World Diabetes Day 2019

Today is World Diabetes Day, and our post today is the third in our series of diabetes topics this week. Today’s post looks at research on the Dietary Inflammatory Index.

Statistics on diabetes from the World Health Organization are startling, the number of people with diabetes worldwide in 2014 was four times higher than the number of those with diabetes in 1980. It is projected that the number of those with diabetes will increase by 48% by 2045. It is estimated that there are 425 million people with diabetes worldwide. The Marshall Islands have the highest prevalence of diabetes. In the U.S., West Virginia has the highest prevalence of diabetes. Research indicates that obesity, physical inactivity, and poor dietary choices are closely associated with the development of diabetes type 2.

The Dietary Inflammatory Index (DII) was developed in 2009, as a way to measure the role of inflammation induced by diet and nutrition. The DII was updated in 2014. The index was designed to measure a particular individual’s diet with regard to it’s inflammatory potential. The effect of 45 different food and nutrient parameters on inflammatory biomarkers such as IL-4, IL-6, IL-10, and c-reactive protein was analyzed, with inflammatory scores assigned based on extensive research.

A research group from the West Virginia University Department of Family Medicine recently looked at the relationship between the Dietary Inflammatory Index and the presence of diabetes in a sample of adults from the National Health and Nutrition Survey (NHANES). In addition, they examined the relationship between DII and the severity of diabetes.

Over 4400 subjects from the NHANES (2013-2014) were included, 53.5% women and 46.5% men. The results were adjusted for age, alcohol use, BMI, gender, physical activity level, smoking status, and socioeconomic status.

The researchers discovered a significant association between the incidence of diabetes and Dietary Inflammatory Index scores, In addition, there was significant association between the severity of diabetes, and the Dietary Inflammatory Index scores.

High inflammatory diets have been shown to be associated with cardiovascular disease and arthritis. It should probably not surprise anyone that a pro-inflammatory diet is associated with a higher incidence of diabetes as well. The CDC estimates that nearly 1/4 of those with diabetes are not yet diagnosed. Perhaps future research will examine using the Dietary Inflammatory Index to identify those at higher risk for developing diabetes, so that a dietary intervention could be implemented.

Diabetes is one of the leading causes of vision loss among those age 20 and older, and is also one of the leading causes of kidney failure. Perhaps the best way to recognize World Diabetes Day is to carefully consider what one’s daily diet is comprised of, and make some changes going forward to lower the inflammatory potential of the diet. If you are overweight, or have a family history of diabetes, take the step of getting tested for diabetes. 

“I think I can wipe out diabetes.”–  Robert Atkins

(Source- Journal of the American Board of Family Medicine 2019;32:801-806)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Fruit Helps Prevent Diabetes Type 2

November 14th is designated as World Diabetes Day, and in recognition of this our posts this week will review topics related to diabetes. Today’s post will examine the role of fruit in the diet, and subsequent development of diabetes.

Statistics from the World Health Organization regarding diabetes are quite startling. Well over 400 million adults worldwide suffer from diabetes. Global prevalence of diabetes is over 8%. Diabetes is estimated to be the 7th leading cause of death worldwide.

Researchers from the Harvard School of Public Health tackled the question of whether certain types of fruits are associated with the risk of type 2 diabetes. Data from the Nurse’s Health Study, the Nurses Health Study II, and the Health Professionals Follow-Up Study was used for their research.

The participants were queried about their intake of individual fruits- apricots, peaches or plums; apples or pears; bananas, blueberries, cantelope, grapes or raisins; grapefruit; oranges; and strawberries. Participants were also questioned about fruit juices, including apple, grapefruit, and orange. The questionnaires were given at baseline, and then every two years in follow-up.

The results of the study were interesting. Total whole fruit intake was associated with a lower risk of diabetes. In particular, greater consumption of apples, bananas, blueberries, grapes and grapefruit were significantly associated with a decreased risk of diabetes. Conversely, increased fruit juice consumption was associated with an increased risk of diabetes, and switching from fruit juice to whole fruit in general led to a lower risk of diabetes. Even more interesting was the fact that the glycemic index alone did not seem to account for the association with Type 2 diabetes. 

Proper diet and regular exercise are two of the most important components of diabetes treatment. It appears incorporating fruit into the diet may be a strategy for prevention of diabetes as well.

“Fruit is definitely on the maintenance diet. It’s on the lifestyle diet.”– Robert Atkins

(Source- BMJ 2013; 347:15001)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Mediterranean Diet Helps Prevent Diabetes

November 14th is World Diabetes Day, and in recognition of this day several posts this week will discuss diabetes. Today’s post will examine the effects of a particular diet on the development of diabetes.

Statistics from the CDC paint a grim picture. Over 9% of Americans have diabetes. About 1 1/2 million Americans are diagnosed with diabetes each year. What is even more disturbing is that it is estimated that over 84 million have prediabetes, which puts them at much higher risk for developing full-blown diabetes. It is estimated that about 70% of those with prediabetes eventually develop diabetes. The direct and indirect costs of diabetes in 2012 were estimated at $245 billion. Diabetes is the 7th leading cause of death in the U.S.

More evidence of the benefits of a Mediterranean-style diet was demonstrated in a study performed primarily in Spain. In this particular study, results showed a significant protective effect from developing diabetes by following a Mediterranean-type diet, supplemented with extra-virgin olive oil and mixed nuts. The study was performed in a high risk group of men and women with risk factors such as history of smoking, high blood pressure, overweight, and high cholesterol.

Approximately 3500 subjects were enrolled in the study, and were followed for an average of 4 years. A 40% relative risk reduction in diabetes was found in the Mediterranean diet group supplemented with olive oil, while a 18% diabetes risk reduction was found in the Mediterranean group supplemented with mixed nuts. 

The Mediterranean Diet concept stems from the traditional dietary practices of Greece, Southern Italy, Portugal and Spain. The diet consists of moderate to high consumption of fish, high consumption of olive oil, fruits and vegetables, and moderate consumption of dairy products. What is missing from the Mediterranean diet is also important. Food items such as red and processed meat, refined cereals, fast foods and sodas are very limited in a Mediterranean diet.

Given the significant and often overwhelming health problems associated with diabetes, perhaps more serious consideration should be given to simple dietary modifications as a strategy for prevention.

“Insulin is not a cure for diabetes, it is a treatment”.–  Frederick Grant Banting

(Source- Annals of Internal Medicine: 2014; 160)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

World Mental Health Day- A Call To Action

Today is recognized as World Mental Health Day throughout the world, with the focus this year on suicide prevention. According to the World Health Organization, about 800,000 people die by suicide worldwide each year. In addition, the week of October 6-12 is recognized as Mental Illness Awareness Week in the U.S.  This will be our 100th post, and I can’t think of a more worthy health issue for this milestone. Today’s post will focus on just published research on depression in adolescents, a group at particularly high risk for suicide.

Data from the CDC from 2014 indicate about 11% of American youth had a major depressive disorder during the previous year, with the 2014 rate being a higher prevalence than the rate reported just ten years earlier (9%). Nearly 45,000 lives were lost to suicide in 2016. Between 1999 and 2016 suicides rates increased in most states. In Idaho for example, the suicide rate rose 43.2%. Suicide is the 2nd leading cause of death for those in the 15-24 age range.

A recently published study from India looked at the prevalence of depression among teenagers in West Godavari India. The Beck Depression Inventory, a validated self-reported screening tool was used. The Beck Depression Inventory was first published in 1961 by Dr. Adam T. Beck, and revised in 1978 and 1996. A total of 1015 subjects participated in the study between October 2018 and July 2019. Participants were roughly divided evenly between boys and girls. The higher the score on the Beck Inventory, the more severe depressive symptoms are indicated. The participants were queried regarding their feelings during the prior two weeks.

33.9% of subjects scored in the “minimal” range, and 21.9% in the “mild” range. The results of the study for the more severely impaired subjects were quite startling, with 29.5% scoring in the “moderate” range, and 14.7% scoring in the “severe” range. The prevalence of severe depression was statistically higher in females.

The results of this study show an incredibly high prevalence of depression among teenagers in India. Data from the CDC indicate similar findings in the U.S., with about 7.6% of Americans age 12 and over suffering from depression in any two week period. The symptoms of depression in teenagers can be subtle, and are often confused with the moodiness which is common in this age group. 

Today is also National Depression Screening Day. Interestingly, more than half of the individuals who die by suicide do not have a known mental health diagnosis. This may be because they have not yet sought medical help. If you or someone you care about is exhibiting signs of depression such as lack of energy, issues with sleep or eating, withdrawal from friends or lack of concentration, please seek help from a medical or mental health professional. A simple office visit may be all that’s needed to be evaluated and determine a treatment plan and begin the path to feeling better. This may well be the best way to honor World Mental Health Day.

“Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad.”–  Henry Wadsworth Longfellow

(Source- International Journal of Scientific Research, Volume 8, Issue 9, September 2019)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Acupuncture for Depression- Part II

October 10th is World Mental Health Day, and this week is Mental Illness Awareness Week. In recognition of this our posts this week will focus on mental health topics. Today’s post will examine recently published research on the use of acupuncture for depression.

Statistics from the NIH indicate that over 17 million adults in the U.S. had at least one major depressive episode, which is about 7% of all U.S. adults. The prevalence was higher in females (8.7%) than males (5.3%). An estimated 2/3rds of the adults with major depression combined treatment with medication with treatment from a healthcare professional. Interestingly, about 35% of those adults with major depression did not receive any type of treatment.

An international group of researchers completed a review and meta-analysis of the existing research of the effects of acupuncture on depression. 29 studies and nearly 2300 subjects were included in the analysis. They studied the effects of acupuncture compared to usual care, to sham or fake acupuncture, to psychologist treatment, and commonly used medications (such as selective serotonin re-uptake inhibitors). The studies included subjects from China, Hong Kong, Australia, the U.S. and UK.

After completing their analysis the researchers concluded that acupuncture was found to have clinically relevant benefit in reducing the severity of depression, when compared to usual care alone, to sham or fake acupuncture, and to medication alone. Importantly, the researchers also found a trend between greater acupuncture treatment frequency and reduction in the severity of depression.

As noted above over a third of those with major depression do not seek any treatment. Some of these individuals may well be trying alternative treatments. Given the results of this analysis perhaps some of those who do not currently seek treatment could benefit from acupuncture, or consideration of acupuncture as an add-on therapy to conventional treatment may offer additional help.

“The pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne.The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain.”–  William Styron

(Source- Journal of Clinical Medicine 2019, 8, 1140)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Pro-Inflammatory Diet Associated With Depression Among Women

This week is designated Mental Illness Awareness Week. In addition, October 10th is World Mental Health Day. In recognition, our post today will examine research on the effect of diet upon depression in women.

Data from the NIH from 2017 estimate 11 million U.S. adults had at least one episode of major depression with severe impairment, which represents 4.5% of all U.S. adults. Even more alarming are the statistics on U.S. adolescents aged 12-17 years. For 2017 it is estimated that 3.2 million adolescents had at least one major depressive episode, representing 13.3% of the U.S. adolescent population.  

An international research group including researchers from Harvard University, Canada and Germany performed a prospective analysis of the relationship between dietary pattern and risk of depression. The researchers looked at participants from the Nurses Health Study (NHS). The NHS included nearly 122,000 U.S. female registered nurses, who were age 30-55 years at enrollment in the study in 1976. At two year intervals, the participants were asked to provide updated information about their health. The subjects diets were assessed by a food-frequency questionnaire. Inflammatory markers such as c-reactive protein and interleukin-6 were also measured.

The researchers looked at what they termed an “inflammatory dietary pattern” (IDP). The high inflammatory dietary pattern included high intake of such things as diet soft drinks, margarine, refined grains, and sugar-sweetened soft drinks.

The researchers discovered that worsening IDP scores were associated with an increased risk of developing depression.

A pro-inflammatory diet has been shown to be associated with cardiovascular disease and diabetes. It should probably be no surprise that a pro-inflammatory diet would also be associated with an increased risk of depression. Given the alarming statistics above regarding depression, particularly among adolescents in the U.S., all potential therapeutic strategies should be considered. Incorporating a diet low in inflammatory foods seems a simple way to lower one’s risk of developing depression.

“If you are in a bad mood, go for a walk. If you are still in a bad mood go for another walk.”–  Hippocrates

(Source- Brain, Behavior, and Immunity 36 (2014)46-53)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Acupuncture for Post-Stroke Depression

October 10th is World Mental Health Day, while this week is designated Mental Illness Awareness Week, and so this week’s posts will address mental health topics. Today’s post will examine research on the use of acupuncture for post-stroke depression.

Statistics from the CDC indicate that nearly 800,000 Americans have a stroke each year. Every 40 seconds, someone has a stroke. These strokes result in nearly 140,000 deaths annually. The risk of stroke is nearly twice in blacks compared to whites. In those that survive their stroke, post-stroke depression is common, with the prevalence estimated at 29-35%.

A group of researchers from China performed a meta-analysis of existing randomized controlled trials, examining the effects of acupuncture therapy as a treatment for post-stroke depression. They included seven random controlled studies in their analysis, totaling over 500 participants. Those in the control group received medications which are often given for depression, such as citalopram and fluoxetine. The Hamilton Rating Scale for Depression was used to evaluate the degree of depression.

The researchers concluded that acupuncture therapy resulted in improved depressive symptoms in the post-stroke subjects, compared to medicine alone. It is important to note that there were no observed adverse effects from the acupuncture therapy.

Stroke is common in the U.S., and worldwide. Depression following stroke is common as well. Given the results of this study, acupuncture treatment may be worthy of consideration for treatment of post-stroke depression.

“Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear.”–  C.S. Lewis

(Source- Medicine (2019) 98:22)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

 

Coffee- For Your Health

Sunday September 29th is celebrated as National Coffee Day in the U.S. In recognition of this important day, our post today will cover some interesting research on coffee consumption and various health outcomes.

The largest coffee producer in the world is Brazil, and has been so for over 100 years. Second on the list of producing countries is Vietnam, followed by Columbia. While over 50% of Americans drink coffee daily, the leading coffee consuming country is actually Finland, followed by Norway. There are many bioactive compounds found in coffee, including polyphenols, which are thought to be one of the sources of coffee’s health benefits.

A group of researchers affiliated with the University of Edinburgh as well as the University of Southampton in the UK performed what they termed an “umbrella review”, examining the effects of coffee consumption on several different health conditions. Their review included 201 meta-analyses of observational studies, as well as 17 meta-analyses of interventional research.

After completion of their analysis, the researchers concluded that coffee consumption was associated with a lower risk of cardiovascular mortality, total cancer, and all-cause mortality.

For cancer, coffee consumption was associated with a lower risk of endometrial cancer, melanoma, oral cancer, and prostate cancer.

For the liver, in those with any coffee consumption versus those with none, there was a 39% lower risk for liver cirrhosis, 27% lower risk for liver fibrosis, and 29% lower risk on non-alcoholic fatty liver disease.

In comparing high versus low coffee consumption, high consumption was associated with a lower risk of diabetes type 2, and was also associated with a 9% lower risk of metabolic syndrome.

Other notable findings- coffee consumption was associated with a lower risk of both gallstone disease and Parkinson’s disease. In fact, the only evidence of potential harm seemed to be in those that are pregnant and perhaps women and bone loss.

This was a massive study, spread over multiple countries and with many participants. While studies such as these do not prove cause and effect, they do provide areas where further research may be helpful.

So, on National Coffee Day, consider a cup or two with friends and family. It may be good for your health!

“The morning cup of coffee has an exhilaration about it which the cheering influence of the afternoon or evening cup of tea cannot be expected to reproduce.” – Oliver Wendell Holmes Sr.

(Source-BMJ 2017;359)

This blog is a review of published research and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

 

Fried Foods Bad for Prostate

September is designated National Prostate Cancer Awareness Month, and September 24th is Prostate Cancer Awareness Day. In recognition of this, today’s post will discuss research which examines the intake of deep fried foods and risk of prostate cancer.

Data from the National Cancer Institute estimates that there will be nearly 175,000 new cases of prostate cancer in the U.S. in 2019, and nearly 32,000 deaths. It is the 2nd most common cancer among men, second only to lung and bronchus cancers. The most common risk factor for prostate cancer is advancing age. Prostate cancer is more common among African-American men, who are twice as likely to die from prostate cancer as white men are.

It has been documented that when immigrants from Asian countries, which generally have low prostate cancer incidence, move to the U.S., their prostate cancer rates increase significantly within one generation, indicating perhaps some dietary or environmental exposure at work.

A group of researchers affiliated with the Fred Hutchinson Cancer Research Center and the School of Public Health at the University of Washington performed an interesting study, examining the relationship between intake of deep fried foods and subsequent risk of prostate cancer. Researchers used data from two population-based case-control studies, comprised of residents of Kings County, Washington. There were slightly over 1500 cases, and nearly as many in the control group. The two groups were similar in age, body mass index, education level, and race.

Participants in the study were given a food frequency questionnaire, which assessed the use of butter, margarine, oil or other fat in cooking. The food frequency questionnaire also queried about intake of doughnuts, french fries, fried chicken, fried fish, and snack chips.

The researchers discovered that compared with the reference intake (less than once per month), intake of doughnuts once per week or more was associated with a 35% increased risk of prostate cancer, while intake of french fries once per week or more was associated with a 37% increased risk of prostate cancer. Similarly, intake of fried chicken once per week or more was associated with a 30% increased risk of prostate cancer, and fried fish had a 32% increased risk.

In addition, the researchers discovered that increased fried food intake was associated with more aggressive prostate cancer. Compared to the reference intake of less than once per month, intake of doughnuts once per week or more was associated with a 38% increased risk of more aggressive prostate cancer, while the intake of french fries weekly or more was associated with a 41% increased risk of aggressive prostate cancer. Similarly, the intake of fried chicken once per week or more was associated with a 30% increased risk of aggressive prostate cancer, while fried fish had a 41% increased risk of aggressive prostate cancer.

Interestingly, there did not appear to be a relationship between intake of snack chips and development of prostate cancer. However, intake of snack chips once a week or more was associated with a 14% increased risk of more aggressive prostate cancer.

It is not entirely clear what is the mechanism between fried foods and prostate cancer. Certainly fried foods are pro-inflammatory, which could be a possible mechanism. Deep fried foods have high levels of advanced glycation endproducts, which are also pro-inflammatory. Another possibility is the substance acrylamide, a known carcinogen, which is found after deep frying common foods. 

It should be no surprise that the foods we eat regularly have an effect on our health, as the old adage “You are what you eat” suggested. This is not a new concept. For instance in traditional Chinese Medicine food is thought to be a form of medicine. So, next time you are reaching for that doughnut, go for something healthy instead.

“Don’t eat fried food, it angries up the blood”– Satchel Paige

(Source- The Prostate, 2013)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

High Glucose a Risk Factor for Dementia

September 21st is designated World Alzheimer’s Day. In recognition of this today’s post will review research on the effects of glucose on dementia.

Alzheimer’s disease is the most common form of dementia. Statistics from the CDC indicate as many as 5 million Americans are currently living with Alzheimer’s disease. This number is expected to reach 14 million people by 2060.

It is important to consider that Alzheimer’s disease is not a normal part of aging. There is currently no cure for Alzheimer’s, so recognition of risk factors as a potential strategy for prevention is important.

A research group affiliated with the University of Washington, the Swedish Neuroscience Institute, Harvard Medical School and Harvard School of Public Health and Wake Forest School of Medicine performed a study examining the relationship between glucose levels and risk of dementia.

Enrollees for the study were selected from the Adult Changes in Thought study, which consisted of randomly selected members from Group Health Cooperative in Washington State. These members were all considered to be dementia-free. There were 2067 participants, 839 men and 1228 women, whose mean age was 76 years.

Study subjects were assessed every two years to look for incident cases of dementia. The Cognitive Abilities Screening Instrument was used. Average glucose levels were calculated for each subject at initiation into the study, and then in 5 year rolling periods thereafter. Mean follow-up period was nearly 7 years.

The researchers discovered that among those subjects with diabetes, those with higher levels of glucose had increased risk for dementia. For example, the risk for dementia was 40% higher in those with average glucose of 190 mg/dl compared to 160 mg/dl. 

Even more important, among the subjects without diabetes, those with an average glucose level of 115 mg/dl had an 18% higher risk of dementia compared to those with an average 100 mg/dl glucose level.

The last result bears repeating, in participants WITHOUT diabetes, a 15 mg/dl difference in glucose (115 vs 100) led to an 18% increased risk of dementia. This particular result may indicate that early interventions to lower blood glucose, while one is still in the insulin resistance stage and not advanced into full blown diabetes, may lower the risk of dementia.

At this time there is no cure for dementia. Alzheimer’s disease and dementia in general have a profound impact not only at the individual level, but also on the individual’s caregivers. Perhaps incorporating a low-carb lifestyle may be a strategy to prevent future dementia.

“The power of intuitive understanding will protect you from harm until the end of your days.”–     Lao Tzu

(Source- New England Journal of Medicine, 369.6)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.