FDA Says Jardiance Can Claim Cardiovascular Death Prevention 

Jardiance is a diabetes drug in the class called SGLT2 inhibitors.

How do they work? Our kidneys filter glucose (sugar) out of our bloodstream, then reabsorb that glucose back into the bloodstream. SGLT2 inhibitors impair that reabsorption process, allowing some glucose to be excreted in our urine. You could call it a diuretic effect. For example, an SGLT 2 inhibitor called dapagliflozin, at a dose of 10 mg/day, causes the urinary loss of 70 grams of glucose daily.

How drugs like this could prevent cardiovascular disease in type 2 diabetics is a mystery to me.

From MPT:

“The diabetes drug empagliflozin (Jardiance) may be marketed for prevention of cardiovascular death in patients with type 2 diabetes and co-existing cardiovascular disease, the FDA said Friday.

It’s the first such claim ever allowed for a diabetes drug.

Empagliflozin, first approved in 2014, is an inhibitor of the sodium-glucose co-transporter 2 (SGLT2) pathway, reducing blood glucose by causing it to be excreted in urine.Its benefit for cardiovascular risk reduction was demonstrated in the so-called EMPA-REG trial, results of which were reported in 2015.”

Source: Jardiance Wins CV Prevention Indication | Medpage Today

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Turkish Get-Up

I’m going to start doing Turkish get-ups again. I fell out of the habit a couple years ago. Turkish get-ups promote flexibility, balance, joint range of motion, and strength. If you’re just doing the Big Five exercises, TGUs will strengthen some of the smaller muscles (and portions of major muscles) you may be neglecting.

Below are a couple YouTube examples. They are not complete tutorials. You can use a dumbbell or kettlebell. Start with either no weight in your hand, or just a small one. Then work up to higher weights as you get stronger.

These videos may only show how to work one side of the body; you work both sides, of course, and call it a pair. I used to do only five pairs with a 25-lb dumbbell. In weightlifting lingo, you’d call that 1 set of five reps (repetitions). It was exhausting.

Do enough reps and it will be both strength and aerobic training.

Steve Parker, M.D.


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What About a Low-Carb Vegetarian Diet for Diabetes?

Spaghetti squash with parsley, olive oil, snow peas, garlic, salt, pepper

Spaghetti squash with parsley, olive oil, snow peas, garlic, salt, pepper

It works for David Mendosa, who’s been doing it for three years. He shares some ideas on how to do it at the link below. From the intro:

About nine years ago, I started to eat only food low in carbohydrates that don’t have a high glycemic index.  I knew that this was the only proven way to bring my blood glucose level down where I wanted it to be without using drugs or supplements. My most recent A1C test showed that my level is 5.1 percent, well within the range considered normal.

While continuing to eat this way, about three years ago I added the further restriction of eating no meat, fish, or seafood. This was a substantial shift in what I was eating, and I made it mainly because I don’t want to be intentionally responsible for the death of animals or other sentient beings. Only later did I begin to realize its health benefits.

Source: How to Manage Your Diabetes with a Low-Carb Vegetarian Diet – Diabetes

David seems to adhere to the lacto-ovo strain of vegetarianism, rather than vegan or pesco-vegetarian. In other words, he’ll eat eggs and milk products but not fish. I suspect he eats under 40 grams/day of digestible carbohydrate.

Here are more of David’s ideas on implementation of a very low-carb vegetarian diet.

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Seafood Linked to Lower Alzheimer Dementia Risk in Those Genetically Predisposed

…according to an article at the Journal of the American Medical Association. The study involved Chicago-area residents who had provided information about their eating habits. After death, their brains were biopsied, looking for typical pathological findings of Alzheimers Disease.

fresh salmon and lobsters

Rich sources of omega-3 fatty acids include salmon, sardines, herring, trout, and mackerel

Participants who ate seafood at least once a week had fewer Alzheimers lesions in their brains, but only if they were carriers of a particular gene the predisposes to Alzheimers. The gene is called apolipoprotein E or APOE ε4.

You’ve heard that seafood may be contaminated with mercury, right? The seafood eaters in this study indeed had higher brain levels of mercury, but it didn’t cause any visible brain damage.

The Mediterranean diet, relatively rich in seafood, has long been linked to a lower risk of dementia.

A weakness of the study is that the researchers didn’t report results of clinical testing for dementia in these participants before they died. You can have microscopic evidence of Alzheimers disease on a biopsy, yet no clinically diagnosis of dementia.

Steve Parker, M.D.

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Recipe: Roasted Radishes and Brussels Sprouts

Roasted Radishes and Brussels Sprouts. Copyright Steve Parker MD

Roasted Radishes and Brussels Sprouts.
Copyright Steve Parker MD

A year ago I ran across online praise for roasted radishes. I’m not a big fan of radishes, perhaps because they weren’t part of Parker cuisine when I was growing up, but finally gave them a try.

Beautiful, huh?

Beautiful, huh?

This won’t be as detailed as most of my recipes because I need to get into the hospital soon.

Raw Brussels Sprouts

Raw Brussels Sprouts

My basic ingredients were raw radishes and Brussels sprouts, diced onions, a bit of parsley (probably not needed), extra virgin olive oil, dried rosemary (i.e., not fresh), coarse salt, and pepper.

With the radishes, I cut off the little rootlet and green top, then cut them in half unless they were tiny radishes. Brussel sprouts take longer to cook, so I cut them in half, too. I put all the veggies  into a bowl, added just enough olive oil to coat them, sprinkled in some salt and pepper, then mixed with a spoon. Then I spread all that on a cooking sheet and popped it into an oven pre-heated to 425°F. (I covered my cooking sheet with aluminum foil to ease cleanup.)

All ingredients mixed in a bowl

All ingredients mixed in a bowl

I cooked in the oven for 17 minutes (15-20), using a turner to flip the veggies once or twice while cooking.

Ready for roasting

Ready for roasting

They were a little bland, so I topped off with Weber Roasted Garlic and Herb Seasoning. I enjoyed them and will do it again. Next time I may try coating with melted butter rather than olive oil. I felt very virtuous for eating my vegetables.

Steve Parker, M.D. 

PS: I ate half of this in one sitting. I refrigerated the rest and ate it about six hours later. It was much more flavorful. If you’re one of those people who never eats leftovers…

…reconsider.

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Another Theory to Explain the Obesity Epidemic

Dr. Michael Eades of Protein Power fame thinks he knows why we’ve gotten fat starting 35 years ago (at least in the U.S.):

Along with carbohydrates, vegetable oils have increased dramatically in the typical American diet. Over the same time period, we’ve all started eating away from home more and more, so that we’ve lost control of exactly what kinds of fats we’ve been eating.

Click the link for the details of his hypothesis, which involves the effects of various dietary fats and carbohydrates on intracellular energy metabolism and insulin resistance.

Steve Parker, M.D.

low-carb mediterranean diet

Front cover of book

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I Lost My Virginity at an Indian Restaurant

 

Chennai Chettinaad Palace in Phoenix, Arizona

Chennai Chettinaad Palace in Phoenix, Arizona

Tonight I ate at my first Indian restaurant, Chennai Chettinaad Palace, at 2814 W. Bell Rd., Phoenix AZ 85053. This post isn’t a restaurant review, however. It’s a thumbnail sketch of my introduction to Indian food.

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We ended up here because it was recommended to my wife by an Indian gentleman she happened to sit next to on a plane trip. The restaurant has an extensive menu of what they say is authentic North Indian, South Indian & Gujarati food, both vegetarian and non-vegetarian.

We arrived at 6:40 PM and there were few patrons present. One hour later the place was full of apparent Indians.

Two of us started out with, and enjoyed, an appetizer called Gobi Manchurian.

Gobi Manchurian: spicy cauliflower pieces lightly battered and fried.

Gobi Manchurian: spicy cauliflower pieces lightly battered and fried. Yum!

It would have been too spicy for my third dining mate, who simply ate garlic naan (bread) and vegetarian fried rice. Both were delightful, although the rice was a tad oily. The rice dish easily serves four diners. The naan is addictive; split an order with your mate or you’ll eat too much.

Garlic Naan, a type of flat bread

Garlic Naan, a type of flat bread

Vegetarian Fried Rice with bits of cabbage, carrot, celery, and (?) cilantro.

Vegetarian Fried Rice with bits of cabbage, carrot, celery, green onion, and (?) cilantro.

My main entree was Chicken Kolhapuri. I was forewarned it would by spicy hot. I enjoyed it. My wife wouldn’t dare taste it. I’d get it again. I dipped my naan in the copious chicken sauce (a curry?).

Chicken Kolhapuri. Sauce includes ginger, garlic, sesame, and red chilly (sic) paste.

Chicken Kolhapuri. Sauce includes ginger, garlic, sesame, and red chilly (sic) paste.

Brian ordered Chicken Tikka Masala but didn’t like it. I don’t think it was bad; it just didn’t suit his taste, the way some folks don’t like asparagus.

Chicken Tikka Masala with a "traditional North Indian sauce" of roma tomatoes, fenugreek, and garam masala.

Chicken Tikka Masala with a “traditional North Indian sauce” of roma tomatoes, fenugreek, and garam masala.

We finished with an ice-cream style dish. If you want ice cream, stop at Baskin-Robbins on your way home.

Mango and Pistachio Kulfi

Mango and Pistachio Kulfi

Service was good. Our waitress was patient with us Indian food virgins. If you’re not familiar with Indian food, you won’t make sense of much of the menu. The restaurant was too cold for my wife, but fortunately she had brought a jacket. The bill for three of us was $63.42 (USD). We brought home two platefuls of leftovers.

I’ll visit again. I’m interested in vegetarian dishes, lamb, goat, and seafood. The secret to Indian food may be in the spices.

The rice, naan, and desert have too many carbohydrates for many diabetics. I’m sure there are low-carb alternatives, even if you have to make them yourself.

Steve Parker, M.D.

PS: The restaurant offered a 10% discount for customers paying with cash instead of credit. I always thought the credit card companies cut of credit card payments was only 3-4%.

 

 

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