Health and Your Metabolic Health: Does Obesity Matter?

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Should obese people who are metabolically healthy be advised to lose weight?

Risk of type 2 diabetes, heart disease and cancer all increase with excess body fat. Yet research has identified two unique groups: those who are obese but metabolically healthy, and those who are a healthy weight but metabolic unhealthy. This was the topic of a sesscanstockphoto2174868ion I especially looked forward to attending at last month’s American Diabetes Association Scientific Sessions.

Metabolic health matters when it comes to cancer. Inflammation and the elevated insulin levels that come with insulin resistance are believed to promote cancer development.

Metabolically healthy obesity (MHO) refers to people who have a body mass index (BMI) of 30 or more (for someone who is 5’6” tall, weight of at least 186 pounds) yet don’t have the metabolic abnormalities that typically accompany obesity. There’s not yet a standard definition for MHO, but usually a person with MHO has no more than one of the following: diabetes, high blood pressure, elevated blood triglycerides or low HDL cholesterol. Studies generally report from 3 to 20 percent of obese people meet criteria to be classified as metabolically healthy. Read more… “Health and Your Metabolic Health: Does Obesity Matter?”

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    Mediterranean Diet, Heart Disease and Cancer Risk

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    Yesterday, a major study published in the New England Journal of Medicine put a spotlight on how making dietary changes can have a major affect on health. The canstockphoto6734517study focused on the Mediterranean Diet and heart disease, finding that consuming a plant-based diet, along with plenty of nuts and healthy oils, linked to a reduced risk of stroke, cardiovascular death and heart attacks compared to those following a low-fat diet.

    Here’s the study.

    Briefly, researchers split almost 7,500 Spaniards at risk of heart disease – but showing no signs of any – into three dietary groups. One group consumed more extra-virgin olive oil, about four cups per week; a second group added about one ounce of nuts to their day; the third group was assigned to a low-fat diet. Along with nuts and healthy oils, the two Mediterranean-diet groups also ate more fish and legumes compared to the low-fat group.

    After five years, those following the two Mediterranean Diet patterns showed primarily a reduced risk of stroke.

    The Mediterranean Diet shares many qualities to the evidence-based diet shown to reduce cancer risk. Here, we asked AICR Nutrition Advisor Karen Collins, MS, RD, CDN, to talk about the diet and how it relates to cancer prevention.

    Q: Can you describe a Mediterranean Diet?
    A: It’s a plant-based diet that uses a large and abundant variety of vegetables and fruits. It makes vegetables and fruits the centerpiece of the meal, not just in the proportion but in the way they are seen as a way to enjoy and savor. The diet also has healthy fats and uses legumes abundantly. Meats, especially red meat but even poultry, are eaten in limited amounts.

    Q: What does the Mediterranean Diet share with AICR’s cancer-protective diet?
    A: They are both plant-based diets, with a wide variety of vegetables and beans, and they both limit red meats. The Mediterranean diet does generally involve some red wine but it’s not required – it’s not an essential part of the diet and for those who do drink, its only in moderation and generally only at meals.

    Q: What does the research show on the Mediterranean Diet and cancer risk? The research seems to be much clearer for heart disease.
    A: There are just more studies looking at heart disease and the Mediterranean Diet than with cancer. It’s not that the Mediterranean Diet doesn’t link to cancer prevention, its just not as well studied. So far, it looks like the Mediterranean diet can prevent certain cancers. Some research has suggested that following a Mediterranean Diet can reduce cancer mortality and incidence.

    Cancer develops over many years, which makes intervention-type trials a challenge. Research does link the Mediterranean diet with reductions in markers of inflammation, and combined with the abundance of antioxidant, cancer-fighting phytochemicals in the Mediterranean diet, this is an eating pattern that fits well in the overall model of a diet to lower cancer risk that we see in the New American Plate.

    Q: For people concerned with both heart health and cancer prevention, what can we take away from this?
    A: This study compared Mediterranean to a low-fat diet, which other studies have also done, and this shows that a singular focus in defining low-fat as being healthy is misplaced. It depends on what your eating when you reduce your fat.

    By eating a healthy diet and embracing the real principals of a varied and plant-based diet, its showing that it’s not just what you don’t eat, its what you do eat that counts. Eating healthy fats and a plant-based diet together can lower the risk of both heart disease and cancer.

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      Cancer, Diabetes and Heart Disease: A Paradigm Shift

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      Patients with type 2 diabetes need to make a paradigm shift, and their doctors and other health providers can help them, according to AICR nutrition consultant Karen Collins, presenting yesterday at the annual meeting of the American Association of Diabetes Educators.

      Type 2 diabetes, heart disease and cancer form a “triad of disease” says Collins. These three diseases share many common risk factors such as obesity, inflammation and insulin resistance, so we can’t think of them in isolation. How patients manage these diseases through lifestyle changes can help each of these diseases and lower risk for all three.

      For example, people with type 2 diabetes often focus only on blood sugar control as the way to manage their disease, but that singular focus may not always lead to better overall health. High levels of insulin seem to promote some cancers, so using more and more insulin to manage blood sugar may, in the long run, increase cancer risk.

      Read more… “Cancer, Diabetes and Heart Disease: A Paradigm Shift”

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