Dietary Patterns Can Predict Metabolic Syndrome and Diabetes

A recent study looked at young adulthood dietary patterns to determine if the patterns can predict the risk of metabolic syndrome (MetS) and diabetes-related biomarkers prior to middle age. And the researchers determined that eating patterns can be predictive. The diabetes-related biomarkers that can be predicted  include high blood pressure, insulin resistance, prediabetes and high β-cell function.

MetS is a collection of comorbid conditions that raise the risk of cardiovascular disease, stroke, and type 2 diabetes. These conditions include hypertension, hyperglycemia, abdominal obesity, and abnormal cholesterol and triglyceride levels.

High blood pressure, also known as hypertension, is a common illness where the blood's long-term push on your artery walls is so great that it may ultimately result in health issues including heart disease.

Insulin resistance is the inability of muscle, fat, and liver cells to use glucose from the blood for energy. Prediabetes is a condition in which the blood glucose is higher than normal, but not high enough to be diagnosed as diabetes.

High beta-cell (β-cell) function refers to β-cells producing more insulin than normal in order to reduce blood sugar levels.  This can make the β-cell overwork. "This overwork can lead to the loss of β-cells or to β-cells being unable to carry out their function effectively."

To do the analysis, the researchers, in the study, used data on young adults from a long running birth cohort in Australia. The researchers assessed persons in two groups who followed two diet patterns. One group followed a typical western dietary pattern which was rich in meats, refined grains, processed and fried foods. And the other group followed a dietary pattern rich in fruits and vegetables, whole grains and legumes. The participants were examined at 21 years and 30 years. Among the cardiometabolic parameter the researchers looked at were blood pressure, MetS, insulin resistance, prediabetes, and  β-cell function.

The researchers concluded that following an unhealthy Western diet was associated with increased chances of MetS and insulin resistance, while following a healthy, sensible diet was associated with decreased risks. Diets must be optimized in early adulthood in order to promote later cardiometabolic health.

Healthcare providers should start advising young adults in their twenties and thirties to follow a healthy eating pattern such as a whole foods, plant-based pattern. Following this type of diet could likely improve long-term health and possibly prevent metabolic syndrome and diabetes. And this will benefit the patient and lower healthcare costs.

 

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Intermittent Fasting with a High Quality Eating Pattern

Although the most desired strategy for weight reduction and weight management is a mix of food, exercise, and lifestyle adjustment, this approach typically fails to accomplish long-term weight loss. But other diet options, being explored, are adding to our understanding of potentially successful weight loss procedures. Intermittent fasting is one of those strategies. Intermittent fasting (IF) is a cyclical eating pattern characterized by alternating periods of eating and fasting. However, in most IF diets, the food's quality is not addressed.

So, one study compared the weight lost achieved using a one-day fasting protocol with the weight loss achieved using a two-day fasting protocol, where all participants followed a high-quality, nutrient-dense eating pattern. It was found that while two days of fasting achieved better results than one day of fasting, both the two-day method and the one-day method achieved respectable results.

The randomized, controlled study contrasted a one-day fasting regimen, consisting of 10 individuals, with a two-day fasting regimen, also consisting of 10 individuals. The researchers examined the effect of the two diet regimens on weight reduction, body composition, cardiovascular markers such as blood pressure, and cholesterol. The researchers also looked at body composition.

The researchers examined "hormone and hunger responses" in the "20 overweight men and women" over a four-week period. A licensed dietician provided weekly dietary advice and compliance monitoring to the participants. All outcome indicators were evaluated during the week before the study started and during the week after the five-week study ended.

The participants in the one-day IF protocol followed a high-quality nutrient-dense meal pattern consisting of 400 calories on the fasting day and a high-quality diet on the non-fasting days. The participants in the two-day IF protocol followed the same high-quality nutrient-dense meal pattern as the participants in the one-day protocol. However, the participants in the two-day protocol consumed an additional 100 calories on the fasting days.

Both protocols resulted in good results: The researchers concluded that each IF protocol optimized weight loss and improved body composition, cardiometabolic health, and hunger management. However, the two-day protocol provided “enhanced benefits in overweight women and men.”

As in most cases, more research is needed. However, consuming high-quality food while on an IF diet appears to be beneficial.

 

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Prediabetes and Retinopathy

 Retinopathy is a disease of the retina. There are various forms of the disease. For example, there is hypertensive retinopathy and there is diabetic retinopathy. Treatment and prevention of these diseases involves controlling  high blood pressure and blood glucose levels. And of course, a yearly eye exam is critically important for those persons with retinopathy. Diabetic retinopathy is the most common form of the disease. And this type of retinopathy is one of the principal causes of vision loss worldwide. At least two studies have linked prediabetes to a high level of retinopathy.

Prediabetes is where there is a higher than normal level of glucose in the blood, but the elevated level is not high enough to be deemed diabetes. For some time, it was known that prediabetes was often followed by diabetes. So, a study was designed to look into the progression from prediabetes to diabetes. The Diabetes Prevention Program trial was done between 1996 and 2001. The researchers looked at how prediabetes could lead to diabetes. It was found that prediabetes raises the risk of type 2 diabetes, and treating prediabetes could delay or prevent type 2 diabetes is many cases.

Further investigation into the incidence of retinopatyh among persons with prediabetes was done after the original Diabetes Prevention Program study. The researchers looked at a subset of the participants in the original study. There were 3224 participants in the original Diabetes Prevention Program study. The subset consisted of 302 participants. The researchers "found detectable retinopathy in 7.6% of patients," who had prediabetes. So, retinopathy can be associated with prediabetes.

In another study, to determine a relationship between retinopathy and prediabetes, researchers examined articles in MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Google Scholar and the Cochrane databases. After examining 5994 abstracts and 98 full-text articles, the researchers chose twenty-four studies for their analysis. The twenty-four studies consisted of 8759 participants with prediabetes. The researchers concluded that there was a 6.6% rate of retinopathy among persons with prediabetes compared with 3.2% for populations with normal levels of blood glucose.

The above studies indicate that healthcare providers may want to examine the eyes of patients with prediabetes. The providers may detect early signs of retinopathy. And this would be beneficial to the patient and the provider.

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Using Simulation to Investigate Obesity and Type 2 Diabetes

According to Wikipedia, “A simulation is the imitation of the operation of a real-world process or system over time. Simulations require the use of models; the model represents the key characteristics or behaviors of the selected system or process, whereas the simulation represents the evolution of the model over time. Often, computers are used to execute the simulation.”

Simulation is beneficial for assessing public health concerns.
Indeed, simulation, using modeling, has been employed to forecast future levels of obesity and the relationship between obesity and type 2 diabetes as we age.

In one study, 41,567 children and adults' life paths were examined using simulation. And the researchers concluded that, "Given the current level of childhood obesity, the models predicted that a majority of today’s children, [approximately 57%] will be obese at the age of 35 years, and roughly half of the projected prevalence will occur during childhood.”

Additionally, another study employed simulation to analyze the incidence and trends of obesity, as well as the influence of obesity on the risk of type 2 diabetes in a computer model of Los Angeles-born children.

The researchers created the Virtual Los Angeles cohort-ViLA. This was a model calibrated to the Los Angeles County population. The model incorporated trends, causes, and effects of obesity, with a particular emphasis on diabetes as a significant obesity consequence over the duration of the participants represented in the simulation.

Each person depicted in the model engaged in both beneficial and not so beneficial behaviors that are known to be associated with obesity and diabetes. These behaviors included the intake of sugar-sweetened beverages, engagement or non-engagement in physical activity, fast-food consumption, and consumption of diets rich in fresh fruits and vegetables.

Additionally, the model used probability estimates to predict which modeled person might acquire or lose weight and develop type 2 diabetes, based on the person’s sociodemographic characteristics, historical activities, and previous weight or type 2 diabetes status. The researchers utilized the model to create a simulation of 98,230 residents ranging in age from birth to 65 years and residing in 235 Los Angeles County areas.

The simulation results indicated that obesity prevalence frequently increased from 10% to 30% across the life-course of the modeled individuals. And the prevalence of type 2 diabetes  typically increased from less than 2% in the 18-to-24 age group to 25% in the 40-to-49 age group.

As demonstrated, simulation can be beneficial for examining public health concerns. And obesity is a significant public health problem. Another significant public health problem is type 2 diabetes. The modeling experiments cited above indicate the magnitude of the health issues created by the combination of obesity and type 2 diabetes. Additionally, the research underscores the need for the healthcare sector to step up efforts to address obesity and diabetes.

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Treating Obesity and Other Related Conditions with Telehealth

According to the Health Resources Services Administration, telehealth may be defined as "the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration." Telehealth has the potential to improve the treatment of overweight, obesity and related diseases.

A Finnish study analyzed the outcomes of their healthy weight coaching (HWC) program. This is a "web-based obesity management program integrated into standard Finnish clinical care." The program lasts 12 months. And the participants receive coaching support, remotely, in a one-on-one format. The researchers concluded that the HWC is an effective program for helping participants lose weight. And that the program can be integrated into a clinical setting.  

A 2009 study was done in Ottawa Canada to determine the effectiveness of telehealth for home health care. In the study, literature was analyzed to compare the benefits of treating diabetes using telehealth versus treating diabetes using common diabetes treatment procedures. It was found that patients who received treatment via telehealth had a higher quality of life, and experienced less hospitalization than diabetes patients receiving the normal diabetes treatment.

Although the leaders of the Canadian study indicated that more research needs to be done, as stated above, telehealth improved quality-of life and reduced hospitalizations. The use of telehealth also improved glycemic control and patient satisfaction.

A 2007 study was done in the United States to establish the effectiveness of telehealth in treating obesity.  Three weight loss programs were compared. These programs were telehealth, traditional classes, and no program. The study looked at the amount of weight participants regained in each program. The study also assessed a participants' satisfaction with a given program, and the convenience of a program for the participants. Participants in the telehealth program lost slightly more weight than participants in the other two programs.

However, the difference in weight loss was not enormous. But the telehealth group found the telehealth program to be more convenient. And convenience  is important in trying to modify a lifestyle. If one program is more convenient to follow than another, a person is more likely to follow the more convenient program.

Telehealth may elevate the treatment of obesity by making it easier to modify lifestyle. Healthcare providers are paying close attention to telehealth methodology, not only in the fight again overweight and obesity, but, also, in the treatment of other medical conditions.

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We Need to Heighten the Treatment of Prediabetes in the Primary Care Setting

 A person with prediabetes is at a high risk of developing type 2 diabetes. Kidney difficulties, cardiac problems, strokes, and other comorbidities can all be caused by type 2 diabetes. As a result, both healthcare and community organizations are developing programs to fight prediabetes in the hopes of delaying or preventing type 2 diabetes.
However, primary care organizations must play a larger role in the treatment of prediabetes. And, at the moment, these groups are not engaged in the treatment to the extent that they could.

In a recent study, researchers looked at 3888 patients who were diagnosed with prediabetes based on lab results. The diagnoses were later confirmed. However, only 10.4% of the patients were coded as having prediabetes. Only 5.4% received a prescription for metformin, and only 1.0% of the patients received a nutrition-services referral.

Few individuals with untreated prediabetes are ever notified that they are at high risk for diabetes, according to one study. Furthermore, the study concluded that better patient-centered treatment is required for diabetes prevention, which begins by giving the patients more information.

Primary care organizations, on the other hand, are reticent to diagnose and treat prediabetes for a variety of reasons. There is only a vague understanding of what prediabetes is, and some people do not believe it is a disease. Some argue that because the patient already has enough to worry about, it's not a good idea to give him or her more issues to be concerned about.
 
Other factors contribute to primary care organizations' refusal to provide prediabetes therapy. According to one study, clinicians may be unaware of how successful interventions are at reducing diabetes risk. There may also be a "lack of access to providers of dietary and exercise advice."

In any case, in order to avoid or delay type 2 diabetes, more attention should be paid to the diagnosis and treatment of prediabetes.
And the CDC's National Diabetes Prevention Program (DPP) is a terrific place to start.

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Sedentary Lifestyle Can Be a Factor in Low Back Pain

A sedentary lifestyle is one where an individual gets very little exercise. And people all over the world are getting less and less exercise. During their leisure time, people sit while using computers, watching TV or playing video games. And at work, people often do their job while sitting at a desk.  A sedentary lifestyle can increase a person’s risk for many cardiometabolic problems including obesity, heart disease, high blood pressure and cholesterol. And a recent study has shown that a sedentary lifestyle can also raise the risk for low back pain (LBP).

There are basically two types of back pain. There is acute back pain that may last up to a few weeks, and there is chronic back pain that can last 12 weeks or more. Most of us experience back pain at some point, but the back pain usually goes away. However, LBP is a chronic condition for about twenty percent of the people who have the condition.

In the study mentioned above, 27 meta-analyses were researched. The meta-analyses were taken from articles published in PubMed, Embase, Web of Science, and Scopus. And the analysis of the 27 meta-analyses showed that sedentary lifestyle raised the risk of LBP.

The set of meta-analyses showed that a sedentary lifestyle was a big risk factor for LBP in both adults and children. For example, one of the meta-analyses showed that using a computer for more than four hours a day, while at work, could lead to LBP. One of the analyses indicated that sitting for more than seven hours a day can lead to LBP. And another one of the analyses concluded that playing video games for at least twelve hours a week could lead to LBP.

Since a sedentary lifestyle can lead to LBP, exercise should be encouraged by healthcare providers for patients to prevent LBP, as well as other undesirable health conditions. 

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