Major U.S. Diet Changes over the Last 100 Years

Medical student Kris Gunnars has an article at Business Insider, of all places, that shows graphically many of the major U.S. dietary changes of the last hundred years. In this case, transmogrification may be a better term than mere “changes.” Much of the Western world has evolved in similar fashion.

You need to read the article and ponder the graphs if you question why we have so much obesity, type 2 diabetes, heart disease, hypertension, and perhaps cancer. You’ll see dramatic increases in consumption of added sugars, industrial seed oils (esp. soybean), soda pop and fruit juice (added sugar!), total calories, and fast food. You’ll see how much we’ve increased dining away from home. Butter consumption is down drastically, but doesn’t seem to have done us much good, if any.

Sugar cane

Sugar cane

 

There’s fairly good evidence that coronary artery disease (CAD) the cause of most heart attacks) was very prominent between 1960 to 2000 or so, but it’s been tapering off in recent years and didn’t seem to be very common 100 years ago. Understand that you can have it for 20 years or more before you ever have symptoms (angina) or a heart attack from it. In fact, the disease probably starts in childhood. I’ve always wondered about the cause of the CAD prevalence trends, and wondered specifically how much of the long-term trend was related to trans-fat consumption. But I’ve never been able to find good data on trans-fat consumption. Kris came up with a chart of margarine consumption, which may be a good proxy for trans-fats. Another of his charts includes shortening, a rich source of trans-fats and probably also a good proxy. I remember growing up in the 1960s that we always had a 1/2 gallon tin can of Crisco hydrogenated fat in the cupboard. Shortening consumption increased dramatically from 1955 until dropping like a rock around 2000.

The timeline curves for trans-fat consumption (by proxy) and prevalence of coronary heart disease seem to match up fairly well, considering a 20 year lag. In the early 1990s, we started cutting back on trans-fats, and here we are now with lower mortality and morbidity from coronary artery disease. (CAD is very complex; lower rates of smoking surely explain some of the recent trend.)

Read the whole enchilada. Very impressive. Highly recommended.

Steve Parker, M.D.

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Filed under Causes of Diabetes, coronary heart disease, Fat in Diet, Heart Disease

Live Longer and Reduce Risk of Cancer and Heart Disease With Vegetables and Fruits

MedPageToday has some of the details.  A quote:

The largest benefits were seen in people who ate seven or more servings of fruits and vegetables a day compared with those who ate less than one serving, with the higher level of consumption associated with significantly lower all-cause mortality (hazard ratio 0.67; 95% CI 0.58-0.78), lead researcher Oyinlola Oyebode of University College London, and colleagues, reported online in the Journal of Epidemiology and Community Health.

Spaghetti squash, an under-utilized vegetable

Spaghetti squash, an under-utilized vegetable

The population under study was English. In addition to lower risk of death, the heavy fruit and vegetable consumers had lower rates of cancer and cardiovascular disease. Click for the actual research report.

If seven servings a day seems like a lot, note that a typical serving is only half a cup. You’ll get those with the Low-Carb Mediterranean Diet.

Steve Parker, M.D.

1 cup spaghetti squash with minced black olive, sweet pepper, garlic, salt, pepper, celery

1 cup spaghetti squash with minced black olive, sweet pepper, garlic, salt, pepper, celery

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Filed under cancer, Heart Disease, Longevity

If You’re Having Bariatric Surgery to Treat Your Type 2 Diabetes, You May Want RYGB Instead of LAGB

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An article at Diabetes Care suggests that insulin-treated T2 diabetics getting bariatric surgery were almost twice as likely to get off insulin if they had roux-en-Y gastric bypass rather than laparoscopic adjustable gastric banding. The former procedure is also generally more effective for weight loss.

If you think bariatric surgery is a sure-fire cure for type 2 diabetes, it’s not.

Steve Parker, M.D.

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Our Latest Kitchen Gadget: A Vitamix

Our first creation with the Vitamix

Our first creation with the Vitamix

 

I call it a mixer; my wife calls it a food processor. My wife had been thinking about getting a contraption like this for months. She got excited and bit the bullet when she saw a live demonstration at Costco last year.

Almost immediately out of the box, my wife threw in a couple handfuls of ice, couple handfuls of frozen strawberries, and one and a half bananas. I thought this would be a fruit smoothie, but with the very thick consistency, “Italian ice” might be a better term.

One of our goals is to sneak more fiber, vegetables, and fruit into our kids diets. (Shhhh….don’t tell!)

It's a little noisy, but easily bearable

It’s a bit noisy, but easily bearable

$500 (USD) at Costco, so not cheap. It seems well-made and has a good SEVEN-year warranty!

$500 (USD) at Costco, so not cheap. It seems well-made and has a good SEVEN-year warranty!

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Preserve Your Brain Function Despite Aging

There are ways of slowing or reversing losses in cognitive function. The most effective discovered so far is physical exercise, which protects the brain by protecting the body’s cardiovascular health. Mental exercise, often called brain training, is widely promoted, but it boosts only the particular skill that is practised – its narrow impact mirroring that of educational interventions at other ages. Various drugs are being investigated for their value in staving off normal cognitive decline, but for now preventive maintenance is still the best bet – avoid smoking, drinking to excess, head injuries and the like.

MRI scan of brain

MRI scan of brain

The quote above is from an Instant Expert paper on intelligence. It’s full of interesting facts such as the typical difference in IQ between strangers is 17 points. It answers the question whether an enriched school or home environment can increase intelligence.

Also, for preserving brain function, I think the Mediterranean diet helps, but it’s difficult to prove.

On a different note, the article mentions overload of patients’ brains when medical care is too complicated:

Given the complexity of self-care regimes, it is hardly surprising that some people make dangerous errors or fail to comply. The effective management of diabetes, for example, requires a person to keep blood sugar levels within a healthy range, which means coordinating diet, exercise and medication throughout the day, which in turn requires planning for contingencies, recognising when blood sugar is veering too high or low, knowing how to regain control and conceptualising the imperceptible but cumulative damage caused by failing to maintain control. There is no set recipe for people with diabetes to follow – their bodies and circumstances differ. Moreover, they get little training, virtually no supervision and no days off. Effectively managing your diabetes is a cognitively complex job and poor performance has serious consequences, including emergency room visits, lost limbs or eyesight, and even death. The lower the diabetic person’s IQ, the greater the risks.

You’ll also learn about the Flynn effect and possible explanations for it:

Over the past century, each successive generation has answered more IQ test items correctly than the last, the rise being equivalent to around 3 IQ points per decade in developed nations. This is dubbed the “Flynn effect” after the political scientist James Flynn, who most thoroughly documented it. Are humans getting smarter, and if so, why? 

I’m more inclined to think Idiocracy describes our future.

Steve Parker, M.D.

h/t James Fulford

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Wine Ratings: Legitimate or Malarkey?

"Is the room spinning, or is it just me?"

“Is the room spinning, or is it just me?”

Wine is a time-honored component of the healthy Mediterranean diet and probably contributes to the longevity seen with Mediterranean-style eating. That’s why wine is an option on my Advanced Mediterranean Diet, Ketogenic Mediterranean Diet, and Low-Carb Mediterranean Diet. Folks new to wine-drinking are confused by the myriad wine varieties and don’t know which kind to get. This post should help separate the wheat from the chaff. Wine snobs typically think “the more expensive the wine, the better.” But are they right?

A couple years ago, someone gave me an expensive bottle of champagne that I’d never had before. I won’t mention the brand because I’m not looking for trouble. The brand is iconic and a bottle costs $150-200 (USD). The more you pay, the better it should be, right?

I’m no expert on champagne, but this stuff was awful. Had the bottle simply gone bad? Too old? My wife had drunk this champagne several times before in business settings, and said this flavor was typical. It was a real eye-opener for me.

Robert T. Gonzalez has an article on wine-tasting at IO9. A quote:

 In 2001, researcher Frédéric Brochet invited 54 wine experts to give their opinions on what were ostensibly two glasses of different wine: one red, and one white. In actuality, the two wines were identical, with one exception: the “red” wine had been dyed with food coloring.

The experts described the “red” wine in language typically reserved for characterizing reds. They called it “jammy,” for example, and noted the flavors imparted by its “crushed red fruit.” Not one of the 54 experts surveyed noticed that it was, in fact a white wine.

David McRaney has a more nuanced article on the same issue at The Atlantic. For instance:

In blind taste tests, long-time smokers can’t tell their brand from any of the competitors and wine connoisseurs have a hard time telling $200 bottles from $20 ones. When presented microwaved food from the frozen food section in the setting of a fine restaurant, most people never notice. Taste is subjective, which is another way of saying you are not so smart when it comes to choosing one product over another. All things equal, you refer back to the advertising or the packaging or conformity with your friends and family. Presentation is everything.

If you have more time, check out Calvin Trillin’s article on white-red differentiation in The New Yorker. His suspicion is that “…experienced wine drinkers can tell red from white by taste about seventy per cent of the time, as long as the test is being administered by someone who isn’t interested in trying to fool them.”

The take-home points for me after reading all these are:

  • the more expensive wines are by no means better tasting; I’m sticking with cheaper
  • when you hear someone waxing eloquent about the various flavors in a particular wine, they’re most likely full-of-it (FOS); in other words, it’s malarkey
  • you’re as good a wine judge as anyone else; satisfy your own palate

Steve Parker, M.D.

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Recipe: Brussels Sprouts and Bacon Bits

Bacon Bit Brussels Sprouts

Bacon Bit Brussels Sprouts

Brussels sprouts are a classic low-carb vegetable and a good source of vitamin C and fiber. A while back I posted a meal recipe for Bacon Brussels Sprouts to accompany Brian Burgers. To make it a little more convenient, I’ve substituted off-the-shelf real bacon bits instead of frying my own bacon. I traded olive oil for the bacon grease. The two versions taste very similar. You can easily fit Bacon Brussels Sprouts into either the Low-Carb Mediterranean Diet or Ketogenic Mediterranean Diet.

diabetic diet, paleobetic diet, low-carb diet

It’ll take 10 minutes to shred the sprouts

Ingredients:

1 lb (454 g) Brussels sprouts, raw, shredded (slice off and discard the bases first)

4 tbsp (60 ml) extra virgin olive oil

5 tbsp (75 ml or 35 g real bacon bits or crumbles (e.g., by Hormel or Oscar Mayer)

2 garlic cloves, minced (optional)

1/8 (0.6 ml) tsp salt

1/4 tsp (1.2 ml) ground black pepper

3 tbsp (45 ml) water

Instructions:

diabetic diet, paleobetic diet, low-carb diet

Steaming in progress

You’ll be steaming this in a pan with a lid. Put the garlic and olive oil in a pan and cook over medium-high heat for a few minutes to release the flavor of the garlic. Add the water to the pan and let it warm up for a half a minute or so on medium-high heat. Then add the shredded sprouts and cover with the lid. After a minute on this medium-high heat, turn it down to medium. The sprouts will have to cook for only 4–6 minutes. Every minute, shake the pan to keep contents from sticking. You might need to remove the lid and stir with a spoon once, but that lets ourtyour steam and may prolong cooking time. The sprouts are soft when done. Then remove from heat, add the bacon bits, salt, and pepper, then mix thoroughly.

When time allows, I’d like to experiment with this by leaving out the bacon and using various spices instead. Do you know what goes well with Brussels sprouts?

Number of Servings: 3 (1 cup or 240 ml each)

Nutritional Analysis per Serving:

71% fat

19% carbohydrate

10% protein

270 calories

14 g carbohydrate

6 g fiber

8 g digestible carbohydrate

328 mg sodium

646 mg potassium

Prominent feature: High in vitamin C (over 10o% of your RDA)

diabetic diet, low-carb diet, paleobetic diet

Brian burger and bacon Brussels sprouts

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