Tuesday, June 5, 2012

Coconut Butter: Health Hoax or Health Miracle?


Coconut Butter: Health Hoax or Health Miracle?

Extra virgin coconut butter – it’s one of the trendier nutritional ingredients. Coconut oil is advanced for its ability deliver fast energy without affecting blood sugar. Its use is touted as a way to speed up the metabolism making weight loss easier. It is being sold as essential oil for addressing certain forms of cognitive decline and dementia.
Coconut oil also is a saturated fat that does cause an increase in cholesterol levels. For 4-6 hours after a meal, it also has been shown to hinder our arteries’ ability to relax and dilate. It may contribute to insulin insensitivity, and – despite the antioxidant levels of extra virgin coconut oil – is likely somewhat inflammatory.
Health aside, extra virgin coconut oil/butter is a great for baking! Flaky and crusty cakes, pies and other baked goods without out the animal products.

The good, the bad, and the delicious.

We have long known that some fats are healthier and some are harmful—with saturated fats (SFAs) generally falling into the harmful category. Coconut butter is substantially a saturated fat, but……
….The saturated fat in coconut is different from that of most other fats and oils, not only saturated kinds, but also the polyunsaturated and monounsaturated fats. While most dietary fats are composed of long-chain fatty acids, coconut butter is composed largely of lauric acid, a medium-chain fatty acid.
Without going into the chemistry, the key point to understand is that lauric acid can be absorbed directly into the body and even directly into the cells, undigested. Other fats and oils must first be broken down. The lauric acid thus can serve as quick, no-sugar source of energy.
For some time, coconut oil has been known to be a useful source of energy for selected groups. Coconut butter has been shown beneficial for infants, individuals with difficulty digesting fats, and possibly for athletes requiring a quick burst of energy.

And Cholesterol

Tropical Traditions Coconut Oil GiveawayCoconut oil, like other saturated fats and trans fats, does increase cholesterol levels.
Adding 10 percent or 20 percent coconut oil in the diet for one to two weeks increased cholesterol levels, including LDL cholesterol levels, as well as total triglycerides in the blood.[i]
In India, coconut butter has been used widely by much of the population. Heart disease in India is among the highest in the world. Indian researchers sought to determine the effects of blending a polyunsaturated fat (PUFA), like those found in vegetable oils, with the coconut butter. Cholesterol levels were reduced between 5 percent and 21 percent, when the amount of coconut oil was reduced by blending in PUFAs. The authors of the Indian study concluded that the atherogenic (the artery blocking build of plaque) potentials of a coconut oil can be significantly decreased by reducing this oils intake by blending it with the polyunsaturated vegetable oils.[ii]

And Arterial Dilation

Another study also found that coconut oil compromised how the arteries functioned for four to six hours after a meal when compared with polyunsaturated fats.[iii] The coconut oils adversely impacted the arteries ability to relax and dilate. These results are the similar to those found for any saturated fats

And Blood Sugar Regulation

High-fat diets, particularly those rich in SFAs, also have been shown to reduce the body’s ability to regulate blood sugars. These diets are associated with a decline in the body’s ability to use insulin effectively. One study compared three types of diets: a diet high in medium-chain fats like the lauric acid found in coconut oil, a diet high in long-chain fats, and a low-fat diet.[iv]
Both high-fat diets led to the less effective use of insulin compared to the low-fat diet. The effect, however, was less significant with the high medium-chain fats.[v], [vi]
In another study, however, only the long-chain SFAs affected insulin levels. The medium-chain fats did not.[vii]

And Weight Loss

What about increasing metabolic rate? There may be some science here – but here is the trick. Coconut oil is still high in calories. Whatever the increase metabolic rate, it will be overwhelmed by the additional calories. Cut back on another source of calories for any potential benefit. Figure a teaspoon of coconut oil is about 45 calories.

Using Coconut Butter: Summary

While the research continues, coconut butter falls somewhere between a healthful and a harmful fat. For some specific groups, though, notably infants and adults with difficulty digesting fats, coconut butter may have a very useful nutritional role. Some also suggest that coconut butter helps improve certain types of dementia, but the data again is far from conclusive.
What about the antioxidant and anti-inflammatory compounds in extra-virgin coconut oil? Personally, I see no reason to seek out a high calories source of these compounds – and the lauric fatty acid may have some inflammatory effects itself. Look to high nutrient, higher fiber vegetables, fruits, nuts, and fish for these compounds.
Looking beyond the health benefits though, coconut butter has some great culinary benefits. For the baker, coconut butter offers a somewhat better alternative to the standard dairy butter. For the vegan baker, coconut butter may be an essential ingredient for making delicious desserts.
For most of us, however, more research is needed before we take steps to add a lot more coconut butter to our diets. It may be healthier than other types of SFAs, but the evidence does not seem to suggest it would qualify as a healthy fat, and remember, even healthier fat should be used smartly.
Learn more about how you can keep you arteries young and healthy, and beat back diabetes, dementia and heart disease – and still love food every day – in the Kardea Heart Smart Solution (affiliate link).

Tuesday, March 6, 2012

Blood Sugar Testing 101 for Type 2 Diabetes

Blood Sugar Testing 101 for People with Type 2 Diabetes: Why, When & What to Do

The Why
I am a registered dietitian and certified diabetes educator, have run Diabetes Centers in hospitals, have a private practice in medical nutrition therapy specializing in metabolic syndrome, weight loss, and type 2 diabetes, and have written a NY Times Bestselling book on the same topics. January 10, 2012 was the world-wide release of my newest book, The Diabetes Miracle.
I have had type 2 diabetes for 15 years.
Guess what?  If you asked me what my blood sugar is right now, I have no idea.  Neither do you!
  • Did you know that unless your blood sugar is over 200mg/dL, you most likely will have none of the traditional diabetes symptoms such as excessive thirst, urination, fatigue, hunger, or wounds that will not heal?
  • If you’ve run blood sugar over 200mg/dL for a period of time, you probably won’t even have symptoms when your sugar exceeds that 200mg/dL point.
  • If you have been prescribed medication for diabetes that is aimed at reducing your blood sugar and you begin to feel shaky, dizzy, nauseated, can’t speak clearly, can’t think, feel wiped out….you may assume that you are hypoglycemic.   Are you?  Without testing, you really have no idea…your once high readings may have returned to normal range…and your body may assume you are hypoglycemic when you are far from it!   If you grab some juice or glucose tabs, you will push that normal sugar right back into the very high range.
  • Or maybe those symptoms really are hypoglycemia and if you don’t treat it, you will lose consciousness, fall down the stairs, drop your child, run off the road.
  • Your Hemoglobin A1C might be 6.3 and you think to yourself:  “Wow, my blood sugar is now normal…why should I spend the money and take the time to test?”  Do you realize that hemoglobin A1C is your average blood sugar 24 hours/day, for about 3 months back in time?  An average is the average of highs and lows.  It is possible to have a 6.3 hemoglobin A1C because you are averaging normal from blood sugar readings that are in the high 200’s and in the low 50’s!
  • You may be following your meal plan, exercising, are not stressed, haven’t been sick and think maybe you don’t need that medication.  Without monitoring, how can your physician make an educated decision on your medication or doses?

The When

Testing your blood sugar is a quick, not too painful, fairly accurate way to determine where your blood sugar stands at different times of the day.  Many people don’t know when they should test.   People with type 1 diabetes usually test before each meal, at bedtime, and anytime they feel low.  People with type 2 diabetes have a much different test schedule.
I can’t tell you the number of patients I’ve seen who only test first thing in the morning.  They initially come to my office with months of wake up (fasting) readings.  I scan them, see some high readings, and ask…What do you think caused your fasting reading to be so high on this morning or that one?
Invariably, the patient will “confess” one of the following scenarios:
  • The night before, they went out to dinner late and ate pasta, garlic bread, and zeppoles. .
  • The night before, they over-snacked watching a late night football game.
  • They had a bagel for breakfast and a candy bar in the afternoon the day before.
  • They had a snack right before bed
Well, here is an eye-opener.  When a person with type 2 diabetes has a high fasting blood sugar, it is not because of anything that happened dietarily the day or night before!!!!  Why?  Carbohydrate is the nutrient that converts into blood sugar and carbs have a lifespan of about 5 hours.  When more than 5 hours pass after you eat carbs, your brain sends a signal to the pancreas to release a hormone called glucagon and this hormone signals the liver to release glycogen (sugar stores) into the blood.  So…anytime you check your blood sugar and more than 5 hours has passed since you last ate, you are looking at your liver’s self feeding mechanism!
If you only test your blood sugar in the morning before you eat, you are only seeing what your liver is up to.  That reading tells you nothing about how your body is reacting to the food you ate the previous day/night.
So, how can you find out how you are handling food (specifically carbohydrates)?  You should consider testing your blood sugar 2 hours after the START of a meal.  So, if you are having dinner at 6 PM and want to assess how high your blood sugar rose from dinner, test at close to 8PM.  If you wait until bedtime at 11PM, you missed it….because you are at the 5 hour mark.  After you eat, your sugar rises for about 2 hours, then comes back to normal over the next 2 hours, then hangs tight for the last hour of the 5 hour blood sugar curve.
If I have type 2 diabetes, and I want to know how my sugar is doing at the 2 times of the day it is likely to be highest…I would check first thing in the morning before I eat (checks the liver) and 2 hours after the start of my largest meal (checks the food).

What’s Normal?

I suggest that you ask your MD or health care provider for what your target blood sugar should be.  The following are the blood sugar ranges I typically use with my patients with type 2 diabetes whether they are following diet/exercise or diet/exercise/oral meds:
Fasting:  blood sugar less than 120mg/dL  (80-120mg/dL)
2 hours after the start of a meal:  blood sugar less than 140mg/dL.  If you happen to miss the 2 hour after time and check at 3 hours it should be under 130mg/dL.  If you don’t check until 4 -5 hours after the start of a meal it should be under 120mg/dL.  You can see that the highpoint is at the 2 hour mark.
Those with type 2 diabetes taking insulin will usually test premeal and at bedtime.  Your MD will tell you your individual targets if you use insulin to control your diabetes.

What to Do with It?

I find it is helpful to write my numbers down.  I know that the meter can keep hundreds of readings in memory…and I know they are time stamped (if you bother to set the meter’s time) but for me….I like to see patterns.  Even if you only use a sheet of paper…you can head it like this and mark or circle your readings that are out of zone.  Then, try to come up with a reason.
Chart for those in the USA using mg/dl 
Fasting After Breakfast After Lunch After Dinner Reason
 110 2 hrs = 126


 107
 2 hrs = 157
had a bagel
 140

 2 hrs 122 didn’t sleep well
 152  3 hrs = 120

poor sleep
 139

 2 hrs 109 poor sleep

Chart for the rest of the world in mmol/L
Fasting After Breakfast After Lunch After Dinner Reason
 6.1 2 hrs = 7


 6.0
 2 hrs = 8.7
had a bagel
 7.8

 2 hrs 6.8 didn’t sleep well
 8.4  3 hrs = 6.6

poor sleep
 7.7

 2 hrs 6.0 poor sleep

By highlighting any numbers that are out of range and trying to come up with a reason for the reading, I can see that my sleep difficulties are really affecting my blood sugar and may need to address this with my MD if the situation does not improve.   Why would my fasting reading be elevated?
  • Poor sleep
  • Pain
  • Infection or Illness
  • Not eating a night snack (liver is “on” longer)
  • No exercise previous evening (muscles “consume” blood sugar for hours after exercise ends)
  • Forgot to take my Metformin at bedtime
  • Right before menstrual period
  • Stress out
Why would my post meal readings be elevated?
  • Forgot my medication today
  • Pain
  • Illness or infection
  • Overeating carbs at the meal I’m checking
  • No exercise earlier in the day
  • Right before menstrual period
  • Taking steroid based medication (prednisone/cortisone)
  • High stress day

What about low blood sugar?

Blood sugar under 70mg/dL, when taking diabetes medication (orals or insulin) is considered to be hypoglycemia and needs to be treated as directed by your physician.  The standard treatment is a quick source of carb like 3-4 glucose tabs, ½ cup juice, ½ can regular soda (6 ounces), 8 ounces nonfat milk,, etc.  After waiting 10 minutes, retest your blood sugar and make sure it is over 80.  If it remains under 80 after the treatment, repeat and retest in 15 minutes ascertaining that does, indeed, rise over 80.  Report repeated hypoglycemia (not an isolated event) to your physician as you may require a medication or dosage change.
Diane Kress is the author of the New York Times Bestseller; The Metabolism Miracle and it’s companion book, The Metabolism Miracle Cookbook.  She just released her breakthrough book on preventing and controlling type 2 diabetes: The Diabetes Miracle.  Read more about her program at www.thediabetesmiracle.com.

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