BMI: A New Calculation and Where You Rank

I can't embed these but clicking them will take you to BBC's calculator.

Here's a new BMI calculation, and some background on it. It doesn't do away with BMI's poor ability to distinguish between fat and muscle, but it does fix some error at the extremes. The classic BMI, as the new BMI's originator Nick Trefethen says, has "millions of short people think[ing] they are thinner than they are, and millions of tall people think[ing] they are fatter."

You'll have to scroll down past the photo of Brad Pitt.





Below is a calculation for where your BMI ranks, both within your country and globally. It will tell you which country has the most people like you (people of your sex, age, and BMI).


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Study: Low-Fat Diet Reduces Incidence Of Precancerous Skin Lesions

Actinic keratoses (AK) are innocuous-seeming, precancerous skin lesions. They can progress to squamous cell skin cancer. They have a high prevalence (~50%) among fair-skinned people who've had lots of sun exposure.

"Millions of Americans have AKs, and the number continues to grow. In fact, AKs are so common today that treatment for these lesions ranks as one of the most frequent reasons people consult a dermatologist."
- American Academy of Dermatology

Some images, from VisualDxHealth. Click for larger. There are more on their site:






The following study found that a low-fat diet reduces the incidence of AKs:
Effect of a Low-Fat Diet on the Incidence of Actinic Keratosis, New England Journal of Medicine, 1994

Design:

• 76 men and women, caucasian, non-diabetic, with a history of nonmelanoma skin cancer.
• Randomly assigned to a control group (n = 38) or intervention (low-fat) group (n = 38).
• 24 month follow-up.

Results:

• Control group consumed ~40% of their calories from fat.
• Intervention group consumed ~20% of their calories from fat.
• No significant difference in the ratio of polyunsaturated fat to saturated fat between the two groups during the 24 months.
• No significant difference in body weight between the two groups during the 24 months.

Findings:

"Our dietary intervention trial clearly indicates that a large decrease in calories consumed as fat reduces the incidence of actinic keratosis."

● Control group, 40% of calories from fat

о Intervention group, 20% of calories from fat

A person in the control group:

• With no history of AK, < 65 years, had a 56% chance of having one or more AKs during the 24 months (a risk 4.7 times greater than similar patient in low-fat group).
• With a history of AK, ≥ 65 years, had a 99% chance of having one or more AKs during the 24 months (a risk 8.4 times greater than similar patient in low-fat group).

Calories were kept the same between groups such that the low-fat group were eating more carbohydrates, getting ~65% of their calories from carbs.
________ Photos: VisualDxHealth. More there.

Environmental Chemicals Cause Obesity?

New York Times journalist Nicholas Kristof led off a recent article with this photo:



He said:

"[The mice are] genetically the same, raised in the same lab and given the same food and chance to exercise.

The only difference is that the top one was exposed at birth to just one part per billion of an endocrine-disrupting chemical. The brief exposure programmed the mouse to put on fat, and although there were no significant differences in caloric intake or expenditure, it continued to put on flab long after the chemical was gone."

Here's the study:
Developmental Exposure To Estrogenic Compounds And Obesity, Birth Defects Research, 2005

The endocrine-disrupting chemicals used in this study were:

• DES (Diethylstilbestrol, a synthetic estrogen prescribed in the 1950s-1960s to prevent miscarriage. Was withdrawn in 1971 after it was found to cause cancer in offspring.)
• Estrodial (Estradiol is the predominant estrogen in premenopausal women.)
• Genistein (A phytoestrogen found in some plant foods, notably soybeans. Has antioxidant and antiinflammatory properties.)

All of them resulted in overweight mice. Exposure was during the first 5 days after birth. The authors concluded:

"Our data support the idea that brief exposure to low levels of environmental estrogens early in life increases body weight as the mice age."

Some other environmental estrogens are PCBs (bioaccumulate and end up in animal food), BPA (found in can linings, register receipts) and phthalates (found in plastics). You can do a search on "xenoestrogens" for more.
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Diet Role Models

Vegsource has a new video out:



The people who are slender in this video eat a very low-fat, whole-food, plant-based diet. I am curious how the chemical body-burdens differ between those who eat diets rich in fat and animal food, and those who do not.

This comment appeared under the video:

"My wife and I adopted a plant-based, no-oil diet 18 months ago. We call it vegan plus. She was type 2 diabetic before, not now. I was on 2 BP meds, 70 lbs. over weight. Now I have lost 40 pounds and no longer have high BP. Coincidence? Doubt it. Pre-cancerous lesions from sun exposure on my skin, gone. Anecdotal evidence? Perhaps, but good enough for us. We continue to follow the plant-based crowd and don't look back."

That point about precancerous lesions? I've heard that before. Even if it's anecdotal, it's worth pursuing.

Update: Study: Low-Fat Diet Reduces Incidence Of Precancerous Skin Lesions
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Body Burden: The Pollution In People

In 2001, journalist Bill Moyers had a sample of his blood and urine analyzed.

"Even though Moyers has never worked in a chemical plant – or lived near one – he learned that his body contains a chemical soup of 84 industrial chemicals, including 31 different types of PCBs, 13 different dioxins, and pesticides such as DDT."

He chronicled the story of how and why his body became riddled with toxic chemicals in the PBS program Trade Secrets, A Moyers Report
Here's the video: Moyers' 2-hour Program: Trade Secrets

"Over the last five decades, more than 75,000 chemicals have been produced, turned into consumer products or released into the environment. ... Only a fraction have gone through complete testing to find out whether they might cause problems for human health. Many that are produced in enormous quantities have never been tested at all."

"Today, every man, woman and child has synthetic chemicals in their bodies. No child is born free of them."

That same year, the Centers for Disease Control and Prevention (CDC) published its first in a series of assessments of the US population's exposure to chemicals.

Here's the CDC's latest report:
National Report on Human Exposure to Environmental Chemicals, Fourth Report, 2009

A tiny sample of the hundreds of chemicals they tested for:

"Polybrominated diphenyl ethers are fire retardants used in certain manufactured products. These accumulate in the environment and in human fat tissue. One type of polybrominated diphenyl ether, BDE-47, was found in the serum of nearly all of the NHANES participants."

"Bisphenol A (BPA), a component of epoxy resins and polycarbonates, may have potential reproductive toxicity. General population exposure to BPA may occur through ingestion of foods in contact with BPA-containing materials. CDC scientists found bisphenol A in more than 90% of the urine samples representative of the U.S. population."

Everyone reading this likely has dozens of chemicals in their bodies that their grandparents did not have. And what we eat has a profound impact on our body burden. In particular, processed foods and animal foods (fish, meat, eggs, and dairy), especially fatty versions, present the greatest chemical exposure.

It's not far-fetched to think that the increase in metabolic and endocrine disorders (obesity and diabetes are two) is linked to the chemical revolution of the last half century. Yet in the years I've been reading about this link, very little has emerged in the media.

There was this piece by Nicholas Kristof in the New York Times last August: Big Chem, Big Harm?

Where he concluded:

"Like a lot of Americans, I used to be skeptical of risks from chemicals like endocrine disruptors that are all around us. What could be safer than canned food? I figured that opposition came from tree-hugging Luddites prone to conspiracy theories.

Yet, a few years ago, I began to read the peer-reviewed journal articles, and it became obvious that the opposition to endocrine disruptors is led by toxicologists, endocrinologists, urologists and pediatricians. These are serious scientists, yet they don’t often have the ear of politicians or journalists.

I’m hoping these new studies can help vault the issue onto the national stage. Threats to us need to be addressed, even if they come not from Iranian nuclear weapons, but from things as banal as canned soup and A.T.M. receipts."

Are people who care Luddites?

Resources:

• Environmental Health News
• Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement, 2009
• Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival? - a 1996 book that chronicles the development of the endocrine disruptor hypothesis.
  
• A Strong Dose-Response Relation Between Serum Concentrations Of Persistent Organic Pollutants And Diabetes, Results from the National Health and Examination Survey 1999–2002, Diabetes Care, 2006
  
• Environmental Working Group: Body Burden, The Pollution In People, 2003
  
• Wikipedia: Biomonitoring
• Gestational Exposure to Bisphenol A Produces Transgenerational Changes in Behaviors and Gene Expression, Neuroendocrinology, June 2012.

________DDT advertisement which appeared in TIME Magazine, June 30, 1947, from International Society for Environmental Ethics.

A Beak Is A Wonderful Thing

Melinda sent this series of photos of a bird building a mud nest on a window ledge. There are more at the source.

















Thanks to Melinda we know the bird is a Rufous Hornero, native to South America. The nest, or "oven," is constructed by the male-female team. It can take from 5 days to several months to complete.

This always gets me:

"The species is monogamous and the pair bond is long term, sometimes for life."

That's true for the Northern Cardinals, 2 of which live in the bushes behind my house - Chuck and Charlene II. I suspect Charlene the First failed to outfly the visiting falcon.
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Being Privileged Makes You Unhappy?

The Wall Street Journal published an article this month, How Much Will Your Taxes Jump? that included this infographic:



The median household income in the US is $52,762. So, half of all households in this country made less than $52,762.

Why do the people depicted in this graphic look so downcast? They have incomes from 3 to 12 times the median! The bigger question ... Why would a prominent national newspaper design an infographic that represents a well-to-do minority of Americans (only 3.9% of American households bring in over $200K.)... and yet say "your" taxes?
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PCBs: Primary Exposure Is Dietary, Primary Source Is Animal Food

The World Health Organization says the main source of human exposure to PCBs is dietary, and the foods causing most concern are "large fish*, shellfish, marine mammals, meat, milk, and other dairy products."¹

Levels of PCBs in different foods:

• Animal fat: 20 to 240 μg/kg
• Cow's milk: 5 to 200 μg/kg
• Butter: 30 to 80 μg/kg
• Fish: 10 to 500 μg/kg, on a fat basis. Certain fish species (eel) and fish products (fish liver and fish oils) may contain much higher levels, up to 10 mg PCBs/kg
• Vegetables, cereals, fruits, and a number of other products: <10 μg/kg

PCBs as well as other POPs (Persistent Organic Pollutants, including many pesticides) are fat soluble and accumulate in the fat and milk of animals. They also bioaccumulate, becoming more concentrated in animal tissue as you move up the food chain.

* Tuna is a large fish. Paul Greenberg: "Tuna Are Something Bigger Than The Space They Occupy"

________ ¹ Persistent Organic Pollutants, World Health Organization, July 2008

Eating Blue, Purple, And Red Plants May Decrease Heart Attack Risk

A new study found that diets rich in a class of flavonoids called anthocyanins were associated with a 32% drop in the risk of heart attack:

High Anthocyanin Intake Is Associated With a Reduced Risk of Myocardial Infarction in Young and Middle-Aged Women, Circulation, January 2013

The study population was >93,000 women from the Nurses' Health Study 2. The benefit was seen in high consumers vs. low consumers and it was statistically adjusted for a number of covariates - behaviors or qualities that you think might result in this effect.¹

Anthocyanins are merely pigments. They appear blue, purple, or red. They're found in many plants but are, as you'd guess, especially concentrated in blue, purple, and red plant tissues. Blueberries, cranberries, black and red raspberries, blackberries, cherries, eggplant skin, black rice, black soybeans, red and black grapes, and red cabbage are good sources.

Separately, they found:

"Combined intake of 2 anthocyanin-rich foods, blueberries and strawberries, tended to be associated with a decreased risk of [heart attack] in a comparison of those consuming >3 servings a week and those with lower intake."

But that could have been because blueberries and strawberries are a major source of anthocyanins in the US diet, at least they were in this cohort.

There was also a dose-response effect. The more anthocyanins the women ate, the greater their benefit: "For every 15-mg increase in intake of anthocyanins, the relative risk of MI decreased by 17% in the multivariate model."

Interestingly, this reduction in heart attack risk was independent of total fruit and vegetable consumption. So, the adage "Eat your veggies." wouldn't do it here. Maybe "Eat your violet veggies."
________¹ Researchers controlled for "body mass index (<25, 25–29.9, or ≥30 kg/m2); physical activity (metabolic equivalents per week, in quintiles); alcohol consumption (0, 0.1–4.9, 5–14.9, 15–29.9, ≥30 g/d); energy intake (kcal/d, in quintiles); cereal fiber intake (g/d, in quintiles); saturated, trans, polyunsaturated, and monounsaturated fat intake (g/d, in quintiles); caffeine intake (mg/d, in quintiles); use of aspirin (nonuser or <6 or ≥6 per week); menopausal status (premenopausal, unknown menopause, postmenopausal); postmenopausal hormone use (never, past, or current hormone use); oral contraceptive use (never, past, or current hormone use); smoking (never, past and current [1–14 or ≥15 cigarettes per day]); and family history of [heart attack]."

NSAIDS Combined With High Blood Pressure Meds Damage Kidneys

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) reduce pain. Common NSAIDS are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve), all of which are available over the counter. Prescription NSAIDS include Celebrex and at one time Vioxx (withdrawn because it increased risk for heart attack and stroke).

NSAIDS are losing favor as a safe pain reliever. They:

• Raise blood pressure and when taken consistently can contribute to hypertension.
• Adversely affect the kidneys. (They decrease the kidney's filtration rate (Glomerular Filtration Rate: GFR) and cause sodium and fluid retention.)
• Increase risk for bleeding.
• Increase risk for heart attack in healthy people.
• Increase risk for stroke in healthy people. One cheap 200 mg Advil tablet increased stroke risk up to 90%.
• Damage joints and bone.

Now it appears NSAIDS can severely damage the kidney when taken with antihypertensive agents:

Concurrent Use Of Diuretics, Angiotensin Converting Enzyme Inhibitors, And Angiotensin Receptor Blockers With Non-Steroidal Anti-Inflammatory Drugs And Risk Of Acute Kidney Injury: Nested Case-Control Study, British Medical Journal, January 2013

Taking these 3 drugs together - a diuretic, an ACE inhibitor or angiotensin receptor blocker (ARB), and an NSAID - significantly increased the risk for kidney injury requiring hospitalization.

As I've seen, diuretics plus ARBs or ACE inhibitors are commonly prescribed together for high blood pressure. In an older population that often faces pain from chronic inflammatory conditions, NSAIDS are a frequent add-on.

This quote by the study's lead author is for you, Claudia:

"He [senior author Dr. Samy Suissa] adds that the study findings are indicative of how hypertension is now being managed. "It's being controlled with two drugs, not just one, and then if you have pain, we will add an NSAID to that. In our cohort of antihypertensive-drug patients, 11% were treated with this triple therapy, which is quite large. We were surprised."

That 11% says nothing of the Advil and Motrin people pick up at Walgreens and Target.

If you take NSAIDS more than occasionally (once or twice a month, or for many months), even over-the-counter Advil, you should be under a doctor's care. If you have kidney disease (which frequently accompanies diabetes) or high blood pressure or have a history of heart attack or stroke, it's wise to consult with an MD prior to taking any NSAID.

This information isn't fringe or extremist or meant to be alarmist. Here's a video by the mainstream and generally reliable Consumer Reports that iterates everything above, except for the results of the recent study about antihypertensives. It's had only 35 views since July. I don't think people care, or at least they aren't paying attention. The information it contains is current, factual, and relayed in a succinct and accessible manner.


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Forgiveness

Psychiatrist and author Peter Breggin:
How Forgiveness Can Change Your Life

Breggin says:

"A great deal of personal suffering, including what gets called mental illness, is rooted in an angry, unforgiving attitude toward oneself, other people, and the world."

He says that in the long run, an unforgiving attitude can wear us out. It makes us anxious, keeps us up at night, and wastes our energy.

Notable figures who spoke of forgiveness include Lincoln in his second inaugural address:

"With malice toward none, with charity for all, ... let us strive on to finish the work we are in, ... to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations."

Mother Teresa:

"People are often unreasonable and self-centered. Forgive them anyway. If you are kind, people may accuse you of ulterior motives. Be kind anyway."

Ghandi:

"The weak can never forgive. Forgiveness is the attribute of the strong."

Martin Luther King:

"Forgiveness is not an occasional act, it is a constant attitude."

Nelson Mandela:

"As I walked out the door toward the gate that would lead to my freedom, I knew if I didn't leave my bitterness and hatred behind, I'd still be in prison."

"Men of peace must not think about retribution or recriminations. Courageous people do not fear forgiving, for the sake of peace."

It strikes me, as it does with many virtues, that the act of engaging them gives you a sense of being on higher ground, makes you feel superior, that is, virtuous. But that's inconsistent with other virtues such as humility. The challenge in life seems to be getting them all on the plate at the same time.

My list of determinates to health is getting longer ... diet, exercise, effective breathing, compassion, and forgiveness.
________The photo of the owl captures, for me, feelings wrapped up in forgiveness - letting go, taking flight, moving forward. You can't fly if you are encumbered.

Mark Bittman's Dream Food Label

Mark Bittman has an idea for a new food label:
My Dream Food Label, New York Times, 13 October 2012

This is what it looks like:


From: The Proposed Nutrition Label: A Quick Read, Out Front

It's a beautifully rendered idea. I'll give him, and his design team, that. But some of these characteristics are subjective. I don't think I would pull blueberries down a whole point in "foodness" just because they ended up in a freezer. And I have a hard time believing that commodity crops like corn and soy result in no harm to animals. Here's a government file that lists the deaths, most of them intentional, of 4,120,291 animals in one year alone. Many met their demise because they interfered, or it was claimed they interfered, with agriculture:

USDA: Animals Taken by Wildlife Services - FY 2009

I like the essence of his idea. But I can see the difficulty in bringing it to fruition.

What do you think?
________

Never Before Seen: Young Gorillas Dismantling Poachers' Traps

These wild gorillas are taking apart a primitive snare in a Rwandan forest last July:


From: Gorilla Youngsters Seen Dismantling Poachers' Traps—A First, National Geographic

Days before, a similar trap had killed one of their group, an infant that couldn't break free and died of her wounds.

The trap is simple, but not that straightforward:

"Poachers build the snares by tying a noose to a branch or a bamboo stalk. Using the rope, they pull the branch downward, bending it. They then use a bent stick or rock to hold the noose to the ground, keeping the branch tense. A sprinkling of vegetation camouflages the noose.

When an animal budges the stick or rock, the branch springs upward, closing the noose around the prey."

The gorillas live in a National Park, where hunters set thousands of traps for food ... and where conservationists, "trackers," spend their days dismantling those traps to protect the dwindling gorilla population. It's likely the gorillas learned from the trackers:

"Tracker John Ndayambaje spotted a trap very close to the Kuryama gorilla clan. He moved in to deactivate the snare, but a silverback named Vubu grunted, cautioning Ndayambaje to stay away.

Suddenly two juveniles - Rwema, a male; and Dukore, a female; both about four years old - ran toward the trap. Rwema jumped on the bent tree branch and broke it, while Dukore freed the noose.

The pair then spied another snare nearby - one the tracker himself had missed - and raced for it. Joined by a third gorilla, Rwema and Dukore destroyed that trap as well."

________

Good Health Is Not Just About Diet And Exercise

The late Dr. Alexander Leaf, as he traveled the globe studying long-living populations, observed that diet and exercise contributed mightily to health:

"Whether they were 120 or older, as many of the subjects had claimed, or in their late 90s, as was later found, he concluded that people who lived in mountainous places, worked outdoors into their old age and consumed local food high in vegetable content and low in animal fat tended to live very long and healthy lives free of heart disease."
- Alexander Leaf Dies at 92; Linked Diet and Health, New York Times, 6 January 2013

________
But there are other contributing factors. Breathing is one. Or, I should say, effective breathing. Dr. Weil:

"While diet and exercise are important, they are not the sole determinants of health. People who eat excellent diets and exercise faithfully are not always healthy, but the likelihood of being a healthy person who does not breathe well is slim."

In Breathing: Basic How-To's, Weil says breathing can lower heart rate, blood pressure, and settle an upset digestive system. It also influences emotional states:

"When you're upset, you breathe rapidly, shallowly and irregularly, but you can't be upset if your breathing is slow, deep, quiet and regular."

He gave basic techniques:

"Practice moving your breath. Keep your back straight. Begin with a deep, audible sigh, then quietly inhale and see how slow, deep, quiet and regular you can make your breathing and still have it feel perfectly comfortable.

Pay attention to your exhalation. ... Exhalation is usually passive and takes less time than inhalation. When you breathe this way, you do not move nearly as much air in and out of your lungs as you can. The more air you move, the healthier you will be, because the functioning of all systems of the body depends on delivery of oxygen and removal of carbon dioxide. To get more air into your lungs, concentrate on getting more air out of them by attending to exhalation."

________
And spirituality. Or, what I'll call spirituality. Dr. Richard Gunderman offered this insightful piece on Christmas Eve:

Our Health Comes Through Commitment To Others, The Atlantic

We should beware the temptation to think too much about the body, especially if it leads us to neglect what [the Roman poet Juvenal] would have called the needs of the soul. Health is not just the absence of disease. Nor is it merely the sum total of a battery of biological metrics, such as our waistlines, blood pressures, serum chemistry values, and an appropriately balanced mix of neurotransmitters. To be sure, it is a good thing when such values are in the normal range, but no amount of attention to getting the numbers right can guarantee the flourishing of mind and character.

As everyone is talking of the "holiday spirit," remember that it means waking up each morning with the conviction that we are on a mission to enrich others' lives. Isolation, mistrust, resentment, greed, and fear are all bad for us, not primarily because they render us more likely to develop cancer or suffer a heart attack or stroke, but because they undermine our capacity to live. The interests of the body are best served not by designated drivers and rigidly enforced diet plans, but by organizing our days so that each of us brings more humanity into the world.

Health is not the most important thing in life. It is primarily a byproduct of the pursuit of the most important things life has to offer.

Health is also not something that we can hoard up for ourselves. Its value is realized not in its accumulation, but in its spending.

If one day we wake up in full possession of our bodily faculties and feeling our best, our best course of action is not to down a fruit and vegetable puree or go for a jog. Health achieves its fullest expression in connection, trust, gratitude, and a habit of rejoicing in the flourishing of others.

How aware are we of one another? How committed are we to one another? How much of our hope and ambition for every day is bound up in an ongoing commitment to make a difference in the life of another person?

What Scrooge experiences for the first time in a very long time is the best medicine we have for the human soul. It is not found in a bottle, a pair of jogging shoes, or a juicer. The highest and best medicine, the only one that can truly suffuse and elevate everything else, is joy. Joy is life-affirming, life-restoring, and life-enhancing. Joy, and only joy, brings us truly and fully to life."

________The photo is of George C. Scott playing Scrooge in a 1984 television version of the story that this author gave good marks: "This Ebenezer Scrooge is a human wrecking ball, laying waste to everything around him. Alternately raging, caustic, sly and sarcastic, he allows no one to feel at ease in his presence. ... Scott owns this picture. His self-righteous rage is soon stripped away into a petulant defensiveness, and then honest repentance as the consequences of his wasted life are made clear."

High Protein Diets Increase Risk For Diabetes: Update

Some people were concerned that the information in this post from September 2011 was from an oral presentation and had not undergone peer review. It has since been published:

High Intakes Of Protein And Processed Meat Associate With Increased Incidence Of Type 2 Diabetes, British Journal of Nutrition, August 2012

In fact, abstracts accepted for presentation do undergo peer review. Mine did. Peer review is a nail-biting experience, not least of which for the egos involved. But, that's probably true everywhere.

Abstract:

"Diets high in protein have shown positive effects on short-term weight reduction and glycaemic control. However, the understanding of how dietary macronutrient composition relates to long-term risk of type 2 diabetes is limited. The aim of the present study was to examine intakes of macronutrients, fibre and protein sources in relation to incident type 2 diabetes.

In total, 27 140 individuals, aged 45–74 years, from the population-based Malmö Diet and Cancer cohort, were included. Dietary data were collected with a modified diet history method, including registration of cooked meals. During 12 years of follow-up, 1709 incident type 2 diabetes cases were identified. High protein intake was associated with increased risk of type 2 diabetes (hazard ratio (HR) 1·27 for highest compared with lowest quintile; 95 % CI 1·08, 1·49; P for trend = 0·01). When protein consumption increased by 5 % of energy at the expense of carbohydrates (HR 1·20; 95 % CI 1·09, 1·33) or fat (HR 1·21; 95 % CI 1·09, 1·33), increased diabetes risk was observed. Intakes in the highest quintiles of processed meat (HR 1·16; 95 % CI 1·00, 1·36; P for trend = 0·01) and eggs (HR 1·21; 95 % CI 1·04, 1·41; P for trend = 0·02) were associated with increased risk. Intake of fibre-rich bread and cereals was inversely associated with type 2 diabetes (HR 0·84; 95 % CI 0·73, 0·98; P for trend = 0·004).

In conclusion, results from the present large population-based prospective study indicate that high protein intake is associated with increased risk of type 2 diabetes. Replacing protein with carbohydrates may be favourable, especially if fibre-rich breads and cereals are chosen as carbohydrate sources."

This was a large and prospective study with more rigorous data collection than studies of the type (it didn't rely solely upon self-reported questionnaires), all of which increase the internal validity, or make the findings more believable.

Eggs and processed meats (e.g. bacon, ham, sausage, deli meats, luncheon meats, hot dogs) were especially risk-laden. However, replacement of protein with carbohydrate, especially fiber-rich breads and cereals, decreased diabetes risk.
________

2 Ideas For The New Year: Twenty Plus Campaign (For Exercise) And 5:2 Intermittent Fasting

Twenty Plus Campaign

Dr. Michael Mosley has an idea about exercise that deserves mention. He calls it the "Twenty Plus Campaign." He recalled it in one of his latest articles.

It is:

• 20 seconds of intense activity when I can (running up stairs, cycling like crazy for short bursts on my bike).
• A minimum of 20 minutes of walking every day.
• No more than 20 minutes of sitting at my computer or in front of the telly without getting up and moving around.

He says that sitting for long stretches, 20 or 30 minutes at a time, may be more detrimental to health than not regularly engaging in aerobic activity for 20 or 30 minutes. The 20-second energy bursts are familiar to me from the diabetes literature. Here's one study: Extremely short duration high intensity interval training substantially improves insulin action in young healthy males.

5:2 Intermittent Fasting

Mosley hosted a one-hour documentary on BBC last fall, Eat, Fast, and Live Longer, where he described the benefits of intermittent fasting. Here's Mosley a few days ago discussing the technique, which he outlines in his new little book, The Fast Diet:

BBC News - Diet Doctor Urges Intermittent Fasting



The 5:2 program involves eating normally (normally?) for 5 days and then fasting for 2 days. They can be any 2 days; they don't have to be consecutive. Fasting means eating about 25% of your normal intake, about 600 calories for a man, 500 calories for a woman, and drinking often throughout the fasting day. Mosley has lost 19 pounds over 3 months plus quite a bit of body fat by eating this way.
________

The Rise Of The Narcissist

There are some overlaps between this article and the book I'm reading. Some highlights from the article:

"Over the past four decades, there has been a dramatic rise in the number of students who describe themselves as being "above average" for academic ability, drive to achieve, mathematical ability and self-confidence.

Self-appraisals of traits that are less individualistic - such as co-operativeness, understanding others and spirituality - saw little change, or a decrease, over the same period.

Students are increasingly likely to label themselves as gifted in writing ability, [yet] objective test scores indicate that actual writing ability has gone down since the 1960s.

Another study by Twenge suggested there has been a 30% tilt towards narcissistic attitudes in US students since 1979."

Why is there a rise in narcissism?

"In The Narcissism Epidemic, co-written with Keith Campbell, Twenge blames the growth of narcissistic attitudes on a range of trends - including parenting styles, celebrity culture, social media and access to easy credit, which allows people to appear more successful than they are."

Some belief in your abilities is a good thing, but...

"You need to believe that you can go out and do something but that's not the same as thinking that you're great," says Twenge. She gives the example of a swimmer attempting to learn a turn - this person needs to believe that they can acquire that skill, but a belief that they are already a great swimmer does not help."

This piece could have been lifted directly from Cain's book:

"Our culture used to encourage modesty and humility and not bragging about yourself," says Twenge. "It was considered a bad thing to be seen as conceited or full of yourself."

________

The Rise Of The Extrovert

Susan Cain, in her book:
Quiet: The Power of Introverts in a World That Can't Stop Talking

... says that at least one third of the people we know are introverts.

"They are the ones who prefer listening to speaking, reading to partying; who innovate and create but dislike self-promotion; who favor working on their own over brainstorming in teams."

She discusses the appearance, or at least the rise in the twentieth century of what she calls the "Extrovert Ideal - the omnipresent belief that the ideal self is gregarious, alpha, and comfortable in the spotlight."

And as the extrovert rose, the introvert became stigmatized:

"Introversion - along with its cousins sensitivity, seriousness, and shyness - is now a second-class personality trait, somewhere between a disappointment and a pathology."

More to come...
________Painting from Biblioklept: Old Woman Reading, by Gerrit Dou.