Tag Archives: glucose

Diabetes 101: What you need to know for American Diabetes Month.

Diabetes is among the fastest-growing health conditions in the United States. Over 30 million adults have diabetes, with 1.5 million new cases each year. If you include prediabetes, which tends to lead to diabetes if untreated, over 115 million Americans are affected. Fortunately, most cases of diabetes can be treated or prevented through healthy eating, weight control, and regular exercise.

Since November is American Diabetes Month, this seems like a good time to raise awareness about the prevention, treatment, and consequences of this serious medical condition.  If you want to learn more about diabetes, a great place to start is American Diabetes Association. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

diabetes


Diabetes mellitus is a metabolic disorder characterized by high blood glucose (sugar) caused by a lack of insulin production or impaired insulin action. The lack of insulin production can be caused by an autoimmune disorder that damages the pancreas. This typically occurs during childhood, as in type 1 or “juvenile” diabetes, but it can occur in adults, a condition called latent autoimmune diabetes of adulthood (LADA). For both types, injected insulin is required to control blood glucose.

More commonly, diabetes is caused by the body’s cells not responding to the insulin that is produced, a condition called insulin resistance. This is called type 2 diabetes and is thought to be caused by some combination of obesity, particularly excess abdominal fat, and physical inactivity.

Diabetes can be diagnosed based on a fasting blood glucose test, taken 8–12 hours after a meal, usually in the morning. Another test is an oral glucose tolerance test in which blood glucose is measured for two hours after drinking a special beverage containing glucose. This measures the body’s response to glucose. The hemoglobin A1C test is a long-term measure of blood glucose control. This is important because the higher the hemoglobin A1C level, the greater the risk of diabetes complications.

For most diabetics, the main treatment goal is to control blood glucose level to prevent serious complications including nerve damage, blindness, infection and amputation, heart attack, and stroke. This is typically accomplished through a combination of diet, exercise, and medications, with varying degrees of success. But “curing” diabetes is rare, so most patients require continued treatment.

Exercise is important for blood glucose control because exercise causes an increase in the uptake of glucose into cells and can improve glucose tolerance and insulin sensitivity. In addition, exercise has the added benefits of promoting weight loss and improving strength and fitness. Both aerobic and strength training are recommended, with a minimum goal of 30 minutes per day, every day.

Meal planning involves selecting healthy foods to help maintain consistent blood glucose levels while meeting energy needs for exercise and other activities. The dietary recommendations for preventing and treating diabetes are almost identical to the general recommendations for good health: Emphasize whole grains, fruits, vegetables, legumes, and low-fat meat and dairy and reduce unhealthy fats, added sugars, and salt. The diet should also promote weight loss and weight maintenance, especially for overweight patients. The glycemic index (GI), a measure of how much a food raises blood glucose, can be helpful in dietary planning, but it is not the only meal planning tool that should be used.

Proper diet, blood glucose testing, medication use, and regular exercise can improve blood glucose control, reduce the risk of other health problems, and improve quality of life in diabetics. In those with prediabetes these efforts can delay the progression to diabetes and may even result in a return to normal blood glucose. In fact, diet and exercise have been shown to be more effective than medications in preventing diabetes. Plus, these lifestyle changes lead to weight loss and improved fitness, benefits that no medication can match.


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The Science of Sports Drinks

What do you drink during exercise? For most people, the answer is probably water. But many athletes and people who do vigorous exercise are likely to consume a sports drink, like Gatorade or Powerade, while they work out. While there are some differences among the various sports drinks, these beverages are specially formulated to meet the demands of athletes engaged in prolonged, intense exercise. In fact, most contain a similar combination of water, sugar, and salt, along with flavoring to make them palatable. Research and practical experience supports the use of sports drinks to improve performance in endurance events (think running and cycling) that last an hour or more. In my Health & Fitness column in the Aiken Standard this week I explore the the components of sports drinks and why they may be beneficial—and when they aren’t.

Sports drink


Obviously, water is important for replacing sweat loss during exercise, something that is even more critical in a hot, humid environment. During intense exercise on a hot day, sweat losses can be well above one liter per hour. Failure to replenish this water loss can lead to poor performance due to physiological and psychological fatigue. In extreme cases, severe dehydration can lead to hyperthermia and heat stroke. For most athletes, 500–1000 ml (16–32 oz.) of fluid per hour is sufficient, but more may be needed to meet individual needs.

Carbohydrate replacement has long been associated with endurance performance. Vigorous exercise requires lots of carbohydrates in the form of glucose to fuel the active muscles. Your muscles can use 60–120 g of glucose per hour, depending on intensity. You store glucose in your liver and muscles as glycogen which gets broken down during exercise. But these supplies are limited and are diminished after an hour or so of intense exercise. Recommended intake is in the range of 30–60 g carbohydrate per hour during exercise to deliver glucose to the muscle sustain exercise. Almost any carbohydrate will work, but sports drinks contain sugars that are absorbed quickly. It is also essential to maintain blood glucose since, as I tell my students, “if your blood glucose drops, you drop!”

Sports drinks also contain some salt. First the salt replaces what you lose in your sweat, preventing a dangerous condition called hyponatremia. Fortunately, most people eat enough salt throughout the day and don’t lose enough in their sweat to create problems. Another reason for including salt is that glucose is absorbed with sodium, so having both gets the carbohydrates into your blood faster. Additionally, levels of sodium in the blood act to stimulate thirst. Consuming salt makes athletes thirsty, and thirsty athletes are more likely to drink more.

The composition of sports drinks is important, but the way they are consumed matters, too. Research shows that drinking smaller amounts of fluid more frequently, say 12 ounces every 15 minutes, is better than 32 ounces at the end of an hour. Carbohydrate content is important, but more isn’t necessarily better. Most sports drinks are in the range of 8%, which is ideal for getting the sugar absorbed into the blood. Drink temperature matters, too, and colder drinks are absorbed faster. Obviously, you are more likely to drink beverages that taste good, so finding a flavor you like is important.

Much of the research into hydration, sports drinks, and performance  has been done at the Gatorade Sports Science Institute. Despite the name, the research done by GSSI scientists has served to advance the knowledge of exercise physiologists, sports nutritionists, and sports medicine professionals as well as athletes, coaches, and trainers. The research and recommendations are relevant even if you don’t use Gatorade.

Now that you know what is in most sports drinks and why, you may wonder if you need one during exercise. Unless you are doing intense exercise lasting over an hour, probably not. Water is sufficient for most people who exercise. And consider this: sports drink contain as much sugar and calories as soda. If you are exercising to lose weight, a sports drink during (or after) exercise might sabotage your efforts!


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

Diabetes 101: What you need to know

Diabetes is among the fastest-growing health conditions in the United States. Nearly 30 million adults have diabetes, with nearly 2 million new cases each year. If you include prediabetes, which tends to lead to diabetes if untreated, over 115 million Americans are affected. Fortunately, most cases of diabetes can be treated or prevented through healthy eating, weight control, and regular exercise.

Since November is American Diabetes Month, this seems like a good time to raise awareness about the prevention, treatment, and consequences of this serious medical condition.  If you want to learn more about diabetes, a great place to start is American Diabetes Association. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

diabetes


Diabetes mellitus is a metabolic disorder characterized by high blood glucose (sugar) caused by a lack of insulin production or impaired insulin action. The lack of insulin production can be caused by an autoimmune disorder that damages the pancreas. This typically occurs during childhood, as in type 1 or “juvenile” diabetes, but it can occur in adults, a condition called latent autoimmune diabetes of adulthood (LADA). For both types, injected insulin is required to control blood glucose.

More commonly, diabetes is caused by the body’s cells not responding to the insulin that is produced, a condition called insulin resistance. This is called type 2 diabetes and is thought to be caused by some combination of obesity, particularly excess abdominal fat, and physical inactivity.

Diabetes can be diagnosed based on a fasting blood glucose test, taken 8–12 hours after a meal, usually in the morning. Another test is an oral glucose tolerance test in which blood glucose is measured for two hours after drinking a special beverage containing glucose. This measures the body’s response to glucose. The hemoglobin A1C test is a long-term measure of blood glucose control. This is important because the higher the hemoglobin A1C level, the greater the risk of diabetes complications.

For most diabetics, the main treatment goal is to control blood glucose level to prevent serious complications including nerve damage, blindness, infection and amputation, heart attack, and stroke. This is typically accomplished through a combination of diet, exercise, and medications, with varying degrees of success. But “curing” diabetes is rare, so most patients require continued treatment.

Exercise is important for blood glucose control because exercise causes an increase in the uptake of glucose into cells and can improve glucose tolerance and insulin sensitivity. In addition, exercise has the added benefits of promoting weight loss and improving strength and fitness. Both aerobic and strength training are recommended, with a minimum goal of 30 minutes per day, every day.

Meal planning involves selecting healthy foods to help maintain consistent blood glucose levels while meeting energy needs for exercise and other activities. The dietary recommendations for preventing and treating diabetes are almost identical to the general recommendations for good health: Emphasize whole grains, fruits, vegetables, legumes, and low-fat meat and dairy and reduce unhealthy fats, added sugars, and salt. The diet should also promote weight loss and weight maintenance, especially for overweight patients. The glycemic index (GI), a measure of how much a food raises blood glucose, can be helpful in dietary planning, but it is not the only meal planning tool that should be used.

Proper diet, blood glucose testing, medication use, and regular exercise can improve blood glucose control, reduce the risk of other health problems, and improve quality of life in diabetics. In those with prediabetes these efforts can delay the progression to diabetes and may even result in a return to normal blood glucose. In fact, diet and exercise have been shown to be more effective than medications in preventing diabetes. Plus, these lifestyle changes lead to weight loss and improved fitness, benefits that no medication can match.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr