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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Diabetes Diet'

Diabetes without Drugs

December 15th, 2013 · 12 Comments

If you have type 2 diabetes, you can manage it well without any drugs — without any oral medications and without insulin. If you have type 1 diabetes, you will always have to take insulin injections, but you can likely use less than you do now.

To manage diabetes well means keeping your blood sugar level down in the same range as that of people who don’t have diabetes. The way we check this level is the A1C (sometimes called glycated hemoglobin, hemoglobin A1c, or HbA1c). This test tells you what your average blood sugar level was during the previous two or three months by using a drop of blood about as small as that you use on your regular fingerstick tests that tells you what your level is right then.

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Drinking and Diabetes Don’t Mix

December 8th, 2013 · 8 Comments

Compared with some other stuff we put in our mouths, the trouble with alcohol might not seem to be a big deal for most of us who have diabetes. We all know, of course, that even a little alcohol can mean big trouble for those of us who can’t handle alcohol in moderation.

More than 30 percent of adult Americans have “experienced alcohol use disorders during their lifetimes,” according to a 2007 study in JAMA Psychiatry. That study also found that 17.8 percent have alcohol abuse problems and that 12.5 are alcohol dependent.

Our genes are responsible for about half of the risk for alcoholism, according to the National Institute on Alcohol Abuse and Alcoholism. The other half is our environment, which includes our friends.

If you were sure from your experience that you can handle a little alcohol and if you were a middle-aged or older man who didn’t have diabetes, a little alcohol might actually be good for you. That’s because the response of some people to different amounts of alcohol seems to be quite unusual. It’s not something that could be plotted on a straight line. Researchers call it a U-shaped or J-shaped curve, where among middle-aged and older men, abstinence seems to be a little worse than moderate consumption, while heavy consumption is much worse.

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The Trouble with Peanuts in Managing Diabetes

November 18th, 2013 · 3 Comments

If you have diabetes, beware of peanuts, peanut butter, and peanut oil.

Some people think that because most tree nuts, like almonds, are so healthy, that peanuts should also be good for us. But peanuts aren’t nuts at all. They are a legume, and unlike most nuts we can’t eat them raw.

Actually, we can’t eat them at all if we want to avoid some of the side effects that we can get from them. Some of these side effects can be quite serious.

I can think of only nine reasons why we have to avoid peanuts or anything made from them. Maybe you can think of more, but these eight might be enough to give anyone pause:

1. Peanuts have a lot of carbohydrates, which raise our blood sugar level. Take a look at the US Department of Agriculture’s National Nutrient Database, which is the gold standard of nutrient facts and is fortunately back online today now that the government shutdown has ended. When you exclude the water content in peanuts, they are 37 percent carbohydrate, 39 percent fat, and 24 percent protein.

“One tablespoon of natural, unsweetened peanut butter contains 3 grams of carbohydrate and will raise my blood sugar 15 mg/dl,” writes Dr. Richard K. Bernstein in the 2011 edition of his book Dr. Bernstein’s Diabetes Solution. “Imagine the effect on blood sugar of downing 10 tablespoons!”

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The Best Snack for Weight Loss and Diabetes

November 11th, 2013 · No Comments

Almonds are both my favorite snack and trail food. In fact, lately I seldom eat anything else between meals or on trails.

Unlike some other tasty nuts like cashews, almonds are much lower in carbohydrates, which are the part of our diet that is almost solely responsible for raising our blood sugar level. Nothing else in our diet is more important for managing our diabetes than keeping that level in check.

Some other nuts have a somewhat more favorable ratio of those super-healthy monounsaturated to polyunsaturated fats than almonds. But I avoid them as a matter of taste. I can eat macadamia nuts nonstop until the container is empty, but my body gets so full that I can easily put on a few pounds. On the other hand, I don’t particularly appreciate the taste of other healthy nuts like pecans or walnuts.

As a trail food nothing can compare with any sort of nuts. They can withstand rough handling in our packs and require no refrigeration. But when I’m at home, I keep my snacking almonds in the freezer. Raw almonds are sometimes too soft for my taste, but eating them right out of the freezer gives them that degree of crunch that I appreciate.

Two big reasons why almonds have become my only snack and trail food are weight loss and diabetes. After traveling almost all summer, I’m struggling to take off the last few pounds that I gained on my trips. I stick with almonds for my diabetes because they are one of the most carb-friendly snacks.

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Diabetic Grain Brain

October 11th, 2013 · 6 Comments

Later this month a renowned neurologist will publish an important book about how wheat, carbs, and sugar are destroying our brains. While all of us have some interest in our brains, what could this have to do with diabetes?

The connection is actually too close for comfort. Having diabetes doubles your risk for Alzheimer’s disease, the most dreaded form of dementia. In fact, many people, like Mark Bittman in The New York Times, are beginning to say that Alzheimer’s is type 3 diabetes. You may also want to read “Alzheimer’s Disease is Type 3 Diabetes” in the Journal of Diabetes Science and Technology.

Adding dementia to the well known list of complications of diabetes is enough to give anyone pause. But not to worry. Diabetes doesn’t cause anything, as I wrote here two years ago at “Diabetes Causes Nothing.” Well managing diabetes is the leading cause of nothing. Poor management causes all of these complications. Including Alzheimer’s.

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The Bad Fats for Diabetes

September 30th, 2013 · No Comments

All of us know that we need to avoid the bad fats. But nobody is quite certain yet which of the fats are bad for us. A new study of saturated fats helps to clear up the confusion.

Bad fats are those that are bad for our hearts. Nothing is more important for those of us who have diabetes, because heart disease is the most serious and common complication that we face.

The scientific community does agree that one type of fat is quite bad for our hearts. The bad guys are the trans fats that we made in large amounts in the previous century from partially hydrogenated vegetable oil. In 2001 a large study that I reviewed then began to wake us up to the dangers of this artificial fat. These findings and subsequent government pressure on manufacturers and the spread of knowledge has substantially reduced the amounts of trans fats in the American diet.

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When Omega 3 Works for Diabetes

September 29th, 2013 · 1 Comment

The easiest way to protect our hearts is to increase the amount of omega 3 in our diets. Since heart disease is the most serious complication of diabetes, nothing could be more important for us. But it’s not that simple.

A study to be reported in the September 2013 issue of The Journal of Nutrition shows a surprising connection between omega 3 and physical activity. An observational study of 344 healthy adults living in and around Pittsburgh, Pennsylvania, found that those people who had regular physical activity had more omega 3 in their blood — and were therefore at less of a risk of heart disease — than those who didn’t exercise.

We have, of course, known for a long time that diet and exercise are the cornerstones of diabetes management. But until now who could have guessed that that they were so closely linked!


The Best Source of Omega 3

Some earlier studies showed that people who consume the most omega-3s seem to have the least risk of heart disease. But not all studies found this to be true. The authors of the current study examining the connection between omega 3 and physical activity on heart disease risk felt that some of the earlier studies failed to control for interacting factors.

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Diabetes Eating on the Wild Side

August 20th, 2013 · No Comments

We are getting better at producing sweet tasting food. Farmers have been breeding ever more palatable fruit and vegetables for 10,000 years. Scientists have been speeding up this process for the past century.

Our food today is more pleasurable than what our ancestors had to eat. It’s generally more tender and less bitter. It is increasingly higher in sugar and starch.

But as we bred taste into our food we unwittingly bred out nutrition. Ever since we stopped foraging for wild plants, we have been getting fewer and fewer phytonutrients from our food. These are the compounds that could help us manage the diseases of civilization — diabetes, cancer, heart disease, and dementia.

It’s too late for us to return to foraging for more than a tiny part of what we eat. I sometimes pick wild raspberries and dandelion greens along a trail, but never get enough for a full meal.

Instead, we can choose those fruits and vegetables that retain much of the nutritional content of their wild ancestors. We can’t all go Stalking the Wild Asparagus that Euell Gibbons wrote about in his 1962 bestseller about living off the land. But we can go “eating on the wild side,” which Jo Robinson writes about in her new book of that title.

“We can choose those select varieties of fruits and vegetables that have retained much of the nutritional content of their wild ancestors,” Ms. Robinson writes. “One of the most important discoveries of twenty-first-century food science is that there are vast nutritional differences among the many varieties of a given fruit or vegetable.”

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From the Garden

June 9th, 2013 · No Comments

From the Garden

In 2001, when Rich Pirog wrote that our food typically travels 1,500 miles from the farm where it is grown to where we actually eat it, he got many of us thinking about where our food comes from. I remember that thought reaffirmed my long-standing passion to eat locally grown food that might help me better manage my type 2 diabetes. And no food that I eat is more local than the vegetables I grow in my own garden.

Pirog, then the education coordinator at Iowa State University’s Leopold Center for Sustainable Agriculture, presented his research in an obscure report. But it attracted nationwide attention.

A “food mile” is the distance food travels from where it is grown or raised to where it is ultimately purchased. Pirog used this measurement as a simple metaphor to contrast local versus global food systems and their resulting fuel usage and levels of greenhouse gas emissions. However, he does recognize the limitations of focusing only on “food miles,” noting that food grown far away from our table isn’t always harder on the environment than locally grown food. Higher food miles for some foods don’t always translate into higher energy use, he says. And foods grown locally in greenhouses might use more energy than foods grown in open fields and transported across the country.

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Intermittent Fasting for Diabetes Control

June 7th, 2013 · 5 Comments

Intermittent fasting is older than civilization. Our paleolithic ancestors certainly practised it in times of scarcity whether they wanted to or not. And for centuries many people have fasted for cosmetic or religious reasons. But only now is intermittent fasting getting the respect that its health benefits for people with diabetes warrant.

Case in point: The current issue of The British Journal of Diabetes and Vascular Disease, a bimonthly peer reviewed journal read by scientists, diabetologists, endocrinologists, cardiologists, and vascular surgeons (and a few writers like me) includes a positive review of  “Intermittent fasting: a dietary intervention for prevention of diabetes and cardiovascular disease?

Publishers sometimes make the full-text of their most important articles free online. In this case the publisher announced that it would be “available to access for free for a limited period,” and as I write it is still free. In fact, it is currently this journal’s “most read” article.

The benefits of intermittent fasting for weight loss are established, according to the three authors of the new review. They are researchers at two universities in Birmingham, England. Intermittent fasting also helps reduce the risk of heart disease. Beyond these benefits, the researchers studied intermittent fasting to see how well it works to treat obesity and type 2 diabetes.

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