Sunday, June 28, 2009

Artificial Sweeteners and Incidence of Diabetes

This just out. I thought this was quite interesting. When we researched ketogenic low-carb diets in the lab, whenever we'd let someone have an "artificially-sweetened" product, it would knock them out of ketosis.This indicates that the body was recognizing the "carb-free" product as an actual carb.

I'll comment more on this later this week.

Happy Weekend!

From Medscape Medical News
ENDO 2009: Use of Artificial Sweeteners Linked to 2-Fold Increase in Diabetes

Crina Frincu-Mallos, PhD

June 15, 2009 (Washington, DC) — People who use artificial sweeteners are heavier, more likely to have diabetes, and more likely to be insulin-resistant compared with nonusers, according to data presented here during ENDO 2009, the 91st annual meeting of The Endocrine Society.

Results show an inverse association between obesity and diabetes, on one side, and daily total caloric, carbohydrate, and fat intake, on the other side, when comparing artificial sweetener users and control subjects.

First author Kristofer S. Gravenstein, a postbaccalaureate researcher with the Clinical Research Branch at the National Institute of Aging (NIA), National Institutes of Health (NIH), said the association may reflect the increased use of artificial sweeteners by obese and/or diabetic study participants. "This is a cross-section study," Mr. Gravenstein told Medscape Diabetes & Endocrinology, "so there are limitations — we cannot say that artificial sweetener use causes obesity, we can say it is associated with it."

Increased Use vs Increased Glucose Absorption

Artificial sweeteners activate sweet taste receptors in enteroendocrine cells, leading to the release of incretin, which is known to contribute to glucose absorption. Recent epidemiologic studies in Circulation (2008;117:754-761) and Obesity (2008;16:1894-1900) showed an association between diet soda consumption and the development of obesity and metabolic syndrome.

This report tested whether participants in the Baltimore Longitudinal Study of Aging (BLSA), which began in 1958, differ in anthropometric measures, daily caloric intake, and glucose status, separating them into 3 different groups: artificial sweetener users, artificial sweetener nonusers, or controls.

A total of 1257 participants, with a mean age of 64.8 years (range, 21 - 96 years), had data on self-reported 7-day dietary intake, 2-hour oral glucose tolerance test (OGTT), and anthropometric measures. The major artificial sweetener consumed was aspartame, preferred by 66% of BLSA participants, followed by saccharin (13%), sucralose (1.0%), and combinations of the three (21%).

"In our study, we were actually able to isolate what type of sweetener was used at a certain point in time, as we used food diaries, and not food questionnaires," Mr. Gravenstein pointed out.

"When we first did this analysis, we found that people ate more fat before 1983, which is the year [of] a big increase in artificial sweetener consumption in the American population — it was actually when aspartame was approved and diet Coke was introduced," he explained.

As a result, the study further analyzed data from a subset of participants, starting in 1983. Compared with 550 people who did not use artificial sweeteners, the 443 people who did were younger, heavier, and had a higher body mass index (BMI), yet they did not consume more calories from people who did not use artificial sweeteners. Fat, carbohydrate, protein, and total caloric intake were not different between the 2 groups (users vs nonusers).

Furthermore, Mr. Gravenstein noted that people who used artificial sweeteners "were less likely to have a normal OGTT, or they were less likely to be diagnosed as having a normal glucose homeostasis."

In terms of glucose status, the impaired glucose tolerance (IGT), and/or impaired fasting glucose (IFG), the data show that artificial sweetener users "were not different than the prediabetics, ie, they had the same prevalence of prediabetes," he said, adding that "in our population, people who used artificial sweeteners were twice as likely to have diabetes, 8.8% compared to 4.4% for controls."

Analyzing the data further, the investigators focused on a subpopulation, in which fasting insulin values were available from 374 nonusers and 311 artificial sweetener users. The users had a higher fasting glucose levels, higher fasting insulin levels, and a higher measure of insulin resistance, as measured by the homeostasis model assessment, but glycosylated hemoglobin A1C levels were similar between the 2 groups.

Alternative Hypothesis and Clinicians' Role

The researchers suggest an alternative hypothesis, that artificial sweeteners modulate the metabolic rate through enteroendocrine cells, therefore contributing to the development of diabetes and/or obesity. However, this hypothesis needs further testing in longitudinal analysis and intervention studies, said the investigators.

"Also, it could be that artificial sweeteners are causing diabetes, or it could be that there is a higher use of them because a lot of physicians actually recommend people to use artificial sweeteners to prevent diabetes...." Mr. Gravenstein said. The researchers are planning to address this question with a prospective analysis.

"This is a very interesting study," Rachel C. Edelen, MD, a pediatric endocrinology practitioner at the Aspen Centre in Rapid City, South Dakota, told Medscape Diabetes & Endocrinology in an interview. "I diet screen all my patients, and they are not drinking enough milk. Usually, they replace the milk with something else, sweetened tea, Gatorade, etc, not just water. With my type 1 diabetics, the information they were getting from the hospital was to drink diet pop. But who even goes into the hospital and drinks pop?" she wondered.

Support for this study was provided by the Intramural Research Program of the National Institute on Aging of the National Institutes of Health. Dr. Edelen and Mr. Gravenstein have disclosed no relevant financial relationships.

ENDO 2009: The Annual Meeting of the Endocrine Society: Abstract P2-478. Presented June 11, 2009.

Authors and Disclosures

Crina Frincu-Mallos, PhD

Crina Frincu-Mallos is a freelance writer for Medscape Medical News.

Thursday, June 25, 2009

Tiger Balm Neck & Shoulder Rub

I'm so proud to say that after 10 months, my dietetic internship is coming to an end tomorrow. All the while I was doing my dissertation this past year, I also was in this internship. I worked 4-days a week on it since August, and had a lot of great experiences. I'm really glad I did it.

Now though, with more time on my hands, I've started hitting the gym and outdoor sports with a vengeance. In fact, I could hardly get out of bed this morning because my legs were so sore from heavy deadlifts and heavy reverse lunges the other day. But, it's a soreness that I totally love.

My traps and shoulders were also quite fired up, but thankfully, I have Tiger Balm Neck and Shoulder Rub. I rubbed this non-greasy, soothing lotion onto my neck before I went to bed last night and it really helped ease my aches and pains in that area (I think I'm going to use it on my legs tonight too).

If you're someone who lifts heavy like me and enjoys a good feeling of DOMS (delayed on-set muscle soreness), but also appreciates when their muscles are given relief, you should really try this product.

I've been using Tiger Balm products for years and am so happy they've extended their line of products. To learn more about Tiger Balm, visit their website here.

Also, the first 3 people from the U.S. (sorry Canada... shipping is too expensive) who email me at will get a free bottle of this new neck and shoulder rub product.

Make those muscles happy!

Tuesday, June 23, 2009

What the world eats. Quite the difference between countries.

My husband recently returned home from a 9-day business trip to Germany. All the while he was there, he kept telling me: "Nobody here is overweight...What's wrong with Americans?"

Here on the East Coast of the U.S., we have our fair share of overweight and obese people. In fact, when I first moved here from Canada 5 years ago, I was astonished at how large and out of shape people here were! Then I walked into my first grocery store and finally understood. Compared to Canada (at least where I came from in British Columbia), the grocery stores here were packed with more junk food than I'd ever seen in my life. I also couldn't for the life of me find a can of tuna that didn't contain soy because it was packed in vegetable broth, or couldn't find a sprouted grain bread product that didn't contain excess sugar (I've found one now thankfully).

The other difference between my home country and here is the lack of physical activity that people participate in each day. I swear, since moving here, I've driven more in my car in the past 5 years than I have in my whole life! I used to walk to stores, ride my bike or take the bus. There's none of that happening here, that's for sure.

The increased physical activity is also what my husband noticed in Germany and felt attributed to the lack of fatness. Women (beautiful ones he had to tell me...) rode their bikes everywhere wearing dresses or skirts, while the men wore their suits. That was just the way it was.

Here I once tried riding my bike to the gym and to school, but because of the lack of sidewalks or bike paths, I saw my life flash before my eyes as cars tried to use me for target practice. I never did that again.

Daily food choices just are totally different in Germany compared to the US (and yes, I'll admit, parts of Canada), which accounts for a lot of the differences between body composition of the people. My husband absolutely LOVED the HIGH FAT diet of the Germans. Yes, I said high fat. But, the diet wasn't high sugar, which is the difference between here and there. For example, there isn't such as thing as low-fat milk over there. Whereas here, we push low-fat milk like it's supposed to be a calorie-saver. However, the lack of fat leads to lack of satiety. And, there are beneficial fats in milk (like MCTs and CLA), that might actually increase fat oxidation.

Doesn't it seem strange that for the past 40 years, our country has been pushing a low-fat diet and the people have gotten fatter??? When in other countries fat isn't restricted, and the people are leaner? Hmmmm....

Anyways, to prove my point a bit more, have a look at the difference between food intake from families around the world in this slide show from the book "Hungry Planet" by Peter Menzel. This is a slide show portraying a week's worth of food from families across the world.

Pay close attention to the vast difference between each country/family. For example in the US and Mexican families, the fluids are all in plastic bottles (in Germany, the bottles are glass), there's a lot of fast food and processed food, and specifically, from the North Carolina family, there are BARELY any fruits and vegetables in their weekly grocery line-up (but there sure are a lot of potato chips! [don't those count as vegetables?]).

I'd be interested to hear all your thoughts about this and if you think there's something drastically wrong with the way many Americans (and some Canadians) live their lives. Lack of physical movement and poor food choices sure aren't making anyone's waist line smaller.

Monday, June 22, 2009

How to save money on good food - tips for tough times

Times are tough for a lot of people now, including myself. It's not like after finishing a PhD I'm swimming in money... in fact, it's quite the opposite. But, things will turn around soon and at this time I'm learning how to save money on good food everyday. I just thought I'd share with you how I've learned to save money on groceries.

I will be the first to admit that all through college (university for the Canadians), I NEVER sacrificed eating good food. Nope, I wasn't one of those kids eating Mr Noodles (Ramen noodles) soup, or Kraft Mac N'Cheese. Instead, I ensured my fridge and cupboards were full of vegetables, fruit, protein, and whole grain carbs. The same holds true to this day, and even though money is tight, I still won't let my diet fall to the wayside.

When I went grocery shopping, I always looked for sale items, and tried not to buy something if it was overpriced. For example, if I was planning on buying turkey, but chicken was cheaper, I'd make the switch.

I also tried to use coupons when I could. I remember laughing at one of my colleagues for clipping coupons, but now, I look forward to the penny saver section of the newspaper.

Recently, I've discovered "discount grocery stores". And I'm ecstatic! These stores have already save me hundreds of dollars on good food items, without sacrificing quality. One has to be careful though and still read labels, because hidden sugars and trans fats are still lurking in some of their products. For example, this store has it's own "Fit & Active" product line and something they call a "protein bar" is really just a sugary granola bar with 5 grams of soy protein added.... oh my.

At this grocery store though, I can buy fresh fruit, veggies, canned and frozen products, meats, eggs, spices and even paper products for so MUCH LESS than other stores in my area. Here, at Aldi, they reduce costs by not having fancy signage on the shelving, not having some over-paid dietitian tell me to eat a food because it's gluten-free , the basic line of products without all the fluff, no free samples, cashiers that do not bag your items when you check out, and carts that you pay $0.25 to use (but then get back when you're done shopping - which btw, it something they do in Canada and Australia already to help control the flow of grocery carts).

I actually love the idea of bagging my own groceries with re-usable bags from home rather than having someone do it for me. Oftentimes, the people bagging waste bags anyhow, and by bringing my own, I'm preventing over-accumulation in the environment (although, I do recycle those bags when I do get them - or use them to pick up doggy poopies :) ).

Sure, I will admit that the produce here is probably not organic, and sometimes isn't from a 100-mile radius, but, once I can get back to affording those foods, I'll start buying them again. I do look at the labels though and try not to buy things from overseas...rather I ensure it at least came from North America. I also wash my produce well with a natural cleaner to rid it of any possible chemicals. Most people don't even try to buy local or organic anyhow, so why not save money instead?

Overall, this store has been a money-saver for me and my family (pups and husband). I'd encourage you to try and find a store like this in your area.

Also, now that it's summer, plenty of farmer's markets are open along the road side. Sometimes you can find inexpensive local items that taste SOOO good. For example, yesterday on my way home I stopped and picked up a crate of fresh local strawberries (they're in season and so weren't quite cheap), and a bag of fresh picked peas.

Other tips: Look for coupons for items you would buy anyways, stick to the perimeter of your grocery store and choose items on sale, look at sale fliers and plan your grocery trips for great deals, and NEVER shop hungry - you might buy something you'd never usually buy if you do go with a grumbly tummy.

Happy Shopping! Eat well, and live long and healthy.

Best, Cassandra

Saturday, June 13, 2009

Guest post: Why Women Should Lift Weights.

Today's blog post comes from Nicole White at Health Care Administration and is about a topic close to my heart: Weight lifting for women. Thank you Nicole!

Why Women Should Lift Weights

There is a lingering misconception among many women that lifting weights will make them look “masculine” or that a great cardio workout is all they really need to be fit and toned. Neither of these are necessarily true, and women of all ages can take advantage of numerous health benefits by adding a few weight training sessions into their personal workouts. Here are just a few reasons to consider starting your own weight training program:

You’ll look better.
Most women will not gain significant amounts of muscle mass from regular weight training. Even those gifted with an athletic physique generally don’t have enough testosterone to support big, bulging muscles and only stand to gain more strength and toning from weight lifting. Of course, gaining the physique of a highly trained athlete isn’t really so bad compared to risks of being seriously overweight.

You’ll be stronger. Why rely on someone else to do the heavy lifting? With continued weight training you’ll be stronger and more able to take care of your own needs. Even things around the house will be easier, and you’ll be more adept at everything from carting around the kids to carrying in the groceries from the car.

You’ll lose weight faster. Gaining more muscle mass will help you burn your unwanted body fat off more quickly. As your lean muscle mass increases, your resting metabolism increases as well helping you burn more calories throughout the day. This small amount of extra calorie loss can make a big difference over time, helping you reach your goals faster and feel better while doing it.

You’ll improve your sports performance. Whether you love golf, swimming or even just riding your bike around town, weight training can help you do it better. With stronger muscles, you’ll be able to engage in activities for longer periods of time and reduce your risk of serious injuries that can have you on the sidelines for weeks.

You’ll lower your risk of illness and injury. Studies have shown that weight training can have some really great long-term health benefits. From decreasing your risk of osteoporosis to alleviating lower back pain, working out using weights certainly won’t hurt your overall health and may even have you feeling better than you have in years.

Whether you’re in your 20’s or your 60’s it’s always a good time to start weight training and enjoying the benefits of a stronger, healthier you.

This post was contributed by Nicole White, who writes about a masters of health care degree. She welcomes your feedback at

Sunday, June 7, 2009

Stainless steel water bottles to replace plastic

It is WAAYYY too nice for me to be inside working today, but alas I am. I have one last weekend of internship homework to complete before I'm done FOR-EVER! Yay!

I did manage to get in a good, yet short, mountain bike ride this morning, but now I'm back at the grind.

In any matter: in relation to my previous posts about the nastiness of plastic water bottles, there are a few people wondering what they should use instead.

Pictured here is one of my favorite options: Kleen Kanteen water bottles. I have a few of these bottles, so I'm always with protected water. This company is just awesome, not just because they make these stainless steel water bottles, but because they are so eco-friendly and wonderful. Check out this quote for example, from their website:

"In addition to including environmental and fair labor consciousness in our business practices, we partner with local, national, and international organizations to support efforts toward health, clean drinking water, and protecting the environment. In 2008, Klean Kanteen became a member of 1% for the Planet, committing to donation of at least 1% of our annual sales to non-profits working to protect and promote the wellness of this one great Earth."

To ensure your tap water is safe, you can/should invest a bit of your money into a total home purification system. It's not just your drinking water that can be an issue, but the water you shower in can be problematic too. A whole home water filter is your best bet. That way you can ensure all the water in your house is safe

Here's a great article by John Hinds at about home water purification systems:

Another thing you can do to save $$ on your water bills, is to use grey water (or gray water if you're Canadian) in your toilet and to water your lawn, etc. Rather than flushing perfectly good water down the drain, you can use recycled water to do the trick.

Here's an example of a Grey/Gray Water System from

Have wonderful weekend! I'm going back out in the sun after I get a bit more work done! Yay!

Happy Summer! :)

Wednesday, June 3, 2009

Harvard study confirms health risks from BPA leaching

This was posted originally on

Harvard study confirms health risk from BPA leaching

By Mike Stones, 25-May-2009

Critics of the chemical bisphenol A or BPA have received powerful new ammunition in the form of a study from the Harvard School of Public Health (HSPH) which confirmed that the substance can leach from polycarbonate drinking bottles into humans.

The study revealed that participants who drank for a week from polycarbonate bottles and baby bottles showed a two-thirds increase of BPA in their urine.

According to HSPH: “The study is the first to show that drinking from polycarbonate bottles increased the level of urinary BPA, and thus suggests that drinking containers made with BPA release the chemical into the liquid that people drink in sufficient amounts to increase the level of BPA excreted in human urine.”

Cardiovascular disease

BPA, used in the manufacture of polycarbonate and other plastics, has been linked to cardiovascular disease and diabetes in humans and disrupted reproductive development in animals.

The chemical is commonly found in drinking bottles, baby bottles and sipper cups as well as dentistry composites and sealants and in the lining of aluminum food and beverage cans.

Karin B. Michels, associate professor of epidemiology at HSPH and Harvard Medical School and senior author of the study, commented: “We found that drinking cold liquids from polycarbonate bottles for just one week increased urinary BPA levels by more than two-thirds. If you heat those bottles, as is the case with baby bottles, we would expect the levels to be considerably higher. This would be of concern since infants may be particularly susceptible to BPA's endocrine-disrupting potential."

Harvard College students were recruited for the study which was conducted in April 2008. The 77 participants began the study with a week of drinking all cold beverages from stainless steel bottles in order to minimize BPA exposure. They were then given two polycarbonate bottles and asked to drink all cold beverages from the bottles during the next week. Urine samples were provided throughout the trial.

Polycarbonate bottles

The results showed that the participants' urinary BPA concentrations increased 69% after drinking from the polycarbonate bottles,” said HSPH. “Previous studies had found that BPA could leach from polycarbonate bottles into their contents; this study is the first to show a corresponding increase in urinary BPA concentrations in humans.”

BPA levels might have been higher had students drunk hot liquids from the bottles, the researchers note.

Canada banned the use of BPA in polycarbonate baby bottles last year and some polycarbonate bottle manufacturers have voluntarily eliminated BPA from their products.

Further research is needed to explore the effect of BPA on infants and on reproductive disorders and on breast cancer in adults, concluded the study.

The study appears on the website of the journal Environmental Health Perspectives and is available at .

Tuesday, June 2, 2009

More safe water resources

Wow! The responses to my last blog post were great! Some emails, some comments, but overall, so many people are also concerned about safe drinking water.

Remember: water cooler bottles are also #7 plastic... so stay away.

To help understand what kind of water crisis we're really in, and how to make your tap water even safer, I encourage you to visit the following sites:

The Free Water Report

Hunger and Environmental Nutrition Water Task Force

Food and Water Watch Report

Then, for a really great read, all about water, please check out John Hinds book (pictured above): What's in your water? , available on It's rated with nine 5stars and gives you many ways to obtain safe drinking water.

Water: it shouldn't be so dangerous, but it can be, so choose wisely.