World Health Organization Recommends Mediterranean Diet to Reduce Dementia Risk

Steve Parker MD, low-carb diet, diabetic diet

Olives, olive oil, and vinegar: classic Mediterranean foods

Two quotes:

In guidelines released Tuesday, WHO issued its first recommendations to reduce the risk of dementia globally. They include regular physical exercise, not using tobacco, drinking less alcohol, maintaining healthy blood pressure and eating a healthy diet — particularly a Mediterranean one.

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“The Mediterranean diet is the most extensively studied dietary approach, in general as well as in relation to cognitive function,” the report said. “Several systematic reviews of observational studies have concluded that high adherence to the Mediterranean diet is associated with decreased risk of mild cognitive impairment and Alzheimer’s Disease, but modest adherence is not.”

Source: New global guidelines to reduce risk of dementia released

Steve Parker, M.D.

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FDA warns doctors  about rare occurrences of a serious infection of the genital area with SGLT2 inhibitor drugs

The infection is called Fournier Gangrene. It’s a nasty infection that I’ve seen only a few times, always in men. The FDA reports cases in both men and women taking SGLT2 inhibitors to treat their diabetes.

“Patients should seek medical attention immediately if you experience any symptoms of tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell. These symptoms can worsen quickly, so it is important to seek treatment right away.”

Source: FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes | FDA

Steve Parker, M.D.

PS: With the right diet, you’ll need fewer drugs to control your diabetes. So, fewer drug side effects and less expense.

low-carb mediterranean diet

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Tighter Blood Pressure Control Benefits Type 2 Diabetes

Not bad

From Diabetes Self-Management:

The new study evaluated roughly 11,000 people with type 2 diabetes in 20 countries over four years, finding that those who received the blood pressure drugs perindopril and indapamide to keep their blood pressure levels at or below 130/80 had fewer heart attacks, strokes and other complications than those receiving placebo (inactive treatment). They also had a “lower overall risk of dying from any cause.”

Source: Tight Blood Pressure Control Benefits Type 2 Diabetes: Study – Diabetes Self-Management

You may think the aforementioned health benefits stem from use of perindopril and/or indapamide. It’s either that or simply the result of BP lowering. I suspect it’s the latter while admitting that not all BP drugs are created equal. As a hospitalist in Scottsdale, AZ, I rarely run across patients taking perindopril, and only occasionally folks on indapamide. Popularity of various drugs varies often depends on which part of the country you’re in. We need to be more scientific than that.

Steve Parker, M.D.

PS: Losing excess weight and exercise are two ways to lower blood pressure without the expense and side effects of drugs.

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Low-Calorie Mediterranean Diet Helps With Metabolic Syndrome and T2 Diabetes

“PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.”

Source: Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial | Diabetes Care

Steve Parker, M.D.

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Dietary Strategies for Management of Diabetic Gastroparesis

bariatric surgery, Steve Parker MD

The only picture of stomach I have

When you eat a meal, your stomach holds it there for a while then gradually releases contents into the duodenum, the first part of the small intestine. The stomach makes those releases by contraction of muscles in the wall of the stomach. Those muscles are under control of the autonomic nervous system. In some folks with diabetes, the nerves controlling the stomach muscles don’t work very well, so stomach contractions are weak. Food just sits in the stomach for too long, delaying digestion and absorption of nutrients. One result is unpredictable blood sugar levels after meals, no matter how carefully you count carb grams. The medical term for these weak stomach contractions is gastroparesis.

From Diabetes Care:

“How is diabetic gastroparesis best managed?

Consultation by an RDN [registered dietitian, I reckon] knowledgeable in the management of gastroparesis is helpful in setting and maintaining treatment goals. Treatment goals include managing and reducing symptoms; correcting fluid, electrolyte, and nutritional deficiencies and glycemic imbalances; and addressing the precipitating cause(s) with appropriate drug therapy. Correcting hyperglycemia is one strategy for the management of gastroparesis, as acute hyperglycemia delays gastric emptying. Modification of food and beverage intake is the primary management strategy, especially among individuals with mild symptoms.

People with gastroparesis may find it helpful to eat small, frequent meals. Replacing solid food with a greater proportion of liquid calories to meet individualized nutrition requirements may be helpful because consuming solid food in large volumes is associated with longer gastric emptying times. Large meals can also decrease the lower esophageal sphincter pressure, which may cause gastric reflux [heartburn], providing further aggravation.

Results from a randomized controlled trial demonstrated eating plans that emphasize small-particle-size (<2 mm) foods may reduce severity of gastrointestinal symptoms. Small-particle-size food is defined as “food easy to mash with a fork into small particle size.” High-fiber foods, such as whole intact grains and foods with seeds, husks, stringy fibers, and membranes, should be excluded from the eating plan. Many of the foods typically recommended for people with diabetes, such as leafy green salads, raw vegetables, beans, and fresh fruits, and other food like fatty or tough meat, can be some of the most difficult foods for the gastroparetic stomach to grind and empty. Notably, the majority of nutrition therapy interventions for gastroparesis are based on the knowledge of the pathophysiology and clinical judgment rather than empirical research.”

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

Steve Parker, M.D.

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Diabetes Care Consensus Panel Recommends Fish

Cold-water fatty fish loaded with omega-3 fatty acids include salmon, trout, sardines, herring, and mackerel, but not goldfish

“The recommendation for the general public to eat a serving of fish (particularly fatty fish) at least two times per week is also appropriate for people with diabetes.”

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

That’s been my recommendation to patients since 2007.

Steve Parker, M.D.

Conquer Diabetes and Prediabetes, Steve Parker MD

Salmon is a rich source of omega-3 fatty acids

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Do Nutritional Supplements Help Control Diabetes?

From Diabetes Care

“The routine use of chromium or vitamin D micronutrient supplements or any herbal supplements, including cinnamon, curcumin, or aloe vera, for improving glycemia in people with diabetes is not supported by evidence and is therefore not recommended.”

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

Did Big Pharma pay for this article in Diabetes Care?

Steve Parker, M.D.

PS: The Low-Carb Mediterranean Diet typically reduces or eliminates the need for drugs or supplements to control diabetes.

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