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  1. Very Low-Carb Diets for Diabetes: Results of a Research Trial (Want to keep your heart & brain healthy as you age? See my other helpful, research-based posts in the Healthy Diabetes Living group forum (http://www.rvillage.com/group/878/diabetes-healthy-living) & the Healthy RVers (http://www.rvillage.com/group/80/healthy-rvers group forum at www.RVillage.com) ©2015, David Leonard, M.Ag., Nutrition Educator (retired), University of New Hampshire Cooperative Extension What You Can Learn From This Post 1. A quick review of why moderate-carb diets usually beat very low-carb diets (VLCD’s). 2. Results of a recent 12-month diabetes trial comparing an unusually healthy VLCD with a high-carb diet (HCD). I read the full journal article carefully and summarized the study & its conclusions (no distortions) 3. How to make the trial’s VLCD healthier if you want to try it Below is a quick recap on the downsides of most VLCD’s (RVillage members can see the full post at http://www.rvillage.com/groups/topic/view/group_id/878/topic_id/4316?query=P3RpdGxlPSZwYWdlPQ==): Too high in health-risky saturated fat, especially from red meat (see my 1/14/15 post at http://www.rvillage.com/groups/topic/view/group_id/80/topic_id/3515?query=P3RpdGxlPSZwYWdlPTM= ) Increased colon cancer risk Promotion of unhealthy inflammation which is linked to many diseases Too low in healthy carb sources like whole grains, whole fruit, veggies, and beans that are vital for overall wellness, especially protection against heart disease, high blood pressure, stroke, cancer, and dementia. But a well-designed VLCD can be reasonably healthy like the one used in a recent 12-month Australian trial with 110 obese adults (average wt. 224 lbs.) with type 2 diabetes and aged 35-68 (Journal reference: American Journal of Clinical Nutrition 2015;102:780-90 at http://ajcn.nutrition.org.libproxy.unh.edu/content/102/4/780.abstract ). They were randomly assigned to 2 groups: A VLCD diet (about 54-75 g carbs daily or about 14-17% calories from carbs. 1 g carbs = 4 cals. A “high-carb” diet (HCD) with about 202-218 g carbs daily or 50-52% cals. from carbs. The typical American diet averages 50%. Both diets aimed to reduce weight, so the calorie content was individually tailored to create a 30% deficit. So, if someone needed 2000 calories a day to maintain their current weight, they were prescribed 1400 calories. Both diets averaged 1430 cals. but varied from 1357-2143, depending on the person’s initial weight. Note that both groups did three 60-minute exercise sessions weekly (moderate intensity aerobics + strength training). The Trial’s Detailed Results (after one year) 1. Average weight loss for both groups was statistically equal (21.6 lbs. for the VLCD, 22.4 lbs. for the HCD). The same for reductions in body fat & waist circumference. 2. Average A1c fell by 1.0% in both groups. 3. 24-hour blood sugar stability improved in both groups, but the VLCD group did significantly better on 2 out of 4 types of tests used to measure blood sugar variability. This means they were likely to spend less time in the high blood sugar range (above 140 mg/dl). However, experts disagree on the validity & significance of these 2 tests called CONGA-1, CONGA-4. 4. Diabetes medication reduction: Despite the similar 1% A1c reduction in both groups, 52% of VLCD members were able to reduce their oral diabetes meds by 20% of more vs. 21% in the high-carb group. 5. Cholesterol & blood pressure med reduction: More VLCD than HCD participants were able to reduce these meds, but the difference wasn’t statistically significant. 6. Both groups equally improved their total cholesterol, LDL cholesterol, blood pressure, CRP (a measure of inflammation), and insulin sensitivity (how well your body’s own or injected insulin works). But the VLCD group had greater improvements in triglycerides (a 35 point drop vs. 1 pt. drop) and good HDL cholesterol (4 point rise vs. a 2.4 point rise). Overall Trial Summary 1. Both diet groups improved their scores on some 24 different health measurements compared to baseline. 2. There was no statistical difference between groups in weight loss, A1c reduction, and improvements in total cholesterol, LDL, blood pressure, and inflammation. 3. But the VLCD was better in improving HDL and triglycerides and also provided better blood sugar stability based on 2 out of 4 types of tests. 4. Over twice as many VLCD participants were able to reduce their diabetes meds than in the HCD group. And the Winner Is? So, is this unusually healthy VLCD is the way to go? Not necessarily. Consider This 1. The trial didn’t include a moderate-carb diet (about 40% cals. from carbs) which is recommended by Joslin Diabetes Center (Boston) and also backed by impressive research, especially if it’s Mediterranean-style (see my 2/6/15 post at http://www.rvillage.com/groups/topic/view/group_id/80/topic_id/3684?query=P3RpdGxlPSZwYWdlPTI= ). It might well have equaled the VLCD’s superior blood sugar stability while also providing a greater range of overall health benefits like cancer and dementia protection by including more healthy carb sources. For a description of a Mediterranean diet, go to http://oldwayspt.org/resources/heritage-pyramids/mediterranean-diet-pyramid. NOTE: A diet with 40% cals. from carbs would equal 640 carb calories (160 g of carbs) in a 1600-cal. diet or 720 carb cals. (180 g of carbs) in an 1800-cal. diet). 2. If you want to try this healthy VLCD, consider adding some “tweaks” (see below) that will make it even healthier. The same with the HCD. CAUTION! Always check with your physician or registered dietitian before making dietary changes. 3. Participants were actively losing weight & exercising during the trial which tends to optimize a diet’s benefits, help overcome any downsides, and also aid weight loss. In fact, adding an extra 2 days a week of aerobics (5 days total) would likely help the HCD group lower triglycerides more and also enable more of them to reduce their diabetes meds. Details On the Trial’s VLCD 1. Fat: It was unusually low in health-risky saturated fat, averaging about 17-21 g daily, but not as low as the HCD (13-17 g). Both diets emphasized healthy polyunsaturated and monounsaturated fat. In both groups, sat. fat crept up over the months with the VLCD group exceeding recommended daily limits halfway through the trial. Solution: Eat more broiled/baked fish and skinless chicken and less pork & beef (Australians love their meat!). 2. Fiber: The VLCD had an unusually high & healthy 25 g from actual foods rather than supplements. The high-carb diet averaged 31 g. The typical American adult has about 17 g. 3. Grains: One ounce (about 80 calories) extra-high-fiber, low glycemic index cereal (type not specified but likely similar to ½ cup Kellogg’s All Bran Original (10 g fiber) or 1/3 cup All Bran Buds (13 g fiber). You could use oatmeal occasionally but its lower in fiber even though it’s whole grain. The HCD used about 1.3 oz. of high-fiber cereal (2/3 cup All Bran Original or just under 1 cup All Bran Buds). One high-fiber whole-grain crispbread like Wasa brand (2 g fiber, 60 cals.). The HCD used 5 crispbreads + 2 slices of whole wheat bread. 4. Major proteins sources: 9 oz. of lean chicken, red meat (pork & beef), and fish 3-4 times a week. Suggestion: Keep red meat to 3-4 oz. (about a deck of cards) 2-3 times weekly. Higher amounts are linked to higher mortality plus breast and colon cancer. Focus on skinless chicken and baked/broiled fatty fish like salmon, arctic char, sardines, pollock, rainbow trout which are rich in healthy omega-3 fat (see my 3/1/15 post at http://www.rvillage.com/groups/topic/view/group_id/80/topic_id/3847?query=P3RpdGxlPSZwYWdlPTI= ). The HCD used 3 oz. of red meat 4 times a week + 3 oz. of fish twice a week + 3 oz. of beans once a week. Consider replacing some meat with soy foods like tofu and textured vegetable protein (virtually no carbs) or with egg whites. 5. Nuts: About 1.5 oz. almonds (36 or just over ¼ cup) and ¾ oz. pecans (13 halves or just under ¼ cup). Could substitute walnuts (14 halves = 1 oz.), pistachios (49 kernels per oz.), or peanuts (just under ¼ cup per oz.). Cashews have fewer documented health benefits. (See my 4/7/15 post at http://www.rvillage.com/groups/topic/view/group_id/878/topic_id /3973?query=P3RpdGxlPSZwYWdlPTI= ). The HCD had no nuts but would have benefited from them. 6. Veggies: 3 cups low-starch veggies daily (omit potatoes, sweet potatoes, corn, but carrots, peas are OK). The HCD had the same amount but didn’t exclude starchy veggies. Focus on those with the best research-proven benefits: broccoli, dark green leafy veggies (like kale, pack choy, turnip greens), beets, garlic, carrots, winter squash. Note that it takes 3-4 cups of raw, leafy veggies to equal a cup of non-leafy veggies or cooked leafy veggies, so 3 cups of fluffy salad is a far cry from 3 cups of regular veggies. 7. No fruit, but it’s an important part of a healthy diet. No reason you can’t add modest amounts of lower glycemic index fruits like cherries, strawberries, blueberries, prunes, and plums. (See my 1/10/15 post at http://www.rvillage.com/groups/topic/view/group_id/80/topic_id/3484?query=P3RpdGxlPSZwYWdlPTM= ). The HCD had 14 oz. fruit daily (equal to 1 med. banana + 1 med. apple + ¾ cup blueberries) 8. Dairy Skim milk: Just under a cup. The HCD used 1 cup 1-2% milk. Diet yogurt: just under ½ cup. The HCD used about 2/3 cup non-diet reduced fat yogurt (no mention of whether plain or added sugar; plain with your own fruit is best). ¾ oz. regular cheese. Same with the HCD. 9. Fats & oils: 6 teaspoons vegetable oil high in monounsaturated fat like canola or olive oil or use a trans-fat-free spread. The HC diet used 5 teaspoons. Extra virgin olive oil has the most all-around health benefits which kick in at around 5 to 6 teaspoons. California Olive Ranch brand got good reviews by Consumer Reports and is available at Walmart. See my 5/17/15 EVO post at http://www.rvillage.com/groups/topic/view/group_id/80/topic_id/4450?query=P3RpdGxlPSZwYWdlPQ== IMPORTANT DISCLAIMERS The info presented in this post should not replace professional medical or dietary advice, diagnosis or treatment. Always consult your registered dietitian or physician before making any significant dietary changes. Don't ignore professional medical advice due to the info presented here
  2. ©2016 by David Leonard, M.Ag.,Nutrition Educator (retired), University of NH Cooperative Extension Fatty Liver Disease Common in Type-2 Diabetes: Prevention, Treatment Non-alcoholic fatty liver disease (NAFLD) in its mildest form is called simple fatty liver disease or hepatic steatosis and has no symptoms. It can potentially progress to NASH (non-alcoholic steatohepatitis) which causes liver inflammation. NASH also has no symptoms initially but can lead to increased fibrosis (scarring) and cirrhosis (scar tissue replaces normal liver tissue and educes proper function), increased risk of liver cancer, and even liver failure. Some later-stage symptoms of NASH are fatigue, unexplained weight loss, and an ache in the upper right part of the abdomen (www.webmd.com/digestive-disorders/tc/nonalcoholic-steatohepatitis-nash-overview). Risk Factors NAFLD is strongly linked to too much sugar & saturated fat, lack of exercise, and excessive body fat (especially deep abdominal or visceral fat found beneath the stomach muscles and associated with an "apple" shape). Visceral fat releases harmful amounts of fatty acids into the bloodstream which can lower good HDL cholesterol and increase, blood pressure, triglycerides, blood sugar, and insulin resistance (your body’s natural insulin doesn’t work as well). The same for excess liver fat. Obesity raises NAFLD risk by over 4 fold. One study found that NAFLD patients averaged a 42” waistline (typically an "apple" shape, meaning more risky visceral fat) vs. 37.5” for those without NAFLD. NAFLD is very common in type 2 diabetes: In a study of 100 type-2 patients (average diabetes duration 8.5 years), liver imaging revealed a NAFLD incidence of 79% (under age 58), 68% (ages 58-65), and 47% (over age 65). What’s more, the advanced fibrosis rate was 3% (under age 58), 6% (ages 58-65) and 13% (over age 65) (Alimentary Pharmacology and Therapeutics, e-pub 9/15/15). Diagnosing NAFLD: Experts recommend that all people with type 2 diabetes be routinely screened. Those with several risk factors should be referred to a liver specialist (hepatologist) for further tests. Treating NAFLD A healthy diet low in saturated fat, cholesterol, sweetened beverages, and other added-sugar foods. Sugar from whole fruit is fine, but go easy on 100% juices. Weight loss (when needed) and exercise can rapidly reverse NAFLD, along with the possible use of cholesterol meds and oral diabetes meds like metformin that reduce insulin resistance [Nutr Reviews, 6/07;Mayo Clinic Health Letter, 9/06; Pediatrics, 10/06, Br J Diabetes Vasc Dis. 2006;6(6):251-260]. A 52-week Cuban trial encouraged 261 overweight or obese adults with NASH to lose weight by diet (750 fewer cals./day) & exercise (200 minutes weekly walking). Among the 29 who lost at least 10% of their body weight, all had NASH improvement, 26 (90%) became free of NASH, and 13 (45%) had reduced liver fibrosis (the other 16 saw no worsening). Among those with a less than 5% weight loss, 32% improved, 10% became free of NASH, and 16% had reduced fibrosis, 63% stabilized it, and 21% saw a worsening (Gastroenterology 2015;14:367-78). Another study with 109 severely obese adults with NASH found that bariatric surgery resolved mild NASH in 94% and severe NASH in 74% after 12 months (Gastroenterology 2015;14:379-88). Fish oil, especially its DHA, appears beneficial for NASH treatment (J. of Nutr., e-pub, 2/5/13; PLOS ONE 2013; 8(12). A 6-month randomized trial with 40 adult patients, found that 50% of those receiving 2 g/day actual EPA/DHA from fish oil (along with a healthy diet) had a regression of the disease (complete regression in 33.4%). In the placebo group (healthy diet, no fish oil), 27% had some reversal but none achieved complete remission [Dig Liver Disease 12/2/07 E-pub ahead of print]. Two other studies also obtained positive results (Alimentary Pharmacol Ther., 2006; 23(8): 1143-51; Clin Endocrinol Metab, 2009 Jul 21 [Epub ahead of print]). DHA appears more effective than EPA based on a lab animal study (J. of Nutr, e-pub 2/5/13). See my 3/1/15 post on EPA & DHA in the Healthy RVers Group Forum at www.rvillage.com/groups/topic/view/group_id/80/topic_id/3847?query=P3RpdGxlPSZwYWdlPTI= . Check with your doctor before taking this relatively high dosage of fish oil. Cinnamon: A 12-week trial with 50 NAFLD patients randomized them to placebo or 1.5 mg cinnamon (750 mg twice a day). Average LDL dropped significantly in both groups but markedly more so in the cinnamon group (from 95.5 to 90.3 for placebo vs. from 74.8 to 55.8 for treatment group). Moreover, the treated group saw significant improvements in liver enzymes (serum ALT & AST markedly improved), insulin resistance, fasting blood sugar, hs-CRP, total cholesterol, and triglycerides. HDL levels were unchanged in both groups (Nutr Research, e-pub 12/6/13). Cinnamon caution!: See my 12/27/15 post on cinnamon in the Healthy Diabetes Living group (http://www.rvillage.com/group/878/diabetes-healthy-living) on RVillage.com for possible adverse effects. Milk thistle’s silybin & silymarin compounds may help treat NAFLD due to their anti-inflammatory effect and other properties, but more research is needed. Adverse effects are usually minor, but it should be avoided by those with ragweed allergy. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924972/ , http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226378/, both full text articles.) Probiotics & prebiotics look promising as an add-on NAFLD treatment to improve the gut microbiome (intestinal bacteria) to help reduce inflammation plus other benefits (Heptatology, 6/09). In a 28-week randomized trial with 52 newly diagnosed NAFLD patients, a formulation containing 7 strains of beneficial bacteria was significantly superior to lifestyle changes alone re several markers of liver health such as alanine aminotransferase, aspartate aminotransferase, inflammatory markers and reduced fibrosis (Am J Clin Nutr 2014;99: 425-26 & 535-42). Lifeway kefir (a yogurt-type milk drink) has 5 of the bacteria types used (the Evolve brand has 4) but not necessarily the exact strains. They may still be worth a try at around ½ cup twice a day; Lifeway is gluten free. Evolve contains 20 billion organisms per cup vs. 7-10 billion for Lifeway. Yogurt has fewer beneficial types of bacteria. Some research-proven prebiotics (they promote the growth of “good” gut bacteria) are walnuts, almonds, pistachios, apples, oats, and barley. High-dose vitamin E is often used for progressive, biopsy-confirmed NAFLD in non-diabetic patients, but metformin may be preferred for diabetics and is safer (Dig Dis 2014; 32(5):597-604; World J Gastroenterol. 2014 Oct 21; 20(39):14219-14229, free full text). Vitamin E caution!! 400 IU or more daily is associated with increased prostate cancer risk in some studies [JAMA 2011; 306:1549-56], and 600 IU daily was linked with higher lung cancer risk in smokers (Tufts Univ. Health & Nutrition Letter, 6/08). The type-2 diabetes drug liraglutide resolved NASH in 9 of the 26 patients randomized to receive it (vs. 2 out of 26 in the placebo group) in a 48-week trial. Only 2 patients in the treated group progressed to liver fibrosis (scarring) vs. 9 in the placebo group, and the treated group lost more weight (11.6 lbs. vs. 1.3 lbs.) during treatment, but over half of it was regained in the 3 months after stopping treatment (Lancet, e-pub 11/19/15). IMPORTANT DISCLAIMERS The info presented here should not replace professional medical or dietary advice, diagnosis or treatment. Always consult your registered dietitian or physician before making any significant changes in diet or exercise Don't ignore professional medical advice due to the info presented here.
  3. Please see the full article in my newer 10/13/15 post (Fatty Liver Disease Common in Type 2 Diabetes) at http://www.rvnetwork.com/index.php?showtopic=120256 . Thank you! David
  4. (Want to keep your heart & brain healthy as you age? See my other research-based posts in the Healthy Diabetes Living group forum (http://www.rvillage.com/group/878/diabetes-healthy-living) & the Healthy RVers (http://www.rvillage.com/group/80/healthy-rvers ) group forum at www.RVillage.com) Copyright 2015, by David Leonard, M.Ag. Nutrition Educator (retired) University of NH Cooperative Extension Every year, 100’s of RVers undergo chelation infusion therapy (a course of 20 to 40 infusions) primarily for heart disease at centers in Mexico along the border. Anecdotal stories abound about chelation’s benefits, but major medical associations won’t endorse it. Now the results of the first scientifically-conducted chelation trial provide valid but preliminary evidence of benefit for some (but not all) patients. Below is a summary of the trial. It’s long, so I’ve provided the “bottom line” directly below, followed by the details. The Bottom Line on Chelation The TACT trial detailed below demonstrated that properly administered chelation infusion therapy is safe and may have significant benefits for some (but not all) heart-disease patients who have suffered a first heart attack. At the end of an impressive 5 year follow-up period, one out of every 12 patients receiving chelation + vitamin infusions benefited by avoiding one of the study’s adverse endpoints (like a second heart attack) used to evaluate the therapy's effectiveness. For diabetics, one out of every 6.5 patients benefited, and there was a 43% lower incidence of all-cause death compared to placebo (16% death rate for placebo vs. 10% for chelation). Others may well have benefited in ways that the study wasn’t designed to measure like increased energy, reduced exercise induced angina. Despite the impressive 5-year follow-up period, the TACT study authors conclude that their results, by themselves, aren’t sufficient to recommend the routine use of chelation therapy without further supporting evidence. Anecdotal success stories can over-inflate chelation’s benefits for several reasons: 1): Successes are more likely to make news than failures and don’t convey the reality that only a minority of patients significantly benefit; 2) Since chelation treatment lasts so long, the patient may have improved over time w/o treatment; 3) Some testimonials may be exaggerated (or become so as passed from person to person) or may even be bogus. History of Chelation Therapy Intravenous chelation therapy using disodium EDTA along with other ingredients was initially used in the 1940’s as an effective treatment of lead toxicity and removal of other war contaminants in patients. However, some chelation patients with heart disease also noted an improvement in their symptoms, especially angina (chest pain), and chelation therapy began to be used for this purpose in the 1950’s, particularly for patients with a prior heart attack. It’s also used for peripheral artery disease (PAD). Despite chelation therapy’s increasing popularity over the years, its benefits remained largely based on anecdotal information (personal experiences) and some case reports. There were 3 small studies (2 on walking distance achieved for patients with PAD and one on exercise-induced angina in heart-disease patients). No benefit was found in all 3 studies, but they had too few participants to accurately detect differences. Over the years, major medical groups like the AMA have consistently stated that chelation therapy for cardiovascular disease is ineffective and possibly dangerous. (It is true that an overly rapid infusion rate of EDTA can cause low blood calcium and possibly death). Due to the growing use of this controversial therapy, the National Institutes of Health eventually approved and funded a well-designed randomized controlled trial (RCT) called TACT or Trial to Assess Chelation Therapy which took place from 2003 to 2011. RCT trials are considered the “gold standard” of research, because participants are randomly assigned to different treatments which also include a placebo treatment. The TACT Study’s Design The study’s endpoints (the outcomes used to measure chelation’s benefits): The composite (combined) incidence of the following adverse events among the 4 treatment groups during the treatment phase of the study and up to 5 years of follow-up: ▪▪ Another heart attack ▪▪ A stroke ▪▪ Need for a bypass procedure ▪▪ Hospitalization for angina ▪▪ Death from any cause Study participants: 1708 men and women aged 50 and older with normal kidney and liver function, no history of heart failure, but who had suffered a prior heart attack (occurrence varied from 1.6 to 9.2 years prior to study). Candidates using tobacco within 3 months of the trial start were disqualified. The typical participant was overweight (average BMI of 30.0 which is borderline “obese”), 31% had diabetes, 56% were former smokers, 83% had undergone prior bypass surgery, and 73% were on statin drugs. Location: Participants received treatment at one of 81 sites in the U.S. and Canada. Treatments: Participants were randomized to one of 4 “blinded” treatments (neither researchers nor participants knew who was receiving which treatment during the entire trial): 1. Active chelation + active high dose oral vitamins (since these are usually part of chelation therapy; 28 vitamins & minerals were given) 2. Active chelation + placebo (sham) oral vitamins/minerals 3. Placebo chelation + active high-dose oral vitamins/minerals 4. Placebo chelation + placebo oral vitamins/minerals In addition, participants in all 4 groups were given low-dose vitamins and minerals (B6, B12, zinc, chromium, copper, and manganese to offset potential depletion by chelation therapy. Treatment length & follow-up period: 30 weekly infusions plus an additional 10 that were 2 to 8 weeks apart. Infusions lasted 3 hours each. Participants were examined on enrollment and visited during each infusion. After the final infusion, they were phoned quarterly, attended an annual clinic visit, and were seen at 5 years or at the trial’s end whichever came first. The Study’s Results Treatment compliance: A total of 55,222 infusions were made; 65% of the participants completed all 40 infusions (considered remarkable, given the time burden), and 76% had at least 30. About 30% discontinued the infusions. Adverse effects & safety: 4 unexpected severe adverse events occurred that were possibly or definitely due to the treatments: 2 in the chelation groups (1 death), and 2 in the placebo groups (1 death). Hypocalcemia (low blood calcium) occurred in 6.2% of chelation patients and 3.5% of placebo patients. Heart failure occurred in 7% of chelation patients and 8% of placebo patients. Was chelation superior to placebo? ▪▪ During the 5 years of follow-up, 32.8% of the active chelation participants suffered an adverse endpoint event (death from any cause, another heart attack, a stroke, bypass surgery or hospitalization for angina) compared to 38.5% of the placebo participants. That equals an 18% reduction in risk compared to placebo which was determined to be statistically significant (not due to chance). ▪▪ Based on these figures, an analysis showed that, at 5 years after treatment, one out of every 18 patients who received active chelation had benefited by avoiding one or more of the composite endpoint’s adverse events. The need for new bypass surgery was the most common occurring endpoint event (45%). However, when each endpoint was examined individually, there was no statistically significant benefit for chelation, except for reduced death risk in diabetics (see below) ▪▪ Chelation’s benefits were greatest when comparing the chelation/vitamin group with the double placebo group (sham chelation and sham vitamins): a 26% relative reduction in incidence of the composite endpoint compared to placebo treatment. In this case, an analysis showed that, at 5 years after treatment, one out of every 12 patients who received active chelation had benefited by avoiding one or more adverse events making up the composite endpoint. ▪▪ Chelation showed the strongest benefit for participants with diabetes: a 41% lower relative incidence of the composite endpoint (a 25% incidence in the treated group vs. a 38% incidence in the placebo group. Moreover, all-cause mortality incidence was 43% lower in diabetics receiving chelation vs. placebo. The death incidence for diabetic participants was 10% in the chelation groups vs. 16% for placebo. An analysis showed that, at 5 years after treatment, one out of every 6.5 diabetic patients who received active chelation had benefited by avoiding one or more of the composite adverse endpoints. ▪▪ Another subgroup of chelation patients who especially benefited were those who had suffered a heart attack involving the left anterior descending artery which has the worst prognosis. There was a 37% relative reduction in endpoint incidence compared with the placebo participants. ▪▪ Note that the TACT study didn’t measure less significant possible benefits such as a reduction in exercise-induced chest pain or increased energy level anecdotally reported by a meaningful number of chelation patients over the years. What Might Account for Chelation’s Benefit? Researchers say the most likely mechanism is the chelation infusions’ ability to reduce levels of toxic metals like lead, cadmium, antimony, cobalt and tungsten that cause cardiovascular damage through oxidative stress caused by generation of free radicals. These toxic heavy metals are associated with heart attack and stroke. Chelation may also possibly improve blood vessel function. As for chelation’s especially strong cardiovascular benefit in diabetes patients, a likely mechanism is a reduction of AGE’s (advanced glycation end products) generated by the body and the high-temperature cooking of foods (especially those high in animal protein like meat and cheese) by frying, broiling, baking, and grilling. AGE’s are linked to diabetes, heart disease, inflammation, blood vessel and nerve damage, and accelerated aging. People with diabetes are extra sensitive to AGE’s and should do most of their cooking at low temps (steaming, microwaving, stewing, boiling, poaching). Could Lifestyle Changes Yield Similar Results? There’s reasonable research evidence that chelation’s benefits (except for toxic metal decontamination) could be achieved through long-term lifestyle changes such as improved diet, regular exercise, and low-temperature cooking methods to reduce AGE’s for diabetics. For example: The 4 year Lyon Diet Heart Study randomized 600 heart-attack patients to a Mediterranean-style diet (see http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview) or to the American Heart Association’s recommended diet. At 4 years, the Med diet group had a 50-75% lower incidence of cardiac events (fatal & non-fatal heart attack, sudden cardiac death, and stroke) compared to the AHA diet (Circulation 1999;99;779-85). A combined analysis of 23 randomized trials with 11,085 heart-disease patients found that lifestyle modification programs reduced all-cause mortality by 25% and heart-related hospital admissions by 26% over an average follow-up period of 10.2 months; some of the changes were maintained at an average long-term follow-up period of 33.7 months (Eur J Prev Cardiol 2013;4:620-40) So, it's obvious that chelation patients should also adopt improved lifestyle to magnify benefits and broaden since exercise asnd healthy eating also reduce risk of cancer and dementia. References Note: I thoroughly reviewed the full-text medical journal articles below, not just their much shorter summary abstracts. Effect of Disodium EDTA chelation regimen on cardiovascular events in patients with previous myocardial infarction (heart attack): The TACT Randomized Trial, JAMA 2013 March 27;309(12):1241-1250. Free full text available online at http://www.ncbi.nlm.nih.gov/pubmed/23532240 Chelation Therapy After the Trial to Assess Chelation Therapy: Results of a Unique Trial, Current Opinion Cardiology 2014, 29:481-88. Free full text available online at http://www.ncbi.nlm.nih.gov/pubmed/25023079 The effect of an EDTA-based chelation regime on patients with diabetes mellitis and prior myocardial infarction (heart attack) in the Trial to Assess Chelation Therapy (TACT). Circ Cardiovasc Qual Outcomes, 2014, Jan;7(1):15-24. Free full text at:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4111470 IMPORTANT DISCLAIMERS Seek & consider the advice of your physician or cardiologist before undergoing chelation therapy. The info presented in this post should not replace professional medical or dietary advice, diagnosis or treatment. Always consult your registered dietitian or physician before making any significant dietary changes. Don't ignore professional medical advice due to the info presented here.
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