Diet Can Prevent Chronic Kidney Disease and Albuminuria

Folks with diabetes are at risk for chronic kidney disease, often heralded by albumin (a protein) in the urine.

The heathy diet describe in this Renal and Urology News article sounds like the Mediterranean diet to me, not a typical paleo diet. It will be years, if ever, before the paleo diet is tested as a preventative for chronic kidney disease. But anyway…

Adhering to a healthy diet may reduce the risk of chronic kidney disease (CKD) and albuminuria, according to a new systematic review and meta-analysis.

Such a diet is rich in vegetables, fruit, legumes, nuts, whole grains, fish, and low-fat dairy products and low in red and processed meats, sodium, and sugar-sweetened beverages.

Jaimon T. Kelly, PhD, of Bond University in Australia, and collaborators, analyzed 18 studies that included a total of 630,108 healthy adults followed for a mean 10.4 years. Their meta-analysis of low to moderate grade studies found that a healthy dietary pattern was associated with a 30% lower incidence of CKD and a 23% lower incidence of albuminuria, according to results published in the Clinical Journal of the American Society of Nephrology.

The dietary patterns that were most frequently studied included the Mediterranean diet, DASH (Dietary Approaches to Stop Hypertension) diet, and US dietary guidelines.

Source: Healthy Diet May Prevent CKD, Albuminuria – Renal and Urology News

Steve Parker, M.D.

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Red Meat Not Quite as Deadly as Imagined

From New York Times:

Public health officials for years have urged Americans to limit consumption of red meat and processed meats because of concerns that these foods are linked to heart disease, cancer and other ills.

But on Monday, in a remarkable turnabout, an international collaboration of researchers produced a series of analyses concluding that the advice, a bedrock of almost all dietary guidelines, is not backed by good scientific evidence.

Whew…What a relief! Dodged that bullet.

Click for Gina Kolata’s article.

Steve Parker, M.D.

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Eat Nuts to Prevent Weight Gain Over the Years

Remember…peanuts aren’t nuts, they’re legumes

Nuts are a staple of most paleo diets, including mine.

From NPR:

Eating a handful of almonds, walnuts, peanuts or any type of nut on a regular basis may help prevent excessive weight gain and even lower the risk of obesity, new research suggests.

It may be that substituting healthy nuts for unhealthy snacks is a simple strategy to ward off the gradual weight gain that often accompanies aging, according to the researchers. Nuts also help us feel full longer, which might offset cravings for junk food.Researchers looked at the diet and weight of more than 280,000 adults taking part in three long-term research studies. Over more than 20 years of monitoring, participants were asked every four years about their weight and, among other things, how often, over the preceding year, they had eaten a serving (about one ounce) of nuts.

Source: Just A Handful Of Nuts May Help Keep Us From Packing On The Pounds As We Age : The Salt : NPR

Steve Parker, M.D.

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Raman May Increase Risk of Fatal Stroke

…at least if you’re Japanese. I rarely eat ramen, but understand it’s fairly popular among young adults in the U.S, particularly among college students, because it’s cheap, quick, and tasty.

Click for details of the study in Nutrition Journal. Some background from the article:

Ramen is one of the most popular foods in Japan, despite being of Chinese origin [11]. Since its original introduction in Japan, ramen has been adapted and now consists of wheat noodles served in broth topped with sliced pork, seaweed, or menma (a Japanese condiment made from lacto-fermented bamboo shoots; Additional file 1). Being tasty and inexpensive, ramen became a popular food that was available from street food stands in Japan after World War ΙΙ. Although the number of ramen stands has decreased markedly, ramen remains highly popular in Japan. High dietary sodium content was recently reported to be a risk factor for stroke [12]; ramen has a high sodium content. However, the relationship between stroke and ramen consumption remains unclear. In this study, we investigated the association between the number of ramen restaurants in each Japanese prefecture and stroke mortality in that prefecture.

Steve Parker, M.D.

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Eat Nuts to Prevent Weight Gain

Paleobetic diet

Macadamia nuts

From NPR:

Eating a handful of almonds, walnuts, peanuts or any type of nut on a regular basis may help prevent excessive weight gain and even lower the risk of obesity, new research suggests.

It may be that substituting healthy nuts for unhealthy snacks is a simple strategy to ward off the gradual weight gain that often accompanies aging, according to the researchers. Nuts also help us feel full longer, which might offset cravings for junk food.

Researchers looked at the diet and weight of more than 280,000 adults taking part in three long-term research studies. Over more than 20 years of monitoring, participants were asked every four years about their weight and, among other things, how often, over the preceding year, they had eaten a serving (about one ounce) of nuts.

Source: Just A Handful Of Nuts May Help Keep Us From Packing On The Pounds As We Age : The Salt : NPR

Steve Parker, M.D.

PS: All of my published diets—since 2007—feature nuts.

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A “New” Theory of Obesity From Kevin Hall

paleo diet, paleolithic diet, caveman diet

Not Kevin Hall

At Scientific American:

Nutrition researcher Kevin Hall strives to project a Zen-like state of equanimity. In his often contentious field, he says he is more bemused than frustrated by the tendency of other scientists to “cling to pet theories despite overwhelming evidence that they are mistaken.” Some of these experts, he tells me with a sly smile, “have a fascinating ability to rationalize away studies that don’t support their views.”

Among those views is the idea that particular nutrients such as fats, carbs or sugars are to blame for our alarming obesity pandemic. (Globally the prevalence of obesity nearly tripled between 1975 and 2016, according to the World Health Organization. The rise accompanies related health threats that include heart disease and diabetes.) But Hall, who works at the National Institute of Diabetes and Digestive and Kidney Diseases, where he runs the Integrative Physiology section, has run experiments that point fingers at a different culprit. His studies suggest that a dramatic shift in how we make the food we eat—pulling ingredients apart and then reconstituting them into things like frosted snack cakes and ready-to-eat meals from the supermarket freezer—bears the brunt of the blame. This “ultraprocessed” food, he and a growing number of other scientists think, disrupts gut-brain signals that normally tell us that we have had enough, and this failed signaling leads to overeating.

*  *  *

At the end of the 19th century, most Americans lived in rural areas, and nearly half made their living on farms, where fresh or only lightly processed food was the norm. Today most Americans live in cities and buy rather than grow their food, increasingly in ready-to-eat form. An estimated 58 percent of the calories we consume and nearly 90 percent of all added sugars come from industrial food formulations made up mostly or entirely of ingredients—whether nutrients, fiber or chemical additives—that are not found in a similar form and combination in nature. These are the ultraprocessed foods, and they range from junk food such as chips, sugary breakfast cereals, candy, soda and mass-manufactured pastries to what might seem like benign or even healthful products such as commercial breads, processed meats, flavored yogurts and energy bars.

Wasn’t David Kessler, M.D., saying the same things ten years ago?

Here’s another new theory from me: If you had to kill and butcher your own animals, you’d eat less.

Steve Parker, M.D.

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Our Skulls Have Been Changing for the Last 20,000 Years, Not Necessarily for the Better

Wide-set teeth and prominent jaw

Did you know that human brains have been shrinking over the last 10,000 to 20,000 years?

Other parts of our heads have also been changing. An article at OneZero has some of the details, with a focus on breathing problems that interfere with sleep in children:

Skeletal records show that for hundreds of thousands of years, people had beautiful skulls: straight teeth, wide jaws, forward faces, large airways. Robert Corruccini, an emeritus anthropology professor at Southern Illinois University, found perfectly straight teeth and wide jaws in children’s skulls from pre-Roman times among Etruscan remains in southern Italy.

Then, about 250 years ago, our faces began to change. Boyd argues that industrialization interrupted the ancestral patterns of weaning and feeding, with babies nursing on demand for years while also trying solid foods under adults’ watchful eyes. Boyd says that the widespread adoption of bottle feeding, pacifiers and soft processed food deprived toddlers of practice chewing and distorted the shapes of their mouths. (“In modern society you have Gerber’s baby food,” Corruccini told me. “Etruscan kids had to chew once they were getting off breast milk. Babies have remarkably powerful chewing capabilities.”) Just like diabetes and heart disease, malocclusion — the misalignment of jaws and teeth — followed industrialization around the globe. Meanwhile, people in societies that never industrialized enjoyed well-aligned teeth and jaws.

*  *  *

There is no easy way to turn back the evolution of our skulls. It’s unrealistic to advise parents to eschew processed food, breastfeed longer, move to open-air cabins in the country, or perhaps put children on the Paleo diet to prevent these changes taking hold in the skulls of the next generation. We are stuck with our smaller modern faces, but there are steps we can take to address the conditions that come with them.

Source: Our Skulls Are Out-Evolving Us – OneZero

Steve Parker, M.D.

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Tighter Blood Pressure Control Benefits Folks With Diabetes

Not bad

For decades, physicians thought a blood pressure of under 140/90 was adequate for preventing heart attacks, strokes, and premature death. Not so.

From Diabetes Self-Management:

The new study evaluated roughly 11,000 people with type 2 diabetes in 20 countries over four years, finding that those who received the blood pressure drugs perindopril and indapamide to keep their blood pressure levels at or below 130/80 had fewer heart attacks, strokes and other complications than those receiving placebo (inactive treatment). They also had a “lower overall risk of dying from any cause.”

Source: Tight Blood Pressure Control Benefits Type 2 Diabetes: Study – Diabetes Self-Management

You may think the aforementioned health benefits stem from use of perindopril and/or indapamide. It’s either that, or simply the result of BP lowering. I suspect it’s the latter while admitting that not all BP drugs are created equal. As a hospitalist in Scottsdale, AZ, I rarely run across patients taking perindopril, and only occasionally folks on indapamide. The popularity of various drugs often depends on which part of the country you’re in and the attractiveness of the drug reps visiting the prescribers. We need to be more scientific than that.

Steve Parker, M.D.

PS: Losing excess weight and exercise are two ways to lower blood pressure without the expense and side effects of drugs.

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Fitness Markers Deteriorate After Just Two Weeks of Sedentary Behavior

Starting a hundred-yard dash

From UPI:

A new study proves that the old adage “use it or lose it” is definitely true when it comes to fitness.After just two weeks of sedentary behavior, formerly fit people had:

—A decline in heart and lung health

—Increased waist circumference

—Greater body fat and liver fat

—Higher levels of insulin resistance

Source: Study: Two weeks of no exercise enough to damage fit people’s bodies – UPI.com

It’s a small study, just 28 subjects, so may not be reproducible.

Steve Parker, M.D.

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Does Calcium Consumption Help Prevent Brittle Bones in Older Women?

Waste of money and effort?

Due to a lack of milk products, paleo diets may not meet the Recommended Daily Intake of calcium. Your blood must have a certain amount of calcium, and if that level is too low, your bones donate calcium to the bloodstream.

Many physicians worry that inadequate calcium consumption causes or contributes to thin, brittle, easily breakable bones in postmenopausal women. A recent study suggests that calcium intake doesn’t matter.

Abstract

CONTEXT:

Calcium intakes are commonly lower than the recommended levels, and increasing calcium intake is often recommended for bone health.

OBJECTIVE:To determine the relationship between dietary calcium intake and rate of bone loss in older postmenopausal women.

PARTICIPANTS:

Analysis of observational data collected from a randomized controlled trial. Participants were osteopenic (hip T-scores between -1.0 and -2.5) women, aged >65 years, not receiving therapy for osteoporosis nor taking calcium supplements. Women from the total cohort (n = 1994) contributed data to the analysis of calcium intake and bone mineral density (BMD) at baseline, and women from the placebo group (n = 698) contributed data to the analysis of calcium intake and change in BMD. BMD and bone mineral content (BMC) of the spine, total hip, femoral neck, and total body were measured three times over 6 years.

RESULTS:

Mean calcium intake was 886 mg/day. Baseline BMDs were not related to quintile of calcium intake at any site, before or after adjustment for baseline age, height, weight, physical activity, alcohol intake, smoking status, and past hormone replacement use. There was no relationship between bone loss and quintile of calcium intake at any site, with or without adjustment for covariables. Total body bone balance (i.e., change in BMC) was unrelated to an individuals’ calcium intake (P = 0.99).

CONCLUSIONS:

Postmenopausal bone loss is unrelated to dietary calcium intake. This suggests that strategies to increase calcium intake are unlikely to impact the prevalence of and morbidity from postmenopausal osteoporosis.

Source: Dietary Calcium Intake and Bone Loss Over 6 Years in Osteopenic Postmenopausal Women. – PubMed – NCBI

Steve Parker, M.D.

PS: Elderly men get osteoporosis, too. But when the Emergency Department calls me to admit an older patient with a hip fracture, it’s a woman 9 out of 10 times.

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