Sex, cars, and food: what more could you want? This is Healthcare Triage News.

Last December, we posted a Healthcare Triage on how the sky isn't falling, but I don't think many of you really appreciate how much better some things are right now.

I talk to parents all the time, and they are utterly convinced - and I mean CONVINCED -  that today's kids are the most sex obsessed, uninhibited, and morally corrupt generation ever to have walked the planet. They just KNOW. But you know how I feel about 'knowing.' What did the data tell us? To the research!

Between 2007 and 2013 the number of teenagers who have given birth to babies has fallen in the United States by more than 38%. And it's not because teens are getting abortions the abortion rate is dropping too. 

the teen birth rate peaked recently in 1991 at 61 births per 1000 teens. But don't think that the "good ole days" were better. It last peaked before that in 1960 at 89 births per 1000 teens. And in 1950 it was still more than 80 births per 1000 teens. In 2012?  29 births per 1000 teens. Tell me again how the internet is corrupting teens - and get off my lawn!


Our second story comes to us from the International Transport Forum -  part of the OECD, which released its annual road safety report. Evidently, you don't want to drive in Malaysia - which has the highest road fatality rate of 23.6 per 100,000 people. It's also not that safe to drive in Cambodia, Argentina, Colombia, Chile, Jamaica or Korea.

But, at 10.7 fatalities per 100,000 people, the US is WAY worse than pretty much all of Europe, Australia and Japan. Oh, and for those of you that are arguing we should use a different metric - the US does pretty much just as badly with fatalities per billion vehicle kilometers and per 10,000 registered vehicles. 

Some interesting facts I didn't know before I perused the report:

Did you know the United States has pretty much the most lax regulations for blood alcohol content allowed? At 0.8 grams per liter, it's tied for the highest allowable levels; at 0.4 grams per liter for professional drivers, it's all by itself!

And it's not the speed limits! On highways, a fairly large number of countries allow 130 km per hour or above - which is more than 80 miles per hour, for those of you who still can't work the metric system. And their fatality rates are lower than ours!


Our final story involves a new study published in the annals of Internal Medicine. You see, for decades it's been thought that fat is going to kill you: it's the red meat, it's the butter, it's the bacon. Then along came some "crazies" who said it was carbs instead, 
so we tried to reduce carbs.

But, I mean, you gotta to eat SOMETHING, so which is better? a low-carb or a low-fat diet? This study was a randomized control trial of a low-carb vs. a low-fat diet.

Low-carb is defined as less than 40 grams per day and low-fat was defined as less than 30% daily calories from fat and less than 7% of a diet from saturated fat.
 
Well, those are defined differently, so let's try this: Those in the low-carb diet obtained about 30% of their calories from carbs, those in the low-fat diet shot for 30% of their calories from fats. 

Outcomes of interest included: weight, risk factors for cardiovascular disease, and compliance with the diet. The percentage of people who completed the study in each arm was about 80% - which is pretty good. 

So, who won?

Well, it turns out that people in the low-carb diet lost on average more weight - about 7.7 lbs more over a year. They also had more of a fat loss  - 1.5% more. Their ratio of total to HDL cholesterol improved more. and their triglyceride levels fell more. Their HDL cholesterol levels - or "good" cholesterol -  went up more. In terms of ten year Framingham risk scores: those on the low-carb diet saw significant decreases in those risk factors, while those in the low-fat diet did not.

Oh, and while  the low-fat group DID lose weight, it seems they lost more muscle than fat... awesome. 

So, in pretty much every metric you could pick, the low-carb diet beat the low-fat diet. But I expect you'll see the usual caveats in the media. They'll warn us that "even though cholesterol levels improved on the low-carb diet more, that eating more fats just simply MUST be bad for you." They'll repeat how Framingham risk scores and risk factors aren't the same thing as actual bad outcomes, while using those same factors to promote low-fat diets as better.

And they'll attack this randomized control trial for being only one-year in design, while ignoring that almost all of their data is observational. The 2010 Dietary Guidelines for Americans recommend that 45 - 65 % of our diets be from carbohydrates, and that 20-35% from our calories be from fats. in essence they're recommending a low-fat diet for everyone and a low-carb diet for none. Will the 2015 Dietary Guidelines for Americans be any different? Don't hold your breath.