January 26, 2013 · 9:39 AM

Is It Time To Worry About Chemical Pollution?

From Bix at Fanatic Cook:

“Everyone reading this likely has dozens of chemicals in their bodies that their grandparents did not have. And what we eat has a profound impact on our body burden. In particular, processed foods and animal foods (fish, meat, eggs, and dairy), especially fatty versions, present the greatest chemical exposure. 

It’s not far-fetched to think that the increase in metabolic and endocrine disorders (obesity and diabetes are two) is linked to the chemical revolution of the last half century. Yet in the years I’ve been reading about this link, very little has emerged in the media.”

I’m not sure what to think about this issue other than to admit I need to pay it more attention if and when time allows.  Despite man-made chemicals in us, we’re living much longer than our grandparents.  Is that despite the chemicals and thanks to advances in medical care and technology?  Or do the chemicals to more good than harm?    

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January 26, 2013 · 2:30 AM

Five Tibetan Rituals for Back Pain

A position you’ll see in the video

I was browsing at author Jerry Pournelle’s blog recently and noticed his 2006 reference to five Tibetan rituals (sometimes called rites) that relieved his back pain.  I assume the author has garden-variety run-of-the-mill low back pain like most middle-aged folks.

I’m not recommending or endorsing these.  I may try them someday myself.  They just look like flexibility and strengthening exercises to me.

If interested, here’s a how-to article at eHow.com.  Here’s a video demonstration (ignore the top video of Dr. Oz; view the next one down).

Ignore any references you see to Ayurvedic medicine and chakras.

Don’t worry, I’m not going woo on you.

Please share if  you’ve had experience—good or bad—with these.

—Steve

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January 25, 2013 · 2:17 AM

Hypoglycemia: A Few Causes

Insulin and sulfonylurea drugs are common causes of hypoglycemia

Insulin and sulfonylurea drugs are common causes of hypoglycemia

Low-carbohydrate diets are often so effective at controlling blood sugars that low blood sugar (hypoglycemia) becomes a serious risk for some diabetics. It’s rarely a problem for prediabetics. But people with diabetes using particular drugs could develop life-threatening hypoglycemia, particularly when switching to a reduced-calorie or low-carb style of eating.

CARBOHYDRATES AND BLOOD SUGAR

Never forget that carbohydrate consumption has a major effect on blood sugar (glucose) levels—often causing a rise—in many people with type 2 diabetes and prediabetes. Most folks with diabetes are taking medications to lower their glucose levels.

Remember that the main components of food—called macronutrients—are proteins, fats, and carbohydrates. Common carbohydrate sources are:

■  grains

■  fruits

■  starchy vegetables (e.g., potatoes, corn, peas, beans)

■  milk products

■  candy

■  sweetened beverages

■  other added sugars (e.g., table sugar, high fructose corn syrup, honey)

Low-carb and very-low-carb diets restrict the dieter’s carbohydrate consumption rather dramatically. The standard American diet, for instance, provides 250–300 grams of carbohydrate daily, or 50–60% of total energy (calories). A low-carb diet may provide in the range of 50–130 grams daily, or 10 to 25% of total calories. A very-low-carb diet provides under 50 grams of carb daily (under 10% of all calories), often starting at 20–30 grams. With very-low-carb diets, our bodies must use fats instead of carbohydrates as an energy source, and a result of this fat metabolism is the generation of ketone bodies in the bloodstream. So very-low-carb diets are often called ketogenic diets.

Plenty of carbs in this bread!

Plenty of carbs in this bread!

Many dietitians have been taught that you must eat at least 130 grams of carbohydrate daily to provide a rich, readily available source of energy—glucose, specifically—to your brain in particular, and other tissues. Millions of “low-carbers”—people with a low-carb way of eating—know that isn’t right, having proven it to themselves by experience. I personally lived on 30 grams (or less) daily for four months without problems with my brain or other organs. (Well, my wife might argue about the brain issue.) I felt fine and had plenty of energy.

In healthy people, prediabetics, and mild diabetics not treated with medication, carbohydrate restriction rarely causes low blood sugar problems. But in other diabetics, carbohydrate restriction can lead to serious, even life-threatening, symptoms of hypoglycemia.

DRUGS, DIET, AND HYPOGLYCEMIA

Traditional balanced diets for diabetics typically provide 50 to 60% of all calories as carbohydrates. Low-carb diets, remember, provide 25% or less of calories as carbohydrates. A diabetic trying to lose excess weight with a traditional balanced diet is told also to reduce total calories, which necessarily means lowering carbohydrate grams. So, hypoglycemia is also a potential problem for diabetics on these traditional reduced-calorie diets if they are taking particular diabetic medications.

Hypoglycemia, however, is an even greater risk for diabetics taking certain diabetic drugs while on a low-carb or very-low-carb diet. Serious, even life-threatening, symptoms of hypoglycemia may arise.

For diabetics taking certain diabetic drugs, carbohydrate restriction can lead to serious, even life-threatening, symptoms of hypoglycemia.

I hope I’ve made my point. This is dangerous territory. Review your diabetes drugs to see if they can cause hypoglycemia.

Steve Parker, M.D.

 

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January 24, 2013 · 7:16 AM

How About the Paleo Diet for Diabetes?

Not Dr. Frassetto

Dr. Lynda Frassetto is a Professor of Medicine and Nephrology at the University of California San Francisco.  She and her colleagues have completed a study of the Paleolithic diet as a treatment for diabetes (type 2, I think).  As far as I know, details have not yet been published in the medical literature.

Dr. Frassetto spoke at the Ancestral Health Symposium-2012 earlier this year.  You can view the 35-minute video here.

She is convinced that a paleo diet, compared to a Mediterranean-style diet, is better at controlling blood sugars and “reducing insulin” in diabetics (presumably type 2s).  Insulin sensitivity is improved, particularly in those with insulin resistance to start with.  The paleo diet group saw an average drop of fasting glucose by 23 mg/dl (1.3 mmol/l).  One slide you’ll see in the video indicates the paleo diet reduced absolute hemoglobin A1c by 0.3%, compared to 0.2% with the “Mediterranean” diet.  (Let me know if I got the numbers wrong.)

Color me underwhelmed so far.

Questions raised by the video include:

  • what is the UCSF version of the paleo diet?
  • how many participants were in her study?
  • how long did her study last?
  • did she study only type 2 diabetics?
  • what exactly was the control diet?
  • how severe were the cases of diabetes studied?

For answers, we await publication of the formal report.

Steve Parker, M.D.

PS: I’m quite interested in the paleo diet as a treatment for diabetes.  I explore the concept at the Paleo Diabetic blog.

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January 23, 2013 · 4:40 PM

How Many Snacks Do You Eat Per Day?

Here’s some American data:

“So what is the current state of snacking in America? A recent study released by The Hartman Group, a market research company, sought to find out. As described in an article on the study at DrugStoreNews.com,Americans eat an average of 2.3 snacks per day. Most snacking takes place at home; only 12% of people eat snacks at work, and 7% consume them while traveling from one place to another. The at-home nature of snacking may be explained by another result from the study: Most snacking takes place in the afternoon and evening hours.”

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January 19, 2013 · 2:00 AM

Meal Plans From “Conquer Diabetes and Prediabetes”

These recipes are from Conquer Diabetes and Prediabetes.

Day 3

Breakfast:  Bacon and Eggs

3 large eggs (50 g each)

1.5 tbsp (22 ml) olive oil

6 slices pork bacon, cured (about 50 g cooked)

Fry the eggs in olive oil. Bake or fry the bacon. Digestible carb grams: 2.

Lunch:  Chicken Salad Over Mixed Greens

1 large egg (50 g)

4 oz (110 g) cooked, diced chicken (canned or freshly sautéed in olive oil)

½ oz (14 g) raw onion, diced (about 2 tbsp)

8-inch stalk (40 g or 20-cm stalk) of raw celery, diced

2.5 tbsp (40 ml) Miracle Whip Dressing or regular Mayonnaise

2 oz (60 g) romaine lettuce

2 oz (60 g) raw baby spinach

1 oz (28 g) almonds

salt and pepper

Hard-boil an egg, then peel and dice. In a bowl, place the chicken and add the egg, onion, celery, and Miracle Whip Dressing or regular mayonnaise. Mix all together, with salt and pepper and/or a dash of lemon juice to taste. Place on bed of lettuce and baby spinach. Enjoy almonds around mealtime or later as a snack. Digestible carb grams: 10.

Dinner:  Baked Balsamic Salmon and Green Beans

16 oz (450 g) salmon filets

salt and pepper

4 cloves (12 g) garlic, minced

1 tbsp (15 ml) olive oil

1.5 oz (45 ml) white wine for the glaze

4.5 tsp (22 ml) mustard

4 tbsp (60 ml) balsamic vinegar

1 tbsp (15 ml) granulated Splenda (or 1 packet (1g) of tabletop Splenda)

1.5 tbsp (22 ml) fresh chopped oregano (or 1 tsp (5 ml) dried oregano)

200 g canned green beans (or fresh green beans sautéed in olive oil/garlic)

5 oz (150 ml) dry white wine

This makes two large servings.

Preheat oven to 400°F (200°C). Line a baking sheet or pan (8″ or 20 cm) with aluminum foil. Lightly salt and pepper the fish in the lined pan, with the skin side down.

Now the glaze. Sauté the minced garlic in olive oil in a small saucepan over medium heat for about three minutes, until it’s soft. Then add and mix white wine (1.5 oz), mustard, vinegar, granulated Splenda, and 1/8 tsp (0.625 ml) salt. Simmer uncovered over low or medium heat until slightly thickened, about three minutes. Remove glaze from heat and spoon about half of it into a separate container for later use.

Drizzle and brush the salmon in the pan with the glaze left in the saucepan. Sprinkle the oregano on top.

Bake the fish in the oven for about 10–13 minutes, or until it flakes easily with a fork. Cooking time depends on your oven and thickness of the fish. Over-cooking the fish will toughen it and dry it out. When done, use a turner to transfer the fish to plates, leaving the skin on the foil if able. Drizzle the glaze from the separate container over the filets with a spoon, or brush it on. Don’t use the unwashed brush you used earlier on the raw fish.

Heat canned green beans (200 g) on stovetop or serve at room temperature straight out of the can.

Enjoy a 5-oz glass of dry white wine with your meal. This recipe makes two servings of fish and green beans. Digestible carb grams in wine, half the fish, half the green beans: 14.

(The balsamic vinegar adds six g of carb to each serving. To reduce vinegar carbs to zero, you could try this recipe with red wine vinegar, white wine vinegar, or cider vinegar. I’ve not tried that. Digestible carbs per serving would drop to 8 g.)

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Higher Blood Sugar Levels at Time of Admission for Heart Failure are Linked to Higher Death Rates In Next 30 Days

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January 18, 2013 · 9:16 AM
January 18, 2013 · 2:00 AM

QOTD: James Fisher on Efficient Resistance Exercise

We recommend that appreciably the same muscular strength and endurance adaptations can be attained by performing a single set of ~8–12 repetitions to momentary muscular failure, at a repetition duration that maintains muscular tension throughout the entire range of motion, for most major muscle groups once or twice each week. All resistance types (e.g. free-weights, resistance machines, bodyweight, etc.) show potential for increases in strength, with no significant difference between them, although resistance machines appear to pose a lower risk of injury.

—Fisher, James, et al.  Evidence-based resistance training recommendations.  Medicina Sportiva, 15 (2011): 147-162.

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January 17, 2013 · 4:46 AM

Sugar and Carbohydrates Linked to Impaired Brain Function in Elderly

 

Note the sugar cubes

Note the sugar cubes

The Mayo Clinic recently reported that diets high in carbohydrates and sugar increase the odds of developing cognitive impairment in the elderly years.

Mild cognitive impairment is usually a precursor to dementia.  Many authorities think dementia develops more often in people with diabetes, although some studies refute the linkage.

Mayo investigators followed 940 patients with normal baseline cognitive functioning over the course of four years. Diet was assessed via questionnaire. Study participants were ages 70 to 89. As the years passed, 200 of them developed mild cognitive impairment.

Compared with those eating at the lowest level of carbohydrate consumption, those eating at the highest levels were almost twice as likely to go to develop mild cognitive impairment.

The scientists note that those eating lower on the carbohydrate continuum were eating more fats and proteins.  Whether the Low-Carb Mediterranean Diet prevents cognitive impairments remains to be seen.

Steve Parker, M.D.

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January 17, 2013 · 3:36 AM

Some Type 1s Skip Insulin to Lose Weight

Another article on diabulimia from the BBC.  I don’t recall any type 2s doing this.

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