LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

prediabetes

Natural Cures for Depression: Prediabetes and Your Brain

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I’ll agree that getting someone in the deep throes of depression to exercise is not likely to happen.  But that does NOT mean that natural cures for depression won’t work.

Motivation is not high on the list of character traits of a person with depression.  For this reason exercise, which is arguably the most powerful tool available for improving depression, is not going to happen.

But, what I cannot accept, is that other lifestyle choices that don’t require motivation, but rather require the right choices, cannot be implemented.  The right lifestyle choices, largely dietary, are a conscious decision made most often at the grocery store.  Anyone can choose to buy a bag of potato chips or choose to buy vegetables or nuts.  These decisions will clearly have an impact on brain health.

Many will snort in derision at the idea that diet can impact brain health and subsequently depression.  To these people–how can you possibly think that the foods and nutrients that you put into your body are NOT going to affect your brain?  It’s not like the brain is isolated from every other organ system; rancid processed hydrogenated oil, aspartame, FD&C red dye, that brominated vegetable oil, mercury present in the high fructose corn syrup; they are ALL going to touch the cells in your brain.  These toxic compounds will insinuate themselves into the very machinery of your neurons and interrupt function.

Does this sound like diet does not have an impact on brain function?  To think otherwise tells me that you have too many of these compounds in your life already.

As I was reviewing all the research that went into my Depression Risk Factors: Beat it Before it Starts, Fight it Once it Does eBook, I was reminded of just how powerful healthy fats such as DHA and EPA (fish oils) are in depression.  And this is not information from Reader’s Digest–it is from medical studies supporting the benefit of heathy fats on depression.

All of this leads us to this particular study.  In it, researchers looked at the what happened to depression scores (using the Beck Depression Inventory) in 55 prediabetic patients who followed one of two low-calorie diets (30% fewer calories) for 6 months.  Here are the details:

  1. Both diets improved self-perceived depression.
  2. Those who ate more omega-3-fatty acids had lower depressive symptoms at baseline.
  3. Those who increased their dietary folate had better improvement in depression.
  4. Those with a greater decrease in oxidative stress (as measured by malondialdehyde levels) also had better improvement in depressive symptoms.

Back to the individual depressed person who does not have the motivation to exercise and does not believe that dietary changes can have an impact on depression.  You can no longer hide behind the belief that dietary changes are pointless.  Dietary changes do not require effort, they require a decision.

Make that decision now and follow these changes for 3 months and see how you feel.  If (when?) the changes help your brain, use this window of time to add in exercise.  Dietary changes and exercise all the long-term tools to help your brain.

 

Natural Cures for Psoriasis Starts Here

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I don’t write much about psoriasis, although it is not uncommon for me to see these patients in my office.  Severe cases can be embarrassing and keep these patients from living a full life.

One thing that I do find surprising, however, is that diet has never been discussed with any of the psoriasis patients I have come across, and they are usually doubtful that dietary changes could have an impact.

Treatment is all topical stuff, and if that doesn’t work, it’s onto the biologicals like Humera, Enbrel and Remicade, high powered and expensive drugs that inhibit the action of an inflammatory keystone in our bodies called TNF-alpha.

But diet?

The first time I began to see the links was when I saw that being prediabetic, an inflammatory state, led to increases in TNF-alpha levels.  Then came these high powered drugs to lower levels of TNF-alpha and you can begin to see the connection.  Dietary changes that will pull you back from diabetes are very likely to have an impact on psoriatic plaques.  Sure enough, my psoriasis patients all have prediabetic tendencies, making me think the link may be stronger than we think.

Lest those psoriasis patients out there think I’m making all this up, I present this particular study, looking at the addition of a 6-month reduced calorie diet (20 kcal/kg/ideal body weight/day–so someone who should weigh 200 lbs would take in 1800 calories / day)  high in omega-3 fatty acids (average 2.6 grams / day) and low in omega-6 fatty acids (a pattern known to be anti-inflammatory) in 44 obese patients with mild-to-severe plaque-type psoriasis who were already being treated with immuno-suppressive drugs. Here’s what they found:

  1. Psoriasis Area Score Index, itch scores and Dermatological Life Quality Index all improved.
  2. In addition, there was also a decrease in body weight, waist circumference, triglycerides and total cholesterol.

Overall, in just 6 short months, there were changes all across the board in these psoriasis patients from increasing their intake of healthier fats and decreasing the intake of less desirable, omega-6 fats.  Given how much of an impact a skin condition like psoriasis can social life, this seems like a pretty good thing.

 

My Doctor Told Me I’m NOT Prediabetic–Is He Right?

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I have certainly made it clear that diabetes is the beast we all fight against.  But how do you tell if you’re on your way?

Just in case you don’t have a good answer to this question, it seems that many doctors get confused on this question as well.  I recently had a new patient who told me that her primary care doctor had told her she was prediabetic.   A little confused myself, I asked her some questions.  She had told her primary that she had been dealing with fatigue over the past few months, so she had blood work done.  Nothing terribly off, but her doctor, concerned about prediabetes, ordered a post-prandial glucose tolerance test (can’t remember, but I think it was the 2 hour variety).  From this, he told her she was prediabetic and needed to go on a special low glycemic index diet.  No problems with fasting glucose, triglycerides, HDL or total cholesterol.

Basically, fatigue was the only thing he was running with and looking hard to find prediabetes.  By the end of a new patient interview I can tell someone with a high degree of certainty just how fast they are running towards diabetes.  This women wasn’t it.  Incidentally, her fatigue is a pretty clear-cut case of adrenal fatigue, further confirmed by medication for anxiety.  Fatigue is not a common symptom of prediabetes.

On the flip side, I’ve had many patients over the years who had been told that they were NOT prediabetic and yet they clearly were.  Most doctors seem to only look at the sugar / glucose markers:  fasting glucose, HbA1c and maybe fasting insulin.  But long, long before insulin has a problem getting sugars out of the bloodstream there is going to be a problem with getting fats out of the blood (refer to the glucose-fatty acid cycle of Randle from 1963 if you’d like more info on this).

In other words, do not waste time looking at glucose and HbA1c in the early part of the spectrum–they’re going to be normal.  Instead, look at the triglyceride and HDL level.  THIS is probably one of the best screening tools to get a quick guess about where you are (or are not) on the diabetic spectrum.  Which brings us to this particular article.  In it, researchers looked to see what ratios between HDL and triglycerides were of concern in 2,244 healthy college students (17–24 years old) of Mexican Mestizo ancestry.  Here’s what they found:

  1. The highest 25% TG/HDL-C ratio was used to identify those with prediabetes who were at increased risk of heart disease.
  2. Heart disease risk factors were greatest in those whose TG/HDL-C ratios exceeded 3.5 (men) and 2.5 (women).

Personally, I don’t like to see the ratio get much above 2, but I’m pretty picky.  Normal triglycerides are considered below 150 mg/dl and normal HDL should be greater than 40 mg/dL (men) and 50 mg/dL (women).  As an example, a man having “normal” levels could have a ratio of 3.75–way too high.  But if your doctor does not recognize this fact, you’ll be sent away with mistaken reassurances that everything is doing ok.

As a side note, don’t confuse this ratio with the “good” to “bad” cholesterol ratio–the triglyceride to HDL ratio is far more important.

The “Soy is Evil” Saga Continues: 7 Effects on Prediabetes

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For those of you that read my blog post on soy a few weeks ago and still think I’m off my rocker and being paid under the table by the soy growers association, I present exhibit B.

With the usual caveats of non-processed and non-GMO soy, the research is overwhelmingly in support of soy as part of a healthy lifestyle.  I’ve read the arguments stating that soy was only recently introduced into the human diet maybe 75 years ago, but much like all the other misconceptions about soy, this is untrue and, in this case, the authors are only maybe 5,000 years off (and, in the timeframes of the universe as well as carbon dating techniques, this is merely a rounding error).

In this particular study, authors looked at the ability of genistein (the protective isoflavone found in soy) to help improve prediabetes.  120 women with prediabetes were given 54 mg genistein (about the amount found in a serving of soy) for 1 year.  Here’s what they found:

  1. With genistein use, fasting glucose and fasting insulin dropped.
  2. HDL-C increased an average of 10 mg/dL.
  3. Increased adiponectin levels (an anti-diabetic hormone produced by the fat cells).
  4. Decreased total cholesterol, LDL-C down 30 points, triglycerides and visfatin (another fat derived hormone that drives inflammation and chronic disease).
  5. Homocysteine levels dropped as well (an amino acid linked to heart disease and stroke).
  6. Systolic and diastolic blood pressure was also reduced.

To top it all off, genistein users complained of no more side adverse effects than the non-users in the study and did not discontinue the study at any different rate.

Looking at the drop in LDL cholesterol and triglycerides coupled with the increase in HDL, the risk of heart disease is going to plummet with this as well.

Compare this to statins, the wonder drug that I love so much, which ONLY effects one single blood marker (LDL) and will actually LOWER HDL.  So, a drug with loads of side effects (which can be perused ad nauseam in my eBook, which can be found on the eBooks page by clicking here) that has almost no effects on heart disease or stroke rates is not even in the same ballpark as a serving of soy at protecting your heart.

Much life the proverbial death match between the HR Block accountant and the ninja warrior.  Too bad the accountant has billions of dollars backing him up.

Want My Advice on Healthy Eating? This is the 1st Question I Ask

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Somewhere along the lines, people trying to lose weight decided that skipping meals was a good idea.  Maybe it was the idea that fewer calories were better, but the advice is ill-founded.

Whenever I have a patient who needs or wants dietary advice (unfortunately, those two categories do not always go hand in hand) there is one question I ask that gives me the most information about where this patient is at on the healthy living continuum.

“What is a typical breakfast for you?”

It’s only on a rare occasion that I get an answer that is ideal.  It usually ranges from nothing to oatmeal to an Egg McMuffin.  Breakfast is something that many people think they are doing right, but most likely is a decision based on poor information from their doctor or excellent marketing.  Some less-than-ideal examples include:

  1. Skipping breakfast altogether will increase your risk of developing diabetes.
  2. Skipping breakfast will lead to higher calories being eaten at the next meal, again leading towards diabetes.
  3. High glycemic foods like bagels for breakfast throw off digestive and satiety signals and send you towards diabetes.
  4. Higher glycemic meals trigger addiction like reactions in the brain.

Here’s the rub–most oatmeal and certainly most junk breakfast cereals like Cheerios would fall under the category of “high glycemic” index foods.  Unless you’re eating the real heavy-duty steel cut oatmeal that takes forever to cook, you should be avoiding oatmeal.  Or, your breakfast cereal needs to have 8 grams of naturally occurring fiber or more.  Fiber One, for example, adds corn bran to get the fiber content up.  That’s cheating and doesn’t count.  (Even worse–ALL the Fiber One products have artificial sweeteners in them, so they’re off the list anyway).

The other option is a protein based breakfast.  Eggs, chicken, hummus, peanut butter (my particular favorite, on whole grain bread and a banana sliced on top) are good options.  There have been times when, due to time constraints, I have recommended that a patient just eat a small handful of nuts for breakfast.  It is not unusual for these patients to actually lose weight in the first month from actually adding food.

All of this brings us to this particular study.  Researchers looked at the eating habits of 26,900 health professionals over the course of some 16 years.  Here’s what they found:

  1. Men who skipped breakfast had a 27% higher risk of heart disease.
  2. Men who ate late at night had a 55% higher risk.
  3. Mostly, this association was due to BMI, hypertension, hypercholesterolemia, and diabetes mellitus.
  4. No association was observed between eating frequency (times per day) and risk.

As I sit here writing this blog post at 11 PM eating a bowl of air-popped popcorn sprayed with basil olive oil and sprinkled with garlic spices drinking unsweetened Teavana tea, #2 has me a wee bit concerned.  However, I’m pretty sure that the average late night snack is probably not quite the same as mine, so that makes me feel a little better.

Clearly eating patterns had a strong role.  The proverbial midnight snack was almost literally a killer.  Overall, though, knowing existing relationships between skipping breakfast and diabetes risk, the results of this study should be nothing more than a reminder of why you are already eating breakfast.

And, if you don’t eat breakfast, just make sure your life insurance premiums are paid up.

What Kind of Carbs Did YOU Have for Breakfast? 3 Things to Know

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It’s be awhile since I touched on the topic of good versus bad carbs, but it remains of critical importance.  And it’s not as simple as counting the carbs on the label.

If it was, we’d all just go for the bread with the “no carb” label and be done with it and damn the sucralose that’s probably hiding inside.

As a quick primer between the evil refined carbohydrates and the angelic whole grains, this is a summary from a previous blog article:

  • The whole grain contains the germ (the bulk of the protective nutrients), endosperm (the calories) and the bran (the fiber). To extend shelf life and increase palatability to the oblivious American public, the germ and bran is lopped off and we’re left with the endosperm–the calories minus some 90% of the phytonutrients that where present in the whole grain. The result is a devastating calorie rich/phytonutrient poor staple consumed by the vast majority of Americans. So “enriched wheat flour,” “sugar” and “high fructose corn syrup” all fall into this category.
  • It is rare that someone truly understands the distinctions between the whole grain and refined carbohydrate, but this understanding is critical to health.  Refined carbohydrates have been linked to pretty much every chronic disease, while whole grains generally protect.  Opposite ends of the spectrum.  Despite this clear difference and the very clear research that states that refined carbohydrates are pretty much evil, our national recommendations still do not tell us to avoid them.

Hopefully now you can begin to understand why bagels aren’t a good idea for breakfast and why most of the oatmeals are a far cry from being healthy.

When we refer to they glycemic index of foods, we are referring to how fast they show up as sugar in the blood stream.  Low GI means that sugar trickles slowly into your system, while a high GI level indicates that the sugar from that meal is pretty much in your blood by the time you even smell it.

This particular study looked at the effects of a high GI meal versus a low GI meal on certain parameters in the blood of a small group of volunteers.  In addition, researchers looked at how hungry they were 4 hours after the meal (around that time that you may be thinking about your next meal or even taking a quick look in the pantry).  Here’s what they found:

  1. Glucose was 2.4-fold greater after the high- than the low-GI meal.
  2. Plasma glucose was lower and reported hunger was greater 4 hours after the high- than the low-GI meal.
  3. The high-GI meal elicited greater brain activity centered in the right nucleus accumbens–the area of the brain related to addiction.

This means that starting the day with a poor choice for breakfast, such as a fast food croissant sandwich, poor quality oatmeal, Cheerios or most low-quality cereals will likely sabotage the REST OF YOUR DAY!  Of course, the same goes for all the meals of your day, but it seems to me that starting out on the right foot is the best option.

Doctor, Why Is My Vitamin D Level Low?

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This is actually a very pertinent question and one I have asked many times.  Why are some many patient’s vitamin D levels very low despite good sun exposure.  I may have the answer.

When researchers first discovered that levels of vitamin D deficiency were darn near ubiquitous in our population, the initial thoughts ranged from particulate matter in the air blocking UVB light penetration to heavy use of sunscreen.

None of the ideas seemed to fit completely.  Sure, the average person lathers up with SPF 300 to walk to the car, but what about my patient who swam outside on a high school swimming team and still had a vitamin D level of 17 (optimal range 60-100) at the END of season here in Arizona?

Then I came across this particular study.  While it is a rat study, the concepts put forth could answer the question for at least half of the population.

The diabetic spectrum.

Yup.  Makes sense given that upwards of 50% of the population are on this trajectory, and the numbers are likely much higher.

Here’s how it works:

  • The diabetic spectrum, even in its early stages, is very damaging to the kidneys.
  • Studies have shown that, in Type 2 diabetic rats, there is a significant loss of vitamin D and vitamin D binding protein (a protein in the blood that holds vitamin D while it floats through the bloodstream) in the urine due to kidney damage.
  • This study confirms that the same problems exist in Type 1 diabetes as well.

Makes for some very interesting fodder, wouldn’t you say?  And, if this holds true in humans (and I can’t see any reason to believe that it wouldn’t) certainly goes a very long way towards explaining why so much of the population has low vitamin D levels.

It also helps to explain why so many patients have a hard time boosting their vitamin D levels despite high levels of supplementation.

Here’s some further musings…

Some have suggested that low vitamin D levels are not the problem, but rather, the body lowers the level of vitamin D in response to a disease state such as cancer.  Because of this, for someone with chronic disease, they should do everything possible to almost eradicate vitamin D in their blood.  I firmly disagree with this hypothesis and treatment approach, even having one patient who went through the protocol and got VERY ill from it.

But what if low vitamin D is just yet another marker of physiology gone haywire as our bodies move towards diabetes?

It would not be the first time that we have looked at a single marker (like cholesterol) and thought that low levels, by themselves, were important, rather than looking at the big picture.

This also means that all the doctors out there diligently checking vitamin D and recommending supplementation but not addressing other aspects of lifestyle (like living an anti-diabetic lifestyle) are, once again, missing the boat entirely.

An additional interesting note to this study. The researchers also looked at whether the addition of resistant starch (think fiber—or you can read a previous blog article on the topic by clicking here) could affect the loss of vitamin D through the kidneys.

Wonderfully, the resistant starch virtually eliminated all the vitamin D lost through the kidneys.  Given that the resistant starch in a higher fiber diet would go a long way towards avoiding or managing diabetes, it meshes nicely with the findings in this study.  Higher fiber, more anti-diabetic diet = higher vitamin D levels.  Not a bad outcome, regardless of how you look at it.

So, from now on, I know that, in those patients whose vitamin D levels just won’t budge despite strong supplementation, increasing the fiber in the diet and an overall anti-diabetic diet (my personal recommendations can be found in my free eBook by clicking here) will be strongly recommended.

Does Sugar Cause Diabetes? Where DOES Diabetes Come From?

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Regular readers of the Rantings will know that I consider your body’s biggest fight to be against the diabetic spectrum.

I refer to it as the “diabetic spectrum” rather than just diabetes to make sure that patients understand that, just because they haven’t been given the diagnosis of diabetes, there is danger everywhere along the process. Prediabetes increases your risk of just about every chronic disease you can think of.  Many times, the only reason the patient did not become diabetic is because the prediabetic process killed them off through a heart attack, stroke or cancer.

So why is diabetes such a problem?  Is it genetics?

Yes and no.

No, your genetics do NOT cause you to develop diabetes.  If you treat your genes badly, yes, you can develop diabetes.  However, when we talk about genetic risk as it relates to chronic disease, many people mistakenly believe the outcome is set in stone.  This is clearly, absolutely not true.

Yes.  The number one challenge the human body has, historically (with the exception of the past 100 years or so), had to fight against starvation for survival.  Our bodies are incredibly well adapted to fight starvation.  The slightest extra calories will get stored for a rainy day.

Basically, your body has a mechanism in place to fight off starvation.  There is NO protection in place for the opposite end of the spectrum.  In other words, how can you have a genetic predisposition for a situation that your body has no mechanism for?

You have to understand that diabetes is the “normal” response of your body, or at least it is a very predictable response.

Stress falls under this same category.  Your body’s stress response is a protective response designed to help you survive a significant challenge in the environment.  Generally designed for a short term challenge to your system.  But once this stress becomes chronic, your body again does not know how to handle the situation.

So back to the original question–where does diabetes come from?

It comes from your body’s attempt at a short term solution to stress or excess calories that occurs in a chronic timeframe.  Sure, the details are far more complex, but this pretty much sums it up.

Just in case you think this is my isolated opinion, you can read through this particular article…