Category Archives: Longevity

If You Have Type 2 Diabetes, Coffee May Prolong Your Life

Posted on August 21, 2021 | 4 comments
“Is the world shaking, or is it just me?”

Compared to no coffee-drinking, drinking four cups a day reduced overall death rate by 20%, reduced cardiovascular deaths by 40%, and reduced death rate form coronary artery disease by 30%. The study at hand was a meta-analysis involving over 80,000 folks with type 2 diabetes living in multiple studies and followed clinically for 5-20 years. “Cardiovascular deaths” are usually heart attacks, strokes, cardiac arrest, or heart failure.

I vaguely recall a study several decades ago linking coffee to pancreas cancer, one of the deadliest cancers. The research was subsequently discredited.

Is coffee as a drink considered “paleo”? It seems to have originated in Africa, which is considered the cradle of humanity. I’m not sure anybody knows when we started drinking it; maybe 14 centuries ago. It’s possible we chewed it as a stimulant even before that. Extant humans who’ve been drinking four cups a day for many years are unlikely to drop the habit even if it isn’t paleo.

From Nutrition, Metabolism & Cardiovascular Diseases:

Aims

To evaluate the long-term consequences of coffee drinking in patients with type 2 diabetes.

Data synthesis

PubMed, Scopus, and Web of Sciences were searched to November 2020 for prospective cohort studies evaluating the association of coffee drinking with risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes. Two reviewers extracted data and rated the certainty of evidence using GRADE approach. Random-effects models were used to estimate the hazard ratios (HRs) and 95% CIs. Dose–response associations were modeled by a one-stage mixed-effects meta-analysis. Ten prospective cohort studies with 82,270 cases were included. Compared to those with no coffee consumption, the HRs for consumption of 4 cups/d were 0.79 (95%CI: 0.72, 0.87; n = 10 studies) for all-cause mortality, 0.60 (95%CI: 0.46, 0.79; n = 4) for CVD mortality, 0.68 (95%CI: 0.51, 0.91; n = 3) for coronary heart disease (CHD) mortality, 0.72 (95%CI: 0.54, 0.98; n = 2) for CHD, and 0.77 (95%CI: 0.61, 0.98; n = 2) for total CVD events. There was no significant association for cancer mortality and stroke. There was an inverse monotonic association between coffee drinking and all-cause and CVD mortality, and inverse linear association for CHD and total CVD events. The certainty of evidence was graded moderate for all-cause mortality, and low or very low for other outcomes.

Conclusions

Drinking coffee may be inversely associated with the risk of mortality in patients with type 2 diabetes. However, more research is needed considering type of coffee, sugar and cream added to coffee, and history of CVD to present more confident results.

Citation

Steve Parker, M.D.

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Posted in Heart Disease, Longevity, stroke

High Blood Pressure: How Low Should You Go?

Posted on June 13, 2021 | 1 comment
Not a bad monitor

First, remember that blood pressure is reported as two numbers: systolic and diastolic. E.g., 135/92. The first number is the systolic number. A systolic pressure goal of under 120 mmHg may be better than the traditional goal of under 140, at least if you’re “at increased risk for cardiovascular disease.” The study at hand excluded folks with diabetes or prior stroke.

We randomly assigned 9,361 participants who were at increased risk for cardiovascular disease but did not have diabetes or previous stroke to adhere to an intensive treatment target (systolic blood pressure, <120 mm Hg) or a standard treatment target (systolic blood pressure, <140 mm Hg). The primary outcome was a composite of myocardial infarction, other acute coronary syndromes, stroke, acute decompensated heart failure, or death from cardiovascular causes. Additional primary outcome events occurring through the end of the intervention period (August 20, 2015) were adjudicated after data lock for the primary analysis. We also analyzed post-trial observational follow-up data through July 29, 2016.

RESULTS

At a median of 3.33 years of follow-up, the rate of the primary outcome and all-cause mortality during the trial were significantly lower in the intensive-treatment group than in the standard-treatment group (rate of the primary outcome, 1.77% per year vs. 2.40% per year; hazard ratio, 0.73; 95% confidence interval [CI], 0.63 to 0.86; all-cause mortality, 1.06% per year vs. 1.41% per year; hazard ratio, 0.75; 95% CI, 0.61 to 0.92). Serious adverse events of hypotension, electrolyte abnormalities, acute kidney injury or failure, and syncope were significantly more frequent in the intensive-treatment group. When trial and post-trial follow-up data were combined (3.88 years in total), similar patterns were found for treatment benefit and adverse events; however, rates of heart failure no longer differed between the groups.

Click for article abstract at NEJM.

Steve Parker, M.D.

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Posted in Heart Disease, Longevity, stroke

Is “evolutionary-concordance lifestyle” the new “paleo diet”?

Posted on April 28, 2021 | 2 comments

From the March 6, 2021, European Journal of Nutrition:

Sedentary lifestyle NOT an option back then

Purpose:

Evolutionary discordance may contribute to the high burden of chronic disease-related mortality in modern industrialized nations. We aimed to investigate the associations of a 7-component, equal-weight, evolutionary-concordance lifestyle (ECL) score with all-cause and cause-specific mortality.

Methods:

Baseline data were collected in 2003-2007 from 17,465 United States participants in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The ECL score’s components were: a previously reported evolutionary-concordance diet score, alcohol intake, physical activity, sedentary behavior, waist circumference, smoking history, and social network size. Diet was assessed using a Block 98 food frequency questionnaire and anthropometrics by trained personnel; other information was self-reported. Higher scores indicated higher evolutionary concordance. We used multivariable Cox proportional hazards regression models to estimate ECL score-mortality associations.

Results:

Over a median follow-up of 10.3 years, 3771 deaths occurred (1177 from cardiovascular disease [CVD], 1002 from cancer). The multivariable-adjusted hazard ratios (HR) (95% confidence intervals [CI]) for those in the highest relative to the lowest ECL score quintiles for all-cause, all-CVD, and all-cancer mortality were, respectively, 0.45 (0.40, 0.50), 0.47 (0.39, 0.58), and 0.42 (0.34, 0.52) (all P trend < 0.01). Removing smoking and diet from the ECL score attenuated the estimated ECL score-all-cause mortality association the most, yielding fifth quintile HRs (95% CIs) of 0.56 (0.50, 0.62) and 0.50 (0.46, 0.55), respectively.

Conclusions:

Our findings suggest that a more evolutionary-concordant lifestyle may be inversely associated with all-cause, all-CVD, and all-cancer mortality. Smoking and diet appeared to have the greatest impact on the ECL-mortality associations.

Source: A novel evolutionary-concordance lifestyle score is inversely associated with all-cause, all-cancer, and all-cardiovascular disease mortality risk – PubMed

Steve Parker, M.D.

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Posted in Cancer, Heart Disease, Longevity

High Glycemic Index Diet Linked to Cardiovascular Disease and Premature Death

Posted on March 22, 2021 | 1 comment
Low glycemic index meal

Haven’t we know this for years? From a recent New England Journal of Medicine:

Most data regarding the association between the glycemic index and cardiovascular disease come from high-income Western populations, with little information from non-Western countries with low or middle incomes. To fill this gap, data are needed from a large, geographically diverse population.

METHODS

This analysis includes 137,851 participants between the ages of 35 and 70 years living on five continents, with a median follow-up of 9.5 years. We used country-specific food-frequency questionnaires to determine dietary intake and estimated the glycemic index and glycemic load on the basis of the consumption of seven categories of carbohydrate foods. We calculated hazard ratios using multivariable Cox frailty models. The primary outcome was a composite of a major cardiovascular event (cardiovascular death, nonfatal myocardial infarction, stroke, and heart failure) or death from any cause.

RESULTS

In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease.

CONCLUSIONS

In this study, a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death.

Source: Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality | NEJM

The paleo diet is low glycemic index.

Steve Parker, M.D.

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Posted in Heart Disease, Longevity

How to Prevent Age-Related Muscle Loss

Posted on February 23, 2021 | 1 comment
paleo diet, low-carb, Steve Parker MD
This hunter-gatherer snagged himself a brown trout

Axel Sigurdsson, MD, PhD, published a great article on prevention of age-related sarcopenia (loss of muscle mass). Click through for details. To stay vigorous as you age, you should preserve muscle mass and the strength it provides. If you’ve lost muscle mass, you can re-build it. Summary from the good doctor:

Age-related loss of muscle mass (sarcopenia)may start as early as in our thirties and appears to continue for the rest of our lives.

There is also a loss of muscle strength and muscle function. The consequences may often be severe, particularly in the elderly.

Increased physical activity and adequate nutrition are the most powerful tools at our disposal to delay age-related loss of muscle mass.

Well-rounded exercise programs consisting of aerobic and resistance exercises are believed to be most effective

Modification of dietary habits may be an important tool to prevent the decline in muscle mass and function that occurs with aging.

Adequate protein intake is of key importance. Animal-derived protein may provide a higher and broader biological value than vegetable protein.

Fish consumption is recommended and fruits and vegetables should be consumed regularly.

Nutritional supplements containing essential amino acids may be helpful. This is particularly true for whey protein.

Fish-derived protein hydrolysates also appear promising.

Adequate intake of vitamin D is essential.

“Fish-derived protein hydrolysates” doesn’t sound very appetizing. I’ll stick with real fish for now, especially cold-water fatty fish.

Steve Parker, M.D.

front cover of Paleobetic Diet

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Posted in Exercise, Longevity

For Type 2 Diabetes, Gastric Bypass May Improve Cardiac and Renal Outcomes

Posted on June 11, 2020 | Comments Off on For Type 2 Diabetes, Gastric Bypass May Improve Cardiac and Renal Outcomes

Steve Parker MD, bariatric surgery, gastric bypass

Band Gastric Bypass Surgery

From a recent Diabetes Care article:

Our data suggest robust benefits for renal outcomes, heart failure, and CV [cardiovascular] mortality after GBP [gastric bypass] in individuals with obesity and T2DM. These results suggest that marked weight loss yields important benefits, particularly on the cardiorenal axis (including slowing progression to end-stage renal disease), whatever the baseline renal function status.

Source: Renal and Cardiovascular Outcomes After Weight Loss From Gastric Bypass Surgery in Type 2 Diabetes: Cardiorenal Risk Reductions Exceed Atherosclerotic Benefits | Diabetes Care

Because of the risk of surgery, I’d make sure first that diet modification was seriously tried and failed.

Steve Parker, M.D.

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Posted in Heart Disease, Kidney Disease, Longevity, Uncategorized

Medical Errors May Be the Third Most Common Cause of Death in the U.S.

Posted on February 12, 2020 | 1 comment

Hospitals are notorious for iatrogenic deaths

“May be.” But they’re not. The 3rd leading cause of death is accidents (unintentional injuries).

From Dr Gorski at Science Based Medicine (and he’s right):

I say this at the beginning of nearly every post that I write on this topic, but it bears repeating. It is an unquestioned belief among believers in alternative medicine and even just among many people who do not trust conventional medicine that conventional medicine kills. Not only does exaggerating the number of people who die due to medical complications or errors fit in with the world view of people like Gary Null and Joe Mercola, but it’s good for business. After all, if conventional medicine is as dangerous as claimed, then the quackery peddled by the likes of Adams and Mercola starts looking better in comparison. Unfortunately, there are a number of academics more than willing to provide quacks with inflated estimates of deaths due to medical error. The most famous of these is Dr. Martin Makary of Johns Hopkins University, who published a review (not an original study, as those citing his estimates like to claim) estimating that the number of preventable deaths due to medical error is between 250,000 and 400,000 a year, thus cementing the common (and false) trope that “medical error is the third leading cause of death in the US” into the public consciousness and thereby doing untold damage to public confidence in medicine. As I pointed out at the time, if this estimate were correct, it would mean that between 35% and 56% of all in-hospital deaths are due to medical error and that medical error causes between 10% and 15% of all deaths in the US. The innumeracy that is required to believe such estimates beggars the imagination.

Source: Are medical errors really the third most common cause of death in the U.S.? (2020 edition) – Science-Based Medicine

Steve Parker, M.D.

PS: Minimize your risk of iatrogenic death by getting and staying as healthy as possible. Let me help.

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Posted in Longevity

Tea May Postpone Death and Prevent Heart Disease

Posted on February 1, 2020 | Comments Off on Tea May Postpone Death and Prevent Heart Disease

One of my favorite green teas

For years we’ve been hearing about the potential longevity and cardiovascular benefits of green tea. If memory serves, most of the data comes from Japanese studies. Now a Chinese observational study finds 15–20% reductions in atherosclerotic cardiovascular disease (ASCVD) and death, compared to non-tea drinkers. Most of the participants drank green tea, and they did so at least thrice weekly.

From the European Journal of Preventive Cardiology:

Using large prospective cohorts among general Chinese adults, we have provided novel evidence on the protective role of tea consumption on ASCVD events and all-cause mortality, especially among those who kept the habit all along. The current study indicates that tea might be a healthy beverage for primary prevention against ASCVD and premature death.

Source: Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: The China-PAR project – Xinyan Wang, Fangchao Liu, Jianxin Li, Xueli Yang, Jichun Chen, Jie Cao, Xigui Wu, Xiangfeng Lu, Jianfeng Huang, Ying Li, Liancheng Zhao, Chong Shen, Dongsheng Hu, Ling Yu, Xiaoqing Liu, Xianping Wu, Shouling Wu, Dongfeng Gu,

The researchers point out that results may not apply to non-Chinese populations.

Steve Parker, M.D.

h/t to Jan at The Low Carb Diabetic (click link for more details about the study)

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Posted in Heart Disease, Longevity

Suicide Rate Among Young Americans Is Skyrocketing

Posted on January 23, 2020 | Comments Off on Suicide Rate Among Young Americans Is Skyrocketing

This too shall pass

From The New York Times:

After declining for nearly two decades, the suicide rate among Americans ages 10 to 24 jumped 56 percent between 2007 and 2017, according to data from the Centers for Disease Control and Prevention. And for the first time the gender gap in suicide has narrowed: Though the numbers of suicides are greater in males, the rates of suicide for female youths increased by 12.7 percent each year, compared with 7.1 percent for male youths.

If you or someone you know needs help dealing with suicidal thought, please please please contact the National Suicide Prevention Lifeline at 1-800-273-8255

Steve Parker, M.D.

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Posted in Longevity

Should You Eat Salads?

Posted on December 30, 2019 | Comments Off on Should You Eat Salads?

A masterpiece by Sunny Parker

I’m not generally a fan of U.S. federal government committee recommendations on what we should eat. They’ve led us astray before. For what it’s worth, the USDA and National Cancer Institute have put together a Healthy Eating Index. Salad-eaters score higher on the Index, which they say is better for you. I do believe the best salads are better than the crap most Americans eat.

From the Journal of the Academy of Nutrition and Dietetics:

Abstract

Background

Consuming salad is one strategy with the potential to harmonize diets more closely with national dietary guidance. However, it is not known whether nutrient intake and diet quality differ between people who consume vegetable-based salad and those who do not.

Objective

The objective of this study was to compare nutrient intake and diet quality between salad reporters and nonreporters.

Design

This study is a cross-sectional analysis of 1 day of dietary intake data collected via 24-hour recall.

Participants/setting

Adults 20 years and older (n=9,678) in What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 were included. Respondents who ate salad on the intake day were considered salad reporters.

Main outcome measures

This study estimated nutrient intake from all foods and beverages (excluding supplements) and evaluated diet quality using the Healthy Eating Index (HEI) 2015.

Statistical analyses

Nutrient intake and HEI scores were compared between salad reporters and nonreporters using paired t tests with regression adjustment for confounding variables. Results were considered significant at P<0.001.

Results

On the intake day, 23% of adults consumed salad. Energy, protein, and carbohydrate intakes did not differ between salad reporters and nonreporters. Salad reporters had higher intakes than nonreporters of dietary fiber, total fat, unsaturated fatty acids, vitamins A, B-6, C, E, K, folate, choline, magnesium, potassium, and sodium (P<0.001). Total HEI 2015 scores were significantly higher for reporters (56 of a possible 100 points) than nonreporters (50 points) P<0.001. Reporters also had significantly higher scores for eight of 13 HEI components: total vegetables, greens and beans, whole fruits, total protein foods, seafood and plant proteins, fatty acids, refined grains, and added sugars (P<0.001).

Conclusions

Incorporating vegetable-based salad into one’s diet may be one effective way to increase nutrient intake and improve overall diet quality. Regardless of salad reporting status, HEI scores show that diets of US adults need improvement.

Source: Consuming Vegetable-Based Salad Is Associated with Higher Nutrient Intakes and Diet Quality among US Adults, What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 – Journal of the Academy of Nutrition and Dietetics

Steve Parker, M.D.

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Posted in Longevity