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EATING PATTERNS Consensus recommendations A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes. Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key factors that are common among the patterns: Emphasize non starchy vegetables. Minimize added sugars and refined grains. Choose whole foods over highly processed foods to the extent possible. Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences. For select adults with type 2 diabetes not meeting glycemic targets or where reducing anti-glycemic medications is a priority, reducing overall carbohydrate intake with low or very low carbohydrate eating plans is a viable approach (2019).

Recent Advances: Less HIIT, Same Effect? Despite the evidence that low-volume HIIT can improve several markers of health in individuals with or at risk for type 2 diabetes, the characteristics of the optimal HIIT session (e.g., interval number, length, and intensity) are not known. There is a growing trend in HIIT research to explore the minimal amount of exercise that is required to improve cardiometabolic health. In this regard, there is evidence that as little as 1 minute of vigorous exercise performed in a 10-minute training session (3 x 10-20 seconds) done thrice weekly for 6 weeks can improve glucose tolerance in overweight men (37). It remains to be determined whether all the benefits of traditional aerobic exercise can be achieved with such low-volume HIIT and whether this style of exercise is effective for individuals with type 2 diabetes.

One study reviewed the blood glucose levels of 8 patients with type 2 diabetes before and after 6 sessions of interval training set out over 2 weeks. Each training session included 1 minute bouts of cycling with 1 minute breaks in between each of the 10 bouts of cycling.

5. Conclusion Adherence to exercise in individuals at risk for T2D is remarkably low. HIIT has recently gained popularity as a potential health-enhancing exercise strategy that is time-efficient and distinct from traditional MICT [17, 18]. However, the application of HIIT for persons at risk of chronic disease has been questioned due to perceptions that adherence to vigorous-intensity physical activity is unlikely. In this feasibility study, we provide preliminary evidence that individuals with prediabetes can adhere to HIIT over the short term and do so at a level that is greater than MICT. These findings support the potential utility of HIIT as an alternative exercise strategy that could bolster exercise adherence. Future studies are warranted to assess long-term adherence, cardiometabolic benefits, and safety of HIIT in individuals with prediabetes.

Getting the wake-up call of prediabetes can be very useful. A three-part strategy can keep many people with it from ever getting diabetes. The strategy includes modest weight loss, increased physical activity, such as walking 30 minutes a day, and choosing a healthier diet. In addition to helping stave off diabetes, these lifestyle changes can also help protect against heart attack, stroke, bone-thinning osteoporosis, and a host of other chronic conditions.

52 percent of adults in the United States have type 2 diabetes or prediabetes, which means that you are more likely than not to have diabetes or be developing it. How did we get here? Well, in 1977, the U.S. government recommended new dietary guidelines. Remember the food pyramid? The food pyramid recommended 6-11 servings of carbs per day, and very little fat—a low-fat, high-carb diet. As we outlined in our last video, type 2 diabetes is a disease of carbohydrate intolerance. Someone with type 2 diabetes or prediabetes has a low carbohydrate tolerance, so eating carbs will lead to exaggerated blood sugar spikes. While those with a high carb tolerance may be able to eat a carb-heavy diet and remain healthy, someone with a low carb tolerance will experience chronic high blood sugar and likely even weight gain if they eat a high-carb diet. Soon after these guidelines were recommended in 1977, type 2 diabetes prevalence increased dramatically, and it hasn't slowed down since. These dietary recommendations have made high carb, low-fat foods a staple of the American diet. "Healthy" foods like fruit-on-the-bottom yogurt, sugary protein shakes and low-fat processed grains flooded the market. The standard American diet began to include more sugary drinks and sodas, as well as more processed grains. Since all carbohydrates (even complex carbs) are broken down into sugar in the body, these dietary recommendations meant that the average blood sugar of Americans began to rise, and the diabetes epidemic began to grow.

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10 foods that may impact your risk of dying from heart disease, stroke, and type 2 diabetes

The effect of fasting prior to morning exercise on 24-hour energy intake was examined using a randomized, counterbalanced design.

These results reinforce the view that "adipose tissue often faces competing challenges," Thompson wrote. After eating, adipose tissue "is busy responding to the meal and a bout of exercise at this time will not stimulate the same [beneficial] changes in adipose tissue. This means that exercise in a fasted state might provoke more favorable changes in adipose tissue, and this could be beneficial for health in the long term," he noted.

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How does one explain the fact that two groups with near identical risk factors have such a disparity in CVD? Perhaps cholesterol, "good" or "bad" makes no difference except in familial hypercholesterolemia, the genetic condition for which statins were first created.

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A simple protein could revolutionize the way we treat type 2 diabetes and insulin resistance. While the focus on weight loss and diabetes has always been on our white fat, the new therapy harnesses brown fat, the body's second fat that burns sugars to warm us when we're cold. Although it's always been known that babies have brown fat, it was assumed we lose it as we get older, but it was only 20 years ago that researchers discovered adults retain some brown fat, usually around the shoulders, to regulate body temperature. Adding the protein, perilipin 5, to brown adipose tissue (BAT) helps control levels of glucose, our blood sugars, and makes us more sensitive to insulin, which breaks down the sugars from the carbohydrates in our diet.

Drinking that first cup on an empty stomach dramatically increases the insulin you produce when you do eat. The blood glucose response can be as much as 50 percent greater, say researchers from the University of Bath. The metabolic damage is far greater than anything done by a bad night's sleep, and regularly drinking coffee first thing could eventually lead to type 2 diabetes and heart disease, both caused by poor insulin control. It's a common habit. "We all know that nearly half of us will wake up in the morning and, before doing anything else, drink coffee, and the more tired we feel, the stronger the coffee," said lead researcher James Betts. But if we do need the coffee kick-start, make sure it's done after breakfast. The researchers tested a group of 29 healthy men and women after they had experienced restful and disturbed nights' sleep and were given coffee on an empty stomach and after eating breakfast. (Source: British Journal of Nutrition, 2020; 1; doi: 10.1017/S000071145200001865)

"Put simply, our blood sugar control is impaired when the first thing our bodies come into contact with is coffee especially after a night of disrupted sleep. We might improve this by eating first and then drinking coffee later if we feel we still feel the need it. Knowing this can have important health benefits for us all." Lead researcher, Harry Smith from the Department for Health at Bath added: "These results show that one night of disrupted sleep alone did not worsen participants' blood glucose/insulin response to the sugary drink compared to a normal night of sleep which will be reassuring to many of us. However, starting a day after a poor night's sleep with a strong coffee did have a negative effect on glucose metabolism by around 50%. As such, individuals should try to balance the potential stimulating benefits of caffeinated coffee in the morning with the potential for higher blood glucose levels and it may be better to consume coffee following breakfast rather than before. There is a lot more we need to learn about the effects of sleep on our metabolism, such as how much sleep disruption is necessary to impair our metabolism and what some of the longer-term implications of this are, as well as how exercise, for instance, could help to counter some of this."

Abstract Morning coffee is a common remedy following disrupted sleep, yet each factor can independently impair glucose tolerance and insulin sensitivity in healthy adults. Remarkably, the combined effects of sleep fragmentation and coffee on glucose control upon waking per se have never been investigated. In a randomised crossover design, twenty-nine adults (mean age: 21 (sd 1) years, BMI: 24.4 (sd 3.3) kg/m2) underwent three oral glucose tolerance tests (OGTT). One following a habitual night of sleep (Control; in bed, lights-off trying to sleep approximately 23.00-07.00 hours), the others following a night of sleep fragmentation (as Control but waking hourly for 5 min), with and without morning coffee approximately 1 h after waking (approximately 300 mg caffeine as black coffee 30 min prior to OGTT). Individualised peak plasma glucose and insulin concentrations were unaffected by sleep quality but were higher following coffee consumption (mean (normalised CI) for Control, Fragmented and Fragmented + Coffee, respectively; glucose: 8.20 (normalised CI 7.93, 8.47) mmol/l v. 8.23 (normalised CI 7.96, 8.50) mmol/l v. 8.96 (normalised CI 8.70, 9.22) mmol/l; insulin: 265 (normalised CI 247, 283) pmol/l; and 235 (normalised CI 218, 253) pmol/l; and 310 (normalised CI 284, 337) pmol/l). Likewise, incremental AUC for plasma glucose was higher in the Fragmented + Coffee trial compared with Fragmented. Whilst sleep fragmentation did not alter glycaemic or insulinaemic responses to morning glucose ingestion, if a strong caffeinated coffee is consumed, then a reduction in glucose tolerance can be expected.

Design This single-centre, double-blind, placebo-controlled trial randomised 96 participants at high risk of diabetes or with newly diagnosed type 2 diabetes to vitamin D3 5000 IU daily or placebo for 6 months. Conclusions In individuals at high risk of diabetes or with newly diagnosed type 2 diabetes, vitamin D supplementation for 6 months significantly increased peripheral insulin sensitivity and beta-cell function, suggesting that it may slow metabolic deterioration in this population.

The answer could be down to one type of bacteria in the gut, or the lack of it. The bacterium is called Akkermansia muciniphila, and it seems to regulate weight gain and even type 2 diabetes, which often occurs after people start becoming seriously overweight, or obese. So, people who easily put on weight could be low in levels of the bacterium, while slimmer folk have ample stores of it in their gut. You can increase your levels of the bacterium by taking food supplements that contain it, and that’s just what researchers did when they gave Akkermansia capsules to laboratory mice. Researchers from the University of Louvain first stumbled on the beneficial effects of the bacterium back in 2007, but that was just on mice, and now they’ve taken their research a stage further by testing a pasteurized form of Akkermansia on people. The pasteurized variety seems to be more protective against diabetes-like symptoms such as insulin resistance than the live form of the bacterium, they reckon. They’ve tested the pasteurized form on a group of overweight and obese people who were showing early signs of heart disease. The volunteers were put into three groups, and were either given a placebo, or dummy supplement, a ‘live bacteria’ supplement, or the pasteurized version. After taking the supplements every day for three months, the ones that took the pasteurized form had lower inflammation markers in the liver, a slight drop in weight – the average loss was around 2.3 kg, or 5 lbs – and cholesterol levels were also down. By comparison, those given the dummy supplements showed a continued deterioration of their pre-diabetic symptoms. (Source: Nature Medicine, 2019; doi: 10.1038/s41591-019-0495-2)

The diet also improves depression – the problem is three times greater among diabetics – and general wellbeing, researchers from the University of London have found. Diabetics also lose weight on the diet. The dietary change could dramatically reduce the $176bn annual costs in the US, and the £24bn in the UK, to manage the problem with drugs and other medical therapies. A vegan diet “significantly” reduces the symptoms of type 2 diabetes to the extent that drugs can be stopped, or dosages lowered, the researchers discovered after they took another look at 11 previously-published studies that involved 433 diabetics with an average age of 55. In fact, the diet was more successful than most of the official guidelines recommended by diabetes help groups around the world, they say. The vegan diet excludes all animal products, including dairy, and allows only fruits, vegetables, legumes (such as nuts and lentils), seeds and whole grains. (Source: BMJ Open Diabetes Research & Care, 2018; 6: e000534)

Having breakfast before 8.30 in the morning reduces your risk of type 2 diabetes. Your blood sugar levels are likely to be lower and you’ll be less insulin resistance, which is an early-warning sign for the disease. Starting to eat earlier in the day is the single most important factor in preventing diabetes, and is more beneficial than other strategies, such as restricted windows of time for eating. Researchers from Northwestern University in Chicago analysed data from 10,575 people who had taken part in a survey that tracked their eating habits and health. They divided up the participants into three groups based on the number of hours they ate—including ‘windows’ of less than 10 hours, 10 to 13 hours and more than 13 hours a day—and then sub-divided those into the times they started eating. Fasting blood sugar levels were similar in all the ‘eating window’ groups, but the real difference was seen in those who started eating earlier in the morning, and before 8.30am. “These findings suggest that timing is more strongly associated with metabolic measures than duration, and support early eating,” said lead researcher Marriam Ali. (Source: Proceedings of the Endocrine Society annual meeting, March 18, 2021)

Fasting for 24 hours intermittently – either every other day or for three days straight – can reverse the condition and eliminate the need for drug treatment. Diabetics who had been taking insulin and medication for high blood pressure and cholesterol levels were drug-free after 10 months of intermittent fasting, researchers from the University of Toronto have discovered. The patients weren’t going entirely without food. During the 24-hour fast, they could drink low-calorie beverages such as tea or coffee, water or broth, and were allowed one low-calorie meal in the evening. Fasting was tested on three diabetics, whose problem had become so advanced that they were injecting insulin every day to help break down sugars. Two intermittently fasted every other day, and the third fasted for three days and ate normally the other four days in the week. (Source: BMJ Case Reports, 2018; bcr-2017-221854)

One serving – around 3 ounces – every day could be all it takes to kick-start the positive chain reaction in the gut, say researchers at the Penn State’s College of Agricultural Sciences. The mushrooms help populate the gut with more short-chain fatty acids – succinate and propionate – that manage glucose production, which could have positive knock-on effects for the prevention of type 2 diabetes and other metabolic disorders. In a healthy person, insulin is released by the pancreas to break-down the sugars n carbohydrates and converts them to glucose, or blood-sugar. But in diabetics and prediabetics, the insulin becomes less effective, and the glucose is not properly managed, and this can lead to heart disease and stroke. But the discovery by the Penn State researchers that mushrooms can give the process a helping hand opens the door to new and more effective therapies to treat diabetes. Their research has been limited to laboratory mice, but they are hopeful similar effects would be seen in people. They fed the mice the equivalent of a daily serving of the mushrooms and noted the changes that started to happen in the gut; the most significant change was the increase in the population of Prevotella, bacteria that produce propionate and succinate. The mushrooms acted as a prebiotic, the researchers said, which feeds beneficial bacteria already in the gut. A probiotic instead introduces the ‘good’ bacteria back into the gut. (Source: Journal of Functional Foods, 2018; 45: 223)

Although eggs have high levels of cholesterol, they don’t raise our cholesterol levels, and they don’t increase our weight, either. Researchers from the University of Sydney said they wanted to clarify advice we get about a healthy diet, and especially about eating eggs; one study had even likened eggs to cigarettes, so damaging were they to our health. But the Australian researchers found that eggs weren’t escalating the risk of cardiovascular disease, even among diabetics who are already at higher risk. In fact, they are a good source of protein and micronutrients that help maintain eye and heart health, healthy blood vessels, and regulate our fat and carbohydrate intake. The researchers monitored the heart health and weight of 128 people who had been diagnosed as having early signs of diabetes. Half the group ate more than 12 eggs a week, and the rest ate fewer than two eggs, for a year, and during that time both groups were put on a weight-loss programme. But the weight loss was similar in both groups, and markers for cardiovascular disease were also the same. Even if you have diabetes, you don’t have to “hold back from eating eggs,” said Nick Fuller, the lead researcher. (Source: American Journal of Clinical Nutrition, 2018; doi: 10.1093/ajcn/nqy048)

Eating just 850 calories a day reverses type 2 diabetes, known as the ‘lifestyle disease’ because it’s often triggered by a poor diet of processed foods with high sugar content. Within a year, diabetes was in remission for half of a group of diabetics who went on the diet for between three to five months, researchers from the University of Newcastle discovered. In that time, each of the participants had lost an average of 10 kilos (22 lbs), although a quarter had lost 15 kg (33 lbs). One of the researchers, Prof Michael Lean from the University of Glasgow, reckons that a low-calorie diet can reverse diabetes even after six years, and the process of recovery could be accelerated if the patient was also exercising. For their test, the researchers tested the diet on 306 people who had been diagnosed with diabetes over the past six years. They were aged between 20 and 65 years, and they had a BMI (body mass index) of between 27 and 45. Half of the group was put on a strict low-calorie diet of between 825 and 850 calories a day for three to five months, while the rest continued to follow standard medical advice. After a year, half of those on the low-calorie diet had reversed their diabetes, compared to just 6 per cent in the standard-care group, who also lost on average just 1 kg (2 lbs) in weight. Seven of those on the low-calorie diet reported minor health problems, including colic and abdominal pain in one participant, although none were so bad that they had to come off the diet. (Source: Lancet, 2017; doi: hhtp://

In fact, eating any of the coloured vegetables, such as carrots, sweet potatoes and tomatoes, will help reduce the risk of age-related macular degeneration, which – as the name suggests – is a progressive sight problem as we get older. Adding more coloured vegetables to our diet, or supplementing with beta-carotene and vitamin A supplements, can dramatically reduce the risk, as can stopping smoking. But although it seems to be common knowledge, it’s something that opticians and ophthalmologists aren’t recommending to their patients, a new survey has discovered. At best, just 40 per cent of optometrists are talking about dietary ways of reducing the risk, and it’s worse among ophthalmologists, with just 5 per cent recommending the lifestyle changes. Age-related macular degeneration, where the eye’s retinal pigment is progressively destroyed, is a completely avoidable disease, say researchers from Malardalen University in Sweden. It’s established that beta-carotene – the pigmentation that makes vegetables tallow, orange or red – vitamin A, and lutein, from green leafy vegetables, dramatically reduces the risk – as can stopping smoking – but someone just has to tell the optician. (Source: Clinical Optometry, 2017; 77: doi: 10.2147/OPTO.S129942)

Eating less, exercising and keeping glucose under control by eating ‘slow-burn’ or low-glycaemic carbs combine to reverse a disease that has been considered chronic and controlled by drugs. Around 40 per cent of cases who went on the diet are now symptom-free, and are no longer taking any drugs to control the condition. Researchers from McMaster University in Canada tested the dietary approach on 83 people who had been diagnosed with type 2 diabetes and had the condition for an average of three years. Although the study was designed to last a year, researchers were seeing big changes inside four months – and once the patients stopped taking their anti-diabetes drugs, which lower glucose in the body. The major change was seen after their daily calorie-intake was reduced by between 500 and 750 calories, and by avoiding processed carbs that are high in sugars. The diet had a bigger effect than the drugs. After eight weeks, around half of the patients had glucose under control from taking medication, but this shot up to 70 per cent when they started the four-month diet. The glucose levels were checked again three months after they stopped the diet, and 40 per cent were still showing their diabetes was in “complete or partial remission”, the researchers said. Type 2 diabetes happens when the body doesn’t respond to insulin, which is produced by the pancreas to break down sugars in carbohydrates. When we eat high-sugar carbs, such as in processed and ‘white’ foods, the body is on constant alert and continually produces large amounts of insulin. As the researchers said, they think the diet was effective because it gave the pancreas a rest from producing insulin. (Source: Journal of Clinical Endocrinology & Metabolism, 2017; doi:

The villagers, who live in Acciaroli, a remote coastal community, have very low rates of heart disease and Alzheimer’s, and their lifestyle and diets are being researched for the very first time by the University of California at San Diego. Although the research has only just started, researchers have so far discovered that the villagers eat a healthy Mediterranean diet – but with their own twist: they add rosemary to most meals. They also walk long distances every day and hike through the surrounding mountains as part of their daily life. In a separate study into longevity, Japanese researchers have discovered that the elderly are low in antioxidants. After people reach the age of 65, they should eat more foods that are rich in antioxidants. They should also exercise to maintain muscle strength, as this diminished as we age. Researchers from the Okinawa Institute of Science and Technology made the discovery after they analysed metabolites – substances that are created during metabolism – that are related to the ageing process. (Sources: Italian study: University of California at San Diego; Japanese study: Proceedings of the National Academy of Sciences, 2016; 201603023)

People need to avoid low-fat, processed foods and instead eat whole foods, such as meat, fish and dairy, says the National Obesity Forum and the Public Health Collaboration, a UK-based charity. It’s sugars – and not fats – that are the real cause of obesity and heart disease, the charity says. Not only does eating fat not make us fat, full-fat foods such as milk, yoghurt and cheese can even protect the heart. The current advice, which has been official policy since 1983, has resulted in people eating junk and processed foods and ‘bad’ carbohydrates, which are high in sugar. Dr Aseem Malhotra, a cardiologist and member of the charity, said that the advice to eat a low-fat diet is “perhaps the biggest mistake in modern medical history, resulting in devastating consequences for public health.” The obesity epidemic is alone costing the UK’s National Health Service around £6bn a year. The advice is based on flawed science but has also been influenced by the processed foods industry, which has funded research as well as individual scientists behind the advice over the years, he says. Aside from eating fats and avoiding sugars and processed food, people should also be advised to avoid snacks between meals.

There’s even a difference among vegetarians. Those who have followed the diet for 17 years or more are likely to live for 3.6 years longer than a short-term vegetarian. But the biggest impact on longevity is eating red and processed meat every day, say researchers at the Mayo Clinic in Arizona. There are similar variances among meat eaters. Those who ate meat only occasionally – as opposed to every day – saw their mortality risk drop by as much as 50 per cent. And one study quoted by the Mayo researchers concluded that the real risk was with processed meats, such as bacon, sausages, salami, hot dogs and ham. Another added red meat to the list. Whatever the actual risk – and there are many other factors at play – the take-home message is one that is already well-known: eat less meat and eat more vegetables and fruit. (Source: Journal of the American Osteopathic Association, 2016; 116: 296)

In fact, just three 20-second bursts of fast cycling three times a week could be all you need to do to maintain a healthy heart. And if you can’t get to a gym, running up a flight of stairs has the same benefits. The approach, known as sprint interval training (SIT), has been developed by scientists at McMaster University in Ontario, Canada. They’ve already established that it improves heart and lung fitness and insulin sensitivity, but in a new trial they’ve tested it against more conventional, moderate exercise. The McMaster researchers got together a group of 27 men, who had done little or no exercise, and had them do SIT or moderate exercise for 12 weeks. The moderate exercise was 45 minutes of continuous cycling three times a week. Health improvements were almost identical, even though the moderate-exercise group had spent five times as long in exercising and made a fivefold greater commitment of time. The SIT protocol involves three 20-second ‘all-out’ intense exercise sessions, such as cycling, over a 10-minute period. The workout time also included a two-minute warm-up and a three-minute cool-down period. This was carried out three times a week. “Most people cite ‘lack of time’ as the main reason for not being active, Our study shows that an interval-based approach can be more efficient; you can get health and fitness benefits comparable to the traditional approach, in less time, “ says researcher Martin Gibala, professor of kinesiology at McMaster’s. (Source: PLOS ONE, 2016; 11: e0154075)

High doses of the supplement – up to 10 times the recommended daily allowance – help the body regain its capacity to process glucose, or blood sugar. Diabetics have become insulin resistant, and, as a result, can’t break down glucose properly. But after taking the supplement for six months, glucose metabolism was starting to improve, say researchers from Laval University in Quebec. It had a positive effect even among diabetics whose vitamin D levels were normal. The researchers tested glucose metabolism in a group of diabetics and prediabetics before and after they were given the supplements. After six months, tests showed that the supplements had “significantly improved” the ability of insulin to break down glucose. (Source: European Journal of Endocrinology, 2019; doi: 10.1530/EJE-19-0156)

An avocado a day can help women lose the hard-to-budge belly fat and make them look slimmer. The fat-known as visceral abdominal fat-surrounds the body's organs and increases the risk for diabetes. The fat-moving qualities of the avocado surprised a research team who were looking to see the fruit's impact on the way people store fat. Researchers from the University of Illinois at Urbana-Champaign recruited 105 obese or overweight men and women, and put them on a diet of just one meal a day for 12 weeks, but half the group was also given an avocado as part of their daily meal plan. Although the men didn't benefit from eating avocados, the women's visceral fat reduced and the fat that was surrounding their organs also dispersed. (Source: Journal of Nutrition, 2021; 151: 2513)

Eating 125g (less than one cup) of raspberries every morning can reduce the chances of developing diabetes, even in people who are already at risk, such as those who are overweight or obese and are already showing signs of insulin resistance. The berries can also lower blood sugar levels in diabetics after they've eaten a meal, a second research paper has established. Raspberries are rich in polyphenols, antioxidants that also protect against cancers, heart disease and general inflammation. The two new studies focused on the fruit's impact on diabetes. The first tested a group of 32 people who were pre-diabetic and gave them either 125g or 250g of red raspberries for three days along with a high-carbohydrate breakfast, which usually causes the body to release more insulin to break down the sugars. As a control, a group of healthy people were just given the breakfast without any raspberries. Both amounts of raspberries "significantly reduced" insulin levels, researchers from the Illinois Institute of Technology concluded. In a separate trial, the fruit was tested on people who already had diabetes. Their blood glucose was "significantly lower" after they had eaten the raspberries for a month. The berries reduced hyperglycaemia (high blood sugar) and inflammation markers, say researchers from Oklahoma State University. (Sources: Obesity, 2019; 27: 542-550 (pre-diabetes study); Annals of Nutrition & Metabolism, 2019; 74: 165-174)

They've tested it against low-fibre wheat bread and reckon it reduces the risk of type 2 diabetes. It does this by controlling levels of intestinal serotonin which, in turn, keeps blood sugar (glucose) levels in check. Serotonin is best known as a neurotransmitter that helps control brain signalling, but the variety created in the gut has an impact on glucose. Too much intestinal serotonin can cause high levels of blood sugar - and that, in turn, can lead to diabetes. That's why wholegrain bread is known to reduce the risk of diabetes, say researchers at the University of Eastern Finland, and may also lower the risk of colorectal cancer. Other studies have suggested the bread could also reduce the risk of heart disease. Although the benefits of whole grains are well known, the biological processes aren't. The researchers fed laboratory mice with both types of bread and analysed their blood afterwards. After eating the wholegrain rye, serotonin levels in the blood were far lower than after eating low-fibre wheat bread. (Source: American Journal of Clinical Nutrition, 2019; doi: 10.1093/ajcn/nqy394)

Restricting the time that you eat to within an eight to 10-hour window every day can help you manage chronic health problems such as diabetes and heart disease. Time-restricted eating is a form of intermittent fasting that works with our own body clock, and can help regulate chronic diseases. Our genes, hormones and metabolism rise and fall during the 24-hour day, and restricting the times we eat keeps us in tune with these rhythms, say researchers at the Salk Institute for Biological Studies. Snacking and 'grazing' throughout the day breaks the body's synchrony and makes us more prone to disease, said Satchidananda Panda, one of the paper's authors. Intermittent fasting can also help improve the quality of our sleep and our overall health, as well as reduce the risk of obesity, diabetes and heart disease. Fasting can help manage these chronic problems, and also lower our risk of getting the diseases in the first place. (Source: Endocrine Reviews, 2021; doi: 10.1210/endrev/bnab027)

Rye sourdough - used for baking rye bread - is rich in lactic acid bacteria that help the gut microbiome, the 'universe' of bacteria, and also control insulin metabolism, so reducing the risk for diabetes. It also triggers a positive chain reaction that lowers the amount of oxygen the heart muscles need, which may reduce the risk of stroke, researchers from the University of Eastern Finland say. Although the health benefits of rye have been known for a long time, scientists haven't researched the biological processes that happen when we eat it. The Finnish researchers have started to put that right with tests on laboratory mice. From their results, they found that rye has bioactive compounds, or phytochemicals, that work as antioxidants, and their health benefits are amplified by gut bacteria. (Source: Microbiome, 2019; 7: 103)

They've been demonised for the past 40 years as the cause of heart disease, but now researchers have discovered the very opposite: high-fat dairy products, such as milk, cheese and butter, actually reduce your risk of CVD (cardiovascular disease). People who eat the most dairy in their diet have the greatest protection from CVD, still the West's major killer, responsible for one in three deaths. Consuming dairy can reduce your risk by around 14 percent, compared to someone who instead chooses low-fat and non-dairy alternatives, a major new study has discovered. Researchers from Johns Hopkins Bloomberg School of Public Health profiled the diets and prevalence of CVD disease of 4,150 Swedes, all of whom were 60 years of age, for 16 years, and discovered that those with the highest biomarkers of dairy fat intake were also the least likely to develop CVD. They checked their analysis with 18 other studies to confirm their findings. Dairy has been wrongly fingered as the bad guy. They are an important source of nutrients, and cheese is especially rich in vitamin K, which the researchers say protects the cardiovascular system, while the probiotics in yoghurt and fermented milk help keep the gut healthy, and this too may have a beneficial effect. The researchers focused on Sweden because the country's dairy consumption is one of the highest in the world, and so they could clearly see any effects on cardiovascular health. Other studies among Nordic people found that drinking non-fermented milk reduced the risk of premature death from any cause. (Source: PLoS Med, 2021; 18: e1003763)

Background Wholegrain consumption has been associated with beneficial health effects including reduction of diabetes and cancer risk; however, the underlying mechanisms are not fully understood. Objective The aim of this study was to characterize the effects of wholegrain rye intake on circulating metabolites in a human intervention study using untargeted metabolomics.

A 40g (one-and-a-half ounces) slice of cheese eaten every day reduces the risk of heart disease by 14 per cent and a stroke by 10 per cent, researchers have discovered. The risk reduction was greatest in those who ate the most cheese, up to 40 g, say researchers at Soochow University in Suzhou, China. Their findings support the phenomenon of the 'French paradox', which has found that heart disease is lower among the French despite them eating a high-fat diet, including meat, cheese and other dairy produce. The researchers aren't sure why cheese should have a protective effect, but they think it could be because it also contains calcium, which reduces the absorption of saturated fats, and an acid that helps stop arteries getting clogged. Or it could be that the fats/heart disease theory was wrong in the first place. (Source: European Journal of Nutrition, 2017; 56: 2565-75)

The recommended doses of vitamins we're supposed to take are so low that they have almost no impact on our health, new research has found. Some of the RDAs (recommended daily allowances) are based on poor science that's nearly 80 years old, and are designed to prevent diseases of deficiency, such as scurvy, but do little to promote health and wellbeing. The RDA for vitamin C, for example, should be doubled, say researchers from the University of Washington. Currently, we're supposed to take 45mg a day, according to recommendations from the World Health Organization, but this should be at least doubled to 95mg to support basic functions such as wound healing. Exploring the origins of the RDA levels, the researchers uncovered a "shocking" research programme that took place during the Second World War on conscientious objectors. In 1944, the Sorby Research Institute recruited 20 people who refused to fight and starved them of vitamin C before slowly introducing it by various levels to discover the optimum amount that was needed to help heal scar tissue. The malnourished recruits faced life-threatening emergencies during the trial and may have suffered longterm problems, the researchers found. The vitamin is vital for healthy immune system functioning, and helps maintain healthy bones, blood and skin. But what is true for vitamin C is also true for every other vitamin; the RDA levels are way too low, and would explain why studies sometimes fail to see any benefits from taking supplements. (Source: American Journal of Clinical Nutrition, 2021; nqab262; doi:

Adding whole grains to your diet can reduce your risk for type 2 diabetes. Just one serving starts to have a positive impact, and the risk drops significantly when people follow current nutritional guidelines of three to six servings a day. It's part of a healthy diet that also prevents weight gain, which is often a precursor of diabetes, say researchers from the University of Eastern Finland. Countless studies have demonstrated that eating whole grains reduces the risk of diabetes, but "one third of Finns do not eat even one dose of whole grains on a daily basis, and two-thirds have too little fibre," said researcher Jaana Lindstrom. Adopting a healthier diet also has an impact on the economy. In just 10 years, Finland alone could achieve cost savings of up to one billion euros, the researchers estimate. (Source: Nutrients, 2021; 13: 3583)

RESULTS A total of 1,079 participants were aged 25-84 years (mean 50.6 years, BMI 33.9 kg/m2). Weight loss was the dominant predictor of reduced diabetes incidence (hazard ratio per 5-kg weight loss 0.42 [95% CI 0.35-0.51]; P <0.0001). For every kilogram of weight loss, there was a 16% reduction in risk, adjusted for changes in diet and activity. Lower percent of calories from fat and increased physical activity predicted weight loss. Increased physical activity was important to help sustain weight loss. Among 495 participants not meeting the weight loss goal at year 1, those who achieved the physical activity goal had 44% lower diabetes incidence.