Diet, Exercise, and Diabetes

Diet and Exercise

There have been several studies in the past that promote lifestyle factors and compare them to drug treatments like metformin. For diabetes type 2 including pre-diabetes – here is another one – too bad more physicians are not “prescribing” this intervention instead of putting their patients on one drug after another to control diabetes type 2.

“Researchers randomly assigned 100 sedentary adults aged 65 to 85 with type 2 diabetes and overweight or obesity to either an intensive lifestyle intervention or a control group that only had monthly sessions about a healthy diet.  

A dietitian helped the intensive group consume a diet with sufficient protein, vegetables, fruits, and whole grains and 500 to 750 fewer calories a day. The group also did 90 minutes of aerobic and resistance training three times a week.

After a year, the intensive group had lost 18 pounds and the control group lost virtually zero. The intensive group also gained more strength and fitness and had lower hemoglobin A1c (a long-term measure of blood glucose) and better insulin sensitivity.

The authors recommended that if you have diabetes type 2, Medicare covers behavioral therapy for obesity, and some Medicare Advantage plans offer gym memberships.”

Diabetes Care 2022. doi: 10.2337/dc22-0338.

In the News: Vitamin D

Low levels of vitamin D linked to poor cognitive function

Source: Medical News Today, Sunday, December 11, 2022
“There is growing evidence for how your body relies on vitamin D to ward off inflammation, cancer, and heart disease. Having enough of it in your blood is linked to a lower risk of dying prematurely. But what about vitamin D and the brain? What is its role in cognition, or dementia, if any? As one researcher told Medical News Today this week, “we did not know if vitamin D was even present in the human brain.”

The researcher, Kyla Shea, PhD, is lead author of a study offering the first evidence that vitamin D is not only present in the brain, a healthy level of it is associated with better cognitive function and a lower risk of dementia in older adults.

The evidence comes from the postmortem study of the brains of 290 individuals who had agreed to donate their organs after death. Researchers found that higher concentrations of vitamin D across the brain were associated with up to a 33% lower chance of developing dementia.

It is early days, so precisely how vitamin D supports healthy cognitive function is not yet understood. Dr. Shea sees signs that it is involved in cell-signaling pathways that may be part of neurodegeneration, but more research is needed to build on this groundbreaking study.” Stay tuned???

Who Needs Vitamin B12?

Vitamin B12 helps maintain nerve tissues, aids in reactions that build up protein tissues

Needed for normal red blood cell development.

Older people, those who have had stomach surgery and vegans are at risk for vitamin B12 deficiency. Some people become deficient in B12 because they are unable to absorb it.

Vitamin B12 is found in animal products and microorganisms only.



Author: Stephen Devries, MD


The Obesity Burden?

The Burden of Obesity Is Not Carried Equally

— Misconceptions are hurting the fight for health equity in communities of color

by David Satcher, MD, PhD August 26, 2022


“Since leaving my post in 2002 as the U.S. Surgeon General, the nation’s leading public health role, America has made great strides in battling public health crises. From reducing tobacco use and improving maternal and child health, to most recently advancing vaccine technology to fight the COVID-19 pandemic. Yet, another epidemic has gained strength, debilitating and killing millions of people on its deadly upward trajectory. The chronic disease of obesity is a misunderstood condition impacting millions of Americans from every demographic group living in every corner of the country. Unfortunately, obesity and comorbid diseases disproportionately impact communities of color in nearly incalculable ways.

In the early 2000s, the national adult obesity rate was 30.5% and we had made progress on achieving many health goals related to heart disease, type 2 diabetes, cancer, and multiple other chronic health challenges. Back then, my office released “The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity,” which underscored the increasing severity of obesity’s impact on our collective health and outlined a vision for the future. Today, the adult obesity rate has climbed to 42.4% and is projected to reach nearly 50% by 2030.

Disparities in obesity rates between racial and ethnic groups are stark. The latest data show that non-Hispanic Black adults have the highest age-adjusted prevalence of obesity in the country at 49.6%, followed by Hispanic adults at 44.8%, and non-Hispanic white adults at 42.2%. Obesity is also a significant health challenge among American Indians and Alaskan Natives, with adults in those communities 50% more likely to have obesity than white adults. Furthermore, a projection of obesity rates found that “severe obesity” will become the most common BMI category among non-Hispanic Black adults (31.7%) — as well as among women (27.6%) and low-income adults (31.7%) — by 2030.

Despite researchers making significant advances in the last 2 decades, obesity is too often myopically viewed as the result of an individual’s lifestyle choices around diet and exercise. Viewing the disease through this lens omits that body weight is determined by a combination of genetic, metabolic, behavioral, environmental, cultural, and socioeconomic factors. In fact, we know that a significant proportion of obesity can be influenced by genetics.

While recent scientific discoveries have greatly improved obesity care options, our collective effort to stem the tide of the disease has fallen short. Obesity is a public health crisis deserving maximum effort from policymakers, healthcare providers, insurers, and community partners working in concert to dramatically reduce the burden of this disease.

Our politicians and policymakers must focus on the core causes and dire consequences of unchecked increases in obesity rates among the people they serve. It is imperative that updated federal, state, and local policies grant equitable access to the full continuum of obesity care. Healthcare providers must seek continuing education on advances in metabolic science and the availability of pharmacotherapies that are proven to safely reduce disease prevalence and the impact of comorbid diseases. Insurers must take a long view of obesity care, taking immediate action to close coverage gaps that block access to obesity trained physicians, consultation with nutritionists, physical therapists, and prescriptions for FDA-approved metabolic therapies. Our community leaders must advocate for healthcare equality and equitable access to obesity care to lift the physical, mental, and financial burden of the disease on all Americans, especially Black and brown people.

I believe generating coordinated, sustained solutions for a positive impact on obesity in America will come from the hard work of public health stewards, policymakers, healthcare providers, and community leaders at the intersection of health equity and policy. I am making a renewed call to action for the challenging situation we find ourselves in. Every one of us deserves the opportunity to live our healthiest life. It is time we remove the impediments to health equity through access, and promote a path that eliminates the obesity epidemic persisting in communities of color across our nation.”

David Satcher, MD, PhD, is the 16th U.S. Surgeon General and the founder of the Satcher Health Leadership Institute.

Those interested should also read the book by Sandra Aamodt, Ph.D., Why Diets Make Us Fat: The Unintended Consequences of Our Obsession with Weight Loss. More emphasis should be placed on the development of how to control or manage damaging weight regain after endless weight loss attempts. Sally Feltner, M.S, Ph.D.

A Brief Look at Diet Culture

Soure: Social and Health Research Center

Written by: Timandra Rowan

April 21, 2022

Diet culture has a long history of fads and facts. In the U.S., there have been multitudes of “diets” designed for health with more emphasis on weight loss than in other countries over the last century. Why is our national obsession on the relationship of dietary fat been the prominent discourse? A little history may help.