Saturday, October 29, 2011

Kresser: Thyroid Matters

What’s most important to understand about this condition is that, although it does involve low levels of T3 (the most active form of thyroid hormone), it is not caused by a problem with the thyroid gland. This is a crucial distinction and it’s what distinguishes Low T3 Syndrome from “garden-variety” hypothyroidism.
In this series we’re going to discuss 1) what causes Low T3 Syndrome, 2) it’s clinical significance, and 3) if it should be treated, and if so, how.

Regulation of thyroid metabolism can be broken down into the following five steps:
  1. The hypothalamus (a pea-sized gland in the brain) monitors the levels of thyroid hormone in the body and produces thyrotropin releasing hormone (TRH).
  2. TRH acts on the anterior pituitary (directly below the hypothalamus, but outside of the blood-brain barrier) to produce thyrotropin, a.k.a. thyroid stimulating hormone (TSH).
  3. TSH acts on the thyroid gland, which produces thyroxine (T4) and triiodothyronine (T3), the primary circulating thyroid hormones. The thyroid produces T4 in significantly greater quantities (in a ratio of 17:1) than T3, which is approximately 5x more biologically active than T4.
  4. T4 is converted into the more active T3 by the deiodinase system (D1, D2, D3) in multiple tissues and organs, but especially in the liver, gut, skeletal muscle, brain and the thyroid gland itself. D3 converts T3 into an inactive form of thyroid hormone in the liver.
  5. Transport proteins produced by the liver – thyroid binding globulin (TBG), transthretin and albumin – carry T4 and T3 to the tissues, where they are cleaved from their protein-carriers to become free T4 and free T3 and bind to thyroid hormone receptors (THRs) and exert their metabolic effect.
http://chriskresser.com/low-t3-syndrome-i-its-not-about-the-thyroid
A long series which answer "everything you ever wanted to know about your thyroid."

Friday, October 28, 2011

Kresser: B12

B12 deficiency is often missed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low. This is why most studies underestimate true levels of deficiency. Many B12 deficient people have so-called “normal” levels of B12.
Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).

Read on to find out how to test your B12 level, why 50% of vegetarians and 80% of vegans are B12 deficient, and why you may also be deficient, even on a Paleo diet, due to meds or other irregularities.

Thursday, October 27, 2011

Kresser: Stressed, Diabetic, Obese

A huge – and I mean huge – amount of research over the past two decades shows that stress causes both obesity and diabetes in a variety of ways. Studies also show that stress makes it hard to lose weight.
When stress becomes chronic and prolonged, the hypothalamus is activated and triggers the adrenal glands to release a hormone called cortisol. Cortisol is normally released in a specific rhythm throughout the day. It should be high in the mornings when you wake up (this is what helps you get out of bed and start your day), and gradually taper off throughout the day (so you feel tired at bedtime and can fall asleep).
Recent research shows that chronic stress can not only increase absolute cortisol levels, but more importantly it disrupts the natural cortisol rhythm. And it’s this broken cortisol rhythm that wreaks so much havoc on your body. Among other effects, it:
Each one of these consequences alone could make you fat and diabetic, but when added together they’re almost a perfect recipe for diabesity.
http://chriskresser.com/10-ways-stress-makes-you-fat-and-diabetic

So, just get rid of stress, problem solved, right?  R-I-G-H-T!!
Best concept of stress management available is here: 
http://activinsight.com/
http://www.psychologytoday.com/blog/the-myth-stress/201004/the-myth-stress-revealed
http://www.forbes.com/sites/marcbabej/2011/06/02/the-myth-of-stress-a-concept-worth-reading-about/
http://www.amazon.com/Myth-Stress-Really-Happier-Healthier/dp/1439159459

Wednesday, October 26, 2011

Kresser: Diabesity

Obesity, insulin resistance, metabolic syndrome and type 2 diabetes have reached epidemic proportions. There’s not a person reading this article who isn’t affected by these conditions, either directly or indirectly. Yet as common as these conditions are, few people understand how closely they’re related to one another.
It is now clear that not only do these conditions share the same underlying causes – and thus require the same treatment – they are 100% preventable and, in some cases, entirely reversible.
Because of these similarities, Dr. Francine Kaufman coined the term diabesity (diabesity + obesity) to describe them. Diabesity can be defined as a metabolic dysfunction that ranges from mild blood sugar imbalance to full-fledged type 2 diabetes. Diabesity is a constellation of signs that includes:
  • abdominal obesity (i.e. “spare tire” syndrome);
  • dyslipidemia (low HDL, high LDL and high triglycerides);
  • high blood pressure;
  • high blood sugar (fasting above 100 mg/dL, Hb1Ac above 5.5);
  • systemic inflammation; and,
  • a tendency to form blood clots
  • http://chriskresser.com/diabesity
This isn't just a US problem, it is worldwide, and affects an astronomical number of people.  We sell a lot of drugs to a lot of folks to offer treatment of the symptoms.  Strangely, those drugs are totally un-needed - because the disease is a dietary disease, and all of the symptoms can be treated by un-frocking one's diet.  But our government, inexplicably, recommends a diet which does not help with diabesity and for most, makes it worse.  The Brit government has one upped that, and made statins available over the counter.  It sometimes feels like reverso world.

Tuesday, October 25, 2011

Kresser: Statins

Statins are the most popular drugs in history. Drug companies made $26 billion selling statins alone in 2008. 25 million Americans take them, and the number is growing each year.
One reason why statins are the best-selling drug category by far is that 92% of people taking them are healthy. The FDA has approved the prescription of statins to people at low risk for heart disease and stroke, who don’t even have high cholesterol. Two years ago the American Academy of Pediatricians recommended that statins be prescribed for kids as young as eight years old.
With sales statistics like this, you’d think statins are wonder drugs. But when you look closely at the research, a different story emerges. Statins have never been shown to be effective for women of any age, men over 65, or men without pre-existing heart disease. Early studies did suggest that statins are effective for men under 65 with pre-existing heart disease, but later, more rigorous clinical trials has not confirmed this benefit.
In addition, statins have been shown to have serious side effects and complications in up to 30% of people who take them. Studies have also shown that the majority of these adverse events go unreported, because doctors are largely unaware of the risks of statins.
http://chriskresser.com/the-hidden-truth-about-statins

Plain truth, which I think even doctors would agree with - if you can get healthy by eating smarter, and stop using statins, it is an all win case for virtually any of us.

Monday, October 24, 2011

Kresser on Minger

This is the beginning of the Kresser Week.  It goes without saying that I don't see everything the same as Chris, but that's never mattered.  What matters is how much clear thought and good information you can get from his site.
Usually I direct those folks to Chris Masterjohn’s excellent critique of the China Study. Now, however, I’ll be sending them over to read Denise Minger’s freshly published China Study smackdown.
http://chriskresser.com/rest-in-peace-china-study
Denise got hold of the raw study data and took it apart with a fine-toothed comb. And what she found is that the claims Campbell made in his China Study book are not supported by the data. She also found important data points Campbell never bothered to mention in the book because they didn’t support his vegan agenda.
For example, Campbell conveniently fails to mention the county of Tuoli in China. The folks in Tuoli ate 45% of their diet as fat, 134 grams of animal protein each day (twice as much as the average American), and rarely ate vegetables or other plant foods. Yet, according to the China Study data, they were extremely healthy with low rates of cancer and heart disease; healthier, in fact, than many of the counties that were nearly vegan.
You can read more – and I mean a lot more – over at Denise’s blog. I recommend starting with her article China Study: Fact or Fallacy? For many of you, it will be more than enough. But if you’re interested in this stuff, she has written several other articles worth reading.
There are also reviews of Denise’s article at Free the Animal, Whole Health Source, Robb Wolf and PaNu.

The China Study is a fascinating phenomenon, first that they did it, and second, how it became the Holy Grail of those who want to prove that eating animals will kills you, and now - as an example of why peer review is considered a cornerstone of science.  It's also pointing at a truth - professional journals are no longer either necessary, or useful, in the peer review process, since they have to compete with highly motivated and brilliant investigators like Ms. Minger. 
And for the record, again, I don't care if you don't want to eat animals.  I don't, however, want you to use fraud or the force of the government to keep me from eating animals.  I have as much right to eat animals as tigers, fish and sharks do.  Take that back - animals don't have rights and shouldn't.  I am a human and I have rights as I should.
Politics of food and science and such aside, the China Study was a massive observational study.  The value of observational studies in science is that they allow detection of corellation, so that the correlations may be further investigated in order to determine causality.  In my opinion, we already have far more observational studies than we can use as regards diet and health.  We need to spend a bazillion dollars for an outrageously expensive, long term intervention study that will be almost impossible to execute well - or just hang up our "spurs."  There really is little more to be learned from observational studies of generalized diet and health matters. 
One thing we have learned is that the China Study never meant what it was purported to mean. 
Nevermind what any of the observational studies say - eat meat and vegetables, nuts and seeds, little fruit or starch, no sugar/wheat so that your body will manage your glucose, your lipid profile will reflect the health that is your homo sapien birthright, and you will therefore have the best chance to enjoy your days and maximize your purpose. 

Friday, October 21, 2011

The Dark Side of Mercola

This is the sort of speculation and faux judgement disguised as insight and wisdom, up with which, I will not put (with apologies to Sir Winston C):  http://articles.mercola.com/sites/articles/archive/2011/10/21/seeing-red-over-pink-the-dark-side-of-breast-cancer-awareness-month.aspx

I have plenty in common with the good doc on the idea of carb restriction, and frequently enjoy his articles.  The ill logic in this article does not inspire confidence in the doctor's commitment to truth. 

First, he quotes some organization that finds that blaming any victim is wrong, even if the victim is to blame.  "Truth" anyone?
"Imperial Chemical Industries has supported the cancer establishment's blame-the-victim attitude toward the causes of breast and other cancers. This theory attributes escalating cancer rates to heredity and faulty lifestyle, rather than avoidable exposures to industrial carcinogens contaminating air, water, food, consumer products, and the workplace."
~ Cancer Prevention Coalition

Next, he delivers this pablum:
The primary causes of breast cancer: nutritional deficiencies, exposure to environmental toxicity, inflammation, estrogen dominance and the resultant breakdown in genetic integrity and immune surveillance, are entirely overlooked by this fixation on drug therapy and its would-be "magic bullets" and the completely dumbed down and pseudo-scientific concept that "genes cause disease."
This logic is as circular as the arguments which is critiques.  Sure, genetic susceptibilities determine how the neolithic lifestyle will be expressed as disease, but they do not seem to be the cause of disease itself.  That said, there's still no evidence, despite years of protestation to the contrary, that "environmental toxicity" is a special driver of disease.  If you are a greenie, though, industry sure is a convenient target.

This is another absolute jewel of logic:
On first account, a pharmaceutical "cure" is as unlikely as it is oxymoronic. Drugs do not cure disease anymore than bullets cure war.
First off, if you have enough bullets, the other guys are not likely to make war on you in the first place as our history demonstrates fairly convincingly.  Secondarily, if there's a war, bullets are a essential to ending it.  We can argue to the semantics of whether or not ending a war is a "cure" - but unless the analogy implies that we have to get rid of every weapon every rock, every pointed stick to "cure" war, this is as meaningless a slogan as JFK's signature "Ask not what your country can do for you" line.  Pure propaganda.

Billions of dollars are raised and funneled towards drug research, when the lowly turmeric plant, the humble cabbage and the unassuming bowl of miso soup may offer far more promise in the prevention and treatment of breast cancer than all the toximolecular drugs on the market put together.
Hey, I have my own frustrations with the focus on creating powerful drugs to fix that which neolithic diets break.  But there's an easy solution here - find someone to fund a big intervention study to test this conjecture, and until then, quit whining.
Which brings us to this fabulous display of the complete abandoment of logic and scientific proof as regards advancing the understanding of the cause of disease:
Have we really come to the point where the common sense consumption of fruits and vegetables in the prevention of disease can so matter-of-factly be called into question? Do we really need randomized, double-blind and placebo controlled clinical trials to prove beyond a shadow of a doubt that our bodies can benefit from the phytonutrients and antioxidants in fruits and vegetables in the prevention of cancer?
Well, heck no, let's use strongly held belief and years of vegetarian propaganda as proof instead!!!  I've looked and can still find no reason to believe that fruits and vegetables, organic or otherwise, are a magic bullet for health.  Do you need some fruit and veg?  Sure, have some.  Do they taste good?  Heck yes, I love to eat them.  Are they less harmful than twinkies?  Sure seems like it to me, since they don't flood the body with sugar and omega 6 fats and transfats.  Are they essential to good health?  Nope.  And that's a good thing because there's nothing more destructive or toxic to the environment than industrial scale production of fruits and vegetables.
You can find populations who rarely if ever ate fruits and veggies and they looked and lived about as well as the paleo populations who had full (if seasonal) access to fruits and veggies. 
What it seems to boil down is that the fruitnicks have said "fruits and veggies are health's magic bullets!" so many times and for so long that the masses have bought into that strongly held belief as strongly as they bought into the low fat nonsense.
Just when I'm ready to boycott the Mercola site once and for all, this article delivers this stunner:
GrassrootsHealth is changing the current Breast Cancer Awareness Month to Breast Cancer Prevention Month with a focus on taking action to prevent breast cancer with vitamin D testing and education.
"It's time to take action, women are already fully aware of breast cancer and its consequences," says Carole Baggerly, director of GrassrootsHealth. "When you can project that fully 75 percent of breast cancer could be prevented with higher vitamin D serum levels, there is no justification for waiting to take preventive measures such as getting one's vitamin D level up to the recommended range of 40-60 ng/ml (100-150 nmol/L)."
According to Dr. Cedric F. Garland of the Moores Cancer Center and the UCSD School of Medicine:
"This will potentially be the most important action ever conducted toward prevention of breast cancer. The more women who participate in this study, the greater the chance that we will defeat breast cancer within our lifetimes."
Women across the world are invited to enroll in a 5-year Breast Cancer Prevention Study initiated by GrassrootsHealth. To be eligible to enroll, you must be at least 60 years of age and have no current cancer. A free vitamin D home test kit will be provided for the first 1,000 women to enroll. The study aims to fully demonstrate health outcomes of vitamin D serum levels in the range of 40-60 ng/ml (100-150 nmol/L) and will examine the occurrence of breast cancer among a population of women 60 and over who achieve and maintain a targeted vitamin D serum level in the bloodstream. In addition to breast cancer prevention, short-term effects of vitamin D such as hypertension, falls, colds and flu will also be tracked. More information can be found at www.grassrootshealth.net.

Brilliant!

Thursday, October 20, 2011

Right When Wrong

I received another email about the topic of running from Mike Boyle -
and enjoyed it, even though I think he's wrong.

How to help an athlete run faster is a concern for any coach and/or parent of an athlete (would be athlete?).  In every game I watch my kids play, the athlete with the most speed generally makes the most impact - not always, but it evident what they say is true, "there is no substitute for speed." 

There is also no shortage of strongly held beliefs about running and how to run faster.  There are any number of tools designed for the purpose - ladders, dot drills, mini barricades, jump ropes, etc.  What's interesting is how little data there is to validate any particular method.  I consider this something of an indictment against exercise science.  How many years will take until they define what running is a devise a way to measure where it comes from and why? 

You don't need scientists in a university lab to figure out how to make people faster, though.  Barry Ross has impressive athletes, and he focuses on deadlifts (to the tune of 130 pound teen aged female athletes deadlifting over 400 pounds?!) and additional core training, and hard, short sprinting.  Louie Simmons reports he can take an accomplished collegiate football player and reduce the athlete's 40 yard sprint time with a combination of strength and power training and with no sprinting.  Obviously, Mike Boyle agrees with these two about where speed comes from:
It is not how fast the feet move, but rather how much force goes into the ground. This is basic action-reaction physics. Force into the ground equals forward motion. This is why the athletes with the best vertical jumps are most often the fastest. It comes down to force production. Often coaches will argue the vertical vs. horizontal argument and say the vertical jump doesn't correspond to horizontal speed, but years of data from the NFL Combine begs to differ.
The best solution to slow feet is to get stronger legs. Feet don't matter. Legs matter. Think about it this way: If you stand at the starting line and take a quick first step but fail to push with the back leg, you don't go anywhere. The reality is that a quick first step is actually the result of a powerful first push. We should change the buzzwords and start to say "that kid has a great first push." Lower body strength is the real cure for slow feet and the real key to speed and to agility. The essence of developing quick feet lies in single-leg strength and single-leg stability work… landing skills. If you cannot decelerate, you cannot accelerate, at least not more than once.
The reality is it comes down to horsepower and the nervous system, two areas that change slowly over time.
How do we develop speed, quickness and agility? Unfortunately, we need to do it the slow, old-fashioned way. You can play with ladders and bungee cords all you want, but that is like putting mag wheels on an Escort.
...development of speed, agility and quickness simply comes down to good training. We need to work on lower body strength and lower body power and we need to do it on one leg.
 

I subscribe more to the idea that speed comes from gravity, vice the idea that it comes from a leg propelling us forward, but will again note: there is a distinct lack of proof in this arena, which is why there's so much argument!  In the "speed comes from gravity" idea as advanced most notably by Dr. Nicholas Romanov (http://www.posetech.com/), running is the process of falling forward under the influence of gravity.  In this model, the ability to change support the fastest (support being the leg underneath you that prevents gravity from pulling you all the way down to the ground) will result in the fastest runner.  The ability to change support more rapidly seems to result from the ability to generate force against the ground - quickly.

The interesting thing, by the way, once you start looking at running this way, is how many ways you can interfere with the process of falling.  "As easy as falling off of a log?"  Yes, but not as simple. 

But suppose for a moment, that Mike Boyle and others are correct in the prescription for speed - suppose strength and power development is the "secret" to running, not because it allows one to propel oneself with a leg, but because he with the most ability to exert force can change legs faster, and therefore sustain a greater angle of body lean (to be clear, body lean is the angle between the point of support and the point where the center of gravity is found, meaning the "lean" will not be obvious; we're not talking about head and shoulders "leaning" ahead of the body like a tree falling), which would allow gravity to better accelerate the runner in question. 

If this bit of conjecture is true, then Boyle could right (about how to train) even though he is wrong (about why to train that way). 

Why do you care?  For one thing, it is true that the best runners run like Dr. Romanov prescribes, and this is a skill that can be taught.  You may not be able to transform yourself into Usain Bolt by "learning how to run" but you can run with less effort, more speed, and less destruction of your joints by running in way the body was designed to run.  From what I can tell in my fledgling efforts to do so, running with skill also feels very good.
(Minor edits December 5, 2011)

Monday, October 17, 2011

Magnesium and Inflammation

Summary : To evaluate the association between severe hypomagnesemia and the low-grade inflammatory response in subjects with metabolic syndrome (MetS), ninety-eight individuals with new diagnosis of MetS were enrolled in a cross-sectional study. Pregnancy, smoking, alcohol intake, renal damage, hepatic disorders, infectious or chronic inflammatory diseases, malignancy, use of diuretics, statins, calcium antagonist, antioxidants, vitamins, anti-inflammatory drugs, or previous oral magnesium supplementation were exclusion criteria. According serum magnesium levels, participants were assigned to the following groups: 1) severe hypomagnesemia (≤1.2 mg/dL)\; 2) hypomagnesemia (>1.2≤1.8 mg/dL)\; 3) Normal serum magnesium levels (>1.8 mg/dL). The low-grade inflammatory response was defined by elevation of serum levels of (CRP;1.0 ≤10.0 mg/L) or TNF-alpha (TNF-α ≥3.5 pg/mL). Severe hypomagnesemia, hypomagnesemia, and normomagnesemia were identified in 21 (21.4%), 38 (38.8%), and 39 (39.8%) individuals. The ORs, adjusted by WC, showed that severe hypomagnesemia (OR: 8.1\; CI 95%: 3.6-19.4 and OR: 3.7\; CI 95%: 1.1-12.1), but not hypomagnesemia (OR: 1.8\; CI 95%: 0.9-15.5 and OR: 1.6\; CI 95%: 0.7-3.6), was strongly associated with elevated CRP and TNF-α levels, and that normomagnesemia exhibited a protective role (OR: 0.32\; CI 95%: 0.1-0.7 and OR: 0.28\; CI 95%: 0.1-0.6) for elevation of CRP and TNF-α. Results of this study show that, in subjects with MetS, severe hypomagnesemia, but not hypomagnesemia, is associated with elevated concentrations of CRP and TNF-α.
http://www.jle.com/en/revues/bio_rech/mrh/e-docs/00/04/69/2E/resume.phtml

What's the story here?  Since you don't get magnesium in your water any longer, you likely need to supplement.  Good news?  It's easy and cheap to do! http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=natural+calm
The 16oz bottle lasts months.  The Eades and Robb Wolf advocate supplementing this mineral, with the recommendation that it be taken before bedtime as a natural "calming" or "soothing" effect.  However, beware, too much will create the Milk of Magnesia effect, go easy at first, and add more to discovery how much you can tolerate.

Friday, October 14, 2011

Jaminets on LLVC

This is a long, detailed post by the Jaminets, and not necessary for the average guy or gal to understand in order to be healthy on a paleo prescription.  However, for those geeks wanting to delve into the workings of the human body, it's highly explanatory:

Brain and nerves typically consume about 480 calories per day of glucose. Ketones can displace up to perhaps 60% of this, but ketones do not diffuse well into cortical areas of the brain and the brain always requires some glucose.
After 3 days of fasting, when the brain’s glucose consumption has been roughly halved by ketosis and the rest of the body is conserving glucose, the body’s rate of glucose manufacture in liver and kidneys is about 600 calories per day. [1]
Two things to note:
  • Even in fasting, peripheral utilization of glucose exceeds the brain’s.
  • The fasting level of glucose utilization is likely to be suboptimal for health: fasting invokes glucose-and-protein-conservation measures which evolved to make us more likely to survive famine, but almost certainly have a cost in long-term health. (The logic is similar to Bruce Ames’s triage theory [2].)
This fasting level of glucose production of about 600 calories per day is a key number: the body must obtain glucose at at least this level, either through diet or endogenous production, if it is to avoid a glucose deficiency.
When not fasting, the body’s glucose utilization is somewhat higher – say, 800 to 1000 calories per day for a sedentary person. Glucose needs are slightly reduced by some endogenous sources of glucose, such as from glycerol released from lipolysis of triglycerides or phospholipids. So the body’s net glucose needs are on the order of 600 to 800 calories per day.
http://livinlavidalowcarb.com/blog/paul-jaminets-response-to-the-critics-of-his-safe-starches-concept/11920
What's the bottom line?  Nearly all the players in the low carb arena point out a break point at about 100 to 120 grams per day of carb consumption, because at this level, your body has to produce enough carbohydrate to fully meet your carb needs.  That means you will not be giving your body an excess glucose problem to solve (assuming the ~120g is mostly "good" carbs!). 

There are folks who need to eat fewer carbs to maintain health and weight loss, and I do well on less than 100g/day.  For example, since January of 2007 when I weighed 225, I've sustained a 15 pound weight loss, which put my under 15% body fat, which is easily in a safe, functional range.  In the last few months, I've reduced my weight by another 10 pounds, by combining intermittent fasting with carb restriction.  I'm within about five pounds of matching my body weight as a 22 year old.   That's nothing special, but doing that without counting or even considering caloric intake, or hunger, while eliminating a compulsive sweet tooth, and generating good numbers on every objective health measure, and competing at a reasonably high level in CrossFit, whilst working against a poor genetic back ground (as regards weight gain on the SAD), is an endorsement of a paleo oriented carb restriction - in my humble as ever opinion.

Wednesday, October 12, 2011

Muscle Mass Is A Bonus for Diabetes/Metabolic Syndrome

Abstract

Context: Insulin resistance, the basis of type 2 diabetes, is rapidly increasing in prevalence; very low muscle mass is a risk factor for insulin resistance.
Objective: The aim was to determine whether increases in muscle mass at average and above average levels are associated with improved glucose regulation.
Design: We conducted a cross-sectional analysis of National Health and Nutrition Examination Survey III data.
Participants: Data from 13,644 subjects in a national study were evaluated.
Outcome Measurements: We measured homeostasis model assessment of insulin resistance (HOMA-IR), blood glycosylated hemoglobin level, prevalence of transitional/pre- or overt diabetes (PDM), and prevalence of overt diabetes mellitus.
Results: All four outcomes decreased from the lowest quartile to the highest quartile of skeletal muscle index (SMI), the ratio of total skeletal muscle mass (estimated by bioelectrical impedance) to total body weight. After adjusting for age, ethnicity, sex, and generalized and central obesity, each 10% increase in SMI was associated with 11% relative reduction in HOMA-IR (95% confidence interval, 6–15%) and 12% relative reduction in PDM prevalence (95% CI, 1–21%). In nondiabetics, SMI associations with HOMA-IR and PDM prevalence were stronger.
Conclusions: Across the full range, higher muscle mass (relative to body size) is associated with better insulin sensitivity and lower risk of PDM. Further research is needed to examine the effect of appropriate exercise interventions designed to increase muscle mass on incidence of diabetes.
http://jcem.endojournals.org/content/96/9/2898.abstract

The second half of this study would be to determine if increasing muscle mass will in fact result in increased insulin sensitivity, or if the correlation is just the result of the some other causative agent.  For example, it is highly likely that those with better insulin sensitivity will be that way because they eat better food, with a lower carb content, and as a result, feel better and are more active.  

Tuesday, October 11, 2011

Jobs - Inspired, Inspiring


 "Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma - which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary."
"When I was 17, I read a quote that went something like: ‘If you live each day as if it was your last, someday you'll most certainly be right.' It made an impression on me, and since then, for the past 33 years, I have looked in the mirror every morning and asked myself: ‘If today were the last day of my life, would I want to do what I am about to do today?' And whenever the answer has been ‘No' for too many days in a row, I know I need to change something."
"Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don't settle."
Easy to say, hard to do.  Persevere.

Monday, October 10, 2011

Work On Your Weakness!! Sort of ...

Just then he stopped me and said something I’ll never forget: “That’s exactly your problem.”
As we turned onto the Interstate, I sat there thinking that Louie was out of his mind. How could being strong in the gym be a bad thing?
How can being strong as hell in the gym be a bad thing?
“You know what you need, Dave?” Louie continued. “You need to do those things you suck at. You’re at a point where your weaknesses are killing you, and you’re doing nothing to address them. Your legs and upper back can easily squat a grand, but your abs and lower back can’t squat 860 pounds. Which do you think you’ll squat, 1000 or 860?
http://articles.elitefts.com/articles/training-articles/the-vault-do-the-stuff-you-suck-at/

This is one of the most complex and simple subjects in life, not to mention fitness.  If you are a detail guy, you won't be successful working on inspiration and charm - but you better be doing something to round these skills out.  If you are at your best in a dynamic event where you get to keep a bunch of balls in play but don't have to worry for days on end about details, awesome, but you better have some activity in your life that allows you to, demands that you, work on the details.  I've seen this play out a number of times - the best on the planet routinely fail when they ride their competence into an arena in which their competence is no longer enough to meet all the demands they face.  Presidents, football coaches, naval officers, fitness professionals, you see them all finding out what Napoleon found out at Waterloo. 

As for the powerlifter's tale above - he says he needs to work on the thing he sucks at, but I'll bet he did not actually do that.  He sucks at anything with a duration greater than about 10 seconds.  What he worked on was making his torso strength better in the less than 10s arena that powerlifters specialize in.  IOW, he working on an attribute that was weak relative to some aspect of his competence, but he stayed within his area of competence - developing incredible amounts of force for a very short time.  Should he have been on a bike or rower instead, seeking to enhance his ability to generate very little force for a very long amount of time?  Nope, not to be a champion powerlifter - but yes, to be a healthier and more functional human being.

CrossFit advocates working on weaknesses in a different perspective, but I even have trouble with that.  For example, if I can run now as fast as I could when just about all I did was run, but I don't run much, I see little virtue in spending more time running.  The real challenge becomes in how to assess your weakness - which is really, relative weakness.  I know there are many athletes that are better than I in every arena, so I could be considered weak in all aspects.  What I need to know is - in which arena is my relative ability the least?  For a CrossFit athlete, accurate assessment of weakness is critical information which, if addressed effectively, will provide the best return on training time.

For most non-competitive and non-CrossFitters, the best advice is "just do something".  Any training you will do is good.  If you are looking for training considerations, I would recommend to anyone that learning how to squat properly is fundamental to a good life, and keeping oneself out of a nursing home.  In other words, if you did ten squats to your best depth (at least parallel) every day, you would never have to fear being too weak or immobile to cart yourself around.  The exception to that is if your mind goes, but then you won't care whether you are in a nursing home anyway.

Friday, October 7, 2011

USDA Helps and Hurts

Fascinating angle on the interaction between crony politics and weight gain.  http://www.foxnews.com/politics/2011/09/22/new-report-links-agricultural-subsidies-to-childhood-obesity/#ixzz1ZHq1YPBG

But the real problem is the fact that the USDA insists on weighing in about what foods are or are not healthy, but lacks to science to back up their assertions.

Thursday, October 6, 2011

Statin Trifecta

This is a long, brilliantly written post, with a very interesting conclusion, that lives up to its title (How Statins Really Work Explains Why They Don't Work):
So, in my view, the best way to avoid heart disease is to assure an abundance of an alternative supply of cholesterol sulfate. First of all, this means eating foods that are rich in both cholesterol and sulfur. Eggs are an optimal food, as they are well supplied with both of these nutrients. But secondly, this means making sure you get plenty of sun exposure to the skin. This idea flies in the face of the advice from medical experts in the United States to avoid the sun for fear of skin cancer. I believe that the excessive use of sunscreen has contributed significantly, along with excess fructose consumption, to the current epidemic in heart disease. And the natural tan that develops upon sun exposure offers far better protection from skin cancer than the chemicals in sunscreens.

I wouldn't say that Dr. Mercola's site is an unbiased source for information but that's probably to the good in this case, because his site will publicize information like this:
A study found that statin drugs are associated with decreased myocardial (heart muscle) function.
Statin use is known to be associated with myopathy, muscle weakness and rhabdomyolysis, a breakdown of muscle fibers resulting in the release of muscle fiber contents into the bloodstream. For the study, myocardial function was evaluated in 28 patients.
According to Green Med Info:
“There was significantly better function noted ... in the control group vs the statin group”.
A study found that statin drugs are associated with decreased myocardial (heart muscle) function.
Statin use is known to be associated with myopathy, muscle weakness and rhabdomyolysis, a breakdown of muscle fibers resulting in the release of muscle fiber contents into the bloodstream. For the study, myocardial function was evaluated in 28 patients.
According to Green Med Info:
“There was significantly better function noted ... in the control group vs the statin group”.

Dr. Briffa is also refreshing for his "biased" reporting:
It’s easy to believe that statins have dramatic life-saving properties. The reality is, however, that for the majority of people who take them, they don’t. In the biggest and best review published to date, statins were not found to reduce overall risk of death in individuals with no previous history of cardiovascular disease [1]. What this study shows is that for great majority of people who take statins, the chances of them saving their life are, essentially, nil (just so you know).

Wednesday, October 5, 2011

Wheat Growers Should Be Arrested In The Drug Wars

Almost without exception, all people on earth today are sustained by agriculture. With a minute number of exceptions, no other species is a farmer. Essentially all of the arable land in the world is under cultivation. Yet agriculture began just a few thousand years ago, long after the appearance of anatomically modern humans.
Given the rate and the scope of this revolution in human biology, it is quite extraordinary that there is no generally accepted model accounting for the origin of agriculture. Indeed, an increasing array of arguments over recent years has suggested that agriculture, far from being a natural and upward step, in fact led commonly to a lower quality of life. Hunter-gatherers typically do less work for the same amount of food, are healthier, and are less prone to famine than primitive farmers (Lee & DeVore 1968, Cohen 1977, 1989). A biological assessment of what has been called the puzzle of agriculture might phrase it in simple ethological terms: why was this behaviour (agriculture) reinforced (and hence selected for) if it was not offering adaptive rewards surpassing those accruing to hunter-gathering or foraging economies?
This paradox is responsible for a profusion of models of the origin of agriculture. 'Few topics in prehistory', noted Hayden (1990) 'have engendered as much discussion and resulted in so few satisfying answers as the attempt to explain why hunter/gatherers began to cultivate plants and raise animals. Climatic change, population pressure, sedentism, resource concentration from desertification, girls' hormones, land ownership, geniuses, rituals, scheduling conflicts, random genetic kicks, natural selection, broad spectrum adaptation and multicausal retreats from explanation have all been proffered to explain domestication. All have major flaws ... the data do not accord well with any one of these models.'
Recent discoveries of potentially psychoactive substances in certain agricultural products -- cereals and milk -- suggest an additional perspective on the adoption of agriculture and the behavioural changes ('civilisation') that followed it. In this paper we review the evidence for the drug-like properties of these foods, and then show how they can help to solve the biological puzzle just described.

http://disweb.dis.unimelb.edu.au/staff/gwadley/msc/WadleyMartinAgriculture.html

Really interesting points, and it seems like that they are correct that the addictive properties of grains played a significant role in their adoption - but I also think Diamond's answer is correct:  agriculture resulted in the "Guns, Germs and Steel" that allowed smaller, weaker, sicker agriculturalists to out breed hunter gatherers, and to out specialize and thus over power them.  Blacksmiths, politicians, religious leaders, wheel makers, etc.  By the time we agriculturalists began to study the hunter gathers with the idea of learning what made them so much healthier, they had already been pushed out of the most desirable areas, and the image we sustained of them, for the most part, was that "they are savages."  OK, but they also would easily outlive, outwork and outplay us - if they wanted to - and lived free of the fear of cancer, heart disease, and the other diseases of civilization.  There's no going back, and I wouldn't if I could, but it is foolish to try to understand human health without considering the fact that we are built to hunt and gather, eat with the seasons, get vitamin D from the sun, eat the essential fatty acids and micronutrients we need from the animals we kill, and sleep when it is dark.  Picking seeds and grinding them for bread or paste is not the yellow brick road for human health.

Tuesday, October 4, 2011

Jumping Is Big Money

Advice from an expert on preparation for learning the olympic lift (clean and jerk, and the snatch):
10. Correct flexibility problems before attempting to coach the Olympic lifts. 
11. One athletic skill should precede learning the Olympic lifts: jumping. The most important skill an athlete should bring to training is the ability to perform a technically sound vertical jump, preferably out of a full squat.
12. Holding a rack position for the clean should be learned before attempting to perform the squat
clean. The improvement of a rack position for the clean depends on the specific impeding problem. Many people can’t get their shoulders forward to rest the bar on the deltoids.  Others take the wrong grip width. Both of these can be experimented with. Figuring out how to front-squat properly will do much to teach the proper rack position. There are a few people who cannot ever rack for a variety of reasons.
I point this info out because some will use it to get themselves ready to Oly lift, but also to make the point that Oly lifting is great for athleticism mainly because it allows one to jump with a load, which is otherwise difficult to do.  That said, if you are training a youngster, one of the absolute finest methods to use for them is to get them to jump.  Make it a game, vice work.  If you want to set up a way for them to jump to progressively higher levels, that's great too, but mostly kids need play.  Broad jumps, box jumps, rope jumping, drop jumps, speed jumps to low boxes, or repetitive jumps to higher boxes ... it is all fabulous, and relatively low risk (no risk training incurs a high risk of having no benefit at all) training for kids. 

What are the benefits?  Well, one is motor neuron recruitment for power output (there're are few of us who don't need this), bone density, coordination, balance and confidence in moving ourselves through space.  If you kids do any physical activity with an eye on performance, jumping is good training for them.  Make as many jumping games as you can.  Note their interest and when it is high, encourage them to play with jumping and give them mountains of attention for their jumping play.  Record their PRs, video their play, tell their grandparents what they've done lately when they can tell you are bragging on them. 
And whatever you do, don't let them get sucked down the black hole of endurance training until they are over 15 or so ... unless you think the gift of a lifetime of SLOW is good.

Some individuals are not ready to begin Oly lifts due to a lack of range of motion at the shoulders, hips and ankles, or a lack of torso strength or leg strength. Standing presses, flat-footed squats with a straight back and straight-legged, wide-stance good mornings will best remediate these issues before technique training can begin.

Monday, October 3, 2011

Of Course Not

When I first started reading this blog, I thought the posts were nice but boring.  But these folks are right on target - fabulous work, searing insight.
I used to work in some of these neighborhoods that are considered "food deserts"- the term that has been assigned by advocacy groups to areas where there is a lack of supermarkets and access to fresh food. Most of the programs designed to improve nutrition in these areas focus on bringing more fruits and vegetables to these families, either through increased vegetable markets and produce stands, food stamp programs that can be used at farmers markets, and education programs (teaching families to eat more fruits and vegetables). Ten years in and it doesn't seem like these food programs are really working since morbidity rates keep going up. This leads me to believe that simply providing more fruits and vegetables may not be the answer.

Obesity, diabetes, and other associated chronic diseases are associated with poverty. In the past, poor Americans suffered from being underweight due to malnutrition and food insecurity. Today, poor Americans suffer from being overweight due to malnutrition and food insecurity. Cheap, processed nutritionally poor foods (or food stuff) are more ubiquitous and abundant in the US then they ever have been in the history of this country. So are poor people eating more junk food? Probably, but bad choices are not the only reason and are only part of the picture. Poverty is associated with many determinants of bad health - it's not just about eating fast food. Other significant factors are stress (social, financial, work), lack of health care, lack of education, depression, disrupted routines because of familial or employment insecurity, cultural norms (i.e. - fear of food insecurity can cause parents to over feed children), lack of outdoor space for physical activity, lack of resources for any activity, and reliance on poor quality food either in “food desert” neighborhoods or in the form of food aid, to name just a few.

So while these programs are well-meaning, and I do think that increasing good supermarkets, farmers markets, and fruit and vegetable stands in food deserts are positive steps in the right direction, I think new approaches to food access and nutrition must address these other problems with multi-pronged strategies at different policy levels for improvement - not just teaching people "how to..."

First, I think it's paternalistic, elitist, and irresponsible for government or non-profit organizations to think they should "teach" people how to eat, and that lesson being: eat like a vegan. This is not to say that we, especially those of us with chronic diseases, shouldn't be provided with nutritional information and guidelines on what we should and shouldn't be eating (obviously no sugar and carbs for diabetics). But most of you already know where I stand on carb and protein intake - so you know where I'm going with this. Of course, convincing people to cut back on processed fast food and getting them to cook fresh food at home would be ideal. But trying to convince people to eat expensive organic fruits and vegetables to fill bellies that have been used to calorie-dense starchy, sugary carbs is not exactly the most satisfying alternative or realistic approach.

Along with plenty of vegetables and some fruits (but not for diabetics), part of these guidelines should also include healthy animal proteins and fats - which are both energy and nutritionally dense foods. They fill you up, give you energy, and won't cause insulin resistance or diabetes. Our
present nutritional guidelines that are promoted both by government and non-government agencies are created from junk science, ideological trends, and advertising. They distract us from our traditional diets that have kept our ancestors healthy for generations. Until we start promoting REAL food again and stop believing there is a magic bullet (like non-fat, soy, spelt, gluten-free, whole grain, organic cane juice, agave sweetened, nugget/food/stuff), we will continue to get fat and sick. And until we approach the root causes of poverty and tackle the different problems associated with bad health outcomes, we will continue to see a rise in these chronic diseases and mortalities.
http://youarewhatieat.blogspot.com/2011/09/more-fruits-and-vegetables-is-not.html

Sunday, October 2, 2011

Get Your Sulphur On

Fascinating concept:

"The macrophages in the plaque take up LDL, the small dense LDL particles that have been damaged by sugar... The liver cannot take them back because the receptor can't receive them, because they are gummed with sugar basically. So they're stuck floating in your body... Those macrophages in the plaque do a heroic job in taking that gummed up LDL out of the blood circulation, carefully extracting the cholesterol from it to save it – the cholesterol is important – and then exporting the cholesterol into HDL – HDL A1 in particular... That's the good guy, HDL.
The platelets in the plaque take in HDL A1 cholesterol and they won't take anything else... They take in sulfate, and they produce cholesterol sulfate in the plaque.
The sulfate actually comes from homocysteine. Elevated homocysteine is another risk factor for heart disease. Homocysteine is a source of sulfate. It also involves hemoglobin. You have to consume energy to produce a sulfate from homocysteine, and the red blood cells actually supply the ATP to the plaque.
So everything is there and the intent is to produce cholesterol sulfate and it's done in the arteries feeding the heart, becauseit's the heart that needs the cholesterol sulfate. If [cholesterol sulfate is not produced]... you end up with heart failure."
So, in a nutshell, high LDL appears to be a sign of cholesterol sulfate deficiency—it's your body's way of trying to maintain the correct balance by taking damaged LDL and turning it into plaque, within which the blood platelets produce the cholesterol sulfate your heart and brain needs for optimal function... What this also means is that when you artificially lower your cholesterol with a statin drug, which effectively reduces that plaque but doesn't address the root problem, your body is not able to compensate any longer, and as a result of lack of cholesterol sulfate you may end up with heart failure.

http://articles.mercola.com/sites/articles/archive/2011/09/17/stephanie-seneff-on-sulfur.aspx?e_cid=20110917_DNL_art_1

Saturday, October 1, 2011

Kresser: GERD

I will present evidence demonstrating that, contrary to popular belief, heartburn and GERD are caused by too little (not too much) stomach acid. In the second article I’ll explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. In the third article I’ll discuss the important roles stomach acid plays in maintaining health and preventing disease, and the danger long-term use of acid suppressing drugs presents. In the final article, I’ll present simple dietary and lifestyle changes that can eliminate heartburn and GERD once and for all.

http://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd

Drugs for acid reflux and GERD are cash cows for the pharmaceutical companies. More than 60 million prescriptions for GERD were filled in 2004. Americans spent $13 billion on acid stopping medications in 2006. Nexium, the most popular, brought in $5.1 billion alone – making it the second highest selling drug behind Lipitor.
.... heartburn and GERD can have serious and even life-threatening complications, including scarring, constriction, ulceration, and ultimately, cancer of the esophagus.
Recent studies also show that the damage from poor stomach function and GERD not only extends upward to the sensitive esophageal lining, but also downward through the digestive tract, contributing to Irritable Bowel Syndrome (IBS) and other gastrointestinal problems. IBS is now the second-leading cause of missed work, behind only the common cold.

Just as studies show acid secretion declines with age, it is also well established in the scientific literature that the risk of GERD increases with age.
If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping Rolaids instead of elderly folks. But of course that’s the opposite of what we see.

Read Chris' article to find out why MORE stomach acid is good for you, and how you can cure GERD by adding more hydrocholric acid to your guts - and the rest of his series for how to treat your GERD.

If you are already eating meat, vegetables, nuts and seeds, little fruit and starch, and no sugar/wheat, you probably don't have GERD anyway.

As I was thinking about how this situation parallels the statin situation, I got to this part of the article:
Note: if you think this sounds strangely like the situation with the #1 selling drug, Lipitor, you’re correct. Lipitor arbitrarily lowers cholesterol across the board, even though evidence clearly indicates that high LDL cholesterol is not the cause of heart disease. What’s more, low cholesterol is associated with greater risk of death in the elderly population. Something is definitely wrong with our “healthcare” system when the #1 and #2 medications are actually contributing to the conditions they’re supposed to treat.

So, let's get this strait.  We didn't have the money (in the US Treasury), but passed a "prescription drug benefit" to make sure everyone could afford drugs, and the two most common are drugs which treat conditions which are nearly 100% preventable through a dietary intervention - so we then recommend a diet which does not help GERD, but which may exacerbate GERD, and diabetes ... yes, reverso world.