Diabetes control on a plate

Diabetes currently affects 2.3 million people in the UK and thousands more may not know they have the condition. Diabetes Mellitus is a condition where sugar in the blood stream is not properly used and managed by the body. Long term raised blood sugar levels can cause severe damage to the cells in the body especially that of the eyes, nerves, kidneys and cardio-vascular system.

There are two types of diabetes. Type I is a chronic condition where the failure of the pancreas to produce insulin results in the necessity for insulin injections. This type usually occurs before the age of 40. Type II is the most common type and usually develops gradually and many people experience the symptoms of diabetes before being diagnosed. In the case of type II diabetes, the pancreas may still be producing insulin, but in small amounts. Sometimes the cells may not be responding to the presence of insulin; this is called Insulin Resistance (IR).

Weight control and daily exercise can reduce the occurrence of diabetes in susceptible people, however, there these two measures are not enough. Understanding the role of blood sugar control is paramount in preventing and controlling diabetes.

Understanding the role of blood sugar balance.

The food you eat gets converted to sugar which enters the blood stream. Food in your stomach and subsequent rising blood-sugar, triggers the pancreas to release a hormone called Insulin. Insulin’s role is to get sugar from the blood stream into the cells of the body which is needed for energy. Some foods such as white sugar do not need to be converted into glucose so it literally rushes into the blood stream, making the blood sugar levels rise rapidly. Other foods such as wholegrains (brown bread, oats) are slow-releasing, meaning they release their sugars much more slowly than white sugar which means that the blood sugar rises steadily. It is fundamental for the blood sugar levels to remain constant.

Imbalanced blood sugar

When a diet is constantly high in refined foods, such as sweets, white bread, pasta and ready meals there is a high level of instant sugar available, which is released into the bloodstream all at once as glucose. Insulin is released in larger quantities to bring down the sugar in the blood to a normal level but can sometimes drop too low causing low energy, cravings, dizziness and lethargy. The sudden drop in blood sugar levels then causes the body to release other hormones such as adrenalin and cortisol to raise blood sugar levels again by converting sugar stores in the liver and muscles back to glucose.

These highs and lows of blood sugar imbalance are often referred to as a yo yo effect.
Over time the body may becomes less receptive to insulin, less insulin may be produced, adrenalin and cortisol keep releasing even more glucose into the bloodstream, causing prolonged high blood sugar. This can be the onset of type II diabetes if diet and exercise patterns do not change.

Other factors that may affect blood sugar balance

Stress, a reaction to a situation, induces a "fight or flight" response. Adrenalin and cortisol are released and cause glucose to rush from cells, in the body, into the bloodstream raising blood sugar levels. Stimulants such as alcohol, tea and coffee also produce a stress response. That is, they induce exactly the same response as stress therefore compounding blood sugar imbalance.

Diabetes control via diet

Diabetics should become familiar with The Glycemic Index (GI) or Glycemic Load (GL) as this is the cornerstone maintaining blood sugar balance. The key is to eat protein with every meal and eat complex carbohydrates rather than refined foods (white bread, grains) as they release their sugars more slowly into the blood stream. Protein helps maintain an even blood sugar level for longer. This is important for all people, but vital for anyone who is pre diabetic or who has been diagnosed with diabetes. Root vegetables should be kept to a minimum and combined with protein but vegetables such as brassicas can be eaten liberally as they have less of an effect on blood sugar. Protein foods include fish, lean meats and eggs, but sources of vegetarian protein such as legumes (nuts, seeds, lentils, peas and pulses) should be eaten more regularly as they are a source of leaner protein, and also contain fibre and nutrients vital for blood sugar balance.

Eating little and often is important too. Six mini meals a day is preferable to 3 larger meals a day. This keeps blood sugar topped up and less likely for insulin to be released in great quantities which can ultimately complicate the condition.

Sugars and foods containing sugars should be avoided. They are often hidden in cakes, biscuits, chocolates, pastries as corn syrup or high glucose-fructose syrup. Taking time to study labels is the only way to know ...

Drinks such as coke and squash contain large amounts of sugars and should be avoided and replaced with fruit juices diluted with water or herbal teas. Some fruits contain high levels of sugar called fructose so must be limited. These include bananas, grapes and mangos. Fruits such as berries, apples and pears contain fibre that slows the release of its sugars so these are fine to eat but no more than twice per day. Over ripe fruit tends to be more sugary than under ripe. The antioxidants found in fruits help protect the cells from damage caused by elevated sugars and the B vitamins help improve insulin sensitivity in the cells. Alcohol can affect blood sugar the same way as sugar or caffeine, so should be limited or drunk in moderation at meal times.

Increasing foods rich in the mineral Chromium can help balance blood sugar. Chromium helps to get sugar into the cells in the presence of insulin so prevents insulin resistance. Sources of chromium are found in rye bread, cabbage, black pepper, apples and carrots.

Some studies have shown a link between casein, the protein in cow’s milk and type I diabetes. A reasonable percentage of type-I diabetics are celiac which means they cannot tolerate gluten, the protein found incertain grains. This may not be the case for type II diabetes so should not necessarily cut these foods out of their diets unless they believe they have a problem with them.

Some studies have demonstrated that certain spices such as cinnamon, fenugreek and juniper can help stabilise blood sugar as they have insulin like effects on the cells. Cinnamon is a good alternative to sugar on cereal, porridge and in stews.

Any diabetic following this diet should contact their GP during the initial stages so their blood sugar levels can be closely monitored. They may find that their medication needs to be adjusted as their body gets used to a more constant blood sugar level.

Diabetes control with exercise

Increasing exercise helps to balance blood sugar levels. Introduce some gentle forms to help with stress as well such as yoga, tai chi and walking. Introducing other stress reducing activities is also important, relaxing with a book (not a thriller!), a quiet 10 minutes each day to meditate or to just sit and be calm may also be beneficial.

Itching to be free of eczema?

What is eczema?

Eczema encompasses a number of skin conditions that may present as a dry, scaly rash or weepy, oozing blisters. It is a type of dermatitis that literally means "inflamed skin." Chronic eczema causes dry, red, flaky patches on the skin, most frequently involving the face; neck; scalp; arms; elbows; wrists; and knees. Eczema is divided into two main types: contact and atopic.

Contact Dermatits

This occurs when an irritating substances comes into contact with the skin. The most common irritants are cosmetics or cleaning products, wool, lanolin, rubber, metals such as nickel, gold, and silver. It is characterised by similar symptoms as eczema but does not involve the same inherited factors or links with asthma or hay fever.

Atopic Eczema

This type of eczema is often caused by several factors. The most common factors tend to be food sensitivities; environmental allergens such as pollen, dust or animal fur; gut dysbiosis (disruption of the normal bacterial flora of the gut); poor metabolism of Essential Fatty Acids (EFA); family history or allergies (eczema, asthma, dermatitis or hayfever); stress and being bottle fed as baby.

How can poor nutrition make eczema worse?

1.Antioxidants are compounds that are important for skin health as they protect it from damage caused by the sun’s rays, pollution and toxins from our food or from cleaning products and cosmetics. The most important antioxidants for skin health are vitamins A, C, E and the mineral zinc. A lack of these nutrients in the diet can leave it more susceptible to free radical damage.

2. Essential fatty acids from nuts, seeds and oily fish are also important for good skin health as they keep the membranes of the cell flexible and therefore allowing nutrients to pass into and toxins to flow out of the cell easily. Essential fats also help to reduce inflammation in the skin.

3. Toxins in the body must be processed by the liver and eliminated via the bowels. If the liver is sluggish or the bowels are blocked, it is difficult for toxins to be neutralised and excreted in the correct manner. When this happens, toxins are sometimes eliminated via the skin as this is another way for the body to get rid of unwanted matter. Therefore, maintaining a healthy liver and clear bowel can help reduce the toxic load on the skin.

4. Food intolerance or sensitivities can sometimes be a cause of eczema or dermatitis as the immune system is triggered in the presence of a food it does not recognise or deems non-self. This can encourage inflammation that appears in the form of eczema.

Which types of food can help alleviate eczema?

High fibre foods such as complex carbohydrates from whole grains, fruit and vegetables such as root or green leafy vegetables, peppers, apples, berries and pears help get the bowels moving and help to bind toxins in the gut, reducing the burden on the liver and also providing the skin with important antioxidant nutrients to protect it and help it repair.

Oily fish such as mackerel, herring, salmon, sardine or anchovies plus nuts and seeds such as walnuts, linseed, Brazil nuts or pumpkin seeds contain essential fatty acids.

Legumes such as lentils, beans and pulses are better and alternative sources of protein to protein from meat as they do not create so much inflammation in the body.

Water- this is key to good skin health. It helps eliminate toxins from the skin and helps to rehydrate, allowing improved exchange of nutrients into the cells. Herbal teas such as green, peppermint, nettle or camomile should replace tea, coffee and fizzy, sugary drinks.

Onions, Jerusalem artichokes and garlic are rich in a non-digestible fibre called inulin, which helps to maintain a healthy gut by feeding the beneficial bacteria. Inulin is also anti-bacterial so this helps keep skin bacteria at bay. Presence of a certain strain of skin bacteria namely, Staphylococcus aureus, is common amongst eczema sufferers.

Which types of food can aggravate eczema?

Avoid refined carbohydrates and sugars. These can upset the processing of essential fatty acids, which is often already a problem for people with atopic eczema.

Avoid saturated fats from red meat and dairy products as these encourage inflammation. Red meat is also difficult to digest and therefore may cause digestive problems which can exacerbate skin conditions.

Avoid hydrogenated or trans fats usually found in some margarines, confectionary, pastries, biscuits and some fast or processed ready meals. Trans fats also block the processing of essential fatty acids but they also weaken the cells in the skin so they cannot function optimally.

Reduce the intake of stimulating drinks such as tea and coffee as these affect the adrenal glands and encourage the stress response, which can be a contributory factor.

Tired all the time?

Constant tiredness, fatigue and low energy plague millions of people in the Western world. Indeed these are the most common reasons which lead people to see their G.P. It seems that there is no single cause of low energy and fatigue, however, recent scientific research has uncovered issues relating to poor nutrition and faulty cellular energy metabolism.

A modern day, stress-filled lifestyle coupled with environmental chemicals, pollution and a nutrient-sparse diet, it is no wonder our energy levels are not as they should be.

Energy comes from the food we eat, but it does not come readily available and must be broken down and converted to glucose before being processed by enzymes. Enzymes are catalysts, like the spark plugs to an engine, and without them the release of energy would not be possible. Enzymes are made up of proteins that come from food. In order for these catalysts to work, they need co-factors which come from the vitamins and minerals also found in food. Essentially, the food we eat is the driving force of the entire energy and repair systems of the body.

So what is wrong with a “well balanced diet” and does it not provide the body with the correct levels of nutrients for proper function? This may be true, but how many people are actually eating a “well balanced diet” and how much goodness are we getting from the food we eat?

It is easy for anyone to obtain a calorie-adequate diet in the Western world due to the widespread availability of cheap food. However, due to intensive farming which depletes soil of nutrients, followed by food refining, transportation and storage, not to mention the addition of food additives and preservatives that further restrict any ingested nutrients from being absorped plus poor cooking methods such as microwaving and frying, it is no surprise that very few of us are achieving the Recommended Daily Allowance (RDA) of vitamins and minerals, let alone the optimum level.

Vitamin and mineral insufficiency aside, there are other factors that can cause fatigue, such as food intolerances, underactive thyroid, adrenal stress, blood sugar imbalance and so on. It is possible to get tested for these conditions via your GP; alternatively a Nutritional Therapist who focuses on the link between health and diet, will be able to identify the root cause of a health problem such as fatigue.

Food intolerance is a common cause of lethargy and fatigue. The body’s reaction to a food allergen is to mount an immune response and it takes much energy to do so. In cases of severe allergic reactions such as to peanuts or a bee sting, it takes a shot of intravenous adrenaline to counteract the body’s response mechanism, so during a milder immune response, such as in the case of food intolerance, it takes smaller but more frequent hits of adrenaline from the adrenal glands to restore balance. In short, food intolerances cause adrenaline to be used up robbing the body of energy, motivation, and good mood.

So how do we maintain our energy levels via nutrition?

1. Maintain a balanced blood sugar level
   -Eat little and often
   -Avoid caffeine as this depletes nutrients and drains the adrenal glands
   -Combine protein with complex carbohydrate with every meal as this sustains energy for longer and prevents blood sugar dips.
   -Avoid refined foods such as white bread, white rice and pasta and swap for complex carbohydrates such as brown, or whole grains.
   -Cut out any foods that may be causing problems. The usual signs are bloating, headaches, tiredness and a brain fog. The most common foods tend to be wheat and dairy.
2. Eat wholesome, unprocessed foods that have been locally grown
   -Unrefined foods contain more nutrients and fibre so help clear out toxins as well as provide the body with essential nutrients.
   -Locally grown produce is fresher and its nutrients content tends to be higher due to the reduced journey time from picking to eating.
3. Eat organic where possible.
   A £12 million 4 year project has demonstrated that organic produce contains higher levels of vitamins and minerals compared with non organic produce. Click here to read more.
4. Reduce nutrient-depleting foods from your diet such as refined sugar, tea, coffee, hydrogenated fats, chemical additives, preservatives and stabilizers.
5. Increase antioxidant rich foods in the diet found in fresh fruit and vegetables, nuts and seeds. Antioxidants are types of nutrients that help strengthen the immune system and help to detoxify chemicals from the body.
6. Increase Essential Fatty Acids (EFA) in the diet as these are energy rich.
7. Drink 1.5-2 litres of water a day. Dehydration can cause fatigue.
   

Osteoarthritis- can we blame our genes?

The incidence of osteoarthritis (OA) is rising around the world due to both increasing levels of obesity, poor diet and ageing populations.

OA is a chronic disease of the joints, usually affecting the hips, knees, spine or fingers. It is caused by a breakdown of cartilage that surrounds the joints. This can cause the bone at the edge of the joint to thicken and spur forming osteophytes which can lead to inflammation. Symptoms include severe pain and decreased mobility and function.

Genetics, old age and general wear and tear play a role in developing OA; however new research has demonstrated that there is a link between OA and diet.

The journal, Arthritis Research & Therapy, recently linked an increased intake of antioxidants to a reduced risk of osteoarthritis and improved bone and joint health. Click here to see an abstract from the original research paper.

So let us take a look at how diet can help with both the reduction in symptoms and the prevention of OA:

Antioxidants

Antioxidants are substances that protect cells from the damage caused by unstable molecules known as free radicals. Free radicals are molecules that can damage cells, causing inflammation and pain. They are made in all combustion processes which include smoking, radiation, frying, barbecuing, meat smoking and curing. Sun exposure, stress, alcohol, exhaust fumes and even breathing create free radicals; therefore it is important for the body to be well equipped against these potentially harmful molecules.

Vitamins A, C and E are the primary antioxidant vitamins, found in fresh fruit, vegetables, whole grains and legumes that can neutralise free radicals. Vitamin C is especially crucial for cartilage growth and repair. Good sources of vitamin C are found in kiwi fruit, peppers, watercress, cabbage, broccoli and strawberries.

"Bad" Oils and Fats

Hydrogenated or trans fats (found in certain biscuits, chocolate, pastries and some margarines or created by shallow frying and deep frying) are to be avoided. When these fats are incorporated into normally very fluid cell membranes, they pack very tightly because of their structure. Thus, essential nutrients are unable to get into the cell, making the cell less healthy and more prone to injury. In contrast, poly-unsaturated fats are beneficial to cells because they prevent the tight packing of fatty acids in the membrane. Unsaturated fatty acids (found in nuts, seeds, cold compressed oils (flax, hemp, borage oils) and oily fish) have gaps in their chains and these gaps allow for a certain amount of "fluidity” and therefore improved function of the cell. Saturated fats found in processed foods and animal products such as red meat causes inflammation in the body so these fats are best kept to a minimum in the diet.

Anti-inflammatory foods

Alcohol, refined sugars, and coffee are likely to cause more inflammation in the body and intake should be reduced. Foods that may reduce inflammation tend to be fruit and vegetables and foods containing essential fatty acids from oily fish, nuts and seeds. It must be noted that certain foods such as citrus fruit or foods from the “nightshade family” such as aubergines, potatoes, tomatoes and peppers can sometimes aggravate joint pain and swelling so are best avoided if there is a noticeable worsening of symptoms.

Healthy Bones are Important Too

Where there is low bone mineral density, there may be an increased risk for OA, therefore adequate bone nutrients in the diet can help to maintain bone density and strength.
The most important bone nutrients are calcium, magnesium and boron, although recent research suggests that vitamin D is just as important as calcium in maintaining bone health.

Research presented this month (Nov 2007) at the American College of Rheumatology Annual Scientific Meeting highlighted the importance of vitamin D in joint health. They presented several research papers highlighting the link between low levels of vitamin D and higher incidence of knee pain and decreased mobility amongst OA patients. Vitamin D aids the uptake of calcium from the gut but also helps retain calcium in the bone.

Foods rich in vitamin D are cold water fish such as mackerel and herring, liver, cottage cheese and egg yolk. Exposure to sunlight allows the body to produce its own supply of vitamin D.

What about exercise?

Maintaining normal body weight through diet and exercise is an important part of treating OA. Research has found that obesity increases the risk of OA and excess weight puts increased stress on weight-bearing joints. Weight-bearing exercise is crucial for maintaining healthy bones and joints. This includes brisk walking, jogging, and aerobics. Exercise such as yoga, swimming, tai chi and cycling are gentler on the joints and good for strengthening the muscles, ligaments and tendons around the joint but should be combined with weight-bearing exercise in order to maintain optimum bone health.

Amanda Michie is a Urbod Nutritionist working in the City and Canary Wharf.

Welcome to the Nutritionist in the City of London Blog

Welcome to Nutrition in the City of London Blog, Nutrition for Busy Professionals

Over the coming months we hope to bring you lots of simple, sensible advice on Nutrition & Health

Who are we?

Our company is called UrBod, we are a team of qualified nutritionists. All of the team are fully insured and members of the British Association of Nutritional Therapists.

Amanda Michie, Nutritional Therapist & Foresight Practitioner, City of London.

Kenny Tranquille Nutritional Therapist & NLP Coach, in Canary Wharf and the City of London.