Heresy!? Dietary Cholesterol Is Unrelated to Heart Disease Risk

…according to this article at American Journal of Clinical Nutrition.

This is quite contrary to the  party line spread by public health authorities for the last 40 years.

Enjoy your eggs! (If you can afford them.)

Steve Parker, M.D.

Even if you eat lots of eggs, most of your cholesterol is made by your liver. That's where statin drugs work.

Even if you eat lots of eggs, most of your cholesterol is made by your liver. That’s where statin drugs work.

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Benefits of T2D Triple Therapy Hold Up Over Time

“Treating newly diagnosed diabetes patients upfront with metformin/pioglitazone/exenatide therapy appeared to lower blood glucose and reduce hypoglycemic events better than standard sequential therapy, researchers reported here.

After 36 months of treatment, patients who were treated with the combination had a HbA1c of 5.8% compared with an HbA1c of 6.71% if they were treated with metformin, had a sulfonylurea added on and, then had basal insulin added (P<0.0001), according to Muhammed Abdul-Ghani, MD, PhD, at the University of Texas Health Science Center at San Antonio, and colleagues, in a poster presentation at the European Association for the Study of Diabetes.”

Source: EASD: Benefits of T2D Triple Therapy Hold Up Over Time | Medpage Today

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Sugar Industry Made Dietary Fat the Villain

See Larry Husten’s article for MedPageToday”

“Newly uncovered documents reveal that 50 years ago the sugar industry gave secret support to prominent Harvard researchers to write an influential series of articles in the New England Journal of Medicine that downplayed the negative effects of sugar.Instead, the articles shifted the blame from sugar to fat as the “dietary culprit” behind heart disease.

In recent years there has been growing awareness that decades of dietary policy demonized fat and ignored or played down the dangers of increased consumption of carbohydrates and sugars. Many believe this policy had a significant adverse effect on public health, contributing to the obesity and diabetes epidemics.”

Source: How Sweet: Sugar Industry Made Fat the Villain | Medpage Today

Remember that sugar doesn’t always refer to just table sugar. Starches -as in bread, potatoes, and peas – are easily and quickly broken down by the body into simple sugars.

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Filed under coronary heart disease, Heart Disease, Sugar

Save $26,000 on Weight-Loss Surgery and Do This Instead

Dr. Sarah Hallberg makes a hell of a lot of sense in her New York Times article:

“Recently, 45 international medical and scientific societies, including the American Diabetes Association, called for bariatric surgery to become a standard option for diabetes treatment. The procedure, until now seen as a last resort, involves stapling, binding or removing part of the stomach to help people shed weight. It costs $11,500 to $26,000, which many insurance plans won’t pay and which doesn’t include the costs of office visits for maintenance or postoperative complications. And up to 17 percent of patients will have complications, which can include nutrient deficiencies, infections and intestinal blockages.

It is nonsensical that we’re expected to prescribe these techniques to our patients while the medical guidelines don’t include another better, safer and far cheaper method: a diet low in carbohydrates.”

Source: Before You Spend $26,000 on Weight-Loss Surgery, Do This – The New York Times

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1 in 5 Seafood Samples Is Incorrectly Labeled

Wish I were here

Wish I were here

Fraudulent labeling of fish and other seafood is a problem. It matters to me because I advocate frequent consumption of cold-water fatty fish as healthful. It’s the omega-3 fatty acids in those fish that are good for you.

If what you believe to be trout is actually catfish, you’re not getting the omega-3s you paid for.

Click over to the New York Times for details:

“One in five seafood samples tested worldwide turns out to be completely different from what the menu or packaging says, according to a report on seafood fraud released Wednesday by the ocean conservation group Oceana. Of the more than 25,000 seafood samples the group analyzed, 20 percent were incorrectly labeled.“It is likely that the average consumer has eaten mislabeled fish for sure,” said Beth Lowell, the senior campaign director for Oceana and an author of the paper. “You’re getting ripped off, while you enjoyed your meal you’re paying a high price for a low fish.”

Source: Catfished by a Catfish: 1 in 5 Seafood Samples Is Fake, Report Finds – The New York Times

On a related note…I’ve been eating a lot of canned smoked oysters lately. Nearly all on the supermarket shelves in Arizona USA come from China. Why is that? I worry about pollutants in those oysters, regardless of provenance. If you have any info on this issue, please share.

Steve Parker, M.D.

PS: Search my blog for the list of high omega-3 cold-water fatty fish, or read my books.

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WebMD Slide Show: What’s Really in Your Fast Food?

Slide #1 is French Fries:

“The humble potato, fried in a vat of simmering oil, and finished with a sprinkling of salt. What could be simpler? Apparently, quite a lot. Fast-food fries often have more than 15 ingredients, including sugar and artificial coloring. They also have preservatives like sodium acid pyrophosphate and tert-butylhydroquinone, which in high doses has been linked to vision problems.”

Source: Pictures: What’s Really in Your Fast Food?

You won’t be surprised to see what’s the #1 ingredient in most fast food sauces, but chicken nuggets may surprise you.

Steve Parker, M.D.

PS: I doubt you’ll find tert-butylhydroquinone in my books. If you do, don’t eat one.

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LCHF Diet Cures GERD In European-American Women

Looks European-American to me

Looks European-American to me

European-American? I guess that’s American women who are of European descent rather than Asian, Eskimo, African, etc.

LCHF in my headline refers to low-carb, high-fat.

GERD is gastro-esophageal reflux disease, i.e., frequent or severe heartburn. GERD is the most common reason to use a proton pump inhibitor drug like Prilosec. It’s expensive. I run across patients taking it every day for years.

Dr. Michael Eades has a great post about GERD and the potential drawbacks of proton pump inhibitors (PPIs):

The scientific literature has shown long-term PPI therapy to be related to the following conditions:

Anemia
Pneumonia
Vitamin B12 deficiency
Impaired calcium absorption
Impaired magnesium absorption
Increased rate fractures, especially hip, wrist and spine
Osteopenia [thin brittle bones]
Rebound effect of extra-heavy gastric acid secretion
Heart attacks

From the recent study at hand:

“GERD symptoms and medication usage was more prevalent in European-American women, for whom the relationships between dietary carbohydrate intake, insulin resistance and GERD were most significant. Nevertheless, high-fat/low-carbohydrate diet benefited all women with regard to reducing GERD symptoms and frequency of medication use.”

Source: Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women. – PubMed – NCBI

Pay attention and follow all the links and you may be able to see the entire journal report. You just can’t wait, right?!!

Another study showed improvement in heartburn with a low-carb diet a few years ago.

All of my diet books offer low-carb high-fat options except for the original first edition of Advanced Mediterranean Diet from 2007. In 2009, I learned that low-carb high-fat eating wasn’t dangerous.

Steve Parker, M.D.

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Insulin cost in U.S. doubled between 2002-2013

This is NOT an insulin rig!

This is NOT an insulin rig!

You can’t blame inflation for the cost increase. I’m not sure the link below explains why.

If you’re worried about the cost of insulin, you can take action today to reduce your required dose: lose the excess weight, eat fewer carbohydrates, improve your insulin sensitivity with exercise.

From Reuters:

“The cost of the hormone insulin, one of the most important treatments for diabetes, rose nearly 200 percent between 2002 and 2013, according to a new study.

While other diabetes medications also increased in price, total spending on insulin in 2013 was greater than the combined spending on all those other drugs, researchers report in JAMA.

“The large increase in costs can largely be explained (by) much greater use of newer types of insulin known as analog insulins,” said senior author Philip Clarke, of the University of Melbourne in Australia. “While these drugs can be better for some patients, they are much more costly than the human insulin they replaced.”

Source: Insulin cost in U.S. more than doubles between 2002-2013 | Reuters

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How to Prevent Obesity and Eating Disorders in Adolescents 

From the American Academy of Pediatrics journal:

“Family involvement in the treatment of both adolescent obesity and EDs [eating disorders] has been determined to be more effective than an adolescent-only focus. An integrated approach to the prevention of obesity and EDs focuses less on weight and more on healthy family-based lifestyle modification that can be sustained. Pediatricians can encourage parents to be healthy role models and supportively manage the food environment by creating easy accessibility to healthy foods (eg, fruits, vegetables, whole grains, beans and other legumes, and water) and by limiting the availability of sweetened beverages, including those containing artificial sweeteners, and other foods containing refined carbohydrates. Discussions between pediatricians and parents about increasing physical activity and limiting the amount of total entertainment screen time to less than 2 hours/day are important and may lead to changes in family behavior. Another area of prevention is avoiding the presence of a television in the teenager’s bedroom, because having a television in the room predicts significantly less physical activity as well as poorer dietary intakes compared with not having a television in the room. Other evidence-based approaches encourage parents to include more family meals, home-prepared meals, and meals with less distractions as well as fewer discussions about weight and about dieting.  Understanding that poor body image can lead to an ED, parents should avoid comments about body weight and discourage dieting efforts that may inadvertently result in EDs and body dissatisfaction.

Source: Preventing Obesity and Eating Disorders in Adolescents | From the American Academy of Pediatrics | Pediatrics

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Intensive Program Extended Lifespan By Eight Years in Type 2 Diabetes

"I don't mind dying. I just don't want to be there when it happens."  --Woody Allen

“I don’t mind dying. I just don’t want to be there when it happens.” –Woody Allen

MedPageToday has some details:

“Type-2 diabetics lived nearly 8 years longer when treated with an intensive, multifactorial approach that employed behavioral and pharmacological interventions.

The 160 patients with type-2 diabetes mellitus and microalbuminuria, now followed for 21 years, received either conventional or intensified therapy.

Thirty-eight intensive-therapy patients died during the follow-up period compared with 55 conventional-therapy patient deaths during the same time. This translated to a median survival period 7.9 years longer for the intensive-therapy cohort, as well as a median delay of 8.1 years to a first cardiovascular event, the investigators reported in the journal Diabetologia.

“The outcome of our study is very encouraging and emphasizes the need for early and intensified treatment of multiple modifiable risk factors for a poor prognosis of patients with type 2 diabetes,” said lead study author Peter Gaede, MD, of the University of Southern Denmark in Odense, in a statement.”

Source: Intensive Program Extends Lifespan in T2D Patients | Medpage Today

Study participants were northern Europeans (Danes) who had small amounts of protein (albumin) in their urine and were mostly in their 50s when this long-term study started.

Medical intervention included diet changes, drugs for diabetes/blood pressure/lipids, and exercise. Therapy for the intensive therapy group was “target-driven, with stepwise implementation of both behavioral and pharmacological treatment following a structured approach.”

If you’re a researcher and want to test how my diabetes diets would perform in a study like this, contact me for a discount on books.

Steve Parker, M.D.

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Filed under Diabetes Complications, Longevity