Health for life

Thats a popular question around here. Rather than try to argue the merits of one diet over another, Ill point you to a study that appeared in a January 2005 issue of the Journal of the American Medical Association.

The researchers compared the effectiveness of 4 popular diets:

• Atkins (low carbohydrate)
  
• Ornish (low fat)
  
• Weight Watchers (calorie restriction)
  
• Zone (carb/protein/fat balance)

They randomly assigned 160 people to one of the diets above. After a year they assessed their findings.

They found all diets produced a modest weight loss, and all improved scores of cardiovascular health (the more weight the subject lost, the lower his cholesterol, C-reactive protein, and insulin levels) - as long as the participant stuck with the diet. The more extreme diets such as Atkins and Ornish had the greatest drop-out rates.

Maria Adams, author of the summary article Ive linked below, included this comparison table:



________
For a summary of the study:
Atkins, Ornish, Weight Watchers, and Zone Diets: A Comparison

For the study itself (abstract only, subscription required for full article):
Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction

Pharmaceuticals are not the answer to cure or treat diabetes. Avandia is the latest drug to be questioned for its efficacy and side effects that increase the risk of heart attack by a whopping 43%. The Commission on Human Medicines in Great Britain has recommended pulling the drug because its risks outweigh the benefits.

Back to the Poor Man Diet.  If you missed last weeks post, you should probably read that first.  Otherwise none of this will make any frickin sense.  In the last post, I talked about 5 of the best choices you can make if youre compromising cost and health.  Theyre not the healthiest 5 foods in the world, and theyre not the cheapest 5 foods in the world... but theyre just about the most nutritious foods you can find for the least amount of money.  Its all about compromise.

Today, though, Im giving you 10 complementary foods.  Ive given you a solid base, but its the complementary foods that can make or break your diet.  If youre eating pop-tarts and ho-hos on the side, you could be in trouble.  These arent foods you need to eat every day, and because of that Im being a little more forgiving on the cost end of things and leaning more towards nutrient-density.  Still, you wont find lobster tail here, or raw oysters, or white truffles... okay nevermind Ill stop blabbering and get on with it... here you are, 10 nutritious complementary foods for your Poor Man Diet.


1. Chicken Thighs
$1.29/lb (bone-in), $1.99/lb (boneless)
$0.50/serving
Youre in luck.  Since everyone has gone chicken boob crazy, thats left chicken butt on the sidelines.  Little does everyone know, chicken thighs are much juicier and more flavorful than breasts... and theres nothing wrong with a little more fat in your life, especially if youre looking to get the most food for your dollar.  In terms of nutrition, theyre a great source of protein, B vitamins, and zinc.  Probably your most cost-effective source of meat!


2. Onions
$3.49/3 lb
$0.44/onion (size matters)
One of the most versatile foods in your Poor Man kitchen is onions.  They work with just about everything, whether its a rice dish, a stir fry, a salad, or meat.  Although theyre not particularly dense with vitamins and minerals, they make up for it with a few other interesting benefits.  Onions are allyl propyl disulphide, a compound that has a blood sugar lowering effect; great for diabetics.  Theyre also really high in antioxidants, including quercetin, which has known anti-cancer properties.  You can eat them liberally.


3. Sweet Potatoes
$1.29/lb
$0.52/serving
Theyre a little more expensive then regular potatoes, but theyre just as nutritious (if not more so).  The nutrient breakdown is similar to a white potato, the only major difference being the huge whack of beta-carotene in sweet potatoes.  I honestly dont know where this good-sweet-potato/bad-white-potato nonsense came from... theyre both great foods, and they should be an important part of a healthy diet.  As for the sweet ones, bake them, boil them, mash them, roast them with cinnamon and coconut oil... any way you prepare them, theyre a yummy treat. 


4. Liver, heart, or other organ meat
$1.11/lb (chicken liver), $2.49/lb (beef liver)
$0.37/serving
Yuck, right?  I know, personally I have a hard time eating liver; I just cant get used to the pungent flavor.  But liver is by far the most nutrient dense food for your dollar.  Its the best source of vitamins A and B12 youll find, and its also very high in iron, zinc, folate, and all the B vitamins.  Luckily, it only takes a little liver to get a nice burst of all these important vitamins and minerals.  Cant get past the taste?  Give beef heart a try... its not as gross at it sounds; if you put it in a stew it would be indistinguishable from normal beef, I promise.  And the nutritional content is in the same league as liver.  Be brave and try it!  Heart is for lovers <3.


5. Grass-Fed Butter
$2.99/8 oz
$0.19/Tbsp
Yup, butter is on the list!  Its inexpensive, tasty, and full of good fat (believe it or not).  Grass-fed butter, which you can get in just about every grocery store in America at this point, is not your average butter.  It comes from cows grazed on pasture, not penned up indoors eating corn, and that has a big impact on the nutrient content of the butter.  Grass-fed butter has more vitamin A, K2, and CLA, and it has more flavor than grain-fed butter.  Give Kerrygold a try, youll never look back.


6. Baby Carrots
$1.99/lb
$0.40/serving
Carrots arent the most nutritious vegetable around, but theyre not too shabby.  And considering the price, youve got yourself a winner.  Theyre a great source of fiber, beta carotene, and theyve got a little bit of just about every vitamin and mineral we need.  Theyre versatile and convenient; you can snack on them as is, throw them in a stir fry, or use them in a stew.


7. Extra Virgin Olive Oil
$19.49/3 Liters
$0.10/Tbsp
But... extra virgin olive oil is so expensive!?!?  Shut it.  Its not.  Every time I go to the grocery store, theres at least one giant container of extra virgin on sale.  It may not be the worlds most yummiest olive oil, but its still decent nonetheless.  Its full of heart-healthy fats, you need it in your life.  Use it in salad dressings, pour it over steamed veggies, or cook with it.  Keep the temperature to a low-medium in cooking though... extra virgin isnt really meant for high heat cooking.


8. In-Season Fruit
$Cheap
$Cheap/serving
Where else can you find something for $Cheap???  No matter the time of year, theres something in season.  In the summer its berries, in the fall its apples, in the winter its oranges, etc etc etc.  Buying a giant bag of whatever it is will get you the most fruit for your dollar.  But buying fruit in season has benefits that go beyond price, too.  Most importantly, it tastes better.  Youll notice that immediately.  But its also better for the environment and it promotes a more sustainable agricultural system.  We cant afford to be shipping this stuff around the world all the time. And if you happen to live in an area where avocados grow... then god bless you child you dont know what you got.


9. Canned Wild Salmon
$3.79/lb
$0.95/serving
Thought wild salmon was out of your price range??  Not when youre buying it canned!  For reasons that are unknown to me, salmon in a can is far more affordable than fresh or frozen.  And its nearly always wild, not farmed.  The wild type is higher in important omega-3s, and its full of lots of important vitamins and minerals, like B12 and selenium.  And canned salmon, unlike fresh or frozen, actually has a good amount of calcium... there are little bones in there too.  You wont even taste them.  This stuff works wonders on salads... very super-convenient and tasty.



10. Whole Milk
$3.89/gallon
$0.24/cup
Only for the dairy-tolerant, of course.  Despite what youve been told, whole milk is your best milk option.  The fats wont kill you.  Besides, you cant afford to be throwing the fat out when youre poor.  Skim milk, on the other hand, is downright scary.  Its an empty food, and it tastes like nothing.  And of course, milk is a great source of calcium, along with fat soluble vitamins like A and D.  Oh, and dont forget B12 and potassium.  Of course, raw, grass-fed milk would be better... but you cant afford that.



Phew!  All done.  Now... with the 5 base foods, and 10 complementary foods, Id say weve got a pretty solid, nutritious, affordable diet here.  As far as I can tell, Ive covered all of the nutritional bases... plenty of protein, healthy fats, and good carbs, as well as adequate vitamins and minerals.

Now that its all out there, Id love some feedback.  Do you agree with these?  Are there foods I left out that you feel should have been included?  Do you think Im a complete moron and should shut down my blog altogether??  Let me hear it in the comments section!

Its such a no-brainer, right?  If persons at risk for diabetes would only eat right and exercise more, theyd avoid the disease.  And for those who develop diabetes, diet and exercise will reduce death rates and complications.

Yes and no, say Elizabeth Sumamo Schellenberg and colleagues at the University of Alberta.  Their review of the mixed published scientific evidence on the topic appears in the October 15 issue of the Annals of Internal Medicine.  The purpose of their study was to ascertain the impact of diet and exercise on the prevention of "Type 2 diabetes," as well as lowering complications among persons with who had established Type 2 diabetes. 

To be included, studies had to be prospective and compare the outcomes from an intervention versus a randomly selected control group. The study could only be included if it examined the impact of exercise plus diet and "one other component," such as "counseling, smoking cessation and behavior modification."  The outcomes had to include the development of Type 2 diabetes (in the prevention trials) or complications (in the treatment trials).

1289 candidate studies were found but only 20 made the grade. Nine were prevention trials and 11 were treatment trials.

For the prevention trials:

The interventions lasted from 6 to 72 months, with follow-up going for 3 to 20 years for between 39 to 3234 participants.  The counseling varied and included group and/or individual with or without tobacco cessation, telephony, goal setting, cooking classes or pills involving a range of physician and non-physician professionals.

Results?

Seven of the nine studies showed that diabetes can be delayed. When the results were pooled, compared to the control patients, the risk of developing diabetes over 10 years was only a third and the difference was statistically significant.

But, there was no detectable impact on cardiovascular disease events or on eye, kidney or nerve damage. That may have been due to not all the studies including these outcomes as well as the time it takes for these complications to occur once diabetes develops.  With more patients or more time, a difference could have become apparent.
 
For the treatment trials:

The interventions lasted from 6 to 48 months with follow-up for 6 to 93 months. The counseling was as varied as the prevention trials but included glucose and blood pressure monitoring as well as stress management and, in one instance, a three day residential retreat. There was likewise the range of professionals who provided the interventions.

Results? 

Compared to the control patients, there was no statistically significant difference in all-cause mortality.  Some individual studies had beneficial outcomes involving cardiovascular events or diabetes complications, but they included the aggressive use of medications.  There were no sustained impacts on weight or dietary intake.  And if pills were not included, there was also no real improvement in measures of blood glucose control.

The Disease Management Care Blogs take?

The good news is that there is good evidence that exercise and diet can prevent diabetes.  The bad news is that it takes years for that "return on investment" to declare itself and typically involves interventions that fall outside the traditional health care delivery system.  Its unlikely, thinks the DMCB, that current iterations of payment orm (value based purchasing, bundled payments or upside risk) can be marshaled to make this a reality.  That being said, population health management (PHM) companies like Omada Health are making their evidence-based services available to, for example, employers who have a longer term commitment to the well being of their "human capital" outside of the traditional insurance market.

The bad news is that once diabetes declares itself, diet and exercise dont result in life extension, and control of complications as well as overall blood sugar levels is more a function of pills than lifestyle. Accordingly, expectations need to be realisitically shared with patients and PHM should emphasize taking the pills as prescribed.

Image from Wikipedia

A high-fiber diet may have the clinical potential to control the progression of prostate cancer in patients diagnosed in early stages of the disease.

The rate of prostate cancer occurrence in Asian cultures is similar to the rate in Western cultures, but in the West, prostate cancer tends to progress, whereas in Asian cultures it does not. Why? A University of Colorado Cancer Center study published in the January 2013 issue of the journal Cancer Prevention Research shows that the answer may be a high-fiber diet.

The study compared mice fed with of inositol hexaphosphate (IP6), a major component of high-fiber diets, to control mice that were not. Then the study used MRI to monitor the progression of prostate cancer in these models.

"The studys results were really rather profound. We saw dramatically reduced tumor volumes, primarily due to the anti-angiogenic effects of IP6," says Komal Raina, PhD, research instructor at the Skaggs School of Pharmacy and Pharmaceutical Sciences, working in the lab of CU Cancer Center investigator and School of Pharmacy faculty member, Rajesh Agarwal, PhD.

Basically, feeding with the active ingredient of a high-fiber diet kept prostate tumors from making the new blood vessels they needed to supply themselves with energy. Without this energy, prostate cancer couldnt grow. Likewise, treatment with IP6 slowed the rate at which prostate cancers metabolized glucose.

Possible mechanisms for the effect of IP6 against metabolism include a reduction in a protein called GLUT-4, which is instrumental in transporting glucose.

"Researchers have long been looking for genetic variations between Asian and Western peoples that could explain the difference in prostate cancer progression rates, but now it seems as if the difference may not be genetic but dietary. Asian cultures get IP6 whereas Western cultures generally do not," Raina says.

A diet high in omega-3 polyunsaturated fat lowers levels of problem enzyme

Columbia University Medical Center (CUMC) researchers have found that a diet high in saturated fat raises levels of endothelial lipase (EL), an enzyme associated with the development of atherosclerosis, and, conversely, that a diet high in omega-3 polyunsaturated fat lowers levels of this enzyme. The findings establish a "new" link between diet and atherosclerosis and suggest a novel way to prevent cardiovascular heart disease. In addition, the research may help to explain why the type 2 diabetes drug rosiglitazone (Avandia) has been linked to heart problems.

The study, conducted in mice, was published in the October 4 online edition of Atherosclerosis, Thrombosis, and Vascular Biology.

Like other lipases, EL plays a role in the metabolism of blood lipoproteins, which are complexes of lipids (fats) and proteins. EL, which is secreted by macrophages (a type of white blood cell) and other cells in arteries, was discovered in 1999. Studies have shown that elevated EL is associated with atherosclerosis and inflammation. Until now, however, little was known about how dietary fats might affect this enzyme, said study leader Richard Deckelbaum, MD, the Robert R. Williams Professor of Nutrition professor of pediatrics and of epidemiology and director of the Institute of Human Nutrition at CUMC.

In the current study, a strain of mice susceptible to atherosclerosis was fed a normal diet enriched with either palmitic acid (a common saturated fat) or eicosapentaenoic acid (an omega-3 fatty acid, or polyunsaturated fat, found in fish oil, among other foods). After 12 weeks, the mices aortas were examined for changes in the expression of EL and inflammatory factors. Aortas of mice fed the saturated fat diet showed a significant increase in EL and detrimental changes in inflammatory factors, while those of mice fed the polyunsaturated fat diet showed a significant decrease in EL and beneficial changes in inflammatory factors. Studies in cultured macrophages showed similar results.

"Our study identifies a new way in which the high-saturated-fat Western diet could lead to the development of atherosclerosis, though, of course, these results need to be confirmed in human studies," said Dr. Deckelbaum. "The findings might also explain some of the cardiovascular benefits that have been attributed to omega-3 fatty acids."

The researchers also found, in cell culture studies, that macrophages fed saturated fat showed increased expression of PPAR-gamma, a cell signaling molecule that plays a role in regulating lipid metabolism and inflammatory responses. This increase was blocked when the cells were fed an omega-3 fatty acid.

"These findings are intriguing, because we know that the diabetes drug rosiglitazone (sold under the brand name Avandia) is a strong PPAR-gamma activator and that it has been associated with an increased risk of heart disease," said Dr. Deckelbaum. "So we hypothesized that if rosiglitazone activates ppar-gamma, it might also activate EL, which would explain its effects on the heart."

In fact, when the macrophages were given rosiglitazone, the expression of EL increased markedly. The addition of omega-3 fatty acids to the cells blocked this increase. "This would suggest that besides raising LDL cholesterol levels, rosiglitazone can raise the risk of cardiovascular disease by increasing EL," said Dr. Deckelbaum. "In addition to its potential role in increasing arterial inflammatory responses, EL increases the anchoring of LDL to cell surfaces, which could be associated with increased LDL accumulation in coronary arteries."

Use of Avandia was severely restricted in 2010, when the drug was linked to the development of heart disease.

A study due in the upcoming July 15 issue of the American Heart Association journal Circulation will be reporting that: ¹

"Greater adherence to the prudent pattern [of eating] may reduce the risk of cardiovascular and total mortality, whereas greater adherence to the Western pattern may increase the risk among initially healthy women."

What did the researchers define as a "prudent pattern"?

"High prudent pattern scores represented high intakes of vegetables, fruit, legumes, fish, poultry, and whole grains, whereas high Western pattern scores lected high intakes of red meat, processed meat, ined grains, French fries, and sweets/desserts."

It was a large prospective evaluation of the diets of 72,113 women who participated in the Nurses Health Study. They were followed for 18 years.

The prudent diet reduced risk of cardiovascular death by 28% when compared to the Western diet. It reduced risk of all-cause death by 17%.

The Western diet increased risk of cardiovascular death by 22%, cancer death by 16%, and all-cause death by 21%.

These findings are similar to those reported earlier this year in the same journal.² In that study, the diets of 9,514 participants of the ARIC cohort (Atherosclerosis Risk in Communities study) were evaluated over the course of 9 years. Those men or women who ate a Western pattern - high in meat and fried foods - had a higher risk of developing metabolic syndrome. Metabolic syndrome is a constellation of risk factors for heart disease. These include insulin resistance, diabetes, hypertension, high blood lipids, high uric acid levels, and obesity - especially weight carried around the waist.

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¹ Dietary Patterns And Risk Of Mortality From Cardiovascular Disease, Cancer, And All Causes In A Prospective Cohort Of Women, Circulation, 2008

² Dietary Intake And The Development Of The Metabolic Syndrome. The Atherosclerosis Risk In Communities Study, Circulation, 2008

Stroke is a debilitating and often deadly condition that strikes more than 800,000 people each year and ranks as the third leading cause of death. A stroke is caused by a blockage of blood flow to the brain from either a clot or blood vessel constriction.

The Basics of a Healthy Diabetes Diet

Contrary to what you may have heard, there is no "diabetes diet," per se -- and thats good news! The foods recommended for a diabetes diet to control blood glucose (or blood sugar) are good for those with diabetes -- and everyone else. This means that you and your family can eat the same healthy foods at mealtime. However, for people with diabetes, the total amounts of carbohydrates consumed each day must be monitored caully. Of the different components of nutrition -- carbohydrates, fats, and proteins -- carbohydrates have the greatest influence on blood sugar levels. Most people with diabetes also have to monitor total fat consumption and protein intake, too.


To keep your blood sugar levels in check, you need to make healthy food choices, exercise regularly, and take the medicines your health care provider prescribes. A dietitian can provide in-depth nutrition education to help you develop a personalized meal plan that fits your lifestyle and activity level, and meets your medical needs.
Learn the ABCs of a Diabetes Diet

The goal of nutrition for people with diabetes is to attain the ABCs of diabetes. The A stands for the A1c or hemoglobin A1c test, which measures average blood sugar overthe previous three months. B is for blood pressure, and C is for cholesterol. People with diabetes should attain as near as normal blood sugar control (HbA1c), blood pressure, and healthy cholesterol levels.
Alcohol and Diabetes

Use discretion when drinking alcohol if you have diabetes. Alcohol is processed in the body very similarly to the way fat is processed, and alcohol provides almost as many calories as fat. If you choose to drink alcohol, only drink it occasionally and when your blood sugar level is well-controlled. Its a good idea to check with your doctor to be sure drinking alcohol is acceptable.

Diabetes and Glycemic Index

For years, researchers have tried to determine what causes blood sugar levels after meals to soar too high in those with diabetes. Potential culprits have included sugar, carbohydrates, and starches, among other foods. The glycemic index is a ranking that attempts to measure the influence that each particular food has on blood sugar levels. It takes into account the type of carbohydrates in a meal and its effect on blood sugar.

Foods that are low on the glycemic index appear to have less of an impact on blood sugar levels after meals. People who eat a lot of low glycemic index foods tend to have lower total body fat levels. High glycemic index foods generally make blood sugar levels higher. People who eat a lot of high glycemic index foods often have higher levels of body fat, as measured by the body mass index (BMI).

Talk to your doctor, a registered dietitian, or a diabetes educator and ask if the glycemic index might work to help gain better control of your blood sugar levels.

The glycemic load takes into account the effect of the amount of carbohydrates in a meal. Both the type of carbohydrate and the amount have an effect on blood sugar.
Eating Right With Diabetes

If you have diabetes, its important to eat right every day to keep your blood sugar levels even and stay healthy. Heres some easy tips:

    * Be sure to eat a wide variety of foods. Having a colorful plate is the best way to ensure that you are eating plenty of fruits, vegetables, meats, and other forms of protein such as nuts, dairy products, and grains/cereals.
    * Eat the right amount of calories to maintain a healthy weight.
    * Choose foods high in fiber such as whole grain breads, fruit, and cereal. They contain important vitamins and minerals. You need 25 to 35 grams of fiber per day. Studies suggest that people with type 2 diabetes who eat a high fiber diet can improve their blood sugar and cholesterol levels. Similar results have been suggested in some studies in people with type 1 diabetes.

Serving Sizes and Diabetes

Be sure to eat only the amount of food in your diabetes meal plan. Excess calories result in excess fat and excess weight. In people with type 2 diabetes, excess body fat means less sensitivity to insulin. Weight loss in overweight and obese people with type 2 diabetes helps improve blood sugars and reduces those risk factors which lead to heart disease. Your dietitian can help you determine the appropriate serving sizes you need, depending on if you need to maintain your weight, gain weight, or lose weight, and if you have high or low blood sugar levels.

    * In women with gestational diabetes, its important to eat multiple meals and snacks per day as recommended.
    * Do not skip meals.
    * Eat meals and snacks at regular times every day. If you are taking a diabetes medicine, eat your meals and take your medicine at the same times each day.

Note: If you are taking some of the newer diabetes drugs, some of these tips may not apply to you; ask your health care provider the tips you should follow.
The Sweet Truth about Food and Diabetes

You might have heard that, as a person with diabetes, you shouldnt have any table sugar. While some health care providers continue to promote this, many -- realizing that the average person lives in the real world and will probably indulge in a bit of sugar every now and then -- have adopted a more forgiving view. Most experts now say that small amounts of sugar are fine, as long as they are part of an overall healthy meal plan. Table sugars do not raise your blood sugar any more than similar amounts of calories from starches, which is found in many foods that we consume. It is important to remember that sugar is just one type of carbohydrate.

When eating sugar, keep these tips in mind:

    * Read food labels. Learn how to determine how much sugar or carbohydrates are in the foods that you eat.
    * Substitute, dont add. When you eat a sugary food, such as cookies, cakes, or candies, substitute them for another carbohydrate or starch (for example, potatoes) that you would have eaten that day. Make sure that you account for this in your carbohydrate budget for the day. If it is added to your meal for the day, then remember to adjust your insulin dose for the added carbohydrates so you can continue to maintain glucose control as much as possible. In other words, readjust your medications if you do add sugars to you meals.
    * Sugary foods can be fattening. Many foods that have a lot of table sugar are very high in calories and fat. If you are watching your weight (and many people with diabetes must), you need to eat these foods in moderation!
    * Check your blood sugar after eating sugary foods and talk to your health care provider about how to adjust your insulin if needed when eating sugars.
    * Ultimately, the total grams of carbohydrates -- rather than what the source of the sugar is -- is what needs to be accounted for in the nutritional management of the person with diabetes.

Diabetes Diet Myths

Before you start a diabetes diet, get the facts. So many people believe that having diabetes means you must avoid sugar and carbohydrates at all cost, load up on protein, and prepare "special" diabetic meals apart from the familys meals. Wrong! Most individuals with diabetes can continue to enjoy their favorite foods, including desserts, as long as they monitor the calories, carbs, and other key dietary components and keep a regular check on their blood glucose levels.

Get the facts and start enjoying the foods you love on a diabetes diet.

What Is the TLC Diet for Diabetes?

People with diabetes who have abnormal cholesterol levels will likely be placed on a diet known as a "TLC" diet. The TLC diet will help reduce the intake of cholesterol-raising nutrients. As part of this diet you may be asked to lose weight and increase physical activity levels -- all of these are components that will help lower bad LDL cholesterol. Looking at food labels will help you become more knowledgeable about your intake of fats and cholesterol.

Specifically, the TLC diet calls for the following:

    * Total fat consumption should be 25%-35% or less of total calories eaten per day.
    * Saturated fats should be less than 7% of total calories eaten in a day.
    * Polyunsaturated fats (from liquid vegetable oils and margarines low in trans fats) should be up to 10% of the total calories per day consumed.
    * Monounsaturated fats (derived from vegetable sources like plant oils and nuts) should be up to 20% of total calories per day eaten.
    * Carbohydrates should be 50%-60% of total calories per day eaten
    * We should eat 20-30 grams of fiber per day. These can be derived from oats, barley, psyllium, and beans.
    * The amounts of protein in the diet should equal about 15%-20% of total calories eaten per day.
    * Cholesterol content of the diet should be less than 200 milligrams per day.

How Much Fat Is Acceptable on a Diabetes Diet?

People with diabetes have higher than normal risk for heart disease, stroke, and disease of the small blood vessels in the body. Controlling blood pressure and limiting the amount of fats in the diet will help reduce the risk of these complications.

Limiting the amounts of saturated fats, increasing the amount of regular exercise, and receiving medical treatment can lower bad LDL cholesterol. This has been repeatedly shown in medical studies to help people with diabetes reduce their risk of heart disease and reduce the risk of death if a heart attack does occurs in a diabetic person.

Artificial Sweeteners and Diabetes

Artificial sweeteners can be added to a variety of foods and beverages without adding more carbohydrates to your diabetes diet. Using non-caloric artificial sweeteners instead of sugar also greatly reduces calories in your favorite foods.

Keep in mind that foods with artificial sweeteners are not necessarily zero carbohydrates foods. Many have carbohydrates; theore, you must read the food labels to determine the gram amounts per serving that these have in order to take into account the effect that these carbohydrates have on your glycemic control. Foods labeled with artificial sweeteners can affect your blood sugar.

As long as you are aware of the content of carbohydrates you can adjust your meal or medication to maintain blood sugar control. "Sugar free" means no sugar has been added, but you must remember these foods still contain carbohydrates which does affect your blood sugars.

Examples of artificial sweeteners you can use include:

    * Aspartame
    * Acesulfame-k
    * Saccharine
    * Sucralose
    * Other non-nutritive sweeteners

Pregnant or breastfeeding women should avoid saccharine, and people who suffer from phenylketonuria should not use aspartame. People with phenylketonuria are unable to metabolize phenylalanine, an amino acid thats a common part of many proteins.

Some artificial sweeteners -- such as xylitol, mannitol, and sorbitol -- have some calories and do slightly increase blood sugar levels.

The American Diabetes Association cautions that eating too much of any artificial sweetener can cause gas and diarrhea.

A diet high in glycemic index foods and dairy products is now linked to acne, according to a new study published in the Journal of the Academy of Nutrition and Dietetics.

The study also suggests using medical nutrition therapy (MNT) as a form of acne treatment. The findings support rising evidence of a link between diet and acne.

Over 17 million people in the United States have acne, which generally occurs during their teen and young adult years. Acne can affect quality of life and lead to:

* anxiety
* depression
* social withdraw

Because of these unfavorable consequences associated with the skin condition, treatment for acne is crucial.

Previous studies have always associated diet to this common skin condition. Since the 1800s, research pinpointed chocolate, sugar, and fat as diet factors contributing to acne. However, starting in the 1960s, studies began disassociating diet from acne.

Jennifer Burris, MS, RD, of the Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education, and Human Development, New York University said:

"This change occurred largely because of the results of two important research studies that are repeatedly cited in the literature and popular culture as evidence to ute the association between diet and acne. More recently, dermatologists and registered dietitians have revisited the diet-acne relationship and become increasingly interested in the role of medical nutritional therapy in acne treatment."



The researchers, led by Burris, conducted a literature review to examine evidence for the link between acne and diet during three time periods: early history, the rise of diet-acne myth, and recent studies.

The investigators took information from studies between 1960 and 2012 that examined acne and diet. The study factors that were analyzed were:

* design
* participants
* erence
* intervention method
* results and conclusions
* primary outcome
* covariate considerations
* limitations

The study showed that a high glycemic index/glycemic load diet and high dairy intake are the primary factors in establishing the association between acne and diet.

Isobel Del Los Rios, a low-carb weight control expert says: "Did you know that less than 50% of people who make eating healthier and losing weight their New Years resolution actually stick to it?"

The one thing that would make me go off of a diet in the past was always "expectations of perfection." I would work really hard at following the rules of whatever diet I was on but at some point I would go nuts and eat cake, or some other such item. Not a little bit of cake, I would eat half a cake. Then I would look at what I had done and feel like a pervert. I would feel so ashamed that I would simply quit trying while I finished off the rest of the cake.

I would be telling myself, "Whats the use? I cant do it." My going bonkers over some food that was not on the diet-du-jour would completely wipe out any shreds of self esteem that I ever had. Notice the word "ever." When we get like that everything looks like it is eternal.

I am so glad glad glad that the Lord showed me, one wrong meal does not a pervert make!! That "diet perfection" mantra was insanity at its most insidious. The problem was not in making the wrong choices for that one meal or even that day... the problem was not fulfilling the expectation that I was never going to make a mistake again. Going on a diet, does not instantaneously transform anything about you. Going on a diet is a set of choices. And yes, I am using the "dreaded word:" diet. Diet, in its simplest terms simply means "what you eat." Everybody is always on a diet!! The first day of your life your diet was your mamas milk and at some point we started picking out other things. We probably wanted a little more variety.

If you were incredibly blessed you had either someone in your life who guided you to eat only fresh raw healthy vegetables, fruit, fish, meat and  foods -- or you were just "naturally thin."  Then there is the rest of us!! LOL My mom did try to feed us healthy. She very caully made sure we had a meat, a cooked vegetable, and a potatoe -- or some other similar combination -- and only rarely we had a dessert. I never saw the inside of a restaurant until I was twelve years old.

Unfortunately, my body structure gained weight on the healthy food my mother made. I had the addiction young. By the time I was eight years old, I was "chubby" and my mother told her friends that I had "baby fat." Can you imagine being a robust eight-, nine-, or ten-year old and hearing your mom continue to tell everyone you had "baby fat." She fully expected me to "grow out of it" but I didnt. Every single one of my siblings, and I had quite a few of them, was as thin as a zipper when we were kids. I was sure there was something wrong with me, but had no idea what it was, or what to do about it. Unfortunately for them, they are all over weight now, too -- although not as extremely as I am. I dont hold it against them. It just happens while you are living your life, chasing your dreams, and not paying attention.

So. That is why I share my foolish eating and then move on. I am so glad, not to be stuck in the "diet perfection" trap. Of course I lose weight a little more slowly. It almost does not matter, I lose weight slowly. But I am losing weight. I used to hover around 352 -- now I hover around 328. Nice!! I am hoping with this new round of fresh focus and better choices I will start hovering around 318. The closest I have been is 321, so I know I can get there. When I was in "quit" mode, I never thought I could do anything but hover around 352. Ive now got enough experience to know that old thinking was a lie.

What lies are you living with? Anything that stems from "diet perfectionism" will very likely be a lie. We seem to have linear thinking. Someone once drew a line and said "this is life." Well it was probably a very nice illustration of a particular point, but weve taken it too far. Look around your living room. Do you see that line? LOL Our lives are not straight lines. At this point the usual thing would be to replace that line with some other shape or form or idea. But if you look, you wont find that in your house either. The thing of importance in your house is you and whoever else is there with you. Our lives are moment by moment experiences. When it gets down to the real nitty gritty, the thing that is important to us is relationships. The one ancient saying about "life" that does seem to fit is that life is a journey. Step by step we are going somewhere but it very rarely could actually be depicted with a straight line.

So loosen up a little. When you eat a wrong item, dont have a cow, just do what you need to do to not repeat that one. Make a decision not to do that again. Make a decision to get that out of the house. Take the clean up action and let go. There is no real purpose in beating yourself up about a fouled up meal. Just do the next one right. Then do the next one right and chalk up "two for you." Then do the next one right. Pretty soon you will have a pattern of eating right and the numbers on your glucose monitor will get smaller -- and the numbers on your scale will get smaller too. You will have formed a habit. Then you will screw up another one. Just give yourself a "do over" and move on.

Im not a coffee drinker and usually dont drink much tea either. I bought a coffee maker because I have some friends who love coffee and I wanted to be able to serve them some when they come to my house. They taught me how to make it to suit them and that is the way I make coffee. So the rest of the time it just sits on my counter doing nothing. Sometimes I would make a pot of tea by putting tea bags in the coffee filter and let it drip. I would drink one cup and then let the rest of it sit on the hot plate and change color and flavors until I threw it out. I finally figured out a better way for me. Duh! I simply use it to heat the water and keep it hot on the plate until I want a cup of tea. Then I just get out a cup and a tea bag and make a fresh one. If I am doing dishes and need to heat up the water ( I dont have a dish washer -- dark ages, I know) I pour some of the hot water in the dish pan and keep going. I always liked the "two birds with one stone" idea.

Today I was 96% on target (not a scientific number) and I lost a pound. My blood sugar this morning was 107. Not bad. The salads are tasty. I found a new sugar free dressing from "Cindys Kitchen" called "Rosemary and Roasted Garlic Vinaigrette" which I purchased at Whole Foods in the produce section cooler. I am really loving it. I read the ingredients and there really is no sugar in it -- and no ugly sugar substitutes either. It really is a good and tasty natural one and I recommend it. Cant wait to share it with Julianna this Saturday.

Wearing the knee brace. Looking forward. Feeling good.

Be back soon,

Marcia

A heart-healthy diet helped men at high risk for heart disease reduce their bad cholesterol, regardless of whether they lost weight, in a study presented at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology 2013 Scientific Sessions.

The 19 24- to 62-year-old men in the study had metabolic syndrome, which ers to three or more significant risk factors for heart disease and stroke. The risk factors included in this study were high waist circumference, high blood pressure, high levels of triglycerides and fasting glucose and low levels of high density lipoprotein or HDL “good” cholesterol.

For five weeks, the men followed a standard North American diet which is high in fats, carbohydrates, ined sugar and red meat. For a second five weeks, they ate a Mediterranean-style diet, which is high in fruits, vegetables and whole grains, and low in red meat. It also includes olive oil and moderate wine drinking.

The men then went on a 20-week weight-loss regime, then another five weeks of Mediterranean eating.

Regardless of whether patients lost weight, following the Mediterranean-style diet resulted in a 9 percent decrease in levels of low density lipoprotein (LDL) known as “bad” cholesterol. Similarly, blood concentrations of the protein part of the lipoprotein, called apolipoproteinB, dropped 9 percent after eating Mediterranean-style. Apolipoprotein plays an important role in lipid transport and metabolism.

“The Mediterranean-style diet, or MedDiet, may be recommended for effective management of the metabolic syndrome and its related risk of cardiovascular disease,” said Caroline Richard, M.Sc., study lead author and a registered dietician and Ph.D. candidate in nutrition.

New research shows that a Mediterranean-style diet and diets low in available carbohydrates can offer protection against type 2 diabetes. The study is published in Diabetologia, the journal of the European Association for the Study of Diabetes (EASD), and is by Dr Carlo La Vecchia, Mario Negri Institute of Pharmacological Research, Milan, Italy, and colleagues.

The authors studied patients from Greece who are part of the ongoing European Prospective Investigation into Cancer and nutrition (EPIC), led by Dr. Antonia Trichopoulou, from the University of Athens. From a total of 22,295 participants, actively followed up for just over 11 years, 2,330 cases of type 2 diabetes were recorded. To assess dietary habits, all participants completed a questionnaire, and the researchers constructed a 10-point Mediterranean diet score (MDS) and a similar scale to measure the available carbohydrate (or glycaemic load [GL]) of the diet.

People with an MDS of over 6 were 12% less likely to develop diabetes than those with the lowest MDS of 3 or under. Patients with the highest available carbohydrate in their diet were 21% more likely to develop diabetes than those with the lowest. A high MDS combined with low available carbohydrate reduced the chances of developing diabetes by 20% as compared with a diet low in MDS and high in GL.

The authors say: "The role of the Mediterranean diet in weight control is still controversial, and in most studies from Mediterranean countries the adherence to the Mediterranean diet was unrelated to overweight. This suggests that the protection of the Mediterranean diet against diabetes is not through weight control, but through several dietary characteristics of the Mediterranean diet. However, this issue is difficult to address in cohort studies because of the lack of information on weight changes during follow-up that are rarely recorded."

They point out that a particular feature of the Mediterranean diet is the use of extra virgin olive oil which leads to a high ratio of monounsaturated to saturated fatty acids. But again research here has been conflicting. One review of dietary fat and diabetes suggests that replacing saturated and trans fats with unsaturated fats has beneficial effects on insulin sensitivity and is likely to reduce the risk of type 2 diabetes. However, in a randomised trial of high-cardiovascular-risk individuals who were assigned to the Mediterranean diet supplemented with either free extra virgin olive oil or nuts and were compared with individuals on a low-fat diet (comparison group), there was no difference in diabetes occurrence between the two variants of the Mediterranean diet when compared with the comparison group.

Regarding GL, the authors say: "High GL diet leads to rapid rises in blood glucose and insulin levels. The chronically increased insulin demand may eventually result in pancreatic β cell failure and, as a consequence, impaired glucose tolerance and increased insulin resistance, which is a predictor of diabetes. A high dietary GL has also been unfavourably related to glycaemic control in individuals with diabetes."

They conclude: "A low GL diet that also adequately adheres to the principles of the traditional Mediterranean diet may reduce the incidence of type 2 diabetes.