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Childhood obesity leads to type 2 diabetes, which, as a recent study just revealed is not easily treated with pills. Instead kids in the study quickly needed to learn to inject insulin in order to control their blood sugars. Sticking yourself 4-5 times a day and having to calculate the correct amount of insulin to inject based on what you are planning to eat is no easy task. Just ask any type I diabetic...it's NO fun! And uncontrolled blood sugars lead to a flurry of complications later on that are completely preventable, ie, amputations, digestive problems, neuropathies, blindness, kidney failure, heart disease, stroke, etc, etc.
So my message to you is - do the right thing. PREVENT TYPE 2 DIABETES IN CHILDREN AND YOURSELVES by eating more fresh fruits and vegetables, getting off of the sweets, breads and other carbs and MOVING EVERY DAY. Read below for more details of the study's findings. Have a great day! Dr. M From the AMA (American Medical Association) daily newsletter - "A study on blood sugar control in young patients with type 2 diabetes received moderate print and online coverage. It was the lead story on one national news broadcast and appeared on the front page of one major paper. Most sources portrayed the study's findings as disappointing, and indicative of the difficulties faced by physicians trying to treat young patients with the condition. The CBS Evening News (4/29, lead story, 2:10, Glor) reported that "the release of a new report offers new insight" on how to treat young patients with type 2 diabetes. During a second segment on CBS Evening News (4/29, story 2, 0:50, Glor), Dr. Robin Goland of Columbia University Medical Center discusses the findings. The New York Times (4/30, A10, Grady, Subscription Publication) reports, "As obesity rates in children have climbed, so has the incidence of type 2 diabetes, and" the "study adds another worry: the disease progresses more rapidly in children than in adults and is harder to treat." In a front-page story, the Wall Street Journal (4/30, A1, Winslow, Subscription Publication) reports that the study was published online in the New England Journal of Medicine and presented at the Pediatric Academic Societies meeting. The National Institute for Diabetes and Digestive and Kidney Diseases sponsored the research. The AP (4/30, Chang) reports that that the research included nearly 700 "overweight and obese teens recently diagnosed with diabetes." Participants "had their blood sugar normalized with metformin, then were given one of three treatments to try to maintain that control: metformin alone, metformin plus diet and exercise counseling, or metformin plus a second drug, Avandia [rosiglitazone]." The San Antonio Express-News (4/30, Finley) reports that "even with the aggressive, two-drug treatment, 39 percent of those children lost the ability to produce insulin on their own and had to switch to insulin shots. That was better than the 46.6 percent failure rate for the metformin and lifestyle group, and 52 percent for those only taking metformin." "Perhaps the study's biggest paradox was the failure of exercise and dietary counseling to lead to substantial weight loss large enough to help manage or even reverse the diabetes," the Boston Globe (4/30, Kotz) reports. According to Bloomberg News (4/30, Gale, Gale), "The report didn't say why type 2 diabetes is harder to treat in children, though the researchers suggested the normal growth cycle may be at least partly at fault." HealthDay (4/30, Reinberg) reports that the researchers also found that "blood sugar control was harder to achieve in black and Hispanic children." WebMD (4/30, Boyles) points out that "in September of 2010, while the trial was under way, the FDA placed broad restrictions on Avandia's use following reports of heart attacks and strokes in adults taking the drug." Patients "in the Avandia part of the study continued taking the drug following a safety review, and no serious side effects were reported." MedPage Today (4/30, Fiore) reports, "In an accompanying editorial, David Allen, MD, of the University of Wisconsin in Madison, called the overall findings of the trial 'discouraging' because of the high rates of treatment failure across all three groups.'"
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From Dr. Katz's most recent column...
"Preventive Medicine Column April 26, 2012 Minding Our Business I believe we should diligently regulate food marketing to children. You may believe I should mind my business. I agree with you! There doesn’t seem to be much we can agree on these days across the spectrum of ideologies and politics. But if there is something, it’s that decent adults look out for the well being of children. ‘Loving Parents and Grandparents, Inc.’ could be the most powerful special interest group of all time! The well being of children is, to varying degrees, the business of every responsible adult. And it’s business we should be minding a whole lot better. The evidence that we have failed to mind this business adequately is overwhelming and incontrovertible, and all but common knowledge. Epidemic obesity didn’t ‘happen’ to our kids because of some extra-terrestrial invasion we were powerless to withstand. We let it happen. We made it happen- by what we have chosen to condone and prioritize as a culture. We have made the proliferation and sale of energy-dense, manufactured foods more of a priority than the health of our kids. We have made indulgence of ‘free’ market forces more of a priority than the health of our kids. And so, predictably, the health of our kids has gone where we sent it: to hell in our hand basket. Epidemic childhood obesity is just the visible tip of an iceberg of present, and pending peril. We have widespread type 2 diabetes among our children; a generation ago, this was called “adult onset” diabetes. The proliferation of ever more cardiac risk factors in ever younger people is reported in the medical literature at regular intervals. There is actual coronary disease in adolescents. There is ever more bariatric surgery among teenagers. And we have recent evidence that the rate of stroke has risen 35% in children 5 to 14, with epidemic obesity the only smoking gun on the scene to account for it. All of this is entirely preventable with better use of feet and forks. We don’t need new biomedical advances to eliminate most obesity and 80% of chronic disease; we simply need a societal commitment to use what we already know. And we are even beginning to get some hopeful evidence that when we do so, it works. The rate of childhood obesity has dipped slightly in recent years in both the New York City schools, and among young children in Massachusetts. In both cases, a dedicated effort underlies these modest, but encouraging results. Study after study indicates that the foods most assiduously marketed to children are the foods they would be well advised to minimize or avoid. The foods they would be best advised to eat for health promotion are marketed least, not at all, or ineffectively. The inadequate budgets and modest effects of ‘5 a day’ and subsequent campaigns to encourage produce intake are infamous in public health circles. You might like to think your child is immune to this marketing- and if they aren’t, at least you are. If you think this, I would like to sell you a bridge- and with a little help from Madison Avenue, have no doubt I could do it. Marketing works, and that means we ARE vulnerable to it. It is the art of manipulation, and those who practice it have PhD biologists, psychologists, sociologists, economists, and reams of research on their side. We know it works because they keep spending money on it. We know it works because of innumerable studies that confirm it. And we know it works because occasionally, someone like Brian Wansink of Cornell brings expert marketing knowledge out of the boardroom and into daylight. You may accept that marketing works, but feel that the industry should self-regulate. There are lesser and greater problems with this concept. The lesser problem is that it creates a conflict of interest. How can you do your best job selling what you make when it is also your job not to sell too much of what you make? The business of business is business. The greater problem is- it doesn’t work. We have volumes of real-world research showing business doesn’t regulate itself effectively. It advertises aggressively the foods most likely to harm our kids, and if some avenue of advertising shuts down, they devise a new and generally better one- such as advergaming. The well being of children is everybody’s business, and everybody should mind that children are staring down the barrel of a glow-in-the-dark cheese doodle or sugar laden cereal loop at foreshadowed health and foreshortened lives. So yes, I should mind my business. I’m a parent; this is my business! As for the businesses that profit from selling excesses of new-age candies to babies, we should be minding them a whole lot better than we do. -fin Dr. David L. Katz; www.davidkatzmd.com ; www.turnthetidefoundation.org Per Dr. Weil...
"What Is Tight Jean Syndrome? A friend tells me she has been diagnosed with “tight jean syndrome.” Is this a joke? She swears that her doctor also told her that wearing tight clothes can cause nerve problems, heartburn and lower back pain. He also warned that wearing spike heels can deform the feet. Is any of this true? Answer (Published 3/28/2012) All true. Wearing tight clothes can compress a sensory nerve called the lateral femoral cutaneous nerve that runs from the abdomen through the thigh. The compression can cause numbness, tingling, and a burning pain in the legs above the knees, a condition called "meralgia paresthetica," also known as "tingling thigh syndrome" and now sometimes termed "tight jean syndrome." Tight clothes are not always to blame; weight gain, pregnancy, trauma and diabetes are also associated with compression of the nerve. Another risk: if you combine today's fashionable tight jeans with equally stylish spike heels, you can make matters worse - the shoes push the pelvis forward, which adds to the pressure of the jeans on the relevant nerve. Clinical appraisal suggests that tingling thigh syndrome may affect policemen who wear their guns on their hips and construction workers who wear heavy tool belts. Tight clothes can also cause digestive problems, including abdominal distention and heartburn after eating. This doesn't just apply to young women wearing skintight jeans; it can affect middle-aged men who squeeze into trousers that are too small for them. As far as shoes are concerned, stiletto heels have been linked to many foot problems including hammertoes,bunions, stress fractures and Morton's neuroma, a persistent pain in the ball of the foot caused by thickening of a nerve in response to pressure. High heels also can aggravate Hagland's deformity, bony enlargements on the back of the heels that can be hereditary and that are often seen in individuals whose feet have high arches, those who have a tight Achilles tendon, and those who have a tendency to walk on the outside of the heel. You can have a Hagland's deformity on one foot or both. It shows up as a noticeable bump on the back of the heel, sometimes called a "pump bump." Pressure and rubbing from shoes that have rigid backs such as women's pumps, men's dress shoes, and ice skates can irritate soft tissue near the Achilles tendon, leading to painful bursitis. You can't shrink the bony protrusions, but you can treat bursitis pain and reduce the associated inflammation. Wearing backless or soft-backed shoes can help you avoid further irritating the area. Women who carry large and heavy shoulder bags can also become unwitting victims of fashion. The weight of the bags can throw the back out of line and cause shoulder soreness, stiff neck, muscle strain, joint pain and, sometimes, bad headaches. The obvious solution to this problem is to carry smaller, lighter bags. If you habitually carry a big shoulder bag and have back or neck pain, consider adhering to this advice of the American Chiropractic Association: make sure that the weight of your bag is no more than 10 percent of your body weight. Andrew Weil, M.D." In my opinion...YES! Here's why...(from an excerpt from my hospital's nutrition newsletter. Go SHS!)
"Sugar is considered a form of empty, unnecessary calories in the diet. Despite this, the consumption of sugar has tripled worldwide in the past 50 years. Recent scientific evidence believes that fructose, a dietary sugar often added to commercial foods and beverages, may contribute to liver toxicity as well as a multitude of other chronic diseases. The primary forms in which fructose is added to processed foods are high fructose corn syrup and sucrose. The use of high fructose corn syrup (HFCS) has caused a lot of controversy, but Dr. Sanjay Gupta in a recent interview on “60 Minutes” states that the use of any added sugars in processed foods are equally toxic. Sugar contributes to all of the diseases associated with metabolic syndrome, a group of diseases that increase the risk for Coronary Artery Disease, Stroke and type 2 Diabetes, such as Hypertension, High Triglycerides, and Insulin Resistance. Many public health professionals are now placing added sugars in the same category as alcohol and tobacco in regards to its negative health effects and high costs on society. Metabolic syndrome is estimated to cost the U.S. $150 billion in health-care resources annually. Research also suggests that sugar contains dependence-producing properties in humans, acting on the brain to encourage increased sugar intake. According to the USDA, it is estimated that approximately 16% of American’s total daily calories come from added sugars with the primary source being sugary beverages and grain-based desserts (cakes, cookies ,etc). Of course, a little sugar in an overall balanced diet is not a concern, but what is “a little”? Currently, the American Heart Association recommends that women have no more than 100 calories per day of added sugars (approximately 6 teaspoons) and men no more than 150 calories per day (9 teaspoons). Children should have no more than 4 teaspoons of added sugars a day. A 20 fl. oz. bottle of Coca Cola (the size most often sold in vending machines) contains almost 10 teaspoons of sugar; a bottle of Snapple Lemon Ice Tea contains 11.5 teaspoons. Both beverages exceed the recommended daily amount for all Americans. This is the reason why some health experts are encouraging the U.S. to begin taxing any processed foods that contain added sugars, similar to the use of taxing alcohol and tobacco products. Canada and some European countries already require additional taxes on some sweetened food products. Whether you agree with the idea to tax foods with added sugars or not, reducing added sugar intake in your own diet is a healthy move. See below for some tips on removing excess sugar from the diet. Source: Lustig, RH, Schmidt LA, Brindis CD. Public Health: The toxic truth about sugar. Nature. 2012;482: 27-29. Tips to Cut Back on Added Sugars:
Source: Today Health: MSNBC.com." I sure do! And apparently I'm not alone.
A recent study published in the Journal of Social and Clinical Psychology showed that people with higher "people-pleasing tendencies", defined as "those who tended to put others' needs before their own, worried about hurting others, and were sensitive to criticism, among other behaviors", tended to eat more so as not to hurt the other person involved. Interesting and definitely something to be aware of in social situations. Here's the full article from Medical News Today: "If you are a people-pleaser who strives to keep your social relationships smooth and comfortable, you might find yourself overeating in certain social situations like Super Bowl watch parties. A new study from Case Western Reserve University found that, hungry or not, some people eat in an attempt to keep others comfortable. "They don't want to rock the boat or upset the sense of social harmony," says Julie Exline, a Case Western Reserve psychologist and lead author of the study. Turning down cake or cookies when others are indulging is tough for everyone, but it poses a special problem for people-pleasers, Exline says. If people-pleasers feel a sense of social pressure to eat, they will often eat more in an attempt to match what others around them are eating. But even if people-pleasers overeat in order to keep others comfortable, they may pay an emotional price. "Those who overeat in order to please others tend to regret their choices later. It doesn't feel good to give in to social pressures," Exline says. The research findings were reported in the Journal of Social and Clinical Psychology article, "People-Pleasing through Eating: Sociotropy Presents Greater Eating in Response to Perceived Social Pressure." This study looked at the eating habits, but, Exline says, the same behaviors that affect food consumption can surface in other areas of the individual's life. For example, people-pleasers may feel anxious or guilty if they outperform others in areas such as academics, athletics or relationship success. People-pleasers have a strong desire to avoid posing a threat to others, so they often put a lot of energy into trying to keep others comfortable. Exline led a two-part study of 101 college students (41 men and 60 women) who completed a questionnaire that assessed characteristics for people-pleasing, also known as "sociotropy." Students high in people-pleasing were those who tended to put others' needs before their own, worried about hurting others, and were sensitive to criticism, among other behaviors. After answering these questions along with some other background measures, students were seated with a female actor who was posing as a second participant in the study. The experimenter handed a bowl of M&M candies to the actor, who took a small handful of candies (about 5) before offering the bowl to the participant. After taking the candies, participants reported how many they took and why. Researchers also assessed the number of candies taken. High sociotropy (people-pleasing) scores were associated with taking more candy, both in this laboratory experiment and in a second study involving recall of real-life eating situations. "People-pleasers feel more intense pressure to eat when they believe that their eating will help another person feel more comfortable," Exline says. "Almost everyone has been in a situation in which they've felt this pressure, but people-pleasers seem especially sensitive to it.'" Again, not surprising as fast food products are PRODUCTS, that do not necessarily contain the same nutrients as real FOOD. Suffice it to say, junk food junkies are also probably less likely to exercise routinely, get less omega-3 fatty acids from their diet and are less likely to take part in other healthy activities on a regular basis, such as stress reduction techniques and/or proper sleep. The interesting point about this study is that fast food junkies were found to have a 50% higher risk of depression than those not abstaining from junk food.
It's no surprise that Americans are so depressed and fast food companies are so rich. (although personally, I think they should be outlawed, but who am I to quench capitalistic opportunities? Moderation in everything...) Here's the study blurb from Dr. Weil. "Fast Foods Fueling Depression Here's yet another good reason to avoid fast foods: a new study from Spain and the Canary Islands found that the risk of depression was 51 percent higher in junk-food-junkies than in those who don't indulge. The foods in question were processed bakery items including donuts and croissants, along with the typical fast foods such as hamburgers, hotdogs and pizza. The study found that the more fast food a participant consumed overall, the greater the risk of depression. At the study's outset, none of the 8,964 participants had ever been diagnosed with depression or taken antidepressants. Data on their eating habits was collected via food frequency questionnaires, and then the participants were followed for an average of six months. During that period 493 of them were diagnosed with depression. Those with the greatest consumption of processed baked goods and fast foods were at a much higher risk of being diagnosed with depression than study participants that ate the least amount of junk food or had started to take antidepressants. The investigators also reported that study participants who ate the most fast food and commercial baked goods were more likely to be single and less active. Smoking and working more than 45 hours a week were also common among this group. An earlier studied found a 42 percent increased risk of depression associated with eating fast food. The study was published in the March 2012 issue of Public Health Nutrition." From Journal Watch today. I applaud the ABIM for raising awareness on the need for more discernment in all medical tests and procedures. We are too wasteful!
"The American Board of Internal Medicine, in partnership with nine medical specialty groups, is urging physicians to perform 45 common tests and procedures less frequently, the New York Times reports. The Times notes that unnecessary treatment accounts for an estimated one third of medical spending in the U.S. The initiative, called Choosing Wisely, is aimed at both physicians and patients. Among the tests and treatments being cited: Routine EKGs during physicals MRIs for back pain Antibiotics for mild sinusitis Routine stress cardiac imaging in asymptomatic patients Imaging scans for simple headaches" |
AuthorDr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil. Archives
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