Monthly Archives: September 2021

on weight and diabetes

Interesting article in the Sydney Morning Herald on diabetes.  As you all know, I had gestational diabetes during pregnancy.  During my pregnancy that ended in miscarriage in 2019, my A1C was measured at 5.6.  (5.7 is considered prediabetic, and 6.5 diabetic.)  My A1C was measured a year after this most recent pregnancy again at 5.6.  Then, I had it measured again recently, roughly two years after pregnancy at 5.5.  Not terrible, but definitely not great.

I read pretty extensively about diabetes when I was pregnant, and the number one knob you can turn is to reduce the amount of fat you have, especially around your abdomen.  As far as I know, it’s not really possible to control where the fat on your body goes, so if you want to reduce fat around your middle, you need to reduce fat, period.  I have always stored a disproportionate amount of my body fat on my abdomen, and this trend has only increased with time.

The closest proxy for body fat is weight, or BMI.  (Given your height is constant, for an individual, there is no real difference.)  Reduce your weight, and your body fat will in general go down.  Obviously if you lift weights or engage in some other muscle building activity, you might be able to reduce body fat while maintaining your weight.  Studies have shown that more muscle reduces risk of diabetes.

You read a lot about how obesity causes diabetes.  This is true in some ways.  Given that for any individual, more body fat means for that person they will require more insulin to process sugar after eating, and will have higher glucose in their blood, if the body weight of a population is increased across the board, more people will get diabetes.  There is probably no other illness, not even heart disease, affected as profoundly by your weight (as a proxy for fat) as diabetes.

However, I do think this generalization obscures a very important fact.  Every individual has a body weight they can maintain (given a % fat) which will allow them to avoid diabetes.  Let’s assume we’re talking about people who are 5’6″ (my height).  For person A, that weight might be 130 pounds.  For person B it might be 150.  For person C it might be 200 pounds.  Person D might be able to maintain 280 pounds with no blood sugar issues.  Genetics is an incredibly powerful force.

Rather than harping at people about the dangers of obesity, I think it’s more important to tell people to get their A1C tested.  If you’re reading this, you’re probably over 40.  Get your A1C tested!  Figure out if your weight is acceptable for your body.  Believe me, you don’t want to get diabetes.   For me, the most important quote from the article was this:

Taylor said the results “demonstrate very clearly that diabetes is not caused by obesity but by being too heavy for your own body”.

Life is not fair.  Some of us need to be skinnier to avoid diabetes.  Some of us can be fatter but will have to work much, much harder all the same to maintain that non-diabetic weight.  But I’ve watched my relatives deal with the health problems that diabetes causes, including vision loss and amputations.  I also did not enjoy the finger-pricking, and I’m sure injecting insulin sucks as well, not to mention watching your diet all the time.

As for me, I’d let my weight creep up close to 140.  That’s technically a “normal” weight, but it’s just not healthy for me.  Based on my life experience, I believe my optimal weight is probably 120 to 125.  (That’s still more than I weighed in high school and college.)  So, I’ve been working on losing a few pounds over the last couple months, and I’m down to about 134.  It’s annoying.  I want to be able to eat whatever I want, especially since I’m exercising a lot, but that’s just not how it works for most people.  Hopefully, I can get to my goal weight and have my A1C tested again and see some improvement.

A friend of mine has Type 2 diabetes.  He was overweight, probably technically obese when diagnosed.  Maybe not.  You certainly wouldn’t have seen him on the street and thought him excessively fat.  He’s less than 5 years older than me.  He got diagnosed when he started losing his vision.  He started exercising and losing weight, and being a data nut, was able to chart the decrease in his fasting glucose and A1C as he dropped the pounds few years.  We are friends on Strava, and I know how hard he works to maintain his health, but it’s working.  His numbers are close to mine at this point.  (He also cut back his work hours drastically to no more than 40 per week, which I’m sure was critical.)

the path to herd immunity

The ascension of Mississippi to the top of the deaths per capita table is . . . interesting.  (They’re still only edging NJ by 3%.)  Until recently, it didn’t matter how self-righteous the Covid lockdowners were, Covid stubbornly refused to behave to the desired political message.  TX had only 10% more deaths than CA  this spring right before vaccines became widely available.  In other words, if draconian CA-style restrictions were implemented nationwide, instead of TX-style moderation, we’d have expected to save about 50,000 lives last year – pretty typical for an average flu season.  Limiting restaurants to 50% capacity, blocking large gatherings, shutting churches, and mandating masks is just not that effective.  Australia style DONOTLEAVEYOURHOUSEFORANYREASON rules were quite effective (pre-Delta), but the US has never tried not, not anywhere, not ever.  Not even in the first few weeks.

But the vaccine changes everything.  Vaccines, unlike masks and closing a few tables in restaurants, really work.  Half the country is achieving immunity through infection, which the CDC has told us results in 10 times the deaths along the way.  I believe it.   Only 42% of Mississippians are fully vaccinated.  Same with Alabama.  TX isn’t much better at 50%.  By contrast, NY is at 63%, CA at 58%, and WA at 60%.  I imagine having an extra 20% of people vaccinated will make quite a big difference.  Though I’m guessing we’re all getting to herd immunity eventually one way or another.  We know which is the bloodier route.  Which is the fast route?

postbac

Is it just me, or are book reviews often borderline absurd, especially when the reviewer is fawning over a critically acclaimed Booker-style novel?  On Real Life (which may in fact be a stellar  novel, but give me a break):

Real Life is a novel of profound and lacerating power, a story that asks if it’s ever really possible to overcome our private wounds, and at what cost.

“Lacerating power”?  Really?

In other news, I discovered I could have applied as a post-bac student at UW had I known about the option.  Because I didn’t know, I have to wait until Fall ’21.  (The application deadline has passed.)  This is important because as a non-matriculated student, you’re at the back of the line to take classes, behind UW students.  (This obviously is a sensible policy.)  Anyway.  I e-mailed them, but I’m sure the situation is hopeless for the near term.

I’m still struggling to find childcare and am not optimistic at this point.  My new plan is instead of taking one class in Fall and one class in Winter and one class in Spring, I’ll take three or four classes in Winter.  This would be far more efficient in terms of childcare required (due to saved driving time and other factors).  Also, it’s a lot easier to hire a nanny for more hours.  People understandably don’t want to traipse up to Newcastle for a few hours a week in the middle of the day.  However, there are two issues.  (1) Pre-reqs and (2) Classes being full.  (2) is actually the bigger problem.

All of this is making me ask myself, what do I really want?  Answer – not sure.  In the short term, I know I want to take some classes at UW.  But how badly?  At what cost?

In the medium term, I’m excited about a little family adventure H and I are talking about.  It’s helping ease my Covid angst, which is unabated.

 

tired and cranky

I am exhausted and demoralized this evening.  It’s inevitable to feel like this from time to time, of course.  I ran a half marathon last weekend as a training run, and I ran it faster than planned, which was predictable, but my legs are just so sore now, and I am also still just feeling exhausted.  My training plan called for 8 miles today (with the stroller) so off I went, then 90 minutes at the playground with S, then lunch and this and that, then picking up the girls from school, dropping L at swim, and taking B to soccer.  Soccer is too far from home to just drop her off, so I stayed and chased S for an hour.  Then home, dinner, bedtime routine, etc.  NBD, but I am just so, so tired.  A young, single person can take it easy after a half marathon.  A parent comes home to childcare.

They finally opened the border with Europe, which is great – about fing time.  But we had randomly ended up planning a trip to Kona at the same time as friends of ours, and they are now planning to cancel and go to Europe instead (as they are EU nationals).  Which is unfortunate.  I also realized that I’d booked our flights for the wrong day.  This was easily fixed, miraculously, but still makes me feel incapable of functioning as an adult.

We will have vaccines for kids in November, it seems, which should make me happy, but I feel that out here in the Democratic People’s Republic of Washington, nothing at all will change, and this depresses me immensely.

Finally, I’ve got all the signatures needed for my class, but I’ve been unable to find childcare using my usual nanny search methods.  I am not a hugely attractive employer (three kids, temporary job, part-time hours), and it is an employees’ market.  I’m not giving up, but right now I’m having serious doubts about whether I’ll be able to take the class.

antiscience in Seattle

Who’s more anti-science?

  • The Texans who refuse vaccination and won’t wear masks indoors
  • Or Washingtonians who, fully vaccinated, wear masks outdoors while alone and require 50-60 students to quarantine from school for 14 days when a single student tests positive

It’s hard to say which is worse.  The CDC says if students are masked, no quarantine is required when a student tests positive except for the student.  Close contacts do not need to quarantine, vaccinated or not.  However, I just read today that 30 to 60 students are being required to quarantine for 14 days every time a single students tests positive in Puget Sound schools.  It is INSANE.  I posted before that I would guess students in Texas – mask free and engaging in who knows what other risky behavior – will miss far less school than kids in Seattle.

For example: “The Lake Washington School District had to quarantine 53 people after one case was reported at Kamiakin Middle School, spokesperson Shannon Parthemer said.”

I also am tired of feeling like a leper when I go outside without a mask.  I’m not talking about concerts or fairs here – watching a (not crowded) soccer game or a walk through the park.

Biden and his vaccine mandate

Two things happened yesterday:

(1) Biden declared a vaccine mandate for all workers in companies with 100 or more people

(2) LA mandated vaccines for all students 12 and up

Personally, I am strongly supportive of the first, and really on the fence about the second.  The vaccine has not yet been approved for students under 16; it’s still under emergency use.  Children under 18 have extremely low risk from the virus; in the UK, they claim that the risk of the virus is only marginally greater than the risk from the vaccine for that age group.  Since most parents cannot afford private school or to quit work and home school and children must attend school, they might as well go door to door with armed guards and a pharmacist vaccinating children.  CA makes it virtually impossible for parents to opt out of vaccination requirements for school.

On the flip side, I really want this to end, and the FDA is taking its sweet time approving the vaccine.  Having vaccinated kids will mean less hysteria and fewer school closures.  I honestly go back and forth about whether I think this is the right thing to do or not.

On the flip side, for adults, the illness is more dangerous than the vaccine.  The older you are, the more lopsided the risk is.  It’s a no-brainer for any adult to get the vaccine, not only for their own well-being but for the well-being of society.  The vaccine is no longer under emergency use authorization for adults.  And if you really don’t want the vaccine, you can quit your job and go work for a company with less than 100 people.  Everybody is hiring right now.   The only thing is that this is a national mandate, unlike school vaccine mandates, which are usually by the states.

The hysteria over Biden’s announcement dwarfs reactions to vaccine mandate for LAUSD.  That’s obviously in part because it affects more people.  But in general, I am sick of the “suffer the children” mentality in the US.  Adults should be forced to vaccinate!  Kids are required to get all kinds of vaccines, many of which the vast majority of adults have not received.  It’s time adults stepped up and got their jabs and took one for the team.  Children have sacrificed so much for a disease that is – literally – less risk to them than the seasonal flu.  Why?  For the well-being of over-40s.

There are undoubtedly going to be legal challenges.  I sincerely hope Biden prevails.  I would honestly like to see some kind of mandate that forced the vaccine on every single adult over 60.  But this is a great step in the right direction.

Covid in the news

1.) King County has added a new dashboard showing outcomes by vaccinated status.  It’s fascinating, encouraging and disheartening at the same time.  It’s definitely worth checking out.  Highlights:

  • Over the past 30 days, unvaccinated people are 7x more likely to get Covid, 50x more likely to be hospitalized, and 30x more likely to die of Covid.  Normalized by age.
  • BUT 32% of Covid cases, 13% of Covid hospitalizations, and 30% of Covid deaths are among the vaccinated.  Read that again.  30% of Covid deaths in the Seattle area in the last 30 days were among vaccinated people.
  • Note that 78% of people are considered vaccinated in King County.  (Partially vaccinated and not vaccinated are both considered unvaccinated for the outcomes dashboard.)

To me, the high percentage of deaths among vaccinated people indicates that probably the vaccine is not in fact 97% effective among all age groups, or among all people.  I would guess that among exceptionally vulnerable people, the vaccine is less effective.  This to me speaks to the importance of booster shots.  I am extremely displeased with the way the Biden administration is bungling the booster shot situation.

2.) In Israel, the virus czar has indicated that people should expect to receive a second booster (fourth shot) of vaccine.  They have set up their system over there such that your vaccine passport expires six months after your last shot, so you need to get a vaccine shot every six months to stay current and do things that require a passport, like dining indoors.

Israel’s national coronavirus czar on Saturday called for the country to begin making preparations to eventually administer fourth doses of the coronavirus vaccine.

“Given that that the virus is here and will continue to be here, we also need to prepare for a fourth injection,” Salman Zarka told Kan public radio.

“It seems that if we learn the lessons from the fourth wave, we must consider the [possibility of subsequent] waves with the new variants, such as the new one from South America,” he said at the time.

“And thinking about this and the waning of the vaccines and the antibodies, it seems every few months — it could be once a year or five or six months — we’ll need another shot.”

4.) Really interesting article on China.  It’s an opinion piece, but I find it interesting just to learn a little bit more about how China has (mostly) stamped out Delta, something Australia failed to do.  One of the things they did, per the article, in one affected area, was not allow anyone in the city to leave their dwelling for any reason for a month.  It’s a whole different ballgame from what’s possible over there.  But China is the only country with a land border that I know of that has managed to eliminate Covid even temporarily.

5.) The ridiculousness of masking young kids from a likeminded person.

6.) More people starting to realize cloth masks are ineffective.  Many airlines have banned them.  France has banned them.   And a large recent study concluded (on adults) that surgical masks are highly effective but cloth masks, not so much.

The study does not quite claim to be the final word on masks. The authors found that while cloth masks clearly reduced symptoms, they “cannot reject” the idea that unlike surgical masks, they may have only a small effect on symptomatic coronavirus infections, and possibly none at all.

7.) The Joint Committee on Vaccination and Immunisation in the UK has recommended against vaccination for healthy children ages 12 to 15.   They state:

The assessment by the Joint Committee on Vaccination and Immunisation (JCVI) is that the health benefits from vaccination are marginally greater than the potential known harms. However, the margin of benefit is considered too small to support universal vaccination of healthy 12 to 15 year olds at this time.

Their recommendation solely considers benefits and risks to children, not to society at large.  i think it’s likely the UK will eventually recommend vaccination for this age group to reduce Covid spread and reduce death of elderly and otherwise vulnerable.  However, the take-home point here is not that this group of experts considers Covid only marginally more dangerous then the vaccine for this age group.

Covid is just not dangerous for children under 18.  Where by “not dangerous” I mean equal or less dangerous than the seasonal flu.  I will almost certainly vaccinate my kids, but I’m really not worried about them, especially L and B.

8.) Australia has given up on eliminating Covid but is still running the country like a police state.  NZ, however, appears to be making good progress on getting back to 0 cases.  It’ll be interesting to see what ends up happening in both countries.  Australia is in a not great place with zero natural immunity and Delta raging.  They are doing a great job vaccinating people, but there is vaccine resistance over there as well.