A Weight Lifted

Diabetes: Diabetes And Alzheimer's Disease Linked By Salk Institute Study

Did you know that people with type 1 or type 2 diabetes have a 30 to 65 percent greater risk for Alzheimer's? Until now, researchers have been mystified as to the reason behind the link, but a recent study (published in the current online issue of Neurobiology of Aging by the Salk Institute for Biological Studies) has pinpointed the molecular connection.

David R. Schubert, Ph.D., professor in the Cellular Neurobiology Laboratory, and his team report that the cranial blood vessels of young diabetic mice sustain damage from the interplay between elevated blood sugar levels and low levels of beta amyloid, a peptide that forms the senile plaques in Alzheimer's disease.

"Our data clearly describe a biochemical mechanism to explain the epidemiology, and identify targets for drug development," says Dave R. Schubert, Ph.D.

Salk researchers Schubert, Burdo and Qi Chen, along with diabetes expert Nigel Calcutt, a pathology professor at UCSD, selected mice whose genetics predisposed them to Alzheimer's and then induced type 2 diabetes  to study the damage to their vascular systems. The mice's blood vessels became damaged long before they suffered overt signs of Alzheimer's disease.  The overproduction of free radicals, they determined, caused oxidative damage to linings of cells in cranial blood vessels.

"While all people have a low level of amyloid circulating in their blood, in diabetics there may be a synergistic toxicity between the amyloid and high level of blood glucose that is leading to the problems with proper blood vessel formation," says Burdo.

In the U.S., incidences of Alzheimer's and type 2 diabetes are both growing at a concerning rate. 1 in 10 people over 65 develops Alzheimer's and that jumps to nearly half of all people over 85. About 20 million Americans, most of whom are over 60, have either type 1 or type 2 diabetes.  That figures out to be roughly 7 percent of the population.

Disordered Eating: The "New" Epidemic

Several years ago I was on a media tour in New York, visiting various women's magazine editors in an attempt to get them to think about publishing different kinds of stories on eating and weight loss and weight loss programs. My focus: That women (and increasingly men) were suffering from disordered eating -- too much focus on calories, fat grams, weight loss, even 'healthy' choices. The response I remember from one prominent magazine in particular was that the term 'disordered eating' was too 'scary,' that it was even too sensational for magazines (imagine that!).

So imagine my relief that they have finally jumped on board (although I do admit a bit of exasperation that they didn't even talk to me in putting together their story on the issue!). Self magazine recently published the results of survey that showed '65 percent of American women are disordered eaters." MSNBC published this story on the survey:

The disorder next door: Alarming eating habits

SELF poll reveals 65 percent of American women are disordered eaters

By Tula Karras, SELF

SELF's groundbreaking survey reveals that more than six in 10 women are disordered eaters. Another one in 10 has an eating disorder. Find out if you're at risk and how to get healthier, starting today:

Michelle Marsh, 32, of Harrisburg, Pennsylvania, seems like the perfect dieter. If you ran into the 5-foot-1-inch, 103-pound marketing specialist checking food labels for calories in the supermarket or powering through one of her seven weekly workouts, you'd envy her ability to control her intake and burn off any excess, too. But Marsh, who had her first baby nine months ago and is now below her prepregnancy weight ("I'm the tiniest I've ever been!" she says), could be the poster girl for an unrecognized epidemic among women: disordered eating.

No, she doesn't starve herself to an unnatural weight (like anorexics) or throw up daily (like some bulimics), but she doesn't seem to have a healthy relationship with food or her body, either. "I spend about half my time thinking about food and meal planning," she says, although her meals don't require much planning — she usually restricts herself to the same foods every day (oatmeal, brown rice and two small corn tortillas with chicken and a sweet potato). "I weigh myself every morning, and if the scale goes up a pound, I exercise more. If I gained 5 pounds, I'd be very upset."

To read the rest of the story, go to http://www.msnbc.msn.com/id/24295957/. They even have tips at the end of the story for moving away from disordered eating and achieving healthy weight loss, if it's in your cards. The tips echo what we've been saying at Green Mountain at Fox Run for years. It's nice to know they've gone mainstream.

Diabetes: Diabetes UK Funds Trial To Explore Effects Of Chocolate Compound

Older women with type 2 diabetes have a five-fold increased risk for developing heart disease than women of the same age who do not have diabetes. Statin drugs are generally indicated for heart disease, but there may be an alternative: chocolate - or, at least - flavonoids that can be found in cocoa. 

A three year study has just been funded by Diabetes UK to research the potential heart-protecting properties of flavonoids.

But don't throw your healthy eating plan to the curb! Diabetes UK advises against consuming large amounts of chocolate.

"We certainly don't advise people to start eating a lot of chocolate as it's very high in sugar and fat", said Dr. Iain Frame, Director of Research at Diabetes UK. "We would always recommend that people with diabetes eat a diet low in fat, salt and sugar with plenty of fruit and vegetables."

Soy protein, which also contains flavonoids, has been shown in clinical studies to have a protective effect on the heart, blood vessels, and kidneys of patients with type 2 diabetes.

Look for this week's healthy recipe which will feature both soy and chocolate!

Read our other blog posts on chocolate and soy:

More Good News on Chocolate!
Healthy Eating – Is Chocolate the Answer?
It's That Chocolate Time of Year Again
So, So, Soy
Soy Protein Beneficial in Type 2 Diabetics

Diabetes: Soy Protein Beneficial in Type 2 Diabetics

People with type 2 diabetes may benefit from a healthy eating lifestyle that includes soy protein. In the journal Diabetes Care, researchers reported that the heart, blood vessels, and kidneys are positively affected in type 2 diabetes patients who consume soy protein.

Over 4 years, the Iranian study followed 41 patients with type 2 diabetes, twenty of whom ate a diet that contained 35 percent animal protein, 35 percent textured soy protein and 30 percent vegetable protein. The other patients were the control group, and they consumed a diet that consisted of 70 percent animal protein and 30 percent vegetable protein. 

Dr. Leila Azadbakht, of Isfahan University of Medical Sciences, and colleagues determined that consuming soy protein lowered fasting blood sugar level, total cholesterol, LDL cholesterol, and triglycerides. Also reduced were indicators of inflammation called C-reative proteins and other urinary markers of kidney disease.

In the past, other shorter studies have shown the potential benefits of soy protein, but apparently, this is the first study that indicates these benefits are lasting and stable over the long term in people with type 2 diabetes.

Read So, So, Soy for more information about soy protein.  Want to try using soy in a healthy recipe? Rigatoni with Zucchini and Onions is a easy and delicious way to go.

Overcome Self-Doubt to Build Self Esteem

My daughter first looked at me strangely when I mentioned to her that her "I feel fat" thoughts really weren't about her body. I explained that fat is not a feeling; instead, when we think we feel fat, we're usually distracting ourselves from something else that's bothering us. For many of us, negative body image often has to do with feelings of insecurity -- we're worrying about how we're falling short in some area.

To the rescue: Tips from one of my favorite e-letters -- that from Annette Colby. She recommends we try the following tips when fears and self-doubt threaten to overwhelm us.

1. Awareness Recognize the fear and doubt within you. The first step to overcoming doubt is to be willing to face the situation. By being honest and admitting that you have doubts can you seek alternatives.

2. Acceptance
Understand that it is all right to have doubt. What matters most is that you love yourself enough to overcome your doubt by taking calculated risks.

3. Explore Your Fears
Take out a piece of paper and write down a list of your fears. Explore your doubt, examine your fear, and look at the areas in your life where they get the upper hand.

4. Examine Your Excuses
Write down your reasons for not pursuing a personal challenge or moving forward on something important to you

5. Say Good Bye
Write a goodbye letter to your doubt, then bury it, burn it, or release it in some other creative way.

6. Mirror Mirror On the Wall
When your doubt pops up, go to the mirror and talk to yourself. Positive talk isn’t the entire answer, but without we haven’t got a chance of success. People are more successful when they talk to themselves in a reassuring, compassionate, and loving way.

7. Build Self-Esteem
Keep reminding yourself that you are valuable, that you have worth, and that your life matters.

8. Take Positive Action
Take positive action in the direction of your dreams. You can put doubt in it’s place when you take action on the activities and goals that are most important to you.

9. What's the Best that Could Happen
Imagine the best possible outcome. Practice allowing yourself to envision yourself being the person you want to be.

10. Take Care of Yourself
Take some action every day that allows you to feel better about yourself.

No matter what self-doubt is blocking our way to -- whether it be successful weight loss or going after our dream job -- these tips can help us move forward. The bottom line is believing in ourselves because our minds are the most powerful tool we have to help us achieve our dreams.

Meditation for Healthy Living & Healthy Eating

I recently began meditating as a way to help myself move forward in life, to find what I want to do with the rest of my life and get out of the rut that I felt myself in. So on the vacation that I just returned from, it was good that my two girlfriends were as interested in meditation as I was. We took time each morning we were in Sicily to spend time focused inward. I do believe it made our time there more fun, as I certainly felt calmer and more able to deal with the anxiety of navigating a country in which I do not speak the language -- and not many of the folks there speak English that well.

We've talked about the value of meditation before on this blog and covered it in length in an article on mindfulness in meditation Here's how we describe the value of meditation:

The practice of meditation is about relaxing in order to focus: a daily session in which we intentionally focus our minds on something, such as our breath or a word. When the mind inevitably strays to a thought or emotion, we bring our attention back to the chosen focus. By letting thoughts and feelings pass without judging them, most regular meditators describe feeling more relaxed, less anxious and therefore less disturbed by negative thoughts, feelings, and perceptions.

Meditation can also help us with eating struggles, such as binge eating, eating to manage type 2 diabetes, or just plain eating well. To wit:

Meditation can be very useful for people who struggle with eating. The relaxed, upright posture produces a calmer, more balanced emotional state. Watching the mind, being aware of thoughts, feelings and sensations, and bringing the mind back to a focus gradually trains us to be a “witness” rather than “victim” of our own states. Every time we bring the mind back to the focus, it is like exercising a muscle in the gym—the ability to let go of disturbances and focus the mind grows stronger. Gradually, we recognize that thoughts and feelings are temporary experiences, arising and falling away like waves in the ocean.

I try to spend about 20 minutes a day meditating, but shorter or longer periods are useful, too. That's just the amount of time that seems to work for me. And now -- excuse me -- I need to go meditate. I've got a lot of catching up to do after being gone for two weeks, and meditation will help me approach what seems like an overwhelming amount to do in a more relaxed fashion.

Ciao for now!

Diabetes: Big Apple's Big Problem - Obesity and Type 2 Diabetes on the Rise

NYC's Department nad Health and Hygiene reports that type 2 diabetes and obesity increased by 17 percent between 2002 and 2004.  Nationwide, obesity has gone up by 6 percent and the diabetes rate has remained static at 7 percent.

The study, which is published in April's issue of Preventing Chronic Disease, involved a telephone survey of around 10,000 Big Apple adults.  Responses to the Community Health Survey was compared to a similar national survy called the Behavioral Risk Factor Surveillance System.

In 2002, 19.5 percent of the city's adults were obese; in 2004, 22.8 percent were, the study said. Diagnosed type 2 diabetes cases rose from 8.1 percent of New Yorkers to 9.5 percent, the study said.

Pending Fast Food Legislation

Thomas Frieden, NYC Health Commissioner, has spearheaded a new city ordinance that requires fast-food chains to post calorie counts and he says that this study underscore the pressing need for such legislation.

On the grounds that the new law violates free speech, a restaurant trade group's law suit has delayed the legislation from taking effect at the end of March. A court ruling is expected by mid-April.

(Read full article on Yahoo News)

Diabetes: Tart Cherries May Reduce Inflammation, Lower Risk For Type 2 Diabetes & Heart Disease

A new study shows tart cherries, one of today's hottest "Super Fruits," may help reduce inflammation, potentially lowering the risk of type 2 diabetes and cardiovascular disease in animals. The study was presented by University of Michigan researchers today at the Experimental Biology annual meeting. As science continues to reveal inflammation may be a marker for many chronic diseases, the researchers say emerging studies like this are important in examining the role diet may play in disease management and prevention.

"We're learning how important reducing inflammation is for our overall health and lowering the risk for heart disease and type 2 diabetes - two of the most critical health epidemics we have in this country today," said study co-author Dr. Steven F. Bolling, a cardiac surgeon at the University of Michigan Cardiovascular Center who also heads the U-M Cardioprotection Research Laboratory, where the study was performed. "This study offers further promise that foods rich in antioxidants, such as cherries, could potentially reduce inflammation and lower disease risk."

Tart cherries, frequently sold as dried, frozen or juice, contain powerful antioxidants known as anthocyanins, which provide the bright, rich red color. Studies suggest these colorful plant compounds may be responsible for cherries' anti-inflammatory properties and other health benefits.

This new study is the latest linking this red hot "Super Fruit" to protection against heart disease and inflammation. In fact, research suggests the red compounds in cherries that deliver the anti-inflammatory benefits may also help ease the pain of arthritis and gout. There have been more than 65 published studies on the potential health benefits which can be found in the Cherry Nutrition Report posted on http://www.choosecherries.com.

(Read full article in Medical News Today)

Diabetes: Tai Chi May Improve Type 2 Diabetes

Researchers in Taiwan assert that moderate exercise like Tai Chi can help people with type 2 diabetes to control or improve their condition. According to their recent study, which will soon be published in the British Journal of Sports Medicine, strenuous physical activity depresses the immune system response whereas moderate exercise seems to boost it.

"This interesting new research further confirms that moderate exercise is vital in effectively managing Type 2 diabetes," said Cathy Moulton, Care Advisor at Diabetes UK. "Good diabetes control reduces people's risk of developing serious complications such as heart disease, stroke and blindness. "

Examples of Moderate Exercise

"Any activity that leaves you feeling warm and slightly breathless but still able to hold a conversation counts as moderate exercise," says Moulton, "including vigorously cleaning the house, briskly walking the dog and, of course, Tai Chi."

Tai Chi, a form of martial arts, involves breathing deep from the diaphragm combined with gentle movement and relaxation.

"In addition to the importance of moderate physical activity, the relaxation element of Tai Chi may help to reduce stress levels, preventing the release of adrenalin which can lead to insulin resistance and high blood glucose levels."

Diabetes UK recommends that people with type 2 diabetes do a minimum of 30 minutes of moderate physical activity on at least five days of the week. 

Type 2 Diabetes: 60 Minutes Explores the Effect of Sleep Deprivation in 'The Science of Sleep'

Last night, many people (myself included) tuned into 60 minutes to watch the interview with Dennis Quaid and his wife about the hospital error that almost killed their newborn twins last year. It's another segment, however, on sleep deprivation which caught my eye and is also getting a lot of buzz today on internet message boards.

In the recent 60 minutes episode called The Science of Sleep, Part 2 (link to video), correspondent Lesley Stahl opens by announcing an interesting statistic - Americans report receiving an average of 6.7 hours of sleep, down from 8 hours in less than a generation. Stahl interviewed Eve Van Cauter, an endocrinologist at the University of Chicago School of Medicine, who studies the effect of sleep on the body (excerpt from CBSnews.com):

At [Cauter's] lab, healthy, young volunteers...are paid to come one at a time and have virtually every system in their bodies monitored while their sleep is interfered with.

"We did a study where we restricted sleep to four hours per night for six nights," Van Cauter explains. "And we noticed that they were already in a pre-diabetic state. And so, that was a big finding."

The study's subjects were on the road to type 2 diabetes in just six days, and that’s not all - they were also hungry. Van Cauter has made a radical discovery: that lack of sleep may be contributing to the epidemic of obesity in this country through the work of a hormone called leptin that tells your brain when you’re full.

"We observed that the volunteers, they actually had a drop in leptin levels," Van Cauter explains. "Leptin was telling the brain, 'Time to eat. We need more food.'"

Van Cauter's research is new in that it demonstrates a correlation between the lack of deep sleep - to be distinguished from REM or light sleep - and health issues.  In fact, says Cauter, as we age naturally, we automatically spend less and less time in deep sleep.  This raises an interesting question about the diseases - such as high blood pressure, high cholesterol - that we normally associate with aging.  It also sheds light on a possible cause of type 2 diabetes and obesity in younger adults, teens and children, all of whom, Cauter says, are receiving less and less sleep. 

Cauter agreed with Stahl that health experts should add 'sleep' to their normal mantra of 'diet and exercise.' When asked about napping, Cauter says there is debate on whether not getting 8 consecutive hours of deep sleep or napping to increase the cumulative time spent sleeping is more important for preventing health problems.

We've posted several blogs on the importance of sleep, weight loss, and a healthy lifestyle as well as the connection of sleep deprivation and type 2 diabetes.  Some of our posts include: A Weight Lifted: Sleep Like a Baby and Lose Weight?, A Weight Lifted: When Getting Your ZZZ’s Seems like Mission Impossible, and Diabetes: Short, Long Sleep Duration Raises The Risk For Diabetes.

A Time of Change

Spring is a glorious time of year, especially here in the Northeast where we've been buried under snow for months (or if it's been a snowless winter, the brown landscape gets pretty dreary). Spring represents change at its best -- a time of growth, a time of awakening, a time to celebrate.

Many of us don't look at change that way in our personal lives, however. We may actively resist it, instead of seeking out the positive aspects of change. My favorite self-help website, Daily OM, describes the benefits of change this way:

It is only through change that we are able to grow. Transformation takes you out of your comfort zone so you can evolve. A change will always bring new experiences and add different elements to your life. In the midst of change, we learn how to handle a fresh set of variables. As we adapt, we assimilate this change into our beings; we have already grown when we become more than we were just a moment before. When you allow change to happen naturally today, any plans you make will be able to evolve organically so that you can realize your dreams.

Women who come to Green Mountain are seeking change -- change in how they eat to adopt healthy eating, how they move their bodies to start to enjoy exercise, how they think about themselves to improve body image and how they view the world around them. They may not realize the seek change in all these areas, but all these areas generally get touched upon in the journey to taking better care of ourselves.

Change is not always a smooth course to the finish. Witness snowstorms in April -- we've even seen snow in June in these parts! But one thing is true about Spring -- it's persistent. It's there regardless of the form it takes, and it leads the way to sunnier times.

Of course, lifestyle change is the same. It can get pretty bumpy. But staying positive, and keeping our eye on the goal can keep us going. Try this affirmation: I embrace the change that is inevitable in my life, to find the positive and continue to grow into the person I want to be.

Diabetes: More Evidence How Overeating, Obesity and Elevated Blood Sugar Contribute to Insulin Resistance

Overeating and obesity can eventually decrease the body's sensitivity to insulin, in part by disabling the body's 'sugar switch' which allows blood sugar to rise and leads to type 2 diabetes.  Elevated high levels of serum glucose, in turn, make insulin resistance worse in a vicious cycle.

The Sugar Switch

Normally, this 'switch' or enzymatic pathway shuts down the liver's sugar production when insulin levels rise. But if blood sugar starts to go haywire due to habitual overeating or obesity, the body's 'sugar switch' gets turned off. 

"The islet cells in the pancreas can compensate with increased insulin production only for so long when confronted with chronic obesity and inactivity," says Marc Montminy, Ph.D., a professor in the Clayton Foundation Laboratories for Peptide Biology, who led the study. "As a result glucose levels start to rise causing a host of problems."

In the March 7 issue of Science, resarchers at the Salk Institute for Biological Studies theorize that inhibiting the enzymes that keep the 'sugar switch' turned off may be a helpful treatment for lowering glucose in people with type 2 diabetes, which, in turn, reduces the risk for complications such as blindness, stroke and renal failure. 

A new treatment may help control serum glucose in the future, but may not be a substitute for exercise and healthy eating - proven methods for regulating/normalizing high blood sugar and improving type 2 diabetes.

(Read full article in Medical News Today)

Diabetes: Link Found Between Excessive Nutrient Levels And Insulin Resistance

A missing link in how the insulin system is triggered and halted has now been found, which may lead to new treatments for type 2 diabetes patients.

Researchers at the Salk Institute for Biological Studies have discovered how the enzyme OGT (short for O-linked ß-N-acetylglucosamine transferase), is the last link in a chain of enzymes that are responsible for transport sugars in and out of cells.

OGT and Fat Storage

OGT apparently shuts down insulin signaling soon after the body begins to pull glucose from the blood stream, causing the sugars to be stored in fat pads on in the liver.

"For the first time we have a real understanding of how the insulin signaling system is turned on and off," says Howard Hughes Medical Investigator Ronald M. Evans, Ph.D., a professor in the Salk Institute's Gene Expression Laboratory, who led the study that appears in the Feb. 21 issue of Nature.

With abundant food, excessive quantities of nutrients increase these enzyme levels, resulting in a dampened insuling response and a progresion of insulin resistance.

Insulin Resistance and Type 2 Diabetes

Most people with insulin resistance will eventualy have type 2 diabetes within a decade, unless they lose 5-7 percent of their body weight with healthy eating and fitness. Successful permanent weight loss can be difficult; these new findings may lead to drugs that make it easier to control blood sugar, lose weight, and help type 2 diabetes to go into remission.

Evans hopes that "this [discovery] could lead to a new class of insulin-sensitizing drugs that loosen the brake and let insulin work a little bit longer."

Diabetes: Hispanics Have More Difficulty Controlling Type 2 Diabetes/Diabetes Than Non Hispanic Whites

Results of an analysis of multiple studies show type 2 diabetes and diabetes control is more challenging for Hispanics than non-Hispanic whites, according to researchers at Wake Forest University Baptist Medical Center and colleagues.

The results revealed that Hispanic patients with type 2 diabetes have approximately 0.5 percent higher levels on a test that measures blood sugar control, called the A1C test, than non-Hispanic white patients. The researchers noted the consistency of these findings across the studies.

An A1C test measures hemoglobin linked with glucose, or blood sugar, over a time period of two to three months. Higher A1C values indicate type 2 diabetes patients have difficulty controlling their blood sugar.

The results of the "meta-analysis" are reported in the February issue of Diabetes Care.

"A high percentage of Hispanics in this country have low incomes, no health insurance, and limited access to health care," said Kirk. "The Hispanic population has a high prevalence of [type 2 diabetes] and higher A1C than non-Hispanic whites. This further elucidates the health disparities that characterize the Hispanic population."

Read full article in Medical News Today. More information for Hispanics with diabetes may want to read "Prevengamos la diabetes tipo 2. Paso a Paso" ("Let's prevent type 2 diabetes. Step by Step") - a campaign from the National Diabetes Education Program.

Diabetes: The Impaired Fat-Burning Gene and Insulin Resistance

According to researchers, previously unknown cellular mechanisms are responsible for causing insulin resistance in people with type 2 diabetes.

A New Culprit for Insulin Resistance

The research team, led by Professor Juleen R. Zierath at Karolinska Institutet in Stockholm, has identified a 'fat-burning' gene.  The enzymes manufactured by this gene are necessary for cells to remain sensitive to insulin.  People with type 2 diabetes and high blood sugar have reduced genes in muscle tissue, fewer enzymes, and therefore reduced insulin sensitivity and impaired fat burning ability. It all adds up to an increased risk of developing obesity.

Insulin Resistance and Type 2-diabetes

The pancreas' inability to produce insulin and /or the body's lack of responsiveness to insulin occurs over time with type 2 diabetes, leading to a rise in blood sugar. Higher levels of glucose in the blood, in turn, promote insulin resistance, putting diabetics at risk for disease-related complications.

The Silver Lining

The impaired fat-burning cell can bounce back with a healthy lifestyle that includes fitness and healthy eating, or with medications.

"The expression of this gene is reduced when blood sugar rises, but activity can be restored if blood sugar is controlled by pharmacological treatment or exercise", says Professor Juleen Zierath. "Our results underscore the importance of tight regulation of blood sugar for people with diabetes."

Publication:
Down-Regulation of Diacylglycerol Kinase Delta Contributes to Hyperglycemia-Induced Insulin Resistance
Alexander V. Chibalin, Ying Leng, Elaine Vieira, Anna Krook, Marie Björnholm, Yun Chau Long, Olga Kotova, Zhihui Zhong, Fumio Sakane, Tatiana Steiler, Carolina Nylén, Jianjun Wang, Markku Laakso, Matthew K. Topham, Marc Gilbert, Harriet Wallberg-Henriksson, and Juleen R. Zierath
Cell, 8 February 2008, online 7 February 2008

Healthy Cooking vs. Healthy Eating Out

I was sitting in on a cooking class at Green Mountain yesterday where Chef Jon was talking about adding flavor to foods. His lively presentation showed how to make healthy eating fun. And his food proves he knows of what he speaks. Interesting combinations of ingredients that are often jazzed up by clever spicing.

At the end of the class, a participant noted that she just couldn't get up the interest in cooking for herself -- she lives alone and is surrounded by really good restaurants. My first response was that you can eat healthfully when eating out. In a good restaurant, there are generally lots of choices that don't spell trouble for healthy eating. Consider these ideas:

- Go simple. The more complicated a dish, the richer it is likely to be. Likewise, the more items we order, the more we're tempted to eat. So consider whether you really want an appetizer and an entree. If the appetizer really appeals, can you make it your entree?

- Listen to your body. If you really want the richer dish, remember that our bodies are very good at giving us signals when we've had enough...if we listen. Tune into those internal cues. They're likely to tell you that finishing the whole serving of fettucini alfredo isn't something your body wants. In general, restaurant portions are enough for a couple of meals.

- Go well-fed. That doesn't mean to eat right before you go. But you don't want to skip meals or 'save calories' in order to 'eat what you want.' All that does is set you up for overeating out of hunger. The fact is, the more well nourished we are over time -- that means regularly eating well-balanced meals and snacks that provides our bodies with sustenance -- the stronger we will be at making supportive choices when faced with a variety.

- Eat what you want on a regular basis. If you deprive yourself of foods you like, you'll be more vulnerable to food in general, less likely to be able to resist external cues that call to you to eat richer foods and more of them. Design your daily meals and snacks to include the foods you like. That way, when putting together a special meal, whether it be at home or in a restaurant, you'll be better able to balance your choices so that you enjoy the meal and enjoy what you feel like after.

Bon appetit!

Diabetes: What is Your Bra Telling You?

Okay, I've seen a lot of new studies on type 2 diabetes, but this one is a little 'brazere' bizarre!

"Diabetes is linked to breast size," reads the headline in The Sun.  The story goes on to report that "women who wear a large bra size are much more likely to develop diabetes than women with an A cup". Type 2 diabetes is often linked to lifestyle factors, such as obesity and a lack of exercise but "even after adjusting for such factors and any family history, researchers found that the risk was still high", the newspaper adds.

Dr Joel Ray from the Li Ka Shing Knowledge Institute, University of Toronto, Canada and colleagues from the Harvard School of Public Health, Harvard Medical School and the Institute for Health Sciences in the Netherlands carried out the study. Results, the analysis and the Nurses' Health Study II were supported by the Canadian Institutes of Health Research, the Research Division at St Michael's Hospital, Toronto and the US National Institutes of Health. It was published in the peer-reviewed: The Journal of the Canadian Medical Association.

Apparently, the researchers have looked at women's cup size and the rates of diabetes developing over 20 years in Canadian women. A link between breast size and diabetes was seen, but the researchers are unable to say from this study if the relationship is simply due to the overall weight or waist circumference increase you might expect in women who had larger than average breast size, as the link between obesity and type 2 diabetes is well known.

However, conclusions from this research are limited by the very strong association shown between body mass index (BMI) and the risk of developing type 2 diabetes.

Read full article in Medical News Today.

Diabetes: Caffeine Increases Blood Sugar in Type 2 Diabetics

Is it time to kick the caffeine habit?

It looks that way if you have type 2 diabetes. According to a recently published study, people with type 2 diabetes who drink the equivalent of four cups of coffee or more a day may experience an 8 percent rise (vs. non-caffeine days) in blood glucose levels.

Java junkies

Dr James Lane, a psychologist at Duke University Medical Center, in Durham, North Carolina, and colleagues, conducted the study which is published in the February issue of Diabetes Care. Lane notes that coffee is "such a common drink in our society that we forget that it contains a very powerful drug: caffeine."

Caffeine: the drug test

To see the effects of caffeine on blood sugar, patients included in the study could not be on insulin; rather, people were chosen only if they were trying to manage their type 2 diabetes through a healthy eating lifestyle, exercise, and other medications. In the double-blind study, subjects were given caffeine capsules equal to 4 cups of coffee alternating every other day with a placebo. All consumed a nutritional breakfast drink, but were on their own for lunch and dinner.

The results demonstrated the patients' average daily blood glucose levels went up by 8 per cent on the caffeine days. After meals the blood sugar levels jumped even higher: 9 per cent after breakfast, 15 per cent after lunch, and 26 per cent after dinner.

How does caffeine cause this rise in blood sugar?

"It could be that caffeine interferes with the process that moves glucose from the blood and into muscle and other cells in the body where it is used for fuel. It may also be that caffeine triggers the release of adrenaline -- the fight or flight -- hormone that we know can also boost sugar levels," said Lane.

A new prescription for diabetics: healthy eating and healthy drinking

Future research may decisively confirm that managing blood sugar is easier in patients with type 2 diabetes who give up caffeine. In the meantime, doctors may prescribe the elimination of caffeine for good measure.

"It's not easy," Lane acknowledges, "but it doesn't cost a dime, and there are no side effects."   

"Caffeine Increases Ambulatory Glucose and Postprandial Responses in Coffee Drinkers With Type 2 Diabetes." James D. Lane, Mark N. Feinglos, and Richard S. Surwit. Diabetes Care 31: 221-222.

Staying on Track with Healthy Eating

Our FitBriefing alert for the month of January alluded to lagging New Year's resolutions. It's pretty predictable. We start out strong the first of the year with our get healthy and lose weight resolutions, but as the month goes on, well, life does get in the way.

One thing that goes first for many food and weight strugglers are healthy eating resolutions. And many of us agree that diets often seem easier to follow than eating mindfully, because all the decisions are taken away. Diets tell us what to eat -- and what not to eat -- so we don't have to spend a lot of time thinking about it.

We can marry the eating structure of diets with the concept of mindful eating. It's all in how we think about it. In truth, eating structure goes a long way towards helping us stay on track with healthy eating and start to feel well and lose weight if we need to. Read our FitBriefing "Healthy Eating for Healthy Weight Loss: It May Look Like a Diet but It's How You Think About It" to understand this idea more, and start to put it in place in your life. This concept can make the difference between staying with our New Year's resolutions to eat well and reverting to old eating habits that don't get us where we want to go.

Btw, if you want notice each time we post a new FitBriefing, sign up here (if you don't want our brochure, just say so in the box for comments).

Diabetes: Possible Link Between Environmental Pollution And Type 2 Diabetes

Cambridge scientists, Drs. Oliver Jones and Julian Griffin, believe a link between persistent organic pollutants (or POPs) in the environment and insulin resistance, may lead to type 2 diabetes.

"Of course correlation does not automatically imply causation," says Dr. Jones. "But if there is indeed a link, the health implications could be tremendous. At present there is very limited information. Research into adult onset diabetes currently focuses on genetics and obesity; there has been almost no consideration for the possible influence of environmental factors such as pollution."

What are POPs?

In the 1940s, POPs became popular pesticides along with DDT, but were blamed for harming wild birds,  animals, and possibly humans.  After their discontinuation, they remain in the environment, slowly biodegrading and eventually entering the food chain. Once in the body, POPs can persist in body fat for very long periods of time following exposure.

The POPs Link

In their research, Jones and Griffin reviewed other studies in this area and noted that one conducted by Dr D Lee, et al, demonstrated NO association between obese subjects and diabetes when they had low concentrations of POPs in their blood. In fact, thin people with high levels of POPs were more at risk for developing type 2 diabetes than obese individuals with low levels.

While the exact mechanism by which this link exists remains unknown, it bears further investigation, say Jones and Griffin. POPs may not be responsible for all cases of type 2 diabetes, but if a causal relationship can be found, new treatments for the disease may be possible.

The article by Jones and Griffin, "Environmental pollution and diabetes: A neglected relationship," appears in the latest edition of the "Lancet."

Diabetes: Diabetes Remission In Obese Patients More Likely With Weight Loss Surgery?

This headline has been splashed all over the Internet and media.  But does this preliminary study take into account health risks associated with weight loss surgery or the percentage of patients who regain weight?

Weight Loss Surgery vs. Healthy Lifestyle Change

The results of an Australian study conducted by Dr John B Dixon and colleagues, of Monash University, Melbourne have been published in the January 23rd issue of the Journal of the American Medical Association (JAMA).

Over 2 years, a small test group of 60 patients, (55 of whom completed the study), gastric banding was compared to conventional diabetes treatment in people with type 2 diabetes.

Apparently, weight loss in the surgical group was responsible for a remission rate 5 times higher and a drop in blood sugar that was 4 times that found in the control group.

But What About The Long Term?

While researchers acknowledge that a larger, more diverse population and longer followups will be needed to confirm these results, they believe this study shows that "intensive weight loss" rather than "simple lifestyle change" is more effective when combating type 2 diabetes.

Will such a strategy really work in the long term?  Some people regain a significant amount of weight after a success gastric surgery, which would put them at risk for type 2 diabetes again. In addition, a good portion of obese patients who undergo surgery develop gallstones, nutritional deficiencies, have more serious complications due to the operation itself or will require a secondary surgery.

"After 10 years, only 1 out of 5 people have kept the weight off. A review of studies on stomach stapling (vertical banded gastroplasty) notes that 60% of excess weight (the weight above what is considered healthy) was lost, although a large portion of people regained the lost weight after 3 to 5 years.

About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis. And about 1 out of 5 people may need a second operation because the connection between the stomach and the intestines narrows (stomal stenosis), leading to nausea and vomiting, or because of an increase of gastroesophageal reflux after eating." (WebMD)

While surgical weight loss for obese patients with type 2 diabetes may be greater than healthy lifestyle changes in the short term, so are the risks.  Traditionally, surgery has been recommended for the morbidly obese only after conservative measures such as diet, exercise, and medication have failed. With America's growing obesity problem, I hope this and other similar studies won't pressure patients into 'bypassing' careful consideration before undergoing weight loss surgery.

Food Cravings for Calories, Not Carbs

It wasn't a surprise to read a press release on a recent study conducted at Tufts University on food cravings. Researcher Susan Roberts said, ""The findings [of this study] suggest that cravings are for calories, not carbohydrate, as is widely assumed." Although foods craved do contain carbohydrate, they often contain fat and protein, too.

The study then went on to say that food cravings are normal (91 percent of people report having them), but it appears that dieting increases the frequency. Which makes sense, of course -- when we're hungry, we crave food! No rocket science there.

In this month dubbed National Diet Month, it's useful info to keep in mind as many of us seek healthy weight loss. When we start craving food, it's a good sign that we need it. It's not a sign that we're weak willed.

If you're having trouble managing food cravings, think first whether you really need to eat. Then, if you're not hungry, but still craving, could deprivation be at work? When we cut out foods in the belief that they 'make us fat' or somehow interfere with weight loss, we might set ourselves up for wanting them even more. Think moderation, not elimination if this is the case for you.

Tags:
healthy eating ,
food cravings ,
healthy weight loss ,
diet

Diabetes: Spice Slashes Blood Sugar Levels

Move over ginseng! Recently, nutrionists have been touting the medicinal benefits of cinnamon. Used in a variety of recipes - from hot chocolate to soup to grapefruit - this spice has been shown to promote healthy blood sugar levels in people with type 2 diabetes.

"Good medicine doesn't always take the form of a pill. Sometimes the answer, or part of the answer, can be found in your kitchen cabinet," says Dr. Richard Goldfarb, the medical director for the Bucks County Clinical Research Center.

In a recent Pakistani study, participants ingested 1-6g of cinnamon daily for a total of 40 days, while a control group took a placebo in the same amounts. The cinnamon group showed a significant drop in their blood sugar, cholesterol, and triglyceride levels, even after the study was concluded.

"It is our hope that better eating habits and simple, everyday herbs like cinnamon can become allies in people's journey toward disease-free living through proper nutrition," says Dr. Goldfarb.  Working with an Arizona biotech company, Goldfarb hopes the development of a concentrated liquid extract of cinnamon will bring down high blood sugar to healthier levels in type 2 diabetics. Cinnamon health products may prove to be another potent diabetes prevention treatment.

So spice up your healthy eating! Cinnamon is a great source of manganese, fiber, iron, and calcium and - moreover - it just tastes great!

Tags: type 2 diabetes, diabetes prevention, healthy eating, cinnamon, blood sugar

 

Avoiding Health Mistakes in the New Year

The Washington Post had an article on this subject this week that I found interesting. The snippets are from readers, and reminds me of important advice we've long given at Green Mountain. For the full effect, take a gander at the article itself. I list below the healthy weight loss tips that stood out for me, with a few comments of my own following the tip. If you're a regular reader of our blog, you won't necessarily find these insights revealing, but they do bear reminding.

"Don't go on a diet." So what do we do when we feel like we've overdone things and need to find a healthier weight? Eat sensibly -- three meals a day and snacks if we need them. Healthy eating includes plenty of lean protein, vegetables and fruit and reasonable amounts of healthy starch foods like whole grains (wheat, rice, oatmeal), legumes (beans and peas), winter squashes, etc. This type of eating keeps us satisfied. If we also feel like eating a piece of chocolate or other treat, we can be satisfied with a small amount because we're not hungry.

"Don't give up! On exercise, that is." But don't do it for weight loss; do it to feel well. And regular, reasonable exercise does just that -- it helps us feel great! And that helps us keep doing the other things that are important for healthy weights -- like eating sensibly. It creates its own feedback loop. If you need to conquer your fears about exercise, read our FitBriefing "Overcoming Exercise Fears."

"Don't think you can do it alone." Support is one of the key predictors of success. You can find support from friends and/or family, or you can find it online via blogs like this or other venues. Just get it. It helps you stay the course when things get tough...and they will get tough at times as we our busy lives and self-doubts get in the way of living healthfully.

Hope your 2008 has started off strong. We'll do our best to help keep you going with our posts each week!

Tags: healthy eating , healthy weight loss , healthy weight , diet

Diabetes: Obesity And Diabetes Prevention May Come From Within The Body

Does your body hold the secret to losing weight and reversing diabetes? Well, it does 'secrete' a very interesting hormone called gastric inhibitory polypeptide (GIP) that many reserchers believe to be a key player in fat metabolism.  Although it's full role in the body is not yet understood, a new study with mice shows that blocking GIP of a hormone results in significant weight loss, improvement of insulin resistance and amelioration of diabetes/type 2 diabetes.

What is GIP?

GIP is found in the intestine, heart, stomach, adipose (fatty tissue) and in the brain.  The body makes this hormone in response to food in order to inhibit the production of acids responsible for stimulating the release of insulin during the digestive process. Researchers have observed that high-fat diets in obese patients with diabetes/type 2 diabetes can cause prolonged secretions of GIP.

The Study

Entitled, "GIP Receptor Antagonism Reverses Obesity, Insulin Resistance, and Associated Metabolic Disturbances Induced in Mice by Prolonged Consumption of High-Fat Diet," this study was conducted by Paula L. McClean, Nigel Irwin, Roslyn S. Cassidy, Victor A. Gault and Peter R. Flatt (School of Biomedical Sciences, University of Ulster, Northern Ireland); and Jens J. Holst (Department of Medical Physiology, The Panum Institute, University of Copenhagen, Denmark).*

The researchers used a model for diet-induced obesity that has been used extensively alongside genetic models and has close parallels with obesity.  For details on the study design, please read the full article in Medical News Today.

Key Findings

• Mice on the high-fat diet showed an increase in body weight and blood sugar levels that remained elevated throughout the study.
• The progressive weight gain and high blood sugar lead to impaired insulin sensitivity and glucose intolerance. Fat (adipose) tissue deposits were increased as were circulating cholesterol and triglyceride concentration levels.
• (Pro3)GIP was able to counter many of the detrimental effects of high fat diet on body weight and indices of glucose and lipid metabolism.

Implications

Besides the heart, brain and stomach, GIP is found in a variety of tissues, including the intestine, which is the precise area circumvented by gastric bypass surgery.

Researcher Nigel Irwin, Ph.D., "Interestingly, possible parallels exist with the benefits of Roux-en-Y surgery (gastric bypass surgery) in treating gross obesity and associated diabetes in people. In this procedure, nutrients surgically bypass the area of the small intestine, resulting in a deficiency of circulating GIP. We are looking to better understand how and why."

The study's findings provide hope to physicians and patients alike for the development of non-invasive treatments for obesity and type 2 diabetes as well new methods in diabetes prevention.

*Complete findings appear in the American Journal of Physiology - Endocrinology and Metabolism (doi:10.1152/ajpendo.00460.2007), a publication of the American Physiological Society (APS; http://www.the-aps.org/).

Posted by Laura Brooks

Tags: type 2 diabetes, insulin resistance, diabetes prevention, GIP

Resolutions for a Healthy New Year

If you know us at Green Mountain, you know we're not into the usual New Year's Resolutions. They just too full of the old way of looking at healthy living, healthy eating, healthy weights, taking care of ourselves. Actually, the old way is not about those things really at all; it's more about diets. Consider this ditty we posted previously in a FitBriefing that best describes how we encourage looking at the coming year.

Important: Read through to the 'after' part or you'll get the wrong message!

Before

‘Twas the month after Christmas, and all through the house,
nothing would fit me, not even a blouse!

The cookies I’d nibbled, the eggnog I’d taste
at the holiday parties have gone to my waist.

When I got on the scales, there arose such a number!
When I walked to the store (less a walk than a lumber)

I’d remember the marvelous meals I’d prepared,
the gravies and sauces, and beef nicely rared,
the wine and the rum balls, the bread and the cheese,
and the way I’d never said, “No thank you, please.”

As I dressed myself, in my husband’s old shirt,
and prepared once again to do battle with dirt,
I said to myself, as only I can,
“You can spend the winter disguised as a man!”

So away with the last of the sour cream dip.
Get rid of the fruitcake, every cracker and chip!
Every last bit of food that I like must be banished
‘til all the additional ounces have vanished.

I won’t have a cookie, not even a lick.
I’ll want only to chew on a long celery stick.
I won’t have hot biscuits, or cornbread, or pie;
I’ll munch on a carrot, and quietly cry!

I’m hungry, I’m lonesome, and life is a bore –
but isn’t that what January is for?

Unable to giggle, no longer a riot,
Happy New Year to all, and to all a good DIET!!!!!!!!!

After

Hey, what am I thinking? That's really old hat!
A 'dieting' mind-set will just make me fat.

So away with restriction! I'll eat what I want.
I'll start when I'm hungry and stop when I'm not.

May all my friends join me in this state of mind.
For then we'll be happy,creative,and kind.

Wishing a Happy, Healthy and Prosperous New Year!

Tags: healthy eating , healthy weights , New Years resolutions , diet

Diabetes: Short, Long Sleep Duration Raises The Risk For Diabetes

ZZZZZZZ...

Getting more Z's may be another strategy (besides a healthy lifestyle, weight loss) in diabetes prevention.

(From MedicalNewsToday.com)

The most common factors believed to contribute to diabetes (and type 2 diabetes) are a decreased amount of physical activity and access to highly palatable processed foods. However, there is growing evidence that another aspect of our modern lifestyle, short sleep duration, is also contributing toward the "diabetes epidemic".

The study, authored by James E. Gangwisch, PhD, of Columbia University in New York, explored the relationship between sleep duration and the diagnosis of type 2 diabetes over an eight-to-10-year follow-up period between 1982 and 1992 among 8,992 subjects who participated in the Epidemiologic Follow-Up Studies of the first National Health and Nutrition Examination Survey. The subjects' ages ranged from 32 to 86 years.

According to the results, subjects who reported sleeping five or fewer hours and subjects who reported sleeping nine or more hours were significantly more likely to have incident diabetes over the follow-up period than were subjects who reported sleeping seven hours, even after adjusting for variables such as physical activity, depression, alcohol consumption, ethnicity, education, marital status, age, obesity and history of hypertension.

The effect of short sleep duration on diabetes incidence is likely to be related in part to the influence of short sleep duration upon body weight and hypertension, said Dr. Gangwisch. Experimental studies have shown sleep deprivation to decrease glucose tolerance and compromise insulin sensitivity by increasing sympathetic nervous system activity, raising evening cortisol levels and decreasing cerebral glucose utilization. The increased burden on the pancreas from insulin resistance can, over time, compromise β-cell function and lead to type two diabetes, warned Dr. Gangwisch.

"If short sleep duration functions to increase insulin resistance and decrease glucose tolerance, then interventions that increase the amount and improve the quality of sleep could potentially serve as treatments and as primary preventative measures for diabetes," said Dr. Gangwisch.

It is unknown as to how long sleep duration contributes to diabetes, although increased time in bed to compensate for poor sleep quality is one possible explanation, noted Dr. Gangwisch.

Recent estimates show that at least 171 million people worldwide suffer from diabetes, and that, by the year 2030, this number is projected to double.

Lawrence Epstein, MD, medical director of Sleep HealthCenters, an instructor of medicine at Harvard Medical School, a past president of the American Academy of Sleep Medicine (AASM) and a member of the AASM board of directors, said that this study is one of several large studies that have shown that people who don't get enough sleep have higher rates of diabetes.

"Restricting sleep to four hours a night for only a few days causes abnormal glucose metabolism, suggesting the mechanism for increased rates of type 2 diabetes in sleep deprived individuals," said Dr. Epstein. "Additionally, sleep disorders that disrupt sleep, such as obstructive sleep apnea, also increase the likelihood of developing diabetes. Treating the sleep disorders improves glucose metabolism and diabetes control. These studies underscore the fact that sleep is integral to good health."

On average, most adults need seven to eight hours of sleep each night to feel alert and well-rested. Adolescents should sleep about nine hours a night, school-aged children between 10-11 hours a night and children in pre-school between 11-13 hours a night.

The AASM offers the following tips on how to get a good night's sleep:

- Follow a consistent bedtime routine.
- Establish a relaxing setting at bedtime.
- Get a full night's sleep every night.
- Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
- Do not go to bed hungry, but don't eat a big meal before bedtime either.
- Avoid any rigorous exercise within six hours of your bedtime
- Make your bedroom quiet, dark and a little bit cool.
- Get up at the same time every morning.

SLEEP is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the AASM and the Sleep Research Society.

SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

Posted by Laura Brooks

Tags: type 2 diabetes, diabetes prevention, healthy lifestyle, sleep

Planning for Healthy Eating

Sometimes it pays to do what you are supposed to do. While waiting for my car to be serviced the other day, I started leafing through professional journals to see if I was missing any important new info. Nothing really big popped up, but I did discover a short article that listed a variety of resources to help people with planning healthy meals. That's a big question that comes up frequently at Green Mountain at Fox Run -- do we really need to plan menus and, if so, help!

The answer to the first question is a resounding yes. Although planning can be very different than many of us think. Instead of the written-in-stone menus that we might be familiar with -- you know, monday at breakfast, lunch or dinner i'll eat this, tuesday i'll eat that, etc... -- meal planning can be as simple as putting together a list of foods you know you like, and making sure to keep ingredients for those meals on hand. Of course, it also helps to think about oth