Coffee and doughnuts: double-trouble for diabetes risk

Mysterious protective effects of coffee against diabetes have been reported in the past.  A 2010 meta-analysis analyzing data from 18 studies reported that each additional cup of coffee consumed per day was associated with a 7% reduction in risk of diabetes.1  This was surprising, especially because coffee consumption has been shown to raise glucose levels after a meal so you would expect it to worsen diabetes, not help it.  However, this is true of both decaffeinated and regular coffee, although regular coffee raises blood glucose more than decaf.2 

The reason for the decreased diabetes risk remains uncertain, but since coffee comes from a darkly colored bean, it is likely that antioxidants, minerals, or other phytochemicals present in coffee may be responsible for the long term benefits seen in the observational studies.3 With this in mind, we must also remember that almost all of the subjects in the observational studies were eating the standard American diet and therefore starving for antioxidants and phytochemicals. 

Is the standard American diet so nutrient-poor that a significant portion of people’s phytochemical intake comes from their morning coffee? 

It’s likely. Additional studies support this possibility. One observational study of 28,000 postmenopausal women actually found that decaffeinated coffee was more protective than regular coffee – which suggests that the caffeine in coffee might be increasing risk, while the phytochemicals decrease risk.4 Chlorogenic acid and trigonelline, two of the major phytochemicals in coffee, have been shown to decrease blood glucose and insulin concentrations in the blood compared to placebo after ingesting sugar, so these phytochemicals likely increase insulin sensitivity.5  It is doubtful that coffee would offer any additional protection on top of a nutrient dense diet - the responsible phytochemicals can be obtained from other plant foods and the diet would not be so lacking in antioxidants.  For example, blueberries contain the antioxidant chlorogenic acid, and the phytoestrogen trigonelline is also found in peas, lentils, soybeans, and sunflower seeds. 6-8  The only reason coffee is beneficial is because of the severe deficiencies in the plant-derived phytochemicals in the diet of most Americans, and coffee at least supplies something.  

New research has found something that makes the insulin desensitizing effects of caffeine even worse - ingesting caffeine with a high-fat meal.

High-fat meals are another factor known to impair glucose tolerance, and saturated fat consumption causes the body to produce inflammatory molecules that contribute to insulin resistance.9  This study demonstrated caffeine consumption and a high-fat meal had additive insulin desensitizing effects, and this did  not merely raise the blood glucose - but also when the insulin doesn’t work well the body has to make more of it, and higher insulin causes weight gain and increases cancer risk.10-12 When subjects ingested a high-fat meal followed by a sugary drink, and blood glucose levels were 32% higher compared to subjects who had water in place of the high-fat meal.  In the second part of the study, subjects were given two cups of caffeinated coffee in addition to the high-fat meal and sugary beverage – this time, blood glucose was even higher – 65% higher than the subjects who had only water before the sugary drink.13  Apparently, coffee can have good or bad effects on insulin depending on whether it is consumed with high fat animal products or not.

The message here is that coffee can be both good and bad, but its powerful addictive qualities, with the potential for withdrawal headaches and to increase blood pressure should make people cautious;14-16 the most likely risks are almost never mentioned in news reports.  I do not think anyone should rely on coffee to protect themselves against diabetes.  If you do choose to drink coffee, stick to water-processed (non-chemical) decaf, and of course skip the doughnuts!

 

References:

1. Huxley R, Lee CM, Barzi F, et al: Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Arch Intern Med 2009;169:2053-2063.

2. Greenberg JA, Owen DR, Geliebter A: Decaffeinated coffee and glucose metabolism in young men. Diabetes Care 2010;33:278-280.

3. Tunnicliffe JM, Shearer J: Coffee, glucose homeostasis, and insulin resistance: physiological mechanisms and mediators. Appl Physiol Nutr Metab 2008;33:1290-1300.

4. Pereira MA, Parker ED, Folsom AR: Coffee consumption and risk of type 2 diabetes mellitus: an 11-year prospective study of 28 812 postmenopausal women. Arch Intern Med 2006;166:1311-1316.

5. van Dijk AE, Olthof MR, Meeuse JC, et al: Acute effects of decaffeinated coffee and the major coffee components chlorogenic acid and trigonelline on glucose tolerance. Diabetes Care 2009;32:1023-1025.

6. Zheng W, Wang SY: Oxygen radical absorbing capacity of phenolics in blueberries, cranberries, chokeberries, and lingonberries. Journal of Agricultural and Food Chemis ry 2003;51:502-509.

7. Rozan P, Kuo YH, Lambein F: Nonprotein amino acids in edible lentil and garden pea seedlings. Amino Acids 2001;20:319-324.

8. Sanchez-Hernandez L, Puchalska P, Garcia-Ruiz C, et al: Determination of trigonelline in seeds and vegetable oils by capillary electrophoresis as a novel marker for the detection of adulterations in olive oils. Journal of Agricultural and Food Chemis ry 2010;58:7489-7496.

9. Wen H, Gris D, Lei Y, et al: Fatty acid-induced NLRP3-ASC inflammasome activation interferes with insulin signaling. Nat Immunol 2011.

10. Bowker SL, Majumdar SR, Veugelers P, et al: Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin. Diabetes Care 2006;29:254-258.

11. Davies M, Gupta S, Goldspink G, et al: The insulin-like growth factor system and colorectal cancer: clinical and experimental evidence. Int J Colorectal Dis 2006;21:201-208.

12. Harish K, Dharmalingam M, Himanshu M: Study Protocol: insulin and its role in cancer. BMC endocrine disorders 2007;7:10.

13. Beaudoin MS, Robinson LE, Graham TE: An oral lipid challenge and acute intake of caffeinated coffee additively decrease glucose tolerance in healthy men. J Nutr 2011;141:574-581.

14. Giggey PP, Wendell CR, Zonderman AB, et al: Greater Coffee Intake in Men Is Associated With Steeper Age-Related Increases in Blood Pressure. Am J Hypertens 2010.

15. Noordzij M, Uiterwaal CS, Arends LR, et al: Blood pressure response to chronic intake of coffee and caffeine: a meta-analysis of randomized controlled trials. J Hypertens 2005;23:921-928.

16. James JE: Critical review of dietary caffeine and blood pressure: a relationship that should be taken more seriously. Psychosom Med 2004;66:63-71.

Healthy Eating for Diabetics

As the number of people with type-two (adult onset) diabetes continues to soar, it is openly recognized that the growing waistline of the modern world is the main cause of this epidemic; however, most physicians, dieticians, and even the American Diabetes Association have virtually given up on weight reduction as the primary treatment for diabetics. Consider this statement from a medical advisory committee: “It is nearly impossible to take very obese people and get them to lose significant weight. So rather than specifying an amount of weight loss, we are targeting getting metabolic control.” This is doublespeak for—our recommended diets don’t work, so we just give medications and watch patients gradually deteriorate as the diabetes advances. Today, medications are the mainstay of treatment and, unfortunately, most of these medications cause weight gain, worsening the syndrome and making the individual more diabetic. Additionally, the narrow focus on blood-sugar reduction and reliance on medications gives patients a false sense of security because they mistakenly think their somewhat better controlled glucose levels are an indication of restored or improved health. They continue to gain weight following the same dietary habits that originally caused the problem.

It is well accepted that if it were possible for people to stick with weight reduction and high nutrient eating, that route would be the most successful. Patients with diabetes who successfully lose weight from undergoing gastric bypass surgery typically see their diabetes melt away.1 Dietary programs that have been successful at effecting weight loss have been dramatically effective for diabetics too, enabling patients to discontinue medications.2 Preventing and reversing diabetes is not all about weight loss. The nutritional features of Eat for Health have profound effects on improving pancreatic function and lowering insulin resistance over and above what could be accomplished with weight loss alone. The increased fiber, micronutrients, and stool bulk, plus the cholesterol-lowering and anti-inflammatory effects of this eating-style, have dramatic effects on type-II diabetes. Scores of my patients have been able to restore their glucose levels to the normal range without any further need for medications. They have become non-diabetic. Even my thin, type-I, insulin-dependent diabetic patients are typically able to reduce their insulin requirements by almost half and have better glucose control using this high-nutrient eating-style.

Diets high in fiber and vegetables have been consistently shown to be beneficial for diabetic patients and offer considerably better results when compared to the current recommendations of the American Diabetic Association Diet.3 The dietary advice typically offered to diabetics is not science-based, and it caters to Americans’ social and food preferences and food addictions. In contrast, the qualities of an eating-style that maximizes benefits for weight reduction, cardio protection, and diabetes reversal are described in Eat for Health.

This is an excerpt from Dr. Fuhrman’s book Eat For Health.

1. Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238(4):467-484; discussion 84-85.

2. Harder H, Dinesen B, Astrup A. The effect of a rapid weight loss on lipid profile and glycemic control in obese type 2 diabetic patients. Int J Obes Relat Metab Disord. 2004;28(1):180-182.

3. Barnard ND, Cohen J, Jenkins DJ, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29(8):1777-1783.

Ford ES, Mokdad AH. Fruit and vegetable consumption and diabetes mellitus incidence among U.S. adults. Prev Med 2001;32(1):33-39.

Montonen J, Knekt P, Harkanen T, et al. Dietary patterns and the incidence of Type 2 Diabetes. Am J Epidem 2004;161(3):219-227.

Breakfast Cereal Raises Blood Sugar, Heart Risks

Put the cornflakes down! New findings in the Journal of the American College of Cardiology claim high-glycemic foods spike blood sugar and interfere with normal functioning of blood vessels. Subjects fed cornflakes, glucose and high-fiber cereal had impaired the endothelial function—the cells that line the inside of blood vessels—compared to people given oatmeal, fruits, vegetables, legumes and nuts. Poor endothelial function is believed to increase the risk of heart disease; Health Day News reports.

Breakfast cereal and white bread are processed foods, i.e. empty carbohydrates with no nutrition. Even “whole wheat” bread is a scam. Dr. Fuhrman says caramel color is added to give it the appearance of whole wheat. Luckily, fruits and vegetables are packed with healthful fiber and nutrients.

In April, a study showed overweight Latino teenagers switching to a high-fiber, low-sugar diet had less risk of type-2 diabetes and experienced substantial drops in blood glucose levels.

Image credit: vinduhl

Teenage Belly Fat Means Adult Heart Trouble

New research in the journal Diabetes shows young adults who had too much belly fat as teenagers have a higher risk of heart disease later in life. Among the 612 participants, men ages 18 to 20, those whose body mass index increased during adolescence had greater amounts of fat surrounding their abdominal organs. Belly fat, or visceral fat, has been closely linked to diabetes, high blood pressure and cardiovascular disease; via Reuters.

No pun intended, but this is a BIG deal. A previous report reveals young men who are obese at age 18 are more likely to die prematurely as adults. Too make matters worse, our high rate of childhood obesity is expected to skyrocket heart disease among teenagers.

In related news, teenage Latino children switching to a diet consisting of more fiber and less sugar had significant drops in blood sugar and glucose, slashing diabetes risk.

Image credit: chalkdog

Grapes Help Fight Abdominal Fat

A new study in the journal Molecular Nutrition and Food Research suggests polyphenols, found in grape seeds, may protect against oxidative stress linked to obesity. Scientists fed hamsters a high-fat diet supplemented with Chardonnay grape seed extract for 12 weeks. At the end of the experiment mice not given the grape seed extract had more abdominal fat than mice given the extract. Also, data revealed the high-fat group had increases in blood sugar, triglycerides and insulin resistance, while the extract group was “in part” protected from these effects; via Food Navigator.

In October, grapes were shown to lower blood pressure and reduce heart damage, but lots of plant foods, like blueberries and kiwis, contain polyphenols, antioxidants and other nutrients shown to prevent cancer. Nuts and seeds are other excellent sources phytochemicals and fibers that prevent blood vessel inflammation, raise good cholesterol and lower blood glucose.

I snack on grapes when I’m chained to my desk blogging. Good thing I find them on the cheap! As a kid, my grandfather had an old-school Italian grapevine growing all over the garage. It was cool.

Image credit: Nikita Kashner

Diabetes: Brits Get Drugs Before Better Diet

In the United Kingdom 1 in 3 people with diabetes are given medication too soon, instead of being encouraged to eat better and exercise. The study, presented at a Diabetes UK conference, revealed 36% of the 650 people studied were put on medication within 1 month of being diagnosed, despite medical guidelines recommending lifestyle changes be tried first. Startling when you consider 400 people a day are diagnosed with type-2 diabetes in the United Kingdom; BBC News investigates.

This is sad, especially in light of all the research linking diet to diabetes, such as the dangers of drinking soda and the benefits of eating vegetables. Consuming a lot of high-fiber, high-nutrient foods, i.e. fruits and veggies, improves pancreatic function and lowers insulin resistance, allowing glucose levels to return to normal range without medications.

The UK’s had a rough go of it. Health officials recently urged people to buy less saturated fat and Prince Charles blasted junk food for children’s disconnect with nature, but luckily they’ve enlisted Wallace and Gromit to help fight obesity and improve health!

Image credit: palestrina55