Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 The recommendations of the diabetes web site are, as is any version of the low-fat diet, a guaranteed recipe for causing diabetes. And heart failure. And cancer. And . . . You get the picture. For some very good reading on this get a copy of Dr. Schwartzbein's book, " The Schwartzbein Principle. " It's intended as a weight loss book, but she explains exactly why the PC (politically correct) diet is killing us. And what she learned when she first went into practice. She differs from Atkins in two major ways that I disagree with. One, she says no one should ever be in ketosis. And, Two, no one should ever eat salt. Judith Alta -----Original Message----- It's always amazed me that the prescribed diet for diabetes is so high in carbs and an almost irrational fear of fats. Would I be far off the mark that anyone eating a diet mainly of carbs and sugar and fat substitutes would be more prone to get heart disease? Esp. someone who has an impaired ablility to process sugars in the first place? From the official diabtes web site: Which foods are unhealthy? Fat is a nutrient, and you need some fat in your diet. But too much fat isn't good for anyone. And it can be very harmful to people with diabetes. Too much fat or cholesterol may increase the chances of heart disease and/or hardening of the arteries. People with diabetes have a greater risk of developing these diseases than those without diabetes. So, it is very important that you limit the fat in your diet. Fat is found in many foods. Red meat, dairy products (whole milk, cream, cheese, and ice cream), egg yolks, butter, salad dressings, vegetable oils, and many desserts are high in fat. To cut down on fat and cholesterol, you should: * Choose lean cuts of meat. Remove extra fat. * Eat more fish and poultry (without the skin). * Use diet margarine instead of butter. * Drink low-fat or skim milk. * Limit the number of eggs you eat to three or four a week and choose liver only now and then. Can anyone be trusted who still promotes margarine? My two cents Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 To answer your (rhetorical, I'm sure) question, NO!!!!!!!!!!!!!!!!!!!!! This is the diet my mother in law has been on for YEARS (she's had type 2 diabetes for awhile now). Guess what? She survived mild (!!!!) breast cancer and suffered a stroke that left her partially paralyzed last year. My husband and I are trying our best to open her eyes, but she equates MDs with God, so it's an uphill battle. She actually lives near Dr. Bernstein (of " Dr. Bernstein's Diabetes Solution " )--we bought her the book and hope to convince her to see him soon. He advocates control of blood sugar through diet--a proper diet, that is, with lots of FAT and severely limited grain and starch. > * Choose lean cuts of meat. Remove extra fat. > * Eat more fish and poultry (without the skin). > * Use diet margarine instead of butter. > * Drink low-fat or skim milk. > * Limit the number of eggs you eat to three or four a > week and choose liver only now and then. > > Can anyone be trusted who still promotes margarine? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 People with diabetes may be more prone to developing heart disease, but if the basic premise of what causes heart disease is way off, then all the recommendations are going to be in the wrong direction. I just wonder when these " health gurus " are going to pull their heads out and pay attention to the research that shows that fat is not bad. Well, it was the same with Galileo, he told the mainstream scientist and leaders that they were wrong about the universe rotating around the earth, and here he had all this research he had done to prove it and they still wouldn't accept it. Michele Diabetes Diet > It's always amazed me that the prescribed diet for > diabetes is so high in carbs and an almost irrational > fear of fats. Would I be far off the mark that anyone > eating a diet mainly of carbs and sugar and fat > substitutes would be more prone to get heart disease? > Esp. someone who has an impaired ablility to process > sugars in the first place? > > From the official diabtes web site: > Which foods are unhealthy? > > Fat is a nutrient, and you need some fat in your > diet. But too much fat isn't good for anyone. And it > can be very harmful to people with diabetes. > > Too much fat or cholesterol may increase the chances > of heart disease and/or hardening of the arteries. > People with diabetes have a greater risk of developing > these diseases than those without diabetes. So, it is > very important that you limit the fat in your diet. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 If the " health gurus " you speak of were to admit that fat is where it's at they would have to admit that they have lied to us lo these many years. And losing face is not something they want to do. Also, they would lose a huge portion of their incomes, as I feel they will anyway, as low-carb takes hold. People who eat " unhealthy " quantities of animal protein and naturally saturated animal fats will be healthy people, and will not need to throw money at the medical and drug establishments. Judith Alta -----Original Message----- People with diabetes may be more prone to developing heart disease, but if the basic premise of what causes heart disease is way off, then all the recommendations are going to be in the wrong direction. I just wonder when these " health gurus " are going to pull their heads out and pay attention to the research that shows that fat is not bad. Well, it was the same with Galileo, he told the mainstream scientist and leaders that they were wrong about the universe rotating around the earth, and here he had all this research he had done to prove it and they still wouldn't accept it. Michele Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 Judith- Unfortunately, as in many fields, the old guard probably has to die off before the new guard can be fully ascendent. Unfortunately, profits complicate things a lot further in medicine. >If the " health gurus " you speak of were to admit that fat is where it's at >they would have to admit that they have lied to us lo these many years. And >losing face is not something they want to do. - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 > > Well, it was the same with Galileo, he told the mainstream > scientist and leaders that they were wrong about the universe > rotating around the earth, and here he had all this research > he had done to prove it and they still wouldn't accept it. Well, they did eventually, precisely because he did have good science to back him up. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 i have a diabetic friend who utilises a polish book. THe name which is escaping me early today. However he is on a ratio of 3:1:0.5 of fat/protein/carbs when he has been able to eat like this ( somtimes cant cook fro himself ect due to work ) he has been able to ween himself off insulin. the fats he has are primarily egg yolk, lard and bacon fat _____ From: Judith Alta K [mailto:jaltak@...] Sent: Thursday, 18 December 2003 3:15 AM Subject: RE: Diabetes Diet The recommendations of the diabetes web site are, as is any version of the low-fat diet, a guaranteed recipe for causing diabetes. And heart failure. And cancer. And . . . You get the picture. For some very good reading on this get a copy of Dr. Schwartzbein's book, " The Schwartzbein Principle. " It's intended as a weight loss book, but she explains exactly why the PC (politically correct) diet is killing us. And what she learned when she first went into practice. She differs from Atkins in two major ways that I disagree with. One, she says no one should ever be in ketosis. And, Two, no one should ever eat salt. Judith Alta -----Original Message----- It's always amazed me that the prescribed diet for diabetes is so high in carbs and an almost irrational fear of fats. Would I be far off the mark that anyone eating a diet mainly of carbs and sugar and fat substitutes would be more prone to get heart disease? Esp. someone who has an impaired ablility to process sugars in the first place? >From the official diabtes web site: Which foods are unhealthy? Fat is a nutrient, and you need some fat in your diet. But too much fat isn't good for anyone. And it can be very harmful to people with diabetes. Too much fat or cholesterol may increase the chances of heart disease and/or hardening of the arteries. People with diabetes have a greater risk of developing these diseases than those without diabetes. So, it is very important that you limit the fat in your diet. Fat is found in many foods. Red meat, dairy products (whole milk, cream, cheese, and ice cream), egg yolks, butter, salad dressings, vegetable oils, and many desserts are high in fat. To cut down on fat and cholesterol, you should: * Choose lean cuts of meat. Remove extra fat. * Eat more fish and poultry (without the skin). * Use diet margarine instead of butter. * Drink low-fat or skim milk. * Limit the number of eggs you eat to three or four a week and choose liver only now and then. Can anyone be trusted who still promotes margarine? My two cents Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 - I'm guessing that would be either _Homo Optimus_ or _Optimal Nutrition_, both by Dr. Jan Kwasniewski, a Polish doctor who advocates low-carb high-fat eating. >i have a diabetic friend who utilises a polish book. THe name which is >escaping me early today. - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 ah yes that is the books he has by Jan ive read homo optimus but not optimal nutrition as my mate has that book in polish ( he is polish himself ) _____ From: Idol [mailto:Idol@...] Sent: Thursday, 18 December 2003 8:32 AM Subject: RE: Diabetes Diet - I'm guessing that would be either _Homo Optimus_ or _Optimal Nutrition_, both by Dr. Jan Kwasniewski, a Polish doctor who advocates low-carb high-fat eating. >i have a diabetic friend who utilises a polish book. THe name which is >escaping me early today. - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 > > i have a diabetic friend who utilises a polish book. THe > name which is escaping me early today. Its probably Dr. Jan Kwasniewski and his " Optimal Diet " . > However he is on a ratio of 3:1:0.5 of fat/protein/carbs > when he has been able to eat like this ( somtimes cant cook > fro himself ect due to work ) > > he has been able to ween himself off insulin. the fats he > has are primarily egg yolk, lard and bacon fat There's some information on Dr. Jan Kwasniewski and his diet at http://homodiet.netfirms.com/misc/cv_jk.htm . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 In a message dated 12/17/2003 10:50:23 PM Eastern Standard Time, heidis@... writes: identified the auto-immune factor that destroys the pancreas, and it stops getting produced (in the gluten sensitive kids) when they stop eating gluten. I think there is more to it than carbs ... after all, the Indians had corn and potatoes before the Europeans did. (though a higher meat diet has more nutrients, ## I have mentioned this here before but one of my employees has type 2 diabetes and has been able to throw away the insulin by dropping grains and of course processed sugars from her diet. She still eats carbs--but not grains and follows NT philosophy for the most part. The interesting thing is that she was on insulin and eating this way but it did not occur to her to drop the insulin. She was stabilized and assumed that it was at least in part the insulin and not JUST the diet changes. And even had it occurred to her that it was just the diet changes it would have been a big leap of faith for her to drop insulin on that chance. But chance did it for her when her completely irresponsible physician FORGOT to call in her insulin prescription to her pharmacy on a Friday. So she went 3 days without insulin and had no problems. So when she was able to fill the prescription the next week she did not and has not since then. She is also a heavyset person but has lots a lot of weight eating this way, in addition to being able to ditch the insulin and she has not been actively dieting. Alison Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 At 07:40 AM 12/18/2003 +1000, you wrote: >I think their misguided theory is if you are smothering yourself with carbs >all day then they can control the insulin. Rather than suddenly having a >carb meal in the day that really " blows stuff out the water " > >The problem is medical beelives u ned a certain amount of carb in yoru day >and they try to fit that in with a diabetic Am on a Native American diabetes list and have been in a not well taken by some at all but not totally ignored presentation of higher fat/protein low carb dieting for diabetes control. One person from an organization for type l,which has its own set of more common problems (ketoacidosis and hypoglycemia) than type ll, uses and suggests hi quality whole grain crackers and bread after insulin to get it going as it was in a U.S. medical report. If the report was from a study l found, the study was done in southern Europe and the trial people were named as all southern Europeans, where grains have been used next to the longest in history. Gluten intolerance l covered because gluten grains were not in the Native American diet until the last few hundred years. Few went back on Atkins as they were familiar with it. One even asked for a safe carb level so l suggested Schwarzbein's. I'd posted this acticle sent to this list about a year ago by Dedy. Just makes sense to me if you're living in northern latitudes and your ancestry is from the same you can't maintain health eating like you live on a tropical island. Wanita Lakota man credits traditional diet for diabetes control By Heidi Bell Gease, Journal Staff Writer <http://www.rapidcityjournal.com/articles/2003/01/12/news/local/news04>http ://www.rapidcityjournal.com/articles/2003/01/12/news/local/news04. txt EAGLE BUTTE - Chasing Hawk is in touch with his triglycerides. " When my triglycerides goes up, my back of my head hurts, " he explained, touching his head for emphasis. Triglycerides are a form of fat found in food. They can provide energy for the body, but high levels of triglycerides can mean there is too much fat in the diet. They can also indicate a high risk for heart disease or poorly controlled diabetes. Triglycerides aren't the only thing Chasing Hawk, 57, is aware of within his body. He knows a serving of raisins will raise his blood sugar by 80 points. He can estimate his cholesterol at any given time. And he's convinced that eating the higher protein, lower carbohydrate diet of his ancestors has made him, as he likes to say, " the healthiest diabetic around. " In fact, Chasing Hawk now relies on diet and exercise, not insulin, to control his diabetes. He wasn't always so healthy. About 20 years ago, Chasing Hawk, who stands 5 feet 8 inches tall, weighed 224 pounds. He was Cheyenne River Sioux tribal chairman then, " and I was embarrassed about my big stomach. " So he began exercising, dropping to 176 pounds. Meanwhile, several family members were diagnosed with diabetes. " I was proud that I wasn't diabetic, " he said. But in 1992, Chasing Hawk's vision became blurry - a common sign of diabetes. Tests showed his cholesterol was 375, well over the American Heart Association's " high risk " point of 240 or above. He, too, was diabetic. Chasing Hawk became a model patient. He exercised daily and followed food-pyramid guidelines that encourage a diet heavy in grains (i.e., carbohydrates) and low in meat/protein and fat. Yet in late 1997, his cholesterol was still 294. " Two weeks later, I had a heart attack, " Chasing Hawk said. Triple bypass surgery followed. " I was mad. Because why me? I exercised, " he said. " I followed the food pyramid. ... I even had my own keys to the fitness room. " Then, in December 1999, he and his wife, Ernestine, went out for a steak dinner. Ernestine always told him protein was good for him, he said, " but I didn't believe her. " Before dinner, Chasing Hawk's blood sugar was 160. Ninety minutes later, after eating a big steak, the reading had dropped to 31. " All that time, " he said, " Ernestine was right. " Soon afterward, Chasing Hawk ran across a book on carbohydrate addiction. He stayed up late, reading the whole book straight through. The next morning, his blood sugar was 140. After a high-protein breakfast of bacon and eggs, it had dropped to 105. Chasing Hawk began experimenting and exploring how different foods affected his body. He checked his blood sugar 15 times a day. He studied nutrition. Then, he read about the Atkins Diet, which promotes high protein and low carbohydrate intake. " I read five chapters, and it clicked in my mind that my ancestors were a high-protein, low-carbohydrate people, " he said. Genetically, " Native Americans will have a harder time breaking up the sugar in carbohydrates. " Nutritionist Kibbe Conti agrees with that assessment. Indian people whose ancestors were hunter/gatherers have an atypical response to carbohydrates, she said, releasing more insulin after eating carbohydrates than someone whose ancestry is better adapted to that diet. Chasing Hawk's move to a more traditional diet fits in well with Conti's Medicine Wheel nutrition guide (see related story on Page A1), which is based on the eating habits of pre-reservation-era tribes. " Basically, how Bob and I see it, it's a historical diet, " Conti said. " My whole thing is if you're predominantly Lakota, then you can't ignore your ancestor foodway. You just can't. " Chasing Hawk isn't eating just buffalo meat and wild turnips. He follows what he calls a " traditional diet in modern times. " He continually asks himself whether the food he's about to eat is something his ancestors might have eaten. Steak? Yes. Pasta? No. " My great-great-grandfather didn't eat that bread, so why should I eat that bread? " he asked. Chasing Hawk has also found that for him, eating twice as much protein as carbohydrates helps keep his blood sugar down. That doesn't mean no carbs, though. " I still eat my apple pie, " he said. " I still have my ice cream, on the sneak. " The trade-off is exercise. Chasing Hawk has monitored his blood sugar enough to know exactly how a two-mile jog or a brisk walk will affect his body, which he refers to as " a research center. " Now, he's ready to spread the word. He speaks at schools and workshops, encouraging people to take responsibility for their own health. He would like to see changes in commodity food programs and the USDA-approved food pyramid. Chasing Hawk is also starting a diabetes organization called " Ehanni Lakol Wicounye Piye Yukini Inc., " or " Re-Awakening the Past Lakota Healthy Lifestyle. " He hopes it eventually could offer inpatient treatment for diabetics. Not everyone agrees with Chasing Hawk's theories. Indian Health Service administrators say his diet plan has not been scientifically researched and could prove dangerous. The main concern is that excessive protein can be hard on the kidneys, which is an extra concern for diabetics whose kidneys are already stressed. But Conti believes " excessive " is a relative term. " If you're a white European ... (a diet like his) might be of high protein to you, " she said. But if you're a full-blooded Lakota, as Chasing Hawk is, your body might be accustomed to more protein. Conti also notes that AIC blood tests show Chasing Hawk's diabetes is under control. " You can't lie on that test, " she said, because it measures blood sugar for the past eight weeks. " I totally believe he's a success story. " Chasing Hawk says people should check with a doctor before trying his eating plan. And he says there's something else they need to do. " If you really want to do it, get connected with that guy, " he said, pointing skyward. " You gotta ask that guy to walk beside you. " Contact reporter Heidi Bell Gease at 394-8419 or at heidi.bell@r... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 Wanita, Thanks for the great article. The establishment complains that the " Lakota diet " is not scientific. But neither is the low-fat diet. Yes, it has been tested extensively and those tests have not proven that it is either safe or healthy. The low-fat diet has been created to make money for the drug companies, and no other reason. In that respect it is a rousing success. Judith Alta RE: Diabetes Diet At 07:40 AM 12/18/2003 +1000, you wrote: >I think their misguided theory is if you are smothering yourself with carbs >all day then they can control the insulin. Rather than suddenly having a >carb meal in the day that really " blows stuff out the water " > >The problem is medical beelives u ned a certain amount of carb in yoru day >and they try to fit that in with a diabetic Am on a Native American diabetes list and have been in a not well taken by some at all but not totally ignored presentation of higher fat/protein low carb dieting for diabetes control. One person from an organization for type l,which has its own set of more common problems (ketoacidosis and hypoglycemia) than type ll, uses and suggests hi quality whole grain crackers and bread after insulin to get it going as it was in a U.S. medical report. If the report was from a study l found, the study was done in southern Europe and the trial people were named as all southern Europeans, where grains have been used next to the longest in history. Gluten intolerance l covered because gluten grains were not in the Native American diet until the last few hundred years. Few went back on Atkins as they were familiar with it. One even asked for a safe carb level so l suggested Schwarzbein's. I'd posted this acticle sent to this list about a year ago by Dedy. Just makes sense to me if you're living in northern latitudes and your ancestry is from the same you can't maintain health eating like you live on a tropical island. Wanita Lakota man credits traditional diet for diabetes control By Heidi Bell Gease, Journal Staff Writer <http://www.rapidcityjournal.com/articles/2003/01/12/news/local/news04>http ://www.rapidcityjournal.com/articles/2003/01/12/news/local/news04. txt EAGLE BUTTE - Chasing Hawk is in touch with his triglycerides. " When my triglycerides goes up, my back of my head hurts, " he explained, touching his head for emphasis. Triglycerides are a form of fat found in food. They can provide energy for the body, but high levels of triglycerides can mean there is too much fat in the diet. They can also indicate a high risk for heart disease or poorly controlled diabetes. Triglycerides aren't the only thing Chasing Hawk, 57, is aware of within his body. He knows a serving of raisins will raise his blood sugar by 80 points. He can estimate his cholesterol at any given time. And he's convinced that eating the higher protein, lower carbohydrate diet of his ancestors has made him, as he likes to say, " the healthiest diabetic around. " In fact, Chasing Hawk now relies on diet and exercise, not insulin, to control his diabetes. He wasn't always so healthy. About 20 years ago, Chasing Hawk, who stands 5 feet 8 inches tall, weighed 224 pounds. He was Cheyenne River Sioux tribal chairman then, " and I was embarrassed about my big stomach. " So he began exercising, dropping to 176 pounds. Meanwhile, several family members were diagnosed with diabetes. " I was proud that I wasn't diabetic, " he said. But in 1992, Chasing Hawk's vision became blurry - a common sign of diabetes. Tests showed his cholesterol was 375, well over the American Heart Association's " high risk " point of 240 or above. He, too, was diabetic. Chasing Hawk became a model patient. He exercised daily and followed food-pyramid guidelines that encourage a diet heavy in grains (i.e., carbohydrates) and low in meat/protein and fat. Yet in late 1997, his cholesterol was still 294. " Two weeks later, I had a heart attack, " Chasing Hawk said. Triple bypass surgery followed. " I was mad. Because why me? I exercised, " he said. " I followed the food pyramid. ... I even had my own keys to the fitness room. " Then, in December 1999, he and his wife, Ernestine, went out for a steak dinner. Ernestine always told him protein was good for him, he said, " but I didn't believe her. " Before dinner, Chasing Hawk's blood sugar was 160. Ninety minutes later, after eating a big steak, the reading had dropped to 31. " All that time, " he said, " Ernestine was right. " Soon afterward, Chasing Hawk ran across a book on carbohydrate addiction. He stayed up late, reading the whole book straight through. The next morning, his blood sugar was 140. After a high-protein breakfast of bacon and eggs, it had dropped to 105. Chasing Hawk began experimenting and exploring how different foods affected his body. He checked his blood sugar 15 times a day. He studied nutrition. Then, he read about the Atkins Diet, which promotes high protein and low carbohydrate intake. " I read five chapters, and it clicked in my mind that my ancestors were a high-protein, low-carbohydrate people, " he said. Genetically, " Native Americans will have a harder time breaking up the sugar in carbohydrates. " Nutritionist Kibbe Conti agrees with that assessment. Indian people whose ancestors were hunter/gatherers have an atypical response to carbohydrates, she said, releasing more insulin after eating carbohydrates than someone whose ancestry is better adapted to that diet. Chasing Hawk's move to a more traditional diet fits in well with Conti's Medicine Wheel nutrition guide (see related story on Page A1), which is based on the eating habits of pre-reservation-era tribes. " Basically, how Bob and I see it, it's a historical diet, " Conti said. " My whole thing is if you're predominantly Lakota, then you can't ignore your ancestor foodway. You just can't. " Chasing Hawk isn't eating just buffalo meat and wild turnips. He follows what he calls a " traditional diet in modern times. " He continually asks himself whether the food he's about to eat is something his ancestors might have eaten. Steak? Yes. Pasta? No. " My great-great-grandfather didn't eat that bread, so why should I eat that bread? " he asked. Chasing Hawk has also found that for him, eating twice as much protein as carbohydrates helps keep his blood sugar down. That doesn't mean no carbs, though. " I still eat my apple pie, " he said. " I still have my ice cream, on the sneak. " The trade-off is exercise. Chasing Hawk has monitored his blood sugar enough to know exactly how a two-mile jog or a brisk walk will affect his body, which he refers to as " a research center. " Now, he's ready to spread the word. He speaks at schools and workshops, encouraging people to take responsibility for their own health. He would like to see changes in commodity food programs and the USDA-approved food pyramid. Chasing Hawk is also starting a diabetes organization called " Ehanni Lakol Wicounye Piye Yukini Inc., " or " Re-Awakening the Past Lakota Healthy Lifestyle. " He hopes it eventually could offer inpatient treatment for diabetics. Not everyone agrees with Chasing Hawk's theories. Indian Health Service administrators say his diet plan has not been scientifically researched and could prove dangerous. The main concern is that excessive protein can be hard on the kidneys, which is an extra concern for diabetics whose kidneys are already stressed. But Conti believes " excessive " is a relative term. " If you're a white European ... (a diet like his) might be of high protein to you, " she said. But if you're a full-blooded Lakota, as Chasing Hawk is, your body might be accustomed to more protein. Conti also notes that AIC blood tests show Chasing Hawk's diabetes is under control. " You can't lie on that test, " she said, because it measures blood sugar for the past eight weeks. " I totally believe he's a success story. " Chasing Hawk says people should check with a doctor before trying his eating plan. And he says there's something else they need to do. " If you really want to do it, get connected with that guy, " he said, pointing skyward. " You gotta ask that guy to walk beside you. " Contact reporter Heidi Bell Gease at 394-8419 or at heidi.bell@r... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 If Indian Health Services took half the salaries of health workers plus diabetes drug costs and put it into changing food subsidies and correct dietary, exercise education alone there'd probably be room for a bigger cut after because diabetics would no longer be the majority of patients. Boggles my mind that minds that choose to be and make decisions of leadership cannot think to the point of linking diseases of fat metabolism to the commercial altering of fats and diabetes to increase in use of refined carbohydrates. Wanita > >Thanks for the great article. > >The establishment complains that the " Lakota diet " is not scientific. But >neither is the low-fat diet. Yes, it has been tested extensively and those >tests have not proven that it is either safe or healthy. > >The low-fat diet has been created to make money for the drug companies, and >no other reason. In that respect it is a rousing success. > >Judith Alta Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 At 03:37 PM 12/17/2003, you wrote: >) than >type ll, uses and suggests hi quality whole grain crackers and bread after >insulin to get it going as it was in a U.S. medical report. If the report was >from a study l found, the study was done in southern Europe and the trial >people were named as all southern Europeans, where grains have been used next >to the longest in history. Gluten intolerance l covered because gluten grains >were not in the Native American diet until the last few hundred years. Gluten grains are very much associated with T1 diabetes too. Sounds like they've identified the auto-immune factor that destroys the pancreas, and it stops getting produced (in the gluten sensitive kids) when they stop eating gluten. I think there is more to it than carbs ... after all, the Indians had corn and potatoes before the Europeans did. (though a higher meat diet has more nutrients, it doesn't seem that the Indians had as high a rate of obesity and diabetes til they got the European foods). I really wonder about the recommendation to eat small hi-carb meals for diabetics ... it seems there is some consensus that insulin resistance comes from eating more carbs when the glycogen stores are already full. So constantly " topping off " the glycogen seems intuitively counterproductive, even for the folks that don't believe in fat. " When people with diabetes start burning more calories than they consume, their blood sugar control improves within a mere 24 hours " Health magazine, nov 2003 -- talking about the feast/fast protocol. They had diabetics eat " light " now and then, 400-600 caloires for the day -- and their blood sugar control improved (they also lost more weight than people on a standard low-cal diet). -- Heidi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 In a message dated 12/18/2003 2:27:11 AM Eastern Standard Time, heidis@... writes: I'm assuming she has a glucose meter though? So when you mean " no problems " you mean her blood sugar isn't high? If so, then that is WONDERFUL! @@@ Yes she has a glucose meter and yes, 'no problems' means no high blood sugar. Alison Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 >But chance did it for her when her completely irresponsible physician FORGOT >to call in her insulin prescription to her pharmacy on a Friday. So she went >3 days without insulin and had no problems. So when she was able to fill the >prescription the next week she did not and has not since then. > >She is also a heavyset person but has lots a lot of weight eating this way, >in addition to being able to ditch the insulin and she has not been actively >dieting. > >Alison I'm assuming she has a glucose meter though? So when you mean " no problems " you mean her blood sugar isn't high? If so, then that is WONDERFUL! I always get nervous when people ditch insulin or blood pressure medication unless they are monitoring ... -- Heidi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2003 Report Share Posted December 18, 2003 Heidi wrote -- in Health magazine, nov 2003 -- talking about the feast/fast protocol. They had diabetics eat " light " now and then, 400-600 caloires for the day -- and their blood sugar control improved (they also lost more weight than people on a standard low-cal diet). Heidi, is this article available on line?...TIA Dedy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2003 Report Share Posted December 18, 2003 >Heidi wrote -- in Health magazine, nov 2003 -- talking about the feast/fast protocol. They had diabetics eat " light " now and then, 400-600 caloires for the day -- and their blood sugar control improved (they also lost more weight than people on a standard low-cal diet). > >Heidi, > >is this article available on line?...TIA > >Dedy No, not unless you have a subscription. You can probably check it out at the library though. The doctor doing that study is , maybe you can find something by him (I didn't find much on a web search though, just http://www.findarticles.com/cf_0/m0CUH/5_23/64730780/p5/article.jhtml?term= I expect other magazines will be picking up on the story though, and they will be online. Science News this week has an article on " Ketones to the rescue " -- using ketosis to cure diseases (I haven't read it yet) but THAT isn't online either. without a subscription. Harsh. Discover is making some articles " Members only " also. Time to support your local library ... -- Heidi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2003 Report Share Posted December 18, 2003 Here is one that is publically available ... http://www.sciencenews.org/20030607/food.asp Intermittent feeding also improved the animals' resistance to a neurotoxin that simulates Alzheimer's disease, the researchers report in the May 13 Proceedings of the National Academy of Sciences. ..... When resting, rats fed only on alternating days had lower heart rates and blood pressure and less circulating glucose and insulin in their blood than did the other rats. The sometimes-fasting rats also showed muted cardiovascular responses to stress, suggesting that they more readily adapt physiologically to such situations. -- Heidi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2003 Report Share Posted December 18, 2003 Heidi wrote -- Time to support your local library ... thanks for the reply Heidi... unfortunately my local library doesn't carry this publication... but... as you say, the story will no doubt be soon published elsewhere... meanwhile, I'll be practicing being patient :-) Dedy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2003 Report Share Posted December 18, 2003 Heidi. Trying to find another diabetes article l had that linked diabetes to mainly environmental factors (foods, pollutants, stress, etc.) and secondly to a starvation gene, which would be aggravated by 3-6 meals day constant digestion of diabetes/hypoglycemic diets. Backs up the warrior diet feast/famine and my experience. Highest diabetes statistics have always been Native Americans, Blacks and Hispanics in this country. Asians have just recently seen a rise in incidence as someone mentioned in another post. With type I it could be a mutation, no insulin being produced brought on possibly by years of gluten sensitivity through generations. Like Dangerous Grains says, gluten randomly can attack organs. Wanita Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2003 Report Share Posted December 18, 2003 : >Trying to find another diabetes article l had that linked diabetes to >mainly environmental factors (foods, pollutants, stress, etc.) and secondly >to a starvation gene, which would be aggravated by 3-6 meals day constant >digestion of diabetes/hypoglycemic diets. Backs up the warrior diet >feast/famine and my experience. I esp. liked the part that the fasting experience helps one cope with stress, so the two get combined. > Highest diabetes statistics have always >been Native Americans, Blacks and Hispanics in this country. Asians have >just recently seen a rise in incidence as someone mentioned in another >post. With type I it could be a mutation, no insulin being produced brought >on possibly by years of gluten sensitivity through generations. Like >Dangerous Grains says, gluten randomly can attack organs. Gluten does randomly attack organs, but they've found at least one specific pathway ... See below. Also when they give rats zonulin, which increases intestinal permeability, they tend to get T1 diabetes. Gluten sensitive people secrete zonulin when they get gluten. So it isn't just gluten that gets into the blood, who knows what other chemicals get involved, plus the food antibodies that are in the gut (to attack potential food toxins) get into the blood. ============== >Patients >WESTPORT, Sep 07 (Reuters Health) - Patients with celiac disease have >high levels of diabetes- and thyroid-related autoantibodies that > " disappear " when the patients are placed on a gluten-free diet. > The finding confirms the high prevalence of organ-specific >autoantibodies in patients with celiac disease, and supports the theory >that these antibodies are gluten-dependent, Dr. Alessandro Ventura, of >the Universita di Trieste, Italy, and colleagues say in the August issue >of the Journal of Pediatrics. > The investigators tested 90 children with celiac disease for serum >antibodies to islet cells, glutamic acid decarboxylase, insulin, and >thyroperoxidase. The overall prevalence of diabetes- and thyroid-related >autoantibodies was 11.1% and 14.4%, respectively. > Prior studies have suggested that the presence of organ-specific >autoantibodies in patients with celiac disease is " related to the >presence of a second autoimmune disease. " However, the fact that serum >organ-specific autoantibodies tended to disappear in the current study >when patients were placed on a gluten-free diet supports the position >that these antibodies are at least partly gluten-dependent. > " A gluten-free diet started early may prevent the other autoimmune >diseases frequently associated with celiac disease, " Dr. Ventura and >colleagues hypothesize. However, further studies will be needed to >determine the clinical significance of the organ-specific autoantibodies >in these patients and to confirm this hypothesis. ==================== See also: http://jama.ama-assn.org/cgi/content/abstract/290/13/1713?etoc Results Children initially exposed to cereals between ages 0 and 3 months (hazard ratio , 4.32; 95% confidence interval [CI], 2.0-9.35) and those who were exposed at 7 months or older (HR, 5.36; 95% CI, 2.08-13.8) had increased hazard of IA compared with those who were exposed during the fourth through sixth month, after adjustment for HLA genotype, family history of type 1 DM, ethnicity, and maternal age. In children who were positive for the HLA-DRB1*03/04,DQB8 genotype, adjusted HRs were 5.55 (95% CI, 1.92-16.03) and 12.53 (95% CI, 3.19-49.23) for initial cereal exposure between ages 0 to 3 months and at 7 months or older, respectively. Conclusion There may be a window of exposure to cereals in infancy outside which initial exposure increases IA risk in susceptible children. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2003 Report Share Posted December 19, 2003 Heidi, Thanks for gluten articles! There are two articles l was referring to it seems. Excerpt of starvation paragraph here. Doesn't say starvation gene in second article. Leaves me with 3 square meals a day isn't good when you look at ability to survive starvation and ethnicities most prone in first article. Evolutionary biologists suspect that a predisposition toward diabetes developed among certain ethnic groups—such as Pima Indians or Americans of African descent—as a result of repeated, perhaps even recent, bouts of starvation. Those individuals who were better able to decrease energy expenditures during a famine survived and passed on the trait to their offspring. Unfortunately, that ability seems to cause insulin resistance when food is plentiful. In other words, says Dr. ielsz, director of the Center for Women's Health Research at New York University, " you come out into the world—at least the developed world—and there is no shortage of cheap, fast food. Your thrifty metabolism has prepared you for the wrong future. " Wanita Sunday, Nov. 30, 2003 Why So Many of Us Are Getting Diabetes Never have doctors known so much about how to prevent or control this disease, yet the epidemic keeps on raging. How you can protect yourself By CHRISTINE GORMAN Hillary Carroll knew something was amiss. she had spent Memorial Day happily frolicking in her grandmother's swimming pool, but by that evening she was doubling over in pain every time she went to the bathroom. Her mother figured it was probably an infection and the next day took Hillary, then 10, to the pediatrician. Instead of getting a prescription for an antibiotic, however, the 220-lb. youngster was immediately admitted to the hospital. Lab tests showed that she had something far more serious—Type 2 diabetes. Hillary is not the first overweight child to learn she has this form of diabetes, a chronic metabolic disorder that used to be called adult onset but was renamed in part because so many kids Hillary's age were getting it. As doctors have repeatedly warned, the U.S. is experiencing a diabetes epidemic. Some 18 million Americans suffer from one form or another, with 1.3 million new cases diagnosed last year—up from 878,000 in 1997. And although Type 2 diabetes still tends to strike people in their fifth or sixth decade, more children are getting it, a fact of grave concern to health officials. Not only are these kids likely to face a lifetime of problems—including higher risks of blindness, heart disease and stroke—they are also a warning sign that something in our way of life has gone terribly wrong. And yet scientists in just the past decade have learned that the most devastating complications of diabetes—and in some cases the disease itself—are almost entirely preventable. There are better techniques for monitoring diabetes and more effective drugs for treating it, and a major study published last year shows that by making only modest changes in diet and exercise, people at high risk of Type 2 diabetes can stave off the disease for at least three years and perhaps a lot longer (more on Type 1 in just a bit). It's a puzzle. Never have physicians known so much about Type 2 diabetes and how to control it, yet the number of cases is expected to rise at an alarming rate. Epidemiologists predict that by 2025 the incidence in the U.S. will double. Annual treatment costs are projected to rise, from $132 billion to $192 billion in 2020—not counting inflation. Hardest hit will be certain ethnic groups—including African Americans and Native Americans, Hispanics and Asians—that for complicated reasons are more prone to the disorder. To the dismay of health experts, diabetes is becoming a global problem. In the next couple of decades, the prevalence of diabetes is expected to triple in Africa, the eastern Mediterranean, the Middle East and Southeast Asia, to double in the western Pacific and to nearly double in Europe. With an estimated 33 million cases, India has the most people with diabetes; China has 23 million. Lots of doctors will tell you that the reason for the explosion is obvious: Americans are eating too much and exercising too little, and much of the world is following our bad example. There is no question that excessive weight increases your risk of becoming diabetic. But that explains only part of the problem. Diabetes has a strong genetic component, and scientists are beginning to suspect that certain evolutionary factors, as well as your mother's metabolic or nutritional status during pregnancy, may predispose you to develop diabetes. That may explain why Indians from the subcontinent often become diabetic after gaining just a few pounds and why the consequences of obesity seem far more devastating for Americans of African, as opposed to European, descent. A complex picture is emerging that is changing the way we think about what was already a complex disease. It turns out that patients are not as helpless against its ravages as was once thought, especially if they are warned at the disease's very earliest stages. Changes in lifestyle and diet can, in the vast majority of cases, make a big difference. The future for anyone with diabetes has never been brighter, provided he or she has access to the right treatments. But the consequences of inaction have never been more broadly devastating. This year more than 200,000 Americans with diabetes will die from its complications. What Is Diabetes? To understand the latest insights into the disease, it helps to know a little more about two key molecules—glucose and insulin—and the roles they play in the conditions doctors call Type 1 and Type 2 diabetes. We'll start with glucose, the sugar molecule that is a major source of fuel for the body. You can get your glucose levels tested at a doctor's office or at home with a device called a glucometer. What you're looking for is a reading measured in milligrams of glucose per deciliter of blood (or, on some glucometers, in millimoles per liter). Anyone whose glucose level before breakfast—the fasting level—is 126 mg/dL (7 mmol/L) or higher is considered diabetic. A normal fasting level runs anywhere from 65 mg/dL to just under 100 mg/dL (3.6 mmol/L to 5.6 mmol/L). Insulin is a hormone made by specialized cells in the pancreas, whose job is to push glucose out of the blood into various cells in the body. Whenever the amount of glucose in the blood starts to rise, which happens just about whenever you eat, the pancreas pumps out more insulin to keep sugar levels stable. Here's where the difference between Type 1 and Type 2 is clearest. Type 1 diabetics have high glucose levels because their pancreas can no longer make insulin. By definition, Type 1 diabetics must eventually take insulin shots to get their diabetes under control. Type 2 diabetics can still make their own insulin, but their bodies don't respond as well to it—a situation called insulin resistance. Any scientist who can figure out why Type 2 diabetics are insulin resistant will probably be a candidate for a Nobel Prize. It's not a simple consequence of being overweight. Many obese people are not insulin resistant, and not everyone who is insulin resistant is overweight. Researchers at the Salk Institute in La Jolla, Calif., believe that at least part of the answer lies not in the pancreas but in the liver. In a study of mice published in the Nov. 13 issue of Nature, scientists identified a protein that tells the liver to favor the metabolism of fat over that of glucose. The result is a buildup of glucose levels in the blood, a hallmark of insulin resistance. Evolutionary biologists suspect that a predisposition toward diabetes developed among certain ethnic groups—such as Pima Indians or Americans of African descent—as a result of repeated, perhaps even recent, bouts of starvation. Those individuals who were better able to decrease energy expenditures during a famine survived and passed on the trait to their offspring. Unfortunately, that ability seems to cause insulin resistance when food is plentiful. In other words, says Dr. ielsz, director of the Center for Women's Health Research at New York University, " you come out into the world—at least the developed world—and there is no shortage of cheap, fast food. Your thrifty metabolism has prepared you for the wrong future. " The Sugar Blues What's so bad about being insulin resistant and having too much glucose in your blood? For reasons that researchers are still trying to figure out, having diabetes greatly increases your risk of suffering a heart attack or a stroke. A man with diabetes appears to have the same risk of cardiovascular problems as a nondiabetic who has had a heart attack. A woman who develops diabetes loses the cardioprotective benefits of being female. And kids with Type 2 diabetes are more likely to develop heart disease in their 20s and 30s. The condition also damages small blood vessels throughout the body—particularly those in the eyes and kidneys. As many as 24,000 diabetics in the U.S. become blind each year, more than 100,000 require dialysis or kidney transplantation, and 82,000 need to have a toe, foot or leg amputated. Diabetics are twice as likely as nondiabetics to suffer from depression. It doesn't have to be this way. Back in 1993 doctors proved that Type 1 diabetics could greatly reduce their risk of complications by intensively managing their glucose levels to keep them as close to normal as possible (using a glucometer to measure the level of sugar in a pinprick of blood and an insulin shot when necessary to bring the level down). Similar results have since been seen with Type 2 diabetics. But most Type 2 diabetics don't have to resort to insulin shots to manage their condition. Because the fundamental problem in Type 2 diabetes is insulin resistance—not the inability to produce insulin as in Type 1—other options are available. Your physician may first give you pills that can either sensitize your body to insulin's effects or help your body produce more of the hormone. But some of your best allies in this struggle are your muscles. Building them up and using them regularly in such pursuits as walking or dancing draw more glucose out of the bloodstream and increase insulin's efficiency. It also pays to avoid easily digested foods—like chips, nondiet soda and other junk food—which require large amounts of insulin to metabolize. Finally, losing a little weight usually makes insulin's job a lot easier. Donna Black Bradley, 52, of Los Angeles is living proof. Bradley was driving home from work one evening when she suddenly was unable to read the freeway signs. When her doctor diagnosed diabetes, she felt paralyzed. " Then I said O.K., I got something I got to do here, " Bradley says. " I got to change. " And change she did. The 5-ft. 7-in. mother and grandmother started eating better and working out on a treadmill several times a week. Her weight dropped from 272 lbs. to 210 lbs., and her fasting glucose fell from 300 mg/dL to 103 mg/dL. " It's amazing how your cravings diminish when you're eating the right food groups, " Bradley says. Her vision problems have disappeared, and her doctor believes she will no longer need to take insulin-sensitizing drugs if she can get her weight under 200 lbs.—something she's determined to do, both for herself and for her grandson Isaiah. Says she: " I want to be around for that 2-year old. " Small Steps, Big Rewards The more scientists learn about diabetes and the complications it causes, the more they find themselves looking at the conditions that precede it. " The big question now is, When does the diabetes clock start ticking? " says Dr. Vinicor, director of the diabetes program at the Centers for Disease Control. " For eye or small-vessel disease, we think the clock starts ticking when blood sugar starts to go up. But for heart disease, we think the clock may start ticking much, much earlier, even before the first sign of blood sugar going up. " That's why researchers are focusing on a precursor condition called prediabetes, in which glucose levels are only slightly elevated but which may put at risk an additional 20 million Americans. In 2002 researchers published the results of the Diabetes Prevention Program (D.P.P.), one of the largest, most rigorous clinical trials ever conducted on the subject. More than 3,000 people from all over the U.S. participated. All were overweight, and blood tests indicated that their bodies were having trouble handling glucose, though none had yet developed diabetes. Half were from ethnic communities that are at higher risk. Participants in the D.P.P. were divided into three groups. One was given the diabetes drug metformin, one was given a dummy pill, and one was enrolled in a nutrition and exercise program with the goal for participants to lose 7% of their initial weight and to exercise 30 minutes a day, five times a week. The D.P.P. trial was halted a full year early " because the results were just so remarkable, " says Dr. , director of the Diabetes Center at Massachusetts General Hospital in Boston, who chaired the study. During the three years of the study, nearly 30% of the placebo group developed diabetes. For the metformin group the figure was 22%. The subjects who exercised moderately and lost weight had the lowest incidence of all—just 14%. (The first two groups were given diet and exercise information but did not lose as much weight as the last group.) The study is continuing to see if lifestyle changes can prevent diabetes for life or merely delay its occurrence. At the very least, the trial proves that the point of no return is not as early or as fixed as was once feared. Diabetes researchers have been so impressed by the D.P.P. results that many would like to lower the thresholds that determine who is prediabetic. In January the American Diabetes Association plans to officially recommend that physicians consider treating anyone with a fasting glucose of 100 mg/dL or higher, down from 110 mg/dL or higher in the previous guidelines. " If your fasting blood sugar is below 100, your chances of getting diabetes are quite low, " says Dr. Rizza, an endocrinologist at the Mayo Clinic in Rochester, Minn., and a vice president of the American Diabetes Association. " But if your fasting glucose is over 100, you have a 10% to 15% chance of getting diabetes in the next seven years. " You don't have to convince Tom Marinello, 51, of Carson, Calif., that prediabetes should be taken seriously. After his father-in-law died of complications from diabetes, Marinello, unaware that he was at risk, enrolled in the Diabetes Prevention Program at the University of California, Los Angeles, hoping to help others with the disease. He was surprised to learn that he was prediabetic. By paying closer attention to what he eats and by making sure to walk nearly every day, Marinello dropped 28 lbs. from his 260-lb., 6-ft. 1-in. frame, and his fasting-glucose level is down to 110 mg/dL. " I may still be at risk, but I'm not diabetic, " Marinello says. " I'm kind of proud of that. " Beyond Apples and Pears Is it possible to turn the clock back even further to find who is at greatest risk of developing prediabetes and lower their risk of future health problems? That turns out to be much more complicated. Cardiologists have long known that if you carry extra weight around your waist, which they liken to being shaped like an apple, you are at greater risk of heart disease. The other configuration, being shaped like a pear, with excess weight around the hips, doesn't eliminate your risk but seems to lessen it. Over the years it has become clear that apple-shaped folks have a certain kind of metabolism: they are more likely to be resistant to insulin, have high amounts of triglycerides (one of the fatty molecules you don't want too much of in your blood) and have low levels of hdl (the " good " cholesterol). They also tend to have high blood pressure. Coincidence? Probably not, which is why physicians have lumped all these symptoms together in one condition that they now call metabolic syndrome. They believe that anyone with metabolic syndrome is at much greater risk of developing not just heart disease but diabetes as well. They're not sure whether there is a primary trigger for metabolic syndrome—say, obesity or insulin resistance—or if several biological pathways are involved. Whatever the case, says Dr. Grundy, a leading expert on cholesterol who chaired the American Heart Association's first clinical conference on metabolic syndrome in September, " right now there's no single drug that can treat the whole metabolic syndrome. " Individual symptoms like high blood pressure still have to be treated separately. But your best bet for an overall solution is to eat better, lose weight and get more exercise. An Inflammatory Question As central as insulin resistance has become to understanding Type 2 diabetes, scientists are starting to wonder whether another factor, the inflammatory response, may also play a key role. Inflammation is a complex biological process the immune system uses to limit the damage caused by various injuries. (Ever notice how a turned ankle swells or a sunburn feels warm to the touch? That's inflammation in action.) But when inflammation becomes chronic, it no longer limits damage. In fact, it starts to do harm to the body. Over the past five years, researchers have shown that inflammation is at least as important as high cholesterol levels in causing heart disease. (High levels in the blood of certain molecules, such as C-reactive protein (CRP), indicate a runaway inflammatory process and are better predictors of heart attacks than cholesterol.) Could the same be true for diabetes? " In 2001, when we published our first paper on inflammation and diabetes, everybody thought we were just wrong, " recalls Dr. Ridker, a cardiologist at Brigham & Women's Hospital in Boston. " Now there are half a dozen studies confirming that if you measure markers of inflammation, and CRP in particular, you can do a good job of predicting who's going to get diabetes. " If these results are confirmed and inflammation turns out to be as important as insulin resistance in triggering diabetes, then it should become much easier to identify incipient problems in metabolism before they get out of control. Why? Because inflammation is much easier to measure than insulin resistance; all that is required is a single blood test. (Abnormal glucose levels only suggest the possibility of insulin resistance; they don't prove it. Insulin resistance is difficult to measure directly.) It might also mean that anti-inflammatory agents like aspirin may be particularly effective in diabetics. An Ounce of Prevention Advances in diabetes research over the past few years have been swift and wide ranging. Scientists are beginning to identify the genetic and environmental factors that predispose some people to insulin resistance and increase their risk of diabetes. They are looking beyond glucose levels to gauge patients' health and progress. They have identified other pathways that may play a role in triggering diabetes. Every new insight into Type 2 diabetes, from its biochemistry to its metabolic roots, makes clear that it can be avoided—and that the earlier you intervene the better. The real question is whether we as a society are up to the challenge. " Our health-care system is currently set up to deliver care for acute disease, " says Ann Albright, chief of the California Diabetes Prevention and Control Program. " It's get in, get your shot, and away you go. " Diabetes, however, is a chronic disorder that demands constant attention. You have to change your eating habits and incorporate physical exercise into each day's activities. You need to monitor your glucose levels several times a day to see how well you're doing. These prevention measures pay off in the long run in fewer heart attacks, strokes, amputations and cases of blindness and kidney failure. But very few insurance programs focus on them—or pay for health professionals who can teach folks how best to incorporate them into their lives. Comprehensive prevention programs aren't cheap, but the cost of doing nothing is far greater. " If we don't take care of this issue now, we will have huge numbers of Type 2 diabetics, and we will be paying for them with our tax dollars, " says Dr. Phyllis Preciado, an internist who runs a diabetes clinic in California's farming-rich Central Valley. As the U.S. loses productive members of the work force, she notes, more people will turn to public assistance for treatment. And the increased toll in human suffering will be staggering. There are ways to keep costs down. It doesn't take a physician to teach a patient the principles of better nutrition or how to use a glucometer. Nurses, nutritionists, diabetes educators and other non-M.D.s can play a key role. Experts say it's important to reach the communities that are hardest hit by diabetes—American Indians, for example—all the while taking cultural differences into account. " You can't give everybody the same diet to solve the problem, " says Albright, a registered dietitian. " People obviously eat the foods they've grown up with. So you have to try to help them get as much of those things that they like into their eating plan but also make the changes that will help lower the fat or moderate the carbohydrates. " Hillary Carroll and her family have taken those lessons to heart. While still in the hospital, Hillary went through a kind of diabetes boot camp in which she learned how to monitor her blood-sugar levels, change the way she eats and boost the amount of physical activity in her life. Her parents bought her a turquoise BMX bike, which she rides at least an hour every day. She has lost 24 lbs. so far, and her glucose levels have stabilized. " Before she was diagnosed, she was happy to sit here by herself, playing with her Barbies, " says Tammy Carroll, Hillary's mother. " I thought she was so calm then, but now that we have her sugar under control, she's more active. " Hillary, now 11, is taking charge of her life. To get control of the diabetes epidemic, the rest of us may have to do the same. —Reported by Bjerklie and Alice Park/New York, Dan Cray/ Los Angeles and Randall/ Cincinnati http://www.time.com/time/magazine/printout/0,8816,552059,00.html Diabetes Genes Stacking Up Gabe Romain Betterhumans Staff Tuesday, December 02, 2003, 4:58:33 PM CT The linkage of eight genes to type 2 diabetes has provided support for the theory that an accumulation of many small genetic variations makes people susceptible to the disease. Researcher Inês Barroso and colleagues at the University of Cambridge in the UK found the genes while correlating genetic variations with metabolic changes characteristic of diabetes. The researchers analyzed 71 genes in more than 2,000 people and found that eight of the 71 were linked to type 2 diabetes. Major health problem Diabetes is a disease that impairs the body's ability to use glucose, a sugar that is a cell's main source of energy. Also known as adult onset diabetes, type 2 diabetes is the most common form of the disease. In type 2 diabetes, either the pancreas doesn't produce enough insulin—a hormone that regulates levels of glucose in the blood—or tissues become resistant to the action of the hormone. Type 2 diabetes is a major health problem affecting more than 100 million people worldwide. While the influence of environmental factors such as obesity and lifestyle on the disease's development has been well documented, genetic components have proven more elusive. Understanding such components could lead to more effective prevention and treatment. Multiple factors The researchers report that most of the genes they linked to type 2 diabetes are related to B cells—cells that are responsible for the production of antibodies—and not to insulin function. This may suggest that dysfunctions associated with type 2 diabetes are affected differently by environmental and genetic factors, with insulin resistance related more to environmental factors and problems with insulin secretion related more to genetic factors. The findings also suggest that large-scale gene screening studies are a good way to identify a multitude of disease-associated genes that individually exert weak effects. The research is reported in the journal PLoS Biology (read full text). http://www.betterhumans.com/News/news.aspx?articleID=2003-12-02-2 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2003 Report Share Posted December 19, 2003 " Any scientist who can figure out why Type 2 diabetics are insulin resistant will probably be a candidate for a Nobel Prize. " Dr. Atkins, Dr. Schwarzbein and the Drs. Eades, among others, have the answer, but I'm not aware that any of them have received a Nobel Prize. Anyone see anything wrong with these two articles? Nowhere is it mentioned that our low nutrient, fake food, junk food diet is to blame for diabetes. Nowhere is it mentioned that eating whole, non-commercially processed food will help to prevent diabetes. The only good part was the bit about exercise. I'm sure I'm not the only one to have noticed that these types of articles never, or almost never, point their fingers at the garbage the government is pressuring everyone to eat. Sure wouldn't want to make their advertisers and supporters unhappy. Billions of dollars are made each year from diabetes treatments and paraphernalia. The people who rake in that money sure don't want a " cure " or prevention unless it's everyone taking prescription drugs from birth to death Judith Alta -----Original Message----- Heidi, Thanks for gluten articles! There are two articles l was referring to it seems. Excerpt of starvation paragraph here. Doesn't say starvation gene in second article. Leaves me with 3 square meals a day isn't good when you look at ability to survive starvation and ethnicities most prone in first article. Evolutionary biologists suspect that a predisposition toward diabetes developed among certain ethnic groups-such as Pima Indians or Americans of African descent-as a result of repeated, perhaps even recent, bouts of starvation. Those individuals who were better able to decrease energy expenditures during a famine survived and passed on the trait to their offspring. Unfortunately, that ability seems to cause insulin resistance when food is plentiful. In other words, says Dr. ielsz, director of the Center for Women's Health Research at New York University, " you come out into the world-at least the developed world-and there is no shortage of cheap, fast food. Your thrifty metabolism has prepared you for the wrong future. " Wanita Sunday, Nov. 30, 2003 Why So Many of Us Are Getting Diabetes Never have doctors known so much about how to prevent or control this disease, yet the epidemic keeps on raging. How you can protect yourself By CHRISTINE GORMAN Hillary Carroll knew something was amiss. she had spent Memorial Day happily frolicking in her grandmother's swimming pool, but by that evening she was doubling over in pain every time she went to the bathroom. Her mother figured it was probably an infection and the next day took Hillary, then 10, to the pediatrician. Instead of getting a prescription for an antibiotic, however, the 220-lb. youngster was immediately admitted to the hospital. Lab tests showed that she had something far more serious-Type 2 diabetes. Hillary is not the first overweight child to learn she has this form of diabetes, a chronic metabolic disorder that used to be called adult onset but was renamed in part because so many kids Hillary's age were getting it. As doctors have repeatedly warned, the U.S. is experiencing a diabetes epidemic. Some 18 million Americans suffer from one form or another, with 1.3 million new cases diagnosed last year-up from 878,000 in 1997. And although Type 2 diabetes still tends to strike people in their fifth or sixth decade, more children are getting it, a fact of grave concern to health officials. Not only are these kids likely to face a lifetime of problems-including higher risks of blindness, heart disease and stroke-they are also a warning sign that something in our way of life has gone terribly wrong. And yet scientists in just the past decade have learned that the most devastating complications of diabetes-and in some cases the disease itself-are almost entirely preventable. There are better techniques for monitoring diabetes and more effective drugs for treating it, and a major study published last year shows that by making only modest changes in diet and exercise, people at high risk of Type 2 diabetes can stave off the disease for at least three years and perhaps a lot longer (more on Type 1 in just a bit). It's a puzzle. Never have physicians known so much about Type 2 diabetes and how to control it, yet the number of cases is expected to rise at an alarming rate. Epidemiologists predict that by 2025 the incidence in the U.S. will double. Annual treatment costs are projected to rise, from $132 billion to $192 billion in 2020-not counting inflation. Hardest hit will be certain ethnic groups-including African Americans and Native Americans, Hispanics and Asians-that for complicated reasons are more prone to the disorder. To the dismay of health experts, diabetes is becoming a global problem. In the next couple of decades, the prevalence of diabetes is expected to triple in Africa, the eastern Mediterranean, the Middle East and Southeast Asia, to double in the western Pacific and to nearly double in Europe. With an estimated 33 million cases, India has the most people with diabetes; China has 23 million. Lots of doctors will tell you that the reason for the explosion is obvious: Americans are eating too much and exercising too little, and much of the world is following our bad example. There is no question that excessive weight increases your risk of becoming diabetic. But that explains only part of the problem. Diabetes has a strong genetic component, and scientists are beginning to suspect that certain evolutionary factors, as well as your mother's metabolic or nutritional status during pregnancy, may predispose you to develop diabetes. That may explain why Indians from the subcontinent often become diabetic after gaining just a few pounds and why the consequences of obesity seem far more devastating for Americans of African, as opposed to European, descent. A complex picture is emerging that is changing the way we think about what was already a complex disease. It turns out that patients are not as helpless against its ravages as was once thought, especially if they are warned at the disease's very earliest stages. Changes in lifestyle and diet can, in the vast majority of cases, make a big difference. The future for anyone with diabetes has never been brighter, provided he or she has access to the right treatments. But the consequences of inaction have never been more broadly devastating. This year more than 200,000 Americans with diabetes will die from its complications. What Is Diabetes? To understand the latest insights into the disease, it helps to know a little more about two key molecules-glucose and insulin-and the roles they play in the conditions doctors call Type 1 and Type 2 diabetes. We'll start with glucose, the sugar molecule that is a major source of fuel for the body. You can get your glucose levels tested at a doctor's office or at home with a device called a glucometer. What you're looking for is a reading measured in milligrams of glucose per deciliter of blood (or, on some glucometers, in millimoles per liter). Anyone whose glucose level before breakfast-the fasting level-is 126 mg/dL (7 mmol/L) or higher is considered diabetic. A normal fasting level runs anywhere from 65 mg/dL to just under 100 mg/dL (3.6 mmol/L to 5.6 mmol/L). Insulin is a hormone made by specialized cells in the pancreas, whose job is to push glucose out of the blood into various cells in the body. Whenever the amount of glucose in the blood starts to rise, which happens just about whenever you eat, the pancreas pumps out more insulin to keep sugar levels stable. Here's where the difference between Type 1 and Type 2 is clearest. Type 1 diabetics have high glucose levels because their pancreas can no longer make insulin. By definition, Type 1 diabetics must eventually take insulin shots to get their diabetes under control. Type 2 diabetics can still make their own insulin, but their bodies don't respond as well to it-a situation called insulin resistance. Any scientist who can figure out why Type 2 diabetics are insulin resistant will probably be a candidate for a Nobel Prize. It's not a simple consequence of being overweight. Many obese people are not insulin resistant, and not everyone who is insulin resistant is overweight. Researchers at the Salk Institute in La Jolla, Calif., believe that at least part of the answer lies not in the pancreas but in the liver. In a study of mice published in the Nov. 13 issue of Nature, scientists identified a protein that tells the liver to favor the metabolism of fat over that of glucose. The result is a buildup of glucose levels in the blood, a hallmark of insulin resistance. Evolutionary biologists suspect that a predisposition toward diabetes developed among certain ethnic groups-such as Pima Indians or Americans of African descent-as a result of repeated, perhaps even recent, bouts of starvation. Those individuals who were better able to decrease energy expenditures during a famine survived and passed on the trait to their offspring. Unfortunately, that ability seems to cause insulin resistance when food is plentiful. In other words, says Dr. ielsz, director of the Center for Women's Health Research at New York University, " you come out into the world-at least the developed world-and there is no shortage of cheap, fast food. Your thrifty metabolism has prepared you for the wrong future. " The Sugar Blues What's so bad about being insulin resistant and having too much glucose in your blood? For reasons that researchers are still trying to figure out, having diabetes greatly increases your risk of suffering a heart attack or a stroke. A man with diabetes appears to have the same risk of cardiovascular problems as a nondiabetic who has had a heart attack. A woman who develops diabetes loses the cardioprotective benefits of being female. And kids with Type 2 diabetes are more likely to develop heart disease in their 20s and 30s. The condition also damages small blood vessels throughout the body-particularly those in the eyes and kidneys. As many as 24,000 diabetics in the U.S. become blind each year, more than 100,000 require dialysis or kidney transplantation, and 82,000 need to have a toe, foot or leg amputated. Diabetics are twice as likely as nondiabetics to suffer from depression. It doesn't have to be this way. Back in 1993 doctors proved that Type 1 diabetics could greatly reduce their risk of complications by intensively managing their glucose levels to keep them as close to normal as possible (using a glucometer to measure the level of sugar in a pinprick of blood and an insulin shot when necessary to bring the level down). Similar results have since been seen with Type 2 diabetics. But most Type 2 diabetics don't have to resort to insulin shots to manage their condition. Because the fundamental problem in Type 2 diabetes is insulin resistance-not the inability to produce insulin as in Type 1-other options are available. Your physician may first give you pills that can either sensitize your body to insulin's effects or help your body produce more of the hormone. But some of your best allies in this struggle are your muscles. Building them up and using them regularly in such pursuits as walking or dancing draw more glucose out of the bloodstream and increase insulin's efficiency. It also pays to avoid easily digested foods-like chips, nondiet soda and other junk food-which require large amounts of insulin to metabolize. Finally, losing a little weight usually makes insulin's job a lot easier. Donna Black Bradley, 52, of Los Angeles is living proof. Bradley was driving home from work one evening when she suddenly was unable to read the freeway signs. When her doctor diagnosed diabetes, she felt paralyzed. " Then I said O.K., I got something I got to do here, " Bradley says. " I got to change. " And change she did. The 5-ft. 7-in. mother and grandmother started eating better and working out on a treadmill several times a week. Her weight dropped from 272 lbs. to 210 lbs., and her fasting glucose fell from 300 mg/dL to 103 mg/dL. " It's amazing how your cravings diminish when you're eating the right food groups, " Bradley says. Her vision problems have disappeared, and her doctor believes she will no longer need to take insulin-sensitizing drugs if she can get her weight under 200 lbs.-something she's determined to do, both for herself and for her grandson Isaiah. Says she: " I want to be around for that 2-year old. " Small Steps, Big Rewards The more scientists learn about diabetes and the complications it causes, the more they find themselves looking at the conditions that precede it. " The big question now is, When does the diabetes clock start ticking? " says Dr. Vinicor, director of the diabetes program at the Centers for Disease Control. " For eye or small-vessel disease, we think the clock starts ticking when blood sugar starts to go up. But for heart disease, we think the clock may start ticking much, much earlier, even before the first sign of blood sugar going up. " That's why researchers are focusing on a precursor condition called prediabetes, in which glucose levels are only slightly elevated but which may put at risk an additional 20 million Americans. In 2002 researchers published the results of the Diabetes Prevention Program (D.P.P.), one of the largest, most rigorous clinical trials ever conducted on the subject. More than 3,000 people from all over the U.S. participated. All were overweight, and blood tests indicated that their bodies were having trouble handling glucose, though none had yet developed diabetes. Half were from ethnic communities that are at higher risk. Participants in the D.P.P. were divided into three groups. One was given the diabetes drug metformin, one was given a dummy pill, and one was enrolled in a nutrition and exercise program with the goal for participants to lose 7% of their initial weight and to exercise 30 minutes a day, five times a week. The D.P.P. trial was halted a full year early " because the results were just so remarkable, " says Dr. , director of the Diabetes Center at Massachusetts General Hospital in Boston, who chaired the study. During the three years of the study, nearly 30% of the placebo group developed diabetes. For the metformin group the figure was 22%. The subjects who exercised moderately and lost weight had the lowest incidence of all-just 14%. (The first two groups were given diet and exercise information but did not lose as much weight as the last group.) The study is continuing to see if lifestyle changes can prevent diabetes for life or merely delay its occurrence. At the very least, the trial proves that the point of no return is not as early or as fixed as was once feared. Diabetes researchers have been so impressed by the D.P.P. results that many would like to lower the thresholds that determine who is prediabetic. In January the American Diabetes Association plans to officially recommend that physicians consider treating anyone with a fasting glucose of 100 mg/dL or higher, down from 110 mg/dL or higher in the previous guidelines. " If your fasting blood sugar is below 100, your chances of getting diabetes are quite low, " says Dr. Rizza, an endocrinologist at the Mayo Clinic in Rochester, Minn., and a vice president of the American Diabetes Association. " But if your fasting glucose is over 100, you have a 10% to 15% chance of getting diabetes in the next seven years. " You don't have to convince Tom Marinello, 51, of Carson, Calif., that prediabetes should be taken seriously. After his father-in-law died of complications from diabetes, Marinello, unaware that he was at risk, enrolled in the Diabetes Prevention Program at the University of California, Los Angeles, hoping to help others with the disease. He was surprised to learn that he was prediabetic. By paying closer attention to what he eats and by making sure to walk nearly every day, Marinello dropped 28 lbs. from his 260-lb., 6-ft. 1-in. frame, and his fasting-glucose level is down to 110 mg/dL. " I may still be at risk, but I'm not diabetic, " Marinello says. " I'm kind of proud of that. " Beyond Apples and Pears Is it possible to turn the clock back even further to find who is at greatest risk of developing prediabetes and lower their risk of future health problems? That turns out to be much more complicated. Cardiologists have long known that if you carry extra weight around your waist, which they liken to being shaped like an apple, you are at greater risk of heart disease. The other configuration, being shaped like a pear, with excess weight around the hips, doesn't eliminate your risk but seems to lessen it. Over the years it has become clear that apple-shaped folks have a certain kind of metabolism: they are more likely to be resistant to insulin, have high amounts of triglycerides (one of the fatty molecules you don't want too much of in your blood) and have low levels of hdl (the " good " cholesterol). They also tend to have high blood pressure. Coincidence? Probably not, which is why physicians have lumped all these symptoms together in one condition that they now call metabolic syndrome. They believe that anyone with metabolic syndrome is at much greater risk of developing not just heart disease but diabetes as well. They're not sure whether there is a primary trigger for metabolic syndrome-say, obesity or insulin resistance-or if several biological pathways are involved. Whatever the case, says Dr. Grundy, a leading expert on cholesterol who chaired the American Heart Association's first clinical conference on metabolic syndrome in September, " right now there's no single drug that can treat the whole metabolic syndrome. " Individual symptoms like high blood pressure still have to be treated separately. But your best bet for an overall solution is to eat better, lose weight and get more exercise. An Inflammatory Question As central as insulin resistance has become to understanding Type 2 diabetes, scientists are starting to wonder whether another factor, the inflammatory response, may also play a key role. Inflammation is a complex biological process the immune system uses to limit the damage caused by various injuries. (Ever notice how a turned ankle swells or a sunburn feels warm to the touch? That's inflammation in action.) But when inflammation becomes chronic, it no longer limits damage. In fact, it starts to do harm to the body. Over the past five years, researchers have shown that inflammation is at least as important as high cholesterol levels in causing heart disease. (High levels in the blood of certain molecules, such as C-reactive protein (CRP), indicate a runaway inflammatory process and are better predictors of heart attacks than cholesterol.) Could the same be true for diabetes? " In 2001, when we published our first paper on inflammation and diabetes, everybody thought we were just wrong, " recalls Dr. Ridker, a cardiologist at Brigham & Women's Hospital in Boston. " Now there are half a dozen studies confirming that if you measure markers of inflammation, and CRP in particular, you can do a good job of predicting who's going to get diabetes. " If these results are confirmed and inflammation turns out to be as important as insulin resistance in triggering diabetes, then it should become much easier to identify incipient problems in metabolism before they get out of control. Why? Because inflammation is much easier to measure than insulin resistance; all that is required is a single blood test. (Abnormal glucose levels only suggest the possibility of insulin resistance; they don't prove it. Insulin resistance is difficult to measure directly.) It might also mean that anti-inflammatory agents like aspirin may be particularly effective in diabetics. An Ounce of Prevention Advances in diabetes research over the past few years have been swift and wide ranging. Scientists are beginning to identify the genetic and environmental factors that predispose some people to insulin resistance and increase their risk of diabetes. They are looking beyond glucose levels to gauge patients' health and progress. They have identified other pathways that may play a role in triggering diabetes. Every new insight into Type 2 diabetes, from its biochemistry to its metabolic roots, makes clear that it can be avoided-and that the earlier you intervene the better. The real question is whether we as a society are up to the challenge. " Our health-care system is currently set up to deliver care for acute disease, " says Ann Albright, chief of the California Diabetes Prevention and Control Program. " It's get in, get your shot, and away you go. " Diabetes, however, is a chronic disorder that demands constant attention. You have to change your eating habits and incorporate physical exercise into each day's activities. You need to monitor your glucose levels several times a day to see how well you're doing. These prevention measures pay off in the long run in fewer heart attacks, strokes, amputations and cases of blindness and kidney failure. But very few insurance programs focus on them-or pay for health professionals who can teach folks how best to incorporate them into their lives. Comprehensive prevention programs aren't cheap, but the cost of doing nothing is far greater. " If we don't take care of this issue now, we will have huge numbers of Type 2 diabetics, and we will be paying for them with our tax dollars, " says Dr. Phyllis Preciado, an internist who runs a diabetes clinic in California's farming-rich Central Valley. As the U.S. loses productive members of the work force, she notes, more people will turn to public assistance for treatment. And the increased toll in human suffering will be staggering. There are ways to keep costs down. It doesn't take a physician to teach a patient the principles of better nutrition or how to use a glucometer. Nurses, nutritionists, diabetes educators and other non-M.D.s can play a key role. Experts say it's important to reach the communities that are hardest hit by diabetes-American Indians, for example-all the while taking cultural differences into account. " You can't give everybody the same diet to solve the problem, " says Albright, a registered dietitian. " People obviously eat the foods they've grown up with. So you have to try to help them get as much of those things that they like into their eating plan but also make the changes that will help lower the fat or moderate the carbohydrates. " Hillary Carroll and her family have taken those lessons to heart. While still in the hospital, Hillary went through a kind of diabetes boot camp in which she learned how to monitor her blood-sugar levels, change the way she eats and boost the amount of physical activity in her life. Her parents bought her a turquoise BMX bike, which she rides at least an hour every day. She has lost 24 lbs. so far, and her glucose levels have stabilized. " Before she was diagnosed, she was happy to sit here by herself, playing with her Barbies, " says Tammy Carroll, Hillary's mother. " I thought she was so calm then, but now that we have her sugar under control, she's more active. " Hillary, now 11, is taking charge of her life. To get control of the diabetes epidemic, the rest of us may have to do the same. -Reported by Bjerklie and Alice Park/New York, Dan Cray/ Los Angeles and Randall/ Cincinnati http://www.time.com/time/magazine/printout/0,8816,552059,00.html Diabetes Genes Stacking Up Gabe Romain Betterhumans Staff Tuesday, December 02, 2003, 4:58:33 PM CT The linkage of eight genes to type 2 diabetes has provided support for the theory that an accumulation of many small genetic variations makes people susceptible to the disease. Researcher Inês Barroso and colleagues at the University of Cambridge in the UK found the genes while correlating genetic variations with metabolic changes characteristic of diabetes. The researchers analyzed 71 genes in more than 2,000 people and found that eight of the 71 were linked to type 2 diabetes. Major health problem Diabetes is a disease that impairs the body's ability to use glucose, a sugar that is a cell's main source of energy. Also known as adult onset diabetes, type 2 diabetes is the most common form of the disease. In type 2 diabetes, either the pancreas doesn't produce enough insulin-a hormone that regulates levels of glucose in the blood-or tissues become resistant to the action of the hormone. Type 2 diabetes is a major health problem affecting more than 100 million people worldwide. While the influence of environmental factors such as obesity and lifestyle on the disease's development has been well documented, genetic components have proven more elusive. Understanding such components could lead to more effective prevention and treatment. Multiple factors The researchers report that most of the genes they linked to type 2 diabetes are related to B cells-cells that are responsible for the production of antibodies-and not to insulin function. This may suggest that dysfunctions associated with type 2 diabetes are affected differently by environmental and genetic factors, with insulin resistance related more to environmental factors and problems with insulin secretion related more to genetic factors. The findings also suggest that large-scale gene screening studies are a good way to identify a multitude of disease-associated genes that individually exert weak effects. The research is reported in the journal PLoS Biology (read full text). http://www.betterhumans.com/News/news.aspx?articleID=2003-12-02-2 Quote Link to comment Share on other sites More sharing options...
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