Does carefully following our Dietary Guidelines for Americans (DGA) work to improve blood sugar control and blood lipids? This 8 week RCT, testing a near-ideal DGA diet versus a typical American diet, suggests the answer is "NO." "Fasting insulin, glucose, triglycerides, oral-glucose tolerance, and indexes of insulin resistance were not affected by either of the diets." The only improvement was a reduction in blood pressure.
Cutting back on salt? Why bother? MedPage reports that new PURE study results, published in this week's The Lancet, show, for those consuming less than 4g sodium/day, reducing salt is associated with MORE heart events. (Average US consumption is 3.4g/day.)
NYT reporter, Anahad O'Connor, reports on another dietary advice switcharoo. The American Heart Association rolls back its longstanding advice to eat a variety of foods. Now, its researchers recommend a focus on quality and less worry about variety. Because sometimes, more variety means more bad choices.
Stanford Medicine announces results of a stunning new study showing diabetic-level blood sugar excursions in healthy volunteers. The study utilized CGM (Continuous Glucose Monitoring) technology to document post-meal blood sugar levels. Senior author, Dr. Michael Snyder, explains: “We saw that some folks who think they’re healthy actually are misregulating glucose — sometimes at the same severity of people with diabetes — and they have no idea... We saw that 80 percent of our participants spiked after eating a bowl of cornflakes and milk. Make of that what you will, but my own personal belief is it’s probably not such a great thing for everyone to be eating.”
New York Times reporter Anahad O'Connor takes a look at time restricted feeding, also known as intermittent fasting. His piece, "When We Eat, or Don't Eat, May Be Critical for Health" explores the growing body of research that suggests we experience better health when we align our eating patterns with our circadian clocks. Hint: no more bedtime snacks.
Nippon reports that a survey conducted by Japan's Ministry of Health, Labor, and Welfare found record levels of diabetes. Among Japanese adults, 16.1% of men and 9.3% of women have diabetes. Note that the article incorrectly states, "Once a person has contracted diabetes there is no cure." Experts now believe that for many patients with T2D, carbohydrate restriction can resolve their condition.
A new Cochrane systematic review shows that fish oil (Omega 3) supplements do NOT improve health or longevity. The review encompassed 79 randomized trials and included over 112,000 subjects. Lead author Dr. Lee Harper states, “The review provides good evidence that taking long-chain omega 3 (fish oil, EPA or DHA) supplements does not benefit heart health or reduce our risk of stroke or death from any cause. The most trustworthy studies consistently showed little or no effect of long-chain omega 3 fats on cardiovascular health."
Fiona Godlee, editor in chief of The BMJ, pens an op-ed entitled "Pills are not the answer to unhealthy lifestyles." In it, she writes, "... Pills can’t be the answer to diseases caused by unhealthy living. As well as unsustainable cost for often marginal benefit, they always cause harm. Rather than medicating almost the entire adult population, let’s invest our precious resources in societal and lifestyle change, public health, and prevention." Amen.
Stanford scientists John Ioannidis and John Trepanowski write a prescription for improved nutrition research in review journal Advances in Nutrition. A key recommendation is pooling resources for larger randomized trials. "Pivotal megatrials with tens of thousands of participants and lifelong follow-up are possible in nutrition science with proper streamlining of operational costs."
Not all carbs are created equal. Harvard's prolific Dr. David Ludwig illuminates the connection between carbohydrate quality and health, this time in BMJ. A key message: "Replacing processed carbohydrates with unprocessed carbohydrates or healthy fats would greatly benefit public health."
The BBCruns a 5 minute feature on UK Deputy Labor Leader Tom Watson, who has lost 96 pounds in eleven months by cutting out sugar and starch and eating more fat. Given his personal transformation, Watson asks if government should be giving dietary advice when there is such scientific controversy surrounding nutrition.
One of the world's leading oncologists, Dr. Siddhartha Mukherjee of Columbia University Medical Center (and The Emperor of All Maladies fame), set to launch human trial of ketogenic diet therapy as an accompaniment to drug therapy in specific types of cancer treatments. Recent mouse studies demonstrate the efficacy of administering ketogenic diets—which lower insulin levels—while treating some types of cancer.
Are ketones the "fourth macronutrient" and can a ketone supplements make you run faster? Runner's World reports on the trendy ($99 for three 2.2oz bottles) supplement. Warning: "I liken the flavor to a mixture of raspberry-flavored vodka, cough syrup, and nail polish remover; others have described it as a mix of rubbing alcohol and toilet cleaner with a hint of fruit."
FDA Commissioner, Scott Gottlieb, announces new steps to improve health through nutrition. The FDA reportedly regulates 80% of America's food supply, so potential to make a difference seems real. But announcement underwhelms, with bureaucratic double-speak and little, if any, meaningful innovation. Dr. Gottlieb pins his "Nutrition Innovation Strategy" on modernized nutrition labels, better ingredient lists, and resolving issues of 'identity' (as in should an almond beverage be called "milk"). Public comments may be submitted and a public hearing is set for July 26.
Pittsburgh area politician, John Fetterman, loses ~150 pounds by cutting out sugar/grains and walking more. Will this mayor and Democratic nominee for LT Governor help bring the message of reducing processed sugar and starch for better health to the people of Pennsylvania?
Former FDA Commissioner, Dr. David Kessler, argues with food pundit Marion Nestle about what we really know about healthful eating: "I think we have failed in giving nutritional advice to people. If diet & exercise were the answer, we'd all do it & there wouldn't be a problem...I would try to get answers to very basic questions...Is a calorie a calorie?" Unfortunately, NuSI's crusade to address this sort of question has been diminished.
Professor Tim Noakes, a leading scientist in the field of sports medicine, acclaimed author of The Lore of Running, and now advocate for low-carb diets, was found innocent of endangering the public and unprofessional conduct for the second time. The Nutrition Coalition covers the ruling and the story behind it. Congratulations, Professor Noakes!
California mayor, Sean Wright, is sharing his success with a keto diet for weight loss, reversing prediabetes, and resolving fatty liver. He invites fellow residents of Antioch to learn more and join him in a journey to better health.
Problems with sugar start early and get worse. According to reports on a new CDC study, American toddlers build up to 7 teaspoons added sugar per day by age 2. "High amounts of added sugar can be hidden in seemingly healthy food: a single-size serving of yogurt with fruit at the bottom can contain up to six teaspoons of sugar. In a regular 8 ounce serving of apple or orange juice, there are 5.5 teaspoons of sugar, on average."
Author Nina Teicholz's op-ed in the LA Times asks why our government has enacted new regulations that require chain restaurants to post calorie counts on menus when the science doesn't support the notion that this will make a difference in the battle against obesity.
New study shows lifestyle advice to "eat less, exercise more" fails to meaningfully reduce the progression from prediabetes to a type 2 diabetes diagnosis.
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.
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.
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 sameNYT 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 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."
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.
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.)
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.
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 inCell 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 Metabolismpublished 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.
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.
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.
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.
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.
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."
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.
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.