Category Archives: Uncategorized

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

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

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

Dietitian Julianne Taylor Reviewed 9 Paleo Diet Studies…

“Overall results worth a mention:

Compared to baseline or other healthy diets, the paleo diet achieved better results in every singly study in all the following measures

  • Satiety and satiety hormones
  • Greater reduction in caloric intake without counting calories
  • Greater reduction in fat mass
  • Greater reduction in waist circumference
  • Greater improvements in insulin sensitivity and other markers of pre-diabetes and type 2 diabetes
  • Greater reduction in blood pressureGreater improvements in blood lipids”

Source: Paleo diets studies show increased satiety and decreased calorie intake | Julianne’s Paleo & Zone Nutrition

Will A Modified Paleo-Style Diet Improve Multiple Sclerosis?

Not Dr Wahls

Dr Terry Wahls for several years has advocated a radical diet for multiple sclerosis patients. She has (or had) the disease herself, and achieved a dramatic improvement with a diet, as I recall, fairly compliant with generally accepted paleo principles. She certainly seems to be a true believer.

I have yet to run across a patient in person who has even heard of the Wahls protocol.

In the video linked above, Dr Wahls says she saw improvement after three months of her new way of eating, with continued improvement over the next 3–9 months or longer.

Dr Wahls and associates are putting it to the test.

Abstract

BACKGROUND:Fatigue is one of the most disabling symptoms of multiple sclerosis (MS) and contributes to diminishing quality of life. Although currently available interventions have had limited success in relieving MS-related fatigue, clinically significant reductions in perceived fatigue severity have been reported in a multimodal intervention pilot study that included a Paleolithic diet in addition to stress reduction, exercise, and electrical muscle stimulation. An optimal dietary approach to reducing MS-related fatigue has not been identified. To establish the specific effects of diet on MS symptoms, this study focuses on diet only instead of the previously tested multimodal intervention by comparing the effectiveness of two dietary patterns for the treatment of MS-related fatigue. The purpose of this study is to determine the impact of a modified Paleolithic and low saturated fat diet on perceived fatigue (primary outcome), cognitive and motor symptoms, and quality of life in persons with relapsing-remitting multiple sclerosis (RRMS).

Source: Dietary approaches to treat MS-related fatigue: comparing the modified Paleolithic (Wahls Elimination) and low saturated fat (Swank) diets on perce… – PubMed – NCBI

One in Eight Healthcare Dollars in the U.S. Goes for Diabetes Care

Healthcare dollars

Most of the numbers below won’t mean much to you because they are mind-boggling—and mind-numbing. Also note that most of the cost is caused by type 2 diabetes in people over 65. From Diabetes Care:

“The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity. For the cost categories analyzed, care for people with diagnosed diabetes accounts for 1 in 4 health care dollars in the U.S., and more than half of that expenditure is directly attributable to diabetes. People with diagnosed diabetes incur average medical expenditures of ∼$16,750 per year, of which ∼$9,600 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures ∼2.3 times higher than what expenditures would be in the absence of diabetes. Indirect costs include increased absenteeism ($3.3 billion) and reduced productivity while at work ($26.9 billion) for the employed population, reduced productivity for those not in the labor force ($2.3 billion), inability to work because of disease-related disability ($37.5 billion), and lost productivity due to 277,000 premature deaths attributed to diabetes ($19.9 billion).”

Source: Economic Costs of Diabetes in the U.S. in 2017 | Diabetes Care

Drastically reduce your diabetes healthcare expenditures by incorporating the ideas in my books. The ball’s in your court.

Steve Parker, M.D.

T1 Kelley Shares Her Details on U.S. Healthcare Costs

Kelley at her Below Seven blog writes about the sad state of the U.S healthcare “system,”  mostly about how insanely expensive it is for those of us not in a socialized program like Medicare or Medicaid. If you’re tempted to put the blame only on doctors, hospitals, and Big Pharma, know that insurance companies and politicians are also at fault. Politicians alone could solve the cost problem.

If you want to learn how to negotiate lower healthcare prices, check out this post at ZeroHedge. You could save thousands of dollars.

If you have 15 minutes to spare, read Karl Denninger’s article on comprehensive healthcare reform.

From Kelley:

This year, I have a deductible of $6,500, which means that I have to pay 100% of expenses until I reach that deductible.  I’m not sure if “healthy” people realize how much money a person with a chronic disease spends on healthcare each year, but $6,500 isn’t chump change.  That’s a whole lot of money!

Since my husband and I have our own company, we go through peaks and valleys when it comes to income.  Sometimes, it’s just not feasible to spend $3,000 in one month for diabetes supplies, which is when I’m thankful I was able to stock up so I can make it another month.

I’m not trying to write a woe is me post, but because I have to pay so much out of pocket, I am frustrated at how the health care system works.  You never get an exact price of how much something is going to cost before it goes through insurance.   But because of my insurance plan, I am on the hook for 100% of whatever they decide the cost is.

Source: Unknown Costs with Healthcare – Below Seven

Physicians are not immune to this malarky either. Health insurance for my family-of-four is about $12,000/year, with individual deductibles of $1000/year, family deductible of $3000/year, and family out-of-pocket maximum of $9000/year. And of course if I want to keep my out-of-pocket expenses at a mininum, I have to use the healthcare providers the insurer picks for me.

Steve Parker, M.D.

Do You Know Anything About Nutritics?

I’m thinking about using Nutritics for my nutrient analysis, rather than some of the free options like SparkPeople or FitDay. NutritionData still seems to be very popular, too, but they don’t keep up with new versions of the USDA database (currently on Release 28). The fine print at NutritionData shows they use Release 21. FitDay doesn’t say.

I looked up two cups of broccoli florets at FitDay and NutritionData, and was surprised to see zero grams of fiber. How could that be correct? Nutritics shows 3.3 grams, as does the USDA Nutrient Database. I believe Nutritics and USDA on this one. The free nutrient analysis tools you find on the internet all use some version of the USDA database as far as I know.

Click the link below to see Nutritics’ report.

https://www.nutritics.com/app/rec/4b82cb50b2

In that report you’ll see “%RI”, which I assume is short for  percentage of Dietary Reference Intake. The National Health Institutes defines DRI or Dietary Reference Intake:

DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and gender, include:

  • Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy people.

  • Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.

  • Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.

So what does Nutritics mean by %RI? I don’t know yet.

And by the way, Nutritics isn’t free like the other sources I mentioned above.

Any comments on Nutritics, or your source for nutritional analysis?

Steve Parker, M.D.

Merry Christmas!

Credit: Zvonimir Atletic / Shutterstock.com

Seafood May Contaminate You With Mercury, But Does It Matter?

Dead whole fish aren't very appealing to many folks

Dead whole fish aren’t very appealing to many folks

I advocate consumption of cold-water fatty fish a couple times per week for long-term protection against heart and brain disease. The protective component of fish may be the omega-3 fatty acids.

On the other hand, much seafood is contaminated with mercury, which can be toxic. So, is the mercury in fish actually toxic to brain tissue of folks eating reasonable amounts of fish?

A recent autopsy study answers, “No.”

Read further for details.

Much more appetizing!

From the Journal of the American Medical Association, 2016 Feb 2;315(5):489-97. doi: 10.1001/jama.2015.19451. “Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults.”

IMPORTANCE:Seafood consumption is promoted for its many health benefits even though its contamination by mercury, a known neurotoxin, is a growing concern.

OBJECTIVE:To determine whether seafood consumption is correlated with increased brain mercury levels and also whether seafood consumption or brain mercury levels are correlated with brain neuropathologies.

DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional analyses of deceased participants in the Memory and Aging Project clinical neuropathological cohort study, 2004-2013. Participants resided in Chicago retirement communities and subsidized housing. The study included 286 autopsied brains of 554 deceased participants (51.6%). The mean (SD) age at death was 89.9 (6.1) years, 67% (193) were women, and the mean (SD) educational attainment was 14.6 (2.7) years.

EXPOSURES:Seafood intake was first measured by a food frequency questionnaire at a mean of 4.5 years before death.

MAIN OUTCOMES AND MEASURES:Dementia-related pathologies assessed were Alzheimer disease, Lewy bodies, and the number of macroinfarcts and microinfarcts. Dietary consumption of seafood and n-3 fatty acids was annually assessed by a food frequency questionnaire in the years before death. Tissue concentrations of mercury and selenium were measured using instrumental neutron activation analyses.RESULTS:Among the 286 autopsied brains of 544 participants, brain mercury levels were positively correlated with the number of seafood meals consumed per week (ρ = 0.16; P = .02). In models adjusted for age, sex, education, and total energy intake, seafood consumption (≥ 1 meal[s]/week) was significantly correlated with less Alzheimer disease pathology including lower density of neuritic plaques (β = -0.69 score units [95% CI, -1.34 to -0.04]), less severe and widespread neurofibrillary tangles (β = -0.77 score units [95% CI, -1.52 to -0.02]), and lower neuropathologically defined Alzheimer disease (β = -0.53 score units [95% CI, -0.96 to -0.10]) but only among apolipoprotein E (APOE ε4) carriers. Higher intake levels of α-linolenic acid (18:3 n-3) were correlated with lower odds of cerebral macroinfarctions (odds ratio for tertiles 3 vs 1, 0.51 [95% CI, 0.27 to 0.94]). Fish oil supplementation had no statistically significant correlation with any neuropathologic marker. Higher brain concentrations of mercury were not significantly correlated with increased levels of brain neuropathology.

CONCLUSIONS AND RELEVANCE:In cross-sectional analyses, moderate seafood consumption was correlated with lesser Alzheimer disease neuropathology. Although seafood consumption was also correlated with higher brain levels of mercury, these levels were not correlated with brain neuropathology.

Source: Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults. – PubMed – NCBI

Steve Parker, M.D.