Articles

EAT & BE WELL

Mediterranean Diet May Cut Diabetes Risk

By Nicholas Bakalar

Published: June 10, 2008

SOURCE:  http://health.nytimes.com/pages/health/nutrition/index.html

Sticking to the Mediterranean diet — rich in olive oil, grains, fruits, nuts, vegetables and fish, and low in meats and dairy — may lower the risk for diabetes.

Scientists followed 13,380 healthy Spanish university graduates for an average of four and a half years, tracking their dietary habits and confirming new cases of diabetes through medical records. The study was published online May 29 in The British Medical Journal.

The researchers ranked the strictness of adherence to the diet on a 10-point scale, and found that those with the highest scores reduced their relative risk of diabetes by 83 percent compared with those with the lowest.

The authors acknowledge that the number of cases of diabetes they found was small, which limits the statistical power of the finding, and that the nutritional information is based on self-reporting, which is not always reliable.

Still, the large sample and the finding of a dose-response relationship between stricter adherence to the diet and lowered risk of diabetes give the study strength.

“There are good fats, like those in olive oil, that are quite healthful,” said Miguel A. Martínez-González, the lead author and a professor of epidemiology at the University of Navarra. “We have to change this belief that a low-fat diet is the key to good health.”

© 2007-2008 The New York Times Company

SUPPLEMENTATION

Selenium Dietary Supplements may raise Risk of Diabetes

By Mark Isaac Thyss
Garden of Healing®

July 2007

Are you one of the many people taking selenium supplements to stay healthy? Recent research reported by the Annals of Internal Medicine paints a different story.

While some research suggests that selenium supplements can improve the way the body handles sugar and might prevent some of the complications of diabetes, other data suggest that supplementation with selenium has no effect on diabetes or health.

People who took a 200-micro gram daily dose of the mineral for 7 years had a 50 percent higher risk of developing type 2 diabetes compared with placebo, the study found.

Selenium is a mineral that is required in very low doses for the body to function normally. Selenium is an antioxidant. Antioxidants prevent damage to cells caused by oxygen. Selenium is involved in many biological functions, including protection against oxidative stress, immune function, and thyroid function.

Although most people get enough selenium in their diet, selenium is included in many multivitamins and is sold as a supplement itself.

Before it was found to be an essential nutrient, selenium was considered highly toxic to animals and humans. Now, more than 1% of the U.S. population take selenium supplements. Additionally, more than 35% take multivitamin and multimineral supplements that often contain selenium.

The Tolerable Upper Intake Level (UL) for selenium is set at 400 µg/d to avoid visible symptoms of selenium toxicity in sensitive persons. In the U.S., the recommended dietary allowance for adults is a minimum of 55 micrograms. Most multivitamins include 33 to 200 micrograms of selenium.

In short, this research suggests that taking selenium supplements on top of an adequate dietary intake may increase your risk for diabetes.

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This information is not a substitute for advice from your own medical provider. If you have questions about selenium, and/or need advice about your health, contact your physician.

© 2007 Garden of Healing®. All rights reserved.

PERSONAL HEALTH

Diabetes and Pre-Diabetes

by Peter Wannigman, RPh, ND

New statistics from the Department of Health and Human Services show a hidden threat on the rise.

The number of cases of type 2 diabetes has doubled in the last 20 years and what precedes many of these cases is a silent category – prediabetes. Get tipped-off to this easy-to-miss red flag.

An estimated 40% of U.S. adults aged 40 to 74 currently have pre-diabetes, a condition characterized by blood glucose levels that are higher than normal, but not yet considered in the diabetic range. These statistics are of grave concern since many people with prediabetes go on to develop the more classic form of diabetes within 10 years, and are also at an increased risk for heart disease and stroke.

With this new information, it is vital to address blood sugar level issues and to begin preventive measures early on. New research suggests that lifestyle modification, including targeted nutritional support and a low-glycemic dietary program are the best methods of preventing prediabetes and associated cardiovascular risk.

The primary way to address diabetes is by regulating or stabilizing blood sugar levels through diet and nutritional supplementation.

The key benefit of stabilizing your blood sugar is that you essentially tonify adrenal function. The adrenal glands are the control center of our “fight or flight” responses. The adrenal glands control the hormones that are ultimately responsible for getting us up in the morning, and for keeping us alert and energized during the day.

Insulin is released in direct proportion to the amount of high or low-glycemic carbohydrates (glucose) in your food.

If the foods you are eating contain high-glycemic carbohydrates, your blood sugar spikes high. This creates a corresponding upward spike in your insulin levels.

Sounds OK so far, but the reality is spiking insulin is then followed by blood sugar levels that plummet. This in turn leaves you with LOW blood sugar levels. Now you’ve crashed, you’re out of gas/energy, and your body is looking for more fuel (glucose). At this point your adrenal glands step up and help the liver CREATE glucose. This is all part of the normal balancing act that the body goes through to maintain your blood sugar levels.

Clearly, poor choices in the form of HIGH-glycemic index foods result in spiking glucose and insulin. In moderation, insulin is a good hormone to call into action, but it becomes a killer when its levels spike repeatedly.

When your blood sugar soars, so does insulin. Insulin’s job is to scoop up excess blood sugar and store it safely in muscle tissue.

Long-term damage to the overall system occurs when you place demands on your glands to pick up the slack for your poor choices in food. Your adrenals are happy to accommodate for a time, but after awhile, they just cannot keep up with your wacky ways.

Since food selection can voluntarily be changed, and it only makes sense to help your adrenals “save” or “bank” resources for their all-important “fight or flight” role.

Our adrenals need to be able to turn on the juice in order to help defend us against anything that might come up during the day. It’s the constant spiking and plummeting of glucose and insulin that burn the system to the ground causing diabetes.

Understanding this mechanism is imperative for patients to grasp, since crashing fatigue is so often part of the picture defining prediabetes.

Protect, nourish and tonify your adrenals to ensure healthy function. This can be achieved by asking your body to operate in a more balanced manner by the way you feed it.

Targeted Nutritional Support

Cinnamon

Yes, Cinnamon! Recent research suggests that this aromatic bark can lower blood sugar, cholesterol, and triglycerides even in those with established type 2 diabetes. In short, cinnamon has a positive effect on blood glucose control.

Catechins

Long-term consumption of these powerful compounds derived from green tea has been found to reduce the risk of obesity, and may decrease the risk of related conditions such as diabetes and coronary heart disease. Rather than starting your day with a cup of coffee and pastries topped with frosting, thereby sending blood sugar levels into the stratosphere, try drinking green tea; it is especially effective as a premeal or wake-up beverage.

Alpha-Lipoic Acid

This powerful and versatile antioxidant nutrient helps to regulate blood sugar and to prevent complications associated with type 2 diabetes. On the constructive side, lipoic acid promotes nerve regeneration which is soothing news for one serious complication - neuropathy. Furthermore, alpha-lipoic acid has been demonstrated to increase the activity of GLUT-4 transporter proteins in a similar way that vanadium does; learn more below.

Chromium

This is an essential trace mineral that plays a role in enhancing the body’s sensitivity to insulin, which is beneficial to regulating blood sugar levels. Chromium found in the form of GTF (Glucose Tolerance Factor) is best. This form binds chromium to niacin better than the more popular binding agent known as picolinate.

Research that identified chromium as a valuable nutritional supplement for blood sugar regulation used the picolinate form even though the GTF form is clearly preferable. The reason the picolinate is not ideal is that it has a tendency to leech minerals (calcium, magnesium, selenium, etc) from your body. Sure the chromium is doing its job, but you may be depleting your mineral resources if you use the picolinate.

Vanadium

Preliminary research strongly suggests vanadium compounds (vanadium is a trace mineral) markedly improve measures of diabetes. Vanadium acts in a manner very similar to insulin helping to regulate blood sugar levels. Vanadium mimics the action of insulin by activating GLUT-4 transporters, which allows the needed glucose molecule to be drawn into the cell, where it is capable of undergoing metabolic changes. These metabolic changes transform glucose into energy for the body.

Low-Glycemic Dietary and Life Style Program

Low-Glycemic-Load Diet

These buzzwords have been creating a lot of confusion.

Certain foods (with a high glycemic index) can cause dramatic increases in blood sugar, while other foods (with a low glycemic index) will tend to cause milder changes in blood sugar levels. It’s important to select foods that are low on the index to help maintain normal or more balanced levels.

A very good resource to learn more about glycemic load and glycemic index is: http://www.mendosa.com. Visit this Web site to better understand these terms and how to use the concept to help keep your blood sugar balanced.

Exercise

Exercise directly increases insulin sensitivity (something you want), thus enabling glucose to enter muscle cells much easier without having to produce extra insulin. As discussed above, this helps keep the adrenals ‘healthy’. Exercise must always be included as an essential part of any approach to create good health.

Prediabetes is on the rise. It is the tip-off to more serious type 2 diabetes now epidemic in America. It is important to get your blood sugar levels checked to see if you are at risk.

If you have blood sugar and/or weight issues, high blood pressure or cholesterol, or simply want to maintain good body composition, please don’t hesitate to see your doctor to discuss a targeted nutritional program that suits your individual health needs.

© 2007 Garden of Healing®. All rights reserved.

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Dr. Peter Wannigman (aka DocWanni) is a pharmacist and licensed naturopathic doctor in San Diego. His Web site is: www.docwanni.com

THE TAKE ON PHARMACEUTICALS
 
Diabetes Drug Avandia; Consult Your Doctor
 
Richard Harkness, Pharm, CDM, Natural Medicines Specialist
 

Avandia has been at the epicenter of controversy since findings from a recent meta-analysis suggested it might boost the risk of heart attack.
 
Avandia (rosiglitazone) is widely prescribed to control blood sugar in those with type 2 diabetes. Rosiglitazone, combined with another diabetes drug, is also present in Avandaryl and Avandamet.
 
Federal overlords have responded to the media blitz with a typical “Casablanca”-style approach: Round up the usual suspects.
 
Congress called hearings. Experts testified. Lawmakers properly admonished the FDA for not dogging the drug more closely after it was approved and turned loose. Never mind that it is congressional underfunding that keeps the FDA bloodhounds underfed and thinned out.
 
There’s even a bit of cloak-and-dagger. One medical expert told Congress he was harassed by company representatives in 1999 when he first called attention to heart problems in some patients using Avandia. Reportedly, the company’s stock value plummeted billions of dollars in reaction.
 
On to information you can use.
 
Since my prior column, researchers have released partial results from the ongoing clinical trial called RECORD. The data were presented as positive for Avandia, but the results were actually inconclusive in regard to heart attack risk.
 
If the noose continues to tighten around Avandia, clinicians will be wondering whether its sibling Actos (pioglitazone) might also be implicated. Actos seems to have more favorable effects on cholesterol and triglycerides, and some debatable research suggests it might actually help prevent heart attacks.
 
The FDA has scheduled a meeting July 30 with outside experts to wade through the muddle of data.
 
In contrast to the U.S., European product labeling for Avandia carries a caution about possible heart attack risk.
 
The FDA, perhaps feeling pressure to do something, has proposed a “black box” warning on product labeling for both Avandia and Actos. But the warning won’t be about heart attack risk.
 
Instead, it will highlight the risk of congestive heart failure, a caution that is already present in product labeling and well-known to prescribers.
 
Heart failure occurs when the heart is unable to pump blood efficiently. Avandia and Actos can cause fluid retention (edema). This increases the heart’s workload and can lead to new heart failure or worsening of existing heart failure.
 
The tell-tale signs of heart failure include edema (e.g., swelling of feet or ankles), sudden weight gain, or shortness of breath.
 
Another potential danger is drug-induced liver impairment, though this problem appears to be rare with Avandia and Actos. Rezulin (troglitazone), the original drug in this family, was withdrawn from the market in 2000 for this reason.
 
Symptoms of liver damage include unexplained nausea and vomiting, abdominal pain, tiredness, appetite loss, and yellow skin or eyes (jaundice).
 
Alternative drugs for type 2 diabetes include metformin, the sulfonylureas (glimepiride, glipizide, glyburide), and Januvia (sitagliptin), as well as insulin.
 
The American Diabetes Association is now encouraging patients taking Avandia to consult with their doctor to decide whether the benefits outweigh the potential risks.
 

© 2007 Richard Harkness. All rights reserved.

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Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books.  Write him at 1224 King Henry Drive, Ocean Springs, MS 39564. 

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

Email Richard Harkness at: rharkn@aol.com.