LIFESTYLE COUNSELING ON A REGULAR BASIS WILL GET YOU THE WANTED RESULTS IN DIABETES HYPERTENSION AND HIGH CHOLESTEROL

Lifestyle Counseling in Routine Care and Long-Term Glucose, Blood Pressure, and Cholesterol Control in Patients With Diabetes
Fritha Morrison, MPH1, Maria Shubina, SCD1 and Alexander Turchin, MD, MS1,2,3⇓
+ Author Affiliations

1Division of Endocrinology, Brigham and Women’s Hospital, Boston, Massachusetts
2Harvard Medical School, Boston, Massachusetts
3Clinical Performance Measurement, Partners HealthCare System, Boston, Massachusetts
Corresponding author: Alexander Turchin, aturchin@partners.org.
Abstract

OBJECTIVE In clinical trials, diet, exercise, and weight counseling led to short-term improvements in blood glucose, blood pressure, and cholesterol levels in patients with diabetes. However, little is known about the long-term effects of lifestyle counseling on patients with diabetes in routine clinical settings.

RESEARCH DESIGN AND METHODS This retrospective cohort study of 30,897 patients with diabetes aimed to determine whether lifestyle counseling is associated with time to A1C, blood pressure, and LDL cholesterol control in patients with diabetes. Patients were included if they had at least 2 years of follow-up with primary care practices affiliated with two teaching hospitals in eastern Massachusetts between 1 January 2000 and 1 January 2010.

RESULTS Comparing patients with face-to-face counseling rates of once or more per month versus less than once per 6 months, median time to A1C <7.0% was 3.5 versus 22.7 months, time to blood pressure <130/85 mmHg was 3.7 weeks versus 5.6 months, and time to LDL cholesterol <100 mg/dL was 3.5 versus 24.7 months, respectively (P < 0.0001 for all). In multivariable analysis, one additional monthly face-to-face lifestyle counseling episode was associated with hazard ratios of 1.7 for A1C control (P < 0.0001), 1.3 for blood pressure control (P < 0.0001), and 1.4 for LDL cholesterol control (P = 0.0013).

CONCLUSIONS Lifestyle counseling in the primary care setting is strongly associated with faster achievement of A1C, blood pressure, and LDL cholesterol control. These results confirm that the findings of controlled clinical trials are applicable to the routine care setting and provide evidence to support current treatment guidelines.

IF THE VEGETARIAN DIET CAN MAKE YOU HAPPIER, WHY ARE THE INDIANS SO MOROSE?

iTHE POINT OF THIS ARTICLE IS NOT ABOUT VEGETARIAN DIET ELSEWHERE THAN USA BECAUSE THE MEAT PRODUCTS ARE SO TAINTED THAT GOING VEGETARIAN IS LIKE DETOXIFYING YOURSELF AND THE SENSE OF WELL BEING COMES FROM THE DE TOXIFICATION..

Vegetarian Diet Could Make You Happier And Less Stressed, Study Shows

Posted: 03/11/2012 10:59 am
By Elizabeth Nolan Brown, for Blisstree.com
Omnivores, take note: Embracing a vegetarian diet could make you happier and less stressed, according to new research published in Nutrition Journal.
The reason comes down to fatty acids: Diets that include meat and fish are higher in arachidonic acid (AA), an animal source of omega-6 fatty acids. Much of the meat Americans eat today is quite high in AA: The average omega-6 to omega-3 fatty acid profile of modern grain-fed meat is 5 times higher than grass-fed meat, like our ancestors ate. And previous research has shown high levels of AA can cause mood-disturbing brain changes.

High-fish diets also mean higher levels of long-chain, or omega-3 fatty acids, like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Both EPA and DHA combat the negative effects of AA. High dietary levels of omega-3 fatty acids are linked to better brain health, better mood and a host of other health benefits. Most health experts recommend an omega-6/omega-3 ratio of about 4:1.

In theory, then, frequent fish eaters should have be protected against the damaging effects of AA because of their higher intake of omega-3 acids. But an earlier study found omnivores reported significantly worse moods than vegetarians, despite higher intakes of EPA and DHA.
In this follow-up study, 39 meat-eating participants were assigned to one of three diets. A control group ate meat, fish or poultry daily; a second group ate fish 3-4 times weekly but no meat; and a third group ate strictly vegetarian. After two weeks, mood scores were unchanged for the fish- and meat-eating groups, but vegetarians reported significantly better moods and less stress.
“Restricting meat, fish, and poultry improved … short-term mood state in modern omnivores,” the researchers concluded.
After two weeks on a vegetarian diet, participants had “negligible amounts” of EPA, DHA and AA in their bodies. Fatty acid levels in the control group were unchanged. Participants in the fish eating group showed 95 to 100% higher levels of EPA and DHA fatty acids—but their omega-6 to omega-3 ratios were still heavily skewed toward omega-6′s.
To work plant sources of omega-3 fatty acids (called ALA) into your diet, try chia seeds, hemp seed, cauliflower and purslane.

Red meat increases death, cancer and heart risk, says study

A diet high in red meat can shorten life expectancy, according to researchers at Harvard Medical School.

The study of more than 120,000 people suggested red meat increased the risk of death from cancer and heart problems.

Substituting red meat with fish, chicken or nuts lowered the risks, the authors said.

The British Heart Foundation said red meat could still be eaten as part of a balanced diet.

The researchers analysed data from 37,698 men between 1986 and 2008 and 83,644 women between 1980 and 2008.

They said adding an extra portion of unprocessed red meat to someone's daily diet would increase the risk of death by 13%, of fatal cardiovascular disease by 18% and of cancer mortality by 10%. The figures for processed meat were higher, 20% for overall mortality, 21% for death from heart problems and 16% for cancer mortality.

The study said: "We found that a higher intake of red meat was associated with a significantly elevated risk of total, cardiovascular disease, and cancer mortality.

"This association was observed for unprocessed and processed red meat with a relatively greater risk for processed red meat."

The researchers suggested that saturated fat from red meat may be behind the increased heart risk and the sodium used in processed meats may "increase cardiovascular disease risk through its effect on blood pressure".

Victoria Taylor, a dietitian at the British Heart Foundation, said: "Red meat can still be eaten as part of a balanced diet, but go for the leaner cuts and use healthier cooking methods such as grilling.

"If you eat processed meats like bacon, ham, sausages or burgers several times a week, add variation to your diet by substituting these for other protein sources such as fish, poultry, beans or lentils."