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Processed Food Increases Risk of Depression: This report is based on data from a long-running cohort study of middle-aged civil servants. An analysis found that eating processed foods was associated with depression five years later, even after other social and health factors were taken into account. What were the basic results? People with the highest intake of whole foods were less likely to have depression. This was the case even after all the factors that may have influenced this link were taken into account. This study suggests that a healthier diet protects against depression. NHS Choices

Pistachios Deter Obesity and Diabetes: Researchers are parading pistachios as a way to moderate sugar consumption. Pistachios are one of the healthiest nuts for weight management with about 170 calories and 13 grams of fat per ounce. New research shows that a daily dose of pistachios may offer protective benefits against cardiovascular disease, according to a study. "These results are exciting because the research indicates that adding pistachios to the daily diet can help protect the heart without a dramatic dietary lifestyle change," said Dr. James Cooper. "This research challenges the previously-held belief that a low-fat diet is best for heart health. Studies now show that a diet with a moderate amount of healthful monounsaturated fat, like the kind found in pistachios, is a more effective way to prevent heart disease than reducing overall fat intake." The Journal of the American College of Nutrition. Volume 26, Number 2 issue

Fitness Levels Drop More Rapidly after Age 45 Years: Fitness levels drop more rapidly after age 45 years, especially in men, according to the results of a study. However, exercise, maintaining a healthy body mass index (BMI), and not smoking were associated with better fitness levels and cardiovascular health. Andrew S. Jackson, PED, from the University of Houston writes, "The U.S. population is aging and is becoming more obese and sedentary ... and it is well-documented that the cardiorespiratory fitness (CRF) of men and women declines with age and that body composition and habitual physical activity are related to CRF.... Low CRF levels increase the risk of diseases and interfere with older adults' ability to function independently." "These data indicate the need for physicians to recommend to their patients the necessity to maintain their weight, engage in regular aerobic exercise and abstain from smoking," the study authors conclude. Archives of Internal Medicine. October 26, 2009

People in Developing Countries Pay More for Diabetes Care and Have Poorer Health Results: Type 2 diabetes is often seen as a condition affecting older, unproductive adults in wealthy countries. However, the reality is that 70% of people with diabetes now live in low and middle-income countries and the economic impact of diabetes is much greater in poorer countries. Yet the majority of the spending, 90% of all medical expenditures for diabetes care, is made in the United States, Canada, the countries of Western Europe, and other wealthy countries. This is the conclusion of the most comprehensive investigation of the economic impact of diabetes ever to be conducted in low and-middle-income countries. International Diabetes Federation 2009

Scientists have identified a master regulator gene for early embryonic development of the pancreas and other organs, putting researchers closer to coaxing stem cells into pancreatic cells as a possible cure for Type 1 diabetes. Besides having important implications in diabetes research, the study offers new insights into congenital birth defects involving the pancreas and biliary system by concluding both organs share a common cellular ancestry in the early mouse embryo. See This Week's Item 1

New Diabetes Drug May Work Better than Byetta: Roche announced last week that its GLP-1 drug, taspoglutide (which is still in phase 3 trials), worked better than Byetta in lowering blood sugar, according to the results of a late stage study. The study marks a small step on the way to possible approval of the drug, for which Roche has seven additional trials underway. After 24 weeks of treatment, patients who had been given taspoglutide experienced a bigger decline in their blood sugar than those who had been given Byetta. Results to be published shortly in a major diabetes journal.

Updated 2009 Diabetes Prevalence in the United States: The prevalence of diabetes in the U.S. was 13.7% among men and 11.9% among women 30 years or older. Age-standardized diabetes prevalence was highest in Mississippi, West Virginia, Louisiana, Texas, South Carolina, Alabama, and Georgia (15.8 to 16.6% for men and 12.4 to 14.8% for women). Vermont, Minnesota, Montana, and Colorado had the lowest prevalence (11.0 to 12.2% for men and 7.3 to 8.4% for women). Men in all states had higher diabetes prevalence than women. The absolute prevalence of undiagnosed diabetes, as a percent of total population, was highest in New Mexico, Texas, Florida, and California (3.5 to 3.7 percentage points) and lowest in Montana, Oklahoma, Oregon, Alaska, Vermont, Utah, Washington, and Hawaii (2.1 to 3 percentage points). See This Week's Item #9.

Exercise Can Make You Smarter: Research from the University of Illinois shows that moderate exercise, such as a fairly intense walk, can make you smarter. Studies involving people who worked out for just 30 minutes found it could help make them 10 percent brainier. The immediate cognitive effects can last a few hours. Other ongoing research suggests that regular exercise has long term effects on the brain. It seems to increase the frontal lobes, helps form connections and may even prevent Alzheimer's.

One-third to one-half of primary care physicians don't recommend weight management to their overweight or obese patients. This comes from a new survey from the Joslin Diabetes Center. They don't believe patients are motivated enough or they think it will be too costly, as health care insurers don't typically cover the cost of weight loss programs. Studies also find that despite initial weight loss success, people typically regain the weight and only 25 percent can maintain the weight loss for a year after treatment. Joslin Diabetes Center

Comparison of Physician Workforce Estimates and Supply Projections: Estimates of physician supply in the United States have been based on data that may overestimate the number of older physicians in the workforce. Comparing physician workforce estimates and supply projections using the American Medical Association Physician Masterfile data, along with estimates and projections using data from the US Census Bureau Current Population Survey(CPS), it was found that the estimates using the CPS data found more young physicians entering the workforce and fewer older physicians remaining active, resulting in estimates of a smaller and younger physician workforce now and in the future. JAMA. 2009;302(15):1674-1680

FDA Defers Liraglutide Until Fourth Quarter: Novo Nordisk, said on Sept. 23, that the formal feedback from the U.S. Food and Drug Administration has been deferred until the fourth quarter for liraglutide, a once-daily treatment for Type 2 diabetes. "Novo Nordisk continues the constructive dialog with the FDA regarding the regulatory process for liraglutide," the company said in a statement. Novo Nordisk submitted a new-drug application for liraglutide to the FDA on May 23, 2008, and submitted the drug for clearance in Japan on July 14, 2008. On July 3, 2009, Novo Nordisk was cleared to market liraglutide in Europe under the brand name Victoza and has launched the medication there.

More Money Spent on Diabetes Meds than on Any Other Condition: The Diabetes UK Center claimed that the increase was being pushed up by younger people developing Type 2 diabetes and being prescribed insulin to manage their condition. A spokeswoman for the center stated that, "Type 2 is increasing in younger people, and because it is a progressive disease people are needing an increasing number of interventions as time goes by." People with diabetes often take a combination of drugs to treat their condition. The co-morbidities of diabetes mean that it is not only vital to lower blood glucose levels through insulin or tablets, but also to prevent and treat complications. This may mean people have to take blood pressure control medication and drugs to lower cholesterol, for example, alongside blood glucose lowering agents. Diabetes UK

First Ever Guidelines Issued for Management of Diabetes in Pregnancy: Also the first ever guidelines on the use of self-monitoring of blood glucose for Type 2 patients not on insulin. Learn more in this week's Item #2.

Cinnamon for Type 2 diabetes works for some. To determine whether cinnamon lowers HbA1c in patients with Type 2 diabetes, researchers performed a randomized, controlled trial of 109 Type 2 diabetic (HbA1c >7.0) pediatric, adult, and geriatric patients. Control was usual care with management changes by their primary care physician and intervention was usual care with management changes plus cinnamon capsules, 1g daily for 90 days. The researcher concluded, "Taking cinnamon could be useful for lowering serum HbA1c in Type 2 diabetics with HbA1c >7.0 in addition to usual care." For the full abstract, click here (http://www.jabfm.org/cgi/content/abstract/22/5/507).

If Mom Works, Kids' Lifestyle Less Healthy: Children of working mothers may be less likely to lead a healthy lifestyle, researchers said. British kids whose mothers worked part- or full-time were more likely to have bad diet and exercise habits than those whose moms stayed at home. Compared with children whose mothers did not work outside the home, kids whose mothers worked full time were more likely to drink sugary beverages between meals, watch TV or use the computer at least two hours a day, and be driven to school rather than walking or biking, the researchers found. Similarly, those whose mothers worked part time, defined as 20 hours a week or less, were also more likely to go for sugary drinks, occupy themselves in front of a video monitor, and be driven to school. Sherburne Hawkins S, et al "Examining the relationship between maternal employment and health behaviors in five-year-old British children" J Epidemiol Community Health 2009; DOI: 10.1136/jech.2008.084590.

Mediterranean Diet May Be Best for Type 2 Diabetes. Reduced need for meds, helped some lose weight compared to low-fat diet. The Mediterranean diet, long touted as a healthy eating plan, may help people with Type 2 diabetes stay off blood sugar-lowering medications, as well as help them lose weight and lower cardiovascular risk factors. Researchers found that while 70 percent of people with Type 2 diabetes following a low-fat diet eventually needed diabetes medications, just 44 percent of those following the Mediterranean diet needed such drugs. See This Week's Item #14.

B12 Deficiency in Diabetes: Although metformin use and advanced age are associated with vitamin B12 deficiency and often present in Type 2 diabetic patients, the prevalence of vitamin B12 deficiency in the diabetic population is unknown. So in a cross sectional study of 203 outpatient Type 2’s they looked at B12 deficiencies. The results found a 22% prevalence of metabolically confirmed B12 deficiency in the primary care Type 2 diabetic population. Although further research needs to be performed to determine the clinical implications of the findings, B12 deficiency should be considered in Type 2 diabetic patients, especially those taking metformin. Furthermore, a daily multivitamin may protect against B12 deficiency. The Journal of the American Board of Family Medicine September-October 2009 22 (5): 528-534 (2009) Abstract.

Researchers Unlock the Secret to Aging. A team of researchers has discovered they can extend the lives of mice by genetic manipulation, which mimics the health benefits of a low-calorie diet. Researchers have known for a while that consuming less calories may extend lifespan in some animals, however they have yet to figure out why. In this new research, released in the Oct. 2 issue of Science, scientists genetically manipulated mice and primates to block production of a protein that controls the body's response to food intake without actually decreasing consumption. Knocking out the S6K1 gene only changed longevity in female mice; the reasons for that are not fully understood from the study. The research also offered a potential genetic drug target for protecting against aging-related diseases, they said. "What we have shown is that this gene is one that regulates life span and also determines how healthy animals are in middle and late age," said Dominic Withers of the Center for Diabetes and Endocrinology at University College London. The results of this new study have coincided with those of other recent studies, which have given evidence that cutting back the calorie intake in rats, mice, or more recently, primates, leads to an increase in their life span by 40 percent.

Metformin appears to reduce the risk for pancreatic cancer in patients with diabetes, whereas insulin therapy appears to increase the risk, according to the results of a large case-control study. See This Week's Item #8 (http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=8293&catid=1&Itemid=8).

Long known for its antioxidants, immune boosting and, most recently, antihypertensive properties, black tea could be used to control diabetes, according to a study. Next to water, tea is the second most consumed beverage in the world. Researchers studied the polysaccharide levels of green, oolong and black teas and whether they could be used to treat diabetes. Polysaccharides, a type of carbohydrate that includes starch and cellulose, may benefit people with diabetes because they help retard absorption of glucose. The researchers found that of the three teas, the polysaccharides in black tea had the most glucose-inhibiting properties. The black tea polysaccharides also showed the highest scavenging effect on free radicals, which are involved in the onset of diseases such as cancer and rheumatoid arthritis. Journal of Food Science, July 2009

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