In episode 395, James and Mike bring in Adrienne to chew and digest all the evidence around the ketogenic diet. At the end we realize we will likely never have definitive evidence around these diet issues so we all commiserate by drowning our sorrows in a large helping of deep fried Mars Bars.
Show notes
Tools for Practice
Less Pancakes, More Bacon? The Ketogenic Diet for Weight Loss
In episode 394, James and Mike bring in Tina and Joey to look at all the evidence around omega-3 supplements and dry eye and, despite widespread use, the evidence is far from convincing.
Show notes
Tools for Practice
Omega-3 Supplements for Dry Eye: Fishy evidence or a big catch?
In episode 393, James and Mike bring in Tina to deal with the issue of the evidence around CPAP. We find out that there is little evidence that CPAP reduces CVD so it is all about does the person feel better while on it – over and above the nuisance and cost.
Show notes
Tools for Practice
In episode 392, James and Mike get back to work after a European tour and other reasons. We go over the results from the latest large aspirin trials and, low and behold, the results show pretty much what we already knew.
Show notes
1) Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial.
Lancet 2018 Aug 24. pii: S0140-6736
2) Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus
N Engl J Med. 2018 Aug 26. doi: 10.1056/NEJMoa1804988
3) The best CVD risk calculator
In episode 391, Mike and James have yet again a PREMIUM moment that will leave you short of breath. We go over 2 new studies that looked at asthma action plans and does increasing doses of inhaled corticosteroids work. In the last study we go over a comparison of vaginal estradiol, vaginal moisturizer or placebo for perimenopausal vulvovaginal symptoms, and placebo ends up working as well as anything else.
Show notes
1) Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations
2) Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations
3) Efficacy of Vaginal Estradiol or Vaginal Moisturizer vs Placebo for Treating Postmenopausal Vulvovaginal Symptoms
In episode 390, James and Mike have a discussion about how a shared-decision may be the only real outcome to measure if one is doing, or evaluating, evidence-based practice. Do our arguments convince you? Have we missed something important? Is this the best podcast ever on shared-decision making? Do you think we should be locked up? We would love feedback.
Show notes
Shared decision is the only outcome that matters when it comes to evaluating evidence-based practice
In episode 389, Mike and James go over with Adrienne Lindblad the evidence for a simple treatment for beast engorgement. Who knew that cabbage leaves worked for breast engorgement? At the end of the podcast we decide to attach cabbage leaves to all our microphones all the time, just in case – see last podcast description for context.
Show notes
Tools for Practice
Is that cabbage in your bra? Cabbage leaves for breast engorgement
In episode 388, Mike and James go over with Adrienne Lindblad the evidence for a simple treatment for nausea and vomiting in the ER. Who knew that inhaling isopropyl alcohol worked for nausea and vomiting? – possibly as good as the medications we have used in the past. At the end of the podcast we decide to attach isopropyl alcohol swabs to all our microphones all the time, just in case.
Show notes
Tools for Practice
Smell This: Isopropyl alcohol for nausea/vomiting in the emergency department
In episode 387, Mike and James go over the best available evidence for opioids in neuropathic pain. As with many pain treatments the evidence suggests there is some benefit and also some harm. Overall, it seems a reasonable approach would be to only use opioids in patients with refractory pain after multiple therapeutic trials with other agents.
Show notes
1) Tools For Practice
Nerve-ous About Opioids? Treatment of neuropathic pain with opioids
In episode 386, James and Mike talk about the latest low fat low carb weight loss study and then put it all into context of the more global evidence for low carbs vs low fats. The bottom line is, the evidence is even lower than the carbohydrates in a ketogenic diet – which is pretty low – or in other words nobody can really say what is the best diet – except maybe the one to which you will adhere.
Show notes
1) Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial
JAMA. 2018 Feb 20;319(7):667-679
2) Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials
Br J Nutr. 2016 Feb 14;115(3):466-79
3) Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study
J Intern Med. 2007 Apr;261(4):366-74
4) Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates
THE NUTRITION PROPOSITION BOOK
Check it out at nutritionproposition.com and think about picking up a copy on Amazon. All the evidence you ever wanted about nutrition and the only nutrition book that won’t tell you what to eat.
This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)
