RGV Gastro

05/03/2022

Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction. (Funded by the National Key Research and Development Project [No. 2018YFA0800404] and others; ClinicalTrials.gov number

04/27/2022

Keep your naps short!

Napping for more than 60 minutes during the day positively correlated with risk for nonalcoholic fatty liver disease in an occupational population in China, according to research published in BMC Gastroenterology.

11/11/2021

Happy Veterans Day! I had the honor to serve in the reserves and was proud to do so for our country. Here I am in 1989 at Fort Sam Houston.

Thank you to all the fellow veterans who have served!

10/11/2021

Surprisingly, the gut microbiome gene profile was a better predictor of weight loss than baseline dietary patterns or blood metabolite and protein levels according to a recent study!

The authors concluded that, “the gut microbiome is a major player in modulating whether a weight loss intervention will have success or not.”

A bit early to draw sweeping conclusions and start taking Prevotella bacteria as in probiotics for weight loss, as we need more research to establish the right combination of beneficial bacterial species. For example Prevotella have been linked to many infections. In the meantime, perhaps we all can eat more plant based diets which seem to promote a healthy gut microbiome including Prevotella.

A study reports that differences in the functional profile of the gut microbiome are associated with an individual's response to weight loss interventions.

09/19/2021

My post this Sunday will get into a controversial topic.

My daughter, Sunita sends me this podcast with the following remark, “I know you don’t listen to the podcasts I send you, but you should actually listen to this! Hosts are annoyingly liberal, but historically it’s pretty accurate.” Well, I did listen to this podcast! (Shh! Don’t tell her, but I actually listen to most of the podcasts she sends--Sunita is super smart and brings me a perspective that is quite different. After all, I don’t want to be in an echo chamber.)

Measures and definitions can hurt our feelings, but if the intent is to help us achieve better health (largely true) one should be more accepting of these. Bad health effects of severe obesity is not a figment of some racist insensitive imagination, but quite real affecting the longivity and quality of life. Are there pitfalls and shortcomings when these indices are applied across the board in a wide generalization without paying attention to race,/ethnicity, age, muscle mass/athleticism, etc.,? Absolutely, yes. Are there influences from insurance companies, Big Pharma, the military, and Big Healthcare in shaping policy that suits them? - most certainly. But, to throw away something like BMI (Body Mass Index) as a standardizing tool for measuring obesity and health is ill warranted. For example, scoring on standarized testing, such as the SAT or MCAT are generally good. However, they still have biases and are not perfect measures of selecting candidates for further education. We should strive to make these measures less biased and more rooted in science.

My mentor and professor (who is a native of India) used to jokingly say, “Indians are not made to eat and Mexicans are not made to drink, but both do plenty.” That statement would get him canceled in the current "woke" climate, but he was largely right. Brown people have a tremendous risk of metabolic syndrome - which is a complex of truncal or abdominal obesity, hyperlipidemia (high triglycerides or fats in the blood), fatty liver and diabetes mellitus. Just because it offends us as a race, we should not ignore the higher risks posed by our genetics. The Pima people are held out as a bad example for metabolic syndrome. While the Pimas in Arizona have all these health problems, the Pimas living in the Sierra Madre mountains in Mexico are fit as a fiddle and are very healthy! Even though they have the same “bad” genes, they eat healthy foods and are very active. So, yes, we can overcome our genetic shortcomings by controlling our environment.

So, here is that podcast. Yes, it is “historically” correct, but it cherry picks the exceptions and in my view overstates the case for racism and sexism.

‎Show Maintenance Phase, Ep The Body Mass Index - Aug 3, 2021

09/12/2021

I recently ditched sugar and artificial sweeteners in my coffee, but, not whole milk. There's no evidence whole milk makes you fat and indeed there's growing evidence to show that people who consume whole milk have no weight gain or increased risk of heart disease or diabetes mellitus. (refer to the studies posted in the comments ⬇️)

Now back to the featured article. Ha ha! I love this:
"I next spoke to Caroline Hesse, a manager and cheese authority at Crown Finish Caves in Brooklyn, about how and why so many of us turned our backs on dairy in the first place, even if it was not medically necessary. Her answer edged on spiritual fulfillment. “There’s this quest for absolution in the foods we eat,” she said. “I think consumers were fed this lie by what I call the Goop Industrial Complex that if you cut dairy from your diet you will have more energy, clearer skin, and you will never ever fart ever again. But the case against dairy ignores many of the complexities of our food system, and I think people are starting to realize that.”

“Hot girls are ditching the alternatives and are going back to basics.”

09/05/2021

Exercise in Nonalcoholic Fatty Liver Disease (NAFLD): Just do it!

Physical activity, in addition to diet modification, has been recommended to patients with NAFLD to promote weight loss. However, little is known regarding the effect of physical activity on mortality in this population. Also, most studies to date are based on self-reported physical activity.

In a longitudinal analysis of data from the U.S. National Health and Nutrition Examination Study (2003–2006) and death records (through 2015), researchers examined the association between objectively measured physical activity level and mortality in patients aged ≥20 years with NAFLD. Physical activity was measured using accelerometers during a 7-day period and classified as sedentary behavior or moderate-to-vigorous activity.

More than 5000 individuals were included in the study, and average follow-up was approximately 10 years. In looking at various factors, increasing the duration of total physical activity was associated with reduced all-cause mortality when comparing the highest to the lowest levels of activity A similar association was seen with cardiovascular-related death.

Modified from Atif Zaman, MD, MPH, reviewing Kim D et al. Clin Gastroenterol Hepatol 2020 Jul 16. The actual study is linked in the comment section.

08/29/2021

Here's a wrinkle! We use BoTox for unexpected reasons and gastroparesis is one of those. I was not aware until recently that August is Gastroparesis Awareness month. Gastroparesis literally means paralysis of the stomach—the stomach simply does not empty like it should and food stays longer within resulting in abdominal bloating, nausea, vomiting, early satiety (feeling full after a few bites) and abdominal pain/discomfort.

The most common cause is diabetes mellitus, but in the vast majority of the cases the cause is unknown. Since we have a very high prevalence of diabetes mellitus in the Valley, we have a large number of cases of gastroparesis as well. It is a frustrating disease that is difficult to manage.

It is diagnosed by a gastric emptying study, a radiology test, and some times by using what is called a "Smart Pill" to measure the transit time in the GI tract.

The treatment generally consists of controlling diabetes by eating healthy and small meals frequently as opposed to 3 large meals. We also utilize medications for nausea and vomiting to make the stomach empty faster (the so called pro-kinetic agents such as metoclopromide and erythromycin; and domperidone and cisapride, etc outside the US).

Currently, we are learning more about the use of endoscopic treatments such as Botox injections into the pyloric sphincetr and endoscopic pyloric myotomy (cutting the muscles at the pyloric sphincter). Gastric pacemakers have had mixed success in treating the condition and ultimately surgery is a consideration in refractory cases.

We do offer comprehensive multi-disciplanary management of gastroparesis at DHR Gastro for this vexing problem. An appointment can be made at 956-362-8700.

Gastroparesis, a chronic and long-term gastrointestinal disorder, is estimated to burden 5 million individuals in the United States with crippling symptoms of delayed gastric emptying. “Gastroparesis (GP) can be extremely debilitating and life threatening,” Ceciel T. Rooker, president of...

08/22/2021

Animal research shows the ill effects of artificial sweeteners on the gut bacteria resulting in glucose intolerance. The very idea of taking these sugar alternatives to avoid high blood sugar levels and diabetes apparently is wrong according to this well conducted animal research study. It raises some interesting questions about the safety of artificial sweeteners and certainly adds to the mounting evidence that they can be problematic for our GI tracts. This topic requires further investigation, specifically with human-based studies. Personally, I am trying to learn to drink my coffee without sugar or sugar substitutes as I try to lose excess weight and control my blood sugar levels.

Artificial Sweeteners Could Harm Gut Microbiota Previously, we have mentioned the possibility that sucralose disrupts the gut mucosa, which could be a factor in the development of Crohn’s disease in susceptible individuals. Now, artificial sweeteners are once again under fire. This time, researche...

08/08/2021

IBD or Inflammatory Bowel Disease as the name implies is an autoimmune condition that causes inflammation of the intestines. It largely comprises of two diseases, Ulcerative Colitis and Crohn's disease. Ulcerative Colitis involves the inner layer or mucosa of the colon and Crohn's affects the entire gastrointestinal tract from mouth to a**s and all three layers of the gut (mucosa, muscle layer and serosa) are compromised. IBD starts mostly in late teens and early twenties, but can affect any age group with a spike in the above sixty group. The disease is chronic and is characterized by diarrhea, abdominal pain and re**al bleeding. There are many potential complications including abscesses, fistulas, bowel obstruction and even colon cancer.

Apparently there is more IBD being recognized in young Hispanics in the South of late. This underscores the importance of studying diverse populations including the Hispanics in the South to understand the dynamics of diseases in our rapidly changing demographic profile.

A new study of children with inflammatory bowel disease in the eastern United States revealed higher incidence rates among white children in the North, similar to the North–South IBD incidence gradient observed globally.

08/01/2021

Constipation is the most common digestive complaint in the United States, outnumbering all other chronic digestive conditions. Most often we recommend high fiber diet, increased intake of fluids/water, and increased physical activity for constipation. If you cannot get much fiber in the diet, a fiber supplement such as Metamucil (Psyllium) or prunes can be helpful. Gas and bloating are not uncommon with increased fiber intake. Eating Kiwi fruit apparently causes less of abdominal pain/bloating and gas while relieving constipation. Those with worsening constipation and bloating that are not responsive to dietary modification or over the counter stool softeners/laxatives need to see their doctor or a gastroenterologist to rule out any serious underlying problem and to escalate medication therapy.

A gastroenterologist teams up with his son to find out if kiwifruits measure up to prunes and psyllium when it comes to combatting chronic constipation.

07/25/2021

Here is some food for thought. The microbes that live in your body might be influencing your behavior. Buying probiotic supplements is not necessary for most healthy people. There are plenty of good probiotic foods: yogurt, kombucha, buttermilk, sauerkraut, cottage cheese, and the pickled Korean dish kimchi that provide the same benefits. Mediterranean diet has been shown to be beneficial for a healthy gut microbiome as well. Healthy gut means sound mind!

A century ago, some studies found a link between diet and mental health. Now, it’s emerging the bacteria inside us could be a crucial link between our diet and mental state.