Strong, consistent evidence shows that managing obesity can delay progression of prediabetes to type 2 diabetes. Obesity management is also highly beneficial in treating type 2 diabetes, based on the degree of weight loss achieved. Losing excess weight improves glycemic control, reduces the need for glucose-lowering medications, can substantially reduce A1C, and can even promote sustained diabetes remission.

Diabesity Clin Diabetes 2022;40(4):392–393 — https://doi.org/10.2337/cd22-0088

Remember, Stay as Thin as You Can as Long as You Can

Millions Suffer – Junk Food Industry Profits

Increased consumption of ultraprocessed foods (UPFs) was associated with more than 10% of all-cause premature, preventable deaths in Brazil in 2019. That is the finding of a new peer-reviewed study in the American Journal of Preventive Medicine.

Examples of UPFs are prepackaged soups, sauces, frozen pizza, ready-to-eat meals, hot dogs, sausages, sodas, ice cream, and store-bought cookies, cakes, candies and doughnuts.

UPFs have steadily replaced the consumption of traditional whole foods, such as rice and beans, in Brazil.

Millions Suffer as Junk Food Industry Rakes in Profit, by Colin Todhunter — STRAIGHT LINE LOGIC

Here is a link to the original study https://www.ajpmonline.org/article/S0749-3797(22)00429-9/fulltext

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

The skeptical cardiologist was asked to give a lecture in July on diet to the cardiology fellows in our training program at Saint Louis University. Needless to say, I didn’t hew to current recommendations from the American Heart Association or the Dietary Guidelines for Americans. For example, these recommendations are still promoting the narrative that…

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

Great lecture. Thank you Dr. Pearson.

IBS – Diet or Medication?

What are the new findings?

  • In a controlled trial enrolling 470 newly diagnosed primary care IBS patients, a self-management FODMAP-lowering smartphone application was superior to standard medical therapy in alleviating IBS symptoms.
  • The superiority of the diet app was already present at 4 weeks and persisted at 8 and 16 weeks.
  • The diet app had a high acceptability and adherence rate.
Diet or medication in primary care patients with IBS: the DOMINO study – a randomised trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute — https://gut.bmj.com/content/71/11/2226?rss=1

Fatal Fungi

This lethal lineup of mushrooms contains amatoxins, which include alpha, beta, and gamma amanitin. Amatoxin poisoning accounts for more than 90 percent of all deaths resulting from mushroom poisoning worldwide. Part of what makes them so deadly is that they can easily be confused with other, completely edible mushrooms. Death caps, for instance, can look much like straw and Gypsy mushrooms. The various destroying angels can be mistaken for button, meadow, and horse mushrooms. In Cleveland, Gholam recently treated a patient who had eaten a deadly Amanita mushroom he found in his yard after a plant identification app on his phone identified the mushroom as an edible variety. It almost killed him.

The mushrooms’ amatoxins are easily absorbed through the gastrointestinal tracts once they’ve been eaten. From there, the toxins head to the kidneys and, in particular, the liver, which is one of the most important organs in the body for making proteins. Amatoxins work by blocking a key enzyme involved in making new proteins, called RNA polymerase type II. In the liver, blocking this enzyme causes a cascade of trouble that results in cell death and tissue necrosis. While some of the toxin ultimately gets flushed in urine, some gets transported out of the liver with bile acids, where they end up back in the intestines for the process to begin again—in what’s called an enterohepatic cycle.

After ingestion, symptoms only appear six to 24 hours later, once significant damage has accumulated. Then the poisoning proceeds through three distinct phases. First, there’s gastrointestinal distress—marked by excruciating abdominal pain, nausea, vomiting, diarrhea, and blood in the urine—and can sometimes be accompanied by rapid heartbeat, low blood sugar, and dehydration. All that can last for 12 to 36 hours. Then, there’s the second, “latent” phase, when symptoms quiet down as liver and kidney damage set in at about 72 hours. In this phase, a person may be lulled into thinking they’re in the clear, potentially causing them to decline emergency medical care that could save their life.

In the three-to-five days after ingestion, things go downhill, with abrupt liver and multi-organ failure. Some patients end up needing liver transplants. Fatality rates vary but sometimes range between 10 and 20 percent, though some studies have found higher rates.

There are no specific treatments for amatoxin poisoning.

Ohio foragers are accidentally poisoning themselves with lethal mushrooms — https://arstechnica.com/science/2022/10/ohio-foragers-are-accidentally-poisoning-themselves-with-lethal-mushrooms/

“…a plant identification app on his phone identified the mushroom as an edible variety.”

Go ahead and search for the phrase “mushroom identification app” in your favorite search engine.

Foraging for wild mushrooms is a perfect example of you don’t know what you don’t know even if an app on your phone leads to believe you know.

Unhealthful Eating – Pandemic Style

Mindless eating and snacking;

Increased food consumption;

Generalized decrease in appetite or dietary intake;

Eating to cope;

Pandemic-related reductions in dietary intake;

And, a re-emergence or marked increase in eating disorder symptoms.

Approximately 8% of those studied reported extreme unhealthy weight control behaviors, 53% had less extreme unhealthy weight control behaviors and 14% reported binge eating. The study revealed that these outcomes were significantly associated with poorer stress management, greater depressive symptoms and moderate or extreme financial difficulties.

University of Minnesota Medical School. “COVID-19 pandemic has been linked with six unhealthy eating behaviors: Study shows a slight increase in eating disorders, one of the deadliest psychiatric health concerns.” ScienceDaily. http://www.sciencedaily.com/releases/2021/04/210412114740.htm (accessed May 1, 2021).

Pandemic or no pandemic at times I am guilty of number one on the list. I found the absolute best pita crackers, crispy and salty, and…

Brussels Chicory Stabilizes Unstable Atherosclerotic Plaques and Reshapes the Gut Microbiota (in Mice)

Brussels chicory might help stabilize atherosclerotic plaques in mice by reducing intestinal permeability and gut microbial LPS production. This study provides a promising approach to slow the progression of atherosclerosis.

The Journal of Nutrition, Volume 152, Issue 10, October 2022, Pages 2209–2217, https://doi.org/10.1093/jn/nxac103

Does not look like mice food.

(Image borrowed from the internet. If you own the copyright on this photo let me know and I’ll delete immediately. If copyright infringement has occurred I assure you it was unintentional.)

Brussels chicory aka Belgian endive aka Witloof. We don’t eat much of this vegetable in the US. Maybe because virtually no one grows it.

Demand has grown such that California Endive Farms, who are the only commercial endive producer in the country, has had to expand their operations in order to keep up.

Belgian endive consumption in the US on the rise — https://www.infiniteherbs.com/belgian-endive-consumption-in-the-us-on-the-rise/

Factors associated with food choice among long-term weight loss maintainers

Journal of Human Nutrition and Dietetics Notes

My Editor’s Pick for October 2022 is this paper by Jacob Young, Suzanne Phelan, Noemi Alarcon, James Roake, Chad Rethorst and Gary Foster.

One of the biggest problems associated with weight loss protocols for individuals living with obesity is the difficulty of maintaining the lost weight loss. Weight regain is frequently observed following weight loss assisted by pharmacological agents, or dietary change alone. Among individuals who successfully maintain weight loss, success appears to be associated with consistency of intake across all days of the week and a strong ability to consciously control overeating.

In this study the authors accessed weight stable individuals living with obesity following a commercial weight loss programme, and weight loss maintainers (WLM) via the WW Success Registry. The WLM group had all reported a weight loss that was greater than or equal to 9.1 kg for more than a year. 8047 individuals were approached to complete…

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Another Sweet Saturday – 09.17.22

Our 1-year RCT indicated that a lifestyle intervention program can be highly successful in older adults with diabetes and chronic comorbidities. In this specific population, lifestyle intervention not only improved glycemic control associated with improved insulin action and secretion but also improved age-relevant outcomes such as body composition, physical function, and quality of life.

Alessandra Celli, Yoann Barnouin, Bryan Jiang, Dean Blevins, Georgia Colleluori, Sanjay Mediwala, Reina Armamento-Villareal, Clifford Qualls, Dennis T. Villareal; Lifestyle Intervention Strategy to Treat Diabetes in Older Adults: A Randomized Controlled Trial. Diabetes Care 1 September 2022; 45 (9): 1943–1952. https://doi.org/10.2337/dc22-0338

From the periods 1988–1994 to 2017 to March 2020, there was an increase in the prevalence of diagnosed diabetes (from 4.6% to 11.7%), but no change in prevalence of persistent undiagnosed diabetes (from 2.23% to 2.53%) or confirmed undiagnosed diabetes (from 1.10% to 1.23%). Consequently, the proportion of all undiagnosed diabetes cases declined from 32.8% to 17.8% (persistent undiagnosed diabetes) and from 19.3% to 9.5% (confirmed undiagnosed diabetes). Undiagnosed diabetes was more prevalent in older and obese adults, racial/ethnic minorities, and those without health care access. Among persons with diabetes, Asian Americans and those without health care access had the highest proportion of undiagnosed cases, with rates ranging from 23% to 61%.

Michael Fang, Dan Wang, Josef Coresh, Elizabeth Selvin; Undiagnosed Diabetes in U.S. Adults: Prevalence and Trends. Diabetes Care 1 September 2022; 45 (9): 1994–2002. https://doi.org/10.2337/dc22-0242

Remember, Stay as Thin as You Can as Long as You Can.

Variation in cardiovascular disease risk factors among older adults in the Hunter Community Study cohort: A comparison of diet quality versus polygenic risk score — Journal of Human Nutrition and Dietetics Notes

The study of Reay and colleagues was an analysis of data from a subset (n=1703) of the Hunter Community Study cohort, comprising 3253 Australian men and women aged 55-85 at recruitment (between 2004 and 2007). Across the cohort there were 138 participants self-reporting that they suffered angina, 176 atrial fibrillation, 689 high cholesterol, 758 hypertension, 129 a heart attack and 164 an arterial bypass surgery. The CVD phenotypes data had a large number of missing data points (only 1678 subjects responding).

…the ARFS (Australian Recommended Food Score) data suggest that dietary quality was poor across the whole cohort. In the absence of a wide distribution of diet quality it is difficult to evaluate the relationship of diet with disease endpoints (i.e. without a lot of participants consuming a healthy diet it is impossible to detect the effects of a healthy diet on lipids and CVD outcomes)

Variation in cardiovascular disease risk factors among older adults in the Hunter Community Study cohort: A comparison of diet quality versus polygenic risk score — Journal of Human Nutrition and Dietetics Notes

Study shortcomings noted. I am still planning on stir fried veggies with brown rice and Thai sauce for dinner tonight despite not knowing my exact CVD genetic risk.

Dinner. (There’s a fried egg hiding on the bottom of the bowl).