More and more people have become aware of the dangers of excessive fructose in their diet. A new review on fructose in an upcoming issue of the Journal of the American Society of Nephrology (JASN) indicates just how dangerous this simple sugar may be.

Richard J. Johnson, MD and Takahiko Nakagawa, MD (Division of Renal Diseases and Hypertension, University of Colorado) provide a concise overview of recent clinical and experimental studies to understand how excessive amounts of fructose, present in added sugars, may play a role in high blood pressure, diabetes, obesity, and chronic kidney disease (CKD).

Dietary fructose is present primarily in added dietary sugars, honey, and fruit. Americans most frequently ingest fructose from sucrose, a disaccharide containing 50% fructose and 50% glucose bonded together, and high fructose corn syrup (HFCS), a mixture of free fructose and free glucose, usually in a 55/45 proportion. With the introduction of HFCS in the 1970s, an increased intake of fructose has occurred and obesity rates have risen simultaneously.

The link between excessive intake of fructose and metabolic syndrome is becoming increasingly established. However, in this review of the literature, the authors conclude that there is also increasing evidence that fructose may play a role in hypertension and renal disease. “Science shows us there is a potentially negative impact of excessive amounts of sugar and high fructose corn syrup on cardiovascular and kidney health,” explains Dr. Johnson. He continues that “excessive fructose intake could be viewed as an increasingly risky food and beverage additive.”

Concerned that physicians may be overlooking this health problem when advising CKD patients to follow a low protein diet, Dr. Johnson and Dr. Nakagawa recommend that low protein diets include an attempt to restrict added sugars containing fructose.

Notes:

Disclosures: Dr. Johnson and Dr. Nakagawa are listed as inventors on several patent applications related to lowering uric acid for the treatment or prevention of hypertension, diabetes, and fatty liver. Dr Johnson has also published a book, The Sugar Fix that covers this topic for the general public.

The article, entitled “The Effect of Fructose on Renal Biology and Disease,” appeared online on November 29, 2010, doi 10.1681/ASN.2010050506.

Source: American Society of Nephrology

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Source: http://www.medicalnewstoday.com/articles/209057.php

However. Many that have had islet transplants tout the procedure as an overwhelming success. Kathy, of the online blog My New Isletsrecently recounted her experience at the Diabetes Transplant Summit in Bethesda, Md. earlier this month. It was organized by the Diabetes Research and wellness Foundation. Kathy, who lives in Ohio and has had diabetes for 25 years, received an islet transplant in the summer of 2008. She takes immunosuppressants Prograf and Rapamune.  

Kathy recounted how Dr. Bernard Hering explained that islet cell transplants can actually help reverse some of the complications from Type 1 diabetes. He also claimed, according to Kathy, that the blood sugar management of those with transplanted islets was far superior when compared to those with “tight control” using an insulin pump or continuous blood glucose monitor.

“I had described my transplant several times as the feeling that I had made a miraculous escape from a place that I didn’t want to be,” Kathy writes in her blog. She said that she has so much more energy now than before. While she considers the surgery a success, she does still have to take a small dose of insulin.

There were other transplant recipients speaking at the conference as well, including Mary Buche. She has remained insulin independent since her transplant in 2007. Before her surgery, Buche’s coworkers were spotting her low blood sugars before she could. She began to intentionally keep her blood sugar levels high to avoid scary lows.

Another islet recipient, Dave Thoen, was having trouble with hypo-unawareness, a condition where the patient doesn’t recognize or experience the symptoms of low blood sugar levels. Thoen was having seizures before the transplant. Ellen Berty, who has a transplant in 2001, was having lows while driving. She would stop her car in the middle of the road to fix the problem, if necessary. Gary Kleiman, who has had two kidney transplants and an islet transplant, has also been encouraged by the results.

Lastly, a speaker named Karla received a transplant in 2005. She doesn’t take insulin, but does take one unit of Byetta before breakfast and dinner. Karla once had her blood sugar fall as low as 10 and was rushed to the emergency room.

While there are some drawbacks to such a surgery, which is still not approved for widespread use, the recipients at this conference all say it has improved their lives dramatically.

Source: http://diabetesnewshound.com/type1/islet-transplant/

Now Juan Ramirez has come to my help. In March I wrote here about “Eating Too Fast” and some of the strategies I use. After that article, Juan wrote me about his invention to help us slow down at the table.

When we eat slowly, we can avoid overeating and therefore can control our diabetes better. But some of us eat fast because we like our meals to be hot rather than lukewarm. I know that’s my excuse.

Now, however, the great food cool off is no longer inevitable. I know this because I bought one of the “HotSmart Gourmet Plates” that Juan Ramirez invented and wrote me about.

“I am pre-diabetic myself and I am convinced that eating slowly works to avoid overeating, preventing obesity and type 2 diabetes,” Juan emailed me. “My heat-retentive plates keep food warm, need only one minute preheating, and stay hot for more than 30 minutes. The rim stays always cool for safe easy handling with your bare hands.”

This message grabbed my attention. I had to have one, but when Juan wrote me, he had one little problem. He was sold out of them at that time.

Recently he wrote to tell me that he was caught up with demand, and Amazon.com now has them in stock. “All you have to do is type HotSmart in the main page for all departments.” Or you can go to Amazon’s direct link for HotSmart Gourmet Plates.

Two of Juan’s websites explain the HotSmart plate in more detail. They are HotSmart Gourmet Plates and Lose Weight By Eating Slowly.

As soon as I got Juan’s message that Amazon had his plates back in stock I ordered one. Amazon sells them for $18.85 each.

Since then I have made a point of using my HotSmart plate for every hot meal that I eat now. It really works for keeping my food hot and keeping me from gobbling it down.

My guess is that like me you may have the secret little vice of eating too fast. If you do, eating off a HotSmart plate can help. While it won’t force you to slow down, it will take away any excuse you made to yourself to bolt your food down the hatch.

In a cross-sectional study from the 2004 and 2007 Australian National Drug Strategy Household (NDSH) surveys, respondents were questioned about their current and past drinking, the presence of formal diagnosis for specific diseases (heart disease, type 2 diabetes, hypertension, cancer, anxiety, depression) and self-perceived general health status. The sample sizes for the 2004 and 2007 NDSH surveys were 24,109 and 23,356, respectively.

The authors report that respondents with a diagnosis of diabetes, hypertension, or anxiety were more likely to have reduced or stopped alcohol consumption in the past 12 months. The likelihood of having reduced or ceased alcohol consumption in the past 12 months increased as perceived general health status declined from excellent to poor (although the authors do not point out that lifetime abstainers were more likely than moderate drinkers to report less than excellent health status).

The authors conclude that the experience of ill health is associated with subsequent reduction or cessation of alcohol consumption (“sick quitters”), which is consistent with most prospective epidemiologic studies. The authors also conclude that this may at least partly underlie the observed ‘J-shaped’ function relating alcohol consumption to premature mortality. On the other hand, most modern epidemiologic studies are careful not to include “sick quitters” within the non-drinking category, and relate health effects of drinkers with those of lifetime abstainers. Further, prospective studies in which alcohol intake is assessed at different times (rather than having “changes” based only on recall at one point in time, as was done in this study) usually indicate that subjects who decrease their intake are more likely to subsequently develop adverse health outcomes, especially related to cardiovascular disease, than those who continue moderate drinking.

Notes:

Reference: Liang W, Chikritzhs T. Reduction in alcohol consumption and health status. Addiction 2010; in press (doi:10.1111/j.1360-0443.2010.03164.x).

Contributions to this critique by the International Scientific Forum on Alcohol Research were from the following members:

Ross McCormick PhD, MSC, MBChB, Associate Dean, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Harvey Finkel, MD, Hematology/Oncology, Boston University Medical Center, Boston, MA, USA.
Pierre-Louis Teissedre, PhD, University Victor Segalen Bordeaux 2, Bordeaux, France.
Erik Skovenborg, MD, Scandinavian Medical Alcohol Board, Practitioner, Aarhus, Denmark.
R. Curtis Ellison, MD, Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA.
Ulrich Keil, MD, PhD, Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Dominique Lanzmann-Petithory,MD, PhD, Nutrition/Cardiology, Praticien Hospitalier Hôpital Emile Roux, Paris, France.
David Vauzour, PhD, Dept. of Food and Nutritional Sciences, The University of Reading, UK.

Source:
R. Curtis Ellison
Boston University Medical Center

Source: http://www.medicalnewstoday.com/articles/209215.php

Performing a combination of aerobic exercise and resistance training was associated with improved glycemic levels among patients with type 2 diabetes, compared to patients who did not exercise, according to a study in the November 24 issue of JAMA. The level of improvement was not seen among patients who performed either aerobic exercise or resistance training alone.

Although it is generally accepted that regular exercise provides substantial health benefits for individuals with type 2 diabetes, the exact exercise type (aerobic vs. resistance vs. both) has been unclear. “Given that the 2008 Federal Physical Activity Guidelines recommend aerobic exercise in combination with resistance training, the unanswered question as to whether for a given amount of time the combination of aerobic and resistance exercise is better than either alone has significant clinical and public health importance,” the authors write.

Timothy S. Church, M.D., M.P.H., Ph.D., of Louisiana State University System, Baton Rouge, La., and colleagues conducted the HART-D trial, which compared among 262 sedentary women and men with type 2 diabetes the effect of aerobic training, resistance training, and a combination of both on change in hemoglobin A1c levels (HbA1c; a minor component of hemoglobin [the substance of red blood cells that carries oxygen to the cells] and to which glucose [blood sugar] is bound; HbA1c levels are used to monitor the control of diabetes mellitus). Study participants were 63.0 percent women, 47.3 percent nonwhite, average age of 56 years, HbA1c level of 7.7 percent and duration of diabetes of 7.1 years. The individuals were enrolled in the 9-month exercise program between April 2007 and August 2009. Forty-one participants were assigned to the nonexercise control group; 73 to resistance training sessions; 72 to aerobic exercise sessions; and 76 to combined aerobic and resistance training.

The researchers found that the absolute change in HbA1c in the combination training group vs. the control group was -0.34 percent. In neither the resistance training (-0.16 percent) nor the aerobic (-0.24 percent) groups were changes in HbA1c significant compared with those in the control group. The prevalence of increases in hypoglycemic medications were 39 percent in the control, 32 percent in the resistance training, 22 percent in the aerobic, and 18 percent in the combination training groups.

“Only the combination exercise group improved maximum oxygen consumption compared with the control group. All exercise groups reduced waist circumference from [-.75 to -1.1 inches] compared with the control group,” the authors write. The resistance training group lost an average of 3.1 lbs. fat mass and the combination training group lost an average of 3.7 lbs., compared with the control group.

“The primary finding from this randomized, controlled exercise trial involving individuals with type 2 diabetes is that although both resistance and aerobic training provide benefits, only the combination of the 2 were associated with reductions in HbA1c levels,” the researchers write. “It also is important to appreciate that the follow-up difference in HbA1c between the combination training group and the control group occurred even though the control group had increased its use of diabetes medications while the combination training group decreased its diabetes medication uses.”

( JAMA. 2010;304[20]:2253-2262.)

Editorial: Combined Aerobic and Resistance Exercise for Patients With Type 2 Diabetes

Ronald J. Sigal, M.D., M.P.H., of the University of Calgary, Alberta, Canada, and Glen P. Kenny, Ph.D., and Dr. Sigal of the University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, write in an accompanying editorial that this study provides important evidence on the effects of aerobic and resistance training on improving hemoglobin A1c levels.

“Based on the results of the HART-D trial, patients with type 2 diabetes who wish to maximize the effects of exercise on their glycemic control should perform both aerobic and resistance exercise. The HART-D trial clarifies that, given a specific amount of time to invest in exercise, it is more beneficial to devote some time to each form of exercise rather than devoting all the time to just one form of exercise.”

( JAMA. 2010;304[20]:2298-2299.)

Source.
JAMA

Source: http://www.medicalnewstoday.com/articles/209356.php