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mercredi 29 février 2012

Chronobiology and diet

Short timesleepers, rs1801260 CLOCK variant of the Clock gene, and other factors may interfere with obesity and the Metabolic syndrome.
Rhythmic expression of clock genes (hPer2hBmal1 and hCry1) in human subcutaneous and visceral adipose tissue(A) hPer2(B) hBmal1 and (C) hCry1. Adipose depots were isolated at 6-h intervals over the course of the day from adipose tissue cultures (time at 0, 6, 12 and 18 h). Results are presented relative to the lowest basal relative expression for each gene.
Data are reported as means ± standard error of the mean (SEM). SEM of differences in cycle threshold are represented in parenthesis.
AU: Arbitrary unit.
Aschoff J: Circadian rhythms: general features and endocrinological aspects. In: Endocrine Rhythms. Krieger DT (Ed.). Raven Press, NY, USA, 1–61 (1979).

Statins and diabetes: check the benefit/risk ratio

"Increases in glycosylated hemoglobin (HbA1c) and fasting plasma glucose

FDA’s review of the results from the Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) reported a 27% increase in investigator-reported diabetes mellitus in rosuvastatin-treated patients compared to placebo-treated patients. High-dose atorvastatin had also been associated with worsening glycemic control in the Pravastatin or Atorvastatin Evaluation and Infection Therapy – Thrombolysis In Myocardial Infarction 22 (PROVE-IT TIMI 22) substudy.18

FDA also reviewed the published medical literature.19-26 A meta-analysis by Sattar et al.,19 which included 13 statin trials with 91,140 participants, reported that statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1.09; 95% confidence interval [CI] 1.02-1.17), with little heterogeneity (I2=11%) between trials. A meta-analysis by Rajpathak et al.,20 which included 6 statin trials with 57,593 participants, also reported a small increase in diabetes risk (relative risk [RR] 1.13; 95% CI 1.03-1.23), with no evidence of heterogeneity across trials. A recent study by Culver et al.,26 using data from the Women’s Health Initiative, reported that statin use conveys an increased risk of new-onset diabetes in postmenopausal women, and noted that the effect appears to be a medication class effect, unrelated to potency or to individual statin.

Based on clinical trial meta-analyses and epidemiological data from the published literature, information concerning an effect of statins on incident diabetes and increases in HbA1c and/or fasting plasma glucose was added to statin labels."

Clearly in primary prevention statins must be prescribed IF dieting is unable to lower the LDL cholesterol and CRP US levels. Med diet and paleo diet work very efficiently in primary prevention. Several studies showed a potential of 30% reduction in LDL cholesterol for the both! So it seems unnecessary to prescribe statins before any period of dieting of at least 3 months. Dieting is not easy you need coaching and follow up... 
In secondary prevention at least for the first years the benefit outweighs the risk BUT HbA1c must be checked...

dimanche 26 février 2012

L'agriculture biologique est elle productive?

Cette question a longtemps été considérée comme tranchée... Le bio produit moins et donc il est plus cher...
Rien n'est plus faux. Ainsi l'agriculture conventionnelle basée sur les céréales est rentable uniquement grace aux subventions. L'économie agricole basée sur le pâturage et le fourrage est plus rentable que celles basée sur les céréales sans aide étatique...
En réalité les produits issus de l'agriculture intensive basée sur des céréales subventionnées en Europe par la PAC ne sont pas à leur vrai prix...
De surcroît ces productions basées sur des céréales ne sont pas de bonne qualité nutritionnelle eu égard à la quantité de gras dans la viande, à la présence prédominante d'acides gras oméga 6, à l'absence de CLA et d'autres micronutriments ayant des effets métaboliques favorables chez l'humain.

samedi 25 février 2012

Is it med diet or low carb diet which improves heart health?

Actually the authors tried a low refined carb diet and showed improvements in glucose tolerance. Indeed what we call today med diet is far from the original med diet:
1/ med diet despite of massive advertising is not olive oil but veggies with small amount of olive oil...
2/ med diet is not high refined carb like bread pasta and so on but meat fish veggies roots and fruits...
3/ med diet is not corn and soy fed animals but grassfed ones...
4/ med diet is rich in fish and seafood...

mercredi 15 février 2012

A regarder avec attention: S Guyenet sur la transition alimentaire

Retenez que l'alimentation industrielle est addictive car elle fonctionne comme une RECOMPENSE.
Bientôt sur Slideshare une conférence prononcée en 2006 intitulée: "L'obésité est elle une récompense?".

dimanche 12 février 2012

Bisphenol A and insulin secretion

D2 and atheroma are multigenic multifactorial diseases. Is the fact that environmental concentrations of Bisphenol A induce insulin secretion relevant to the present obesity/D2 epidemy? Recent research in Plos One by Spanish authors raises the question.

mercredi 8 février 2012

Med diet and the agrofood industry

It is of great interest to read in this paper of the BMJ that med diet is difficult to follow in UK for several reasons: namely, availability, prices and taste of med nutrients. Except for taste, it seems to me that these obstacles are the same on the continent, especially in urban areas either in med countries or other non med countries even Spain.
To explain that one must describe the main obstacle to consuming a med diet and which is widely underestimated in the comments: I mean the present state of products from the agribusiness.
The production of agriculture and breeding were so deeply transformed since WWII, that our food environment is completely different. We don't eat grassfed meat of ruminants but processed products made of cornfed sedentary obese animals heavily transformed by heating, mincing, mixing, sterilising and so on. Wild meat is below 10% of fat and crops are now > 25% fat. We know that processed meat is a recognised factor for colon cancer and other chronic diseases. We don't eat the same cereals because they are now products made of refined corn or wheat, high temperature cooked, sugared, mixed with trans fats, with added multivitamins. Consumption of high GI foods and fructose is clearly associated with D2. We don't eat the same olive oil because med populations consume olives, non refined and unfiltered olive oil and a lot of wild greens or crops naturally rich in alphalinoleic acid. Instead at best we buy white salads like the iceberg one which is depleted in phytonutrients and alphalinoleic acid and we pour on it sunflower oil which is pure W6 linoleic acid. Consequently a dramatic change has occurred in the W6/W3 ratio of PUFA which is in favor of inflammation--a common final way of chronic diseases. We don't eat the same dairy products because more than 80% of them are sugared, flash pasteurised, and made with milk from cow fed cornstarch... 
This kind of examples are endless. 
But the question is: Why do we consume these foods? Is it a clear choice or a mandatory buying in the different supermarkets which sell the same industrialised products? Clearly the anwer is: the agrofood industry and the low cost of goods transportation (at least until oil reach new unsustainable prices) had standardised food in a way which is not compatible with our genome. It is impossible for our genome to adapt in only fifty years to those dramatic changes... 
Consequently med diet for all demands a change in agriculture and breeding. The recent policies toward more sustainable and energy efficient farming are in favor of the med diet. Other changes need to occur and it seems to me that medicine must take charge of them.