Another Reason to Spice it Up!

Curcumin, a component of the spice turmeric (Curcuma longa), prevented type 2 diabetes, according to a randomized, placebo-controlled trial recently published in Diabetes Care.(1) Investigators Chuengsamarn et al. of Thailand reported people with pre-diabetes who took 1500mg of a highly concentrated curcumin supplement (or is it a drug?) for nine months had a 16.4% reduction in diagnosable type 2 diabetes,  when compared to the placebo group. More interestingly 0% of those taking curcumin transitioned to diabetes (said differently- no one taking curcumin developed diabetes)!

In addition to reductions in fasting blood sugar, and hemoglobin A1c (a 3-month measure of average glucose), people taking curcumin appeared to have reduced need for insulin, demonstrated in their results as increased insulin sensitivity. The authors also reported an improvement in beta-cell function (i.e., the cells that produce insulin), yet this is likely a relative improvement, and not necessarily a change in the number or capacity of the cells. (In this trial, those receiving curcumin also had a reduction in c-peptide, a biomarker of longer-term insulin production; again suggesting an overall reduced need for insulin).

Study Quality Assessment & Scientific Curiosity

In my brief assessment, this trial is designed rather well, and was performed in a modestly-sized sample of participants (n=237) adding strength to the results; although the trial is limited in ethnic representation and therefore not necessarily generalizable to other ethnic groups. That said, the trial was very well described, with standardized interventions (including a standardized diet and lifestyle intervention before randomization) plus clearly defined outcome measures. The consistency of the findings also lends credibility, and points to a promising mechanism.

One curiosity is that most studies of oral curcumin administration in people have demonstrated its bioavailability to be very low (curcumin was undetectable in serum following oral doses up to 8g daily or in liver tissue following doses up to 3.6 grams daily). (2, 3) However, doses of 3.6 grams of mixed curcuminoids have increased serum concentrations  in other studies (still only in the 10nmol/L range), and were well tolerated. (4) Based on the low dose administered in this trial, the findings support a potentially gut-based mechanism of action, i.e., one not requiring systemic bioavailability. Unfortunately the investigators did not report changes in blood or urine concentrations of the compounds administered, nor other biomarkers that may have provided insight into potential tissue sites of activity.

Implications

Although highly provocative, this study requires replication in other populations before this potential treatment goes "prime time". The trial, while well-designed, is still of short duration, i.e., nine months. However, given the long-term safety of these compounds (there were no adverse events in the curcumin group of this trial), the promising results of numerous studies suggesting health benefits, and the overwhelming historical use in the culinary traditions of many cultures, there is reason to eat turmeric! Even a lot of it!! As often as you'd like!

If you have pre-diabetes, and decide to try turmeric as a supplement, or especially if you try a concentrated curcumin product, work with your naturopathic, or other primary care provider, to monitor your lab changes periodically. Remember, improvements in diet and increases in physical activity are the only time-tested, completely natural ways to prevent diabetes!

In health-
Ryan Bradley, ND, MPH and Erica Oberg, ND, MPH

P.S. For more reading on the potential mechanisms of herbs and spices to impact diabetes, see Complementary Corner on the website of the Diabetes Action Research and Education Foundation follow this link.


Citations:
1. Chuengsamarn S, Rattanamongkolgul S, Luechapudiporn R, Phisalaphong C,

Jirawatnotai S. Curcumin extract for prevention of type 2 diabetes. Diabetes

Care. 2012 Nov;35(11):2121-7. doi: 10.2337/dc12-0116. Epub 2012 Jul 6. PubMed

PMID: 22773702; PubMed Central PMCID: PMC3476912.

2. Lao CD, Ruffin MT 4th, Normolle D, Heath DD, Murray SI, Bailey JM, Boggs ME,

Crowell J, Rock CL, Brenner DE. Dose escalation of a curcuminoid formulation. BMC

Complement Altern Med. 2006 Mar 17;6:10. PubMed PMID: 16545122; PubMed Central

PMCID: PMC1434783.

3. Garcea G, Jones DJ, Singh R, Dennison AR, Farmer PB, Sharma RA, Steward WP,

Gescher AJ, Berry DP. Detection of curcumin and its metabolites in hepatic tissue

and portal blood of patients following oral administration. Br J Cancer. 2004 Mar

8;90(5):1011-5. PubMed PMID: 14997198; PubMed Central PMCID: PMC2409622.

4. Sharma RA, Euden SA, Platton SL, Cooke DN, Shafayat A, Hewitt HR, Marczylo TH,

Morgan B, Hemingway D, Plummer SM, Pirmohamed M, Gescher AJ, Steward WP. Phase I

clinical trial of oral curcumin: biomarkers of systemic activity and compliance.

Clin Cancer Res. 2004 Oct 15;10(20):6847-54. PubMed PMID: 15501961.

Get moving!

Yet more evidence to inspire you to get moving -- new research shows that people who do regular physical activity, such as brisk walking, live longer than those who lounge in front of the television or computer, regardless of weight. "This finding may help convince currently inactive persons that a modest physical activity program is 'worth it' for health benefits, even if it may not result in weight control," says lead researcher Steven Moore from the National Cancer Institute in Bethesda, Maryland, in the US. This update comes from NY Daily News (NY) - Exercise can extend your life, even if you're overweight: study - (Wednesday, November 7, 2012) via the AANP Daily News.

Precautionary Principle Says No to GMO

A recent study published in Food and Chemical Toxicology (see abstract and citation below for details) evaluated the impact of feeding mice the common herbicide Roundup, as well as GMO Roundup-tolerant maize cultivated with and without Roundup, on mortality and cause of death compared to control animals (fed non-genetically modified maize).

The results were rather astounding and demonstrated that all treated animals died 2-3 times more than control animals and  they died more quickly.

Female animals developed large breast tumors almost always more often than and before controls, and the pituitary gland (in the brain) was also affected. Sex hormonal balance was modified by both GMO and Roundup treatments. In male animals, liver congestions and necrosis were 2.5–5.5 times higher.

After reading this study, I reflected on 2 main issues:

1. Why wasn't this study performed, and the duration extended, prior to the approval and availability of GMO-modified Roundup tolerant products to the public? How in the world did any regulatory agency approve the use of modified seeds in the US food supply before this type of independent toxicology study was performed?

2. Doesn't anyone actually apply the "Precautionary Principle" anymore, i.e., the Public Health principle that roughly states, don't expose the public until we know it's safe?

http://en.wikipedia.org/wiki/Precautionary_principle

Regardless of whether or not future studies confirm these results, they are frightening. Regardless of whether or not your "trusted" regulatory agencies follow the "Precautionary Principle" - you should! How do you do it in this case?

1. Eat organic
2. Move to Europe (they are older and smarter there)
3. Move to New Zealand (they are just plain smarter there)

Putting Health into Practice-

Ryan Bradley, ND, MPH

"The health effects of a Roundup-tolerant genetically modified maize (from 11% in the diet), cultivated with or without Roundup, and Roundup alone (from 0.1 ppb in water), were studied 2 years in rats. In females, all treated groups died 2–3 times more than controls, and more rapidly. This difference was visible in 3 male groups fed GMOs. All results were hormone and sex dependent, and the pathological profiles were comparable. Females developed large mammary tumors almost always more often than and before controls, the pituitary was the second most disabled organ; the sex hormonal balance was modified by GMO and Roundup treatments. In treated males, liver congestions and necrosis were 2.5 5.5 times higher. This pathology was confirmed by optic and transmission electron microscopy. Marked and severe kidney nephropathies were also generally 1.3–2.3 greater. Males presented 4 times more large palpable tumors than controls which occurred up to 600 days earlier. Biochemistry data confirmed very significant kidney chronic deficiencies; for all treatments and both sexes, 76% of the altered parameters were kidney related. These results can be explained by the non linear endocrine-disrupting effects of Roundup, but also by the overexpression of the transgene in the GMO and its metabolic consequences."

2012 Elsevier Ltd. All rights reserved.


Citation: Séralini, G.-E., et al. Long term toxicity of a Roundup herbicide and a Roundup-tolerant genetically modified maize. Food Chem. Toxicol. (2012), http://dx.doi.org/10.1016/j.fct.2012.08.005)

Pickles - and the benefits of acetic acid

 I love pickles, especially the hard-to-find bread and butter ones. I once received a jar of handmade bread & butter pickles in a CSA box, over a decade ago and I've been thinking of them ever since!

Pickles are a good snack option, although their high salt content can be problematic for some people with high blood pressure or edema. And, some of the brands are filled with high fructose corn syrup. For most people, however, they are an excellent functional food. A tasty and healthy way to get a few more vegetables into you diet, plus, the health benefits of vinegar.

Vinegar is acetic acid, and acetic acid slows gastric emptying. That is, it helps your feel full faster and longer - which helps you eat less.  One great way to include vinegar is to eat salad at the beginning of your meal with a simple dressing of olive oil, vinegar, salt, and pepper. Any vinegar will be beneficial, it doesn't just have to be apple cider vinegar. Balsamic vinegar, white wine vinegar, rice vinegar all do it.  Pickles, of course, are another great way to get acetic acid.

The other week, we got a box of "field cucs" and a fistful of whole dill from the farm stand near Mt. Vernon and decided to make some homemade pickles.  They are delicious - in fact, I'm eating one right now! I'm posting the recipe below for making approximately a single quart jar of pickles. Classic dill pickles are excellent too.

Assembling the ingredients

Sterilized hot jars, ready for filling

Once the jars are filled, the boiling brine mixture is poured over the cucumbers.  Then hot sterile lids are put on...

And you've got pickles!

Recipe

Bread & Butter Pickles (here's the original from Saveur)

4 persian or kirby or other small cucumbers, thickly sliced

1 shallot, chopped

1/4 red pepper, julienned

1 clove garlic

2-3 whole cloves

1 grape leaf (optional but it makes the pickles more crunchy)

1 T salt

1 cup hot water

2/3c. cider vinegar

3/4c. sugar

1 tsp mustard seed 

1/4 tsp celery seed

1/2 tsp turmeric

Make brine: In a pan, bring the salt, vinegar, water and spices to a full boil.

Pack the first 5(6) ingredients into a sterile, hot quart jar (dip the jar in boiling water) leaving 1/2 at the top.

Pour the brine over the cucumbers, covering everything but leaving an air space.

Cover with a new canning lid and gently tighten a ring to secure it.

Leave the jar sitting on the counter to cool - you'll hear a ping/pop when it cools enough to seal the jar.  If it doesn't seal, keep it in the refrigerator. 

Let it pickle for 2-3 days before eating.

Clean Eating on a Tight Budget

Here comes fall! Time to head back to school and back to routine.  It's a great time to re-commit to some systems to help you and your family stay on track for eating well.  A favorite way for us to do this is to make a big batch of something that is easily frozen in serving-size quantities, or that can be re-arranged into different meals over the week. The Environmental Working Group recently published their Back-to-School guide for low cost healthy ideas.  It's a great resource.  I love their modular recipes. Check it out!

Eating Well on the Road

Labor Day weekend and we've taken advantage of these last days of summer to enjoy the ocean on the Oregon coast.  This is our favorite way to restore our own health: trading views of computer screens and office walls for the expansive horizon and endless rolling waves.  Getting our vitamin D from the sun, not a supplement.  Working our muscles through hiking, paddling & exploring rather than programming the elliptical with the "hills tour." Yet, eating well on a road trip is a challenge.

We've come prepared.  A cooler in the car and a rental with a kitchen.  We've brought already-chopped carrots, celery, radish, cucumber and jicama and a tub of our favorite hummus.  Greens, tortillas, nut butter & a nutty trail mix, fresh & dried fruit, smoked salmon, dark chocolate, parmesan and our "spice kit" comprise the staples we've brought along to ensure "the healthy choice is the easy choice. Yet somehow, after a day in the sun and surf, we find ourselves in front of the pizza parlor instead of heading back to our lodging to make our own dinner.  Sound familiar?

So what do you do when faced with 1) hunger, 2) desire for festive ambiance, 3) a pizza parlor 1.5 blocks off the beach, and 4) a desire to stay committed to eating well?  Well, you go on in and ask for a table for 2!

Here's what we did.  Started with a large green salad to share - dressing on the side. We asked the waitress "Please, don't bring that tempting bread basket." Next, we ordered a 10" thin crust, veggie dense pizza, light on the cheese.  We skipped the tiramisu and opted for a post-dinner walk on the beach.  In all - healthy, delicious, and we left dinner feeling both indulgent in our vacation-mode and physically good for having resisted too much bread and cheese. Bon appetit!