Is Type 2 Diabetes Reversible?

Seems to be, at least for some folks who are overweight. Nine of 10 T2 diabetes are overweight or obese

Science Alert has the story.

The “cure” at hand involves reduction of daily calories to 800 for four weeks. Average weight loss of those in the experimental group was 10 kg (22 lb). I look forward to the published scientific journal report. I bet the drop-out rate was high.

 

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High-Carb Diet Linked to Cardiovascular Disease

These cows may give you cancer

Carcinogenic cows?

The idea that heart attacks and other cardiovascular diseases are caused by dietary saturated fats is losing credibility. I lost faith in that theory in 2009.

Instead, cardiovascular disease is now linked to high consumption of carbohydrates, particularly those carbs that are rapidly absorbed and turned into blood sugar.

Unfortunately, the diet that reduces risk of cardiovascular disease may increase your risk of cancer. Keep reading.

If you’re a nutrition science nerd, here’s a pertinent report from researchers at Masaryk University in the Czech Republic:

“The results of our study show that high-glycaemic carbohydrates or a high overall proportion of carbohydrates in the diet are the key ecological correlates of cardiovascular disease (CVD) risk. These findings strikingly contradict the traditional ‘saturated fat hypothesis’, but in reality, they are compatible with the evidence accumulated from observational studies that points to both high glycaemic index and high glycaemic load (the amount of consumed carbohydrates × their glycaemic index) as important triggers of CVDs. The highest glycaemic indices (GI) out of all basic food sources can be found in potatoes and cereal products, which also have one of the highest food insulin indices (FII) that betray their ability to increase insulin levels.The role of the high glycaemic index/load can be explained by the hypothesis linking CVD risk to inflammation resulting from the excessive spikes of blood glucose (‘post-prandial hyperglycaemia’). Furthermore, multiple clinical trials have demonstrated that when compared with low-carbohydrate diets, a low-fat diet increases plasma triglyceride levels and decreases total cholesterol and HDL-cholesterol, which generally indicates a higher CVD risk. Simultaneously, LDL-cholesterol decreases as well and the number of dense, small LDL particles increases at the expense of less dense, large LDL particles, which also indicates increased CVD risk. These findings are mirrored even in the present study because cereals and carbohydrates in general emerge as the strongest correlates of low cholesterol levels.

In light of these findings, the negative correlation of refined sugar with CVD risk may seem surprising, but the mean daily consumption of refined sugar in Europe is quite low (~84 g/day), when compared with potato and cereal carbohydrates (~235 g/day), and makes up only ~20% of CA energy. Refined sugar is also positively tied to many animal products such as animal fat and total fat and animal protein, and negatively to % PC CARB energy and % CA energy. Therefore, a high consumption of refined sugar is accompanied by a high consumption of animal products and lower intakes of other carbohydrates. Furthermore, the glycaemic index of refined sugar (sucrose) is rather moderate (~65).”

Source: Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries | Grasgruber | Food & Nutrition Research

Elsewhere in this long article:

“Current rates of cancer incidence in Europe are namely the exact geographical opposite of CVDs. In sharp contrast to CVDs, cancer correlates with the consumption of animal food (particularly animal fat), alcohol, a high dietary protein quality, high cholesterol levels, high health expenditure, and above average height. These contrasting patterns mirror physiological mechanisms underlying physical growth and the development of cancer and CVDs. The best example of this health paradox is again that of French men, who have the lowest rates of CVD mortality in Europe, but the highest rates of cancer incidence. In other words, cancer and CVDs appear to express two extremes of a fundamental metabolic disbalance that is related to factors such as cholesterol and IGF-1 (insulin-like growth factor).”

I wish these researchers had looked at over death rates associated with various ways of eating. Perhaps that will be in a future paper.

I’d rather die of a heart attack than cancer.

Steve Parker, M.D.

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Does Indian Food Confuse You, Too?

 

Chennai Chettinaad Palace Indian restaurant in Phoenix, AZ

The first time I ate at an Indian restaurant, I was as confused as a newborn baby in a topless bar. The menu had too many unfamiliar foreign words.

Ian Anderson of Jethro Tull fame published a guide to Indian food for greenhorns. A snippet:

Let’s first consider the mild: Korma, Passanda and Muglai are the words to watch for. Liberal in their creamy mildness, these dishes, from different areas of the Indian sub-continent, will be face and bowel-savers when the chips are down.

For those who favour the dryer ,purer and not-too-hot taste of the source meat or fish, try the Tikka or Tandoori versions.

Really spicy hot stuff will be tackled head-on in the Madras or Vindaloo variations on the theme. Brave but occasionally foolish forkers, like me, will feel compelled to go for the Phal or Tindaloo, those macho show-off botty-crippling dishes which we become strangely ever-addicted to. Nothing disrupts a band sound-check like the pervasive after-effects of the Tarka Dhal (lentils and garlic).

It’s a very helpful guide to Indian restaurant menus although not necessarily for authentic Indian cuisine.

In case you didn’t get my metaphor…

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Brain Benefits of Exercise Diminish After Short Rest, According to Gretchen Reynolds

Run, Spot, Run!

Run, Spot, Run!

Admittedly, Gretchen may not have written the headline to her article at Carlos Slim’s blog. The headline is wrong. The gist is that blood flow to the brain diminishes in older competitive runners if they stop exercising for 10 days. Tests of cognitive function showed no deterioration.

Click the link below to read Gretchen’s article, which is brief. A snippet:

Before you skip another workout, you might think about your brain. A provocative new study finds that some of the benefits of exercise for brain health may evaporate if we take to the couch and stop being active, even just for a week or so.

I have frequently written about how physical activity, especially endurance exercise like running, aids our brains and minds. Studies with animals and people show that working out can lead to the creation of new neurons, blood vessels and synapses and greater overall volume in areas of the brain related to memory and higher-level thinking.

Presumably as a result, people and animals that exercise tend to have sturdier memories and cognitive skills than their sedentary counterparts.

Exercise prompts these changes in large part by increasing blood flow to the brain, many exercise scientists believe. Blood carries fuel and oxygen to brain cells, along with other substances that help to jump-start desirable biochemical processes there, so more blood circulating in the brain is generally a good thing.

Source: Brain Benefits of Exercise Diminish After Short Rest – The New York Times

I believe regular physical activity does help preserve brain function over time. But there’s more involved than blood flow.

Steve Parker, M.D.

PS: I bet your brain blood flow increases, compared to watching Dancing With the Stars on Tell-a-Vision, if you read one of my books.

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Improve Your Quality of Life With the Mediterranean Diet

Not only overall quality of life, but reduced pain, disability, and depression symptoms.

Action Plan: Move your current way of eating more towards Mediterranean.

Source: Adherence to the Mediterranean diet is associated with better quality of life: data from the Osteoarthritis Initiative

Improve your quality of life and lose excess weight with with the Advanced Mediterranean Diet.

Santorini, Greek seaside

Santorini, Greek seaside

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Tips on Fasting From Dr. Fung, But Beware Hypoglycemia

This guy had long spans of time between meals, perhaps days

This guy had long spans of time between meals, perhaps days

Yet another good post from DietDoctor! Why fast? Among many reasons is that fasting turns on autophagy, which helps clear the debris of daily living out of your cells, probably leading to longer life.

Click here for P.D. Mangan’s post on fasting and autophagy.

Dr. Fung at DietDoctor also warns about the danger of hypoglycemia for certain folks with diabetes. Read that part carefully (click the Source link below).

Anyway, here are Dr. Fung’s top eight tips (direct quotes):

  • Drink water: Start each morning with a full eight-ounce glass of water.
  • Stay busy: It’ll keep your mind off food. It often helps to choose a busy day at work for a fast day.
  • Drink coffee: Coffee is a mild appetite suppressant. Green tea, black tea, and bone broth may also help.
  • Ride the waves: Hunger comes in waves; it is not continuous. When it hits, slowly drink a glass of water or a hot cup of coffee. Often by the time you’ve finished, your hunger will have passed.
  • Don’t tell anybody you are fasting: Most people will try to discourage you, as they do not understand the benefits. A close-knit support group is often beneficial, but telling everybody you know is not a good idea.
  • Give yourself one month: It takes time for your body to get used to fasting. The first few times you fast may be difficult, so be prepared. Don’t be discouraged. It will get easier.
  • Follow a nutritious diet on non-fast days: Intermittent fasting is not an excuse to eat whatever you like. During non-fasting days, stick to a nutritious diet low in sugars and refined carbohydrates.
  • Don’t’ binge: After fasting, pretend it never happened. Eat normally, as if you had never fasted.

Source: More Practical Tips for Fasting – Diet Doctor

Steve Parker, M.D.

PS: I don’t feature fasting in any of my books, but I’ve gradually come around to seeing the potential benefits.

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New Insulin Delivery Recommendations 

Going in at a 45 degree angle with a 6 mm needle

Going in at a 45 degree angle with a 6 mm needle

“Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015.”

Source: New Insulin Delivery Recommendations – Mayo Clinic Proceedings

Here are some bullet points that most insulin users need to know:

  • Average skin thickness is 2 to 2.5 mm, with 90% of people under 3.25 mm.
  • Use the shortest needles: 6 mm for syringes, 4 mm for pen injectors. The short needles help you avoid injections into muscle. Injection into muscle increases risk of hypoglycemia and wide blood glucose excursions.
  • Acceptable injection sites: abdomen, thighs, buttocks, upper arms (usually on the back of the arm).
  • If an arm site is chosen with a 6 mm needle, inject into a lifted skin fold (otherwise you might hit muscle).
  • When using the 6 mm needle, inject into a lifted skinfold if you are a child or normal-weight adult. Alternatively, insert the needle at a 45 degree angle.
  • The preferred site for regular insulin (soluble human insulin) is the abdomen, for faster absorption.
  • Use needles only once. (Admittedly, many get away with multiple uses without much trouble.)
  • Don’t inject into lipohypertrophy areas. Lipohypertrophy eventually is an issue in half of insulin users. It is a localized area of swelling or lumpiness at the site of prior injections. It’s often easier to feel than to see. Injection into these areas causes erratic absorption of insulin, with potential widely fluctuating and unpredictable blood sugar levels.
  • Rotate injection sites to avoid lipohypertrophy.
  • If using cloudy insulins (e.g., NPH and some pre-mixed insulins), gently roll and tip the vial or pen until the solution is milk white.

Click here to read about…

  • How to roll and tip a vial to make cloudy insulin milk white.
  • Proper needle disposal.
  • Insulin infusion sets for continuous subcutaneous insulin injection via pumps.

Steve Parker, M.D.

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