michael.massing + peer-reviewed + research   804

Sauna bathing reduces the risk of stroke in Finnish men and women | Neurology
Baseline habits of sauna bathing were assessed in 1,628 adult men and women aged 53–74 years (mean age, 62.7 years) without a known history of stroke in the Finnish Kuopio Ischemic Heart Disease prospective cohort study. Three sauna bathing frequency groups were defined: 1, 2–3, and 4–7 sessions per week. Hazard ratios (HRs) (95% confidence intervals [CIs]) were estimated for incident stroke.

Results During a median follow-up of 14.9 years, 155 incident stroke events were recorded. Compared with participants who had one sauna bathing session per week, the age- and sex-adjusted HR (95% CI) for stroke was 0.39 (0.18–0.83) for participants who had 4–7 sauna sessions per week. After further adjustment for established cardiovascular risk factors and other potential confounders, the corresponding HR (95% CI) was 0.39 (0.18–0.84) and this remained persistent on additional adjustment for physical activity and socioeconomic status at 0.38 (0.18–0.81). The association between frequency of sauna bathing and risk of stroke was not modified by age, sex, or other clinical characteristics (p for interaction > 0.10 for all subgroups). The association was similar for ischemic stroke but modest for hemorrhagic stroke, which could be attributed to the low event rate (n = 34).

Conclusions This long-term follow-up study shows that middle-aged to elderly men and women who take frequent sauna baths have a substantially reduced risk of new-onset stroke.
sauna  risk  reduction  benefit  bathing  peer-reviewed  research  human  in  vivo  situ  prospective  cohort  stroke  ischemic  correlation 
51 minutes ago by Michael.Massing
Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank - ScienceDirect

13 250 (3·5%) of 379 511 white European individuals in UK Biobank had developed diabetes in the first six decades of life. 1286 more cases of diabetes were in the half of the population with high genetic susceptibility to type 1 diabetes than in the half of the population with low genetic susceptibility. These genetically defined cases of type 1 diabetes were distributed across all ages of diagnosis; 537 (42%) were in individuals diagnosed when aged 31–60 years, representing 4% (537/12 233) of all diabetes cases diagnosed after age 30 years. The clinical characteristics of the group diagnosed with type 1 diabetes when aged 31–60 years were similar to the clinical characteristics of the group diagnosed with type 1 diabetes when aged 30 years or younger. For individuals diagnosed with diabetes when aged 31–60 years, the clinical characteristics of type 1 diabetes differed from those of type 2 diabetes: they had a lower BMI (27·4 kg/m2 [95% CI 26·7–28·0] vs 32·4 kg/m2 [32·2–32·5]; p<0·0001), were more likely to use insulin in the first year after diagnosis (89% [476/537] vs 6% [648/11 696]; p<0·0001), and were more likely to have diabetic ketoacidosis (11% [61/537] vs 0·3% [30/11 696]; p<0·0001).


Genetic susceptibility to type 1 diabetes results in non-obesity-related, insulin-dependent diabetes, which presents throughout the first six decades of life. Our results highlight the difficulty of identifying type 1 diabetes after age 30 years because of the increasing background prevalence of type 2 diabetes. Failure to diagnose late-onset type 1 diabetes can have serious consequences because these patients rapidly develop insulin dependency.
diabetes  type  1  age  incidence  prevalence  diagnosis  peer-reviewed  research  genetics  risk  adult  onset  T!D  demographics  presentation  UK  Europe  genetic 
5 weeks ago by Michael.Massing
RT : Sauna baths 2-3 a week correlate with 12% less likelihood of stroke; 4-7 times a week appears to reduce risk by 62%…
sauna  peer-reviewed  research  correlation  risk  benefit  stroke  from twitter
9 weeks ago by Michael.Massing
Determining the Optimal Time for Postprandial Peak Hyperglycemia (PPG) in the Follow up of the Patients with Diabetes Mellitus | American Diabetes Association
Cardiovascular Disease (CVD) Cardiovascular Disease (CVD) is a common cause of mortality in patients with type 2 diabetes. Glycemic control is essential for effective CVD risk reduction. PPG is particularly deleterious to vascular function and a stronger predictor of CVD than elevation of glucose at fasting. There is no consensus about timing of PPG measurement. Our aim was to determine the optimal time for estimating PPG by measuring fasting and PPG, insulin secretion, triglyceride and free fatty acids (FFAs). We studied on 4 groups; 15 patients on diet or plus metformine 850 mg twice daily at noon and bedtime, 15 patients using rapid acting insulin analogues, 15 patients having glinides (as repaglinide 2 mg three times daily) and 15 healthy controls. All subjects were free from clinically apparent atherosclerotic disease and diabetic complications. Blood samples were withdrawn at 8.00 AM after 12 h of fasting and following breakfast composed of foods proper for each patient, at 60[sup]th[/sup], 90[sup]th[/sup] and 120[sup]th[/sup] minutes. Patients were maintained on their usual treatment with glinide and rapid acting insulin analogue during the period of blood withdrawal. Control group received a mixed meal breakfast. In control group glycemia peak occured at 90th minute and insulin peak at 60th minute, when the levels of FFA was lowest. In the group of patients using glinide, glycemia and insulinemia levels peaked at 90th minute (there was no difference between 60th and 90th minutes). In the group of patients on diet and metformin, glycemia and insulinemia levels peaked at 60th minute, whereas glycemia has peaked at 60th and 90th minutes at insulin group. FFA levels were lowest at 120th minutes in both groups. FFAs were decreasing postprandially in all groups and triglycerides were increasing and reaching a maximum level at 2nd hour. In conclusion, postprandial glucose levels are better predictors of overall glycemic control and are correlated better with HbA1c than fasting glucose levels. Our results indicate that measurement of plasma glucose 1h after the end of a meal generally approximates the peak value in patients with diabetes and provides a reasonable assessment of postprandial hyperglycemia.
blood  peak  research  timing  in  after-meal  management  care  glucose  vivo  clinical  postmeal  human  self  postprandial  peer-reviewed 
january 2018 by Michael.Massing
Diet-induced insulin resistance precedes other aspects of the metabolic syndrome. - PubMed - NCBI
This study was designed to examine the effects of a high-fat refined-sugar (HFS) or a low-fat complex-carbohydrate (LFCC) diet on insulin-stimulated skeletal muscle glucose transport, plasma insulin, blood pressure, plasma triglycerides, plasma glycerol, body weight, and body fat in female Fischer rats. Insulin-stimulated glucose transport was significantly reduced in the HFS group at 2 wk, 2 mo, and 2 yr, whereas serum insulin was significantly elevated at all time points. Blood pressure was not significantly elevated in the HFS group until 12 mo, and all HFS animals were hypertensive by 18 mo. Glycerol, triglycerides, and abdominal fat cell size were not significantly different at 2 wk but were significantly elevated in the HFS rats at 2 and 6 mo. Body weight was similar in both groups until 20 wk on the diet, when the HFS rats started to gain more weight. These results demonstrate that insulin resistance and hyperinsulinemia occur before the other manifestations of the metabolic syndrome and that diet, not obesity, is the underlying cause.
insulin  resistance  metabolic  syndrome  factor  risk  symptom  etiology  diabetes  in  vivo  animal  peer-reviewed  research  diet  high  fat  sugar  complex  carbohydrate  low 
january 2018 by Michael.Massing
Diet-induced insulin resistance precedes other aspects of the metabolic syndrome | Journal of Applied Physiology
This study was designed to examine the effects of a high-fat refined-sugar (HFS) or a low-fat complex-carbohydrate (LFCC) diet on insulin-stimulated skeletal muscle glucose transport, plasma insulin, blood pressure, plasma triglycerides, plasma glycerol, body weight, and body fat in female Fischer rats. Insulin-stimulated glucose transport was significantly reduced in the HFS group at 2 wk, 2 mo, and 2 yr, whereas serum insulin was significantly elevated at all time points. Blood pressure was not significantly elevated in the HFS group until 12 mo, and all HFS animals were hypertensive by 18 mo. Glycerol, triglycerides, and abdominal fat cell size were not significantly different at 2 wk but were significantly elevated in the HFS rats at 2 and 6 mo. Body weight was similar in both groups until 20 wk on the diet, when the HFS rats started to gain more weight. These results demonstrate that insulin resistance and hyperinsulinemia occur before the other manifestations of the metabolic syndrome and that diet, not obesity, is the underlying cause.
insulin  resistance  metabolic  syndrome  factor  risk  symptom  etiology  diabetes  in  vivo  animal  peer-reviewed  research  diet  high  fat  sugar  complex  carbohydrate  low 
january 2018 by Michael.Massing
Continuous Glucose Profiles in Healthy Subjects under Everyday Life Conditions and after Different Meals
The mean 24-hour interstitial glucose concentration under everyday life conditions was 89.3 ± 6.2 mg/dl (mean ± SD, n = 21), and mean interstitial glucose concentrations at daytime and during the night were 93.0 ± 7.0 and 81.8 ± 6.3 mg/dl, respectively. The highest postprandial glucose concentrations were observed after breakfast: 132.3 ± 16.7 mg/dl (range 101–168 mg/dl); peak concentrations after lunch and dinner were 118.2 ± 13.4 and 123.0 ± 16.9 mg/dl, respectively. Mean time to peak glucose concentration was between 46 and 50 minutes. After ingestion of standardized meals with fast absorption characteristics, peak interstitial glucose concentrations were 133.2 ± 14.4 and 137.2 ± 21.1 mg/dl, respectively. Meals with a higher fiber, protein, and fat content induced a smaller increase and a slower decrease of postprandial glucose concentrations with peak values of 99.2 ± 10.5 and 122.1 ± 20.4 mg/dl, respectively.


This study provided continuous glucose profiles in nondiabetic subjects and demonstrated that differences in meal composition are reflected in postprandial interstitial glucose concentrations. Regarding the increasing application of continuous glucose monitoring in diabetic patients, these data suggest that detailed information about the ingested meals is important for adequate interpretation of postprandial glucose profiles.

Keywords: continuous glucose monitoring, continuous glucose profiles, healthy subjects, interstitial fluid glucose, postprandial glucose
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Tight glycemic control has been shown to reduce the risk of complications in patients with type 1 and type 2 diabetes.1,2
tight  glucose  control  management  interstitial  blood  diet  cycle  metabolism  normoglycemia  peak  postprandial  peer-reviewed  research  in  vivo  human  rhythms  circadian 
november 2017 by Michael.Massing
Effect of fructose consumption on insulin sensitivity in nondiabetic subjects: a systematic review and meta-analysis of diet-intervention trials. - PubMed - NCBI
Twenty-nine articles that described 46 comparisons in 1005 normal-weight and overweight or obese participants met the eligibility criteria. An energy-matched (isocaloric) exchange of dietary carbohydrates by fructose promoted hepatic insulin resistance (SMD: 0.47; 95% CI: 0.03, 0.91; P = 0.04) but had no effect on fasting plasma insulin concentrations (MD: -0.79 pmol/L; 95% CI: -6.41, 4.84 pmol/L; P = 0.78), the homeostasis model assessment of insulin resistance (HOMA-IR) (MD: 0.13; 95% CI: -0.07, 0.34; P = 0.21), or glucose disposal rates under euglycemic hyperinsulinemic clamp conditions (SMD: 0.00; 95% CI: 20.41, 0.41; P = 1.00). Hypercaloric fructose (∼25% excess of energy compared with that of the weight-maintenance control diet) raised fasting plasma insulin concentrations (MD: 3.38 pmol/L; 95% CI: 0.03, 6.73 pmol/L; P < 0.05) and induced hepatic insulin resistance (SMD: 0.77; 95% CI: 0.28, 1.26; P < 0.01) without affecting the HOMA-IR (MD: 0.18; 95% CI: -0.02, 0.39; P = 0.08) or glucose disposal rates (SMD: 0.10; 95% CI: -0.21, 0.40; P = 0.54). Results may have been limited by the low quality, small sample size, and short duration (mostly <60 d) of included trials.
Short-term fructose consumption, in isocaloric exchange or in hypercaloric supplementation, promotes the development of hepatic insulin resistance in nondiabetic adults without affecting peripheral or muscle insulin sensitivity. Larger and longer-term studies are needed to assess whether real-world fructose consumption has adverse effects on insulin sensitivity and long-term outcomes.
fructose  normoglycemia  hyperglycemia  insulin  resistance  hepatic  liver  peer-reviewed  research  overview  review  in  vivo  human  clinical  trial 
november 2017 by Michael.Massing
Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. - PubMed - NCBI
The intake of wholegrain foods clearly protects against heart disease and stroke but the exact mechanism is not clear. Fibre, magnesium, folate and vitamins B6 and vitamin E may be important. The intake of high GI carbohydrates (from both grain and non-grain sources) in large amounts is associated with an increased risk of heart disease in overweight and obese women even when fibre intake is high but this requires further confirmation in normal-weight women.
Carbohydrate-rich foods should be wholegrain and if they are not, then the lowest GI product available should be consumed. Glycemic index is largely irrelevant for foods that contain small amounts of carbohydrate per serve (such as most vegetables).
antioxidant  GI  glycemic  index  load  GL  carbohydrates  vegetables  fiber  blood  glucose  lipids  management  risk  diet  self  care  peer-reviewed  research  zinc  magnesium  vitamin  E  supplements  cholesterol  harm  reduction  bran  CHD  cardiovascular  protection  in  vivo  human  review  overview  stroke  saelf  B6  folate 
november 2017 by Michael.Massing
Effect on Insulin, Glucose and Lipids in Overweight/Obese Australian Adults of 12 Months Consumption of Two Different Fibre Supplements in a Random... - PubMed - NCBI
Higher fibre intakes are associated with risk reduction for chronic diseases. This study investigated the effects of supplementation with PolyGlycopleX® (PGX), a complexed polysaccharide, on insulin, glucose and lipids in overweight and obese individuals. In this double-blind 12 months study, participants were randomised into three groups: control (rice flour); PGX or psyllium (PSY). Participants followed their usual lifestyle and diet but consumed 5 g of their supplement before meals. Insulin was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months and in the PSY group compared to control at 12 months. Serum glucose was significantly lower in the PGX group at 3 months compared to control. Total cholesterol was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months. High density lipoprotein (HDL) cholesterol was significantly increased in the PGX group compared to control at 12 months. low density lipoprotein (LDL) cholesterol was significantly lower in the PGX group at 3 and 6 months compared to control and in the PSY group at 3 months compared to control. A simple strategy of fibre supplementation may offer an effective solution to glucose, insulin and lipid management without the need for other nutrient modification.
fiber  blood  glucose  lipids  management  risk  diet  self  care  peer-reviewed  research  supplements  cholesterol  harm  reduction  insulin  psyllium  in  vivo  human  clinical  trial 
november 2017 by Michael.Massing
Carbohydrate issues: type and amount. - PubMed - NCBI
Both the type and amount of carbohydrate found in foods influence postprandial glucose levels and can also affect overall glycemic control in individuals with diabetes. This review, based on the American Diabetes Association's Nutrition Recommendations and Interventions for Diabetes, and the American Dietetic Association's Evidence Analysis Library (Diabetes 1 and 2), provides a description and interpretation of the clinical studies involving diabetes and type and amount of carbohydrate. Although the relationship between blood glucose and insulin is linear, not all types of carbohydrate are fully metabolized to blood glucose. Added sugars such as sucrose and high fructose corn syrup are digested, absorbed, and fully metabolized in a similar fashion to naturally occurring mono- and disaccharides. Only about half of the carbohydrate grams from sugar alcohols and half or less from dietary fiber are metabolized to glucose whereas almost all "other carbohydrate" (mainly starch such as amylose and amylopectin) becomes blood glucose.
diet  starch  glucose  metabolism  management  peer-reviewed  research  review  overview  database  library 
november 2017 by Michael.Massing
Epidemiological support for the protection of whole grains against diabetes. - PubMed - NCBI
Intake of wholegrain foods may reduce diabetes risk. Three prospective studies in 160000 men and women examined the relationship of whole-grain or cereal-fibre intake with the risk of type 2 diabetes. Each study used a mailed Willett food-frequency questionnaire and similar methods of quantifying wholegrain foods and cereal fibre. The self-reported incident diabetes outcome was more reliably determined in the two studies of health-care professionals than in the study of Iowa women. Risk for incident type 2 diabetes was 21-27% lower for those in the highest quintile of whole-grain intake, and 30-36% lower in the highest quintile of cereal-fibre intake, each compared with the lowest quintile. Risk reduction persisted after adjustment for the healthier lifestyle found among habitual whole-grain consumers. Observations in non-diabetic individuals support an inverse relationship between whole-grain consumption and fasting insulin levels. In feeding studies in non-diabetic individuals insulin resistance was reduced using whole grains or diets rich in whole grains. Glucose control improved with diets rich in whole grains in feeding studies of subjects with type 2 diabetes. There is accumulating evidence to support the hypothesis that whole-grain consumption is associated with a reduced risk of incident type 2 diabetes; it may also improve glucose control in diabetic individuals.
whole  grain  diet  intake  risk  factor  benefit  prevention  harm  reduction  glucose  management  peer-reviewed  research  correlation  statistics  protection  effect  epidemiology  large  cohort 
november 2017 by Michael.Massing
Nutmeg Uses, Benefits & Dosage - Drugs.com Herbal Database
Nutmeg has shown insulin-like activity in vitro. 38 Inhibitory effects on protein tyrosine phosphate 1B, involved in insulin cellular signaling, have been demonstrated. 39

Animal data
Serum glucose and lipid profiles improved in mice when mace lignan was administered. 40 In rabbits given an ethanolic extract of nutmeg, total and low-density lipoprotein (LDL) cholesterol and triglyceride were reduced; however, high-density lipoprotein levels were not changed. 41....

Other effects
Screening and in vitro experiments in nutmeg components demonstrated ultraviolet-protectant effects and inhibition of melanin biosynthesis. 65 , 66 Anti-inflammatory and analgesic activities of nutmeg have been recorded in mice, as well as antithrombotic activity. 67 , 68 Other studies document hepatoprotective properties, 69 effects on osteoblast differentiation, 70 and reduced acidity and volume of gastric secretion. 71 , 72
nutmeg  mace  diabetes  insulin  cholesterol  blood  glucose  lipids  peer-reviewed  research  in  vitro  vivo  animal  triglyceride 
november 2017 by Michael.Massing
Getting to Goal in Type 2 Diabetes: Role of Postprandial Glycemic Control
In the continuum of chronic glucose exposure, fasting hyperglycemia being persistently a problem is how we develop microvascular complications. That's a person who clearly has something other than the episodic exposure to hyperglycemia, which we see in the prediabetic or the IGT state. And yet in the IGT state or the prediabetic condition, you are at risk for macrovascular disease.

Microvascular disease is the hallmark of clinical diabetes. So it is legitimate to ask the question, is the threshold for the initiation of macrovascular damage lower than that required for initiation of microvascular disease? Or, is postprandial hyperglycemia to be considered as a first strike that leads to the outcomes, coronary heart disease and other significant vascular abnormalities, which we are the most concerned about in diabetes?

So this is, indeed, the leading cause of death in people with diabetes and it is strongly driven by postprandial hyperglycemia.
postprandial  hyperglycemia  glucose  blood  risk  factor  epidemiology  rhythms  metabolic  circadian  self  care  management  mitigation  peer-reviewed  research  in  vivo  situ  human 
october 2017 by Michael.Massing
Dietary carbohydrate: relationship to cardiovascular disease and disorders of carbohydrate metabolism. - PubMed - NCBI
The nature of carbohydrate is of considerable importance when recommending diets intended to reduce the risk of type II diabetes and cardiovascular disease and in the treatment of patients who already have established diseases. Intact fruits, vegetables, legumes and wholegrains are the most appropriate sources of carbohydrate. Most are rich in nonstarch polysaccharides (NSPs) (dietary fibre) and other potentially cardioprotective components. Many of these foods, especially those that are high in dietary fibre, will reduce total and low-density lipoprotein cholesterol and help to improve glycaemic control in those with diabetes. There is no good long-term evidence of benefit when NSPs or other components of wholegrains, fruits, vegetables and legumes are added to functional and manufactured foods. Frequent consumption of low glycaemic index foods has been reported to confer similar benefits, but it is not clear whether such benefits are independent of the dietary fibre content of these foods or the fact that low glycaemic index foods tend to have intact plant cell walls. Furthermore, it is uncertain whether functional and manufactured foods with a low glycaemic index confer the same long-term benefits as low glycaemic index plant-based foods. A wide range of carbohydrate intake is acceptable, provided the nature of carbohydrate is appropriate. Failure to emphasize the need for carbohydrate to be derived principally from wholegrain cereals, fruits, vegetables and legumes may result in increased lipoprotein-mediated risk of cardiovascular disease, especially in overweight and obese individuals who are insulin resistant.
risk  benefit  industrialized  processed  lipids  vegetables  cardiovascular  blood  whole  grain  fruit  carbohydrate  legumes  glucose  peer-reviewed  research  response  insulin  fiber  comparison  overview  correlation  type  2  T2D  effect  diet  epidemiology  etiology  self  care  management  long  term  short  soluble  insoluble  metabolism  prevention  intact  integrity 
september 2017 by Michael.Massing
Cereal grains, legumes and diabetes. - PubMed - NCBI
Epidemiological studies strongly support the suggestion that high intakes of whole grain foods protect against the development of type II diabetes mellitus (T2DM). People who consume approximately 3 servings per day of whole grain foods are less likely to develop T2DM than low consumers (<3 servings per week) with a risk reduction in the order of 20-30%. The role of legumes in the prevention of diabetes is less clear, possibly because of the relatively low intake of leguminous foods in the populations studied. However, legumes share several qualities with whole grains of potential benefit to glycaemic control including slow release carbohydrate and a high fibre content. A substantial increase in dietary intake of legumes as replacement food for more rapidly digested carbohydrate might therefore be expected to improve glycaemic control and thus reduce incident diabetes. This is consistent with the results of dietary intervention studies that have found improvements in glycaemic control after increasing the dietary intake of whole grain foods, legumes, vegetables and fruit. The benefit has been attributed to an increase in soluble fibre intake. However, prospective studies have found that soluble fibre intake is not associated with a lower incidence of T2DM. On the contrary, it is cereal fibre that is largely insoluble that is associated with a reduced risk of developing T2DM. Despite this, the addition of wheat bran to the diets of diabetic people has not improved indicators of glycaemic control. These apparently contradictory findings might be explained by metabolic studies that have indicated improvement in glucose handling is associated with the intact structure of food. For both grains and legumes, fine grinding disrupts cell structures and renders starch more readily accessible for digestion. The extent to which the intact structure of grains and legumes or the composition of foods in terms of dietary fibre and other constituents contribute to the beneficial effect remains to be quantified. Other mechanisms to help explain improvements in glycaemic control when consuming whole grains and legumes relate to cooking, type of starch, satiety and nutrient retention. Thus, there is strong evidence to suggest that eating a variety of whole grain foods and legumes is beneficial in the prevention and management of diabetes. This is compatible with advice from around the world that recommends consumption of a wide range of carbohydrate foods from cereals, vegetables, legumes and fruits both for the general population and for people with diabetes.
breakfast  blood  whole  grain  lsgumes  glucose  peer-reviewed  research  response  insulin  fiber  comparison  review  overview  correlation  type  2  T2D  effect  diet  epidemiology  etiology  self  care  management  long  term  short  soluble  insoluble  metabolism  prevention 
september 2017 by Michael.Massing
The Effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism. - PubMed - NCBI
Findings from epidemiologic studies indicate that there are associations between breakfast consumption and a lower risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome, prompting interest in the influence of breakfast on carbohydrate metabolism and indicators of T2DM risk. The objective of this review was to summarize the available evidence from randomized controlled trials assessing the impact of breakfast on variables related to carbohydrate metabolism and metabolic wellness. Consuming compared with skipping breakfast appeared to improve glucose and insulin responses throughout the day. Breakfast composition may also be important. Dietary patterns high in rapidly available carbohydrate were associated with elevated T2DM risk. Therefore, partial replacement of rapidly available carbohydrate with other dietary components, such as whole grains and cereal fibers, proteins, and unsaturated fatty acids (UFAs), at breakfast may be a useful strategy for producing favorable metabolic outcomes. Consumption of fermentable and viscous dietary fibers at breakfast lowers glycemia and insulinemia. Fermentable fibers likely act through enhancing insulin sensitivity later in the day, and viscous fibers have an acute effect to slow the rate of carbohydrate absorption. Partially substituting protein for rapidly available carbohydrate enhances satiety and diet-induced thermogenesis, and also favorably affects lipoprotein lipids and blood pressure. Partially substituting UFA for carbohydrate has been associated with improved insulin sensitivity, lipoprotein lipids, and blood pressure. Overall, the available evidence suggests that consuming breakfast foods high in whole grains and cereal fiber, while limiting rapidly available carbohydrate, is a promising strategy for metabolic health promotion.
carbohydate  protein  breakfast  blood  whole  grain  unsaturated  fatty  acids  lipids  UFA  glucose  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  correlation  type  2  T2D  effect  diet  self  care  management  long  term  short  viscous  soluble  fermentable  insoluble  metabolism  risk  reduction  harm  prevention  diabetes  metabolic  syndrome 
september 2017 by Michael.Massing
Whole Grain Intake and Glycaemic Control in Healthy Subjects: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. - PubMed - NCBI
There is growing evidence from both observational and intervention studies that Whole Grain (WG) cereals exert beneficial effects on human health, especially on the metabolic profile. The aim of this study was to perform a meta-analysis of randomised controlled trials (RCT) to assess the acute and medium/long-term effect of WG foods on glycaemic control and insulin sensitivity in healthy individuals.
A search for all the published RCT on the effect of WG food intake on glycaemic and insulin response was performed up to December 2016. Effect size consisted of mean difference (MD) and 95% CI between the outcomes of intervention and the control groups using the generic inverse-variance random effects model.
The meta-analysis of the 14 studies testing the acute effects of WG foods showed significant reductions of the post-prandial values of the glucose iAUC (0-120 min) by -29.71 mmol min/L (95% CI: -43.57, -15.85 mmol min/L), the insulin iAUC (0-120 min) by -2.01 nmol min/L (95% CI: -2.88, -1.14 nmol min/L), and the maximal glucose and insulin response. In 16 medium- and long-term RCTs, effects of WG foods on fasting glucose and insulin and homeostatic model assessment-insulin resistance values were not significant.
The consumption of WG foods is able to improve acutely the postprandial glucose and insulin homeostasis compared to similar refined foods in healthy subjects. Further research is needed to better understand the long-term effects and the biological mechanisms.
blood  whole  rye  glucose  metabolism  peer-reviewed  research  response  insulin  fiber  correlation  review  meta-analysis  diet  self  care  management  metabolic  profile 
september 2017 by Michael.Massing
Effects of whole grain rye, with and without resistant starch type 2 supplementation, on glucose tolerance, gut hormones, inflammation and appetite... - PubMed - NCBI
Whole grain has shown potential to lower the risk of obesity, cardiovascular disease and type 2 diabetes. One possible mechanism behind the benefits of whole grain is the gut fermentation of dietary fiber (DF), e.g. non-starch polysaccharides and resistant starch (RS), in whole grain. The purpose of the study is to investigate the effect of whole grain rye-based products on glucose- and appetite regulation.
Twenty-one healthy subjects were provided four rye-based evening test meals in a crossover overnight study design. The test evening meals consisted of either whole grain rye flour bread (RFB) or a 1:1 ratio of whole grain rye flour and rye kernels bread (RFB/RKB), with or without added resistant starch (+RS). White wheat flour bread (WWB) was used as reference evening meal. Blood glucose, insulin, PYY, FFA, IL-6 as well as breath H2 and subjective rating of appetite were measured the following morning at fasting and repeatedly up to 3.5 h after a standardized breakfast consisting of WWB. Ad libitum energy intake was determined at lunch, 14.5 h after evening test and reference meals, respectively.
The evening meal with RFB/RKB + RS decreased postprandial glucose- and insulin responses (iAUC) (P < 0.05) and increased the gut hormone PYY in plasma the following morning 0-120 min after the standardized breakfast, compared to WWB (P = 0.01). Moreover, RFB increased subjective satiety and decreased desire to eat, and both RFB and RFB/RKB decreased feeling of hunger (AUC 0-210 min). All rye-based evening meals decreased or tended to decrease fasting FFA (P < 0.05, RFB/RKB: P = 0.057) and increased breath hydrogen concentration (0-120 min, P < 0.001). No effects were noted on energy intake at lunch or inflammatory marker IL-6 (0 + 180 min) after the rye-based evening meals, compared to WWB.
Whole grain rye bread has the potential to improve cardiometabolic variables in an 11-14.5 h perspective in healthy humans. The combination RFB/RKB + RS positively affected biomarkers of glucose- and appetite regulation in a semi-acute perspective. Meanwhile, RFB and RFB/RKB improved subjective appetite ratings. The effects probably emanate from gut fermentation events.
blood  whole  grain  rye  glucose  metabolism  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  correlation  comparison  type  2  T2D  second-meal  phenomenon  effect  diet  self  care  management 
september 2017 by Michael.Massing
Effect of cereal test breakfasts differing in glycemic index and content of indigestible carbohydrates on daylong glucose tolerance in healthy subj... - PubMed - NCBI
Frequent hyperglycemic episodes are increasingly being associated with an increased risk of type 2 diabetes and cardiovascular disease.
We studied the extent to which acute glycemia and glycemia after subsequent meals can be modulated by the characteristics of cereal foods, such as glycemic index (GI) and content of indigestible carbohydrates.
Twelve healthy subjects consumed test meals in a random order. In series 1, the test meals were consumed at breakfast, and postprandial blood glucose incremental areas under the curve (IAUCs) were calculated after the test breakfast, standardized lunch, and standardized dinner. In series 2, the subjects consumed test evening meals and IAUCs were calculated after a subsequent standardized breakfast. Breath hydrogen was measured as an indicator of colonic fermentation.
Barley or rye kernel breakfasts lowered the blood glucose IAUC (0-120 min) at breakfast, at a subsequent lunch, and the cumulative IAUCs (breakfast+lunch+dinner) when compared with white-wheat bread (P < 0.05). The lunch blood glucose IAUCs were positively correlated with breakfast IAUCs (r = 0.30, P < 0.05). Breath hydrogen excretion was negatively correlated with blood glucose IAUCs after lunch (r = -0.33, P < 0.05) and dinner (r = -0.22, P < 0.05). A barley kernel evening meal resulted in lower IAUCs (P < 0.05) and higher breath hydrogen (P < 0.001) after a subsequent breakfast compared with white-wheat bread.
Glucose tolerance at subsequent meals can be notably improved during the course of a whole day or overnight by choosing specific low-GI, whole-grain cereal products. A low GI may be sufficient to achieve a second-meal effect from breakfast to lunch. A specific indigestible carbohydrate mixture appears to be required to show benefits on glucose tolerance in a longer time frame (9.5 h), most likely mediated through colonic fermentation.
breakfast  blood  barley  rye  glucose  metabolism  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  correlation  comparison  type  2  T2D  second-meal  phenomenon  effect  diet  self  care  management 
september 2017 by Michael.Massing
Matching Meals to Body Clocks—Impact on Weight and Glucose Metabolism
The prevalence of type 2 diabetes continues to rise worldwide and is reaching pandemic proportions. The notion that this is due to obesity, resulting from excessive energy consumption and reduced physical activity, is overly simplistic. Circadian de-synchrony, which occurs when physiological processes are at odds with timing imposed by internal clocks, also promotes obesity and impairs glucose tolerance in mouse models, and is a feature of modern human lifestyles. The purpose of this review is to highlight what is known about glucose metabolism in animal and human models of circadian de-synchrony and examine the evidence as to whether shifts in meal timing contribute to impairments in glucose metabolism, gut hormone secretion and the risk of type 2 diabetes. Lastly, we examine whether restricting food intake to discrete time periods, will prevent or reverse abnormalities in glucose metabolism with the view to improving metabolic health in shift workers and in those more generally at risk of chronic diseases such as type 2 diabetes and cardiovascular disease....

There is a general belief that consumption of more energy throughout the day is preferable to evening consumption. Few studies have examined this prospectively in humans, or for any length of time. Nonetheless, time restricted feeding has shown promise as a tool to mitigate the metabolic sequelae of diet induced obesity in mouse models. Good quality evidence for TRF as a dietary approach to improve glucose control in humans is lacking. Controlled trials are necessary, and must determine if there is adaptation in the approach, whilst keeping in mind the practicality of translating this approach into the community.
opblood  protein  glucose  metabolism  peer-reviewed  research  response  insulin  meal  timing  in  vivo  animal  correlation  comparison  type  2  T2D  circadian  rhythms  social  factor  environmental  etiology  risk  shift  work  obesity  body  fat 
september 2017 by Michael.Massing
Role of glycemic index and glycemic load in the healthy state, in prediabetes, and in diabetes. - PubMed - NCBI
The choice of carbohydrate-rich foods in the habitual diet should take into account not only their chemical composition but also their ability to influence postprandial glycemia (glycemic index). _Fiber-rich foods generally have a low glycemic index (GI), although not all foods with a low GI necessarily have high fiber content._ Several beneficial effects of low-GI, high-fiber diets have been shown, including lower postprandial glucose and insulin responses, an improved lipid profile, and, possibly, reduced insulin resistance. In nondiabetic persons, suggestive evidence is available from epidemiologic studies that a diet based on carbohydrate-rich foods with a low-GI, high-fiber content may protect against diabetes or cardiovascular disease. However, no intervention studies have so far evaluated the potential of low-GI, high-fiber diets to reduce the risk of diabetes, although in studies aimed at diabetes prevention by lifestyle modifications, an increase in fiber consumption was often part of the intervention. In relation to prevention of cardiovascular disease, intervention studies evaluating the effect of a low-GI diet on clinical events are not available; moreover, the results of the few available intervention studies evaluating the effects of GI on the cardiovascular disease risk factor profile are not always concordant. The best evidence of the clinical usefulness of GI is available in diabetic patients in whom low-GI foods have consistently shown beneficial effects on blood glucose control in both the short-term and the long-term. In these patients, low-GI foods are suitable as carbohydrate-rich choices, provided other attributes of the foods are appropriate.
breakfast  blood  protein  glucose  metabolism  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  correlation  comparison  prediabetes  type  2  T2D  load 
september 2017 by Michael.Massing
A high-glycemic index, low-fiber breakfast affects the postprandial plasma glucose, insulin, and ghrelin responses of patients with type 2 diabetes... - PubMed - NCBI
The area under the curve (AUC) [mean (95% CI); P for LSD tests] for plasma glucose (mmol/L × min) was higher after patients consumed the HGI-LF breakfast [9.62 (8.39, 10.84)] than after the LGI-HF breakfast [8.95 (7.71, 10.18)] (P ≤ 0.05). Insulin AUC (μIU/mL × min) after patients consumed the HGI-LF meal [65.72 (38.24, 93.19)] was higher than after the HGI-HF meal [57.24 (32.44, 82.04)] (P ≤ 0.05). The other observed difference was higher insulin AUC after the consumption of the LGI-LF breakfast [61.54 (36.61, 86.48)] compared with the AUC after the LGI-HF breakfast [54.16 (31.43, 76.88)] (P ≤ 0.05). Plasma ghrelin decreased in comparison with baseline only after patients consumed the LGI-HF and LGI-LF breakfasts (P ≤ 0.05). Subjective satiety did not differ between breakfasts.
Plasma glucose, insulin, and ghrelin responses were least favorable when patients with type 2 diabetes consumed a breakfast with a high GI and low fiber, which suggests that reducing the GI or increasing the fiber content or both of breakfasts may be a useful strategy to improve the postprandial metabolic profile of these patients.
breakfast  blood  protein  glucose  metabolism  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  ghrelin  correlation  comparison 
september 2017 by Michael.Massing
Effects of breakfast meal composition on second meal metabolic responses in adults with Type 2 diabetes mellitus. - PubMed - NCBI
Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests.
In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (P<0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type.
These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal.
breakfast  blood  lunch  protein  glucose  metabolism  second-meal  phenomenon  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index 
september 2017 by Michael.Massing
A high-protein breakfast induces greater insulin and glucose-dependent insulinotropic peptide responses to a subsequent lunch meal in individuals w... - PubMed - NCBI
The previous meal modulates the postprandial glycemic responses to a subsequent meal; this is termed the second-meal phenomenon.
This study examined the effects of high-protein vs. high-carbohydrate breakfast meals on the metabolic and incretin responses after the breakfast and lunch meals.
Twelve type 2 diabetic men and women [age: 21-55 y; body mass index (BMI): 30-40 kg/m(2)] completed two 7-d breakfast conditions consisting of 500-kcal breakfast meals as protein (35% protein/45% carbohydrate) or carbohydrate (15% protein/65% carbohydrate). On day 7, subjects completed an 8-h testing day. After an overnight fast, the subjects consumed their respective breakfast followed by a standard 500-kcal high-carbohydrate lunch meal 4 h later. Blood samples were taken throughout the day for assessment of 4-h postbreakfast and 4-h postlunch total area under the curve (AUC) for glucose, insulin, C-peptide, glucagon, glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide 1 (GLP-1).
Postbreakfast glucose and GIP AUCs were lower after the protein (17%) vs. after the carbohydrate (23%) condition (P < 0.05), whereas postbreakfast insulin, C-peptide, glucagon, and GLP-1 AUCs were not different between conditions. A protein-rich breakfast may reduce the consequences of hyperglycemia in this population. Postlunch insulin, C-peptide, and GIP AUCs were greater after the protein condition vs. after the carbohydrate condition (second-meal phenomenon; all, P < 0.05), but postlunch AUCs were not different between conditions. The overall glucose, glucagon, and GLP-1 responses (e.g., 8 h) were greater after the protein condition vs. after the carbohydrate condition (all, P < 0.05).
In type 2 diabetic individuals, compared with a high-carbohydrate breakfast, the consumption of a high-protein breakfast meal attenuates the postprandial glucose response and does not magnify the response to the second meal. Insulin, C-peptide, and GIP concentrations demonstrate the second-meal phenomenon and most likely aid in keeping the glucose concentrations controlled in response to the subsequent meal.
breakfast  blood  lunch  protein  glucose  metabolism  second-meal  phenomenon  peer-reviewed  research  response  insulin 
september 2017 by Michael.Massing
Glucose-lowering effect of whey protein depends upon clinical characteristics of patients with type 2 diabetes. - PubMed - NCBI
Effects of WP supplementation on glycemia in T2DM depend on the baseline characteristics. Lower body weight, normal triglyceride and lower GLP-1 levels predict glucose lowering. In contrast, obesity, hypertriglyceridemia and high baseline GLP-1 predict increased glucose response.
breakfast  protein  glucose  whey  blood  response  spike  triglycerides  GLP-1  body  fat  obesity  correlation  peak  excursion  peer-reviewed  research 
september 2017 by Michael.Massing
Effects of Higher Dietary Protein and Fiber Intakes at Breakfast on Postprandial Glucose, Insulin, and 24-h Interstitial Glucose in Overweight Adults. - PubMed - NCBI
The HPHF treatment did not affect postprandial glucose and insulin responses or 24-h glucose total area under the curve (AUC). Higher fiber intake reduced 240-min insulin AUC. Doubling the amount of protein from 12.5 g to 25 g/meal and quadrupling fiber from 2 to 8 g/meal at breakfast was not an effective strategy for modulating insulin-mediated glucose responses in these young, overweight[, nondiabetic] adults.
breakfast  fiber  protein  glucose  metabolism  blood  interstitial  insulin  response  postprandial  peak  excursion  spike  peer-reviewed  research 
september 2017 by Michael.Massing
Timing of Peak Blood Glucose after Breakfast Meals of Different Glycemic Index in Women with Gestational Diabetes
There was no significant difference in subjective satiety throughout the test period. In conclusion, the low GI breakfast produced lower postprandial glycemia, and the peak PBGL [postprandial blood glucose level] occurred closer to the time recommended for PBGL monitoring (i.e., 1 h postprandial) in GDM than a macronutrient matched high GI breakfast.
breakfast  glucose  metabolism  appetite  diabetes  gestational  peak  postprandial  blood  SMBG  self  care  glycemic  index  high  timing  monitoring  excursion  spike  peer-reviewed  research 
september 2017 by Michael.Massing
Breakfast Protein Source Does Not Influence Postprandial Appetite Response and Food Intake in Normal Weight and Overweight Young Women. - PubMed - NCBI
No difference was found between [normal weight] and [overweight] participants or breakfasts for postprandial appetite responses. [Animal protein] had a significantly lower glucose response at 30 minutes compared with [plant protein] (-11.6%; 127 ± 4 versus 112 ± 4 mg/dL; P < 0.05) and a slower return to baseline. There was no difference in daily energy intake between breakfasts. These data suggest that protein source may influence postprandial glucose response without significantly impacting appetite response in breakfast consumers.
breakfast  animal  plant  foods  protein  glucose  metabolism  appetite  blood  peak  excursion  spike  peer-reviewed  research 
september 2017 by Michael.Massing
Targeting glucose metabolism for healthy aging. - PubMed - NCBI
Advancing age is the greatest single risk factor for numerous chronic diseases. Thus, the ability to target the aging process can facilitate improved healthspan and potentially lifespan. Lack of adequate glucoregulatory control remains a recurrent theme accompanying aging and chronic disease, while numerous longevity interventions result in maintenance of glucoregulatory control. In this review, we propose targeting glucose metabolism to enhance regulatory control as a means to ameliorate the aging process. We highlight that calorie restriction improves glucoregulatory control and extends both lifespan and healthspan in model organisms, but we also indicate more practical interventions (i.e., calorie restriction mimetics) are desirable for clinical application in humans. Of the calorie restriction mimetics being investigated, we focus on the type 2 diabetes drug acarbose, an α-glucosidase inhibitor that when taken with a meal, results in reduced enzymatic degradation and absorption of glucose from complex carbohydrates. We discuss alternatives to acarbose that yield similar physiologic effects and describe dietary sources (e.g., sweet potatoes, legumes, and berries) of bioactive compounds with α-glucosidase inhibitory activity. We indicate future research should include exploration of how non-caloric compounds like α-glucosidase inhibitors modify macronutrient metabolism prior to disease onset, which may guide nutritional/lifestyle interventions to support health and reduce age-related disease risk.

[Note mention of metformin in graphical abstract.]
hyperglycemia  diabetes  type  2  T2D  blood  glucose  diet  foods  legumes  berries  sweet  potatoes  SMBG  self  care  risk  cardiovascular  kidney  neuropathy  nephropathy  chronic  disease  progression  aging  caloric  calorie  restriction  acarbose  metformin  peak  excursion  spike  peer-reviewed  research 
september 2017 by Michael.Massing
Postprandial glucose regulation: new data and new implications. - PubMed - NCBI
Type 2 diabetes is characterized by a gradual decline in insulin secretion in response to nutrient loads; hence, it is primarily a disorder of postprandial glucose (PPG) regulation. However, physicians continue to rely on fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) to guide management.
The objectives of this article are to review current data on postprandial hyperglycemia and to assess whether, and how, management of type 2 diabetes should change to reflect new clinical findings.
Articles were selected from MEDLINE searches (key words: postprandial glucose, postprandial hyperglycemia, and cardiovascular disease) and from our personal reference files, with emphasis on the contribution of postprandial hyperglycemia to overall glycemic load or cardiovascular (CV) risk.
About 33% of people diagnosed as having type 2 diabetes based on postprandial hyperglycemia have normal FPG. PPG contributes > or =70% to the total glycemic load in patients who are fairly well controlled (HbA1c <7.3%). Furthermore, there is a linear relationship between the risk of CV death and the 2-hour oral glucose tolerance test (OGTT). Increased mortality is evident at OGTT levels of approximately 90 mg/dL (5 mmol/L), which is well below current definitions of type 2 diabetes. Biphasic insulin aspart was shown to be more effective at reducing HbA1c below currently recommended levels than basal insulin glargine (66% vs 40%; P < 0.001), and it reduced endothelial dysfunction more effectively than regular insulin (P < 0.01). Repaglinide achieved regression of carotid atherosclerosis (intima-media thickness) in 52% of patients versus 18% for glyburide (P < 0.01) over 1 year, although levels of HbA1c and CV risk factors were similar for both treatment groups. Finally, acarbose reduced the relative risk of CV events by 49% over 3.3 years versus placebo in patients with impaired glucose tolerance (2.2% vs 4.7%; P = 0.03) and by 35% over > or =1 year in patients with type 2 diabetes (9.4% vs 6.1%; P = 0.006).
All components of the glucose triad (ie, FPG, HbA1c, and PPG) should be considered in the management of type 2 diabetes. Therapy targeted at PPG has been shown to improve glucose control and to reduce the progression of atherosclerosis and CV events; therefore, physicians should consider monitoring and targeting PPG, as well as HbA1c and FPG, in patients with type 2 diabetes.
hyperglycemia  diabetes  type  2  T2D  blood  glucose  postprandial  spike  peak  SMBG  self  care  risk  cardiovascular  excursion  damage  vessel  wall  epithelial  atherosclerosis  morbidity  mortality  threshold  peer-reviewed  research 
september 2017 by Michael.Massing
Postprandial hyperglycaemia: noxious effects on the vessel wall. - PubMed - NCBI
In recent years postchallenge or postprandial hyperglycaemia has been found to be an independent risk factor for cardiovascular comorbidities and all-cause mortality in impaired glucose tolerance (IGT) and type 2 diabetes. With the database of the Risk Factors in IGT for Atherosclerosis and Diabetes (RIAD) study, it was also shown that atherosclerosis as measured by intima-media thickness of the common carotid arteries was associated with 2-hour postchallenge glucose level when HbA1c was normal. Taken together there are now comprehensive and consistent data from pathophysiological as well as epidemiological studies that excessive post-load glucose excursions have acute and chronic harmful effects on the endothelium and vessel wall. This is supported by four outcome studies that included control of postprandial glucose to prevent cardiovascular disease: Diabetes Intervention Study (DIS), Kumamoto study, DIGAMI study, and STOP-NIDDM trial. Therefore, in addition to HbA1c and fasting blood glucose, postprandial glucose monitoring should be an integral part of treatment to prevent acute and chronic complications.
hyperglycemia  diabetes  type  2  T2D  blood  glucose  postprandial  spike  peak  SMBG  self  care  risk  cardiovascular  excursion  damage  vessel  wall  epithelial  atherosclerosis  peer-reviewed  research 
september 2017 by Michael.Massing
Postprandial peaks as a risk factor for cardiovascular disease: epidemiological perspectives. - PubMed - NCBI
A key issue in diabetes care is selecting glucose parameters to monitor and control. The recommendations of the American Diabetes Association for glycaemic control do not address postprandial glucose (PPG), but patients with type 2 diabetes experience wide variations in glucose levels after meals. We have observed a remarkable increase in plasma glucose two hours after breakfast and/or lunch in most non-insulin-treated patients; for up to 40% of them the increase is >40 mg/dl (2.2 mmol/l). As many as 70% of patients with an HbA1c <7% have PPG values >160 mg/dl (8.9 mmol/l) after meals. Fasting plasma glucose (FPG) is a poor indicator of plasma glucose at other times. The coefficient of correlation of FPG with plasma glucose at other times ranges from 0.50-0.70. Nor is the correlation of FPG with HbA1c very strong: in hundreds of determinations of HbA1c and FPG in our patients, the coefficient of correlation was not greater than 0.73. For the same FPG value, HbA1c varied markedly, and vice versa; further, the correlation between PPG and HbA1c was no higher than that between FPG and HbA1c (r = 0.65). Thus, monitoring in type 2 diabetes should include PPG along with FPG and HbA1c. Recent data provide direct and indirect evidence suggesting that PPG is independently related to cardiovascular disease (CVD), and supporting the idea that PPG should be assessed and glucose excursions with meals should be controlled: 1. Studies conducted by other investigators and ourselves in patients with type 2 diabetes have shown that the incidence of CVD is independently related to postprandial or post-OGTT (oral glucose tolerance test) blood glucose at baseline. In addition, data collected in the general population show an association between 2-hour OGTT plasma glucose (a surrogate of PPG) and cardiovascular morbidity and mortality that is independent of FPG. Also, subjects with impaired glucose tolerance (IGT) and isolated post-challenge hyperglycaemia have an increased cardiovascular risk over subjects with normal glucose tolerance (NGT). We found that IGT subjects had a risk of carotid stenosis 3-fold higher than subjects with NGT, even after adjustment for several confounders. Thus, a modest increase in post-OGTT plasma glucose and, by extrapolation, PPG seems to have a major detrimental effect on the arteries. 2. When FPG and/or HbA1c were the targets of glucose control in studies of patients with type 2 diabetes (the UGDP, VACSDM, and UKPDS) the effects on CVD were minimal. However, when the targets of glucose control included PPG (the Kumamoto Study and DIGAMI Study) favorable effects on CVD were observed. 3. There is experimental data suggesting that acute hyperglycaemia can exert deleterious effects on the arterial wall through mechanisms including oxidative stress, endothelial dysfunction, and activation of the coagulation cascade. This evidence prompted the European Diabetes Policy Group to set postprandial targets for blood glucose control: postprandial peaks should not exceed 135 mg/dl (7.5 mmol/ml) to reduce arterial risk and should not exceed 160 mg/dl (8.9 mmol/l) to reduce microvascular risk. Thus, glucose care in diabetes is not only "fasting glucose care" or "HbA1c care" but is also "postprandial glucose care."
hyperglycemia  diabetes  type  2  T2D  blood  glucose  postprandial  spike  peak  SMBG  self  care  risk  cardiovascular  excursion  peer-reviewed  research 
september 2017 by Michael.Massing
Peak-time determination of post-meal glucose excursions in insulin-treated diabetic patients. - PubMed - NCBI
The mean peak time after breakfast was 72+/-23 min, which was reached in less than 90 min in 80% of the patients. The apparent glucose rate of increase from pre-meal to the maximum postprandial value was 1.23+/-0.76 mg/dL/min, while the glucose rate of decrease was 0.82+/-0.70 mg/dL/min. Peak time correlated with the amplitude of postprandial excursions, but not with the peak glucose value. Also, peak times were similar after breakfast, lunch and dinner, and in type 1 and type 2 diabetic patients.
To best assess peak postprandial glucose levels, the optimal time for blood glucose monitoring is about 1h and 15 min after the start of the meal, albeit with wide interpatient variability. Nevertheless, 80% of post-meal blood glucose peaks were observed at less than 90 min after the start of the meal.
hyperglycemia  diabetes  type  2  a  T1D  T2D  blood  glucose  postprandial  spike  peak  rhythm  meal  SMBG  timing  insulin  dependent  excursion  peer-reviewed  research 
september 2017 by Michael.Massing
Effect of carbohydrate distribution on postprandial glucose peaks with the use of continuous glucose monitoring in type 2 diabetes. - PubMed - NCBI
We investigated the effect of carbohydrate distribution on postprandial glucose peaks with continuous blood glucose monitoring (CGMS), when consuming a moderate carbohydrate diet in energy balance in subjects with type 2 diabetes.
Twenty-three subjects with type 2 diabetes were randomly assigned to each of four 3-d interventions in a crossover design with a 4-d washout period. Identical foods were provided for each treatment with a ratio of total carbohydrate to protein to fat of 40%:34%:26% but differing in carbohydrate content at each meal: even distribution (CARB-E; approximately 70 g carbohydrate), breakfast (CARB-B), lunch (CARB-L), and dinner(CARB-D), each providing approximately 125 g carbohydrate in the loaded meal in a 9-MJ diet. Glucose concentrations were continuously measured with CGMS. Outcomes were assessed by postprandial peak glucose (G(max)), time spent > 12 mmol/L (T > 12), and total area under the glucose curve (AUC(20)).
Daily G(max) differed between treatments (P = 0.003) with CARB-L (14.2 +/- 1.0 mmol/L), CARB-E (14.5 +/- 0.9 mmol/L), and CARB-D (14.6 +/- 0.8 mmol/L) being similar but lower than CARB-B (16.5 +/- 0.8 mmol/L). Meal G(max) was weakly related to carbohydrate amount and glycemic load (r = 0.40-0.44). T > 12 differed between treatments (P = 0.014), and a treatment x fasting blood glucose (FBG) interaction (P = 0.003) was observed with CARB-L (184 +/- 74 min) < CARB-B (190 +/- 49 min) < CARB-D (234 +/- 87 min) < CARB-E (262 +/- 91 min). Total AUC(20) was not significantly different between treatments. After adjustment for FBG, treatment became significant (P = 0.006); CARB-L (10 049 +/- 718 mmol/L x 20 h) < CARB-E (10 493 +/- 706 mmol/L x 20 h) < CARB-B (10 603 +/- 642 mmol/L x 20 h) < CARB-D (10 717 +/- 638 mmol/L x 20 h).
CARB-E did not optimize blood glucose control as assessed by postprandial peaks, whereas CARB-L provided the most favorable postprandial profile.
hyperglycemia  diabetes  type  2  T2D  blood  glucose  postprandial  spike  peak  rhythm  meal  excursion  peer-reviewed  research 
september 2017 by Michael.Massing
Can Postprandial Blood Glucose Excursion Be Predicted in Type 2 Diabetes?
We investigated the relationship between carbohydrate intake and postprandial blood glucose (BG) levels to determine the most influential meal for type 2 diabetic subjects treated with basal insulin and needing prandial insulin.


Three-day BG profiles for 37 type 2 diabetic subjects, with A1C levels of 7.7%, treated with sulfonylurea and metformin, and well titrated on insulin glargine, were analyzed using a continuous glucose monitoring system. Food intake from 680 meals was recorded and quantified during continuous glucose monitoring.


The median BG excursion (ΔBG) was higher at breakfast than at lunch or dinner (111 [81; 160] vs. 69.5 [41.5; 106] and 82.5 mg/dl [53; 119] mg/dl, P < 0.0001). There was a weak overall correlation between ΔBG and carbohydrate intake. Correlation improved when mealtime was taken into account. Simple relationships were established: ΔBG (mg/dl) = 65 × carbohydrate/body weight + 73 for breakfast (R2 = 0.20, P < 0.0001); the slope was reduced by half at lunch and by one-third at dinner. Twelve relevant variables likely to affect ΔBG were integrated into a polynomial equation. This model accounted for 49% of ΔBG variability. Two groups of patients were identified: responders, in whom ΔBG was well correlated with carbohydrate intake (R2 ≥ 0.30, n = 8), and nonresponders (R2 < 0.30, n = 29). Responders exhibited a greater insulinopenic profile than nonresponders.


The carbohydrate intake in responders clearly drives ΔBG, whereas, in nonresponders, other factors predominate. This sort of characterization should be used to guide therapeutic choices toward more targeted care with improved type 2 diabetes management.
blood  glucose  excursions  SMBG  metabolic  rhythms  mealtime  self  management  care  peak  excursion  spike  peer-reviewed  research 
september 2017 by Michael.Massing
Increasing Adiposity | Lifestyle Behaviors | JAMA | The JAMA Network
Ninety years ago, an editorial in JAMA questioned the prevailing approach to obesity treatment: “When we read that ‘the fat woman has the remedy in her own hands—or rather between her own teeth’ . . . there is an implication that obesity is usually merely the result of unsatisfactory dietary bookkeeping. . . [Although logic suggests that body fat] may be decreased by altering the balance sheet through diminished intake, or increased output, or both . . . [t]he problem is not really so simple and uncomplicated as it is pictured.”1 Since then, billions of dollars have been spent on research into the biological factors affecting body weight, but the near-universal remedy remains virtually the same, to eat less and move more. According to an alternative view, chronic overeating represents a manifestation rather than the primary cause of increasing adiposity. Attempts to lower body weight without addressing the biological drivers of weight gain, including the quality of the diet, will inevitably fail for most individuals. This Viewpoint summarizes the evidence for this seemingly counterintuitive hypothesis, versions of which have been debated for more than a century.2
fat  management  control  carbohydrates  insulin  high  glycemic  processed  food  peer-reviewed  research  correlation  causation  diet  foods 
july 2017 by Michael.Massing
Always Hungry? Here’s Why - The New York Times
As it turns out, many biological factors affect the storage of calories in fat cells, including genetics, levels of physical activity, sleep and stress. But one has an indisputably dominant role: the hormone insulin. We know that excess insulin treatment for diabetes causes weight gain, and insulin deficiency causes weight loss. And of everything we eat, highly refined and rapidly digestible carbohydrates produce the most insulin.
fat  management  control  carbohydrates  insulin  high  glycemic  processed  food  peer-reviewed  research  correlation  causation  diet  foods  genetic  risk  genetics 
july 2017 by Michael.Massing
Think you know why obesity rates are rising? You’re probably wrong. | Public Health
Work isn’t taking time away from cooking: We’re actually working fewer hours; what’s increased is leisure time and transportation time.

We may be exercising more. Four minutes more per day in 2012 than in 2003, although that’s self reported. The authors also believe a decline in physically demanding work doesn’t account for obesity rates, since obesity has risen equally among all groups, including children.

Food isn’t too expensive. Or at least, we’re only spending less than 10% of our income on it, compared to 20% in the 1950s and 25% in the 1930s (which is comparable to medium-income countries today). The implication: we could afford to spend more on food, we just don’t want to.

We’re eating lots of fruit and veggies. Now, it’s not enough to meet guidelines (in fact, even if we ate all the veggies produced in the US, we still wouldn’t meet the guidelines). But fruit and vegetable availability has increased over time, and consumption has been relatively steady.

It’s not food deserts. Low-income neighborhoods have fewer supermarkets, but distance to a supermarket doesn’t correlate with obesity or the quality of a person’s diet. When a new supermarket opens, residents’ fruit and vegetable consumption doesn’t change.

It could be TV and video games. That fits the time trend; they specifically track the introduction of VCRs.

It could be sodapop. Consumption of sugar-sweetened beverages is going up and up, and the timing is right.

Or carbs in general. The authors don’t dig into this one, but see this JAMA article (or the accompanying NYT op-ed) for an explanation. Carbs promote insulin which promotes hunger and weight gain. And back to the economists, they point out that carb intake increased most sharply during the 1980s focus on lowering dietary fat.
obesity  correlation  causation  trend  peer-reviewed  research  public  health  epidemiology  earnest 
july 2017 by Michael.Massing
Do multivitamin supplements increase mortality risk? | Public Health
An unescapable facet of public health is that we lumber forward with our scientific methods in an inescapable fight against powerful industries that produce the conditions in which ill-health forms and is reproduced.
vitamin  supplements  benefit  mortality  risk  peer-reviewed  research 
july 2017 by Michael.Massing
Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. - PubMed - NCBI
9 of 11 trials testing high-dosage vitamin E (> or =400 IU/d) showed increased risk (risk difference > 0) for all-cause mortality in comparisons of vitamin E versus control. The pooled all-cause mortality risk difference in high-dosage vitamin E trials was 39 per 10,000 persons (95% CI, 3 to 74 per 10,000 persons; P = 0.035). For low-dosage vitamin E trials, the risk difference was -16 per 10,000 persons (CI, -41 to 10 per 10,000 persons; P > 0.2). A dose-response analysis showed a statistically significant relationship between vitamin E dosage and all-cause mortality, with increased risk of dosages greater than 150 IU/d.
High-dosage (> or =400 IU/d) trials were often small and were performed in patients with chronic diseases. The generalizability of the findings to healthy adults is uncertain. Precise estimation of the threshold at which risk increases is difficult.
High-dosage (> or =400 IU/d) vitamin E supplements may increase all-cause mortality and should be avoided.
vitamin  E  mortality  risk  dosage  dose-dependent  peer-reviewed  research 
july 2017 by Michael.Massing
Is Sexual RacismReallyRacism? Distinguishing Attitudes Toward Sexual Racism and Generic Racism Among Gay and Bisexual Men | SpringerLink
Sexual racism is a specific form of racial prejudice enacted in the context of sex or romance. Online, people use sex and dating profiles to describe racialized attraction through language such as “Not attracted to Asians.” Among gay and bisexual men, sexual racism is a highly contentious issue. Although some characterize discrimination among partners on the basis of race as a form of racism, others present it as a matter of preference. In May 2011, 2177 gay and bisexual men in Australia participated in an online survey that assessed how acceptably they viewed online sexual racism. Although the men sampled displayed diverse attitudes, many were remarkably tolerant of sexual racism. We conducted two multiple linear regression analyses to compare factors related to men’s attitudes toward sexual racism online and their racist attitudes more broadly. Almost every identified factor associated with men’s racist attitudes was also related to their attitudes toward sexual racism. The only differences were between men who identified as Asian or Indian. Sexual racism, therefore, is closely associated with generic racist attitudes, which challenges the idea of racial attraction as solely a matter of personal preference.
sexual  racism  gay  community  ethos  mores  Australia  correlation  peer-reviewed  research  self-esteem  internalized 
june 2017 by Michael.Massing
Sexual racism in gay communities: negotiating the ethnosexual marketplace
This qualitative study was an in-depth examination of sexual racism (i.e., racism occurring in sexual contexts) within the gay community of the Seattle metropolitan area. Data was collected through key informant interviews and focus groups with self-identified gay Asian/Pacific Islander, African American/Black, and White men. Data analyses using a grounded theory approach revealed a variety of social locations in which sexual racism manifests including the internet, pornographic media, gay clubs and bars, casual/anonymous sexual encounters, and romantic relationships. Within these locations, sexual racism was reported to take different forms, manifesting as ethnosexual stereotypes, racial fetishism, and race-based sexual rejection. Participants of color identified internalized sexual racism, decreased self-esteem, and psychological distress as the primary psychological consequences of sexual racism. The data analyses revealed quantitatively and qualitatively distinct racial pressures operating in the gay community in Seattle. Participants estimated that compared to the heterosexual community, their gay community was more racially stratified and exhibited higher rates of sexual racism. They described the uniquely sexual basis of racial stereotypes and pointed to a skewed set of social norms operating in the gay community which allow greater expression of sexual racism than in the heterosexual community. Finally, the data revealed key differences in the psychological impact of sexual racism reported by Asian and Black gay men. An emergent hypothesis is presented outlining the relationships between experienced sexual racism and its sequelae, as well as protective factors. Theoretical, research, and clinical implications are discussed.
sexual  racism  gay  community  ethos  mores  US  Seattle  peer-reviewed  research  self-esteem  internalized 
june 2017 by Michael.Massing
Persistence of the efficacy of zoster vaccine in the shingles prevention study and the short-term persistence substudy. - PubMed - NCBI
In the STPS as compared to the SPS, vaccine efficacy for HZ burden of illness decreased from 61.1% to 50.1%, vaccine efficacy for the incidence of PHN decreased from 66.5% to 60.1%, and vaccine efficacy for the incidence of HZ decreased from 51.3% to 39.6%, although the differences were not statistically significant. Analysis of vaccine efficacy in each year after vaccination for all 3 outcomes showed a decrease in vaccine efficacy after year 1, with a further decline thereafter. Vaccine efficacy was statistically significant for the incidence of HZ and the HZ burden of illness through year 5.
shingles  prevention  study  followup  short-term  persistence  herpes  zoster  vaccine  efficacy  peer-reviewed  research 
april 2017 by Michael.Massing
Salacia reticulata (Kothala himbutu) revisited; a missed opportunity to treat diabetes and obesity?
The evidence available from animal and human studies point towards effective reduction of plasma glucose and weight in SR treated subjects. Alpha glucosidase inhibition is the most likely mechanism for the reduction of postprandial glucose. Reduction of fasting glucose, improvement in glucose handling following glucose loading and weight is most likely explained by decreased insulin resistance mediated through increasing adiponectin, suppression of lipogenesis and increased lipolysis.

Meticulously planned studies both animal and human, addressing the unresolved issues as well as studies that involve larger number of human subjects specifically addressing long-term outcomes and safety of SR treatment needs to be performed in the future.
Salacia  reticulata  diabetes  glucose  blood  insulin  postprandial  plasma  HbA1c  serum  lipids  peer-reviewed  research  in  vivo  vitro  clinical  human  body  fat  management  review  overview 
april 2017 by Michael.Massing
Anti-diabetic and Anti-hyperlipidemic Effects and Safety of Salacia reticulata and Related Species. - PubMed - NCBI
Extracts of Salacia reticulata Wight (Hypocrataceae) roots, stems, and leaves have been used in Asia for hundreds of years for the folkloric treatment of diabetes and other health problems. Constituents that have been identified as exhibiting anti-diabetic effects include salacinol, kotalanol, ponkorinol, salaprinol, and their corresponding de-0-sulfonated compounds. Mangiferin, kotalagenin 16-acetate and various proanthocyanidin oligomers have also been isolated. Studies indicate that Salacia extracts modulate multiple targets that influence carbohydrate and lipid metabolism including α-glucosidase, aldose reductase, pancreatic lipase, peroxisomal proliferator-activated receptor-α, glucose transporter-4 mediated glucose uptake, and angiotensin II type 1 receptor. Furthermore, Salacia extracts exhibit free radical scavenging, antioxidant and hepatoprotectant activities. In human studies, Salacia extracts have been shown to decrease plasma glucose and insulin levels, decrease HbA1c, and modulate serum lipid levels with no adverse effects being reported. Similar results have been demonstrated in rat and mouse models as well as in vitro systems. Safety of S. reticulata and other Salacia species as S. oblonga and S. chinensis in rats and mice indicate that extracts are exceedingly safe. No clinical studies have examined the effects of Salacia extracts on human weight loss, although weight loss and decreases in weight gain have been demonstrated in animal models. Because of the large number of pharmacologically active compounds, it is difficult to establish standards for extracts.
Salacia  reticulata  diabetes  glucose  blood  insulin  postprandial  plasma  HbA1c  serum  lipids  peer-reviewed  research  in  vivo  vitro  clinical  human  body  fat  management 
april 2017 by Michael.Massing
Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study
Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks.

At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group.

The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
periodontitis  scaling  root  planing  SRP  Lactobacillus  reuteri  probiotic  adjunct  therapy  peer-reviewed  research 
april 2017 by Michael.Massing
The Obesity-Impulsivity Axis: Potential Metabolic Interventions in Chronic Psychiatric Patients. - PubMed - NCBI
Recently, a strong association was found between impulsivity and obesity which may explain the high prevalence of metabolic disorders in individuals with mental illness even in the absence of exposure to psychotropic drugs. As the overlapping neurobiology of impulsivity and obesity is being unraveled, the question asked louder and louder is whether they should be treated concomitantly. The treatment of obesity and metabolic dysregulations in chronic psychiatric patients is currently underutilized and often initiated late, making correction more difficult to achieve. Addressing obesity and metabolic dysfunction in a preventive manner may not only lower morbidity and mortality but also the excessive impulsivity, decreasing the risk for aggression. In this review, we take a look beyond psychopharmacological interventions and discuss dietary and physical therapy approaches.
self  treatment  management  behavior  dietary  diet  intervention  correlation  obesity  impulsivity  impulse  control  metabolic  disorder  metabolism  mental  illness  neurobiology  peer-reviewed  research  aggression  physical  therapy 
april 2017 by Michael.Massing
A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. - PubMed - NCBI
In a small pilot trial, patients with atypical depression demonstrated significant positive therapeutic response to chromium picolinate. This finding is of interest because of the demonstrated link between depression, decreased insulin sensitivity, and subsequent diabetes and chromium picolinate's insulin enhancing effect.
: In this double-blind, multicenter, 8-week replication study, 113 adult outpatients with atypical depression were randomized 2:1 to receive 600 mug/day of elemental chromium, as provided by chromium picolinate (CrPic), or placebo. Primary efficacy measures were the 29-item Hamilton Depression Rating Scale (HAM-D-29) and the Clinical Global Impressions Improvement Scale (CGI-I).
: Of the 113 randomized patients, 110 (70 CrPic, 40 placebo) constituted the intent-to-treat (ITT) population (i.e., received at least one dose of study medication and completed at least one efficacy evaluation) and 75 (50 CrPic, 25 placebo) were evaluable (i.e., took at least 80% of study drug with no significant protocol deviations). In the evaluable population, mean age was 46 years, 69% were female, 81% were Caucasian, and mean body mass index (BMI) was 29.7. There was no significant difference between the CrPic and placebo groups in both the ITT and evaluable populations on the primary efficacy measures, with both groups showing significant improvement from baseline on total HAM-D-29 scores during the course of treatment (p < 0.0001). However, in the evaluable population, the CrPic group showed significant improvements from baseline compared with the placebo group on 4 HAM-D-29 items: appetite increase, increased eating, carbohydrate craving, and diurnal variation of feelings. A supplemental analysis of data from the subset of 41 patients in the ITT population with high carbohydrate craving (26 CrPic, 15 placebo; mean BMI = 31.1) showed that the CrPic patients had significantly greater response on total HAM-D-29 scores than the placebo group (65% vs. 33%; p < 0.05) as well as significantly greater improvements on the following HAM-D-29 items: appetite increase, increased eating, carbohydrate craving, and genital symptoms (e.g., level of libido). Chromium treatment was well-tolerated.
: The study did not include a placebo run-in period, did not require minimum duration or severity of depression, and enrolled patients with major depression, dysthymia, or depression NOS.
: In a population of adults with atypical depression, most of whom were overweight or obese, CrPic produced improvement on the following HAM-D-29 items: appetite increase, increased eating, carbohydrate craving, and diurnal variation of feelings. In a subpopulation of patients with high carbohydrate craving, overall HAM-D-29 scores improved significantly in patients treated with CrPic compared with placebo. The results of this study suggest that the main effect of chromium was on carbohydrate craving and appetite regulation in depressed patients and that 600 mug of elemental chromium may be beneficial for patients with atypical depression who also have severe carbohydrate craving. Further studies are needed to evaluate chromium in depressed patients specifically selected for symptoms of increased appetite and carbohydrate craving as well as to determine whether a higher dose of chromium would have an effect on mood.
carbohydrate  craving  chromium  picolinate  peer-reviewed  research  depression  psychotropic  effects 
march 2017 by Michael.Massing
Dietary chromium supplementation for targeted treatment of diabetes patients with comorbid depression and binge eating. - PubMed - NCBI
Dietary chromium supplementation for the treatment of diabetes remains controversial. The prevailing view that chromium supplementation for glucose regulation is unjustified has been based upon prior studies showing mixed, modest-sized effects in patients with type 2 diabetes (T2DM). Based on chromium's potential to improve insulin, dopamine, and serotonin function, we hypothesize that chromium has a greater glucoregulatory effect in individuals who have concurrent disturbances in dopamine and serotonin function--that is, complex patients with comorbid diabetes, depression, and binge eating. We propose, as suggested by the collective data to date, the need to go beyond the "one size fits all" approach to chromium supplementation and put forth a series of experiments designed to link physiological and neurobehavioral processes in the chromium response phenotype.
chromium  picolinate  comorbidity  depression  T2D  type  2  diabetes  individual  response  variability  treatment  intervention  psychotropic  appetite  carbohydrate  craving  peer-reviewed  research  Plexus  opinion  overview 
march 2017 by Michael.Massing
Psychiatric Disorders and Polyphenols: Can They Be Helpful in Therapy? - PubMed - NCBI
The prevalence of psychiatric disorders permanently increases. Polyphenolic compounds can be involved in modulation of mental health including brain plasticity, behaviour, mood, depression, and cognition. In addition to their antioxidant ability other biomodulating properties have been observed. In the pathogenesis of depression disturbance in neurotransmitters, increased inflammatory processes, defects in neurogenesis and synaptic plasticity, mitochondrial dysfunction, and redox imbalance are observed. Ginkgo biloba, green tea, and Quercus robur extracts and curcumin can affect neuronal system in depressive patients. ADHD patients treated with antipsychotic drugs, especially stimulants, report significant adverse effects; therefore, an alternative treatment is searched for. An extract from Ginkgo biloba and from Pinus pinaster bark, Pycnogenol, could become promising complementary supplements in ADHD treatment. Schizophrenia is a devastating mental disorder, with oxidative stress involved in its pathophysiology. The direct interference of polyphenols with schizophrenia pathophysiology has not been reported yet. However, increased oxidative stress caused by haloperidol was inhibited ex vivo by different polyphenols. Curcumin, extract from green tea and from Ginkgo biloba, may have benefits on serious side effects associated with administration of neuroleptics to patients suffering from schizophrenia. Polyphenols in the diet have the potential to become medicaments in the field of mental health after a thorough study of their mechanism of action.
polyphenols  depression  psychotropics  treatment  peer-reviewed  research  overview  pycogenol  green  tea  extract  gingko 
march 2017 by Michael.Massing
Natural polyphenols in the management of major depression. - PubMed - NCBI
Natural polyphenols, the non-essential micronutrients, found in array of plant products, are known to affect various physiological and biochemical functions in the body. Studies have shown the protective effect of these polyphenols in different neurological and mental disorders. These polyphenols modulate monoaminergic neurotransmission in the brain and thus possess antidepressant-like activity at least in animal models of depression.
The present review discusses the use of these natural polyphenols in the treatment of major depression. The review article discusses the antidepressant potential of some important polyphenols such as amentoflavone, apigenin, chlorogenic acid, curcumin, ferulic acid, hesperidin, rutin, quercetin, naringenin, resveratrol, ellagic acid, nobiletin and proanthocyanidins. The mechanism of action of these polyphenols in the treatment of major depression is also discussed in detail.
There is an exciting prospect in the discovery of natural polyphenols as therapeutic agents in the treatment of major depression.
polyphenols  depression  psychotropics  treatment  peer-reviewed  research  chlorogenic  acid 
march 2017 by Michael.Massing
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