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.

Jul
01
2007

Waist line reduction scores in health prevention

By | Health, Hormones, Men's Health, Nutrition, Obesity, Prevention

To women waist measurement has always been of importance. Increased waist measurement and weight gain go hand in hand, and a poor fitting garment in the waist usually signals to cut out the junk food. In the past century extremely tiny waists became an unhealthy obsession, till common sense got the upper hand.

In the past males seemed to be unperturbed by a large girth and often ridiculed the opposite sex about their preoccupation with their waist lines. With more knowledge about the intricate play of metabolism increased waist circumference is a signal to health problems. It may be that a simple measuring tape can be one of the most helpful tools to predict a group of health problems in males. While type 2 diabetes, hypertension and high cholesterol and triglycerides are the problems that would first come to mind, there are more, namely coronary artery disease, prostate enlargement, a high prostate-specific antigen level, erectile dysfunction and ejaculatory dysfunction. Dr. Steven Kaplan, professor of urology at Cornell University, New York presented a study at the American Urological Association. Men with moderate to severe urinary tract symptoms were divided into groups based on their waist sizes, 30 to 36 inches, 36 to 40 inches and greater than 40 inches.

Waist line reduction scores in health prevention

Waist line reduction scores in health prevention

Results surprised even the researchers. Metabolic disorders like diabetes showed an incidence of 11.25% in the first group, 22.3 % in the next higher group and 37.8% in the group with waistlines over 40 inches. Erectile dysfunction was seen in 34.6%, 49.5% and 78.6 % respectively. The percentiles for hypertension showed 12.6% in the first group, versus 24.7% and 37.8 %. The researchers stressed that male pelvic dysfunction and the derailment of metabolic function, also known as the “metabolic syndrome” are closely linked.

More information about metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Last edited November 2, 2014

Nov
01
2006

Body Can Fight Weight Loss

By | Nutrition, Obesity, Weight loss

Embarking on a weight loss program needs long-term commitment and persistence. Many dieters have experienced the yo-yo effect of good initial results in losing weight, after which the weight loss stopped, and gradually the weight was gained back. Often dieters blame themselves for their lack of success or are criticized for a lack of self-control.
The “plateau effect” has been discussed and documented before, and now an Australian study has found that “it is not just you”. After initial success and weight loss the human body is designed to strongly resist attempts to lose weight. Dr. Neil King from Queensland University of Technology does research on appetite regulation and energy balance. He conducted studies on groups of people who were overweight and obese people. He found that weight loss from exercise and calorie restriction stops at a certain point, and this plateau remains firmly in place for a prolonged time, despite continuing dieting and exercise.

In the first study 30 obese men and women from Britain took part in a 12-week, laboratory based exercise program in which they exercised five times a week. The second study observed the weight loss in 200 Australian men who were enrolled in a commercial weight loss program, which involved both an exercise program and dietary advice. Although both groups followed different plans, their weight loss still plateaued. The first group averaged a loss of 3 kg during the first 8 weeks, and weight loss in the next 4 weeks was markedly reduced (0.7 kg). The second group had a variable pattern of weight loss, but it, too, showed a plateau.

Body Can Fight Weight Loss

Body Can Fight Weight Loss

Researchers believe that the human body is designed to cope with famine. As a result there is a built-in mechanism responsible for weight loss resistance. It may be a source of frustration to people on a weight loss program in a society where there are no food shortages, but it is meant to be a lifesaver in times when there was a shortage of food.
For the person who wants to lose weight it involves taking a closer look at the caloric output. Longer exercise times, higher intensity or cross training can combat the plateau effect, but patience is also needed along with the determination to carry on with the program.

More information about weight loss: http://nethealthbook.com/health-nutrition-and-fitness/weight-loss-and-diet/

Reference: The Medical Post, October 10, 2006, page 19

Last edited November 1, 2014

Nov
01
2006

Diverticulitis Associated With Obesity

By | Gastrointestinal Disease, Nutrition, Obesity

Medical textbooks used to describe acute diverticulitis as a disease that was mostly seen in adults over 50 years of age. Researchers at the University of Maryland Medical Center have assessed the medical records of 104 patients ages 22 to 88 years with the condition of diverticulitis diagnosed between 1999 and 2003. 56 patients (54%) were age 50 or younger, and the remaining 48 (46%) were over 50. The researchers found that a significantly higher proportion of patients (88 %) with abdominal obesity were present in the younger age group with diverticulitis.
Acute diverticulitis is a condition characterized by the chronic inflammation of sacs in the intestinal tract. The condition causes constipation and severe abdominal pain. It is usually related to a low fiber diet containing refined carbohydrates or processed foods.
Dr. Barry who was leading the study observed that the younger the patients with diverticulitis are, the more obese they are likely to be.

Diverticulitis Associated With Obesity

Diverticulitis Associated With Obesity

Also, he found the younger they are when they get the disease, the more likely they will get recurrent attacks, and he sees the most important point in diverticulitis prevention is a change to healthy eating habits without over-processed food from fast food outlets.

More information about diverticulitis: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/diverticulitis/

Reference: The Medical Post, October 10, 2006, page 1 and 60

Last edited November 1, 2014

Oct
01
2006

Lowering Cholesterol Aggressively Saves Lives

By | Diabetes, Heart Disease, Obesity, Stroke

A 5-year multinational prospective study (“Treating to New Targets or TNT Study” involving top cardiologists from around the world has found significant benefits in using higher doses of statins. They investigated the effects of increasing the statin concentration (a cholesterol lowering medication) and have now come to new insights how to approach the metabolic syndrome, which is the metabolic derangement associated with obesity. Of 10,001 patients aged 35–75 years with clinically proven heart disease 5,584 patients had metabolic syndrome at the same time. Half of them were put on 10 milligrams of Atorvastatin (brand name: Lipitor, made by Pfizer Inc.), the other half on 80 milligrams per day. They were followed for 5 years and many questions were asked, blood tests done and statistics kept. Of particular concern was whether survival rates and numbers of heart attacks or strokes would be different for the various groups. The major focus of interest was on people who were over weight or obese.

As the image above shows, percentages of complications (heart attacks and strokes) were used as clear end points of cardiovascular complications to measure the response to the statin. The results showed that two subgroups of obese patients, those who have at the same time diabetes and those who don’t, were both benefitting from the higher dose of Lipitor in an equal manner (about a 30% relative reduction of risk).

The amazing result was that dosage of the statin mattered very much. In the past it was thought that taking a pill for high cholesterol was all that mattered. However, now we know that physicians need to watch the blood level response of the bad cholesterol (LDL cholesterol) and titrate the abnormal levels down to a normal level by using adequate dosing. The authors came to the conclusion that metabolic syndrome patients with heart disease, and particularly those where diabetes was present at the same time, would need more intensive statin therapy (higher dosage) than patients who were only having cardiovascular disease. The new goal post for lowering the low-density lipoprotein cholesterol (LDL cholesterol) of 1.8 mmol/L (70 mg/dL) was recommended.

5-Year Study Shows Further Reduction of Major Cardiovascular Complications In Patients
(Expressed as %) With Metabolic Syndrome Using Higher Doses of Atorvastatin(P. Deedwania et al. Lancet 368, No. 9539: 919-928, Sept. 9, 2006)
 

 

 

 

 

 

 

 

 

 

This study showed that there was a 44% increase in absolute risk for an adverse outcome in coronary heart disease patients who also have metabolic syndrome than those without metabolic syndrome. This justifies a very aggressive treatment with Lipitor down to the new target blood values indicated above that your doctor needs to monitor. In high risk patients for heart attacks and strokes where more than 3 cardiovascular risk factors are present the patient’s outlook (longer survival) can be improved by several years. This was shown with treatment using the higher dose of Lipitor when blood levels and cardiovascular complications were compared between 5 years of treatment and the treatment results after the first year of the study.

More information on:

1. Treatment of a heart attack: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/treatment-heart-attack/

2. Metabolic syndrome and obesity: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: The Lancet 2006; 368:919-928 (09 September 2006)

Last edited November 1, 2014