Women suffering from diabetes plus depression have a greater risk of dying, especially from heart disease, a new study suggests.In fact, women with both conditions have a twofold increased risk of death, researchers say. “People with both conditions are at very high risk of death,” said lead researcher Dr. Frank B. Hu, a professor of medicine at Harvard Medical School. “Those are double whammies.” When people are afflicted by both diseases, these conditions can lead to a “vicious cycle,” Hu said. “People with diabetes are more likely to be depressed, because they are under long-term psychosocial stress, which is associated with diabetes complications.”
People with diabetes plus depression are less likely to take care of themselves and effectively manage their diabetes, he added. “That can lead to complications, which increase the risk of mortality.” Hu stressed that it is important to manage both the diabetes and the depression to lower the mortality risk. “It is possible that these two conditions not only influence each other biologically, but also behaviorally,” he said.
Type 2 diabetes plus depression are often related to unhealthy lifestyles, including smoking, poor diet and lack of exercise, according to the researchers. In addition, depression may trigger changes in the nervous system that adversely affect the heart, they said.
The report is published in the January issue of the Archives of General Psychiatry.
Commenting on the study, Dr. Luigi Meneghini, an associate professor of clinical medicine and director of the Eleanor and Joseph Kosow Diabetes Treatment Center at the Diabetes Research Institute of the University of Miami Miller School of Medicine, said the findings were not surprising.
“The study highlights that there is a clear increase in risk to your health and to your life when you have a combination of diabetes and depression,” he said. Meneghini noted there are many diabetics with undiagnosed depression. “I am willing to bet that there are quite a number of patients with diabetes and depression walking around without a clear diagnosis.” Patients and doctors need to be more aware that depression is an issue, Meneghini added.
For the study, Hu’s team collected data on 78,282 women who were aged 54 to 79 in 2000 and who were participants in the Nurses’ Health Study. Over six years of follow-up, 4,654 women died, including 979 who died of cardiovascular disease, the investigators found. Women who had diabetes had about a 35 percent increased risk of dying, and those with depression had about a 44 percent increased risk, compared with women with neither condition, the researchers calculated. Those with both conditions had about twice the risk of dying, the study authors found.
When Hu’s team looked only at deaths from heart disease, they found that women with diabetes had a 67 percent increased risk of dying and those with depression had a 37 percent increased risk of death. But women who had both diabetes and depression had a 2.7-fold increased risk of dying from heart disease, the researchers noted.
In the United States, some 15 million people suffer from depression and 23.5 million have diabetes, the researchers say. Up to one-fourth of people with diabetes also experience depression, which is nearly twice as many as among people who don’t have diabetes, they added. “The combination of diabetes and depression needs to be addressed,” Meneghini concluded. He added that patients need to tell their doctors if they are feeling depressed, and doctors also need to be on the lookout for signs of depression in their diabetic patients.
SOURCES: HealthDay News; Frank B. Hu, M.D., Ph.D., professor, medicine, Harvard Medical School, Boston; Luigi Meneghini, M.D., associate professor, clinical medicine and director, Eleanor and Joseph Kosow Diabetes Treatment Center, Diabetes Research Institute, University of Miami Miller School of Medicine; January 2011, Archives of General Psychiatry
New research into the health benefits of beetroot juice suggests it's not only athletes who can benefit from its performance enhancing properties – its physiological effects could help the elderly or people with heart or lung-conditions enjoy more active lives.
Beetroot juice has been one of the biggest stories in sports science over the past year after researchers at the University of Exeter found it enables people to exercise for up to 16% longer. The startling results have led to a host of athletes – from Premiership footballers to professional cyclists – looking into its potential uses. A new piece of research by the university in conjunction with the Peninsula College of Medicine and Dentistry has revealed the physiological effects of drinking beetroot juice could help a much wider range of people.
In the latest study, published in the Journal of Applied Physiology, the researchers looked at low intensity exercise and found that test subjects used less oxygen while walking – effectively reducing the effort it took to walk by 12%. Katie Lansley, a PhD student from the university's Sport and Health Sciences department and lead author of the study, said: “As you get older, or if you have conditions which affect your cardiovascular system, the amount of oxygen you can take in to use during exercise drops considerably. This means that, for some people, even simple tasks like walking may not be manageable. “What we've seen in this study is that beetroot juice can actually reduce the amount of oxygen you need to perform even low-intensity exercise. In principle, this effect could help people do things they wouldn't otherwise be able to do.”
When consumed, beetroot juice has two marked physiological effects. Firstly, it widens blood vessels, reducing blood pressure and allowing more blood flow. Secondly, it affects muscle tissue, reducing the amount of oxygen needed by muscles during activity. The combined effects have a significant impact on performing physical tasks, whether it involves low-intensity or high-intensity effort. So far the research on the impacts of beetroot juice has only been carried out on younger people who are in good health, but the researchers believe there is no reason why the effects of beetroot juice wouldn't help others. “While we haven't yet measured the effects on the elderly or those with heart or lung conditions, there is the potential for a positive impact in these populations which we intend to go on and investigate further,” Katie Lansley added.
Beetroot juice contains high levels of nitrate. The latest study has proved that this is the key ingredient which causes the increase in performance, rather than any other component of the beetroot juice. Professor Andy Jones, the senior scientist on the study and a pioneer of research into beetroot juice, said: “In this study, we were able to use – for the first time – both normal beetroot juice and beetroot juice with the nitrate filtered out. Test subjects didn't know which one they were getting. The drinks both looked and tasted exactly the same. Each time the normal, nitrate-rich juice was used, we saw a marked improvement in performance which wasn't there with the filtered juice – so we know the nitrate is the active ingredient.”
The idea that disease-causing genes can be beneficial is not new. The most clear-cut case involves a gene variant that, when present in two copies, causes sickle cell anaemia, which can result in severe pain, organ damage and death. Although it seems that natural selection would work to eliminate the disorder, the variant remains prevalent in some areas of Africa because people with just a single copy are less susceptible to malaria. Evolutionarily the trade-off is worth it: Far more people are protected from malaria than ever develop sickle cell anaemia even in today’s environment.
Unlike sickle cell anaemia, which is caused by a mutation in just one gene, many complex diseases are associated with several variants – specific locations in the DNA where the nucleotide ‘letters’ vary between individuals. These locations are known as SNPs, for single nucleotide polymorphisms. Some of these SNPs are associated with an increased disease risk, while others protect against developing the disease. When calculating an individual’s overall genetic risk, it’s necessary to consider the net effect of all of his or her variants.
Researchers at Stanford University picked seven well-known conditions to study: type-1 and type-2 diabetes, rheumatoid arthritis, hypertension, Crohn’s disease, coronary artery disease and bipolar disorder. Previous genome wide association studies have identified several hundred SNPs associated with each disorder. Corona found that of the top SNPs associated with type-1 diabetes, 80 have been recently increasing in prevalence, meaning that they underwent positive selection. Of these, a surprising 58 are associated with an increased risk of the disorder, while 22 appear protective. Similarly, SNPs associated with an increased risk for rheumatoid arthritis were found to be positively selected. In contrast to type-1 diabetes and rheumatoid arthritis, Corona found that we’re evolving away from a tendency to develop Crohn’s disease (that is, more protective SNPs than risky SNPs have been positively selected).
Results for the other three disorders – type-2 diabetes, coronary artery disease and bipolar disorder – showed that protective and risky SNPs were positively selected in about equal proportions. ‘Now we’re starting to see little hints as to why this might be the case,’ said Butte. For example, a recent study in another lab showed that genetic variations in an antiviral response gene called IFIH1 that improve its ability to protect against enterovirus infection (and the resulting severe, potentially deadly, abdominal distress) also increase a carrier’s risk for type-1 diabetes. And scientists who study global disease patterns have long noted that the prevalence of tuberculosis varies inversely with that of rheumatoid arthritis.
‘It’s possible that, in areas of the world where associated triggers for some of these complex conditions are lacking, carriers would experience only the protective effect against some types of infectious disease,’ said Butte, who pointed out that the cumulative effect of many SNPs in a person’s genome may buffer the effect of any one variant, even if it did raise a person’s risk for a particular condition.
Regardless of the reason, some evolutionary tenets still apply. Healthier people are, presumably, more likely to reproduce and pass those same genes – be they protective or risky – to their offspring. When conditions changed because of differences in diet, exposures or location as populations move around the globe, carriers of the risky SNPs began to develop the conditions we struggle with today.
Corona and Butte are now expanding their investigation to include even more SNPs and diseases. They are also looking at the genetic profile of various types of tumours to see if there’s evidence for positive evolutionary pressure there as well.
‘Even though we’ve been finding more and more genetic contributions to disease risk,’ said Butte, ‘that’s not really an appealing answer. There have got to be some other reasons why we have these conditions.’
Source: Stanford University Medical Centre
The study, to be published in the journal Pain, found that particular areas of the brain were less active as meditators anticipated pain, as induced by a laser device. Those with longer meditation experience (up to 35 years) showed the least anticipation of the laser pain.
Dr Brown, who is based in the University's School of Translational Medicine, found that people who meditate also showed unusual activity during anticipation of pain in part of the prefrontal cortex, a brain region known to be involved in controlling attention and thought processes when potential threats are perceived.
He said: “The results of the study confirm how we suspected meditation might affect the brain. Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events. This may be why meditation is effective at reducing the recurrence of depression, which makes chronic pain considerably worse.”
Dr Brown said the findings should encourage further research into how the brain is changed by meditation practice. He said: “Although we found that meditators anticipate pain less and find pain less unpleasant, it's not clear precisely how meditation changes brain function over time to produce these effects.
“However, the importance of developing new treatments for chronic pain is clear: 40% of people who suffer from chronic pain report inadequate management of their pain problem.”
In the UK, more than 10 million adults consult their GP each year with arthritis and related conditions. The estimated annual direct cost of these conditions to health and social services is £5.7 billion.
Study co-author Professor Anthony Jones said: “One might argue that if a therapy works, then why should we care how it works? But it may be surprising to learn that the mechanisms of action of many current therapies are largely unknown, a fact that hinders the development of new treatments. Understanding how meditation works would help improve this method of treatment and help in the development of new therapies.
“There may also be some types of patient with chronic pain who benefit more from meditation-based therapies than others. If we can find out the mechanism of action of meditation for reducing pain, we may be able to screen patients in the future for deficiencies in that mechanism, allowing us to target the treatment to those people.
Everyone gets the odd spot, but longer-term skin conditions can affect your level of self-confidence, especially if they are on your face. If you are suffering from acne or dry skin, don't worry. There are lots of easy treatments around that can help. Seeing a dietitian like Nastaran to improve your diet may also help with Skin Conditions.
Most people get spots, and they do always seem to break out when you really don't want them to. They're caused by your glands producing too much sebum – a substance that your body produces naturally to stop your hair drying out. Too much sebum makes your skin oily and causes spots.
Spots usually go away, but there are some things you can do to make them disappear a bit quicker:
- wash with an anti-bacterial face wash, instead of soap or shower gel, until the spots have gone
- don't squeeze them, as this can spread the infection and cause more spot outbreaks
- drinking a couple of pints of water a day can help
If your spots don't seem to be clearing up, you may be suffering from acne. Acne can be a more serious condition, so you should make an appointment with your doctor who can give you a check-up.
Acne is different from getting a few spots. It can appear on your back, shoulders and chest as well as your face and can sometimes be painful. Whether or not you suffer from acne doesn't depend on your level of personal hygiene; it can sometimes run in the family or it can be caused by high levels of stress.
Some people can get relatively mild forms of acne, where outbreaks are months apart. Others can get quite serious forms of the condition that can lead to scars. Although some sufferers get rid of acne by their early 20s, some people with very sensitive skin can still have the condition a number of years later.
Acne can also affect you emotionally. Sufferers of the condition can often get teased or bullied in school or college. It can also affect someone's self-confidence or body image and can cause stress – which in turn can make acne outbreaks even more severe.
Although special face washes and creams can help some people, serious acne usually needs to be treated with specialist medical treatments. These treatments are only available with a prescription. Make an appointment to see your doctor who can diagnose how serious the acne is decide the best course of action. Your doctor will also be able to talk to you about how to deal with any emotional distress you've suffered.
Patches of dry skin can affect anyone, especially when the weather turns colder and the wind starts to gust. Dry skin can form anywhere, but it's most common on your face, as that's the area that exposed to the cold air.
Using a moisturiser can help, as can using a lip balm if your lips are chapped. If your dry skin lasts for a long time and is itchy or feels hot when you touch it, go and see your doctor. They may be able to prescribe special creams that help more serious forms of dry skin like eczema or dermatitis.
Teenage boys who shave may find that they get a rash on their chin or neck after shaving. Although it's not painful, you may find it becomes itchy and irritating.
Using moisturiser after you've finished shaving stops your skin from drying out. Using an aftershave that doesn't contain any alcohol can also help if you've got particularly sensitive skin.
Source: Directgov. Reproduced with permission.
Curcumin, one of the principal components of the Indian spice turmeric, seems to delay the liver damage that eventually causes cirrhosis, suggests preliminary experimental research in the journal Gut. Curcumin, which gives turmeric its bright yellow pigment, has long been used in Indian Ayurvedic medicine to treat a wide range of gastrointestinal disorders.
Previous research has indicated that it has anti-inflammatory and antioxidant properties which may be helpful in combating disease. The research team wanted to find out if curcumin could delay the damage caused by progressive inflammatory conditions of the liver, including primary sclerosing cholangitis and primary biliary cirrhosis.
Both of these conditions, which can be sparked by genetic faults or autoimmune disease, cause the liver's plumbing system of bile ducts to become inflamed, scarred, and blocked. This leads to extensive tissue damage and irreversible and ultimately fatal liver cirrhosis.
The research team analysed tissue and blood samples from mice with chronic liver inflammation before and after adding curcumin to their diet for a period of four and a period of eight weeks.
The results were compared with the equivalent samples from mice with the same condition, but not fed curcumin.
The findings showed that the curcumin diet significantly reduced bile duct blockage and curbed liver cell (hepatocyte) damage and scarring (fibrosis) by interfering with several chemical signalling pathways involved in the inflammatory process.
These effects were clear at both four and eight weeks. No such effects were seen in mice fed a normal diet.
The authors point out that current treatment for inflammatory liver disease involves ursodeoxycholic acid, the long term effects of which remain unclear. The other alternative is a liver transplant.
Curcumin is a natural product, they say, which seems to target several different parts of the inflammatory process, and as such, may therefore offer a very promising treatment in the future.
Source: Anna Baghdasaryan, Thierry Claudel, Astrid Kosters, Judith Gumhold, Dagmar Silbert, Andrea Thüringer, Katharina Leski, Peter Fickert, Saul J Karpen, Michael Trauner. Curcumin improves sclerosing cholangitis in Mdr2-/- mice by inhibition of cholangiocyte inflammatory response and portal myofibroblast proliferation. Gut, 2010; 59: 521-530
Some people may be at risk of not getting enough vitamin D because they don’t get enough in their diet or because they have more limited sun exposure which reduces the amount of vitamin D their bodies make. Those at risk include:
Breastfed infants require 400 IU vitamin D per day from birth. Because breast milk is naturally low in vitamin D and infants are not usually exposed to the sun, a vitamin D supplement of 400 IU is recommended. Healthy term infants fed infant formula do not require a vitamin D supplement as it is already added to the formula.
- Pregnant women should consume vitamin D from food (for example, from a least 3 glasses of milk der day) or supplements (usually 200-400 IU is provided in a supplement) to ensure the baby is born with optimal vitamin D in their body. If a supplement is taken, be sure not to exceed 2000 IU vitamin D per day.
- Adults over 50 years may not prodce vitamin D in skin as well as when they were younger. It is recommended that adults (men and women) over 50 years take a supplement of 400 IU / day.
- People with skin darkly pigmented with melanin are less able to make vitamin D from exposure to sunlight. Since many people with darker skin colour also avoid vitamin D fortified milk due to lactose intolerance, their dietary intake of the vitamin may be low, so extra vitamin D, such as the amount typically found in a general multivitamin-mineral supplement (200-400 IU) would be a good idea.
- People with limited sun exposure sun exposure is limited due to mostly living or working indoors, wearing clothing such as long robes and head coverings, then it is wise to carefully choose vitamin D rich foods (see above) or to take a vitamin D supplement, such as the amount typically found in a general multivitamin-mineral supplement (200-400 IU).
Some medical conditions such as Crohn's disease, cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines, and some forms of liver disease, interfere with absorption of vitamin D. Being overweight and obese causes fat to stay stored in fat tissues and not be released into the blood, preventing vitamin D from being available to the body. If you have one of these conditions, check with your doctor to ask if a vitamin D supplement is needed.
Can I take too much vitamin D?
Yes. Too much vitamin D can be harmful. The total daily intake from food and supplements combined should not exceed 1000 IU for infants and young children and 2000 IU for adults.
The Bottom Line
Most people, except those in the risk groups noted above, can get enough vitamin D if they eat enough vitamin D rich foods (for example, milk, vitamin D fortified foods and some fatty fish) and if they engage in safe sun practices. If you are concerned about your vitamin D status, discuss the issue with Nastaran.
Source: Dietitians of Canada. Reproduced with Permission. Note: The Australian adequate intake is 200 IU however Nastaran recommends 400 IU as per the Canadian recommended intake.
Nastaran’s individually-designed client plans:
- Provide early diagnosis of nutrition-related health problems
- Facilitate better management of chronic conditions through diet and lifestyle change
- Lead to fewer nutrition-related secondary complications such as neuropathies from diabetes
- Dispel myths regarding fad diets
- Teach patients how to take personal responsibility for their own health status
- Raise awareness regarding nutrition-related problems like high cholesterol, diabetes and hypertension
Placement in Practitioner’s Office
Some practitioners would prefer their patients receive all medical services in their own offices. Nastaran is available for scheduled placement in your office to meet with patients you believe would benefit from professional nutrition services. From once a month, to once a week, Nastaran can accommodate your office and patient needs.
Lunch & Learn
Recognizing how quickly nutritional information changes, Nastaran offers free lunchtime programs in your office, specifically tailored to your patient base and staffing needs.
- Eating for thyroid disorder
- Celiac disease
- Chronic fatigue
- Supplement protocols
- Diabetes care and prevention
- General Nutrition
- Pediatric Nutrition
Please contact Nastaran directly with any questions regarding any of our services.