Diabetic Mediterranean Diet

January 29, 2020 · 9:00 AM

How’s Your New Years’ Weight Loss Resolution Working Out? If Not So Great, Let Me Help

That excess weight can shorten your life

If you’re down at least 4–5 pounds (2.5 kg) since Jan. 1, that’s great. Keep it up. But most folks did well for a couple weeks and started gaining the weight back. Don’t be too hard on yourself. Weight management is not a walk in the park. You probably weren’t adequately prepared for the challenge.

Longterm success requires careful forethought. That’s why I’ve written this eight-part series.

Questions beg for answers. For example . . .

Which of the myriad weight-loss programs will I follow? Can I design my own program? Should I use a diet book? Sign up for Nutri-System, Weight Watchers, or Jenny Craig? Should I stop wasting my time dieting and go directly to bariatric surgery? Can I simply cut back on sodas and chips? What should I eat? What should I not eat? Do I need to start exercising? What kind? How much? Do I need to join a gym? What methods are proven to increase my odds of success? How much weight should I lose? Should I use weight-loss pills or supplements? Which ones? What’s the easiest, most effective way to lose weight? Is there a program that doesn’t require willpower? Now, what were those “top 10 super-power foods” that melt away the fat? Am I ready to get serious and stick with it this time?

This series will answer many of these questions and get you teed up for success. Teed up like a golfer ready to hit his first shot on hole #1 of an 18-hole course. Take 10 minutes to read the following articles. The time invested will pay dividends for years.

C’mon now. Let’s be realistic.

Part 1: Motivation

Immediate, short-term motivation to lose weight may stem from an upcoming high school reunion, swimsuit season, or a wedding. You want to look your best. Maybe you want to attract a mate or keep one interested. Perhaps a boyfriend, co-worker, or relative said something mean about your weight. These motivators may work, but only temporarily. Basing a lifestyle change on them is like building on shifting sands. You need a firmer foundation for a lasting structure. Without a lifestyle change, you are unlikely to vanquish a chronic overweight problem. Proper long-term motivation may grow from:

the discovery that you feel great and have more energy when you are lighter and eating sensibly
the sense of accomplishment from steady progress
the acknowledgment that you have free will and are responsible for your weight and many aspects of your health
the inspiration from seeing others take charge of their lives successfully
the admission that you have some guilt and shame about being fat, and that you like yourself more when you’re not fat [I’m not laying shame or guilt on you; many of us do it to ourselves.]
the awareness of overweight-related adverse health effects and their improvement with even modest weight loss.

Appropriate motivation will support the commitment and willpower that will be needed soon.

PS: I’m thinking of how Dave Ramsay, when he’s counseling people who have gotten way overhead in debt, tells them they have to get mad at the debt. Then they can attack it. Maybe you have to get mad at your fat. It’s your enemy, dragging you down, trying to kill you. Now attack it!

Part 2: The Energy Balance Equation

An old joke from my medical school days asks, “How many psychiatrists does it take to change a light bulb?” Only one, but the light bulb must want to change.

How many weight-loss programs does it take before you lose that weight for good? Only one, but…

Where does the fat go when you lose weight dieting? Metabolic reactions convert it to energy, water, and carbon dioxide, which weigh less than fat. Most of your energy supply is used to fuel basic life-maintaining physiologic processes at rest, referred to as resting or basal metabolism. Basal metabolic rate (BMR) is expressed as calories per kilogram of body weight per hour. Even at rest, a kilogram of muscle is much more metabolically active than a kilogram of fat tissue. So muscular lean people sitting quietly in a room are burning more calories than are fat people of the same weight sitting in the same room.

The major determinants of BMR are age, sex, and the body’s relative proportions of muscle and fat. Heredity plays a lesser role.

Energy not used for basal metabolism is either stored as fat or converted by the muscles to physical activity. Most of us use about 70 percent of our energy supply for basal metabolism and 30 percent for physical activity. Those who exercise regularly and vigorously may expend 40–60 percent of their calorie intake doing physical activity. Excess energy not used in resting metabolism or physical activity is stored as fat.

If you want to lose excess weight and keep it off, you must learn the following equation:

The energy you eat,

minus the energy you burn in metabolism and activity,

determines your change in body fat. [read more]

Cute mouse, but a slave to instincts.

Part 3: Free Will

The only way to lose excess fat weight is to cut down on the calories you take in, increase your physical activity, or do both.

Oh, sure. You could get a leg amputated, develop hyperthyroidism or out-of-control diabetes, or have liposuction or bariatric surgery. But you get my drift.

Although the exercise portion of the energy balance equation is somewhat optional, you must reduce food intake to lose a significant amount of weight. Once you reach your goal weight you will be able to return to nearly your current calorie consumption, and even higher consumption if you have increased your muscle mass and continue to be active.

Are you be able to reduce calorie intake and increase your physical activity temporarily? It comes down to whether we have free will. Free will is the power, attributed especially to humans, of making free choices that are unconstrained by external circumstances or by an agency such as divine will.

Will is the mental faculty by which one chooses or decides upon a course of action; volition.

Willpower is the strength of will to carry out one’s decisions, wishes, or plans.

If we don’t have free will, you’re wasting time trying to lose weight through dieting; nothing will get your weight problem under control. Even liposuction and weight-reduction stomach surgery will fail in time if you are fated to be fat. The existence of free will is . . . [read more]

Part 4: Starting New Habits

You already have a number of good habits that support your health and make your life more enjoyable, productive, and efficient. For example, you brush your teeth and bathe regularly, put away clean clothes in particular spots, pay bills on time, get up and go to work every day, wear your seat belt, put your keys or purse in one place when you get home, balance your checkbook periodically.

At one point, these habits took much more effort than they do now. But you decided they were the right thing to do, made them a priority, practiced them at first, made a conscious effort to perform them on schedule, and repeated them over time. All this required discipline. That’s how good habits become part of your lifestyle, part of you. Over time, your habits require much less effort and hardly any thought. You just do it.

Your decision to lose fat permanently means that you must establish some new habits, such as regular exercise and reasonable food restriction. You’ve already demonstrated that you have self-discipline. The application of that discipline to new behaviors will support your commitment and willpower.

Exercise isn’t very important for weight loss, but critical for preventing weight regain.

Part 5: Supportive Social System

Success at any major endeavor is easier when you have a supportive social system. And make no mistake: losing a significant amount of weight and keeping it off long-term is a major endeavor.

As an example of a supportive social system, consider childhood education. A network of actors play supportive roles. Parents provide transportation, school supplies, a home study area, help with homework, etc. Siblings leave the child alone so he can do his homework, and older ones set an example. Neighbors may participate in carpooling. Taxpayers provide money for public schools. Teachers do their part. The school board oversees the curriculum, supervises teachers, and does long-range planning.

Success is more likely when all the actors work together for their common goal: education of the child. Similarly, your starring role in a weight-loss program may win an Academy Award if you have a strong cast of supporting actors. Your mate, friends, co-workers, and relatives may be helpers or hindrances. It will help if they . . . [read more]

Part 6: Weight Goals

Despite all the chatter about how to lose weight, few talk about how much should be lost.

Down 4 pounds in 6 months. I’ll take it!

If you are overweight, deciding how much weight you should lose is not as simple as it seems at first blush. I rarely have to tell a patient she’s overweight. She knows it and has an intuitive sense of whether it’s mild, moderate, or severe in degree. She’s much less clear about how much weight she should lose. If it’s any consolation, clinicians in the field aren’t always sure either.

Five weight standards have been in common usage over the last quarter-century . . . [read more]

Part 7: Creative Visualization

How will your life be different after you make a commitment and have the willpower to lose weight permanently?

Odds are, you will be more physically active than you are now. Exercise will be a habit, four to seven days per week. Not necessarily vigorous exercise, perhaps just walking for 30 or 45 minutes. It won’t be a chore. It will be pleasant, if not fun. The exercise will make you more energetic, help you sleep better, and improve your self-esteem.

After you achieve your goal weight, you’ll be able to cut back on exercise to three or four days per week, if you want. If you enjoy eating as much as I do, you may want to keep very active physically so that you can eat more. I must tell you that I rarely see anyone lose a major amount of weight and keep it off without . . . [read more]

Part 8: Choosing A Program

I listed most of your weight-loss program options in the introductory comments to this series. Now it’s time to make a choice. And it’s not easy sorting through all the options.

Straight away, I must tell you that women over 300 pounds (136 kg) and men over 350 pounds (159 kg) rarely have permanent success with self-help methods such as diet books, meal replacement programs, diet pills or supplements, and meal-delivery systems. People at those high weights who have tried and failed multiple different weight-loss methods should seriously consider bariatric surgery.

I respect your intelligence and desire to do your “due diligence” and weigh all your options: diet books, diet pills and supplements, bariatric surgery, meal replacement products (e.g., SlimFast), portion-control meal providers (e.g., NutriSystem), Weight Watchers, fad diets, no-diet diets, “just cutting back,” etc. You have to make the choice; I can’t make it for you. Here are some well-respected sources of advice to review before you choose . . . [read more]

Last modification date: November 1, 2017

1 Comment

Filed under Weight Loss

January 27, 2020 · 9:00 AM

What’s the Optimal Diet for Fatty Liver (Hepatic Steatosis)?

Stages of liver damage. Healthy, fatty, liver fibrosis and cirrhosis. Vector illustration

From Dr Bret Scher at DietDoctor:

Fortunately, we have emerging evidence that low-carb and ketogenic diets improve fatty liver while also helping with glycemic control and weight loss, an impressive combination rarely seen with medications. As we reported earlier, studies have shown that carbohydrate restriction changes liver metabolism, stimulating the breakdown of liver fat. Another study mentioned in the same post showed that when children substitute complex forms of starch to replace sugar, they experience reduced amounts of liver fat.

Yet another impressive study found that despite equal weight loss, a low-carb Mediterranean diet was better than a low-fat diet for reversing liver fat and signs of NAFLD. And finally, Virta Health published a subset of its data showing that one year on a ketogenic diet improved non-invasive tests for NAFLD and liver scarring.

Source: Limiting Carbs Likely Better Than Drugs for Fatty Liver — Diet Doctor

Steve Parker, M.D.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com

1 Comment

Filed under liver disease

January 26, 2020 · 9:00 AM

1 in 5 U.S. Adolescents Has Prediabetes

Exercise can prevent prediabetes and T2 diabetes

Stats from JAMA Pediatics:

In the United States, about 1 of 5 adolescents [12-18 y.o.] and 1 of 4 young adults [19-34 y.o.] 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. – PubMed – NCBI

I’m doing my part to prevent conversion of prediabetes to type 2 diabetes.

Steve Parker, M.D.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords.com.

3 Comments

Filed under Prediabetes

January 25, 2020 · 9:00 AM

High-Intensity Interval Training May Prevent Dementia

A slow leisurely pace won’t cut it

Dementia is a devastating and expensive development for an individual and his family. Most dementias are progressive and incurable. If it can be prevented, it should be. Exercise is one preventative. But how much and what kind of exercise?

Nine percent of U.S. adults over 65 have dementia. That’s 3.650,000 folks. The initial clue to incipient dementia is usually memory impairment.

From The Globe and Mail:

In 2017, a team led by the lab’s director, Jennifer Heisz, published a five-year study of more than 1,600 adults older than 65 that concluded that genetics and exercise habits contribute roughly equally to the risk of eventually developing dementia. Only one of those two factors is under your control, so researchers around the world have been striving to pin down exactly what sort of workout routine will best nourish your neurons.

Heisz’s latest study, published last month in the journal Applied Physiology, Nutrition, and Metabolism, offers a tentative answer to this much-debated question. Older adults who sweated through 12 weeks of high-intensity interval training improved their performance on a memory test by 30 per cent compared with those who did a more moderate exercise routine.

This was a small study, only about 20 sedentary participants (all over 60 years old) subjected to one of three protocols for twelve weeks, exercising thrice weekly:

Four-minute bouts of vigorous treadmill walking at 90-95% of maximum heart rate, repeated four times, with three minutes easy walking between the high-intensity spells intervals (HIIT)
Walking at 70-75% of max heart rate for 47 minutes (burning the same number of calories as group #1
Thirty minutes of relaxed stretching

Alex Hutchinson’s full article is well worth a couple minutes of your time if you want to avoid dementia.

Source: New study shows the right workout routine can help fight dementia – The Globe and Mail

Most experts agree that diabetes is a risk factor for dementia, and the Mediterranean diet helps prevent it.

Steve Parker, M.D.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords.com.

1 Comment

Filed under Dementia, Exercise

January 24, 2020 · 9:00 AM

Paul Ingraham Cured My PFPS: Patello-Femoral Pain Syndrome

…and Paul’s not even a physician or physical therapist. But he’s a smart guy, writer, and former massage therapist. Click for his article on patello-femoral pain syndrome if interested. I paid about $20 USD for the full article, and it was well worth it. Full disclosure: I don’t know Paul and earn no commission or other compensation for this endorsement.

Photo credit: Steven Paul Parker II

The key to my cure was probably radical rest, or what Paul calls profound rest.

If you have PFPS, I hope you find something useful here.

Regular readers here know I’m a huge proponent of exercise. Unfortunately, exercise can be risky. You can injure yourself. I did that a few years ago when I was getting in shape to climb Humphreys Peak. I accelerated my training program too rapidly and developed patell0-femoral pain syndrome (PFPS).

This is how my right knee felt in 2017:

I’ve developed over the last month some bothersome pain in my right knee. It’s not interfered much with my actual hiking, but I pay for it over the subsequent day or two. I’m starting to think this may put the kibosh on my Humphries Peak trek next month.

The pain is mostly anterior (front part of the knee) and is most noticeable after I’ve been sitting for a while with the bent knee, then get up to walk. The pain improves greatly after walking for a minute or less. It also hurts a bit when I step up on something using my right leg. If I sit with my knee straight (in full extension), it doesn’t hurt when I get up. The joint is neither unusually warm nor swollen. Ibuprofen doesn’t seem to help it.

That episode resolved after I stopped hiking for 3-4 months. But in 2018 I had recurrence of similar pains in my left knee, with no clear precipitant this time. I continued my usual weight-training program and expected another spontaneous resolution. Six months passed…no improvement. That’s when I found Paul Ingraham’s article.

By the way, I’m the one who diagnosed my PFPS. It’s been said that a doctor who diagnoses and treats himself has a fool for a patient. He can’t be adequately objective.

Alternative diagnoses would include patello-femoral osteoarthritis and degenerative meniscus, due to my age (over 60). Diagnosis of the osteoarthritis could be facilitated by knee X-rays: weight-bearing posterior-anterior imaging, weight-bearing lateral view, and sunrise view.

This was my treatment plan for PFPS in early Feb 2019, based on Paul Ingraham’s recommendations. Paul explains how to do various specific exercises below in his article.

Avoid all activities that stress the patella-femoral joint or aggravate pain for at least two weeks, if not longer (2–3 months). Paul calls it “profound rest.” I started this Feb 17. No knee-loading exercise (e.g., leg presses, any kind of squat, deep knee bends) until pain is truly in remission from rest. I quit my usual squats, Bulgarian split-squats, and single-leg Romanian deadlifts.
Consider Motrin (ibuprofen) 400-600 mg three times daily for two weeks (I did 600 mg 3x/day) but usually no help
Consider cold-packs (10–20 mins) when it flares up but usually no help. (I never did this because I couldn’t find my WalMart cold-pack.)
Find a substitute for the squats? E.g., stationary bike? No bike for now: too much stress on patello-femoral joint at this time
Paul’s not big on stretching (quadriceps and hamstring stretches routinely recommended by others). I didn’t stretch.
While recovering, keep leg straight most of the time, even when sitting. Sit less. (I didn’t sit less but did make a huge effort to keep my affected led fully extended, or at least not bent more that 20 degrees at any time. This necessitated sitting on the edge of my seat at work, and/or lowering the height of the seat. At home relaxing, I’d keep my leg fully extended. I think this was extremely important for my healing. I considered getting a standing desk for home or work but didn’t.)
Start with exercises that keep knees straight. Exercise both lower extremities. As condition improves, can start to add other exercises, very slowly, that allow bent knees. Single-leg RDLs may be a good start (started in Sept 2019). Restart squats, deep knee bends, and leg presses (cycling?) only very late into recovery. Rehab must progress VERY SLOWLY. If an exercise causes more knee pain, back off and work the hips first. Exercise 2–3 times/week. Walking on the flat in moderation is usually OK. Strengthening hip abductors may be helpful.
Hamstring curls via machine or therabands. Curl to 60 degrees, not 120. (I curled to 90 degrees using therabands).
Quadricep setting. (I didn’t do this. Straight-leg raises on your back seem to be similar, which I did.)
Straight-leg raises, on back and side-lying. (Done: 3 sets of 10 reps each side.)
Clam shells. (Done: 3 sets of 10 reps each side.)
Knee lifts? (don’t know what that is; not done).
Consider the following although not from Paul: Hip abductor strengthening: “monster walks” (lateral steps with elastic band around (just proximal to) knees: 1 min x 3 sets. Hip hikes (what’s this?): 2 sets of 20 reps each side.
Consider the following although not from Paul: Quad strengthening: terminal knee extensions with elastic band, 3 sets of 15 reps; leg presses?; semi squat, 3 sets of 10 reps (also recumbent bike?). Also consider stork stance TKE (terminal knee extensions) as alternative to standard TKE.
Paul likes trekking poles for hikers. (I’ve been using these for years; Leki brand.)
Not from Paul: Home physical therapy for six weeks
Not from Paul: Turkish get-ups now or later? Much further into recovery!

Update of Progress on April 4, 2019:

Knee definitely feeling better, probably due to profound rest as above. On Feb 23, I aggravated knee mildly by sledding in snow with Paul in Care Free – no regrets! Around Feb 26, Sunny got me started on Platinum’s Ortho-Chon Plus, 3 caps twice daily. Per 3 caps: glucosamine sulfate 800 mg, turmeric 380 mg, methylsulfonylmethane 350 mg, berberine HCL 145 mg, Boswellia serrata extract 140 mg, hyaluronic acid 50 mg, cat’s claw 10 mg, total cetylated fatty acids 3 mg. Not sure if these did any good at all; I’m skeptical. Started feeling less pain around Feb 29.

I am not healed or in remission yet. Doing hip exercises twice or once/wk with Therabands: clamshells, straight leg raises, side-lying straight leg raises, hamstring curls.

I had to put hip exercises on hold temporarily on March 28 due to a right low back muscle strain either from the exercises or weed pulling.

Update on Nov 25, 2019:

The PFPS is in remission and has been since July or so. For the last couple months I’ve been doing single-leg Romanian deadlifts and “walking” on elliptical-type aerobic machines at Anytime Fitness—some machines also work the upper limbs, others don’t—which are very easy on my knees. Avoiding treadmill since I have a palpable click in one knee, and treadmill aggravates my degenerative joint disease (DJD in both knees but predominantly left knee).

Next step is to slowly re-introduce exercises that load the knees (particularly the patell0-femoral joint). This is scary but must be done. My quads have atrophied somewhat. Squats? Lunges? Bulgarian split squats?

Steve Parker, M.D.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com

1 Comment

Filed under Knee Pain

January 23, 2020 · 7:00 AM

Both Low- and High-Carb Diets May Kill You

In the research at hand, low-carb was defined as under 40% of calories from carbohydrate, and high-carb was over 70% of calories.

Garlic Naan, a type of flat bread, definitely high-carb

The longevity sweet spot was 50-55% of calories from carbs. You know what? That’s the typical carb percentage in the traditional Mediterranean diet.

If you want to eat low-carb, read more below to identify the possibly healthier substitutions for carbs. Tl;dr version: Eat plant-derived protein and fats.

From a 2018 study in The Lancet Public Health:

Background

Low carbohydrate diets, which restrict carbohydrate in favour of increased protein or fat intake, or both, are a popular weight-loss strategy. However, the long-term effect of carbohydrate restriction on mortality is controversial and could depend on whether dietary carbohydrate is replaced by plant-based or animal-based fat and protein. We aimed to investigate the association between carbohydrate intake and mortality.

Methods

We studied 15 428 adults aged 45–64 years, in four US communities, who completed a dietary questionnaire at enrolment in the Atherosclerosis Risk in Communities (ARIC) study (between 1987 and 1989), and who did not report extreme caloric intake (4200 kcal per day for men and 3600 kcal per day for women). The primary outcome was all-cause mortality. We investigated the association between the percentage of energy from carbohydrate intake and all-cause mortality, accounting for possible non-linear relationships in this cohort. We further examined this association, combining ARIC data with data for carbohydrate intake reported from seven multinational prospective studies in a meta-analysis. Finally, we assessed whether the substitution of animal or plant sources of fat and protein for carbohydrate affected mortality.

Findings

During a median follow-up of 25 years there were 6283 deaths in the ARIC cohort, and there were 40 181 deaths across all cohort studies. In the ARIC cohort, after multivariable adjustment, there was a U-shaped association between the percentage of energy consumed from carbohydrate (mean 48·9%, SD 9·4) and mortality: a percentage of 50–55% energy from carbohydrate was associated with the lowest risk of mortality. In the meta-analysis of all cohorts (432 179 participants), both low carbohydrate consumption (70%) conferred greater mortality risk than did moderate intake, which was consistent with a U-shaped association (pooled hazard ratio 1·20, 95% CI 1·09–1·32 for low carbohydrate consumption; 1·23, 1·11–1·36 for high carbohydrate consumption). However, results varied by the source of macronutrients: mortality increased when carbohydrates were exchanged for animal-derived fat or protein (1·18, 1·08–1·29) and mortality decreased when the substitutions were plant-based (0·82, 0·78–0·87).

Interpretation

Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.

Source: Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis – The Lancet Public Health

Steve Parker, M.D.

PS: These types of studies are often unreliable.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com

2 Comments

Filed under Carbohydrate, Longevity

January 22, 2020 · 7:00 AM

Diabetes Drug Dapagliflozin Prevents Worsening Heart Failure and Cardiovascular Deaths

Pulmonary artery arrow is wrong

The amazing thing about this research is that dapagliflozin 10 mg/day seemed to benefit patient who didn’t even have diabetes. Unfortunately, the abstract doesn’t mention how many non-diabetic patients were in the study. As always, you should take news like this with a grain of salt.

Conclusion from the abstract:

Among patients with heart failure and a reduced [left ventricular] ejection fraction [under 40%], the risk of worsening heart failure or death from cardiovascular causes was lower among those who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes.

Source: Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction | NEJM

Steve Parker, M.D.

PS: Your doctor isn’t going to prescribe dapagliflozin for you if you don’t have diabetes. Guess what else helps prevent heart failure and premature cardiac death. The Mediterranean diet.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com

1 Comment

Filed under Heart Disease

January 21, 2020 · 7:00 AM

Dr David Unwin Explains Why He Favors Low-Carb Eating as Best Diet for Type 2 Diabetes

diabetic diet, Paleobetic diet, diabetes,

Sunny’s Super Salad

The Diet Doctor website posted a video interview of Dr David Unwin (in the U.K.) discussing his experience with low-carb diets in folks with diabetes (type 2, I assume). If you’re short on time, just read the transcript. Thanks, Diet Doctor!

I took note of Dr Unwin’s transformation from a run-of-the mill follow-the-herd practitioner to a low-carb advocate. This happened around 2012 when Dr Unwin was 55 years old and on the threshold of retirement. Here it is:

Dr David Unwin speaking: ….There was one particular case I’ve talked about before where there was a patient who – so in 25 years I’d never seen a single person put their [type 2] diabetes into remission, I had not seen it once. I didn’t even really know it was possible.

Dr Bret Scher speaking: We were not [taught] that it’s possible.

Dr Unwin: No, my model was that the people with diabetes… It was a chronic deteriorating condition and I could expect that they would deteriorate and I would add drugs and that’s what would be normally going to happen. And then one particular patient wasn’t taking her drugs and she actually went on the low-carb diet and put her diabetes into remission.

But she confronted me with, you know, “Dr. Unwin, surely you know that actually sugar is not a good thing for diabetes.” “Yes, I do.” But then she said, “But you’ve never once in all the years mentioned that really bread was sugar, did you.” And, you know, I never did. I don’t know what my excuse was. So this this lady had done this wonderful thing and she’d also changed her husband’s life as well.

She’d sorted his diabetes out and she’d done it with a low-carb diet and that really made me think I didn’t know much about it. I didn’t know much about it. So I found out what she’d been on… on the low-carb forum of diabetes.co.uk and to my amazement there was 40,000 people on there, all doing this amazing thing. And I was blown away but then I was very sad because the stories of the people online were full of doctors who are critical of these people’s achievements.

***

Dr Unwin: And that original case that showed me you could put into remission; if you could repeat that, how wonderful for people… And when I now – because I think we’ve done 60 patients who put their type 2 diabetes into remission. So I’m able to say with confidence to people, you know, you stand a good chance. In fact I can say that of my patients who take up low-carb, about 45% of them will put their diabetes into remission which is amazing.

At no point does the transcript indicate they’re talking about type 2 diabetes rather than type 1, but that must be the case. Nor does it mention the amount of required carbohydrate restriction. I figure it’s between 20 and 100 grams/day of digestible carbohydrate, depending on one’s metabolic health and how many years of diabetes.

I’ve mentioned Dr Unwin before.

Source: Diet Doctor Podcast #33 – Dr. David Unwin – Diet Doctor

Steve Parker, M.D.

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com

2 Comments

Filed under Carbohydrate

January 13, 2020 · 7:00 AM

Think Twice Before Heart Artery Stenting or Bypass

Heart attacks and chest pains are linked to blocked arteries in the heart

Doctors are often criticised for over-using coronary artery angioplasty/stenting and coronary artery bypass grafting.

From Stanford Medicine:

Patients with severe but stable heart disease who are treated with medications and lifestyle advice alone are no more at risk of a heart attack or death than those who undergo invasive surgical procedures, according to a large, federally-funded clinical trial led by researchers at the Stanford School of Medicine and New York University’s medical school.

The trial did show, however, that among patients with coronary artery disease who also had symptoms of angina — chest pain caused by restricted blood flow to the heart — treatment with invasive procedures, such as stents or bypass surgery, was more effective at relieving symptoms and improving quality of life. “For patients with severe but stable heart disease who don’t want to undergo these invasive procedures, these results are very reassuring,” said David Maron, MD, clinical professor of medicine and director of preventive cardiology at the Stanford School of Medicine, and co-chair of the trial, called ISCHEMIA, for International Study of Comparative Health Effectiveness with Medical and Invasive Approaches.

***

“Based on our results, we recommend that all patients take medications proven to reduce risk of heart attack, be physically active, eat a healthy diet and quit smoking,” Maron said. “Patients without angina will not see an improvement, but those with angina of any severity will tend to have a greater, lasting improvement in quality of life if they have an invasive heart procedure. They should talk with their physicians to decide whether to undergo revascularization.”

Source: Stents, bypass surgery show no benefit in heart disease mortality rates among stable patients | News Center | Stanford Medicine

Steve Parker, M.D.

PS: The Mediterranean diet is a healthy diet, reduces the risk of heart disease, and you can even lose weight with it!

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords.com.

1 Comment

Filed under coronary heart disease, Heart Disease

January 12, 2020 · 10:10 PM

Not Into Salads? Try This!

Salad and cheese

Jan over at Low Carb Diabetic has a great post on building a salad from the ground up.

“Salads make a nutritious and satisfying meal, whether it’s for lunch or dinner. The best part is that no two salads are exactly the same. There are limitless ways to make salad unique and flavourful. Get some tips for what to add to your next salad….”

Source: The Low Carb Diabetic: Super Salads – Some Tips for Building A Better Salad

Click for my nutritional assessment of various salad greens. Variety is also important.

Steve Parker, M.D.