Not quite what you were expecting, was it?
Wishing a glorious Father’s Day to all you dads.
Impact of Artificial Sweeteners on Lifespan: New Findings
A July 2024 article in the July 31, 2024, Nutrition Journal suggests that artificially sweetened beverage consumption may cause increased risk of death, particularly from cardiovascular disease. Yet the researchers say that if one substitutes sugary beverages with artificially sweetened beverages, it lowers risk of all-cause mortality and cardiovascular disease mortality. This is a round about way to say that, as far as sweet drinks go, avoiding both sugary and artificially sweetened drinks may help you live longer.
From the abstract:
Our systematic review and meta-analysis demonstrated a higher consumption of artificially sweetened beverages in relation to higher risks of all-cause and cardiovascular mortality, whereas no relationship of artificially sweetened beverages with cancer mortality was observed. Compared with the participants in the lowest category of artificially sweetened beverage intakes, those in the highest category had a 13% higher risk of premature death from any cause, and a 26% higher risk of CVD (cardiovascular disease) mortality. Each one additional serving increase in artificially sweetened beverage consumption was associated with 6% and 7% higher risk for all-cause and CVD mortality, respectively. In a dose-response meta-analysis, we also observed a linear association of artificially sweetened beverage consumption with CVD mortality, with a non-linear positive association of artificially sweetened beverages with all-cause mortality. Despite this, substitution of sugary sweetened beverages with artificially sweetened beverages was associated with a lower risk of all-cause and CVD mortality. Various sensitivity analyses and subgroups analyses demonstrated the robustness of the pooled associations. Per NutriGrade, quality of the overall evidence was scored moderate for CVD mortality and all-cause mortality.
Steve Parker, M.D.
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Filed under coronary heart disease, Heart Disease, Longevity
How to Navigate the U.S. Healthcare System
Opthalmologist Dr. Will Flannery has put together a whimsical yet accurate guide to the U. S. healthcare system. Well worth your time if you’re relatively new to the system and need help understanding deductibles, co-pays, out-of-pocket maximums (hint: they’re not really maximums), in-network, out-of-network, vertical integration, “surprise” medical bills, etc. I was particularly impressed with the section on fighting claim denials; I hope I remember to re-read it when the time comes.
Dr. Glaucomflecken’s Incredibly Uplifting and Really Fun Guide to American Healthcare.
Remember how Obamacare was supposed to make healthcare more affordable? From the guide, “The 2025 out-of-pocket maximum for an Affordable Care Act plan can’t be more than $9,200 for an individual and $18,400 for a family.” When half of Americans can’t afford an emergency $500 bill, how do they pay up to $9,200?
Dr. Glaucomflecken also offers some system improvements that I also advocate in my latest book, Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform.
Steve Parker, M.D.
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Filed under healthcare reform
ABC News Reports Possible FRAUD in Basic Alzheimer Disease Research
Science magazine has been investigating this for six months. This is disturbing, to say the least.
For several decades, a leading theory on the “cause” of Alzheimer disease is that a toxic protein called beta amyloid builds up in certain parts of the brain, impairing function. If that’s true, the next questions are 1) why does the protein accumulate, and 2) what can be done to prevent it.
From ABC News:
Allegations that part of a key 2006 study of Alzheimer’s disease may have been fabricated have rocked the research community, calling into question the validity of the study’s influential results.
Science magazine said Thursday that it uncovered evidence that images in the much-cited study, published 16 years ago in the journal Nature, may have been doctored.
***
More than $1 billion of government funding, through the National Institutes of Health, has been directed to amyloid-related Alzheimer’s research. While the investigation suggests that studies of Aβ*56 should be opened up to new scrutiny, experts said the entire theory shouldn’t be discredited.
Steve Parker, M.D.
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Filed under Dementia
Ten Minutes of Beautiful Art & Music
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Filed under Uncategorized
Managing ADPKD: Dietary Strategies for Kidney Health
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common inherited cause of end-stage kidney disease and affects 500,000 Americans. It is characterized by fluid-filled cysts in both kidneys and gradual deterioration of kidney function. By age 70, affected folks constitute as much as 10% of the end-stage kidney disease population.
Autosomal Recessive Polycystic Kidney Disease is much less common but is more severe.
Trust me, you want to maintain normal kidney function if possible. In ADPKD, standard interventions include adequate fluid consumption, dietary sodium restriction, and keeping blood pressure below 120-125/80 mmHg.
A 2024 article in Nutrients suggests other potentially helpful dietary interventions: carbohydrate restriction and ketogenic diets. Also, avoid kidney stone formation.
Understanding chronic kidney disease (CKD) through the lens of evolutionary biology highlights the mismatch between our Paleolithic-optimized genes and modern diets, which led to the dramatically increased prevalence of CKD in modern societies. In particular, the Standard American Diet (SAD), high in carbohydrates and ultra-processed foods, causes conditions like type 2 diabetes (T2D), chronic inflammation, and hypertension, leading to CKD. Autosomal dominant polycystic kidney disease (ADPKD), a genetic form of CKD, is characterized by progressive renal cystogenesis that leads to renal failure. This review challenges the fatalistic view of ADPKD as solely a genetic disease. We argue that, just like non-genetic CKD, modern dietary practices, lifestyle, and environmental exposures initiate and accelerate ADPKD progression. Evidence shows that carbohydrate overconsumption, hyperglycemia, and insulin resistance significantly impact renal health. Additionally, factors like dehydration, electrolyte imbalances, nephrotoxin exposure, gastrointestinal dysbiosis, and renal microcrystal formation exacerbate ADPKD. Conversely, carbohydrate restriction, ketogenic metabolic therapy (KMT), and antagonizing the lithogenic risk show promise in slowing ADPKD progression. Addressing disease triggers through dietary modifications and lifestyle changes offers a conservative, non-pharmacological strategy for disease modification in ADPKD. This comprehensive review underscores the urgency of integrating diet and lifestyle factors into the clinical management of ADPKD to mitigate disease progression, improve patient outcomes, and offer therapeutic choices that can be implemented worldwide at low or no cost to healthcare payers and patients.
Steve Parker, M.D.
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Filed under kidney disease
Medical Care Pre-Payment Versus True Insurance
William M. Briggs thinks that “true insurance” is the better idea. He starts with this explanation:
Health Insurance should be, but isn’t, a bet you make that you hope you lose.
It has become instead an inefficient form of socialized medicine, increasing costs. Here’s how.
Here’s what insurance should be. You bet with an Insurer that you get cancer, say. If you get it, the Insurer pays costs of care X. If you lose and remain cancer free, you pay Y. You re-bet every month (or whatever). You pay Y every time you lose. The X and Y are negotiated between you and the Insurer, and the risk of cancer is decided by you and separately by the Insurer. That is the bare bones of true Insurance. Or, indeed, of any bet.
You can also group diseases, say cancer and CHF. Then you pay Y_1 + Y_2 (say) and the costs are X_1 + X_2. The result is a contract bet just the same. But with higher stakes for both.
Suppose you already have cancer and bet the Insurer you won’t get it. You immediately win the bet! The Insurer must pay X.
How much should the Insurer charge you for this sure-thing bet? X. After all, your “pre-existing condition” is a sure-thing bet the Insurer is bound to lose. There is no sense in you making the bet.
Unless a Ruler steps in and says “Insurer, you must take this bet!” Which, of course, happens. Then the Insurer must spread the costs of X to others.
If the Insurer doesn’t spread the costs, he has sure loss (assuming calibrate bets, about which more later). Which means if you bet you have cancer when you do, when your neighbor makes a bet for cancer when he doesn’t have it, he must pay Y+S, where S represents the spread. The more people in the system, the smaller S is.
Voilà! With coverage mandates Insurance automatically becomes socialized medicine. Very inefficient, too, because not only are we paying a private entity to manage this, and take his profits, we pay bureaucrats to monitor it all. Costs must increase. Health care won’t get better, but costs must rise.
It’s worse than all this, too!
RTWT. I discuss the pros and cons of the “true insurance” idea in my book below. Dramatic price reductions done today.
Steve Parker, M.D.
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Filed under healthcare reform
“Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform”: Now Available For Less Than You Pay for Fancy Coffee
I’d be much appreciative of some Amazon reviews of my 2024 book, Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform.
To make the book available to more readers, I just dramatically reduced the price at the U.S. Amazon store. $2.99 for the e-book (Kindle) or $9.95 for the paperback. I don’t know how long the prices will stay this low.
If you’re curious, at those prices Amazon pays me $2.06 for each e-book sold, and $2.74 for the paperback.
I don’t care if you leave a favorable or bad review at Amazon. Just be honest. I’ll incorporate helpful and insightful criticism into the 2nd edition.
Steve Parker, M.D.
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Filed under healthcare reform
The Christmas Truce of 1914
From the Holy Bible (NIV), Matthew 22:36-40:
36 “Teacher, which is the greatest commandment in the Law?”
37 Jesus replied: “‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ 38 This is the first and greatest commandment. 39 And the second is like it: ‘Love your neighbor as yourself.’[ 40 All the Law and the Prophets hang on these two commandments.”
Or if you prefer, click for a written account of The Christmas Truce of 1914.
Filed under Uncategorized
Diets That Lower CRP Levels May Prevent Chronic Disease
C-reactive protein (CRP) is a bloodstream marker of body-wide inflammation. A prominent theory is that if your CRP is too high, it causes chronic disease states like hypertension, dementia, and cardiovascular disease. A 2024 meta-analysis published in British Journal of Nutrition looked at the effects of various diets on CRP. The implication is that your odds of developing particular chronic diseases is lowered if you adopt a diet that lowers your CRP. Check the Abstract below to see how your diet stacks up:
Adopting a healthy dietary pattern may be an initial step in combating inflammation-related chronic diseases; however, a comprehensive synthesis evaluating current evidence is lacking. This umbrella review aimed to summarise the current evidence on the effects of dietary patterns on circulating C-reactive protein (CRP) levels in adults. We conducted an exhaustive search of the Pubmed, Scopus and Epistemonikos databases, spanning from their inception to November 2023, to identify systematic reviews and meta-analyses across all study designs. Subsequently, we employed a random-effects model to recompute the pooled mean difference. Methodological quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, and evidence certainty was categorised as non-significant, weak, suggestive, highly suggestive or convincing (PROSPERO: CRD42023484917). We included twenty-seven articles with thirty meta-analyses of seven dietary patterns, fifteen of which (50 %) exhibited high methodological quality. The summary effects of randomised controlled trials (RCT) found that the Mediterranean diet was the most effective in reducing circulating CRP levels, followed by Vegetarian/Vegan and Energy-restricted diets, though the evidence was of weak quality. In contrast, Intermittent Fasting, Ketogenic, Nordic and Paleolithic diets did not show an inverse correlation with circulating CRP levels. Some results from combined interventional and observational studies, as well as solely observational studies, also agreed with these findings. These dietary patterns show the potential in reducing CRP levels in adults, yet the lack of high-quality evidence suggests future studies may alter the summary estimates. Therefore, further well-conducted studies are warranted.
Steve Parker, M.D.
Filed under Longevity, Mediterranean Diet
Diabetic Mediterranean Diet 