Monday, 27 December 2010
In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review
Steve T Johnson email, Amanda S Newton email, Meera Chopra email, Jeanette Buckingham email, Terry T-K Huang email, Paul W Franks email, Mary M Jetha email and Geoff DC Ball email
BMC Pediatrics 2010, 10:97doi:10.1186/1471-2431-10-97
There is no high quality evidence to suggest lifestyle modification improves either short- or long-term glycemic control in children and youth with T2D. Additional research is clearly warranted to define optimal lifestyle behaviour strategies for young people with T2D.
Tuesday, 21 December 2010
Phys Ed: The Benefits of Exercising Before BreakfastBy GRETCHEN REYNOLDS
The holiday season brings many joys and, unfortunately, many countervailing dietary pitfalls. Even the fittest and most disciplined of us can succumb, indulging in more fat and calories than at any other time of the year. The health consequences, if the behavior is unchecked, can be swift and worrying. A recent study by scientists in Australia found that after only three days, an extremely high-fat, high-calorie diet can lead to increased blood sugar and insulin resistance, potentially increasing the risk for Type 2 diabetes. Waistlines also can expand at this time of year, prompting self-recrimination and unrealistic New Year’s resolutions.
But a new study published in The Journal of Physiology suggests a more reliable and far simpler response. Run or bicycle before breakfast. Exercising in the morning, before eating, the study results show, seems to significantly lessen the ill effects of holiday Bacchanalias.
For the study, researchers in Belgium recruited 28 healthy, active young men and began stuffing them with a truly lousy diet, composed of 50 percent fat and 30 percent more calories, overall, than the men had been consuming. Some of the men agreed not to exercise during the experiment. The rest were assigned to one of two exercise groups. The groups’ regimens were identical and exhausting. The men worked out four times a week in the mornings, running and cycling at a strenuous intensity. Two of the sessions lasted 90 minutes, the others, an hour. All of the workouts were supervised, so the energy expenditure of the two groups was identical.
Their early-morning routines, however, were not. One of the groups ate a hefty, carbohydrate-rich breakfast before exercising and continued to ingest carbohydrates, in the form of something like a sports drink, throughout their workouts. The second group worked out without eating first and drank only water during the training. They made up for their abstinence with breakfast later that morning, comparable in calories to the other group’s trencherman portions.
The experiment lasted for six weeks. At the end, the nonexercising group was, to no one’s surprise, super-sized, having packed on an average of more than six pounds. They had also developed insulin resistance — their muscles were no longer responding well to insulin and weren’t pulling sugar (or, more technically, glucose) out of the bloodstream efficiently — and they had begun storing extra fat within and between their muscle cells. Both insulin resistance and fat-marbled muscles are metabolically unhealthy conditions that can be precursors of diabetes.
The men who ate breakfast before exercising gained weight, too, although only about half as much as the control group. Like those sedentary big eaters, however, they had become more insulin-resistant and were storing a greater amount of fat in their muscles.
Only the group that exercised before breakfast gained almost no weight and showed no signs of insulin resistance. They also burned the fat they were taking in more efficiently. “Our current data,” the study’s authors wrote, “indicate that exercise training in the fasted state is more effective than exercise in the carbohydrate-fed state to stimulate glucose tolerance despite a hypercaloric high-fat diet.”
Just how exercising before breakfast blunts the deleterious effects of overindulging is not completely understood, although this study points toward several intriguing explanations. For one, as has been known for some time, exercising in a fasted state (usually possible only before breakfast), coaxes the body to burn a greater percentage of fat for fuel during vigorous exercise, instead of relying primarily on carbohydrates. When you burn fat, you obviously don’t store it in your muscles. In “our study, only the fasted group demonstrated beneficial metabolic adaptations, which eventually may enhance oxidative fatty acid turnover,” said Peter Hespel, Ph.D., a professor in the Research Center for Exercise and Health at Catholic University Leuven in Belgium and senior author of the study.
At the same time, the fasting group showed increased levels of a muscle protein that “is responsible for insulin-stimulated glucose transport in muscle and thus plays a pivotal role in regulation of insulin sensitivity,” Dr Hespel said.
In other words, working out before breakfast directly combated the two most detrimental effects of eating a high-fat, high-calorie diet. It also helped the men avoid gaining weight.
There are caveats, of course. Exercising on an empty stomach is unlikely to improve your performance during that workout. Carbohydrates are easier for working muscles to access and burn for energy than fat, which is why athletes typically eat a high-carbohydrate diet. The researchers also don’t know whether the same benefits will accrue if you exercise at a more leisurely pace and for less time than in this study, although, according to Leonie Heilbronn, Ph.D., a professor at the University of Adelaide in Australia, who has extensively studied the effects of high-fat diets and wrote a commentary about the Belgian study, “I would predict low intensity is better than nothing.”
So, unpleasant as the prospect may be, set your alarm after the next Christmas party to wake you early enough that you can run before sitting down to breakfast. “I would recommend this,” Dr. Heilbronn concluded, “as a way of combating Christmas” and those insidiously delectable cookies.
after multiple warnings from the watchdogs, the final study by the epidemiologists from Villejuif hospital has confirmed that around 2000 people in France have died after taking the medication, Mediator..
This particular drug had been banned in the USA but the French kept them on despite mounting evidence of deaths and the doctors continued to prescribe them.
I wonder why two such pharamaceutically advanced countries differ from each other: Avandia is banned in France but allowed to be prescribed in the USA.. in general USA seems to have a more publicized approach to the drugs..
In any case, one by one many of the new touted miracle drugs are getting the exit sign..perhaps it is like describing all the beaches in every country as Paradise on earth, there are just few outstanding beaches... there are drugs which are extraordinary such as Aspirin and the concocted ones which treat an array of symptoms and some people get better. Most of the Oral Anti Diabetes drugs and including injectable drugs such as Byetta (but not insulin ) fall into this category.. In the end, what is new may not be the best, what is tried and proven may be.. such as Insulin introduced 70+ years ago and Aspirin introduced in the 19th century? French scientist Gerhardt 1853!
Friday, 17 December 2010
If there were no Indians in Cuba in 1903 where did they suddenly appear from in 1983 when Cuban born European researchers from Camaguey living in the USA and Mulattos raised in Puerto Rico and New York began "researching" the Indians in Cuba with local cultural prostitutes or jinateros?
Why dont these people come to Cuba and meet up with the Ministry of Culture and present their case for the presence of the Indians in Cuba and solve this questions once and for all? The current minister of Culture in Cuba is Mr Abel Prieto a well educated and well traveled Cuban with an extremely open mind and I am sure he will be willing to listen to these New Indians.
I shall wait to hear of such a meeting so that I can myself correct my understanding or confirm it.