A U.S.A. Memorial Day Poem

It is the Soldier, not the minister

Who has given us freedom of religion.

It is the Soldier, not the reporter

Who has given us freedom of the press.

It is the Soldier, not the poet

Who has given us freedom of speech.

It is the Soldier, not the campus organizer

Who has given us freedom to protest.

It is the Soldier, not the lawyer

Who has given us the right to a fair trial.

It is the Soldier, not the politician

Who has given us the right to vote.

It is the Soldier who salutes the flag,

Who serves beneath the flag,

And whose coffin is draped by the flag,

Who allows the protester to burn the flag.

 —Charles M. Province

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FDA Advisory Panel to Look at Rosiglitazone Once Again

Larry Husten writing at Forbes has the details. For example:

Battle lines are being drawn two weeks before a highly unusual two-day FDA advisory committee meeting to discuss the contentious diabetes drug rosiglitazone (Avandia, GlaxoSmithKline). This will be the second time an FDA panel has wrestled with the fate of the drug and expectations have been that the discussion will once again be heated.

 

But at least one source of fierce criticism won’t be participating in the panel. Steve Nissen, who originally raised concerns about the drug and who has remained the most consistent critic of the drug, will not participate in the deliberations or present to the committee. Early on Thursday Nissen contributed a blog post on Forbes accusing the FDA of stacking the committee in favor of rosiglitazone. The FDA leadership, he says, is trying to use the meeting to “whitewash” its reputation…

Are they considering lifting the heavy restrictions on the drug? I see very few rosiglitazone users these days.

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Carbohydrate Restriction Improve Polycystic Ovary Syndrome

MedPageToday reports that women cutting carbs from 55 to 41% of total calories see improved insulin sensitivity, lower testosterone levels, lower blood sugar levels, and improved lipid numbers.

Learn more about PCOS at UpToDate.com. It affects 5 to 10% of U.S. women.

From MedPageToday:

“A moderate reduction in dietary carbohydrate reduced both insulin and testosterone,” Gower told MedPage Today. “There is no reason not to recommend reduction in dietary carbohydrate, particularly processed carbohydrate, for women with PCOS. It may have tremendous benefit, and there is certainly no downside.”

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You Got Sleep Apnea AND Prediabetes? Kill Two Birds With One Stone By Using CPAP

See MedPageToday for details.

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Excellent Advice For Women Approaching Menopause

…and struggling with weight gain and other hormonal issues. Visit Franziska Spritzler’s blog for details. A quote:

While the aging process is inevitable and to some extent dependent on your genes, there are ways to make the transition easier in terms of weight management, loss of muscle mass, and blood sugar control. My advice is to cut back on carbs to a level that allows you to achieve a healthy weight and optimal glycemic levels, keeping in mind that this is highly individualized and may change over time. Some women at this stage may be able to continue the same moderate-to-high-carb diet they’ve always consumed without any issues, but after looking into the research and hearing many anecdotal accounts, I know that many are simply not. It saddens me to hear about  ladies in their mid-40s to mid-50s eating low-fat diets and continuing to struggle with food cravings and weight. I feel many would benefit from the hunger-reducing, hormone-altering, blood-sugar-stabilizing effects of carb restriction.

Franziska recommends women consult their doctors before starting a low-carb diet or exercise program.

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Dr. Richard Bernstein on Insulin Pumps

Click for details at DiabetesHealth. He starts like this:

I spent a month in a major insulin pump center and saw several things. Many of the female patients seemed to have wings on their sides where the pump tubing was inserted and they got lipohypertrophy from localized injections, but that was the least of it. None of them actually had remotely normal blood sugars. 

 

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“ItsTheWooo” Explains Reluctance to Try Very-Low-Carb Eating For Weight Management

Click for details. ITW, BTW, is a nurse. A snippet:

At work, a few days ago, I was sitting at the station alongside a new nurse; she’s very young (about my age when I first started using a ketogenic diet for my obesity) and she is also very very overweight. In addition to being a young female (thus common sense that she prefers to be thin), observing her eating behavior made it patently obvious this poor girl has been trying for years to correct her obesity.  She always refuses food if offered to her, and when she does bring food, she rarely eats it, and it’s always healthy food like salads.

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Smaller Breakfast May Help With Waist Management

…according to an article at MedPageToday. In a study of overweight and obese folks, those who ate larger breakfasts ended up eating 270 calories more per day than those eating a smaller breakfast. It’s too soon to know for sure, but eating a smaller breakfast may help with weight loss or maintenance of weight loss. Calories count.

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Are Diabetes Camps For Kids Worthwhile?

Victoria Cumbow sings their praises. A quote:

As a teenager, diabetes was a bitter subject mainly because it made me different and sometimes caused me to stand out. I resented diabetes for several years and even ignored it at times. But these friends have been an amazing part of my life for 15 years now and have gotten me through some tough times.Camp was special for each of us in different ways, and for me, it helped me gain ownership of my diabetes. It was no longer an excuse or something I resented. I took responsibility and it changed my perspective completely. It’s hard to wallow in something when you are no longer the only one struggling.

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Is Resistance Training Just as Good as Aerobic?

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Resistance or strength training may be just as effective as, or even superior to, aerobic training in terms of overall health promotion.  Plus, it’s less time-consuming according to a 2010 review by Stuart Phillips and Richard Winett.

I don’t like to exercise but I want the health benefits.  So I seek ways to get it done safely and quickly.

Here’s a quote from Phillips and Winett:

A central tenet of this review is that the dogmatic dichotomy of resistance training as being muscle and strength building with little or no value in promoting cardiometabolic health and aerobic training as endurance promoting and cardioprotective, respectively, largely is incorrect.

Over the last few years (decade?), a new exercise model has emerged.  It’s simply intense resistance training for 15–20 minutes twice a week.  It’s not fun, but you’re done and can move on to other things you enjoy.  None of this “three to five hours a week” of exercise that some public health authorities recommend.  We have no consensus on whether the new model is as healthy as the old.

More tidbits from Phillips and Winett:

  • they hypothesize that resistance training (RT) leads to improved physical function, fewer falls, lower risk for disability, and potentially longer life span
  • only 10–15% of middle-aged or older adults in the U.S. practice RT whereas 35% engage in aerobic training (AT) or physical activity to meet minimal guidelines
  • they propose RT protocols that are brief, simple, and feasible
  • twice weekly training may be all that’s necessary
  • RT has a beneficial effect on LDL cholesterol and tends to increase HDL cholesterol, comparable to effects seen with AT
  • blood pressure reductions with RT are comparable to those seen with AT (6 mmHg systolic, almost 5 mmHg diastolic)
  • RT improves glucose regulation and insulin activity in those with diabetes and prediabetes
  • effort is a key component of the RT stimulus: voluntary fatigue is the goal (referred to as “momentary muscular failure” in some of my other posts)
  • “In intrinsic RT, the focus and goal are to target and fatigue muscle groups.  A wide range of repetitions and time under tension can be used to achieve such a goal.  Resistance simply is a vehicle to produce fatigue and only is adjusted when fatigue is not reached within the designated number of repetitions and time under tension.”

Our thesis is that an intrinsically oriented (i.e., guided by a high degree of effort intrinsic to each subject) program with at minimum of one set with 10–15 multiple muscle group exercises (e.g., leg press, chest press, pulldown, overhead press) executed with good form would be highly effective from a public health perspective.

The authors cite 60 other sources to support their position.

These ideas are the foundation of time-efficient resistance training of the sort promoted by Dr. Doug McGuff, Skyler Tanner, Fred Hahn, Chris Highcock, James Steele II, and Jonathan Bailor, to name a few.

Only a minority will ever exercise as much as the public health authorities recommend.  This new training model has real potential to help the rest of us.

Steve Parker, M.D.

Reference:  Phillips, Stuart and Winett, Richard.  Uncomplicated resistance training and health-related outcomes: Evidence for a public health mandate.  Current Sports Medicine Reports, 2010, vol. 9 (#4), pages 208-213.

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