Just Read: Carbon footprint of the global pharmaceutical industry – “Significantly worse than the automotive industry”

Just Read: Carbon footprint of the global pharmaceutical industry - “Significantly worse than the automotive industry”

I was highly interested in reading this paper because I have informally worked to understand the greenhouse gas (GHG) emissions of the pharmaceutical industry through their own web sites, and usually leave confused and uninformed. Apparently, it’s not just me. This analysis includes the use of datasets that are not publicly available for the major …

Just Read: Defending Beef – Unlearning and Relearning the Sustainable Diet

Just Read: Defending Beef - Unlearning and Relearning the Sustainable Diet

Defending Beef: The Case for Sustainable Meat Production This is one of the best books I’ve read in a long time. Why? It covers a topic I know very little about, how our food is produced. I’d argue the overwhelming majority of my physician colleagues don’t know much about this either. Some pretend to know …

Just Read:  The Global Influence of the Seventh-Day Adventist Church on Diet 

Just Read:  The Global Influence of the Seventh-Day Adventist Church on Diet 

This is a very well written piece in the journal Religions (Religions_MDPI) covering the title of the piece. Even if you live in the future and know where you want to go, it’s important to know where you came from. I’m posting this here for reference – I encourage people interested in the history of …

Just Read: A clinician’ s guide to inpatient low-carbohydrate diets for remission of type 2 diabetes

Just Read: A clinician’ s guide to inpatient low-carbohydrate diets for remission of type 2 diabetes

This paper, by Cucuzzella et. al (of all the authors Adele Hite, PhD RD is on Twitter – @ahhite) is a nice review of what’s known about standards of care for initiating low carbohydrate nutrition, especially in the inpatient setting. The appendices also include provider/physician handouts, patient handouts, and a deprescribing guide (since medications usually …

Just Read: Care of The Transgender Patient & my 7th Capital TransPride – doctors telling humans how to exist fails 100 % of the time, so why would we want to do that…

Just Read: Care of The Transgender Patient & my 7th Capital TransPride - doctors telling humans how to exist fails 100 % of the time, so why would we want to do that...

Last evening was the annual Washington, DC Capital TransPride (@DCTransPride365) rewind, held a few months out from the TransPride celebration as a review and planning for next year. 2019 marks my 7th Capital TransPride attendance. It marks my first participation as a Capital Pride (@CapitalPrideDC) photographer – the best photographs are ones of humans in …

Just Read: Guidelines for Creating Guidelines: Dissecting American Diabetes Association Nutrition and Eating Pattern Guidelines

Just Read: Guidelines for Creating Guidelines: Dissecting American Diabetes Association Nutrition and Eating Pattern Guidelines

For as long as I’ve been following Dr. Sarah Hallberg’s (@DrSarahHallberg) work, she’s been following the progression of American Diabetes Association (@AmDiabetesAssociation) guidelines for nutrition therapy and eating guidelines in diabetes. I give her credit for turning my attention toward metabolic health instead of obesity, and toward an interest in the ADA’s work. FUN FACT …

Just Read (and thanks for publishing my photos): Inside the Hyper-specific Quest to Add a Transgender Emoji | | Eye on Design

Just Read (and thanks for publishing my photos): Inside the Hyper-specific Quest to Add a Transgender Emoji | | Eye on Design

Thank you Meg Miller and @AIGAeyeondesign for publishing this wonderful piece on the work to add a transgender pride flag emoji to the character set defined by the @Unicode consortium. As the piece indicates, this may be the most documented emoji proposal process in human history. See my blog posts for more info 🙂 . …

Just Read: Conflicts in Nutritional Science: There are some things doctors cannot do

Just Read: Conflicts in Nutritional Science: There are some things doctors cannot do

There’s a saying/complaint that doctors do not get enough nutrition education in medical school. Actually this is wrong. We do get a lot of nutrition education, we just get it from the wrong places. Witness this advertisement from the New York State Medical Journal of Medicine in 1957 (!). Does anyone believe our profession wasn’t …

Just Read: Reversing Type 2 Diabetes (It’s Possible and a Choice for Patients) – A Narrative Review of the Evidence

Just Read: Reversing Type 2 Diabetes (It's Possible and a Choice for Patients) - A Narrative Review of the Evidence

When I went to medical school, I was taught that diabetes is an incurable, chronic disease, a part of human existence that we could only prevent from getting worse. The percentage of people with diabetes when I was taught with was also a fraction of what it is today: Now, in this century, we realize …

Just Read: Lifestyle Management, Standards of Medical Care in Diabetes 2019, American Diabetes Association (behavior, a little less strange – low carbohydrate eating now included)

Just Read: Lifestyle Management, Standards of Medical Care in Diabetes 2019, American Diabetes Association (behavior, a little less strange - low carbohydrate eating now included)

I had noted previously that non-adherence to the latest evidence around nutrition has resulted in strange behavior on the part of nationally respected organizations, who do things like endorse sugar sweetened cereals and pure fruit juice, or advise the consumption of high amounts of dietary carbohydrate in the setting of dietary carbohydrate intolerance. Some of this may be related to visible conflicts of interest.

I recently read the 2019 Standards of Medical Care in Diabetes and see there has been a change in approach, which I’m calling a little less strange, and quite welcome. I clipped the relevant pages in the slide above, and what they contain are:

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

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

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 …

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

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

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 …

Just Read: Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016 (Are you in the 12%? here’s how I am)

Just Read: Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016 (Are you in the 12%? here's how I am)

This paper, written by lead author See: June Stevens, at the UNC Lineberger Comprehensive Cancer Center, is an analysis of 7 years of NHANES data (a United States’ commissioned annual survey of people’s health) and their likelihood of being in metabolic health. Early Days, We Still only Define Metabolic Disease As we learned a long …

Just Read: Continuous glucose monitoring: A review of the technology and clinical use (except no mention of diet, diabetes prevention, or diabetes reversal)

Just Read: Continuous glucose monitoring: A review of the technology and clinical use (except no mention of diet, diabetes prevention, or diabetes reversal)

This paper, published in 2017, provides an overview of studies and potential applications of continuous glucose monitoring (CGM) done to date. The paper is of interest to me as I’ve been wearing a CGM as a non-diabetic, normoglycemic, physician for some time now (see: Part 1: Why I decided to wear a continuous glucose monitor …

Just Read: Hospitals Lead by Poor Example: An Assessment of Snacks, Soda, and Junk Food Availability in Veterans Affairs Hospitals

Just Read: Hospitals Lead by Poor Example: An Assessment of Snacks, Soda, and Junk Food Availability in Veterans Affairs Hospitals

It’s not just us. More and more physicians are noting an unhealthy food environment where they work to save lives. In this study, physicians used the Freedom of Information Act process to get information about food available at VHA hospitals. Process verification for a Freedom of Information Act request was used to assess government-run inpatient …

Just Read: The Metabolic Advantages of a Lower Carbohydrate Diet

Just Read: The Metabolic Advantages of a Lower Carbohydrate Diet

In English: following weight loss, people on lower carbohydrate diets were able to eat more food to keep their weight stable than people on high carb low-fat diets, putting another nail in the coffin of low fat diets and “calories-in/calories-out” – weight may be more dependent on hormonal interaction with food (insulin/ghrelin/leptin) than on simple …

Just Read: Hypercholesterolemia and low carbohydrate diets – study of highly trained keto-adapted athletes

Just Read: Hypercholesterolemia and low carbohydrate diets - study of highly trained keto-adapted athletes

This is a very helpful study which establishes via a good protocol that people on low-carbohydrate diets can experience a significant rise in their cholesterol levels. Across a population, there may not be a significant rise of LDL cholesterol on average. However, at the individual level, there may be changes that significantly concern patients and …

Just Read: Estimating Insulin Sensitivity using common lab values (HDL, TG, BMI) – The Single Point Insulin Sensitivity Estimator (SPISE)

Just Read: Estimating Insulin Sensitivity using common lab values (HDL, TG, BMI) - The Single Point Insulin Sensitivity Estimator (SPISE)

This paper, written by european researchers, describes a newer way to estimate insulin sensitivity (or it’s unhealthy opposite, insulin resistance) using commonly obtained lab values. Here’s the equation they came up with: The novel formula for SPISE was computed as follows: SPISE = 600 X HDL-0.185/(TG0.2 x BMI1.338, with fasting HDL-C (mg/dL), fasting TG concentrations …

Just Read: Type 2 Diabetes: When Does It Start? (Estimate: 20 years prior to diagnosis)

Just Read: Type 2 Diabetes: When Does It Start? (Estimate: 20 years prior to diagnosis)

This is a retrospective look back at the health of 27,392 people in Japan to see when the earliest signs of diabetes of pre-diabetes were present among those who became diabetic or pre-diabetic. And, it turns out the signs were present more than 10 years before they were diagnosed, with a better estimate being 20 …

Just Read: US dietary guidelines: is saturated fat a nutrient of concern?

Just Read: US dietary guidelines: is saturated fat a nutrient of concern?

Answer: No. This is true across multiple venues and pieces of scholarship. See this video clip from June, 2018’s #Food4Thought18 in this blog post: Photo Friday: Narrative Art and Exploding Myths in the era of Diabetes Reversal Zoe Harcombe, PhD (@ZoeHarcombe) is an international expert on the data and science and scientific techniques connected to …

Just Read: Increased Cardiovascular Risk in Hypertriglyceridemic Patients With Statin-Controlled LDL Cholesterol – Impact of Nutrition? (not discussed)

Just Read: Increased Cardiovascular Risk in Hypertriglyceridemic Patients With Statin-Controlled LDL Cholesterol - Impact of Nutrition? (not discussed)

This is a study done using data from Kaiser Permanente, performed by the Kaiser Permanente Center for Health Research (@KPCHR), looking at the relationship between triglyceride levels and cardiovascular disease in a group of patients who had their LDL’s controlled (values of 40 to 100 mg/dl). H/T @MacroFour for the link. I believe the paper …

Just Read: Federal Commission for Nutrition. Vegan diets: review of nutritional benefits and risks. Expert report of the FCN

Just Read: Federal Commission for Nutrition. Vegan diets: review of nutritional benefits and risks. Expert report of the FCN

Federal Commission for Nutrition. Vegan diets: review of nutritional benefits and risks. Expert report of the FCN [Internet]. Bern: Federal Food Safety and Veterinary Office 2018. Available from: https://www.eek.admin.ch/eek/de/home/pub/ernaehrungsbezogene-und-gesundheitliche-vor–und-nachteile-einer.html (scroll down for English version) In the #FMRevolution, there’s no limit to ideas of interest when it comes to health… First (#Food4Thought18), now this. The Swiss …

Just Read: New Insights into Glucose Dysregulation from Continuous Glucose Monitoring & Foods Most Recommended for Reversing Prediabetes Seem to Have Greatest Potential to Cause Prediabetes

Just Read: New Insights into Glucose Dysregulation from Continuous Glucose Monitoring & Foods Most Recommended for Reversing Prediabetes Seem to Have Greatest Potential to Cause Prediabetes

This was bound to happen, and h/t Zoe Harcombe (@ZoeHarcombe) to alerting us to this new study looking at the measurements coming from continuous glucose monitors in a 30-57 subjects all various states of metabolic health. New technology shows early signs of metabolic unhealth In the slide above, the challenges to glucose regulation can be …

In the era of the social scientist, the finding that in usual/current care more people with diabetes die in a year than go into remission is a cause for hope, not grief

In the era of the social scientist, the finding that in usual/current care more people with diabetes die in a year than go into remission is a cause for hope, not grief

This post is a visual representation of the story I posted previously (see: A Different Take- My Conversation With the Author: Diabetes Remission Data from Kaiser Permanente Shows that Patients are Right to Have Hope. I needed to create a visual version for a set of slides I’m producing. Even then, it’s a little difficult …

Just Read: Orbiting the Giant Hairball, A Corporate Fool’s Guide to Surviving with Grace, by Gordon MacKenzie

Just Read: Orbiting the Giant Hairball, A Corporate Fool's Guide to Surviving with Grace, by Gordon MacKenzie

Orbiting the Giant Hairball: A Corporate Fool’s Guide to Surviving with Grace I don’t consider myself a corporate fool and this post is not about corporate foolery (hint, read the book…), it’s really the opposite. This work is a find recommendation the most recent Innovation Learning Network (@ILNmuse) in person meeting, which for me continues …

Just Read: Dietary and nutritional approaches for prevention and management of type 2 diabetes, via #Food4Thought18

Just Read: Dietary and nutritional approaches for prevention and management of type 2 diabetes, via #Food4Thought18

This is a good overview of how to think about nutrition for various populations, via the #Food4Thought18 series.

Unlike the previous paper in the series that I just read (Just Read: Dietary fat and cardiometabolic health evidence, controversies, and consensus for guidance (written by the team of non-usual collaborators…)), I don’t know how often this group of authors collaborates.

I know and visited Will Yancy, MD, (@DrWillYancy) recently at the Duke Diet and Fitness Center (@DukeDFC), and was really impressed with what I saw (Just Read and Just Visited: Duke Diet and Fitness Center and Management of Type Diabetes With a Very Low–Carbohydrate Diet – More reasons I love this century)

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Just Read: Dietary fat and cardiometabolic health evidence, controversies, and consensus for guidance (written by the team of non-usual collaborators…)

Just Read: Dietary fat and cardiometabolic health evidence, controversies, and consensus for guidance (written by the team of non-usual collaborators...)

This paper is part of a pretty remarkable series published by BMJ (which you can access here).

If you know the names of the people in the nutrition space, these are not names that appear on papers together usually (ever)? Their cred in this space precedes them. I’m sure many would love to be on the conference calls or emails where the piece was being formulated.

The papers are tied to a remarkable dialogue hosted by @SwissRe last week, which you can also access here.

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