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Tuesday, April 23, 2024
Diabetes

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It has been just over a year since the World Health Organization (WHO) declared COVID-19 a global pandemic. In that time, more than 121 million people have contracted the virus, and 2.6 million have died.

Researchers have developed multiple vaccines over the past year, which are being administered all over the world. Recently, in some regions, the number of new COVID-19 cases has gone down.

However, testing is vital, as it allows medical professionals to know who has the virus and act quickly to quarantine others who may be at risk of exposure.

A team led by researchers from the University of Surrey in Guildford, England, developed a new method to test for COVID-19. The test utilizes skin swabbing, which is a non-invasive procedure.

COVID-19 testing

There are two types of diagnostic tests that can detect whether a person has the virus that causes COVID-19 — molecular tests and antigen tests.

Molecular tests detect genetic material from the virus, and antigen tests detect proteins from the virus. These tests diagnose active infections, and medical professionals perform these tests by collecting mucus samples from individuals.

As both types of tests generally involve using a long test swab in a person’s throat or nasal passages, most people consider them invasive. Molecular tests typically involve a nasopharyngeal swab (a swab of the part of the throat behind the nose), a nasal swab, or a throat swab. Experts consider molecular tests to be highly accurate, but it can take days to get results.

Antigen tests take less time to get results, but these tests are generally less accurate. Antigen tests may have higher rates of false negatives compared with molecular tests.

Doctors also use antibody testing to find out whether someone has recently had an infection. This type of test requires a blood sample.

The current testing methods have some limitations — the molecular tests can take longer, the antigen tests can be less sensitive, and both can be invasive. However, vaccine researchers continue trying to improve COVID-19 testing.

Not only can improved testing methods encourage people to get tested, but accurate results can also reduce the spread of the virus.

Sebum testing

A team led by researchers from the University of Surrey in the United Kingdom recently published a paper that describes a new method for testing COVID-19. The paper appears in The Lancet-EClinicalMedicine.

Instead of using mucus or blood samples to test for the virus, their method uses skin swabs to test sebum secretions.

The test analyzes the sebum secretions present on the skin. Sebum is “an oily substance, produced in the sebaceous glands.”

Sebaceous glands are located directly beneath the skin. Sebum is made up of a mixture of lipids, including triglycerides and fatty acids.

Study lead author Matt Spick says, “COVID-19 damages many areas of metabolism. In this work, we show that the skin lipidome can be added to the list, which could have implications for the skin’s barrier function, as well as being a detectable symptom of the disease itself.”

The sebum swab test works by analyzing the possible changes the virus causes in the body.

“Sebum sampling has the potential to support both needs by looking at what the virus does to us, rather than looking for the virus itself,” the authors write.

Testing sebum secretions for a disease is not new. Previous studies have identified changes in the profiles of sebum secretions in people with Parkinson’s disease and with type 1 diabetes.

“Investigating new methods of diagnosis and surveillance in a new disease such as COVID-19 that has had such a devastating effect on the world is vital,” says study co-author Dr. George Evetts, a consultant in Anaesthesia & Intensive Care Medicine at Frimley Park Hospital in Surrey, U.K.

“Sebum sampling is a simple, non-invasive method that shows promise for both diagnostics and monitoring of the disease in both a healthcare and a non-healthcare setting.”

Skin-swab results

The team obtained samples from 67 hospitalized participants. Of the participants, 37 tested negative for COVID-19, and 30 tested positive.

Researchers collected the samples by swabbing a gauze on the upper back skin of the participants.

“A sample can be collected easily and non-invasively via a gentle swab of skin areas rich in sebum (for example the face, neck or back),” the authors write.

The lipid profiles showed that the levels of certain lipids were lower in participants who had tested positive for COVID-19 than people who had tested negative. The study authors noted that triglycerides were the most consistently reduced lipid in the participants with COVID-19.

The study authors note that the sample in the research was small, and the evidence is still preliminary.

However, senior study co-author Dr. Melanie Bailey thinks healthcare professionals could use this form of testing in similar situations in the future. She adds:

“Unfortunately, the specter of future pandemics is firmly on the top of the agenda for the scientific community. Our study suggests that we may be able to use non-invasive means to test for diseases such as COVID-19 in the future — a development, which I am sure, will be welcomed by all.”

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Humans first drank caffeinated tea more than 4,000 years ago in China. Since then, it has become one of the most popular drinks worldwide, second only to water.

Both green and black teas are brewed from the leaves of the same shrub, Camellia sinensis, but green tea, which is made from unfermented leaves, contains more antioxidants.

Oxidation during the fermentation process of black tea reduces its antioxidant levels.

Several studies have found that green tea inhibits the formation of cancers, lowers high blood pressure, and reduces the risk of heart disease.

However, the molecular mechanism responsible for the effect on blood pressure has been unclear until now.

Scientists at the University of California, Irvine (UCI) and the University of Copenhagen, in Denmark, have found that antioxidants in tea open ion channels and can relax the muscles that line blood vessels.

They report their findings in the journal Cellular Physiology & Biochemistry.

Preventable risk factor

The discovery could guide the design of more effective antihypertensive drugs, which could potentially improve the health of millions of people around the world.

According to the National Heart, Lung, and Blood Institute, controlling or lowering high blood pressure can help prevent chronic kidney disease, heart attacks, heart failure, and possibly dementia.

The Centers for Disease Control and Prevention (CDC) report that almost half of all adults in the United States have hypertension. It estimates that in 2018, the condition played a role in the deaths of nearly half a million people in the country.

The World Health Organization (WHO), meanwhile, estimate that more than 1 billion people worldwide have hypertension.

The new study first shows that two antioxidants in tea, known as catechins, open a protein channel in the membranes of the smooth muscle cells that line blood vessels. This allows positively charged potassium ions to leave the cells.

Channels in nerve and muscle cells maintain voltages across their membranes by allowing negative and positive ions to pass in and out in a controlled way. They are “voltage-gated,” which means that they respond to changes in this voltage by opening or closing.

The researchers found that the catechins in green tea activate a particular type of potassium ion channel, called KCNQ5.

Previous work by some of the same scientists suggests that this protein channel may underlie the antihypertensive effects of several plants used as folk medicines for millennia.

Voltage sensor

For the new study, the researchers used computer modeling and mutated versions of the channel protein to show that the two catechins bind to a section that senses voltage changes.

“This binding allows the channel to open much more easily and earlier in the cellular excitation process,” explains senior study author Prof. Geoffrey Abbott, of the Department of Physiology & Biophysics at the UCI School of Medicine.

In theory, this should make the muscle cells less “excitable” and therefore less likely to contract. They should instead relax, dilating the blood vessel and reducing blood pressure.

To test this theory, Prof. Abbott’s co-authors at the University of Copenhagen measured changes in tension in the walls of arteries from rats. Their findings confirmed that the two catechins from tea relax and dilate arteries by activating the KCNQ5 ion channel.

Milky tea

The authors are confident that adding a dash of milk to black tea does not reduce its antihypertensive effects.

Milky tea, applied directly to cells in the lab, failed to activate their KCNQ5 channels. But this is likely not the case when a person drinks it.

Prof. Abbott explains:

“We don’t believe this means one needs to avoid milk when drinking tea to take advantage of the beneficial properties of tea. We are confident that the environment in the human stomach will separate the catechins from the proteins and other molecules in milk that would otherwise block [the] catechins’ beneficial effects.”

The scientists also discovered that warming green tea to 35°C increased the activation of KCNQ5.

However, lovers of iced tea need not be concerned.

“Regardless of whether tea is consumed iced or hot, this temperature is achieved after tea is drunk, as human body temperature is about 37°C,” says Prof. Abbott. “Thus, simply by drinking tea, we activate its beneficial, antihypertensive properties.”

Electrical activity in the brain

KCNQ5 also exists in the membranes of nerves in the brain, where it helps regulate electrical activity and signal transmission.

People with a disorder called epileptic encephalopathy have a version of the channel protein that does not respond effectively to voltage changes, which leads to frequent seizures.

The study authors point out that catechins can cross the blood-brain barrier, which prevents larger molecules, including some drugs, from entering the brain.

In theory, drugs modeled on catechin molecules could, therefore, help correct the cause of epileptic encephalopathy.

“Discovery of their ability to activate KCNQ5 may suggest a future mechanism to fix broken KCNQ5 channels to ameliorate brain excitability disorders stemming from their dysfunction,” the researchers conclude.

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For many decades, nutritionists have recommended a balanced diet to provide the body with the proper nutrients to stay healthy. The core components of this diet include vegetables, fruits, grains, proteins, and dairy.

A recent study by researchers at the Harvard T. H. Chan School of Public Health in Boston, MA, provides further evidence for current dietary guidelines and expands on them, finding that consuming at least 2 fruit and 3 vegetable servings on a daily basis may lower the risk of both disease-related death and death from all causes.

The study appears in Circulation, a scientific journal of the American Heart Association (AHA).

Current dietary guidelines

“While groups like the American Heart Association recommend 4–5 servings each of fruits and vegetables daily, consumers likely get inconsistent messages about […] the recommended amount and which foods to include and avoid,” says Dr. Dong D. Wang, M.D., Sc.D., an epidemiologist and nutritionist at Harvard Medical School and lead author of the study.

The Department of Health and Human Services and the Department of Agriculture published their recommendations in the form of the 2020–2025 Dietary Guidelines for Americans.

According to this set of guidelines, half of the plate for every meal should contain fruits and vegetables.

However, the guidelines also note that more than 80% of people in the United States do not meet this recommendation and should aim to increase their consumption of nutrient-dense foods.

Participant dietary information

The researchers collected self-reported dietary information from two large cohort studies: the Nurses’ Health Study (NHS) and the Health Professionals’ Follow-up Study (HPFS).

The NHS cohort included registered female nurses between the ages of 30 and 55 years, while the HPFS cohort included males aged 40–75 years with occupations in the health profession. These studies included follow-ups with the participants every 2–4 years to accumulate dietary information over a span of approximately 30 years.

The researchers excluded participants with baseline heart disease, cancer, or diabetes, leaving them with data from 66,719 females and 42,016 males.

They also incorporated data from an additional 26 studies involving a total of 1.9 million participants, which examined the relationship between fruit and vegetable intake and death rates.

The high participant numbers and continuous longitudinal assessments provided the team with an extensive collection of data for analysis.

However, it is important to note that the criteria of the two cohorts — occupation and corresponding education — suggest a similar socioeconomic status across the participants, who may have been more likely than other members of the population to have access to a healthy diet. The study does not address the realities and effects of food insecurity.

Nutritional values of fruits and vegetables lower risk of death

The study outcomes showed that an increased intake of fruits and vegetables is associated with a lower risk of death, including death due to cancer, heart disease, or respiratory disease.

Additionally, the researchers saw the lowest risk of death at a threshold of a combined 5 servings, beyond which there was no apparent benefit on risk.

These results point to the nutritional value of these foods. For example, higher consumption of fruits and vegetables increases the intake of potassium and antioxidant activity, which link to lower blood pressure and improved lung function, respectively.

As the data are fully self-reported, there may be discrepancies between the actual and reported intakes. Participants with higher intake, in particular, may have tended to overestimate how many servings they consumed.

This margin of error may blur the defined threshold of 5 servings, so the study authors acknowledge that slightly higher servings (up to 10) could also lead to lowered risk.

This study also expands beyond current guidelines by differentiating among specific groups of fruits and vegetables.

The researchers observed trends with a lowered risk of death for leafy greens and foods rich in vitamin C and beta carotene. Fruits and vegetables that fall into these categories include spinach, kale, carrots, and citrus fruits.

Conversely, they did not identify any trends for fruit juices or starchy vegetables, such as potatoes and peas. One possible reason for the latter is the prominence of canned foods. The canning process may deprive starchy vegetables of their antioxidant properties.

Compared with whole fruits, the fluid form of juices may cause a more rapid elevation of blood glucose and insulin levels, which can increase the risk of disease.

In contrast to the existing guidelines, which include canned foods and juices among the recommended foods and drinks, this study calls for further research on the effects of these items on health.

Continued support for ‘5-a-day’ serving recommendation

Rather than being an interventional study, in which researchers directly implement variables and analyze the effects, this study was observational. As a result, it is not possible to conclude that the trends present in this study indicate a causal relationship.

Regardless, there is plentiful evidence that highlights the benefits of a balanced diet containing plenty of fruits and vegetables. The present conclusions also correspond to findings from similar observational studies on the associations between fruit and vegetable intake and disease.

The findings of this study conform to the overall current dietary guidelines to eat at least 5 servings of fruits and vegetables a day. Additionally, it provides further insight into the specificities and benefits of fruit and vegetable intake.

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New research into the plant-based sweetener stevia indicates that the sugar substitute may have negative implications for gut health.

People use sugar substitutes as a way to reduce their sugar intake. Excess sugar consumption can cause weight gain, lead to diabetes, and contribute to inflammation in the body.

For this reason, researchers have worked to find the perfect replacement that tastes like real sugar and is safe to consume.

Scientists have considered stevia a safe sugar alternative for years, but a new study raises the question of whether it can be harmful to gut health.

What is stevia?

Sugar replacements come in handy for many people, including individuals with diabetes who need to control their blood sugar and those trying to reduce their calorie intake to reach or maintain a moderate weight.

Various substitutes are available. These include several artificial sweeteners, such as sucralose, aspartame, and saccharin, and the sugar alcohols xylitol and erythritol.

Some people use plant-based options to replace sugar, and stevia is one such sweetener that is widely available.

People have used the plant stevia as a sweetener for hundreds of years. People originally discovered the plant in Brazil and Paraguay and now grow it all over the world.

Stevia is up to 300 times sweeter than table sugar, so only a very small amount is necessary to achieve a sweetening effect.

Some people prefer plant-derived stevia over artificial sweeteners that manufacturers create in a lab.

Moreover, stevia is a zero-calorie substitute, whereas other artificial sweeteners may have a few calories. Another benefit to stevia is that it has a glycemic index of less than 1, so it does not raise blood sugar the way a few alternatives do.

Some sugar substitutes are also safer than others. Studies have linked other substitutes, such as sucralose and saccharin, with tumor growth in mice, although these effects are not confirmed. Research on stevia, on the other hand, had not previously uncovered any serious negative health implications.

Importance of gut health

Although people generally understand the importance of maintaining a moderate weight and engaging in best practices for heart health, they sometimes overlook gut health.

According to Dr. Elizabeth Hohmann of the Infectious Diseases Division at Harvard-affiliated Massachusetts General Hospital, “This is a new frontier of medicine, and many are looking at the gut microbiota as an additional organ system.”

Hohmann goes on to say, “It’s most important to the health of our gastrointestinal system, but may have even more far-reaching effects on our well-being.”

The digestive system is home to various types of bacteria. Some of these bacteria help keep the body healthy. Maintaining a healthy and balanced gut is important in many ways.

Some gut bacteria can prevent inflammation, protect against certain types of cancer, and reduce symptoms associated with rheumatoid arthritis.

There are various ways to maintain a healthy gut, one of which is to avoid the overuse of antibiotics. Antibiotics can affect the good bacteria living in the gut.

Avoiding foods that can harm gut health, such as processed foods and red meat, is also important. People can take probiotics, eat foods high in fiber, and eat fermented foods, such as yogurt or kombucha, to promote good gut health.

Stevia research results

While experts typically view stevia as a safe sugar replacement, the latest research indicates that it may have some drawbacks.

Researchers from Ben-Gurion University of the Negev (BGU) in Beersheba, Israel, focused on stevia in a study that recently featured in Molecules. Their findings suggest that stevia can have a negative effect on gut health.

The research team studied two forms of stevia: the commercialized herb supplement and purified stevia extract. They looked at how the different forms of stevia affect bacterial communication.

The gut has quorum sensing (QS) pathways. These pathways enable bacteria molecules to communicate with each other, which is important in terms of microbial regulation.

The team found that the stevia herb supplement had an “inhibitory effect on bacterial communication.” The purified stevia extract showed “a molecular interaction and possible interruption of [some forms of] bacterial communication.”

While the study shows that stevia may contribute to an unbalanced gut, neither form of stevia showed evidence of killing bacteria in the gut.

Lead researcher Dr. Karina Golberg, who is part of the BGU Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, commented on the findings:

“This is an initial study that indicates that more research is warranted before the food industry replaces sugar and artificial sweeteners with stevia and its extracts.”

The researchers plan to study stevia more closely and use their findings to shape guidelines for stevia intake.

“With reference to the effects identified in our study and the growing consumption of stevia, we urge that more studies be conducted to help further elucidate the effects of these sweeteners and to adjust the highest daily doses recommended today,” the study authors write.

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Do you suffer from gas, bloating, or other digestive issues? You’re definitely not the only one out there – but it doesn’t have to be this way.

We all know the foods we like and dislike, and some of us are even in tune enough to know the foods that do and don’t sit well within our body – but how well do we really understand the process of our own digestion? Certain physical cues often indicate whether everything is running, ahem, smoothly, and others are often common signs that your digestive system isn’t working properly.

I’m hesitant to choose a favorite system of the human body, but the intricacies and needs of our digestive system are fascinating. The very process of digestion itself involves taking all our wonderful, nutritious foods (or those less so), and breaking them down into the minuscule monomers needed for our body’s day-to-day functioning. When you consider every reaction in the human body, right down to a cellular level, that has to go right for this process to work, it can be very humbling.

Digestion is arguably one of the most important functions of the human body. But when something’s not going right with the system, such as an underlying issue or illness, all the wonderful foods won’t be absorbed in the way they should. Luckily, there are a number of signs and indicators that you’ll likely recognize in your own body to suggest your digestive system might not be flourishing.

1. Changes To Bowel Movements

While we all have different experiences of what it means to be ‘regular’, we do have our own natural digestive rhythm. Your bowel movements are one of the best indicators of what’s going on inside your body, and while changes to your usual schedule will come and go – anything significant is usually a symptom of a malfunctioning digestive system. Laurentine has written this amazing article that goes into the details of how to understand what it all means for your health, and how to navigate the Bristol Stool Scale, to shed some more insight on what your movements actually mean.

2. Reflux & Heartburn

Resting at the other end of the gastrointestinal tract (GIT) is our esophagus, and there are a few issues that can be another indication that something isn’t sitting right with our digestive system. Primarily, these are often reflux or heartburn, coupled with excessive burping in some instances. These symptoms can be caused by a number of digestive issues, ranging from simple food intolerances to bacteria overgrowths or stomach ulcers. If you’re experiencing persistent reflux or heartburn, start by first noticing any patterns with your triggers, and if removing these triggers is unsuccessful, like always, I recommend consulting with a qualified practitioner.

3. Bloating, Cramping & Uncomfortable Gases

Bloating happens when your GIT fills with gases, oftentimes caused by something as simple as a chemical reaction to the food you eat. Common occurrences include both lactose and gluten intolerances, as the digestive system lacks all the tools it needs to break down these foods efficiently. Many allergies and intolerances will also lead to cramping as the tissues in your abdomen struggle to deal with the food that has been put into it, however cramping may also be indicative of conditions such as IBS or gastritis.

4. Changes In Appetite

Much like other aspects of our digestive system, our body will often come to understand what normal looks like. You are the most qualified person to talk about your normal eating habits and patterns, the foods that make you feel good, and those that bring you down. And just as you know what’s normal, it’s good to check-in and ask yourself if there have been any changes of late? This might mean the size and frequency of meals, changes in how your body responds to a certain food, or even skipping meals altogether. These changes could be for any number of reasons, ranging from a shift in our energy expenditure levels to binge eating disorder, or perhaps an underlying chronic illness. So once you begin to identify these changes, whether they’re long-term or just temporary, seek out the protocol best suited to helping you figure out why these are occurring – just to be on the safe side.

5. Malabsorption Of Nutrients

Unless you’ve got a pathology lab in your attic, this can be a little more difficult to diagnose. And as a full disclaimer, Food Matters always recommends you do diagnose and begin treatment plans with a licensed practitioner that works for you. However, some examples of instances include difficulty absorbing iron due to a multitude of underlying causes, or damage caused to the intestines by an autoimmune condition like celiac disease. But the main takeaway is any ongoing malabsorption issues indicate your body may need a deep reset before rebuilding your digestion.

While the causes for your digestive concerns will vary from person to person, there’s one protocol we always suggest for a total reset before taking more extreme measures. A gentle detox is one way to give the digestive system a much-needed rest and reset from life’s daily stressors – including any aggravating foods.

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A recent study found an association between metformin and a significantly reduced mortality risk in women with type 2 diabetes or obesity who were hospitalized with COVID-19.

Metformin is a first-line medication for treating type 2 diabetes, and many in the United States use the branded version Glucophage.

The results of the recent investigation into metformin use, obesity, diabetes risk, and COVID-19 mortality appear in The Lancet Healthy Longevity.

In the week ending November 28, 2020, the cumulative COVID-19 hospitalization rate in the United States reached a new peak.

The reported mortality rate due to pneumonia, influenza, and COVID-19 was 12.8%, though the receipt of additional data is likely to increase this figure.

People with certain medical conditions, including obesity and type 2 diabetes, have an increased risk of severe COVID-19, and may require hospitalization, intensive care, or mechanical ventilation. The risk of death from the illness is also higher for these groups.

Visceral fat accumulating around organs may lead to insulin resistance, increasing the risk of developing type 2 diabetes. Meanwhile, visceral fat cells secrete inflammatory substances, such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and D-dimer, which may be associated with severe COVID-19.

People with type 2 diabetes also have increased levels of TNF-α, which contributes to insulin resistance. In addition, the anti-inflammatory cytokine IL-10 is present in lower levels in people with obesity and type 2 diabetes.

Anti-inflammatory effects

Metformin, a safe, effective, relatively inexpensive drug, elevates anti-inflammatory IL-10 levels while decreasing the inflammatory markers TNF-α and IL-6 in people with or without diabetes.

Due to metformin’s anti-inflammatory effects and early reports of decreased COVID-19 mortality rates in people taking the drug, researchers at the University of Minnesota Medical School, in Minneapolis, and UnitedHealth Group (UHG), in Miami, FL, decided to investigate whether metformin decreased COVID-19 death risk — and whether any reduction would be sex-specific.

They refer, in their study paper, to previous findings that metformin reduced inflammation to a greater extent in women than in men.

“While effective therapies to mitigate the harm of the SARS-CoV-2 virus are being developed, it is important that we also look to and evaluate commonly used medications with good safety profiles for their potential to combat the virus,” stated Dr. Deneen Vojta, co-senior study author and executive vice president of research and development at UHG.

The researchers conducted a retrospective analysis of claims data from January 1 through June 7, 2020, from UHG’s Clinical Discovery Claims Database. This contains enrollment records, medical claims, laboratory results, and pharmacy claims for individuals of diverse ages, races, and ethnicities who had been admitted to hospitals with COVID-19 throughout the 50 states.

People included in the study were 18 years or older, had a diagnosis of obesity or type 2 diabetes, and had at least 6 months of continuous enrollment in UHG during 2019. Each had also been admitted to a hospital for COVID-19.

In total, the study analyzed the claims data of 6,256 individuals, with 3,923 in the non-metformin group and 2,333 in the metformin group.

In the non-metformin group, the average age was 76 years, approximately 55% were female, and 95% had type 2 diabetes. In the metformin group, the average age was 73 years, approximately 48% were female, and 99% had type 2 diabetes.

In all, 20.2% of those in the non-metformin group died of COVID-19 during hospitalization, compared with 16.9% of the metformin group.

The study did not show that metformin use significantly decreased COVID-19-related mortality in the overall group of men and women. However, the subgroup analysis of data by sex demonstrated a significant association between metformin use and decreased mortality in women.

Among people with type 2 diabetes or obesity, the study found a 21–24% reduction in mortality among women who had filled a metformin prescription before hospitalization, compared with women who had not.

There are certain limitations to the study. For instance, retrospective analyses are often affected by biases and unmeasured confounders. Also, claims data do not provide information about adherence to metformin treatment, account for patients who paid cash for metformin, or differentiate among people with different classes of obesity.

Wide-reaching consequences

In the U.S., more than 42% of women have obesity, and 16.2 million women have diabetes. The use of a medication that is relatively inexpensive, is readily available, and has a good safety profile might significantly reduce COVID-19-related mortality in this at-risk population.

“Observational studies like this cannot be conclusive but contribute to growing bodies of evidence. Seeing a bigger association with protection in women over men may point toward inflammation reduction as a key way that metformin reduces risk from COVID-19.” – Principal investigator Dr. Carolyn Bramante

Dr. Bramante and Dr. Christopher Tignanelli, a co-senior author of the study, plan to conduct a multi-site, prospective, randomized pilot study with Dr. Ken Cohen, executive director of clinical research at UHG Research and Development, to understand how metformin may decrease mortality, plus the optimal duration and timing of the treatment.

This upcoming study may provide the data needed to discern the true impact of metformin on COVID-19-related mortality.

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For people who may wish to lose weight, plant-based diets could be the best solution thanks to the way in which they influence metabolism.

That is the takeaway from a recent study published in the JAMA Network Open.

According to the research results, switching to a low fat, plant-based diet could boost the body’s metabolism enough to burn excess weight and fat — even without vigorous exercise.

Researchers with the Physicians Committee for Responsible Medicine (PCRM) partnered with Dr. Kitt Petersen and Dr. Gerald Shulman of Yale University. Together, they conducted a 16-week trial where participants in the intervention group adopted a low fat, vegan diet.

The study team hoped to find the full impact of a low fat, vegan diet. Could it improve metabolism, reduce visceral fat, and aid in significant weight loss?

Initially, 3,115 people responded to the flyers distributed by the research team. Of these, 244 met the criteria for participation in the study.

Eligible study participants had overweight, with body mass indexes ranging between 28 and 40, and were aged 25–75.

Researchers randomly split the study participants into two groups. The first group followed a 4-month-long low fat, vegan diet, eating fruits, vegetables, pulses, and grains in serving sizes comparable to what they ordinarily consumed at mealtimes. The second group, functioning as the control group, did not change their dietary habits.

Members of both groups curbed their daily alcohol consumption for the duration of the study. Women could drink a single alcoholic beverage daily, while men could have up to two drinks per day. Neither group began an exercise routine or deviated from any existing physical habits during the 16-week trial.

Study outcome and implications

Researchers took measurements at the beginning and end of the trial. By the end of the study, the plant-based diet group averaged an 18.7% increase in their after-meal calorie burn. They also saw an average weight loss of about 14 pounds (lb).

Additionally, the vegan diet group experienced a decrease in insulin resistance and a reduction in body fat. Crucially, this group saw a significant loss of visceral fat, the more detrimental type of fat that gets stored around the internal organs.

By contrast, the control group experienced no significant loss of weight or reduction in body fat. After comparing the two groups, it was clear to researchers that the low fat, vegan diet had a measurable impact on the weight and health of the intervention group.

Lead study author Dr. Hana Kahleova, director of clinical research at the PCRM, considers the results “groundbreaking for the 160 million Americans struggling with overweight and obesity.”

She adds, “Over the course of years and decades, burning more calories after every meal can make a significant difference in weight management.”

Findings back up existing research

These findings are consistent with a number of previous studies that have shown plant-based diets to be associated with reduced excess body fat. As reviewed recently by Rami S. Najjar and Rafaela G. Feresin in Nutrient:

“Plant-based diets can reduce body fat […] [and] cumulatively lead to reduced calorie intake and increased energy expenditure.”

It is worth noting that the PCRM and Yale University researchers focused on people without a history of diabetes. The pool of participants also skewed heavily toward one gender, with females constituting 86% of all participants.

Additional research might be needed for those already experiencing related health issues, or with a more balanced group of participants.

Still, there is enough existing research to suggest that no matter a person’s current diabetes status, their health outcomes could improve through following a diet mainly consisting of fruits and vegetables.

At least one participant in the clinical study decided to make a permanent change to his lifestyle. Sam T., who lost 34 lb during the 4-month study, continued with the plant-based diet. He reached his goal weight and began partaking in half-marathons and marathons.

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Encouraging people to eat more dried fruit — without added sugar — could be an effective way to boost their intake of vital nutrients, researchers have concluded.

Low consumption of fruit in the United States and other countries is a major contributor to diet-related disease and disability, according to a recent analysis.

Fruit is a good source of nutrients, such as fiber and potassium, that many people lack in their diet. It also contains bioactive nutrients that provide extra health benefits, including polyphenols and carotenoids.

Research suggests that eating fruit is associated with a lower risk of cardiovascular disease, cancer, and type 2 diabetes.

However, only about 24% of females and 14% of males in the U.S. eat the recommended daily amount of fruit, according to the National Cancer Institute.

Several factors might contribute to people’s low intake of fresh fruit, including limited availability, high cost, and perishability.

Recommending that people eat more dried fruit could be one solution.

Healthful snack?

Dried fruit offers several advantages over fresh fruit in terms of cost, availability, and ease of storage and transport. It could also replace more unhealthful snack food that is high in sugar, salt, and saturated fat.

At the same time, however, there are concerns about overconsumption leading to excess calorie intake because dried fruit is such an “energy dense” form of fruit.

Previous observational studies have found that eating dried fruit is associated with health benefits. However, the evidence is inconclusive because people who eat more dried fruit may tend to have a more healthful diet and lifestyle overall.

The new study by researchers at Pennsylvania (Penn) State University in University Park aimed to get around this difficulty by comparing days when particular participants reported eating dried fruit with days when they ate none.

They found that people tended to consume more key nutrients on the days they ate dried fruit, including dietary fiber and potassium. However, they also consumed more calories.

“Dried fruit can be a great choice for a nutritious snack, but consumers might want to be sure they’re choosing unsweetened versions without added sugar,” says Valerie Sullivan of Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, who was a grad student at Penn State when she led the study.

“Portion sizes can also be tricky because a serving of dried fruit is smaller than a serving of fresh since the water has been taken out. But the positive is that dried fruit can help people potentially consume more fruit because it’s portable, it’s shelf-stable, and can even be cheaper.”

The research appears in the Journal of the Academy of Nutrition and Dietetics.

Health and nutrition survey

For their analysis, the scientists drew on survey responses from 25,590 individuals who took part in the National Health and Nutrition Examination Survey (NHANES) 2007–2016.

The respondents provided information about the food they had consumed in the past 24 hours (called “dietary recalls”).

Dried fruit accounted for only 3.7% of all the fruit consumed. However, a total of 1,233 participants reported consuming dried fruit on one out of two dietary recalls, allowing the scientists to compare their intake on these days.

Data were also available on the participants’ health, including their body mass index (BMI), waist circumference, and seated resting blood pressure.

Even after adjusting for demographic and lifestyle factors, the participants who ate significant amounts of dried fruit tended to have better diets, a lower BMI, a smaller waist circumference, and lower systolic blood pressure compared with those who did not.

When the researchers compared the days when a participant ate dried fruit with those when they did not, they found that the average intake of total carbohydrate, dietary fiber, potassium, and polyunsaturated fat was greater on the days they ate dried fruit.

Active lifestyle

Taken together, the findings suggest that people who ate dried fruit expended more energy, compensating for the extra calories.

“In our study, people who consumed dried fruits had a higher calorie intake but a lower BMI and waist circumference, which suggests they were more physically active,” says co-author Penny Kris-Etherton, Evan Pugh University Professor of Nutritional Sciences at Penn State.

“So, when incorporating dried fruits, pay attention to calories and be sure to substitute out calories from low nutrient foods for dried fruits to get the greatest benefit of eating dried fruits,” she adds.

The researchers write that eating dried fruit tended to increase total fruit consumption, rather than replacing other forms of fruit. “Thus, increasing dried fruit consumption might help Americans achieve greater fruit intakes.”

The authors acknowledge that their study did not prove that eating dried fruit improves health, only that there seems to be an association. People who are likely to eat dried fruit may have better health for other reasons, such as taking more exercise or leading less stressful lives.

In addition, they note that the survey relied on the participants’ recollection of what they had eaten over the past 24 hours and their ability to estimate quantities accurately.

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A newly released study found that people with heart failure who received the diabetes drug empagliflozin showed significant improvements in heart structure and function, with many experiencing a reversal of the disease.

Approximately 6.2 million adults in the United States have heart failure. As a result of its high prevalence, the national cost of healthcare services, medicines, and missed workdays related to this disorder reached an estimated $30.7 billion in 2012.

Globally, the disease affects approximately 23 million people.

What is heart failure?

Heart failure occurs when the heart cannot pump blood effectively to other parts of the body, causing symptoms that include shortness of breath, difficulty breathing, weakness and tiredness, and weight gain and swelling in the legs, ankles, feet, or stomach.

It may progress to congestive heart failure due to the buildup of fluids in the lungs, liver, and lower extremities.

Underlying causes of heart failure include coronary artery disease, high blood pressure, obesity, heart valve disease, and diabetes. Over time, these diseases may result in “adverse modeling,” which is the heart’s attempt to compensate for its added workload by getting larger, developing thicker walls, and pumping more frequently.

Among people with heart failure, about 50% present with heart failure with reduced ejection fraction (HFrEF). The lowered ejection fraction occurs when the heart’s left ventricle cannot pump blood effectively, decreasing the amount of blood that leaves the ventricle to circulate the body after each contraction.

Treatment options for heart failure include taking prescription drugs, reducing the amount of sodium in the diet, consuming a lower volume of liquids, and making any necessary lifestyle changes, such as reaching a moderate weight, quitting smoking, and eating a heart-healthy diet.

New study shows promising results

With limited heart failure treatment options available, researchers from the Icahn School of Medicine at Mount Sinai set up a clinical trial called EMPATROPISM to investigate the use of empagliflozin, a diabetes drug, for treating HFrEF in people without diabetes.

The researchers presented the trial results on November 13 at the American Heart Association (AHA) Scientific Sessions 2020, with a pre-proof appearing in the Journal of the American College of Cardiology.

In the double-blind, placebo-controlled, randomized study, the scientists divided the 84 participants, who were 18–85 years of age, into two groups. One group received 10 milligrams (mg) of empagliflozin daily, and the other took a placebo.

At the trial’s onset, all of the participants underwent baseline evaluations, which included cardiac MRI, a 6-minute walk test, and a cardiopulmonary exercise test to determine their oxygen levels. They also completed questionnaires regarding their quality of life.

After 6 months of receiving either the placebo or empagliflozin, the participants completed the same tests again.

The researchers found that approximately 80% of those who received the medication showed significant improvement in their condition, with a 16.6% improvement in left ventricle ejection fraction.

They also experienced a reduction in heart size and thickness and had less congestion, indicating that their heart failure had become less severe.

Remarkably, the investigators note that the heart returned to near normal in this group of participants.

Additionally, those who received empagliflozin experienced no severe side effects and saw improvements in their exercise levels and quality of life, which occurred relatively quickly after beginning the medication.

Although empagliflozin is an antidiabetes drug, the investigators noted no adverse blood sugar-related side effects, such as hypoglycemia, in the study participants, despite them not having diabetes.

Conversely, the study participants who took the placebo showed no improvements. Their condition either stayed the same or worsened, with a further reduced ejection fraction, increased heart size and thickness, and an abnormal change in the heart’s overall shape.

According to the researchers, the study results also explain why this medication effectively treats heart failure. They explain that it essentially reverses the adverse modeling that occurs when the heart attempts to restructure itself to compensate for changes associated with other chronic conditions.

Supporting evidence

The EMPEROR-Reduced trial, a slightly earlier study that featured in the New England Journal of Medicine, saw similar results. In this double-blind trial, 3,730 people with HFrEF took either empagliflozin (10 mg once daily) or a placebo, in addition to recommended therapy.

The results concurred with the EMPATROPISM findings, showing that people both with and without diabetes in the empagliflozin group experienced a lower risk of cardiovascular death or hospitalization for heart failure than those in the placebo group.

Researchers look to the future

The EMPATROPISM study’s first author, Carlos Santos-Gallego, a postdoctoral fellow at the Icahn School of Medicine, explains the implications of these findings.

He says, “Our clinical trial’s promising results show this diabetes drug can ameliorate lives of heart failure patients with reduced ejection fraction, enhance their exercise capacity, and improve their quality of life with little to no side effects.”

“We expect this work will help lead to U.S. Food and Drug Administration [FDA] approval of empagliflozin for this patient population in the coming months.”

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Scientists have advanced search for herbal cures for diabetes mellitus with the discovery of a blood sugar reducing syrup made predominantly with bitter leaf (Vernonia amygdalina) and plantain (Musa paradiasica) as well as validating guava (Psidium guajava) leaves as better alternative therapy in ameliorating diabetic-associated disorders of the kidney.

Previous studies had identified bitter melon; Aloe vera; bitter kola; bitter leaf; clove oil; coconut oil; garlic; ginger; black pepper (utazi in Ibo); guava leaves; velvet beans; bush mango; onion; okra; plantain; scent leaf; soursop; soybeans; tea leaves; and turmeric for the prevention and treatment of diabetes.

Researchers in Uganda have formulated aspartame- sweetened syrup from the most active combinations of bitter leaf and plantain. The syrup is pale brown, sweet, homogeneous, with a vanillin flavour and pH 4.27.

The study titled “Efficacy of a syrup formulated from combined extracts of Vernonia amygdalina and Musa paradisiaca for the management of type 2 diabetes” was published in African Journal of Pharmaceutical Research and Development.

The researchers from the Department of Pharmacy, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda, said Vernonia amygdalina (VA) and Musa paradisiaca (MP) are some of the major plants used in Uganda for the management of diabetes mellitus type 2 by herbalists and individual patients; though without proper dosing and safety considerations since there are no standard formulations.

They evaluated the efficacy of syrup formulated from ethanol VA leaf and methanol MP flower extracts for the management of type 2 diabetes mellitus in streptozocin (STZ) induced diabetic male waster rats.

Efficacy was determined by assessing the glucose lowering abilities of varying combinations of the extracts based on the Oral Glucose Tolerance (OGT) and Random Blood Glucose (RBG) tests against glibenclamide standard. In both the OGT and RBG tests, the 1:1 combination (100 mg/kg VA and 200 mg/kg MP) of the extracts showed hypoglycemic effect greater than that of either of the plants extracts used singly at their most effective doses (100 mg/kg VA or 200 mg/kg) MP. The hypoglycemic effect of the 1:1 combination (100mg/kg VA and 200 mg/kg MP) was also comparable to glibenclamide (0.05 mg/kg) at 60 and 120 minutes for the OGT tests and on day two for the RBG tests.

The maximum observed activity of Vernonia amygdalina (100 mg/kg) was greater than that of Musa paradisiaca (200 mg/kg) though not significant.

“This study showed that a combined preparation of MA and VP extracts exhibits a synergistic and clinically significant hypoglycemic activity; and that the aspartame based syrup base has not effect on that hypoglycemic effects on MA and VP extracts, made singly or as combination,” the researchers wrote.

Meanwhile, another study published in the Journal of Cytology and Histology found that guava (Psidium guajava) could be a better alternative therapy in ameliorating diabetic-associated disorders of the kidney.

The study is titled “Effects of Four Herbal Plants on Kidney Histomorphology in STZ-induced Diabetic Wistar Rats.”

The herbal plants used for this study were leaves of Veronia amygdalina, shaft of Citrullus colocynthis seed, leaves of Psidium guajava, and leaves of Ficus mucuso.

Veronia amygdalina (VA) commonly called bitter leaf belongs to the family Asteraceae. It has petiolate leaves of about 6 mm diameter and elliptic shape. The leaves are green with a characteristic odour and a bitter taste. It is called Ewuro by the Yoruba of Nigeria. The leaves have been used in traditional folk medicine as anthelmintics, antimalarial, antimicrobial anticancer and as a laxative herb.

Phytochemical substances in VA include oxalates, phylates and tannins, and also flavonoids.

Citrullus colocynthis (CC) popularly known as ‘bitter apple’, ‘colosynth’, and ‘vine-of-Sodom’ is a tropical plant belonging to the family Cucurbitaceae. It is also commonly referred to as ‘egusi’ amongst the Yorubas of Nigeria. In the traditional medicine, it has been used in treatment of constipation, diabetes oedema, fever, jaundice leukaemia, bacterial infections, cancer and used as an abortifacient.

Psidium guajava (PG) is a semi deciduous tropical tree commonly known as ‘guava’ and belongs to the family Myrtaceae. Phytochemical constituent have been shown to include Vitamin C, B1, B2, and B6, free sugars. Guava fruits have been shown to have antioxidant properties. The fruits have been shown to possess hypoglyceamic effects in diabetic mice and human volunteers. Studies have indicated the presence of various flavonoids, terpenoids and their glycosides, and these compounds have been shown to be anti-diabetic.

Ficus mucuso (FM) belongs to the family Moraceea. The Ficus genus has wide distribution and is used traditionally as medicine, vegetable, food, fodder and fuel wood. Phytochemical analyses of FM have revealed the presence of monoterpenoids and flavonoids.

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia (high blood glucose level), which results from defects in insulin secretion, insulin action or both.

The chronic hyperglycaemia of DM is associated with long-term damage, dysfunction and failure of various body structures and organs especially the eyes, nerves, heart, blood vessels and also the kidney. Existing therapy for DM are known to provide good glycaemic control, but are believed to do little in regards to the complications to various organs. Besides, these anti diabetic drugs are associated with mild to moderate side effects.

Consequently, the present study has investigated the effects of some common plants traditionally used in herbal management of diabetes amongst the Yorubas of Ile-Ife, Nigeria, on the histomorphology of the kidney in STZ-induced Wistar rats.

The Nigerian researchers at the Department of Anatomy and Cell Biology, and Department of Medical Biochemistry, Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, investigated the effect of four herbal extract and their efficacy on the histomorphometry of the kidney in STZ induced diabetic rats with a view to understanding their anti-diabetic properties.

Forty- two healthy adult Wistar rats (Rattus novergicus) with an average weight of 153.4 g were randomly divided into seven groups (n=6). STZ (65 mg/kg) dissolved in citrate buffer was administered intraperitoneally to animals in groups (B-G) while animals in group A received equivalent volume of citrate buffer. Plant extracts (100 mg/kg) were administered daily (orally) to animals in groups C-F and glimepiride (anti-diabetic drug) to animals in group G for
14 days.

After the expiration of the study the animals were sacrificed and the kidneys were excised, fixed in 10 per cent formol saline for histology and morphometric analysis. The glomeruli of the diabetic group were atrophied which is validated by significant decrease in its density, shrinkage and increased bowman’s space. These observations were also characterized by diminished cellular proliferation, decreased cellular volume and ischemia. The histology and morphometric analysis revealed that the kidney in the group treated with Psidium guajava shows a better histoarchitectural outline of all the four plant extracts used.

The researchers concluded: “… The groups administered with PG extract demonstrated a distinct regenerative capacity over the other three extract. The group administered with FM extract closely followed this. Previous studies have reported some similar histopathological findings. The plant extracts used for the study, are common herbal plant used traditionally in the management of diabetes, amongst the Yorubas of Ile-Ife, Nigeria. Three of these plants – VA, CC, and PG; have been reported to possess anti-diabetic properties. The four medicinal plants used in this study are well known for their antioxidant properties, which are due to their high level content of flavonoids. The present study has provided useful information in the management of kidney related disorders resulting from diabetes.”

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