There are many other options, including a different medication, adjusting the dose. You know. Yeah. There are things to do. It's okay.

SPEAKER_00 26:07

Ooh, ooh. Can I stop my medication if my cholesterol improves?

SPEAKER_01 26:12

So, no, not without talking to your doctor. Talk to your doctor first. Um, it's the medication that's keeping your cholesterol controlled. So the same as if you're taking a medication for your high blood pressure and you say, Oh, my blood pressure is normal now. Can I stop taking my medication? Like someone we know, or like if you take a medicine for depression and then you're not depressed anymore. Same thing. Okay.

SPEAKER_00 26:40

Darn. Do I still need to eat healthy if I'm a medication?

SPEAKER_01 26:44

Yes. Yes, you do. You should be eating healthy anyway. And that will only um, you know, everything will just work best when you also have that lifestyle modification.

SPEAKER_00 26:57

Awesome. Thank you so much.

SPEAKER_01 26:59

You're welcome.

What To Ask At Visits

Match Week And Medical Training Stress

SPEAKER_00 26:59

So as we wrap up here, just a couple thoughts. Managing cholesterol or dyslipidemia, I like to say, is mainly because like all cholesterol isn't bad. It's HDL, um, is a partnership between you and the people taking care of you. So please ask questions if you don't understand something. Write them down, come with a list, do whatever you got to do to make sure you feel successful at your visit. Um, report any side effects from medications. Let people know they want to help you, but let them know because they need to know. Keep all follow-up appointments. Literally, don't cancel if you think that you don't need to, because there's always something on the person who's taking care of you's mind to help you. Um, you should probably take your medications as prescribed, and you should continue in the background, the foundation of all of your healthy lifestyle habits. You could ask about an LPA test if you haven't been tested. Questions to ask your doctor also include what is my 10-year heart disease risk? They can calculate it right in front of you. What are my specific cholesterol goals? It's a thing now. People should have them. Some people have ones as low as 55 for LDL. Um, have I been tested for LP little A? If my LP little A is elevated, what does this mean for my treatment? Should my family members be tested? The answer is yes. What are my risks and benefits of my medications? People always forget the benefits, but medications have benefits. And are there clinical trials about new LPA lowering medications I might qualify for? Which might be a conversation for the cardiologist. Dyslepidemia management is one of the most important things you can do to prevent heart disease. And so we hope that today you were able to learn a lot. I mean, we probably shoved two episodes into one to make this episode for you. And I think there's a certain energy to it because it is about prevention. And that's what we I think both of us care a lot about, trying to prevent things from happening before they happen, if we can afford to. So it's a really nice, sunny, Sunday, early evening, afternoon as we are recording this. Thank goodness the weather broke. Look, I'm telling you, like I went, I walked Ollie earlier in the week and I popped outside. It's like sub-30 degrees. My hands hurt again.

SPEAKER_02 29:21

Oh.

SPEAKER_00 29:22

You know, I decided to not wear gloves because I thought it was nearly spring. But um, that's gone. Um, now it's spring and went for a little run today. I was happy about that. You're suffering from an injury, as it were.

SPEAKER_01 29:40

Yeah.

SPEAKER_00 29:42

Yeah. That being an unexciting thing, we won't have to spend time talking about it. Um, what is exciting is that it was just match week, um, which for anyone not listening is the very, or anyone not like in medicine listening, it's the extremely dramatic unveiling of where medical students end up going to train for residency after It's like actually so diabolical if you think about it. It really is.

SPEAKER_01 30:09

Don't you think?

SPEAKER_00 30:10

I think so.

SPEAKER_01 30:11

Like it's like ranking your like top friends on MySpace. Yeah. But like at a much larger scale, and like in a way that completely alters the trajectory of someone's life.

SPEAKER_00 30:24

Yep.

SPEAKER_01 30:25

Yeah, they always try to say all by a computer, really.

SPEAKER_00 30:28

Yeah. They try to give euphemisms of like everything happens for a reason, or oh my goodness, this is this is how it's supposed to be. But at the end of the day, it is an incredibly stressful thing.

SPEAKER_01 30:44

Yeah, it's really dramatic.

SPEAKER_00 30:46

And if it wasn't enough, they don't just like email it to you, they do, but you know, most schools create this like system they create this like event that people like all everyone and their families go to and they make it very dramatic, and everyone gets dressed up and there's cameras, and then like people end up like elated, some people end up disappointed, end up disappointed.

SPEAKER_01 31:12

That's actually so crazy.

SPEAKER_00 31:14

Devastated. So it's uh it's a very complicated thing. Um, we we had uh our near, dear, loved Alex go through his match, and we're so happy for where he ended up, and we are so excited for his journey ahead. Um, I like definitely didn't ask him to, so I won't share any details, but um Yeah, I'm actually so jealous where he gets to move to.

SPEAKER_01 31:42

We're gonna be stuck here.

SPEAKER_00 31:44

A.

SPEAKER_01 31:45

For the foreseeable future.

SPEAKER_00 31:47

Easy, easy. Um, no, we're happy for him and congratulations.

SPEAKER_01 31:51

Well, we are adults with free will, so we could move anywhere we wanted, whenever we wanted to. Theoretically, we could have a two-year contract here. We could go anywhere when that's up.

SPEAKER_00 32:02

Easy. Um, so we're we're so happy and proud of him and wish him nothing but the best in his upcoming adventures and this new journey. Look, residency stinks no matter where you do it, what you're doing it for for training, but doing it in a place like he's going to makes it stink a little less, to be completely honest.

SPEAKER_01 32:23

He just doesn't know it yet.

SPEAKER_00 32:24

He just doesn't know it yet. Yeah, the whole thing though is like is crazy. They um they know it's like all these applicants have to just for like, I think this is how we're gonna spend our banter section. Um, applicants have to send out their that they have to apply, big, big application. Then they have to go do like several interviews while they are in the middle of like doing rotations in the fourth year, and then they have to meet people, and then on the other side, the programs have to meet people, and everyone picks each other and everyone makes a list. And the whole thing is figured out in a matter of seconds because of the computer. And you know, they leave the poor souls who don't match, like they give them like five days, five days to figure out where they're gonna go. Which I've always made the argument they should extend that time by like a month. Like, if you know, tell the people whether they matched or not a month before match, so that there is like some opportunity for people to look around. Right?

SPEAKER_01 33:28

Yeah, but that would make too much sense.

SPEAKER_00 33:32

It would. Well, that's our little blurb on match day. Um, we got to celebrate with Alex afterwards, and that was good fun had by all. And we'll probably see him for laundry day on Thursday.

SPEAKER_01 33:47

Yeah, we have laundry day.

SPEAKER_00 33:51

Yeah, like the laundry machines in his building like blew up, so now he's been coming over to do laundry. And it was very nice. Um he came over even when you were you were here, um, and I was at work, which is very nice. Speaks to the the friendship that you two have. Did you um did you notice anything new about him this time?

SPEAKER_01 34:13

Anything new about him? Oh, his new tattoo.

SPEAKER_00 34:18

He does have a new tattoo.

SPEAKER_01 34:20

He does. Well, it wasn't really something I noticed. I like asked what he was gonna be up to and if he was going to be going to the gym that evening to go see the love of his life, who he really like hasn't spoken to, but like tells us how much he's like in love with this girl. And he's like, Oh no, I like haven't been. I might just go to like go in the treadmill. I like got this new tattoo, so like I can't lift or whatever. I don't know.

SPEAKER_00 34:45

Yeah, yeah, yeah. Did you um when you got your tattoo, did you abide by all those rules?

SPEAKER_01 34:52

Um, I mean, I have like a very little microscopic tattoo. Um, I don't really even recall what they told me. The directions were not something on my entire arm.

SPEAKER_00 35:04

You don't have a falcon on your back?

SPEAKER_01 35:07

No, it's actually a pirate ship.

Chicken Meatballs And Smarter Snacks

SPEAKER_00 35:11

Oh, well, um, I'm really looking forward to gravy this week. Um, maybe or gravy, not this week, literally tonight. Yeah, a couple hours, a couple hours. And tell can you guide us through? I I really want to like fluff up. I want to like, you know, the meat and potatoes section ends up being a lot of me. I really do. Our audience loves you.

SPEAKER_01 35:36

Do they?

SPEAKER_00 35:37

They do. Even when people come back at work and they're like, Yeah, yeah, your patients do tell you that.

SPEAKER_01 35:41

Oh my god, we love her.

SPEAKER_00 35:43

So while you're click-clacking away on your puzzle over there, tell us about the balls of meat that you've done recently.

SPEAKER_01 35:49

The meatballs?

SPEAKER_00 35:50

Yeah.

SPEAKER_01 35:51

Yeah, we've been okay. Like traditionally, a meatball, as in spaghetti and meatballs would be mud on a combination of beef, pork, and veal. And the last couple times we've been making them with just ground chicken and then, you know, like parsley, breadcrumbs, eggs, SP, locatelli, all the things. But we've really been enjoying the chicken meatballs. And we did it just to, you know, chicken's a little leaner, it's a bit healthier. But we've actually been preferring them. Alrighty. Um, so meatballs got interrupted.

SPEAKER_00 36:29

We did. Turns out uh when Nikki's on call, they call you a lot.

SPEAKER_01 36:34

People okay. Oh my god, so annoying.

SPEAKER_00 36:37

We'll definitely get back to the meatballs.

SPEAKER_01 36:39

People call me for like I would say 80% of the time, it's like not something, either one, something that can't just wait until Monday, or it's something that I can't do anything about.

SPEAKER_00 36:51

The engine's gonna be revved.

SPEAKER_01 36:53

It's so like yesterday, yep, the resident called me. And I am not like one of those like people or nurses who like crap on the residents, and like I'm like friendly, like we've like gone out with a bunch of them.

SPEAKER_02 37:09

Yeah.

SPEAKER_01 37:09

And like I'm like friendly with them, and like I understand, and like watching you go through residency, like I like have like a even more like better like appreciation of it and like what they have to do. But then sometimes I'm like, you are a whole entire doctor, you went through medical school, you are in your well, that one yesterday was a second year. Calls me because a patient's daughter had a paper that needed to be signed by the attending, so he thought his call was to me.

SPEAKER_02 37:42

Yeah.

SPEAKER_01 37:42

I'm like, bro, how about you call your attending? Yeah, or they can wait until Monday and the regular attending can see what, like, I don't know. Which, like, on one hand, it's like, okay, this is a call, like, it's whatever, it will take 30 seconds. I don't actually have to do anything. Fair, but then I'm also like, oh my God.

unknown 38:02

Oh, I know.

SPEAKER_00 38:03

But like, it's not just so you know, people listening might be like this is like an isolated incident, but this is it's not, it's not isolated.

SPEAKER_01 38:10

I either like don't the phone never rings, which is perfect, because then I'm just like getting paid extra to like have this phone out on the table all weekend, or they call me for dumb stuff. Yeah, and like just got like another call from like another stupid thing, but whatever. I'll get paid a couple hundred dollars to answer a stupid phone call. So it's fine.

SPEAKER_00 38:32

It's not yeah, that it could be better. It could be worse, it could be worse, worse rather.

SPEAKER_01 38:36

So you were saying, Okay, anyway, before we were so rudely interrupted, uh, meatballs. So we've been making them with ground chicken, and we've actually do we prefer them that way? I think we do.

SPEAKER_00 38:51

I think I've liked them so much, and I think the tradition was pulling me towards BPV. But yeah, I'm like, wow, no, these are just like so delicious. Do you put more garlic in the chicken ones?

SPEAKER_01 39:05

Or is it the I have been really loading them up with garlic?

SPEAKER_00 39:09

Yeah, I just look, and it I feel guiltless like when with eating.

SPEAKER_01 39:14

Yeah, they're good. And like the Caesar salad, or yeah, the Caesar dressing we've been having. Oh my god, the Caesar is we've have been liking a creamier Caesar, not one that's like traditionally like Caesar dressing doesn't have like mayo, it's not mayo based, but we've kind of been liking a creamier one. And if you don't know, Eddie's like probably like in his top three main food groups are condiments and dressings, and so he will just eat the salad dressing, which like we don't like buy salad dressing, so at least like I'm always making it, but then a lot of times they're like olive oil based. Most of mostly it's like olive oil based. Yeah. So I started making one um that was Greek yogurt-based because while a homemade salad dressing is healthier, the rate at which you consume it, it's not probably the best to have a problem, you know, drink like an entire cup of olive oil.

SPEAKER_00 40:22

So yeah, I'm accepting this feedback.

SPEAKER_01 40:25

Not a part of my make any live longer method method. So we've made making, I've been making a creamier like Caesar dressing that's Greek yogurt-based, and it's very good.

SPEAKER_00 40:39

It's so good.

SPEAKER_01 40:40

You really like can't tell the difference. No, you absolutely cannot. I also like Skeeve mayo. It like freaks me out. No, you don't like it.

SPEAKER_00 40:46

But do you eat so if you call it aioli? If you called it aioli, would you like it? No. No, fair.

SPEAKER_01 40:53

Um, or sour cream. Something about white condiments, but like Greek yogurt. I love.

SPEAKER_00 41:00

No, we love it. Um, I think I mean we usually the oikos ones we have are usually not a promo, um, usually vanilla based, and then we jazz them up. You put chia seeds in them. I'm a little naughty, and put granola um as it's gotta up the fiber.

SPEAKER_01 41:19

Start your day off. You already have like half your fiber for the day, you know?

SPEAKER_00 41:23

Yeah. Um, but for anyone like listening to us and be like, what do they actually eat? We've had a nice rotation. Um, can you tell us about some of the snacks that we've been having?

SPEAKER_01 41:32

Um, I've been making like these protein balls.

SPEAKER_00 41:35

Oh, these, yeah, these are.

SPEAKER_01 41:37

I used to make them a lot, or I would make it in like a uh like bar form. It's just like oats, peanut butter, whatever protein powder. We've been doing chocolate, a little cocoa powder if you're doing some sort of chocolate something, a little honey. Uh I think that's it. Oh, chocolate chips to make it fun.

SPEAKER_00 41:59

How do you like get it into that? Do you just like roll them up? You just mix it up. Oh and then you just put them in the balls. It's they're so good. And they're so filling too. I need something. That's been great. And what about them? I mean, there's two I always bring. We've been big on grapes recently.

SPEAKER_01 42:18

Yeah. Grapes and strawberries and blueberries. Although the last time I ordered blueberries, they weren't the best. Which is the one thing I don't love about like I love the grocery order. It's been it really just makes our life so much different, especially like living in the city. It's like more difficult with the car and lugging all the groceries back home. But you can't pick the produce, you have to just like trust that whoever's doing your grocery order pick something good. So the blueberries weren't that good last time. So I ordered double strawberries.

SPEAKER_00 42:48

Okay.

SPEAKER_01 42:48

But we go through a lot of fruit. And I did I say this on here, or was I telling it to someone else, like at work or something? How when people like when they say they have kids and like how much like fruit your kid eats, and they're like, Oh my god, I have to take out a second mortgage on my house to keep up with the amount of like berries my kids eat. I'm like, were you guys not eating fruit before? Probably not. Because we go through them a lot, like pretty quickly.

SPEAKER_00 43:20

Admittedly, like my life before you, I was not eating. I mean, like, we had we had some fruit when I was growing up, but the gap of time between like you know, leaving Jackson and then uh meeting my wife, I was not eating a lot of fruit. So um there it I I can identify with someone who's not eating a lot of fruit. Now fruit, it's delicious. The fistful of red fruit.

SPEAKER_01 43:46

And now we have grapes for dessert.

SPEAKER_00 43:49

That that's a big a big change. Like, I mean, now it's like once in a full moon, literally like once every month, probably. It's like ice cream. And it used to be. A big thing. We used to have a lot of ice cream.

SPEAKER_01 44:03

We are gonna have some. We plan to have it tonight.

SPEAKER_00 44:06

I asked you when we were at the gym to texted you on the side. Um we were kind of out of earshot for anyone who thinks that we were that might be weird. Um for me to text you at the gym.

SPEAKER_01 44:17

Oh yeah, when we were sitting next to each other on the what are those leg squeezy things called? We were both we were sitting next to each other in their like recovery room. And they have those leg squeezy things.

SPEAKER_00 44:29

Everyone knows what we're talking about.

SPEAKER_01 44:31

And he text me, can we have ice cream tonight?

SPEAKER_00 44:38

And there's um there's pretzel protein pretzel peanut butter pretzel. Oh my god, we are that we're really, really into obsessed with pretzels. We've been having a lot of pretzels recently.

SPEAKER_01 44:50

We are obsessed with the pretzel thins.

SPEAKER_00 44:53

Mmm. Great for hummus or mustard, a vessel for mustard or a vessel for hummus.

SPEAKER_01 45:00

And the um peanut butter filled pretzels.

SPEAKER_00 45:04

Yeah, that's what I've been doing. I've been like taking a leftover from dinner or the Mediterranean bowl, which I'm very proud of. That the Mediterranean bowl was an idea that you've probably had before, obviously. But like I resurfaced with me and chat, made it once, and now it's been like a th in the rotation for three weeks.

SPEAKER_01 45:22

Yeah, just made us some now to have to bring for lunch.

SPEAKER_00 45:25

Because you're the best. And that a couple handfuls of grapes and the pret the peanut butter pretzels. I can't get that one out. And that's like that's lunch and occasionally a Greek yogurt sometimes if I gotta have something a little extra, but it's been great. I've been incorporating a walk-in-lunch. Really happy about that. Yeah, almost every day last week.

SPEAKER_01 45:46

I think it's gonna be a good walk-out lunch week this week. It was kind of weird and rainy last week. Yeah, tomorrow I think we're gonna have like it's gonna be 70 degrees on Thursday.

SPEAKER_00 45:57

Oh speaking of Thursday, meet the Mets meet the Mets. Yeah, well, I'm ready to be heard again. Um their Mets are coming back, and we're gonna start another season of baseball.

SPEAKER_01 46:12

Baseball. And baseball is so boring. Anyone who likes baseball has serious mental problems.

SPEAKER_00 46:20

And um, so they're playing at one o'clock and they're playing the Pirates. I think they're home at City Field. I am thinking about my one of my favorite times when I went to go to an opening day. I think, oh gosh, was it 2022 maybe? It was the season they won a hundred games. Um, and I went to that opening day and it was so fun at City Field. I won't be going this year, but my butt will be in the corner of that couch. And it may be laundry day, but I'm going to be watching that baseball game.

SPEAKER_01 46:50

I'm sure Alex won't mind.

unknown 46:52

No.

SPEAKER_01 46:53

Does he like the Mets? He's from like up.

Next Steps And Related Episodes

SPEAKER_00 46:56

No. Random. I don't even think he can muster up enough care for baseball to think about picking a team. So I'm gonna say no. We've been at this for a little while. This has been fun. People are probably bored. Well, what I'm gonna do is I'm you know, in the um, I'm gonna try to switch things up. One thing that chat and I came up with was putting. So thank you for coming back to another episode of your checkup. Hopefully, you were able to learn something for yourself, a loved one, or a neighbor. You can come back next week. You can listen to episode 89 about LP Little A, and you can listen to episode 69 about the Mediterranean diet if you were hoping to continue this conversation and be more proactive. But most importantly, stay healthy, my friends. Until next time, I'm Ed Deleski.

SPEAKER_01 47:54

I'm Nicole Arufo.

SPEAKER_00 47:55

Thank you, and goodbye.

SPEAKER_01 47:56

Bye.

SPEAKER_00 48:02

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