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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.

Wednesday, August 27, 2014

GUT BACTERIA HELP PROTECT AGAINST FOOD ALLERGIES

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:
http://www.sciencedaily.com/releases/2014/08/140825152016.htm
http://www.uchospitals.edu/news/2014/20140825-nagler.html
http://www.healthline.com/health-news/can-gut-bacteria-protect-against-allergies-082514

Sources:
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 Immunology2003 Feb;3(1):15-20.  Available at:  http://www.medscape.com/viewarticle/448473_5

Tuesday, August 26, 2014

GETTING HEALTHIER SAVES DIABETICS MONEY

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:
http://www.nlm.nih.gov/medlineplus/news/fullstory_147988.html
http://www.hngn.com/articles/40024/20140822/healthy-living-reduces-type-2-diabetes-care-costs-by-about-500-a-year.htm
http://www.sciencedaily.com/releases/2014/08/140821153509.htm
Source:
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

Tuesday, August 5, 2014

HEALTHY LIFESTYLE DECREASES CELLULAR AGING CAUSED BY STRESS

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:
http://www.sciencedaily.com/releases/2014/07/140729073524.htm
http://www.foodexposed.co.za/uc-study-reveals-that-accumulative-life-stressors-can-be-modified-by-a-healthy-lifestyle/

Source:

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.

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, 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


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


Wednesday, June 25, 2014

KEEPING INDOOR TEMPS LOWER INCREASES METABOLISM-BOOSTING BROWN FAT

A new small study has found that keeping indoor temperatures lower increases adults’ levels of healthy brown fat.  Brown fat is a specialized type of fat that is very metabolically active and helps to generate body heat.  Brown fat is plentiful in babies but adults have very small amounts.  Prior research has found that persons with greater levels of brown fat are less prone to developing obesity and diabetes.  This small study is one of the first to show that adults are capable of growing additional brown fat and that cooler indoor temperatures stimulate its growth while warmer temperatures cause the loss of this beneficial type of fat.

In this study, 5 healthy men lived in a temperature-controlled environment.  During the day they lived their normal lives but at the end of the day they returned for at least 10 hours to the climate controlled environment.  Temperatures were kept at 75°F during the first month, 66°F during the second month, and then back to 75°F during the third month, and finally up to 80.5°F during the fourth month. Researchers assessed brown fat levels using CT scans, as well as muscle and fat tissue biopsies.   They found that brown fat levels rose by 30-40% during the cool second  month, returned to original levels in the third month, and then fell below original levels in the warmer fourth month. 

Another important result was that participants’ insulin sensitivity (the amount of insulin the pancreas needs to produce to bring blood sugar levels down after a meal) improved as amounts of brown fat increased.  This is a key result because as the body’s cells become insensitive to insulin, diabetes develops.

What to do:  Research in the US indicates that over the last couple decades, target indoor temperatures have risen approximately 6°F.  While this was only a small study, consider keeping indoor spaces cooler. So, to give your metabolism a little boost, turn down the heat and turn up the air conditioner!

Articles adapted from:
http://www.sciencedaily.com/releases/2014/06/140622142228.htm

Source:
Lee P,Smith S, Linderman J, Courville AB, Brychta RJ, Dieckmann W, Werner CD, Chen KY, Celi FS.  Temperature-acclimated brown adipose tissue modulates insulin sensitivity in humans. Diabetes, June 22, 2014 DOI: 10.2337/db14-0513