Diets Don’t Work so Why Are More Teens Dieting?

Well, my first thought was Body Dysmorphic Disorder (BDD) — https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd. But this is merely an educated guess from an insurance guy who has lost 200 pounds and not a trained licensed practicing clinical psychiatrist.

In 2015, 42% of 14-year-old girls and boys said they currently were trying to lose weight, compared to 30% in 2005.

Lead author Dr Francesca Solmi (UCL Psychiatry) said: “Our findings show how the way we talk about weight, health and appearance can have profound impacts on young people’s mental health, and efforts to tackle rising obesity rates may have unintended consequences.

“An increase in dieting among young people is concerning because experimental studies have found that dieting is generally ineffective in the long term at reducing body weight in adolescents, but can instead have greater impacts on mental health. We know, for instance, that dieting is a strong risk factor in the development of eating disorders.”

University College London. “Dieting and weight worries on rise in teens.” ScienceDaily. http://www.sciencedaily.com/releases/2020/11/201116112855.htm (accessed November 21, 2020). — https://www.sciencedaily.com/releases/2020/11/201116112855.htm

And in case you made it this far on this blog post my estimated BMI at age 20 was 53.1. My current BMI is 25.1.

Nutrition Matters

By many measures, the population of the United States is the unhealthiest of any high-income country despite spending much more money, as a share of the economy, on health care. The incidence of chronic disease is higher and life expectancy is lower.

Many chronic conditions plaguing Americans, such as obesity, diabetes, and high blood pressure, are avoidable with a prudent diet and lifestyle. Today, more than 42% of American adults have obesity, as do 19.3% of children of age 19 and under. The U.S. has the world’s 12th-highest obesity rate, after Kuwait. (The top 10 are all small Pacific island nations.)

Diet makes a difference. Nearly half of all deaths in the U.S. from heart disease, stroke, and type 2 diabetes are associated with diet, such as the over-consumption of processed meats and sugar-sweetened beverages and insufficient intake of fruits, vegetables, and whole grains.

Make America healthy again by paying more attention to nutrition — https://www.statnews.com/2020/11/04/nutrition-make-america-healthy-again/?utm_campaign=rss

Presented without the usual snarky comment from yours truly. Read the full article. You’ll find more links for your reading pleasure.

More on Vitamin D and Covid-19

As of this article’s writing, there are over two hundred fifty articles on PubMed about the connection between vitamin D and COVID-19. As the research studies are undergoing, evidence is mounting that adequate vitamin D levels may be a protective factor against COVID-19 infection and severity. Here’s what the research shows.

Is there a role for vitamin D in the treatment of COVID-19? — https://www.kevinmd.com/blog/2020/11/is-there-a-role-for-vitamin-d-in-the-treatment-of-covid-19.html

Yesterday I was going to post a link to an article “Over 80 percent of 200 COVID-19 patients in a hospital in Spain have vitamin D deficiency” when I realized I was unable to access or read the original study. It was late, I was tired, and I didn’t feel like crawling through PubMed to find the study. Well someone out there did the crawling for me. If you follow the link to the original article above you’ll find more links to more research on Vitamin D and Covid-19 like the following:

Evidence suggests that vitamin D supplementation could potentially be effective either in treatment or prevention of coronavirus disease 2019 (Covid‐19). Indeed, several studies and trials have begun to investigate the impact of vitamin D supplementation on patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. In this review, we focus on the potential mechanisms of vitamin D in the pathogenesis of Covid‐19. We consider whether deficiency of vitamin D may be one of the underlying biological factors that could explain the excess mortality seen among non‐Caucasians. We also raise several important questions which need to be addressed to provide a clear picture of the extent to which vitamin D supplementation may benefit patients with Covid‐19, particularly those with underlying risk factors.

Vitamin D and Covid‐19: From potential therapeutic effects to unanswered questions — https://doi.org/10.1002/rmv.2159

A little over a month ago I had my annual wellness check up. The medical nerd in me jotted a list of discussion items I wanted to cover during my visit. After catching up on family and checking off the items on my list I asked my doctor if there was anything else she wanted to talk to me about.

No, your list covered all of the things I wanted to talk about except for one. Tell your wife to start taking a Vitamin D supplement.

True story.

Vitamin D and Calcium Reduce Incidence of Recurrent Vertigo (BPPV)

The multi-center study included 957 people in South Korea with benign paroxysmal positional vertigo who had undergone canalith repositioning maneuvers—head movements that shift displaced calcium carbonate crystals in the inner ear. The intervention group included patients who received 400 IU vitamin D and 500 mg calcium carbonate twice daily for 1 year when their baseline serum vitamin D level was below 20 ng/mL along with patients who had higher baseline levels and took no supplements. An observation group had no baseline testing or interventions.

The supplements significantly reduced the annual vertigo recurrence rate by 24%. There were 0.83 recurrences per 1 person-year in the intervention group compared with 1.10 in the observation group. Patients with greater vitamin D deficiencies at baseline derived the most benefit.

JAMA. 2020;324(16):1599. doi:10.1001/jama.2020.18695 — https://jamanetwork.com/journals/jama/fullarticle/2772275

BPPV = benign paroxysmal positional vertigo. The original study in Neurology and the JAMA summary both use the word “prevent” in their respective titles. I think reduce is a more apt description. Semantics aside a 24% reduction in recurrent BPPV episodes is significant.

And yet another example of nutritional deficiencies underlying another disease.

NAFLD – Why are Life Insurers Taking This Risk at Standard Rates?

Conclusion All NAFLD histological stages were associated with significantly increased overall mortality, and this risk increased progressively with worsening NAFLD histology. Most of this excess mortality was from extrahepatic cancer and cirrhosis, while in contrast, the contributions of cardiovascular disease and HCC were modest.

Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort — https://gut.bmj.com/content/early/2020/10/09/gutjnl-2020-322786?rss=1

Diet. That’s it. That’s my post.

COVID-19 and Diabetes, Sub-types of DM2, B Vitamins in Diabetes Incidence and more

This article provides an overview of the clinical evidence on the poorer clinical outcomes of COVID-19 infection in patients with diabetes versus patients without diabetes, including in specific patient populations, such as children, pregnant women, and racial and ethnic minorities.

COVID-19 and Diabetes: A Collision and Collusion of Two Diseases — Diabetes 2020 Oct; dbi200032. https://doi.org/10.2337/dbi20-0032

In the article above the researchers reviewed nearly 90 studies.

Novel diabetes subtype characteristics. Overview of distribution and characteristics of subtypes generated by clustering based on clinical parameters in the Swedish ANDIS cohort.

Type 2 diabetes (T2D) is defined by a single metabolite, glucose, but is increasingly recognized as a highly heterogeneous disease, including individuals with varying clinical characteristics, disease progression, drug response, and risk of complications. Identification of subtypes with differing risk profiles and disease etiologies at diagnosis could open up avenues for personalized medicine and allow clinical resources to be focused to the patients who would be most likely to develop diabetic complications, thereby both improving patient health and reducing costs for the health sector. More homogeneous populations also offer increased power in experimental, genetic, and clinical studies. Clinical parameters are easily available and reflect relevant disease pathways, including the effects of both genetic and environmental exposures. We used six clinical parameters (GAD autoantibodies, age at diabetes onset, HbA1c, BMI, and measures of insulin resistance and insulin secretion) to cluster adult-onset diabetes patients into five subtypes. These subtypes have been robustly reproduced in several populations and associated with different risks of complications, comorbidities, genetics, and response to treatment. Importantly, the group with severe insulin-deficient diabetes (SIDD) had increased risk of retinopathy and neuropathy, whereas the severe insulin-resistant diabetes (SIRD) group had the highest risk for diabetic kidney disease (DKD) and fatty liver, emphasizing the importance of insulin resistance for DKD and hepatosteatosis in T2D. In conclusion, we believe that subclassification using these highly relevant parameters could provide a framework for personalized medicine in diabetes.

Subtypes of Type 2 Diabetes Determined From Clinical Parameters — Diabetes 2020 Oct; 69(10): 2086-2093. https://doi.org/10.2337/dbi20-0001

Not just potential for personalized medicine in the treatment of diabetes but perhaps a framework for better risk stratification and selection in life insurance.

Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study

RESULTS During 30 years (mean 20.5 ± 8.9) of follow-up, 655 incident cases of diabetes occurred. Intake of folate, but not vitamin B6 or vitamin B12, was inversely associated with diabetes incidence after adjustment for potential confounders. Compared with the lowest quintile of total folate intake, the multivariable-adjusted hazard ratios (95% CI) in quintiles 2–5 were 0.85 (0.67–1.08), 0.78 (0.60–1.02), 0.82 (0.62–1.09), and 0.70 (0.51–0.97; Ptrend = 0.02). Higher folate intake was also associated with lower plasma homocysteine (Ptrend < 0.01) and insulin (Ptrend < 0.01). Among supplement users, folate intake was inversely associated with serum C-reactive protein levels (Ptrend < 0.01).

CONCLUSIONS Intake of folate in young adulthood was inversely associated with diabetes incidence in midlife among Americans. The observed association may be partially explained by mechanisms related to homocysteine level, insulin sensitivity, and systemic inflammation.

Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study — Diabetes Care 2020 Oct; 43(10): 2426-2434. https://doi.org/10.2337/dc20-0828

Folate is a B vitamin that occurs naturally in foods such as green leafy vegetables, citrus fruit, and beans. So eat your greens and beans. Taking a supplement can’t hurt either. My multivitamin has plenty of folate.

Nearly 39,000 Meat Packers Have COVID-19

As of Sept. 18, there have been at least 39,000 reported positive cases tied to meatpacking facilities in at least 419 plants in 40 states, and at least 185 reported worker deaths in at least 51 plants in 27 states.

Tracking Covid-19’s impact on meatpacking workers and industry — https://investigatemidwest.org/2020/04/16/tracking-covid-19s-impact-on-meatpacking-workers-and-industry/

And in case you missed this interesting hypothesis…

Our laboratory work has shown that SARS-CoV-2 can survive the time and temperatures associated with transportation and storage conditions associated with international food trade. When adding SARS-CoV-2 to chicken, salmon and pork pieces there was no decline in infectious virus after 21 days at 4°C (standard refrigeration) and –20°C (standard freezing).

Seeding of outbreaks of COVID-19 by contaminated fresh and frozen food — https://doi.org/10.1101/2020.08.17.255166 (This article is a preprint and has not been certified by peer review) — https://www.biorxiv.org/content/10.1101/2020.08.17.255166v1.full#disqus_thread

I will keep an eye open for other studies that either confirm or dismiss the findings of this study.

Eat More Broccoli

Published in the British Journal of Nutrition the research has found higher consumption of cruciferous vegetables, such as broccoli, Brussels sprouts and cabbage, is associated with less extensive blood vessel disease in older women.

Using data from a cohort of 684 older Western Australian women recruited in 1998, researchers from ECU’s School of Medical and Health Sciences and The University of Western Australia found those with a diet comprising more cruciferous vegetables had a lower chance of having extensive build-up of calcium on their aorta, a key marker for structural blood vessel disease.

Dr Blekkenhorst said women in this study who consumed more than 45g of cruciferous vegetables every day (e.g. ¼ cup of steamed broccoli or ½ cup of raw cabbage) were 46 percent less likely to have extensive build-up of calcium on their aorta in comparison to those consuming little to no cruciferous vegetables every day.

Edith Cowan University. “Broccoli and Brussels sprouts a cut above for blood vessel health.” ScienceDaily. http://www.sciencedaily.com/releases/2020/08/200820102434.htm (accessed August 20, 2020).

https://www.sciencedaily.com/releases/2020/08/200820102434.htm

Photo by Buenosia Carol on Pexels.com

14 Guys Eat Pizza in the Name of Science

A pizza study.

You can’t make this stuff up.

…young, healthy men (aged 22 — 37) who volunteered for the trial consumed almost twice as much pizza when pushing beyond their usual limits, doubling their calorie intake, yet, remarkably, managed to keep the amount of nutrients in the bloodstream within normal range.

 Pizza study shows body copes surprisingly well with one-off calorie indulgence

Journal reference and link

Aaron Hengist, Robert M. Edinburgh, Russell G. Davies, Jean-Philippe Walhin, Jariya Buniam, Lewis J. James, Peter J. Rogers, Javier T. Gonzalez, James A. Betts. Physiological responses to maximal eating in men. British Journal of Nutrition, 2020; 124 (4): 407 DOI: 10.1017/S0007114520001270

Diabulimia

I live with “the world’s most dangerous” eating disorder

I have been struggling with diabulimia on and off since my diagnosis of type 1 diabetes in 2011, at age 30. I had just started a PhD and spent the first semester walking around campus with all the classic symptoms of type 1 diabetes: famished, dehydrated, constantly needing to urinate, and experiencing rapid weight loss. After my diabetes diagnosis, when I started injecting insulin, I gained the weight back—and then some. It didn’t take long to figure out that omitting insulin was not only an effective weight loss tool, compared with vomiting, it was a much less violent way to purge. Having a history of bulimia nervosa, I thought I had found the holy grail. I could eat what I wanted, not use insulin, and not gain weight.

And I thought Orthorexia Nervosa was bad.