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Category: diabetes

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Bottom line: Try to avoid artificial sweeteners!

From Scientific American: Artificial Sweeteners May Have Despicable Impacts on Gut Microbes

I find it ironic that Thanksgiving coincides with American Diabetes Month. In honor of that irony, two recently published studies have suggested a possible link between what you eat, how it impacts the behavior of the microbes living in your gut, and type II diabetes.

Results from a study by researchers in Israel, published in the journal Nature in October, have suggested that consumption of artificial sweeteners—found in over 6,000 food products—can lead to changes in the gut microbiome, and have put forth an explanation for how this alteration might be associated with diseases such as type II diabetes.

Jotham Suez, a PhD candidate and lead author of the study explains, “We asked people who do not regularly consume artificial sweeteners to add them to their diet for one week, and saw that the majority of these subjects had poorer glycemic responses.” And like humans, mice that were given saccharin-spiked water also developed marked glucose intolerance compared to mice drinking sugar water, or water alone.

Their experiment revealed that mice did exhibit different microbiome profiles after consuming artificial sweeteners, just as with the human volunteers who had developed glucose intolerance. And importantly, the humans who did not show glucose intolerance after consuming artificial sweeteners also did not see changes in the community composition of their microbiome.

Consequently, this change in microbial community in mice also modified how the microbiota functioned as a group to regulate metabolism. Pathways that impact the transport of sugar in the body were found to have decreased function after saccharin treatment and, notably, there was an increased abundance of short-chain fatty acids (SCFAs), which are implicated in lipid biosynthesis.

An investigation done by an independent group of researchers in Canada found similar results in a study published in October in the journal PLoS ONE. Although conducted using rats instead of mice, and with a different artificial sweetener (aspartame instead of saccharin) this study also found an increased risk of glucose intolerance. In addition, both studies showed that propionate—a SCFA highly involved in sugar production—is increased in animals consuming artificial sweeteners (although, unfortunately, propionate concentrations in humans weren’t assessed in the Nature study).

But the take home point is this: findings from two independent studies suggest that messing with the microbiome may have despicable consequences. Artificial sweeteners were originally intended to stave off the increasing obesity and metabolic disease epidemic, but instead they may have directly contributed to it.

In other words, consuming artificial sweeteners appears to throw metabolism out of whack by upsetting the critical balance of the biota in the gut—just as how chaos would surely ensue if you were to throw Gru’s minions out of whack.

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Are probiotic bacteria the reason?

From Medical Xpress: Does a yogurt a day keep diabetes away?

A high intake of yogurt has been found to be associated with a lower risk of developing type 2 diabetes, according to research published in open access journal BMC Medicine. This highlights the importance of having yogurt as part of a healthy diet.

Type 2 diabetes is a chronic condition that occurs when the body doesn't produce enough insulin, or the body's cells develop resistance to insulin. There is an increased risk of developing it if a relative has the condition or if an individual has an unhealthy lifestyle. 

Researchers from Harvard School of Public Health pooled the results of three prospective cohort studies that followed the medical history and lifestyle habits of health professionals. These studies were the Health Professionals' Follow-up Study (HFPS), which included 51,529 US male dentists, pharmacists, vets, osteopathic physicians and podiatrists, aged from 40 to 75 years; Nurses' Health Study (NHS), which began in 1976, and followed 121,700 female US nurses aged from 30 to 55 years; and Nurses' Health Study II (NHS II), which followed 116,671 female US nurses aged from 25 to 42 years beginning in the year 1989.

Within the three cohorts 15,156 cases of type 2 diabetes were identified during the follow-up period. The researchers found that the total dairy consumption had no association with the risk of developing type 2 diabetes. They then looked at consumption of individual dairy products, such as skimmed milk, cheese, whole milk and yogurt. When adjusting for chronic disease risk factors such as age and BMI as well as dietary factors, it was found that high consumption of yogurt was associated with a lower risk of developing type 2 diabetes.

The authors then conducted a meta-analysis, incorporating their results and other published studies, up to March 2013, that investigated the association between dairy products and type 2 diabetes. This found that consumption of one 28g serving of yogurt per day was associated with an 18 per cent lower risk of type 2 diabetes.

Previous research has suggested calcium, magnesium, or specific fatty acids present in dairy products may lower the risk of type 2 diabetes. It has been shown that probiotic bacteria found in yogurt improves fat profiles and antioxidant status in people with type 2 diabetes and the researchers suggest this could have a risk-lowering effect in developing the condition. 

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Another reason to eat vegetables, whole grains, seeds, fish, and nuts - they provide magnesium. From Medical Xpress:

Magnesium cuts diabetes risk

Getting enough magnesium in the diet may reduce the risk of diabetes, especially for those who already show signs of heading that way. A Tufts study led by Adela Hruby, N10, MPH10, N13, found that healthy people with the highest magnesium intake were 37 percent less likely to develop high blood sugar or excess circulating insulin, common precursors to diabetes.

Among people who already had those conditions, those who consumed the most magnesium were 32 percent less likely to develop diabetes than those consuming the least. The second association held true even when researchers accounted for other healthful factors, such as fiber, that often go along with magnesium-rich foods.The study, published in Diabetes Care, followed 2,582 participants in the Framingham Heart Study Offspring cohort for seven years. The study subjects had an average age of 54.

Only half of Americans get the recommended daily amount of magnesium in their diet, which is 400 to 420 milligrams for adult men and 310 to 320 milligrams for adult women. You can find it in whole grains, vegetables, fish, nuts and seeds and dark chocolate.

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The link between pesticide exposure (pesticides used in the home or in the garden or lawn) and childhood brain tumors has been known for years. From Science Daily:

Factors associated with childhood brain tumors identified

Older parents, birth defects, maternal nutrition and childhood exposure to CT scans and pesticides are increasingly being associated with brain tumors in children, according to new research. Brain and central nervous system tumors are the second leading cause of cancer death in children.

A team of researchers, led by Kimberly Johnson, PhD, assistant professor of social work at the Brown School, a member of the Institute for Public Health and a research member of Siteman Cancer Center, examined studies published since 2004 that analyzed the incidence of childhood brain tumors and survival in different parts of the world.

In this research, binge drinking was defined as drinking four or more units of alcohol in a day on at least one occasion during the pregnancy.From Science Daily:

Binge drinking in pregnancy can affect child's mental health, school results

Binge drinking during pregnancy can increase the risk of mental health problems (particularly hyperactivity and inattention) in children aged 11 and can have a negative effect on their school examination results, according to new research on more than 4,000 participants.  This builds on earlier research on the same children that found a link between binge drinking in pregnancy and their mental health when aged four and seven, suggesting that problems can persist as a child gets older. Other effects, such as on academic performance, may only become apparent later in a child's life.

Women who are pregnant or who are planning to become pregnant should be aware of the possible risks associated with episodes of heavier drinking during pregnancy, even if this only occurs on an occasional basis.'The consumption of four or more drinks in a day may increase the risk for hyperactivity and inattention problems and lower academic attainment even if daily average levels of alcohol consumption during pregnancy are low.

From Science Daily: Healthy lifestyle could prevent nearly half of all diabetic pregnancies

Nearly half of all cases of diabetes during pregnancy, known as gestational diabetes, could be prevented if young women eat well, exercise regularly and stop smoking before and during pregnancy, finds a study.

Several modifiable risk factors before pregnancy have been identified over the past decade. These include maintaining a healthy weight, consuming a healthy diet, regular physical activity, and not smoking.So a team of researchers based in the United States set out to examine the effect of these "low risk" lifestyle factors on the risk of gestational diabetes -- and measure the portion of the condition that may be preventable through adhering to them.

The strongest individual risk factor for gestational diabetes was pre-existing overweight or obesity -- having a body mass index (BMI) above 25 before pregnancy. Women with a BMI above 33 were over four times more likely to develop gestational diabetes than women who had a normal BMI before pregnancy. ..Compared with women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of developing gestational diabetes.

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More research on the benefits of exercise. From Medical Xpress:

An hour of moderate exercise a day may decrease heart failure risk

In a new study reported in the American Heart Association journal Circulation: Heart Failure, researchers say more than an hour of moderate or half an hour of vigorous exercise per day may lower your risk of heart failure by 46 percent. Heart failure is a common, disabling disease that accounts for about 2 percent of total healthcare costs in industrialized countries. Risk of death within five years of diagnosis is 30 percent to 50 percent, researchers said.

Swedish researchers studied 39,805 people 20-90 years old who didn't have heart failure when the study began in 1997. Researchers assessed their total- and leisure time activity at the beginning of the study and followed them to see how this was related to their subsequent risk of developing heart failure. They found that the more active a person, the lower their risk for heart failure. 

From Medical Xpress:

Workers who exercise lower health risks, cost less

Get moving: just 20 minutes of exercise a day dramatically lowers the risk of diabetes and heart disease, even for employees with a high risk of developing those conditions.

A University of Michigan study looked at the impact of exercise on 4,345 employees in a financial services company that had just started a workplace wellness program. Roughly 30 percent of employees were high risk and suffering from metabolic syndrome, a dangerous cluster of risk factors associated with diabetes and heart disease. Overall, about 34 percent of U.S. adults have metabolic syndrome.

The study found that when the high-risk employees accumulated the government-recommended 150 minutes of moderate-intensity exercise a week, their health care costs and productivity equaled that of healthy employees who didn't exercise enough, said Alyssa Schultz, a researcher at the Health Management Research Center in the U-M School of Kinesiology.

"It was a real surprise, the level of protection physical activity gave to people with metabolic syndrome," Schultz said. 

Research done in mice, but may apply to humans. From Science Daily:

How physical exercise protects the brain from stress-induced depression

Physical exercise has many beneficial effects on human health, including the protection from stress-induced depression. However, until now the mechanisms that mediate this protective effect have been unknown. In a new study in mice, researchers show that exercise training induces changes in skeletal muscle that can purge the blood of a substance that accumulates during stress, and is harmful to the brain.

"In neurobiological terms, we actually still don't know what depression is. Our study represents another piece in the puzzle, since we provide an explanation for the protective biochemical changes induced by physical exercise that prevent the brain from being damaged during stress," says Mia Lindskog, researcher at the Department of Neuroscience at Karolinska Institutet.

 

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More long-standing medical advice goes out the window. New advice: avoid diet soda and artificial sweeteners. The amazing part is that our gut bacteria are involved.

From Science Daily: Certain gut bacteria may induce metabolic changes following exposure to artificial sweeteners

Artificial sweeteners -- promoted as aids to weight loss and diabetes prevention -- could actually hasten the development of glucose intolerance and metabolic disease, and they do so in a surprising way: by changing the composition and function of the gut microbiota -- the substantial population of bacteria residing in our intestines. These findings, the results of experiments in mice and humans, ...says that the widespread use of artificial sweeteners in drinks and food, among other things, may be contributing to the obesity and diabetes epidemic that is sweeping much of the world.

For years, researchers have been puzzling over the fact that non-caloric artificial sweeteners do not seem to assist in weight loss, with some studies suggesting that they may even have an opposite effect.

Next, the researchers investigated a hypothesis that the gut microbiota are involved in this phenomenon. They thought the bacteria might do this by reacting to new substances like artificial sweeteners, which the body itself may not recognize as "food." Indeed, artificial sweeteners are not absorbed in the gastrointestinal tract, but in passing through they encounter trillions of the bacteria in the gut microbiota.

The researchers treated mice with antibiotics to eradicate many of their gut bacteria; this resulted in a full reversal of the artificial sweeteners' effects on glucose metabolism. Next, they transferred the microbiota from mice that consumed artificial sweeteners to "germ-free," or sterile, mice -- resulting in a complete transmission of the glucose intolerance into the recipient mice. This, in itself, was conclusive proof that changes to the gut bacteria are directly responsible for the harmful effects to their host's metabolism.... A detailed characterization of the microbiota in these mice revealed profound changes to their bacterial populations, including new microbial functions that are known to infer a propensity to obesity, diabetes, and complications of these problems in both mice and humans.

Does the human microbiome function in the same way? Dr. Elinav and Prof. Segal had a means to test this as well. As a first step, they looked at data collected from their Personalized Nutrition Project (www.personalnutrition.org), the largest human trial to date to look at the connection between nutrition and microbiota. Here, they uncovered a significant association between self-reported consumption of artificial sweeteners, personal configurations of gut bacteria, and the propensity for glucose intolerance. They next conducted a controlled experiment, asking a group of volunteers who did not generally eat or drink artificially sweetened foods to consume them for a week, and then undergo tests of their glucose levels and gut microbiota compositions.

The findings showed that many -- but not all -- of the volunteers had begun to develop glucose intolerance after just one week of artificial sweetener consumption. The composition of their gut microbiota explained the difference: the researchers discovered two different populations of human gut bacteria -- one that induced glucose intolerance when exposed to the sweeteners, and one that had no effect either way. Dr. Elinav believes that certain bacteria in the guts of those who developed glucose intolerance reacted to the chemical sweeteners by secreting substances that then provoked an inflammatory response similar to sugar overdose, promoting changes in the body's ability to utilize sugar.

This image depicts gut microbiota. Credit: Weizmann Institute of Science

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These results go against the medical advice we've been hearing for years (why am I not surprised?). The new advice: High-fat dairy  yes, low-fat dairy no. I also think processed meat (with nitrates) should not be lumped together with unprocessed meat. From Science Daily:

Consumption of high-fat dairy products associated with lower risk of developing diabetes

People with the highest consumption of high-fat dairy products -- eight or more portions per day -- have a 23 percent lower risk of developing type 2 diabetes (T2D) than those with the lowest consumption -- one or less per day, a new study shows.

The study included 26 930 individuals (60% women), aged 45-74 years, from the population-based Malmö Diet and Cancer cohort. Dietary data was collected with a modified diet history method. During 14 years of follow up, 2860 incident T2D cases were identified. 

The researchers found that high intake of high-fat dairy products was associated with a 23% lower incidence of T2D for the highest consuming 20% of participants (or quintile) (median=8 portions/day) compared with the lowest consuming 20% (median=1 portion/day).

In contrast to these findings, there was no association found between intakes of low-fat dairy products and risk of developing type 2 diabetes.

High intakes of meat and meat products were, regardless of fat content, associated with increased risk, but the increased risk was higher for lower fat meats (increased risk of type 2 diabetes for high fat meats 9%, for low fat 24%), both referring to the risk in the highest-consuming versus lowest-consuming 20%). The highest consuming group for the high-fat meat had 90g or more per day, and for the low-fat meat 80g per day.

Same research, some extra details in write-up. From Medscape:

Big Intake of High-Fat Dairy May Be Protective for Diabetes

Previous research led by Nita Forouhi, MD, program leader and public-health physician at the MRC Epidemiology Unit, University of Cambridge, United Kingdom, published in August this year, suggested that molecules with odd numbers of carbon atoms (15 and 17), which are found in dairy products such as yogurt, cheese, and milk, appeared to have a protective effect.

This contrasts with evidence suggesting that even-chain saturated fatty acids, as found in alcohol or margarine, are associated with a greater risk for type 2 diabetes.

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Excerpts from an article by Jane Brody in the NY Times:

Beating Back the Risk of Diabetes

This year, nearly two million American adults and more than 5,000 children and adolescents will learn they have a potentially devastating, life-shortening, yet largely preventable disease: Type 2 diabetes. They will join 29.1 million Americans who already have diabetes.

Diabetes and its complications are responsible for nearly 200,000 deaths a year; the fatality rate among affected adults is 50 percent higher than among similar people without diabetes. Alarmingly, recent studies even have linked diabetes to an increased risk of dementia and Alzheimer's disease. Even people with above-average blood glucose levels, but not diabetes, have an elevated risk.

The Diabetes Prevention Program study, conducted among about 3,800 people who had pre-diabetes, found that moderate weight loss — an average of 12 pounds —  reduced the odds of progression to diabetes by nearly 50 percent.

An excellent discussion of what is known about the effect on diabetes of various foods and supplements appeared recently in Nutrition Action Healthletter at cspinet.org/iceberg.pdf. Some highlights:

Carbohydrates - breads, grains, cereals, sugary drinks and sweets of all kinds — are most problematic for people with diabetes or at risk of developing it. Carbohydrates are eventually metabolized to glucose, which raises the body’s demand for insulin. Consume less of them in general, and choose whole-grain versions whenever possible.

If you must have sweet drinks, select artificially sweetened ones. In two huge studies of nurses and other health professionals who were followed for 22 years, those who drank one or more sugary soft drinks a day had about a 30 percent higher risk of developing diabetes than those who rarely drank them, even after their weight was taken into account.

But there’s good news about coffee. Two or three cups of coffee (but not tea) a day, with or without caffeine, have been consistently linked to a lower risk of Type 2 diabetes. 

For protein, limit consumption of red meat, especially processed meats like sausages, hot dogs and luncheon meats, which are linked to a higher diabetes risk. Instead, choose fish, lean poultry (skinless and not fried), beans and nuts. Low-fat dairy products, including yogurt, and even fatty ones may lower the risk of diabetes; the reason is unclear.

Most protective are green, leafy vegetables — spinach, chard, kale, collards, mustard greens and even lettuce — as well as cruciferous vegetables like cabbage, broccoli and cauliflower. But all vegetables are good and should fill at least two-thirds of your dinner plate.

The nutrients magnesium and vitamin D are also potentially protective. In fact, the preventive value of leafy greens, whole grains, beans and nuts may lie in their high magnesium content. In a well-designed clinical trial of 32 overweight people with insulin resistance, the prelude to diabetes, blood glucose levels and insulin sensitivity improved in those who took a daily magnesium supplement for six months. Don’t go overboard: More than 350 milligrams of magnesium daily can cause diarrhea. 

Vitamin D, long known to be crucial to healthy bones, may also be helpful. In one study of 92 overweight or obese adults with prediabetes, those who took a supplement of 2,000 international units of vitamin D daily had better function of the pancreatic cells that produce insulin..

Of course, how much you weigh and what you eat are not the only concerns. Regular, preferably daily, physical exercise is a vital component of any prevention and treatment program for Type 2 diabetes, or most any chronic ailment. Weight loss can reduce diabetes risk by about 50 percent, but adding exercise to that can lower the odds by 70 percent, compared with people who remain overweight and inactive, according to a study that followed nearly 85,000 female nurses for 16 years. Women who were active for seven or more hours weekly had half the risk of developing diabetes as did women who exercised only a half-hour a week.

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Great reason to add more rosemary and oregano to your diet. From Science Daily:

Rosemary, oregano contain diabetes-fighting compounds

The popular culinary herbs oregano and rosemary are packed with healthful compounds, and now lab tests show they could work in much the same way as prescription anti-diabetic medication, scientists report. In their new study, researchers found that how the herbs are grown makes a difference, and they also identified which compounds contribute the most to this promising trait.

Elvira Gonzalez de Mejia and colleagues point out that in 2012, type-2 diabetes affected more than 8 percent of Americans and cost the country $175 billion. ... Recent research has shown that herbs could provide a natural way to help lower glucose in blood. So Gonzalez de Mejia's team decided to take a closer look.They tested four different herbs, either greenhouse-grown or dried commercial versions, for their ability to interfere with a diabetes-related enzyme, which is also a target of a prescription drug for the disease.

They found that greenhouse herbs contained more polyphenols and flavonoids compared to the equivalent commercial herbs. But this didn't affect the concentration required to inhibit the enzyme. Commercial extracts of Greek oregano, Mexican oregano and rosemary were better inhibitors of the enzyme, required to reduce risk of type-2 diabetes, than greenhouse-grown herbs.

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Research reports and articles on the benefits of exercise have been piling up. Here are some worth looking at. From Science Daily:

Sitting too much, not just lack of exercise, is detrimental to cardiovascular health

Cardiologists have found that sedentary behaviors may lower cardiorespiratory fitness levels. New evidence suggests that two hours of sedentary behavior can be just as harmful as 20 minutes of exercise is beneficial.

From Science Daily:

Out of shape? Your memory may suffer

Here's another reason to drop that doughnut and hit the treadmill: A new study suggests aerobic fitness affects long-term memory. "The findings show that lower-fit individuals lose more memory across time," said a co-author. The study is one of the first to investigate young, supposedly healthy adults. 

From Science Daily:

Less exercise, not more calories, responsible for expanding waistlines

Sedentary lifestyle and not caloric intake may be to blame for increased obesity in the US, according to a new analysis. A study reveals that in the past 20 years there has been a sharp decrease in physical exercise and an increase in average body mass index (BMI), while caloric intake has remained steady. 

From Science Daily:

Older adults: Build muscle and you'll live longer

The more muscle mass older Americans have, the less likely they are to die prematurely, new research shows. The findings add to the growing evidence that overall body composition -- and not the widely used body mass index, or BMI -- is a better predictor of all-cause mortality. "In other words, the greater your muscle mass, the lower your risk of death," said the study's co-author. "Thus, rather than worrying about weight or body mass index, we should be trying to maximize and maintain muscle mass."

From Medical Xpress:

Keeping active pays off in your 70s and 80s

Older people who undertake at least 25 minutes of moderate or vigorous exercise everyday need fewer prescriptions and are less likely to be admitted to hospital in an emergency, new research has revealed.

Researchers from the Universities of Bath, Bristol and UWE-Bristol looked at data from 213 people whose average age was 78. Of people studied, those who carried out more than 25 minutes of moderate to vigorous physical activity per day – such as walking quickly, cycling or swimming - received 50 per cent fewer prescriptions than those who were more active over a four to five year period.

Such physical activity leads to a higher metabolism and better circulation, reducing the risk of conditions and diseases common in older age such as high blood presure, type 2 diabetes, coronary heart disease, and strokes.

From Everyday Health:

The Best Anti-Aging Medicine? Exercise

Everyone knows that exercise is good for you — it helps manage weight, improves muscle and bone strength, and even lifts your spirits. It can also add years to your life.“People have been looking for the secret to a long and healthy life for millennia,” said Neil Resnick, MD, chief of the division of geriatrics and director of the University of Pittsburgh Institute on Aging. “It turns out the most powerful intervention is exercise.”

A recent study conducted at Harvard found that exercise can be at least as effective as prescription drugs when it comes to preventing common conditions such as heart disease, stroke, and diabetes.

Exercise at any age is beneficial. From Science Daily:

Seniors who exercise regularly experience less physical decline as they age

Older adults in retirement communities who reported more exercise experienced less physical decline than their peers who reported less exercise, although many adults -- even those who exercised -- did not complete muscle-strengthening exercises, which are another defense against physical decline.