Author Archives: ewperttulamd

Exercise and Weight Loss Good for Diabetes

With the New Year now here, it is a great time to consider resolutions for exercise and weight loss for 2018.

A small study published in 2015 shows some of the benefits of exercise and weight loss, even over a short period of time. In this study, completed at the University of Vermont, patients were enrolled that had recently been diagnosed with Type 2 diabetes. These patients were typical of what is seen in a primary care setting, with HbA1c readings between 6.5-8.0%, and BMI from 27-40 Kg/M2. 

The patients engaged in exercise 5-6 days each week, including walking and supervised exercise. In addition, participants engaged in weekly group counseling sessions led by a registered dietician. It is important to note that participants were not on diabetes medications during the six month study.

At completion of the six month study, the majority of the participants went into at least partial remission of their diabetes, with the mean HbA1c dropping from 6.8 to 6.2, while one individual achieved what was termed a “total remission” with an HbA1c=5.6%. Mean weight loss amongst the group was 21+ pounds, and peak aerobic activity increased by 18%. Other cardiac risk factors such as CRP, fasting insulin and triglyceride levels all improved. Women made up the majority of those enrolled.

This study shows what is possible with directed efforts towards diet and exercise modifications. The authors suggest that no medication similarly used in this patient population would have provided such “broad reaching preventative efforts”, and perhaps that is true.

To be sure, this was a small study with only 12 patients enrolled and ten who completed. However, given the robust results, a more extensive study certainly seems warranted. Particularly for those patients who are very early in their diabetes disease process a diet and exercise regimen seems worthy of consideration. Combined with medication when appropriate, this intervention would likely yield even more profound results.

(Source- Journal of Cardiopulmonary Rehabilitation and Prevention, Vol 35(3), May/June 2015)

This blog is a review of 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.

Blueberries- Good For Your Brain?

July is National Blueberry Month and in recognition of this today’s post will examine research related to the benefits of blueberry supplementation in children.

 

Bluberries1

 

A group of researchers affiliated with the University of Reading in the United Kingdom designed a study to examine the potential benefits of blueberry supplementation in children. The researchers took a group of 7-10 year olds and administered a drink containing either 15 or 30 grams of freeze-dried wild blueberries, or a placebo drink. The researchers did their best to conceal from the participants the real blueberry drink from the placebo drink, using opaque cups and straws.

Children in the study were administered a variety of tests of cognitive performance, including the Auditory Verbal Learning Task, Modified Flanker Task, and Picture Matching Task tests.

Results of the study showed that wild blueberry supplementation led to significant improvement in cognition. The 30 gram supplemented group showed the best improvement in their performance compared to baseline, while the 15 gram supplemented group also showed improvement, but not as substantial as the 30 gram group.

Eating healthy blueberries seems a simple and low risk way to possibly improve cognitive performance, and celebrate National Blueberry Month at the same time.

 

This blog is a review of 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.

(Source- European Journal of Nutrition, October 5, 2015)

 

Testosterone Reduces Lying in Men

In recognition of the last day of Men’s Health Month, this post will examine a unique study conducted in Germany.

Thousands of medical research studies are published each year. Many add to the existing knowledge base about a certain medical condition, while others may suggest new areas for future research. A handful of studies each year could be considered “game changers”, and may lead to immediate re-examination of existing clinical treatment protocols.

On the other hand, there are also those studies which may make you scratch your head and mutter “huh?”. A recent study may fall into this latter category. In the study, entitled “Testosterone Administration Reduces Lying in Men”, German researchers looked at the effects of the application of testosterone to a group of healthy men, average age 24 years. On day one of the experiment, men were given either real testosterone gel or a placebo. On the second day of the experiment the men participated in dice rolling and other experiments. Testosterone levels were checked in all study subjects, and were (as expected) much higher in the testosterone treated group.

The researchers concluded that there was a lower incidence of lying in the testosterone treated group.

It’s not clear if there will be a follow-up study here in the US, perhaps sponsored by one of the testosterone replacement product manufacturers. Politicians may be a group worthy of further study. 

 

(Source-PLOS ONE, October 2012, Volume 7, Issue 10)

This blog is a review of 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 to Prevent Migraines

June is designated National Migraine Headache Awareness Month. In recognition of this today’s post is related to the topic of migraine headaches.

A group of researchers in China recently designed a study to investigate the long-term effects of true acupuncture on migraine headaches. A total of 249 subjects with ages from 18 to 65 years old and who had migraine headaches 2-8 times a month were included in the study.

The study lasted 24 weeks, and consisted of 4 weeks of treatment followed by 20 weeks of follow-up. Participants were randomized to a true acupuncture group, a fake acupuncture group, or a control group (wait list). Those in the true and fake acupuncture groups were treated 5 days a week for a total of 20 treatments, usually 30 minutes each visit.

The outcome measure of the study was the change in frequency of migraine headaches from the start of the study until 16 weeks. This was assessed by a migraine diary. A total of four acupuncture points were used for each treatment, two of which were fixed points that were used in each treatment session.

At the end of the study researchers found that in the true acupuncture group the frequency of migraines, number of days with migraines, and pain intensity of migraines was reduced to a greater degree than that in the fake acupuncture or control group.

Two important additional points-  although the acupuncture was only administered for four weeks the benefits last until the end of the study, which was 24 weeks, or 20 weeks after the last session of acupuncture. Also, the study consisted of 77% women, who suffer from migraines disproportionately.

It is estimated that over 37 million people in the U.S. suffer from migraine headaches. These are found most often in folks between the ages of 35 and 55, and are much more common in women than men. Based on the results of this well-designed study perhaps acupuncture should receive more consideration as a prevention strategy for these debilitating headaches.

(Source- JAMA Internal Medicine 2017; 177 (4))

This blog is a review of 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.

 

Soda May Cause Worsening of Osteoarthritis in Men

In a study published in the BMJ Open, researchers found that the consumption of soft drinks may be associated with an increased progression of osteoarthritis (OA)  of the knees in men. Researchers examined data from the Osteoarthritis initiative, which was started in 2002 by the National Institutes of Health.

Data from over 2000 participants was examined. X-rays of the knees were taken to evaluate the joint space narrowing in patients, over a course of four years.

Results of the study showed that increased soft drink intake was associated with an increasing rate of OA progression in the knees of men. Interestingly, this relationship did not hold for women. The research group also looked at fruit juice intake and OA progression, and no association was found.

Diet sodas were not examined as part of this particular study. It would be helpful to know if diet sodas were better, worse or the same relative to regular soda. It would also be helpful to know if discontinuation of soda led to improving osteoarthritis status. These may be areas of further research. In any case, this study provides yet another reason to cut back or eliminate sodas entirely, particularly in men.

(Source- BMJ Open 2013; 3: e002993)

This bog is a review of 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 Arthritic Knee Pain

May is designated Arthritis Awareness Month, and in recognition of this several posts will review topics related to arthritis. In a systematic review published in the journal Osteoarthritis and Cartilage, researchers found acupuncture to be effective in reducing knee pain from osteoarthritis. Researchers looked at several published studies to compare the effectiveness of acupuncture to other treatments for arthritic knee pain.

The research group, based in the UK, reviewed a total of 156 published trials. In addition to acupuncture, they reviewed other treatment modalities such as aerobic exercise, muscle-strengthening exercise, heat treatment, manual therapy, laser/light therapy, Tai Chi, TENS, and weight loss, among others. The purpose of the review was to compare acupuncture with alternative treatments that a primary care physician might typically prescribe for osteoarthritic knee pain.

The researchers found that several treatment modalities including acupuncture, TENS, aerobic exercise, and muscle strengthening exercise all showed some benefit when compared to “standard care”. Standard care in this instance would include analgesic pain medications and general exercise advice. In turn, when the other treatment modalities were compared to acupuncture, acupuncture was statistically superior in reducing knee pain compared to weight loss, muscle-strengthening exercises, neuromuscular electrical stimulation, and pulsed electromagnetic fields.

It is important to note that when the research group specifically looked at what they described as “better quality studies” acupuncture again showed a statistically significant reduction in knee pain when compared to standard of care. Also, when the better quality studies were considered, acupuncture was better at relieving knee pain when treatment modalities such as muscle strengthening exercise, weight loss and aerobic exercise were compared. 

This thorough review paper again highlights the benefits of acupuncture, in this case for arthritic knee pain. Acupuncture should be considered as a treatment option for osteoarthritic knee pain.

(Source- Osteoarthritis and Cartilage 21 (2013))

This blog is a review of 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.

 

 

Walnut Oil Lowers Cholesterol in Diabetics

May 17th is National Walnut Day, and in recognition of this today’s post will review recently published research on walnut oil.

A group of researchers in Iran designed a study to examine the effects of walnut oil on lipids in a group of patients with Type 2 diabetes. Compared to other tree nuts such as almonds, cashews, hazelnuts and pecans, walnuts are particularly high in essential fatty acids, such as linoleic acid and alpha-linolenic acid. Because of favorable nutritional qualities such as this walnuts have been the subject of research in regards to potential health benefits. China is the largest producer of walnuts in the world, while the U.S. is the largest exporter of walnuts.

The researchers completed a double-blind, randomized placebo-controlled trial, enrolling 45 diabetic patients in the walnut oil group, and another 45 patients in the placebo group. Those in the walnut oil group ingested four capsules of walnut oil three times each day. Those in the placebo group ingested similar capsules which contained simply water.

Labs were drawn at the start of the study and again at the conclusion after three months. The primary outcome measure was change in total cholesterol, triglycerides, LDL (“bad cholesterol”) and HDL (“good cholesterol”).

After 90 days researchers found that the participants in the walnut oil group had a significant decrease in total cholesterol, triglycerides and LDL. There was also a trend towards higher HDL. The walnut oil preparation was well tolerated, with no significant side effects. 

Walnuts may be part of a low-risk diet strategy for primary prevention in a high risk population of diabetic patients.

 (Source- Nutrition&Diabetes (2017) 7, 259)

This blog is a review of 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.

 

Curcumin For Knee Arthritis

May is recognized as Arthritis Awareness Month and we will have several posts on arthritis during the month of May.

Curcumin is a spice that has been used since ancient times, often as a coloring agent in Asian foods. Curcumin is an active ingredient of the Asian spice turmeric, which is a member of the ginger family. Turmeric is a widely used spice in South Asian and Middle Eastern cooking and is grown in India, Nepal, Indonesia, Thailand, Vietnam and elsewhere. Turmeric is also used in Ayurvedic Medicine, and is currently being studied in Western Medicine for possible uses. Curcumin has been shown to have antioxidant and anti-inflammatory properties. There has been a lot of interest in this spice due to its potential health benefits.

A research group in Thailand recently completed a study of the efficacy of an extract of curcuma domestica in patients with osteoarthritis of the knee. A total of 367 subjects enrolled in the study. The participants in the study were primarily female (90%), with a mean age of 60 years. The group receiving the curcuma extract was compared to a similar group which instead received ibuprofen for the knee pain. 

The enrollees in the study were assessed at baseline, at 2 weeks, and at 4 weeks, which was the end of the study. Patients were assessed via a functional pain scale, and a six-minute walk test.

At the end of the four-week study the extract of curcuma domestica was found to be as effective as ibuprofen. The curcuma was generally well tolerated, with few side effects.

(Source- Clinical Interventions in Aging 2014:9)

This blog is a review of 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.

 

Curcumin Helps With Depression- Part Two

Today’s post is the 4th in a series covering topics in mental health, in recognition of National Mental Health Month.

A group of researchers from Murdoch University in Western Australia examined the use of curcumin, as well as a curcumin/saffron combination, in treating major depression. Curcumin is an active ingredient of the Asian spice turmeric, which is a member of the ginger family. Turmeric is a widely used spice in South Asian and Middle Eastern cooking and is grown in India, Nepal, Indonesia, Thailand, Vietnam and elsewhere. Turmeric is also used in Ayurvedic Medicine, and is currently being studied in Western Medicine for possible uses. Curcumin has been shown to have antioxidant and anti-inflammatory properties.

The study was a randomized double-blind placebo controlled trial, which ran for 12 weeks. There were 123 participants in the trial, all of which were diagnosed with major depression. There were four different groups- a placebo group, a low-dose curcumin group, a high-dose curcumin group, and a low-dose curcumin/saffron combination group. The score on the Inventory of Depressive Symtomatology was the primary outcome measure.

After 12 weeks researchers found that the 3 groups treated with curcumin all had significantly greater improvements in depressive symptoms compared to the placebo group. The response rate in the groups treated with curcumin was 28% versus only 13% in the placebo group. 

Interestingly, the addition of saffron to the curcumin did not seem to improve the efficacy of the curcumin. Also, a comparison of the high and low doses of curcumin did not appear to show any major differences in efficaciousness.

This study adds to the growing body of evidence indicating potential benefits of curcumin for depression.

(Source- Journal of Affective Disorders 207 (2017))

This blog is a review of 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.

Healthy Diet Reduces Risk For Depression

Today’s post is our third in recognition of National Mental Health Month. Today’s post will examine recently published research from Australia.

Researchers performed a meta-analysis on existing research regarding the association between dietary habits and the risk of depression. They were able to identify 21 studies (20 observational and one random controlled trial) that met their inclusion criteria. These studies were from Europe, the U.S., Australia, Japan, Taiwan and the UK, and involved thousands of patients, with ages between 20 and 94 years.

 After compiling data from these 21 different studies and performing the analysis, researchers concluded that a healthy diet composed of high consumption of fruits and vegetables, whole grains, poultry and fish was associated with a statistically significant reduction in the odds of depression.

The  World Health Organization has concluded that depression is the leading cause of disability worldwide. It is estimated that more than one out of twenty Americans ages 12 and older will report moderate to severe depression symptoms over a given two-week period. With statistics like these, a healthy dietary approach seems like a beneficial primary prevention strategy for depression.

 (Source- American Journal of Clinical Nutrition 2014;99)

This blog is a review of 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.