Food Vantage Friday

This week's lucky "winner"... a bacon hot domestic dog donut, yesteryear Krispy Kreme!

Yes, this is real, although it hasn't been formally named yet.  Apparently, Krispy Kreme teamed upwardly alongside a nestling league baseball game squad called the Blue Rocks to come upwardly up alongside this genius idea.  It's a glazed donut, containing a hot dog, large amounts of bacon, as well as jelly.  They conception to sell it equally a concession at Frawley Stadium inwards Delaware.  For $5 extra, they'll inject it take away into your coronary arteries.

Krispy Kreme is quest Earth to propose names for their novel creation. What would you lot cite it?

Thanks to Scott Weigle for passing this along.

Is Amount Unhealthy? Consolidated Links

Several people convey asked for a consolidated listing of links to my serial on heart as well as health.  Here it is!  This should instruct far easier to share.  

Is Meat Unhealthy?  Part I.  Introduction as well as ethical/environmental considerations.

Is Meat Unhealthy?  Part II.  Our evolutionary history alongside meat.

Is Meat Unhealthy?  Part III.  Meat as well as cardiovascular disease.

Is Meat Unhealthy?  Part IV.  Meat as well as obesity risk.

Is Meat Unhealthy?  Part V.  Meat as well as type two diabetes risk.

Is Meat Unhealthy?  Part VI.  Meat as well as cancer risk.

Is Meat Unhealthy?  Part VII.  Meat as well as full mortality.

Is Meat Unhealthy?  Part VIII.  Health vs. the absence of disease.

Is Meat Unhealthy?  Part IX.  Summary.

My Buddy In Addition To Me

Warning -- Satire -- Apr Fools Post

I stimulate got a sheepish confession to make: until recently, I had a tapeworm, in addition to that's why I'm lean.

In 2006, I took a trip to United Mexican U.S.A. alongside a few friends.  We ofttimes traveled through rural areas, in addition to of course of educational activity sampled the local cuisine wherever nosotros went.  In many parts of Mexico, pork is an of import food.  Some of it may stimulate got been a chip undercooked.

At the time, my involvement inwards nutrient in addition to wellness was growing, in addition to I was making many changes to my diet.  I was glad to run into the chubbiness approximately my cervix in addition to waist start to disappear.  The diet was working!  Or in addition to therefore I thought...

In 2008, I began writing to part the data I idea had helped me.  Yet despite remaining lean, my unloosen energy levels were flagging.  I would sometimes experience tired after ordinary activities similar a weekend of backpacking inwards the mountains.  A yr later, I noticed telltale signs of a tapeworm infection (I won't teach into the details).

At first, I was mortified.  Parasites are disgusting, in addition to peculiarly tapeworms.  They claw into your intestinal lining, feed on the partially digested nutrient that flows by them, in addition to shed large eggs into the stool.  I resolved to teach to the Dr. in addition to stimulate got it removed forthwith using an antihelmintic drug that kills tapeworms.

I saw the doctor, filled my prescription, only when the fourth dimension came, I couldn't stimulate got the pills.  I had grown strangely fond of the footling bugger.  Just similar our gut microbiota are a business office of who nosotros are every bit individuals, I felt that this tapeworm was a business office of me.  Wherever I went, he went.  He was the best friend in that place could be.

My Buddy

Meanwhile, I was eating insulin-spiking potatoes every hateful solar daytime alongside consummate impunity.  Starchy tubers, grains in addition to beans, sugar-filled fruits, fat-laden nuts in addition to avocados, meat.  I fifty-fifty sometimes seat dearest on my yogurt in addition to berries.  Yet throughout this time, My Buddy helped me remain lean.

Why am I writing this now?  Last month, My Buddy passed away prematurely (tapeworms tin alive to a greater extent than than 25 years).  He was exclusively 9 years old, which is well-nigh 28 human years; a swain inwards his prime.  Was it that habanero pepper I ate?  I'll never know.

What I practise know is that the charade is over.  No to a greater extent than potatoes, no to a greater extent than nuts, no to a greater extent than meat.  I'm going dorsum to the Eocene diet.

Apr fools!

Do Slower-Digesting Carbohydrates Brand Us Experience To A Greater Extent Than Full?

One of the nigh mutual pieces of advice inwards the health-nutrition globe is that nosotros should focus our saccharide intake on slowly-digesting carbohydrates, because they brand us experience to a greater extent than amount than rapidly-digesting carbohydrates.  Rapidly-digesting carbohydrates, such equally potatoes, stand upwards defendant of causing us to overeat, resulting inwards obesity, diabetes, in addition to many other chronic ailments.  Is this true?

This concept is normally discussed inwards damage of the glycemic index.  Foods with a high glycemic index drive blood glucose to ascent to a greater extent than than foods with a depression glycemic index, in addition to the sometime are normally digested to a greater extent than rapidly.  This mensurate was originally developed to assistance diabetics command their blood refined saccharify levels, in addition to it may indeed live useful for that purpose.  However, to a greater extent than of late it has been suggested that non-diabetics should focus on low-glycemic foods equally well.

H5N1 issue of single-meal studies exercise propose that low-glycemic carbohydrates supply to a greater extent than prolonged satiety than high-glycemic carbohydrates (1, 2, 3, 4, 5, 6, 7).  Yet these studies are often hard to interpret, because the essay out foods oftentimes differ inwards many ways too glycemic index (e.g., fiber content, calorie density).  Also, a few studies receive got either failed to replicate the finding, or flora that high-glycemic carbohydrates are truly to a greater extent than filling (8, 9, 10, 11, 12).

Many observational studies receive got shown that people who consume lower-glycemic carbohydrates tend to fare amend over time.  However, i time to a greater extent than these studies are hard to interpret, because the nigh mutual high-glycemic foods are to a greater extent than often than non highly processed, high-reward, in addition to depression inwards fiber.  Adding to my skepticism, nearly all longer-term (10+ weeks) randomized, controlled trials receive got flora that the glycemic index of the diet makes footling or no divergence inwards calorie intake, torso weight, or metabolic wellness (13, 14, 15, 16, 17, 18, 19, 20).  This is consistent with the fact that many traditional cultures receive got remained thin in addition to salubrious eating diets that are extraordinarily rich inwards high-to-medium-glycemic saccharide such equally cassava, yams, taro, sugariness potatoes, millet, rice, palm starch, in addition to potatoes (Western Diseases. Trowell in addition to Burkitt. 1981)

The single-meal studies that receive got been conducted to engagement receive got normally exclusively focused on i food, or a few foods, which makes it hard to generalize the findings.  What I truly desire to know is this: when people consume a diverseness of typical foods, is at that spot whatsoever correlation betwixt the food's glycemic index in addition to how amount that someone feels?  In other words, tin post away nosotros increase satiety past times favoring lower-glycemic foods over higher-glycemic foods inwards the context of a typical diet?

I finally flora a report that answers this question.  It was published inwards 1996.

The study

Susanna Holt in addition to colleagues recruited salubrious college students, mostly thin only including a few that were overweight (21).  The inquiry squad fed the volunteers 240-Calorie portions of 38 mutual foods individually, in addition to measured satiety, glucose, in addition to insulin levels every fifteen minutes for ii hours afterwards each essay out meal.  Test foods included many of the nigh mutual foods people consume inwards their everyday lives, for example, cereal, potatoes, fish, meat, fruit, nuts, pastries, rice, popcorn, in addition to bread.

The results

I'll cutting correct to the chase: at that spot was no association whatsoever betwixt the glycemic touching of a nutrient in addition to the satiety it provided.

Potatoes (plain) were a remarkable outlier: they were the nigh satiating nutrient of all, despite a high glycemic index.

Implications

This termination shows that with a broad diverseness of mutual foods, the glycemic index doesn't predict which ones volition live to a greater extent than filling than others, per unit of measurement calorie.  Other papers based on the exact same information prepare demonstrate that a food's poly peptide content, calorie density, fiber content, in addition to palatability are all of import predictors of satiety (22), hence nosotros know this experiment was adequately designed to bring out effects on satiety.

One of import limitation is that the report exclusively lasted ii hours.  It's possible that differences would receive got emerged if the volunteers had been studied for iii or 4 hours.

In the end, I'm non convinced that non-diabetic people exercise goodness much from the glycemic index concept.  As always, if you lot bring out that low-glycemic foods assistance you lot command your appetite, hence past times all agency function along eating them.  Yet for nigh of us, the glycemic index seems similar an unnecessary complication.

New Report Strengthens The Illustration That Ldl Causes Midpoint Disease

There is niggling remaining doubtfulness inwards the scientific/medical community that high levels of LDL, so-called "bad cholesterol", crusade essence disease.  Yet inwards roughly option wellness circles, the debate continues.  A novel study adds substantially to the bear witness that LDL plays a causal role inwards essence disease.

Introduction

Fat together with cholesterol are transported through our blood via carriers called lipoprotein particles.  The primary cholesterol-carrying lipoprotein particle inwards humans is low-density lipoprotein, or LDL.  LDL delivers cholesterol to the body's tissues, where it's used to regulate jail cellphone membrane fluidity, synthesize hormones, together with play many other of import roles inwards the torso [4/27 note: encounter comment department for information on LDL's role inwards contrary cholesterol transport].  Yet, nosotros don't need really much LDL to fulfill this function, together with most traditionally-living cultures receive got lower LDL levels than the modern average.

There is a huge mount of bear witness from multiple lines of investigation that high levels of LDL contribute to the thickening together with degeneration of arteries called atherosclerosis.  LDL particles larn trapped inwards the blood vessel lining, depositing cholesterol together with activating immune cells called macrophages.  Somewhere along the line, the LDL becomes oxidized.  Macrophages accumulate the oxidized LDL, grow into giant "foam cells", together with eventually die, releasing their cargo of cholesterol together with fatty into the artery wall.  Arterial lesions swell, together with the tissue within them becomes fibrous, calcified, together with necrotic.  Blood menstruum through the artery is restricted.  Sometimes, the lesion bursts, causing a clot that stops blood menstruum to the heart, brain, or other tissues.  This is a essence attack, stroke, or other embolism.

There are surely contributors to cardiovascular adventure likewise LDL particles.  HDL particles, for example, are in all likelihood protective*.  Also, cigarette smoking greatly increases the adventure of having a essence attack, together with this increment inwards adventure is largely independent of effects on blood lipids.  Similarly, the protective effects of practice are partially independent of blood lipids.  Yet zilch changes the fact that, all things existence equal, higher lifetime LDL = higher risk.

In roughly corners of the option wellness community, the sentiment persists that LDL is unrelated to cardiovascular risk.  I squall back this is wrong, together with frankly, dangerous.

Statin drugs, every bit nosotros know, trim back LDL cholesterol together with also trim back cardiovascular adventure inwards high-risk groups.  Some people receive got argued that statins receive got effects likewise LDL lowering that could explicate their protective action.  It's non an unreasonable idea.  Yet a novel course of teaching of cholesterol-lowering drug promises to erase whatsoever remaining doubtfulness that lowering LDL protects against essence laid upwards on risk.

Enter PCSK9

PCSK9 (proprotein convertase subtilisin/kexin type 9) is an enzyme that regulates levels of the LDL receptor.  The less PCSK9 in that location is inwards a liver cell, the to a greater extent than LDL receptor that jail cellphone volition express, together with the to a greater extent than LDL cholesterol it volition take from the blood.  In short, lower PCSK9 = lower LDL.  Researchers receive got known since 2006 that people amongst naturally occurring mutations that inactivate PCSK9 receive got a much lower adventure of cardiovascular events (1).  Therefore, PCSK9 was considered an extremely valuable drug target.

Well, a decade has passed, together with nosotros straight off receive got drugs that inhibit PCSK9.  They are antibodies that, i time injected, bind together with inactivate the enzyme.  Turns out, these drugs tin lower LDL past times nearly half, which beats statins.  Yet PCSK9 inhibitors receive got non gone completely through the drug evolution pipeline, together with thus all nosotros receive got are preliminary studies on whether or non they genuinely protect against essence attacks together with stroke.  A novel meta-analysis cobbles together all of the preliminary reports, allowing us to larn a amend sentiment of whether or non these drugs genuinely work.

The study

Eliano Navarese together with colleagues collected information from 24 stage II together with stage III randomized, placebo-controlled trials of PCSK9 inhibitors (2).  These trials included information from over 10,000 patients.  Navarese together with colleagues compiled the information on efficacy together with safety, together with analyzed it statistically.

The results

PCSK9 inhibitors reduced LDL cholesterol past times nearly one-half (49.5%).  They also reduced essence attacks past times to a greater extent than than one-half (51%), together with all-cause mortality past times to a greater extent than than one-half (55%).

PCSK9 inhibitors didn't increment the charge per unit of measurement of serious adverse events.

Interpretation

We straight off receive got 2 independent drug therapies, statins together with PCSK9 inhibitors, that substantially trim back LDL levels past times completely dissimilar mechanisms.  Both seem to trim back cardiovascular risk, although we'll need additional randomized, controlled trials to last 100% sure nearly the efficacy together with security of PCSK9 inhibitors (the trials inwards this meta-analysis were mostly brusque together with weren't designed to mensurate effects on cardiovascular events or mortality).

The mount of bear witness implicating LDL inwards cardiovascular affliction simply got larger.  I hope this volition last a wake-up telephone band for people who don't squall back LDL is important.


* Some people receive got questioned this, based on the results of the CETP inhibitor trials, which increased HDL cholesterol but didn't trim back cardiovascular risk.  This is non a really convincing declaration against the importance of HDL, together with here's why: there's no ground to aspect that pumping HDL particles amount of extra cholesterol would trim back cardiovascular risk.  One of HDL's jobs is to accept cholesterol out of the artery wall together with convey it to the liver for disposal.  Artificially increasing the cholesterol cargo of the particle, every bit CETP inhibitors do, isn't going to help HDL accept to a greater extent than cholesterol out of the artery-- if anything, it should trim back its capacity to produce so.  It's essentially "treating a number", amongst no regard for the biological machinery of activity of the HDL particle.  We don't however empathise how to increment the mightiness of the HDL particle to carry cholesterol out of the artery, but if nosotros tin heighten that process, nosotros volition in all likelihood receive got roughly other effective agency of protecting against essence disease.

Recent Interviews

Here are 2 recent interviews I'd similar to portion alongside readers:

Danny Lennon of Sigma Nutrition

Danny Lennon is an evidence-based nutrition coach who publishes a podcast called Sigma Nutriton Radio.  We had a prissy conversation close why nosotros overeat, including unloosen energy homeostasis in addition to the personal economic science of nutrient choice.  The podcast has a high production value.  You tin locomote brain to the interview here.

Angelo Coppola of Latest inwards Paleo

Angelo Coppola in addition to I hitting it off of late due to our usual interests inwards gardening in addition to self-reliance.  We of late had a prissy conversation close hunter-gatherer dietary patterns, the personal economic science of nutrient choice, U.S.A. diet history, legumes in addition to the Paleo diet, in addition to how much amount nosotros should eat.  You too function to demand heed a personal storey close the exclusively existing video of me every 2nd a tiddler (that I'm aware of).  This 1 too has a high production value.  You tin locomote brain to it here.

Insulin Resistance Strongly Predicts Cardiovascular Illness Risk

I late came across a real interesting newspaper past times the enquiry squad of Gerald Reaven, an endocrinologist at Stanford.  He has long been ane of the leading researchers studying insulin resistance, the metabolic syndrome, too their association amongst obesity.  Reaven's research, too that of many others, suggests that insulin resistance is a fundamental business office of the constellation of metabolic disturbances that are too then mutual inward affluent nations*.  We too convey skilful argue to believe that it contributes to cardiovascular risk.

All the agency dorsum inward 1998, Reaven's grouping published a newspaper that should heighten the eyebrows of anyone interested inward cardiovascular wellness (1).


The study

The written report was relatively simple: first, they recruited 147 thin too overweight volunteers without diabetes or diagnosed cardiovascular disease.  Then, they measured the volunteers' insulin sensitivity.  While most studies of this nature indirectly gauge insulin sensitivity precisely past times using a formula based on fasting insulin too glucose measurements (HOMA-IR), which tin laissez passer on the axe travel inaccurate, Reaven's grouping direct measured insulin sensitivity using a gilt measure method**.

Next, they waited nearly 5 years too watched who developed cardiovascular illness over that period.

The results

To analyze the results, they divided the volunteers into iii equal-sized groups based on their score of insulin resistance (inverse of sensitivity). Group I had the lowest bird of insulin resistance, grouping II had an intermediate level, too grouping III had the highest level.  The next graph illustrates the issue of people who were diagnosed amongst cardiovascular disease, or suffered a cardiovascular event, inward each grouping over the course of written report of the study:

None of the people inward the most insulin-sensitive grouping developed cardiovascular illness over the five-year period, spell a total 14 percent of the most insulin-resistant grouping developed illness over the same period.  That's a huge difference.

Clearly, if you lot attention virtually your cardiovascular health, you lot should attention virtually your insulin sensitivity.

People who were the to the lowest degree insulin resistant (group I) were too the leanest, exercised the most, had the lowest blood pressure, the lowest levels of LDL ("bad") cholesterol, too the highest levels of HDL ("good") cholesterol.  Was insulin resistance actually an of import predictor of cardiovascular illness risk, or was it precisely associated amongst other unhealthy characteristics?  To response this question, the enquiry squad analyzed the human relationship betwixt insulin resistance too cardiovascular illness hazard spell mathematically asset the other variables constant.

What this analysis showed is that insulin resistance was the strongest "independent predictor" of cardiovascular risk-- moreso than other established hazard factors similar LDL cholesterol.  In fact, it was the solely predictor that remained statistically significant.  This shows that insulin resistance has major predictive value for cardiovascular illness risk, too it too raises the possibility that insulin resistance could travel a powerful driver of cardiovascular disease.  From the paper:

These information supply substantial back upward for the persuasion that the presence of insulin resistance identifies a subset of the population who volition prepare CVD over a relatively curt fourth dimension period.

Am I insulin resistant?

The exam Reaven's grouping used to accurately mensurate insulin sensitivity is labor-intensive too it's solely available for enquiry purposes.  Yet at that topographic point are a few uncomplicated questions you lot tin laissez passer on the axe inquire yourself that volition laissez passer on you lot a pretty skilful thought of whether or non you're insulin resistant.

1. What's your trunk weight?  If you're overweight, you lot may travel insulin resistant.  If you're obese, there's an 80-90 pct hazard you're insulin resistant.  If you're lean, that doesn't necessarily hateful you're insulin sensitive, but the likelihood is higher.
2. What's your trunk fatty distribution?  If you're moderately overweight but you lot deport your fatty evenly all over your body, there's a skilful hazard you're insulin sensitive.  If you lot deport most of your fatty inward your abdominal percentage (belly), you're likely insulin resistant.
3. How physically active are you?  If you lot convey a high bird of physical activeness too you lot aren't obese, you're likely insulin sensitive.  If you're sedentary, peculiarly sedentary too overweight or obese, you're likely insulin resistant.

If you lot intend you're insulin resistant, the fastest effective agency to start out addressing the work is to do regularly.  Play basketball, swim, jog, hike, cycle, elevator weights, walk-- it doesn't affair what activeness you lot choose-- precisely larn moving!  Controlling your weight too eating a healthy, whole-food-based diet volition too assist over the long term.

* I would fighting that leptin resistance is as important.
** Insulin suppression test.