Is Schizophrenia an Autoimmune Disorder?

Posted on January 27, 2013 | Comments Off on Is Schizophrenia an Autoimmune Disorder?

Dr. Emily Deans reviews the evidence at her blog.  Here’s the conventional explanation of schizophrenia from UpToDate.com:

“Although the pathogenesis [cause] of the disorder is unknown, it is almost certain that schizophrenia represents a syndrome comprised of multiple diseases that present with similar signs and symptoms. This heterogeneity complicates the elucidation of the etiological and pathophysiological factors that underlie the group of disorders. Schizophrenia appears to be a uniquely human condition, which limits the utility of animal models. There is little doubt that schizophrenia proceeds from a complex interaction between genes and the environment, but even the attempt to differentiate genetic from environment risk factors may be artificial, since environmental factors can influence gene expression just as a person’s genetic make-up can influence response to environmental stressors.”

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Weight-Loss Tricks and Tips

Posted on January 26, 2013 | Comments Off on Weight-Loss Tricks and Tips

“Look…the soda’s not for me, OK?”

These have worked for lots of my patients.  Take what works for you and discard the rest.

  1. Plan on grocery shopping, meal preparation, and taking meals to your workplace.
  2. Keeping a record of your food consumption is often the key to success.
  3. Accountability is another key.  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 one of many ways to have accountability.
  4. If you tend to over-eat or snack too much, floss and brush your teeth after you’re full.  You’ll be less likely to go back for more anytime soon.
  5. Eat at least two or three meals daily.  Eat breakfast every day.  Ignore the diet gurus who say you must eat every two or three hours.
  6. Eat slowly and allow yourself time to enjoy your food.  You’ll be a better judge of when your’re full.
  7. Don’t eat while watching TV.
  8. Give yourself a specific reward for every 10 pounds (4.5 kg) of weight lost.  Consider a weekend get-way, jewelry, new clothes, an evening at the theater, a professional massage, etc.  Choose the reward in advance, to give you something to work toward.
  9. Don’t start a diet during a time of stress.
  10. Maintain a consistent eating pattern throughout the week and year.
  11. If you know you’ve eating enough at a meal to satisfy your nutritional requirements yet you still feel hungry, drink a large glass of water and wait a while.  Or try a sugar-free psyllium fiber supplement: three grams of fiber in 8 oz (240 ml) of water.
  12. Weigh yourself frequently: daily during your active weight-loss phase and during the first two months of your maintenance-of-weight-loss phase.  Weekly thereafter.
  13. Be aware that you’ll probably regain five or 10 pounds (2.3 or 4.5 kg) of fat now and then.  That’s normal.  Just get back on your original weight-loss plan for a month or two.
  14. Tell your housemates you’re on a diet and ask for their support.  You may also need to tell your co-workers and others with whom you spend significant time.  If they care about you, they’ll be careful not to tempt you off the diet.

Steve Parker, M.D.

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What Causes Type 2 Diabetes?

Posted on January 26, 2013 | Comments Off on What Causes Type 2 Diabetes?

“Beats me. I teach math!”

There’s no simple answer, unfortunately.

You can lower your risk of type 2 diabetes significantly by avoiding overweight and obesity, by exercising regularly, and by choosing the right parents.  These provide clues as to the causes of diabetes.  The Mediterranean diet also prevents diabetes.

UpToDate.com offers a deceptively simple answer:

Type 2 diabetes mellitus is caused by a combination of varying degrees of insulin resistance and relative insulin deficiency. [Insulin is the pancreas hormone that lowers blood sugar.] Its occurrence most likely represents a complex interaction among many genes and environmental factors, which are different among different populations and individuals.

So, what causes the insulin resistance and relative insulin deficiency?

Understanding the pathogenesis [cause] of type 2 diabetes is complicated by several factors. Patients present with a combination of varying degrees of insulin resistance and relative insulin deficiency, and it is likely that both contribute to type 2 diabetes. Furthermore, each of the clinical features can arise through genetic or environmental influences, making it difficult to determine the exact cause in an individual patient. Moreover, hyperglycemia itself can impair pancreatic beta cell function and exacerbate insulin resistance, leading to a vicious cycle of hyperglycemia causing a worsening metabolic state.

The UpToDate article then drones on, discussing mouse studies, various genes, free fatty acids, adiponectin, leptin, amylin, insulin secretion, insulin resistance, impaired insulin processing, insulin action, body fat distribution, inflammation, various inflammatory markers, low birth weight, high birth rate, prematurity, etc.

More excerpts:

Increased free fatty acid levels, inflammatory cytokines from fat, and oxidative factors, have all been implicated in the pathogenesis of metabolic syndrome, type 2 diabetes, and their cardiovascular complications.

Insulin resistance may, at least in part, be related to substances secreted by adipocytes [fat cells] (“adipokines” including leptin adiponectin, tumor necrosis factor alpha, and resistin).

Type 2 diabetes most likely represents a complex interaction among many genes and environmental factors.

That’s the simplest answer I can give now.

Steve Parker, M.D.

Reference: “The Pathogensis of Type 2 Diabetes Mellitus”  by David K McCulloch, MD, and R Paul Robertson, MD, at UpToDate.com, updated June 2012, and accessed November 19, 2012.

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Elizabeth Hughes, Dogs, and the Discovery of Insulin

Posted on January 25, 2013 | Comments Off on Elizabeth Hughes, Dogs, and the Discovery of Insulin

Man’s best friend, especially if you have take insulin

Dr. Harriet Hall over at Science-Based Medicine reviews the Canadian  discovery and purification of insulin, truly a modern medical miracle.  Thanks to Banting and Best.  One of the first human users was Elizabeth Hughes.

—Steve

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Should Our Dietary Fats Be More Saturated Or Unsaturated?

Posted on January 24, 2013 | 2 comments

The jury’s still out, but the editors at The Evolution and Medicine Review discuss dietary fat effects on gut microbiota and systemic inflammation.  The authors tend to favor unsaturated fats at this point.

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Surprising Results of a Three-Week Fitness Lay-Off

Posted on January 24, 2013 | 2 comments

MP900182524[1]I’m reminded of a quote from a famous violinist: “If I don’t practice for one day, I can tell.  If I don’t practice for two days, my conductor can tell.  If I don’t practice for three days, the audience can tell.”

A few months ago, I laid off all exercise for three weeks straight, partly due to a long vacation, partly to see how much my fitness would deteriorate.

Here’s what I found:

  • My time for the one-mile run increased from 8 mins and 54 seconds to 9 mins and 30 seconds
  • My maximum number of push-ups increased from 32 to 36
  • My maximum number of sit-ups increased from 32 to 34
  • My maximum number of pull-ups increased from 8 to 9

CLOSING THOUGHTS

Strength measures increased, surprisingly.  Was it just a good day, or did my muscles need the time off to rest and re-build?  Over-training is a real problem for some folks.  At 20 minutes of weight-training twice a week, I doubt I was anywhere near what most consider over-training.  I don’t fiddle-fart around during my exercise sessions, but I’m not puking either.

So I won’t feel too bad in the future if I take a couple or three weeks off from strength training periodically.

My endurance for running deteriorated significantly.  Is it related to the lack of strength training, the lack of treadmill interval work, or both?

Your mileage will vary.

Steve Parker, M.D.

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Who Is Silverlobster?

Posted on January 21, 2013 | 1 comment

My 14-year-old son is a budding artist.  His work is viewable and for sale at DeviantArt.  You can order prints of various sizes and quality, along with his art on cups and refrigerator magnets.  Thanks for taking a look.  Paul will get a kick out of the bump in page views whether you buy or not!

Some samples:

Wink!

Deadmau5 copy

Soaring eagle

Impressionist snake

REEEAOGH

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Five Tibetan Rituals for Relief of Low Back Pain

Posted on January 19, 2013 | Comments Off on Five Tibetan Rituals for Relief of Low Back Pain

A position you’ll see in the video

I was browsing at author Jerry Pournelle’s blog recently and noticed his 2006 reference to five Tibetan rituals (sometimes called rites) that relieved his back pain.  He didn’t say, but I assume Mr. Pournelle has run-of-the-mill low back pain like most middle-aged folks.

I’m not recommending or endorsing these.  I may try them someday myself.  They just look like flexibility and strengthening exercises to me.

If interested, here’s a how-to article at eHow.com.  Here’s a video demonstration (ignore the top video of Dr. Oz; view the next one down).

Ignore any references you see to Ayurvedic medicine and chakras.

Don’t worry, I’m not going woo on you.

Please share if  you’ve had experience—good or bad—with these.

—Steve

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QOTD: Adam Smith on Economic Self-Interest

Posted on January 18, 2013 | 1 comment

“It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.”

—Adam Smith, author of The Wealth of Nations

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Git’R Done: Efficient Exercise For Those Who Don’t Enjoy It

Posted on January 17, 2013 | 3 comments

“Wanna arm wrestle?”

I hate exercising.

I’d rather watch TV, play Parcheesi, play my mandolin, bowl, go to a movie, sleep, blog, surf the ‘net, work on my next book, fish, visit with my wife and kids, practice shooting, work on new recipes, or even go to work.

But….

I want the health benefits of exercise.

Loren Cordain, a godfather of the modern paleo diet movement, characterizes the physical activity pattern of hunter-gatherers thusly: “periods of intense exertion generally alternated with days of rest and relaxation.”  Nevertheless, “the amount of physical activity performed by an average hunter-gatherer would have been about four times greater that that of a sedentary office worker….”

Eaton and Eaton suggest than ancient hunter-gatherers burned 490 calories a day in physical activity, which would require about an hour of modern exercise.

For much of this year I’ve been experimenting with various exercise programs that may yield the health benefits with minimal time commitment.  Like 60 minutes a week.  Not the 150 minutes recommended by some public health authorities.  In case you’re interested, here are some links that outline the programs:

If you’re tempted to try any of these programs, get your personal physician’s blessing first.  I’d love to hear about your experience with them.

Steve Parker, M.D.

PS: Cordain quotes are from The Paleo Diet (2002).

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