Alcohol Intake and Diabetes

This week's topic is how alcohol affects blood sugar and other aspects of Type II Diabetes. Normally, doctors tell diabetic patients that they may enjoy alcohol moderately like everyone else. The guidelines are: 2 or less drinks per day for men and 1 or less for women. The servings for 1 drink are 12 oz of beer, 5 oz of wine or 1.5 oz of alcohol.

The following list details the affects of alcohol in the body and how it may interfere with treatment plans for diabetic patients.

• Carbohydrate content in alcohol can raise blood sugar
• Alcohol in moderation may raise blood sugar, but in excess can actually lower blood sugar to dangerous levels.
• Alcohol interferes with glycemic control medications making them less effective.
• Alcohol stimulates appetite, which can deter the patient from following calorie and glycemic load restriction diets.
• The side effects of alcohol include high blood pressure and increased triglyceride levels.

Due to the above effects of alcohol, people at risk for diabetes and those with diagnosis of diabetes should consult their Nutritionist or medical physician before using alcohol. Male or female, alcohol should be limited to 0-1 servings per day. Drinks mixed with sugary juices or sodas, cordials, and sweet wine should especially be avoided. If alcohol is consumed, it should be at a slow pace and with a meal.

Your Nutritionist will also be able to counsel you through a proper liver detoxification program to ensure proper function and efficiency of the liver if you are using alcohol and medications.

Enjoy! (In Moderation...)

Dr. Behnke

References:

1. Diabetes Health Center: Diabetes and Alcohol. http://diabetes.webmd.com March 8, 2009.

2. Seiki N, Noda M and T Kodawaki. Alcohol Consumption and Risk of Type 2 Diabetes Meillitus in Japanese: a systematic review. Asia Pac J Clin Nutr. 2008;17(4):545-51.

Cortisol: Is it only about stress?

Cortisol is a hormone that most people have heard of, yet few are able to explain its function other than it being a "stress hormone." Today I will explain a bit about the hormone, its functions and why it's not completely bad to have circulating around the body.

Cortisol is the primary glucocorticoid involved in both glucose metabolism and in response to stress. During periods of stress (particularly new stressors on the body), Cortisol helps the body adapt and maintain normal body functions and metabolism until the stress-induced physiology is exhausted or the stressor is removed. Studies have repeatedly shown that animals can survive without the organs that produce Cortisol and the other adaptation hormones when given doses of these hormones, but they are unable to survive without the hormones themselves.

Levels of Cortisol also fluctuate with the sleep-wake cycle. Normally, there is a sharp increase in Cortisol in the morning which peaks by 8:00 am followed by gradual lowering until midnight. Any physical, mental, environmental, or chemical stress can affect the output levels and timing of Cortisol.

Since the multiple roles of the hormone act on many types of cells (immune, liver, fat, bone and others), the effects of imbalance are many.

Symptoms of Cortisol Excess include: sugar craving, trunk obesity, insulin resistance, weakness, shakiness between meals, irritability, high blood pressure, bruising easily, impotence, oily skin, trouble sleeping and headaches.

Symptoms of Cortisol Deficiency include: chronic weakness and fatigue, weight loss, stress intolerance, alternating diarrhea and constipation, salt craving, dizziness, joint and muscle pain, low blood pressure, and anemia.

Not only can these symptoms prevent you from feeling good, but chronic altered levels of Cortisol can lead to other problems that decrease Calcium absorption, and depletions of B-Vitamins, Vitamin E and Vitamin C.

Does one of those categories sound like you? Don't let your bad-days linger, consider consulting a qualified physician who can test your adrenal hormones and help you with the treatment of these conditions.

Dr. Behnke


References:
1. Lord and Bralley. Laboratory Evaluations for Integrative and Functional Medicine. 2nd Edition. 2008. Duluth, GA.

2. Lee Scung hye, Shin Dong-won and Mark A Stein. Increased Cortisol after Stress is Associated with Variability in Response Time in ADHD Children. Yonsei Med J. 2010;51(2):206-11.

Grave's Disease

Grave's Disease is one form of hyperthyroidism (over-active thryoid gland). This disease affects women much more than men, at a rate of 7-10:1. It is actually an autoimmune condition, and the affected patient will have autoantibodies to Thyroid Stimulating Hormone receptors on the thyroid gland. The antibodies stimulate or attack the receptors causing increased production of thyroid hormone T4, and therefore results in overactivity of the gland. Current medical treatments for Grave's Disease are antithyroid medications, surgery and radioactive iodine.

Grave's Disease is often triggered by a very stressful event, and it does have some genetic influence. Other things that increase the risk are smoking, excess iodine, Cadmium and Mercury exposure, and toxic reactions to medications. Diagnosis is usually made based on lab testing for thyroid hormones. Classic presentation are increased thyroid hormones and decreased Thyroid Stimulating Hormone, as well as the presence of thryoid receptor antibodies. Symptoms of Grave's Disease include: increased heart rate, weakness, sweating, weight loss, nervousness, loose stools, intolerance to heat, fatigue, irritability, warm or thin moist skin, tremors, goiter, and exopthalamus (classic bulging eyes of hyperthyroidism).

A condition like this should not be self-treated and a physician should be consulted when beginning new treatments. Following are some suggestions for natural, non-invasive ways to control hyperthyroid symptoms.

• Reduce risk factors (stress, smoking, excess iodine intake, avoid toxins)
• Avoid situations that cause excitation or anger
• Stress counceling or meditation
• Dietary changes: consume organinc, whole foods, increase calorie intake through small frequent meals
• Avoid caffeine and other stimulants
• Avoid refined sugars and foods made with white flour and white sugar
• May increase consumption of cabbage to 1/2 raw head of cabbage per day
• Increasing goitrogens is controversial, but may help. (turnips, broccoli, brussels sprouts, kale, cauliflower, soybeans, peanuts, pine nuts, millet)
• Maintain gut health with fiber intake, probiotic use and get tested for food sensitivities
• Supplement the following: Vitamin A, Vitamin C, Vitamin E, Selenium, Calcium, Zinc, L-Carnitine, CoQ10, EPA/DHA. Amounts are specific to patients, to avoid mis-use of supplements, I will not give dosage amounts here.

References:
1. Brent GA. Graves’ Disease. N Engl J Med. 2008;358:2594–2605.
2. Streetman DD and U Khanderia. Diagnosis and Treatment of Grave's Disease. Ann Pharmacother. 2003;37(7-8):1100-9.

How important is Fiber consumption?

This week I am inspired to open your hearts to the wonderful world of Fiber. Fiber consumption could be argued to be one of the most important ways to feed our bodies, but it is far too low, and sometimes even completely missing from the Standard American Diet (SAD). Fiber is derived from the cellular residues of the foods we eat, and it not actually digested like the fat, protein and carbohydrate parts of the foods. The fibrous portions of foods get all the way to the large intestine virtually unchanged from when they are put into the mouth. The role of fiber in your gut is critical for the biological processes to happen, and therefore to keep you healthy.
Fiber deficiency is liked to many diseases including: appendicitis, breast cancer, colon and prostate cancer, colitis, diverticular disease, gallstones, hemorrhoids, hiatal hernia, ulcers and other gastrointestinal disorders.

The health benefits are many:

• reduces colon transit time
• binds bile acids
• increases fecal bulk
• causes fermentation in the large bowel
• increases water content in the bowels

Because of these great functions of fiber and the digestive system, increasing fiber intake has a benefit on many diseases. Soluble fibers function to lower cholesterol, reduce heart disease, regulate blood sugar, lower blood pressure and promote the life of beneficial bacteria. Insoluble fibers aid digestion and elimination and help decrease the toxicity of irregular bowels.

The recommended daily fiber intake is 35 grams! Are you getting enough?

When cooking or purchasing foods, look at the labels for fiber content per serving. Try to estimate your current fiber intake and consider making changes in your diet to increase your fiber to 35 grams per day. It may sound like a daunting task at first, but you will notice benefits quite rapidly. Ask your doctor for help!

The best way to get fiber working for your health is to consume fiber of all kinds, mixing soluble and insoluble fiber sources. Good sources of fibers include: whole grains (wheat, rice, corn, barley, millet, oats), legumes, nuts, fruits, leafy green vegetables, and seeds.

Enjoy!

Dr. Behnke

Reference: Kamen, Betty. New Facts About Fiber. 1997. Nutrition Encounter Inc. Novato, CA.

Type 1 Diabetes

This past weekend, a very large event was held at the Mall of America. It's goal was to raise money for research and awareness of Type 1 Diabetes, or Juvenile Diabetes. Friday morning I had a local news station on while I was getting ready for the day, and I overheard and interview with someone involved in the planning of this great event. I'm not sure if I'm breaking rules by naming the source/channel, so I will leave those details to myself.

Part of this interview was explaining bits and pieces of this disease, and I found myself questioning the content of their conversation when the interviewee told the audience that the difference between Type 1 and Type 2 Diabetes is that Type 1 is not responsive to exercise and activity levels have no bearing on the severity or treatment of Type 1 Diabetes. In my opinion, because of the strong trend for Americans to get little to no physical activity, people should not be told that there is no benefit of exercise regardless of what disease is being discussed.

Type 1 Diabetes affects only 5-10% of diabetic patients, and is usually diagnosed in childhood or before young adulthood. Many factors are involved in the risk of having Type 1 Diabetes: Gut infections, mother's Vitamin D deficiency, poor protein digestion, genetic predisposition, auto immune destruction of pancreatic cells, viral or environmental triggers. To diagnosis of Type 1 Diabetes is usually due to high C-Peptide levels, autoantibody presence, glucose and ketones in urine, and random blood glucose above 200 mg/dL. Signs and symptoms of the disease include: increased hunger and thirst, excess fatigue, increased urination, weight loss, blurred vision, numbness in hands or feet, rapid breathing, dry skin and mouth, sweet odor of breath, and vomiting.

Because the pathogenesis of Type 1 Diabetes is destruction of the insulin-releasing cells of the pancreas, medical treatment consists of insulin injections and daily monitoring of blood glucose levels. Severe cases are treated with pancreas transplants.

My diet and other recommendations:

• Eat several meals at the same time each day, using portion size control.
• Choose low glycemic foods, non-starch vegetables, reduce sugary snacks and desserts.
• Increase fruits and vegetables.
• Use lean meats, dried beans, fish, non-fat dairy, whole grains and water.
• No-flush Niacinamide to reduce immune-mediated cell destruction. Dosage should be given by a healthcare professional.
• Epicatechin to save beta-cells.
• Vitamin D
• Exercise and physical activity

The benefits of exercise are numerous:

Reduce blood pressure and blood sugar levels
Raise good cholesterol levels, lower the bad ones
Improve how your body uses insulin
Reduce the odds of having a stroke or developing heart disease
Promote a strong heart and strong bones
Reduce your odds of falling
Help you shed pounds
Provide more energy
Reduce stress levels

Make sure to balance stretching, aerobic and strengthening exercises. Be careful to avoid exercising in a dangerous way, particularly to diabetics, heavy weight training and high impact aerobics should be avoided due to the side effects of diabetes. Always tell your doctor your activity levels and know your ketone levels, the signs for too low blood sugar, and do not exercise alone if you have numbness in your feet or other conditions that would make exercise dangerous to you.

References:

Riddell M and BA Perkins. Exercise and Glucose Metabolism in Persons with Diabetes Mellitus: Perspectives on the Role for Continuous Glucose Monitoring. J Diabetes Sci Technol. 2009;3(4):914-23.

Man CD, Breton MD and C Cobelli. Physical activity into the meal glucose-insulin model of type 1 diabetes: in silico studies. J Diabetes Sci Technol. 2009;3(1):56-7.

Rachimiel M, Buccino J and D Daneman. Exercise and type 1 diabetes mellitus in youth; review and recommendations. Pediatr Endocrinol Rev. 2007;5(2):656-65.

Enjoy,

Dr. Behnke

Children's eating habits

This past week I had a conversation with a patient about her child and it got me thinking about ways to get kids to eat well and how important it is to get them into good habits very early, and to teach kids how to be self-sufficient so they are making good choices on their own. The patient I am referring to was just telling me a bit about her son. He is a 9 year old boy who is diagnosed with Autism Spectrum Disorder. He is a very anxious boy, and has constipation so bad and so often that he misses school at least once every couple of weeks due to pain. His texture issues and "pickiness" are not helping his mother to get him a great diet that will help to decrease his symptoms and improve his life, but his issues with food and feelings are contributing to the problem. We discussed at length some ideas on food, but I became worried about her son, the way she described his symptoms, especially with his constipation creating toxicity problems. So I did some brainstorming and looked for something else to help this patient with her son and his diet. I found the website listed below, and spent some time browing through the info and activities. I think the activities would be fun for kids, and there are educational tools all over this website that are tailored to children. There was even a Valentine's Day smoothie recipe this week in the daily recipe section. Check it out and share with your children.
http://www.nutritionexplorations.org/kids/main.asp

Hope this helps those of you struggling to help your children make healthy choices,
Enjoy!
Dr. Behnke

A John Stewart Interview

http://www.thedailyshow.com/watch/mon-january-4-2010/michael-pollan

I recently stumbled upon this interview that John Steward did with author Michael Pollen. I found it very interesting how he relates people's eating habits with lifestyle and how he talks about industry is the greatest factor in our food production with our health being a very small concern. I have not read the book he is discussing in the interview, I just think that he makes a very relevant point when speaking of how the bulk of our foods are produced.

Enjoy!
Dr. Behnke

Introductory Blog

I will use this first blog opportunity to introduce myself and my work. My name is Alison Behnke and I am a Chiropractor. I work in Burnsville, MN and my clinic is called Southview Chiropractic Health and Wellness Center. We offer chiropractic care, massage therapy, acupuncture, exercise and injury rehabilitation therapy, and nutritional therapy.



The nutritional aspect of the clinic is the newest, and the reason that I am new to the blogging experience. I hope to use this tool to benefit the people who read it, whether they are already a part of the Southview community or not. I like to use nutrition to guide my patients into a healthier being. Whether someone feels good or they feel terrible, I consider their nutritional habits to be a very great part of the reasons for a person's health status. Nutrition interests me because to figure out what is missing requires a lot of thought, science and investigation. The more I learn about how nutrition can help people with problems affecting every system in the body, the more I come to realize that it is such a wonderous part of "the big picture." I enjoy teaching patients how and why it will work, and I really love the great results we get when nutritional protocols are added to chiropractic care. Food should be an exciting part of your lifestyle, and it takes a lot of effort to use food as a healing element rather than the reason for the damage being done in the body.

Outside of work, I like to further my education by reading and I have several hobbies that keep me outdoors. I have always been a resident of Minnesota, and I couldn't imagine living somewhere that couldn't provide me with 4 seasons each year. I love cross country skiing, being on the lakes, mountain biking, playing softball and spending time laughing with family and friends.

Enjoy!
Dr. Behnke