Can Fasting Be Part of a Diabetes Meal Plan?

There’s been a lot of buzz in the media recently promoting the benefits of intermittent fasting—skipping a meal or limiting daily calories on some days—as a means to lose weight, reduce cardiovascular risk, improve insulin sensitivity, and decrease inflammation and the risk of  type 2 diabetes. Fasting goes against the mainstream approach of eating regular meals to keep blood sugars stable. Because weight loss is an overwhelming issue with type 2 (and a difficult one to master), it’s worth considering whether fasting is a safe and reasonable option.

Studies have shown that restricting calories can increase the life span of certain animals by as much as 50 percent. Fasting is not a new concept. For centuries, many religions have used fasting for physical and spiritual benefits. We evolved from ancestors who did not have continuous access to food; the norm was feast or famine. It has been suggested that perhaps our genes are designed to respond better to sporadic eating, instead of eating throughout the day, because it mimics the stress and shock that our ancestors experienced, which in turn keep the body healthier and tougher.

A recent review in the British Journal of Diabetes and Vascular Disease evaluated various approaches to intermittent fasting. The researchers found that overweight people with type 2 diabetes who fasted intermittently lost as much or more weight than those who cut calories on a daily basis.There are several approaches to intermittent fasting, but the basic idea is to alternate days of eating normally with days of restricted calorie consumption (500 to 600 calories per day). One example is to choose two nonconsecutive days each week as fasting days along with five days of eating normally. Another approach is to restrict eating to a specific period each fasting day, such as an eight-hour window of time. For example, all calories would be consumed from 12 p.m. to 8 p.m. The rationale for this approach is that it takes about six to eight hours to burn the carbohydrate stored in your body as glycogen. After the stores are drained—and until more food is consumed—the body is primed to burn fat as its primary fuel.

Intermittent fasting is not for the faint of heart, yet it is doable. Unlike total fasting, you simply eat less on fast days. Many study participants reported that after the initial hunger and discomfort of calorie restriction, their hunger subsided and cravings diminished, and they experienced a sense of alertness, a high energy level, and improved mood.

There is good evidence that intermittent fasting may be useful in preventing type 2 diabetes, but how does this translate to people living with diabetes? As you may know, anyone who takes insulin or uses sulfonylureas will risk hypoglycemia when fasting. Discuss this with your health care provider if you are considering intermittent fasting as a weight-loss strategy.

Source: http://forecast.diabetes.org/fasting-aug2013?loc=homepage_dfmaglinks_aug2013

Osteoporosis: How to Get Your Bones Back!

Bone health is not high on most people’s worry list. It is invisible and certainly below the surface of concern. Unfortunately, when a problem is discovered it is invariably after a fracture or an abnormal bone density test. Up to that point, let’s face it, what we don’t know can hurt us.

Decreased bone density can signal weakness of other organ systems.  For instance, if your bones are losing calcium and strength, it is likely that it’s more than a calcium deficiency and related to Vitamin D levels, blood glucose surges, hormonal flux or  adrenal function (high cortisol levels will inhibit bone formation) or… well a lot of other things that aren’t called calcium. In fact, in my experience, osteoporosis can be successfully controlled by thoroughly dealing with inflammation and hormone issues.  That’s why I’m writing this—because all the most recent scientific studies show that a combination of factors, organ systems, food intake and genes, determine your bone strength health, and it turns out that you have control of about 80% of that.

Quickly, initial bone loss (below normal) is called osteopenia and more substantial bone loss is called osteoporosis.  If you are reading this, probably you or someone you care about is suffering from either of these.  This is scary, because fracture is so sudden, painful and disabling.

Here’s the deal: In osteoporosis, we are constantly making and losing (excreting) bone matrix all the time. In fact, your bones are replaced every seven years. It’s a balance thing with some going out while some is going in. This process is pushed toward losing matrix with low functioning organ systems in the body. We’re unable to add matrix if we can’t absorb correctly or form matrix out of our diet. It’s just not a simple issue of not having enough calcium.

We’ve been told for many years that you can solve this problem by taking drugs like bisphosphonates (Fosamax, Boniva).  Well, kinda. Initially the bone mass will increase but not in the way you, or anyone else, would like. It turns out that the crystal lattice structure that sets the stage for the incredible stability in bone (like concrete and re-bar) is not stabilized by these drugs at all. So these woman, after a few years of taking the drug do not improve, but in fact have increased fractures in odd places, like the middle of the thigh bone—very unusual.  This is because these drugs don’t allow any natural breakdown of bone leading to old, funky bone.  Also, if that wasn’t disappointing enough, taking calcium supplements simply doesn’t work because low calcium is not the cause in the first place.

So where does this strong bone matrix come from?  Well, let’s take a look at absorption.

First, minerals are absorbed in the small intestine and if it is inflamed we absorb fewer minerals. In this case, calcium, zinc, copper, magnesium can’t be used to make bone.  This is the reason osteoporosis is high with celiac disease, Crohn’s disease and autoimmune disease. These conditions all involve inflamed intestines and malabsorption.

Second, the retention/secretion issue here is basically one of acid/base relationships and a net alkalinizing diet. A diet with at least 20% coming from fruits and veggies should do the trick.

Third, clearly hormone flux can be at the heart of bone loss and evaluation of all the players of hormone function need to be at optimal levels.

We have to look at each person as an individual because the cause in one person may not be the same cause in another. Proper lab work with bone markers and adrenal gland testing for proper cortisol levels is required.  Gut testing and clear and concise exercise options are a must.

If this makes sense to you, let’s take a look at your total profile to find out what your body can tell us about your bone density matrix.

Source: http://aliveeastbay.com/wellness/osteoporosis-how-to-get-your-bones-back/

Erythema Toxicum Neonatorum

Erythema toxicum neonatorum is a common skin rash affecting healthy newborn babies. It is not serious, does not cause the baby any harm, and clears up without any treatment.


What is erythema toxicum neonatorum?

Erythema toxicum neonatorum (ETN) is often shortened to erythema toxicum, and is also known as baby acne or toxic erythema of the newborn. ETN is a common harmless skin rash that affects healthy newborn babies.

What do the words erythema toxicum neonatorum mean?

Erythema is the medical word for redness. Neonatorum refers to the fact that the rash occurs in the neonatal period. The neonatal period is the time between birth and 28 days of age. A baby in this age range is called a neonate.

The name ETN is confusing because the condition is not toxic. It is also not the same as the acne that affects young people and adults. (See separate leaflet calledAcne for more information.)

What causes erythema toxicum neonatorum?

The exact cause is unknown. It is not due to an infection, even though pustules (pus-filled spots) are often present.

Various ideas have been suggested, including the possibility that it is a normal inflammatory or immune system response in babies. It has not been proven to be an allergic problem. It is also not related to whether the baby is breast-fed or formula-fed.

How common is erythema toxicum neonatorum?

ETN is very common. Between 3 and 7 in every 10 babies develop it. It seems to be more common in babies born at full term (between 37 and 40 weeks’ gestation) compared with premature babies.

Which babies get erythema toxicum neonatorum?

On average, ETN occurs in healthy babies born at full term, between 3 and 14 days of age. The rash can occur in the first 48 hours of life, but 9 out of 10 cases are in babies more than 2 days old.

Overall, it seems to be more common in male babies (about half of male babies get it) compared with female babies (about a third of female babies get it). However, it is more common in baby girls if it is a woman’s first pregnancy.

What does the rash of erythema toxicum neonatorum look like?

The rash of ETN generally looks like red blotches, predominantly affecting the face and trunk (body). It does occur on the arms and legs too (but is rare on the palms or the soles).

Little raised spots called papules are common. Sometimes there will be little pustules (pus-filled spots) or vesicles (fluid-filled small blisters). There may be many spots or very few. The different spots vary in size. The spots blanch with light pressure. This means that they become pale and fade when pressed. The rash can be very transient (temporary) and sometimes individual spots can disappear within hours.

The baby appears well and the rash does not seem to cause any bother.

Note: if there is any doubt as to the cause of a skin rash in any baby or child, it is essential that you seek medical advice and a firm diagnosis. This is especially important if your baby seems unwell in any way (for example, if your baby has a temperature, is not feeding, is lethargic or inconsolable and not the same as normal). Other rashes can occur in babies and may be the sign of serious illness.

Are any tests needed to diagnose erythema toxicum neonatorum?

No tests are needed to diagnose ETN. The rash is generally easily recognisable by doctors and midwives. Tests may be needed if there is any uncertainty as to the cause of the rash, particularly if your baby is unwell.

What is the treatment for erythema toxicum neonatorum?

There is no specific treatment for ETN. The rash settles completely without any treatment.

What should I do?

If your baby develops ETN, there is no need to worry. Your baby will not be in any discomfort or have any distress related to the rash. The skin may look red and angry (and your baby may look less than perfect temporarily), but do your best to ignore it.

Avoid over-washing your baby – babies have delicate skin that can dry out easily with detergents. Resist any temptation to pick, squeeze or burst any pustules – as this would make a skin infection more likely to occur. Creams and lotions are not required for the rash. If you are already using products to wash and moisturise your baby it is fine to continue them, but ensure they are fragrance-free and designed for use in babies.

How long does erythema toxicum neonatorum last for?

Typically, the rash lasts for a few days only. In almost all cases it has completely gone within 2 weeks. Very occasionally the rash can recur. This can happen up to 6 weeks of age. Usually recurrences are mild.

Are there any long-term effects?

There are no long-term problems associated with ETN. The rash settles spontaneously, leaving normal skin. Of course, some babies develop dry skin, eczema or other skin problems, but these are not related to ETN.

Source: http://www.patient.co.uk/health/erythema-toxicum-neonatorum

Oral Health, General Health and Quality of Life

Aubrey Sheiham

The compartmentalization involved in viewing the mouth separately from the rest of the body must cease because oral health affects general health by causing considerable pain and suffering and by changing what people eat, their speech and their quality of life and well-being. Oral health also has an effect on other chronic diseases . Because of the failure to tackle social and material determinants and incorporate oral health into general health promotion, millions suffer intractable toothache and poor quality of life and end up with few teeth.

Health policies should be reoriented to incorporate oral health using sociodental approaches to assessing needs and the common risk factor approach for health promotion. Oral diseases are the most common of the chronic diseases and are important public health problems because of their prevalence, their impact on individuals and society, and the expense of their treatment. The determinants of oral diseases are known — they are the risk factors common to a number of chronic diseases: diet and dirt (hygiene), smoking, alcohol, risky behaviours causing injuries, and stress — and effective public health methods are available to prevent oral diseases.

 In some countries, oral diseases are the fourth most expensive diseases to treat.  Treating  caries, estimated at US$ 3513 per 1000 children, would exceed the total  health  budget for  children of most low-income countries. The situation for  adults  in  developing countries is  worse, as they suffer from the accumulation of  untreated  oral  diseases. There are few  efficient dental care systems to cope with  their  problems, and  where there are, the cost is  beyond most people’s means.  Millions  with untreated  caries  have cavities and suppuration,  yet planners  continue to  overlook oral diseases,  despite their significant impact on cost and quality of life. This  oversight will lead to  more decay and expensive, ineffective clinical interventions.

Oral health affects people physically and psychologically and influences how they grow, enjoy life, look, speak, chew, taste food and socialize, as well as their feelings of social well-being. Severe caries detracts from children’s quality of life: they experience pain, discomfort, disfigurement, acute and chronic infections, and eating and sleep disruption as well as higher risk of hospitalization, high treatment costs and loss of school days with the consequently diminished ability to learn. Caries affects nutrition, growth and weight gain. Children of three years of age with nursing caries weighed about 1 kg less than control children because toothache and infection alter eating and sleeping habits, dietary intake and metabolic processes. Disturbed sleep affects glucosteroid production. In addition, there is suppression of haemoglobin from depressed erythrocyte production.

Ninety per cent of pre-adolescents reported an impact related to oral health. Prevalence of dental pain was found to be about 33% among Brazilian teenagers, of whom 9% reported distressing, excruciating pain. Toothache leads to school absence, which is a ready indicator of children’s health. In the USA, where caries is lower than elsewhere, visits or dental problems accounted for 117 000 hours of school lost per 100 000 children. Because most school dental services work mainly during school hours, loss of schooling among the poor, who have higher caries rates, is high.

In Thailand, 74% of 35–44-year olds had daily performances affected by their oral state: 46% reported their emotional
stability was affected. Dental problems that cause chewing to be painful affect intake of dietary fibre and some nutrient-rich foods; consequently, serum levels of beta carotene, folate and vitamin C were significantly lower in those with poorer oral status.

Contemporary concepts of health suggest that oral health should be defined in general physical, psychological and social well-being terms in relation to oral status. Cohen & Jago consider the greatest contribution of dentistry is to improve quality of life. Disruptions in physical, psychological and social functioning are therefore important in assessing oral health. Traditional measures use mainly clinical indices, though there are alternatives using measures of oral health-related quality of life in sociodental approaches to assessing need.

Chronic diseases such as obesity, diabetes and caries are increasing in developing countries, with the implication that quality of life related to oral health, as well as general quality of life, may deteriorate. Because oral and other chronic diseases have determinants in common, more emphasis should be on the common risk factor approach. The key concept underlying future oral health strategies is integration with this approach, a major benefit being the focus on improving health conditions in general for the whole population and for groups at high risk, thereby reducing social inequities.

By integrating oral health into strategies for promoting general health and by assessing oral needs in sociodental ways, health planners can greatly enhance both general and oral health.

Source: http://www.who.int/bulletin/volumes/83/9/editorial30905html/en/

Dealing With Acne

Facial acne

Acne usually starts in puberty, but it affects adults too. Around 80% of teenagers get some form of acne, and there are many myths about what causes it. Here are the facts and details of treatments.

Acne consists of spots and painful bumps on the skin. It’s most noticeable on the face, but can also appear on the back, shoulders and buttocks. Severe acne can cause scarring.

What causes acne?

Acne is mostly due to the way skin reacts to hormonal changes. The skin contains sebaceous glands that naturally release sebum, an oily substance that helps protect it. During puberty, raised levels of the hormone testosterone can cause too much sebum to be produced. This happens in both boys and girls.

The sebum can block hair follicles. When dead skin cells mix with the blockage, it can lead to the formation of spots. Bacteria in the skin multiply, which can cause pain and swelling (inflammation) beneath the blockages.

There are different kinds of spots:

  • Blackheads are small, blocked pores.
  • Whiteheads are small, hard bumps with a white centre.
  • Pustules are spots with a lot of pus visible.
  • Nodules are hard, painful lumps under the skin.

Inflammatory acne is when the skin is also red and swollen. This needs to be treated early to prevent scarring.

Try not to pick or squeeze spots as this can cause inflammation and lead to scarring. Spots will eventually go away on their own, but they might leave redness in the skin for some weeks or months afterwards.

Acne can become worse during times of stress. In women, it can be affected by the menstrual cycle. Sometimes, acne can occur during pregnancy.

If you have acne, wash your skin gently with a mild cleanser and use an oil-free moisturiser. Scrubbing or exfoliating can irritate the skin, making it look and feel sore.

Myths about acne

There are several myths about what causes acne:


Many people say that eating chocolate or greasy food causes acne, but this isn’t true. There isn’t any evidence that acne is caused by what you eat. However, eating a balanced diet is good for your general health so aim to eat as healthily as you can.

Bad hygiene

Some people believe that acne is caused by bad personal hygiene, but this is not true. If you are going to get acne, you will get it no matter how much you clean your skin. Too much cleaning can make the condition worse by removing the protective oils in your skin.


There is also a myth that wearing make-up can cause spots, but there is no evidence that this is the case. The less you touch your skin, the fewer bacteria will be spread to your skin. If you wear make-up, wash your hands before putting your make-up on and always remove it before going to bed.

Treatments for acne

Acne will usually go away on its own, but it can take many years. There are treatments that can help clear acne more quickly. Over-the-counter treatments can help with mild acne. Ask a pharmacist for advice on which treatment could help and how long you will have to use it. You may not see results for several weeks.

If over-the-counter treatments don’t help, treatments are available on prescription. Your GP can assess how bad your acne is and discuss the options with you. Don’t be afraid to tell your GP how your acne affects your life and how it makes you feel.

Mild, non-inflammatory acne consists of whiteheads and blackheads. Treatments include gels or lotions that can contain retinoids (vitamin A), topical (applied to the skin) antibiotics, benzoyl peroxide (which is antibacterial) or azelaic acid.

These medications, or a combination of them, can also be used to treat mild-to-moderate inflammatory acne, which has some pustules and nodules. It can take up to eight weeks before you see a difference in your skin, and treatment may need to be continued for six months.

In women, contraceptive pills that contain oestrogen can help clear acne.

If acne is severe, your GP can refer you to a dermatologist who may prescribe a stronger medication called isotretinoin (Roaccutane). Find out about acne treatments,including isotretinoin.

Some light and laser therapies claim to help get rid of acne. However, few if any of these are available on the NHS.

Source: http://www.nhs.uk/Livewell/skin/Pages/Acne.aspx