Fructose Link to Diabetes May be Different for Sodas than Fruit

Lisa Rapaport wrote . . . . . . . . .

Sodas sweetened with fructose may have a greater impact on risk factors for diabetes than whole fruits that are natural sources of fructose, a research review suggests.

The link between fructose and diabetes has been unclear. Some research has suggested this relationship may be explained at least in part by what people eat and drink and whether they are overweight or obese.

For the current analysis, researchers examined data from 155 studies that assessed the effect of different food sources of fructose on blood glucose levels. Combined, these studies included about 5,000 people with and without diabetes.

Fruit and fruit juices as part of a diet with a healthy amount of calories appeared to have a slightly beneficial effect on blood sugar, especially in people with diabetes, the analysis found.

But foods, sodas and juices with lots of calories and few nutrients seemed to have harmful effects on blood sugar.

Most of this evidence was low quality, however, researchers report in the BMJ.

“While this analysis did not find consistent effects of fructose per se on risk for diabetes, results appear to support the adverse effects of added sugars in the form of sugar-sweetened beverages,” said Dr. Mark Herman of Duke University in Durham, North Carolina.

“This analysis also supported potentially beneficial effects of fruit,” Herman, who wasn’t involved in the study, said by email. “It is likely beneficial to restrict consumption of sugar-sweetened beverages, and someone that is craving something sweet might consider a piece of fruit instead.”

Globally, almost one in 10 adults has diabetes, according to the World Health Organization. Most have type 2 diabetes, which is associated with obesity and aging.

Doctors generally advise patients with diabetes and people at high risk for developing the condition to limit sodas, juices and other sugary treats with fructose, sucrose or other sweeteners that add lots of empty calories to the diet. This can help reduce the risk of weight gain, and help keep blood sugar within a healthy range.

Fructose occurs naturally in a range of foods, including whole fruits and vegetables, natural fruit juices and honey. It is also added to foods, such as soft drinks, breakfast cereals, baked goods, sweets, and desserts.

It’s possible fruit and certain other foods with naturally occurring fructose might help improve blood sugar levels because they are high in fiber, which can slow down the release of sugars in the blood stream, the study authors note.

“These findings might help guide recommendations on important food sources of fructose in the prevention and management of diabetes,” senior study author Dr. John Sievenpiper of St. Michael’s Hospital in Toronto said in a statement.

Sievenpiper has received money from a variety of food and beverage companies and advocacy groups including the International Dried Fruit and Nut Council, Calorie Control Council, Dr. Pepper Snapple Group, The Coca- Cola Company, and PepsiCo.

Patients should consume sweets in moderation, limit added sugars, and beware hidden sweeteners in processed foods, said Dr. Valerio Nobili of University La Sapienza in Rome.

“For example, 1 tablespoon of ketchup contains about 4 grams (about 1 teaspoon) of sugars, while a single can of sweetened soda contains up to 40 grams (about 10 teaspoons) of sugars,” Nobili, who wasn’t involved in the study, said by email.

“Both . . . patients with type 2 diabetes and healthy individuals should avoid added sugars while increasing the natural sugars, such as those contained in whole fruit,” Nobili advised.

Source: Reuters


Sweetened Drinks Pose Greater Diabetes Risk than Other Sugary Foods

The findings suggest that fruit and other foods containing fructose seem to have no harmful effect on blood glucose levels, while sweetened drinks and some other foods that add excess “nutrient poor” energy to diets may have harmful effects.

“These findings might help guide recommendations on important food sources of fructose in the prevention and management of diabetes,” said Dr. John Sievenpiper, the study’s lead author and a researcher in the Clinical Nutrition and Risk Factor Modification Centre of St. Michael’s Hospital in Toronto, Canada. “But the level of evidence is low and more high quality studies are needed.”

The role of sugars in the development of diabetes and heart disease attracts widespread debate and increasing evidence suggests that fructose could be particularly harmful to health.

Fructose occurs naturally in a range of foods, including whole fruits and vegetables, natural fruit juices and honey. It is also added to foods, such as soft drinks, breakfast cereals, baked goods, sweets, and desserts as ‘free sugars’.

Current dietary guidelines recommend reducing free sugars, especially fructose from sweetened beverages, but it is unclear whether this holds for all food sources of these sugars.

So researchers based at St. Michael’s and the University of Toronto in Canada analysed the results of 155 studies that assessed the effect of different food sources of fructose sugars on blood glucose levels in people with and without diabetes monitored for up to 12 weeks.

Results were based on four study designs: substitution (comparing sugars with other carbohydrates), addition (energy from sugars added to diet), subtraction (energy from sugars removed from diet), or ad libitum (energy from sugars freely replaced).

Outcomes were glycated haemoglobin or HbA1c (amount of glucose attached to red blood cells), fasting glucose, and fasting insulin (blood glucose and insulin levels after a period of fasting).

Studies were also assessed for bias and certainty of evidence. Overall, no serious risk of bias was detected, but the certainty of evidence was low.

The results show that most foods containing fructose sugars do not have a harmful effect on blood glucose levels when these foods do not provide excess calories. However, a harmful effect was seen on fasting insulin in some studies.

Analysis of specific foods suggest that fruit and fruit juice when these foods do not provide excess calories may have beneficial effects on blood glucose and insulin control, especially in people with diabetes, whereas several foods that add excess “nutrient poor” energy to the diet, especially sweetened drinks and fruit juice, seem to have harmful effects.

The low glycaemic index (GI) of fructose compared with other carbohydrates, and higher fibre content of fruit, may help explain the improvements in blood glucose levels, by slowing down the release of sugars, say the researchers.

They point to some limitations, such as small sample sizes, short follow-up periods, and limited variety of foods in some studies. However, strengths included an in-depth search and selection process and thorough assessment of evidence quality.

As such, they conclude: “Until more information is available, public health professionals should be aware that harmful effects of fructose sugars on blood glucose seem to be mediated by energy and food source.”

Source: EurekAlert!

Exercise and Diabetes

– Diabetes Awareness

Adults — with or without diabetes — need at least 150 minutes of moderate-intensity physical activity per week. Plus, experts also recommend resistance and strength exercises at least twice per week.

Fight Diabetes with Physical Activity

Exercise delays the onset of Type 2 diabetes. And, it improves diabetes control. Whether you have Type 1 or Type 2 diabetes, or if you are at risk for diabetes, get moving!

Physical activity:

  • Raises your heart rate. Whether by walking, jogging, bicycling or swimming, being active gets your heart pumping, which helps your body use insulin more effectively.
  • Improves blood circulation. Exercise also gets the blood to all organs, especially the kidneys, brain, heart and eyes, which can be injured by poor diabetes management.
  • Decreases risk of heart disease. Plus, by reducing LDL cholesterol and blood pressure, regular activity reduces your risk of heart disease.
  • Reduces stress. Stress can increase you risk for developing diabetes. And, for people with diabetes, stress makes it harder to manage the condition.
  • Lowers blood sugar and A1c. Exercising when you have diabetes lowers blood sugar and reduces A1c. It also improves protein and fat metabolism, slowing organ damage.

Check in with Your Doctor

Before beginning a program of physical activity of more than brisk walking, you should be assessed by your doctor. If you are taking insulin, you need to keep a close eye on your carbohydrate intake and how you feel. If your medicine dose is not adjusted properly, you may be at risk for hypoglycemia.

Whether starting your first exercise program or training for an endurance event — such as a marathon or triathlon — increase your training slowly, check your blood sugars, and fuel and hydrate before, during and after exercising. Your goal is to be in the blood glucose range that your health care provider recommends. As your fitness improves, you will reap greater health benefits.

Pick an Activity

Did you know that dancing and gardening count as physical activity? Cleaning counts towards your activity minutes, too. Some examples of moderate physical activity are walking (including at the grocery store and mall), stationary bicycling, swimming, badminton, mowing the lawn and mopping or scrubbing the floor.

Also, you don’t need to get all of your physical activity done at one time — spread it throughout the day and week. Start slowly and build from where you are, then mix it up. Remember, you don’t have to do it all at once; start with as little as 5 minutes and then build up gradually. Try different activities to keep you going and keep you interested.

Resistance exercise includes activities that increase strength and muscle mass. Some examples include body weight exercises such as push-ups and lunges, as well as using resistant bands or free weights.

Fuel Smart for Activity

Your new exercise program may require some changes to how you eat. If you have diabetes, activity can lower your blood sugars and your health care provider may adjust your diabetes medicine. A registered dietitian nutritionist can help you adjust your meal plan so you have the fuel your body needs.

  • Before – A small whole-grain or carbohydrate snack with some protein provides enduring energy for your activity. You’ll need about 150 to 200 calories, as found in ½ cup oatmeal and ½ cup fat-free milk, or a slice of whole-grain bread with a tablespoon of peanut butter.
  • During – If you’re exercising for more than an hour, you may need additional carbohydrates (such as 8 ounces of a sport beverage, half a banana or a handful of raisins) during activity to prevent low blood sugar.
  • After – If you plan to exercise for more than an hour, refuel with a post-workout snack, such as 6 ounces of fat-free yogurt and a small apple.
  • Fluids – Before, during and after exercising, stay hydrated by drinking water. Drink 8 ounces of water before exercise, and continue drinking water so that you have clear urine within two hours of completing your activity. If urine is dark colored, keep drinking water until it is clear.

* * * * * *

3-Step Beginner Walking Plan

Step 1: Get Ready!

  • Wear comfortable clothes and supportive shoes.
  • Set aside time each day for your new activity.
  • Plan your route. An outdoor trail, a gym treadmill, a museum or a shopping mall — there are plenty of options to accommodate for any weather conditions. Recruit a friend or listen to your favorite music or podcast.

Step 2: Get Set!

  • Go at a comfortable pace for you. Ask your doctor for your safe target heart rate.
  • Set a goal based on time or distance:
    • Time-based goal:
      • – Weeks 1-2: Walk 15 minutes a day on 3 days.
      • – Weeks 3-5: Increase walking time to 20 minutes a day on 4 days each week.
      • – Weeks 6-8: Increase walking time by 5 minutes a day with a goal of walking 30 or more minutes on at least 5 days a week.
    • Distance-based goal:
      • – While wearing a pedometer, record your steps each day for a week.
      • – Add 500 steps each day on at least 3 days in the next week.
      • – Increase every few weeks to reach your goal of 8,000 to 10,000 steps daily on at least 5 days per week.

Step 3: Go!

  • Keep a record of your daily and weekly time or distance goals and achievements.
  • If you have diabetes, also record your blood sugar readings before and after exercising.
  • Writing down your progress lets you see your accomplishments and increases your opportunity for success.

Source: Academy of Nutrition and Dietetics

Read also:

What You Can Do to Prevent Diabetes . . . . .

Today’s Comic

For Diabetics, Going Vegan May Boost Mood Along With Health

Dennis Thompson wrote . . . . . . . . .

Diabetes is a formidable foe that can tax the bodies and the spirits of people diagnosed with the blood sugar disease.

But a plant-based diet may help boost the physical and the mental health of unhappy people with type 2 diabetes, a new evidence review reports.

Diabetics who switched to a plant-based diet tended to experience a significant improvement in their emotional well-being, according to the combined findings from 11 prior studies.

The researchers behind the review believe this is because a plant-based diet helped them better control their diabetes.

“They feel more in control of their health, and therefore their mood and overall well-being improves,” said study lead author Anastasios Toumpanakis. He is a doctoral candidate with the University of London, in England.

Diet is central to the control of type 2 diabetes, which affects more than 30 million people in the United States, the researchers said in background notes.

Vegan diets eliminate all animal products from your food, including eggs and dairy, said Rahaf Al Bochi, a registered dietitian nutritionist and spokeswoman for the Academy of Nutrition and Dietetics.

For their evidence review, Toumpanakis and his colleagues collected data on 433 participants in 11 different clinical trials. Of those trials, eight involved fully vegan diets, while the remainder were vegetarian. The trials lasted an average 23 weeks.

People eating plant-based diets experienced an improvement in their physical health and better control of their diabetes, the findings showed.

“These studies demonstrated that this eating pattern helped them to better control their serum glucose [blood sugar] levels, as well as improve their lipid and cholesterol levels,” Toumpanakis said.

People eating the plant-based diets also experienced a marked easing of their diabetes-related nerve pain, with the results suggesting that such an eating plan might slow progressive nerve damage associated with diabetes, the researchers said.

In six of the studies, patients were able to cut down or discontinue drugs they were taking either for their diabetes or for symptoms of diabetes.

The studies also found that people experienced improved psychological well-being. Depression levels dropped, while overall quality of life improved.

“We would say that people with type 2 diabetes following a plant-based diet might be happier because, as the studies suggest, the majority found that through this eating pattern they can have a better control of their condition,” Toumpanakis said.

“If through diet they can have the power to improve their physical symptoms and their glucose levels, and reduce or even stop some of their medication, then this has a huge impact on their quality of life,” he added.

Toumpanakis said there’s nothing to be lost in switching to a plant-based diet, noting that both the American Association of Clinical Endocrinologists and the American College of Endocrinology promote vegetarian or vegan diets as the optimal nutrition plan for people with diabetes.

But the study didn’t prove that a plant-based diet improved the patients’ mental and physical health, just that there was an association.

And Al Bochi isn’t ready to embrace the review’s findings.

She noted that of the 11 studies included in the review, only four tracked the people’s psychological well-being.

“Keeping that in mind, we’re working with very small sample sizes,” Al Bochi said.

Prior studies have shown that food can play a role in a person’s mood, she said, but “whether there’s an exact mechanism with meat products and mood, I’m not sure if there is an actual association.”

In addition, protein can increase the release of dopamine, a neurotransmitter that can help improve mood, she noted.

Al Bochi suggested that people can best control their mood through food by making sure they eat regular meals, to prevent the “hangry” feelings that can come from blood sugar swings.

“There’s a lot of different nutrients we know that can help with mood. I’m not sure if eliminating certain groups like meat products can have a positive effect on mood,” Al Bochi said.

The evidence review was published online in the journal BMJ Open Diabetes Research & Care.

Source: HealthDay

Increasing Vigorous Exercise Decreases Risk of Type Two Diabetes, Cardiovascular Disease in Children

Physical exercise can reduce the risk factors of type 2 diabetes and cardiovascular disease even in children, a new study from the University of Eastern Finland shows. In a two-year follow-up of primary school children, sedentary behaviour increased the accumulation of risk factors, whereas increasing the amount of vigorous exercise reduced it. This is one of the first follow-up studies to reliably demonstrate these associations in children.

The results are based on follow-up data from the Physical Activity and Nutrition in Children (PANIC) Study, ongoing at the University of Eastern Finland. Conducted in collaboration with scientists from the University of Cambridge, the Norwegian School of Sport Sciences and the University of Copenhagen, the findings of the study were published in the Scandinavian Journal of Medicine & Science in Sports.

The two-year follow-up study analysed associations of changes in the amount of vigorous, moderate and light exercise, as well as sedentary behaviour, with risk factors of type 2 diabetes and cardiovascular disease, such as body fat content, waist circumference, blood insulin and glucose levels, blood lipids and blood pressure. The amounts of vigorous, moderate and light exercise, as well as sedentary behaviour, were objectively measured using the Actiheart® device, which records heart rate and body movement. Children wore the Actiheart® device continuously for a minimum of four days, and the measurement period included weekdays and days of the weekend.

During the two-year follow-up, the overall risk and individual risk factors of type 2 diabetes and cardiovascular reduced in children who increased their amount of vigorous exercise. In children whose sedentary behaviour increased, the risk increased as well. These changes were independent of gender, biological maturity and lean body mass, as well as of the levels of risk factors and physical activity measured at the beginning of the study. The study is highly significant, as it is one of the first follow-up studies in the world to reliably show that increasing the amount of vigorous exercise is independently associated with a reduced risk of type 2 diabetes and cardiovascular disease in ordinary primary school children.

“A physically passive lifestyle is gradually becoming alarmingly widespread among children and young people almost all over the world. Our findings provide support for the role of physical activity in preventing common chronic diseases already in childhood,” says Researcher Juuso Väistö, the first author of the article, from the University of Eastern Finland.

He points out that children and young people should engage in more physical exercise than what it takes to go about their daily activities.

“Our findings show that increasing the amount of vigorous exercise and reducing sedentary behaviour are equally important in preventing type 2 diabetes and cardiovascular disease. According to latest recommendations, children need diverse physical activity every day, and at least 60 minutes should be vigorous exercise. In practice, vigorous exercise refers to exercise or games that cause shortness of breath and perspiration.”

Prevention of type 2 diabetes and cardiovascular disease are best begun already in childhood

The PANIC Study has earlier shown that the accumulation of risk factors of type 2 diabetes and cardiovascular disease, which typically exists in people who are overweight, often begins already in childhood. This is a cause for concern, as the accumulation of risk factors in childhood significantly increases the risk of these diseases in adulthood. According to this newly published study, regular exercise and avoiding a physically passive lifestyle constitute efficient means of mitigating the risk factors type 2 diabetes and cardiovascular disease.

PANIC Study — a source of scientifically valuable data on children’s health

The Physical Activity and Nutrition in Children (PANIC) Study is an on-going lifestyle intervention study. A total of 512 children aged 6 to 8 years participated in the onset measurements in 2007-2009. The study applies scientifically sound methods to extensively study the lifestyles, health and well-being of children. The study provides novel information on children’s physical activity, sedentary behaviour, nutrition, physical fitness, body composition, metabolism, cardiovascular system function, brain function, oral health, life quality, effects of exercise and nutrition on children’s health and well-being, and on the effects of these factors on health care costs.

Source: Science Daily