Gita's Articles

Essential fats in walnuts good for the heart and diabetes - By Gita Patel

A cardio-protective dietary fat profile is recommended for the treatment of type 2 diabetes (1). There have been major changes in the American diet in the past few decades as people have increased their use of processed foods, containing saturated- and trans-fats. This has led to an unhealthy balance of essential fatty acids (EFA) (2, 3). Ideally, the two families of EFA (omega-6 and omega-3 (n-6 and n-3)) should be balanced in a ratio of no more than 4:1 for optimum health (2, 3). The average American’s dietary ratio can be in excess of 20:1, or more (2). According to Simopoulos, “Walnuts are unique because they have a perfect balance of n-6 and n-3 polyunsaturated fatty acids (PUFA), a ratio of 4:1, which has been shown to decrease the risk of sudden death in the Lyon Heart Study.” N-3s are heart healthy because they reduce the bloodstream levels of LDL cholesterol and maintain or raise HDL cholesterol (2, 3).

In the U.S. 18.2 million people, or 6.3 percent, have diabetes and most have the type 2 form of the disease (4). The World Health Organization reports that at least 171 million people worldwide have diabetes and this number will likely double by 2030 (5). According to the American Diabetes Association, more than 65 percent of people with diabetes die from heart disease or stroke (4).
The heart benefits of walnuts include lowering cholesterol (6), increasing HDL cholesterol-to-total cholesterol ratio (6), reducing inflammation (7) and improving arterial function (8). An April 2004 clinical study from the University of Barcelona showed that substituting walnuts for MUFA in a Mediterranean diet improved, and even restored, endothelial function. According to the researchers, walnuts are the first whole food to show such cardiovascular benefits (8).

Cardio-protective dietary fat intakes are recommended as part of the treatment for Type 2 diabetes patients (1). However, even when food-based advice matches nutrient targets, achieving long-term adherence to dietary advice is a challenge. Patients may lower their total fat intake without changing the proportion of saturated fats (SFA). In an effort to increase unsaturated fat intake, patients may inadvertently consume excess total fat calories.
Studies have shown (9) that although nuts are considered energy-dense, those who consume them on a regular basis display strong dietary compensation and little change in total energy balance. Thus, it is thought that the incorporation of nuts into low-fat energy-controlled diets may be an appropriate strategy for adequate achievement of unsaturated fatty acid targets. Because walnuts are high n-3 PUFA, they may provide an additional source of these essential fatty acids.

In the previous article, researchers Gillen and colleagues carried out a study to assess the achievement of dietary fatty acid targets in a sample of Type 2 Diabetes Mellitus (T2DM) patients. This study concluded that specific advice for regular inclusion of walnuts in the context of total diet helps achieve optimal fat proportions without adverse effects on total fat or energy intakes and blood glucose control in patients with type 2 DM. The combination of walnuts and oily fish appears more effective than simply increasing intake of fish while decreasing meat consumption. Walnuts are easily apportioned and do not require any preparation; this serves to facilitate patient compliance with dietary advice.
Walnuts contribute nutrients essential to a healthy lifestyle. Eating walnuts is one of the easiest things a person can do to improve their health. Best of all, they taste great and are ideally suited for inclusion in any diet, as part of meals or snacks. Walnuts can be eaten alone as a snack, with fresh or dried fruit, in salads, soups, yogurt, breakfast cereals, oatmeal or with rice and pasta dishes. Dietitians and diabetes educators may need to encourage their type 2 DM patients to incorporate walnuts in a low to moderate fat diet.

References:
1. The American Diabetes Association: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. position statement. Diabetes Care 27(suppl 1):S36-S46, 2004.
2. Simopoulos AP: The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharm 56:365-379, 2002
3. Simopoulos AP, Leaf A, Salem N: Workshop on the essentiality of and
recommended dietary intakes for omega-6 and omega-3 fatty acids.
http://www.issfal.org.uk/adequateintakes.htm
4. American Diabetes Association. National Diabetes Fact sheet. Available at:
http://www.diabetes.org/diabetes-statistics.jsp
5. Diabetes Care. May 2004, volume 27. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. S. Wild, G. Roglic, A. Green, R. Sicree, H. King.
6. Tapsell LC, Gillen LJ, Patch CS, Batterham M, Owen A, Bare M, Kennedy M. Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. Diabetes Care 27:2777-2783, 2004.
7. November 2004, Zhao et al, Journal of Nutrition, 0022-3166/04
The Pennsylvania State University, Dietary Alpha-Linolenic Acid Reduces Inflammatory and Lipid Cardiovascular Risk Factors in Hypercholesterolemic Men and Women
8. April 6, 2004, Ros et al, Circulation: Journal of the American Heart Assoc.
Hospital Clinic of Barcelona. A walnut diet improves endothelial function in hypercholesterolemic subjects: A randomized crossover trial.
9. Garcia-Lorda P, Megias Rangil M, Salas-Salvado J: Nut consumption, body weight and Insulin resistance. Eur J Clin Nutr 57:S8-S11, 2003.

STRESS and DISEASE! - By Gita Patel

“The best doctors in the world are Doctor Diet, Doctor Quiet and Doctor Merryman,” said Jonathan Swift, 1667-1745

Chronic stress appears to have the potential to shorten the life of cells, at least the immune cells. Stress has an effect on the body- heart disease, cancer, diabetes and immune system. It is a constant side effect of our 24/7, technology-driven contemporary lifestyles. For people of all ages, feeling stressed can impact diet, sleep and activity patterns, which in turn affects overall health and well-being. The body responds to stress in a variety of ways, including headaches, emotional irritability, insomnia, high blood pressure, depressed immune function and muscular tension. All of these can drain energy and interfere with one’s ability to function. As lives become more hectic-juggling family, friends and career-it is essential for us to find balance in our lives.

Our bodies were designed to move in response to stress. For primitive people this was a matter of survival. However, changes in the lifestyle of modern people may make some of these survival responses not only ineffective but sometimes deadly.

STRESS --> HYPERTENSION --> HEART DISEASE

All cells, tissues and organ systems are connected with each other via chemical messengers, the hormones. Hormones are chemical substances formed in one part of the body and carried in the blood to another part where they exert powerful influences. Nervous system, endocrine system and the immune system are interconnected. Stress, whether it is caused by anxiety or aggression, elevates the hormones adrenaline, noradrenaline and cortisol in the blood. Cortisol prepares the body for metabolic and physical activity, making the body ready for action.
These hormones stimulate the activity of enzymes in fat tissue, increasing the rate of fat break up, resulting in an increase in the fatty acid and glucose concentrations in the blood. This ensures the ready availability of fuels for the “fight or flight” response to the stressful situation.

Adrenaline and noradrenaline are released into the blood in response to distress signals from the central nervous system. They cause increased heart rate and force of contraction, preparing the body for a sudden high energy output. The vasoconstriction of the arteries increases the blood pressure. Cortisol facilitates both fat breakdown and fat accumulation resulting in body fat redistribution, and causes fat to accumulate around the abdominal area.
Today, the stress-inducing situations are very different from those of primitive people. We are mostly sedentary, sitting at meetings or driving. In these cases, blood glucose and fatty acid concentrations will be raised but, since action is unlikely to follow the stress-inducing situation, the fuel concentrations in the blood can remain elevated for prolonged periods, resulting in fat deposits in the arteries, which is the leading cause of heart disease.
Since physical activity does not always follow the stressful condition, the rate of fatty acid release far exceeds energy requirements for handling the modern day stresses. This failure to oxidize the fatty acids and glucose, after the stress condition, results in the fatty acids being converted to cholesterol in the liver. Frequent elevations of the blood cholesterol over many years, especially in the obese or unfit individual, could cause damage to the lining of arteries resulting in hardening of the arteries (atherosclerosis).

How can modern man live with stress? We cannot eliminate stress from our lives, but, we can choose our reactions to stressful situations present in our modern day life-style. As the famous psychiatrist Victor Frankle said “It is not what happens to us, but, it is our reaction to what happens to us that hurt’s us.” Two of my favorite stress relievers are exercise to burn up the excess fuel in the blood and meditation to condition ourselves to be less reactive.
Does this mean we have control over the release of our hormones? May be, yes, since it is our reaction to stress that releases the stress hormones which can raise the blood pressure and result in heart disease. So…..RELAX and ENJOY! It could save your life.

Try the following suggestions to reduce the effects of stress.

• Do some deep breathing exercises, take a deep breath and exhale. Do this several times. Smile as you breathe in and out. Breathing deeply can calm your mind and give your whole body an energizing dose of oxygen.
• Relieve stress through gentle yoga stretches or pilates.
• Get regular physical exercise. We all have the same 24 hours each day. Can we not give ourselves 60 minutes each day?
• Adequate sleep and time for relaxation to unwind both the Body and mind.
• Staying well hydrated by drinking plenty of water and herbal teas.
• Let SILENCE do the heavy lifting. Martha Beck, PhD Harvard graduate, a popular life coach, author of “The joy Diet” says “You must do nothing for at least 15 minutes a day”, “What I mean is that the best way to break through any barrier is to access a point of perfect stillness at the center of your being, a self deeper than your senses or your mind.” Meditate daily.