A new study from France suggests that women who drink large amounts of diet soda are at increased risk for type 2 diabetes. The findings also support the previously documented association between high intake of regular sugar-sweetened beverages and the condition, report Guy Fagherazzi, from the Center for Research in Epidemiology and Population Health, Villejuif, France, and colleagues in a study published online January 30 in the American Journal of Clinical Nutrition.

Prior research into the relationship between diet soda (artificially sweetened beverages) and type 2 diabetes has produced conflicting results, and while the current study does not necessarily imply causation, there are some biologically plausible mechanisms, the researchers suggest.

And given that diet sodas are "considered — and marketed — as healthier than sugar-sweetened beverages," the findings require further investigation, they say. In the meantime, the authors advise that "a precautionary principle could be applied to the promotion of [artificially sweetened beverages]."

"Our results — in accordance with a recent joint scientific statement of the AHA and ADA — strongly suggest the need to conduct randomized trials that evaluate metabolic consequences of [artificially sweetened beverage] components, such as artificial sweeteners, to prove a causal link between [artificially sweetened beverage] consumption and type 2 diabetes," the study authors conclude.

Am J Clin Nutr . Published online January 30, 2013. Abstract

Men may not have ovaries, but that doesn’t mean they can’t develop some of the features of polycystic ovary syndrome (PCOS). That’s one of the reasons Andrea Dunaif, MD, Charles F. Kettering Professor of Endocrinology and Metabolism, would like to change the way scientists think about the complex genetic disease.

“It should really be seen as a metabolic disorder affecting men as well as women across the lifespan, rather than a female reproductive disorder with metabolic features,” Dunaif said.The current definition of the disorder is rooted in history. PCOS was first identified in 1935 as a gynecologic condition known as Stein-Leventhal syndrome, named after the physicians who described it. Since then, the understanding of PCOS has evolved. Symptoms in women often first become apparent in adolescence and may include irregular periods and excess hair on the face, chest, or back – all caused by high levels of male hormones. The syndrome is seen as a major health concern because it is frequently associated with obesity and substantially increases risk for type-2 diabetes and, perhaps, heart disease. It is also among the most common disorders of reproductive-age women, affecting up to 10 percent of the population worldwide.

PCOS runs in families, indicating that there is likely a genetic susceptibility to the disorder. This observation first raised the question as to whether men in PCOS families might also be affected. Dunaif’s research group has been able to show that brothers and fathers of women with PCOS also have elevated male hormone levels and face the same long-term health risks, such as diabetes, obesity, and heart disease. 

“Because this is a genetic condition, our research studying families has provided a powerful resource for finding causal genes,” said Dunaif. “We are very fortunate to have recruited more than 500 families over the years. Many of these families are ideal for the application of the newest technologies for identifying disease genes, such as whole genome sequencing, because we have DNA available from affected and unaffected sisters, as well as both parents.”

Thus far, the research points to the likelihood that the same gene defect is responsible for both the reproductive and the metabolic abnormalities. Sponsored by several National Institutes of Health grants, Dunaif and her co-investigators, Margrit Urbanek, PhD, associate professor of medicine-endocrinology, and M. Geoffrey Hayes, PhD, assistant professor of medicine, are leading an international collaboration to map genes for PCOS.

“Ultimately, we hope that we can find what causes the condition so we can develop drugs to reverse or prevent PCOS,” Dunaif said.

Dunaif is also co-chair of the steering committee for the first NIH-sponsored evidenced-based methodology workshop on PCOS, which will be held in December on the NIH campus. An independent panel with broadly-based expertise will develop a scientific statement based on the information presented at this conference. The consensus statement will advance both clinical care and future research in the field. In addition, Dunaif hopes that this statement will highlight the major health implications of PCOS so that the condition is recognized as an important medical disorder.

“PCOS is a major women’s health problem, and the fact that it is genetic means that the male relatives of affected women are at increased risk for the adverse metabolic outcomes associated with PCOS,” she said.

It is no wonder why the weight-loss industry is a $20 billion per year industry.  Dieters spend money on diet books, diet drugs and weight-loss surgery.  108 million people in the United States are on diets and typically attempt four or five diets a year.  85% of dieters are women.

Some diets preach low-calorie, some are low-carbohydrate.  Some allow for only eating grapefruit or cabbage soup.  Some say it’s only about how much you eat and the amount of time spent exercising, while others say not all calories are created equal and it is about what we eat as well as how much of it.  We are constantly bombarded by different information and different diets.  No wonder we cannot keep the weight off.

A promising study published in the Journal of the American Medical Association may finally set the record straight.  It found that a specific mix of carbohydrate, fat and protein might be ideal.  It also suggested that not all calories are created equal, meaning that calories can have different effects on the body.

The study followed 21 adults ages 18 through 40 for four years to determine the effects of various diets on the ability to burn calories following weight loss. At the start of the study, the participants had a BMI over 27, which is considered overweight or obese.  The participants were originally placed on a diet to lose 10%-15% of their body weight.  After the initial weight loss, researchers placed the participants on three different diets in a random order each for four weeks at a time.  All diets maintained the same total number of calories.  However, they did differ in their carbohydrate, fat and protein content.

The low-fat diet required that 60% of calories came from carbohydrates, 20% from fat and 20% from protein.  The low-glycemic diet required that 40% of calories be derived from carbohydrates, 40% from fat and 20% from protein in order to prevent spikes in blood sugar.  The very low-carbohydrate diet (“Atkins”) required that 10% of calories came from carbohydrate, 60% from fat and 30% from protein.

Researchers measured participants’ energy expenditure as well as other aspects of metabolism and concluded that the total number of calories burned daily differed with each diet.  Researchers also studied hormone levels and metabolic measures concluding that they too varied by diet.

On average the very-low carbohydrate diet burned calories most efficiently with participants burning 3,137 calories daily.  The low-glycemic diet burned 2,937 calories per day, 200 less than the very-low carbohydrate.  The low-fat diet burned 2,812 calories daily.

While researchers did conclude that it improved metabolism the best, don’t switch to the very-low carbohydrate diet just yet.  The participants showed higher levels of risk factors for diabetes and heart disease, including the stress hormone cortisol.

The low-glycemic diet resulted in only a 200 calorie difference and showed similar benefits to the very-low carbohydrate diet, with less negative effects.  A low-glycemic diet consists of less-processed grains, vegetables and legumes.  According to researchers, this may be the best diet for both long-term weight loss and heart disease prevention when coupled with exercise.

A low-glycemic index diet emphasizes foods based on how they affect blood sugar levels.  Foods, specifically carbohydrates since they have the most effect on blood sugar, are given a score between 0 and 100.  High scores of 70 and up include white and brown rice, white bread, white skinless baked potato, boiled red potatoes and watermelon.  Medium scores between 56-69 include sweet corn, bananas, raw pineapple, raisins and some ice creams.  Examples of low scoring foods of 55 and under include raw carrots, peanuts, raw apple, grapefruit, peas, skim milk, kidney beans and lentils.

The diet does not require counting carbs, counting calories or reducing portion sizes.  It only directs dieters to the right kind of carbohydrates in order to keep blood sugar levels balanced.  Specifically, lower glycemic diets are digested less rapidly by the body, which raises the blood sugar in a regulated, balanced way; whereas higher glycemic foods and beverages are digested more rapidly causing a blood sugar spike followed by a drastic decline.  Since low-glycemic index foods are digested more slowly, they remain in the digestive tract longer, potentially controlling appetite and hunger.  This can also reduce the risk of insulin resistance.

The study shows that a low-glycemic diet can work for long-term weight-loss, as it is easily sustainable because whole food groups are not removed.  Furthermore, it may reduce the risk of serious diseases such as diabetes and cardiovascular disease.

Sources:

Weight-Loss Stats: http://abcnews.go.com/Health/100-million-dieters-20-billion-weight-loss-industry/story?id=16297197#.UBBfZo7p7ao

NIH: http://www.nih.gov/researchmatters/july2012/07162012weight.htm

Mayo Clinic on the Low-Glycemic Diet: http://www.mayoclinic.com/health/glycemic-index-diet/MY00770

Heart disease and stroke deaths drop significantly for people with diabetes!
According to the Centers for Disease Control and Prevention (CDC) healthier lifestyles, better disease management are helping people with diabetes live longer.   Death rates for people with diabetes dropped substantially from 1997 to 2006, according to a study published May 22 in the journal Diabetes Care. Among the most promising findings,

• Deaths from all causes declined by 23%.

• Deaths related to heart disease and stroke dropped by 40%.

• Although an adult with diabetes is likely to die at a younger age than one who does not have diabetes, the difference is getting smaller.

These findings parallel other surveillance reports showing improved medical treatment for cardiovascular disease, better management of diabetes, and some healthy lifestyle changes contributed to the decline. On average, people with diabetes were less likely to smoke and more likely to be physically active than in the past. Better control of high blood pressure and high cholesterol also may have contributed to improved health among diabetics.  However, obesity levels among people with diabetes continued to increase ☹.