R.I.P.: Dr Sarah Hallberg, Low-Carb Hero

I was saddened to hear of the untimely death of Dr Sarah Hallberg even though I didn’t know her personally. DietDoctor has a tribute article about her in case you’re not familiar. An excerpt:

Dr. Hallberg first burst onto the low carb scene with a 2015 TED Talk: “Reversing type 2 diabetes starts with ignoring the guidelines” The video advocated using a low carb diet – eating minimally unprocessed whole foods like eggs, meat, and vegetables with butter or cheese – to improve blood sugar and reverse diabetes symptoms.

The video went viral and has now had more than 8.6 million views. As news of her passing spread, hundreds of viewers posted on the site saying how her advice had saved their lives.

Steve Parker, M.D.

Dietitian Experiments With Low-Carb Eating for Five Years: Results?

Sous vide chicken and sautéed sugar snap peas

Registered Dietitian Joy Kiddie has a blog post summarizing the results of her five-year low-carb journey.

It starts thusly:

Tomorrow is March 5th [2022] and it is five years since I began my personal health and weight recovery journey that I’ve dubbed “A Dietitian’s Journey“.  While it began in 2017, in a way it still continues today and that is the point behind this post. 

Five years ago, I was obese, had type 2 diabetes for the previous 8 years, and had developed dangerously high blood pressure. 

Recommended. You’ll find out if low-carb eating put her diabetes into remission.

Steve Parker, M.D.

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Got a Surprise Medical Bill? Know Your Rights

From JAMA Health Forum: Law Banning Surprise Medical Bills Takes Effect

A new law that took effect on January 1 protects patients with private insurance from surprise medical bills for services received in an emergency situation or when care at a facility covered by a patient’s health insurance plan is provided by an out-of-network clinician.

The No Surprises Act, which the US Congress passed in 2020 as part of legislation to fund the federal government for fiscal year 2021 and provide stimulus relief for the COVID-19 pandemic, applies to most surprise bills for emergency care and for nonemergency services received at in-network facilities.

According to a recent issue brief from the Kaiser Family Foundation, the federal government estimates that the act will apply to approximately 10 million out-of-network surprise medical bills a year.

Steve Parker, M.D.

PS: Avoid the medical-industrial complex as much as you can by exercising and avoiding obesity. Let me help.

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COVID-19 Link Dump: Ivermectin Effectiveness, Florida’s Surgeon General Defies CDC’s Child Vax Guideline

But it’s horse de-wormer!

Malaysian study says ivermectin doesn’t work in COVID-19. Patients were 50 or older and considered to be at high risk of severe disease. The dose of ivermectin was reasonable.

Dr Pierre Kory disagrees:

There are really three main problems with this study and its aftermath; 

1) Publication Bias: given my personal knowledge of a number of researchers whose profoundly positive ivermectin studies were rejected by JAMA [Journal of the American Medical Association], they, for the second time in a row, reveal a profound publication bias. It is a well-known disinformation tactic for high impact journals like JAMA to somehow only publish studies without “statistically significant benefits” for medicines that Pharma does not want to see in play (generally generic medicines), as they similarly avoid publishing studies of “harms” associated with Pharma favored products (i.e tobacco studies last century and/or vaccine studies this one). What is fascinating is that JAMA’s (“PHAMA’s”) ivermectin papers actually all report important benefits, but most importantly for JAMA, none that reach “statistical significance.” 

2) Study Conclusion: JAMA saw fit to ensure inclusion of this phrase at the end of the conclusion, “the findings do not support the use of ivermectin for treatment of mild COVID-19,” despite what could arguably be called a compellingly supportive study based on a number of important, near statistically significant reductions in secondary outcomes like death. An absurdly obvious reason why statistical significance was not reached was that, in this population of patients, like many other upcoming trials (NIH’ ACTIV-6, U Minnesota’s COVID-OUT, Oxford’s Principle trial etc) they allowed patients to enter the trial up to 7 days from first symptoms. It is well known anti-virals efficacy is strongest.. earlier. In this trial, the average time from first symptoms was 5.1 days with a confidence interval of 1.3, meaning, pretty much nobody got treatment within 3 days of symptoms. Yet, this critical feature of this trial gets ignored in the conclusion (many conclusions will include important limitations of the study’s findings, unsurprisingly, not this one).

JAMA, per their strict criteria, also consistently avoids mention in conclusion statements of large differences in massively important secondary outcomes. Best example of this behavior by JAMA was the IV Vitamin C in ARDS trial. Read the conclusion. Then read the paper, and look at Table 2 and Figure 3… you find a massive, statistically significant reduction in mortality in those treated with IV Vitamin C. Hard to find.. but it is there. If JAMA wouldn’t allow those authors to mention it in that paper’s abstract conclusion, no surprise they did it again here. 

3) the masses of doctors and media who simply propagate and disseminate that sentence and abstract without reading the actual study or reviewing the actual data while ignorant of the findings from the highest level of medical evidence.. the “meta-analyses” of ivermectin (summary analyses of all trials).


Dr Joseph Ladapo says Florida will be the first state to recommend against COVID-19 vaccines for healthy kids.


Now that Vladimir Putin has cured COVID-19, I’ll be posting less about it.

Steve Parker, M.D.

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Cataract Extraction Linked to Lower Risk of Dementia

From JAMA Network, December 2021:

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Association Between Cataract Extraction and Development of Dementia

Question  Is cataract extraction associated with reduced risk of developing dementia?

Findings  In this cohort study assessing 3038 adults 65 years of age or older with cataract enrolled in the Adult Changes in Thought study, participants who underwent cataract extraction had lower risk of developing dementia than those who did not have cataract surgery after controlling for numerous additional risks. In comparison, risk of dementia did not differ between participants who did or did not undergo glaucoma surgery, which does not restore vision.

Meaning  This study suggests that cataract extraction is associated with lower risk of developing dementia among older adults.

Importance  Visual function is important for older adults. Interventions to preserve vision, such as cataract extraction, may modify dementia risk.


Details in the abstract:

Objective  To determine whether cataract extraction is associated with reduced risk of dementia among older adults.

Design, Setting, and Participants  This prospective, longitudinal cohort study analyzed data from the Adult Changes in Thought study, an ongoing, population-based cohort of randomly selected, cognitively normal members of Kaiser Permanente Washington. Study participants were 65 years of age or older and dementia free at enrollment and were followed up biennially until incident dementia (all-cause, Alzheimer disease, or Alzheimer disease and related dementia). Only participants who had a diagnosis of cataract or glaucoma before enrollment or during follow-up were included in the analyses (ie, a total of 3038 participants). Data used in the analyses were collected from 1994 through September 30, 2018, and all data were analyzed from April 6, 2019, to September 15, 2021.

Exposures  The primary exposure of interest was cataract extraction. Data on diagnosis of cataract or glaucoma and exposure to surgery were extracted from electronic medical records. Extensive lists of dementia-related risk factors and health-related variables were obtained from study visit data and electronic medical records.

Main Outcomes and Measures  The primary outcome was dementia as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Multivariate Cox proportional hazards regression analyses were conducted with the primary outcome. To address potential healthy patient bias, weighted marginal structural models incorporating the probability of surgery were used and the association of dementia with glaucoma surgery, which does not restore vision, was evaluated.

Results  In total, 3038 participants were included (mean [SD] age at first cataract diagnosis, 74.4 (6.2) years; 1800 women (59%) and 1238 men (41%); and 2752 (91%) self-reported White race). Based on 23 554 person-years of follow-up, cataract extraction was associated with significantly reduced risk (hazard ratio, 0.71; 95% CI, 0.62-0.83; P < .001) of dementia compared with participants without surgery after controlling for years of education, self-reported White race, and smoking history and stratifying by apolipoprotein E genotype, sex, and age group at cataract diagnosis. Similar results were obtained in marginal structural models after adjusting for an extensive list of potential confounders. Glaucoma surgery did not have a significant association with dementia risk (hazard ratio, 1.08; 95% CI, 0.75-1.56; P = .68). Similar results were found with the development of Alzheimer disease dementia.

Conclusions and Relevance  This cohort study found that cataract extraction was significantly associated with lower risk of dementia development. If validated in future studies, cataract surgery may have clinical relevance in older adults at risk of developing dementia.


What else reduces risk of dementia? The Mediterranean Diet!

Steve Parker, M.D.

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Weight-Loss Drugs: Semaglutide Versus Liraglutide

How much does it cost?

Semaglutide and liraglutide are drugs that were developed to treat diabetes and are FDA-approved for that. They are given by subcutaneous injection. Semaglutide is also FDA-approved for weight loss in non-diabetics if certain conditions are met.

Once-weekly semaglutide outperformed daily liraglutide in overweight and obese non-diabetics.

From JAMA Network:

Question  Among adults with overweight or obesity without diabetes, what is the effect of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg, on weight loss when each is added to counseling for diet and physical activity?

Findings  In this randomized clinical trial that included 338 participants, mean body weight change from baseline to 68 weeks was –15.8% with semaglutide vs –6.4% with liraglutide, a statistically significant difference.

Meaning  Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide, compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity resulted in significantly greater weight loss at 68 weeks.

For prevention or improvement of overweight- and obesity-related illnesses, aim for loss of at least 5 to 10% of body weight. Assuming you’re overweight or obese in the first place. 16% body weight change is significant. 16% of 300 pounds (136 kg) would be 48 pounds (22 kg).

Steve Parker, M.D.

PS: Needle-phobic? Try this instead:

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Green-Mediterranean Diet Out-Performed the Mediterranean Diet for Loss of Liver Fat

stages of liver damage
Stages of liver damage. Healthy, fatty, liver fibrosis and cirrhosis

About one quarter of the world’s adults have excess fat accumulation in the the liver called non-alcoholic fatty liver disease (NAFLD). This can lead to liver inflammation, scarring (cirrhosis), and liver cancer. The adverse effects of liver fat can be prevented by loss of that fat. The most common medical recommendation to accomplish that is to loss excess body weight via any reasonable method.

A study published in Gut last year found greater reduction in liver fat in those eating a “green-Mediterranean” diet compared to a regular Mediterranean diet over 18 months. Both diets were supplemented with walnuts 28 grams/day. Details of the green-Med diet:

In addition to [physical activity] and the provision of 28 g/day walnuts, the green-MED diet was restricted in processed and red meat and was richer in plants and polyphenols. The participants were guided to further consume the following provided items: 3–4 cups/day of green tea and 100 g/day of frozen Wolffia globosa (Mankai strain) plant frozen cubes, as a green shake replacing dinner. Both green tea and Mankai together provided additional daily intake of 800 mg polyphenols ((GAE), according to Phenol-Explorer and Eurofins lab analysis, including catechins (flavanols)) beyond the polyphenol content in the prescribed MED diet. Both the MED and green-MED diets were equally calorie-restricted (1500–1800 kcal/day for men and 1200–1400 kcal/day for women).

The researchers don’t tell us where to get frozen Wolffia globosa (Mankai strain) plant frozen cubes.

Study participants were almost all men, so results may not apply to women.

Click for some of the details in Endocrinology Advisor.

Steve Parker, M.D.

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Everything You Know About the Russia-Ukraine War is Wrong

according to Carlo Maria Viganò, Archbishop, former Apostolic Nuncio to the U.S.A.

It’s a long essay but well worth your time. The mainstream media is not giving you the facts.

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Update on March 9, 2022:

I’m glad to hear Jeffrey Prather predict that nuclear war in the near-term is unlikely. Click for his video in which he agrees with much of Fr Vigano’s ideas.

Did you think Trump was a crass buffoon? Check out these bonus vids:

  1. Ukrainian President Zelensky doing a gay dance in high heels:

Zelensky faking playing a piano with his penis:

Update on March 18, 2022:

Click for a machine transcript of Putin’s March 16, 2022, speech on the Russia/Ukraine war. Excerpts:

We are meeting at a difficult time, when our Armed Forces are conducting a special military operation in Ukraine and Donbas. Let me remind you that at the very beginning of it, in the early morning of February 24, I publicly and openly named the reasons and the main goal of Russia’s actions. This is assistance to our people in the Donbas, who for almost eight years were subjected to real genocide by the most barbaric methods – blockade, large-scale punitive actions, terrorist attacks and constant artillery shelling. And for what? Only for the fact that they sought basic human rights – to live according to the laws and traditions of their ancestors, to speak their native language, to raise their children the way they want.

At the same time, the Kiev authorities not only ignored and sabotaged the implementation of the Minsk Package of Measures for the Peaceful Settlement of the Crisis throughout all these years, but at the end of last year they publicly refused to implement it altogether.

They have also begun to put into practice plans to join NATO. Moreover, there were also statements by the Kiev authorities about their intention to create their own nuclear weapons and their means of delivery. It was a real threat. Already in the foreseeable future, with foreign technical assistance, the pro-Nazi regime in Kiev could get its hands on weapons of mass destruction, and the target for it, of course, would be Russia.

In Ukraine, there was also a network of dozens of laboratories where military biological programs were conducted under the leadership and with the financial support of the Pentagon, including experiments with samples of coronavirus, anthrax, cholera, African swine fever and other deadly diseases. Traces of these secret programs are now being intensively tried to cover up. But we have every reason to believe that in the immediate vicinity of Russia, on the territory of Ukraine, in fact, biological weapons components were created.

Our repeated warnings that such a development poses a direct threat to Russia’s security have been rejected by Ukraine and its patrons in the United States and NATO, with ostentatious and cynical disdain.

Thus, all diplomatic options were completely exhausted. We were simply left with no options to peacefully solve problems that arise through no fault of our own. And in this regard, we were simply forced to launch a special military operation.

The appearance of Russian troops near Kiev and other cities of Ukraine is not connected with the intention to occupy this country. We do not have such a goal, and I also explicitly stated this in my address on February 24.

As for the tactics of combat operations, which were developed by the Ministry of Defense of Russia and our General Staff, they have fully justified themselves. And our guys – soldiers and officers – show courage and heroism, do everything that depends on them to avoid losses among the civilian population of Ukrainian cities.

I want to say this for the first time: at the very beginning of the operation in the Donbas, the Kiev authorities were asked through various channels, in order to avoid senseless bloodshed, not to enter into hostilities, but simply to withdraw their troops from the Donbass. They didn’t want to. Well, that’s their decision. Awareness of what is happening in the real world, on the ground, will inevitably come.

The operation is developing successfully, in strict accordance with pre-approved plans.

I would like to note that Ukraine, encouraged by the United States and a number of Western countries, purposefully prepared for a scenario of force, carnage and ethnic cleansing in Donbass. A massive offensive into the Donbas and then crimea was only a matter of time. And our Armed Forces foiled these plans.

Kiev was not only preparing for war, for aggression against Russia, against Donbass– they were fighting it. Attempts to organize sabotage and terrorist underground in Crimea did not stop. In recent years, hostilities have continued in the Donbas, shelling of peaceful settlements. During this time, almost 14,000 civilians were killed, among them children.


I want ordinary citizens of Western countries to hear me: they [Western leaders and media?] are now persistently trying to convince you that all your difficulties are the result of some hostile actions of Russia, that from your own wallet you need to pay for the fight against the mythical Russian threat. It’s all a lie.

The truth is that the current problems faced by millions of people in the West are the result of years of actions by the ruling elites of their states, their mistakes, short-sightedness and ambition. These elites are not thinking about how to improve the lives of their citizens in countries. They are obsessed with their vested interests and super-profits.

Evidence of this is the data of international organizations that directly say that social problems, even in the leading Western countries, have only worsened in recent years, that inequality, the gap between the rich and poor are growing, racial and national conflicts are making themselves felt. The myth of a Western welfare society, of the so-called golden billion, is crumbling.

Let me repeat that today the entire planet has to pay precisely for the ambitions of the West, for its attempts by any means to maintain its elusive dominance.

Evidence of this is the data of international organizations that directly say that social problems, even in the leading Western countries, have only worsened in recent years, that inequality, the gap between the rich and poor are growing, racial and national conflicts are making themselves felt. The myth of a Western welfare society, of the so-called golden billion, is crumbling.

Let me repeat that today the entire planet has to pay precisely for the ambitions of the West, for its attempts by any means to maintain its elusive dominance.

The imposition of sanctions is a logical continuation, a concentrated expression of the irresponsible, short-sighted policies of the governments and central banks of the United States and the EU countries. In recent years, it has been they who have dispersed the spiral of global inflation with their own hands, led to the growth of global poverty and increased inequality, to new flows of refugees around the world. And this begs the question: Who will now be responsible for the millions of starvation deaths in the world’s poorest countries due to growing food shortages?

I repeat, a serious blow has been dealt to the entire global economy and trade, to confidence in the US dollar as the main reserve currency.

Thus, illegitimate actions to freeze part of the Bank of Russia’s foreign exchange reserves draw a line under the reliability of so-called first-class assets. In fact, both the United States and the EU have declared a real default on their obligations to Russia. Now everyone knows that financial reserves can simply be stolen. And seeing this, many countries in the near future can begin – I am sure that this will happen – to convert their paper and digital savings into real reserves in the form of commodities, land, food, gold, and other real assets, which will only increase the deficit in these markets.


Propaganda? Yes, maybe. You’re seeing propaganda from all sides if you’re paying attention.

Without a declaration of war from Congress, President Biden is using my and your tax dollars to send war-fighting materiel to Ukraine. Hey, Brandon, how about addressing U.S. citizens as to what exactly is our vital national interest in Ukraine?

From George Washington’s Farewell Address to the People of the United States:

The great rule of conduct for us in regard to
foreign nations is, in extending our commercial
relations, to have with them as little political connection
as possible.

An excerpt from a Foreign Affairs article:

“It is our true policy to steer clear of permanent alliance with any portion of the foreign world”: it was George Washington’s Farewell Address to us. The inaugural pledge of Thomas Jefferson was no less clear: “Peace, commerce, and honest friendship with all nations – entangling alliances with none.”

Update on March 30,2022:

For even more background, click for Scott Horton’s The History Behind the Russia-Urkraine War.

Steve Parker, M.D.

Update on June 20, 2024:

It looks like Archbishop Vigano is being excommunicated.

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Viagra May Be the Dementia Preventative We’ve Been Waiting For

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Viagra (one brand name for generic sildenafil) is used to treat erectile dysfunction and pulmonary hypertension. I bet that usage for ED is far more common than for pulmonary hypertension.

From an article published in Dec 2021 by National Institutes of Health:

…the team analyzed insurance claims data from more than 7 million Americans. They found that the people (mostly men) who took sildenafil were 69% less likely to develop AD [Alzheimer’s Disease] over 6 years than those who did not take the drug. This association between sildenafil and AD held after adjusting for sex, age, and other diseases and conditions.

To understand how sildenafil might affect AD, the researchers grew neurons from stem cells derived from AD patients. Exposing the cells to sildenafil led to increased growth of neurites, which connect neurons to each other, and decreased tau phosphorylation, an early biomarker of AD.

Taken together, these results show an association between sildenafil use and reduced AD risk. But the researchers emphasize that they haven’t shown that sildenafil prevents or reverses AD.

These things usually don’t pan out, but one can hope. How often were these guys taking viagra? Once a month? Twice a week? To treat erectile dysfunction, sildenafil is typically taken as needed one hour before sexual activity. Typical dose for pulmonary hypertension is 20 mg by mouth three times a day, every day. Would this drug affect dementia in women? As they say, further studies are needed.

Steve Parker, M.D.

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Ultra-Processed Foods ——> Higher Coronary Artery Disease Risk

Heart attacks and chest pains are linked to blocked arteries in the heart (coronary artery disease)

What are ultra-processed foods? I’m not paying $35 for the scientific article to find out. If you can grab the definition from your copy, please share in the Comments section. The 2020 profit from my publishing company was only $937.08, so I’m watching my expenses.

Here’s the free abstract:

ABSTRACT

Background

Higher ultra-processed food intake has been linked with several cardiometabolic and cardiovascular diseases. However, prospective evidence from US populations remains scarce.

Objectives

To test the hypothesis that higher intake of ultra-processed foods is associated with higher risk of coronary artery disease.

Ultra-processed versus processed?

Methods

A total of 13,548 adults aged 45–65 y from the Atherosclerosis Risk in Communities study were included in the analytic sample. Dietary intake data were collected through a 66-item FFQ. Ultra-processed foods were defined using the NOVA classification, and the level of intake (servings/d) was calculated for each participant and divided into quartiles. We used Cox proportional hazards models and restricted cubic splines to assess the association between quartiles of ultra-processed food intake and incident coronary artery disease.

Results

There were 2006 incident coronary artery disease cases documented over a median follow-up of 27 y. Incidence rates were higher in the highest quartile of ultra-processed food intake (70.8 per 10,000 person-y; 95% CI: 65.1, 77.1) compared with the lowest quartile (59.3 per 10,000 person-y; 95% CI: 54.1, 65.0). Participants in the highest compared with lowest quartile of ultra-processed food intake had a 19% higher risk of coronary artery disease (HR: 1.19; 95% CI: 1.05, 1.35) after adjusting for sociodemographic factors and health behaviors. An approximately linear relation was observed between ultra-processed food intake and risk of coronary artery disease.Conclusions

Higher ultra-processed food intake was associated with a higher risk of coronary artery disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed foods may affect health.

Article

I admit I must eat some ultra-processed foods, but try to limit them.

Heart disease is the #1 killer in the developed world, even more lethal the COVID19! If you’ve abandoned your New Years’ weight-loss diet, consider one low in ultra-processed foods, like the Mediterranean diet.

Greek salad with canned salmon. Salmon is rich in heart-healthy omega-3 fatty acids.

Steve Parker, M.D.

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Click to purchase at Amazon.com. E-book also available at Smashwords. com.