The final list of the year

Published 12.19.2016
As the year winds down, this may well be the last post of the year, and if that is the case, the next new post may be in 2017. It may be that I will repost (on the front page anyway) popular (such as it is) posts from this past year. We will be traveling soon, both before and after Christmas. We are fortunate this year as our entire immediate family will be together for the holiday. I hope the same is true for you and yours. 2016 has not been a great year, and I am more fearful than hopeful about 2017. That said, I wish any who read this a happy, healthy holiday season!

The following are interesting links found while surfing the interwebs.

• Well, this is different than what usually gets reported.

  In the modest, moderate, and high weight groups, 40%, 36%, and 19% of patients, respectively, regained more than half of the weight 2 years. But patients who lost the most weight were more likely than those who lost less to keep it off, and to continue losing weight, the authors reported.

  The data were taken from doctors notes made in electronic health records (EHR), so it’s a bit better than self reported surveys. EHR data can be incorrect, though my personal experience is that EHR accuracy improved as health workers became accustomed to them.

• You can have too much vitamin D. It turns out that 70 mcg (microgram) per day (about 3000 IUs) lowered the chance of conceiving in women (not an issue for post-menopausal me, of course).

  "This study reinforces data from previous studies looking at falls and fractures, which indicate that too much vitamin D can have adverse effects. This causes substantial concern regarding the incautious advocacy for high doses of vitamin D from some groups, particularly in North America," said Ian Reid, MD, of The University of Auckland in New Zealand, in an email to MedPage Today.

  A dose of 2000 IU* is 50 mcg and increases blood levels 20 ng/ml. I am currently alternating days of 2000 IU per day and 4000 IU per day, hoping the average would be 3000 IU. I haven’t noticed any change in my finger nails, so I might drop down to 2000 IU per day.

  "Vitamin D metabolites are biologically active compounds, the levels of which are tightly regulated. Therefore, to override these regulatory mechanisms with administration of very high doses is clearly unwise. This reinforces the view that physiological levels of vitamin D can be restored and maintained with doses of 400-800 IU/day, which have not been associated with any adverse effects," Reid said.

Read the rest.

• “Keto” Diets should NOT be the chose of most people, and certainly not for children.

• More bad news for Gary Taubes' “Alternate” hypothesis on obesity.

  The ‘carbohydrate-insulin theory of obesity’ is used to justify popular health claims stating that carbohydrates make you fat or a high glycemic load and consumption of sugar-sweetened beverages (SSBs) and breakfast skipping increase fat gain. According to this theory, the elevated postprandial insulin secretion to a high glycemic challenge is blamed as a causal mechanism by directing nutrients away from oxidation in muscle towards storage in adipose tissue. Scientific evidence is however largely disagreeing with an adverse effect of postprandial hyperinsulinemia on fuel partitioning. Possible reasons for this disagreement are differences in insulin sensitivity and energy balance. Diet-induced hyperinsulinemia may lead to a higher fat storage only at a positive energy balance. A shift in fuel partitioning towards fat storage requires improved or maintained insulin sensitivity in adipose tissue when compared with skeletal muscle. This may be the case during refeeding (after weight loss), physical inactivity or in metabolically healthy obese subjects (relative to insulin-resistant subjects). The adverse effect of a high-glycemic diet, SSBs consumption or breakfast skipping on body weight is likely due to increased energy consumption rather than to increased fat storage.

• Not every doctor is on board with the idea of giving everyone of a certain age a prophylactic statin. his has particular resonance for me as a good friend was recently convinced by a cardiologist to start a statin. Fortunately, she hasn’t had any muscle aches or any other evident reaction. For people with heart disease, (my friend has not been so diagnosed) statins are a relevant means of treatment with demonstrated efficacy. As a preventative measure, the jury is still out. As I’ve written before, if at all possible, stay out of the cardiologist’s office. It’s the Hotel California of medicine. You can check in any time you like, but you can never leave.

• Menopause is a significant change in a woman’s life, it is not a disease. Post menopause, a woman’s body is less able to compensate for the various ways she has been stressing it (smoking, overeating, drinking too much etc) and health issues begin to manifest, or worsen. But aging is not a disease. I agree that it’s an opportunity to alter habits— that’s certainly what happened for me when I found myself in early menopause.

• Why aren’t public weight loss programs successful? Let’s Move was a bit successful I think, but the main reason they aren’t successful is that people don’t want to accept responsbility for their condition. But that’s exactly what he objects to, people having to take a bit of responsibility. Anyway, the answer is not to limit people’s choices or increase taxes. The piece was written in April— none of this will happen under Trump.

• The bottom line here is move. Moving (exercising is the focus in the story, but walking and just not sitting the entire day goes a long way too. Yoga goes a long way towards increasing flexibility in my experience, and you don’t need to join a gym to do it. In fact, there are Youtube videos that provide better demonstrations of poses than any class I’ve taken at my gym.

• Exercise lowers risk of cervical cancer.

  Compared with 512 age-matched, noncancer controls, patients with cervical cancer (n=128) had significantly increased odds of reporting abstinence from recreational physical activity (OR 2.43; 95% CI 1.56-3.80) during the previous 20 years, as well as prior to that period. No association was noted between occupational-related physical inactivity and cervical cancer (OR 0.88; 95% CI 0.58-1.36) in this study.

* IU = International Units
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