A medical mystery: What happened to US healthcare spending, beginning around 1980? The New York Times documents how US spending has escalated relative to peer countries, but life expectancy gains have fallen behind. Could the low-fat, grain-heavy diet, introduced in the late 70s, be playing a role?
"Our livers are in trouble." Read more about The Hidden Liver Crisis in America and how a lower-carb, higher-fat diet can turn things around.
A public-private partnership to reverse type 2 diabetes? Working together with county and city governments, can Virta Health bring better health to a region of Indiana, and demonstrate the efficacy and cost saving potential of its virtual clinic model for reversing type 2 diabetes?
A well written, detailed post from Drs. Wood, McKenzie, Volek and Phinney of Virta Health, discusses the impressive improvement in CVD markers seen after 1 year with Virta's T2D reversal protocol, which includes a low-carb, high-fat diet. Peer reviewed study published in Cardiovascular Diabetology.
The New York Times (and MedPage) report on a new survey out of Boston Children's Hospital, published in AAP's Pediatrics, demonstrating exceptional glucose control in patients (both adults and children) with T1 diabetes consuming a very low-carb diet and using less insulin. These patients also report fewer adverse events like hypoglycemia. This was not an RCT, but is nonetheless very encouraging data that documents an otherwise unheard of phenomenon: normal blood glucose levels for those with Type 1 diabetes.
Another small, short duration RCT published in the British Journal of Nutrition shows replacing carbohydrates with fat and protein improves glucose control and satiety in patients with type 2 diabetes.
Given the failure of our national dietary prescriptions to reduce levels of chronic disease, it is no wonder that the "nutrition debate" continues. In the latest volley, nutritional epidemiologist Dr. Dariush Mozaffarian argues in the BMJ that nutrition science can indeed be relied upon to improve our understanding of the connection between food and health. But Gary Taubes and Nina Teicholz disagree, and make a strong case for "caution and humility" when interpreting epidemiological data for the purposes of population-wide dietary strategies for prevention of chronic disease.
On a related note, back and forth we go with epidemiological studies. The New York Times reports on a new Swedish analysis, published in Heart, which makes the case that when fully adjusted for confounding variables, nuts aren’t as heart healthy as previously reported. Case in point, the same NYT reporter published an article entitled, "Nuts may lower your risk of heart disease" in November, 2017. Similarly, the Star Tribune reports that many older Americans are paying for vitamin supplements that may cause harm, as early exuberance for vitamins outpaces the evidence and consumers can't keep up with the ever-changing recommendations.
Virta Health, a Silicon Valley startup reversing type 2 Diabetes with a virtual clinic model and strict, low-carb diet, receives a shot in the arm from the VC community—$45 million in additional funding to help bring its model to scale. This is a strong endorsement of Virta's excellent results.
- Can a healthier diet help battle depression? The Wall Street Journal reports on a new field: nutritional psychiatry. Recommendations center around replacing sugar and processed foods with real, whole foods.
- A small West Virginia hospital—WVU Medicine Jefferson Medical Center—eliminates sugar-sweetened beverages. Here's to a health system practicing what it preaches!
- FDA Commissioner Scott Gottlieb apparently believes that clearer food labels and salt reduction will improve American diets and save lives. But logic tells us that tweaks around the edges of a failing dietary paradigm will amount to nothing.
- A new, Czech epi study (a large-scale ecological analysis) of cardiovascular disease risk across 158 countries points the finger at dietary carbs, not fat. "Results... identify high carbohydrate consumption (mainly in the form of cereals & wheat) as the dietary factor most consistently associated with the risk of CVDs." For a thoughtful analysis of this study, see The Nutrition Coalition's post.
- The CDC releases a new report on diabetes prevalence in US adults. The National Health Interview Survey was expanded to include questions about type 1 (0.55% of adults) vs. type 2 (8.6% or adults) and insulin status, so this report includes more robust information. Non-hispanic black adults have highest diabetes prevalence: 11.52%.
- The "obesity paradox" is debunked once again. A large cohort study (of white Europeans) shows lowest risk of CVD events/death at BMI of 22-23. "Any public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged."
- Trouble in paradise... The American Diabetes Association and American College of Physicians (ACP) quibble over blood sugar targets & drugs. The ACP defends its new, higher, blood sugar targets for diabetic patients, claiming it wants to "minimize harms such as low blood sugar, other medication-related adverse effects, medication burden, and costs." Note that carbohydrate restriction—never on the table in mainstream conversations—meets all of those goals AND results in lower, rather than higher, blood sugar.
- While on the topic of food and blood sugar management, Dr. Robert Lustig posts a pdf of a fantastic letter from a UK Member of Parliament to the British Prime Minister. The MP testifies to the potential of low-carb, full-fat eating for improved health, especially among citizens with diabetes. "My blood sugars are not only more stable, but I have managed to reduce my insulin requirements by almost 50%."
- The New York Times reports on a new JAMA study (based on NHANES data) that confirms Americans are still getting heavier. Between 2007/8 and 2015/16, obesity rates among adults climbed from 33.7% to 39.6%. Meanwhile, The Hill reports on new data from NCHStats which shows that over the last 12 yrs (as obesity has escalated) more Americans are exercising. Now over 53% of American adults meet activity guidelines, versus just 41% in 2005. Something is not working, here.
- The NYT reports on a new comprehensive scientific review that found optimal protein levels for people over 40 trying to gain muscle mass are roughly twice our federal recommendations. And remember, many women do not even get the recommended level of ~46g/day.
- A concise opinion piece by Ben Greenfield in The Hill on why the dietary guidelines are failing Americans, and why Congress needs to act to change them to align with modern science. Case in point, a retired special ops combat controller asks, in an op-ed in The Dallas Morning News, why so many of our troops struggle with weight? It's not lack of exercise. His answer? It's the food... controlled by our dietary guidelines.
- Might this non-invasive continuous blood sugar monitoring wearable help regular people understand that the bagel they are eating is essentially pure glucose after 15 minutes in their digestive tract?
- A small clinical trial, ongoing in overweight men with recurrent prostate cancer, shows a keto diet leads to significant weight loss. At six months, patients averaged 28 lbs lost on keto versus 0 lbs in control group. BMI was reduced by an average of more than 4pts. Unclear if diet/weight loss deters cancer growth (trial ongoing). Similarly, a small prospective pilot study of patients placed on a 4 week ketogenic diet to prepare for bariatric surgery showed "highly significant decreases in body weight (− 10.3%, p < 0.001, in males; − 8.2%,p < 0.001, in females), left hepatic lobe volume (− 19.8%, p < 0.001)" and a resolution of micronutrient deficiencies.
- A clinical report, published in Cell Metabolism, finds that carbohydrate restriction delivers "rapid and dramatic reductions of liver fat and other cardiometabolic risk factors" in patients with nonalcoholic fatty liver disease (NAFLD). No pill can do this for you.
- Diabetes, Obesity, and Metabolism published a study that demonstrates how fasting glucose creeps up gradually, often tied to chronic insulin resistance. Authors argue for early detection and intervention to prevent progression.
- Is it possible to reverse type-2 diabetes? Virta Health proves the answer is "yes," releasing hands-down stellar one year results, published in JIMR Diabetes. Here's an easy-to-understand animated short that explains how Virta works. For a longer read, try this interview with Dr. James McCarter, Virta's Head of Research. Separately, the British Journal of Sports Medicine runs the text of Virta Medical Director Dr. Sarah Hallberg's popular (~3 million views) TEDx, "Reversing type 2 diabetes starts with ignoring the guidelines."
- Dr. David Ludwig pens a grim reality check on rising obesity rates in kids, published last month in Pediatrics. Ludwig writes: "The second, more fundamental lesson is that our public health approach to the epidemic has largely failed so far." Fortune reports briefly on the same study to which Ludwig was responding, which looks a NHANES data from 1999-2016.
- The obesity paradox—the idea that obesity might protect patients with heart disease and help them live longer— has been debunked. The LA Times explains why a new study published in JAMA Cardiology demonstrates that excess weight can mean younger onset of CVD and, thus, fewer years of disease free life.
This week, we introduce Dinner Ideas, a free online tool that will help you answer that age-old question, "What's for Dinner?" We've got you covered with thousands of easy, everyday meals.
It is a fun, visual experience... with a click-through to basic recipes (in case you need help executing)! Mix-and-match the three sections until your plate looks just right!
Why not give it a go—try Dinner Ideas.
Once you've created your first few Dinner Ideas, you are ready to get started thinking about which Vintage Diet is right for you!
There are 6 to choose from. The flow chart, below, will lead you to the diet that works best for you based on your health and preferences.
Get started below!
- What is Chile doing to protect its children from the aggressive advertising campaigns that aim to hook kids on junk food?
- How did hippie food preferences—like vegetarianism—spread across America? Read about it in a new book. And while we are on the subject, read about how carob traumatized a generation.
- Is the obesity epidemic raging in Africa worse than the HIV epidemic of the 90s?
- Looking for a comprehensive list of over 70 clinical trials that compare lower-carb, higher fat diets to higher-carb, lower-fat diets? This list was put together by Virta Health's Dr. Sarah Hallberg, and in virtually every trial, the lower-carb regimen does as well or better than the lower-fat arm on one or more of the following measured outcomes: weight loss, blood sugar control, and CVD risk factors. So for those who think lower-carb eating is just a fad, think again.
- Which comes first? High insulin levels or obesity? A new genetic study from Dr. David Ludwig’s team shows high insulin levels predict weight gain, not the other way around.
- Yale News reports on a new study, published in Cell, that “has identified leptin — a hormone made by fat cells — as a key mediator" in the body's switch from burning carbs to burning fat during fasting.
- JAMA publishes an important summary of the growing interest in ketogenic diets for weight loss and type 2 diabetes in its theme issue, "Reimagining Obesity in 2018."
- The Atlantic reports on a new study that illuminates the startling association between high blood sugar—INCLUDING pre-diabetic levels—and cognitive decline. Results suggest “Alzheimer’s is another potential side effect of a sugary, [starchy] Western-style diet.” Also this month, The BMJ published a new essay by Gary Taubes: “What if sugar is worse than just empty calories?” It explores the (still ambiguous) science and policy implications.
- Time reports on a study that shows obesity shaves almost a year from US life expectancy. "Drug and alcohol abuse are often blamed for reductions in life expectancy... [but] the country faces multiple challenges when it comes to longevity and public health," including record rates of obesity.
- Last week in The Globe and Mail, Gary Taubes asks if anecdotal evidence of the efficacy of low-carb diets should be taken more seriously, especially given the unfortunate across-the-board lack of rigorous science in the realm of nutrition.
- Life expectancy in the US declined for the second year in a row. Opioid overdoses are behind this year's decline, but the diabetes epidemic's impact may be underestimated.
- In The Dallas Morning News, Dr. Jake Kushner asserts "Government is helping to feed the diabetes crisis in Texas," by perpetuating out-of-date, low-fat dietary advice. Kushner writes, "Despite all the new research exonerating fats and implicating carbohydrates, leading nutritionists refuse to reconsider entrenched norms of a healthy diet." Indeed.
- Sugar industry deceit is back in the news. The New York Times reports that "the sugar industry funded animal research in the 1960s that looked into the effects of sugar consumption on cardiovascular health — and then buried the data when it suggested that sugar could be harmful, according to newly released historical documents." Forbes weighs in on the ethics of this intentional obfuscation.
- A new study out of Washington University takes aim at ultra-processed food. "This review shows that ultra-processed foods, in particular products made from substances extracted from whole foods, particularly oils, flours and sugar, were not part of evolutionary diets and may be a main driver of malnutrition" including over-nutrition (obesity). Back to basic whole foods, folks.
- Cardiologist John Warner, president of the American Heart Association, suffered a heart attack while at an AHA conference. Thankfully, Dr. Warner is doing well. But is this a sign (from the universe) that there is something terribly wrong with AHA advice?
- Understanding the cancer-sugar-obesity link: The LA Times reports that science points to cancer risk resulting not just from eating too much (or weighing too much), but from eating too much refined carbohydrate, especially sugar. Fortune reports on a curious interaction between a cancer gene and a sugar molecule that may begin to explain how sugary diets contribute to cancer risk. Plus, the CDC reports on the rise of incidence rates for cancers linked to obesity.
- The Endocrine Society puts the story of a dangerous imbalance caused by the omega-6-rich vegetable oil in our food supply on the cover of Endocrine News. These processed oils are inflammatory and contribute to obesity... so back to butter.
- New obesity statistics were reported by the CDC. It's official— 39.8% of American adults are now obese. And, a new study, published in The Lancet,shows a ten-fold increase, worldwide, in the number of obese children over just four decades.
- The CDC releases the latest obesity data and maps, by state and county. All 50 states now have registered a prevalence of at least 20%, and 5 states have an obesity prevalence greater than 35%.
- The National Academy of Sciences releases its congressionally mandated report: Redesigning the Process for Establishing the Dietary Guidelines for Americans. The Nutrition Coalition, an advocacy organization seeking science-based nutrition guidance, applauds the report and summarizes the findings. On a related note, RealClear Health riffs on the importance of basing nutrition policy on science.
- CNBC reports on diabetes and prediabetes in America. According to a new CDC report, 33% of American adults have either diabetes or prediabetes—over 100 million people. The vast majority of those with prediabetes are undiagnosed.