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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, July 15, 2014

STRESSORS INTERFERE WITH METABOLIC RATE AND INCREASE BLOOD INSULIN LEVELS

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:
http://www.nlm.nih.gov/medlineplus/news/fullstory_147297.html
http://medicalcenter.osu.edu/mediaroom/releases/Pages/Stress-and-High-Fat-Foods.aspx
http://www.sciencedaily.com/releases/2014/07/140714100128.htm

Source:

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

Wednesday, July 9, 2014

COMBINATION OF CARDIO AND STRENGTH TRAINING MOST EFFECTIVE FOR DIABETICS' HEALTH

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:
http://www.nlm.nih.gov/medlineplus/news/fullstory_147121.html
http://www.nlm.nih.gov/medlineplus/news/fullstory_147192.html
http://www.medicaldaily.com/diabetes-management-use-aerobic-and-resistence-training-combination-exercises-more-effective-either
http://www.sciencedaily.com/releases/2014/07/140707134243.htm
http://www.latimes.com/science/sciencenow/la-sci-sn-lack-of-exercise-linked-to-rise-in-obesity-20140707-story.html

Sources:
Schwingshackl L, Missbach B, Dias S, K├Ânig 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


Tuesday, July 8, 2014

ALL ABOUT HEALTHY GUT BACTERIA: PROBIOTICS, PREBIOTICS, AND YOUR MICROBIOME

Making themselves at home, inside your intestinal tract, are some 100 trillion living microorganisms. These gut bacteria, collectively known as your “microbiome,” are so abundant that they outnumber all the cells in your body by 10 to one.  The 400+ different strains of bacteria that inhabit your gut help you digest food and are essential in synthesizing essential nutrients including vitamins K, B12, thiamin and riboflavin. They also defend against infections caused by harmful bacteria.  But the function our microbiome goes beyond that of the digestive system.  Emerging research suggests that our microbiome has  a wide-ranging impact on our early development, our behavior, our susceptibility to disease and our ability to recover from disease. Imbalances in our gut bacteria appear to play a role in everything from diarrhea and stomach upset to conditions such as allergies and asthma, autism, attention deficit hyperactivity disorder, mood disorders, acne, obesity, diabetes, heart disease, inflammatory bowel disease and auto-immune disorders.  The more we learn, the more clear it becomes that maintaining a healthy gut bacteria is crucial to our overall health. Here's some things you can do to support your resident microbes.

Eat foods that contain probiotics. Probiotics are live bacteria that are either the same as or similar to the ones found naturally in your gastrointestinal tract. You can help replenish your beneficial bacteria by eating probiotic dairy foods such as yogurt, frozen yogurt, kefir, and buttermilk. Many fermented foods, such as miso, tempeh, and kimchi also contain probiotics.  Some yogurts such as Activia and DanActive have added probiotics but these are not necessarily better than other yogurts.  All yogurts, even those made from dairy substitutes such as soy or almonds, are made with live active bacteria.  The strains used in the product are always listed, usually with the ingredients.  Products made with a greater variety of bacterial strains may offer more probiotic benefits.

Feed your probiotics some prebiotics. Prebiotics are high-fiber foods that feed the good bacteria in your intestines and help them to flourish. Give your probiotics something to chew on by eating food sources rich in soluble fibers and digestion-resistant starches.  Some of the best sources of prebiotics are oatmeal, barley, cooked root vegetables, onions, garlic, beans, avocados, dark leafy greens, bananas (especially green bananas), chicory root, Jerusalem artichokes (sunchokes), and asparagus.

Use antibiotics only when prescribed.  Antibiotics help to kill disease causing bacteria and can be life saving when you have a bacterial infection.  Unfortunately they also kill the healthy bacteria in our system.  Many people take antibiotics when they are sick even though most colds are caused by viruses.  Only take antibiotics when they have been prescribed by your physician.  When you do take antibiotics, it is a good idea to emphasize yogurt in your diet to help restock the healthy bacteria.  You may also want to take a probiotic supplement after a course of antibiotics.   

Consider a probiotic supplement. Talk with your physician or dietitian about whether a probiotic supplement is right for you.  If you suffer from recurring diarrhea or antibiotic-associated diarrhea or vaginal yeast infections, a probiotic supplement may very well help. There is also substantial evidence that gastrointestinal symptoms, such as those associated with irritable bowel syndrome, ulcerative colitis and pouchitis, are helped by probiotic supplements. 
Look for a probiotic supplement that has at least 1 billion CFU's (colony forming units) and that contains a variety of bacterial strains.  The potency of products diminishes over time so check the expiration date.  Products that are refrigerated and packaged in dark glass are likely to be best preserved.  At home, store you probiotics in the fridge, even if they were not refrigerated at the store.  Taking probiotics with food, especially foods that are not acidic such as diary may help them survive the acidity of the stomach.  There are many different types of healthy bacteria and certain strains appear to help with certain conditions.  The  following list is a brief guide to some of the best strains of some different conditions.

Diarrhea from antibiotic usage
  • Lactobacillus rhamnosus GG
  • Saccharomyces boulardii
  • Streptococcus thermophilus
  • Bacillus clausii
  • Lactibacillus acidophilus

Irritable bowel syndrome
  • Lactobacillus plantarum
  • Bifidobacterium infantis
  • Lactobacillus rhamnosus GG
  • Saccharomyces boulardii

Weakened immunity
  • Lactobacillus plantarum
  • Bifidobacterium infantis
  • Lactobacillus salivarius
  • Bifidobacterium bifidum

Lactose(dairy)  indigestion
  • Lactobacillus bulgaricus
  • Streptococcus thermophilus