Tag Archives: diet

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.

 

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.

 

 

Sugary Drinks Increase Risk of Cancer

In a study published three weeks ago, researchers from France looked at the relationship between the consumption of sugary drinks and the risk of cancer.

The average American consumes about 45 gallons of soda each year. An average 12 ounce can of soda contains upwards of 40 grams of total sugar, or about nine teaspoons of sugar.

A population-based prospective cohort study was completed with over 100,000 subjects from the French NutriNet-Sante study. Participants were 18 years of age and older, with a predominance of women (79%) to men (21%). Mean age at baseline was 42 years.

The sugary drink group consisted of energy drinks, fruit drinks, sodas, sports drinks, 100% juice drinks, among others. Consumption of sugary beverages was assessed by 24 hour dietary records. Association of beverage intake and risk of overall, breast, colorectal, and prostate cancer was assessed.

The researchers found that there was a positive association between the amount of sugary drink intake, and risk of overall cancer and breast cancer. Also, when looking specifically at 100% fruit juices these were also positively associated with risk of overall cancer.

Interestingly, the researchers did not find an association between artificially sweetened beverage consumption and the risk of cancer.

The researchers suggest several possible mechanisms by which sugary drinks may increase cancers risks. These include obesity, increased visceral fat, higher glycemic index, and increased pro-inflammatory markers.

This is a solid study, which included nearly 80,000 women. This study demonstrates how a simple dietary intervention, in this case limiting sugary beverages including 100% juices, may potentially have a meaningful impact on our health. Perhaps next time you are reaching for a soda, grab a glass of water instead.

“I can remember a reporter asking me for a quote, and I didn’t know what a quote was. I thought it was some kind of soft drink.” –  Joe DiMaggio

(Source- BMJ 2019; 365:12408)

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.

 

 

Blueberries and Metabolic Syndrome

July 8th is designated National Blueberry Day, and in recognition of this delicious fruit today’s post will examine a study just published in June on the effect of blueberry consumption on cardiovascular risk factors.

The US is the world’s largest producer of blueberries, producing more that twice the tonnage of blueberries annually than the 2nd largest producer, Canada. The largest blueberry producing state is Washington, followed by Georgia, Michigan and Oregon. Low bush or wild blueberries, and high bush or cultivated blueberries, are all native to North America. Many of the beneficial properties of blueberries are thought to be due to their anthocyanins. Anthocyanins are water-soluble pigments which may appear black, blue, purple or red. Plants rich in anthocyanins include black rice, blueberries and raspberries. Anthocyanins have anti-oxidant properties.

A research group from the UK and Harvard looked at the relationship between blueberry consumption and its effect if any on insulin resistance and markers of cardiometabolic function. A random controlled double blind study was performed, with 138 enrollees, randomly assigned to one of three groups- a group which consumed the dietary equivalent of one cup of fresh blueberries each day, a second group which consumed a dietary equivalent of 1/2 cup of fresh blueberries each day, while the third group consumed a placebo. It is important to note that the study subjects had all been diagnosed with metabolic syndrome and were overweight or obese. The study enrolled both men and women, ages 50-75.

The study lasted six months. The researchers discovered that while metabolic syndrome markers were not significantly changed by blueberry consumption, the group that consumed one cup of blueberries per day did show improvements in HDL (“good cholesterol”), endothelial function, and systemic arterial stiffness. It was estimated that a 13% reduction in future cardiovascular events was possible in the one cup per day group.

This is an important study, with one of the longer study periods (six months) completed to date. The study population had significant health issues, including metabolic syndrome and was older. Although the intervention did not change the insulin resistance numbers, it is possible that the study intervention was simply not long enough.

Metabolic syndrome is a cluster of conditions including elevated blood pressure, excessive fat around the waist, elevated triglyceride levels, and decreased HDL. Individuals with metabolic syndrome are at higher risk for heart attack and stroke, and metabolic syndrome is thought to be a precursor for Diabetes Mellitus Type 2.

Here is a well-designed study showing the benefits of a simple dietary intervention on metabolic syndrome. Next time you are considering something for dessert or a snack, put the cake, cookies and ice cream away and reach for blueberries instead. And buy local if possible, and support our farmers and propagators.

“There are eyes, to be sure, that give no more admission into the man than blueberries.”-    Ralph Waldo Emerson

(Source- American Journal of Clinical Nutrition 2019; 109)

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 Good for Women’s Heart Health

May 12-18 is celebrated as National Women’s Health Week, and in recognition of this important week today’s post will examine research studying the effects of a Mediterranean-style diet on cardiovascular risk factors in women.

For those who are unfamiliar with the Mediterranean Diet, it is loosely based on the traditional cooking styles of those countries that border the Mediterranean Sea. Some of the important tenants of the diet include eating lots of vegetables and whole grains, using olive oil as a substitute for butter and margarine, eating more fish and less red meat, and choosing nuts as a healthy snack.

In a recently published paper, researchers affiliated with Harvard Medical School examined the effects of a Mediterranean-style diet upon cardiovascular risk factors in a group of women participants. This particular study involved nearly 26,000 women. To assess the women’s dietary habits, a food-frequency questionnaire which included 131 items was administered at enrollment in the study. The researchers then calculated what they termed the “Med Score” for each participant. The Med Score ranged in scale from 0 to 9, with a higher score indicating better adherence to the Mediterranean Diet. The subjects were then placed into three different categories (Low, Medium, High) based on their Med Score. Multiple lab markers were taken as well, including LDL, HDL, CRP, fibrinogen, and lipoprotein (a).

This group of women was then followed for about 12 years. They were monitored for cardiovascular events such as heart attack and stroke. The researchers discovered that the subjects in both the Medium Med Score group and the High Med Score group had significant cardiovascular risk reduction, compared to the Low Med Score group. The risk reduction was 28% in the High Med Score group, and 23% reduction in the Medium Med Score group, compared to the Low Med Score Group.

This is a very well done study, which adds to previous research on the benefits of the Mediterranean Diet. This is a large group of women, who were considered healthy at baseline, which is important to note. Here we have a relatively simple dietary modification that had a profound positive impact on women’s cardiovascular health. The Mediterranean Diet seems to be a low-risk diet, that is worthy of consideration by women, and men as well.

“No disease that can be treated by diet should be treated with any other means.”– Moses Maimonides

(Source- JAMA Network Open, 2018:1(8))

This bog 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.

 

 

Eat Your Veggies- Help Your Heart

In recognition of registered dietician nutritionist day, our post today will look at how some dietary factors impact cardiovascular health.

A recent study examined a group of Swedish women and their dietary habits. Nearly 39,000 women completed a 96 item food frequency questionnaire. The questionnaire asked about how certain food or beverages had been consumed over the prior year. Researchers then calculated estimates of the total antioxidant capacity of each respondents diet. Four categories including fruit and vegetable consumption, whole grain consumption, and coffee consumption were used. The participants in the study were followed for approximately ten years. Women in the highest ranking group of total antioxidant capacity of diet, compared to the lowest ranking group, had a 20% lower risk of a heart attack.

This study is an interesting one as it examines a group of women. Women have been typically underrepresented in medical research. This was also a large study of nearly 39,000 subjects, and large is better in this regard.

Finally, which one of us has not encouraged our children to “eat more vegetables”? Now we can add that it is good for their heart as well!

“I eat more vegetables than the average vegetarian.”– Dr. Robert Atkins

(Source- American Journal of Medicine, Vol 125, No. 10, Oct. 2012)

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.

 

 

 

Worried About Your Heart? Don’t Skip Breakfast!

Today’s post is another in recognition of American Heart Month. Many of us can recall being reminded by our mother to “eat your breakfast” when we were young, usually as teenagers. It turns out that as is usually the case, mom was giving us good advice.

An interesting study from a research group primarily located in Spain and the US used data from PESA (Progression of Early Subclinical Atherosclerosis) and looked at the association of breakfast styles and cardiovascular risk factors and the presence of subclinical atherosclerosis.

The PESA study is an ongoing observational investigation of over 4000 employees who work at the Bank Santander Headquarters in Madrid, Spain. Female and male participants in the study were ages 40-54, and were free from cardiovascular disease at the time of enrollment in the study. The participants were asked to complete a computerized food questionnaire, which included over 800 food items. Based on this data the “energy consumed during breakfast” was calculated.

Three different categories of breakfast patterns were established. First were the “breakfast skippers”, whose breakfast intake did not exceed 5% of the their total daily energy intake. The next category was the “low energy” breakfast group, who consumed between 5% and 20% of their total daily energy intake at breakfast. The third group was the “high energy” breakfast group which consisted of those who consumed more than 20% of their total energy intake at breakfast. Of the over 4000 study subjects, 3% were in the “breakfast skipper” group, 69% were in the “low energy” group, and 28% were in the “high energy” breakfast group.

Ultrasound was used to assess for atherosclerotic plaques in the carotids, the abdominal aorta, and the illiofemoral arteries. The prevalence of subclinical atherosclerosis for the PESA subjects was 62.5% in the “breakfast skippers” group, 60.3% in the “low energy” group, and 13.4% in the “high energy” group.

Importantly, regularly skipping breakfast was associated with 2.57 higher odds for generalized atherosclerosis, and 1.55 higher odds for noncoronary atherosclerosis, independent of traditional cardiovascular risk factors (such as diabetes, high cholesterol, high blood pressure, and smoking).

So, make some time in the morning for breakfast. It turns out mom was right, again.

“Sometimes I’ve believed as many as six impossible things before breakfast”. Lewis Carroll

(Source- Journal of the American College of Cardiology, Vol. 70, No. 15, 2017)

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 Glycemic Index Diet Increases Cancer Risks

In honor of World Cancer Day, today’s post will examine research from Italy published last year, regarding dietary glycemic index, glycemic load, and subsequent cancer risk.

Researchers enrolled nearly 48,000 subjects into this study, from five different clinical centers in Italy. Subjects completed food frequency questionnaires, and were followed for an average of nearly 15 years. The questionnaires were designed to access glycemic Index, as well as glycemic Load, of the diet of each participant.

The Glycemic Index is a measure of the ability of different types of carbohydrate containing foods to raise blood glucose levels within two hours. Pure glucose is given the value of 100. High Glycemic Index foods cause more rapid rise in blood glucose levels. High Glycemic Index foods include white bread, white rice, high fructose corn syrup, and sodas. Low Glycemic Index foods include beans, most vegetables, and nuts such as cashews, peanuts, and walnuts. High Glycemic foods elevate blood glucose as well as insulin levels, and in turn promote fat storage. Low Glycemic Index foods tend not to overly elevate blood glucose levels or insulin levels in the body.

The Glycemic Load on the other hand is a function of the amount of carbohydrate and the Glycemic Index of that particular food. The Glycemic Load is calculated as the Glycemic Index multiplied by the grams of carbohydrate per serving size.

What the Italian researchers found was a high Glycemic Index diet increased risk of colon cancer, bladder cancer, and melanoma, among others. High Glycemic Load diets were related to a high risk of developing colon cancer, liver cancer, cervical cancer, and endometrial cancers, among others.

This study provides evidence that limiting carbohydrates may be a strategy for limiting risk of certain cancers later in life.

(Source- Scientific Reports, 7:9757)

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 and health concerns with your personal physician.