LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

prediabetes

Stopping Prostate Cancer Recurrence: How to Completely Miss the Boat

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Having prostate cancer at all is a bad thing, but living with the constant fear of prostate cancer recurrence can be worse.

There is no shortage of controversy over our fascination with overdiagnosis of both prostate cancer and breast cancer in medicine today.  I have covered this in a previous blog article (that can be read by clicking here) so I won’t go into it the controversy in detail here.

There is also no shortage of lifestyle factors that clearly, strongly play a role in the development of prostate cancer.  Dairy intake increases the risk of prostate cancer.  Exercise decreases it.  Smoking increases risk.  A plant-based diet decreases risk.

But there is one thing that absolutely plays a role in the development of most types of cancers, with prostate cancer being no exception.

The diabetic spectrum.  Whether we are talking about full-blown diabetes or somewhere along the prediabetic pathway, this absolutely, positively increases your risk of developing prostate cancer.

One of the hallmarks of being prediabetic is abnormalities of lipids like total cholesterol, HDL and LDL cholesterol, VLDL and triglycerides.  Lipids are the first thing I like to look at on a patient’s blood work to see if prediabetes is a concern.

It would then make sense that one of the best ways to lower your risk of developing prostate cancer in the first place would be to live an anti-diabetic lifestyle (again—out of the scope of this article, but you can purchase my eBook on diabetes by clicking here).

But what about prediabetes and prostate cancer recurrence?

This is not exactly what researchers called it in this particular article, but that is essentially what they were looking at.  They looked at the relationship between lipids abnormalities and the risk of prostate cancer recurrence in 843 radical prostatectomy.

Here’s what they found:

  • Elevated triglycerides were associated with a 3% increased risk of prostate cancer recurrence FOR EVERY 10 mg/dl increase.  This can add up fast.
  • Total cholesterol, LDL and HDL did not affect prostate cancer recurrence risk.
  • However, if the men were prediabetic with lipid problems, each 10 mg/dl increase in cholesterol up recurrence risk 9% while the same increase in HDL lowered risk a respectable 39%.

Seems to be in line with expectations.  Lipid problems that indicated prediabetes clearly increased the risk of recurrence.  But it was after this point in the article abstract that I found myself smacking my forehead against the computer monitor…

The authors concluded that these findings suggest that lipid levels should be explored as a modifiable risk factor for prostate cancer recurrence.  In other words, we should use statins to lower the risk of prostate cancer recurrence.

Huh?

Rather than suggesting that an anti-diabetic lifestyle would be powerful for preventing prostate cancer recurrence, they just completely skirt the prediabetic / lifestyle issue and jump right to using medications to treat the surrogate end marker and hope for the best.

UGH!!

Diabetes , Prediabetes = Osteoporosis? The Funny Math of Physiology

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diabetes and osteoporosis linked
Photo courtesy of https://www.flickr.com/photos/naudinsylvain/

I recent taught a 12 hour CE class on gut to bone to gut on the links between the GI tract, bone and the risk of diabetes.

The links between these body systems are so far outside the realm of how we “treat” in medicine today   as to make medicine appear as up to date as bloodletting and performing surgery with a blood-stained lab coat.

Somewhere along the line the powers that be that control medicine decided that splitting the practice of medicine into specialties was a good idea. Unfortunately, the body has never respected these boundaries. As a result, the chronic diseases we see so often today quite frankly can’t be fully managed by the specialists assigned to treat them.

The endocrinologist does not and could not fully address the cardiology and neurological complaints of a diabetic patient.   The cardiologist does not and could not address the colon cancer developing in a high number of his or her heart disease patients.

This interconnected relationship exists in all systems for all diseases. This particular study does a great job of illustrating this. In it, researchers looked at the relationship between HBA1c (a marker of diabetes) and C-telopeptide (CTX-a marker of bone turnover—higher levels indicate that bone is breaking down faster).

Here’s the important factor: all the women in this study had normal glucose tolerance, meaning that they were not diagnosed as being diabetic or prediabetic.

Despite the fact that these women were not labeled as prediabetic, those with the highest levels of HBA1c also had the highest levels of bone turnover as measured by CTX. In other words, even if you have not (yet) been diagnosed with prediabetes, as you become more and more prediabetic (and ultimately diabetic) you will start losing more and more bone.

How can this happen? It has to do with the hormone osteocalcin. Osteocalcin is a hormone released from healthy osteoblasts (the cells in bone that helps us build new bone) that helps actually acts on abdominal   fat cells to help them fight off diabetes.

While this study finds an association between HBA1c and bone, it does not really give an indication of what direction the association lies. Is prediabetes bad for the bones or does poor bone health increase your risk of diabetes?

While the fact that poor bone health will increase your risk of developing diabetes (through the hormone noted above, osteocalcin), it would not surprise me to find that diabetes is also bad for the bones (not to be confused with “bad to the bone,” which would relate to something else entirely).

The bottom line is that healthy lifestyle changes geared to help with avoiding diabetes are also going to improve bone health and dietary changes to help build more bone are also going to be anti-diabetic as well.

 

Sunlight and Vitamin D; More Complicated than We Thought?

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I admit have fallen into a bad habit when it comes to vitamin D.  I have exchanged the benefits of sunlight for vitamin D supplementation.  Turns out I may be mistaken.

This is not to say that vitamin D, by itself, does not have a long list of benefits and has not been associated with pretty much every chronic disease you can think of, because it has.

But somewhere along the way I thought we could have our cake and eat it, too.  Don’t worry about sun exposure and basal cell and squamous cell skin cancers–just take vitamin D instead and you’ll get all the same beneifts.  (You’ll notice I didn’t throw in melanoma–the relationships between melanoma and sun exposure are not exactly clear-cut, despite what most people think).

But, just like everything else that has to do with the way our bodies are built and the way we interact with our environment, the story is always far, far more complex.  Beyond vitamin D production in the epidermis, what about that first sensation of warmth you get after walking out in the sun from a cold building?  Or sitting in a lawn chair in the spring feeling the sun on your skin?  (This of course does not apply here in Arizona in July, in which case you would be burnt to a crisp in about 8 minutes)

There is an emotional component to sun exposure that may go beyond anything we can really measure accurately.  This can never be replaced by vitamin D supplementation.

So why all this philosophizing?  It has to do with this particular article.  In this mouse study researchers looked at the effects of sunlight on multiple diabetes risk factors (weight gain, glucose intolerance, insulin resistance, nonalcoholic fatty liver disease measures and blood levels of fasting insulin, glucose, and cholesterol).  What was interesting is that these same benefits were not all seen when vitamin D supplementation was used instead of sun exposure.  Clearly this indicates that sunlight has benefits above and beyond its ability to help your body produce vitamin D.

So what gives?

Turns out that sunlight (specifically UVA) leads to the production of the compound nitric oxide (NO) in the skin.  While small, NO is a pretty unique little compound that has a commendable list of biological effects.  On the top of the list is its ability to lower blood pressure.  The decades-long search for this compound (originally termed “endothelial derived relaxation factor) led to the awarding of the Nobel Prize in medicine in 1998 to Drs Furchgott, Ignarro and Murad.

While NO is not the end-all-and-be-all of anti-diabetes molecules found in our bodies, it certainly does play a role.  This is the reason why the market for arginine-based products was created (our bodies use arginine to make more NO).  However, I personally think that adding more NO to the equation does not overcome a pro-diabetic lifestyle and the long-term studies looking at arginine supplementation bear this out.

This does not mean that using rationale sunlight exposure as a tool in the toolbox to help combat diabetes is a bad idea.  Quite the opposite.  I think that sunlight exposure should be a part of a healthy lifestyle, not just for vitamin D production but also for the psychological effects and the NO effects on diabetes as well.

Remember that next time you slap on SPF-80 and run to the car under a black umbrella…

 

How to Lose Weight; Are You Eating the "Sumo Wrestler" Diet?

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high fat diets and magnesium
Photo courtesy of https://www.flickr.com/photos/kingstongal/

Not everyone is on a constant struggle to lose weight. Even fewer have deliberately goals to achieve a weight worthy of donning a Mawashi.

But you may be unwittingly doing just that.  There are many things that we do in our daily lives that you may think are healthy, but actually contribute to weight gain.  The quick list can include doing things such as drinking out of plastic water bottles and drinking orange juice with your breakfast.  Many of the items on this list, however, you could probably nod your head in understanding when things like BPA in plastics and excess calories from drinks are pointed out.

Sometimes, however, the things you do that contribute to weight gain aren’t so obvious.  Or rather, it’s the wrong combination of things that send the dial of your scale to the right.

This concept is outlined quite nicely in this particular study.  In it researchers looked at what happened when a high fat diet was combined with a magnesium deficiency in rats.  A high fat diet is not inherently bad for you, despite what the USDA food guide pyramid led you to believe in the 90’s.  The right choices of fats makes all the difference.  When was the last time you ran into someone who became morbidly obese eating avocados?  It just doesn’t happen.

These good fats come in things like nuts and seeds, wild caught fish, avocados and olive oil.  These food items are not entirely guilt-free, but you shouldn’t lose any sleep when you indulge in foods with healthy fats.  Many of these food items (most notably the nuts, seeds and avocados) are a very good source of magnesium.  Maybe Mother Nature knew what she was doing.

Other good sources of magnesium are dark chocolate, green leafies, beans and whole grains.  Keep in mind that magnesium is an incredibly important mineral that is used in hundreds of ways in the human body.  Unfortunately, it is also a very commonly deficient mineral.

Back to the study.  Researchers put rats into 4 separate diet groups and compared:

  1. A normal, control diet to;
  2. A high-fat diet to;
  3. A magnesium-deficient high-fat diet group

When the dust settled, it was clear that both high fat groups had the most prediabetic profiles (as measured by protein phosphorylation in the insulin-signaling pathway).  Between the two high fat diets, the group that was magnesium deficient had the worst profile and greatest risk of developing diabetes.

The take-home message is that there is not a single aspect of your lifestyle that is going to make or break your health and long-term weight goals.  In this instance, make sure that your higher fat choices include foods that are also higher in magnesium such as nuts, seeds and avocados.

Pre-diabetes and the Brain—You’re Losing Brain Cells as Your Read This

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Very few patients and providers are aware of just how damaging prediabetes is. Fewer still know that it destroys the brain.

Countless times, after looking at the patient, certain lab values, patient’s history and family history it is clear that this patient is on his or her path to diabetes.  Sometimes at a slow stroll, sometimes at a full-out sprint.  When I bring this concern up to the patient the response is frequently, “Oh…my doctor checked me for diabetes and said I was ok.”  Ugh.

I equate this to the cigarette smoker stating that his or her doctor checked for lung cancer and, since nothing was found, everything is hunky-dory.  In this scenario it sounds ridiculous.

However, prediabetes is arguably more dangerous to your health than cigarette smoking.  There is not a chronic disease that is not in some way increased by prediabetes.  Some, like heart disease, neurodegenerative disorders (Alzheimer’s and Parkinson’s), stroke and many cancers are strongly linked to prediabetes, with being prediabetic almost one of the strongest risk factors.

For those of you wondering if you might just happen to be prediabetic, here’s a short list of things to look for:

  1. Abdominal obesity
  2. PCOS / menstrual problems / infertility
  3. High cholesterol (especially with low HDL, high triglycerides)
  4. Elevated liver enzymes
  5. Gout or elevated uric acid
  6. High blood pressure
  7. Anyone with heart disease or an ischemic stroke (even a TIA)
  8. Family history of diabetes, cancer, heart disease or dementia

While the list is much longer, you get the idea…

Our society has not yet adopted this level of concern with prediabetes and, as a result, few understand the level of danger that he or she is living under.  Given that over 50% of the US population can be classified as being prediabetic, this lack of fear really needs to change.

This particular article is yet another that adds to the long list of damage done to your body by being prediabetic.  In it researchers looked at 127 individuals (aged 41–86 years) and sorted out those who had high insulin resistance (most prediabetic) and those who had low a level of insulin resistance (least prediabetic).  There was a very clear association between damage to the white matter and insulin resistance.  For those neuroanatomy geeks, changes were seen in areas such as the:

  • corpus callosum, corona radiata, cerebral peduncle, posterior thalamic radiation, and right superior longitudinal fasciculus
  • white matter underlying the frontal, parietal, and temporal lobes
  • body and genu of corpus callosum
  • parts of the superior and anterior corona radiate

Basically—pretty much every area of the brain was affected by the prediabetic process.  Even more concerning was the fact that the worse the insulin resistance, the greater the white matter damage.

Brain damage from being prediabetic.  Let me repeat that in another way: Over half of the population (and there is a good chance this means YOU) is experiencing brain damage and a loss of healthy brain cells as a result of being prediabetic.

If brain cells are important to you, what changes are YOU making to be less prediabetic?

Which is Better? Exercise in the Morning or Split Up in Day?

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interval aerobic training wins again
Photo courtesy of https://www.flickr.com/photos/knight725/

I hate to beat a dead horse, especially if he dropped dead from too much aerobic exercise, but society just does not seem to be getting the point about aerobic exercise.

Quite frankly, we’re doing too much.

I know that many of you are disappointed to hear this. After all, in today’s rush-rush society everyone is getting the recommended 30 minutes minimum of aerobic exercise at least 3 times per week, right? Yeah. Reality check–most Americans still do not have regular exercise as part of their lifestyle routine. And, even if they are, it’s likely they are not doing the most beneficial type.

The research continues to support a short-burst, high intensity, aerobic activity rather than a single bout of light to moderate intensity workout. Personally, when I’m doing one of my short bursts on the treadmill or elliptical, I’m going all out for that 30 second session. It’s not a leisurely pace at which I could maintain a conversation on my cell phone to some out of the country customer service rep for my mortage. When I’m done with my burst, it takes some time (1-2 minutes) to recover somewhat from the oxygen debt I have accumulated.

This particular study is yet another one to chalk up for the short-burst aerobic crowd. This small study looked at 11 obese individuals (aged 18–35 years) who were prediabetic and had them performed differently on three different days:

1. Sedentary behavior with no exercise
2. Otherwise sedentary behavior with 1-hour of morning exercise at 60%–65% peak VO2
3. Same sedentary behavior with 12-hourly, 5-min intervals of exercise at the same intensity

Researchers than checked sugar and insulin levels in the bloodstream. Here are the results:

• Glucose levels were actually lower in the interval exercise and sedentary situations.
• Glucose levels were higher in the 1 hour exercise situation than in the sedentary situation for about 2.5 hours.
• Glucose levels were also higher in the 1 hour exercise situation than the interval exercise situation for about 4 hours.
• The production of insulin was 20% higher with the interval exercise when compared to the other two situations.

While this study was not on high-intensity aerobic activity, it does demonstrate the benefit of breaking up the exercise routine into small groups instead of a single time period.

How do YOU spend your time exercising??

Surprising 4 Benefits of Vitamin D on Diabetes Progression

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I’m pretty sure this isn’t the first time I’ve mentioned that I’m not a one supplement:one condition type of person.  It’s all about a long list of lifestyle changes to avoid chronic disease.

However, when I come across a study that has a pretty potent effect with a simple intervention I can’t help but point it out.  This particular study looked at the effect of vitamin D supplementation on the progression to diabetes, the normalization of blood sugar levels and inflammation.

As I write this post, I can hear a radio commercial looking for guinea pigs for an “investigational new medication for the treatment of diabetes.”  I guess I just don’t understand.  Given how massively powerful lifestyle changes are for avoiding and “curing” diabetes and given how certain supplements (namely vitamin D, magnesium and fish oils) have also shown some potent effects, why on Earth do we need more new drugs?

Anyway, here are the details from the study that was done in an Eastern Indian population:

  1. There was a lower progression to diabetes in those who got vitamin D (11% versus 26.5%).
  2. Those who got the vitamin D were more likely to get back to having normal blood sugar (42% versus 20%)
  3. Those who got vitamin D had lower levels of inflammation (as measured by TNFα and IL6).
  4. Most importantly, baseline vitamin-D and 2 hour post prandial blood glucose independently predicted progression to diabetes.

Of these 4 points, #4 is arguably the biggest take home message.  You see–we already know that poor sugar handling 2 hours after drinking a putrid, awful, pure glucose drink is one of the better markers for determining if someone is on his or her way to diabetes.  The results of this study suggest that lower levels of vitamin D are equally important at predicting whether or not someone is going to become diabetic.  Wow.

So, for about $20 per YEAR (the cost of the vitamin D we sell in our office) you can go a long way towards fighting off diabetes.  Or, you could lounge around, eat like crap, stress yourself incessantly and drink out of plastic water bottles that you left in the car with the windows rolled up for 4 days in August and then just sign up for the research study I heard advertised on the radio.

Your choice.

Foods with Fat do NOT Make You Fat!! 7 Reasons to Eat MORE Fat

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pistachios and prediabetes
Pistachios help fight off diabetes

A decade of brainwashing by the USDA’s food guide pyramid putting “fats and oils: use sparingly” at the top of the diagram is hard to undo.

So hard that, despite continual reminders at holiday gatherings, even my own mother still avoids olive-oil based salad dressings, replacing them with high fructose corn syrup or, even worse (gasp!!), salad dressings with sucralose. (Her dedication to eating low fat is so strong that, even after reading this post, it won’t change her habits…).

To clarify, bad fats will always be bad. Fats like trans fats (the all-evil partially hydrogenated oils), animal based fats, high levels of omega-6 fats (corn, soybean, cottonseed, peanut, sunflower oils) should be avoided as much as possible.

The healthy fats, however, have NEVER been shown to lead to weight gain. Now, I could be wrong in using the term “never” but I don’t really think so. Our body needs and functions well with healthy fats such as those found in wild caught fish (or, if you don’t like fish, you can just eat the algae and seaweed directly), avocados, olive oil and nuts.

Nuts.

Eating pistachios may reduce your body’s response to the stresses of everyday life, according to a Penn State study conducted by principal investigator Sheila G. West, professor of biobehavioral health and nutritional sciences.

I don’t think I’ve ever come across a study using nuts that did not show a positive benefit on our health. And it doesn’t seem to matter whether we’re talking about almonds, cashews, walnuts, hazelnuts, Brazil nuts or pecans—they all have been shown to be good for us and help us fight off heart disease and diabetes.

This particular study adds pistachios to the list, as would be expected. In this study, researchers replace 20% of the calories in a group of prediabetic patients’ diets with unsalted pistachios for 24 weeks to see what effect this had on markers of diabetes. Here’s what they found:

1. Waist circumference improved.
2. Fasting blood sugar improved.
3. Total cholesterol improved.
4. LDL (the “bad”) cholesterol improved.
5. The inflammatory marker TNF-α improved.
6. TBARS (a marker of oxidative stress) improved.
7. Adiponectin levels (a hormone produced by fat cells that protects against diabetes) improved.

Could we ask for anything more?

In a typical 2,000 calorie per day diet, replacing 400 calories with pistachios would equal just over a 1/2 cup of pistachios. Not exactly a difficult intervention.

Personally, I’ve become attached to the POM brand salt and pepper pistachios that I buy from Costco (or you can get them at Amazon by clicking here). They do have a wee bit of sugar, but not enough to counterbalance the positive effects of the pistachios themselves and the added spices as well.

One little caveat—never eat nuts with added oils, like peanut or cottonseed oil. This completely destroys the healthy benefits of the good fats. Other than that little rule, feel free to munch away.