Vegetarianism

There are many benefits to eating a plant based diet. However, there are some special considerations that vegetarians need to be aware of in order to be proactive towards preventing long-term deficiency problems. The following articles are not an exhaustive list of the necessary considerations but indicate some important precautions (please see a Naturopathic Doctor or Registered Dietitian for information specific to you).

1. "Dietary Iron Intake and Iron Status of German Female Vegans: Results of the German Vegan Study." (2004)

Authors: Annika Waldmann, Jochen W. Koschizke, Claus Leitzmann, and Andreas Hahn

2. "Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians." (2003)

Authors: Wolfgang Herrmann, Heike Schorr, Rima Obeid, and Jürgen Geisel.

3. "Vegetarian diets : nutritional considerations for athletes."(2006)

Authors: Angela M ,Venderley and Wayne W. Campbell.

Diabetes Prevention

Here are 2 articles published in the New England Journal of Medicine showing the powerful effect of lifestyle modification towards preventing diabetes. Lifestyle modification had almost double the incidence reduction of diabetes over the most popular drug Metformin (which some sources report a side effect rate in 50% of patients - mainly diarrhea and GI upset).

The first article is called, "Reduction in the Incidence of Type 2 Diabetes with Lifestyle intervention or Metformin" (2002)

The authors are: William C. Knowler, M.D., Dr.P.H., Elizabeth Barrett-Connor, M.D., Sarah E. Fowler, Ph.D., Richard F. Hamman, M.D., Dr.P.H., John M. Lachin, Sc.D., Elizabeth A. Walker, D.N.Sc., and David M. Nathan, M.D.

**One thing of interest I noticed was that the fasting glucose was nearly identical between the lifestyle group and the pharmaceutical group (Figure 3). Yet, the lifestyle group had double the preventive effect. This highlights the idea that solely controlling a biomarker (blood glucose in this case) to what is considered a "healthy range" may not be entirely effective towards preventing a disease.

The second is called, "Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle Among Subjects with Impaired Glucose Tollerance." (2001)

The authors are: Jaakko Tuomilehto, M.D., Ph.D., Jaana Lindstrom, M.S., Johan G. Eriksson, M.D., Ph.D., Timo T. Valle, M.D., Helena Hamalainen, M.D., Ph.D., Pirjo Ilanne-Parikka, M.D., Sirkka Keinanen-Kiukaanniemi, M.D., Ph.D., Mauri Laakso, M.D., Anne Louheranta, M.S., Merja Rastas, M.S., Virpi Salminen, M.S., Sirkka Aunola, Ph.D., Zygimantas Cepaitis, Dipl.Eng., Vladislav Moltchanov, Ph.D., Martti Hakumaki, M.D., Ph.D., Marjo Mannelin, M.S., Vesa Martikkala, M.S., Jouko Sundvall, M.S., Matti Uusitupa, M.D., Ph.D.

Hamilton Health Symposium II

Although waist circumference (WC) does not distinguish between subcutaneous and visceral fat (or a person's frame size), research shows that WC is highly correlated with visceral fat. Furthermore, Kuk et al. (2006) showed that "Visceral fat is an independent predictor of all cause mortality in men." Accordingly, WC should be taken very seriously and become another target of health promotion and disease prevention.

However, when a person is put on an exercise program, we must be careful not to put too much emphasis on weight loss. It may be surprising to know that a "fit" overweight person may have a lower risk of disease than an "unfit" normal weight person. Research has shown that, "low cardiorespiratory fitness was a strong and independent predictor of CVD and all-cause mortality and of comparable importance with that of diabetes mellitus and other CVD risk factors." (1)

The key here (from a Kinesiologists perspective) is the benefits of attaining some cardiovascular fitness. If you are interested, look up Dr. Robert Ross (from Queens University) who has recently published many papers on the necessity of exercise/physical activity for the prevention or management (in the case of diabetes) of many diseases far beyond what diet alone can do.

1. Wei et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 1999; 282:1547-53.

Hamilton Health Symposium

Sprint interval training or High Intensity Training (HIT) is very applicable for cardiac patients. It is similar preparation for activities of daily living (e.g. Climbing stairs) and psychologically, the shorter term duration may help adherence.

Research shows HIT exercise is very comparable to endurance exercise in regards to cardiovascular benefits (the newest research is done by Dr. Gibala at McMaster in Hamilton):

1. Gibala et al. Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans. J Physiol. 2008 Jan 1;586(1):151-60. Epub 2007 Nov 8.

2. Warburton et al. Effectiveness of high-intensity interval training for the rehabilitation of patients with coronary artery disease. Am J Cardiol. 2005 May 1;95(9):1080-4.

3. Gibala et al. Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain? Exerc Sport Sci Rev. 2008 Apr;36(2):58-63.

4. Gibala et al. High-intensity interval training: a time-efficient strategy for health promotion? Curr Sports Med Rep. 2007 Jul;6(4):211-3.

Running and Memory

Recent studies (published in Am J Physiol Regul Integr Comp Physiol, 2007 & Neurobiology of Learning and Memory, 2007) show that high impact running increases the release of Brain Derived Neurotrophic Factor (BDNF). This neurochemical is responsible for increased production of proteins that are responsible for remodeling the brain and increasing its function.

Check out, "High impact running improves learning" published in Neurobiology of Learning and Memory in May 2007 (Volume 87, Issue 4).

Glycemic Index Old Paradigm

Here is an article published in the American Journal of Clinical Nutrition with a surprising finding about the Glycemic Index (GI). It suggests that we need to rethink the supposed insulin sparing effects of what have been called low GI foods. Blood samples taken showed the low GI of some foods was due to a higher insulin response, thereby keeping the blood glucose levels lower.

http://www.ajcn.org

The article is called, "Different glycemic indexes of breakfast cereals are not due to glucose entry into blood but to glucose removal by tissue."

The authors are: Simon Schenk, Christopher J Davidson, Theodore W Zderic, Lauri O Byerley, and Edward F Coyle.