Looks Like “Diabetes Care” is Recommending a  Paleo Diet for Diabetes

From Diabetes Care:

Consensus recommendations:

A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes.

Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key factors that are common among the patterns:

○ Emphasize nonstarchy vegetables.

○ Minimize added sugars and refined grains.

○ Choose whole foods over highly processed foods to the extent possible.

Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.

For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach.

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

Urinary Sodium and Potassium Excretion Predict Adverse Cardiovascular Events

Heart attack is one of several cardiovascular diseases.

There’s a reason I take a magnesium supplement daily…

“In an observational study, lowest CV (cardiovascular) risk occurred with moderate sodium intake and high potassium intake.

The WHO recommends restricting sodium intake (to 3.5 g daily). However, prior research has shown a J-shaped association between sodium intake and cardiovascular (CV) disease. In this international cohort study, researchers evaluated the combined association of sodium and potassium excretion (as surrogate measures of intake) on major adverse CV events (i.e., myocardial infarction, stroke, and heart failure) and death.

More than 100,000 people in 18 countries provided morning fasting urine samples for estimation of 24-hour excretion of sodium and potassium. Median sodium and potassium excretions were 4.9 g and 2.1 g daily. After a mean 8.2 years, 6% of participants had experienced major adverse CV events or died. A J-shaped association between sodium excretion and adverse CV events and death was observed (risk nadir was at sodium excretion of 3–5 g daily). Lowest risk occurred in participants with moderate sodium excretion (3–5 g daily) and high potassium excretion (≥2.1 g daily). Compared with this combination, all other combinations were associated with higher risk, including lower sodium and higher potassium excretion. Higher potassium excretion significantly attenuated risk associated with higher sodium excretion.”

Source: Urinary Sodium and Potassium Excretion Predict Adverse Cardiovascular Events

For the  Multiple Sclerosis Community: Compare Low Saturated Fat and Modified Paleolithic Diets

Wahls or Low Saturated Fat? He needs the calories from fat.

“Abstract

The precise etiology of multiple sclerosis (MS) is unknown but epidemiologic evidence suggests this immune-mediated, neurodegenerative condition is the result of a complex interaction between genes and lifetime environmental exposures. Diet choices are modifiable environmental factors that may influence MS disease activity. Two diets promoted for MS, low saturated fat Swank and modified Paleolithic Wahls Elimination (WahlsElim), are currently being investigated for their effect on MS-related fatigue and quality of life (NCT02914964). Dr. Swank theorized restriction of saturated fat would reduce vascular dysfunction in the central nervous system (CNS). Dr. Wahls initially theorized that detailed guidance to increase intake of specific foodstuffs would facilitate increased intake of nutrients key to neuronal health (Wahls™ diet). Dr. Wahls further theorized restriction of lectins would reduce intestinal permeability and CNS inflammation (WahlsElim version). The purpose of this paper is to review the published research of the low saturated fat (Swank) and the modified Paleolithic (Wahls™) diets and the rationale for the structure of the Swank diet and low lectin version of the Wahls™ diet (WahlsElim) being investigated in the clinical trial.”

Source: Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic. – PubMed – NCBI

Exercise Training Adds Heart and Metabolic  Benefits to a Paleolithic Diet in Type 2 Diabetes Mellitus

Caveman selfie

“Abstract

Background

The accumulation of myocardial triglycerides and remodeling of the left ventricle are common features in type 2 diabetes mellitus and represent potential risk factors for the development of diastolic and systolic dysfunction. A few studies have investigated the separate effects of diet and exercise training on cardiac function, but none have investigated myocardial changes in response to a combined diet and exercise intervention. This 12-week randomized study assessed the effects of a Paleolithic diet, with and without additional supervised exercise training, on cardiac fat, structure, and function.

Methods and Results

Twenty-two overweight and obese subjects with type 2 diabetes mellitus were randomized to either a Paleolithic diet and standard-care exercise recommendations ( PD ) or to a Paleolithic diet plus supervised exercise training 3 hours per week ( PD – EX ). This study includes secondary end points related to cardiac structure and function, ie, myocardial triglycerides levels, cardiac morphology, and strain were measured using cardiovascular magnetic resonance, including proton spectroscopy, at baseline and after 12 weeks. Both groups showed major favorable metabolic changes. The PD – EX group showed significant decreases in myocardial triglycerides levels (-45%, P=0.038) and left ventricle mass to end-diastolic volume ratio (-13%, P=0.008) while the left ventricle end-diastolic volume and stroke volume increased significantly (+14%, P=0.004 and +17%, P=0.008, respectively). These variables were unchanged in the PD group.

Conclusions

Exercise training plus a Paleolithic diet reduced myocardial triglycerides levels and improved left ventricle remodeling in overweight/obese subjects with type 2 diabetes mellitus.

Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01513798.”

Source: Exercise Training Adds Cardiometabolic Benefits of a Paleolithic Diet in Type 2 Diabetes Mellitus. – PubMed – NCBI

Carbohydrate Restriction: What’s the Effect on  Resistance-Based Exercise Performance? 

Should she load up on carbs before weight training?

From a recent scientific article:

“Highlights

•The metabolic glycolytic response to resistance exercise is diverse and likely most attributable to volume, duration, and intensity of effort.

•Low muscle glycogen may not impair all resistance exercise performance, but increasing blood glucose before exercise may enhance higher-volume, longer-duration performance.

•Carbohydrate-restricted hypocaloric diets are effective for reducing fat mass during resistance exercise, but carbohydrate-sufficient hypercaloric diets are likely optimal for inducing muscle hypertrophy.

Source: Carbohydrate restriction: Friend or foe of resistance-based exercise performance? – ScienceDirect

Management of T1 Diabetes With a Very Low-Carb Diet

diabetic diet, low-carb mediterranean diet

Long-term diabetes management begins in the kitchen

From the medical journal Pediatrics:

“Abstract

OBJECTIVES: To evaluate glycemic control among children and adults with type 1 diabetes mellitus (T1DM) who consume a very low–carbohydrate diet (VLCD).

METHODS: We conducted an online survey of an international social media group for people with T1DM who follow a VLCD. Respondents included adults and parents of children with T1DM. We assessed current hemoglobin A1c (HbA1c) (primary measure), change in HbA1c after the self-reported beginning of the VLCD, total daily insulin dose, and adverse events. We obtained confirmatory data from diabetes care providers and medical records.

RESULTS: Of 316 respondents, 131 (42%) were parents of children with T1DM, and 57% were of female sex. Suggestive evidence of T1DM (based on a 3-tier scoring system in which researchers took into consideration age and weight at diagnosis, pancreatic autoimmunity, insulin requirement, and clinical presentation) was obtained for 273 (86%) respondents. The mean age at diagnosis was 16 ± 14 years, the duration of diabetes was 11 ± 13 years, and the time following a VLCD was 2.2 ± 3.9 years. Participants had a mean daily carbohydrate intake of 36 ± 15 g. Reported mean HbA1c was 5.67% ± 0.66%. Only 7 (2%) respondents reported diabetes-related hospitalizations in the past year, including 4 (1%) for ketoacidosis and 2 (1%) for hypoglycemia.

CONCLUSIONS: Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD. The generalizability of these findings requires further studies, including high-quality randomized controlled trials.”

Source: Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet | Articles | Pediatrics

Weight Training Rather Than Aerobics Is Better for Heart Health

One…..more…..rep!

“Lifting weights is healthier for the heart than going for a run or a walk, new research has found.Scientists looking at the health records of more than 4,000 people have concluded that, while both forms of exercise reduce the risk of developing heart disease, static activities such as weight lifting or press-ups have a greater effect than an equivalent amount of dynamic exercise such as running, walking or cycling.

The research challenges commonly held assumption that so-called “cardiovascular” pursuits like running are of greatest benefit to the heart.”

Source: Weight lifting better for heart health than running, new study finds

I like these findings, but wonder if they can be replicated.

Dr Ken Berry: How to Lower Blood Pressure Naturally

Lot’s of good ideas in this video. Additionally, I’ve see a couple studies supporting hibiscus tea as a natural remedy.

Which Dietary Patterns Are Best for Type 1 Diabetes Control?

A mess of Bacon Bit Brussels Sprouts: 6 grams of fiber per serve

Dr. Muccioli over at Diabetes Daily posted a brief article on a recent research study. A snippet:

The authors found that a higher intake of fiber was associated with lower average blood glucose values. In contrast, a higher intake of carbohydrate, alcohol, and monounsaturated fat was negatively associated with glycemic control (these patients typically experienced more variability in their blood glucose levels). Finally, the analysis revealed that “substituting proteins for either carbohydrates, fats, or alcohol, or fats for carbohydrates, were all associated with lower variability in the measured blood glucose values.”

Source: Which Dietary Patterns Are Best for Type 1 Diabetes Control? – Diabetes Daily

Eaton and Konner figured the Paleolithic diet provided over 70 g/day of fiber. How much are we in the West eating now? Something like 15–20 grams.

Steve Parker, M.D.

Skipping Breakfast May Increase Risk of Type 2 Diabetes

“In total 6 studies, based on 96,175 participants and 4935 cases, were included. The summary RR for type 2 diabetes comparing ever with never skipping breakfast was 1.33 (95% CI: 1.22, 1.46, n = 6 studies) without adjustment for BMI, and 1.22 (95% CI: 1.12, 1.34, n = 4 studies) after adjustment for BMI. Nonlinear dose-response meta-analysis indicated that risk of type 2 diabetes increased with every additional day of breakfast skipping, but the curve reached a plateau at 4–5 d/wk, showing an increased risk of 55% (summary RR: 1.55; 95% CI: 1.41, 1.71). No further increase in risk of type 2 diabetes was observed after 5 d of breakfast skipping/wk (P for nonlinearity = 0.08).

Conclusions

This meta-analysis provides evidence that breakfast skipping is associated with an increased risk of type 2 diabetes, and the association is partly mediated by BMI.”

Source: Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies | The Journal of Nutrition | Oxford Academic