A study in Germany looked at four lifestyle factors and 4 diseases in 23,513 Germans, aged 35 to 65.

The four factors were never smoking, having a body mass index lower than 30; doing 3.5 hours, or more, per week exercise; and adhering to healthy dietary principles (high intake of fruits, vegetables, and whole-grain bread and low meat consumption). The 4 factors (ranked healthy, 1 point; unhealthy, 0 points) were summed to form an index that ranged from 0 to 4.

The diseases were heart attack, stroke and new diagnoses of diabetes, and cancer

Less than 4% of participants had zero healthy factors, most had 1 to 3 healthy factors, and approximately 9% had 4 factors.

During an average follow-up of 7.8 years, the percentages of participants that developed diabetes was 3.7%, myocardial infarction was 0.9%, stroke was 0.8%, and cancer was 3.8%.

Participants with all 4 factors had a 78% reduced risk of developing a chronic disease overall. The reduced risk for diabetes was 93%; heart attack was 81%; stroke was 50%; and cancer was 36%, compared to participants without a healthy factor.

The hazard ratio for developing a chronic disease decreased progres, the less likely you are to get a chronic disease of aging.

So which factors had the most impact on having a lower risk for common chronic diseases?

The largest reduction in risk was associated with having a BMI lower than 30, followed by never smoking, followed by at least 3.5 hours of exercise and last adhering to good dietary principles.

So, unfortunately this study suggests that the thing that you could do to have the greatest impact on long term health is to keep below a BMI of 30 (a BMI of 30 and greater is considered obese). For most of us this is probably the hardest of the four factors to control.

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My answer would be something like the following. A healthy lifestyle is eating a good diet that has lots of servings of vegetables and fruits and is not too high in “bad” fats or simple carbs. It is not smoking, not drinking too much alcohol, exercising and maintaining a BMI (body mass index) appropriate for height and muscle mass.

Why did I even ask? We are bombarded with news items, articles, etc., about diet, exercise and lifestyle habits. Nearly everybody already knows all this.

However, comparison of NHANES (National Health and Nutrition Examination Survey) data from 1988-1994 and 2001-2006 shows that though we might know this, we are not following through.

In the 10+ years between the surveys, in adults who were 40-74 years, the percentage with a BMI greater than 30 (considered obese) has increased from 28% to 36%, and eating 5 or more fruits and vegetables has decreased from 42% to 26%. Looking at five categories, physical activity, eating a diet high in fruits and vegetables, maintaining a healthy weight, moderate alcohol use and not smoking the percentages of people who were in all five categories had dropped from 15% to 8%.

Is this a big surprise? No.

Education and knowledge is not where it is at. It is what is available, makes our lives easier and more pleasurable. Plus unhealthy lifestyles are usually cheaper.

How do we reverse this change? Short of transporting us all back 50, or more, years to a different era, I don’t think we can. We are in a different era, busy, stressed and short of time. Preparing healthy tasty meals takes personal interest and time. Not something that is that common.

The current economic crisis has to be making this worse, since cheap and frugal means more fast food. Plus major stress does not usually lead to good lifestyle choices.

Hell, now that I have decided that it is hopeless, I might as well have to have a drink to forget about my unhealthy lifestyle.

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Previously on this blog there have been several posts about how lack of sleep has negative health effects. A recent post Sleep more and weight less discussed how the regulation of appetite is controlled by the hormones. Lack of sleep decreases leptin levels and increases ghrelin levels, resulting in more food intake, less energy expenditure and more fat deposition.

Yet another study has come out showing that those who tend to sleep less are more likely to be obese. A study of nurses who wore 24 hour activity monitors, showed that those who slept the least more likely to have a higher BMI (body mass index).

Further it has been shown in a study that eating a high fat diet, particularly having a fatty evening meal, can result in poorer and less sleep, suggesting that in some people there could be a sort of negative downward spiral.

Short sleep times have also been suggested to increase the risk of both high blood pressure and diabetes. And of course, there can be a link between diabetes and obesity.

Here are some suggested guidelines for getting more and good quality sleep.

- Follow a consistent bedtime routine.
- Establish a relaxing setting at bedtime.
- Do not watch TV in bed.
- Avoid foods or drinks that contain caffeine, or any stimulant, including medications, prior to bedtime.
- Do not go to bed hungry, but don’t eat a big meal before bedtime either.
- Make your bedroom quiet, dark and relatively cool.
- Get up at the same time every morning

Perhaps it is time to consider good sleep habits as important as other health factors such as good nutrition. The American Academy of Sleep Medicine has a website www.sleepeduction.com that has guidelines and useful information about sleep.

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The study collected information for 22 years. The activity levels of study participants were followed over this time. The activity levels at the beginning of the study and the end were compared.

The study found that higher education and higher income level individuals were more likely to be active. No surprise there either, this is both having more time to exercise, a better understanding of the need to exercise and more social acceptance of exercising.

What did surprise me was that women were less likely to exercise than men. Additionally women were less likely than men to take up exercise. Unless the age group being studied is mainly in late teens and twenties, I would not have predicted this. Of the people I know, who are past 30 or so, there are many more women who regularly exercise then men. When I walk the dog in the morning, I see lots more women.

The bottom line for this study is that the majority of people do not do enough exercise. The findings were that 56% of the study participants were inactive in every survey. Only 12% were active in every survey. This is pretty pathetic.

The study also showed being active in your youth does not mean that you are going to be an active adult. I think most people assume that often exercising patterns are set for life. Guess not.

Here just a few things that being active can help with, as you age.

Exercisers have better blood flow in the brain. This will help your brain function as you age and perhaps decrease the risk of dementia. Those that exercise have a lower risk of disability in old age. A lower risk of heart disease. A lower risk of diabetes.

We should all get out there and get moving.

photo credit: greg westfall.

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For instance, over the weekend I was looking at the ingredient lists for a number of cosmetic products, including daily chemical peel products and after peel moisturizers. Many of the products had tea extracts in them, usually called extract of Camellia sinensis. Additionally, tea extracts have been suggested to be helpful for treating skin damaged in cancer patients after radiation.

White tea has been suggested to help with obesity. An extract of white tea has been shown to stop the formation of new fat cells, and to make the existing fat cells start to break down the fat that they contain.

So what is white tea? I had no idea. It made from the same plant as regular tea, but only young still downy white buds and young leaves are used, and not fermented like regular tea. If you are going to make it and drink it, apparently you should not use boiling water. The water used for brewing should be quite a bit cooler than boiling water. This is supposed to be the best for its delicate taste. White tea is lower in caffeine but higher in antioxidants than regular tea.

Another news item suggests that an African tea that is used in traditional Nigeria medicine may help with diabetes. It is made from leaves of the lovely sounding Rauvolfia vomitoria and the fruit of Citrus aurantium. The tea helped mobilize fat, and in a small human trial after 4 months there was better glucose control. The genus Rauvolfia, a tropical evergreen shrub, is widely used in folk medicine and has been shown to lower blood pressure, have psychological effects, be a hypnotic and can irritate those with digestive diseases.

In Asia though the population tends to smoke heavily there is less cardiovascular disease and cancer than in the west. This is known as the Asian paradox. It has been suggested that part of the reason, for the lower levels of these diseases, is the high consumption of tea, particularly green tea.

Green Tea has also been suggested to have antibacterial activity too.

Low calorie and healthy. So, have a cuppa (used in the UK, for a cup of tea).

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Lipoic acid and alpha lipoic acid are generally used interchangeably. The lipoic acid that is found in foods is alpha lipoic acid. It is found in both animals and plants and in is the cells of our bodies. It is essential for life.

Lipoic acid is required for correct functioning mitochondria (the powerhouses of cells) and has antioxidant properties. One property of lipoic acid is that it is able to interact with both reactive oxygen species (ROS) in both water (aqueous) and fatty environments. This potentially makes it very effective as an antioxidant.

Lipoic acid is thought to be helpful for diabetes (discussed below), Alzheimer’s and several other conditions. Now comes a demonstration that lipoic acid may lower triglycerides

One effect of lipoic acid is to increase the uptake of glucose into cells. It does this by mimicking insulin, which increases the uptake of glucose by a type of glucose receptor called glut4. This may be of benefit for those with type 2 diabetes or prediabetes. For many people increasing uptake of glucose into cells will help lower blood glucose. The studies with animal models of diabetes look promising, it remains to be seen if lipoic acid is helpful for human diabetes.

One of the effects of both type 1 and type 2 diabetes is that there is increased oxidative stress in the body. Since lipoic acid has antioxidant properties, it may also be useful in reducing some of the negative health consequences of diabetes. Again looking at animals with diabetes there is a benefit. One benefit is a reduction in peripheral neuropathy, which is damage to nerves in the body, caused by diabetes.

New research suggests that lipoic acid may reduce triglycerides. High triglycerides are a risk factor for cardiovascular disease and are often increased in diabetics. Triglycerides levels increase in diabetes due to lipoprotein lipase, the enzyme that degrades triglycerides, becoming less sensitive to insulin. (Reduced sensitivity to insulin, called insulin resistance, is a hallmark of type 2 diabetes.) Since lipoic acid is thought to act as an insulin mimetic for glucose uptake, perhaps it also works the same way for lipoprotein lipase as it does with glucose uptake by glut4.

Most foods have low levels of lipoic acid. However, it is not possible to eat enough food to get the amounts of lipoic acid used in research. Therefore, anyone who wants to significantly increase their lipoic acid intake will have to take supplements.

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An estimate of the health effect of consuming a little less salt, 3 grams per day (which is about 1,200 mg of sodium) is there would be a quarter of a million less new cases of heart disease in a decade. This number is quite staggering considering that most people would not even notice a 3 gram per day decrease in their salt intake. Apparently most Americans eat 9 to 12 grams of salt (3,600 – 4,800 mg sodium) per day. The recommendation is 5-6 grams of salt (2,000 – 2,400 mg sodium) per day.

Now that most of us are eating out less due to the economy, reading the labels on foods and choosing more low sodium foods, should make it easier for most people to lower their salt/sodium intake. Many brands of prepared foods will have the American Heart Association check mark on them if they are within the heart healthy guidelines.

Those that routinely get less than 6 hours sleep per night on workdays are at an increased risk of having higher fasting glucose. An increase in fasting glucose levels is an indicator of the beginning of development of diabetes. There was no downside, with regards to fasting blood glucose, to getting more than eight hours sleep. This is yet another study that shows a negative impact on health for those who consistently do not get enough sleep. We all need to get lots of sleep.

Those who exercise after a heart attack improve blood vessel function. Both aerobic and resistance training are effective. Those who did not exercise had very little improvement in the functioning of their blood vessels. The bad news is that for the improvement to be maintained, the exercise program had to be maintained.

So – lower your salt intake, make sure you get your zzzz, and keep exercising.

photo credit: Franck Mahon

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Several years ago, a number of researchers suggested that lecithin, which is found in high levels in egg yolk, could reduce cholesterol uptake in the gut. Though egg yolk is high in cholesterol, the research findings suggested that the lecithin inhibited the uptake of the cholesterol into the blood. This is consistent with many studies that have shown that moderate consumption of eggs generally does not increase cholesterol levels in the blood.

It is has been demonstrated that there is an increase in the amount of lutein in the body after eating eggs. Lutein is a yellow pigment that is thought to be a necessary nutrient of our diet. Low levels of lutein have been suggested to increase the risk of age-related macular degeneration, which results in loss of eyesight. Some researchers have suggested that an adequate intake of lutein in the elderly may reduce the risk of macular degeneration. In addition, to eggs, leafy green vegetables including spinach, broccoli and corn are high in lutein.

Over the years there have been indications that eggs have blood pressure lowering effects. The most researched effect seems to be inhibition of angiotensin 1 converting enzyme (ACE). There is already a widely prescribed class of drugs, developed for treatment of high blood pressure, that inhibit this enzyme. These are the ACE inhibitors.

In a recent study, both boiled and fried eggs were digested with pepsin. The stomach releases pepsin to digest food. By using pepsin with conditions similar to that found in the digestive tract, the aim was to mimic what happens when we eat cooked egg.

Interestingly, analysis of eggs digested by pepsin, showed that there was more ACE inhibitory activity in the whole fried egg, than the boiled egg.

So fried eggs are a health food?

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Abdominal obesity increases the risk of diabetes, since it increases insulin resistance.

Generally, when obesity is discussed there is a focus on fat and exercise. What is not often mentioned is that obesity is an inflammatory state.

Abdominal fat is considered an endocrine organ. The endocrine system is the hormone system. An endocrine organ is an organ that secretes hormones into the body. Some of these signaling compounds and proteins are secreted by the fat cells, others come from other cells that are found located in between the fat cells. A type of macrophage (cells that are part of the immune system) are found within abdominal fat.

Some of the compounds that are released by abdominal fat stimulate an inflammatory response. Recently it has shown that obesity results in chronic subclinical inflammation. Which in plain English means, having continual inflammation at a level that does not give obvious symptoms to the person.

What does this have to do with diabetes?

A recent study in obese mice has shown that if the type of macrophage that is found in abdominal fat, is “knocked out”, that the insulin resistance is reversed very quickly. Within 24 hours of killing the macrophages the insulin resistance was reversed though, of course, the mice were still obese.

As well as furthering the understanding of pathology of type 2 diabetes, this research suggests a new target for drugs for treating diabetes.

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In the study some employees of a hospital, who had a sedentary lifestyle, were instructed to use the stairs, and not to use the elevators.

After 3 months the study participants had improved lung capacity, blood pressure and cholesterol levels. Their weight, waist measurements had decreased. Not unexpectedly their aerobic capacity had improved too.

These positive changes decreased the risk for a wide range of health problems and premature death.

It is suggested that just having a small increase in physical fitness and stamina can have a major impact on health.

I will have to think of something else, I work in a single storey building.

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