Archive for the 'Nutrition Health Tips' Category

Stress and the Risk of Weight Gain

July 19, 2014

Stress and weight gain? Yes they are closely associated.  Recently published data from the Biological Psychiatry has closely examined the relationship.

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Background
Depression and stress promote obesity. This study addressed the impact of daily stressors and a history of major depressive disorder (MDD) on obesity-related metabolic responses to high-fat meals.

Methods
This double-blind, randomized, crossover study included serial assessments of resting energy expenditure (REE), fat and carbohydrate oxidation, triglycerides, cortisol, insulin, and glucose before and after two high-fat meals. During two separate 9.5-hour admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar control subjects), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. Prior day stressors were assessed by the Daily Inventory of Stressful Events.

Results
Greater numbers of stressors were associated with lower postmeal REE (p = .008), lower fat oxidation (p = .04), and higher insulin (p = .01), with nonsignificant effects for cortisol and glucose. Women with prior MDD had higher cortisol (p = .008) and higher fat oxidation (p = .004), without significant effects for REE, insulin, and glucose. Women with a depression history who also had more stressors had a higher peak triglyceride response than other participants (p = .01). The only difference between meals was higher postprandial glucose following sunflower oil compared with saturated fat (p = .03).

Conclusions
The cumulative 6-hour difference between one prior day stressor and no stressors translates into 435 kJ, a difference that could add almost 11 pounds per year. These findings illustrate how stress and depression alter metabolic responses to high-fat meals in ways that promote obesity.

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Stress indeed can bring about eating the wrong choice of food.  Almost always we can’t avoid stress BUT we can do something about it to avoid stress induced weight gain.

It has always been my recommendation to my patients that one way to avert the temptation of eating wrong foods is to stock our pantry and refrigerator with foods that are healthy like fruits or nuts so one can prepare healthy food choices instead.

 

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Nuts and Health

December 5, 2013

I ama  regular nut eater… mostly pistachios. Nuts are my favorite snacks.

Health benefits derived from eating nuts are numerous and this new study published in NEJM, 2013 affirms that association.

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BACKGROUND

Increased nut consumption has been associated with a reduced risk of major chronic diseases, including cardiovascular disease and type 2 diabetes mellitus. However, the association between nut consumption and mortality remains unclear.

METHODS

We examined the association between nut consumption and subsequent total and cause-specific mortality among 76,464 women in the Nurses’ Health Study (1980–2010) and 42,498 men in the Health Professionals Follow-up Study (1986–2010). Participants with a history of cancer, heart disease, or stroke were excluded. Nut consumption was assessed at baseline and updated every 2 to 4 years.

RESULTS

During 3,038,853 person-years of follow-up, 16,200 women and 11,229 men died. Nut consumption was inversely associated with total mortality among both women and men, after adjustment for other known or suspected risk factors. The pooled multivariate hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.93 (95% confidence interval [CI], 0.90 to 0.96) for the consumption of nuts less than once per week, 0.89 (95% CI, 0.86 to 0.93) for once per week, 0.87 (95% CI, 0.83 to 0.90) for two to four times per week, 0.85 (95% CI, 0.79 to 0.91) for five or six times per week, and 0.80 (95% CI, 0.73 to 0.86) for seven or more times per week (P<0.001 for trend). Significant inverse associations were also observed between nut consumption and deaths due to cancer, heart disease, and respiratory disease.

CONCLUSIONS

In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death. (Funded by the National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation.)

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The Amount of Exercise You need to Burn off Calories from eating a Burger…

April 26, 2013

Let me share you this link from Yahoo. Very interesting fact that one can use this strategy to lose weight.  Think how much exercise you need to do to burn off the calories from the food you re eating…

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Is a Burger Worth 7,500 Sit-Ups?

Most people have stared down a pint of ice cream or a bag of chips and tried to figure out how much more they’d need to work out in order to burn off the extra calories. Unfortunately, you can’t really eat whatever you want and just work out a little more later. “No, it is not an even exchange,” Franci Cohen, a personal trainer, certified nutritionist, and exercise physiologist in New York City, told Yahoo! Shine. “In fact, over-exercising will actually cause the muscles to break down instead of build up, and the metabolism slows down as a result of excess exercise as well.” Still, a Texas Christian University study of 300 adults presented at the Experimental Biology 2013 conference in Boston this week found that learning how much more you’d need to exercise to work off a burger was enough to make people pick a lower-calorie meal. Wondering if that candy bar is worth it? Here’s what it would take to work off some of our favorite indulgences. 

A single Whopper from Burger King is 630 calories, or the equivalent of spending an hour going full-tilt on the elliptical machine. Rather do sit-ups or crunches? You’ll have to bust out 7,500 of them. (All workout results calculated for a 140 pound woman, using exercise data from HealthStatus.com.)

Ben & Jerry’s Phish Food premium ice cream packs 280 calories into each 1/2-cup serving. That’s a little more than an hour’s worth of pumping iron. But who stops at a single serving? Eat the whole pint and do about five hours of weight lifting (or almost two hours of bare-handed rock climbing).

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I enjoyed reading the link that it makes us realize… fat is really from all the food we eat..and therefore…controlling ones desire to indulge is key to curbing  your appetite.

Indulge but only on occasions.

 

Are All Sugars The Same?

January 11, 2013

Read the rest of this entry »

Is Frying Foods Bad for the Health?

February 16, 2012

Almost a resounding YES! Until recently the British Medical Journal 2012 published an article that looked at frying and the risk of heart disease. The data will otherwise give us a smile for most who love frying as a way to cook and enjoy food!

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Abstract

Objective To assess the association between consumption of fried foods and risk of coronary heart disease.
Design Prospective cohort study.
Setting Spanish cohort of the European Prospective Investigation into Cancer and Nutrition.
Participants 40,757 adults aged 29-69 and free of coronary heart disease at baseline (1992-6), followed up until 2004.
Main outcome measures Coronary heart disease events and vital status identified by record linkage with hospital discharge registers, population based registers of myocardial infarction, and mortality registers.
Results During a median follow-up of 11 years, 606 coronary heart disease events and 1,135 deaths from all causes occurred. Compared with being in the first (lowest) quarter of fried food consumption, the multivariate hazard ratio of coronary heart disease in the second quarter was 1.15 (95% confidence interval 0.91 to 1.45), in the third quarter was 1.07 (0.83 to 1.38), and in the fourth quarter was 1.08 (0.82 to 1.43; P for trend 0.74). The results did not vary between those who used olive oil for frying and those who used sunflower oil. Likewise, no association was observed between fried food consumption and all cause mortality: multivariate hazard ratio for the highest versus the lowest quarter of fried food consumption was 0.93 (95% confidence interval 0.77 to 1.14; P for trend 0.98).
Conclusion In Spain, a Mediterranean country where olive or sunflower oil is used for frying, the consumption of fried foods was not associated with coronary heart disease or with all cause mortality.

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It is always our notion that frying is really bad. Foods that are fried lose water and instead take up fat and increase the caloric density of the food that is fried.  Worst is when the oil is reused as one loses the healthier unsaturated fat and instead increases the amount of the unhealthiest fat which is the trans fat!  What is known is that the risk of obesity and overweight strongly correlated with eating fried foods but this is the only study so far that has evaluated prospectively the relationship between fried foods and cardiovascular disease.

In this study Olive oil or Sunflower oil were used.  Of the total amount of fried food consumed, 24% (34 g/day) was fish, 22% (31 g/day) meat, 21% (30 g/day) potatoes, and 11% (15 g/day) eggs.

In this study population, the detailed analysis of the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition significantly found no association between consumption of fried food and risk of coronary heart disease or all cause mortality.

Some explanations can be made:

1. The oil used in the study was mainly olive and sunflower rather than solid fat.  Olive oils is less prone to oxidation than other edible oils or fat.

2. We are not talking here of fried food in Fast food Burger joints where oils used in deep frying are reused several times and therefore unhealthy!

3. The analysis should not be made to say that fried chips or snacks therefore are safe because the study population here has low consumption of fried snacks that are usually loaded with salt.

This is indeed an exciting development in the field of FRYING!

Just the same..choose foods wisely ….

Choose Healthy!

How To Lose Weight: A Novel Way To Teach Kids About Proper Nutrition

December 24, 2011

Recent article published in AMERICAN JOURNAL OF PUBLIC HEALTH brings us back to how fast our world is becoming obese and how slow we have been in addressing this issue.  The temptation to eat and the lack of discipline to follow what is right and adequate make each one of us vulnerable to this dreaded condition we call Obesity.

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Objectives. We examined the effect of an intervention to provide caloric information about sugar-sweetened beverages (SSBs) on the number of SSB purchases.

Methods. We used a case-crossover design with 4 corner stores located in low-income, predominately Black neighborhoods in Baltimore, Maryland. The intervention randomly posted 1 of 3 signs with the following caloric information: (1) absolute caloric count, (2) percentage of total recommended daily intake, and (3) physical activity equivalent. We collected data for 1600 beverage sales by Black adolescents, aged 12–18 years, including 400 during a baseline period and 400 for each of the 3 caloric condition interventions.

Results. Providing Black adolescents with any caloric information significantly reduced the odds of SSB purchases relative to the baseline (odds ratio [OR] = 0.56; 95% confidence interval [CI] = 0.36, 0.89). When examining the 3 caloric conditions separately, the significant effect was observed when caloric information was provided as a physical activity equivalent (OR = 0.51; 95% CI = 0.31, 0.85).

Conclusions. Providing easily understandable caloric information—particularly a physical activity equivalent—may reduce calorie intake from SSBs among low-income, Black adolescents.

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The study tells us one thing:

Letting out kids understand the nutrition information of the food they eat versus telling them how long they have to workout or exercise to burn the calories can make a difference.

The impact was noticeable more if kids understand how long they have to run to burn the amount of calories they ingested from the sugary drinks.  The easier it is for everyone to understand the equivalent amount of physical activity of what we take in makes sense.  You get a clearer picture of what you need to do to burn those calories.

A great article and a great wake up call for everyone.

AACE Philippines as part of our advocacy is providing modules to Grade school students on the Power of Prevention Through Fitness and Nutrition or POPFTN. For this year, we already have started the program and involved the Grade 5 students of St Bennedicts and for January, we will go to PAREF Springadale both in Cebu.  AACE Philippines as an organization composed of Endocrine Specialists dealing with Diabetes, Obesity and endocrine diseases hope to make a difference in the early lives of these kids.

Healthy Cereals for Breakfast

December 14, 2010

Its always difficult to wake kids up during school days…more difficult to let them eat.  I usually alternate oatmeal, cereals and rice on my kids breakfast meal.  Oats with fruits and milk, low sugar Cherrios cereals and in between days they get rice and eggs with ham.  It is always good to start the kids young and learn the importance of a healthy breakfast.

The mistake that parents always have with regard to kids food choices is that we always allow our kids to dictate what they like to eat.  Or rely our kids meals on their yayas.  It is easier for us to fry chicken with french fries because for sure the kids will eat them BUT are they healthy?  Likewise yayas find it easier to feed fried chicken than veggies.  As the saying goes..at least they eat rather than no breakfast!  This is the reason why in the long run, parents will find it difficult to introduce healthy food choices for the kids.

Now comes a new study published in Pediatrics that these Cherrios low sugar cereals are really acceptable options for a healthy breakfast.  Likewise surprisingly kids love them!

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Objectives To test (1) whether children will consume low-sugar ready-to-eat (RTE) cereals and (2) the effects of serving high- versus low-sugar cereals on the consumption of cereal, refined sugar, fresh fruit, and milk.

Participants and Methods Using an experimental design, we randomly assigned children (n = 91) who were attending summer day camp to receive a breakfast that included either the choice of 1 of 3 high-sugar cereals (high-sugar condition) or low-sugar cereals (low-sugar condition), as well as low-fat milk, orange juice, bananas, strawberries, and sugar packets. Participants served themselves and completed a background questionnaire after eating. Researchers measured the amount and calories consumed of each food.

Results In both conditions, children reported “liking” or “loving” the cereal they chose. Children in the low-sugar cereal condition consumed, on average, slightly more than 1 serving of cereal (35 g), whereas children in the high-sugar condition consumed significantly more (61 g) and almost twice the amount of refined sugar in total (24.4 vs 12.5 g). Milk and total calories consumed did not differ significantly between conditions, but children in the low-sugar condition were more likely to put fruit on their cereal (54% vs 8%) and consumed a greater portion of total calories from fresh fruit (20% vs 13%).

Conclusions Compared with serving low-sugar cereals, high-sugar cereals increase children’s total sugar consumption and reduce the overall nutritional quality of their breakfast. Children will consume low-sugar cereals when offered, and they provide a superior breakfast option.

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This clinical study is true based on my experience.  My kids love these Cherrios low sugar low fat whole grain cereals more than the sugary chocolate laden corn flakes.   The good news with these data is that those children in the study who were offered low-sugar cereals enjoyed their breakfast with good satisfaction but only consumed half the amount of refined sugar at breakfast compared with those who ate high-sugar cereals (12.5 g versus 24.4 g, P<0.001).  Not only are the parents happy but the kids are satisfied too!

It is really best to start our kids day with a healthy meal that can provide them with calories that matter…

Choose wisely and Be Involved!

The Dangers of Sugary Drinks

November 16, 2010

Consumption of sugary drinks not only make you gain weight BUT now has been proven to strongly increase your risk to develop Diabetes and other obesity related diseases. 

A new study has shown us there is a  link regarding the risk of developing diabetes to intake of sugary drinks and this link is high enough to approximate the risk that one gets from smoking!!!!

This new study is published in the recent publication of Diabetes Care in 2010:

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OBJECTIVE: Consumption of sugar-sweetened beverages (SSBs), which include soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks has risen across the globe. Regular consumption of SSBs has been associated with weight gain and risk of overweight and obesity, but the role of SSBs in the development of related chronic metabolic diseases, such as metabolic syndrome and type 2 diabetes, has not been quantitatively reviewed.

RESEARCH DESIGN AND METHODS: We searched the MEDLINE database up to May 2010 for prospective cohort studies of SSB intake and risk of metabolic syndrome and type 2 diabetes. We identified 11 studies (three for metabolic syndrome and eight for type 2 diabetes) for inclusion in a random-effects meta-analysis comparing SSB intake in the highest to lowest quantiles in relation to risk of metabolic syndrome and type 2 diabetes.

RESULTS: Based on data from these studies, including 310,819 participants and 15,043 cases of type 2 diabetes, individuals in the highest quantile of SSB intake (most often 1-2 servings/day) had a 26% greater risk of developing type 2 diabetes than those in the lowest quantile (none or <1 serving/month) (relative risk [RR] 1.26 [95% CI 1.12-1.41]). Among studies evaluating metabolic syndrome, including 19,431 participants and 5,803 cases, the pooled RR was 1.20 [1.02-1.42].

CONCLUSIONS: In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes. These data provide empirical evidence that intake of SSBs should be limited to reduce obesity-related risk of chronic metabolic diseases.

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In practical terms, the association between intake of sugary drinks and Diabetes can be translated to something like this:

For every  12 oz sugar laden drink that you order in a restaurant today like the ever famous and popular sugary and tasty Ice Tea or canned OJ… a roughly 25% increase in risk  for you to develop Diabetes on top of your risk to gain more weight!

So if one actually drinks 2-3 bottles of Soda per day then the risk is further increased to 30% roughly similar to the risk one gets due to smoking!

Would it be better to take Diet Drinks then? It maybe safer BUT the associated increase in food intake is the culprit.  Likewise there are some concerns now that link Diet Sodas also to increased risk of Metabolic syndrome suggesting that artificial sweeteners may have a role in itself. 

So my recommendation to my patients is to limit one’s consumption to only 1 diet soda per day and if possible enjoy Water instead!

Heres A Simple Way To Lose Weight…

September 11, 2010

Go to fullsize imageJust being too busy or just plain lazy, we have many excuses why we cant exercise.  Too stressed out at work gives us the reason to indulge in  food that we feel comfortable and happy.  But outcomes do matter and weight gain spells disaster.

We have heard of fad diets that do work but temporarily.  It still boils down to strict discipline and watching carefully what we eat and following the right regimen to the right activity.  We all know that… we heard that advice in the news, in the magazine so what esle is new?  Something that is simple and so close within your grabs but never thought about it?

Well heres something interesting and novel study  that was presented at the 2010 National Meeting of the American Chemical Society in Boston:

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The study included 48 adults between age 55 and 75 who were divided into two groups.  The study participants drank about 1.5 cups of water per day prior to joining in the study.

One group drank two cups of water before meals and the other didn’t. All participants ate a low-calorie diet throughout the study.

After 12 weeks, water drinkers lost about 15.5 pounds, compared to non-water-drinking dieters, who lost only 11 pounds.

Not only were those who drank water before meals more successful after 12 weeks, but they also kept “the weight off for a full year after the weight loss study.”  Even better, most water drinkers, followed for an additional 12 months, not only kept weight off but “even lost another 1 to 2 pounds”.

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The study is really not novel in idea but for the first time, a scientific study has been done to substantiate what I have been recommending to my patients who are diabetics and overweight.  It is a smple formula of dirinking water before each meal to allow one to feel full and therefore less hungry.  By doing so, one tends to be more careful with what one eats and therefore has the best  chance of losing weight or maintaining it.

Water is still the best to fill you up…. its available 24 hours and free.  How much water do I recommend one to take daily?

I recommend at least 8- 10 glasses of water for women and up to 14 glasses for men!

But remember.. to be successful means the triad of discipline, low calorie healthy food and the right amount of exercise! Now ADD Plenty of WATER!!!!

Simple regimen to lose weight…TRY IT!

Diet Sodas and Your Kidneys… BEWARE!

December 17, 2009

Drinking soad is not really helping people achieve a healthier lifestyle.  They contain no vitamins or macronutrients except artificial flavoring, sodium ,artifical color and sweetener.  People drink soda instead of water or milk or the healthier tea.

Now comes some no to good  health news relating to intake of diet soda and kidney function. 

During the recent convention of the American Society of Nephrology comes a novel finding of diet soda and kidney function.  The study from Brigham and Women’s Hospital in Bosto involving 3,256 women, median age of 67 participating in the Nurses’ Health Study were involved.  Apparently, there is an association between increase intake of diet soda and the decline in kidney function apprently related to the sodium content.

Results of the study showed that women who drank diet soda > 2 cns a day resulted in a 30% decline of kidney function which was considered significant.  The results persisted even after considering other factors, such as age, physical activity, high blood pressure, and diabetes.

No link howevere was ssen among women who took less than 2 diet sodas per day.

Implications of the study:  Some women I know use diet sodas to help them lose weight.  To help them reduce their cravings for food and to make feel full easily.  It may be true that they contain zero caloris but now concerns regarding the food additives, the artificial coloring and the high sodium content of these drinks may cause harm.

Long term prospective studies however need to be done to determine the exact culprit of the decline…. but for now…suffice it to say taht diet sodas will always be at the bottom of the health food pyramid…and should never be used as a substitute for milk or water.

So this Christmas season…maybe a can every not so often will suffice.  Even during this merry holiday season, lets not forget that health is still a priority and  for me…. the best gift I can offer to myself!

How Much Exercise is Needed to Lose the FAT?

November 26, 2009

It has been known that losing weight is a game of discipline and balance… Balance between food intake and physical activity. 

But what is not known is how much activity is needed to lose the fat inside the viscera or  abdomen known to be the Bad Fat!  Remember if you want to lose weight: the equation is more toward lesser intake of FOOD…  while If you want physical conditining and maintenance of weight, the balance points more to physical activity.

Now comes this interesting data that looked at this particular question.  How much exercise does one need to lose fat?  The study was published in journal  Obesity, Oct 8, 2009

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The purpose of this study was to determine what effect aerobic and resistance exercise training has on gain of visceral fat during the year following weight loss.

After being randomly assigned to aerobic training, resistance training, or no exercise training, 45 European-American (EA) and 52 African-American (AA) women lost 12.3 plusminus 2.5 kg on a 800 kcal/day diet. Computed tomography was used to measure abdominal subcutaneous and visceral adipose tissue, whereas total fat and regional fat (leg, arm, and trunk) were measured by dual energy X-ray absorptiometry after weight loss and 1 year following the weight loss. Because not all the subjects adhered to the 2 time/week 40 min/day exercise training during the 1-year follow-up, subjects were divided into five groups for analysis: aerobic adherers, aerobic nonadherers, resistance adherers, resistance nonadherers, and no exercise.

No significant differences were observed between the aerobic training and resistance training adherers for any variable. However, the aerobic (3.1 kg) and resistance (3.9 kg) exercise adherers gained less weight than any of the other three groups (all >6.2 kg).

In addition, the two exercise adherence groups did not significantly increase visceral fat (<0.8%) as compared with the 38% increase for the two nonadhering exercise groups and the 25% for the nonexercise group.

In Conclusion:

 As little as 80 min/week aerobic or resistance training had modest positive effects on preventing weight regain following a diet-induced weight loss. More importantly, both aerobic and resistance training prevented regain of potentially harmful visceral fat.

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I have been a  believer of this fact… that relying heavily on physical activity alone to help one lose weight is doomed to fail.  One needs to brisk walk for example around 70 minutes to burn 250 calories while eating french fries in a 5 minute snack time will already give you 320 calories!!!!

The above study points out the balance between cutting calories and physical activity.  The mere 80min per week exercise resulted in the prevention of weight regain after a diet induced weight loss … especially the prevention of the regain of the visceral fat which is considered the Bad fat!

Now that is definitely not difficult to do!!!!  How much more if we do physical activity on a daily basis?  Once you get used to it…you’re hooked. 

An example of being hooked: Just last night for example, I have to be in a symposium to give a lecture to cardiologists…but I really squeezed in at least a 20 min run prior to preparing for my talk…boy was it exhilirating to have sweat it out and boy was it refreshing afterwards!

No more excuses….

A little of something is better than Nothing….

Weight Loss and Health….

November 6, 2009

Now the good news….

The main reason for my weight loss through lifestyle change is my aim to reduce my risk to develop diabetes in the future.  After a scary 96 mg/dl fasting blood sugar during my annual executive checkup, I pushed myself to achieve my ideal BMI becuase apparently I was overweight.

Now as published in Lancet this October 29, 2009, the long term Diabetes Prevention Program extended study showed long term benefits of modest weight loss through lifestyle as better in preventing the progression of the disease compared to intake of medication called Metformin. 

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Background

In the 2·8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term.

Methods

All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5·7 years (IQR 5·5—5·8). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov, number NCT00038727.

Findings

During the 10·0-year (IQR 9·0—10·5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 4·8 cases per 100 person-years (95% CI 4·1—5·7) in the intensive lifestyle intervention group, 7·8 (6·8—8·8) in the metformin group, and 11·0 (9·8—12·3) in the placebo group. Diabetes incidence rates in this follow-up study were similar between treatment groups: 5·9 per 100 person-years (5·1—6·8) for lifestyle, 4·9 (4·2—5·7) for metformin, and 5·6 (4·8—6·5) for placebo. Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24—42) in the lifestyle group and 18% (7—28) in the metformin group compared with placebo.

Interpretation

During follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group. Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years.

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The study clearly shows that weight loss through lifestyle changes can significantly reduce ones risk to develop diabetes by as much as 34%. 

The Intensive lifestyle changes in the study consisted of lowering fat and calories in the diet and increasing regular physical activity to 150 minutes per week.  Most exercise was in a form of walking.  Modest weight loss was around 15 lbs in the first year but overtime regained them all but 5 lbs over the next 10 years.  I guess this shows that lifestyle really is difficult for some to maintain.

What matters most for this study is that lifestyle change through fitness and nutrition really works.  The only problem is how one can maintain to be active throughout ones life and how one can withstand the sight of FOOOOD!!!! 

For me….Its a matter of discipline and focus… The two main ingredients to achieving success through behavioral modification.  Clinically, the measure of success is when one is able to maintain the weight loss beyond 1 year of intervention.  Losing weight in 6 months is good…but gaining them back in the next 6 months is bad…..

The Facts are here… the Benefits are known… The rest now depends on YOU!

High Protein Diet and Alzheimers’ Dsiease: Is There a Link?

October 27, 2009

Go to fullsize imageThe famous FAD diet fo the century is the Atkins or High Protein diets.  Short term weight loss made these diets so popular that even the medical community has to take a second look.

One new possible side effect of  this FAD-  high protein diet is believed to be neurotoxicity that can possibly lead to premature aging or alzheimers disease. 

In a recent study published in Molecular Neurodegeneration, 2009, 4:40 (21 October 2009), animal studies involving mice that were fed with this kind of diet resulted in having brains that apprently shrank.  This clinically may therefore be relevant to the onset of forgetfulness in the long run to humans.

This study is experimental but may be a signal to further develop a prospective study to elucidate the important effects of a high protein diet in the brain on humans.  Whether this is true to any age group or not remains to be seen.

In my practice, I maybe a maverick in terms of  prescribing a specific diet plan for my pateints BUT ive always been against any FAD diets which I know will only result in short term results rather than long term outcomes.

Better Still… Be Well by Eating Right!

How To Eat and Live Longer….

September 3, 2009

People have been looking for the miracle pill to live longer.  Cosmetic surgeries are on the rise because of vanity and the desire to feel and look young. Healthy lifestyle through proper food choices have always been advocated by different medical societies as the way to go BUT finding the right choices of food and the most practical activities to do remain elusive to most.

The so called Mediterranean diet has long been touted as having shown to have the most healthy components in terms of food choices.  Recently in a population based study done in Greece published in British Medical Journal, June, 2009, Mediterranean diet appeared to contribute to increased longetivity.

After a mean follow-up of 8.5 years, there were more deaths among individuals who were on low Mediterranean diet components than among individuals whose diet components were high of the Mediterranean-diet.  Furthermore, the study was able to teased out the contribution of each component to low mortality:

  • moderate consumption of alcohol (23.5% of the effect),
  •  low consumption of meat (16.6%),
  • high consumption of vegetables (16.2%),
  • high consumption of fruits and nuts (11.2%),
  • high monounsaturated-to-saturated lipid ratio (10.6%), and
  • high consumption of legumes (9.7%).

The study suggested therefore that the largest effects on reduced mortality came from drinking moderate amounts of alcohol equivalent to five small glasses of wine (10 g/day to less than 50 g/day) for men and half that for women as well as eating little meat while eating lots of vegetables, eating fruits and nuts, and using olive oil.  It is however very important to note that the individual components of the Mediterranean diet gave an additive protective effect to the overall mortality.  The study suggests that it is still the overall dietary habit that will determine whether your diet is healthy and can lead to longer life than just relying on the health benefits of an individual diet component.

So change to a healthier lifestyle with five servings of vegetables, three to four servings of fruits, nuts a day, lots of vegetables, less meat and moderate amount of the so called French Paradox: Wine

Toast To A Long Life!!!

Walk and Jog or The WOG… A Perfect Exercise!!!

July 7, 2009

Since the time Ive lost weight, Ive been apporached several times by my friends how I did it.  Ive posted in thia website my diet regimen…now I am posting my exercise routine.  To lose weight…the right food and the right discipline are both essential.  To maintain your weight, then the right kind of exercise that you feel good and you can do for years should be the best way to increase your metabolic rate!

Can we call it the WOG?  Short for Walk and Jog!!!

Ive been a brisk walker for sometime.  I find it a good exercise that’s not too tiring nor too destructive for my joints.  But overtime, after several articles touting the benefits of short bouts of exercise in between breaks that I thought of trying to alternate my walking exercise with jogging.

The intensity of exercise is more…the surge of adrenaline is more and boy…you feel better and better everytime you do the routine.  Lots and lots of sweat too!  Besides, you allow you body to rest in between the jogging by brisk walking.

Jogging being a high-intensity exercise kicks your metabolism up and by doing so,  your metabolic rate stays up longer (five times longer after a vigorous workout than after an easy one).   By doing the same routine, one therefore tends to add up the number of calories burned because the jogging can easily add up another 200 calories compared to walking alone.

Here’s what I do:

Before I walk, warming up by stretching the muscles is very important.  Then I start my brisk walking slowly increasing the pace  until I start jogging. 

 I then do the alternate walk and jog routine every 3 minutes until 40 to 40 minutes!!!!  

Initially it may seem “laborious” compared to walking alone but soon…you will be running a marathon as the running becomes easier.  But at this time, I have no plans to pursue a running career!  I just want to burn more calories and make myself healthier and hopefully avoid myself getting the risk of developing diabetes!

To stay Fit and Slim…Discipline is the KEY!

You are What You Eat and Do the WOG!

How To Lower Cholesterol Levels Naturally

June 3, 2009

Here’s one interesting article from the Harvard Health Publications HealthBeat on ways we can do to lower cholesterol naturally without meds:

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15 tips for lowering your cholesterol naturally

Many factors contribute to the development of heart disease or stroke. Genes and gender play a role, but for most of us, what we eat is an important factor as well. The good news is that a few small changes to your diet can help lower your cholesterol, which in turn will lower your risk for heart disease and stroke. Here are 15 heart-healthy eating tips to help you in the fight against high cholesterol.

1. Eat meat sparingly. Relegate meat to a minor part of your diet instead of making it the centerpiece of most meals. Trim off fat and skin from meats and poultry. Avoid fatty cuts of beef, pork, and lamb; instead choose lean meats, or substitute fish or skinless white-meat poultry. When dining out, choose a smaller portion of meat, or meatless pasta or fish dishes.

2. Opt for low-fat dairy products. Avoid dairy foods that contain whole milk or cream; instead, use low-fat or nonfat versions.

3. Watch the snacks. Choose low-fat snacks (homemade popcorn, carrots, dried fruits, or fresh fruits) instead of high-fat ones (potato chips and candy bars). Avoid store-bought bakery products unless they are explicitly low in saturated fats and free of trans fats.

4. Cut down on saturated fat in cooking. Use liquid cooking oils rather than butter or margarine. Use nonstick pans. Instead of frying your food, bake, broil, roast, steam, or stew. Discard drippings, and baste with wine or broth.

5. Avoid palm and coconut oils. Most vegetable oils are unsaturated, but these two contain mostly saturated fat. Choose canola, sunflower, safflower, corn, soybean, olive, and peanut oils.

6. Reduce dietary cholesterol. Strive to eat less than 200 mg of dietary cholesterol a day. Limit eggs to no more than four egg yolks per week; two egg whites can replace a whole egg in most recipes. Limit lean meat, fish, and poultry to no more than 6 ounces per day (a 3-ounce portion is about the size of a deck of playing cards). Stay away from cholesterol-rich organ meats, such as liver, brains, and kidneys.

7.  Increase complex carbohydrates and fiber. Emphasize foods with complex carbohydrates—such as fruits and vegetables, whole-grain products, and legumes (dried beans and peas)—that are low in calories and high in fiber. Eat more water-soluble fiber, such as that found in oat bran and fruits. This type of fiber can significantly lower your blood cholesterol level when eaten in conjunction with a low-fat diet.

8. Eat fruits and vegetables. To protect your heart, eat plenty of fruits and vegetables.

9. Go for nuts. Nuts are associated with a lower risk of heart disease. They’re a healthful and filling source of protein, but go easy on them; they have lots of calories, so too much could cause weight gain.

10. Add fish to your diet. Countries with high fish consumption have a lower risk of death from all causes as well as from cardiovascular disease. Like nuts, oily fish contain the essential fatty acids known as omega-3s and omega-6s. Since our bodies can’t make these, we have to eat foods that contain them to gain their benefits, which include improved cholesterol levels.

11. Reduce salt intake. High blood pressure is a major risk factor for cardiovascular disease. Diets high in salt increase risk of hypertension.

12. Avoid trans fats. According to the Institute of Medicine’s Food and Nutrition Board, there are no redeeming qualities to trans fats, and no safe levels. They raise LDL cholesterol and lower HDL cholesterol. The National Cholesterol Education Program urges people to eat as little as possible. Avoid or eat only very small quantities of foods that list hydrogenated oil or partially hydrogenated oil among their first ingredients. These products contain a lot of trans fat.

13. Drink alcohol only in moderation. Regular, moderate drinking can reduce the risk of cardiovascular disease, but heavy drinking negates the benefits. Moreover, the advantages aren’t strong enough to recommend alcohol for anyone who doesn’t already drink. For those who do, the Dietary Guidelines for Americans recommend no more than one drink a day for women, and one or two drinks a day for men.

14. Read labels carefully. Avoid prepared foods that list any of the following among the first few ingredients: meat fat, coconut or palm oil, cream, butter, egg or yolk solids, whole milk solids, lard, cocoa butter, chocolate or imitation chocolate, or hydrogenated or partially hydrogenated fat or oil. Watch out for fast foods and other unlabeled products; when you don’t know what you’re getting, eat sparingly.

15. Change strategies. If three months of healthy eating doesn’t bring your total and LDL cholesterol levels into the desired range, consult your physician and a dietitian. If the numbers still don’t budge after six months, it may be time to consider medication.

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Simple measures we can at home to avoid getting th compications associated with a high cholestrol level in the blood.  High cholesterol levels have been shown to increase ones risk to suffer from stroke and heart attack. 

The good news is , we now have ways to control and lower the cholestrol levels by taking care of what we eat and through medications.

Be Health Smart and Check the Labels!

Meat Is Not NEAT!

April 7, 2009

Go to fullsize imageIt is easier to convince a child to eat meat than to eat veggies.  This scenario is given.  We are exposed to too many ads on meat whether chicken meat or beef meat on TV and newspapers.  It is therefore a challenge to parents to introduce other varieties of food that we deem healthier to the next generation.  It may take us some time to be successful but a little step can indeed go a long way overtime!

Now comes another study to support the concept that meat is really not neat!  Published in the latest edition of  Archives of Internal Medicine:

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Background  High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.

Methods  The study population included the National Institutes of Health–AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.

Results  There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up.

  • Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality.
  • Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes.
  • Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes.
  • When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.

Conclusion  Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.

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This study further confirms the relationship between red meat and cancer, heart and overall risk of death.  Likewise, the study also showed that fish or intake of white meat was associated with a reduction in the risk of death.

Translating the data to common language…it means…

Over 10 years, those that eat meat equivalent to a quarter-pound hamburger can increase ones risk to die from cancer by 22 percent and the risk to die from heart disease by 27 percent. 

Bottom Line is:

Cut The Red Meat… Enjoy Fish in time for the Lenten Season….

Can I Eat Eggs Everyday? Yes You Can!!!!

March 28, 2009

New studies have been made to refute the previous claims that eggs can increase ones cholesterol. 

A recent article published in the International Journal of Obesity showed that the previous notion of limiting eggs because they can increase cholesterol is no longer an acceptable fear.  In fact eggs can help one lose weight!

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Objective:

 To test the hypotheses that an egg breakfast, in contrast to a bagel breakfast matched for energy density and total energy, would enhance weight loss in overweight and obese participants while on a reduced-calorie weight loss diet.

Design:

Otherwise healthy overweight or obese participants were assigned to Egg (E), Egg Diet (ED), Bagel (B) or Bagel Diet (BD) groups, based on the prescription of either an egg breakfast containing two eggs (340 kcal) or a breakfast containing bagels matched for energy density and total energy, for at least 5 days per week, respectively. The ED and BD groups were suggested a 1000 kcal energy-deficit low-fat diet, whereas the B and E groups were asked not to change their energy intake.

Results:

After 8 weeks, in comparison to the BD group,

  • the ED group showed a 61% greater reduction in BMI,
  • a 65% greater weight loss ,
  • a 34% greater reduction in waist circumference (P<0.06) and
  • a 16% greater reduction in percent body fat (P=not significant).
  • No significant differences between the E and B groups on the aforementioned variables were obtained.
  • Further, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, did not differ between the groups.

Conclusions:

  The egg breakfast enhances weight loss, when combined with an energy-deficit diet, but does not induce weight loss in a free-living condition. The inclusion of eggs in a weight management program may offer a nutritious supplement to enhance weight loss.
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It is however to be emphasized that in this study, the egg diet was part of a calorie restircted diet suggesting that eating eggs as part of a low calorie diet can help one lose weight.  
  • But the added bonus of the study is the fact that eggs did not have any effect on the blood cholesterol level suggesting that it is really the intake of Saturated fat in the diet found in pastries, cakes and cookies that is harmful to the body!
  • The results of the study  were further confirmed in a similar finding from the University of Surrey research group which showed a similar no effect on cholesterol level with intake of 2 eggs per day for 6 to 8 weeks.
Hopefully…these two studies can now end the debate as to whether eggs are safe to eat or not.  Enjoy!!!!!

How Safe Are Artificial Sweeteners….

March 25, 2009

One topic that has never died down during these years is the safety of artifical sweteeners.  The problem stems from internet messages and information being propagated by unknown sources regarding the dangers of these products.  As an endocrinologist, I have been recommending these sweeteners to my patients as they actually help stave off the craving for sugar without necessarily increasing the sugar load.

But how much is enough for these sweeteners?

Recently the Mayo Clinic organization published views on this controversy and recommendations.

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The Food and Drug Administration (FDA) has approved the following low-calorie sweeteners for use in a variety of foods. The FDA has established an “acceptable daily intake” (ADI) for each sweetener. This is the maximum amount considered safe to eat each day during your lifetime. ADIs are intended to be about 100 times less than the smallest amount that might cause health concerns.

Artificial sweetener ADI* Estimated ADI equivalent** OK for cooking?
Aspartame (NutraSweet, Equal) 50 milligrams (mg) per kilogram (kg) 18 to 19 cans of diet cola No
Saccharin (Sweet’N Low, SugarTwin) 5 mg per kg 9 to 12 packets of sweetener Yes
Acesulfame K (Sunett, Sweet One) 15 mg per kg 30 to 32 cans of diet lemon-lime soda*** Yes
Sucralose (Splenda) 5 mg per kg 6 cans of diet cola*** Yes

*FDA-established acceptable daily intake (ADI) limit per kilogram (2.2 pounds) of body weight.
**Product-consumption equivalent for a person weighing 150 pounds (68 kilograms).
***These products usually contain more than one type of sweetener.

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How about the safety of these products?

Although this is one product has been bombarded with bad publicity probably because of its popularity being present in almost any low calorie foods to diet sodas… the National Cancer Institute and other major health oragnizations including the American Diabetes Association and the US FDA continue to refute these claims… as so far,  there’s no scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer and that there are now numerous studies to confirm that artificial sweeteners are safe for the general population.

I for one contnue to use aspartame or splenda for my coffee eevry morning or in the afternoon. I am a user and a believer in these low calorie sweeteners that as long as used properly and not in excess of what is recommended…then it is safe!

Enjoy The Sweetness of Health!

Is There Any Benefit in Taking A Multivitamin?

February 12, 2009

Go to fullsize imageI used to take one multivitamin pill per day.  I know of others who take tons of vitamins because they make them feel “better”. Or just a habit difficult to change. Or better still, relatives in the US send us with big bottles of these Vitamins as presents.  But are they USEFUL? 

Ever since, I already doubted the usefullness of these vitamins UNLESS one is not eating properly or is very choosy with food that predisposes one to deficiency of certain vitamins that we usually get from food.  But for people that have problems of the Opposite, that is… controlling the intake, I suggest you might as well spend your money on something else that’s healthy and has important benefit on ones health.

The latest issue of the Archives onf Internal Medicine published this recent study looking at the effectiveness of taking multivitamins.

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Background  Millions of postmenopausal women use multivitamins, often believing that supplements prevent chronic diseases such as cancer and cardiovascular disease (CVD). Therefore, we decided to examine associations between multivitamin use and risk of cancer, CVD, and mortality in postmenopausal women.

Methods  The study included 161 808 participants from the Women’s Health Initiative clinical trials (N = 68 132 in 3 overlapping trials of hormone therapy, dietary modification, and calcium and vitamin D supplements) or an observational study (N = 93 676). Detailed data were collected on multivitamin use at baseline and follow-up time points. Study enrollment occurred between 1993 and 1998; the women were followed up for a median of 8.0 years in the clinical trials and 7.9 years in the observational study. Disease end points were collected through 2005.

We documented cancers of the breast (invasive), colon/rectum, endometrium, kidney, bladder, stomach, ovary, and lung; CVD (myocardial infarction, stroke, and venous thromboembolism); and total mortality.

Results  A total of 41.5% of the participants used multivitamins. After a median of 8.0 years of follow-up in the clinical trial cohort and 7.9 years in the observational study cohort, 9619 cases of breast, colorectal, endometrial, renal, bladder, stomach, lung, or ovarian cancer; 8751 CVD events; and 9865 deaths were reported. Multivariate-adjusted analyses revealed no association of multivitamin use with risk of cancer (hazard ratio [HR], 0.98, and 95% confidence interval [CI], 0.91-1.05 for breast cancer; HR, 0.99, and 95% CI, 0.88-1.11 for colorectal cancer; HR, 1.05, and 95% CI, 0.90-1.21 for endometrial cancer; HR, 1.0, and 95% CI, 0.88-1.13 for lung cancer; and HR, 1.07, and 95% CI, 0.88-1.29 for ovarian cancer); CVD (HR, 0.96, and 95% CI, 0.89-1.03 for myocardial infarction; HR, 0.99, and 95% CI, 0.91-1.07 for stroke; and HR, 1.05, and 95% CI, 0.85-1.29 for venous thromboembolism); or mortality (HR, 1.02, and 95% CI, 0.97-1.07).

Conclusion  After a median follow-up of 8.0 and 7.9 years in the clinical trial and observational study cohorts, respectively, the Women’s Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women.

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In short … wanna live long?  Live a healthy lifestyle.  There are other ways to better living not simple taking of pills as a shortcut or better still … lets take a walk and think again.

Pills or exercise?  I know your answers…keep it to yourselves.  You choose … it’s your life!