Lifestyle changes may stave off diabetes for 10 years

Lifestyle changes may stave off diabetes for a decade

November 2, 2009 (Physorg.com)

Sustaining modest weight loss for 10 years, or taking an anti-diabetic drug over that time, can prevent or lower the incidence of type 2 diabetes in people at high risk for developing the disease, according to the Diabetes Prevention Program Outcomes Study (DPPOS), a long-term follow-up to a landmark 2001 diabetes prevention study.

Jill Crandall, M.D., associate professor of clinical medicine at Albert Einstein College of Medicine of Yeshiva University, was a principal investigator in the follow-up study, which appears online in the current edition of the British medical journal the Lancet.

The original study ─ the Diabetes Prevention Program (DPP) ─ was a large, randomized trial involving 3,234 people at high risk for developing diabetes. At the start of the study, all were overweight or obese adults with elevated blood glucose levels. Researchers disclosed the findings from DPP in 2001 ─ a year earlier than scheduled ─ because results were so clear. After three years, intensive lifestyle changes (modest weight loss coupled with increased physical activity) reduced the rate for developing type 2 diabetes by 58 percent compared with placebo. The oral diabetes drug metformin (850 milligrams twice daily) reduced the rate of developing diabetes by 31 percent compared with placebo.

Since these striking results were based on just three years of data, researchers could not determine how long the benefits would last. Following a seven-month bridge period after the original study ended, the follow-up DPPOS began, with 88 percent of DPP volunteers taking part. During the study pause, all participants learned the results and were offered 16 education sessions on making intensive lifestyle changes. The latest results, reflecting a full decade of participation ─ three in the DPP study and seven in DPPOS ─ indicate that lifestyle interventions producing even modest weight loss can significantly help to prevent or delay diabetes over the long term.

Specifically, for the 10 years spanning the DPP and DPPOS studies, the diabetes incidence (i.e., rate at which new diabetes cases were diagnosed) in the lifestyle group was reduced by 34 percent compared with placebo. For the group taking the diabetes drug metformin, diabetes incidence was reduced by 18 percent. Expressed another way, the lifestyle group delayed type 2 diabetes by about four years compared with placebo, and the metformin group delayed it by two years.

"The fact that we've continued to delay and possibly even prevent diabetes in people at very high risk for developing the disease is certainly a positive finding," says Dr. Crandall. She notes that those people randomly assigned to make lifestyle changes also had more favorable cardiovascular risk factors (including lower blood pressure and triglyceride levels) despite a reduction in drug treatment prescribed by their personal physicians.

The benefits of intensive lifestyle changes were especially pronounced among older people. Those aged 60 and over lowered their rate of developing type 2 diabetes in the next 10 years by about half.

The increase in the number of overweight Americans has led to an epidemic of type 2 diabetes that shows no signs of slowing. More than two-thirds of adults are now overweight or obese. About 11 percent of adults ─ 24 million people ─ have diabetes, and up to 95 percent of them have type 2 diabetes, according to the National Institutes of Health. Diabetes is a major cause of heart disease and stroke and the major cause of kidney failure, limb amputations and new-onset blindness.

The researchers are now analyzing the DPPOS data to see whether clinical outcomes differ among the three groups. "The long-term weight loss and reduction in diabetes that we observed in DPPOS are encouraging," says Dr. Crandall. "But ultimately, establishing the benefits of preventing diabetes means showing that you can reduce the deaths and the severe complications associated with this disease."

More information: The study, "10-year Follow-up of Diabetes Incidence and Weight Loss in the Diabetes Prevention Program Outcomes Study," appears in the October 29, 2009 online edition of the Lancet. In addition to Dr. Crandall, other Einstein researchers involved in DPPOS were Harry Shamoon, M.D., Elizabeth Walker, Ph.D., Judith Wylie-Rosett, Ed. D., Swapnil Rajpathak, M.B.B.S, Dr. P.H., and Janet Brown-Friday, R.N., M.P.H.

Tips for Low GI Eating

* Choose denser breads containing whole or cracked grains, and those made from stone-ground flours.

* Add barley or lentils to rice to lower the overall GI and reduce the amount of rice you eat.

* Instead of potatoes, use legumes, pasta, low-GI noodles, steamed unpeeled orange sweet potato, basmati rice or Doongara rice (CleverRice™).

* Don't chop or cut foods too finely or puree or mash them (this increases their GI value).

* Add a green salad dressed with vinegar to meals containing starchy foods, such as rice or potatoes (the vinegar helps reduce the meal's GI value).

* Don't cook pasta or rice until it is soft and soggy.

* Serve pasta with lots of salad and a tomato-based sauce, so you can fill up on vegetables and reduce the amount of pasta you eat.

Taken from Healthy Food For Life
Info by Dr Susanna Holt (PhD, dietician)

Low GI good for the skin

NUTRITION MATTERS: Skin savers and skin killers
	Published: 2009/11/04 02:19:46 PM (Business Day)

AGE DEFYING: Berries are skin savers that can help you to keep your youthful glow. Picture: VISMEDIA

FEW of us actually look at our diet and lifestyle before resorting to expensive skin treatments, like Botox, chemical peels and even plastic surgery. A healthy diet should really form the basis of your skin care regime, because when it comes to visible ageing, the real damage starts within and works its way out to the surface.

There are three major reasons why our skins age, and all three have dietary implications:

Free radical damage

These villains are produced in our body from stress, excessive sun, smoking, pollution and bad diet. Free radicals attack our collagen and elastin, which give skin its structure and keep it firm and plump. A diet rich in plant foods helps supply necessary antioxidants, which are the body’s artillery against free radicals.

Inflammation

Ageing and bad diet lead the way for inflammation to form. It has now been proven that low levels of inflammation in the body can accelerate the ageing process and therefore damage the skin. On the diet side, its bad fats, fried foods, sugars and simple carbohydrates that trigger these inflammatory responses. Omega 6 and omega 3 fatty acids (or the essential fatty acids from fish and seed oils) on the other hand, tend to inhibit this inflammatory response.

Blood sugar alterations

Glycation, or glycosylation, is a fancy word for the damage caused by excess sugar. A diet high in sugar and refined carbohydrates results in higher blood glucose levels. Glucose, in turn, can directly damage collagen and elastin, rendering them stiffer and less resilient.

Each or a combination of these factors underpins all major theories into why we age, and thankfully they are things we can actually control. The obvious things like genetics, stress and sun aside, what we eat can increase our susceptibility to these forces, or protect against them.

There are some general dietary guidelines for healthy skin.

- Eat fatty fish at least three times per week.

- Lean red meats, skinless chicken breasts or eggs are acceptable sources of protein.

- Eat yellow/orange and green vegetables daily.

- Use nuts and seeds and seed oils daily.

- Drink eight to 10 glasses of spring or distilled water throughout the day. Caffeine- free herbal teas are also a good choice.

p Include fruits with a low-GI (glycemic index) rating daily. The glycemic index is a measure of the speed with which a carbohydrate food releases its glucose content into your bloodstream.

- Avoid salt, sugar, refined carbohydrates and fried foods

Here are the specifics of the many skin-saver foods:

Salmon

Oily fish, like salmon, contain omega-3 fatty acids that help keep skin moist and prevent inflammation. Salmon contains high amounts of a powerful antioxidant known as DMAE (dimethylaminoethanol) known for its effects in keeping skin firm. Fish is also a good source of protein, which helps repair and reconstruct skin cells. Lean protein sources like skinless chicken, eggs and whey protein powders are acceptable. Look out for omega-3 fatty acid enriched eggs on the shelves.

Raw vegetables oils

Flaxseed oil is a great source of anti-inflammatory essential fatty acids and is the richest vegetable source of omega-3 fatty acids. Other raw oils, like those found in olive oil, avocados and avocado oil, nuts and seeds are rich in Vitamin E, a natural skin antioxidant. Having enough fat in the diet also ensures that the skin is lubricated and smooth.

Berries

Strawberries, raspberries, cherries and in particular, blueberries are excellent sources of antioxidants, and are particularly useful for preventing skin ageing due to pollution and free radical damage.

Low-GI foods

Fruit is a preferred source of carbohydrate for healthy skin. Apples, pears, peaches, citrus fruits and kiwi fruit are all low GI, which means they release sugar slowly into the blood. Berries also fall into the low- GI category.

Low-GI carbohydrates include rolled oats, low-GI mueslis and cereals that are labelled as such, low-GI breads, sourdough rye breads, quinoa, brown, basmati and wild rice, sweet potatoes, corn on the cob, legumes and wholewheat pasta.

Yellow and orange vegetables

These are great sources of beta- carotene, an antioxidant that helps reverse damage to the skin caused by excessive exposure to sunlight. Good sources include paw-paw, mangoes, carrots, butternut, sweet potato and pumpkin.

Green vegetables

Green veggies like broccoli and spinach are a rich source of antioxidants and other anti-ageing phytochemicals.

Water

Eight to 10 glasses of good quality water each day helps prevent dehydration, which can make the skin look dry, dull and lined.

Exercise

Regular exercise has an anti-inflammatory effect on the cells. Aim for at least 20 minutes a day, three to four times a week.

There are also foodstuffs and habits that are death to that youthful glow. Skin killers include:

Coffee

A high intake of caffeine can raise levels of the hormones cortisol and insulin, which in turn accelerates ageing. Use non-caffeinated herbal teas instead.

Alcohol

Alcohol can lead to free radical damage, a sluggish liver and dehydration and should be avoided.

Salt

Salt and sodium-rich foods tend to dehydrate the skin, making it look dull and dry. Rather use fresh herbs, lemon juice or grated ginger for flavour in foods.

Sugar and refined carbohydrates

Fried foods

Foods that have been fried in oil generate a huge amount of free radicals and destroy vitamin E.

Smoking

Cigarette smoke comes into direct contact with the skin, causing blockage of the pores and exposing it to free radicals.

Stress

Chronic stress not only generates free radicals, but also increases levels of cortisol — the stress hormone that has been linked to accelerated ageing.

Sun exposure

UVA and UVB rays have long been notorious for their damaging effects on the skin. To minimise the damage, apply a sun block with a high SPF every day .

- Ashleigh Caradas is a dietician in private practice. She also consults to corporates. Visit www.intelihealth.co.za.

Typical meal plan

Breakfast: Cooked oatmeal made from rolled oats and a tablespoon crushed flaxseeds.

Snack: Yogurt and mixed fresh berries.

Lunch: Sashimi salad — salmon sashimi on a bed of romaine lettuce with sliced red, green and yellow peppers, carrots, onions, corn and cucumber with flaxseed oil, low sodium soya sauce and fresh lemon juice dressing.

Snack: Stewed apple with cinnamon.

Dinner: Grilled chicken breast served with steamed bok choy or spinach and brown rice.

Vegetable Chilli Bowl

Great and tasty meal that fills you up.
Serves 3

Ingredients:
2 cloves garlic
2 red chillies , finely chopped
2 tsp ground cumin
250g mushrooms
1 tin of chopped tomatoes
1 tin of kidney beans
150g green beans, cut into strips
half-fat crème fraîche , to serve

Method:
1. Fry the garlic and chilli in 1 tbsp olive oil for 2 minutes. Add the cumin and mushrooms and cook for 3 minutes. Add the tomatoes, kidney beans and 200ml water, stir and simmer for 10 minutes. Add the green beans and cook for another 5 minutes until the sauce is thickened and veg is tender. Serve in bowls with a dollop of crème fraîche and some crusty bread.

Per serving

Nutrition
133 kcalories, protein 8.1g, carbohydrate 16.7g, fat 4.2 g, saturated fat 0.5g, fibre 6.6g, salt 0.86 g

Quinoa and Black Beans

Quinoa: "Very flavorful alternative to black beans and rice. Quinoa is a nutty grain from South America." Get in in the health food section of your supermarket

PREP TIME : 15 Min
COOK TIME: 35 Min
READY IN : 50 Min


Servings : 4

INGREDIENTS (Nutrition)
2 ml vegetable oil
3/8 onion, chopped
1-1/4 cloves garlic, peeled and chopped
50 g uncooked quinoa
140 ml vegetable broth
0.8 g ground cumin
0.2 g cayenne pepper
salt and pepper to taste
65 g frozen corn kernels
3/4 (15 ounce) can black beans, rinsed and drained
9 g chopped fresh cilantro

DIRECTIONS
1. Heat the oil in a medium saucepan over medium heat. Stir in the onion and garlic, and saute until lightly browned.
2. Mix quinoa into the saucepan and cover with vegetable broth. Season with cumin, cayenne pepper, salt, and pepper. Bring the mixture to a boil. Cover, reduce heat, and simmer 20 minutes,
3. Stir frozen corn into the saucepan, and continue to simmer about 5 minutes until heated through. Mix in the black beans and cilantro.

It's very hard to eat a healthy meal in Forbes, NSW...unless you make it yourself. Everthing is battered!!!

A chance to win a free ebook by giving us your valued feedback! http://ping.fm/abQYF