ATMC: Get the Best Bed You Can Afford

I slept in a sleeping bag on a 1-inch thick foam pad in this Eureka Solitaire 1-man tent.

I slept in a sleeping bag on a 1-inch thick foam pad in this Eureka Solitaire 1-man tent.

You spend a third of your life in bed. Make it a good bed.

When you’re a kid or young adult, you can sleep just fine on a couch or a pallet on the floor made from a few folded blankets. After the age of 25 or so, your body won’t appreciate that sort of treatment. You’ll sleep fitfully and wake up with scattered aches and pains. Sleep in a bed that gives you support, comfort, and peace. By no means is that the most expensive bed on the market.

Back in 1981, I graduated from medical school and moved to Austin, Texas, for three years of internship and residency. My starting pay was $14,400/year. If that doesn’t sound like much, you’re right. The low pay was a hold-over from ye olde days when interns and residents were mostly young single men who actually resided in the hospital. They didn’t need a house or apartment. $14,400/year was just enough for a single guy to survive. We were working 100-hr weeks—no time for a second job. By the third year of residency, I was making $16,000-sumpin’.

I was new to Austin and needed a bed, so I went to a cheap furniture store in the low-rent part of town and bought a crappy twin-size box spring and mattress, $40 I think. At least it was new—I didn’t have to worry about anybody else’s bedbugs, fleas, or germs. Good times.

I upgraded as soon as I could afford it.

—Dad

PS: Remember those cars back then that had a vinyl-like covering over the roof? I had one of those in 1981, probably a Chevrolet or Oldsmobile sedan. It was so old that the vinyl was half gone, rotted off. One of my pulmonology attending physicians said they shouldn’t let me park that embarrassing mess in the doctors’ lot at the hospital. I think he was only half-joking.

PPS: I graduated medical school with only $22,000 of educational debt. I made monthly payments for 10 years. Medical student debt these days averages $176,000. Consider that before you gripe that doctors make too much money.

 

Advice to My Children

"Listen up, son"

“Listen up, son.”

I think it was Hunter S. Thompson who gave avuncular advice in Rolling Stone magazine 40 years ago:

  • Never play cards with a man named Doc
  • Never eat at a place called “Mom’s”
  • Never get involved with a woman who has more problems than you do

I’m starting a new category of posts: Advice To My Children (ATMC).

My father died six years ago at the age of 83. I can’t remember a single specific piece of advice he ever gave me. Which may be a reflection more on me than him.

He was a good father. I would say he taught me through quotidian action rather then with words. Allan Edward Parker, Sr., was a great provider for the family. He respected and loved my mother. He was always available and always seemed to be in a good mood. We had some great camping, fishing, and sailing adventures.

My two children, a boy and a girl, will probably be leaving home in the next few years. Any ability I have to influence them will wane significantly then. For the last few years I’ve been thinking about core concepts I’d like them to remember, if not take entirely to heart. Maybe they’ll refer back to these posts when life throws them for a loop or after I’m dead and gone.

Life can be hard, and we don’t get an owner’s manual at birth. We build our own manual by trial and error, learning from our elders or other reasonable adults, reasoning, observation, and through literature.

Why make your own mistakes if you can learn from others’?

Steve Parker, M.D.

Sure-Fire Ways to Overcome a Weight-Loss Stall

It's time to re-commit to the program

It’s time to re-commit to the program

It’s common on any weight-loss program to be cruising along losing weight as promised, then suddenly the weight loss stops although you’re still far from goal weight. This is the mysterious and infamous stall.

Once you know the cause for the stall, the way to break it becomes obvious. The most common reasons are:

  • you’re not really following the full program any more; you’ve drifted off the path, often unconsciously
  • instead of eating just until you’re full or satisfied, you’re stuffing yourself
  • you need to start or intensify an exercise program
  • you’ve developed an interfering medical problem such as adrenal insufficiency (rare) or an underactive thyroid; see your doctor
  • you’re taking interfering medication such as a steroid; see your doctor
  • your strength training program is building new muscle that masks ongoing loss of fat (not a problem!).

If you still can’t figure out what’s causing your stall, do a nutritional analysis of one weeks’ worth of eating, with a focus on daily digestible carb (net carbs) and calorie totals. You can do this analysis online at places like FitDay (http://fitday.com/) or Calorie Count (http://caloriecount.about.com/).

What you do with your data depends on whether you’re losing weight through portion control (usually reflecting calorie restriction) or carb counting. Most people lose weight with one of these two methods.

If you’re a carb counter, you may find you’ve been sabotaged by “carb creep”: excessive dietary carbs have insidiously invaded you. You need to cut back. Even if you’re eating very-low-carb, it’s still possible to have excess body fat, even gain new fat, if you eat too many calories from protein and fat. It’s not easy, but it’s possible.

Those who have followed a calorie-restriction weight loss model for awhile may have become lax in their record-keeping. The stall is a result of simply eating too much. Call it “portion creep.” You need to re-commit to observing portion sizes.

A final possible cause for a weight loss stall is that you just don’t need as many calories as you once did. Think about this. Someone who weighs 300 lb (136 kg) is eating perhaps 3300 calories a day just to maintain a steady weight. He goes on a calorie-restricted diet (2800/day) and loses a pound (0.4 kg) a week. Eventually he’s down to 210 lb (95.5 kg) but stalled, aiming for 180 lb (82 kg). The 210-lb body (95.5 kg) doesn’t need 3300 calories a day to keep it alive and steady-state; it only needs 2800 and that’s what it’s getting. To restart the weight loss process, he has to reduce calories further, say down to 2300/day. This is not the “slowed down metabolism” we see with starvation or very-low-calorie diets. It’s simply the result of getting rid of 90 pounds of fat (41 kg) that he no longer needs to feed.

Steve Parker, M.D.

Omega-3 Fatty Acids Linked to Improved Strength and Muscle Size in Elderly

Rich sources of omega-3 fatty acids include salmon, sardines, herring, trout, and mackerel

Rich sources of omega-3 fatty acids include salmon, sardines, herring, trout, and mackerel

Admittedly it was a small study but it was randomized and the only intervention applied was for the experimental group to take 1.86 grams of EPA and 1.5 grams of DHA daily for six months. The control group was given corn oil. Study participants were 60–85 years old. The specific form of the fish-derived fatty acids was a proprietary product called Lovaza.

Improved strength during aging should help with maintenance of independent daily activities and prevention of falls. In other words, these fatty acids are anti-aging. I’d like to see the study replicated with more study participants.

I don’t know if the study was paid for by Lovaza’s manufacturer, nor whether that would influence results.

This study supports my recommendation of cold-water fatty fish (great sources of omega-3 fatty acids) in all my diets:

Steve Parker, M.D.

 

Is That Scientific Journal Legitimate?

"Diabetes Care" isn't on Beall's list

“Diabetes Care” isn’t on Beall’s list

Librarian Jeffrey Beall has a blog (Scholarly Open Access) where he keeps a list of what he calls predatory publishers and questionable journals. This would only matter to you if you, like me, enjoy reading scientific journal articles. The problem with some journals is that they exist only to make a profit for the publishers, and will do so by any means necessary. Researchers in academic settings feel great pressure to publish their research results, or anything that looks like research. Even if they have to pay the publisher $1,8000 USD. The result can be a research report that has very little, if any, scientific validity. In other words, if you got the money, you’ll get published even if your research is crap.

If you wonder if a particular journal is questionable, check to see if it’s on Beall’s list.

Steve Parker, M.D.

QOTD: Weight Training Versus Gravity

Average age of study subjects was 71

A good resistance training program will strengthen her bones, improve her balance, and prevent that hip fracture 60 years from now

Adult life is a battle against gravity. Weight training postpones your inevitable defeat.

—Steve Parker, M.D.

Recipe: Cabbage Soup

This version of cabbage soup isn’t a powerhouse in any one particular nutrient but provides a fair amount of zinc, protein, and vitamins A, B12, and C. A serving of this only has 9 grams of digestible carbohydrate, so you can easily fit it into diabetic diets or ketogenic diets. If you’re a constipated, a bowl or two of cabbage soup may get things moving, thanks to raffinosepaleo diet, Steve Parker MD, cabbage soup

Plan well in advance because this takes a while to cook

Ingredients:

  • water, 4 quarts (3.8 L)
  • parsley, fresh, to taste (3 or 4 sprigs)
  • stew meat (beef), raw, 8 oz (230 g)
  • pepper, to taste (1/4 tsp or 1.2 ml)
  • salt, to taste (1.5 tsp or 8.4 mL) (don’t use this much if on a low-sodium diet)
  • tomato sauce, canned, 4 fl oz (120  ml)
  • carrot, raw, large (4.5 oz or 130 g), peeled and sliced into 1/4-inch (1/2-cm) thick discs
  • cabbage, green, raw, 1/2 of a small one (whole one weighs about 2 lb or 900 g), rinsed, cored, then sliced into quarters or smaller
  • fresh lemon (optional)

Instructions:

Add raw meat to the water in a large pot and boil gently for 30 minutes. Then add tomato sauce, carrot, salt, pepper, parsley, and cabbage. Bring to boil over medium heat and them simmer for 45 minutes.

If it’s too bland for you, add a squeeze of fresh lemon.  Or as a last resort, add some beef bouillon cube or powder.

Servings:

Makes four servings of 2 cups each (475 ml).

Advanced Mediterranean Diet boxes: 1 veggie, 1/2 fat, 1/2 protein

Nutritional Analysis Per Serving:

  • 46% fat
  • 23% carbohydrate
  • 31% protein
  • 200 calories
  • 12 g carbohydrate
  • 3 g fiber
  • 9 g digestible carb
  • 1,200 mg sodium
  • 495 mg potassium
  • Prominent features: see first paragraph

PS: Nutritional analysis done at FitDay.com.