1 May 2017

WHAT’S NEW?

APPLES AND ORANGES FRUITFUL IN REDUCING RISK OF TYPE 2 DIABETES

Eating more fruit is linked to a lower likelihood of developing type 2 diabetes and diabetes-related complications reports a new study. The authors studied 500,000 Chinese people over seven years and found those who said they ate more fresh fruit were less likely to develop type 2 diabetes than others. Those who already had diabetes but ate a lot of fruit were less likely to die within a five-year period. “This large prospective study of Chinese adults with and without diabetes showed that higher fresh fruit consumption was significantly associated with a lower risk of developing diabetes, and also with a lower risk of dying or developing vascular complications among those who have already developed diabetes. These associations appeared to be similar in both men and women, in urban and rural residents, and in those with previously diagnosed and screen-detected diabetes. Moreover, higher fresh fruit consumption was not associated with elevated level of blood glucose,” conclude the researchers

Study: Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults

Contact: huaidong.du@ctsu.ox.ac.uk; lmlee@vip.163.com

Oranges

KIDS AND JUICE

The findings of a meta-analysis published in Pediatrics reports that consumption of 100% fruit juice:

  • is associated with a small amount of weight gain in children ages 1 to 6 years, that is not clinically significant 
  • is not associated with weight gain in children ages 7 to 18 years. 
“I think caution is definitely in order and that when possible, parents should give whole fruit to kids, instead of fruit juice,” says lead author Dr Brandon Auerbach. "Water or low-fat unsweetened milk are other good alternatives to 100 percent fruit juice.”

While we agree water and low-fat milk are good drinks for kids, they aren’t alternatives to 100% fruit juice because they don’t deliver vitamin C. It’s worth remembering that some young children won’t touch veg and fuss a fair bit about eating enough whole fruit so they may miss out. Call us old fashioned, but we think whole fruit or 100% fruit juice is better than vitamin drops or a chewable supplement.

We asked dietitian Nicole Senior, who has a 4-year-old, for some words of wisdom for parents of picky eaters. “Pure fruit juices are fine for kids but in small quantities. Use them as a flavour base and add water in a 1:3 (that will make up 1 cup) ratio to obtain their nutritional benefits without too many kilojoules (calories)” she says, adding, “just so you know, ¼ cup (60ml) 100% home-squeezed orange juice will provide a pre-schooler with 32mg vitamin C (that’s nearly the recommended intake (35mg/day) for this age group).”

Study: Fruit Juice and Change in BMI: A Meta-analysis

Contact: Address correspondence to Brandon Auerbach, MD, MPH, Division of General Internal Medicine, University of Washington, Harborview Medical Center, Box 359780, 325 Ninth Ave, Seattle, WA 91804. E-mail: auerbach@post.harvard.edu

Child with juice

MYTH BUSTERS 

Obesity myths are abundant, annoying, and problematic for people who want to move on to real solutions. Thanks to Ted Kyle of ConscienHealth for this report on Ruopeng An and Roland Sturm’s research funded by the Rand Corporation.

Myth #1: Obesity Is an Epidemic of Poorly Educated, Low SES People The truth is that people at all education and economic status levels are gaining weight. Different groups started with different rates of obesity. But all those groups have moved up in lockstep.

Myth #2: Obesity Is a Problem of Blacks and Hispanics Once again, different racial and ethnic groups are gaining weight in parallel. While black and Hispanic Americans have a higher prevalence, the problem is growing across all racial and ethnic groups.

Myth #3: The South is Where the Problem Is Growing This myth has two big problems. First, as An and Sturm explain, obesity prevalence appears to be growing across the board in every state. But even more important is the flakiness of the numbers for state by state obesity rates. Those numbers are based on self-reports of height and weight. Self reports are unreliable. Worse, the degree of their unreliability varies from place to place and from time to time. We’ve explained this one here.

Myth #4: People Don’t Have Time to Exercise The truth is that Americans have more leisure time than ever. They report working out more than ever. Now of course, those self-reports need a grain of salt. But it’s not clear that running around in our yoga pants is doing much to fight obesity. Mainly, it’s a fashion and virtue statement.

Myth #5: Missing Out on Fruits and Veggies Is Making Us Fat Overall, Americans are eating more. And we are eating more fruits and veggies – just not enough to keep Mom and our dietitian happy. The message of “eat more” works perversely. People eat more of whatever’s being promoted – without cutting back on anything else.

Moving on An and Sturm admit that rock-solid, evidence based solutions don’t exist. They suggest that the “eat more healthy stuff” and “do more healthy things” strategies are not changing obesity trends. Perhaps we have not adapted very well to abundance. Being economists, they like the idea of taxing empty calories to drive calorie consumption down across the board. It’s a reasonable theory, but it needs to be tested. Otherwise we risk creating a new myth. Let’s see what happens in Mexico. Just driving down soda consumption is not the same as driving down obesity rates.

Studies: Click here and here to read more from An and Sturm.

Afterword: Prof Manny Noakes’ and colleagues study shows Australians are eating less added sugar, drinking less soft drink and less juice, but eating more whole fruit and a greater range of veggies, including more beans and legumes and more whole grain cereals so they deserve a big pat on the back for that. However, Aussies are still prone to falling off the wagon – drinking more calories in the form of alcoholic beverages and consuming more chocolate and confectionery.

MONITORING BGL MONITORS 

We recently received a query from a reader re BGL meters whose new one reads on the high side. “I have done the recommended calibration test” he says “and while in the appropriate range the results are in the higher half of the range. My older meter still works well and seems to be much more accurate, judging by my HBA1c results and personal experience of lower readings. Info on this area would be very valuable, as it bears directly on food choices and insulin dosage.” Diabetes UK provide a monitor guide that may be of use. Seems to us this is something every diabetes organisation should be providing.

NORDIC FOOD PATTERNS GOING GLOBAL FOR HEALTH: TED KYLE REPORTS 

The Nordic Way

Seeing good science translated into something that can enhance both life and health is a true delight. So, if you’re looking for something different, consider The Nordic Way. Like the Mediterranean diet, the Nordic diet is a satisfying way of eating, with deep roots in culture. And it has an impressive body of science to document health benefits. Arne Astrup, Jennie Brand-Miller, and Christian Bitz have just published a fine volume on the subject.

Compared to the Mediterranean diet, the Nordic diet is barely a blip in popular culture. But, it’s beginning to generate some buzz. Some of the iconic foods of this Scandinavian food culture – whole grain rye, unsweetened yogurt, wild berries, root vegetables, herbs, and healthful fatty fish – are becoming favorites for avant-garde chefs.

Beyond the distinctive flavors of this cuisine, you can find some solid evidence for health benefits. In January, a Danish cohort study found a 14% reduction in stroke associated with following a healthy Nordic diet. The whole grains abundant in the Nordic diet help to lower the risk of type 2 diabetes and heart disease.

The collaboration behind this latest volume on the Nordic diet is a bit of a surprise. It started with a scientific feud. Brand-Miller, a distinguished nutrition scientist from Sydney, took issue with a small study published by Astrup and others in 2004. On the opposite side of the world in Copenhagen, Astrup had suggested that the benefits of low-glycemic diets might be overstated. Brand-Miller – a pioneering researcher on glycemic index – wrote a sharp response in the American Journal of Clinical Nutrition. Though Astrup’s findings were “useful,” she said, “the conclusions should be tempered.” From that disagreement, a collaboration was born. Astrup embarked upon the largest clinical study of low GI diets ever. Based on the results, he reversed his views. Thanks in part to that skirmish, we now have an excellent book of good insights on the Nordic diet. It covers the science. It explains how to make it work. And most of the book is devoted to some beautiful recipes.

Study: Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance

Book: Click here for the book and here for more on the Nordic diet from Harvard Health.