Sometimes you wake up with a song in your head. This was today’s. I posted this a couple years ago. Today I appended the two versions at the bottom. I like Peters’ version because it gives the song an atmosphere that fits. And, I mean, her voice!

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Here is Bernadette Peters singing Hank Williams’ song, I’m So Lonesome I could Cry. (The singing starts around 2:20.)

That was a remarkable performance. Live. Just a piano as accompaniment.

Here’s Hank Williams singing his song:

“I’m So Lonesome I Could Cry”
Hank Williams, 1949

Hear that lonesome whippoorwill
He sounds too blue to fly
The midnight train is whining low
I’m so lonesome, I could cry

I’ve never seen a night so long
When time goes crawling by
The moon just went behind the clouds
To hide its face and cry

Did you ever see a robin weep
When leaves begin to die?
Like me, he’s lost the will to live
I’m so lonesome, I could cry

The silence of a falling star
Lights up a purple sky
And as I wonder where you are
I’m so lonesome, I could cry

Rolling Stone ranked it number 111 on their list of the 500 Greatest Songs of All Time, the oldest song on the list, and number three on its 100 Greatest Country Songs of All Time.
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In his autobiography, Bob Dylan recalled, “Even at a young age, I identified with him. I didn’t have to experience anything that Hank did to know what he was singing about. I’d never heard a robin weep, but could imagine it and it made me sad.”
– Wikipedia

I like this version too. I don’t know the band but I like the lead singer:

And Norah Jones, just playing in her living room:

What Percentage of Americans Smoke Marijuana?, Gallup, 5 February 2024

Seventeen percent of Americans in 2023 reported they smoke marijuana, similar to the 16% found in 2022 but higher than the 11% to 13% range recorded from 2015 to 2021.

Americans’ reported marijuana smoking has more than doubled since 2013, when Gallup first added the question in its annual Consumption Habits survey.

A Plant-Based Diet For The Prevention And Treatment Of Type 2 Diabetes, Journal of Geriatric Cardiology, May 2017

Abstract
The prevalence of type 2 diabetes is rising worldwide, especially in older adults. Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. Plant-based diets are eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds and discourage most or all animal products. Cohort studies strongly support the role of plant-based diets, and food and nutrient components of plant-based diets, in reducing the risk of type 2 diabetes. Evidence from observational and interventional studies demonstrates the benefits of plant-based diets in treating type 2 diabetes and reducing key diabetes-related macrovascular and microvascular complications. Optimal macronutrient ratios for preventing and treating type 2 diabetes are controversial; the focus should instead be on eating patterns and actual foods. However, the evidence does suggest that the type and source of carbohydrate (unrefined versus refined), fats (monounsaturated and polyunsaturated versus saturated and trans), and protein (plant versus animal) play a major role in the prevention and management of type 2 diabetes. Multiple potential mechanisms underlie the benefits of a plant-based diet in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron.

Conclusions
There is a general consensus that the elements of a whole-foods plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of refined foods and animal products—are highly beneficial for preventing and treating type 2 diabetes. Equally important, plant-based diets address the bigger picture for patients with diabetes by simultaneously treating cardiovascular disease, the leading cause of death in the United States, and its risk factors such as obesity, hypertension, hyper-lipidemia, and inflammation. The advantages of a plant-based diet also extend to reduction in risk of cancer, the second leading cause of death in the United States; the World Cancer Research Fund and the American Institute for Cancer Research recommend eating mostly foods of plant origin, avoiding all processed meats and sugary drinks, and limiting intake of red meats, energy dense foods, salt, and alcohol for cancer prevention.[149] Large healthcare organizations such as Kaiser Permanente are promoting plant-based diets for all of their patients because it is a cost effective, low-risk intervention that treats numerous chronic illnesses simultaneously and is seen as an important tool to address the rising cost of health care.[147] Plant-based eating patterns also carry significant environmental benefits. The World Health Organization and the United Nations have promoted diets higher in plant foods as not only effective for preventing chronic diseases and obesity, but also more environmentally sustainable than diets rich in animal products,[150] a position also supported in the scientific report of the 2015 United States Dietary Guidelines Advisory Committee.[151] While larger interventional studies on plant-based diets carried out for longer periods of time would add even more weight to the already mounting evidence, the case for using a plant-based diet to reduce the burden of diabetes and improve overall health has never been stronger.

Plant-based diets tend to be high in carbohydrates. It’s a good idea, as they stated, to choose carbohydrates that are less refined. That increases fiber, slows absorption, and often provides more nutrients.

After writing about this for years, it’s gratifying to see it move into the mainstream.

I liked this explanation of insulin resistance by Dr. Greger:

What if there’s enough insulin, but the insulin doesn’t work? The key is there, but something’s gummed up the lock. This is called insulin resistance. Our muscle cells become resistant to the effect of insulin. What’s gumming up the door locks on our muscle cells, preventing insulin from letting sugar in? Fat. What’s called intramyocellular lipid, or fat inside our muscle cells.

Fat in the bloodstream can build up inside the muscle cells, create toxic fatty breakdown products and free radicals that can block the signaling pathway process. So, no matter how much insulin we have out in our blood, it’s not able to open the glucose gates, and blood sugar levels build up in the blood.

Here’s a graphical representation of that, about mid-way:

He goes on to explain:

This mechanism, by which fat (specifically saturated fat) induces insulin resistance, wasn’t known until fancy MRI techniques were developed to see what was happening inside people’s muscles as fat was infused into their bloodstream. And, that’s how scientists found that elevation of fat levels in the blood “causes insulin resistance by inhibition of glucose transport” into the muscles.

And, this can happen within just three hours. One hit of fat can start causing insulin resistance, inhibiting glucose uptake after just 160 minutes.

Same thing happens to adolescents. You infuse fat into their bloodstream. It builds up in their muscles, and decreases their insulin sensitivity—showing that increased fat in the blood can be an important contributor to insulin resistance.

Then, you can do the opposite experiment. Lower the level of fat in people’s blood, and the insulin resistance comes right down. Clear the fat out of the blood, and you can clear the sugar out of the blood. So, that explains this finding. On the high-fat diet, the ketogenic diet, insulin doesn’t work as well. Our bodies are insulin-resistant.

But, as the amount of fat in our diet gets lower and lower, insulin works better and better. This is a clear demonstration that the sugar tolerance of even healthy individuals can be “impaired by administering a low-carb, high-fat diet.” But, we can decrease insulin resistance—the cause of prediabetes, the cause of type 2 diabetes—by decreasing saturated fat intake.

This photo is from a Bon Appetite article  that describes uses for various vinegars. I don’t see a particular vinegar being used across studies, so maybe any of these will do.

It looks like vinegar’s ability to lower blood glucose isn’t new:

Examination Of The Antiglycemic Properties Of Vinegar In Healthy Adults, Annals of Nutrition and Metabolism, 2010

Results: Two teaspoons of vinegar ( 10 g) effectively reduced postprandial glycemia (PPG), and this effect was most pronounced when vinegar was ingested during mealtime as compared to 5 h before the meal. Vinegar did not alter PPG when ingested with monosaccharides, suggesting that the antiglycemic action of vinegar is related to the digestion of carbohydrates.

Conclusions: The antiglycemic properties of vinegar are evident when small amounts of vinegar are ingested with meals composed of complex carbohydrates. In these situations, vinegar attenuated PPG by 20% compared to placebo.

But how does it do it? One way: It may improve insulin resistance:

The Role Of Acetic Acid On Glucose Uptake And Blood Flow Rates In The Skeletal Muscle In Humans With Impaired Glucose Tolerance, European Journal of Clinical Nutrition, 2015

Conclusions: In individuals with impaired glucose tolerance (IGT), vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state.

Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake By The Forearm Muscle In Humans With Type 2 Diabetes, Journal of Diabetes Research, 2015

Conclusions: In type 2 diabetes vinegar reduces postprandial hyperglycaemia, hyperinsulinaemia, and hypertriglyceridaemia without affecting lipolysis. Vinegar’s effect on carbohydrate metabolism may be partly accounted for by an increase in glucose uptake, demonstrating an improvement in insulin action in skeletal muscle.

These are all small studies. But the signal is there.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

It is now widely accepted that diets high in animal fat and processed foods are an important risk factor for development of type 2 diabetes. And it’s not just animal fat, but animal protein intake intensifies insulin resistance, which predisposes people to type 2 diabetes. No wonder studies have shown that elevated consumption of animal products and low intake of unprocessed plant foods increases the risk of not only cardiovascular disease but diabetes. But of all the whole plant foods to pick, why choose oatmeal to treat diabetes, which, as I discussed in my last video, was used for the treatment of diabetes before insulin was discovered.

We’ve long known that higher consumption of whole grains, including oats, is associated with a lower risk of diabetes. But you don’t know, until you put it to the test. There have been over a dozen randomized controlled trials looking at the metabolic effects of oats intake in patients with type 2 diabetes. Oats were found to significantly improve both short-term blood sugar control and long-term blood sugar control, in addition to lowering cholesterol levels. We think the benefits arise from a fermentable fiber in oats called beta glucan, because you can get cholesterol-lowering even if you just give the oat fiber straight––as well as an improvement in blood sugar control and insulin sensitivity in both type 2 diabetics as well as type 1 diabetics. How exactly does the fiber do that? Well, we know one of the underlying cholesterol-lowering mechanisms of oatmeal consumption might be its microbiome-manipulating ability––in other words, having a beneficial effect on our intestinal bacteria.

A little fiber goes a long way. Here, they were talking about the anti-inflammatory effects of the short-chain fatty acids that our good gut flora makes from fiber. There are dozens of randomized controlled trials showing the types of fiber found in oats and beans can improve long-term blood sugar control in diabetics—in fact, nearly double the FDA threshold required for new blood sugar-lowering drugs. Why? Because the gut bacteria selectively promoted by dietary fiber intake can help alleviate type 2 diabetes.

In fact, on the basis of 50 distinct bacterial markers of the feces, you can tell who does and does not have diabetes. But change your diet, and you can change your gut flora within one day. We feed them with fiber, and in return, they feed us right back with these short-chain fatty acids, like butyrate that have all these wonderful effects. Put people on a diet packed with oats, beans, fruits, vegetables, and nuts, and the number of fiber-feeders churning out the beneficial short-chain fatty acids shoots up, and fasting diabetic blood sugars drop about 25 percent within one month. And the more fiber-feeders they fostered, the better their blood sugar control. When the fiber-promoted short-chain fatty acid producers were present in greater diversity and abundance, participants had better improvement in their hemoglobin A1c levels (which is a measure of longer-term blood sugar control). Then, before-and-after fecal transplant studies helped nail down cause and effect.

The oat fiber itself has been shown to act as a prebiotic, boosting the growth of beneficial bacteria like lactobacillus and bifidobacteria. So, between the lack of animal protein, lack of animal fat, and bursting at the seams with prebiotic fiber, it’s no wonder that oatmeal diets grew to become part of the clinical routine in the treatment of diabetics. However, over time, this practice has later become increasingly forgotten, a disappearance that’s been compared to the fate of unpopular theories in successive editions of Soviet encyclopedias.

Despite advances in therapy, we still have many people with poorly controlled diabetes. Thankfully this forgotten tool is back. I’ll review all the new oatmeal diet studies next.

I’m reposting this to add the following study:

Chocolate-candy consumption and 3-year weight gain among postmenopausal U.S. women, Obesity, February 2015

Each additional 1 oz/day was associated with a greater 3-year weight gain (kg) of 0.92. [0.92 kg is about 2 pounds.]
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Conclusions: Greater chocolate-candy intake was associated with greater prospective weight gain in this cohort of postmenopausal women.

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Dr. Greger’s latest firestorm:

He makes a good point about prior cross-sectional studies being just a snapshot in time. Those studies found that eating chocolate was associated with lower weight. But … Maybe heavy people cut back on chocolate in an attempt to lose weight. If that was true, it would appear that heavy people eat less chocolate, and light people eat more. Indeed, that’s exactly what this prospective study found. The presumed weight benefits of eating chocolate went away when people with weight disorders were excluded:

Habitual Chocolate Consumption May Increase Body Weight In A Dose-Response Manner, PLOS One, 17 August 2013

More frequent chocolate consumption was associated with a significantly greater prospective weight gain over time, in a dose-response manner.

In this next study, an intervention trial (not a cross-sectional snapshot in time), adding 4 squares (25 grams) of chocolate to people’s daily diets caused them to gain 2 to 4 pounds in just 3 months:

Low Vs. Higher-Dose Dark Chocolate And Blood Pressure In Cardiovascular High-risk Patients, American Journal of Hypertension, June 2010

This was an interesting study, because even though they didn’t employ a no-chocolate control group, they did have a group that ate just a little chocolate –  6 grams or 1 square instead of 4 squares. Their end point was actually blood pressure, not weight. You know what? The 1-square eaters reduced their blood pressure more than the 4-square eaters, just shy of significance. Perhaps the weight gain offset the expected reduction in blood pressure?

Sleep and circadian rhythm disturbances: plausible pathways to major mental disorders?, World Psychiatry, 12 January 2024

Of note has been the delineation of the molecular architecture of the core circadian clock, along with the revelation that the circadian system’s stability is fundamentally regulated by common environmental factors, such as the timing, intensity and spectrum of light exposure 4. It appears that there are specific brain circuits in mammals by which light regulates mood, learning and activity, which are not wholly dependent on mediation by the master circadian timekeeper.
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An intriguing finding from over 80,000 adults in the UK Biobank was that more exposure to artificial light at night was associated not only with increased rates of major depression, but also with an increased incidence of several other mental disorders, including bipolar disorder, generalized anxiety disorder and post-traumatic stress disorder, as well as with higher rates of self-harm behavior and psychosis-like experiences 4. As predicted on the basis of the evidence that day-time light exposure is the primary synchronizer of the circadian clock in mammals, as well as the success of bright light therapy in the treatment of mood disorders, more light exposure during the day was also associated with lower rates of mental disorders 4. Triangulation of evidence from animal models, experimental studies in humans, and epidemiology has provided strong evidence for a major role of daily light exposure to good mental health.

This was surprising:

The discovery that treatments such as selective serotonin reuptake inhibitors (SSRIs) may increase sensitivity to light, and thereby destabilize the circadian system in at-risk individuals, is a major concern 9.