Diabesity

Strong, consistent evidence shows that managing obesity can delay progression of prediabetes to type 2 diabetes. Obesity management is also highly beneficial in treating type 2 diabetes, based on the degree of weight loss achieved. Losing excess weight improves glycemic control, reduces the need for glucose-lowering medications, can substantially reduce A1C, and can even promote sustained diabetes remission.

Diabesity Clin Diabetes 2022;40(4):392–393 — https://doi.org/10.2337/cd22-0088

Remember, Stay as Thin as You Can as Long as You Can

Social Isolation and Dementia Risk

A study by Huang and colleagues is the first nationally representative cohort study examining the association between social isolation and incident dementia for older adults in community dwelling settings. A cohort of 5,022 older adults participating in the National Health and Aging Trends Study was followed from 2011 to 2020. When adjusting for demographic and health factors, including race, level of education, and number of chronic health conditions, socially isolated adults had a greater risk of developing dementia, compared with adults who were not socially isolated (hazard ratio, 1.27; 95% CI, 1.08 – 1.49). Potential mechanisms to explain this association include the increased risk of cardiovascular disease and depression in older adults who are socially isolated, thereby increasing dementia risk.

Mengru Wang. Geriatrician Advises on Use of Vitamin D Supplementation, Lecanemab, and Social Media for Her Patients – Medscape – Jan 20, 2023 — https://www.medscape.com/viewarticle/987285?src=rss#vp_2

One week ago we had our older adult friends over for dinner. Midweek my wife went out with her friends while I gathered with my friends. Last night was date night and we got out of the house. This evening we’re having dinner at a friend’s house.

Dementia risk reduction activities!

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

The skeptical cardiologist was asked to give a lecture in July on diet to the cardiology fellows in our training program at Saint Louis University. Needless to say, I didn’t hew to current recommendations from the American Heart Association or the Dietary Guidelines for Americans. For example, these recommendations are still promoting the narrative that…

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

Great lecture. Thank you Dr. Pearson.

Another Sweet Saturday – 09.17.22

Our 1-year RCT indicated that a lifestyle intervention program can be highly successful in older adults with diabetes and chronic comorbidities. In this specific population, lifestyle intervention not only improved glycemic control associated with improved insulin action and secretion but also improved age-relevant outcomes such as body composition, physical function, and quality of life.

Alessandra Celli, Yoann Barnouin, Bryan Jiang, Dean Blevins, Georgia Colleluori, Sanjay Mediwala, Reina Armamento-Villareal, Clifford Qualls, Dennis T. Villareal; Lifestyle Intervention Strategy to Treat Diabetes in Older Adults: A Randomized Controlled Trial. Diabetes Care 1 September 2022; 45 (9): 1943–1952. https://doi.org/10.2337/dc22-0338

From the periods 1988–1994 to 2017 to March 2020, there was an increase in the prevalence of diagnosed diabetes (from 4.6% to 11.7%), but no change in prevalence of persistent undiagnosed diabetes (from 2.23% to 2.53%) or confirmed undiagnosed diabetes (from 1.10% to 1.23%). Consequently, the proportion of all undiagnosed diabetes cases declined from 32.8% to 17.8% (persistent undiagnosed diabetes) and from 19.3% to 9.5% (confirmed undiagnosed diabetes). Undiagnosed diabetes was more prevalent in older and obese adults, racial/ethnic minorities, and those without health care access. Among persons with diabetes, Asian Americans and those without health care access had the highest proportion of undiagnosed cases, with rates ranging from 23% to 61%.

Michael Fang, Dan Wang, Josef Coresh, Elizabeth Selvin; Undiagnosed Diabetes in U.S. Adults: Prevalence and Trends. Diabetes Care 1 September 2022; 45 (9): 1994–2002. https://doi.org/10.2337/dc22-0242

Remember, Stay as Thin as You Can as Long as You Can.

Exposome! (I Learned a New Word Today)

In an extensive review, the team found that the early life exposome, which encompasses one’s diet, lifestyle, weight, environmental exposures, and microbiome, has changed substantially in the last several decades. Thus, they hypothesized that factors like the westernized diet and lifestyle may be contributing to the early-onset cancer epidemic…

Possible risk factors for early-onset cancer included alcohol consumption, sleep deprivation, smoking, obesity, and eating foods. Surprisingly, researchers found that while adult sleep duration hasn’t drastically changed over the several decades, children are getting far less sleep today than they were decades ago. Risk factors such as highly-processed foods, sugary beverages, obesity, type 2 diabetes, sedentary lifestyle, and alcohol consumption have all significantly increased since the 1950s, which researchers speculate has accompanied altered microbiome.

Cancers in adults under 50 on the rise globally – https://www.sciencedaily.com/releases/2022/09/220906161454.htm. Brigham and Women’s Hospital. “Cancers in adults under 50 on the rise globally: Researchers identify risks factors and trends behind an increasing incidence of early-onset cancers around the world.” ScienceDaily. (accessed September 7, 2022).

I’ve been cooking a lot this week and decided to give myself a break tonight. Grab a burger maybe some pizza.

Then I read this article.

Maybe I will cook tonight.

Loneliness and Mortality

The discomfort of loneliness eases with time. You come to accept solitude like a cracked tile in a corner of the bathroom floor. Eventually, you just stop noticing the defect. For older people, however, one crack could easily, quietly, lead to more. Living in isolation, for people over 50, can spur a 50 percent increased risk of dementia, according to the CDC, and a 32 percent increased risk of stroke. Loneliness is also associated with higher rates of anxiety, depression, and suicide. Prolonged isolation is the equivalent to smoking 15 cigarettes a day. (And older members of marginalized communities are at an even higher risk for all of the above when they’re socially secluded.) In the years since my mom lost her husband and her friends in Florida, her health declined and her shine dimmed. The woman who owns more makeup than Dolly Parton — including Stila compacts from the early aughts she audaciously calls “my vintage cosmetics” — stopped putting on her face.

My Mom Has No Friends — https://www.thecut.com/2022/08/helping-my-mom-make-friends.html

A beautifully written article. I hope you choose to read the entire piece.

Covid-19 and a Plant Based Diet

Okinawa, one of the blue zone regions, is highlighted due to its extreme longevity, plant-based diet, and now, the population’s resistance to COVID-19.

People in Okinawa, for example, consume a predominantly plant-based diet rich in phytochemicals and antioxidants… They also consume abundant green leafy vegetables and soy products, with minimal fat (about 6% of the total energy intake). In addition to their high life expectancy and low mortality from cardiovascular disease and certain types of cancers, Okinawans have enjoyed a remarkable resistance to COVID-19 mortality. As of June 16, 2021, the COVID-19 mortality in Okinawa, Japan, was 0.08% (163 deaths out of 19,782 cases), which is one-sixteenth that of Tokyo (mortality rate 1.3%; 2183 deaths out of 167,416 cases).

Can a Plant-Based Diet Mitigate the Risk of Severe COVID-19? — https://www.bluezones.com/2022/02/can-a-plant-based-diet-mitigate-the-risk-of-severe-covid-19/#

Journal Reference: Kahleova, H., Barnard, N.D. Can a plant-based diet help mitigate Covid-19?. Eur J Clin Nutr 76, 911–912 (2022). https://doi.org/10.1038/s41430-022-01082-w

Incidence and Characteristics of Remission of Type 2 Diabetes in England: A Cohort Study Using the National Diabetes Audit

Remission of type 2 diabetes was generally infrequent in routine care settings but may be a reasonable goal for a subset of people who lose a significant amount of weight shortly after diagnosis.

Incidence and Characteristics of Remission of Type 2 Diabetes in England: A Cohort Study Using the National Diabetes Audit – Diabetes Care 2022;45(5):1151–1161
https://doi.org/10.2337/dc21-2136

Thinking About Retirement (or just another fine Saturday Morning)

Andel’s suggestion to anyone contemplating retirement: “Find a new routine that’s meaningful.” He points to people living in the Blue Zones, regions of the world that have been identified to be home to a greater number of residents who’ve reached the age of 100 and beyond. One of the common characteristics among Blue Zone inhabitants is, says Andel, “these people all have purpose.”

Think Retirement Is Smooth Sailing? A Look at Its Potential Effects on the Brain — https://getpocket.com/read/2840794990

The funny thing about life at “retirement age” and still working is you think about retirement a lot.

Since I still work a full time job I have a lot of trouble envisioning what my retirement will look like.

After reading this article and listening to Andel’s short talk I am now scared of retirement.

I need to figure out how to avoid brain rot. But my journal tells me I already have.

My Purpose is to educate others on diet and disease, weight loss and weight management by sharing my personal journey through writing and other teaching activities.