Type 1 Diabetic Notes Improvement On Paleo Diet

Posted on May 18, 2013 | 1 comment

Type 1 PWD (person with diabetes) AllisonN wrote about her one-month paleo diet trial at DiabetesMine. The paleo diet version she followed was the Whole30 program, with which I’m not terribly familiar. Some quotes:

3. I have the best control in recent memory, but it’s not perfect. Like anything that involves tweaking and adjustments, the Paleo diet is hardly a cure. Now that I’m taking less insulin, there are fewer chances for me to go low, and more chances for me to go high. You can never expect anything — not a diet, not a medication, not an insulin pump — to run the show for you.

4. If you eat low-carb, you have to bolus for protein. This was the biggest shock for me. After querying my friends, I discovered that bolusing for approximately half the protein is what I need to do to prevent a post-meal spike. Gary Scheiner, author and CDE at Integrated Diabetes Services, explained, “Since your Central Nervous System needs glucose to function, if your diet is lacking in carbs, the liver will convert some dietary protein into glucose.  So it is usually necessary to bolus for some of your protein whenever you have a meal that is very low in carbs.” For me, a low-carb meal is anything under 30 grams of carbs.

***

One thing that I kept thinking about during my month-long Paleo experiment was how much of diabetes really is an experiment anyway. Think about how often we have to try out different things to see what works: Changing up bolus ratios and basal rates. Fiddling with different temp basals or snack choices before working out. Alternating what we eat for breakfast. While the Paleo diet may not be for everyone, I wholeheartedly believe that if what you’re doing currently isn’t giving you the results you want, maybe you should consider starting another experiment!

AllisonN wrote that the paleo diet hasn’t been studied scientifically in people. That’s not accurate. A handful of studies have been done, even involving people with diabetes. Search this site and you’ll find them. In addition, Lynda Frassetto’s study at University of California-San Francisco should be published later this year.

Read AllisonN’s post.

1 Comment

Posted in Testimonials

Tagged , , , ,

Shouldn’t We Be Vegans or Vegetarians?

Posted on May 16, 2013 | Comments Off on Shouldn’t We Be Vegans or Vegetarians?

I ran across some nutrition-advice videos of Dr Michael Greger six months ago and started following him at Twitter.  It soon became clear he favors a vegan or vegetarian diet.  Dr. Harriet Hall at Science-Based Medicine has Dr. Greger in her crosshairs, challenging many of his claims.  Well worth a read.  An excerpt:

Vegans tell us the Inuit, who lived almost exclusively on food of animal origin, had a short life span. That’s not true. Statistics on the Inuit between 1822 and 1836 showed that their average life expectancy was about the same as that of European peasants of the time who ate a diet overwhelmingly based on bread. 25% of Inuit lived past 60, and some lived into their 80s and 90s.

Comments Off on Shouldn’t We Be Vegans or Vegetarians?

Posted in Uncategorized

Tagged , , , , ,

Anastasia on Resistant Starch

Posted on May 9, 2013 | 1 comment

Primalmeded physician Anastasia has started a series on resistant starch. I’m still trying to get the definition into my thick skull. Anastasia offers this one:

The official website named Resistantstarch.com – An Information Portal for Health Professionals (don’t you wish that broccoli had an official website?), gives us this definition:

”Resistant starch is the sum of starch and products of starch digestion not absorbed in the small intestine of healthy individuals”

It is also classified as the third type of fibre (together with soluble and insoluble) by several health agencies, including Food Standards Australia and New Zealand, and its MO [modus operandi] is to bypass the normal absorption process in the small intestine straight to the colon where it is fermented by colonic bacteria (which also makes it a “prebiotic”).

Read the whole enchilada.

 

1 Comment

Posted in Uncategorized

Tagged

Exercise Frequency: Are Two Sessions a Week as Good as Six?

Posted on May 8, 2013 | Comments Off on Exercise Frequency: Are Two Sessions a Week as Good as Six?
exercise for weight loss and management, dumbbells

If you’re not familiar with weight training, a personal trainer is an great idea

Weight Maven Beth Mazur  found evidence in favor of the fewer days, at least in post-menopausal women.

I don’t like to exercise.  Too often I find excuses to avoid even my twice weekly 40-minute workouts.

You may well have good reasons to exercise every day.  Maybe you’re a competitive athlete or enjoy exercise.  If you just want the health benefits of exercise, I’m increasingly convinced that twice a week is enough.

Comments Off on Exercise Frequency: Are Two Sessions a Week as Good as Six?

Posted in Exercise

Tagged , ,

The Road to Dental Health

Posted on May 6, 2013 | Comments Off on The Road to Dental Health

Whole9 is publishing a two-part series on dental health written by Eva Twardokens.  Part 1 covers:

  • finding a dentist
  • scheduled professional teeth cleaning
  • baseline x-rays
  • night guards
  • flossing

Click for Part 1.

Stay tuned for Part 2 covering periodontal disease, fluoride, dental materials, mouthwash, insurance, and ZOOM whitening.

Comments Off on The Road to Dental Health

Posted in Teeth

Tagged , , ,

Paleo Diet Movement Reminiscent of “Physical Culture” From a Century Ago

Posted on May 5, 2013 | Comments Off on Paleo Diet Movement Reminiscent of “Physical Culture” From a Century Ago

Here’s an excerpt from NPR:

Consider this quote: “It is reasonably certain that man was originally made to live and exercise in the open air, bathe in rivers, and expose his body to the healthful action of the sun.”

And this one:

“Civilized man is manufacturing and eating many substances that slowly but surely lead to degeneration, disease and premature death.”

These nuggets could easily come from a paleo lifestyle blog, the kind that argues our modern diet and way of life are making us sick.

Except that the first one is from an 1894 book called Athletics for Physical Culture. And the second is from a 1926 book called Natural Foods: The Safe Way to Health.

Both were written by proponents of physical culture, a fringy movement of health enthusiasts, which lasted from the 1880s to 1920s in the U.S. and Europe.

Read the rest.

Comments Off on Paleo Diet Movement Reminiscent of “Physical Culture” From a Century Ago

Posted in Uncategorized

Tagged

Type 1s Exercising May Need to Reduce Insulin Both Before AND After Exercsise

Posted on May 5, 2013 | Comments Off on Type 1s Exercising May Need to Reduce Insulin Both Before AND After Exercsise

…to avoid hypoglycemia, according to an article at DiabetesHealth. A snippet:

Previous research had suggested that reducing insulin intake before exercise was enough to prevent hypoglycemia.

“It’s been well known that people with type 1 diabetes need to heavily reduce their insulin before exercise, but now we’ve showed that it’s important to reduce it after exercise,” says lead author Daniel J. West, PhD, from North Umbria University in the United Kingdom, in an article that appeared on the Medscape Medical News website.

The article looks at the experience of only 11 exerciser, all men.

Comments Off on Type 1s Exercising May Need to Reduce Insulin Both Before AND After Exercsise

Posted in Exercise

Physical Activity Reduces Prostate Cancer Risk

Posted on May 3, 2013 | 1 comment

…according to an article in MedPageToday.

Not Darrin Carlson

Yet another reason to work out

In a forward-looking study, white men suspected of prostate cancer and scheduled for biopsy were less likely to have the disease if they were at least moderately active, according to Lionel Bañez, MD, of the Durham Veterans Affairs Medical Center in Durham N.C., and colleagues.

If they did have cancer, they were significantly less likely to have high-grade disease if they had been working out regularly, Bañez and colleagues reported  in Cancer.

Another way to reduce your risk of prostate cancer is to follow the Mediterranean diet.  Other cancers reduced by the Mediterranean diet are breast, colo-rectal, and uterus.

The association of exercise and lower prostate cancer risk was not noted in black men, for unclear reasons.

1 Comment

Posted in Exercise, Uncategorized

Tagged , ,

Fermentable Carbohydrates May Cause or Aggravate Irritable Bowel Sydrome

Posted on April 27, 2013 | 2 comments
"Dr. Parker, what can I do about these severe belly cramps?"

“Dr. Parker, what can I do about these severe belly cramps?”

Irritable bowel syndrome (IBS) is one of the conditions that allegedly improves with a paleo diet. It’s frustrating for sufferers and their doctors. My ears perk up when I hear about a new treatment.       

Four weeks of fermentable carbohydrate restriction reduces symptoms of irritable bowel syndrome, according to UK and Australian researchers.

Here’s the theory of how it works.  Our intestines—colon, mostly—are loaded with bacteria.  The food you feed your bacteria—fermentable carbohydrates, for example—may have an effect on the bacteria.  Changes in bacterial populations in response to feeding, in turn, may lead to changes in irritable bowel syndrome and other aspects of health.  This “gut microbiome” is a hot area of research and speculation.

I don’t have irritable bowel syndrome (IBS), but did notice a major decrease in gastrointestinal gas production when I reduced my digestible carbohydrate consumption to less than 50 g/day a few years ago. That alone has at least potential to reduce IBS symptoms. (I eat more than 50 g a day now.)

IBS is extremely common, affecting 10–15% of individuals in the developed world.  Only 15% of those bother to seek medical attention.   Of all referrals to gastroenterologists (stomach specialists), at least 25% are for IBS.  There are few reliable treatments and cures.  In some cases it mysteriously resolves on its own.

So I got excited when I ran across the study I reference above.  I’m not going to spend a lot of time on it because I’ve already spent too much trudging through the article, and I don’t have much to show for it.

The way the investigators wrote their report gave me some heartburn:

  • They never bothered to define “fermentable.”  In this context it probably refers to digestion or breakdown of food by gut bacteria rather than by human hosts.
  • They never bother to spell out exactly what foods the experimental subjects were eating as they restricted fermentable carbohydrate consumption.
  • The intervention group (n=19) was instructed to restrict foods “high in fructans (e.g., wheat products, onions), galacto-oligosaccharide (e.g., legumes), polyols (e.g., pear, sugar-free gums), lactose (e.g., mammalian milk), and excess fructose (e.g., honey).”  Does “restrict” mean “cut back a little” or “avoid entirely upon penalty of death”?  Your guess is as good as mine.  (It’s a joke—I know they wouldn’t kill’em.) Some of the aforementioned foods are restricted or forbidden on the paleo diet.

Have you heard of FODMAPs?  That seems to be the intervention diet that restricted fermentable carbohydrates. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

You need a break. Enjoy.

You need a break. Enjoy.

Let me summarize their results simply by saying they found changes in gut bacteria and a reduction in irritable bowel syndrome symptoms, as compared with control subjects. The particularly responsive symptoms were bloating, borborygmi, and the urge to defecate. Abdominal pain strongly tended to improve but didn’t quite reach statistical significance. Diarrhea wasn’t affected. Also note that the IBS patients allowed into the study were not the type with constipation as a major issue.

So What? 

If you want to try a FODMAP diet for your IBS, you won’t be able to figure out what to eat based on this report. Consult your own physician about it.  I wonder whether many of them have even heard of FODMAP. Barbara Bolen, Ph.D., at About.com says the diet should be undertaken only with the supervision of a qualified nutritionist.

BTW, I’m not aware of any scientific reports looking at the paleo diet as a treatment for IBS. If it works for you, stick with it.

Steve Parker, M.D.

Reference:  Staudacher, Heidi, et al.  Fermentable Carbohydrate Restriction Reduces Luminal Bifidobacteria and Gastrointestinal Symptoms in Patients with Irritable Bowel Syndrome.  Journal of Nutrition, 142: 1520-1518 (2012)

2 Comments

Posted in Dietary Carbohydrate

Tagged , ,

Will Low Normal Blood Sugars Prevent Brain Degeneration?

Posted on April 26, 2013 | 4 comments
MRI scan of brain

MRI scan of brain

Our bodies keep blood sugar levels in a fairly narrow range.  You might think you’re fine if you’re anywhere within the defined normal range.

Think again.

Australian researchers found that people with fasting blood sugars toward the upper end of the normal range had more degeneration (atrophy) in parts of the brain called the hippocampus and amygdala, compared to those in the low normal range.  Degeneration in those areas is often manifested as dementia.

The hippocampus is critical for learning and memory formation and retention.  The amygdala is also involved in memory as well as emotion.  The two areas are intimately connected, literally.

How Was the Study Done?

Over 250 study participants aged 60 to 64 years had normal brains at baseline and were free of diabetes and prediabetes.  Nearly all were caucasian.  MRI brain scans were done at baseline and again four years later.  Significant atrophy (shrinkage) was seen in the hippocampus and amygdala over time, with greater atrophy seen in those with higher baseline fasting glucose levels.

Fasting blood sugar was measured only once, at the start, and ranged from 58 to 108 mg/dl (3.2 to 6.0 mmol/l).  (Fasting glucose of 108 would be prediabetes according to the American Diabetes Association, but not by the World Health Organization.)  Participants weren’t tested for deterioration of cognition.

So What?

The results of the study at hand are consistent with others that link higher rates of dementia with diabetes.  Diabetics, even when under treatment, usually have higher average blood sugars than non-diabetics.  The study authors speculate that damage from higher blood sugars may be mediated by inflammation and abnormal blood clotting (prothrombotic factors and platelet activation).

The Mayo Clinic recently reported that diets high in carbohydrates and sugar increase the odds of developing cognitive impairment in the elderly years.

It’s interesting to contemplate whether non-diabetics and diabetics would have less risk of developing dementia if blood sugars could be kept in the lower end of the normal range.  How could you do that?  Possibilities include:

  • avoid sugars and other refined carbohydrates
  • limit all carbohydrates
  • favor low-glycemic-index foods over high-GI
  • regular exercise, which helps maintain insulin sensitivity (insulin is a major blood sugar regulator)
  • avoid overweight and obesity, which helps maintain insulin sensitivity
  • for diabetics: all of the above plus drugs that control blood sugar

Steve Parker, M.D.

Reference:  Cherbuin, Nicolas, et al.  Higher normal fasting plasma glucose is associated with hippocampal atrophy: The PATH Study.  Neurology, September 4, 2012, vol. 79, No. 10, pp: 1,010-1,026.  doi:10.1212/WNL.0b013e31826846de

4 Comments

Posted in Uncategorized

Tagged , , , , ,