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

Intermittent Fasting and Protein – Not for Body Builders?

Intermittent fasting is becoming a hot topic for weight loss and/or practicing calorie restriction that is limited to a certain amount of time every day, e.g. 16 hours of fasting with an 8 hour time frame of eating your daily calories..

The problem does arise as to whether people can obtain their protein requirement with that eating pattern. This pattern usually results in eating only two meals a day. The following article explains the issues. The bottom line: This type of diet may not be practical for those who want to build muscle; however, weight training does appear to help to preserve lean body mass when eaten with sufficient amounts of protein.

CLICK HERE.

Dieting in America: An Ongoing Issue

After 150 years of becoming a nation obsessed with weight loss, we still have not grasped the true experience of how difficult it is to lose and more importantly maintain that loss (if it occurs) so many still seek the “quick fix” Of course, the obesity industry likes it that way – success does not help them obtain more business and appears to keep their customers coming back for more promises and sometimes unhealthy claims.

This post addresses with more detail a previous post on a diet time line, tilted Is Dieting Dead ? from Banting to weight loss surgery for the morbidly obese. The obese get blamed for their dilemma which adds to their guilt, whereas, the emphasis should be more focused on not only how hard weight loss is, but keeping it off avoiding the Yo-Yo dieting phenomenon. This leaves the obesity industry even more gleeful as their customers keep returning. From Obesity Soap in 1903 to the dangerous Tape Worm Diet, the Drinking Man’s Diet, and eating disorders, the quest furthers our national obsession with weight. An excellent book,The Hundred Year Diet: America’s Voracious Appetite for Losing Weight, by Susan Yager aptly addresses this issue.

CLICK HERE.

Can We Say What Diet is Best for Health?

Can We Say What Diet is Best for Health?

Over the past few decades, it has been reported that a lifestyle pattern of poor dietary choices is linked to a growing disparity between life span (longevity) and health span, defined as years of healthy life. Globally, lifestyle-related chronic diseases constitute an enormous and growing burden of obesity, diabetes, hypertension, heart disease, cancer, all of which involve diet in some manner.

What are these dietary patterns that often claim successes over another pattern? This comparison offers a brief description of each pattern as well as the rationale for the claims.

Dietary Pattern	Primary Characteristics	Rationale
Low Carbohydrate	Restriction of total carbohydrate to less than 45% calories High protein or either animal or plant origin	Has recent and widespread interest. Can include a popular variation called the ketogenic diet (highly restrictive)
Low Fat (Vegetarian and traditional Asian)	Restriction of total fat or 20% of daily calories. Some can include dairy and eggs, limited meat such as chicken and seafood	Long-standing use, extensive research backup. Popularity is weak due to limited appeal; lack of taste
Low glycemic (blood sugar)	Limits the glycemic load of certain vegetables and many if not all fruits.	Relevant to diabetes and pertains to carbohydrate quality as to effects on blood glucose in the body.
Mediterranean	Emphasis on olive oil, fruits and vegetables, nuts and seeds, whole grains, beans, limited meat, moderate wine included	Mimics the traditional diets of Mediterranean countries. Associated with extensive research that emphasizes “healthy” fats

Mixed Balanced

Includes both plant and animal foods that conform to the Dietary Guidelines for Americans, DASH and Diabetes Prevention diets

Long-standing, widespread use. Associated with extensive research and intervention trials to address chronic diseases.

Paleolithic

Focus on diet of our Stone Age ancestors. Avoiding processed foods with emphasis on fruits and vegetables, nuts, seeds, lean meats.

Dairy and grains are excluded.

Native human diet emphasis with substantial research. Emphasis on lean proteins.

Vegan

Often exclude all animal products, including dairy and eggs. If ill-conceived, can include plant-based junk food leading to nutrient deficiencies.

Relevant to ethics, animal welfare issues, environmental sustainability

Claims for other dietary patterns exist in abundance. Many such practices such as juicing or fad dieting does not meet the requirements for a healthy diet pattern. Add to these raw food eating, detoxification schemes that enjoy media attention in the popular culture but only contribute to the confusion of those who seek existing legitimate dietary advice.

Can we say what diet is best for health? It would be difficult based on individual needs for one thing. Ideally, It is often said that the best diet is one you decide for yourself based on some basic knowledge and your particular lifestyle. The diet should focus on health and weight control, not just weight loss.

Even if the healthy diet claims are made clear, we must learn somehow to navigate our way through the supermarket that constantly appeals to our senses with a myriad of some 40,000 products with the majority of them processed in bags, boxes, bottles, jars, and cans. Many are loaded with fat, sugar or salt. Often, many Americans are drawn to the appeal of convenience that many of these foods offer.

Here is what we think we know. From assessing the diets presented in the table above, compatible elements of these diets include: Limited refined starches, added sugars, processed foods, limited intake of certain fats, emphasis on whole plant foods (nuts, seeds, legumes) with or without lean meats, fish, poultry, and seafood.

To put this in its most simplest form, Michael Pollan, author of In Defense of Food and The Omnivores Dilemma says:

Food, not too much, mostly plants.

Tea Time – Green or Black?

First, a little background. Tea is currently the most consumed beverage in the world besides water. Americans consume an average of 153 cups a year. Most Americans drink black tea while green tea is becoming more popular as claims are made about its health benefits. more than likely from phytochemicals called polyphenols, specifically catechins and flavonoids. Phytochemicals are substances that have been proposed to have health benefits over and above what the vitamins or minerals provide. Phyto is the Greek word for plants. Phytochemicals often have strange names (hard to pronounce, so bear with me.)

The active phytochemical in teas is called epigallocatechin -3 galate (EGCG) found in green tea. Green tea is produced from the withered leaves and buds of Cameillia sinensis by heating or steaming before drying.

Bottled tea is not equivalent to brewed tea in terms of polyphenol content. While all teas (not herbal) contain between 100-300 mg of flavonoids per serving, bottled teas (16 oz.) contain fewer than one cup of brewed tea.

CANCER

From anecdotal evidence, epidemiological and experimental models, tea is thought to have cancer preventive effects. A prospective study of a group of Japanese people younger than 79 years old after a 13-year follow-up indicated a delay of cancer onset and cancer-related death, as well as all-cause mortality with an increased consumption of green tea. Another cohort of 8,552 general residents of Japan presented evidence for preventive effects of drinking green tea on both cancer and heart disease. In one animal study, researchers showed that green tea as a main beverage in the diet of mice could suppress colon cancer. Another study suggested a reduction of chronic inflammation by green tea which may be associated with cancer and heart disease.

There are few human studies on green tea. Generally cancer risk is reduced more in those people who consume green tea than black tea since the polyphenols in black tea are not absorbed as well. Studies show that the amount of tea consumed effects cancer prevention effects – i.e. the range has been from two to three cups of green tea per day to 10 cups per day.

HEART DISEASE

Black and green tea consumption and the risk of coronary artery disease: a meta-analysis

Ze-Mu Wang, Bo Zhou, Yong-Sheng Wang, Qing-Yue Gong, Qi-Ming Wang, Jian-Jun Yan, Wei Gao, and Lian-Sheng Wang

Conclusions: Our data do not support a protective role of black tea against CAD. The limited data available on green tea support a tentative association of green tea consumption with a reduced risk of CAD. However, additional studies are needed to make a convincing case for this association.

It appears from a meta-analysis (see abstract above through the link provided) of studies on black and green tea that there was no association with black tea and coronary artery disease; however, green tea did show a tentative association. There are few studies on green tea; more are needed.

However, another meta-analysis reported that either green or black tea (3 or more cups) reduced ischemic stroke risk by 21%. (Stroke, 2009; 40:1786-1792.)

WEIGHT LOSS

Green tea extracts are often found in the weight loss sections of health food stores and supermarkets. I could only find one or two studies on humans from reputable journals. Most of the studies were animal studies. The studies are inconclusive and inconsistent. Don’t believe the hype that green tea will burn fat.

What is the Bottom Line?

If you’re looking for dramatic health benefits from tea – the evidence is not yet there. As with most nutrition studies, there are mixed results. The problem may be that tea consumption is variable as far as amounts of cups consumed. Some bottled teas have added sugar; some people add sugar to brewed tea; some add milk. Most epidemiological studies are based on recall or observation, which is always a problem in these types of studies. One drawback of overconsumption is that the polyphenols in tea interfere with nonheme iron absorption that can lead to anemia.

Tea has been around for the last 2,000 years and is the beverage of choice of many Asian countries. There is no reason to not enjoy it. If you have not tried green tea, do so. It may take a while to get used to it; however, it may be the best bet for health. Everyone can benefit from any tea. It has the potential to offer powerful antioxidant protection, reduce blood sugar, is anti-inflammatory, and lowers cholesterol. For a common little beverage that costs next to nothing – that’s a pretty powerful resume.

FAD DIETS: A TIMELINE

Fad diets have in the distant past have embraced some of the most bizarre activitir with most built on gimmicks. Included in an entertaining book titled Calories & Corsets, our ancestors relied on recommendations that included “suspending themselves in weighing chairs or lukewarm baths, drinking vinegar and eating carbolic soup in the hopes of shedding unwanted pounds.”

A rice diet was designed in the 1940s to lower blood pressure; now it has resurfaced as a Weight Loss Diet. The first phase consists of eating only rice and fruit until you can’t stand them any longer. Another novelty diet is the egg diet, on which you eat all the eggs you want. On the Beverly Hills diet, you eat mostly fruit.

The most bizarre of the novelty diets proposes that food gets stuck in your body. A common supposition from the 1800’s is that food gets stuck in the intestine, putrefies, and creates toxins, which invade the blood and cause disease. This leads to the headlines proclaiming the latest detox formula of strange concoctions of foods that if consumed promise to “cleanse” the blood. This is utter nonsense.

How to recognize a fad diet.

They promote quick weight loss. This primarily results from glycogen, sodium, and lean muscle mass depletion. All lead to a loss of body water.
They limit food selection and dictate specific rituals, such as eating only fruit for breakfast or cabbage soup every day.
They use testimonials from famous people and bill themselves as cure-alls. They often recommend expensive supplements.
Probably the cruelest characteristic of fad diets is that they essentially guarantee failure for the dieter since these diets are not designed for permanent weight loss. Habits are not changed, and the food selection is so limited that the person cannot follow the diet in the long run.
The dieter appears to have failed, when actually the diet has failed. This whole scenario can add more blame and guilt, challenging the self-worth of the dieter. If someone needs help losing weight, professional help is advised.
It should be noted that some “fad” diets can work for weight loss due to their highly restrictive nature but should not be considered a healthy diet since their long term effects are not usually known. A good example is the current ketogenic (keto) diet.

FAD DIET TIMELINE

Slimming down through the ages through fad diets has been around for centuries from President Taft to Victoria Beckham. Here’s a look at some of the most famous and infamous moments in diet fad history.

1820 Lord Byron brings people the once popular vinegar and water diet which entails drinking water mixed with apple cider vinegar.

1903 President William Howard Taft pledges to slim down after getting allegedly getting stuck in the White House bathtub.

1925 Lucky Strike cigarette brand launches the “reach for a Lucky” instead of a sweet” campaign capitalizing on its nicotine content.

1930s The Grapefruit Diet also known as the Hollywood diet is born. The popular plan calls for eating grapefruit with every meal. Grapefruit is claimed to have fat burning capabilities.

1950s the Cabbage Soup Diet promises you can lose 10 to 15 pounds a week by eating a limited diet including cabbage soup every day.

Mid-1950 Urban legend has it that opera singer Maria Callas dropped 65 pounds on the Tapeworm Diet by swallowing a the tapeworm parasite in a pill.

1963 Weight Watchers is founded by Jean Nidetch “a self-described overweight housewife obsessed with cookies.”

1969 Jazzercise founded by professional dancer Judi Sheppard Missett, is a combination of aerobics exercise and dance.

1970 Sleeping Beauty Diet which involves drug sedation is rumored to have been tried by Elvis Presley.

1975 A Florida doctor. creates the Cookie Diet, a plan where you eat cookies made with a blend of amino acids Hollywood eats it up.

1977 A Slim Fast shake for breakfast, a shake for lunch, then a sensible dinner becomes a diet staple.

1978 Dr. Herman Tarnower, a cardiologist publishes the Complete Scarsdale Medical Diet. Two years later he is shot by his girlfriend, a headmistress of a girl’s school, Jean Harris. (not related to a diet).

1979 Dexatrim, a pill containing phenylpropanolamine (PPA), appears on drugstore shelves. It’s formula changes after PPA is linked to an increased risk of stroke in 2000.

1980s A popular appetite suppressant candy called Ayds is taken off the market after the AIDS crisis hits.

1982 The aerobics craze sweeps into high gear when Jane Fonda launches her first exercise video work- out starring herself. Her catchphrase “no pain no gain.”

1985 Harvey and Marilyn Diamond publish Fit for Life, which prohibits complex carbs and proteins from being eaten during the same meal.

1987 in her memoir/self-help book Elizabeth Takes Off, actress Elizabeth Taylor advises dieters to eat veggies and dip each day at 3 PM.

1988 Wearing a pair of size 10 Calvin Klein jeans, Oprah walks onto the stage pulling a wagon full of fat to represent the 67 pounds she lost on a liquid diet.

1991 Americans are still obsessed with low fat food like McDonald’s Mclean Deluxe burger. The recipe called for seaweed extract called carrageenan. Beef made up only 90 percent of the patty, and water and carrageenan made up the remaining 10 percent. Despite the addition of “natural” beef flavor additives, the result was a dry failure of a burger that was later called “the McFlopper”. Johnnie Carson made many jokes about it.

1994 The guide to nutrition labeling and education act requires food companies to include nutritional info on nearly all packing packaging.

1995 The Zone Diet called for a specific ratio of carbs, fat and protein in each meal and begins to attract celeb fans.

1996 Could your blood type determine how much weight you could lose? That’s the idea behind the Blood Type Diet, created by naturopath Peter J. D’Adamo. He claims that the foods you eat react chemically with your blood type. If you follow a properly designed diet for your type, your body will digest food more efficiently and you will lose weight and be healthier.

1997 Robert C. Atkins, MD publishes Dr. Atkins New Diet Revolution, A high protein low carb plan. A previous book was published as Dr. Atkins Diet Revolution in 1972. It took the diet world by storm, since its primary goal was to eat fat, not avoid it. Fat-starved people loved it.

2000 Gwyneth Paltrow lends her support for the macrobiotic diet, a very restrictive Japanese plan based on whole grains and veggies.

2001 Renee Zellweger packs on nearly 30 pounds to play Bridget Jones.

2003 Miami Dr. Arthur Agatston adds fuel to the low carb craze by publishing the South Beach diet, seen as a more moderate version of Atkins.

Early 2000 The FDA bans the sale of diet drugs containing ephedrine after it’s linked to heart attacks.

Late 2000 The Biggest Loser makes its debut on TV, turning weight loss into a reality show. All but one contestant regained all their weight loss back after the show ended.

2006 Beyoncé admits to using the Master Cleanse, a concoction of hot water lemon juice maple syrup and Cayenne pepper to shed 20 pounds for “Dream Girls.”

2007 Alli hits the market. The non-prescription drug is taken with meals to keep your body from absorbing some of the fat a you eat. The drug was not popular due to unpleasant gastrointestinal side effects.

2010 Jennifer Hudson loses a jaw-dropping 80 pounds on Weight Watchers.

2011 The hCG diet combines a fertility drug with a strict 500 to 800 calorie a day regimen that invites interest and criticism. The FDA has called this diet dangerous, illegal and fraudulent.

2012 Jessica Simpson loses 60 pounds of baby weight on Weight Watchers.

NOTE: In our current virus centered world, hope these fad diets bring a few smiles to your face.

The French Diet vs. the Standard American Diet (SAD)

Savor Variety with the French Cuisine

To safeguard one’s heath at the cost of too strict a diet is a tiresome illness indeed.

— Francois Duc de La Rochefoucauld (1613-1680) French writer and moralist.

The French have long known that eating well is a integral part of the whole of French culture. This is reflected in their custom of a set of what is called “global” secrets from an engaging book entitled 30 Secrets of the World’s Healthiest Cuisines by Steven Jonas, M.D. and Sandra Gordon. In addition, the French attachment to the finer foods in life has resulted in them being some of the healthiest, leanest, and perhaps most guilt-free people in the world.

France At A Glance:

Moderate drinking – of course moderation is the key. Everyone knows the hazards of excess drinking. The French drink only with food – no happy hours!!!
Lots of fruits and vegetables
No snacking or dieting – this is important since the typical American eater often binges on snacks when on a very restrictive diet. Chronic dieting has been shown to increase weight gain in some people.
They eat large lunches and often extend and enjoy the lunch hour – no grabbing a carton of yogurt at your desk or going through the drive-thru or visiting the vending machine like the typical American eater.
They resize the supersize. “There is no such thing as a doggie bag in France, since restaurants never give you enough to put anything in it,” one says.
They don’t feel guilty about food. One of their reminders about food – “If you eat too much, the next day you eat less,” they say. They weigh themselves about once a month – if that. However, scale weight can be used as a red flag when weight begins to creep upward.
Take the time to cook properly and use fresh, quality ingredients. You don’t need to be Julia Child, but butter and cream are revered (in moderation, of course). Microwave ovens and can openers are not staple kitchen items.

CLICK HERE.

Make 2020 A “No Dieting” Year

Research has shown us that simply the process of dieting can make us fatter. Year after year a tremendous number of people attempt to diet. However, long-term studies of of those who diet consistently find they are more likely to end up gaining weight in the next few years than people who don’t diet.

Restrictive diets can lead to cravings, binge-eating, depression, and other eating disorders. The body has a range of weights referred to as a set-point at which it prefers to maintain in terms of body weight. When this set point is challenged by chronic dieting, you trigger the body’s natural hormonal and nervous systems mechanisms to protect your body from perceived starvation. One of these is to lower your metabolic rate and thus conserve energy so you burn fewer calories. The following article offers some sensible tips to avoid strict dieting and still be able to manage your weight loss or maintenance.

CLICK HERE.

Weight Loss and Fitness: An Opinion

The following article by Shannon Hilson writing on Medium is one of the best weight loss experiences ever This article is written by a real person in a real life situation, not by some so-called diet expert. Some experts tend to espouse nutrition platitudes, leaving the reader feeling guilty, depressed and tired of hearing the same thing over and over again. (my opinion).

This article can pertain to not only dieting (aka as torture), but weight management (staying at your desired weight goal).

The bottom line: Dieting is just not a pleasant state of mind or body – no matter how easy a Nutrisystem commercial may seem – “just eat the food….”

For a sensible approach:

CLICK HERE.

Eat Like the French?

Eat Like the French?

To safeguard one’s health at the cost of too strict a diet is a tiresome illness indeed.

Francois Duc de La Rochefoucauld (1613-1680)

French writer and moralist

To say the French know their food is an understatement. Even their children are aware of the gourmand cuisine – they have two-hour multi course lunches in schools and the presentation and preparation of the food becomes a normal part of their education.

A lot of attention was paid to the French way of eating due to what became known as the “French Paradox”. Consider these facts:

The French diet is high in saturated fat compared to the American diet. The good cholesterol (HDL) and high blood pressure rates are about the same as they are in North America; however, the total serum cholesterol levels are higher in the French population. Their smoking rates are relatively high which is a risk factor for heart disease.

So, all things considered, the French should have a lot more heart attacks than the U.S. population with our obsession with cholesterol and smoking cessation efforts. But quite the opposite is true. Compared with North Americans, the French are far less likely to die of heart disease with reports of death rates that are among the lowest in the world – second only to Japan. Also their rates of colon and prostate cancers are roughly 30 and 60 percent lower, respectively, than those in the U.S. That’s the paradox!!

Another part of the puzzle is that the French are leaner. In 2010, their obesity rate was 17% whereas in America in 2015 it is close to 39.8% and counting. The French are reported to live longer on average – French men by about a year and French women by two and one-half years. Is it genetics? Probably not much – when the French move to Montreal and begin to consume a more Western diet, they get “fatter” and their heart disease rates begin to resemble that of North America.

The Traditional French Diet At A Glance: Surprisingly Simple in Form with no tricks or gimmicks

Moderate drinking – one to two drink a day defined.
Lots of fruits and vegetables (35 to 38 percent of total calories) or on average four or more servings of vegetables a day.
No snacking or dieting – this is astounding! Compare to the typical American with our vast snack aisles in the supermarket and our obsession with diets (fad and otherwise).

Source: 30 Secrets of the World’s Healthiest Cuisines, Steven Jonas, MD and Sandra Gordon

How do they stay so slender?

Their food is nutrient dense. They emphasize quality over quantity.

Eating is mindful at each meal. They pay close attention to the type of foods they eat.

They don’t eat in a hurry or when stressed or in front of the TV.

They see food as a ritual with accompanying wine, family or friends, laughter and reverence of the food quality.

They enjoy market trips and understand where their food comes from. They favor seasonal, local foods.

“Sinfully delicious” is a ridiculous oxymoron in French culture. They eat without guilt.

They adhere to traditional dietary guidelines and eat a wide variety of foods. The children eat what is given them. Most French parents would never give their children the option of a hot dog instead of eating “grownup foods.”

The French don’t count pounds or calories or step on the scale each morning. Instead they are mindful of how their clothes fit – using the “zipper syndrome” or a tape measure. When clothes feel tight – they will simply cut back on high caloric dense foods or have a lighter dinner.

They are aware that yo-yo and crash dieting ruins their metabolism since the body senses a period of starvation and then burns calories more slowly to conserve energy.

They don’t eat “fake” foods – they stick to butter instead of using canola oil sprays, e.g.

They appreciate the art of cooking (remember Julia Child?)

We think we know a lot about nutrition science, but we may sadly be kidding ourselves. We can learn a lot from other cultures and their traditional ways as exemplified by the French experience and the following known the Roseto Effect.

“A remarkable discovery by physician Stewart Wolf found a strikingly low incidence of heart disease and deaths from heart attacks, spanning three generations, in a small Italian immigrant community in Roseto, Pennsylvania and was reported in the early 1990s.

It was a astonishing discovery that it wasn’t their diet that was protecting their heart health. To the contrary, Rosetons embraced westernized foods and cooking, at the expense of their Italian-Mediterranean culinary roots. For example, they:

Shunned olive oil, and used lard instead, as the main fat for cooking.
Dipped their bread in a lard-based gravy, rather than olive oil.
Ate an Italian ham, including its one-inch rim of fat.
The average Roseton diet was high in fat, containing 41% of calories from fat.

The distinguishing protector of their heart health and longevity was found to be social cohesion and social support.

—once again as with the French, effect of positive emotional experiences can have a greater impact on health than which foods people actually eat.”

Source: Evelyn Tribole, M.S., R.D. and Elyse Resch, M.S., R.D., F.A.D.A., C.E.D.R.D. Intuitive Eating: A Revolutionary Program That Works. Page 201.

My opinion: We find this same phenomenon in the study of the Blue Zones cultures where lifestyle patterns appear to affect the longevity and health of these populations. We need to rethink how we diet and learn to maintain our weight losses. From my experiences, it may be prudent to begin to seriously investigate the role that mindfulness and intuitive eating has on our food intake and body weight maintenance.