Monthly Archives: March 2012

Elderly Mental Decline Is Slowed by Mediterranean Diet

The Mediterranean diet slowed age-related mental decline in elderly Chicago residents, according to researchers at Rush University Medical Center. The investigators noted that a Manhattan population following the Mediterranean diet also showed slower mental decline and lower rates of Alzheimers dementia.Over 3,000 study participants (2,280 blacks, 1,510 whites) were studied for an average of eight years. Food consumption was determined by questionnaires, and mental function was tested every three years. Adherence to the Mediterranean diet was judged according to a Mediterranean diet score developed by Panagiotakis, et al.

The greater the adherence to the Greek-style Mediterranean diet, the lower the rate of mental decline over the course of the study.

Mental decline to some extent is a normal part of aging. If we can avoid it or lessen it’s impact, why not? A couple ways to do that are regular exercise and the Mediterranean diet.

Would a low-carb Mediterranean diet work just as well or better? Nobody knows yet.

Steve Parker, M.D.

Reference: Tangney, Christine, et al. Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. American Journal of Clinical Nutrition, 2010. doi 10.3945/ajcn.110.007369


What About the Omega-6-Omega-3 Fatty Acid Ratio?

It’s estimated that the Old Stone Age diet provided much more omega-3 fatty acids and much less omega-6s, compared to modern Western diets. This may have important implications for development of certain chronic diseases like cancer and heart disease.

Fatty acids, by the way, refer to the long chains of molecules that comprise the majority of fats and oils.

Some folks speculate that the Stone Age (Paleolithic) diet may be the healthiest way to eat because our genes are adapted to it. In other words, we evolved in a certain food environment over hundreds of thousands of years, so we should have optimal health if we follow our ancestral diet (whatever that is).

A major change in human eating habits over the last century has been the dramatic increase in consumption of industrial seed oils like corn and soybean oil. These have dramatically increased the omega-6 fatty acids in our diets. i.e., they’v3e increased the omega-6/omega-3 ratio. Another major change starting about 10,000 years ago is the increase in consumption of grains.

This’ll improve your omega-6/omega-3 ratio!

I haven’t studied omega-6/omega-3 ratio issue in great detail but hope to do so at some point. Evelyn Tribole has strong opinions on it; I may get one of her books.

I saw an online video of William E.M.Lands, Ph.D., discussing the omega-6/omega-3 ratio. He mentioned free software available from the National Insitutes of Health that would help you monitor and adjust your ratio.

You can see the video here. Dr. Lands’ talk starts around minute 12 and lasts about 45 minutes. He says it’s just as important (if not more so) to reduce your omega-6 consumption as to increase your omega-3. And don’t overeat.

Steve Parker, M.D.

Coronary Artery Disease Declining In U.S.

The U.S. Centers for Disease Control and Prevention reported last year that the prevalence of self-reported coronary heart disease declined from 6.7% of the population in 2006, to 6% in 2010. Figures were obtained by telephone survey. Coronary heart disease, the main cause of heart attacks, remains the No.1 cause of death in the U.S.

Self-reports of heart disease may not be terribly reliable. However, I remember an autopsy study from Olmstead County, Minnesota, from 2001 that confirmed a lower prevalence of coronary heart disease there. I wrote about that at the Heart Health Blog, but those posts may not be around much longer.

The CDC report mentioned also that mortality rates from coronary heart disease have been steadily declining for the last 50 years.

Improved heart disease morbidity and mortality figures probably reflect better control of risk factors (e.g., smoking, high blood pressure), as well as improved treatments. I’ve never seen an estimate of the effect of reduced trans fat consumption.

Obesity is always mentioned as a risk factor for heart disease, yet obesity rates have skyrocketed over the last 40 years. You’d guess heart disease prevalance to have risen, but you’d have guessed wrong. In view of high obesity rates, some pundits have even suggested that the current generation of Americans wil be the first to see a decrease in average life span.

The American Diabetes Association offers a free heart disease risk calculator, if you’re curious about your own odds. My recollection is that the calculator works whether or not you have diabetes.

Steve Parker, M.D.

Should Exercise Be Fun?

Exercise is not supposed to be fun. If it is, then you should suspect that something is wrong.

That quote is from an essay by Ken Hutchins posted at the Efficient Exercise website.

When I was a young man in my 30s, I was jogging 20 miles a week and ran a couple marathons (26.2 miles). I enjoyed it and didn’t do much else for exercise or overall fitness. I thought I was in pretty good shape. You can get away with that when you’re 35, but not when you’re 50. At 57 now, I can’t think of any single recreational activity that can help me maintain the overall strength, functionality, and injury resistance I want and need as I age.

I’ve come to view exercise as a chore, like flossing/brushing teeth, changing the oil in my car, and sleeping when I’d rather not. I’ve got my current exercise chore whittled down to an hour three times a week. OK, sometimes just twice a week.

Skyler Tanner takes a thoughtful and in-depth look at the exercise versus recreation dichotomy at his blog. If you have comments, more people will see them at his site than here.

Steve Parker, M.D.

U.S. Army Fitness Benchmarks

I’ve written previously how it’s helpful to have some baseline physical fitness measurements on yourself.  That post mentioned up to 14 different items you could monitor.  In the comment section, I recognized that’s too much for some folks.  For them, I suggested just doing the five-item functional testing: 1-mile run/walk (timed), maximum number of push-ups and pull-ups, toe touch, and vertical jump.

A week ago, I was at a training session for adult Boy Scout leaders.  One of the items covered was environmental heat illness: how to avoid, recognize, and treat.  One of the risk factors for heat illness is “poor fitness,” defined as taking over 16 minutes to run two miles.  Inquiring minds want to know where that number came from.  No reference was given. has an article on fitness requirements for U.S. army soldiers, who are tested at least twice yearly.  There are only three components tested:

  • Number of push-ups
  • Number of sit-ups
  • Time to complete a two-mile run

Fortunately, the Army doesn’t expect a 57-year-old man to perform as well as a 17-year-old.  For instance, a 17-year-old has to run two miles in 19 minutes and 24 seconds or less; the 57-year-old is allowed up to 23 minutes and 24 seconds.  Females and males have different performance standards: a 17-year-old woman has 22 minutes and 24 seconds to run two miles.

The simplicity of the Army’s approach appeals to me.  Check out the APFT tables in the article if you want to see how you compare to Army soldiers.

Steve Parker, M.D.

“LCHF Diet” Popular in Sweden

LCHF Cheese

Dr. Eenfeldt of gave a talk at the recent Ancestral Health Symposium in California, on the rationale of the current low-carb, high-fat diet (LCHF) so popular in his home country of Sweden. It’s very understandable to the general public and is a good introduction to low-carb eating. The entire YouTube video is 55 minutes; if you’re pressed for time, skip the 10-minute Q&A at the end.

He also discusses the benefits of LCHF eating for his patients with diabetes.

If you reduce carbohydrates, you’re going to replace it with either protein, fat, or both. As Dr. Eenfeldt recommends, the Ketogenic Mediterranean and Low-Carb Mediterranean Diets replace carbs more with fats than protein.

Steve Parker, M.D.

What About “The Biggest Loser”?

Dr. Barry Sears (Ph.D., I think) recently wrote about a lecture he attended by a dietitian affiliated with “The Biggest Loser” TV show. She revealed the keys to weight-loss success on the show. Calorie restriction is a major feature, with the typical 300-pounder (136 kg) eating 1,750 calories a day. On my Advanced Mediterranean Diet, 300-pounders get 2,300 calories (men) or 1,900 calories (women).

Although not stressed by Dr. Sears, my impression is that contestants exercise a huge amount.

Go to the link above and you’ll learn that all contestants are paid to participate. In researching my Conquer Diabetes and Prediabetes book, I learned that the actual Biggest Loser wins $250,000 (USD). Also, “The Biggest Loser” is an international phenomenon with multiple countries hosting their own versions, with different pay-off amounts. A former winner, Ali Vincent, lives in my part of the world and still has some celebrity status.

This TV show demonstrates that the calories in/calories out theory of body weight still applies. Including the fact that massive exercise can help significantly with weight loss. In real-world situations, exercise probably contributes only a small degree to loss of excess weight. The major take-home point of the show, for me, is that you can indeed make food and physical activity choices that determine your weight.

Most of us watch too much

I know losing 50 to 10o pounds of fat (25–45 kg) and keeping it off for a couple years is hard; most folks can’t do it. Do you think you’d be more successful if I gave you $250,ooo for your success?

Steve Parker, M.D.