Supplements Diet

http://nccam.nih.gov/health/diabetes/#11 alpha-lipoic acid alpha-lipoic acid (ala, also known as lipoic acid or thioctic acid) is a chemical that is similar to a vitamin. it is an antioxidant--a substance that prevents cell damage caused by substances called free radicals in a process called oxidative stress. high levels of blood glucose are one cause of oxidative stress. ala is found in some foods, such as liver, spinach, broccoli, and potatoes. ala can also be made in the laboratory. ala supplements are marketed as tablets or capsules.c it is theorized that ala may be beneficial because of its antioxidant activity. c there is some use, reported from outside the united states, of ala delivered intravenously (iv). these trials are not discussed in this report. summary of the research findings the evidence on ala for type 2 diabetes and obesity is limited. there are a number of small studies in animals and in people that have shown hints of beneficial effects. in a few of these studies, some possible benefit from ala was seen in glucose uptake in muscle; sensitivity of the body to insulin; diabetic neuropathy; and/or weight loss. more research is needed to document whether there is any benefit of ala in diabetes and to better understand how ala works. side effects and possible risks while ala appears to be safe for the general adult population, people with diabetes need to know that ala might lower blood sugar too much, and thus they would need to monitor their blood sugar level especially carefully. ala may also lower blood levels of minerals, such as iron; interact with some medicines, such as antacids; and decrease the effectiveness of some anti-cancer drugs. other possible side effects of ala include headache, skin rash, and stomach upset. chromium\alpha-lipoic acid alpha-lipoic acid (ala, also known as lipoic acid or thioctic acid) is a chemical that is similar to a vitamin. it is an antioxidant--a substance that prevents cell damage caused by substances called free radicals in a process called oxidative stress. high levels of blood glucose are one cause of oxidative stress. ala is found in some foods, such as liver, spinach, broccoli, and potatoes. ala can also be made in the laboratory. ala supplements are marketed as tablets or capsules.c it is theorized that ala may be beneficial because of its antioxidant activity. c there is some use, reported from outside the united states, of ala delivered intravenously (iv). these trials are not discussed in this report. summary of the research findings the evidence on ala for type 2 diabetes and obesity is limited. there are a number of small studies in animals and in people that have shown hints of beneficial effects. in a few of these studies, some possible benefit from ala was seen in glucose uptake in muscle; sensitivity of the body to insulin; diabetic neuropathy; and/or weight loss. more research is needed to document whether there is any benefit of ala in diabetes and to better understand how ala works. side effects and possible risks while ala appears to be safe for the general adult population, people with diabetes need to know that ala might lower blood sugar too much, and thus they would need to monitor their blood sugar level especially carefully. ala may also lower blood levels of minerals, such as iron; interact with some medicines, such as antacids; and decrease the effectiveness of some anti-cancer drugs. other possible side effects of ala include headache, skin rash, and stomach upset. chromium

chromium is a metal and an essential trace mineral. chromium is found in some foods, such as meats, animal fats, fish, brown sugar, coffee, tea, some spices, whole-wheat and rye breads, and brewer's yeast. it is marketed in supplement form (capsules and tablets) as chromium picolinate, chromium chloride, and chromium nicotinate. summary of the research findings there are scientific controversies about the use or need for chromium supplementation by persons with diabetes. first, it is difficult to determine, including through tests, whether a person has a chromium deficiency. second, it is not known whether it is beneficial to take chromium supplementation in diabetes, and there is a lack of rigorous basic science studies to explain or support any evidence of benefit. in sum, there is not enough evidence to show that taking chromium supplements is beneficial for diabetes. side effects and other risks at low doses, short-term use of chromium appears to be safe in the general adult population. however, chromium can add to insulin in its effects on blood sugar; this might cause the blood sugar to go too low. possible side effects at low doses include weight gain, headache, insomnia, skin irritation, sleep problems, and mood changes. high doses can cause serious side effects. the foremost concern for persons with diabetes who use chromium is the development of kidney problems. other possible effects include vomiting, diarrhea, bleeding into the gastrointestinal tract, and worsening of any behavioral or psychiatric problems. magnesium magnesium is a mineral. foods high in magnesium include green leafy vegetables, nuts, seeds, and some whole grains. various supplemental forms of magnesium are marketed as tablets, capsules, or liquids. magnesium has many important functions in the body, including in the heart, nerves, muscles, bones, handling glucose, and making proteins. low levels of magnesium are commonly seen in people with diabetes. scientists have studied the relationship between magnesium and diabetes for a long time, but it is not yet fully understood. summary of the research findings there have been a handful of studies on magnesium and type 2 diabetes, many of them very small in size and/or short in length and primarily looking at blood glucose control. the results have been mixed, with most finding that magnesium did not affect blood glucose control. some studies have suggested that low magnesium levels may make glucose control worse in type 2 diabetes (interrupting insulin secretion in the pancreas and increasing insulin resistance) and contribute to diabetes complications. there is evidence that magnesium supplementation may be helpful for insulin resistance. additional controlled studies are needed to establish firmly whether magnesium supplements have any role or benefit as a cam therapy for type 2 diabetes. side effects and other risks magnesium supplements appear to be safe for most adults at low doses. high doses can be unsafe and cause such problems as nausea, diarrhea, loss of appetite, muscle weakness, difficulty breathing, extremely low blood pressure, irregular heart rate, and confusion. magnesium can interact with and affect the action of certain drugs, including some antibiotics, drugs to prevent osteoporosis, certain high blood pressure medicines (calcium channel blockers), muscle relaxants, and diuretics ("water pills"). omega-3 fatty acids

omega-3 fatty acids (omega-3s, for short) are a group of polyunsaturated fatty acids that come from food sources, such as fish, fish oil, some vegetable oils (primarily canola and soybean), walnuts, wheat germ, and certain dietary supplements. as supplements, omega-3s are marketed as capsules or oils, often as fish oil. omega-3s are important in a number of bodily functions, including moving calcium and other substances in and out of cells, the relaxation and contraction of muscles, blood clotting, digestion, fertility, cell division, and growth. omega-3s have been the subject of much media attention in recent years, because of studies finding they may be useful for such purposes as decreasing the rate of heart disease, reducing inflammation, and lowering triglyceride levels. some countries and organizations have issued formal recommendations on the intake of omega-3s, through meals, oils, and possibly supplementation. omega-3s have been of interest for diabetes primarily because having diabetes increases a person's risk for heart disease and stroke. summary of the research findings randomized clinical trials have found that omega-3 supplementation reduces the incidence of cardiovascular disease and events (such as heart attack and stroke) and slows the progression of atherosclerosis (hardening of the arteries). however, these studies were not done in populations that were at higher risk, such as those with type 2 diabetes. with regard to studies on omega-3 supplementation for type 2 diabetes, there is somewhat more literature available than for most other cam therapies for this condition. a 2001 analysis was published by the cochrane collaboration, of 18 randomized placebo-controlled trials on fish oil supplementation in type 2 diabetes. the authors found that fish oil lowered triglycerides and raised ldl cholesterol but had no significant effect on fasting blood glucose, hba1c, total cholesterol, or hdl cholesterol. (the authors did not identify and include studies with cardiovascular outcomes, but noted that this is an area for further research.) another analysis was published in 2004 by the agency for healthcare research and quality, of 18 studies on omega-3 fatty acids for a number of measurable outcomes in type 2 diabetes. this study confirmed virtually all the cochrane authors' findings, except for finding no significant effect on ldl cholesterol. additional studies are needed to determine whether omega-3 supplements are safe and beneficial for heart problems in people with type 2 diabetes. studies that look specifically at heart disease outcomes in this population are needed. side effects and possible risks omega-3s appear to be safe for most adults at low-to-moderate doses. there have been some safety questions raised about fish oil supplements, because certain species of fish can be contaminated with substances from the environment, like mercury, pesticides, or pcbs. fish oil is on the list of food substances that the u.s. food and drug administration considers to be "generally recognized as safe." how well a product is prepared is another factor for consumers to consider. women who are pregnant or breastfeeding should not take fish oil supplements. fish oil in high doses can possibly interact with, and affect the action of, certain medications, including blood-thinning drugs and drugs for high blood pressure. potential side effects of fish oil include a fishy aftertaste, belching, stomach disturbances, and nausea. ************* in addition, insulife contains other compounds that promote healthy blood sugar levels, including the herbal extract goat�s rue (galega officinalis), the flavonoid quercetin, the amino acid derivative n-acetylcysteine, the antioxidant

alpha-lipoic acid, the minerals chromium and vanadium, and vitamins b6, c, e, and k. ************* saw palmetto has not been thoroughly compared to other types of drugs used for bph, such as doxazosin (cardura�) or terazosin (hytrin�). ************** theoretically, eating large amounts of barley may lower blood sugar levels. caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary. hordenine, a chemical in the root of developing barley, may stimulate the sympathetic nervous system. the effects of hordenine from barley in humans are not clear, although theoretically increased heart rate or wakefulness may occur. eye, nasal, and sinus irritation or asthmatic reactions can occur from exposure to barley dust. some individuals may experience inflammation or irritation of the skin, eyelids, arms or legs. contact with the malt in beer may cause skin rash. evening "feverish episodes" have been reported in dockworkers and silo operators after handling barley products or dust. contamination of barley with fungus has been associated with kashin-beck disease (kbd), a bone disease estimated to affect 1 to 3 million people in rural china and tibet. another contaminant that has been found in barley is ochratoxin a. pregnancy and breastfeeding traditionally, women have been advised against eating large amounts of barley sprouts during pregnancy. infants fed with a formula containing barley water, whole milk, and corn syrup developed malnutrition and anemia, possibly due to vitamin deficiencies. interactionsreturn to top ************ dosing adults (18 years and older) high cholesterol: 1.5 milliliters of barley oil twice daily or 30 grams of barley bran flour daily by mouth has been used in studies. constipation: limited research has used 9 grams of germinated barley foodstuff (gbf) daily for up to 20 days. most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. the interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. you should always read product labels. if you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. interactions with drugs fiber in barley may decrease the absorption of medications taken by mouth and prevent full beneficial effects. eating barley in large quantities may lower blood sugar concentrations. caution is advised when using medications that may also lower blood sugar. patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. medication adjustments may be necessary. barley has been associated with decreased total cholesterol and low-density lipoprotein (ldl) concentrations, and may act additively with other cholesterollowering agents such as lovastatin (mevacor�) or atorvastatin (lipitor�). hordenine, a chemical in the root of the developing barley, stimulates the sympathetic nervous system. in theory, taking hordenine with stimulant drugs may

result in additive effects such as increased heart rate or wakefulness. interactions with herbs and dietary supplements fiber in barley may reduce the absorption of some herbs and supplements that are taken by mouth. in theory, barley may lower blood sugar levels. caution is advised when using herbs or supplements that may also lower blood sugar. blood glucose levels may require monitoring, and doses may need adjustment. possible examples include: aloe vera , american ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, horse chestnut seed extract (hcse), marshmallow, milk thistle, panax ginseng, rosemary, siberian ginseng, stinging nettle and white horehound. barley has been associated with decreased total cholesterol and low-density lipoprotein (ldl) concentrations, and may add to the effects of cholesterollowering agents such as fish oil, garlic, guggul, or niacin. hordenine, a chemical in the root of the developing barley, stimulates the sympathetic nervous system. in theory, taking hordenine with stimulant agents such as ephedra or caffeine may result in additive effects such as increased heart rate or wakefulness. ************** what are the implications of the study? caffeine is linked with a decline in the body�s ability to turn glucose into energy, regardless of exercise, obesity, or type 2 diabetes. in this study, caffeine was taken in a pill. the results of this study do not apply to coffee, which contains many other substances (potassium, antioxidants, and magnesium) that seem to help people with type 2 diabetes. more studies are needed to look at the long-term effects of caffeine, taken in any form, on the body�s use of glucose and blood glucose levels. ************** over the next 15 years, men who consumed cocoa regularly had significantly lower blood pressure than those who did not. over the course of the study, 314 men died, 152 due to cardiovascular diseases. men in the group with the highest cocoa consumption were half as likely as the others to die from cardiovascular disease. their risk remained lower even when considering other factors, such as weight, smoking habits, physical activity levels, calorie intake and alcohol consumption. the men who consumed more cocoa were also less likely to die of any cause. although blood pressure is usually linked with risk of cardiovascular death, that was not the case in this study. "the lower cardiovascular mortality risk associated with cocoa intake could not be attributed to the lower blood pressure observed with cocoa use," the authors write. "our findings, therefore, suggest that the lower cardiovascular mortality risk related with cocoa intake is mediated by mechanisms other than lowering blood pressure." the benefits associated with flavan-3-ols may play a role. the link between chocolate and overall lower risk of death suggests that other mechanisms also may be involved. "because cocoa is a rich source of antioxidants, it may also be related to other diseases that are linked to oxidative stress (e.g. pulmonary diseases, including chronic obstructive pulmonary disease, and certain types of cancer)," the authors conclude. "however, this merits further investigation." ********* test to predict heart-attack risk underused younger, healthier patients who would benefit don't get the exam, study says url of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_31004.html (*this news item will not be available after 04/13/2006)

healthday healthday tuesday, march 14, 2006 tuesday, march 14 (healthday news) -- a new test that predicts which patients with heart-attack symptoms are at greater risk of dying isn't being used in younger, healthier patients -- the ones who could benefit most from the exam, a new study contends. studies have consistently found that elevated levels of brain natriuretic peptide (bnp) are associated with an increased risk of death in heart attack patients. in most hospitals, the bnp test is typically performed on patients who already have clinical risk factors, such as a history of congestive heart failure, older age and diabetes, that put them at a higher risk of death, the duke university researchers found. yet younger and healthier patients with elevated bnp levels are at a two- to fourtimes greater risk of dying in a hospital than high-risk patients with elevated bnp levels, the researchers reported. dr. matthew roe, from the duke clinical research institute, presented the findings tuesday at the american college of cardiology annual meeting, in atlanta. "the bnp test has been used primarily in patients with heart failure to assess their risk of death or other complications," roe said. in their study, roe and his colleagues looked at the use of the bnp test in u.s. hospitals that were part of the crusade study, which stands for "can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the acc/aha guidelines." over a 20-month period, roe's group found that 30,324 patients were treated at 312 crusade hospitals, and 19.4 percent of those patients had their bnp levels measured. "about a quarter of the hospitals did not use the test at all," roe said. "we found that in younger patients who did not have heart failure or diabetes, the test was a more powerful predictor of death and other complications than it was in older patients with heart failure," roe said. "the test was more useful in a lower-risk population in whom it was less likely to be used in the first place," he added. roe believes that more studies are needed to determine how to use the test most effectively. "we need to understand who this test will benefit most," he said. "if you can identify patients who are at the most risk, you could treat them more aggressively." one expert agrees that the bnp test is useful. "this test is coming into more use in different areas than heart failure, the area it was originally designed for," said dr. david d. waters, the chief of cardiology at san francisco general hospital and a professor of medicine at the university of california, san francisco. there are a lot of different tests to assess risk in heart attack patients, waters said. "the [bnp] test is a useful tool to add to what we do already," he said,

adding that he regularly uses the test with his patients. another expert concurred with that view. "bnp will add information that is separate and unique than what you get from other prognostic indicators," said dr. alan s. maisel, a professor of cardiology at the university of california, san diego. maisel believes it's not yet clear how the test should be used in routine clinical practice. however, he thinks it could help in making treatment decisions. "this data suggests that you should get a bnp, because it's going to be higher in people you don't expect," he said. maisel believes the exam will eventually become part of standard guidelines for treating heart attack patients. elevated bnp would be a reason to have patients receive further examinations, such as an angiogram, maisel said. "in addition, elevation in bnp would lead me to get some idea of heart function before sending patients home," he said. healthday copyright � 2006 scoutnews llc. all rights reserved. related medlineplus pages: * heart attack - http://www.nlm.nih.gov/medlineplus//heartattack.html * laboratory tests - http://www.nlm.nih.gov/medlineplus//laboratorytests.html date last updated: 15 march 2006 ************* # choose lean cuts, such as pork loin chops, tenderloin or sirloin. lean cuts of beef include round, chuck, sirloin or tenderloin. lean pork includes tenderloin and loin chops. look for usda choice or usda select grades of beef rather than usda prime, which usually has more fat content. # avoid meat that is heavily marbled. marbled meat is streaked with fat. look for meat with the least amount of visible fat. # look for moistness and bright color. red or pink meat is a sign of freshness, although vacuum-packed meats may look slightly purplish for lack of exposure to air. avoid meat that looks brown. it may be spoiled. potassium sodium