Older Women Don’t Need the Proverbial 10,000 Steps a Day for Longevity

Overton trail near Scottsdale, AZ

Among older women [average age 72], as few as approximately 4400 steps/d was significantly related to lower mortality rates compared with approximately 2700 steps/d. With more steps per day, mortality rates progressively decreased before leveling at approximately 7500 steps/d. Stepping intensity was not clearly related to lower mortality rates after accounting for total steps per day.

Source: Association of Step Volume and Intensity With All-Cause Mortality in Older Women | Geriatrics | JAMA Internal Medicine | JAMA Network

10,000 steps is about five miles, depending on stride length. 6,000 steps would be about three miles. Walking at two miles per hour, a leisurely stroll, it would take 90 minutes to walk three miles.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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Vegetarians Less Healthy Than Omnivores

From Independent:

Vegetarians are less healthy than meat-eaters, a controversial study has concluded, despite drinking less, smoking less and being more physically active than their carnivorous counterparts.

A study conducted by the Medical University of Graz in Austria found that the vegetarian diet, as characterised by a low consumption of saturated fat and cholesterol, due to a higher intake of fruits, vegetables and whole-grain products, appeared to carry elevated risks of cancer, allergies and mental health problems such as depression and anxiety.

While not mentioned in the Independent article, the full PLOS One report defined “vegetarian”:

While 0.2% of the interviewees were pure vegetarians (57.7% female) [vegan, then?], 0.8% reported to be vegetarians consuming milk and eggs (77.3% female), and 1.2% to be vegetarians consuming fish and/ or eggs and milk (76.7% female).

I haven’t read the whole thing, but if you’re a vegetarian, you should digest it. Note the study was done in Austria. And if vegetarians are so unhealthy, why do Seventh Day Adventists in Loma Linda, CA, seem to have a longevity benefit. Do ya think maybe there’s more involved than diet, like culture or genetics?

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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Are Ketogenic Diets Nutritionally Deficient?

From the journal Nutrition:

Objective

A 12-week ketogenic diet was shown to have many beneficial effects in healthy obese adults, but it is not clear if the supply of micronutrients is adequate.

Methods

In 35 adult individuals with BMI above 30, the intakes of minerals and their serum levels were analyzed at baseline and at weeks 4 and 12 of the ketogenic diet intervention. The intake of vitamins and serum antioxidative potential were also investigated.

Results

Throughout the diet the intakes of magnesium, calcium, iron, phosphorus and potassium were below recommended values, but their serum levels always remained within the reference range. Nevertheless, the level of calcium decreased significantly (from 2.52 ± 0.10 mmol/L at baseline to 2.36 ± 0.07 mmol/L at week 12, P < 0.001) which could be due to the omission of legumes and reduced dairy intake or due to the high fat intake alone. The levels of phosphate increased concomitantly. Calcium serum levels were negatively associated with ω-6 but not with ω-3 unsaturated fatty acid intake. The intakes of water-soluble vitamins were also too low. However, the antioxidative potential of serum did not change during intervention.

Conclusion

Careful choice of foods which would provide the necessary micronutrients is of utmost importance when consuming ketogenic diet. In the 12 weeks the decreased intakes did not reflect in serum values, but special attention to calcium should be advised if such diet is recommended through longer periods.

Source: Assessment of micronutrients in a 12-week ketogenic diet in obese adults – ScienceDirect

Steve Parker, M.D.

A ketogenic diet — including a “careful choice of foods which would provide the necessary micronutrients” — is one of two options in The Advanced Mediterranean Diet.

Steve Parker MD, Advanced Mediterranean Diet

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Wealth Inequality In the U.S.: It’s a Problem

From The Big Picture (emphasis added):

Yes, America is wealthier than ever, especially if you are in the top 10% of households. The Fed [Federal Reserve] found that the top 1% of American households held wealth of $32.5 trillion. That works out to be an average household asset value of about $25 million each. The rest of the top 10% (90th to 99th wealth percentiles) held total wealth of $42.8 trillion. Add the top 1% to this group and we get a total of $75.3 trillion, with an average household wealth of $5.8 million. To be sure, this is an average and is skewed by the enormous wealth of those at the very top; the median, or midpoint, would be lower.

The next 40% (50th to 90th percentiles) has total assets of $35.3 trillion. The 63.8 million households in the top half of America have average household total wealth of $1.72 million apiece. Note this does not include liabilities such as mortgages, student loans, consumer credit, which offsets some of this.

Where things get interesting is when we look at the bottom 50% of households in America by wealth. They own total assets of $6.86 trillion. That reflects wealth (before liabilities) of a mere $107,523 per household.Let’s dig a bit deeper: The top decile of America holds almost about 70% of the national wealth — 31% is held by the top 1%, while the rest of the top 10% holds about 39%.

Source: Wealth Distribution Analysis – The Big Picture

Is Subclinical Hypothyroidism Real and Should It Be Treated?

From JAMA Network:

Subclinical hypothyroidism is common [up to 10% of adults] and most individuals can be observed without treatment. Treatment might be indicated for patients with subclinical hypothyroidism and serum thyrotropin [TSH]  levels of 10 mU/L or higher or for young and middle-aged individuals with subclinical hypothyroidism and symptoms consistent with mild hypothyroidism.

Source: Subclinical Hypothyroidism: A Review | Cardiology | JAMA | JAMA Network

Steve Parker MD, Advanced Mediterranean Diet

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Low-Carb, High-Fat Diet Improves Metabolic Syndrome Even Without Weight Loss

My monitor works well

“Metabolic syndrome” may be a new term for you. It’s a collection of clinical features that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome. Diagnosis requires at least three of the following five conditions:

  • high blood pressure (130/85 or higher, or using a high blood pressure medication)
  • low HDL cholesterol:  under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)
  • triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a cholesterol-lowering drug)
  • abdominal fat:  waist circumference 40 inches (102 cm) or greater in a man, 35 inches (89 cm) or greater in a woman
  • fasting blood glucose over 100 mg/dl (5.55 mmol/l)

One approach to improving the numbers is a LCHF diet. Here’s a journal article abstract from JCI Insight:

BACKGROUND. Metabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS.

METHODS. Individuals who were obese with a diagnosis of MetS were fed three 4-week weight-maintenance diets that were low, moderate, and high in carbohydrate. Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets.

RESULTS. Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.

CONCLUSION. Consistent with the perspective that MetS is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high-carbohydrate intake, LC/high-fat diets benefit MetS independent of whole-body or fat mass.

TRIAL REGISTRATION. ClinicalTrials.gov Identifier: NCT02918422.

FUNDING. Dairy Management Inc. and the Dutch Dairy Association.

Source: JCI Insight – Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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Problematic Liver Fat? Low-Carb Mediterranean Diet Works Better Than Low-Fat Diet

From an article at International Business Times:

Reducing hepatic [liver] fat or fat around the liver by 30%, along with moderate weight loss is an important part in reducing obesity-related health risks from a long-term perspective, the researchers of the study said. In addition to moderate weight loss, visceral fat or fat stored within the abdominal cavity was reduced by 25% and fat around the heart decreased by 11%. Fat in and around the muscle and pancreas was also reduced by 1 to 2%.

“Reduction in liver fat is a better predictor of long-term health than reduction of visceral fat, which was previously believed to be the main predictor,” Professor Shai explained in a press release. “The findings are a significant contributor to the emerging understanding that for many obese individuals, excess liver fat is not merely a sign of health risks associated with obesity, including cardiovascular disease and diabetes, but is likely also a cause.”

Source: Scientists Reveal Most Effective Diet For Weight Loss, And It’s Not Keto

Click for details of the study.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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Denninger Predicts Severe Economic Contraction in 2024, Thanks to Uncontrolled Healthcare Spending

U.S.A in 2030?

If Karl’s right, you’ll find good deals in real estate in a few years. If you have any money left.

You must expect that no medical care will be available for anything currently paid for by “insurance” or the government.  This is likely too pessimistic but if you count on it and are wrong you die, so being pessimistic by a bit over what’s likely is good rather than bad.  If you can change a chronic disease outcome with lifestyle you better do it now.  If you can’t then get your affairs in order, make peace with God if you believe in him, and then figure out whether you want to settle some scores when the bad stuff starts, because it’s going to and you’re going to have a very bad time of it.D

You must also expect that state, local and federal governments will all get very aggressive in trying to increase tax revenue.  If you live in a large metro area where embedded costs are high you need to get out now.  There is a very high probability that either through internal rot and collapse (e.g. they can’t pay for infrastructure repairs and they fail) or due to either an external actor or an uncoordinated and thus impossible to interdict group of Americans who decide they’ve had enough of the Blue “steal it all” crap infrastructure collapse is initiated and the large Blue Enclaves go feral within days.

If you lose this bet you will die fast and nasty.  If you stay and “win” you still lose; you’ve already seen property tax ramps in most of these places of 100% or more.  If you look at the discounted inflation-adjusted value of your house you’ve lost half of its value over the last 20 years not including the taxes already paid and thus forever gone!  That is, even if you “win” and there is no mass collapse due to either disgruntled Americans or some external actor you will still lose in that the value of your holdings will be destroyed over the next ten years.  It will be gone.  For most people not in the 1% who “own” houses their real estate holdings are more than half of their net worth and for many people it’s essentially all of it.  Get the **** out now or you will lose all of that value.  That much is assured and that’s if you win the bet; lose it and it’s not just money you lose, it’s your life as well.

RTWT.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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Mediterranean Diet Improves Brain Function in Type 2 Diabetes

I don’t know if the study at hand is valid or not; I’m skeptical. The abstract is poorly written. The study population was Boston Puerto Ricans only, so may not apply to other ethnic groups. I’m not paying $35 to get access to the full article. Diabetes Self-Management has coverage that will be more palatable than the abstract below.

OBJECTIVE To determine associations of a Mediterranean diet score (MeDS) with 2-year change in cognitive function by type 2 diabetes and glycemic control status and contrast it against other diet quality scores.

RESEARCH DESIGN AND METHODS We used data from the longitudinal Boston Puerto Rican Health Study (n = 913; 42.6% with type 2 diabetes at 2 years). Glycemic control at baseline was categorized as uncontrolled (hemoglobin A1c ≥7% [53 mmol/mol]) versus controlled. Two-year change in glycemic control was defined as stable/improved versus poor/declined. We defined MeDS, Healthy Eating Index, Alternate Healthy Eating Index, and Dietary Approaches to Stop Hypertension scores. Adjusted mixed linear models assessed 2-year change in global cognitive function z score, executive and memory function, and nine individual cognitive tests.

RESULTS Higher MeDS, but no other diet quality score, was associated with higher 2-year change in global cognitive function in adults with type 2 diabetes (β ± SE = 0.027 ± 0.011; P = 0.016) but not without (P = 0.80). Similar results were noted for Mini-Mental State Examination, word recognition, digit span, and clock drawing tests. Results remained consistent for individuals under glycemic control at baseline (0.062 ± 0.020; P = 0.004) and stable/improved over 2 years (0.053 ± 0.019; P = 0.007), but not for uncontrolled or poor/declined glycemic control. All diet quality scores were associated with higher 2-year memory function in adults without type 2 diabetes.

CONCLUSIONS Both adhering to a Mediterranean diet and effectively managing type 2 diabetes may support optimal cognitive function. Healthy diets, in general, can help improve memory function among adults without type 2 diabetes.

Source: The Mediterranean Diet and 2-Year Change in Cognitive Function by Status of Type 2 Diabetes and Glycemic Control | Diabetes Care

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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Your PPI Might Kill You

Proton pump inhibitors (PPIs) are widely used in the U.S. to treat or prevent heartburn and ulcers. For example, omeprazole is the 6th most prescribed drug in the U.S. according to one source. PPIs reduce acid production by the stomach. But doesn’t it make sense that God or Nature gave us that stomach acid for a reason?

From the British Medical Journal:

Taking PPIs is associated with a small excess of cause specific mortality including death due to cardiovascular disease, chronic kidney disease, and upper gastrointestinal cancer. The burden was also observed in patients without an indication for PPI use. Heightened vigilance in the use of PPI may be warranted.

Source: Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study | The BMJ

Click for UPI’s coverage.

If you suffer from frequent heatburn, try cutting down on carbohydrates.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com