One Mom in the Middle…
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Weight is still related to health and other tidbits

Published 2.20.2017
As on most Mondays, what follows are brief commentary on recent items related to diet or health.

Call the neighbors, wake the kids, losing weight can positively affect health. It’s amazing to me that this is still considered new and worth of study. Is anyone at this point surprised by evidence that obese people who lose weight can resolve many of their medical conditions— outside the health at every size (HAES) crowd (who will ignore it anyway)?

The researchers predicted that about 20% of new diabetes cases could be prevented if adulthood weight was maintained within one body mass index (BMI) point (Population attributable fraction 21.9%, 95% CI, 15.8-27.6%), or within 3% of total weight (PAF 22.0%, 15.5, 28.0%).

On a population level, about 40% of new cases could be prevented through weight loss of 1.5±.5 BMI points (PAF 38.2%, 23.4-50.0%), or with a loss of 5±2% of body weight (42.4%, 24.3,5.1%), according to Adina L. Feldman, PhD, of the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge in the U.K., and colleagues, writing online in BMC Public Health.

Basically anyone with a BMI of 30 or higher were treated and had a benefit. This bit is different, though:

However, the researchers reported that the benefits of weight maintenance and weight loss were not significantly associated with diabetes risk among normal weight individuals. Also, individuals who were age 30 at baseline did not experience the same relationship between incidence risk and BMI change among the BMI categories <25.0 and 25.0-29.9, except among those in the top category of 30.0-34.9 (ORs 1.11, 1.14, 1.08 per unit BMI change, respectively, for baseline categories).

So you only benefit if you’re obese— in other words, if you are carrying enough extra weight that your body can’t compensate. My hypothesis remains that the body compensates until it cannot. When it cannot, look out, because a cascade of issues arise.

Fact checking Robert Lustig always yields some interest. It would seem that Lustig is still imprecise (disturbing for someone who is now a lawyer) with his usage of terms. He also too often relies on his own research.

Lustig says that when they are consumed in excess, they are metabolised (deaminated to be technical) in the liver, causing fat accumulation. This to me was mind blowing. In all the years I’ve spent in nutrition research, I had never associated branched chain amino acids (BCAA) with processed foods and never associated them with liver fat accumulation.

The reviewing blogger is (or was) a nutrition professor.

Now the idea that food processing was an experiment that failed is absurd. Food processing took the wheat from flour to make bread, cakes, biscuits; it took grapes to make us wine and milk to make us butter, cheese and yogurt. It allowed us to preserve food through pickling or smoking or drying. And all of these are millennia old. Popcorn was used as a garland for young Aztec women in ceremonial dances. Pizzas were sold in Venice 800 years ago and every city in Europe had its unique patented sausage: Chorizo, Bratwurst, Biroldo, and Salami etc. Canned food came centuries ago and frozen foods a 100 years ago. High sugar foods such as cakes or biscuits were common in ancient Rome such as Cantuci or Savillum. Fundamentally, from the advent of fire, man has transformed the food chain to make it safer and tastier and modern times have done little to add to this except to make food cheaper and more available. I have argued this area at length in my recent book: “Ever seen a fat fox ~ Human obesity explored.”

All in all, this ‘Viewpoint’ would be failed if an undergraduate student were to present it, at least in my time. The editor of JAMA paediatrics should be ashamed of his or herself for gross negligence of the peer review process.

This article seemed pretty reasonable, until he got to what he actually eats, which is an incredibly high protein diet. There really is no need to eat 25-30% in protein. Compared to a typical or so-called standard American diet (SAD— get it?), it’s low fat at 25% or less, but yikes, 30% protein? No thank you. I should note here that I have no idea what my “macros” are because I don’t track or measure them. I’d be stunned though if my protein was ever that high a percentage of my intake.

Basically, the author drifted to a higher carb intake because of thyroid issues, exercise performance issues, sleep quality and more steady weight loss. Low carb (LC) in his definition is 100g of carbs or less. That’s roughly 400 calories of carbs, which isn’t much, but is much more than many low carb dieters claim to eat.

Higher carbohydrate diets tend to be better for thyroid health, which is the master organ for regulating your metabolism. If you consistently under eat (stay in a deficit), and lower carbs, it’s been shown to down-regulate thyroid hormone production.

I’ve read this before, but I’ve seen little research evidence to show it (not saying it doesn’t exist, just that I haven’t seen any) and low carb shills deny it vehemently. This despite numerous anecdotes (especially from LC women) that it can be an issue.

Slowly, this guy might be coming around to the truth about low carb and especially ketosis (keto). Low carb is not a panacea, and if you want to grow (or just keep) your muscles eat carbs.

Walter Willett discusses the butter debate, but also demonstrates why I am not a fan of meta-analyses, despite the fact that some anoint them as the peak for the evidence pyramid. Per Willett, butter is only the best fat if you compare it to transfat riddled margarine or refined carbs. Compared to plant oils, butter doesn’t come off as well. MedPage published a followup article, collecting quotes from other doctors. Dean Ornish and David Katz are among those quoted.

Why are so many women being prescribed opioids after delivery? The pain of childbirth ends with birth— shouldn’t it?

Jarlenski's group examined data from 164,720 Medicaid-enrolled women in Pennsylvania who delivered a live-born infant vaginally from 2008 to 2013, and used ICD-9-CM codes to identify pain-inducing conditions: bilateral tubal ligation or anal sphincter tear, fourth-degree laceration or episiotomy. They noted that while they also assessed first and second-degree lacerations, periurethral trauma, laceration of the cervix, and high vaginal laceration, prevalence of opioid prescriptions did not differ by these diagnoses.

The fact that smoking increased the likelihood of opioids being prescribed mystifies me as well. Does nicotine affect pain perception?

Married women get fat, divorced women lose weight. Do I really need to list reasons why this is not a surprise?

There are plenty of metals in our body (the link is to a video), and the amount matters as to health. Throwing off the natural balance is one of the reasons that supplements are stupid. Many are trace substances. For example, all the zinc and copper would be the size of a penny, 95% zinc and 5% copper. The speaker studies zinc in eggs (eggs are big compare to other cells) There’s a master regulatory switch that’s regulated by zinc related to reproduction. Lots of potential apps, all drug related. Get your metals from food, not pills.

Metabolism slows at night? Really? Because maybe we’re sleeping most of that time? It doesn’t matter when a healthy body eats. It may well matter for a body following some fool low carb diet… but that’s my bias showing. I fail to see how eating when hungry (even in the evening) can be considered unhealthy… so long as intake (them pesky calories again) doesn’t exceed expenditure.

A non-vegan arguing that B12 is a lame argument against veganism… To my mind it comes down to whether or not you accept that a diet that requires supplementation is by definition unhealthy. Vegans who eat oysters are omnivores, Nori does not have B12 unless microscopic crustaceans are included amongst the kelp, and the mushroom B12 thing is unknown to me, and likely comes down to how much dirt (read manure) is still on the mushrooms when eaten. But if mushrooms had any significant a amount of B12, vegan doctors would be shouting it from the rooftops, and they do not. Because it’s not true. Want to be vegan? Take a damn B12 supplement and go on with life.

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