Many physicians and dietitians have been hesitant to suggest ketogenic diets due to 1) possible increased risk of cardiovascular disease, and 2) unknown effects on overall mortality.
But a study published at Scientific Reports in October 2024 suggests that ketogenic diets reduce overall mortality by 24% with no effect on cardiovascular-related deaths. Click the link to see the full report. I haven’t read it yet. Don’t ask me what “restricted cubic spline function” means!
Steve Parker, M.D.
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Filed under coronary heart disease, Heart Disease, ketogenic diet, Longevity, Stroke
In the video below, JP implies that it is. He’s technically correct in that it is banned in some European countries according to a January 2024 article at HealthNews. Ozempic and Wegovy are brand names for the same drug: semaglutide, a GLP-1 receptor agonist. Wegovy is FDA-approved for treatment of particular folks with obesity whereas Ozempic is FDA-approved for treatment of type 2 diabetes.
I understand the superficial appeal of drug-induced weight management: no need to fool with exercise and dietary restriction.
Steve Parker, M.D.
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Filed under Drugs for Diabetes, Weight Loss
We’ve heard or suspected for years that whole foods are healthier for us than processed and ultra-processed foods. But is it true?
The British Medical Journal earlier this year published a study concluding that:
…a higher intake of ultra-processed foods was associated with slightly higher all cause mortality, driven by causes other than cancer and cardiovascular diseases. The associations varied across subgroups of ultra-processed foods, with meat/poultry/seafood based ready-to-eat products showing particularly strong associations with mortality.
You can read the study for yourself free online. Did Big Food (e.g., Archer Daniels Midland, Con-Agra, Monsanto) exert any pressure on the researchers. I dunno.
From the Intro:
Ultra-processed foods are ready-to-eat/heat industrial formulations made mostly or entirely from substances derived from foods, including flavors, colors, texturizers, and other additives, with little if any intact whole food.1Ultra-processed foods, which are typically of low nutritional quality and high energy density, have been dominating the food supply of high income countries, and their consumption is markedly increasing in middle income countries.2 Ultra-processed food consumption accounts for 57% of daily energy intake among adults and 67% among youths in the US according to the National Health and Nutrition Examination Survey (NHANES).34
Ultra-processed foods usually disproportionately contribute added sugars, sodium, saturated fats and trans fats, and refined carbohydrates to the diet together with low fiber.56 As well as having low nutritional quality, ultra-processed foods may contain harmful substances, such as additives and contaminants formed during the processing.
Neurologist Steven Novella wrote a brief post about this study over at Science-Based Medicine. You may also find the comment section there enlightening.
Steve Parker, M.D.
Filed under Longevity
If memory serves, when I started my medical career in 1981 we only had three classes of drugs for treating diabetes: insulin, sulfonylureas, and metformin. We have so many options now, that I have lost track. From Everyday Health earlier this year:
Metformin, a decades-old generic drug for type 2 diabetes, may also help treat COVID-19, a new study suggests.
Scientists at the University of Minnesota randomly assigned more than 1,300 adults with COVID-19 to take metformin or a placebo pill. All of the participants took nasal swab tests for viral levels after 1, 5, and 10 days.
Lab tests showed that metformin significantly reduced the amount of COVID-19 virus circulating in the body and also decreased the odds that virus levels would rebound after an initial reduction during treatment, according to study results published in Clinical Infectious Diseases.
Among the key research results:
***
Steve Parker, M.D.
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Filed under Coronavirus
Fruits and veggies are good for us, right. We should eat more more of them, right?
UK’s Daily Mail published a worrisome article about pesticide residues (PFAS) on many fruits and veggies: strawberries, grapes, cherries, spinach, tomatoes, peaches/nectarines, etc. The tested foods were from UK supermarkets but I bet the numbers are just as bad or worse in the U.S. PFAS stands for per- and polyfluoroalkyl substances. These man-made and long-lasting chemicals are implicated in causation of cancer, immunity impairment, infertility, impaired kidney function, thyroid disease, and low birth weight.
Thrice in the last six months I’ve heard that compared to the European Union, U.S. regulators allow many more chemical contaminants in food. That sounds like a deep and circuitous rabbit hole that I’m not ready to explore. Please mention in the comments an authoritative book or website on the subject.
I’ve been trying to grow food here in the Sonoran Desert for the last three years. I’m about ready to give up. My primary pests have been mealy bugs, caterpillars, mice, pack rats, and squirrels.
Steve Parker, M.D.
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Filed under Longevity
I learned a new word today: deprescription. It apparently refers to the act of stopping a prescribed drug.
There’s a class of type 2 diabetes drugs called GLP-1 receptor agonists. Popular examples are Ozempic and Trulicity. They help users to lose excess weight. But there’s concern about long-term drug side effects regain of lost weight when the drug is stopped. So do successful users need to take the drug lifelong?
A study published earlier this year in Diabetes Therapy suggests that successful users of GLP-1 receptor agonists can stop the drug without weight regain and without loss of diabetes control if they also adhere to a very carbohydrate restricted diet. How much carb restriction? Under 30 grams/day, at least at first. That’s going to be ketogenic in most folks. Although I don’t recall seeing “ketogenic” in the study at hand.
Steve Parker, M.D.
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Filed under Drugs for Diabetes
…..South Koreans, specifically. Korea has one of the lowest overweight/obesity rates among OECD countries: 33.7%. Life expectancy at birth is 83.4 years, compared to 80.9 in the U.S., 82.2 in UK, 82 in Ireland, and 72.3 in Russia. Anna Lee in the video below postulates why the Korean numbers look so good. She makes a lot of sense.
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Filed under Longevity, Overweight and Obesity
I’m increasingly distrustful of the mainstream (aka legacy) media. Ownership of it is in the hands of surprisingly few people. This makes reported news susceptible to manipulation by folks that have an agenda that may be at odds with your desire for “just the facts.”
In 1976, when the U.S had only three or four national over-the-air TV stations and no Internet, 72% of Americans trusted mass media. A Gallup poll found that in 2023, only 32% of Americans had a “great deal” or a “fair amount” of trust in the mass media. A larger percentage—39%—had “none at all.” In view of AI or CGI-generated imaging, it’s getting hard to believe anything you don’t see with your own eyes.
Most of the mainstream media (aka legacy media) consumed in the U.S. originates from a handful of companies. From a 2021 essay by Helen Johnson:
In 1983 there were 50 dominant media corporations. Today there are five. These five conglomerates own about 90 percent of the media in the United States, including newspapers, magazines, book publishers, motion picture studios and radio and television stations. As of 2020, the five media giants are AT&T (Time Warner, CNN, HBO), Comcast (NBC Universal, Telemundo, Universal Pictures), Disney (ABC, ESPN, Pixar, Marvel Studios), News Corp (Fox News, Wall Street Journal, New York Post) and ViacomCBS (CBS, Paramount Pictures).
Alternative Media for Your Consideration (not for local news, sports, weather)
By no means do I endorse or agree with everything you see or hear at these sites.
I’d like to know if you agree or disagree with these choices, or if you’d add any.
Steve Parker, M.D.
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Filed under Uncategorized
From an April, 2024, Nutrition, Metabolism & Cardiovascular Diseases issue:
Cardiovascular diseases (CVDs) are major causes of mortality around the world. High blood pressure (BP) or hypertension is one of the most significant predisposing factors to CVDs. Ketogenic diets (KDs) have been the center of attention for their possible health benefits. The aim of this analysis is to study the impact of KDs on BP through the existing literature.
We investigated the impact of KDs on systolic and diastolic blood pressures (SBP and DBP) conducted in the format of randomized controlled trials (RCTs). Four online databases (PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar) were searched from inception up to November 2022. Subgroup analyses were carried out to find the sources of heterogeneities.
Twenty-three RCTs with 1664 participants were identified. KDs did not exert any significant impacts on SBP (WMD: −0.87 mmHg, 95% CI: −2.05, 0.31) nor DBP (WMD: −0.11 mmHg, 95% CI -1.14, 0.93). Subgroup analyses did not reveal any further information. Also, non-linear dose-response analysis could not detect any associations between the percentage of calorie intake from fat in the KD format and BP levels.
KDs do not seem to be effective in improving BP. Nonetheless, further investigations are recommended to examine the proportion of fat intake needed to induce favorable clinical impacts.
Steve Parker, M.D.
Comments Off on If You’re Planning on Ketogenic Diet to Control Blood Pressure: Fuggetaboutit
Filed under Heart Disease
A few months ago I heard fitness guru Mark Sisson mention during an interview that he was taking a collagen supplement for a painful hip condition that might need surgery, which he is trying to avoid. At the time, I had never heard of collagen supplementation. I used the google machine to find out it was indeed “a thing.” The popular trend may have been started after endorsement by a female celebrity (Jennifer Anniston?).
I have osteoarthritis (aka degenerative joint disease or DJD) in my knees, mainly manifested by very transient aching and stiffness if I sit for too long, and impaired range of motion. I cannot do a deep squat. I got my first inkling of arthritis awareness thirty years ago when I thought I’d start skipping rope because it’s such a great aerobic workout. After just a few jumps, my knees convinced me that was a bad idea.
Six months ago I developed a strange awareness of my left knee; it just didn’t feel like it was quite mine, like how I imagine it feels like to have a prosthetic knee joint. Plus some minimal aching while in bed, relieved by simply changing position. I walk around without any discomfort.
Does genetics play a role? My mother had knee replacement surgery for DJD at age 83. By that time her gait had become quite impaired.
I did a little Internet research and determined I had little to lose if I tried collagen, except for $. A family member was going to Costco so I asked them to get me some. I didn’t research various brands. Pictured is what they brought home. ~$40 for a month’s worth. I planned a two-month trial although WebMD suggested that 3-5 months may be needed for arthritis. (This is not a formal endorsement of the brand, nor am I being paid to feature it here.)
My two month trial of 20 grams daily ended yesterday. Did it work? I think maybe it did. The knee feels like it’s mine again, and sleep-time aching is less frequent. Could these be placebo effect? Yes. Was this a fair trial? Not entirely. In a totally legit experiment, you should only change one variable. Meaning: take this supplement but keep everything else exactly the same. In my experiment, I inadvertently added probiotics in addition to collagen (my shopper picked the product). I also significantly upped my exercise with more walking and weight training. Maybe my subjective improvement was due to those non-collagen factors. Heck, even the season of the year may have been an issue. A legitimate trial would involve hundreds of study subjects, a placebo group, before and after range of motion testing, a validated knee function questionaire, etc.
I was going to stop supplementation at this point but my wife already got me another cannister that lasts a month.
Click for my other posts on knee arthritis.
Steve Parker, M.D.
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Filed under Knee Pain
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