|
Better School Nutrition
Diabetes Revisited
Diabetes Supplement Update
Lutein and Macular Degeneration
Ask Dr. J: Folic Acid Safety
References
In the Health News
Diet and Disease
Recipe of the Month: Seasonal Vegetables
Dear Friends,
Glimmers of hope have begun to appear on the nutrition horizon.
Schools in Nashua, New Hampshire, have banned vending machines
that dispense junk and soda beverages. The new vending machine
offerings will include water, flavored water, juices, and
sports drinks (the last only available after school). The
news article reported that “the policy is meant to offer
healthy foods throughout a school, as opposed to offering
a piece of fruit with lunch, and a candy bar down the hall...”
Around the country, 75 to 85 percent of snacks are of poor
nutritional value, right in line with the rise of obesity
and diabetes in young people, so to see this shift is gratifying,
even if it is just a start. At the end of July, the French
parliament voted to ban vending machines selling junk (candy
and soft drinks) in all schools, partly due to the rising
obesity levels in children.
In Italy, Britain, Sweden, and other European countries,
concern about obesity is growing, and this is particularly
important to some Mediterranean countries where the traditional
diet of fruits, vegetables, grains and pastas, and fish is
being threatened by highly processed junk. Some of these countries
are taking steps to curb advertising aimed at children, and
to educate people about the value of maintaining their traditional
diets. In Britain, a member of parliament introduced a bill
to ban preschool TV advertising of foods high in sugar, salt,
and fat. I am sure this will help not only their health, but
their school performance as well.
Watching television and playing computer games has overtaken
physical activity for many children, but at least many countries
are recognizing the danger of an increasingly sedentary lifestyle.
I remember watching TV as a kid, but also spending lots of
time at recess playing sports, and lots of time after school
playing outside, as well as riding bikes, weekend hikes, summers
at the shore playing baseball, swimming, and running around
in general (we had no TV at the summer house).
It is true that I spend a lot of time at the computer these
days, writing, researching, and learning. Even though I also
spend a lot of time in the garden being very physical, this
is not enough, so I feel the need for a specific exercise
program (running and bicycling) to complement my more sedentary
activities. With cities in the USA and with so many other
countries beginning to recognize the problems brought on by
poor diet and sedentary lives, it is refreshing to see that
some of them are doing something about it, emphasizing traditional,
less-processed diets and increased physical activity as important
for overall health.
It is important for all of us to contribute improving children’s
health, partly by setting the example of healthy living. Everyone
will benefit from a healthier society, and it will reduce
health care costs.
Adult onset (type II) diabetes has been in the news extensively
in recent months, and it is clear that the incidence of diabetes
and the complications from it are increasing, and not only
in this country.
I reported last year (October, 2003) on the extent of diabetes
in developing countries and the pandemic nature of the disease
(occurring over a wide geographic region and affecting a large
percentage of people). In most developing countries, infectious
disease associated with poverty is often the leading cause
of death. Now, in Mexico, diabetes is the number one killer.
Death from diabetes is increasing in Mexico at three percent
per year, and is now the cause of 12 percent of all deaths.
(Deaths from heart disease, cancer, and hypertension have
also increased dramatically in the past 50 years.) It is clear
that as developing countries industrialize the food supply
the health of the population suffers accordingly. It appears
that junk food is extremely popular in Mexico, but obesity
and diabetes are also rising in other developing countries.
While the sugar and soft drink industries try to deny it,
evidence is mounting that dietary sugar, particularly from
soft drinks, is related to the increasing rate of diabetes.
(In the U.S. it is estimated that 18 million people have diabetes,
and it is increasing at 1.3 million per year.) The recent
revision of the USDA dietary guidelines falls short in recommending
the reduction of sugar and soft drinks (perhaps because the
panel is influenced by the industry).
The Nurses’ Health Study of 91,249 women shows a direct
relationship between the rise in sugar drink consumption (during
20 years, adult consumption rose 61 percent, and children’s
intake more than doubled). In this study, women who increased
their intake from less than one a week to one per day nearly
doubled their risk of diabetes. They also significantly increased
their weight with the increased sugar. Fruit juice consumption
was not associated with an increased risk.
The highly absorbable sugars in these drinks (as well as
other junk sweets) cause rapid blood glucose elevations and
subsequent release of excess insulin. The rise in sugar determines
what is called the “glycemic index” or GI of the
food being studied. The GI can be misleading, though, in other
contexts, because healthy foods with a high GI are often not
eaten alone. For example, a baked potato has a high GI, but
if you add some olive oil or flaxseed oil it changes the effect.
Studies of food combinations would produce a different picture
of the GI than single foods. Sodas, however, are often consumed
by themselves.
Recently, diabetes and pre-diabetes have been linked with
the loss of mental function and dementia. A study of 7027
post-menopausal women showed that diabetes and prediabetes
almost doubled the loss of cognitive function.
Of course, diet is not the only contributor to diabetes and
obesity. Sedentary lifestyles also contribute to diabetes
risk. Exercise blunts the rise in blood sugar after meals,
and it makes insulin more effective by increasing muscle-cell
insulin sensitivity. Brisk walking, jogging, cycling, and
similar activities are helpful in controlling blood sugar
(animals have to be physically active every time they want
to eat). These also help to reduce weight.
While diet and exercise are the primary influences on blood
sugar, dietary supplements are also important in the management
of diabetes. Recent studies confirm the value of high-dose
chromium in controlling blood sugar. A study of elderly diabetics
showed that 400 mcg of chromium reduced blood sugar by 20
percent after only three weeks. Lipid levels were also lowered.
Higher doses (1000 mcg) are even more valuable.
Alpha-lipoic acid helps to control blood sugar. A new animal
study shows that it improves insulin sensitivity. Higher doses
(1000 mg) help to reverse peripheral neuropathy that is often
associated with chronic diabetes. Alpha-lipoic acid is a potent
antioxidant and a cofactor for mitochondrial energy production.
It counteracts free radicals, removes toxic metals, and enhances
vitamin C and glutathione levels.
Recently, researchers have found that cinnamon can improve
sugar control. A daily dose of up to 6 gms (about a teaspoon)
reduces fasting sugars by 29 percent. It also improves lipids,
lowering total cholesterol, triglycerides, and LDL-cholesterol
by 25 to 30 percent.
New research suggests that lutein is even better than previously
reported in helping age-related macular degeneration (ARMD),
a deterioration of the most sensitive area of the retina.
A 12-month study of 90 patients with ARMD showed that lutein
supplements (10 mg daily) increased the visual pigment in
the retina, and was associated with a significant improvement
in visual acuity (using the Snellen eye chart). The ability
to detect contrast was also better in the treatment group
than in the controls.
In another study, seven patients with ARMD were treated for
five months with 10 mg of lutein. The pigment was found to
concentrate in the macula, suggesting that even diseased retinas
can absorb and accumulate visual pigment.
In addition to preventing ARMD, as previous research has
shown, this is the first information showing potential reversal
of the condition. Macular pigments, such as lutein and zeaxanthin,
are carotenoids that come exclusively from the diet. They
not only provide the visual pigment, but they are antioxidants
that protect the macula from oxidative free-radical damage.
Lutein in the diet is found in spinach, other dark leafy
greens, leeks, peas, and egg yolks. Low dietary levels are
associated with increased ARMD and also with cataracts. Supplemental
lutein is derived from marigolds. Carotenoids are fat soluble,
and should be taken with oil-containing foods for better absorption.
Q. What do you consider to be the safe limit
for folic acid supplements? I’ve been told not to take
more than 1000 mcg (1 mg).
—RG, Indiana, U.S., via Internet
A. Folic acid (also called folacin or folate) is a B vitamin
with a number of functions. It is essential for cell replication
and both DNA and RNA production, as well as protein synthesis.
Tissues that need a lot of folate are those that multiply
rapidly, such as red blood cells, immune cells, and the developing
fetus.
A deficiency of folate during pregnancy can lead to birth
defects. In others, it can cause anemia, with abnormally enlarged
red blood cells. Vitamin B12 deficiency also leads to anemia
with enlarged red cells, which is early evidence of that deficiency.
High doses of folate can correct the enlarged red cells seen
with B12 deficiency, hiding that deficiency from detection,
so folate has developed an unwarranted reputation for causing
B12 deficiency, when it only masks it.
Increasing dietary or supplemental folate is associated with
a lower risk of colon cancer, and may also help to prevent
lung and breast cancer. Folate in larger doses (along with
B6 and B12) has value in reducing the production of homocysteine,
a metabolic byproduct associated with an increased risk of
heart disease.
If patients have high homocysteine, I often recommend that
they take 5000 mcg (5 mg) or more. Supplements of vitamin
B12 can prevent a hidden deficiency while taking higher doses
of folate. Undetected B12 deficiency can lead to irreversible
nerve damage. B12 deficiency does not always cause anemia,
so independent of folate, it is good to attend to B12 intake
and check levels. I am unaware of any other folate problems.
Nashua Schools Remove Sodas, Keene (NH)
Sentinel, July 22, 2004.
France bans junk food vending machines
in schools. Agence France Presse, August 1, 2004.
Junk food supersizing Europeans, USA Today,
August 16, 2004.
Diabetes Now Mexico’s Leading Cause
of Death (Report from Mexico’s Health Ministry), Reuters,
August 24, 2004.
Schulze MB, et al., Sugar-sweetened beverages,
weight gain, and incidence of type 2 diabetes... JAMA. 2004
Aug 25;292(8):927-34.
Marcus A, Though diabetes epidemic worsens,
researchers make strides. HealthDay News, August 22, 2004.
Yaffe K, et al., Diabetes, impaired fasting
glucose, and development of cognitive impairment... Neurology.
2004 Aug 24;63(4):658-63.
Dela F, Physical training may enhance {beta}-cell
function in Type 2 Diabetes. Am J Physiol Endocrinol Metab.
2004 Jul 13.
Bruce CR, et al., Disassociation of muscle
triglyceride content and insulin sensitivity after exercise...
Diabetologia. 2004 Jan;47(1):23-30.
Rabinovitz H, et al., Effect of chromium
supplementation on blood glucose and lipid levels in type
2 diabetes mellitus elderly patients. Int J Vitam Nutr Res.
2004 May;74(3):178-82.
[No authors listed], A scientific review:
the role of chromium in insulin resistance. Diabetes Educ.
2004;Suppl:2-14.
Smith AR, et al., Lipoic acid as a potential
therapy for chronic diseases ... Curr Med Chem. 2004 May;11(9):1135-46.
Khan A, et al., Cinnamon improves glucose
and lipids of people with type 2 diabetes. Diabetes Care.
2003 Dec;26(12):3215-8.
Anderson RA, et al., Isolation and characterization
of polyphenol type-A polymers from cinnamon with insulin-like
biological activity. J Agric Food Chem. 2004 Jan 14;52(1):65-70.
Koh HH, et al., Plasma and macular responses
to lutein supplement... Exp Eye Res 2004 Jul;79(1):21-7.
Richer S, et al., ...lutein and antioxidant
supplementation in the intervention of atrophic age-related
macular degeneration... Optometry. 2004 Apr;75(4):216-30.
Long term use of acetominophen (Tylenol) is associated with
a decline of kidney function (Curhan GC, et al., Lifetime
nonnarcotic analgesic use and decline in renal function in
women. Arch Intern Med. 2004 Jul 26;164(14):1519-24.). In
this report, 10 percent of 1697 women showed a 30 percent
decline in the filtration ability of the kidneys over 11 years.
Tylenol is used as a pain killer, and other pain killers have
been associated with kidney damage, but not in this study.
Women who took between 1500 and 9000 tablets (averaging less
than 1 to about 2 per day) had a 64 percent decline in kidney
filtration. For arthritis pain, alternative treatments are
available.
a. Blueberries are known for containing powerful antioxidant
phytochemicals. New research presented at a meeting of the
American Chemical Society (Reuters, August 24, 2004) shows
that they can also help control cholesterol levels and blood
sugar. Blueberries contain a compound called pterostilbene,
similar to resveratrol (both are also found in grapes). It
protects against cancer and heart disease. Related compounds
are found in other berries.
b. Linoleic acid, one of two essential fatty acids, found
in grains, legumes, seeds, and nuts, appears to lower the
risk of prostate cancer. (Laaksonen DE, et al., Serum linoleic
and total polyunsaturated fatty acids in relation to prostate
and other cancers...Int J Cancer. 2004 Sep 1;111(3):444-50.)
Researchers following 2002 men for 13 years found that those
with the highest intake had about half the prostate cancer
risk as those with the lowest intake, possibly because it
displaced saturated fat in their diets. Other cancers were
also reduced, but not as much as prostate cancer.
(Or what to do with all of those garden zucchini, yellow
squash, string beans, and tomatoes!) I find that you can easily
mix them all in a variety of dishes that are simple and tasty.
I first sauté some organic onions and garlic in a mixture
of olive oil and curry powder. Then I add diced potatoes and
water, and simmer with a lid for 10 minutes. Next, I add cauliflower
pieces, cooked chick peas, tamari soy sauce, and slices of
the above veggies, then simmer until all the flavors suffuse
the mixture. I serve this over brown rice. I also use the
same vegetables, but substitute oregano, thyme and fresh basil
from the garden instead of the curry, use white cannelloni
beans instead of chick peas and potatoes, and add fresh-ground
pepper. This combination gives the mix more of an Italian
flavor, and it can be served over whole wheat or buckwheat
pasta.
drjanson@drjanson.com
Year-round phone: 386-409-7747
180 Massachusetts Ave.,
Arlington, MA 02474
225 North Causeway, New Smyrna Beach, FL 32169
3 Overlook Dr., Suite 3, Amherst, NH 03131
About
| Health Consults | Books
| Newsletters
Health Articles | Seminars
| Ask Dr. J.
© 2010
|
