type 2 diabetes

High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

January 10, 2019

Science Daily/The Lancet

Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fiber a day, according to a series of systematic reviews and meta-analyses.

 

People who eat higher levels of dietary fibre and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycaemic load and low glycaemic index diets are less clear. Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fibre a day, according to a series of systematic reviews and meta-analyses published in The Lancet.

 

The results suggest a 15-30% decrease in all-cause and cardiovascular related mortality when comparing people who eat the highest amount of fibre to those who eat the least. Eating fibre-rich foods also reduced incidence of coronary heart disease, stroke, type 2 diabetes and colorectal cancer by 16-24%. Per 1,000 participants, the impact translates into 13 fewer deaths and six fewer cases of coronary heart disease.

 

In addition, a meta-analysis of clinical trials suggested that increasing fibre intakes was associated with lower bodyweight and cholesterol, compared with lower intakes.

 

The study was commissioned by the World Health Organization to inform the development of new recommendations for optimal daily fibre intake and to determine which types of carbohydrate provide the best protection against non-communicable diseases (NCDs) and weight gain.

 

Most people worldwide consume less than 20 g of dietary fibre per day. In 2015, the UK Scientific Advisory Committee on Nutrition recommended an increase in dietary fibre intake to 30 g per day, but only 9% of UK adults manage to reach this target. In the US, fibre intake among adults averages 15 g a day. Rich sources of dietary fibre include whole grains, pulses, vegetables and fruit.

 

"Previous reviews and meta-analyses have usually examined a single indicator of carbohydrate quality and a limited number of diseases so it has not been possible to establish which foods to recommend for protecting against a range of conditions," says corresponding author Professor Jim Mann, the University of Otago, New Zealand.

 

"Our findings provide convincing evidence for nutrition guidelines to focus on increasing dietary fibre and on replacing refined grains with whole grains. This reduces incidence risk and mortality from a broad range of important diseases."

 

The researchers included 185 observational studies containing data that relate to 135 million person years and 58 clinical trials involving 4,635 adult participants. They focused on premature deaths from and incidence of coronary heart disease, cardiovascular disease and stroke, as well as incidence of type 2 diabetes, colorectal cancer and cancers associated with obesity: breast, endometrial, esophageal and prostate cancer. The authors only included studies with healthy participants, so the findings cannot be applied to people with existing chronic diseases.

 

For every 8g increase of dietary fibre eaten per day, total deaths and incidence of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 5-27%. Protection against stroke, and breast cancer also increased. Consuming 25g to 29g each day was adequate but the data suggest that higher intakes of dietary fibre could provide even greater protection.

 

For every 15g increase of whole grains eaten per day, total deaths and incidence of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 2-19%. Higher intakes of whole grains were associated with a 13-33% reduction in NCD risk -- translating into 26 fewer deaths per 1,000 people from all-cause mortality and seven fewer cases of coronary heart disease per 1,000 people. The meta-analysis of clinical trials involving whole grains showed a reduction in bodyweight. Whole grains are high in dietary fibre, which could explain their beneficial effects.

 

The study also found that diets with a low glycaemic index and low glycaemic load provided limited support for protection against type 2 diabetes and stroke only. Foods with a low glycaemic index or low glycaemic load may also contain added sugars, saturated fats, and sodium. This may account for the links to health being less clear.

 

"The health benefits of fibre are supported by over 100 years of research into its chemistry, physical properties, physiology and effects on metabolism. Fibre-rich whole foods that require chewing and retain much of their structure in the gut increase satiety and help weight control and can favourably influence lipid and glucose levels. The breakdown of fibre in the large bowel by the resident bacteria has additional wide-ranging effects including protection from colorectal cancer." says Professor Jim Mann.

 

While their study did not show any risks associated with dietary fibre, the authors note that high intakes might have ill-effects for people with low iron or mineral levels, for whom high levels of whole grains can further reduce iron levels. They also note that the study mainly relates to naturally-occurring fibre rich foods rather than synthetic and extracted fibre, such as powders, that can be added to foods.

 

Commenting on the implications and limitations of the study, Professor Gary Frost, Imperial College London, UK, says, "[The authors] report findings from both prospective cohort studies and randomised controlled trials in tandem. This method enables us to understand how altering the quality of carbohydrate intake in randomised controlled trials affects non-communicable disease risk factors and how these changes in diet quality align with disease incidence in prospective cohort studies. This alignment is seen beautifully for dietary fibre intake, in which observational studies reveal a reduction in all-cause and cardiovascular mortality, which is associated with a reduction in bodyweight, total cholesterol, LDL cholesterol, and systolic blood pressure reported in randomised controlled trials... There are some important considerations that arise from this Article. First, total carbohydrate intake was not considered in the systematic review and meta-analysis... Second, although the absence of association between glycaemic index and load with non-communicable disease and risk factors is consistent with another recent systematic review, caution is needed when interpreting these data, as the number of studies is small and findings are heterogeneous. Third, the absence of quantifiable and objective biomarkers for assessing carbohydrate intake means dietary research relies on self-reported intake, which is prone to error and misreporting. Improving the accuracy of dietary assessment is a priority area for nutrition research. The analyses presented by Reynolds and colleagues provides compelling evidence that dietary fibre and whole grain are major determinants of numerous health outcomes and should form part of public health policy."

https://www.sciencedaily.com/releases/2019/01/190110184737.htm

Plant-based or vegan diet may be best for keeping type 2 diabetes in check

It is linked to improved wellbeing, quality of life, weight loss and lower blood glucose

Science Daily/October 30, 2018

BMJ

A predominantly plant-based or vegan diet may be best for keeping type 2 diabetes in check, not least because of its potential impact on mood, suggests a systematic review of the available evidence.

 

This diet is associated with improved psychological wellbeing, a reduction in some of the known risk factors for type 2 diabetes, and possibly some of those linked to cardiovascular disease, one of the main causes of early death in people with the condition, the findings indicate.

 

The International Diabetes Federation estimates that 642 million people will be living with diabetes by 2040. In the UK around 4.5 million people have been diagnosed with it; in the US the equivalent figure is more than 30 million.

 

Nearly 15 per cent of all global deaths are attributed to diabetes; and it killed 5 million people before the age of 60 in 2015. It is also frequently associated with depression, which in turn affects how well blood glucose levels are controlled.

 

While a predominantly plant-based diet-rich in fruits, vegetables, nuts, legumes, and seeds with no (vegan) or few animal products-has been linked to a significantly lower risk of developing type 2 diabetes, it's not clear if it might also be linked to improved mood and wellbeing.

 

To try and find out, the researchers trawled through the available evidence and found 11 relevant English language clinical trials, published between 1999 and 2017, comparing plant-based diets with other types of diet. The studies involved a total of 433 people in their mid-50s, on average.

 

Eight of the trials assessed the impact of a vegan diet and six included patients being given information on optimal nutrition to help them better understand the benefits of a plant based diet. The trials lasted for an average of 23 weeks.

 

A systematic critical analysis of the results showed that quality of life-both physical and emotional-improved only in those patients on a plant based/vegan diet. Similarly, depressive symptoms improved significantly only in these groups.

 

Nerve pain (neuropathy) eased in both the plant based and comparator diet groups, but more so in the former. And the loss of temperature control in the feet in those on the comparator diets suggests that eating predominantly plant based foods may have slowed the progressive nerve damage associated with diabetes, say the researchers.

 

Average (HbA1c) and fasting blood glucose levels fell more sharply in those who cut out or ate very few animal products and these participants lost nearly twice as much weight: 5.23 kg vs 2.83 kg. The fall in blood fats -- a known risk factor for cardiovascular disease -- was also greater in those on plant based/vegan diets.

 

The researchers point out several caveats to their findings, including the small sample sizes of the studies they reviewed and the reliance of the data on participant recall. But this review is the first to attempt to look at the psychological impact of a plant based diet in people with type 2 diabetes, and it draws on research from five different countries, they say.

 

In six of the studies, those following a plant based/vegan diet were able to cut down or discontinue the drugs they were taking for their diabetes and associated underlying conditions, such as high blood pressure.

 

Overall, the results indicated that even though the plant based diets were more difficult to follow, at least to begin with, participants stuck to them better than those in the comparator groups.

 

"Based on the evidence of the research analysis by this systematic review, it can be concluded that plant-based diets accompanied by educational interventions can significantly improve psychological health, quality of life, HbA1c levels and weight, and therefore the management of diabetes," write the researchers.

 

"Furthermore, plant-based diets could potentially improve diabetic neuropathic pain and the levels of total cholesterol, [low density lipoprotein] cholesterol and triglycerides in [type 2 diabetes].

https://www.sciencedaily.com/releases/2018/10/181030184510.htm

When fathers exercise, children are healthier, even as adults

October 22, 2018

Science Daily/Ohio State University Wexner Medical Center

Most parents know that the diet and exercise habits of a pregnant woman impacts the health of her baby, but little is known about how a father's health choices are passed to his children. A new study finds that lifestyle practices of fathers prior to conception may have a major impact on the lifelong health of their children.

 

In a new study led by Kristin Stanford, a physiology and cell biology researcher with The Ohio State University College of Medicine at the Wexner Medical Center, paternal exercise had a significant impact on the metabolic health of offspring well into their adulthood.

 

Laurie Goodyear of the Joslin Diabetes Center and Harvard Medical School co-led the study, published today in the journal Diabetes.

 

"This work is an important step in learning about metabolic disease and prevention at the cellular level," said Dr. K. Craig Kent, dean of the Ohio State College of Medicine.

 

Recent studies have linked development of type 2 diabetes and impaired metabolic health to the parents' poor diet, and there is increasing evidence that fathers play an important role in obesity and metabolic programming of their offspring.

 

Stanford is a member of Ohio State's Diabetes and Metabolism Research Center. Her team investigated how a father's exercise regimen would affect his offspring's metabolic health. Using a mouse model, they fed male mice either a normal diet or a high-fat diet for three weeks. Some mice from each diet group were sedentary and some exercised freely. After three weeks, the mice bred and their offspring ate a normal diet under sedentary conditions for a year.

 

The researchers report that adult offspring from sires who exercised had improved glucose metabolism, decreased body weight and a decreased fat mass.

 

"Here's what's really interesting; offspring from the dads fed a high-fat diet fared worse, so they were more glucose intolerant. But exercise negated that effect," Stanford said. "When the dad exercised, even on a high-fat diet, we saw improved metabolic health in their adult offspring."

 

Stanford's team also found that exercise caused changes in the genetic expression of the father's sperm that suppress poor dietary effects and transfer to the offspring.

 

"We saw a strong change in their small-RNA profile. Now we want to see exactly which small-RNAs are responsible for these metabolic improvements, where it's happening in the offspring and why," Stanford said.

 

Previous studies from this group have shown that when mouse mothers exercise, their offspring also have beneficial effects of metabolism.

 

"Based on both studies, we're now determining if both parents exercising has even greater effects to improve metabolism and overall health of offspring. If translated to humans, this would be hugely important for the health of the next generation," Goodyear said.

 

The researchers believe the results support the hypothesis that small RNAs could help transmit parental environmental information to the next generation.

 

"There's potential for this to translate to humans. We know that in adult men obesity impairs testosterone levels, sperm number and motility, and it decreases the number of live births," Stanford said. "If we ask someone who's getting ready to have a child to exercise moderately, even for a month before conception, that could have a strong effect on the health of their sperm and the long-term metabolic health of their children."

 

Other Ohio State researchers involved in the study were Lisa Baer, Adam Lehnig and Joseph White.

 

Funding from the National Institutes of Health supported this research.

https://www.sciencedaily.com/releases/2018/10/181022085844.htm

Increasing vigorous exercise decreases risk of type two diabetes, cardiovascular disease in childhood

October 15, 2018

Science Daily/University of Eastern Finland

Physical exercise can reduce the risk factors of type two diabetes and cardiovascular disease even in children, a new study shows. In a two-year follow-up of primary school children, sedentary behavior increased the accumulation of risk factors, whereas increasing the amount of vigorous exercise reduced it. This is one of the first follow-up studies to reliably demonstrate these associations in children.

 

The results are based on follow-up data from the Physical Activity and Nutrition in Children (PANIC) Study, ongoing at the University of Eastern Finland. Conducted in collaboration with scientists from the University of Cambridge, the Norwegian School of Sport Sciences and the University of Copenhagen, the findings of the study were published in the Scandinavian Journal of Medicine & Science in Sports.

 

The two-year follow-up study analysed associations of changes in the amount of vigorous, moderate and light exercise, as well as sedentary behaviour, with risk factors of type 2 diabetes and cardiovascular disease, such as body fat content, waist circumference, blood insulin and glucose levels, blood lipids and blood pressure. The amounts of vigorous, moderate and light exercise, as well as sedentary behaviour, were objectively measured using the Actiheart® device, which records heart rate and body movement. Children wore the Actiheart® device continuously for a minimum of four days, and the measurement period included weekdays and days of the weekend.

 

During the two-year follow-up, the overall risk and individual risk factors of type 2 diabetes and cardiovascular reduced in children who increased their amount of vigorous exercise. In children whose sedentary behaviour increased, the risk increased as well. These changes were independent of gender, biological maturity and lean body mass, as well as of the levels of risk factors and physical activity measured at the beginning of the study. The study is highly significant, as it is one of the first follow-up studies in the world to reliably show that increasing the amount of vigorous exercise is independently associated with a reduced risk of type 2 diabetes and cardiovascular disease in ordinary primary school children.

 

"A physically passive lifestyle is gradually becoming alarmingly widespread among children and young people almost all over the world. Our findings provide support for the role of physical activity in preventing common chronic diseases already in childhood," says Researcher Juuso Väistö, the first author of the article, from the University of Eastern Finland.

 

He points out that children and young people should engage in more physical exercise than what it takes to go about their daily activities.

 

"Our findings show that increasing the amount of vigorous exercise and reducing sedentary behaviour are equally important in preventing type 2 diabetes and cardiovascular disease. According to latest recommendations, children need diverse physical activity every day, and at least 60 minutes should be vigorous exercise. In practice, vigorous exercise refers to exercise or games that cause shortness of breath and perspiration."

 

Prevention of type 2 diabetes and cardiovascular disease are best begun already in childhood

 

The PANIC Study has earlier shown that the accumulation of risk factors of type 2 diabetes and cardiovascular disease, which typically exists in people who are overweight, often begins already in childhood. This is a cause for concern, as the accumulation of risk factors in childhood significantly increases the risk of these diseases in adulthood. According to this newly published study, regular exercise and avoiding a physically passive lifestyle constitute efficient means of mitigating the risk factors type 2 diabetes and cardiovascular disease.

 

PANIC Study -- a source of scientifically valuable data on children's health

 

The Physical Activity and Nutrition in Children (PANIC) Study is an on-going lifestyle intervention study. A total of 512 children aged 6 to 8 years participated in the onset measurements in 2007-2009. The study applies scientifically sound methods to extensively study the lifestyles, health and well-being of children. The study provides novel information on children's physical activity, sedentary behaviour, nutrition, physical fitness, body composition, metabolism, cardiovascular system function, brain function, oral health, life quality, effects of exercise and nutrition on children's health and well-being, and on the effects of these factors on health care costs.

https://www.sciencedaily.com/releases/2018/10/181015100459.htm

Can't sleep? Could be down to genetics

Large study confirms that insomnia is hereditary

March 9, 2018

Science Daily/Springer

Researchers have identified specific genes that may trigger the development of sleep problems, and have also demonstrated a genetic link between insomnia and psychiatric disorders such as depression, or physical conditions such as type 2 diabetes.

 

Up to 20 percent of Americans and up to 50 percent of US military veterans are said to have trouble sleeping. The effects insomnia has on a person's health can be debilitating and place a strain on the healthcare system. Chronic insomnia goes hand in hand with various long-term health issues such as heart disease and type 2 diabetes, as well as mental illness such as post-traumatic stress disorder (PTSD) and suicide.

 

Twin studies have in the past shown that various sleep-related traits, including insomnia, are heritable. Based on these findings, researchers have started to look into the specific gene variants involved. Stein says such studies are important, given the vast range of reasons why people suffer from insomnia, and the different symptoms and varieties of sleeplessness that can be experienced.

 

"A better understanding of the molecular bases for insomnia will be critical for the development of new treatments," he adds.

 

In this study, Stein's research team conducted genome-wide association studies (GWAS). DNA samples obtained from more than 33,000 soldiers participating in the Army Study To Assess Risk and Resilience in Servicemembers (STARRS) were analyzed. Data from soldiers of European, African and Latino descent were grouped separately as part of efforts to identify the influence of specific ancestral lineages. Stein and his colleagues also compared their results with those of two recent studies that used data from the UK Biobank.

 

Overall, the study confirms that insomnia has a partially heritable basis. The researchers also found a strong genetic link between insomnia and type 2 diabetes. Among participants of European descent, there was additionally a genetic tie between sleeplessness and major depression.

 

"The genetic correlation between insomnia disorder and other psychiatric disorders, such as major depression, and physical disorders such as type 2 diabetes suggests a shared genetic diathesis for these commonly co-occurring phenotypes," says Stein, who adds that the findings strengthen similar conclusions from prior twin and genome-wide association studies.

 

Insomnia was linked to the occurrence of specific variants on chromosome 7. In people of European descent, there were also differences on chromosome 9. The variant on chromosome 7, for instance, is close to AUTS2, a gene that has been linked to alcohol consumption, as well as others that relate to brain development and sleep-related electric signaling.

 

"Several of these variants rest comfortably among locations and pathways already known to be related to sleep and circadian rhythms," Stein elaborates. "Such insomnia associated loci may contribute to the genetic risk underlying a range of health conditions including psychiatric disorders and metabolic disease."

https://www.sciencedaily.com/releases/2018/03/180309095520.htm

 

PTSD doubles diabetes risk in women

January 7, 2015

Science Daily/Columbia University's Mailman School of Public Health

Women with post-traumatic stress disorder are nearly twice as likely to develop type 2 diabetes compared with women who don't have PTSD, according to new research. The longitudinal cohort study provides the strongest evidence to date of a causal relationship between PTSD and type 2 diabetes.

 

The longitudinal cohort study provides the strongest evidence to date of a causal relationship between PTSD and type 2 diabetes. Results are published online in the journal JAMA Psychiatry.

 

The researchers analyzed survey data collected between 1989 and 2011 from 49,739 women enrolled in the Nurses Health Study II and found a dose-response relationship: the greater the number and severity of PTSD symptoms, the greater a woman's risk of type 2 diabetes. Four percent of the nurses reported the highest number of PTSD symptoms. By age 60, nearly 12 percent of women with the highest number of PTSD symptoms had developed type 2 diabetes, whereas fewer than 7 percent of women with no trauma exposure had diabetes.

 

Antidepressant use and elevated body mass index accounted for nearly half of the increased risk of type 2 diabetes, or 34 and 14 percent, respectively. On the other hand, smoking, diet quality, alcohol intake, and physical activity did not explain the association.

 

One in nine women will have PTSD at sometime over the course of her lifetime--twice the rate of men. Women are also more likely to experience extreme traumatic events like rape that carry a high risk for the disorder.

 

"Not only is PTSD devastating to mental health, but it affects physical health too, raising risk for cardiovascular disease, diabetes, and obesity," said senior author Karestan C. Koenen, PhD, professor in the Department of Epidemiology at the Mailman School.

 

"Women with PTSD and the health professionals who care for them should be aware that these women are at greater risk for diabetes," said first author Andrea L. Roberts, PhD, research associate in the Department of Social and Behavioral Sciences at Harvard School of Public Health. "As fewer than half of Americans with PTSD receive treatment, our study adds urgency to the effort to improve access to mental health care to address factors that contribute to diabetes and other chronic diseases."

 

To assess type 2 diabetes, the researchers used a validated survey method that first asked women whether they had been diagnosed by a doctor, then confirmed diagnosis with information about test results, symptoms, and medications. PTSD was assessed using the Short Screening Scale. The nurses reported a range of trauma, including sexual assault, domestic violence, car accidents, and unexpected death of a loved one.

 

The study builds on past findings by the researchers, including a 2013 study that reported a link between PTSD and obesity. Other research has shown a link between mental health issues like anxiety, social phobia, and agoraphobia and type 2 diabetes.

 

Further research is needed to identify the biochemical and possible additional behavioral changes, such as sleep disturbance, that mediate the relationship between PTSD and type 2 diabetes.

http://www.sciencedaily.com/releases/2015/01/150107122906.htm

 

Posttraumatic Stress Disorder Associated with Type 2 Diabetes

May 16, 2013 —

Science Daily/Helmholtz Zentrum Muenchen - German Research Centre for Environmental Health

The presence of posttraumatic stress disorder is significantly associated with the development of type 2 diabetes. This is the finding of scientists from the Helmholtz Zentrum München and the University Hospital Gießen and Marburg who worked with data from the population-based KORA cohort study. A sustained activation of the hormonal stress axis due to chronic stress symptoms is most likely a major causing mechanism.

 

People suffering from posttraumatic stress disorder (PTSD) have a significant risk of developing type 2 diabetes. PTSD is a prolonged stress response syndrome whose symptoms develop in the aftermath of extremely stressful life events of exceptionally threatening or catastrophic nature.

 

A correlation between stress from mental illnesses and diabetes mellitus has already been under discussion for some time, but now Dr. Karoline Lukaschek from the Institute of Epidemiology II (EPI II) at the Helmholtz Zentrum München (HMGU) and Prof. Johannes Kruse from the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen and Marburg, and their colleagues have been able to provide the first proof of a significant association between the two illnesses.

 

The development of new approaches to the diagnosis, therapy and prevention of major widespread diseases such as diabetes mellitus are goals of the Helmholtz Zentrum München. Almost ten percent of the population in Germany is affected by diabetes mellitus. The study was supported by the Competence Network Diabetes Mellitus and the German Center for Diabetes Research (DZD), in which the Helmholtz Zentrum München is a partner.

http://www.sciencedaily.com/releases/2013/05/130516063839.htm

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