Archive for Diabetes and obesity tips
If only it were that simple, but physiology rarely is. But this does not mean you can’t use this info on probiotics and weight gain to your advantage.
Out of all the topics I’ve covered in the past 13 years and some 2500 blog posts, there are a few that stand out. Vitamin D, exercise, diabetes prevention, chronic migraine relief. Probiotics, or those beneficial little buggers that should be present in your gut, is also way up on this list.
That is because the research on probiotics is everywhere across multiple specialties and any number of disease states. Many times I do not flag interesting journal articles on probiotics because I sound like such a darn broken record. So why am I doing it again? Certainly not boredom–I’ve got 20 other articles in my inbox for blog fodder. Maybe it’s because, at times, the evidence for a particular benefit becomes so overwhelming that it needs to be said again.
We are clearly at that point when it comes to probiotics and regulation of body weight.
The problem is that it is not a matter of having obese people add in some probiotics and “Viola!” They wake up skinny. The reality is that having the right blend of healthy bacteria in your gut seems to help set the tone for your body weight over a lifetime. This begins from birth. I recently had a patient with a 4 month old infant tell me that her pediatrician actually recommended probiotics, but that she should start after 6 months.
Well intentioned, but off base by 6 months. Passage through the womb begins the process and nursing continues the exposure of the newborn and infant to bacteria. Waiting for 6 months in a formula fed baby is just WAY too long to wait. This could potentially make the difference between a lifetime of being at an ideal weight versus this child fighting his weight for the rest of his life. Needless to say, I stressed how important it was not to wait 6 months.
As this particular article points out, the details on the process still are not ironed out. Frankly, given the difference in everyone’s physiology and the hundreds of species of bacteria that are present in the gut, I don’t think we’ll ever get the specifics.
Besides this study, here are some previous blog articles looking at the relationship between probiotics and weight:
The take home message is twofold. First, the use of antibiotics for non-life threatening situations needs to go away. Nothing will destroy the delicate balance of the bacteria in your gut faster than antibiotics. Second, supplementation of probiotics intermittently is not a bad idea. this concept is particularly important for newborns, infants, toddlers and children.
My general recommendations are as follows:
- Teens and Adults: 20 billion cfu / day taken one or two weeks per month.
- Infants and toddlers: 5-10 billion cfu / day at least several days per week.
- Preschoolers and elementary kids: 10-20 billion cfu several days per week.
While these recommendations vary greatly based on the individual situation, it is a good place to start.
Why should gastroenterologists be interested in nutrition and obesity?
Umm…because it is the keystone upon which health and disease pivots? Because it holds the potential to stave off most diseases known to man? Because it can modify the progression and severity of many (if not all…) chronic diseases, many of them GI disorders? Because the GI tract is the first and largest area food we eat is exposed to? Why is this even a question?? This is a sad state of how behind medicine is when it comes to health.
Troglitazone Antagonizes Metabolic Effects of Glucocorticoids
Ahh…the slippery slope of multiple medications; each drug designed to counteract the effects of the one before it. How about doing everything possible to reduce the steroid use in the first place, and if still absolutely necessary, using weight training and diet to manage the insulin resistance? What a novel concept!!!
Diabetes — Abstracts: Willi et al. 51 (10): 2895
Acidic Drinking Water and Risk of Childhood-Onset Type 1 Diabetes
This article is very intriguing to me and raises several issues. The findings of this study show that acidic municipal water led to a fourfold increase in risk of developing Type 1 DM. Zinc was also evaluated, and higher levels were protective. The authors suggest that the acidity may work indirectly by fostering the growth of certain types of bacteria that influence risk. A few comments here. First, this just strengthens the case for filtered/bottled water. Second, zinc is known to help modulate the Th1/Th2 cytokine expression–might this help guide the immune system into proper development and avoid autoimmune disorders? Or might the zinc support healthy immune function and override any infections that may lead to Type 1 DM? Stay tuned…
Dia Care — Abstracts: Stene et al. 25 (9): 1534
Human Adenovirus Promotes Weight Gain in Monkeys
While I don’t have much to say on this topic (surprised?), I must admit that I have never given much thought to an infectious etiology for obesity. I just hope that we do not tread too heavily down this path, releasing patients of their own personal responsibility with lifestyle changes promoting a healthy weight and blaming excess weight on a virus that is beyond our control.
Nutrition.org — Abstracts: Dhurandhar et al. 132 (10): 3155
Fructose, weight gain, and the insulin resistance syndrome
There are beliefs out there that fructose does not contribute to weight gain and alterations in insulin resistance. “Health” drinks contain glucose-fructose syrup and high fructose corn syrup is virtually ubiquitous in junk and processed food.
Well, this study debunks these beliefs and supports the idea that fructose does get readily converted to fat in the liver, induces insulin resistance and increases blood pressure.
AJCN — Abstracts: Elliott et al. 76 (5): 911 -
Many think that preventing Type 2 diabetes requires a major overhaul on your lifestyle. For many, this IS true, but sometimes some incredibly simple changes can have powerful results.
I have always felt that food is, and should be, a celebration of life. Think of the events, meetings and dinners that you have gone to in your life. Many times food is at the center of this experience. And this isn’t just today–this hedonistic experience has been at the heart of celebrations for as long as we have been keeping records.
But part of that celebration should, arguably, be actually enjoying the food that you are eating. Let me rephrase this a little more clearly…
Slow down when you eat.
How can you enjoy your food if you’re scarfing it down like the smallest child in a family of 12 at dinner? Quite frankly, you can’t.
But besides enjoying the experience more, there are distinct health benefits associated with this behavior. Merely chewing more has been shown to have very positive anti-diabetic properties. This includes better absorption of healthy fats from a meal, higher levels of GLP-1 in the bloodstream (a very potent anti-diabetic hormone in your body) and greater satiety (the people who chewed more felt more full after eating).
All pretty good things.
But let’s take this out to a lifetime of eating our meals rapidly without enjoying them to their fullest. This particular study looked at the risk of developing diabetes in slow versus fast eaters.
Here’s what they found:
A pretty startling 252% increased risk of developing diabetes in someone who described themselves as a fast eater.
That’s pretty dramatic for an aspect of diet that few ever consider.
Think on this just before you take a bite of that Big Mac or Egg McMuffin as you are driving on your way to work…
Not surprising, considering that the diabetic spectrum is the worst thing that could happen to your body. So, there are clear associations between prediabetes / diabetes and thyroid problems. But what about thyroid cancer?
Before we delve into thyroid cancer in particular, let’s look at cancer and the diabetic spectrum. (BTW, I refer to the “diabetic spectrum” rather than prediabetes or diabetes in particular because the difference is purely arbitrary–both are incredibly devastating to the human body). Insulin levels are elevated in the diabetic spectrum as the body tries to better manage the elevated glucose that is having a harder and harder time making it into the cells.
Insulin is a proliferative hormone, meaning that it causes cells to divide more. Any time a cell divides, the chance for an error is present. And, while cell division is darn near perfect, it is not 100% perfect. An error in cell division can lead to cancer. This means that anything that causes a cell to divide more would potentially increase the risk of a cancer developing.
And this would be relatively non-discriminatory as to the type of cancer. This is why we see an elevation of so many different types of cancer in the diabetic spectrum.
Now back to thyroid cancer.
In this particular study, researchers looked at the contribution of diabetes to the development of and mortality associated with thyroid cancer. While there was a clear association between diabetes and thyroid cancer mortality, that wasn’t the shocker.
Here’s the shocking stats of diabetics’ risk of dying from thyroid cancer:
- Men 75 years of age, 185% increased risk, women 22% lower risk
- Men 65-74 years old, 121% increased risk, women 203% increased risk
- Men 55-64 years old, 253% risk, women 299%
- Men 25-54 years old, a whopping 580% increased risk, women, not to be outdone, 534% increased risk
The surprising aspect of these numbers is the greatly increased risk in the younger ages. And these are some pretty serious increases in risk.
The bottom line is that this study confirms, yet again, that the diabetic spectrum is THE most dangerous beast you will ever battle against. While many would believe heart disease, cancer or dementia would be the answer, it is not. These conditions are the end result of NOT doing battle against the original enemy.
If you’re not sure what changes to make to lower your risk, be sure to download (AND read!) my ebook, Dr. Bogash’s Lifestyle Recommendations.
Type 1 diabetes in a child is a heartbreaking scenario. While children readily adapt, it’s not fair that any child should need to be tied that closely to any type of consistent medical intervention.
On the plus side, I think we’re getting closer to an answer for those who have already been diagnosed. I’ve addressed my thoughts on this in a prior blog post that can be read by clicking here. In addition, careful attention to lifestyle choices that are helpful for Type 2 diabetics will also help those with Type 1 diabetes.
But there is also a wealth of information about what contributes to the development of Type 1 diabetes. Sadly, due to our society’s lack of attention to preventing chronic diseases, these insights seem to be relegated to a secret society. These contributing factors include:
Now, thanks to this particular study, the list is just a little longer.
Researchers looked at the contribution of different bacteria species in the guts of children with Type 1 diabetes and how this differed in the children who had evidence of autoimmunity to the beta cells of the pancreas (the cells that produce insulin in our body).
Here’s what they found:
- Low levels of lactate-producing and butyrate-producing species was associated with the beta cell autoimmunity.
- Specifically, there were low levels of the two most dominant Bifidobacterium species, B. adolescentis and B. pseudocatenulatum.
- In addition, these children had higher levels of the Bacteroides family of bacteria.
So what does this mean?
It boils back down to what I have written time and time again. The destruction of the normal flora in the gut of infants, toddlers and children may be the worst thing that could potentially happen to the development of his or her immune system.
Because of this, C-section births, lack of breastfeeding (or antibiotic use in a mom who is nursing) and antibiotic use can very well be added to the list of factors that contribute to the development of Type 1 diabetes in our children.
Recently, for the very first time today in my 15 years of practice, I had a patient mention that his granddaughters’ (yes–twins!) pediatrician had actually recommended that giving probiotics to the infants was a good thing. And, while the probiotic dose recommended was far too low, but it’s a start.
Maybe there is hope for medicine after all…