Marc Joseph Nutrition - Blog

In a meta-review study published in the Journal of Internal Medicine, researchers found that for every 100 mg increase in magnesium intake, the risk for type 2 diabetes fell by 15 percent.

Magnesium is an essential mineral cofactor used in many enzyme reactions throughout the body, and is especially important in energy production. Several studies indicate that magnesium may help to improve insulin sensitivity and, in turn, glucose tolerance.

Deficiency Widespread, Impact Costly

Magnesium deficiency is common. The Recommended Daily Allowance (RDA) is 420 mg and 320 mg per day for men and women, respectively. But the average adult intake is less than 320 mg/day for men and less than 230 mg/day for women. Magnesium intake in seniors may be even lower. And realize that the RDA is a level set to avoid deficiency, not a level to encourage optimal health.

Likewise, diabetes is widespread and costly in both personal and financial terms. In the U.S., 7 percent of the population, or 20 million people, have diabetes. Those afflicted are at greater risk for many serious conditions, including heart disease, hypertension, stroke, kidney disease, vision loss, amputations, and dementia.

The annual cost of taking care of diabetics is estimated at more than $130 billion. One out of every eight U.S. federal health care dollars goes toward treating people with diabetes. And the costs are estimated to soar going forward.

What You Can Do

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If the increased risks for heart disease, cognitive decline, vision loss, kidney damage, peripheral nerve damage, and limb amputation haven’t provided enough incentive to take the nutritional and lifestyle steps to avoid developing type 2 diabetes, a recent paper published in the journal Diabetes Care may get your attention.

In the study, which included 355 men over the age of 30 with diabetes, researchers found that 42% of the men were deficient in testosterone. Specifically, 17% had low testosterone (hypogonadism), while another 25% had borderline low testosterone.

Additionally, body mass index (BMI) and waist circumference were negatively correlated with testosterone levels in this group of diabetic men, with the latter having the strongest association. Spare tire holders beware.

(Not So Good) Symptoms

Common symptoms of low testosterone in males include a decreased sex drive, reduced strength of erections, fatigue, reduced physical strength, inability to concentrate, and mood changes. Researchers for this study noted that the two most frequently observed symptoms were erectile dysfunction (70%) and decreased sex drive (63%).

What You Can Do

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In a study published in the journal Diabetes Care, researchers found that individuals exposed to higher levels of persistent organic pollutants (POPs), such as organochlorine (OC) pesticides and polychlorinated biphenyls (PCBs), had a significantly greater likelihood of having insulin resistance, which, in turn, may be associated with higher risk of developing type 2 diabetes. The strongest relationship was observed with OC pesticides.

Researchers also noted that the link between OC pesticides and insulin resistance strengthened as waist circumference increased. Not too surprising, as pesticides are thought to be stored in fatty tissue.

Note, though, that the study was a cross-sectional analysis, so it couldn’t prove cause and effect. It may be the case that insulin resistance reduces the body’s ability to excrete pesticides and other pollutants, rather than exposure to the pollutants necessarily causing insulin resistance.

What You Can Do

Nevertheless, it seems prudent to try to reduce exposure to pesticides, PCBs, and other pollutants whenever possible. You can read more about reducing pesticide exposure in produce here:

Which Vegetables & Fruits Are Highest and Lowest in Pesticides?

And you can reduce exposure to PCBs and other pollutants in fish by getting healthy Omega-3 fats from supplements that have undergone molecular distillation processing. There’s a link to a good list of safe products in this post:

Safe Fish or “Just Trying to Make Consumers Feel Good”?

There are other safe, tested fish oil supplements out there, too. Just be sure to check with the manufacturer to confirm the processing method and tested residual contaminant levels.

(Image: EPA)

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Discover How Nutrition Can Make a Difference in Your Life …

Marc Joseph Nutrition

In a recent study published in the journal Cell, Canadian scientists identified a breakthrough understanding of the role of pain nerves in insulin-producing (islet) cells, and in turn, learned how to prevent pancreatic cell inflammation and reverse Type 1 diabetes in mice.

The researchers found that the nerve receptors in the islet cells of non-obese diabetic (NOD) mice were not secreting enough neuropeptides, chemical compounds that can help nerve cells to communicate with one another and regulate physiologic processes.

When scientists supplied these diabetic-prone mice with neuropeptide substance P, which acts as both a neurotransmitter and neuromodulator and plays a key role in pain transmission, islet cell inflammation subsided in one day and insulin sensitivity returned to normal for a period of weeks.

Apparently, there is a key “control circuit” between the insulin-producing cells in the pancreas and the associated pain nerves:

“We started to look at nervous system elements that seemed to play a role in Type 1 diabetes and found that specific sensory neurons are critical for islet immune attack in the pancreas,” said Dr. Hans Michael Dosch, the principal investigator. “These nerves secrete insufficient neuropeptides which sustain normal islet function, creating a vicious circle of progressive islet stress.” …

… “The major discovery was that removal of sensory neurons expressing the receptor TRPV1 neurons in NOD mice prevented islet cell inflammation and diabetes in most animals, which led us to fundamentally new insights into the mechanisms of this disease,” said Dr. Michael Salter, co-principal investigator, senior scientist at SickKids, professor of Physiology and director of the Centre for the Study of Pain at the University of Toronto. “Disease protection occurred despite the fact that autoimmunity continues in the animals. This helped us to focus our studies on finding the new control circuit in the islets.”

Potential Future Application in Type 2 Diabetes

This discovery is big news. Researchers are currently looking to test the approach in human trials and also to extend the study to the much more prevalent Type 2 (obesity-associated) diabetes and potentially other autoimmune conditions.

In Type 1 diabetes, islet cells in the pancreas do not produce insulin, and affected individuals must get daily insulin injections to manage blood glucose levels.

In Type 2 diabetes, the body’s cells become insensitive to the action of insulin, and the body may also eventually stop producing sufficient insulin.

You can learn more about Type I and Type II diabetes, their potential causes, and my treatment approaches that focus on addressing nutritional and environmental factors here.

(Image Credit: HowStuffWorks)

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Discover How Nutrition Can Make a Difference in Your Life …

Marc Joseph Nutrition

In a study published in the journal Diabetes, researchers found that increased belly fat led to the production by fat cells of higher levels of inflammatory molecules that may directly promote systemic (whole body) inflammation. This increase in systemic inflammation may, in turn, raise the risk for several diseases, such as heart disease, diabetes, cancer, and cognitive decline.

There are two types of abdominal fat:

1. Subcutaneous fat - found just beneath the surface of the skin (the fat you can “pinch”)
2. Visceral fat - found in the spaces between internal organs

(Image: LA Times)

Visceral fat appears to be the primary source of the problem:

[T]he research team says visceral fat likely contributes to increases in systemic inflammation and insulin resistance. They sampled blood from the portal vein [which routes blood to the liver from the gastrointestinal tract] in obese patients undergoing gastric bypass surgery and found that visceral fat in the abdomen was secreting high levels of an important inflammatory molecule called interleukin-6 (IL-6) into portal vein blood.

“The portal vein is filled with blood that drains visceral fat,” says first author Luigi Fontana, M.D., Ph.D., assistant professor of medicine at Washington University in St. Louis and an investigator at the Istituto Superiore di Sanita, Rome, Italy. “Portal vein blood had levels of IL-6 that were 50 percent higher than blood from the periphery.”

Increased IL-6 levels in the portal vein correlated with concentrations of an inflammatory substance called C-reactive protein (CRP) in the body. High CRP levels are related to inflammation, and chronic inflammation is associated with insulin resistance, hypertension, type 2 diabetes and atherosclerosis, among other things …

… “Many years ago, atherosclerosis was thought to be related to lipids and to the excessive deposit of cholesterol in the arteries,” Fontana says. “Nowadays, it’s clear that atherosclerosis is an inflammatory disease. There also is evidence that inflammation plays a role in cancer, and there is even evidence that it plays a role in aging. Someday we may learn that visceral fat is involved in those things, too.”

Evidence Building

This latest study is one of many to highlight the influence of excess fat on systemic inflammation and disease risk. Here are links to a few other studies:

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Last week, I wrote about the potential risks of exposure to the estrogenic chemical, bisphenol-A.

Another class of chemicals that may have negative health effects is phthalates, which are used in plastic packaging, cosmetics, shampoos, soaps, lotions, lubricants, paints, and pesticides. Phthalates are also commonly used as a softener for products made using PVC (polyvinylchloride) and as a key ingredient in fragrances. One kind of phthalate helps prevent the fragrance in perfumes, lotions, shampoos, make-up, nail polish and hair sprays from degrading.

Research has shown that phthalates impair testicular function in rats and are linked to abnormal sperm counts and anti-androgenic effects in humans, such as decreased testosterone levels. In recent years, a significant population-wide decline in testosterone levels has been observed in American men. More than 75% of the US population has measureable levels of several phthalates in the blood.

Latest Research

A study (full-text PDF) published in the latest issue of Environmental Health Perspectives further explored the potential negative effects of phthalates. Researchers found that adult males with the highest urinary levels of several different phthalates were more likely to be insulin resistant and obese.

Study Limitations

The study’s authors note that:

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In a recent study published in Nutrition and Metabolism, researchers found that interesterified (IE) fat, which is being pushed as a replacement for trans fats, may actually have more negative health effects than trans fats themselves.

The negative health effects of trans fats have been widely known for some time:

• increase bad cholesterol (LDL)
• decrease good cholesterol (HDL)
• impair endothelial cell (e.g., arterial) function
• associated with greater risk for heart disease and diabetes

Beginning in 2006, the Food & Drug Administration (FDA) began requiring all food manufacturers to list trans fats separately on the Nutrition Facts labels on packaged foods:

That move certainly has helped make it easier to select healthier products at the grocery store.

And, late last year, in a move that may start a trend, New York City banned trans fat use in restaurants.

Questions remain, though. What will replace trans fat products? Many products have been developed for both frying and baking. Will the replacements be any healthier?

Interesterified (IE) fats have been developed as one alternative. These fats are made by combining liquid oils (e.g., canola oil) with solid fats (e.g., palm oil) and mixing them with acids or enzymes to form a fat of desired consistency. The process is called interesterification.

The study mentioned above put study participants in three groups using the following test fats (~30% overall fat, >70% test fat):

• palm oil (a saturated fat) - PO
• partially hydrogenated soybean oil (containing 3.2% trans fat and 6.5% palm oil) - PHSO
• and an interesterified fat (with 12.5% stearic acid, a saturated fat) - IE

Researchers found that after four weeks:

• Blood glucose levels were 40% higher after meals in individuals using the IE diet versus those using the PO or PHSO diet.
• Fasting insulin levels were 10% lower in those using the PHSO diet and 22% lower in those using the IE diet.
• HDL (or good cholesterol) fell by 8 percent for the PHSO diet and 7 percent for the IE diet.

Not so good. Although the results of this study need to be replicated (this study was funded and staffed by the Malaysian Palm Oil Board), it seems like IE fats may be ones that you’ll want to avoid.

Your best bet is including in your diet unaltered fats in healthy combinations. For example, try using olive oil (high in monounsaturated fats) as your primary dietary oil, and layering on essential fats (Omega-3 fats as found in fish oil and small amounts of Omega-6 fats as found in vegetable oils).

A recent study in the Journal of the American Medical Association examined different midlife risk factors and their association with survival rates in men.

Researchers found that 42% of the study’s 5820 original study participants survived to the age of 85. However, only 11% of the study participants survived to 85 years without getting one of 6 major chronic diseases and without physical and cognitive impairment (a state referred to by the authors as “exceptional survival”).

Participants who had high (hand) grip strength and avoided risk factors, including:

• Becoming overweight
• High blood pressure
• High blood sugar
• Smoking
• Excessive alcohol consumption

in mid-life had a greater chance of both reaching age 85 and exceptional survival.

Being married and avoiding high triglycerides were also associated with exceptional survival. Being single, on the other hand, was not associated with reaching age 85.

Researchers estimated that the probability of survival to 85 may be as high as 69% for men with no risk factors and as low as 22% with six or more risk factors. Exceptional survival to age 85 was estimated as high as 55% for men with no risk factors and as low as 9% with six or more risk factors.

Those are some pretty big differences. Nutrition plays a significant role in many of the risk factors - e.g., high blood sugar, high blood pressure, and more. There’s clearly a lot that an individual can do well before reaching older age to both lengthen and improve the quality of life.

A really interesting article discussing the dynamics of diabetes in India:

. . .Throughout the world, Type 2 diabetes, once predominantly a disease of the old, has been striking younger people. But because Indians have such a pronounced genetic vulnerability to the disease, they tend to contract it 10 years earlier than people in developed countries. It is because India is so youthful — half the population is under 25 — that the future of diabetes here is so chilling.

. . .In perverse fashion, obesity and diabetes stand almost as joint totems of success.

Last year, for instance, the MW fast-food and ice cream restaurant in this city proclaimed a special promotion: “Overweight? Congratulations.” The limited-time deal afforded diners savings equal to 50 percent of their weight (in kilograms). The heaviest arrival lugged in 135 kilograms (297 pounds) and ate lustily at 67.5 percent off. . .

. . .In the United States, an inverse correlation persists between income and diabetes. Since fattening food is cheap, the poor become heavier than the rich, and they exercise less and receive inferior health care. In India, the disease tends to directly track income. . .

It’s a scary unfolding of events. The rise in infections, amputations, and heart and kidney disease as a result of the disease is bankrupting people physically, financially, and emotionally. Few people in India have health insurance, and policies often don’t cover diabetes. Divorce rates are increasing as people become disabled.

As mentioned above, East Indians, like other ethnic cultures such as American Indians and Hispanics, are especially susceptible to diabetes, possibly because their bodies are genetically programmed to better store fat when food is in ample supply.

Whatever the genetics, type 2 diabetes is preventable (and, in some cases, reversible) with good dietary habits and supplementation. The question is, as it is around the world, will people take the necessary steps?

A recent University of Michigan study projected the cost of strokes in the U.S. to be $2.2 trillion over the next 45 years. The study factored in everything from hospital care to medications to home health care.

And that’s a conservative estimate, as it’s based on the current rates of primary risk factors such as diabetes, heart disease , obesity, and high blood pressure. With rates of obesity and Type 2 diabetes rapidly increasing in younger populations, the eventual costs could be much greater.

Fortunately, these risk factor conditions are largely preventable, with nutrition playing a significant role.