Milk & Diabetes

from Coffee Today

People with high intake of fat in dairy products have low probability of developing diabetes, according to research. After studying more than three thousand U.S. 700 adults, researchers found that those with high blood levels of a fatty acid called transpalmitoleico were 60 percent less likely than others to develop type 2 diabetes within 20 years. This would contradict the recommendations to replace the whole milk and cheese by the fat-free versions for health care.

But the experts make it clear that it is too early to choose only the whole milk. On the one hand, it is unknown whether fatty acids reduce the risk of diabetes. Then the whole milk are high in calories and saturated fat increases LDL or “bad” and encouraging the emergence of cardiovascular disease.

“We should not change dietary recommendations from a single study,” said Dr. Dariush Mozaffarian, an associate professor in the School of Public Health at Harvard. But he added that the results are “exciting” and deserve more study.

The findings, published in Annals of Internal Medicine, would provide a possible explanation for previous findings that milk lovers are less likely to develop diabetes than those who consume few dairy products. “I think this study confirms that there is something in the milk that produces that effect,” he said.

Mozaffarian’s team could take into account several risk factors for diabetes in participants, including age, weight, exercise and diet, they did not explain the relationship between dairy fat intake and decreased risk of diabetes.

Effect of Exercise on Diabetes

As posted in US Medicine (The Voice of Federal Medicine)

BETHESDA, MD—For years now, physicians have been imploring the nation to get more exercise. Pointing to research showing great benefits in overall health and in combating chronic disease, researchers have also been pressing employers to include exercise and nutrition programs into the workplace. The theory is that an exercising workforce is a healthier, happier, and more productive workforce. Also, with the cost of insurance rising due to the need to treat chronic diseases, a healthier workforce is a less expensive one.

Employees as Research Subjects

In 2004, NHLBI undertook a commitment to put its research where its mouth is, establishing a worksite wellness program called Keep-the-Beat. The program encouraged heart-healthy behaviors, and included physical and nutrition activities for all NHLBI employees. Physical activity rooms were installed in several NIH buildings, and interested employees were given pedometers. Health stations were set up where employees could measure their blood pressure and weigh themselves.

The following year, a fellow working at NHLBI took note of the program and suggested opening a research protocol to measure the effects of the program on vascular disease.

“At the time the protocol’s primary focus was on the endothelium,” explained Dr Richard Cannon, NHLBI clinical director at an NIH symposium on diabetes and heart health last month. “[The focus was] on the idea that participation in the program could mobilize bone-marrow derived cells—called endothelial progenitor cells.”

Researchers believed those cells would be pushed out of the bone marrow into the blood stream and attach themselves to diseased or damaged endothelium, helping repair it.

“What we learned was that sedentary employees of the clinical center entering the Keep-the-Beat program were overweight or obese [with] many cardiovascular risk factors,” Cannon explained.

The study showed a reduction in blood pressure, as well as in total LDL and HDL cholesterol. “We did see increased EPCs, but only a small contribution to improved endothelial function.”

Examining Insulin Resistance

Believing studying employees in the program might yield even more data, Cannon and his colleagues wrote a second protocol. This one looked at other vascular functions that might be improved by the program, including changes in insulin sensitivity, high-density lipoprotein function and adipokines—cell-to-cell signaling proteins secreted by adipose tissue, or body fat—in overweight and obese women. This time, they looked specifically at women in the program, recruiting 200 women for six months of exercise training, nutritional counseling, and caloric reduction.

“How exercise interacts with insulin is not entirely clear, but there’s clearly an interaction between the two,” Cannon noted. “There’s some controversy in the field. Is it fatness, or fitness, or lack thereof [that determines outcome]? Some people think you can be fat and fit, and it’s just as good as being not fat. A lot of epidemiologists have looked at this over the years and shown that fitness does matter. Most of the trials are in men [and most show] that fit people do better over time.”

Preliminary data from 100 of the participants—a mix of black and white employees—has shown a significant relationship between BMI and insulin sensitivity. The two have an inverse relationship, with the higher BMI leading to lower insulin sensitivity. “Most of our participants are below the [insulin resistant line], with about 25% in the insulin resistant range,” Cannon explained. “BMI was a predictor of diminished insulin sensitivity.”

Researchers also found that there was a racial difference in what body types were the best predictors of diminished insulin sensitivity. For blacks, waist circumference was a strong predictor, while truncal fat was the strongest predictor for whites.

“Skeletal muscle may be less effective in oxygen consumption during exercise and less insulin sensitive in blacks compared with whites, contributing to poor fitness and insulin resistance, respectively, in black women,” Cannon noted.

The study also found that poor fitness plays an even larger role in non-insulin dependent glucose uptake in blacks and whites.

Currently the participants are set to enter the activity phase of the study, which involves 30 minutes of activity on most days, with caloric decrease and expected weight loss. Researchers will then examine whether these changes will have a demonstrable effect on patients’ health.

Asked why death by CV disease is decreasing in the face of the obesity and diabetes epidemic, Cannon predicted that the steady decrease the nation has experienced over the last few decades might be coming to an end. “That decrease is probably from better control of blood pressure, statins to control cholesterol, judicious use of revascularization and surgical heart treatments, and better drugs for treating acute coronary syndromes,” he explained. “But obesity is clearly working against this. I read editorials that speculate that now we’ll see an uptick in CV disease and that our children will not live as long as we are going to live, as they become more obesity and diabetes prone.”

US Medicine

World Health Organization Fitness Guidelines For Adults

Physical Activity and Adults
Recommended levels of physical activity for adults aged 18 – 64 years

In adults aged 18–64, physical activity includes leisure time physical activity (for example: walking, dancing, gardening, hiking, swimming), transportation (e.g. walking or cycling), occupational (i.e. work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities.

In order to improve cardiorespiratory and muscular fitness, bone health, reduce the risk of NCDs and depression:

• Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.
• Aerobic activity should be performed in bouts of at least 10 minutes duration.
• For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.
• Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

For further information click below and download the complete document “Global Recommendations on Physical Activity for Health” available in:

English | Spanish | French

Physical Activity For All

These recommendations are relevant to all healthy adults aged 18–64 years unless specific medical conditions indicate to the contrary. They are applicable for all adults irrespective of gender, race, ethnicity or income level. They also apply to individuals in this age range with chronic noncommunicable conditions not related to mobility such as hypertension or diabetes.

These recommendations can be valid for adults with disabilities. However adjustments for each individual based on their exercise capacity and specific health risks or limitations may be needed.

There are multiple ways of accumulating the total of 150 minutes per week. The concept of accumulation refers to meeting the goal of 150 minutes per week by performing activities in multiple shorter bouts, of at least 10 minutes each, spread throughout the week then adding together the time spent during each of these bouts: e.g. 30 minutes of moderate-intensity activity 5 times per week.

Pregnant, postpartum women and persons with cardiac events may need to take extra precautions and seek medical advice before striving to achieve the recommended levels of physical activity for this age group.

Inactive adults or adults with disease limitations will have added health benefits if moving from the category of “no activity” to “some levels” of activity. Adults who currently do not meet the recommendations for physical activity should aim to increase duration, frequency and finally intensity as a target to achieving them.

Benefits of physical activity for adults

Overall, strong evidence demonstrates that compared to less active adult men and women, individuals who are more active:

• have lower rates of all-cause mortality, coronary heart disease, high blood pressure, stroke, type 2 diabetes, metabolic syndrome, colon and breast cancer, and depression;
• are likely to have less risk of a hip or vertebral fracture;
• exhibit a higher level of cardiorespiratory and muscular fitness; and
• are more likely to achieve weight maintenance, have a healthier body mass and composition.

Exercise is Medicine!

from HOPE WARSHAW, RD, CDE who was attending the Food and Nutrition Expo of the American Dietetic Assoc.

Exercise is Medicine! Understanding the Evidence and Initiating the Client Conversation: Prior to this session, I was unaware of the Exercise is Medicine initiative of the American College of Sports Medicine and American Medical Association. Robert Sallis, MD, Chair of the Exercise is Medicine Task Force, kicked off the program giving us our marching orders: nutrition professionals MUST integrate exercise advice and encouragement into our counseling.

He noted, “physical inactivity has an astonishing array of harmful health effects and that physical inactivity is THE major public health problem of our time.” As we know with prediabetes and type 2, exercise is a powerful prevention and treatment tool. Relevant to many people at risk for and with T2, low level of fitness is a bigger risk factor for mortality than mild to moderate obesity. Sallis noted that the benefits of physical activity are the same regardless of weight status.

The litany of mental and physical health benefits are well known to us all. Exercise is Medicine promotes several concepts:

1. assess and discuss exercise with every patient, every visit and make it part of every treatment plan,
2. record exercise as a vital sign
3. provide consistent message across providers.

Joan Hill, RD, CDE, LDN

Consultant to the Diabetes Prevention & Control Program
Massachusetts Department of Public Health
250 Washington Street, 4th Floor
Boston, MA 02108

Fitness Together has created a program specifically for Type 2 Diabetics.

To view videos on our Type 2 Diabetes Study and Program, go here.

For more information on the study and program go here.

Last-Minute Gift Ideas for the Diabetic Cook

Christmas is literally right around the corner and if you’re in need of an idea or two as to what to get that special person, here’s some ideas from the Diabetic Lifestyle site.

Here’s ten nifty suggestions for someone  who has diabetes and does the cooking, or is the person responsible for preparing diabetic meals for someone else, or just someone trying to stay on a trim and fit diet.

1. A digital roasting thermometer with preset temperatures for 15 different kinds of meat or poultry that alert you when the item is done (or nearly done).
2. A food processor that chops, slices, shreds, and purees, making these time-consuming preparation tasks quick and easy.
3. A nickel-plated steel cookbook holder with an acrylic splash guard that keeps cookbooks neatly displayed at your preferred reading angle while you’re cooking.
4. A stainless steel rolling mincer for chopping a handful of fresh herbs or a clove of garlic.
5. An electronic food scale for weighing foods. Some models are pre-programmed to give you nutritional values for more than 1,000 foods, and keeps running totals over a period of time for tracking calories, fat grams, carbs, and more.
6. A fat separator for sauces and gravy that separates the fat from the pan juices in seconds.
7. Tupperware food storage containers, seasoning blends, and knife sets. Many containers go from freezer to microwave for cooking and then to the table for serving. Order from our Diabetic Supply Store.
8. Silicone spatulas that won’t crack, chip, or lose their shape while withstanding temperatures up to 450°F. Great for making omelets and scrambled eggs.
9. A programmable crockpot that allows you to cook delicious meals (without additional fat) while you’re away from home.
10. One of our cookbooks from our Book Store: The Joslin Diabetes Great Chefs Cook Healthy (delicious diabetic recipes from some of the best chefs in the world), The Joslin Diabetes Healthy Carbohydrate Cookbook (more than 200 fabulous ways to cook foods with carbohydrate and no animal protein), The Joslin Quick and Easy Cookbook (more than 200 yummy recipes for breakfast, lunch, and dinner-mostly for two servings), and The Joslin Diabetes Gourmet Cookbook (more than 500 outstanding recipes for family and friends).

Merry Christmas!

Diabetic Lifestyle

Managing Your Diet during the Holidays

by Joslin Diabetes Blog

[While this post from Joslin is focused on those with diabetes, the tips are great for all of us trying to stay healthy.]

Are you feeling the holiday spirit yet? ‘Tis the season of many extras: extra smiles, extra kindness, extra trips to the mall, and often extra helpings of food.

This is a great time of year for all of those reasons, but it can be extra challenging if you are struggling to manage your blood sugar. Keep these helpful tips in mind to keep your blood sugar and your stomach happy.

• Limit intake of carbohydrates and keep your carb intake consistent. Don’t go overboard just because it’s a holiday.

• Don’t take home leftovers.

• Maintain portion control—keep track of how much you’re eating and measure your servings. If you’re not doing this as consistently as you’d like, make an effort to start now. It’ll be easier to carry your pattern over to the holidays

• Bring food alternatives. For instance, make your own pie with a suitable sugar substitute and low-fat whip cream.

Don’t let diabetes stress out your holiday! Smart pre-meal planning and conscious food decisions can make your holiday meals memorable and fun.

Joslin Blog

Fitness Tip Of The Week from Ashley Landon (FT Westborough)

5 Holiday tips to avoid over indulging!

1. Chew on gum or have a cup of coffee or tea while cooking to avoid taste testing too much of your favorite holiday cooking or baking.

2. When baking poor water in the bowl immediately after you are done so you don’t lick the bowl clean!

3. Make your own holiday wish list:

• Thinner Thighs
• Tighter Abs
• Smaller Butt
  **Hang it where ever you will see it the most on the refrigerator or bathroom mirror**

4. Don’t skip meals and never show up to a party starving.

5. Step away from the food!! When you are done eating walk away from the food table and keep yourself busy . “Out of sight out of mind”

And remember any amount of exercise is better than none. Even if you only have 20min to spare it is WORTH IT!

Ashley Landon
Ashley is a graduate from Framingham State College with a bachelors degree in Fashion Merchandising. However, her true passion and drive always came from fitness, which lead her to a change in career paths. She is now a certified personal trainer, graduate from The National Personal Training Institute (NPTI), Waltham, MA. She is also certified in CPR, First Aid, and AED.

Ashley has always had an undeniable interest in fitness and health, putting it at the top of her list. She truly enjoys working out and shows it through her training, making it fun and challenging!

Ashley has been a trainer at Fitness Together –Westborough since 2007 and has helped many people push themselves beyond what they thought possible.

In her free time, Ashley enjoys strength training, running and coming up with new and improved ways of making healthy recipes.

Fitness Together Westborough

Other FT studios in Eastern New England

Kid Will Eat Low-Sugar Cereal

By Nancy Walsh (MedPage Today)

Despite the heavy marketing of sugary breakfast cereals to children, kids seem willing to eat low-sugar cereals — particularly if they can add fresh fruit or a small amount of table sugar, researchers found.

It’s widely accepted that children benefit from eating breakfast — for reasons ranging from better overall nutrition to improved academic performance.

However, ready-to-eat breakfast cereals contribute 8% to 9% of added sweeteners in children’s diets — and cereals marketed directly to children contain significantly more added sugar than those promoted for adults, totaling 32% to 43% of cereal content by weight, according to background provided by the authors.

“As a consequence, children may consume considerably more than the recommended 27- to 30-g serving for these cereals,” Harris and co-authors wrote.

Some pediatric experts have recommended that parents serve only low-sugar cereals — while others suggest that “a sugar-sweetened cereal is better than no breakfast at all,” according to the researchers.

In this study, Children eating low-sugar cereals were more likely to add fresh fruit (54% versus 8%, P<0.001), Harris and co-authors wrote in the January Pediatrics.

To explore children’s willingness to consume low-sugar cereals, Harris and colleagues enrolled 91 children ages 5 years to 12 years who were attending a summer day camp, assigning them to two groups.

Children in the low-sugar cereal group were offered a choice of Cheerios, Rice Krispies, and Corn Flakes, which contain 1 to 4 grams of sugar in a serving.

Kids assigned to the high-sugar cereal group were offered Froot Loops, Cocoa Pebbles, and Frosted Flakes, which contain 11 to 12 g of sugar in each serving.

At each place-setting there was a small cup of orange juice, an 8-oz container of 1% fat milk, and bowls of pre-cut strawberry and banana sections.

In the center of each table there were additional containers of milk and juice, as well as individual sugar packets.

The children were instructed to eat as much as they wanted.

After eating, the children filled out a questionnaire on how much they enjoyed the cereal — using a smiley-face scale of one (loved it) to five (hated it) — and whether they typically put sugar on their cereal at home.

The mean rating for the cereals in the low-sugar group was 4.5 and 4.6 in the high-sugar group, with 90% of the children saying they “liked” or “loved” their choice.

The low-sugar group consumed about a single serving of cereal, while those in the high-sugar group consumed twice as much, which was a significant difference (P<0.001).

Children in the low-sugar group added more sugar to their cereal — but the overall refined sugar consumption was 5.7 teaspoons in the high-sugar group and 0.7 teaspoons in the low-sugar group.

Milk and orange juice consumption did not differ between the two groups.

In the high-sugar group, refined sugar was the source of about 25% of calories consumed, compared with 14% in the low-sugar group (P<0.001).

And in the high-sugar group, fresh fruit was the source of only 12% to 13% of calories, compared with 18% to 20% in the low-sugar group (P=0.03).

The researchers observed that their findings probably underestimated the overall effects of providing children with high-sugar breakfast cereals.

"Children's taste preferences develop over time through continued experiences with different foods," they wrote.

If kids are given highly sweetened cereals regularly, they are likely to learn to prefer sweetened foods in general, the researchers suggested.

Limitations of the study included the fact that sugar consumption was measured only on one day and in one meal, so the results may not be generalizable to longer periods.

In addition, the participants were mostly black and Hispanic children from disadvantaged families, so the results may also not be generalizable to children of different backgrounds and ethnicities.

MedPageToday

Do People Really Gain Weight During The Holidays?

by Tamara Duker Freuman, MS, RD, CDN from FYI LIVING

With Halloween and Thanksgiving behind us and the major holiday season right around the corner, we’re right in the thick of the seasonal indulgence marathon.  Ironically, the magazines that publish decadent photos of gooey pecan pies, rich chocolate treats and festive holiday cocktails are the same ones that warn us about the perils of overindulgence in the form of excess holiday weight gain.

Depending on where you look, you may come across some pretty alarming “statistics” about the average American’s holiday-season weight gain. I’ve seen reports of everything from 3 to 7 lbs over the years.  What I haven’t seen, however, is any actual scientific data to back such numbers up.

Holiday Weight Gain Facts: There are only a small handful of studies I’m aware of that have actually gone to the trouble of methodically and scientifically measuring holiday weight gain trends in Americans, and their findings offer us both some good news and some bad news as far as what we can expect the true outcomes of our annual season of decadence to be.
First, the good news: most Americans appear to only gain about 1 lb of body weight during the holidays on average.  This figure is based on the most commonly-cited research, a 2000 study published in the New England Journal of Medicine, that followed 165 racially-diverse Americans whose average age was 39 and whose average weights reflected those found in the general U.S. population, from the pre-holiday period through the post-holiday period.

The bad news, however, is that these subjects appeared not to lose this extra holiday weight in the post-holiday period.  This suggests that a seemingly minor holiday gain of 1 lb may add up over the course of years and decades and contribute to the gradual, upward creep that typically accompanies aging. The other note of caution from this study is that the heavier a person started out, the more likely they were to experience a “major” holiday weight gain of 5 pounds or more, though only 10% of participants actually gained this amount.

Focusing on a younger adult population, a small study of 82 college students found that average body weight did not change significantly between Thanksgiving and New Year’s at all.  However, their body compositions did, resulting in an increase in their body fat as a total percentage of weight over the holiday period.  Since lean body mass contributes to an increased metabolism and higher fat mass (especially in the belly area) contributes to increased risk of chronic diseases like diabetes and heart disease, in theory, such a change in body composition could spell trouble if not corrected.  However, since the study did not track the students beyond the post-New Year period, it’s unclear whether their body composition change was temporary or permanent.

The study can be found [ Here ]

Read more at FYI Living:

Exercise Minute: Dumbbell Chest Press with Reverse Crunch

This exercise can be performed by anyone. This is a strength exercise, which targets your chest and core muscles primarily but also your shoulders and triceps. Start with lighter weights than you would with a traditional chest press until you are comfortable with the coordination and balance of the movement.

Bill Coleman, Assistmant Manager of Fitness Together’s Cohasset Studio is featured in this exercise minute.

A resident and native of Cohasset, Coleman is a certified personal trainer through the American College of Sports Medicine and is AED and CPR certified. A lifelong fitness enthusiast, Coleman has competed in power lifting competitions and run the Boston Marathon. He is a graduate of Cohasset High School and has been active in the local Little League. Coleman’s father was the well known “voice of the Red Sox” Ken Coleman. He is also a member of the American Drugfree Power Lifting Federation.

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