The Facts about Diabetes

We may be approaching one of  the greatest healthcare crises ever. The numbers keep rising and no one really seems  to earnestly do much about it. That is where the Diabetes Prevention programs may offer some help in the future. Prevention always is the best medical advice but it’s difficult to find help due to a lack of interest or funding.  In my opinion, many cases of diabetes type 2 can be prevented if enough attention is paid to understanding the dietary and exercise aspects of the disease. Studies of previous prevention programs have shown to make a difference. One particular study compared lifestyle  modifications with the anti-diabetes drug, metformin and found that the lifestyle modifications were just as effective as taking the drug.

 

 

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You can find the complete study HERE.

Listeriosis: An Update

Inside a bacterium

The food industry appears to be having more food safety issues with the food-borne illness called Listeriosis. This may be due in part to more and more consumers using highly processed foods and ready-to-eat meals with long shelf lives. This bacteria can also live at refrigerator temperatures. It also is found often on the surfaces of food processing equipment and can be the reason for many food recalls.  CDC estimates: 2,500 cases in the U.S. annually with 20 percent resulting in death. Delicatessen cold cuts and soft cheeses (Brie,  Camembert, blue cheeses) have been associated with a significant number of cases.

Listeriosis primarily affects newborns, pregnant women, the elderly and other people with weak immune systems. The symptoms can include fever, malaise, arthritis and jaundice. Healthy people may experience occasional digestive and neurological symptoms.

Read about its increased prevalence with the food industry HERE.

 

 

Personalized Nutrition: Is It a Waste of Time and Money?

Can we rely on the newest field in nutrition science to lead us to better health? The field of nutrigenomics (how our diet choices affect our health) promises us these benefits. So, are these claims valid?

The following article discusses this possibility. Research has suggested that genetic testing may provide slight benefits, but this evidence is weak. Another thought is that in our current food environment, the biggest beneficiaries  may be the food and supplement industry and will take this opportunity to  create and sell, for example, breakfast cereals and diet supplements touted to prevent certain diseases. But we still need the science to back up these claims.  Another aspect is that food is not just about health but also about pleasure, culture, sociability, identify, and beliefs.

Some day we may be able to have our genes analyzed and have specific foods and dietary supplements prescribed to prevent diseases.  By then our knowledge of the gene/diet interaction may be accurate enough to predict our chance of chronic disease.  But until then, save your money or don’t take the results too seriously (my opinion).

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The Red Meat Debate: Use Some Common Sense

October 1, 2019:

For the past decade or so red and processed meats (beef in particular) has been associated with a higher risk of heart disease and certain cancers. Two NYT articles are presented here to that addresses this issue and helps to clarify how to deal with this ongoing issue.

The red meat debate continues as we wake up  this morning to the news that consumption of red and processed meats are of little risk to our health.

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November 5, 2015

Back in 2015, an article appeared to agree with the current assessment about red and processed meat and in addition tells us how to deal with the disturbing reports about red and processed meat and heart disease and cancer.

So what can we really believe? The following article first appeared in 2015 and seems to me to take a common sense approach to the debate that never ceases. Hint: Life is a risk.

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Athletes, Football and Protein

An interesting approach to why having inadequate protein in our diets can have short-term and long-term detrimental effects, maybe even on our favorite football team records. Why? Simply check out these examples of functions of protein in the body (and don’t forget the vitamin B12):

• Serves as a structural material in muscles, connective tissue, organs, and hemoglobin
• Maintains and repairs protein-containing tissues
• Serves as the basic component of enzymes, hormones, and other biologically important chemicals
• Serves as an energy source
• Helps maintain body fluid balance
• Helps maintain acid-base balance in body fluids

Complete proteins are found in animals and do provide all nine essential amino acids needed for protein synthesis.

Animal products such as meat, eggs, and milk provide all of the nine essential amino acids as well as soy proteins.

Some combinations of plant foods that provide complete protein(all 9 essential amino acids):

• Rice and black beans
• Hummus and bread
• Corn and black-eyed peas
• Bulgar (whole wheat) and lentils
• Tofu and rice
• Corn and lima beans
• Tortilla with refried beans
• Pea soup and bread

Source: Judith Brown, Nutriiton Now, 7th Edition

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Obesity on the Rise – Some Solutions?

The Obesity/Diabesity Pandemic

Obesity is a major risk factor for the development of  type 2 diabetes mellitus, so much so that the epidemic is often called diabesity. It has been described as one of the most important crises that has invaded our public health system.

Global Statistics,  Source: Lancet

• Since 1980, the number of adults with diabetes worldwide has quadrupled from 108 million to 422 million in 2014.
• Diabetes is fast becoming a major problem in low and middle-income countries.
• From 1980 to 2014, the prevalence of diabetes more than doubles for men in India and China.
• Half of adults worldwide with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.
  

So what are some solutions?  

The standard American diet is in much need of an overhaul and our national food systems need to change if we wish to reverse or at least slow down this trend. Many say that it would take the same determination as the campaigns to change behaviors that were utilized during the campaigns against smoking. .

Prevention awareness should be first on the front lines of treating the people with prediabetes that can often be reversible using lifestyle modifications. There are already some prevention models in the community; however, these should be expanded so that they become more easily accessible to more people. The Diabetes Prevention Program (DPP) uses intensive behavioral therapy to help people lose a little bit of weight (typically 5-10%). When this program is followed, the number of people progressing to have diabetes comes down by more than half. In people over 60, the reduction was 70%.

Nutrition education should be incorporated into the school system in the early years to help young children understand the importance of knowing where our food comes from and why nutritious foods are the best choice. They can be taught about balanced eating, calories, reading labels and grocery shopping. Nutrition education can also be offered at the middle and high schools levels by returning to a revamped and modernized home economics course in the curriculum. 

A lingering problem has existed for many primary care physicians for many years in that they say they were never adequately prepared in nutrition principles in medical schools. In a survey of family physicians (2009), two thirds said that dealing with extremely obese patients is “frustrating “and one-half said treatments are often ineffective. This is reflected by a lack off obesity training.

Shockingly, another survey in 2010 of 140 doctors revealed that nearly one-third were not even familiar with the American Diabetes Association (ADA) prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors and on average, the doctors could only identify just eight of the warning signs. Only 17 percent knew the correct laboratory values for blood glucose and only 11 percent said they would refer a patient to a behavioral weight loss program..

There should be an increased access to professional treatments. Medical professionals not trained in obesity management should refer their patients to outside providers such as dietitians, exercise trainers, behavior therapists, psychologists, or a new concept of health coaches. These providers should be trained, certified, and credentialed to protect the public from unscrupulous treatments and to provide quality care. Reimbursement of qualified health professionals needs to be enhanced to keep. Otherwise patient volume high and they lessen out-of-pocket expenses.

We have become a nation of non-cooks and prefer to have our meals prepared by someone else. Encourage home cooking and home kit meals to help to counter using fast foods and packaged highly processed meals loaded with calories, fat, sugar and salt.

Educate the public on food labeling including ingredient lists. Beware of food companies that promote products with a “health halo” meaning exaggerated claims are made that appear to make unhealthy foods seem healthy because of an added nutrient or ingredient. Corporations also mislead consumers with their labeling so they include four different types of sugar to keep sugar from being listed as the first ingredient. This is misleading to the consumer when attempting to make wise food choices.

Stop corporate-government partnerships and diminish lobbying.
The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is funded by myriad food companies such as Coca-Cola, PepsiCo and Kellogg’s. The dairy industry has a long history of influencing the food pyramid and Dietary Guidelines. A good example is the placing of a glass of milk on the MyPlate Logo.

Another health organization guilty of taking in millions from food companies is the American Heart Association. They offer a “Heart – Check logo for a price: $5, 490 to $7,500 that is renewable for another fee annually. The product has to be low in fat, saturated fat and cholesterol to gain this “honor.” However, some products such as Boar’s Head processed meats have the logo and still may still contain high levels of sodium. If the AHA were sincere in their efforts to help consumers choose healthier foods to rein in obesity/diabetes, they would realize that research has shown that a 1.8 oz. daily serving of processed meat raised the risk of diabetes by 19 percent and heart disease by 42 percent. Most current dietary recommendations emphasize a reduction in processed meats (my emphasis).

There is bad news on rising obesity rates – read about them HERE.

It will take a concerted effort from government, politics, industry, communities, and consumers and the perpetrators of our obesigenic culture to begin to change this trend.

 

 

Why Do Doctors Ignore Nutrition?

How many people get diet advice from their physicians? My personal experience has been that most docs do not mention it – even though the internet is teeming with advice – some legitimate but more often nonsense.

Why isn’t there more attention paid by medical professionals to one of the most historic public health issues the world has ever seen –  that being the obesity and childhood obesity health problems, often referred to as an epidemic? At last count, in the U.S. there has been an alarming percentage of people with either obesity issues or its cousin, diabetes/ pre-diabetes type 2 with no real solutions in sight.

Based on the latest statistics from the CDC:

 

• The prevalence of obesity was 39.8% and affected about 93.3 million of US adults in 2015~2016.
• Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer that are some of the leading causes of preventable, premature death.
• The estimated annual medical cost of obesity in the United States was $147 billion in 2008 US dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight.

People listen to their doctors (or should) but when nutrition is not mentioned as part of at least a routine visit, it tends to minimize its importance for overall health and well -being. At the same  time, segments of the public health community are screaming that obesity is the latest scourge to our heath.

 

There is a distinct “disconnect” as stated in the following article.

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Is Fish Brain Food? Examining the Omega 6 and Omega 3 Fatty Acids

Omega-6 and Omega-3 and Brain Health

Fat is a key nutrient in our diet and is often the first thing you may note on a food label. Most foods contain a mixture of many different types of fat: the commonest are saturated, monounsaturated, polyunsaturated and trans fats. Are some good and some bad.? This conundrum is often debated among nutritionists and still a definitive answer remains elusive.

What kind of nutrients are best for keeping our brains healthy?

Can lifestyle factors including diet help to prevent or alleviate the signs of dementia and neurodegenerative disease? Lately there has been an interest in examining some imbalances in the U.S. diet that may be influencing the onset and/or severity of these diseases.

Recently there was a major published study that looked at the effects of certain foods and food components on cognitive functioning titled “Nutrient biomarker patterns, cognitive function and MRI measures of network efficiency in the aging brain.”  A group of elderly Americans (n = 116 heathy adults with an average age of 69) underwent cognitive testing, MRI scans to assess brain function, and blood tests to assess nutrient status.

The Results: The results identified five categories of plasma nutrients associated with enhanced cognitive performance that measured general intelligence, executive function, and memory. The plasma nutrients associated with improved cognitive performance included carotenoids (like lycopene), homocysteine-lowering vitamins (folate, B6, B12), Vitamin D, and a healthy balance of omega-3 to omega-6 fatty acids.

MRI imaging revealed enhanced brain network connectivity in those with higher plasma carotenoid status and healthy balances of omega-6/omega-3 fatty acids.

Conclusion of the Authors:

These findings contribute to “the development of novel nutritional therapies for the targeted treatment and clinical management of cognitive and neurological impairments in the aging brain”.

This study was published in NeuroImage, Volume 188, March 2019, Pages 239-251.

What exactly are the omega-6 and omega 3 fats?

We have to begin with the polyunsaturated essential fatty acids, linoleic (omega-6) (LA)  and alpha linolenic acids (omega-three) (ALA). They are called essential because they cannot be made in the body and must be acquired from the diet.

Linoleic acid (LA) is required for growth, healthy skin and normal functioning of the reproductive system and is a structural part of cell membranes.  Foods high in omega 6 fats include unhealthy foods like processed snacks, fast foods, cakes, fatty meats, and cured meats. Other omega 6 foods are healthy including tofu, walnuts, and peanut butter. They are also prevalent in vegetable oils, like corn oil, safflower, sunflower and soybean oils. Linoleic acid is converted in the body to another fatty acid called arachidonic acid (AA). Food sources of AA include meat, poultry, and eggs. The adequate daily intake (AI) for omega 6 foods is 17000 mg per day.

Alpha linolenic acid (ALA) is also a structural compound of cell membranes and found in high amounts in the brain. Alpha linolenic acid is found in walnuts, dark, leafy green vegetables, flaxseed and chia seeds, canola and soybean oils.

ALA is converted in the body to two more fatty acids called eicosapentaenoic acid (EPA) and docosapentaenoic acid (DHA). This conversion rate of ALA to EPA can be slow and may depend on many factors, one being the ratio of omega-6 to omega-3 fatty acids.

EPA and DHA are found in fish, krill, and algae oil capsules as well as in fatty fish like salmon, tuna, sardines, mackerel, herring and trout. The AI for omega-3 fatty acids is 1.6 grams (men) and 1.1 g (women).

Arachidonic acid and EPA are necessary for making hormone-like compounds called eicosanoids that participate in regulation of blood pressure, blood clotting, inflammation, and a host of other important body functions.

So, the major players so far are: LA, ALA, AA, EPA, and DHA.

What is the omega-6/omega-3 ratio?

It is not enough to consume adequate levels of omega-3 fats but to avoid over-consumption of omega-6 fatty acids. Most modern diets contain excessive amounts of omega-6s and insufficient amounts of omega-3s. Americans regularly eat vegetable oils but eat fish infrequently, so we end up with many more omega-6s and fewer omega-3s.

The optimal 6 to 3 ratio approaches 4:1 that may be difficult for some people in our current food environment to achieve, so we try for 4:1 in hopes of realistically attaining less than 10:1. On average in the U.S., the omega-6 to omega-3 ratio is a disastrous 16:1. Soybean oil is so ubiquitous that an astounding percent of calories in the American diet (especially processed foods) are estimated to come from this single omega-6 source.

How Do Eicosanoids Affect Health?

Omega-6 fatty acids produce eicosanoids that tend to favor higher blood pressure, more blood clotting, and inflammatory compounds in the body.  They are often referred to as “bad” eicosanoids.

Omega-3 fatty acids produce eicosanoids with opposing effects, i.e., lower blood pressure, less blood clotting, and anti-inflammatory effects.  They are often referred to a “good” eicosanoids.

Eicosanoids from omega-3 EPA can diminish the effects of the “bad” eicosanoids by producing opposing compounds that will help tip the ratio back to a more favorable eicosanoid environment in the cell.

Another way to improve the fatty acid ratio is to help block excess arachidonic acid formation. By making sure your body has an adequate amount of EPA that acts as an inhibitor of the enzyme that can produces the “bad” eicosanoids.   The higher the EPA in the diet, the more the enzyme is inhibited, and the less “bad” eicosanoids are produced.

The problem with vegetable oils

Vegetable oils that turn rancid easily have been used since lard was designated as having a high saturated fat content when the low-fat craze to prevent heart disease was in full swing. The troubled history of these oils has never been resolved.  In a series of workshops in the 1980’s, it was observed that using diets high in soybean oil showed subjects dying of cancer at very high rates. Gallstones were also associated with diets high in vegetable oils. Subsequent research demonstrated that these oils that are high in omega-6, compete with the healthier omega-3’s found in fish virtually at important spots in every cell membrane throughout the body, including those in the brain. (Nina Teicholz, The Big Fat Surprise).

The vast amount of omega-6 that has entered our food supply via vegetable oils appear to have literally swamped the omega-3’s (the supply of which has remained relatively constant over the past century. (Teicholz,  page 275-6). Conversely, the American Heart Association encourages Americans to eat more vegetable oils due to their ability to lower LDL-cholesterol (the bad cholesterol.) So the debate on “healthy” oils will continue to the confusion.

Nonetheless, excessive intake of polyunsaturated fatty acids, including omega-3 and omega-6, has several risks. The double bonds in the fatty acid molecules are very reactive. They tend to react with oxygen, forming chain reactions of free radicals. These free radicals can cause cell damage, which is one of the mechanisms behind aging and the onset of cancer.

If you want to improve your ratio of omega-6 to omega-3, it’s probably a bad idea to eat a lot of omega-3 to compensate. Having a relatively low, balanced amount of each is best. Using olive oil in salad dressings and coconut oil for cooking is recommended. Olive oil contains monounsaturated fat and coconut oil is more stable since it has more saturated fat content.

What to Take Away from all this:

Linoleic acid (LA), an omega-6 fatty acid, and α-linolenic acid (ALA), an omega-3 fatty acid, are considered essential fatty acids because they cannot be made in the body by humans.

Both omega-6 and omega-3 fatty acids are important structural components of cell membranes, serve as precursors to eicosanoids and provide a source of energy. Long-chain omega-3 polyunsaturated fatty acids in particular exert anti-inflammatory effects; it is recommended to increase their presence in the diet.

The long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can be synthesized from ALA, but due to low conversion efficiency, it is recommended to consume foods rich in EPA and DHA or consume fewer omega-6 foods.

Some but not all observational studies using supplements have found fish intake to be associated with lower risks of cognitive deterioration and Alzheimer’s disease, but it is not yet clear whether supplementation with marine-derived omega-3 PUFA can help prevent cognitive decline. There is a great need for intervention studies, especially with DHA to determine if improvements in brain health will occur. The Rancho Bernardo Study of Healthy Aging found a protective effect of DHA from diet on various aspects of cognitive decline and/or dementia.

Best to cut down on omega-6 foods (processed and junk foods), add a couple of fish meals a week, use olive oil for salads, coconut oil for cooking.

Top 10 Foods with the Highest Omega 3 to Omega 6 Ratio

Food	Ratio of Three to Six
Snow crab (3 oz)	61:1
Atlantic cod (6 oz)	29:1
Tuna (6 oz)	25 :1
Mussels (3 oz)	25:1
Broccoli Rabe (1 cup)	7:1
Spinach (1 cup)	5:1
Flax seeds (1 oz)	4:1
Mangos (1 cup)	3;1
Lettuce (1 cup)	2:1
Kidney beans (1 cup)	2:1

Sources:

Judith E. Brown. Nutrition Now Seventh Edition, 2013.

Life Extension, October 2019

Linus Pauling Institute, Oregon State University

 

 

 

 

Our National Eating Disorder: Facing the Facts

Preventing obesity in childhood and adults is the primary goal. Many adults gain weight at a slow pace as they age (about a pound a year); however, others gain a substantial amount in a shorter period of time primarily between the ages of 25 and 34 years. Perhaps we are taking the wrong approach in helping people restrict that “natural” weight gain by using very restrictive fad diets (less calories) that often fail to result in maintaining weight after weight loss.

Since our food environment does not seem to change, more emphasis on mindful eating should be taught early in life by paying more attention to the “I’m hungry” and “I’m full” signals of our bodies.  Because appetite is triggered by external cues such as the sight and smell of food, it is usually appetite, and not hunger that makes us stop for ice cream or chocolate chip cookies while at the mall.

Getting eight hours of sleep at night may also be somewhat effective. Lack of sleep is linked to obesity, new evidence shows. Inadequate sleep impacts secretion of the signal hormones ghrelin, which increases appetite, and leptin, which indicates when the body is satiated. This can lead to increased food intake without the compensating energy expenditure. Paying attention to the kinds and amounts of food we consume can also help.  Studies have also indicated that eating fast may lead to eating more. It takes about 15 minutes for your brain to decode that your stomach is full.

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Why We Get Fat?

THE FIRST DIET BOOK – 1917

The influence of obesity on health is the most important aspect of the condition even though a lot of people consider appearance to be  the most important. What ever the reason, it’s useful to know that our health should be the biggest concern.

Health problems associated with obesity makes up a very large list:

Type 2 diabetes, chronic inflammation, hypertension, stroke, elevated cholesterol, certain cancers, heart disease, gallbladder disease, fatty liver disease, discrimination, depression, skin disorders, sleep disorders, shortened life expectancy.

The increased risk of disease appears to be primarily due to a higher prevalence of metabolic abnormalities in many obese people. About 70% of obese people have two or more metabolic disorders such as:

• Hypertension
• Elevated triglycerides, glucose, and/or insulin
• Low HDL-cholesterol (the “good cholesterol”)
• high C-reactive protein (a marker of inflammation)

Weight loss of 10-15% of initial body weight, paired with exercise improves physical fitness level, reduces metabolic abnormalities and the risk of disease.

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