Short-Term Benefits of Low-Carb Compared to High-Carb Diet in Type 1 Diabetes

Posted on January 25, 2018 | 3 comments

Shrimp Salad

A scientific study published 2017 compared a high-carb (at least 250 grams/day) to low-carb diet (50 grams or less) in 10 patients with type 1 diabetics. The low-carb diet yielded more time in the normal blood sugar range, less hypoglycemia, and less variability of glucose levels.

I assume the low-carb diet required less insulin, but I don’t know since I haven’t seen the full article. Let me know if you can confirm.

In case you’re wondering, the Paleobetic diet provides about 60 grams of carb daily.

Here’s the abstract:

The aim of the present study was to assess the effects of a high carbohydrate diet (HCD) vs a low carbohydrate diet (LCD) on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes. Ten patients (4 women, insulin pump-treated, median ± standard deviation [s.d.] age 48 ± 10 years, glycated haemoglobin [HbA1c] 53 ± 6 mmol/mol [7.0% ± 0.6%]) followed an isocaloric HCD (≥250 g/d) for 1 week and an isocaloric LCD (≤50 g/d) for 1 week in random order. After each week, we downloaded pump and sensor data and collected fasting blood and urine samples. Diet adherence was high (225 ± 30 vs 47 ± 10 g carbohydrates/d; P < .0001). Mean sensor glucose levels were similar in the two diets (7.3 ± 1.1 vs 7.4 ± 0.6 mmol/L; P = .99). The LCD resulted in more time with glucose values in the range of 3.9 to 10.0 mmol/L (83% ± 9% vs 72% ± 11%; P = .02), less time with values ≤3.9 mmol/L (3.3% ± 2.8% vs 8.0% ± 6.3%; P = .03), and less glucose variability (s.d. 1.9 ± 0.4 vs 2.6 ± 0.4 mmol/L; P = .02) than the HCD. Cardiovascular markers were unaffected, while fasting glucagon, ketone and free fatty acid levels were higher at end of the LCD week than the HCD week. In conclusion, the LCD resulted in more time in euglycaemia, less time in hypoglycaemia and less glucose variability than the HCD, without altering mean glucose levels.

Steve Parker, M.D.

3 Comments

Posted in Diabetic Diet

If You Resolved to Lose Weight in 2018…

Posted on December 28, 2017 | Comments Off on If You Resolved to Lose Weight in 2018…

…you need to read my series on preparing for weight loss. It will improve your odds of success.

The answer’s not in this TV infomercial

Comments Off on If You Resolved to Lose Weight in 2018…

Posted in Weight Loss

Merry Christmas!

Posted on December 24, 2017 | Comments Off on Merry Christmas!

Credit: Zvonimir Atletic / Shutterstock.com

Comments Off on Merry Christmas!

Posted in Uncategorized

Even If You’re Old, You Can Preserve Muscle Mass During Weight Loss. Here’s How.

Posted on December 10, 2017 | 1 comment
dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“Honey, please come to the gym with me.”

We’ve known for a while that resistance training helps preserve muscle mass in younger folks during weight-loss programs. I’ve always figured the principle applied to older folks, too. Now we have proof. Average age of these study participants was 67.

From UPI.com:

Seniors who want to lose weight should hit the weight room while they cut calories, a new study suggests.

Older folks who performed resistance training while dieting were able to lose fat but still preserve most of their lean muscle mass, compared with those who walked for exercise, researchers report.

“The thought is if you lose too much lean mass, that this will exacerbate risk of disability in older adults,” said lead researcher Kristen Beavers, an assistant professor of health and exercise science at Wake Forest University in Winston-Salem, N.C. “Our findings show if your treatment goal is to maximize fat loss and minimize lean mass loss, then the resistance training is probably the way to go.”

 

 

1 Comment

Posted in Exercise

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

Posted on December 4, 2017 | 1 comment
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.

1 Comment

Posted in Uncategorized

Tagged , ,

Lose Weight With Diet; Maintain Weight Loss With Exercise

Posted on November 17, 2017 | 2 comments

Exercise was natural when we were kids

It’s a lesson most of us working in the field learned years ago.

From The New York Times:

It is a question that plagues all who struggle with weight: Why do some of us manage to keep off lost pounds, while others regain them?

Now, a study of 14 participants from the “Biggest Loser” television show provides an answer: physical activity — and much more of it than public health guidelines suggest.

On average, those who managed to maintain a significant weight loss had 80 minutes a day of moderate activity, like walking, or 35 minutes a day of vigorous exercise, like running.

Steve Parker, M.D.

2 Comments

Posted in Exercise, Weight Loss

PURE Study: High Carb Consumption Increases Risk of Death

Posted on November 12, 2017 | 2 comments

How many innocent lives will be cut short by this tasty but silent killer?

Here’s the abstract of a new epidemiological study that investigated the relationships between diet, cardiovascular disease, and death rates. I don’t have the entire article. My sense is that the 18 countries studied are mostly non-Western:

Background

The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear.

Methods

The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.

paleo diet, paleolithic diet, caveman diet

“Do you understand the words that are coming out of my mouth?”

Findings

During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

Interpretation

High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

Source: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet

2 Comments

Posted in Dietary Carbohydrate, Heart Disease, Longevity

My Solution to the U.S. Opioid Crisis

Posted on November 8, 2017 | 3 comments

Not your typical street-level drug pusher, but a great source of oxycodone

The mainstream news outlets in the U.S. tell us we are in the midst of a narcotic use epidemic. People are dropping like flies from overdose.

Narcotics are also called opioids. I’m talking about oxycodone, hydrocodone, hydromorphone (Dilaudid), morphine, fentanyl, heroin, etc. Not Xanax, Ativan, or Valium.

On average, it takes three weeks of daily narcotic use to get physically dependent on it. “Dependent” means that when you stop the drug completely and suddenly, your body may crave it and you could have withdrawal symptoms. The severity of withdrawal symptoms varies from person to person. Possible symptoms include anxiety, sweating, nausea, vomiting, diarrhea, hyperactivity, restless legs, weakness, easy fatigue, shaking, suicidal thoughts, insomnia, and muscle pain or cramps.

Good and bad news, bad news first: Narcotic withdrawal can be very uncomfortable but rarely causes medically serious complications. The serious complications are usually in folks with pre-existing heart disease, high blood pressure, low blood pressure, or heart rhythm disturbances.

Here’s how you stop your chronic daily narcotic habit without suffering a withdrawal syndrome (if needed, see the postscript for an example):

  1. Total up your current total daily dose in milligrams
  2. Determine 10% of the amount by dividing the milligrams by 10
  3. Reduce your daily milligram intake by that 10% every week
  4. Nine weeks later you’ll be off narcotics

Congratulations! You’ve done your part to solve America’s opioid crisis. You’ve reduced your drug bill, avoided Opiate Use Disorder, and reduced your risk of narcotic overdose death by 100%. And you did it without political meddling or an expensive stay at a detox center.

Be aware that as you taper off your narcotic, you may have a flare of an underlying psychiatric condition such as depression, anxiety, PTSD, bipolar disorder, panic attacks, or psychosis. If so, see a mental health professional posthaste.

Good luck, America!

Steve Parker, M.D.

PS: Take Percocet 10/325 for example. It’s 10 mg of oxycodone and 325 mg of acetaminophen. Say you’re taking Percocet 10/325, four pills at at time, four times a day. That’s a total daily oxydocodone dose of 160 mg (16 pills x 10 mg). 160 mg divided by 10 = 16 mg. We have to round off 16 mg to 15 mg due to the availability of various strengths of Percocet. So starting today, you reduce your daily oxycontin dose by 15 g, which is one-and-a-half pills. After one week, you reduce your daily pill count by another one-and-a-half pills. Etc.

PPS: Let you’re doctor know what you’re doing beforehand. He’ll be overjoyed and ensure it’s safe for you to do this taper.

3 Comments

Posted in Uncategorized

Tagged , , ,

Who Said the Paleo Diet Cures Dementia?

Posted on November 6, 2017 | 1 comment

Christopher E. Pitt, a general practitioner in Australia, wrote an article in 2016 questioning the safety of the paleo diet and veracity of some of its more prominent advocates. Dr. Pitt reviewed most of the available scientific studies and concluded:

Overall, conclusions about the effectiveness of the Palaeolithic diet should be considered cautiously. Positive findings should be tempered by the lack of power of these studies, which were limited by their small numbers, heterogeneity and short duration. Nevertheless, there appears to be enough evidence to warrant further consideration of the Palaeolithic diet as a potential dietary option in the management of metabolic diseases. Larger independent trials with consistent methodology and longer duration are required to confirm the initial promise in these early studies. Claims that the Palaeolithic diet could treat or prevent conditions such as autism, dementia and mental illness are not supported by clinical research.

The Palaeolithic diet is currently over-hyped and under-researched. While the claims made by its celebrity proponents are not supported by current evidence, the Palaeolithic diet may be of benefit in the management of various metabolic derangements. Further research is warranted to test these early findings. GPs should caution patients on the Palaeolithic diet about adequate calcium intake, especially those at higher risk of osteoporosis.

I’ve read most of the clinical studies cited by Dr. Pitt and reviewed them here, except I don’t recall the Bligh study. [Bligh HF, Godsland IF, Frost G, et al. Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: An acute-effects randomised study. Br J Nutr 2015;113:574–84.]

I’m not going to address Dr. Pitt’s article point by point. I merely bring it to your attention for your consideration. I will say I think Dr. Pitt is being too deferential to entrenched and sclerotic “authoritative” panels (e.g., Australian dietary guidelines). I was the same until 2009. Regarding calcium, you’ll find my assessment via the search box above and to the right.

I certainly agree with Dr. Pitt that the paleo diet is no panacea, and that further research is warranted.

Steve Parker, M.D.

1 Comment

Posted in Paleo Theory

Weight-Loss Diets Don’t Work: True or False?

Posted on November 3, 2017 | Comments Off on Weight-Loss Diets Don’t Work: True or False?

Comments Off on Weight-Loss Diets Don’t Work: True or False?

Posted in Weight Loss