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Can Vitamin D Lower Your Risk Of Diabetes?

20 Nov

Vitamin-DPhysicians have suspected for some time that Vitamin D may play a role in the control of blood sugar and prevent the onset of Type 1 and Type 2 diabetes.  Studies have already shown that a vitamin D supplement taken during pregnancy or in infancy can reduce the risk of Type 1 diabetes.

Now, a new, large-scale study is getting underway funded by the National Institutes of Health, to determine if Vitamin D can control or prevent Type 2 diabetes.

What is Vitamin D’s role in your body?

You’re probably familiar with the fact that along with calcium, Vitamin D is critical for building and maintaining bone mass. But Vitamin D plays a much wider role in your body, affecting many system-wide functions. Chronically low levels of Vitamin D are associated with many chronic diseases, most famously rickets.

In the new study, scientists are examining

  • the ability of vitamin D to influence certain cells in the pancreas (pancreatic beta-cells) known to store and release insulin
  • if vitamin D influences insulin sensitivity by stimulating insulin receptors
  • if vitamin D affects insulin secretion and sensitivity by regulating calcium levels in cells
  • if vitamin D boosts the level of T-cells in your body, which would influence the steps leading to Type 1 diabetes

If vitamin D is found to influence or regulate these systems in your body, it could go a long way towards explaining why Type 2 diabetes has become epidemic. The theory goes that the typical high-carb, high in red meat, low-D diet of most Americans results in levels of the vitamin far below what’s needed for proper function. Additionally, our sedentary, mostly indoor lifestyle leaves little opportunity for our bodies to synthesize vitamin D by way of sunlight.

In an analysis from the Nurses Health Study, there was a statistically significant association with lower risk of type 2 diabetes among women who reported the highest intake of both vitamin D and calcium… A statistically significant association between higher vitamin D status and lower risk of incident type 2 diabetes was also reported among men in the Mini-Finland Health Survey. – National Institutes of Health

How can you get enough vitamin D?

The answer to that question is shockingly simple: eat the right foods and spend some time in the sun.

Many foods are rich in vitamin D, primarily those in the fish family (see below). Additionally, your body can produce much of the vitamin D it needs simply by exposing your skin to direct sunlight. Ultraviolet radiation penetrates uncovered skin and converts certain fat-dwelling substances in your cells into the precursor for vitamin D3. The season of the year, cloud cover, smog, and the amount of melanin in your skin all affect how much is produced. Fortunately, the vitamin D produced this way is stored in your liver and fat cells and can be drawn upon as needed by your body.

It’s important to note that this synthesis of vitamin D by sunlight can only happen outdoors by allowing the sun to directly shine on your skin. Sitting near a sunny window won’t help at all. Ten to thirty minutes of midday sun exposure (10 am-3 pm) at least twice each week to the face, arms, legs, or back without sunscreen is usually sufficient to build enough D reserves. Despite its importance in synthesizing vitamin D, don’t go on a massive D-quest and expose your skin to direct sunlight for hours at a time. UV radiation from sunlight and tanning beds has the potential to act as a carcinogen in your body, causing metastatic melanoma. Everything in moderation.

Foods that are naturally high in Vitamin D (does not include foods fortified with vitamin D)

  • Cod Liver Oil
  • Swordfish
  • Shiitake and Button Mushrooms
  • Beef Liver
  • Mackerel
  • Sockeye Salmon
  • Herring
  • Sardines
  • Catfish
  • Tuna
  • Trout
  • Eggs

If you’re diabetic, maintain your “D”

It all once again, comes down to a healthy diet and moderate amounts of exercise. Diabetics and non-diabetics alike should be cutting down on their red meat intake, and swapping it for the fish mentioned above. It is also recommended that 1/2 of the food on your plate at lunch and dinner be vegetables, preferably fresh. You can easily get enough sunlight to produce Vitamin D by exercising outdoors a few times a week, by simply walking for 20-30 minutes and making sure the sun is hitting your face, hands, and arms (assuming you don’t have a health condition which prohibits this).

As part of your diabetes management, have your physician check your vitamin D levels to make sure they’re sufficient. If they’re lacking, start on a complete vitamin D supplement, start exercising outdoors, and follow the dietary guidelines above. However, don’t make the mistake of taking a vitamin D supplement in lieu of getting it through diet and sunlight – too much vitamin D in this form has been associated with kidney stones and other complications. Many foods not on the list are fortified with vitamin D: milk, cereals, orange juice, yogurt and cheese, but check each product’s label, as amounts differ.

The federal government’s Dietary Guidelines for Americans states that “nutrients should come primarily from foods. Foods in nutrient-dense, mostly intact forms contain not only the essential vitamins and minerals that are often contained in nutrient supplements, but also dietary fiber and other naturally occurring substances that may have positive health effects. …Dietary supplements…may be advantageous in specific situations to increase intake of a specific vitamin or mineral.”

Holiday Meal Planning for Diabetics

14 Nov

family-cooking-thanksgiving-dinnerTurkey. Cranberry sauce. Stuffing. Mashed potatoes. Sweet potatoes. Green beans. Corn. Carrots. Biscuits. Pumpkin Pie. Pecan Pie. Apple Pie.

There are a thousand ways to prepare these basic components of the holiday feast. But it’s in the preparation, with the addition of fats and sugars, where the unhealthy calories intrude, and the invariable blood sugar spikes for diabetics.

For chefs, the key to keeping your weight and blood sugar under control at the holiday feast is to prepare these foods with a minimum of added fat and sugar (nix the deep fried turkey!).  The American Diabetes Association recommends that you always roast a turkey, as it cooks in its own juices, which keeps the calories down. When you deep fry it, or glaze it, the calories shoot through the roof. Make the mashed potatoes with low-fat milk and olive oil instead of butter. Steam vegetables and serve with an olive oil and herb drizzle, instead of baking them in a casserole with creamy sauces. Bake the stuffing in a casserole instead of inside the turkey – this cuts way down on the fat. Serve fresh cranberries, one of the healthiest fruits on the planet – when sold as cranberry sauce, they become something else entirely.

If you’re a guest at the feast, choose wisely and eat modestly. At dinner time, take the skin off your turkey, and choose white meat instead of dark. The ADA says that “White turkey meat (without skin) is low in fat and high in protein. It is a good source of iron, zinc, phosphorus, potassium and B vitamins. It is also one of the only parts of the Thanksgiving meal with no carbohydrate.”  Say “no” or “just a pinch” to butter and gravy, and take a big portion of fresh vegetables and a small portion of white potatoes. If you have a glass of wine, drink it with dinner, instead of before. Alcohol metabolizes much more slowly in the presence of food.

There’s really very little difference in sound diet advice for diabetics or non-diabetics. The modern American diet, the primary culprit in the diabetes epidemic, is so far off the rails, that it would do us all some good to reign it in a little this holiday. For anyone, a healthy diet is one with generous portions of fruits and vegetables, and is low in fat, sugar, and salt.

Start Thanksgiving and Christmas Day with a healthy breakfast: high fiber cereal, fresh fruit, whole wheat toast with olive oil, or a scrambled egg with smoked salmon on toast. Instead of snacking on cookies, keep a bag of baby carrots or your favorite vegetables handy and reach for those instead. High fiber foods give us a full feeling much faster than those that are low in fiber.

After the meal, go for a walk with family members – it’s a great way to catch up, enjoy some fresh air, and burn off calories and excess blood sugar at the same time. It will also keep you from falling into a turkey coma (which really isn’t from the turkey, it’s from the carbohydrates).

But whether you’re diabetic or not, we darn well know that we’ll probably eat if not too much, then more than we should. To deal with the extra calorie load, exercise more strenuously for a few days before the feast and for a few days after.

Ask your family members to support you and to help you celebrate another year of good health.

When your child is diagnosed with diabetes

6 Nov

diabetes in children

“Go out and play”, and “eat your vegetables”, is probably the simplest, best advice you can give your diabetic child.

Before 1990, when a child or teen was diagnosed with diabetes, it was usually with Type 1.  But in the past twenty years, Type 2 diabetes, which was rarely seen in those under 20, has been growing at an alarming rate in this young population.

Type 1 diabetes is an autoimmune disorder, and is not the result of diet or lifestyle. Type 2 diabetes occurs when the body’s cells develop a resistance to the hormone insulin, which regulates blood sugar levels. As the need for insulin increases, the pancreas has difficulty producing the hormone, and blood glucose spikes to dangerously high levels.

Most kids diagnosed with Type 2 diabetes are between 10 and 19, are clinically obese, and have a family history of Type 2 diabetes. It appears in children of all ethnic groups, but it’s more common in non-white kids. If a mother develops diabetes during pregnancy (gestational diabetes), her children are also more likely to develop the disease.

The recent phenomenon of childhood obesity has been accompanied by a rise in Type 2 diabetes in children.  The sudden increase is troubling to doctors, because the longer a person has diabetes, the greater the risk of developing its side effects: heart disease, eye problems, nerve damage, kidney disease, and other complications.

The bright side is that with proper medical treatment and a program of self-care that includes weight management, exercise, regular glucose monitoring, and a proper diet, most children can keep their blood sugar under control and avoid serious side effects.

The most common symptoms of diabetes in children

  • Frequent headaches
  • Blurred vision
  • Frequent thirst or urination
  • Dry, itchy skin

If your child is diabetic and exhibits any of these symptoms, their blood glucose levels may be on the high side. Have their medical team reevaluate their blood sugar management program. If your child has not been diagnosed, but is exhibiting any of these symptoms, have them screened for diabetes.

Treatments for children with Type 2 diabetes

Children with Type 1 diabetes are treated with insulin shots, but that’s usually not necessary for kids with Type 2. Most can manage their disease by getting plenty of exercise, and cutting back on calories, sugar, and fats. Some may also need to take oral medicine to control their blood glucose.

As a parent, you can lead the way. Speak openly with your child about their disease, so they understand its effects. At meal times, avoid fast food, high fat meals, and sugar-laden beverages like soda and sports drinks. Instead, serve lots of fresh fruit, vegetables, and whole grains. Have your own exercise program, which will set an example for your child, because a sedentary lifestyle puts them at great risk for developing the complications of diabetes.

Check out the National Diabetes Education program’s resources for teens.

Does your ethnicity determine if you’ll get diabetes?

5 Nov

ethnicity diabetesIt’s no secret that Type 2 diabetes has achieved epidemic status in the United States. But we’re not alone – recently it was reported that China’s diabetes rate is now the highest in the world, and it’s also gaining ground quickly in other countries.  But regardless of where you live, your ethnicity may play a role in your susceptibility to the disease.

In a healthy person, blood sugar levels fluctuate, depending on what you eat, if you exercise, and a number of other factors. Your blood sugar is kept in check by the hormone insulin, which is produced by the pancreas. Insulin regulates the flow of blood sugar into your cells, where it’s burned for energy. In a person with Type 2 diabetes, insulin no longer controls blood sugar adequately.

According to Enrique Caballero, MD, director of the Latino Diabetes Initiative at the Joslin Diabetes Center, Type 2 Diabetes is much more common among Latinos, African Americans, Asian Americans, Native Americans, and Pacific Islanders than among Caucasians. Why this is so is still somewhat of a mystery, but research points to heredity, and more specifically to genes that affect insulin function.

African Americans and Native Americans at highest risk for Type 2 diabetes

Among those Americans over 20 years of age, 7.1 percent of non-Hispanic whites have been diagnosed with diabetes. In ethnic populations, that percentage increases to 8.4 percent of Asians, 11.8 percent of Hispanics/Latinos, 12.6 percent of non-Hispanic blacks, and 16.1 percent of Native Americans. Remarkably, members of these minorities who eat an unhealthy diet are more likely to get the disease than whites who eat the same unhealthy diet.

The secondary effects of Type 2 diabetes are also out of proportion for minorities. African Americans are 50% more likely to develop blindness caused by diabetes, are 5 times as likely to develop kidney disease, and are nearly 3 times as likely to suffer a lower limb amputation.

Research points to a gene that regulates insulin differently. According to the ADA, in several studies, Blacks, Asians, and Mexican Americans were found to be less insulin-sensitive than non-Hispanic whites (insulin sensitivity is the body’s ability to respond to glucose). This suggests that these minorities may be genetically programmed to utilize glucose less effectively than whites.  When this genetic predisposition is combined with the American high carb, high fat diet, and a sedentary lifestyle, the risk of contracting type 2 diabetes skyrockets.

Steps to reduce your risk of Type 2 diabetes

Regardless of your ethnic background, dietary and lifestyle changes are the proven, most effective ways to reduce your chances of contracting Type 2 diabetes. They’re also a significant part of your blood sugar control program if you have been diagnosed.

  • Replace high fat meals with low fat meals. Choose olive oil over butter, vegetable oil over lard
  • Reduce the amount of sugar in your diet, especially sodas and other sugary drinks
  • Reduce carbohydrates – ditch the potato chips
  • Increase fresh fruits and vegetables – eat carrots and apples for snacks, not corn chips or cookies
  • Increase whole grains – swap white bread for whole wheat, and white rice for brown rice
  • If you’re overweight or obese, start a weight management program
  • Exercise daily. If you’re out of shape, begin by walking as far as you can, and increase your workout a little bit every day.

If you’re overweight or obese, but haven’t been diagnosed with diabetes, you’re still at high risk, regardless of your ethnicity. If you’ve been diagnosed with diabetes or prediabetes, take the advice of your medical team about how to get your blood sugar under control.

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Study Shows New Link Between Diabetes and Heart Disease

1 Oct

A remarkable new study done at the University of California Davis Health System has identified the reason that diabetes and heart disease are so intimately connected. Specifically, UC reserachers have shown that a biological pathway is activated when blood sugars are abnormally high, leading to cardiac arrhythmia – irregular heartbeats – which can cause heart failure and sudden cardiac death.

Cardiovascular disease diabetesHeart disease is of course common in the general population. But according to the National Institutes of Health, the risk is four times greater for diabetics. The American Heart Association estimates that at least 65 percent of people with diabetes die from heart disease or stroke and has emphasized the need for research focused on understanding this relationship.

The UC Davis study showed that when blood glucose levels are abnormally high, a specific sugar molecule in heart muscle cells fuses to a protein known as CaMKII. This protein plays a vital role in regulating calcium levels, electrical activity, and pumping action of the heart. The sugar molecule caused the CaMKII to become overactive, causing changes in the finely tuned calcium signaling system it controls. This was shown to trigger full-blown arrhythmias in minutes.

Scientists have understood for quite some time that CaMKII plays a critical role in heart function. This study however, is the first to identify how hyperglycemia activates CaMKII. “The novel molecular understanding we have uncovered paves the way for new therapeutic strategies that protect the heart health of patients with diabetes,” said Donald Bers, chair of the UC Davis Department of Pharmacology and senior author of the study.

Visit the Diabetic Foot and Ankle Center for the Lehigh Valley

In an additional experiment, the team found elevated levels of the fused CaMKII in both hearts and brains of deceased humans who were diagnosed with diabetes. The highest levels were found in the hearts of patients who had both heart failure and diabetes.

“This represents the most clear-cut mechanistic study to date of how high glucose can directly affect the function of a critical regulatory protein,” said Hart. “The Bers group’s findings undoubtedly will lead to development of treatments for diabetic cardiovascular disease and, potentially, therapeutics for glucose toxicity in other tissues that are affected by diabetes such as the retina, the nervous system and the kidney.”

What can you do to lower your risk of cardiovascular disease from diabetes?

Studies have shown that the higher your blood sugar is, the higher your risk for developing diabetic heart disease. Take precautions and keep an eye on your blood sugar levels.

  • Reach and stay at a healthy weight
  • Check your blood glucose levels regularly
  • Take your prescribed medication as directed to control your blood glucose levels
  • Exercise regularly to lose weight and burn excess blood glucose
  • Maintain an appropriate diet for your disease

Read more: Avoiding Diabetes With A Healthy Diet and Diabetes Diet: What’s Good, What’s Bad

Diabetes Control – Hearty Breakfast Could Be Your Best Tool

27 Sep

As reported in Philly.com:

diabetes breakfastNew research suggests that a breakfast of fried eggs with oatmeal or plain, greek yogurt with fresh fruit may be the most effective way to control blood sugar and hunger for those with Type 2 diabetes.

A recent research trial assigned a group of people with Type 2 diabetes to either a big or small breakfast group. Each person in the big breakfast group ate about 1/3rd of their daily calories upon rising. The small breakfast contained about 12 percent of total daily calories. The big breakfast also contained a higher percentage of protein and fat (think eggs, ham, or yogurt, not cereal or pop tarts).

After 13 weeks, the big breakfast group had:

  • Reduced their blood glucose levels 3 times as much as the small breakfast group
  • 1/3rd of the group were able to reduce the amount of daily medicine they took to control their diabetes
  • Showed blood pressure reductions that were four times greater
Seventeen percent of those in the small breakfast group actually had to increase their medication during the trial, and it probably comes as no surprise that those who ate a big breakfast experienced less hunger during the day.

As the study progressed, we found that hunger scores increased significantly in the small breakfast group while satiety scores increased in the big breakfast group,” said study co-author Dr. Hadas Rabinovitz, of the Hebrew University of Jerusalem. “In addition, the big breakfast group reported a reduced urge to eat and less preoccupation with food, while the small breakfast group had increased preoccupation with food and a greater urge to eat over time.” Rabinovitz speculated that a big breakfast rich in protein causes suppression of ghrelin, which is known as the “hunger hormone.”

So why does the protein and fat control hunger and blood sugar when a high-carb breakfast like sugary cereal doesn’t? Because carbohydrates elevate blood sugar as quickly as 15 minutes after eating. Protein on the other hand, may take as long as three hours to convert into glucose, and along the way, it’s also used to do other things like repair muscle.

The researchers based their new study on previous investigations that found that people who regularly eat breakfast tend to have a lower body mass index (BMI) than those who skip the meal. BMI is a measurement that takes into account height and weight. Breakfast eaters also enjoy lower blood sugar levels and are able to use insulin more efficiently.

So what constitutes a low carb, high protein breakfast? That’s tricky.  All sugars – of any kind – are carbohydrates. Fruits and vegetables are carbs, as is refined white sugar, and so are grain products like bread and pasta. However, there’s a difference in how they’re all digested.

Sugary, grain-based cereals break down quickly in your gut and blast your blood with glucose. To your body, the only purpose of these foods is a fast and calorie-dense source of energy. They’re sort of “here and gone”. Proteins like eggs or meat break down slowly in your gut and slowly elevate blood sugar. Carbohydrates like fruits and vegetables contain fiber which slows their breakdown, and also contribute much more slowly to blood glucose levels. All of these foods also affect hunger hormone levels differently.

It can all be quite complicated, so here are our suggestions for a healthy start. (Note: read labels on packaged foods and know what you’re buying. Many products, even supposed healthy products like flavored yogurts may have lots of added sugars.)

Dr Oz has a menu of excellent diabetic breakfast recipes, like this one:

Sunrise Smoothie

Ingredients 

1/2 banana
1/2 mango, peeled and chopped
1/2 cup sugar-free, fat-free yogurt (vanilla or citrus)
2/3 cup skim milk
Several ice cubes
2 tsp of protein powder (optional)

Directions

Whirl together in a blender or smoothie maker.

The American Diabetes Association has recipes, like this one:

Broccoli Feta Omelette

Prep time: 10 minutes
Serves 4; serving size: 1/4 of omelette

Ingredients
1 Tbsp olive oil
2 cups chopped broccoli florets
1/4 cup chopped onion
1 1/2 cups liquid egg substitute
1 tsp dried dill weed
Salt to taste (optional)
1/8 tsp pepper
1/2 cup reduced-fat finely crumbled feta cheese
4 whole wheat luncheon rolls (optional)

Preparation

  1. In a large nonstick skillet with sloping sides, combine the oil, broccoli, and onion. Cook over medium heat, stirring frequently, until the onion is tender, about 5 or 6 minutes.
  2. Meanwhile, place the egg substitute in a medium bowl. With a fork, beat in the dill, salt, if desired, and pepper.
  3. When the onion is tender, add the egg substitute to the pan, if necessary tipping the pan so that the egg mixture covers the entire bottom. Cook over medium heat for 2 minutes.
  4. Sprinkle the cheese evenly over the top of the egg mixture. Cover, reduce heat, and cook an additional 4 to 6 minutes or until the omelette is set.
  5. With a plastic spatula, cut the omelette into four servings, and transfer the servings to plates. Serve with luncheon rolls, if desired.

Is Red Meat The Real Cause Of Type 2 Diabetes?

19 Jun

Avoid white sugar and carbs, avoid white sugar and carbs. It’s repeated like a mantra for every person afflicted with Type 2 diabetes.

But according to a new study published in Journal of the American Medical Association, red meat may also play a significant role in the onset of diabetes.

Luncheon-red-meat-hamburger-steak-increase-diabetes-riskResearchers followed a group of almost 150,000 men and women for 12-16 years, who ate red meat daily, averaging from half a serving to two servings each day (a serving being equivalent to one 3 ounce burger or two bacon slices). At the end of the study, there were 7,540 new cases of Type 2 diabetes, significantly outside the statistical norm, even when lifestyle factors like the rest of the diet, activity level, body weight, and smoking were factored in. The two groups were compared against a group which did not change the amount of red meat they ate. We should note that this is the first study to examine changing levels of red meat consumption over time, because we tend to eat very differently as we age (what was your diet like 16 years ago?).

The study’s authors discovered that increasing red meat consumption by more than half a serving a day – just 1.5 ounces more – was linked with a 48% higher risk of diabetes. But they also found that reducing red meat consumption by the same amount was linked with a 14% lower risk of diabetes.  The findings included every kind of red meat, from bologna to steak, but there seemed to be a stronger link with the processed types: deli meats, hot dogs, bacon, sausage, etc.

The study’s senior author Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health, says that the presence of sodium and nitrites (added as preservatives)  in processed meats and a specific kind of iron in red meat may be the real villains. The authors also note that the accompanying saturated fatty acids in red meat which lead to weight gain may also play a role.

Bottom line is, a healthy diet to avoid diabetes and many other diseases is one that includes lean sources of protein – nuts, whole grains, and low-fat dairy products. Not that you need to eliminate red meat entirely from your diet – in fact, it can be quite healthful when consumed in small amounts. But focus on lean cuts of steak and limit your consumption of processed meats. Grill those steaks, but do it on special occasions only, not every day.

Diabetes: Walk It Off!

12 Jun

In a study published this week in the medical publication Diabetes Care, researchers concluded that a 15 minute walk after eating every meal lowers blood glucose levels more than taking a 30 or 45 minute walk once a day.

fitness walking diabetesAccording to an article from ABC News:

“…researchers monitored blood sugar levels in healthy adults with an average age of 70 who were at risk of impaired glucose intolerance, a precursor of diabetes. Each study participant… on different days… did a 15-minute, post-meal walk (three meals per day, three walks per day), one 45-minute morning walk and a 45-minute afternoon walk.

The winner in terms of lower blood glucose levels? The after-meal walk.

“A post meal walk is timed to when blood glucose just starts to climb,” said Dr. Loretta DiPietro, lead author of the study and chair of the Department of Exercise Science at The George Washington University School of Public Health and Health Services. “The muscle activity and the muscle contractions help to clear glucose. It’s like another set of hands to help the pancreas halt the surge of glucose.”

Dr DiPietro stressed that this type of low-stress exercise, won’t keep you fit in the long term, however. It’s really targeted at middle aged, obese people who show signs of pre-diabetes or for elderly patients who may not be able to perform a heavier regimen. And exercising for short periods three times a day may not be practical for most people.

But the important takeaway from this study is to KEEP MOVING. As we explained in an earlier post, aerobic exercise – walking, running, swimming, bicycling, etc – burns blood glucose more efficiently than any other kind of activity. And keeping these levels in check, whether you’re diabetic or pre-diabetic makes all the difference in avoiding the high cost of Type 2 Diabetes.

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