Category Archives: Uncategorized

“Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo.”

Source: Effect of Aspirin on Disability-free Survival in the Healthy Elderly | NEJM

I hesitated to link to this story about a porn star, but decided to do it anyway. You judge her lifestyle for yourself.

Looks to me like she could use some weight training.

From Fox News:

“For dinner, Jameson, 44, says she prepares salmon in the oven with lemon, butter and dill around 5 p.m. and serves it with broccoli or asparagus.

Jameson also noted that she doesn’t mix meat and dairy because she eats Kosher, but says her followers should feel welcome to do so.The blonde bombshell, who welcomed daughter Batel Lu in April 2017, says that when she’s hungry, she eats, particularly because she’s breastfeeding — but that she makes it a point to avoid keto breads and snacks and focus solely on whole, organic foods.

The “How to Make Love Like a Porn Star” author has shared her weight loss progress for months.”

Source: Jenna Jameson shares keto diet tips after 80-pound weight loss | Fox News

Is this the diet she used?

“Honey, let’s talk to doc about stopping those drugs.”

I commonly admit patients to the hospital who happen to be taking either Aricept or memantine (or both) in an effort to slow the cognitive decline of dementia. Aricept is a cholinesterase inhibitor, abbreviated ChEI below.

A meta-analysis published in November 2018 in JAMA Network suggests that folks taking those drugs have a more rapid cognitive decline compared to those who don’t. Moreover, the rate of decline for those taking memantine, with or without ChEIs, was faster than those receiving ChEIs only or receiving neither medication.

A typical dose of Aricept (donepezil) is 10 mg/day. The average wholesale price for that pill is $20.23 (USD). One brand of memantine is called Namenda, and the usual dose is 10 mg twice daily. Average wholesale dose for that is $17.80/day.  Take both those drugs daily for one month and it’s $1,140.90. Or $13,690.80 for a year. And that’s the wholesale price.

I can think of a few better uses of that money.

Admittedly, there must be individual patients that respond better than average to these drug, and some respond worse than average. You can’t tell in advance who those are.

Click the link below for the full study. From the Abstract:

Results

Across 10 studies, of 2714 participants, the mean (SD) age was 75.0 (8.2) years, 58% were female, and 9% were racial/ethnic minorities. There were 906 participants (33.4%) receiving ChEIs, 143 (5.3%) receiving memantine, 923 (34.0%) receiving both, and 742 (27.3%) receiving neither. Meta-analysis showed those receiving ChEIs or memantine were associated with significantly greater annual rate of decline on the ADAS-cog [a test of cognition] than those receiving neither medication (1.4 points/y; 95% CI, 0.1-2.7).

Conclusions and Relevance

Similar to observational studies, many participants in AD clinical trials receiving ChEIs or memantine experience greater cognitive decline. This difference is nearly as large as the hypothesized effect sizes of the treatments investigated in the trials. Concomitant use of ChEIs or memantine may be confounded with outcomes on the ADAS-cog and should be considered in design of clinical trials of potential therapeutic agents for AD. Post hoc analyses stratifying by ChEIs or memantine must be interpreted cautiously given the potential for confounding.

Source: Association of Concomitant Use of Cholinesterase Inhibitors or Memantine With Cognitive Decline in Alzheimer Clinical Trials: A Meta-analysis | Dementia and Cognitive Impairment | JAMA Network Open | JAMA Network

From Dr Georgia Edes:

“A new study conducted at the University of Sydney and published in the journal Cell Reports is inspiring headlines around the world, like this one: “Low-protein, high-carb diet may help ward off dementia”

In the study, scientists compared diets containing different amounts of protein and carbohydrate to a low-calorie diet. Their results suggested that diets lower in protein and higher in carbohydrate may, in some cases, provide subtle brain benefits similar to the benefits seen with calorie restriction. The researchers concluded, “A very low-protein, high-carbohydrate diet may be a feasible nutritional intervention to delay brain aging.”

Source: The Truth About Low-Protein, High-Carb Diets and Brain Aging | Psychology Today

This is ground-breaking research if you’re a mouse.

No surprise here:

“A review of studies that looked at the effect of the Mediterranean diet on long-term cognitive function established that people who adhered to this way of eating had less cognitive decline, had improvements in cognitive function, or were less likely to develop Alzheimer’s disease compared to people who did not stick to this diet. The Mediterranean diet emphasizes fruits, vegetables, whole grains, beans, nuts, fish and olive oil, with lesser amounts of poultry and cheese and limited amounts of red meat and sweets.”

Source: Keeping Alzheimer’s Disease at Bay – Diabetes Self-Management

“Abstract

Objective

To test the effectiveness and safety of a total diet replacement (TDR) programme for routine treatment of obesity in a primary care setting.Design Pragmatic, two arm, parallel group, open label, individually randomised controlled trial.Setting 10 primary care practices in Oxfordshire, UK.

Participants 278 adults who were obese and seeking support to lose weight: 138 were assigned to the TDR programme and 140 to usual care. 73% of participants were re-measured at 12 months.Interventions The TDR programme comprised weekly behavioural support for 12 weeks and monthly support for three months, with formula food products providing 810 kcal/day (3389 kJ/day) as the sole food during the first eight weeks followed by reintroduction of food. Usual care comprised behavioural support for weight loss from a practice nurse and a diet programme with modest energy restriction.

Main outcome measures

The primary outcome was weight change at 12 months analysed as intention to treat with mixed effects models. Secondary outcomes included biomarkers of cardiovascular and metabolic risk. Adverse events were recorded.Results Participants in the TDR group lost more weight (−10.7 kg) than those in the usual care group (−3.1 kg): adjusted mean difference −7.2 kg (95% confidence interval −9.4 to −4.9 kg). 45% of participants in the TDR group and 15% in the usual care group experienced weight losses of 10% or more. The TDR group showed greater improvements in biomarkers of cardiovascular and metabolic risk than the usual care group. 11% of participants in the TDR group and 12% in the usual care group experienced adverse events of moderate or greater severity.

Conclusions

Compared with regular weight loss support from a practice nurse, a programme of weekly behavioural support and total diet replacement providing 810 kcal/day seems to be tolerable, and leads to substantially greater weight loss and greater improvements in the risk of cardiometabolic disease.”

Source: Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial | The BMJ

No surprise here…

“The Mediterranean diet was linked to prolonged survival in two different studies spanning multiple age groups, according to findings recently published in the British Journal of Nutrition.

“We already knew that the Mediterranean diet is able to reduce the risk of mortality in the general population, but we did not know whether it would be the same specifically for elderly people,” Marialaura Bonaccio, PhD, epidemiologist at the Istituto Neurologico Meditteraneo Neuromed in Italy, said in a press release.

Researchers conducted a longitudinal analysis on the dietary habits of 5,200 participants of a previously existing cohort.

They found that for each one-point increase in a patient’s Mediterranean diet score, the risk for mortality from a variety of causes declined: all-cause mortality (HR = 0.94; 95% CI 0.9-0.98); coronary artery disease/cerebrovascular disease mortality (HR = 0·91; 95% CI, 0.83-0.99) and non-cardiovascular/non-cancer mortality (HR = 0.89; 95% CI, 0.81-0.96).”

Source: Mediterranean diet increases lifespan

“Women with gestational diabetes who were on a Mediterranean diet for 3 months had improved glycemic levels, that were comparable to pregnant women with normal glucose levels, a new study from Madrid, Spain suggests.

The objective of the study was to assess whether Mediterranean diet-based medical nutrition therapy facilitates near-normoglycemia in women with gestational diabetes.

“Medical nutrition therapy based on a MedDiet enhanced with extra virgin olive oil and pistachios, thus with a high-fat content, is associated with glycemic control and with a reduction in gestational diabetes-related adverse perinatal outcomes,” Dr. Alfonso Calle-Pascual, one of the study authors told dLife.”

Source: Mediterranean Diet Linked to Improved Gestational Diabetes Outcomes, Study | dLife

I thought we already knew this…

Protecting a patient’s eyes may be more heavily influenced by diet than previously thought. A new study, which analyzed data from a pair of previous study populations, found that people aged 55 and over who maintained a Mediterranean-style diet reduced their risk of developing late-stage age-related macular degeneration (AMD) by 41%.

Source: Mediterranean Diet Associated with 41% Risk Reduction for AMD | MD Magazine