Category Archives: Diabetes

Potatoes Don’t Cause Diabetes, Obesity, or Cardiovascular Disease

…at least according to researchers in Denmark who did a review of the scientific literature.

“The identified studies do not provide convincing evidence to suggest an association between intake of potatoes and risks of obesity, type 2 diabetes, or cardiovascular disease. French fries may be associated with increased risks of obesity and type 2 diabetes although confounding may be present. In this systematic review, only observational studies were identified. These findings underline the need for long-term randomized controlled trials.”

Source: Potatoes and risk of obesity, type 2 diabetes, and cardiovascular disease in apparently healthy adults: a systematic review of clinical intervention and observational studies

Mediterranean Diet Reduces Inflammation in Type 2 Diabetes

 

Santorini, Greek seaside

Santorini, Greek seaside

Markers of inflammation that circulate in our blood are linked to higher rates of type 2 diabetes.

One such marker is C-reactive protein: the higher the CRP, the greater the risk of T2 diabetes.

Another inflammatory marker is adiponectin, a protein secreted by fat cells. Adiponectin levels are inversely related to ongoing inflammation: higher levels of adiponectin indicate lower levels of inflammation. Folks with higher adiponectin levels are at lower risk of type 2 diabetes.

Italian researchers affiliated with the MEDITA clinical trial took 215 men and women with newly diagnosed type 2 diabetes and randomized them to eat either a Mediterranean diet or a low-fat diet. Hemoglobin A1c and inflammatory markers were followed for up to eight years. (I’m not sure, but I think these were relatively mild diabetics from the get-go, probably with HgbA1c under 7%.)

At the end of year one, CRP dropped by 37% and adiponectin rose by 43% in the Mediterranean diet group. In other words, inflammatory markers moved in a healthful direction.

Levels in the low-fat group were unchanged.

For individual Mediterranean dieters who were deemed diet failures (HgbA1c over 7%) at one year, CRP levels were higher and adiponectin levels were lower than their counterparts without diet failure.

Values were also measured two and four years after baseline, but results are not easy to summarize, and I don’t give too much credence to a diet modification purported to last that long. After six to 12 months of a new diet, most folks drift back to their usual way of eating.

Grapes are a time-honored component of the Mediterranean diet

Grapes are a time-honored component of the Mediterranean diet

Action Plan

If you have type 2 diabetes or want to avoid it, consider a Mediterranean-style diet.

Steve Parker, M.D.

PS: Even if you think inflammation is important, you’ll find no shortage of chapters in my books.

Reference: Anti-inflammatory effect of Mediterranean diet in type 2 diabetes is durable: 8-year follow-up of a controlled trial. Diabetes Care, 2016. doi: 10.2337/dc15-2356

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Olive Oil Helps Control Blood Sugar Levels

Steve Parker MD, Advanced Mediterranean DIet

Naturally low-glycemic index Caprese salad: mozzarella cheese, tomatoes, basil, extra virgin olive oil

Italian researchers found that extra-virgin olive oil taken with meals helps to reduce blood sugar elevations after meals in type 1 diabetics. This may help explain the lower observed incidence of diabetes seen in those eating a traditional Mediterranean diet, which is rich in olive oil.

Before going further into the weeds, remember that glycemic index refers to how high and quickly a particular food elevates blood sugar. High-glycemic index foods raise blood sugar quicker and higher compared to low-glycemic index foods.

The study at hand is a small one: 18 patients. They were given both high- and low-glycemic meals with varying amounts and types of fat. Meals were either low-fat, high in saturated fat (from butter), or high in monounsaturated fat from olive oil. Meals that were high-glycemic index resulted in lower after-meal glucose levels if the meal had high olive oil content, compared to low-fat and butter-rich meals.

If meals were low in glycemic index, blood sugar levels were about the same whether the diet was low-fat, high in saturated fat, or rich in olive oil.

Action Plan

If you have type 1 diabetes and plan on eating high on the glycemic index scale, reduce your blood sugar excursions by incorporating extra-virgin olive oil into your meals.

Steve Parker, M.D.

Reference: Bozzetto, Luigarda, et al. Extra-virgin olive oil reduces glycemic response to a high-glycemic index meal in patients with type 1 diabetes: a randomized controlled trial. Diabetes Care, online before print, February 9, 2016. doi: 10.2337/dc15-2189

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Diabetes and Alzheimer’s Dementia: What’s the Connection?

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“More basic research is critical.”

Several scientific studies, but not all, link type 2 diabetes with Alzheimer’s disease. Some go so far as to say Alzheimer’s is type 3 diabetes.

My Twitter feed brought to my attention a scientific article I thought would clarify the relationships between diabetes, carbohydrate consumption, and Alzheimer’s dementia (full text).

It didn’t.

Click the full text link to read all about insulin, amylin, insulin degrading enzyme, amyloid–β, and other factors that might explain the relationship between type 2 diabetes and Alzheimer’s dementia. You’ll also find a comprehensive annotated list of the scientific studies investigating the link between diabetes and Alzheimer’s.

Bottom line: We still don’t know the fundamental cause of Alzheimer’s disease. A cure and highly effective preventive measures are far in the future.

Action Plan For You

You may be able to reduce your risk of Alzheimer’s disease by:

  • avoiding type 2 diabetes
  • preventing progression of prediabetes to diabetes
  • avoiding obesity
  • exercising regularly
  • eating a Mediterranean-style diet

Carbohydrate restriction helps some folks prevent or resolve obesity, prediabetes, and type 2 diabetes. A low-carb Mediterranean diet is an option in my Advanced Mediterranean Diet (2nd edition).

Steve Parker, M.D.

Reference: Schilling, Melissa. Unraveling Alzheimer’s: Making Sense of the Relationship Between Diabetes and Alzheimer’s Disease. Journal of Alzheimer’s Disease, 51 (2016): 961-977.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

 

 

 

 

Tsunami of Diabetes About To Hit California

Almost half of adults in California—46%—have prediabetes, according to researchers at UCLA. The LA Times has the story.

“Our genes and our environment are kind of on a collision course,” said Dr. Francine Kaufman, the former head of the American Diabetes Assn., who was not involved with the research. “It’s not stopping.”

The problem with prediabetes is that it often evolves into full-blown diabetes. It’s also associated with increased risk for cardiovascular disease such as heart attack and stroke. The Times article says “up to 70% of those with prediabetes develop diabetes in their lifetime.” I’d never heard that vague number before; I say vague because “up to 70%” could be anything between zero and 70. It’s more accurate to note that one in four people with prediabetes develops type 2 diabetes over the course of three to five years.

Prediabetes is defined as:

  1. fasting blood sugar between 100 and 125 mg/dl (5.56–6.94 mmol/l), or
  2. blood sugar level 140–199 mg/dl (7.78–11.06 mmol/l) two hours after drinking 75 grams of glucose

How To Prevent Progression of Prediabetes Into Diabetes

  • If you’re overweight or obese, lose excess fat weight. How much should you lose? Aim for at least 5% of body weight and see if that cures your prediabetes. For instance, if you weigh 200 lb (91 kg), lose 10 lb (4.5 kg).
  • If you’re sedentary, start exercising regularly.
  • Cut back on your consumption of sugar-sweetened beverages, other sugar sources, and other refined carbohydrates like wheat flour.

Steve Parker, M.D.

 

Alcohol Consumption May Protect Against Type 2 Diabetes

…according to an article in the American Journal of Clinical Nutrition. A review of the scientific literature looked at various populations at baseline, noting alcohol consumption,  then determined who developed type 2 diabetes over subsequent years. Folks with light to moderate alcohol consumption were 20% less likely to develop diabetes.

Beautiful woman smiling as she is wine tasting on a summer day.

Wine is one of the potentially healthy components of the Mediterranean diet

This doesn’t prove that alcohol prevents diabetes. Alcohol intake may instead just be a marker for other factors that do prevent diabetes. For instance, maybe drinkers are genetically less susceptible to diabetes, or they exercise more.

Steve Parker, M.D.

Asking the Important Questions: Why Do Old Folks Tend to Have Ugly Toenails?

The NYT’s Well Blog has some potential answers: fungus infections, poor circulation, diabetes, accumulated trauma.

I question the assertion that inadequate drying after bathing is an issue.

I like the advice not to wear the same shoes every day.

Steve Parker, M.D.