» nutrition

Chubby Neck Becomes the New Normal

Dr. G. Pepper — Fri, 20 Aug 2010 21:30:50 +0000

After reading the latest research on the metabolic hazards associated with chubby necks I am more sensitive to the size of people’s necks then ever. Of course I look at the size of my patient’s neck but people who I pass in the street or supermarket may find me staring. Watching TV a few days ago I was startled by a series of people in one commercial for Quicken Loans who definitely qualify for the metabolic high risk category based on neck chubbiness. One after another the characters in this commercial walk on, outdoing each other in this physical trait. Has the chubby neck become the new normal? If so, the incidence of diabetes and heart disease is sure to continue to rise.

Let me know if you agree with my impression, or am I biased by being an endocrinologist?

Gary Pepper, M.D.
Editor-in-chief, Metabolism.com

Large Neck Size Equals Big Metabolic Problems

Dr. G. Pepper — Wed, 18 Aug 2010 16:10:37 +0000

Large Neck Size Equals Big Metabolic Problems:

A bulging stomach is widely accepted as a sign of poor metabolic health. A recent study published in the August Clinical Endocrinology and Metabolism (95:3701, 2010), finds a chubby neck is likely to hold even a worse prognosis for metabolic health.

The research team evaluated the relationship between waist circumference and neck circumference with levels of blood sugar, good cholesterol (HDL), bad cholesterol (LDL), triglycerides, and insulin resistance, as well as blood pressure. What was found was that neck circumference was a better predictor than waist circumference of elevated blood pressure, LDL, triglycerides and insulin resistance, with lower levels of HDL. All this amounts to a greater risk of cardiovascular disease as neck size increases. As an example, an increase in neck circumference of about one inch is expected to result in a 2.5 point rise in blood pressure.

The authors point out that the neck circumference was a more accurate predictor of cardiovascular risk in women than men. The average neck size for men in this study was about 16 inches (40.5 cm) and about 13.7 inches for women (34 cm).

Alfred Hitchcock, the famous director of suspense movies, made a trademark of his corpulent silhouette with bulging chin and abdomen. Thanks to this research we know his silhouette can signify more than a movie that will thrill you but also a metabolism that will kill you.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

Dear Oprah, It was Fun While it Lasted!

Dr. G. Pepper — Thu, 08 Jul 2010 18:30:19 +0000

It’s over between me and Oprah. If you are a regular reader of metabolism.com you probably know about my proposal to Oprah. Don’t get worked up, it wasn’t a marriage proposal. It was a proposal to create a Diabetes Lifestyles reality show for her new cable network. Here’s the background. Oprah is starting her “Own” network on cable and is hosting a contest for ideas to add to her line up. For the past 6 months visitors to Oprah’s website have been able to view all the ideas submitted by the public and vote for their favorite ones. My idea was to produce a Diabetes Lifestyle reality show called This Sweet Life. Over two months my idea acquired about 60 votes and was still in the running. The problem between Oprah and I started when she asked for a commitment. I’m not phobic about commitments but she asked for too much. In order to stay in the contest I had to commit to taking 6 weeks away from my medical practice to go to Los Angles to participate in filming of the conclusion of the contest. I’m sorry Oprah…I’m already committed to my medical practice so you can’t have me!

Maybe some other time. But it was fun while it lasted.

Gary Pepper, M.D., Editor-in-Chief, metabolism.com

Common Liver Disease Responds to Vitamin E

Dr. G. Pepper — Tue, 18 May 2010 18:40:25 +0000

Vitamin E May Be of Help in Common Liver Disease:

Over the years the medicinal qualities of vitamin E have been both praised and criticized. For decades there has been a debate whether this vitamin could prevent cancer or heart disease. Large studies have pretty much determined that cancer and heart disease don’t respond to vitamin E supplementation. For that reason many physicians believe that vitamin E treatment is worthless for any purpose. This assumption is incorrect. For example, a recent study in the New England of Medicine has shown vitamin E to be of great use in the treatment of a common liver disease resulting from fat accumulation in the liver (steatosis).

The liver normally store some fat but in excess it can lead to inflammation of the liver, a condition called steatohepatitis. In up to 15% of those with steatohepatitis, cirrhosis and liver failure can result. Steatohepatitis itself is relatively common. In my endocrinology practice several patients per day show evidence of this liver disease, manifested as abnormalities on routine liver blood tests. Patients most likely to show characteristic abnormalities on liver blood tests are those with high cholesterol (particularly if taking the cholesterol lowering medications known as statins), diabetes, and obesity. If the blood tests are particularly abnormal an ultrasound of the liver is usually obtained to be sure nothing else is occurring, such as liver cancer or cirrhosis. Simple steatosis itself is generally easy to diagnose on the ultrasound.

A recent study in the New England Journal of Medicine (Volume 362, No. 18) demonstrates that vitamin E is beneficial for treating steatohepatitis. 247 subjects with evidence of steatohepatitis not due to alcohol use or diabetes were given various treatments. The group getting 800 IU vitamin E per day showed a 43% improvement in measures of steatohepatitis. Also examined as a possible treatment for steatohepatitis was Actos (pioglitazone), a popular diabetes drug. Although the results with Actos were promising they weren’t as good as the results with Vitamin E.

As always, the researchers conclude that further studies will be needed to confirm this benefit. Before using vitamin E in your own program be sure to check with your physician first. Vitamin E can act like a blood thinner, so its use in people who have bleeding abnormalities or on drugs that influence blood clotting, is of particular concern.

This article is for educational purposes only and is not intended as medical advice. The disclaimer for metabolism.com applies to this and all my posts.

Gary Pepper, M.D., Editor-in-Chief, metabolism.com

What to expect from a Nutrition Consultation

Clinical Nutritionist — Mon, 17 May 2010 14:31:54 +0000

What exactly is a Nutrition Consultation? That is Question Number One from the public! Well, a nutrition consultation is something that takes into account someone’s medical and weight history; blood work/laboratory values; activity; habits; Calorie, protein, carbohydrate, fat and fluid needs; nutrition support needs and personal goals. A good nutrition assessment will take all of this into account in order to get a full picture of a client and what their specific needs and recommendations are.

A very common issue is that people think they are eating way too much at night and want to cut down on their intake a night. Most of the time, these folks aren’t eating enough during the day and find themselves so hungry at night that they make up for missed meals and more! In this case, I teach that food is the best appetite suppressant around! If you eat good, solid, healthy meals and snacks, you won’t feel so hungry later on in the night.

Of course, sometimes people experience “emotional eating” where they are counting on food to meet an emotional need that they have. At first it may feel like the need is fulfilled. Food is comforting, nurturing, it can seem like a “companion”. HOWEVER, food is fuel, not emotional support. When we mistake food for emotional support, we stop looking for the real, underlying emotional issues that need our attention. That is when food becomes a distraction, a past time, even an addiction. I urge clients to look at food as food and not an emotional crutch or distraction.
On the other end of the spectrum are the folks who need to gain weight and can’t seem to gain no matter what they do. A nutrition consultation will provide an assessment of exactly how many Calories they need to maintain and to gain weight. It will provide guidance for consuming healthy foods and not empty Calories, as well as recommendations for maintaining lean body mass.

Some folks need nutrition support, especially if they are on medications that deplete nutrients. My professional opinion is that the majority of people in this country do not even meet the RDA’s for many nutrients and I believe that the RDA’s need to be updated to reflect current knowledge and research in the science of nutrition.

A Nutrition Consultation will also help dispel the numerous misleading concept about nutrition that are out there floating around on the internet and in the media. I teach people some very basic concepts so that when they look at the latest headlines or listen to what other people have to say about nutrition, they will be armed with knowledge that will help them to judge what it truly best for themselves. So that is a Nutrition Consultation in a NUTshell.
And as always,
Consider having an individualized consultation!
http://www.metabolism.com/beth-ellen-diluglio/

Beth Ellen DiLuglio, MS, RD, CNSD, CCN, LD/N
In regards to this reply please read the our terms of service at:http://www.metabolism.com/legal_disclaimer/

Vitamin B Supplement Harmful in Diabetics?

Dr. G. Pepper — Tue, 04 May 2010 14:40:34 +0000

Several years ago studies suggested that high levels of homocysteine, a naturally occurring amino acid in the blood, could be harmful to cardiac health. B vitamin supplementation is known to lower blood levels of homocysteine. According to the thinking at that time lowering homocysteine levels by taking B vitamins such as B6 and Folic acid should then improve cardiac health. A great deal of publicity surrounding the supposed cardiac benefits of these vitamins led to the promotion of prescription strength B vitamin preparations such as Folbee. These expensive vitamin preparations were then routinely prescribed by physicians for cardiac protective purposes.

Since then several large studies showed no cardiac benefit of lowering homocysteine levels. Worse still, a study just published April 28, 2010 in the Journal of the American Medical Association shows that B vitamin supplementation in diabetics with kidney problems can lead to a doubling of risk of heart attack, stroke or dying. Diabetics with kidney disease are already at higher risk for developing these problems but adding the B vitamins makes the situation much worse. Additionally, kidney function declined faster in those on B vitamin supplements.

The lesson here is to be careful before adopting new therapies based on unsubstantiated research, particularly if you are more vulnerable due to pre-existing medical conditions.

Gary Pepper, M.D., Editor-in-Chief, metabolism.com

Diet Success May Be Genetic

Dr. G. Pepper — Wed, 21 Apr 2010 17:11:39 +0000

Diet Success May be Genetic

A few years ago the book, Eat Right for Your (Blood) Type, was published by Dr. Peter D’Adamo with the premise that our present day nutritional needs are dependent on the types of food available to our genetic ancestors. For example, if your ancient ancestors evolved in a region of the world where protein was plentiful, then your body now requires a protein rich diet to stay healthy. According to the author your blood “type” is the clue to determining your nutritional heritage and your ideal diet type. I was never convinced of the usefulness of this blood type theory but agree that genetics strongly influences the way an individual stores fat and what constitutes their optimal nutritional requirements.

Along these lines recent research points to a connection between success with various weight loss diets and genetic differences between individuals. This was the conclusion of a study known as the A to Z Weight Loss Study. This study compared the results of 300 women who followed one of four possible diets ranging from those low in carbs (Adkins diet) to those low in fats (Ornish diet) to those high in protein (Zone diet). The women were then screened for genetic differences in specific genes that control fat metabolism.

Found was that some participants needed low carbs to lose weight while others required a diet low in fat to achieve weight loss. Analysis of the fat metabolizing genes showed that a specific favorable genetic profile was associated with up to a 6 fold increase in the amount of weight loss achieved with a particular diet. A participant was much more likely to lose weight if they were on the diet that harmonized with their particular genetic type.

How can you tell in advance if you are a carb sensitive or a fat sensitive dieter? For those with access to these experimental genetic tests (conducted by Interleukin Genetics) you could conceivable get the information you need. For the rest of us, starting with one type of diet and switching to the other type if weight loss isn’t achieved seems like a common sense approach.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

Sandy Shares Her Thoughts on Ways to Prevent Diabetes

Dr. G. Pepper — Sat, 17 Apr 2010 14:12:07 +0000

Occasionally, at Metabolism.com, we publish articles sent to us by our members. Here is a contribution by Sandy Harris explaining why maple syrup may possess surprising health benefits. Among the benefits Sandy highlights is a possible link to prevention of diabetes. Metabolism.com welcomes your thoughts on these issues so feel free to post a comment at the bottom of her article.

Sandy writes:

Little Known Ways to Prevent Diabetes with Maple Syrup by Sandy Harris; Guest Writer for Metabolism.com

Are you looking for a natural solution to reduce the risk of diabetes and slow down the growth of cancer cells?
Your search is probably over because recent studies have shown that maple syrup holds the key to these problems.US researchers have found that maple syrup has the ability to substantially decrease the risk of diabetes. The syrup also showed great potential in slowing down the growth of cancerous cells. Maple syrup has thirteen active antioxidant substances.
These antioxidants were previously unknown but were discovered only recently. Because of these antioxidants, researchers have firmed up that maple syrup has a great potential in fighting cancer growth, diabetes, and infections.

Maple Syrup as an Anti Diabetic Food

Considerable amounts of the phytohormone, abscisic acid, are found in maple syrup. This acid is a powerful defense against diabetes and metabolic syndrome, because it encourages the release of insulin through pancreatic cells and enhances fat cells’ sensitivity to insulin. Seeram revealed the results of his tests on Canadian maple syrup during the annual meeting of the American Chemical Society in San Francisco.

Maple Syrup as Your Best Chance against Cancer

A recent study by researchers in Quebec showed that maple syrup has the ability to slow down the growth of cancerous cells. The results of the study were published in the Journal of Medicinal Food. The study was an attempt to test the capability of maple syrup in inhibiting the growth of cancer cells.
The researchers proved that maple syrup is effective against cancer. More specifically, the syrup can significantly slow down cancer growth in the brain, lungs, and prostate. However, the effect of maple syrup on breast cancer cells was less significant.
Better Than Other Anti Cancer Foods
Maple syrup can serve as your tasty alternative in fighting cancer and diabetes. There are many anti cancer foods today like blueberries, tomatoes, broccoli, and carrots. However, recent studies have shown that maple syrup is more effective against cancer compared to other anti cancer foods. Laboratory testing results also show that the syrup is more potent compared to the maple sap
.It is also ideal to use the pure dark syrup rather than the lighter syrup. Dark syrup has high color oxidation. This is the reason why darker maple syrup should be preferred. So if you want a better alternative to fight cancer and diabetes, then your favorite maple syrup is a good option.
Reference: Journal of medicinal food. 01/02/2010; ISSN: 1557-7600, OI: 10.1089/jmf.2009.0029
About the Author – Sandy Harris writes for the diabetic appetizer recipes blog , her personal hobby blog focused on tips to prevent, cure and manage diabetes using healthy snacks and recipes.

Disclaimer for Metabolism.com:
The author’s views do not necessarily reflect the views of Metabolism.com, and this website is not responsible for the research or accuracy of the statements in this article.

Carol Reveals Her Weight Gain Secrets

Dr. G. Pepper — Wed, 14 Apr 2010 15:59:28 +0000

Carol, a member of metabolism.com, recently posted her approach to healthy weight gain. I thought it was interesting enought to post on the main blog. My major concern with her advice is that some people are lactose intolerant and a diet high in dairy products as Carol outlines, could cause severe gastrointestinal symptoms. Many people are unaware they are lactose intolerant since this problem can develop later in life (20’s, 30’s 40’s). As a kid they could eat ice cream, cheese, drink milk without a problem but slowly they develop frequent heart burn, diarrhea, gas etc and fail to attribute it to dairy intake.

Anyway, here is Carol’s secret to weight gain:

Carol writes:

Ok, I found something that helps me to maintain what I have, but as yet I haven’t been able to actually gain any weight: Dairy products, lots of them, and don’t go for the lite or skim version – go for the gold. I have been going through about a gallon to a gallon and a half of soymilk (the one with the extra vanilla in it. Has about 190 calories per serving. Also I make sure to have yogurt every day and I put honey in and granola on top. Cheese and cracker snacks are good too. I have also find that if I do anything physical (walk the dog, work in the yard etc) I need to have a large heavy (but healthy) snack right after and sit quietly for a good 20 or 30 minutes. The key seems to be stay away from the junk food….for most it packs the calories on but for us it burns right through and you just end up not feeling good as your body doesn’t get what it needs.
Take heart – most of you that I am hearing from are much younger (I am 52, 5′5″ and 103 pounds) I have been battling this since I was a kid. I was always told after kids, age 40 etc it would get better – it didn’t for me, but maybe it will for you.

Watch Dr. G. Pepper and Beth Ellen DiLuglio on Youtube

Dr. G. Pepper — Mon, 05 Apr 2010 12:39:05 +0000

We are initiating a series of talks on nutrition by our staff, on Youtube. Click on the video below (or cut and paste the URL into your browser)

Click here to view the embedded video.

to access this informative first session featuring Beth Ellen and Dr. Pepper.

http://www.youtube.com/watch?v=g3peYebK_J0

Your feedback will help us prepare our future programs, so feel free to post your thoughts about our video here or on Youtube!