Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Posts Tagged ‘diabetes’

Diabetes In Teens More Than Doubles In a Decade

Monday, May 21st, 2012

Twenty three percent of kids ages 12 to 19 in the U.S. now have diabetes or prediabetes, according to a study out today in the journal Pediatrics. A decade ago that figure was just nine percent.

Looking at risk factors for heart disease and stroke in adolescents, researchers from the U.S. Centers for Disease Control and Prevention (CDC) examined data on more than 3,300 adolescents participating in a national survey from 1999 to 2008. Along with the increase in diabetes, they found that:

• 61% of obese teens in the survey had one risk factor for cardiovascular disease – such as high LDL cholesterol, high blood pressure, physical inactivity or diabetes – besides their weight

• 49% of overweight teens had one additional cardiovascular risk factor

• 37% of normal-weight teens had at least one cardiovascular risk factor

“I think this is an eye opener,” says Steven Mittelman, M.D., Ph.D., of the Children’s Hospital Los Angeles Center for Endocrinology, Diabetes & Metabolism, who was not involved in the study. “Parents really need to think about what their kids are eating and what their activity level is. Parents have to step up and help prevent these devastating diseases that last a lifetime.”

One of every three children with diabetes now has type 2 (which used to be called “adult-onset diabetes,” but is now far too common in children to merit that name), and Mittelman points out that the disease is not easily managed in kids. Adults with type 2 diabetes can improve their health with lifestyle changes and medications, but 50 percent of kids diagnosed with type 2 will end up on insulin within five years – and need it for the rest of their lives. “Over time that number will get worse, so eventually most teenagers diagnosed with type 2 diabetes will need insulin,” he says.

The prevalence of obesity among teens did not increase during the study period. “The prevalence of obesity and overweight really plateaued in the last 10 years,” says Mittelman, who credits public education about the obesity epidemic with spurring some progress. There are still far too many overweight kids, “but at least it’s not going up like it was 10 years ago,” he says.

His suggestions for parents looking to improve their kids health:

Pay attention during checkups. Doctors should be checking children’s height, weight and blood pressure at every visit, and taking the time to calculate Body Mass Index (BMI, a measure of height related to weight) for patients. Under some circumstances, they should also test kids’ cholesterol levels, and test for diabetes.

Know your family history. Let your pediatrician know if your child’s parents or grandparents have high cholesterol, diabetes or heart disease. Find out what medications your child’s grandparents take, and share that information as well. “That helps us know what might run in the family,” Mittelman says.

Check out resources that get kids moving. Mittelman recommends the CDC childhood obesity page (cdc.gov/obesity/childhood), Michelle Obama’s Let’s Move! campaign (LetsMove.gov) and your local YMCA (YMCA.org) as great places to start. “I often send my parents who say they have a tough time getting their kids to exercise [to the YMCA],” he says. “They really are focused on healthy weight.”

Mittelman is quick to point out that heart disease and diabetes are just two of the many life-threatening conditions caused by obesity. He specializes in studying the connections between obesity and cancer (and says that 20% of cancers in the U.S. are now caused by obesity). Studies show that many kids carry their weight problems into adulthood, but Mittelman and other experts consider adolescence a key window for change. And much of that change is up to moms and dads.

“Parents do have the power,” he says.

Broccoli and Eggs During Pregnancy Could Program Healthier Babies

Friday, May 11th, 2012

Boosting intake of a nutrient called choline during pregnancy could be the key to decreasing babies’ chances of hypertension and diabetes – for life. That’s the finding from a small study published last week out of Cornell University.

Choline, an essential nutrient similar to the B vitamins, is used in many chemical reactions in the body and is especially important to the central nervous system. It is present in breast milk and routinely added to infant formula, though not common in prenatal vitamins.

Researchers followed a group of 26 third-trimester pregnant women for 12 weeks, providing all of their meals and beverages and monitoring their choline intake. Half of the women consumed the recommended 450 milligrams daily, while the other half took more than double that amount, 930 mg.

Babies born to women taking the higher amount of choline had 33 percent lower concentrations of the hormone cortisol, which is produced in response to stress and raises the body’s blood sugar level, than those whose mothers took less choline. Marie Caudill, Ph.D., RD, associate professor of nutritional sciences at Cornell and lead author of the study, believes the choline impacted the genes involved in cortisol production in the babies, and that the effect should be permanent.

“We would expect that a 33 percent reduction in cortisol concentrations would be enough to [reduce] risk of stress-related diseases throughout life,” says Caudill. “However, we did not follow the babies to assess whether this reduced response to stress was maintained. Additional studies are needed to replicate our study findings and to assess whether this early nutritional manipulation results in changes that last throughout life.”

During pregnancy, Caudill says that choline is especially needed to remove fat from the liver and transport it to other areas of the body, such as the placenta. And animal studies have consistently shown that boosting choline levels in the mother improves lifelong brain function in her offspring.

“We know that there is a high demand for choline during pregnancy and that most women are not consuming the recommended intake levels of 450 mg per day,” says Caudill.

Dietary sources of choline include:

• Egg, 1 large:  125 mg

• Beef steak, 3 oz:  110 mg

• Salmon, 3 oz: 95 mg

• Pork, loin chop, 3 oz:  95 mg

• Chicken breast, 3 oz: 75 mg

• Beef ground, 85% lean, 3 oz: 70 mg

• Milk, 1% low fat, 1 cup: 45 mg

• Baked beans, canned, ½ cup: 40 mg

• Yogurt, low fat, 8 oz: 30 mg

• Broccoli, cooked, ½ cup: 30 mg

• Cauliflower, cooked, ½ cup: 24 mg

Caudill says the boosted choline levels reached by some women in her study were achieved with the help of supplements, and that reaching 930 mg per day would be difficult through diet alone. If further research bears out her findings, supplements could be especially helpful for women experiencing anxiety, depression or even preeclampsia during pregnancy. And while further study is needed to test its potential benefits to Baby, she says there is no harm in mothers taking choline supplements now, as long as they stay below the 3,500 mg per day upper safe level established by the Institute of Medicine.

The study was published online in The Journal of the Federation of American Societies for Experimental Biology.

Type 2 Diabetes Toughest To Treat In Children

Monday, May 7th, 2012

Treatment with medications and lifestyle interventions that have been successful in adults fails in as many as half of children with type 2 diabetes, underscoring the need to get the childhood obesity epidemic under control and prevent the disease in the first place.

Researchers from the University of Pennsylvania School of Nursing looked at 699 overweight children ages 10 to 17 recently diagnosed with type 2 diabetes. They found that treatment with medication commonly used to control diabetes in adults did not help almost half of patients maintain healthy blood sugar levels, forcing those children to begin insulin injections within a year. One in five of the children in the study had a serious complication such as very high blood sugar, and many were hospitalized.

Among various treatment programs, the study found that:

• Treatment with a medication called Metformin (also called Glucophage) alone failed 52 percent of children in the study.

• Treatment with Metformin plus a medication called rosiglitazone (brand name Avandia) failed 39 percent.

• Metformin plus an intensive diet, exercise and weight-loss program failed 47 percent of children. The intervention included a lifestyle coach and a family member designated for support.

Better treatment to manage type 2 diabetes in children is needed, but study author Terri H. Lipman, Ph.D., said prevention is key. “What we have learned is that the effect of the obesity-prone environment of these youths is even more difficult to overcome than we had predicted,” she said in a statement accompanying release of her study, which was published in May in The New England Journal of Medicine.

 

Obesity in Pregnancy Linked to Autism in Kids

Monday, April 9th, 2012

Moms who struggle with diabetes, hypertension or obesity while pregnant are more likely to have children with autism spectrum disorders (ASD) or developmental delays, a new study has revealed.

The findings come on the heels of a well-publicized report by the national Centers for Disease Control, which revealed that autism and ASD diagnoses continue to rise, with one in 88 children in the United States now affected.

In this new study, researchers from the MIND Institute at UC Davis and the Vanderbilt University School of Medicine looked at California children, ages 2 to 5, enrolled in a population-based study from 2003 to 2010. Of the group, 500 had ASD, 200 had developmental delays and 300 were developing typically. The researchers reviewed medical records for the children’s mothers during pregnancy, asked the mothers about a history or diagnosis of diabetes or hypertension, and noted the women’s body-mass indexes (BMIs), a measure of weight related to height.

Women who were obese before pregnancy had a 60 percent higher chance of having a child with ASD, and twice the risk of having a child with a developmental delay. Those with high blood pressure or diabetes before or during pregnancy were also more likely to have children with ASD or delays, but the increase wasn’t statistically significant.

Diabetes during pregnancy has previously been associated with developmental problems in children, but not consistently linked with ASD.

Obesity is a significant risk factor for hypertension and diabetes, and all three conditions impact the body’s ability to regulate blood sugar (glucose). Exposing a developing fetus to too much glucose can trigger a condition called fetal hypoxia (increased metabolism leading to lack of oxygen), as well as iron deficiency – both of which can profoundly impact development of the brain.

The authors point out that nearly 60 percent of U.S. women of childbearing age are overweight, one-third are obese, and 16 percent are at risk of diabetes.  “Our findings raise concerns that these maternal conditions may be associated with neurodevelopmental problems in children and therefore could have serious public health implications,” they note.

The study appears in the April 9 issue of the medical journal Pediatrics.

A Healthy Turnaround – For You and the Kids

Thursday, February 23rd, 2012

The volume of statistics about childhood obesity has exploded along with America’s waistlines. Around 20% of kids ages 6-11 are now obese, putting them at risk for type 2 diabetes, hypertension and heart disease and a host of other health problems. And the chorus of experts raising the alarm about this situation keeps coming back to the same root cause – our diets.

“The American eating style is basically upside down from what it should be,” says Jennifer Nelson, R.D., Associate Medical Editor of The Mayo Clinic Diabetes Diet (Good Books, November 2011). We eat too many fat-filled and cholesterol-laden animal products, and too little fruit, vegetables and whole grains.

Clearly, change is in order, and Nelson wants to start with our view of the word “diet.” “The origin of the word is much broader than the restriction of food,” she explains. The word comes to us from the Greek “diaita,” which means “lifestyle,” or, as Nelson puts it, “what gives you life, enjoyment, vitality.”

In their new book, she and other weight-loss experts at the Mayo Clinic suggest lifestyle changes that can help families do an about-face weight-wise, stave off diabetes and other health problems, and maybe pump up their “enjoyment and vitality” quotient.

The Most Important Meal

The book isn’t specifically targeted at children – especially the portion sizes and eating plan specifics – but Nelson says the habits suggested and types of foods recommended are all healthy and all appropriate for anyone, including kids.

Starting every day with a healthy breakfast is the first habit they suggest for all families. And every day the plan calls for four or more servings of vegetables, three or more servings of fruits, and whole grains whenever possible. Healthy fats like olive oil, vegetable oil and nuts are also encouraged.

Not encouraged are sugar (except what’s found naturally in fruit), outsize portions of meat (the size of a deck of playing cards or bar of soap is enough at mealtime), and full-fat dairy.

Moving toward a diet based on energy density – which means eating foods that are higher in nutrients, fiber and volume so that you have “the biggest bang for your bite,” will help everyone in the family maintain or achieve a healthy weight without feeling deprived.

Adults are advised to snack only on fruits and vegetables, but Nelson says kids shouldn’t adhere to this rule. “Their energy needs are different,” she explains, adding that children filling up on plant-based foods at mealtime will not get enough energy to sustain themselves without substantial snacks, so you can add whole grains and even some nonfat dairy to their between-meals fare.

The ideal is to eat as many natural, whole foods as possible, and stay away from heavily processed foods as much as you can. As a “bonus” habit, consider keeping a food diary.

Keep On Moving

Mayo Clinic experts advise that everyone in the family walk or exercise for at least 30 minutes per day, and that 60 minutes or more is a good goal to work toward. Eating in front of the TV is a definite no-no, and it’s best to balance “screen time” with equal amounts of physical activity.

This can be easier if you do it as a family. Consider heading out the door together to walk the dog or play a game, Nelson suggests. You’re setting an example that could lead to healthier lives for your children. “Mom and Dad are kind of the gatekeepers of a lot of practices, and over time, those practices do become habits,” Nelson says. Eventually those habits impact – for better or worse – children’s health. Turning your own health around is great. “If you pass those habits along to your children, that’s even better,” she says.

A Healthy Inheritance

And because genetic predisposition to diabetes (even type 2) tends to run in families, she Nelson it is essential to address these issues across generations. If a child has a weight problem, “chances are, Mom and Dad are struggling with some nutrition issues, too,” Nelson says.

Rather than being overwhelmed by trying to make a complete lifestyle turnaround at once, Nelson suggests making just one healthy change at a time. “Over time, the cumulative effect will make a big difference,” she explains. “Also, find a way to make these lifestyle changes enjoyable. If you and your family don’t enjoy the food you eat or the activities you do, you are less likely to stick with it. So find foods that your family will enjoy, and find activities that you’ll enjoy, too!”

Despite the dire statistics about the state of America’s weight, Nelson says she is hopeful because many important efforts, such as Michelle Obama’s Get Moving campaign, are beginning to align in an attempt to address the epidemic of childhood inactivity and obesity. “It’s a very tough problem that we’re facing,” she says, “but it takes just one person at a time making a choice to change, and sharing that with their family.”

And that change is about so much more than just putting down the cookies and chips. The idea is to change your family environment and lifestyle so that you can be the best you can be, and be in better balance. “The family unit is at many people’s core,” Nelson says. “What better way of recreating your lifestyle than doing this as a family unit?”

Diabetes Association’s Preferred Test Fails To Spot Kids With Diabetes

Wednesday, November 30th, 2011

diabetesThe number of kids with diabetes has skyrocketed in recent years, and the U.S. Centers for Disease Control now estimates that 2.5 million children should be screened for the disease. To make that screening easier, the American Diabetes Association in 2009 recommended a test called the Hemoglobin A1c – which doesn’t require overnight fasting – as the exclusive diabetes test for children.

But a new study from researchers at Michigan’s C.S. Mott Children’s Hospital found that method fails to identify as many as two thirds children with diabetes. Testing 254 overweight children, the study looked at the following methods:

• 1-hour glucose challenge test, where the patient doesn’t have to fast, drinks 50gm of a sugary substance and has their glucose drawn 1 hour later

• Random glucose, where the patient has glucose drawn without having to fast

• Hemoglobin A1c, a test that measures blood glucose 2 hours after the patient eats

• Fasting glucose, where the patient does not eat or drink for 8-12 hours before testing

• 2-hour glucose tolerance test, where the patient may not eat or drink for 8-12 hours, drinks 75gm of a sugary substance, and has glucose drawn two hours later

“We found that a 1-hour glucose challenge test or a random glucose were the best tests for identifying which kids have prediabetes or diabetes,” says pediatric endocrinologist Joyce M. Lee, M.D., lead author of the study. “We also looked at hemoglobin A1c, which has recently been advocated as a test for diabetes in children and adults, and found that it had poor test performance.”

Lee says that fasting glucose and the 2-hour glucose tolerance test remain the “gold standard for defining prediabetes or diabetes,” but because it’s inconvenient to have kids return for a second office visit for a blood draw, she and colleagues decided to evaluate the nonfasting tests – 1-hour glucose, random glucose and hemoglobin A1c.

Because their study found that hemoglobin A1c missed two of three children that the fasting tests identified as having diabetes or prediabetes, the researchers are urging that the 1-hour glucose or random glucose tests be used in kids instead.

Rat Study Shows the Perils of Snacking

Friday, June 17th, 2011

snack-mouseResearchers studying obesity have found a new, more efficient way to fatten their lab rats: feed them the type of snack foods we humans love most.

During a 15-week study, rats with free access to tasty junk foods such as cookies, chips and processed meats (which the researchers dubbed the “cafeteria diet”) ate more food and gained more weight than those on the lard-based high-fat diets usually used to make them fat. And they gained almost double the weight of those on standard rat chow.

In fact, the snacking rats took in about 30% more calories than the rats eating a high-fat diet, eventually ending up showing warning signs of diabetes. The rats on the high-fat chow actually dropped their food intake by the second week of the study, so that they were taking in the same level of calories as the rats on a healthy diet.

Authors of the study, conducted at the University of North Carolina at Chapel Hill and published in the June issue of the journal Obesity, say they can’t pinpoint what component of the snack foods is causing the pre-diabetes conditions, but that their effect on the snacking rats mimics what is happening to humans who eat these foods regularly.

So next time you find yourself reaching for that bag of chips, maybe consider leaving it for the rats.

Keeping Dads (and Other Men) Healthy

Wednesday, June 16th, 2010

dadtiesWe love them (especially on Father’s Day, which is Sunday), but men just don’t live as long as women. They ignore symptoms, won’t go to the doctor – you know the drill. Here’s a bit of info from the Men’s Health Network on the checkups and screenings men need to stay healthy.

In their 20s and 30s:

  • A complete physical exam at least every two years
  • Blood pressure check every two years
  • Screening for cancers of the thyroid, testicles, lymph nodes, mouth and skin every three years
  • Cholesterol test every five years

In their 40s:

  • A complete physical every year
  • Blood pressure check every two years
  • Cholesterol tests every five years
  • Screening for prostate cancer if they’re in a high-risk group
  • Thyroid, testicular, lymph node, mouth and skin cancer screenings yearly

Starting at age 50, all of the above plus:

  • Colon cancer screening every three to five years
  • Stool test for colon and rectal cancers yearly
  • Screening for prostate cancer yearly

For more information …

Men’s Health Network 

Urology Channel 

Dean & Betty Gallo Prostate Cancer Center 

American Urological Association 

American Cancer Society 

American Heart Association 

Men’s Health Library 

More About Eyes From Bill Nye the Science Guy

Tuesday, June 8th, 2010

A routine eye exam can spot problems with your vision, but it can also point to other serious health conditions — like diabetes. Find out more in this video from wacky Bill Nye.

Detecting Diabetes Before It’s Official

Wednesday, December 30th, 2009

It’s no secret that Americans are getting fatter, and that puts more of us at risk for type 2 diabetes. A recommendation from the American Diabetes Association, published yesterday, would bring those diabetes cases to light before some are even full-fledged through expanded screening with a blood test called A1C.

Unlike other blood glucose tests you might have encountered (especially if you’ve ever been pregnant), you don’t have to prepare for the A1C by fasting, which makes it lots more convenient to administer. The test measures average glucose levels in the blood for the prior 2-3 months, and can be a solid indicator of diabetes or even risk for diabetes.

The test works by measuring the amount of excess glucose linked with hemoglobin proteins in red blood cells (called “glyated hemoglobin” or A1C). This changes about every 120 days as old cells die and are replaced by new ones, thus the 3-month average in the result.

A1C screening is now suggested for everyone over age 45 and everyone with risk factors for diabetes:

  • Family history of the disease
  • Excess weight
  • High blood pressure
  • High cholesterol

Normal range is 5%. A score of 5.7-6.4% is considered “at risk” for diabetes, but if you add 30 minutes of moderately vigorous physical activity to your day, you can reduce your risk of developing diabetes by 60%. The good news? Scores of 6.5% or higher are in the diabetic range, but it takes two consecutive tests to confirm a diagnosis. That gives you a month or two to shape up and improve your score (and your health!).

 Read more about the recommendation …