Q: I have been identified with Kind 2 diabetes. What’s extra essential, dropping pounds (I am 40 kilos chubby) or getting my blood sugar stage right down to regular? — Chaz R., Fort Price, Texas
A: Nice query and one which researchers have been specializing in just lately. That is as a result of the emphasis on getting blood sugar ranges down, which has been the tenet of therapy for Kind 2 diabetes for the reason that Eighties, seems to not be an efficient technique to reverse the illness — and it’s reversible!
Doctor-researchers now advocate that you just deal with weight problems first and glucose management second so you may ship Kind 2 diabetes into sustained remission, not simply reduce its injury to your coronary heart, nerves, digestion, eyesight, psychological well being and extra. That is the message in a brand new examine in The Lancet that exhibits dropping 15% or extra of your physique weight can have a profound disease-modifying impact — easing obesity-triggered insulin resistance and beta-cell dysfunction (they make insulin).
The researchers do acknowledge that it is onerous to shed pounds and preserve it off. The very best approaches are:
— Reshaping your food regimen to scale back your calorie consumption when you remove inflammatory meals (purple meat, added sugars, ultraprocessed meals) that change how your physique shops fats.
— Bariatric surgical procedure, resembling gastric bypass. It is extremely efficient in inflicting weight reduction that places diabetes into remission — for 70% of sufferers in line with one Danish examine.
— New weight-loss drugs (they could additionally decrease glucose ranges) — some can be found, some coming down the pike. One instance: A examine discovered that 12 weeks of therapy with FDA-approved semaglutide results in round 11 kilos of weight reduction, largely fats. Different meds, resembling AM833, nonetheless in scientific trials, helped examine individuals lose 11% of their physique weight, partly by slowing motion of meals by way of the intestines.
So discuss to your diabetes doc about one of the simplest ways to start out a weight-loss program, and talk about whether or not bariatric surgical procedure or weight-loss drugs are a good suggestion. Glucose management will comply with.
Q: My doc has me on a low-sodium food regimen. What are the advantages? — Kim R., Albany, N.Y.
A: Historically, a low-salt food regimen has been prescribed to people with hypertension, coronary heart illness and fluid retention. That is as a result of it might probably improve the quantity of blood in your veins — upping strain inside your arteries and rising your danger of coronary heart assault, stroke and mind fog.
For folk with out identified cardiovascular points, elevated LDL ldl cholesterol or hypertension, salt should be a no-no, as a result of they’re salt delicate. Which means they’ve a genetic predisposition that makes salt pump up their blood strain by 5 factors or extra in the event that they change from a low salt to a excessive salt food regimen — and even a little bit of salt may cause cardio woes.
As for the remainder of you, chances are high you are still overdosing your self with salt that is added to deli meats, tacos, pizzas, canned soups, sauces, chips, snacks and sweets. Round 90% of Individuals over the age of two soak up an excessive amount of salt — on common about 3,400 milligrams of sodium per day. The advisable quantity? Lower than 2,300 milligrams day by day — about 1 teaspoon of desk salt.
Why does that matter? Even when further salt does not increase your blood strain, a brand new lab examine exhibits it might disrupt your inside physique clock (circadian rhythm). That ups the danger for metabolic syndrome, irritation, temper issues, most cancers and even untimely demise. It does that by affecting receptors that play a key function in managing sodium all through your physique — and those self same forms of receptors are in your mind, the place they assist synchronize all of your physique clocks. Mess with one, you mess with the opposite.
The easiest way to decrease your salt consumption: Ditch ultraprocessed meals, processed meats and snacks. Prepare dinner at dwelling utilizing herbs (parsley, coriander, mint, basil) and spices (every part from chili peppers to turmeric, cinnamon and fennel seed) to carry advanced satisfying flavors to your meals.
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