Dr. Sekula on weight loss, fitness and nutrition

In the last post, I detailed the 10 books I read last year. Here’s a list of books I intend to read this year. As stated, the goal is 11 books. The list contains nine, leaving two spots open. There are two reasons for this. One, it’s early and something is bound to come out I’ll want to read. Two, now that the Mitch Rapp series is complete, they will be hard to ignore.  

The Power of Less by Leo Babauta. In a world full of clutter, how is less more? Already skimmed through. Suits my style perfectly. To the point. Practical and a quick read.

4HWW-Expanded and Updated by Tim Ferris. This one is next. Can’t wait to get started. Should be in it before January is over.

Lone Survivor by Marcus Luttrell. Reading it now. After all I’ve heard, very excited to get this book. The sole Navy SEAL survivor of a mission gone bad in Afghanistan. In case you didn’t know, SEALS are badasses.

The Covenant of the Wild by Stephen Budiansky. From the back cover, Animal-rights extremists argue that eating meat is murder and that pets are slaves. … shows domestication of animals is not an act of exploitation but a brilliantly successful evolutionary strategy. Sounds like my kind of book.

The Blind Side by Michael Lewis. Because I’m in love with Sandra Bullock and I’d rather read the book than watch the movie. Plus I love me some football.

Memorial Day and Consent to Kill by Vince Flynn. No explanation needed. 

Living Life in the Zone by Kyle Rote and Joe Pettigrew. A book for men on being a better Christian.

The Vegetarian Myth by Lierre Keith. After all I’ve heard and read about this book, I feel like I’ve read it. Sadly, that is not the case. But it won’t be for long.

So there you have it. The books I read last year and what I’m going to read this year. When the open slots get filled, I’ll let you know. What are you going to read this year?

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I”m not one for New Year’s Resolutions. Don’t know why. Never have been. But most people want to lose weight or start exercising more at this time of year. Those great and I help people do this all day, but I also like to read. Books, magazines, newspapers, journals, anything, really. Not much for the pop culture type stuff, something that will keep me involved (Mitch Rapp series) or teach me something (Eades, Ferris, Taubes) is my preference.

In the spirit of New Year’s Resolutions, I decided to post a list of books I read last year, with a brief review. My resolution this year is to read at least one more book than last. In the next post, I’ll put a list of books I intend to read this year.

Books that I read last year…

Good Calories, Bad Calories, Gary Taubes. It was my 3rd time through. Each time feels like the first. I’ll read it again this year. 

Beating Cancer with Nutrition, Patrick Quillin. Thorough book on dietary practices and cancer with a focus on food and supplements. If your approach is to do all you can,  Beating Cancer with Nutrition is the book you need. 

4HWW, Tim Ferriss. I read this book in 3, maybe 4 days. It was a fast, entertaining and educational read. Read it while in Mexico last year. Karma?

In Defense of Food, Michael Pollan. After two failed attempts, finally forced myself to read it. The message is good. The writing style, not so much. Too many words. Too many long sentences. I thought Pollan was a journalist? 

Outliers, Malcolm Gladwell. Bill Gates is just lucky, I guess. The 10,000 hour rule lives!

Training Camp, Jon Gordon. A book on the importance of hard work and the desire to succeed.

23 Minutes in Hell, Bill Weise. If you’re a Christian and have questions about Hell, read this book. It will change a lot (if not everything), that’s all I’m going to say. 

The 3rd Option, Separation of Power and Executive Power by Vince Flynn, from the Mitch Rapp series. If CIA secret spy stuff is your game, this series was written for you. Mitch Rapp is a terrorist and bad politician killing machine. Is bad politician redundant?

That’s the list of books, all 10 of them. I didn’t mention blog posts and journal articles. Like I said, my objective is to read 11 books this year, which will be detailed in the next post. The list already has 9 books. One little rule: it won’t count if I’ve already read it. 

What did you read last year and what is on your list for this year? Give me some ideas for the remaining spots.

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We interrupt our regularly scheduled programming (Top 10 non-generic and generic prescription drugs) to bring you this, what appears to be a concerted effort on the part of Big Pharma to keep their precious statins high on the list of prescribed drugs. (can you blame them? Between Lipitor and Simvistatin you’re looking at 109.2 million prescriptions and $7.4 billion in sales per year!).

In case you haven’t heard, statins and big pharma took it on the chin in a new study from the Journal of the American College of Cardiology. The results showed niacin was significantly more effective at reducing carotid artery plaque than statins alone. In fact, results showed plaque continuing to grow in the statins only group while regressing in the niacin group. I’m not going to detail the study and author’s conclusions, Dr. Eades has done a wonderful job of that.

I’m not even going to get into whether or not reducing LDL prevents heart attacks. I’m taking a different approach.

Now, a normal thinking individual might conclude niacin as a better alternative to statins in preventing cardiovascular disease. Such as Dr. William Davis over at the Heart Scan blog. He’s not really normal thinking, more like forward thinking (WAY forward compared to his colleagues) and he’s been banging on statins and tooting the niacin horn for a while.

What really has me perturbed is a concerted effort to keep precious statins at the top of the prescription list. For example, a Google news search today (11/20/09) showed 800+ stories on the search term: statin+niacin. Scrolling through the headlines of those on the first page, you see phrases like, “Vitamin B niacin offers no extra benefit to statin therapy,” “Niacin may not help arteries,” “No benefit for statin patients,” and on and on.

Another example is this, a press release published November 20, 2009, which relates study details showing an approximate 1/3 drop in “bad” cholesterol levels in the US from 1999 to 2006 (study abstract here). The last sentence in the first paragraph sums it up nicely,

“But a high percentage of adults still are not being screened or treated for high cholesterol levels.” 

I’m not sure what they mean by high. As you’ll see in my next post, about 1 in 2 adults in the US are taking a statin. You would think this one-third drop would be cause for celebration, and it is among the statins crowd. But while there is a significant drop in the number of cardiovascular-related deaths, incidence hasn’t decreased.

So the question isn’t whether or not statins work. They reduce LDL cholesterol but they don’t reduce the incidence of heart disease. So why take them? Why prescribe them? It’s like the statinators and policy makers can’t see the forest for the trees.

The unfortunate (for them) news on the effectiveness of niacin, the quick-to-the-table message parroted by the media, that the incidence of cardiovascular disease has not decreased and the $7.4 billion cash cow of statins is enough to make one skeptical, or disgusted.

Your thoughts?

This post is part of the Kathleen Show, Prevention not Rx.

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In last weeks post I detailed the Top 10 prescription drugs for the US in 2008. And since I was half-way through before realizing it was non-generic only, I decided to complete it and follow up with this one.

In a follow-up post I’m going to get into the metrics a little more, comparing generic and non-generic.

Let me preface the descriptive nature of this post by saying it’s amazing we prescribe drugs at this rate. I knew we took too many prescription drugs. I knew we were too dependent on them. But actually looking at this data and what it says sheds light on the extent of the problem, which is why I’m writing a follow-up. So on with this one…

Forty percent of non-generic drugs are related, one way or another, to hyperinsulinemia. For generic drugs, it’s 50% and for the same conditions – metabolic syndrome. Table 1 shows Top 10 Generic Drugs by number of prescriptions (millions). Additionally, the table also shows total sales (billions) and rank (in parentheses).

Table 1. Top 10 Generic Drugs in US for 2008.

Metabolic Syndrome Fab 5

The 50% of drugs related to metabolic syndrome (italicized in table) account for 258.1 million (or 44%) of prescriptions and $3.3 billion (or 40%) of retail sales. Chew on that for a moment…258.1 million prescriptions related to hyperinsulinemia, which is 25.1 (edit: 21.5 – operator error) million prescriptions and $270 million in retail sales per month.

Think anyone’s interested in keeping that kind of cash flowing? Do I have to ask?

Furthermore, these dollars are only a small part of the direct costs. No estimates for other direct or indirect costs are included.

Pretty disgusting, actually.

I mentioned last week that cognitive dissonance was to blame. I’m not so sure anymore. In my opinion, what we’re seeing here is nothing short of disgusting. There is plenty of research showing most of these problems can be fixed with simple changes in diet and exercise. Yet those recommendations aren’t coming. The ADA, for example, thinks type 2 diabetics need to eat 45-60 grams of carbs at each meal! It’s like telling someone with lung cancer that it’s okay to smoke one cigarette a day. Statinators are blind or on the dole. American Heart still spouts the low-fat dogma that has blinded all of them.

The more I think about it and the more I write about it, the more disgusted I get. What I need is a good laugh.

This post is part of the Kathleen Show, Prevention not Rx.

References (both are pdf documents)

1. 2008 Top 200 generic drugs by total prescriptions

2. 2008 Top 200 generic drugs by retail dollars

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Most people I work with are significantly overweight – average weight > 300 pounds. As you might expect, all have a cluster of metabolic disorders. Coincident with their condition,  they take a laundry list of prescription medications. In general the lists are nearly identical and include prescriptions for hypertension, diabetes, cholesterol and digestive disorders.

Given this, I assumed their laundry list was similar to that of the general public. So I went looking for the top 10 prescription drugs of 2008 to see if my thoughts would be confirmed.

Finding the Data.
I scoured the FDA website and could find nothing (for some reason, I thought the organization in charge of controlling this industry might track this stuff – go figure). I decided to contact them by phone and the person I spoke with (after about 3 minutes of menu clicks – seriously), directed me to drugtopics.com – here is their about page.

Table 1 shows information for 2008 (1), including the top 10 prescriptions, the number of prescriptions (millions) and retail sales (in billions) (2). Note: the list is for non-generic drugs only. Additionally, drugtopics.com separates their publications by top prescriptions and top selling. Table 1 is a combination of the two. The Sales column includes rank information.

 Table 1. Top 10 Prescribed Drugs in 2008.

Confirmation and Surprise.

So what was the confirmation? Cholesterol, hypertensive and digestive (GERD) disorder medications occupy spots #1, 2, 7 and 10 (italicized in table). They represent 110.2 million prescriptions and $15.3 billion in retail sales. It’s 40% of the top 10, 45% of all prescriptions and 49% of total retail sales. Lipitor by itself is 20% of all prescriptions and 19% of all retail sales for those in the top 10!

What surprised me? For starters, no diabetes drug in the top 10. Actos was the highest rated and it was 18th, with 12.5 million prescriptions. The $2.4 billion in sales would have been good enough for 10th on the sales list. This piqued my curiosity and led to another visit to drugtopics.com.

Thankfully they track prescriptions and sales of generic drugs too. Guess what was in the top 10? I’ll give you a hint. It starts with “M” and ends with “M.” This list too is dominated similarly and I’m working on a follow-up post.

My thoughts…

Insulin resistance is big business in this country, playing a small or large role in nearly all of these on the list. And the Standard American Diet (SAD) is being pushed down our throats by so many factions, I don’t even know which way is up sometimes.

With all the healthcare debate going on, it’s amazing to me those in charge can’t see what’s right under their noses. I’m blaming cognitive dissonance and the powerful sugar, corn and wheat lobbies.

My advice, trash the food guide pyramid. Ignore nearly all advice from registered dieticians and your doctor – they’re part of the cognitive dissonance crowd. Eat quality protein and healthy fats (including naturally saturated ones) at every meal, along with vegetables and exercise vigorously 2-3 days per week. That and keeping your stress levels down will go a long way to keep you from being on this list.

This post is part of the Kathleen Show, Prevention not Rx.

References (both are pdf documents).

1. 2008 Top 200 branded drugs by total prescriptions.

2. 2008 Top 200 branded drugs by retail dollars.

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Can the insanity of listening to celebrities ever stop? Are they ever right about anything?

Why is it news when Paul McCartney and Yoko Ono (and a bunch of other, pasty looking pseudo-celebrities) attempt to create a free yourself from meat day? Jeez, if giving up meat (even for one day) would bring me closer to looking like them, I’d put beef jerky in my socks.

And why are they the experts on “climate change?” I’ll bet they were consulted on the name change too, huh? As a perfect display on her understanding of the situation, Yoko provided this brilliant piece of evidence…

Give up one day and then it will be two days maybe. It’s a very, very intelligent idea.”

Very intelligent, indeed.

Sounds about as intelligent as the lady in the video (not identified, although she sounds like a nutritionist).

Cutting your meat consumption in half would be better for the climate than cutting your car use in half.

She looks like a vegetarian – too many carbs! (if you know what I mean)

Hey, I have an idea. Why don’t I start walking or riding my bike everywhere and doubling my meat consumption? All that extra activity will require more protein, gotta rebuild that tissue – and as I said before, I’m not not putting soy in my body.

I’ll let Paul and all the other men eat soy. Then I’ll put them in contact with Kramer – they’re gonna need some of these.

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Some random links on cholesterol and diabetes. They arrived in my daily research update and I’ve found them interesting. Interesting in that most of the treatments focus on a big pharma approach when simply dietary changes will work just as well.

So without further adieu, here are the ones I found most interesting…

• Could it be they’re targeting the wrong LDL particles? After all, statin therapy doesn’t care and the lipophobes certainly don’t. But according to this study from JAMA, lowering your LDL-C doesn’t necessarily reduce your risk of MI. Go figure. They seem a bit confused and hell-bent on finding a prophylactic treatment. I’ll do a full post on this article next week.
• And yet they’re told fructose is okay in moderation. Could it be all the fructose in their diet leads to liver problems? Why not tell them to control their carbohydrate intake and eliminate fructose (HFCS, specifically – see this post)? Oh no, that wouldn’t be prudent. That doesn’t fit with our ability to prescribe medicine.
• More backpedaling on the ACCORD trial. The mess that is the ACCORD trial has been discussed by Dr. Eades. It amazes me that aggressive behavior entails more intense prophylactic treatment. Could it be the danger arose from the prophylactic cocktails? Why not? Intensive HbA1C control through diet works extremely well and there is no cocktail effect.
• Red wine is good for you? What? No Glevlivet or Anejo. I’ll take a glass or two after a long week!

So there you have it. A few research updates.

Next week I’ll do a full review of the JAMA article.

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At least that’s the message from top researchers who wanted to set the record straight.

Let’s lay the groundwork. Three top researchers (as labeled by the press release) wanted to correct the inaccuracies and misunderstandings about high fructose corn syrup and it’s impact on the American diet.

At the Institute of Food Technologists annual meeting, a session entitled “High Fructose Corn Syrup: Sorting Myth from Reality” was held to set the record straight.

The first quote is telling.

Contrary to its name, high fructose corn syrup is essentially a corn sugar, stated sweetener expert John S. White, Ph.D., president of White Technical Research. "Recent marketing claims that sugar is healthier than high fructose corn syrup are misleading to consumers.

Yeah, sort of like saying stabbing myself with a big knife will hurt more than with a small knife. I can read the headlines already. “Leading researchers have discovered that stabbing yourself with a smaller knife causes less pain.” Somehow the whole wound thing gets completely ignored.

It’s convenient for them to gloss over the influence of HFCS (and sugar) in heart disease and a whole host of metabolic disorders, which happen to have coincided with an approximately 20% increase in fructose consumption from 1970 to 2007. Yikes, that’s a big knife!

After a few more mundane quotes aligning the similarities between sugar and HFCS, we get to the meat of the special session and press release.

This is a marketing issue, not a metabolic issue," stated David Klurfeld, Ph.D., national program leader for human nutrition in USDA’s Agricultural Research Service and editor of the June 2009 Journal of Nutrition supplement, "The State of the Science on Dietary Sweeteners Containing Fructose," in response to recent reformulations by manufacturers of products that once contained high fructose corn syrup. "The real issue is not high fructose corn syrup. It’s that we’ve forgotten what a real serving size is. We have to eat less of everything," he noted.

And there you have it…a marketing issue. It’s not about whether people are confused. In fact, these people are confused. They start with marketing and end with just eat less of everything. Can we apply that eating less mantra to HFCS?

It seems more like an act of desperation. Remember the Corn Refiners HFCS commercials? Here’s one and two.  And I don’t think people are confused. Here’s a list of HFCS spoofs on youtube. Accurate and funny.

To strengthen my hypothesis, I looked through the exhibitor list of the IFT annual meeting. I sorted by nutritive sweeteners and featured exhibitors. Here’s what I found (it’s an interactive database, so not sure results will come up properly – select featured exhibitors and nutritive sweeteners from the ingredient list). It’s pretty populated, showing a large number of nutritive sweetener exhibitors (somewhere between 40 and 50%). There’s also some overlap between featured exhibitors, sponsors and manufacturers of nutritive sweeteners. I’ll just say it’s pretty interesting…

What’s next, a special session on soy eggs? I produce plenty of estrogen, thank you very much.

Brian

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CSPI has released their 2009 Xtreme eating awards. The press release is here and their website announcement is here. 

Should I laugh? Should I cry? Or should I get pissed off? There hasn’t been much sleep this week, pissed off is leading down the stretch. 

CSPI does not have the public interest at heart (watch the first video).  They think you can’t make a decision on your own. You’re too dumb to decide, so they should decide for you.

This whole idea that I, you or anyone else will suddenly change our mind on what to order at the counter when presented with caloric content is silly. And to blame restaurants and fast food on obesity is further destruction of personal responsibility.

And I’m not so sure McDonald’s is responsible. Sure, there’s Spurlock and Supersize Me. But there are major issues with Spurlock, which I won’t completely detail here but he has refused to show his food logs – raising questions on the 5,000 daily caloric intake.

Next, he gained 10 pounds in one week. If the obesity argument is all about calories in versus calories out, how do you explain that? That’s an extra 35,000 calories in one week. That’s an extra 5,000 calories per day, with emphasis on extra! So if we take him at his word, that he was eating 5,000 calories per day, where does this extra fit in?

Which brings me back to CSPI and their Xtreme awards. If they really stood by their name – Center for Science in the Public Interest, they would promote what we’ve learned from science and not personal dogma. Science has taught us a significant reduction, if not complete elimination of bad carbohydrates from the body leads to a multitude of positive health benefits.

Now that I got that off my chest, it was a photo finish and feeling better won by a nose.

Brian

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Stephan over at Whole Health Source (an excellent blog – and in the list of Blogs I Read) has written a 3-part series on Eicosanoids.

If you’re interested in maintaining excellent cardiovascular health and wondering if your diet could be improved, these posts are mandatory reading.

The first, Eicosanoids, Fatty Liver and Insulin Resistance is the primer for metabolic syndrome.

The second, Eicosanoids and Ischemic Heart Disease is an eye-opener regarding consumption of poly-unsaturated fatty acids (PUFA).

The final, Eicosanoids and Ischemic Heart Disease part II shows that it’s not just the ratio of omega-6 and 3’s in the diet that’s important, but the amount too.

All of Stephan’s posts are good but this series may top them all!

Brian

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