Patients With Type II Diabetes Benefit From Naturopathic Care

Diabetes is a complex, multi-factorial condition that takes many variables into account, including diet, exercise, and family history.  Typically, if certain markers are detected early enough (elevated blood glucose, increased hemoglobin A1C), lifestyle and/or pharmaceutical treatments can be implemented to slow or reverse the progression of type II diabetes before long-term complications arise.  Since the essence of naturopathic medicine is addressing core diet and lifestyle issues that may be contributing to disease, it’s essential for anyone who’s dealing with type II diabetes, or even “pre-diabetes”, to incorporate a naturopathic treatment protocol as part of their long-term strategy.

A new joint study by Group Health Research Institute and Bastyr University Research Institute found that type II diabetes patients who received naturopathic care (as an adjunct to conventional care) had lower blood-sugar levels, better eating and exercise habits, improved moods, and a stronger sense of control over their condition than did patients receiving only conventional care.  The findings, published in BMC Complementary and Alternative Medicine, show that complementary and alternative medicine (CAM) may have several positive effects on people with type 2 diabetes, which is very encouraging for patients who are seeking out alternatives to manage their symptoms.  Forty study participants received counseling on diet, exercise, and glucose monitoring from four naturopathic physicians (NDs) in addition to conventional diabetes care from their medical doctors, including prescription medications. Many of the participants also received stress-management care and dietary supplements. Researchers then compared these 40 participants with 329 patients receiving only conventional diabetes care.  After six months and about four naturopathic treatment visits, participants demonstrated improved self-care, more consistent monitoring of glucose, and improved moods. Hemoglobin A1c rates (a measure of blood-sugar control) were nearly a full percentage point lower for those patients. This compares with a drop of only 0.5 percent over the same time period for 329 clinically similar patients receiving only conventional diabetes care.

Hopefully, this will encourage medical doctors and patients alike to seriously consider the benefits of naturopathic medicine in the management of type II diabetes.  Doing as much as possible to get a handle on this disease is extremely important, as it’s one of the top 10 causes of death for Americans, racking up close to $178 billion per year in health care costs.  By making a collaborative effort, there’s no reason why we can’t be proactive about halting this epidemic from spiraling out of control!

Rethinking Fat in the Diet

With all the hype surrounding statin medications this past week (see http://www.nytimes.com/2012/03/05/opinion/the-diabetes-dilemma-for-statin-users.html), it’s a perfect opportunity to take a step back and discuss some basic diet fundamentals.  For the past 40 or more years, the “benefits” of low-fat diets have been ingrained in our consciousness, and advocated by a majority of the medical community.  The thinking behind this was simple: high fat in the diet must lead to a buildup of fat and plaque in the arteries, so the less fat you eat, the better.  In recent years, research evidence has overwhelmingly refuted this concept, yet it continues to be the mainstream recommendation for preventing heart disease.  Even the “Dairy” section in the USDA’s “My Plate” emphasizes low or non-fat sources of dairy.

A scientific analysis of 21 earlier studies showed “no significant evidence” that saturated fat in the diet is associated with an increased risk of coronary heart disease.  In fact, the dietary evidence collected from these thousands of participants found no difference in the risk of coronary heart disease, stroke, or coronary vascular disease between those individuals with the lowest and highest intakes of saturated fat.  The bigger issue appears to be the added amounts of sweeteners and carbohydrates that people are eating instead of fats.  More and more evidence is suggesting that it’s this continuous increase in carbohydrate consumption that is truly responsible for an increased risk in diabetes and coronary artery disease.

I think the main take-away message from this information is that you don’t have to be afraid of good quality sources of saturated fat.  We’ve been so trained to be suspicious of it for so long that it becomes difficult to change our perception of how healthy it can be.  Now, does this mean you should be eating nothing but cheese, bacon, and beef for the rest of your life?  Of course not!  If you’re already consuming low-fat sources of dairy (skim milk, low-fat yogurt, etc.), switch to organic whole milk sources, and use butter instead of margarine or other processed forms of fat.  In general, try to limit your saturated fat intake to 10% of your total diet, while discontinuing the consumption of hydrogenated oils, artificial sweeteners, and high-glycemic carbohydrates.  By doing this, and continuing to emphasize fruits and vegetables as a mainstay, you’ll be much better off in the long run!

Neuropathy and Natural Medicine

Neuropathy, whether it’s diabetic or idiopathic, is often challenging to treat, with any modality. However, I do find that the combination of acupuncture and naturopathic interventions tend to be much more successful than the “standard” protocol (which usually includes gabapentin and various cocktails of prescription painkillers). A recent study from the journal Diabetes Care (2011 July 25) discovered that 600 mg/day of the nutrient alpha-lipoic acid lead to a clinically significant improvement in patients with diabetic neuropathy. Clinically, I’ve also found that other forms of neuropathy often respond well to alpha-lipoic acid therapy as well. Other treatments that help to enhance peripheral circulation and restore nutrition to damaged nerves, such as acetyl-l-carnitine, mixed bioflavonoids, and B-vitamins, can also be beneficial in the treatment of peripheral neuropathy.

It’s not uncommon for people to be kept on medications for life when trying to deal with peripheral neuropathy pain, with the resulting relief being minimal at best. If this is something you have suffered from, don’t be afraid to seek alternatives, as there is enough clinical and research evidence to support the benefits.

Artificial Sweeteners=Real Trouble

Most of my patients know that I’m not a fan of artificial sweeteners, but people often have      a hard time cutting them out of their diet. Hopefully this evidence (excerpted from   mercola.com) will be enough of a motivator!

Why Artificial Sweeteners Can be Detrimental to Your Waistline

The belief that eating artificially sweetened foods and drinking artificially sweetened beverages will help you to lose weight is a carefully orchestrated deception. So if you are still opting for sugar-free choices for this reason, you are being sorely misled.

For years now studies have shown that consuming artificial sweeteners breaks the connection between a sweet sensation and a high-calorie food, thereby changing your body’s ability to regulate intake naturally.

In one study by psychologists at Purdue University’s Ingestive Behavior Research Center, rats that ate yogurt sweetened with an artificial sweetener consumed more calories (and didn’t make up for it by cutting back later), gained more weight, and put on more body fat than rats that ate yogurt sweetened with sugar.

Other studies, too, have shown that eating artificial sweeteners might hinder your body’s ability to estimate calorie intake, thus boosting your inclination to overindulge. Your body and your brain simply do not have the same biological response to artificial sweeteners that they do to regular sugar, and this can pose some serious problems.

Your Brain Can Tell the Difference

You may have convinced yourself that your favorite artificial sweetener tastes the same as sugar, but rest assured your brain is not being fooled.

In one brain-scan study by neuroscientist Paul Smeets, volunteers were given two version of a beverage, one sweetened with sugar, the other with a blend of artificial sweeteners. The brain scans showed that the artificially sweetened beverage failed to activate an area of the brain called the caudate nucleus, which is an area associated with rewards.

A separate study by psychiatrist Guido Frank at the University of Colorado in Denver also looked into your brain’s response to sugar versus artificial sweeteners. Women given a taste of the two said they could not consciously determine a difference. However, a functional magnetic resonance imaging (fMRI) of their brain responses showed differences indeed.

As in the previously mentioned study, the sugar activated the reward areas of your brain more strongly than the artificial sweetener, suggesting that the latter may not make you feel satisfied the way sugar would.

This is not an endorsement to indulge in sugar; rather it’s a major clue that your body is not being fooled by artificial sweeteners.

High Fructose Corn Syrup Tries To Hide Behind Name Change

In an attempt to try and fool the public, the Corn Refiner’s Association has applied with the FDA to change the name of high fructose corn syrup to “corn sugar”. This would imply that high fructose corn syrup is a “natural” product, when in reality it is a highly synthetic product. The move may have partly been prompted by a recent Princeton University study demonstrating that rats who consumed high fructose corn syrup “gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same.”
For more information, visit the following website:

http://www.takepart.com/news/2010/09/14/high-fructose-corn-syrup-up-for-a-new-name?fb_js_fbu=757915220

Green Tea and Metabolic Syndrome

Because metabolic syndrome is something I tend to see on a weekly basis, it’s always good to see new information on what can help to control and reverse this condition. The latest research points out the benefits of green tea in treating metabolic syndrome. It’s also well known that green tea contains weight-loss promoting properties, among many other beneficial compounds. 

Here is a summary of the research findings:

Reference: “Green tea minimally affects biomarkers of inflammation in obese subjects with metabolic syndrome,” Basu A, Lyons TJ, et al, Nutrition, 2010 Jun 1; [Epub ahead of print]. (Address: Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA).
Summary: In a randomized, controlled study involving 35 obese subjects with metabolic syndrome, results indicate that green tea intake may exert cardioprotective benefits. The subjects were randomized to receive green tea (4 cups/d), green tea extract (2 capsules and 4 cups water/d), or no treatment (4 cups water/d) for 8 weeks. At intervention end, green tea (drink and capsule) intake was associated with significant reduction of plasma serum amyloid alpha, compared with control. Thus, the authors of this study conclude, “green tea significantly reduced plasma serum amyloid alpha, an independent cardiovascular disease risk factor, in obese subjects with metabolic syndrome.”

Weight Gain and Fatty Acids-Born Into Obesity?

For years, the naturopathic profession has emphasized the importance of balancing the ratio between omega 3 and omega 6 intake. The standard American diet is overloaded with omega 6 fatty acids, while being deficient in omega 3, which can lead to a chronic inflammatory state, increasing the risk of cancer and other serious diseases. Now, a new study in the Journal of Lipid Research has found that a high omega 6:omega 3 ratio may not only lead to insulin resistance in individuals, but may actually predispose their offspring to a life-long struggle with obesity.

In addition to high consumption of fast foods and refined carbohydrates, the high omega 6:omega 3 ratio in the American diet is largely due to the shift from grass-fed to grain-fed livestock. For meat eaters, this means seeking out sources of locally raised or grass-fed livestock, along with incorporating more wild game (bison, venison) into the diet. In general, a diet that is well-balanced with fruits, vegetables, fish, and healthy oils should insure a healthy balance of omega fats. Supplementation with fish oil and ground flax seeds is also recommended, to further bolster your omega 3 intake. 

Who’s Bad? (Not Fats)

There continues to be a false assumption in the medical community that increased fat consumption leads to heart disease and other long-term problems. I often find it difficult to reprogram people, after they’ve been brainwashed for so many years to avoid fats, and eat only low-fat foods. This topic warrants much more detail than what I can cover in one blog post, but evidence continues to mount that refutes the low-fat concept. For example, a recent study in the American Journal of Clinical Nutrition (2010 May 12) demonstrates that people with higher levels of omega-3s and fats derived from olive oil and nuts had an inverse correlation with coronary artery disease. This further supports the advantages of following a Mediterranean Diet, and disregarding the “Food Pyramid” recommended by the USDA.

Diabetes Increases Cancer Risk

Evidence is proving that diabetes may double the risk of pancreatic, liver, and endometrial cancer, while also significantly increasing the risk of colorectal, breast and bladder cancer. It’s still uncertain whether this is due to the disease itself, or the treatments that are being used for diabetes. However, it does strongly suggest that inflammation plays an underlying role, and how important it is to detect and treat diabetic changes as early as possible. Here is an article taken from Medscape that goes into more detail about this discovery:

June 16, 2010 — People with diabetes are at increased risk of certain cancers — but why?

Could it be that some diabetes treatments trigger or promote cancer? Or do the underlying causes of diabetes also underlie cancer?

These are the questions put before an expert panel from the American Diabetes Association and the American Cancer Society (ACS).

Their conclusion: We aren’t sure.

Even so, lifestyle changes that prevent or reverse diabetes will certainly cut cancer risk, says panel member Susan M. Gapstur, PhD, ACS vice president of epidemiology.

“The full biologic link between diabetes and cancer has not been completely defined,” Gapstur tells WebMD. “But first of all we should prevent diabetes. Then we can prevent some cancers. And for those who do have diabetes, it should be controlled as much as possible through a healthy lifestyle.”

Diabetes doubles the risk of liver, pancreas, and endometrial cancer. It increases the risk of colorectal, breast, and bladder cancer by 20% to 50%. But it cuts men’s risk of prostate cancer.

People with diabetes tend to have some known risk factors for cancer: older age,obesity, poor diet, and physical inactivity. And problems common in diabetes — too-high insulin levels, too-high blood sugar levels, and inflammation — increase cancer risk.

“No matter what science ultimately reveals … we already know what we need to do to lower risk for both cancer and diabetes,” Alice Bender, RD, of the American Institute for Cancer Research, says in a news release. “Eat a healthy, varied, predominantly plant-based diet, be physically active every day, and maintain ahealthy body weight.”

Do Diabetes Treatments Raise Cancer Risk?

There is evidence, but not definitive proof, that diabetes treatments affect cancer risk.

Metformin, the most commonly used diabetes drug, seems to lower cancer risk. But there’s also evidence from some studies — contradicted by others — that insulin, particularly long-acting insulin glargine (Lantus), may increase cancer risk.

Mo
reover, there are at least theoretical concerns that other relatively new diabetesdrugs may affect cancer risk. Unfortunately, the panel found too little data to form an opinion on this question.

Because there is no definitive link between diabetes treatment and cancer, the panel strongly advises people with diabetes — except those at extremely high risk of cancer — not to make treatment decisions based on fear of cancer.

“Clearly those being treated for diabetes need to be talking with their doctors about the importance of regular cancer screenings as recommended by the American Cancer Society,” Gapstur says.

The consensus panel’s report appears in the July/August issue of the ACS journalCA: A Cancer Journal for Clinicians.

Processed Meats=Unhealthy Eats

I always try to emphasize with patients the importance of avoiding processed meats, particularly due to the increased cancer risk that they pose. Now, it’s even more clear that this advice is warranted, as these foods substantially increase the risk of heart disease and Type II diabetes as well. For more information regarding this Harvard study, visit: