Some great mountain bike rides in and around Humboldt county- Raspberry Creek and Bloody Shin trails in November.
I'm reading the book "Faster, Better, Stronger: 10 Proven Secrets to a Healthier Body in 12 Weeks". I will blog the key points and other interesting tidbits. I also plan to have some meetings/classes to discuss details for people interested in fitness. If you have read this please let me know what you think.
The other book on its way from Amazon is "Transformation in Christ: On the Christian Attitude". Anyone interested in discussing please contact me.
Thursday, January 22, 2009
Friday, October 10, 2008
Bicycle adventures
5 years ago I was 25# heavier and gasping for air on a 2 mile bike ride. Last weekend I rode a metric century supported ride at the Fallon No-Hills Hundred. Including the ride to and from the start line I logged 75 miles in 5 hours. Yes, I hurt the day after. Yes, I will do it again, only faster. You, too, are not too old to get thinner and faster.
Thursday, August 28, 2008
Do kidneys get better with age?
The most common way to assess kidney health is with a blood test called creatinine. This test is used in a calculation for glomerular filtration rate (GFR), the amount of fluid filtered by the kidney in one minute. In addition to the creatinine blood test the person's age, gender and race have big impact on the overall calculation. As you might expect, as you get older the kidney function slows down even if the blood test is stable.
When I was 20 years old my GFR was 74 ml/min. This is fairly low for that age. My doctor said it was due to my diabetes and high blood pressure. At age 45 my GFR was down to 54 ml/min. My blood test was unchanged over the years. I had been on a wide variety of blood pressure pills and very diligent controlling my diabetes yet the kidney funtion did not improve.
After carefully analysing all my food, beverages, medicines and exercise I concluded that I might be eating too much protein. A high protein diet has been the cornerstone of diabetes nutritional therapy for decades and I had been carefully following it. So I cut my animal protein in half- less milk, less cheese, less beef, pork and poultry, less fish. I ate more carbohydrates and I did not gain any weight. I ate more carbohydrates yet I did not need more insulin and my average blood sugar did not go up. I ate less protein and my GFR improved by 40%. I 'found' a treatment for my kidney disease that cost no money and had no side effects. It will not be recalled by the FDA, will not react with any other medications and I will never develop an allergy to it. I hope you can find better health through better nutrition as I did.
When I was 20 years old my GFR was 74 ml/min. This is fairly low for that age. My doctor said it was due to my diabetes and high blood pressure. At age 45 my GFR was down to 54 ml/min. My blood test was unchanged over the years. I had been on a wide variety of blood pressure pills and very diligent controlling my diabetes yet the kidney funtion did not improve.
After carefully analysing all my food, beverages, medicines and exercise I concluded that I might be eating too much protein. A high protein diet has been the cornerstone of diabetes nutritional therapy for decades and I had been carefully following it. So I cut my animal protein in half- less milk, less cheese, less beef, pork and poultry, less fish. I ate more carbohydrates and I did not gain any weight. I ate more carbohydrates yet I did not need more insulin and my average blood sugar did not go up. I ate less protein and my GFR improved by 40%. I 'found' a treatment for my kidney disease that cost no money and had no side effects. It will not be recalled by the FDA, will not react with any other medications and I will never develop an allergy to it. I hope you can find better health through better nutrition as I did.
Tuesday, July 15, 2008
Preventing diabetes: can it be done?
The challenge in preventing type 1 diabetes is figuring out who will get it before most of the damage is done. The immune system may be attacking the insulin-producing cells (beta cells) up to 5 years before the blood sugar goes up. By then only about 10% of the beta cells are left. Scientists are also discovering how challenging it is to stop the immune sytem from completing the attack. The research goes on...
Prevention of type 2 diabetes is easier to study because it's easier to predict who will likely get it. Studies compare treatment groups to a group of people who are not given any specific treatment to lower their chance of getting diabetes and are given vague directions to exercise and eat healthy. The research results are as follows:
metformin 2000 mg daily reduces frequency of diabetes by 30-40%
specific diet + exercise program reduces diabetes 50-70%
strictly following diet + exercise goals reduces diabetes by 90%
Actos 45 mg daily reduces diabetes ~70%
Avandia 8 mg daily reduces diabetes ~70%
So it's important to know what type of diabetes you might get in order to know how you might prevent it. It's also important to know that even with the most effectve prevention, it doesn't work all the time.
Prevention of type 2 diabetes is easier to study because it's easier to predict who will likely get it. Studies compare treatment groups to a group of people who are not given any specific treatment to lower their chance of getting diabetes and are given vague directions to exercise and eat healthy. The research results are as follows:
metformin 2000 mg daily reduces frequency of diabetes by 30-40%
specific diet + exercise program reduces diabetes 50-70%
strictly following diet + exercise goals reduces diabetes by 90%
Actos 45 mg daily reduces diabetes ~70%
Avandia 8 mg daily reduces diabetes ~70%
So it's important to know what type of diabetes you might get in order to know how you might prevent it. It's also important to know that even with the most effectve prevention, it doesn't work all the time.
Monday, July 14, 2008
Byetta for weight loss or people on insulin
I recently received questions about using Byetta combined with insulin, and using Byetta for weight control when a person ahs well-controlled diabetes. Here is my response.
I'll start with the Amylin company position that Byetta is not FDA approved for use with insulin.
I have dozens of patients on insulin and Byetta, most commonly for weight loss and improved control. People well-controlled on small doses of insulin sometimes get off the insulin. A patient with an A1c of 7 but gaining weight would benefit from Byetta; I would be inclined to cut the insulin in half, and if on 20 units/d or less stop it when starting Byetta. They need to know that they may need to go back up on the insulin dose or restart it if the Byetta doesn't quiet control things.
I've also added Byetta or switched people to Byetta who are well controlled on oral agents but struggling with weight. As long as the A1c is >6.5 it should be covered by insurance. If they're on a weight-gaining medication such as sulfonylurea, Actos or Avandia I would reduce or stop them while adding Byetta.
Don't change or stop any of your medications based on the above information. Only make medication changes by working with your treating physician.
I'll start with the Amylin company position that Byetta is not FDA approved for use with insulin.
I have dozens of patients on insulin and Byetta, most commonly for weight loss and improved control. People well-controlled on small doses of insulin sometimes get off the insulin. A patient with an A1c of 7 but gaining weight would benefit from Byetta; I would be inclined to cut the insulin in half, and if on 20 units/d or less stop it when starting Byetta. They need to know that they may need to go back up on the insulin dose or restart it if the Byetta doesn't quiet control things.
I've also added Byetta or switched people to Byetta who are well controlled on oral agents but struggling with weight. As long as the A1c is >6.5 it should be covered by insurance. If they're on a weight-gaining medication such as sulfonylurea, Actos or Avandia I would reduce or stop them while adding Byetta.
Don't change or stop any of your medications based on the above information. Only make medication changes by working with your treating physician.
Wednesday, July 9, 2008
Dietary definition: MEAT
Many times a day when asking patients about food intake I am told 'I don't eat meat'. When I ask how the person gets protein in their diet, they tell me they eat chicken, fish, turkey, dairy products. Somehow the term 'meat' has come to mean specifically 'beef' or 'red meat'. Well, you can take the following as good news or bad news: beef as a general source of animal protein is no more or less healthy than chicken, turkey, pork or fish. a lean cut of any animal flesh will have about the same fat content and overall nutritional value. You will be no healthier eating a pound of chicken or bluefin tuna than a pound of sirloin steak or pork loin. There are a number of on-line nutritional content tables that can verify this. If you know of any dietary research that shows a health benefit from specifically consuming only one source of animal protein or specifically excluding one source of animal protein I will happily share it on my blog.
Wednesday, June 18, 2008
ADA news: Byetta gets better
Byetta will soon be available as a once-weekly injection. The study presented revealed more weight loss and better improvement in hgb A1c compared to twice daily Byetta. The people who inititally took twice daily Byetta were switched over to the weekly dose and they also experienced further weight loss and further improvement with hemoglobin A1c. The weekly dose initially caused some itching and irritation at the injection site but this side effect goes away over time. There's no projected date for weekly yetta to be available.
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