Health for life

Laurel Miller, via Salon.com, reviewed Mark Bittmans new cookbook, "Food Matters: A Guide to Conscious Eating With More Than 75 Recipes." (Bittman writes a food column for the New York Times and blogs for the NYTs at Bitten.)

How To Live What Michael Pollan Preaches, Salon.com, January 2009

Here are some excerpts from her article:

"[Bittmans book is] an unusual blend of manifesto, self-help manual and cookbook designed to convince people that they can drastically improve their diets with relatively little discomfort."

Bittmans formula: "Eat less of certain foods, specifically animal products, ined carbs, and junk food; and more of others, specifically plants, in close to their natural state."

"At 57, [Bittman had] gained 50 pounds over his college weight and had developed high cholesterol, high blood sugar (especially scary for someone with a family history of diabetes) and sleep apnea, a condition caused by his excess weight."

Bittmans specific tactics ...

"With a colleague, Kerri Conan, Bittman devised a plan they called "vegan until six." They ate almost no animal products at all until dinnertime, no simple carbohydrates and no junk food. (Simple carbs are sugars, white flours and other processed grains like white rice.) At dinner, they ate as they had before, although in time Bittman found that even his evening meals came to include more "vegetables, fruits, legumes and whole grains and less meat, sugar, junk food, and overined carbohydrates."

"It was easy, and in a matter of months hed lost 35 pounds, lowered his cholesterol and blood sugar, and had no trouble sleeping through the night. Most important, he continues to eat this way and is content to do so for the rest of his life."

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Scientists today described evidence that natural substances extracted from unroasted coffee beans can help control the elevated blood sugar levels and body weight that underpin type 2 diabetes. Their presentation on chlorogenic acids -- widely available as a dietary supplement -- was part of the 245th National Meeting & Exposition of the American Chemical Society (ACS), the worlds largest scientific society, being held here this week.

Joe Vinson, Ph.D., who led the research, pointed out that type 2 diabetes, the most common form of diabetes, is an increasing global health problem. In the United States alone, almost 26 million have the disease, in which the pancreas does not produce enough of the insulin that enables the body to use sugar, or cells resist the effects of that insulin. Blood sugar levels rise, increasing the risk of heart attacks, stroke and other health problems. Current treatments focus on oral medications that stimulate insulin secretions and/or reduce insulin resistance, dietary changes that control blood sugar levels and weight loss that reduces insulin resistance.

"A simple natural pill or capsule that would both help control blood sugar and foster weight loss at the same time would be a major advance in the treatment of type 2 diabetes," Vinson said. "Our own research and studies published by other scientists suggest that such a treatment may, indeed, exist. There is significant epidemiological and other evidence that coffee consumption reduces the risk of type 2 diabetes.

"One large study indicated a 50 percent risk reduction for people who drank seven cups of coffee a day compared to those who drank only two cups a day. I am trying to make the coffee and diabetes story as clear as possible for the public. The evidence points to chlorogenic acids as the active ingredients in coffee that both prevent diabetes and improve glucose control in normal, pre-diabetic and diabetic people."

Chlorogenic acids are a family of substances that occur naturally in apples, cherries, plums, dried plums and other fruits and vegetables. Vinson, who is with the University of Scranton in Pennsylvania, pointed out that coffee ― due to its popularity as a beverage ― is a major dietary source of these substances. Large amounts of chlorogenic acids exist in green, or unroasted, coffee beans. However, the high temperatures used to roast coffee beans to make them suitable for use in coffee breaks down much of the chlorogenic acids. Thus, the focus has been on using concentrated extracts of green coffee beans, which contain higher amounts of chlorogenic acids.

In a previous study, Vinson found that overweight or obese people who took such an extract lost about 10 percent of their body weight in 22 weeks. The new study sought to document the effects of various doses of a commercial green coffee extract on the blood sugar levels of 56 men and women with normal blood sugar levels. They got a glucose tolerance test to see how their bodies responded to the sugar. Then over a period of time, they took 100, 200, 300 or 400 milligrams (mg) of the extract in a capsule with water. Follow-up glucose tolerance tests showed how the green coffee extract affected their responses.

"There was a significant dose-response effect of the green coffee extract and no apparent gastrointestinal side effects," Vinson said. "All doses of green coffee extract produced a significant reduction in blood sugar relative to the original blank glucose challenge. The maximum blood glucose occurred at 30 minutes and was 24 percent lower than the original with the 400 mg of green coffee extract and the blood glucose at 120 minutes was 31 percent lower."

Vinson acknowledged funding from Applied Food Sciences, Inc., which markets a green coffee antioxidant product.

Postmenopausal women who consumed sugar-sweetened beverages were more likely to develop the most common type of endometrial cancer compared with women who did not drink sugar-sweetened beverages, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Postmenopausal women who reported the highest intake of sugar-sweetened beverages had a 78 percent increased risk for estrogen-dependent type I endometrial cancer (the most common type of this disease). This association was found in a dose-dependent manner: the more sugar-sweetened beverages a woman drank, the higher her risk.

"Although ours is the first study to show this relationship, it is not surprising to see that women who drank more sugar-sweetened beverages had a higher risk of estrogen-dependent type I endometrial cancer but not estrogen-independent type II endometrial cancer," said Maki Inoue-Choi, Ph.D., M.S., R.D., who led this study as a research associate in the Division of Epidemiology and Community Health of the University of Minnesota School of Public Health in Minneapolis. "Other studies have shown increasing consumption of sugar-sweetened beverages has paralleled the increase in obesity. Obese women tend to have higher levels of estrogens and insulin than women of normal weight. Increased levels of estrogens and insulin are established risk factors for endometrial cancer."

Because this study is the first to show the association between high sugar-sweetened beverage consumption and endometrial cancer, such findings need replication in other studies, according to Inoue-Choi.

Inoue-Choi and colleagues used data from 23,039 postmenopausal women who reported dietary intake, demographic information, and medical history in 1986, prior to the cancer diagnosis, as part of the Iowa Womens Health Study.

Dietary intake was assessed using the Harvard Food Frequency Questionnaire (FFQ), which asked study participants to report intake frequency of 127 food items in the previous 12 months. A typical portion size for each food item was provided to give study participants a sense of scale.

As reported in the study, the FFQ included four questions asking usual intake frequency of sugar-sweetened beverages, including 1) Coke®, Pepsi®, or other colas with sugar; 2) caffeine-free Coke®, Pepsi®, or other colas with sugar; 3) other carbonated beverages with sugar (e.g., 7-Up®); and 4) Hawaiian Punch®, lemonade, or other noncarbonated fruit drinks.

"Sugar-free soft drinks" included low-calorie caffeinated and caffeine-free cola (e.g., Pepsi-Free®), and other low-calorie carbonated beverages (e.g., Fresca®, Diet 7-Up®, and Diet Ginger Ale®).

The "sweets and baked goods" category comprised 13 items in the FFQ, including chocolate, candy bars, candy without chocolate, cookies (home-baked and ready-made), brownies, doughnuts, cakes (home-baked and ready-made), sweet rolls, coffeecakes or other pastries (home-baked and ready-made), and pies (home-baked and ready-made).

The researchers categorized the sugar-sweetened beverage consumption patterns of these women into quintiles, ranging from no intake (the lowest quintile) to between 1.7 and 60.5 servings a week (the highest quintile).

Between 1986 and 2010, 506 type I and 89 type II endometrial cancers were recorded among the women Inoue-Choi and colleagues studied. They did not find any association between type I or type II endometrial cancers and consumption of sugar-free soft drinks, sweets/baked goods, and starch.

"Research has documented the contribution of sugar-sweetened beverages to the obesity epidemic," said Inoue-Choi. "Too much added sugar can boost a persons overall calorie intake and may increase the risk of health conditions such as obesity, diabetes, heart disease, and cancer."

And Im back for part 2 of my AHS 2012 review.  Read part 1 if you missed it.  And no, this blog is not about AHS, the leader among home warranty providers.  Its the Ancestral Health Symposium.  Only the biggest event in the paleo nutrition world, everyone knows that.  Now read......

Can you believe Mark Sisson is 60?  I guess this paleo thing works.

Mark Sisson and Robb Wolf Q&A
This was another highlight of the weekend, in which Mark and Robb took questions from the audience.  It was only a 40 minute session, but I could have listened to this for hours.  I honestly dont remember what any of the questions were, so I guess I dont have much to talk about here, but they were very engaging and hilarious.  Great stuff.  I would love to spend a night socializing with these guys over NorCal margaritas.



Gut Health and Obesity
Stephan Guyenets talk on gut health and obesity was just fascinating.  Hes been one of my favorite people in the paleo community for a while now, Ive learned so much valuable information from his blog.  The gist of his talk, from what I can remember, was on how your intestinal health affects your propensity to gain weight.  And he made a major distinction between visceral fat and subcutaneous fat (visceral being the fat gained within the abdominal cavity, and subcutaneous fat being fat located under the skin).  Theres a big difference.  A person with more visceral fat will be at much higher risk for metabolic abnormalities and chronic disease, while someone with mostly subcutaneous fat is likely to be metabolically healthy, regardless of the fact that theyre obese.

Ill certainly need to go back and watch Stephans presentation again to really take in the information (once they get the lectures online, that is).  But as I recall, the most interesting part to me was about gut bacteria and obesity.  He talked about a few studies in rats, in which they performed fecal transplants to transfer gut bacteria from one rat to another.  Yes, that means taking the poop from one rat and sticking it up the butt of another rat.  We do it in humans too.  But the basic idea was that the gut flora differed between lean and obese mice.  But when the gut bacteria from the obese rat was transferred to a lean rat, that lean rat then became obese.  There was much more to it than this, but as I said, I need to go back and watch it again and take notes.  But its very intriguing to me that simply changing the gut flora of an animal could make them become obese.  It sounds like this area has a lot of potential for future study, and its definitely something Ill be following.

On another note, on the last night of the conference I was able to meet Stephan and chat a little bit.  He was super nice and down-to-earth.  We talked about beer and other manly things, apparently he brews beer.  But I also talked with him about probiotics.  Probiotics can be found in either food or in supplement form, but they are essentially healthy bacteria for your gut.  The idea is that they make it to your large intestine, set up shop there, and do good things for your digestion and your body.  But according to Stephan, and I suspected this to be true, probiotics dont significantly change your gut bacteria, and they dont really have any effect at all.  Most of the bacteria get killed on the way to the large intestine, and the few that are left just dont make a dent in the billions of bacteria that are already there.  Ill be sure to look into this more in the future as well.

Maybe the best part of Stephans talk though... the opening.  "Hi, Im Stephan Guyenet, and Im not going to talk about carbs."  Loved it.


Lustig and His New Research
Dr. Robert Lustig gave one of the better talks at AHS as well, about sugar (as if he ever talks about anything else).  It was really great though.  Even though Ive seen his lecture Sugar: The Bitter Truth, and Ive seen his 60 Minutes special on sugar, I still learned something.  He discussed the danger of fructose overconsumption, per the usual, but one thing he stressed this time was that fructose is only toxic if it is consumed in the context of a hypercaloric diet.  Translation:  if youre in caloric balance, or caloric deficit, fructose doesnt exhibit the same dangerous effects on insulin sensitivity, weight gain, etc.  Only if you are overconsuming calories will it exhibit these toxic effects.  I had read this on Stephans blog as a criticism of Lustigs work, so I was happy to see Lustig evolve his information.  In a real life situation though, it seems as though many people who consume a lot of sugar would be in caloric excess, especially those who consume a lot of sugar-sweetened beverages.  High-sugar foods typically arent satiating and can lead to overconsumption.


Dr. Lustig also revealed some data on a new sugar/fructose/metabolic syndrome study that hes working on getting published.  He asked the audience not to take any pictures of his slides since this study isnt published yet, and as a result, I have no way of remembering any of the details.  However, he was very pleased with the results, and as you can guess, it made sugar look pretty shitty.  Cant wait for that one to be published.


Okay, thats it for this edition of my AHS review.  Ive still got much more to talk about, so come on back for part 3 tomorrow!

Heres ACCU-Cheks A1C calculator. (The pic should take you to their site.)



A handy tool. But their caveat is important:

* This tool uses average plasma blood sugar readings — the measure used by most meters available today. It should not be used to predict an A1C and is not a substitute for a clinical test performed by your doctor. It is intended to show the relationship between a healthy A1C and self-monitoring results, and give you an idea of how you can help prevent long-term diabetes complications.
________

• 1.       Pancakes and syrup, sugary cereal, plain cereal, toast, oatmeal and orange juice for breakfast.
• 2.       Sandwiches and a soft drink for lunch.
• 3.       Casseroles of noodles, or potatoes, or bread for dinner.
• 4.       Bread with every meal.
• 5.       Potatoes, pasta, or rice at every meal.
• 6.       Sugary drinks at every meal.
• 7.       Meat and fish coated with breading, or sandwiched between two bread slices.
• 8.   Desserts at every party, and every special occasion -- or even after every meal.

• 1.       You create a habit that focuses your mind directly on your own goal every single day. You eliminate the opportunity to slide…. Or to procrastinate
• 2.       As you write down everything you eat (with no judgments) you have reality staring you in the face and you can no longer “forget” what you ate or what you are supposed to eat. It keeps you honest and real
• 3.       You can see your progress – and nothing motivates like progress.
• 4.       If, for some reason, you gain a pound or two, you can look back at your record and analyze what the problem may be and make a correction – immediately – without beating yourself up – because you know you are still headed in the right direction.
• 5.       You always know precisely where you stand and you don’t have to “guess” about anything because you have a record.
• 6.       You can show your record to your doctor and consult with them. They may offer helpful corrective suggestions or advice. Our health is in our own hands – and mouths. Use your doctor as a “coach” – but you are the one out on the field, playing the game.  It is your life.
• 7.       You begin to realize you don’t have to be “perfect” to accomplish your goal – you just have to be ocused every day which is what keeping a record does for you. When you are focused on your goal you automatically do the things you need to do to reach your goal.
• 8.       Your keeping track, keeps you on track – it helps you to continue going in the right direction.

“The Diabetes Prevention Program showed that exercise and diet were nearly twice as effective as metformin at reducing the risk of progressing to type 2 diabetes.^[70]”

“Naturopathic approaches to insulin resistance have been advocated including supplementation of vanadium…, bitter melon (Momordica…⁾, and Gymnema sylvestre.^[76]”