Archive for the 'Nutrition Health Tips' Category

Tips For The Holidays…..

December 23, 2008

The Christmas holiday spirit is just around the corner and everyone is now busy preparing for reunions with family and friends.  And what better way to prepare the celebration is to have a feast!  What is Christmas anyway without the parties?  The bulge and the extra fat that we get after these merry making activities is what makes us feel guilty enough to make us vow to do better on our Annual New Year’s resolutions.

So how can one avoid gaining weight during the holidays? Common sense advise is to keep in mind to always keep track of the calories we take in. But most of all, in situations where food is in abundance in the buffet table…my advise is to enjoy the foods that are nutrient rich but modestly high in protein (20 to 25% of the total calories) and low in carbohydrates (40% to 45% of total calories).

The fad of low carbohydrate and high protein diet has put protein at the center stage.  Since the Atkins Diet and the South Beach diet came into our attention, a lot of controversies has been made because of the absence of long term studies to document their efficacy and safety.  Recent data however have shown that a moderate intake of protein is not only efficacious in making one lose weight but also in improving blood sugar and cholesterol.

Protein intake is important to our body. If we don’t get enough protein- it can lead to growth failure, loss of muscle mass, a reduction in heart and lung function as well as impairment in ones immunity.  However, too much protein can also cause harm.  It can take a lot of calcium from the bone and can lead to fractures. Likewise, people with kidney disease should be warned about a high protein diet since it can further exacerbate the kidney problem.

Let me give you some tips on how to enjoy the benefits of a modestly high protein diet SAFELY….

Remember…different protein sources give different effects on our health.  Proteins coming from vegetables definitely are healthier because they are devoid of fat than those coming from meat. A steak and a salmon may have the same amount of protein but the saturated fat in beef is more than half that of the fish. It is the FAT that can cause harm and can lead to chronic disabling conditions like heart attack and stroke! 

Here are some Tips in Choosing Your Protein Sources wisely:

1. If you are a meat lover then get the lean cuts of beef or pork.  However a healthier alternative would be the white meat of fish and chicken breast.

2. A better option for a healthier protein source would be from vegetable sources like nuts, lentils, beans and whole grain.

3. For your daily protein needs, get them from different sources…mix and match for variety!

4. Soy based foods are also good alternatives to red meat but limit to 2 to 3 servings a week.

Lastly… simple lifestyle measures that you can observe during parties or in preparation for the holiday parties that can matter most in avoiding weight gain:

1.     Always eat breakfast everyday of your life.  If you haven’t done so regularly…do it now!  Avoid skipping meals as this habit can cause more weight gain!

2.     Begin your meals with soup or salad to lessen your cravings for the sinful fat filled dishes on the buffet table.

3.     Try to eat slowly by chewing your food thoroughly so your body will have time to analyze that you are already full.

4.     Once full then stop and walk away from the sight of food.  This habit will make you avoid getting more food even if you are no longer hungry!

5.     Use a smaller plate so it will look full with only a small amount of food.  

A nutrient rich meal that has a modest increase in protein content and a modest restriction of carbohydrates coupled with simple practical lifestyle measures can go along way in helping us avoid the holiday bulge!

Advertisements

How to EAT and Lose Weight….

October 27, 2008

Go to fullsize imageMy previous posts have always been toward trying to help people lose weight.  I am one person following my own theories and they worked and are working up to now.  Here are the no-nonsense tips that I follow DAILY: 

If you want to lose weight…

  • EAT,  But stop when you feel you’re already FULL and Leave the table at once. 
  • CHEW your food properly so it will take time for you to finish a meal and by the time you’re halfway through…you’re FULL! 
  • Avoid the visual stimulation of food… the longer you stay in the table, the more likely you’ll eat more!

Then of course… you MOVE!

A recent article publsihed in the British Medical Journal confirms these basic prinicples:

_____________________________________________________________________________________________________

Participants 3287 adults (1122 men, 2165 women) aged 30-69 who participated in surveys on cardiovascular risk from 2003 to 2006.

Main outcome measures Body mass index (overweight 25.0) and the dietary habits of eating until full (lifestyle questionnaire) and speed of eating (validated brief self administered questionnaire).

Results 571 (50.9%) men and 1265 (58.4%) women self reported eating until full, and 523 (45.6%) men and 785 (36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 (95% confidence interval 1.53 to 2.62) for men and 1.92 (1.53 to 2.40) for women and for eating quickly was 1.84 (1.42 to 2.38) for men and 2.09 (1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 (2.20 to 4.45) for men and 3.21 (2.41 to 4.29) for women.

Conclusion Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

___________________________________________________________________________________________________________________ There you go…Simple tips and simple measures that will surely WORK for ALL!

The Many Benefits of Broccoli…

October 16, 2008

Go to fullsize imageI am a fan of Brocolli.  I thought of making broccoli the star of today’s post and thought of what ways can this veggie benefit us all.

A recent study done in University of Warwick published in the Journal Diabetes showed some interesting findings that made me realize how lucky am I to enjoy Broccoli.  The study looked at a compound present in broccoli that has the potential to help prevent complications of diabetes.

__________________________________________________________________________________________________

RESEARCH DESIGN AND METHODS–: Human microvascular HMEC-1 endothelial cells were incubated in low and high glucose concentrations (5 and 30 mM) and activation of nrf2 assessed by nuclear translocation. The effect of SFN on multiple pathways of biochemical dysfunction, increased reactive oxygen species (ROS) formation, hexosamine pathway, protein kinase C pathway and increased formation of methylglyoxal, was assessed.

RESULTS–: Activation of nrf2 by SFN induced nuclear translocation of nrf2 and increased ARE-linked gene expression. For example, 3 – 5 fold increased expression of transketolase and glutathione reductase. Hyperglycemia increased the formation of ROS – an effect linked to mitochondrial dysfunction and prevented by SFN. ROS formation was increased further by knockdown of nrf2 and transketolase expression. This also abolished the counteracting effect of SFN, suggesting mediation by nrf2 and related increase of transketolase expression. SFN also prevented hyperglycemia-induced activation of the hexosamine and protein kinase C pathways, and prevented increased cellular accumulation and excretion of the glycating agent, methylglyoxal.

CONCLUSION–: We conclude that activation of nrf2 may prevent biochemical dysfunction and related functional responses of endothelial cells induced by hyperglycemia in which increased expression of transketolase has a pivotal role.

__________________________________________________________________________________________________________________

This study is particularly interesting because it is known that patients with diabetes are at higher risk to develop complications especially heart disease.  And from previous studies, it has also been shown that eating vegetables like broccoli was significantly linked to reduced heart disease.  The relationship stems from the finding that damage to blood vessels is due to an increased levels of reactive oxygen species (ROS) in the presence of high sugar.  The recent study has confirmed that the substance Sulforaphane present in Broccoli can indeed prevent damage brought about by these ROS with high sugar level. 

Sulforaphane substance present in abundance in broccoli was able to reduce ROS level by 73% and likewise results in activation of an gene regulator in the cells that resulted in the increase of antioxidant compounds. Great news!!! Great findings!!!

But does this mean lets all eat broccoli? We have to wait for studies that will look at end result.  But whatever it is…we know veggies are healthy food, broccoli for one has the potential to be a “star” vegetable due to its touted many benefits including prevention of cancer, cataracts Plus this new finding which am sure will make my diabetic patients crave for more broccoli.

Eat Veggies…Eat Broccoli… for Health!

Recommended Foods If You ARe AT Risk Of Diabetes?

September 24, 2008

Go to fullsize imageI am one of those at risk to develop Diabetes.  I am the youngest of 9 siblings and am sure my mom was already a diabetic by the time I was born.  In short I have the genetic makeup to have one and it now depends on the environment …how I can modify the risk factors… that will determine if indeed I will develop this disease or not.

So when my latest Fasting blood sugar reached 96 mg/dl… I was laready alarmed.  Remember from my previous posts that individuals with a normal fasting blood sugar between 89 to 99 mg/dl have the highest risk to become diabetic in the next few years.  So the first thing I did was to change the way I eat…modify my lifestyle in terms of preference of food and settled in to more fruits and vegetables PLUS brisk walking almost everyday. I have already lost at least 14 pounds and I have reached a normal BMI of 22 …YAHOOO:)

Now comes a new study publsihed this September 2008 in Diabetes Care:

____________________________________________________________________________________________

Subjetcs: White, black, Hispanic, and Chinese adults, aged 45–84 years and free of cardiovascular disease and diabetes, completed food frequency questionnaires at baseline (2000–2002). Incident type 2 diabetes was defined at three follow-up exams (2002–2003, 2004–2005, and 2005–2007) as fasting glucose >126 mg/dl, self-reported type 2 diabetes, or use of diabetes medication.
Two types of dietary patterns were studied: four empirically derived (principal components analysis) and one author-defined (low-risk food pattern) as the weighted sum of whole grains, vegetables, nuts/seeds, low-fat dairy, coffee (positively weighted), red meat, processed meat, high-fat dairy, and soda (negatively weighted).
RESULTS

  • High intake of tomatoes, beans, refined grains, high-fat dairy, and red meat was associated with an 18% greater risk :95% CI 1.06–1.32]
  •  High intake of whole grains, fruit, nuts/seeds, green leafy vegetables, and low-fat dairy was associated with a 15% lower diabetes risk (0.85 [0.76–0.95]; P = 0.005).
  • The low-risk food pattern was also inversely associated with diabetes risk (0.87 [0.81–0.99]
  • Individual component food groups were not independently associated with diabetes risk.
  • Associations were not modified by sex or race/ethnicity.

CONCLUSIONS—Multiple food groups collectively influence type 2 diabetes risk beyond that of the individual food groups themselves.

____________________________________________________________________________________________

Beans and tomatoes are nutrient-rich foods so I thought they should be part of a healthy meal?  But the most likely reason why intake of tomatoes and beans are linked to a higher risk of diabetes is the fact that in the study group, their intake was associated with intake of less healthy meals from pizza parlors or burger junctions as well as cheese and tacos

The study specifically also points out that in terms of health benefits and effects of foods, one should focus more on the importance of the whole diet rather than on certain foods or food groups that might be beneficial to us.

So…I guess am doing well with my lifestyle change because I am eating foods now proven to help me lower my risk and am enjoying eating them.

Again By Eating Right … We Should Live Well!

 

How To Reduce Your Risk To Develop DIABETES….

September 1, 2008

If you have a family history of diabetes, if you are overweight and sedentary  and wants to reduce your risk to develop diabetes, then this article is for you!

This new study was recently published in the Archives of Internal Medicine and as far as I know is the first one that conclusively looked at how fruits and vegtables can alter the risk of a patient to develop this chronic disease called diabetes.

_________________________________________________________________________________________

Methods  We administered a semiquantitative food frequency questionnaire to men and women from a population-based prospective cohort (European Prospective Investigation of Cancer–Norfolk) study who were aged 40 to 75 years at baseline (1993-1997) when plasma vitamin C level was determined and habitual intake of fruit and vegetables was assessed. During 12 years of follow-up between February 1993 and the end of December 2005, 735 clinically incident cases of diabetes were identified among 21 831 healthy individuals. We report the odds ratios of diabetes associated with sex-specific quintiles of fruit and vegetable intake and of plasma vitamin C levels.

Results 

  • A strong inverse association was found between plasma vitamin C level and diabetes risk.
  • The odds ratio of diabetes in the top quintile of plasma vitamin C was 0.38 (95% confidence interval, 0.28-0.52) in a model adjusted for demographic, lifestyle, and anthropometric variables.
  • In a similarly adjusted model, the odds ratio of diabetes in the top quintile of fruit and vegetable consumption was 0.78 (95% confidence interval, 0.60-1.00).

Conclusions  Higher plasma vitamin C level and, to a lesser degree, fruit and vegetable intake were associated with a substantially decreased risk of diabetes. Our findings highlight a potentially important public health message on the benefits of a diet rich in fruit and vegetables for the prevention of diabetes.

________________________________________________________________________________________

A word of caution from this study is that the plasma Vitamin C level correlated with the intake of fruits and vegetables and NOT Vitamin C Supplements.  Therefore do not grab all the Vitamin C supplements in the shelves to boost up your levels.  It is believed that beyond Vitamin C, there are properties in fruits and vegetables that help patients reduce their risk to develop diabetes.

As fas a I know, this is the first conclusive evidence that looked objectively at the effect of fruit and vegetable intake and the risk of diabetes.  And a reduction of diabetes risk by 62% is a great bonus to those who love fruits and vegetables on top of the other benefits associated with their intake.

So Eat Vegetables everyday and every meal… take fruits after each meal and you can even enjoy an apple or pear for snacks. Chances are… the more you eat the better the risk reduction.  Again…go for the low glycemic index fruits like apple and pear instead of a mango, banana or pineapple!

Love Yourself By Eating Right!

Vitamin D and The Risk of Death….

August 22, 2008

While reviewing my journals…I again came across another study on Vitamin D but this time relating this vitamin to mortality or the risk of death in the general population.  This study was published in the Archives of Internal Medicine, August 15, 2008 issue.

_______________________________________________________________________________________

Background  In patients undergoing dialysis, therapy with calcitriol or paricalcitol or other vitamin D agents is associated with reduced mortality. Observational data suggests that low 25-hydroxyvitamin D levels (25[OH]D) are associated with diabetes mellitus, hypertension, and cancers. However, whether low serum 25(OH)D levels are associated with mortality in the general population is unknown.

Methods  We tested the association of low 25(OH)D levels with all-cause, cancer, and cardiovascular disease (CVD) mortality in 13 331 nationally representative adults 20 years or older from the Third National Health and Nutrition Examination Survey (NHANES III) linked mortality files. Participant vitamin D levels were collected from 1988 through 1994, and individuals were passively followed for mortality through 2000.

Results 

  •  In cross-sectional multivariate analyses, increasing age, female sex, nonwhite race/ethnicity, diabetes, current smoking, and higher body mass index were all independently associated with higher odds of 25(OH)D deficiency (lowest quartile of 25(OH)D level, <17.8 ng/mL
  • while greater physical activity, vitamin D supplementation, and nonwinter season were inversely associated.
  • During a median 8.7 years of follow-up, there were 1806 deaths, including 777 from CVD.  compared with the highest quartile, being in the lowest quartile (25[OH]D levels <17.8 ng/mL) was associated with a 26% increased rate of all-cause mortality (mortality rate ratio, 1.26; 95% CI, 1.08-1.46) and a population attributable risk of 3.1%.
  • The adjusted models of CVD and cancer mortality revealed a higher risk, which was not statistically significant.

Conclusion  The lowest quartile of 25(OH)D level (<17.8 ng/mL) is independently associated with all-cause mortality in the general population.

_______________________________________________________________________________________

Another reason for us to check our Vitamin D level.  All along I am right.  I have been a proponent of the wonders of Vitamin D and the perils of what Vitamin D Deficiency can do.

The best way again for us to avoid getting the lowest Vitamin D level is to eat foods rich in Vitamin D and to enjoy the sun as much as we can! The flesh of fish such as salmon, tuna, and mackerel aa well as fish liver oils are among the best sources of Vitamin D that we can get naturally.  I would not recommend supplements if we can avoid them.

Live Long… Enjoy the SUN!

Watermelon Can Boost Your Sexual Function… How True?

August 11, 2008

Go to fullsize imageI saw the news: Watermelon as the Natural Viagra..how true? 

The study where this headline was taken from was published recently in the Journal NUTRITION and really is an eye opener for those who have problems with sexual function.  The question is…will the results translate to actual outcome?

__________________________________________________________________________________________

Methods

Subjects (n = 12–23/treatment) consumed a controlled diet and 0 (control), 780, or 1560 g of watermelon juice per day for 3 wk in a crossover design. The treatments provided 1 and 2 g of citrulline per day. Treatment periods were preceded by washout periods of 2 to 4 wk.

Results

Compared with the baseline, fasting plasma arginine concentrations increased 12% after 3 wk of the lower-dose watermelon treatment; arginine and ornithine concentrations increased 22% and 18%, respectively, after 3 wk of the higher-dose watermelon treatment. Fasting citrulline concentrations did not increase relative to the control but remained stable throughout the study.

Conclusion

The increased fasting plasma concentrations of arginine and ornithine and stable concentrations of plasma citrulline in response to watermelon juice consumption indicated that the citrulline from this plant origin was effectively converted into arginine. These results demonstrate that plasma concentration of arginine can be increased through intake of citrulline from watermelon.

_____________________________________________________________________________ 

The only association with viagra is the fact that watermelon is rich in a substance called citrulline know to have dilating effects on the vessel as the study implies.  This amino acid citrulline is actually converted into arginine which is a precursor for nitric oxide that helps blood vessel dilate!  In theory…it looks good but how about in actual practice?

SO…before we grab all the watermelons in the market, it is very important for us to understand that no study as of now has been done to confirm if indeed intake of watermelon can improve erection!!!!  And likewise nobody knows how much watermelon we need to take to achieve the effect!!!! Probabaly tons of watermelon before enough arginine can be made to cause an effect!

So to say that watermelon is a natural viagra is a doubtful claim. And definitely needs more studies if ever any study will be done.  Remember, arginine deficiency is not the sole cause of erectile dysfunction but rather it is more complicated than that! 

I love watermelon…if indeed it can help me in my other needs…the better!!!! It’s a PLUS!

 

Can Coffee Increase Your Lifespan?

August 4, 2008

I am a coffee drinker.  I usually have a cup of coffee everyday and nothing more.  Except on occasions where I take another cup in the afternoon but usually I average only 5-7 cups per week.  I’ve written about the many benefits of coffee in this website and in the newpapers…and seems like more benefits are being known the more we know about coffee.

Now comes a recently published article on coffee and mortality published in the Annals of Internal Medicine, June of 2008: the official journal of the American College of Physicians.

_______________________________________________________________________________________

Design: to investigate the association between coffee consumption and incidence of all-cause and disease-specific mortality in a prospective cohort study.

Setting: Health Professionals Follow-up Study and Nurses’ Health Study: 41 736 men and 86 214 women with no history of CVD or cancer at baseline.

Results: After adjustment for age, smoking, and other CVD and cancer risk factors, the relative risks for all-cause mortality in men across categories of coffee consumption (<1 cup per month, 1 cup per month to 4 cups per week, 5 to 7 cups per week, 2 to 3 cups per day, 4 to 5 cups per day, and 6 cups per day) were 1.0, 1.07 (95% CI, 0.99 to 1.16), 1.02 (CI, 0.95 to 1.11), 0.97 (CI, 0.89 to 1.05), 0.93 (CI, 0.81 to 1.07), and 0.80 (CI, 0.62 to 1.04), respectively (P for trend = 0.008). For women, the relative risks were 1.0, 0.98 (CI, 0.91 to 1.05), 0.93 (CI, 0.87 to 0.98), 0.82 (CI, 0.77 to 0.87), 0.74 (CI, 0.68 to 0.81), and 0.83 (CI, 0.73 to 0.95), respectively (P for trend < 0.001). This inverse association was mainly due to a moderately reduced risk for CVD mortality and was independent of caffeine intake.

By contrast, coffee consumption was not statistically significantly associated with risk for cancer death after adjustment for potential confounders.

Decaffeinated coffee consumption was associated with a small reduction in all-cause and CVD mortality.

Conclusion: Regular coffee consumption was not associated with an increased mortality rate in either men or women. The possibility of a modest benefit of coffee consumption on all-cause and CVD mortality needs to be further investigated.

___________________________________________________________________________________________________________________________

 

To further summarize the data in layman’s terms:

  • This study shows that increasing consumption of coffee was associated with decreasing mortality or death.  
  • People who drank at least 5 -7 cups of coffee per week had a significantly LOWER overall risk of dying from any cause. 
  • People who drank 4-5 cups per day or more had the strongest protection.

What was interesting also in the study was that among women who were coffee drinkers, most reduction in death was due to a reduction in cardiovascular disease. What I like most in coffee are the studies showing its frequent consumption to result in a reduction albeit small, in the risk of diabetes.

Is Regular better than Decaf?  Well, In the study, whether people drank regular or decaffeinated coffee, benefits were noted, suggesting that the one product present in coffee that results in health benefits maybe its high levels of polyphenols  known to reduce inflammation and also known to provide other positive effects on the heart, blood vessels, and blood sugar.

What more can you ask?

I will continue to enjoy my coffee everyday whatever benefits they give me is already a PLUS!!!!

Why Japanese Men Have Low Heart Disease….

August 1, 2008

Japanese are known to be workaholic.  They ahve been known to work long hours. Many are also smokers BUT why do they have a lower risk of heart disease?

A recent study published in the Journal of American College of Cardiology, August 2008 may have the reasons why….

________________________________________________________________________________________

Methods: A population-based cross-sectional study in 281 Japanese (defined as born and living in Japan), 306 white (defined as white men born and living in the U.S.), and 281 Japanese-American men (defined as Japanese men born and living in the U.S.) ages 40 to 49 years was conducted to assess intima-media thickness (IMT) of the carotid artery, coronary artery calcification (CAC), and serum fatty acids.

Results:

  • Japanese men had the lowest levels of atherosclerosis, whereas whites and Japanese Americans had similar levels.
  • Japanese had 2-fold higher levels of marine-derived n-3 fatty acids than whites and
  • Japanese Americans in the U.S. Japanese had significant and nonsignificant inverse associations of marine-derived n-3 fatty acids with IMT and CAC prevalence, respectively.

Conclusions: Very high levels of marine-derived n-3 fatty acids have antiatherogenic properties that are independent of traditional cardiovascular risk factors and may contribute to lower the burden of atherosclerosis in Japanese, a lower burden that is unlikely the result of genetic factors.

_______________________________________________________________________________________________________

This study further proves why Fish is the healthiest meat to eat. This trully explains why Japanese have a low risk of heart disease because of their lifetime increased intake of fish esepcially salmona dn mackerel which are both rich in omega 3 fatty acids.

I caution those who are buying Omega 3 supplements though because the effects are not proven in terms of the omega 3’s protective effect on the heart with regard to supplements. 

Instead to reap the benefits of Omega 3:

Eat FISH 2-3 x a week!

The Benefits of Eating Apple

July 17, 2008

As I was preparing for the things to bring on my trip to Hawaii thia afternoon, I felt the urge to eat something.  And what I found inside my fridge were 6 apples.  Being the favorite fruit of my second child, I always make sure there are apples for her to eat after each meal.  So there I was, eating on apple with the SKIN and slowly feeling satisfied and full!  Boy, was it nice, and healthy….

So I though of leaving you something nice about apple.

Definitely the saying: “An apple a day keeps doctors away” was true all along as more studies have found out that apples have plenty of vitamins and minerals, as well as phytonutrients especailly the flavonoids called quercetin, which has high antioxidant activity. Likewise apples are high in fiber and potassium, and contain no fat or salt.

The UC Davis Department of Internal Medicine study showed that “not only do apples and apple juice contain a variety of phytonutrients, but that making apples a regular part of the diet may translate into real health benefits”.  Eating apples in that study showed reduced oxidation indicators and a 22-percent increase in dietary fiber.

Other studies have also shown that individuals who regularly incorporated apples into their diet cut their lung cancer risk in half. lower the risk for stroke, reduce the growth of colon cancer and liver cancer cells with just two-thirds of a medium apple!!!!!

Lastly… dont peel the skin when eating apple. It is said that most of the fiber and antioxidants are in the peel.   Contrary to popular belief…laboratories have consistently shown that the skin of apples contain very low levels of pesticides….So they’re SAFE to eat!!!!

There You Go…

An Apple A Day…Saves You More Than A Day!

A Hearty Breakfast Equals Weight Loss?

July 10, 2008

This new study again refutes what has been said about the low carb hype.

We all know the breakfast is an important meal. In this website, I have emphasized that skipping breakfast equals weight gain equals metabolic syndrome. Therefore it is a must that we all have to break the fast to maintain our weight and be healthy.

In the recent convention of the Endocrine Society, one abstract that caught the attention of many was the study comparing the low carb high fat high protein diet versus high carb, high protein low fat diet.

____________________________________________________________________________

The low-carb diet allowed 1,085 calories a day with 17 grams of carbohydrates, 51 grams of protein, and 78 grams of fat. Breakfast for members of this group was to be 290 calories with 7 grams of carbohydrates and 12 grams of protein.
The modified form of this diet allowed 1,240 calories a day with less total fat (46 grams) but more carbs (97 grams) and protein (93 grams). The main feature was a 610-calorie “big breakfast” accounting for about half of the daily carbohydrates (58 grams), protein (47 grams), and fat (22 grams).

During the first 16-week weight-loss phase, the big-breakfast group lost about the same amount of weight as the low-carb group (10.6 kg versus 12.6) with no significant difference between groups.

During the following 16-week maintenance phase, though, the groups’ experience diverged. The big-breakfast group continued losing weight and reached an average 21.3% weight loss by the end of the trial (18.1 kg below baseline).

The low-carb group, on the other hand, regained much of the weight lost to end at just 4.5% below baseline (4.3 kg). The protein- and carbohydrate-heavy breakfast appeared to regulate hunger cues, the researchers said.

Visual analog scale scores after breakfast for the two groups were improved with the big-breakfast diet compared with the low carb diet for the following:

  • Hunger (P=0.018)
  • Feeling of still being able to eat a lot more food (P=0.001)
  • Fullness (P=0.001)
  • Satiety (P=0.07)

The difference in fullness extended beyond lunch and through 11 p.m. (P=0.001).

____________________________________________________________________________

This study suggests that having a heart high carb and high protein breakfast translates to lesser craving for sweets and lesser hunger.  Again as we emphasized in any weight loss counseling, it is not recommended that patients trying to lose weight are on a dietary regimen that makes them feel hungry.

This is one study that I will wait for the final posting in a peer reviewed journal.  It would be nice to see how the study was conducted and see where the flaws could be and whether this can be translated into clinical practice.

For now…

Eat Your Breakfast To Help You Lose Weight!

Dark Chocolate Can Lower Blood Pressure and Cholesterol…

June 17, 2008

Another interesting research and great news for chocolate lovers. 

A new study published in the Journal of Nutrition has shown a beneficial effects of dark chocolate in reducing cholesterol and blood pressure.

________________________________________________________________________________________

This double-blind, placebo-controlled, cross-over study evaluated the efficacy of daily consumption of a cocoa flavanol-containing dark chocolate bar with added PS on serum lipids, blood pressure, and other circulating cardiovascular health markers in a population with elevated serum cholesterol.

Regular consumption of the PS-containing chocolate bar resulted in reductions of 2.0 and 5.3% in serum total and LDL cholesterol (P < 0.05), respectively. Consumption of CF also reduced systolic blood pressure at 8 wk (-5.8 mm Hg; P < 0.05).

Results indicate that regular consumption of chocolate bars containing PS and CF as part of a low-fat diet may support cardiovascular health by lowering cholesterol and improving blood pressure.

________________________________________________________________________________________

In this study the participants utilized the AHA style diet, and were instructed to consume 2 cocoa flavanol-containing dark chocolate bars per day with (1.1 g sterol esters per bar) or without PS.  The participants really had fun because they were asked to consume 1 bar 2 times per day for 4 wk then switched to the other bar for an additional 4 wk. How I wished I can be part of a study like this!!!!

The research is again one of the many studies done so far on dark chocolate that provides intriguing information regarding the role of plant sterols (PS) and cocoa flavanols (CF) in maintaining cardiovascular health.

Remember though, these are dark chocolates supplemented with plant sterols in addition to cocoa flavanols. These are available in both CVS and Walgreens Pharmacy Stores in the US.  Meaning these dark chocolates are not the usual regular dark chocolates available anywhere. 

So Dark Chocolate…Anyone? 

Quick Steps To Achieve Healthy Weight…

June 6, 2008

Go to fullsize imageI came across a well written short article on how to achieve a healthy weight.  The advises sound so simple yet precise and direct to the point of concern.  We tend to disregard simple measures in life and then look for rigorous steps to achieve our goal.  That’s where failure can set in.  Make things simple and Let them work for you….

Here’s the quick 5 steps to a healthy weight from the Harvard Medical Group: The Harvard School of Public Health

__________________________________________________________________________________________________

1. Ban the strange diets. They may work in the short term, but almost any strange, extreme diet is doomed to fail. Your best friends when it comes to losing weight—and keeping it off? Choosing healthy foods and eating smaller portions, slowly.

2. Be more active. If there’s one best weight loss mantra it’s “exercise, exercise, exercise.” Choose activities you enjoy and do them every day. Exercising with a friend can help keep you on track. 

3. Turn off the television. Watching less TV can give you more time to be active—and less time to be enticed by junk food ads. Two easy ways to cut back on TV-watching: take the TV out of your bedroom, and make sure it’s off during meals.

4. Skip the sugary drinks. Drinking sugared soda, fruit drinks, or juice can give you several hundred calories a day without realizing it. Research suggests children and adults who drink soda or other sugary drinks are more likely to gain weight than those who don’t, and that switching from these to water or unsweetened drinks can reduce weight.

5. Think before you eat. Before you mindlessly reach for a snack, pause and ask yourself, Am I really hungry? Is there a healthier choice? It’s easy to lose sight of good food choices in today’s ad-crazy world. Simple questions like these can help keep us on track.

________________________________________________________________________________________________

Simple common sense tips for healthy living as well…

Live Life To The Fullest…By Living Healhty!

The Many Benefits of Mediterranean Diet

June 4, 2008

What is Mediterranean Diet?

The common Mediterranean dietary pattern has these characteristics according to the American Heart Association :

  • high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
  • olive oil is an important monounsaturated fat source
  • dairy products, fish and poultry are consumed in low to moderate amounts, and little red meat is eaten
  • eggs are consumed zero to four times a week
  • wine is consumed in low to moderate amounts

The diet simply put focuses more on our consumption of olive oil, vegetables, fruits, nuts ( my post on Going nuts on Nuts) , cereals, legumes and fish ( my post on the Benefits of Eating fish)  and avoiding the well liked and “unhealthy meat and “saturated fat loaded” dairy products.

The many touted benefits of this diet has long been known in the medical field.  In fact major organizations have patterned their recommended healthy diets on the contents of the mediterranean diet.  Why?  Because… Many epidimeological studies have shown that the incidence of heart disease in Mediterranean countries is lower than in the United States where meat and saturated fat is a plenty!!!!.  In fact in those studies, where people practice the Mediterranean diet, mortality rates or the risk of death were also significantly lower!!!!

In a recent article published in the May 30 online of BMJ, Mediterranean diet has been shown to lower the risk of developing diabetes.  Another PLUS to this otherwise healthy alternative way of eating….

__________________________________________________________________________________________________

Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3). In the fully adjusted analyses the results were similar.

A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis.

Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.

________________________________________________________________________________________________________________-

In this study, during an average of 4 years of follow-up, the researches found that found that people who adhered to a Mediterranean diet very closely had a lower risk of developing type 2 diabetes. and their risk were reduced by 83 percent.

It is however very important to emphasize that major health benefits may not be entirely due to the diet alone.  A healthy diet should always partner with healthy lifestyle including more physical activity.  All these require no shortcut but plain discipline!

A Healthy Diet For More Wealth!

The Wonders of Vitamin D…

May 28, 2008

Vitamin D has been a negelcted Vitamin for several centuries.  People are so mystified by Vitamin E and Vitamin C that almost always every patient that I encounter is either on E or C as vitamin supplements.  But recent data have shown that one Vitamin that stand out among the rest in terms of preventing illnesses is Vitamin D.

A new study that looked at how important Viatmin D in terms of it causing muscle pain was recently published. It looked at how deficiency of Vitamin D may play a big role in causing this chronic complaints among the elderly population. This study published in the American Journal of Geriatrics in May 2008 involved Nine hundred fifty-eight persons (aged ≥65) selected from city registries of Greve and Bagno a Ripoli.

_______________________________________________________________________________________ 

Lower concentrations of 25(OH)D are associated with significant back pain in older women but not men. Because vitamin D deficiency and chronic pain are fairly prevalent in older adults, these findings suggest it may be worthwhile to query older adults about their pain and screen older women with significant back pain for vitamin D deficiency.

_______________________________________________________________________________________

The main function of Vitamin D is in helping maintain a normal calcium level in the blood which is important for bone strength.  It aids in the absorption of calcium from the gut and can provide protection from osteoporosis as well as other chronic illnesses like hypertension (high blood pressure), cancer, and others.

Some health benefits of Vitamin D although will need more studies to fully prove its worth include for:

  •  Diabetes where Vitamin D has been shown to improve insulin sensitivity; 
  •  Colon cancer where a Metaanalysis showed VitaminD supplementation decreased the risk
  •  Multiple Sclerosis
  •  Prostate cancer where a reduction in risk was noted with higher Vitamin D Intake among others….

So how can we get enough Vitamin D?

Exposure to the morning sun for 10 to 15 minutes should provide you enough Vtamin D.  Other food sources include fish like salmon and tuna , egg yolk, cheese, fortified milk including yogurt, and cod liver oil.  It is best to check your Vitamin D level to determine if you are deficient or not.  There are many supplements of Vitamin D available in the market and it is best to discuss which is best for you with your doctor.

Soy Protein and The Heart….

May 26, 2008

Go to fullsize imageThere are many conflicting data on soy protein and the heart especially the claim that they lower cholesterol.  In fact in 1999 based on studies during that time, the US FDA allowed a health claim on food labels stating that a daily diet containing 25 grams of soy protein, also low in saturated fat and cholesterol, may reduce the risk of heart disease. 

However, the American Heart association in January of 2006 made a review of available data and made a conclusion that soy protein in itself did not significantly lower the bad cholestrol nor did it have any significant effect in increasing the good cholesterol.

But as an endocrinologist looking for alternative source of meat protein, the use of soy protein in place of meat which has high staurated fat will continue to play a major role in our attempt to reduce the risk of our patients from cardiovascular disease.

Recently a new article on the benefit of soy protein came out in Annals of Internal Medicine.  This study is so relevant to my practice especially among diabetic patients with kidney disease.  These are the patients we try to avoid taking meat protein because of the possibility of causing kidney function deterioration.  The study did not only show a good effect in sugar control but also markers of inflammation suggesting a potential effect in reducing cardiovascular disease plus improving markers of kidney function.

________________________________________________________________________________________

Soy protein consumption significantly affected cardiovascular risks such as fasting plasma glucose , total cholesterol , LDL cholesterol, and serum triglyceride concentrations.

Serum CRP levels were significantly decreased by soy protein intake compared with those in the control group .

Significant improvements were also seen in proteinuria  and urinary creatinine ( both measures od kidney function) by consumption of soy protein.

CONCLUSIONS—Longitudinal soy protein consumption significantly affected cardiovascular risk factors and kidney-related biomarkers among type 2 diabetic patients with nephropathy.

______________________________________________________________________________________________________

Here is a list of the common sources of soy protein that we can enjoy includes: Tofu, soymilk, soyflour. Tempeh and Miso.  The soymilk and textured soy protein can be used as subsitute for meat or cows milk while the soyflour can be used in baking needs.

I believe in the benefits of soy protein.  I hope for more studies to come that will provide us with more data on its beneifts and potential to reduce disease risk especially the Heart!

Soy Protein: A Better Partner for the Heart!

Foods That Can Make Us Feel FULL….

May 12, 2008

Go to fullsize imageDifferent kinds of food give us different levels of satiety and the feeling of fullness.  You may not have realized it but in one meal, you get easily hungry in less than 2 hours and are wondering why this is so.

It is important for us to remember that the main role of food is solely to satisfy our craving, our hunger and definitely to provide us the needed calories for energy.  But the kind of food we eat will determine if we feel the feeling of satisfaction or not.  This satiety factor therefore will be a factor in making us eat more and therefore provide us with unecessary calories that make us gain weight!

What determines the feeling of fullness include the quantity of food we eat, the actual contents of the food and the texture including the smell.  Signals to the brain from the stomach make us feel satisfied or make us eat more.   

What foods can give us the highest satiety level? 

If your food contains a high level of protein, enough amounts of fiber and water, this food will give you the highest satisfaction rating.  In contrast foods high in fat will make you less satisfied and makes you want to eat more…this be the reason why a high fat diet makes you gain weight!  Intake of protein like a meal that includes fish meat or egg  gives a higher satiety level than carbohydrates.  But carbohydrate rich foods like pasta, rice or bread also provides a high satiety level. 

So to provide one with the highest satiety level of food for a meal… a whole grain bread with leans cuts of meat can provide a better satiety level and longer period of preventing hunger than if one eats a croissant!

The satiety factor of a food like glycemic index is just one of the many factors that affect the way we eat, the way we manage our lifestyle and the way we prevent weight gain. Complex factors come into play including social norms, culture and even mood in deciding whether we feel satisifed and enough food is enough for the meal!

The bottom line is: the higher the satiety factor the lesser we eat!  Likewise…my advise to all: once you feel full…then stop eating especially if you are indulging in a high carbohydrate meal!!!! Sometimes, its the great taste of food even if we are already full that makes us want to eat more. 

Dont be Fooled by Food…Be “Fulled” The Right Way!

Are Eggs Healthy To Eat?

May 1, 2008

One of the top posts in my website is my article on how much eggs can one eat.  The emphasis on eggs as being healthy but laden with cholesterol has made the public very confused.  Now comes a new study published in the American Journal of Nutrition done in Harvard University linking consumption of egg to increased mortality. 

_________________________________________________________________________________________________

Background: A reduction in dietary cholesterol is recommended to prevent cardiovascular disease (CVD). Although eggs are important sources of cholesterol and other nutrients, limited and inconsistent data are available on the effects of egg consumption on the risk of CVD and mortality.

Objective: We aimed to examine the association between egg consumption and the risk of CVD and mortality.

Design: In a prospective cohort study of 21 327 participants from Physicians’ Health Study I, egg consumption was assessed with an abbreviated food questionnaire. Cox regression was used to estimate relative risks.

Results: In an average follow-up of 20 y, 1550 new myocardial infarctions (MIs), 1342 incident strokes, and 5169 deaths occurred.

  • Egg consumption was not associated with incident MI or stroke in a multivariate Cox regression.
  • Adjusted hazard ratios (95% CI) for mortality were 1.0 (reference), 0.94 (0.87, 1.02), 1.03 (0.95, 1.11), 1.05 (0.93, 1.19), and 1.23 (1.11, 1.36) for the consumption of <1, 1, 2–4, 5–6, and 7 eggs/wk, respectively (P for trend < 0.0001).
  • This association was stronger among diabetic subjects, in whom the risk of death in a comparison of the highest with the lowest category of egg consumption was twofold (hazard ratio: 2.01; 95% CI: 1.26, 3.20; P for interaction = 0.09).

Conclusions: Infrequent egg consumption does not seem to influence the risk of CVD in male physicians. In addition, egg consumption was positively related to mortality, more strongly so in diabetic subjects, in the study population.

_________________________________________________________________________________________________________________

The data suggests that the higher the number of eggs consumed, the higher the mortality risk especially among diabetic patients.  This seems interesting because the risk to develop heart disease was not seen among those who are frequent egg eaters suggesting that the risk to die was not associated with heart disease but something else! Nevertheless, looking at prevoius relationships of cholesterol and death, the most likely explanation as assessed in the editorial by Dr Eckel of University of Colorado is still atherosclerotic disease.

The relationship between egg consumption and heart disease continues to be confusing.  This is understandable because now we know that the effect of cholesterol intake in the diet has less effect on the LDL or bad cholesterol in the blood than an intake of saturated fat or trans fat in the diet.  And as we all know, the egg yolk mainly contains cholesterol.

The editorial sums it all up:

So, if you are a male physician and are going to eat 1 egg/d, why not eat the whites only? Just think—with all of the trimmings, that 3-white egg omelet is almost indistinguishable by taste from an omelet enriched with 600 mg cholesterol, and the whites-only omelet also remains a very good source of protein, riboflavin, and selenium. If you cannot do without the yolks, go ahead and enjoy them, but why eat them >3–4 d/wk? If you are a man with diabetes, a more limited egg intake pattern seems prudent. But, remember: eggs are like all other foods—they are neither “good” nor “bad,” and they can be part of an overall heart-healthy diet.

The Dangers of Too Much TEA….

April 24, 2008

One of the highlights of the Mayo Endocrine Course in Mallorca Spain was the Clinical Pearls that we get after a case presentation.  And one of those cases that I found very interesting was a case of  lady who had a bone xray suggestive of a “strong” bone and a bone mass that was suggestive of a “thick ” bone.  She was therefore confident that she won’t fracture because she did not have any osteoporosis based on Xray and Bone mass measurement.

However upon review at the Mayo Clinic her bones were actually not normal.  So further evaluation was done and showed her to be drinking at least 10 tea bags of a commercial brand per day as a way of quenching her thirst.  Without her knowledge, she was taking in too much flouride into her sytsem coming from drinking too much tea!!!  She was developing a state of Flourosis which can cause a bone disease called Osteosclerosis.  From being told that she has strong bones to now being counseled to be careful not to fracture… was too extreme for her to understand!

Osteosclerosis can be due to taking in too much flouride in the body.  The problem with this disease is you have Brittle bones and therefore on Xray, you may have thick bones but the quality of the bone is poor!!!

Just how much flouride in is one tea bag?  In one study published in Amercan Journal of Medicine in 2005:

“Two independent testing laboratories determined that mean fluoride concentrations in 10 brand-name tea solutions ranged from 1.0 to 6.5 ppm. One tea exceeded the EPA safety limit of 4.0 ppm for drinking water, and several surpassed the U.S. Food and Drug Administration limit of 1.4 to 2.4 ppm for bottled beverages. “

So my frineds…please be careful with too much tea in a day.  I know of some chinese patients who use tea as their drinking water.  Just as the saying goes…

 Too much of a Good Thing can also be BAD!

A High Fiber Diet: Does It Really Matter?

April 11, 2008

Go to fullsize imageWe have been exposed to ads regarding the benefits of a high fiber diet.  We know it is good for our health but what does it do and where do we get these fiber rich products?

It has been shown in several studies that a high fiber diet can indeed lower ones risk to develop heart diseaese by as much as 30% as well as lower ones risk to develop diabetes and improve cholesterol.   We know it works well for roughage and therefore can prevent constipation and improve bowel habits.  In fact it was recommended as a way of preventing colon polyps and cancer BUT so far no long term studies have proven that fiber can indeed lower the risk for colon cancer.  Nonetheless, the multiple benefits we can get from eating a high fiber meals are more than enough to recommend intake of these products to our patients and the public in general.

But what are the best sources of fiber? Here is a list of the different kinds of fiber compiled by the Harvard School of Nutrition:

Sources of Fiber

Soluble Fiber

Insoluble Fiber

oatmeal
oatbran
nuts and seedslegumes

  • dried peas
  • beans
  • lentils

apples
pears
strawberries
blueberries

whole grains

  • whole wheat breads
  • barley
  • couscous
  • brown rice
  • bulgur

whole-grain breakfast cereals
wheat bran
seeds
carrots
cucumbers
zucchini
celery
tomatoes

The best fiber source in several studies that proved a high fiber diet to be beneficial is the cereal based fiber or fiber from grains and those coming from fruits.  It is recommended that a diet with at least 21 to 38 gms of fiber should be taken per day.  On an average Filipino diet, we are only consuming at most less than 15 gms of fiber per day so we better bulk it up more with the sources mentioned in the table for health reasons.  Increase the fiber intake gradually rather that abruptly and to make sure we also increase the intake of water ans fiber absorbs water.

What Do I recommend: here’s a sample advise that I give to my patients:

  • Avoid fruit juices as they are devoid of fiber, instead eat whole fruits.
  • Eat brown rice instead of white rice
  • Buy whole grain products instead of white bread and pasta.
  • Try snacking with raw veggies..they may not be as yummy as a pastry BUT they are triple times  as healthy.
  • Choose whole-grain cereals for breakfast instead of rice and sausage! 
  • Eat Right By Eating Healthy..Try FIBER!