Vitamin D Improves Insulin Response

Diabetics and many people diagnosed as “pre-diabetics” may be helped by vitamin D supplementation, according to a new study previewed in our Diabetes Research Page.

Unlike studies that look at populations and try to determine the underlying factors for a certain health aspect, this study is a true randomized, double-blind study. One group of 42 insulin-resistant women were given 4000 IU of vitamin D3 and another group of 39 were given a placebo. As is standard in this type of study, neither the women or their doctors knew if they were getting the vitamin or the placebo. To further refine the study, all of the women were south Asian, to try and account for any racial or ethnic differences in the way the vitamin might be metabolized. The trial lasted 6 months, with direct testing of insulin levels.

The study will be published soon; the link above is to the synopsis and “preview” of the study’s results. The conclusion of the researchers is that supplementing vitamin D levels improved insulin resistance and made the cells more sensitive to insulin without affecting the pancreas’ insulin secretion (that’s a good thing). In addition, they didn’t note any change in overall lipid profile (cholesterol, triglycerides, etc.) or high sensitivity C-reactive protein, a measure of inflammation associated by some researchers with increased risk of coronary heart disease. Another good thing!

Diabetics should consult with their physician to see if supplementing with vitamin D can be a part of their treatment. If the vitamin D response is the same as found in this study, it may be possible to reduce of the amount of insulin needed daily.

Dieting for Risk Factors

With the usual caveat that I am not a medical professional, I want to propose an idea for your consideration. I would encourage you to discuss this idea with your doctor before embarking on any diet plan.

I think it makes sense to first identify your individual risk factors for the things that kill us. The Centers for Disease Control (CDC) publishes charts showing the leading causes of death for men and for women. Looking at the charts you see that heart disease is the leading cause of death at about 27% of all deaths. We tend to focus on those stats and work to minimize our chances of dying from heart disease. That’s certainly the approach taken on a society-wide level with the low-fat diet recommendations (the low fat diet is thought to reduce serum cholesterol levels leading to less heart disease, although many of us find that it increases cholesterol instead.) What I think we are ignoring is that our individual risk factors may be for something entirely different. Remember, that heart disease is not the cause of death for a majority of the people … 73% of them, in fact. Are we increasing our risk of dying early by trying to reduce our risk for heart disease?

The American Heart Association (AHA) identifies the risk factors for heart disease in two categories, those you can change and those you cannot. The categories are a mistake, in my view. It is the risk factors you cannot change that may be the most susceptible to changes in diet: age, sex and heredity. 83% of the deaths due to heart disease happen after age 65, so time is on your side if you are younger than that. Males are more susceptible to heart disease, and have a higher incidence of dying younger than that age 65 statistic. And family history, including race, plays a factor.

The factors you “can change”, according to the AHA, are things like tobacco use, obesity, high blood pressure, serum cholesterol levels, activity levels, and diabetes.

The standard treatment to reduce risk factors for heart disease is a low fat, relatively high carbohydrate diet and prescription drugs to lower cholesterol. The prescription drugs are necessary because many people find a low fat, high carbohydrate diet raises cholesterol (especially triglycerides). Low carb diet advocates challenge this view, and note that many people find a low carb diet improves their lipid profile without the use of prescription drugs (as well as improving weight, high blood pressure and other factors).

The problem is that there is no easy way to score these factors. Do you check off each factor, and if you have more than three, start to worry? Or is family history such an important factor that it, by itself, compels you to work to reduce your risk? Certainly, if your parents and all your siblings died of heart attacks, you probably realize it “runs in your family.” But for most of us, even getting the full list of risk factors isn’t enough to tell us if we, personally, are at risk.

The place to start is a doctor who knows your medical history. Ask him point blank: what do you think I’m going to die from? The answer will be about risk factors for the diseases on those CDC charts, and which one your history indicates the greatest risk for you. Heart disease and cancer are at the top, by a large margin. But as you read down the list, you see stroke, respiratory disease, and diabetes.

Its interesting that diabetes is a risk factor for heart disease, and diabetes itself is the 6th leading cause of death.

My largest risk factor, given my family history and age, sex and physical condition is diabetes. Several people in my family, a brother and my mother, have adult-onset diabetes. I’m male, over 50, and have more than two of the markers for “metabolic syndrome” (pdf file from CDC on metabolic syndrome). In contrast to that, I have very little heart disease in my immediate family.

My doctor recommended a low carb diet to reduce my high triglyceride level; success is shown by lowering triglycerides from 462 to 113 on my last blood test. I’m staying on it to lower my weight and blood glucose level, as well as meet the other cholesterol goals (HDL, LDL, etc., as shown on the About Page).

The term “diet” is often associated with a reduced calorie, temporary eating regimen that you abandon after reaching a weight goal. The problem with this approach is that it ignores the very real impact your diet has on your health. The real goal should be to live longer, not simply to lose weight and “look good”. A pretty corpse is still dead.

Your diet should reflect the best bet to protect against your individual risk factors, and not to fulfill a broad societal goal.

Bodies and Bonfires

Ever wonder just how they determined what a dietary calorie is, and how they know how much energy you get from it? Like many things in dietary science, the answer is surprising.

They burn it and measure the calories (a unit of heat energy) the food gives off. Sort of. A scientist in the 1800’s figured this out, and we’ve been using his system ever since.

Except it doesn’t work. Your body does not “burn” food, it digests it. So there are problems with the method. But as New Scientist notes, there is resistance to changing the flawed system:

“There will be errors, but not very serious errors, and nobody can do their calories anyway so what difference does it make?” says Marion Nestle, a nutritionist at New York University.

Gotta’ love those nutritionists.

The article gives a real-world example that is worth noting. Two foods may have similar calorie counts but end up being utilized (DIGESTED!) by the body in different ways. A brownie, filled with refined starches and sugars, may have a calorie rating of 250 and a “healthy” snack bar with “complex carbs” a rating of 300, yet the body will extract more calories from the brownie. The dieter counting calories is fooled by the system. But, it doesn’t really matter to nutritionists; no one does it right anyway, right?

After the not-so-compelling browning/muslei bar example, the article actually talks about real food. What you quickly see is that trying to count calories becomes incredibly complex, and as our expanding waistlines have told us, does nothing to help reduce obesity.

For my money, counting what you can’t count accurately doesn’t make a lot of sense. Paying attention to what you eat, and not just how much, seems more consistent with human health.

Unless you think you really are a bonfire. Then burn, baby, burn.