Nov
01
2008

Pills For Diabetes Not Always Useful

By | Diabetes, Fitness, Heart Disease, Nutrition, Obesity, Prevention

Oral anti-diabetic drugs have been on the market for decades. They are often prescribed to patients with type 2 diabetes in an effort to control blood sugar levels. Type 1 diabetes patients, those who suffer from diabetes since childhood, generally require a different therapeutic approach. They receive insulin in the form of injections, or more recently by pump. The usefulness of the oral antidiabetic drugs has been researched by Elizabeth Sevin, PhD,MPH of John Hopkins Blomberg School of Public Health, Baltimore. Pooled data analysis found that patients who took one of the older medications, metformin, were at a reduced risk of death from cardiovascular illness. Metformin works by blocking the breakdown of glycogen (a storage form of sugar) in the liver, reduces absorption of sugar from the gut and increases insulin sensitivity thus controlling blood sugar more tightly. This protected the heart from cardiovascular illness. None of the other oral medications for type 2 diabetes was significantly linked to cardiovascular illness, but cardiovascular disease and mortality was higher in the patient group that took the drug rosiglitazone.

Pills For Diabetes Not Always Useful

How metformin works for type 2 diabetes

Due to the controversial reports about this drug, the researchers took a closer look at all the other oral anti-diabetic medications. None of them, not even the newest ones, proved to be superior, and the only one that showed a slight benefit was metformin. The author cautions that the association is too weak to be of significance, and a lot more long-term research would be needed to substantiate the benefits for cardiovascular protection.

More information on Diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Comments on Nov. 18, 2012: I do not see any further benefit for more research on oral anti-diabetic agents. Rather this type of research would indicate that subcutaneous insulin treatment 3 or 4 times per day as originally suggested by Banting and Best is still the best treatment for diabetes coupled with an exercise program and a low fat, low glycemic carbohydrate diet.

Arch Intern Med. 2008;168:2070-2080

Last updated Nov. 6, 2014

Nov
01
2008

Early Childhood Weight Gain Leads To Weight Problems in Teens

By | Health, Nutrition, Obesity, Prevention

A Finnish Study enrolled 541 children in a prevention trial at the age of 7 months. The same children were seen again at the age of 13 years. Every year the height and weight were measured. By the time the children were 13 years old, 16% were classified as overweight, based on body mass index determinations. For girls, there was an abnormally high weight gain (2.8 to 7.5 kg annually) from the 3rd to 4th year until the 12th year of age while normal weight kids gained only 2.1 to 4.8 kg annually. Boys showed no difference in weight gain pattern until the age of 5 years or older. Now the boys who developed an overweight pattern showed an increase from 3.5 to 7.9 kg annually while normal weight boys gained only from 2.6 to 5.5 kg annually. With respect to the body mass index the upper limit of a normal was exceeded for girls at the age of 5 years and for boys at the age of 8 years. Another important finding of the study was that the parents of the overweight adolescents were also overweight while the parents of normal weight adolescents were also within the range of a normal body mass index.

Early Childhood Weight Gain Leads To Weight Problems in Teens

Overweight child turns into overweight teen

Two major risks of developing overweight and later obesity were found: overweight parents and abnormally high weight gain in early childhood (ages 2 to 4). The investigators concluded that treatment for developing overweight problems in childhood needs to be addressed at this age, not later when it is much more difficult to treat.

More information about health for children: http://nethealthbook.com/news/health-children/

Lack of B vitamins in children predicts obesity: http://nethealthbook.com/news/lack-b-vitamins-children-predicts-obesity/

Pediatrics. 2008;122:e876-e883

Last updated November 6. 2014

Sep
01
2008

Survey Shows People Underestimate Lifestyle Factors As Cancer Causes

By | Cancer, Health, Nutrition, Obesity, Prevention, Weight loss

Roy Morgan Research Company and Gallup International have released an opinion poll study at the recent International Union Against Cancer’s World Cancer Congress in Geneva (August 27 to 31, 2008) that reveals significant differences among low-income countries and high-income countries. Cancer of the liver and other cancers can be caused by alcohol and throat and lung cancer as well as others are caused by carcinogens from cigarette smoking. These are medical facts that have been well established. But the opinion poll showed that there is ignorance and confusion in the public both in poor and wealthy nations. For instance in high-income countries 42% felt that there was no cancer risk from drinking alcohol and 8% were unsure, in low-income countries 15% were of the opinion that alcohol was not a cancer risk and 29% were unable to say. Other differences were that 62% of people in wealthier nations believed that cancer was one of the three top health issues in the country, while only 36% of people in poorer nations believed this. On the other hand with so much information about pollution in the press 76% to 78% of people living in middle and high income countries are of the opinion that this is an important cause of cancer while only 30% believe this in the poorer countries. The reality is that smoking and drinking of alcohol are more important in terms of cancer causation than pollution is.

Survey Shows People Underestimate Lifestyle Factors As Cancer Causes

Survey Shows People Underestimate Lifestyle Factors As Cancer Causes

David Hill, president-elect of the International Union Against Cancer, said that these opinion polls reveal data about attitudes and believes previously unknown. This kind of data can be used to formulate programs for cancer prevention so that the public is accurately informed about cancer facts and they learn in rich and poor countries alike that factors like smoking, drinking alcohol and a high body mass index are more significant cancer causes than pollution. Pollution is more difficult to control by the individual, but these life style factors can be modified, and people need to be empowered to make the right choices. People have the power to stop smoking, to cut down their alcohol consumption and to increase their exercise, which helps them to shed pounds.

More information about causes of cancer: http://nethealthbook.com/cancer-overview/overview/epidemiology-cancer-origin-reason-cancer/

International Union Against Cancer’s World Cancer Congress in Geneva (August 27 to 31, 2008)

Last edited November 3, 2014

Jul
01
2008

Genetic Difference Influences Sweet Tooth

By | Diabetes, Nutrition, Obesity, Weight loss

Environmental factors and ethnic customs can influence us to have certain likes and dislikes of foods, but researcher Ahmed El-Sohemy has found in his studies that there is also a biological and genetic basis for some of our food preferences. Researchers from the University of Toronto have discovered a genetic difference in people who consume extra sugar in their diet. The specific genetic constellation which the researchers have called GLUT2 does not only work in the pancreas, but it also is responsible for turning on satiety signals in the brain. It seems to have an impaired ability to notice high blood sugar levels that ultimately send “stop eating” signals to the brain. The habit to eat more sweets has been researched in persons with diabetes, but Dr. El-Sohemy does not believe that diabetes is directly connected with gene GLUT2. On the other hand he does not suggest that the presence of the gene should be an excuse to overindulge in sugar high foods. He states that food habits in humans are often connected to the availability of foods: if there is a birthday party and birthday cake, the people with a liking of sweets will be the first to get a slice of cake. On the other hand, if there are no sweets available, they will not make an extra trip to the store just for a piece of cake. The most logical approach is to minimize the availability of foods that are high in sugar, which is especially important for individuals who have GLUT2, the ”sweet tooth gene”, so they are not tempted to overindulge.

Genetic Difference Influences Sweet Tooth

Genetic Difference Influences Sweet Tooth

Much was learnt from two separate studies that involved 100 older adults on the one hand who were overweight or obese and 587 healthy younger adults who were mostly lean. Foods and beverages that were consumed were carefully recorded. In both investigations blood was drawn for DNA analysis and the presence or absence of the variation of the GLUT2 gene was compared to the food intake data. The older obese group with the variant gene consumed 112 grams of sugar per day versus 86 Grams per day for the non-variant gene group (normal control). The younger population carrying the variant gene consumed 131 Grams of sugar per day, while the non-variant control of young people consumed 115 Grams of sugar per day. This illustrates how genetic influences have an effect on our eating habits and also that younger people ought to be careful that they do not overuse sugar containing foods.

It also points to the solution of controlling your weight, if you belong to the higher risk group with the GLUT2 gene: you must exercise more to burn up the extra calories you tend to eat. A brisk walk on a treadmill will consume about 300 or 350 Cal in 30 minutes depending on the slope and the miles per hour setting.

Reference: Medical Post Vol 44, No. 16, June 16, 2008: page 19 (based on May issue of Physiological Genomics)

Last edited December 4, 2012

Jul
01
2008

High-protein, Low-refined carb diet useful in controlling diabetes

By | Diabetes, Nutrition, Obesity, Weight loss

Diabetes type 2 is often associated with obesity (body mass index higher than 30.0 kg per meter squared). At the 16th European Congress on Obesity in Geneva Dr. Neil Mann presented a study of 99 patients. Half were put on a high protein diet, the other half on a high carbohydrate low glycemic index diet and followed for one year with periodic blood tests and examinations by their family doctors. The study population’s age ranged from 30 to 75 years and their body mass index varied from 27 to 40. The hemoglobin A1C level that is a measure of severity of the diabetic condition ranged from 6.5% to 10%.

The high-protein diet was structured so that 30% of calories came from protein, 40% came from carbohydrates and 30% came from fat. With the high-carbohydrate low glycemic index diet 15% of the calories came from protein, 55% from low glycemic index carbs and 30% from fat. In both groups the total calorie intake per day was restricted to 1500 calories and the carbohydrates were given as low glycemic index carbohydrates (less processed). In both groups the diabetes was better controlled with hemoglobin A1C, triglyceride levels and cholesterol levels normalizing. Both groups also showed an equal amount of weight loss that stayed down as long the patients adhered to the diet. However, the high-protein group was able to reduce diabetes pills (metformin) and insulin achieving the same results as the high-carbohydrate low glycemic index group that could not reduce their medications. The conventional approach is to use a low-fat, high-carbohydrate diet along with medication. However, this diet tends to lead to higher triglyceride levels, higher blood sugar levels and a reduction in the good cholesterol (HDL).

High-protein, Low-refined carb diet useful in controlling diabetes

High-protein, Low-refined carb diet useful in controlling diabetes

Dr. Mann who is a professor and head of the department of nutrition and food science at RMIT University, Melbourne, explained the people get confused when they hear the term high-protein diet as they think of the Atkins diet where the protein component was much higher. The diet that was investigated here is a more natural diet consisting of slightly higher protein and less processed carbohydrates. By containing more fat than in the conventional diabetic diet the patient is not getting hungry and finds it easy to stick to the diet, which leads to weight loss and improvement of the metabolism. Many patients can normalize their blood values and often even get off their diabetic medication (under careful supervision by their treating physician). The physician will address the three components of diabetic control (energy balance, glycemic control, and vascular complications) by recommending to the patient this high-protein/low-carb diet. This likely will replace the conventional approach of using a low-fat, high-carbohydrate diet.

More information about a Mediterranean type diet in firefighter’s, which is very similar to this study: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

Reference: 16th European Congress on Obesity, Geneva June 23, 2008

Last edited November 4, 2014

Jun
01
2008

You Are What You Sleep

By | Obesity, Stress management

Lack of sleep can lead to childhood obesity

Stressful lifestyles often contribute to physical disorders and psychological difficulties, but little has been known about the fact that unbalanced sleep patterns also dysbalance a healthy body weight. Jean-Philippe Chaput of Laval University, Quebec City presented some facts at the 16 th European Congress on Obesity in Geneva, that emphasizes the importance of a balanced sleep pattern. There can be not only too little sleep but also too much sleep, as Dr. Chaput found out by studying 276 adults. Those who had a pattern of short duration sleep (5 to 6 hours) and those individuals who slept 9 to 10 hours were 35% and 25% more likely, respectively to show weight gains of 5 kg compared to the group that slept for 7 to 8 hours. The most likely reason is an alteration of certain hormones: short sleepers had high leptin levels and low ghrelin levels. In a previous study on children it also became obvious that to little sleep increases the risk of overweight and obesity in children. It was also possible to establish the type of weight gain.

You Are What You Sleep

You Are What You Sleep

Short sleep duration in kids lead to abdominal fat rather than to overall body fat deposits. Too little sleep in children seems to have more health consequences than previously thought, as it is the most important risk factor for overweight in this group. The most important risk factor was sleep duration that is too short, followed by parental obesity, watching TV and lack of physical activity.

More information about sleep apnea: http://nethealthbook.com/ear-nose-and-throat-diseases-otolaryngology-ent/nose-problems/sleep-apnea/

Reference: From the 16th European Congress on Obesity, May 2008

Last edited November 3, 2014

May
01
2008

Glucose and Colorectal Cancer Are No Sweet Deal

By | Cancer, Diabetes, Heart Disease, Nutrition, Obesity

It has been noted in various publications that insulin resistance carries a host of health risks: aside from type 2 diabetes, there is cardiovascular disease. Also high insulin levels are associated with growth hormone like substances in the body. These substances are contributing to the development of some cancers.

There is other extensive medical literature stating that glucose (=sugar) and refined carbohydrate (cookies, cakes, French fries, doughnuts, bread, rice, potatoes)  intake lead to chronic inflammation in blood vessels throughout the body, but also to a weakening of the immune system. This explains why such varied diseases as high blood pressure, hardening of arteries with resulting strokes and heart attacks, diabetes, asthma and cancer are caused by the same chronic inflammation that in turn is brought on by our eating habits of a refined diet consumed by most industrialized nations. This blog deals only with cancer of the colon and cancer of the rectum as a result of  chronic inflammation.

Researchers from Minnesota and Maryland examined 375 individuals with recurrent polyps (=adenomas) and the identical number without recurrent adenomas. They followed the course of the patients for 4 years. In their study they looked at fasting serum. Patients who were found to have the highest levels of both insulin and glucose in their serum were at an approximately 50% higher risk of colorectal cancer recurrence. The strongest risk factors were elevated glucose levels.

Glucose and Colorectal Cancer Are No Sweet Deal

Glucose and Colorectal Cancer Are No Sweet Deal

The individuals with the highest glucose levels also tended to be slightly older, have a higher waist to hip ratio and a higher body mass index. These results do point out the necessity of keeping a close tab on glycemic control in person with a history of colorectal polyps. It also is evident that consuming foods with a low to medium glycemic index will help to reduce the risk for colonic cancers.

More information about:

1. Colon cancer: http://nethealthbook.com/cancer-overview/colon-cancer/

2. Sugar causes cancer: https://www.askdrray.com/sugar-as-a-cause-of-cancer/

Reference: The Medical Post, April 1, 2008, page 21

Last edited November 3, 2014

Mar
01
2008

U.S. Dietary Guidelines May Have Contributed To Obesity

By | Nutrition, Obesity

Dr. Paul Marantz of the Albert Einstein College of Medicine, New York has taken a closer look at the current obesity epidemic. He and his coauthors are observing that Americans have listened to the recommendations to reduce their fat intake. This recommendation which first made its appearance in 1980 pointed out the risk of a high fat diet and its connection to cardiovascular disease. Even though there is enough evidence that a modification of fat intake could reduce cholesterol, the government guidelines against fat have not managed to improve cardiovascular disease outcome. The authors of the publication noted that Americans have slightly reduced their fat intake, but their carbohydrate and total calorie intake have actually increased. The consequence is logical: higher calorie intake is contributing to the rise in obesity and the increase in adult onset diabetes. Dr. Marantz drew on records from the Centers for Disease Control and Prevention to arrive at these results. From 1971 to 2001 fat intake has decreased by 9% in women and 5% in men, but carbohydrate intake went up by 6% in women and 7% in men. Total daily caloric intake went up by 335 calories in women and by 168 calories in men. Both genders showed an increase in obesity. While 55% of men and 41% of women were overweight or obese in 1971, by 2001 the rate had risen to 70% in men and 62% in women. The reasons for this are very likely due to many factors. Aggressive marketing of low-fat foods may have given the public the impression, that these foods can be consumed without consequences.

U.S. Dietary Guidelines May Have Contributed To Obesity

Obesity on the rise since the 1970’s

Another reason likely is that fat in the diet can induce satiety and stop us from eating excess calories. It has not helped to label fat in the diet as an enemy instead of pointing out that small amounts of heart healthy fats in the daily diet are an important part of our nutritional team players and allies in the quest to good health. Key to successful dieting is to consume a low fat diet, rich in unrefined, low glycemic carbohedrates. Caloric intake has to be restricted for successful weight loss.

More information about:

Refined carbs: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

Metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: American Journal of Preventative Medicine, Feb. 8, 2008

Last edited November 3, 2014

Sep
01
2007

Weight Loss Surgery Reduces Mortality

By | Diabetes, Heart Disease, Nutrition, Obesity

Excessive bodyweight contributes to a host of illnesses. Diets and lifestyle changes, physical activity and exercise programs can contribute to successful weight loss, but for a group of patients morbid obesity remains a significant problem. Weight loss surgery, also known as bariatric surgery has been on the increase.

Opinions about the usefulness of bariatric surgery have been divided. Often it was seen as a heroic effort with lots of risks and questionable benefits. In some procedures patients did not show significant weight loss, and there were some doubts whether the risk of surgery was worth taking.

Dr. Lars Sjoestroem of Gothenburg University has a detailed study on 4,047 Swedish patients with obesity, of which 2,010 underwent bariatric surgery, while 2,037 received non-surgical treatment. The two groups were compared for overall mortality after 11 years. The non-surgical control group lost little or no weight. The bariatric surgery patients did better. The most successful group was the one which received gastric bypass surgery with a weight loss of 25%. Vertical-based gastroplasty patients lost 16% of their weight, and those who underwent gastric banding lost 14% of their weight over 10 years.

Weight Loss Surgery Reduces Mortality

Gastric bypass surgery

At follow up the overall mortality was significantly decreased in the group that underwent surgery. Death risk from disease which is associated with obesity, such as coronary artery disease was significantly decreased by 56%. The risk of death from diabetes was decreased by 92% and the risk of death from cancer also showed a reduction of 60%.

US data show similar results of a decrease in long-term mortality in obese patients who underwent bariatric surgery and lost weight.

More information on weight loss: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/weight-loss/

Reference: August 23, 2007 issue of The New England Journal of Medicine.

Last edited November 3, 2014

Jul
01
2007

Estrogen In Early Menopause Saves Lives

By | Alzheimer’s disease, Anti-aging medicine, Heart Disease, Hormones, Obesity, Stroke

Introduction

In the June 21, 2007 issue of the New England Journal of Medicine a randomized study of  8.7 year duration the question was examined whether postmenopausal women following hysterectomy would have a higher risk with estrogen replacement therapy than controls who did not take estrogen therapy. The lead author was Dr. JoAnn E. Manson of Harvard Medical School and the method chosen to examine the heart disease risk was a CT of the heart to measure calcium  in plaque of coronary arteries.

Previous research had shown a good correlation of calcification of coronary arteries with the degree of hardening of coronary arteries as shown in this image.

Various doses of estrogen were used and overall there was a reduction of calcium scores in all of the groups ranging from 22% to 31% when the calcium scores of the estrogen treated patients were compared to the non treated controls. This translated into 36% to 64% less heart attack rates when the treated groups were compared to the controls not treated with estrogen.

Discussion regarding estrogen replacement therapy

The discussion regarding estrogen replacement therapy following menopause is not finished, but women can be reassured that the cardiovascular risk appears to not be as straight forward as research seemed to suggest in the recent past. There likely was a bias in these retrospective studies and the present prospective study is much stronger having been done over 8.7 years following randomization. As this study was done on patients who had previous hysterectomies, there is no concern about uterine cancer. Breast cancer risk was not examined in this study.

Estrogen In Early Menopause Saves Lives

Estrogen In Early Menopause Saves Lives

The authors concluded that low dose estrogen replacement with 0.625mg of conjugated estrogen (Premarin) appears to be safe and has the most beneficial effect on coronary artery health when taken between the ages of 50 and 59. However, the authors also cautioned that estrogen would have multiple effects and may have negative effects on the cardiovascular system in some other way.

Reference: N Engl. J Med. 2007;356:2591-2602

Comment

Comment on Nov. 18, 2012:  The real problem of this study is that the authors took the wrong “hormone replacement”, namely Premarin, which is a non-bioidentical estrogen concoction from horses, which translates into an ill fitting key. The human body’s estrogen receptors do not fit this “key”. The proper experimental set-up would have been to use bio-identical estrogen hormones, which are usually given as a cream and would be the perfect key for the human estrogen receptors. This would have to be balanced with bio-identical progesterone to achieve a balance the way it is in a younger woman. We know from other studies that this prolongs life by preventing coronary artery disease, prevents Alzheimer’s disease, prevents strokes and does not cause uterine cancer or breast cancer. Women on bio-identical hormone replacement also retain their normal sex drive.

See this chapter on menopause in the Net Health Book.