Category Archives: Uncategorized

How Much Calcium Do Your Bones Need?

paleo diet, Steve Parker MD,calcium, osteoporosis

That milk mustache is a tell-tale sign she’s not eating pure paleo

I don’t know, and I’m not sure anybody knows.

The biggest concern about inadequate calcium consumption is that your bones will be weak and brittle, leading to fractures.

Dr Harriet Hall at Science Based Medicine reviewed a NEJM article written by Drs Willets and Ludwig on the health effects of milk.

From Dr Hall:

I was surprised to learn that the US recommendations for milk consumption were based on small, flawed studies of calcium balance. Other countries recommend lower levels of calcium intake. The US recommends 1000-1200 mg for adults, the UK 700 mg, and the World Health Organization, 500 mg. Counterintuitively, countries with high milk and calcium intake actually have the highest rates of hip fracture. Clinical trials of calcium for fracture prevention are complicated, because of confounding factors like vitamin D, phosphorous, and adult height. High calcium intake during childhood and adolescence was thought to serve as a way to “bank” calcium, but studies have not supported that hypothesis. In fact, men’s risk of hip fracture increased by 9% for every additional glass of milk consumed during adolescence.

Source: Milk and Health: The Evidence – Science-Based Medicine

Steve Parker, M.D.

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Future Posting on #Coronavirus #COVID19

Artist’s rendition of Coronavirus

I’ve been cross-posting about coronavirus and COVID-19 among my three blogs. In view of time limitations and efficiency, I’m going to be posting nearly all my coronavirus thoughts at Advanced Mediterranean Diet. Check it out if interested.

Thus far I haven’t treated a confirmed case of COVID-19 although I’m a full-time hospitalist in Scottsdale, AZ. I’ve been off-duty for four days but return to work soon. If the mainstream media is correct, I’m about to be overwhelmed by cases. So far, I’m overwhelmed by the damage this thing is doing to our economy, not to mention my 401k, which I just did.

Spicy times, indeed.

Steve Parker, M.D.

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Diabetes Daily Article: Coronavirus and Diabetes

How old is this device?

From Dr Muccioli at Diabetes Daily:

Why are people with diabetes more vulnerable to infections and complications of infections? It has been shown that people with diabetes are at a higher risk for infections and related complications, and, in particular, for various bacterial infections. Although the reasons for this are not completely elucidated yet and are likely multifactorial, research has shown that high blood glucose levels can directly and negatively impact the immune system and that  “…good control of blood sugar in diabetic patients is a desirable goal in the prevention of certain infections and to ensure maintenance of normal host defense mechanisms that determine resistance and response to infection.”As it relates to the COVID-19 outbreak, it follows that maintaining target blood glucose levels is an important preventative strategy for avoiding serious related complications, such as a secondary bacterial infection (i.e., pneumonia) and is likely an important determinant in the patient prognosis for anyone who becomes infected.

Source: Coronavirus & Diabetes: Your Questions Answered – Diabetes Daily

Read the whole thing.

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Are You PWT1D or PWT2D?

A decade ago, some folks began to object to being called diabetics. Instead, they proposed “person with diabetes” or “people with diabetes.” Or simply PWD.

Given the major differences between type 1 and type 2 diabetes, I now propose PWT1D (person or people with type 1 diabetes) and PWT2D.

And so no one’s left out: PWLADA. Person with Latent Autoimmune Diabetes in Adulthood.

Whadda u think?

Steve Parker, M.D.

low-carb mediterranean diet

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U.S. Youths at Risk for Type 2 Diabetes and Prediabetes

Great exercise, but with risk of concussions, broken bones, and torn menisci

Obesity is a risk factor for type 2 diabetes in adults and also plays a significant role in the development of the disease at younger ages. Obesity is highly prevalent among US adolescents and young adults. Many adolescents and young adults with obesity already have blood sugar metabolism abnormalities, which is of great public health concern in view of the sharp increase in type 2 diabetes in adolescence.

From JAMA Network:

In the United States, about 1 of 5 adolescents and 1 of 4 young adults have prediabetes. The adjusted prevalence of prediabetes is higher in male individuals and in people with obesity. Adolescents and young adults with prediabetes also present an unfavorable cardiometabolic risk profile, putting them both at increased risk of type 2 diabetes and cardiovascular diseases.

Source: Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016 | Adolescent Medicine | JAMA Pediatrics | JAMA Network

Steve Parker, M.D.

PS: Regular exercise and loss of excess fat weight are two great ways to prevent both prediabetes and type 2 diabetes. They also help with treatment.

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Improve Your Diet Quality With Salads

A masterpiece by Sunny Parker

I’m not generally a fan of U.S. federal government committee recommendations on what we should eat. They’ve led us astray before. For what it’s worth, the USDA and National Cancer Institute have put together a Healthy Eating Index. Salad-eaters score higher on the Index. I do believe the best salads are better than the crap most Americans eat.

From the Journal of the Academy of Nutrition and Dietetics:

Abstract

Background

Consuming salad is one strategy with the potential to harmonize diets more closely with national dietary guidance. However, it is not known whether nutrient intake and diet quality differ between people who consume vegetable-based salad and those who do not.

Objective

The objective of this study was to compare nutrient intake and diet quality between salad reporters and nonreporters.

Design

This study is a cross-sectional analysis of 1 day of dietary intake data collected via 24-hour recall.

Participants/setting

Adults 20 years and older (n=9,678) in What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 were included. Respondents who ate salad on the intake day were considered salad reporters.

Main outcome measures

This study estimated nutrient intake from all foods and beverages (excluding supplements) and evaluated diet quality using the Healthy Eating Index (HEI) 2015.

Statistical analyses

Nutrient intake and HEI scores were compared between salad reporters and nonreporters using paired t tests with regression adjustment for confounding variables. Results were considered significant at P<0.001.

Results

On the intake day, 23% of adults consumed salad. Energy, protein, and carbohydrate intakes did not differ between salad reporters and nonreporters. Salad reporters had higher intakes than nonreporters of dietary fiber, total fat, unsaturated fatty acids, vitamins A, B-6, C, E, K, folate, choline, magnesium, potassium, and sodium (P<0.001). Total HEI 2015 scores were significantly higher for reporters (56 of a possible 100 points) than nonreporters (50 points) P<0.001. Reporters also had significantly higher scores for eight of 13 HEI components: total vegetables, greens and beans, whole fruits, total protein foods, seafood and plant proteins, fatty acids, refined grains, and added sugars (P<0.001).

Conclusions

Incorporating vegetable-based salad into one’s diet may be one effective way to increase nutrient intake and improve overall diet quality. Regardless of salad reporting status, HEI scores show that diets of US adults need improvement.

Source: Consuming Vegetable-Based Salad Is Associated with Higher Nutrient Intakes and Diet Quality among US Adults, What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 – Journal of the Academy of Nutrition and Dietetics

Steve Parker, M.D.

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Intermittent fasting improved health in new study 

One way to break your fast

Eating within a 10-hour window shouldn’t be too hard. Breakfast at 7 AM, finish dinner by 5 PM. That’s  right, we don’t need to be eating every 3–4 hours. Do you think our ancestors have been eating three meals a day for the last 200,000 years? I don’t. The probably went 24–48 hrs without much food on a regular basis.

From LA Times:

In an early effort to explore the benefits of daily fasting in humans, researchers have found that people who are at high risk of developing diabetes improved their health in myriad ways when they ate all of their meals over a span of just over 10 hours, then fasted for the remainder of their 24-hour day.

Source: Variant of intermittent fasting improved health in new study – Los Angeles Times

Steve Parker, M.D.

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