In this episode of the JIM Podcast, Editor-in-Chief Richard McCallum speaks with David Cistola of Texas Tech University Health Sciences Center El Paso about American Diabetes Month.
Medicine: ‘Diabetes’ – Risks & Diagnosis (BMJ Podcast)
Category Archives: Diet
Diet Study: The Top 250 U.S. Movies Depict Unhealthy Foods & Drinks (Stanford)
Stanford researchers examined the 250 top-grossing American movies of recent decades and found the on-screen foods and beverages largely failed U.S. government nutrition recommendations and U.K. youth advertising standards.
Study: “Anti-Inflamatory” Diet Of Vegetables, Fruits, Coffee & Tea Lowers Heart Disease And Stroke Risks
Dietary patterns with a higher proinflammatory potential were associated with higher CVD risk. Reducing the inflammatory potential of the diet may potentially provide an effective strategy for CVD prevention.
Background
Inflammation plays an important role in cardiovascular disease (CVD) development. Diet modulates inflammation; however, it remains unknown whether dietary patterns with higher inflammatory potential are associated with long-term CVD risk.
Health: ‘Diabetes And Chronic Kidney Disease’ – New Guidelines (OCt 2020)
Comprehensive care in patients with diabetes and CKD
Management of CKD in diabetes can be challenging and complex, and a multidisciplinary team should be involved (doctors, nurses, dietitians, educators, etc). Patient participation is important for self-management and to participate in shared decision-making regarding the management plan. (Practice point).
We recommend that treatment with an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin II receptor blocker (ARB) be initiated in patients with diabetes, hypertension, and albuminuria, and that these medications be titrated to the highest approved dose that is tolerated (1B).
Lifestyle interventions in patients with diabetes and CKD
We suggest maintaining a protein intake of 0.8 g protein/kg)/d for those with diabetes and CKD not treated with dialysis (2C).
On the amount of proteins recommended in these guidelines, they suggest (‘recommend’ becomes a ‘suggest’ at this level of evidence) a very precise intake of 0.8g/kg/d in patients with diabetes and CKD. Lower dietary protein intake has been hypothesized but never proven to reduce glomerular hyperfiltration and slow progression of CKD, however in patients with diabetes, limiting protein intake below 0.8g/kg/d can be translated into a decreased caloric content, significant weight loss and quality of life. Malnutrition from protein and calorie deficit is possible.
Physical activity
We recommend that patients with diabetes and CKD be advised to undertake moderate-intensity physical activity for a cumulative duration of at least 150 minutes per week, or to a level compatible with their cardiovascular and physical tolerance (1D).
Top Medical Podcasts: ‘Diverticular Disease’ (BMJ)
Colonic diverticulosis refers to herniation of the mucosa and submucosa through the muscular layer of the colonic wall and may be the result of colonic smooth muscle over-activity. Diverticular disease may be defined as any clinical state caused by symptoms pertaining to colonic diverticula and includes a wide-ranging spectrum from asymptomatic to severe and complicated disease.
Mohamed Thaha, Senior Lecturer & Lead Consultant in Colorectal Surgery, National Bowel Research Centre, Barts and The London School of Medicine and Dentistry, tells us more.
Nutrition Infographics: “Good And Bad Fats”
Covid-19 Studies: 77% Of Hospitalized Patients Are Overweight Or Obese
But on its own, “BMI [body mass index] remains a strong independent risk factor” for severe COVID-19, according to several studies that adjusted for age, sex, social class, diabetes, and heart conditions, says Naveed Sattar, an expert in cardiometabolic disease at the University of Glasgow. “And it seems to be a linear line, straight up.”
- For starters, the blood of people with obesity has an increased tendency to clot—an especially grave risk during an infection that, when severe, independently peppers the small vessels of the lungs with clots
- Immunity also weakens in people with obesity, in part because fat cells infiltrate the organs where immune cells are produced and stored, such as the spleen, bone marrow, and thymus, says Catherine Andersen, a nutritional scientist at Fairfield University. “We are losing immune tissue in exchange for adipose tissue, making the immune system less effective in either protecting the body from pathogens or responding to a vaccine,” she says.
The impact extends to the 32% of people in the United States who are overweight. The largest descriptive study yet of hospitalized U.S. COVID-19 patients, posted as a preprint last month by Genentech researchers, found that 77% of nearly 17,000 patients hospitalized with COVID-19 were overweight (29%) or obese (48%). (The Centers for Disease Control and Prevention defines overweight as having a BMI of 25 to 29.9 kilograms per square meter, and obesity as a BMI of 30 or greater.)
Health Videos: “You Have The Gut Microbiome You Deserve” (Cambridge)
Do you have good or bad microbiome? Or do you have the microbiome you deserve?
Gut Microbiome, the new Open Access journal from Cambridge University Press and The Nutrition Society has published its first papers, including the animated abstract above from the paper: Hill, C. (2020) “You have the microbiome you deserve,” Gut Microbiome, Cambridge University Press, 1, p. e3.
Access the paper here: https://bit.ly/3bFOjc7
Healthy Diet Podcasts: “Spoon-Fed” Author & Professor Tim Spector
According to a recent study, obesity increases the risk of dying of Covid-19 by nearly 50%. Governments around the world are now hoping to encourage their citizens to lose weight. But with so much complex and often contradictory diet advice, as well as endless food fads, it can be hard to know what healthy eating actually looks like.
How many pieces of fruit and vegetables should you eat a day? Will cutting out carbs help you lose weight? Is breakfast really the most important meal of the day? Speaking to Tim Spector, professor of genetic epidemiology at King’s College London about his new book Spoon-Fed, Madeleine Finlay asks why we’re still getting food science wrong, and explores the current scientific evidence on snacking, supplements and calorie labels.
Tim Spector is a Professor of Genetic Epidemiology and Director of the TwinsUK Registry at Kings College, London and has recently been elected to the prestigious Fellowship of the Academy of Medical Sciences. He trained originally in rheumatology and epidemiology. In 1992 he moved into genetic epidemiology and founded the UK Twins Registry, of 13,000 twins, which is the richest collection of genotypic and phenotypic information worldwide. He is past President of the International Society of Twin Studies, directs the European Twin Registry Consortium (Discotwin) and collaborates with over 120 centres worldwide. He has demonstrated the genetic basis of a wide range of common complex traits, many previously thought to be mainly due to ageing and environment. Through genetic association studies (GWAS), his group have found over 500 novel gene loci in over 50 disease areas. He has published over 800 research articles and is ranked as being in the top 1% of the world’s most cited scientists by Thomson-Reuters. He held a prestigious European Research Council senior investigator award in epigenetics and is a NIHR Senior Investigator. His current work focuses on omics and the microbiome and directs the crowdfunded British Gut microbiome project. Together with an international team of leading scientists including researchers from King’s College London, Massachusetts General Hospital, Tufts University, Stanford University and nutritional science company ZOE he is conducting the largest scientific nutrition research project, showing that individual responses to the same foods are unique, even between identical twins. You can find more on https://joinzoe.com/ He is a prolific writer with several popular science books and a regular blog, focusing on genetics, epigenetics and most recently microbiome and diet (The Diet Myth). He is in demand as a public speaker and features regularly in the media.
Infographics: “Reducing Salt In Diet & Foods To Improve Blood Pressure”
Does reducing salt improve our blood pressure?
There is consistent evidence that moderate reductions (i.e. a decrease of 3 to 5 g or ½ to 1 teaspoon a day) in salt intake can lead to a reduction in blood pressure.5,6 However, these effects may not be the same for everyone and will depend on an individual’s starting blood pressure (greater benefits are seen in those with higher blood pressure), their current level of salt intake, genetics, disease status and medication use.
It is important to note that salt is not the only lifestyle factor that can influence our blood pressure. Other factors such as eating enough potassium, maintaining a healthy body weight, not smoking, and being physically active are also important when it comes to reducing blood pressure. You can find 7 lifestyle tips to help reduce blood pressure here.
High salt foods:
- Processed meats such as bacon, salami, sausages and ham
- Cheeses
- Gravy granules, stock cubes, yeast extracts
- Olives, pickles and other pickled foods
- Salted and dry-roasted nuts and crisps
- Salted and smoked meat and fish
- Sauces: soy sauce, ketchup, mayonnaise, BBQ sauce
What is salt?
Salt is the common name for sodium chloride (or NaCl). It consists of 40% sodium and 60% chloride. In other words, 2.5 g of salt contains 1 g of sodium and 1.5 g of chloride.
Why do we need salt?
Both sodium and chloride are essential for many body functions. They help regulate blood pressure, control fluid balance, maintain the right conditions for muscle and nerve function and allow for the absorption and transport of nutrients across cell membranes. Chloride is also used to produce stomach acid (hydrochloric acid, HCl) which helps us digest foods.
How much salt do we need per day?
The exact minimum daily requirement for salt is unknown, but it is thought to be around 1.25 g – 2.5 g (0.5 – 1 g sodium) per day.1 As salt is found in a large variety of foods the risk of deficiency is low.1,2 The European Food Safety Authority (EFSA) has stated that a salt intake of 5 g per day (equivalent to 2 g of sodium) is sufficient to meet both our sodium and chloride requirements as well as reduce our risk of high blood pressure and heart disease.1,2 This is equivalent to around 1 teaspoon of salt per day from all sources.
Both sodium and chloride are released from our body through our urine and when we sweat. This means bouts of heavy sweating such as during exercise can increase our salt requirements slightly. However, as most people consume well above required levels it is usually not necessary to increase salt intake during these conditions.1
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