Monthly Archives: March 2013

Businesses May Have a Way to Escape Obamacare

…through self-insurance according to an article at MedPageToday.  Many businesses are quite concerned about their ability to pay for the Affordable Care Act.  They’re looking for ways around it so they can stay in business, keep all their employees, without raising prices too high.  From the referenced article, here’s how self-insurance works:

To employees, medical self-insurance looks like a regular health plan. Self-insured employers pay for most worker health costs directly, though they contract with an insurer or other company to administer claims. The employers also buy coverage known as stop-loss for claims exceeding a certain amount. Brokers say a growing number of firms see such plans as low-cost alternatives to conventional coverage because they’re exempt from ACA requirements such as insurance taxes and specified benefits.

For example, if an employer doesn’t want to pay for sex-change operations, they could exclude that as a covered service.

Read the rest.

High Calcium Intake Linked to Higher Risk of Death In Swedish Women

Six of every 10 middle-aged and older women in the U.S. are taking calcium supplements, hoping to keep their bones strong and thereby avoid osteoporotic fractures of the hip, spine, and wrist.  A new study in the British Medical Journal suggests that high calcium consumption, whether from food or supplements, increases the risk of death.

The researchers wrote: 

In this study of women in the Swedish mammography cohort, a high calcium intake (>1400 mg/day) was associated with an increased rate of mortality, including death from cardiovascular disease. The increase was moderate with a high dietary calcium intake without supplement use, but the combination of a high dietary calcium intake and calcium tablet use resulted in a more pronounced increase in mortality. For most women with lower intakes we observed only modest differences in risk.

 

 

The Ashley Goes Behind the Scenes at The Biggest Loser Show

 …details are here.  What’s it like to be at the ranch for days?  Are there many injuries?

 

h/t Dr. Yoni Freedhoff

High-Intensity Interval Training: A Primer and the Science Behind It

A treadmill is one of many ways to do high-intensity interval training.  Tabata's classic study used a stationary bicycle.

A treadmill is one of many ways to do high-intensity interval training. Tabata’s classic study used a stationary bicycle.

I found a free article by Martin Gibala,Ph.D., a major researcher into high-intensity interval training (HIIT).  He prefers to abbreviate it as HIT.

I don’t like to exercise, so I’ve been incorporating HIIT into my workouts for over a year.  It’s helped me maintain my level of fitness to that required of U.S. Army soldiers, without being a exercise fanatic.

So what’s HIIT?  Gibala’s definition:

High-intensity interval training is characterized by repeated sessions of relatively brief, intermittent exercise, often performed with an “all out” effort or at an intensity close to that which elicits peak oxygen uptake (i.e., ≥90% of VO2peak).

HIIT involves short sessions of very intense exercise about three times per week, for as little as 15 minutes.  That’s total time, not 15 minutes per session!  Yet you see a significant fitness improvement.  Be aware: the brief exercise bouts should be exhausting.

The Gibala article has all the scientific journal references you’d want, plus a suggested HIIT program for an absolute beginner.

One final quote from Dr. Gibala:

It is unlikely that high-intensity interval training produces all of the benefits normally associated with traditional endurance training. The best approach to fitness is a varied strategy that incorporates strength, endurance and speed sessions as well as flexibility exercises and proper nutrition. But for people who are pressed for time, high-intensity intervals are an extremely efficient way to train. Even if you have the time, adding an interval session to your current program will likely provide new and different adaptations. The bottom line is that — provided you are able and willing (physically and mentally) to put up with the discomfort of high-intensity interval training — you can likely get away with a lower training volume and less total exercise time.

Read the rest.

Steve Parker, M.D.

PS:  Why won’t Gibala give some credit to Izumi Tabata who did a pioneering study on HIIT in 1996?

PPS:  Gibala narrated this stationary bike HIIT video.

h/t Tony Boutagy

Does Female Hormone Replacement Therapy Really Cause Breast Cancer?

Hormone replacement therapy at the time of menopause fell out of favor a decade ago.  One of the concerns was that such therapy caused breast cancer.  Some investigators question the association.  Details are here.

Consensus Statement on Hormone Replacement Therapy for Menopausal Symptoms

Hormone therapy after onset of menopause is a complex issue. A couple decades ago it was widely accepted as a way to suppress symptoms and side effects of menopause. Subsequently, we had fears that it may be linked with breast cancer or cardiovascular disease, with potential to shorten life span.

An international group of professional societies has published some guidelines recently:

The consensus recommendations included the following, as listed at MedPageToday:

  • Among women younger than 60 or within 10 years after menopause, estrogen-alone HRT at standard doses “may decrease coronary heart disease and all-cause mortality.” Mortality benefits of estrogen plus progestogen in this group are less clear with no increase or decrease in cardiovascular risk.
  • For women whose only menopause symptom is vaginal dryness or discomfort during intercourse, low-dose topical estrogen is preferred.
  • Estrogen-only HRT is preferred in women after hysterectomy; other women should receive estrogen plus progestogen.
  • Venous thromboembolism and ischemic stroke risk increases with oral HRT but the absolute risk remains low in women younger than 60. Such risks may be smaller with transdermal therapy.
  • HRT is not recommended in breast cancer survivors.
  • Custom-compounded “bioidentical” hormone therapy is not recommended.

Read more details at MedPageToday.

Gwyneth Paltrow Apparently Has Her Kids on a Low-Carb Diet

…according to Joanna Blythman.  Some dietitians are upset.  Blythman writes:

Of course, the processed food industry works ceaselessly to convince us that we must eat highly refined starchy foods, such as breakfast cereals and white bread, trumpeting that they give us energy. But all food gives us energy. Contrary to what we have been led to believe, there is no dietary “need” to eat starchy carbohydrates at all.

I agree with that last statement.  That’s how a healthy adult can live two months without any food whatsoever: any carbohydrate we need (glucose) can be made from our stores of protein and fat.

Does a Low-Carb High-Fat Diet Impair Performance of High-Level Endurance Athletes?

…Dr. Jeff Volek would probably say no. On the other hand, personal  trainer Alan Aragon says yes.  Read about their recent debate at Alan’s blog, they you decide.

Here’s and excerpt from an invited editorial at Journal of Applied Physiology:

“…it seems that we are near to closing the door on one application of this dietary protocol [high-fat, low-carb eating (aka “fat adaptation”) for optimal sports performance]. Scientists may remain interested in the body’s response to different dietary stimuli and may hunt for the mechanisms that underpin the observed changes in metabolism and function. However, those at the coal-face of sports nutrition can delete fat loading and high-fat diets from their list of genuine ergogenic aids for conventional endurance and ultra-endurance sports.”

 

If You’re a Fan of Brave Maverick Doctor Stanislaw Burzynski

…please read this post at Science-Based Medicine.  You may change your mind.  I’m surprised the Texas Medical Board hasn’t been able to rein him in.

Feds Spend $1.5 Million to Study Why Lesbians Are Fat

For every dollar spent on this, we borrow 40¢ that will have to be paid back by the taxpayers.  This is so crazy, I question whether the story is even accurate.  A snippet:

The National Institutes of Health (NIH) has awarded $1.5 million to study biological and social factors for why “three-quarters” of lesbians are obese and why gay males are not, calling it an issue of “high public-health significance.”