Yoghurt and Diabetes

A March 2022 study by Université Laval and Danone Nutricia Research said, 

• “These metabolites, called branched chain hydroxy acids (BCHA), result from the action of yogurt lactic bacteria on naturally occurring amino acids in milk,”

• “In the group that was not given yogurt, the amount of these metabolites in the bloodstream and in the liver decreased with weight gain. In the yogurt group, the amount of BCHA was partially maintained,” 

• “We also found that an abundance of BCHA in the liver was tied to improved fasting glucose and hepatic triglycerides.” 

• “BCHA are found in fermented dairy products and are particularly abundant in yogurt. Our body produces BCHA naturally, but weight gain seems to affect the process,” 

Two Cups of Grapes a Day with a High-Fat Diet

An August 2022 study by Western New England University found that two cups of grapes a day added to a high-fat diet was helpful for fatty liver and extended lifespans.

sucrose and high fructose corn syrup and health risks

An August 2021 study by University of California, Davis, said,

• “This is the first dietary intervention study to show that consumption of both sucrose- and high fructose corn-sweetened beverages increase liver fat and decrease insulin sensitivity,” 

• “People often have a skewed perspective of aspartame and give sucrose a pass, but this study suggests that consumers should be equally concerned about both major added sugars in our food supply.”

• “Within the span of two weeks, we observed a significant change in liver fat and insulin sensitivity in the two groups consuming sucrose- or high fructose corn syrup-sweetened beverages,” 

• “That’s concerning because the prevalence of fatty liver [nonalcoholic fatty liver disease] and Type 2 diabetes continues to increase globally.”

• “It’s all physiologically connected, although we’re not sure [in what] direction it goes,” 

• “It’s very likely that the mechanism by which we develop metabolic syndrome goes through liver fat and insulin resistance. An increase in liver fat can be benign for a certain amount of time and for certain people. But it can also progress to associated inflammation in liver cells that causes fibrosis and negatively impacts liver function, which can make an individual more prone to liver cancer.”

Rye -v- wheat for weight loss

An October 2021 study by Chalmers University of Technology, Sweden, said,  

• “The results were clear ­– the participants who received rye products lost more weight overall, and their levels of body fat decreased compared to those who received wheat products,” 

• “Although we saw an overall difference in weight loss between the rye and the wheat group, there was also very large variation within those groups. Increasing our understanding of why different people respond differently to the same foods can pave the way for more specifically tailored diets based on individual needs. We are currently investigating whether certain specific bacteria in the intestine might be the explanation behind why some people lost more weight than others who were also on the rye diet,”

• “But surprisingly, in this study, we actually never observed any difference in appetite. We think this may be simply because the method we used to measure appetite was not good enough. We are therefore working on evaluating and developing the method further,”

• “A particularly positive aspect of our study is that the rye products we used are easily attainable in normal supermarkets in Scandinavia and most of Europe. Consumers can therefore act on the new results immediately. It does not require particular effort or dedication to have a diet rich in whole grain rye”,

• “As we continue to look for the exact reasons why, our advice is to choose the rye bread instead of the sifted wheat bread,”

Diet and Diabetes

A September 2021 study by the University of British Columbia and Teesside University said, 

• “Type 2 diabetes can be treated, and sometimes reversed, with dietary interventions,” 

• “However, we needed a strategy to help people implement these interventions while keeping an eye on their medication changes.”

• “Community pharmacists have expertise in medication management and can serve an important role in overall diabetes care,” 

• “When Type 2 diabetes patients follow a very low-carbohydrate or low-calorie diet, there is a need to reduce or eliminate glucose-lowering medications. Community pharmacists are ideally positioned to safely and effectively deliver interventions targeted at reducing diabetes medications while promoting Type 2 diabetes remission.”

• “The intervention was effective in reducing the need for glucose-lowering medications for many in our study,” 

• “This indicates that community pharmacists are a viable and innovative option for implementing short-term nutritional interventions for people with Type 2 diabetes, particularly when medication management is a safety concern.”

The glycemic index and healthier diets

A May 2022 perspective by Food Context, LLC said, 

• “The GI is increasingly used and interpreted as a measure of overall carbohydrate food quality, with some proponents advocating for its broader adoption as a public health tool. However, the GI model doesn’t address nutrient density or translate well to healthy dietary patterns, and its narrow focus on just one dimension of carbohydrate-containing foods may divert public attention away from approaches to improving health that are accessible, affordable, culturally appropriate and environmentally sustainable,”

• “At best, it’s an incomplete gauge of carbohydrate food quality. At worst, it may be counterproductive to achieving the dietary recommendations set forth in the DGA.”

• “The reliability of the GI has been scrutinized since its introduction more than 40 years ago, including critiques about methodology and questions about the relationship between a food’s GI value and true post-meal glycemic response,” 

• “Under the GI model, fat, protein and fiber are treated as entirely independent variables, but that assumption is at odds with current views about our understanding of how eating patterns influence health based on all food and beverage contributions,”

• “The Mediterranean Diet is one example of a dietary pattern that has been associated with reduced disease risk; yet, not every food in a Mediterranean eating pattern is low GI,” 

• “Evidence increasingly suggests that it’s the total diet that counts. Improving the overall quality of an individual’s dietary patterns can have beneficial effects on a variety of diet-related chronic disease, but the effect of any single food choice is mediated by the other foods and beverages eaten, physical activity and other lifestyle choices. While the GI may illuminate some narrow insights, it also keeps many of these relevant variables in the dark.”

Intermittent fasting

A March 2022 study by the University of Illinois Chicago looked at

(1) Alternate-day fasting — consuming 0-500 calories on alternating feast days; 

(2) The 5:2 diet — two fast days and five feast days per week; 

and 

(3) Time-restricted eating — eating only during a prescribed time window each day.

The study said,

• “The main myth is people are going to feel weak and not be able to concentrate during fasting. We’ve shown it is the opposite: They actually have a better ability to concentrate,”

• “With any diet, as you lose weight, your metabolism, like your calorie needs, will go down because they’re correlated tightly with your muscle mass. As you lose weight, people tend to lose a little bit of muscle. But fasting doesn’t tank your metabolism at all. We’ve shown that it is the same that would happen with like traditional dieting,”

Cooking, diabetes and self-management education

An August 2022 study by the Ohio State University Wexner Medical Centre and College of Medicine said, 

• “… Cooking Matters for Diabetes may be an effective method of improving diet-related self-care and health-related quality of life, especially among individuals living with food insecurity…” 

• “Teaching cooking skills has been shown to help reduce the burden of food insecurity. But broader skills required to get food on the table, such as meal planning, shopping, budgeting, food safety and nutrition, are also of critical importance,”

• “We found that study participants ate more vegetables and fewer carbohydrates. We saw improvements, including significant changes in diabetes self-management activities and numerical lowering of A1C among food-insecure study participants. This is important, because food insecurity and a lack of access to nutritious food can make diabetes management and A1C control more difficult,” 

• “Many outcomes improved more substantially among individuals with food insecurity compared to those without. But during the post-intervention follow-up period, the food insecure group experienced greater regression, emphasizing the importance of sustained follow-up in populations made vulnerable related to one or more social determinants of health,”

Dieting plus Higher protein

In a June 2022 study by the Rutgers School of Environmental and Biological Sciences (SEBS) said,

• “It’s somewhat remarkable that a self-selected, slightly higher protein intake during dieting is accompanied by higher intake of green vegetables, and reduced intake of refined grains and added sugar …But that’s precisely what we found.”

• “The impact of self-selected dietary protein on diet quality has not been examined before, to our knowledge, like this,” 

• “Exploring the connection between protein intake and diet quality is important because diet quality is often suboptimal in the U.S., and higher-protein weight loss diets are popular.”

Time restricted eating and diabetes

A July 2022 study by NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, the Netherlands said, 

“Mechanisms underlying the improvement in glucose regulation upon TRE [Time Restricted Eating] remain unclear. Our results show that TRE did not improve peripheral and liver insulin sensitivity, skeletal muscle mitochondrial function, energy metabolism or liver fat content, all of which are known to be affected in T2D [Type 2 Diabetes].” 

They concluded,  

“A daytime 10 h TRE regimen for 3 weeks decreases glucose levels and prolongs the time spent in the normal blood sugar range in adults with T2D as compared with spreading daily food intake over at least 14 h. These data highlight the potential benefit of TRE in T2D”

And “Since our TRE protocol was feasible and safe, and resulted in improved 24 h glucose levels, it would be interesting to examine the impact of 10 h TRE on glucose regulation and insulin sensitivity in type 2 diabetes in the long term to address the clinical relevance of TRE.”

The feeding window and obesity

A May 2021 study by the University of Surrey said,

"Time-restricted feeding has the potential to become an extremely effective tool in the fight against the obesity epidemic facing many countries. However, the study clearly shows that the ability of people to restrict their daily feeding window is dependent on their individual lifestyles.”

The study found that most people could reduce their feeding window by 3 hours.

Diabetes type 2: New Treatment pathway

A June 2021 study from University of Arizona College of Agriculture and Life Sciences and BIO5 Institute, and  Washington University in St. Louis, the University of Pennsylvania and Northwestern University,

• "All current therapeutics for Type 2 diabetes primarily aim to decrease blood glucose. So, they are treating a symptom, much like treating the flu by decreasing the fever,”

• "Obesity is known to be a cause of Type 2 diabetes and, for a long time, we have known that the amount of fat in the liver increases with obesity,”

• "As fat increases in the liver, the incidence of diabetes increases."

• "We found that fat in the liver increased the release of the inhibitory neurotransmitter Gamma-aminobutyric acid, or GABA," 

• "We then identified the pathway by which GABA synthesis was occurring and the key enzyme that is responsible for liver GABA production - GABA transaminase."

• "When the liver produces GABA, it decreases activity of those nerves that run from the liver to the brain. Thus, fatty liver, by producing GABA, is decreasing firing activity to the brain," 

• "That decrease in firing is sensed by the central nervous system, which changes outgoing signals that affect glucose homeostasis."

• "Inhibition of excess liver GABA production restored insulin sensitivity within days," 

• "Longer term inhibition of GABA-transaminase resulted in decreased food intake and weight loss."

gut inflammation and infection

A June 2021 study at Washington University School of Medicine in St. Louis and Cleveland Clinic said,

• "Inflammatory bowel disease has historically been a problem primarily in Western countries such as the U.S., but it's becoming more common globally as more and more people adopt Western lifestyles," 

• "Our research showed that long-term consumption of a Western-style diet high in fat and sugar impairs the function of immune cells in the gut in ways that could promote inflammatory bowel disease or increase the risk of intestinal infections."

• "Obesity wasn't the problem per se,”

• "Eating too much of a healthy diet didn't affect the Paneth cells. It was the high-fat, high-sugar diet that was the problem."

• "This was a short-term experiment, just eight weeks,”

• "In people, obesity doesn't occur overnight or even in eight weeks. People have a suboptimal lifestyle for 20, 30 years before they become obese. It's possible that if you have Western diet for so long, you cross a point of no return and your Paneth cells don't recover even if you change your diet. We'd need to do more research before we can say whether this process is reversible in people."

Overweight -v- Obese

An intriguing March 2021 study by The Ohio State University found that,

• "The impact of weight gain on mortality is complex. It depends on both the timing and the magnitude of weight gain and where BMI started.”

• "The main message is that for those who start at a normal weight in early adulthood, gaining a modest amount of weight throughout life and entering the overweight category in later adulthood can actually increase the probability of survival."

Intermittent Fasting and Belly Fat

A March 2021 study by the University of Sydney on mice found that, 

• "While most people would think that all fat tissue is the same, in fact, the location makes a big difference,"

• "Our data show both visceral and subcutaneous fat undergo dramatic changes during intermittent fasting,"

• "visceral [belly] fat can adapt to repeated fasting bouts and protect its energy store,"

• "This type of adaptation may be the reason why visceral fat can be resistant to weight loss after long periods of dieting."

Fat around the waist

A May 2021 study by Dr Alexis Elias Malavazos, I.R.C.C.S.Policlinico San Donato, San Donato Milanese, Italy, and colleagues, said, 

"Abdominal obesity might predict a high chest X-ray severity score better than general obesity in hospitalised patients with COVID-19. Therefore, in hospital, waist circumference should be measured and patients with abdominal obesity should be monitored closely."

The role of added sugar in fat production

A March 2021 study by the University of Zurich found, 

"Eighty grams of sugar daily, which is equivalent to about 0.8 liters of a normal soft drink, boosts fat production in the liver. And the overactive fat production continues for a longer period of time, even if no more sugar is consumed,"

"The body's own fat production in the liver was twice as high in the fructose group as in the glucose group or the control group - and this was still the case more than twelve hours after the last meal or sugar consumption,”

Visceral fat and cognition

A March 2020 study by Augusta University said,

• "We have moved beyond correlations saying there is a lot of visceral fat here, and there is cognitive decline here so they may be interacting with each other."

• "We have identified a specific signal [proinflammatory protein signal interleukin-1 beta] that is generated in visceral fat, released into the blood that gets through the blood brain barrier and into the brain where it activates microglia and impairs cognition."

• "Obesity-induced inflammation occurs over years and so does inflammation in some … chronic inflammatory diseases."

For visceral fat, BMI (body mass index, dividing weight by height) is inferior to the waist-hip ratio.

Attitudes to Obesity

A March 2020 study by Leeds University said,  

• "…weight stigma and discrimination are common within healthcare settings and affects the quality of care that patients receive."

• "Attributions of personal responsibility can lead to bias... with a person's health status perceived to be within an individual's control, which leads to fault and blame.

•  Obesity is "...a complex, multifaceted health condition that can be caused by, for instance, by genetics, epigenetics, biological, environmental, and societal factors."

• "The most striking difference is that the language used about cancer is positive, reflecting optimism and hope … When compared with obesity, the language is negative, reflecting pessimism, fear and unpleasantness."

The report’s proposals include

1. Using “object descriptions such as "weight" or "excess weight"”

2. Putting “people first - not using 'obese people' but 'people with obesity'”

3. Being “accurate in the description of the complex causes of weight gain”

4. No implying “there is a group of people who do not wish to manage their weight.”

Nobiletin, oranges, weight loss

A March 2020 study by the University of Western Ontaria of sweet oranges and tangerines said,

"We went on to show that we can also intervene with nobiletin,"

"We've shown that in mice that already have all the negative symptoms of obesity, we can use nobelitin to reverse those symptoms, and even start to regress plaque build-up in the arteries, known as atherosclerosis."

"This result told us that nobiletin is not acting on AMP Kinase, and is bypassing this major regulator of how fat is used in the body,"

"What it still leaves us with is the question - how is nobiletin doing this?" [They don’t know yet].

“Obesity and its resulting metabolic syndromes are a huge burden to our health care system, and we have very few interventions that have been shown to work effectively… We need to continue this emphasis on the discovery of new therapeutics."