June 27, 2017

Artery-Clogging Saturated Fat Is a Myth

Among doctors and the public alike, there is a popular belief that dietary saturated fat clogs up the arteries and results in coronary heart disease.  A new editorial published in the British Journal of Sports Medicine says that this notion of saturated fat clogging a pipe is "just plain wrong."

According to researchers, 'the conceptual model of dietary saturated fat clogging a pipe is just plain wrong.'

The article is the result of a collaboration between a team of cardiologists, including: Dr. Aseem Malhotra, of Lister Hospital in Stevenage, in the United Kingdom; Prof. Rita Redberg, of the University of California-San Francisco School of Medicine and editor of JAMA Internal Medicine; and Pascal Meier, of University Hospital Geneva in Switzerland and University College London, who is also the editor of BMJ Open Heart.

The team cited reviews that show no association between intake of saturated fat and a greater risk of heart disease, in order to support their argument against the existence of artery-clogging saturated fat.

"It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat," say the authors. Instead of focusing on lowering blood fats and cutting out dietary saturated fats, the importance of eating "real food," partaking in regular physical activity, and minimizing stress, should all be emphasized.

According to Malhotra, Redberg, and Meier, the current approach to managing heart disease echoes the practice of plumbing, but the notion of improving the condition by "unclogging a pipe" has been invalidated by a series of clinical trials. The trials found that when a stent was inserted to widen narrowed arteries, the risk of heart attack or death was not lessened.

"Decades of emphasis on the primacy of lowering plasma cholesterol, as if this was an end in itself and driving a market of 'proven to lower cholesterol' and 'low fat' foods and medications, has been misguided," the panel contends. These misconceptions may stem from "selective reporting of data," they suggest.

Coronary artery heart disease is the most common type of heart disease and the leading cause of death for men and women in the United States. The chronic inflammatory condition responds positively to a Mediterranean-style diet, rich in the anti-inflammatory compounds often found in extra virgin olive oil, vegetables, oily fish, and nuts, the researchers note.

The best predictor of heart disease risk involves a high total cholesterol (TC) to high-density lipoprotein (HDL) ratio, not low-density lipoprotein. Dietary changes, such as substituting refined carbohydrates with healthful high-fat foods including olive oil and nuts, can significantly reduce the high TC to HDL ratio, the experts explain.

Exercise plays an essential role in preventing heart disease and may increase life expectancy by 3.4 to 4.5 years. Just 30 minutes of moderate activity per day on more than three occasions each week has been shown to make a difference to risk factors for inactive adults. Furthermore, the researchers point out that regular brisk walking may be more effective at preventing coronary disease than running.

Chronic stress is a risk factor for coronary heart disease that "should not be overlooked," the team underline. Chronic stress puts the body's inflammatory response on a continuous state of high alert. Research has shown that environmental stress, such as childhood trauma, can decrease life expectancy by up to 20 years.

The authors write:
"Combining a complete lifestyle approach of a healthful diet, regular movement, and stress reduction will improve quality of life, reduce cardiovascular, and all-cause mortality."

The researchers add that spending just 22 minutes per day walking and eating healthful food can prevent coronary artery disease. However, "there is no business model or market to help spread this simple yet powerful intervention," the authors conclude.

June 26, 2017

Can People with Diabetes Safely Eat Popcorn?

Yes, popcorn can be a healthful snack for most people, depending on how it is prepared.  With its fairly low calorie and high-fiber content, air popped popcorn is often a go-to snack for dieters.

However, people with diabetes have more to worry about than their waistlines when snacking on popcorn.  People with diabetes can eat popcorn but need to choose carefully the type of popcorn, how it is cooked, and how much they eat, due to popcorn's high carb content.

Air-popped popcorn offers very few calories per cup.  In addition, a cup of air-popped popcorn contains a little over 1 gram (g) in fiber.  It also contains about 1 g of protein and about 6 g of carbohydrate.  Additionally, popcorn contains zero cholesterol and is almost fat-free, far less than 0.5 g per cup.  The total calories in a 5-cup serving are between 100-150.

Popcorn qualifies as a whole-grain food.  One serving can provide about 70 percent of the recommended daily intake of whole grain.  Popcorn is full of vitamins and minerals.  A single serving of popcorn contains a number of vitamins and minerals, including:

Popcorn is a whole-grain, low-calorie snack, including vitamin A, vitamin E, vitamin B6, pantothenic acid, folate, thiamin, niacin, and riboflavin.

A serving of popcorn also contains iron and trace amounts of manganese, calcium, phosphorus, copper, magnesium, potassium, and zinc.  The popcorn's hull or shell is the source of much of its nutritional value.  The shell contains beta-carotene, lutein, and zeaxanthin, which are important for maintaining eye health.  The shell also contains polyphenols with antioxidant and anti-inflammatory properties, which may protect against cancer and cardiovascular disease.

Researchers have stated that popcorn contains up to 300 milligrams of polyphenols per serving.  This high amount of polyphenols is more than 60 percent of the amount provided by fruits and vegetables in the average American diet.

However, popcorn's benefits are greatest when the popcorn is air-popped. Similar to salads and potatoes, these health benefits are often reduced by adding too much salt, butter, oil, and other condiments or toppings.

Like any food, popcorn comes with recommended serving sizes and should not be enjoyed in excess.  Additionally, the choice of toppings has a serious impact on how much a person can or should eat per serving.

As mentioned above, a serving size of popcorn of roughly 5 cups popped, offers a number of nutrients.  This equates to a small bowl of popcorn.

Nutritional yeast is packed with vitamin B12. Its cheesy flavor makes it a great topping for popcorn.

For people on a restricted diet, such as people with diabetes, it is best to avoid adding large amounts of other add-ons to popcorn.  Air-popped popcorn is the best option to get the most benefit with minimal extras.

I admit that I will only eat popcorn loaded with butter which seems to run contrary to this article.  But I still insist that I need the butter for the fat in my diet.

For people who want some additional flavor, oil-popped popcorn does not add many calories and adds a bit of flavor.  Other suggestions include small amounts of grated cheese, nutritional yeast, a bit of olive oil, and spices such as chili powder, garlic powder, or even cinnamon.

For people with diabetes, the glycemic index (GI) is an important number to know when considering what food to buy and eat.  GI is a scale from 1 to 100 and refers to how much the body's blood sugar increases after eating carbohydrate-filled foods.  The higher the value, the more the blood sugar will rise.

In general, foods with a higher GI are rapidly digested, leading to quick absorption.  As a result, they produce marked changes in blood sugar levels.

By comparison, low-GI foods are much slower to digest and are absorbed at a slower rate.  In turn, they produce gradual rises in blood sugar and insulin levels.

Low-GI diets have some proven health benefits, including:
  • improving both glucose and lipid levels in those with type 1 or type 2 diabetes
  • weight control, as the slow absorption helps control appetite and delay hunger

Air-popped popcorn has a GI of 55, which is at the upper end of low-GI foods but much better than other salty snacks.

Please read the full article here to help your decision and not way I eat popcorn. 

June 24, 2017

Discussion on Dawn Phenomenon

As a person with type 2 diabetes, the following does affect me, but most of the time I have avoided it with adjustments to my insulin.  The biggest aid has been splitting my long acting insulin into two doses per the doctors instructions.
The dawn phenomenon is a normal, natural rise in blood sugar that occurs in the early morning hours, between roughly 4 and 8 a.m. The shift in blood sugar levels happens as a result of hormonal changes in the body.
All people experience the dawn phenomenon to one level or another, which can vary day by day. People without diabetes may never notice it happening, as a normal body's insulin response adjusts for the rise without intervention.
A person with diabetes is more likely to experience symptoms from the rise in blood sugar levels, however.
How does it affect people with diabetes?
Dawn phenomenon is a normal rise in blood sugar released by the liver. The release happens as the person's body is preparing to wake for the day.
The rise in blood sugar is normally handled with insulin. For people with diabetes, insulin is not produced in high enough quantities, or the body is unable to use the insulin properly.
As a result, a person with diabetes will feel the effects of having high sugar levels in the blood.
These effects can include: faintness, nausea, vomiting, weakness, disorientation, feeling tired, and extreme thirst.
Managing the dawn phenomenon
Managing blood sugar levels is nothing new to most people with diabetes. A combination of diet, exercise, and medication often help keep the symptoms and problems under control.
In the case of dawn phenomenon, there are some additional changes that may help prevent issues caused by the spike in blood sugar.
Some steps people with diabetes can take to manage the dawn phenomenon include:
   changing medication entirely or making adjustments with a doctor on existing medication
   avoiding skipping meals or medication doses
   avoiding carbohydrates around bedtime
   taking medication closer to bedtime and not at dinner time

Other steps include eating dinner earlier in the evening. After dinner, some light physical activity, such as going for a walk, jogging, or yoga, is encouraged.

It is likely that a person with diabetes will experience high morning blood sugar levels from time to time. Occasional, mild issues from dawn phenomenon are not too worrisome. However, if the frequency becomes much more regular, then it's time to call a doctor.

If blood sugar levels spike too high as a result of dawn phenomenon, the effects can range from mild to a life-threatening medical emergency.

Some complications that a person with diabetes may experience as a result of dawn phenomenon include:
   nerve damage
   damage to blood vessels
   organ damage
   ketoacidosis, an extremely dangerous buildup of acid in the bloodstream

People who experience repeated high blood sugar levels due to dawn phenomenon should see a doctor to prevent these consequences.

Do options differ between type 1 and type 2 diabetes?

Differences in dealing with dawn phenomenon depends more on the individual person than what type of diabetes they have or what their treatment plan is.

A person with type 1 diabetes may adjust the dosage or type of insulin to account for any changes overnight. In other cases where the person wears an insulin pump, they may adjust the pump to deliver extra insulin in the morning.