Advanced Mediterranean Diet

January 1 this year, many folks made New Years’ resolutions to start exercising in conjunction with their other resolution to lose excess weight. I’ve got bad news for them.

Exercise is overrated as a pathway to major weight loss. Sure, a physically inactive young man with only five or 10 pounds (2 to 4 kg) to lose might be able to do it simply by starting an exercise program. That doesn’t work nearly as well for women. The problem is that exercise stimulates appetite, so any calories burned by exercise tend to be counteracted by increased food consumption.

“Should I go with aerobic or strength training….?”

On the other hand, exercise is particularly important for diabetics and prediabetics in two respects: 1) it helps in avoidance of overweight, especially after weight loss, and 2) it helps control blood sugar levels by improving insulin resistance, perhaps even bypassing it.

Even if it doesn’t help much with weight loss, regular physical activity has myriad general health benefits. First, let’s look at its effect on death rates.   

EXERCISE PREVENTS DEATH

As many as 250,000 deaths per year in the United States (approximately 12% of the total) are attributable to a lack of regular physical activity. We know now that regular physical activity can prevent a significant number of these deaths.

Exercise induces metabolic changes that lessen the impact of, or prevent altogether, several major illnesses, such as high blood pressure, coronary artery disease, diabetes, and obesity. There are also psychological benefits. Even if you’re just interested in looking better, awareness of exercise’s other advantages can be motivational.

The traditional Mediterranean diet of the mid-20th century may owe some of it’s healthfulness to a physically active lifestyle.

Exercise is defined as planned, structured, and repetitive bodily movement done to improve or maintain physical fitness.

Physical fitness is a set of attributes that relate to your ability to perform physical activity. These attributes include resting heart rate, blood pressure at rest and during exercise, lung capacity, body composition (weight in relation to height, percentage of body fat and muscle, bone structure), and aerobic power.

Aerobic power takes some explanation. Muscles perform their work by contracting, which shortens the muscles, pulling on attached tendons or bones. The resultant movement is physical activity. Muscle contraction requires energy, which is obtained from chemical reactions that use oxygen. Oxygen from the air we breathe is delivered to muscle tissue by the lungs, heart, and blood vessels. The ability of the cardiopulmonary system to transport oxygen from the atmosphere to the working muscles is called maximal oxygen uptake, or aerobic power. It’s the primary factor limiting performance of muscular activity.

Aerobic power is commonly measured by having a person perform progressively more difficult exercise on a treadmill or bicycle to the point of exhaustion. The treadmill test starts at a walking pace and gets faster and steeper every few minutes. The longer the subject can last on the treadmill, the greater his aerobic power. A large aerobic power is one of the most reliable indicators of good physical fitness. It’s cultivated through consistent, repetitive physical activity.

Physical Fitness Effect on Death Rates

Regular physical activity postpones death.

Higher levels of physical fitness are linked to lower rates of death primarily from cancer and cardiovascular disease (e.g., heart attacks and stroke). What’s more, moving from a lower to a higher level of fitness also prolongs life, even for people over 60.

Steve Parker, M.D.

Up to now, I’ve actually been doing Verstegen’s “Preliminary” Core Performance since I was too out of shape to do the real deal.  [”Can’t remember the last time you were able to bend at the waist and touch your toes?  Start with the preliminary program.”]  I give him credit for holding folks back until they’re ready for it.

Week 4 is easier than the previous weeks.  Completion takes only 30-45 minutes daily.  More focus on aerobic exercise than previously; Verstegen calls it ESD (energy systems development).  I’m now able to consistently do a slow jog for 12 minutes without stopping.  One day this week calls for 20 minutes of aerobics.  The aerobic exercise choice is yours.  You could run, skip rope, use a treadmill or bicycle, etc.  He give you a target heart rate.

Injury Update

• Right hip pain is gone.
• Left chest wall pain got worse before getting better.  Still there.  Interferes with sleep a little.  Don’t worry about my heart; it’s definitely musculoskeletal. 

So this is the first week of the classic 12-week program.  Intensity ramps up next week.

Steve Parker, M.D.

The program is getting easier now that I have many of the movements memorized.  On one of two occasions I was able to slow jog for 12 minutes without stopping, so this is progress.

Injury Report

• Right hip pain is fading and not a problem.  Doubt arthitis.  Probably a soft tissue thing.
• Two days of pain in the left side of my chest, worse with chest wall muscle movement.  I suspect I caused it by too much pressure on a muscle when using the hard foam roller.  This is a 5-inch wide cylinder that you put on the ground then roll various parts of your body against, to give yourself a massage.  It hurts if you allow too much of your body weight to be supported by the foam.  The pain came on gradually, so it shouldn’t be a cracked rib or torn muscle/ligament.

I’m glad to report I can finish some of the work outs in 30 minutes, in contrast to the two hours I spent on the very first day.

Steve Parker, M.D.

Disclosure: I don’t know Mark Verstegen.  I’m not being paid to write about his Core Performance program, nor do I earn a commision if you click the link to his book at Amazon.com.

In January, the U.S. Centers for Disease Control and Prevention released the latest estimates for prevalence of diabetes and prediabetes.  The situation is worse than it was in 2008, the last figures available. 

• Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
• Half of Americans 65 and older have prediabetes
• 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
• 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

The CDC estimates that one of every three U.S. adults could have diabetes by 2050 if present trends continue.

The press release from the CDC mentions that physical activity and avoidance of overweight will prevent some cases of diabetes.  I believe that  limiting consumption of refined carbohydrates like sugar and flour would also help.

Those who already have diabetes and prediabetes should consider carbohydrate-restricted Mediterranean-style eating, as in Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet.

Steve Parker, M.D.

For the last two years, I’ve been working on an adaptation of the healthy Mediterranean diet for people with type 2 diabetes and prediabetes.  The Mediterranean diet alone has too many carbohydrates for the average diabetic. 

The initial adaptation has been done and available free for many months at my other blog, the Diabetic Mediterranean Diet blog.  The whole shebang is now available in book and ebook form, entitled Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet. 

You’ll find the printed version at Amazon.com and CreateSpace.  The ebook is available in multiple formats at Smashwords, and the Kindle version is at the Kindle Store.

Compared with jumping from page to page at the DMD blog and using your own printer, the book’s a pretty good deal.  It runs $16.95 (USD) at Amazon, and the ebook is $9.99.

What’s In the Book?

Here’s the news release:

Dr. Steve Parker has created the first-ever low-carbohydrate Mediterranean diet, designed for people with type 2 diabetes and prediabetes.  His science-based plan blends the healthy components of the traditional Mediterranean diet with the ease and effectiveness of low-carb eating.  Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet teaches how to lower blood sugars naturally, reduce or eliminate diabetic medications, and lose excess weight if needed.

Type 2 diabetics and prediabetics have lost the ability to process carbohydrates safely.  Carbohydrates have become poisonous for them.  Carb toxicity too often leads to numb and painful limbs, impaired vision, kidney failure, amputations, cancer, and premature heart attacks, strokes, and death.

Nutrition experts worldwide agree that the Mediterranean diet is the healthiest way of eating for the general public.  It prolongs life and reduces rates of heart attack, stroke, cancer, and dementia.  The only problem for diabetics is that it provides too many toxic carbohydrates.

Dr. Parker initially recommends a very-low-carb ketogenic diet for 12 to 18 weeks, then teaches the reader how to gradually add more healthy carbohydrates depending on blood sugar and body weight changes.  Due to the toxic nature of carbohydrates in people with impaired blood sugar metabolism, most diabetics won’t be able to tolerate more than 80-100 grams of carbohydrate daily.  (The average Western diet provides 250 grams.)  

The book provides recipes, a week of menus, instruction on exercise, discussion of all available diabetic medications, advice on prevention of weight regain, lists of delicious doctor-approved foods, 71 scientific references, an annotated bibliography, and an index. All measurements are given both in U.S. customary and metric units.

Steve Parker, M.D., is a leading medical expert on the Mediterranean diet and author of the award-winning Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer.   He has over two decades’ experience practicing Internal Medicine and treating patients with diabetes and prediabetes.

I survived Mark Verstegen’s first week.  Yay!  I was pretty sore overall for the first 48 hours after the first day but not thereafter.  I must admit I sorta buy into the old saw, “No pain…no gain.”  But my muscular aching wasn’t much of a hindrance—”pain” seems too strong a word. 

I do have a bit of localized discomfort in my right hip.  Not sure if it’s a touch of greater trochanteric bursitis or just a strained muscle.  Not a deal killer by any means.

The program thus far is well-designed.  Light days follow heavy work out days; good variety.  The biggest hassle now is that I have to flip back and forth in the book since I can’t remember exactly what I need to do to perform “the scorpion,” “backward lunge with a twist,” “PB reach, roll, and lift,” “AIS 90/90 twist,” etc.  Talk about variety!  I count 40 or 50 maneuvers I’ve had to learn thus far.

I’m in such bad shape I couldn’t do a slow jog for 12 minutes, so I alternated running and fast walking.  Got my heart rate up and did some heavy breathing, however, which is the goal for now.  This is an embarrassing admission for someone who has run two marathons (26.2 miles).

Steve Parker, M.D.

Ketogenic diets have seen a resurgence in the last two decades as a treatment for childhood epilepsy, particularly difficult-to-control cases not responding to drug therapy.  It works, even in adults.  That’s why some brain experts are wondering if ketogenic diets might be helpful in other brain disorders, such as Alzheimer’s disease and Parkinson’s disease. 

I’ll save you some time and just give you the conclusion of a 2006 scientific article I read: maybe, but it’s way too soon to tell.

The article is called “Neuroprotective and disease-modifying effects of the ketogenic diet,” from researchers at the National Institutes of Health’s National Institue of Neruological Disorders and Stroke.  Sounds promising doesn’t it?

The article goes into detail about how the ketogenic diet might be good for brain health.  Dr. Emily Deans would be very interested in that, but most of my readers not.  Two-and-a-half pages on non-human animal studies, too. 

What is this ”Ketogenic diet” used for epilepsy?

The most common ketogenic diet for childhood epilepsy is the one developed by Wilder in 1921.  It was a popular treatment for epilepsy in the 1920s and 1930s.  Fats provide 80 to 90% of the calories in the diet, with sufficient protein for growth, and minimal carbohydrates.  Since carbs are in short supply, the body is forced to use fats as an energy source, which generates ketone bodies—acetoacetate, acetone, beta-hydroxybutyrate, largely from the liver.

So what?

Not much.  This article may have been written to stimulate future research, and I hope it does.  I just searched PubMed for “ketogenic diet AND Alzheimer” and came up with nothing new since 2006. 

Could the Ketogenic Mediterranean Diet prevent or alleviate Alzheimer’s disease?  At this point, just flip a coin.

Steve Parker, M.D.

Reference: Gasior M, Rogawski MA, & Hartman AL (2006). Neuroprotective and disease-modifying effects of the ketogenic diet. Behavioural pharmacology, 17 (5-6), 431-9 PMID: 16940764

Researchers note lower risk of asthma symptoms in Greek 10- to 12-year-olds following a traditional Mediterranean diet, according to a recent Journal of the American Dietetic Association.

I reported in 2008 on a Portuguese study that found much improved control of adult asthma in those eating a Mediterranean diet.  Why, I even seem to recall a study that found a lower incidence of asthma in children of mothers who ate Mediterranean-style.

If you’re an overweight adult with asthma, why not look into the Sonoma Diet by Connie Guttersen, or my Advanced Mediterranean Diet?

Steve Parker, M.D.