About Me

My photo
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.

Wednesday, October 22, 2014

MEDITERRANEAN DIET: A HEART-HEALTHY EATING PLAN

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

ARTIFICIAL SWEETENERS MAY IMPACT BLOOD SUGAR CONTROL


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.

Sources:
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: 10.1080/15287390802328630

Adapted from articles available at: