Omega-3 fatty acids supplementation and risk of atrial fibrillation
I've read a article by a cardiologist David Becker in the Philadelphia Inquirer concluding Omega 3 supplementation was no longer worth the risk pointing to the European Heart Journal article linked below. What are your thoughts? Thanks, Bruce https://academic.oup.com/ehjcvp/advance-article/doi/10.1093/ehjcvp/pvab008/6255232
Torn between adding muscle and calorie restriction for longevity
I consistently conflicted about how to approach the second half of my life. On one hand I hear a lot about caloric restriction being a key driver of longevity. On the other hand I hear about maintaining muscle mass as a key driver of longevity. For me it seems to be one or the other. I'm naturally lanky and caloric restriction seems to prevent me from gaining much strength/muscle. When I ramp up my calories I can put on some muscle but then I'm not getting the benefits of caloric restriction. How should I think about this from a longevity perspective?
Type 2 Diabetes "Outliers"
I would like to know more about what I could call the “Outliers” of Type 2 Diabetes, of which I am one, but I’m sure I’m not unique. Although I have high fasting blood glucose levels and an A1c in the diabetic range, I have never been obese or even much overweight. I’m 5’3.5” and weigh 130. I have been active all my life, including being an aerobic dance teacher (think Joanie Greggins in the 80s), an Outward Bound instructor (think portaging an 80+ pound canoe for more than ½ mile over swampy or hilly terrain without a break), and a wildland firefighter (includes passing the arduous level pack test once a year – carrying a 45-pound pack 3 miles in less than 45 minutes, running not allowed). I have eaten a healthy diet most of my life with the exception of those 5 for $1 macaroni and cheese college years and having a penchant for sweets, which I have mostly controlled pretty well. I went through 5 full-term pregnancies with no gestational diabetes. My blood pressure has always been at a healthy level, now usually around 120/70. I’ve never smoked. I sleep very well 95% of the time. I drink 1-2 glasses of red wine about 4-5 times a week, sometimes going weeks without. My only other metabolic issue is high cholesterol, which includes high HDL levels. I have lost weight since my initial diagnosis and the months of low carb, but it has largely been muscle. I’ve lost a lot of strength (although I still pass the arduous level pack test). I never lose the roll of belly fat I’ve accumulated. I feel like that’s a symptom and that suggesting, as much of the literature does, that if I lost that fat I wouldn’t be diabetic is like telling a cancer patient that if they would just lose that tumor they wouldn’t have cancer. Because there has been Type 2 Diabetes in my family (just my maternal grandfather), I have been aware of the potential since I was an adolescent, so had my fasting blood sugar tested every few years most of my adult life. When it began to be above 100, I educated myself about glycemic index and have been conscientious about that for more than 15 years. When my fasting blood sugar eventually reached 125 and my A1c was at 6.7 I began trying different eating plans. I tried vegan (How Not to Die and Forks Over Knives) for several months. I did low carb at less than 40g per meal. I tried Keto for a few months at levels varying from 20-50 grams of carbs a day. (I was always SO tired!) I have not yet tried actually fasting, although I regularly do intermittent fasting. Nothing I do in terms of food or exercise seems to have any effect on my morning fasting blood sugar, although if I eat a heavy serving of sweets (I did that once in the past four years), my blood sugar soars. In the past several months my FBS has ranged between 113 and 180, with no obvious behavior accounting for either end of this spectrum. My A1c stays pretty steady at 6.9. Sometimes, especially when it is high, my blood glucose goes down when I eat. I’m baffled. A year after I was diagnosed with Type 2 and food intake wasn’t helping, I began taking Metformin at 500 mg/day. I doubled the dose after several months. I stopped taking it for a year or so, but resumed when Covid came and I heard that people taking Metformin did better if they were hospitalized. It has never seemed to have any effect on my A1c or morning fasting blood sugars. My primary care physicians, who are my friends and my daughters’ co-workers so I get better care than the average patient, say that my blood sugar levels’ unpredictability based on food or exercise is proof that I have a disease – my pancreas is just not functioning properly. I don’t have easy (or affordable) access to the more specific lab tests you suggest, although I’ve been able to get a few of them when I think the results will help me understand my body better. Although your podcasts often make me want to take an organic chemistry class, the bottom line always seems to be the same – eat well, not too many carbs, and exercise more. So that’s my current approach. So often research results indicate that a large percentage of the population responds in a certain way. I always wonder, what about the people in that small percentage who don’t? I hope one of your AMA podcasts might address what is going on with Type 2 diabetics like me who don’t fall within the usual parameters of this disease. Thank you for considering it!