Diabetic Mediterranean Diet

February 14, 2019 · 1:35 AM

Diet to Lose Weight, Exercise to Keep It Off

Exercise is more helpful for preventing weight gain than for inducing weight loss

It is a question that plagues all who struggle with weight: Why do some of us manage to keep off lost pounds, while others regain them?

Now, a study of 14 participants from the “Biggest Loser” television show provides an answer: physical activity — and much more of it than public health guidelines suggest.

On average, those who managed to maintain a significant weight loss had 80 minutes a day of moderate activity, like walking, or 35 minutes a day of vigorous exercise, like running.

My patients taught me this years ago.

1 Comment

Filed under Exercise, Weight Loss, Weight Regain

January 25, 2019 · 5:43 AM

PURE Study: Higher Carb Consumption Linked to Greater Risk of Death

Adult life is a battle against gravity. Eventually we all lose.

Here’s the abstract of a new epidemiological study that investigated the relationships between diet, cardiovascular disease, and death rates. I don’t have the entire article. My sense is that the 18 countries studied are mostly non-Western:

Background

The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear.

Methods

The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.

Findings

During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

Interpretation

High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

Source: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet

5 Comments

Filed under Heart Disease, Longevity

January 7, 2019 · 3:18 PM

Is Your Glucose Meter as Accurate as You Think?

DiaTribe has an article on glucose meter accuracy by Jeemin Kwon and Adam Brown. I quote:

Results from the Diabetes Technology Society’s Blood Glucose Meter Surveillance Program identifies only six out of 18 meters that passed. Did yours make the cut?

The Diabetes Technology Society (DTS) recently revealed long-awaited results from its Blood Glucose Monitor System (BGMS) Surveillance Program. The rigorous study tested the accuracy of 18 popular blood glucose meters (BGM) used in the US. These FDA-cleared meters were purchased through retail outlets and tested rigorously at three study sites in over 1,000 people (including 840 people with diabetes). The results were troubling: only six out of the 18 devices met the DTS passing standard for meter accuracy – within 15% or 15 mg/dl of the laboratory value in over 95% of trials.

The devices that passed were:

Contour Next from Ascensia (formerly Bayer) – 100%
Accu-Chek Aviva Plus from Roche – 98%
Walmart ReliOn Confirm (Micro) from Arkray – 97%
CVS Advanced from Agamatrix – 97%
FreeStyle Lite from Abbott – 96%
Accu-Chek SmartView from Roche – 95%

The devices that failed were:

Walmart ReliOn Prime from Arkray – 92%
OneTouch Verio from LifeScan – 92%
Prodigy Auto Code from Prodigy – 90%
OneTouch Ultra 2 from LifeScan – 90%
Walmart ReliOn Ultima from Abbott – 89%
Contour Classic from Bayer – 89%
Embrace from Omnis Health – 88%
True Result from HDI/Nipro – 88%
True Track from HDI/Nipro – 81%
Solus V2 from BioSense Medical – 76%
Advocate Redi-Code+ from Diabetic Supply of Suncoast – 76%
Gmate Smart from Philosys – 71%

Source: Are Blood Glucose Meters Accurate? New Data on 18 Meters | diaTribe

1 Comment

Filed under Uncategorized

December 19, 2018 · 12:40 AM

Should You Start Drinking Tea for Your Health?

Green tea isn’t always green

From P.D. Mangan’s book “Best Supplements for Men“:

Green tea, which is commonly drunk in China and Japan, is associated with lower rates of cancer, about 30% lower in those who drank the highest amounts of green tea compared to the lowest. Deaths from cardiovascular disease were about 25% lower in the highest consumption group versus the lowest. This is of course epidemiological evidence, meaning that it can’t show whether green tea actually prevented disease, or that there’s some other connection such as that heather people drank more green tea.

Laboratory and other evidence, however, provides some good reasons to think that green tea is the real deal when it comes to sides prevention.

A recent study of the elderly in Singapore found tea consumption linked to much lower risk of neurocognitive decline in women and carriers of the “dementia gene” APOE ε4.

P.D. suggests that the health-promoting dose of tea is 3 to 5 cups a day, and black tea may be just as good as green.

Steve Parker, M.D.

1 Comment

Filed under tea

December 11, 2018 · 5:11 PM

Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet

diabetic diet, low-carb mediterranean diet

Long-term diabetes management begins in the kitchen

From the medical journal Pediatrics:

“Abstract

OBJECTIVES: To evaluate glycemic control among children and adults with type 1 diabetes mellitus (T1DM) who consume a very low–carbohydrate diet (VLCD).

METHODS: We conducted an online survey of an international social media group for people with T1DM who follow a VLCD. Respondents included adults and parents of children with T1DM. We assessed current hemoglobin A1c (HbA1c) (primary measure), change in HbA1c after the self-reported beginning of the VLCD, total daily insulin dose, and adverse events. We obtained confirmatory data from diabetes care providers and medical records.

RESULTS: Of 316 respondents, 131 (42%) were parents of children with T1DM, and 57% were of female sex. Suggestive evidence of T1DM (based on a 3-tier scoring system in which researchers took into consideration age and weight at diagnosis, pancreatic autoimmunity, insulin requirement, and clinical presentation) was obtained for 273 (86%) respondents. The mean age at diagnosis was 16 ± 14 years, the duration of diabetes was 11 ± 13 years, and the time following a VLCD was 2.2 ± 3.9 years. Participants had a mean daily carbohydrate intake of 36 ± 15 g. Reported mean HbA1c was 5.67% ± 0.66%. Only 7 (2%) respondents reported diabetes-related hospitalizations in the past year, including 4 (1%) for ketoacidosis and 2 (1%) for hypoglycemia.

CONCLUSIONS: Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD. The generalizability of these findings requires further studies, including high-quality randomized controlled trials.”

Source: Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet | Articles | Pediatrics

Comments Off on Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet

Filed under Drugs for Diabetes

December 11, 2018 · 4:26 PM

Food Versus Feed

Future Feed

From Hawaiian Libertarian:

“Food is grown, raised, harvested and processed — and if not consumed while fresh — preserved in as natural and organic a state as possible to keep most of it’s nutritious and nourishing qualities intact.

Feed is mass produced by a few large multinational corporations line using bio-technological innovations to quickly and efficiently manufacture product units ready for global distribution and a near infinite shelf life. Its primary traits are using genetically modified grain products to create a marketable product that is usually adulterated with preservatives and flavor enhancements that give it a long shelf life in airtight packaging and designed in a laboratory to stimulate the taste buds to fool the human body into thinking it’s something good for you.

But above all, the primary difference between Food and Feed can be discerned by this: most real food requires little (if any) corporate mass media marketing campaigns to sell product and expand market shares and waistlines alike.”

Source: Hawaiian libertarian: FEED Inc. & The Corporate Campaign Dialectic

Comments Off on Food Versus Feed

Filed under Uncategorized

December 6, 2018 · 5:58 PM

Is It True That “Diets Don’t Work”?

3 Comments

Filed under Weight Loss

December 3, 2018 · 4:59 AM

Recipe: Sous Vide Chicken and Sauteed Sugar Snap Peas

Sous vide chicken and sautéed sugar snap peas

Click the pic for our YouTube demonstration.

This is so low-carb that you can eat it in a ketogenic diet.

Ingredients:

2 boneless skinless chicken breasts, 8-9 oz each (225-255 g each) (raw weight)

2.5 tbsp (37 ml) extra virgin olive oil

few sprigs of fresh rosemary (optional)

2 cloves garlic, diced

lemon-pepper seasoning

Montreal Steak Seasoning to taste

garlic salt to taste

Morton sea salt (coarse)

black pepper to taste

9 oz (255 g) fresh sugar snap peas

Instructions:

Choose one of two seasonings: 1) Montreal Steak or 2) Rosemary lemon-pepper.

Brush one side of the breasts with about 1/2 tbsp olive oil. For Rosemary-style chicken, sprinkle the breasts with lemon-pepper seasoning, sea salt, and pepper to taste. Garnish with rosemary sprigs.

For Montreal-style, that seasoning is all you need; it already contains salt and pepper. Rosemary sprigs are optional.

Then cook the breasts in a sous vide device (see video) at 142°F for two hours.

When that’s done, my wife likes to sear the breasts in a frying pan (with a little olive oil) over medium-high heat, 1–2 minutes on each side. The chicken is fully cooked after two hours in the sous vide device, but the searing may enhance the flavor and appearance. It’s optional.

When the chicken is close to being done, sauté the garlic in two oz of olive oil over medium high heat for a minute or two, then add the sugar snap peas and a little garlic salt and pepper to taste, and cook for two to four minutes, stirring frequently.

Number of servings: 2

AMD boxes: 1 veggie, 2 fat, 1 protein

Nutritional analysis per serving:

Calories: 500

Calorie breakdown: 42% fat, 8% carbohydrate, 50% protein

Carb grams: 10

Fiber grams: 4

Digestible carb grams: 6

Prominent nutrients: protein, B6, iron, niacin, pantothenic acid, phosphorus, selenium

4 Comments

Filed under ketogenic diet, Recipes

December 1, 2018 · 4:17 PM

The Mediterranean Ketogenic Lifestyle – By Dr. Colin Champ

Colin Champ, M.D., published and article on his version of a Ketogenic Mediterranean Diet.

“The Study Participants – The Mediterannean Ketogenic Lifestyle

Regardless, the study was a massive success, as it allowed 40 overweight individuals with an average BMI of 37 to switch from their diabetes-provoking diet containing over 50% carbohydrates for 12 weeks. Ketosis was apparently confirmed via ketone strips in the morning. This concerns me, because if they were urine strips, after 2-3 weeks they would have been inaccurate. Once again, we must question whether it was a ketogenic diet or simply a very low-carbohydrate diet. Yet, the proof is it the pudding as the Spanish Ketogenic dieters experienced an average reduction in bodyweight from 240 to 208 lbs. Most importantly, there was a clear loss of fat over muscle. Blood pressure dropped, blood lipids improved, triglycerides divebombed as they were cut in half, blood sugar dropped by almost 20 mg/dl, and HDL cholesterol – a difficult number to budge – rose significantly. Take note, as expected, the largest reduction overall was the massive drop in triglycerides, which is especially important as elevated triglycerides are strongly associated with an increased risk of stroke, heart disease, and cancer.

Globally, all of these changes are desired. The question I pose, is can we take this a step further to encourage a full-blown Mediterranean Ketogenic Diet? I have been following what I consider a Mediterranean Ketogenic Diet for years by combining the cultural and social aspects of my Southern Italian heritage along with the scientific approach of the ketogenic diet. Sounds complicated? It’s not. In fact, it is so simple, that I have distilled it down to seven steps that are so simple, your great-grandfather likely followed most of them (mine certainly did).”

Source: The Mediterranean Ketogenic Lifestyle – Colin Champ

Compare with my version.