Type 2 Diabetes has been regarded by the medical establishment as irreversible. Once you had it, it inevitably went only one way - downhill. Treatment focuses on minimizing the damage and slowing the decline, yet diabetics suffer from a wide range of serious conditions including high blood pressure, increased risk of stroke and heart attack, blindness, neuropathy, ketoacidosis, digestive disorders and fatigue. And if that were not enough, about 60% of all foot and leg amputations are caused by diabetes.
The current thinking is that there is nothing you can do other than try to manage the symptoms and minimize the inevitable damage. But that may all be about to change thanks to a clinical trial underway in the UK called the Diabetes Remission Clinical Trial (DiRECT) that released its initial results in March of 2019.
The trial assigned 272 people in the UK to receive either the standard treatment (the control group) or a closely supervised, very low calorie diet (the intervention group). For those in the intervention group, all diabetes medication was halted on day one of the trial. After one year, 46% of those in the intervention group were completely free of diabetes and off all their medications. At the 2 year point in the trial, 36% of those in the intervention group remained diabetes free. And the control group? After 2 years, 3% were diabetes free and off their medication. Regardless of which group they were in, 64% of those who lost 22 pounds or more were diabetes free after 2 years.
So the approach did not work for 100% of the people or 100% of the time. But nearly half of those assigned to the intervention group were diabetes free and medication free after 2 years.
This is not an approach for the faint of heart, and it absolutely, positively should not be attempted unless under close medical supervision. The intervention group was on a diet that provided only 850 calories a day from vegetables, salads and a specially formulated nutritional shake. They remained on this diet for 12 - 20 weeks. After the initial restrictions, they slowly added foods back into their diet over the next 4 - 8 weeks. After that, they had regular meetings with a nurse clinician and dietician to help them maintain their lower weight. Anyone who gained 10 or more pounds was immediately restarted on the initial calorie restricted diet.
Clearly this was no fun. But if you were one of those who walked away free of diabetes and all its many health dangers, perhaps worth the cost.
In the United States, the number of people with Type 2 diabetes has tripled between 1990 and 2010. In 2015 there were 30.3 million Type 2 diabetics, about 10% of the population. Another 84 million (nearly 1 in 3 of us) have pre-diabetes, many of them undiagnosed and unaware.
The takeaway from this is embarrassingly simple. "The incidence of diabetes increases if a population is overfed," says Roy Taylor, one of the researchers involved in the DiRECT study. "If a population is short of food, diabetes disappears."
We eat to much of the wrong things and we exercise too little. And it can kill us. Now, at least, it looks like we can step back from the brink. IF we are willing to give up the garbage we bring home from the grocery store, the 3,000 calorie meals we eat in restaurants and some of our couch time.
For more details on the DiRECT trial go to ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation .
04 December 2019
26 November 2019
14 October 2019
Tasteless Tomatoes by Design
You've probably tasted a fresh, garden grown tomato at some point. And you've probably mentioned how tasteless the typical store-bought variety is more often than your friends want to hear. So you think store-bought tomatoes are tasteless? Well, according to research done at Cornell University and published in the journal Nature Genetics, you are right. But probably not for the reasons you think.
More than 90% of store-bought tomatoes lack a specific gene that is responsible for producing the chemicals that cause their distinctive taste. The tomatoes lost the gene as growers produced varieties selected for their size, color, shape, sturdiness and shelf life.
Your best bet for finding a tomato that still tastes like a tomato is with heirloom varieties.
More than 90% of store-bought tomatoes lack a specific gene that is responsible for producing the chemicals that cause their distinctive taste. The tomatoes lost the gene as growers produced varieties selected for their size, color, shape, sturdiness and shelf life.
Your best bet for finding a tomato that still tastes like a tomato is with heirloom varieties.
11 October 2019
Mo Pro(biotics)!
Probiotics are all the rage. Between 2007 and 2012 the number of Americans taking probiotic supplements more than quadrupled. As of 2012 that is 4 million adults and 300,000 children. In 2016, the market for probiotics reached $4.3B and was projected to grow by 38% a year through 2021. Probiotics are forecast to outsell all other supplement products by 2020.
Considerable research supports the positive impact of a healthy microbiome - the trillions of bacteria that inhabit our gut, urinary tract, lungs, mouth and skin. Human studies confirm that certain strains of bacteria can alleviate irritable bowel syndrome, stave off the diarrhea sometimes associated with antibiotic use and certain illnesses and enhance our ability to digest the lactose in dairy products.
With that much money on the table and that much projected growth, you will probably be shocked to learn that food and supplement manufacturer's marketing departments are tripping over each other to capitalize on the boom. Equally surprising, many of their claims are bulls....err, questionable.
According to Prevention magazine, there is little evidence that probiotic supplements or additives have any impact at all on healthy people, and most of the benefits touted by the companies that manufacture them are, at best, hypothetical. "There is no compelling evidence that continued consumption of probiotics if you are healthy has any benefit," according to Jack Gilbert, head of the University of Chicago's Microbiome Center. But wait! There's more.
Probiotic manufacturers have a labeling problem. Shocking, I know. In one 2015 study analyzing the content of 16 probiotic supplements from a variety of manufacturers found that only 1 accurately identified their contents on the label.
Taking a page from their fiber playbook, many supplements contain only cheap, common and relatively ineffective bacteria when in fact a dazzlingly wide variety inhabit our innards.
And to ice the cake, many of the supplements sold today pass right on through your gut before the bacteria have any chance at all to replicate there. "You often read that probiotics are supposed to colonize and then reshape the microbiome," says University of Alberta microbiologist Jens Walter. "But there is virtually no evidence that that can actually happen."
This may all change soon. Scientists are developing "cocktails" of organisms that may be more potent and posses more staying power. In the meantime, if you are a basically healthy person and are spending money on probiotics, you are not spending it on something that might actually do you some good.
All this being said, there are things you can do to nurture and care for your microbiome, and you don't need a supplement to do it.
"One of the largest influences on our microbiomes and their activity in our gut is diet," advises Susan Lynch, a microbiome researcher at UCSF. Cultured milk like kefir and yogurt brim with healthy bacteria. And fiber encourages healthy bacteria to multiply, so - surprise! - fruits, vegetables and whole grains will do more than a supplement. Also, skip antibacterial products containing triclosan. Studies suggest that is can severely alter your microbiome, and it is in everything from soap to deodorant to toothpaste.
Considerable research supports the positive impact of a healthy microbiome - the trillions of bacteria that inhabit our gut, urinary tract, lungs, mouth and skin. Human studies confirm that certain strains of bacteria can alleviate irritable bowel syndrome, stave off the diarrhea sometimes associated with antibiotic use and certain illnesses and enhance our ability to digest the lactose in dairy products.
With that much money on the table and that much projected growth, you will probably be shocked to learn that food and supplement manufacturer's marketing departments are tripping over each other to capitalize on the boom. Equally surprising, many of their claims are bulls....err, questionable.
According to Prevention magazine, there is little evidence that probiotic supplements or additives have any impact at all on healthy people, and most of the benefits touted by the companies that manufacture them are, at best, hypothetical. "There is no compelling evidence that continued consumption of probiotics if you are healthy has any benefit," according to Jack Gilbert, head of the University of Chicago's Microbiome Center. But wait! There's more.
Probiotic manufacturers have a labeling problem. Shocking, I know. In one 2015 study analyzing the content of 16 probiotic supplements from a variety of manufacturers found that only 1 accurately identified their contents on the label.
Taking a page from their fiber playbook, many supplements contain only cheap, common and relatively ineffective bacteria when in fact a dazzlingly wide variety inhabit our innards.
And to ice the cake, many of the supplements sold today pass right on through your gut before the bacteria have any chance at all to replicate there. "You often read that probiotics are supposed to colonize and then reshape the microbiome," says University of Alberta microbiologist Jens Walter. "But there is virtually no evidence that that can actually happen."
This may all change soon. Scientists are developing "cocktails" of organisms that may be more potent and posses more staying power. In the meantime, if you are a basically healthy person and are spending money on probiotics, you are not spending it on something that might actually do you some good.
All this being said, there are things you can do to nurture and care for your microbiome, and you don't need a supplement to do it.
"One of the largest influences on our microbiomes and their activity in our gut is diet," advises Susan Lynch, a microbiome researcher at UCSF. Cultured milk like kefir and yogurt brim with healthy bacteria. And fiber encourages healthy bacteria to multiply, so - surprise! - fruits, vegetables and whole grains will do more than a supplement. Also, skip antibacterial products containing triclosan. Studies suggest that is can severely alter your microbiome, and it is in everything from soap to deodorant to toothpaste.
01 October 2019
A Brief History of Diets
The idea of dieting - as opposed to having a diet - is fairly new to human history, not really gaining traction within a mass audience until after World War II. Since then the diet industry has surged (to a $64 billion business in 2014), with this fad and that promising better health and less weight. Recently though the growth trend has begun to reverse as more and more people realize that actual nutritionists have been right all along: a varied, balanced diet is best.
Here is a rundown of 60 years of diets.
1950: The Cabbage Soup Diet
"Lose 10 - 20 pounds in one week!"
Well ok, but you do it by basically eating water for 7 days.
Besides being unhealthy, you can't remain on this "diet" for
very long.
1965: Weight Watchers
"Follow our point system to maintain balanced, healthy
eating habits long term."
Combined with AA-style support groups and a simple to
follow system rather than a list of permitted and forbidden
foods, this is one of the few really sensible diet programs to
come along.
1990: Diet Shakes
"Simply replace one meal a day with one of our tasty, easy
to use shakes, and watch the pounds melt off."
Slim Fast Foods built a following of 23 million people on this
promise (and $100 million in advertising). There is little
evidence that it works long term.
1995: Low Fat Diets
"Cut out the fat to lose weight and protect your heart!"
Manufacturers rolled out some 1,300 new fat free and low
fat foods in response to the government's recommendation
to adopt a low fat diet. They pretty much all crashed and
burned because the products were packed with sugar.
2000: The Blood Type Diet
"Customize your diet to your own unique blood type
and metabolism!"
This really was a thing. Sadly there is ample evidence
showing no variation in nutritional requirement by
blood type.
2003: The Atkins Diet
"Ultra-low carbs not only solve blood sugar problems
but improve your health and energy across the board!"
It also gave people headaches and fatigue and proved
too difficult for most people to stick with.
2004: The South Beach Diet
"The realistic Atkins Diet: low carbs and reduced fat."
This quickly became the best selling diet book of all time
and is one of the better approaches and still popular today.
2015: Gluten Free
"Eliminate this wheat protein from your diet an enjoy
almost unlimited benefits."
Perhaps 3% of the US population needs to be on a gluten
free or reduced gluten diet. The rest apparently just likes
to eat whatever is popular in Hollywood.
2016: The Paleo Diet
"If it worked for cave people it will work for us!"
Experts warn that the diet, which attempts to recreate the
meat heavy, grain and dairy free diet of our paleolithic
ancestors is dangerously misguided. The meats available
to our ancestors is not available to us but were "biologically
distinct". Also, the food groups eliminated have significant
nutritional benefits.
2017: The Ketogenic Diet
"Burn fat instead of carbs!"
Originally developed as a treatment for pediatric epilepsy,
this diet forces your body into a potentially dangerous state
of ketosis. Ketosis occurs when people eat a low- or no-carb
diet and molecules called ketones build up in their
bloodstream. It can indeed help you shed a few pounds, but
Ketosis is actually a mild form of ketoacidosis. Ketoacidosis
mostly affects people with type 1 diabetes. In fact, it is the
leading cause of death of people with diabetes who are
under 24 years of age.
Since 2018, eating plans promoting balance and variety began making headway. The DASH, Mediterranean and Flexitarian diets were ranked #1, #2 and #3 on the US News and World Report diet plan listing. Atkins, Paleo and Ketogenic were the worst three diets evaluated.
Here is a rundown of 60 years of diets.
1950: The Cabbage Soup Diet
"Lose 10 - 20 pounds in one week!"
Well ok, but you do it by basically eating water for 7 days.
Besides being unhealthy, you can't remain on this "diet" for
very long.
1965: Weight Watchers
"Follow our point system to maintain balanced, healthy
eating habits long term."
Combined with AA-style support groups and a simple to
follow system rather than a list of permitted and forbidden
foods, this is one of the few really sensible diet programs to
come along.
1990: Diet Shakes
"Simply replace one meal a day with one of our tasty, easy
to use shakes, and watch the pounds melt off."
Slim Fast Foods built a following of 23 million people on this
promise (and $100 million in advertising). There is little
evidence that it works long term.
1995: Low Fat Diets
"Cut out the fat to lose weight and protect your heart!"
Manufacturers rolled out some 1,300 new fat free and low
fat foods in response to the government's recommendation
to adopt a low fat diet. They pretty much all crashed and
burned because the products were packed with sugar.
2000: The Blood Type Diet
"Customize your diet to your own unique blood type
and metabolism!"
This really was a thing. Sadly there is ample evidence
showing no variation in nutritional requirement by
blood type.
2003: The Atkins Diet
"Ultra-low carbs not only solve blood sugar problems
but improve your health and energy across the board!"
It also gave people headaches and fatigue and proved
too difficult for most people to stick with.
2004: The South Beach Diet
"The realistic Atkins Diet: low carbs and reduced fat."
This quickly became the best selling diet book of all time
and is one of the better approaches and still popular today.
2015: Gluten Free
"Eliminate this wheat protein from your diet an enjoy
almost unlimited benefits."
Perhaps 3% of the US population needs to be on a gluten
free or reduced gluten diet. The rest apparently just likes
to eat whatever is popular in Hollywood.
2016: The Paleo Diet
"If it worked for cave people it will work for us!"
Experts warn that the diet, which attempts to recreate the
meat heavy, grain and dairy free diet of our paleolithic
ancestors is dangerously misguided. The meats available
to our ancestors is not available to us but were "biologically
distinct". Also, the food groups eliminated have significant
nutritional benefits.
2017: The Ketogenic Diet
"Burn fat instead of carbs!"
Originally developed as a treatment for pediatric epilepsy,
this diet forces your body into a potentially dangerous state
of ketosis. Ketosis occurs when people eat a low- or no-carb
diet and molecules called ketones build up in their
bloodstream. It can indeed help you shed a few pounds, but
Ketosis is actually a mild form of ketoacidosis. Ketoacidosis
mostly affects people with type 1 diabetes. In fact, it is the
leading cause of death of people with diabetes who are
under 24 years of age.
Since 2018, eating plans promoting balance and variety began making headway. The DASH, Mediterranean and Flexitarian diets were ranked #1, #2 and #3 on the US News and World Report diet plan listing. Atkins, Paleo and Ketogenic were the worst three diets evaluated.
27 September 2019
Two Really Great Reads
I don't often recommend books because, well, its 2020 and who reads books? I do though, and here are two really great ones that anyone interested in a long, healthy and happy life really ought to be reading.
"The Hacking of the American Mind" by Robert H Lustig, MD
The first half of the book is a little challenging, dealing as it does with the biochemistry of our brain and topics like pleasure vs happiness, addiction and stimulus-response. But the second half's detailed description of how corporations have applied neuroscience to manipulate our responses to their products and messages is a real page turner. Its scary stuff but in this case knowledge really is power.
"Is Gwyneth Paltrow Wrong about Everything? How the Famous Sell Us Elixers of Health, Beauty & Happiness" by Timothy Caulfield
An expose of the unholy alliance between Hollywood and Advertising that brings us irresistible science-free therapies, supplements, homeopathy, colonics and intravenous vitamins. Everything from the gluten free diet craze to Kim Kardashian's $500,000 social media posts. If you suspected that celebrity endorsements were mostly bogus, you were mostly right. But you had NO idea how far its gone.
"The Hacking of the American Mind" by Robert H Lustig, MD
The first half of the book is a little challenging, dealing as it does with the biochemistry of our brain and topics like pleasure vs happiness, addiction and stimulus-response. But the second half's detailed description of how corporations have applied neuroscience to manipulate our responses to their products and messages is a real page turner. Its scary stuff but in this case knowledge really is power.
"Is Gwyneth Paltrow Wrong about Everything? How the Famous Sell Us Elixers of Health, Beauty & Happiness" by Timothy Caulfield
An expose of the unholy alliance between Hollywood and Advertising that brings us irresistible science-free therapies, supplements, homeopathy, colonics and intravenous vitamins. Everything from the gluten free diet craze to Kim Kardashian's $500,000 social media posts. If you suspected that celebrity endorsements were mostly bogus, you were mostly right. But you had NO idea how far its gone.
25 September 2019
Five Foods to Help You Not Feel Hungry
Despite what you might think from all of the miracle diet plans and no-lifestyle-change weight loss programs, the big secret to losing weight is to burn more calories than you take in. And there are two ways to do this: take in less or burn more. For most people a combination of both is the best approach.
One of the things that is probably going to doom your weight loss effort to eventual failure is to restrict your eating to the point where you are always hungry and can hardly think about anything else except for when you are allowed to have your next stick of celery. If you aren't feeling like you are getting enough to eat, your diet is not going to last. This is one reason why exercise is such an important part of successful weight loss, it lets you eat a bit more.
Here are five foods that will help you feel full longer and keep the hunger pangs at bay.
1. Avocados
The oleic acid in an avocado is a fat contained in very few other
foods. The body converts oleic acid into a compound that is
believed to signal satiation (i.e., fullness) to the brain and a recent
Italian study found that people who ate a breakfast high in oleic
acid consumed about 250 fewer calories at lunch than those who
did not. That adds up to about 1/2 pound lost per week, other
things being equal.
2. Green Bananas
Yes, green. Slightly unripened bananas contain a starch which is
more resistant to digestion and acts to help stabilize blood sugar.
If green is too hard for you, blend it into a smoothie and you won't
be able to tell the difference.
3. Oatmeal
No surprise here. Oatmeal's generous helping of both soluble and
insoluble fiber slows digestion and will leave you feeling fuller for
longer. I like to make it overnight in a slow cooker with eggnog
and cranberries.
4. Soup
The exact type doesn't matter all that much, just be careful of all
of the sodium. A Penn State study found that people who start
dinner with 150 calories of soup consumed fewer calories overall
than those who went straight to the entree. Cream based soups
are likely to surpass that 150 calorie threshold fast though.
5. Salmon
Follow up that soup with with a serving of this healthy-fat rich
fish. The combination of healthy Omega fats and high quality
protein will make you feel fuller and more satisfied after your
meal.
Don't starve yourself between meals either. Feel free to graze to keep the edge off any hunger pangs. Just be a little picky about what you snack on. Pretty much any fruits or vegetables are better than "snack food" (aka, crap) and there is plenty to choose from. Besides that celery stick, reach for cherry tomatoes, carrots, an apple or even a stick of mozzarella string cheese. Pick up some hummus as a dip. Vegetables are fiber rich and practically "free" from a calorie point of view.
Remember, if you are so hungry that all you can think about is food, your "diet" is doomed before you even get started.
One of the things that is probably going to doom your weight loss effort to eventual failure is to restrict your eating to the point where you are always hungry and can hardly think about anything else except for when you are allowed to have your next stick of celery. If you aren't feeling like you are getting enough to eat, your diet is not going to last. This is one reason why exercise is such an important part of successful weight loss, it lets you eat a bit more.
Here are five foods that will help you feel full longer and keep the hunger pangs at bay.
1. Avocados
The oleic acid in an avocado is a fat contained in very few other
foods. The body converts oleic acid into a compound that is
believed to signal satiation (i.e., fullness) to the brain and a recent
Italian study found that people who ate a breakfast high in oleic
acid consumed about 250 fewer calories at lunch than those who
did not. That adds up to about 1/2 pound lost per week, other
things being equal.
2. Green Bananas
Yes, green. Slightly unripened bananas contain a starch which is
more resistant to digestion and acts to help stabilize blood sugar.
If green is too hard for you, blend it into a smoothie and you won't
be able to tell the difference.
3. Oatmeal
No surprise here. Oatmeal's generous helping of both soluble and
insoluble fiber slows digestion and will leave you feeling fuller for
longer. I like to make it overnight in a slow cooker with eggnog
and cranberries.
4. Soup
The exact type doesn't matter all that much, just be careful of all
of the sodium. A Penn State study found that people who start
dinner with 150 calories of soup consumed fewer calories overall
than those who went straight to the entree. Cream based soups
are likely to surpass that 150 calorie threshold fast though.
5. Salmon
Follow up that soup with with a serving of this healthy-fat rich
fish. The combination of healthy Omega fats and high quality
protein will make you feel fuller and more satisfied after your
meal.
Don't starve yourself between meals either. Feel free to graze to keep the edge off any hunger pangs. Just be a little picky about what you snack on. Pretty much any fruits or vegetables are better than "snack food" (aka, crap) and there is plenty to choose from. Besides that celery stick, reach for cherry tomatoes, carrots, an apple or even a stick of mozzarella string cheese. Pick up some hummus as a dip. Vegetables are fiber rich and practically "free" from a calorie point of view.
Remember, if you are so hungry that all you can think about is food, your "diet" is doomed before you even get started.
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