Diabetes Can Make Weight-Loss Harder. Here’s Help

Because of the medications, they take, losing weight can be difficult for people with diabetes.

Diabetes medications are a major roadblock to weight loss, according to a paper from the American Association of Diabetes Educators.

“Diabetes medications are vital in helping manage blood sugar, so you shouldn’t stop taking them. Instead, ask (your doctor) about alternative medications and treatment strategies,” co-author Patricia Davidson said in an association news release. She’s an assistant professor at
West Chester University in Pennsylvania.

There are other things that could be holding you back, too. “Everyone needs an individualized strategy for managing diabetes and losing weight. A diabetes educator can help,” said co-author Katherine O’Neal, of the University of Oklahoma College of Pharmacy.

The paper outlines ways for people to manage their diabetes and lose weight. The tips might also help others avoid or delay getting type 2 diabetes, especially those with prediabetes.

Get at least 150 minutes a week (about 22 minutes a day) of physical activity. The more the better, so try to work toward 300 minutes of activity a week (about 43 minutes a day).

This might be easier to achieve if you do things you enjoy, such as dancing at home or at a club, walking the dog, or going for a stroll after dinner. Work activity into your daily routines, such as walking around the grocery store before loading up your cart, parking in the farthest spot when running errands, or sprinting up and down the stairs when doing laundry.

Watch your diet. High-fiber foods can lower your blood sugar, help you lose weight, and decrease the amount of medication you need. Try to get 25 to 30 grams of fiber a day.

At least 10 grams of your daily fiber intake should come from fruits and vegetables. Aim for five servings a day: ideally, one or two fruits and three or four veggies. Whole grains are another important source of fiber.

A food and/or activity tracking mobile app can help keep you motivated. It’s also a good idea to seek online and in-person support groups of people in the same situation.

Weight-loss surgery may be an option, but is typically limited to people who are very obese. It also carries significant risks.

More information

The American Diabetes Association has more on weight loss.

Facebook Posts May Hint at Depression

People may rely on social media such as Facebook to showcase the highlights of their lives, like vacations. But new research suggests the language they use in posts might also help predict depression.

Using sophisticated software, researchers were able to scan social media posts and detect depression months before it was apparent on clinical screening tests.

“Social media has made it possible for people to share a little bit of their daily life with researchers,” said study author Andrew Schwartz, an assistant professor of computer science at Stony Brook University in New York.

“Basically, we used the language people wrote on a daily basis and related it to whether they had a diagnosis of depression,” he explained.

Looking at Facebook posts “was slightly more accurate than standard screening questions in finding depression,” Schwartz said.

So what types of language might reveal someone suffering from depression?

Using first-person pronouns was one of the patterns researchers saw. That means people used “I” or “me” frequently in their social media posts.

Schwartz said people eventually diagnosed with depression often talked about their feelings, physical aches and pains, and being alone.

But he cautioned against trying to diagnose your friends or family based on a couple of social media posts.

“A single post isn’t enough to see depression. We were looking at six months of posts before a diagnosis of depression, so I wouldn’t advocate that people try to judge their friends and family,” he said.

Every year, more than 6 percent of Americans experience depression, the study authors noted. But fewer than half receive treatment for the disorder. These high rates of underdiagnosis or undertreatment suggest that current ways of identifying depression could be improved.

The research team was led by Johannes Eichstaedt, a doctoral student at the University of Pennsylvania.

The investigators accessed the Facebook posts of nearly 700 people who had gone to the emergency department of an academic center, including 114 who had been diagnosed with depression. All consented to sharing their Facebook information and their health records.

The researchers reviewed more than half-a-million Facebook posts to build the depression-detecting software algorithm. They determined the most frequently used words and phrases to identify depression-associated language markers.

Using these language markers, the researchers were able to predict future depression as early as three months before it was documented in medical records.

“Social media gets a lot of negative attention, but there’s a flip side. It could be a very powerful tool for the overburdened mental health industry,” Schwartz said.

The researchers envision this could be a screening tool for clinicians to use to perhaps detect depression sooner. But Schwartz also said more study is needed.

Dr. Alan Geller is a psychiatrist at Gracie Square Hospital in New York City who was not involved with the new study. He said, “Depression is a real problem and preventive treatment is better than having to rescue someone.

“The idea that you could capture someone’s risk on Facebook is engaging. Any sort of technology for mental health — especially because we don’t have tests like labs or imaging and have to rely on what people tell us — could help,” he added.

The study was published online Oct. 15 in the Proceedings of the National Academy of Sciences.

More information

Learn more about depression from the National Alliance on Mental Illness.

5 Salad Killers to Skip

A huge bowl of greens can be filling and chock full of vitamins, minerals and fiber. But what you top it with can turn it from diet delight to diet disaster.

Whether you’re at home or facing a tempting all-you-can-eat salad bar at a restaurant, these tips will keep fat and calories in check.

Creamy dressings can have more than 130 calories per serving, nearly all of them fat — and not the healthiest type of fat, either. Ranch, cheese and mayo-based dressings are all culprits. Instead, a drizzle of vinegar and a spray of olive oil will dress your lettuce with few calories.

Protein can turn salad into a meal, but stay away from fatty meats, bacon and fried chicken or shrimp. Try grilled salmon or chicken instead.

Cheese may be the worst of the salad bar mistakes — mounds of shredded cheese add hundreds of calories. If you want some cheesy taste, sprinkle on a tablespoon of grated Parmesan. Even better, add a few chunks of fresh avocado for its healthy fats and creamy feel.

Croutons and crispy noodles add crunch, but little nutrition and lots of calories. A few nuts and seeds can provide the same type of crunch plus great nutrients. But use a spoon, not a ladle, to add them judiciously because they’re relatively high in calories (due to healthful fats). Just make sure they’re not sugar-glazed or overly salty.

Finally, if you’re ordering a salad from a menu, watch out for the vessel it’s served in. A bread or taco bowl, for instance, is just like eating extra servings of carbs and fat. Enjoy the contents, but not the shell.

More information

Consumer Reports has a great guide for new ways to eat leafy greens.

Gluten-Free Craze a ‘Double-Edged Sword’ for Celiac Patients

The gluten-free diet craze is both reassuring and upsetting to people with celiac disease who are allergic to the nutrient, a small study suggests.

People with celiac disease say they’re happy to have more food choices at stores and restaurants. But some with celiac sense a growing stigma as other people voluntarily go gluten-free. And many patients fear people see them as “high-maintenance” and misunderstand the severity of their disease.

“On the one hand, you have a lot more options available for patients that taste better and are becoming more affordable. But at the same time, you have this gluten-free craze that’s recognized as kind of a fad diet, so celiac disease goes misunderstood in social situations, leaving patients more anxious,” said study author James King.

He’s a graduate student in the department of community health services at the University of Calgary, in Canada.

Celiac is an inherited autoimmune disorder affecting about 1 percent of people in North America. When those who have it consume gluten — a protein found in wheat, rye and barley — their immune system reacts by attacking the small intestine.

And, according to the Celiac Disease Foundation, the disorder has been tied to other serious health problems, including cancer and type 1 diabetes. Avoiding gluten is the only current treatment.

Meanwhile, a gluten-free diet has become a trendy choice for many without celiac disease, either to shed pounds or for other purported health benefits. Some embrace it due to a sensitivity to gluten that creates unpleasant, but not damaging, gastrointestinal symptoms.

For the study, King’s team interviewed 17 celiac disease patients about their experiences in an evolving gluten-free world.

“Just having a prescription of a gluten-free diet for people with celiac disease … doesn’t acknowledge some of the challenges patients face after treatment,” King said.

His team found, for example, that participants were fearful of inadvertently consuming gluten when they eat out. That’s because restaurants may say they are “gluten-free friendly,” but not do enough to avoid cross-contaminating foods. After all, King said, many of their customers simply prefer gluten-free, but they don’t require it.

“Some participants discussed how they sometimes feel high-maintenance or difficult by asking how food is prepared,” he said. “They felt a lot of restaurants nowadays have embraced this business opportunity to have gluten-free options … but are unsure how strict they’re going to be to make it gluten-free.”

Marilyn Geller is chief executive officer of the Celiac Disease Foundation in California and wasn’t involved in the new research. She said the findings reinforce what celiac patients typically report.

“Overwhelmingly, they feel socially stigmatized because of the disease,” she said. “With the push to a gluten-free diet, the disease is no longer taken seriously. If you go into a restaurant now and the server hears you’re gluten-free … they often don’t consider it a medical condition.”

Geller said a drug treatment for celiac disease must be developed to impress its seriousness upon the public. Better training for restaurant workers also might help, she said, but not as much as a medication.

“The real drawback is because there’s not yet a medication — and in America, we equate medications with serious conditions — people are not going to take it seriously,” she said.

King suggested that health care providers point celiac patients to registered dieticians, local support groups and other resources that might help.

The study was published online recently in the Journal of Human Nutrition and Dietetics.

More information

The U.S. National Library of Medicine has more about celiac disease.

5 Strength-Training Mistakes to Avoid

Developing lean muscle mass is important for everyone — it can keep you active and independent throughout your life.

But to maximize the benefits of strength training, make sure you’re not making these common mistakes.

Mistake number 1: Letting momentum drive your workout. If you power through repetitions at a rapid clip, chances are that you’re using momentum rather than controlled muscle movement to do those reps. To get the most out of each rep, take two to three seconds to lift the weight and three to four seconds to return to the starting position.

Mistake number 2: Not moving through a complete range of motion. You’re shortchanging yourself if you’re also rushing through reps without carefully moving from your starting position to a full extension, no matter what the exercise. If you’re unable to do this, chances are you’re lifting too heavy a weight for your current ability.

Mistake number 3: Not lifting enough weight. Some women still incorrectly believe that they’ll develop manly muscle mass if they lift more than a few pounds. But female hormones typically won’t allow that to happen. To get the benefits of strength training, you have to challenge yourself, and that means lifting the most weight you can while still maintaining proper form.

Mistake number 4: Changing your routine too often. This can actually set you back because you’re not giving muscles time to react. Resist jumping to different exercises because you think you’re not seeing results fast enough. Progress is slow and steady. Expect it to take from one to three months to see results, according to the American Council on Exercise.

Mistake number 5: Not changing your routine often enough. On the flip side, not updating your routine enough can keep you from progressing. You might simply need to increase the weight you’re lifting, but it also could be time to move to more complex exercises or switch from free weights to machines.

If you’re unsure about the effectiveness of your current training regimen, schedule a brush-up session with a fitness expert.

More information

The American Council on Exercise has more common exercise mistakes to avoid.

Omega-3s in Seafood May Keep You Healthier, Longer

Tuna, salmon, mackerel, cod: Whatever your preference, eating more seafood may help you stay healthy as you age, new research suggests.

In a study spanning 22 years, researchers found that higher blood levels of the omega-3 fatty acids found in seafood were associated with a better chance of healthy aging.

The study involved more than 2,600 U.S. adults participating in a major study of heart health. Participants averaged 74 years of age at the start of the study.

“Healthy aging” was defined as growing older with good physical and mental function and without major chronic diseases. Only 11 percent of people in the study achieved that goal, noted a team led by Heidi Lai of the School of Nutrition Science and Policy at Tufts University in Boston.

The study wasn’t designed to prove cause and effect. However, after accounting for lifestyle and other factors, Lai’s team found that people with the highest blood levels of seafood-derived omega-3 fatty acids had a 24 percent lower risk of aging in an unhealthy way, compared to those with the lowest levels.

The report was published Oct. 17 in the BMJ.

The beneficial effect of omega-3 fatty acids derived from seafood didn’t seem to fade over the more than two decades of the study, the researchers noted in a journal news release.

The findings “support guidelines for increased dietary consumption of fish among older adults,” Lai’s group concluded.

Two experts in aging and nutrition weren’t surprised by the findings.

“Omega-3 fatty acids are now generally recognized as key nutrients in the prevention of pathological conditions associated to the aging process,” noted Melanie Boehmer, a registered dietitian at Lenox Hill Hospital in New York City.

The nutrients “positively affect risk factors associated with heart disease and have a neuroprotective effect on people suffering from dementia and other age-related mental decline, including Alzheimer’s disease,” Boehmer said. “They also reduce system-wide inflammation and support healthy bones and joints.”

Dr. Maria Torroella Carney directs geriatric medicine at Northwell Health in New Hyde Park, N.Y. She said the new study helps “clarify” a key ingredient in maintaining health with age.

Still, more study is needed to sort out whether “elevated levels of fatty acids [in the blood] are due to diet alone or there is another factor that impacts having higher levels,” Carney said.

In the meantime, Boehmer advised, it can’t hurt to take in more omega-3s.

“Getting them from whole foods, such as wild Alaskan salmon or other oily fish (3.5-ounce serving) at least two times per week is a good start,” Boehmer said. “And if you don’t eat a lot of fatty fish — or fish at all — talk to your friendly neighborhood dietitian about taking an omega-3 supplement.”

More information

The U.S. Office of Disease Prevention and Health Promotion outlines how to protect your health as you age.

AHA: Why It’s So Hard to Quit Smoking

The science behind why it’s so difficult to quit smoking is crystal clear: Nicotine is addictive — reportedly as addictive as cocaine or heroin.

Yet any adult can stroll into a drug store and buy a pack of cigarettes, no questions asked.

“From a scientific standpoint, nicotine is just as hard, or harder, to quit than heroin but people don’t recognize that,” said Dr. Neil Benowitz, a nicotine researcher at the University of California, San Francisco.

Smoking is the world’s leading preventable cause of death. More than 1.1 billion people worldwide smoke, according to the World Health Organization. And more are continually joining the ranks. Every day in the U.S. alone, more than 3,200 youth 18 and younger smoke their first cigarette, while another 2,100 youth and young adults move from smoking occasionally to having a daily habit.

In 1964, the U.S. surgeon general’s famous report, “Smoking and Health,” linked smoking to cancer. Two decades later in 1988, another landmark surgeon general’s report on nicotine addiction declared nicotine to be as addictive as cocaine or heroin.

“Every drug of abuse, including nicotine, releases dopamine, which makes it pleasurable to use,” said Benowitz. “And when you stop smoking, you have a deficiency of dopamine release, which causes a state of dysphoria: you feel anxious or depressed.”

Nicotine also acts as a stimulant, said Benowitz. “It helps people concentrate, and if they don’t have a cigarette, they have trouble focusing.”

The U.S. Food and Drug Administration intends to implement new rules that would reduce the level of nicotine in tobacco products to “minimally addictive” or “non-addictive” levels. It’s not clear when the FDA will issue its new ruling.

Benowitz said he’s “cautiously optimistic” that the FDA will force tobacco companies to make cigarettes non-addictive. “If they did, I think that would really be the end of the cigarette epidemic,” he said.

Meanwhile, debate rages over increasingly popular e-cigarettes, which are marketed as a healthier alternative to traditional cigarettes. E-cigarette vapor doesn’t contain as many toxic chemicals as the smoke from regular cigarettes. However, most e-cigarettes contain nicotine and some deliver dangerous chemicals such as formaldehyde.

Critics of e-cigarettes complain that makers are marketing them to youth by selling them in a variety of kid-friendly flavors, from pizza to cookies-and-cream.

“We still need a lot of studies on all of these chemicals,” Benowitz said. “E-cigarettes may pose some harms we don’t yet know about.”

Many people find they are unable to stop smoking on their own. Benowitz said nicotine patches, nicotine gum and smoking-withdrawal medications are all proven ways to increase a person’s odds of quitting. Support groups and quit lines can also help.

Gary A. Giovino, a nicotine researcher at the State University of New York at Buffalo, said as helpful as medication can be, people who really want to quit smoking also have to be willing to modify their lifestyle.

“People need to focus on behavioral change …, they need the right skills and knowledge and social support. They need a plan,” said Giovino, a professor and chair of his school’s Department of Community Health and Health Behavior, who quit smoking 40 years ago.

Giovino said good nutrition may be an important factor in helping people quit. He hopes to launch a study that will look at whether there is a correlation between smokers’ vitamin D levels and their ability to stop smoking. He said he’d also like to see researchers explore whether plant-based diets, B vitamins and hydration impact nicotine addiction.

Giovino advises people to tap into the “mind-body connection” and try yoga and deep breathing techniques to help them quit. “After a meal, instead of taking a long breath on a cigarette, (a smoker could) try taking a long, deep breath and exhale without the 7,000 chemicals,” he said.

It’s also important for those who have decided to quit to prepare themselves for how difficult it will be, Giovino said.

“There’s this real roller-coaster ride of not feeling well and being irritable and having cravings,” he said. “The first few days might be very intense, then it might level off and come back again. But the longer you’re off cigarettes, the more your brain goes through the process of neural adaptation, the more you recover. And eventually, the ride subsides.”

Take 10 for Mindfulness

Feel yourself being pulled in a million directions and losing track of what’s really important? The meditative practice called mindfulness can help you get centered and re-focus on what’s meaningful to you.

And it doesn’t take time that’s already in short supply on your busy schedule. You can reap the benefits in less time than it takes for a coffee break.

Mindfulness shows you how to block out distractions and replace stress and other negative emotions with a sense of well-being. You accomplish this by focusing on the here-and-now — your present thoughts and feelings, not past concerns or future worries. You also learn to accept these thoughts and feelings without passing judgment on them, such as labeling them as good or bad, right or wrong.

Practicing mindfulness is easier than you might think. At the start of each day, you might take 10 minutes to do a few yoga stretches — yoga incorporates mindfulness because it teaches you to focus on your breathing as you move through poses.

Or spend 10 minutes at lunch or anytime during your workday to do a head-to-toe de-stress. Breathe in and out as you zero in on each part of your body, going from toes to the top of your head.

To unwind at night, consider more formal “guided” mindfulness, maybe with a podcast you can listen to through your smartphone. The UCLA Mindful Awareness Research Center offers free ones, starting at just 3 minutes long.

Who doesn’t have time for that?

More information

Learn more about mindfulness at the website of the UCLA Mindful Awareness Research Center.

Brain’s ‘Self-Control’ Center May Be Key to Weight-Loss Success

A behavioral therapist could be as important as a calorie-cutting diet for folks who want to lose weight, researchers say.

Brain scans reveal that people who are better at losing weight have more activity in regions of the brain associated with self-control, a small new study reports.

Teaching people to trigger their brain’s self-control centers could be a key factor in losing weight and keeping it off, said senior researcher Dr. Alain Dagher. He’s a neurologist with McGill University’s Montreal Neurological Institute in Canada.

“The analogy that’s good here is smoking,” he said. “Cigarette smoking has been largely beaten in the Western world through a combination of strategies, and some of these target self-control.”

Dieting is a brawl between two different regions of the brain, Dagher said.

Weight loss causes the body to signal that there’s an energy deficit, activating a region of the brain associated with motivation and desire, he said. That region — the ventromedial prefrontal cortex — promotes hunger pangs in response.

But there’s a counterbalancing force, another section of the brain that promotes self-control, called the lateral prefrontal cortex.

“It’s a struggle, and we’re doing brain imaging of that struggle, the struggle between the desire to lose weight and the desire to eat tasty food,” Dagher said.

For the study, Dagher and his colleagues took brain scans of 24 people enrolled in a 1,200 calorie-per-day diet at a weight-loss clinic. One brain scan took place before starting the diet, another one month into the diet, and a third at three months.

“We showed them appetizing pictures of food and measured the brain response to these pictures,” which naturally triggered the motivation region of the brain, Dagher said.

People who lost the most weight also displayed increased activity in the brain regions that promote self-control, overriding the hunger signals from the motivation centers, the researchers said.

According to Dr. Jeffrey Zigman, an endocrinologist with UT Southwestern Medical Center in Dallas, “Those people who achieved greater weight loss had a greater activation of brain regions that are involved in self-regulation, which might suggest they are better able to self-control their food intake.”

In addition, Zigman said, “It seemed to indicate that in people who regained weight further down the line, those areas of the brain were not as active. It does suggest that a person’s ability to activate those areas of the brain involved in cognitive control or self-regulation did better with achieving greater weight loss.”

Dagher noted that it isn’t as simple as saying that some people are better wired to maintain a healthy weight, since many factors can influence how well the self-control center functions.

For example, stress tends to cause a person’s self-control systems to fail, Dagher said.

“It’s possible people who had less success were more stressed. Events in their lives conspired to make it difficult for them to activate those brain regions,” he said.

Effective weight-loss plans might need to include treatments that promote self-control, such as cognitive behavioral therapy, Dagher suggested.

Smokers use cognitive behavioral therapy to come up with strategies that head off urges to reach for a cigarette. The same could be done for dieters, he explained.

“People will say, ‘I tend to overeat in this situation.’ You train people to understand that and to engage an automatic system of response,” Dagher said. “I know when I’m stressed I eat junk food, so I’m going to have another plan. Whenever I’m stressed and I have a craving for junk food, I’m going to have a healthy snack instead. You can actually train people to automatically enact those sort of plans.”

Even better might be a combination of such therapy with medications that control hunger hormones, Dagher added.

However, Zigman said, it could be difficult for dieters to find a qualified cognitive behavioral therapist to help them lose weight.

“It’s often the case, unfortunately, that those types of therapies are not easily available to people,” Zigman said. “It’s very difficult to make those types of changes, but this suggests it might be worth people’s while to try to seek out those sort of behavioral treatments.”

The study was published online Oct. 18 in the journal Cell Metabolism.

More information

The American Psychological Association has more about cognitive behavioral therapy.

Protein-Packed Foods That Should Be Part of Your Diet

Protein is key to your well-being and deserves a significant place in every diet. Knowing the best sources can boost your health as well as help you feel more satisfied on fewer calories.

Seafood is an excellent protein source, with dozens of types of fish and shellfish to try. Eat a 3.5-ounce serving at least twice every week, and include fish high in omega-3 fatty acids, such as salmon and trout. These are nutrients that your body needs, but can’t make, so you must get them through your diet.

Make friends with the manager of the seafood section at your favorite market and don’t be shy about asking for the freshest choices. Note: It’s usually seafood that’s past its prime that’s guilty of smelling up your kitchen, not fresh fish.

Chicken and turkey are other well-known protein sources, but you may not realize that it’s OK to cook them with the skin on to keep the meat moist. Just remove it before eating. Also, keep in mind that breast meat has less fat and therefore fewer calories than dark meat.

Be sure to put vegetable proteins on the menu. These include legumes such as beans and lentils. They have a protein-fiber combo that helps regulate blood sugar as well as fill you up.

What about red meat? For many people, it’s fine to eat it once a week or so. But choose lean cuts — skip the cold cuts, hot dogs and other cured meats — and limit the portion size to three ounces. Trim off as much fat as you can before cooking, and pour off any melted fat before eating. Also use healthier cooking methods, such as baking, broiling and grilling on a rack, which allow fat to drain off.

More information

The American Heart Association has tips to help you get more non-beef sources of protein into your diet.