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.

High fat intake - especially saturated fat - is associated with macular degeneration

 

Age-related macular degeneration (AMD) is the leading cause of vision loss in Americans over 60 years of age. This disease involves cell death in the macula of the eye, which has a high density of cone cells and is responsible for central vision.1 

A recent study published in the Archives of Ophthalmology2 investigated the relationship between fat intake and the presence of intermediate AMD 4-7 years later in over 1700 women, and found that some fats may benefit eye health while others may be damaging.

Total fat.Women aged 50-75 who consumed the highest proportion of calories from fat (43%) had the greatest risk of AMD – 70% higher odds than those with the lowest proportion of calories from fat (21%). As the authors stated,

"High-fat diets might be a marker for diets that are poor in many micronutrients that could protect against age-related macular degeneration.”3

They then looked further into the associations between specific types of dietary fat and AMD.

Saturated fats are detrimental when it comes to heart disease and cancer, so these results are no surprise - saturated fats showed the greatest association with AMD – 60% increased odds of AMD in women who consumed the greatest amounts. Monounsaturated fats, which are present in nuts, seeds, and avocados, were associated with a lower prevalence of the disease.

The associations between polyunsaturated fats and AMD are more difficult to interpret – the authors reported that both omega-3 and omega-6 polyunsaturated fatty acids were associated with a two-fold risk of AMD. But don’t overreact and throw away your walnuts and flaxseeds - the intakes of omega-3 and -6 in this study were highly correlated to one another, making it difficult to discern the effects of one from the other. Also, a 12-year study in the American Journal of Clinical Nutrition last month found that people at high risk for AMD were less likely to develop the disease if they had a greater intake of omega-3 fats.4 The authors of the current study hypothesized that excessive omega-6 fatty acid intake may influence AMD by promoting inflammation that can contribute to retinal damage. Vegetable oils, processed foods, and animal products contain high levels of omega-6 fats – with that in mind, the authors also stress that the associations that they found likely do not represent effects of only the types of fat, but the cumulative effects of the all the compounds in the foods that contain each type of fat.3

The evidence is overwhelming that a Nutritarian diet-style, with raw seeds and nuts as the major fat source, and the high exposure to phytochemicals and carotenoids is the healthiest way to eat. Can you imagine all the personal medical tragedies that could be prevented?   It would sure put a lot of drug companies and doctors out of business.

 

References:

1. http://www.nlm.nih.gov/medlineplus/maculardegeneration.html

2. Parekh N et al. Association Between Dietary Fat Intake and Age-Related Macular Degeneration in the Carotenoids in Age-Related Eye Disease Study (CAREDS). An Ancillary Study of the Women's Health Initiative. Arch Ophthalmol. 2009;127(11):1483-1493.

3. http://www.medpagetoday.com/Ophthalmology/GeneralOphthalmology/16950

4. Sangiovanni JP et al. {omega}-3 Long-chain polyunsaturated fatty acid intake and 12-y incidence of neovascular age-related macular degeneration and central geographic atrophy: a prospective cohort study from the Age-Related Eye Disease Study. Am J Clin Nutr. 2009 Oct 7. [Epub ahead of print]

 

Red Meat and Processed Meats Are Bad News

Red meat and processed meats contain more saturated fat and trans fat than other animal products, and, therefore, are poorer food choices. However, the fat issue does not tell the whole story. Scientific studies have documented that red meat has a much more pronounced association with colon cancer and pancreatic cancer compared with other animal products. The consumption of red meat and processed meats on a regular basis more than doubles the risk of some cancers. Even ingesting a small amount of red meat, such as two to three ounces a day, has been shown to significantly increase the risk of cancer.1 Toxic nitrogenous compounds (called N-nitroso) occur in larger concentrations in red meat and processed meats. Red meat also has high haem (also spelled heme) content. Haem is an iron-carrying protein, and it has been shown to have destructive effects on the cells lining our digestive tract.2 Processed meat, luncheon meat, barbequed meat, and red meat must not be a regular part of your diet if you are looking to maintain excellent health into your later years of life.

The frequent consumption of animal products also increases the risk of cancer. To achieve optimal health, we require a significant exposure to a full symphony of phytochemicals in unprocessed plant matter that we would not be eating sufficiently as animal products increase as a percent of total calories and the percentage of vegetation decreases proportionally. Also, since animal products contain no fiber, they remain in the digestive tract longer, slowing digestive transit time and allowing heightened exposure to toxic compounds.

Your goal is to gradually reduce the consumption of animal products in your diet until you’re only consuming them two to three times per week, but you should certainly avoid processed meat and barbecued meat.

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

1. Chao A, Thun JT, Connell CJ, et al. Meat Consumption and Risk of Colorectal Cancer JAMA 2005;293:172-182.

2. Sesink AL, Termont DS, Kleibeuker JH, Van der Meer R. Red meat and colon cancer: dietary haem-induced colonic cytotoxicity and epithelial hyperproliferation are inhibited by calcium. Carcinogenesis 2001;22(10):1653-1659. Hughes R, Cross AJ, Pollock JR, Bingham S. Dose dependent effect of dietary meat on endogenous colonic N-nitrosation. Carcinogenesis 2001; 22(1):199-202.

Keep a Tight Limit on Saturated Fat

Just as eating the high salt content in the Standard American Diet will almost certainly cause you to develop high blood pressure, the high saturated fat content in that diet will eventually cause high levels of blood cholesterol, which can then be deposited in plaque on blood vessels. This leads to cardiovascular disease and also depresses the immune system and increases the risk of cancer.1 Autopsy studies on adult Americans who die in car accidents, unrelated to heart conditions, demonstrate that heart disease is present in the vast majority of American adults. Almost all people over the age of 40 are found to have a significant amount of atherosclerosis in their coronary arteries.2 The bottom line is if you eat the Standard American Diet or something close to it, you most likely will develop the same diseases—heart disease, high blood pressure, stroke, dementia, and cancer—that most Americans get. You cannot escape from the biological law of cause and effect. If you eat the diet most Americans eat, you will get the diseases most Americans get. Our long-term health is determined by our food choices.

Saturated fat comes from many food sources, including processed foods, meat, cheese, and other animal products. Thousands of scientific research studies demonstrate that saturated fat promotes both heart disease and cancer and powerfully raises cholesterol.3 It is exceedingly clear that avoiding all fat is not the secret to protecting your heart. It is avoiding saturated fat, trans fat, and processed oils.4 We get heart-healthy fats in their natural, high-antioxidant environment when we eat raw seeds and nuts. Indeed, avocado, nuts, and seeds are rich in fat. They may even contain a small amount of saturated fat, but their consumption is linked to substantial protection against heart disease. But, in the American diet, fats come primarily from meat and dairy, which are saturated, and we compound the problem by the low level of food derived antioxidants and phytochemicals we ingest.

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

1. Duwe AK, Fitch M, Ostwald R, et al. Depressed Natural Killer and Lecithin- Induced Cell Mediated Cytotoxicity in Cholesterol-Fed Guinea Pigs. J Nat Cancer Inst 1984;72(2):333-338.

2. Roberts JC, Moses C, Wilkins RH. Autopsy Studies in Atherosclerosis. I. Distribution and Severity of Atherosclerosis in Patients Dying without Morphologic Evidence of Atherosclerotic Catastrophe. Circulation 1959;20:511. Berenson GS, et al. Bogalusa Heart Study: A long-term community study of a rural biracial (black/white) population. Am J Med Sci 2001;322(5):267-274.

3. Huxley R, Lewington S, Clarke R. Cholesterol, coronary heart disease and stroke: a review of published evidence from observational studies and randomized controlled trials. Semin Vasc Med. 2002;2(3):315-323.

4. Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001;20(1):5-19.

Image credit: VirtualErn

Ha Ha Ha! Low-Carb, High-Protein Diets Damage Arteries.

Oh, those silly low-carb diets. Will they ever learn! Here’s more bad news for low-carb. A new study in the journal Proceedings of the National Academy of Sciences found low-carb, high-protein diets damage arties:

Diets based on eating lots of meat, fish and cheese, while restricting carbohydrates have grown in popularity in recent years.

But the Beth Israel Deaconess Medical Center in the US found such habits caused artery damage in tests on mice.

The researchers and independent experts both agreed a balanced diet was the best option…

…Lead researcher Anthony Rosenzweig said the findings were so concerning to him that he decided to come off the low-carb diet he was following.

He added: "Our research suggests that, at least in animals, these diets could be having adverse cardiovascular effects.

"It appears that a moderate and balanced diet, coupled with regular exercise, is probably best for most people."

And in 2007, a study found low-carb diets, like Atkins, cause long-term damage to blood vessels. Dr. Fuhrman is no fan of high-protein diets, all that saturated fat and insufficient plant nutrients increases risk of heart disease and cancer:

The Atkins diet (and other diets rich in animal products and low in fruits and unrefined carbohydrates) is likely to significantly increase a person's risk of colon cancer. Scientific studies show a clear and strong relationship between cancers of the digestive tract, bladder, and prostate with low fruit consumption. What good is a diet that lowers your weight but also dramatically increases your chances of developing cancer?

A meat-based, low-fiber diet, like the one Atkins advocates, includes little or no fruit, no starchy vegetables, and no whole grains. Following Atkin's recommendations could more than double your risk of certain cancers, especially meat-sensitive cancers, such as epithelial cancers of the respiratory tract.1 For example, a study conducted by the National Cancer Institute looked at lung cancer in nonsmoking women so that smoking would not be a major variable. Researchers found that the relative risk of lung cancer was six times greater in women in the highest fifth of saturated-fat consumption than those in the lowest fifth.

I asked Dr. Fuhrman to comment on this study. He chuckled at the news, saying, “This study definitely proves once and for all that mice should not be eating the Atkins diet. They should get Jenny Craig. Furthermore, vegetables make pigs fat, so maybe we shouldn't eat them either.”

Image credit: jaxxon

Want Some Strawberry Frozen Yogurt?

I know. No one here eats yogurt, but that stuff isn’t actually frozen yogurt. And its not sorbet, ice cream or gelato either. It’s chicken! No, I’m not joking. It’s the result of something called Advanced Meat Recovery, where the bones of chickens, turkeys, pigs and cows are stripped of any leftover meat.

This congealed vomit is used to make hot dogs, bologna, chicken nuggets, salami and other processed meats. Dr. Fuhrman has a BIG problem with processed meat. He says it’s a major source of saturated fat and toxins, which can lead to heart disease and cancer. Sorry for giving you dry heaves.

Via Fooducate Blog.

Image credit: Fooducate Blog

Animal Fat Increases Risk of Pancreatic Cancer

Published in the Journal of the National Cancer Institute, a new study claims high intake of saturated fat—specifically red meat and dairy—results in a 36% higher risk of pancreatic cancer, compared to people with lower consumption. And a high in take of total fat lead to a 53% increased risk of pancreatic cancer in men and 23% higher risk in women. Scientists examined data on 500,000 individuals, in which 1,337 were diagnosed with pancreatic cancer; Food Navigator reports.

Meat, i.e. saturated fat, is risky and research paints a grim picture. Previous studies have linked meat with higher risk of heart disease, age-related vision loss and various cancers. Fortunately, foods like fruits and vegetables lower the risk of developing cancer and cardiovascular disease.

In related news, experts found people who regularly eat charred or barbecued meat have a 60% higher risk of pancreatic cancer. Burned meat builds up of cancer-causing heterocyclic amines.

Image credit: wickenden

What Vegans May Be Missing...

Certainly a plant-based diet which minimizes animal products is the best approach for losing weight, preventing and reversing disease, and optimizing health. However, those following a vegetarian or vegan diet, and those not consuming fatty fish like salmon each week, should be aware of recent studies that suggest they may be deficient in a critical and essential nutrient, especially EPA & DHA, the long-chain omega-3 fatty acids.

Alpha-linolenic acid (ALA) is an omega-3 fat and is the precursor of the longer chain omega 3 fats eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and to a lesser extent DHA can be made in the body from ALA. Primary sources of these fatty acids are certain fish and seafood.

As a result, vegetarian, and especially vegan, diets provide little EPA and DHA directly. A recent study reviewed the varying dietary fat intake across vegetarians, vegans, omnivores, and semi omnivores and its impact on essential omega-3 fatty acid availability in tissues. It concluded that vegetarians were left with reduced levels of omega-3 and recommended that they consume additional direct sources of EPA and DHA, regardless of age or gender, for physical, mental and neurological health benefits.1

In addition, ALA, EPA, and DHA are especially important for the prevention of certain cancers, particularly those of the breast and colon, and possibly of the uterus and the skin, and are likely to reduce the risk of postpartum depression, manic-depressive psychosis, dementias, Parkinson's, hypertension, toxemia, diabetes, and to a certain extent, age-related macular degeneration.2

Although vegetarian diets are generally lower in total fat, saturated fat, and cholesterol than are non-vegetarian diets and may appear to offer cardiovascular health benefits due to higher intakes of antioxidants and fiber, the lack of direct EPA or DHA dietary sources may cause an adverse effect.3,4

With all of this documented research, it is not surprising that when I draw blood for fatty acid analysis on many of my patients, I find that a large percentage of individuals who do not eat fish or seafood regularly do not have optimal levels of DHA, even those eating walnuts and flaxseeds on a regular basis. I often see patients eating otherwise excellent diets with itchy dry skin, seborrheac dermatitis and other signs of DHA deficiency.

Although, there are some vegans and vegetarians regularly consuming walnuts and flaxseeds (which supply adequate ALA) may produce enough DHA on their own and may not require supplementation. However, because this issue is so imperative to their health it should be confirmed with a blood test before assuming that the conversion level is adequate. In order to assure optimal production of DHA fat, without recommending that the consumption of fish or refined fish oils, I recommend taking a vegetable sourced DHA supplement. DHA alone can deliver the same benefits of fish oil, since the intake of DHA can cause a natural retro-conversion to EPA internally.

Laboratory cultivated DHA is made from microalgae and is a pure form of DHA without environmental contamination. It is grown in the laboratory, not collected in the wild. It has no mercury or other toxins, which is a concern even for non-vegans who are cautious about eating fish or seafood.

DHA has been shown to protect against dementia, depression, inflammatory diseases, attention deficit and hyperactivity disorder (ADHD), allergies, and to offer significant benefits for overall cardiovascular health.

There are other problems with consuming fish oils. The main problem is that the fat turns rancid as it sits on store shelves. As a result, many people complain of burping, indigestion, a foul taste, and long lasting fish-breath. I have also observed that rancidity of this fish fat can place a stress on the liver. Patients of mine have had blood tests showing abnormal liver function when consuming fish oil in significant amounts and then have had these tests return to normal when the fish oils were stopped.

Fortunately, vegetable derived DHA, from microalgae, is an alternative. However, even algae derived DHA can become rancid if not cared for properly. We go through great lengths to deliver the purest and freshest DHA product available on the market today. My DHA Purity is manufactured under strict conditions to ensure purity. Every step of the way, from production to packaging, transportation and storage, this product is kept refrigerated and handled to ensure optimal freshness.

In conjunction with a high nutrient, plant-based diet, I advise all people take a daily DHA supplement from a clean source. Early in life, DHA is supplied via the placenta and from breast milk. While adequate DHA is particularly important for pregnant and nursing women and young children, it is beneficial for all ages!

1. Kornsteiner M, Singer I, Elmadfa I. Very low n-3 long-chain polyunsaturated fatty acid status in Austrian vegetarians and vegans. Ann Nutr Metab. 2008; 52(1):37-47.

2. Bourre JM Dietary omega-3 fatty acids for women. Biomed Pharmacother. 2007; 61(2-3):105 12.

3. Davis BC; Kris-Etherton PM Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr. 2003; 78(3 Suppl):640S-646S

4. Lee HY; Woo J; Chen ZY; Leung SF; Peng XH Serum fatty acid, lipid profile and dietary intake of Hong Kong Chinese omnivores and vegetarians. Eur J Clin Nutr. 2000; 54(10):768-73.

Image credit: CB Photography

Vegetable Diets Better for Diabetes

Appearing in the journal Nutrition Reviews, new findings suggest vegetarian and vegan diets offer significant benefits for diabetes control, more so than non-vegetarian. Clinical trials show individuals with type-2 diabetes on low-fat vegan diets had improved glycemic control, compared to conventional diets. Weight-loss is part of the explanation why, but reduced consumption of saturated fat and increased intake of fiber and plant nutrients offer additional advantages; Unbound Medline reports.

Plant foods, like green veggies, garlic and nuts, are potent diabetes-fighters, helping to keep glucose levels within normal range and eventually allowing people to kick their diabetes for good, unlike taking insulin, which can actually make things worse!

And last month, a report claimed Hispanic teenagers who started eating more fruits and vegetables and less sugar, lowered their risk of type-2 diabetes.

Image credit: Lars Odemark

Health-Points: Friday 5.8.09

 

Image credit: Steve Rhodes