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Deep Thoughts: Sabermetrics and my annual checkup

Feb 13, 2013, 12:56 PM EDT

LDL

I went for my annual physical this morning. I’m OK and stuff, but I am NOT in the Best Shape of My Life. And the entire conversation I had with my doctor about it made me realize how silly and stupid old school, anti-sabermetric arguments are.

Note: I warn the medical professionals among you that I am going to refer to some things in a very hamfisted way. Please feel free to correct my mistakes and misleading statements in the comments.

Most of us know that you really don’t want to have a high cholesterol number. We probably had it ingrained in our heads since the 1980s at least that if your “cholesterol” — the term usually used generically, but also known as “bad cholesterol” or LDL-C — is pushing 200 or more that you’re in a bad place and at risk of heart attacks and all of that.  So, dude, lower that cholesterol!

Except it’s not that simple anymore. In the past few years general practitioners have increasingly moved away from talking to their patients about that old bad cholesterol scale to more sophisticated and refined measures. Measures which have a much greater correlation with heart health than the old numbers. I’m sure it’s way more complicated than this (really, talk to your doctor), but for our purposes, LDL-P is a WAY better measure than the bad cholesterol/LDL-C measure. Indeed, you may very well have a low LDL-C number but still be at serious risk of a heart attack because your LDL-P number is too high.

This is where I am. I get a physical every year. After a not great one in 2010 I bought a treadmill, cut out sweets, cut back on beer and lost weight. I lost about 25 pounds or so, in fact. I went for a physical in December 2011. My “bad cholesterol” number was much improved. In the healthy range. As far as I knew, I was in the BSOML.

Since last year, however, my doctor began, as a matter of course, testing LDL-P levels. I am way, way too high in my LDL-P levels. This is true even though I’m still down in weight from where I was back in 2010 and despite the fact that my bad cholesterol numbers are still in good shape. The old metrics are misleading! They were failing me because they were not telling me and my doctor about my heart attack risks nearly as well as the newer, more sophisticated metrics.

After getting lectured by my doctor about how I need to change my diet, I began to laugh. I began to imagine myself as an old school baseball writer listening to this. I began to formulate a rebuttal to my doctor that could have easily shown up in Jon Heyman’s Hall of Fame column or something, switching out WAR for LDL-P:

“LDL-P. What is it good for? Absolutely nothing.  Look, doc, you can bury your head in your spreadsheets and clinical studies which purport to show correlation between dying of heart attacks and your fancy acronyms, but bad cholesterol numbers are widely accepted and understood by people who aren’t doctors. If they were good enough for the doctor I had in 1984 they’re good enough for me. I prefer the eye test anyway. I look in the mirror and I see a much thinner me than I saw two years ago. I see that my 34 jeans are actually loose. I see my breakfast each morning and note that I’m eating way more cereal now than eggs, and my 1984 doctor told me that’s what I should do.  I don’t need some abstract number to tell me something which goes against all intuitive sense. You’re using LDL-P as an argument-ender, and frankly, the tone of you LDL-P people has gotten extreme.”

Science and math is science and math no matter what you apply it to. If people in any other field besides baseball treated scientific and mathematical metrics with the sort of willfully ignorant disdain that many baseball writers treat advanced baseball metrics, they’d be laughingstocks. And while, yes, it is an extreme example, if doctors did so in the medical field more people would die.  Baseball isn’t life and death of course, but I’m glad my doctor doesn’t approach his field of study like Jon Heyman and guys like him approach theirs.

Anyway, end of deep thought. I’m off to chuck all of the cereal, bread, crackers and pasta I have into the garbage and begin steeling myself for egg-white omelets, fish and a lot more lentils and things. If that makes me a dietary stathead who needs to get his head out of his laptop and eat some damn bagels once in a while, well, so be it.

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