WEDNESDAY, JANUARY 02, 2008

The fatter we get, the sicker we get and the greater our risk of getting type 2 diabetes becomes. Yet, based upon recent news, we are on the verge of a breakthrough for this growing epidemic – diabetes operations.

Forget that artificial pancreas, these new treatments leverage the fact that researchers are finally getting to the root cause of type 2 diabetes. "The prevalence of diabetes is going up because obesity is going up," says Judith Fradkin, director of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health.

Adult onset diabetes (Type 2 diabetes) used to just affect adults, hence the name, now because of the obesity epidemic there is an emerging diabetes epidemic among children. Because of seriousness of this problem, 2007 "World Diabetes Day" focused on children and adolescence.  One message that came out of "World Diabetes Day" – type 2 diabetes is preventable.  How?  With changes to diet and lifestyle (which includes exercise, stress and weight management).

Type 2 diabetes is an epidemic that is killing us both literally and economically. The latest stats say over 246 million people have diabetes and most of these people are obese.  The research says that 90% of these cases are preventable.  This means 222 million people do not have to be sick.  Think about it.  Over 200 million people have this life threatening disease because they are fat.

John Buse, president of the American Diabetes Association, and other experts warn that it will take a major societal change of the kind that changed smoking habits to prevent a future of fatter, sicker people. But what kind of change are we looking for?

Enter the Diabetes Wonder Cure!

Yes, the diabetes operation is on its way. What is it? It’s putting a band around your stomach. Isn’t that amazing?

Some researcher feel that the only way people will lose weight is to  band  their stomachs, laparoscopic adjustable gastric banding (LAGB), so they can't eat as much food. This is a restrictive procedure that connects a balloon to a band around the upper part of the stomach. A reservoir is placed under the skin and is used to inflate the balloon and adjust the gastric band. With the inflation of the balloon the gastric band tightens and decreases the amount of food passing through at the given time. When the balloon is deflated the band loosens and the weight loss begins to be reduced.

Of course, LAGB is not without risk.

Some studies document a substantial number of patients who have required re-operation for long-term complications of the adjustable band (such as for port problems, erosions and slippage, or inadequate weight loss). In addition, conversion of a failed LAGB to another bariatric procedure may be technically more difficult and associated with more complications than with a first time operation.

But is this stopping our brilliant but illogical surgeons?  

Hardly. In the Wednesday, January 23rd issue of The Journal of the American Medical Association (JAMA), Dr. John Dixon said, "I think diabetes surgery will become common within the next few years." Dr. Dixon and his collegues at the Monash University in Melbourne, Australia published their study in JAMA that showed how laparoscopic adjustable gastric banding (LAGB) surgery was more effective in getting rid of diabetes than other treatments.  
http://jama.ama-assn.org/cgi/content/abstract/299/3/316?
lookupType=volpage&vol=299&fp=316&view=short

Why?  Because people cannot eat as much, so they lose weight.

"An important finding of this study is that degree of weight loss, not the method, appears to be the major driver of glycemic improvement and diabetes remission in obese participants," says Dr. Dixon.

Reread the last paragraph.  The degree of weight loss and NOT the method.  FAT is killing us.  How many times do we need to hear this?  However, instead of eating more enhancing foods (fresh raw fruits and veggies), eating less in general and exercising, we are choosing to put a band around our stomachs to force us not to eat as much?  What planet are we from?

If we could cut out diabetes like we do cancer, we would.  But just like with cancer, we would get rid of the symptom but not the cause. Diabetes is a symptom of a diseased body.  And the sad truth is that we can stop and reverse the diabetes epidemic so much more easily, effectively and economically with a focus on healthy life style choices.

The diabetes operation sounds like another ineffective and illogical band (excuse the pun) aide approach that gives us some short-term relief and consequently dooms us to long-term disease.

SATURDAY, DECEMBER 01, 2007

If it's not salty, will you still like it?

The Grocery Manufacturers Association doesn't think so. There is now a move to regulate the amount of salt in processed foods, but, The Grocery Manufacturers Association agrues that cutting salt too much turns off consumers because of bland taste. It also said studies on health risk have not been rigorous enough.  Robert Earl, senior director for nutrition policy at the Grocery Manufacturers of America, says "Salt has been used safely in foods since antiquity."

But is salt safe???

According to the Center for Science in the Public Interest (CSPI), cutting the overuse of salt by most Americans could save thousands of lives annually and urged tighter restrictions by the U.S. Food and Drug Administration on salt content in food.

Excessive salt in Americans' diets is a major factor in high blood pressure and increases risk for heart disease.  Salt consumption has risen steadily in the U.S., and with it, heart-related diseases.

The bulk of sodium in modern diets comes from processed foods like frozen dinners and condiments. One frozen chicken teriyaki dinner, or one small can of Bloody Mary mix, contains a full day's worth of sodium, said Michael Jacobson, executive director of CSPI.

"Clearly, salt should be considered generally recognized as dangerous, not safe," Jacobson said.

Britain adopted an aggressive labeling system including front-of-package labeling, and it has been successful in moving the industry to change.

According to Jacobson, several of McDonald's Corporation products in Britain contain nearly half the amount of sodium as similar products in the United States.

"Americans don't consume large amounts of salt because they request it, but often do so unknowingly because manufacturers and restaurants put it in," says Dr. Stephen Havas, vice president for science and public health at the American Medical Association.

Trimming the salt content in processed and restaurant foods by half could save up to 150,000 lives a year by reducing heart-related disease.

According to Dr. Hayas, "I am sure no one would tolerate so many deaths from airline crashes, so why tolerate it from food?"

Some easy ways to lower the salt in your diet:

1.    Use herbs and lemon to add zest and flavor to foods, instead of relying on salt to bring out flavor.
2.    Purchase products without salt.  If you really want salt, add it yourself. You will probably add less.
3.    Prepare food without salt, especially if you are cooking because the tongue doesn’t really taste the amount of salt cooked in.  If you really want salt, add a little before eating.
4.    If you are used to eating a lot of salt, cut back slowly.  Your taste buds will start tasting the food and adapt to not having as much salt.  If you continue to do this, your taste buds will be more in tune to the taste of your food and you may find that you don't need salt to make your food taste good.

FRIDAY, NOVEMBER 02, 2007

Can cancer be prevented? Latest report from cancer research says, "yes!"

In a recent survey of 1,022 adults, 49% said it was highly unlikely that they could do anything to prevent cancer.

However, the World Cancer Research Fund and the American Institute for Cancer Research in their latest report, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective, tells us differently.  It states that over 1/3 of cancer can be prevented with weight control, regular physical activity and healthy eating choices.

The report was the result of a five year project which involved 7,000 large scale studies and world leaders in science, nutrition, public health and researchers on the epidemiology and biology of cancer, to work on an issue of profound importance to global public health: the prevention of cancer by means of healthy patterns of eating and physical activity.

The panel found parallels between dietary causes of cardiovascular disease and cancer.
"In general, recommendations in this Report to prevent cancer will also be of great relevance to cardiovascular disease. The only significant contradiction is with alcohol. From the point of view of cancer prevention, the best level of alcohol consumption is zero."

They will publish a second report on policy for diet, nutrition, physical activity, and the prevention of cancer, which they expect to be ready next year.  According to Michael Marmot, the panel's chair,

"Individuals and populations have in their hands the means to lead fuller, healthier lives. Achieving that will take action, globally, nationally, and locally, by communities, families, and individuals." He added, "The current Report and next year’s Policy Report have one overriding aim: to reduce the global burden of cancer by means of healthier living."

We are getting there, slowly but surely.

The following are their 10 recommendations for cancer prevention, right out of the report.  (with my explanation in parenthesis)
 
BODY FATNESS
Be as lean as possible within the normal range of body weight (be on the low side of your body weight to height ratio range)

PHYSICAL ACTIVITY
Be physically active as part of everyday life

FOODS AND DRINKS THAT PROMOTE WEIGHT GAIN
Limit consumption of energy-dense foods.  Avoid sugary drinks (they measure in energy-density instead of calories - animal products are the highest and fruit is the lowest)

PLANT FOODS
Eat mostly foods of plant origin

ANIMAL FOODS
Limit intake of red meat and avoid processed meat

ALCOHOLIC DRINKS
Limit alcoholic drinks

PRESERVATION, PROCESSING, PREPARATION
Limit consumption of salt. Avoid mouldy cereals (grains) or pulses (legumes)

DIETARY SUPPLEMENTS
Aim to meet nutritional needs through diet alone

BREASTFEEDING
Mothers to breastfeed; children to be breastfed

CANCER SURVIVORS
Follow the recommendations for cancer prevention

The report is available for your review at:
http://www.dietandcancerreport.org/

SUNDAY, JULY 08, 2007

Is fat contagious? New study shows that it's likely . . . look out!

If your friends are fat – watch out, states a recent news article. A new study published in the New England Journal of Medicine shows that one of the strongest associations in the spread of obesity are your relationships with obese friends.  It’s not some new virus that’s recently been discovered, the articles go on to say, but the behavioral influence. It seems obesity is socially contagious.

The study was conducted using information gathered from a base of over 12,000 people who had participated in a multi-generational heart study collected from 1971 to 2003. The study showed that if a subject had a friend that became obese, they had a 57% higher chance of becoming obese themselves. That went up to 171% higher chance if both friends identified the other as strong friends. Friendship was apparently the strongest correlation and it didn’t matter how far away the friends were. Geographic distance did not have a strong influence on the results. Sibling influence was also ranked highly with an increased 40% chance of becoming obese if another sibling was obese.

The study is located here: http://content.nejm.org/cgi/content/full/357/4/370

One of many articles was in US News and World Report at this link: http://health.usnews.com/usnews/health/articles/070725/25fat.htm

The study highlights the network effect on health issues and makes a strong point that our health is influenced by many factors, not the least of which are the role models around us. That powerful influence works both ways it seems, as the study’s authors also stated that that same network effect showed up between friends who were losing weight. Health conscious friends improve their health and their friends’ health as well.

For those of you who are leading the way to better health in your circle of friends, your friends may soon join you. In the meanwhile, there are support networks available to you. Many of the most successful weight programs include some type of group support. Here at OTM mindbody we are building a web-based community, the Mythbuster Network, dedicated to providing support for people interested in improving their health and fitness. The program will be a subscription service once it goes live, but is free during the month of August as part of our test drive program. It will have coaching calls, tele-seminars, message boards and personal tools such as journals and meal/activity planners. Take a look at the subscribers page on this web site for more details.

Said the author of the study, “People are connected, and so their health is connected.” So when you bust some myths, you might not be only changing your life, you may be changing the lives of your friends. That would be a pretty great thing to do for them and for you.

TUESDAY, MAY 15, 2007

Hidden fat even more dangerous. Thin people beware.

Overweight and obese people have been warned time and again about how dangerous it is for them to carry high amounts of fat on their body.  Now new findings show that people who look thin can also carry internal fat that surrounds the vital organs like the heart, liver or pancreas – fat that is invisible to the naked eye.gerous

"Being thin doesn't automatically mean you're not fat," said Dr Jimmy Bell, a professor of molecular imaging at Imperial College, London.  Since 1994, Bell and his team have scanned nearly 800 people with MRI machines to create "fat maps" showing where people store their fat.  Their research was funded by Britain's Medical Research Council.

Bell refers to TOFIs, or people who are "thin outside, fat inside." "The thinner people are, the bigger the surprise," he said. He said that they have even found TOFIs among people who are professional models.

People who eat non-nutritious foods, especially sugars, and maintain their weight by eating less, are thin but unhealthy.  This type of diet, in combination with a lack of exercise, can build internal fat around the internal organs.

Thin people, who store internal fat, when they do put on a few noticeable pounds, according to Bell, are on the "threshold of being obese."

With these new finings, we can clearly see that we cannot rely on Body Mass Index (BMI) scores to determine fat.  I've been saying this for years.  And, Bell found that 45% of the women and 60% of the men scanned, who had normal BMIs, also had excessive level of internal fat.  

What's the answer?  Don't work on being thin, work on being healthy.  Diet and lifestyle are the keys to good health.  Nutritious foods, eating only enough to maintain a healthy weight, keeping stress in check, having a great attitude about life and exercising to produce and maintain lean muscle mass will keep us lean, fit, happy and healthy.

THURSDAY, MARCH 01, 2007

Fat is killing us, not aging!

High blood pressure, heart disease, diabetes, orthopedic problems and a decrease in life expectancy.

According to Dr. Jerry Wortzman, chairman of pediatrics at the MetroWest Medical Center, these are the health risk that children are facing these days, overweight children.   He said local pediatricians see overweight children with health problems every day. And, it's getting worse.

A public awareness campaign that focuses on the serious health effects of childhood obesity could help motivate some families, he said. The MetroWest Community Health Care Foundation is providing such a campaign. Billboard, television and print ads directed to parents about the health risks to children's lives. Visit their education site:

http://metrowestkids.org/

A 2002 study published in the Journal of the American Medical Association indicated that 9 million American children are overweight, three times the number from two decades earlier. The federal Centers for Disease Control and Prevention in Atlanta found that obesity among children ages 2 to 5 has increased 35 percent in 10 years.