Just Read: Cherry Picked References in Journal Articles on Diets for Health – Is there a Hidden Nutrition Curriculum for Physicians?

Just Read: Cherry Picked References in Journal Articles on Diets for Health - Is there a Hidden Nutrition Curriculum for Physicians?

I was recently asked about the influences on physicians in the counseling and advocating of nutritional approaches. People believe physicians have complete autonomy in fitting nutritional guidance to the needs of the patient. So, for example, if they wish to support approaches such as carbohydrate restriction for people with insulin resistance, they are free to …

Just Read: Diets for Health, Goals and Guidelines (Except what if the guidelines aren’t working?) – American Family Physician

Just Read: Diets for Health, Goals and Guidelines (Except what if the guidelines aren't working?) - American Family Physician

I had high(er) hopes for this article, published in the journal of my medical specialty, American Family Physician (@AFPJournal), especially after other medical journals such as JAMA have begun to take a more expansive view of nutrition. However, I am disappointed. This quote for example. Diets for the treatment of specific medical conditions are beyond …

Just Read: 55% of Californians have Insulin Resistance

Just Read: 55% of Californians have Insulin Resistance

As the title of the post says.

This data comes from the UCLA Center for Health Policy Research (@UCLAchpr) and used a combination of interviews and statistical modeling from the US based NHANES survey (which does retrieve blood samples). The paper cites a figure of 90% of people who do not know they are insulin resistant.

Here’s the summary along with required terms of use statement (data used under the terms of use on the site).

Continue reading→

Just Read: Insulin Access and Affordability Working Group: Conclusions and Recommendations

Just Read: Insulin Access and Affordability Working Group: Conclusions and Recommendations

I read this paper and prepared a few slides relevant to a presentation I am putting together for a meetup I am organizing. As the title states, a working group convened by the American Diabetes Association convened a workgroup to examine the (significant) problem of insulin affordability.

I’ve placed stories next to the data to show the impact of the near tripling of insulin prices since 2003. For more information about the impact, you can follow the #insulin4all hashtag on twitter.

Continue reading→

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

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

The first few sentences of this paper tell the story to those who aren’t aware of the history here.

I learned about the paper while visiting one of its authors, Will Yancy, MD (@DrWillYancy) who’s the Director of the Duke Diet and Fitness Center (@DukeDFC), in Durham, North Carolina. This is one of the places in the United States that has been on the forefront of innovating in science-based lifestyle change. Since 1969.

Continue reading→

Just Read: Dietary greenhouse gas emissions of meat-eaters, fish-eaters, vegetarians and vegans in the UK; A Low Carbon Diet is also High Carbohydrate Diet

Just Read: Dietary greenhouse gas emissions of meat-eaters, fish-eaters, vegetarians and vegans in the UK; A Low Carbon Diet is also High Carbohydrate Diet

I created this chart based on the data in this paper published in the journal Climactic Change (see reference below), which was used in this report: Building a Climate-Smart Healthcare System for California | Bay Area Council Economic Institute, in this context: Due to meat’s carbon-intensive production, simply moving from a diet “heavy” in meat …

Just Read: Resisting influence from agri-food industries on Canada’s new food guide (and the irony of the competing interest disclosures within)

Just Read:  Resisting influence from agri-food industries on Canada’s new food guide (and the irony of the competing interest disclosures within)

This is a piece written about the upcoming Canada Food Guide, which is Canada’s version of the United States dietary guidelines, and concerns about food industry influence. The article is paywalled, however this response from Dr’s Carol Loffelmann (@KetoAnaesMD) and Barbra Allen Bradshaw is available to review, and I recommend it as a counterpoint to …

Just Read: High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance (except that maybe it’s not)

Just Read: High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance (except that maybe it's not)

This paper is just now starting to receive some discussion online, however, it came to me via the alerts service of my medical specialty society, the American Academy of Family Physicians (@AAFP). This is a link to the actual brief, which caught my eye because of three things: Insulin Resistance NAFLD Red Meat Israeli researchers …

Just Read: The State of US Health, 1990-2016 – Noticing: Significant Fasting Plasma Glucose Increase, Impact of Current Dietary Recommendations, Non-mention of (non-acoholic) Liver Disease + (Mis)Understanding Washington, DC

Just Read: The State of US Health, 1990-2016 - Noticing: Significant Fasting Plasma Glucose Increase, Impact of Current Dietary Recommendations, Non-mention of (non-acoholic) Liver Disease + (Mis)Understanding Washington, DC

This paper is lengthy and well covered throughout the social media sphere, so I won’t repeat what’s already been said.

A few things haven’t been said that I’m commenting on:

1. Significant Increases in Fasting Blood Glucose and Current Dietary Recommendations
2. Diabetes is increased, Non-alcoholic fatty liver disease is unaccounted for
3. Continued misconceptions about Washington DC as a high sociodemographic index (SDI) future-State

In the body of the paper, phenomena of increases in fasting blood glucose is not connected to current dietary recommendations, which promote carbohydrate intake and may be partially responsible for this increase. See this paper for more (More from my trip to the Library of Congress and incredible US News and World Report photo collection: 1968’s Harried Housewife Preparing Convenience Foods (and how her diet was re-engineered to be carbohydrate-rich))

Continue reading→

Just Read: Where and when did non-alcoholic fatty liver come from and connection to carbohydrates – Common Causes of Chronic Liver Diseases in the United States

Just Read: Where and when did non-alcoholic fatty liver come from and connection to carbohydrates -  Common Causes of Chronic Liver Diseases in the United States

As I’ve written here previously, the condition of non-alcoholic fatty liver disease (NAFLD) has seemed to come out of nowhere, is still creating confusion within the medical profession, and is continuing to grow in prevalence. It’s a follow-up to a previous post here, see: Just Read: Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of …

Now Reading: Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars

Now Reading: Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars

Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars I normally post about things I’m reading after I’ve read them. However this one is going to take a bit longer to get through, and I’m getting ready for my Now update, and want to include this in there. As with many things …

Just Read: Assessing the nutrient intake of a low-carbohydrate, high-fat (LCHF) diet

Just Read: Assessing the nutrient intake of a low-carbohydrate, high-fat (LCHF) diet

This paper asks an interesting question that feels like a subtext of so many other papers – Why do people express fear of an LCHF (low carbohydrate, healthy fat) diet? Which, according to Google trends, is winning in mindshare. It’s written by Caryn Zinn (@CarynZinn), Amy Rush, and Rebecca Johnson (@type_oneder), the CEO of Telethon …

Just Read: Real Visibility Is Transgender People Living Openly And Authentically and, I am a person who talks about transgender people who would be much happier if there were more transgender people to talk about

Just Read: Real Visibility Is Transgender People Living Openly And Authentically and, I am a person who talks about transgender people who would be much happier if there were more transgender people to talk about

Real Visibility Is Transgender People Living Openly And Authentically | HuffPost, @BrynnTannehill Today is Transgender Day of Visibility (#TDOV2018): The International TDoV is an annual holiday celebrated around the world. The day is dedicated to celebrating the accomplishments and victories of transgender & gender non-conforming people while raising awareness of the work that is still …

Just Read: Confronting unprofessional behaviour in medicine; thoughts on being bullied in health care

Just Read: Confronting unprofessional behaviour in medicine; thoughts on being bullied in health care

I’m putting this piece and related podcast, featuring Jo Shapiro, MD from @BWHSurgery here as a reference. This issue has existed as long as the practice of medicine and it always will, somewhere, as long as humans are involved. What will change is who the actors are and the venues. I wrote about an internationally …

Just Read: Prevalence trends tell us what did not precipitate the US obesity epidemic

Just Read: Prevalence trends tell us what did not precipitate the US obesity epidemic

but for all subgroups most people became heavier at about the same time. This simple observation indicates something important about factors that did not precipitate the US obesity epidemic. We believe it is implausible that each age, sex and ethnic group, with massive differences in life experience and attitudes, had a simultaneous decline in willpower …

Just Read: Stable Coronary Artery Disease: Treatment (American Family Physician) – Role of diet?

Just Read: Stable Coronary Artery Disease: Treatment (American Family Physician) - Role of diet?

There is one mention of diet in the treatment of coronary artery disease and it’s here:

“Management of Risk Factors and Comorbidities
Risk reduction to prevent cardiovascular events includes blood pressure (BP) control and management of cholesterol and glucose levels. Lifestyle modifications (e.g., smoking cessation, increased physical activity, weight control, healthy diet) and management of comorbid conditions such as hypertension and diabetes mellitus can reduce overall and CVD-related mortality.”

…it’s just the words “healthy diet.”

Continue reading→

Just Read: Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes

Just Read: Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes

Still catching up on the threads of not this recent #LCB18 but the more distant #LowCarbSanDiego, and this paper on the prevalence of the disease the medical profession is just starting to understand, non-alcoholic fatty liver disease, or NAFLD.

NAFLD is important in the context of diabetes reversal and nutrition.

There is no currently known drug treatment for NAFLD. Its causes are related to nutrition, and specifically high-carbohydrate/low-fat nutrition, and recent studies are showing it abates with nutrition approaches:

Continue reading→

Just Read: The USDA is opening the door to saturated fats and low-carbohydrate diets for 2020-2025 Dietary Guidelines

Just Read: The USDA is opening the door to saturated fats and low-carbohydrate diets for 2020-2025 Dietary Guidelines

There proved to be many, what I called “gaspworthy” moments at Low Carb Breckenridge #LCB18. This is one of those after the fact.

In this release USDA and HHS Announce New Step Toward Added Transparency in Development of 2020-2025 Dietary Guidelines | Food and Nutrition Service and related documents, most notably Dietary Guidelines | Center for Nutrition Policy and Promotion new questions are under consideration.

Continue reading→

Just Read: Temporal Trends in Gender-Affirming Surgery Among Transgender Patients, Insights from Study Authors, Evidence that Providing Medical care is more Cost-effective than Denying It

Just Read: Temporal Trends in Gender-Affirming Surgery Among Transgender Patients, Insights from Study Authors, Evidence that Providing Medical care is more Cost-effective than Denying It

This paper, published in JAMA Surgery last week, provides important evidence of the value of providing medically-necessary care to people who are trasngender or gender nonconforming.

he primary importance of this paper is as the first study to our knowledge that broadly evaluates national temporal trends in gender-affirming surgery for transgender patients in the United States.

The importance to physicians and the people we serve is the above plus the data in Table 1: “Characteristics of Patients Who Have a Diagnosis Code for Transsexualism or Gender Identity Disorder in the National Inpatient Sample”

Of the 37,827 inpatient encounters in the sample, 14,128, or 40.5 % are for Mental Health. This dwarfs the number for actual treatment-related reasons, such as gender affirming surgery.

Continue reading→

Just Read: How a low-carbohydrate diet rapidly reverses risk factors in people with high liver fat, in the disease we’ll all be hearing about – NAFLD, NASH, Diabetes Reversal

Just Read: How a low-carbohydrate diet rapidly reverses risk factors in people with high liver fat, in the disease we'll all be hearing about - NAFLD, NASH, Diabetes Reversal

I am back from #LCB18 in time to review this paper that just came out, which presents several important points of view Less confusion about the best way to treat non-alcoholic fatty liver disease The near immediate impact of using a low-carbohydrate diet to reverse the fatty liver condition Impacts beyond liver fat into the …

Just Read: Putting insulin resistance into context by dietary reversal of type 2 diabetes

Just Read: Putting insulin resistance into context by dietary reversal of type 2 diabetes

This paper has a title that’s easy to figure out 🙂 . It’s very useful in explaining the mechanism of insulin resistance, the role of the liver, influence on diabetes, and more recently/importantly on diabetes reversal. The article is brief and explains the liver’s central role in diabetes progression, separate from muscle cells. As fat …

Just Read: The role of diet and nutritional intervention for the management of patients with non-alcoholic fatty liver disease (NAFLD)

Just Read: The role of diet and nutritional intervention for the management of patients with non-alcoholic fatty liver disease (NAFLD)

Continuing a little pre-reading before #LCB18. This is a paper referenced from the European Guidelines I posted about previously, it is also from a pre-historic era (2014), so it’s posted here just as baseline. It seems to me to add to the confusion about non-alcoholic fatty liver disease and what should be done about it. …

Just Read: The Disease You’ll be Hearing a Lot more About: Management of Nonalcoholic Fatty Liver Disease in Patients With Type 2 Diabetes: A Call to Action

Just Read: The Disease You'll be Hearing a Lot more About: Management of Nonalcoholic Fatty Liver Disease in Patients With Type 2 Diabetes: A Call to Action

This paper provides a good overview of the significance of nonalcoholic fatty liver disease (NAFLD) and its unrecognized threat today in Medicine. Unlike the review I just posted, this one dives heavily into pharmacologic treatment options and doesn’t discuss lifestyle or diet in much detail compared to other papers. Diet to reduce insulin resistance is …

Just Read: EASL–EASD–EASO Clinical Practice Guidelines (and the health threat and confusion around) the management of non-alcoholic fatty liver disease

Just Read: EASL–EASD–EASO Clinical Practice Guidelines (and the health threat and confusion around) the management of non-alcoholic fatty liver disease

I know these are from 2016 which is a century ago in this field, I wanted to start somewhere. A Growing Epidemic I was introduced to the threat of Non-Alcoholic Fatty Liver Disease (NAFLD) not too long ago (at Low Carb San Diego actually), and the medical profession, not too long before that. As Nicolai …

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?

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?

2018.02.16 Metabolic Health Calculations, DIETFITS Randomized Control Trial 3212018.02.16 Metabolic Health Calculations, DIETFITS Randomized Control Trial 321 (View on Flickr.com)

Long anticipated study findings, previously reported in conference proceedings. I posted on the methods previously (see link below).

lipid changes, there are significant ones:

“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 group.”

Unfortunately, I couldn’t make sense of the values in Table 3 of the paper, so I ended up going to the supplemental data to review lipid and metabolic health changes. I plotted those in the attached images.

Continue reading→

Just Read: Evidence that supports the prescription of low-carbohydrate high-fat (or healthy-fat) diets: a narrative review

Just Read: Evidence that supports the prescription of low-carbohydrate high-fat (or healthy-fat) diets: a narrative review

Somehow I missed this article, or actually, I’m still catching up 🙂 . As the title says, this is a good review of the state of low-carbohydrate diets, how they are thought to work, and what their impacts are. Thinking “healthy fat” rather than “high fat” diet I appreciate the comment Therefore, even though the …

Physicians’ 20th Century Nutrition Education: via Medical Journal Advertisements (Food Has Always Been Medicine)

Physicians' 20th Century Nutrition Education: via Medical Journal Advertisements (Food Has Always Been Medicine)

I know I have the gene that makes me a history geek. While reading Denise Minger’s book, Death by Food Pyramid: How Shoddy Science, Sketchy Politics and Shady Special Interests Have Ruined Our Health, I was attracted to the analysis by Yerushalmy and Hillboe about the association between fat intake and mortality, published in 1957 …

A Different Take- My Conversation With the Author: Diabetes Remission Data from Kaiser Permanente Shows that Patients are Right to Have Hope

A Different Take- My Conversation With the Author: Diabetes Remission Data from Kaiser Permanente Shows that Patients are Right to Have Hope

After recently reading this paper about the natural history of diabetes remission using Kaiser Permanente data, Just Read: Predicting Risk of Diabetes Progression, and Incidence of Remission in Usual Care – data from Kaiser Permanente, I had the opportunity to walk and talk with one of its authors, Shantanu Nundy, MD (@DrNundy) who framed the …

Just Read: Predicting Risk of Diabetes Progression, and Incidence of Remission in Usual Care – data from Kaiser Permanente

Just Read: Predicting Risk of Diabetes Progression, and Incidence of Remission in Usual Care - data from Kaiser Permanente

These are two papers, one just published in one of my favorite journals (@PermanenteJ) and one a few years old, published in Diabetes Care. They are interesting to read together because they both leverage Kaiser Permanente data to understand the health of populations. Predicting the Risk of Diabetes Progression In the Permanente Journal article, the …

Just Read: Evaluating the environmental impacts of dietary recommendations (what is the impact if “recommended” and “healthy” aren’t the same in an era of diabetes reversal)

Just Read: Evaluating the environmental impacts of dietary recommendations (what is the impact if "recommended" and "healthy" aren't the same in an era of diabetes reversal)

Continuing my exploration of what a sustainable diet is in the context of overall health, this paper looks at nationally recommended diets around the globe and the impact on the environment of those recommendations actually being followed. In the United States, for example, there has been a long-standing recommendation, starting in 1961, to reduce fat …

Just Read: Livestock: On our plates or eating at our table? A new analysis of the feed/food debate

Just Read:  Livestock: On our plates or eating at our table? A new analysis of the feed/food debate

This is a follow-up to a comment I received on a previous post (thankful for the kindness of co-innovators). The commenter did not identify themselves, I think it may be Professor Grant Schofield (@grantsnz), but I could also be wrong, in any event, they show a much more expanded knowledge of impacts of diet than …

Just Read: Do low-carbon-emission diets lead to higher nutritional quality and positive health outcomes? A systematic review of the literature.

Just Read: Do low-carbon-emission diets lead to higher nutritional quality and positive health outcomes? A systematic review of the literature.

As the title says, this study looks at whether low-carbon-emission diets (typically those that include less meat, more grains) are correlated with better health. This is important because Climate change is a risk to human health. Climate change increases disparities because it disproportionally affects vulnerable populations. Diversity allows the human species to survive 🙂 Diets …

Just Read: Nutritional and greenhouse gas impacts of removing animals from US agriculture

Just Read: Nutritional and greenhouse gas impacts of removing animals from US agriculture

This study, published in November, 2017, is authored by scientists at Virginia Tech and the US Department of Agriculture, and models a food production scenario in the United States that eliminates animals. This view is interesting because it requires several assumptions to be made, which the authors list: Assumptions when animals are removed from US …

Just Read: Diabetes Prevalence in Sweden at Present and Projections for Year 2050 (what’s the impact of diet going to be?)

Just Read: Diabetes Prevalence in Sweden at Present and Projections for Year 2050 (what's the impact of diet going to be?)

Andersson T, Ahlbom A, Carlsson S. Diabetes Prevalence in Sweden at Present and Projections for Year 2050. Icks A, editor. PLoS One [Internet]. Public Library of Science; 2015 Nov 30 [cited 2017 Dec 29];10(11):e0143084. http://dx.plos.org/10.1371/journal.pone.0143084 I read this piece because I read this piece: Just Read: Is a diet low in greenhouse gas emissions a …

Just Read: Is a diet low in greenhouse gas emissions a nutritious diet? (or what if what was thought to be a nutritious diet is actually higher in greenhouse gas emissions because it is poorer for health)

Just Read: Is a diet low in greenhouse gas emissions a nutritious diet? (or what if what was thought to be a nutritious diet is actually higher in greenhouse gas emissions because it is poorer for health)

I am not an environmentalist – I am a health activist. Climate change is a risk to human health. Climate change increases disparities because it disproportionally affects vulnerable populations. Diversity allows the human species to survive 🙂 I desire to be low carbon, and low carbohydrate, both for health reasons. Is this possible? There are …

Just Read: Alzheimer’s Disease Is Type 3 Diabetes—Evidence Reviewed

Just Read: Alzheimer’s Disease Is Type 3 Diabetes—Evidence Reviewed

I was stimulated to read this paper by: The recent publication in The Lancet of Dementia prevention, intervention, and care. Georgia Ede, MD’s (@GeorgiaEdeMD) talk at Low Carb San Diego (Adventures at Low Carb San Diego ) which was triggered by the above General interest in knowing if there’s a better way to do something …

Just Read: Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, by Robert Lustig, MD

Just Read: Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, by Robert Lustig, MD

Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease Fat Chance was published in 2013 and I know is not the most recent book by Robert Lustig, MD (@RobertLustigMD), a pediatric endocrinologist at UCSF. As I’ve said previously, I’m still catching up 🙂 . The book was a recommendation by Mark Cucuzzella …

Just Read + Thanks for using my photographs: Twenty Years of Change Since the Revitalization Act, State of Business in the District of Columbia, 2017

Just Read + Thanks for using my photographs: Twenty Years of Change Since the Revitalization Act, State of Business in the District of Columbia, 2017

Wow, thank you. This post is a combo thank you and learning more about the city I enjoy so much 🙂 . It’s been wonderful seeing the work of the D.C. Policy Center (@DCPolicyCenter) gain attention over the past year and to be a small part of it through providing some imagery of Washington, DC. …

Just Read: The Effects of Ketogenic Dieting on Body Composition, Strength, Power, and Hormonal Profiles in Resistance Training Males & the era of the social scientist

Just Read: The Effects of Ketogenic Dieting on Body Composition, Strength, Power, and Hormonal Profiles in Resistance Training Males & the era of the social scientist

This is a follow-up review of a paper mentioned in the Ketogenic Bible, and also one that I learned about when I was at Low Carb San Diego (see: ). It references one of the great (unfounded?) fears of people in the nutrition/medicine realm: changing dietary habits or weight loss will preferentially affect muscle vs …

Just Read: The Ketogenic Bible: The Authoritative Guide to Ketosis, by Dr. Jacob Wilson and Ryan Lowery, PhD(c)

Just Read: The Ketogenic Bible: The Authoritative Guide to Ketosis, by Dr. Jacob Wilson and Ryan Lowery, PhD(c)

The Ketogenic Bible: The Authoritative Guide to Ketosis, Dr. Jacob Wilson and Ryan Lowery, PhD(c) I began reading this book over the summer after I went to Low Carb San Diego (see: Adventures at Low Carb San Diego) and saw Jacob and Ryan speak. However, I got side-tracked by another book (Just Read: Tim Noakes …