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High Fiber Diet Promotes Select Gut Bacteria to Better Manage Diabetes

In line with many other countries, the usual care for patients with diabetes in China is education about balanced diets and blood sugar management strategies. In a small study, 43 patients with diabetes were randomly assigned to either these standard recommendations, or a high-fiber diet with whole grains and traditional Chinese medicinal foods. Both groups significantly improved their blood sugar (as measured by HbA1c) over the 12-week study, but significantly more people in the whole grain group (89% vs 50%) got their blood sugar to a well-managed level (HbA1c < 7%). To see how gut microbes might play a role, researchers also analyzed the gut bacteria of the participants. They found that the fiber from whole grains stimulated select bacteria to produce short chain fatty acids, which in turn, helped the body better manage blood sugar.
Science. 2018 March 9;6380(359):1151-1156. (Zhao L et al.)

High Glycemic Index Foods Linked with Bladder Cancer

Carbohydrates are the building blocks of a balanced diet, but not all carbs are created equal. To see how diet might relate to bladder cancer risk, researchers analyzed the diets of 578 adults with bladder cancer and 608 controls without bladder cancer. Those regularly eating high glycemic index and glycemic load foods (foods that are more rapidly absorbed into the bloodstream, thus spiking your blood sugar) were more likely to have bladder cancer, as were those who regularly ate refined grains like bread and pasta. However, these results were not as strong in people who regularly eat vegetables. People who regularly eat whole grains and/or legumes tended to be less likely to have bladder cancer, but the results were not statistically significant.
British Journal of Nutrition. 2017 Nov;118(9):722-729. (Augustin LSA et al.)

Whole Grains Linked with Weight Loss, Less Inflammation

Why worry about calorie counting when whole grains can keep you satiated and help you lose weight? Researchers randomly assigned 50 Danish adults to a whole grain or refined grain diet for 8 weeks each, with a 6-week washout period in between. All of the participants were overweight, obese or had large waist sizes, and also had slightly high levels of blood sugar, cholesterol, or blood pressure before the study. The participants lost significantly more weight on the whole grain diet (- 0.4 pounds) compared to the refined grain diet (+ 2 pounds). This is likely because people naturally ate fewer calories on the whole grain diet, as whole grains are more satiating. Additionally, the whole grain diet (especially rye foods) significantly lowered inflammation (measured by IL-6 and CRP). However, the researchers noted no significant changes in insulin sensitivity (an indicator of how well your body is able to manage blood sugar), or the gut microbiome over the 8-week study.
Gut. 2017 Nov 1. pii: gutjnl-2017-314786. [Epub ahead of print.] (Roager HM et al.)  

Whole Grain Foods Improve Blood Sugar Management After Meals

Whole grains are thought to help prevent type 2 diabetes, but researchers want to learn more about this protective effect. In a review of 14 randomized controlled studies, scientists found that whole grain foods led to better post-meal blood sugar management than refined grain foods. However, the medium- and long-term effects (6 weeks or more) on fasting blood sugar were not significantly different between whole grain and refined grain meals. 
Nutrients. 2017 Jul 19;9(7). pii: E769. (Marventano S et al.)

Substituting Refined Grains with Whole Grains During Gestational Diabetes Linked with Less Childhood Obesity

Foods that moms choose during pregnancy may have an impact on their children’s health down the line. In a study of more than 500 mother-child pairs in Denmark, in which all of the moms were diagnosed with gestational diabetes (diabetes during pregnancy), Harvard researchers found that substituting 1 serving of refined grains per day with whole grains in the mom’s diet during pregnancy was associated with a 10% lower risk of the child being overweight or obese at age 7. They also found that eating more than 4.3 servings of refined grains per day during pregnancy was linked with nearly double the risk of children becoming overweight or obese at age 7 compared to those who ate fewer than 1.8 servings of refined grains per day. These results were especially strong in kids who were breastfed for less than 6 months.
American Journal of Clinical Nutrition. 2017 June 7. [Epub ahead of print.] (Zhu Y et al.)

Whole Grains Linked with Lower Circulating Insulin in Kids

Whole grains have long been associated with chronic disease prevention in adults, but research suggests that children may benefit as well. In this study, researchers analyzed the 7-day food records of more than 700 Danish children and confirmed whole grain intake by also taking biomarkers of whole wheat and rye intake. They found that whole grains and fiber were linked with lower levels of serum insulin, indicating healthier blood sugar management. Additionally, oats were linked with less body fat, and lower systolic blood pressure (the first number in your blood pressure reading), insulin, and LDL (bad cholesterol).
Journal of Nutrition. 2017 May 1;147(5):816-824. (Damsgaard CT et al.)

Low Gluten Diet Linked with Diabetes

For those without a medically diagnosed gluten issue (such as celiac disease), the support for gluten-free and low-gluten diets appears to be more fad than fact. In a study of nearly 200,000 health professionals, researchers at Harvard found that eating lower amounts of gluten is related to a higher risk for type 2 diabetes. In fact, those in the top 20% of gluten intake were 13% less likely to get type 2 diabetes over the 30-year study period, even after adjusting for family history, exercise habits, weight, and calorie intake. (Note that research presented at meetings is considered preliminary until published in a peer reviewed journal.)
Presented at the American Heart Association’s Epidemiology and Prevention / Lifestyle and Cardiometabolic Health 2017 Scientific Sessions. Portland, OR. March 9, 2017. (Zhong G et al.)

Inadequate Vegetables, Fruits, Whole Grains, Omega 3’s Linked with Cardiometabolic Death

Researchers created models to estimate the percentage of US cardiometabolic deaths (deaths from heart disease, stroke, or type 2 diabetes), that can be attributed to specific aspects of a poor diet. After analyzing decades of eating pattern data from large, nationally representative surveys (NHANES), the researchers estimated that nearly half of all cardiometabolic deaths can be attributed to poor diet. Specifically, they found that high sodium diets, low nut & seed intake, high intake of processed meats (like sausage or bacon), low seafood omega-3 fats, low vegetable intake, low fruit intake, high intake of sugar sweetened beverages (like soda), and low intake of whole grains contributed the most to cardiometabolic deaths, at about 5.9-9.5% each. The researchers note that the importance of eating more healthy foods (like whole grains or vegetables) is very important, in addition to decreasing less healthy foods (like soda or bacon).
JAMA. 2017 Mar 7;317(9):912-924. (Micha R et al.)

Healthier Diet May Reduce Greenhouse Gas Emissions & Cut Healthcare Costs

Healthy diets nourish both people and the planet, and the savings can be quite impressive. Scientists in California created models to analyze how greenhouse gas emissions and healthcare costs might change if we decrease red & processed meat and refined grains in our standard US diet, and shift to eat more beans and peas, whole grains, fruits, and vegetables. The researchers found that opting for the healthier diets can reduce risk of heart disease, colorectal cancer, and type 2 diabetes by 20-40%, saving the US $77-93 billion per year in healthcare. These shifts can also lower greenhouse gas emissions by 222-826 kg CO2, which is equivalent to 6-23% of the US Climate Action Plan’s target. Climatic Change. 2017 Mar 6. [Epub] (Hallstrom E et al.)

Fruits, Vegetables, Legumes, Whole Grains Linked with Less Pre-Diabetes

Pre-diabetes can increase the risk of diabetes and heart disease, so understanding lifestyle factors is important. To see how diet relates to pre-diabetes, scientists analyzed the eating habits of 150 pre-diabetic adults in Iran, and 150 healthy, matched controls. Two distinct eating patterns emerged: the “vegetable, fruit, legume” pattern, with lots of plant foods including produce, whole grains, nuts, low fat dairy, and fish, and the “sweet, solid fat, meat, and mayonnaise” pattern, with lots desserts, red meat, fried potatoes, and solid fats. Those whose diets more aligned with the “vegetable, fruit, legume” pattern were significantly less likely to be pre-diabetic than those whose diets more closely resembled the “sweet, solid fat, meat, and mayonnaise” pattern.
British Journal of Nutrition. 2016 Sep;116(5):874-81. (Bagheri F et al.)

Whole Grains Linked with Lower Risk of Heart Disease, Cancer, Respiratory Disease, Infectious Diseases, Diabetes, and Early Death

Researchers in Europe and the US analyzed 45 studies (ranging from 245,012 to 705,253 participants each) in a meta analysis to understand the relationship between whole grains and health. Compared to people who ate the least whole grains, people who ate the most whole grains had a 16-21% lower risk of heart disease, an 11% lower risk of cancer, and an 18% lower risk of death from all causes, as well as a 19% lower risk of death from respiratory disease, a 36% lower risk of death from diabetes, a 20% lower risk of death from infectious disease, and a 21% lower risk of death from all non-cardiovascular, non-cancer causes. The researchers also found that a 90g increase in whole grain foods per day (about 3 servings) was linked with a 19-22% lower risk of heart disease, a 15% lower risk of cancer, and a 17% lower risk of death from all causes, and that “even moderate increases in whole grain intake could reduce the risk of premature mortality.” Whole grain bread, whole grain cereals, total grains, total cereals, total bread, pasta, and bran, were also singled out for their relationship with lower rates of various diseases and/or early death. The researchers conclude that their findings “strongly support existing dietary recommendations to increase whole grain consumption in the general population.”
British Medical Journal. 2016 June 14;353. (Aune D et al.)

Healthy Plant Foods (Whole Grains, Pulses, Vegetables, Nuts, etc.) May Lower Diabetes Risk

Plant-based diets are linked with numerous health benefits, but you must take care to choose healthier plant foods close to nature, that haven’t been refined or include lots of added sugars. To investigate the importance of this point, Harvard researchers analyzed the eating habits of 195,727  adults across three large cohorts, and tracked their health records for decades. Eating a healthy plant based diet (with whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea, and coffee) was linked with a 34% lower risk of type 2 diabetes, while eating a less healthy plant based diet (with fruit juice, sugary drinks, refined grains, potatoes, and desserts) was linked with a 16% higher risk of diabetes.
PLoS Medicine. 2016 Jun 14;13(6):e1002039. (Satija A et al.)

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