Hypertension (HTN) affects more than a third (32.6%) of Americans and is a major risk factor for heart disease and mortality.1 Unfortunately, the exact mechanisms as to development and maintenance of this condition are yet to be understood. It has been suggested that HTN is associated with a fundamental defect in the ability for the kidneys to excrete sodium.2 Salt sensitivity of blood pressure (BP) is a measurable, physiological, trait where an increase in dietary sodium intake leads to an increase in…

During periods of over-nutrition, excess energy is stored in white adipose tissue (WAT); continuing expansion of WAT may lead to obesity. Obesity alters the cellular physiology of adipocytes, the cells of WAT. In the context of obesity, adipocytes secrete elevated levels of free fatty acids and adipokines, but decreased levels of adiponectin. These pathophysiologic changes have many effects. Elevated free fatty acids contribute to insulin resistance, oxidative stress, inflammation, and impaired arterial flow regulation Download the PDF

The clinical results of a randomized controlled research study that showed a diabetes-specific nutrition formula for glucose control in combination with a structured dietary plan resulted in significant reduction in HbA1c levels and body weight in overweight and obese patients with type 2 diabetes (T2D) compared to an individualized dietary plan alone. The study, conducted by the Joslin Diabetes Center, was presented at the American Diabetes Association’s 76th Scientific Sessions in New Orleans, Louisiana. "Effective management of A1c levels, while challenging, is…

Type 2 diabetes is an increasing global health issue, which benefits from ongoing research in medical nutrition therapy. All attempts to introduce a modified diet, reduced caloric intake and physical activity have been shown to assistance patients experiencing glucose toxicity. Impaired glucose tolerance causes many health issues, including cardiovascular disease. This review covers the criteria for diagnosis of diabetes and prediabetes research completed by Osama Hamdy, MD, PhD, Medical Director of the Obesity Clinical Program, at the Joslin Diabetes Center.…

by Bianca Garilli, ND, IFMCP A common concern in peri- and postmenopausal years is weight gain, typically 1.5 pounds per year during the fifth and sixth decades of life and shown to be independent of a woman’s initial body size or race/ethnicity. It was previously believed that the increase in weight coincided with the onset of menopause most likely due to the drop in estrogen levels. Although declining estrogen levels has, in fact, been shown to lead to an increase…

by Bianca Garilli, ND Diabetic peripheral neuropathy (DPN), a common complication of diabetes, leads to pain and loss of feeling in the hands, arms, feet and legs. The incidence of neuropathy is approximately 45% for patients with type 2 diabetes mellitus (T2D) and is responsible for more hospital admissions than all other diabetic complications combined; as well as accounting for 50-75% of non-traumatic amputations.1-2 The most common pharmaceutical treatments utilized in DPN cases include analgesics and anti-depressants along with physical therapy,…

A meta-analysis including 12 studies that included > 280,000 participants found that both obesity and underweight are associated with an increased risk for migraines.1 Prior research had indicated an association between higher weight and migraines and while exact mechanisms are not known, it has been postulated that overweight individuals may have increased adipose tissue secretion of pro-inflammatory cytokines, increased adipocytokines, and increased circulating sex hormones all of which may play a role in migraine development and severity. Studies have also shown patients…

by Lewis Chang, PhD  An editorial perspective, recently published in the Journal of American Medical Association (JAMA) obesity-themed issue, helps to explain the growing interest in the ketogenic diet for weight and type 2 diabetes (T2D) management [1]. Many people successfully lose weight via diet over the short haul; however, because of physiological adaptations, it becomes much more difficult to maintain that weight loss in the long run. As a result, a majority of people regain their weight—and sometimes more. Interestingly, accumulating evidence suggests…

The Centers for Disease Control (CDC) recently released their latest National Diabetes Statistics Report— and the news is not optimistic. The report indicates that one in 10 (30.3 million) US adults has diabetes, while more than one in three–or 84.1 million–has prediabetes. What is even more disconcerting is that 90% of those with prediabetes are not aware of their condition!  As the CDC report notes, most people with prediabetes do not know that they are at high risk to progress to…

A recent article  published in a recent edition of Preventing Chronic Disease: Public Health Research, Practice and Policy proposes a shift from discussing BMI and weight loss with patients in the provider’s office, to focusing on the topics of awareness and education surrounding healthy life habits, physical activity in particular.  Authors Emily Dollar and team encourage an emphasis on cardiorespiratory fitness over body size to minimize the risk of stigma associated with overweight and obesity and increase collaboration between patient and provider.…