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Q&A #66 with Dr. Rhonda Patrick (1/4/25)

Posted on January 9th 2025 (4 months)

Dr. Rhonda Patrick discusses GLP-1 agonists, alpha-lipoic acid, ubiquinone vs. ubiquinol, calcium needs, and liquid biopsy cancer screening.

rhonda
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Q&A #61 with Dr. Rhonda Patrick (8/3/24)

Posted on August 28th 2024 (9 months)

Dr. Rhonda Patrick discusses xylitol safety, strategies to reduce hemoglobin A1C, klotho and dementia risk, and the timing of hormone replacement therapy.

exercise

HIIT – contraindications and considerations for older adults | Dr. Martin Gibala

Posted on October 4th 2023 (over 1 year)

In this clip, Dr. Martin Gibala weighs the risks vs. benefits of interval training across ages, highlighting its advantage over sedentary life.

Topic Pages

  • Alcohol

    Alcohol is one of the most widely used and abused drugs and is associated with several health conditions.

  • Berberine

    Berberine is a plant-based compound with pharmacological actions that share many features with metformin.

  • Breast milk and breastfeeding

    Breast milk is a complex, dynamic fluid containing nutritional and non-nutritional components that support infant development. Breastfeeding benefits both infants and mothers.

  • Cold exposure

    Cold exposure may be a hormetic stressor that reduces inflammation, activates antioxidant enzymes, and boosts the immune system to protect against age-related diseases.

  • Metformin

    Metformin, a drug commonly used to treat type 2 diabetes, may modulate certain aging processes.

  • Polyphenol-rich diets and neurodegeneration (glycemic control)
    stub

    Polphenol-rich diets promote better glucose regulation can help slow brain aging, preserve hippocampal function, and reduce cognitive decline over time.

  • Sugar-sweetened beverages (SSBs)

    Sugar-sweetened beverages such as soda, juice, and sports drinks provide large doses of rapidly absorbable sugar, posing a unique risk to health.

  • Ultra-processed Foods (UPFs)

    UPFs are formulations of mostly cheap industrial sources of dietary energy (calories) and nutrients plus additives that have negative effects on human health.

News & Publications

  • The combined effects of hypertension, diabetes, and smoking may accelerate brain aging, with hypertension being the most significant predictor of structural decline. spj.science.org
    Brain Aging Diabetes Blood Pressure

    Your brain may be aging faster than the rest of your body. While some people maintain brain health well into old age, others experience structural decline much earlier. A recent study found that multiple health factors—including hypertension, diabetes, smoking, and low educational attainment—may speed up brain aging, increasing the risk of cognitive decline and neurodegenerative diseases.

    Researchers analyzed brain scans and long-term health data from 964 adults in northern China, monitoring them for 16 years. They used machine learning to estimate brain age based on imaging techniques and compared brain aging among groups with various high-risk health factors. They also focused on people with high blood pressure to see how it affects brain structure.

    They found that people with four or five high-risk factors had considerably older-looking brains than those with fewer risks, suggesting that multiple health problems may accelerate brain aging. Hypertension, high blood sugar, elevated creatinine (a feature of metabolic disease), smoking, and lower education were the strongest predictors of brain structure decline. However, hypertension had the strongest link, with hypertensive participants exhibiting more substantial structural deterioration.

    These findings suggest maintaining good cardiovascular and metabolic health may help slow brain aging. Hypertension damages the brain’s microvasculature. Learn how exercise preserves these tiny blood vessels, helping to maintain cognitive health.

    Read more
  • A daily dose of coenzyme Q10—100 milligrams or less—reduces blood pressure by about 4mmH systolic and 3mmHG diastolic in people with type 2 diabetes, potentially lowering cardiovascular risk. www.clinicaltherapeutics.com
    Diabetes Blood Pressure Antioxidant Cardiovascular

    Most people with type 2 diabetes know they need to manage their blood glucose levels, but many may not realize they are at higher risk for heart disease. One potential option for reducing that risk is coenzyme Q10, a naturally occurring antioxidant. A recent study found that supplementing with coenzyme Q10 (CoQ10) helps lower blood pressure in people with type 2 diabetes.

    Researchers reviewed data from 16 clinical trials that measured CoQ10 levels in people with type 2 diabetes. They focused on changes in blood pressure and cholesterol levels, comparing those who took the supplement to those who did not.

    Their analysis revealed that CoQ10 lowered systolic blood pressure by about 4 mmHg and diastolic blood pressure by about 3 mmHg. While it didn’t improve cholesterol levels overall, some subgroup analyses showed better results with lower doses (100 milligrams daily or less) and shorter study durations (less than 12 weeks). Notably, these findings were more pronounced in studies with larger participant groups (more than 50 people) and participants aged 55 or younger.

    A reduction of 4 mmHg in systolic blood pressure may seem modest, but even small reductions can lower the risk of heart disease and stroke. For example, a comprehensive analysis found that a 5-mmHg decrease in systolic blood pressure reduced the risk of major cardiovascular events by approximately 10%00590-0/fulltext).

    These findings suggest that CoQ10 could be a useful addition to diabetes treatment for managing blood pressure and reducing cardiovascular risk. A common feature of diabetes and cardiovascular disease is inflammation. Learn how to reduce chronic inflammation in Aliquot #84: Putting the Brakes on Chronic Inflammation

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  • Nearly half of people with type 2 diabetes have multiple micronutrient deficiencies—the most common being vitamin D. nutrition.bmj.com
    Vitamin D Diabetes Micronutrients Magnesium Vitamin B12 Insulin Metformin

    Micronutrient deficiencies contribute to insulin resistance, a key driver of type 2 diabetes, but researchers still don’t fully understand their role in the disease’s progression. A recent study found that nearly half of people with type 2 diabetes suffer from multiple micronutrient deficiencies, with vitamin D being the most prevalent.

    Researchers analyzed data from studies investigating links between micronutrient deficiencies and type 2 diabetes. Their analysis included 132 studies and more than 52,000 participants.

    They found that 45% of people with type 2 diabetes had multiple micronutrient deficiencies. Women with the disease were more likely to have deficiencies, with 48% affected compared to 41% of men. Vitamin D deficiency was the most common, affecting 60% of participants, followed by magnesium (42%) and vitamin B12 (28%)—the latter being especially prevalent among people with type 2 diabetes who were taking metformin. The prevalence of deficiencies also varied by region.

    These findings suggest that micronutrient deficiencies are widespread in people with type 2 diabetes, particularly among women. Check out our many resources on micronutrients, including vitamin D and magnesium, and the long-term health consequences of deficiencies.

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  • Sulforaphane-rich broccoli sprout extract modestly lowers fasting blood sugar in some people with prediabetes, perhaps due to variations in gut microbiota and individual metabolic traits. www.nature.com
    Diet Diabetes Sulforaphane

    Many people with prediabetes never receive structured treatment, even though early intervention offers the best chance of reversing high blood sugar. While lifestyle changes are the primary recommendation, they are challenging to implement and often ineffective. A recent study found that a broccoli sprout extract rich in sulforaphane modestly lowered fasting blood sugar in some people with prediabetes.

    Researchers conducted a 12-week, randomized, double-blind, placebo-controlled trial involving 74 participants with prediabetes who had not previously taken medication for the condition. Participants took a daily dose of broccoli sprout extract or a placebo, and researchers measured changes in their fasting blood sugar. They also analyzed gut microbial composition and genetic markers to explore potential differences in response.

    Overall, the extract slightly reduced fasting blood sugar levels (3.6 milligrams per deciliter, mg/dL) compared to the placebo but did not meet the predefined target for effectiveness. However, a subgroup of participants with mild obesity, lower insulin resistance, and reduced insulin secretion saw a greater reduction in blood sugar—about 7.2 mg/dL. These participants also had a distinct gut microbiota composition, including a higher abundance of bacterial genes linked to sulforaphane activation.

    Sulforaphane forms when glucoraphanin, found in broccoli sprouts, interacts with the enzyme myrosinase. Myrosinase activates when the plant cells are damaged, such as during chewing or processing. In the absence of myrosinase, some people’s gut microbes produce similar enzymes, helping convert more glucoraphanin into sulforaphane. This variation in gut bacteria may explain why some people respond more strongly to sulforaphane-rich foods or supplements.

    These findings suggest that gut microbes and individual metabolic traits may influence the effectiveness of nutritional interventions for prediabetes. One in three people in the U.S. has prediabetes. Learn more in this clip featuring Dr. Michael Snyder.

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  • GLP-1 receptor agonists may lower risks for major illnesses like dementia and seizures. www.nature.com
    Diabetes Drug Dementia Weight Loss Cardiovascular

    Ozempic, Wegovy, and other glucagon-like peptide-1 (GLP-1) drugs have catapulted into the mainstream of diabetes care, with more than 15 million people in the U.S. currently taking one. Evidence suggests GLP-1 drugs have many off-target effects—both good and bad—but healthcare providers don’t currently know the full extent of the drugs' effects. However, a recent analysis found that GLP-1s may reduce the risk of dementia, seizures, respiratory illnesses, cardiometabolic disorders, and certain infections more effectively than other diabetes drugs and typical care.

    Using the U.S. Department of Veterans Affairs healthcare databases, researchers identified roughly two million people with diabetes who were using a GLP-1 drug, one of three common anti-diabetes drugs (sulfonylureas, DPP4 inhibitors, or SGLT2 inhibitors), or continuing their usual care without adding new therapies. They tracked the participants' health for about 3.6 years.

    They found that GLP-1 use was associated with a reduced risk of dementia (8%), seizures (10%), respiratory illnesses (10% to 25%), cardiometabolic disorders (7% to 22%), and certain infections (12% to 25%). However, the drugs were associated with an increased risk of gastrointestinal issues (5% to 20%), low blood pressure (10%), kidney problems (10% to 15%), arthritic disorders (10% to 16%), and pancreatitis (15% to 20%).

    These findings suggest that GLP-1 receptor agonists offer promising benefits for people with diabetes while highlighting potential risks. Further research will illuminate the full range of the drugs' effects. Learn more about GLP-1 drugs in this clip featuring Dr. Rhonda Patrick.

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  • High-protein, low-calorie diets—whether animal or plant-based—lead to an average weight loss of ~18 pounds and improved glucose metabolism in people at risk for type 2 diabetes. dom-pubs.pericles-prod.literatumonline.com
    Diet Obesity Diabetes Muscle Protein Weight Loss

    The global obesity epidemic is driving a marked increase in the incidence of type 2 diabetes, and some experts estimate that by 2024, more than 780 million adults worldwide will develop the disease. A recent study found that high-protein, low-calorie diets promote weight loss and improve cardiometabolic markers in people at risk for type 2 diabetes.

    The study involved 117 adults with either prediabetes or type 2 diabetes and a body mass index (BMI) over 27.5—considered overweight or obese. Participants consumed an animal- or plant-based high-protein diet that provided 35% of their total calories for six months. The remainder of their calories came from fat (30%) and carbohydrates (35%).

    Participants in both groups saw similar improvements in body composition, including an average weight loss of approximately 8 kilograms (~18 pounds) and reduced visceral (abdominal) fat. Glucose metabolism indicators, such as fasting glucose and glycated hemoglobin levels, improved equally in both groups, as did lipid levels, liver enzymes, and inflammatory markers.

    These findings suggest that high-protein, low-calorie diets—whether animal- or plant-based—can improve body composition, glucose metabolism, and other cardiometabolic markers in people with prediabetes or type 2 diabetes.

    Dietary protein supports muscle hypertrophy and maintenance—critical aspects of glucose metabolism. Learn how to optimize protein intake to support muscle health when following a plant-based diet in this clip featuring Dr. Luc van Loon.

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  • A daily cup of coffee could reduce your risk of heart disease and diabetes by half. academic.oup.com
    Sleep Heart Disease Diabetes Biomarkers Coffee Green Tea Caffeine Stroke Cardiovascular

    Drinking your daily cup of coffee or tea might do more than give you a boost—it could lower your risk of developing multiple serious cardiometabolic conditions simultaneously, like diabetes, heart disease, or stroke. A recent study found that moderate coffee or caffeine consumption may cut your risk of cardiometabolic multimorbidity by as much as 50%.

    Researchers analyzed data from more than 172,000 participants enrolled in the UK Biobank who had no cardiometabolic diseases at the start. Participants reported their coffee, tea, and caffeine consumption; about half provided blood samples for metabolic marker analysis.

    They found that people who drank about three cups of coffee daily (or consumed 200 to 300 milligrams of caffeine daily) were 40% to 50% less likely to develop multiple cardiometabolic diseases than those who drank little or no caffeine. They also discovered that specific blood markers, such as certain lipid components, were linked to coffee and caffeine consumption and a lower risk of cardiometabolic conditions.

    These findings suggest that moderate coffee or caffeine intake reduces the risk of developing cardiometabolic diseases but also slows their progression if they occur. Other evidence points to the many health benefits associated with coffee and caffeine, but it’s crucial to remember their effects on sleep. Learn more in this Aliquot featuring Drs. Guido Kroemer, Satchin Panda, Elissa Epel, Matthew Walker, and Rhonda Patrick

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  • What are the optimal time-restricted eating patterns for cardiovascular wellness? pubmed.ncbi.nlm.nih.gov
    Diet Obesity Diabetes Cholesterol Time-Restricted Eating Blood Pressure Cardiovascular

    Time-restricted eating is a dietary pattern that restricts the time during which a person eats to a specific window, such as a “16:8" pattern, where they fast for 16 hours a day and consume food only during the remaining eight hours. Evidence suggests that time-restricted eating improves cognitive function, supports weight loss, and reduces systemic inflammation. Findings from a recent review and meta-analysis suggest that time-restricted eating also reduces the risk of cardiovascular disease.

    Researchers analyzed the findings of 33 studies involving 1,725 participants investigating the effects of time-restricted eating on markers of cardiovascular health. They conducted a sub-group analysis to determine how age, health characteristics, and eating patterns influenced the effects of time-restricted eating.

    They found that the effects of time-restricted eating on cardiovascular disease varied according to a person’s risk factors, age, and when they ate. The table below presents their findings for the optimal time-restricted eating for different groups.

    This meta-analysis and review identifies the optimal time-restricted eating interventions for blood pressure, obesity, lipids, and glucose. It effectively provides a best-practices guide for people interested in implementing time-restricted eating as a lifestyle modification to improve cardiovascular health. Learn more about time-restricted eating in this episode featuring Dr. Satchin Panda.

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  • Daily cinnamon supplementation averaging 2,100 milligrams – roughly a teaspoon – shows promise in managing type 2 diabetes. pubmed.ncbi.nlm.nih.gov
    Diet Diabetes Insulin Resistance Insulin Polyphenol

    Cinnamon is one of the most consumed spices in the world, popular in both sweet and savory dishes in many cuisines. Evidence suggests cinnamon improves lipid profiles and protects against damage induced by oxidative stress. A recent systematic review and meta-analysis found that cinnamon helps maintain healthy blood glucose levels and reduces insulin resistance in people with type 2 diabetes.

    Researchers analyzed the findings of 24 clinical trials investigating the effects of cinnamon supplementation on blood glucose levels. The various trials included more than 1,800 participants from 11 nations.

    The analysis revealed that cinnamon supplementation reduced fasting blood glucose levels, hemoglobin A1c concentrations, and insulin resistance (without lowering insulin) in people with type 2 diabetes. The trials varied in duration from six to 16 weeks, and daily cinnamon doses ranged from 120 to 6,000 milligrams, averaging 2,100 milligrams – roughly a teaspoon.

    These findings suggest that cinnamon improves symptoms of type 2 diabetes and may be a valuable adjunct to traditional therapies. Cinnamon is rich in polyphenols, a broad class of plant bioactive compounds. Learn more about polyphenols in our overview article.

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  • Kombucha reduces blood glucose levels by nearly 30 percent. www.frontiersin.org
    Nutrition Gut Diet Microbiome Diabetes

    Kombucha is a fermented beverage made from tea, sugar, bacteria, and yeast. Some evidence suggests that kombucha exerts antimicrobial, antioxidant, detoxifying, and liver-protective effects. A new study has found that kombucha lowers blood glucose levels by nearly 30 percent in people with type 2 diabetes.

    Researchers conducted a small trial involving 12 adults with type 2 diabetes. The participants drank approximately 8 ounces of either kombucha or a placebo beverage daily for four weeks. Eight weeks later, they switched to the other option. During each intervention, they measured their fasting blood glucose levels at the start and after one and four weeks. They completed questionnaires about their overall health, insulin needs, gut health, skin condition, and mental state. The researchers analyzed the kombucha’s microbiota and quantified its fermentation products.

    When the participants drank the kombucha, they experienced a notable drop in average fasting blood glucose levels by the end of the intervention compared to the start (164 versus 116 mg/dL – nearly 30 percent lower). However, the placebo group did not experience the same reduction (162 versus 141 mg/dL – less than 13 percent lower). The microbiota analysis revealed lactic acid bacteria, acetic acid bacteria, and yeast as the dominant components. The primary fermentation products were lactic acid, acetic acid, and ethanol.

    This was a very small study, but the findings suggest that kombucha might have blood glucose-lowering potential for people with diabetes. Learn how consuming fermented foods, such as kombucha, kefir, and others, increases gut microbial diversity and decreases inflammation in this clip from a live Q&A with Dr. Rhonda Patrick.

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  • Supplemental vitamin K2 improves diabetes markers and glycemic control. pubmed.ncbi.nlm.nih.gov
    Metabolism Diabetes Insulin Resistance Vitamin K Insulin

    Vitamin K2 – a form of vitamin K produced in the gut – plays important roles in blood clotting, bone mass maintenance, and blood vessel contractility. But new research shows that supplemental vitamin K2 also improves diabetes markers. People with type 2 diabetes who took supplemental vitamin K2 had better markers of glycemic control than those who took a placebo.

    Researchers performed a three-part study in humans and mice. First, they conducted a randomized controlled trial involving 60 adults who had type 2 diabetes. Half of the participants took vitamin K2 every day for six months, while the other half took a placebo. Then the researchers transplanted gut microbes from vitamin K2-supplemented mice into obese mice. Finally, they analyzed the gut microbial composition and their metabolites in both humans and mice.

    They found that the participants who received supplemental vitamin K2 experienced marked reductions in levels of fasting blood glucose (13.4 percent), insulin (28.3 percent), and HbA1c (7.4 percent), indicating improved glycemic control. Similarly, the mice demonstrated improved glucose tolerance after receiving the gut microbe transplants. Lastly, the researchers found that certain metabolites that play roles in glucose metabolism, including bile acids and short-chain fatty acids, increased in the feces of both groups. Furthermore, they identified a specific type of bacteria that was responsible for producing these metabolites.

    Vitamin K is a fat-soluble vitamin. The body has limited vitamin K storage capacity, so the body recycles it in a vitamin K redox cycle and reuses it multiple times. Naturally occurring forms of vitamin K include phylloquinone (vitamin K1) and a family of molecules called menaquinones (vitamin K2). Vitamin K1 is synthesized by plants and is the major form found in the diet. Vitamin K2 molecules are synthesized by the gut microbiota and found in fermented foods and some animal products (especially liver).

    These findings suggest that vitamin K2 participates in maintaining glycemic control in people with type 2 diabetes. They also underscore the role of the gut microbiota in this process. Learn about other roles for the gut microbiota in this episode featuring Dr. Eran Elinav.

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  • Peripheral amyloid-beta produced in the liver in type 2 diabetes may be a crucial link to Alzheimer’s disease www.sciencedaily.com
    Brain Alzheimer's Diabetes Neurodegeneration

    Amyloid-beta produced in peripheral tissues provides a link between diabetes and Alzheimer’s disease risk.

    Type 2 diabetes, a metabolic disorder characterized by glucose intolerance and insulin resistance, poses a significant public health concern, affecting roughly 470 million people worldwide. Having type 2 diabetes greatly increases a person’s risk of developing Alzheimer’s disease, but scientists don’t fully understand the mechanisms that drive the increased risk. Findings from a recent study suggest that amyloid-beta produced in tissues outside the brain provides the link between type 2 diabetes and Alzheimer’s disease.

    Amyloid-beta, a toxic peptide produced in the brain, clumps together and forms plaques with age. Its accumulation is a pathological hallmark of Alzheimer’s disease. However, amyloid-beta is produced in peripheral tissues, as well, including those that are sensitive to glucose or insulin, such as the pancreas, adipose tissues, skeletal muscles, and liver. Scientists don’t fully understand the roles peripheral amyloid-beta plays in human health.

    The investigators conducted a three-part experiment in mice, live mouse tissues, and cell cultures. First, they injected mice with glucose after they had fasted for 16 hours to examine the effects of glucose and insulin on blood amyloid-beta levels. They found that the mice experienced a transient increase in blood levels of glucose, insulin, and amyloid-beta. Then they injected amyloid-beta and glucose into mice that can’t produce the protein and found that amyloid-beta suppressed the animals’ insulin response.

    Next, they applied glucose and insulin to live tissues from the pancreas, adipose tissue, skeletal muscle, liver, and kidneys of mice. They found that glucose stimulated the release of amyloid-beta from the pancreas, whereas insulin stimulated its release from adipose tissue, skeletal muscle, and liver tissue. However, when the scientists added glucose along with amyloid-beta to the pancreatic tissue, insulin release was suppressed.

    Finally, they used antibodies that target the amyloid-beta protein to determine where the protein was produced. They found that amyloid-beta was produced and stored in the beta cells of the pancreas and released into circulation when stimulated with glucose.

    These findings suggest that amyloid-beta protein produced in peripheral tissues modulates insulin secretion. They may further provide a mechanism linking type 2 diabetes to Alzheimer’s disease. The investigators posited that high blood glucose and insulin levels that occur in the setting of diabetes increase peripheral amyloid-beta production, altering the balance between brain and peripheral amyloid-beta levels and suppressing the protein’s efflux from the brain. Furthermore, high insulin levels in the brain may impair normal degradation of brain amyloid-beta, increasing the protein’s levels in the brain and driving its accumulation. Learn more about the role of amyloid-beta in Alzheimer’s disease in this clip featuring Dr. Dale Bredesen.

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  • Cardio exercise increases the production of FGF21 3x more than strength training: a hormone with relevance to metabolic disorders www.sciencedaily.com
    Exercise Obesity Diabetes Aerobic Strength FGF21

    From the article:

    In a new study published in the scientific Journal of Clinical Investigation – Insight, the researchers show that cardio training on an exercise bike causes three times as large an increase in the production of the hormone FGF21 than strength training with weights. FGF21 has a lot of positive effects on metabolism.

    […]

    Endurance training on a bicycle has such a marked effect on the metabolic hormone that we know ought to take a closer look at whether this regulation of FGF21 is directly related to the health-improving effects of cardio exercise. FGF21’s potential as a drug against diabetes, obesity and similar metabolic disorders is currently being tested, so the fact that we are able to increase the production ourselves through training is interesting', Christoffer Clemmensen elaborates.

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  • Long-term weight-loss reduces cancer risk in adults with obesity and type 2 diabetes. www.sciencedaily.com
    Cancer Obesity Diabetes

    Obesity and type 2 diabetes cause perturbations in metabolism and immunity that increase the risk of cancer. Bariatric surgery is the most effective intervention for substantial and enduring weight loss in those with obesity and has been shown to [reverse type 2 diabetes](​​https://pubmed.ncbi.nlm.nih.gov/33485454/) and reduce cancer risk. Findings of a recent report demonstrate a lower risk of cancer in patients with obesity and diabetes up to 31 years following bariatric surgery.

    Weight gain occurs when the body stores excess calories in the form of fat in adipose tissue depots around the body. As the amount of energy stored increases, the body’s tolerance for glucose and other fuels decreases, leading to insulin resistance and type 2 diabetes. The high circulating levels of glucose, insulin, insulin-like growth factors, and inflammatory proteins observed in type 2 diabetes increase cancer cell proliferation and suppress apoptosis (programmed cell death). Reducing energy stores through bariatric surgery or other weight-loss therapies restores insulin sensitivity and reduces cancer risk.

    The authors collected data from an ongoing trial with over 4,000 participants investigating the long-term effects of bariatric surgery in adults with obesity and type 2 diabetes. At their baseline visit, participants underwent a physical exam, gave a blood sample, and completed questionnaires regarding health and lifestyle factors. Participants chose to undergo bariatric surgery or receive conventional obesity treatment during the years of 1987 and 2001. They continue to provide additional questionnaire data and blood samples as the study remains ongoing. The investigators followed participants in the current sample for an average of 21 years.

    Participants who chose to undergo bariatric surgery lost an average of 60 pounds two years after the baseline visit, compared to just 7 pounds in participants who received standard obesity treatment. These levels of weight loss remained stable 10 years after the baseline visit. At two years follow-up, 70 percent of participants who underwent surgery had diabetes remission, compared to 34 percent at 10 years follow-up. Bariatric surgery reduced cancer risk by 48 percent in women and 37 percent in the whole group. Participants who underwent surgery and maintained diabetes remission after 10 years had 55 percent reduction in cancer risk compared to participants with diabetes at 10 years follow-up. Participants who did not undergo surgery but achieved diabetes remission had an even greater risk reduction of 60 percent at 10 years follow-up.

    These findings support long-term weight-loss, including bariatric surgery, as a strategy to reduce type 2 diabetes and cancer risk among adults with obesity.

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  • Allulose reduces blood sugar and insulin levels. drc.bmj.com
    Diabetes Sugar Insulin Blood Sugar

    Foods with a high glycemic index, such as sugar-sweetened soft drinks, desserts, and white bread products, contain sugars that are rapidly absorbed into the bloodstream, causing hyperglycemia (high blood glucose). Regular consumption of high glycemic foods may lead to insulin resistance, type 2 diabetes, and obesity. Low-calorie sweeteners (i.e., artificial sweeteners) such as allulose have a low glycemic index and can be used in place of sugar to reduce the intake of calories and high-glycemic carbohydrates; however, the effects of allulose in addition to sugar require further investigation. Findings published in a new report show that allulose significantly reduces glucose and insulin levels following sugar consumption.

    Allulose is a rare sugar that can be found in small amounts in some fruits and grains and is sold as a low-calorie sweetener. Allulose is an epimer of fructose, meaning its chemical structure is very similar to fructose, giving it a nearly identical taste and texture; however, allulose provides only 0.4 calories per gram, compared to 4 calories per gram of fructose. A meta-analysis of previous research found that small doses of allulose improved glucose and insulin regulation; however, additional randomized controlled trials are needed, especially in Western populations and in people without type 2 diabetes.

    The researchers recruited 30 participants (average age, 33 years) without type 2 diabetes and asked them to follow an individualized diet plan that provided 50 to 65 percent of calories from carbohydrates for up to eight weeks. Participants completed five study visits with one to two weeks between visits. At each visit, the researchers gave participants a beverage containing 50 grams of fructose (the amount in about 16 ounces of sugar-sweetened soda) with escalating doses of allulose (0, 2.5, 5, 7.5, or 10 grams). They measured glucose and insulin levels in the blood 0, 30, 60, 90, and 120 minutes after beverage consumption.

    Allulose consumption reduced plasma glucose levels among participants in a dose-dependent manner, meaning as the dose of allulose increased from 0 to 10 grams, glucose levels at each time point decreased. The relationship between allulose and lower glucose levels was statistically significant at the 30-minute time point when either 7.5 or 10 grams of allulose was added to the fructose beverage. Compared to consuming a fructose beverage with no added allulose, the 10-gram dose of allulose also significantly decreased insulin levels 30 minutes after beverage consumption.

    These findings demonstrate that allulose decreased glucose and insulin levels when added to a high-sugar beverage in healthy young people without diabetes. The authors suggested that future studies explore more of the mechanisms underlying these results.

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  • Maternal diabetes causes birth defects by increasing cellular aging. apple.news
    Brain Aging Diabetes Pregnancy

    Neural tube defects (e.g., spina bifida, hydranencephaly) are a group of birth defects caused by incomplete development of the outer layers of the brain or spinal cord. Prenatal folate supplementation prevents an estimated 70 percent of neural tube defects, but additional therapies are needed. A recent report describes the relationship between maternal diabetes and abnormal cell aging in the fetal nervous system in mice.

    Previous research has demonstrated a relationship between maternal diabetes and the incidence of neural tube defects in mice; however, the mechanisms that drive this relationship are unknown. High blood glucose levels cause oxidative damage and promote cellular senescence, a state in which cells are not metabolically active and do not reproduce. Aging cells accumulate damage over time and become senescent. In adults, an excess of senescent cells can promote inflammation and disease. In the developing fetus, senescence is vital for tissue remodeling and the building of limbs and organs. However, inappropriate senescence may lead to abnormal development.

    The investigators used multiple mouse models in their study. In a first experiment, they used a strain of mice that develop diabetes and compared them to wild-type mice that are not predisposed to any disease. They injected pregnant females from both groups with either rapamycin, a compound that slows cellular aging by inhibiting the enzyme mTOR, or a placebo. In a second experiment, they used diabetic and non-diabetic strains of knockout mice, whose genomes do not contain the gene FoxO3a, a regulator of aging that may slow cellular senescence.

    Maternal diabetes increased the abundance of biomarkers of cellular senescence and DNA damage in the lining of the brain in offspring. Pregnant diabetic mice that were exposed to rapamycin had offspring with lower levels of senescence biomarkers and fewer neural tube defects compared to placebo. Offspring from FoxO3a knockout mice experienced the same decrease in senescence biomarkers and neural tube defect rates as rapamycin-treated mice.

    These results elucidate the mechanisms by which maternal diabetes can cause birth defects through metabolic changes that accelerate aging. Learn more about the role of cellular senescence in aging in this episode featuring Dr. Judith Campisi.

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  • Sulforaphane improves blood glucose control in obese people with type 2 diabetes. stm.sciencemag.org
    Nutrition Diabetes Sulforaphane NRF2 Metformin Glucoraphanin

    Type 2 diabetes is a progressive metabolic disorder characterized by high blood glucose levels and insulin resistance. Long-term complications from poorly controlled type 2 diabetes include heart disease, stroke, and kidney failure, among others. Findings from a 2017 study demonstrated that sulforaphane reduces glucose production in the liver and improves blood glucose control. Glucose is the body’s primary metabolic fuel. In the fasted state, the body can produce glucose via gluconeogenesis, a highly conserved pathway that occurs primarily in the liver. Increased liver gluconeogenesis among people with type 2 diabetes is a major contributor to high blood glucose and subsequent disease complications.

    The authors of the study investigated the effects of sulforaphane in several rodent models of type 2 diabetes and found that sulforaphane ameliorated many of the hallmark characteristics of the disease. Then they assessed sulforaphane’s effects in 97 people with type 2 diabetes. Sixty of the participants had well-regulated disease, but 37 had poorly regulated disease. Of those with poorly regulated disease, 17 had obesity. Nearly all of the participants took metformin, a common blood glucose-lowering drug.

    Participants received either an oral placebo or glucoraphanin-rich broccoli sprout extract every day for 12 weeks. The authors of the study measured the participants' fasting blood glucose and HbA1c (a measure of long-term blood glucose control) levels and assessed their glucose tolerance prior to and after the intervention.

    Sulforaphane administration improved fasting blood glucose and HbA1c levels in the obese participants who had poorly regulated type 2 diabetes. Sulforaphane mediated these effects via Nrf2 activity and subsequent reduced expression of enzymes that promote glucose production in the liver.

    These findings suggest that sulforaphane ameliorates some of the hallmark characteristics of diabetes in humans. The mechanisms by which sulforaphane mediates these effects differ from those of metformin, suggesting that the two could work in a complementary manner to improve blood glucose control in obese people with type 2 diabetes.

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  • Consumption of dairy products – especially high fat products – linked to lower risk of developing diabetes and high blood pressure. www.eurekalert.org
    Diabetes Blood Pressure Dairy

    Metabolic syndrome is a constellation of disorders that includes high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol and triglyceride levels. Having metabolic syndrome increases a person’s risk for developing cardiovascular disease, diabetes, and premature death. An estimated one billion people worldwide have metabolic syndrome. Findings from a new study indicate that dairy product intake is associated with a lower prevalence of metabolic syndrome and its complications.

    Dairy products comprise a wide range of foods derived from the milk of cows, sheep, goats, and others. They provide protein, carbohydrates, fats, vitamins, and minerals. Full-fat dairy products are high in saturated fat. The nutritional benefits of dairy products are hotly debated.

    The study drew on data from the Prospective Urban Rural Epidemiology study, which involved participants between the ages of 35 and 70 years living in Africa, Asia, Europe, and North and South America. The authors of the study first conducted a cross-sectional analysis involving nearly 113,000 people to determine whether there was an association between dairy intake and prevalence of metabolic syndrome. The participants completed food frequency questionnaires that provided information about their dietary intake, including dairy products.

    Analysis of the questionnaires revealed that people who consumed two or more servings of dairy products per day were 24 percent less likely to have metabolic syndrome. If they consumed two or more servings of high fat dairy products (instead of low fat) per day, they were 28 percent less likely to have metabolic syndrome.

    The study authors also conducted a prospective analysis to determine whether there was an association between dairy intake and the incidence of hypertension and diabetes. They reviewed data from nearly 190,000 participants. People who consumed three or more servings of dairy products per day were as much as 14 percent less likely to develop the two conditions. The associations were stronger when the people consumed full fat dairy products (instead of low fat).

    High fat dairy products include full fat milk, full fat yogurt, and cheese. Cheese, in particular, contains spermidine, a compound that serves as a calorie restriction mimetic, capable of inducing autophagy even in the setting of sufficient nutrient intake. Watch this clip with autophagy expert Dr. Guido Kroemer in which he describes this phenomenon.

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