For perhaps 15-20 years, many health experts have recommended you walk 10,000 steps/day as important for maximizing your health and longevity. Depending on your stride length, that’s roughly 5 miles (8 km). When I walk my dogs 4 miles, it takes about 90 minutes, which is a big time commitment. Frankly, it’s often boring. But not for the dogs. So many fascinating odors!
The good news is, you don’t need to walk the 10,000 steps in one fell swoop. Your walking around your residence and workplace throughout the day counts, too.
I admitted a patient to the hospital a few days ago who told me her health insurer sends her a small check monthly if she meets their step goal. She’s saving them money via lower healthcare expenditures, and they’re sharing with her. I love it!
This research from Poland doesn’t look very interesting to me, so I’ve not read the free full text of the article. Let us know what you think.
Abstract
The aim of the study was to assess the impact of an eight-week Paleo diet on the health status (body composition, haematology and biochemistry of blood and urine) and the level of physical capacity (aerobic and anaerobic) of professional handball players. Fifteen athletes were assigned to two groups: 9 in the experimental group (PD) and 6 in the control group (CD). Significant decreases in body mass (BM), body mass index (BMI), and fat mass (FM) as well as an increase in the fat-free mass (FFM) (%) in both groups were observed. There were no significant differences between groups in particular series during the experiment in all haematological and biochemical indicators of blood and urine. Only HDL-C was significantly higher in the last series in the PD compared to the CD (1.63 mmol/l vs. 1.23 mmol/l). In the Wingate test, there were only single intragroup changes, consisting of a significant decrease in the Wt, MAP and Pmean in the experimental group. There were no significant differences between the groups in individual series or intragroup differences during the experiment, determined by the VO2max, VEmax, VE ∙ VCO2-1, RER, and the time of the test with a gradually increasing load on a treadmill, except for a significant decrease of maximum tidal volume (TVmax) in the PD. No adverse effect of the Paleo diet on the health status was found. The use of the Paleo diet slightly adversely affects anaerobic capacity and does not affect the level of aerobic capacity.
Posted onJanuary 18, 2024|Comments Off on Neurontin and Lyrica for Pain Suppression: Do They Work?
“You can take this pill, but there’s not much evidence it does any good.”
Physicians in the U.S. who prescribe opioids need a license from the Drug Enforcement Administration and it has to be renewed periodically. By the time of my next renewal, I must be able to prove to the DEA that I’ve had six (eight?) hours of approved continuing medical education on drug abuse and addiction. Because of the prescription opioid “epidemic” that reared its head several years ago, regulators are putting pressure on prescribers to reduce prescriptions. I’m not saying that’s a bad thing, but it can be taken too far, like expecting a patient with very recent knee or hip replacement surgery to be just fine with acetaminophen (aka paracetamol) alone. Big Pharma has convinced some prescribers to substitute opioids with Neurontin (aka gabapentin) or Lyrica (pregabalin). If not substitution, then augmentation of opioid effect at lower doses. I definitely see that in my part of the world.
One of the most notorious examples of Big Pharma living up to its reputation for evil-doing is the illegal promotion of anticonvulsant drugs like Neurontin and Lyrica for painful problems like back pain. Pfizer coughed up billions for lawsuit settlements and record-breaking fines. I think it’s safe to say that they didn’t actually pay enough to undo the damage, though…
Thanks to that horror show, and to research by Peet et al, we now know that there was a mighty 5× surge in gabapentin prescriptions in the 2000s and 2010s. That was — and continues to be — a chilling demonstration of the power of under-handed and well-funded marketing. Even as opioid prescriptions fell somewhat, gabapentin scrips rose dramatically, despite the dubious value for most of what it was being prescribed for (most kinds of pain).
Steve Parker, M.D.
PS: Pregabalin and gabapentin are commonly used and often effective drugs for painful diabetic neuropathy in the U.S. This blog post isn’t about that neuropathic pain.
Posted onJanuary 12, 2024|Comments Off on Having Trouble Losing Weight? Try these 19 Tricks and Tips
Certified paleo-compliant, plus high omega-3 fatty acids and low-carb
Record-keeping is often the key to success.
Accountability is another key to success. Consider documenting your program and progress on a free website such as FitDay, SparkPeople, 3FatChicks, or others. Consider blogging about your adventure on a free platform such as WordPress or Blogger, or try the newer social media sites. Such a public commitment may be just what you need to keep you motivated.
Do you have a friend or spouse who wants to lose weight? Start the same program at the same time and support each other. That’s built-in accountability.
If you tend to over-eat, floss and brush your teeth after you’re full. You’ll be less likely to go back for more anytime soon.
Eat at least two or three meals daily. Skipping meals may lead to uncontrollable overeating later on. On the other hand, ignore the diet gurus who say you must eat every two or three hours. That’s codswallop.
Eat meals at a leisurely pace, chewing and enjoying each bite thoroughly before swallowing.
Plan to give yourself a specific reward for every 10 pounds (4.5 kg) of weight lost. You know what you like. Consider a weekend get-away, a trip to the beauty salon, jewelry, an evening at the theater, a professional massage, home entertainment equipment, new clothes, etc.
Carefully consider when would be a good time to start your new lifestyle. It should be a period of low or usual stress. Bad times would be Thanksgiving day, Christmas/New Years’ holiday, the first day of a Caribbean cruise, and during a divorce.
If you know you’ve eaten enough at a meal to satisfy your nutritional requirements yet you still feel hungry, drink a large glass of water and wait a while.
Limit television to a maximum of a few hours a day.
Maintain a consistent eating pattern throughout the week and year.
Eat breakfast routinely.
Control emotional eating.
Weigh frequently: daily during active weight-loss efforts and during the first two months of your maintenance-of-weight-loss phase. After that, cut back to weekly weights if you want. Daily weights will remind you how hard you worked to achieve your goal.
Be aware that you might regain five or 10 pounds (2-4 kg) of fat now and then. You probably will. Don’t freak out. It’s human nature. You’re not a failure; you’re human. But draw the line and get back on the old weight-loss program for one or two months. Analyze and learn from the episode. Why did it happen? Slipping back into your old ways? Slacking off on exercise? Too many special occasion feasts or cheat days? Allowing junk food or non-essential carbs back into the house?
Learn which food item is your nemesis—the food that consistently torpedoes your resolve to eat right. For example, mine is anything sweet. Remember an old ad campaign for a potato chip: “Betcha can’t eat just one!”? Well, I can’t eat just one cookie. So I don’t get started. I might eat one if it’s the last one available. Or I satisfy my sweet craving with a diet soda, small piece of dark chocolate, or sugar-free gelatin. Just as a recovering alcoholic can’t drink any alcohol, perhaps you should totally abstain from…? You know your own personal gastronomic Achilles heel. Or heels. Experiment with various strategies for vanquishing your nemesis.
If you’re not losing excess weight as expected (about a pound or half a kilogram per week), you may benefit from eating just two meals a day. This will often turn on your cellular weight-loss machinery even when total calorie consumption doesn’t seem much less than usual. The two meals to eat would be breakfast and a mid-afternoon meal (call it what you wish). The key is to not eat within six hours of bedtime. Of course, this trick could cause dangerous hypoglycemia if you’re taking drugs with potential to cause low blood sugars, like insulin and sulfonylureas. If you take drugs for diabetes, talk to your dietitian or physician before instituting a semi-radical diet change like this.
One of the fitness bloggers I used to follow was James Fell. He said, “If you want to lose weight you need to cook. Period.”
Regular exercise is much more important for prevention of weight regain rather than for actually losing weight.
Posted onDecember 27, 2023|Comments Off on A Hundred Years From Now, You and Everyone You Know Will Be Dead
Only one thing really matters. That’s your relationship with Jesus Christ/God. Who was Jesus? Did he exist? Was he crucified for your eternal salvation?
Jesus is my Lord and Savior. He died for my sins. After my death, I’ll be with him in heaven forever.
Posted onDecember 20, 2023|Comments Off on Will You Participate In Dry January?
See you in February. Or not.
I’ve run across a number of patients who slowly increased their alcohol consumption over months or years, not realizing it was causing or would cause problems for them. Alcohol is dangerous, lethal at times.
From a health standpoint, the generally accepted safe levels of consumption are:
no more than one standard drink per day for women
no more than two standard drinks per day for men
One drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80 proof distilled spirits (e.g., vodka, whiskey, rum, gin).
Dry January was conceived in the UK in 2012 or 2014. (A related concept is Sober October.) The idea is simply to abstain from all alcohol for the month of January. The Alcohol Change UK website can help you git ‘er done. Many folks notice that they sleep better, have more energy, lose weight, and save money. There are other potential benefits.
If you think you may have an unhealthy relationship with alcohol, check your CAGE score. It’s quick and easy.
Alternatively, if you make a commitment to a Dry January but can’t do it, you may well have a problem.
Posted onDecember 10, 2023|Comments Off on Osteoarthritis Is a Metabolic Disorder, Not Wear and Tear
Radical new information on osteoarthritis from Paul Ingraham:
One of the most deeply held beliefs in musculoskeletal medicine is that osteoarthritis is a “wear and tear” condition — that joints slowly crumble under the onslaught of gravity and use and abuse. This fundamentally mechanical view of arthritis directly suggests that the heavier we are, the more likely we are to have trouble in our load-bearing joints.
But that’s just not the case: osteoarthritis prevalence doubled in the 20th Century independent of age and weight (Wallace 2017).
So something else has to be going on. People got heavier on average, but not twice as heavy!
Or consider this: obese people get more osteoarthritis of the hand (Jiang 2016), but probably not because they are walking on their hands.
So … why?
This post weaves together the threads of several past posts about the biochemical foundations of seemingly “mechanical” problems, and you may recognize some pieces. But this is an all-new synthesis, anchored by some good science news you can use — practical and encouraging, which is a rare pleasure.
Posted onAugust 15, 2023|Comments Off on Which Way of Eating is Best for Health and Longevity?
If you’re totally sold on the paleo diet, be aware that the scientific article at hand doesn’t even mention it.
Proper diet undoubtedly promotes healthier aging and longevity. But what’s the right diet? A meta-analysis diet studies proposes an answer. Or more accurately, answers, based on diet-related biomarkers linked to disease and aging. Half of the studies were done in Europe, the rest from North America and Asia. The February, 2023, article was published in Nutrients. You can read the entire article online.
“….the main goal of this systematic review was to perceive the quantity and quality of different diets or aspects in nutrition, how they could modulate biomarkers and prevent aging-related diseases, in order to enlighten new intervention strategies. Biomarkers that are linked to aging-associated metabolism, inflammation processes, cognitive decline, and telomere attrition were scrutinized in order to understand how these mechanisms could actually influence healthy aging. Moreover, it could provide information to future health professionals.”
The researchers conclusions:
“In conclusion, this systematic review demonstrated the necessity for individuals to improve their diets, to reduce the emergence and development of several comorbidities and promote healthy aging. Diets rich in vegetables, fruits, nuts, cereals, fibers, fish, unsaturated fats, containing antioxidants, vitamins, potassium, omega-3—and reducing red meat and ultra-processed food intake—could prevent obesity, CVD [cardiovascular disease], and inflammation, and promote favorable glycemic, insulinemic, and lipidemic responses. Moreover, the Mediterranean diet and ketogenic diet, or a combination of these diets (MMKD), and increasing consumption of vegetables and green tea catechins, could improve one‘s working memory and decrease destabilization of the brain network and the attention domain, preventing cognitive decline. Finally, the Mediterranean diet, supplemented with CoQ or virgin olive oil, or a low-fat diet, also rich in antioxidants, could help to decrease the prevalence of atherothrombosis [arterial blood clots], hepatic steatosis, diabetes, and telomere attrition, as well as prevent oxidative and DNA damage. These diets can enhance one‘s quality of life and increase life expectancy. Moreover, a putative panel of molecular markers would follow the impact of diet/nutrition alterations during aging.”
The biomarkers tested included C-reactive protein, telomere length, HOMA-IR (insulin resistance), cholesterols, fibrinogen, platelet activating factor acetylhydrolase in HDLs, glucose, white blood cells, apolipoproteins, adiponectin, leptin, visceral adiposity index, etc.
Diets mentioned in the article include DASH, modified Alternative Healthy Eating Index, Southern European Atlantic (SEAD), Baltic Sea (a Nordic alternative to the Mediterranean diet), Mediterranean, and ketogenic Mediterranean.
This article is pretty dense reading. For science nerds only!
I was gratified to see several mentions of the ketogenic Mediterranean diet. It deserves more attention from the general public.
Steve Parker, M.D.
PS: If you have my Advanced Mediterranean Diet (2nd edition), you already have the Ketogenic Mediterranean Diet. It’s there in addition to the traditional Mediterranean diet.
Paleo Diabetic 