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Diabetes Research

Psychosocial

Who the Empowered Health Seekers Are

The odds are that you haven’t yet fully empowered your search for good health. I know this about you because a couple of months ago HealthCentral surveyed 2,888 of its registered members who have one of eight chronic conditions, including diabetes, and who completed the study. And in this respect at least people with diabetes are just like the people with the other seven chronic conditions.

HealthCentral CEO Christopher M. Schroeder and James E. Burroughs, associate professor of commerce at the University of Virginia, presented their findings at the DTC National Conference in Washington, D.C. earlier this month and shared them with me. After asking the people in the survey all sorts of standard psychological assessments, they found that about 30 percent of us take an active role in our health care plan. If you are in this group, one of your characteristics is that you are energized and engaged when you need to learn new tasks or master new subjects — you are what the survey calls a person with a need for cognition. If you are an empowered health seeker, the other characteristic you have is self-confidence — you have, in the formal terminology of the survey, high self-efficacy.

You can click to view the study, “Understanding What Motivates the Empowered Patient,” here. Mr. Schroeder and Professor Burroughs prepared it in association with Ted Smith, Ph.D., HealthCentral’s executive vice president for research.

My posts here at HealthCentral and your many comments are just one small corner of this huge health resource. HealthCentral is a collection of condition and wellness websites providing clinical information, tools, and mobile applications. Its sites provide a platform for more than 3,000 bloggers, 200 expert patients, and more than 12 million monthly visitors sharing real-life experiences about specific conditions. Continue Reading

Diabetes Diet

The Trouble with Naps

My most recent post here reviewed a new study indicating that resting after meals is hard on the pancreas, could lead to diabetes, and could make existing diabetes worse. This is an interesting hypothesis and one that you can check out yourself.

But one of my correspondents suggests that the results might be related to the fact that overweight people who overeat at a meal are more likely to lie down. “Edgy thin people probably jog instead,” she says.

That’s a good suggestion, and I’m not sure that the authors of the new study controlled for weight. But now comes a closely related study that indirectly offers support for the hypothesis that lying down after we eat isn’t a good idea.

People in China in the 50s and over who regularly take naps after a meal increase their risk of diabetes by 28 to 36 percent, according to a study just published in Sleep, the official publication of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The authors of the study are associated with universities and hospitals in China and the U.K.

Correlation, of course, doesn’t prove causality. It is suggestive and may be a good suggestion to follow, because the only downside is probably being a bit tired, which in fact could lead to a better night’s sleep. Anyway, a little jog after a meal will do a lot more to reduce blood glucose than lying down ever will.

The authors of the study that I review last week are in Kazakhstan and Ukraine, while the new study is China-based. Some of the most interesting research on diabetes now seems to be coming from countries that hadn’t been at the forefront of diabetes research. This Internet age seems to be leveling the playing field.

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

Diabetes Diet

The Rest Trap

Learning that you have diabetes can be overwhelming. All at once your life has changed.

In fact that is really good. Now you can be healthier than you ever were — if you get more active, lose weight, take your medicine, and cut your stress.

Those are the essentials. The rest are optional tweaks and theory.

Like this one today. The journal Medical Hypotheses deals only in theory, as its title implies.

This journal has an “article in press” that it will publish soon. It’s not online yet.

One of the authors, Alexander Dynyak, M.D., lives and works in Almaty, Kazakhstan. If you don’t know where that is, join the crowd. But Kazakhstan is in Eurasia and is the ninth largest country in the world in land area. It is also the world’s largest landlocked country.

Another author, Andrey Dynyak, is currently pursuing his M.D. degree in Ukraine. Andrey also publishes their research findings on diabetesnewfrontiers.org and sent me a copy of the Medical Hypotheses study.

The study has the usual technical title: “Diabetes mellitus: Hypoxia of the islets of Langerhans resulting from the systematic rest prone on the back after a meal?” In plain English, that means that the islet cells in our pancreas might not get enough oxygen and cause diabetes if we lie down in the two hours after we eat.

Who would have thought of that! I certainly never did. But the islets are especially susceptible to oxygen deficiency. This study investigated whether the pressure on the pancreas of food in the stomach after a meal might be related to diabetes. To test their hypothesis, the authors surveyed people with diabetes compared with a control group. The people with diabetes numbered 91 and those in the control group numbered 20. Every one of the people with diabetes had been resting after eating at least three or four times each week. But only 2 of those in the control group, or 10 percent, did.

Then the researchers attempted to get the people with diabetes to change their resting behavior. The researchers recommended that the people with diabetes not lie down within two hours of a meal. That’s because this is the average time it takes for food to pass through our stomachs.

But only 20 percent of the people with diabetes were consistent in not resting during those two hours. Of those, however, the researchers found general improvements, an increased capacity for work, better blood glucose control, and less need for diabetes medication.

The article indicates that resting during the two hours after a meal might lead to diabetes. I wondered if this might, however, imply that people who already have diabetes should also avoid resting then.

“Yes, that is basically what it implies,” Andrey Dynyak replied. “In general, a passive rest within one to two hours after a meal in a recumbent position should be avoided. However, being more specific for diabetes, a passive rest after a meal prone on the back or reclined is what should be avoided.

“Unfortunately, it is becoming such a common and usual behavior that by many is regarded as normal. Fortunately, it is easy to test, and positive results can be seen shortly after changing this specific behavior.”

I think that these far-off researchers might be onto something. It’s definitely worth testing if you have been lying down during the two hours that it takes for your stomach to digest your food. It won’t make your life worse, and could well make it a lot better.

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

Diabetes Testing

Omega-3: Tested

No wonder that I’m so healthy and happy lately! I just got back the results of my omega-3 test, and they were quite satisfactory.

In December I wrote in “Testing Omega 3” about the HS-Omega-3 Index that uses a standardized methodology to measure the percentage of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) in our red blood cells. It also measures the ratio of omega 3 to omega 6. In that article I gave a brief review of some of the reasons why I think that omega-3 is crucial to our diet — and deficient in the diet of most people who have diabetes.

On January 27 I ordered my test from GeneSmart, and I got my results in today’s mail.

A “desirable” level on the HS-Omega-3 Index is over 8 percent. My level came back as 12.6 percent.

A desirable ratio of omega-6 to omega-3 is under 5 to 1. My ratio is 2.1 to 1.

The only advice that GeneSmart was able to offer me was to maintain my intake of the omega-3 fatty acids, EPA and DHA. I will.

But in the packet they did include a nice set of tables about fish and their omega-3 content. Here is a copy:

Click to enlarge

Click on the image above to enlarge

I get my omega-3 levels from eating fresh or frozen (not farmed) cold-water fish about five times a week. I prefer king salmon and Chilean sea bass — technically Patagonian toothfish — which tastes a whole lot better than it sounds. I usually add canned salmon, sardines, or albacore tuna — packed in water, not oil — to my salad at lunch. Sometimes I add a small can of anchovies, which I have been able to find only packed in oil, which I drain off. I also supplement my omega-3 from krill oil, which I wrote about here exactly two years ago at “Krill Oil.”

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Diabetes Diet

Broken Link Between Saturated Fat and Heart Health

You won’t read it in the mainstream press. But the most significant study ever of the effect of saturated fat on our hearts appeared Wednesday.

In fact, I couldn’t find any mainstream articles about it today. Not one of the four sources that I rely on heavily for leads to new studies has carried a word about this one. In fact, another source, Google News, instead turned up articles headlined like “Reduce your intake of saturated fats or suffer a heart condition,” “Ban butter to save our hearts, says doctor,” and “Not all fats are equal – saturated fat is the real baddie.”

Not.

The new study should drive the last nail in the coffin of the supposed link between eating saturated fat and getting heart disease. Since heart disease is the most common as well as the most serious complication of diabetes, nothing could be more relevant to us.

Ever since 1953, when a physiologist named Ancel Keys, Ph.D., compared fat intake and deaths from heart disease in six countries, including the U.S., the American medical establishment has clung to an unproven belief that saturated fat was evil. But even by 1957 we should have known better, after Jacob Yerushalmy, Ph.D., established that Keys was guilty of the sin of cherry picking. While Dr. Keys used data from six country, he actually had statistics from 22 countries available. And when scientists analyzed those statistics, the apparent link between eating fat and heart disease disappeared. Continue Reading

Diabetes Diet

Fit and Not Fat

We can’t be truly healthy if we are fat. That’s the bottom line of study reported online December 28 before it’s printed in Circulation, the journal of the American Heart Association.

Previous studies seemed to show that something called “healthy obesity” might exist. They indicated that obese people who didn’t have the metabolic syndrome — a pre-diabetic condition — weren’t at increased risk of heart disease.

But the new research indicates that those studies didn’t follow those people long enough. Only after about 15 years did their heart problems show up in an exceptionally long-term study of 1,758 Swedish men starting when they were 50. The study, “Impact of Body Mass Index and the Metabolic Syndrome on the Risk of Cardiovascular Disease and Death in Middle-Aged Men,” followed them for 30 years. Continue Reading