jeudi 26 décembre 2019

mercredi 25 décembre 2019

Meat: how to increase your cancer risk by transforming real meat: burning, nitrating...

1/ cook but don't burn or char, try tartare too
Ce n'est pas une question de viande trop cuite c'est une question de viande carbonisée à la flamme.

2/ Processed meat is mainly nitrating it

Nutri-Score and MTL: the costly failure of front-of-package food labels

Is your Doctor more ignorant of nutrition than you? Probably yes.

Indeed you are obviously more aware of your genetical susceptibilities and issues with foods.

Subventions a la betterave sucrière: subventionner et taxer le sucre

vendredi 20 décembre 2019


Statins and CVD

This meta-analysis is indeed a study about interventional clinical trials with drugs (Statins or Statins and Ezetimibe vs no drug) in patients with CVD and the endpoints are clinical events but not death either CV deaths or all deaths.
The issue is that the biomarker control of drug efficiency is not the drug concentration, nor the volume of plaques all over the arterial tree and nor the flow of LDL particles in plaques; it is a fraction of lipid particles in the circulating blood identified by the cholesterol content of those LDL particles. Nothing new indeed.
Statins act as anti-inflammatory drugs for the arterial plaques. They reduce the number of plaque ruptures which occur spontaneously or under stress conditions like surgery, exercise or other circumstances. And it is interesting to observe that the maximum RR effect is in symptomatic patients and especially during the months or 1-2 years following the ischemic event (cf Stroke and statins, 10.1056/NEJMe1914757). This is not according to my point of view a "proof" of the lipid-heart hypothesis. But it is a strong back to use statins in symptomatic patients for a limited time if they succeed after the event to manage their risk factors.

Une revue hippocratique ?

jeudi 19 décembre 2019

Reasonning on observational studies

Dans aucune étude observationnelle la causalité n’est établie. Pourquoi ? Parce que la constatation rétrospective ou prospective quand les deux groupes de comparaison ne sont pas tirés au sort n’est qu’une association, une corrélation. Si bien que le sens de la causalité suspectée n’est pas non plus défini. A peut entraîner B mais B peut aussi entraîner A.
Les études observationnelles avec des critères des facteurs très précis et infalsifiables donne des renseignements utiles. En matière de nutrition avec quatre ou 5000 molécules organiques à chaque repas, des interactions métaboliques qui touchent tous les organes et tous les métabolismes c’est un pur gaspillage d’argent.
Seules des études randomisées qui n’ont pas besoin d’avoir une taille d’échantillons importante mais qui doivent comprendre des données extensives sur le métabolome la génétique sont extraordinairement efficaces pour faire avancer les connaissances et donner des conseils fondés aux patients.
Dans une étude randomisée correctement designee il n’y a pas de causalité inverse.

samedi 14 décembre 2019

Cancer and evolutionary research of causes

Coffee: Even roasted it seems that it protects our DNA

It is clearly counter intuitive. Indeed roasting coffee is creating Maillard molecules, acrylamide if temperature is sufficiently high and presumably some tars like burning meat in a barbecue. Personally  I don’t like black roasted coffee beans and I do like the taste of slightly roasted blond coffee beans but I’m very reassured by the study on a medical perspective. However that kind of studies have a limit. Looking at the DNA on a short duration exposition of four weeks is relying on one biomarker which is far from mirroring the true risk and the true clinical situation. The clinical situation is consuming roasted coffee during more than 60 years long.

lundi 9 décembre 2019

Sun, skin, vitamin D and the gut flora

This is the first study that reports changes in the human gut microbiota in response to UVB light. As decreased exposure to UVB light and subsequent decreased vitamin D production has been suggested to take part in the current rise in chronic inflammatory diseases, the fact that gut microbiota composition could also be a piece in this puzzle opens new avenues for research that needs to be validated in larger cohorts.

dimanche 8 décembre 2019

Wrong or useless studies in medicine

Although it is a difficult subject we do have at least in medicine a sieve for the worst studies. Observational studies even true are useless. But the preeminence of these studies is still strong because of several factors and among them the data mania and the magic of stat analysis. First, a cohort paid to have one or two "clinical" (actually a huge very unreliable "questionnaire") assessments for 5 years and a lot of "results".  In the same time one or two biological assessments with a huge number of variables. Second, a battery of statistical tests in order to find something like a probability < 0.05. The Graal is so easy.

mercredi 4 décembre 2019

The conditionally essential LCPUFA which is forgotten: DHA and veganism is so wrong on this issue!

"Omega-3 Index status >8% correlates positively with brain structure, function and health
Across multiple studies, the Omega-3 Index correlates positively with better brain structure, function and health:
  • In a study of individuals aged 67 years on average, who were free of clinical dementia, total brain volume correlated with Omega-3 Index, as did cognitive functions like visual memory, executive function, and abstract thinking (15).
  • In a study of females aged 65 years or older and free of dementia the Omega-3 Index correlated with total brain volume measured 8 years later (16). Also, the progression to dementia was much less likely and occurred later in life in those with a higher Omega-3 Index (14).
  • In younger individuals the Omega-3 Index correlated with executive function and cognitive flexibility (17, 18) while in the oldest individuals yet studied, aged >88 years, cognitive impairment was four times more likely with a mean Omega-3 Index below, 8% (11).
  • A recent meta-analysis also identified low levels of EPA & DHA as a risk factor for cognitive impairment (19,20).
At all ages studied therefore, there is robust support for an Omega-3 Index target range of 8-11% for optimal brain structure, function and health. "

1. Blasbalg TL, Hibbeln JR, Ramsden CE, Majchrzak SF, Rawlings RR. Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century. Am J Clin Nutr. 2011;93:950-62
2. Sprague M, Dick JR, Tocher DR. Impact of sustainable feeds on omega-3 long-chain fatty acid levels in farmed Atlantic salmon, 2006-2015. Sci Rep. 2016;6:21892.
3. von Schacky C. w-3 Fettsäuren und Hirnfunktion. Orthomol Med 2016;2:6-10
4. Amen DG, Harris WS, Kidd PM, Meysami S, Raji CA. Quantitative Erythrocyte Omega-3 EPA Plus DHA Levels are Related to Higher Regional Cerebral Blood Flow on Brain SPECT. J Alzheimers Dis. 2017;58:1189-1199
5. Joris PJ, Mensink RP, Adam TC, Liu TT. Cerebral Blood Flow Measurements in Adults: A Review on the Effects of Dietary Factors and Exercise. Nutrients. 2018;10. pii: E530.
6. Schwarz C, Wirth M, Gerischer L, et al. Effects of Omega-3 Fatty Acids on Resting Cerebral Perfusion in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial. J Prev Alzheimers Dis. 2018;5:26-30.
7. Setiawan E, Wilson AA, Mizrahi R, et al. Role of translocator protein density, a marker of neuroinflammation, in the brain during major depressive episodes. JAMA Psychiatry. 2015;72:268-75
8. Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans. 2017;45:1105-1115.
9. Schuchardt JP, Hahn A. Bioavailability of long-chain omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids. 2013;89:1-8.
10. Davidson MH, Johnson J, Rooney MW, Kyle ML, Kling DF. A novel omega-3 free fatty acid formulation has dramatically improved bioavailability during a low-fat diet compared with omega-3-acid ethyl esters: the ECLIPSE (Epanova(®) compared to Lovaza(®) in a pharmacokinetic single-dose evaluation) study. J Clin Lipidol. 2012;6:573-84.
11. Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot Essent Fatty Acids. 2010;83:137-41.
12. Harris WS and von Schacky C. The Omega-3 Index: A New Risk Factor for Death from CHD? Preventive Medicine 2004;39:212-20.
13. Lukaschek K, von Schacky C, Kruse J, Ladwig K. Cognitive impairment is associated with low Omega-3 Index in the elderly. Results from the KORA-Age study. Dementia Geriatr Cogn Dis 2016;42:236-45
14. Ammann EM, Pottala JV, Robinson JG, Espeland MA, Harris WS. Erythrocyte omega-3 fatty acids are inversely associated with incident dementia: Secondary analyses of longitudinal data from the Women's Health Initiative Memory Study (WHIMS). Prostaglandins Leukot Essent Fatty Acids. 2017;121:68-75
15. Tan ZS, Harris WS, Beiser AS, et al. Red Blood Cell Omega-3 Fatty Acid Levels and Markers of Accelerated Brain Aging. Neurology 2012;78:658-64
16. Pottala JV, Yaffe K, Robinson J, Espeland MA, Wallace R, Harris WS. Higher RBC EPA+DHA corresponds with larger total brain and hippocampal volumes: WHIMS-MRI study. Neurology 2014;82:435-42
17. Johnston DT, Deuster PA, Harris WS, Macrae H, Dretsch MN. Red blood cell omega-3 fatty acid levels and neurocognitive performance in deployed U.S. Servicemembers. Nutr Neurosci. 2013;16:30-8
18. Bigornia SJ, Scott TM, Harris WS, Tucker KLs. Prospective Associations of Erythrocyte Composition and Dietary Intake of n-3 and n-6 PUFA with Measures of Cognitive Function. Nutrients 2018;10,1253
19. Lin PY, Chiu CC, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in dementia. J Clin Psychiatry. 2012;73:1245-54
20. Coley N, Raman R, Donohue MC, Aisen PS, Vellas B, Andrieu S. Defining the Optimal Target Population for Trials of Polyunsaturated Fatty Acid Supplementation Using the Erythrocyte Omega-3 Index: A Step Towards Personalized Prevention of Cognitive Decline? J Nutr Health Aging. 2018;22:982-998
21. West, A. L., Kindberg, G. M., Hustvedt, S. O. & Calder, P. C. A Novel Self-Micro-Emulsifying Delivery System Enhances Enrichment of Eicosapentaenoic Acid and Docosahexaenoic Acid after Single and Repeated Dosing in Healthy Adults in a Randomized Trial. The Journal of Nutrition (2018). doi:10.1093/jn/nxy127
22.       Qin, Y., Nyheim, H., Haram, E. M., Moritz, J. M. & Hustvedt, S. O. A novel self-micro-emulsifying delivery system (SMEDS) formulation significantly improves the fasting absorption of EPA and DHA from a single dose of an omega-3 ethyl ester concentrate. Lipids Health Dis. 16, 204 (2017).

Brain functions related to omega-3 status 

Supplements should be regulated as drugs: the case report of this child is a shame for parents

This supplement is suspected to have caused an hypokalaemia in a child
"3.2. Description du cas
Il s’agit d’un enfant de dix ans, mesurant 125 cm et pesant 21 kg, ayant un syndrome de Williams- Beuren ( )avec troubles de l'oralité. Jusqu'à ses sept ans, il était sous nutrition entérale par gastrostomie.
Depuis 2015, il consomme quotidiennement quatre flacons de 200 mL d’un CNO hyperénergétique destiné aux adultes. Il mange très peu d'aliments solides ou liquides, en dehors du CNO, qui lui permet une autonomie nutritionnelle (il n'a plus de gastrostomie). Le CNO s'est quasi entièrement substitué au reste de son alimentation, en étant alors utilisé comme un aliment complet alors qu’il s’agit d’un aliment incomplet.
En mars 2019, une hypokaliémie à 2,7 mmol/L (norme : 3,50-5,10 mmol/L) est découverte fortuitement sur un bilan sanguin dans un contexte d'asthénie. La famille rapporte une polyurie avec cinq mictions dans la journée et cinq réveils nocturnes.
Il est hospitalisé du 14 au 18 mars 2019 pour le bilan de cette hypokaliémie.
A l'arrivée, il a une température à 36,5°C, une pression artérielle à 120/69 mmHg. L'auscultation cardiopulmonaire est normale. Il est conscient et orienté. L'abdomen est souple, dépressible et indolore. Il a une tendance à la constipation. Il ne présente pas de myalgies.
La glycémie est à 1,1 g/L, la kaliémie à 3 mmol/L, la natrémie à 139 mmol/L, la créatininémie à 39 μmol/L, l'urémie à 5,5 mmol/L. Les ASAT, ALAT, GGT et CPK sont normales. La kaliurie est à 7 mmol/L, l'osmolalité urinaire à 332 mosm/kg, la rénine à 182 mlUI/L. Le pH sanguin est à 7,4. Le dosage de la calcémie est manquant.
L'echo-doppler rénal ne montre pas d’anomalie hémodynamique. L'ECG montre un allongement de l’intervalle QT mais pas d'aplatissement de l'onde T. Le rythme sinusal est régulier.
Un apport potassique complémentaire est instauré. La kaliémie se normalise avec, à la sortie, une kaliémie à 3,6 mmol/L. Les ionogrammes urinaires mettent en évidence une kaliurèse adaptée. Dans l’hypothèse d’autres carences alimentaires, une supplémentation en calcium et en vitamines est également instaurée."

Observational studies are waste of time and waste of money

Just another completely unuseful observational study on carbs.

Veganism and the brain


Obesity in UK

mardi 3 décembre 2019

Metabolic syndrome: more than an iceberg

Clearly, hyperinsulinism leads to pancreas failure and that is why.

Facing this huge issue there are still papers advocating carb consumption...

Basic slides from Lustig on cooking, fructose, sugar and so on

I don't buy usually the claim of "protecting" our organs with foods. But is this an exception?

The microbiome reacts very fast to our diet

T2D needs innovation

Ketodiet and immune defenses against virus

Nitrosamines and cancer