Saturday, April 3, 2010
Consider using the glycemic index (GI) and glycemic load (GL) to control diabetes, metS, obesity
Recent research shows that diabetics who keep their blood sugar under tight control best avoid the complications associated with the disease. Most experts agree that what works best for people with diabetes - and the rest of us as well – is regular exercise, no trans fats and a high fiber diet. However, the GI value only tells us how rapidly a particular carbohydrate turns into glucose. It does not tell how much carbohydrate is in a serving of that food. As far back as 1997, Harvard School of Public Health professor and researcher Walter Willett, M.D., and his associates developed the concept of GL which takes the quantity of available carbohydrates into account. The glycemic load measures the effect of the glycemic index of a food times its available carbohydrate content in grams in a standard serving. One needs to know both indices to understand a food's effect on blood sugar. The carbohydrate in watermelon, for example, has a high GI. But there isn't a lot of it, so watermelon's GL is relatively low. A GL of 20 or more is high, a GL of 11 to 19 inclusive is medium, and a GL of 10 or less is low. Foods that have a low GL almost always have a low GI. Foods with an intermediate or high GL range from very low to very high GI. A very helpful table about Glycemic Values of Common American Foods can be found on www.mendosa.com. A complete list of foods according to the Revised International Table of Glycemic Index (GI) and Glycemic Load (GL) Values published in 2008 can be found on the same webpage. The list contains 2480 different food items.
Sunday, March 28, 2010
How strong is saturated fat intake associated with cardiovascular disease?
Two very good scientific articles published in 2009 caught my attention regarding this very hot topic. The first one was published by C. Murray Skeaff and Jody Miller Department of Human Nutrition, University of Otago, Dunedin, New Zealand in the Annals of Nutrition and Metabolism 2009;55:173–201. This is a summary of evidence from prospective cohort and randomised controlled trials regarding dietary fat intake and coronary heart disease. They looked at saturated fat, trans fat, monounsaturated fat, polyunsaturated fats and n-3 long chain polyunsaturated fats.They included 28 cohort studies and specifically looked at different fat intake habits of different populations (114 page pdf). They concluded that the available evidence from cohort and randomized controlled trials is unsatisfactory and unreliable to make judgement about and substantiate the effects of dietary fat on risk of CHD. The exception were trans fats and n-3 fatty acids. A strong inverse relationship between increased intake of n-3 fatty acids and decreased incidence of CHD exists. The observational evidence that trans fats are independently associated with increased risk of CHD events is convincing, though based on a more limited body of evidence.
The second study is a meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease published by Patty W Siri-Tarino et al. in the American Journal of Clinical Nutrition in 2010. They reviewed 21 studies. The meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat. These findings raise serious questions about the current low fat dietary trends. According to four National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2000 evaluated by the CDC the prevalence of obesity in the US increased from 14.5% to 30.9%. While mean energy intake in kcals increased, mean percentage of kcals from carbohydrate increased, and mean percentage of kcals from total fat and saturated fat decreased. There is a clear association between the prevalence of obesity and the increased risk of developing heart disease. At this point the question should focus on the potential risks of heart disease associated with increased intake of carbohydrates and trans fats. follow these links
Dr. Eric Westman Metabolism society William S. Yancy Jr, MD, MHS
The second study is a meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease published by Patty W Siri-Tarino et al. in the American Journal of Clinical Nutrition in 2010. They reviewed 21 studies. The meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat. These findings raise serious questions about the current low fat dietary trends. According to four National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2000 evaluated by the CDC the prevalence of obesity in the US increased from 14.5% to 30.9%. While mean energy intake in kcals increased, mean percentage of kcals from carbohydrate increased, and mean percentage of kcals from total fat and saturated fat decreased. There is a clear association between the prevalence of obesity and the increased risk of developing heart disease. At this point the question should focus on the potential risks of heart disease associated with increased intake of carbohydrates and trans fats. follow these links
Dr. Eric Westman Metabolism society William S. Yancy Jr, MD, MHS
Sunday, March 14, 2010
Fructose and Glucose are metabolized differently in the body!
There is considerable debate about what factors lead to obesity, diabetes and heart disease. There is mounting evidence that fructose could be a significant contributor to obesity, fatty liver disease, metabolic syndrome and insulin resistance to name a few. In this blog I want to focus on some key differences between fructose and glucose and how these two monosaccharides are metabolized in the body:
Glucose for one is metabolized by different tissues in the body including the liver, muscle, fat, brain etc. In contrast, fructose is exclusively handled by the liver. Secondly, the intake of fructose does not elicit the secretion of insulin or leptin, two key hormones involved in central regulation of hunger. This of course might lead to increased caloric intake without decreasing appetite. Then, there is little evidence that extra fructose in the liver is utilized to produce glycogen even though the pathway theoretically exists. All research points to the rapid formation of fatty acids increasing the secretion of serum lipids by the liver (leading to dyslipidemia) and/or the accumulation of excess fat in the liver (fatty liver disease).
It is undisputed that the intake of sugars in the US has dramatically increased in the past 30 years. The two most consumed sugars are sucrose (table sugar; 50% glucose and 50% fructose) and high fructose corn syrup HFCS (either 42% or 55% fructose). As the intake of table sugar has decreased some, the intake of HCFS has dramatically increased resulting in a net increase of glucose and fructose intake all together. Considering the fact that most Americans have been urged to shun fat in their diet to maintain proper weight, it appears more than plausible that the increased intake of sugars is a stronger contributor to obesity and associated risk factors than fat intake. Fructose consumed in high amounts may ultimately be the strongest trigger for obesity given its effect on liver metabolism and lack of hormonal impact on insulin and leptin.
http://www.ajcn.org/cgi/content/full/76/5/911
http://www.medbio.info/Horn/PDF%20files/carbohydrate_metabolism_March_2007b.pdf
Glucose for one is metabolized by different tissues in the body including the liver, muscle, fat, brain etc. In contrast, fructose is exclusively handled by the liver. Secondly, the intake of fructose does not elicit the secretion of insulin or leptin, two key hormones involved in central regulation of hunger. This of course might lead to increased caloric intake without decreasing appetite. Then, there is little evidence that extra fructose in the liver is utilized to produce glycogen even though the pathway theoretically exists. All research points to the rapid formation of fatty acids increasing the secretion of serum lipids by the liver (leading to dyslipidemia) and/or the accumulation of excess fat in the liver (fatty liver disease).
It is undisputed that the intake of sugars in the US has dramatically increased in the past 30 years. The two most consumed sugars are sucrose (table sugar; 50% glucose and 50% fructose) and high fructose corn syrup HFCS (either 42% or 55% fructose). As the intake of table sugar has decreased some, the intake of HCFS has dramatically increased resulting in a net increase of glucose and fructose intake all together. Considering the fact that most Americans have been urged to shun fat in their diet to maintain proper weight, it appears more than plausible that the increased intake of sugars is a stronger contributor to obesity and associated risk factors than fat intake. Fructose consumed in high amounts may ultimately be the strongest trigger for obesity given its effect on liver metabolism and lack of hormonal impact on insulin and leptin.
http://www.ajcn.org/cgi/content/full/76/5/911
http://www.medbio.info/Horn/PDF%20files/carbohydrate_metabolism_March_2007b.pdf
Sunday, March 7, 2010
Can low fat diets lead to osteoporosis? A hypothesis!
After reviewing information on Vitamin K2 and its beneficial effects on bone health last week I did review the scientific evidence on this matter. A fair amount of good studies have been published in the past 10 years and most of the research has been conducted by Japanese researchers. According to a systematic review and meta-analysis of randomized controlled trials published in the Archives of Internal Medicine in 2006, this systematic review suggests that supplementation with phytonadione and menaquinone-4 reduces bone loss. In the case of the latter, there is a strong effect on incident fractures among Japanese patients. Phytonadione is a man-made form of vitamin K (in this case Vitamin K1) whereas menaquinone-4 is vitamin K2. A study published in the European Journal of Epidemiology in 2008 demonstrates a significant correlation between hip fracture incidence and vitamin K intake suggesting that a review of the dietary reference value of vitamin K from the perspective of osteoporosis would be useful. Another study published by the international osteoporosis foundation in 2007 suggests that Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women.
According to the journal of nutrition in 2006, natto intake may help prevent postmenopausal bone loss through the effects of menaquinone 7 or bioavailable isoflavones, which are more abundant in natto than in other soybean products.
According to the Weston A. Price foundation, natto, a fermented soy product contains by far the highest percentage of Vitamin K2 amongst a list of selected foods. Vitamin K2 is synthesized by animal tissues or by bacteria during the fermentation process. What is most intriguing about the list of foods is the fact that all foods are derived from animal products with the exception of natto and sauerkraut. Amongst the top foods listed we find goose liver paste, hard and soft cheeses, egg yolk, butter, chicken liver etc.
Given the strong association of bone health and the intake of fat soluble Vit K2 and D it appears plausible to raise the question about recommending a low fat diet for general health purposes especially in North America. Osteoporosis prevention certainly does encompass more than optimal calcium intake, that we know for sure.
for more information follow these links: http://www.vitamink2.org/ http://www.westonaprice.org/On-the-Trail-of-the-Elusive-X-Factor-A-Sixty-Two-Year-Old-Mystery-Finally-Solved.html#bone
According to the journal of nutrition in 2006, natto intake may help prevent postmenopausal bone loss through the effects of menaquinone 7 or bioavailable isoflavones, which are more abundant in natto than in other soybean products.
According to the Weston A. Price foundation, natto, a fermented soy product contains by far the highest percentage of Vitamin K2 amongst a list of selected foods. Vitamin K2 is synthesized by animal tissues or by bacteria during the fermentation process. What is most intriguing about the list of foods is the fact that all foods are derived from animal products with the exception of natto and sauerkraut. Amongst the top foods listed we find goose liver paste, hard and soft cheeses, egg yolk, butter, chicken liver etc.
Given the strong association of bone health and the intake of fat soluble Vit K2 and D it appears plausible to raise the question about recommending a low fat diet for general health purposes especially in North America. Osteoporosis prevention certainly does encompass more than optimal calcium intake, that we know for sure.
for more information follow these links: http://www.vitamink2.org/ http://www.westonaprice.org/On-the-Trail-of-the-Elusive-X-Factor-A-Sixty-Two-Year-Old-Mystery-Finally-Solved.html#bone
Sunday, February 28, 2010
Vitamin K2 and bone health, the missing link!
Vitamin K has been known as the coagulation vitamin, because of its role in the blood clotting process. However, research over the last few decades has shown that the role of K Vitamins - and natural Vitamin K2, the menaquinones, in particular - has greatly been expanded. Vitamin K2 helps to activate vitamin K - dependent proteins responsible for healthy tissues.
Skeletal metabolism and particularly bone metabolism depend on two Vitamin K dependent proteins, osteocalcin and matrix Gla protein (MGP). Osteocalcin is a non collagenous protein found in bone and dentin. It is secreted by osteoblasts and believed to be involved in bone mineralization and calcium ion homeostasis. Osteocalcin specifically appears to influence the functional quality of bone and its shape. As osteoblasts secrete protein rich bone matrix, they also secrete osteocalcin in response to vitamins A and D. Osteocalcin however only appears to accumulate if it is activated by Vitamin K2. The exact dynamics of this process are not completely clear.
What is known is that by drawing a person's blood and measuring osteocalcin that is activated versus inactivated, we can determine whether that individual's bone cells have enough Vitamin K2 to build healthy bone. According to research people with highest percentages of inactive osteocalcin are at a more than five fold increased risk of hip fracture.
There is good evidence that Vitamin K2 is the preferred K vitamin of the bones.
Humans are very limited in absorbing Vitamin K1 from whole foods. By contrast, large amounts of Vitamin K2 are readily absorbed from foods. According to a study from the University of Maastricht in the Netherlands, Vitamin K2 was three times more effective at raising the percentage of activated osteocalcin compared to Vitamin K1. The percentage of inactive osteocalcin in the blood can therefore be considered an accurate marker of Vitamin K2 status. It appears that Vitamin K2 deficiency is universal. This means that variations in K2 status within the population may simply reflect varying degrees of deficiency.
These findings provide significant new information regarding the risks and management of osteoporosis.
Please join me next week as I explore the findings of several Japanese trials showing that Vitamin K2 can completely reverse bone loss and even increase bone mass in populations with osteoporosis.
For more information click; http://www.vitamink2.org/ http://64.71.152.183/basicnutrition/vitamin-k2.html#summary http://en.wikipedia.org/wiki/Osteocalcin
Skeletal metabolism and particularly bone metabolism depend on two Vitamin K dependent proteins, osteocalcin and matrix Gla protein (MGP). Osteocalcin is a non collagenous protein found in bone and dentin. It is secreted by osteoblasts and believed to be involved in bone mineralization and calcium ion homeostasis. Osteocalcin specifically appears to influence the functional quality of bone and its shape. As osteoblasts secrete protein rich bone matrix, they also secrete osteocalcin in response to vitamins A and D. Osteocalcin however only appears to accumulate if it is activated by Vitamin K2. The exact dynamics of this process are not completely clear.
What is known is that by drawing a person's blood and measuring osteocalcin that is activated versus inactivated, we can determine whether that individual's bone cells have enough Vitamin K2 to build healthy bone. According to research people with highest percentages of inactive osteocalcin are at a more than five fold increased risk of hip fracture.
There is good evidence that Vitamin K2 is the preferred K vitamin of the bones.
Humans are very limited in absorbing Vitamin K1 from whole foods. By contrast, large amounts of Vitamin K2 are readily absorbed from foods. According to a study from the University of Maastricht in the Netherlands, Vitamin K2 was three times more effective at raising the percentage of activated osteocalcin compared to Vitamin K1. The percentage of inactive osteocalcin in the blood can therefore be considered an accurate marker of Vitamin K2 status. It appears that Vitamin K2 deficiency is universal. This means that variations in K2 status within the population may simply reflect varying degrees of deficiency.
These findings provide significant new information regarding the risks and management of osteoporosis.
Please join me next week as I explore the findings of several Japanese trials showing that Vitamin K2 can completely reverse bone loss and even increase bone mass in populations with osteoporosis.
For more information click; http://www.vitamink2.org/ http://64.71.152.183/basicnutrition/vitamin-k2.html#summary http://en.wikipedia.org/wiki/Osteocalcin
Sunday, February 14, 2010
Boswellia Serrata for Arthritis pain
Boswellia is an Ayurvedic plant from India that contains anti-inflammatory triterpenoids called boswellic acids. Boswellic acid and its derivatives have anti-carcinogenic, anti-tumor, and blood lipid lowering activities. Dried extracts of the resin of the Boswellia serrata tree have been used since antiquity in India to treat inflammatory conditions.
Clinical studies using herbal formulas with Boswellia have yielded good results in both OA and rheumatoid arthritis. The standard dosage for boswellic acids in arthritis is 400mg tid (three times per day). No side effects due to boswellic adics have been reported. More research data is needed in the future. Preliminary research findings appear to be very promising.
I recommend a product by Mediherb from Australia. For more information check out http://www.mediherb.com/product_pdf/BoswelliaComplexLR.pdf
Clinical studies using herbal formulas with Boswellia have yielded good results in both OA and rheumatoid arthritis. The standard dosage for boswellic acids in arthritis is 400mg tid (three times per day). No side effects due to boswellic adics have been reported. More research data is needed in the future. Preliminary research findings appear to be very promising.
I recommend a product by Mediherb from Australia. For more information check out http://www.mediherb.com/product_pdf/BoswelliaComplexLR.pdf
Tuesday, February 2, 2010
21 Day detox program
This is the third year we are offering the 21 day detox program by Standard Process to our patients. We usually offer an informational meeting at no cost to interested patients. We enjoyed a nice turnout this year and were privileged to have several "detoxers" attending the meeting. These people actually had just completed the program and were able to provide our attendees first hand experience with the program. I would like to take the opportunity to point out a great testimonial from one of our patients.
He recently had been diagnosed with prediabetes and a gastrointestinal endoscopy had revealed significant erosions in his stomach lining which explained his chronic acid reflux problem. Apparently he had been using NSAIDS for a very long time to manage chronic neck pain and he was a smoker as well. This evaluation took place at the Mayo clinic in Rochester Minnesota. His doctors prescribed Metformin and a proton pump inhibitor. He was also put on blood pressure medication.
His wife who is a patient in our office decided to further investigate this matter and eventually, both her and her husband decided to try the 21 day detox program. Within the first week, he started feeling better and quit the proton pump inhibitor drug. By the second week, his blood sugar readings were in the 80s and 115s after a meal and so he decided to stop taking metformin. To his amazement, his blood sugar readings remained normal. Finally he decided to stop taking his blood pressure medication as well. In three weeks he lost 16 pounds, started to sleep better, had much more energy and his wife commented that his stomach which had been hard as a rock was getting nice and soft. He also started noticing that his neck pain was getting better and that his overall pain in his body was decreased. He can't wait to return for a follow up evaluation at the Mayo clinic in 6 weeks.
Dr. Fred
for more information go directly to http://www.standardprocess.com/display/psppurification.spi
He recently had been diagnosed with prediabetes and a gastrointestinal endoscopy had revealed significant erosions in his stomach lining which explained his chronic acid reflux problem. Apparently he had been using NSAIDS for a very long time to manage chronic neck pain and he was a smoker as well. This evaluation took place at the Mayo clinic in Rochester Minnesota. His doctors prescribed Metformin and a proton pump inhibitor. He was also put on blood pressure medication.
His wife who is a patient in our office decided to further investigate this matter and eventually, both her and her husband decided to try the 21 day detox program. Within the first week, he started feeling better and quit the proton pump inhibitor drug. By the second week, his blood sugar readings were in the 80s and 115s after a meal and so he decided to stop taking metformin. To his amazement, his blood sugar readings remained normal. Finally he decided to stop taking his blood pressure medication as well. In three weeks he lost 16 pounds, started to sleep better, had much more energy and his wife commented that his stomach which had been hard as a rock was getting nice and soft. He also started noticing that his neck pain was getting better and that his overall pain in his body was decreased. He can't wait to return for a follow up evaluation at the Mayo clinic in 6 weeks.
Dr. Fred
for more information go directly to http://www.standardprocess.com/display/psppurification.spi
Monday, February 1, 2010
Welcome to my nutrition blog
Welcome to my nutrition blog.
My name is Frederic Falentin. I own Broadway Chiropractic PA in New Ulm. The clinic was founded in 1996 as a home based chiropractic office. Within a few years, it became very obvious to me that providing chiropractic care exclusively did not meet my clinical expectations. There was a missing link. At that point my wife Bonnie and I decided to implement nutritional services in our office. Bonnie acquired a degree as a nutrition consultant and we started offering nutritional services and supplements to some of our patients. Those were the days when taking a multivitamin was essentially a novelty. How times have changed.
This marked the beginning of an amazing journey. Since then we have had the privilege to witness amazing results with some of our nutrition patients and it keeps getting better and better.
Early in 2009 I decided to go back to school and pursue a nutritional diplomate degree offered thru my alma mater, Northwestern Health Science University. Needless to say, this has been a very educational experience. I truly enjoy going back to school and learning more about nutrition. This field is rapidly expanding providing us with new tools to help our patients.
Hopefully, this blog will engage patients in our clinic to ask more questions about nutrition and to learn about new treatment options.
Dr. Fred
My name is Frederic Falentin. I own Broadway Chiropractic PA in New Ulm. The clinic was founded in 1996 as a home based chiropractic office. Within a few years, it became very obvious to me that providing chiropractic care exclusively did not meet my clinical expectations. There was a missing link. At that point my wife Bonnie and I decided to implement nutritional services in our office. Bonnie acquired a degree as a nutrition consultant and we started offering nutritional services and supplements to some of our patients. Those were the days when taking a multivitamin was essentially a novelty. How times have changed.
This marked the beginning of an amazing journey. Since then we have had the privilege to witness amazing results with some of our nutrition patients and it keeps getting better and better.
Early in 2009 I decided to go back to school and pursue a nutritional diplomate degree offered thru my alma mater, Northwestern Health Science University. Needless to say, this has been a very educational experience. I truly enjoy going back to school and learning more about nutrition. This field is rapidly expanding providing us with new tools to help our patients.
Hopefully, this blog will engage patients in our clinic to ask more questions about nutrition and to learn about new treatment options.
Dr. Fred
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