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Tag: Stroke

  • Xylitol sugar substitute linked to increased risk of heart attack and stroke, study finds

    Xylitol sugar substitute linked to increased risk of heart attack and stroke, study finds

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    Xylitol is the latest sugar substitute to be linked to potential negative health impacts.

    In a study from the Cleveland Clinic, published Thursday in the European Heart Journal, researchers found higher amounts of xylitol are associated with an increased risk of heart attack and stroke. 

    Xylitol, a sugar alcohol found naturally in some plants, is not the most common sweetening agent in sugar-free food products in the U.S. but is often found in sugarless gum and some toothpastes.

    The study, which included more than 3,000 participants in the U.S. and UK, was observational, meaning it does not prove causation. Still, it prompts pause when it comes to the use of artificial sweeteners, especially as they continue to gain popularity as healthy alternatives.  

    “This study again shows the immediate need for investigating sugar alcohols and artificial sweeteners, especially as they continue to be recommended in combatting conditions like obesity or diabetes,” said research lead Dr. Stanley Hazen in a news release. “It does not mean throw out your toothpaste if it has xylitol in it, but we should be aware that consumption of a product containing high levels could increase the risk of blood clot related events.” 

    The authors note further studies are warranted to better understand the potential health risks. 

    Last year, the same research team found erythritol, a zero-calorie sugar substitute used to sweeten low-cal, low-carb and “keto” products, to have similar effects on the heart.

    While this study also didn’t definitively show causation, then-CBS News medical contributor Dr. David Agus said there was “certainly enough data to make you very worried.”

    In response to the erythritol study, Robert Rankin, executive director of the Calorie Control Council, an international association representing the low- and reduced-calorie food and beverage industry, told CBS News the results are “contrary to decades of scientific research showing low- and no-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages, and should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events.” 

    CBS News has reached out to the Calorie Control Council for comment on the latest research involving xylitol. 

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  • DC Council member Vincent Gray suffers 2nd stroke in 3 years – WTOP News

    DC Council member Vincent Gray suffers 2nd stroke in 3 years – WTOP News

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    The Ward 7 council member had been working to improve his mobility for months, but a spokesperson called Gray’s most recent stroke “a setback in that regard.”

    In this file photo, D.C. Mayor Vincent Gray prepares to testify before the Senate Committee on Homeland Security & Governmental Affairs at a hearing on statehood for D.C., on Capitol Hill Monday, Sept. 15, 2014. Federal prosecutors announced Wednesday that Gray would not face charges in connection to the probe of how his 2010 election campaign was funded. Seven others have pleaded guilty to various charges stemming from the four-year investigation.
    (AP Photo/J. Scott Applewhite)(AP/J. Scott Applewhite)

    D.C. Council member and former Mayor Vincent Gray suffered another stroke in April and has been receiving physical therapy ever since.

    In an emailed statement to WTOP, spokesperson Chuck Thies wrote Gray’s recovery from a “recent, minor stroke is proceeding.” The Ward 7 council member had been working to improve his mobility for months, but Thies called Gray’s most recent stroke “a setback in that regard.”

    “What we know for certain is that the Councilmember’s cognitive abilities are unaffected by this stroke or the one he experienced in 2021,” Thies wrote.

    Gray is undergoing daily physical therapy and plans to continue on council business while he recovers. In a separate statement, Thies confirmed that Gray still plans to attend George Washington University’s commencement on the National Mall on Sunday, where he is set to be awarded an honorary doctoral degree in public service.

    The 81-year-old commented on his health Thursday after Chairman Phil Mendelson wished him a speedy recovery on X. In a social media post, Gray called the stroke “a health setback,” and added that he has had “no subsequent issues.”

    It is Gray’s second stroke in three years. In 2021, he was hospitalized for bronchitis when he had a mild stroke. He still worked on other council business while in the hospital.

    In December of 2023, Gray announced that he won’t be running for reelection in 2024, closing out a nearly two-decade-long career in public service. His term is set to end on January 2025.

    Gray began his first term on the council in 2005 and served as D.C. mayor from 2011-2015.

    The Washington Post was first to report Gray’s health status.

    Get breaking news and daily headlines delivered to your email inbox by signing up here.

    © 2024 WTOP. All Rights Reserved. This website is not intended for users located within the European Economic Area.

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    Jose Umana

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  • Irregular Meals, Night Shifts, and Metabolic Harms  | NutritionFacts.org

    Irregular Meals, Night Shifts, and Metabolic Harms  | NutritionFacts.org

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    What can shift workers do to moderate the adverse effects of circadian rhythm disruption?

    Shift workers may have higher rates of death from heart disease, stroke, diabetes, dementia, and cardiovascular disease, as well as higher rates of death from cancer. Graveyard shift, indeed! But, is it just because they’re eating out of vending machines or not getting enough sleep? Highly controlled studies have recently attempted to tease out these other factors by putting people on the same diets with the same sleep—but at the wrong time of day. Redistributing eating to the nighttime resulted in elevated cholesterol and increases in blood pressure and inflammation. No wonder shift workers are at higher risk. Shifting meals to the night in a simulated night-shift protocol effectively turned about one-third of the subjects prediabetic in just ten days. Our bodies just weren’t designed to handle food at night, as I discuss in my video The Metabolic Harms of Night Shifts and Irregular Meals.

    Just as avoiding bright light at night can prevent circadian misalignment, so can avoiding night eating. We may have no control over the lighting at our workplace, but we can try to minimize overnight food intake, which has been shown to help limit the negative metabolic consequences of shift work. When we finally do get home in the morning, though, we may disproportionately crave unhealthy foods. In one experiment, 81 percent of participants in a night-shift scenario chose high-fat foods, such as croissants, out of a breakfast buffet, compared to just 43 percent of the same subjects during a control period on a normal schedule.

    Shiftwork may also leave people too fatigued to exercise. But, even at the same physical activity levels, chronodisruption can affect energy expenditure. Researchers found that we burn 12 to 16 percent fewer calories while sleeping during the daytime compared to nighttime. Just a single improperly-timed snack can affect how much fat we burn every day. Study subjects eating a specified snack at 10:00 am burned about 6 more grams of fat from their body than on the days they ate the same snack at 11:00 pm. That’s only about a pat and a half of butter’s worth of fat, but it was the identical snack, just given at a different time. The late snack group also suffered about a 9 percent bump in their LDL cholesterol within just two weeks.

    Even just sleeping in on the weekends may mess up our metabolism. “Social jetlag is a measure of the discrepancy in sleep timing between our work days and free days.” From a circadian rhythm standpoint, if we go to bed late and sleep in on the weekends, it’s as if we flew a few time zones west on Friday evening, then flew back Monday morning. Travel-induced jet lag goes away in a few days, but what might the consequences be of constantly shifting our sleep schedule every week over our entire working career? Interventional studies have yet put it to the test, but population studies suggest that those who have at least an hour of social jet lag a week (which may describe more than two-thirds of people) have twice the odds of being overweight. 

    If sleep regularity is important, what about meal regularity? “The importance of eating regularly was highlighted early by Hippocrates (460–377 BC) and later by Florence Nightingale,” but it wasn’t put to the test until the 21st century. A few population studies had suggested that those eating meals irregularly were at a metabolic disadvantage, but the first interventional studies weren’t published until 2004. Subjects were randomized to eat their regular diets divided into six regular eating occasions a day or three to nine daily occasions in an irregular manner. Researchers found that an irregular eating pattern can cause a drop in insulin sensitivity and a rise in cholesterol levels, as well as reduce the calorie burn immediately after meals in both lean and obese individuals. The study participants ended up eating more, though, on the irregular meals, so it’s difficult to disentangle the circadian effects. The fact that overweight individuals may overeat on an irregular pattern may be telling in and of itself, but it would be nice to see such a study repeated using identical diets to see if irregularity itself has metabolic effects.

    Just such a study was published in 2016: During two periods, people were randomized to eat identical foods in a regular or irregular meal pattern. As you can see in the graph below and at 4:47 in my video, during the irregular period, people had impaired glucose tolerance, meaning higher blood sugar responses to the same food.

    They also had lower diet-induced thermogenesis, meaning the burning of fewer calories to process each meal, as seen in the graph below and at 4:55 in my video.

    The difference in thermogenesis only came out to be about ten calories per meal, though, and there was no difference in weight changes over the two-week periods. However, diet-induced thermogenesis can act as “a satiety signal.” The extra work put into processing a meal can help slake one’s appetite. And, indeed, “lower hunger and higher fullness ratings” during the regular meal period could potentially translate into better weight control over the long term. 

    The series on chronobiology is winding down with just two videos left in this series: Shedding Light on Shedding Weight and Friday Favorites: Why People Gain Weight in the Fall.

    If you missed any of the other videos, see the related posts below. 
     

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    Michael Greger M.D. FACLM

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  • Lose Weight by Eating More in the Morning  | NutritionFacts.org

    Lose Weight by Eating More in the Morning  | NutritionFacts.org

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    A calorie is not a calorie. It isn’t only what you eat, but when you eat.

    Mice are nocturnal creatures. They eat during the night and sleep during the day. However, if you only feed mice during the day, they gain more weight than if they were fed a similar amount of calories at night. Same food and about the same amount of food, but different weight outcomes, as you can see in the graph below and at 0:18 in my video Eat More Calories in the Morning to Lose Weight, suggesting that eating at the “wrong” time may lead to disproportionate weight gain. In humans, the wrong time would presumably mean eating at night. 

    Recommendations for weight management often include advice to limit nighttime food consumption, but this was largely anecdotal until it was first studied experimentally in 2013. Researchers instructed a group of young men not to eat after 7:00 pm for two weeks. Compared to a control period during which they continued their regular habits, they ended up about two pounds lighter after the night-eating restriction. This is not surprising, given that dietary records show the study participants inadvertently ate fewer calories during that time. To see if timing has metabolic effects beyond just foreclosing eating opportunities, you’d have to force people to eat the same amount of the same food, but at different times of the day. The U.S. Army stepped forward to carry out just such an investigation.

    In their first set of experiments, Army researchers had people eat a single meal a day either as breakfast or dinner. The results clearly showed the breakfast group lost more weight, as you can see in the graph below and at 1:35 in my video. When study participants ate only once a day at dinner, their weight didn’t change much, but when they ate once a day at breakfast, they lost about two pounds a week. 

    Similar to the night-eating restriction study, this is to be expected, given that people tend to be hungrier in the evening. Think about it. If you went nine hours without eating during the day, you’d be famished, but people go nine hours without eating overnight all the time and don’t wake up ravenous. There is a natural circadian rhythm to hunger that peaks around 8:00 pm and drops to its lowest level around 8:00 am, as you can see in the graph below and at 2:09 in my video. That may be why breakfast is typically the smallest meal of the day. 

    The circadian rhythm of our appetite isn’t just behavioral, but biological, too. It’s not just that we’re hungrier in the evening because we’ve been running around all day. If you stayed up all night and slept all day, you’d still be hungriest when you woke up that evening. To untangle the factors, scientists used what’s called a “forced desynchrony” protocol. Study participants stayed in a room without windows in constant, unchanging, dim light and slept in staggered 20-hour cycles to totally scramble them up. This went on for more than a week, so the subjects ended up eating and sleeping at different times throughout all phases of the day. Then, the researchers could see if cyclical phenomena are truly based on internal clocks or just a consequence of what you happen to be doing at the time.  

    For instance, there is a daily swing in our core body temperature, blood pressure, hormone production, digestion, immune activity, and almost everything else, but let’s use temperature as an example. As you can see in the graph below and at 3:21 in my video, our body temperature usually bottoms out around 4:00 am, dropping from 98.6°F (37°C) down to more like 97.6°F (36.4°C). Is this just because our body cools down as we sleep? No. By keeping people awake and busy for 24 hours straight, it can be shown experimentally that it happens at about the same time no matter what. It’s part of our circadian rhythm, just like our appetite. It makes sense, then, if you are only eating one meal per day and want to lose weight, you’d want to eat in the morning when your hunger hormones are at their lowest level. 

    Sounds reasonable, but it starts to get weird.

    The Army scientists repeated the experiment, but this time, they had the participants eat exactly 2,000 calories either as breakfast or as dinner, taking appetite out of the picture. The subjects weren’t allowed to exercise either. Same number of calories, so the same change in weight, right? No. As you can see in the graph below and at 4:18 in my video, the breakfast-only group still lost about two pounds a week compared to the dinner-only group. Two pounds of weight loss eating the same number of calories. That’s why this concept of chronobiology, meal timing—when to eat—is so important. 

    Isn’t that wild? Two pounds of weight loss a week eating the same number of calories! That was a pretty extreme study, though. What about just shifting a greater percentage of calories to earlier in the day? That’s the subject of my next video: Breakfast Like a King, Lunch Like a Prince, Dinner Like a Pauper. First, let’s take a break from chronobiology to look at the Benefits of Garlic for Fighting Cancer and the Common Cold. Then, we’ll resume checking other videos in the related posts below.

    If you missed the first three videos in this extended series, also check out related posts below. 

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    Michael Greger M.D. FACLM

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  • Are Branched-Chain Amino Acids Good for Us?  | NutritionFacts.org

    Are Branched-Chain Amino Acids Good for Us?  | NutritionFacts.org

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    I discuss why we may not want to exceed the recommended intake of protein.

    Diabetes isn’t just about the amount of body fat, but also the distribution of body fat. At 0:26 in my video Are BCAA (Branched-Chain Amino Acids) Healthy?, you can view cross-sections of thighs from two different patients using MRI. In the images, the fat shows up as white and the thigh muscle is black. At first glance, you might think the bottom cross-section has more fat since it’s ringed with more white. That is the subcutaneous fat, the fat under the skin. But, if you look at the top cross-section, you’ll see how the middle of the thigh muscle is more marbled with fat, like those really fatty Japanese beef steaks. That is the fat infiltrating into the muscle. In the graph below and at 0:48 in my video, the two cross sections are colored so you can see the different types of fat: the fat infiltrating the muscle in red, the fat between the muscles in green, and subcutaneous fat outside of the muscles and under the skin in yellow. If you add up all three types of fat, both of those thighs actually have the same amount of fat—just distributed differently.

    This seems to be the critical factor in terms of determining insulin resistance, the cause of type 2 diabetes. Researchers found that the subcutaneous adipose tissue, the fat right under the skin, was not associated with insulin resistance. Going back to the two cross sections, as seen below and at 1:20 in my video, it is healthier to have the bottom thigh with the thicker ring of subcutaneous fat but less fat infiltrating muscle than the top thigh with more fat present in the muscle.

    Is it possible a more plant-based diet also affects a more healthful distribution of fat?

    We now know the effect of a vegetarian diet versus a conventional diabetic diet on thigh fat distribution in patients with type 2 diabetes. Researchers took 74 people with diabetes and randomly assigned them to follow either a vegetarian diet or a conventional diabetic diet. Both diets were calorie-restricted by the same number of calories. The vegetarian diet was also egg-free, and dairy was limited to a maximum of one serving of low-fat yogurt a day. What did the researchers find? The reduction in the more benign subcutaneous fat was comparable; it was about the same in both groups. However, the more dangerous fat—the fat lodged inside the muscle itself—“was reduced only in response to a vegetarian diet.” So, even getting the same number of calories, there can be a healthier weight loss on a more plant-based diet.

    Those eating strictly plant-based also had lower levels of fat stuck inside the individual muscle fibers themselves, which may help explain why vegans in particular are often found to have the lowest odds of diabetes. It is not just because vegans are generally slimmer either. Even if you match subjects pound for pound, there is significantly less fat inside the muscle cells of vegans compared to omnivores. This is a good thing, since storing fat in muscle cells “may be one of the primary causes of insulin resistance,” which is what’s behind both prediabetes and type 2 diabetes. On the other hand, if you put someone on a high-fat diet, the fat in their muscle cells shoots up by 54 percent in just a single week.

    What about a high-protein diet? That may undermine one of the principal benefits of weight loss: eliminating the weight-loss-induced improvement in insulin resistance. Researchers put obese individuals on a calorie-restricted diet of less than 1,400 calories a day until they lost 10 percent of their body weight. Half of the participants were getting more of a regular protein intake (73 grams a day), and the other half were on a higher-protein diet (about 105 daily grams). Normally, if you lose 10 percent of your body weight, your insulin resistance improves. That’s why it is so critical for obese individuals with type 2 diabetes to lose weight. However, the beneficial effect of a 10 percent weight loss was eliminated by the high protein intake. Those extra 32 grams of protein a day abolished the weight-loss benefit. “The failure to improve…insulin sensitivity in the WL-HP [weight-loss high-protein] group is clinically important because it reflects a failure to improve a major pathophysiological [cause-and-effect] mechanism involved in the development of T2D,” type 2 diabetes. In summary, the researchers concluded that they demonstrated “the protein content of a weight loss diet can have profound effects on metabolic function.” 

    Is this true of any protein? As you can see below and at 4:19 in my video, if you split it between animal protein versus plant protein, following people over time, intake of animal protein is associated with an increased risk of diabetes in most studies.

    Intake of plant protein, however, appears to have either a neutral or even protective association with diabetes, as shown below and at 4:25 in my video

    Those were just observational studies, though. People who eat a lot of animal protein might have many unhealthy behaviors. However, you see the same thing in randomized, controlled, interventional trials, where you can improve blood sugar control just by replacing sources of animal protein with plant protein.

    We think it may be the branched-chain amino acids concentrated in animal protein. Higher levels in the bloodstream are associated with obesity and the development of insulin resistance. As you can see below and at 5:00 in my video, we may be able to drop our levels by sticking to plant proteins, but you don’t know if that has metabolic effects until you put it to the test. 

    Ruining the suspense, researchers titled their study: “Decreased Consumption of Branched-Chain Amino Acids Improves Metabolic Health.” They demonstrated that “a moderate reduction in total dietary protein or selected amino acids can rapidly improve metabolic health,” and this included improving blood sugar control, while also decreasing body mass index (BMI) and body fat. As you can see at 5:27 in my video, the protein-restricted group was eating hundreds more calories per day, significantly more calories than the control group, so they should have gained weight. But, no. They lost weight! After about a month and a half, they were eating more calories but lost more weight—about five more pounds than participants in the control group who were eating fewer calories, as you can see at 5:38 in my video. What’s more, this “protein restriction” had people eat the recommended amount of protein per day, about 56 daily grams. They should have been called the normal protein group or the recommended protein group instead, and the group eating more typically American protein levels and suffering because of it should have been called the excess protein group. Just sticking to the recommended protein intake doubled the levels of a pro-longevity hormone called FGF21, too, but we’ll save that for another discussion.

    To better understand the negative impact of omnivores getting too much protein relative to vegetarians, see my video Flashback Friday: Do Vegetarians Get Enough Protein?.

    I have several additional videos and blogs that may help explain some of the benefits of plant-based proteins. Check in the related posts below.

    Of course, the best way to treat type 2 diabetes is to get rid of it by treating the underlying cause, as described in my video How Not to Die from Diabetes

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    Michael Greger M.D. FACLM

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

    The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

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    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

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    Michael Greger M.D. FACLM

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

    The Safety of Weight-Loss Supplements  | NutritionFacts.org

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    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

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    Michael Greger M.D. FACLM

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  • Coffee, Tea And Good Health

    Coffee, Tea And Good Health

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    Coffee and tea have been seen as villains for the body.  An entire industry has popped up around alternatives to just good coffee or a piping hot cuppa tea. There is a rough estimate the world drinks three cups of tea for every cup of coffee. And tea is the second most popular beverage in the world (behind water). Now science is indicate Coffee, tea and good health may go together.

    The study, published in PLOS Medicine, surveyed data on 360,000 people between the ages of 50 and 74, looking for their coffee and tea drinking habits and incidents of dementia and strokes over the years. After the initial survey was conducted, these same participants were followed up with 11 years later, allowing researchers to compare and contrast.

    RELATED: Coffee Protects You From This Disease According To New Research

    Photo by Kira auf der Heide via Unsplash

    The study concluded participants who drank two to three cups of any of these two drinks a day fared better than those who didn’t drink them at all. The sweet spot was found when people consumed the amount of each beverage daily (4 to 6 cups total), resulting in a 28% lower risk of dementia and 32% lower risk of a stroke.

    In an email exchange with CNN, Dr. Lee H. Schwamm, chair of the American Stroke Association Advisory Committee and chair in Vascular Neurology at Massachusetts General Hospital, explained while the study was intriguing there was no way of establishing causation from this initial data.

    RELATED: This Type Of Coffee Is Best For Your Heart Health

    “We cannot impute causality, and say ‘drinking more coffee or tea is good for your brain.’ What we can only say in this study, people who reported moderate coffee/tea drinking were less likely to have a stroke or dementia occur in the 10 years of follow-up,” he said.

    This Type Of Coffee Is Best For Your Heart Health
    Photo by Jenny Ueberberg via Unsplash

    RELATED: Here’s When You Should Drink Coffee For Maximum Productivity

    Coffee has long been associated with preventing a wide range of diseases and improving heart health. Still, it’s always important to approach caffeine in moderation, managing your coffee intake without keeping too much of a stern hold on it. When it comes to tea, studies have found links suggest lower odds of cardiovascular disease, better teeth, and even protection against cancer.

    In short, go for the warm drink in the morning, and don’t overthink it if you get the urge to have more later on in the day.

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    Maria Loreto

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  • Under bombing in eastern Ukraine and disabled by illness, an unknown painter awaits his fate

    Under bombing in eastern Ukraine and disabled by illness, an unknown painter awaits his fate

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    SLOVIANSK, Ukraine — Mykola Soloviov, 88, is a painter the world does not know. His landscapes of eastern Ukraine, records of a lost time, lie tucked away in a modest home under threat of Russian attack.

    Soloviov can’t hear or walk and barely speaks. Disabled since a 2017 stroke, he spends his days bedridden in an apartment in Sloviansk, a city 25 kilometers (15 miles) from the front line in the region of Donetsk.

    Waves of Russian missile attacks have continued to pound civilian areas across Ukraine as the war approaches its second anniversary next month, killing scores of Ukrainian civilians, often in their own homes. Eastern Ukraine, where troops live among the civilian population, is often hit the hardest.

    But his wife, Liudymla, doesn’t want Mykola and his paintings to die in anonymity. She wants the world to know he’s not just another civilian caught in the middle of a war.

    From the sofa where he lies motionless for much of the day, Mykola’s lively eyes are fixed on the window, his only view into the changing world he can no longer comprehend.

    He’d paint the same scenes again and again. “It’s not about what you paint, it’s about how you paint it,” he used to tell his wife when she asked why.

    Employed for much of his life as a painter in a factory, Mykola would spend hours by the window, gazing at the view and producing his works. Liudmyla, 78, held up a painting of that view: expertly layered soft colors bring out the purity of fresh winter snow.

    On Saturday, the window was a hole framed by shattered glass, showing emergency crews cleaning up debris from the kindergarten across the yard. Men in military fatigues picked their way across ground pockmarked by artillery craters and covered in debris left in the wake of a Russian air attack.

    Earlier that day, a Russian Iskander missile hit a ceramics workshop a few meters away from the Soloviovs’ home, leveling it and shattering their windows.

    The blast jolted Liudymla awake, who ran to her paralyzed husband’s side and covered him with blankets as bitterly cold air wafted in.

    “How can I feel? There is no joy in my life,” she said. “We are living on needles.” Her mind is occupied with all the things she must do for her husband. “I already changed (the blankets) and cooked for him, but it is cold inside my house.”

    Sloviansk was never a luxurious place but it had allowed the couple to build a life. Both were the children of parents who moved to the city, known for its factories and riverside resorts, looking for work. Mykola’s family came from Russia, and Liudmyla’s from western Ukraine. When she was 16, she helped her father build them a house, making cinder blocks and planing boards after school.

    On Saturday, she watched as workers sliced wooden boards to cover the holes left when the Russian attack shattered windows in dozens of apartments.

    The Associated Press asked her about the explosion, but she changed the subject back to her husband’s paintings.

    Liudmyla leafs through an old photo album containing images of Mykola’s paintings, the closest thing he has to an artist’s monograph, and then brings out a few of the originals she’s packed away for safe-keeping.

    The paintings are unknown in Sloviansk, let alone the world. An old newspaper clipping contains a short article, describing a gallery of 60 of his works “charming” and “cleverly composed.”

    Occasionally Mykola glances at her holding up his paintings, his face brightening.

    “He has been drawing since childhood,” she said, “but stopped when he got sick.”

    Soloviov often returned to the banks of the Kazenny Torets River to capture the changing seasons. “He was painting this river all the time, in summer, winter,” Liudymla said, her voice trailing off.

    Mykola never aimed for realism, but his paintings captured the feeling of the pastoral landscapes, waterways and abundant greenery that defined Sloviansk’s landscape before the war. His loose and fluid brush work convey vibrancy and nostalgia for the passing seasons; vivid colors show his deep attachment to the land.

    In 2014, Sloviansk was a flashpoint in the war against Russia’s invasion and one of the first cities to be seized by Moscow’s forces. Liudmyla’s sister was badly wounded by shrapnel during the fighting, dying of complications four years later.

    By the time of Russia’s full-scale invasion in 2022, Mykola was too sick to be moved. His family, including his 49-year-old son Vitallii, stayed in Sloviansk, despite rapidly deteriorating conditions.

    “There are places to go, for example, to western Ukraine or the Vinnytsia region, where my cousin lives,” Liudmyla said, “but it is very problematic because he cannot move around on his own. And now I don’t know what to do and where to go.”

    In recent months a missile strike destroyed Vitallii’s home and he moved in with his parents.

    “I will never leave my father,” he said, rolling cigarettes in the kitchen. “No matter the bombs.”

    Outside, the screech of a saw cutting wood rang out. Her neighbors were still in line, waiting for their turn to seal off their homes from the elements.

    Internet searches yield no results for Mykola’s name, or his art, but Liudymla preserves his paintings and his clippings as though they were important historical documents.

    Just then, Vitallii tells her the heating system is damaged.

    “One problem after another,” she sighs.

    Soloviov has not uttered a word throughout the interview. His shriveled hand motions for the blanket, but his gaze is fixed on that window.

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  • Keto Diets and Diabetes  | NutritionFacts.org

    Keto Diets and Diabetes  | NutritionFacts.org

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    Ketogenic diets are put to the test for diabetes reversal. 
     
    As you can see at the start of my video Does a Ketogenic Diet Help Diabetes or Make It Worse?, ketogenic diets can lower blood sugars better than conventional diets. So much so, in fact, that there is a keto product company that claims ketogenic diets can “reverse” diabetes. However, they are confusing the symptom (high blood sugars) with the disease (carbohydrate intolerance). People with diabetes can’t properly handle carbohydrates, and this manifests as high blood sugars. Clearly, if you stick to eating mostly fat, your blood sugars will stay low, but you may be actually making the underlying disease worse at the same time. 
     
    We’ve known for nearly a century that if you put people on a ketogenic diet, their carbohydrate intolerance can skyrocket within just two days. Below and at 0:46 in my video, you can see a graph from the study showing the blood sugar response two days after eating sugar. On a high-carb diet, blood sugar response is about 90 mg/dL. But, the blood sugar response to the same amount of sugar after a high-fat diet is about 190 mg/dL, nearly double. The intolerance to carbohydrates skyrocketed on a high-fat diet. 

    After one week on an 80 percent fat diet, you can quintuple your blood sugar spike in reaction to the same carb load compared to a week on a low-fat diet, as you can see in the graph below and at 1:12 in my video

    Even a single day of excessive dietary fat intake can do it, as you can see in the graph below and at 1:26 in my video. If you’re going in for a diabetes test, having a fatty dinner the night before can adversely affect your results. Just one meal high in saturated fat can make carbohydrate intolerance, the cause of diabetes, worse within four hours. 


    Given enough weight loss by any means, whether from cholera or bariatric surgery, type 2 diabetes can be reversed, but a keto diet for diabetes may not just be papering over the cracks, but actively throwing fuel on the fire. 
     
    I’ve been trying to think of a good metaphor. It’s easy to come up with things that just treat the symptoms without helping the underlying disease, like giving someone with pneumonia aspirin for their fever instead of antibiotics. However, a keto diet for diabetes is worse than that because it may treat the symptoms while actively worsening the disease. It may be more like curing the fever by throwing that pneumonia patient out into a snow bank or “curing” your amputated finger by amputating your hand. One of the co-founders of masteringdiabetes.org suggested it’s like a CEO who makes their bad bottom line look better by borrowing tons of cash. The outward numbers look better, but on the inside, the company is just digging itself into a bigger hole. 
     
    Do you remember The Club, that popular car anti-theft device that attaches to the steering wheel and locks it in place so the steering column can only turn a few inches? Imagine you’re in a car at the top of a hill with the steering wheel locked. Then, the car starts rolling down the hill. What do you do? Imagine there’s also something stuck under your brake pedal. The keto-diet equivalent response to this situation is who cares if you’re barreling down into traffic with a locked steering wheel and no brakes—just stick to really straight deserted roads without any stop signs or traffic lights. If you do that, problem solved! The longer you go, the more speed you’ll pick up. If you should hit a dietary bump in the road or start to veer off the path, the consequences could get more and more disastrous over time. However, if you stick to the keto straight and narrow, you’ll be a-okay! In contrast, the non-keto response would be to just unlock the steering wheel and dislodge whatever’s under your brake. In other words, fix the underlying problem instead of just whistling past—and then into—the graveyard. 
     
    The reason keto proponents claim they can “reverse” diabetes is they can successfully wean type 2 diabetics off their insulin. That’s like faith-healing someone out of the need for a wheelchair by making them stay in bed the rest of their life. No need for a wheelchair if you never move. Their carbohydrate intolerance isn’t gone. Their diabetes isn’t gone. In fact, it could be just as bad or even worse. Type 2 diabetes is reversed when you are weaned off insulin while eating a normal diet like everyone else. Then and only then do you not have diabetes anymore. A true diabetes reversal diet, as you can see below and at 4:58 in my video, is practically the opposite of a ketogenic diet: getting diabetics off their insulin within a matter of weeks by eating more than 300 grams of carbs a day! 
    The irony doesn’t stop there. One of the reasons people with diabetes suffer such nerve and artery damage is due to an inflammatory metabolic toxin known as methylglyoxal, which forms at high blood sugar levels. Methylglyoxal is the most potent creator of advanced glycation end products (AGEs), which are implicated in degenerative diseases—from Alzheimer’s and cataracts to kidney disease and strokes, as you can see below and at 5:31 in my video

    You get AGEs in your body from two sources: You can eat them preformed in your diet or make them internally from methylglyoxal if you have high blood sugar levels. On a keto diet, one would expect high exposure to preformed AGEs, since they’re found concentrated in animal-derived foods high in fat and protein, but we would expect less internal, new formation due to presumably low levels of methylglyoxal, given lower blood sugars from not eating carbs. Dartmouth researchers were surprised to find more methylglyoxal! As shown in the graph below and at 6:11 in my video, a few weeks on the Atkins diet led to a significant increase in methylglyoxal levels. Those in active ketosis did even worse, doubling the level of this glycotoxin in their bloodstream. 

    It turns out that high sugars may not be the only way to create this toxin, as you can see below and at 6:24 in my video. One of the ketones you make on a ketogenic diet is acetone (known for its starring role in nail polish remover). Acetone does more than just make keto dieters fail breathalyzer tests, “feel queasy and light-headed, and develop what’s been described as ‘rotten apple breath.’” Acetone can oxidize in the blood to form acetol, which may be a precursor for methylglyoxal.

    That may be why keto dieters can end up with levels of this glycotoxin as high as those with out-of-control diabetes, which can cause the nerve damage and blood vessel damage you see in diabetics. That’s another way keto dieters can end up with a heart attack. The irony of treating diabetes with a ketogenic diet may extend beyond just making the underlying diabetes worse, but by mimicking some of the disease’s dire consequences. 

    This is part of a seven-video series on keto, which you can find in related videos below.

    I also recently tackled diabetes.

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    Michael Greger M.D. FACLM

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  • The Safety of Keto Diets  | NutritionFacts.org

    The Safety of Keto Diets  | NutritionFacts.org

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    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.

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    Michael Greger M.D. FACLM

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  • Is It Safe to Take Weight-Loss Pills?  | NutritionFacts.org

    Is It Safe to Take Weight-Loss Pills?  | NutritionFacts.org

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    Why don’t more people take the weight-loss medications currently on the market? 

    Despite the myriad menus of FDA-approved medications for weight loss, they’ve only been prescribed for about 1 in 50 patients with obesity. We tend to worship medical magic bullets in the United States, so what gives? As I discuss in my video Friday Favorites: Are Weight-Loss Supplements Safe and Effective?, one of the reasons anti-obesity drugs are so “highly stigmatized is that, historically, they’ve been anything but magical and the bullets have been blanks—or worse. 

    To date, most weight-loss drugs that were initially approved as safe have since been pulled from the market for unforeseen side effects that turned them into a “threat to public health.” As you may remember from my video Brown Fat: Losing Weight Through Thermogenesis, it all started with DNP, a pesticide with a promise to safely melt away fat that melted away people’s eyesight instead. (That actually helped lead to the passage of the landmark Food, Drug, and Cosmetic Act in 1938.) Thanks to the internet, DNP has made a comeback with “predictably lethal results.” 

    Then came the amphetamines. Currently, more than half a million Americans may be addicted to amphetamines like crystal meth, but the “original amphetamine epidemic was generated by the pharmaceutical industry and medical profession.” By the 1960s, drug companies were churning out about 80,000 kilos of amphetamines a year, which is nearly enough for a weekly dose for every man, woman, and child in the United States. Billions of doses a year were prescribed for weight loss, and weight-loss clinics were raking in huge profits. A dispensing diet doctor could buy 100,000 amphetamine tablets for less than $100, then turn around and sell them to patients for $12,000.  

    At a 1970 Senate Hearing, Senator Thomas Dodd (father of “Dodd-Frank” Senator Chris Dodd) suggested that America’s speed freak problem “was no by means an ‘accidental development’: ‘Multihundred million dollar advertising budgets, frequently the most costly ingredient in the price of a pill, have, pill by pill, led, coaxed and seduced post-World War II generations into the ‘freaked-out’ drug culture…’” I’ll leave drawing the Big Pharma parallels to the current opioid crisis as an exercise for the viewer.  

    Aminorex was a widely-prescribed appetite suppressant before it was pulled for causing lung damage. Eighteen million Americans were on fen-phen before it was pulled from the market for causing severe damage to heart valves. Meridia was pulled for heart attacks and strokes, Acomplia was pulled for psychiatric side effects, including suicide, and the list goes on, as you can see below and at 2:51 in my video. 

    The fen-phen debacle resulted in “some of the largest litigation pay-outs ever seen in the pharmaceutical industry, with individual amounts of up to US$200,000 and a total value of ~US$14 billion,” but that’s all baked into the formula. If you read the journal PharmacoEconomics (and who doesn’t!), you may be aware that a new weight-loss drug may injure and kill so many that “expected litigation cost” could exceed $80 million, but Big Pharma consultants estimate that if it’s successful, the drug could bring in more than $100 million, so do the math. 

    What does work for weight loss? I dive deep into that and more in How Not to Diet.  For more of my videos on weight loss, check out the related videos below. 

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    Michael Greger M.D. FACLM

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  • Apple co-founder Steve Wozniak says he’s back home after having a minor stroke in Mexico

    Apple co-founder Steve Wozniak says he’s back home after having a minor stroke in Mexico

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    Apple co-founder Steve Wozniak has told ABC News that he suffered a minor stroke while attending a business conference in Mexico City

    ByThe Associated Press

    November 9, 2023, 12:34 PM

    File – Apple co-founder Steve Wozniak speaks at the Novathon Conference in Budapest, Hungary, on Oct. 30, 2019. Wozniak remains hospitalized in Mexico City on Wednesday, Nov. 9, 2023, following a “health problem” while he was in the city to speak at a business conference. (Marton Monus/MTI via AP, File)

    The Associated Press

    MEXICO CITY — Apple co-founder Steve Wozniak says he suffered a minor stroke while attending a business conference in Mexico City.

    Wozniak told ABC News in a text Thursday that he felt dizzy Wednesday morning, then experienced vertigo before going to the hospital where a MRI revealed he had had a “minor but real stroke.”

    Wozniak, 73, had been scheduled to speak at the World Business Forum in Mexico City, a two-day gathering billed as the world’s most important management event. Other advertised speakers were Carly Fiorina, the former CEO of Hewlett-Packard and Muhammad Yunus, a pioneer in microfinance who was awarded the Nobel Peace Prize.

    The convivial Wozniak, who teamed up with the late Steve Jobs to found Apple in 1976, had been scheduled as the conference’s closing speaker Wednesday afternoon.

    Wozniak told the New York Times that he was released from the hospital Thursday, flew back to California and was waiting for dinner at home in Los Gatos. “I’m back home and feeling good,” Wozniak said.

    Wozniak left Apple in 1985 to pursue a wide range of other interest, but has remained a fervent supporter of the company and a technology evangelist. More recently he has pursued a range of other interests including competing on “Dancing With The Stars” in 2009 and participating as a judge in an online video show called “Unicorn Hunters” that assesses ideas from entrepreneurs vying to build startups potentially worth $1 billion or more.

    While dabbling in other startups, Wozniak also has helped keep alive the memory of his longtime friend, Jobs, who died of cancer in 2011.

    ——-

    Associated Press writer Michael Liedtke in San Francisco contributed to this report.

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  • Diabetes Associations Recognize Plant-Based Diets  | NutritionFacts.org

    Diabetes Associations Recognize Plant-Based Diets  | NutritionFacts.org

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    Plant-based diets are the single most important—yet underutilized—opportunity to reverse the pending obesity and diabetes-induced epidemic of disease and death. 

    Dr. Kim Williams, immediate past president of the American College of Cardiology, started out an editorial on plant-based diets with the classic Schopenhauer quote: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.” In 2013, plant-based diets for diabetes were in the “ridiculed” stage in the official endocrinology practice guidelines and placed in the “Fad Diets” section. The guidelines acknowledged that strictly plant-based diets “have been shown to reduce the risk for T2DM [type 2 diabetes] and improve management of T2DM” better than the American Diabetes Association recommendations, then inexplicably went on to say that it “does not support the use of one type of diet over another” with respect to diabetes or in general. “The best approach for a healthy lifestyle is simply the ‘amelioration of unhealthy choices’”—whatever that means. 

    But, by 2015, the clinical practice guidelines from the same professional associations explicitly endorsed a plant-based diet as its general recommendation for diabetic patients. The times they are a-changin’! 

    As I discuss in my video Plant-Based Diets Recognized by Diabetes Associations, the American Diabetes Association itself is also now on board, listing plant-based eating as one of the dietary patterns acceptable for the management of the condition. The Canadian Diabetes Association, however, has really taken the lead. “Type 2 diabetes mellitus is considered one of the fastest growing diseases in Canada, representing a serious public health concern,” so it isn’t messing around and recommends plant-based diets for disease management “because of their potential to improve body weight and A1C [blood sugar control], LDL-cholesterol, total cholesterol and non-HDL-cholesterol levels, in addition to reducing the need for diabetes medications.” The Canadian Diabetes Association uses the Kaiser Permanente definition for that eating pattern: “a regimen that encourages whole, plant-based foods and discourages meats, dairy products and eggs, as well as all refined and processed foods,” that is, junk. 

    It recommends that diabetes education centers in Canada “improve patients’ perceptions of PBDs [plant-based diets] by developing PBD-focused educational and support as well as providing individualized counseling sessions addressing barriers to change.” The biggest obstacle identified to eating plant-based was ignorance. Nearly nine out of ten patients interviewed “had not heard of using a plant-based diet to treat or manage T2DM.” Why is that? “Patient awareness of (and interest in) the benefits of a plant-based diet for the management of diabetes…may be “influenced by the perception of diabetes educators and clinicians.” Indeed, most of the staff were aware of the benefits of plant-based eating for treating diabetes, yet only about one in three were recommending it to their patients.  

    Why? One of the common reasons given was they didn’t think their patients would eat plant-based, so they didn’t even bring it up, but “[t]his notion is contrary to the patient survey results that almost two-thirds of patients were willing” to at least give it a try. The researchers cite the PCRM Geico studies I’ve covered in other videos, in which strictly plant-based diets were “well accepted with over 95% adherence rate,” presumably because the study participants just felt so much better, reporting “increased energy level, better digestion, better sleep, and increased satisfaction when compared with the control group.” 

    A number of staff members also expressed they were unclear about the supportive scientific evidence as their second reason for not recommending this diet, but it’s been shown to be more effective than an American Diabetes Association–recommended diet at reducing the use of diabetes medications, long-term blood sugar control, and cholesterol. It’s therefore possible that the diabetes educators were simply behind the times, as there is “a lag-time” in the dissemination of new scientific findings from the literature to the clinician and finally to the patient. Speeding up this process is one of the reasons I started NutritionFacts.org. 

    As Dr. Williams put it, “the ‘truth’ (i.e., evidence) for the benefits of plant-based nutrition continues to mount. This now includes lower rates of stroke, hypertension, diabetes mellitus, obesity, myocardial infarction, and mortality [heart attacks and cardiac death], as well as many non-cardiac issues that affect our patients in cardiology, ranging from cancer to a variety of inflammatory conditions.” We’ve got the science. The bigger challenge is overcoming the “inertia, culture, habit, and widespread marketing of unhealthy foods.” He concludes, “Reading the existing literature and evaluating the impact of plant-based nutrition, it clearly represents the single most important yet underutilized opportunity to reverse the pending obesity and diabetes-induced epidemic of morbidity and mortality,” disease and death. 

    I highlighted the PCRM Geico studies in my videos Slimming the Gecko and Plant-Based Workplace Intervention. 

    Aren’t plant-based diets high in carbs? Get the “skinny” by checking out my video Flashback Friday: Benefits of a Macrobiotic Diet for Diabetes. 

    To learn more about diet’s effect on type 2 diabetes, see the related videos below. 

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    Michael Greger M.D. FACLM

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  • Goodbye my hound.

    Goodbye my hound.

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    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    Goodbye my hound.. This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times

    This morning I had to have my dog Skelum put down after he suffered a stroke. He had been with me 15 years, helped me through many hard times, saw me get married and has helped me play with and protect my four children.
    Goodbye my faithful hound, my best friend. I’ll always love you.
    I’ll see you in the next place.

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  • Lucinda Williams talks about writing and performing rock ‘n’ roll after her stroke

    Lucinda Williams talks about writing and performing rock ‘n’ roll after her stroke

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    LOS ANGELES — A little too country for rock ‘n’ roll, and a little too rock ‘n’ roll for country, Grammy-winning singer-songwriter Lucinda Williams has always played by her own rules.

    That’s never changed — even after November 2020, when she suffered a stroke. Williams underwent grueling rehabilitation, eventually leading to her memoir, “Don’t Tell Anybody the Secrets I Told You,” and her album, “Stories from a Rock N Roll Heart.” The latter, released earlier this summer, features contributions from Bruce Springsteen, his wife Patti Scialfa, Jesse Malin, Angel Olsen, Margo Price, Jeremy Ivey, Buddy Miller, and more.

    “The recovery part is really hard because you get impatient,” Williams told the Associated Press. “You want it to happen all at once.”

    On Saturday, Williams reaches another recovery milestone: Her 2023 tour kicked off at the famed Ryman Auditorium in Nashville, Tennessee.

    In a phone interview earlier this year, Williams spoke to the AP about her recovery, collaborating in new ways, and what’s in store for the future.

    This conversation has been edited for brevity and clarity.

    WILLIAMS: I wasn’t able to write how I usually write, which is with my guitar, because I haven’t been able to play. But I was able to make enough of a chord to make a note, and I’d figure out something in my head. And, you know, my friends jumped in and helped by playing the chords. It turned into a collaboration, a collaborative effort. So, in a way, it was a mixed blessing. We ended up with songs we might not have otherwise.

    It ended up being kind of liberating to work with other people because I hadn’t really done it before, to that extent.

    WILLIAMS: Margo, we’ve started to (become) really good friends. She’s in the same neighborhood we’re in Nashville. We were in the studio and I think (my husband) Tom (Overby) suggested seeing if she wanted to come in and sing some background stuff and she was excited about it. She’s just so fun to work with because she’s real enthusiastic, and, you know, she’s fun to be with. And then, Angel Olsen was in town already. She didn’t live here. She’s living in Asheville. But she was in Nashville when we were recording, so she came in and an added amazingly beautiful, really small little part vocal to “Jukebox,” which I think just makes the whole song.

    WILLIAMS: People are just amazed. They can’t believe I’ve been going out and playing shows and I’m in the studio. I mean, I’m still doing the same stuff. I can manage things well enough. I’ve got a lot of great help. I’ve got a great band, two fantastic guitar players … they play, and I sing.

    WILLIAMS: Yeah. The physical therapist gave me hand exercises that I do. I kind of stretch my fingers out. I do about 50 of those a day with my left hand. And I do some with my right hand, too, just in case. It’s mainly the left side of my body that was affected. But, you know, I just try to think positive. I keep thinking, ‘Well, I didn’t know if I was going to be able to walk across the room without falling down at one point.’ But I was able to, you know, I overcame that.

    WILLIAMS: I think the world’s caught up, with Americana, you know, that’s exactly what that is. I wish they would bring back “folk rock.”

    WILLIAMS: Another album. We’re already talking about that.

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  • A former New York bishop has died at 84. He promoted social justice, but covered up rape allegations

    A former New York bishop has died at 84. He promoted social justice, but covered up rape allegations

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    Howard Hubbard, a retired Catholic bishop who acknowledged covering up allegations of sexual abuse in his upstate New York diocese and recently married a woman in a civil ceremony, has died after suffering from a massive stroke

    FILE — Bishop Howard Hubbard swings incense during an Ash Wednesday communion service, at the Cathedral of the Immaculate Conception, Feb. 25, 2004, in Albany, N.Y. Hubbard, a retired Catholic bishop who acknowledged covering up allegations of sexual abuse in his upstate New York diocese and recently married a woman in a civil ceremony, has died after suffering from a massive stroke, Saturday, Aug. 19, 2023. He was 84. (AP Photo/Jim McKnight, File)

    The Associated Press

    ALBANY, N.Y. — Howard Hubbard, a retired Catholic bishop who acknowledged covering up allegations of sexual abuse in his upstate New York diocese and recently married a woman in a civil ceremony, has died after suffering from a massive stroke. He was 84.

    Hubbard passed away at Albany Medical Center on Saturday after being hospitalized for the stroke days prior, bishop spokesman Mark Behan confirmed.

    Hubbard was known as a champion of social justice causes during his long tenure leading the Albany, New York-based diocese from 1977 to 2014. But his reputation suffered as the church became engulfed in sexual abuse scandals.

    Hubbard had adamantly denied accusations that he abused minors. But he acknowledged in a 2021 deposition that he and the diocese covered up allegations of sexual abuse against children by priests in part to avoid scandal.

    Last fall, Hubbard said he wanted to be returned to the lay state — leave the clergy — since he could no longer function as a priest due to a U.S. church policy that bars accused priests from ministry. He said his request to the Vatican was rejected in March and he was encouraged to wait while the seven civil lawsuits against him proceeded.

    Instead, he announced earlier this month that he had recently married an unidentified woman.

    “I could be 91 or 92 before these legal matters are concluded,” Hubbard said in a prepared release at the time. “In the meantime, I have fallen in love with a wonderful woman who has helped and cared for me and who believes in me.”

    The current bishop of the upstate New York diocese, Edward Scharfenberger, said the church did not consider Hubbard’s marriage to be valid.

    Hundreds of lawsuits have been filed against the Albany diocese under a state law that allowed people to sue over sexual abuse they say they endured as children, sometimes decades ago.

    The diocese filed for bankruptcy this year amid the flood of lawsuits.

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  • Tatum O’Neal Reveals She ‘Almost Died’ After Having A Stroke In 2020

    Tatum O’Neal Reveals She ‘Almost Died’ After Having A Stroke In 2020

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    Tatum O’Neal and her family are opening up about the health crisis she experienced more than three years ago.

    In a new interview with People, the actor revealed she had a drug overdose as well as a stroke that left her in a coma for six weeks in 2020.

    “I almost died,” O’Neal said. “I’ve been through a lot.”

    According to the report, a friend found O’Neal ― who had overdosed on a combination of pain medication, opiates and morphine ― in her Century City, California, apartment in May 2020.

    “It was the phone call we’d always been waiting for,” O’Neal’s son, Kevin McEnroe, added. “She also had a cardiac arrest and a number of seizures. There were times we didn’t think she was going to survive.”

    She was rushed to a local hospital, where she fell into a coma and was diagnosed with aphasia. According to the National Institutes of Health, aphasia is a disorder that results from damage to portions of the brain that are responsible for language.

    Tatum O’Neal in 2017.

    Paul Archuleta via Getty Images

    McEnroe believes the isolation brought on by the COVID-19 pandemic had taken an emotional toll on O’Neal prior to her hospitalization. At times, he and his siblings Emily and Sean feared their mother would not live, or be unable to recover.

    “At times, it was touch and go,” McEnroe said. “I had to call my brother and sister and say she was thought to be blind, deaf and potentially might never speak again.”

    Since her hospitalization, O’Neal has worked to regain her strength and her memory in various rehabilitation facilities. She’s also in recovery for her drug addiction, and has been regularly attending 12-step meetings.

    “I’ve been trying to get sober my whole life,” she told People. “Every day, I am trying.”

    Now 59, O’Neal catapulted to fame when she starred opposite her father, Ryan O’Neal, in the 1973 film “Paper Moon.” Her portrayal of Addie Loggins won her an Academy Award for Best Supporting Actress the following year when she was just 10 years old. She remains the youngest Oscar winner in history.

    O'Neal at the 1974 Academy Awards, where she won the Oscar for Best Supporting Actress.
    O’Neal at the 1974 Academy Awards, where she won the Oscar for Best Supporting Actress.

    Ron Galella via Getty Images

    From 1986 to 1994, O’Neal was married to tennis legend John McEnroe. The couple’s marriage was the source of intense tabloid scrutiny and marked by accusations of drug abuse and violence. Four years after the divorce, she lost custody of her children due to a heroin addiction.

    Acknowledging that she’s been “an addict my whole life, pretty much on and off, for the past 30 to 40 years,” O’Neal said her 2020 health scare has given her a renewed sense of purpose.

    “Every day I am trying,” she said. “I want to be with my beautiful three kids.”

    Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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  • Keegan Bradley and Denny McCarthy share the Travelers lead at tournament-record 15 under

    Keegan Bradley and Denny McCarthy share the Travelers lead at tournament-record 15 under

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    CROMWELL, Conn. — Keegan Bradley and Denny McCarthy shared the Travelers Championship lead Friday at a tournament-record 15-under 125.

    McCarthy followed his first-round 60 with a 65 in the morning at TPC River Highlands. A few hours later, Bradley shot a 63 to go with his opening 62.

    Chez Reavie, the 2019 winner, was two strokes back after a 63. Eric Cole had a 65 to get to 11 under.

    McCarthy and Bradley broke the 36-hole mark of 14 under set by Justin Rose in 2010 and matched last year by Xander Schauffele in his run to the title.

    “It’s nice, but golf tournaments aren’t 36 holes unfortunately,” McCarthy said. “I know there’s still a lot of golf left and I’m playing some really nice golf, so I’m looking forward to having fun this weekend.”

    The 30-year-old from Maryland started slowly, bogeying the second hole. But that was the only blemish on a round that included six birdies, five on the back nine.

    McCarthy, who lost in a playoff at the Memorial this month, is trying to become the 18th player to pick up his first PGA Tour victory in Connecticut. Ken Duke was the last in 2013.

    Bradley also had a blistering back nine, making five birdies in a row between the 12th and 16th holes. He had just under 174 feet of made putts and after every big make, he held his putter in front of him with two fingers and bowed before handing it to his caddie.

    “We just pay our respects,” said the Vermont player, who holed about a 60-footer on No. 3 for his first birdie. “If the putter is working, we’ll do whatever just to keep it going. We just bow and say, ‘Thank you.’”

    Cole is the son of former tour players Laura Baugh and Bobby Cole. His father played River Highlands just once professionally, finishing 50th in 1987, but his son didn’t get to see that.

    “I was born in ’88, so it would’ve been before me,” the younger Cole said.

    Rory McIlroy was tied for 10th at 8 under after a 64. He had a double bogey on the par-3 eighth, the hole he aced Thursday for his first hole-in-one on the PGA Tour. This time, McIlroy put his tee shot in the water.

    “I hit a pretty good shot, I just misjudged the wind a little bit and it came up short in the one place you couldn’t miss today,” he said. “But, other than that, it was a really good round of golf.”

    McIlroy got a break on his last hole when his tee shot landed on a cable trench behind a tree on the ninth hole. He was given relief by a tournament official, but hit a limb on his approach shot, which still landed just short of the green, where he managed to get up and down for par.

    Schauffele also was 8 under after a 64. Top-ranked Scottie Scheffler reached 7 under with a 70.

    Wyndham Clark, the U.S. Open champion Sunday in Los Angeles who arrived here Wednesday, had a 67 to get to 5 under. He spent the first part of the week in New York, appearing on numerous talk shows.

    A light rain left the greens soft, helping keep the scores low. The cut line was at 4 under, with Masters champion Jon Rahm dropping out with round of 67 and 71.

    On Saturday, with heavy rain expected in the morning, the players will start at 10:45 a.m. in threesomes off both Nos. 1 and 10.

    ____

    AP golf: https://apnews.com/hub/golf and https://twitter.com/AP_Sports

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  • Your Sleep Can Affect Your Stroke Risk

    Your Sleep Can Affect Your Stroke Risk

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    By Cara Murez 

    HealthDay Reporter

    THURSDAY, April 6, 2023 (HealthDay News) — Sleep problems — from snoring to sleeping too much or too little — may be associated with elevated stroke risk, researchers say.

    Snorting during sleep, having poor quality of sleep and sleep apnea may also be linked with greater risk of stroke, according to study findings published online April 5 in the journal Neurology.

    “Not only do our results suggest that individual sleep problems may increase a person’s risk of stroke, but having more than five of these symptoms may lead to five times the risk of stroke compared to those who do not have any sleep problems,” said study author Dr. Christine McCarthy, of University of Galway in Ireland.

    “Our results suggest that sleep problems should be an area of focus for stroke prevention,” McCarthy said in a journal news release.

    For the study, the researchers looked at nearly 4,500 people, including more than 2,200 stroke survivors. They were matched with more than 2,200 people who did not have a stroke.

    Participants were an average age of 62. They were asked about their sleep behaviors, including napping and breathing problems during sleep.

    A total of 162 of those who had a stroke got less than five hours of nightly sleep, compared to 43 of those who did not have a stroke. Those with less than five hours of sleep were three times more likely to have a stroke than those who got an average seven hours of sleep, the investigators found.

    Another 151 stroke survivors got more than nine hours of sleep a night, compared to 84 of those who did not have a stroke. The long sleepers were twice as likely to have a stroke as those who got seven hours of sleep.

    In addition, people who took naps longer than one hour were 88% more likely to have a stroke than those who did not, the study found.

    The researchers also reported that people who snore during sleep are 91% more likely to have a stroke than those who do not. Those who snort are nearly three times more likely to have a stroke than those who do not. Participants with sleep apnea are nearly three times more likely to have a stroke than those without breathing disruptions during sleep.

    The study adjusted for other factors that affect stroke risk — including smoking, physical activity, depression and alcohol consumption — but got similar results. However, it cannot prove a cause and effect relationship, only an association.

    Still, “with these results, doctors could have earlier conversations with people who are having sleep problems,” McCarthy said. “Interventions to improve sleep may also reduce the risk of stroke and should be the subject of future research.”

    Limitations of the study include that people reported their own symptoms of sleep problems.

    More information
     

    The U.S. Centers for Disease Control and Prevention has more on stroke risk.

     

    SOURCE: Neurology, news release, April 5, 2023

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