Dr. Jonny Bowden

Tag: diabetes

  • Diabetes: Prevention and Cure

    Diabetes: Prevention and Cure

    It’s almost impossible to talk about diabetes these days without also mentioning its constant companion: obesity.

    In fact, the two have become so linked that health practitioners have come up with their own nickname for the pair, a kind of medical version of “Brangelina”-they call it Diabesity.

    According to Linda Geiss, a statistician with the Center for Disease Control, obesity is a major factor in the increase in diabetes. And what an increase it is- just in the six year period between 1997 and 2003 there was a 41% increase in the incidence of diagnosed diabetes. Unquestionably, obesity is part of the reason. In 2003, only 2 of 1000 normal-weight people had diabetes, but 18.3 of every 1000 obese people had it. Even being overweight increases risk- 5.5 out of every 1000 overweight people have the disease as well, almost three times as many as those of normal weight.(1)

    Should we be worried?

    Well, if current trends continue, 1 in 3 Americans will develop diabetes sometime in their lifetime.

    And in case you’re wondering, those with diabetes will lose on average 10-15 years of life.

    Diabetes is the leading cause of new cases of blindness among adults, not to mention kidney failure and non-traumatic lower-extremity amputations. And as of 2006, it was the 7th leading cause of death in the US-the risk of dying for a person with diabetes is about twice that of a person without the disease. (2)

    But here’s the thing: type ll diabetes, which is what we’re mainly talking about here, is virtually 100 percent preventable.

    It’s also treatable. And interestingly, the same things that benefit those with diabetes benefit those who are overweight and obese.

    To understand why dietary changes can have such a profound impact on diabetes, it helps to understand just what happens in the body when a person with a “normal” metabolism eats food:

    1. Food is broken down in the digestive system to smaller units that the body can do something with; carbs break down to glucose (sugar), protein breaks down to amino acids (some of which can be turned into sugar), and fat breaks down to fatty acids.
    2. The glucose (from the carbs and some of the amino acids) gets into the bloodstream, raising your blood sugar.
    3. In response, the pancreas secretes a hormone called insulin which- among its many jobs- helps escort that extra sugar out of the bloodstream and into the cells (especially the muscle cells) where it can be “burned” for energy.

    That’s when everything is going right.

    But there’s very little that’s “right” about the typical American diet.

    The Standard American Diet is Making Us Fat

    We eat far too much sugar, far too many carbs (which, as we’ve seen, turn into sugar) and far too many calories. Couple this with the fact that our sedentary lifestyle creates very little demand among the muscle cells for “fuel” (sugar).

    The result?

    Many of us have much more sugar floating around our bloodstream than we could possibly use. The pancreas tries desperately to keep up with the increased demand for insulin which is needed to bring blood sugar back down to normal.

    Sometimes it works, sometimes it doesn’t. The pancreas might manage to secrete enough insulin to keep blood sugar from being in the “diabetic” range, but the cost is a high level of insulin, which keeps fat from being “burned” (it also raises blood pressure). Your blood sugar may stay just under the cutoff for a diabetes diagnosis, but your high levels of insulin (and the inevitable inability of the cells to “listen” to insulin) classify you as “pre-diabetic”.

    In some cases even that extra insulin that the pancreas labored to produce can’t manage to get blood sugar down into the relatively “safe” (or non-diabetic) range. At this point, with elevated insulin and elevated blood sugar- you’ve got full blown type ll diabetes.

    Once you understand this, the importance of diet and exercise become very clear. Your diet needs to be one that doesn’t send your blood sugar through the roof. And exercise creates a natural demand from the muscle cells for sugar, therefore helping to reduce blood sugar naturally.

    Low-Carb Diets Work for Diabetes… and Weight Loss!

    In my opinion, the absolute best strategy for treating (and preventing!) diabetes is a controlled carbohydrate diet. Why? Because of the three “macronutrients” in every diet- protein, carbs and fats– the one that raises blood sugar the most is carbohydrates. Protein raises blood sugar and insulin a bit, but not nearly as much as carbs do. And fat raises it not at all.

    That’s why a low-fat high-carb diet is precisely the wrong way to go when you’re dealing with diabetes.

    Now this view is controversial (though becoming less so, particularly in view of mounting research showing the positive effect of low-carb diets on blood sugar and insulin). There have been successes with conventional low-fat diets, but they are nearly always loaded with fiber and vegetables (the so-called “low-glycemic” carbs), not with the processed carbs and sugar that are rampant in the conventional American diet. But reducing carbohydrate intake (especially from sugars and starches) virtually always normalizes insulin metabolism, and helps bring blood glucose (sugar) under control.

    What is Exactly Constitutes “Low-Carb” These Days?

    The following guidelines are adapted from the (sadly) out-of-print masterpiece, “Diabetes: Prevention and Cure” by C. Leigh Broadhurst, PhD. I’ve modernized them slightly, but the essence of her recommendations are hard to improve upon.

    • Limit carb consumption to fruits and vegetables.
    • Eat no pasta, bread, noodles, macaroni, rice, cereal or crackers.
    • Eat absolutely no sugar or sugary foods. “If it’s sugar-sweet or made of wheat, don’t eat”, she says.
    • Don’t drink fruit juices, except for a little in blender drinks. Eat the whole fruit.
    • Don’t eat meals or snacks composed mainly or wholly of carbs, especially at breakfast and late at night. Meals and snacks need to be a balance of protein, carbs and fat.
    • Eat copious quantities of fresh non-starchy vegetables (first choice) and fruits (second choice).
    • Don’t drink alcohol. “Alcohol, like refined sugars and starches, forces you to cannibalize your body’s nutrient stores just to metabolize it”.
    • Always consume your daily protein requirement. Donald Layman, PhD, one of the premiere researchers in the field of low-carb diets, routinely puts everyone on a diet of 125 grams a day of protein (along with 60 grams of fat and 100 grams or less of carbs, mostly from vegetables and fruits).
    • And, of course, start exercising. Every single day.

    Remember, a controlled carb diet doesn’t have to be extreme. Most Americans eat over 300 grams of the stuff on a daily basis. You should get huge benefits if you can cut that to 100, though some people may find that they need even greater restriction.

    My Recommended Reading List

    Some of the best information on diet and diabetes comes from Richard Bernstein, MD, a doc who himself has type l diabetes. His book “The Diabetes Diet” should be required reading.

    Also worth reading: “The Atkins Diabetes Revolution” by Mary Vernon, MD.

    Diabetes is one of those conditions where you actually can take control of your own health. Do it. As the kids would say, “it’s so worth it”.

     

    Sources

    1. WebMD, “Diabetes Up, Obesity to Blame”, April 20, 2006
    2. Centers for Disease Control and Prevention, Diabetes: At A Glance 2009
  • Skipping Sleep Can Lead to Diabetes

    Skipping Sleep Can Lead to Diabetes

    A study in the journal Science Translational Medicine found that not getting enough sleep, or getting poor-quality sleep, can make you fat and eventually lead to diabetes.

    Unlike past epidemiological studies, this one looked at people sequestered in a lab over a six-week period. Doing this allowed researchers to mimic third-shift work, jet lag, and other conditions that prevent a quality, full night’s sleep.

    In other words, by keeping these 21 brave participants tightly confined, researchers could control how many hours of sleep they got, when they slept, as well as other factors like diet and exercise. It wasn’t like they could slip off for a nap or anything.

    At the beginning of this six-week study, researchers allowed participants about 10 hours of sleep every night.

    Nice, right? Sign me up!

    But not so fast. Researchers eventually cut back participants’ sleep to less than six hours over a 24-hour period.

    Even more challenging, they rotated these six hours over different times of day and night to disrupt circadian rhythm, much like a hospital worker or someone flying to a different time zone might get inconsistent sleep.

    After suffering weeks of aberrant sleep patterns, researchers concluded the study by allowing participants plenty of recovery sleep.

    Regardless, these sleep-deprived people showed higher blood sugar levels, which can lead to obesity and diabetes. Even though they recovered, those weeks of not getting quality, consistent rest took its course.

    “The evidence is clear that getting enough sleep is important for health,” said lead author Dr. Orfeu M. Buxton, “and that sleep should be at night for best effect.”

    I know how easy it is to say this and yet how few people get seven to nine hours of high-quality, consistent sleep every night.

    More likely, you’re staying up late to meet deadlines, awakening at 3 a.m. with the next day’s business on your mind, or tossing for hours and hopelessly glancing at your alarm clock.

    To change those patterns, you need to prepare for sleep. About an hour before bed, shut down electronics and other stimulation, and unwind with a cup of tea and maybe a hot bath.

    Sleep is actually one of the seven key principles for living longer and living better covered in my DVD  7 Pillars of Longevity »

    Developing better sleeping patterns might require a natural sleep aid. One of my favorites is melatonin, a hormone your brain’s pineal gland produces to regulate sleep, circadian rhythm, and your body’s internal clock.

    Especially as you get older, your brain makes less melatonin. If you occasionally suffer from jet lag, have aberrant sleeping patterns, or just can’t get a good night’s rest, melatonin might be your ticket.

    A meta-analysis in the Cochrane Database of Systematic Reviews  found melatonin safe and remarkably effective to reduce or eliminate jet lag.

    And a study in the Journal of Sleep Research found that melatonin could help night-shift workers sleep better during the day.

    My favorite melatonin supplement comes from Designs for Health.

    This high-quality melatonin has vitamin B6 to aid the conversion process, contains no cheap fillers or binders to inhibit efficacy, and comes from one of the best, most ethical supplement companies in the world.

    Best of all I think it is only $11 for a 60 day supply.

    Nothing is more important than a good night’s sleep, so take the very best melatonin to help you get there.

  • Slowing Down to Eat Reduces Your Diabetes Risk

    Slowing Down to Eat Reduces Your Diabetes Risk

    If you want to reduce your risk for diabetes, slow down.

    That’s what a new study presented at the joint International Congress of Endocrinology and European Congress of Endocrinology concluded.

    People who mindlessly devoured their food in this study were two and a half times more likely to develop type 2 diabetes compared with those who slowly savored what they ate.

    Researchers here compared 234 people recently diagnosed with type 2 diabetes with 468 people without diabetes. Besides taking body measurements, they asked participants to complete a questionnaire about diabetes risk factors. Among those questions included how quickly they ate compared with their dining companions.

    Other than increased diabetes risk, people who ate faster had a higher body mass index (BMI).

    Are you seeing a pattern here?

    I’m willing to wager too the speed eaters weren’t eating wild salmon and broccoli. More likely, they were devouring In-N-Out burgers and milkshakes.

    Diabetes studies come out all the time. This one proves significant because it was the first to show how quickly you eat can determine whether you’ll develop this chronic – and in my opinion, completely reversible – disease.

    Experts often look for oversimplified culprits for diabetes, including higher consumption of high-fructose corn syrup HFCS), lack of exercise, and the ubiquitous fat-salt-sugar combo that makes up most of the processed and fast food people eat.

    And while these things certainly play a role, scientists often overlook that psychological factors also significantly contribute to diabetes.

    We’re a fast-paced, multitasking society that hardly seems aware what we’re shoveling down our mouths as we fight rush-hour traffic while taking a cell phone call from our irate boss.

    That’s why this study proves important. It provides an often-neglected component to prevent diabetes: slow down.

    I get it: saying it is easier than doing it, especially in these tough economic times where you might be struggling to stay afloat and stopping everything else for 30 minutes to savor your food just doesn’t seem possible.

    But it’s worth it, for peace of mind and – as we’re seeing more and more – your health. I want to conclude with seven strategies to help you put the brakes on your eating pace:

    1. Eat with slow people. You know those people who linger over their meal and enjoy every bite? Opt to dine with them rather than your friend who pounds cheeseburgers like a keg party at a fraternity house.
    2. Put your fork down between bites. Remind yourself this isn’t one of those Coney Island hot dog eating contests and shoveling down your food will only give you indigestion.
    3. Stop the dashboard dining. You know that cramming down an Egg McMuffin while sitting in rush hour traffic is hardly the best way to start your day. Whenever possible, eat sitting down (but not behind the wheel!), preferably at your kitchen table. My friend JJ Virgin has more great information about slowing down.
    4. Chew thoroughly. A new study in The American Journal of Clinical Nutrition showed that people who chew more eat less food and absorb more nutrients. Sounds like a win-win to me.
    5. Be mindful while you’re eating. Put away your iPhone and other distractions. And establish a no-texting rule at the dinner table. Be present and listen to what others say. Or if you’re eating alone, focus on food rather than the TV.
    6. Pause before you eat. If you’re religious, you could say a short prayer before you dive into your food. And if you’re not, simply taking a moment to breathe and offer thanks can calm your mind and digestive system.
    7. Visit a gourmet multi-course restaurant. Ever visited one of those prix fixe restaurants where you linger for hours enjoying course after course? That’s a great way to learn how to slow down and savor food.
  • Processed Meat Linked to Diabetes (Maybe Not)

    Processed Meat Linked to Diabetes (Maybe Not)

    A new study in the American Journal of Clinical Nutrition found that processed canned meat – more affectionately known as spam – could double your risk for diabetes.

    The study involved 2,000 Native Americans, a high-risk demographic for type 2 diabetes. Statistics show, in fact, that almost one in two Native Americans will have diabetes by age 55. So it makes sense to conduct studies and figure out what’s triggering this chronic disease.

    According to Amanda Fretts, the study’s lead author and a researcher at the University of Washington School of Medicine, spam has become a staple on reservations due to its long shelf life, particularly since many Native Americans have limited access to grocery stores.

    I should also mention the U.S. Department of Agriculture’s food assistance program provides this spam. That it’s free might be another reason to stock up on it.

    Back to the study: when it began, none of the participants had diabetes. A five-year follow-up survey, however, revealed 243 of the 2,000 Native Americans had developed diabetes.

    Of the 500 people in the original study who ate the most canned meats, 85 had developed diabetes.

    On the other hand, among the 500 people who ate the least amount of spam, 44 developed diabetes.

    Researchers noted that people who feasted on spam more often also tended to be overweight.

    Despite these statistics, Fretts said the study could not prove that eating processed meats contributed to the increased risk of diabetes. “I think there needs to be more follow-up,” she said.

    I’m not a fan of spam and other processed meats. They’re often filled with gluten, sugar, and God knows what else. If you’ve ever eaten a hot dog or sausage and wondered what was in it, chances are you don’t want to know. Particularly not while you’re eating it.

    That said, I want to know exactly what else these people ate for five years besides the spam that potentially contributed to diabetes.

    My guess is, with limited funds and access to grocery stores, the spam eaters weren’t eating organic broccoli and sipping green tea. Instead, they likely consumed all sorts of processed crap and guzzled sugary sodas that, like spam, have a shelf life of forever.

    In other words, I’m not a fan of spam, but neither am I convinced it was the culprit in these Native Americans’ diabetes surge.

    I also want to point out researchers did not find that unprocessed meat also triggers diabetes. I’m happy they said that, because I believe meat gets unfairly stigmatized regardless of its source.

    As you know, a world of difference exists between spam and healthy meats like grass-fed beef, wild salmon, and free-range poultry. In other words, a McDonald’s cheeseburger is a whole different ballgame than a grass-fed steak.

    Red meat in particular has been unfairly criticized for potentially creating diabetes. Again, let’s go back to the drawing board: what else were these people eating besides the meat in these studies?

    If the standard American diet is any indication: lots of carbs. And you know what carbs do well. They raise insulin. Eventually your cells get burned out from insulin overload. Insulin resistance and subsequently diabetes are often the result.

    Now, let’s say you have a grass-fed steak with spinach and a salad. You guessed it: you don’t have that insulin surge and all its subsequent metabolic problems.

    My point is, I don’t think meat – processed or not – is the problem. It’s all the other crap people eat combined with that meat that leads to diabetes.

    One more thing: many of these studies that indict red meat for diabetes use conventional meat, not the far healthier grass-fed beef that’s richer in omega 3s, conjugated linoleic acid, and other nutrients.

    My verdict: skip the sugar and processed carbs, choose the highest-quality meats, eat plenty of leafy green vegetables and low-glycemic fruits, and you’ll dramatically reduce your diabetes risk.

  • Low Levels of Vitamin D Linked with Diabetes

    Low Levels of Vitamin D Linked with Diabetes

    A new Australian study links low levels of vitamin D with a higher risk of diabetes.

    This study comes on the heels of a finding presented at the American Diabetes Association 2011 Scientific Sessions that showed that examined data from the Diabetes Prevention Program which showed that participants in the upper third of vitamin-D levels had a 26% less chance of developing diabetes compared to the participants in the lower third.

    These studies add to the growing body of research demonstrating a positive effect of vitamin D on literally dozens of conditions ranging from cancer to obesity.

    In the Australian study, 5200 non-diabetic men and women were evaluated for blood sugar issues using a glucose tolerance test. In addition, the researchers tested their blood levels of vitamin D. The subjects were then followed-up for five years.

    During the five-year follow-up, 199 cases of diabetes were diagnosed. Those who developed diabetes had lower vitamin D levels compared to those who remained free of diabetes.

    Even after adjusting for all possible confounding variables like smoking, physical activity, hypertension, and family history of diabetes, each 25nmol/L increment in blood levels of vitamin D was associated with a 24% reduced risk of diabetes.

    Each 25 nmol/L increment in serum vitamin D was associated with a 24% reduced risk of diabetes.  A single vitamin D capsule of 1000 IUs of vitamin D would raise your blood levels of vitamin D by the amount needed to reduce the risk of diabetes by 24%. Two thousand IUS- the amount I generally recommend as a daily supplement— would reduce the risk by 48%. Not a bad return for one of the most inexpensive, easiest-to-take supplements on the planet!

    Another nice finding of this study:  higher levels of vitamin D were associated with greater levels of insulin sensitivity!

    (Insulin sensitivity is the opposite of insulin resistance. In insulin resistance, the cells stop “listening” to insulin; insulin resistance at the root of both metabolic syndrome and diabetes. You want your cells to be insulin sensitive, not insulin resistant!)

    Note that there are two systems of measurement for vitamin D levels in the blood. In Europe they use the nmol/L standard used in the present study, but in the US we mostly use ng/ml. If you have your vitamin D levels tested, make sure to compare apples to apples. According to the vitamin D council, optimal ranges using the US measurement of ng/ml are between 50-80.

  • Flaxseed Oil Associated with Decreased Risk of Type II Diabetes

    Flaxseed Oil Associated with Decreased Risk of Type II Diabetes

    Alpha-linolenic acid—the plant based omega-3 found in flaxseed—has been shown to be associated with a decreased risk of diabetes.

    Any reader of this newsletter knows by now of the myriad health benefits associated with greater omega-3 consumption. But there have been relatively few studies comparing the effects of marine-based omega-3’s to plant based omega-3’s. The two omega-3’s found in fish—EPA and DHA—have long been touted for their benefits to the heart and brain. The plant-based omega-3 found in flaxseeds and flaxseed oil- has been less studied.

    Now a study known as the Singapore Chinese Health Study has analyzed data from over 43,000 Chinese men and women free of chronic disease, aged 45-74 years old. The participants were followed for six years. The researchers compared dietary intakes from each of the three omega-3 fatty acids with the incidence of type ll diabetes.

    The first finding was not surprising. Those consuming the highest amounts of omega-3’s from all sources had the lowest risk for diabetes—in other words, there was an inverse relationship between omega-3 consumption and diabetes risk.

    But what was surprising was that when the researchers tabulated the dietary intake of individual fatty acids, they found no particular relationship between the marine omega-3’s (EPA and DHA) and decreased risk of diabetes. Those consuming the most ALA, on the other hand, had a statistically significant decreased risk of the disease.

    “Consumption of nonmarine sources (ALA) of omega-3’s is associated with a decreased risk of type 2 diabetes.. (in this population)”, they concluded.

    It’s worth noting that in the same issue of the American Journal of Clinical Nutrition, another study examined data from over 3000 older men and women over the course of 10 years and tracked their intake of all three omega-3 fatty acids. In this study, higher intakes of both the marine omega-3’s (EPA-DHA) and the plant based omega-3 (ALA) were found to be associated with lower risk of diabetes.

    Bottom line: Get your omega-3’s from any source you can, but be sure to take them on a daily basis. It’s one supplement you really can’t afford to be without.

  • Vitamin D and Diabetes: Is There a Link?

    Vitamin D and Diabetes: Is There a Link?

    San Diego, CA – Higher levels of vitamin D in the blood appear to be associated with a reduced risk of incident diabetes among people with high risk for the disease, according to a new report.

    Dr Anastassios G Pittas (Tufts New England Medical Center, Boston, MA), and colleagues presented the findings here at the American Diabetes Association (ADA) 2011 Scientific Sessions.

    According to Pittas, vitamin D may have a role in diabetes via improvements in insulin secretion and insulin sensitivity.

    To determine the relationship between vitamin-D status and risk of incident diabetes, the researchers analyzed data from the Diabetes Prevention Program (DPP), a three-arm trial comparing intensive lifestyle modification or metformin vs placebo for prevention of diabetes in patients with prediabetes.

    The mean follow-up of the cohort of 2039 participants was 3.2 years. Plasma vitamin-D levels were measured at yearly intervals, and subjects were assessed for incident diabetes.

    Participants in the upper third of vitamin-D levels had a 26% less chance of developing diabetes compared with participants in the lowest third.

    Interestingly, those in the highest third had an average blood concentration of only 30.1 ng/mL. Though conventional medicine believes that 30 ng/mL is “sufficient”, virtually no serious vitamin D researcher agrees that 30ng/mL is an optimal amount.

    “Much higher levels are better”, said well-known vitamin D expert Michael F. Holick, MD, PhD. “(It was) decided that 30 ng/mL is the minimum level but 40-60 ng/mL is recommended for both children and adults”, he said.

    The findings of this study also suggested a dose-dependent effect for vitamin-D levels. The folks with the highest blood levels of vitamin D levels (>50 ng/mL, which I consider way more optimal than 30 ng/mL), had the very least chance of developing diabetes. Those with the lowest levels (<12 ng/mL) had the greatest risk.

    “This study offers several methodological advantages over previous studies,” said Pittas. According to Pittas, vitamin-D status was assessed multiple times during follow-up, not just a single assessment at baseline, which may not reflect long-term vitamin-D status.

    “Our study also includes a large clinically relevant population at high risk for diabetes with a substantial proportion of nonwhite participants, which improves the external validity of the results,” he said.

    “This prospective study confirms that there is an association between levels of vitamin D and risk of diabetes even when correcting for body weight” commented Dr Clifford Rosen (Jackson Laboratory, Bar Harbor, Maine).

  • Magnesium Can Reduce the Risk of Diabetes

    Magnesium Can Reduce the Risk of Diabetes

    Daily supplements of magnesium may improve insulin sensitivity and help reduce the risk of diabetes in overweight people, a new German study suggests.

    In the randomized controlled trial, 52 overweight, non-diabetic participants received magnesium supplements at a dose of 365 mg per day or placebo for six months (1).

    In order to study the effect of oral magnesium supplementation on diabetes risk, researchers looked at several important markers for insulin sensitivity, such blood glucose levels, blood insulin levels, blood pressure and overall lipid profile.

    The study results showed that two out of three measures of insulin sensitivity (blood glucose and insulin levels) improved significantly following magnesium supplementation, and there was also a trend towards an improvement in blood pressure as well..

    The scientists concluded that the study provides significant evidence that magnesium supplementation ameliorates insulin resistance and subsequently type-2 diabetes in obese people.

    Magnesium supplementation was effective even in people who had “normal” blood levels of magnesium to begin with!

    According to the researchers, several mechanisms may be responsible for the beneficial effect of magnesium on insulin resistance, including direct effects of magnesium on the insulin receptor and its signaling processes.

    In 2007, the results from a meta-analysis of observational including 286,668 participants had shown that, for every 100 mg increase in magnesium intake, the risk of developing type-2 diabetes decreased by 15 percent (2).

    Magnesium is one of my seven basic “can’t-do-without” supplements. I recommend magnesium for everyone. It’s required for over 300 metabolic operations, nearly no one gets enough of it, it helps support strong bones, it’s relaxing, and it lowers blood pressure, all in addition to its positive effect on insulin resistance and diabetes risk.

    REFERENCES:

    1. Mooren F. C. et al. Oral magnesium supplementation reduces insulin resistance in non- diabetic subjects – a double-blind, placebo-controlled, randomized trial. Diabetes, Obesity and Metabolism. 2011.

    2. Larsson S. C. and Wolk A. Magnesium intake and risk of type-2 diabetes: a meta-analysis. J Intern Med. 2007; 262(2):208–214.