- Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC
- Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.
Tuesday, December 16, 2014
A new study has found that ingestion of beverages kept in cans lined with bisphenol A, BPA, raises blood pressure. BPA is widely found in plastic bottles, plastic packaging, receipt paper, and the linings of food and beverage cans. Previous studies have linked chronic BPA exposure with increased rates of heart disease, diabetes, thyroid dysfunction, and cancer. This new study reveals that BPA exposure is not only a problem over the long-term, but that blood pressure increases within hours of ingesting products kept in BPA-lined cans.
The researchers found that when study participants drank soy milk from glass bottles their urinary BPA levels remained low. But, within two hours of drinking soy milk from a can, their levels of BPA were 16 times greater. As their BPA levels rose so did their blood pressure with systolic readings increasing by an average of 5 mm Hg. To put this rise in perspective, every 20 millimeter increase in systolic blood pressure doubles cardiovascular disease risk. The researchers chose soy milk as the beverage in the study because it does not have any properties that are known to increase blood pressure, and, unlike soda, fruit juice, tomato juice and other acidic products which are known to promote BPA leaching, soy milk is neutral.
While a single instance of increased blood pressure is unlikely to be harmful, the findings suggest that for people who drink from multiple cans or plastic bottles every day, the repeated exposure over time could contribute to hypertension. BPA is an endocrine disrupter that can mimic the actions of estrogen. BPA is known to block certain estrogen receptors that are thought to be responsible for repairing blood vessels and controlling blood pressure. The chemical may also affect blood pressure indirectly by disrupting thyroid hormone.
What to do: Because of growing concerns about BPA, some packaged products now carry “BPA free” claims on their labels. However, these products often contain chemically similar alternatives – like bisphenol S that also leach chemicals with estrogenic activity. To minimize exposure avoid #3, #6, #7 plastics and aluminum cans as much as possible. Products that are liquid and/or acidic cause more chemical leaching. Look for products packaged in glass bottles instead. Avoid freezing, microwaving, or machine dishwashing plastics as these processes degrade the plastic allowing more BPA to leach into your foods. Store foods in glass or stainless steel containers.
Adapted from articles available at:
Bae S, Hong Y-C. Exposure to Bisphenol A from drinking canned beverage increases blood pressure: Randomized crossover trial. Hypertension. 2014; DOI: 10.1161/HYPERTENSIONAHA.114.04261
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 3:07 PM
Wednesday, December 3, 2014
A new trial has found that when vitamin D deficient patients with chronic obstructive pulmonary disease (COPD) are supplemented with the vitamin, rates of respiratory flare-ups decrease by 40%.
Chronic bronchitis and emphysema are two types of COPD. These conditions are characterized by coughing, excess mucus, shortness of breath, wheezing, fatigue, and tightness in chest but when a flare-up strikes these symptoms become so severe that individuals often require hospitalization.
This randomized controlled trial included 240 patients with COPD. For one year, half of the patients received 120,000 IU of vitamin D every 2 months (equivalent to taking 2000 IU daily) while the other half received a placebo. The risk, severity and duration of flare-ups was then compared between the two groups. The supplemented group experienced a 40% reduction in flare-ups.
How vitamin D reduced COPD flare-ups is not entirely understood. Because adequate levels of vitamin D appear to be important in immune function, researchers had speculated that supplementation would decrease rates of upper respiratory tract infections, but, instead, they found that the supplemented patients and controls did not differ in their rate of respiratory infections. Instead, it appears that the anti-inflammatory properties of vitamin D are what mediates the reduction in COPD flare-ups. Interestingly, while it is not believed that vitamin D supplementation can prevent COPD, patients with chronic lung diseases such as asthma, cystic fibrosis, COPD, and interstitial pneumonia appear to be at increased risk for vitamin D deficiency.
What to do: Increasingly, it is being recognized that vitamin D plays an important role not only in bone health but also immune, endocrine, and pulmonary function. Blood tests can reliably check vitamin D levels. If deficient, patients are often prescribed a prescription dose. Vitamin D is naturally produced when the skin is exposed to the sun but having darker skin, excess weight, and/or older age decreases the body’s ability to produce vitamin D. Salmon, sardines (and other fish in which the bones are eaten), and cod liver oil are some of the few foods that contain significant amounts of vitamin D. Milk and many other products are now fortified. When taking a supplement choose the Vitamin D3 form. Discuss with your provider what level of supplementation is appropriate.
Adapted from articles available at:
Martineau AR, James WY, Hooper RL et al.. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. The Lancet Respiratory Medicine, 2014; DOI: 10.1016/S2213-2600(14)70255-3
Gilbert CR, Arum SM, Smith CM. Vitamin D deficiency and chronic lung disease. Canadian Respiratory Journal : Journal of the Canadian Thoracic Society 2009;16(3):75-80. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706673/
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 12:23 PM
Tuesday, December 2, 2014
Tart cherries, the red cherries commonly used in cherry pie, are one of the fruits highest in anti-oxidant plant compounds known as anthocyanins. Two recent studies add to a growing body of evidence on the joint health benefits of regular tart cherry consumption. In the studies researchers found tart cherries caused changes in how the body processes uric acid -- a substance that is elevated in those suffering from gout. They also found that sour cherry juice reduces c-reactive protein, a biomarker of systemic inflammation.
In the studies, healthy participants consumed tart cherry juice concentrate equivalent to 45 or 90 tart cherries. Researchers collected blood and urine samples from the participants immediately before and at numerous intervals for up to 48 hours after the tart cherry juice was consumed. They found that after consumption of the juice, participants’ blood levels of uric acid significantly decreased and urinary excretion of uric acid increased and that these changes persisted for more than 12 hours. They also found that c-reactive protein levels significantly declined after consumption.
In addition to joint health benefits, tart cherries appear to help with sleep. They are one the richest natural sources of melatonin, a hormone that helps regulate the sleep-wake cycle. A study from April of this year, found that seniors who drank 8 oz. of tart cherry juice in the morning and at night were able to sleep more than an hour longer each night compared to those taking a placebo.
What to do: Studies on the cherries thus far have been relatively small but results are encouraging. Doses and preparations used in studies have varied. Be mindful that any of the cherry preparations add calories and natural sugars to your diet. If you are up for giving the cherries a go, try having an 8oz glass of the juice, 2 Tablespoons of sour cherry juice concentrate, or 1-1.5 cups of sour cherries twice daily. Also, though perhaps not quite as packed with anthrocyanins as tart cherries, diets rich in all kinds of cherries (not just sour cherry), blueberries, and cranberries appear to be helpful in reducing gout flare-ups and increasing the body’s anti-oxidant defenses.
Bell PG, Gaze DC, Davison GW, George TW, Scotter MJ, Howatson G. Montmorency tart cherry (Prunus cerasus L.) concentrate lowers uric acid, independent of plasma cyanidin-3-O-glucosiderutinoside. Journal of Functional Foods. 2014; 11: 82-90. DOI: 10.1016/j.jff.2014.09.004
Bell PG, Walshe IH, Davison GW, Stevenson E, Howatson G. Montmorency cherries reduce the oxidative stress and inflammatory responses to repeated days high-intensity stochastic cycling. Nutrients. 2014;6:829-843. DOI:10.3390/nu6020829
Seymour EM, Warber SM, Kirakosyan A, Noon KR, Gillespie B, Uhley VE, Wunder J, Urcuyo DE, Kaufman PB, Bolling SF. Anthocyanin pharmacokinetics and dose-dependent plasma antioxidant pharmacodynamics following whole tart cherry intake in human adults. Journal of Functional Foods. Sept. 2014; Available online ahead of print. DOI: 10.1016/j.jff.2014.08.007
Liu AG, Tipton RC, Pan W, Finley JW, Prudente A, Karki N, Losso JN, Greenway FL. Tart cherry juice increases sleep time in older adults with insomnia. Experimental Biology. 2014. San Diego, CA. April 28, 2014. http://www.fasebj.org/content/28/1_Supplement/830.9
Adapted from articles available at:
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 3:27 PM
Wednesday, November 19, 2014
Millions of Americans attempt to lose weight each year, spending an estimated 66 billion on weight loss related products and services. In a recent review, researchers examined the existing research on the weight loss and heart health effects of following Atkins, South Beach, Zone, or Weight Watchers.
Atkins, Zone, and South Beach are all diets that emphasize carbohydrate restriction while Weight Watchers has more flexibility as to carbohydrate composition. While the diets differ in the amount of carbohydrate allowed (with Atkins eliminating nearly all carbohydrate at the initial stages), all emphasize moderating energy intake and choosing slowly digested carbohydrates rather than refined grains and sugars.
The recent survey of the research on these diets found that after 12-months, all plans were similarly effective in producing modest weight loss but that individuals often regained most of the lost weight over time. At 12-months out, the diets produced modest improvements in blood cholesterol and blood pressure though results varied across studies, with improvements varying more according to level of weight loss rather than diet type.
While the diets yielded similar results, persons following Weight Watchers lost slightly more weight than those following the other plans. Unlike the other plans, Weight Watchers, has a social component – individuals attend weekly meetings in which their progress is shared with a group.
What to do: The fact that all four diets produced similar results indicates that weight loss is less about diet composition (i.e. low carb vs. low fat) and more about behavioral modification. All the diets emphasized keeping a record of one’s intake and tracking one’s weight. And, even if the diets vary significantly in their initial induction phases, long-term, they emphasize intake of high-volume low calorie foods like green vegetables, preparing foods at home rather than eating out, and limiting refined grains and sugars. So, weight management is not about finding the magic food formula but making a long-term commitment to a healthy lifestyle and practicing the behaviors that keep you focused on making healthy food choices – making time to prepare food, tracking your weight and intake, and finding a supportive community.
Adapted from articles available at:
Atallah R, Filion KB, Wakil SM et al. Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: A systematic review of randomized controlled trials. Circulation: Cardiovascular Quality and Outcomes. 2014; DOI: 10.1161/CIRCOUTCOMES.113.000723/-/DC1.
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 7:47 AM
Tuesday, November 4, 2014
Recent studies have shown that kidney stone rates are on the rise across the country. About 13% of men and 7% of women in the U.S. will develop a kidney stone during their lifetime. Without treatment, up to 50% of those people will have a recurrence within five years. The American College of Physicians (ACP) recently reviewed all research studies on kidney stones published since 1948 to formulate updated treatment recommendations.
Kidney stones are small, hard deposits that form inside your kidneys. They are created when the urine becomes concentrated, allowing minerals to crystallize and stick together. The most common symptom is severe pain. Most stones pass on their own, but medical procedures are necessary to remove some kidney stones.
What to do: The APC advises the following to prevent stone recurrence:
- The first and foremost line of defense against kidney stones is to drink plenty of water -- at least 12 cups but fluid needs vary depending on body size, weather, activity level, etc. Drink enough that you produce at least 2 liters of urine. Since most of us do not measure, make sure you are drinking enough to keep your urine very light.
- Talk with your doctor about prescription medications that help to prevent recurrence including thiazide diuretics, citrate, and allopurinol.
- Moderate foods high in oxalate (such as chocolate, beets, nuts, rhubarb, spinach, strawberries, tea, and wheat bran) and pair high oxalate foods with a calcium source such as dairy. Do not limit calcium intake but instead eat a diet rich in calcium.
- Control sodium intake. High sodium intake increases calcium losses and stone formation.
- Moderate intake of meat and animal proteins. These foods are high in purines and increase the acidity of urine. Organ meats, anchovies, sardines, bacon, beef, lobster, shrimp, cod, ham, veal and venison are especially high.
- Minimize intake of dark colas such as Coke & Pepsi. These are very acidic and increase calcium in the urine.
Adapted from article found at:
Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD. Dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2014;161:659-667. Doi:10.7326/M13-2908
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 4:54 PM
A new study has found yet another reason to steer clear of sugary drinks. Researchers found that independent of weight, drinking a daily 20-ounce soda is associated with an increased rate of cellular aging comparable to smoking.
Researchers assessed cellular "aging" by measuring telomere length. Telomeres are the protective caps at the ends of chromosomes that affect how quickly cells age. They are combinations of DNA and proteins that protect the ends of chromosomes and help them remain stable. As they become shorter, and as their structural integrity weakens, the cells age and die quicker. Shorter telomeres are associated with decreased life span as well as a host of chronic diseases including heart disease, vascular dementia, diabetes, and some types of cancer.
In the study, researchers collected information on dietary intake and measured the telomere length of 5,309 participants, ages 20 to 65, with no history of diabetes or cardiovascular disease. They found that compared to those who drank less than an ounce of soda daily, those who drank an average of 8-ounces of soda experienced an additional 1.9 years of aging. About 21% of the sample consumed on average at least 20-ounces of soda per day. This level of consumption was equivalent to an average of 4.6 years of telomere shortening. This effect on telomere length is comparable to the effect of smoking, and to the effect of regular exercise in the opposite, anti-aging direction.
What to do: Quit the sugary drinks already! Diet drinks did not appear to be associated with telomere length so opt for these when you really need something sweet but most of the time, opt for water. Try flavoring water or seltzer with lemon, oranges, mint, a splash of juice, cucumbers, or herbal tea to keep your taste buds satisfied. In addition to consuming a healthy diet rich in fruits and vegetables and low in sugar, maintaining a healthy weight, getting adequate sleep, exercising regularly, minimizing stress, and not smoking help to preserve telomere length.
Adapted from articles available at:
Leung CW, Laraia BA, Needham BA, Rehkopf DH, Adler NE, Lin J, Blackburn EH, Epel ES. Soda and cell aging: Associations between sugar-sweetened beverage consumption and leukocyte telomere length in healthy adults from the national health and nutrition examination surveys. American Journal of Public Health. 2014. doi: 10.2105/AJPH.2014.302151
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 4:48 PM
Wednesday, October 22, 2014
The Mediterranean diet is a way of eating rather than a formal diet plan. It is based on the dietary traditions of the island of Crete in Greece circa 1950. At this time, the rates of chronic disease there were among the lowest in the world, and adult life expectancy was among the highest, even though medical services were limited.
The Mediterranean Diet emphasizes fruits, veggies, whole grains, beans, nuts, olive oil; eating fish two or more times a week; enjoying poultry, eggs, cheese, and yogurt in moderation; and saving sweets and red meat for special occasions. Top it off with a splash of red wine (if you want). Remember to stay physically active, and you’re set.
Health Benefits of the Mediterranean Diet
There has been a lot of research on the potential health benefits of following the Mediterranean diet. Many large studies link the Mediterranean diet with reduced rates of heart disease, diabetes, stroke, rheumatoid arthritis, Alzheimer's, Parkinson's', and many types of cancer. Even when one already has heart disease, adopting the Mediterranean diet is associated with lower rates of heart attacks and other complications.
What about the diet makes it so healthy? It appears to reduce systemic inflammation in the body. Its plentiful legumes, fruit, and vegetables deliver ample phytonutrients rich in antioxidants as well as heart healthy minerals such as potassium and magnesium. The fats in the diet come primarily from olives, nuts, and avocados. These foods are rich in monounsaturated fats that have been shown to have a positive effect on blood cholesterol. Olive oil, in particular appears to have unique anti-inflammatory properties, especially when it is combined with raw vegetables. Also, the prominent role of fish in the diet means that it is rich in essential omega-3 fats which have been shown to lower triglycerides, decrease blood clotting, improve the health of your blood vessels, and help moderate blood pressure. Being rich in plant based foods means that the diet is very high in fiber. Fiber helps to slow digestion and moderate the blood sugar rise after meals. This makes it helpful in blood sugar regulation. Also, beans are especially rich in soluble fiber which has been shown to have beneficial effects on blood cholesterol.
HOW TO FOLLOW A MEDITERRANEAN DIET
Eat your fruits & veggies – The cornerstone of the diet is an emphasis on plant-based foods. Fill up on these at every meal. Vegetables are eaten several times per day, raw and cooked. Traditionally, salad greens tossed in oil & lemon accompanied every meal. Use fruits for snacks and dessert.
Use beans daily - Legumes including lentils, chickpeas, and beans are a daily part of the diet. Opt for more vegetarian meals. Legumes are very versatile. They are great in soups, casseroles, spreads/dips (i.e. hummus, black bean dip) and salads. Try roasting chickpeas for nutritious snack.
Make grains whole - Opt for 100% whole grain or whole wheat products. Try to consume grains that have been minimally processed- so, instead of choosing flour-based items try cooking with the intact grain. For example, instead of pasta, try whole grains (such as wild rice, barley, and bulgur) in salads and soups.
Go nuts - Nuts and seeds are an important part of the diet. All types are good sources of fiber, protein and healthy fats. Keep them on hand for a quick snack. Try blended sesame seeds (tahini) with chickpeas as a dip or spread. Avoid candied or honey-roasted and salted nuts.
Choose olive oil instead of butter - Olive oil is the primary source of fat in the diet. "Extra-virgin" (the least processed form) contains the highest levels of protective antioxidants. Use it instead butter or margarine which contain unhealthy saturated fats. For sautéing, choose "light" or "refined" olive oil that is formulated for high heat. The focus of the Mediterranean diet is not about limiting total fat consumption (fats typically make up 25-35% of total calories) but rather on choosing healthier types of fat.
Go fish - Eat fish twice a week or more. Prepare a variety of fish and seafood. Fatty fish — such as mackerel, herring, sardines, tuna and salmon — are rich sources of anti-inflammatory omega-3 fatty acids.
Rein in the red meat, cheese, & sweets - Limit red meat to no more than a few times a month and instead opt for fish, poultry, and/or legumes. When choosing red meat, make sure it's lean and keep portions small (about the size of a deck of cards). Luncheon meats are absent from the diet. Try to avoid processed meats as much as possible as they are particularly linked with heart disease and increased mortality. While we think of Mediterranean food as rich in cheese, cheese is also very high in saturated fat and the traditional diet only contained very limited amounts. Also watch out for sugar. Refined sugars and sweets are rarely eaten and reserved for special occasions. Instead of ice cream or cake, opt for strawberries, fresh figs, grapes, or apples.
Smell the roses - The traditional Mediterranean diet was accompanied by a heart healthy lifestyle. Daily activity, sharing meals and enjoying the company of loved ones, and minimizing stress are all vital to long-term heart health. Our hectic lives are a long way from Crete in the 1950's but challenge yourself to find ways to incorporate exercise, healthy social interactions, and quiet moments to release stress into your life. Small changes can be significant and easier to fit in than you might think. Take the stairs. Eat lunch outdoors at a nearby park. Use part of your lunch hour to take a 15 minute stroll with a friend. Step away from the electronics (TV, smart phone, computer) during meals. Limit screen time during leisure hours. Go for a walk with your kids or friends after dinner. Take a mindful moment and belly breath ten times.
Wednesday, October 8, 2014
A set of intriguing but preliminary studies on mice and humans suggests that consumption of artificial sweeteners may impair the body's ability to regulate blood sugar. The studies also suggest that this disruption of blood sugar control is due to changes in intestinal bacteria caused by artificial sweeteners. Artificial sweeteners have typically been recommended to persons with diabetes and excess weight because, unlike sugar and other natural sweeteners, they contain no calories or carbohydrates. However, if the results of these studies hold true in future investigations, than artificial sweeteners may actually cause metabolic changes that increase the risk for diabetes.
First, the researchers added three artificial sweeteners, either sucralose (Splenda), aspartame (Equal), or saccharin (Sweet n' Low), to the water of three groups of mice. Three other control groups of mice were given normal water or water with added sucrose or glucose. 11 weeks later, the mice consuming artificial sweeteners exhibited glucose intolerance (a condition in which there are greater blood sugar increases and a reduced capacity to lower blood sugar after a meal).
The researchers then tested whether gut bacteria changes might be responsible for the metabolic changes of the mice fed the artificial sweeteners. When they gave the artificial sweetener fed mice antibiotics that eliminated the bacteria living in their intestines, they found that the metabolic problems went away. Researchers also found they could glucose intolerance in healthy mice never exposed to artificial sweeteners by transplanting gut bacteria from the mice who had been fed saccharine. Researchers hypothesize that when gut bacteria come into contact with artificial sweeteners, they produce substances that increase bodily inflammation and glucose intolerance. Notably, the changes researchers observed in the gut bacteria of the mice consuming artificial sweeteners resembled the patterns of microbiota that are observed in mice with obesity and diabetes. A previous study found similar changes in the microbiota of rats given sucralose (Splenda).
The researchers then evaluated a group of nearly 400 people who were long-term users of artificial sweeteners. The researchers found that they were more likely to have glucose intolerance compared with people who don't normally use such sweeteners. In a small follow-up experiment, the researchers tested blood sugar levels of seven people who don't normally consume artificial sweeteners. The researchers found that four of these people had higher fasting blood sugar levels and greater glucose intolerance after consuming the U.S Food and Drug Administration's maximum recommended daily amount of saccharine (equivalent to 8.5 packets of Sweet n' Low) for six days straight .
Previous studies on the health effects of artificial sweeteners have yielded conflicting findings. Some have found the sweeteners were associated with weight loss while others have found the exact opposite, that people who drank diet soda actually weighed more and had higher rates of excess weight and diabetes, but this may be due to the fact that persons using artificial sweeteners are doing so because they are overweight. A recent observational study involving more than 300,000 people showed no association between consumption of artificially sweetened drinks and the development of diabetes.
What to do: Certainly much larger studies on humans need to be conducted before definitive conclusions about the effect of artificial sweeteners on gut bacteria and glucose intolerance can be made. Meantime, a single 20-ounce regular soda has nearly 20 teaspoons of sugar and there is ample evidence that consumption of sugary drinks is strongly linked to excess weight which drives the development of diabetes. So, diet drinks are likely a better alternative to regular sweet drinks if you must consume them. But, your best bet is to drop the sweet tasting drink habit and go for water. For added taste appeal, try flavoring water or seltzer with lemon, oranges, mint, a splash of juice, cucumbers, or herbal tea.
Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014;514;181-186. DOI: 10.1038/nature13793
Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, et al. Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. Journal of Toxicology & Environmental Health. 2008;71(21):1415-29. DOI:
Adapted from articles available at:
Tuesday, September 23, 2014
A large new study adds to the body of evidence showing diets rich in potassium reduce blood pressure and stroke risk. The study tracked more than more than 90,000 postmenopausal women aged 50 to 79 for an average of 11 years. Researchers found women who consumed the most potassium were 10% less likely to die during the study period and 12% less likely to suffer a stroke compared to those who ate the least potassium.
Potassium is an important mineral that helps the body maintain a balance of fluid and minerals. It also helps blunt some of the harmful effects of sodium on blood pressure. In the study, the average daily intake of potassium was just over 2,600 mg per day. The lowest potassium group consumed less than 1,925 mg daily. The highest group consumed more than 3,194 mg per day. More than 97% of women in the study did not get the recommended 4,700mg of daily potassium in their diets.
What to do: Like the study participants, most Americans do not get adequate potassium. In 2012, the U.S. Centers for Disease Control and Prevention found that fewer than 2% of Americans consume the recommended 4,700mg of potassium daily. So, make a point of including plenty of high potassium foods in your diet. The foods richest in potassium are fruits, vegetables, beans, nuts, and dairy. Particularly good fruit and veggie options include bananas, citrus, apricots, melons, kiwis, tomatoes, Swiss chard, Romaine, turnip greens, spinach, collard greens, kale, broccoli, Brussels sprouts, yams, and potatoes. Always talk to your health care provider before taking potassium supplements as too much potassium can be dangerous for persons with certain health conditions and/or medications.
Adapted from articles available at:
Blanch N, Clifton PM, Petersen KS, et al. Effect of high potassium diet on endothelial function. Nutrition, Metabolism, and Cardiovascular Diseases; Sept 2014,Vol 24(9), pgs 983-989. DOI: 10.1016/j.numecd.2014.04.009
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 1:47 PM
Wednesday, September 10, 2014
A new analysis of 16 studies including nearly 900,000 subjects from around the world finds that having pre-diabetes is associated with an increased the risk of many types of cancer. Researchers found that people with pre-diabetes had a 15% increased risk of cancer overall and specifically pre-diabetes increases the risk of stomach, colorectal, liver, pancreas, breast and endometrial cancers.
People with pre-diabetes have blood sugar levels that are higher than normal, but not high enough to be considered full-blown diabetes. An estimated 36% of adult Americans currently have pre-diabetes and this percentage is expected to rapidly rise in the coming decade. The increased risk remained even after controlling for overweight/obesity, an important risk factor for many types of cancer as well as diabetes.
There are several reasons why pre-diabetes and cancer appear to be linked. Chronically elevated blood sugar increases oxidative stress on the body and depresses the immune system increasing the likelihood that cancer will take hold. Additionally, the accumulation of advanced glycated end-products that are the result of high blood sugar are believed to be carcinogenic. Additionally pre-diabetes is characterized by insulin resistance in which the body must produce much more insulin than normal. Excess insulin is known to promote cancer cell growth and division. On the plus side, the drug metformin, a first line therapy for pre-diabetes that decreases high blood sugar and insulin resistance, has been found to decrease cancer risk among diabetics by as much as 30%.
What to do: Most people with pre-diabetes do not know they have it. Keep up to date with your healthcare to ensure you are being screened for pre-diabetes. Excess weight and inactivity are two of the most important risk factors for pre-diabetes (as well as most other chronic diseases). So, eat healthier and get moving! Losing as little as 7% of body weight and getting in 30 minutes of moderate physical activity (such as brisk walking) five days a week has been shown to be quite effective at preventing and improving pre-diabetes.
Adapted from articles available at:
Huang Y, Cai X et al. Prediabetes and the risk of cancer: A meta-analysis. Diabetologia, September 2014. DOI: 10.1007/s00125-014-3361-2
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 12:07 PM
Wednesday, August 27, 2014
A new study performed in mice has found that the presence of Clostridium gut bacteria plays an important role in preventing the development of food allergies. In recent years, food allergy rates among children in the US have risen sharply -- increasing approximately 50% between 1997 and 2011. Studies have shown a correlation between antibiotic and antimicrobial use and risk of food allergens, suggesting that disruptions of the body's microbiota, the population of bacteria that naturally live in and on people, might play a role in the development food allergies.
To see how changes in the microbiota of the intestines might influence allergic responses to food, researchers compared the immune response to peanuts (one of the most allergenic foods) of germ-free mice (mice reared in sterile conditions so that they have no microbes inside them), mice treated with antibiotics as newborns (these which have significantly reduced gut bacteria levels), and mice with normal gut bacteria. When exposed to peanut proteins, the immune systems of both the sterile mice and the antibiotic treated mice exhibited much stronger antibody responses than the immune systems of mice with normal microbiota.
The scientists then investigated which types of gut bacteria, if any, could be given to mice to prevent them from developing peanut allergies. They found that when a class of bacteria called Clostridia was implanted into the mice's intestines, it could both prevent these mice from developing a peanut allergy and reverse any sensitivity they had to peanut allergens. Clostridia are a highly diverse class of bacteria common in humans. Further investigations revealed that the presence of the Clostridia triggers the body's release of molecules that decrease the permeability of the gut lining and thus prevent antigens from entering the bloodstream where sensitization to allergens occurs.
What to do: These results highlight just how integral healthy gut bacteria are to the proper development and functioning of our immune systems. Take care of your microbiota by consuming a healthy diet rich in fibers (these feed our natural bacteria) and cultured foods such as yogurt (these contain healthy bacteria), and by only using antibiotics when prescribed by a physician.
Adapted from articles available at:
Stefka AT, Feehley T, Tripathi P et al. Commensal bacteria protect against food allergen sensitization. Proceedings of the National Academy of Sciences, 2014; DOI: 10.1073/pnas.1412008111
Kalliomäki M, Isolauri E. Role of intestinal flora in the development of allergy. Current Opinion in Allergy and Clinical Immunology. 2003 Feb;3(1):15-20. Available at: http://www.medscape.com/viewarticle/448473_5
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 11:52 AM
Tuesday, August 26, 2014
A new study has found that not only does eating better and exercising improve diabetics' quality of life but it also saves them hundreds in out of pocket healthcare costs each year. Diabetes is an expensive disease. Patients must obtain medications plus blood sugar testing equipment and strips, and they often have diabetes-linked complications that involve hospitalizations and/or surgery. Nationally, total healthcare costs related to diabetes are estimated to be $245 billion annually and this value is expected to rapidly rise as an estimated 35% of U.S. adults now have pre-diabetes.
This analysis, led by Dr. Mark Espeland, evaluated medical histories for over 5,000 obese and overweight type 2 diabetes patients, ranging in age from 45 to 76, who were participating in the Look AHEAD intervention by the Center for Disease Control. In this trial, participants, were randomly assigned to either an intensive "lifestyle change program" focused on diet and exercise, or to a standard diabetes support and education program.
Over 10 years of follow-up, the patients in the intensive lifestyle change group had higher levels of physical activity and maintained a lower body weight, resulting in better diabetes control, blood pressure, sleep, physical function and fewer symptoms of depression. The lifestyle change intervention group also had 11% fewer hospitalizations, 15% shorter hospital stays, and fewer prescription medications than those in the diabetes support and education program. Those benefits led to an average savings of $5,280 in health-care costs per person over 10 years, or about $528 a year. Researchers reported that the cost savings for people in the lifestyle intervention gro up were similar regardless of age, initial weight, gender or race.
What to do: Modest lifestyle changes can make a big difference in your health. Results from the LookAHEAD trial indicate that losing as little as 7% of body weight and getting in 30 minutes of moderate physical activity (such as brisk walking) five days a week can help prevent or delay type 2 diabetes by up to 58%. So, to save your health and your wallet, challenge yourself to make some healthy changes! The curriculum from the Look AHEAD trial is available online at Lookaheadtrial.org. Or, for personalized help with these changes, see NYCC's in-house dietitian.
Adapted from articles available at:
Espeland MA et al. Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: The Action for Health in Diabetes. Diabetes Care, August 2014 DOI: 10.2337/dc14-0093 1935-5548
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 11:02 AM
Tuesday, August 5, 2014
A new study has found that major stressful events such as the loss of a job or the death of a loved one accelerate aging at the cellular level. But, individuals who maintain healthy patterns of diet, activity, and sleep minimize the damage that major stressors exert on our cells.
Researchers assessed cellular "aging" by measuring telomere length. Telomeres are the protective caps at the ends of chromosomes that affect how quickly cells age. They are combinations of DNA and proteins that protect the ends of chromosomes and help them remain stable. As they become shorter, and as their structural integrity weakens, the cells age and die quicker. In recent years, shorter telomeres have become associated with a broad range of aging-related diseases, including stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis diabetes, and many forms of cancer.
In the study, researchers tracked physical activity, dietary intake and sleep quality of 239 post-menopausal, non-smoking women for one year. The women provided blood samples at the beginning and end of the year for telomere measurement and reported on any stressful events that occurred. length Among women who had lower levels of healthy behaviors, for every major life stressor that occurred during the year there was a significantly greater decline in telomere length. Yet women who maintained active lifestyles, healthy diets, and good quality sleep appeared protected when exposed to stress -- accumulated life stressors did not appear to lead to greater shortening.
What to do: While we cannot avoid experiencing stressful events, we can make an effort to maintain healthy behaviors even when experiencing stress. Building healthy habits into your life situation such as meal planning, minimizing TV time (less TV is associated with more sleep), and establishing convenient ways to get activity (such as getting a treadmill) can help you weather stressful times while not abandoning healthy behaviors.
Adapted from articles available at:
Puterman E, Lin J, Krauss K, Blackburn EH, Epel ES. Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter. Molecular Psychiatry, 2014; DOI: 10.1038/mp.2014.70.
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 3:43 PM
Tuesday, July 15, 2014
An interesting new study has found that increased stress levels take a toll on metabolic rate. The recent study included 58 women, with an average age 53, who were asked about their stress levels the previous day and then given a meal that included 930 calories and 60 grams of fat. After the meal, participants’ metabolic rate was tested for 20 minutes of every hour for the next seven hours. Researchers also measured blood levels of glucose, triglycerides, insulin and the stress hormone cortisol. On average, the women in the study who reported one or more stressors during the previous 24 hours burned 104 fewer calories than non-stressed women in the seven hours after eating the high-fat meal -- a difference that could result in weight gain of almost 11 pounds in one year. The women who had experienced a previous day stressor also had higher levels blood insulin after the meal. When there are excess levels of insulin nutrients are less likely to be used for fuel and more likely to be stored as fat.
There is ample evidence that persons who are chronically stressed are more likely to have unhealthy weight gain. Much of this gain has been attributed to emotional eating. Previous studies have shown that when individuals are stressed they tend to crave foods high in carbohydrates and fat -- comfort foods. While food choices often do become less healthy in times of stress, this study, though small, also demonstrates there is a direct metabolic cost to being stressed.
What to do: Knowing that stress interferes with our metabolism, it is all the more important to make healthier decisions in times of stress. While we cannot always avoid stressors, we can work to make our food environment supportive. By keeping healthy options available, we are more likely to ride out stressful times without resorting to poor food choices. We can also work to develop non-food based coping strategies such as journaling, mindful breathing, and physical activity.
Adapted from articles available at:
Kiecolt-Glaser JK, Habash DL, Fagundes CF, Andridge R, Peng J, Malarkey WB, Belury MA. Daily stressors, past depression, and metabolic responses to high-fat meals: a novel path to obesity. Biological Psychiatry, 2014; DOI: 10.1016/j.biopsych.2014.05.018
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 2:49 PM
Wednesday, July 9, 2014
A new review of existing research finds that combined aerobic and resistance training, rather than either alone, is best for controlling both blood sugar and blood fat profiles among people with type 2 diabetes. Researchers analyzed data from 14 experimental trials that included more than 900 people with type 2 diabetes. The studies looked at the role of aerobic or resistance training (such as weightlifting) in improving diabetics' health.
Compared with either aerobic or resistance training alone, a regimen that combined both types of workouts was more effective in controlling blood sugar, blood fats (cholesterol and triglycerides), blood pressure and weight. Aerobic activity alone was more effective than resistance activity alone in improving metabolic parameters but certainly not as effective as doing a the combination of cardio and resistance work.
Studies have consistently found that both forms of exercise are good for metabolic health but in different ways. Resistance training builds muscles and thereby increases glucose utilization through increased muscle mass. Aerobic training utilizes blood sugar to fuel activity and also appears to improve muscle cell's sensitivity to insulin for as much as 24-hours after the activity. Insulin sensitivity is especially responsive to vigorous aerobic activity.
While researchers found that a combination of aerobic and resistance activity yields the best health results, they also stressed that there is significant evidence that any regular exercise regimen is helpful to diabetic health. Unfortunately, a growing number of Americans, are not exercising at all. In another recent analysis, U.S. government data from the last 20 years revealed that the number of women who reported no physical activity rose from about 19% in 1994 to nearly 52% in 2010 and the number of men not exercising increased from about 11% to about 43%. Black and Mexican-American women showed the greatest decreases in reported exercise. Over this same period, there were marked increases in adults' average body mass index (BMI), an estimate of body fat based on height and weight, with the most dramatic rise among women aged 18 to 39.
What to do: If you have health problems, always consult your healthcare provider before increasing activity. Then, get moving! Work up to doing aerobic activity, such as brisk walking, at least 150 minutes per week and try to do strength exercises three times per week. No time for exercise? Americans watch, on average, 3 hours of television daily - make a push to swap up TV for activity and your health will improve.
Adapted from articles available at:
Schwingshackl L, Missbach B, Dias S, König J, Hoffmann G. Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetologia, 2014; DOI: 10.1007/s00125-014-3303-z
Hannley PP. Move more, eat less: It’s time for Americans to get serious about exercise. The American Journal of Medicine, 2014; DOI:10.1016/j.amjmed.2014.05.026
Ladabaum U, Mannalithara A, Myer PA, Singh G. Obesity, abdominal obesity, physical activity, and caloric intake in U.S. adults: 1988-2010. The American Journal of Medicine, 2014; DOI:10.1016/j.amjmed.2014.02.026
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 10:59 AM