Category Archives: Disease Physiology

refined carbs

Prediabetes, A Cry For Help

Diabetes doesn’t just come knocking at the door one morning when you wake up.  Diabetes is foreshadowed if you understand its disguise.  If you can catch prediabetes before it becomes diabetes you can prevent some the permanent damage to your cardiovascular system and pancreas, the insulin-producing organ.

The Significance of Prediabetes

There are over 86 million people in the US that have prediabetes and 9 out of 10 of those people do not even know they have it.  Once someone is diagnosed with prediabetes they will most likely develop diabetes within ten years if they do not make lasting lifestyle changes.  Being diagnosed with prediabetes is a gift or warning to make changes now before permanent damage occurs.

How Would You Know If You Have Prediabetes?

Prediabetes doesn’t have any signs or symptoms.  That is the scary thing.  Your body doesn’t give any warning until diabetes has shown its ugly face.  However, your healthcare provider may have checked a basic or complete metabolic panel that includes a blood glucose test.  In our busy healthcare system, having an elevated blood sugar at the prediabetes level often gets missed by busy providers.  Ask for your results and if your glucose level was done after you had been fasting and was greater than 100, then you should have this repeated with one of the tests below.  If you have symptoms of excessive thirst, increased urination, blurry vision or frequent fatigue, then this could indicate that you have diabetes.

What Is Prediabetes?

Prediabetes is a problem with processing sugar or glucose, mostly from the foods we eat, leading to higher than normal blood glucose levels but not high enough to be diabetes.   This is partially due to the body not utilizing insulin in the normal way.  Over time this problem with insulin progresses, leading to higher blood sugars and diabetes.  There are three tests for diagnosing prediabetes and diabetes:

  • Glycated Hemoglobin (A1c) which indicates an average blood sugar over 2-3 months time.   An A1c between 5.7-6.4 indicates prediabetes.  An A1c over 6.4 over two different occasions indicates diabetes.
  • Fasting Blood Sugar is done by taking a blood sample after 8 hours of fasting (usually done overnight).  Under 100 is considered normal.  Having a result between 100-125 indicates prediabetes.  Having a result 126 or greater on two different occasions indicates the individual may have prediabetes.
  • Oral Glucose Tolerance Test is a slightly more involved test but probably the most accurate since it directly assesses how the body manages a glucose challenge.  This test is done fasting as well but the individual is given a sugary drink and blood sugar levels are checked before and several times afterwards.  A normal reading is under 140.  Having a reading between 140-199 is considered prediabetes; greater than 199 is considered diabetes.

Who Should Be On Alert For Prediabetes?

The exact cause of prediabetes isn’t well understood but there is a genetic link and it is associated with leading an inactive lifestyle and having abdominal fat.  The following are indications for getting checked for prediabetes:

  • Have/had a parent with type 2 diabetes
  • Having a waist circumference > than 35 for women, > 40 for men
  • Are overweight
  • Are inactive
  • Are of Asian, African, Pacific Island, Hispanic or American Indian descent
  • Are over 45
  • Had gestational diabetes or a baby weighing over 9 pounds
  • Had PCOS- polycystic ovary syndrome
  • Have sleep apnea
  • Have high triglycerides, low HDL or have high blood pressure

Prediabetes Is A Chance For A Do-Over!

The Diabetes Prevention Program, a multi-center clinical research study, showed that a 7% weight loss along with 150 minutes of moderate intensity exercise a week greatly reduced the risk of developing diabetes in those who had prediabetes.  For a 200 pound individual that’s only 14 pounds!  That’s not a huge amount of weight.  Couple that with a walk after dinner most nights and that’s a pretty doable plan.

Let Me Help You

This is my passion.  I understand the nuances to making lifestyle changes.  I will help you find your steps towards prevention of diabetes.

good carbs

Make Your Carbs Count

Some of us are carnivores, people who crave steaks, ribs and other bloody meat, and some of us are carbivores, my definition of people who crave chips, cookies and candy.  But too many carbs, especially the processed ones, do us more harm than the few minutes of pleasure we get from eating them.  It’s not about abstention from them; it is about making informed choices.

Carbohydrate Sources

Carbohydrates (carbs) are those foods that contain sugar, starch and/or fiber.  Some grow naturally in the environment while others are manufactured.  Naturally occurring carbs inherently contain more fiber, vitamins and minerals than manufactured carbs.  Manufactured carbohydrates are often times more manipulated to enhance shelf life, taste, advertising appeal and texture.  These are the kinds of manufactured carbohydrates I’m referring to in this article.  It’s the degree and intent to which these “man-made” carbs are manufactured that is the issue when it comes to health.

Naturally Occurring Carbs

Naturally occurring carbs include fruits and starchy veggies, legumes and whole grains, and some dairy.  The amount of carbohydrates found in fruits can vary depending on the kind and the ripeness.  A cup of grapes has 28 grams of carbs, while a cup of raspberries has 15 grams.  Less ripe fruits have more resistant starches in them that are not digestible while riper fruits have more of their starch converted to easily digested sugar, raising their carb load and their impact on blood sugars.  Starchy veggies include all potatoes, corn, peas and winter squashes.  Think of veggies that are denser and sweeter.   Lower carb veggies are less sweet and have a higher water content like celery, zucchini and broccoli.

And like those resistant starches converted in riper fruit, the same thing happens when grains are cooked longer.  Soft pasta has a higher carb load than the less boiled al dente pasta.

Milk has the natural occurring sugar, lactose, which adds about 12 grams of carbs per cup.  Cheese and plain unsweetened yogurts, especially plain Greek, have less lactose, therefore fewer carbs.

Manufactured Carbs

Manufactured carbs include things like certain breads and pasta, candy and baked goods, chips and crackers, and ice cream and fruit-filled yogurt.  In particular I want to focus on the manufactured carbs that strip the good, naturally occurring benefits out of the product and then try to add other ingredients to artificially enhance a product.

Manufactured goodness pasta labelFor example, Barilla Plus pasta tries to appeal to the health conscious consumer by advertising on their food label “multigrain”, “protein, fiber and ALA Omega-3”.  When you look at the complicated food label you can see that what they’ve done is take wheat flour (only part of the wheat berry) and blended it with flour from lentils, chick peas, flaxseed(tha t’s how it gets to promote the ALA omega 3), oats and barley, and enhanced the fiber artificially by adding oat fiber, enhanced the protein by adding egg whites, and enhanced the nutrients by adding vitamins and iron.  There are 16 ingredients in this product.  Now compare that to Luigi Vitelli organic pasta which contains only one ingredient – whole wheat durum semolina flour grown organically – and you can see what I am talking about.  Not only is the Luigi pasta higher in naturally occurring fiber but there is no food manipulation going on.  A food shouldn’t brag on the front of the box when there are 16 ingredients in it when only one truly good ingredient is needed.  You don’t need to mess around with mother nature to try to enhance a product.

Another example is oatmeal.  Oatmeal comes as quick cooked, old-fashioned, steel-cut and in its pure form, the “grout”.  You can find quick cooked that has added fiber to make consumers think they are getting a really good thing but they really aren’t in this case. Quaker Oats High Fiber Instant Cinnamon Swirl Oatmeal is made from precooked and dried oatmeal, a created fiber called maltodextrin, sugar and sugar substitute, caramel coloring and vitamins and minerals to make it sound really healthy.  Keep in mind that maltodextrine is a type of  manipulated fiber that doesn’t provide the same health benefits of naturally occurring fiber.  This cereal gets high ratings for taste but in a man-made, less healthy way.  The less processed the oatmeal grain – which starts with the grout, the more naturally occurring fiber, vitamins and minerals you will get.  You’re better off eating steel-cut oats flavored with a teaspoon of honey and cinnamon than a quick cooked sweetened oatmeal if you are really trying to take care of your health.

In general, look at the number of ingredients in a label when you are comparing similar foods.  The fewer the ingredients, the less man has manipulated it, and the more nature leaves its imprint.

Good Carbs, Bad Carbs

I think of carbs as the body’s gas pedal.  When you eat a lot of manufactured carbs, especially ones made with white flour and lots of sugar, the body’s rpm’s go really high.  This causes blood sugars to go really high and the pancreas to have to work really hard to take care of the extra blood sugar.  Getting back to the car metaphor, carbs are the gas pedal and the brake pads are the pancreas.  Eating foods that are highly processed, laden with sugar and stripped of the bran and germ of the grain is like pressing down hard and fast on the gas pedal and the pancreas, like the brake pads of your car, gets worn out.

Not "whole" foods

Not “whole” foods

These kind of carbs in the picture at left, are what cause the insulin spike and when consumed frequently, keep blood insulin levels high creating the cascade of events mentioned in the previous post.

Getting back to the gas pedal metaphor, choosing mostly intact carbs with little processing like whole grains, fruits and beans it’s like gently putting your foot on the pedal to  accelerate.  When you choose these kinds of carbs you get a more gradual blood sugar rise and put less stress on the pancreas.  And because they are high in fiber you stay fuller longer – which is like getting more mileage for the same amount of gas.  Furthermore, the best payback that I hear from my clients is that they have more energy.  With fewer blood sugar swings there are also fewer times during the course of the day where they have trouble focusing and feel sleepy.

How Many Carbs Should You Have?

Last post I talked about reducing carbs to the lower end of the Institute of Medicine acceptable range of around 45% of total daily calories.  How many grams of carbohydrates does that amount to for a day?  First you need to calculate your recommended daily caloric needs that considers your age, sex, height and activity level.  The Mayo Clinic has a nice interactive calculator you can use here.

For me to maintain my current weight considering my activity level, I would need 2100 calories daily.  To determine my daily carbohydrate needs Based on the points made in my last post, I will multiply the 2100 calories by the 45% and then divide it by 4 since there are 4 calories per gram of carbohydrate.

                                                                     2100 X .45 = 945                                                                                                                                              945/4 = 236 grams

If I divide the 236 grams over my three meals it works out to about 80 grams per meal.  If I were to have a snack containing carbohydrates I would reduce the carbs in the meals accordingly.  You can look at the food label under total carbohydrate to see how many grams a serving has.  For those foods that do not have a food label The Calorie King Calorie and Carbohydrate Counter Book is a nice resource.  Keep in mind that many prepared food items contain more than one serving.  The Stouffer’s Macaroni and Cheese in the above picture actually contains 5 servings in the box.  Many people would either eat the whole box or split it with someone.

How To Begin

  • Cut out or reduce your soda intake.   A 12 oz. coke has 55 grams of sugary carbs.  Try seltzer water with natural flavoring or tea.
  • Reduce the amount of chips you ea.   A serving of Stacy’s pita chips has 19 grams of carbs.  Measure your portion and put it on a plate, do not eat out of the bag.  And don’t think that just because pretzels have little fat and are low in calories are a good choice.  Most pretzels are make with white flour.  Eating a few servings of those is just like putting the pedal to the metal.
  • Switch to black coffee or coffee with whole milk with less sugar or use Truvia.  A vanilla Frappuccino at Starbucks has 68 grams of carbs.
  • Eat your fruit instead of drinking it so you get the fiber.  Juice glasses use to be 4 ounces, now they are 8 oz – that’s 30 grams of quickly digested sugary carbs.
  • Cut out the donuts and muffins (unless it’s my high fiber, high protein recipe) and eat a breakfast with more protein and fiber from whole grains and fewer carbs- like my frittata with 2 pieces of whole grain bread.  Or something more simple might be a cup of plain Greek lowfat yogurt, with 1/2 cup of thawed frozen berries and some chopped nuts.
  • If you are a candy lover switch to one small piece of dark chocolate which is lower in carbs (4 gms) and has heart healthy flavonoids.  A candy bar like 3 Musketeers can have 42 grams of sugary carbs.

Most of us love our carbs whether they are sweet, salty or crunchie.  Everything in moderation has to be defined.  It can’t be permission to indulge without discretion.  Next post I’ll discuss tips to make this process easier.

 

 

 

 

45 or Older, Your Muscles Are Shrinking

Everyone loses 1% of their muscle mass every year starting at age 45. This is a big deal because our metabolism as well as the utilization of glucose for energy largely takes place in our muscles.  But we have the ability to stop the natural progression of muscle wasting called sarcopenia.  The anecdote?  Strength training and adequate protein intake as discussed in the previous blog.

Metabolism and Muscle Mass

Many people blame their excess weight on having a slow metabolism.  But in reality obesity is rarely due to a metabolic disorder like hypothyroidism.  Excess weight is due to how much we eat, what we eat and how much we exercise.  There are other factors that can impact one’s metabolism like body size, sex and age.  In general, people who are larger, have more muscle mass, are male and younger than 45 will have a higher metabolism.  Basal metabolic rate is the amount of calories needed to carry out the normal functions of the body and accounts for about 60-75 percent of the calories you burn each day.  Two other factors that also effect metabolism are thermogenesis or food processing, and physical activity. Thermogenesis is defined as the amount of energy used in the digestion, absorption and distribution of food consumed and accounts for about 10 percent of the calories used in a day. It is believed that diet induced thermogenesis can play a part in obesity.  They conclude that protein plays a big part in raising thermogenesis of food.  There is also some evidence that eating “whole” foods like whole grain breads and less processed food like cheddar cheese versus processed cheese product also increase thermogenesis.  In one study a diet higher in protein and carbs as opposed to one high in fat and carbs lead to higher thermogenesis as well as a longer feeling of satiety.  There has also been some evidence that the regular ingestion of chili or the capsaicin in it has been linked to increased thermogenesis.  I guess that is a good reason to eat a lot of chili soup and salsa!  In general, the more difficult it is to process the foods we eat, the more calories we burn in the process of digesting them.  Dietary fat is very easy to process, while protein is not.

muscle mass

That’s some muscle mass!

Physical activity also plays a role in our metabolism.  We also know that just doing aerobic exercise will benefit our heart and lungs  but will do little to maintain muscle mass.  Research at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston have repeatedly shown the benefit of strength training for reversing the effects of sarcopenia.  For adults 45 or older, adding strength training is nonnegotiable if you want to prevent sarcopenia.  Furthermore, muscle mass effects metabolism.  For those over 45, avoiding strength training will lead to a slowing of metabolism, a drop in caloric needs, and most likely weight gain.  The Centers for Disease Control and Prevention (CDC) recommends each week 150 minutes of moderate intensity exercise (like a brisk walk) and 2 strengthening sessions involving all major muscle groups – legs, arms, chest, shoulders, abdomen, hip and back.  If vigorous exercise is done then the time can be decreased to 75 minutes a week of the aerobic, along with the same strengthening sessions.  Evidence also supports that the aerobic portion can be broken up into 10 minute sessions – you will get the same cardio benefit versus doing it all at once.

Insulin Resistance and Muscle Mass

If you have a parent with type 2 diabetes then you have a 40% chance of developing it as well. Type 2 diabetes starts with the inability of the body to effectively recognize and utilize insulin.  Insulin is the hormone that helps glucose get into the cells for energy.  If the cells do not get adequate glucose, that person will not only feel tired but will increase the liklihood of developing diabetes.  There is a very effective solution to reduce insulin resistance.  You guessed!  Strength training.  Insulin resistance starts in the muscles, liver and fat cells.  When you do strenghthening exercises you are moving those muscles and improving the muscles ability to recognize insulin, not just while exercising but for the next 24 hours.  And you are increasing your muscle mass.  Pretty powerful and better than taking a medication for it.

Your Steps to Protect Your Muscle Mass

1.  To preserve muscle mass make sure you are getting enough protein.  If you don’t eat an adequate amount of protein your body will break down it’s own muscle mass to get the amino acids it needs.  If you are over 45 then make sure you are getting about 30 grams of protein each meal.  As mentioned in the previous post your needs go up with age as much as 1-1.5 grams of protein per kilogram of weight.  You might want to think about adding a protein powder shake as one of your meals. Next blog will discuss testing done by Consumer Lab on protein powders. If your are eatting 4 ounces of lean meat for your dinner then you are getting enough protein. Other good sources of protein include fish, fat-free or reduced fat plain Greek yogurt, low-fat cottage cheese, eggs and egg whites, tofu, edamame and even quinoa. 2.  Schedule a regular time on your calendar to get regular, moderate intensity exercise.  Perhaps take the bus to work, get off the bus early and walk the last mile to work or park a mile away from work and walk.  There are some wonderful walking DVD’s by Leslie Sansone, that you can also purchase on Amazon.com. 3. Twice a week take 20 minutes to do strengthening exercises.  Here is a good from the CDC link if you are new to doing strengthening.  There are tablet apps like the 7 minute workout that include a nice regimen that works all the muscle groups.  Or think about joining Planet Fitness where the memberships are cheap and you can work with a trainer twice a week to get your started on the machines and weights.  If you are new to doing strengthening and reluctant to do it then look for a Strong Living Program in your area.  This is a group exercise program designed by Tufts University that has well researched success. Much of what I have said here applies to those who are 45 or older.  But as we all know, habits are much easier to start the younger you are.  Why not take this information and jump-start your health by doing these suggestions now.  Not only will it help you to reach and maintain a healthy weight, but it will relieve stress, improve your health numbers, help you to sleep better and make you feel mahh-velous!  Bet you can’t find that in any pill!

Protein = Muscle Power + Healthy Weight

So what’s the scoop on protein?  You go to the grocery store and you see labels bragging about being “a good source of protein” or how it “satisfies hunger longer.”  In the past, eating low-fat foods was the best way to lose weight. Then came the Adkin’s diet that was all about eating an ultra low carbohydrate diet in order to go into ketosis and force the fat to melt away.  Now the focus is on protein and making sure you are getting enough of it – whatever enough is. Why is protein so important and how much is enough?

Protein Plays A Big Role In Our Body

Protein on a food label

You’ll find protein listed last on every food label

Protein is a food nutrient used to build and repair every cell in our body and to make hormones, enzymes and hemoglobin.  One of the biggest roles protein has as we age is to build and maintain our muscles.  This is important because as we age, we lose muscle mass.  According to Nathan LeBrasseur, a researcher at the Muscle Performance and Physical Functions Laboratory at the Mayo Clinic in a June 23, 2014 article in the Wall Street Journal, most people will lose about 30% of their muscle mass over their lifetime due to inactivity and inadequate nutrition.  And it is our muscles that determine our metabolism – how many calories we burn at rest.  When muscle mass deteriorates, not only do we get weaker which can lead to falls, but we burn fewer calories at rest as well.  Muscle loss usually leads to weight gain.  Most people do not decrease their caloric intake as they age to compensate for the drop in metabolism, so over time their weight gradually increases putting even more strain on the body and creating more difficulty with mobility.

How Much Protein Do We Need?

The USDA recommends 0.8 grams per kilogram of protein per day, but there has been a growing body of evidence to support consuming a larger amount as one ages.  In order to slow down sarcopenia, or the loss of muscle mass, the Society on Sarcopenia, Cachexia and Wasting Disorders recommends in a 2010 article that protein intake for the over 50 age group be as high as 1-1.5 grams per kilogram per day, divided over all three meals.  To convert pounds into kilograms, divide your weight in pounds by 2.2.  For example a 200 pound individual weighs 91 kg.  For someone less than 50, the recommended protein intake would be about 72 grams per day.  For someone over 50, the recommendation would be 91-140 grams of protein per day.  Furthermore, the society recommends 20-30 minutes of strengthening and aerobic exercise three times a week to prevent sarcopenia.  Just increasing protein intake alone without exercise will only slow down the destruction of muscle mass but will not prevent sarcopenia.  It is also advised that Vitamin D levels be in adequate range and may require supplementation.  As we age Vitamin D levels decline and low levels are associated with low muscle strength as well as other chronic diseases.

As we age, kidney function can decline, particularly if someone has diabetes or hypertension.  If someone has any of these conditions or has been told that they have kidney disease, then before you increase your protein intake discuss your kidney health with your doctor.  If you have any kidney disease, protein intake should be determined by your provider and a registered dietitian who can make other recommendations to preserve kidney function.  You should ask your healthcare provider about your kidney function and learn about your GFR or glumerular filtration rate.

Getting Enough Protein

As our bodies age, how we utilize the amino acids from the protein we consume also changes.  When protein is eaten, it is broken down in the gastrointestinal tract into amino acids which are then absorbed in the blood stream.  It’s the rapid change in concentration of amino acids in the blood stream that then triggers a chain of metabolic reactions that stimulate the formation of new protein.  However, according to research done at the University of Texas Medical Branch in Galveston as well as at Arizona State University and mentioned in the Staying Strong article in the April 2011 Nutrition Action Healthletter, older adults need a larger amount of amino acids to stimulate protein synthesis.  According to Douglas Paddon-Jones, a researcher at University of Texas, giving 30 grams of protein to a young or older adult will stimulate the same kind of protein synthesis.  Paddon-Jones states that if you give only 15 grams of protein to each age group, the younger age group will synthesize about half the protein, while the older age group will not synthesize any or a very minimal amount.  The older adult needs to get about 30 grams of protein in each meal to stimulate protein synthesis and preserve muscle mass.  This is why cereal for breakfast is not as good for the older adult as a large egg white omelet, with a side of lean Canadian bacon and a piece of whole grain toast.  Most cereals only have about 5-7 grams of protein in a serving size and a cup of milk has 8 grams of protein.  If someone were to boost the serving size in order to get the recommended protein they would be greatly increasing the carbohydrates and calories that can lead to weight gain and not muscle mass protection.

Types of Protein

Protein is made up of amino acids – 9 of them are “essential”, meaning we must consume them because our bodies can not make them like the other amino acids.  Amino acids are the building blocks for repairing our body.  Some proteins are considered complete, meaning they have all 9 of the essential amino acids, and some are incomplete meaning that they lack some of the essential amino acids.  Complete protein sources include meat, poultry, fish, eggs and dairy – but also include soybeans and quinoa as well.  Choose lean sources like poultry, fish and plant-based or very lean beef and reduced fat dairy since animal proteins can be high in saturated fat.  And if it’s in your budget, buy organic where the type of fat is higher in heart healthy omega 3’s.  Incomplete sources are those from plants like beans, grains and legumes.   A vegetarian diet can get all the essential amino acids needed as long as a variety of plant foods is consumed.  Of all the 20 amino acids, leucine is the amino acid that does the majority of protein synthesis and is a good one to focus on.  It is found in animal proteins but in the article, Staying Strong from the April 2011 issue of the Nutrition Action Health Letter, there is a list of good food sources of leucine.

How Much Protein Is In My Food?

Become aware of the protein in your foods.  Three ounces of cooked chicken breast has about 26 grams of protein.  Three ounces of cooked salmon has 21 grams.  A cup of plain fat-free Greek yogurt has 23 grams of protein.  A large egg has 7 grams of protein and a cup of edamame has 14 grams.  But remember that you don’t have to get all your protein from animal based foods.  A good breakfast for someone under 50 might be a cup of plain fat-free Greek yogurt mixed with some berries and topped with a couple of tablespoons of walnuts.  A good breakfast for someone over 50, particularly if they are getting daily aerobic exercise combined with some strengthening exercises, might include my smoothie recipe(email me for my recipe) along with a good source of protein powder.  Look for my upcoming article on good sources of protein powders.  In the meanwhile, put away the cereal unless you are using a small amount as a topping on your Greek yogurt or smoothie and consider a large egg white and veggie omelet for breakfast, or heck, even some of that leftover chicken from dinner last night!

In Pickles, Really??

pickles frontYes, both of these jars of pickles have the dye coloring, Yellow 5 in them.  Craved by pregnant women, accompanied with sandwiches and even touted as a healthy snack, many manufacturers of pickles are adding Yellow 5 to their spears, baby dills and sandwich toppers to make you choose them.  The only reason food coloring or dye is added to any food is to enhance visual appeal.  Doesn’t the yellow sharp cheddar cheese look more appealing than the white?  Isn’t cheese suppose to be yellow like in every cartoon?  Think twice before you choose your yellow and red foods unless they are in the produce section.

Safety of Yellow 5, Yellow 6, and Red 40 Questioned

pickles back

Yellow 5 is in both these jars of pickles!

It turns out that since 1955 United States consumption of food dye has increased five fold with 90% of the food coloring in foods coming from Red 40, and Yellow 5 and Yellow 6.  In 2010, Centers for Science in the Public Interest (CSPI) reviewed studies done on the safety of the nine FDA approved food dyes.   CSPI’s mission is to inform the public of unsafe products, unsafe practices and laws that need to be changed.  CSPI’s review revealed that the research done on the safety of food dyes was not done by independent researchers, nor were adequate mice samples used and testing was done only over two years – not sufficient time to test for the development of cancer.  Furthermore, all of the studies were done on individual dyes, therefore not taking into consideration the synergistic effect of multiple dyes as when people may eat a variety of foods with different dyes during a meal.  So the real safety of food dyes has not been sufficiently proven.  CSPI has petitioned the FDA to ban all food dyes due to their possible carcinogenic effects, cause of hypersensitivities and behavior problems, and insufficient testing.  The British government has banned the use of artificial food coloring and the European Union requires all food labels that contain dyes to label that they may cause hyperactivity in children.  In England, McDonald’s strawberry milkshake is made with real strawberries but here in the US, Red 40 is used.  In an article provided by the National Institute of Environmental Health Science, Bernard Weiss, a professor at University of Rochester, argues that there has been a link between artificial dyes and behavior problems in children, and goes on to say that the FDA’s “inaction amounts to approval of ongoing experiment with children”.

Foods That Contain Red 40, Yellow 5 and 6

Red 40 is contained in soda, candy, gelatin desserts, pastries, pet food, and even sausage!  Yellow 5 and 6 is found in candy, gelatin desserts, pet food, beverages, and baked goods.  Most likely if a boxed cake mix is yellow or pink, then it contains artificial food coloring.  To make that pet food look meatier, it’s got artificial dyes.  Do you really want Rover to be more hyper than he already is?  Could these dyes have the same effect on our four legged friends? To make that jello jiggle in reds, oranges or yellows, it contains artificial food dyes.  That red M&M your kids may fight over not only may have an accumulative cancer risk, but may truly be causing hyperactivity in your kids.  Basically, if it’s from one of those large food manufacturers, and it’s either made for you or saving you some steps, it contains artificial ingredients, including dyes that not only increase the chance of cancer, but they make your kids bounce off the walls.

Alternatives to Artificial Food Coloring

There are safe alternatives to making foods more appealing through color.  Beet extracts and other natural colorants can be added to your dogs pet food or to the jello.  Paprika or beta-carotene can be added for yellow.  WILD Flavors, Inc has a thorough list of all natural coloring substitutes that are an alternative to using artificial dyes.  Manufacturers should be required to use these alternatives and if the FDA won’t ban them, then as a consumer, demand that they use them by either writing to your favorite manufacturers or stop buying them and go back to basics.  If you want candy, eat dark chocolate.  If you want cereal, eat unflavored oatmeal and flavor it with a teaspoon of honey, raisins and some cinnamon.  If you want some cake then make one from scratch – they freeze well too!  If you want a popsicle then buy ones made from 100% juice or make your own with blenderized frozen fruit and vanilla Greek yogurt and get some popsicle molds.  If you want a pickle, then find a manufacturer like Rick’s Picks found online or sold at Whole Foods and many other specialty stores that even have a low sodium all natural pickle or look for pickles without yellow 5 listed in the ingredients.

Get Back To Basics

Doesn’t it just make sense to get back to simple ingredients?  If a label has more than 5 ingredients and it contains words that you cannot pronounce, then doesn’t it seem sensible to just not buy it?  Think back to your great grandparents, before there were more than 3 aisles in the grocery store and the only jar of pickles found were those canned in the fall.  Back then, they didn’t even have refrigeration.  At least now you can make foods and freeze in bulk to enjoy over many weeks or you can be a discerning consumer.   You should always be suspicious of the ingredients sneaking into your foods under the guise of enhancing nutritional experience, but really just making the foods more attractive and extending their shelf life.  Start looking at the labels in your closet to see what may be lurking on them.   Not only may you find making different food choices to help your children and household be calmer, but you may keep cancer at bay down the road.

 

Transcending Trans Fats

The FDA has moved forward with stating that trans fats are not “generally recognized as safe” for use in food.  Many food manufacturers and restaurants have been using them less and less but now the curtain is coming down on them.  Based on expert panels including the Institute for Medicine (IOM) the FDA finds that there is no safe level of consumption of artificial trans fat. The FDA has not set an official date for banning them but is in the process of meeting with food manufacturers to negotiate a time line.

Trans fats are made by adding hydrogen to vegetable oils to make them more solid.  Trans fats are used to enhance flavor, texture and extend the shelf life of food.  They are the worst kind of fat because unlike saturated fat that just raises the bad fat in our blood, trans fat also lowers the good heart protective fat in our blood.  Food labels have been allowed to claim a food item had zero trans fat on the label and actually contain up to 0.5 mg of the partially hydrogenated oil.  By eliminating trans fats from foods, Commissioner Margaret Hamburg from the FDA states many thousands of lives can be saved.  It is estimated that trans fats have been linked to over 20,000 heart attacks and 7,000 deaths.

In 2007, New York City and Philadelphia had passed laws forbidding the use of trans fats in restaurants.  Health care providers have been struggling to get trans fats out of the American diet for decades because of its link to heart disease.  A high LDL and low HDL increases the risk for heart disease.  By reducing the use of this artificially created fat, the prevalence and severity of heart disease can be reduced – as long as consumers become wise to substitutions for this fat that enhances flavor and texture.

Doughnuts get their light texture due to trans fats.  Coffee creamers have that smooth appearance due to trans fats.  Many peanut butters get their smooth “spread-ability” due to trans fats.  So it makes you wonder what food manufacturers will come up with to replace these food enhancing qualities.  How will this impact us as consumers?

What Will Replace Trans Fats?

Be a savvy consumer.  Although saturated fats do not lower the good cholesterol (HDL) in our blood they are still linked to coronary heart disease.  Saturated fats come from animals and certain plants.  They are found in:

  • High fat cheeses
  • Certain cuts of meat – the more marbling in the meat, the higher the saturated fat.  The cheaper cuts tend to have less embedded saturated fat.
  • Whole fat milk and cream
  • Butter
  • Ice cream
  • Palm and coconut oils.

The Dietary Guidelines for Americans 2005 recommend consuming less than 10% of your total daily calories from saturated fat.  That means in a 2000 calorie daily diet, no more than 200 calories or 22 grams should come from saturated fat.  To give you an idea of what that looks like, 1 ounce of cheddar cheese has 6 grams of saturated fat.  A Dunkin Donuts Apple Crumb donut has 9 grams and a Big Mac has 10 grams of saturated fat.  So you can see how it quickly adds up in a day.

Although it’s a big step to have the FDA push to reduce trans fats in the American diet, being aware of all the fats that cause heart disease is what puts control in the individual consumers hands.

Type 1 Versus Type 2 Diabetes

There is a big difference between type 1 and type 2 diabetes.  They are two completely different disease processes that really should not share the same name.  Type 1 is actually an autoimmune disease with a small genetic link that usually occurs in youth and causes damage to the insulin producing cells of the pancreas.  If diagnosed early then some of the pancreatic function can be preserved.   However in most cases of recently diagnosed type 1 diabetes significant permanent damage occurs requiring the individual to administer multiple daily  insulin injections to control blood sugar levels. With frequent daily blood sugar checking, insulin administration and dietary planning a person with type 1 diabetes can lead a full healthy life.  If blood sugars are not kept in good control,  blindness, kidney disease, heart disease and amputation due to poor circulation and infection can occur. Since the pancreas is not producing any insulin, it’s always a challenge for an individual with type 1 diabetes to find the balance between managing their disease and not letting it overrun their life.

Type 2 diabetes is actually a stress state of the associated with a strong family history of diabetes in conjunction with an unhealthy lifestyle.  The typical individual diagnosed with type 2 diabetes has excessive abdominal fat, leads a sedentary lifestyle and consumes a diet high in refined carbohydrates, saturated fats and not enough legumes, whole grains, and fruits and vegetables.  They often feel tired due to high blood sugars and/or sleep apnea.  It can lead to increased inflammatory markers that contribute to atherosclerosis or hardening of the arteries, decreased insulin production and sensitivity, and stress on the overworked pancreas.  Medications can help to control the disease process but without lifestyle changes as well, eventually the pancreas fails and insulin through injection is required.  Type 2 diabetes is really a vascular problem that if not controlled leads to circulatory problems resulting in slow healing of cuts, loss of vision from retinopathy, erectile dysfunction, painful neuropathies of extremities due to nerve damage, and kidney damage from high blood sugars that damage the intricate filtering components, the nephrons, of the kidneys.

The National Institute of Health did a large study involving 27 medical centers across the country on preventing diabetes in those diagnosed with prediabetes.   Prediabetes is diagnosed with a blood test as having a fasting blood sugar greater than 100 or an A1c greater than 5.8.  The results of the study were published in the New England Journal of Medicine February 7, 2002.  Initially the study involved  four groups of randomly assigned people to either a lifestyle intervention group involving motivational counseling, one of two medication groups or a placebo group.  One of the medication intervention groups was discontinued after the drug was found to cause severe liver damage.  The lifestyle intervention group involved losing 7% of body weight and exercising 150 minutes at moderate intensity level a week.  The drug group was given the oral medication, Glucophage.  The study was stopped early because the results found that a 7% weight loss in conjunction with 150 minutes of exercise a week to be the most effective in preventing diabetes in those already diagnosed with prediabetes.

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In prediabetes the pancreas makes extra insulin in order to help glucose get into the cells where it is needed for energy. Over time insulin production decreases, and blood sugars increase, leading to the development of type 2 diabetes. Once type 2 diabetes has developed there is some permanent damage done to the pancreas.

Almost 26 million people in the United States  have type 2 diabetes.  That’s 8.3% of the population!   It takes a good understanding of disease management, planning, and good support both financially and emotionally to maintain good control.  Can you imagine the cost savings of preventing this disease if everyone diagnosed with prediabetes could just lose 7% of their weight and find 150 minutes out of the 10,080 minutes in the week to exercise?  And for those already diagnosed with type 2 diabetes, just being physically active for 30 minutes daily and reining in the fast food, chips, sweets, cheese and full fat dairy and eating more whole grains, fruits and vegetables, could make all the difference in the world between just living and living well.  In this time of rising health care costs and limited resources don’t we all have a responsibility to take our health seriously and give it the focus that we give to other parts of our lives?