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Diabetes Diet

Diabetes Diet

Brain Food

Whether people with diabetes need bigger brains that other people is something that science hasn’t studied yet. But some scientists who have studied our early ancestors have just discovered that we got our big brains originally from a diet that came in large part from fish and other aquatic animals.

Until now, most of the scientists who study our early ancestors assumed that they lived on the plains of East Africa. This “savannah theory” seemed to point at a diet of roots, seeds and nuts, some green plants and the occasional small game — the hunter-gatherer hypothesis. This is pretty far from the oceans where fish live.

But fish also live in lakes and streams. And now we know that some of our earliest ancestors about 1.95 million years ago lived around such a wet environment. Archeologists working in northern Kenya found that our ancestors ate a lot of fish, turtles, and crocodiles. By analyzing the bones of the animals and the stone tools that our ancestors made the scientists showed that in fact we descend from a long line of fish-eaters.

Yesterday This Fisherman Caught a Smallmouth Bass — Our Ancestors Caught Prehistoric Bass

The connection between fish and brains is omega-3 oils, which make up about 60 percent of the fatty acids in our brains. And about 2 million years ago our ancestors first developed the big brains that humans have.

We didn’t get their big brains from plants, because our bodies are inefficient in converting plant-based omega-3 into the long-chain omega-3 that our brains need. Only fish, shellfish, algae, and those animals that feed largely on aquatic sources have a lot of omega-3 that our brains can use.

Our mothers told us that fish was brain food. And now we know that they were right in this as in so many other things.

This article is based on an earlier version of my article published by HealthCentral.

Diabetes Diet, Exercise For Diabetes

Weight Control Registry

The National Weight Control Registry is the best guide we have showing us how people actually lose weight and keep it off. These are the people who have succeeded in a major weight loss program and in keeping off the pounds.

Diabetes doctors typically tell us to loose 10 percent of our body weight. I know from my own experience that this helps to control our blood glucose level. And I know too that getting down to a normal body mass index, or BMI, is even better for maintaining a low A1C level.

The National Weight Control Registry started in 1994 and now tracks more than 5,000 people. And because I am one of them, the people at the registry sent me a copy of a publication that summarizes their findings as thanks for returning a one-year questionnaire. The article, “Long-term weight loss maintenance,” appeared in the American Journal of Clinical Nutrition.

To be included in the registry, people have to be at least 18 and have kept off at least 30 pounds for a year or more. I reached that milestone four years ago. And a couple of years ago my friend Gretchen Becker encouraged me to share my results with the registry.

I haven’t seen any statistics about how many of the people included in the registry have diabetes. But I know that my weight loss strategies have been different from most. Using Byetta got me started with my weight loss program, and a very low-carb diet intensified it.

Most people, however, say that they have lost weight by following a low-calorie, low-fat diet. Without question, weight loss means a low-calorie diet. Almost certainly, following a diet of any sort is also a key to success. In fact, participants who maintained a consistent diet during the week and year after year were much more likely to maintain their weight than those who varied their approach.

Other keys include:

Eating breakfast every day, followed by 78 percent of registry members.

High levels of physical activity. Fully 94 percent report that they get more exercise now than they did before they lost weight, and 90 percent report that on the average they exercise an hour a day. Walking is the most common activity, reported by 78 percent of the participants.

Regular weighing. More than 44 percent report that they weigh themselves at least once a day.

I know from my own experience that when my scales broke in February just before I went on a long trip that not weighing myself regularly was disastrous for my weight. In a three-month period I gained 12 pounds and am now fighting to take them off.

The really good news is that it gets easier. People who successfully maintained their weight loss for two to five years had a much greater chance of long-term success.

This article is based on an earlier version of my article published by HealthCentral.

Psychosocial

Education Helps in A1C and Weight Control

Your best help in reducing your A1C and your weight could be to work with a Certified Diabetes Educator and a nutritionist. That’s the implication of a study that Issac Sachmechi, M.D., presented at the annual meeting and clinical congress of the American Association of Clinical Endocrinologists in Boston today.

Health Central sent me to the meeting, where I interviewed Dr. Sachmechi this morning. He is clinical associate professor of medicine at Mount Sinai School of Medicine in New York City and Queens Hospital Center in Jamaica, New York.
Dr. Sachmechi presented his poster and abstract, “Impact of Diabetes Education on HbA1C and Weight Reduction at the meeting.” He told me that he designed the study and involved the chief resident and one of his colleagues. Certified Diabetes Educators and nutritionists provided the diabetes education.

Dr. Sachmechi Supports Diabetes Education

Don’t people with diabetes generally get diabetes education? “No,” Dr. Sachmechi replied. “In many areas of the country people with diabetes don’t get nutritional advice or see CDEs. The CDEs show them how to do home glucose monitoring, how to prevent hypoglycemia, the importance of exercise, and other things that are needed for the care of diabetes.”

But doesn’t it cost a lot of money? “I don’t think so,” Dr. Sachmechi replied. “Certainly, a session with a CDE costs less than a session with a physician!”

The study group of 150 people included people with type 2 diabetes who their primary care physician referred to two CDEs and a dietitian. A control group of 150 people with type 2 diabetes didn’t get to see either a CDE or a dietitian.

The researchers compared the A1C and weight of the study participants before and then six months after the study. A1c went down 1.02 percent in the study group but only 0.59 percent in the control group. The average weight went down 2 pounds in the study group but only 0.71 pounds in the control group.

“This is one of the few studies demonstrating a measurable improvement in diabetes control and weight loss solely due to diabetes education and diet counseling in a municipal hospital with limited resources,” Dr.Sachmechi concluded. Dr. Sachmechi’s study worked with people with diabetes who are largely uninsured and generally have poor health literacy. My conclusion is if diabetes education works there, it can work for you too.

Dr. Sachmechi tells me that he is now working on the impact of support groups on the impact of A1c and other measures of diabetes control. Do support groups help us? That’s what he hopes to find out, and I will let you know here the results of that study.

This article is based on an earlier version of my article published by HealthCentral.

Diabetes Medication

Losing Weight with a Hydrogel

Today, after 15 years of work, a Boston-based company focused on obesity and diabetes came out of stealth mode. Gelesis Inc. unveiled something that promises to make losing weight a lot easier.

Nothing on the immediate horizon could be more important for most of us who have diabetes. More than 85 percent of us are overweight or obese, according to a survey by the U.S. Centers for Disease Control and Prevention.

While I lost a lot of weight by using the first GLP-1 mimetic, Byetta, and then more by following a very low-carb diet, it wasn’t easy. That personal experience is in part what makes me so excited about the product that Gelesis presented to the public for the first time today.

The company made its presentation at a media briefing that I was privileged to attend. Health Central sent me to Boston this week to attend the 19th annual meeting and clinical congress of the American Association of Clinical Endocrinologists. About 1,700 doctors from all over the world are here for the association’s largest meeting ever.

I arrived in Boston yesterday evening, and for me the meeting started with the media briefing this morning. It started with a bang as two doctors presented the results of their efforts to date. After the briefing, I cornered four other experts involved with the development of their product.

Dr. Hassan Heshmati, the chief medical officer for Gelesis, kicked off the presentation. He announced that they have developed the first superabsorbent hydrogel composed entirely of food components. They call it Attiva.

It swells up after people swallow it, making people feel full. This feeling of satiety lasts even after it goes through the stomach into the intestines. Then it safely degrades in the colon and releases the liquids that it absorbs, one of Attiva’s important safety features.

They designed Attiva to have the same physical properties as masticated food. The most common side effect was nausea. But only about 7 percent of the people in their clinical trial experienced it, Dr. Heshmati said.

After Dr. Heshmati’s introduction of Attiva, Eric Elenko, Ph.D., showed us what Attiva can do. Dr. Elenko is a partner in Puretech Ventures, which co-founded Gelesis.

Eric Elenko Shows How Absorbent Attiva Really Is

To measure Attiva’s effect on satiety, doctors at the Gemelli Hospital in Rome, Italy, gave it to 95 people. While some of them had a normal weight, others were overweight or obese, and they had an average body mass index of 31. Continue Reading

Diabetes Diet

Eating Too Fast

Eating fast probably comes naturally to all of us. Hiking a long trail on my vacation in New Zealand a few days ago, I ate as quickly as I could when I stopped, because I wanted to get to the hut before dark.

I ate for the energy that I needed to finish the hike, not for pleasure. For once, I wasn’t concerned about the taste of the food or eating too much of it too fast.

This must have been the way my ancestors and yours ate back in the days when they went out on the hunt or to gather roots and berries. This comes naturally to human beings.

But nowadays we have much more food much more readily available. Normally we don’t have to be concerned about getting enough energy to get to our destination. We have the pick of the most tasty food from around the world. We eat for pleasure much more than for sheer energy.

With a different goal we need a different eating strategy. Specifically, we need to slow down so we won’t overeat. As a bonus, slowing the speed with which we consume our meals giaves us more time to savor them.

Eating slowly has been one of the hardest eating lessons that I have had to learn.  Not until I admitted to a friend that I always eat too fast have I been able to control my eating speed. My acknowledgement to another person was the key to controlling my behavior.

We have to fully accept the truth of our existing state before we can expect to progress or to heal.  Recognizing and admitting our own problem is the necessary first step towards change. This is perhaps because the light of awareness or acceptance or humility is in itself a healing.  If we are forever in denial about where we are stuck, we will continue to overlook the keys that are out there that can set us free.

Once I fully accepted that I ate too fast, I adopted some specific strategies. I had always told myself that I ate fast just because I didn’t want my hot food to get cold. So I started with food that we normally eat at room temperature, like a salad.

Then I consciously told myself to put down the fork or spoon between bites. Now I completely chew what was in my mouth before picking it up again.

While chewing, I don’t do anything else except concentrate on the wonderful food that I am eating. Now, I really taste my food.

Eating more slowly means for me that I don’t eat as much as I did before. This is because of the fact that was long well known to me that our bodies and brains need some time, like about a quarter of an hour, to register that we are full.

The great food that we get now can be so much better and so much easier to obtain then what our hunter-gatherer ancestors were able to eat. We owe it to ourselves to savor it.

This article is based on an earlier version of my article published by HealthCentral.

Diabetes Diet

Sources of Omega-3

The best way for us to boost the amount of omega-3 fats in our diet might be to come to New Zealand. This country must have the largest offering of fish in the world.

This month I am vacationing on the country’s South Island and have been feasting on all sorts of fish. I know that many people don’t love fish as much as I do. But even those who aren’t particularly found of them will certainly find some varieties and different preparations to suit their taste buds.

Those of us who have diabetes really need the benefits to our heart health that regularly eating fish provide. Everyone’s hearts are healthier when we consume high levels of the long-chain omega-3 fats that cold-water fish in particuar have.

Of course, coming to New Zealand isn’t the only way to increase our omega-3 consumption. In fact, eating fish isn’t the only way either. For starters, we don’t actually have to limit ourself to cold-water fish, even though these fish have the most omega-3.

Take a quick look through the KIM-2 database, which I have written about earlier in this series of articles on achieving a good balance of omega-3 and omega-6 fats. These two types of polyunsaturated fats compete in our bodies. High levels of omega-3 fats are anti-inflammatory, while high levels of omega-6 fats are pro-inflammatory.

The KIM-2 database does show that the cold-water fish like salmon and sardines have extraordinarily good ratios of omega-3 to omega-6 fats. But it also doesn’t show ANY fish with more omega-6 than omega-3. That’s one reason why I am eating fish with Maori names that I have never heard of and which don’t appear in the KIM-2 database.

And it’s not just fish where we can get our long-chain omega-3s. The world also has a great variety of seafood that is high in omega-3.

Beyond fish and seafood we have fish oil or krill oil to supplement our omega-3 level. These supplements come in either liquid or capsule form. Some people who don’t like the taste of the liquid do very well with capsules.

But what about the dilemma that vegetarians and vegans face? Even this is not a problem. Think for a moment where fish and seafood find the ultimate source of their omega-3 fats. That source is the lowest on the food chain, a plant called algae.

We can skip the intermediate links in the chain and go ourselves directly to the source. Several companies now offer long-chain omega-3 fats in vegan algae.

Those capsules aren’t cheap. On the other hand coming to New Zealand to eat fish isn’t either.

P.S: I originally wrote this article for HealthCentral.com on March 11, 2010. I am now back in the U.S. after vacationing in New Zealand. You can read about the trip here: http://www.mendosa.com/fitnessblog/?cat=17

This article is based on an earlier version of my article published by HealthCentral.