Fight with Spouse May Worsen Chronic Pain, Other Symptoms

Katie Bohn wrote . . . . . . .

A fight with a spouse may end in hurt feelings, but for those with chronic conditions like arthritis or diabetes, those arguments may have physical repercussions as well, according to researchers.

They found that in two groups of older individuals — one group with arthritis and one with diabetes — the patients who felt more tension with their spouse also reported worse symptoms on those days.

“It was exciting that we were able to see this association in two different data sets — two groups of people with two different diseases,” said Lynn Martire, professor of human development and family studies, Penn State Center for Healthy Aging. “The findings gave us insight into how marriage might affect health, which is important for people dealing with chronic conditions like arthritis or diabetes.”

Martire said it’s important to learn more about how and why symptoms of chronic disease worsen. People with osteoarthritis in their knees who experience greater pain become disabled quicker, and people with diabetes that isn’t controlled have a greater risk for developing complications.

The researchers said that while previous research has shown a connection between satisfying marriages and better health, both physically and psychologically, there’s been a lack of research into how day-to-day experiences impact those with chronic illness.

“We study chronic illnesses, which usually involve daily symptoms or fluctuations in symptoms,” Martire said. “Other studies have looked at the quality of someone’s marriage right now. But we wanted to drill down and examine how positive or negative interactions with your spouse affect your health from day to day.”

Data from two groups of participants were used for the study. One group was comprised of 145 patients with osteoarthritis in the knee and their spouses. The other included 129 patients with type 2 diabetes and their spouses.

Participants in both groups kept daily diaries about their mood, how severe their symptoms were, and whether their interactions with their spouse were positive or negative. The participants in the arthritis and diabetes groups kept their diaries for 22 and 24 days, respectively.

The researchers found that within both groups of participants, patients were in a worse mood on days when they felt more tension than usual with their spouse, which in turn led to greater pain or severity of symptoms.

Additionally, the researchers found that within the group with arthritis, the severity of the patient’s pain also had an effect on tensions with their spouse the following day. When they had greater pain, they were in a worse mood and had greater tension with their partner the next day.

“This almost starts to suggest a cycle where your marital interactions are more tense, you feel like your symptoms are more severe, and the next day you have more marital tension again,” Martire said. “We didn’t find this effect in the participants with diabetes, which may just be due to differences in the two diseases.”

Martire said the results — recently published in the journal Annals of Behavioral Medicine — could potentially help create interventions targeted at helping couples with chronic diseases.

“We usually focus on illness-specific communications, but looking at tension in a marriage isn’t tied to the disease, it’s not a symptom of the disease itself,” Martire said. “It’s a measure you can get from any couple. It suggests to me that looking beyond the illness, to improve the overall quality of the relationship might have some impact on health.”

Source: The Pennsylvania State University


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Using Diet to Prevent and Manage Diabetes

Len Canter wrote . . . . . . . .

Diabetes has become a worldwide epidemic, but you can protect yourself with a healthier diet. And the same type of diet can help you manage diabetes if you already have it.

According to experts at Boston’s Joslin Diabetes Center and the Harvard School of Public Health, specific foods that help reduce your risk include green leafy vegetables, oat cereal, yogurt and dairy products, grapes, apples, blueberries and walnuts. Surprisingly, coffee and decaf java are also on the list.

Though weight loss for people who are overweight is often suggested, the researchers also found that even without weight loss, changing to a healthier diet helps stave off diabetes.

The quality of your fats and carbs matters more than the quantity. That means making choices like whole grains instead of refined ones, while limiting processed carbs in general and choosing fish and chicken in place of red and processed meats. Also, choose plant-based fats rather than animal fats, which also promotes heart health. And aim to add other fruits, vegetables, legumes and nuts, while limiting alcohol and skipping sugary drinks and foods.

If you find it more helpful to follow a set plan, there are many healthful diets that can be tailored to your personal tastes and calorie needs.

Diet Starting Points:

  • Mediterranean diet.
  • Low-glycemic index diet.
  • Moderately low carbohydrate diet.
  • Vegetarian diet.

Keep in mind that it’s never too late to use diet to your advantage, even if you already have diabetes. People enrolled in Joslin’s “Why WAIT” program, which includes a low-carb diet and regular exercise, not only lost weight and maintained it, but were also able to cut their diabetes medications by more than half.

Source: HealthDay


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Vitamin D Deficiency Linked to Greater Risk of Diabetes

Scott LaFee wrote . . . . . . . .

An epidemiological study conducted by researchers at University of California San Diego School of Medicine and Seoul National University suggests that persons deficient in vitamin D may be at much greater risk of developing diabetes.

The findings are reported in the online issue of PLOS One.

The scientists studied a cohort of 903 healthy adults (mean age: 74) with no indications of either pre-diabetes or diabetes during clinic visits from 1997 to 1999, and then followed the participants through 2009. Vitamin D levels in blood were measured during these visits, along with fasting plasma glucose and oral glucose tolerance.

Over the course of time, there were 47 new cases of diabetes and 337 new cases of pre-diabetes, in which blood sugar levels are higher than normal but not yet high enough to be categorized as type 2 diabetes.

For the study, the researchers identified the minimum healthy level of 25-hydroxyvitamin D in blood plasma to be 30 nanograms per milliliter. This is 10 ng/ml above the level recommended in 2010 by the Institute of Medicine, now part of The National Academies, a health advisory group to the federal government. Many groups, however, have argued for higher blood serum levels of vitamin D, as much as 50 ng/ml. The matter remains hotly debated.

“We found that participants with blood levels of 25-hydroxyvitamin D that were above 30 ng/ml had one-third of the risk of diabetes and those with levels above 50 ng/ml had one-fifth of the risk of developing diabetes,” said first author Sue K. Park, MD, in the Department of Preventive Medicine at Seoul National University College of Medicine in South Korea.

Study co-author Cedric F. Garland, DrPH, adjunct professor in the UC San Diego School of Medicine Department of Family Medicine and Public Health, said persons with 25-hydroxyvitamin D levels below 30 ng/ml were considered vitamin D deficient. These persons, the researchers found, were up to five times at greater risk for developing diabetes than people with levels above 50 ng/ml.

Garland, who has previously investigated connections between vitamin D levels and various types of cancer, said the study builds upon previous epidemiological research linking vitamin D deficiency to a higher risk of diabetes. Epidemiological studies analyze the distribution and determinants of health and disease conditions. They do not necessarily prove cause-and-effect.

“Further research is needed on whether high 25-hydroxyvitamin D levels might prevent type 2 diabetes or the transition from pre-diabetes to diabetes,” said Garland. “But this paper and past research indicate there is a strong association.”

Garland and others have long advocated the health benefits of vitamin D. In 1980, he and his late brother Frank C. Garland, also an epidemiologist, published an influential paper that posited vitamin D (produced by the body through exposure to sunshine) and calcium (which vitamin D helps the body absorb) together reduced the risk of colon cancer. The Garlands and colleagues subsequently found associations with breast, lung and bladder cancers.

To reach 25-hydroxyvitamin D levels of 30 ng/ml, Garland said would require dietary supplements of 3,000 to 5,000 international units (IU) per day, less with the addition of moderate daily sun exposure with minimal clothing (approximately 10-15 minutes per day outdoors at noon).

The current recommended average daily amount of vitamin D is 400 IU for children up to 1 year; 600 IU for ages 1 to 70 years (less for pregnant or breastfeeding women) and 800 IU for persons over 70, according to the National Institutes of Health. Higher daily amounts of vitamin D are generally considered safe, but blood serum levels exceeding 125 ng/ml have been linked to adverse side effects, such as nausea, constipation, weight loss, heart rhythm problems and kidney damage.

Source: University of California – San Diego


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Hypertension Plus Prediabetes a Dangerous Duo for the Heart

High blood pressure and prediabetes together may do more harm to the body than either one alone.

The first study of its type looking into the association between slightly elevated blood sugar levels and high blood pressure found that prediabetes didn’t increase cardiovascular risk by itself. But when researchers looked at prediabetes paired with high blood pressure, they found a significant increase in coronary artery disease severity and cardiovascular events.

The study’s senior author Dr. Jian-Jun Li, director and professor at the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing, provided a scenario to explain how the conditions’ coexistence can make matters much worse.

“For example, when there is a crack on the road, the combination of a heavy rainstorm and rolling of vehicles will make it bigger more rapidly than either one alone,” she said.

People should take the conditions seriously. Prediabetes and high blood pressure, also known as hypertension, affect blood vessel integrity. Both conditions could lead to stroke, the second-leading cause of death in the world and a leading cause of disability.

A systolic blood pressure of 120-129 with a diastolic of less than 80 is consider elevated. High blood pressure is defined as a systolic pressure of 130 or above, or a diastolic pressure of 80 or above. Prediabetes is considered to be present when blood sugar or hemoglobin A1c readings are above normal range but not yet in the range of diabetes.

Prediabetes increases the odds of a person developing Type 2 diabetes and its many complications. Diabetes alone is projected to grow by 41 percent worldwide, from 422 million cases in 2014 to 642 million cases in 2040.

That’s in part because prediabetes and diabetes are associated with the growing obesity rate worldwide, which has been called a “global epidemic” by the World Health Organization. Health care costs related to obesity are expected to cost more than $150 billion each year in the United States.

China is also following the trend, said Li. Researchers decided to look at the two chronic diseases “because of the increasing number of either obese or hypertensive people, especially in China.”

The results showed hypertension and prediabetes together elevate cardiovascular risks, which could have implications for most of the U.S. population. About half of all Americans have hypertension and more than a third have prediabetes. (Ninety percent of them don’t even know it, according to the Centers for Disease Control and Prevention.)

The study authors said that special attention should be paid to patients who have both issues.

Dr. Robert Eckel, an endocrinologist and physician-scientist at the University of Colorado Anschutz Medical Campus who wasn’t involved in the study, said its results raise concern. But Eckel, a past president of the American Heart Association, cautions that guidelines for the American College of Cardiology/AHA cardiovascular disease risk estimator use diabetes as a component not prediabetes.

The study was published Wednesday in the journal Hypertension.

Source: HealthDay


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Dietary Fibers Promote Gut Bacteria that Benefit Blood Glucose Control in Type 2 Diabetes

The fight against type 2 diabetes may soon improve thanks to a pioneering high-fiber diet study led by a Rutgers University-New Brunswick professor.

Promotion of a select group of gut bacteria by a diet high in diverse fibers led to better blood glucose control, greater weight loss and better lipid levels in people with type 2 diabetes, according to research published today in Science.

The study, underway for six years, provides evidence that eating more of the right dietary fibers may rebalance the gut microbiota, or the ecosystem of bacteria in the gastrointestinal tract that help digest food and are important for overall human health.

“Our study lays the foundation and opens the possibility that fibers targeting this group of gut bacteria could eventually become a major part of your diet and your treatment,” said Liping Zhao, the study’s lead author and a professor in the Department of Biochemistry and Microbiology, School of Environmental and Biological Sciences at Rutgers University-New Brunswick.

Type 2 diabetes, one of the most common debilitating diseases, develops when the pancreas makes too little insulin – a hormone that helps glucose enter cells for use as energy – or the body doesn’t use insulin well.

In the gut, many bacteria break down carbohydrates, such as dietary fibers, and produce short-chain fatty acids that nourish our gut lining cells, reduce inflammation and help control appetite. A shortage of short-chain fatty acids has been associated with type 2 diabetes and other diseases. Many clinical studies also show that increasing dietary fiber intake could alleviate type 2 diabetes, but the effectiveness can vary due to the lack of understanding of the mechanisms, according to Zhao, who works in New Jersey Institute for Food, Nutrition, and Health at Rutgers-New Brunswick.

In research based in China, Zhao and scientists from Shanghai Jiao Tong University and Yan Lam, a research assistant professor in Zhao’s lab at Rutgers, randomized patients with type 2 diabetes into two groups. The control group received standard patient education and dietary recommendations. The treatment group was given a large amount of many types of dietary fibers while ingesting a similar diet for energy and major nutrients. Both groups took the drug acarbose to help control blood glucose.

The high-fiber diet included whole grains, traditional Chinese medicinal foods rich in dietary fibers and prebiotics, which promote growth of short-chain fatty acid-producing gut bacteria. After 12 weeks, patients on the high-fiber diet had greater reduction in a three-month average of blood glucose levels. Their fasting blood glucose levels also dropped faster and they lost more weight.

Surprisingly, of the 141 strains of short-chain fatty acid-producing gut bacteria identified by next-generation sequencing, only 15 are promoted by consuming more fibers and thus are likely to be the key drivers of better health. Bolstered by the high-fiber diet, they became the dominant strains in the gut after they boosted levels of the short-chain fatty acids butyrate and acetate. These acids created a mildly acidic gut environment that reduced populations of detrimental bacteria and led to increased insulin production and better blood glucose control.

The study supports establishing a healthy gut microbiota as a new nutritional approach for preventing and managing type 2 diabetes.

Source: The State University of New Jersey


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