Stay as Thin as You Can as Long as You Can

Based on the evidence from clinical trials weight loss (typically 15 kg or greater) is the main driver and predictor of remission.

Dietary strategies for remission of type 2 diabetes: A narrative review — https://doi.org/10.1111/jhn.12938

A weight loss program can lead to type 2 diabetes remission, even in individuals with a normal body mass index (BMI), via loss of body fat, particularly in the liver and pancreas, shows a UK study.

Type 2 Diabetes Remission Possible For Those With Lower BMI — https://www.medscape.com/viewarticle/971599?src=rss#vp_1

The title of this post is a direct quote from an Endocrinologist who at the time was practicing in Dallas Texas. I asked if he had any advice for me to reduce my risk of developing diabetes.

“Stay as thin as you can as long as you can.”

These words have stuck with me ever since.

More on Vitamin D and Covid-19 – 02.06.22

The records of 1,176 patients admitted between April 2020 and February 2021 to the Galilee Medical Center (GMC) with positive PCR tests were searched for vitamin D levels measured two weeks to two years prior to infection. Patients with vitamin D deficiency (less than 20 ng/mL) were 14 times more likely to have severe or critical case of COVID than those with more than 40 ng/mL. Strikingly, mortality among patients with sufficient vitamin D levels was 2.3%, in contrast to 25.6% in the vitamin D deficient group.

Bar-Ilan University. “Pre-infection deficiency of vitamin D is associated with increased disease severity and mortality among hospitalized COVID-19 patients: Study affirms that sufficient vitamin D levels may positively influence the outcome of infection.” ScienceDaily. http://www.sciencedaily.com/releases/2022/02/220203161135.htm (accessed February 6, 2022).

Links to a few older posts on the same topic.

Vitamin D Treatment and Covid-19 Related Outcomes – Hospital del Mar, Barcelona, Spain

Does Vitamin D Deficiency Raise COVID-19 Risk? – JAMA

Vitamin D Deficiency Is Inversely Associated with COVID-19 Incidence and Disease Severity in Chinese People

More on Vitamin D and Covid-19 Vitamin D and Mortality Risk in People With CVD

Fatigue and Higher Mortality

Glynn and her colleagues administered the Pittsburgh Fatigability Scale to 2,906 participants aged 60 or older in the Long Life Family Study, an international study that follows family members across two generations. Participants ranked from 0 to 5 how tired they thought or imagined that certain activities — such as a leisurely 30-minute walk, light housework or heavy gardening — would make them. Follow-up for this work concluded at the end of 2019, to avoid any increased mortality impact from the COVID-19 pandemic, which gave the team an average of 2.7 years of data on each participant. After accounting for a variety of factors that influence mortality, such as depression, pre-existing or underlying terminal illness, age and gender, the team found that participants who scored 25 points or higher on the Pittsburgh Fatigability Scale were 2.3 times more likely to die in the 2.7 years after completing the scale, compared to their counterparts who scored below 25.

University of Pittsburgh. “Feelings of fatigue predict early death in older adults.” ScienceDaily. http://www.sciencedaily.com/releases/2022/01/220124084616.htm (accessed January 27, 2022).

The App That Helps Me Be a More Patient Centered Physician — A Country Doctor Writes:

One of the most rewarding things I do in my clinic happens on my iPhone. When I sit down with a middle aged patient to talk about their cardiovascular risk, I open the risk calculator created by the American Heart Association and the American College of Cardiology. I talk my way through as I enter […]

The App That Helps Me Be a More Patient Centered Physician — A Country Doctor Writes:

The risk calculator is quite useful but I re-blogged this post for its link to the Hale study, which was news to me. This study published in 2004 showed older people between the ages of 70 and 90 who followed a Mediterranean diet have 50% lower rate of all-cause and cause-specific mortality than people who dine on the SAD Western diet. The four primary risk factors were diet, moderate alcohol intake, physical activity, and non-smoking.

Lifestyle matters.

Exercise Alters Brain Chemistry – May Protect Aging Synapses

When elderly people stay active, their brains have more of a class of proteins that enhances the connections between neurons to maintain healthy cognition.

University of California – San Francisco. “Exercise alters brain chemistry to protect aging synapses: Enhanced nerve transmission seen in older adults who remained active.” ScienceDaily. http://www.sciencedaily.com/releases/2022/01/220107100955.htm (accessed January 8, 2022).

I was about to write a snarky comment but I forgot what it was.

Journal Reference – Kaitlin Casaletto, Alfredo Ramos‐Miguel, Anna VandeBunte, Molly Memel, Aron Buchman, David Bennett, William Honer. Late‐life physical activity relates to brain tissue synaptic integrity markers in older adults. Alzheimer’s & Dementia, 2022; DOI: 10.1002/alz.12530

Going Back to the Office? (You Can’t. Not now. Not Ever)

People with talent and high-value skills, like most technology workers, aren’t returning to traditional offices.

How to lure employees back to the office? You can’t. Not now. Not ever. — https://www.zdnet.com/article/they-really-arent-going-back-work-from-home-is-here-to-stay/

I started working from home in 2006. I love reading articles on topics I already know a lot about.

The future of knowledge work will be a hybrid. A small percentage (like myself) will WFH 100% of the time and an even smaller percentage will work in an office 100% of the time. Most will travel to their offices a few times a month and WFH the rest of the time.

I drove a 2006 Ford Taurus for nearly 15 years and didn’t pass 80,000 miles. (short commute)

My business casual attire consists of jeans and a tee shirt.

Coffee is cheaper and tastes a lot better than office coffee too.

Diet Quality and Covid-19 Risk/Severity

Poor metabolic health and unhealthy lifestyle behaviors have been associated with higher risk and severity of COVID-19.

A dietary pattern characterized by healthy plant-based foods was associated with lower risk and severity of COVID-19.

We found evidence of a synergistic association of poor diet and increased socioeconomic deprivation with COVID-19 risk that was higher than the sum of the risk associated with each factor alone.

Merino J, Joshi AD, Nguyen LH, et al
Diet quality and risk and severity of COVID-19: a prospective cohort study
Gut 2021;70:2096-2104. — https://gut.bmj.com/content/70/11/2096

In six countries, plant-based diets or pescatarian diets were associated with lower odds of moderate-to-severe COVID-19. These dietary patterns may be considered for protection against severe COVID-19 In 2884 front-line healthcare workers from six countries (France, Germany, Italy, Spain, UK, USA), individuals who reported following plant-based diets and plant-based diets or pescatarian diets that were higher in vegetables, legumes and nuts, and lower in poultry and red and processed meats, had 73% and 59% lower odds of moderate-to-severe COVID-19, respectively.

Kim H, Rebholz CM, Hegde S, et al. Plant-based diets, pescatarian diets and COVID-19 severity: a population-based case–control study in six countries
BMJ Nutrition, Prevention & Health 2021;4:doi: 10.1136/bmjnph-2021-000272 — https://nutrition.bmj.com/content/4/1/257

Eat your vegetables!

Diet-induced Alteration of Intestinal Stem Cell Function (in mice)

“The first thing we noticed was that the small intestine increases greatly in size on the high-calorie diet,” says study leader Anika Böttcher. “Together with Fabian Theis’ team of computational biologists at Helmholtz Munich, we then profiled 27,000 intestinal cells from control diet and high fat/high sugar diet-fed mice. Using new machine learning techniques, we thus found that intestinal stem cells divide and differentiate significantly faster in the mice on an unhealthy diet.” The researchers hypothesize that this is due to an upregulation of the relevant signaling pathways, which is associated with an acceleration of tumor growth in many cancers. “This could be an important link: Diet influences metabolic signaling, which leads to excessive growth of intestinal stem cells and ultimately to an increased risk of gastrointestinal cancer,” says Böttcher.

Helmholtz Zentrum München – German Research Center for Environmental Health. “New link between diet, intestinal stem cells and disease discovered.” ScienceDaily. http://www.sciencedaily.com/releases/2021/11/211119155604.htm (accessed November 27, 2021).

I wonder what Dr. Lustig would say about this study?

Dr. Robert Lustig – The Sugar Pandemic – 2012 Presentation at Yale University and Dr. Robert Lustig on Sugar.