June 5, 2019 · 1:50 AM

THIS May Be Why Americans Are Fat

Your average Americans

There’s no shortage of speculation as to why 70% of us in the U.S. are overweight or obese. A few possibilities include:

  • we’re too sedentary
  • we eat too many carbohydrates
  • we eat too much fat
  • our foods are over-processed
  • we eat away from home too often
  • we eat too many industrial seed oils
  • our water and food are contaminated with persistent organic pollutants that disrupt our endocrine systems

I was reading an article at Nutrition Today and came across this graph of calorie consumption change from 1971 to 2004 (or 2000?):

The verbal summary is from this article cited by the cited by the Nutrition Today authors: During 1971—2000, a statistically significant increase in average energy intake occurred. For men, average energy intake increased from 2,450 kcals to 2,618 kcals, and for women, from 1,542 kcals to 1,877 kcals. So men’s daily calorie intake went up by 168, and women’s by 335.

The original article I read states, alternatively, that men’s daily caloric consumption rose from 2450 to 2693, a gain of 243. I can’t explain the discrepancy between 243 and 168, nor why 2004 is in the graph instead of 2000.

Maybe you don’t think an extra 168 calories a day is much. If you believe in the validity of the Energy Balance Equation, those 168 daily calories will turn into  17.5 pounds of fat in a year unless you “burn them off” somehow. If you weigh 150 lb (68 kg), you can burn those 168 calories by doing a daily 15-minute jog at 5.5 mph (8.9 km/hr). But you ain’t gonna do that, are you?! (I’m not getting into a debate about validity of the equation now; for another perspective, read Lyle McDonald.)

But year 2000 was a long time ago. How much are Americans eating now? According to a 2016 report from Pew Research Center:

Broadly speaking, we eat a lot more than we used to: The average American consumed 2,481 calories a day in 2010, about 23% more than in 1970. That’s more than most adults need to maintain their current weight, according to the Mayo Clinic’s calorie calculator. (A 40-year-old man of average height and weight who’s moderately active, for instance, needs 2,400 calories; a 40-year-old woman with corresponding characteristics needs 1,850 calories.)

Bottom line? We’re eating more than we did in 1970. Which could explain why we’re fat. Unless we’re burning more calories than we did in 1970, which I doubt.

Steve Parker, M.D.

PS: In scientific literature, kcal is what everybody else calls a calorie.

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June 4, 2019 · 5:48 AM

Brief Review of P.D. Mangan’s “Best Supplements for Men”

Death in a bottle?

Best Supplements for Men: for more muscle, higher testosterone, longer life, and better looks was published in 2017. I have the paperback but it’s also available as a Kindle e-book. Per Amazon.com’s rating system, I give it five stars (I love it).

*  *  *

My favorite sentence in this book is, “If you don’t eat, exercise, and sleep right, the health effects of adding any supplement may be minimal to non-existent.” That sets an honest tone. Also in favor of integrity is that the author doesn’t offer Mangan-branded supplements for sale.

I like this book. I learned a lot from it. I’ve benefited by reading the author’s tweets and blog (Rogue Health and Fitness) for many years. He’s smart and, I believe, honest.

The author supports his assertions with numerous scientific references, organized by chapter at the back of the book. If he cites a study done in mice, he tells you. Human studies admittedly carry more weight.

Have you wondered if protein supplements and creatine are good for muscle strength and energy? Does magnesium increase testosterone levels? Does berberine have beneficial health effects? The answers are here.

The author gives good advice regarding calcium supplements that even most physicians don’t know about.

Great recommendations on food.

No book is perfect, and this one is no different. It has no index. So if you’re curious about turmeric or supplements that control diabetes, you have to scan the whole book. My copy didn’t include references for chapter 11. Page numbers for chapters in the index didn’t match the actual chapter starts. My least favorite sentence in the book was something about Dr. Joseph Mercola being a trustworthy source of health information; he is not (search “mercola” at ScienceBasedMedicine.org).

Again, I like this book, learned much from it, and recommend it to men. If you’re taking lots of supplements now, read this book to find out if they help, harm, or are only good for making expensive urine.

Steve Parker, M.D.

PS: Some personal notes from my reading. Many of the cited studies are “association”-type evidence rather causation. Berberine may help reduce blood sugars in diabetics just as well as metformin. Creatine: Yes, for muscle growth and strength. Magnesium 700 mg/day increases testosterone. Mag oxide may be worthless due to poor absorption. Mangan likes mag citrate but Lexicomp says it’s no better than oxide; absorption “up to 30%.” Citrulline: Yes, for erectile dysfunction, and may help with HTN. DHEA 50 mg/day increases testosterone in men by 50%, but only in men over 70. During fat weight loss, whey protein helps prevent muscle loss. MCT oil may also help (e.g., cook with coconut oil). ASA 81 mg/day seems to prevent some cancers in folks over 55, especially colorectal cancer.

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May 31, 2019 · 5:07 PM

Which Foods Make Us Fat?

At my other Advanced Mediterranean Diet website, a few years ago I asked visitors to answer a poll question. 2,367 responded thusly:

What single food category makes you gain the most fat weight?Fatty foods like bacon, butter, oils, nuts:
5%
Protein-rich foods: meat, eggs, fish:
0%
Sugary sweet items:
23%
Starches: bread, potatoes, peas, corn:
16%
Carbohydrates:
30%
Pastries, cake, pie, cookies:
25%
Other:
1%

Total Votes: 2367

Yes, I know it’s not a scientific poll, but it’s something. I’m not surprised at the results. I’m wishing I’d offered nuts as a choice since there are at least a few folks who gain weight on nuts, perhaps not realizing that nut calories are mostly from fat. To participate in the poll, click the link above.

Steve Parker, M.D.

low-carb mediterranean diet

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May 29, 2019 · 5:10 PM

Certain Blood Pressure Medications May Injure or Impair Athletes

Not that serious…yet

Seriously athletic folks, particularly those in sports with high aerobic demand, should avoid these BP drug classes:

  • Diuretics (they predispose to dehydration)
  • Beta blockers (they may decrease exercise tolerance via slowing of heart rate)

Better choices for athletes are:

  • Angiotensin converting enzyme inhibitors (ACEIs)
  • Angiotensin II receptor blockers (ARBs)
  • long-acting dihydropyridine calcium channel blockers

These latter drugs are not likely to affect athletic performance or cause other complications. If you can’t figure out which class of drug you take, ask your physician, pharmacist, or Dr Google.

Steve Parker, M.D.

low-carb mediterranean diet

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May 25, 2019 · 5:20 PM

A Whole Grain Food Isn’t What You Think

Now THIS is whole grain

Do you know what a whole grain food is? I thought I did. I was wrong. Here’s the definition in a 2013 article in Scientific American:

The term “whole grain” might evoke an image of a whole, intact grain—that is, a fiber-rich coating of bran surrounding a starchy endosperm and a small reproductive kernel known as the germ. But in a definition created in 1999 by the American Association of Cereal Chemists (AACC) International, an organization of food industry professionals and scientists, and adopted by the U.S. Food and Drug Administration in 2006, “whole grain” refers to any mixture of bran, endosperm and germ in the proportions one would expect to see in an intact grain—yet the grains can be, and usually are, processed so that the three parts are separated and ground before being incorporated into foods. (Refined grains, on the other hand, are grains that have been stripped of their bran and germ.) For a food product to be considered whole grain, the FDA saysit must contain at least 51 percent of whole grains by weight. Compared with intact grains, though, processed whole grains often have lower fiber and nutrient levels.

Many of the scientific studies that support the healthfulness of whole grains, and there aren’t many, considered wheat germ and bran cereals as whole grain foods. But those are only parts of a whole grain. The studies that linked lower heart disease and type 2 diabetes with whole grain consumption were diets high in fiber or bran as a whole grain.

Read the whole article (it’s not long) to find out how modern processing of whole grains can reduce their healthfulness.

Food companies lump ground whole grains, partially processed grains and intact unprocessed grains together under the same broad category of “whole grains,” so it’s difficult for consumers to know which they’re getting.

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May 24, 2019 · 2:19 PM

NASEM Concludes U.S. Dietary Guidelines Are Not Trustworthy

Back to the drawing board

NASEM is the National Academies of Sciences, Engineering, and Medicine. Dr. Andy Harris writes that:

The nation’s senior scientific body recently released a new report raising serious questions about the “scientific rigor” of the Dietary Guidelines for Americans. This report confirms what many in government have suspected for years and is the reason why Congress mandated this report in the first place: our nation’s top nutrition policy is not based on sound science.

Dr. Harris notes that since 1980, when the guidelines were first published, rates of obesity have doubled and diabetes has quadrupled.

Current recommendations to reduce saturated fat consumption and to eat health whole grains do not, after all, reduce rates of cardiovascular disease. That was my conclusion in 2009.

For a mere $68 US you can read the NASEM report yourself. Better yet, read Tom Naughton’s thoughts for free.

Steve Parker, M.D.

PS: The diets I’ve designed are contrary to U.S. Dietary Guidelines.

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May 23, 2019 · 5:13 PM

Mediterranean and Paleo Diets Linked to Longer Lifespan

The Journal of Nutrition in 2017 published a study that looked at baseline diet characteristics of over 21,000 folks, then over the next six years noted who died, and why. Guess how many died?

Here’s a clue. These U.S. study participants were at least 45 years old at the start of the study.

2,513 died. Seems high to me, so I bet the average age was close to 65.

Hank’s not worried about death

I can’t tell for sure from the report’s abstract, but it looks like the researchers were interested in the Mediterranean and “caveman” diets from the get-go. Study subjects who ate Paleo- or Mediterranean-style were significantly less likely to die over six years. They were less likely to die from any cause or from cancer or from cardiovascular disease.

Composition of the paleo diet is debatable (click for my 2012 definition).

Consider adopting some Mediterranean diet features, too.

Steve Parker, M.D.

Reference:

Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with All-Cause and Cause-Specific Mortality in Adults. First published February 8, 2017, doi: 10.3945/​jn.116.241919. Authors:

  1. Kristine A Whalen
  2. Suzanne Judd
  3. Marjorie L McCullough
  4. W Dana Flanders
  5. Terryl J Hartman
  6. Roberd M Bostick

Abstract

Background: Poor diet quality is associated with a higher risk of many chronic diseases that are among the leading causes of death in the United States. It has been hypothesized that evolutionary discordance may account for some of the higher incidence and mortality from these diseases.

Objective: We investigated associations of 2 diet pattern scores, the Paleolithic and the Mediterranean, with all-cause and cause-specific mortality in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a longitudinal cohort of black and white men and women ≥45 y of age.

Methods: Participants completed questionnaires, including a Block food-frequency questionnaire (FFQ), at baseline and were contacted every 6 mo to determine their health status. Of the analytic cohort (n = 21,423), a total of 2513 participants died during a median follow-up of 6.25 y. We created diet scores from FFQ responses and assessed their associations with mortality using multivariable Cox proportional hazards regression models adjusting for major risk factors.

Results: For those in the highest relative to the lowest quintiles of the Paleolithic and Mediterranean diet scores, the multivariable adjusted HRs for all-cause mortality were, respectively, 0.77 (95% CI: 0.67, 0.89; P-trend < 0.01) and 0.63 (95% CI: 0.54, 0.73; P-trend < 0.01). The corresponding HRs for all-cancer mortality were 0.72 (95% CI: 0.55, 0.95; P-trend = 0.03) and 0.64 (95% CI: 0.48, 0.84; P-trend = 0.01), and for all-cardiovascular disease mortality they were 0.78 (95% CI: 0.61, 1.00; P-trend = 0.06) and HR: 0.68 (95% CI: 0.53, 0.88; P-trend = 0.01).

Conclusions: Findings from this biracial prospective study suggest that diets closer to Paleolithic or Mediterranean diet patterns may be inversely associated with all-cause and cause-specific mortality.

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