Plate of the Week

Click through for a basic recipe:

• Roast Turkey
• Green Beans
• Braised Fennel

This plate is very low carb and takes about 30 minutes to prepare the veggies. (Turkey roasting time varies depending upon size and method; a rotisserie chicken is a good substitute for a quicker meal.)

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1. 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. 
2. 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.
3. 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?

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1. 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.
2. 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.
3. 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. 

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1. 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."
2. 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.
3. 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.

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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.

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1. What is Chile doing to protect its children from the aggressive advertising campaigns that aim to hook kids on junk food?
2. 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.
3. Is the obesity epidemic raging in Africa worse than the HIV epidemic of the 90s?

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1. 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.
2. 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.
3. 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.

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1. 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."
2. 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.
3. 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.

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1. 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.
2. 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.
3. 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.

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1. 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.
2. 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.
3. 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?

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1. 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.
2. 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.
3. 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.

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1. 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%. 
2. 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.
3. 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. 

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1. Really. Big. News. Prestigious medical journal, The Lancet, published the results of the PURE study, showing that high carbohydrate diets are linked to higher rates of mortality. And that fats, including saturated fat, are neutral to slightly protective. Analysis from Larry Husten for MedPage, here. Delightful headlines ensue, like this one in the Telegraph: Low-fat diet could kill you, major study shows. 
2. Also in The Lancet, Senior Executive Editor Stuart Spencer endorsed Nina Teicholz's 2014 bestseller, The Big Fat Surprise. Better late than never. Spencer writes: "Researchers, clinicians, and health policy advisors should read this provocative book."
3. Mainstream podcast, Revisionist History's "The Basement Tapes," tells the story of recovering data from an old (1960s and 70s era) study that, when reanalyzed, showed corn oil was worse for health than butter. While working on the story, podcast host, Malcolm Gladwell, read and endorsed Nina Teicholz's book, The Big Fat Surprise. 

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1. Doctors Demasi, Lustig, and Malhotra put their heads together to write an opinion piece for Clinical Pharmacist entitled, "The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance." Great reading.
2. Sugar foe Gary Taubes pens another great piece for The New York Times about why sugar and carbs are so hard to quit and how strict limits work best for him. His article: "Are You a Carboholic? Why Cutting Carbs is So Tough." 
3. Nina Teicholz, author of The Big Fat Surprise, and cardiologist Eric Thorn team up with this post to contest the American Heart Association's recent Presidential Advisory which cautions against consuming saturated fats. Teicholz and Thorn observe, "What is striking about the latest AHA Presidential Advisory is that it's such an anomaly." The co-authors demonstrate that most recent analyses find no significant relationship between dietary saturated fat and CVD mortality. More from Teicholz in her op-ed in The LA Times, "Don't believe the American Heart Assn. — butter, steak and coconut oil aren't likely to kill you."

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1. Doubling down, the American Heart Association reaffirms its counterintuitive advice to replace whole, full-fat food with refined, processed seed oils in this Presidential Advisory published in Circulation. Investigative journalist Gary Taubes parses the AHA's Advisory, and the actual science, in a quick but effective takedown. Meanwhile, a new meta-analysis by Hamley, just published in Nutrition Journal, concludes there is no benefit to replacing saturated fats with PUFA's, and adds, "the suggestion of benefits reported in earlier meta-analyses is due to the inclusion of inadequately controlled trials."
2. Virta Health continues to slay diabetes. The VC funded firm, dedicated to reversing diabetes in 100 million people by 2025, shared some preliminary results. At one year, 82% remained in the trial, and body weight was down an average of 13.6%. WOW. Additionally, 97% reduced or halted insulin use; oral meds, excluding metformin, were reduced by 84%. 👍
3. “'It’s a disgrace' that so little is known [about diabetes drugs and their efficacy], said Dr. Victor M. Montori, a diabetes expert at the Mayo Clinic." That's The New York Times reporting on the failure of the medical community and pharmaceutical companies to study and understand the affects of diabetes drugs on patient outcomes, especially real endpoints like heart disease mortality. “'Daunting' is how Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital, describes the situation for patients and their doctors. She explained the options and uncertainties in a recent commentary in JAMA."

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1. The New York Times reports that the American Academy of Pediatrics revised its guidance on fruit juice, now advising NO juice in a child's first year. Finally—this recommendation should have been made years ago. Further, according to the AAP's report, fruit juice “has no role in healthy, balanced diets of children.” Amen. For more on this topic, check out ETB post, "Juiced on Juice" from the archives.
2. Baylor researchers report a low-carb diet is associated with less weight gain after menopause. Specifically, the analysis showed that post-menopausal women "who consumed the fewest carbohydrates had a significantly reduced risk of gaining 10 percent of their body weight over an eight-year period, whereas those who consumed the least fat had a significantly increased risk of gaining more than 10 percent of their body weight over that time period." Their report was published this month in the British Journal of Nutrition."
3. Do the 2015 Dietary Guidelines remove the upper limit on dietary fat? It has been widely reported that the current set of guidelines remove the fat limit, but an intrepid RD MPH (repeatedly) asked the USDA to confirm this... and apparently the 35% upper limit still stands. Get the Alternative Fa(c)ts directly from Ms. Hite.

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1. Three prominent cardiologists contend that saturated fat does NOT clog arteries in an opinion piece in the British Journal of Sports Medicine. Instead of obsessing about the naturally occurring fat in food, the doctors advise us to eat real, whole food and walk 22 minutes each day. The CBC reports on the controversy, here. And we Iove this easy summary of mainstream and alternative reactions from Treehugger. For a more technical look at the controversy, Henderson and Schofield have you covered.
2. Professor Tim Noakes, a sports medicine doc with expertise in endurance sports and metabolism, ignited a low-carb-high-fat revolution in South Africa, with millions following his lead. He was finally exonerated from a trumped up Twitter incident that was a huge distraction. Hopefully the attention paid to the scientific evidence (during the lengthy trial) will move the conversation forward. Congratulations, Prof!
3. Forbes reports on a recent study that shows obesity and diabetes are killing even more Americans than our death statistics suggest. Also in Forbes is a report on the association between high sugar consumption and poorer memory and lower brain volume.

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1. Big news out of Silicon Valley. VC funded Virta Health opens it doors to the public. Virta is an online specialty medical clinic that reverses type 2 diabetes without medications or surgery. Forbes reports on Virta's toolbox—a ketogenic diet and a supportive, virtual clinic model ideal for treatment from any location. A preliminary study, documenting 10-week results, shows impressive 48% of subjects achieve HbA1c below 6.5% (no meds or Metformin only) and mean weight reduction of 7.2%. 
2. In spite of record obesity rates, Time reports fewer Americans are trying to lose weight. Lesson (IMO)—conventional 'eat less, exercise more' advice is failing people. It doesn't work so many are giving up. Time for a new paradigm.
3. The New York Times reports on a pioneering cookbook author's fight against Alzheimer's disease. Her main therapeutic weapon? A very low-carb diet. For more details on why low-carb eating can help prevent or even reverse cognitive decline, check out this new Chelsea Green release, The Alzheimer's Antidote, by Amy Berger.

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1. Prominent Canadian cardiologist, Dr. Yusuf, President of the World Heart Federation, delivered a breakout lecture, presenting new PURE study findings on the connection between diet and heart disease. Excellent summary here. Yusuf asserts saturated fat consumption is neutral to protective, high carbohydrate intake is bad for heart health, salt intake guidance is far too low, and vegetables are not really that important. Mic drop.
2. Exactly what are Americans eating? USDA released a report on the food available to Americans, and how it has changed since 1970. A big deal, as this data is only issued every 10 years. Get the CliffsNotes version in this short post from Nina Teicholz. But basically, as instructed by our dietary guidelines, we are eating more fruits and vegetables, more grains, more lean meat (chicken), more fish/seafood, more low-fat dairy, and way more vegetable oil. And we are eating less red meat, fewer eggs, and less animal fat (butter and lard). And it is NOT WORKING. (Obviously.) We are eating far too much refined grains and oils—they are in everything processed... Again, not real food.
3. The Washington Times reports on a BMJ review of data from a long buried study that shows removing butter and replacing it with vegetable oil increases death rates.

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1. Sugar's evil ways continue to be top of mind, as Taubes defends his book, The Case Against Sugar, (WSJ review here), and explains that nutritionists have been Big Sugar's secret ally in a NYT op-ed. In an LA Times op-ed, Taubes asks "How much sugar is too much?" and ponders whether moderation is possible. In The Atlantic, Teicholz calls for clear science before making dietary recommendations about sugar (or fat). Meanwhile, prominent sugar foe Dr. Robert Lustig points his finger at processed food in a new JAMA Pediatrics editorial.
2. The New York Times reports that soda tops grocery purchases in SNAP households... then Kristin Lawless counters that this is true in most households. While some call for regulation, cooler heads voice concernabout punishing the poor and a 'nanny state.' Separately, CSPI sues Coke for obfuscating soda's role in diabesity, and a new CDC study shows 60% of US kids have at least one sugary drink each day.
3. A shocking analysis by FAIR Health of a pool of over 21 billion health claims shows pediatric claims for type 2 diabetes doubling between 2011 and 2015, and claims with a diagnosis of obesity up 154% for 19-22 year olds in the same period.

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