Continued Adventures in Metabolic Health and Diabetes Reversal, a Health Peace, not a Diet War, LowCarbDenver 2019

2019.03.10 Low Carb Denver, Denver, CO, USA 7528
2019.03.10 Low Carb Denver, Denver, CO, USA 7528 (View on Flickr.com)

If you would have told me in medical school, “One day you are going to meet people who have reversed their diabetes,” I wouldn’t have believed you. If you would have added, “Many of their doctors won’t believe or support them,” that part I might have believed.

And yet, here we are.

It is said that the LGBTQ rights movement is the most successful social movement of our time – at meetings on social movements, the rooms with LGBTQ humans are the ones most crowded with people who want to learn “how” – and I see many of the same elements here. Elements in the way the medical profession reacts (rather than responding) to innovation, diversity, authenticity, elements in the way the science is advancing and experience is spreading at an impressive rate.

I wrote a post about the similarities previously (Why Doctors should meet patients (and each other) where they are: My intersection of #LGBTQ , #LCHF, and #LetPatientsHelp)

Citizen science continues to transform our understanding of human metabolism

If you would have told me in medical school that low density lipoprotein (aka “bad cholesterol”) is a dynamically changing, multi-functional molecule, I wouldn’t have believed you. Now, it’s very hard to refute what’s being demonstrated by people with a desire to know, and the resources to know it.

There isn’t a diet war, it’s a health peace

I still love spending time with people in control of their health and life destiny

More photographs below, enjoy.

Transgender Pride Flag Emoji Submission for inclusion in the Unicode Standard for 2020 (Update 16: In the Unicode Document Register as of March 14, 2019)

Updates

  • The first twitter moment became too full (98 tweets maximum, so a part 2 has been created):

Transgender Pride Flag Emoji Proposal – Part 2, July, 2019 on

Transgender Pride Flag Emoji Proposal – Part 1, up toJuly, 2019.

Update 16

Update 15

Update 14

Submitted by:

  • Alda Vigdís Skarphéðinsdóttir (she, hers), Berlin, Germany (Independent software consultant) – @AldaVigdis
  • Bianca Rey (she, hers), Washington, DC, USA (Chair, Capital TransPride) – @BiancaRey
  • Hannah Simpson (she, hers), Washington, DC USA (Writer, speaker, comedian, advocate) – @Hannsimp
  • Tea Uglow (she, hers), Sydney, Australia, (Google) – @teaelleu
  • Ted Eytan, MD (he, him), Washington, DC, USA (physician, Capital TransPride Producers) – @tedeytan
  • Chad Cipiti (he, him), Washington, DC, USA (Capital TransPride Producers) – @chaddashwick
  • Monica Helms (she, hers), Atlanta, GA, USA (creator of the Transgender Pride Flag) – <a href=”https://twitter.com/MF_Helms>MF_Helms

Additional help from:
* Seb Grubb (he, him), San Francisco, CA, USA (Google) – @seb_uk
* Jennifer Daniel (she, hers), Berkeley, CA, USA (Google) – @jenniferdaniel
* Olli Jones (he, him), London, UK (Microsoft) – [email protected]

Update 13

Update 12

A social movement is born, independent of our team. Hashtag: #ClawsOutForTrans

Update 13

Update 12

A social movement is born, independent of our team. Hashtag: #ClawsOutForTrans

Still no response from @Unicode

Update 11

List of global collaborators – March, 2018

  • Alda Vigdís Skarphéðinsdóttir (she, hers), Berlin, Germany (Independent software consultant) – @AldaVigdis
  • Bianca Rey (she, hers), Washington, DC, USA (Chair, Capital TransPride) – @BiancaRey
  • Hannah Simpson (she, hers), Washington, DC USA (Writer, speaker, comedian, advocate) – @Hannsimp
  • Tea Uglow (she, hers), Sydney, Australia, (Google) – @teaelleu
  • Ted Eytan, MD (he, him), Washington, DC, USA (physician, Capital TransPride Producers) – @tedeytan
  • Chadwick Cipiti (he, him), Washington, DC, USA (Capital TransPride Producers) – @chaddashwick
  • Monica Helms (she, hers), Atlanta, GA, USA (creator of the Transgender Pride Flag) – @MF_Helms

Submission for the 2019 deadline – March, 2018

Download/view: Proposal for New Valid Emoji Sequence-version 4 for 2019.pdf

Backup location: Slideshare

Update 10: March, 2018

Comprehensive responses to questions posed by @Unicode, written by collaborator @HannSimp

Trans Flag Unicode (pdf)

Update 9: February, 2018

Response to request: “Members would like to see better data”

What Does Google Trends Tell Us About A Proposal for a Future Valid Emoji Sequence for Transgender Visibility?

Response to request: “Multiple possibilities” & general comments

My Thoughts on Emoji Recently Added, v11.0, without #Transvisibility, without full #LGBTQ inclusion

Update 8: January, 2018

Response from Unicode consortium:

From: UTC Document Submission 
Subject: Re: UTC Document Submission: Transgender Flag and related symbols
Date: January 8, 2018 at 2:16:59 PM EST

This proposal was reviewed by the emoji subcommittee. Members would like to see better data.

There are multiple possibilities for this flag, so this issue could be discussed:  https://en.wikipedia.org/wiki/Transgender_flags

As far as data goes, it would be helpful to include comparisons to the sum of the values terms such as for ‘gay’, ‘lesbian’, ‘bisexual’. Comparisons of usage of flags for transgender vs other causes or identity groups would be helpful.

Regards,

Based on the above, our plan is to re-submit with the following helpful information

We are open to any other feedback/suggestions, feel free to add a comment or contact me.

Update 7: December, 2017

  • We’ve joined with Alda Vigdís Skarphéðinsdóttir (she,hers) (@aldavigdis) from Berlin, Germany, an independent software developer to complete the technical specification for transgender symbols

Complete changelog:

  1. New major revision
  2. Additional authors
  3. Detailed technical proposal
  4. New Google Trends data
  5. Aesthetic and layout changes
  6. Additional data from the European Union
  7. Some information on design moved from introduction article
  8. Removal of Bianca Rey quote*
  9. Additional Photo
  10. Removal of Intersex CLDR keyword
  11. Other minor changes
  • To respect the direction from @Unicode not to propose emoji’s based on “causes” we’ve moved @BiancaRey’s quote from the proposal to this blog post.
  • Making clear, in addition, that transgender person visibility in the emoji character set is not a cause nor is it political – the absence of the symbols from the set is a gap of exclusion (see data in the proposal) – as quoted by an earlier reviewer – “It’s a false assumption that emojis are only selected based on quantitative data – there are multifaceted considerations that go into determining what is selected… otherwise a female welder probably wouldn’t have made the cut.”

The Trans Pride Flag to me represents my identity as a trans person, that I belong to a community and that I’m visible – and I don’t think usage metrics can measure that feeling.

I think about a Trans person from a small town who feels like they are alone or they don’t have a community – with the emoji being available, it will be something that the individual can say “This is me!” or “Yay! Trans Pride Flag emoji”. It will bring happiness, a sense of community or support the identity to that individual.

Having the emoji available would reach so people in the world looking for something that allows them to say “there is an emoji for me. It reflects who I am.” It can also create conversation and education for many.Bianca Rey, Chair of Capital TransPride, Washington, DC USA November 2017

Update 6: November 23, 2017

  • We’ve joined with Tea Uglow (@Teaelleu) who led us by a year in making this proposal to the Unicode consortium, to integrate her knowledge about the method to produce a transgender symbol and ZWJ sequence to produce a transgender pride flag emoji
  • Updated the Google trends data regarding searches for transgender emoji symbols – there has been significant change since June, 2017
  • Updated the narrative, as provided by Bianca Rey (@BiancaRey), for a societal and health perspective
  • Added additional photographs showing the use of the transgender pride flag symbol by more people in the United States’ capital, Washington, DC

Finally, pointing out news of the Transgender Day of Remembrance event in South Dakota, United States this week, demonstrating the importance of TransVisibility in our society today.

Would you like to join with us or sign on to this proposal? Please post in the comments or contact me.

Update 5: October 23, 2017

No update from @Unicode yet, just some very interesting conversation about inclusion and language:

I especially appreciate this comment

…because while our proposal has some legitimate technical dependencies, there are other social considerations that come into focus, especially if the other emoji’s that are being proposed are the “heart with knife”, “sad poop” and pirate flag.

All of this said, as it is said, “don’t react, innovate” – important to understand how @Unicode and associated vendors work together and participate, even if we have to learn ZWJ sequences.

I believe Unicode is meeting this week.

And I never imagined that as a family doctor I would be participating in the formation of a language. On the other hand, these things matter for health, and so therefore it’s exactly the right place for a family doctor to be.

Update 4: August 8, 2017

Not approved at this time, appears to be grouped in with other flag proposals for consideration in October.

Recommendations as of August 8, 2017 (via @Unicode)

Primer on ZWJ sequences (for the curious)

Update 3: August 6, 2017

@PinkNews is reporting that the proposal has not been accepted by @Unicode. However, we have not received any communication from the Unicode consortium about this. See the dialogue about this on twitter.

Update 2: July 7, 2017

Thank you again for your proposal. This is just a status-update. The emoji subcommittee needs a larger discussion about how to handle different types of flags. Your proposal is being held with some others pending outcome of that discussion.

Update 1: June 30, 2017

Thank you for your submission. This is to let you know it has been safely received, and will be reviewed by the emoji subcommittee.


Transgender Pride Flag Emoji Submission

Proposal (First Version, Newer Version Above)

Emoji Proposal Version 1.0 – Transgender Pride Flag – Download (pdf)

As the title of the post says, this is the official submission to Unicode for the Transgender Pride Flag Emoji.

Monica Helms, the creator of the Transgender Pride Flag, is a signatory on the submission 🙂 .

The transgender pride flag signifies visibility in a world that’s learning to love better. A sticker may seem like a small innovation but it means a lot to a community that’s been marginalized.

This year at Capital Trans Pride, we lamented that the only emojis we could send to each other are the rainbow pride flag.

“My reason for wanting a trans flag emoji is so that a trans individual can feel a sense of belonging and visibility when using technology to communicate.”
Bianca Rey (@BiancaRey), Co-Chair, Capital Trans Pride, Washington, DC (Trans Pride Sticker Set Site)

If you don’t like the news, go make your own. Hopefully the news will be good. Feel free to review the submission and provide us with your comments.

More people with health care = more humans living authentically and able to help the world learn to ❤️ better. Isn't this century great? equalitymarch2017 #EqualityEqualsHealth #dc #WeareDC trans.equalityy
More people with health care = more humans living authentically and able to help the world learn to ❤️ better. Isn’t this century great? @equalitymarch2017 #EqualityEqualsHealth #dc #WeareDC @trans.equalityy (View on Flickr.com)

Just Completed: RCGP e-learning Course: Type 2 diabetes and the low GI diet, comparing to my ABFM educational experience

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001-622
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001-622 (View on Flickr.com)

As discussed in @DrAseemMalhotra’s testimony to the UK Parliament last week: In June, 2018, the Royal College of General Practitioners (@rcgp) published an e-learning course “Type 2 diabetes and the low GI diet” with lead author Dr. David Unwin (@lowcarbGP):

Type 2 diabetes is an increasingly common and progressive disease, the progression of which can sometimes be paused or even reversed using a low glycaemic-index (GI diet). Many patients with type 2 diabetes are on multiple drugs, yet are still not well controlled. This module describes the use of a low GI diet as an adjunct treatment for diabetes, using a case study of a real patient registered at the author’s practice. The physiology and evidence behind a low glycaemic-index diet are described, as well as how to implement it in real life.Type 2 diabetes and the low GI diet

I completed this course as an American specialist in Family Medicine and found it compelling and informative, in a short period of course completion (less than 30 minutes).

What most/all physicians appreciate is the care and rigor that must go into producing continuing education for a physician audience, and I could tell that Unwin and collaborators worked to ensure content is based in science, of the kind we were never taught in medical school (or taught incorrectly)

They included a patient story, which even for me was stunning in a good way.

My very different experience recertifying as an American family medicine specialist

At the same time, I recertified as a family medicine specialist at the end of 2018 and was disappointed to find learning modules riddled with inaccuracies and old information around the topics of diabetes prevention, diabetes reversal (no information), and nutrition. The modules allow learners to leave comments, and I found I was not the only physician disappointed in the content. This is my comment on one of the evaluation questions of one of the modules:

“Did you notice any problems with the content of the knowledge self-assessment activity? – Yes”

“Extremely out of date, especially the nutrition questions, which still mention “calories in, calories out” (no evidence that this valid) and focus on low-fat diets, which again have been proven unhealthy and without any evidence of support. I would overhaul this entire section.”

In my glass ¾ fully self, I was delighted to find fellow family medicine specialists question the information and embrace curiosity (it’s what we’re trained to do).

I am supportive of Maintenance of Certification – it’s about the content, not the concept

This is not a blog post decrying or diminishing the importance of maintenance of certification (MOC) for family medicine specialists.

As I wrote in this three part series on what it means to be a family medicine specialist (because apparently the public doesn’t know what we are), I am proud of the fact that we were the first medical specialty to mandate ongoing certification to keep current. Unlike other specialties which “grandparented” their members, the founders of family medicine guaranteed their obsolescence the day they created us.

I look forward to American specialty societies following the lead of the RCGP in producing learning modules for diabetes prevention, remission, reversal. Dr. Unwin and his patient’s goals are the same as ours – enjoy disability-free life-years with as low a pharmaceutical burden as possible and as high a enjoyment of life’s opportunities as possible.

Physicians have been receiving nutrition education all along, just not unconflicted information

When people say “physicians don’t receive nutrition education,” I challenge that statement, because I’ve found that we do receive education, just not from credible sources. A quick browse through the pages of the 1957 New York Academy of Medicine (!) tells the story. It’s been like this for over 60 years.

2018.02.11 Pharmaceutical Ads, New York State Journal of Medicine, 1957 291
2018.02.11 Pharmaceutical Ads, New York State Journal of Medicine, 1957 291 (View on Flickr.com)

Here’s a gallery of additional advertisements from 1957 that will gently blow your mind.

Thanks for Publishing my Photo, in Could “build higher” untangle a thorny Shaw school controversy? – Greater Greater Washington

2016.08.16 DC People and Places 07393
2016.08.16 DC People and Places 07393 (View on Flickr.com)

Thank you for publishing my photograph, @ggwash, in this in depth piece, which I will not try to summarize in this post.

I recall I took this photograph when I was first learning photoshop. Here’s what I created with it, how did I do (no endorsement of any candidate implied)?

2016.08.16 DC People and Places 07393-Edit
2016.08.16 DC People and Places 07393-Edit (View on Flickr.com)

Two groups of DC school parents are at loggerheads. In the heart of Shaw is a large, vacant building that once housed a junior high school. One group wants the school rebuilt and reopened as a neighborhood middle school, while others want to move Benjamin Banneker High School to the area. Can both get what they want?

Source: Could “build higher” untangle a thorny Shaw school controversy? – Greater Greater Washington

Just Read: Ultra-processed diets cause excess calorie intake and weight gain

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001-620
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001-620 – Hall KD. Ultra-processed diets cause excess calorie intake and weight gain: A one-month inpatient randomized controlled trial of ad libitum food intake. NutriXiv; [cited 2019 Mar 4]; Available from: osf.io/preprints/nutrixiv/w3zh2

Images and content used under a CC0 1.0 Universal License (View on Flickr.com)

This is a cool new study that, in a rigorous way, shows that without changing macronutrient (carbohydrate, fat, protein) proportions of a diet, ie. even if keeping carbohydrate intake high, there’s still benefit from eating un-processed (“real / whole”) food.

Ultra-processed foods have been described as “formulations mostly of cheap industrial sources of dietary energy and nutrients plus additives, using a series of processes” and containing minimal whole foods (Monteiro et al., 2018)” and have never been studied in a randomized control trial compared to unprocessed (“real”) food. 20 non-diabetic adults were hospitalized for 4 weeks and fed ultra-processed and un-processed diets for 2 weeks each, and told to eat as much or as little as they wanted, over a 60 minute period.Hall KD. Ultra-processed diets cause excess calorie intake and weight gain: A one-month inpatient randomized controlled trial of ad libitum food intake. NutriXiv; [cited 2019 Mar 4]; Available from: osf.io/preprints/nutrixiv/w3zh2

I really like that the pre-print paper includes photographs of the meals – I chose to highlight meals in this slide in each category that look somewhat similar, to demonstrate that a change is not as complicated as some people think it is (I made the change in my own life, like many physicians, I am recovering from a low-fat, processed diet that I was told was healthy, very incorrectly). Unfortunately, this is still what we’re presented with on a regular basis. I of course did not partake, except for a cup of coffee with cream:

Kevin Hall, PhD (twitter:KevinH_PhD), explains the significance in a tweetstorm, and he knows much more than I about double-labeled water and respiratory chambers:

Speaking of not knowing of these things, if there’s anything inaccurate in my slide above, feel free to check my work, accuracy is better than speed, and my next point….

Is it a war, or really a desire to know how to help the people we serve achieve their life goals 🙂

The paper’s first sentence starts with the phrase “diet-wars” which I feel is inaccurate and contributes to a lack of curiosity about science. We are not at war with our patients; we are at peace with them. This is an approach/mindset physicians should not be using, especially given well-publicized incidents of academic bullying.

Reference

Hall KD. Ultra-processed diets cause excess calorie intake and weight gain: A one-month inpatient randomized controlled trial of ad libitum food intake. NutriXiv; [cited 2019 Mar 4]; Available from: osf.io/preprints/nutrixiv/w3zh2

Images and content used under a CC0 1.0 Universal License

Last Century: “You Are What You Eat” – This Century: “You Are What You Do With What You Eat”

2019.03.01 Continuous Glucose Monitor, Washington, DC USA 00333
2019.03.01 Continuous Glucose Monitor, Washington, DC USA 00333 (View on Flickr.com)

In the last century, people were told based on faulty science, “you are what you eat.”

In this century we now know “you are what you do with what you eat.”

Continuous glucose monitors (#CGM) confirm the science we were taught in medical school works as advertised. Combined with a #FoodNotPharma approach, we could end the (Type 2) diabetes epidemic in our lifetimes.

As predicted, thee was no increase in blood glucose from these meals.

2019.03.02 DC People and Places, Washington, DC USA 00547
2019.03.02 DC People and Places, Washington, DC USA 00547 (View on Flickr.com)
2018.09.08 Low Carb and Low Carbon 01-527
2018.09.08 Low Carb and Low Carbon 01-527 (View on Flickr.com)

Getting ready for Low Carb Denver, and reflecting on what I’ve learned in the last 2+ years – value of continuous learning as a family medicine specialist 🙂 .

View this post on Instagram

In the last century, people were told incorrectly, "you are what you eat." . In this century we now know "you are what you do with what you eat.” As predicted, no increase in blood glucose from these meals. . Continuous glucose monitors (#CGM) confirm the science we were taught in medical school works as advertised. Combined with a #FoodNotPharma approach, we could end the (Type 2) diabetes epidemic in our lifetimes. . #DataOverDogma #LCHF #RealFood #FatAdapted #DiabetesPrevention #MetabolicHealth #ThisCenturyBestCentury #EmbraceCuriosity #WorldBelongsToOptimists #LowCarbDenver #LCD19 #HealthyPeopleHealthyPlanet #FamilyMedicine #SonyAlpha #Bokeh #food #RealFood #FoodPhotography #Science #Yes2Meat 🥩🌐🕊🥦🔭🔬👨‍🔬

A post shared by Ted Eytan, MD (@tedeytan) on

Video Friday: Life is a beautiful one of these – Rehoboth Beach, DE via Drone

2018.12.29 Rehoboth Beach by Drone, Rehoboth Beach, DE USA 0148
2018.12.29 Rehoboth Beach by Drone, Rehoboth Beach, DE USA 0148 (View on Flickr.com)

I am doing video very sparingly (I’m more of a still photo person). There are also very few places in the United States where it’s legal to fly a drone. Rehoboth Beach, DE is one of them, and a beautiful one.

Enjoy the video, and some stills below.

Music credit: Drift by Scott Buckley – www.scottbuckley.com.au

Just Read: DIETFITS new analysis showing benefits for low carbohydrate over low fat diets for blood lipids – changing the focus from weight to metabolic health

2018.02.16 Metabolic Health Calculations, DIETFITS Randomized Control Trial 333
My original analyses of data not included in the main body of the DIETFITS paper, which shows evidence of poorer metabolic health among people eating a low-fat vs low-carb diet, despite the conclusion in the paper that the diets were equivalent for weight loss. See this blog post for more. 2018.02.16 Metabolic Health Calculations, DIETFITS Randomized Control Trial 333 (View on Flickr.com)

This heavily paywalled study is a more thorough analysis of something that caught my eye and was glossed over in the original publication of DIETFITS last year, which showed that weight loss was equivalent in groups of people who either ate a healthy low carbohydrate or a healthy low-fat diet.

The conclusion for some was “the diets are all the same.”

Except maybe they’re not…

The problem I noticed with DIETFITS not addressed in the main paper – worse metabolic health in the low-fat group

See: Just Read: DIETFITS and Effect of Low-Fat vs Low-Carbohydrate Diet, real food is better, is the low fat diet worse for metabolic health?

I took the time to dive into the supplemental materials where this information was (it wasn’t in the main paper) and made these pretty charts which show a visible tendency to insulin resistance and poorer lipid status (cholesterol,HDL, LDL, triglycerides) in the “healthy low fat” diet group.

So maybe “healthy low fat” wasn’t as “healthy.”

I didn’t have access to the raw data, this paper is an analysis of what I couldn’t analyze…

The focus on LDL in the original paper is not consistent with current science

The 12-month changes in low-density lipoprotein cholesterol concentrations significantly favored a healthy low-fat diet. High-density lipoprotein cholesterol concentrations increased significantly more and concentrations of triglycerides decreased significantly more for the healthy low-carbohydrate diet group than for the healthy low-fat diet groupGardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JPA, et al. on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion. JAMA [Internet]. 2018 Feb 20;319(7):667.

This is a misleading statement in my opinion because of the “favored” status given low-fat diet. This statement also invokes our profession’s laser-light focus on LDL when we now know that the overall profile (HDL, triglycerides, and more recently particle type/size) is more important for cardiovascular health.

The dogma-challenging data here – people who increased their % of saturated fat (SFA) on the low carb (LCHF) diet:

  • didn’t increase the quantity of saturated fat they ate – their overall calories decreased as well as their protein and carbohydrate intakes. This explodes the myth that an LCHF diet means eating more saturated fat.
  • didn’t significantly increase their LDL cholesterol
  • increased their HDL (not significantly)
  • significantly decreased their triglycerides

Without getting too complicated, the low-carbohydrate group did these things better than the low fat group, who did not drop their triglycerides.

The researchers showed that the drop in triglycerides in the low carbohydrate group (a good thing for health) was strongly related to the drop in carbohydrate intake, which makes low-carbohydrate superior in this case for metabolic health.

These are similar to the findings in the paper cited below, which tend to be repeatable – an overall improvement in lipid profile when lipids are looked as a group, not as a single number (kind of like what we should do in life itself):

2018.11.12 Low Carb and Low Carbon 586
A study of 10 keto-adapted athletes and 10 high-carbohydrate adapted athletes describes typical cholesterol changes seen in people who go on low carbohydrate, healthy fat (LCHF) diets. Often only one number is looked at (LDL-C) in criticizing this approach, however there are other changes that may be compensatory at the same time. It’s not known exactly why this happens or if it increases CVD risk.

Noting also from the data above that while none of the athletes (high carbohydrate and low carbohydrate) met criteria for insulin resistance, markers of insulin sensitivity (TG/HDL-C ratio and Lipoprotein insulin resistance index) were significantly better in the low carbohydrate group.

“Ketogenic diets in normal-weight and overweight non-athletes result in a moderate increase in total, LDL-C and HDL-C concentrations relative to low-fat diets. The observation that highly trained, ultra-endurance athletes consuming a very low-carbohydrate/high-fat diet exhibited a more dramatic and uniform hypercholesterolaemia is counterintuitive since high-volume exercise tends to lower total and LDL-C levels. The explanation for this paradox may involve high intake of cholesterol and saturated fat combined with high-energy demands for lipid metabolism characteristic of the keto-adapted phenotype. LC athletes who adopt a ketogenic diet may experience an expansion of their endogenous cholesterol pool during the adaptation phase of the diet, after which they maintain greater circulating cholesterol levels.”

Individual lipid measures for high-carbohydrate (n=10) and low-carbohydrate (n=10) ultra-endurance athletes. Bars represent mean±1SD. HDL-C, high-density lipoprotein-cholesterol; LDL-C, low-density lipoprotein-cholesterol. TC, total cholesterol; TG, triglyceride. Source; Creighton BC, Hyde PN, Maresh CM, Kraemer WJ, Phinney SD, Volek JS. Paradox of hypercholesterolaemia in highly trained, keto-adapted athletes. BMJ Open Sport Exerc Med [Internet]. 2018 Oct 4;4(1):e000429. Available from: bmjopensem.bmj.com/lookup/doi/10.1136/bmjsem-2018-000429 – Re-use permitted under CC BY-NC.

#LCHF #MetabolicHealth #DiabetesReversal #KetogenicDiet #DiabetesPrevention #Cholesterol #LMHR #LMHRScience

2018.11.12 Low Carb and Low Carbon 586 (View on Flickr.com)

Despite the pitch for plant-based eating, there’s no evidence here of superiority

The term “plant-based” was sprinkled throughout the paper, however it’s acknowledged that there’s no evidence here of superiority of plant-based over plant-free:

This study did not separate the analysis between plant-and animal-based saturated fat. Thus, the differential effects of plant- and animal-based sources of saturated fat on cardiovascular outcomes should be investigated further.Shih CW, Hauser ME, Aronica L, Rigdon J, Gardner CD. Changes in blood lipid concentrations associated with changes in intake of dietary saturated fat in the context of a healthy low-carbohydrate weight-loss diet: a secondary analysis of the Diet Intervention Examining The Factors Interacting with Treatment. Am J Clin Nutr [Internet]. 2019 [cited 2019 Jan 21]

“investigated further” is translated into english as “we failed to prove this” 🙂

Shifting the emphasis to weight loss (not as important) to metabolic health (more important)

The conclusion of the paper is well stated:

Specifically, these secondary analyses support shifting the focus from concern about percentage SFA intake on the overall lipid profile to instead aiming to maintain a relatively stable absolute level of saturated fat intake while focusing on improving the quality of the overall diet by incorporating more whole foods and decreasing processed carbohydrates as much as possible.Shih CW, Hauser ME, Aronica L, Rigdon J, Gardner CD. Changes in blood lipid concentrations associated with changes in intake of dietary saturated fat in the context of a healthy low-carbohydrate weight-loss diet: a secondary analysis of the Diet Intervention Examining The Factors Interacting with Treatment. Am J Clin Nutr [Internet]. 2019 [cited 2019 Jan 21]

Dislcosure: I’m in the 12% of Americans in metabolic health, and I’m not cancelling my trip to #LowCarbDenver

  • By the way, I am in the 12 %, this is as a good a time as any to state that I am on a healthy fat, low carbohydrate diet
  • I have no other personal interests or conflicts to disclose – conflict-free is the way to be (see: My Disclaimers and Disclosures)

See everyone there. I continue to love this century 🙂

Reference

Shih CW, Hauser ME, Aronica L, Rigdon J, Gardner CD. Changes in blood lipid concentrations associated with changes in intake of dietary saturated fat in the context of a healthy low-carbohydrate weight-loss diet: a secondary analysis of the Diet Intervention Examining The Factors Interacting with Treatment. Am J Clin Nutr [Internet]. 2019 [cited 2019 Jan 21]

Thanks for Publishing my Photos, in How can D.C. make bikesharing family-friendly? – D.C. Policy Center

2015 Greenbuild Tour Bike DC- Transit, Health, and Gardens Kaiser Permanente Center for Total Health  00244
2015 Greenbuild Tour Bike DC- Transit, Health, and Gardens Kaiser Permanente Center for Total Health 00244 (View on Flickr.com)

Thanks for publishing my photos, @DCPolicyCenter (and syndicated to @ggwash) in another excellent analysis involving data, insights, active transportation, and Washington, DC – many of my favorite things 🙂 .

DC Bike Party High Tide Ride Washington DC USA 46128
DC Bike Party High Tide Ride Washington DC USA 46128 (View on Flickr.com)

D.C. is still a pioneer in bikesharing, but more must be done for it to be a part of local families’ car-free transportation options.

Source: How can D.C. make bikesharing family-friendly? – D.C. Policy Center

Thanks for Publishing my Photo, in What These 2020 Candidates’ DC Neighborhoods Tell Us About Them | Washingtonian

2017.03.19 Ivy City, Washington, DC USA 01689
2017.03.19 Ivy City, Washington, DC USA 01689 (View on Flickr.com)

Thanks (again) for publishing one of my photographs, @Washingtonian.

This one was taken in the Ivy City Neighborhood of Washington, DC (of course)

Here’s a more recent one of the same landmark, taken at the @CapitalPrideDC annual reveal event. Equality Equals Health 🙂 .

2019.01.31 Pride2019 Reveal, Capital Pride Alliance, Washington, DC USA 09918
2019.01.31 Pride2019 Reveal, Capital Pride Alliance, Washington, DC USA 09918 (View on Flickr.com)

Mostly, that they want to live near work. But let’s dig a little deeper.

Source: What These 2020 Candidates’ DC Neighborhoods Tell Us About Them | Washingtonian (DC)