No Surprise: U.S. Women Getting Fatter

From the Journal of Obesity:

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…. 10-year weight gain is substantially greater in US women compared to men. On average (±SE), women gained 5.4 ± 0.3 kg and 9.2 ± 0.4 percent of their initial weight over the previous 10 years, whereas men gained 2.6 ± 0.2 kg and 3.8 ± 0.3 percent of their initial weight. In general, compared to US men, women gained about twice as much weight (kg) and 2.4 times more weight expressed as a percent of initial weight, over the previous 10 years. Fourth, 10-year weight gain is significantly higher in Non-Hispanic Blacks than in other racial groups, especially NH [non-Hispanic] Black women. Moreover, 10-year weight gain is significantly lower in Non-Hispanic Asians compared to other racial categories.

If you think in pounds instead of kilograms, like me, note that 1 kg = 2.2 lb.

Since 2000, U.S. obesity in adults has increased from 30% to 42% of the population. This doesn’t even include suspected pandemic-related weight gain.

Mean 10-year weight gain was 4.2 ± 0.2 kg or 6.6 ± 0.2% of initial body weight within the United States. 

The incidence of severe obesity had increased from 5% in 2000 to almost 10% now. (The article likely defines “severe obesity” but I didn’t catch it in my quick scan.)

Not enough Americans are implementing my Paleobetic Diet!

Steve Parker, M.D.

Would Vitamin D Supplementation Prevent Fractures in the Healthy Adult Population?

No. Vitamin D supplementation of 2000 IU/day does not prevent fractures in the general population of healthy midlife and older adults.

The study at NEJM.

Steve Parker, M.D.

Permanent Adipose Breasts in Women Is a Uniquely Human Trait

Photo by MART PRODUCTION on Pexels.com

Discover Magazine has an article on the evolutionary role of non-pregnant human female breasts.

From Biological Reviews of the Cambridge Philosophical Society:

ABSTRACT

The possession of permanent, adipose breasts in women is a uniquely human trait that develops during puberty, well in advance of the first pregnancy. The adaptive role and developmental pattern of this breast morphology, unusual among primates, remains an unresolved conundrum. The evolutionary origins of this trait have been the focus of many hypotheses, which variously suggest that breasts are a product of sexual selection or of natural selection due to their putative role in assisting in nursing or as a thermoregulatory organ. Alternative hypotheses assume that permanent breasts are a by-product of other evolutionary changes. We review and evaluate these hypotheses in the light of recent literature on breast morphology, physiology, phylogeny, ontogeny, sex differences, and genetics in order to highlight their strengths and flaws and to propose a coherent perspective and a new hypothesis on the evolutionary origins of perennially enlarged breasts in women. We propose that breasts appeared as early as Homo ergaster, originally as a by-product of other coincident evolutionary processes of adaptive significance. These included an increase in subcutaneous fat tissue (SFT) in response to the demands of thermoregulatory and energy storage, and of the ontogenetic development of the evolving brain. An increase in SFT triggered an increase in oestradiol levels (E2). An increase in meat in the diet of early Homo allowed for further hormonal changes, such as greater dehydroepiandrosterone (DHEA/S) synthesis, which were crucial for brain evolution. DHEA/S is also easily converted to E2 in E2-sensitive body parts, such as breasts and gluteofemoral regions, causing fat accumulation in these regions, enabling the evolution of perennially enlarged breasts. Furthermore, it is also plausible that after enlarged breasts appeared, they were co-opted for other functions, such as attracting mates and indicating biological condition. Finally, we argue that the multifold adaptive benefits of SFT increase and hormonal changes outweighed the possible costs of perennially enlarged breasts, enabling their further development.


Steve Parker, M.D.

Recipe: Adam Piggotts’ Insalata di Cavolo Capuccio (green cabbage salad)

Photo by freestocks.org on Pexels.com

I have posted one or more cabbage recipes on this blog. Use the search box if interested.

When I was a wee lad, my mother never served cabbage. Don’t know why.

Adam Piggott is a good writer. He claims he has the best cabbage recipe ever. Here ’tis:

Ingredients:

  • 1 fresh green cabbage
  • Salt
  • Cumin
  • Apple [cider] vinegar
  • Extra virgin olive oil.

Remove the rough outside leaves of the cabbage and then cut it into quarters. Using a mandoline slicer or a grater, carefully shave the cabbage as thinly as possible. 

Now add the other ingredients in the order in which I listed them. Then mix well together and leave to sit for a few hours. Yes, a few hours and the longer the better. A minimum of one hour but if you can leave it all afternoon then you will thank me. This is why I was worried about them running out at the lunch. The cabbage will release some fluids over this time. Check for seasoning and olive oil before serving as you may have to add a little more.

His original post didn’t include specific amounts of most ingredients. Adam elaborated in the comments section:

Yes, the amounts are the issue here and it is what makes this a unique dish. Salt is the key. I use a large salt grinder which you can see in the last photo. I had half a cabbage for lunch and I would say that I used a good half tablespoon of salt. I added a little more at the end. Remember though with salt – you can always add more but you can’t take any away.

I used a quarter teaspoon of cumin. You’re just after a hint of the taste there. A small splash of the vinegar. Too much vinegar becomes overpowering; you can always add more later if you think you need it. Olive oil you can give it a good splash. Looking at the bowl of cabbage you should not see any liquid oozing out of the bottom. If you do then you have used too much oil or vinegar.

You can definitely refrigerate it but you don’t have to. If you do then you should cover it with cling film.

Read Adam’s entire post. It’s not long. You won’t regret it.

Steve Parker, M.D.

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This cabbage soup only has 9 grams of digestible carbohydrate per 2-cup serving. Use the search box for the recipe.

Recipe: Are Salads Low-Carb?

Hamburger-Avocado Salad with tomatoes, cucumbers, lettuce, salt/pepper, and olive oil vinaigrette

They can be. 20 recipes from Diet Doctor:

Many people think of salads as boring diet food that will leave you hungry and unsatisfied. But we disagree. Our keto salad recipes are rich in protein — and they’re filled with nutrition, flavors, and healthy fats to keep you fueled all day long.

Steve Parker, M.D.

“Cellular Exercise” May Be the Key to Longevity

Photo by Fayette Reynolds M.S. on Pexels.com

London researchers introduce the concept of “cellular exercise.”

Nutritional discipline and dietary restriction result in resistance exercise for our cells. Triggered by calorie restriction or physical exercise, our cells end up producing transcription factors that lead to protection against oxidation, inflammation, atherosclerosis, and carcinogenic proliferation. In the long-term, this results in longevity and a decrease in cancer, T2DM [type 2 diabetes], myocardial infarction, and stroke. Since centuries past, studies on humans, rhesus monkeys, and multilevel organisms have demonstrated the benefits of calorie restriction without malnutrition. Periodic fasting and calorie restriction show increases in regeneration markers and decreases in biomarkers for diabetes, CVD [cardiovascular disease], cancer, and aging.

The present review concluded that longevity can be increased through moderation of diet and exercise. Research shows that a concoction of the diverse diets modernly popularized— MED [Mediterranean], DASH, high-protein diets±—tempered by overall calorie restriction through periodic fasting or chronic calorie restriction, will provide protection against CVD, cancer, and aging. Exercise has also been shown to increase longevity in the general population, lower incidence of diabetes and cancer, and produce psychological benefits.

This review of research indicates that incorporating a moderate caloric restriction or fasting regimen could provide substantial benefits at low risk. Cellular exercise through calorie restriction and physical exercise can increase longevity and prevent the greatest killers of human society today—stroke and heart disease.


Caloric restriction is a form of hormesis. If interested, read more about it in free article from Journal of Physiological Anthropology.

Steve Parker, M.D.

Your Proton Pump Inhibitor May Be Hurting You

I have nothing against Prilosec in particular. It can be very helpful. It’s one of several PPIs on the market.

Proton Pump Inhibitor drugs (PPIs) greatly reduce the production of acid in the stomach. They revolutionized and improved the treatment of ulcers in the stomach and duodenum. When I started medical practice in 1981, I saw many patients who had required stomach surgery to treat their ulcers. Remember the good ol’ Billroth procedures? Of course you don’t. The first PPI approved for use in the US. was cimetidine (Tagamet) in 1979.

But wait, you say. “Isn’t there a reason we have stomach acid in the first place?” Good question! Because if we reduce stomach acid, it may cause problems. Regardless of what acid contributes to food digestion, it also kills germs in food and water. Germs that may kill us if ignored. Most of us in the developed world would be horrified to drink untreated water out of a lake, stream, river, or spring. But what do you think Homo sapiens did for most our 200,000 years of our existence?

From Joe Alcock, M.D.:

Omeprazole was made over the counter in 2003 but I don’t think these drugs should ever have been made available without prescription. PPIs are powerful drugs that treat heartburn by reducing gastric acid production. This is accomplished by PPI binding to the hydrogen/potassium ATPase enzyme on gastric parietal cells lining the stomach. PPIs do more than block acid. They are associated with an increased risk of congestive heart failure, kidney disease, long bone fractures, and dementia, vitamin B12 deficiency, reviewed here. Regular use of proton pump inhibitors is associated with increased incidence of type two diabetes, about 24% higher compared to non-users of the drug. Proton pump inhibitors are also linked an with increased risk of small intestinal bacterial overgrowth (which is a clue as to why these drugs can be harmful). They also increase the risk of infection by Clostridiales difficile by about 2x.

Most of these individual observational studies are unable to establish causation, but the preponderance of evidence points to PPIs causing harm.

Dr Alcock also found evidence that PPI users who catch COVID-19 have 1.6x increased risk for severe disease and death.

If you’re prescribed a PPI for chronic use, check with your physician to see if you still need it. Occasional use for heartburn shouldn’t be a problem. For chronic heartburn, consider a low-carb diet and stop nocturnal alcohol consumption.

Steve Parker, M.D.

Books on Type 1 Diabetes

Diabetes Daily has an article by Julia Flaherty that reviews books regarding type 1 diabetes. Just thought you might be interested. It didn’t discuss Cheating Destiny: Living with Diabetes, which I am mentioned in.

Steve Parker, M.D.

Tirzepatide for Weight Loss

The drug is not approved for infants

Here’s the evidence at New England Journal of Medicine for tirzepatide for weight loss. It is a once-weekly injection. Cost? Unknown to me.

At baseline, the mean body weight was 104.8 kg, the mean BMI was 38.0, and 94.5% of participants had a BMI of 30 or higher. The mean percentage change in weight at week 72 was −15.0% (95% confidence interval [CI], −15.9 to −14.2) with 5-mg weekly doses of tirzepatide, −19.5% (95% CI, −20.4 to −18.5) with 10-mg doses, and −20.9% (95% CI, −21.8 to −19.9) with 15-mg doses and −3.1% (95% CI, −4.3 to −1.9) with placebo (P<0.001 for all comparisons with placebo). The percentage of participants who had weight reduction of 5% or more was 85% (95% CI, 82 to 89), 89% (95% CI, 86 to 92), and 91% (95% CI, 88 to 94) with 5 mg, 10 mg, and 15 mg of tirzepatide, respectively, and 35% (95% CI, 30 to 39) with placebo; 50% (95% CI, 46 to 54) and 57% (95% CI, 53 to 61) of participants in the 10-mg and 15-mg groups had a reduction in body weight of 20% or more, as compared with 3% (95% CI, 1 to 5) in the placebo group (P<0.001 for all comparisons with placebo).

Three to 7% of users stopped the drug due to side effects.

Click for a Diabetes Daily article about the drug.

Steve Parker, M.D.

PS: Let me help with weight loss.

Eggs and Portobello Mushrooms for Breakfast?

Click for the recipe.

That looks scrumptious to me! (That’s a word, right?) And it’s fairly paleo-compliant.

My wife and daughter would never try this. There’s just something about mushrooms, they say. Can’t even stand the smell.

Posting this here for future reference. Just a matter of time…

Steve Parker, M.D.

h/t Jan at The Low Carb Diabetic blog.