Have You Heard of the Milk Diet?

hiking, Arizona, Steve Parker MD,

Tom’s Thumb trail in Scottsdale, AZ

 

I vaguely recall a milk diet to treat stomach ulcers in the mid-20th century. Tagamet changed that!

I’ve been reading scientific articles on low-energy liquid diets for weight loss and diabetes remission, and ran across a reference to a milk diet. I found impressive results in a 16-week study.

This was a small randomized trial that enrolled 45 very fat folks — BMI 41-47, average weight 122 kg (268 lb), mostly women — and assigned them to one of three diets:

  1. Control: conventional balanced diet of normal foods providing about 800 calories/day and at least 36 grams of protein.
  2. Milk: “variable combination of full cream or semi-skimmed milk and unsweetened yoghurt,” about 800 calories/day. BTW, a cup (240 ml) of whole milk has 150 calories.
  3. Milk Plus: same as the milk diet plus “unlimited amount of a single food selected by the patient on each day of the week. Of these seven extra foods, three were a fruit or vegetable, two were a high protein food, and two were a “favourite” food. The seven foods were repeated on the same day of successive weeks.” (If you understand this, you’re smarter than me, which wouldn’t be unusual.) Average calories were 1,350/day.

The researchers figured these adults were eating about 2,500 calories/day at baseline. Diabetics were excluded.

Results

The Milk group lost the most weight. Eleven of the 14 participants completed the 16-week study, with an average weight loss of 11.2 kg (24.6 lb). Constipation was the only “serious” side effect reported. The authors admitted that deficiencies in some vitamins and iron might be a problem, but cited a similar but longer trial (24 weeks) that found no such deficiencies.

Eleven of the 17 in the Milk Plus group persevered for the whole 16 weeks. Average weight loss was 8.2 kg (18 lb).

Nine of the 14 in the Control Group were able to put up with it for the duration. Average weight loss was only 2.6 kg (5.7 lb). I suspect they had a bit of a compliance problem. When you weigh 268 lb, a 5.7 lb loss isn’t much.

“Analysis of compliance (not reported) showed that it was similar for the two milk diets but much lower for the conventional diet.”

Comments

The researchers opine that…

  • “Patients are more likely to respond to a simple diet which they have not tried before than to advice on conventional diets.”
  • Probably the best strategy is to rotate diets,…[to prevent compliance from falling].”

I wonder how well the Milk diet would work for someone who weighs 205 lb (93 kg) and just wants to lose 25 lb (11.4 kg).

I wonder how important are the exact proportions of “full cream or semi-skimmed milk and unsweetened yoghurt.”

I wonder if the Milk diet has ever been tested in overweight people with diabetes. The carbohydrate in milk shouldn’t be a problem since overall calories are so low. A cup of milk has 12 grams of carbohydrate.

As with all diets, weight regain will be a problem after the 16 weeks.

I’m skeptical about the nutritional adequacy of the Milk diet.

The Milk diet might be a good temporary option for someone who wants to lose more excess weight but has hit a weight-loss plateau in their current regimen.

The simplicity of the milk diet is very appealing to me.

Steve Parker, M.D.

Reference: Summerbell, C.D., et al. Randomised controlled trial of novel, simple, and well supervised weight reducing diets in outpatients. British Medical Journal, 317: 1487-1489. November 28, 1998.

Low-Carb Mediterranean Diet, front cover

 

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Sofia Norton Debunks 21 Weight-Loss Myths

Click the link below for her article at Kiss My Keto. The preamble:

Before we dive into the weight loss myths, it’s important to state the truth about weight loss.It’s not as simple as eating healthy and following an exercise program.

Of course, those can make a big difference, however, it doesn’t work that way for everyone.

There are so many factors that come into play when it comes to weight loss. Some of those factors include genetics, endocrine disorders, medications, insomnia, and cultural reasons.

This is why women with the polycystic ovarian syndrome may find it harder to lose weight than those who don’t have it.

So the next time you come across a trending weight loss tip, pause for a moment, and research about it to see if it’s even true. Secondly, analyze your current situation to see if this particular weight loss strategy will work for you.

Source: 21 Popular Weight Loss Myths Debunked! – Kiss My Keto

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Can Diet Reduce Your Gingivitis and Periodontitis?

Yes...at least according to a tiny short-term study done in Germany. Only 10 experimental subjects.

Here’s their description of the food: “…low in carbohydrates, rich in Omega-3 fatty acids, and rich in vitamins C and D, antioxidants and fiber for four weeks.” How low in carbs? To a level “as far as possible to a level < 130 grams/day.” Click the link above for full diet details. It looks to me like a paleo diet.

Certified paleo-compliant, plus high omega-3 fatty acids and low-carb

The researchers note in the body of their report that they can’t tell for sure which components of the experimental diet were most helpful, but they suspect it’s 1) the carbohydrate restriction, 2) increased omega-3 fatty acids, and 3) reduced omega-6 consumption.

Those three factors are at play in the both the Paleobetic Diet and Low-Carb Mediterranean Diet.

Here’s the study’s abstract for you science nerds:

Background

The aim of this pilot study was to investigate the effects of four weeks of an oral health optimized diet on periodontal clinical parameters in a randomized controlled trial.

Methods

The experimental group (n = 10) had to change to a diet low in carbohydrates, rich in Omega-3 fatty acids, and rich in vitamins C and D, antioxidants and fiber for four weeks. Participants of the control group (n = 5) did not change their dietary behavior. Plaque index, gingival bleeding, probing depths, and bleeding upon probing were assessed by a dentist with a pressure-sensitive periodontal probe. Measurements were performed after one and two weeks without a dietary change (baseline), followed by a two week transitional period, and finally performed weekly for four weeks.

Results

Despite constant plaque values in both groups, all inflammatory parameters decreased in the experimental group to approximately half that of the baseline values (GI: 1.10 ± 0.51 to 0.54 ± 0.30; BOP: 53.57 to 24.17 %; PISA: 638 mm2 to 284 mm2). This reduction was significantly different compared to that of the control group.

Conclusion

A diet low in carbohydrates, rich in Omega-3 fatty acids, rich in vitamins C and D, and rich in fibers can significantly reduce gingival and periodontal inflammation.

Thanks to BioMed Central for making the entire report available for free.

Reference:

An oral health optimized diet can reduce gingival and periodontal inflammation in humans – a randomized controlled pilot study

  • J. P. WoelberEmail author,
  • K. Bremer,
  • K. Vach,
  • D. König,
  • E. Hellwig,
  • P. Ratka-Krüger,
  • A. Al-Ahmad and
  • C. Tennert
BMC Oral Health 2016, 17:28

https://doi.org/10.1186/s12903-016-0257-1

Published: 26 July 2016

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Short-Term Metabolic Effects of Low-Carb Versus High-Carb Diet In Type 1 Diabetes

Shrimp Salad

A scientific study published 2017 compared a high-carb (at least 250 grams/day) to low-carb diet (50 grams or less) in 10 patients with type 1 diabetics. The low-carb diet yielded more time in the normal blood sugar range, less hypoglycemia, and less variability of glucose levels.

I assume the low-carb diet required less insulin, but I don’t know since I haven’t seen the full article. Let me know if you can confirm.

In case you’re wondering, the Paleobetic diet provides about 60 grams of carb daily, and the Low-Carb Mediterranean Diet ranges from 20 t0 100 grams.

Here’s the abstract:

The aim of the present study was to assess the effects of a high carbohydrate diet (HCD) vs a low carbohydrate diet (LCD) on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes. Ten patients (4 women, insulin pump-treated, median ± standard deviation [s.d.] age 48 ± 10 years, glycated haemoglobin [HbA1c] 53 ± 6 mmol/mol [7.0% ± 0.6%]) followed an isocaloric HCD (≥250 g/d) for 1 week and an isocaloric LCD (≤50 g/d) for 1 week in random order. After each week, we downloaded pump and sensor data and collected fasting blood and urine samples. Diet adherence was high (225 ± 30 vs 47 ± 10 g carbohydrates/d; P < .0001). Mean sensor glucose levels were similar in the two diets (7.3 ± 1.1 vs 7.4 ± 0.6 mmol/L; P = .99). The LCD resulted in more time with glucose values in the range of 3.9 to 10.0 mmol/L (83% ± 9% vs 72% ± 11%; P = .02), less time with values ≤3.9 mmol/L (3.3% ± 2.8% vs 8.0% ± 6.3%; P = .03), and less glucose variability (s.d. 1.9 ± 0.4 vs 2.6 ± 0.4 mmol/L; P = .02) than the HCD. Cardiovascular markers were unaffected, while fasting glucagon, ketone and free fatty acid levels were higher at end of the LCD week than the HCD week. In conclusion, the LCD resulted in more time in euglycaemia, less time in hypoglycaemia and less glucose variability than the HCD, without altering mean glucose levels.

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Seniors, Preserve Your Muscle Mass as You Lose Weight

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“Honey, please come to the gym with me.”

We’ve known for a while that resistance training helps preserve muscle mass in younger folks during weight-loss programs. I’ve always figured the principle applied to older folks, too. Now we have proof. Average age of these study participants was 67.

From UPI.com:

Seniors who want to lose weight should hit the weight room while they cut calories, a new study suggests.

Older folks who performed resistance training while dieting were able to lose fat but still preserve most of their lean muscle mass, compared with those who walked for exercise, researchers report.

“The thought is if you lose too much lean mass, that this will exacerbate risk of disability in older adults,” said lead researcher Kristen Beavers, an assistant professor of health and exercise science at Wake Forest University in Winston-Salem, N.C. “Our findings show if your treatment goal is to maximize fat loss and minimize lean mass loss, then the resistance training is probably the way to go.”

 

 

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Should You Restrict Sodium Intake?

I’m still not convinced that severe sodium restriction is necessary or even possible for most people

U.S public health authorities recommend maximum daily sodium consumption of 2.3 grams a day, in order to prevent cardiovascular disease. But a 2018 multi-country study published in Lancet supports a much different and higher maximum sodium intake level:

Sodium intake was associated with cardiovascular disease and strokes only in communities where mean intake was greater than 5 g/day. A strategy of sodium reduction in these communities and countries but not in others might be appropriate.

The researchers also found, “All major cardiovascular outcomes decreased with increasing potassium intake in all countries.”

Click for a list of potassium-rich foods from a .gov website.

You’ll find several cold-water fatty fish there.

My Low-Carb Mediterranean Diet recommends the fish but you’ll find no sodium restriction advice.

Source: Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study – The Lancet

low-carb mediterranean diet

Front cover of book

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What’s the Best Diet For Diabetes?

From a recent Diabetes Care journal article:

“The Consensus Report highlights the role of weight management, dietary patterns, and technology-enabled tools in diabetes prevention and management. There is a clear consensus on reducing intake of added sugars, sodium, and unhealthy fats, especially trans fat, in the diet, although the panel does not recommend a “one-size-fits-all” eating plan. Instead, multiple eating patterns including the Mediterrranean diet, DASH (Dietary Approaches to Stop Hypertension) diet, and vegetarian and low-carbohydrate diets can be used for weight and diabetes management. However, the quality and food sources of the macronutrients are among the most critical factors determining the efficacy and long-term outcomes of these diets.”

Source: Nutritional Strategies for Prevention and Management of Diabetes: Consensus and Uncertainties | Diabetes Care

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8 Scientific Health Benefits of the Mediterranean Diet 

There are reasons I adapted the Mediterranean diet for folks with diabetes. the article linked below lists some of them.

“If there’s one so-called diet that is widely acclaimed for its health benefits, it’s the Mediterranean diet. In fact, U.S. News & World Report ranked the Mediterranean diet No. 1 on its 2019 41 Best Diets Overall list, citing a “host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control.” More of an eating pattern than a calorie-restricted diet, the Mediterranean regimen emphasizes eating lots of vegetables, fruits, nuts, legumes, seeds, and fish, with liberal use of olive oil, a moderate amount of dairy foods, and a low amount of red meat — a way of eating common in Mediterranean countries such as Spain, Italy, and Greece, noted an article published in June 2018 the journal Current Atherosclerosis Reports.”

Source: 8 Scientific Health Benefits of the Mediterranean Diet | Everyday Health

low-carb mediterranean diet

Front cover of book

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This May Be Why You’re Not Losing That Weight

Old-school preparation for exercise; stretching actually doesn’t do any good for the average person

You’ll see the term “diet resistant” in the scientific abstract below. It refers to folks who are on a reduced-calorie diet who aren’t losing the weight they should, base on total calorie consumption. Long story short, they’re eating much more than the think and exercising less than they think.

BACKGROUND AND METHODS

Some obese subjects repeatedly fail to lose weight even though they report restricting their caloric intake to less than 1200 kcal per day. We studied two explanations for this apparent resistance to diet — low total energy expenditure and underreporting of caloric intake — in 224 consecutive obese subjects presenting for treatment. Group 1 consisted of nine women and one man with a history of diet resistance in whom we evaluated total energy expenditure and its main thermogenic components and actual energy intake for 14 days by indirect calorimetry and analysis of body composition. Group 2, subgroups of which served as controls in the various evaluations, consisted of 67 women and 13 men with no history of diet resistance.

RESULTS

Total energy expenditure and resting metabolic rate in the subjects with diet resistance (group 1) were within 5 percent of the predicted values for body composition, and there was no significant difference between groups 1 and 2 in the thermic effects of food and exercise. Low energy expenditure was thus excluded as a mechanism of self-reported diet resistance. In contrast, the subjects in group 1 underreported their actual food intake by an average (±SD) of 47±16 percent and overreported their physical activity by 51±75 percent. Although the subjects in group 1 had no distinct psychopathologic characteristics, they perceived a genetic cause for their obesity, used thyroid medication at a high frequency, and described their eating behavior as relatively normal (all P<0.05 as compared with group 2).

CONCLUSIONS

The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis. (N Engl J Med 1992; 327:1893–8.)

Source: Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects | NEJM

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Seafood Contaminates Your Brain With Mercury, But Does It Matter?

Dead whole fish aren't very appealing to many folks

Dead whole fish aren’t very appealing to many folks

I advocate consumption of cold-water fatty fish a couple times per week for long-term protection against heart and brain disease. The protective component of fish may be the omega-3 fatty acids.

On the other hand, much seafood is contaminated with mercury, which can be toxic. So, is the mercury in fish actually toxic to brain tissue of folks eating reasonable amounts of fish?

A recent autopsy study answers, “No.”

Read further for details.

Much more appetizing!

From the Journal of the American Medical Association, 2016 Feb 2;315(5):489-97. doi: 10.1001/jama.2015.19451. “Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults.”

IMPORTANCE:Seafood consumption is promoted for its many health benefits even though its contamination by mercury, a known neurotoxin, is a growing concern.

OBJECTIVE:To determine whether seafood consumption is correlated with increased brain mercury levels and also whether seafood consumption or brain mercury levels are correlated with brain neuropathologies.

DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional analyses of deceased participants in the Memory and Aging Project clinical neuropathological cohort study, 2004-2013. Participants resided in Chicago retirement communities and subsidized housing. The study included 286 autopsied brains of 554 deceased participants (51.6%). The mean (SD) age at death was 89.9 (6.1) years, 67% (193) were women, and the mean (SD) educational attainment was 14.6 (2.7) years.

EXPOSURES:Seafood intake was first measured by a food frequency questionnaire at a mean of 4.5 years before death.

MAIN OUTCOMES AND MEASURES:Dementia-related pathologies assessed were Alzheimer disease, Lewy bodies, and the number of macroinfarcts and microinfarcts. Dietary consumption of seafood and n-3 fatty acids was annually assessed by a food frequency questionnaire in the years before death. Tissue concentrations of mercury and selenium were measured using instrumental neutron activation analyses.RESULTS:Among the 286 autopsied brains of 544 participants, brain mercury levels were positively correlated with the number of seafood meals consumed per week (ρ = 0.16; P = .02). In models adjusted for age, sex, education, and total energy intake, seafood consumption (≥ 1 meal[s]/week) was significantly correlated with less Alzheimer disease pathology including lower density of neuritic plaques (β = -0.69 score units [95% CI, -1.34 to -0.04]), less severe and widespread neurofibrillary tangles (β = -0.77 score units [95% CI, -1.52 to -0.02]), and lower neuropathologically defined Alzheimer disease (β = -0.53 score units [95% CI, -0.96 to -0.10]) but only among apolipoprotein E (APOE ε4) carriers. Higher intake levels of α-linolenic acid (18:3 n-3) were correlated with lower odds of cerebral macroinfarctions (odds ratio for tertiles 3 vs 1, 0.51 [95% CI, 0.27 to 0.94]). Fish oil supplementation had no statistically significant correlation with any neuropathologic marker. Higher brain concentrations of mercury were not significantly correlated with increased levels of brain neuropathology.

CONCLUSIONS AND RELEVANCE:In cross-sectional analyses, moderate seafood consumption was correlated with lesser Alzheimer disease neuropathology. Although seafood consumption was also correlated with higher brain levels of mercury, these levels were not correlated with brain neuropathology.

Source: Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults. – PubMed – NCBI

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