Collagen Supplementation for Knee Arthritis

A few months ago I heard fitness guru Mark Sisson mention during an interview that he was taking a collagen supplement for a painful hip condition that might need surgery, which he is trying to avoid. At the time, I had never heard of collagen supplementation. I used the google machine to find out it was indeed “a thing.” The popular trend may have been started after endorsement by a female celebrity (Jennifer Anniston?).

I have osteoarthritis (aka degenerative joint disease or DJD) in my knees, mainly manifested by very transient aching and stiffness if I sit for too long, and impaired range of motion. I cannot do a deep squat. I got my first inkling of arthritis awareness thirty years ago when I thought I’d start skipping rope because it’s such a great aerobic workout. After just a few jumps, my knees convinced me that was a bad idea.

Six months ago I developed a strange awareness of my left knee; it just didn’t feel like it was quite mine, like how I imagine it feels like to have a prosthetic knee joint. Plus some minimal aching while in bed, relieved by simply changing position. I walk around without any discomfort.

Does genetics play a role? My mother had knee replacement surgery for DJD at age 83. By that time her gait had become quite impaired.

I did a little Internet research and determined I had little to lose if I tried collagen, except for $. A family member was going to Costco so I asked them to get me some. I didn’t research various brands. Pictured is what they brought home. ~$40 for a month’s worth. I planned a two-month trial although WebMD suggested that 3-5 months may be needed for arthritis. (This is not a formal endorsement of the brand, nor am I being paid to feature it here.)

My two month trial of 20 grams daily ended yesterday. Did it work? I think maybe it did. The knee feels like it’s mine again, and sleep-time aching is less frequent. Could these be placebo effect? Yes. Was this a fair trial? Not entirely. In a totally legit experiment, you should only change one variable. Meaning: take this supplement but keep everything else exactly the same. In my experiment, I inadvertently added probiotics in addition to collagen (my shopper picked the product). I also significantly upped my exercise with more walking and weight training. Maybe my subjective improvement was due to those non-collagen factors. Heck, even the season of the year may have been an issue. A legitimate trial would involve hundreds of study subjects, a placebo group, before and after range of motion testing, a validated knee function questionaire, etc.

I was going to stop supplementation at this point but my wife already got me another cannister that lasts a month.

Click for my other posts on knee arthritis.

Steve Parker, M.D.

Too Good to Be True? Vitamin D May Prevent Dementia

I’m tempted to get my blood level of 25-hydroxyvitamin D checked.

Dr. John Campbell is “totally convinced” that high-dose vitamin D supplementation would prevent many cases of dementia, particularly Alzheimer dementia, which is 75% of all dementia cases. He takes 4,000 IU of vitamin D/day plus 100 mcg of vitamin K2. Unclear to me if that’s year-round or only in fall and winter. I assume it’s oral vitamin D3 (there are several types of vitamin D). Dr. Campbell didn’t say why he takes the K2. Click for a brief review of K2. In contrast to his vitamin D dose of 4,000 IU/day, U.K. health authorities recommend a tenth of that — 400 IU — in autumn and winter.

Several observational studies link higher risk of dementia with blood levels of vitamin D that are deficient or insufficient. Blood levels of 25-hydroxy-vitamin D under 25 mg/ml are particularly linked to dementia. Dr. Campbell admits that it’s difficult to prove that adequate vitamin D supplementation would prevent Alzheimer dementia.

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  Steve Parker, M.D.

Do You Trust the Mainstream Media?

I’m increasingly distrustful of the mainstream (aka legacy) media. Ownership of it is in the hands of surprisingly few people. This makes reported news susceptible to manipulation by folks that have an agenda that may be at odds with your desire for “just the facts.”

In 1976, when the U.S had only three or four national over-the-air TV stations and no Internet, 72% of Americans trusted mass media. A Gallup poll found that in 2023, only 32% of Americans had a “great deal” or a “fair amount” of trust in the mass media. A larger percentage—39%—had “none at all.” In view of AI or CGI-generated imaging, it’s getting hard to believe anything you don’t see with your own eyes.

Most of the mainstream media (aka legacy media) consumed in the U.S. originates from a handful of companies. From a 2021 essay by Helen Johnson:

In 1983 there were 50 dominant media corporations. Today there are five. These five conglomerates own about 90 percent of the media in the United States, including newspapers, magazines, book publishers, motion picture studios and radio and television stations. As of 2020, the five media giants are AT&T (Time Warner, CNN, HBO), Comcast (NBC Universal, Telemundo, Universal Pictures), Disney (ABC, ESPN, Pixar, Marvel Studios), News Corp (Fox News, Wall Street JournalNew York Post) and ViacomCBS (CBS, Paramount Pictures).

Alternative Media for Your Consideration (not for local news, sports, weather)

By no means do I endorse or agree with everything you see or hear at these sites.

  • Tucker Carlson on X (news, opinion, politics, interviews)
  • RamzPaul on Rumble (news, cultural commentary, nationalism)
  • The Dan Bongino Show on Rumble (politics, news, opinion)
  • Michael Farris’ podcast “Coffee and a Mike” (interviews)
  • “Redacted” with Natali and Clayton Morris on Rumble (news, cultural commentary)
  • Jeffrey Prather’s “The Prather Point” on Rumble (preparedness, Deep State exposure, communitarianism)
  • The Epoch Times (U.S. and international news, lifestyle, health, Falun Gong)
  • The Unz Review (cultural commentary, economics, literature, politics, conspiracy)
  • Catherine Austin Fitts at Solari.com (for personal finance and investing, banking, government)
  • RT at RT.com (news and commentary from a Russian viewpoint)
  • O’Keefe Media Group (citizen journalism, expose wrongdoing)
  • Democracy Now! at http://www.democracynow.org or on YouTube (independent global news)
  • Paul Craig Roberts at paulcraigroberts.org (opinion, politics, cultural decay)
  • Al Jazeera at aljazeera.com (international news organization based in Qatar)
  • Lew Rockwell at LewRockwell.com (news and opinion)
  • Alex Jones at Infowars.com (news, opinion, health, politics, economics, conspiracy, vitamins)
  • Vox Popoli at voxday.net (philosophy, economics, politics, books, Arktoons, socio-sexual hierarchy, Christianity, classic literature)
  • Russell Brand on Rumble.com (news, social commentary, iconoclasm, politics)
  • Glenn Greenwald on Rumble.com (mostly politics)
  • Stew Peters Network on Rumble.com (social commentary, news)
  • Karl Denninger, The Market Ticker at market-ticker.org (finance and politics)
  • The Joe Rogan Experience at Spotify.com (long-form interviews with comics, entertainers, politicians, scientists, etc.
  • The Chris Hedges Report at The Real News Network (TheRealNews.com) or YouTube, or ChrisHedges.substack.com (wide-ranging interviews, essays)
  • The Real News Network at TheRealNews.com (journalism “advancing the cause of a more just, equal, and livable planet”);
  • Elijah Schaffer’s “Slightly Offensive” channel at Rumble.com (social commentary, interviews)
  • Censored.tv (Comedy and cultural commentary; some free content, much behind paywall)
  • Louder With Crowder podcast (Steven Crowder: comedy, news, politics)
  • Judging Freedom (Andrew Napolitano) on YouTube (law and politics)
  • The Jimmy Dore Show on Rumble.com (comedy, news, politics)
  • Timcast IRL (Tim Pool) podcast or YouTube (news, politics, culture)
  • Matt Taibbi at http://www.racket.news and the podcast America This Week (news, opinion, cancel culture, culture war)

I’d like to know if you agree or disagree with these choices, or if you’d add any.

Steve Parker, M.D.

Can Children Thrive on a Ketogenic Diet?

Diabetes Daily has in interesting article that addresses that question. A snippet:

In October 2023, the American Academy of Pediatrics (AAP) published a report examining low-carbohydrate diets like keto in children and adolescents. You probably won’t be surprised that the authors are concerned. Despite the increasing popularity of carbohydrate restriction, evidence to support the benefits of low-carb diets in young people under 18 with obesity or diabetes is very limited. And though diabetes authorities have acknowledged that carb restriction has “the most evidence” for improving blood sugar levels, the American Diabetes Association has only endorsed low-carb eating as one of multiple possible eating patterns.

And yet, there are many people in the diabetes community who believe in the effectiveness of low, even very-low, carbohydrate diets for their children. There’s at least one study that supports their advocacy


I’m not a pediatrician and never treat children in my hospital practice, not even 17-year-olds. Nor have I reviewed the pertinent pediatric scientific literature. So I’ve never been comfortable writing about keto diets for children. The linked DD article was reviewed by Anna Goldman, M.D.

Steve Parker, M.D.

Red Meat Linked to Higher Type 2 Diabetes Risk

This looks healthful to me, despite the red meat

Red meat consumption — whether processed or not — was linked to onset of type 2 diabetes in the U.S. according to a 2023 article in American Journal of Clinical Nutrition. The research was a long-term observational study by mostly Harvard-based scientists. Among the authors that might be familiar to you are Walter Willett, Frank Hu, and Frank Sacks. Click the link for the deets.

This doesn’t prove that red meat consumption causes diabetes. But if you enjoy a fair or high amount of red meat, you might benefit by cutting back, especially if diabetes runs in your family. I’d also suggest regular exercise and avoiding overweight and obesity to reduce your risks of type 2 diabetes. The author suggest red meat alternatives: nuts, legumes, dairy foods.

In the same journal issue is a commentary by Daan Kremer. Some snippets:

The current observational study is unlikely to end the discussion on whether red meat intake increases risk of type 2 diabetes and even less likely to end the epistemological debates on how to grade quality of observational evidence when many efforts are made to reduce bias and confounding.

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All in all, the study by Gu et al. may arguably be the best evidence to date on the relation between red meat intake and type 2 diabetes. Yet somehow, I feel that the books have not been closed.

  Steve Parker, M.D.

Paleolithic Diet Linked to Lower Risk of Death, Tumor, Cardiovascular, Respiratory, Neurological, and Digestive Disease

The study at hand was done on a Swedish population, published in 2024 in European Journal of Nutrition. It’s not perfect but suggestive of benefit. You can read the entire report yourself (I haven’t). Reports like this usually give their strongest findings in the first paragraph of the Discussion section:

PDF [paleo diet fraction] was inversely associated with the risk of death from all causes, tumor, cardiovascular, respiratory, neurological, and digestive disease. PDF was also inversely but non-significantly associated with death from other diseases combined. For incident event outcomes, PDF was inversely associated with the risk of coronary events and also inversely, but non-significantly associated, with ischemic stroke and type 2 diabetes. Besides longer follow-up, the present study extends previous research by examining associations for a measure of how Paleolithic a diet is based on absolute food intakes with mortality and incidence of cardiometabolic disease. This enables comparison between studies not possible for Paleolithic diet pattern scores based on relative food intakes.

Abstract

Purpose

Paleolithic Diet Fraction (PDF) estimates how large a portion of the absolute dietary intake stems from food groups included in the Paleolithic diet. In randomized controlled trials higher PDFs have been associated with healthier levels of cardiometabolic risk markers. Our aim was to build upon these findings by examining associations between PDF and mortality and incidence of cardiometabolic disease in the prospective Malmö Diet and Cancer Study.

Methods

PDF was calculated from an interview-based, modified diet history method, and associations were estimated by using multivariable Cox proportional hazards regression. The examined cohort consisted of 24,104 individuals (44–74 years, 63% women) without previous coronary events, diabetes, or stroke at baseline (1992–1996). A total of 10,092 individuals died during a median follow-up of 18 years.

Results

Median PDF was 40% (0–90%). The adjusted hazard ratios (HR) for PDF as a continuous variable (from 0 to 100%) were for risk of death from all causes 0.55 [95% CI 0.45, 0.66], tumor 0.68 [95% CI 0.49, 0.93], cardiovascular 0.55 [95% CI 0.39, 0.78], respiratory 0.44 [95% CI 0.21, 0.90], neurological 0.26 [95% CI 0.11, 0.60], digestive, 0.10 [95% CI 0.03, 0.30], and other diseases 0.64 [95% CI 0.41, 1.00]. The corresponding HR for risk of coronary event was 0.61 [95% 0.43, 0.86], for ischemic stroke it was 0.73 [95% 0.48, 1.09] and for type 2 diabetes it was 0.82 [95% 0.61, 1.10].

Conclusion

Observational data suggest an inverse association between PDF and all-cause as well as cause-specific mortality and incidence of cardiometabolic disease.


Steve Parker, M.D.

Why Do Women Outlive Men?

Logging is dangerous work and it’s mostly men who do it.
Photo by AX H on Pexels.com

Jim Goad is one of my favorite living cultural commentators. On par with a young P. J. O’Rourke, who died in 2022 at age 74. Last year Goad wrote a thoughtful and thought-provoking article on why women outlive men. A sample:

This disparity is not exclusive to the United States. In fact, it’s worse elsewhere. Worldwide, women outlive men by an average of seven years. According to a 2001 report, the only five countries on Earth where men outlived women were the flea-bitten open-air latrines we call Afghanistan, Nepal, Papua New Guinea, Namibia, and Zimbabwe. But a report from 2017 says there’s no longer any country on the planet where men outlive women.

It wasn’t always this way.

According to data from developed countries, men lived longer than women throughout most of the 1800s, only for the longevity stats to tip in favor of females during the 1890s — an advantage that women have held ever since. Women are supposedly more vulnerable than men to infectious diseases, but once male scientists got a grip on the microbes and brought those pesky critters to heel, women started living longer than men.

As far as I know, women have never thanked men for it.

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For another example of Goad’s work, check out his valentine, Why I Never Gave Up On Women.


  Steve Parker, M.D.

Walk Faster to Prevent Type 2 Diabetes?

You probably want to shoot for a speed of 3 miles per hour or higher. (I’ll convert to kilometers per hour below.)

About one in 500 dogs will acquire diabetes. Some breeds are more prone than others.

The British Journal of Sports Medicine published an article by researchers based in Iran. They analyzed 10 cohort studies that looked at average habitual walking speed and the incidence of type 2 diabetes. Study subjects were not in Iran, but in the U.S., U.K., and Japan.

An easy, casual walking speed is 2 miles per hour (mph) or less. Brisk walking speed is 3-4 mph. I tried walking my dog today at 4 mph and couldn’t keep it up for long. Dog was fine with it.

The researchers found that a habitual walking speed of even 2.5 mph was linked to a slightly lower risk of type 2 diabetes compared to the casual walkers. A more definitive reduction of diabetes incidence (25%) was seen in those who walk at 3 to 4 mph.

For those of you who think in terms of km/hr: An easy, casual walking speed is 3.2 km/hr or less. Brisk walking speed is 4.8-6.4 km/hr. The researchers found that a habitual walking speed of even 4 km/hr was linked to a slightly lower risk of type 2 diabetes compared to the casual walkers. A more definitive reduction of diabetes incidence (25%) was seen in those who walk at 4.8-6.4 km/hr.

This doesn’t necessarily mean that you’ll cut your risk of developing type 2 diabetes if you increase your habitual walking speed from an easy stroll to 3 mph or higher. But it is suggestive and there is physiological science to support that suggestion. The problem is that this study was observational. Which means it’s possible that faster walkers are simply overall healthier than slower ones. They walk faster because they’re healthier and are just constitutionally (genetically?) less prone to illness. To prove that faster walking speeds prevent some cases of type 2 diabetes, you’d have to take 2,000 slow walkers and somehow motivate 1,000 of them to walk faster habitually, while making sure the slow-pokes stay slow for 5-10 years. Keep everything else the same for all 2,000. After 5-10 years, you compare the incidence of diabetes. That study will not, probably cannot, be done.

  Steve Parker, M.D.

h/t to Diabetes Daily for a well-written article on this.

Eaton and Konner Update Their View of the Paleo Diet

Melvin Konner and S. Boyd Eaton are highly respected pioneers in the paleo diet movement. Their new article in Evolutionary Anthropology is titled “Hunter-gatherer diets and activity as a model for health promotion: Challenges, responses, and confirmations.” For the low, low price of $15 USD you can read it here.

Abstract

Beginning in 1985, we and others presented estimates of hunter-gatherer (and ultimately ancestral) diet and physical activity, hoping to provide a model for health promotion. The Hunter-Gatherer Model was designed to offset the apparent mismatch between our genes and the current Western-type lifestyle, a mismatch that arguably affects prevalence of many chronic degenerative diseases. The effort has always been controversial and subject to both scientific and popular critiques. The present article (1) addresses eight such challenges, presenting for each how the model has been modified in response, or how the criticism can be rebutted; (2) reviews new epidemiological and experimental evidence (including especially randomized controlled clinical trials); and (3) shows how official recommendations put forth by governments and health authorities have converged toward the model. Such convergence suggests that evolutionary anthropology can make significant contributions to human health.


  Steve Parker, M.D.

Effect of Paleo Diet on Body Composition & Carbohydrate and Fat Metabolism of Professional Handball Players

Not your average cave-woman

This research out of Poland doesn’t interest me right now. You can read the entire article for free! Let us know what you think.

Abstract

The Paleo diet (PD) involves a restriction of carbohydrates and increased fat content (35% energy from carbohydrates, 35% energy from fats and 30% energy from protein). The aim of this study was to examine the effect of the PD on body composition, concentration of carbohydrates and lipids, as well as insulin, irisin, adiponectin and leptin in the blood. A total of 25 handball players were assigned to two groups: 14 in the experimental group (PD) and 11 in the control group (CD), using a PD and a rational diet, respectively. Analysis of body mass and body composition (body mass index, fat mass, lean body mass, fat-free mass, muscle mass, bone mineral content and bone mineral density), as well as blood concentration of metabolism markers (glucose, insulin, total cholesterol, HDL-cholesterol, non-HDL-cholesterol, LDL-cholesterol, triglycerides, free fatty acids, β-hydroxybutyrate, irisin, adiponectin and leptin), were determined at the beginning and after 4 and 8 weeks of nutritional intervention. Body mass was lower (p < 0.01), and adiponectin blood concentration was higher (p = 0.03) in the PD group at the end of the intervention. There were no changes (p ≥ 0.05) in body composition and blood levels of other biochemical markers in either group.


  Steve Parker, M.D.