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Do you know someone the “incretin” drug for type 2 diabetes?

May 20th, 2013 by drmaurer No comments »

“Safety of Incretin-Based Therapies Hotly Debated”. The headline from WebMD drew my attention. Incretins were part of the treatment that caused more death in the more aggressively “drug-managed” type 2 diabetics. The article begins by stating that researchers express concern about the safety of “incretins” – a class of drugs that raise insulin to lower blood glucose. They do indeed lower glucose but raise the risk of so many diseases that the wisdom of the drug’s use is in question. Your goal, when you follow your Blood Code, is the opposite, it is to lower insulin and improve your insulin sensitivity.

So where is the debate? The article continues, ONE researcher, Dr. Michael A, Nauck, “begs to differ.” One M.D. against years of clinical data makes a debate? I looked up Dr. Nauck’s conflict of interest statement, published on an article from 2012 on WebMD. Is it possible for someone to have millions of dollars of pharmaceutical interest at stake and legitimately provide a debate that impacts your life and medical treatment? Decide for yourself, these are his active conflicts of interest.

Type 2 diabetes is reversible with properly advised dietary and fitness intervention. The scientific community must not put a sugar-coating on a class of drugs that comes with significant if not excessive risk. Conflict of interest aside, the medical industry is here to serve the greater good of the public, right? Right?

Faculty and Disclosures: http://www.medscape.org/viewarticle/772418
Michael A. Nauck, MD, PhDServed as an advisor or consultant for: Amylin Pharmaceuticals, Inc.; AstraZeneca Pharmaceuticals LP; Berlin-Chemie AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Diartis Pharmaceuticals; Eli Lilly and Company; F. Hoffmann-La Roche Ltd; GlaxoSmithKline; Intarcia Therapeutics, Inc.; MannKind Corporation; Merck Sharp & Dohme Corp.; Novartis Pharmaceuticals Corporation; Novo Nordisk; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.; Versartis, Inc.; Wyeth Pharmaceuticals Inc.
Served as a speaker or a member of a speakers bureau for: Amylin Pharmaceuticals, Inc.; AstraZeneca Pharmaceuticals LP; Berlin-Chemie AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Diartis Pharmaceuticals; Eli Lilly and Company; F. Hoffmann-La Roche Ltd; GlaxoSmithKline; Intarcia Therapeutics, Inc.; MannKind Corporation; Merck Sharp & Dohme Corp.; Novartis Pharmaceuticals Corporation; Novo Nordisk; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.; Versartis, Inc.; Wyeth Pharmaceuticals Inc.
Received grants for clinical research from: AstraZeneca Pharmaceuticals LP; Berlin-Chemie AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Eli Lilly and Company; GlaxoSmithKline; Merck Sharp & Dohme Corp.; MetaCure Inc.; Novartis Pharmaceuticals Corporation; Novo Nordisk; Roche; Tolerx, Inc.

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7 minutes of exercise to reverse insulin resistance on your Blood Code

May 14th, 2013 by drmaurer No comments »

12resistance exercises in 7 minutesI continually remind people with insulin resistance that aerobic exercise is inadequate to really turn around the metabolic thriftiness that they are so good at. We need 5-10 minutes of resistance exercises after a walk, run or bike ride. A friend and follower of the Blood Code sent me this article from a terrific writer for the New York Times. Rather than hearing the reasons to do the exercise, it helps to see a diagram and just do it. Thanks to Gretchen Reynolds from The Times – http://well.blogs.nytimes.com/2013/05/09/the-scientific-7-minute-workout/

Blood Code Fitness Principles: If you have any insulin resistance, do weight resistance twice per week, and on the other days, put a few resistance/srenuous exercises at the end a walk, even if your walk is only a few minutes long! The most important take home message is “no days off”. This is truest for those with insulin resistance and hypothyroid…fitness is a daily lifestyle not an occasional event. And while you won’t be an elite athlete at 10 minutes per day, you will maintain your healthier life.

–Richard Maurer

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Tamoxifen and Evista Recommendation for Cancer Prevention is an Insult to Basic Math

April 17th, 2013 by drmaurer No comments »

When drug company interests enter preventative medicine….

This week, there was a “expert panel” report from the Annals of Internal Medicine that hormonal drugs taken long term can reduce the incidence of breast cancer. Sounds compelling doesn’t it? If a woman is at higher risk of breast cancer, there is a pill to take. Let’s do the math from the study, ready?
Of 1000 high risk women, 24 would be likely to get cancer within 5-years, this is 2.5%. If all of them took the drug, there would be 8 fewer cases of breast cancer over the 5-years, 1.6% of the women, for a total reduction of less than 1%.

But of the 1000 women who might take the drug, 6-7 would likely develop blood clots and there would be 4 extra cases of uterine cancer. There is also the issue of hot flashes, severe vaginal dryness and accelerated cataracts. Just the extra clots and cancers add up to about 1.1%.
The researchers suggest that doctors could maybe guess who is at lower risk of having a stroke and heart attack and use the drugs on only them. The NYT headline? “Panel Report Urges Breast Cancer Drugs for Healthy Higher Risk Women.”

The insanity that I present is something I confront daily as the drug industries bully their way into preventive wellness. Common drugs that are taken long term include Metformin to prevent diabetes and Statins to lower heart attack risk and aspirin for stroke prevention– These drugs are proven to either shorten your life or add complications without any life extension. Prevention of illness is through your lifestyle, your diet and your nutrition. Know what you are prone to through a smart assessment of blood tests and then find the habits that promote your healthiest expression. There is not a drug for this.

Yours in lifelong wellness,

Dr. Richard Maurer
The Blood Code©

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TMAO protein and heart disease silliness.

April 12th, 2013 by drmaurer No comments »

The headlines have been spinning the wrong story. But spin is good for publishing no matter whether it is right or wrong. People have torn copies of their New York Times for me with questions about the “newly vilified TMAO chemical from red meat.” Let’s see what this study really displays. If you are interested, the study is at: http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.3145.html

The study headlines were mistakenly about red meat. The study was not at all about red meat, even though the six subjects ate 8-ounces of steak for the test, nothing but lean steak. The study subject was really the human gastrointestinal microbiota. This term refers to the gut bacteria that live inside the human colon. The bacterial landscape is a new and exciting area of study, and there are researchers well on their way to mapping the total microbiota genome. Genetics of these bacteria aside, we fully accept that there is a beneficial and inseparable relationship between our digestion and absorption and the gastrointestinal bacteria. And lo, there is a bacteria that feeds on L-carnitine, a protein found in all animal meats such as fish, poultry and red meat, which produces a compound that can then be turned into another compound in your liver and KaPow – TMAO! You now have a potentially inflammatory compound that can cause vascular disease in rats.

The researcher posits that antibiotics could be a therapy for atherosclerosis treatment.

The silliness starts right there. This is such a wildly preliminary study, the only reason I can see to posit a drug therapy is to gain company funding. Since the steak intake and the L-carnitine capsules are the only medium of intake that has been studied, what is the effect of soluble fiber with meat intake? The anti-atherogenic effect from compounds in vegetables? How about fermented foods, like sauerkraut or crème fraiche to promote GI bacterial health? How do all these traditional dietary factors affect the harmful effects of a nothing-but-meat test diet.

It is not a sensational story to state that we have inseparably co-evolved with the microbiota that is in and on us. So, In light of the newly spun TMAO headlines, my recommendations:

1) Don’t be in the top 10% of meat eaters. Be in the middle.
2) Eat cultured foods at least two meals per day like a couple spoonfuls of sauerkraut or some plain yogurt
3) With any meat serving, assure at least two vegetable servings. This is healthy and part of most traditional cuisine.
4) Fats should be an integral part of any meat intake. The subject of the study is a pure protein; traditional and natural fats in your protein-rich meal prevent the overindulgence of meat proteins.

Thanks for reading
-Dr Maurer of The Blood Code ©

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It’s the Excess Processed Meat that Will Kill You…Not the Red Meat!

March 8th, 2013 by drmaurer No comments »

The headlines just can’t get it right. On my complementary and metabolic medical news subscription, here is the headline that I woke to this morning. “Red and Processed Meat Tied to Early Cancer and Cardiovascular Death.“

I assumed that the headline was written by someone who did not actually read the article,and I believe I was correct in that assumption. I remain in awe that this kind of rubbish journalism can persist. When I linked to the full journal article, the authors’ conclusions were quite clear. Here are the bullet points, all directly quoted from the article.

• In the EPIC cohort, a high consumption of processed meat was related to moderately higher all-cause mortality. After correction for measurement error, red meat intake was no longer associated with mortality, and there was no association with the consumption of poultry.
• Also, several vegetarian studies did not find increased all-cause mortality among non-vegetarians compared with vegetarians
• We observed a consistent association between processed meat consumption and total mortality but not between red meat consumption and total mortality.
• In contrast to the US cohorts, there was no statistically significant association of red meat consumption with risk of cancer or cardiovascular mortality.

They make note that those that are at the highest quintile of processed meat consumption were more likely to be smokers, so that might be confounding. It is noted throughout their study report that the prior US studies combined processed meat and red meat. When viewed separately, red meat is not associated with cancer or cardiovascular disease, especially if researchers control for smoking and lifestyle factors.
What is processed meat? If you buy meat, and it has a list of ingredients on the package, it is processed.
Unprocessed Red meat: Ground hamburger (not leaner than 85%!) – Go where a butcher grinds it fresh. roasts, steaks, lamb cuts, etc.

Processed red meats: sandwich meats (ONE slice of sandwich ham often has a full 600-mg of sodium. A quarter of a days need.), flavored bacon, processed sausages, hot dogs and any meat product that has an ingredient list. Remember, we do not actually know what it is about the processed meat that is a problem, is it the preservatives, the excess salt, the oxidation and degradation of the fats due to aeration and excessive storage times? “Organic” sandwich meat may not be the answer. Seek meats that are real, traditional and without added flavorings, preservatives, sweeteners or excessive salt.

So why do the headlines always demonize red meat? When we assume something is tru, we should heed the quote of Mark Twain, “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.” We need to end the misinformed color discrimination of meat! Go big Red!

Dr. Richard Maurer
The Blood Code and MaineMetabolism

Rohrmann S, et al. Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition. BMC Medicine 2013 11:63 [http://www.biomedcentral.com/content/pdf/1741-7015-11-63.pdf]

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A Mediterranean Diet Does What???

February 26th, 2013 by drmaurer No comments »

White beans served daily with a meal in Florentine cuisine, Italy (Small)This study is so wildly over hyped. The NYT even put it on the front page. Older Spaniards who have high heart disease risk, such as smoking, high blood pressure or diabetes, were put in one of three groups. One ate a huge handful of nuts. The other was told to eat 4 TBS of olive oil. But both of these groups were also regularly told to avoid “commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.” The “control group” was told to eat a low fat diet.

The first two groups were given intensive guidance initially then quarterly meetings with a nutritional team and given gifts of olive oil and “non-food gifts”. The low fat group was given one instructional visit and then received an annual leaflet.

The researchers claim that the low fat group did not comply and the therefore the study design failed. But with 18 doctors listed on the research paper, they were not going to let a failed study…fail. So they made up what they wanted. The failed third-arm of the study, they decided to rename a control group. A control group needs to get the same extraneous treatment as the study group, like quarterly meetings and “non-food gifts”. It is known that diabetics improve their longevity and reduce their complications merely by meeting more frequently with office staff. Prior studies have also shown that it doesn’t even matter what they talk about, just being cared for makes people have less cardiovascular disease.

Maybe a low-fat diet caused an increased incidence of heart disease. Remember, they did ot actually have a control group in the study. Assuring that a 70 year old Spaniard eats 4 TBS of olive oil a day is probably of little change to their normal life. And perhaps the low fat group did make changes and lowered some fat and raised their carbohydrate intake, which raised their risk of stroke.
It is not about whether we “believe” in the Mediterranean diet, it is about good science. For that, the New England Journal of Medicine should be ashamed.

Ramón Estruch, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. NEJM Feb 25, 2013.

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Stay in shape as you age, but how to measure “shape”?

February 22nd, 2013 by drmaurer No comments »

I have been trying to think of something intelligent to say about this study, besides “It’s important to stay in shape as you age.” Researchers found that as people get more fat percentage in their thighs, they are worse at walking, which results in greater morbidity as they age. Body fat percentage in the thigh mirrors the body fat in the triceps. Using skinfold calipers can accurately identify who needs to turn this pattern around. In The Blood Code©/FatBack Diet program, calipers are used at the triceps and biceps to assess conditioning of the extremities.

Blood Code Rule: triceps skinfold (in mm) should equal hip skinfold (in mm). Triceps and biceps don’t get much better with dietary changes, they require physical exercises.

Basically, if you stay in better shape as you age, you will decrease the likelihood that you will fall, be sick and/or die. This study indicates that body fat percentage measured on the thighs or triceps is an accurate indicator of risk.

It is important to note that as we age, it is not important to maintain our activity, to keep the same muscle tone over time; we actually need to exercise and nourish ourselves a little better over time. No rest for the weary, healthy aging is not for the lazy.

-Dr. Richard Maurer

“Associations between body composition and gait-speed decline: results from the Health, Aging, and Body Composition study”

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How do you spend your calories? Hypothyroid and The Blood Code (C)

January 28th, 2013 by drmaurer No comments »

Use The Blood Code(c) to understand you thyroid. And why to avoid taking too much prescription thyroid hormone.

Your spending rate is related to what you burn at rest and during activity

Countless people will say that they have a sluggish metabolism. Remember, survival of our species has depended upon our having an efficient metabolism. Excessive metabolic burning is associated with a shorter life, essentially burning out from protein breakdown, which includes immunological breakdown. I am writing in response to the trend in “natural health” clinics to excessively use thyroid hormone prescription for everyone who is tired or thinks they are overweight..

Our Basal Metabolic Rate is part of our hormonal function. This is, essentially, a brilliant way your body can burn less calories at rest; by lowering the cellular activity at rest we lose less heat. The “basal body temperature” will be a little bit lower in these people. They burn less calories at rest. The thyroid gland is behind your Basal Metabolic Rate – or BMR. It is easy to see why this gland has become the scapegoat for someone’s weight gain or difficulty losing weight.

Hypothyroid is another historically advantageous condition which allowed people to use less calories at rest, thereby squandering less of the precious ingested calories. What’s the advantage? Imagine if someone had to cut their calories at the same time they had to expend more energy, like having to walk a long distance to get to a displaced food supply. If the body could slow the thyroid function it would prevent burning out. If the body has to endure low caloric intake with increased physical exertion, the slowing of the thyroid activity helps preserve capital. People with hypothyroid are more resistant to the effects of weight loss diets that promote a significant caloric deprivation at the same time there is increased exercise/stress, like a famine with increased manual labor. Here lies the theory that the anti-thyroid antibodies, aka. thyroid peroxidase (TPO), sit in waiting, and if “times get tough” – low caloric intake with sudden stressful increases in activity, the antibodies will take-out some of the function of the thyroid gland. Clearly there is an intimate relationship between our nervous, endocrine and immune system.

If insulin resistance is someone who saves and stockpiles calories as fat, glucose and glycogen; then hypothyroid is the spendthrift.

Some weight loss medical clinics wrongfully over prescribe thyroid hormone to “get someone’s metabolism going”. Physiologically, the result of a less active thyroid is a cooler body temperature only at rest. When uncorrected and more severe, hypothyroid can slow other processes, resulting in constipation, fatigue, weight gain and a poor circulation. But when someone has a mild hypothyroid trait, scientific evidence support that they might actually live longer.

If you are just starting to unlock your Blood Code(c) and discover a slight hypothyroid trait, do not expect hormone replacement to be the cure. Whether you add some prescription thyroid hormone or not, a proper fitness plan is a key toward your long life.

-Dr. Richard Maurer

1.Kim, B., Thyroid hormone as a determinant of energy expenditure and the basal metabolic rate. Thyroid, 2008. 18(2): p. 141-4.
2.Rozing, M.P., et al., Low serum free triiodothyronine levels mark familial longevity: the Leiden Longevity Study. J Gerontol A Biol Sci Med Sci, 2010. 65(4): p. 365-8.
3.Rozing, M.P., et al., Familial Longevity Is Associated with Decreased Thyroid Function. J Clin Endocrinol Metab, 2010

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Diet and exercise cure type 2 diabetes, but drug companies take objection.

January 7th, 2013 by drmaurer No comments »

The headline sounds like something out of “the Onion”, but this is medical research for you.

A study comes out and shows that a minimal amount of exercise (less than three hours per week), and moderate caloric restriction (1200-1800 calories per day) cures one in nine people with type 2 diabetes. This is a study from the CDC and printed in the Journal of American Medical Association on December 14th, 2012. The participants reached normal blood sugar levels without medications. And in many cases were able to stop taking medication.

While an 11-12% cure rate is pretty poor in my experience, the participants in this study just restricted calories, not carbohydrates. Their exercise recommendations were the equivalent to mild aerobic exercise. In my experience, with a low carbohydrate intake and strenuous exercise, the cure rate goes to well over 95%.

So did I see my medical websites state: “Diet and exercise are safe and effective tools to cure type 2 diabetes?” No. Instead I read a response by Dr. John Buse of the University of North Carolina at Chapel Hill School of Medicine. He acknowledged that lifestyle intervention is beneficial to diabetes patients, but he questioned how it compared with other diabetes treatments. He told Reuters: “How cost effective is it, what are the long-term consequences (and) how would it really compare with alternative approaches like bariatric surgery and drug therapy?”

Here is the list of companies (I count 28) Dr. Buse has financial obligations toward. Now I not against his financial success, but we must realize that the “medical establishment” may not be looking out for our health and wellness. You make the call, who do you think this “medical expert” is speaking for?
Disclosure list from Medscape 2012: John B. Buse, MD, PhD, has disclosed the following relevant financial relationships:
Served as a director, officer, partner, employee, advisor, consultant, or trustee for: Amylin Pharmaceutical, Inc. Andromeda, Bayhill Therapeutics, Biodel, Boehringer Ingelheim, Catabasis, Diartis, Elcelyx, Eli Lilly and Co., Exsulin, GI Dynamics, Halozyme, Inc., Hoffman-LaRoche Inc., Johnson & Johnson, Lexicon, LipoScience, Medtronic MiniMed, Inc., Merck, Metabolon, Novan, Novo Nordisk Pharmaceuticals, Inc., Osiris Therapeutics, Inc., Orexigen, Pfizer, Inc., sanofi-aventis, Tolerex, Transition Therapeutics, TransPharma

Moral of this story? As Deep Throat said to Robert Redford in All the Presidents Men, “Follow the money.” To live a long and healthy life, prevention of illness will not likely come from a pharmaceutical company or a hospital surgery. Learn about your own body and find the diet and fitness program that lets you live your life to the fullest.
–Dr. Richard Maurer

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Cancer risk and prescription drugs for type 2 diabetes

January 4th, 2013 by drmaurer No comments »

In the Health section of the NYT on January 1st 2013, an all too familiar story of a 62 year old woman appeared. She had been diagnosed with type 2 diabetes 9 years earlier, and the article writes that she had been “diligently taking her medicine” to “manage” her diabetes. And then, Lo, she was found to have cancer.

It is true, once you have shown the ability to elevate insulin and glucose in your body, you have an elevated risk of getting cancer. Furthermore, it appears that once you have had cancer, you have an increased incidence of developing insulin resistance. But we need to beware when drugs that “manage” diabetes contribute to that cancer risk.

Could the DPP-4 Inhibition Caused by Januvia (sitagliptin) and Onglyza Promote Cancer?

The DPP-4 inhibitor drugs work by blocking the enzyme that normally breaks down a class of compounds called incretins, which stimulate insulin release. This drug class has only been on the market a short period of time, less than ten years, but even in this time frame, an elevated risk of pancreatitis, pancreatic cancer and thyroid cancer has been identified with certainty. Most drug trails last for less than a year, and for diabetes drug trials, the researchers use the convenient (for Pharma) reductionist end points of glucose and A1C. Cancer risks only come to light once we have some “after-market” research. I am saddened that most people believe this research has been done prior to a drug release, but people taking drugs long-term for a condition are more likely unwitting guinea pigs.

Seek non drug treatment whenever possible. And since type 2 diabetes is 99% resolvable with a diet like the FatBack Diet and fitness which incorporate significant metabolic improvements, this is a simple place to start. –Dr. Maurer

[Elashoff, M, et.al. Pancreatitis, Pancreatic, and Thyroid Cancer With Glucagon-like Peptide-1–Based Therapies. Gastroenterology. 2011;141(1):150-156.]

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