An unprecedented window into how diseases take hold years before symptoms appear

> What UK Biobank is revealing, scan by scan and layer by layer, is that disease doesn’t arrive out of nowhere. It accumulates quietly, shaped by genes, environment, and habits.

I think that is already known for a while. It's called functional reserve, and was a big topic in HIV patients (and then again for SARS-CoV-2).

Like people with higher cognitive capabilities will be protected by those a bit longer before onset of HIV-associated neurocognitive disorder (or even dementia).

Same for kidneys: They have a functional reserve that you are born with gets used up during life, until it is gone. Acute kidney disease treatment is aimed at preserving whatever little function is left.

It would be interesting what this functional reserve is, right? The microbiome perhaps, or intracellular minerals? Some other thing we haven’t even identified?

In case of kidneys, my understanding is that only a certain subset of glomerular cells are actively filtrating blood at any given point. The other cells form the functional reserve, and start to become active once the other cells age out, or are disrupted due to an event (like poisoning, such as mycotoxin damage from eating moldy food). Once the functional reserve is exhausted however, no new cells can become active and you are left with whatever dwindling GFR you have, until you get a transplant.

With the vascular system you have example arterial elasticity which is an important measure of vascular health. When your blood vessels become less elastic it does not immediately cause symptoms, but it increases the risk of heart disease and stroke. This is also why periodontitis and gum disease is a predictor for vascular diseases: Bacteria enter the bloodstream through inflamed oral mucosa and form plaques along the blood vessels.

>"This is also why periodontitis and gum disease is a predictor for vascular diseases: Bacteria enter the bloodstream through inflamed oral mucosa and form plaques along the blood vessels."

And yet in the year 2025 dental care is globally treated as seperate from other healthcare, a strange historical artifact that clings on.

Story from the US: had an awful tooth infection (from a known dead tooth) that I tried to ride out, half my face was swollen up, even my eye looked half shut. Well after a day of this I couldn't take the pain. Called my doctor "we don't pull teeth, you have to call a dentist." So I called a dozen dentist and was told either "we aren't taking new patients" or "we can't get you in for 6 months".

I ended up just driving to a dentist and saying "look at my fucking face! Pull this fucking tooth out!" Finally a dentist was able to spare 30 seconds to yank it. Bill was something like $750.

The US is a dystopian hellhole.