New Study: Nutrition Therapy Can Lower Your Chances of Getting Type 2 Diabetes! Are You at Risk?

Get out your pencil and a piece of paper for the Diabetes Risk Test! Why? A new study shows that people who are at risk for type 2 diabetes can lower that risk by getting medical nutrition therapy from a registered dietitian. The researchers looked randomly put 76 overweight or obese adults with moderately high blood sugar in the “usual care” group or in the nutrition therapy group. The usual care group was told to exercise and eat healthy. The nutrition therapy group got one-on-one nutrition counseling. After 12 weeks, the usual care group’s blood sugar went up. The group who got nutrition counseling saw their blood sugar go down.
Why is this study important? Your insurance may not cover a meeting with a dietitian until you actually get diabetes. Studies like this show the importance of medical nutrition therapy before you get diabetes - at the pre-diabetic stage. 

So, how to you know you are at risk? Take this test on www.diabetes.org

Know Your Risk: 

How old are you?
Less than 40 years (0 points)
40—49 years (1 point)
50—59 years (2 points)
60 years or older (3 points)

Are you a man or a woman?
Man (1 point) Woman (0 points)

If you are a woman, have you ever been diagnosed with gestational diabetes?
Yes (1 point) No (0 points)

Do you have a mother, father, sister, or
brother with diabetes?
Yes (1 point) No (0 points)

Have you ever been diagnosed with high blood pressure?
Yes (1 point) No (0 points)

Are you physically active?
Yes (0 points) No (1 point)

What is your weight status? (Use this Table)

As you can see, being overweight, having a family history, not being physically active, and having high blood pressure are all things that can increase your chances of getting diabetes.

If you scored a 5 or higher, you should talk to your doctor about getting a blood sugar test to see if you have pre-diabetes or diabetes. Your doctor can refer you to a registered dietitian! You can also find a dietitian in your area at eatright.org.

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Reference: Parker A, et al. Abstract #1209. Presented at: Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2015; Nashville, Tenn. 

UAB Study: Life After Breast Cancer and How Exercise Can Help

UAB researchers want to know how to help breast cancer survivors exercise more to lower the chances of the cancer coming back. If you are a breast cancer survivor, you may be able to help by joining the BEAT Cancer Exercise Study!

One of the biggest fears of breast cancer survivors is the cancer coming back. Dealing with the worries, feeling strong, healthy, and confident take time. Researchers are studying ways to lower the chances of the cancer returning. They are also studying ways to help women cope with the stress and worry. Here is what they know so far:  

• Don’t Drink Too Much Alcohol. Drinking alcohol may be related to a higher risk of breast cancer. Drinking large amounts of alcohol seems to stimulate more estrogen production in the body that could increase one type of breast cancer.  So, limit your alcohol intake to no more than one alcoholic beverage a day or fewer. When it comes to alcohol and breast cancer, less is best!

• Stay at a Healthy Weight.  While being overweight before the diagnosis of breast cancer seems to be the strongest predictor of recurrence, many doctors recommend maintaining a healthy weight for better health. Many women gain weight after a breast cancer diagnosis. The numbers could be as high as 60% to 70%. Some studies show that this could increase the risk of breast cancer recurrence and of heart disease. Less exercise, starting menopause, and some breast cancer treatments may be to blame for the increased weight gain.

• Eat Low Fat. Some studies show that a low fat diet can lower the chances of recurrence. Focus on fruits and vegetables, whole grains, and lean meats!

• Get Checked for Vitamin D. Low levels of vitamin D may be related to an increased risk of breast cancer. Taking more is not better, but if your levels are low, you need to get them into the normal, healthy range.

• Stay on Your Medicines. Be sure to stick with your medication regimen that your cancer doctor prescribes. Many women don’t take their medicines as their doctor advises – this could lead to a cancer coming back.

• Exercise! Ten-year survival rates are higher for women who exercise.

And speaking of exercise, here is a great opportunity to help researchers and yourself if you are a breast cancer survivor! UAB researchers are working with the National Cancer Institute on the BEAT Cancer Study. BEAT stands for Better Exercise Adherence for Treatment. They want to see if they can help breast cancer survivors exercise more to lower their stress levels and lower the chances of the cancer coming back.

The 12-week program encourages women to walk at a healthy pace. If you take part in the study, the staff will help you begin an exercise program and monitor your progress. You begin with 20 minutes a day, three times a week and working toward 150 minutes a week. During the program’s first six weeks, you will receive coaching from an exercise specialist and learn how to use a heart-rate monitor.

  

You may qualify for the BEAT study if you:

·       You have had breast cancer

·       Are 19 to 70 years old

·       Do not exercise more than 60 minutes a week

·       205-975-1247 or email moveforward@uab.edu

     Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

 

Taking a Closer Look at Eye Health Supplements

If you’re taking a nutritional supplement for your eyes, you might want to look a little more closely at what’s in it.

Back in 2001, a well-done study by the National Eye institute found that a specific combination of nutrients could slow down the progression of age-related macular degeneration. Macular degeneration is one of the biggest causes of blindness in people over the age of 65.

The landmark study is “AREDS” (Age-Related Eye Disease Study). The researchers randomly assigned over 3600 participants either to a placebo or to a high dose supplement. The researchers found that the participants on the AREDS supplement reduced their risk of progressing to advanced disease by about 25%. The researchers also looked at whether the supplement had an effect on cataracts. It did not.

The supplement only helped people at the intermediate and advanced of macular degeneration. People in the early stages did not see much benefit. So this high-dose supplementation is only for people with intermediate or advanced stage macular degeneration and should only be taken under the supervision of an eye doctor.

The AREDS Formula:

500 mg vitamin C

400 IU’s vitamin E

15 mg beta-carotene OR Lutein/Zeaxanthin
80 mg zinc (as zinc oxide)

2 mg copper (as cupric acid)

These amounts are much higher than what you could get in your diet or in a typical vitamin/mineral supplement.  Of course, after this study came out, sales of eye supplements boomed. But recently some researchers took a look at some popular eye formulas on the market. What they found, is that despite claims to promote eye health, few of them contained the AREDS formula. Many of them marketed themselves as promoting eye health in general when there is really no evidence that they help. ­­­­­­

Eye Formulas that Met Standards:

• PreserVision Supplements
• I-Caps AREDS Formula (although, when I looked at the formulation online, this one does not seem to meet the guidelines)

Eye Vitamins NOT meeting the Standard:

• Eye Science Macular Health Formula 
• Ocuvite Eye Vitamins

Here is a detailed list of supplements with a comparison to the ARED formula. However, when I looked online, some of the supplements on this list that they state are the same as the AREDS formula, did not seem to be the same!

Surprisingly, none of the Ocuvite formulas had the recommended levels of nutrients in the AREDS study. Also, these supplements that did not meet the standards also added a lot of additional nutrients that have not been studied for eye health. So basically for this last list, the makers are making a lot of unproven claims and don’t have the right formula.

The Bottom Line: If you have macular degeneration, talk to your doctor about which eye supplement is best for you.  Read the labels carefully to make sure they have the right combination of nutrients in them.  If you are shopping for the supplement, you need to compare directly the label on the bottle with the information from the National Eye Institute.  And remember, if you do not have macular degeneration, there is no proof that an eye health supplement will help prevent diseases of the eye!

For more information on eye supplements, the ARED study, and advice on whether you need an eye health supplement, visit the National Eye Institute site. 

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Beth's Tasty, Quick Salmon Salad

I am re-publishing this blog on my salmon salad recipe because my segment this week on FOX 6 Good Day Alabama is on the proposed update on the FDA's recommendations on how much fish pregnant women should eat. Instead of the old advise of eat up to 12 ounces of fish a week, the new advise states eat 8 to 12 ounces of fish a week. While this seems like a small, subtle difference, it's actually not. The new advice is saying "you need to eat fish" while the old simply said "eat up to 12 ounces". You can read the FDA's draft of the new proposal here.  

Why the change? More and more research is coming out that shows that the omega 3 fats in some fish can promote brain development in the fetus. The problem is some fish also contains somewhat high levels of mercury which can damage brain development in a fetus. But this advise was met with much criticism that it was not specific enough. Critics said that the recommendation does not specify which fish are highest in omega 3's and also the lowest in mercury. And of course, healthy fish is not just for pregnant women. We all may benefit by adding fish to our diets. Here's a great chart to use to see how many milligrams of omega 3's your favorite fish has. Go to the Natural Resources Defense Council website to see which fish is the lowest in mercury.

One of the best choices - high omega 3's/low mercury - is salmon. So here's my re-issue of my salmon salad recipe so you can have a quick, inexpensive, tasty way of including more salmon in your diet:

I get a lot if requests for recipes. The problem is that I rarely cook with recipes. I just go with what looks right and tastes good. I made this salmon salad out of a desperate need to eat wild Alaskan salmon that didn’t cost an arm and a leg. I’ve never been one for canned salmon – always preferring the fresh. So why not just buy farm raised salmon – which is much less expensive?

Farm raised salmon is more likely to be higher PCB’s (polychlorinated biphenyls) which are harmful to human health in multiple ways. PCB’s were banned in the 70’s. But because of past use and disposal, they’re still part of the environment – and part of our food chain. Farm raised salmon are higher in PCBs mainly because the food they are fed is high in other ground up fish that are high in PCB’s. Wild Alaskan salmon is much lower in PCB’s because their food sources and environment are lower in the contaminant.

The problem with eating wild Alaskan salmon regularly is the cost – often upwards of $14 a pound depending on where you shop. But canned wild Alaskan salmon is inexpensive and it’s still packed with healthy omega 3 fatty acids. I was never crazy about the taste of canned salmon until I concocted this recipe. Forgive me for not giving you exact amounts – just go with what looks and tastes right!

Beth’s Quick and Tasty Salmon Salad:

• 1 6-ounce can wild Alaskan salmon – boneless and skinless (make sure you get boneless and skinless!)
• 2 small (or 1 large) scallions finely chopped
• Seasoning blend to taste (I like Morton’s “Nature’s Seasoning” – it’s a nice blend of salt, pepper, garlic, celery and other nice flavors. You can also use some salt, pepper, garlic and celery powder)
• 1 to 2 tablespoons of Lemonaise (I use the Ojai Cook Lemonaise but you can use any good tasting mayonnaise – the lemon flavor adds a nice zing)

Just blend it all together in a bowl and you’re ready to go. You can eat it as is or put it atop a bed of salad greens.

Enjoy! Let me know if you have any good canned salmon recipes - I need some variations on this theme!

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Diet Drugs That Work – Are They Right for You?

If you’ve ever tried to lose weight and keep it off, you know it’s tough. Many people get lured into over-the-counter gimmicks that are unproved, not approved by the FDA, and may even be dangerous.  But what many people don’t know is that two medicines have been approved by the FDA for long term weight loss. And if you’ve struggled with weight loss over the years, these may give you the boost you need. Interestingly, not many primary care doctors are using these helpful tools to help their obese patients.

Some of this reluctance may be a holdover from the fen-phen fiasco back in the 90’s. Fen-phen was a combination of two drugs – fenfluramine and phentermine that had been FDA-approved separately. When used together, they seemed to speed up weight loss. However, the combination of the two drugs had never been studied nor approved. While it is legal for doctors to prescribe combinations of separately approved medicines in what is called “off label use”, it can be dangerous. This was the case with fen-phen.  The dangerous combination of the two weight loss medicines caused heart valve disease and the fatal disease primary pulmonary hypertension in some patients.

But the good news is that newer and safer weight loss medications are now available. But they are not for everyone. If you just want to lose a few pounds before your high school reunion, your doctor should not prescribe these for you. However if you have:

•   A BMI of 30 or higher

•  A BMI of 27or higher and health problems that are related to body weight like diabetes, high blood pressure or heart disease

Your doctor may consider prescribing one of these medicines for you. To find out what your BMI is, use this BMI Calculator on the Academy of Nutrition and Dietetics website.

Two of the FDA-approved weight loss drugs that are the most effective are:

·       

 Belviq
o   Dose: 10 mg tablet twice a day
 o   How it works: Belviq activates hunger control mechanism in the brain
 o   The research: Researchers tested Belviq in three large clinical studies from 1 to 2 years with a total of 8,000 overweight and obese participants. Almost half (47%) of the people in the studies lost at least 5% of their total body weight after 12 weeks. The participants taking Belviq lost 3 to 3.7% more of their body weight than the participants on the placebo.

·        

  

        Qsymia

o   Dose: the once-a-day dose varies based on how you respond to the medication.

o   How it works: Qsymia is a combination of two medicines: phentermine and

topirmate. The combination reduces appetite (how much you eat) and your desire to eat.

• The research: Researchers tested Qsymia in two large clinical studies that included almost 3,700 overweight and obese participants. On the lowest dose, the participants lost 6.7% more weight than the participants on the placebo . On the recommended dose (the middle dose), participants lost an average of 8.9% more than those on the placebo. Sixty-two percent of the participants on the lowest dose and 70 percent of the participants in the recommended dose groups lost at least 5% of their total body weight compared to 20% of the participants in the placebo group.     

  A very important point to remember here is that all of the participants were still dieting and exercising. None of these medications will magically melt the pounds away – you still need to change your health habits. But they can help you lose weight better than diet and exercise alone. These medications also have possible side effects that you should discuss with your doctor.

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham