What’s best for type 2 diabetes?
Diabetes is where people lose control of their blood glucose (blood
sugar). Glucose is the basic fuel that the body needs for energy but to get
glucose from the blood into the cells to make that energy, we need the
hormone insulin, which is made in the pancreas – an organ at the back of
the abdomen. In type 1 – or insulin dependent diabetes – the pancreas fails
to produce insulin, whereas in type 2 diabetes – the kind that comes on in
adulthood – the body doesn’t respond to insulin. In other words it resists
the message from insulin to take up glucose and so blood sugar levels rise
and when they rise sufficiently, that’s when type 2 diabetes is diagnosed.
The complications include blindness, kidney failure, heart attacks,
strokes, increased risk of dementia and loss of limbs from artery and nerve
damage.
Type 2 diabetes occurs mostly in older people, usually over 40, and is
caused by a combination of genetic (in their genes) and environmental
(external) factors. Lifestyle influences such as being overweight or obese,
not getting enough exercise, a poor diet and carrying extra weight around
the waist are all big risk factors. Type 2 diabetes is common – perhaps
three times as common as it was 20 years ago – with more than 800,000
Australians diagnosed with the disease. It’s thought that many people
remain undiagnosed as the condition has few symptoms in the early
stages.
Diabetes is a chronic condition meaning it rarely goes away and with the
risk of such serious complications, it’s no surprise some specialists
believe people with diabetes need to get their blood sugar back to normal
aggressively using drugs and insulin. It’s called intensive glucose
lowering and isn’t standard practice in Australia. Doctors here tend to
bring blood sugars down more gently, using diet and increased physical
activity, and slowly introducing medications as they’re needed.
Progressive resistance exercise – weight training – can help to prevent
the onset of diabetes, because the more muscle you have, the better your
insulin behaves. But what if you already have type 2 diabetes? A trial in
Canada compared aerobic exercise, strength training and a combination of
the two. The combined aerobic and resistance exercise improved the control
of blood sugar significantly more than either form of exercise by itself.
So while an intensive program in a gym isn’t for everyone, it may provide
more opportunities for different types of exercise.
Eventually, most people with type 2 diabetes will need medications and
sometimes insulin, to keep their blood sugar levels low enough to minimise
damage to blood vessels, nerves, the heart and kidneys. Early diagnosis
makes a big difference, and remember – losing just 5-10% of your body
weight can delay or even prevent type 2 diabetes, especially for the
obese.
Less meat beats weight gain
It’s not hard to see why eating a lot of meat will make you put on
weight - it’s high in energy and in fat, particularly red and processed
meats. Our lifestyles are increasingly sedentary - meaning we sit around
too much – and when our typical western dietary pattern sees us eat too
much meat, saturated fat and refined carbohydrates, and not enough fruit,
vegetables and fibre, it’s no wonder we’re getting fatter.
We love quick food that’s high in sugar, fat and calories. So many of
the modern diets (The Dukan, for example) try to offer a quick fix by
limiting or removing carbohydrates altogether and increasing protein via
meats, eggs and dairy products like cheese, yoghurt and milk, supposedly
making people feel fuller for longer and decreasing the amount of food they
consume. This often leads to fairly rapid weight loss, however critics say
the weight returns (plus some) when people return to normal patterns of
eating. The effect on cholesterol can be devastating, particularly for
those predisposed to high cholesterol and heart disease.
A five year study from the UK investigated the association between
consumption of meat with weight gain in more than 370,000 men and women.
The researchers looked at participants’ diets and measured their weight and
height, then looked for links between how much meat they ate and annual
weight change. Men consumed more meat than women however excess meat was
associated with weight gain in both men and women, for normal weight and
overweight participants.
This was the case for red meat (beef, veal, pork and lamb), poultry
(chicken, turkey and rabbit was included in this category in some groups)
and processed meat (ham, bacon, sausages, and other meat products mainly
from beef and pork). An increase in meat intake of 250 grams a day (e.g. a
steak at 450 calories) would lead to an additional 2kg after 5 years. Going
‘meatless’ even just a few times a week can help slow or stop weight gain
and improve cholesterol and cardiovascular risk factors. It’s worth a try –
for the sake of our health and our waistlines.
Your Doctor Recipe – take home with you!
Healthy Spinach and Ricotta Rolls
Ingredients
1 onion, chopped
1 clove garlic, crushed
2 large bunches spinach, leaves chopped and thoroughly washed (ends
discarded)
2T water
250g tub low fat ricotta cheese
1t grated nutmeg
1T dried oregano
1 egg
8 sheets filo pastry
1T olive oil
1 egg, whisked (for brushing)
Poppy or sesame seeds to top
Method
Preheat oven to 200°C
In a saucepan, heat 2T water and add onion, garlic and spinach – then
cover with a lid and cook for 5 minutes until spinach is wilted. Remove
from heat and cool, then strain mixture through a colander to remove excess
moisture
In a mixing bowl combine spinach mixture, ricotta cheese, nutmeg,
oregano and egg – mix well until all combined
Work with 4 sheets of pastry at a time. Spread out 2 sheets of pastry on
the bench and brush lightly with olive oil. Top with another two sheets of
pastry and brush lightly with oil again
Spoon spinach mixture along the length of the pastry (all the way to the
ends) and roll up tightly to create one long roll. Repeat with remaining
pastry so you have 2 long rolls in total
Brush tops lightly with the whisked egg and sprinkle with poppy or
sesame seeds
Cut into desired size rolls and place on a lined baking tray
Bake for 15 minutes or until crisp and golden brown, then serve with
tomato sauce or relish
Sausage rolls are usually high in processed meat, saturated fat and
calories. This version has removed the meat and uses filo pastry instead of
puff pastry – saving plenty of calories but keeping that crispy texture and
great taste we love. Great for the kids or for party food!
Trying to lose weight? Spend a bit more time in bed
We all know what it’s like to feel tired and reach for sugary snacks or
junk food to give us an energy boost throughout the day. Our sleeping
habits have been known for some time to be connected with our weight, and
now we know that not getting enough sleep is almost certainly a cause of
being unable to shift unwanted flab. Insufficient sleep affects hormones
that are important to how our appetite is regulated, which increases the
chance of overeating during the day. In a small study, researchers
recruited 10 overweight men and women to live and sleep in a sleep lab for
two separate fortnight-long periods. In one of the sessions they were
allowed to sleep for 8.5 hours a night, and for the other, they were
restricted to just 5.5 hours. All of the volunteers ate the same strictly
monitored, calorie-restricted diet.
They all lost a similar amount of weight under the different sleep
conditions due to the restricted calorie intake. What’s interesting is that
during the sleep-restricted period, people mostly lost muscle, rather than
fat. People who want to lose weight don’t want to lose muscle - less muscle
means a lower metabolic rate, making weight loss more difficult.
During the sleep-deprived period, participants reported greater feelings
of hunger during the day and had higher levels of a blood hormone called
ghrelin which is known to stimulate appetite. If it weren’t for the
controlled laboratory situation and restricted diet, it’s likely these
people would have eaten more.
Losing weight and keeping it off is hard enough, doing it while burning
the candle at both ends and not getting enough sleep may make it
impossible. If you’re trying to lose weight and having trouble, perhaps
have a look at your sleeping patterns to see if they could be contributing
to the problem.
Did You Know?
Watching your favourite sport could be bad for your heart?
It was once a well believed myth that excitement and acute stress could
make you drop dead from a heart attack. Research has suggested this could
be true, especially when it comes to watching highly anticipated sporting
games. German researchers compared heart emergencies around Munich in the
month of the 2006 World Cup to other months of the same year and also the
same month in years during which the World Cup didn’t occur. They also
compared games where Germany was playing to those where it wasn’t.
When Germany was playing there was a four-fold increase in coronary
events in people with known heart disease and the risk doubled for people
with no prior known heart disease. The penalty shoot-out against Argentina
was especially ‘cardio toxic’ - in general the more at stake in the game
and the more tense the contest, the more numbers of heart attacks
increased. The most dangerous period was the first couple of hours from
kick-off. Something to keep in mind next time you settle in to watch the
game!
Myth & Fact
Myth
Menopause is a heart disease trigger
Fact
It was a long held medical belief that women were protected from heart
disease until the menopause set in. The theory was that oestrogen protects
against heart disease and so once menopause arrives, oestrogen levels fall
and as a result heart disease risk increases. However research from the UK
has shown this to be a myth. There’s no spike in heart disease after the
menopause. Age is what counts. Heart disease steadily rises as women
age.
Heart disease is a highly preventable and treatable condition using a
combination of diet, lifestyle and medication, yet it’s still Australia’s
number one killer in women. The focus on heart health in women needs to be
throughout their lives, not just after the menopause.
High blood pressure
High blood pressure claims millions of lives prematurely each year, not
to mention the millions of healthy life years lost as a result of
disabilities from strokes and heart attacks, many of which are caused by
raised blood pressure. In case you’re complacent about your own, research
has shown that many of the people who get into grief are those whose blood
pressure wouldn’t have been classified as being a problem in the first
place.
The important thing to know about your blood pressure is that there
isn’t really a magic number which suddenly says you’ve a problem. What
matters is your total risk of heart disease and stroke. So if you are a bit
overweight, especially around the waist, your cholesterol is up a little
and you’re not getting much exercise, your blood pressure only needs to be
a little up for it to be a real problem.
Your doctor can tell you about your total risk and what to do about it.
The good news about blood pressure is that losing 10% of your body weight
and keeping it off is equivalent to taking a blood pressure pill, as is 30
minutes of moderate exercise on most days of the week, as is reducing your
alcohol and probably salt intake. Something to keep in mind when you next
get your blood pressure checked.
