Posted 1st July, 2010 in "Wellbeing" from Sydney Morning Herald

http://www.smh.com.au/lifestyle/wellbeing/big-food-and-you-rules-for-a-healthy-life-20100701-zp5p.html

Would you have thought a can of Coke and a "97% fat-free" yoghurt had the same amount of sugar in them? If you didn't, well that's OK - you're not alone. This article looks at how "healthy" diets and "healthy" foods can be doing us more harm than good!

"Michael Pollan is desperate to end our addiction to processed food. Jon Henley hears why

Michael Pollan, tall, fit, not quite skinny but very definitely lean, is holding a fruit yoghurt in one hand and a Coca-Cola in the other.

"So," he says, "which do you think, per 100 grams, contains more sugar?"

The Coke, I reply. Duh.

"Wrong," he says. "The yoghurt. And look, it's low-fat. Isn't that great? We're getting fat on low-fat food."

It's a nice illustration of Rule Nine in Pollan's magnificently sensible new book, Food Rules.

Along with such gems as "Don't eat anything your great-grandmother wouldn't recognise as food" and "Don't get your fuel from the same place your car does", Pollan recommends that you "Avoid food products with 'lite' or 'low-fat' or 'non-fat' in their names."

His reasoning: if you remove the fat from a foodstuff, it doesn't necessarily make it non-fattening.

Certainly not if the producer ratchets up the sugar content to compensate.

In fact, Pollan notes, since Americans began producing low-fat food products, they have been consuming up to 500 extra calories a day. Brilliant.

Pollan, an award-winning author, journalist and campaigner, is on a mission.

Food Rules is, in effect, a condensation of his previous work: much of the science behind these 64 deliberately catchy injunctions towards a healthier diet ("The whiter the bread, the sooner you're dead") has already been expertly dissected in his earlier books The Omnivore's Dilemma and the US bestseller In Defence of Food.

The rules spring from two facts.

The first is that people who eat what Pollan defines as a western diet ("lots of everything except vegetables, fruits and whole grains") tend to suffer from western ailments: obesity, type 2 diabetes, cardiovascular disease and cancer.

The second is that people who eat more traditional diets - including those of certain indigenous peoples - that, by the lights of western food science, might be considered way too high-fat, high-carb or high-protein, do not tend to suffer from these diseases.

In other words, people can thrive on a wide variety of foods and diets, with one major exception: the diet most of us in the west are now eating.

So why are we eating our way to death?

Because for big food manufacturers, the western diet is payday, every day.

"The more a food is processed, the more profitable it gets," says Pollan, who refers to these products as "edible food-like substances".

And that status quo is not challenged by modern food science, which is all about identifying the "good" and "bad" nutrients in processed foods and tinkering with them - by lowering the fat, for example, or fortifying the vitamins - rather than questioning the value of processed food products in the first place.

"We don't talk about food any more," says Pollan.

"We talk about nutrients, omega-3, antioxidants, saturated fats, polyphenols. And so we play into the hands of the food marketers."

This all has the crushing logic of truth.

But can we do anything about it?

Pollan has little faith that Big Food will change voluntarily: legislation will be needed, he fears, although he takes heart from the Obama administration's victory on healthcare reform in the US.

"Pretty soon," he explains, "the insurance industry is going to realise that we have to tackle obesity and type 2 diabetes.

"They might even come out in favour of taxes on soft drinks. And once we see one powerful industry pitted against another, then we might see progress."

The complication of food has been under way for a long time now.

After agriculture became more productive following the second world war, "corn and soy and wheat and rice got cheaper - and the only way to make money out of them was to process them.

"A sort of arms race started to make food more complicated: don't buy flour, buy cake-mix; don't buy cake-mix, buy cakes.

"Don't buy oats, buy Cheerios; not Cheerios, cereal bars."

Is that process reversible?

It may have to be, Pollan argues, as we start running out of fossil fuels.

Big Food as it exists today is, patently, not sustainable.

Pollan is sure we can produce enough real food, but fossil fuels will have to be replaced by manpower.

"Organic farms are wildly productive," he says, "but a lot more labour-intensive.

So convincing is Pollan's logic that you wonder where it all came from.

He started out, he says, as more of a naturalist than a foodie, but was gradually won over by the notion that "what happens on our plate represents our most powerful engagement with the natural world".

He no longer eats junk food (though his teenage son does).

He acknowledges, though, that many of the exchanges he has about this issue "are with skinny people".

An interest in good food is, still, something of a middle-class preoccupation.

"But abolition, women's suffrage, those movements began as elitist too," Pollan says. "I won't be discouraged."

The Guardian"

New Data Shows Kidney Disease Rising Due to Rampant Rates of Diabetes

AUSTIN, Texas--(BUSINESS WIRE)--New data confirms the rate of chronic kidney disease is inching upward, keeping pace with the rising rates of diabetes. In late September, the U.S. Renal Data System published its 2009 Annual Data report, which shows the incidence of chronic kidney disease in the U.S. Medicare population is now 9.8%, up from 8.7% reported in last year’s data analysis.

Diabetes, the leading cause of kidney disease, moved closer to affecting one in four Medicare beneficiaries nationally: the newest data shows 24.8% have this disease, up from the 23.6% reported a year earlier. The Texas Department of State Health Services estimates more than 1.8 million Texans have diabetes.¹

Dallas-based nephrologist Roberto Collazo-Maldonado, MD, is not surprised by the data.

“Because Texas has a big problem with diabetes,” Dr. Collazo says, “more people will get kidney disease. If we find it early, we can effectively treat kidney disease to prevent and avoid dialysis. That is, if we find it early.”

The American Diabetes Association recommends people with diabetes check their kidneys with an annual microalbumin test. However, fewer than 40% of Texas Medicare beneficiaries with diabetes received this screening in 2007, according to claims data from the Centers for Medicare & Medicaid Services².

“I regularly see patients who discover they have kidney disease when they come to the hospital for emergency treatment because their kidneys have failed,” Dr. Collazo continues. “This is too late. People with diabetes must check their kidney health every year.”

Why preventive testing is critical for people with diabetes

“It’s optimal to treat kidney disease before the damage is apparent to the patient,” says Dr. Collazo. “In the earliest stages, it’s unlikely the patient will experience obvious symptoms that would prompt a doctor’s visit.”

The urine microalbumin test looks for traces of albumin, a protein, in a patient’s urine. Damage impairs the kidneys’ ability to filter the blood for proteins, which then “spill” into a patient’s urine. This is an early marker of kidney disease.

“Getting a microalbumin test is very easy. It’s just a urine sample. No needles and no pain,” says Dr. Collazo. “If we find kidney disease at the early stages, we can treat it and most likely avoid dialysis. Not everyone with kidney damage progresses to kidney failure, but first you have to get tested regularly and then get timely treatment to prevent that outcome.”

People with diabetes and minorities at higher risk

Up to 40% of people with diabetes will experience kidney problems in their lifetime.³ Minorities with diabetes are also disproportionately affected: African-Americans are four times more likely than Caucasians to experience kidney failure, and Mexican-Americans with diabetes are twice as likely as non-Hispanic whites to have diabetes.^4,5

Accounting for 44% of new cases, diabetes is the leading cause of kidney disease, the U.S. Renal Data System reported in 2007. The second leading cause is high blood pressure.⁶ Other risk factors are age, obesity and a family history of kidney problems.

About TMF Health Quality Institute

TMF Health Quality Institute is an Austin, Texas-based nonprofit consulting company focused on promoting quality health and health care through contracts with federal, state and local governments, as well as private organizations. TMF partners with health care providers in a variety of settings to ensure that every person receives the appropriate care, every time. www.tmf.org

World Diabetes Day: Understanding Diabetes and Taking Control
Diabetes increases our risk of cancer and depression by 50 – 80%
We have all heard of diabetes and the obesity epidemic sweeping the world. We know that diabetes puts our health at greater risk, but the fall out of this epidemic is more far reaching than we ever thought possible. For many years we have known that diabetes is linked to obesity and heart disease and now ground breaking new research from Europe has turned the medical world on its head.  
At the 2009 European Association for the study of Diabetes Conference in Vienna, research1 was presented which showed that if you develop type 2 diabetes your risk of developing cancer is far greater.  In men, having diabetes increases your risk of getting the following cancers: 80% for pancreatic cancer; 30% for colorectal cancer; and 24% for bladder cancer. For women too, breast and endometrial cancer risk increases by 20 to 100% respectively, if you have diabetes.
In addition there is a new relationship between cancer and obesity, which is often seen with diabetes. Research has shown us that if you have a high BMI (over 35 or 40), men are 52% and women 62% more likely to die from cancer2
The devastation of diabetes does not stop there.
The relationship between diabetes and depression is often overlooked. People with diabetes have double the risk of developing depression compared to people without diabetes.3 Approximately 15% of people with diabetes will experience major depression, and 25–30% will have milder forms of depression.4 Unfortunately, depression often goes undiagnosed and untreated in people with diabetes, as there are often other medical issues that need addressing. This often leaves people to suffer depression without assistance or sometimes awareness of it.  

Even here in Australia we have determined that there is consistent evidence that depression is a risk factor for heart disease, stroke and diabetes mellitus.5 The relationship works in both directions, as older adults with depressive symptoms are at least twice more likely to develop diabetes than those without depressive symptoms.6

There is good news! Research has shown that simple lifestyle changes such as increased physical activity and diet change can dramatically reduce a person’s chance of developing diabetes, depression and cancer.   

Studies in both the US7 and Australia8 have highlighted the benefits of exercise in the treatment of depression. These studies showed that physical activity was up to two times as effective as anti-depressive medication in the treatment of depression. Similarly, studies have been completed on physical activity substantially reducing the risk of cancer9.

Diabetes, depression and cancer are three of the most devastating and life changing medical conditions we can ever experience. Knowing that they are linked places an even greater importance on leading a healthy lifestyle in order to prevent these diseases and any related complications.
Diabetes experts and authors of the book Sugar Daddy Dr Adam Fraser and Christine Armarego are working to raise awareness of the impact, complications and risks of diabetes for World Diabetes Day.
World Diabetes Day (WDD) is celebrated every year on November 14. The International Diabetes Federation (IDF) and its member associations lead the World Diabetes Day campaign. It engages millions of people worldwide in diabetes advocacy and awareness. Diabetes Education and Prevention is the World Diabetes Day theme for the period 2009-2013. The campaign slogan for 2009 is "Understand Diabetes and Take Control".  Type 2 diabetes can be prevented in the many cases by helping and encouraging those at risk to maintain a healthy weight and take regular exercise.

The Glucose Club
http://www.theglucoseclub.com.au
http://www.worlddiabetesday.org/
For more information or comments contact:
Aimée Cavanagh
E: aimee@dradamfraser.com
Ph: +61 2 9564 5763

1.    Jeffrey A Johnson, School of Public Health, University of Alberta, Edmonton Canada.
2.    Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ.  Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.  N Engl J Med. 2003 Apr 24;348(17):1625-38.
3.    Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24:1069–78.
4.    Polonsky W. Diabetes burnout: what to do when you can’t take it anymore. Alexandria (Virginia, USA): American Diabetes Association, 1999.
5.    Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence.  Med J Aust. 2009 Apr 6;190(7 Suppl):S54-60.
6.    Atlantis E, Browning C, Sims J, Kendig H. Diabetes incidence associated with depression and antidepressants in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA). Int J Geriatr Psychiatry. 2009 Oct 5. [Epub ahead of print]Click here to read Links
7.    Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, Waugh R, Napolitano MA, Forman LM, Appelbaum M, Doraiswamy PM, Krishnan KR. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. Effects of exercise training on older patients with major depression.Arch Intern Med. 1999 Oct 25;159(19):2349-56.
8.    Singh NA, Stavrinos TM, Scarbek Y, Galambos G, Liber C, Fiatarone Singh MA. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci. 2005 Jun;60(6):768-76.
9.    Emilie Friberg, Christos Mantzoros and Alicja Wolk Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden and 2Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

ATHENS, Nov. 10 (Xinhua) -- With dire estimates about the present and equally alarming predictions about the future, the Hellenic Diabetes Association unites its voice with other international organizations in the fight against the illness ahead of the World Diabetes Day which is celebrated on November 14.

    Almost one in ten Greeks suffers from type 2 diabetes today, after a 16 percent raise in the cases counted down between 2002-2006, according to a survey made by the Diabetes Department of the General Hospital of Nikaia in Piraeus and released by its director Alexis Sotiropoulos on Tuesday.

    "We must drastically change our diet and take up regular exercise to avoid the worse", he stressed at the press conference in Athens, warning that if citizens of the world will not change their life styles worldwide more than 380 million people will be diabetics by the end of the following decade.

    Hellenic Diabetes Association is taking part in the international awareness campaign which this year is titled "Understand Diabetes and Take Control".

Studies in the US are now looking at red grapes and pomegranate to see if it can assist in the fight against diabetes.  They are interested in a chemical compound called Resveratrol, which has shown promise in mice, in how it affects the brain.  Essentially they believe that mice given Resveratol can increase their lifespan.

They had some mice on a high fat diet and a usual group. After five weeks, 50% of the mice that were on high-fat diets showed that healthy insulin levels.  The research does hold promise, but the researchers warn there is a lot more to do before it’s near ready for humans.  They also state that using red wine as a substitute won’t work because it doesn’t contain enough Resveratrol in each serving (I hear the collective groan). The article will be published in the December edition of Endocrinology.  So as grapes are coming into season – enjoy the red ones!

Source: http://www.healthnews.com/medical-updates/red-grape-compound-showing-promise-against-diabetes-3792.html

With more than 70% of people over 15 years of age in Australia being sedentary or having low exercise levels according to the ABS National Health Survey for 2007-2008.  Being time poor is one of the most common reasons cited by people as to why they aren’t being active - they find it hard to fit in, they have kids, they run their own business, they have a stressful and demanding job.  However if you read Sunday Life magazine this weekend you will have seen the article on how busy people fit in exercise.  There’s a pilot and mother of four who’s also a dermatologist, Guy Grossi who you may have seen on Masterchef and an executive lawyer.  

What is common about them is that they all have challenges. They complete long days (up to 15-16 hours), have interrupted or poor sleep times, have high stress jobs and none of them were highly sporty as children or young adults. However they all discovered how valuable physical activity was to their health, to their well being, to their performance at work. There are many benefits in simply participating – you don’t have to be a “sporty type of person”.

In the article, they listed all the different ways they found to make exercise work for them and fit into their lifestyle.  They learnt about what makes them tick and use that as the driver.  Rex Wells (the pilot) tells himself that he only has to do 20 minutes but finds once he has started he is happy to go for longer – he just has to get there.  Josephine Yeatman (the dermatologist) sets goals for herself, attends courses and involves her family, she puts in her diary and ensures it is scheduled.  Guy Grossi talked about the time of day he exercises and he makes sure that on the weekends, which are his busiest days that he attends the gym.

What each of these high performers has done is worked out what drives them, how their mind works and stay within that. They have found what they can do to beat their Sugar Daddy and that is the key to their success.  There is no one program that will work for all of us all of the time.  But if you have control of your Sugar Daddy and know him or her well enough, you can manage all of the challenges life throws at you.

An article in yesterdays Daily Telegraph (Monday 6th July 2009) entitled “Kids put at risk by fatty diet” brings to the fore some startling statistics about Australian Children (http://www.news.com.au/adelaidenow/story/0,,25737756-2682,00.html).

The research to be published in Diabetes Care states that one third of all 14 year olds and one in four eight year olds fall into high-risk category for heart disease, stroke and diabetes.  One of the authors for the report, Professor Stanley, advises that this is so because there has been a dramatic increase in the amount of cheap and high fatty foods with “slick” advertising.  She also states that more activity for the whole family is needed.  They also comment that the definition of obesity is too focused on Body Mass Index alone and that in this report they considered waist circumference, blood pressure and insulin resistance.


This highlights how important a healthy lifestyle and getting control of your Sugar Daddy is for the whole family and how our kid’s health is suffering in this fast paced society.  I for one look forward to reading the report in full!

Blood Pressure and Resting Heart rates effect Type 2 diabetes

Posted by Christine Armarego AEP Thursday 2 July 2009

A new study published in June 2009 in the International Journal of Epidemiology shows that having a higher resting heart rate and high blood pressure are both risk factors in whether or not you will develop type 2 diabetes. More interestingly they are independent of each other, so either one as well as both will influence this.  The study looked at over 16000 men and 8000 women in Japan from ages 39-50 years and showed not significant differences across genders.

And of course exercise and a healthy diet is the most effective way to keep your resting heart rate and BP down!

Reference: Nagaya T, Yoshida H, Takahashi H, Kawai M.Resting heart rate and blood pressure, independent of each other, proportionally raise the risk for type-2 diabetes mellitus Int J Epidemiol. 2009

Will free Lap-band surgery fix the obesity or diabetes epidemic?

Posted by Christine Armarego AEP

Yesterday the media headlines were “Free Fat Surgery”! It related to a story about a government report which makes recommendations to the Australian Government on how to tackle the obesity crisis that costs $58 billion last year.  

One of the recommendations is for gym memberships to be subsidized.  Now this is certainly a step in the right direction especially with the GFC forcing people to make decisions based on money in the short term rather than the cost to their health in the long term.  However for many of the clients we see in “The Glucose Club” they get greater benefit from more individualized sessions rather than simply purchasing a gym membership, as this doesn’t guarantee attendance or weight loss.  Having caring, supportive and educated Allied Health professionals available who understand behavior change and are experienced in designing individualized programs, specifically if the person has injuries or a chronic health condition will make weight loss more likely.  Also not every one is interested in going to a gym – what about out-door training or a pool membership?  The government could also consider increasing the number of Enhanced Primary Care plan sessions available from 5 to 10 per year, allowing for more personalized care of those at greatest risk of developing morbid obesity.

They also recommend that Bariatric or Lap-banding surgery be subsidized by the government.  While this type of surgery is beneficial to those who are morbidly obese and who cannot exercise, there still needs to be education on nutrition and exercise and assistance in how to change these lifestyle habits to prevent the person falling into old habits. Surgery is only half the battle and it’s surgery plus support through lifestyle changes that is successful.  And bear in mind surgery has it’s own risks, including unsuccessful or procedures that need to be repeated.

I think the main problem is that the report is looking at ways to reduce weight – but have forgotten that the science shows that being fit is more important than being thin – and that is where their focus should be!  Being fit improves your glucose and insulin interaction and prevents metabolic health problems such as diabetes. Feel free to leave your comments below!