Telehealth Can be Useful in Treating Chronic Diseases

The aging population is increasing worldwide. The number of people 60 years and older are expected to reach $2.1 billion by 2050. And with this increase in age comes an increase in overweight and obesity. And we know that with an increase in overweight and obesity, we will get an increase in chronic diseases. But many of these chronic diseases can be avoided or effectively managed using lifestyle change and self-management techniques facilitated using telehealth.

To address the onset of type 2 diabetes, the CDC established the National Diabetes Prevention Program in 2010. And one of the optional delivery modes in that program is telehealth. Telehealth can lower the cost of delivery, and allow participants in distant areas to take part in the treatment. The treatment uses weight loss as a key objective of the prevention program. And one study has shown just how effective the use of telehealth can be in weight management for individuals 60 and older.

The study was done in China, and employed remote management as the primary tool for delivering the weight management protocol. Participants in the study had to be between 60 and 80 years of age. Participants had to have a BMI of 24 or greater. They could not have participated in any other weight loss study. They had to have a smart phone, and be able to use the phone.

People were excluded from the study who had problems with cognitive skills, schizophrenia or depression. Participants were not to have a pacemaker, walking difficulties, bariatric surgery, or any history of alcoholism. All participants were to be amenable to lifestyle change.
As with the National Diabetes Prevention Program, participants in the study were allowed to set their own goals, use smart scales and activity trackers connected to their smart phones via Bluetooth.

Nutrition and physical activity experts were on hand to provide personalized assistance via the internet and phone. The participants were encouraged to get a minimum of 20 minutes of resistance training or 20 minutes of aerobic physical activity per day. Or the participants could choose to walk 6000 steps each day.

The researchers concluded that intervening via remote management could improve diet and enhance physical activity. And that the interventions were beneficial in weight management. This is also been the conclusion drawn from the National Diabetes Prevention Program.

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You Can Derive Health Benefits from Less Than 150 Minutes of Physical Activity Per Week

Physical activity is essential for maintaining both physical and mental health. Regular physical activity can assist people in living a healthy and fulfilling existence. The benefits of exercise range from reducing the risk of chronic diseases to enhancing mental health. Typically, individuals are advised to engage in at least 150 minutes of physical activity per week to maintain health. However, a recent study indicates that less than half of the recommended 150 minutes of physical activity per week can have beneficial effects.

The study was done in Norway over a period of 36 years. The aim of the study was to determine how different amounts of physical activity were associated with mortality. There were approximately 123,000 participants in the study. For the study, the participants were divided into three groups. One group engaged in frequent activity, one group was completely inactive, and one group consisted of mixed participants: some participants were very active, and some were inactive. The researchers used two cut off points for measuring physical activity: One was 60 minutes per week and the other was 150 minutes per week.

The researchers concluded that as little as 60 minutes per week of physical activity provides health benefits to an individual. Indeed, there was a significant reduction in mortality for those individuals who did participate in at least 60 minutes of physical activity over the 36-month period. So, if an individual can get at least 60 minutes during the week, that activity may add years to the person’s life.

Exercise is essential for a person's health, as it can reduce the risk of chronic diseases such as type 2 diabetes, cardiovascular disease, and certain cancers. Exercise also helps to control blood sugar, lower blood pressure, and improve cholesterol levels. Physical activity can help to reduce anxiety, tension, and depression and improve a person's quality of sleep. Physical activity improves energy levels, strengthens muscles and bones, and enhances brain function by increasing blood flow to the brain. Physical activity can improve life's overall quality by improving cognitive function, memory, and focus.

If 60 minutes of physical activity per week can provide some of the benefits mentioned above, healthcare providers should let patients know that although 150 minutes of physical activity per week is recommended, a smaller amount of physical activity can increase longevity.

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Almonds May Reverse Prediabetes

Prediabetes is a real problem. And it should be taken seriously according to the CDC. Not only is prediabetes a precursor to type 2 diabetes, but the condition raises the risk of stroke and heart disease. Diet is a key tool in treating prediabetes and diabetes. Nuts are typically key foods in diets that fight diabetes and prediabetes. And a recent study has suggested that almond-consumption may be a possible approach to reversing prediabetes.

The American Diabetes Association (ADA) and the CDC use the following blood-glucose criteria for prediabetes: 5.7% ≤ A1c ≤ 6.4%; 100 mg/dl ≤ FPG ≤ 125 mg/dl; and 140 mg/dl ≤ OGTT≤ 199 mg/dl.

And one study revealed just how much heart disease is associated with prediabetes -- even at the lower ends of the criteria. For example, cardiovascular disease is associated with 140 mg/dl, the lower end of the oral glucose tolerance criterion, and 110 mg/dl for the fasting plasma glucose criterion, which is closer to the lower end than the upper end of the criterion. The study consisted of  95,783 subjects, who had experienced cardiovascular disease within the last 12.4 years.

In the almond-related study mentioned above, it was shown that consumption of almonds can reverse prediabetes. The study consisted of 66 Asian Indians. The aim of the study was to determine if consuming almonds before meals could slow the progression of prediabetes to type 2 diabetes. The potential slow-down resulting from almonds is important since Asian Indians are known to move from prediabetes to type 2 diabetes at a higher pace than some other ethnic groups.

The researchers wanted to determine if consuming 20 g of almonds 30 minutes before major meals could improve glycemic, anthropometric, and metabolic parameters over a period of three months. And, indeed, the researchers concluded that consuming 20 g of almonds 30 minutes before major meals can reduce body weight, waist circumference, fasting blood glucose and glucose levels after the two-hour oral glucose tolerance test.

Almonds are known to be a healthy addition to an eating pattern. The almond-related study results just add to the list of benefits that can be derived from almond consumption: prediabetes reversal.

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Plant-Based Diet Quality is Important for Cardiovascular Health

A leading cause of death and disability in the world is cardiovascular disease (CVD). Food has a vital influence on the development and management of cardiovascular disease. And reducing the consumption of animal products has been shown to have a positive impact on cardiovascular health. However, simply reducing meat intake is not enough. A focus on overall diet quality, including the consumption of a variety of plant-based foods, is essential for reducing cardiovascular risk.

Studies have consistently shown that a diet high in animal products, particularly red and processed meat, is associated with an increased risk of CVD. Animal products are high in saturated fats and cholesterol, which have been linked to an increased risk of CVD.

A diet filled with plant-based foods, like fruits, vegetables, whole grains, legumes, and nuts, has been shown to have a protective effect on cardiovascular health. These foods are high in fiber, antioxidants, and unsaturated fats, and have been linked to improved blood pressure and lipid profiles which can reduce the risk of CVD.

Indeed, individuals should select plant-based foods that are close to natural. The foods should be whole foods. These are foods that have received very little processing or refining. Whole foods typically contain no additives or artificial ingredients. Although individuals can select from animal products infrequently in moderation, individuals should abstain from eating fried foods such as fried poultry and fried fish. Also, when animal products such as low-fat dairy and eggs are consumed, these products should be eaten infrequently and in moderation.

Healthcare providers should discuss the importance of diet quality with their patients when discussion cardiovascular health. This is especially true for patients considering a plant-based diet. Patients should be warned not to assume that all plant-based diets will improve cardiovascular health, just because there is an absence of meat. The patients should be warned to avoid non-meat foods that have been processed or contain additives or artificial ingredients.

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Using Biomarkers to Predict Type 2 Diabetes

Diabetes has been a dangerous chronic illness in the United States for some time. And the disease has garnered considerable attention in recent years. One reason that attention has been paid to prediabetes is because it is a frequent precursor to type 2 diabetes. Approximately 30 million Americans suffer from type 2 diabetes, while more than 96 million have prediabetes. However, biomarkers exist that can predict type 2 diabetes. Therefore, by using biomarkers, a healthcare provider can take action to help a patient delay or prevent the condition.

In a Japanese study, 27,392 non-diabetic subjects were evaluated from 2005 to 2016. The researchers discovered that, on average, a number of risk factors were more prevalent among people who developed type 2 diabetes than among those who did not. In particular, BMI, fasting glucose, and insulin resistance were elevated up to ten years prior to diagnosis.

Another study conducted in Sweden revealed that risk factors for type 2 diabetes are present long before the condition is diagnosed. Twenty years were spent observing 296,439 individuals who were not initially diabetic. During the twenty-year-period, around 10% of the study participants were diagnosed with type 2 diabetes. Looking at the biomarkers, BMI, triglycerides, and fasting glucose, it was discovered that those with higher-than-normal levels of these biomarkers had a greater chance of developing type 2 diabetes 20 years later.

In a recent study of 12,823 people with a mean age of 43.54 years, a median follow-up length of 7.02 years (maximum of 13 years) revealed that 320 participants developed diabetes. In addition, waist circumference (WC) was the best simple anthropometric measure of obesity reflecting diabetes risk followed by waist-to-height ratio (WHtR).

Further, the researchers found that WHtR may be the most beneficial for predicting pre-diabetes, since WHtR's thresholds fluctuate less. WHtR thresholds ranged from 0.47 to 0.50. Subjects with greater WHtR readings had an increased chance of developing diabetes within 6 to 12 years.

Therefore, clinicians should be aware that diabetes can often be predicted.  It is also possible to delay or prevent type 2 diabetes. This knowledge can help physicians more effectively manage patients who are more likely to develop type 2 diabetes.

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Plant-Based Diets Can Slow the Decline of Cognitive Skills

No dietary plan can guarantee a healthy brain as we age. Nonetheless, following a balanced diet rich in fruits, vegetables, whole grains, legumes, and dairy products can help maintain a healthy mind. Choosing healthy fats like olive or canola oil, over saturated fats, and protein from fish and plants is also a good idea. Research shows that plant-based diets that include nutritious vegetables may slow cognitive deterioration. Specifically, a recent study revealed that the Mediterranean diet and the MIND diet can prevent or reduce the decrease of cognitive abilities.

The traditional cuisine of Greece, Italy, and other countries bordering the Mediterranean Sea comprise the Mediterranean diet. The diet consists mostly of plant-based foods, including whole grains, vegetables, legumes, fruits, nuts, seeds, spices, and herbs. Most of the fat in the diet comes from olive oil. In moderation, dairy, poultry, and fish are permissible. Eating sweets and red meat should be infrequent. 

Because the MIND diet incorporates foods from the Mediterranean and DASH diets, let's discuss the DASH Diet. The DASH diet is an eating regimen meant to treat or prevent hypertension. The acronym for Dietary Approaches to Stop Hypertension is DASH. The diet comprises potassium, calcium, and magnesium-rich foods. These minerals aid in blood pressure regulation. The diet prohibits high-sodium, high-saturated-fat, and added-sugar foods.

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) eating pattern promotes a healthy brain health. The MIND diet combines elements of the Mediterranean and DASH diets. The MIND diet incorporates items from the Mediterranean and DASH diets that help boost cognitive function and protect the brain from age-related conditions like Alzheimer's disease. Kale, spinach, and collard greens and other green leafy vegetables are MIND dietary staples.

In a study, researchers combed the ScienceDirect, PubMed, and Web of Science electronic databases to identify brain-healthy diets. And the researcher discovered evidence indicating that plant-based diets can promote brain function. The researchers determined that the MIND diet enhanced memory, focus and cognition. And that the Mediterranean diet improved cognitive capacities. Healthcare providers should educate their patients on the cognitive benefits of plant-based diets based on the findings of this study.

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Retinopathy Can Start in Prediabetes

Retinopathy is a retinal illness, and there are several types of the disease. There is hypertensive retinopathy and diabetic retinopathy, for example. Controlling high blood pressure and blood glucose levels is essential in the treatment and prevention of these disorders. A yearly eye checkup is also vital for people who have retinopathy. The most frequent form of the disease is diabetic retinopathy. And this type of retinopathy is one of the leading causes of visual loss around the world. At least three studies have found a relationship between retinopathy and prediabetes.

Prediabetes occurs when the blood glucose level is greater than usual but not high enough to be classified as diabetes. For a long time, it was assumed that prediabetes was frequently followed by diabetes. As a result, a study was done to investigate the path from prediabetes to diabetes.

Between 1996 and 2001, the Diabetes Prevention Program study was conducted. The researchers investigated how prediabetes could progress to diabetes. Prediabetes was discovered to increase the incidence of type 2 diabetes, and treating prediabetes could postpone or prevent type 2 diabetes in many cases.

Following the original Diabetes Prevention Program study, more research investigating the incidence of retinopathy among people with prediabetes was conducted. The researchers examined a subgroup of the original study's participants. The initial Diabetes Prevention Program trial had 3224 participants.
There were 302 people in the subset. The researchers identified retinopathy in 7.6% of the study's prediabetic patients.

In another study, researchers looked at publications in the MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Google Scholar, and Cochrane databases to see if there was a link between retinopathy and prediabetes. The researchers chose twenty-four studies for their study after reviewing 5994 abstracts and 98 full-text articles. There were 8759 prediabetic patients in the twenty-four studies. The researchers observed that prediabetes had a 6.6% rate of retinopathy compared to 3.2% in those with normal blood glucose levels.

Finally, in a more recent meta-analysis of 18 articles, researchers discovered a strong link between prediabetes and macular diseases. The researchers suggested that persons with prediabetes should be evaluated for retinal disorders.

According to the findings of the preceding investigations, healthcare providers may want to examine the eyes of patients with prediabetes. Early indications of retinopathy may be detected by the providers. This would benefit both the patient and the provider.

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