Posts Tagged ‘Diabetes’

Diabetes – Easily Preventable Yet Tragically Unstoppable

June 13th, 2014 at 4:29 pm by timigustafson

The Centers for Disease Control and Prevention (CDC) estimates that over 29 million Americans suffer from diabetes today, an increase of more than 10 percent since 2010 when the agency issued its last report. The actual numbers may still be higher because a quarter of all diabetics don’t even know they have the disease, according to the survey. Other research predicts that more than half of the U.S. population will be affected by the end of this decade.

Worldwide, the statistics are equally as discouraging. The World Health Organization (WHO) thinks that globally nearly 350 million people have diabetes. The vast majority of those, about 80 percent, live in low- and middle-income countries. The disease is projected to be the seventh leading cause of death by 2030.

Alarmingly, more and more people develop diabetes at a younger age. 1.7 million Americans aged 20 years and older, and nearly a quarter of a million children and adolescents, have been newly diagnosed in 2012 alone, according to the CDC study. A whopping 86 million adults have pre-diabetes, meaning they are at an elevated risk of getting sick in the near future. Minorities, including African Americans, Hispanics, and Native Americans, seem especially vulnerable.

In 2012, treating diabetes and related health complications accounted for $245 billion in medical costs and lost work and wages. Overall productivity loss could be much higher and reach well over one trillion, the researchers suggest.

Diabetes is an illness that occurs when the pancreas fails to produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. If untreated, diabetes can lead to hyperglycemia, chronically elevated blood sugar, which can cause irreversible damage to blood vessels and nerves, and, in advanced stages, result in loss of limb and blindness.

There are two kinds of diabetes. One is called Type 1 diabetes, an insulin deficiency that is usually linked to a damaged pancreas and is not considered preventable. The other, Type 2 diabetes, results from ineffective use of insulin, and is presumably acquired through diet and lifestyle. It is often seen in connection with weight problems. The vast majority of diabetes cases is of this type.

While the occurrence of Type 2 diabetes is mainly blamed on poor diet choices, overeating, and sedentary lifestyle, it is less clear why the disease has been spreading so fast and even seems to accelerate. Experts warn that unless we succeed in implementing more effective countermeasures, we won’t be able to stop this looming pandemic.

“We need a sense of urgency,” said Dr. Dennen Vojta, a senior vice president of the UnitedHealth Center for Health Reform and Modernization in Minneapolis to WebMD. “There is a lot of money and human suffering at stake. The good news is that we know what works, and if we work together in a concerted national way, we can win.”

But what would such concerted action entail? Past attempts have been less than encouraging. For example, proposals to raise taxes on fast food and sugary beverages, which are known to contribute to weight problems, or posting warning labels and detailed nutritional information on such items have not gone far in most places, despite of growing support among consumers.

The tragedy of it all is that we have at least some answers to these problems, but are – for whatever reasons – unable or unwilling to apply them. Soon enough, the consequences of today’s inaction will become overwhelming.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Education, the Best Protection Against Obesity and Related Diseases

March 12th, 2014 at 12:43 pm by timigustafson

With growing wealth in many developing countries around the world, diet and lifestyle changes are showing dramatic increases in obesity and related diseases like diabetes, heart disease and cancer. From Central and South America to the Middle East to Asia, weight problems are now among the leading causes of morbidity and mortality. But more than rising standards of living, lack of education seems to contribute to these dismal trends.

In China, India and Brazil, where economic growth has been especially dramatic but has also created vast inequalities in their populations, diet and lifestyle changes have had a particularly profound impact on the risk of obesity, according to one study that investigated the effects of rising incomes on people’s health.

In Mexico, which is considered a middle-income country, prevalence of obesity proved to be the highest among those who were better off financially but had little education. Similar findings were made in Egypt, a low-income country, where obesity has become a fast growing problem, especially among women. Here too, increasing wealth is a predictor – but even more so, lack of schooling.

“For the first time, we have studied the interaction between wealth and education and found they have fundamentally different effects on obesity,” said Dr. Amina Aitsi-Selmi, the lead author of the Egypt study.

Greater exposure of emerging economies to global food markets and rising buying power of consumers lead to these consequences. The best way to prevent this from happening would be to invest in education, especially in women who are in charge of food shopping, cooking, and taking care of the health needs of their families, she said.

“Our study suggests that investing in women’s education protects against this effect by empowering individuals to look after their health,” she said to Science Daily.

As ‘gatekeepers’ in their households, women have the most influence on the nutritional wellbeing of children, which is our best hope for breaking the vicious circle that begins with childhood obesity and subsequent, often chronic, health issues during adulthood.

Scientific evidence leaves no doubt that the environment we live in is largely responsible for the obesity epidemic, Dr. Aitsi-Selmi said. We can only change the environment by changing the behavior of individuals. And that is best accomplished through education.

Obviously, providing even a basic amount of health education in different socio-economic and cultural settings is no easy task in one country, let alone on a global scale. But, as this study and others have shown, increase in literacy and greater opportunities for learning have many benefits and can provide the groundwork for attitude and behavior modifications, including improving eating habits.

It also means that greater affordability of food does not automatically lead to better health outcomes – sometimes to the contrary. Only when people understand how their diet and lifestyle choices affect them, they can make appropriate changes and take control of their wellbeing.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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A Responsibility Not to Get Sick

February 26th, 2014 at 11:39 am by timigustafson

According to the World Health Organization (WHO), no other current health threats spread as fast as so-called ‘non-communicable diseases’ (NCDs) like obesity, diabetes, heart disease and cancer. What distinguishes these from infectious illnesses is that humans bring them mostly upon themselves through poor diet and lifestyle choices. Nevertheless, the impact is very real and there is no letting up in sight.

How can that be? How can we self-inflict debilitating and potentially life-threatening diseases on a pandemic scale? How can this happen when we have a pretty good understanding of the causes and how they could be averted? And why is it that the countless messages about diet and lifestyle changes produce such meager results?

Unsurprisingly, there is great uncertainty among the experts about how to address these issues. For example, only last year, the American Medical Association (AMA) decided to classify obesity as a “disease,” with the goal to bring greater attention to the urgency of the matter. Yet some have expressed skepticism about the helpfulness of such a move.

In a recent op-ed article in the New York Times, psychology professors Dr. Crystal L. Hoyt and Dr. Jeni L. Burnette, both of the University of Richmond, Virginia, suggested that the classification may in fact be counterproductive because it potentially diminishes incentives to deal effectively with weight problems.

“Calling obesity a disease provides a clear warning of the significant health risks associated with excessive weight,” they wrote. “We wondered, however, if there also might be psychological ramifications inherent in that message. Would it reduce or add to the burden of body-image concerns and shame? Would it empower people to fight back, or lead to a fatalistic acceptance of being overweight?”

They both agreed that stigmatization and discrimination of any kind have no place in how we view obesity and other related health issues. On the other hand, we ought not simply relieve people of all responsibility for their own well-being.

Suggesting that someone’s weight is his or her unfortunate fate, a “fixed state like a long-term disease,” can make efforts of weight loss and dietary improvements seem futile and may indeed undermine them, the professors warned.

As a dietitian and health counselor, I have no problem with declaring obesity a disease, especially considering the complexity of potential causes, some of which are indeed beyond an individual’s control. Having said that, I also believe that the only appropriate response to illness is to make every effort to overcome it as quickly possible. An even better approach would be prevention, so that damages don’t occur in the first place. For this, I believe, we all have a duty, a personal responsibility not to get sick as a consequence of our own actions.

Yes, there is much confusion around diet and lifestyle issues. Many people have given up and are tired of listening to oftentimes inconsistent, if not contradictory, messages. But there is also some certainty. Eating healthily by adding more fresh fruits and vegetables and cutting back on processed foods is part of that. So is observing portion sizes. Regular exercise is a must without question. Reducing stress and getting enough sleep matter as much. All these we know to be true. If we acted upon just this bit of knowledge each and every day, things could improve real fast.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Diabetes, the Hidden Killer

November 13th, 2013 at 12:28 pm by timigustafson

Like many other so-called non-communicable diseases (NCDs), diabetes is on the rise worldwide. Here in the United States, 17 million have been diagnosed with the condition, but more strikingly, about one third of those affected don’t even know about it, according to surveys by the Centers for disease Control and Prevention (CDC).

Not unlike heart disease, diabetes is considered a “silent killer” because it cannot be detected through clearly identifiable symptoms, which contributes to the discrepancy between diagnosed and actual cases.

Diabetes is the seventh leading cause of death among Americans, after heart disease, cancer, stroke, accidents and Alzheimer’s disease. It is the leading cause of blindness, kidney failure, lower extremity amputations, and also increases the risk of heart attack and stroke, according to the CDC.

Diabetes alone accounts for well over $100 billion in direct medical costs and an additional $60 billion in indirect costs such as loss of productivity and disability annually.

Researchers say that the most common form of the disease – type 2 diabetes – is preventable in large parts through lifestyle improvements like weight control, healthy eating and regular exercise.

The easiest way to diagnose diabetes is through a simple blood sugar test. Outside of that, there are a number of symptoms that can indicate whether someone either has or is at risk of developing the disease.

One common sign is frequent urination as well as excessive thirst. The urge to urinate is caused by the kidneys’ struggle to get rid of high amounts of glucose in the blood. The heightened thirst is a response to the need for replenishing the lost fluids. So, for example, having to go to the bathroom repeatedly during the night can be, among other reasons, an indication that the body has difficulties managing high blood sugar.

Other possible symptoms are rapid weight loss (without diet or lifestyle changes), excessive hunger pangs due to sudden drop in blood sugar level, fungal infections (including yeast infections), slow healing of wounds, skin problems like dry skin and skin darkening around the neck and armpit areas, blurry vision, and tingling and numbness in hands and feet, along with pain and swelling because of progressive nerve damaging.

There are several exams available to determine whether a person is diabetic or pre-diabetic, which is a serious health condition in itself. The most common is a blood sugar test administered after a minimum of eight hours fasting. Amounts under 99 milligrams per deciliter (mg/dL) are considered normal. 100 to 125 mg/dL indicates you may be pre-diabetic. Levels above 126 mg/dL means you have the disease.

Untreated diabetes can have dangerous, even life-threatening outcomes. Besides medical intervention, dietary improvements can make a significant difference. While there is no such thing as a specific diet plan for diabetes patients, cutting back or eliminating processed foods that are filled with fat and sugar, and following a regimen that includes plenty of fresh produce is an important step. Weight management (and weight loss, if necessary) as well as fitness training are also essential. Of course, as always, prevention is preferable to any treatment, medical and otherwise.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Americans don’t like to cook. They don’t want to spend the time it takes for food shopping, food preparation and clean up, especially when it’s so much easier to stop for a quick bite at a restaurant or drive-thru or bring home some take-out. Yet, experts are convinced that making home cooking fashionable again would be one of the most effective steps we could take to address the nation’s obesity crisis.

The United States ranks at the bottom of industrialized countries not only in terms of time spent on meal preparation but also on consumption, according to surveys conducted by the Organization for Economic Cooperation and Development (OECD), an international group that analyzes economic data worldwide. In other words, we not only don’t cook, we also don’t set much time aside to enjoy our food. Instead, more and more of us skip breakfast, work through lunch and sustain ourselves throughout the day by snacking.

The percentage of calories from snacks in the American diet has doubled since the 1970s, as more people have turned into all-day grazers while foregoing sitdown meals on most days, a study by the National Health and Nutrition Examination Surveys (NHANES) found.

Over half of American adults say they have three or more snacks a day. Almost a third of children and adolescents eat chips, popcorn, pretzels and the likes on a daily basis. The amount of pizza eaten, both in restaurants and at home, has nearly tripled over the past thirty years. Meanwhile, the number of calories in pizzas has increased by 25 percent on average since the late 1970s. Over the same time period vegetable consumption has declined from 2.6 to just 1.9 servings per day – and that includes French fries.

The easiest way to turn these developments around would be to start preparing our meals from scratch again, says Mark Bittman, food writer and author of “Cooking Solves Everything: How Time in the Kitchen Can Save Your Health, Your Budget, and Even the Planet” (Kindle edition, 2011). Millions of Americans don’t ever cook. The rest cooks on occasion, often just microwaving. Many don’t bother with sitting down at the dinner table but rather eat in the car, at a counter, or in front of a screen. “And that’s a shame, because cooking is a basic essential, worthwhile and even enjoyable task,” he writes.

Bittman applauds others who are trying to get the message out about the many benefits of home cooking, like his fellow-book-author Michael Pollan who just published a new book on the same subject, titled, “Cooked: A Natural History of Transformation” (Penguin Press, 2013). In a review on the then upcoming publication he writes: “Cooking is probably the most important thing you can do to improve your diet.”

The reasons are obvious. If you are in charge of the ingredients that go into your food, you already are going to eat better because you won’t include extra fat, salt, sugar, preservatives, dyes and other additives. You also won’t eat as many highly caloric items like French fries, which are cumbersome to make at home. The same goes for pizza (made from scratch, not the ones you just heat up).

One of the central problems with cooking is that we don’t value it enough any more. We are used to having tasks like these done for us by outside service providers. But unlike getting your car or computer fixed by someone else, cooking is much more intimate. It connects us with our bodies, nature and loved ones.

Michael Pollan even thinks that the experience of cooking brings us closer to the most basic elements that surround us: fire, water, air and earth and also tightens our social and ecological relationships. All that has deeply transformational characteristics that can change us on multiple levels, but all for the better.

That is much to hope for – perhaps too much. Still, it is a fact that an increasing number of people are looking for ways to eat more healthily and also reduce stress on the environment, e.g. by cutting back on meat consumption and buying more produce from local farms. A rediscovery of home cooking would fit squarely within these trends. Whether it will be enough to transform or currently predominant way of life remains doubtful.

If you liked this article, you may also enjoy reading “Home Cooking for Healthy Eating” and “Tips for Leaner Cooking Techniques

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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It’s a proven fact that most people change their eating habits and lifestyle choices only after a serious health scare such as a heart attack or a diabetes diagnosis. Still, in many cases that may not be enough. Old habits tend to die hard, but often there are also not many alternatives to what they’ve been doing in terms of eating right and taking care of themselves.

A recent study found that most consumers after being confronted with a major health crisis were still influenced in their choices by factors other than what’s good for their health. For example, people can find it difficult to change their long established eating habits, says Dr. Yu Ma, an economics professor at Alberta School of Business and author of the study. Another highly influential factor is price, he says. If they get a good deal on a particular item, they will go for it, and if it’s too expensive, they will stay away, no matter how much they would benefit healthwise.

Another issue is what he calls the “health halo effect.” Most people divide foods simply into two categories: healthy and unhealthy, he says. If something is considered healthful, e.g. a salad or a breakfast cereal, as opposed to a cheeseburger or a sugar-laden donut, people tend to overindulge in the “healthy” stuff without much further thought. We have seen that phenomenon when, for example, fat-free cookies came on the market and many believed they could consume those in almost unlimited quantities because of the absence of fat. Of course, eliminating the fat did not make those cookies less caloric, and the results became apparent soon thereafter.

Another study, this one on heart attack and stroke patients, showed that nearly 15 percent did not alter their eating and lifestyle habits after the incident, including poor diet choices, lack of exercise and smoking. Less than half of all participants in the study reported having made at least one change, and less than a third said they made several improvements. Only 4 percent claimed they did everything that was recommended to them to prevent further deterioration of their health.

Much of the unwillingness or inability to make healthier diet and lifestyle choices can be blamed on the widespread confusion among the public due to the ceaseless onslaught of sometimes contradictory messages in the media about health matters. In addition, many of the warnings issued by experts are hard to heed by consumers who are oftentimes ignorant, if not intentionally kept in the dark, about the nutritional quality of their food supply. For instance, recommendations to avoid high fat, salt and sugar content may be well-meaning, but they are by and large useless when ingredients lists are hard to decipher or when restaurants aren’t required to follow any dietary guidelines or to post nutritional information on their menus.

“I think people are interested in making changes and they are heeding the warnings,” said Dr. Sara Bleich, an associate professor of health policy at the John Hopkins School of Public Health to NBCNews. “But when it comes to food, it’s much more complicated. Cereal, for example, has a tremendous amount of added sugar. And not everyone understands that breakfast foods like muffins and pastry, things that people don’t consider to be a dessert or an indulgence, pack a lot of sugar.” Similar concerns apply to salt in countless processed foods, many of which don’t even taste salty, and certain types of fats, some of which are obscured by arbitrary serving descriptions on food labels.

Undoubtedly, more and more people want to be better informed about nutritional health and be empowered to make the right choices. With growing consumer demand for further regulation and protection, that may be feasible over time. But for now, it’s an ongoing uphill battle, and most of us have to fend for ourselves as well as we can.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Searching for the Cause(s) of Obesity

March 13th, 2013 at 12:08 pm by timigustafson

Two thirds of Americans are overweight. One third is obese. Obesity and a host of illnesses related to weight problems kill more people than any other disease. Experts are scrambling to find answers for what causes the epidemic and seem to come up with new explanations every day, only to be contradicted by the next study. Unsurprisingly, consumers are confused and stop paying attention.

How is it that we are eating ourselves to death, not just here but increasingly around the world? Does the so-called “Western diet,” consisting of cheap, highly processed, highly caloric foods, make us fat? Or is it sugary sodas? Are portion sizes too big? Does the food industry turn us into addicts? Do we just not exercise enough?

So far, none of the countless studies on these subjects have had much impact in practical terms. Lobbying efforts and political gridlock are oftentimes blamed for the maddeningly slow progress. But that may not be the only reason. Some experts warn that despite of all the research, finding definite answers may prove elusive for some time to come.

“If we can find the causes of obesity, we can try to eliminate or counter them,” wrote Christopher Chabris, a professor of psychology at Union College, together with his colleague Daniel Simons of the University of Illinois in an op-ed piece in the New York Times. “Unfortunately, finding causes is easier said than done, and causes we think we see can turn out to be illusions.”

Hoping for a smoking gun that lets us clearly identify causation may not be in the cards, ever. As an example, the authors cite a study that analyzed potential connections between food advertising on billboards and prevalence of obesity in certain parts of Los Angeles and New Orleans. The study results showed that areas with more outdoor food advertisements had a higher proportion of obese people than those with fewer ads. So, there seems to be a direct link.

Not so fast, say the professors. Studies like these have a significant problem: They can show association between separate phenomena but not causation. In this particular scenario, interpretations of the findings could go in totally different directions. Even if you accept the existence of a correlation between food advertisements and obesity, you still have to consider a wide field of possible explanations. One could be that food vendors tend to invest more of their advertising budget in places where they believe food consumption is especially high. Obesity then may be an indicator that this is a good market for them. Which comes first, the chicken or the egg?

So does this mean there is no proof that food advertising influences people’s eating habits, and not necessarily in a good way? Studies like these can at best provide some indication that there may be a link, but they don’t provide evidence for causation, the professors conclude. Only the gold standard of scientific research, which is the randomized controlled trial, could prove such connections, they say. And these standards are often not achievable in the real world.

The question is what does that mean in terms of taking anti-obesity measures. Do we have to remain indolent in the face of this alarming health crisis just because we can’t pinpoint its causes with the highest standards of certainty? Food manufacturers and restaurant operators support that view. But if no compelling evidence can be had that advertising works, why would they keep spending billions of dollars every year on doing just that?

With all due respect for scientific standards, I can’t help but think that calling for more and more studies on the causes of obesity only delays critical action that ought to be taken now. We may not know whether food ads influence everyone’s eating habits, but we still can ban them from children’s programs on TV. We may never be sure whether drinking sugary sodas or consuming sweet snacks cause diabetes, but we still can stop offering them on school campuses. It may be unclear whether posting calorie counts in restaurants will make patrons order smaller portions, but we should at least give them the option, so their choices can be better informed. How many more studies and trials do we really have to conduct before we take at least a few steps in the right direction?

If you liked this article, you may also enjoy reading “How Serious Is the Food Industry About Helping in the Fight Against Obesity?” and “Obesity Must Be Addressed on Multiple Levels.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Diabetes Can Be Caused by High Sugar Intake Alone, New Study Finds

March 3rd, 2013 at 2:43 pm by timigustafson

Diabetes affects over 25 million Americans today, more than 8 percent of the population. One in four seniors suffers from the disease, and the numbers among young people, including teenagers, are dramatically on the rise. Over a third of all diabetics in the United States remain undiagnosed and are not treated, according to the latest statistics of the Centers for Disease Control and Prevention (CDC).

In most cases, type 2 diabetes (traditionally known as adult onset diabetes) develops in connection with overweight and obesity. A new study, however, found that consuming large amounts of sugar may cause the disease independently from weight problems.

For the study, researchers from Stanford University School of Medicine, the University of California, Berkeley (UCB) and the University of California, San Francisco (UCSF) compared the availability of sugar and diabetes rates in 175 countries. The underlying data came from the Food and Agricultural Organization of the United Nations and the International Diabetes Federation.

The scientists believe they have clearly identified a correlation between rising sugar consumption and the growing diabetes epidemic. Specifically, they found that an additional 150 calories from sugar per person per day – the equivalent of just one 12-ounce soda drink – increased the prevalence of diabetes by one percent in that population. The longer the exposure to the higher amount of sugar lasted, the more pronounced the diabetes risk became. Conversely, whenever sugar consumption was reduced, diabetes rates diminished as well. These variations still registered when other potentially contributing factors like weight, age, gender and race were taken into account.

While the research cannot prove direct causation, the evidence is compelling, said Dr. Robert Lustig, a pediatric endocrinologist at UCSF and senior author of the study. “This study is proof enough that sugar is toxic. Now it’s time to do something about it,” he was quoted saying by the New York Times.

Many of his colleagues in the science community agree. “The results make clear that sugar consumption is fueling the global epidemic of diabetes and that reducing that consumption is an essential step in controlling the rise of the disorder,” said Dr. Walter Willett, professor of epidemiology at the Harvard School of Public Health, to the Los Angeles Times.

Based on his findings, Dr. Lustig said, manufacturers of sugary sodas can no longer claim that calories from their products don’t differ from those of other sources.

In an op-ed article written in response to the study, Mark Bittman, a food writer for the New York Times, called for immediate action by the Food and Drug Administration (FDA) that should include re-evaluating the toxicity of sugar and removing fructose (the molecule that gives sugar its sweet taste) from the list of products the government considers safe to use.

The Center for Science in the Public Interest (CSPI), a consumer advocacy group, has reportedly petitioned the FDA to revise safety limits for sugar consumption.

By contrast, the American Beverage Association (ABA) has rejected the conclusions drawn from the study. “This study does not show – or even attempt to show – that consuming sugar causes diabetes,” the trade group says in a statement on its website.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Obesity Must Be Addressed on Multiple Levels

February 24th, 2013 at 2:36 pm by timigustafson

Obesity has grown into an alarming public health crisis, and there is no telling when or even whether we will be able to get this epidemic under control. Over two thirds of Americans now struggle with weight problems, and there is no consensus among the experts over the precise causes. Recommendations for countermeasures range from calls for more government involvement to greater responses from food manufacturers and restaurant operators to better health education of the public.

Recent legislation for the improvement of nutrition standards of school lunches and initiatives like “Let’s Move” to reduce childhood obesity have gotten some traction, but progress remains slow and uncertain, according to the latest report by the Centers for Disease Control and Prevention (CDC). Overall, there is no significant change in the current trends, and so the battle for America’s health continues unabated. There is general agreement that more, much more needs to be done.

Demands for tougher regulation of industry and policies to influence the behavior of consumers have become louder in recent years, but we have not seen the results we had hoped for. In a recent op-ed articleNew York Times columnist Mark Bittman has faulted the current Surgeon General, Dr. Regina Benjamin, for being “missing in action” in the fight against obesity, especially childhood obesity. On this issue, he writes, “Benjamin, like most of her predecessors, is virtually invisible.” Even with regards to seemingly straight forward measures like curbing children’s exposure to junk food via advertisements on TV or banning soda sales from school campuses, the government remains inexplicably passive. Instead, it still lays most of the blame at the feet of the victims by overemphasizing personal accountability.

Voluntary commitments by food manufacturers and restaurant operators have not produced much success either, despite of ample promises to show more cooperation by making food labels less confusing, offering healthier alternatives on fast food menus, or limiting exposure of kids to food advertisements.

But there is another aspect to this discussion that is often neglected. It is people’s real life experience that is not taken enough into account. By this I don’t mean to lend credence to oversimplifying statements that people are responsible for their own actions and should not blame others for their demise. Those who read my columns and blog posts know very well that I am a strong supporter of many of the measures Mr. Bittman and others are proposing.

Asking folks to make better nutritional choices makes no sense if they live miles and miles away from food outlets that carry fresh produce or in neighborhoods where getting physical exercise is difficult because of safety concerns and lack of public facilities like bike paths and parks. It is also futile to make dietary recommendations that completely ignore financial limits or access to health education.

But still, no matter what we will try from here on in terms of legislation and policy making, changing individual behavior will always play a predominant role. Eating habits are rarely just about food. They are also about stress, anxiety, loneliness, boredom, addiction, past traumatic experiences, and more. By exclusively focusing on the quality and quantity of our food supply, we will not be able to really understand these concerns and make them part of the equation, as they need to be. As they say, all politics are local. And all health issues are personal.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Most Weight Gain Comes from Stress, Scientists Say

February 20th, 2013 at 12:08 pm by timigustafson

People get fat from eating too much and exercising too little. At least that’s the most widely held explanation for the growing obesity crisis around the world. But it’s not that simple, says Dr. Achim Peters, a professor of neurology at the University of Lübeck in Germany and author of “The Selfish Brain – Why Our Brain Sabotages Dieting and Resists the Body” (Ullstein, 2011).

The worldwide obesity epidemic is in truth a stress epidemic, and unhealthy weight gain is just one of the ills that plague an increasingly stressed population trying to cope with the ever-growing demands of modern life, he says in an interview with the German news magazine “Der Spiegel” (2/9/2013).

In reality, weight issues are often rooted in socio-economic difficulties like job loss, poverty, rising food prices and other existential uncertainties, he says. It puts tremendous pressure on people. Stress-producing situations can be immensely damaging to our health, especially when they persist over long periods of time with no reprieve in sight.

Dr. Peters is best known for the “Selfish Brain Theory,” which he developed together with an interdisciplinary team of scientists over a decade ago when researching the origins of obesity. In essence, the theory describes how the brain takes care of its own needs first when regulating energy distribution throughout the body. It is “selfish” in the sense that it always wins out in any competition for energy resources, at the expense of all other organs if necessary.

In times of stress, the brain spends particularly high amounts of energy, which requires an increase in food intake. During acute stress situations, a rapid spike in energy demand is natural and not harmful. It is different when stress is prolonged. Then it can become a chronic state and as such quite dangerous.

To shed some light on these dynamics, it is important to understand our body’s hormonal responses to stress. Energy in the body is regulated and mobilized by a hormone called cortisol. Cortisol selects the right type and amount of energy to meet the body’s demands when responding to a particular situation. Cortisol is also responsible for mobilizing energy by tapping into the body’s fat stores and moving it to where it’s most needed, primarily in the brain.

Studies in animals and humans have shown that heightened secretion of cortisol is associated with increased appetite, especially for sugar. In cases of enduring stress, this can stimulate food consumption to the point of overeating with all the detrimental consequences we are so familiar with. Moreover, too much cortisol can slow the metabolism, causing more weight gain than would normally occur. It can also affect fat distribution. Fat in the stomach area is considered a greater health risk than when it’s stored around the hips and thighs.

Ultimately, we will not be able to address the obesity crisis effectively if we continue to ignore the effects of chronic stress on our hormonal system, says Dr. Peters. Asking people to diet and force themselves to lose weight through deprivation can only make things worse. The solution is to de-stress our lives. This doesn’t mean more yoga and meditating, although that can help too, but mostly better socio-economic security and, as a result, peace of mind for more people.

As a point in case he cites a study conducted by the University of Chicago that compared two groups of single mothers from low-income neighborhoods. One group of women was moved to a more upscale area with safer streets, greater job opportunities and better schools, the other was left in place. Within a few years, most of the women who had moved away showed considerable improvement in their health, especially in reduction of diabetes and obesity. As their stress lessened, their well-being increased on every level.

If you liked this article, you may also enjoy reading Can’t Lose Weight? t Could Be Stress

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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