
A man with an empty stomach has one problem, but a man with a full stomach has a hundred.
-Anonymouse

A man with an empty stomach has one problem, but a man with a full stomach has a hundred.
-Anonymouse
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Posted in Quote of the Day
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.

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Posted in Longevity
Introduction

Topics
Arizona is blessed with thousands of miles of beautiful trails. Most hikers complete their treks without injuries or other adverse events. However, you can get into serious trouble—even life-threatening—if you don’t know what you’re doing. The most common hazards are related to weather, water, and falls. Our goal with this guide is to help you thrive and survive on southern AZ’s low desert trails. It’s only a start; learn more on your own from authoritative sources.
“Low desert” refers to elevations of roughly 1,000-2,500 feet above sea level, although many low desert trails may take you up mountains to 3,500-4,500 feet. For instance, Scottsdale’s elevation is 1,200 feet and Tucson’s is 2,400 feet. In contrast, the Mogollon Rim (e.g., Payson, AZ) is around 6,000 feet and Flagstaff is 7,000. At these higher elevations the climate, flora, and fauna are often radically different from the low desert.
Before your trek, it’s critically important be honest about your physical coordination and fitness level. If you haven’t walked more than two miles non-stop during the last year, don’t try a four-mile hike. Learn all you can about your proposed trail before you start. Trail descriptions will often note whether it is easy, moderate, difficult, strenuous, or “expert level.” A “primitive trail” will be easier to get lost on and usually have worse footing. Also pay attention to “elevation gain”; a 500 foot or more gain in elevation increases the difficulty. Scottsdale’s famous Camelback Mountain peak is at 2,700 feet, but the Cholla trail starts 1,300 vertical feet below that. That’s not a stroll in the park.
The farther away you get from civilization, the potential adverse outcomes of hiking increase. For any but the easiest and crowded urban trails, tell someone which exact trail you will be on and when to expect a call from you after you finish. That way they know where to send the search party when you don’t check in. On remote or uncrowded trails, hike with a buddy who can help if you become injured or disabled.
Numerous rescues and several deaths occur yearly on AZ’s trails. Are you scared yet? Let’s alleviate that fear and minimize risks! What follows pertains mostly to day hikes on established trails, not bushwhacking or overnight backpacking.
Weather
Heat kills. From mid-May through late September, high temperatures in the low desert often hit 105 to 110° F or even higher. Low temps in summer may not drop below 95! Most Arizonans will NOT be on the trail in the sun when it’s above 95 degrees. We’ll hit the trail at sunrise and be off it by 10 AM. Memorize and avoid these signs of Heat Illness: muscle cramps, feeling faint (dizzy), goosebumps, unusually high pulse, extreme fatigue, nausea, headache, rapid breathing. If ignored, these can lead to heat stroke, which can be fatal. Adequate hydration and perhaps salty snacks or electrolyte packets help prevent Heat Illness.
Some trails will have almost no shade, so you should avoid them in summer after 10 AM unless high temps under 95° are predicted.
High temps are not much of a problem in late fall, winter, and early spring. Low temps are easily manageable with the right clothing. But always check the forecast for temps, rain, snow, and thunderstorms before heading out. The higher the elevation, the cooler it tends to be.
AZ has a season called “monsoon” from June 15 to Sept 30 when overall humidity is higher than usual. It’s characterized by occasional violent storms with rain, high winds, lightning, and flash flooding. Don’t get caught outside in a monsoon storm. Be very careful to avoid creeks and dry creek beds (washes or arroyos) when rain is in the area or even miles away, or you could die in a flash flood. From the Centers for Disease Control : “Lightning often strikes outside of heavy rain and can strike as far as 10 miles away from any rainfall. Many lightning deaths occur ahead of storms or after storms seemingly have passed. Remember, if you can hear thunder, you might be in danger of a lightning strike.”
Water
Dehydration kills. Especially in the hot months. Adequate hydration will help prevent Heat Illness. How much water you carry with you depends on body weight, length of hike, humidity level, temperature, personal preference, etc. Everybody should start out well-hydrated and take more water than you think you’ll need. One rule-of-thumb is that, when a third of your water is gone, it’s time to turn around unless you’re half-way to your destination. For hot summer hikes, Arizona Hiking Shack (phone 800-964-1673) advises adults to take one liter of water for every hour you’ll be out, plus and an extra bottle “for whatever.” There’s a fair chance you’ll run across someone on the trail who needs water. You may need water to cleanse abrasions or wet your neck’s cooling towel. Another rule-of-thumb from the Shack is: “When your water’s half done [gone?], your hike is half done.”
Clothing and Gear
Footwear:
If a trail is labelled as “easy,” you’ll probably be fine wearing sneakers. “Easy” usually means fairly flat and smooth. Avoid sandals because they don’t provide much protection against cactus needles, scorpions, rocks, etc. For a “moderate” level trail, you might get by with sneakers but specific hiking shoes or boots are better, which is what you’ll want for “difficult” trails. Moderate, difficult, and primitive trails usually have more rocks, and your feet need protection from them with a thicker or stiffer shoe sole.
Clothing:
Use your judgment and dress for the weather. You may fall or rub against bushes, cacti, and rocks, so sturdier clothes beat flimsy. White or light-colored clothing will keep you cooler in the summer. A broad-brimmed hat protects against the sun.
Sun Protection Options:
Sunscreen, long pants, long-sleeve shirts, gloves, sunglasses, hat.
Backpack:
Size depends on individual needs and preferences. A comfortable one is worth the money. A pack with a hip belt will make heavy loads (water!) more comfortable by shifting some weight onto the hips. Built-in water-carrying bladders are popular.
Trekking poles (optional):
Helpful for maintaining balance on uneven, unstable, or slanted surfaces. They take pressure off arthritic or weak knees when moving downhill.
Miscellaneous:
First aid kit, communication devices, maps, navigation aids, multi-tool, cooling towel for neck (requires water).
First Aid Kit
Commercial kit or DIY (do it yourself). You need tweezers to remove cactus needles and splinters, an assortment of band-aids, antibiotic ointment, 1% hydrocortisone cream, antiseptic towelettes, steri-strips, 2-inch gauze wrap, “2nd Skin” or other blister remedy, medical tape, 4×4” gauze pads, 2×2” gauze pads, small scissors or paramedic shears, latex or nitrile gloves. Barebones kit: tweezers, band-aids, 4×4” gauze pads, 2-inch gauze wrap. Optional: acetaminophen, NSAID such as ibuprofen, Benadryl (for itching). [sterile needle or other device for help removing splinters?]
Navigation Aids
A few trails are so obvious and/or crowded that you won’t need any navigation aids. Unless you’re sure about that, be prepared to prevent getting lost. Use a trail map and keep track of your location on that map. If you are in a remote area, strongly consider a handheld GPS navigation device (Garmin brand is the market leader), topographic map, and a compass. Learn how to use the compass and map before you need it. Hiking with someone familiar with the area could be life-saving.
Animal Hazards
Lions and tigers and bears, Oh My! AZ has no wild tigers but there are a few jaguars. Here are some problematic critters you may run across:
From the list above, if you have a scary animal encounter it’s most likely to involve a rattlesnake, scorpion, or bees. Odds are, you won’t have any problem at all. Search for information at trailheads about which dangerous animals are in the area and advice on avoidance and defense.
Plant Hazards
The desert is home to many spikey and prickly plants that are not always obvious upon inspection. Be vigilant. Watch young children closely.
How to Request Emergency Help
A cell phone is the usual first option. But remote areas often lack cell phone service. If service is marginal, try moving to a higher location and/or send a text message. If you’re disabled by injury, someone in your party can hike back to civilization for help, if time allows.
Another option is an emergency whistle. The idea is to get the attention of someone in the area. The whistle is louder and will transmit farther than shouting, up to a mile or so, and takes less energy. A common distress signal from a whistle is three blasts (2-3 seconds each) in succession, rest for a bit then repeat. Or use the old Morse code for SOS: three short blasts, three long blasts, then three short blasts.
After cell phones, a satellite phone is the next most reliable and quick-response option although financially out of reach for most of us. Less expensive options are PLBs (personal locator beacons) and satellite messengers. PLBs solely send an SOS with your location to rescue agencies via satellite and do not have a subscription fee. Alternatively, satellite messengers allow you to send SOS signals, plus text messages to friends or loved ones and have additional features like navigation. A subscription fee is required. Examples are Garmin inReach, SPOT, and Bivy Stick.
Prepare for the Worst?
Imagine planning on a four-hour afternoon hike alone on a remote trail, but you trip and fall into a ravine, fracturing your leg, losing your ability to walk. And you have no way to call for help. Assuming a search party is planned, they may not find you until 12-48 hours later. You’ll have to spend the night in the wild and it’s getting cold. Are you prepared? Items to consider packing: tarp for making a shelter, 550 paracord, flashlight, space blanket for warmth, knife, method for purifying water, method for making fire (matches, lighter), firearm for protection, warm clothes, and food. Before heading out on the trail, take a full-body photo of yourself in your hiking clothes and send it to a loved one; this will help rescuers quickly identify you.
Conclusion
Be prepared, not scared.
Steve Parker, M.D.

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Posted in Exercise

From Peggy at Buttoni’s Low-Carb Recipes:
If you think you don’t like cabbage (like my husband) you have GOT to try this recipe! You’ll swear you are not eating cabbage!! No cabbage odor or strong taste whatsoever to this dish! It is a delightfully crunchy side dish with grilled Tandoori Chicken or pork chops! I order my nigella seeds (black onion seeds or kalongi seed) on-line, but you may be fortunate to have a spice supplier where you live. I would not recommend omitting them, as you will miss out on a flavor layer that is quite nice. Once you taste this recipe (without alterations) you’ll wish you had found this simple recipe long ago! This dish is Atkins Induction, Primal and Paleo friendly.
I haven’t tried this yet but will someday. Filing it here so I don’t lose it. Click for details.
Steve Parker, M.D.

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Posted in Uncategorized
If so, it may well be because of your genes according to an article at SBS.com. Particular genes determine whether you can detect a bitter chemical (called PTC) in broccoli and other brassicas like cauliflower and brussels sprouts.

“On average, about 70% of us can taste something bitter in broccoli or PTC, but those with two copies of the bitter sensitivity gene are closer to 20%, and they are much more likely to hate it.”
U.S. President George H.W. Bush said in March 1990, “I do not like broccoli. And I haven’t liked it since I was a little kid and my mother made me eat it. And I’m President of the United States and I’m not going to eat any more broccoli!” He banned it on Air Force One.
Most of us at the Parker Compound like broccoli. My wife usually sautes it in olive oil and seasons with garlic, other herbs, and salt.
Steve Parker, M.D.

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Posted in Uncategorized

I found a review article at Animal Frontiers that makes the argument in favor of meat consumption. The authors admit little focus on the downsides of eating meat. I’ve been cutting back on my meat consumption out of sympathy for the animals. Here are some of the key points verbatim:
Steve Parker, M.D.

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Posted in Paleo Theory
…in Muslim Iranian women, according to an article at Journal of Nutrition and Metabolism.
There’s a lot going on in this study. I didn’t understand some of the statistics. Click the link above for full details. Here’s the abstract:
Psychiatric disorders have been a challenge for public health and will bring economic problems to individuals and healthcare systems in the future. One of the important factors that could affect these disorders is diet.
In the current study with a cross-sectional design, we investigated the association of Paleolithic and Mediterranean diets with psychological disorders in a sample of adult women.
Participants were 435 adult women between 20 and 50 years old that refer to healthcare centers in the south of Tehran, Iran. The diet scores were created by the response to a valid and reliable semiquantitative food frequency questionnaire (FFQ), and the psychological profile was determined by response to the Depression, Anxiety, and Stress Scale (DASS-21). The multivariable-adjusted logistic regression was applied to compute the odds ratio (OR) and 95% confidence interval (CI).
After adjusted for potential confounders, it is evident that participants in the highest Paleolithic diet tertile had lower odds of depression (OR = 0.21; 95% CI: 0.12, 0.37: P < 0.001), anxiety (OR = 0.27; 95% CI: 0.16, 0.45: P < 0.001), and stress (OR = 0.19; 95% CI: 0.11, 0.32; P < 0.001) in comparison to the lowest tertile. Furthermore, those in the third tertile of the Mediterranean diet score were at lower risk of depression (OR = 0.20; 95% CI: 0.11, 0.36; P < 0.001), anxiety (OR = 0.22; 95% CI: 0.13, 0.38; P < 0.001), and stress (OR = 0.23; 95% CI: 0.13, 0.39; P < 0.001) compared with those in the first tertile.
The result of the current study suggests that greater adherence to Paleolithic and Mediterranean dietary patterns may be related with a decreased risk of psychological disorders such as depression, anxiety, and stress.
Steve Parker, M.D.

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“Macronutrients” in diet refers to the percentage of calories derived from protein, carbohydrate, and fat. Some proponents of the paleo diet say that its health benefits stem from the macronutrient profile, such as lower carbs and higher protein than is recommended by most health authorities. Two archeologists at Canada’s Simon Fraser University say that the macronutrients aren’t substantially different from those recommended by the U.S. Dept of Agriculture and the World Health Organization.
This should be interesting! But I’m not paying the $31.50 USD for the full article until I pay off a substantial debt. I’m neither on Patreon nor Substack, and I’m not asking for donations.
Here’s the abstract from American Journal of Clinical Nutrition:
One of the main recommendations of the Paleo Diet is that individuals replicate the whole-diet macronutrient ranges of hunter-gatherer diets. These are suggested to be 19%–35% protein, 22%–40% carbohydrate, and 28%–58% fat, by energy. However, the plant food contribution to these ranges was estimated exclusively from Australian data, which is a potential problem.
We investigated whether estimates of the contribution of protein, carbohydrate, and fat to hunter-gatherer diets are impacted by using plant data from other regions of the world.
The values that form the basis of the Paleo Diet’ s recommended macronutrient ranges were generated with a set of equations. We combined these equations with published plant macronutrient data from a multi-region sample of 5 hunter-gatherer groups to generate new estimated macronutrient percentages and then statistically compared the old and new estimates. Subsequently, we collated plant macronutrient data for a sample of 10 hunter-gatherer groups from several regions and repeated the exercise.
The whole-diet macronutrient percentages we calculated are significantly different from those that underpin the Paleo Diet’s recommendations. Additionally, the ranges derived from our whole-diet macronutrient percentages (14%–35% protein, 21%–55% carbohydrate, 12%–58% fat) are markedly wider than those recommended by the Paleo Diet.
The estimated whole-diet macronutrient percentages that form the basis of the Paleo Diet’s macronutrient recommendations are not robust. Using plant data from multiple regions leads to significantly different estimates. Additionally, the macronutrient ranges derived from our whole-diet macronutrient percentages overlap with those recommended by the US Department of Agriculture and the WHO. This undercuts one of the main justifications for adopting the Paleo Diet—namely that because it is vastly different from Western diets, it can reduce the probability of experiencing noncommunicable diseases. There may still be reasons for adopting the Paleo Diet rather than a conventional diet, but healthier macronutrient percentages is not one of them.
Steve Parker, M.D.

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Posted in Paleo Theory

A couple of Dr Singhs in Kansas authored a review article on the paleo diet in January 2023. You can read it for free in the journal Cureus (cute name, huh). I didn’t learn anything new since the most recent references were from 2012. But you may find interesting. The abstract:
“The promotion of healthy diets is likely one of the most cost-effective strategies for preventing a wide range of disorders, including cardiovascular disease, obesity, hypertension, and type 2 diabetes. The majority of present non-communicable chronic diseases are attributed to civilization, an abundance of food, and a lack of physical activity. According to the purported lifestyles of early humans, the paleolithic diet (PD) encourages the intake of wild animal and plant foods. In recent decades, the paleolithic diet has grown in popularity, particularly among younger populations and those with cardiometabolic syndrome and other chronic diseases. Due to the nutrition profile of the paleolithic diet, historical studies have postulated that hunter-gatherers (HGs) have slender physiques and were physically fit and devoid of chronic ailments such as cardiovascular diseases (CVDs). This review highlights the composition/constituent of the paleolithic diet along with an emphasis on current studies and evidence on the effectiveness of the paleolithic diet in mitigating chronic diseases.”
Steve Parker, M.D.

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Posted in Paleo Theory

Dr. Howard J. Luks is an orthopedist who published a reasonable and fairly comprehensive article on knee osteoarthritis management. Thankfully, knee replacement surgery is a last resort for this surgeon. He discusses exercise, tai chi, diet, yoga, knee injections, NSAIDs, ice, heat, etc.
Osteoarthritis of the knee is a prevalent health issue. Despite a diagnosis of arthritis of the knee, the majority of you can live an active, happy life. But you’ve heard awful phrases used to describe your Xrays– phrases like Bone on Bone, bone spurs, degeneration, wearing away, etc. Those phrases scare you. I get that!
Life does not stop after a diagnosis of arthritis. Exercise is perhaps the best medicine for your arthritis. Exercising a joint that you’ve been told is wearing out may seem counterintuitive. Exercise is essential if your goal is to avoid surgery for as long as possible. Being active will not cause your arthritis to worsen. Not all pain implies harm
Click for Dr. Luks’ exercise recommendations for stronger legs.
Steve Parker, M.D.

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Posted in Knee Pain