Half of U.S. Adults Trying (and Failing) to Lose Weight

No wonder they’re not having much success:

“Exercise, eating less, consuming more fruits and vegetables and drinking more water were the most common strategies. The least common were skipping meals and cutting down on fatty foods.”

Source: Nearly Half of Americans Battling to Lose Weight: CDC Data – Bloomberg Quint

Drinking more water? Come on, America, get serious.

Jane Brody Asks: Is the Paleo Diet Right for You?

Not your average cave-woman

Jane Brody at the New York Times wrote an article critical of the paleo diet. One of her objections is that average life spans in the pre-agricultural era were hardly longer than 40 years, so we have no idea what effect the paleo diet would have on longevity and prevention of late-onset “diseases of civilization.”

She writes:

Keep in mind that the life expectancy of people before the advent of agriculture 15,000 years ago rarely reached or exceeded 40, so their risk of developing the so-called diseases of civilization is unknown.

First of all, the widespread adoption of agriculture is thought to have occurred 10-12,000 years ago, not 15,000 years.

Secondly, even in 1900 average life span in the U.S. was only 47 years.

But read her entire article for yourself. She didn’t change my mind.

Steve Parker, M.D.

 

Omega-3 Fatty Acids Have No Effect on Cardiovascular Disease After All

Salmon, a cold-water fatty fish, is a rich source of omega-3 fatty acids

That headline is the conclusion of a Cochrane systematic review of the evidence. As you read the summary below, be aware that the main omega-3 fatty acids are alpha-lenolinic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).

From Cochrane Library:

Increasing EPA and DHA has little or no effect on all‐cause deaths and cardiovascular events (high‐quality evidence) and probably makes little or no difference to cardiovascular death, coronary deaths or events, stroke, or heart irregularities (moderate‐quality evidence, coronary events are illnesses of the arteries which supply the heart). EPA and DHA slightly reduce serum triglycerides and raise HDL (high‐quality evidence).

Eating more ALA (for example, by increasing walnuts or enriched margarine) probably makes little or no difference to all‐cause or cardiovascular deaths or coronary events but probably slightly reduce cardiovascular events, coronary mortality and heart irregularities (moderate/low‐quality evidence). Effects of ALA on stroke are unclear as the evidence was of very low quality.

There is evidence that taking omega‐3 capsules does not reduce heart disease, stroke or death. There is little evidence of effects of eating fish. Although EPA and DHA reduce triglycerides, supplementary omega‐3 fats are probably not useful for preventing or treating heart and circulatory diseases. However, increasing plant‐based ALA may be slightly protective for some heart and circulatory diseases.

Source: Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease – Abdelhamid, AS – 2018 | Cochrane Library

Does a Modified Paleo Diet Improve Multiple Sclerosis Patients?

Dr. Terry Wahls saw a dramatic and major improvement in her multiple sclerosis after adopting a particular diet. I think she’s calling it a modified paleo diet and it was used in the study linked below. I haven’t read the whole thing yet, but you can see the entire journal article at the link below.

From YouTube:


Note this is a small pilot study with no control group. At first blush, it appears her dramatic diet-related improvement may be difficult to reproduce in others.

Effects of a multimodal intervention on gait and balance of subjects with progressive multiple sclerosis: a prospective longitudinal pilot study

Authors: Babita Bisht, Warren G Darling, Emily C White, Kaitlin A White, E Torage Shivapour, M Bridget Zimmerman, and Terry L Wahls

Purpose

To investigate the effects of a multimodal intervention including a modified Paleolithic diet, nutritional supplements, stretching, strengthening exercises with electrical stimulation of trunk and lower limb muscles, meditation and massage on walking performance and balance of subjects with progressive multiple sclerosis (MS).

Materials and methods

Twenty subjects with mean (standard deviation) age of 51.7 (6.4) years and Expanded Disability Status Scale score of 6.2 (1) participated in a 12-month study. Assessments were completed at baseline, 3, 6, 9, and 12 months.

Results

The entire cohort did not show significant changes in any of the assessments over 12 months except higher speed of walking toward the 10 feet mark during timed up and go (TUG) test at 6 months compared with baseline (mean change 7.9 cm/s [95% confidence interval {CI}]: 0.3, 15.2; p=0.041). Sub-group analysis revealed that 50% subjects (n=10) showed decrease in TUG time from baseline to at least 3 of 4 time-points post-intervention and were considered as responders (TUG-Res), the remaining 10 subjects were considered as nonresponders (TUG-NRes). Over 12 months, TUG-Res showed decreased mean TUG time by 31% (95% CI: −52%, −2%), increased median Berg Balance Scale scores (42 to 47), 30% increase in mean timed 25-foot walk speed (>20% considered clinically significant) and increased speed of walk toward 10 feet mark during TUG by 11.6 cm/s (95% CI: −3.0, 25.9) associated with increases in step lengths and decrease in step duration. TUG-NRes showed deterioration in walking ability over 12 months. Comparison of TUG-Res and TUG-NRes showed no significant differences in adherence to intervention but better stride duration and longer step length at baseline for TUG-Res than for TUG-NRes (p<0.05).

Conclusion

A multimodal lifestyle intervention may improve walking performance and balance in subjects with progressive MS who have mild-to-moderate gait impairment, whereas subjects with severe gait impairments may not respond to this intervention. Future trials should assess effects of this intervention in subjects with MS during early stages of the disease.

Source: Effects of a multimodal intervention on gait and balance of subjects with progressive multiple sclerosis: a prospective longitudinal pilot study

Half of U.S. Adults Trying to Lose Weight

No wonder we’re so fat:

“Exercise, eating less, consuming more fruits and vegetables and drinking more water were the most common strategies. The least common were skipping meals and cutting down on fatty foods.”

Source: Nearly Half of Americans Battling to Lose Weight: CDC Data – Bloomberg Quint

Drinking more water? Come on, America, get serious. And it’s the rare person indeed who can lose with with exercise. You don’t have to cut down on fatty foods.

Paleobetic Diet-FrontCover_300dpi_RGB_5.5x8.5

 

 

Do Supplements Work for Osteoarthritis?

Steve Parker MD

Does running promote osteoarthritis. Probably not.

Science Based Medicine has a new article on supplements for osteoarthritis pain. A snippet:

“Based on their review, the authors do not recommend omega-3 fatty acids, vitamins D and E, willow bark extract, collagen hydrolysate, glucosamine, chondroitin, combinations of glucosamine and chondroitin, and rose hip. Based on the review, Boswellia serrata extract and pycnogenol appear to demonstrate the most clinically important effects. They also note that while curcumin and MSM demonstrated clinically important effects, the quality of that evidence was low.”

Furthermore…

“The authors conclude that those with osteoarthritis those that are enthusiastic about using supplements, short-term trials of the pycnogenol, curcumin, Boswellia serrata extract, or MSM could be attempted, and should be discontinued after 4-6 weeks if no obvious benefits are noted. Importantly, drug-supplement interactions are not always well understood or well documented, and any supplement should be used with caution (and preferably, consultation with their pharmacist) if being combined with prescription or non-prescription drugs. There is also the very real concerns about supplement quality and batch-to-bath consistency, which complicates evaluations of risk, and determining whether or not they work.”

The SBM writer (Scott Gavura, a pharmacist) also points out the benefits of ongoing exercise, appropriate weight loss, and topical nonsteroidal anti-inflammatory drugs (e.g., diclofenac). IIRC, there’s good evidence that topical capsaicin also helps with the pain.

Source: Supplements for Osteoarthritis – Evaluating the Evidence – Science-Based Medicine

Need help with weigh loss?

Are Pills the Answer to Unhealthy Lifestyles?

paleobetic diet, low-carb diet, diabetic diet

“This is much easier than exercising and losing 30 pounds!”

Fiona Godlee, editor-in-chief of the British Medical Journal, has a heretical short article at BMJ. I recommend you read the whole thing. It starts thusly:

More than half of adults aged over 45 will be labelled as hypertensive if new US guidelines are adopted, concludes a study in The BMJ this week (doi:10.1136/bmj.k2357). This equates to 70 million people in the US and 267 million people in China being eligible for antihypertensive drugs, a marked increase on already high rates of drug treatment for high blood pressure. Furthermore, the study calculates that 7.5 million people in the US and 55 million in China would be advised to start drug treatment, while 14 million in the US and 30 million in China would be advised to receive more intensive treatment. The evidence from trials indicates some benefit from drugs in terms of reduced risk of stroke and heart disease, but is mass medication really what we want?

Hypertension is just one of the many heads of the lifestyle disease hydra. Another is type 2 diabetes. Once thought to be irreversible and progressive, it is now known to be potentially reversible through weight loss. This is the cautious conclusion of the review by Nita Forouhi and colleagues (doi:10.1136/bmj.k2234), part of our series on the science and politics of nutrition (bmj.com/food-for-thought). Whether by calorie or carbohydrate restriction, weight loss has been shown to improve glycaemic control, blood pressure, and lipid profile and is the key to treatment and prevention of type 2 diabetes, they say.

She goes on to talk about fatty liver disease (NASH) and offers an alternative, of sorts, to pills. Good luck with that.

Source: Pills are not the answer to unhealthy lifestyles | The BMJ

The dawn of bread, 14,000 years ago

Archaeologists working at Shubayqa 1, a site in northeastern Jordan, found tiny fragments of an ancient unleavened bread as they were excavating a hearth. The site was made by people of the Natufian culture, 14,400 years ago. The paper describing the discovery, by Amaia Arranz-Otaegui and coworkers, documents the use of a mixed unleavened dough to make bread more than 4000 years before the introduction of agriculture in this region of the world.

Source: The dawn of bread · john hawks weblog

Low-Carb Diet for Diabetes

This Avocado Chicken soup is low-carb. Use the search box to find the recipe.

Over at Diabetes Daily, Dr Maria Muccioli wrote about recent low-carb diet research as applied to diabetes, as discussed at a recent meeting of the American Diabetes Association. A couple excerpts to whet your appetite:

Dr. Tay stated that a very low carbohydrate diet offers a considerable advantage over a high carbohydrate approach for patients with type 2 diabetes.She noted that reducing medication use is not only cost-effective but can also safeguard from the considerable side effects of some second-line medications. She also explained that achieving less glycemic variability, which may be an independent risk factor for the development of diabetes-associated complications, is “of great clinical importance.”“It is a good diet to have if you have diabetes, and the data support that,” she concluded.

  *   *   *

What about VLC diet for children with type 1 diabetes?

Dr. de Bock does not deny that a VLCD for children with type 1 diabetes can help to achieve exceptional glycemic control, as recently demonstrated in a study showing normal average A1c levels in a large cohort of patients. The speaker remarked that the patients in that study had very low glycemic variability.

He believes that more research needs to be conducted to evaluate the relevance of the potential concerns that he outlined. Until then, he advises parents of children who follow a VLCD to work closely with their medical care providers to monitor growth, cardiac, nutritional, and mental/emotional parameters.

Source: Very Low Carbohydrate Diets for Diabetes (ADA 2018)

Are 4 of 10 Dietary Research Results Wrong?

paleo diet, paleolithic diet, caveman diet

Spewing mis-information?

It wouldn’t surprise me. That’s why I’m not as dogmatic as some of the other diet gurus out there. Patrick Clinton writes:

“There’s a reason everyone’s confused about whether coffee causes cancer, or whether butter’s good for you or bad. Food research has some big problems, as we’ve discussed here and here: questionable data,  untrustworthy results, and pervasive bias (and not just on the part of Big Food). There’s reason to hope that scientists and academic journals will clean up their acts, and that journalists will refine their bullshit detectors and stop writing breathlessly about new nutrition “discoveries” that are anything but.  Until that happens, though, we all need to get better at filtering for ourselves.”

Source: Almost 40% of peer-reviewed dietary research turns out to be wrong. Here’s why | New Food Economy