March 7, 2018 · 4:55 AM

Physicians Disagree On How Aggressively Diabetes Should Be Treated

If you’re a patient, you probably don’t like to hear this. You like to think that doctors have looked carefully at the appropriate scientific studies, understand  the underlying pathophysiology in detail, then reach a consensus on treatment. Sorry, but not in the case of diabetes. NPR has the story. For example:

A major medical association today suggested that doctors who treat people with Type 2 diabetes can set less aggressive blood sugar targets. But medical groups that specialize in diabetes sharply disagree.

Half a dozen medical groups have looked carefully at the best treatment guidelines for the 29 million Americans who have Type 2 diabetes and have come up with somewhat differing guidelines.

The American College of Physicians has reviewed those guidelines to provide its own recommendations, published in the Annals of Internal Medicine. It has decided that less stringent goals are appropriate for the key blood sugar test, called the A1C.

“There are harms associated with overzealous treatment or inappropriate treatment focused on A1C targets,” says Dr. Jack Ende, president of the ACP. “And for that reason, this is not the kind of situation where the college could just sit back and ignore things.”

The ACP, which represents internists, recommends that doctors aim for an A1C in the range of 7 to 8 percent, not the lower levels that other groups recommend.

Source: The American College of Physicians Recommends A1C Levels Between 7 And 8 Percent : Shots – Health News : NPR

I come down in favor of the lower HgbA1c values.

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February 28, 2018 · 4:14 AM

Tina Speaks From the Heart: A friend’s heart attack, a documentary film, and a celebrity death 

“On Saturday evening, I watched the movie WIDOWMAKER and went to bed with a heavy heart thinking of the high incidence of heart attacks among young men in the age group 38 – 50 in my social circle in the past couple of years.  6 of them had heart attacks, 2 survived. (One of them a friend. It was only after the friend got a heart attack that I started observing the trend.) The remaining 4 left behind young widows, little children and old, distraught parents.After some time, I stopped counting. This is the first generation in the history of mankind to lose their adult children not to war, wild animals or plagues, but to chronic diseases. Quite heartbreaking to see parents bury their young children in the prime of their life.I was grateful that my spouse and I started LCHF 4 years ago. He has lost 30 kgs and has some more to lose.

I realise that had we not started and continued to follow LCHF, I would have already become a widow or would become one in the next 10 years. Or I would have probably left him a widower.”

Source: A friend’s heart attack, a documentary film and a celebrity death – Indian LCHF

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February 28, 2018 · 3:59 AM

Low-Carb Mediterranean Diet Beats Low-Fat Diet for Newly Diagnosed Type 2 Diabetes

Conquer Diabetes and Prediabetes, Steve Parker MD

Olive oil and vinegar: prominent features of the Mediterranean diet

I first wrote about this study way back in 2009. To recap how the study was done:

Newly diagnosed type 2 diabetics who had never been treated with diabetes drugs were recruited into the study, which was done in Naples, Italy.  At the outset, the 215 study participants were 30 to 75 years of age, had body mass index over 25 (average 29.5), had average hemoglobin A1c levels of 7.73, and average glucose levels of 170 mg/dl.

Participants were randomly assigned to one of two diets:

  1. Low-carb Mediterranean diet:  rich in vegetables and whole grains, low in red meat (replaced with poultry and fish), no more than 50% of calories from complex carbohydrates, no less than 30% of calories from fat (main source of added fat was 30 to 50 g of olive oil daily).  [No mention of fruits or wine.  BTW, the traditional Mediterranean diet derives 50-60% of energy from carbohydrates.]
  2. Low-fat diet based on American Heart Association guidelines:  rich in whole grains, restricted additional fats/sweets/high-fat snacks, no more than 30% of calories from fat, no more than 10% of calories from saturated fats.

Both diet groups were instructed to limit daily energy intake to 1500 (women) or 1800 (men) calories.

All participants were advised to increase physical activity, mainly walking for at least 30 minutes a day.

Drug therapy was initiated when hemoglobin A1c levels persisted above 7% despite diet and exercise.

The study lasted four years.

The bottom line for the investigators then was  that “a low-carbohydrate, Mediterranean-style diet seems to be preferable to a low-fat diet for glycemic control in patients with newly diagnosed type 2 diabetes.”

Nevertheless, in 2018 the most commonly recommended diet for diabetics is still a low-fat diet.

What About Long-Term Effects?

In 2014, our indefatigable researchers published additional long-term results of this study’s participants, who were followed for a total of 8 years. That’s an incredibly long time for a diet study. Major findings;

  • Compared to a traditional low-fat diet, the low-carb Mediterranean diet postponed the start of diabetes medications by two years , and it wasn’t simply due to weight loss.
  • Complete or partial remission of diabetes occurred in 15% of the low-carb Mediterranean dieters within the first year and 5% after six years. These rates were two to four times higher than seen in the low-fat group. (Lower hemoglobin A1c at the start of the study was a predictor of long-term remission. That is, your best chance of remission is when your diabetes is relatively mild when diagnosed.)
  • Compared to the low-fat diet group, the low-carb Mediterranean dieters saw a greater reduction in Hemoglobin A1c levels.

I don’t know exactly what these successful low-carb Mediterranean dieters ate, but if you need a low-carb Mediterranean diet now, why not try mine?

Steve Parker, M.D.

Low-Carb Mediterranean Diet, front cover

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February 23, 2018 · 11:39 AM

Reinagel Ponders Whether Calcium Supplements Are Safe

 

Death in a bottle?

Death in a bottle?

Monica Reinagel is a smart and media-savvy nutritionist who brought me on board as a blogger at NutritionData many years ago. Click the link below for her surprising conclusion on calcium supplementation.

Monica writes:

“The National Osteoporosis Foundation published a new report this week, insisting that calcium supplements are safe for your heart. Two weeks ago, Johns Hopkins cardiologist Erin Michos published a paper saying the opposite.

She claims that the NOF review (which was funded by a pharmaceutical company that makes calcium supplements) omitted certain studies (such as the ones she included in her own review) that might have changed the conclusion.

These are just the latest two volleys in a five-year-long tennis match between experts on whether you should or shouldn’t take calcium supplements.  And you thought politics was divisive.”

Source: Calcium Supplements: Safe or Not?

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February 22, 2018 · 3:51 PM

Mediterranean Diet Shares Top Ranking With DASH Diet in U.S. News  and World Report

But they both have too many carbohydrates for most folks with diabetes. That’s why I created the Low-Carb Mediterranean Diet.

“Best Diets Overall are ranked for safe and effective weight loss, how easy it is to follow, heart health and diabetes help and nutritional completeness.”

Source: Best Diets Overall : Rankings | US News Best Diets

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February 21, 2018 · 11:39 AM

Soft Drinks Linked to Doubled Risk of T2 Diabetes and LADA

I enjoy an aspartame-flavored Fresca now and then

I enjoy an aspartame-flavored Fresca now and then

LADA is latent autoimmune diabetes in adults.

This new study is out of Sweden. The potential disease-inducing soft drink dose was 400 ml or 13.5 fl oz per day. In the U.S., a typical soda can is 10 fl oz or 355 ml. Surprisingly, artificially-sweetened soft drinks were just as guilty as regular beverages.

From MNT:

“The study included 2,874 Swedish adults, of whom 1,136 had type 2 diabetes, 357 had LADA, and 1,137 were healthy controls.

The team analyzed the self-reported dietary data of each adult, looking specifically at the number of soft drinks consumed up to 1 year before a diabetes diagnosis. Participants’ insulin resistance levels, beta cell function, and autoimmune response were also measured.

The researchers found that adults who reported drinking at least two 200-milliliter servings of soft drinks a day – whether they contained sugar or artificial sweetener – were twice as likely to develop LADA and 2.4 times more likely to develop type 2 diabetes, compared with those who consumed fewer than two soft drinks daily.

What is more, adults who consumed five 200-milliliter servings of soft drinks daily were found to be at 3.5 times greater risk of LADA and 10.5 times greater risk of type 2 diabetes, regardless of whether the drinks were sugary or artificially sweetened.”

Source: Diabetes risk doubles with more than two soft drinks daily – Medical News Today

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February 14, 2018 · 3:10 AM

Actress With Type 1 Diabetes Eats a Ketogenic Diet

The Toronto Sun has an article on Halle Berry and how she has adopted a ketogenic diet to help control her diabetes. Another source suggests she’s had type 1 diabetes since 1989. A snippet:

Halle Berry credits her ketogenic diet with keeping her fit.

The Monster’s Ball star, 50, is known for her enviable physique and she explains not eating any sugars or carbohydrates – because she is diabetic – has helped her maintain her figure.

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February 13, 2018 · 12:25 AM

DietDoctor’s Low-Carb Recipe Section: Not New, But Improved

That's a guacamole deviled egg

That’s a guacamole deviled egg

They’ve always been good recipes—with all-important nutrient analysis—but they’re even better now.

From DietDoctor:

“Our low-carb recipe site is probably already the most popular one in the world, with over 100,000 daily pageviews, several hundred recipes and gorgeous images. Now we’re adding even more great functions.You can now change the number of servings for recipes – the ingredient amount will correspond to the number of servings – and you can now also choose between the US or the metric measurement systems for ingredients. All to make it simpler to use our recipes.

We’ve also added a function for members so that it is now possible to save your personal favorite recipes. To activate the latter feature you need to be logged in, so that your selections can be saved for later.”

Source: The World’s Best Low-Carb Recipes Just Got Better – Diet Doctor

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February 6, 2018 · 4:26 AM

New to Weight Training? P.D. Mangan Cuts Through the Confusion

Women, don’t worry about getting big and bulky with weight training. You don’t have enough testosterone.

I am a huge advocate of weight training (aka resistance or strength training).

Folks new to weight training, or simply thinking about starting a program, are often intimidated by the jargon and contradictory information available. P.D. Mangan clears up a lot of the confusion in a brief article.

I quote:

Misconceptions and wrong ideas abound in weight training, probably because so many enthusiastic amateurs are involved in it. In this article, I’ll try to clear up some of the misconceptions with a look at at science-based weight training.

In recent articles, we saw that brief workouts, at 15 minutes, done infrequently, at twice a week, can produce significant strength gains. We saw that compound lifts, not isolation lifts, are the most effective strength exercises, and are essential for the serious strength trainer. And we saw that hard weight lifting causes muscle damage, which necessitates recovery time.

Here I’ll focus on what science has to say about additional aspects of weight lifting (resistance training). These come from “Evidence-Based Resistance Training Recommendations” by Fisher et al.

Source: Science-Based Weight Training – Rogue Health and Fitness

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February 4, 2018 · 1:53 PM

With All the Pollutants In Fish, Is it Still a Good Idea to Eat Them?

Dead whole fish aren't very appealing to many folks

Dead whole fish aren’t very appealing to many folks

Probably so. Mercury is the key pollutant people think about when considering polluted fish. Mercury toxicity isn’t on the list of top 10 killers in the U.S., but heart disease is.

Heart disease is #1 on the list of top causes of death, followed by cancer and chronic lower respiratory tract disease. “Heart disease” is a broad category; the primary killer is heart attacks. (Following heart disease as leading killer is cancer. Sadly, suicide is tenth leading cause of death. If you’re considering it, call the National Suicide Prevention Lifeline now.)

Eating fish regularly seems to reduce your risk of heart attack. I favor the cold-water fatty fish like salmon, trout, herring, and sardines.

I quote the New York Times:

“Numerous studies have found that people who eat fish on a regular basis are less likely to die of a heart attack than those who don’t eat it or eat it less than once a month, and a 2006 Harvard review concluded that eating one to two servings of fish rich in omega-3s every week cut the risk of dying of a heart attack by one-third.”

Source: Why Is Fish Good for You? Because It Replaces Meat? – The New York Times

Steve Parker, M.D.

PS: Click for ideas on reducing your risk of cancer.

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