October 14, 2016 · 10:25 AM

From a British Medical Journal blog: What are we meant to eat?

“Roll the clock forward, and here we are in 2016 with whole countries refuting the fat is bad, sugar is good mentality. Sweden has adopted a low-carbohydrate approach to public health messaging, lifestyle choice, and health interventions. The switch in dietary advice followed the publication of a two-year study by the independent Swedish Council on Health Technology Assessment. The committee reviewed 16,000 studies published up until 31 May 2013 and upended existing advice in favour of a low-carbohydrate model. Here in the UK we see, almost weekly, documentaries and publications advocating that we reduce our carbohydrate intake, especially for the treatment of obesity and diabetes, and yet the accepted advice is still low fat.”

Source: BMJ Blogs: The BMJ » Blog Archive » Paul Buchanan: What are we meant to eat?

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October 13, 2016 · 4:17 PM

From P.D. Mangan: Higher Altitude Means Much Lower Death Rates

Adult life is a battle against gravity. Eventually we all lose.

Adult life is a battle against gravity. Eventually we all lose.

I quote:

“Death rates from both of these cancers [breast in women, colon in men] were about half as high at an altitude of greater than 1000 meters (3300 feet).  The study also found about a 30% reduction in deaths from coronary artery disease at >1000 meters.

This accords well with a number of other studies. For example, “Lower Mortality From Coronary Heart Disease and Stroke at Higher Altitudes in Switzerland“. This study found 22% less heart disease death for every +1000 meters in altitude, and 12% less stroke death.

“Association Between Alzheimer Dementia Mortality Rate and Altitude in California Counties“: This study found about half the death rate from Alzheimer’s at an altitude of 1600 meters vs that at sea level.

There’s less diabetes at high altitude.”

Source: Higher Altitude Means Much Lower Death Rates – Rogue Health and Fitness

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October 12, 2016 · 5:02 PM

From Kelley Pounds: “I HAVE to Take Insulin Anyways – My Diet is Not THAT Important” 

“I see this comment SO many times. “I have to take insulin anyways, so my diet is not THAT important. I can eat what I want and cover it with insulin.”

When I hear it in people with Type 2, I shake my head. We should know better!  Poor lifestyle choices are what got most of us in this place to begin with.  Giving insulin to a population that still usually makes plenty of insulin just to cover poor lifestyle choices is beyond disturbing. Insulin in this population should be for those that have made every effort at living a healthy lifestyle and still need a little help achieving NORMAL blood sugar.”

Source: I HAVE to Take Insulin Anyways – My Diet is Not THAT Important – Low Carb RN (CDE)

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October 10, 2016 · 12:07 PM

Elders on a Weight-Loss Diet Preserve Bone Mineral Density With Resistance Training, Not Aerobic Exercise

…according to an article at MedPageToday.

"One more rep then I'm outa here!"

“One more rep then I’m outa here!”

In the study at hand, the two experimental groups had about 60 participants each, so it was a relatively small study. (In general, the larger the study, the more reliable the findings.) Most participants were white women; mean age was 69. The experimental intervention ran for five months. An excerpt:

In one trial, the participants were randomized to a structured resistance training program in which three sets of 10 repetitions of eight upper and lower body exercises were done 3 days each week at 70% of one repetition maximum for 5 weeks, with or without calorie restriction of 600 calories per day.
In the second study, participants were randomized to an aerobic program which was conducted for 30 minutes at 65% to 70% heart rate reserve 4 days per week, with or without calorie restriction of 600 calories per day.

The beneficial bone effect was seen at the hip but not the lumbar spine. (I’ve treated lots of hip and lumbar spine fractures. If I’m going to break one of those bones, I’d rather it be the spine.)

Thin old bones—i.e., osteoporotic ones—are prone to fractures. Maintaining or improving bone mineral density probably prevents age-related fractures. In a five-month small study like this, I wouldn’t expect the researchers to find any fracture rate reduction; that takes years.

Most mainstream articles on prevention and treatment of osteoporosis mention “weight-bearing” exercises as what you should do, like walking, jogging, tai chi, and volleyball. The current study adds resistance training to our therapeutic armamentarium. Resistance training is also called weight training or strength training.  

Most elders starting a weight-training program should work with a personal trainer.

Steve Parker, M.D.

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October 6, 2016 · 4:14 PM

Night shift work does NOT raise breast cancer risk, new study finds

MNT has the details:

“In 2007, the World Health Organization published a review that concluded night shift work is likely to raise the risk of cancer, particularly breast cancer. A new review of more than 1.4 million women challenges this conclusion, after revealing night shift work had little or no impact on breast cancer incidence.

Working night shifts has little or no impact on women’s risk of breast cancer, a new study suggests.Study co-author Dr. Ruth Travis, of the Cancer Epidemiology Unit at Oxford University in the United Kingdom, and colleagues publish their findings in the Journal of the National Cancer Institute.

According to the Centers for Disease Control and Prevention (CDC), around 15 million adults in the United States work full-time night shifts, rotating shifts, or other irregular schedules.It is well established that such working patterns can disrupt the body’s circadian rhythm – the physical, mental, and behavioral changes that occur over a 24-hour cycle, which mainly respond to light and dark in the environment.

Circadian rhythm disruption has been associated with an array of health problems, including sleep disorders, obesity, diabetes, depression, and bipolar disorder.”

Source: Night shift work ‘does not raise breast cancer risk,’ study finds – Medical News Today

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October 5, 2016 · 9:05 PM

J&J insulin pump vulnerable to hacking

If you’re one of the 114,000 users of this device in the U.S. or Canada, listen up:

“Johnson & Johnson is telling patients that it has learned of a security vulnerability in one of its insulin pumps that a hacker could exploit to overdose diabetic patients with insulin, though it describes the risk as low.

Medical device experts said they believe it was the first time a manufacturer had issued such a warning to patients about a cyber vulnerability, a hot topic in the industry following revelations last month about possible bugs in pacemakers and defibrillators.

J&J executives told Reuters they knew of no examples of attempted hacking attacks on the device, the J&J Animas OneTouch Ping insulin pump. The company is nonetheless warning customers and providing advice on how to fix the problem.”

Source: J&J warns diabetic patients: Insulin pump vulnerable to hacking | Reuters

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October 5, 2016 · 12:39 PM

FDA approves “artificial pancreas” for type 1 diabetes

CNN has a few details on the Medtronic MiniMed 670G, which should be available to consumers this spring:

“The Food and Drug Administration approved a so-called artificial pancreas Wednesday. The first-of-its-kind device, the size of a cell phone, monitors and treats patients with type 1 diabetes, also known as juvenile diabetes.In those with type 1 diabetes, the pancreas does not produce enough insulin, a hormone people need to get energy from food. The Medtronic MiniMed 670G system continuously monitors glucose (blood sugar) levels and delivers needed insulin to patients.

“This is a revolutionary day for the treatment of diabetes. We’ve been long awaiting the artificial pancreas, and it’s exciting to see it,” said Dr. Robert Courgi, an endocrinologist at Northwell Health’s South Side Hospital in Bay Shore, New York.”

Source: ‘Artificial pancreas’ for type 1 diabetes wins FDA approval – CNN.com

Cost and insurance coverage issues should be interesting.

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October 4, 2016 · 7:13 PM

Overweight Women Lose More Weight If Main Meal Is Lunch Rather Than Dinner

Conquer Diabetes and Prediabetes, Steve Parker MD

It may not matter whether you eat this particular low-carb meal at lunch or dinner

They say that to lose excess weight, you should eat breakfast like a king, lunch like a prince, and dinner like a pauper.

A recent study tested whether weight loss in dieting women was more effective by making lunch rather than dinner (evening meal) the main meal of the day. Over the course of 12 weeks, dieters making lunch their main meal lost 4 lb (2 kg) more than the other group. Furthermore, the lunch eaters had better improvement in their insulin resistance (as measured by HOMA-IR)

From the abstract:

“Background: The association between the time of nutrient intake and health has been described in a few studies. To our knowledge, no study has evaluated the relation between high energy intakes at lunch compared with at dinner on weight loss in overweight and obese subjects.

Objective: We compared the effect of high energy intake at lunch with that at dinner on weight loss and cardiometabolic risk factors in women during a weight-loss program.Design: Overweight and obese women [n = 80; body mass index (BMI; in kg/m2): 27–35; age: 18–45 y] were asked to eat either a main meal at lunch (LM) or a main meal at dinner (DM) for 12 wk while in a weight-loss program.

Conclusions: The consumption of higher energy intake at lunch compared with at dinner may result in favorable changes in weight loss in overweight and obese women after a weight-loss program of 12 wk. The consumption may also offer clinical benefits to improve insulin resistance.”

Source: Beneficial effect of high energy intake at lunch rather than dinner on weight loss in healthy obese women in a weight-loss program: a randomized clinical trial

I don’t have the full text of the research report, so I don’t know what kind of diet the women were on. The researchers seem to be based in both Iran and Great Britain. I don’t know the nationality of the women participating. The metabolism of Iranians may be different from Brits.

Steve Parker, M.D.

 

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October 4, 2016 · 1:15 PM

Harriet Hall on Plavinol and Other Natural Remedies for Diabetes

Harriet Hall, M.D., looked at the evidence for Plavinol as a diabetes treatment. She’s skeptical about it:

“In a recent article on SBM, Scott Gavura quoted a pharmacy customer who said “I don’t want to take any drugs. Do you have something natural I can use to cut my blood sugar?” Scott went on to cover the questionable evidence for cinnamon in that article. Many other “natural” remedies have been proposed. Here’s an alphabetical list: acetyl L-carnitine, aloe, alpha-lipoic acid, banaba leaf (not banana!), basil, berberine, bilberry, biotin, bitter melon, cinnamon, chromium, coQ10, crepe myrtle, fenugreek, fish oil, fructo-oligosaccharides, green tea, ginseng, glucomannan, gymnema, hibiscus, Indian kino tree extract, magnesium, mistletoe, olive leaf, onion, psyllium, purslane, resveratrol, starch blockers, thiamine, vanadium, and vitamins. I compiled that list from just three websites; I’m sure there are many more natural remedies that I missed. These natural remedies have been recommended on the basis of rather shaky preliminary evidence that they lower blood sugar, usually by only a small amount. Even the CAM-friendly National Center for Complementary and Integrative Health (NCCIH) concluded: “There is not enough scientific evidence to suggest that any dietary supplements can help prevent or manage type 2 diabetes.”

Source: Plavinol and Other Natural Remedies for Diabetes: “Condimentary Medicine”? « Science-Based Medicine

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October 4, 2016 · 12:34 PM

P.D. Mangan on Processed Food, Supernormal Stimuli, and Obesity 

Supernormal stimulus

Supernormal stimulus

Read the whole thing (link below). It’s not long. A snippet:

“The obesogenic nature of the kind of foods that most people eat means that you must largely avoid them.

Because of the supernormal stimuli embedded in them, the best course of action in my opinion is to avoid them at all costs. Supernormal stimuli cause addiction, and they may make your steak and eggs, foods that you should be eating, less appealing.

For most people, unless they have plenty of money to throw around, this means preparing food and eating at home. Avoid the center of the grocery store, where processed junk and soda are sols, and shop around the outside, where you’ll find whole, unprocessed food like meat, cheese, eggs, and vegetables.”

Source: Processed Food, Supernormal Stimuli, and Obesity – Rogue Health and Fitness

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