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Tackling Diabetes, Keeping a Healthy Heart . Type 1 Diabetes The pancreas no longer makes insulin. Type 2 Diabetes The cells of the body resist insulin’s action. Gestational Diabetes Occurs during pregnancy, similar to type 2. . A Lesson from Japan. Diabetes Prevalence in Japan .
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Type 1 Diabetes The pancreas no longer makes insulin. Type 2 Diabetes The cells of the body resist insulin’s action. Gestational Diabetes Occurs during pregnancy, similar to type 2.
Diabetes Prevalence in Japan In adults over age 40: Prior to 1980: 1-5% Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.
Rising Fat Intake in Japan 1955 1965 1975 1985 1994 Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.
Falling Carbohydrate Intake in Japan 1955 1965 1975 1985 1994 Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.
Overweight and Obesity in Japan Prevalence in Men % % % % BMI 25-29.9 BMI ≥ 30 % % % Yoshiike N. Obes Rev 2002;3:183-90. Yoshiike N. Asia Pac J Clin Nutr 2002;11(Suppl 8):S727-31.
Diabetes Prevalence in Japan In adults over age 40: Prior to 1980: 1-5% By 1990: 11-12% Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.
Plant-Based Dietary Intervention in Type 2 Diabetes Funding: National Institute of Diabetes and Digestive and Kidney Diseases, NIHDiabetes Action Research and Education Foundation
Study design: Low-fat vegan diet vs ADA diet guidelines 22-week study with 1-year follow-up Track hemoglobin A1c
Individuals with no medication changes, n = 24 vegan, 33 ADA 8.1 7.9 7.4 7.5 7.2 6.8 P = 0.01
The Glycemic Index: • Invented in 1981 by Dr. David Jenkins. • Separates foods that raise blood sugar quickly from those that raise it slowly.
Glycemic Index at a Glance High-GI Foods: Sugar White and wheat breads White potatoes Most cold cereals Low-GI Replacements: Most fruits Rye or pumpernickel Yams, sweet potatoes Oatmeal, bran cereals
The Glycemic Index does nottake the place of other considerations: • Vegan foods • Low-fat foods
Important A daily multivitamin for vitamin B12. Be alert to medications that can cause hypoglycemia. Check blood glucose regularly. `
Lifestyle Heart TrialDean Ornish, M.D.Preventive Medicine Research Institute Ornish D. Lancet 1990;336:129-33.
Experimental program: 1. Vegetarian foods 2. Half-hour walk daily 3. Manage stress 4. Avoid tobacco Lifestyle Heart Trial Ornish D. Lancet 1990;336:129-33.
Lifestyle Heart Trial Ornish D. Lancet1990;336:129-33.
Raw material for making hormones (estrogens, testosterone) Key ingredient in cell membranes In excess, cholesterol leads to artery blockages Why Do We Have Cholesterol?
Total cholesterol LDL (“bad”) cholesterol HDL (“good”) cholesterol Triglycerides (blood fats) Goals <200 mg/dl <100 mg/dl Women: >55 Men: >45 <150 mg/dl Understanding Your Blood Test
Lowering LDL Avoid: meat, dairy, eggs, hydrogenated oils, tropical oils Increase: oats, beans
Leanest beef 29% • Skinless chicken breast 23% • Sea trout 32% • White tuna 16% • Broccoli 8% • Beans 4% • Rice 1–5% • Potato 1% Fat Content(Percentage of Calories from Fat)
Not the same as fat. In meats, cholesterol is found mainly in the lean portion. Cholesterol is found in animal products. Plant foods have essentially no cholesterol. Cholesterol in Foods
Special Cholesterol-Lowering Foods Soluble fiber (oats, barley, eggplant, okra): 20 grams Soy protein (soy milk, tofu): 40 grams (Whole almonds: 28 grams) (Sterol/stanol-enriched margarine: 2 grams) Listed quantities are for a 2,000-calorie diet Jenkins DJA. JAMA 2003;290:502-510.