Can A Low Fat Diet Ward Off Diabetes Without Weight Loss?

HOW your diet affects your health is a big topic in research these days, and this is reflected in the news headlines every week. The problem is that the research findings keep changing the landscape of what’s healthy and what’s not. Eggs were bad, now they’re good. Margarine was good, now it’s bad. Eat low-fat! No, now eat low-carb. For people with no health problems, trying to adhere to the latest dietary advice is simply confusing. For people with chronic conditions such as diabetes, it can be downright dangerous.

So a new research study from the University of Alabama at Birmingham (UAB), which claims that small differences in diet – even without weight loss – can significantly affect risk for diabetes, is bound to raise more questions than it answers.

The unique aspect of this study ‒ published online May 18, 2011, by the American Journal of Clinical Nutrition ‒ is that diabetes risk was reduced independent of weight loss. Received wisdom says overweight individuals can reduce risk of type 2 diabetes by shedding the extra pounds through a combination of diet and exercise.

In the UAB study, 69 healthy, overweight people who did not have diabetes — but were at risk for it — were placed on diets with modest reductions in either fat or carbohydrate for eight weeks. “At eight weeks, the group on the lower fat diet had significantly higher insulin secretion and better glucose tolerance and tended to have higher insulin sensitivity,” said Barbara Gower, Ph.D., professor in the Department of Nutrition Sciences at UAB and lead author of the study. “These improvements indicate a decreased risk for diabetes,” she said in a press statement.

The findings were even stronger in African-Americans, a population with an elevated risk for diabetes. Gower says African-Americans on the lower fat diet showed a stronger difference in insulin secretion compared to the lower carb group, indicating that diet might be an important variable for controlling diabetes risk in that population.

“People find it hard to lose weight,” said Gower. “What is important about our study is that the results suggest that attention to diet quality, not quantity, can make a difference in risk for type 2 diabetes.”

Study participants in the lower fat group received a diet comprising 27 percent fat and 55 percent carbohydrate.  The lower carb group’s diet was 39 percent fat and 43 percent carbohydrate. All food for the eight-week trial was provided by the study.

The study participants were fed exactly the amount of food required to maintain their body weight, and the researchers took into account any minor fluctuations in body weight during analyses. Thus, results from this study suggest that those trying to minimize risk for diabetes over the long term might consider limiting their daily consumption of fat at around 27 percent of their diet.

“The diets used in this study were actually fairly moderate,” said UAB dietitian Laura Lee Goree, R.D., L.D., a study co-author. “Individuals at risk for diabetes easily could adopt the lower fat diet we employed.  Our findings indicate that the lower-fat diet might reduce the risk of diabetes or slow the progression of the disease.”

But then, widely cited research studies also suggest that a low fat, high carb (LFHC) diet causes the following problems:

• Elevates triglycerides, lowers HDL (“good” cholesterol)

• Is ineffective for people with high insulin levels

• Increases insulin levels which spikes blood pressure

• Leads to greater risk for age-related macular degeneration (AMD)

The American Diabetes Association says millions of Americans are unaware they are at high risk with some groups having a higher risk for developing Type 2 diabetes, especially African-Americans, Latinos, Native Americans and the elderly.

It would therefore be premature to jump the gun to think that one can avoid the risk of diabetes without shedding weight by limiting fat intake. Gower rightly says further research is needed to determine if the difference between diets in carbohydrate or fat was responsible for the differences in the measures of glucose metabolism and probe the potential cause-and-effect relationship between insulin and glucose responses to the diets.

In the meanwhile, the best ways to maintain good health, diabetes or no, is to exercise, limit processed and refined foods, focus on fish, and eat a wide variety (and an abundance) of plant foods.

And shedding weight ‒ even if there’s no risk of developing diabetes ‒ will always remain a good idea.

Source: UAB News

Related Posts:

How Fatty Foods Lead To Diabetes

Is the ADA Shifting its Stance About Carbs?

“Breakthrough Medical Food Combined With Low-Glycemic Diet Almost Twice As Effective As One Of The Best Diets Alone For Lowering Diabetes Risk Factors”

Study reminds physicians that the option of prescribing medical food should be considered

The Centers for Disease Control and Prevention (CDC) in the U.S., says chronic illness affects nearly half of all adults and contributes to seven out of 10 deaths. Even more alarming, chronic illness costs Americans more than $1.5 trillion annually in direct medical costs. It is for these reasons researchers and others in the medical profession believe that re-focusing medical practice treatments on the provision of lifestyle therapy will not only significantly improve the health status of most people, but will reduce costs.

The efficacy of lifestyle intervention in reducing the incidence of type 2 diabetes has been established by the Diabetes Prevention Program and other studies. Recently researchers at the University of Florida announced that a program consisting of a breakthrough medical food combined with a low-glycemic, Mediterranean-style diet is almost twice as effective as one of the best diets alone for lowering risk factors for type 2 diabetes and cardiovascular disease.

The results of the multicenter trial have been published in the May/June issue of the Journal of Clinical Lipidology, a publication of the National Lipid Association. The study was sponsored by Metagenics Inc.

As more countries adopt Western dietary habits and sedentary lifestyles, the number of chronic illnesses such as type 2 diabetes, obesity, heart disease, arthritis and autoimmune diseases has increased. Citing the findings of the multicenter research, Metagenics claims its medical food UltraMeal PLUS 360° is 40 percent more likely to resolve metabolic syndrome.

The company’s press release says researchers believe that patients who incorporate the medical food into their diets as well as make necessary lifestyle changes can improve their health faster than by using a Mediterranean diet alone.

Medical foods are foods that are specially formulated and intended for the dietary management of a disease that has distinctive nutritional needs that cannot be met by normal diet alone. They were defined in the Food and Drug Administration’s 1988 Orphan Drug Act Amendments and are subject to the general food and safety labeling requirements of the Federal Food, Drug, and Cosmetic Act. Medical foods are distinct from the broader category of foods for special dietary use and from traditional foods that bear a health claim.

The Mediterranean diet is a pattern marked by daily consumption of fruits, vegetables, whole grain cereals, and low-fat dairy products; weekly consumption of fish, poultry, tree nuts, and legumes; high consumption of monounsaturated fatty acids, primarily from olives and olive oils; and a moderate daily consumption of wine or other alcoholic beverages, normally with meals. Red meat intake and processed foods are kept to a minimum. For these reasons, this diet has been known for long to reduce the risk of metabolic syndrome.

Metabolic syndrome − increasingly common in the United States − occurs if someone has three or more of the following five conditions: blood pressure equal to or higher than 130/85, fasting blood glucose equal to or higher than 100 mg/dl, a waist measuring 35 inches or more in women and 40 inches or more in men, a HDL (“good”) cholesterol under 40 in men and under 50 in women, triglycerides equal to or higher than 150 mg/dl.

The multicenter trial’s requirements were based on standards set forth in the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults – Adult Treatment Panel III (NCEP-ATPIII) criteria. Participants with heart, liver or kidney disease or who were using blood sugar or cholesterol-lowering agents were excluded. Those with type 2 diabetes were not excluded.

The clinical trial, which was conducted at three universities − University of Connecticut at Storrs, University of Florida at Jacksonville, and University of California at Irvine − consisted of 89 women between the ages of 20 and 75. To be eligible for the study, the candidates had to have a LDL-C (low-density–lipoprotein cholesterol) of more than 2.59 mmol/l (100 mg/dl), TG (triglycerides) equal to or greater than 1.70 mmol/l (150 mg/dl), and meet two of the four remaining criteria for metabolic syndrome.

“Chronic illness is draining our healthcare resources and keeping millions of people from enjoying healthy, vibrant lives. Many of these illnesses are the result of long-term lifestyle and behavior choices,” said Robert H. Lerman, MD, PhD, director of medicine and extramural clinical research for Metagenics Inc. “This study is important because it shows how effective UltraMeal PLUS 360°is in resolving metabolic syndrome and cardiovascular risk factors in affected individuals, and identifies a powerful new approach to combating chronic illness.”

“Preventing chronic illness is far more effective from both a cost and treatment perspective than treating the illness once it develops,” said Lerman. “Physicians have evidence-based research that now enables them to actually use lifestyle therapy in their patients to help them avoid chronic illness by treating the cause, not just the symptoms of these conditions.”

“It’s very important for physicians to learn about these new findings. Doctors have not been trained to take a therapeutic lifestyle approach with patients who have metabolic syndrome,” said Mark S. McIntosh, MD, one of the principal researchers who is the Director of Corporate Wellness and Assistant Professor in the Department of Emergency Medicine at the University of Florida – Jacksonville. “Programs like Metagenics’ FirstLine Therapy are needed to provide the tools and support for physicians to change the way they practice and to help patients make real lifestyle changes.”

Both doctors believe that this research underscores the importance of the science of how nutrition impacts genetic expression and its potential to improve health and avoid chronic illness. “Patients who incorporate the medical food along with lifestyle therapy get healthier quickly and safely,” Lerman said.

“Most physicians are accustomed to prescribing drugs for people with lifestyle-related conditions, even though the first line recommended course of treatment is lifestyle therapy,”  said Dr. Wayne S. Dysinger, current president of the American College of Lifestyle Medicine and chair of the Department of Preventive Medicine at Loma Linda University in Loma Linda, California.

“This study reminds physicians that the option of prescribing food, in this case a medical food, should be considered.  It demonstrates the ability of medical foods to reduce risk factors and improve health. The study results are a valuable addition to research on the impact of nutrition on health,” Dysinger added.

In addition to Dr. McIntosh, the other two principal researchers are Maria Luz Fernandez, PhD, Professor in the Department of Nutritional Sciences at the University of Connecticut, Storrs and Wadie I. Najm, MD, Clinical Professor in the Department of Family Medicine at the University of California, Irvine.

Note: This post is for information only. Trade, proprietary, or company names appearing in this article have been used only in the context of the information provided by Metagenics Inc. I do not endorse the products mentioned in the report.

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Diabetic Diet: Is Determining Glycemic Load Better Than Counting Carbs?

 

 

 

 

 

 

 

To count carbs or discount them ‒ the debate continues. Being type 2 insulin dependent, I’m trying to make sense of the differing conclusions of two studies that have been published recently. It’s hard to say what these studies really show ‒ it can get confusing with all the information out there ‒ especially when pilaf (pilao) is on Sunday’s lunch menu!

Dr. Andrea Laurenzi of San Raffaele Vita-Salute University in Milan suggests that diabetes patients may benefit from counting the number of carbohydrates in their diet. In a small study ‒ published online in the America Diabetes Association journal Diabetes Care ‒ the Milan researchers looked at 61 adults on insulin pump therapy and found that those who learned to count carbs had a small reduction in weight and waist size after 6 months. Additionally, they reported gains in quality of life and an improvement in blood sugar levels.

On the other hand, Jiansong Bao at the University of Sydney in Australia, says the number of carbs alone might not be the best way to go. Writing in the American Journal of Clinical Nutrition, he feels that how many carbs you eat might be less important for your blood sugar than your food’s glycemic load, a measure that also takes into account how quickly you absorb those carbs.

Dr. Sanjeev Mehta, of the Joslin Diabetes Center and Harvard Medical School in Boston says while Laurenzi’s findings do not prove that carb counting is the answer for people with type 1 diabetes, it is widely recommended that people on insulin try to estimate the carbohydrate content of their meals to help calculate their insulin doses. Indeed, a few other studies too have suggested that carbohydrate counting can help people with type 1 diabetes control their blood sugar levels.

There are books and online resources available for people who are interested in learning how to count carbs. However, some people have difficulty learning or sticking with the method, Mehta noted, and benefit from help from a professional, such as a dietitian or certified diabetes educator.

Mayo Clinic nutritionist Katherine Zeratsky, R.D., L.D. explains counting carbohydrates is a method for controlling the amount of carbohydrates you eat at meals and snacks. This is because they have the greatest impact on your blood sugar. Eating consistent amounts of carbohydrates every day helps you control your blood glucose level.

But carbohydrates aren’t the only dietary consideration when you have diabetes. You need to also limit fat and cholesterol and control the number of calories you consume. The best way to do this is to control portion sizes, she says.

“Eating a healthy diet helps you control your diabetes and reduces your risk of diabetes-related conditions, such as heart disease and stroke. So, just because a food contains no carbohydrates doesn’t mean that you can eat it in unlimited amounts,” she cautions.

However, Bao claims the so-called glycemic load of a food, which also takes into account how quickly it makes the blood sugar rise, might work better. Foods with soluble fiber, such as apples and rolled oats, typically have a low glycemic index, one of the contributors to glycemic load. Foods with a low glycemic index cause the blood sugar to rise slowly, and so put little pressure on the pancreas to produce insulin.

The glycemic load is calculated by multiplying the amount of carbs in grams per serving by the food’s glycemic index divided by 100. (The glycemic index for a variety of foods can be found here.)

The Sydney researchers say their findings also suggest that eating foods with high glycemic loads could be linked to chronic disease like type 2 diabetes ‒ which does not require insulin injections ‒ and heart disease by raising blood sugar and insulin levels.

The researchers took finger-prick blood samples from 10 healthy young people who ate a total of 120 different types of food ‒ all with the same calorie content. They also had two groups of volunteers eat meals with various staples from the Western diet, such as cereal, bread, eggs and steak. And the glycemic load repeatedly trumped the carb count in predicting the blood sugar and insulin rise after a meal.

A Reuters report quotes Dr. Edward J. Boyko ‒ a diabetes expert at the University of Washington in Seattle who wasn’t involved in the Sydney study ‒ saying it wasn’t certain the findings would hold up in people who aren’t completely healthy, adding, long-term effects and other nutrients in the food might also be important for disease risk.

“It would just be speculation whether a dietary change like this would help people with type 2 diabetes.” The most important problem, Boyko points out, remains pure and simple overeating. “The excess weight is the main thing we ought to focus on…The simplest message would be, eat less.”

Diabetes: Is the ADA Shifting its Stance About Carbs?

Carbohydrates are a very touchy subject with diabetics. And for me at least, understanding carbs in a diabetic diet is more difficult than quantum mechanics (or double-entry accounting if you’re not a science type). Diabetologists and dieticians, too, have differing views. I found this article by LAURA DOLSON very instructive and am reproducing it here for those who may have missed it. You can find the lively discussion that followed the article’s publication here.

You may be surprised to know that for the past couple of decades, the American Diabetes Association has been sort of a cheerleader for carbs. Yes, I’m talking about the organization who’s mission it is to promote education and research in ways aimed at preventing diabetes and alleviating the suffering of diabetics.

What is diabetes? It is essentially a disorder of the body’s ability to process carbohydrates. This includes Type 1 and Type 2 diabetes, pre-diabetes, metabolic syndrome, insulin resistance, and all the other points on the diabetes spectrum. (The Endocrine Society suggests that anyone with a fasting blood glucose of 89 or above is at risk for damage to their health.)

In light of this, you’d think that limiting carbohydrate intake would be a priority in educating people about handling these disorders. And yet, the ADA jumped right onto the Food Pyramid bandwagon and began to advise people to get at least 55% of their calories from carbohydrate, such as in the Food Pyramid for Diabetes (see illustration above).

In 2008, they made one exception: diabetics trying to lose weight could follow a low-carb diet for up to one year; this was later loosened further to two years. But still they did not recommend a low-carb diet for health, blood sugar control, or preventing progression of the diabetes.

Now, in the March 2011 edition of the ADA magazine “Diabetes Forecast” are three rather remarkable articles. The first is called The “ADA Diet” Myth, which claims that there is no such thing as the ADA Diet! (Who else was having this hallucination?) Instead, Stephanie Duncare, director of nutrition and medical affairs for the ADA says, “For more than 15 years now, ADA has recognized that people with diabetes should eat in a way that helps them reach their blood glucose, cholesterol, blood pressure, and weight goals. For some, this means a relatively higher-carbohydrate diet, and for others, the diet may be lower in carbohydrate”. Well, hallelujah to that, especially if the goal is “normal blood glucose” (normal meaning “a blood glucose level that will not cause further damage in the pancreas”).

Even more bold is an article called, “Are Carbs the Enemy?” which attempts to cover the debate. They first present a sort of wimpy pro-carb stance. This section of the article has a notable absence of anything to do with science, instead relying on statements such as “Gone are the days of ‘diabetic diets’ that were meager and confining” and “as long as people eat less or cover their carb intake with medications, they can keep blood glucose levels in check with a healthy diet” (“healthy” in this case meaning “high-carb”).

The article then goes on to describe a low-carb approach, citing Dr. Richard Bernstein. This section cites actual evidence, and makes what I think is a much stronger case for controlling blood glucose by limiting carbohydrates. The article goes on to a section on saturated fats which is much more balanced than usual, and then the normal “we don’t have the long-term studies”. The article concludes with the statement: “In the end, the best diet is the healthy one you’re able to follow.”

The only thing I would add is that people need support in making those changes, and as far as I can tell they are still leaving an awful lot up to the individual to figure it out for themselves. There has been quite a defeatist attitude coming from the organization that is supposed to be helpful – along the lines that it is asking just too much of people to cut carbs in any significant way. Are dietitians now actually going to support people in finding a diet that achieves as close to a normal blood glucose as possible? It would be a very big change if this happened any time soon.

But wait, there’s more! A follow-on short piece called “Eating With Diabetes: 3 Approaches” lists the low-carb approach first, and then follows with “Moderate-Carb” and “Vegan/High-Carb”. The weird thing is that the three approaches are described as “less than 10% carb”, “40-50% carb” and “75% carb”. What about people who normalize their blood glucose with 20% carb or 30% carb? Why not just say, “it’s a spectrum disease, with a spectrum of carb that will treat it effectively”? In any case, I don’t want to complain too loudly, because this is SO great to see in an ADA publication!

Now, to be sure, the ADA is not yet changing their basic stance. Nowhere on the latest update of the diabetes.org Web site is it stated that diabetics should follow a low-carb diet. On the other hand, there is no longer anything I can find that says to eat over half of calories from carbohydrate, either. The former food pyramid, as far as I can tell, has vanished, and there are several hints that low-carb eating is becoming a bona-fide option.

There are statements such as, “Understanding the effect of carbohydrate on blood glucose levels is key to managing diabetes. The carbohydrate in food makes blood glucose levels go up.” Although diabetics are still advised that “a place to start is at about 45-60 grams of carbohydrate at a meal.”, (yikes) it goes on to say to adjust from there. Even though this is not what most of us would call a low-carb diet, for most people it is a reduction from their previous advice.

[Side note: I also notice it doesn’t actually say 45-60 g/meal is a good place to start. If that actually controls someone’s blood glucose, that’s great, but I would think that in the cases where it doesn’t, it would be more disheartening to subsequently take more carb away. Why not start lower, and then add? Also, most likely, the person for whom this works is losing weight – a phase which doesn’t last forever.]

To me this looks like the beginnings of a real change in approach from the ADA. The Titantic may actually be turning around! This could make a difference to the health of millions of people, and nothing could make me smile more than that.

By Laura Dolson/about.com

Image courtesy about.com

Bran Cuts Death Risk in Type 2 Diabetes Mellitus Patients

Type 2 diabetes mellitus in many cases can be prevented by following a modified lifestyle. Studies have suggested that even those who have acquired the disease may well control or even reverse their condition by following a healthy diet.

For example, eating whole grain cereal particularly bran supplemented foods may help reduce risk of premature death in women with type 2 diabetes mellitus, a new study recently published in the journal Circulation suggests.

The study led by Meian He Ph.D. and colleagues from Harvard School of Public Health in Boston Massachusetts found eating high amounts of bran was not only associated with significantly reduced risk of death from all causes, but also from cardiovascular disease (heart disease and stroke) or CVD in women with type 2 diabetes mellitus.

Bran is a hard outer layer of cereal grains such as rice, corn, oats, barley, millet and wheat and consists of combined aleurone and pericarp. It is full of dietary fiver and omegas and contains high amounts of starch, protein, vitamins and dietary minerals.

Type 2 Diabetes mellitus is a health condition that can lead to serious complications including  bladder control problems for women, heart disease and stroke, nerve damage, eye disease, erectile dysfunction, foot problems, and kidney failure.

Whole-grain consumption has early been associated with lower risk of heart disease and stroke and mortality in the general population, according to the background in the study report.

The study was meant to determine the association of whole grain, cereal fiber, bran and germ with all-cause and CVD-specific mortalities in women with type 2 diabetes mellitus.

For the study, 7,822 U.S. women with type 2 diabetes mellitus enrolled in the NUrse’ Health Study were followed for up to 26 years during which 852 all-cause deaths and 295 CVD deaths were identified. Subjects’ dietary intakes and potential confounders were assessed regularly with questionnaires.

The subjects were divided into five groups based on their intakes of whole grain, cereal fiber, bran and germ.  After adjusted for age, the highest intakes of whole grain, cereal fiber, bran and germ were associated with a 16 to 31 percent reduction in the risk of death from all causes compared to the lowest intakes.

After further adjustment for possible lifestyle and dietary risk factors, only bran intake was correlated with reduced risk.

Specifically, women in the group with the highest intake of bran were 28 percent less likely to die from all causes compared to those in the group with the lowest intake. This is an inverse association with higher intake leading to lower risk of all-cause death.

Bran intake was also inversely associated with CVD-related death with the highest intake linked with 45 percent reduction in the risk of heart disease and stroke or CVD compared to the lowest intake.

The researchers concluded “Whole-grain and bran intakes were associated with reduced all-cause and CVD-specific mortality in women with diabetes mellitus. These findings suggest a potential benefit of whole-grain intake in reducing mortality and cardiovascular risk in diabetic patients.”

Previous studies have suggested Mediterranean diet, green leafy vegetables, breastfeeding, brown rice, plant-based diet, soy foods, black tea, vitamin D, L-carnitine, turmeric, selenium, bitter melon, fish oil, psyllium fiber and drinking coffee may help prevent type 2 diabetes mellitus.

Meanwhile, half way across the world, S. Haripriya and S. Premakumari from Pondicherry University and Avinashilingam University for Women in India conducted a small trial and proved that eating wheat bran help type 2 diabetes mellitus patients better control their condition.

The trial involved 30 patients aged 45 to 50. Half were assigned 20 grams of wheat bran, which consisted of 42.8 percent dietary fiber, each day for a 6-month period. And another group of 15 diabetics were not given any bran supplements.

For the trial, blood samples were collected at baseline and at the end of the trial to analyse biochemical factors including serum fasting glucose levels, postprandial glucose levels, and glycosylated hemoglobin levels or HbA1C in all the type 2 diabetes mellitus patients.

In the group of diabetes mellitus patients receiving wheat bran supplements, compared to the levels at baseline, the fasting glucose levels at the end of the trial were reduced by an average of 22.8 mg/ml. Controls did not experience any significant change.

Those on the bran supplement also reduced serum postprandial glucose levels by 39.80 mg/ml and the glycosylated hemoglobin or HbA1C by nearly 2 percent while controls did not have any significant change.

HbA1C is considered the most reliable index of long term diabetes control.  Blood sugar tends to fluctuate from day to day and even from hour to hour while HbA1C reflects a true average index of glucose control for a period of 2 to 3 months.

Both groups of diabetes mellitus patients at baseline had 8.39 to 8.45 percent, a level of HbA1C considered by the definition of American Diabetic Association under unsatisfactory control.

After the supplementation trial, diabetes mellitus patients reduced the index by 1.96 percent, pushing the index down to 6.41 percent, a level which is considered under good control.

Limiting Salt Lowers Blood Pressure and Health Risks in Diabetes

For patients living with diabetes, reducing the amount of salt in their daily diet is key to warding off serious threats to their health, a new review of studies finds.

In the Cochrane review, the authors evaluated 13 studies with 254 adults who had either type 1 or type 2 diabetes. For an average duration of one week, participants were restricted to large reduction in their daily salt intake to see how the change would affect their blood pressure.

“We were surprised to find so few studies of modest, practical salt reduction in diabetes where patients are at high cardiovascular risk and stand much to gain from interventions that reduce blood pressure,” said lead reviewer Rebecca Suckling. “However, despite this, there was a consistent reduction in blood pressure when salt intake was reduced.”

Suckling is part of the Blood Pressure Unit at St. George’s Hospital Medical School, in London.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Patients with diabetes need to be extra cautious to maintain their blood pressure at an acceptable range of less than 130/80 mmHg. However, in the 2003-2004 period, 75 percent of adults with diabetes had blood pressure greater than or equal to 130/80 mmHg or used prescription hypertension medications, according to the American Diabetes Association (ADA).

High salt intake is a major cause for increased blood pressure and, in those with diabetes, elevated blood pressure can lead to more serious health problems, including stroke, heart attack and diabetic kidney disease. The ADA also reports that diabetic kidney disease is the leading cause of chronic kidney disease, accounting for 44 percent of new cases in 2005.

In the Cochrane review, the participants’ average salt intake was restricted by 11.9 grams a day for those with type 1 diabetes and by 7.3 grams a day for those with type 2.

The reviewers wrote that reducing salt intake by 8.5 grams a day could lower patients’ blood pressure by 7/3 mmHg. This was true for patients with both type 1 and type 2 diabetes. The reviewers noted that this reduction in blood pressure is similar to that found from taking blood pressure medication.

Suckling acknowledged that studies in the review only lasted for a week and that the type of salt restriction probably would not be manageable for longer periods.

“The majority of studies were small and only of a short duration with large changes in salt intake,” she said. “These studies are easy to perform and give information on the short-term effects of salt reduction.”

However, Suckling said, the review also found that in studies greater than two weeks, where salt was reduced by a more achievable and sustainable amount of 4.5 grams a day, blood pressure was reduced by 6/4 mmHg.

Diabetes specialist Todd Brown, M.D., of the Division of Endocrinology and Metabolism at Johns Hopkins University, said that practicing low-salt diets of these types is quite challenging for most patients with diabetes even though they know the health risks.

“The effects of salt on blood pressure are well known to health professionals and most patients, but what is less well known is where the salt comes from in our diet,” Brown said.

“The overwhelming majority comes from the processed foods that we eat,” he said. “If we are going to realize the benefits of sodium reduction on blood pressure and other health outcomes, we should focus less on the salt shaker and more on what we buy in the supermarket and at chain restaurants.”

Thank you Health Behavior News Service

Nestlé India Plans Collaboration To Help Manage Diabetes

Nestlé India has signed a memorandum of understanding with the National Diabetes, Obesity and Cholesterol Foundation (N-DOC) to develop nutrition initiatives aimed at helping to manage diabetes. The collaboration – which focuses on increasing consumers’ awareness and knowledge of their diets – will see Nestlé work with N-DOC to understand the impact of local diets and changing lifestyles on the increasing incidence of the disease in India.

Gary Tickle, Regional Business Head of Nestlé Nutrition, South Asia, said: “The Nestlé Nutrition Institute promotes science for better nutrition and N- DOC conducts culturally specific, basic and applied research in the areas of diabetes, obesity, and cholesterol disorders with the help of physicians and scientists. We see this as the beginning of a strong partnership.”

To kick off the announcement last week, a conference was organised by the Nestlé Nutrition Institute and N-DOC on ‘Nutrition Empowerment for Prevention and Management of Diabetes’ in Delhi. The conference was chaired by Professor Anoop Misra, Chairman of N-DOC, and Director and Head of the Department of Diabetes and Metabolic Diseases at the Fortis Group of Hospitals. Research presented suggested that lifestyle measures, physical exercise and good nutrition can all play a major role in managing, and in some cases even helping to prevent the disease.

Clinical nutrition with scientifically-formulated diets can help to provide balanced nutrition to people with diabetes while also delaying its possible long-term complications.

In many countries, including India, Nestlé HealthCare Nutrition already offers a range of nutritional solutions designed to help diabetic patients more effectively manage their disease and minimise its common side effects. Managing diabetes means keeping blood glucose levels in the target range, controlling blood lipids, managing weight as per guidelines and monitoring blood pressure to reduce the risk of complications.

Products formulated to assist in the dietary management of diabetes include Resource Diabetic, a complete, high-fibre diet with a flexible caloric density for oral supplementation or enteral feeding of patients with hyperglycaemia; Novasource Diabet, a complete balanced nutritional formula; and Boost Glucose Control, formulated with a unique balance of protein, fat and slow-digesting carbohydrates.

Nestlé has been using its expertise in science-based nutrition and food technology to develop products with a ‘health plus’ for everyday consumption ever since the company was established more than 140 years ago.