Is a Vegan Diet Better Than Paleo for T2 Diabetes?

We don’t know yet because they’ve never been compared head-to-head.

paleo diet, Steve Parker MD, how to cook asparagus and Brussels sprouts

These might be on the vegan Ma-Pi 2 diet

What we do have is a specific vegan diet (Ma-Pi 2) compared to a low-fat diet in a study published by Nutrition & MetabolismCarbsane Evelyn dove into the study at her blog (recommended reading), or you can read the original research report yourself. Study subjects had fairly well-controlled type 2 diabetes and were elderly (66) and overweight (84 kg or 185 lb). The vegan diet was mostly whole grains, vegetables, legumes, and green tea.  The low-fat and vegan diets both probably supplied 200-300 calories/day fewer than what the subjects were used to: 1900 cals for men, 1700 for women. The study lasted only three weeks.

The vegan group ate 335 grams/day of carbohydrate compared to 235 grams in the low-fat group. In contrast, the Paleobetic Diet provides 60-80 grams/day of digestible carb and the Ketogenic Mediterranean Diet allows a max of 20-30 grams.

The vegans in the study at hand ate 15-20 more grams/day of fiber. High fiber intake is linked to better blood sugar control.

From the study abstract:

After correcting for age, gender, BMI at baseline, and physical activity, there was a significantly greater reduction in the primary outcomes fasting blood glucose and post-prandial blood glucose in those patients receiving the Ma-Pi 2 diet compared with those receiving the control diet. Statistically significantly greater reductions in the secondary outcomes, HbA1c, insulin resistance, total cholesterol, LDL cholesterol and LDL/HDL ratio, BMI, body weight, waist and hip circumference were also found in the Ma-Pi 2 diet group compared with the control diet group. The latter group had a significantly greater reduction of triglycerides compared with the Ma-Pi 2 diet group.

The take-home point for me is that overweight T2 diabetics can improve short-term diabetes numbers despite a high carbohydrate consumption if they restrict calories and eat the “right” carbs. Restrict calories enough—600/day?—and T2 diabetes might be curable

I’ve written before about vegetarian/vegan diets for diabetes. My patients are more resistant to vegan diets than they are to low-carb.

Paleobetic diet, low-carb breakfast

Not allowed not on the Ma-Pi 2 diet. Bacon, eggs, black coffee, and Cholula hot sauce. A caveman wouldn’t recognized any of this except for eggs.

I scanned the original report and don’t see any problems with Evelyn’s summary.

Steve Parker, M.D.

I Failed as a Deer Hunter

ll

ll

Last month I missed my first chance ever to shoot a deer.

Arizona has a lottery system to determine who gets to participate in the harvest. Winners were announced in July or so. I had until early November to get ready.

My family has no hunting tradition, so I’m on my own. Before the hunt, I needed to choose and purchase a rifle*, choose and purchase optics (a scope), learn how to shoot accurately, learn how to hunt deer, and make several advance trips to my designated hunting area to scope it out (exactly where are the deer?). Furthermore, I need new eyeglasses. As you might imagine, I’m fairly obsessive and compulsive about doing things the right way. I ran out of time, thanks to other aspects of life that were more important. Oh, well. Maybe I’ll be ready by next fall.

I did spend a couple hours with my son checking out rifles at Bass Pro Shop in Mesa, Arizona. They had many on my list of prospects.

Notes On Rifle Choice

Although a wood stock is aesthetically appealing, a synthetic stock probably makes more sense in terms of withstanding weather-related stress such as rain, heat, cold, and extremes of humidity. Plus, the synthetic stocks are $200 cheaper.

I’m leaning towards .308 caliber since it packs enough punch for elk hunting. .30-06 would do the trick, too.

I was not greatly impressed with Savage rifles, although the Weather Warrior was not bad. I don’t remember otherwise which Savage models I held. The salesman at Bass said it’s a little more trouble to mount a scope on the Savages. Savages are popular rifles.

He also told me to consider stainless steel barrels.

The Weatherby Vanguard Series 2 Sporter with synthetic stock was OK, but not one of my favorites.

I ruled out the Ruger American simply because I like the Tikka T3 better. I have a Ruger revolver and recommend the company. I also have a soft spot for Browning firearms since I’m happy with my Browning BDA .380 semi-automatic pistol.

The Sako A7 is too expensive, even with synthetic stock. I don’t remember the price, but must be over $1,500.

All of the following are in the running for future purchase:

  • The Tikka T3 (Hunter or Forest model) is made by Sako and I was favorably impressed. $600 with synthetic stock.
  • Browning A-Bolt Medallion (not chambered in .308, but in .30-06).
  • Browning X-Bolt Hunter.
  • Browning X-Bolt Medallion.
  • Winchester Model 70 is very nice. The Alaskan model is probably the only one on this page that comes with iron sites, an option I like. It is chambered in .30-06 but not .308
  • Remington 700. Several different models, and perhaps not in .308 caliber. At least one has iron sites (BDL model).

If I had to choose one right now, it’d be the Tikka T3.

Steve Parker, M.D.

 *Mike S., thanks for offering me the use of one of your rifles. But my goal is a Parker family rifle I can pass down to the next generation.

PS: I just learned that a Remington 700 is what Charles Whitman used to kill 16 people from a tower at the University of Texas (in Austin) in 1966.

Low-Carb Diet Beats Low-Fat for Weight Loss While Improving Cardiovascular Risk Factors

…according to an article at MedPageToday.

Many physicians have been reluctant to recommend low-carb diets out of fear that they increase cardiovascular risk. How could that happen? By replacing carbohydrates with fats, especially saturated fats, leading to atherosclerosis. I don’t buy that theory (here’s why).

medical clearance, treadmill stress test

This treadmill stress test is looking for atherosclerotic heart disease, aka coronary artery disease and coronary heart disease

A recent study compared low-carb to low-fat dieting over 12 months and actually found better improvements in cardiovascular disease risk factors on the low-carb diet (max of 40 grams a day).

After 12 months, folks on a low-carbohydrate diet had lost 5.3 kg (11.7 lb), while those on a low-fat diet with similar caloric value had lost 1.8 kg (3.9 lb). Both groups showed lowering of LDL cholesterol, while the low-carbers had better improvements in HDL cholesterol and triglycerides.

DietDoctor Andreas Eenfeldt can add this study to his list of others that show better weight loss with low-carb diets compared to low-fat.

Steve Parker, M.D.

Pioglitazone May Prevent Dementia

MP900178842[1]

Pioglitazone (aka Actos) is a type 2 diabetes drug in the TZD class. You could call it an “insulin sensitizer.” A recent report out of Germany suggests that pioglitazone prevents dementia, but it’s not a very strong linkage. If it works, I wonder if it’s simply related to better control of blood sugar, which could be accomplished with a variety of means. 

The best popular press report I’ve seen is at Bloomberg.

German researchers went fishing for associations in a huge database of patients and drug usage. Their formal report hasn’t even been published yet. A five-year study was recently initiated to further investigate the possibility that piogoitazone prevents dementia. I doubt this will pan out.

Steve Parker, M.D.

Human Brain Size Shrinking For Last 10,000+ Years

An article at Scientific American offers some explanations, but nobody knows why with certainty. Maybe it’s simply related to the decline in average human body size that started about 10,000 years ago, the dawn of the Agricultural Revolution.

I’d credit the SciAm author but can’t figure out who it is. A quote:

The way we live may have affected brain size. For instance, domesticated animals have smaller brains than their wild counterparts probably because they do not require the extra brainpower that could help them evade predators or hunt for food. Similarly, humans have become more domesticated.

Discovery magazine looked at shrinking brains in 2010.

Steve Parker, M.D.

Segmented Sleep: Our Ancestral Pattern?

klkjh

Richard Wrangham estimates hominins tamed fire and started cooking with it 1.8 million years ago

I heard about segmented sleep a couple years ago. The idea is that you sleep for maybe three hours, then get up and putter around for two or three hours, then go back to sleep for another three or four hours.

The easy availability of light after sunset has changed our sleeping patterns only recently, on an evolutionary scale. Before we had electric lights, candles, oil and gas lamps, our only sources of artificial light after sundown were campfires and short-lived torches.

Karen Emslie has an article on segmented sleep at Aeon. A snippet:

Before electric lighting, night was associated with crime and fear – people stayed inside and went early to bed. The time of their first sleep varied with season and social class, but usually commenced a couple of hours after dusk and lasted for three or four hours until, in the middle of the night, people naturally woke up. Prior to electric lighting, wealthier households often had other forms of artificial light – for instance, gas lamps – and in turn went to bed later. Interestingly, Ekirch found less reference to segmented sleep in personal papers from such households.

For those who indulged, however, night-waking was used for activities such as reading, praying and writing, untangling dreams, talking to sleeping partners or making love. As Ekirch points out, after a hard day of labouring, people were often too tired for amorous activities at ‘first’ bedtime (which might strike a chord with many busy people today) but, when they woke in the night, our ancestors were refreshed and ready for action. After various nocturnal activities, people became drowsy again and slipped into their second sleep cycle (also for three or four hours) before rising to a new day. We too can imagine, for example, going to bed at 9pm on a winter night, waking at midnight, reading and chatting until around 2am, then sleeping again until 6am.

Think about this if you have insomnia that wakes you in the middle of the night and you can’t get back to sleep. It may not be a detrimental condition that requires medication or other intervention. Can you really win a fight with a million years of evolution?

RTWT.

Steve Parker, M.D.

QOTD: Walter Voegtlin on Intellectual Independence

If this book must be dedicated to someone, it should be to the occasional man, woman, or child who still can resist the specious authority of food merchants, their lavish advertisements and spectacular television commercials, and retain sufficient intellectual independence to think for themselves.

—Walter L. Voegtlin, M.D., F.A.C.P., in The Stone Age Diet (1975)

Anne Hathaway Abandons Vegan Diet for Low-Carb Paleo

I don’t generally follow lifestyles of the rich and famous, but if you do, here you go.

“Hathaway” always makes me think of the Beverly Hillbillies, which gives you an idea how old I am. The Beverly Hills movie is a good one, too. It’ll teach you how to do the “California howdy.”

My wife and I are going to Hathaway’s latest movie tonight: Interstellar. I hear it’s best in the IMAX format.

Steve

Listen to Low-Carb Diet Proponents Franziska Spritzler and Dr. Troy Stapleton

Who says low-carb paleo diets are mostly meat?

Who says low-carb paleo diets are mostly meat?

Jimmy Moore posted an interview with Dr. Troy Stapleton and Franziska Spritzler, R.D. These two wouldn’t consider themselves paleo diet gurus by any means. They advocate carbohydrate-restricted diets for management of blood sugars in diabetes, consistent with my approach in the Paleobetic Diet. Dr. Stapleton might argue I allow too many carbohydrates. By the way, he has type 1 diabetes; I’ve written about him before. Franziska is available for consultation either by phone, Skype, or in person.

Steve Parker, M.D.

David Spero, RN, Makes the Case for Tight Blood SugarControl

at Diabetes Self-Managment.

Steve Parker MD, paleobetic diet,

Reduce retinopathy risk with good blood sugar control

David writes:

Two famous studies showed that tight control of glucose did not cause a statistically significant reduction in heart attacks or early death. But roughly 20 years after the studies ended, tight control subjects are living longer and healthier than those who were in the comparison groups.

Those two famous studies, however, did originally show evidence of better eye, nerve, and kidney function via good control.

Steve Parker, M.D.