Ask Doc

I'm No Shoe Salesman

I never mind a little constructive criticism…

Each Friday, when I write that I read every e-mail, it's true. Like this one that came into our inbox recently:

Hey Doc. Why not reverse the order of your weekly mailing? Put your questions up front (the stuff that your readers are actually interested in) and the seemingly obligatory shilling for some Stansberry colleague afterwards. Would give you a bit more credibility.

Otherwise, no complaints here. (Lifetime member of Retirement Trader and member of Retirement Millionaire.) – M.L.

Thanks for your dedicated readership, M.L. Let me level with you...

Our business is paid subscriptions. That's how we keep the lights on. It's how we're able to share so much free content (including our popular Friday Q&As) with you each week in the Health & Wealth Bulletin.

But I'm not a shoe salesman. So you'll keep getting incredible content to help you live healthier and wealthier.

I'll also keep sharing ways you can access my own paid research or that of my Stansberry colleagues. You'll only ever see me promoting a person or product I can confidently stand behind.

And I'll always include a message of educational value in the Health & Wealth Bulletin whether you buy anything or not... I just won't give away all the details or specific stock recommendations.

But today – dedicated to you, M.L. – I am jumping straight to the Q&A.

As folks here in the U.S. prepare for the Thanksgiving weekend, I want to share some of the most interesting, useful, or controversial topics our Q&A has covered this year.

Let's dig in… As always, keep sending your comments, questions, and topic suggestions to [email protected]. As you can see... my team and I really do read every e-mail.

Q: How can a heart problem due to sleep apnea be discovered? Will an EKG do the trick? – C.P.

A: Thanks for the great question, C.P.

If someone has sleep apnea and is worried about their heart, there are a few ways to find out more information...

Sleep apnea may increase the risks of developing an array of cardiovascular issues, like high blood pressure, coronary artery disease (where plaque builds up in the arteries that supply blood to the heart), and left ventricular diastolic dysfunction (where part of your heart doesn't fill with a normal volume of blood while pumping).

So to be thorough and get a wide scope of information about your heart health, you can ask your doctor for a "comprehensive heart and vascular assessment." This is a series of tests that includes the following components:

1. A medical history review to go over your symptoms, family history, and lifestyle factors that may put you at greater risk for cardiovascular disease.

2. A physical examination, which includes taking your blood pressure and checking the sounds in your lungs and heart.

3. Blood tests that investigate various markers of cardiovascular disease, like your cholesterol and blood sugar levels.

4. An electrocardiogram (also known as an "EKG" or an "ECG"), which will record the heart's electrical activity and indicate whether there's a problem with its rhythm.

5. An echocardiogram (also called an "echo"), which is an ultrasound showing the heart's structure as well as the flow of blood through the heart and its valves.

6. A stress test, which involves exercising on a treadmill or stationary bike while being hooked up to a heart monitor. This will depict how well your heart handles physical exertion.

7. Imaging tests, which may include a chest X-ray, CT scan, or MRI. These tests will show your heart and blood vessels in great detail.

The results of this comprehensive assessment should give you the information you need to determine whether your heart has an issue and whether you need further tests or treatment.

Q: Hi Doc. Will you recommend a formula or a percentage to start taking profits on stock gains? For example, sell 20% of position when stock is up 50% from your buy price. Thanks. – B.V.

A: Thanks for being such a loyal subscriber, B.V. Longtime subscribers know I like to hold blue-chip stocks for the long term. For example, I first recommended folks buy Microsoft (MSFT) back in 2010. And we're up more than 1,400%. Microsoft is the kind of company that will likely be around for decades – a classic sleep-well-at-night investment. So this is a case where you can just let your winner ride.

What you should pay attention to is how much of your portfolio a position takes up. For anyone who doesn't know, I recommend subscribers put no more than 4% to 5% of their portfolio in any one stock. And more speculative positions should represent even less. Then I recommend using stop losses that tell you when to sell – typically 25% below your entry price (called a hard stop) or 25% below the position's peak price since you bought in (a trailing stop).

With a 5% position size and a 25% stop loss, the most you can lose on any single stock is around 1% of your entire portfolio.

If you invest in funds, you could consider a larger position size of up to 20% of your investment portfolio. That's because funds are already diversified within the class they invest in.

But whether you're invested in either an individual stock or a fund, your portfolio's makeup will change over time as different positions move up and down at different paces.

That's why I recommend reevaluating your portfolio at least once a year. If you notice a stock is taking up a large portion (say, 10%) of your portfolio, sell part of it to get back closer to the 5% mark. Then, you can put your money to work and try to do the same thing over and over.

Selling doesn't mean it has become a bad investment. It's just a way to protect yourself from having too much of your money in one place and suffering from the risk of a larger loss if that investment were to fall.

Look at your funds the same way... When a single fund takes up more than 20% of your portfolio, consider scaling back and reinvesting the proceeds into other positions.

Q: If BMI isn't any good, what about body composition? My scale measures it. Is this better than BMI? – G.D.

A: Thanks for your question, G.D. For folks wanting a reminder on why the body mass index ("BMI") isn't a great way to quantify your health, we covered it pretty extensively last year.

Essentially, the way BMI is calculated tends to skew the data to classify short people as thinner and tall people as fatter than they really are. You can read more here: "The Truth About Your BMI."

Some "smart" bathroom scales promise to measure your body composition with health metrics that can include body-fat percentage, muscle mass, and water weight.

These measurements – in theory – can be helpful if you're looking to keep track of the changes produced by your health and fitness efforts... But unless you have specific targets in mind (like lowering your body-fat percentage or increasing your muscle mass), then I'd say they're somewhat arbitrary.

What's more, these scales tend to be inaccurate when it comes to body composition...

In 2016, a Consumer Reports research team tested six digital scales – which measured weight and body-fat percentage – to see how accurate their measurements were. The scales ranged in price from $40 to $150, so you'd expect them to be accurate, given the price tag, right?

Well, not exactly...

The research team found that all six scales were off when it came to measuring body-fat percentage. In fact, the scale that came closest to the correct value was off by a whopping 21%.

They also found that many conditions tended to skew the results even further, like whether the participants' feet were wet or dry, and whether they had an artificial knee or hip, for example.

The technology hasn't improved since then. In its latest "Best Bathroom Scales," published in 2023, Consumer Reports said that none of its tested scales accurately identified folks' percentage of body fat.

So, as far as body-composition measurements are concerned, I say don't waste your time...

Instead, keep an eye on your waist circumference.

The reason waist size matters is visceral fat. The first layer of fat under your skin is subcutaneous fat (the fat you feel when you pinch your skin). Under that layer is the visceral fat – which wraps around your organs. Visceral fat builds as we age, when we eat fatty foods, or when we don't exercise.

The problem with visceral fat is that it triggers inflammatory responses and can interfere with our insulin functioning. That means it's a contributor to things like Type 2 diabetes and fatty liver disease.

Keep in mind, waist circumference – as well as your BMI and body-composition metrics – can't provide a full picture of your overall health. But if you're a numbers person like I am, measuring your waist circumference is the best way to gauge your shedding of visceral fat.

And if you want to learn how to accurately measure your waist circumference, don't forget to read our issue, "The Truth About Your BMI."

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
November 27, 2024

Editor's note: Our offices are closed this Thursday and Friday for the Thanksgiving holiday. Your next issue of the Health & Wealth Bulletin will be in your e-mail inbox on Monday, December 2. From the entire Health & Wealth Bulletin team, we wish you and your loved ones a happy and safe Thanksgiving.