We’re So Confused: The Problems With Food and Exercise Studies

From Gina Kolata at the New York Times:

“Nearly everything you have been told about the food you eat and the exercise you do and their effects on your health should be met with a raised eyebrow.

Dozens of studies are publicized every week. But those studies hardly slake people’s thirst for answers to questions about how to eat or how much to exercise. Does exercise help you maintain your memory? What kind? Walking? Intense exercise? Does eating carbohydrates make you fat? Can you prevent breast cancer by exercising when you are young? Do vegetables protect you from heart disease?

The problem is one of signal to noise. You can’t discern the signal — a lower risk of dementia, or a longer life, or less obesity, or less cancer — because the noise, the enormous uncertainty in the measurement of such things as how much you exercise or what exactly you eat, is overwhelming. The signal is often weak, meaning if there is an effect of lifestyle it is minuscule, nothing like the link between smoking and lung cancer, for example.”

Source: We’re So Confused: The Problems With Food and Exercise Studies – The New York Times

Gina and the experts she quotes are right about much of this.

Mediterranean diet may slow cognitive decline, prevent Alzheimer’s 

But we’ve know this for years…

“A new review concludes that a Mediterranean diet is good for the brain, after finding that people who follow the diet are less likely to experience cognitive decline and develop Alzheimer’s disease.

Researchers say greater adherence to a Mediterranean diet may benefit cognitive function for younger and older adults.Lead author Roy Hardman, from the Centre for Human Psychopharmacology at Swinburne University of Technology in Melbourne, Australia, and his team publish their findings in the journal Frontiers in Nutrition.

The Mediterranean diet incorporates a high intake of plant-based foods, such as fruits, vegetables, whole grains, legumes, and nuts, while limiting intake of red meat and replacing butter with healthy fats, such as olive oil.The diet also emphasizes eating fish or poultry at least twice a week and using herbs and spices rather than salt to flavor food.”

Source: Mediterranean diet may slow cognitive decline, prevent Alzheimer’s – Medical News Today

Steven Novella Says Cupping Doesn’t Work

I bet he’s right.

“Cupping is no different than acupuncture, bloodletting, phrenology, or any other medical pseudoscience. The treatment is based in pre-scientific superstitions, and has simply been rebranded to more effectively market the treatment to modern customers.

It is now just another alternative treatment, lacking plausibility, lacking any compelling evidence for efficacy, and promoted for the usual array of subjective symptoms with the usual array of handwaving justifications.

It is unfortunate that elite athletics, including the Olympics, is such a hot bed for pseudoscience. The Olympic Games are supposed to celebrate excellence, hard work, dedication, and friendly competition. Now it also represents gullibility and superstition, and spreads that gullibility to the viewing world.”

Source: Cupping – Olympic Pseudoscience « Science-Based Medicine

A Pharmacist Asks: Should we use PCSK9 inhibitors?

PCSK9 inhibitors are a new class of drug that dramatically lowers LDL cholesterol. LDL is the “bad cholesterol” implicated in blocked arteries that cause heart attacks and strokes. PCSK9 inhibitors are injected every several weeks. They are expensive.

Pharmacist Catherine writes:

“We know this drug lowers LDL cholesterol.  But what we really care about (or should care about) is whether this medication lowers the risk of having a heart attack or a stroke.  This data isn’t yet available.   From what data I could easily access, it seems that the PCSK9 inhibitors can halve your risk of having heart attack over one year.  This might sound good, but when you look at actual numbers, not so good.  Of the ~4500 people studied, about 2% in the control group had an ‘event’ (heart attack, stroke or other cardiovascular event) compared to about 1% in the treatment group.  And the difference between the groups was only about 60 people.  The study size just simply isn’t big enough, nor has it run for long enough to really tell if these medications are worth it.  A bigger study is in progress, but we won’t get the results before 2017.   Even then, we may not have the long-term risk/benefit data.  A systematic review on the medications in 2014 concluded that there is currently insufficient data to show benefit.”

Source: Should we use PCSK9 inhibitors? | Lifestyle Before Medication

I also want to know the effect of these drugs on death rates. As they say, “more studies are needed.”

Hey, guess what? The Mediterranean diet prevents heart attacks and strokes, and extends lifespan.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

“Low Sugar Diet,” Whatever That Is, Is the Most Popular in U.K. This Year

…according to an article at TLE. The second most popular diet plan is carbohydrate restriction (low-carb diet). Of course, sugars are carbohydrates.

The most frustrating sentence I read was that “…less than 10% of respondents stated that they intend to make long term changes to their eating habits.”

People, if you go back to your old way of eating, you’re going to gain the weight back. Duh!

That’s why there’s an endless array of new diets.

Source: Low Sugar Diet Is Most Popular For 2016 – The London Economic

QOTD: E.E. Blaak on Metabolic Effects of Dietary Carbohydrate

Overall, energy restriction is the primary factor producing weight loss, and it is increasingly understood that distinct macronutrients may vary in energy yield and effects on satiety, also based on individuals’ phenotype and genotype. Although an overall healthy diet, either Mediterranean or a low-fat, high-complex CHO diet may be effective in diabetes and cardiovascular prevention, insight is increasing that dietary prevention or treatment may require more personalized approaches to become most effective.

     —E.E. Blaak, in a review of effects of dietary carbohydrate in body weight control, glucose homeostasis and cardiovascular risk

In plain English, Blaak is saying:

  • weight loss depends on calorie restriction
  • proteins, fats, and carbs provide different amounts of energy and have different effects on hunger
  • your response to proteins, fats, and carbs depends on your genes and how you look
  • the healthiest diet for you probably isn’t the best for everyone else

This is why my Advanced Mediterranean Diet book offers two different eating plans: 1) reduced-calorie Mediterranean, and 2) l0w-carb Mediterranean. It also provides tips for deciding which method will work best for you.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Fall in dog fertility may be due to environmental contaminants; Implications for humans? 

“Man’s best friend seems to be experiencing a sharp drop in fertility, and research suggests that it could be due to environmental contamination. Authors of a study published in the journal Scientific Reports believe that contaminants have led to a significant decrease in canine sperm quality.

Is our environment damaging canine fertility?

The findings point to a correlation between reduced sperm function and concentrations of chemicals present in the sperm and testes of adult dogs, as well as some commercially available pet foods.”

Source: Drop in canine fertility may be due to environmental contaminants – Medical News Today

Ketogenic Diet: More Muscle Gains and Fat Loss

exercise for weight loss and management, dumbbells

Not P.D. Mangan. Visit Rogue Health and Fitness for his pic.

If you’re not reading Rogue Health and Fitness by PD Mangan, start today.

For example:

“What happens when you combine weight lifting with a very low carbohydrate ketogenic diet (VLCKD)? You get greater muscle gains and more fat loss than when compared to a conventional diet.

The study looked at a group of “college aged resistance trained men”, and put them on either a conventional Western diet or a VLCKD.

The conventional diet was 55% carbohydrate, 25% fat, and 20% protein, similar to what lots of people eat, though a bit higher in protein, a bit lower in fat.The low-carb diet was 5% carbohydrate, 75% fat, and 20% protein.

Note that protein, the main macronutrient responsible for muscle growth, was the same in both groups. Both groups did resistance training three times a week for 11 weeks.

The very low carbohydrate group gained twice as much muscle as the conventional group, 4.3 kg vs 2.2 kg.The very low carbohydrate group lost 50% more fat than the conventional group, -2.2 kg vs -1.5 kg.”

Source: More Muscle Gains and Fat Loss on a Ketogenic Diet – Rogue Health and Fitness

For an excellent version of a ketogenic diet, see KMD: Ketogenic Mediterranean Diet or The Advanced Mediterranean Diet (2nd Ed.)

Front cover

Front cover

“Spooked by obesity trends, the U.S. military is redefining its basic fitness standards”

I’m astounded that an article fretting about body composition didn’t mention tests of physical fitness, such as Army Physical Fitness Tests. As long as you can perform up to par, does it really matter what is your percentage of body fat?

From Military Times:

“For the first time in 14 years, the military is rewriting its body composition standards and the methods used to determine whether troops are too fat to serve.

Pentagon officials intend to publish a new policy later this year, a document expected to have sweeping effects on how the military defines and measures health and fitness. The review comes amid rising concern about obesity. Among civilians, it is shrinking the pool of qualified prospective recruits. And in the active-duty force, a rising number of overweight troops poses risks to readiness and health care costs.”

Source: Spooked by obesity trends, the U.S. military is redefining its basic fitness standards

PS: If your your body fat percentage is too high, check out my books.

Mediterranean Diet Prevents Cardiovascular Disease

From American Family Physician:

“Cardiovascular disease (CVD) is the leading cause of death in the United States. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality [deaths], whereas the Dietary Approaches to Stop Hypertension (DASH) eating plan is associated with a reduced risk of coronary artery disease.”

Source: Diet and Physical Activity for Cardiovascular Disease Prevention – American Family Physician

There are at least a couple versions of the DASH diet. The most common one is low in total and saturated fats and cholesterol, moderate in low-fat dairy products, high in fruits and vegetables, low in salt, low in sweetened beverages, moderate in whole grains, and low in animal protein but has substantial amounts of plant protein from nuts and legumes.

The Mediterranean diet also has several versions. My favorite ones are here:

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one