Advanced Mediterranean Diet

My monitor works well

“Metabolic syndrome” may be a new term for you. It’s a collection of clinical features that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome. Diagnosis requires at least three of the following five conditions:

• high blood pressure (130/85 or higher, or using a high blood pressure medication)
• low HDL cholesterol:  under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)
• triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a cholesterol-lowering drug)
• abdominal fat:  waist circumference 40 inches (102 cm) or greater in a man, 35 inches (89 cm) or greater in a woman
• fasting blood glucose over 100 mg/dl (5.55 mmol/l)

One approach to improving the numbers is a LCHF diet. Here’s a journal article abstract from JCI Insight:

BACKGROUND. Metabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS.

METHODS. Individuals who were obese with a diagnosis of MetS were fed three 4-week weight-maintenance diets that were low, moderate, and high in carbohydrate. Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets.

RESULTS. Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.

CONCLUSION. Consistent with the perspective that MetS is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high-carbohydrate intake, LC/high-fat diets benefit MetS independent of whole-body or fat mass.

TRIAL REGISTRATION. ClinicalTrials.gov Identifier: NCT02918422.

FUNDING. Dairy Management Inc. and the Dutch Dairy Association.

Source: JCI Insight – Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss

Steve Parker, M.D.

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Hazmat-suited healthcare worker in a decontamination shower

Don’t count on nurse Aesop. I’m sure he’s not alone. Few healthcare providers got into the business to put their lives on the line every day. The Ebola virus is highly contagious and often lethal. Prevention of the spread of Ebola to healthcare providers and the general population requires high-level isolation units. Aesop says there are only 15 such beds in the U.S. (He calls them BL-IV beds). There are zero at most hospitals and zero in most cities.

We aren’t set up for this [virus], and we’re doing nothing to stop it getting here (rather the opposite in fact).

And when it does, after those first 15 beds are occupied, we’ve done nothing anywhere close to adequate to handle things properly and nip it in the bud.

But everyone in charge pretends we’ve done exactly that, when nothing could be further from the truth.

Maybe you can bullshit the Low Information Viewers in flyover country, but you can’t bullshit me or countless other doctors, nurses, and ancillary staff who’ll be on the frontlines (for about 20 seconds, in my case) before we drop our clipboards where we’re standing, and head for the parking lot.

I may make a bullshit excuse about not feeling well, I may pass off report on my patients to someone else who stays, but go I will, and I mean within minutes.

I can’t collect paychecks at Forest Lawn [cemetery], and I won’t be helping anyone shitting my intestines into my scrub pants, and both of those are slam-dunk outcomes with the present (and perpetual) half-assed level of preparedness for Ebola or any one of 27 other pandemic-worthy infections at every hospital (but for a small part of a bare few) from Anchorage to Miami, and Maine to Hawaii.

Anyone wants to go to medical or nursing school, and go work on the frontlines of Ebola with WHO or the CDC, rolling the dice you’ll live to retirement every time you scrub in or out, operators are standing by. (When every hospital has an actual 24/7 BL-IV capability, and staffs and supplies and trains for its use regularly – by which I mean more than once a year or three to salve their own charred consciences and pen-whip JCAHO’s lackadaisical clipboard commandos – we can talk. Otherwise: F**K that noise. Sideways, with a rusty chainsaw.)

In such an epidemic, there is no such thing as a valiant death.There’s just death.

I’ll do my damnedest to save your life if you come into my ER.

But I won’t kill myself to do it, and I won’t die for you because TPTB [the powers that be] at every level are too half-assed and cheapskate to prepare for this as if it was Really A Thing, too stupid to know that, and too evil to care. That ain’t in my contract, and unlike joining the Marines, I took no such oath, and it isn’t part of the deal.

I don’t know how many out of 4,000,000 medical practitioners will be that honest and tell you that up front.

I just did.

Source: Raconteur Report: Where The Problem Is

Have a great day! 🙂

Steve Parker, M.D.

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