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

The Other Pandemic: Obesity

The last I checked, the U.S. is still facing an epidemic other than Covid -19 – one that has been in some degree affecting a large percentage of the population (40%) for quite some time – obesity. Obesity has even been named as a risk factor for the Covid pandemic. About 70% of us are overweight with about 40% classified as obese. One in 10 have diabetes type 2. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it.

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 88 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 84% don’t know they have it.

A feature of this month’s issue of Nutrition Action Health Letter titled Why We Overeat by Bonnie Liebman should be important for all of us who eat food found in the Standard American Diet (SAD). It will ultimately affect all of us with increased health care costs.

As a researcher at the National Institutes of Health, Kevin Hall explains: “We’re trying to understand the properties of our food environment that regulate appetite and cause people to overeat and gain body fat”. Based on several well designed studies, his group found “only one diet led people to gain weight and gain body fat, Hall says, and that diet is the ultra-processed-food diet.”. Examples of ultra-processed foods include breakfast cereals, pizza, soda, chips and other salty/sweet/savory snacks, packaged baked goods, microwaveable frozen meals, instant soups and sauces.

“Companies are all about maximizing the allure of their products” says Michael Moss, a prize winning former New York Times reporter whose recent book is titled: Hooked, Food, Free Will, and How the Food Giants Exploit Our Addictions.  It all begins with three major ingredients: Salt, Sugar, and Fat, also by Moss.

“The industry came up with the term “bliss point” to describe the perfect amount of sugar in a drink or food that would please most Americans. Not too little, not too much”

“In snack foods like potato chips, 50% of the calories typically come from fat which gives them that melt in your mouth phenomenon, which so much ultra processed food has. You hardly even have to chew it.”

“Salt is the flavor burst because it’s often on the surface of the food and the first thing that touches the tongue”.

But wait! There are other factors.

“Fat plus carb foods with high concentrations of both fat and refined carbohydrates like chocolate, ice cream French fries, pizza, cookies and chips are the foods that most people find most irresistible”, says Ashley Gearhardt, associate professor of psychology at the University of Michigan.

Other factors that aid in making the consumer choose ultra-processed foods can include:

Variety, speed (unprocessed food often takes more chewing), advertising (especially TV ads),

Cost. The food industry goal is to make their products as inexpensive as possible for the consumer.

Snacking: “The food industry has developed more and more products that can act as the fourth meal of the day.” Just look at the abundance in the snack aisles.

What To Do

One way is to concentrate more on nutrient dense foods then on calorie dense foods — of course this increase requires adding fruits and vegetables.

Another good source on how to curb your ultra processed food intake is presented by Barbara Rolls, director of the Laboratory for the Study of Human Ingestive Behavior at Penn State, who wrote the Ultimate Volumetrics Diet. 

A study in 2017 by Rolls randomly assigned women with obesity to either eat less fat or eat less fat and eat more fruits and vegetables for a year. After a year, the fruit and vegetable eaters had lost more weight (17 pounds) than the other group (14 pounds), and they reported being less hungry.

“We eat with our eyes and our brain, If we see a big portion, that sets us up to feel more satisfied. If a plate looks half empty, that sets us up to feel hungry”, says Rolls.

All in all, be aware and mindful of what you eat. Mindless eating can be habit forming as usually we pay little attention to what and how much food we are eating. Studies show that we eat more macaroni and cheese while watching TV than while listening to music.

Lays potato chips dares us with the challenge: “bet you

can’t eat just one”.

“Stay away from the gigantic calorie counts in most restaurant food, whether it’s sit down or fast food. Cook your own food whenever possible. Stick with water, coffee, tea, or other calorie free drinks.”

“Don’t let multinational corporations dictate your diet and your health.” It’s up to you to make those choices.

Sources

Bonnie Liebman. Nutrition Action Healthletter, Center for Science in the Public Interest, April, 2021.

Michael Moss. Salt Sugar Fat: How the Food Giants Hooked Us. Random House, 2014.

Obesity on the Rise?

UNHEALTHY PROCESSED FOOD AND SNACKS CAN LEAD TO OBESITY

The obesity news just keeps getting worse. Along with obesity, many people suffer from diabetes type 2 or pre-diabetes. Type 2 diabetes accounts for 95% of all cases in the United States. It occurs when the body cells lose their sensitivity to insulin, a condition called insulin resistance, or when the amount of insulin secreted is reduced.

Type 2 is considered to be a result of genetic and lifestyle factors such as a diet high in refined carbohydrates or when a person follows a sedentary lifestyle. The incidence is higher among some minority groups. Type 2 may also occur as part of a combination of conditions called metabolic syndrome that includes obesity, elevated blood pressure, altered blood lipid levels (HDL LDL triglyerides). These factors increase the chance of developing heart disease, stroke, and diabetes.

Often, diabetes type 2 can be prevented if caught early in the disease and with the proper lifestyle modifications. There is a great need in the U.S. for this type of intervention. Ask your doctor for any available information on Prevention Programs in your area or medical community, for example, a certified diabetes educator(CDE), registered dietitian (RD) or a certified health coach.

Source: Smolin and Grosvenor. Nutrition: Science and Applications, 3rd Edition.

CLICK HERE.

Obesity: Some Solutions?

September 26, 2019 by foodworksblog Leave a comment

The Obesity/Diabesity Pandemic

Obesity is a major risk factor for the development of type 2 diabetes mellitus, so much so that the epidemic is often called diabesity. It has been described as one of the most important crises that has invaded our public health system.

Global Statistics, Source: Lancet

  • Since 1980, the number of adults with diabetes worldwide has quadrupled from 108 million to 422 million in 2014.
  • Diabetes is fast becoming a major problem in low and middle-income countries.
  • From 1980 to 2014, the prevalence of diabetes more than doubles for men in India and China.
  • Half of adults worldwide with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.

So what are some solutions?  

The standard American diet is in much need of an overhaul and our national food systems need to change if we wish to reverse or at least slow down this trend. Many say that it would take the same determination as the campaigns to change behaviors that were utilized during the campaigns against smoking.

Prevention awareness should be first on the front lines of treating the people with prediabetes that can often be reversible using lifestyle modifications. There are already some prevention models in the community; however, these should be expanded so that they become more easily accessible to more people. The Diabetes Prevention Program (DPP) uses intensive behavioral therapy to help people lose a little bit of weight (typically 5-10%). When this program is followed, the number of people progressing to have diabetes comes down by more than half. In people over 60, the reduction was 70%.

Nutrition education should be incorporated into the school system in the early years to help young children understand the importance of knowing where our food comes from and why nutritious foods are the best choice. They can be taught about balanced eating, calories, reading labels and grocery shopping. Nutrition education can also be offered at the middle and high schools’ levels by returning to a revamped and modernized home economics course in the curriculum.

A lingering problem has existed for many primary care physicians for many years in that they say they were never adequately prepared in nutrition principles in medical schools. In a survey of family physicians (2009), two thirds said that dealing with extremely obese patients is “frustrating “and one-half said treatments are often ineffective. This is reflected by a lack off obesity training.

Shockingly, another survey in 2010 of 140 doctors revealed that nearly one-third were not even familiar with the American Diabetes Association (ADA) prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors and on average, the doctors could only identify just eight of the warning signs. Only 17 percent knew the correct laboratory values for blood glucose and only 11 percent said they would refer a patient to a behavioral weight loss program.

There should be an increased access to professional treatments. Medical professionals not trained in obesity management should refer their patients to outside providers such as dietitians, exercise trainers, behavior therapists, psychologists, or the new concept of health coaches. These providers should be trained, certified, and credentialed to protect the public from unscrupulous treatments and to provide quality care. Reimbursement of qualified health professionals needs to be enhanced to keep patient volume high and lessen out-of-pocket expenses.

We have become a nation of non-cooks and prefer to have our meals prepared by someone else. Encourage home cooking and home kit meals to help to counter using fast foods and packaged highly processed meals loaded with calories, fat, sugar and salt.

Educate the public on food labeling including ingredient lists. Beware of food companies that promote products with a “health halo” meaning exaggerated claims made that appear to make unhealthy foods seem healthy because of an added nutrient or ingredient. Corporations also mislead consumers with their labeling, so they include four different types of sugar to keep sugar from being listed as the first ingredient. This is misleading to the consumer when attempting to make wise food choices.

Stop corporate-government partnerships and diminish lobbying.
“Lately, the food industry (Big Agriculture, Big Meat, and Big Food ) has been highly implicated in this epidemic. This includes the advent of ultra-processed foods. “To sell these foods, companies bombard us with billions of dollars in ads, normalize eating junk food, and make it available 24/7, everywhere, and in large amounts at remarkably low cost.”

Source: “Against the Odds: Why our food system makes it tough to eat healthy, Nutrition Action Healthlettter  November, 2020.  

The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is funded by myriad food companies such as Coca-Cola, PepsiCo and Kellogg’s. The dairy industry has a long history of influencing the food pyramid and Dietary Guidelines. A good example is the placing of a glass of milk on the MyPlate Logo. Often this practice only serves the dairy industry and not necessarily the consumer.

Another health organization guilty of taking in millions from food companies is the American Heart Association. They offer a “Heart – Check logo for a price: $5, 490 to $7,500 that is renewable for another fee annually. The product has to be low in fat, saturated fat and cholesterol to gain this “honor.” However, some products such as Boar’s Head processed meats have the logo and still may still contain high levels of sodium. If the AHA were sincere in their efforts to help consumers choose healthier foods to rein in obesity/diabetes, they would realize that research has shown that a 1.8 oz. daily serving of processed meat raised the risk of diabetes by 19 percent and heart disease by 42 percent. Most current dietary recommendations emphasize a reduction in processed meats (my emphasis).

Bottom Line: It will take a concerted effort from government, politics, industry, communities, and consumers and the perpetrators of our obesigenic culture to begin to change this trend.

All About Diabetes Type 2 in the U.S.

We may be approaching another healthcare crisis other than the pandemic.  In both crises, the numbers keep rising and no one really seems  to earnestly do much about it. Both can be frustrating and prevention can be a key factor.  Prevention always is the best medical advice but it’s difficult to find help due to a lack of interest or funding.  In my opinion, many cases of diabetes type 2 can be prevented if enough attention is paid to understanding certain aspects of the disease. Studies of previous prevention programs have shown to make a difference. One particular study compared lifestyle  modifications with the anti-diabetes drug, metformin and found that lifestyle modifications were just as effective as taking the drug. This finding is an important result in that it suggests that lifestyle can influence our health and help to prevent some of the chronic diseases that have become leading causes of death in the U.S.

Even weight loss of 5-10% of body weight  is the first line of defense against diabetes type 2 as well as learning about which foods you eat can help control blood glucose levels thus resulting in insulin secretion and/or insulin resistance.

CLICK HERE.

You can find the complete study HERE.

Doctors and Diets?

So many times I have heard from people that tell me their doctors say:  “Watch your diet”.  What in  the heck does that mean?  Perhaps we hear this from many physicians because they do not receive much nutrition education in medical school.   There has got to be a better way to inspire people about their lifestyle choices.  My recommendation:  Consult a nutritionist (watch for credentials). There are many types of nutritionists that have dubious training and lack any reliable credentials. For diabetes help, look for the credentials “CDE” which tells us that  this person is a certified diabetes educator.  Many are also registered nurses or registered dietitians.  Read the related articles below for a comprehensive discussion of this problem.

CLICK HERE.

CLICK HERE.

 

 

Nutrition Timeline: How the U.S. Diet Evolved

Nutrition Timeline:

Obviously, a lot has happened in nutrition since the first Thanksgiving in America. Many scientific discoveries have given us a better idea how foods can contribute to health and disease. At first, little was known about nutrition science and there is still a lot to know. Knowing our progression helps us to know how we got from there to here.  The bottom Line: After all the science, we often still ponder on “what’s for dinner?”and “how do we lose weight”?

Note: Those events in Bold type tell the story of how our current food patterns evolved and have affected our present health status.

1621 First Thanksgiving Feast at Plymouth Colony

1702 First coffeehouse in America opens in Philadelphia

1734 Scurvy recognized

1744 First record of ice cream in America

Lind publishes “Treatise on Scurvy”and citrus is identified as cure.

Sandwich invented by the Earl of Sandwich

Potato heralded as famine food

Americans drink more coffee in protest over Britain’s tea tax

1775 Lavoisier (“the father of nutrition science) discovers the energy property of food (calories)

1816 Protein and amino acids identified followed by carbohydrates and fats

1833 Beaumont’s experiment on a wounded man’s stomach greatly expand knowledge about digestion

1862 U.S. Department of Agriculture founded by authorization of President Lincoln

1871 Proteins, carbohydrates, and fats determined to be insufficient alone to support life, there are other “essential” compounds in foods

First milk station providing children with un-contaminated milk opens in New York City

Pure Food and Drug Act passed by President Theodore Roosevelt to protect consumers against contaminated foods

Pasteurized milk introduced

Funk suggests scurvy, beriberi, and pellagra caused by deficiency of “vitamines” in the diet

1913 First vitamin discovered (vitamin A)

1914 Goldberger identifies the cause of pellagra (niacin deficiency) in poor children to be a missing component of the diet rather than a germ as others believed

1916 First dietary guidance material produced for the public released: Title is Food for Young Children

1917 First food groups published for the Five Food Groups: Milk and Meat, Vegetables and Fruits, Cereals, Fats and Fat Foods, Sugars and Sugary Foods. (Imagine: Sugar is a food group).

1921 First fortified food produced: iodized salt needed to prevent widespread iodine deficiency goiter in many parts of the U.S.

1929 Essential fatty acids identified

1930’s Vitamin C identified in 1932, followed by pantothenic acid and riboflavin in 1933 and vitamin K in 1934

1937 Pellagra found to be due to the deficiency of niacin.

1938 Health Canada issues nutrient intake standards

1941 First refined grain enrichment standards developed (Niacin, riboflavin,  and iron added)

First Recommended Dietary Allowances (RDAs) announced by President Franklin Roosevelt on the radio

1946 National School Lunch Act passed

1947 Vitamin B12 identified

1953 Double helix structure of DNA discovered

1956 Basic Four Food Groups released by the U.S. Department of Agriculture

1958 The Seven Countries Study was conceived by Ancel Keys, a Minnesota physiologist, who brought together researchers from all over the world. It became a collective effort to study questions about heart and vascular diseases among countries having varied traditional eating patterns and lifestyles. This alone changed the U.S. food supply dramatically to emphasize low fat diets high carbohydrate foods that continued to dominate until around 1983.

1965 Food Stamp Act passed. Food Stamp program established

1966 Child Nutrition Act adds school breakfast to the National School Lunch Program

1968 First National nutrition survey in U.S. launched. (The Ten State Nutrition Survey)

1970 First Canadian national nutrition survey launched (Nutrition Canada National Survey)

1972 The “Atkins Diet” by Dr. Robert Atkins started as a fad, but quickly became a counter-conventional movement that reset people’s thinking of nutrition and weight loss, and its link to health. It promoted a low carbohydrate, high fat diet to replace and challenge  the current conventional thinking that a low fat, high carbohydrate diet promoted by Keys was heart healthy.

1977 Dietary Goals for the U.S. issued  

1978 First Health Objectives for the Nation released

1989 First national scientific consensus report on diet and chronic disease published

1992 The Food Guide Pyramid is released by the USDA that contained a food group recommending 6-11 servings a day from the Bread, Cereal, Rice, Pasta Group (High carbohydrate foods).

1994 The nutritional food label was put into effect by the Nutrition Labeling and Education Act.

1997 RDAs expanded to Dietary Reference Intakes (DRI’s)

1998 Folic acid fortification of refined grain products begins

2003 Sequencing of DNA in the human genome completed; marks beginning of new era of research in nutrient-gene interactions

2015 – 2020 The current  U.S.Dietary Guidelines include the following:

  • Follow a healthy eating pattern across the lifespan. Eating patterns are the combination of foods and drinks that a person eats over time.
  • Focus on variety, nutrient-dense foods, and amount.
  • Limit calories from added sugars and saturated fats, and reduce sodium intake.
  • Shift to healthier food and beverage choices.
  • Support healthy eating patterns for all.

2020  Obesity and diabetes have become global epidemics/pandemics with the highest rates in the U.S. The custom is for them to be revised every five years.  The latest U.S. Dietary Guidelines are due to be published sometime in 2020 or early 2021.

 

 

 

 

The Obesity/Diabesity Pandemic


Obesity is a major risk factor for the development of  type 2 diabetes mellitus, so much so that the epidemic is often called diabesity. It has been described as one of the most important crises that has invaded our public health system.

Global Statistics,  Source: Lancet

  • Since 1980, the number of adults with diabetes worldwide has quadrupled from 108 million to 422 million in 2014.
  • Diabetes is fast becoming a major problem in low and middle-income countries.
  • From 1980 to 2014, the prevalence of diabetes more than doubles for men in India and China.
  • Half of adults worldwide with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.

So what are some solutions?

The standard American diet is in much need of an overhaul and our national food systems need to change if we wish to reverse or at least slow down this trend. Many say that it would take the same determination as the campaigns to change behaviors that were utilized during the campaigns against smoking. .

Prevention awareness should be first on the front lines of treating the people with prediabetes that can often be reversible using lifestyle modifications. There are already some prevention models in the community; however, these should be expanded so that they become more easily accessible to more people. The Diabetes Prevention Program (DPP) uses intensive behavioral therapy to help people lose a little bit of weight (typically 5-10%). When this program is followed, the number of people progressing to have diabetes comes down by more than half. In people over 60, the reduction was 70%.

Nutrition education should be incorporated into the school system in the early years to help young children understand the importance of knowing where our food comes from and why nutritious foods are the best choice. They can be taught about balanced eating, calories, reading labels and grocery shopping. Nutrition education can also be offered at the middle and high schools levels by returning to a revamped and modernized home economics course in the curriculum.

A lingering problem has existed for many primary care physicians for many years in that they say they were never adequately prepared in nutrition principles in medical schools. In a survey of family physicians (2009), two thirds said that dealing with extremely obese patients is “frustrating “and one-half said treatments are often ineffective. This is reflected by a lack off obesity training.

Shockingly, another survey in 2010 of 140 doctors revealed that nearly one-third were not even familiar with the American Diabetes Association (ADA) prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors and on average, the doctors could only identify just eight of the warning signs. Only 17 percent knew the correct laboratory values for blood glucose and only 11 percent said they would refer a patient to a behavioral weight loss program..

There should be an increased access to professional treatments. Medical professionals not trained in obesity management should refer their patients to outside providers such as dietitians, exercise trainers, behavior therapists, psychologists, or a new concept of health coaches. These providers should be trained, certified, and credentialed to protect the public from unscrupulous treatments and to provide quality care. Reimbursement of qualified health professionals needs to be enhanced to keep. Otherwise patient volume high and they lessen out-of-pocket expenses.

We have become a nation of non-cooks and prefer to have our meals prepared by someone else. Encourage home cooking and home kit meals to help to counter using fast foods and packaged highly processed meals loaded with calories, fat, sugar and salt.

Educate the public on food labeling including ingredient lists. Beware of food companies that promote products with a “health halo” meaning exaggerated claims are made that appear to make unhealthy foods seem healthy because of an added nutrient or ingredient. Corporations also mislead consumers with their labeling so they include four different types of sugar to keep sugar from being listed as the first ingredient. This is misleading to the consumer when attempting to make wise food choices.

Stop corporate-government partnerships and diminish lobbying.The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is funded by myriad food companies such as Coca-Cola, PepsiCo and Kellogg’s. The dairy industry has a long history of influencing the food pyramid and Dietary Guidelines. A good example is the placing of a glass of milk on the MyPlate Logo.

Another health organization guilty of taking in millions from food companies is the American Heart Association. They offer a “Heart – Check logo for a price: $5, 490 to $7,500 that is renewable for another fee annually. The product has to be low in fat, saturated fat and cholesterol to gain this “honor.” However, some products such as Boar’s Head processed meats have the logo and still may still contain high levels of sodium. If the AHA were sincere in their efforts to help consumers choose healthier foods to rein in obesity/diabetes, they would realize that research has shown that a 1.8 oz. daily serving of processed meat raised the risk of diabetes by 19 percent and heart disease by 42 percent. Most current dietary recommendations emphasize a reduction in processed meats (my emphasis).

There is bad news on rising obesity rates – read about them HERE.

It will take a concerted effort from government, politics, industry, communities, and consumers and the perpetrators of our obesigenic culture to begin to change this trend.