More good news for fruits and veggies

A new study out of Loma Linda University shows that people who follow a vegetarian diet had a "substantial and independent reduction in diabetes incidence." 

Researchers found that among the black population, a vegan diet lead to a 70% reduction in diabetes risk.  A vegetarian diet was also impressive and cut the risk of diabetes by 53%.

The study examined over 41,000 people (7,172 black) Seventh Day Adventists.  While the results were similar among white participants, it is important to note that Seventh Day Adventists generally abstain from alcohol and tobacco. 

The study also found that exercising 3x per week decreased risk of diabetes by 35%.   This is another win for people advocating a plant based diet and regular exercise... in other words; a healthy lifestyle.

Reversing diabetes

Sorry for the long delay between posts.  This article was really encouraging and I wanted to share with you all.  Nearly 26 million Americans have diabetes with the vast majority of those people having type 2.  Type 2 diabetes is characterized by insulin resistance.  Once insulin resistance kicks in, there is a domino effect of physiological demise.  Bad stuff happens; very bad.  

The nice part about type 2 diabetes is that is 100% manageable.  Some diseases are very difficult to treat; diabetes is not one of them.  In fact, you could even argue that up to a certain point, diabetes (type 2) is curable! That's what these researchers found.  It was a very small sample size, but the results are not only encouraging but somewhat predictable.

Eleven volunteers were newly diagnosed diabetics.  After following a 600 calorie per day diet for 8 weeks, there disease disappeared!  Blood sugar levels returned to normal and the pancreas improved its appearance and function.  Three months after the study was completed, 7 out of 11 were still diabetes free.

There are 2 ways to look at this.  First, you could say that eating a 600 calorie per day diet is not realistic in the long run.  The participants in this study consumed nothing but liquid drinks and non-starchy vegetables.  It doesn't seem like a lot of fun so may have little application for real people in the long run.  Who wants to live like that forever?

The other way to look at it (and the preferred way), is to understand that you can reverse early diabetes.  While this study doesn't directly say the following, I would argue that even in severe diabetes, you can make the disease regress and dramatically improve the functioning of your body.  Eat well.  Food has enormous potential to heal you.  

What would happen on a less restrictive diet coupled with regular walking?  What about a 1200 calorie per day diet with a regular yoga class?  1400 calorie per day diet with resistance exercise and yoga together?  The possibilities are endless.

You don't need to be on a liquid diet with lettuce and broccoli alone.  You can eat tons of veggie and reasonable amounts of other real foods and still have the same effect.  Perhaps it will be 9 weeks rather than the 8 weeks of this study.  Perhaps it will take 4 months?  But you will move in the right direction.  That is a guarantee.

The Future of America...unless things change

Another bleak report was published by the Centers for Disease Control recently indicating that the state of health in the U.S. in 2050 will be very, very sad.  They emphasize that unless things change, there will be an increasing number of diabetics.   We are reminded in this report that the health care costs associated with diabetes is $174 billion per year!

Experts predict that up to 1 in 3 American adults could have diabetes.   I've used the following example before but it's worth repeating; if I told you that 1 in 3 Americans would catch a virus that would significantly reduce their quality of life, consume massive amounts of health care dollars, cause kidney failure, blindness, nerve issues, sexual dysfunction, increase risk of many cancers, promote infertility and heart attacks.... we would be up in arms!  There would be a massive public outcry to develop a vaccine against this virus that could assault and destroy the lives of so many Americans.  

The real threat here is much more insidious.  I admit- eating lots of vegetables and exercising regularly is not quite as sexy as the idea of a brilliant team of scientists developing a new vaccine (cue the suspenseful music) against a ticking clock... to conquer this threat.  You probably won't see Hollywood make movies on how a healthy lifestyle can destroy this epidemic. 

Folks- you can change this.  I know it sounds a bit idealistic, but one bite at a time, one person- one family- one community at a time, we can prove these CDC scientists wrong.

Economic burden of diabetes

A new report published indicates that 23% of hospital stays involve a patient with diabetes.   Diabetics racked up a total of $83 billion dollars in hospital fees.  These patients were in the hospital for longer periods than individuals without diabetes, costing nearly $2,200 more per stay.  

If $83 billion dollars in hospital bills seems high, consider this; the total cost of diabetes related care is over $218 billion dollars per year.  Couple this with the knowledge that the vast majority of diabetes is preventable.  It is a result of poor diet and lifestyle.

More on AGEs

You may have heard of many people taking a baby aspirin daily to "thin the blood."  This "thinning" effect is accomplished by shutting down the function of platelets; cell fragments involved in blood clotting.  The AGEs mentioned in the previous post negatively affect platelets.

This study shows that when albumin is glycated, it can activate platelets.  These activated platelets can then go on to promote heart disease.

Additionally, AGEs have also been implicated in degenerative joint disease.  AGEs may collect in joint cartilage to promote the wear and tear typical of osteoarthritis.  By now, you can see that diabetes can wreak quite a bit of havoc through the production of AGEs alone.

Diabetes- AGEs

Another harmful factor generated in diabetes are products called 'advanced glycation end-products', or AGEs.  AGEs develop essentially when proteins in your body (or fats or other compounds) are tagged with a sugar molecule.  While this may see relatively harmless, we must understand that a central tenant in biology is that "form dictates function."  When we add sugar residues, we have changed the form of that molecule.  That will invariably lead to an alteration in function.

These AGEs can go on to make blood vessels stiff (not a good thing), generate free radicals and promote inflammation.  If all of that sounds a little to "science-ey" for you, then how about this;  AGEs also make your skin age.

AGEs are often discussed outside of the context of diabetes.  While they can be generated in our body, we also consume them in our diet.  Diet sodas are a common source of AGE consumption because of the aspartame and caramel colourant.  Animal derived foods with lots of fat and protein are another common source of AGEs.

While we always have some level of AGE production, exogenous intake and extraordinary production during diabetes promotes pathogenic processes.  In fact, doctors often monitor a patient's A1C, a marker of glycated end products, to determine how well blood sugar management has been over an extended period of time. 

In summary, diabetes produces AGEs.  AGEs then promote more insulin resistance (with oxidative stress and inflammation) that exacerbate the diabetes.    Then we make more AGEs.... and the vicious cycle goes on and on.

Diabetes- Avandia

Avandia, a medication used to increase insulin sensitivity, has taken a lot of heat over the past several weeks.  This popular diabetes medication has made headlines because of the increased risk of heart attacks and strokes associated with it.  The matter is far from over.  As of today, the FDA is still considering whether or not to pull Avandia from the market.

When these matters are debated, you often find two camps where one group strongly supports the use of a drug while the other group is staunchly opposed.  Both perspectives are often rooted in the naive idea that "drugs are amazing" or "drugs are evil."

Individuals in the natural health community, like myself, are often guilty of decrying the multiple adverse effects of medications and the overuse of these powerful tools.  This leads to the well intentioned but ill informed opinion that "drugs are evil."  News like this can serve as a sort of vindication for anti-drug advocates.

But consider the broader view here.  Medications clearly save lives and improve the quality of life for millions of people in the U.S.  I read this piece in the LA Times which is a bit more fair and balanced than many viewpoints. 

With any medication, you will help some people and hurt others.  It is impossible for a drug to be everything to all people.  

"It's always a balancing act for us," said Karen Riley, a spokeswoman for the Food and Drug Administration. "Products get approval because we see that the benefits outweigh the risks. Then we try to adjust as we go along." LA Times July 1, 2010.

Our natural tendency is to assume that "the powers that be" have clearly determined that the benefits outweigh the risk.  The case of Avandia is evidence that this is a dangerous assumption.  Consider the recalls we hear daily; McDonald's toys, Toyota cars, cribs, baby bottles and more.  Drugs are no different. 

Diabetes- Inflammation

The risks of diabetes are well known.  Individuals run the risk of kidney failure, blindness, poor wound healing, loss of limbs & nerve damage.  As blood sugar is chronically elevated, a number of other physiological events occurs simultaneously. We'll start this series off discussing chronic inflammation.

A rise in blood sugar alone can be problematic enough by itself.  But it appears that with hyperglycemia, diabetics also experience inflammation.  This inflammation also promotes damage to the eyes, kidneys and nerves.

"In general, hyperglycemia is the main initiator of diabetic retinopathy, nephropathy, and neuropathy, and it participates in the development of diabetic cardiovascular diseases. Although the precise role of inflammation in the development of diabetic microvascular diseases is still unclear, it is likely that inflammation induced by diabetes and insulin resistance can accelerate atherosclerosis in patients with diabetes."  J Periodontol 2008 Aug;79(8 Suppl):1527-34.

Inflammation itself has been implicated in many, if not most, chronic diseases.  Take a look at this article that discusses how peripheral inflammation (away from the brain), can actually damage brain cells!

"As a consequence of excessive inflammatory response triggered by pro-inflammatory cytokines in the periphery, free radicals, oxidants and glucocorticoids are over-produced, which can affect glial cell functions and damage neurons in the brain. Indeed, decreased neurogenesis and the dysfunction of neurotrophic system (up- or down-regulations of neurotrophins and their receptors) have been recently found."  Prog Neuropsychopharmacol Biol Psychiatry 2010 Jul 2. [Epub ahead of print]

There's no doubt that with hyperglycemia, we set off on a downward spiral of multiple physiological systems.  While convenient, it is overly simplified to understand the risks of diabetes as being secondary only to high blood sugar.  High blood sugar assaults your body directly, but then promotes inflammation that will also assault your body.  This is a proverbial "double whammy."

Before continuing on with the next posts, let's consider this.  Do you believe that the pathophysiology of diabetes provides a "double whammy?"  Or is it a "triple whammy?"  "Quadruple whammy?"  

Lots of things go wrong.  This is the tip of the iceberg. 

Diabetes

Approximately 24 million Americans suffer from diabetes.  It sucks up $116 billion dollars each year in direct medical costs and $58 billion dollars a year in indirect costs.  More than 90% of diabetics are considered type 2 diabetics, or non-insulin dependent.  There are ever changing medications used to manage diabetes, many of which dramatically help an individual manage blood sugar, but ultimately fall short in correcting a person's physiology.

In the next series, we'll take a look at how diabetes works and why this crippling disease can be almost entirely prevented.  Most of us probably know at least one diabetic in our inner circle of family and friends.  To some, it seems inevitable because of a defeatist attitude that echoes, "my mom had it and so I'll get it too... it's in my genes."  We'll zoom in and look at the vicious chain of degeneration that diabetes sets off.  Then, we'll look at natural means to manage this disorder.

Many people know something about diabetes.  But the reality is; it's much worse than you think.

Type 1 Diabetes and Wheat

A new report in Diabetes this month showed that patients with type 1 diabetes show significant immune responses to wheat proteins. Type 1 diabetes is an autoimmune condition where the immune system destroys insulin producing beta cells of the pancreas.

The authors state that the results indicate, "... a diabetes-related inflammatory state in the gut immune tissues associated with defective oral tolerance and possibly gut barrier dysfunction."

In other words, gut dysfunction may promote the immune response. This leads to an "irritated" immune system that goes on to attack other organs such as the pancreas.

This idea is hardly new. In a commentary of the article, one author writes, "Given that type 1 diabetes is the unfortunate consequence of the combined effects of the individual genetic setup and exogenous and host-related factors, it is not surprising that the gut might be involved in the process leading to clinical disease."

So it would seem that your immunologist (dealing with the autoimmune component) should be talking to your endocrinologist (about the endocrine abnormalities secondary to diabetes) and should bring in the gastroenterologist (to discuss best methods of dealing with intestinal permeability). If you are a type 1 diabetic, this is a conversation that should be happening.

Alabama's Fat Tax

Obese state employees may soon have to pay an additional $25 in health insurance per month. Some argue that it asks the people most likely to consume health care resources to invest in it now. Others cite discrimination and unfair policies toward the overweight.

I’m not going to comment on the delicate politics of this situation, but it does give us food for thought.

Chronic disease, (not car accidents, trauma, gunshot wounds etc.)… chronic disease which is often preventable, has the potential to bankrupt our health care system. When 1 in 4 Americans has a blood sugar disorder, what will happen to their health 20 years from now? If we don’t wake up now, then 20 years will pass and our hearts will be sick, our brains will be on fire and ours organs will fail. What can any doctor, even the world’s best doctor, do at that point? From an economic standpoint, these sick people will continue to consume healthcare resources for problems that could have largely been prevented.

Check out this article from the Canadian Diabetes Association. It states that the health care system can pay $2000-5000 per year now to properly care for a diabetic or pay $50,000 a year to care for a diabetic who has progressed to kidney failure.

This article was published in the Mississippi Business Journal in 2006. In it, Dr. Marshall Bouldin, Director of the Diabetes and Metabolism Program at the University of Mississippi Medical Center, said, “The burden of both type 2 diabetes and obesity is rapidly increasing and shows no sign of stopping. If our society does not change this, diabetes alone will bankrupt our medical system.”

A “tax on the fat” appears to be one proposed method to prevent this. But the more important message seems to be; to save our health care system, we must first save ourselves.

There are a lot of mysteries surrounding the cause of many chronic diseases. We aren’t even close to having all the answers. Genetic predispositions, single nucleotide polymorphisms, prenatal environment, environmental toxicants, phthalates, BPA’s, heavy metal load etc.à all these things may be relevant and it is easy to feel out of control.

But the one thing we can all do to significantly decrease our risk of most chronic disease: eat better, exercise more, reduce stress and carefully regulate our blood sugar. These things, in our control, usually outweigh the many things beyond our control. For government employees in Alabama, it will also save $300 per year.