Q: I have diabetes. Is it safe to get a pedicure?
— Mica,
A:The short answer is no, you shouldn't get a pedicure. You have to be careful not to expose yourself to potential infection, skin breaks, and other foot damage.
Before you go to a nail salon, it's best to see your doctor first. He or she will examine your feet for any signs of poor circulation, reduced sensation, skin damage, foot or nail infection, or bone and joint changes. Based on this exam, your doctor will advise you on whether or not you should have a pedicure. If there is any immediate concern, you may also be told to see a podiatrist — a foot doctor. Podiatrists can trim nails, remove calluses, and treat warts safely. They can also correct any deformity that might lead to further damage and advise about daily foot care.
If there is no significant abnormality in your feet, then you can safely get a pedicure. You will, however, need to ask for some special treatment because of your diabetes. In general, unless you are visiting a specialized salon that is familiar with diabetic foot care, avoid getting your nails trimmed or your cuticles removed. Also, do not allow any sharp objects to be used on your feet. If you are getting a pedicure for the first time, talk with the salon personnel regarding their disinfection procedures. Examine the place, and observe how they sterilize and care for their tools. Alternatively, you can bring your own tub and supplies (a soft pumice stone, nail polish) to the salon.
In general, to keep your feet healthy and prevent complications, it's important that you stay well hydrated and prevent your skin from becoming dry. Avoid products that might cause your skin to peel or products that contain steroids. Examine your feet daily for any skin breaks and seek care from your doctor or podiatrist promptly if you observe any problems.
Saturday, March 12, 2011
Thursday, March 10, 2011
Whole-Fat Milk and Cheese Can Lower Diabetes Risk
The incidence of Type 2 diabetes declined significantly as levels of a fatty acid found in whole-fat dairy products increased....
Adults with the highest levels of trans-palmitoleic acid had a 60% lower diabetes incidence compared with individuals who had the lowest levels. Higher levels of the fatty acid also were associated with a more favorable metabolic profile.
Multivariate analyses of demographic, clinical, and lifestyle factors showed that whole-fat dairy consumption had the strongest association with levels of trans-palmitoleate. However, the authors remained circumspect about the association.
Dariush Mozaffarian, MD, DrPH, of the Harvard School of Public Health, and coauthors wrote in conclusion that, "Our results demonstrate an inverse relationship between levels of trans-palmitoleate and metabolic risk factors and diabetes incidence."
"The small differences in trans-palmitoleate levels raise questions about whether this is the active compound or a marker for some other, unknown protective constituent of dairy or other ruminant foods."
The findings support previous evidence of favorable associations between whole-fat dairy consumption and metabolic factors. The authors speculated that trans-palmitoleate could exert effects on pathways related to insulin resistance, dyslipidemia, and hepatic fat synthesis.
A product of endogenous fat synthesis, circulating palmitoleic acid has been associated with protection against insulin resistance and metabolic dysregulation in experimental models. Studies in humans, however, have yielded mixed results, the authors wrote in the introduction to their findings.
Efforts to study circulating palmitoleic acid have been confounded by the effects of endogenous synthesis and metabolism. The trans isomer of palmitoleate represents an endogenous source of the fatty acid and avoids confounding endogenous effects. Derived primarily from naturally occurring dairy and other ruminant trans fats, trans-palmitoleate is not associated with increased cardiovascular risk, in contrast to trans fats derived from partially hydrogenated oils.
"In fact, several studies have demonstrated inverse associations between dairy consumption and risk for insulin resistance, the metabolic syndrome, or diabetes," the authors continued. "To our knowledge, no previous studies have evaluated a potential role of trans-palmitoleate in metabolic risk."
The patient cohort of the Cardiovascular Health Study provided an opportunity to examine associations between trans-palmitoleate, metabolic risk factors, and risk of Type 2 diabetes. Mozaffarian and coauthors analyzed data on 3,736 study participants, all of whom were 65 or older and were identified from Medicare eligibility lists.
Baseline assessments included physical examination, diagnostic testing, questionnaires about health status, and laboratory evaluation that included measurement of 45 different fatty acids. Study participants were followed for 10 years, including annual clinic visits and interim telephone calls.
Laboratory results showed that trans-palmitoleate accounted for an average of 0.18% of total fatty acid. Levels had a strong correlation with known biomarkers of dairy-fat consumption but a weak correlation with biomarkers of partially hydrogenated oils.
Whole-fat dairy consumption had the strongest association with trans-palmitoleate levels. Separate analyses of different types of dairy foods further refined the association by showing that levels of the fatty acid were most closely associated with whole-milk consumption. Levels of trans-palmitoleate were not significantly related to consumption of carbohydrates, protein, red meat, or low-fat dairy foods.
In multivariate analyses, higher trans-palmitoleate levels were significantly associated with:
Lower body mass index (-1.8%, P=0.058)
Smaller waist circumference (-1.8%, P=0.009)
Higher levels of HDL cholesterol (1.9%, P=0.043)
Lower triglyceride levels (-19.0%, P<0.001)
Lower total cholesterol:HDL ratio (-4.7%, P<0.001)
Lower levels of C-reactive protein (-13.8%, P=0.050)
Lower fasting insulin levels (-13.3%, P=0.001)
Less insulin resistance by homeostasis model (-16.7%, P<0.001)
During follow-up, 304 study participants developed new-onset diabetes. In adjusted analyses, comparison of trans-palmitoleate quintiles showed that participants in quintiles 4 and 5 had diabetes hazard ratios of 0.44 and 0.36, respectively, compared with quintile 1 (P<0.001 for trend).
"Each higher standard deviation of trans-palmitoleate was associated with a 28% lower risk of diabetes," the authors wrote.
Acknowledging limitations of the study, Mozaffarian and colleagues noted that trans-palmitoleate levels were measured at a single point in time and that food intake was based on self-reports. They also pointed out that causality cannot be determined due to the possibility of residual confounding and that "the small differences in trans palmitoleate levels raise questions about whether this is the active compound or a marker for some other, unknown protective constituent of dairy or other ruminant foods."
Adults with the highest levels of trans-palmitoleic acid had a 60% lower diabetes incidence compared with individuals who had the lowest levels. Higher levels of the fatty acid also were associated with a more favorable metabolic profile.
Multivariate analyses of demographic, clinical, and lifestyle factors showed that whole-fat dairy consumption had the strongest association with levels of trans-palmitoleate. However, the authors remained circumspect about the association.
Dariush Mozaffarian, MD, DrPH, of the Harvard School of Public Health, and coauthors wrote in conclusion that, "Our results demonstrate an inverse relationship between levels of trans-palmitoleate and metabolic risk factors and diabetes incidence."
"The small differences in trans-palmitoleate levels raise questions about whether this is the active compound or a marker for some other, unknown protective constituent of dairy or other ruminant foods."
The findings support previous evidence of favorable associations between whole-fat dairy consumption and metabolic factors. The authors speculated that trans-palmitoleate could exert effects on pathways related to insulin resistance, dyslipidemia, and hepatic fat synthesis.
A product of endogenous fat synthesis, circulating palmitoleic acid has been associated with protection against insulin resistance and metabolic dysregulation in experimental models. Studies in humans, however, have yielded mixed results, the authors wrote in the introduction to their findings.
Efforts to study circulating palmitoleic acid have been confounded by the effects of endogenous synthesis and metabolism. The trans isomer of palmitoleate represents an endogenous source of the fatty acid and avoids confounding endogenous effects. Derived primarily from naturally occurring dairy and other ruminant trans fats, trans-palmitoleate is not associated with increased cardiovascular risk, in contrast to trans fats derived from partially hydrogenated oils.
"In fact, several studies have demonstrated inverse associations between dairy consumption and risk for insulin resistance, the metabolic syndrome, or diabetes," the authors continued. "To our knowledge, no previous studies have evaluated a potential role of trans-palmitoleate in metabolic risk."
The patient cohort of the Cardiovascular Health Study provided an opportunity to examine associations between trans-palmitoleate, metabolic risk factors, and risk of Type 2 diabetes. Mozaffarian and coauthors analyzed data on 3,736 study participants, all of whom were 65 or older and were identified from Medicare eligibility lists.
Baseline assessments included physical examination, diagnostic testing, questionnaires about health status, and laboratory evaluation that included measurement of 45 different fatty acids. Study participants were followed for 10 years, including annual clinic visits and interim telephone calls.
Laboratory results showed that trans-palmitoleate accounted for an average of 0.18% of total fatty acid. Levels had a strong correlation with known biomarkers of dairy-fat consumption but a weak correlation with biomarkers of partially hydrogenated oils.
Whole-fat dairy consumption had the strongest association with trans-palmitoleate levels. Separate analyses of different types of dairy foods further refined the association by showing that levels of the fatty acid were most closely associated with whole-milk consumption. Levels of trans-palmitoleate were not significantly related to consumption of carbohydrates, protein, red meat, or low-fat dairy foods.
In multivariate analyses, higher trans-palmitoleate levels were significantly associated with:
Lower body mass index (-1.8%, P=0.058)
Smaller waist circumference (-1.8%, P=0.009)
Higher levels of HDL cholesterol (1.9%, P=0.043)
Lower triglyceride levels (-19.0%, P<0.001)
Lower total cholesterol:HDL ratio (-4.7%, P<0.001)
Lower levels of C-reactive protein (-13.8%, P=0.050)
Lower fasting insulin levels (-13.3%, P=0.001)
Less insulin resistance by homeostasis model (-16.7%, P<0.001)
During follow-up, 304 study participants developed new-onset diabetes. In adjusted analyses, comparison of trans-palmitoleate quintiles showed that participants in quintiles 4 and 5 had diabetes hazard ratios of 0.44 and 0.36, respectively, compared with quintile 1 (P<0.001 for trend).
"Each higher standard deviation of trans-palmitoleate was associated with a 28% lower risk of diabetes," the authors wrote.
Acknowledging limitations of the study, Mozaffarian and colleagues noted that trans-palmitoleate levels were measured at a single point in time and that food intake was based on self-reports. They also pointed out that causality cannot be determined due to the possibility of residual confounding and that "the small differences in trans palmitoleate levels raise questions about whether this is the active compound or a marker for some other, unknown protective constituent of dairy or other ruminant foods."
Tuesday, March 8, 2011
Diabetic socks: More than meets the toe
With so much emphasis placed on proper diabetic footwear, especially for those who suffer from peripheral neuropathy, patients with diabetes may not realize how crucial the size, fit, fiber, and construction of socks also are. Since socks are an integral part of treatment, the following do’s and don’ts may help practitioners educate patients about proper sock selection and wear.
Do’s
Do prescribe specially constructed, seamless socks that have a soft, flexible, and stretchy toe area where the material is joined.
Do advise patients of the dangers of wearing socks with any irregularities, including darned socks or socks with holes. A seam, wrinkling, or a tiny fold can generate friction, creating microtrauma that can lead to ulceration and worse.
Do prescribe socks made of high quality fibers. They will last longer and wear evenly, instead of leaving thin spots where friction can occur.
Do look for socks made of stretchy synthetics with moisture-wicking properties to minimize the risk of infection and blisters. Any natural fibers should be blended with synthetics and make up a small portion of the total fiber content.
Do choose socks with antibacterial properties. Socks made with silver and copper fibers have been shown to decrease bacteria and combat foot odor.
Do pay attention to fit. Good diabetic socks conform to the foot and resist wrinkling inside the shoe. The best therapeutic socks fit no more than two shoe sizes and offer a range of four or five sizes to choose from.
Do prescribe therapeutic socks with silicone padding to reduce plantar pressure in patients with neuropathy. The padded socks are also a good choice for diabetic patients with rheumatoid arthritis. Double padding can be achieved by wearing two pairs of the socks, one inside the other. To accommodate the extra thickness, the shoe size needs to increase by at least 1/2 size, or suggest the patient wear the socks with extra-depth shoes.
Do make sure patients buy an adequate number of pairs to avoid the temptation to wear the same socks twice or revert to nondiabetic socks.
Do ensure that socks are not causing callus buildup or corns. The presence of a callus or corn on the surface of the foot should be a warning sign that abnormal skin shear is occurring.
Do tell patients how socks fit into their preventive care plan. Patients who find themselves in the high-risk category for ulcers and amputations should know that wearing properly sized prescription shoes and socks as well as visually inspecting and washing feet every day are all necessary to avoid infection.
Do tell patients who develop an infection not to wear socks until they’ve laundered them with bleach or another disinfectant.
Do stress the importance of regulating blood glucose, exercising, and quitting smoking to minimize the risk of foot ulceration and improve healing.
Don’ts
Don’t prescribe socks that are too tight for patients with poor circulation. If the patient has vascular disease as well as neuropathy, the socks need to have the capability of expanding as the foot and ankle swell.
Don’t prescribe socks that are too loose. They may bunch up, causing friction.
Don’t use socks with metallic fibers to treat infections or ulcers. Just because the sock itself resists bacterial growth does not mean it has been demonstrated to reduce infections on the surface of the foot.
Do’s
Do prescribe specially constructed, seamless socks that have a soft, flexible, and stretchy toe area where the material is joined.
Do advise patients of the dangers of wearing socks with any irregularities, including darned socks or socks with holes. A seam, wrinkling, or a tiny fold can generate friction, creating microtrauma that can lead to ulceration and worse.
Do prescribe socks made of high quality fibers. They will last longer and wear evenly, instead of leaving thin spots where friction can occur.
Do look for socks made of stretchy synthetics with moisture-wicking properties to minimize the risk of infection and blisters. Any natural fibers should be blended with synthetics and make up a small portion of the total fiber content.
Do choose socks with antibacterial properties. Socks made with silver and copper fibers have been shown to decrease bacteria and combat foot odor.
Do pay attention to fit. Good diabetic socks conform to the foot and resist wrinkling inside the shoe. The best therapeutic socks fit no more than two shoe sizes and offer a range of four or five sizes to choose from.
Do prescribe therapeutic socks with silicone padding to reduce plantar pressure in patients with neuropathy. The padded socks are also a good choice for diabetic patients with rheumatoid arthritis. Double padding can be achieved by wearing two pairs of the socks, one inside the other. To accommodate the extra thickness, the shoe size needs to increase by at least 1/2 size, or suggest the patient wear the socks with extra-depth shoes.
Do make sure patients buy an adequate number of pairs to avoid the temptation to wear the same socks twice or revert to nondiabetic socks.
Do ensure that socks are not causing callus buildup or corns. The presence of a callus or corn on the surface of the foot should be a warning sign that abnormal skin shear is occurring.
Do tell patients how socks fit into their preventive care plan. Patients who find themselves in the high-risk category for ulcers and amputations should know that wearing properly sized prescription shoes and socks as well as visually inspecting and washing feet every day are all necessary to avoid infection.
Do tell patients who develop an infection not to wear socks until they’ve laundered them with bleach or another disinfectant.
Do stress the importance of regulating blood glucose, exercising, and quitting smoking to minimize the risk of foot ulceration and improve healing.
Don’ts
Don’t prescribe socks that are too tight for patients with poor circulation. If the patient has vascular disease as well as neuropathy, the socks need to have the capability of expanding as the foot and ankle swell.
Don’t prescribe socks that are too loose. They may bunch up, causing friction.
Don’t use socks with metallic fibers to treat infections or ulcers. Just because the sock itself resists bacterial growth does not mean it has been demonstrated to reduce infections on the surface of the foot.
Saturday, March 5, 2011
Can Diabetes Be Cured?
Q: I'm 47 years old and was recently diagnosed with diabetes. I'm about 25 pounds overweight and lead a sedentary lifestyle, but I'm starting a diet and an exercise program. Will my diabetes go away if I lose weight, watch my diet, and exercise regularly?
— Mary, Kansas City
A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetes
The length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
— Mary, Kansas City
A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetes
The length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
Friday, March 4, 2011
Meal Replacements Don't Help Obese Teens
Dietetic shakes and prepackaged entrees help obese teenagers lose weight loss at first. But "meal replacements" were no better than a standard low-calorie diet for helping young people continue losing weight over the course of a year....
Dr. Robert L. Berkowitz, Children's Hospital of Philadelphia, and his team note in their report that swapping regular meals for shakes, bars or prepackaged entrees can be a useful weight loss strategy for adults.
One reason that these meal replacements may work is that they take the guesswork out of dieting; people often sharply underestimate their calorie intake when they eat regular foods. Given that adolescents also underestimate how many calories they consume, the researchers sought to investigate whether meal replacements might be helpful for them, too.
The researchers randomly assigned 113 obese teens and their families to one of three regimens for a year: (1) a standard 1,300- to 1,500-calorie-a-day diet; (2) four months of meal replacements (three SlimFast shakes, one prepackaged entrée, and five servings of fruits and vegetables per day) followed by eight months on the conventional diet; or (3) an entire year of meal replacements.
At four months, patients in the meal replacement groups had reduced their body mass index (BMI) by a mean of 6.3%, compared to 3.8% for teens in the low-calorie diet group.
But by the end of the year, there was no significant difference in mean BMI reduction between the three groups: 2.8% for the low-calorie diet group, 3.9% with four months of meal replacements, and 3.4% with a year of meal replacements.
One-third of the patients dropped out of the study. Among those who stuck with it, adherence waned as time wore on. By the end of 12 months, the researchers note, the meal-replacement group reported using SlimFast only 1.6 days a week, compared with 5.6 days a week in month two.
"The potential benefit of (meal replacement) in maintaining weight loss was not supported," the researchers conclude, and further study is needed to find ways of getting obese teens to start diets and stay on them.
Dr. Robert L. Berkowitz, Children's Hospital of Philadelphia, and his team note in their report that swapping regular meals for shakes, bars or prepackaged entrees can be a useful weight loss strategy for adults.
One reason that these meal replacements may work is that they take the guesswork out of dieting; people often sharply underestimate their calorie intake when they eat regular foods. Given that adolescents also underestimate how many calories they consume, the researchers sought to investigate whether meal replacements might be helpful for them, too.
The researchers randomly assigned 113 obese teens and their families to one of three regimens for a year: (1) a standard 1,300- to 1,500-calorie-a-day diet; (2) four months of meal replacements (three SlimFast shakes, one prepackaged entrée, and five servings of fruits and vegetables per day) followed by eight months on the conventional diet; or (3) an entire year of meal replacements.
At four months, patients in the meal replacement groups had reduced their body mass index (BMI) by a mean of 6.3%, compared to 3.8% for teens in the low-calorie diet group.
But by the end of the year, there was no significant difference in mean BMI reduction between the three groups: 2.8% for the low-calorie diet group, 3.9% with four months of meal replacements, and 3.4% with a year of meal replacements.
One-third of the patients dropped out of the study. Among those who stuck with it, adherence waned as time wore on. By the end of 12 months, the researchers note, the meal-replacement group reported using SlimFast only 1.6 days a week, compared with 5.6 days a week in month two.
"The potential benefit of (meal replacement) in maintaining weight loss was not supported," the researchers conclude, and further study is needed to find ways of getting obese teens to start diets and stay on them.
Thursday, March 3, 2011
A Closer Look At New Developments In Diabetes
The prevalence of diabetes is increasing rapidly and is expected to reach epidemic proportion over the next decade. Recent research estimates that the number of people diagnosed with diabetes will rise from 23.7 million to 44.1 million between 2009 and 2034.1 The Centers for Disease Control and Prevention (CDC) further predict that up to one-third of U.S. adults could have diabetes by 2050 if Americans continue to gain weight and avoid exercise.2
Diabetes is associated with a myriad of complications with foot ulcerations being the most common. An estimated 15 percent of all patients with diabetes will develop foot ulcers.3 About half of these ulcers become infected and 20 percent of those patients will end up with some form of lower extremity amputation.3 With the prevalence of diabetes dramatically increasing, billions of dollars are spent in the field of diabetes research for the early diagnosis, prevention and management of this disease.
With that said, here is a closer look at current research in the field of diabetes and emerging methods of disease management.
What You Should Know About Biomarkers For Diabetes
Researchers are constantly studying biomarkers to help predict the possibility of developing certain diseases. Biomarkers can indicate a change in the expression or state of a protein that correlates with the risk or progression of a disease, or with the susceptibility of the disease to a given treatment.
Recently, researchers from the United Kingdom have reported that microRNA (MiR) can help identify people who are likely to develop type 2 diabetes even before the onset of symptoms.4 MicroRNAs are classes of approximately 22 non-coding nucleotide regulatory ribonucleic acid (RNA) molecules that play important roles in controlling the developmental and physiological processes.5 Specifically, microRNAs regulate gene expression including differentiation and development by either inhibiting translation or inducing target degradation. MicroRNAs can also help serve as diagnostic markers to identify those who are at high risk of developing coronary and peripheral arterial disease.
In a study of 822 people, researchers identified five specific microRNA molecules with an abnormally low concentration in blood in people with diabetes and in those who subsequently went on to develop the disorder.6 One molecule in particular, microRNA 126 (MiR-126), was among the most reliable predictors of current and future diabetes. MiR-126 is known to help with angiogenesis and regulate the maintenance of vasculature. Healthy blood vessel cells are able to release substantial quantities of MiR-126 into the bloodstream.
However, when endothelial damage occurs, the cells retain MiR-126 and subsequently release less MiR-126 into the bloodstream. A decrease in plasma MiR-126 can therefore be an indicator of blood vessel damage and cardiovascular disease. Researchers also found that levels of MiR were lower when they gave large amounts of sugar to mice with a genetic propensity to develop diabetes.6 The MiR test can directly assess vascular endothelial damage secondary to diabetes and has a fairly low cost at around $3 per test. Clinicians may possibly be able to use this in conjunction with conventional tests in the near future.
Plasma thrombin activatable fibrinolysis inhibitor (TAFI) antigen is another biomarker that may participate in arterial thrombosis in cardiovascular diseases and may be involved in the mechanism of vascular endothelial damage in patients with diabetes.
Erdogan and colleagues investigated the association of plasma TAFI antigen level in the development of diabetic foot ulcers in people with type 2 diabetes.7 Specifically, researchers determined TAFI antigen levels in plasma samples in 50 patients with diabetic foot ulcers, 34 patients with diabetes but without diabetic foot ulcers, and 25 healthy individuals. The diabetic foot ulcer group and the diabetic non-ulcer group were similar in terms of mean age and sex distribution.
The researchers found TAFI levels to be significantly elevated in patients with diabetes with or without foot ulcers in comparison to the healthy controls. However, there was no difference in TAFI levels between the diabetic foot ulcer group and diabetic non-ulcer group, or between diabetic foot ulcer stages.
As research in this arena continues, a new class of blood markers may give additional insight to screen people who are at a higher risk of developing diabetes and intervene before the symptoms and the broad spectrum of associated complications occur.
Can An Artificial Pancreas System Enhance Glucose Control?
The artificial pancreas is a technology that is best described as a closed loop glucose management system that is intended to afford patients with diabetes better glucose control while averting the hypoglycemic state.8 With the advancement of technologies, newer artificial pancreas systems consist of a real-time continuous glucose monitoring (CGM) system. This system transmits information every one to five minutes from an under the skin sensor to a handheld receiver that can be integrated into a pump. The device also has an insulin pump with a pre-programmed algorithm that calculates appropriate insulin dosages based on the glucose ratings.
A potential imperfection to this CGM system is that the system reads glucose levels from the patient’s interstitial fluid as opposed to the actual blood glucose levels. The interstitial compartment has a lag time of eight to ten minutes and can affect the glucose readings, especially postprandial readings.
The insulin pump is a beeper-sized device that is flexibly attached via a tube in the tissue just under the skin and will release as per patient requirement. Some partial “half-loop” solutions are available in Europe and the FDA has recently approved three of the closed loop systems. Meticulous testing is still needed before the system can go on the market.9
Emerging Insights On Stem Cell Advances
With islet cell transplantation research quickly on the rise to help regenerate the disordered islet cells of the pancreas, we have seen much promise in stem cell research. Ideally, the in vitro generation of insulin-producing cells from stem or progenitor cells presents a promising approach to overcome the scarcity of donor pancreases for cell replacement therapy in people with diabetes.10
In an ongoing study, researchers at the Diabetes Research Institute are assessing the effects of biohybrid devices, also known as “scaffolds,” to house and protect the transplanted insulin producing cells.11 These “scaffolds” are designed to mimic the pancreatic environment and are being tested in different areas of the body that include the abdominal pouch, muscle tissue or subcutaneously. Furthermore, the “scaffolds” are also being tested to deliver favorable agents that may help promote the growth and viability of the transplanted islet cells.
Current studies are very optimistic in showing that these “scaffolds” co-transplanted with mesenchymal stem cell regenerative islet cells can help accelerate angiogenesis, which prolongs the longevity and functionality of islet cell regeneration.12
Encouraging Patient Adherence: What Recent Studies Reveal
Patient adherence is one of the many challenges in the treatment and management of diabetes. For years, physicians have been researching new methods in tracking patient adherence to glucose monitoring and management, and to pressure mitigation devices.
In an article published in the Annals of Family Medicine, researchers looked at the participation levels of patients with type 2 diabetes in their primary care check-up visits.13 Several offices sent questionnaires to these patients regarding their treatment goals and plans at the initial visit as well as follow-up visits. Researchers found that the more patients participated in their treatment decisions and management, the better they adhered to the prescribed medications and treatment. This resulted in better control of their diabetes.
Another study compared the efficacy of a reciprocal peer support program with that of nurse care management in 244 men with diabetes in two Veterans Affairs healthcare facilities.14 Researchers matched patients in the reciprocal peer support group with another age-matched peer patient and were encouraged to talk via telephone and participate in optional group sessions. Patients in the nurse care management group attended a 1.5-hour educational session and were assigned to a nurse care manager.
After six months, the mean hemoglobin A1C level for patients in the peer support program decreased from 8.02% to 7.73% while it increased from 7.93% to 8.22% in the nurse care management group.14 This was statistically significant.
Both studies support the notion that some patient empowerment in their treatment decisions and management may translate into better long-term outcomes.
In Conclusion
Diabetes is estimated to impose more than $174 billion dollars per year on United States healthcare. This astounding financial toll is expected to continue to rise as more and more people are diagnosed with this debilitating disease.2 In addition to being aware of the plethora of current research, patient education and preventative care are important strategies to emphasize. It is through innovative research, teamwork and preventative strategies that we continue to gain successful outcomes and improvement in the prevention and management of diabetes and its complications.
VOLUME: 24 PUBLICATION DATE: Jan 01 2011
Author(s):David A. Farnen, BS, and Stephanie C. Wu, DPM, MSc
Diabetes is associated with a myriad of complications with foot ulcerations being the most common. An estimated 15 percent of all patients with diabetes will develop foot ulcers.3 About half of these ulcers become infected and 20 percent of those patients will end up with some form of lower extremity amputation.3 With the prevalence of diabetes dramatically increasing, billions of dollars are spent in the field of diabetes research for the early diagnosis, prevention and management of this disease.
With that said, here is a closer look at current research in the field of diabetes and emerging methods of disease management.
What You Should Know About Biomarkers For Diabetes
Researchers are constantly studying biomarkers to help predict the possibility of developing certain diseases. Biomarkers can indicate a change in the expression or state of a protein that correlates with the risk or progression of a disease, or with the susceptibility of the disease to a given treatment.
Recently, researchers from the United Kingdom have reported that microRNA (MiR) can help identify people who are likely to develop type 2 diabetes even before the onset of symptoms.4 MicroRNAs are classes of approximately 22 non-coding nucleotide regulatory ribonucleic acid (RNA) molecules that play important roles in controlling the developmental and physiological processes.5 Specifically, microRNAs regulate gene expression including differentiation and development by either inhibiting translation or inducing target degradation. MicroRNAs can also help serve as diagnostic markers to identify those who are at high risk of developing coronary and peripheral arterial disease.
In a study of 822 people, researchers identified five specific microRNA molecules with an abnormally low concentration in blood in people with diabetes and in those who subsequently went on to develop the disorder.6 One molecule in particular, microRNA 126 (MiR-126), was among the most reliable predictors of current and future diabetes. MiR-126 is known to help with angiogenesis and regulate the maintenance of vasculature. Healthy blood vessel cells are able to release substantial quantities of MiR-126 into the bloodstream.
However, when endothelial damage occurs, the cells retain MiR-126 and subsequently release less MiR-126 into the bloodstream. A decrease in plasma MiR-126 can therefore be an indicator of blood vessel damage and cardiovascular disease. Researchers also found that levels of MiR were lower when they gave large amounts of sugar to mice with a genetic propensity to develop diabetes.6 The MiR test can directly assess vascular endothelial damage secondary to diabetes and has a fairly low cost at around $3 per test. Clinicians may possibly be able to use this in conjunction with conventional tests in the near future.
Plasma thrombin activatable fibrinolysis inhibitor (TAFI) antigen is another biomarker that may participate in arterial thrombosis in cardiovascular diseases and may be involved in the mechanism of vascular endothelial damage in patients with diabetes.
Erdogan and colleagues investigated the association of plasma TAFI antigen level in the development of diabetic foot ulcers in people with type 2 diabetes.7 Specifically, researchers determined TAFI antigen levels in plasma samples in 50 patients with diabetic foot ulcers, 34 patients with diabetes but without diabetic foot ulcers, and 25 healthy individuals. The diabetic foot ulcer group and the diabetic non-ulcer group were similar in terms of mean age and sex distribution.
The researchers found TAFI levels to be significantly elevated in patients with diabetes with or without foot ulcers in comparison to the healthy controls. However, there was no difference in TAFI levels between the diabetic foot ulcer group and diabetic non-ulcer group, or between diabetic foot ulcer stages.
As research in this arena continues, a new class of blood markers may give additional insight to screen people who are at a higher risk of developing diabetes and intervene before the symptoms and the broad spectrum of associated complications occur.
Can An Artificial Pancreas System Enhance Glucose Control?
The artificial pancreas is a technology that is best described as a closed loop glucose management system that is intended to afford patients with diabetes better glucose control while averting the hypoglycemic state.8 With the advancement of technologies, newer artificial pancreas systems consist of a real-time continuous glucose monitoring (CGM) system. This system transmits information every one to five minutes from an under the skin sensor to a handheld receiver that can be integrated into a pump. The device also has an insulin pump with a pre-programmed algorithm that calculates appropriate insulin dosages based on the glucose ratings.
A potential imperfection to this CGM system is that the system reads glucose levels from the patient’s interstitial fluid as opposed to the actual blood glucose levels. The interstitial compartment has a lag time of eight to ten minutes and can affect the glucose readings, especially postprandial readings.
The insulin pump is a beeper-sized device that is flexibly attached via a tube in the tissue just under the skin and will release as per patient requirement. Some partial “half-loop” solutions are available in Europe and the FDA has recently approved three of the closed loop systems. Meticulous testing is still needed before the system can go on the market.9
Emerging Insights On Stem Cell Advances
With islet cell transplantation research quickly on the rise to help regenerate the disordered islet cells of the pancreas, we have seen much promise in stem cell research. Ideally, the in vitro generation of insulin-producing cells from stem or progenitor cells presents a promising approach to overcome the scarcity of donor pancreases for cell replacement therapy in people with diabetes.10
In an ongoing study, researchers at the Diabetes Research Institute are assessing the effects of biohybrid devices, also known as “scaffolds,” to house and protect the transplanted insulin producing cells.11 These “scaffolds” are designed to mimic the pancreatic environment and are being tested in different areas of the body that include the abdominal pouch, muscle tissue or subcutaneously. Furthermore, the “scaffolds” are also being tested to deliver favorable agents that may help promote the growth and viability of the transplanted islet cells.
Current studies are very optimistic in showing that these “scaffolds” co-transplanted with mesenchymal stem cell regenerative islet cells can help accelerate angiogenesis, which prolongs the longevity and functionality of islet cell regeneration.12
Encouraging Patient Adherence: What Recent Studies Reveal
Patient adherence is one of the many challenges in the treatment and management of diabetes. For years, physicians have been researching new methods in tracking patient adherence to glucose monitoring and management, and to pressure mitigation devices.
In an article published in the Annals of Family Medicine, researchers looked at the participation levels of patients with type 2 diabetes in their primary care check-up visits.13 Several offices sent questionnaires to these patients regarding their treatment goals and plans at the initial visit as well as follow-up visits. Researchers found that the more patients participated in their treatment decisions and management, the better they adhered to the prescribed medications and treatment. This resulted in better control of their diabetes.
Another study compared the efficacy of a reciprocal peer support program with that of nurse care management in 244 men with diabetes in two Veterans Affairs healthcare facilities.14 Researchers matched patients in the reciprocal peer support group with another age-matched peer patient and were encouraged to talk via telephone and participate in optional group sessions. Patients in the nurse care management group attended a 1.5-hour educational session and were assigned to a nurse care manager.
After six months, the mean hemoglobin A1C level for patients in the peer support program decreased from 8.02% to 7.73% while it increased from 7.93% to 8.22% in the nurse care management group.14 This was statistically significant.
Both studies support the notion that some patient empowerment in their treatment decisions and management may translate into better long-term outcomes.
In Conclusion
Diabetes is estimated to impose more than $174 billion dollars per year on United States healthcare. This astounding financial toll is expected to continue to rise as more and more people are diagnosed with this debilitating disease.2 In addition to being aware of the plethora of current research, patient education and preventative care are important strategies to emphasize. It is through innovative research, teamwork and preventative strategies that we continue to gain successful outcomes and improvement in the prevention and management of diabetes and its complications.
VOLUME: 24 PUBLICATION DATE: Jan 01 2011
Author(s):David A. Farnen, BS, and Stephanie C. Wu, DPM, MSc
Tuesday, March 1, 2011
The 15 Worst Health & Diet Myths
15 Worst Health and Diet Myths not to follow my friend told me over lunch recently. We were sitting in a great new Italian restaurant near my office.
“I know,” I replied, scanning the menu. “Everything looks terrific!”
“Yeah, but everything is bad for you!” she exclaimed, practically in tears. “I’m passing on the veal—red meat causes cancer. And the eggplant parmesan—cheese has fat, which gives you high cholesterol. And the bread plate—carbs give you diabetes. I can’t eat anything! And I’m really hungry!”
With those kinds of fears, it’s a wonder my “health-conscious” friend didn’t die of starvation: no protein, and no fat, and no carbs? What’s left? Fortunately, as author of Eat This, Not That!, I was able to calm her lunch plate panic, and explain that most of what we consider “bad for you” foods aren’t bad for you at all—they’re just innocent victims of well-intentioned misinformation. A well-balanced diet, combined with some smart choices, is all you need to lose pounds and keep most of our greatest health worries at bay. But many food and nutrition “myths” persist, confusing our food choices and making weight-loss harder and eating less enjoyable. So relax, and start enjoying food again: Here are 15 food fallacies you can forget for good.
Myth #1: Too much protein hurts your kidneys
Reality: Protein helps burn fat, build muscle, and won’t harm your kidneys at all
Way back in 1983, researchers discovered that eating more protein increases the amount of blood your kidneys filter per minute. Many scientists immediately made the leap that a high-protein diet places your kidneys under greater stress. They were proven wrong. Over the past two decades, several studies have found that while protein-rich meals do increase blood flow to the kidneys, this doesn't have an adverse effect on overall kidney function.
Put the Truth to Work for You: Eat your target body weight in grams of protein daily. For example, if you're a chubby 180-pound woman and want to be a lean 160, have 160 grams of protein a day. If you're a 160-pound guy hoping to pack on 20 pounds of muscle, aim for 180 grams each day.
Bonus Tip: Lose weight fast. Build muscle. Get out of debt. Whatever your resolution for 2011, here's your plan.
Myth #2: Sweet potatoes are healthier than white potatoes
Reality: They’re both healthy!
Sweet potatoes have more fiber and vitamin A, but white potatoes are higher in essential minerals such as iron, magnesium, and potassium. As for the glycemic index, sweet potatoes are lower on the scale, but baked white potatoes typically aren't eaten without cheese, sour cream, or butter—all toppings that contain fat, which lowers the glycemic index of a meal.
Put the Truth to Work for You: The form in which you consume a potato—for instance, a whole baked potato versus a processed potato that's used to make chips—is more important than the type of spud.
Myth #3: Red meat causes cancer
Reality: Research says enjoy the steak!
In a 1986 study, Japanese researchers discovered cancer developing in rats that were fed "heterocyclic amines," compounds that are generated from overcooking meat under high heat. Since then, some studies of large populations have suggested a potential link between meat and cancer. Yet no study has ever found a direct cause-and-effect relationship between red-meat consumption and cancer. The population studies are far from conclusive. They relied on broad surveys of people's eating habits and health afflictions—numbers that illuminate trends, not causes.
Put the Truth to Work for You: Don't stop grilling. Meat lovers who are worried about the supposed risks of grilled meat don't need to avoid burgers and steak—just trim off the burned or overcooked sections of the meat before eating.
Myth #4: High-fructose corn syrup (HFCS) is more fattening than regular sugar
Reality: They’re equally fattening. Beware!
Recent research has show that fructose may cause an increase in weight by interfering with leptin, the hormone that tells us when we’re full. But both HFCS and sucrose—better known as table sugar—contain similar amounts of fructose. There's no evidence to show any differences in these two types of sugar. Both will cause weight gain when consumed in excess. The only particular evil regarding HFCS is that it’s cheaper, and commonly shows up everywhere from bread to ketchup to soda.
Put the Truth to Work for You: HFCS and regular sugar are empty-calorie carbohydrates that should be consumed in limited amounts. How? By keeping soft drinks, sweetened fruit juices, and prepackaged desserts to a minimum.
Myth #5: Too much salt causes high blood pressure
Reality: Perhaps, but too little potassium causes high blood pressure too
Large-scale scientific reviews have determined there's no reason for people with normal blood pressure to restrict their sodium intake. Now, if you already have high blood pressure, you may be "salt sensitive." As a result, reducing the amount of salt you eat could be helpful. However, people with high blood pressure who don't want to lower their salt intake can simply consume more potassium-containing foods—it's really the balance of the two minerals that matters. In fact, Dutch researchers determined that a low potassium intake has the same impact on your blood pressure as high salt consumption does. And it turns out, the average person consumes 3,100 milligrams (mg) of potassium a day—1,600 mg less than recommended.
Put the Truth to Work for You: Strive for a potassium-rich diet—which you can achieve by eating a wide variety of fruits, vegetables, and legumes—and your salt intake won't matter as much. For instance, spinach, broccoli, bananas, white potatoes, and most types of beans each contain more than 400 mg potassium per serving.
Myth #6: Chocolate bars are empty calories
Reality: Dark chocolate is a health food
Cocoa is rich in flavonoids—the same heart-healthy compounds found in red wine and green tea. Its most potent form is dark chocolate. In a recent study, Greek researchers found that consuming dark chocolate containing 100 milligrams (mg) of flavonoids relaxes your blood vessels, improving bloodflow to your heart. And remember: Milk chocolate isn't as rich in flavonoids as dark, so develop a taste for the latter.
Put the Truth to Work for You: Now that you know which "bad" foods aren't actually so awful, you need to know which deceptively dangerous diet-destroying foods to avoid. Check out our must-see slideshow of 25 "Healthy" Foods that Aren’t.
Myth #7: Gas station snacks are nutritional nightmares
Reality: Even at filling stations, you’ll find food that isn’t filling
Beef jerky is high in protein and doesn't raise your level of insulin—a hormone that signals your body to store fat. That makes it an ideal between-meals snack, especially when you're trying to lose weight. And while some beef-jerky brands are packed with high-sodium ingredients such as MSG and sodium nitrate, chemical-free products are available.
Put the Truth to Work for You: Sometimes, the service station is a healthier rest stop than a fast food joint. Heck, even pork rinds are better than you’d think: A 1-ounce serving contains zero carbohydrates, 17 grams (g) of protein, and 9 g fat. That's nine times the protein and less fat than you'll find in a serving of carb-packed potato chips.
Myth #8: Restaurants comply with nutrition disclosure regulations
Reality: Most restaurants would rather load you up with additional cheap calories
Even though many restaurants offer healthy alternatives, you could still be at the whim of the kitchen's cook. A recent E.W. Scripps lab investigation found that "responsible" menu items at chains ranging from Chili's to Taco Bell may have up to twice the calories and eight times the fat published in the restaurants' nutritional information.
Put the Truth to Work for You: Restaurants run from us, but they can't hide. Discover their secrets every day by signing up for our free Eat This, Not That! newsletter or by following me right here on Twitter, and you'll make 2011 the year of your flatter, toner belly!
Myth #9: Sports drinks are ideal after-workout refreshment
Reality: You need more than that to keep your muscles growing
Carb-loaded drinks like Vitaminwater and Gatorade are a great way to rehydrate and reenergize; they help replenish glycogen, your body's stored energy. But they don't always supply the amino acids needed for muscle repair. To maximize post-workout recovery, a protein-carb combination—which those drinks may not offer—can help.
Put the Truth to Work for You: After you suck down that sports drink, eat a bowl of 100 percent whole-grain cereal with nonfat milk, suggests a 2009 study in the Journal of the International Society of Sports Nutrition. A glass of low-fat chocolate milk is a good choice as well.
Myth #10: You need 38 grams of fiber a day
Reality: More fiber is better, but 38 is nearly impossible
That's the recommendation from the Institute of Medicine. And it's a lot, equaling nine apples or more than a half dozen bowls of instant oatmeal. (Most people eat about 15 grams of fiber daily.) The studies found a correlation between high fiber intake and lower incidence of heart disease. But none of the high-fiber-eating groups in those studies averaged as high as 38 grams, and, in fact, people saw maximum benefits with a daily gram intake averaging from the high 20s to the low 30s.
Put the Truth to Work for You: Just eat sensibilty. Favor whole, unprocessed foods. Make sure the carbs you eat are fiber-rich—that means produce, legumes, and whole grains—because they'll help slow the aborption of sugar into your bloodstream.
Myth #11: Saturated fat will clog your heart
Reality: Fat has gotten a bum rap
Most people consider turkey, chicken, and fish healthy, yet think they should avoid red meat—or only choose very lean cuts—since they've always been told that it's high in saturated fat. But a closer look at beef reveals the truth: Almost half of its fat is a monounsaturated fat called oleic acid—the same heart-healthy fat that's found in olive oil. Second, most of the saturated fat in beef actually decreases your heart-disease risk—either by lowering LDL (bad) cholesterol, or by reducing your ratio of total cholesterol to HDL (good) cholesterol.
Put the Truth to Work for You: We're not giving you permission to gorge on butter, bacon, and cheese. No, our point is this: Don't freak out about saturated fat. There's no scientific reason that natural foods containing saturated fat can't, or shouldn't, be part of a healthy diet.
Myth #12: Reduced-fat foods are healthier alternatives
Reality: Less fat often means more sugar
Peanut butter is a representative example for busting this myth. A tub of reduced-fat peanut butter indeed comes with a fraction less fat than the full-fat variety—they’re not lying about that. But what the food companies don’t tell you is that they’ve replaced that healthy fat with maltodextrin, a carbohydrate used as a filler in many processed foods. This means you’re trading the healthy fat from peanuts for empty carbs, double the sugar, and a savings of a meager 10 calories.
Put the Truth to Work for You: When you're shopping, don't just read the nutritional data. Look at the ingredients list as well. Here's a guideline that never fails: The fewer ingredients, the healthier the food.
Myth #13: Diet soda is better for you
Reality: It may lead to even greater weight gain
Just because diet soda is low in calories doesn’t mean it can’t lead to weight gain. It may have only 5 or fewer calories per serving, but emerging research suggests that consuming sugary-tasting beverages—even if they’re artificially sweetened—may lead to a high preference for sweetness overall. That means sweeter (and more caloric) cereal, bread, dessert—everything. In fact, new research found that people who drink diet soda on a daily basis have an increased risk of developing type 2 diabetes and metabolic syndrome.
Put the Truth to Work for You: These days, the world of food is full of nasty surprises like this one, and knowledge is power. Check out Eat This, Not That! 2011 and Cook This, Not That! for the best food, nutrition and health secrets, and avoid shocking waistline expanders with our slideshow of 20 Salads Worse Than a Whopper.
Myth #14: Skipping meals helps you lose weight
Reality: Skipping meals, especially breakfast, can make you fat
Not eating can mess with your body's ability to control your appetite. And it also destroys willpower, which is just as damaging. If you skip breakfast or a healthy snack, your brain doesn't have the energy to say no to the inevitable chowfest. The consequences can be heavy: In a 2005 study, breakfast eaters were 30 percent less likely to be overweight or obese.
Put the Truth to Work for You: The perfect breakfast? Eggs, bacon, and toast. It's a nice balance of all the nutritional building blocks—protein, fiber, carbs—that will jumpstart your day. The worst? Waffles or pancakes with syrup. All those carbs and sugars are likely to put you into a food coma by 10 a.m.
Myth #15: You should eat three times a day
Reality: Three meals and two or three snacks is ideal
Most diet plans portray snacking as a failure. But by snacking on the right foods at strategic times, you'll keep your energy levels stoked all day. Spreading six smaller meals across your day operates on the simple principle of satisfaction: Frequent meals tame the slavering beast of hunger.
“I know,” I replied, scanning the menu. “Everything looks terrific!”
“Yeah, but everything is bad for you!” she exclaimed, practically in tears. “I’m passing on the veal—red meat causes cancer. And the eggplant parmesan—cheese has fat, which gives you high cholesterol. And the bread plate—carbs give you diabetes. I can’t eat anything! And I’m really hungry!”
With those kinds of fears, it’s a wonder my “health-conscious” friend didn’t die of starvation: no protein, and no fat, and no carbs? What’s left? Fortunately, as author of Eat This, Not That!, I was able to calm her lunch plate panic, and explain that most of what we consider “bad for you” foods aren’t bad for you at all—they’re just innocent victims of well-intentioned misinformation. A well-balanced diet, combined with some smart choices, is all you need to lose pounds and keep most of our greatest health worries at bay. But many food and nutrition “myths” persist, confusing our food choices and making weight-loss harder and eating less enjoyable. So relax, and start enjoying food again: Here are 15 food fallacies you can forget for good.
Myth #1: Too much protein hurts your kidneys
Reality: Protein helps burn fat, build muscle, and won’t harm your kidneys at all
Way back in 1983, researchers discovered that eating more protein increases the amount of blood your kidneys filter per minute. Many scientists immediately made the leap that a high-protein diet places your kidneys under greater stress. They were proven wrong. Over the past two decades, several studies have found that while protein-rich meals do increase blood flow to the kidneys, this doesn't have an adverse effect on overall kidney function.
Put the Truth to Work for You: Eat your target body weight in grams of protein daily. For example, if you're a chubby 180-pound woman and want to be a lean 160, have 160 grams of protein a day. If you're a 160-pound guy hoping to pack on 20 pounds of muscle, aim for 180 grams each day.
Bonus Tip: Lose weight fast. Build muscle. Get out of debt. Whatever your resolution for 2011, here's your plan.
Myth #2: Sweet potatoes are healthier than white potatoes
Reality: They’re both healthy!
Sweet potatoes have more fiber and vitamin A, but white potatoes are higher in essential minerals such as iron, magnesium, and potassium. As for the glycemic index, sweet potatoes are lower on the scale, but baked white potatoes typically aren't eaten without cheese, sour cream, or butter—all toppings that contain fat, which lowers the glycemic index of a meal.
Put the Truth to Work for You: The form in which you consume a potato—for instance, a whole baked potato versus a processed potato that's used to make chips—is more important than the type of spud.
Myth #3: Red meat causes cancer
Reality: Research says enjoy the steak!
In a 1986 study, Japanese researchers discovered cancer developing in rats that were fed "heterocyclic amines," compounds that are generated from overcooking meat under high heat. Since then, some studies of large populations have suggested a potential link between meat and cancer. Yet no study has ever found a direct cause-and-effect relationship between red-meat consumption and cancer. The population studies are far from conclusive. They relied on broad surveys of people's eating habits and health afflictions—numbers that illuminate trends, not causes.
Put the Truth to Work for You: Don't stop grilling. Meat lovers who are worried about the supposed risks of grilled meat don't need to avoid burgers and steak—just trim off the burned or overcooked sections of the meat before eating.
Myth #4: High-fructose corn syrup (HFCS) is more fattening than regular sugar
Reality: They’re equally fattening. Beware!
Recent research has show that fructose may cause an increase in weight by interfering with leptin, the hormone that tells us when we’re full. But both HFCS and sucrose—better known as table sugar—contain similar amounts of fructose. There's no evidence to show any differences in these two types of sugar. Both will cause weight gain when consumed in excess. The only particular evil regarding HFCS is that it’s cheaper, and commonly shows up everywhere from bread to ketchup to soda.
Put the Truth to Work for You: HFCS and regular sugar are empty-calorie carbohydrates that should be consumed in limited amounts. How? By keeping soft drinks, sweetened fruit juices, and prepackaged desserts to a minimum.
Myth #5: Too much salt causes high blood pressure
Reality: Perhaps, but too little potassium causes high blood pressure too
Large-scale scientific reviews have determined there's no reason for people with normal blood pressure to restrict their sodium intake. Now, if you already have high blood pressure, you may be "salt sensitive." As a result, reducing the amount of salt you eat could be helpful. However, people with high blood pressure who don't want to lower their salt intake can simply consume more potassium-containing foods—it's really the balance of the two minerals that matters. In fact, Dutch researchers determined that a low potassium intake has the same impact on your blood pressure as high salt consumption does. And it turns out, the average person consumes 3,100 milligrams (mg) of potassium a day—1,600 mg less than recommended.
Put the Truth to Work for You: Strive for a potassium-rich diet—which you can achieve by eating a wide variety of fruits, vegetables, and legumes—and your salt intake won't matter as much. For instance, spinach, broccoli, bananas, white potatoes, and most types of beans each contain more than 400 mg potassium per serving.
Myth #6: Chocolate bars are empty calories
Reality: Dark chocolate is a health food
Cocoa is rich in flavonoids—the same heart-healthy compounds found in red wine and green tea. Its most potent form is dark chocolate. In a recent study, Greek researchers found that consuming dark chocolate containing 100 milligrams (mg) of flavonoids relaxes your blood vessels, improving bloodflow to your heart. And remember: Milk chocolate isn't as rich in flavonoids as dark, so develop a taste for the latter.
Put the Truth to Work for You: Now that you know which "bad" foods aren't actually so awful, you need to know which deceptively dangerous diet-destroying foods to avoid. Check out our must-see slideshow of 25 "Healthy" Foods that Aren’t.
Myth #7: Gas station snacks are nutritional nightmares
Reality: Even at filling stations, you’ll find food that isn’t filling
Beef jerky is high in protein and doesn't raise your level of insulin—a hormone that signals your body to store fat. That makes it an ideal between-meals snack, especially when you're trying to lose weight. And while some beef-jerky brands are packed with high-sodium ingredients such as MSG and sodium nitrate, chemical-free products are available.
Put the Truth to Work for You: Sometimes, the service station is a healthier rest stop than a fast food joint. Heck, even pork rinds are better than you’d think: A 1-ounce serving contains zero carbohydrates, 17 grams (g) of protein, and 9 g fat. That's nine times the protein and less fat than you'll find in a serving of carb-packed potato chips.
Myth #8: Restaurants comply with nutrition disclosure regulations
Reality: Most restaurants would rather load you up with additional cheap calories
Even though many restaurants offer healthy alternatives, you could still be at the whim of the kitchen's cook. A recent E.W. Scripps lab investigation found that "responsible" menu items at chains ranging from Chili's to Taco Bell may have up to twice the calories and eight times the fat published in the restaurants' nutritional information.
Put the Truth to Work for You: Restaurants run from us, but they can't hide. Discover their secrets every day by signing up for our free Eat This, Not That! newsletter or by following me right here on Twitter, and you'll make 2011 the year of your flatter, toner belly!
Myth #9: Sports drinks are ideal after-workout refreshment
Reality: You need more than that to keep your muscles growing
Carb-loaded drinks like Vitaminwater and Gatorade are a great way to rehydrate and reenergize; they help replenish glycogen, your body's stored energy. But they don't always supply the amino acids needed for muscle repair. To maximize post-workout recovery, a protein-carb combination—which those drinks may not offer—can help.
Put the Truth to Work for You: After you suck down that sports drink, eat a bowl of 100 percent whole-grain cereal with nonfat milk, suggests a 2009 study in the Journal of the International Society of Sports Nutrition. A glass of low-fat chocolate milk is a good choice as well.
Myth #10: You need 38 grams of fiber a day
Reality: More fiber is better, but 38 is nearly impossible
That's the recommendation from the Institute of Medicine. And it's a lot, equaling nine apples or more than a half dozen bowls of instant oatmeal. (Most people eat about 15 grams of fiber daily.) The studies found a correlation between high fiber intake and lower incidence of heart disease. But none of the high-fiber-eating groups in those studies averaged as high as 38 grams, and, in fact, people saw maximum benefits with a daily gram intake averaging from the high 20s to the low 30s.
Put the Truth to Work for You: Just eat sensibilty. Favor whole, unprocessed foods. Make sure the carbs you eat are fiber-rich—that means produce, legumes, and whole grains—because they'll help slow the aborption of sugar into your bloodstream.
Myth #11: Saturated fat will clog your heart
Reality: Fat has gotten a bum rap
Most people consider turkey, chicken, and fish healthy, yet think they should avoid red meat—or only choose very lean cuts—since they've always been told that it's high in saturated fat. But a closer look at beef reveals the truth: Almost half of its fat is a monounsaturated fat called oleic acid—the same heart-healthy fat that's found in olive oil. Second, most of the saturated fat in beef actually decreases your heart-disease risk—either by lowering LDL (bad) cholesterol, or by reducing your ratio of total cholesterol to HDL (good) cholesterol.
Put the Truth to Work for You: We're not giving you permission to gorge on butter, bacon, and cheese. No, our point is this: Don't freak out about saturated fat. There's no scientific reason that natural foods containing saturated fat can't, or shouldn't, be part of a healthy diet.
Myth #12: Reduced-fat foods are healthier alternatives
Reality: Less fat often means more sugar
Peanut butter is a representative example for busting this myth. A tub of reduced-fat peanut butter indeed comes with a fraction less fat than the full-fat variety—they’re not lying about that. But what the food companies don’t tell you is that they’ve replaced that healthy fat with maltodextrin, a carbohydrate used as a filler in many processed foods. This means you’re trading the healthy fat from peanuts for empty carbs, double the sugar, and a savings of a meager 10 calories.
Put the Truth to Work for You: When you're shopping, don't just read the nutritional data. Look at the ingredients list as well. Here's a guideline that never fails: The fewer ingredients, the healthier the food.
Myth #13: Diet soda is better for you
Reality: It may lead to even greater weight gain
Just because diet soda is low in calories doesn’t mean it can’t lead to weight gain. It may have only 5 or fewer calories per serving, but emerging research suggests that consuming sugary-tasting beverages—even if they’re artificially sweetened—may lead to a high preference for sweetness overall. That means sweeter (and more caloric) cereal, bread, dessert—everything. In fact, new research found that people who drink diet soda on a daily basis have an increased risk of developing type 2 diabetes and metabolic syndrome.
Put the Truth to Work for You: These days, the world of food is full of nasty surprises like this one, and knowledge is power. Check out Eat This, Not That! 2011 and Cook This, Not That! for the best food, nutrition and health secrets, and avoid shocking waistline expanders with our slideshow of 20 Salads Worse Than a Whopper.
Myth #14: Skipping meals helps you lose weight
Reality: Skipping meals, especially breakfast, can make you fat
Not eating can mess with your body's ability to control your appetite. And it also destroys willpower, which is just as damaging. If you skip breakfast or a healthy snack, your brain doesn't have the energy to say no to the inevitable chowfest. The consequences can be heavy: In a 2005 study, breakfast eaters were 30 percent less likely to be overweight or obese.
Put the Truth to Work for You: The perfect breakfast? Eggs, bacon, and toast. It's a nice balance of all the nutritional building blocks—protein, fiber, carbs—that will jumpstart your day. The worst? Waffles or pancakes with syrup. All those carbs and sugars are likely to put you into a food coma by 10 a.m.
Myth #15: You should eat three times a day
Reality: Three meals and two or three snacks is ideal
Most diet plans portray snacking as a failure. But by snacking on the right foods at strategic times, you'll keep your energy levels stoked all day. Spreading six smaller meals across your day operates on the simple principle of satisfaction: Frequent meals tame the slavering beast of hunger.
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