A ketogenic diet was safe and effective for weight loss in children and adolescents, according to a small study in the Journal of Pediatric Endocrinology and Metabolism. Fifty-six children were placed on either a ketogenic diet or a calorie-restricted diet. The investigators judged the low-carb ketogenic diet more effective.
I don’t treat children, so I don’t normally follow the pediatric scientific literature. Thanks to Diet Doctor Andreas Eenfeldt for bringlng this to my attention. I’ve not read the full research report.
In 2010 I reported on research showing a low-carb, high-protein diet was safe and effective for severely obese adolescents.
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Posted in Weight Loss
Tagged adolescent obesity, children, ketogenic diet, low carb diet, obese, overweight, weight loss
Dr. Mark Crislip has some answers at Science-Based Medicine. An excerpt from the infectious disease specialist:
“I tend to leave most symptoms alone if the they are not life threatening or otherwise unbearable for the patient. Codeine is the only really good cough suppressant and none of the over the counter cough medications are effective. I assume that coughing with infection, like diarrhea, is beneficial. Key to treating all infections is to physically remove it. Undrained pus doesn’t heal, and a good cough is the most efficient way I know remove potential pathogens from the lung.”
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“Dr. Parker, what can I do about these severe belly cramps?”
Four weeks of fermentable carbohydrate restriction reduces symptoms of irritable bowel syndrome, according to UK and Australian researchers.
Here’s the theory of how it works. Our intestines—colon, mostly—are loaded with bacteria. The food you feed your bacteria—fermentable carbohydrates, for example—may have an effect on the bacteria. Changes in bacterial populations in response to feeding, in turn, may lead to changes in irritable bowel syndrome and other aspects of health. This “gut microbiome” is a hot area of research and speculation.
I don’t have irritable bowel syndrome (IBS), but did notice a major decrease in gastrointestinal gas production when I reduced my digestible carbohydrate consumption to less than 50 g/day. That alone has at least potential to reduce IBS symptoms.
IBS is extremely common, affecting 10–15% of individuals in the developed world. Only 15% of those bother to seek medical attention. Of all referrals to gastroenterologists (stomach specialists), at least 25% are for IBS. There are few reliable treatments and cures. In some cases it mysteriously resolves on its own.
So I got excited when I ran across the study I reference above. I’m not going to spend a lot of time on it because I’ve already spent too much trudging through the article, and I don’t have much to show for it.
The way the investigators wrote their report gave me some heartburn:
Have you heard of FODMAPs? That seems to be the intervention diet that restricted fermentable carbohydrates. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
You need a break. Enjoy.
Let me summarize their results simply by saying they found changes in gut bacteria and a reduction in irritable bowel syndrome symptoms, as compared with control subjects. The particularly responsive symptoms were bloating, borborygmi, and the urge to defecate. Abdominal pain strongly tended to improve but didn’t quite reach statistical significance. Diarrhea wasn’t affected. Also note that the IBS patients allowed into the study were not the type with constipation as a major issue.
So What?
If you want to try a FODMAP diet for your IBS, you won’t be able to figure out what to eat based on this report. Consult your own physician about it. I wonder whether many of them have even heard of FODMAP. Barbara Bolen, Ph.D., at About.com says the diet should be undertaken only with the supervision of a qualified nutritionist.
Reference: Staudacher, Heidi, et al. Fermentable Carbohydrate Restriction Reduces Luminal Bifidobacteria and Gastrointestinal Symptoms in Patients with Irritable Bowel Syndrome. Journal of Nutrition, 142: 1520-1518 (2012)
MRI scan of brain
Our bodies keep blood sugar levels in a fairly narrow range. You might think you’re fine if you’re anywhere within the defined normal range. Think again. Australian researchers found that folks with fasting blood sugars toward the upper end of the normal range had more degeneration (atrophy) in parts of the brain called the hippocampus and amygdala, compared to those in the low normal range. Degeneration in those areas is often manifested as dementia.
The hippocampus is critical for learning and memory formation and retention. The amygdala is also involved in memory as well as emotion. The two areas are intimately connected, literally.
How Was the Study Done?
Over 250 study participants aged 60 to 64 years had normal brains at baseline and were free of diabetes and prediabetes. They were overwhelmingly caucasian. MRI brain scans were done at baseline and again four years later. Significant atrophy (shrinkage) was seen in the hippocampus and amygdala over time, with greater atrophy seen in those with higher baseline fasting glucose levels.
Fasting blood sugar was measured only once, at the start, and ranged from 58 to 108 mg/dl (3.2 to 6.0 mmol/l). (Fasting glucose of 108 would be prediabetes according to the American Diabetes Association, but not by the World Health Organization.) Participants weren’t tested for deterioration of cognition.
So What?
The results of the study at hand are consistent with others that link higher rates of dementia with diabetes. Diabetics, even when under treatment, usually have higher average blood sugars than non-diabetics. The study authors speculate that damage from higher blood sugars may be mediated by inflammation and abnormal blood clotting (prothrombotic factors and platelet activation).
It’s interesting to contemplate whether non-diabetics and diabetics would have less risk of developing dementia if blood sugars could be kept in the lower end of the normal range. How could you do that? Possibilities include:
Reference: Cherbuin, Nicolas, et al. Higher normal fasting plasma glucose is associated with hippocampal atrophy: The PATH Study. Neurology, September 4, 2012, vol. 79, No. 10, pp: 1,010-1,026. doi:10.1212/WNL.0b013e31826846de
Posted in Dementia
Tagged amygdala, blood glucose, blood sugar, cognitive impairment, dementia, diabetes, emotions, hippocampus, Mayo Clinic, memory
Last year, the FDA approved lorcaserin as a weight-loss drug, the only new drug approved for weight loss in the previous 10 years. How good is it? From Obesity Reviews:
“Weight loss of 3.23 kg … and body mass index reduction of 1.16 kg m−2 … was observed compared with placebo in randomized controlled trials of 1 year duration. The use of lorcaserin for 8 and 12 weeks reduced weight of 1.60 kg … and 2.9 kg …, respectively. In comparison to placebo, lorcaserin decreased waist circumference, blood pressure, total cholesterol, low-density lipoprotein-cholesterol and triglycerides, however did not statistically affect heart rate or high-density lipoprotein-cholesterol. Headache, nausea and dizziness were found to be significantly higher in the patients receiving lorcaserin than patients receiving placebo, whereas diarrhoea is no more likely than in patients receiving placebo. In conclusion, lorcaserin achieves modest weight loss and appears to be well tolerated.”
And quess what’s likely to happen when you stop the drug?
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Tagged lorcaserin, weight loss
From a New York Times article:
“Now medical experts largely agree that there is a condition related to gluten other than celiac. In 2011 a panel of celiac experts convened in Oslo and settled on a medical term for this malady: non-celiac gluten sensitivity.
What they still do not know: how many people have gluten sensitivity, what its long-term effects are, or even how to reliably identify it. Indeed, they do not really know what the illness is.
The definition is less a diagnosis than a description — someone who does not have celiac, but whose health improves on a gluten-free diet and worsens again if gluten is eaten. It could even be more than one illness.”
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Philip Calder writes in the British Medical Journal about a re-analysis of an old study. Middle-aged men with heart disease were placed either on 1) a diet high in linoleic acid, a predominant omega-6 fatty acid, or 2) their habitual diet. The men on the high-omega-6 diet had a higher subsequent overall and cardiac death rate.
“These findings argue against the “saturated fat bad, omega 6 PUFA good” dogma and suggest that the American Heart Association advisory that includes the statement “higher [than 10% of energy] intakes [of omega-6 PUFAs] appear to be safe and may be even more beneficial” may be misguided. The more cautious UK dietary recommendations on fat and fatty acids, which include the statement, “There is reason to be cautious about high intakes of omega 6 PUFAs, ”seem fully justified in the light of the current study’s findings.”
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Tagged diet-heart hypothesis, linoleic acid, omega-6 fatty acid, PUFA, saturated fat
Rosemary Chicken (garnished with pico de gallo) and Rosemary Potatoes
The nightshade family includes potatoes (not sweet potatoes or yams), tomatoes, peppers, eggplant, goji berries, and even tobacco. Anecdotal reports indicate that consumption of these either cause or aggravate specific chronic medical conditions, such as arthritis, chronic fatigue, or irritable bowel syndrome.
Georgia Ede, M.D., has an article on medical effects of nightshades at her website. The potentially offensive chemicals in nightshades are called glycoalkaloids. I looked into this issue when deciding whether to include potatoes in my version of the paleo diet. (They’re included).
Dr. Ede’s writes:
As with any food sensitivity, the only way to find out is to remove nightshades from your diet for a couple of weeks or so to see if you feel better. There are ZERO scientific articles about nightshade sensitivity, chronic pain, or arthritis in the literature, however, the internet is full of anecdotal reports of people who have found that nightshades aggravate arthritis, fibromyalgia, or other chronic pain syndromes.
I bet I could eat a couple potatoes and tomatoes every day without ill effect. And there’s Chris Voigt, head of the Washington State Potato Commission, famous for his 60-day potato diet. As they say, your mileage may vary.
Steve Parker, M.D.
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Tagged arthritis, eggplant, glycoalkaloids, irritable bowel syndrome, nightshades, peppers, potato diet, potatoes, tomatoes
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Advanced Mediterranean Diet 