QOTD: Steve Martin on Success

“Be so good they can’t ignore you.”

That was what Steve Martin said when he was being interviewed by Charlie Rose and Rose asked what advice Martin would give to a young people.

Martin continued, “ . . . it’s not the answer they want to hear.”

according to Wilder, Wealthy, and Wise.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com in the U.S.

Another Physician Discovers the Ketogenic Mediterranean Diet

Colin Champ, M.D., published an article on his version of a Ketogenic Mediterranean Diet.

“The Study Participants – The Mediterannean Ketogenic Lifestyle

Regardless, the study was a massive success, as it allowed 40 overweight individuals with an average BMI of 37 to switch from their diabetes-provoking diet containing over 50% carbohydrates for 12 weeks. Ketosis was apparently confirmed via ketone strips in the morning. This concerns me, because if they were urine strips, after 2-3 weeks they would have been inaccurate. Once again, we must question whether it was a ketogenic diet or simply a very low-carbohydrate diet. Yet, the proof is it the pudding as the Spanish Ketogenic dieters experienced an average reduction in bodyweight from 240 to 208 lbs. Most importantly, there was a clear loss of fat over muscle. Blood pressure dropped, blood lipids improved, triglycerides divebombed as they were cut in half, blood sugar dropped by almost 20 mg/dl, and HDL cholesterol – a difficult number to budge – rose significantly. Take note, as expected, the largest reduction overall was the massive drop in triglycerides, which is especially important as elevated triglycerides are strongly associated with an increased risk of stroke, heart disease, and cancer.

Globally, all of these changes are desired. The question I pose, is can we take this a step further to encourage a full-blown Mediterranean Ketogenic Diet? I have been following what I consider a Mediterranean Ketogenic Diet for years by combining the cultural and social aspects of my Southern Italian heritage along with the scientific approach of the ketogenic diet. Sounds complicated? It’s not. In fact, it is so simple, that I have distilled it down to seven steps that are so simple, your great-grandfather likely followed most of them (mine certainly did).”

Source: The Mediterranean Ketogenic Lifestyle – Colin Champ

Compare with my version.

Odd cover, huh?

Steve Parker MD, Advanced Mediterranean Diet

The KMD is also here

At Five Years Out, Gastric Bypass is as Effective in Adolescents as in Adults 

From The New England Journal of Medicine:

Adolescents and adults who underwent gastric bypass had marked weight loss that was similar in magnitude 5 years after surgery. Adolescents had remission of diabetes and hypertension more often than adults.

Note, however,

Three adolescents (1.9%) and seven adults (1.8%) died in the 5 years after surgery. The rate of abdominal reoperations was significantly higher among adolescents than among adults (19 vs. 10 reoperations per 500 person-years, P=0.003).

Source: Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults | NEJM

Steve Parker MD, Advanced Mediterranean Diet

Not linked to any deaths as far as I know

 

Low-Carb Mediterranean Diet Beats Low-Fat Diet for Reducing Liver Fat

From the study abstract:

Methods

In an 18-month weight-loss trial, 278 participants with abdominal obesity/dyslipidemia were randomized to low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC+28g walnuts/day) diets with/without moderate physical activity (PA). HFC and abdominal fat-depots were measured using magnetic-resonance-imaging at baseline, after 6 (sub-study, n=158) and 18-months.

Results

Of 278 participants [age=48yr;88% men; body-mass-index=30.8kg/m2; mean HFC =10.2%,(range:0.01%-50.4%)], retention rate was 86.3%. %HFC substantially decreased after 6 [-6.6% absolute-units (-41% relatively)] and 18-months [-4.0% absolute-units (-29% relatively);p<0.001 vs. baseline]. Reduction of HFC associated with decreases in VAT beyond weight loss. After controlling for VAT loss, decreased %HFC remained independently associated with reductions in serum gamma-glutamyl-transferase and alanine-aminotransferase, circulating chemerin, and HbA1c (p<0.05). While reduction of HFC was similar between PA groups, compared to LF diet, MED/LC induced a greater %HFC decrease (p=0.036) and greater improvements in cardiometabolic risk parameters (p<0.05), even after controlling for VAT changes. Yet, the greater decreases induced by MED/LC compared to LF diets in triglycerides, TG/HDL ratio and cardiovascular risk score were all markedly attenuated when controlling for HFC changes.

Source: The Beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content – Journal of Hepatology

h/t DietDoctor

Here’s a low-carb Mediterranean diet:

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Sitting is the new smoking? No, it’s worse than that: Not exercising worse is for your longevity than smoking, diabetes AND heart disease

exercise for weight loss and management, dumbbells

At least he’s trying…

I’ve long advocated that life-and health-insurance companies base their premiums on results of individual treadmill exercise tests or similar. Here’s why.

From CNN:

We’ve all heard exercise helps you live longer. But a new study goes one step further, finding that a sedentary lifestyle is worse for your health than smoking, diabetes and heart disease.

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic and senior author of the study, called the results “extremely surprising.”

“Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker,” Jaber told CNN. “We’ve never seen something as pronounced as this and as objective as this.”

Source: Not exercising worse for your health than smoking, diabetes and heart disease – CNN

Most folks can improve their fitness by exercising regularly. But what about nonresponders?

Steve Parker, M.D.

PS: All of my weight-loss books recommend and teach you how to improve your level of fitness.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

High cholesterol doesn’t cause heart disease. Say what?

Plaque unrelated to cholesterol

From The Irish Times:

There is no evidence that high levels of total cholesterol or of “bad” cholesterol cause heart disease, according to a new paper by 17 international physicians based on a review of patient data of almost 1.3 million people.

The authors also say their review shows the use of statins – cholesterol lowering drugs – is “of doubtful benefit” when used as primary prevention of cardiovascular disease.

The authors include Galway-based Prof Sherif Sultan, professor of the International Society for Vascular Surgery; Scottish-based Dr Malcolm Kendrick, author of The Great Cholesterol Con; and Dr David M Diamond, a US-based neuroscientist and cardiovascular disease researcher.

Prof Sultan said millions of people all over the world, including many with no history of heart disease, are taking statins “despite unproven benefits and serious side effects”.

Source: ‘No evidence’ high cholesterol causes heart disease, say doctors

Another Sacred Cow Slaughtered: Omega-3 Fatty Acids Have No Effect on Cardiovascular Disease or Longevity

Salmon, a cold-water fatty fish, is a rich source of omega-3 fatty acids

That headline is the conclusion of a Cochrane systematic review of the evidence. As you read the summary below, be aware that the main omega-3 fatty acids are alpha-lenolinic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).

From Cochrane Library:

Increasing EPA and DHA has little or no effect on all‐cause deaths and cardiovascular events (high‐quality evidence) and probably makes little or no difference to cardiovascular death, coronary deaths or events, stroke, or heart irregularities (moderate‐quality evidence, coronary events are illnesses of the arteries which supply the heart). EPA and DHA slightly reduce serum triglycerides and raise HDL (high‐quality evidence).

Eating more ALA (for example, by increasing walnuts or enriched margarine) probably makes little or no difference to all‐cause or cardiovascular deaths or coronary events but probably slightly reduce cardiovascular events, coronary mortality and heart irregularities (moderate/low‐quality evidence). Effects of ALA on stroke are unclear as the evidence was of very low quality.

There is evidence that taking omega‐3 capsules does not reduce heart disease, stroke or death. There is little evidence of effects of eating fish. Although EPA and DHA reduce triglycerides, supplementary omega‐3 fats are probably not useful for preventing or treating heart and circulatory diseases. However, increasing plant‐based ALA may be slightly protective for some heart and circulatory diseases.

Source: Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease – Abdelhamid, AS – 2018 | Cochrane Library