Technological advances aren’t always worth the cost…
“A new randomized study compared insulin pump therapy vs. an MDI [multiple daily injections] approach among current CGM [continuous glucose monitor] users. The results showed that insulin pump users had a higher A1c, decreased quality of life, and markedly higher medical expenses as compared to MDI patients.”
Source: Study: Insulin Pumps Decrease Quality of Life and Increase A1c in CGM Users – Diabetes Daily
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“In total 6 studies, based on 96,175 participants and 4935 cases, were included. The summary RR for type 2 diabetes comparing ever with never skipping breakfast was 1.33 (95% CI: 1.22, 1.46, n = 6 studies) without adjustment for BMI, and 1.22 (95% CI: 1.12, 1.34, n = 4 studies) after adjustment for BMI. Nonlinear dose-response meta-analysis indicated that risk of type 2 diabetes increased with every additional day of breakfast skipping, but the curve reached a plateau at 4–5 d/wk, showing an increased risk of 55% (summary RR: 1.55; 95% CI: 1.41, 1.71). No further increase in risk of type 2 diabetes was observed after 5 d of breakfast skipping/wk (P for nonlinearity = 0.08).
Conclusions
This meta-analysis provides evidence that breakfast skipping is associated with an increased risk of type 2 diabetes, and the association is partly mediated by BMI.”
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From NMCD:
Highlights
•A meta-analysis of 77 prospective studies was conducted.
•Diabetes was associated with a 2-fold increase in heart failure risk in the general population.
•Diabetes was associated with a 69% increase in heart failure risk in patient populations.
•Elevated blood glucose even in the pre-diabetic range also increased heart failure risk.
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From Sysy Morales at Diabetes Daily:
“My blood sugar levels have never been better than what they are now. This is primarily due to eating a very low-carb diet. It took me a long time to transition, and this post will outline the reasons why.
Over a decade ago I read Dr. Bernstein’s book called, Dr. Bernstein’s Diabetes Solution. When he explained what he calls the Laws of Small Numbers, which refers to how small amounts of carbohydrate are covered by small doses of insulin and this means that blood sugars are more easily managed within tight parameters. He also explained why keeping blood sugar levels within tight parameters is essential to avoid complications. This made sense immediately, and I responded by flinging the book across my bedroom at the wall.”
Source: Reasons Why It Took Me So Long to Transition to Very Low Carb
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“Among older patients with type 1 diabetes, those with majority exposure to HbA1c 8–8.9% and ≥9% had increased dementia risk, while those with majority exposure to HbA1c 6–6.9% and 7–7.9% had reduced risk. Currently recommended glycemic targets for older patients with type 1 diabetes are consistent with healthy brain aging.”
Source: Long-term Glycemic Control and Dementia Risk in Type 1 Diabetes | Diabetes Care
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“Women with gestational diabetes who were on a Mediterranean diet for 3 months had improved glycemic levels, that were comparable to pregnant women with normal glucose levels, a new study from Madrid, Spain suggests.
The objective of the study was to assess whether Mediterranean diet-based medical nutrition therapy facilitates near-normoglycemia in women with gestational diabetes.
“Medical nutrition therapy based on a MedDiet enhanced with extra virgin olive oil and pistachios, thus with a high-fat content, is associated with glycemic control and with a reduction in gestational diabetes-related adverse perinatal outcomes,” Dr. Alfonso Calle-Pascual, one of the study authors told dLife.”
Source: Mediterranean Diet Linked to Improved Gestational Diabetes Outcomes, Study | dLife
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Chicken Kolhapur from Chennai Chettinaad Palace
From Madhur Jaffrey’s “An Invitation to Indian Cooking,” 1973 (43 years ago)
“Curry” is just a vague, inaccurate word which the world has picked up from the British, who, in turn, got it mistakenly from us.
“Us” being Indians.
If “curry” is an oversimplified name for an ancient cuisine, then “curry powder” attempts to oversimplify (and destroy) the cuisine itself.”
“Try to buy only whole spices and grind them yourself in small quantities.”
“It is the preparation and combination of whole or freshly ground spices which makes Indian foods unique.”
Ghee: two types. See p. 9
Her recipes are adapted for American kitchens and stores. They focus on Delhi and adjacent sections of Uttar Pradesh.
Meat is usually goat. Fairly tough, so it is cooked slowly or tenderized.
80% of India is Hindu, who technically do not eat beef.
Cooking chicken? Usually remove skin first.
A tandoor is a clay oven with a live coal or wood fire.
Tandoori chicken is indeed popular in India.
“Indians never use olive oil,” but she does.
Fruits and veggies in India (1973) were/are very seasonal. Not eaten out of season.
Coriander (Chinese parsley or cilantro) and green chilies are essential.
Many Indians don’t like or eat hot (spicy) foods.
Most Indians eat a lot of greens: spinach, mustard greens, fenugreek greens, white radish greens, gram (or chick pea) greens. Spinach is popular over all of India.
Potatoes are a staple in North India.
The average Indian (1973) eats 1/2 to 2/3 pound of rice/day [cooked weight, I guess]. Her recipes use Carolilna (a long-grain uncooked rice) or basmati. (I must re-read. Is Carolilna really Carolina?)
Dals = lentils or pulses = varieties of dried beans and peas.
Various home-made pickles are popular. By no means only made with cucumbers. Even meat can be pickled.
Chutney p. 226-7.
Her childhood family had servants.
Indian breads are called roti.
In India most meals end with fruit.
From “Beyond Curry Indian Cookbook” by Denise D’Silva Sankhé, 2016. Subtitle: A culinary journey through India.
She’s a columnist at Serious Eats (Beyond Curry).
Over 50 languages in India.
“Curry, to most Indians, is only one type of dish, a gravy or sauce-based one, which can have meat or vegetable in it. “In India, there is no one “curry powder.”
Again, many regional differences in flavors and foods.
Grind your own spices. Store them dark and dry, in steel or glass airtight, in fridge maybe.
A masala is just a blend of spices; quite variable.
Nutmeg is poisonous, but use it anyway.
Dal designates more than lentils. Dals are a staple, served at least a few times/week. Dal-chawal is a simple dish of lentils and rice, and perhaps the most comforting of foods to Indians.
“Indian food is traditionally eaten by hand.” The right hand. The left is unclean.
“Mise en place” p. 35.
Some religions forbid alliums (e.g., onions and garlic) and root veggies. Substitute asefetida for the alliums.
Desserts and sweet treat are common, especially in religious and other festivals and celebrations.
Shop for pantry essentials and spices at specialty stores: Indian, Asian, Middle Eastern.
Buy spice in small quantities. They don’t store well for long.
Green chilis (sic): lighter-colored, longer ones are less spicy. Shorter, dark green ones are very hot. Thai and serrano chiles (sic) are fine substitutes.
When her recipes call for onion, she means red onion (can substitute white ones).
Testimonials
Search DietDoctor and you will find. Also http://indialchf.com
From Today’s Dietitian magazine:
August 2014 Issue
Indian Cuisine — Foods That Hold a Special Place in Plant-Based Food Traditions
By Sharon Palmer, RDN
Today’s Dietitian
Vol. 16 No. 8 P. 17
[Ed.: copy/pasted with a few paragraphs deleted. Click the link above for some recipes.]
Gita Patel, MS, RDN, CDE, LD, CLT, author of Blending Science With Spices, explains that Indian culture leans toward vegetarianism due to Hinduism, which hosts a central theme of nonviolence, including animals. “A profound respect for all life is a common Hindu belief that supports vegetarian eating styles,” adds Vandana Sheth, RDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics.
However, British colonial influences and Western food trends, such as the emergence of fast-food restaurants, have brought more animal foods into India, Patel says. “With the globalization of the world and technology, some of the urban lifestyle changes have significantly affected traditional food practices in India,” Sheth adds, listing as evidence the increasing number of fast-food restaurants and premade foods replacing traditional meals in India.
Traditional Eating Patterns
“A lot of people are drawn to Indian cuisine. People like the flavors, herbs, and spices,” Patel says, noting that home cooking is vastly different from what you’re likely to sample in an Indian restaurant.
“The traditional eating pattern is very balanced,” Patel says. She describes typical meals consisting of dal (a legume dish), rice, roti (bread), vegetable, salad, fruit, and a yogurt or buttermilk drink, which may vary slightly depending on the region.
Indeed, there’s scientific consensus that a disease-protective diet is based on a variety of whole plant foods, which sums up the traditional Indian eating pattern. “The traditional Indian vegetarian diet is one that’s rich in a wide variety of grains, beans, lentils, vegetables, fruits, nuts, seeds, spices, and herbs. Research has found that vegetarians have a lower risk of heart disease and some types of cancer,” Sheth says. The National Cancer Institute reports that cancer rates are lower in India than in Western countries, and that diet characteristics such as a high intake of fruits, vegetables, spices, and tea may be responsible for protecting Indians against certain forms of cancer.2
Key Components
While the specific dishes may vary according to different regions of India, the key ingredients basically are the same and include the following:
• Vegetables: “Vegetables are grown all over the country due to the climate,” Patel says, adding that many vegetables are unique to India, such as specific types of gourds, radishes, beans, and greens. However, other dishes are based on more familiar vegetables, such as beets, Brussels sprouts, cabbage, carrots, cauliflower, celery, cucumber, corn, eggplant, green beans, various greens, okra, onions, peas, peppers, potatoes, radishes, spinach, squash, and tomatoes. In addition, fermented foods such as pickled vegetables are a regular feature in Indian cuisine.
• Grains: Rice and wheat are staples in India and used in flatbreads (eg, dosa, roti, chapati), doughs (eg, samosa, kachori), and side dishes (rice) to accompany meals.
• Legumes: Indian cuisine relies on the regular and flavorful use of legumes, such as black-eyed peas, chickpeas, lentils, and beans. In addition to dal, many legumes are sprouted or used as flour in breads.
• Fruits: Apples, apricots, bananas, figs, grapes, guavas, lychees, loquats, mangoes, oranges, papayas, passion fruit, and sweet limes are common fruits in India.
• Dairy: From milk and buttermilk to yogurt and paneer (fresh cheese), dairy products are regular features of the Indian diet. Patel reports that most Indian households receive fresh milk, which is then used for beverages and cooking. Households make their own ghee (clarified butter) from the milk fat, and leftover milk is made into fresh yogurt every day.
• Vegetable oils: Most oils used in traditional cooking are unrefined vegetable oils, such as peanut or sesame. However, Patel reports an increase in the use of refined oils, such as soybean oil, in modern cooking.
• Herbs and spices: At the heart of Indian food is a long list of culinary herbs and spices that have been used for centuries, many of which are proven to have antioxidant, anti-inflammatory, antimicrobial, and anticancer effects. Indian spices include amchur (made from mangoes), aniseed, asafetida (a pungent, onionlike flavor), bay leaf, black pepper, cardamom, chilies, cinnamon, cloves, coconut, coriander, cumin, dill, fennel, fenugreek, garam masala (a spice blend), garlic, ginger, mango powder, mint, mustard, nutmeg, onion seeds, parsley, pomegranate seeds, poppy seeds, saffron, sesame seeds, tamarind, and turmeric.
— Sharon Palmer, RDN, is a contributing editor to Today’s Dietitian and the author of The Plant-Powered Diet and Plant-Powered for Life.
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Olive oil is a prominent source of fat in the Mediterranean diet
From Dr. Emily Deans at Psychology Today:
This year, finally, we have the SMILES trial, the very first dietary trial to look specifically at a dietary treatment in a depressed population in a mental health setting. Participants met criteria for depression and many were already being treated with standard therapy, meds, or both. The designers of this trial took the preponderance of observational and controlled data we already have for general and mental health and decided to train people using dietary advice, nutritional counseling, and motivational interviewing directed at eating a “modified Mediterranean diet” that combined the Australian Dietary Guidelines and the Dietary Guidelines for Adults in Greece. They recommended eating whole grains, vegetables, fruit, legumes, unsweetened dairy, raw nuts, fish, chicken, eggs, red meat (up to three servings per week), and olive oil. Everyone in the study met criteria for a depressive disorder.
The experimental arm of subjects were instructed to reduce the intake of sweets, refined cereals, fried food, fast food, processed meat, sugary drinks, and any alcohol beyond 1-2 glasses of wine with meals. There were seven hour long nutritional counseling sessions and a sample “food hamper” with some food and recipes. The control group had the same number of sessions in “social support,” which is a type of supportive therapy that is meant to mimic the time and interpersonal engagement of the experimental group without utilizing psychotherapeutic techniques.
* * *
Despite the small size, the results were still statistically significant and better than anticipated. The dietary group had bigger reductions in depression scores at the end of 12 weeks. Remission of depression symptoms occurred in 32.3 percent of the diet group as opposed to 8 percent of the control group.
Source: A Dietary Treatment for Depression | Psychology Today
The Mediterranean diet…Is there anything it can’t do?
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Filed under Health Benefits, Mediterranean Diet
Testosterone is one reason men are better than women at push-ups
I’m running across more middle-aged and older men who are taking testosterone supplements. I don’t know if it’s a national trend or simply a Scottsdale, AZ, phenomenon.
The Endocrine Society in 2010 published guidelines regarding testosterone therapy for men who are androgen-deficient. Here are their recommendations on who should be tested for deficiency, and how:
1.1 Diagnosis and evaluation of patients with suspected androgen deficiency
“We recommend making a diagnosis of androgen deficiency only in men with consistent symptoms and signs and unequivocally low serum testosterone levels.
We suggest that clinicians measure serum testosterone level in patients with clinical manifestations shown in Table 1A. We suggest that clinicians also consider measuring serum testosterone level when patients report the less specific symptoms and signs listed in Table 1B.
TABLE 1.
Symptoms and signs suggestive of androgen deficiency in men
A. More specific symptoms and signs
Incomplete or delayed sexual development, eunuchoidism
Reduced sexual desire (libido) and activity
Decreased spontaneous erections
Breast discomfort, gynecomastia
Loss of body (axillary and pubic) hair, reduced shaving
Very small (especially < 5ml) or shrinking testes
Inability to father children, low or zero sperm count
Height loss, low trauma fracture, low bone mineral density
Hot flushes, sweats
B. Other less specific symptoms and signs
Decreased energy, motivation, initiative, and self-confidence
Feeling sad or blue, depressed mood, dysthymia
Poor concentration and memory
Sleep disturbance, increased sleepiness
Mild anemia (normochromic, normocytic, in the female range)
Reduced muscle bulk and strength
Increased body fat, body mass index
Diminished physical or work performance
We suggest the measurement of morning total testosterone level by a reliable assay as the initial diagnostic test.
We recommend confirmation of the diagnosis by repeating measurement of total testosterone.
We suggest measurement of free or bioavailable testosterone level, using an accurate and reliable assay, in some men in whom total testosterone concentrations are near the lower limit of the normal range and in whom alterations of SHBG are suspected.
We suggest that an evaluation of androgen deficiency should not be made during an acute or subacute illness.”
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Plaque unrelated to cholesterol
From The Irish Times:
There is no evidence that high levels of total cholesterol or of “bad” cholesterol cause heart disease, according to a new paper by 17 international physicians based on a review of patient data of almost 1.3 million people.
The authors also say their review shows the use of statins – cholesterol lowering drugs – is “of doubtful benefit” when used as primary prevention of cardiovascular disease.
The authors include Galway-based Prof Sherif Sultan, professor of the International Society for Vascular Surgery; Scottish-based Dr Malcolm Kendrick, author of The Great Cholesterol Con; and Dr David M Diamond, a US-based neuroscientist and cardiovascular disease researcher.
Prof Sultan said millions of people all over the world, including many with no history of heart disease, are taking statins “despite unproven benefits and serious side effects”.
Source: ‘No evidence’ high cholesterol causes heart disease, say doctors
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Bible Verse of the Day
Diabetic Mediterranean Diet 