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.
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
Should she load up on carbs before weight training?
From a recent scientific article:
•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
Long-term diabetes management begins in the kitchen
From the medical journal Pediatrics:
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
“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.
Lot’s of good ideas in this video. Additionally, I’ve see a couple studies supporting hibiscus tea as a natural remedy.
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.
“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).
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
This isn’t an important study, but you might find it interesting anyway…
The purpose of this study was to evaluate the effectiveness of recommending a MyPlate or a Paleolithic-based diet, both with and without exercise, on aerobic fitness, strength, and anaerobic power over eight weeks. Participants (n=20) were randomized to one of four groups, (1) a MyPlate diet (MP), (2) Paleolithic-based diet (PD), (3) MyPlate and exercise (MP + Ex), and (4) Paleolithic-based diet and exercise (PD + Ex). The exercise included two days of unsupervised aerobic and resistance exercise. At baseline and final, absolute and relative peak oxygen consumption (absVO2peak and relVO2peak), anaerobic power, and upper and lower body strength were determined. Data were analyzed using repeated measures two-way analysis of variance (ANOVA). The ANOVA indicated that there was no significant interaction between time point (TP)*diet (D)*exercise (Ex) for all variables except relVO2peak (p = 0.016). The MP + Ex group (Δ+4.4 ml·kg-1·min-1) had a greater change from baseline compared to the MP group (Δ-2.7 ml·kg-1·min-1, p = 0.002), and PD + Ex group (Δ-0.3 ml·kg-1·min-1, p = 0.03). The results suggest recommending a MyPlate diet with both aerobic and resistance training are effective at improving aerobic fitness when compared to PD recommendations with exercise, although these conclusions may be confounded by low compliance to exercise recommendations.
Source: The Effectiveness of MyPlate and Paleolithic-based Diet Recommendations, both with and without Exercise, on Aerobic Fitness, Muscular Strength and … – PubMed – NCBI
At least he’s trying…
I’ve long advocated that life-and health-insurance companies base their premiums on results of individual treadmill exercise tests or similar. Here’s why.
We’ve all heard exercise helps you live longer. But a new study goes one step further, finding that a sedentary lifestyle is worse for your health than smoking, diabetes and heart disease.
Dr. Wael Jaber, a cardiologist at the Cleveland Clinic and senior author of the study, called the results “extremely surprising.”
“Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker,” Jaber told CNN. “We’ve never seen something as pronounced as this and as objective as this.”
Source: Not exercising worse for your health than smoking, diabetes and heart disease – CNN
Most folks can improve their fitness by exercising regularly. But what about nonresponders?
Steve Parker, M.D.
PS: All of my weight-loss books recommend and teach you how to improve your level of fitness.
One of the paleo meals I took to the hospital to eat mid-shift
From Science Alert:
While GMOs may involve splicing genes from other organisms (such as bacteria) to give plants desired traits – like resistance to pests — selective breeding is a slower process whereby farmers select and grow crops with those traits over time.
From bananas to eggplant, here are some of the foods that looked totally different before humans first started growing them for food.
Source: Here’s What Fruits And Vegetables Looked Like Before We Domesticated Them