Pre Diabetes and Cognitive Decline

In the News

Pre diabetes linked to cognitive decline

“People with higher than normal blood sugar called prediabetes, are more likely to experience cognitive decline and vascular dementia according to a study published in Diabetes, Metabolism, and Obesity.  

Researchers analyzed UK biobank data from almost 450,000 people averaging 58 years old who underwent an HB A1C test, which determines average blood sugar levels over the past two to three months.

Based on these results, they were divided into one of five groups:  low normal blood sugar, normal blood sugar, pre diabetes, undiagnosed diabetes, and diabetes. Pre diabetes was classified as having a hemoglobin A1C blood test reading of 6.0% – 6.5% %. Ideal A1C levels are under 5.5%

Results show that people with above normal sugar levels were:

42% more likely to experience cognitive decline over four years and 54% were more likely to develop vascular dementia over eight years. Vascular dementia is caused by reduced blood flow to the brain.

People with prediabetes and diabetes had similar rates of cognitive decline, 42% and 39% respectively.

MRI brain scans revealed that pre diabetes was associated with a smaller hippocampus and more strongly associated with having lesions on the brain, both of which are associated with age related cognitive impairment.”

Diabetes is thought to be prevented by making some easy lifestyle adjustments in diet and exercise, in other words a diet that restricts refined carbohydrates, sweetened drinks (including fruit juice) and keeping your weight at a reasonable level with more emphasis on the lower carbohydrate side (less than 40 percent of total calories.) Please consult with your physician before you begin any calorie restricted diet, however.

Source: Diabetes Obes Metab. 2021; 1-10.

Life Extension, May 2021

Diet and Lifestyle in Diabetes Control

Notes: Sally Feltner, M.S., Ph.D.

Diabetes blood sugar control is getting worse for U.S. adults. By Bobbie Berman, June 14, 2021 .

The study was published in The New England Journal of Medicine, Fang, Michael, Ph.D., et al. Trends in Diabetes Treatment and Control in U.S. Adults. 2021; 384; 2219-2228, 

After scanning the original article in NEJM for any mention of the role of diet in the control of glycemic parameters, I found none.

In the article above by Mr. Berman, there is only a mention of diet in the following manner:

“A person with diabetes can still eat the foods that they enjoy, just less frequently or in smaller portions.

Follow the advice of a doctor or dietitian, eat a varied meal plan that includes foods from all groups, and stick to the recommended amounts.

Some people with diabetes should eat at the same time each day, while others have a little more flexibility when it comes to the timings of meals. Portion size is also very important in people with diabetes. Speak to a dietitian about the best way to manage this.”

Finally, someone gave it at least an after thought. I had a close relative with diabetes type 2 who when asked if he had ever seen a certified diabetic educator (CDE, often a dietitian,) or spoken about diet with his physician. He always said “No”. 

Perhaps if doctors were more educated about the effects of diet on diabetes control, patients would be more compliant with these recommendations. I am not a certified diabetic educator, but am retired as a registered dietitian. I strongly recommend that if you are diabetic, consult with your primary care physician and try to see someone with the proper credentials about diabetes care. (Sally Feltner)

Take a look at the following article on a study done to compare lifestyle factors vs. metformin ( a common compound taken by diabetic patients for glucose control) Spoiler Alert: LIFESTYLE FACTORS WIN OUT OVER METFORMIN and prevention is the key.

CLICK HERE.

Big Food?

“Robert Goldstein, a hedge fund manager in New York, was getting huge cravings for sweets when he came across a tropical plant called Gymnema sylvestre that works a little like methadone for heroin addicts.” What does that have to do with “big food”? Too much, I’m afraid.

CLICK HERE.

UNHEALTHY PROCESSED FOOD AND SNACKS CAN LEAD TO OBESITY

The Mind-Gut Connection

A new developing science states: The connection between the mind and gut is bidirectional; the gut talks to the brain and the brain talks to the gut. Major health problems can appear when this system is disturbed; One way to minimize this is to keep your microbial “self” happy and working properly. The connection can affect mood and overall health.

HOW TO FEED YOUR GUT MICROBES

Try to maintain a variety of diverse gut microbes by maximizing your consumption of naturally fermented food and probiotics (these foods “feed” your own intestinal microbes.)

For reduction of gut inflammation, try these:

Cut down on animal fat in your diet.

Avoid when possible, mass-produced ultra-processed foods.

Reduce stress and practice mindfulness of what you’re eating..

Avoid eating when you are stressed, angry or sad.

Enjoy foods and eat with family and friends.

Listen to your gut feelings and signals.

CLICK HERE.

The Japanese Diet: Deconstructed

The Japanese diet is one of the world’s lowest in fat. Other attributes include fish as a mainstay and soy foods. The Japanese also care about appearance and think of food as an art – resulting in more appetizing and satisfying foods. Do these characteristics contribute to the Japanese record of low rates of major chronic diseases and the fact that they boast the world’s highest life expectancy – age 76 for men and 82 for women?

In contrast, in 1980, 30 percent of U .S. adult population were affected by at least one chronic condition. Today it’s 60 percent. The percentage of those affected by two or more chronic diseases has grown from 16 percent to 42 percent. What and how do the Japanese eat? Often, it is Interesting to study lifestyles, in particular what and how other cultures eat to gain some insights as to what exactly is a healthy diet. No one expects the typical American to start munching on seaweed but the study indicates that what and how we eat can affect our overall health and longevity.

CLICK HERE.

Turmeric/Curcumin: The Facts

Turmeric is a spice that has long been recognized for its medicinal properties and has received interest from both the medical/scientific community and as well from culinary enthusiasts as it is the major source of the polyphenol, curcumin (a phytochemical).

It aids in the management of oxidative and inflammatory conditions, metabolic syndrome, arthritis, anxiety, and hyperlipidemia (high cholesterol).

In addition, a relatively low dose can provide health benefits for healthy people. Its drawback is its problem with poor absorption; therefore, it should be used with foods to enhance this issue. Some supplements contain compounds known to increase absorption – one is a component of black pepper.

Turmeric is a staple in India, where most of it originates. It is the spice that gives food its flavor color. It is use in curries and is especially good on scrambled eggs and omelettes. It can be used as a supplement, but it’s best as a food since curcumin is only one of a family of what is called curcuminoids that may also contain beneficial components.

Turmeric is known for alleviating arthritis and joint inflammation. In one study, it was found to be virtually as effective as an anti-inflammatory medicine (without the side effects). Curcumin has been claimed to be a cancer fighter. There are at least 30 published studies that indicate that it has an anti-tumor effect that reduced the number or size of tumors in animal studies. One study in 2006 found that it inhibited the growth of human colon cancer cells (cell culture study, I presume).

Curcumin lowers cholesterol in animals and humans suggesting it may be heart healthy. Other studies have shown antioxidant capabilities. In a rat study, a group of rats treated with curcumin provided significant protection from cataracts (Induced by a powerful oxidizing chemical.)

For more on this fascinating spice,

CLICK HERE.

Can Diet Affect Your Telomeres?

Glossary:

Apoptosis: the death of cells which occurs as a normal and controlled part of an organism’s growth or development. Also called programmed cell death.

Senescence: the state that cells reach when they stop dividing but do not die.

Telomeres: bits of DNA at the end of a chromosome that protects it during the process of cell division.

Telomerase: an enzyme, often referred to as “anti-aging” that maintains telomeres, helping to keep them long.

Telomeres shorten with age and progressive telomere shortening leads to senescence and/or apoptosis. Older people with shorter telomeres have three to eight times increased risk to die from heart disease and infectious diseases, respectively. Rate of telomere shortening is therefore critical to an individual’s health and pace of aging. Smoking, exposure to pollution, lack of physical activity, obesity, stress, and an unhealthy diet increase oxidative burden and rate of telomere shortening. To preserve telomeres and reduce cancer risk and pace of aging, we may consider to eat less; include antioxidants, fiber, soy protein, and healthy fats (derived from avocados, fish, and nuts) in our diet; and stay lean, active, healthy, and stress-free from regular exercise and meditation. 

Healthy foods such as tuna, salmon, herring, mackerel, halibut, anchovies, catfish, grouper, flounder flax seeds, chia seeds, sesame seeds, kiwi, black raspberries, lingonberries, green tea, broccoli, red grapes, tomatoes, olives area excellent choices. These combined with a Mediterranean type of diet containing whole grains would help protect telomeres.

Source: Telomeres, lifestyle, cancer, and aging

Current Opin Clin Nutr Metab Care. 2011 Janurary; 14(1):28-34

A study published in 2018 looked at fiber intake and telomere length in over 5,000 U.S. adults.

Researchers found there was a significant linear relationship between fiber consumption and telomere length. The more fiber subjects consumed, the longer their telomeres tended to be.

Here’s what the authors found:

“A difference of 4.8 to 6.0 years in cell aging was found between those in the lowest compared with the highest quartiles of fiber intake. Overall, the present study highlights the risk of accelerated aging among U.S. women and men who do not consume adequate amounts of dietary fiber.”

The study reported subjects were eating an average of 13.6 grams of fiber per day before starting the study, which is less than 50% of the Dietary Guidelines for Americans.

The Dietary Guidelines for Americans recommends the intake of 14 g of fiber per 1000 calories.

  • 2000 calories per day = 28 grams of fiber
  • 2500 calories per day = 35 grams of fiber

The best part is some of the most healthy and delicious foods pack the fiber.

It seems a few servings of high fiber foods per day keeps the telomere shortening at bay.

Source: Dietary Fiber and Telomere Length in 5674 U.S. Adults: An NHANES Study of Biological AgingDietary Fiber and Telomere Length in 5674 U.S. Adults: An NHANES Study of Biological Aging

Cancer, Diet and Lifestyle

Lifestyles can interact with the epigenome, defined as the network of compounds around our genes that are capable of altering gene expression in response to environmental influences. The ultimate action can result in cancer prevention.

DIET MODIFICATIONS

The general risk factors of cancer include obesity, physical inactivity, alcohol consumption and/or poor nutrition. These factors have the potential to determine if a cancer will result or in the opposite case, be suppressed.

Consume a nutrient dense, whole-foods diet that predominantly includes plant foods. As Michael Pollan puts it, “Eat food, not too much, mostly plants.” Plant foods are rich in nutrients and phytochemicals that work synergistically to prevent many chronic diseases, primarily heart disease and cancer. Evidence exists that up to 45% of colon cancer cases could be avoided through diet and lifestyle changes alone.

Limit your consumption of high-calorie foods, primarily in the form of ultra-processed foods that are major contributors to weight gain leading to type 2 diabetes, or insulin resistance.

Cancers of the liver, pancreas, endometrium, colon, rectum, breast, and bladder are at higher risks for developing in obesity. Being overweight also raises the risk of developing non-Hodgkin’s lymphoma, multiple myeloma and gallbladder, liver, cervical, ovarian, and aggressive prostate cancers.

Be as lean as possible without becoming underweight. It may be helpful to be able to calculate your own weight status by using the Body Mass Index (BMI).

You simply divide your weight in pounds by your height in inches squared X 703.

For example: BMI =140 pounds divided by 64 inches squared (4096) X 703 = 24.0. A healthy BMI is 20 – 24. Being underweight is considered a BMI of less than 19.0.

Limit your consumption of red meat (including beef, pork and lamb).  There are several reasons:

The International Agency for Research on Cancer (IARC) classifies red meat as a “probable carcinogen. You don’t need to give up meat; however, an intake of up to 18 ounces a week can be safely consumed without too much concern.” BTW, 4 oz. of meat is about the size of a deck of cards. (Finlayson, 2019)

Another factor that raises cancer risk is the overcooking of red meat that produces charred areas of the meat – goodbye grill marks?). These create carcinogenic heterocyclic amines (HCAs) that have been linked to pancreatic and colon cancers.

Another carcinogenic compound comes from burning the fat from meat when grilling that produce polycyclic aromatic hydrocarbons (PAHs), linked to stomach cancer.

Hint: Both compounds can be lessened by using a marinade on the meat.

Highly processed meats such as bacon, hot dogs, and lunch meats are known for their nitrite and nitrate content used as preservatives.  Smoking meats can lead to the formation of N-nitroso compounds which are considered carcinogenic.

Avoid deep-fried foods. When cooked in this manner, foods are exposed to a chemical called acrylamide that increases the risk of prostate cancer.

There are other lifestyle factors that can influence epigenetically the risk of any chronic disease. Alcohol intake, for example is important due to the carcinogenic effects of alcohol itself. 

“Chronic inflammation which is strongly associated with being overweight, can increase the risk of developing cancer.  Excess belly fat produces hormones that can raise levels of insulin, estrogen and leptin, all of which have been linked to cancer development.” (Finlayson, 2019). 

The interconnected factors that trigger chronic diseases are vast and subject to manipulation by the body as well as our microbial environment. It would be wise to attempt to take the best care of your body as you possibly can and begin at an early age.  Aging as you know itself becomes a central factor in the development of any chronic disease. In 1980, Dr. James Fries, Professor of Medicine, Stanford University introduced the compression of morbidity theory. This theory states that “most illness was chronic and occurred in later life and postulated that the lifetime burden of illness could be reduced if the onset of chronic illness could be postponed and if this postponement could be greater than increases in life expectancy.”). That theory tells it all. (Unknown source). SJF

Source: Judith Finlayson. You Are What Your Grandparents Ate: What You Need to Know About Nutrition, Experience, Epigenetics & the Origins of Chronic Disease, 2019

Working for an extension of a Healthy Lifespan

YOU ARE WHAT YOUR GRANDPARENTS ATE

The following post expresses the views of a blog titled Doctor’s Digest and not necessarily the views of Food, Facts and Fads. However, in the field of nutrition, there are always many controversies and it is wise to keep these in mind when seeking diet advice. The following article presents some concepts that are not yet proven by research; however, the future of epigenetics may provide more insight into these hypotheses. The source was based on the book, You Are What Your Grandparents Ate that was sent to me by the authors for review. See the Source below.

In other words:

Out on the edge you see all kinds of things you can’t see from the center. Big, undreamed-of things-the people on the edge see them first. Kurt Vonnegut

http://thedoctorsdigest.com/epigenetics-grandparents-ate

CLICK HERE.

Source:

You Are What Your Grandparents Ate: What You Need to Know About Nutrition, Experience, Epigenetics & the Origins of Chronic Disease. Judith Finlayson, 2019.

Foreword by Dr. Kent Thornburg, Professor of Medicine and Director of the Center For Developmental Health at the Knight Cardiovascular Institute, and Director of the Bob and Charlee Moore Institute for Nutrition and Wellness at Oregon Health and Science University in Portland, Oregon.

“This book explains why we are suffering the largest health epidemic in human history, why we need better wholesome foods to buy, why we need better food policy and why we must pay careful attention to the health and nutrition of our young women and men as they prepare to bear the next generation.”