Paleolithic Diet Improved Metabolic Syndrome in Just Two Weeks

Posted on January 6, 2015 | 3 comments
Wish I were here

Wish I were here

A Paleolithic-type diet over two weeks improves several heart disease risk factors in folks with metabolic syndrome, according to Netherlands-based researchers.

The investigators wondered if the paleo diet, independent of weight loss, would alter characteristics of the metabolic syndrome. They seem to be the first scientists to do a study like this.

“Metabolic syndrome” may be a new term for you. It’s a collection of clinical features that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome, including almost one in four of adults. The most common definition of metabolic syndrome (and there are others) is the presence of at least three of the following characteristics:

  • high blood pressure (130/85 or higher, or using a high blood pressure medication)
  • low HDL cholesterol: under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)
  • triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a triglyceride-lowering drug)
  • abdominal fat: waist circumference 40 inches (102 cm) or greater in a man, 35 inches (88 cm) or greater in a woman
  • fasting blood glucose over 100 mg/dl (5.55 mmol/l)

These five criteria were identical to the ones used in the study at hand. But the study participants were required to have only two of the five, not three, for unclear reasons. I found no consensus definition elsewhere that would define metabolic syndrome as only two of the five conditions. Study participants ate either a paleo-style diet or a reference/control diet. Those eating the reference diet didn’t quite have the metabolic syndrome since they had a mean (“average”) of 2.7 metabolic syndrome characteristics. The paleo group had 3.7 characteristics.

How Was the Study Done?

Average age of the 34 study participants was 53 and they were generally healthy. None had diabetes, cardiovascular disease, or systolic pressure over 180 mmHg. Smokers were excluded. Mean body mass index was 32 (obese). Only 9 of the 34 subjects were men. Subjects were randomized to either a Paleolithic-type diet (n=18) or a “healthy reference diet based on the guidelines of the Dutch Health Council” (n=14). Efforts were made to keep body weight stable during the two-week study. Participants were nearly all caucasian.

All meals were home-delivered free of charge by a catering service.

The Paleolithic-type diet “…was based on lean meat, fish, fruit, leafy and cruciferous vegetables, root vegetables, eggs and nuts. Dairy products, cereal grains, legumes, refined fats, extra salt and sugar were not part of it.” [I like their version of the paleo diet.] Protein supplied 24% of calories while carbohydrate was 32% and fat 41%.

You can consult the full text of the published article for details of the Dutch Health Council diet. Calories were 17% from protein, 50% from carbohydrate, and 29% from fat. Alcohol isn’t mentioned at all.

Despite randomization, the paleo diet group had more metabolic syndrome characteristics than the reference diet group. For instance, 78% of the paleo group had elevated fasting glucose compared to 44% of the reference group. And 67% of the paleo group had low HDL cholesterol compared to just 13% of the reference group. These glucose and HDL differences were statistically significant. 39% of the paleo had high triglycerides compared to 19% of the others. Furthermore, the paleos’ average body weight was 98 kg (216 lb) compared to 86 kg (189 lb) in the others. The paleo group had 3.7 characteristics of the metabolic syndrome versus 2.7 in the other cohort.

Go John trail at Cave Creek Regional Park in Scottsdale, Arizona

Go John trail at Cave Creek Regional Park in Scottsdale, Arizona

Results

Compared to the reference diet, the paleo-style diet:

  • lowered systolic pressure by 9 points and diastolic by 5
  • total cholesterol fell by 0.52 mmol/l (20 mg/dl)
  • triglycerides fell by 0.89 mmol/l (79 mg/dl)
  • HDL cholesterol (good) rose by 0.15 mmol/l (6 mg/dl)
  • body weight fell by 1.32 kg (3 lb)
  • one metabolic syndrome characteristic resolved

No significant changes were seen in intestinal permeability ( by differential sugar absorption test on urine), salivary cortisol, and inflammation (hsCRP, TNFα).

Fasting plasma insulin and HOMA-IR fell in the paleo group but not the other.[Good news for folks with diabetes or prediabetes.] Yet the authors write, “Regarding glucose intolerance we did not find significant changes in our study.”

Fasting blood glucose for the group as a whole at baseline was about 1o8 mg/dl (6.0 mmol/l). Fasting glucose fell in both groups: 16 mg/dl (0.9 mmol/l) in the paleo group, 6 mg/dl (0.35 mmol/l) in the other. This was not a statistically significant difference between the groups. These numbers are from the text of the report; looking at the tables, I calculate different and less impressive reductions. The falls in fasting glucose from baseline were statistically significant for both diets.

Nearly all the statistical analysis focused on comparing the paleo diet group to the reference diet group.

My Comments

Overall, I’m not very pleased with this study. My biggest problems are 1) the unfortunate randomization that created dissimilar experimental groups,  2) the use of two diet protocols, 3) some of the study participants didn’t even have metabolic syndrome, and 4) as is typical for paleo diet studies, not many experimental subjects were involved.

The randomization led to significant differences in the metabolic syndrome patients in the two diet groups. I’m puzzled why the authors don’t comment on this. It’s a problem with clinical studies involving low numbers of participants. Ideally, you want to apply the two different diets to groups of people that are as similar as possible. These groups weren’t that similar.

The investigators’ main goal was to study whether a paleo-style diet, independent of weight loss, alters characteristics of the metabolic syndrome. Then why introduce another variable, the Dutch Health Council diet? Is it the gold standard for treating metabolic syndrome? Has it even been used to treat metabolic syndrome? The authors don’t tell us. And why not restrict participation to subjects who meet the common international definition of metabolic syndrome (at least three of the five characteristics)? Why not just take all your subjects and switch them from their standard Netherlands diet to the paleo diet? That would increase your statistical power, and would have avoided the randomization mis-match in which some in the reference diet group didn’t even have metabolic syndrome.

Here we’ve got two different experimental groups, and we’re applying a different diet to each group. The results are going to be messy and difficult to interpret. It’s always better if you can alter just one variable.

Since the paleo and reference diet cohorts were so different at baseline, why not make it easy to simply compare the paleo diet group’s “before and after numbers”? Maybe the analysis is there and I’m just not smart enough to see it.

There weren’t enough men in the study to tell us anything about the paleo diet in men with metabolic syndrome.

The statistical analysis was difficult for me to read and understand. There’s a good chance I’ve missed or misinterpreted something.

This paleo diet reduced fasting blood sugar significantly, making me think it may help in management of diabetes and prediabetes.

I estimate that as much as a quarter of the experimental subjects didn’t even have metabolic syndrome, so the study title is a bit of a misnomer.

This paleo diet did result in resolution of one metabolic syndrome characteristic, which is a good thing. So you could say the diet improves metabolic syndrome, even resolves it in some folks if it drops their metabolic syndrome characteristics from three to two. It predominantly helps lower blood pressure and triglycerides, and reduces excess weight modestly. In white women. Compared to the healthy Dutch Health Council diet.

If I had metabolic syndrome, I’d do something about it in hopes of lowering my future risk of diabetes and atherosclerotic complications. Standard physician advice is to lose excess weight and exercise regularly. There’s no consensus on diet yet. I think carbohydrate restriction is important. If the study at hand is reproducible in a larger study population, the paleo diet is a reasonable approach. Dietitian Franziska Spritzler has a great review of nutritional management of metabolic syndrome at her blog. The Mediterranean diet supplemented with nuts helps improve metabolic syndrome. The Spanish Ketogenic Mediterranean Diet may cure metabolic syndrome.

Steve Parker, M.D.

Update: I took a fresh look at this study as if it were simply a paleo diet trial involving 18 subjects who had metabolic syndrome. If I’m interpreting Table 5 correctly, and I think I am, these are the statistically significant changes after two weeks:

  • abdominal circumference decreased by 3.1 cm
  • systolic and diastolic blood pressures dropped by 8.5 and 8, respectively
  • fasting glucose dropped by 0.4 mmol/l (7 mg/dl)
  • fasting insulin fell
  • HOMA-IR decreased (less insulin resistance)
  • total cholesterol decreased from 220 to 193 mg/dl (5.7 to 5.0 mmol/l)
  • LDL-cholesterol decreased from 135 to 124 mg/dl (3.5 to 3.2 mmol/l)
  • triglycerides decreased from 168 to 89 mg/dl (1.9 to 1.0 mmol/l)

HDL cholesterol was unchanged.

The fall in AUC (area under the curve) for insulin approached but didn’t reach statistical significance (p=0.08)

Body weight fell from 98 kg (216 lb) to 95.3 kg (210 lb) but I found no p value. HDL-cholesterol was unchanged (the higher HDL I mentioned above is only in comparison to the reference diet, in which HDL fell)

All of these changes (except the lack of change in HDL-chol) would tend to promote health in someone with metabolic syndrome, prediabetes, or overweight type 2 diabetes.

Reference: Boers, Inga, et al. Favorable effects of  consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study. Lipids in Health and Disease. 2014 Oct 11;13:160. doi: 10.1186/1476-511X-13-160.

3 Comments

Posted in Paleo Diet

Tagged , , , , , , , ,

How Did the Agricultural and Industrial Revolutions Change Human Diets?

Posted on January 1, 2015 | 1 comment

MP900227702[1]

With the advent of the Agricultural Revolution 10,000 years ago, mankind took a giant leap away from two million years of evolutionary adaptation. The Industrial Revolution that started in the late 18th century—about 240 years ago—was yet another watershed event. The Agricultural Revolution marks the end of the Old Stone Age and the start of the Neolithic period. The Neolithic ended four to six thousand years ago, replaced by the Bronze Age (or Iron Age in some areas).

EFFECTS OF THE AGRICULTURAL REVOLUTION

The Agricultural Revolution refers to farming the land on a large scale, and all that entails: gathering and planting seeds, nurturing the soil, breeding plants for desirable traits, storing crops, processing plants to maximize digestibility, domesticating wild animals and enhancing them by selective breeding, setting down roots in one geographic location, etc. The revolution allowed for the expansion of reliable food supplies and an explosion of human populations. Less time was needed for hunting and foraging, allowing for the development of advanced cultures.

It wasn’t all sunshine and roses, however. We have evidence that human health deteriorated as a result of the revolution. For instance, some populations declined in height and dental health.

EFFECTS OF THE INDUSTRIAL REVOLUTION

The Industrial Revolution starting in the late 18th century brought its own changes to our diet. Progressive industrialization and affluence changed the composition of our “energy foods.” For instance, peasants in poor developing countries derive about 75% of their calories from high-fiber starchy foods. With modernization, fiber-free fats and sugars become the source of 60% of calories. U.S. consumption of cereal fiber decreased by 90% between 1880 and 1976. In addition to lower fiber content, refined wheat products also had fewer vitamins and other micronutrients. Machinery allowed the production of margarine and vegetable oils. Sugar imports and snacking increased in the Western world.

Obesity suddenly became very common in the upper classes of Europe and England toward the end of the 17th century and even more so in the 18th. Weights also increased throughout populations of developed countries. For instance, if we look at U.S. men of average height between the ages of 30 to 34, average weights were 148 lb (66 kg) in 1863, but were up to 170 lb (77 kg) in 1963. Our current obesity epidemic didn’t even start until around 1970.

Let’s look at a few major U.S. diet changes from 1860 to 1975. Energy derived from protein rose from 12% to 14–15%. Energy from fat rose from 25 to 42% of calories. Energy from starches fell from 53 to 22%. Calories from sugar rose from 10 to 24%. Total carbohydrate calories fell from 63 to 46%.

It only takes a few decades to see major changes in a population’s food consumption. For instance, U.S. per capita consumption of salad and cooking oils increased from 21.2 pounds per person in 1980 to 54.3 pounds per person in 2008 (USDA data). I refer to these oils as industrial seed oils, and they include soybean, corn, and sunflower oil. We’re not entirely sure what effect these have on health. Some suspect they are related to obesity, heart disease, and other “diseases of civilization.” Per capita soybean oil consumption in the U.S. increased over a thousand-fold between 1909 and 1999, to 7.4% of total calories. It’s in many of our processed foods. Linoleic acid is a predominant omega-6 fatty acid in seed oils. Linoleic acid consumption increased by 200% in the last century. Thanks to increasing omega-6 fatty acid consumption, the omega-6/omega-3 ratio increased from 5.4:1 to 9.6:1 between 1909 and 2009. (Reference: Blasbalg TL, Hibbeln JR, Ramsden CE, Majchrzak SF, Rawlings RR. “Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century.” Am J Clin Nutr. 2011 May;93(5):950-62. doi: 10.3945/ajcn.110.006643. Epub 2011 Mar 2.)

The Industrial Revolution also introduced into our diets large amounts of man-made trans-fats, which are highly detrimental to cardiovascular health. Public outcry has lead to diminishing amounts of dietary trans-fats over the last decade.

An occasional teaspoon of sugar probably won't hurt you

Added sugars: table sugar in coffee, high-fructose corn syrup in ketchup

At his Whole Health Source blog, Dr. Stephan Guyenet and Jeremy Landen produced a graph of U.S. sugar consumption from 1822 to 2005. Dr. Guyenet wrote, “It’s a remarkably straight line, increasing steadily from 6.3 pounds (2.9 kg) per person per year in 1822 to a maximum of 107.7 pounds (49 kg) per person per year in 1999. Wrap your brain around this: in 1822, we ate the amount of added sugar in one 12 ounce can of soda (360 ml) every five days, while today we eat that much sugar every seven hours.” Note that added sugars overwhelmingly supply only one nutrient: pure carbohydrate without vitamins, minerals, antioxidants, protein, fat, etc.

 

Think about the typical Western or Standard American Diet (SAD) eaten by an adult these days. It provides an average of 2673 calories a day (not accounting for wastage of calories in restaurants; 2250 cals/day is probably a more accurate figure for actual consumption). Added sugars provide 459 of those calories, or 17% of the total. Grains provide 625 calories, or 23% of the total. Most of those sugars and grains are in processed, commercial foods. So added sugars and grains provide 40% of the total calories in the SAD. That’s a huge change from the diet of our prehistoric ancestors. Remember, we need good insulin action to process these carbohydrates, which is a problem for diabetics. Anyone going from the SAD to pure paleo eating will be drastically reducing intake of added sugars and grains, our current major sources of carbohydrate. They’ll be replacing them with foods that generally require less insulin for processing. (Figures are from an April 5, 2011, infographic at Civil Eats: http://www.civileats.com.)

FUN FACTS! (from the U.S. Dept. of Agriculture)

  • A typical carbonated soda contains the equivalent of 10 tsp (50 ml) of table sugar.
  • The typical U.S. adult eats 30 tsp (150 ml) daily of added sweeteners and sugars.
  • U.S total grain product consumption was at record lows in the 1970s, at 138 pounds per person. By 2008, grain consumption was up by 45%, to 200 pounds per person.
  • Total caloric sweetener consumption (by dry weight) was 110 pounds per person in the 1950s. By 2000, it was up 39% to 150 pounds.
  • Between 1970 and 2003, consumption of added fats and oils rose by 63%, from 53 to 85 pounds. (How tasty would that be without starches and sugars? Not very.)
  • In 2008, “added fat” calories in the U.S. adult diet were 641 (24% of total calories).

Steve Parker, M.D.

1 Comment

Posted in Uncategorized

Tagged , , , , , , , , ,

What’s Your Favorite Paleo Diet Cookbook?

Posted on December 30, 2014 | Comments Off on What’s Your Favorite Paleo Diet Cookbook?

Would you help me out and tell me your favorite paleo diet cookbooks, and perhaps why? My patients are asking me for paleo diet recipes, and I need more sources. 

Ideally, I’d like authors who avoid or minimize use of dairy products, legumes, grains, and industrial seed oils. My favorite version of paleo is Loren Cordain’s. Let’s also minimize hard-to-find or esoteric ingredients. I don’t care whether or not the beef is pastured or if the chickens are free-range happy ones. Prep time under 30 minutes is always appreciated. I would love to have basic nutritional analysis such as digestible (net) carb grams, calories per serving, and percentage of calories from fat, protein, and carbohydrate.

I’m afraid I’m going to have to do the nutritional analyses myself, as I have with my Paleobetic Diet recipes.

Here’s one that I haven’t read yet but have great expectations that it’s good: 500 Paleo Recipes by Dana Carpenter. I’ve read several of her non-paleo low-carb cookbooks and they’re good. Her 500 Paleo Recipes book provided some basic nutritional analysis for each recipe, including carbohydrate grams, which is critical if you have diabetes.

Dr. Cordain has a new cookbook being released in March, 2015. Does his 2011 collaboration with Nell Stephenson provide nutritional analysis (unlikely)?

Some books and authors for your consideration: Mark Sisson’s Primal Blueprint Cookbook, something from the Hartwigs, Robb Wolf, Sarah Fragoso’s Everyday Paleo,  Melissa Joulwan’s Well Fed, Diane Sanfilippo, Nom Nom Paleo by Tam and Fong, and Paul Jaminet.

Steve Parker, M.D.

 

Comments Off on What’s Your Favorite Paleo Diet Cookbook?

Posted in Recipes

Tagged , ,

Do the Drug Companies Have Too Much Influence on Diagnosis and Management of Type 2 Diabetes?

Posted on December 28, 2014 | 2 comments
diabetic mediterranean diet, Steve Parker MD

Pharmacist counting pills

MedPageToday has recently completed a series of articles looking at socioeconomic issues related to diabetes drugs that have come onto the market in the last decade. They call it their Diabetes Drugs Investigation. I recommend the entire series to you if you have type 2 diabetes. The authors’ have five major points:

1. “Diabetes drugs improve lab tests, but not much more, particularly in pre-diabetics.” FDA drug approvals were based mostly on whether hemoglobin A1c or blood sugar levels improved, not on improvements in hard clinical endpoints such as risk of death, heart attacks, stroke, blindness, amputations, etc.

2. “Physicians and drug makers have reported diabetes drugs as the “primary suspect” in thousands of deaths and hospitalizations.”

3. “Diabetes drug makers paid physicians on influential panels millions of dollars.” The implication is that the panelists were not totally unbiased in their assessments of drug effectiveness and safety.

4. “Risk of a risk now equals disease.” This is about the latest redefinition of prediabetes which created many more “patients.” Prediabetes can progress to type 2 diabetes over a number of years: one of every four adults with prediabetes develops diabetes over the next 3 to 5 years. Some doctors are even treating prediabetes with diabetic drugs. (I recommend a “diet and exercise” approach.) The authors think the prediabetic label—one third of U.S. adults, including half of all folks over 65—is over-used and over-treated.

5. “The clinical threshold for diagnosing diabetes has crept lower and lower over the past decade.” For instance, in 1997 expert panels lowered the threshold defining diabetes from a fasting blood glucose level of 140 mg/dl (7.8 mmol/l) to 125 mg/dl (6.9 mmol/l). Four million more American adults became diabetics overnight. In 2003, they lowered the threshold for prediabetes from a fasting blood glucose from 110 mg/dl (6.1 mmol/l) to 100 mg/dl (5.6 mmol/l). Boom! 46 million more American prediabetics.

I fully agree with the authors that we don’t know which drugs for type 2 diabetes are the best in terms of prolonging life, preventing diabetes complications, and postponing heart attacks and strokes. Furthermore, we don’t know all the adverse long-term effects of most of these drugs. For instance, metformin had been on the market for over a decade before we figured out it’s linked to vitamin B12 deficiency.

That’s why I try to convince my patients to do as much as they can, when able, with diet and exercise before resorting to one or more drugs. (All type 1 diabetics and a minority of type 2 diabetics must take insulin.) Maybe it’s healthier to focus primarily on drug therapy…but I don’t think so.

RTWT.

Steve Parker, M.D.

2 Comments

Posted in Drugs for Diabetes

Tagged , , , , ,

Sulfonylurea Drugs Linked to Heart Disease in Women

Posted on December 26, 2014 | Comments Off on Sulfonylurea Drugs Linked to Heart Disease in Women

…according to this article at Diabetes Care. The study population was the Nurses Health Study. The longer the sulfonylurea was used, the stronger the association with Coronary Heart Disease. CHD is by far the most common cause of heart attacks. On the bright side, the drugs were not linked to stroke risk. Remember, correlation is not causation, blah, blah, blah…

This report is another reason to do all you can to control blood sugars with diet and exercise, minimizing the risks—known and unknown—of long-term drugs.

I rarely start my patients on sulfonylureas these days.

Steve Parker, M.D.

Comments Off on Sulfonylurea Drugs Linked to Heart Disease in Women

Posted in Diabetes Complications, Drugs for Diabetes

Tagged , , ,

Merry Christmas!

Posted on December 24, 2014 | Comments Off on Merry Christmas!
Credit: Zvonimir Atletic / Shutterstock.com

Credit: Zvonimir Atletic / Shutterstock.com

Comments Off on Merry Christmas!

Posted in Uncategorized

What We Don’t Know About Diabetes Drugs Could Kill You

Posted on December 21, 2014 | Comments Off on What We Don’t Know About Diabetes Drugs Could Kill You
paleobetic diet, low-carb diet, diabetic diet

How about this one?

MedPageToday has an article on the “Bittersweet Diabetes Economy” talking about the cost of treating diabetes, pharmaceutical company influence on diagnosis and treatment of diabetes and prediabetes, and the unknown long-term effectiveness of diabetes drugs. Most of the article pertains to type 2 diabetes. A quote:

Last year, sales of diabetes drugs reached $23 billion [worldwide or U.S.?], according to the data from IMS Health, a drug market research firm. That was more than the combined revenue of the National Football League, Major League Baseball, and the National Basketball Association.

But from 2004 to 2013, none of the 30 new diabetes drugs that came on the market were proven to improve key outcomes, such as reducing heart attacks or strokes, blindness, or other complications of the disease, an investigation by MedPage Today and the Milwaukee Journal Sentinel found.

The U.S. Food and Drug Administration approved all of those drugs based on a surrogate endpoint: the ability to lower blood sugar. Many of the new drugs have dubious benefit; some can be harmful.

Another key outcome we don’t know about is prevention or postponement of death in type 2 diabetes via drug therapy.

Now you have some inkling of why I exhort my patients to maximize diet and exercise interventions before resorting to drugs, increasing drug dosages, or adding more drugs. (I’m not talking about type 1 diabetes here.)

RTWT.

Comments Off on What We Don’t Know About Diabetes Drugs Could Kill You

Posted in Drugs for Diabetes

Tagged

Is a Vegan Diet Better Than Paleo for T2 Diabetes?

Posted on December 19, 2014 | 6 comments

We don’t know yet because they’ve never been compared head-to-head.

paleo diet, Steve Parker MD, how to cook asparagus and Brussels sprouts

These might be on the vegan Ma-Pi 2 diet

What we do have is a specific vegan diet (Ma-Pi 2) compared to a low-fat diet in a study published by Nutrition & Metabolism. Carbsane Evelyn dove into the study at her blog (recommended reading), or you can read the original research report yourself. Study subjects had fairly well-controlled type 2 diabetes and were elderly (66) and overweight (84 kg or 185 lb). The vegan diet was mostly whole grains, vegetables, legumes, and green tea.  The low-fat and vegan diets both probably supplied 200-300 calories/day fewer than what the subjects were used to: 1900 cals for men, 1700 for women. The study lasted only three weeks.

The vegan group ate 335 grams/day of carbohydrate compared to 235 grams in the low-fat group. In contrast, the Paleobetic Diet provides 60-80 grams/day of digestible carb and the Ketogenic Mediterranean Diet allows a max of 20-30 grams.

The vegans in the study at hand ate 15-20 more grams/day of fiber. High fiber intake is linked to better blood sugar control.

From the study abstract:

After correcting for age, gender, BMI at baseline, and physical activity, there was a significantly greater reduction in the primary outcomes fasting blood glucose and post-prandial blood glucose in those patients receiving the Ma-Pi 2 diet compared with those receiving the control diet. Statistically significantly greater reductions in the secondary outcomes, HbA1c, insulin resistance, total cholesterol, LDL cholesterol and LDL/HDL ratio, BMI, body weight, waist and hip circumference were also found in the Ma-Pi 2 diet group compared with the control diet group. The latter group had a significantly greater reduction of triglycerides compared with the Ma-Pi 2 diet group.

The take-home point for me is that overweight T2 diabetics can improve short-term diabetes numbers despite a high carbohydrate consumption if they restrict calories and eat the “right” carbs. Restrict calories enough—600/day?—and T2 diabetes might be curable. 

I’ve written before about vegetarian/vegan diets for diabetes. My patients are more resistant to vegan diets than they are to low-carb.

Paleobetic diet, low-carb breakfast

Not allowed not on the Ma-Pi 2 diet. Bacon, eggs, black coffee, and Cholula hot sauce. A caveman wouldn’t recognized any of this except for eggs.

I scanned the original report and don’t see any problems with Evelyn’s summary.

Steve Parker, M.D.

6 Comments

Posted in Diabetic Diet

Tagged , , , ,

I Failed as a Deer Hunter

Posted on December 14, 2014 | 4 comments
ll

ll

Last month I missed my first chance ever to shoot a deer.

Arizona has a lottery system to determine who gets to participate in the harvest. Winners were announced in July or so. I had until early November to get ready.

My family has no hunting tradition, so I’m on my own. Before the hunt, I needed to choose and purchase a rifle*, choose and purchase optics (a scope), learn how to shoot accurately, learn how to hunt deer, and make several advance trips to my designated hunting area to scope it out (exactly where are the deer?). Furthermore, I need new eyeglasses. As you might imagine, I’m fairly obsessive and compulsive about doing things the right way. I ran out of time, thanks to other aspects of life that were more important. Oh, well. Maybe I’ll be ready by next fall.

I did spend a couple hours with my son checking out rifles at Bass Pro Shop in Mesa, Arizona. They had many on my list of prospects.

Notes On Rifle Choice

Although a wood stock is aesthetically appealing, a synthetic stock probably makes more sense in terms of withstanding weather-related stress such as rain, heat, cold, and extremes of humidity. Plus, the synthetic stocks are $200 cheaper.

I’m leaning towards .308 caliber since it packs enough punch for elk hunting. .30-06 would do the trick, too.

I was not greatly impressed with Savage rifles, although the Weather Warrior was not bad. I don’t remember otherwise which Savage models I held. The salesman at Bass said it’s a little more trouble to mount a scope on the Savages. Savages are popular rifles.

He also told me to consider stainless steel barrels.

The Weatherby Vanguard Series 2 Sporter with synthetic stock was OK, but not one of my favorites.

I ruled out the Ruger American simply because I like the Tikka T3 better. I have a Ruger revolver and recommend the company. I also have a soft spot for Browning firearms since I’m happy with my Browning BDA .380 semi-automatic pistol.

The Sako A7 is too expensive, even with synthetic stock. I don’t remember the price, but must be over $1,500.

All of the following are in the running for future purchase:

  • The Tikka T3 (Hunter or Forest model) is made by Sako and I was favorably impressed. $600 with synthetic stock.
  • Browning A-Bolt Medallion (not chambered in .308, but in .30-06).
  • Browning X-Bolt Hunter.
  • Browning X-Bolt Medallion.
  • Winchester Model 70 is very nice. The Alaskan model is probably the only one on this page that comes with iron sites, an option I like. It is chambered in .30-06 but not .308
  • Remington 700. Several different models, and perhaps not in .308 caliber. At least one has iron sites (BDL model). But has Remington solved the dangerous trigger issue?

If I had to choose one right now, it’d be the Tikka T3.

Steve Parker, M.D.

 *Mike S., thanks for offering me the use of one of your rifles. But my goal is a Parker family rifle I can pass down to the next generation.

PS: I just learned that a Remington 700 is what Charles Whitman used to kill 16 people from a tower at the University of Texas (in Austin) in 1966.

4 Comments

Posted in Hunting

Tagged , , , ,

Low-Carb Diet Beats Low-Fat for Weight Loss While Improving Cardiovascular Risk Factors

Posted on December 11, 2014 | 2 comments

…according to an article at MedPageToday.

Many physicians have been reluctant to recommend low-carb diets out of fear that they increase cardiovascular risk. How could that happen? By replacing carbohydrates with fats, especially saturated fats, leading to atherosclerosis. I don’t buy that theory (here’s why).

medical clearance, treadmill stress test

This treadmill stress test is looking for atherosclerotic heart disease, aka coronary artery disease and coronary heart disease

A recent study compared low-carb to low-fat dieting over 12 months and actually found better improvements in cardiovascular disease risk factors on the low-carb diet (max of 40 grams a day).

After 12 months, folks on a low-carbohydrate diet had lost 5.3 kg (11.7 lb), while those on a low-fat diet with similar caloric value had lost 1.8 kg (3.9 lb). Both groups showed lowering of LDL cholesterol, while the low-carbers had better improvements in HDL cholesterol and triglycerides.

DietDoctor Andreas Eenfeldt can add this study to his list of others that show better weight loss with low-carb diets compared to low-fat.

Steve Parker, M.D.

2 Comments

Posted in Heart Disease, Low-Carb, Overweight, Weight Loss

Tagged , ,