ReportWire

Tag: seizures

  • Be Prepared: Common Emergencies Every Dog Parent Should Know | Animal Wellness Magazine

    Be Prepared: Common Emergencies Every Dog Parent Should Know | Animal Wellness Magazine

    Dog parents see their fair share of emergency cases. But here’s the good news: being informed about common emergencies can help you stay calm and take the right actions when your dog needs you most. Here are some situations you should be aware of.

    When Your Dog’s Belly Becomes a Ticking Time Bomb

    Bloat, or gastric dilatation-volvulus (GDV), is a life-threatening condition in which a dog’s stomach fills with gas and potentially twists on itself. Large, deep-chested breeds are especially prone. Watch for symptoms like a swollen abdomen, unsuccessful attempts to vomit, and restlessness. If you suspect bloat, it’s crucial to get to a vet immediately – this is a true emergency where every minute counts.

    When Fun in the Sun Turns Dangerous

    Dogs can’t sweat like we do, making them vulnerable to overheating. Signs of heatstroke include excessive panting, drooling, reddened gums, vomiting, and collapse. If you suspect heatstroke, move your dog to a cool area immediately, offer small amounts of water, and use cool (not cold) water to wet their coat. Then, head to the vet right away.

    Curiosity Can Be Toxic

    Dogs are curious creatures, sometimes to their detriment. Common toxins include chocolate, xylitol (found in sugar-free gum), grapes and raisins, onions, and certain plants. Symptoms of poisoning vary but can include vomiting, diarrhea, seizures, or collapse. If you suspect your dog has ingested something toxic, call your vet or a pet poison helpline immediately.

    When Accidents Happen

    Whether it’s a car accident, a fall, or a fight with another animal, trauma can lead to serious injuries. Look for signs like limping, bleeding, swelling, or changes in behavior. Even if external injuries aren’t apparent, internal damage could be present. When in doubt, a vet visit is always the safest decision.

    When Your Dog’s Brain Short-Circuits

    Witnessing your dog have a seizure can be terrifying. During a seizure, clear the area around your dog to prevent injury, and never put your hand near their mouth. Time the seizure if possible. Once it’s over, keep your dog calm and call your vet. If the seizure lasts more than five minutes or your dog has multiple seizures, it’s time for immediate veterinary care.

    When Something’s Stuck

    If your dog is choking, they may paw at their mouth, gag, or have difficulty breathing. For a conscious dog, you can try gently removing the object if you can see it. If you can’t, or if your dog loses consciousness, perform the canine Heimlich maneuver and rush to the vet.

    The Bottom Line: Be Prepared, Not Scared

    While these situations are scary, remember that knowledge and quick action can make all the difference. Keep your vet’s number and the nearest emergency vet clinic’s information easily accessible. Consider taking a pet first aid course to feel more confident in handling emergencies.

    Remember, you’re your dog’s first line of defense in an emergency. By staying informed and prepared, you’re giving your best friend the best chance at a quick recovery should the unexpected occur. Here’s to happy, healthy adventures with your canine companion!


    Post Views: 104


    Animal Wellness is North America’s top natural health and lifestyle magazine for dogs and cats, with a readership of over one million every year. AW features articles by some of the most renowned experts in the pet industry, with topics ranging from diet and health related issues, to articles on training, fitness and emotional well being.

    Animal Wellness

    Source link

  • The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

    The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

    Are there any safe and effective dietary supplements for weight loss?

    In a previous discussion, I noted that an investigation found that four out of five bottles of commercial herbal supplements bought at major U.S. retailers—GNC, Walgreens, Target, and Walmart—didn’t contain any of the herbs listed on their labels, instead “often containing little more than cheap fillers like powdered rice, asparagus and houseplants…”

    You might hope your supplement just contains houseplants. Weight-loss supplements are infamous for being “adulterated with prescription and over-the-counter” drugs. In a sampling of 160 weight-loss supplements that “were claimed as 100% natural,” more than half were tainted with drugs and active pharmacological ingredients, ranging from antidepressants like Prozac to erectile dysfunction medications like Viagra. Diuretic drugs are frequent contaminants, which makes sense. In my previous videos on ketogenic diets, I talk about rapid water loss being “the $33-billion diet gimmick” that has sold low-carb diets for more than a century. But why the Viagra?

    At least the spiked Viagra and Prozac are legal drugs. Researchers in Denver tested every weight-loss supplement they could find within a ten-mile radius. Alarmingly, they found that a third were adulterated with banned ingredients. The most common illegal adulterant of weight-loss supplements is sibutramine, which was sold as Meridia before it was yanked off the market back in 2010 for heart attack and stroke risk. Now, it is also blamed for cases of slimming supplement–induced psychosis.

    An analysis of weight-loss supplements bought off the internet that were advertised with claims like “purely natural products,” “harmless,” or “traditional herbal” found that a third of them contained high doses of the banned drug sibutramine and the rest had caffeine. Wouldn’t you be able to tell if caffeine was added to a supplement? Perhaps not, if it also had temazepam, a controlled substance (benzodiazepine) “downer” sedative found in half of the caffeine-tainted supplements.

    Doesn’t the FDA demand recalls of adulterated supplements? Yes, but they often just pop back up on store shelves. Twenty-seven supplements were purchased at least six months after recalls were released, and two-thirds still contained banned substances. That’s 17 out of 27 with the same pharmaceutical adulterant found originally, and 6 containing one or more additional banned ingredients. Aren’t the manufacturers penalized for noncompliance? Yes, but “the fines for violations are small compared to the profits.”

    One of the ways supplement makers can skirt the law is by labeling them as “not intended for human consumption because it shifts the responsibility from the seller to the user”—for example, labeling the fatal fat-burner DNP as “an industrial- or research chemical.” This is how designer street drugs can be sold openly at gas stations and convenience stores as “bath salts.” Another way is to claim synthetic stimulants added to slimming supplements are actually natural food constituents, like listing the designer drug dimethylamylamine (DMAA) as “geranium oil extract.” The FDA banned it in 2012 after it was determined that DMAA “was not found in geraniums.” Who eats geraniums anyway? Despite being tentatively tied to cases of sudden death and associated with hemorrhagic stroke, DMAA has continued to be found in weight-loss supplements with innocuous names like Simply Skinny Pollen made by Bee Fit with Trish.

    There is little doubt that certain banned supplements, like ephedra, could help people lose weight. “There’s only one problem, and it’s a big one: This supplement may kill you,” wrote a founding member of the American Board of Integrative Medicine.

    Are there any safe and effective dietary supplements for weight loss? As I discuss in my video Friday Favorites: Are Weight-Loss Supplements Safe and Effective?, when popular slimming supplements were put to the test in a randomized placebo-controlled trial, not a single one could beat out placebo sugar pills. “A systematic review of systematic reviews” of diet pills came to a similar conclusion: None appears to generate appreciable impacts “on body weight without undue risks.” That was the conclusion reached in a similar review out of the Weight Management Center at Johns Hopkins, which ended with: “In closing, it is fitting to highlight that perhaps the most general and safest alternative/herbal approach to weight control is to substitute low-energy density [low-calorie] foods for high-energy density and processed foods, thereby reducing total energy intake.” In other words, eat more whole plant foods and fewer animal foods and junk. “By taking advantage of the low-energy density [low-calorie] and health-promoting effects of plant-based foods, one may be able to achieve weight loss, or at least assist weight maintenance without cutting” down on the volume of food consumed or compromising its nutrient value.

    Learn more about the risks of supplements in my video Are Weight Loss Supplements Safe?.

    I referred to a keto diet video I did, check out the related posts below the links to other videos and blogs in that series.

    Learn more about optimal weight loss in my book, How Not to Diet. 

    Michael Greger M.D. FACLM

    Source link

  • The Safety of Weight-Loss Supplements  | NutritionFacts.org

    The Safety of Weight-Loss Supplements  | NutritionFacts.org

    Only 2 out of 12 supplement companies were found to have weight-loss products that were even accurately labeled.

    According to a national survey, one-third of adults who have made serious attempts at weight loss have tried using dietary supplements, for which Americans spend billions of dollars every year. Most people mistakenly thought that over-the-counter appetite suppressants, herbal products, and weight-loss supplements had to be approved for safety by a governmental agency, like the U.S. Food and Drug Administration (FDA), before being sold to the public or at least include some kind of warning on the label about potential side effects. Nearly half even thought they had to demonstrate some sort of effectiveness. None of that is true.

    As I discuss in my video Friday Favorites: Are Weight Loss Supplements Safe and Effective?, the “FDA has estimated that dietary supplements cause 50,000 adverse events annually,” most commonly liver and kidney damage. Of course, prescription drugs don’t just have adverse effects; they kill more than 100,000 Americans every year. But, you at least notionally have the opportunity to parse out the risks versus benefits of prescription drugs, thanks to testing and monitoring requirements typically involving thousands of individuals.

    When the manufacturer of Metabolife 356, a supplement containing ephedrine, had it tested on 35 people, only minor side effects were found, such as dry mouth, headache, and insomnia. However, once unleashed on a broad population, nearly 15,000 adverse effects were reported, including heart attacks, strokes, seizures, and deaths, before it was pulled from the market.

    Given the lack of government oversight, there is no guarantee that what’s on the label is even in the bottle, as you can see in the graph below and at 1:55 in my video. FDA inspectors have found that 70 percent of supplement manufacturers violated so-called Good Manufacturing Practices, which are considered the minimum quality standards. This includes things like basic sanitation and ingredient identification. Not 7 percent in violation, but 70 percent.

    DNA testing of herbal supplements across North America found that most could not be authenticated. In a significant percentage of the supplements tested, the main labeled ingredient was missing completely and substituted with something else. For example, a so-called St. John’s wort supplement contained nothing but senna, a laxative that can cause anal blistering. Only 2 out of 12 supplement companies had products that were accurately labeled.

    This problem isn’t limited to fly-by-night phonies in some dark corner of the internet either. The New York State Attorney General commissioned DNA testing of 78 bottles of commercial herbal supplements sold by Walgreens, Walmart, Target, and GNC “and found that four out of five…did not contain any of the herbs on their labels.” Instead, the capsules “often contained little more than cheap fillers like powdered rice, asparagus and houseplants…”

    What about weight-loss medications? See Are Weight Loss Pills Safe? and Are Weight Loss Pills Effective?. Also, see related posts below.

    Take a deep dive into the best way to lose weight with my book How Not to Diet. 

    Michael Greger M.D. FACLM

    Source link

  • The Neurotoxin in Star Fruit  | NutritionFacts.org

    The Neurotoxin in Star Fruit  | NutritionFacts.org

    Starfruit contains a neurotoxin known as caramboxin that can cause irreversible brain damage at high enough doses. 
     
    If someone walks into the emergency room with intractable hiccups, one of the questions the ER physician should ask is: Have you been eating star fruit? 
     
    In my video cautioning about oxalate-rich foods, Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much, I talked about star fruit nephrotoxicity—that is, kidney toxicity. “Excessive consumption of star fruit has been associated with the development of oxalate nephropathy,” kidney damage. Star fruits aren’t that big. Less than a cup of star fruit juice or “three fruits of star fruit” can result in acute star fruit nephrotoxicity. Indeed, “ingestion of even modest quantities of star fruits can produce oxalate nephropathy” (kidney problems). “It is essential to prevent star fruit nephrotoxicity by educating the public and especially diabetics to avoid consuming star fruit, especially on an empty stomach or in a dehydrated state.”  
     
    Let’s talk about the neurotoxicity. As I discuss in my video Neurotoxicity Effects of Starfruit, we’ve known about the neurotoxic effects for more than a quarter century, but few seem to be familiar with the syndrome. As you can see below and at 1:17 in my video, it most commonly starts with hiccups, then can worsen rapidly, especially in those who already have compromised kidney function. Why? Because “this fruit contains a powerful neurotoxin that can accumulate in the blood, cross the blood–brain barrier…and eventually cause irreversible damage” to the brain. The toxin itself, named caramboxin, is normally excreted by the kidneys, so it is especially toxic to those with renal insufficiency—that is, compromised kidney function—so much so that for those with severe chronic kidney disease, a single-star fruit can put someone in seizures within three hours, a coma, then death within three days. 

    In a series of about a hundred cases of toxicity, consumption ranged between just half a star fruit up to 50 star fruits, with an average of about 4, but most of those participants had some sort of pre-existing kidney disease. The average number of star fruits eaten by those in the normal kidney function group before their toxic dose was more like 15. So, people with normal kidney function may be more likely to suffer from kidney damage than brain damage, which starts with the consumption of around four star fruit. 
     
    The bottom line is that those with chronic kidney disease should avoid star fruit to avoid severe intoxication. In Brazil, where the fruit is popular, there are laws to alert people about the risks. Because of its neurotoxins, star fruit should be prohibited for patients with chronic kidney disease, but even those with normal kidney function may want to avoid the fruit—just something to think about before you reach for the stars. 
     
    For more on kidney health, see related videos below. 

    Michael Greger M.D. FACLM

    Source link

  • CBD Leads to Nonseizure Improvements, AbbVie Launches 24-Hour Levodopa Infusion in EU, CNM-Au8 Improves Visual Function and Cognition – Medical Marijuana Program Connection

    CBD Leads to Nonseizure Improvements, AbbVie Launches 24-Hour Levodopa Infusion in EU, CNM-Au8 Improves Visual Function and Cognition – Medical Marijuana Program Connection

    WATCH TIME: 4 minutes

    Welcome to this special edition of Neurology News Network. I’m Marco Meglio.

    In a survey study of patients with either Lennox-Gastaut syndrome or Dravet syndrome, findings showed that treatment with add-on cannabidiol (CBD; Epidiolex) led to improvements in nonseizure outcomes, regardless of reduction in seizure frequency. Despite the limitations associated with a retrospective survey-based study design, investigators concluded that further evaluation of CBD on nonseizure outcomes in these patient populations is warranted. On nonseizure domains of alertness, cognition, and executive function, 85% of respondents reported improvements in at least 1 survey question. This continued across several other nonseizure-related domains of emotional functioning (82%), language and communication (79% in nonverbal patients and 74% in verbal), and activities of daily living (51%).

    More than a year after it received approval by the European Commission, AbbVie has announced the European market launch of foslevodopa/foscarbidopa (Produodopa), the first and only 24-hour infusion of levodopa-based therapy for patients with advanced Parkinson disease (PD). Prior to the launch, the therapy had received authorization through the Decentralized Procedure in the third quarter of 2022, followed by a CE mark in November of 2023. Also referred to as ABBV-951, this formulation of levodopa and carbidopa prodrugs are delivered as a 24-h/day continuous subcutaneous infusion (CSCI) via…

    Original Author Link click here to read complete story..

    MMP News Author

    Source link

  • Muscle Shrinkage and Bone Loss on Keto Diets?  | NutritionFacts.org

    Muscle Shrinkage and Bone Loss on Keto Diets?  | NutritionFacts.org

    Ketogenic diets have been found to undermine exercise efforts and lead to muscle shrinkage and bone loss. 
     
    An official International Society of Sports Nutrition position paper covering keto diets notes the “ergolytic effect” of keto diets on both high- and low-intensity workouts. Ergolytic is the opposite of ergogenic. Ergogenic means performance-boosting, whereas ergolytic means performance-impairing. 
     
    For nonathletes, ketosis may also undermine exercise efforts. Ketosis was correlated with increased feelings of “perceived exercise effort” and “also significantly correlated to feelings of ‘fatigue’ and to ‘total mood disturbance,’” during physical activity. “Together, these data suggest that the ability and desire to maintain sustained exercise might be adversely impacted in individuals adhering to ketogenic diets for weight loss.” 
     
    You may recall that I’ve previously discussed that shrinkage of measured muscle mass among CrossFit trainees has been reported. So, a ketogenic diet may not just blunt the performance of endurance athletes, but their strength training as well. As I discuss in my video Keto Diets: Muscle Growth and Bone Density, study participants performed eight weeks of the battery of standard upper and lower body training protocols, like bench presses, pull-ups, squats, and deadlifts, and there was no surprise. You boost muscle mass—unless you’re on a keto diet, in which case there was no significant change in muscle mass after all that effort. Those randomized to a non-ketogenic diet added about three pounds of muscle mass, whereas the same amount of weight lifting on the keto diet tended to subtract muscle mass by about 3.5 ounces on average. How else could you do eight weeks of weight training and not gain a single ounce of muscle on a ketogenic diet? Even keto diet advocates call bodybuilding on a ketogenic diet an “oxymoron.” 
     
    What about bone loss? Sadly, bone fractures are one of the side effects that disproportionately plague children placed on ketogenic diets, along with slowed growth and kidney stones. Ketogenic diets may cause a steady rate of bone loss as measured in the spine, presumed to be because ketones are acidic, so keto diets can put people in what’s called a “chronic acidotic state.” 
     
    Some of the case reports of children on keto diets are truly heart-wrenching. One nine-year-old girl seemed to get it all, including osteoporosis, bone fractures, and kidney stones, then she got pancreatitis and died. Pancreatitis can be triggered by having too much fat in your blood. As you can see in the graph below and at 2:48 in my video, a single high-fat meal can cause a quintupling of the spike in triglycerides in your bloodstream within hours of consumption, which can put you at risk for inflammation of the pancreas.  

    The young girl had a rare genetic disorder called glucose transporter deficiency syndrome. She was born with a defect in ferrying blood sugar into her brain. That can result in daily seizures starting in infancy, but a ketogenic diet can be used as a way to sneak fuel into the brain, which makes a keto diet a godsend for the 1 in 90,000 families stricken with this disorder.

    As with anything in medicine, it’s all about risks versus benefits. As many as 30 percent of patients with epilepsy don’t respond to anti-seizure drugs. Unfortunately, the alternatives aren’t pretty and can include brain surgery that implants deep electrodes through the skull or even removes a lobe of your brain. This can obviously lead to serious side effects, but so can having seizures every day. If a ketogenic diet can help with seizures, the pros can far outweigh the cons. For those just choosing a diet to lose weight, though, the cost-benefit analysis would really seem to go the other way. Thankfully, you don’t need to mortgage your long-term health for short-term weight loss. We can get the best of both worlds by choosing a healthy diet, as I discussed in my video Flashback Friday: The Weight Loss Program That Got Better with Time.
     
    Remember the study that showed the weight loss was nearly identical in those who had been told to eat the low-carb Atkins diet for a year and those told to eat the low-fat Ornish diet, as seen below and at 4:18 in my video? The authors concluded, “This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.” That seems like terrible advice. 

    There are regimens out there like “The Last Chance Diet which consisted of a low-calorie liquid formula made from leftover byproducts from a slaughterhouse [that] was linked to approximately 60 deaths from cardiovascular-related events.” An ensuing failed lawsuit from one widower laid the precedent for the First Amendment protection for those who produce deadly diet books. 

    It’s possible to construct a healthy low-carb diet or an unhealthy low-fat one—a diet of cotton candy would be zero fat—but the health effects of a typical low-carb ketogenic diet like Atkins are vastly different from a low-fat plant-based diet like Ornish’s. As you can see in the graph below and at 5:26 in my video, they would have diametrically opposed effects on cardiovascular risk factors in theory, based on the fiber, saturated fat, and cholesterol contents of their representative meal plans. 

    And when actually put to the test, low-carb diets were found to impair artery function. Over time, blood flow to the heart muscle itself is improved on an Ornish-style diet and diminished on a low-carb one, as shown below and at 5:44 in my video. Heart disease tends to progress on typical weight-loss diets and actively worsens on low-carb diets, but it may be reversed by an Ornish-style diet. Given that heart disease is the number one killer of men and women, “recommending any diet that a patient will adhere to in order to lose weight” seems irresponsible. Why not tell people to smoke? Cigarettes can cause weight loss, too, as can tuberculosis and a meth habit. The goal of weight loss is not to lighten the load for your pallbearers. 

     
    For more on keto diets, see my videos on the topic. Interested in enhancing athletic performance? Check out the related videos below. 

    Michael Greger M.D. FACLM

    Source link

  • The Safety of Keto Diets  | NutritionFacts.org

    The Safety of Keto Diets  | NutritionFacts.org

    What are the effects of ketogenic diets on nutrient sufficiency, gut flora, and heart disease risk? 

    Given the decades of experience using ketogenic diets to treat certain cases of pediatric epilepsy, a body of safety data has accumulated. Nutrient deficiencies would seem to be the obvious issue. Inadequate intake of 17 micronutrients, vitamins, and minerals has been documented in those on strict ketogenic diets, as you can see in the graph below and at 0:14 in my video Are Keto Diets Safe?. 

    Dieting is a particularly important time to make sure you’re meeting all of your essential nutrient requirements, since you may be taking in less food. Ketogenic diets tend to be so nutritionally vacuous that one assessment estimated that you’d have to eat more than 37,000 calories a day to get a sufficient daily intake of all essential vitamins and minerals, as you can see in the graph below and at 0:39 in my video. 


    That is one of the advantages of more plant-based approaches. As the editor-in-chief of the Journal of the American Dietetic Association put it, “What could be more nutrient-dense than a vegetarian diet?” Choosing a healthy diet may be easier than eating more than 37,000 daily calories, which is like putting 50 sticks of butter in your morning coffee. 
     
    We aren’t just talking about not reaching your daily allowances either. Children have gotten scurvy on ketogenic diets, and some have even died from selenium deficiency, which can cause sudden cardiac death. The vitamin and mineral deficiencies can be solved with supplements, but what about the paucity of prebiotics, the dozens of types of fiber, and resistant starches found concentrated in whole grains and beans that you’d miss out on? 
     
    Not surprisingly, constipation is very common on keto diets. As I’ve reviewed before, starving our microbial self of prebiotics can have a whole array of negative consequences. Ketogenic diets have been shown to “reduce the species richness and diversity of intestinal microbiota,” our gut flora. Microbiome changes can be detected within 24 hours of switching to a high-fat, low-fiber diet. A lack of fiber starves our good gut bacteria. We used to think that dietary fat itself was nearly all absorbed in the small intestine, but based on studies using radioactive tracers, we now know that about 7 percent of the saturated fat in a fat-rich meal can make it down to the colon. This may result in “detrimental changes” in our gut microbiome, as well as weight gain, increased leaky gut, and pro-inflammatory changes. For example, there may be a drop in beneficial Bifidobacteria and a decrease in overall short-chain fatty acid production, both of which would be expected to increase the risk of gastrointestinal disorders. 
     
    Striking at the heart of the matter, what might all of that saturated fat be doing to our heart? If you look at low-carbohydrate diets and all-cause mortality, those who eat lower-carb diets suffer “a significantly higher risk of all-cause mortality,” meaning they live, on average, significantly shorter lives. However, from a heart-disease perspective, it matters if it’s animal fat or plant fat. Based on the famous Harvard cohorts, eating more of an animal-based, low-carb diet was associated with higher death rates from cardiovascular disease and a 50 percent higher risk of dying from a heart attack or stroke, but no such association was found for lower-carb diets based on plant sources.  
     
    And it wasn’t just Harvard. Other researchers have also found that “low-carbohydrate dietary patterns favoring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favored plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain bread, were associated with lower mortality…” 
     
    Cholesterol production in the body is directly correlated to body weight, as you can see in the graph below and at 3:50 in my video. 

    Every pound of weight loss by nearly any means is associated with about a one-point drop in cholesterol levels in the blood. But if we put people on very-low-carb ketogenic diets, the beneficial effect on LDL bad cholesterol is blunted or even completely neutralized. Counterbalancing changes in LDL or HDL (what we used to think of as good cholesterol) are not considered sufficient to offset this risk. You don’t have to wait until cholesterol builds up in your arteries to have adverse effects either; within three hours of eating a meal high in saturated fat, you can see a significant impairment of artery function. Even with a dozen pounds of weight loss, artery function worsens on a ketogenic diet instead of getting better, which appears to be the case with low-carb diets in general.  

    For more on keto diets, check out my video series here. 

    And, to learn more about your microbiome, see the related videos below.

    Michael Greger M.D. FACLM

    Source link

  • Can You Sustain Weight Loss on Ketosis?  | NutritionFacts.org

    Can You Sustain Weight Loss on Ketosis?  | NutritionFacts.org

    Might the appetite-suppressing effects of ketosis improve dietary compliance? 

    The new data are said to debunk “some, if not all, of the popular claims made for extreme carbohydrate restriction,” but what about ketones suppressing hunger? In a tightly controlled metabolic ward study where the ketogenic diet made things worse, everyone ate the same number of calories, but those on a keto diet lost less body fat. But, out in the real world, all of those ketones might spoil your appetite enough that you’d end up eating significantly less overall. On a low-carb diet, people end up storing 300 more calories of fat every day. Outside of the laboratory, though, if you were in a state of ketosis, might you be able to offset that if you were able to sustainably eat significantly less? 
     
    Paradoxically, as I discuss in my video Is Weight Loss on Ketosis Sustainable?, people may experience less hunger on a total fast compared to an extremely low-calorie diet. This may be thanks to ketones. In this state of ketosis, when you have high levels of ketones in your bloodstream, your hunger is dampened. How do we know it’s the ketones? If you inject ketones straight into people’s veins, even those who are not fasting lose their appetite, sometimes even to the point of getting nauseated and vomiting. So, ketones can explain why you might feel hungrier after a few days on a low-calorie diet than on a total zero-calorie diet—that is, a fast. 
     
    Can we then exploit the appetite-suppressing effects of ketosis by eating a ketogenic diet? If you ate so few carbs to sustain brain function, couldn’t you trick your body into thinking you’re fasting and get your liver to start pumping out ketones? Yes, but is it safe? Is it effective? 
     
    As you can see below and at 1:58 in my video, a meta-analysis of 48 randomized trials of various branded diets found that those advised to eat low-carb diets and those told to eat low-fat ones lost nearly identical amounts of weight after a year.

    Obviously, high attrition rates and poor dietary adherence complicate comparisons of efficacy. The study participants weren’t actually put on those diets; they were just told to eat in those ways. Nevertheless, you can see how even just moving in each respective direction can get rid of a lot of CRAP (which is Jeff Novick’s acronym for Calorie-Rich And Processed foods). After all, as you can see in the graph below and at 2:37 in my video, the four largest calorie contributors in the American diet are refined grains, added fats, meat, and added sugars. 

    Low-carb diets cut down on refined grains and added sugars, and low-fat diets tend to cut down on added fats and meat, so they both tell people to cut down on donuts. Any diet that does that already has a leg up. I figure a don’t-eat-anything-that-starts-with-the-letter-D diet could also successfully cause weight loss if it caused people to cut down on donuts, danishes, and Doritos, even if it makes no nutritional sense to exclude something like dill. 

    The secret to long-term weight-loss success on any diet is compliance. Diet adherence is difficult, though, because any time you try to cut calories, your body ramps up your appetite to try to compensate. This is why traditional weight-loss approaches, like portion control, tend to fail. For long-term success, measured not in weeks or months but in years and decades, this day-to-day hunger problem must be overcome. On a wholesome plant-based diet, this can be accomplished thanks in part to calorie density because you’re just eating so much food. On a ketogenic diet, it may be accomplished with ketosis. In a systematic review and meta-analysis entitled “Do Ketogenic Diets Really Suppress Appetite,” researchers found that the answer was yes. Ketogenic diets also offer the unique advantage of being able to track dietary compliance in real-time with ketone test strips you can pee on to see if you’re still in ketosis. There’s no pee stick that will tell you if you’re eating enough fruits and veggies. All you have is the bathroom scale. 

    Keto compliance may be more in theory than practice, though. Even in studies where ketogenic diets are being used to control seizures, dietary compliance may drop below 50 percent after a few months. This can be tragic for those with intractable epilepsy, but for everyone else, the difficulty in sticking long-term to ketogenic diets may actually be a lifesaver. I’ll talk about keto diet safety next. 

    The keto diet is in contrast to a diet that would actually be healthful to stick to. See, for example, my video series on the CHIP program here. 
     
    This was the fourth video in a seven-part series on keto diets. If you haven’t yet, be sure to watch the others listed in the related videos below. 

    Michael Greger M.D. FACLM

    Source link

  • Keto Diet to Effectively Fight Cancer?  | NutritionFacts.org

    Keto Diet to Effectively Fight Cancer?  | NutritionFacts.org

    What does the science say about the clinical use of ketogenic diets for epilepsy and cancer? 

    Blood sugar, also known as blood glucose, is the universal go-to fuel for the cells throughout our bodies. Our brain burns through a quarter pound of sugar a day because “glucose is the preferred metabolic fuel.” We can break down proteins and make glucose from scratch, but most comes from our diet in the form of sugars and starches. If we stop eating carbohydrates (or stop eating altogether), most of our cells switch over to burning fat. Fat has difficulty getting through the blood-brain barrier, though, and our brain has a constant, massive need for fuel. Just that one organ accounts for up to half of our energy needs. Without it, the lights go out…permanently. 

    To make that much sugar from scratch, our body would need to break down about half a pound of protein a day. That means we’d cannibalize ourselves to death within two weeks, but people can fast for months. What’s going on? The answer to the puzzle was discovered in 1967. Harvard researchers famously stuck catheters into the brains of obese subjects who had been fasting for more than a month and discovered that ketones had replaced glucose as the preferred fuel for the brain. Our liver can turn fat into ketones, which can then breach the blood-brain barrier and sustain our brain if we aren’t getting enough carbohydrates. Switching fuels has such an effect on brain activity that it has been used to treat epilepsy since antiquity. 

    In fact, the prescription of fasting for the treatment of epileptic seizures dates back to Hippocrates. In the Bible, even Jesus seems to have concurred. To this day, it’s unclear why switching from blood sugar to ketones as a primary fuel source has such a dampening effect on brain overactivity. How long can one fast? To prolong the fasting therapy, in 1921, a distinguished physician scientist at the Mayo Clinic suggested trying what he called “ketogenic diets,” high-fat diets designed to be so deficient in carbohydrates that they could effectively mimic the fasting state. “Remarkable improvement” was noted the first time it was put to the test, efficacy that was later confirmed in randomized, controlled trials. Ketogenic diets started to fall out of favor in 1938 with the discovery of the anti-seizure drug that would become known as Dilantin, but they’re still being used today as a third- or fourth-line treatment for drug-refractory epilepsy in children. 

    Oddly, the success of ketogenic diets against pediatric epilepsy seems to get conflated by “keto diet” proponents into suggesting a ketogenic diet is beneficial for everyone. Know what else sometimes works for intractable epilepsy? Brain surgery, but I don’t hear people clamoring to get their skulls sawed open. Since when do medical therapies translate into healthy lifestyle choices? Scrambling brain activity with electroshock therapy can be helpful in some cases of major depression, so should we get out the electrodes? Ketogenic diets are also being tested to see if they can slow the growth of certain brain tumors. Even if they work, you know what else can help slow cancer growth? Chemotherapy. So why go keto when you can just go chemo? 

    Promoters of ketogenic diets for cancer are paid by so-called ketone technology companies that offer to send you salted caramel bone broth powder for a hundred bucks a pound or companies that market ketogenic meals and report “extraordinary” anecdotal responses in some cancer patients. But more concrete evidence is simply lacking, and even the theoretical underpinnings may be questionable. A common refrain is that “cancer feeds on sugar.” But all cells feed on sugar. Advocating ketogenic diets for cancer is like saying Hitler breathed air so we should boycott oxygen. 

    Cancer can feed on ketones, too. Ketones have been found to fuel human breast cancer growth and drive metastases in an experimental model, more than doubling tumor growth. Some have even speculated that this may be why breast cancer often metastasizes to the liver, the main site of ketone production. As you can see below and at 4:59 in my video Is Keto an Effective Cancer-Fighting Diet?, if you drip ketones directly onto breast cancer cells in a petri dish, the genes that get turned on and off make for much more aggressive cancer, associated with significantly lower five-year survival in breast cancer patients, as you can see in the following graph and at 5:05 in my video. Researchers are even considering designing ketone-blocking drugs to prevent further cancer growth by halting ketone production.  

    Let’s also think about what eating a ketogenic diet might entail. High animal fat intake may increase the mortality risk among breast cancer survivors and potentially play a role in the development of breast cancer in the first place through oxidative stress, hormone disruption, or inflammation. This applies to men, too. “A strong association” has been found “between saturated fat intake and prostate cancer progression and survival.” Those in the top third of consumption of these kinds of fat-rich animal foods appeared to triple their risk of dying from prostate cancer. This isn’t necessarily fat in general either. No difference has been found in breast cancer death rates based on total fat intake. However saturated fat intake specifically may negatively impact breast cancer survival, increasing the risk of dying from it by 50 percent. There’s a reason the official American Cancer Society and American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline recommend a dietary pattern for breast cancer patients that’s essentially the opposite of a ketogenic diet. It calls for a diet that’s “high in vegetables, fruits, whole grains, and legumes [beans, split peas, chickpeas, and lentils]; low in saturated fats; and limited in alcohol consumption.” 

    “To date, not a single clinical study has shown a measurable benefit from a ketogenic diet in any human cancer.” There are currently at least a dozen trials underway, however, and the hope is that at least some cancer types will respond. Still, even then, that wouldn’t serve as a basis for recommending ketogenic diets for the general population any more than recommending everyone get radiation, surgery, and chemo just for kicks. 

    “Keto” has been the most-searched keyword on NutritionFacts.org for months, and I didn’t have much specific to offer…until now. Check out my other videos on the topic in related videos below. 

     For an overview of my cancer work, watch How Not to Die from Cancer. 

    Michael Greger M.D. FACLM

    Source link

  • Can You Lose Weight with Pills?  | NutritionFacts.org

    Can You Lose Weight with Pills?  | NutritionFacts.org

    Studies show that many doctors either tend to overestimate the amount of weight that can be lost with obesity drugs or are simply clueless.

    Current options for weight-loss medications include the ridiculously named Qsymia, a combination of phentermine (the phen in fen-phen) and topiramate, a drug that can cause seizures if you stop it abruptly. Qsymia was “explicitly rejected” multiple times for safety reasons in Europe “because of concerns about the medicine’s long-term effects on the heart and blood vessels” but, at the time of making my video Are Weight Loss Pills Effective?, remains available for sale in the United States. Belviq is in a similar boat—allowed in the United States but not in Europe due to “concerns about possible cancers, psychiatric disorders, and heart valve problems…”  

    Belviq is sold in the United States for about $200 a month. If you think that’s a lot, there’s Saxenda, which requires daily injections and is listed at the low, low price of only $1,281.96 for a 30-day supply. It carries a black box warning, the FDA’s strictest caution about potentially life-threatening hazards, for thyroid cancer risk. Paid consultants and employees of the company that makes it argue the greater number of breast tumors found among drug recipients may be due to “enhanced ascertainment,” meaning easier breast cancer detection just due to the drug’s effectiveness. 

    Contrave is another option if you ignore its black box warning about a potential increase in suicidal thoughts. Then there’s Alli, the drug that causes fat malabsorption, thereby resulting in side effects “including fecal urgency, oily stool, flatus with discharge, and fecal incontinence”—Alli can be your ally in anal leakage. The drug evidently “forces the patient to use diapers and to know the location of all the bathrooms in the neighborhood in an attempt to limit the consequences of urgent leakage of oily fecal matter.” A Freedom of Information Act exposé found that although company-sponsored studies claimed that “all adverse events were recorded,” one trial apparently conveniently failed to mention 1,318 of them. 

    What’s a little bowel leakage, though, compared to the ravages of obesity? As with anything in life, it’s all about risks versus benefits. However, in an analysis of more than a hundred clinical trials of anti-obesity medications that lasted up to 47 weeks, drug-induced weight loss never exceeded more than nine pounds. That’s a lot of money and a lot of risk for just a few pounds. Since you aren’t treating the underlying cause—a fattening diet—when people stop taking these drugs, the weight tends to come right back, so you’d have to take them every day for the rest of your life. But people do stop taking them. Using pharmacy data from a million people, most Alli users stopped after the very first purchase and most Meridia users didn’t even make it three months. Taking weight-loss meds is so disagreeable that 98 percent of users stopped taking them within the first year. 

    Studies show that many doctors tend to overestimate the amount of weight that can be lost with these drugs or are simply clueless. One reason may be that some clinical practice guidelines go out of their way to advocate prescribing medications for obesity. Are they seriously recommending drugging a third of Americans—more than 100 million people? You may not be surprised to learn that the principal author of the guidelines has a “significant financial interest or leadership position” in six separate pharmaceutical companies that all (coincidently) work on obesity drugs. In contrast, independent expert panels, like the Canadian Task Force on Preventive Health Care, explicitly recommend against weight-loss drugs, given their poor track record of safety and efficacy. 

    In case you missed my related video, check out Are Weight Loss Pills Safe?.

    As with all lifestyle diseases, it’s better to treat the underlying cause, which, in the case of obesity, is a fattening diet. For an example of what’s possible with a healthy diet intervention, see Flashback Friday: The Weight Loss Program That Got Better with Time. 

    Check out the related videos below for more about weight loss. 

    Michael Greger M.D. FACLM

    Source link

  • Severe Seizures Are Rising, Especially Among Minorities

    Severe Seizures Are Rising, Especially Among Minorities

    By Denise Mann 

    HealthDay Reporter

    MONDAY, Dec. 5, 2022 (HealthDay News) — Growing numbers of Americans are suffering prolonged, life-threatening seizures known as status epilepticus, and Black people are nearly twice as likely to experience these seizures as white people.
     

    These are the main findings from new research looking at hospitalizations for status epilepticus from 2010 to 2019 across the United States.Status epilepticus refers to a seizure that lasts for more than 5 minutes. Some people may experience convulsions during this state, while others may appear confused or seem like they’re daydreaming. Status epilepticus is an emergency and requires treatment in the hospital.

    The study wasn’t designed to say why these severe seizures are on the rise, but researchers have their theories. “It may be related to several causes including changing definitions for status epilepticus over time,” said study author Dr. Gabriela Tantillo. (At one time, only seizures lasting longer than 20 minutes were considered status epilepticus.)

    Also, there’s “greater recognition of seizure, including non-convulsive seizures, by the medical community and the general public,” said Tantillo, an assistant professor of neurology at Baylor College of Medicine in Houston.

    For the study, the researchers reviewed nearly 490,000 hospitalizations for status epilepticus. These rates increased significantly over the study period, especially among minorities.

    What’s more, minorities who experienced status epilepticus were more likely to need advanced treatments, including a breathing tube or feeding tube.

    “I was surprised to see that disparities in the incidence of status epilepticus for minorities have unfortunately persisted and even widened from 2010-2019 despite a greater awareness of status epilepticus and seizures, and changes in insurance with increasing coverage over time,” Tantillo said.

    Older adults were up to six times more likely to die during hospitalization with status epilepticus and were more likely to require breathing tubes or feeding tubes, compared to younger folks with these seizures, the study found.

    The researchers also noted that electroencephalogram (EEG) monitors, which record electrical activity in the brain, were more widely available for people with higher incomes or those treated at urban teaching hospitals.

    There are things that will help make care for people with status epilepticus more equitable, Tantillo said. “We need to understand the underlying causes of status epilepticus as they differ by sociodemographic factors, which requires greater research and investment from government, community groups and philanthropy,” she noted.

    Status epilepticus can be a result of uncontrolled epilepsy, a brain bleed, a brain tumor, or a severe underlying illness such as meningitis, she explained.

    “For cases of status epilepticus that are potentially preventable, such as in people with epilepsy, improving health literacy and reducing the stigma associated with seizures in the community would help get more patients the treatment they need,” Tantillo said.

    Minorities in the studies were less likely to die from status epilepticus. This may be because people with status epilepticus due to low antiseizure medication levels fare better than their counterparts who have other causes for the condition, such as a brain bleed or lack of oxygen to the brain.

    Expanding access to outpatient care can also help bridge some of these gaps, Tantillo said.

    In addition, working to diversify the medical workforce in neurology may also improve patient-physician trust and communication, and reduce implicit biases and health inequity over time, Tantillo suggested.

    “The findings are terrible but not surprising,” said Dr. Daniel Lowenstein. He is a professor and vice chair of neurology at the University of California, San Francisco. “The big picture is that it reveals yet again disparities that exist within the health care system based on race and socioeconomic class.”

    Such disparities are seen in the diagnosis and treatment of many diseases and conditions, he noted.
     

    Treating status epilepticus involves intervening as early as possible with a benzodiazepine and/or other antiseizure medication, said Lowenstein, who was not involved with the new study. How well someone fares is based on the underlying cause since some causes are more treatable than others.

    The findings were presented Friday at the American Epilepsy Society annual meeting, in Nashville. Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

    More information

    The Epilepsy Foundation has more on status epilepticus.

     

    SOURCES: Gabriela Tantillo, MD, MPH, assistant professor, neurology, Baylor College of Medicine, Houston; Daniel Lowenstein, MD, Robert B. and Ellinor Aird Professor, and vice chair, neurology, University of California, San Francisco; presentation, American Epilepsy Society, annual meeting, Dec. 2 to 6, 2022

    Source link