October 16, 2019 · 3:49 AM

Burn More Fat With Interval Training Than Continuous Exercise

You can do interval training on a bicycle

From JAMA Network:

Exercisers can burn slightly more body fat with interval training than moderate-intensity continuous training, according to a recent systematic review and meta-analysis in the British Journal of Sports Medicine. Although the differences in fat loss weren’t huge, the interval workouts were shorter, which could make it easier for people to adhere to them.

Source: For Fat Burning, Interval Training Beats Continuous Exercise | Lifestyle Behaviors | JAMA | JAMA Network

Click for info on interval training.

Steve Parker, M.D.

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

1 Comment

Filed under Exercise

October 13, 2019 · 10:05 AM

Sugary Beverages Increase Risk of Death

Wonder if sugar in coffee counts?

Sugary beverages also make it harder to control blood sugar levels.

From JAMA Network:

Question:  Is the consumption of sugary beverages (ie, sugar-sweetened beverages and fruit juices) associated with an increased mortality risk?

Findings:  In this cohort study of 13 440 black and white adults 45 years and older observed for a mean of 6.0 years, each additional 12-oz serving/d of sugary beverages was associated with an 11% higher all-cause mortality risk, and each additional 12-oz serving/d of fruit juice was associated with a 24% higher all-cause mortality risk. Similar associations were not observed for sugary beverage consumption and coronary heart disease mortality.

Meaning:  These results suggest higher consumption of sugary beverages, including fruit juice, is associated with increased mortality.

Source: Association of Sugary Beverage Consumption With Mortality Risk in US Adults: A Secondary Analysis of Data From the REGARDS Study | Cardiology | JAMA Network Open | JAMA Network

Steve Parker, M.D.

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

3 Comments

Filed under Longevity

October 12, 2019 · 4:13 PM

Cross the Border for Affordable Insulin

Great article by Robin Cressman. Read the whole thing.

“Just a week before the trip [to Tijuana, Mexico], I was down to my very last vial of Humalog. It was June and I was close, but still so far, from hitting my $5,000 deductible for the year, which meant I was still paying full price out of pocket for all of my medical costs until I hit that figure. I had started the year low on supplies (a rookie mistake that I now know to avoid) and had been juggling bills from Dexcom, my doctor’s office, and my pump supplier for months, trying to only use our health savings account but often having to pull out credit cards to cover the costs. I called my pharmacy and asked to fill a single vial of Humalog, and the cost was $248.13. I hung up the phone. Instead I went to Walmart and for the first time bought vials of Novolin NPH and Regular for $24.99 each. It was those vials that were serving as my backup insulin a week later when I found myself in that pharmacy in Tijuana.”

Source: Crossing Borders to Afford Insulin – T1International

Whether it’s legal or not, I don’t know.

Steve Parker, M.D.

low-carb mediterranean diet

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

 

1 Comment

Filed under Drugs for Diabetes, Uncategorized

October 11, 2019 · 9:58 PM

Cutting Back on Ultra-Processed Foods Should Help With Weight Loss

“How about some ultra-processed bread?”

Over the short term, those eating ultra-processed foods at 500 calories a day more than those eating unprocessed foods.

From Kevin D. Hall and associates at Cell Metabolism:

We investigated whether ultra-processed foods affect energy intake in 20 weight-stable adults, aged (mean ± SE) 31.2 ± 1.6 years and BMI = 27 ± 1.5 kg/m2. Subjects were admitted to the NIH Clinical Center and randomized to receive either ultra-processed or unprocessed diets for 2 weeks immediately followed by the alternate diet for 2 weeks. Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber. Subjects were instructed to consume as much or as little as desired. Energy intake was greater during the ultra-processed diet (508 ± 106 kcal/day; p = 0.0001), with increased consumption of carbohydrate (280 ± 54 kcal/day; p < 0.0001) and fat (230 ± 53 kcal/day; p = 0.0004), but not protein (−2 ± 12 kcal/day; p = 0.85). Weight changes were highly correlated with energy intake (r = 0.8, p < 0.0001), with participants gaining 0.9 ± 0.3 kg (p = 0.009) during the ultra-processed diet and losing 0.9 ± 0.3 kg (p = 0.007) during the unprocessed diet. Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.

Source: Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake: Cell Metabolism

Steve Parker, M.D.

Click the pic to purchase at Amazon.com

2 Comments

Filed under Overweight and Obesity, Weight Loss

October 10, 2019 · 8:00 AM

Sure, Gastric Bypass Works for Adolescents, But for How Long?

bariatric surgery, Steve Parker MD

Band-type gastric bypass

From The New England Journal of Medicine:

Adolescents and adults who underwent gastric bypass had marked weight loss that was similar in magnitude 5 years after surgery. Adolescents had remission of diabetes and hypertension more often than adults.

Note, however,

Three adolescents (1.9%) and seven adults (1.8%) died in the 5 years after surgery. The rate of abdominal reoperations was significantly higher among adolescents than among adults (19 vs. 10 reoperations per 500 person-years, P=0.003).

Source: Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults | NEJM

I readily admit that gastric bypass is very effective method of weight loss and way to put type 2 diabetes into remission. But it’s a roll of the dice, and expensive.

Steve Parker, M.D.

low-carb mediterranean diet

Not linked to any deaths as far as I know. Click pic to purchase at Amazon.com.

1 Comment

Filed under Bariatric Surgery

October 9, 2019 · 11:51 AM

Low-Carb Mediterranean Diet Beats Low-Fat Diet for Reduction of Liver Fat

Excessive fat in the liver can lead to hepatitis and eventually cirrhosis. Don’t be that guy.

From the study abstract:

Methods

In an 18-month weight-loss trial, 278 participants with abdominal obesity/dyslipidemia were randomized to low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC+28g walnuts/day) diets with/without moderate physical activity (PA). HFC and abdominal fat-depots were measured using magnetic-resonance-imaging at baseline, after 6 (sub-study, n=158) and 18-months.

Results

Of 278 participants [age=48yr;88% men; body-mass-index=30.8kg/m2; mean HFC =10.2%,(range:0.01%-50.4%)], retention rate was 86.3%. %HFC substantially decreased after 6 [-6.6% absolute-units (-41% relatively)] and 18-months [-4.0% absolute-units (-29% relatively);p<0.001 vs. baseline]. Reduction of HFC associated with decreases in VAT beyond weight loss. After controlling for VAT loss, decreased %HFC remained independently associated with reductions in serum gamma-glutamyl-transferase and alanine-aminotransferase, circulating chemerin, and HbA1c (p<0.05). While reduction of HFC was similar between PA groups, compared to LF diet, MED/LC induced a greater %HFC decrease (p=0.036) and greater improvements in cardiometabolic risk parameters (p<0.05), even after controlling for VAT changes. Yet, the greater decreases induced by MED/LC compared to LF diets in triglycerides, TG/HDL ratio and cardiovascular risk score were all markedly attenuated when controlling for HFC changes.

Source: The Beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content – Journal of Hepatology

h/t DietDoctor

Hey, I know of  a low-carb Mediterranean diet!

low-carb mediterranean diet

Click pic to purchase at Amazon.com

2 Comments

Filed under Health Benefits, Mediterranean Diet

September 28, 2019 · 12:15 PM

Higher HgbA1c Levels Linked to Cognitive Decline Over a Decade

HgbA1c (hemoglobin A1c) is measure of average blood sugar levels over the previous three months. From a 2018 study:

In this community-based population, we observed a significant trend for cognitive decline over a 10 year period among individuals aged ≥50 years with normoglycaemia, prediabetes or diabetes at baseline. Additionally, HbA1c levels were linearly associated with subsequent cognitive decline in memory and executive function (but not orientation) irrespective of diabetes status at baseline.

Source: HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing | SpringerLink

h/t to Jan at The Low-Carb Diabetic

Steve Parker, M.D.

PS: You know what else helps prevent cognitive decline? The Mediterranean diet.

low-carb mediterranean diet

Click the pic to purchase at Amazon.com

2 Comments

Filed under Dementia

September 26, 2019 · 4:21 PM

World Health Organization Recommends Mediterranean Diet to Reduce Dementia Risk

Steve Parker MD, low-carb diet, diabetic diet

Olives, olive oil, and vinegar: classic Mediterranean foods

Two quotes:

In guidelines released Tuesday, WHO issued its first recommendations to reduce the risk of dementia globally. They include regular physical exercise, not using tobacco, drinking less alcohol, maintaining healthy blood pressure and eating a healthy diet — particularly a Mediterranean one.

***

“The Mediterranean diet is the most extensively studied dietary approach, in general as well as in relation to cognitive function,” the report said. “Several systematic reviews of observational studies have concluded that high adherence to the Mediterranean diet is associated with decreased risk of mild cognitive impairment and Alzheimer’s Disease, but modest adherence is not.”

Source: New global guidelines to reduce risk of dementia released

Steve Parker, M.D.

Click the pic to purchase at Amazon.com

1 Comment

Filed under Dementia, Health Benefits, Mediterranean Diet

September 25, 2019 · 5:52 PM

FDA warns doctors  about rare occurrences of a serious infection of the genital area with SGLT2 inhibitor drugs

The infection is called Fournier Gangrene. It’s a nasty infection that I’ve seen only a few times, always in men. The FDA reports cases in both men and women taking SGLT2 inhibitors to treat their diabetes.

“Patients should seek medical attention immediately if you experience any symptoms of tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell. These symptoms can worsen quickly, so it is important to seek treatment right away.”

Source: FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes | FDA

Steve Parker, M.D.

PS: With the right diet, you’ll need fewer drugs to control your diabetes. So, fewer drug side effects and less expense.

low-carb mediterranean diet

Click the pic to purchase at Amazon.com

1 Comment

Filed under Diabetes Complications, Drugs for Diabetes

September 21, 2019 · 5:23 PM

Tighter Blood Pressure Control Benefits Type 2 Diabetes

Not bad

From Diabetes Self-Management:

The new study evaluated roughly 11,000 people with type 2 diabetes in 20 countries over four years, finding that those who received the blood pressure drugs perindopril and indapamide to keep their blood pressure levels at or below 130/80 had fewer heart attacks, strokes and other complications than those receiving placebo (inactive treatment). They also had a “lower overall risk of dying from any cause.”

Source: Tight Blood Pressure Control Benefits Type 2 Diabetes: Study – Diabetes Self-Management

You may think the aforementioned health benefits stem from use of perindopril and/or indapamide. It’s either that or simply the result of BP lowering. I suspect it’s the latter while admitting that not all BP drugs are created equal. As a hospitalist in Scottsdale, AZ, I rarely run across patients taking perindopril, and only occasionally folks on indapamide. Popularity of various drugs varies often depends on which part of the country you’re in. We need to be more scientific than that.

Steve Parker, M.D.

PS: Losing excess weight and exercise are two ways to lower blood pressure without the expense and side effects of drugs.

Click the pic to purchase at Amazon.com

1 Comment

Filed under Heart Disease, Longevity