Obesity In U.S. Adults Is Now Up to 40% (Four in Ten)

…according to the CDC.

For youths 19 or less, the obesity rate is 18.5%.

To find out if you’re obese, use a BMI calculator.

To combat obesity, follow The Advanced Mediterranean Diet (2nd Ed.).

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Las Vegas Shooting: Does This Make Me a Conspiracy Theorist?

I heard about the shooting on TV around two hours after it started at 2210 hrs Oct 1. By three hours after start there were already eye-witness videos posted on Twitter. I listened to several of them and posted this at 1 AM Oct 2:


12 Years Later: Does Gastric Bypass Still Work?

Type 2 diabetes remission persisted in half the surgical patients. Rates of high blood pressure and bad lipid numbers were also better in the surgical patients.

“The follow-up rate exceeded 90% at 12 years. The adjusted mean change from baseline in body weight in the surgery group was −45.0 kg (95% confidence interval [CI], −47.2 to −42.9; mean percent change, −35.0) at 2 years, −36.3 kg (95% CI, −39.0 to −33.5; mean percent change, −28.0) at 6 years, and −35.0 kg (95% CI, −38.4 to −31.7; mean percent change, −26.9) at 12 years; the mean change at 12 years in nonsurgery group 1 was −2.9 kg (95% CI, −6.9 to 1.0; mean percent change, −2.0), and the mean change at 12 years in nonsurgery group 2 was 0 kg (95% CI, −3.5 to 3.5; mean percent change, −0.9). Among the patients in the surgery group who had type 2 diabetes at baseline, type 2 diabetes remitted in 66 of 88 patients (75%) at 2 years, in 54 of 87 patients (62%) at 6 years, and in 43 of 84 patients (51%) at 12 years. The odds ratio for the incidence of type 2 diabetes at 12 years was 0.08 (95% CI, 0.03 to 0.24) for the surgery group versus nonsurgery group 1 and 0.09 (95% CI, 0.03 to 0.29) for the surgery group versus nonsurgery group 2 (P<0.001 for both comparisons). The surgery group had higher remission rates and lower incidence rates of hypertension and dyslipidemia than did nonsurgery group 1 (P<0.05 for all comparisons).

CONCLUSIONSThis study showed long-term durability of weight loss and effective remission and prevention of type 2 diabetes, hypertension, and dyslipidemia after Roux-en-Y gastric bypass. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.)”

Source: Weight and Metabolic Outcomes 12 Years after Gastric Bypass — NEJM

Before resorting to surgery, try the Advanced Mediterranean Diet (2nd Ed.).

Mediterranean diet linked to lower risk for gallbladder removal surgery

“A high score of the Mediterranean diet was associated with 11% reduced risk of cholecystectomy,” the researchers wrote.“Women at risk of gallbladder disease should follow simple preventive measures to reduce the high costs and morbidity associated with complications of gallbladder disease,” Barré said.

Source: Mediterranean diet linked to lower risk for gallbladder removal surgery

Higher Blood Magnesium Levels Linked to Lower Incidence of Hypertension, Cardiovascular Disease, and Type 2 Diabetes

From the abstract of a recent meta-analysis:

“Magnesium (Mg) is the second most predominant intracellular electrolyte, following after potassium. Mg serves as an important cofactor in many essential enzymatic reactions involved in glucose metabolism and several essential physiological processes, including modulating vascular smooth muscle tone and endothelial cell function. The role of Mg in the development and progress of T2DM and cardiovascular diseases (CVD) has drawn researchers’ attention in the recent decades. Several large prospective cohort studies have shown that low Mg intake is associated with incidence of T2DM and CVD. Notably, because Mg intake was usually assessed based on self-administered food frequency questionnaires, misclassification is inevitable. In addition, dietary Mg could not represent the accurate amount of Mg intake without considering the substantial loss during food processing and cooking. Moreover, the health impact of Mg is difficult to be distinguished from intake of other nutrients such as calcium, potassium, phosphorus, and fiber.”

Source: Circulating magnesium levels and incidence of coronary heart diseases, hypertension, and type 2 diabetes mellitus: a meta-analysis of prospective cohort studies | Nutrition Journal | Full Text

Trek Report: Humphreys Peak 2017

Humphreys Peak on the left

The latter half of life is a battle with aging and gravity. We all eventually lose the war, but I’m not ready to give up the fight. Physical fitness is a powerful tactic in that war. For me, hiking is one way to get and stay fit. Mountain climbing, and the preparation therefor, pushes me to greater levels of fitness.

Scruffy little guy

I walked this route to Arizona’s highest point two years ago. Read that report for typical details. The post today is more personal and helps me plan my next climb, if any. A goal of mine for decades has been to climb one of the 14,000 foot peaks in Colorado, like Longs Peak. At my age, 62, that’s probably too ambitious. However, per Infogalactic: “The oldest person to summit Longs Peak was Rev. William “Col. Billy” Butler, who climbed it on September 2, 1926, his 85th birthday.”

Tundra plants above the tree line

I usually label posts like this a “hike report.” But I found one definition of trek as “a trip or movement especially when involving difficulties or complex organization : an arduous journey.” That’s more accurate here than a simple “hike.”

A view from about 10,000 ft

Miscellaneous Details

Two years ago I wrote that if I ever did this hike again, I’d want to acclimate to the altitude first, by spending 4–5 days in the Flagstaff area at 7,000 feet. Family obligations precluded that this year. We came up a day early and took the ski lift up to 11,000 feet, spending about an hour there. We then spent the night in Flagstaff at Sonesta ES Suites (very nice, and less expensive than many other hotels in the area). I slept fitfully, probably because of the altitude. I wonder if Diamox would have helped me sleep better.

A fire near Kendrick Peak

I started on the trail on June 20 at 7 AM and finished at 4:30 PM, so nine and a half hours. If you read trip reports from younger or more avid hikers, six to eight hours is more typical.

I am Groot

Trailhead temperature at the start was 65°F. I was in shorts and a tee shirt the whole day. Even in the afternoon, it can be much colder on the Peak, so you have to be prepared for that. I was too warm for much of this trip, so if I do it again it may be in mid-May instead of June.

Same fire

I drank four quarts (one gallon) on the trail. I ate six orange-colored peanut butter cracker sandwiches, four ounces of leftover Sizzler steak, and dried banana and apple slices.

A view from the Saddle

The hip belt on my backpack did a great job of taking some of the weight off my shoulders. I should have used this more during my training hikes.

On the way from the Saddle to the peak

From the trailhead to the Saddle took four hours. The reverse took 2.5 hrs.

I was surprised that my walk between the Peak and the Saddle took the same amount of time whether I was ascending or descending. About an hour and 15 minutes to cover the mile.

The Peak was covered with thousands of flying gnats. They didn’t bite much so I just ignored them and got off the Peak immediately after taking pictures.

I did it!

It’s easy to lose the trail as you’re heading up at a particular switchback at approximately 11,000 feet. See the photos below for details. This is dangerous, and whoever is in charge of trail maintenance needs to fix it before catastrophe strikes. I lost the trail and searched for it for 10 minutes before finding where I lost it. I was ready to give up and head down the hill when a couple from Prescott, AZ, showed up and pointed me in the right direction. Smooth sailing from then on. Nearly everywhere the trail is easy to see.

Turn left immediately after you pass the log jutting out. From this view going up the hill, the log hides the true trail. We need a sign here. 

Yes, walk up the right side of this log!

This is the view of this log as you’re descending. Very easy to see trail.

I did this on a weekday, so there were not nearly as many folks on the trail as when I did a weekend trek two years ago. If you hike this on a summer weekend, get there early or you may not have a place to park.

There were patches of snow on the ground as low as 10,000 feet. Very unusual for this time of year.

I’m at the Saddle

At the start of the hike and even half-way into it, I put my odds of success—reaching the summit—at 50:50. It’s up to me whether I sprain an ankle or break a bone, but it’s up to God whether I get altitude sickness or have a heart attack or stroke. My biggest doubts were inadequate preparation and my patellofemoral pain (PFP) syndrome. My last training hike was on June 3, and the day after that I was resigned to calling off the trip entirely. Part of me was willing to try it, but my smarter side said it wasn’t worth possible permanent knee injury or 6–12 months of disability and rehabilitation. But by June 14 the knee was feeling much better so I decided to forge ahead. After this trek, I was  done hiking for the summer and expected the knee to be back to normal within the subsequent 3–4 weeks even without rehab or NSAIDs. But it took three months.

Tundra flowers

That last mile to the Peak was not as arduous as it was two years ago. I’m not sure if that’s psychological, or attributable to better hydration, better nutrition or pacing. I consciously kept my pace slow on the way up, averaging one to one and a half miles per hour (don’t be critical; this includes breaks for hydration, food, rest, and photos). I’ll keep this slow pace next time.

Don’t be so focused on the peak that you forget to look around

Overall, I think I was in the same state of physical conditioning as I was two years ago. I had no muscular soreness the day after the hike.

I had no trouble with altitude sickness.


This is the home of Northern Arizona University, a typical small college town. The main drag is Milton Road. I love visiting here. I almost took a job here until I learned that the average daily low temperature is 32°F or below for seven months out of the year. We are “horse people” and didn’t think the low temps were a good fit.

Free Hiking Tips

Obvious dangers to consider on a trek like this: dehydration, rain, sleet, hail, lightning, heat exhaustion, sun over-exposure. Bears and mountain lions don’t seem to be problems on Mt. Humphreys, although bears are certainly in the area.

A less obvious but more common danger is missteps. You always have to be on the lookout for rocks and tree roots that can trip you or sprain your ankle. Particularly treacherous are flat rock surfaces coated with gravel or dust; these can be nearly as slick as ice. In the wilderness, a bad ankle sprain, lower limb fracture, or torn knee ligament or meniscus can put your life at risk, particularly if you’re by yourself. Missteps are more likely to occur when you’re tired.

In the wilderness, keep track of your location constantly, either with a map or GPS unit or both. Yes, GPS units can malfunction and batteries die. If you’re on an established trail but suddenly find yourself off it, stop going forward immediately and try to find the trail. Don’t panic. If you get hopelessly lost, a personal transmitter could save your life. Before your trip, let someone know where you’re going, on which trails, and when you’re expected to be back in civilization. Tell them to expect your call when done. Hike with a pal when able.

Steve Parker, M.D.


PURE Study: Higher Carb Consumption Linked to More Deaths

Here’s the abstract of a new epidemiological study that investigated the relationships between diet, cardiovascular disease, and death rates. I don’t have the entire article. My sense is that the 18 countries studied are mostly non-Western:


The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear.


The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.


During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.


High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

Source: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet