Physical Activity and Weight Loss Among Adults With Type 2 Diabetes and Overweight or Obesity: A Post Hoc Analysis of the Look AHEAD Trial

“[Introduction] Nearly 10% of cardiovascular events are attributed to type 2 diabetes (T2D). [..] Prior large RCTs [randomized controlled trials], including Look AHEAD (Action for Health in Diabetes), DIRECT, and the Diabetes Prevention Program, attempted to investigate the cardiovascular benefits of weight loss and increased PA [physical activity] volume among individuals with prediabetes or T2D, but no relationship between lifestyle-induced weight loss and cardiovascular benefits has been reported. [..] this study evaluates the interactions of weight loss and PA volumes in association with the risk of cardiovascular events by conducting a post hoc secondary analysis of the Look AHEAD trial … Read More

The Quest for Scientific Certainty Is Futile

“I had to learn over and over again that extreme conviction requires extraordinary evidence, and the evidence we have is usually far from extraordinary. For instance, our frontline anti-depression drugs are supposed to work by changing serotonin levels in the brain, but a review published last year found that there’s no consistent evidence that serotonin has much to do with depression at all. (Maybe that’s why antidepressants don’t seem to work that well, especially in the long term.) It seems obvious that sunscreen should protect you from skin cancer, but a 2018 meta-analysis could not confirm that this is true … Read More

Is an All-Meat Diet What Nature Intended?

“Some meatfluencers stress that human beings are animals and maintain that, if allowed to eat according to our animal instincts, we will favor a meaty menu. But the biologists David Raubenheimer and Stephen J. Simpson have been investigating animal alimentation for more than thirty years, and their new book, “Eat Like the Animals,” suggests that the meatfluencers have it all wrong. The authors started collaborating at Oxford, studying the eating preferences of locusts (grasshoppers, basically). First, they found that locusts preferred a certain ratio of carbohydrates to protein. When forced to live on foods higher in carbs and lower in … Read More

Want to Live Longer and Healthier? Peter Attia Has a Plan.

“In his telling, Medicine 2.0 is oriented toward addressing the four chronic diseases of aging that will probably be the cause of most of our deaths, but only after they become problems. (Those chronic diseases are heart disease, cancer, Alzheimer’s and related neurodegenerative diseases and Type 2 diabetes and related metabolic dysfunction.) Medicine 3.0, though, aims to proactively prevent those things for as long as possible and allow us to maintain better health deeper into old age. How exactly? Not through any techno-fantasies of biohacking or wonder-drug supplements but largely with highly rigorous, detailed and personalized monitoring and treatment of our nutrition, … Read More

The Curious Side Effects of Medical Transparency

“Transparency has always been seen as a hallmark of honesty and integrity. The logic is familiar: democracies aspire to be transparent, but dictatorships are opaque; faithful spouses are guileless, while philanderers lie; reputable businesses operate in the open, but shady operations literally draw the shades. Collectively, we’ve embraced Louis Brandeis’s dictum that sunlight is the best disinfectant. We demand transparency in government, charitable institutions, nutrition labels, and middle-school grading rubrics. The medical record should be no different. [..] In 2008, Ethan Bernstein, an associate professor at Harvard Business School, travelled with a team of students to a vast mobile-phone-manufacturing plant … Read More

Psychedelics Open Your Brain. You Might Not Like What Falls In.: Reshaping your mind isn’t always a great idea.

“Psychedelic drugs such as psilocybin, LSD, ayahuasca, and Ecstasy, along with anesthetics such as ketamine, can enhance a user’s neuroplasticity within hours of administration. In fact, some users take psychedelics for the express purpose of making their brain a little more malleable. Just drop some acid, the thinking goes, and your brain will rewire itself—you’ll be smarter, fitter, more creative, and self-aware. You might even get a transcendent experience. Popular media abound with anecdotes suggesting that microdosing LSD or psilocybin can expand divergent thinking, a more free and associative type of thinking that some psychologists link with creativity. Research suggests … Read More

Learning to Focus Without Medication: People with ADHD often rely on stimulants like Adderall, but behavioral techniques can be just as effective in dealing with distraction

Excerpt – In a study published in the journal Psychiatry Research in 2019, researchers divided 124 participants with ADHD into two groups. One group received 12 weekly sessions of cognitive behavioral therapy (CBT) alone, while the other received CBT paired with medication. CBT focuses on breaking down long-term goals into workable steps and also on self-motivation, stress management and thinking more adaptively. The study found that the CBT-only group experienced the same significant improvement in ADHD symptom as the group that had also received medication. “Pills don’t teach skills,” said Dr. J. Russell Ramsay, a professor and co-director of the … Read More

Should we trust Apple with mental health data?

“the new coaching service — codenamed Quartz — sounds like an expansion of the Apple Watch play from physical health to mental health, Bloomberg reported. It is “designed to keep users motivated to exercise, improve eating habits and help them sleep better” using “AI and data from an Apple Watch to make suggestions and create coaching programs tailored to specific users.” [..] About five years ago, I wrote about the various ways that the Apple Watch failed as a behavioral intervention. There’s some behavioral science, but also — because I was using it — I discovered that the constant nudging for achievement made me miserable. … Read More

‘There’s a huge fatphobia problem in the eating disorder world’: Even in treatment, weight stigma fails patients

“There is little consensus about how to protect young people seeking treatment for eating disorders from harmful ideas about weight, or whether treatments for obesity and eating disorders can safely coexist at all within the medical system. And while the vast majority of eating disorder professionals would never prescribe weight loss to somebody recovering from an eating disorder, each clinician’s approach to treatment is affected by their individual beliefs about, and understanding of, obesity. The strong disagreements within the profession about how to best address obesity and weight stigma may leave patients susceptible to inappropriate or harmful care. [..] Clinicians … Read More

Why involuntary treatment for addiction is a dangerous idea

“When I first started out in addiction medicine to now, I thought that this made sense as a last-ditch approach [involuntary commitment]. But my thinking has changed as I’ve seen the clear evidence of its lack of benefit and heard stories and observed data indicating its harm. I also know intimately the feeling of powerlessness that comes with being a close family member to someone dealing with addiction. When I see medical professionals and loved ones reaching to involuntary treatment as a solution, I know it is out of a desperate wish to do something, anything, to respond to the … Read More