Drink Less and Live

Jameson’s in a hotel bar near Chicago

A few months ago I ran across a thoughtful article by Morris van de Camp titled Love Drinking Less. It’s well worth a read if your alcohol consumption is out of control or heading that way.

Alcohol is a two-edged sword. On the one hand it makes life fun and turns strangers into intimate friends in the course of an evening; on the other, it makes a person dysfunctional. Very dysfunctional. Productive time is lost, relationships are damaged, and health is harmed.

I cannot say that I’ve “struggled” with alcohol in the truest sense. I’ve never been arrested for drunk driving, and I’ve had no serious relationship trouble from drinking. All of my drinking has been in an appropriate time and place — but one drink inevitably would lead to another. I’d wind up accidently drunk when I really wanted a light buzz. I also found that when the time came up when I’d be free to drink, I looked a bit too much forward to it.

If you’re a tippler, this is the time of year to consider a “Dry January.” You may learn something about yourself. Be kind to your liver — you only have one.

Steve Parker, M.D.

PS: It’s also time to decide on your weight loss program for the new year.

Paleolithic Diet Associated With Lower Risk of Non-Alcoholic Fatty Liver Disease (NAFLD)

…according to Iranian and Brazilian researchers who studied an Iranian population. The risk reduction was an impressive 50%.

Thanks to Frontiers In Nutrition for publishing the study for free.

A Clinics In Gastroenterology article in 2019 suggested a different diet for treatment of NAFLD (non-alcoholic fatty liver disease.

Steve Parker, M.D.

front cover of paleobetic diet

Click to purchase at Amazon.com. E-book also available at Smashwords. com.

COVID-19: The Drain on the U.S. Economy

Photo by Dids on Pexels.com. Click for the meaning of Novus Ordo Seclorum

From the First Trust Economics Blog:

We will forever believe that locking down the economy for COVID-19 was a massive mistake.  There is virtually no evidence that death rates were lowered by government mandates and lockdowns.

Business activity in certain sectors would surely have slowed as individuals protected themselves from COVID: think hotels, cruises, restaurants & bars, amongst other services.  But the government didn’t have to aggravate the problem by applying a version of medical central planning.  Doctors, epidemiologists, and scientists can be very good at coming up with treatments, cures, and vaccines, but they’re not equipped to weigh trade-offs that involve costs outside the medical arena, like loss of income or basic freedoms.

There is clear evidence that closing schools caused a harmful loss of learning, which could affect the incomes of future workers for decades, while paying people not to work has warped the labor force.

Economically, the United States ran up about $5 trillion in additional debt and boosted the M2 measure of the money supply by more than 40% during the pandemic, which caused a 40-year high in inflation.  In turn, this inflation led politicians to release hundreds of millions of barrels of oil from the strategic petroleum reserve in an attempt to temporarily reduce energy prices.

In other words, the US enters the decades ahead with more debt, less spending power, an undereducated population, and less petroleum put aside for national defense.  The US has made the future riskier.

At the same time, no one can know exactly what the near-term future looks like.  Right now, the conventional wisdom is that the US faces a recession.  Normally, we would disagree with the conventional wisdom, but this time we agree.  Unwinding COVID policies will be painful.

RTWT.

Steve Parker, M.D.

Wake Up, People! Watch This Video If You Believe Everything the Mainstream Media Spoon-Feeds You

Whitney Webb opines on Epstein, WEF, electric vehicles, international political corruption and more. I first saw this remarkable 33-year-old mother in one of the COVID-19 videos I linked to here.

My favorite line of hers from the video: “We have outsourced our needs to corporations that want to enslave us….”

I love Whitney Webb. I’ll be very sad when she’s assassinated. Watch the video before it’s banned.

Facts and Fiction Regarding Fad Diets

professor, equations

Frontiers In Nutrition in July, 2022, published “Fad Diets: Facts and Fiction.” Thank you, FIN, for making it available at no cost. The authors are based in Pakistan and Romania. They attempted to summarize the literature on popular fad diets. I am shocked that they included the Mediterranean diet as a fad diet. Read the article and 134 references then form your own opinion. Some snippets:

Regarding the Atkins Diet: “AD provides several benefits including weight reduction and cardio-metabolic health improvement, but limited evidence exists as compliance is the major barrier to this dietary regimen. Strict supervision by health professionals is advised as adverse metabolic sequelae can result from this type of diet.”

The Paleolithic Diet: “More randomized trials need to be done to highlight the consequences of such diets that eliminate one or more food groups. PD is powerful at advancing weight reduction for the time being but its efficacy in cardiovascular events is not well established as limited long-term data is available.”

Mediterranean Diet: “No evidence of adverse effects associated with MD is available in the literature. Rather, MD has preventive and therapeutic potential for many chronic diseases. It is highly suitable for the general public for the prevention of micronutrient deficiencies and specifically for those patients who are more health-conscious than just weight loss oriented.”

Vegetarian Diet: “No evidence of adverse effects associated with MD is available in the literature. Rather, MD has preventive and therapeutic potential for many chronic diseases. It is highly suitable for the general public for the prevention of micronutrient deficiencies and specifically for those patients who are more health-conscious than just weight loss oriented.”

Intermittent Fasting: “Despite the effectiveness of IF in weight loss as indicated by several studies, the current evidence is non-conclusive. The prime focus of available literature is weight loss but little is known about its sustainability and long-term health effects. More long-term trials should be conducted to draw a clear conclusion.”

Detox Diets: “Energy-restricted DDs are capable of short-term weight loss. But still, there is a high likelihood of health risks from detox products because of their nutritional inadequacy. As no convincing evidence exists in this domain so such diets and products need to be discouraged by health professionals and must be subjected to regulatory review and monitoring.”

Ketogenic Diet: difficult to summarize.

Steve Parker, M.D.

front cover of paleobetic diet

Click to purchase at Amazon.com. E-book also available at Smashwords. com.

Ultra-Processed Foods Associated With Impaired Cognition

Processed or ultra-processed?

An article earlier this year in the European Journal of Nutrition reported that high consumption of ultra-processed foods is linked to worse-than-average performance on one particular test of cognitive function in older U.S. adults (60+ years-old) who did not have chronic diseases such as diabetes or cardiovascular disease. The particular test was “Animal Fluency.” Never heard of it? Me either. Keep reading.

The study included 2,700 participants, average age 69. Participants were asked to recall what they ate in the prior 24 hours. Foods were “classified according to NOVA, a food classification based on the extent and purpose of industrial food processing, into four mutually exclusive groups: (1) unprocessed or minimally processed foods, (2) processed culinary ingredients, (3) processed foods, and (4) UPFs [ultra-processed foods].”

Ultra-processed foods? “…most foods described as “Frozen meals” or “Lunchables”, as well as some items described as consumed in “Restaurant fast food/pizza” or acquired at a “Vending machine” were classified as UPFs.” Furthermore, the authors write in the introduction that “UPFs, according to NOVA classification system, are industrial formulations of processed food substances (oils, fats, sugars, starch, and protein isolates) that contain little or no whole food and typically include flavourings, colourings, emulsifiers, and other cosmetic additives. UPFs are becoming dominant in diets globally and are replacing traditional diets based on unprocessed and minimally processed foods.

Of the entire study population at hand, UPFs were about half of all calories consumed but ranged from 30 to 70%.

“Cognitive performance was assessed using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), Word Learning test, Animal Fluency test, and the Digit Symbol Substitution test (DSST).”

The Animal Fluency test “evaluates categorical verbal fluency (executive function).” “For the Animal Fluency test, the participant is requested to name as many animals as possible within a 60-s [60 seconds, I assume] time period. Each animal corresponds to 1 point and the result is presented as the total sum of points.”

Mr Ed, the fluent horse (You won’t get this if under 63)

The test subjects were given two other tests of cognitive function but the investigators found no differences in performance based on ultra-processed food consumption. Here are these other two tests:

The two parts of the CERAD Word Learning test consist of (1) three consecutive learning trials, where the participant is requested to recall a list of ten unrelated words immediately after their presentation. Each word corresponds to one point, and the result is presented as a total score across the three trials (range 0–30); and (2) a delayed word recall test, performed after the two other cognitive tests. The result ranges from 0 to 10. … For the DSST, the participant is presented a single sheet of paper where they are asked to match a list of nine symbols to numbers according to a key located on the top of the page. The task had 133 numbers and the participant had 2 min to complete it. The result is shown as the total number of correct matches. For all the tests, higher scores represent better cognitive function. 

The authors conclude: “Consumption of UPF was associated with worse performance in Animal Fluency, a cognitive test that assesses language and executive function in older adults without pre-existing diseases such as CVD [cardiovascular disease] and diabetes, while no associations were observed for those with these conditions. While longitudinal studies are required to provide stronger evidence, these results suggest that decreasing UPF consumption may be a way to mitigate age-associated cognitive decline and reduce the risk of dementia.”

I agree these results aren’t very strong.

Steve Parker, M.D.

h/t Jan at The Low Carb Diabetic blog

Overweight U.S. Adolescents Eat Excessive Ultra-Processed Foods

Man-made food

An article in the Journal of the Academy of Nutrition and Dietetics found an association between overweight/obesity and consumption of ultraprocessed foods in U.S. adolescents.

The study looked at 3,600 adolescents who reported their food intake over a 24-hour period. The results are pretty strong: the more ultra-processed food consumed, the greater the odds of overweight and obesity.

Jan at The Low Carb Diabetic blog reported that:

Ultra-processed foods make up ‘two-thirds of calories consumed by children and teens’
Experts from Tufts University in Massachusetts studied two decades of dietary data to 2018 and found that the amount of calories young people consumed from ultra-processed foods jumped from 61 per cent to 67 per cent.

I’m not paying for the JAND scientific report so I don’t know how they defined ultra-processed foods. The definition varies quite a bit over time, by researcher, and by research goals. From the U.S. National Library of Medicine:

The definitions [of ultra-processed foods] used in 2009, 2010, 2012, 2014, and 2016a represent the definitions used from publications devoted solely to that purpose and are heavily referenced in the literature on ultra-processed foods. The definitions used in years 2015, 2016b, and 2017 are from articles that focused on the relation between ultra-processed food intake and public health nutrition, in which definitions of ultra-processed foods are presented in detail in the article. The first definition alludes mainly to the use of both food additives and salt in food products (6). The second introduces the putative impact of ultra-processed foods on accessibility, convenience, and palatability of ultra-processed foods (8). Subsequently, the definitions become longer and include more elements. Thus, the third definition builds on previous definitions but introduces 2 new angles (9). One is the nonavailability of ingredients used in ultra-processed foods from retail outlets such as supermarkets, and the second introduces food additives as the most widely used ingredients, in numerical terms, in the manufacture of ultra-processed foods. The next definition now introduces the role of food fortification as a defining element of ultra-processed foods (4). Further definitions introduce new elements such as the importance of foods synthesized in a laboratory, based on organic materials such as oil- and coal-based additives and flavoring compounds (10), a specification for the minimal number of ingredients to be found in these foods (5), and then an emphasis on the inclusion of salt, sugars, oils, and fats as a starting point for defining ultra-processed foods. This definition gives details of specific categories of food additives and highlights how the intended use of these additives is to imitate sensory qualities of fresh or minimally processed foods (group 1) or to specifically disguise undesirable qualities of ultra-processed foods (11). The final definition from 2017 (12) is quite similar to that used in the 2016b publication (11).

God-made food
Photo by Chan Walrus on Pexels.com

If you want to dive deep, you can download a list of ultra-processed food examples from that NLM article. I didn’t. But I figure the way to avoid over-processed foods is to eat food closer to the way God made it rather than man-made.

Steve Parker, M.D.

Medicare Fines Two Hospitals for Violating Price Transparency Law

hospital emergency room
Not the offending hospital

I’ve long been an advocate for price transparency in healthcare. The Centers for Medicare and Medicaid Services (aka CMS) has recently taken action that requires hospitals to post their prices online, which should boost competition and help you shop around to save money. If memory serves, the price posting only applies to a limited number of services. I presume the rare hospitals that don’t accept Medicare and Medicaid payments are exempt.

From MedPage Today:

This week [June 2022], CMS handed down their first penalties to two hospitals in Georgia for failing to comply with the price transparency law that went into effect Jan. 1, 2021.

Northside Hospital Atlanta in Sandy Springs and Northside Hospital Cherokee in Canton were both fined for a lack of readily available standard charges for hospital services online, despite warnings.

The fines were on the order of $200,000 and $900,000.

If you find a hospital breaking the law, report ’em to CMS.

Steve Parker, M.D.

Chronic Stress Linked to Arthritis Onset

Knees are the most common joint affected by osteoarthritis.
Photo credit: Steven Paul Parker II

A MedPage Today article indicates that chronic stress may precipitate or aggravate arthritis. Even childhood stress. The link is not as strong for rheumatoid arthritis as it is for more common types of arthritis. Most for the reviewed studies “categorized stress as stemming from adverse life events … or adverse childhood experiences …. Most studies … suggested a relationship between exposure to chronic stressors and arthritis development.”

Would stress reduction improve the quality of life of arthritis patients? The study at hand doesn’t address that but I’d wager that it does.

Steve Parker, M.D.

QOTD: Proverbs 13: 20-21

He who walks with the wise grows wise, but a companion of fools suffers harm.

Misfortune pursues the sinner, but prosperity is the reward of the righteous.

Alternatively, the King James version:

He that walketh with wise men shall be wise: but a companion of fools shall be destroyed.

Evil pursueth sinners: but to the righteous good shall be repayed.