All Calories Are Not Equal

  by Kerry Fleckenstein

I think we all have been led to believe that calories in are equal to calories out. Studies now are showing however that this is not true. There are qualities to calories that make them differ. When working with my clients we talk about the difference in 100 Calorie packs vs. 100 calories in greens. These calories are not equal in nature. One feeds you, the other does not.

Fiber: greens for example, have a lot of fiber in them. The same with legumes, seeds, other veggies and fruits. When eating these we have to chew them for a while in order for them to be digestible. This allows your brain to catch up with your stomach so it knows you are eating and filling up. Not all fiber is digested by you body therefore eliminated. Saving calories.

Protein: your body will spend the most calories digesting protein. It takes a while for the breakdown to happen and for the food them to move out of the stomach. Therefore you will feel full longer. Protein is used to build muscle mass and helps to maintain your blood sugar levels, directly opposite of what a simple carb or sugar would do for you. (100 calorie pack)

Fats: you don’t want to consume fats from things like French fries or fried foods and chips, but a good dose of healthy fats you need in your diet. This would come from nuts, avocado, olive oil etc. Stay away from trans-fats.

You also want to stay away from liquids. I know “diet” soda does not have any calories but your body still recognizes it as a sugar. Leading it to ask for more and that will give you cravings. A 100 calories of liquid may mathematically the same as 100 calories of food. An apple for example. But the liquid will not give you any of the above. The fiber in an apple will allow you to digest slower etc.

So the key is make your calories count. Make them a source of good nutrition while you are watching them. That being said you still cannot eat a phenomenal amount without the benefit of exercise.

According the Journal of the American Medical Association researchers have concluded that those who are on a low-carb diet (carbs from veggies and good sources and not bagels and cakes) burn the most calories. This would perfectly fit the above. Low-carb diets include protein, fiber, and a small amount of good healthy fats.

Vitamins and Minerals Can Boost Energy and Enhance Mood

July 16, 2013 — Vitamin and mineral supplements can enhance mental energy and well-being not only for healthy adults but for those prone to anxiety and depression, according to a July 15 panel discussion at the 2013 Institute of Food Technologists (IFT) Annual Meeting & Food Expo® held at McCormick Place.

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Bonnie Kaplan, Ph.D., professor in the faculty of medicine at the University of Calgary, Alberta, Canada, said Monday vitamins and mineral supplements can be the alternative to increasing psychiatric medicines for symptom relief of anxiety and depression. The supplements, she said, also can provide the mental energy necessary to manage stress, enhance mood and reduce fatigue.
In a series of studies she recently conducted in Canada, Kaplan found of the 97 adults with diagnosed mood disorders who kept a three-day food record, a higher intake of vitamins and minerals were significantly correlated with overall enhanced mental functioning.
Other vitamins that have been known to enhance mood, said C.J. Geiger, Ph.D., president of Geiger & Associates, LLC, and research associate professor in the division of nutrition at the University of Utah, include 5-Hydroxytryptophan (5 HTP), Vitamins B and D, as well as ginkgo biloba and Omega 3.
In her research, Geiger has found most adults define energy throughout the day as peaking mid-morning, falling to a valley in the afternoon after lunch and recovering with a pickup in late afternoon, settling back down before bedtime. However, these peaks and valleys did vary with gender, age and climate. She said many adults are known to use coffee, soft drinks, chocolate and candy bars as well as energy drinks, bars and chews with high sugar boosts to maintain energy throughout the day. She found other adults ate more frequent, smaller meals to sustain energy while making time for lots of rest and exercise.
Read the IFT Live article: http://live.ift.org/2013/07/15/undernourished-and-mentally-unbalanced/

Diet Detective: 10 Tips to Reduce Sugar in Your Diet

Added sugar is a nutritional zero.  I know you've heard all kinds of advice over the years: "Don't eat fat; it's horrible." "Low carb is the best way to go." "Avoid all the white stuff." "Low carb is unhealthy." "You need the ‘good' fat."
If you're tired of all the conflicting nutritional advice, you can rest assured that there is one rock solid recommendation: Reduce consumption of ANY added sugar. I'm not 100 percent sure, but I bet that the only ones who would tell you anything different are the companies that add sugar to their products. Added sweeteners quickly boost calorie intake while providing little nutrient value. Those calories can stack up very quickly if you're eating too many highly sweetened foods. If you're consuming more calories than your body needs, the evidence will appear quickly in the form of added pounds.  Here are 10 tips to help you avoid unwanted sugar.

1. Avoid ADDED Sugar and Beware of Sugar's Many Disguises 
According to the Centers for Disease Control and Prevention (CDC), the term "added sugar" is defined as any "sweeteners added to processed and prepared foods."
And while many sugars are found naturally in foods, such as milk, fruit, vegetables and grains, it's the sugars added to many of the foods we eat (by food companies) that we have to watch out for.  When you read the food label, here is what you should look out for:  brown sugar, corn sweetener, corn syrup, dextrin, dextrose, glucose, fructose, high-fructose corn syrup, honey, invert sugar, lactose, maltodextrin, maltose, mannitol, molasses, natural sweeteners, polydextrose, raw sugar, sucrose, syrup, turbinado sugar, and xylitol.
Remember, regardless of the name, whether it's honey (although there is some research that indicates honey can help with allergies and work as an antibiotic), brown sugar, raw sugar or maple syrup, all added sugar is essentially just calories without significant nutritional value. The one exception may be molasses, which is actually a fair source of potassium, calcium and iron.

2. Read The Label 
To track down the amount of sugar you're consuming, read the nutrition label and look for the many different forms of sugar mentioned above. The "sugars" section includes those that are present naturally in the food (such as lactose in milk and fructose in fruit), as well as sugars added to the food during processing.
If you're interested in finding out whether a sweetener has been added, check the ingredients list for terms such as "sugar (sucrose)," "fructose," "maltose," "lactose," "honey," "syrup," "corn syrup," "high-fructose corn syrup," "molasses" and "fruit juice concentrate." If any of these sugars appears first or second, or if many of them are listed among the ingredients, it's most likely a high-sugar food.  Just so you have a reference point, 4 grams of sugar is approximately 1 teaspoon.

3. Are You STILL Blinded By Fat Phobia? 
If you're too preoccupied with reading the number of fat grams on the food label, you may be missing the fact that many reduced-fat or fat-free products still carry a hefty number of calories. Additional sweeteners are often substituted for some of the fat that has been removed from these products.

4. Don't Ban Sugar Completely 
Sugar is part of a normal diet, but it should be in foods such as fruits and vegetables.

1 cup of cauliflower = 2 grams of sugar

1 red tomato = 3.2 grams of sugar

1 cup of broccoli = 1.6 grams of sugar

So, you see, these ALL have sugar, but it's a small amount, and vegetables contain natural (not added) fiber, which helps to slow the release of the sugar into your blood. Plus, green, leafy or cruciferous vegetables (cauliflower, broccoli, Brussels sprouts, kale, cabbage and bok choy) don't have much sugar and are very healthy.

5. Sugar-Caution: What You Should Know About Carbs, Sugar and the Glycemic Index
The glycemic index (GI) was created as a research tool to determine the actual effect carbohydrates, including sugars, have on blood sugar.  GI measures how quickly a food that contains carbohydrate raises a fasting person's blood sugar level and subsequent insulin in two hours. (Insulin is the hormone that activates cells to absorb sugar from the bloodstream, thus reducing blood sugar levels.)
Foods with a high GI value raise the body's blood sugar very quickly, which signals a corresponding rapid release of insulin into the bloodstream; this quick rush of insulin then lowers blood sugar.
High-GI foods include white bread, white potatoes, pasta, doughnuts and bagels, but also watermelon and carrots. Low-GI foods include most vegetables, low-fat yogurt, lentils and peanuts, but also whole milk and pound cake.
When you consume carbohydrates there is a process that switches you from feeling famished to being fed. The problem is that foods with a high GI slow down the feeling that you've eaten and are full and, as a result, can cause hunger. Typically, foods that are high on the glycemic index are highly processed foods that have lots of processed sugar and little naturally occurring fiber.

6. Make Your Sweets Count
I'll be honest, as healthy as I try to be, I do eat sweets.  But the most important thing I do when I'm eating a sweet food or drink is to make sure it is splurge-worthy. I consciously ask myself:  "Does this taste amazing?" "Am I paying attention and focused on the enjoyment of this food, or am I on the phone, computer, in a deep conversation or doing something else distracting?"  "Will this food or drink satisfy my sweet craving?"
Bottom line: I'm not suggesting that you give up sweets altogether.  However, I do suggest that you become more deliberate about your selection of sweet and gooey foods and drinks. Select sweets that offer more than just fast-acting carbohydrates if you can.

7. Avoid "Big" Thinking
When it comes to satiating your sweet tooth, there's a good chance you only need a bite or two to feel satisfied. Ice cream is a great example — if you're going to have it, stick to a ½-cup serving and you should be able to keep the calories under 200 while still satisfying your craving. If you don't trust yourself to do your own scooping, buy individual servings so you won't be tempted to eat more than your share.

8. Eat Lots of Healthy Vegetables and Avoid Getting Too Hungry
If you let yourself get too hungry, chances are the first foods you reach for will be high in sugar and fat and low in nutrients. Prevent this urge by eating meals filled with low-calorie vegetables. If you fill yourself up on the "good" stuff, you will be less likely to eat the "bad" stuff (e.g., foods with added sugar).

9. Reduce Sugar In Recipes and Use Spices 
There's a pretty good chance that, with a little smart thinking, you can cut the sugar in most recipes by one-third, and the finished product will turn out fine (you probably won't even notice the difference).  Check out recipe sites such as eatingwell.com, cookinglight.com and allrecipes.com.  Also, cinnamon, vanilla, nutmeg, anise and mint can add a sweet taste to foods without adding sugar or calories.

10. Buy Right and You Can Easily Switch to Fruit for Dessert
A great peach or a few delicious strawberries can certainly do the trick in most instances.  The good news is that they also provide vitamins, minerals and fiber (which helps to fend off the effect of sugar on your blood). You can also try pureeing fresh frozen fruits to make your own sorbets, drizzling fruits with chocolate syrup, or dipping them in yogurt. Check these fruit buying guides:

7 Foods For Flat Abs

The key to having flat abs lies in your ability to keep fat from forming. So, watching what you eat is definitely a step towards the right direction. Couple that with the right exercise and soon enough your midsection will be as flat as a washboard (or at least very close to it).



Following are the foods that have a reputation for flattening bellies.                                   Avocado

A study in the journal Diabetes Care have found that people who consume monosaturated fat have less stomach bulge than those who consume the same amount of calories with minimal fats. Additionally, a study in the journal Obesity indicates that monkeys that ate trans fats have waistlines 30 percent bigger than those that ate monosaturated fats. What causes this is that monosaturated fats prevent blood sugar levels from spiking which in turn prevents your body from storing fat around your midsection.

The great thing with avocados is that they contain high amounts of monosaturated fats. To be more precise, half an avocado contains 10 grams of healthy monosaturated fats.

Green Tea

Green tea has been known to boost metabolism rate. According to studies, drinking three cups of green tea every day could boost your metabolism rate, enough to burn 30 calories (each day) or 3 pounds a year just from sipping your tea. This metabolism boosting power lies in the compound ECGC (epigallocatechin-3-gallate) that green tea contains. Additionally, the ECGC is also found to be capable of preventing the death of heart muscle cells following ischemia/reperfusion (restriction in blood supply) injury.

Yogurt

Even if you're technically fat free around your midsection, it is still possible that your belly will still look puffy. In addition to fat, abdominal bloating can also be caused by the excessive production of gas by bad bacteria residing in your belly. The good news is a cup of plain yogurt can promote the growth of good bacteria in your stomach which, in turn, could prevent the accumulation of those nasty gas producing bacteria in your tummy.

Blueberries/Blackberries

Blueberries and blackberries are a very good source of antioxidants. As a matter of fact, they top the antioxidant chart. In addition to preventing cancer, antioxidants also improve blood flow which delivers more oxygen to your muscles. Having a good supply of oxygen in your muscles makes exercise easier, thus allowing you to work out harder, longer, and more frequently.

Bulgur

A study in The American Journal of Clinical Nutrition indicates that people who consume whole grains lost more belly fat than calorie cutters who fed on refined grains. The thing is, bulgur has more fiber and fewer calories than other grains. And speaking of fiber, fiber keeps your body's insulin levels low which, according to researchers, could shrink fat cells.

Chocolate Milk

According to the findings presented at the American College of Sports Medicine meeting in Seattle, athletes who consumed chocolate milk had lower levels of muscle damage than those who drank sports drinks (after four days of intense training). It has been found that chocolate milk makes carbs and proteins work better together thus promoting muscle building.

Heat-Induced Acrylamide May Be a Primary Hazard of Processed Food

By Dr. Mercola

Approximately 90 percent of the money Americans spend on food is spent on processed foods, and food marketers do a masterful job at making it seem like fast foods and junk foods are the obvious choice.
Some even manage to make you believe such foods are a healthy option. But not only are these processed foods “dead” and devoid of any natural nutrition, they can also be loaded with potentially carcinogenic substances.
Just over a decade ago, researchers discovered that a cancer-causing and potentially neurotoxic chemical called acrylamide is created when carbohydrate-rich foods are cooked at high temperatures, whether baked, fried, roasted, grilled or toasted.
The chemical is formed from a reaction between sugars and an amino acid (asparagine) during high-temperature cooking. The answer, of course, is to limit or eliminate processed foods and increase the amount of whole, raw foods in your diet. I typically aim for 80-85 percent raw food in my own diet.

Acrylamide May Be a Primary Hazard of Processed Food

Acrylamide can form in many foods cooked or processed at temperatures above 212°F (100°C), but carbohydrate-rich foods are the most vulnerable to this heat-induced byproduct. As a general rule, the chemical is formed when food is heated enough to produce a fairly dry and “browned” surface. Hence, it can be found in:

• Potatoes: chips, French fries and other roasted or fried potato foods
• Grains: bread crust, toast, crisp bread, roasted breakfast cereals and various processed snacks
• Coffee; roasted coffee beans and ground coffee powder. Surprisingly, coffee substitutes based on chicory actually contains 2-3 times more acrylamide than real coffee

Acrylamide is not the only hazard associated with heat-processed foods, however. The three-year long EU project known as Heat-Generated Food Toxicants¹ (HEATOX), identified more than 800 heat-induced compounds in food, 52 of which are potential carcinogens... For example, the high heat of grilling reacts with proteins in red meat, poultry, and fish, creating heterocyclic amines, which have also been linked to cancer.
Humans are not the only victims here. As discussed by holistic veterinarian Dr. Barbara Royal, pet foods also contain acrylamide and heterocyclic amines, courtesy of commercial pet food processing methods.

Exposure to Acrylamide Increases Your Cancer Risk

Animal studies have shown that exposure to acrylamide increases the risk of several types of cancer, and the International Agency for Research on Cancer considers acrylamide a "probable human carcinogen." According to a 1988 study²:

“The data show that acrylamide is capable of inducing genotoxic, carcinogenic, developmental, and reproductive effects in tested organisms. Thus, acrylamide may pose more than a neurotoxic health hazard to exposed humans.

Acrylamide is a small organic molecule with very high water solubility. These properties probably facilitate its rapid absorption and distribution throughout the body. After absorption, acrylamide is rapidly metabolized, primarily by glutathione conjugation, and the majority of applied material is excreted within 24 hours... Acrylamide can bind to DNA... which has implications for its genotoxic and carcinogenic potential.”

A study³ published in 2007 linked higher dietary acrylamide intake with an increased risk of endometrial and ovarian cancer in postmenopausal women, particularly among non-smokers. It has also been linked to nerve damage and other neurotoxic effects, including neurological problems in workers handling the substance.
While the EPA regulates acrylamide in drinking water and the FDA regulates the amount of acrylamide residue in materials that may come in contact with food, they do not currently have any guidelines limiting the chemical in food itself.

How Much Acrylamide Are You Getting from Your Diet?

In drinking water, the federal limit for acrylamide is 0.5 parts per billion, or about 0.12 micrograms in an eight-ounce glass of water. However, a six-ounce serving of French fries can contain 60 micrograms of acrylamide—about 500 times the allowable limit! A 2002 food analysis published in the Journal of Agricultural and Food Chemistry⁴, found moderate levels of acrylamide (5−50 μg/kg) in heated protein-rich foods and higher levels (150−4,000 μg/kg) in carbohydrate-rich foods. Unheated or boiled foods showed undetectable levels (<5 acrylamide="" conclude:="" g="" kg="" leading="" of="" p="" researchers="" the="" to="">

"Consumption habits indicate that the acrylamide levels in the studied heated foods could lead to a daily intake of a few tens of micrograms."

Potato chips in particular are notoriously high in this dangerous chemical. So high, in fact, that in 2005 the state of California actually sued potato chip makers for failing to warn California consumers about the health risks of acrylamide in their products. A settlement was reached in 2008⁵ when Frito-Lay and several other potato chip makers agreed to reduce the acrylamide levels in their chips to 275 parts per billion (ppb) by 2011, which is low enough to avoid needing a cancer warning label.
Still, that’s a far cry from the allowable limit of 0.5 ppb in drinking water!
The 2005 report⁶ "How Potato Chips Stack Up: Levels of Cancer-Causing Acrylamide in Popular Brands of Potato Chips," issued by the California-based Environmental Law Foundation (ELF), spelled out the dangers of this popular snack. According to their analysis, ALL potato chip products tested exceeded the legal limit of acrylamide by a minimum of 39 times, and as much as 910 times! Interestingly, baked chips, which are often touted as a healthier chip, can contain more than three times the level of acrylamide in regular chips, according to US Food and Drug Administration data⁷.

How to Avoid Heat-Induced Toxins in Your Diet

Acrylamide levels vary greatly among processed foods, even among different batches of the same food item. The chemical has so far only been found in foods heated above 250 F/120 C, which includes most processed foods. Basing your diet on whole foods, with the majority or a significant portion eaten raw or lightly cooked is therefore one of the best ways to avoid this cancer-causing cooking byproduct. Aside from creating potentially toxic byproducts, high heat also depletes the food of valuable micronutrients, which is another reason for eating raw or slow cooked food as possible.
Another important aspect of raw foods is the energetic aspect. Dr. Johanna Budwig from Germany has stated that live foods are electron rich and act as high-powered electron donors and “solar resonance fields” to attract, store, and conduct the sun's energy in your body. The greater your body’s store of light energy, the more energy you’ll have available for healing and the maintenance of optimal health. For the times when you do cook your food, keep the following tips in mind:

• Frying, baking and broiling appear to be the worst offenders, while boiling or steaming appear to be safer
• Hotter cooking temps increase acrylamide
• Soaking raw potatoes in water for 15-30 minutes prior to roasting may help reduce acrylamide formation during cooking
• The darker brown the food, the more acrylamide it contains (for instance, dark brown toast compared to light brown toast)
• Acrylamide is found primarily in plant-based foods, such as potatoes and grain products (not typically in meat, dairy or seafood)

According to the findings by the HEATOX project, you're far less likely to ingest dangerous levels of acrylamide when you eat home-cooked foods compared to industrially or restaurant-prepared foods. And when you do eat at home, the best advice they could give was to avoid overcooking your food. For more in-depth information about acrylamide, I recommend reading the online report: "Heat-generated Food Toxicants, Identification, Characterization and Risk Minimization"⁸.

Take Control of Your Health with Whole Food

While many foods – from coffee and breakfast cereal to bread – contain acrylamide, the highest levels have been detected in starchy plant-based foods, particularly French fries and potato chips. As a general rule, just remember that cooking food at high temperatures is ill advised, and that most processed foods will contain acrylamide as a side effect of high-heat processing.
Ideally, consume foods that are minimally processed to avoid these types of toxic byproducts. My nutrition plan emphasizes the need for at least one-third of your foods to be consumed raw.  For a step-by-step guide to make the transition to a healthier diet as simple and smooth as possible, simply follow the advice in my optimized nutrition plan.
Remember, eating fresh whole foods is the "secret" to getting healthier, losing weight and really enjoying your food. Once you get used to it, you'll find you can whip up a healthful meal from scratch in the same amount of time it would have taken you to drive down the street to pick up fast food. The main difference will be greater satisfaction, both physically and mentally, and perhaps even financially, as processed foods typically end up being more expensive than cooking from scratch.

Salty snacks, extra pounds send blood pressure soaring in U.S. kids

Brian Alexander NBC News contributor

July 15, 2013 at 4:30 PM ET

NBC News

Ethan Borst, 15, was overweight and has had sporadic high blood pressure. After attending a camp designed to help kids lose weight, he is on the right track to health.

Spurred by too much salt and too many extra pounds, blood pressure in America's kids and teens has gone sky-high, creating a young generation at risk for serious health problems, including heart disease, stroke -- and worse.
The percentage of American children and adolescents ages 8 to 17 who have high blood pressure -- a risk factor for cardiovascular disease, organ damage, heart attacks and strokes -- climbed 27 percent over 13 years, according to researchers from Harvard Medical School, Brigham and Women's Hospital and other institutions funded by the National Institutes of Health.
The researchers, using two large national surveys, compared blood pressure data of thousands of children from two National Health and Nutrition Examination Surveys, a government program designed to track health and nutritional status of adults and children in the U.S. During the period 1988 to 1994, 15.8 percent of boys, and 8.2 percent of girls could be classified as having elevated blood pressure. By the next survey period, covering the years 1999-2008, those percentages jumped to 19.2 percent for boys and 12.6 percent for girls.
The new research, published Monday in the journal Hypertension, positively links rising blood pressure to increasing body mass index, especially waist circumference, and sodium intake. In short, far too many American children are too fat and eating too many salty snacks.
More than a third of children and teens in the United States are overweight or obese, according to the Centers for Disease Control and Prevention. “The reason we’re seeing high blood pressure in kids, is due to the obesity epidemic,” said pediatrician Dr. Joanna Dolgoff.
Dolgoff has been seeing elevated blood pressure in so many of her young patients, she thought her equipment was broken.
"Recently, I've been a lot more of my patients having high blood pressure," Dolgoff, a child obesity expert and creator of the “Red Light, Green Light, Eat Right” nutrition program, said. "I thought perhaps my blood pressure machine was broken. But actually the incidence of high blood pressure in children is increasing."
Being overweight is a key risk factor for high blood pressure in adults so “it stands to reason that it would be the same in children,” said Dolgoff.
Ethan Borst, 15, of New York, N.Y., started gaining weight when he was just 7. Although high blood pressure and diabetes run in his family, his mother, Renee Katz, was surprised to discover Ethan had high blood pressure at such a young age.
"I wanted to make sure that he wasn't going to have those problems when he gets older." After attending a weight-loss camp run by Dolgoff, Ethan lost almost 30 pounds and has given up his favorite salty snacks.
"I do enjoy corn chips, but I try to stay away from those," Ethan said.
The researchers found that “for total fat, saturated fat, and protein, a large majority of children (70 percent to 80 percent) were above the RDI [recommended daily intake],” the study found. For sodium intake, “over 80 percent” of the children were above the RDI.
“Kids eat far too much sodium,” the study's co-author Dr. Stephen Daniels told NBC News. “And they aren’t adding it at the table, and their parents aren’t putting it into food; they’re getting it through processed foods.”
Past studies have indicated blood pressure among America’s youth might be on the rise, but most used small samples. The NHANES data in this research was made up of 3,248 children for the period 1988 to 1994 and 8,388 for the 1999-2008 survey.
The damage from far too much dietary sodium has been especially pronounced in African-American girls, accounting for much of the higher rate of increase in girls compared to boys, said Daniels, chair of the Department of Pediatrics at the University of Colorado School of Medicine, and the chair of the National Heart, Lung and Blood Institute’s panel that created guidelines for cardiovascular health and risk reduction in children.
“On some level we know there has been some relationship between obesity and blood pressure and some previous studies showed that blood pressure has risen over time,” Daniels said.
Dr. Patrick McBride, a cardiologist, agrees.
“It’s all nutritionally related and activity related,” said McBride, professor of medicine and family medicine and associate director of preventive cardiology at the University of Wisconsin School of Medicine and Public Health. “Children are being parked in front of screens, videos, electronics and then consuming high-caloric-density foods.”
As a result, some have the cardiovascular damage more common in middle-aged and older people.
“I have had a heart disease prevention practice for 30 years,” McBride said, “and we only used to see high blood pressure rarely in children. Now it’s common. Every week I see high blood pressure, high cholesterol. It’s astounding.”
The damage isn’t just long-term, with heart attacks and strokes at ages 25 or 30. McBride can see physical damage in the children. “With ultrasound on the carotid artery, we can see early atherosclerosis,” he said.
Daniels explained that children can also show signs of an enlarged heart ventricle because the heart has to work harder to push blood.
Both Daniels and McBride explained that pediatricians and family physicians should be more diligent about checking blood pressure in children, and, if dietary and exercise advice don't work, consider prescribing blood pressure-lowering drugs.

Undiagnosed Pre-Diabetes Highly Prevalent in Early Alzheimer's Disease Study

July 14, 2013 — When Georgetown University neurologist R. Scott Turner, MD, PhD, began enrolling people with mild to moderate Alzheimer's disease into a nationwide study last year, he expected to find only a handful of participants with undiagnosed glucose intolerance, as all the patients were already under a doctor's care and those with known diabetes were excluded. But Turner says he was "shocked" by how many study participants were found to have pre-diabetes -- a finding that is triggering important questions.

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Turner's study examines resveratrol, a compound found in red grapes and red wine, to see if it might change glucose levels in patients with mild to moderate Alzheimer's disease (AD). Turner says resveratrol is thought to act on proteins in the brain in a way that mimics effects of a low-calorie diet.
"We know from animal studies that caloric restriction prevents diseases of aging such as diabetes and Alzheimer's," explains Turner, director of the Georgetown University Medical Center's Memory Disorders Program. "On the flip side of the coin, having diabetes increases one's risk of developing AD. So perhaps by improving glucose tolerance, we will prevent or delay both diabetes and Alzheimer's."
To join the resveratrol study, participants were first given a fasting glucose tolerance test to obtain a baseline level, and then retested two hours after eating. During digestion, the blood sugar level increases, but the pancreas produces insulin to lower it. A high sugar level after two hours reveals glucose intolerance (pre-diabetes) or diabetes if the level is very high.
"The number of people with glucose intolerance (pre-diabetes) was much higher than expected," says Turner. "I was surprised by how many people didn't know they were pre-diabetic, and these are individuals who already get the best medical care."
Five (4 percent) of 128 participants had impaired fasting glucose levels while three others (2 percent) had findings consistent with type 2 diabetes mellitus. Of the 125 subjects who completed the two-hour test, 38 (30 percent) demonstrated glucose intolerance while 16 (13 percent) had results consistent with diabetes. Thus, the overall prevalence of impaired glucose tolerance or diabetes at two hours was 43 percent -- or almost half of the individuals recruited to the study.
Turner asks, "How does glucose intolerance or diabetes lead to AD? Does the inflammation associated with AD trigger glucose intolerance? Or do both events create a vicious cycle of Alzheimer's and glucose intolerance?"
Turner's study isn't designed to answer these questions, but it might provide important clues. Turner says while a glucose tolerance test is not typically ordered by neurologists, "this result suggests that perhaps we should test all our patients with early Alzheimer's. It's a simple, inexpensive study that reveals critical health information."
Turner will discuss his findings at the Alzheimer's Association International Congress in Boston on July 14.
The resveratrol study is sponsored by the Alzheimer's Disease Cooperative Study through a grant from the National Institute on Aging. Turner reports no personal financial interests related to the study