New Review of Fad Diets

Frontiers In Nutrition in July, 2022, published “Fad Diets: Facts and Fiction.” Thank you, Frontiers, for making it available at no cost. The authors are based in Pakistan and Romania. They attempted to summarize the literature on popular fad diets. I am shocked that they included the Mediterranean diet as a fad. Read the article and 134 references then form your own opinion. Some snippets:

Regarding the Atkins Diet: “AD provides several benefits including weight reduction and cardio-metabolic health improvement, but limited evidence exists as compliance is the major barrier to this dietary regimen. Strict supervision by health professionals is advised as adverse metabolic sequelae can result from this type of diet.”

The Paleolithic Diet: “More randomized trials need to be done to highlight the consequences of such diets that eliminate one or more food groups. PD is powerful at advancing weight reduction for the time being but its efficacy in cardiovascular events is not well established as limited long-term data is available.”

Mediterranean Diet: “No evidence of adverse effects associated with MD is available in the literature. Rather, MD has preventive and therapeutic potential for many chronic diseases. It is highly suitable for the general public for the prevention of micronutrient deficiencies and specifically for those patients who are more health-conscious than just weight loss oriented.”

Vegetarian Diet: “No evidence of adverse effects associated with MD is available in the literature. Rather, MD has preventive and therapeutic potential for many chronic diseases. It is highly suitable for the general public for the prevention of micronutrient deficiencies and specifically for those patients who are more health-conscious than just weight loss oriented.”

Intermittent Fasting: “Despite the effectiveness of IF in weight loss as indicated by several studies, the current evidence is non-conclusive. The prime focus of available literature is weight loss but little is known about its sustainability and long-term health effects. More long-term trials should be conducted to draw a clear conclusion.”

Detox Diets: “Energy-restricted DDs are capable of short-term weight loss. But still, there is a high likelihood of health risks from detox products because of their nutritional inadequacy. As no convincing evidence exists in this domain so such diets and products need to be discouraged by health professionals and must be subjected to regulatory review and monitoring.”

Ketogenic Diet: difficult to summarize.

Steve Parker, M.D.

Do Not Fret…

Do not fret because of evil men or be envious of the wicked, for the evil man has no future hope, and the lamp of the wicked shall be snuffed out.

Proverbs 24: 19-20

Paleo Diet Linked to Lower Risk of Breast Cancer

…in Iranian women. It was a small study so may not be reproducible. Click for some details at Nutrition and Cancer.

Photo by Valeria Boltneva on Pexels.com

Steve Parker, M.D.

Ultra-Processed Foods Linked to Overweight and Obesity in U.S. Adolescents

Man-made food

An article in the Journal of the Academy of Nutrition and Dietetics found an association between overweight/obesity and consumption of ultraprocessed foods in U.S. adolescents.

The study looked at 3,600 adolescents who reported their food intake over a 24-hour period. The results are pretty strong: the more ultra-processed food consumed, the greater the odds of overweight and obesity.

Jan at The Low Carb Diabetic blog reported that:

Ultra-processed foods make up ‘two-thirds of calories consumed by children and teens’
Experts from Tufts University in Massachusetts studied two decades of dietary data to 2018 and found that the amount of calories young people consumed from ultra-processed foods jumped from 61 per cent to 67 per cent.

I’m not paying for the JAND scientific report so I don’t know how they defined ultra-processed foods. The definition varies quite a bit over time, by researcher, and by research goals. From the U.S. National Library of Medicine:

The definitions [of ultra-processed foods] used in 2009, 2010, 2012, 2014, and 2016a represent the definitions used from publications devoted solely to that purpose and are heavily referenced in the literature on ultra-processed foods. The definitions used in years 2015, 2016b, and 2017 are from articles that focused on the relation between ultra-processed food intake and public health nutrition, in which definitions of ultra-processed foods are presented in detail in the article. The first definition alludes mainly to the use of both food additives and salt in food products (6). The second introduces the putative impact of ultra-processed foods on accessibility, convenience, and palatability of ultra-processed foods (8). Subsequently, the definitions become longer and include more elements. Thus, the third definition builds on previous definitions but introduces 2 new angles (9). One is the nonavailability of ingredients used in ultra-processed foods from retail outlets such as supermarkets, and the second introduces food additives as the most widely used ingredients, in numerical terms, in the manufacture of ultra-processed foods. The next definition now introduces the role of food fortification as a defining element of ultra-processed foods (4). Further definitions introduce new elements such as the importance of foods synthesized in a laboratory, based on organic materials such as oil- and coal-based additives and flavoring compounds (10), a specification for the minimal number of ingredients to be found in these foods (5), and then an emphasis on the inclusion of salt, sugars, oils, and fats as a starting point for defining ultra-processed foods. This definition gives details of specific categories of food additives and highlights how the intended use of these additives is to imitate sensory qualities of fresh or minimally processed foods (group 1) or to specifically disguise undesirable qualities of ultra-processed foods (11). The final definition from 2017 (12) is quite similar to that used in the 2016b publication (11).

God-made food; or nature-made if you prefer
Photo by Chan Walrus on Pexels.com

If you want to dive deep, you can download a list of ultra-processed food examples from that NLM article. I didn’t. But I figure the way to avoid over-processed foods is to eat food closer to the way God made it rather than man-made.

Steve Parker, M.D.

Stress Linked to Arthritis Development

Knees are the most common joint affected by osteoarthritis.
Photo credit: Steven Paul Parker II

A MedPage Today article indicates that chronic stress may precipitate or aggravate arthritis. Even childhood stress. The link is not as strong for rheumatoid arthritis as it is for more common types of arthritis. Most for the reviewed studies “categorized stress as stemming from adverse life events … or adverse childhood experiences …. Most studies … suggested a relationship between exposure to chronic stressors and arthritis development.”

Would stress reduction improve the quality of life of arthritis patients? The study at hand doesn’t address that but I’d wager that it would.

Steve Parker, M.D.

Does Diet Have ANY Effect on Health?

A couple of dietitians did an massive literature review looking for evidence that diet has an effect on major health conditions such as obesity, diabetes, and cardiovascular disease. Sounds interesting, and similar to my own obsessive review done between 1995 and 2005. Unknown if they examined the paleo diet. It bothers me that “hypertension” is misspelled in the abstract. For the researchers’ conclusions, you have to pay $27.95 USD.

“How did the paleo diet fare?”

Abstract from the Journal of the Academy of Nutrition and Dietetics:

Appropriate diet can prevent, manage, or reverse noncommunicable health conditions such as obesity, cardiovascular disease, and diabetes. Consequently, the public’s interest in diet and nutrition has fueled the multi-billion-dollar weight loss industry and elevated its standing on social media and the internet. Although many dietary approaches are popular, their universal effectiveness and risks across overall populations are not clear. The objective of this scoping review was to identify and characterize systematic reviews (SRs) examining diet or fasting (intermittent energy restriction [IER]) interventions among adults who are healthy or may have chronic disease. An in-depth literature search of six databases was conducted for SRs published between January 2010 and February 2020. A total of 22,385 SRs were retrieved, and 1,017 full-text articles were screened for eligibility. Of these, 92 SRs met inclusion criteria. Covered diets were organized into 12 categories: high/restricted carbohydrate (n = 30), Mediterranean, Nordic, and Tibetan (n = 19), restricted or modified fat (n = 17), various vegetarian diets (n = 16), glycemic index (n = 13), high protein (n = 12), IER (n = 11), meal replacements (n = 11), paleolithic (n = 8), Dietary Approaches to Stop Hypretension (DASH; n = 6), Atkins, South Beach, and Zone (n = 5), and eight other brand diets (n = 4). Intermediate outcomes, such as body weight or composition and cardiometabolic, were commonly reported. Abundant evidence was found exploring dietary approaches in the general population. However, heterogeneity of diet definitions, focus on single macronutrients, and infrequent macronutrient subanalyses were observed. Based on this scoping review, the Evidence Analysis Center prioritized the need to collate evidence related to macronutrient modification, specifically restricted carbohydrate diets.


Steve Parker, M.D.

Should You Take “Eye Vitamins”?

Steve Parker MD, paleobetic diet,
Couldn’t find my retina picture

I have a particular interest in preventing age-related macular degeneration (ARMD) since it runs in my family. It’s the leading cause of vision loss in adults over 50.

From JAMA Ophthalmology:

Question  What were the long-term findings of Age-Related Eye Disease Study 2 (AREDS2) supplements regarding development of lung cancer or progression to late age-related macular degeneration (AMD)?

Findings  In this epidemiologic follow-up study of the AREDS2 cohort of 3882 participants and 6351 eyes, 10-year follow-up results showed that development of lung cancer nearly doubled in participants assigned to beta carotene among former smokers but not those assigned to lutein/zeaxanthin. Lutein/zeaxanthin was associated with a reduction in the risk of progression to late AMD when compared with beta carotene.

Meaning  These findings suggest that the AREDS2 supplement with lutein/zeaxanthin instead of beta carotene was safe, with no association with developing lung cancer and a potential beneficial association with further reduction in progression to late AMD.


Once you lose vision, you may never get it back.

These are the ones I take. In the U.S., your best price may be at Costco or Sam’s Club.

Steve Parker, M.D.

No Surprise: U.S. Women Getting Fatter

From the Journal of Obesity:

hunter, hunting, prehistoric, paleo diet, caveman, saber-toothed tiger, cavewoman

…. 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.