Diet and Sugar

Cholesterol

2010-02-25T20:20:00.000-08:00

Cholesterol is a fat that circulates in the blood. your body needs some cholesterol to manufacture some harmones and certian kinds of cells. Too much cholesterol can lead to clogged arteries and heart problems.

But you body (specifically your liver) can manufacture all the cholesterol you need. We get additional cholesterol directly from eating animal products -- meat, milk, eggs, etc.

Decreased response inhibition in middle-aged male patients with type 2 diabetes

2010-02-12T07:59:00.000-08:00

The abstract:

Background

This study was performed to examine whether patients with type 2 diabetes have cognitive deficits associated with the prefrontal cortex (PFC).
Methods

Twenty-seven middle-aged patients with newly diagnosed type 2 diabetes and 27 healthy controls underwent physical measurements and neuropsychological tasks. Response inhibition, reward prediction, and executive function were assessed by the Go/NoGo task, the reversal and extinction tasks, and the Wisconsin Card Sorting Test (WCST). To examine the interactions of being overweight with diabetes on cognitive performance, performance data were analysed by two-way ANCOVA with diabetes and overweight as factors and age as a covariate.
Results

Patients with type 2 diabetes showed significantly decreased response inhibition in the Go/NoGo task (discriminability index: P=0.001). There was an interaction of being overweight with diabetes on reaction time in the Go trials of the Go/NoGo task (P=0.009). Being overweight was related to retained responses to the presentiment of reward in the extinction task (P=0.029). The four groups showed normal cognitive performance in the WCST.
Conclusions

Our results showed that middle-aged, newly diagnosed and medication-free patients with type 2 diabetes have a particular neuropsychological deficit in inhibitory control of impulsive response, which is an independent effect of diabetes apart from being overweight.

The full article.

Diabetes plus other stuff

2010-02-04T08:01:00.000-08:00

I have diabetes. I also have high blood pressure, bi-polar disorder, kidney failure, and had recent heart by-pass surgery. And I recently turned 60 so there's every reason to expect such a basket of health issues to continue. So this blog post on patient, doctor disagreements about the importance of different treatments caught my interest.

Newly diagnosed diabetics and their doctors don't always agree on which aspects of the disease are the most important to treat.

It prompted me to do some further reading on the subject. I'll try to get to some of that tomorrow.

Cream of Hot Pepper Soup

2009-09-22T22:04:00.000-07:00

I'm on a low sodium, low phosphorus (which means no milk or nuts), and low protein diet. Here's a recipe that fits into that well and also gives me something to do with the abundance of peppers from the garden I have this time of year.

1 medium onion, finely chopped

about 10 peppers, jalapeno's, Serrano, hot bananas, maybe even throw in a habanero

1 tablespoon cooking oil

2 tablespoon balsamic vinegar

4 teaspoons garlic powder

1 teaspoon turmeric

1 cup chicken stock (I make my own without salt and keep it in the refrigerator)

1 cup soy-milk

3 tablespoons grated Parmesan cheese.

1/2 cup dried macaroni (I like the low carb Dreamfields Elbows
)

Saute the onion in the oil.
Put peppers and soy-milk in a blender and liquefy
When onion is translucent add garlic, turmeric, vinegar, and chicken stock. Stir and simmer.
Add remaining ingredients with 2-3 cups of water.
Simmer for about another 20 minutes.

Some okra dishes

2009-08-27T00:09:00.000-07:00

Here's some tasty ways to cook okra dishes.

Dreamfield pasta and blood sugar

2009-04-04T16:12:00.000-07:00

The other day I reported on my blood sugar effects of a large Asian-syle noodle salad made with Ramen noodles. It wasn't good.

Last night I tried a similar salad made with Dreamfields Linguine instead of the Ramen noodles.

One other difference was that instead of pork I topped it off with a coconut breaded fried shrimp (pre-breaded from the frozen food section). That would add some carbs.

My blood sugar before eating was 91. Five hours later (after a long nap) it was 190. Since blood sugar usually peaks 2-3 hours after eating that suggests that the peak was a little too high.

As a partial check as to whether the spike was caused by the pasta, the next day I had the same dish without the breaded shrimp. My blood sugar was 166 when I ate, and two hours later (after doing some vigorous work in the yard) it was 143.

My overall conclusion: 1. Stay away from the Ramen noodles.
2. A noodle salad made with the Dreamfields Linguine is okay if it's the mid-day meal eaten before doing some walking or yard work. It probably not a good choice for an evening meal.

Noodles and blood sugar

2009-04-02T20:02:00.000-07:00

One of my favorite dishes is an Asian style noodle salad. I'll make one with whatever's in the kitchen or garden -- here's a typical recipe.

I'll start with a base of Ramen noodles (or any Japanese style noodle). I just boil a package of them without the seasoning. The little packs of sodium they come with is just loaded with sodium and not very good for you.

Put the cooked noodles in the bottom of a large bowl. According to the package, that's two servings, but I use the whole thing. That's a lot of carbohydrates, which I'll get to later.

One of the keys to this dish is to create pockets of flavor, not one mish-mash blend. So don't spread the noodles out. Just put them in a pile in the middle of the bowl. That's what you'll do with all the ingredients, just put them in individual piles rather than spread them out. They'll get blended together as you eat.

Next a handful of finely chopped cabbage. Just put them in a pile next to the noodles.

Then a large handful of mixed lettuces -- torn into small pieces.

Then some fresh, finely chopped, parsley, mint, and basil. About a handful in total. Just whatever fresh herbs are available.

Then a small handful of nuts or seeds -- chopped walnuts, sliced almonds, sunflower seeds, anything. I used some roasted sesame seeds mixed with a few chopped pecans.

I keep a jar of thinly sliced carrot marinating in some vinegar. Add a healthy spoonful of those carrots.

One boiled egg, sliced.

A small handful of cooked pork cut into small chunks.

Top it off with some flavored vinegar and maybe some Thai style peanut sauce.

That's what I had for dinner today. Before I ate my blood sugar was 112. Three hours later my blood sugar was 313.

No more noodle salads for this diabetic. That's just too many carbs for me, even if I ate a more rational sized serving like a half package. The peanut sauce has some sugar in it also, but the carbs in the Ramen noodles is just over the top. The package says that a package has 52g of carbs, none of which is sugar but only 6g of which is fiber.

Banana and blood sugar

2009-03-27T11:14:00.000-07:00

How does a banana effect your blood sugar?

12:30 blood sugar 121, Ate 1 banana
1:00 ate a large bowl of cabbage and white bean soup
1:30 blood sugar 146
2:30 blood sugar 151

Conclusion: Eating a banana isn't really a problem for a diabetic so long as you aren't covering it in chocolate and grape jelly.

Tracking Sugar

2009-03-27T02:41:00.000-07:00

My bloodsugar was at 130 when I ate a thin slice of cheesecake (not a no sugar version, but just a cheesecake slice I bought at WalMart).

About 5 houea later my blood sugar reading is 172 and I was hungry.

My new regive is to try to keep my blood sugar below 180 at all times and to limit my carb intake to when the blood sugar is below 130. So I opened a can of Tuna.

Next time I'll have to limit that cheesecake intake to about a half of a thin slice.

UPDATE: It took about 12 hours after eating the cheesecake to get the blood sugar back down to 121 -- at one point it got to 207. The 12 hour period included eating a lot of cabbage soup and a brisk walk of about 6/10 mile.

Fish Oil

2009-01-12T10:49:00.000-08:00

I've been using a linear programming model to look at how different foods combine to provide nutritional requirements that both meet minimums for nutritional items and avoid going over limits for some items for a diabetic with bad kidneys and hypertension.

The model I've been using has some pretty tight restrictions on fat (65 g. on an 1,800 calorie diet). That's not really achievable, especially since the model also calls for a minimum level of omega-3 fats of 1,600 mg. It seems to be impossible to achieve that level of omega-3 fats from the foods I normally eat without exceeding 65 g. of fat by quite a bit.

Such a confilict isn't really unusual when trying to formulate a diet with multiple objectives (In my case, weight loss, low sugar, low protein, low sodium, and meets minimum nutritional requirements otherwise). Such conflicts are why I started using the linear programming formulation to put together a personal diet plan in the first place.

The linear programming formulation helps answer questions such as “Does adding a fish oil supplement to my diet help me achieve minimum levels of omega-3 oils without exceeding desired levels of overall fat?”

The answer is No.

Using olive oil in my food preparation works better than taking a fish oil supplement.

My optimal daily diet plan is a mixture of

pinto beans
bread
fat free margarine
spaghetti
tuna
grilled peppers
olive oil
tomato
spinach

and that provides daily requirements of omega-3, fiber, vitamin A and vitamin C (it's actually just a little light in fiber) without exceeding dietary restrictions on calories, sodium, saturated fats, sugar, and protein. The diet does, however, exeed restrictions on total calories from fat (123 g. fat).

Forcing one 1200 mg fish oil tablet doesn't really change things much. The adjusted diet with that one pill added is the same as the above an addition of some carrots (the quantities of the food list isn't the same) and the only nutritional change is that the diet with the fish oil tablet has slightly higher overall fat (124g) and doesn't quite meet the daily requirement for magnesium and fiber).

My conclusion is that fish oil supplements won't do anything for you that just using olive oil doesn't already do.

Potato Soup

2008-12-24T11:26:00.000-08:00

Here's a potatoes soup I made that turned out pretty good.

2 red potatoes, cupped.
1/2 turnip, diced
1/2 cup chopped cabbage
2 tablespoons olive oil
1/2 jalapeno, chopped
1/4 cup chopped cilantro
1 teaspoon rosemary
1 teaspoon black pepper
1 tablespoon onion powder
1 can cream of potato soup
2 tablespoons shredded cheddar

Cook potatoes and turnips in the oil. Don't brown, add a little water after they're coated with the oil.

When potatoes are soft add jalapeno, pepper, onion powder, rosemary, cilantro.

Add a little water, stir well, simmer for a couple of minutes.

Add can of soup with a couple of cans of water. Add cabbage and cheddar. Stir well. Simmer for another 3-4 minutes.

Balance is better than low carb

2008-12-23T09:30:00.000-08:00

The online magazine, Diabetic Living, has an article on 1-carb recipes. Most of the recipes are heavy on the pork or beef. That's not always a good thing.

You caloric intake needs to strike a balance between calories from carbs, proteins, and fats. Too much protein can damage your kidneys, too much fat makes you fat and hurts your blood flow. You need to keep the fats down, be careful not to load up on protein, and keep the carbs at a steady level. It's a constant balancing act, requiring much more than just low-carb foods.

So be careful with those high-protein, high-fat menu items that are loaded with beef and/or pork. Low carb isn't always good for you.

But one of the recipes in that article looks like it has a lot of potential.

1 cup chopped carrots
1 15-ounce can garbanzo beans (chickpeas), rinsed and drained
1/4 cup tahini (sesame seed paste)
2 tablespoons lemon juice
2 cloves garlic, quartered
1/2 teaspoon ground cumin
1/4 teaspoon salt
2 tablespoons snipped fresh parsley
Assorted dippers (such as toasted whole wheat pita bread triangles, vegetable sticks, and/or whole-grain crackers)

1. In a covered small saucepan cook carrots in a small amount of boiling water for 6 to 8 minutes or until tender; drain. In a food processor combine cooked carrots, garbanzo beans, tahini, lemon juice, garlic, cumin, and salt. Cover and process until mixture is smooth. Transfer to a small serving bowl. Stir in parsley.

2. Cover and chill for at least 1 hour or for up to 3 days. If too thick, stir in enough water, 1 tablespoon at a time, until dipping consistency. Serve with assorted dippers. Makes 2 cups, 16 (2-tablespoon) servings.

A lot of potential here, not just for hummus but for a soup also.

Diet for diabetics

2008-12-23T05:55:00.000-08:00

When I was first diagnosed with diabetes I went to a two day class on food for diabetics. Pretty much they spend two days saying "look at the label and see how much carbohydrates is in a serving. If it's more that 15 then that's a lot of carbohydrates, if it's less than 15 then that's low. Low is good, high is bad".

It turns out that's not actually so helpful. It's a nice place to start when menu planning for a diabetic, but it's a long way from getting the job done.

The truth is that we don't really know what an optimal diet is. We learn something new about what might be relevant almost everyday. At least we might learn if we're paying attention closely enough.

Some of the recent news comes from a couple of articles in Journal of the American Medical Association.

Chowing down on lentil soup and pasta seems to be the way to go if you have type 2 diabetes.

A new study found that a diet of "low-glycemic foods" -- such as beans, nuts, peas, lentils and pasta -- was superior to a high-cereal-fiber diet when it comes to lowering blood sugar

Pasta is ext4remeely high in carbs and I'd been taught that I shoulld stay away from foods with very high carb counts. But I guess that's not all there is to is and that some high carb counts are better than others.

Carbohydrates in a low-glycemic-index diet are absorbed through the small intestine and converted to blood sugar at a slower rate than higher glycemic foods, meaning blood sugar is more stable, the researchers said.

Hemoglobin A1c (HbA1c) levels, a longer-term measure of blood sugar levels, decreased by 0.5 percent in people on the low-glycemic-index diet, compared with a decrease of 0.18 percent in the alternate group.

The VA has recently moved away from suggesting testing your blood sugar seve3ral times a day to the use of A1c two or three times a year to check blood sugar control. But they hav e done a horrible job of explaining to p0atients why they're doing that.

Target weight

2008-12-16T10:36:00.000-08:00

Body Mass Index is a generally accepted way to look at how your height and weight should relate to each other. BMI is the ratio of your weight to the square of your height

An ideal BMI for an adult male is someplace in the range of about 20.7-28.4.

Using the upper end of that range you can estimate a target weight (including a factor for conversion between feet/pounds and metric measurements) as

W = .0404 * H²

where H is your height in inches.

For me, at 68 inches, that gives a target weight of about 186 pounds.

Ideally I think I should probably weigh in less than that, but it provides a good target at the upper range of acceptable weight for me.

Roasted Garlic Mashed Potatoes

2008-12-08T12:14:00.000-08:00

This guys accent drives me nuts.

One of the things diabetics can do with mashed potatoes is to substitute turnips for about half the potatoes.

When he gets to the part where he mentions adding chopped parsley I was thinking, "cilantro might be a better choice". Then later in the clip he suggests that.

He goes past the roasting garlic quickly. Here's a video that takes a little more time showing you that.

All those carrots

2008-12-08T08:44:00.000-08:00

The other day I posted some diet model results that suggested I eat over 30 carrots a day.

I couldn't find anything really wrong with the model logically or mathematically, but 30 carrots a day is clearly just not acceptable.

So I just made a model change to never allow for more than 3 servings per day of anything. Works much better.

A cup of coffee

2008-12-07T11:05:00.000-08:00

When I start out the day I take a look at the diet my model is recommending. Since I'm still adding food items, and correcting errors I might have made in nutritional data, and changing prices to reflect current market conditions, the recommendations aren't the same every day, but they're close.

Today the menu was

CarbWatch yogurt	0.77	containers
bananas	0.17	items
scrambled eggs	2.49	items
bread	3.00	slices
apricot	2.07	items
navybeans	2.51	serving
carrot	38.96	items

Of course I'm not going to eat 40 carrots today, and I'm not going to eat 1/6th of a banana. But this model isn't a menu dictator, it's a tool for menu planning.

Today I'll show you a little bit about how to use it as a tool.

While looking over the recommended menu and trying to decide what to have for breakfast I had a cup of coffee. That's not on the menu but I'm going to drink it anyway. Putting 1 cup as a forced lower bound for coffee in the model gives me a different recommended menu for the day.

		after 1 cup coffee	containers
CarbWatch yogurt	0.77	0.68	containers
bananas	0.17	0.98	items
coffee		1.00	cup
scrambled eggs	2.49	2.45	items
bread	3.00	3.00	slices
apricot	2.07	1.34	items
navybeans	2.51	2.55	serving
carrot	38.96	34.74	items

That doesn't really change things all that much, although it is recommending fewer carrots I'm still not going to eat that many. Maybe another cup of coffee will help

items

		after 1 cup coffee	after 2 cups coffee	containers
CarbWatch yogurt	0.77	0.68	.60	containers
bananas	0.17	0.98	1.79	items
coffee		1.00	2.00	cup
scrambled eggs	2.49	2.45	2.41
bread	3.00	3.00	3.00	slices
apricot	2.07	1.34	.61	items
navybeans	2.51	2.55	2.59	serving
carrot	38.96	34.74	30.54	items

I do have some leftover meatloaf in the refrigerator that needs to get eaten. I don't normally make meatloaf, but my girlfriend brought some over the other day (I think she must be of the mistaken impression that she's the beneficiary on my life insurance).

So I reran the model after forcing a serving of meatloaf, to see who eating that for breakfast would effect the menu plan of rh for the rest of the day

Again, a slight chance in composition, but not really a substantive change. Because of my high blood pressure I try to limit my daily caffeine intake to two cups of coffee a day. So it's time to eat something.

		after 1 cup coffee	after 2 cups coffee	after 2 coffee +meatloaf	containers
CarbWatch yogurt	0.77	0.68	.60	0.0	containers
bananas	0.17	0.98	1.79	.58	items
coffee		1.00	2.00	2.00	cup
scrambled eggs	2.49	2.45	2.41	0.0	items
bread	3.00	3.00	3.00	3.00	slices
apricot	2.07	1.34	.61	0.0	items
navybeans	2.51	2.55	2.59	2.72	serving
key lime (juice>				2.72
cheese				1.28	slice
carrot	38.96	34.74	30.54	32.7	items

That's a little better. but Only a little. I'm eating the meatloaf.

She had about a 1/2 serving of Brussels sprouts in the container with the meatloaf. I ate that also. So, let's rerun the model reflecting the Brussels sprouts, the meatloaf, and the two cups of coffee.

1.43

	after 1 cup coffee	after 2 cups coffee	after 2 coffee +meatloaf	after 2 coffee meatloaf brussels sprouts	containers
CarbWatch yogurt	0.68	.60	0.0	0.0	containers
bananas	0.98	1.79	.58	0.85	items
coffee	1.00	2.00	2.00	2.00	cup
scrambled eggs	2.45	2.41	0.0		items
bread	3.00	3.00	3.00	3.00	slices
apricot	1.34	.61	0.0		items
navybeans	2.55	2.59	2.72	2.56	serving
key lime (juice>			2.72	2.15
cheese			1.28		slice
carrot	34.74	30.54	32.7	31.75	items

I'm going to have to go off into a corner someplace until I figure out why this model keeps telling me to eat so many carrots.

Making mashed poatoes

2008-12-07T09:35:00.000-08:00

Snoop Dogg and Martha Stewart make mashed potatoes.

I originally saw this clip at Althouse and at The Agitator.

Even Paul McCartney likes mashed potatoes.

100 calories per package is a marketing gimmick, not a diet aid

2008-12-06T11:07:00.000-08:00

A press release from the University of Chicago

M&Ms as diet food? 100-Calorie Pack Misconceptions

Beware of mini-packs and mini-foods, especially if you’re a dieter.

Chronic dieters tend to consume more calories when foods and packages are smaller, according to a new study in the Journal of Consumer Research. Authors Maura L. Scott, Stephen M. Nowlis, Naomi Mandel, and Andrea C. Morales (all Arizona State University) examined consumer behavior regarding “mini-packs,” 100-calorie food packages that are marketed to help people control calorie intake.

"Interestingly, one group that over-consumes the mini-packs is chronic dieters—individuals constantly trying to manage their weight and food intake,” write the authors.

The researchers believe their research shows that the ubiquitous small packages may actually undermine dieters’ attempts to limit calories. “ On the one hand, consumers perceive the mini-packs to be a generous portion of food (numerous small food morsels in each pack and multiple mini-packs in each box); on the other hand, consumers perceive the mini-packs to be diet food. For chronic dieters, this perceptual dilemma causes a tendency to overeat, due to their emotion-laden relationship with food.”

In a series of studies, the researchers assessed peoples’ perceptions of M&Ms in mini-packs versus regular-sized packages. They found that participants tended to have conflicting thoughts about the mini-packs: They thought of them as “diet food,” yet they overestimated how many calories the packages contained. In subsequent studies, the researchers assessed participants’ relationship with food, dividing them into “ restrained” and “unrestrained” eaters. The “restrained” eaters tended to consume more calories from mini-packs than “unrestrained” participants.

The authors conclude that dieters should keep an eye on small packages: “While restrained eaters may be attracted to smaller foods in smaller packages initially, presumably because these products are thought to help consumers with their diets, our research shows that restrained eaters actually tend to consume more of these foods than they would of regular foods."
Maura L. Scott, Stephen M. Nowlis, Naomi Mandel, and Andrea C. Morales. “The Effects of Reduced Food Size and Package Size on the Consumption Behavior of Restrained and Unrestrained Eaters” Journal of Consumer Research: October 2008.

TV, fast foods, and fat kids

2008-12-06T10:54:00.000-08:00

A news release from Lehigh University

Study links fast-food TV ads to childhood obesity

The largest study of its kind found that banning or decreasing fast-food ads during children’s shows could curb the number of overweight kids.

Shin-Yi Chou co-authored the study linking fast-food TV advertising and childhood obesity.
A ban on fast-food advertisements in the United States could reduce the number of overweight children by as much as 18 percent, according to a new study co-authored by Shin-Yi Chou, the Frank L. Magee Distinguished Professor at Lehigh’s College of Business and Economics.

The study, which is being published this month in the Journal of Law and Economics, also reports that eliminating the tax deductibility associated with television advertising would result in a reduction of childhood obesity, though in smaller numbers.

The study was conducted for the National Bureau of Economic Research (NBER) by Chou and fellow economists Inas Rashad of Georgia State University and Michael Grossman of City University of New York Graduate Center. Each of the co-authors is an economist with NBER.

Funded by the National Institutes of Health, the study measured the number of hours of fast-food television advertising messages viewed by children on a weekly basis.

Serious policy discussion needed

Chou and her colleagues found that a ban on fast-food television advertisements during children’s programming would reduce the number of overweight children ages 3-11 by 18 percent, while also lowering the number of overweight adolescents ages 12-18 by 14 percent.

The effect is more pronounced for males than females.

Though a ban would be effective, the authors also question whether such a high degree of government involvement—and the costs of implementing such policies—is a practical option.

Should the U.S. pursue that path, they would follow Sweden, Norway and Finland as the only countries to have banned commercial sponsorship of children’s programs.

“We have known for some time that childhood obesity has gripped our culture, but little empirical research has been done that identifies television advertising as a possible cause,” Chou says. “Hopefully, this line of research can lead to a serious discussion about the type of policies that can curb America’s obesity epidemic.”

The study also found that the elimination of tax deductibility tied to advertising would similarly produce declines in childhood obesity, albeit at a smaller rate of 5-7 percent. Advertising is considered a business expense and, as such, it can be used to reduce a company’s taxable income. The authors deduce that, since the corporate income tax rate is 35 percent, the elimination of the tax deductibility of food advertising costs would be equivalent to increasing the price of advertising by 54 percent.

Such an action would consequently result in the reduction of fast-food advertising messages by 40 percent for children, and 33 percent for adolescents.

A major health epidemic

The study—the largest of its kind to directly tie childhood obesity to fast-food advertising on American television—is based on the viewing habits of nearly 13,000 children using data from the 1979 Child-Young Adult National Longitudinal Survey of Youth and the 1997 National Longitudinal Survey of Youth, both issued by the U.S. Department of Labor.

A 2006 report issued by the Institute of Medicine indicated there is compelling evidence linking food advertising on television and increased childhood obesity.

“Some members of the committee that wrote the report recommended congressional regulation of television food advertisements aimed at children, but the report also said that the final link that would definitively prove that children had become fatter by watching food commercials aimed at them cannot be made,” Grossman says. “Our study provides evidence of that link.”

Within one generation, childhood obesity has become a major health epidemic in the United States. The Centers for Disease Control estimate that, between 1970 and 1999, the percentage of overweight children ages 6-11 more than tripled to 13 percent. Adolescents between the ages of 12 and 19 also saw a significant increase in obesity, reaching 14 percent.

An overweight child or adolescent—commonly referred to as childhood obesity—is defined as one having a Body Mass Index (BMI) at or above the 95th percentile based on age- and gender-specific growth charts. Research indicates that there is an 80 percent chance an overweight adolescent will be an obese adult and that more than 300,000 deaths can be attributed to obesity and weight in the United States every year.

Kroger's CarbMaster yogurt

2008-12-05T22:03:00.000-08:00

Actually a "cultured lowfat dairy blend".

It's pretty good though.

A 6 oz. container holds one serving and sells for 44c at the local Dillon's store.

80 calories, 10 from fat
5 mg. cholesterol
80 mg. sodium
90 mg. potassium
12 g. protein
4 g. carbohydrates
1 g. complex carbohydrates

It comes in vanilla, peach, strawberry, and raspberry. The strawberry and raspberry are my favorites.

Body Mass Index

2008-12-05T17:19:00.000-08:00

Body Mass Index (BMI) seems to be the international standard for standardizing ideas about weight goals and ideal weight. It a measurement that reflects how well your weight matches to the ideal for your height.

Your Body Mass Index is the ratio of your weight and height. Actually the ratio of your weight to the square of your height. The standard measurements are in metric but you can use pounds and inches for your measurements and multiply the result of your weight divided by the square of your height by 703 for the conversion.

I need to incorporate BMI into my nutritional constraints and objectives for the diet linear programming model I'm working on. I haven't done that yet, but I will.

Pan fried banana

2008-12-05T00:28:00.000-08:00

I'm beginning to change my mind about bananas. I used to think diabetics should avoid them (I don't take insulin). But I'm coming around to a different opinion about them more recently.

Here's a quick hot banana dish that has some ingredients in addition to the banana that can be very helpful.

Slice a banana longways in 3 parts. Coat the bottom of a frying pan with olive oil. Bring to a high heat and lay the bananas in the oil. Sprinkle the up side liberally with powdered cinnamon. When slightly browned turn over, sprinkle the other side with cinnamon. When browned remove bananas to a plate and squeeze the juice of a lime over them. Serve hot.

The cinnamon helps in insulin production (and helps cholesterol also). The lime juice acts as both a diuretic which can help control hypertension and to restore depleted potassium. Of course we all know how useful olive oil is.

290 calories, 125 from fat
4mg sodium
2 g. protein
47 g carbs
29 g complex carbs

A reading list

2008-12-04T11:56:00.000-08:00

Katsunosuke Mitani and Hirotaka Nakayama (1998). A muliobjective diet planning support system using the satisficing trade-off method. Journal of Multi-Criteria Decision Analysis, V6, pp 131-139.

George B. Dantzig (1990), The Diet Problem, Interfaces, V20.4, pp43-47

Donald K. Layman, Peter Clifton, Mary C. Gannon, Ronald M. Krauss, and Frank Q. Nuttall (2008), Protein in optimal health: heart disease and type 2 diabetes.

American Journal of Clinical Nutrition

, V87, 15718-15755.

Gabriele Riccardi and A. A. Rivellese (2000), Dietary treatment of the metabolic syndrome - the optimal diet. British Journal of Nutrition, V83, pp S143-S148

Infeasibility

2008-12-03T06:26:00.000-08:00

This is a somewhat technical post about he mathematical modeling of an optimal diet, it's not really about food.

A linear programming model is the minimization of the value of a linear function in such a way that the solution still satisfies a collection of linear constrains. In a simple form of the linear formulation of the optimal diet problem we want to

minimize c₁*x₁ + c₂*x₂
such that
p₁*x₁ + p₂*x₂ > 77
x_i > 0 for all i

Where x_i is the quantity of food i (we have two foods to choose from)

c_i is the quantity of carbohydrates contianed in food i (the objective is to minimize this)

p_i is the protein content of food i

and we want to constrain the solution to ensure we have a least the specified level of protein in the diet.

This two variable, one constraint version is pretty easy to solve. Just pick the food that has the highest protein per carb (or lowest carb per protein) and eat as litle of that food as you can and still get enough protein. That's your minimum carbohydrate solution.

I havn't really gotten to the topic of infeasibility yet and the post is starting to get long. So let me just finish off with a specific example and I'll get back to this on another day.

Let's say we have two foods to pick from -- chili and bread. A serving of chili has 18 grams of carbs with 17 grams of protein and a slice of bread has 15 grams of carbs with 3 grams of protein.

Carb per protein for the bread is 15/3 = 5 and for the chili it's 18/17 = 1 (about). The chili is clearly the best choice for this mini-model. Eat enough chili to get the required protein and stop. That's a minimum carb diet that fits the model.

The model is overly simplistic, of course. We'll get to that on another day.

Goal programming

2008-12-02T08:06:00.000-08:00

For now I'm going to stick with the linear programming model of the diet problem that I've been talking about

minimize carbohydrates
subject to constraints on
protein
calorie intake
calories from fat
sodium
etc, etc

But there is an alternative modeling technique (which I might try later) called goal programming.

In goal programming I'd want to minimize deviations from goals where the goals are various intake levels of
carbohydrates
protein
calories
calories from fat
sodium

I'm already doing that to some extent in my linear programming model by introducing slack variables to allow for exceeding or falling short of various levels of nutrients and mathematically treating these slack variables as "foods" with very high carb counts. That's just a mathematical modeling trick to allow the solution algorithm to work even in situations where the constraints are at odds with each other and a feasible solution that meets all the constraints can't be found.

So changing the model to a goal programming model rather than a linear programming model isn't going to be a big leap, but I'm not going to do it for a couple of weeks. I'll be thinking about it though.

Today's Food Music

2008-12-02T06:08:00.000-08:00

Jimmy Buffet, Cheeseburger in Paradise

Status of the diet model

2008-12-01T20:08:00.000-08:00

I've been modifying the minimum carbohydrate diet model I've been working on. Here's what the model looks like now.

Minimize Total carbohydrates
subject to
protein GE 77g
calories GE 1900
calories from fat LE 220
daily cost LE $15
sodium LE 2000
veg GE 5 servings
fruit GE 3 servings
grains GE 3 servings
dairy GE 3 servings

Cold Pea Soup

2008-11-30T19:23:00.000-08:00

Ingredients
Can of peas
2 jalapenos
juice of 1 key lime
``1 tablespoon olive oil

Combine all in a blender and blend.

Calories 390
Calories from fat 133
Sodium 1206
Carbohydrates 51
Complex Carbohydrates 34
Protein 16

Another update on the original diet problem

2008-11-29T09:17:00.000-08:00

Yesterday I did a quick cost update on Stigler's 1939 minimum cost diet recommendation (it was published in 1945 but based on 1939 prices).

An update of his study was published in 2002 (based on 1998 prices). Written by Susan Garner Garille and Saul I Gass it appeared as "Stigler's Diet Problem Revisited" in Operations Research, Jan 2001.

A review of the article is here.

The researchers updated the original data to reflect price changes, revised values of the RDA's, and current evaluations of the nutrient content of the 77 foods chosen by Stigler. The updated problem shows that the optimal solution diet for a 25-50 year old man consists, on a daily basis, of 1.31 cups of wheat flour, 1.32 cups of rolled oats, 16 fluid ounces of milk, 3.86 tablespoons of peanut butter, 7.28 tablespoons of lard, 0.0108 ounces of beef liver, 1.77 bananas, 0.0824 of an orange, 0.707 cup of shredded cabbage, 0.314 of a carrot, 0.387 of a potato, and 0.53 cup of pork and beans. The daily cost of this diet is $1.78.

These costs are actually higher than the estimates I made yesterday for the Stigler diet. But they updated the model with more restrictions than in the original model, which would tend to cause an increase in minimum cost.

Both diets provides servings from all six food groups established by the USDA: 1) fats, oils, and sweets group; 2) milk group; 3) meats and beans group; 4) vegetable group; 5) fruit group; and 6) grain product group.

Cost of subsistence at today's prices

2008-11-28T06:39:00.000-08:00

In Stigler's 1945 Journal of Farm Economics article he gave a solution to the diet problem of minimizing costs subject to some lower bounds on nutrition and vitamin intake which gave a daily ration of just a little more than

1 lb of flour
1/7 can of evaporated milk
.3 lb of cabbage
1 oz spinach
3/4 lb navy beans (dried).

That's a lot of bisquit and beans but it actually sounds like a pretty tasty daily ration.

In 1939 prices that worked out to about 11c a day.

Today you can get a 5 pound bag of flour for about $2. I think the cans are smaller these days than in 1939 but a can of evaporated milk is about $1. Cabbage is 50c a pound and dried navy beans about $1.25 a pound. Spinach prices vary but I'll estimate that at $1 a pound.

So, at today's prices, the daily ration above would cost about $1.69 per day.

Cabbage nutritional information

2008-11-27T21:41:00.000-08:00

Green Cabbage Nutritional Information

Serving size 1/12 med. head (84g)
Calories 25
Total Fat 0g
Sodium 25mg
Total Carbohydrate 6g
Dietary Fiber 2g
Protein 1g

% of U.S. RDA
Vitamin A 0%
Calcium 4%
Vitamin C 60%

There are 454 grams per pound. So, per pound, cabbage has
135 Calories
135 mg sodium
32.4 g carbohydrates
5.4 g protein
21.6% DMR Calcium
324% DMR VC

Evaporated Milk Nutritional information

2008-11-26T21:27:00.000-08:00

(condensed milk is usually sweetened)

Off brand labels are available for about 96c per 12oz can. At 2tbsp per serving, that's about 12 servings (2 tablespoons is about 1 fluid ounce).

The Original Diet Problem

2008-11-25T19:18:00.000-08:00

Over the last few days I've been looking at a linear program to model the development of a minimum carb diet with bounds on protein, calories, and fat[1] [2] [3}. I thought this would be a nice time to take a short look at the origins of the mathematics of diet construction.

The diet problem originally arose about the time of the beginnings of the human experience. But it wasn't until George Stigler published his article, "The Cost of Subsistence" in The Journal of Farm Economics in 1945.

Stigler developed a minimum cost diet containing at least minimum levels of calories, protein, calcium, iron, vitamin A, vitamin B₁, vitamin B₃, niacin, and vitamin C.

This model was developed during WWII, before anyone had figured out an algorithm to solve a linear optimization problem so Stigler used a heuristic solution methodology to come up with a minimum cost diet of wheat flour, evaporated milk, cabbage, spinach, and Navy Beans.

I could live on that.

2008-11-24T18:27:00.000-08:00

Tomato Drink

Lettuce, green leaf, raw 0.5 cup
Lime, raw, 1
Pepper, jalapeno, 0.5 pepper
Tomato juice, canned, 1 cup

Preparation

Chop the raw ingredients and put into a blender with the tomato juice.

FOOD SUMMARY

Total calories. 67
Calories from fat 3 (less than 1 oz fat)
Sodium 214 mg
Carbohydrates 18 g
Calories from carbohydrates
Protein 3g

NUTRITIONAL TARGET MAP™ The Nutritional Target Map™ allows you to see at a glance how foods line up with your nutritional and weight-management goals. The closer a food is to the right edge of the map, the more essential nutrients per calorie it contains. For a more nutritious diet, select foods that fall on the right half of the map.

The closer a food is to the top edge of the map, the more likely it is to fill you up with fewer calories. If you want to restrict your caloric intake without feeling hungry, choose foods from the top half of the map.

Foods that are close to the bottom edge are more calorie-dense. If you want to increase your calorie intake without getting too full, choose foods from the bottom half of the map.
Read more about the Nutritional Target Map

4.5 4.6 Fullness Factor ND Rating

NutritionData's Nutrition Data's Opinion
Opinion

NUTRITION DATA'S OPINION Nutrition Data awards foods 0 to 5 stars in each of three categories, based on their nutrient density (ND Rating) and their satiating effect (Fullness Factor™). Foods that are both nutritious and filling are considered better choices for weight loss. Foods that are nutritious without being filling are considered better choices for healthy weight gain. Foods that have more essential nutrients per calorie are considered better choices for optimum health.

Nutrition Data also indicates whether a food is particularly high or low in various nutrients, according to the dietary recommendations of the FDA.
Read more about Nutrition Data's opinion
Weight loss:
Optimum health:
Weight gain:

The good: This food is very low in Saturated Fat and Cholesterol. It is also a good source of Dietary Fiber, Thiamin, Niacin, Pantothenic Acid, Iron, Magnesium, Copper and Manganese, and a very good source of Vitamin A, Vitamin C, Vitamin K, Vitamin B6, Folate and Potassium.

The bad: This food is high in Sodium, and a large portion of the calories in this food come from sugars.
Caloric Ratio Pyramid Estimated Glycemic Load

CALORIC RATIO PYRAMID™ This graphic shows you what percentage of the calories in a food come from carbohydrates, fats, proteins, and alcohol. If you are trying to achieve a specific distribution of calories, such as the 40/30/30 distribution of the Zone™ diet, or the more traditional 60/30/10 distribution, the Caloric Ratio Pyramid™ will show you how recipes, meal plans, or individual foods line up with those goals.

Foods low in fat, for example, will cluster along the bottom edge of the pyramid, ranging from foods that are high in carbohydrates (at the left edge) to foods that are high in protein (at the right edge). Foods low in carbohydrates will cluster along the right edge of the pyramid, with foods that are high in fat at the upper edge and foods that are high in protein at the lower edge. Foods that have roughly the same number of calories from fats, calories, and protein will be found closer to the center of the pyramid.
Read more about the Caloric Ratio Pyramid

85% 5% 10%
Carbs Fats Protein

5
72
mildly anti-inflammatory
Estimated Glycemic Load

Inflammation Factor

ESTIMATED GLYCEMIC LOAD™ Glycemic load is a way of expressing a food or meal's effect on blood-sugar levels. Nutrition Data’s patent-pending Estimated Glycemic Load™ (eGL) is available for every food in the database as well as for custom foods, meals, and recipes in your Pantry.

How to interpret the values: Experts vary on their recommendations for what your total glycemic load should be each day. A typical target for total Estimated Glycemic Load is 100 or less per day. If you have diabetes or metabolic syndrome, you might want to aim a little lower. If you are not overweight and are physically active, a little higher is acceptable.
Read more about the eGL

IF (INFLAMMATION FACTOR) RATING™ The IF (Inflammation Factor) Rating™ estimates the inflammatory or anti-inflammatory potential of individual foods or combinations of foods by calculating the net effect of different nutritional factors, such as fatty acids, antioxidants, and glycemic impact.

How to interpret the values: Foods with positive IF Ratings are considered anti-inflammatory, and those with negative IF Ratings are considered inflammatory. The higher the number, the stronger the effect. The goal is to balance negative foods with positive foods so that the combined rating for all foods eaten in a single day is positive.
Read more about the IF Rating

Back to the diet problem

2008-11-23T07:00:00.001-08:00

I’m still working on that linear programming model of a low carb diet.

Here’s my most recent solution

Carbohydtrates 3.19 grams

Food selections
yogurt 4
caulwsauce 3
banana 5.23
coffee 2
spinaprsalad 5
chili 0.18
AtkinsShake 0.49
Oatmeal 3

Protein 95
Calories 1800
Calories from fat 220

Note that I’ve added a few foods to select from and I’ve put some limits on how much of certain foods are selected. No more than 4 yogurts, 3 of the cauliflower w/cheese sauce, 2 coffees, 5 salads, and 3 oatmeals.

Foods in the mix that the model does not select are peanut butter w/cracker, tomato juice, and scrambled egg.

I’m still working on adding some foods to the model. Three that come to mind right now are bread, apricots, and maybe a shrimp salad.

The model likes the bread. Adding these three foods gives me a reduction in carbs from 319 g. to 291 grams but it means eating 18 hunks of Italian bread to get there. Limiting bread to 4 servings a day gives a more rational solution.except it calls for eating 28 apricots a day. Sigh.

I have three foods to select form with apricots (the shrimp salad, the spinach salad and the canned apricots). Limiting the combination of those three to a total of five apricots per day gives

Yogurt 4
Cauliflower 3
Banana 5
Coffee 2
Spinach/apricot salad 5
Chili 1.3
Bread 4

With 312 g carbs, less than 95 g. protein, 1800 calories, 220 from fat.

Shrimp and apricot salad

2008-11-22T06:08:00.000-08:00

Kroger has a store brand of canned apricots that are sweetened with Splenda. The local store (Dillons) sells it for $2.09 for a 23.5 oz. bottle. Half cup servings have 30 calories, 7 g. of carbs. Cheap, nutritious, low carb, and tasty. I look for ways to eat it.

This shrimp salad is one way I came up with.

Makes 4 servings.

1 can tiny shrimp
6 canned apricot halves, chopped
1 stalk celery, chopped
1 cucumber, peeled and chopped
5 sprigs dill, chopped
4 green union stalks, chopped

Mix and toss ingredients.

According to this site, each serving has 224 calories (22 from fat), 30 g. protein, and 21 g. carbs.

Still more on the diet problem

2008-11-21T08:51:00.000-08:00

The last couple of days I’ve been working on developing a linear programming model for a minimum carbohydrate diet that meets some restrictions on protein, calories, fat, and cost.

Yesterday I’d found a three food solution of
yogurt 5.6
cauliflower w/cheese sauce 9.5
banana 8.3
coffee 1

I guess that’s four foods if you count the cup of coffee.

Let’s add a couple of foods to the pool of foods for the model to choose from.

A spinach and apricot salad has 49 calories, none from fat, 12 g. of carbs and 2 g. of protein.

But that’s not really what I need to add to the mix. I need to find a high fat, low carb food to select from. Let’s try chili -- 194 calories, 68 from fat, 18 g. of carbs and 17 g. of protein.

Now we get a solution that looks like.

1 yogurt 4.763448 0
2 caulwsauce 0 0.827936
3 peanutbuttercrack 0 111.4818
4 banana 0 0.164621
5 coffee 1.292776 0
6 tomatoejuice 0 1.296119
7 spinaprsalad 18.79003 0
8 chili 2.534787 0
No. Constraint Dual Value Activity (A*x)
1 maxprotein -1.15522 95
2 minprotein 0 77
3 calories 0 2200
4 calfromfat -0.5715 220
5 mincalories 0.298708 1800
6 cost -0.72499 15
7 coffee 0 1

Like the last solution, this one has 3 foods plus coffee. But unlike the last solution this one is really a 4 food solution. The model forces at least 1 cup of coffee a day (I’m addicted). But that constraint isn’t binding in this solution, the optimal calls for 1.3 cups of coffee, more than the minimum.

The four constraints that are binding is the maximum limit on protein, the minimum level of calories, the maximum total cost, and the maximum number of calories from fat.

And although it’s a nice salad, almost 19 servings of the spinach/apricot salad a day isn’t really a satisfactory solution. Tomorrow I’ll add a couple new foods and look at some of the item costs more carefully.

Simple spinach and apricot salad

2008-11-19T19:19:00.000-08:00

1/2 cup raw spinich
2 chopped apricots.

Mix

Sprinkle with the juice of 1 lime.

The diet problem

2008-11-19T13:27:00.000-08:00

I want to limit my carbs, my calories, my fat, and my protein, but I don’t want to starve to death.

One way to look at it is to minimize carbohydrates subject to calories between 1800 and 2200, protein between 77 and 95 grams, and calories from fat less than 220.

That’s a linear program, which I know how to solve. All that’s left to specify is the characteristics of the foods I want to pick from.

Let’s start with Kroger brand CarbWatch yogurt (not really a yogurt). It has 80 calories, 10 from fat, 12 grams of protein and 4 grams of carbs.

A diet of just the low carb yogurt won’t work, it has an infeasible solution to the linear program since to get enough calories from just the one food would greatly exceed my protein limits.

So as a second food I need to add something with very small protein contents. Let’s try a banana. That has 93 calories, 4+ from fat, 1 gram of protein, and 24 grams of carbohydrates..

About 6-7 yogurt containers and 13-14 bananas seems to be a workable mix although I think I’d tire of that diet pretty quickly and I expect that it would cause some deficiencies in vitamins my model isn’t tracking.

To add a little variety let’s think about a spoon full of peanut butter now and then, maybe on a cracker. One cracker with a tablespoon of peanut butter has 99 calories, 65 from fat, 24 grams of protein and 76 of carbs. Adding it still results in a two food solution.

One quirk of linear programming models is that an optimal solution will have no more than m nonzero food quantities if there are m restrictions on the model. My model has restrictions on calories, protein, and calories from fat so the model has room for at most 3 food choices. The three I’ve put into the model aren’t the right 3 to provide a mix though. Let’s try some more.

Kroger store brand has a frozen cauliflower side dish with a low fat cheese sauce., 60 calories, 10 from fat, 2 grams of protein and 10 grams of carbs. Adding that to my mix of food to pick from gives me a 3 food solution, 5 containers of the carbwatch yogurt, 6 bananas and 14 servings of the cauliflower with low fat cheese sauce.

Again, not a daily diet I’m going to look forward to. I like cauliflower, but 14 packages a day is a little much.

To get a 4 food solution I’m going to need a model with at least 4 constraints, in addition to adding more foods to pick from. I'll work on that tomorrow.

Tracking Diet

2008-11-14T19:05:00.000-08:00

I'm having kidney problems, so I need to limit my protein intake. Because of diabetes I need to be careful with my carbohydrate intake. I need to lose weight so I need to limit my fat consumption.

It's quite a juggling act to do all that and still actually eat enough to stay alive.

More exercise would help but I'm limited in that right now also because I have some arterial blockages that cause a lack of stamina, shortness of breath.

Teeth and Sugar

2008-11-08T17:24:00.000-08:00

As I mentioned in another blog posting, I recently discovered that I wasn't going to have to get a payday loan to pay for some new teeth, I'm able to get the VA to pay for it.

My teeth got in pretty bad shape after I developed diabetes. The first step in getting new dentures is to pull all your teeth. Then it takes the VA a couple of months to get the new dentures fitted and made. In the meantime I'm eating a lot of soup.

I was making with mostly just vegetables (I'm having kidney problems and am supposed to keep my protein intake low) and I wasn't putting any potatoes, noodles, or rice in the soups because of carbs.

The result has been that I've had a couple of t hose diabetic low carb attacks I'd always heard about but never experienced. Since I don't take insulin I don't ever get too much insulin. But the soup diet caused me to end up unintentionally restricting my carb intake even more than usual. Too much it seems.

Learn the signs of low blood sugar.

Protein

2008-10-28T22:41:00.000-07:00

I'm having some problems with kidney function (a side effect of my diabetes) and my K-doc told me to limit my protein intake.

The problem is that I don't really know what means and I didn't think to ask her at the time.

So how much protein should I eat?

According to this site someone my weight should eat about 75 grams. But I'm a little overweight, and somebody the weight I probably should be at needs about 55 grams per day.

So, does that mean eating between 55 and 75 grams of protein a day is about right?

Medicinal Plants

2008-06-07T06:25:00.000-07:00

Journal of Ethnobiology and Ethnomedicine is a peer-reviewed research journal with a focus on medicinal plants.

Tracking your food

2008-05-16T13:30:00.000-07:00

I found a website that allows you to analyze recipes and keep track of nutritional intake. I don't have any experience using it yet.

Red Wine and Black Tea

2008-04-19T03:40:00.000-07:00

A little red wine every day, and some black tea, seems like good choices for diabetics.

metoprolol

2008-03-21T16:17:00.000-07:00

Metoprolol is a Beta-blocker. Beta-blockers block the action of the natural flight-or-fight response and are used to treat high blood pressure.

I take 25mg, twice a day.

Taking Metoprolol can be a problem if you have diabets or depression, and I have both. But, my doctor seems to think it's okay. I hope he's right.

Some side effects can be worse than others.

serious side effects:

* slow or uneven heartbeats;
* feeling light-headed, fainting;
* feeling short of breath, even with mild exertion;
* swelling of your ankles or feet;
* nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
* depression; or
* cold feeling in your hands and feet.

Other less serious side effects are more likely to occur, such as:

* vomiting;
* decreased sex drive, impotence, or difficulty having an orgasm;
* sleep problems (insomnia);
* tired feeling; or
* anxiety, nervousness.

Metoprolol has a bad reaction with grapefruit. Some drugs it interacts with include

What other drugs will affect metoprolol?

Before taking metoprolol, tell your doctor if you are using:

*

digoxin (digitalis, Lanoxin);
*

clonidine (Catapres);
*

ritonavir (Norvir);
*

terbinafine (Lamisil);
*

anti-malaria medications such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox);
*

medicine to treat depression or mental illness, such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), thioridazine (Mellaril), and others;
*

an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);
*

a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);
*

a heart medication such as nifedipine (Procardia, Adalat), quinidine (Quinaglute, Quinidex), propafenone (Rythmol), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem);
* medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair);
* a diuretic (water pill) such as amiloride (Midamor, Moduretic), chlorthalidone (Hygroton, Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others; or
* cold medicines, stimulant medicines, or diet pills.

Since I take both Zoloft (similar to Prozac and Paxil) and amiloride, I'm not so sure this drug is a good idea for me.

Divalproex

2008-03-17T21:18:00.000-07:00

Divalproex is an anticonvulsant and antimanic drug. I take it for its antimanic properties because of a prior reaction I had to an overdose of zoloft.

Divalproex has adverse interaction with

Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
Amiodarone (e.g., Cordarone) or
Amitriptyline and nortriptyline
Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
Androgens (male hormones) or
Anticoagulants
Aspirin
Barbiturates or
Carbamazepine (e.g., Tegretol) or
Carmustine (e.g., BiCNU) or
Dantrolene (e.g., Dantrium) or
Daunorubicin (e.g., Cerubidine) or
Disulfiram (e.g., Antabuse) or
Estrogens (female hormones) or
Ethosuximide
Etretinate (e.g., Tegison) or
Gold salts (medicine for arthritis) or
Mercaptopurine (e.g., Purinethol) or
Methotrexate (e.g., Mexate) or
Methyldopa (e.g., Aldomet) or
Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
Plicamycin (e.g., Mithracin)—There is an increased risk of serious side effects to the liver
Central nervous system (CNS) depressants (medicines that cause drowsiness) or
Tricyclic antidepressants (medicine for depression)—There may be an increase in CNS depressant effects
Carbenicillin by injection (e.g., Geopen) or
Dipyridamole (e.g., Persantine) or
Inflammation or pain medicine, except narcotics, or
Pentoxifylline (e.g., Trental) or
Sulfinpyrazone (e.g., Anturane) or
Ticarcillin (e.g., Ticar)—Valproic acid, valproate sodium, or divalproex may increase the chance of bleeding because of decreased blood clotting ability; the potential of aspirin, medicine for inflammation or pain, or sulfinpyrazone to cause stomach ulcer and bleeding may also increase the chance of bleeding in patients taking valproic acid, valproate sodium, or divalproex
Heparin—There is an increased risk of side effects that may cause bleeding
Mefloquine—The amount of valproic acid, valproate sodium, or divalproex that you need to take may change
Other anticonvulsants (medicine for seizures)—There is an increased risk of seizures or other unwanted effects

Side effects include

More common

body aches or pain ; congestion; cough; dryness or soreness of throat; fever ; hoarseness runny nose; tender, swollen glands in neck ; trouble in swallowing; voice changes

Less common

Abdominal or stomach cramps (severe); behavioral, mood, or mental changes; blurred vision;; confusion; ; continuous, uncontrolled back-and-forth and/or rolling eye movements; earache, redness or swelling in ear; dizziness,; double vision; faintness, or light-headedness when getting up from a lying or sitting position suddenly; sweating; unusual tiredness or weakness; fast, irregular, pounding, or racing heartbeat or pulse; heavy, nonmenstrual vaginal bleeding; increase in seizures; loss of appetite; nausea or vomiting (continuing); rapid weight gain; spots before eyes; swelling of face, arms, hands, lower legs, or feet; tingling of hands or feet; tiredness and weakness; unusual bleeding or bruising; unusual weight gain or loss; vomiting of blood or material that looks like coffee grounds; yellow eyes or skin

Sertraline

2008-03-16T04:56:00.000-07:00

Sertraline is the generic name for Zoloft, an SSRI anti-depressant.

Side effects include

nausea
diarrhea
constipation
vomiting
dry mouth
gas or bloating
loss of appetite
weight changes
drowsiness
dizziness
excessive tiredness
headache
pain, burning, or tingling in the hands or feet
nervousness
uncontrollable shaking of a part of the body
sore throat
changes in sex drive or ability
excessive sweating

Some side effects can be serious. If you experience any of the following symptoms call your doctor immediately:

blurred vision
seizures
abnormal bleeding or bruising
hallucinating (seeing things or hearing voices that do not exist)

When I first started taking Zoloft, a few years ago, I was taking too much and did experience blurred vision. However, my doctor was a complete quack and when I described it to him I didn't use the phrase "blurred vision". I just told him that as I drove down the highway the scenery looked like a flat oil painting. So he ignored me.

Pay careful attention to doctors who aren't paying attention to you and if that describes your doctor you need to find another one. Quack doctors do more harm than side effects to medication and psychiatry has more than its share of quacks.

Sertraline has negative interactions with

•astemizole (Hismanal®)
•cisapride (Propulsid®)
•pimozide (Orap®)
•terfenadine (Seldane®)
•thioridazine (Mellaril®)
•medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)

Sertraline may also interact with the following medications:
•amphetamine
•bosentan
•carbamazepine
•certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine)
•certain migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
•cimetidine
•cyclosporine
•dextroamphetamine
•dextromethorphan
•diazepam
•doxercalciferol
•furazolidone
•linezolid
•other medicines for mental depression, mania, anxiety, psychosis or difficulty sleeping
•phenobarbital
•prescription pain medications
•procarbazine
•rifabutin
•rifampin
•rifapentine
•selegiline
•St. John's wort
•tolbutamide
•tramadol
•warfarin

St. Johns Wort is an effective herbal treatment for depression. Do not take both St. Johns Wort and sertraline becuase they have a cumulative effect on brain chemistry.

Erectile dysfunction is one of the most frequent side effects of SSRI medications. An herb that can help counteract that is Ginko Biloba. Ginko Biloba improves blood flow and is helpful in erectile dysfunction, diabetes, high blood pressure, and memory loss.

Glyburide

2008-03-14T11:20:00.000-07:00

Glyburide stimulates the pancreas to produce insulin.

side effects.
skin rash
itching or redness
exaggerated sunburn
yellowing of the skin or eyes
light-colored stools
dark urine
unusual bleeding or bruising
fever
sore throat

Bitter Olive Salad

2008-03-14T10:24:00.000-07:00

Bitter Melon, an Asian squash with a somewhat bitter taste, seems to have some slight medicinal properties for diabetics, stimulating the processing of sugars. So, I'm trying to come up with different ways to include some Bitter Melon in my diet on a regular basis.

2 tbsp Balsamic vinegar
chop 4-5 slices bitter melon (de-seeded).
1 chopped celery stalk
2-3 onion slices, chopped
1/4 cup chopped green olives
1/3 tbsp horseradish
couple of dashes of red pepper flakes
2 tbsp grated Parmesan cheese

Combine all ingredients. Mix well. Marinate from 2 hours to a couple of days.

Serve as a topping for Italian sandwiches, hamburgers, etc.

Metformin

2008-03-13T16:12:00.000-07:00

Metformin is a treatment for Type II diabetes.

It works by decreasing the amount of sugar that the liver produces and the intestines absorb. It also helps to make your body more sensitive to the insulin that you naturally produce.

Be careful what else you take with metformin

Tell your health care provider if you are taking any other medicines, especially any of the following:

Amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin ... may increase the risk of Metformin 's side effects
Calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), insulin, isoniazid, nicotinic acid, phenothiazine (eg, chlorpromazine), phenytoin, sulfonylureas (eg, glipizide), sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because the risk of high or low blood sugar may be increased

Amlodipine besylate is one of the medications I take, and it's a calcium channel blocker.

The other day I went on an overnight trip and packed some pills in old pill boxes to throw in the suitcase. My old metformin script was for 500 mg pills, take 2 twice a day. My new pills are 1000 mg pills, 1 twice a day. I read the bottle, saw the twice a day, and thought I must have been taking the wrong dosage, so I took two pills.

When I got home I kept up the 2 pills twice a day (I just didn't look on the new label) and within a couple of days starting getting throbbing pains in my ankle. That's not listed as one of the side effects of meformin, but when I went back to the correct dosage the throbbing subsided.

So, if you're mixing metformin with other pills pay attention to side effect potentials. Common side effects are

Diarrhea; gas; headache; indigestion; nausea; stomach upset; temporary metallic taste; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or discomfort; dizziness or lightheadedness; fast or difficult breathing; feeling of being unusually cold; fever, chills, or persistent sore throat; general feeling of being unwell; muscle pain or weakness; slow or irregular heartbeat; unusual drowsiness; unusual or persistent stomach pain or discomfort; unusual tiredness or weakness.

Amlodipine besylate

2008-03-13T09:45:00.000-07:00

Amlodipine besylate is a medication that's being prescribed for me because of high blood pressure (a complication that developed from the diabetes).

It is a type of medication called a calcium channel blocker. These drugs dilate blood vessels and slow the heart to reduce blood pressure and the pain of angina.

A once-a-day medication, (it) may be used alone or in combination with other drugs for high blood pressure

More common side effects may include:
Dizziness, fatigue, flushing, fluid retention and swelling, headache, palpitations (fluttery or throbbing heartbeat)
There are no known food or drug interactions with Amlodipine besylate

Bitter Cilantro and Coconut Shrimp

2008-03-12T16:21:00.000-07:00

Make a gravy with 2 tbsp coconut flour, 3 tbsp butter, 1 cup milk.

Add chopped cilantro (about 1/2 cup) and coconut flakes (about 3 tbsp). Be sure and use unsweetened coconut, a lot of the stuff in the grocery store has added sugar.

Add 1/2 cup chopped bitter melon (without seeds) and 1 chopped celery stalk.

Add black pepper and cook over low heat until it's all blended.

Add small jar of artichoke hearts (6 oz) and 1 lb. cooked, shelled shrimp.

Continue cooking over low heat for about 10 minutes, stirring often.

If you aren't diabetic you could serve it over rice. Otherwise just try a toasted slice of low-carb toast.

Bitter tomato soup

2008-03-12T15:01:00.000-07:00

1/2 cup chopped bitter melon (deseeded).
1/2 cup chopped zucchini
1/2 cup chopped onion
1 chopped celery stalk

Saute in pan with light coating of oil.
Add small amount of water and simmer a few minutes.
Add 1 tbsp turmeric.

Add can of tomato soup.
Bring to slight boil.

Diabetic Potato Salad

2008-03-03T13:23:00.000-08:00

Turnips make a good low-carb substitute for potatos.

Boil 1 turnip and 1 red potato. Chop them.
Chop 3 green onions.
Chop 2 celery stalks.

Mix together with 3 large spoons of salad dressing, 1 cooked bacon strip (crumbled).

Add black pepper to taste.

Correction: I got a complaint about how I spelled potatoe, so I changed it. Or is it spelt?

Diabetics Banana Split

2008-03-01T15:41:00.000-08:00

Banana's are fairly high in carbs -- about 30 grams per banana. But they are really good in vitamins, including potassium which is helpful for leg cramps that diabetics sometimes get from poor leg circulation.

So what do we do?

Well, cinamon and baker's dark chocolate help the body process sugars.

So, slice up a banana, put it in the bottem of a bowl.

Add a couple of scoops of a sugar free vanilla ice cream.

Make a sauce of about an ounce of baker's chololate shavings, about an ounce of cinaomon, a couple of ounces of artificial sweetner and a splash of milk by heating it in a microwave until it's all blended.

Poor over the ice cream.

Top with a spoonful of sugar free cherry preserves (about 2 grams of carbohydrates).

That should work.

Search engine terms

2008-03-01T12:36:00.000-08:00

Some search engine terms that have brought people to the blog

avoid blood sugar spikes, how to
alternative diabetic treatments
how to control sugar by yoga
can diabetics eat dark chocolate
"bitter melon" cup tsp
can diabetics eat bananas
Should Diabetics eat Sugar
should diabetics eat bananas
side effdects of amodipine
How many carbohydrates in a hamburger steak
is dark sugar good for you?
tumeric effect on diabet
is eating dark chocolate bad with diabetes

That's just a few. A couple of banana searches in that batch, a couple of dark chocolate queries. Maybe I need to do a blog post about chocolate bananas?

Pan fried bitter melon

2008-02-28T08:23:00.000-08:00

Slice one bitter melon.
Slice one yellow squash.
Slice 1/2 onion.
Saute in oil.
Add garlic powder and hot sauce to taste.
Right before it's finished cooking add 1/2 cup chopped bok choy.

Exercise

2008-02-27T09:27:00.000-08:00

You need some kind of exercise every day. Even if it's just walking around in the yard picking up trash. Anything. Get up, move around.

The best time to get some exercise is after a meal, maybe between one to three hours after eating. Exercise has immediate blood sugar effects in addition to long term health benefits and a couple of hours after eating is typically when you'll be at a blood sugar maximum, most in need of immediate exercise.

Diabetic Hamburger Steak

2008-02-26T19:58:00.000-08:00

Large slice of onion, finely chopped.
Large turnip slice, boiled, then chopped.
1/4-1/2 tspn tumeric
1 hamburger patty, ex-lean.

Mix it all together by folding over and over, form into a patty and fry in a pan.

Fruit bowl for diabetics

2008-02-25T08:05:00.000-08:00

Slice a pear into a bowl, add a splash of lemon juice, sprinkle with cinammon, microwave for a minute or two to soften up the pear (time depending on how green the pear is).

Add strawberry (frozen or fresh). Top with shavings of bakers chocolate (100% cacao).

Microwave to melt the chocolate.

Pears and strawberries aren't bad fruits for diabetics. Cinnamon and cacao seem to have medicinal properties for diabetics.

More diabetic cooking -- Boiled turnip

2008-02-24T05:10:00.001-08:00

Boil 1 large turnip and 1 small red potatoe.

Put in a bowl and chop them up.

Add a pat of butter, black pepper to taste, a dash of balsamic vinegar (I used a raspberry infused one), and a dollop of low-fat sour cream.

Mashed Bitter Melon

2008-02-23T11:01:00.000-08:00

Boil 1 Bitter Melon, 1 small red potatoe, 1 green pear and mash together (spoon our the pear core before mashing). Just use a regular potatoe masher or a large fork.

Add about 1/4-1/2 tsp tumeric as you mix it.

You could also add 1 turnip to the mix.

That's all there is to it. You could add a little butter and black pepper if you like.

A Bitter Melon recipe

2008-02-22T10:07:00.000-08:00

Bitter Melon and tumeric are both good for reducing blool sugar levels.

Boil 1 bitter melon and 1 green pear
Coarsely chop 1 red onion.
Saute onion in a little oil.
Add one large sliced jalapeno.
1 tsp. tumeric and 1/2 tsp. dried red pepper
Keep stirring.
Chop the boiled bitter melon and pear and add to the pan.
At the last minute add 1/2 cup chopped bok choy greens.

If you weren't diabetic you could serve over rice.

This might be a little hot for you, reduce the red pepper, tumeric and jalapeno to taste.

Also, it can't hurt your blood sugar to reserve the stock used to boil the bitter melon anad green pear and use it as a base to make some tea.

Yoga and Diabetes

2008-02-19T10:18:00.000-08:00

Stress is not healthy. Yoga is a formal system for managing stress. The use of Yoga as a part of the management of diabetes

has resulted in reduction in the dosage of hypogliycemic agents and insulin, control over weight, increased glucose tolerance, and reduction in hyperglycemia.*

From, B. Manyam, "Diabetes Mellitus, Ayurveda, and Yoga, Journal of Alternative and Complementary Medicine

But you don't need a formal program of Yoga as much as you just need to calm down. Managing diabetes is about not overeating, getting exeercise, and avoiding stress. Just those three simple things will take you a long ways.

Calories and carbs

2008-02-19T08:23:00.000-08:00

Until recently most of my focus on the Nutrition Facts label during my food shopping had been on the carbs. But I've been looking at calories more closely.

Yesterday I looked at a tub of sour cream at the grocery store. A 2 tablespoon serving had 2 grams of carbs. It was the same for regular sour cream and low-fat sour cream. No difference in carb count. But the regular sour cream was 60 calories per serving, the low-fat 15 calories.

No wonder I was having weight problems. That paying attention stuff really is important.

Herbals treatments for diabetes

2008-02-17T12:16:00.000-08:00

Diabetes is a disease that might be more ameanable to herbal treatments than others because of the nature of it's symptoms. Although not well understood, diabetes has been known for thousands of years. Doctors and witches have been treating diabetes with the means at hand for at least 3,500 years. For most of those years pretty much the only medicines at hand were herbs and tree barks. Some of them probably worked.

Diabetes is an ancient disease. Its symptoms, which include excessive drinking of water and frequent urination (to wash away the excess sugar in the blood), were noted on a scrap of Egyptian papyrus more than 3,500 years ago. The ancient Roman doctor Aretaeus of Cappadocia also gave a vivid description of diabetes, describing it as "a melting down of the flesh and limbs into urine."

Since then, many physicians have remarked on the sweet taste of diabetics' urine. Indeed, the technical term for this disease, diabetes mellitus, means "sweet flow" or "syphon." Because of this hallmark of diabetes, the disease was thought to be a disorder of the kidneys and bladder for more than two thousand years.

Although the future of a control or cure for diabetes lies in modern medicine, not overlook alternative herbal remdies while we're waiting.

Tumeric for Diabetics

2008-02-16T10:25:00.001-08:00

Tumeric (also spelled Turmeric) is a curry type spice made from a powdered from of the root of an Indian herb. It's related to ginger and saffron. You can use it in cooking with at least a partial substituion in pretty much any recipe that calls for curry powder, ginger, or saffron.

It appears to lower both blood sugar and cholesterol levels in diabetics.

Here's a recipe for Cauliflower With Turmeric.

3 Things To Do If You Soak Your Feet

2008-02-15T06:50:00.000-08:00

The feet of diabetics are at high risk of infection and circulation related problems. Soaking your feet sure can feel good, and common sense would seem to tell you that it's a good thing to do. But it's often not as good an idea as it might seem.

Prolonged soaking opens small cracks in your skin where germs can get in. That's how infections get started. Soaking also removes your natural skin oils. Repeatedly wetting and drying your feet can worsen dry skin problems

1. Don't soak your feet for an extended period of time. It's probably enough to keep your feet in a container of water while you wash them.

2. Don't use hot water. The hotter the water, the more it will dry your feet.

3. Use a foot lotion after drying. You need to replenish any oils that the soaking removed.

Diabetes and Teeth

2008-02-14T01:30:00.000-08:00

Here's what the Departement of Veterans Affairs says about dental care and diabetes

If you have diabetes, taking care of your mouth is very important. You are at risk for periodontal disease and other infections. Periodontal disease can damage the gum and bone that support your teeth. It may lead to bleeding gums, chewing problems and tooth loss. Periodontal disease may also make it hard to control blood glucose (sugar).

But they don't typically offer dental care to vets with diabetes as a result of exposure to Agent Orange.

I guess it's just too much trouble.

Fenugreek and Diabetes

2008-02-13T04:50:00.000-08:00

Fenugreek is an herb that grows in the Mediterranean areas and parts of Asia.

The seeds have been found to stimulate insulin production in Type 2 Diabetics and to lower cholesterol.

But it has a side effect that's problematic for diabetics. It stimulates appetite. That's not something very many diabetics have much of a need for. Because of that I don't really recommend it.

Bitter Melon

2008-02-12T10:27:00.000-08:00

Bitter Melon is a tropical squash type vegetable. It appears to have the effect of lowering blood sugar levels in diabetics. (Saxena and Vikram, "Role of selected Indian plants in Management of Type 2 Diabetes", Journal of Alternative and Complementary Medicine, 2004, pp 369-378. That would be a good thing.

The research has mostly been done on rats, with some human research. Bitter Melon juice has been used in most of the research.

It's widely available in capsule forms from health food distributors but I have my doubts about the usefullness of that form.

Just a small glass of juice daily seems to do the trick. To much can cause diarrhea. There are no known drug interactions.

It's available on Amazon in tea form, either in Bitter Melon Tea Bags or in bulk form

You can grow your own with Bittermelon Seeds It's a tropical plant and needs lots of heat and lots of water. The seeds won't germinate if nighttime tempuratures fall below 70 degrees.

Controlling blood sugar with supplements

2008-02-11T07:34:00.000-08:00

I'm never real sure about alternative treatments but with diabetes nutrition does matter.

Vitamins and Herbs Effect on Diabetes
Vitamin C (ascorbic acid)
With vitamin E, helps get sugar out of the blood stream and into the cells.5 Keeps diabetics’ blood vessels and kidneys healthy.6,7

Vitamin E (mixed tocopherols)
With the B vitamins, vitamin E helps keeps the pancreas healthy and helps prevent nerve damage.8,9 Helps prevent kidney damage, blindness, and heart attacks.10,11 With vitamin C, helps keep blood vessels healthy.12,13

Vitamin B6 (pyridoxine HCL)
With folic acid and B12, B6, helps prevents heart attacks and nerve damage.14,15 Helps prevent diabetic blindness, vision loss.16

Folic Acid
Along with B12, folic acid helps prevents strokes and loss of limbs due to diabetic complications.17 Vitamin B12 (cyanocobalamin) Helps relieve neuropathic pain.18 Also works with folic acid and B6 (see above).

Biotin
With chromium’s help, biotin (one of the B vitamins) helps insulin work better, keeps the pancreas working well, and lowers blood sugar levels.19 Magnesium (Krebs cycle chelate) Relieves neuropathic pain and helps insulin work more effectively.20,21

Zinc (picolinate)
Helps blood sugar get into the cells and insulin work better.22

Selenium (aspartate)
Called an "insulin mimic", selenium helps take blood sugar into the cells. Selenium also protects against blood vessel and nerve damage from elevated blood sugars.23,24

Copper (picolinate)
Copper helps protect the cells in the pancreas that make insulin healthy, helps prevent diabetes-related damage to blood vessels and nerves, and lowers blood sugar levels.25

Manganese (Krebs cycle chelate)
Helps prevent damage to blood vessels and nerves.26,27

Chromium (picolinate)
With biotin’s help, chromium helps insulin work better, keeps the pancreas working well, and lowers blood sugar levels.19
Gymnema sylvestre leaf extract
Helps balance blood sugars and may protect us from gaining weight.28,29

Bitter melon whole fruit extract
Helps pathways in the diabetic liver work more efficiently; lowers blood sugar levels.30

Fenugreek seed extract
Helps lower blood sugars and helps our liver and kidneys metabolize blood sugars more efficiently.31

Bilberry berry extract
Helps prevent and reduce the severity of diabetic cataracts.32

Mixed bioflavonoids (citrus)
Helps protect vitamins C and E from diabetic damage. Like bilberry, bioflavonoids help keep diabetics’ vision clear and sharp.33 Vanadyl sulfate Helps cells of both the liver and muscles use insulin more effectively.34

ACCORD

2008-02-10T09:17:00.000-08:00

I hadn't heard of ACCORD until I ran across a reference to it on another blog.

ACCORD is some kind of NIH study of diabetes

The overall goal of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial is to address this challenge by testing three complementary medical treatment strategies for type 2 diabetes to enhance the options for reducing the still very high rate of major CVD morbidity and mortality in this disease.

So much of this kind of stuff is controled by pharacutical interests that I'm not ever sure what to think about it. I'll have to do some reading.

Dental Implants

2008-02-09T06:56:00.000-08:00

For the first couple of years after I developed diabetes I went undiagnosed. I know that now because I was having some symptoms such as a tingling on the bottom of my feet at night. I just didn't know then that they were symptoms of diabets.

One of the things that was happening was that I was getting some gum infections that wouldn't heal and had some teeth start falling out. I was homeless or near homeless through much of that period and the dental care I was able to get was a free clinic that would do extractions. The way the clinic worked was that you went in to see a dental assistint of some kind who'd look at your teeth and go tell the dentist, "Yep, looks bad". The dentists would then schedule you for extraction.

You never actually got to talk to the dentist and the dentist didn't actually see you. I didn't like the idea of having my teeth pulled without at least talking to someone about replacement options. So after that first visit I just never went back, I just let teeth fall out. Which they did over the next couple of years.

When I finially got diagnosed and treated for the diabetes the gum infections stopped and the teeth stopped falling out. But the damage was done. I'm just another toothless redneck these days.

One of my other health problems is depression (hence that homelessness I (mentioned). While depressed I didn't really care about my teeth or appearance because that's kind of how I felt about myself anyway. I finially ran across a competent shrink (finding a competent shrink is a whole 'nother story) who was able to figure out a workable medication schedule for me. So I'm feeling a lot better about myself, actually getting some work done, and I'm going to get my teeth fixed.

But after a couple of decades of being too depressed to work much I'm kind of broke. I think I'd like dental implants. I do have one implant that I got 40 years ago, when I was 19 and a tooth got knocked out in a car wreck. I've been happy with it. But I know I can't afford that, I need way too many of them (I don't even know how many teeth are missing, but a lot).

So I've been checking into Mexican dentists online. My mother lives in Corpus Christi, TX and has a friend who had a dental partial plate made in Mexico and is happy with both price and product. A lot of the border town dentists have web sites with price lists.

Although I might be able to afford dental implants in Mexico, I decided against it. I'm going to go with some combination of partial plate and bridges (I think I need an upper partial plate and a lower bridge, maybe two lower bridges). Looking at the Mexican prices I can afford that with no problem.

The reason I decided against dental implants is that installing implants is kind of a major surgical procedure. I mean, drilling into bone and stuff just seems kind of major. And a lot of the Mexican dentists talk about how they lower the risk of infection by using new plastic gloves with every patient and using water distilled North of the Rio Grande.

New plastic gloves with every patient? That's something they have to point out that they do? It's part of their special care to control the risk of infection.

I'm diabetic. I have a high risk of infection, and a high risk of big problems if I get an intection. I'm going to pass on having bone drilled into at a place that thinks state of the art infection control means fresh rubber gloves with every patient.

But I am going to Mexico for plate/bridge work.

You can't believe the news

2008-02-09T02:42:00.000-08:00

DLife tells us that major news outlets, NYT and NBC among them, sometimes seriously miss-report the results of medical research.

You'd expect them to be able to actually hire journalists with enough general competence to get it right. But, they can't be depended on to do that. Don't take action based on information you get from standard news sources. You just have to check it our yourself, as difficult as that might be.

Turnips and Cauliflower

2008-01-20T22:16:00.000-08:00

I've mentioned using turnips as a potato substitute before. dLife has a recipe for a mashed potato/turnip mix. The same idea works with hash browns.

At the same link they have a suggestion for substituting some cauliflower for some of the macaroni in a macaroni and cheese dish. I'm going to have to try it.

I ordered some Dreamfields Pasta, Healthy Carb Living, Elbow Macaroni, 16-Ounce Box (Pack of 6) and I'll try the cauliflower substitution as soon as it gets here.

Gaining weight

2008-01-17T21:41:00.000-08:00

I got weighed at the doctors office the other day. I'm gaining weight, up to 217 pounds. That's bad, really bad.

I've been careful with my carb intake and things like sodium, but I haven't been paying attention to calories. That has to change. I really need to get down to something more like 170. I have to get serious about losing weight.

My hypertension problems are such that I have shortness of breath and lack of stamina so I can't really do more than what they call moderate exercise (30 minutes of physical activity a day). I can do that, but not all at one time, and that about does it for the day for me. At least until I lose some weight and maybe get some stamina back.

I found some guidelines on calories and weight loss.

It says to establish a baseline calorie need for weight maintenance by multiplying your weight by 15. That gives me 3,255. Let's just call it 3,200. Then they recommend a target loss of 1-2 pounds a week by reducing the maintenance level by 500-1,000 calories.

So they suggest I should target between 2,200 and 2,700 calories per day. Of course once a lose a couple of pounds I can progressively lower that calorie target.

Okay, I'll start counting calories.

Diabetes and depression

2008-01-16T14:52:00.000-08:00

Diabetes Mine talks about depression and diabetes.

Fiber and carbs

2008-01-07T14:06:00.001-08:00

A post on keeping fiber in your diet without the carbs.

Heart and diabetes

2008-01-06T10:35:00.000-08:00

One of the risks associated with diabetes is an increased risk of heart problems. Diabetes causes circulation problems which can lead directly to heart problems.

Since I developed diabetes I've also begun experiencing high blood pressure and most recently high cholesterol, both precursors to heart disease. That's bad.

I've been having problems with a lack of stamina and shortness of breath after minimul exercise for about 6 months now, shortly after the high blook pressure problems begun and even before the high cholesteral problems showed itself. I've had a couple of EKG's and they havn't really seen any problems shown by those tests, but the shortness of breath is pretty extreme and not going away from the various meds I'm on.

I think I need to make another doctor visit and insist on a stress test, which monitors EKG changes while you exercise on a treadmill. This really needs to get fixed.

Water

2008-01-05T11:10:00.000-08:00

It seems that food that are high in water tend to "fill you up", you won't eat as much.

That would make something like a cucumber/tomato/onion salad a pretty good choice for lunch.

Sweet Potatoes

2007-12-23T11:28:00.000-08:00

Sweet Potato is a nutritious food, and it tastes really good (especially for a southern boy). The problem with it for diabetics is that it's high in carbs. That's not a good thing at all.

The solution is to prepare it in a mixture with lower carb foods, to reduce the effective carbs per serving.

One of the good things about sweet potatoes is that its taste blends well with cinnamon, which seems to improve carb processing in diabetics.

Another food that blends well with sweet potato is pumpkin. And, pumpkin itself is pretty low carb, a serving of pumpkin is about 100g with about 8g of carbs. Just use canned pumpkin, not a pumpkin pie mixture which has a lot of sugar added. We won't need any added sugar.

Cook a large sweet potato (or 2-3 medium sized ones). Bake it, boil it, microwave it, just cook it until it softens up.

Mash it together with a half stick of margarine and a splash of milk. Add a dash of clove or nutmeg and a tablespoon or so of cinnamon. Add half a can of mashed pumpkin (about 400 grams). Mash together while cooking over low heat. Add about 6oz of chopped pecans

Green tomatoes

2007-11-07T11:30:00.000-08:00

We had our first freeze last night so yesterday afternoon I went out and picked a whole lot of green tomatoes. I've been picking 2-3 ripe tomatoes pretty much everyday and I got 3-4 dozen green ones yesterday, in various stages of ripening.

There's a couple of things you can do with green tomatoes that don't add much in the way of carbs.

Sauteed

Chop them and saute them in light oil with chopped onion, garlic, squash, eggplant, okra, whatever else you might have on hand.

Cobbler

Yes, cobbler. You can pretty much use any recipe for cobbler, just use a low-carb flour such as Carbquik for the crust, and substitute green tomatoes and rhubarb for the fruits. Add some cinnamon, maybe a little clove, and some extra substitute brown sugar sweetener.

Lemon Juice

2007-10-24T21:46:00.000-07:00

Lemons are not high in carbs, one lemon has about 5.4g of carbs.

But bottled lemon juice concentrate has zero carbs. Make zero carb lemonade with a large splash of the concentrate and a couple of packets of Equal in a glass of water.

Chocolate, Science, and Hershey's

2007-10-24T20:23:00.000-07:00

I've written about the health benefits of dark chocolate before.

What I didn't know until recently was that much of the health benefits of dark chocolates became known from publicity of a study that was sponsored by Mars.

Kind of makes me wonder how true some of this stuff actually is. I don't really trust any of them.

But I like chocolate anyway so I'll pretend it's all true.

I buy baking chocolate, which is kind of bitter. I cut it up in small bits, add a couple of packs of Equal and a slice of margarine (to soften it up) then melt it in a micro wave on low power. I eat it by dipping a rolled up low-carb tortilla.

2007-10-24T11:05:00.001-07:00

I'm confused.

I've always been under the general impression that Vitamin C was a good thing although it's overhyped and it's difficult at times to separate hype from fact when talking about Vitamin C, particularly when talking about mega-doses of Vitamin C.

The Linus Pauling Institute (the main source of Vitamin C hype) says

Cardiovascular diseases (heart disease and stroke) are the leading cause of death in individuals with diabetes. Evidence that diabetes is a condition of increased oxidative stress led to the hypothesis that higher intakes of antioxidant nutrients could help decrease cardiovascular disease risk in diabetic individuals. In support of this hypothesis, a 16-year study of 85,000 women, 2% of whom were diabetic, found that vitamin C supplement use (400 mg/day or more) was associated with significant reductions in the risk of fatal and nonfatal coronary heart disease in the entire cohort as well as those with diabetes

That looks good. But then they follow up with this

In contrast, a 15-year study of postmenopausal women found that diabetic women who reported taking at least 300 mg/day of vitamin C from supplements when the study began were at significantly higher risk of death from coronary heart disease and stroke than those who did not take vitamin C supplements

That looks bad, at least for postmenopausal women with diabetes. It causes them to conclude

The significance of these findings is not entirely clear, but they suggest that there may be a subpopulation of people with diabetes who will benefit from antioxidant therapy while others may not benefit or could actually be harmed.

and

Since vitamin C intake from foods was not associated with increased mortality from cardiovascular disease, there is no reason to limit the intake of vitamin C-rich fruits and vegetables.

What might those Vitamin C-rich fruits and vegetables be? The most hyped is oranges, which is also pretty high in sugar. So that one might not be the best choice for diabetics. Two good choices are cabbage and peppers, especially red peppers. The dark green leaves from Chinese cabbages are particually good choices.

Diabetes and Depression - Cause and Effect

2007-10-18T09:00:00.001-07:00

This short article poses the question, Does Diabetes Cause Depression.

No, it doesn't.

It might trigger an episode of depression, it might aggravate an existing condition, but it's not a cause of depression.

Depression isn't about events in your life, it's about a fundamental brain related disorder in thinking which leads to depressive behaviors, depressed moods, etc. It's not caused by bad potty training and it's not caused by other illness. Some of the episodes of severe depression symptoms can be triggered by life events, but that doesn't mean the life events are the cause.

Diabetes might make a depression worse. It can actually help though. Whether it helps or hurts depends on how you respond to your diabetes. If your able to respond to it pro-actively (something that can be hard to do if you're already depressed) then it might actually help a depression. The diabetes itself won't help it but the pro-active response can.

One of the best things you can do to self-treat depression is to just do things. Exercise helps, a diet high in things like dark green vegetables and fish helps. Accomplishments help.

Diabetes and depression

2007-10-16T17:34:00.000-07:00

Depression is much, much more than just a mood disorder. It's an abnormailty in the way you think and in the way you behave, not just the way you feel. Because of that it's deadly.

A recent study observed

What this study shows is that either alone or in tandem with a chronic physical illness, depression takes a huge toll. And yet we live in a society in which too many people suffer in silence and many insurance plans don't cover treatment for depression as adequately as they do treatment for physical illnesses. This is both unfair and unwise — research has shown us that the sooner depression is treated, the less likely a second or even a third episode will occur.

It can be a very big problem when depression is accompanied by diabetes. Diabetes requires a personal attention to detail in lifestyle that can be hard to accomplish when you're depressed.

Viagra

2007-10-16T06:11:00.000-07:00

Erections are about blood to the penis. I have diabetes, which constricts blood flow. More recently I have developed hyper-tension, which further screws up blood circulation. And I have depression which has some sexual effects.

All-in-all that's not a good combination.

I've discovered that there's a small subset of men with ED who are resistant to Viagra, primarily those with a combination of diabetes, hypertension, and depression.

Sigh. That's a developement that's really helpful in controlling depression.

Update:
An interesting post on the precursers to Viagra

Sunday, Oct 14

2007-10-14T15:37:00.001-07:00

Bulk trash day is tomorrow, Monday. I have an old air conditioner, an old large room heater and an old gas stove along the side of the house that need to be hauled off (it's kind of a redneck flavored yard). It's about 150 feet from the pickkup spot on the street.

I'm still having stamina problems. It took me four trips to get it all hauled out to the street. I do have a light weight two wheeled dolly that was of some help. But it just wore me out. This getting old and sick crap isn't a lot of fun.

Update:
Saw my new primary care physician (I've recently tranfered my care to a new VA hospital, I live between two of them). He didn't seem to be worried about he swelling in the ankle. He said some of the meds I take might cause that.

He gave me some new meds, changed some of them, I'll try the change for a month and go back and see him again.

There's a problem in that he's Vietnamese and I didn't understand much of what he said. So I'm just going to have to sit down on the internet with each drug and figure out what's what on my own. I'll be posting about that later.

Low-carb potatoe pancakes

2007-10-05T17:33:00.000-07:00

1 medium turnip, grated
1 medium white onion, grated
1/4 cup roasted peppers, chopped
I just use what's in the garden, a mixture of cayenne, jalapeno, pablano, and banana peppers.
1 egg
2 serving spoons of low-carb flour
1/4 cup garlic, chopped
1 package 4-cheese instant mashede potatoes
splash of cooking oil.
water, enough to retian a mashed potatoes texture

Mix well.

Form into patties and cook in hot skillet, until dark brown on each side.

Serve with sour cream (or french onion dip) topping.

Oct 1, Mon

2007-10-02T08:36:00.000-07:00

Sep 31, Monday

2007-10-01T21:52:00.000-07:00

I'm writing this after midnight on Monday.

I took some pills this morning, and just took tonites dose.

I don't remember what I ate today, but I have been eating. I just put some defrosted pork chops back in the refrigerator, I was going to cook something but changed my mind, I'm having some chicken bouillon instead.

I've been sleeping off and on all day.

I've gone outside and puttered around in the yard a few times, I've been okay with breathing today, but my right ankle and calf have had some pain pretty much all day.

Alertness has been bad all day. I havn't played any poker online but have plaed some FreeCell soliatare game and lost more sessions than is normal. I've lost probably 4 out of 5 and a typical pattern is more like winning 4 out of 5.

I did find some checks I had and put them in an envelope to mail in a deposit. I've had a couple of small checks sitting around for over a couple of weeks without my doing anything with them. So I'm not totally out of it, but still not at an intellectual peak right now.

Maybe Tuesday will be a better day.

Sep 30, Sunday

2007-09-30T07:46:00.000-07:00

10 am

I slept soundly and for a long time. I got up at 9am.

Took some pills

Amodipine (10 mg)
Glyburide (10 mg)
Metformin (1000 mg)

I feel okay, but am somewhat groggy with sleep. I havn't had a cup of coffee yet becuase I'm actually thinking about going back to bed. That doesn't seem like a good idea becuase I think I got a lot of sleep last night, but I might do it anyway.

No pains. Breathing okay.

12:30 pm

I slept soundly another 2 hours. I'm not hungry at all, which is somewhat suprising. I made a cup of expresso but mixed in a little dark roast decaf grounds, and used a bigger cup (more water than usual).

I think I havn't been writing it down but I've had a couple of no-caffiene diet cokes the last couple of days. They don't have a lot of sodium (40mg, 2%DM), but some.

Friday I had two cups of espresso, and it was Saturday that I had the sleep problem. I don't know if that's related.

I'm feeling okay, just suprised I'm not hungry.

later
I did eat. Probably ended up eating to much by the time the day was over, mostly various sausage and sourkraut tacos.

I seem to have had a problem with alertness and focus, I didn't keep up this diary, it's now late Monday night and I'm just getting around to updating.

I played a couple of small online poker tournaments and played very poorly. I finished in the money twice but could still tell I was playing badly. I lost a lot in some cash games.

I did take the appropriate meds Sunday night. And took some naps off and on.

Sep 29, Saturday

2007-09-29T11:01:00.001-07:00

Noon.

Got up after 4 hours of fitfull sleep. I woke up 3-4 times in that 4 hours.

Felt okay though. No pain in the ankles, could breath okay. But did have slight swelling in the ankles.

Ate pancakes, had an espresso.

Feet damp between toes. Applied powder.

1 pm

Right ankle was sore, almost like a sore muscle. Having trouble breathing.

Took

Amodipine (10 mg)
Glyburide (10 mg)
Metformin (1000 mg)
Ibuprofen (800 mg)

I'm updating this Sunday morning, I didn't keep track Saturday.

I had trouble maintaining alertness all day. I played in a couple of online tournaments and played terrible. I took a few short hour and hour and a half naps throughout the day.

I did remember to transfer some money online, something I need to do the first of every month to get some bills payed. So I wasn't totally out of it, just not very alert.

Not sure how much I ate, pretty much the same I've been eating, pork cops, coleslaw, roasted peppers, some low-carb tortillas. Added some processed cheese.

I did go out and work in the yard for about 5 minutes and didn't suffer extreme exhaustion, although I was short of breath all day. My right ankle and calf was sore all day.

I don't even remember if I took my second round of pills last night. I'm not sure what time I went to bed. It was late.

Sep 28, Friday

2007-09-28T08:41:00.000-07:00

Fri, Sep 28, 10:40 am

Got up about 10 am.

Had a cup of coffee (espresso).

The foot infections seems to be clearing up. No leakage this morning. There's still some soft areas and I put some powder on them. No cream, I'll put some cream on later in the day.

I have some pain in my ankles, but not as bad as it was last night. Not much swelling though.

Took
Amodipine (10 mg)
Glyburide (10 mg)
Metformin (1000 mg)
Ibuprofen (800 mg)

11 am

Cut grass for about 10 minutes. Out of breath. Came in and sat down. Slight pain in lower back.

Over the course of the day ate 3 tacos (low-carb tortillas, sliced pork, coleslaw, roasted peppers) and one small plate of sliced pork and coleslaw.

Made two more short grass-cutting excursions. Out of breath after one of them, (cut off the other exscursion short when mail came). Couldn't take a deep breath pretty much all afternoon.

Late in the afternoon put some anti-fungal cream on the toes. Pain in ankles and some in right calf all day.

Seemed to maintain alertness, finished 2^nd($108) in 2 to 7, 36 players 10+1

8 pm

Took nap from 5:0 to 8. Ankle and calf pain is gone.

BP 177/94 84 heart rate, avg of 3.

Had another cup of espresso. Ate half a small pork chop (pork chops about 1/2 pound).

Ate some pancakes (Carbquick, some corn meal, some baking powder, an egg, water) w/sugar free syrup.

I think poker tournment performance is a good indicator of mental alertness
constant, but steady). Won (finished in top 20%) a small satalitte.

10:45 pm

BP 177/102 87 heart rate

Glyburide (10 mg)
Metformin (1000 mg)
Lisinopril (20 mg)

11:15 pm

Can't take a deep breath

Midnight

Ate 1/2 pork chop, coleslaw, roasted peppers.

2 am

Went to bed. Had trouble breathing, couldn't get to sleep.

4 am

Woke. Must have slept for a few minutes at least, I don't know how long. Breathing was okay but pain in my right ankle was back. Kind of a dull throb.

Lay in bed thinking depressed kind of thoughts for a while. About how simple life would be if I got really depressed and just cried all day.

Parched throat. Got up, drank some water, some chicken bouillon, some tea (herbal).

BP 164/82 pulse 87

Took some Ibuprofen, put some cream on toes.

Went back to bed at 8am

Medications

2007-09-19T14:25:00.000-07:00

Supplements
Chromium Picolinate 200mcg (microgram)
I was taking a pill twice a day at first. Then I noticed my sleep patters were disrupted and I looked up found that was one of the side effects.

I found the recommended dosage is about 120 mcg per day so I cut back to one pill a day.

Then when my ankles started swelling up I stopped entirely. My swollen ankles do not appear to have been related, it's been two weeks without the supplement and they are still swollen.

Diet and Sugar

Cholesterol

Decreased response inhibition in middle-aged male patients with type 2 diabetes

Diabetes plus other stuff

Cream of Hot Pepper Soup

Some okra dishes

Dreamfield pasta and blood sugar

Noodles and blood sugar

Banana and blood sugar

Tracking Sugar

Fish Oil

Potato Soup

Balance is better than low carb

Diet for diabetics

Target weight

Roasted Garlic Mashed Potatoes

All those carrots

A cup of coffee

Making mashed poatoes

100 calories per package is a marketing gimmick, not a diet aid

TV, fast foods, and fat kids

Kroger's CarbMaster yogurt

Body Mass Index

Pan fried banana

A reading list

Infeasibility

Goal programming

Today's Food Music

Status of the diet model

Cold Pea Soup

Another update on the original diet problem

Cost of subsistence at today's prices

Cabbage nutritional information

Evaporated Milk Nutritional information

The Original Diet Problem

Back to the diet problem

Shrimp and apricot salad

Still more on the diet problem

More on the diet problem

Simple spinach and apricot salad

The diet problem

Tracking Diet

Teeth and Sugar

Protein

Medicinal Plants

Tracking your food

Red Wine and Black Tea

metoprolol

Divalproex

Sertraline

Glyburide

Bitter Olive Salad

Metformin

Amlodipine besylate

Bitter Cilantro and Coconut Shrimp

Bitter tomato soup

Diabetic Potato Salad

Diabetics Banana Split

Search engine terms

Pan fried bitter melon

Exercise

Diabetic Hamburger Steak

Fruit bowl for diabetics

More diabetic cooking -- Boiled turnip

Mashed Bitter Melon

A Bitter Melon recipe

Yoga and Diabetes

Calories and carbs

Herbals treatments for diabetes

Tumeric for Diabetics

3 Things To Do If You Soak Your Feet

Diabetes and Teeth

Fenugreek and Diabetes

Bitter Melon

Controlling blood sugar with supplements

ACCORD

Dental Implants

You can't believe the news

Turnips and Cauliflower

Gaining weight