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Staying on top of Type 1 Diabetes

The human body is complexly wired. Each nutrition type, each cell organ, and each cell behaves a certain way to keep our physical health in optimal condition. In a few people, these cells behave in ways that aren’t ideal, for reasons yet unknown. One such condition is type 1 diabetes.

What exactly does type 1 diabetes mean?

Type 1 diabetes mellitus (T1DM) is a disorder where the body’s immune system mistakenly destroys cells that are responsible for insulin production. These cells are called the islets of the pancreas, and the insulin they secrete helps the cells absorb glucose from the bloodstream. Without the islets, your body cannot produce enough insulin, thus resulting in high blood sugar levels and less glucose absorption in cells.

What’s the optimal blood sugar level?

To start with, the HbA1c levels should be anywhere between 4 and 5.6 percentage. This indicates the levels of glucose attached to your hemoglobin. As far as the plasma glucose levels go, the criteria to be diagnosed with diabetes are the fasting plasma glucose level being greater than 126 mg/dL and the random plasma glucose levels being greater than 200 mg/dL.

What are the symptoms of type 1 diabetes?

You have to understand that this disorder is more common in children than adults. So it’s really important to understand these, as a parent. Do lookout for these symptoms in your child, and get their blood sugar levels checked.

  • Abnormal thirst and dry mouth
  • Frequent urination
  • Lack of energy, tiredness
  • Constant hunger
  • Blurred vision
  • Bedwetting
  • Weight loss—even though you are eating more
  • Diabetic Ketoacidosis
Aren’t adults affected by type 1 diabetes at all?

This is a very common myth around this disorder. While children are the ones we risk the most, adults are prone to LADA. The latent autoimmune diabetes in adults sets on late and progresses slowly. The initial stages of LADA often seem so much like type 2 diabetes. People diagnosed with this disorder are usually over 30. Like the autoimmune disease type 1 diabetes, LADA occurs because your pancreas stops producing adequate insulin, most likely from some “insult” that slowly damages the insulin-producing cells in the pancreas.

Risk associated

Though there are no causes for type 1 diabetes, in some cases there’s a correlation between family history, genetics and occurrence. Though people of all ages are at risk, it appears that there are two noticeable peaks. The first peak occurs in children between 4 and 7 years old, and the second is in children between 10 and 14 years old.

The disorder of not coping with responsibility can lead to several problems. Complications associated with type 1 diabetes are

  1. Retinopathy, where there are risks of the disorder affecting the eye.
  2. Dyslipidemia, a condition where the cholesterol levels and fat levels are unnaturally high.
  3. Neuropathy, a complication that causes weakness, numbness and passion in the items and feet due to nerve damage.
  4. CKD, the risk of renal failure and diseased kidneys.
Treatment, diet and ways to cope

General treatment for type 1 diabetes indispensably includes insulin. According to the physician’s directions, insulin intake becomes mandatory to support your body functions. In adults, Sulphonylurea drugs like Metformin, Thiazolidinediones and Insulin therapy are administered.

It is very important that you maintain a cleaner, healthier diet in general. Proteins, good rest and adequate physical activity helps keep your blood sugar levels in check. Constant monitoring and a regulated lifestyle will get you through a lot of complications. Stay informed about the condition, and stay on top of it.

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Blood Cholesterol – The good friend with a bad rep

Blood Cholesterol Levels – The what, why and how.

High cholesterol level in blood has become so common, that almost 10 million people are diagnosed with it, every year. A seemingly simple explanation for this is our sedentary lifestyle, but the issue is a little more deep rooted than just lifestyle. What makes up your plate eventually makes up your physique, and we’re here to help you sort the plate out.

What is cholesterol, really?

Cholesterol is a waxy substance that your body needs for a lot of functions, like hormone secretion, metabolism and maintaining overall health. Carried through the body by lipoproteins, cholesterol essentially helps your body maintain balance and is a good friend.

Until, there’s too much of it in your blood. Too much blood cholesterol has a lot of consequences, but first, how much is too much?

Interpreting your blood cholesterol numbers.

There are two types of cholesterol, the High-Density Lipoprotein and the Low-Density Lipoprotein, commonly referred to as the good and the bad cholesterol. HDL absorbs excess cholesterol and takes it back to the liver, while the LDL collects on the walls of blood vessels.

Total cholesterol levelHDLLDL
OptimalLess than 200 mg/dl<40 mg/dl in men,
<50 mg/dl in women.		<100 mg/dl
HighAnything over 240 mg/dl is very high≥130 mg/dl

 

While it is true that cholesterol levels must be kept in check, neglecting cholesterols is not the way to go either. Any HDL reading below 40 mg/dl in men and 50 mg/dl is considered low, and is not advisable in the long run.

How would I know?

Symptoms for high cholesterol levels in your blood will not show as explicitly, so the risk of it being undetected until it’s serious is quite high. The only way to find out and know for sure that you have high blood cholesterol is to have it tested by a physician.

A few physical symptoms however, are fatty bumps on your skin, called xanthomas, or grayish-white rings around the corneas in your eye, called corneal arcus. These mostly develop in people who have familial hypercholesterolemia. But waiting for these symptoms might not be the wisest decision. Have your blood cholesterol levels periodically checked and keep yourself on the know.

Who’s at risk?

Statistically people between the ages of 40 and 59 are the ones commonly diagnosed with high blood cholesterol. Other than age, there are a few other risk factors that can increase your chances when it comes to getting diagnosed with high blood cholesterol.

As far as lifestyle choices are concerned, eating foods high in saturated fats or trans fats regularly, lack of physical activity, smoking, chronic stress and drinking too much alcohol can pose a threat. Apart from these, high blood cholesterol could also be genetic.

If you have other conditions like obesity, PCOS, Diabetes, Hypothyroidism and/or are taking medications like diuretic, steroids, or medications for chemotherapy, they might be reasons for high levels of blood cholesterol.

Dealing with it

Left unchecked for prolonged periods of time, high blood cholesterol levels can lead to serious problems, such as heart attack and stroke. So it is very important that you cope well and keep your numbers at bay.

First things first, work on what you eat. Reduce the consumption of saturated and trans fats that are found in fatty cuts of meat, dairy products, and many packaged snacks and desserts. We recommend eating fish high in omega-3 fatty acids, nuts, and the usage of certain vegetable oils such as olive oil. The DASH eating plan will help reduce your LDL, or the “bad cholesterol”.

Working on a healthier lifestyle along with a proper diet can work wonders. By healthier lifestyle we mean being physically active, keeping yourself free of too much stress, not smoking, limiting your alcohol consumption and taking the right meds when needed. Speak with your doctor and stick to the protocol, and you’ll be mighty fine!

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Understanding Hypertension

Hello, Yoda here. Today, we’ll discuss one of the most prevalent conditions in the world. As of 2019, hypertension, or high blood pressure had affected around 26% of the world’s population. The number was estimated to grow up to a whopping 29% by 2025, and the pandemic-infused stress has only made it worse.

To tackle hypertension, we must understand the condition first.

So, what is hypertension?

Hypertension is a condition in which the blood vessels have persistently higher pressure than optimum. This means that the blood in the arteries is flowing at a higher pressure than normal, and arteries are overclocking consistently.

It is commonly expressed as the ratio of Systolic Blood Pressure (SBP) to Diastolic Blood Pressure (DBP). Systolic blood pressure is the pressure that the blood exerts on the arterial walls when the heart contracts and diastolic blood pressure is the pressure exerted when the heart relaxes.

How much should your SBP/DBP read, exactly?

Optimally, your SBP should read less than or around 120 and DBP should be less than 80. Here’s a table that’ll help you understand numbers around hypertension better.

 

 

What are all the possible causes of high blood pressure?

To understand why someone’s blood pressure is high, we must first learn about the two types.

Primary or essential high blood pressure is the common type. It develops with old age, a sedentary lifestyle, unhealthy eating habits, stress, or an irregular/insufficient sleeping pattern.

Secondary blood pressure on the other hand is usually the result of a prevailing medical condition or a side effect of certain medicines. This fades gradually after treating the initial condition or as the medicines that cause hypertension are stopped.

How would one know if they have hypertension?

Here’s the tricky part – The only way to be sure if you have high blood pressure is to get it checked by a health professional. There are symptoms like the ones discussed below, but they don’t always show, and if you’re experiencing any of these, you must start taking immediate action.

Speaking about noticeable symptoms, you will experience early morning headaches, occasional nosebleeds, irregular heart rhythms, blurred vision, and a buzz in the ears.

More severe ones include fatigue, nausea, vomiting, anxiety, confusion, chest pain, and muscle tremors. Again, with hypertension, the symptoms are not regular and persistent, which makes it easy to miss. However, ignoring it can cause persistent pain in the chest – a condition called angina, heart attacks, heart failure, and irregular heartbeats. Hypertension left unchecked leads to sudden death, even. so it is important to notice any discomfort or symptom and get your blood pressure checked regularly.

Am I at risk?

One of the most common mistakes a lot of people make is assuming that they are free from the risk of being affected by hypertension because they are young. While it is true that people over 55 are more likely to be affected by it, age isn’t the only criterion here.

Your chances of having high blood pressure increase if you

  • Are overweight
  • Eat salty food or food rich in sodium
  • Do not have an active lifestyle
  • Smoke
  • Consume alcohol a lot
  • Have a family history of high blood pressure

How do I cope with high blood pressure?

The first thing to do is to periodically check your blood pressure levels. If recommended by your physician, do take your medicines every day. Having an active lifestyle definitely helps reduce the risk of hypertension, so do exercise regularly. Keep your body weight in check, and quit smoking. Limit your alcohol intake, and finally, maintain a good sleep cycle.

The last thing to understand when talking about hypertension is that diet plays a very important role in keeping your blood pressure levels low. Dietary Approaches to Stop Hypertension, or the DASH eating plan is one effective meal plan that helps.

The DASH eating plan

The DASH eating habit helps keep your hypertension in check by limiting sodium intake. It encourages foods that are rich in potassium, calcium, magnesium, fiber, and protein. Here are a few food groups and foods recommended in the DASH eating plan.

 

 

There are a lot of other foods that are recommended as part of the DASH eating plan. The focus here is to simply limit your salt/sodium intake and load up on a wholesome, nutritious meal that’ll help regulate your blood pressure. According to the DASH diet, the total sodium intake should not be more than 2,300 mg per day.

Remember to relax

Hypertension, though if left unchecked could become a lot more serious, is not a threatening illness if you follow a decent protocol in diet and lifestyle. Kick back, relax, take the right nutrients, keep fit and move along. Yoda’s here to help you loosen it up.

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Binge Eating

The following information may be triggering to those with eating disorders. Please be mindful should you continue reading. 

 

A severe and life-threatening disorder, Binge Eating Disorder is characterized by recurring episodes of excessive food consumption. A recent but important addition to the officially recognised list of disorders, binge eating is capable of immense harm to the body and mind. Let’s understand what exactly this disorder entails. 

Basics of Binge Eating: 

 

People who binge eat are not just driven by hunger or due to a metabolic need. For some it’s the hedonistic value, for others compulsion to eat and yet others for the stress relief. Binge eating is a behaviour which develops into Binge Eating Disorder. 

 

Diagnosis: 

 

A binge eating episode is characterized by the following: 

 

  1. Eating a significantly large quantity of food than most people would eat in the same period of time, in similar circumstances 
  2. Experiencing a lack of control with eating during this episode 

 

Binge eating episodes are also accompanied with at least three of the following: 

 

  1. Eating faster than normal 
  2. Eating until feeling uncomfortably full 
  3. Eating large quantities of food despite not being physically hungry
  4. Eating alone out of embarrassment for food quantity
  5. Feelings of self-disgustion, depression and guilt from overeating 

 

Mukbang: A growing trend this past year among Youtube vloggers are ‘Mukbangs’, where people eat ridiculous amounts of food on camera. These videos have both a positive and negative impact, where some feel that mukbangs encourage healthy appetites and others find it normalizes eating disorders. 

 

Warning Signs: 

 

Binge eating is an insidious disorder, it gradually develops over a period of time. Be wary of these warning signs: 

  • Stealing or hoarding of food in strange places
  • Withdrawing from friends and usual activities 
  • Going on-and-off on diets 
  • Uncomfortable while eating around others 

 

Symptoms: 

 

Binge eating directly impacts your physiology and psychology, it comes with a plethora of symptoms. They include 

  • Fluctuations of weight, both increase and decrease. 
  • Stomach cramps 
  • Constipation
  • Acid Reflux 
  • Difficulty in concentration 

 

Neurobiology of Binge Eating: Binge eating has been classified as a disorder but the neurobiology mirrors the same traits of substance abuse behaviour. Delicious foods and fluids provide the same reinforcement effects to the natural reward pathways in your brain as addictive substances like drugs. 

 

Consequences: 

 

The prominent health risks associated with Binge Eating Disorder are clinical obesity, weight stigma and weight cycling. Yo-yo dieting is common among those with BED. Not all people who are clinically obese have BED, but two-thirds of people with BED are clinically obese. Similarly, while most people with BED have higher-than-average weight, it can be diagnosed at any weight. 

 

More severe cases of BED lead to Bulimia Nervosa: a life-threatening eating disorder involving cycles of binge eating and behaviours like self-induced vomiting. 

 

Treatment: 

 

Studies show that psychological interventions like Cognitive Behavioural Therapy (CBT) and Behavioural Weight Loss Therapy (BWLT) do seem effective for binge eating disorders.

 

CBT directly targets the core of binge eating since both the psychopathology of eating disorders and over-evaluation of shape and weight are cognitive in nature. A study suggests that people start with extreme and highly specific dietary rules when trying to reverse BED. However, this tends to fail and patients are further negatively affected. CBT helps in this regard.
Cheers and see you soon,  

 

References

  1. Binge eating disorder treatment: a systematic review of randomized controlled trials. Brownley KA, Berkman ND, Sedway JA, Lohr KN, Bulik CM
  2. Personality and eating behaviors: a case-control study of binge eating disorder. Davis C, Levitan RD, Carter J, Kaplan AS, Reid C, Curtis C, Patte K, Kennedy JL
  3. Brownley, Kimberly A., et al. “Binge-Eating Disorder in Adults.” Annals of Internal Medicine, vol. 165, no. 6, 2016, p. 409., doi:10.7326/m15-2455.
  4. Mathes, Wendy Foulds, et al. “The Biology of Binge Eating.” Appetite, vol. 52, no. 3, 2009, pp. 545–553., doi:10.1016/j.appet.2009.03.005.
  5. National Eating Disorders
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Alcohol: A Primer

Get the facts here and the booze elsewhere! 

A contentious topic in the nutrition industry: Alcohol. It’s an addiction, a hindrance, an inhibitor of sense and yet, it’s a pleasure, a social convention and an aggregator of sensations.
 

Did you know? When water was unsafe to consume in Europe, alcohol proved to be a better option for hydration!

 

Why do we drink? 

 

For a multitude of reasons! They’re not just excuses to get sloshed, people. We’re talking about actual scientific facts here. 

 

Let’s get serious.

 

The primary factor that causes humans to consume alcohol is dopamine. When you drink alcohol, it increases the flow of dopamine, which in turn stimulates the pleasure and reward center of the brain. The direct correlation of drink = reward is as simple as it gets. 

 

Did you know? Young adults who love sugar have a predisposition towards alcohol, and are more prone to getting addicted to it.

 

Other factors that incentivise us to drink alcohol include: 

  • appealing taste 
  • stress relief
  • loosens inhibitions  
  • social courtesy
  • assists sleep

 

How does drinking affect us? 

 

Although we humans consume for recreation, alcohol is a toxic substance that can cause a lot of damage to our bodily functions. The toxic-flusher of our bodies – the liver is the organ that is particularly sensitive to alcohol intake.

 

Fatty liver is a common occurrence in those who drink more than 15ml of alcohol per day. While this doesn’t show symptoms and is reversible, binge drinking and excessive alcohol consumption leads to inflamed liver, or worse, cirrhosis.   

 

Physiologically, when we drink we lose control of our inhibitions. Yes, this makes socialising easier but it also increases and encourages risk-taking behaviour. 

 

The World Health Organization estimated that over 3 million people die every year due to alcohol consumption. This constitutes 5% of all deaths!

 

When does drinking become an addiction? 

The simple drink = reward correlation we spoke of earlier? Both a blessing and a bane, an excessive increase in dopamine levels is an addictive factor. Further, alcohol acts on the prefrontal cortex which reduces our inhibitory control and amps up our risk-taking behaviour. These coupled with pre-existing addiction tendencies, lifestyle, environment and company all play a role in creating an alcohol addiction. 

 

We’ve covered the why, the how, and the when. It’s now time for the what.

 

What can you drink? 

 

Leaving aside the physiological and psychological effects of alcohol we’ve outlined above, there’s sure to be times when you do indulge in a sip (or glass) (or bottle) of alcohol. Here’s what you can do to minimise the impact. 

 

Lay. Off. The. Cocktails. 

 

Cocktails, margaritas, fancy shots – therein lies the path of sugaryness. It’s ideal if you stick to hard liquor and a mixer (water, soda or ice). Do make sure to curtail the number of drinks and keep hydrated throughout. 

 

So that’s the high and low of it all. We are not in the business of morals, ethics or sanctity. You’ve read the science, now it’s time for you to make the choices that work for your lifestyle! 

 

Cheers and see you soon,  

 

References

  1. https://www.wdl.org/en/item/3956/
  2. Kampov-Polevoy, Alexey, et al. “Sweet-Liking Is Associated with Transformation of Heavy Drinking into Alcohol-Related Problems in Young Adults with High Novelty Seeking.” Alcoholism: Clinical and Experimental Research, vol. 38, no. 7, 2014, pp. 2119–2126., doi:10.1111/acer.12458.
  3. Crabb, David W. “Pathogenesis of Alcoholic Liver Disease. Newer Mechanisms of Injury.” The Keio Journal of Medicine, vol. 48, no. 4, 1999, pp. 184–188., doi:10.2302/kjm.48.184.
  4. Bergheim, Ina, et al. “Treatment of Alcoholic Liver Disease.” Digestive Diseases, vol. 23, no. 3-4, 2005, pp. 275–284., doi:10.1159/000090175.
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All About Sleep

Sleep is for the weak? No, sleep is for the species! 

 

“If sleep does not serve an absolutely vital function, then it is the biggest mistake the evolutionary process has ever made” – Dr Allan Rechtschaffen

 

Have you ever thought about why we need to sleep? Guess what…

 

Nobody knows!

 

From an evolutionary standpoint, sleep is rather confusing. When the body is at rest, it forsakes all the aspects that constitute humanity. One can’t gather sustenance, socialise, mate, protect offspring and worst of all, sleep leaves you vulnerable to predation. And yet, lack of sleep causes serious physiological and psychological damage to our bodies. Let’s take a gander into the world of zzzs…

 

Types of Sleep 

 

The recommended daily amount of sleep is 7 – 8 hours for adults. However, this comes with a disclaimer. The sleep referred to here includes total sleep and type of sleep, both are required for optimal body functioning. Over and above this, it’s ideal if one sleeps at the time when the body is ready to sleep and not otherwise. 

 

If you were a biology student, I’m sure you’ll remember hearing about REM sleep in school. REM or Random Eye Movement sleep is usually when you get dreams and/or nightmares. Non-REM sleep is commonly known as deep or slow wave sleep. 

 

Circadian Rhythms: We all have an internal body clock which controls when we wake and sleep, which usually follows a 24-hour repetitive pattern. This circadian rhythm affects the working of every single cell, tissue and organ of our bodies! 

 

Off the rhythm 

 

It’s not just dancers that need to maintain a rhythm, our body mechanisms need to as well! When there is an alteration in your circadian rhythm, everything feels ‘off’. Consecutive shifts from our rhythms, whether due to poor or disturbed sleep or lack of sleep entirely, leads to sleep deficiency and ultimately, sleep deprivation. 

 

I’m so sleepy…

 

An oft-spoken phrase, isn’t it? Sleep deficiency has become the new norm, in fact, it’s begotten the term ‘sleep epidemic’. An occasional night awake is expected, but several nights up late binge-watching shows, staring at the ceiling or simply being unable to sleep? It’s not optimal in the slightest. 

 

Microsleeping: Those brief moments of sleep that happen while you’re still awake? If you’ve experienced this, you’ve been microsleeping. A symptom of sleep deficiency, microsleep can’t be controlled and often happens without your awareness.

 

Insufficient sleep on a regular basis interferes with every aspect of our lives: work, school, driving and even social situations. Retention and reaction capabilities are hindered. Gauging  other’s emotions is tough when you haven’t slept enough, and you will find yourself frustrated and anxious when socialising. 

 

All this and more is why we should prioritize sufficient and appropriate sleep. 

 

But, how?

 

Creating a sleep routine is a requisite for sustainable balance in life. Start small. And no, we’re not recommending you count 100 sheep a night, then 200, and so forth. Find a rhythm that works for you! Whether it’s keeping a sleep diary, setting reminders to get ready for bed, or even asking your significant other to wake you up (a parent would be more reliable), make sure you maintain that routine.  

 

The more consistent you are with your routine, the sooner you’ll see results in your day-to-day life. You’ll notice you’re more refreshed in the mornings (no more cranky monday blues), improved concentration at school and work, and a drastic reduction in your midday naps! Do comment below on what helps you sleep, we’d love to hear from you. 

 

See you on the flip side,

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Diabetes 101: We’ve got the Deets!

One of the disorders that’s now a household name, Diabetes has certainly had a global impact in the recent years. With data showing alarming future projections of diabetes cases across the world, let’s first understand this disorder in its entirety. 
 

 
Let’s get real, folks: “A touch of sugar” does not create diabetes. Even sugar consumption cannot cause diabetes on its own. But let’s find out what does: 

 

The deciding factor is insulin. If your body cannot make any, you have type 1 diabetes; if your body doesn’t utilise or make insulin, you have type 2 diabetes. The former is irreversible and lifelong care is required. Type 2 diabetes is majorly a lifestyle disorder which can be managed and in most cases, reversed.
 

 
Now that we’ve understood the role insulin plays in our bodies, let’s narrow down on what happens when there’s an insulin resistance. When you consume food, the digestion does its job and breaks it down to glucose. Now since insulin cannot grab the glucose from the bloodstream, the excess remains and elevates your blood glucose levels.      

 

So how do you know whether you have diabetes or not? Your biomarkers confirm them. When testing for diabetes, the main parameters one checks are fasting blood sugar, post-prandial blood sugar, HbA1c, HOMA-IR and urinary glucose levels.   

 

Does nutrition have an impact on insulin resistance?   

It most certainly does. The how, is still in the works. Even in the scientific world there’s a heated discussion on which nutrition guidelines have a sustainable effect on reversing and/or managing diabetes. Is it the macronutrient composition or the energy activity? How does one examine evidence from previously conducted trials? Is there a truly sustainable method of eating that can without-a-doubt reverse type 2 diabetes?

 

Rest easy, we’ve got the facts compiled for you.

 

There has been a degree of consensus in these areas…

 

A priority is Weight Management, since weight loss goes hand-in-hand with improvements in glycemia, blood pressure and lipids. Maintaining the required Energy Balance is another, where guidelines recommend portion control along with physical activity. Evidence-based Dietary Patterns such as higher intake of vegetables, fruit, whole grains, nuts, legumes and yoghurt, tailored to the individual. Certain Foods to Avoid or reduce include processed red meats, refined grains and sugars for prevention and management of type 2 diabetes. 

 

Whereas in these areas, there remains uncertainty in guidelines…

 

An issue most contentious in type 2 diabetes management is the optimal macronutrient composition, with variations among countries, nutritionists and those with diabetes themselves. While fish intake is recommended to manage cardiovascular risks, there’s a spectrum of association with diabetes: positive, negative or none at all! There has been consistent beneficiary evidence on yoghurt but other dairy products have yet to be conclusively examined. Oils and which type is preferable is still debated, though olive oil has shown evidence of potential benefits.  

 

So what exactly does a person with diabetes eat?

 

Well, therein lies the work. Those with diabetes have had a multitude of diet options thrown at them: paleo, keto, vegan and more. The fact remains that a ‘standardised diet’ does not work in the long term, period. Within the existing nutrition guidelines, one must craft a personalized meal plan based on their food preferences, lifestyle conditions and environment. Do remember that nutrition is an evolving process, it is advisable for those with diabetes to consult a nutritionist before making drastic nutritional shifts. 

 

Among the plethora of studies undertaken, the Mediterranean diet has attracted multiple diabetes trials. A 12-month trial found that participants on a low carb Mediterranean diet demonstrated greater weight loss, improved glycemic and HDL levels! However studies have yet to conclude if the same will continue in the long run.

 

Okay, but is exercise really that necessary? 

 

Exercise is recommended for people regardless of any disorders. Those with diabetes are particularly encouraged to exercise to improve cardiovascular and overall fitness, weight control and to enhance their quality of life. Exercise and resistance training may benefit and improve glycemic control. 

 

Did you know that the type and timing of your meals impact your blood glucose responses to exercise? People with diabetes and insulin dosages have to ensure that their insulin levels and carbohydrate intake are coordinated to reduce hypoglycemia. Care has to be taken with pre-workout and post-workout meals – consuming the appropriate quantity of carbs in accordance with blood glucose levels.

 

So with exercise and nutrition in check, can type 2 diabetes be reversed? 

 

Although once considered irreversible and progressive, recent years have seen a shift in management and reversal of type 2 diabetes. Despite this, there is little evidence on the sustainability and lasting effect of such reversal and the potential for remission. The question of the hour is which plays a more predominant role in achieving remission: energy deficit or macronutrient composition. For more on this, keep an eye out for our next blog post in this series. 

 

Until we meet again,

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Soy and Oestrogen

Soybean is the richest source of protein among plant sources. It contains around 35g of protein per 100g. It is said to be a complete protein as it has all 9 essential amino acids. It is also low on carbohydrates (12g/100g) and high in fibre (21g/100g). Then why is it that this superfood has become a topic of controversy in the recent times? Read to learn more about soy, its origin, uses, benefits and controversies surrounding it.

About soy
Soybean the “king of beans” serves as a key source of high quality protein among plant sources. Since the 1950s, global soybean production has increased 15 times over. The United States, Brazil, and Argentina together produce about 80% of the world’s soy. Soy which was traditionally consumed in Asian countries, is now consumed all over the world. It is very versatile and can be used to produce soy milk, tofu, tempeh, soy sauce, natto, soy chunks, etc. Soy and its benefits in chronic disease prevention have been researched upon for over 25 years now.
 
What is the connection between soy and Oestrogen?
Oestrogen is an important sex hormone, produced by the endocrine system, that is responsible for the development of female body and the secondary sexual characters. It is responsible for the growth of breasts, hips being wider in women than in men, regulation of menstrual cycle, among other functions. For this reason, it is termed as a “female sex hormone”. Men also have oestrogen receptors and oestrogen in their bodies but to a much lower extent compared to women. 
Soy has a type of phytoestrogen called isoflavones (genistein and daidzein) that is similar to oestrogen in terms of chemical structure. Phytoestrogen can bind to oestrogen receptors in humans and can have a relatively weaker oestrogenic or anti-oestrogenic effect i.e. have an effect similar to but weaker than that of oestrogen or act against oestrogen. Due to this property of soy, it has become the topic of controversy with myths associating soy with disruptions in hormone levels in men, development of male breasts, etc. First let us look at the benefits of soy and then discuss the truth about these controversies.
 
Benefits of soy for women

  1. PCOS- Soy may be beneficial to women with Polycystic Ovarian Syndrome, commonly known as PCOS. It is a metabolic, endocrine and reproductive disorder seen in women of reproductive age. PCOS is characterized by a variety of signs and symptoms. Menstrual irregularities, obesity or excess androgen could be a sign of this disease. In a study that administered soy isoflavone to women with PCOS for a period of 12 weeks. Significant improvement was seen in insulin resistance, hormonal status, triglycerides level and biomarkers of oxidative stress in the women studied. 
  2. Breast cancer– Oestrogen hormone stimulates the growth of secondary sexual characteristics including breasts in women. It also stimulates the growth of breast cancer cells. Some studies on soy consumption in women show a protective effect against breast cancer (due to the anti-oestrogenic effect of soy in premenopausal women).
  3. Menopause- It is a widespread belief that soy is beneficial to postmenopausal women and that the phytoestrogen in soy (which has weak oestrogenic effects in humans) helps in regulating oestrogen level after menopause as there is a decline in oestrogen production. Some studies have reported a reduction in the intensity and frequency of hot flashes during menopause in women given soy isoflavone supplements.

 
Other benefits of soy for all

  1. Cardiovascular diseases- Many studies have reported beneficial effects of the isoflavones in soy on blood pressure, glycemic control, obesity and inflammation. A study in which participants included soyfoods in their diet (total quantity corresponding to 30g/day protein) for 12 weeks, a significant improvement was observed in biomarkers associated with cardiovascular risk.
  2. Cholesterol- Soy protein has been proven to have a hypocholesterolemic effect in both normocholesterolemic and hypercholesterolemic people. It lowers LDL cholesterol level and is also associated with a significant decrease in the ratio of plasma LDL cholesterol to HDL cholesterol. Therefore, soyfoods are beneficial for lowering cholesterol levels.

 
Why men fear soy
It is a common misconception among men that eating soy-based foods will lead to lowered testosterone levels or gynecomastia which is the development of male breasts. This fear is rooted in the fact that soy contains phytoestrogen which is perceived as an equivalent of oestrogen, the “female hormone”. Therefore consuming soyfoods is associated with the fear of reduced masculinity in men. But studies conducted on humans have shown that this is not the case. The effect of eating soy in both groups were studied but there were no significant changes in Testosterone levels in men. Consumption of soybeans or soy-based products on a daily basis did not cause any compromise in the virility or reproductive health in men. Nor did it have any other feminizing effects on the men involved in the studies at an intake level that was equal to or even considerably higher than the amount typically consumed by Asians.
 
Soy and thyroid
Recent studies have found an association between soy and thyroid function. There is a lot of confusion surrounding this and whether consuming soybeans are safe or not as studies are yielding mixed results. Let’s take a look at the existing evidence we have so far.
Soy is suspected to interfere with thyroid function but in whom? Animal studies have shown that when animals with pre-existing compromised thyroid function (such as hypothyroidism) and/or low iodine intake consume soy foods, there could be some disruption in their thyroid function. The exact component in soy responsible for this goitrogenic effect is still unclear. However, studies done on humans have not observed the same effect and the result is still inconclusive as to whether people with impaired thyroid function should avoid soy. Therefore, it is suggested that people with an underactive thyroid and those taking thyroid medication consume soy with caution. It is advisable to get sufficient iodine through the diet if consuming soy products. 
A healthy individual with an optimum thyroid function can consume soy products without any fear as long as the iodine intake is sufficient. It is important to meet your iodine requirement if you are consuming a lot of soy products.

References

  1. Effects of Soy Protein and Soybean Isoflavones on Thyroid Function in Healthy Adults and Hypothyroid Patients: A Review of the Relevant Literature
  2. Effects of soy isoflavones on estrogen and phytoestrogen metabolism in premenopausal women.
  3. Goitrogenic and estrogenic activity of soy isoflavones.
  4. Soybean isoflavone exposure does not have feminizing effects on men: a critical examination of the clinical evidence
  5. Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis.
  6. The Effects of Soy Isoflavones on Metabolic Status of Patients With Polycystic Ovary Syndrome.
  7. Effect of soy on metabolic syndrome and cardiovascular risk factors: a randomized controlled trial.
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Supplement Series #4 – Collagen, is it worth your money?

What is Collagen?
Collagen is the most abundant protein in mammals forming about 25% of the total protein content in the body. It is an essential part of the connective tissues in the body. The main components of collagen are 3 non-essential amino acids namely, glycine, proline, and hydroxyproline. The different arrangements of these amino acids results in different varieties of collagen leading to different functions and site of incorporation.

What are the types of collagen?
A collagen molecule is formed by twisting together 3 long chains of amino acids to form a tight coil giving it a great tensile strength. Many of these long collagen chains join together to perform their specific function. The way these chains join at specific sites results in different types of collagen giving it specific characteristics and functions. More than 20 types of collagen have been identified so far. Some of the common types of collagen are:

IMost abundant collagen of the human body; present in scar tissue, the end product when tissue heals by repair; found in tendons, the endomysium of myofibrils, and the organic part of bone
IIArticular cartilage and hyaline cartilage
IIICollagen of granulation tissue; produced quickly by young fibroblasts before the tougher type I collagen is synthesized; reticular fiber
IVBasal lamina; eye lens
VMost interstitial tissue; associated with type I; associated with placenta

 
What are the functions of collagen?
Collagen in majorly secreted by fibroblast. It is sometimes referred to as the body’s scaffolding. The word collagen is derived from Greek and means “glue producer.” 
Collagen fibers support body tissues, it is a major component of the extracellular matrix that supports cells. Collagen and keratin give the skin its strength, waterproofing, and elasticity. Loss of collagen is a cause of wrinkles.
Connective tissue consists primarily of collagen. Collagen forms fibrils that provide the structure for fibrous tissue, such as ligaments, tendons, and skin. Collagen also is found in cartilage, bone, blood vessels, the cornea of the eye, intervertebral discs, muscles, and the gastrointestinal tract.
 
How can I get collagen naturally?
Since collagen is found in connective tissues, foods such as chicken skin, pork skin, beef and fish are great sources of collagen. Collagen obtained by this method is usually broken down to individual amino acids and are used up for formation of other proteins. There are not enough studies to show if collagen levels increase in humans upon consumption of these foods.
Another natural source of collagen is gelatin, a substance commonly used in cooking and derived from cooking collagen.
 
What are the types of Collagen Supplements available?
Collagen initially became famous as injectable solutions to help tighten skin and remove wrinkles. This fell out of trend as it didn’t last long and incited allergic reactions.
However, in recent years hydrolysed collagen supplements have flooded the market. Hydrolysed collagen are collagen threads broken into smaller peptides and chains to aid in easy absorption. Hydrolysed collagen is available majorly as powders. It’s also seen in the form of skin creams or tablets.
A thing to note here is that these supplements are generally marketed as Type-I Collagen or any of the 20 odd collagen types but it doesn’t make a difference which one you pick. While this is talking about the location from which the collagen was extracted, the hydrolysed collagen is already broken and used to form the different forms of collagen as required by the body.
 
Who would benefit from collagen supplementation and does it really work?
Although the body naturally produces collagen, the rate at which it is produced drops as we age. After a point, the rate at which collagen is produced is not enough to keep up with the body’s demand. Since collagen forms an essential part of the connective tissue, there are multiple benefits for taking collagen supplements.
SKIN HEALTH: Collagen production reduces as you age and this leads to dry and wrinkled skin. Studies have shown that supplementing collagen has improved skin elasticity and reduced dryness. The general conclusion is that collagen slows down skin ageing however more studies are needed to confirm the sole role of collagen in this process.
Joint Health: Ageing leads to deterioration and breakdown of joints. Studies have shown that collagen supplementation not only helps promote joint health but also helps alleviate joint pain.
Muscle Mass: Collagen is also a part of the muscle tissue and forms about 10% of muscle tissue. Multiple studies have shown that people taking collagen supplementation while exercising tend to put on more muscle mass and strength.
Heart Health: Collagen fibres line the inner walls of arteries and are shown to lead to weaker arterial walls. Studies have shown an improvement in arterial wall elasticity and reduction in stiffness when supplemented with collagen.
 
Are collagen supplements safe to take for vegans?
Collagen for manufacture of supplements is majorly obtained from animal sources such as bone broth and protein. However, a few vegan and vegetarian alternatives have started appearing online.

References

  1. Lodish H, Berk A, Zipursky SL, et al. Molecular Cell Biology. 4th edition. New York: W. H. Freeman; 2000. Section 22.3, Collagen: The Fibrous Proteins of the Matrix. Available from: https://www.ncbi.nlm.nih.gov/books/NBK21582/
  2. High Yield Orthopaedics. JavadParviziMD, FRCS, Gregory K.Kim MD Associate Editor. https://doi.org/10.1016/B978-1-4160-0236-9.00064-X
  3. Zdzieblik D, Oesser S, Baumstark MW, Gollhofer A, König D. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr. 2015;114(8):1237–1245. doi:10.1017/S0007114515002810
  4. Proksch, E., Schunck, M., Zague, V., Segger, D., Degwert, J., & Oesser, S. (2014). Oral Intake of Specific Bioactive Collagen Peptides Reduces Skin Wrinkles and Increases Dermal Matrix Synthesis. Skin Pharmacology and Physiology, 27(3), 113–119. doi: 10.1159/000355523
  5. Kumar, S., Sugihara, F., Suzuki, K., Inoue, N., & Venkateswarathirukumara, S. (2014). A double-blind, placebo-controlled, randomised, clinical study on the effectiveness of collagen peptide on osteoarthritis. Journal of the Science of Food and Agriculture, 95(4), 702–707. doi: 10.1002/jsfa.6752
  6. Sibilla, S., Godfrey, M., Brewer, S., Budh-Raja, A., & Genovese, L. (2015). An Overview of the Beneficial Effects of Hydrolysed Collagen as a Nutraceutical on Skin Properties: Scientific Background and Clinical Studies. The Open Nutraceuticals Journal, 8(1), 29–42. doi: 10.2174/1876396001508010029

 

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Inflammation – The Basics

The terms Inflammation and anti-inflammatory diet are being tossed around lately and I thought this would be a great time to share some information on these topics. So let’s delve into what these things mean, who would benefit from an anti-inflammatory diet and how to go about it.

What is Inflammation?
The word inflammation is a widely misunderstood term considered to be something that causes harm to our body. The truth is, inflammation is an essential pathway of your immune system to protect your body from something as simple as a small cut to fighting a severe infection. The process of inflammation includes increased blood flow at the site of injury/infection, dilation of capillaries, white blood cell infiltration, and production of chemical mediators to manage the condition.
While inflammation is a natural process that aids the body in certain conditions, it can occur too little causing it to go unnoticed by us before it’s too late (e.x., diabetes, cardiovascular disease) or too much causing a bad reaction (e.x., autoimmune diseases such as rheumatoid arthritis).
What triggers inflammation?
The most common trigger for inflammation is when your body is responding to a stimulus either in the form of a foreign body such as a bacterial infection or when it’s repairing an injury. However, there are certain factors that have the ability to trigger inflammation.
Diet – Various food groups such as sugars, trans fats and refined products have been linked to promoting inflammatory reactions in the body. 
Stress – Multiple studies have shown that chronic stress has a pro-inflammatory response as the hormone cortisol (more commonly known as the stress hormone) is also involved in regulating inflammation.
Excess weight – Although excess weight gain is listed as a trigger for inflammation, this is a bit of a conundrum as inflammation can also lead to weight gain. Different pathways have been linked to show that overeating and excess fat in the body can trigger inflammation.
Alcohol Consumption – While maintaining your limits while consuming alcohol is advisable, drinking too much impairs liver function and may even cause build up of toxic byproducts triggering inflammatory reactions in your body.
Smoking – Multiple studies conducted among smokers has indicated a clear increase in various inflammatory markers. Also there is a clear decline in these markers after they quit smoking indicating a correlation between the two.
What are some of the foods that trigger inflammation?
Various studies have concluded that certain food groups tend to induce or cause an inflammatory reaction leading to adverse effects. Some of them are listed below:

    1. Sugars and Fructose – Studies conducted in animal models and human trials have been shown to induce inflammatory reactions leading to diseases such as obesity, diabetes, etc., What’s more, the high concentration of fructose in refined sugars and high fructose corn syrup plays an adverse role in developing these diseases.
    2. Trans Fats – Trans fats are one of the unhealthiest food options out there and are mostly found in fried fast food items. It is shown that there is a spike in inflammatory markers such as C-Reactive Protein when consuming a diet high in Trans Fats


What is an anti-inflammatory diet?
A prolonged inflammation in the body is characterised by oxidative stress and altered glucose and lipid metabolism in our fat (adipose) cells, muscle, and liver. Making dietary changes can aid in managing oxidative stress and inflammatory pathways.
Anti-inflammatory diets are rich in antioxidants, plant polyphenols and other components that help reduce inflammatory responses. The usual prescription for an anti-inflammatory diet includes foods low in refined carbohydrates, high in soluble fiber, high in mono-unsaturated fatty acids, a higher omega-3 to omega-6 ratio.
The mediteranian diet is considered a good example of an anti-inflammatory diet as it is rich in fruits, vegetables, nuts, whole grains, fish, and healthy oils. The advantage here is that it not only helps reduce inflammation in your body but substitutes your diet with healthier options leading to a better overall health.
Some of the commonly prescribed foods for an anti-inflammatory diet are Berries(rich in antioxidants), Fatty Fish(rich in omega-3 fatty acids), Avocados(high in fiber), Turmeric(contains curcumin, a powerful anti-inflammatory compound).
Who would benefit from an anti-inflammatory diet?
An anti-inflammatory diet is usually prescribed for people suffering from an inflammation based condition such as:

    • Rheumatoid Arthritis
    • Psoriasis
    • Asthma
    • Eosinophilic Esophagitis
    • Crohn’s Disease
    • Colitis
    • Inflammatory Bowel Disease
    • Lupus
    • Hashimoto’s Disease

In addition to this, it might help manage lifestyle conditions such as diabetes, obesity and heart disease.
Although staying on this diet might help reduce the occurrence of inflammation, it may not be the ultimate solution. It is important to consult your physician and continue any medication prescribed. 
It is also considered to be a healthy diet in general as it incorporates a diet high in the major macronutrients and excludes highly processed and refined foods.

References

  1. What is an inflammation? National Center for Biotechnology Information. 
  2. Hunter P. Stress, Food, and Inflammation: Psychoneuroimmunology and Nutrition at the Cutting Edge. EMBO Reports.
  3. Hunter, Philip. The Inflammatory Theory of Disease. EMBO Reports, Nature Publishing Group, Nov. 2012
  4. Galland, Leo. “Diet and Inflammation.” Sage, 7 Dec. 2010
  5. Foods that fight inflammation. (2017, August 13).
  6. Sheldon Cohen, Denise Janicki-Deverts, William J. Doyle, Gregory E. Miller, Ellen Frank, Bruce S. Rabin, and Ronald B. Turner. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS, April 2, 2012 DOI: 10.1073/pnas.1118355109
  7. University of Oslo. “Being overweight causes hazardous inflammations.” ScienceDaily. ScienceDaily, 25 August 2014
  8. Makki K, Froguel P, Wolowczuk I. Adipose tissue in obesity-related inflammation and insulin resistance: cells, cytokines, and chemokines. ISRN Inflamm. 2013;2013:139239. Published 2013 Dec 22. doi:10.1155/2013/139239
  9. Wang HJ, Zakhari S, Jung MK. Alcohol, inflammation, and gut-liver-brain interactions in tissue damage and disease development. World J Gastroenterol. 2010;16(11):1304–1313. doi:10.3748/wjg.v16.i11.1304
  10. Kianoush S, Yakoob MY, Al-Rifai M, et al. Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis: ELSA-Brasil (The Brazilian Longitudinal Study of Adult Health). J Am Heart Assoc. 2017;6(6):e005088. Published 2017 Jun 24. doi:10.1161/JAHA.116.005088
  11. Lee J, Taneja V, Vassallo R. Cigarette smoking and inflammation: cellular and molecular mechanisms. J Dent Res. 2012;91(2):142–149. doi:10.1177/0022034511421200
  12. Tibuakuu M, Kamimura D, Kianoush S, et al. The association between cigarette smoking and inflammation: The Genetic Epidemiology Network of Arteriopathy (GENOA) study. PLoS One. 2017;12(9):e0184914. Published 2017 Sep 18. doi:10.1371/journal.pone.0184914

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