Articles of the Month:

I have a ton of articles this month, as July was packed with some amazing studies.

Diet and Nutrition:

• No surprise here, but a recent study reveals just how inconsistent definitions of “meat” are in differing types of studies, further illustrating the massive issues with population and epidemiology studies.

• The NYT takes an interesting look at the push towards high-quality ethical meat through the lens of vegetarians in The Vegetarians who Turned into Butchers. Check it out, as it is definitely an interesting read.

• For those of you on blood thinners or warfarin, there is good news as you don’t need to pass on your leafy greens, you just have to be a little systematic about it. This often comes up as an issue in my clinic, so I am glad to see the push for including veggies in the diet of those of us on these meds.

• Whole grain consumption did not lead to weight loss, but instead weight gain for many  overweight individuals, in this massive analysis. Their conclusions? Let’s focus on the many other benefits of whole grains, illustrating the massive bias that continues to plague the diet world.

• Our high-sugar diet is breeding a new superbug, according to new studies, providing us with even more reasons to limit this “food” with its unending collateral damage.

• Another study shows the importance of having lean mass as we age, this one in men. Increased muscle mass is associated with improved bone health and strength and less falls, both of which will keep us out of nursing homes and keep us enjoying our “golden years.” Once again, don’t underestimate the importance of lifting heavier weights as we ascend through life.

• Intensity continues to be king when it comes to deriving metabolic benefit from exercise. A recent study reveals high intensity training versus continual exercise results in enhanced fat burning. While we still can’t out-exercise a bad diet, we can take advantage of the metabolic advances of intense exercise.

• A topic near and dear to my heart, the online weight lifting magazine T Nation recently advised that we Puncture All BOSU and Swiss Balls. I couldn’t agree more, and they do a great job of discussing Eric Cressey’s study which was one of many discrediting this fad that needs to stop.

• A highly reported and shocking study prerelease has revealed questioning findings and potential fraud in evaluating centenarians from several Blue Zones. Definitely give this a read: Supercentenarians and the oldest-old are concentrated into regions with no birth certificates and short lifespans. Now follow up with the back and forth feud between the preprint author and head of Gerontology Research Group.

• My article Physician Burnout and Physician Health: Three Simple Suggestions for a Complex Problem was published this month. So far Duke has been quite amazing at promoting an environment that fights burnout instead of fueling it, a change I am welcoming with open arms.

• Vacationing More Often May Reduce Metabolic Syndrome Risk, according to a recent study. While it has all the issues of population studies, the concept is pretty reasonable as vacations tend to provide us with time with family and away from the cortisol-raising jungle known as corporate America.

• While only a phase II study, the addition of metformin to traditional treatment for lung cancer resulted in a massive improvement in outcomes. While we did not see this in our little retrospective study, this is encouraging as metformin works through several metabolic mechanisms, including increasing insulin sensitivity.

• They are placing healthier vending machines in publicly funded parks and recreational areas. Isn’t it time to do the same in hospitals?

• A pilot study of a ketogenic diet in relapsing and remitting Multiple Sclerosis revealed beyond encouraging results. Big ups to the ziMS Foundation for funding the study.

I am getting a little fed up with all the self help books and social media exposure out there and, as you will see below, checked out a book on the topic called Stand Firm. Below is a quote from it that stood out to me.

“It’s a fundamental paradox that self-help literature, on one hand, celebrates the individual, their freedom of choice & their self-realization, & on the other, helps create people who are increasingly addicted to self-help and therapeutic interventions.”

-Svend Brinkmann

Favorites of the Month:

I was off last month, so I read a ton of books. I omitted some from this list, but enjoyed some decent ones.

Books:

• Stand Firm: Resisting the Self-Improvement Craze by Svend Brinkmann: I liked this book a lot. It is a quick and easy read and attacks some modern sacred cows (I generally like books that do this, whether successful or not). Lately the self-help craze is getting out of control and, in my opinion, driving people crazy by consistently telling them that if they aren’t growing or taking advantage of every opportunity they are falling behind.

• Work, Consumerism and the New Poor by Zygmunt Bauman: The book gets repetitive and long-winded, but the first few chapters hit the nail on the head so thoroughly that I found myself underlining and tabbing nearly every line of the page. The book is dirt cheap (buy it used, which I do for all books) and worth a read if consumerism and the constant push to work more so you can buy more of modern society is starting to get to you and you are looking to take a deep dive into the root causes.

• Shop Class As Soulcraft: An Inquiry into the Value of Work by Matthew Crawford: I really liked the premise of this book, though the delivery at times was wordy and tedious. I found myself thinking “man, we get it, you are a good writer and know a lot of big vocab words, but spit it out!” The premise is a good one, however, and as individuals and society as a whole, we need to rethink how we view different jobs that are manual. Furthermore, the rewards from the manual and physical jobs is something we, as a whole, have neglected for the past several decades and should give them more attention.

• Cheap: The High Cost of Discount Culture by Ellen Ruppel Shell: Quantity over quality has been the mantra in all aspects of society and I have seen it dig deep into medicine (many docs are paid not by how good a job they do taking care of patients, but rather how many patients they take care of or how many expensive procedures they perform). In my household (and in my job) I tend to focus solely on quality while minimizing quanitity. Why the push for quantity in our society, especially when purchasing? Read this book for most of the answers.

• Baking Soda: I use this with my 50:50 baking soda and citric acid toilet bowl cleaner by dumping it in the toilet, letting it bubble up, then adding a small amount of vinegar. It works amazingly. I also rinse my mouth with baking soda after my morning coffee to offset the acidity and protect my enamel. I also splash some on my armpits to use as deodorant (and yes, it works well but is not an antiperspirant).

• Citric Acid: The other ingredient in my toilet bowel cleaner, it is very cheap.

• Vinegar: I use this for many things, including in my bone broth to help leach minerals. I would either make this or get it from a local shop or grocery store. Lemon vinegar works, as does Braggs and other apple cider vinegars (my pick). Just mix these all and dump in the toilet. Give it about 10-15 minutes to mix around, bubble up, and look like a volcano from when you were in first grade. You’ll reveal a sparkling clean toilet basin.

• Precision Xtra Blood Ketone Strips: The price of these have plummeted from upwards of $4 each, to well under a dollar each. For those of you checking levels, these have been my go-to. If you are really checking often, 100 strips are now 80 cents each.

• Black Peppercorns in paper packaging by Pure Organic Ingredients: These are great peppercorns in good packaging (though Amazon kills me because they always double bag in plastic) and are very reasonably priced. They are now my go-to.