3 Tweaks To Cut Diabetes Risk By 1/3
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Today, the research we’ll be highlighting builds on the Mediterranean diet, by adding some extra interventions. We’ve written before about the Mediterranean diet, here:
The Mediterranean Diet: What Is It Good For? ← What isn’t it good for?
The Mediterranean diet’s strengths come from various factors including its good plant:animal ratio (leaning heavily on the plants), colorful fruit and veg minimally processed, and the fact that olive oil is the main source of fat:
All About Olive Oil ← pretty much one of the healthiest fats we can consume, if not healthiest all-rounder fat.
This is not the first time we’ve talked about making the Mediterranean even better; see: Four Ways To Upgrade The Mediterranean Diet ← to make it even more anti-inflammatory, even more gut-healthy, even more heart-healthy, and even more brain-healthy, respectively.
Med+
Researchers (Dr. Dolores Corella et al.) wanted to know the effectiveness of adding further interventions on top of the already-healthy Mediterranean diet.
Specifically, the Mediterranean diet, plus:
- Caloric restriction (600 fewer calories per day)
- Moderate exercise (brisk walking, strength, balance)
- Professional weight-loss support
On which note, the study participants were 4,746 adults (ages 55–75) categorized as overweight or obese, with metabolic syndrome but no diabetes at baseline, followed for six years.
With this in mind, the method may not be applicable to all people—if you are already exercising moderately, do not have extra weight to healthily lose, and are eating maintenance calories only, then cutting your caloric intake drastically will probably not be healthy or sustainable.
For more on the science of caloric restriction (including the pros and cons), see: Is Cutting Calories The Key To Healthy Long Life?
As for the study, the intervention group (Mediterranean diet plus those three things) and the control group (Mediterranean diet only) saw the following results after 6 years:
- Intervention group lost 3.3kg (7¼ lbs); control group lost 0.6kg (1⅓ lbs)
- Intervention group lost 3.6cm (1½ inches) waist circumference; control group lost 0.3cm (⅛ inch)
- Intervention group had 9.5% absolute risk of diabetes; control group had 12% risk
The overall reduction of diabetes incidence, however, was 31% lower for the intervention group than the control group
You may be wondering: since 9.5 is about 21% (not 31%) of 12, where did the 31% figure come from?
And the answer is: this is one of those places where absolute risk reduction, relative risk reduction, and hazard ratio-based incidence reduction get easily mixed up:
- Absolute risk reduction (ARR) = we take the cumulative risk in control and subtract the cumulative risk in intervention, so here, that’s 12.0% – 9.5% = 2.5 percentage points ARR
- Relative risk reduction (RRR) = we take the ARR we just calculated, and subtract the cumulative risk in control, so here, that’s 2.5/12 = 20.8% RRR
- Hazard ratio-based incidence reduction = what happens if we apply the resultant hazard ratio to person-years, i.e. instead of of looking at just those 6 years (and not caring if someone gets diabetes in 7 years, say), we take each participant’s 6 years and stretch them all end-to-end, so that we can see more accurately what incidence rate will be over more time. We then take the number of person-years generated (in this case, 6 years x 4746 people = 28,476 person-years, which is a lot of data), look at the reduction rate, and then scale it back down (keeping the same ratio) to a number that makes for a clearer representation that’s easy to apply to other models, in this case, 1,000 person years, using the same hazard ratio as we found from the 28,476 person-years. The result of this calculation, in this case, is a 31% lower incidence rate. This is more or less what we might reasonably have expected from a glance at the data—we could expect that it would be higher than the RRR, because this time we get to factor into the equation the people who will get diabetes in year 7, year 8, year 9, etc, from only a 6-year study, because of how we laid everyone’s 6 years end-to-end.
You can find the paper itself, here: Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes
Is it worth it?
If you have those 7¼ lbs and 1½ inches to lose, then a 31% reduction in diabetes risk is a big benefit.
If, on the other hand, you don’t, then as we say, probably skipping 600kcal per day is not so good an idea for you.
For everyone, meanwhile, moderate exercise is of course great.
As for the professional weight loss help? Well, that depends on the nature of the help, and this study didn’t separate its effects (if any) from the effects of the caloric reduction and moderate exercise. So, honestly we think it’s unhelpful that they included it with doing a separate control for it.
Want to reduce diabetes risk without reducing calories?
Check out:
How To Prevent And Reverse Type 2 Diabetes: Turn Back The Clock On Insulin Resistance!
Take care!
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Breast cancer screening is ripe for change. We need to assess a woman’s risk – not just her age
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Australia’s BreastScreen program offers women regular mammograms (breast X-rays) based on their age. And this screening for breast cancer saves lives.
But much has changed since the program was introduced in the early 90s. Technology has developed, as has our knowledge of which groups of women might be at higher risk of breast cancer. So how we screen women for breast cancer needs to adapt.
In a recent paper, we’ve proposed a fundamental shift away from an age-based approach to a screening program that takes into account women’s risk of breast cancer.
We argue we could save more lives if screening tests and schedules were personalised based on someone’s risk.
We don’t yet know exactly how this might work in practice. We need to consult with all parties involved, including health professionals, government and women, and we need to begin Australian trials.
But here’s why we need to rethink how we screen for breast cancer in Australia.
Pablo Heimplatz/Unsplash Why does breast screening need to change?
Australia’s BreastScreen program was introduced in 1991 and offers women regular mammograms based on their age. Women aged 50–74 are targeted, but screening is available from the age of 40.
The program is key to Australia’s efforts to reduce the burden of breast cancer, providing more than a million screens each year.
Women who attend BreastScreen reduce their risk of dying from breast cancer by 49% on average.
Breast screening saves lives because it makes a big difference to find breast cancers early, before they spread to other parts of the body.
Despite this, around 75,000 Australian women are expected to die from breast cancer over the next 20 years if we continue with current approaches to breast cancer screening and management.
Who’s at high risk, and how best to target them?
International evidence confirms it is possible to identify groups of women at higher risk of breast cancer. These include:
- women with denser breasts (where there’s more glandular and fibrous tissue than fatty tissue in the breasts) are more likely to develop breast cancer, and their cancers are harder to find on standard mammograms
- women whose mother, sisters, grandmother or aunts have had breast or ovarian cancer, especially if there are multiple relatives and the cancers occurred at young ages
- women who have been found to carry genetic mutations that lead to a higher risk of breast cancer (including women with multiple moderate risk mutations, as indicated by what’s known as a polygenic risk score).
For some higher-risk women, could MRI be an option? VesnaArt/Shutterstock Women in these and other high-risk groups might warrant a different form of screening. This could include screening from a younger age, screening more frequently, and offering more sensitive tests such as digital breast tomosynthesis (a 3D version of mammography), MRI or contrast-enhanced mammography (a type of mammography that uses a dye to highlight cancerous lesions).
But we don’t yet know:
- how to best identify women at higher risk
- which screening tests should be offered, how often and to whom
- how to staff and run a risk-based screening program
- how to deliver this in a cost-effective and equitable way.
The road ahead
This is what we have been working on, for Cancer Council Australia, as part of the ROSA Breast project.
This federally funded project has estimated and compared the expected outcomes and costs for a range of screening scenarios.
For each scenario we estimated the benefits (saving lives or less intense treatment) and harms (overdiagnosis and rates of investigations in women recalled for further investigation after a screening test who are found to not have breast cancer).
Of 160 potential screening scenarios we modelled, we shortlisted 19 which produced the best outcomes for women and were the most cost effective. The shortlisted scenarios tended to involve either targeted screening technologies for higher-risk women or screening technologies other than mammography for all screened women.
For example, in our estimates, making no change to the target age range or screening intervals but offering a more sensitive screening test to the 20% of women deemed to be at highest risk would save 113 lives over ten years.
Alternatively, commencing targeted screening from age 40 and offering a more sensitive screening test annually to the 20% of women at highest risk, and three-yearly screening (of the current kind) to the 30% of women at lowest risk, would save 849 lives over ten years.
However, less frequent screening of the lower risk group was expected to lead to small increases in breast cancer deaths in that group.
How do we best assess women for their risk of breast cancer? At this stage, there’s no one answer. Tint Media/Shutterstock We also outlined 25 recommendations to put into action, and set out a five-year roadmap of how to get there. This includes:
- a large scale trial to find out what is feasible, effective and affordable in Australia
- making sure women at higher risk in different parts of Australia are offered suitable options regardless of where they live and who they see
- better data collection and reporting to support risk-based screening
- testing how we assess women for their risk of breast cancer, including whether these assessments work as intended and make sense to women from a range of backgrounds
- clinical studies of screening technologies to determine the best delivery models and associated costs
- ongoing engagement with groups including women, health professionals and government.
Breast cancer screening review out soon
Federal health minister Mark Butler said a review of the BreastScreen program would consider our recommendations. The results of this review are expected soon.
We’re not alone in calling for a move towards risk-based breast cancer screening. This is backed by national and international submissions to government, policy briefing documents and the Breast Cancer Network Australia.
We’ve provided an evidence-based roadmap towards better screening for breast cancer. Now is the time to commit to this journey.
We acknowledge Louiza Velentzis from the Daffodil Centre, and Paul Grogan and Deborah Bateson from the University of Sydney, who co-authored the paper mentioned in this article.
Carolyn Nickson, Adjunct Associate Professor, The Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, and Associate Professor, Melbourne School of Population and Global Health, University of Melbourne, University of Sydney; Bruce Mann, Professor of Surgery, Specialist Breast Surgeon, The University of Melbourne, and Karen Canfell, Professor & NHMRC Leadership Fellow, Sydney School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Complete Guide To Red Light Therapy – by Dr. Melanie Gray
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Red light therapy (RLT) is one of those things that sounds like it should be an ineffectual new-age fad that doesn’t do anything, but in fact, there’s a lot of evidence to show that it confers many benefits.
In particular, and to oversimply rather because this is a book review and not a scientific article (though we have written about RLT before and linked to various studies there), RLT is most noted for rejuvenating skin, and enhancing the healing of same, where applicable.
Dr. Gray explains not just what it does, but also some of how it does it, involving the stimulation of mitochondria, DNA-and-telomere repair, and more. She also talks the difference between RLT and near-infrared therapy, which are often delivered by the same devices, just, we can see part of the spectrum and not the other part.
She covers practical matters too, such as optimizing the frequency for different purposes (helpful when choosing a device, or when adjusting the settings on a multi-setting device), as well as optimal treatment duration, and other factors that can affect dosage (including the intensity of the light, and your skintone).
The style is… a little mixed, and can read a little like AI was involved. But on the bright side, it’s a perfectly easy read (and a short one, at 104 pages), and the author’s input includes a lot of niche technical knowledge, which makes it worthwhile. The bibliography is 12 items long and only 5 of those are scholarly articles, but honestly, she could have padded it with a lot more hard-science evidence for RLT’s benefits and it wouldn’t have actually increased the practical value of the book, so we don’t think this is a terrible thing.
Bottom line: this will probably not become anyone’s favorite book, but it is actually useful, and can help you to get the most out of RLT.
Click here to check out The Complete Guide To Red Light Therapy, and enjoy a healthy glow!
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The Sardinian Cholesterol Paradox
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Broadly speaking, low-density lipoprotein (LDL), or “bad” cholesterol, is generally considered to be… Well… Bad. Specifically because of how it can functionally narrow arteries, causing bits of floating detritus to get stuck in it, narrow it further, and eventually harden into atherosclerotic plaque, at which point it becomes even harder for the body to clear out.
We wrote about the process here: Demystifying Cholesterol
When it comes to cholesterol, the most common lay understanding (especially under a certain age) is “it’s bad”.
A more informed view (and more common after a certain age) is “LDL cholesterol is bad; HDL cholesterol is good”.
A more nuanced view is “LDL cholesterol is established as significantly associated with (and almost certainly a causal factor of) atherosclerotic cardiovascular disease and related mortality in men; in women it is less strongly associated and may or may not be a causal factor”
We wrote more about that, here: Statins: His & Hers? ← despite most research being on men, statins have very different effects (and side effects) for women, often being relatively less useful, and more dangerous. There are exceptions (for some women’s specific profiles they can still be worthwhile), but the trend is certainly troubling.
What, then, of Sardinia?
Sardinia is well-known for being one of the “Supercentenarian Blue Zones”, a place whose inhabitants enjoy (on average, statistically) unusually healthy longevity. These places have been looked to for clues as to how to live the healthiest life.
For example: From Blue To Green: News From The Centenarian Blue Zones
However, researchers recently were investigating life in a region of Sardinia where a lot of people are aged 90+, and followed the health of 168 of them for up to 6 years (because in the case of those who died during that time, obviously the time was less than 6 years).
Note: because this was specifically a Blue Zones study, they only included participants of whom all four grandparents were born within the Blue Zone—so not, for example, looking at the health of someone who just moved there from New York, say.
They collected a lot of interesting data (of course), but what we’re talking about today is that they found that participants with LDL levels above 130 mg/dL had a significantly longer average survival than those with LDL levels below this threshold. Specifically, a 40% lower mortality risk.
This is interesting, because LDL levels ≥130 mg/dL are considered moderate hypercholesterolemia (i.e., the LDL levels are a bit too high).
However, if the same participants had total cholesterol levels over 250mg/dL, they got no extra survival benefits, and very high cholesterol was still linked with shorter survival.
You can read the paper here: The Cholesterol Paradox in Long-Livers from a Sardinia Longevity Hot Spot (Blue Zone)
But before you reach for the butter…
The researchers have several hypotheses about why these results could be so, including:
- The longevity has less to do with LDL itself, and more to do with the diet, with the ratio of grain to olive oil.
- Most of the participants with higher LDL cholesterol were on antihypertensive drugs, which a) will obviously have a cardioprotective effect, and b) means that their heart health is probably enjoying greater scrutiny, and medical scrutiny can also have a protective effect (indeed, that’s the point of it).
- It was also speculated that the locals of that region may have a genetic defense against the harm of moderate hypercholesterolemia, due to historical exposure to malaria meaning that naturally slightly higher cholesterol levels without increased cardiovascular risk may have been naturally selected-for (i.e. those without it were more likely to die of malaria and not pass on their genes).
Thus, it may be that it’s not so applicable more generally. However, it is still reason to at least re-examine how bad LDL cholesterol actually is, and whether for some demographics it could have a protective factor (much like “overweight” BMI is a protective factor for people over 65).
Still, if you’d like to keep on top of your cholesterol levels, check out:
How To Lower Cholesterol Naturally, Without Statins
Enjoy!
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Strawberries vs Raspberries – Which is Healthier?
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Our Verdict
When comparing strawberries to raspberries, we picked the raspberries.
Why?
They’re both very respectable fruits, of course! But it’s not even close, and there is a clear winner here…
In terms of macros, the biggest difference is that raspberries have moderately more carbs, and more than 3x the fiber. Technically they also have 2x the protein, but that’s a case of “two times almost nothing is still almost nothing”. All in all, and especially for the “more than 3x the fiber” (6.5g/100g to strawberries’ 2g/100g), this one’s an easy win for raspberries.
When it comes to vitamins, strawberries have more vitamin C, while raspberries have more of vitamins A, B1, B2, B3, B5, B6, E, K, and choline. Another clear and easy win for raspberries.
In the category of minerals, guess what, raspberries win this hands-down, too: strawberries are higher in selenium, while raspberries have more calcium, copper, iron, magnesium, manganese, phosphorus, and zinc.
Adding up all the individual wins (all for raspberries), it’s not hard to say that raspberries win the day. Still, of course, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Anise vs Diabetes & Menopause
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What A Daily Gram Of Anise Can Do
Anise, specifically the seed of the plant, also called aniseed, is enjoyed for its licorice taste—as well as its medicinal properties.
Let’s see how well the science lives up to the folk medicine…
What medicinal properties does it claim?
The main contenders are:
- Reduces menopause symptoms
- Reduces blood sugar levels
- Reduces inflammation
Does it reduce menopause symptoms?
At least some of them! Including hot flashes and bone density loss. This seems to be due to the estrogenic-like activity of anethole, the active compound in anise that gives it these effects:
Estrogenic activity of isolated compounds and essential oils of Pimpinella species
1g of anise/day yielded a huge reduction in frequency and severity of hot flashes, compared to placebo*:
*you may be wondering what the placebo is for 1g of a substance that has a very distinctive taste. The researchers used capsules, with 3x330g as the dose, either anise seed or potato starch.
❝In the experimental group, the frequency and severity of hot flashes before the treatment were 4.21% and 56.21% and, after that, were 1.06% and 14.44% at the end of the fourth week respectively. No change was found in the frequency and severity of hot flashes in the control group. The frequency and severity of hot flashes was decreased during 4 weeks of follow up period. P. anisum is effective on the frequency and severity of hot flashes in postmenopausal women. ❞
See for yourself: The Study on the Effects of Pimpinella anisum on Relief and Recurrence of Menopausal Hot Flashes
As for bone mineral density, we couldn’t find a good study for anise, but we did find this one for fennel, which is a plant of the same family and also with the primary active compound anethole:
The Prophylactic Effect of Fennel Essential Oil on Experimental Osteoporosis
That was a rat study, though, so we’d like to see studies done with humans.
Summary on this one: it clearly helps against hot flashes (per the very convincing human study we listed above); it probably helps against bone mineral density loss.
Does it reduce blood sugar levels?
This one got a flurry of attention all so recently, on account of this research review:
Review on Anti-diabetic Research on Two Important Spices: Trachyspermum ammi and Pimpinella anisum
If you read this (and we do recommend reading it! It has a lot more information than we can squeeze in here!) one of the most interesting things about the in vivo anti-diabetic activity of anise was that while it did lower the fasting blood glucose levels, that wasn’t the only effect:
❝Over a course of 60 days, study participants were administered seed powders (5 g/d), which resulted in significant antioxidant, anti-diabetic, and hypolipidemic effects.
Notably, significant reductions in fasting blood glucose levels were observed. This intervention also elicited alterations in the lipid profile, LPO, lipoprotein levels, and the high-density lipoprotein (HDL) level.
Moreover, the serum levels of essential antioxidants, such as beta carotene, vitamin C, vitamin A, and vitamin E, which are typically decreased in diabetic patients, underwent a reversal.❞
That’s just one of the studies cited in that review (the comments lightly edited here for brevity), but it stands out, and you can read that study in its entirety (it’s well worth reading).
Rajeshwari et al, bless them, added a “tl;dr” at the top of their already concise abstract; their “tl;dr” reads:
❝Both the seeds significantly influenced almost all the parameters without any detrimental effects by virtue of a number of phytochemicals, vitamins and minerals present in the seeds having therapeutic effects.❞
Shortest answer: yes, yes it does
Does it fight inflammation?
This one’s quick and simple enough: yes it does; it’s full of antioxidants which thus also have an anti-inflammatory effect:
Review of Pharmacological Properties and Chemical Constituents of Pimpinella anisum
…which can also be used an essential oil, applied topically, to fight both pain and the inflammation that causes it—at least in rats and mice:
❝Indomethacin and etodolac were treated reference drugs for the anti-inflammatory activity. Aspirin and morphine hydrochloride were treated reference drugs for the analgesic activity. The results showed that fixed oil of P. anisum has an anti-inflammatory action more than etodolac and this effect was as strong as indomethacin. P. anisum induces analgesic effect comparable to that of 100 mg/kg Aspirin and 10 mg/kg morphine at 30 th min. of the study❞
Summary of this section:
- Aniseeds are a potent source of antioxidants, which fight inflammation.
- Anise essential oil is probably also useful as a topical anti-inflammatory and analgesic agent, but we’d like to see human tests to know for sure.
Is it safe?
For most people, enjoyed in moderation (e.g., within the dosage parameters described in the above studies), anise is safe. However:
- If you’re allergic to it, it won’t be safe
- Its estrogen-mimicking effects could cause problems if you have (or have a higher risk factor for) breast cancer, ovarian cancer, or endometriosis.
- For most men, the main concern is that it may lower sperm count.
Where to get it?
As ever, we don’t sell it (or anything else), but for your convenience, you can buy the seeds in bulk on Amazon, or in case you prefer it, here’s an example of it available as an essential oil.
Enjoy!
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6 Signs Of Stroke (One Month In Advance)
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Most people can recognise the signs of a stroke when it’s just happened, but knowing the signs that appear a month beforehand would be very useful. That’s what this video’s about!
The Warning Signs
- Persistently elevated blood pressure: one more reason to have an at-home testing kit and use it regularly! Or a smartwatch or similar that’ll do it for you. The reason this is relevant is because high blood pressure can lead to damaging blood vessels, causing a stroke.
- Excessive fatigue: of course, this one can have many possible causes, but one of them is a “transient ischemic attack” (TIA), which is essentially a micro-stroke, and can be a precursor to a more severe stroke. So, we’re not doing the Google MD thing here of saying “if this, then that”, but we are saying: paying attention to the overall patterns can be very useful. Rather than fretting unduly about a symptom in isolation, see how it fits into the big picture.
- Vision problems: especially if sudden-onset with no obvious alternative cause can be a sign of neural damage, and may indicate a stroke on the way.
- Speech problems: if there’s not an obvious alternative explanation (e.g. you’ve just finished your third martini, or was this the fourth?), then speech problems (e.g. slurred speech, trouble forming sentences, etc) are a very worrying indicator and should be treated as a medical emergency.
- Neurological problems: a bit of a catch-all category, but memory issues, loss of balance, nausea without an obvious alternative cause, are all things that should get checked out immediately just in case.
- Numbness or weakness in the extremities: especially if on one side of the body only, is often caused by the TIA we mentioned earlier. If it’s both sides, then peripheral neuropathy may be the culprit, but having a neurologist take a look at it is a good idea either way.
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Want to learn more?
You might also like to read:
Two Things You Can Do To Improve Stroke Survival Chances
Take care!
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