Paleo Diet: More Carbohydrates Than We Think?

Photo by Andru00e9 Cook on Pexels.com

I haven’t read the full article in Journal of Human Evolution because I don’t want to part with $20 it costs. Here’s the abstract:

Evidence for plants rarely survives on Paleolithic sites, while animal bones and biomolecular analyses suggest animal produce was important to hominin populations, leading to the perspective that Neanderthals had a very-high-protein diet. But although individual and short-term survival is possible on a relatively low-carbohydrate diet, populations are unlikely to have thrived and reproduced without plants and the carbohydrates they provide. Today, nutritional guidelines recommend that around half the diet should be carbohydrate, while low intake is considered to compromise physical performance and successful reproduction. This is likely to have been the same for Paleolithic populations, highlighting an anomaly in that the basic physiological recommendations do not match the extensive archaeological evidence. Neanderthals had large, energy-expensive brains and led physically active lifestyles, suggesting that for optimal health they would have required high amounts of carbohydrates. To address this anomaly, we begin by outlining the essential role of carbohydrates in the human reproduction cycle and the brain and the effects on physical performance. We then evaluate the evidence for resource availability and the archaeological evidence for Neanderthal diet and investigate three ways that the anomaly between the archaeological evidence and the hypothetical dietary requirements might be explained. First, Neanderthals may have had an as yet unidentified genetic adaptation to an alternative physiological method to spare blood glucose and glycogen reserves for essential purposes. Second, they may have existed on a less-than-optimum diet and survived rather than thrived. Third, the methods used in dietary reconstruction could mask a complex combination of dietary plant and animal proportions. We end by proposing that analyses of Paleolithic diet and subsistence strategies need to be grounded in the minimum recommendations throughout the life course and that this provides a context for interpretation of the archaeological evidence from the behavioral and environmental perspectives.

Easy Ways to Prevent COVID-19

Artist’s renditions of coronavirus

Oral preventatives during disease surges:

  • Vitamin D (cholecalciferol) 1,000-2,000 IU/day. (Gruff Davies and Linda Benskin recommend, in general, 4,000 IU daily, perhaps year-round, or whatever combination of food, supplementation, and sunlight gets your blood level of 25-hydroxy vitamin D to to 50 ng/mL.)
  • Aspirin 81-325 mg/day
  • Vitamin C 500 mg/day
  • Elemental zinc 10-50 mg/day
  • Melatonin 1.5-6 mg/day at night or bedtime

The doses vary, depending on body weight, age, tolerance to the drug. Generally, the higher doses are for younger and heavier folks. If one gets plentiful sunlight exposure, the oral vitamin D may not be needed.

Other strategies during disease surges (or always?):

  • Regular exercise
  • Lose excess weight, especially if obese (BMI over 30)
  • Maintain normal blood sugars (if diabetic, keep HgbA1c under 6.5%)
  • Avoid close, prolonged contact with coughing and sneezing people, especially in enclosed spaces
  • Frequent hand-washing if exposed to public doorknobs, elevator buttons, or other potentially contaminated surfaces, or if around sick (coughing and/or sneezing) people
  • Avoid sick people who are coughing and sneezing
  • Eat healthful food

Alternatively, from Dr Robert Malone on his Dec 31, 2021 substack:

“So, yes back to my thoughts on Omicron – please keep taking that vitamin D3 and get your levels tested, if you haven’t already.  Use a formulation that combines the D3 with Vitamins A and K. Please keep up with the zinc, vitamin C and magnesium.  Work on weight control, glycemic control and please exercise!  All are important.”

Did you notice I haven’t mentioned masks? I’m not a big believer. Do I wear an N-95 mask when I’m seeing a COVID-19 patient at the hospital? You bet. And the mask was fit-tested. Is that testing available to the general public? Not that I’m aware.

Do I have great data to support all these strategies? No, but some. Are they recommended by the CDC or NIH (Nat’l Institutes of Health)? I don’t know or care. I’ve lost faith in them. I’m afraid they’ve been bought and paid for by Big Pharma (and others?).

I don’t know about your personal health and medical history. I’m not your doctor. If you’re considering any of these recommendations, consult your personal physician before implementation.

The patient is wise to look away. If you watch the needle go in, it’ll hurt more.

I was motivated to write this post by the failures and risks of the rushed vaccines. Vaccination might be helpful if you are sickly, over 65, or have underlying conditions such as diabetes, active cancer, a poor immune system, obesity (especially BMI over 35), or some other co-morbidities. I see both very healthy, vigorous 65-year-olds, and sickly 65-year-olds. Which one are you? If you’re over 80, you may have nothing to lose by vaccinating. Average U.S. life expectancy is 79 years, less for men, longer for women.

Steve Parker, M.D.

Does the Paleo Diet Affect Cardiometabolic Risk Factors in Postmenopausal Women?

Photo by Andrea Piacquadio on Pexels.com

You won’t find the answer in the journal article at hand. Probably nobody knows for sure. If you have insomnia, reading the full article (free!) may be cure you temporarily.

Whole-diet interventions and cardiovascular risk factors in postmenopausal women: A systematic review of controlled clinical trials

Abstract

Objectives: Menopause is accompanied by many metabolic changes, increasing the risk of cardiometabolic diseases. The impact of diet, as a modifiable lifestyle factor, on cardiovascular health in general populations has been well established. The purpose of this systematic review is to summarize the evidence on the effects of whole diet on lipid profile, glycemic indices, and blood pressure in postmenopausal women.

Methods: Embase, Medline, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to February 2021. We included controlled clinical trials in postmenopausal women that assessed the effect of a whole-diet intervention on lipid profile, glycemic indices, and/or blood pressure. The risk of bias in individual studies was assessed using RoB 2 and ROBINS-I tools.

Summary of evidence: Among 2,134 references, 21 trials met all eligibility criteria. Overall, results were heterogenuous and inconsistent. Compared to control diets, some studies showed that participants experienced improvements in total cholesterol (TC), low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), fasting blood sugar (FBS), and apolipoprotein A (Apo-A) after following fat-modified diets, but some adverse effects on triglycerides (TG), very low-density lipoprotein cholesterol (VLDL), lipoprotein(a) (Lp(a)), and high-density lipoprotein cholesterol (HDL) concentrations were also observed. A limited number of trials found some effects of the Paleolithic, weight-loss, plant-based, or energy-restricted diets, or of following American Heart Association recommendations on TG, TC, HDL, insulin, FBS, or insulin resistance.

Conclusion: Current evidence suggests that diet may affect levels of some lipid profile markers, glycemic indices, and blood pressure among postmenopausal women. However, due to the large heterogeneity in intervention diets, comparison groups, intervention durations, and population characteristics, findings are inconclusive. Further well-designed clinical trials are needed on dietary interventions to reduce cardiovascular risk in postmenopausal women.


Steve Parker, M.D.

Other Than Vaccination, How Can You Prevent COVID-19?

Masking may be worthless. At least this is a medical-grade mask.

Oral preventatives during disease surges:

  • Vitamin D (cholecalciferol)1,000-2,000 IU/day (Gruff Davies and Linda Benskin recommend, in general, 4,000 IU daily, perhaps year-round, or whatever combination of food, supplementation, and sunlight gets your blood level of 25-hydroxy vitamin D to to 50 ng/mL.)
  • Aspirin 81-325 mg/day
  • Vitamin C 500 mg/day
  • Elemental zinc 10-50 mg/day
  • Melatonin 1.5-6 mg/day at night or bedtime

The doses vary, depending on body weight, age, tolerance to the drug. Generally, the higher doses are for younger and heavier folks. If one gets plentiful sunlight exposure, the oral vitamin D may not be needed.

Other strategies during disease surges (or always?):

  • Regular exercise
  • Lose excess weight, especially if obese (BMI over 30)
  • Maintain normal blood sugars (if diabetic, keep HgbA1c under 6.5%)
  • Avoid close, prolonged contact with coughing and sneezing people, especially in enclosed spaces
  • Frequent hand-washing if exposed to public doorknobs, elevator buttons, or other potentially contaminated surfaces, or if around sick (coughing and/or sneezing) people
  • Avoid sick people who are coughing and sneezing
  • Eat healthful food

Did you notice I haven’t mentioned masks? I’m not a big believer. Do I wear an N-95 mask when I’m seeing a COVID-19 patient at the hospital? You bet. And the mask was fit-tested. Is that testing available to the general public? Not that I’m aware.

Do I have great data to support all these strategies? No, but some. Are they recommended by the CDC or NIH (Nat’l Institutes of Health)? I don’t know or care. I’ve lost faith in them. I’m afraid they’ve been bought and paid for by Big Pharma (and others?).

I don’t know about your personal health and medical history. I’m not your doctor. If you’re considering any of these recommendations, consult your personal physician before implementation.

The patient is wise to look away. If you watch the needle go in, it’ll hurt more.

I was motivated to write this post by the failures and risks of the rushed vaccines. Vaccination might be helpful if you are sickly, over 65, or have underlying conditions such as diabetes, active cancer, a poor immune system, obesity (especially BMI over 35), or some other co-morbidities. I see both very healthy, vigorous 65-year-olds, and sickly 65-year-olds. Which one are you? If you’re over 80, you may have nothing to lose by vaccinating. Average U.S. life expectancy is 79 years, less for men, longer for women.

Steve Parker, M.D.

PS: Updated Dec 28, 2021

Ultra-Processed Foods Linked to Higher Coronary Artery Disease Risk

Ultra-processed versus processed?

What are ultra-processed foods? I’m not paying $35 for the scientific article to find out. If you can grab the definition from your copy, please share in the Comments section. The 2020 profit from my publishing company was only $937.08, so I’m watching my expenses.

Here’s the free abstract:

ABSTRACT

Background

Higher ultra-processed food intake has been linked with several cardiometabolic and cardiovascular diseases. However, prospective evidence from US populations remains scarce.

Objectives

To test the hypothesis that higher intake of ultra-processed foods is associated with higher risk of coronary artery disease.

Methods

A total of 13,548 adults aged 45–65 y from the Atherosclerosis Risk in Communities study were included in the analytic sample. Dietary intake data were collected through a 66-item FFQ. Ultra-processed foods were defined using the NOVA classification, and the level of intake (servings/d) was calculated for each participant and divided into quartiles. We used Cox proportional hazards models and restricted cubic splines to assess the association between quartiles of ultra-processed food intake and incident coronary artery disease.

Results

There were 2006 incident coronary artery disease cases documented over a median follow-up of 27 y. Incidence rates were higher in the highest quartile of ultra-processed food intake (70.8 per 10,000 person-y; 95% CI: 65.1, 77.1) compared with the lowest quartile (59.3 per 10,000 person-y; 95% CI: 54.1, 65.0). Participants in the highest compared with lowest quartile of ultra-processed food intake had a 19% higher risk of coronary artery disease (HR: 1.19; 95% CI: 1.05, 1.35) after adjusting for sociodemographic factors and health behaviors. An approximately linear relation was observed between ultra-processed food intake and risk of coronary artery disease.Conclusions

Higher ultra-processed food intake was associated with a higher risk of coronary artery disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed foods may affect health.

Article

I admit I must eat some ultra-processed foods, but I try to limit them.

Heart disease is the #1 killer in the developed world, even more lethal the COVID19! If you haven’t chosen your New Years’ weight-loss diet yet, consider one low in ultra-processed foods, like the paleo diet or Mediterranean diet.

This Shrimp Salad is minimally-processed

Steve Parker, M.D.

Rice: Great Source of Calories, But How Much Is Too Much?

Eliza Skoler addresses this issue in an interesting article at Diatribe:

Rice. Billions of people around the world eat it every single day, for multiple meals a day – and it’s a primary food for many populations, with research showing that it provides about 20% of the world’s calorie intake. From beans and rice to stir fry with rice, from sushi to risotto to sweet rice desserts, this simple ingredient is a staple across the globe and across cultures.

Unfortunately, rice presents a key challenge for people with diabetes: it’s a spiky carb. Spiky carbs are foods that cause glucose to quickly increase, and they can create unpredictable swings in glucose levels. If you or someone you know has diabetes, you may be wondering how to manage your glucose when faced with this dietary staple.

https://diatribe.org/rice-and-diabetes-how-great-risk

I find that many of my patients with diabetes have better glucose control if they eat fewer daily carb grams than mentioned in this article.

Steve Parker, M.D.

Parents: Don’t Let Them Vaccinate Your Children Against COVID-19

I say”them” because some government authorities around the world, e.g., Australia, will vaccinate against the wishes of parents. I worry that tyrants in California are about to do the same.

ketogenic diet, children
Healthy children have extremely low risk of death from COVID-19. Should we subject them to unknown risks of vaccines just to save elderly Boomer lives?

These are experimental vaccines without a long-term safety record. The short-term record in adults doesn’t look that great either.

Jonathan Howard at Science-Based Medicine figures that fewer than one in 100,000 healthy children who contract COVID-19 will die from it. Among the young decedents, at least three out of four have a predisposing condition such as obesity, asthma, a developmental disorder, a neurological condition, or cardiovascular disease. Additionally, Dr. Howard says three out of four deaths are in Hispanics, Blacks, or indigenous people (American Indian/Alaskan Native).

Dr. Howard admits that the risk of death from COVID-19 for children is very low. But since the risk is not zero, all children should be vaccinated.

Dr. Howard bases his recommendation for the Pfizer/BionNTech vaccine for children on very limited data. This is child abuse since we don’t have long-term vaccination safety data.

You know I’m not a pediatrician. Dr. Howard is a neurologist and psychiatrist. There may be a legitimate role of COVID-19 vaccination for sickly children. But there’s no way in hell I’d vaccinate my healthy children without long-term safety data.

For a healthy child, the potential risks of COVID-19 vaccination outweigh the potential benefits.

Question authority. Including me.

Steve Parker, M.D.

PS: Read William M Briggs: Kids Don’t Need to Be Vaccinated.

Eat Nuts and Seeds to Reduce Risk of Liver Disease

What kind of liver disease? NAFLD: non-alcoholic fatty liver disease.

Paleobetic diet
Macadamia nuts

See the Journal of Nutrition for details:

Conclusions

“Daily consumption for nuts and seeds was associated with a lower prevalence of NAFLD in non-Mediterranean, US adults, although the benefits seem to be greater in females across all categories of nut and seed consumption groups compared with nonconsumers. Both males and females presented with lower prevalence of NAFLD with intakes of 15–30 g/d.”

Stages of liver damage: Healthy, fatty liver, fibrosis, and cirrhosis

Nuts are paleo!

Steve Parker, M.D.

Is a Liver Transplant In Your Future?

Stages of liver damage. Healthy, fatty, liver fibrosis, and cirrhosis.

Experts are predicting an epidemic of NASH: non-alcoholic steatohepatitis. In other words, fat build-up in the liver with associated inflammation and scarring (fibrosis). Which is related to it’s precursor, NAFLD: non-alcoholic fatty liver disease. These are significant issues particularly for folks with type 2 diabetes. From Diabetes Care:

“The clinical burden of both NAFLD overall and NASH specifically has increased steadily since the 1980s. NAFLD currently affects 25% of the global population and >60% of patients with T2D. Studies evaluating the prevalence of NASH suggest that it may involve an estimated 1.5%–6.5% of the general population and as many as 37% of people with T2D. Prevalence of NASH is expected to increase by 63% between 2015 and 2030. Although these numbers seem substantially lower than those for NAFLD overall, they still translate to 4.9 million to 21 million Americans and more than 100 million individuals worldwide. Modeling data estimate that the number of patients with NASH-related advanced fibrosis will likely double by 2030, resulting in 800,000 liver-related deaths.

NASH is already the number 1 indication for liver transplantation in women, patients older than 54 years, and Medicare recipients. Beyond the significant impairment of quality of life experienced by individuals with NASH and advanced fibrosis, Younossi et al. estimated in 2017 that the overall lifetime direct costs of NASH in the United States would be $222.6 billion, and approximately $95.4 billion over the next 2 decades, suggesting a substantial economic burden.”

Loss of excess weight is one way to combat or avoid non-alcoholic fatty liver disease.

Steve Parker, M.D.

PS: The Paleobetic Diet can help you lose excess weight and keep it off.

High Glycemic Eating Linked to Cardiovascular Disease and Premature Death

Naan, a type of flat bread with a high glycemic index

Haven’t we know this for years? From 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

Steve Parker, M.D.

PS: The Paleobetic Diet is low glycemic index, particularly compared with the standard American diet.