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Old 08-19-2008, 04:08 PM   #1
Stanley Daniel
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Default Looking for reference/research articles regarding diet and type-2 diabetes

Hey all, I've got a med school poster exhibit coming up about "Type-2 Diabetes in Rural Kentucky." It's a study of 500 patients that have come to the hospital clinic and the continuing trend of illness which is being passed from the 1st through 4th generations, and it's impact in the next 100 years.

So far, we have collected and charted the data and incorporated the traditional drug treatment and management guidelines and outcomes.... I wanted to add in some additional nutritional thoughts based from some present research articles that are fairly congruent with the paleolithic lifestyle modifications... My doctors are pretty much going on the line that diet/exercise alone or in combination can't cure or prevent, but most certainly can postpone the onset of diabetes.

I've searched a bit and came across some of Mike OD's insulin and carb reference links from his IF blog. I wasn't sure if there were some older back issues of performance menu which also talked about these -

The growth and complications of type-2 diabetes here in S. Eastern KY is horrible, and we wanted to bring some more information to the local health providers.... In certain small towns, the entire population has it -

Anyways, if you could send or share some links as to where I can get some more direction and info to past articles or other reference sources - that would be awesome. I thought it would be a nice addition to the poster exhibit to have some points on that to stir up some conversation and interest... Thanks again for your time!
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Old 08-19-2008, 06:30 PM   #2
Steven Low
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http://www.ncbi.nlm.nih.gov/pubmed/8214047

Quote:
Stable isotope tracers and indirect calorimetry were used to evaluate the regulation of endogenous fat and glucose metabolism in relation to exercise intensity and duration. Five trained subjects were studied during exercise intensities of 25, 65, and 85% of maximal oxygen consumption (VO2max). Plasma glucose tissue uptake and muscle glycogen oxidation increased in relation to exercise intensity. In contrast, peripheral lipolysis was stimulated maximally at the lowest exercise intensity, and fatty acid release into plasma decreased with increasing exercise intensity. Muscle triglyceride lipolysis was stimulated only at higher intensities. During 2 h of exercise at 65% VO2max plasma-derived substrate oxidation progressively increased over time, whereas muscle glycogen and triglyceride oxidation decreased. In recovery from high-intensity exercise, although the rate of lipolysis immediately decreased, the rate of release of fatty acids into plasma increased, indicating release of fatty acids from previously hydrolyzed triglycerides. We conclude that, whereas carbohydrate availability is regulated directly in relation to exercise intensity, the regulation of lipid metabolism seems to be more complex.
Do a bit of research into intramuscular triglycerides and you'll find that accumulation of these is strongly correlated with insulin resistance.

Basically, high intensity exercise can help reverse the effects of insulin resistance.

So can a diet that controls insulin.. but I'll leave that up to someone else.
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Old 08-19-2008, 08:19 PM   #3
sarena kopciel
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Quote:
Originally Posted by Stanley Daniel View Post
Hey all, I've got a med school poster exhibit coming up about "Type-2 Diabetes in Rural Kentucky." It's a study of 500 patients that have come to the hospital clinic and the continuing trend of illness which is being passed from the 1st through 4th generations, and it's impact in the next 100 years.

So far, we have collected and charted the data and incorporated the traditional drug treatment and management guidelines and outcomes.... I wanted to add in some additional nutritional thoughts based from some present research articles that are fairly congruent with the paleolithic lifestyle modifications... My doctors are pretty much going on the line that diet/exercise alone or in combination can't cure or prevent, but most certainly can postpone the onset of diabetes.

I've searched a bit and came across some of Mike OD's insulin and carb reference links from his IF blog. I wasn't sure if there were some older back issues of performance menu which also talked about these -

The growth and complications of type-2 diabetes here in S. Eastern KY is horrible, and we wanted to bring some more information to the local health providers.... In certain small towns, the entire population has it -

Anyways, if you could send or share some links as to where I can get some more direction and info to past articles or other reference sources - that would be awesome. I thought it would be a nice addition to the poster exhibit to have some points on that to stir up some conversation and interest... Thanks again for your time!
Somewhat anecdotal with some cold hard facts I can give are my blood sugar readings!! I had a diagnosis of Type 2, started being meticulous with fitness and changed my nutrition from the standard prescribed "diet" to a paleo type and reversed any sugar issues!!
http://robbwolf.com/?p=62


Maybe this will help
http://robbwolf.com/?p=45
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Old 08-20-2008, 11:16 AM   #4
Stanley Daniel
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Thanks to both of you for replying - really appreciate that!

@Steven, I'll definitely look into the effects of intramuscular triglycerides and exercise in regulating insulin resistance in future related school projects.

@Sarena, these are awesome results as Robb has noted in his blog about "cold hard facts!" I'm really glad to see your dedication and the paleo diet's impact on reversing these profile panels... I hope they continue to get better

Basically for this school exhibit, we're trying to add some good info on dietary habit changes apart from intense exercise for the moment - as most of the population groups here are morbidly obese with glucose hovering around the mid-high 200s and HbA1c's > 10.0...

Just whatever I can show to stir up some interest in approaching and trying "Paleo" to couple with their traditional pharmacological treatments and management. It's just a little rough on explaining some of these things when many of the health care providers think other diets i.e. in the NEJM article last month work better (i.e. Mediterranean.)

I haven't come across too much apart from 1 page, small articles while sifting through google - in regards to finding Paleo articles and it's relation to reducing type-2 diabetes in obese populations...


Well, whatever reference where I can credit and back it up by can help - I really can use it - thanks for those links again!

Stanley
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Old 08-20-2008, 05:31 PM   #5
Ari Kestler
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NEJM just had that low carb vs low fat study....you could spin that... also a ton of articles that Eades mentions in his block that you could use... a few months ago there was a type 2 and paleo study in some european journal... can't find the link though...
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Old 08-20-2008, 06:54 PM   #6
Stanley Daniel
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Cool, I'll check out Eades' blog out - What's the major difference between Eades and Cordain? I notice these two names come up once in a while here with different viewpoints and debates...

Ari, are you talking about this article :

http://www.springerlink.com/content/h7628r66r0552222

Quote:
A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease

S. Lindeberg, Department of Applied Nutrition and Food Chemistry, University of Lund, Lund, Sweden

Published online: 22 June 2007
Abstract

Aims/hypothesis Most studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat, carbohydrate, fibre, fruits and vegetables. Instead, we aimed to compare diets that were available during human evolution with more recently introduced ones.
Methods Twenty-nine patients with ischaemic heart disease plus either glucose intolerance or type 2 diabetes were randomised to receive (1) a Palaeolithic (‘Old Stone Age’) diet (n = 14), based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; or (2) a Consensus (Mediterranean-like) diet (n = 15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines. Primary outcome variables were changes in weight, waist circumference and plasma glucose AUC (AUC Glucose0–120) and plasma insulin AUC (AUC Insulin0–120) in OGTTs.
Results Over 12 weeks, there was a 26% decrease of AUC Glucose0–120 (p = 0.0001) in the Palaeolithic group and a 7% decrease (p = 0.08) in the Consensus group. The larger (p = 0.001) improvement in the Palaeolithic group was independent (p = 0.0008) of change in waist circumference (−5.6 cm in the Palaeolithic group, −2.9 cm in the Consensus group; p = 0.03). In the study population as a whole, there was no relationship between change in AUC Glucose0–120 and changes in weight (r = −0.06, p = 0.9) or waist circumference (r = 0.01, p = 1.0). There was a tendency for a larger decrease of AUC Insulin0–120 in the Palaeolithic group, but because of the strong association between change in AUC Insulin0–120 and change in waist circumference (r = 0.64, p = 0.0003), this did not remain after multivariate analysis.
Conclusions/interpretation A Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference.
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Old 08-21-2008, 12:10 PM   #7
Ari Kestler
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hmm, that might be it...

might want to contact this guy...might be able to give you some good stuff...

http://www.diabetes.ucsf.edu/EN/rece..._2_di abetes/
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Old 08-21-2008, 01:16 PM   #8
Arien Malec
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Quote:
Originally Posted by Stanley Daniel View Post
Anyways, if you could send or share some links as to where I can get some more direction and info to past articles or other reference sources - that would be awesome. I thought it would be a nice addition to the poster exhibit to have some points on that to stir up some conversation and interest... Thanks again for your time!
A simple pubmed search for "diabetes ketogenic" and "diabetes low carbohydrate" turns up a ton of interesting references.

Here's a paper that should lead to lots of interesting references:

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum
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Old 08-22-2008, 12:06 AM   #9
Stanley Daniel
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Wow, awesome stuff y'all!

Thanks again Ari and Arian for those links!

From UCSF, they had a study with the Paleo Diet and Healthy Normals which was cool, but short - I've included the link to the document below which has the lab data results - it's a one page document, w/f/s.

http://files.meetup.com/1129099/12-P...sharaniADA.doc


Quote:
Paleolithic Type Diet and Metabolic Control in Healthy Normals and Type 2 Diabetes Mellitus
University of California, San Francisco

Background Ecologic/migration studies suggest that adoption of a diet rich in processed meat, high fat dairy products and refined grains is associated with the increased incidence of type 2 diabetes (T2D) and cardiovascular disease (CVD). Thus limiting these foods may have a beneficial effect in preventing and treating T2D and reducing CVD risk. To test this hypothesis, we evaluated the effects of a diet of meats, vegetables and nuts (Paleo-diet) on metabolic and cardiovascular parameters in healthy subjects and in T2D subjects.

Methods: 9 healthy sedentary subjects who after a “ramp up” diet of 1 wk then consumed for 10 days, a diet made up of lean meat, fruits, vegetables and nuts - excluding cereal grains, dairy and legumes.

Results After 2 weeks on a Paleo-diet, the normal subjects significantly improved insulin sensitivity, lipid profiles and mean arterial pressure (MAP); and increased FMD (table 1).

Conclusion A Paleo-diet in normal subjects improved lipid profiles, vascular function, insulin sensitivity and blood pressure. Preliminary data from a randomized controlled study currently being conducted on T2D subjects has so far shown similarly positive results.
I'm not necessarily sure what their "Ramp-Up" Diet might be?
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