prediabetes

Think You’re NOT Prediabetic? Better Think Again

May 1, 2013 by James Bogash

It’s pretty clear that the percentage of the US population that is prediabetic is startlingly high. But of course, this does not apply to you, right? Better rethink that.

I won’t repeat my belief that the diabetic spectrum is the worst thing that the human physiology experiences (oops…I guess I just did). But this article isn’t about the horrendously high risk to your long term health that the diabetic spectrum produces, but rather just how common it is.

With my depth of understand into diabetes, it doesn’t take much time for me to decide if someone is headed towards diabetes. Looking at a new patient’s health history, family history and the patient’s body type is usually enough. Rarely, an additional tidbit from the patient is needed (very poor dietary habits despite a lean body type, high stress, etc..). Labwork usually just confirms what I was already suspecting.

Labs are an interesting phenomena. I’ve had patients over the years (usually male) who are genuinely afraid of having labs drawn. I think this stems from the environment we have created in medicine. In medicine today labs are run to find something wrong. It’s just a matter of time before something on them is going to come back abnormal. In our office, if we run labs, we’re trying to find out just how well that patient is living for his or her genetic structure.

When I look to evaluate the diabetic spectrum, I am not merely looking at blood glucose or HbA1c. Rather, I’m looking at liver enzymes (AST, ALT), GGT, the entire lipid panel, urinary microalbuminuria levels and uric acid levels. It’s about stepping back and looking at the whole picture.

When your doctor is able to understand how all of these lab values create a picture that combines with your body type, heritage and family history–this is when the true picture of whether or not you are headed to diabetes or not and just how fast you’re moving on that path.

So why the diatribe? Of course, it relates to this particular article.

In this article, the CDC looks at the problem with prediabetes. In 2010, a whopping ONE-THIRD of the US population was prediabetic. All of this is ok, because once someone realizes that they are on the path to diabetes, he or she can make the lifestyle changes needed to divert the diabetic diagnosis (which can be read in my free downloadable ebook, Dr. Bogash’ Lifestyle Recommendations).

But how many of you walking around fall into this 1/3 statistic but don’t know it?

Are you sitting down?

89%. Yes—only a mere 11% of the prediabetic population were even aware that they were prediabetic.

On the bright side, this is up from 7% in 2005. What a mess.

This is like having all the risks of being a smoker, but not knowing that you’re a smoker. That is the problem. It’s not like this unaware population is doing ok, and it’s merely a fact that, at some point in the future, they are likely to become diabetic.

Being prediabetic is in no way, shape or form a benign process. It is just as bad for you as diabetes, maybe even more so because the vast majority of people who are prediabetic are not aware of it.

Maybe it’s time to take a very hard look at yourself. Carrying even a little too much weight around the middle? Cholesterol or triglycerides too high? Skip breakfast on a regular basis? Stressed out all the time? Have’t had your heart rate over 120 in years?

Don’t rely on your doctor to tell you. I’ve seen way too many cases over the years where patients were clearly on their way to diabetes but the primary care doctor did not inform the patient that this was the case.

If any of this even might fit you, it’s time to make some changes. Today. With the massive increase in heart attacks, cancer and stroke, tomorrow may be too late.

Thyroid Cancer Death Higher In Younger Ages

April 22, 2013 by James Bogash

In a recent blog post, I pointed out the very strong relationship between thyroid nodules and prediabetes and diabetes.

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.

Periodontal Disease Prevention Does NOT Begin In The Mouth

April 10, 2013 by James Bogash

I’m not saying that you should cancel your next dental checkup, but we need to start viewing oral health from the context of a whole body approach.

Lest the dentists out there remove themselves from my email list, the relationship goes both ways–good oral health is also required for good overall health.

So let’s start with the looking at some of the diseases have been associated with poor oral health:

Heart disease tops the list. Any form of chronic inflammation (like periodontal disease) damages the heart. Period.
Pre term birth (yes–chronic inflammation is not good here, either).
Tooth loss increases pancreatic cancer risk 63%.

Here’s where the story gets scarier–in a recent blog article (that can be read by clicking here), I pointed out a study that found that an alarming percentage of the population (well over 50%) had signs of gingivitis.

Clearly we have an issue as it relates to oral health in this country. So where do we start to turn it around?

Regular dental care, daily brushing (I personally like my Sonicare), daily flossing and regular tongue scraping (I’m a big fan of tongue scraping–the best tongue scrapers can be found at BreathRx).

I do, however, have concerns over antibacterial mouthwashs. I think there is mounting research that killing off even the good bacteria in our mouth leads to problems like high blood pressure.

All of this brings us to this particular study. Researchers looked across multiple studies to examine the association between prediabetes / metabolic syndrome and periodontitis. Overally, they found that, in those people who were prediabetic (and let’s face it–that’s well over half of you out there….), he or she was 209% more likely to also have periodontitis.

Wow–that’s a pretty strong association. And while the researchers were unclear about whether the prediabetes caused the dental problems or whether the dental problems contributed to prediabetes, it doesn’t really matter from a practical standpoint. It most likely works both ways.

Overall, this means that good oral health has to include an anti-diabetic lifestyle. My recommendations can be found by clicking here, or, better yet, sign up for the Rantings and get the full ebook for free by clicking here.

Whole Grains and Diabetes Prevention: Are You Reading the Label?

January 25, 2013 by James Bogash

You don’t label shop your grains. Your buying choice comes from the front of the food package. But is this pattern missing your whole grains to prevent diabetes?

It is interesting to note that our national recommendations are NOT to avoid refined carbohydrates. Rather, they suggest we should eat more whole grains. I am generally not a conspiracy minded person, but clearly money is the only reason these recommendations are written as such. Before I get into this, you need to fully understand the difference between a whole grain and a refined carbohydrate.

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.

If the powers that be (namely the USDA and the Surgeon General) stood up and declared that refined carbohydrates should be avoided completely, Nabisco, Kraft, Quaker, Mars and Nabisco would likely go out of business. They really don’t offer any products that do not generate some degree of harm to your health.

Since we can’t have that happen, you are instead told to eat more whole grains. So these companies can make the same crappy products and toss in some whole grains after the “contains less then 2% of…” part of the label. This allows the companies to slap the “made with whole grains” on the front of the package. You, as the unwary customer who does not read the ingredients label thinks that Wonder Bread is now a health food because it is “made with whole grains.”

The analogy I usually give is the guy at the Skittles factory over a vat of product with an eyedropper of fruit juice. After the single drop, they proudly proclaim that Skittles are made with real fruit juice and put it on the front of the label. But does any parent look at the front of the Skittles package and think, “Made with whole grains! I’ve GOT to give this to my kids for their health?”

All of this ranting brings me to this particular article. Researchers looked at whether a higher intake of whole grains led to a lower risk of developing prediabetes.

Overall, those with the highest intake of whole grains had a 34% lower risk of progressing to prediabetes (Tweet this). This level of whole grain intake can only come by replacing refined carbohydrates with whole grains.

The bottom line is, if you are not reading ingredients labels and instead focus exclusively on carbohydrate content in the “nutrition facts” grid, you are missing the most important aspect of what you are eating.

Do you read the label? Do you think that you should, in the best interests of your family’s health, go to the fridge and pantry right now and throw out all the food items with enriched wheat flour and high fructose corn syrup?

Slash Your Risk of Diabetes Today With One Simple Change

November 21, 2012 by James Bogash

Diabetes is THE condition we are constantly fighting against. Preventing diabetes is completely within your control. But for some changes are too hard. Not true.

Exercise hard 7 days a week. Meditate 5 times per day. Eat tofu (non-GMO) and rice. Drink 8 cups of green tea daily steeped for 4 minutes at 96 degrees Celcius in water dripped off the melting snows of the Himalayas in Tibet.

Who’s got the time for all that stuff?

In today’s time crunched, digital age where the average salaried employee is milked out of some 50-60 hours / week fitting in the things we need to do to stay healthy seems daunting. The reality is that you can ALL make time–if I can spend 1+ hour on each of these blog posts 5-6 days per week on top of writing a book, ebooks and running a practice, I think everyone can find the time to eat right and exercise.

Let’s say you’ve rationalized to yourself that you absolutely can’t do any of the right things for your health right now.

How about this?

Slow down when you eat.

Not exactly life changing advice, huh?

According to this particular study, it might be. Researchers looked at Japanese middle aged men and asked them about their eating speed–slow, medium or fast. Here’s what they found:

Obesity rates went up as speed of eating increased (58% higher risk in slow vs fast eaters).
Medium speed eaters were 68% more likely to develop diabetes in the next 7 years.
Fast eaters were 97% more likely to develop diabetes.

This makes sense. We have seen studies where merely chewing more had a pretty dramatic effect on how our bodies used the foods we eat. This was also seen with single food items like almonds.

Here’s something else to consider. Food is a celebration of life. It is the centerpiece of family gatherings and quiet times with people you choose to spend time with. It can be the enjoyment of a fantastic meal, savoring every bite.

Eckhart Tolle, the famed author of The Power of Now, talks about the first steps to get you used to living in the now. It’s about savoring the process of eating and enjoying and savoring the tastes of the foods you eat.

You can’t do this wolfing down a Big Mac in between sales meetings.

So, slow down and enjoy your meal. Your body will thank you for this simple change.

Natural Menopause Treatment for Hot Flash Relief

November 8, 2012 by James Bogash

It’s inevitable as a woman ages: the production of hormones changes and you’re searching for that natural menopause treatment that will provide hot flash relief.

You’re pretty sure Satan just sat down in the cubicle next to you, but no one else seems to have noticed that the temperature gauge is now reading Kelvin instead of Fahrenheit.

Unless you’ve just swallowed 1500 mg of niacin in a single dose, the is likely the dreaded menopausal hot flash.

Many accept that these are just a part of the menopausal transition. But your best friend laughs at you bathing in an ice bath because she never experienced menopausal flushes. You’ve also heard that Asian women generally have less problems with hot flushes than American women.

As unfair as this sounds, is this really true and, if so, is there really a reason why some women experience dramatic menopausal hot flashes and some barely notice the transition?

Certainly a quick Internet search for hot flash relief will lead you to a long list of natural menopause treatment supplements typically containing herbs like black cohosh or soy isoflavones.

Off course, if “natural” is not your speed, you can always rely on the time tested hormone replacement therapy (HRT). Of course, while it may have been “time tested” is was never actually “research tested” until the Women’s Health Initiative discovered that it was causing much greater harm than benefit. The 40 years of so of the untested HRT use in women is about as close as we can get to an epic failure of the medical process as possible.

Back to the hot flash relief topic.

Overall, it’s clear that not every women has the same experience as it relates to menopausal hot flashes. This particular article may begin to explain why.

And it all boils down to our old friend prediabetes.

Researchers looked at the frequency of hot flushes as it related to a marker of insulin resistance (called HOMA, or homeostasis model assessment). The higher the HOMA, the more prediabetic someone is. Here are the findings:

In women experiencing 1-5 hot flashes per day the HOMA index was 237% higher
At 6 or more hot flushes per day it was 591% higher.
Hormone levels of estradiol (e2) or follicle stimulating hormone (FSH) did not affect the results.

Overall, this is really NOT good. Based on this, if you are experiencing more frequent hot flashes, it may mean that you are on a full sprint towards developing diabetes.

What this means is that natural menopause treatment for hot flash relief is not going to come in a bottle. Rather, you need to evaluate your entire lifestyle and make healthier changes to protect your heart and protect against diabetes as you age.

If you experienced severe hot flashes during menopause, what did you find that was able to help?

Chocolate Research: Eat Healthy Chocolate for Your Brain

October 25, 2012 by James Bogash

Many have the mistaken idea that living a healthy lifestyle is painfully boring. These same people are likely not aware of the volume of chocolate research…

I had a discussion with a new patient recently who said she liked sweets too much to be healthy. I asked how she would feel about a regular routine of dark chocolate mixed with sweeter fruits like cranberries, blueberries or strawberries. Didn’t sound too bad to her.

Like many other people, we have an altered perception of what is good and bad for us. Do any of these misconceptions sound familiar?

Nuts are fattening.
Diet soda will help me from gaining weight.
Milk does a body good.
I need to exercise 45 minutes 3 times per week.

Of course there are many more, but these were the first few that popped into my head.

Dark chocolate has been shown time and time again to be very good for us, along with its cousin, cocoa. Both are derived from the cacao plant and so have similar positive effects on health. Most of their power seems to be focused around protecting our blood vessels (aka vascular health). Lest you think vascular health doesn’t have the pizazz of heart disease and stroke, remember that almost ALL heart attacks and strokes begin with a problem in the blood vessels. Protect the blood vessels and you protect everything.

Especially the brain. Nothing destroys the brain more that poor vascular health. This is why conditions like prediabetes are so bad for the brain–the prediabetic state absolutely destroys the health of your blood vessels. Do this for too long and the cells of the brain begin to lose the vital blood flow they need to function optimally. These changes begin to show up as white matter changes.

Just in case you don’t think the chocolate research is really this strong as it relates to vascular health, this particular article looks at the risk of having a stroke as it relates to healthy chocolate.

Overall, high chocolate consumption was associated with a lower risk of stroke.
The highest group of chocolate consumers averaged 62.9 g/week (just under a good sized bar).
The highest group had a 19% lower risk of all types of stroke.

While 19% is not dramatic, make sure you take this into perspective. It’s chocolate.

One last comment, which I’m sure you’re already aware of. We’re not talking about the sugar-laden, dairy containing milk chocolate here. The protective compounds in milk chocolate are almost absent, while they remain very high in dark chocolate. The higher the cacao content, the better.

How do you like to eat your chocolate?

Can Sleep Apnea Cause Headaches? Sleep Lab for Chronic Headaches

October 10, 2012 by James Bogash

Might the horrendous “gasping for air” sound sleep apnea sufferers make cause headaches? If this description fits your night, maybe it’s time to visit a sleep lab.

The brain is a very sensitive organ. Bombard it with toxic chemicals from the environment, deprive it of fuel or stress it out and it’s not going to be happy with you.

The same goes for oxygen. Decrease oxygen supply to the brain cells, even by the smallest amount, and you can trigger a headache.

“But how?” you ask.

When it comes to keeping our brain cells happy and healthy one of the factors that plays a critical role is the ability to carry oxygen to our brains. If the brain doesn’t have enough oxygen, our mitochondria won’t be able to produce the energy (in the form of ATP) that we need, and the brain is not able to function the way it is supposed to.

So, any drop in the ability to deliver oxygen to the brain can create problems. This is exactly the state that many women experience in the second half of their menstrual cycles as the lining of the endometrium begins to build, removing red blood cells from circulation and reducing the ability of the blood to bring oxygen to the brain.

This can be a very subtle drop in red blood cell level, but given how sensitive the brain is to changes in oxygen levels, that can be enough to trigger a menstrual migraine in women who are already sensitive.

While we’re on the subject of reducing oxygen delivery to the brain, what about sleep apnea?

Ask anyone who’s slept next to someone with sleep apnea and they will tell you that it can be a scary experience. The person can stop breathing many times per hour, leaving the other person in the bed unable to sleep, constantly ready to dial 911 if the breathing doesn’t resume this time…

This is a monumentally bad situation for our health. And this is on top of the fact that most cases of central sleep apnea are caused by being prediabetic, which carries its own risk to our health.

Clearly this sleep apnea will both stress the body out as well as deprive the brain of oxygen. As mentioned, this drop in oxygen is not received nicely by the neurons, as we can see from this particular study.

Researchers looked at a group of chronic head sufferers (chronic migraine without aura, episodic migraine without aura, migraine with aura, tension-type headache, chronic post-traumatic headache, medication overuse headache) and identified how many of these experienced sleep apnea. Here are the findings:

All patients were receiving standard treatment for their headaches by their neurologist.
63% of the chronic headache sufferers had obstructive sleep apnea (OSA).
Of the patients with OSA, 63% used CPAP and 82% of these used the CPAP as prescribed.
49% of this group of patients had a positive response to therapy (meds or CPAP)
Patients with OSA who using the CPAP were more likely to have improvement in headaches
Of the 33 patients who used CPAP, 13 reported improvement in headaches specifically due to CPAP therapy.

Overall, this is some pretty strong stuff and would suggest that every chronic headache sufferer should be evaluated at a sleep lab for sleep apnea. This is, of course, in addition to lifestyle changes designed to improve brain health.

If you use a CPAP and have suffered with chronic headaches, did using the CPAP help your headaches?