FDA and Medicare Looking Into Accuracy of Home Blood Glucose Monitors

Paleobetic diet, diabetic diet, low-carb, paleo diet, diabetes

This monitor looks like an antique

The Joslin Diabetes Blog has some details. For example:

Current standards for blood glucose meters were established by the FDA in 2003 in conjunction with the International Organization for Standardization (ISO). Today’s requirements state that a blood glucose system (meter and strips) must meet an accuracy standard of being within 20 percent of reference values (laboratory) for numbers at or above 75mg/dl and within 15mg/dl below 75 mg/dl.

The FDA has been working on revising the current requirements since 2010 and the ISO has already come out with new standards. Whether the FDA will accept the ISO’s recommendations or adopt a different set of standards only time will tell.

The article also mentions various factors that may affect accuracy, including temperature extremes, humidity, and altitude. The user manual that comes with the device should explain these.

Why Everybody Should Eat Nuts

Nuts with more omega-3 fatty acids (compared to omega-6) may be the healthiest

Nuts with the lowest omega-6/omega-3 fatty acid ratios may be the healthiest. In other words, increase your omega-3s and decrease omega-6s.

Conner Middelmann-Whitney explains in her recent post at Psychology Today. In a nutshell, they are linked to longer life and better health. For example:

In the largest study of its kind, Harvard scientists found that people who ate a handful of nuts every day were 20% less likely to die from any cause over a 30-year period than those who didn’t consume nuts. The study also found that regular nut-eaters were leaner than those who didn’t eat nuts, a finding that should calm any fears that eating nuts will make you gain weight.

The report also looked at the protective effect on specific causes of death. “The most obvious benefit was a reduction of 29% in deaths from heart disease—the major killer of people in America,” according to Charles S. Fuchs, director of the Gastrointestinal Cancer Treatment Center at Dana-Farber, the senior author of the report and a professor of medicine at Harvard Medical School. “But we also saw a significant reduction—11% —in the risk of dying from cancer,” added Fuchs.

Read the whole enchilada.

Nuts are integral to my Advanced Mediterranean Diet, Low-Carb Mediterranean Diet, Paleobetic Diet, and Ketogenic Mediterranean Diet.

Walnuts seem to have the lowest omega-6/omega-3 fatty acid ratio of all the common nuts. That may make them the healthiest nut. The jury is still out. Macadamia nuts have a good ratio, too. Paleo dieters focus on cutting out omega-6s and increasing omega-3s. Julianne Taylor has a great post on how to do that with a variety of foods, not just nuts.

Steve Parker, M.D.

Recipe: Turkey Tomato Bowl + Macadamia Nuts

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This Turkey Tomato Bowl fits criteria for the Paleobetic Diet

This is what I did with some of our leftover Thanksgiving turkey. If you don’t have leftover turkey, I bet leftover chicken or steak would be  fine substitutes. Heck, I’m tempted to try it with salmon or canned tuna or chicken. In addition to the flavor, what I like about this meal is that it’s crazy quick.

Ingredients:

6 oz (170 g) cooked turkey chunks, light meat (or 8 oz (225 g) if you’re starting raw and planning to cook it)

5 oz (140 g) raw tomato (2 small roma tomatoes, for example), cut into chunks

2 tbsp (30 ml) balsamic vinaigrette

black pepper to taste

1 oz (30 g) roasted macadamia nuts

paleobetic diet, low-carb, diabetes, diabetic diet, paleo diet

These roma tomatoes were amazingly flavorful for late Fall in the northern hemisphere. Before cooking, my wife injected the bird with olive oil, massaged periodically over 30 minutes, then popped it in the oven.

Instructions:

Toss the turkey and tomato chunks in a bowl, splash on the vinaigrette, then microwave for 60-80 seconds. Pepper as desired. Drink the leftover juice right out of the bowl. Enjoy with macadamia nuts for dessert and you’ve got a full meal.

Discussion:

paleobetic diet, low-carb, diabetes, diabetic diet

Grok wouldn’t have access to this

I was lazy when I made this so I just used a commercial salad dressing rather than making my own vinaigrette. Wish-Bone Balsamic Vinaigrette Dressing “with extra virgin olive oil.” Here are the top ingredients, in order: water, balsamic vinegar, soybean oil and extra virgin olive oil (sic), sugar, salt, spices, etc. So the oil could have been soybean oil (from a legume—the horror!!!) with one drop of EVOO for all I know. Olive oil is a rich source of monounsaturated fatty acid, so you might be able to calculate how much EVOO was in the dressing if I tell you there were five grams of fat per two tbsp (30 ml) serving, of which 1.5 grams were monounsaturated. That serving also has three grams of carbohydrate (all sugar) and only 60 calories. Right there on the bottle is says gluten-free and “no high fructose corn syrup.” I bet it had HFCS in it three years ago and there would be no mention of the trendy “gluten-free.”

I don’t know any home cooks who add water to vinaigrettes. They are essentially oil and vinegar (in a ratio of 3:1) and spices. The ones I make have quite a bit more than 60 calories per two tbsp (30 ml); more like 220 cals. All of the oils you would use have about 120 calories per tbsp all from fat. If you make this recipe with home-made vinaigrette, add 150 calories to the nutritional analysis below. It won’t affect the carb count.

Note that of the common vinegars, balsamic has the most carbohydrates—some vinegars have zero. If you use typical amounts of balsamic vinaigrette, you shouldn’t need to worry about the carbohydrates unless perhaps you’re on a strict ketogenic diet and limited to 20-30 grams of carb daily.

Servings: 1

Nutritional Analysis:

58% fat

7% carbohydrate

35% protein

620 calories

11.5 g carbohydrate

3.7 g fiber

8 g digestible carbohydrate

743 mg sodium

877 mg potassium

Prominent features: High in protein, vitamin B6, iron, manganese, niacin, phosphorus, selenium, and zinc.

paleobetic diet, low-carb, diabetic diet, paleo diet

Bonus pic! A new horse at the Parker Compound. He’s an old-style Morgan.

Recipe: Waldorfian Salad

paleobetic diet, low-carb diet

One cup of Waldorfian salad. I doubled the cinnamon in this batch, so yours won’t look quite like this.

Today’s meal is inspired by the classic Waldorf salad, made famous by New York’s Waldorf Hotel over a century ago. The hotel today is called the Waldorf-Astoria.

The primary ingredients are apples, walnuts, and celery.

The original salad was made with mayonnaise, which I’m leaving out since I don’t yet have a paleo-compliant formula. They’re out there, however. Do you have a favorite?

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Good source of omega-3 fatty acids

Instead of mayonnaise, we use a dressing—a vinaigrette—made with walnut oil. Walnut oil is attractive in part because it is rich in omega-3 fatty acids: 1.77 grams per tbsp (15 ml). Compared with Paleolithic diets, modern Western diets are too low in omega-3s and too high in omega-6s. You can use your left-over walnut oil the way you’d use olive oil.

paleobetic diet, low-carb diet, ketogenic diet

I made my dressing in this BPA-laden plastic container

In composing the Paleobetic Diet, my biggest challenge is breakfast. I’m fine eating eggs almost daily, but that may not be your cup ‘o tea. Most of us in America are accustomed to grain-based options like cold cereal, porridge, bagels, donuts, pancakes, granola, and toast. Plus yogurt. Those aren’t paleo, and they have too many carbohydrates for many diabetics. I came up with Waldorfian salad as a low-carb paleo-style breakfast, reminiscent of Brian’s Berry Breakfast.

This recipe makes two large servings of 2 cups (480 ml) each. Small or sedentary folks may well be satisfied with a 1- or 1.5-cup serving.

paleobetic diet, low-carb diet, ketogenic diet

Apples are the primary source of carbohydrates in this recipe.

Ingredients:

2 apples, raw, medium size, skin on, diced (I used Red Delicious; consider Granny Smith, Fuji, or Gala)

3 celery stalks, 8-inches long (20 cm), diced

1 cup (240 ml) walnuts, broken by hand into small chunks (Option for ? more flavor: toast in a skillet over medium-high heat for 7-10 minutes or in oven (350 F or 175 C) on baking sheet for 10 minutes

1/4 tsp (1.2 ml) black pepper, ground

1/4 tsp (1.2 ml) salt

1.5 tbsp (22 ml) walnut oil

1 tbsp (15 ml) cider vinegar

1/2 tsp (2.5 ml) cinnamon

1/4 tsp (1.2 ml) nutmeg

Instructions:

First make a dressing with the bottom six ingredients. I put mine in a small container with a lid, then shook vigorously. Or you can put them in a small bowel and whisk them.

paleobetic diet, low-carb diet, ketogenic diet

Walnut pieces

Place the walnuts, apples and celery in a bowel, add the dressing and toss thoroughly. You’re done.

Serve as is, or chill first in the refrigerator. Maybe it was my imagination, but I thought it tasted better after it sat on the counter for 10 minutes. Consider serving on a bed of lettuce (1-2 oz), but if you do, increase your digestible carb count by 1-2 grams.

If you want more calories or protein than this recipe provides, chicken or steak should go well with Waldorfian salad and won’t increase your carb grams.

Number of Servings: 2 (2 cups each)

Nutritional Analysis:

73% fat

21% carbohydrate

6% protein

500 calories

27.5 g carbohydrate

7.6 g fiber

20 g digestible carbohydrate

341 mg sodium

529 mg potassium

Prominent features: High in copper and manganese, low in sodium. This is vegetarian (so much for the paleo diet being meat-centric). On a 2,000 calorie diet, this provides only 15% of the Recommended Dietary Allowance for protein, so you’ll want to eat more protein at some point during the day.

Does Stretching Prevent Sports Injuries?

No.

This is a U.S. Army-style sit-up. I do sit-ups with my arms folded across my chest, hands on my shoulders

This is a U.S. Army-style sit-up. I do sit-ups with my arms folded across my chest, hands on my shoulders

For a couple years I’ve thought that stretching didn’t prevent injuries. Now I’ve got a scientific reference to back up my contention. Also from the abstract:

Strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved.

h/t James Steele II

Mouth Bacteria May Be an Important Cause of Heart Disease

…according to an article at University Herald.

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That milk mustache is a tell-tale sign she’s not eating pure paleo

The idea is that nasty bacteria around your gums somehow cause arterial inflammation in your heart arteries, which could lead to heart attacks. I’ve written about this before.

A quote from the article:

The researchers followed 420 adults as part of the Oral Infections and Vascular Disease Epidemiology Study (INVEST), a randomly sampled prospective cohort of Northern Manhattan residents. Participants were examined for periodontal infection. Overall, 5,008 plaque samples were taken from several teeth, beneath the gum, and analyzed for 11 bacterial strains linked to periodontal disease and seven control bacteria. Fluid around the gums was sampled to assess levels of Interleukin-1β, a marker of inflammation. Atherosclerosis in both carotid arteries was measured using high-resolution ultrasound.

Over a median follow-up period of three years, the researchers found that improvement in periodontal health-health of the gums-and a reduction in the proportion of specific bacteria linked to periodontal disease correlated to a slower intima-medial thickness (IMT) progression, and worsening periodontal infections paralleled the progression of IMT. Results were adjusted for potential confounders such as body mass index, cholesterol levels, diabetes, and smoking status.

Thickening of the arterial lining is linked to higher rates of heart attack and stroke.

It remains to be seen whether alteration of gum bacteria and periodontal disease via oral self-care and dental care will reduce cardiovascular risk going forward. Stay tuned.

Read more at http://www.universityherald.com/articles/5322/20131101/brushing-your-teeth-could-prevent-heart-disease.htm#rvx294vC7VKJ6Qu3.99

Consider Low-Carb Eating Instead of Drugs for Your GERD

How about this one?

It’s easier to pop a pill than change your diet, especially if someone else is paying for the pills

Dr. Michael Eades has a recent post on gastroesophageal reflux disease (GERD) and it’s treatment with carbohydrate-restricted eating versus drugs. A quote:

Most people who have GERD, have it for the long term. It’s not something that comes and goes. So these folks go on GERD therapy for the long term, and the most prescribed medications for long-term GERD treatment are PPIs [proton pump inhibitors], which, you now know, keep stomach acid neutralized for the long term, and, as you might imagine, creates a host of problems.

The scientific literature has shown long-term PPI therapy to be related to the following conditions:

  • Anemia
  • Pneumonia
  • Vitamin B12 deficiency
  • Impaired calcium absorption
  • Impaired magnesium absorption
  • Increased rate fractures, especially hip, wrist and spine
  • Osteopenia [thin brittle bones]
  • Rebound effect of extra-heavy gastric acid secretion
  • Heart attacks

Read the rest if you or someone you love has GERD. Acid-reducing Nexium is the second most-prescribed drug (by sales) in the U.S. We have stomach acid for a reason. It’s not nice to fool Mother Nature eliminating it.

Here’s a scientific report supporting Dr. Eades’ clinical experience that carbohydrate restriction helps with GERD. Carbs were reduced to 20 grams a day.

Steve Parker, M.D.

Dr. Guyenet Makes a Case for Beans in the Paleo Diet

As an introduction, he writes…

The canonical Paleolithic diet approach excludes legumes because they were supposedly not part of our ancestral dietary pattern.  I’m going to argue here that there is good evidence of widespread legume consumption by hunter-gatherers and archaic humans, and that beans and lentils are therefore an “ancestral” food that falls within the Paleo diet rubric.  Many species of edible legumes are common around the globe, including in Africa, and the high calorie and protein content of legume seeds would have made them prime targets for exploitation by ancestral humans after the development of cooking.

Richard Wrangham thinks hominins started cooking with fire as long as 1.8 million years ago. There’s no expert consensus yet.

Read the rest.

High Carbohydrate Diet May Cause Atherosclerosis

…and that condition underlies most heart attacks, strokes, and poor circulation to limbs. Here’s the conclusion from an abstract:

High-carbohydrate diets, particularly in the form of high-glycemic index carbohydrate, have the ability to directly induce atherosclerosis. Based on anthropologic facts, the reason for these dietary-induced, insulin-mediated, atherogenic metabolic perturbations are suggested to be an insufficient adaptation to starch and sugars during human evolution. Restriction of insulinogenic food (starch and sugars) may help to prevent the development of atherosclerosis, one of the most common and costliest human diseases.

medical clearance, treadmill stress test

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

The article was published in 2006. In 2007, Harvard’s Dr. Frank Hu  was singing the same tune about carbohydrates. Jenny Brand-Miller and associates implicate high-glycemic-index carbohydrates as a cause of atherosclerotic heart disease in women, but I don’t recall any similar evidence in men. Yet.

I know many diabetics hate to cut dietary carbohydrates. If this new theory of atherosclerosis pans out, maybe carb restriction will be easier to stomach.

 

h/t Mangan

Recipe: BLT Avocado Wraps and Pecans

paleobetic diet, paleo diet for diabetics

Ready to roll up and eat

BLT = bacon, lettuce, and tomato.

As I’ve written before, bacon isn’t a pure paleo food. Cavemen didn’t eat it. It’s too highly processed. You could make your own if you want. But bacon is convenient and no doubt better for you—at least if you have diabetes—than many of our traditional breakfast foods like cereal with milk, pancakes, instant oatmeal, bagels, or donuts. Those could shoot your blood sugar up to the moon.

Some studies link processed meats with cardiovascular disease and cancer, other studies don’t. If you want to be cautious with your health, don’t go hog-wild with bacon or other processed meats like hot dogs, bologna, and liverwurst.

Avocados come in hundreds of varieties. In the U.S., we mainly have California avocados (aka Hass) and Florida avocados. Californians are by far the market leader. They reign at the Parker Compound.

paleobetic diet

California or Hass avocado

paleobetic diet, paleo diet for diabetes

Florida avocado

California avocados are smaller dark green lumpy-skinned ones. Florida avocados are larger, smoother-skinned, and lighter green. Monica Reinagel has an article comparing the two, with notes on ripening and storage.

Oh, and by the way, avocados are fruits, not vegetables. But you knew that, you smartie.

Ingredients:

1 California (Hass) avocado, raw, medium size (about 4 x 2.5 inches or 10 x 6 cm), peeled and seeded, cut into long strips

6 bacon strips, medium thickness

4 oz (115 g) lettuce (e.g., iceberg, romaine, bibb, or broad-leaf lettuce you prefer)

4 oz (115 g) tomato, raw (this is about one-and-a half roma tomatoes or one medium regular tomato), cut into long strips

1 oz (30 g) pecans (option: substitute your favorite tree nut except for cashews—too many carbs)

Instructions:

Fry your bacon in a skillet over medium to medium-high heat. Next you’re gong to build two wraps. Lay out about two oz (  g) of lettuce and load it with three bacon strips, half your tomato, and half your avocado. Fold or wrap lettuce edges together and enjoy. Repeat with remaining ingredients. The pecans are for dessert.

paleobetic diet, paleo diet for diabetes

Our vicious guard dogs waiting for bacon

Number of Servings: 1 (that’s 2 wraps plus nuts)

Nutritional Analysis:

74% fat

12% carbohydrate

14% protein

720 calories

24 g carbohydrate

15 g fiber

9 g digestible carbohydrate

1137 mg sodium

1507 mg potassium

Prominent features: Good source of fiber, sodium, protein, vitamin B6, niacin, thiamine, pantothenic acid, copper, manganese, phosphorus, and selenium.