What Happened to Lard?

Lard? Wut choo talkin' 'bout, Willis?

Lard may be making a come-back.  An NPR article reviews its fall from grace, with mention of Upton Sinclair, Procter and Gamble, and Crisco.

Steve Parker, M.D.

h/t Laura Dolson

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Book Review: Choose to Lose: The 7-Day Carb Cycle Solution

I saw the author of Choose to Lose on a rerun of Dr. Oz in early January.  Then I checked the book’s sales rank at Amazon.com (22nd overall—a blockbuster in my view).  (Don’t get me wrong; I’m not in the habit of watching Dr. Oz.)  Here’s my review of 2012’s Choose to Lose: The 7-Day Carb Cycle Solution, by Chris Powell.  The book is for the general public, not people with diabetes.  I give it three stars per Amazon.com’s five-star system.

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Will it work?  Certainly for some, quite possibly a majority.  Like most published programs, it’ll work for for you if you work the program.  Question is, can you do it?

The underlying idea is to alternate high-carb and low-carb eating days, which supposedly revs up your metabolism and tricks your body into thinking it’s not on a diet so it won’t go into self-preservation starvation mode.  Mr. Powell calls this carb cycling.

The high-carb days are also low-fat, and the low-carb days are low-calorie.  Actually, both days are reduced-calorie if your goal is the most dramatic results.  A moderate calorie deficit is built into the program.  Women get about 1350 calories; men around 1700.  Those levels are lower than necessary. Other than that, it appears you’ll get all the other nutrients you need, which is good.

I can see how the diet would work for some because it drastically reduces consumption of our most fattening carboydrates.  Loser Choosers aren’t supposed to eat baked goods, white flour, refined sugar, beer, candy, chips (crisps, for those in the UK), conventional breads, cookies, crackers, ice cream, sugar-sweetened beverages, corn syrup, and milk.  I suspect if we all stopped eating those right now, the overweight rate in the U.S. would drop by at least 10% in the next 12 months.

The author allows no wheat or white rice except for whole wheat bread and pasta.  Potatoes, peas, and corn made it to the “approved” list.  You eat mostly natural, minimally processed foods (yay!).

I don’t know Mr. Powell, but he comes off as earnest, honest, compassionate, experienced, and intelligent.  He’s not a scammer.  Mr. Powell has more faith than I do in the benefits of exercise for weight loss.  He notes that nutrition is more important.  We agree that exercise is often critical for prevention of weight regain.  He barely, if at all, mentions the benefits of exercise in prevention of disease and prolongation of longevity.  His well-illustrated exercise recommendations are  a good start for fitness beginners.  He wants you to exercise for 10-30 minutes on six days a week, doing a combo of cardio intervals and body weight resistance training.  No expensive equipment to buy.

Carb cycling like this is supposed to “boost your metabolism to burn fat quickly.”  It does not, to any clinically meaningful extent.  Nor is carb cycling mentioned in this year’s massively referenced The Smart Science of Slim.  Contrary to the author’s opinion, neither eating five meals a day nor eating carboydrates revs up your metabolism.

Mr. Powell provides some helpful mind tricks to prepare you for a lifestyle change.

My favorite sentence: “Success doesn’t just happen.  It’s a result of the 4 Ps of action: Planning, Preparation, Performance, Persevance.”

My least favorite sentence: “Water is imperative for loosing [sic] weight.”  A close second was: “Alcohol is a powerful diuretic (it flushes water out of your system), so it dehydrates you, causing water retention and bloating for one to three days after you drink.”  Huh?

I like his incorporation of cheat meals, although he allows more than I would.  To his credit, the all-important maintenance phase is covered well.

Mr. Powell recommends supplementing with probiotics and digestive enzymes, being unaware of their uselessness for most dieters.

I note that Amazon sells Choose to Lose by Dr. Ron and Nancy Goor, and The Carb Cycling Diet by Dr. Roman Malkov.  Coincidence ? 

In terms of complexity, the program is about average. 

I wonder if you’d do just as well by swearing off the fattening carbohydrates I listed above.  If you’re looking to lose weight, you could do a lot worse than Choose to Lose.  And you could do better.

Steve Parker, M.D.

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Noteworthy People With Diabetes

dLife maintains a list of famous, prominent, or noteworthy folks who have or had diabetes.  I mention it here in case you have diabetes and sometimes feel like it’s got you by the throat and is ruining your life.  Be inspired.

Steve Parker, M.D.

B.B. King is No.3 on Rolling Stone's list of 100 Best Guitarists of All Time

PS: Who has a list of infamous diabetics?

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FDA Approves Exenatide for Once Weekly Use

Once-weekly injection of exenatide, sold in the U.S. as Bydureon, has been approved for use by the U.S. Food and Drug Administration.  It’s main competitors are Byetta (exenatide  injected twice daily) and Victoza  (liraglutide).  Byetta  and Bydureon are made by the same company, Amylin Pharmaceuticals.  Bydureon apparently is a slow-release formulation of exenatide.

Victoza is the one that celebrity chef Paula Deen endorsed about a month ago, around the same time she revealed she’s had type 2 diabetes for three years.  Victoza’s injected once daily.

The New York Times has a January 27, 2012, article on Bydureon, focusing on business and investing.  The new drug is expected to retail for $4,200 (USD) a year. 

Click for complete prescribing information.

Click for a press release approved by Amylin.

David Mendosa is excited about Bydureon.

These drugs are in a class called GLP-1 receptor agonists, which mimic the effect of glucagonlike peptide- 1, a hormone that increases insulin secretion by the pancreas when blood sugar levels are high.  They are prescribed as adjuncts to diet and exercise in adults with type 2 diabetes.

Steve Parker, M.D.

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What About Sugar Alcohols?

Dietitian Brenna at Eating Simple recently posted an article on artificial sweeteners exclusive of sugar alcohols.  Now she’s reviewed sugar alcohols.  Many who have a sweet tooth, including myself, use sugar substitutes such as sugar alcohols.  Sometimes they affect blood sugar levels, although not as much as sugar.

Dr. Maria Collazo-Clavell at the Mayo Clinic wrote about use of artificial sweeteners by people with diabetes.  Like Brenna, she notes that sugar alcohols can raise blood sugar levels in people with diabetes.  The Mayo Clinic has another article on sugar substitutes.

Steve Parker, M.D.

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UCSF Investigating Paleolithic Diet For Diabetics

  A May, 2010, press release from University of California San Francisco outlines the university’s research into use of the Paleolithic diet (aka Stone Age or caveman diet) for people with type 2 diabetes.  From the press release:

The initial research findings are striking. Without losing weight, participants in a preliminary study improved blood sugar control, blood pressure control and blood vessel elasticity. They lowered levels of blood fats such as cholesterol. And most amazingly, participants achieved these results in less than three weeks — simply by switching to a Paleolithic diet.

The lead researchers are nephrologist Lynda Frassetto and endocrinologist Umesh Masharani.  Frassetto and team had previously looked at metabolic improvements linked to the paleo diet.

We await publication of their current findings in a peer-reviewed scientific journal.  C’mon people, it’s 2012 already.  In the meantime, I prefer the Low-Carb Mediterranean Diet.

Steve Parker, M.D.

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Metformin May Prevent Cancer and Heart Trouble

David Spero at Diabetes Self-Management has an interesting article about how metformin may prevent cancer and heart disease, and slow the aging process.  Metformin is the usual first drug of choice for type 2 diabetes.

Steve Parker, M.D.

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Brenna Reviews Sugar Substitutes

Too late now!

Dietitian Brenna at Eating Simple has a recent post on sugar substitutes, which I sometimes refer to as non-caloric sweeteners (not entirely accurate).  She reviewed sucralose, saccharine, aspartame, and acesulfame potassium.  Not sure why she didn’t cover sugar alcohols like xylitol, erythritol, and sorbitol.  Brenna links to a Mayo Clinic article on artificial sweeteners, including sugar alcohols.

I never got excited enough to cover this topic in detail myself.  Thanks, Brenna.

Steve Parker, M.D.

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Ketogenic Mediterranean Diet Now in Book Form

A number of my patients and blog readers have asked for a more comprehensive presentation of the Ketogenic Mediterranean Diet. The KMD, as you may be aware, is the basis for the Low-Carb Mediterranean Diet.  Both of them are in Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet.

Odd cover, huh?

The new book is geared for folks who don’t have diabetes, but want to lose weight with a very-low-carb diet.  It’s called KMD: Ketogenic Mediterranean Diet.  Readers of Conquer Diabetes and Prediabetes will get nothing out of the new book: they’ve seen it all before.  Here’s the book description from Amazon.com:

Dr. Steve Parker presents the world’s first low-carbohydrate Mediterranean diet. Nutrition experts for years have recommended the healthy Mediterranean diet. It’s linked to longer life span and reduced rates of heart attack, stroke, cancer, diabetes, and dementia. Dr. Parker (M.D.) has modified the Mediterranean diet to help you lose excess weight while retaining most of the healthy foods in the traditional Mediterranean diet. What’s the secret? Cut back on the fattening carbohydrates such as concentrated sugars and refined starches.

You’ll discover how to manage your weight without exercise, without hunger, without restricting calories, while eating fish, meat, chicken, vegetables, fruits, wine, olive oil, nuts, and cheese.

The book includes advice on how to avoid weight regain, instruction on exercise, a week of meal plans, special recipes, a general index, a recipe index, and scientific references. All measurements are given in both U.S. customary and metric units. This low-carbohydrate Mediterranean diet is included also in Dr. Parker’s Advanced Mediterranean Diet (2nd edition) and Conquer Diabetes and Prediabetes. Are you finally ready to lose weight while eating abundantly and without counting calories?

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KMD: Ketogenic Mediterranean Diet is available for purchase at Amazon.com (Kindle edition here, also) or Barnes and Noble (Nook version here).  The ebook version is available in multiple formats at Smashwords

Steve Parker, M.D.

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Filed under ketogenic diet, Mediterranean Diet, My KMD Experience, Shameless Self-Promotion, Weight Loss

Can Diabetes Be Prevented?

Not Paula Deen

Paula Deen’s recent announcement of her type 2 diabetes got me to thinking about diabetes prevention again.  If you’re at high risk of developing diabetes you can reduce your risk of full-blown type 2 diabetes by 58% with intensive lifestyle modification.  Here’s how it was done in a 2002 study:

The goals for the participants assigned to the intensive lifestyle intervention were to achieve and maintain a weight reduction of at least 7 percent of initial body weight through a healthy low-calorie, low-fat diet and to engage in physical activity of moderate intensity, such as brisk walking, for at least 150 minutes per week. A 16-lesson curriculum covering diet, exercise, and behavior modification was designed to help the participants achieve these goals. The curriculum, taught by case managers on a one-to-one basis during the first 24 weeks after enrollment, was flexible, culturally sensitive, and individualized. Subsequent individual sessions (usually monthly) and group sessions with the case managers were designed to reinforce the behavioral changes.

Although the Diabetes Prevention Program encouraged a low-fat diet, another study from 2008 showed that a low-fat diet did nothing to prevent diabetes in postmenopausal women

I don’t know Paula Deen.  I’ve never watched one of her cooking shows.  She looks overweight and I’d be surprised if she’s had a good exercise routine over the last decade.  I’m sorry she’s part of the diabetes epidemic we have in the U.S.  I wish her well.  Amy Tenderich posted the transcript of her brief interview with Paula, who calculates her sweet tea habit gave her one-and-a-half cups of sugar daily).

  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

I think excessive consumption of concentrated sugars and refined carbohydrates contribute to the diabetes epidemic.  Probably more important are overweight, obesity, and physical inactivity.

The Mediterranean diet has also been linked to lower rates of diabetes (and here).  Preliminary studies suggest the Paleo diet may also be preventative (and here).

Greatly reduce your risk of type 2 diabetes by eating right, keeping your weight reasonable, and exercising.

Steve Parker, M.D.

PS: Paula, if you’d like a copy of Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet, have your people contact my people.

Reference:  Diabetes Prevention Program Research Group.  Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or MetforminNew England Journal of Medicine, 346 (2002): 393-403.

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