March 30, 2019 : Issue #983

• Low Carb Or Low Fat Diet To Lose Weight?
• Sedentary Behavior During Pregnancy and Neonatal Adiposity
• Statins And The Risk of Developing Diabetes

In the last couple of weeks I have been bombarded by ads from CE companies on weight loss programs. Intermittent fasting, keto, low fat, high fat, low carb, low calorie and more. Seems like every “expert” has positive proof that their method works. And you know what, they are all probably right.

This week our UC Denver PharmD candidate Dahlia Elimairi has an article that points to the theory that any program will work if your patient will just follow it. Check what the data really shows by clicking here.

This is a simple risk test for you to use in your office for every patient. You can use a tablet and have your patients fill it out online or use the printed test available below. If they get 5 or more on the test, then you will probably want to order an A1c test (prediabetes = A1c of 5.7-6.4%) or a glucose tolerance test to confirm the diagnosis of prediabetes. 

The American Diabetes Association (ADA) launched its first risk test in 1993. The risk test was adapted by a published study and validated using data from the Centers for Disease Control and Prevention (CDC). When developing the test, researchers looked for specific characteristics that made a person more likely than average to have undiagnosed type 2 diabetes. To make the tool as easy to use as possible, they only considered health characteristics that people would know about themselves without needing a blood test or other medical evaluation—such as age, height, and weight, but not including blood glucose or cholesterol levels. A high score on the online risk test (5 or higher) means an individual has a significant risk for having undiagnosed prediabetes or type 2 diabetes; however, only a blood test can determine a diagnosis. For the online test, go to    https://doihaveprediabetes.org or just print out the Prediabetes Form in English or Spanish: Prediabetes Risk Test in English(pdf) or Spanish(pdf).

Study provides some answers to ongoing debate about which diet causes most weight loss.

Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity.

Recent studies have shown that statins can raise blood sugar and more patients on statin therapy were diagnosed with diabetes mellitus.

Professional opinions vary about whether eggs are good or bad for you, with some experts saying they are OK even though they are high in cholesterol, while others say you should eat them sparingly. For your patients, it can be very confusing. We know that egg yolks contain cholesterol, a substance also found in shellfish, dairy foods, and red meat that can clog the arteries and raise your risk of heart attack and stroke. A large egg contains about 187 milligrams (mg) of cholesterol. In 2016, U.S. Dietary Guidelines for dietary cholesterol changed — from no more than 300 mg per day, 200 mg for those at high risk of heart disease — to no specific recommendation, and egg consumption in the United States went up. In the current study, after accounting for total cholesterol intake, the harm from eggs disappeared. Simply put, it’s not the eggs that kill you, it’s the cholesterol in the eggs that kills you. So why are we talking about eggs? If the culprit here is cholesterol, then why not talk about all foods that are high in cholesterol? This new analysis included data from six large studies involving nearly 30,000 people over an average of more than 17 years. The researchers found that people who ate two eggs per day had a 27 percent higher risk of heart disease, and each additional 300 mg of dietary cholesterol per day resulted in a 17 percent increased risk for heart disease and an 18 percent higher risk of early death from any cause. It makes good sense that low to moderate egg consumption, no more than an egg per day, is now thought to be fine for most people, as long as it is part of a healthy-heart diet that includes fruits, vegetables, whole grains, seeds, and nuts. It was concluded that among U.S. adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner. These results should be considered in the development of dietary guidelines and updates.

References:

Zhong VW, Van Horn L, Cornelis MC, et al. Associations of dietary cholesterol or egg consumption with incident cardiovascular disease and mortality. https://www.medscape.com/medline/abstract/30874756. JAMA. 2019;321:1081-1095.

Qin C, Lv J, Guo Y, et al; China Kadoorie Biobank Collaborative Group. Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults. Heart. 2018;104:1756-1763.

Quote of the Week!

“Age wrinkles the body. Quitting wrinkles the soul.”

…Douglas MacArthur

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:

Dahlia Elimairi, Pharm D Student, UC Denver Skaggs School of Pharmacy

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