Controlling Fat Effects Your Liver

Having too much liver fat is known as nonalcoholic fatty liver disease. The researchers report online in the journal Proceedings of the National Academy of Sciences (Early Edition) that when fat collects in the liver, people experience serious metabolic problems such as insulin resistance, which affects the body's ability to metabolize sugar. They also have increases in production of fat particles in the liver that are secreted into the bloodstream and increase the level of triglycerides.


"We don't know exactly why some fats, particularly triglycerides, will accumulate inside the liver and muscle in some people but not in others," says first author Elisa Fabbrini, M.D., Ph.D., assistant professor of medicine. "But our data suggest that a protein called CD36, which controls the transport of fatty acids from the bloodstream into different tissues, is involved."


Senior Investigator, Samuel Klein, M.D., says those who are obese but don't have high levels of fat in the liver should be encouraged to lose weight, but those with elevated liver fat are at particularly high risk for heart disease and diabetes. He says they need to be treated aggressively to help them lose weight because dropping pounds can make a big difference.
"Fatty liver disease is completely reversible," he says. "If you lose a small amount of weight, you can markedly reduce the fat content in your liver. 


Summary from article: Fat in the Liver, ScienceDaliy.com, Aug 25, 2009


Other related articles: 
http://www.sciencedaily.com/releases/2011/04/110406102135.htm      http://www.sciencedaily.com/releases/2009/08/090824151304.htm

Growing A Garden

This year as we tilled up our small garden area, my husband asked what vegetables are 'safe' (anti-inflammatory) for me to eat. I responded by saying let's plant vegetables everyone can eat. His favorite are fresh tomatoes, mine is zucchini. Our kids and grandkids will eat everything! What a delight to be able to offer them a few fresh options.

         

So often in the city, children do not get to experience growing their own food. They get used to convenience foods as they get rushed here and there for activities or errands. As I watch my daughter prepare to take her kids to the park (or any outing), she always takes along healthy snacks and drinks for everyone. It seems so natural for her to do - and it just amazes me. She works hard to integrate all the food groups into her children's lives and she is mindful of what I can and cannot eat. 


This year we hope to involve the grandkids in caring for our garden. When the time comes to harvest, I will enjoy the look on their faces as they squish into a bright red sweet cherry tomato! You can imagine that freshness, can't you?


One step at a time, we can pass down the tradition of eating a variety of nutritious, FRESH foods that help our bodies grow, develop and THRIVE. My motivation is to build a foundation for these little ones now in their early years, so they won't have to suffer serious health issues in their lifetime. If by chance they do, at least they will understand the importance of having fresh foods in their diets.


Hope you have the chance to plant some vegetables or herbs where you live. Potted plants can thrive quite well too with adequate water and care. Blessings to you and your family. Take care!

Healthy Meal Planners

So many people with diabetes have trouble knowing how many carbs to eat, which food categories to choose them from and how to keep track of them. Why is this important? Because carbohydrates have the greatest impact on raising or stabilizing our blood sugars. Too much (or too little) sugar in the blood creates huge risks for diabetics. 

I was pretty excited when I found an online guide for a Type 2 Diabetes Meal Planner* (click here). This 2 page* planner shows 1,200 - 2,500 calorie plans with a defined number of exchanges for starches, fruits, milk, vegetables, meat (substitutes), and fats. It also has an extended food list for substitutions. Since I have followed a Weight Watcher plan in the past, food exchanges and substitutions make sense to me. Using the 1500 calorie diet*, I copied the basic guideline into an Excel document and added space for my own choices. (Sorry for the misalignment of the lines - it just won't format correctly in the posting section.)

1500 CALORIE DIABETIC MEAL PLANNER

1200 Calorie                                         1500 Calorie

 Exchanges        SAMPLE MENU      Adjustments          Write Down Your Food Choices

                                                                     (Per Page 1*)                     (Use Page 2* for Food Substitutions)

                                                               

BREAKFAST

1 Starch               1/2 English Muffin     Add 1 Starch     _____________________________

1 Fruit                  1/2 (med) Banana                                _____________________________

1 Milk                  1 pkg Hot Cocoa                                 _____________________________

LUNCH

1 Starch                1 oz Tortilla (6")       Add 1 Starch     _____________________________

2 Meat                  1 oz Chicken                                      _____________________________

                             1 oz Cheese                                        _____________________________

1 Vegetable          1/2 cup Green Beans                          _____________________________

1 Fruit                   2" raw Apple                                     _____________________________

1 Fat                     2 Tbsp Lite Ranch Dressing              _____________________________

SNACK

Nothing                (Unless you save an item from lunch)      

DINNER

2 Starches             1/3 cup Rice            Add 1 Fat          _____________________________

                             1 oz Corn Chips                                _____________________________

2 Meat                  2 oz Ground Chicken                        _____________________________

1 Vegetable          Chopped Onion                                 _____________________________

1 Fruit                   1/2 cup Canned Fruit                        _____________________________

2 Fat                     2 tsp olive oil or butter                      _____________________________

SNACK

1 Starch                 3 cups Lite Popcorn                         _____________________________

1 Milk                   8 oz Low-Fat Rice Milk                   _____________________________

GOAL:          Starches: 7        Fruits: 3      Milk: 2       Meats: 4       Vegetables: 2       Fats: 4

YOUR

DAILY          Starches: ___   Fruits: ___   Milk: ___   Meats: ___   Vegetables: ___   Fats: ___

TOTALS

Nutrition is such a complex science. Carbohydrates are found in grains, nuts, fruits, milks and even vegetables. Simple and complex carbohydrates along with fiber play a key role in the management of diabetes. Understanding how to break down the carb count into the various food categories is one thing. Deciphering endless nutrititional information along with controversial food theories of researchers and physicians is quite another. Diabetics must coordinate their food choices along with their insulin dosage or glucose-lowering medications to best stabilize their blood sugars. It's a confusing mess that can leave one with glucose readings which are either too high or too low, and thereby we end up feeling like a failure for getting results which are less than what we strived for. Sometimes we just want to throw up our hands in defeat and hopelessness.

My online research proved difficult in finding a diabetic meal planner with nutritional exchanges. I found this online guide at the Huntsville Pediatric & Adult Medicine Associates webpage. The reviews for this clinic were favorable to outstanding, so I was hopeful this would become a valued guide and useful tool.  

The American Diabetes Association website offers no meal planners or breakdown of food exchanges for carbohydrates. It does define a carbohydrate exchange as 15 grams. The ADA recommends each meal contain 3-4 carb exchanges in the range of 45-60 grams but also says this varies from person to person. The conversion of grams to calories is 1 gram equals 4 calories*. By this general recommendation we would consume somewhere around 180 to 240 calories of carbohydrate per meal. Snacks are suggested to be 4 exchanges or 60 grams of carbohydrate equaling 240 calories.  Taking  into account the 1500 calorie diet would provide 13-16 carbohydrate exchanges equaling 195-240 grams or 780-960 calories.  The carbohydrate servings would make up 52.0-64.0% of the total diet.

My calculation of the "online planner" shows that the 1500 calorie diet includes 12 exchanges of carbohydrate (at 15 grams per exchange) which totals 180 grams or 720 calories, resulting in a percentage of 40.8% of the overall diet. I will check with my nutritionist to see whether I should increase the number of carb exchanges in this planner, and if so, in which of the food exchange categories would this addition be the most beneficial to my health and well-being.

It took a lot of research to get to this point. I'm tired - and perhaps you are too. But if you are a diabetic, I hope this provides some valuable information to you! Thanks for checking in today. Take good care of yourself and keep track of your eating habits and log them in a journal to share with your healthcare provider. Tracking your exchanges gives insight and opportunity to make educated changes.

Finding the Right Healthcare Professionals For You

                 

I am so fortunate. For the 35 years I've been dealing with complicated health issues, I've had my good share of what I consider to be great medical practitioners. I'm not going to say all of them have been good. But when I come across a physician with whom I do not 'connect', I don't hesitate - I look for another.  I value my health too much to waste time, energy and money on someone who could care less about who I am and all the health issues I deal with on a daily basis.

Over the last 5 years I have been so blessed to receive excellent care from wonderful healthcare professionals. After a devastating 4th hip replacement revision surgery which resulted in paralysis of my right leg from femoral nerve damage, my PCP stepped up to the plate when my orthopedic surgeon denied any assistance. 

My PCP referred me to a neurological physical therapist trained in rehabilitative medicine. We worked together on gaining mobility of my paralyzed leg over a 16 month period. Her devotion, knowledge and willingness to 'think outside the box' in treatment options were invaluable. My PCP offered care for my whole person, including mental, physical and emotional support. She worked with me on diet, supplements, medications, mental health options, and developing a good support system. She taught me how to be proactive in defining my choices in healthcare options. I will be eternally grateful for all of her care and wisdom. I also had excellent alternative care providers, the best of which was the intuitive and trusted hands of my shiatsu masseuse.

I have since switched insurance companies and am currently under the services of a large HMO provider system. I expected to be disappointed in their care and lost in their system. Thankfully I've been proven wrong in my basic assumption. I have one of the best PCP's I've ever had. She is easy to talk to, understands the many complications of my health, and offers me shared decision-making in determining my care. She trusts me to make wise choices about how I care for my body every day, and that's RARE for a healthcare physician in this day and age!  I trust her to advise me in the best treatments available to me. I have not had the same experience with all of the specialists I have been referred to in this system. However the availability of electronic medical records in an HMO system does offer other providers a chance to look into the history and results of a patient's medical record which can be a useful tool for further investigations.

Selfishly I miss the integrated team approach of the physicians and healthcare professionals I had with my previous PPO insurance. I had my PCP, a pharmacist, a physical therapist, multiple specialists (for diabetes, fibromyalgia, neurology, orthopedics, etc.) that comprised my healthcare team. I would meet together with several of them once a year to address options and concerns for integrating my care. I realize this was in a teaching university environment  where they look to teach medical students the effects of integrated medicine.  However it was invaluable to me as a patient knowing that all areas of my health were being looked at and addressed as a complete being.  

Now the decision-making responsibility sits wholly upon the shoulders of my PCP in the HMO system. My care is only as good as my PCP, and as I've said, I have a great doctor that I trust. I choose to be responsible for following up with her and my other specialists, knowing that things do and will fall through the cracks without my proactive approach and education. 

I hope you too take your health seriously enough to be accountable for finding the best physician and healthcare providers to give you the services you need. Another concern for me is to reach out to multiple social network arenas to share information and support with  people who have similar health concerns to mine. This is a time of vast expansion on the internet and discernment is really critical. I value my research skills and the multiple reviews available online to help me question and learn more about health issues.  Especially when patient's don't feel well or are overwhelmed by multiple issues, it can be difficult to think clearly. Sometimes "miracle" cures look pretty tempting. It's good to have a reality check with others who understand the "nature of the beast"(the illness) and can offer another perspective.

Thanks for visiting today. If you have any comments or insights, I'd sure love to hear them. Have the best day you can. Blessings to you and your loved ones.

The Progression of Inflammation - How Did This Happen To Me?

I am learning a lot about the inflammatory process in our bodies. Throughout our life unseen things shape our health. As most people age, they usually progress through three distinct phases of health. To succeed in healthful living, it is essential to understand this progression.

[Level 1 is a non-inflammation, non-insulin resistant state. Our body is able to maintain homeostasis, a stable equilibrium, where our metabolism adjusts itself to maintain a steady weight and fights diseases automatically. We look and feel good. This is the optimal phase we would all like to live in.

But the reality is we encounter infections and eat the wrong foods, we lose our ability to maintain a healthy balance. Infections occur which increase inflammation. Also when we eat high levels of sugars or "bad fats", what we often call our "comfort foods", inflammation increases even further.

Each time we become inflamed, we struggle to get back to normal. But sometimes, we don't quite go all the way back. Our body "remembers" our infection and increases its "ready reserve" of inflammatory cytokines, (proteins released by cells of the immune system) and thus keeps our immune system on the edge. Unfortunately, while being constantly ready for the next infection, our body experiences the wear and tear interfering with many of our metabolic systems. Gradually, we move into Level 2, which is chronic low-level inflammation and insulin resistance. 

Level 2 involves a powerful chain reaction. Infection produces inflammation. Inflammation produces insulin resistance. Insulin resistance produces weight gain. Weight gain produces inflammatory cytokines leading to more insulin resistance.

Insulin resistance starves our muscles. They react by sending messages that lower our resting energy. Then, the insulin resistance makes us hungry in an effort to feed our starving muscles. Under these conditions, weight loss is almost impossible. We look "fat" to others, but our muscles "think" we're starving... at least chemically. As a result of this starvation, we crave and finally eat more sugars, fast-burning "high glycemic load" starches and saturated fats. These nutrient-poor foods add to our disease. Eating them is preventing or slowing weight loss in spite of our dieting efforts.

As these conditions worsen, we finally begin to show signs of diseases at Level 3 -- cardiovascular diseases, diabetes,hypertension, Alzheimer's, arthritis, stroke, cancer...  It's a big list.]


Can we stop this unhealthy cycle?


You betcha! [Reverse the inflammation caused by the high sugar, high fat, low fiber foods by eating colorful high fiber vegetables like sweet peppers, kale, parsley, celery, raw carrots, radishes, onions, garlic, cabbage, broccoli, cauliflower, squash, cucumber, apples, pears, berries, nuts, plums, grapes, bananas, citrus fruits and so on. Fatty animal products like red meats and dairy are minimized. Lean cuts of chicken, turkey and fish are encouraged. Olive oils and avocado replace other unhealthy oils from corn, soybeans, safflower, and sunflower or other vegetable oils.


People on this anti-inflammatory diet tend to normalize their weight and reverse their heart disease and diabetes, and improve risks for cancer or heart attacks. Arthritis and Alzheimer's symptoms improve as well]. If you want to know more about anti-inflammatory foods go to level1diet.com.