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Long-Term Metformin Treatment Linked to Vitamin B12 Deficiency

May 2010 — In type 2 diabetes, long-term metformin treatment is linked to vitamin B12 deficiency, according to the results of a multicenter, randomized, placebo-controlled trial reported Online First May 20 in the BMJ.

”Metformin is considered a cornerstone in the treatment of diabetes and is the most frequently prescribed first line therapy for individuals with type 2 diabetes,” write Jolien de Jager, from the Academic Medical Center in Amsterdam, the Netherlands, and colleagues. “Metformin does, however, induce vitamin B-12 malabsorption, which may increase the risk of developing vitamin B-12 deficiency — a clinically important and treatable condition.”

“Long term treatment with metformin increases the risk of vitamin B-12 deficiency, which results in raised homocysteine concentrations,” the study authors write. “Vitamin B-12 deficiency is preventable; therefore, our findings suggest that regular measurement of vitamin B-12 concentrations during long term metformin treatment should be strongly considered.”

Dr. Tucker’s comments: Dietary counseling should be considered with every person on Metformin. I know eating a low-sugar diet can be difficult. A new formula called Glucorest contains touchi extract which has been shown to blunt the glycemic response and supports healthy glucose and triglyceride metabolism – without reported adverse effects. Order Glucorest from the Metagenics link.

BMJ. Published online May 20, 2010.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20488910&dopt=Abstract

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Weight Loss Tips

A big part of my private practice is helping people lose fat. Here are 3 nutrition principles that will serve you well throughout your fat loss journey. I suggest that you pick one from the list to start out with, master that one and then move on to the next ones.
If you are a client you know that I recommend eating a healthy Mediterranean Diet or The Paleo Diet. Both are low sugar, high fiber, with foods such as lean protein (beef, chicken, fish, eggs and whey protein), vegetables (technicolor plates), fruits (strawberries, blueberries, etc.), nuts (almonds, cashews and walnuts) and very little whole grains (oatmeal and multigrain bread). I usually up everyone’s protein & fat intakes.
1) Eat Breakfast Every Day.
Studies have consistently shown that making breakfast a daily habit will help you lose weight and keep it off. People skip breakfast thinking they’re cutting calories, but by mid-morning and lunch, that person is starved. Breakfast skippers replace calories during the day with mindless nibbling, binging at lunch and dinner. Don’t set yourself up for failure. Eating breakfast also jump starts your metabolism for the day. When you don’t eat breakfast, you’re actually fasting for 15 to 20 hours, so you’re not producing the enzymes needed to metabolize fat to lose weight. If you don’t have time for breakfast, make a delicious protein shake using UltraMeal from Metagenics (see link).
2) Eat a little something every 2-3 hours that you are awake.
Basically you’re going to eat whenever you are truly hungry. Hunger is the best indication of when you need to nourish your body and will help control over eating and not eating enough. Aim to eat only when you are truly hungry and stop eating when you are satisfied. This generally works out to 3 larger meals alternating with 2-3 smaller snacks throughout the day. This will help keep you full and satisfied and will reduce the likelihood of binge eating at the end of the day. This is one of the best principles you can follow to blast fat and build lean muscle.

3) Unless you are on the 28 Day Cleanse, for one meal a week, eat your favorite foods.
You shouldn’t be deprived of your favorite foods. This is a reward meal. A reward for eating healthy the entire week. So pick one meal per week to eat anything you want. Pasta, ice-cream, chocolate, wine….anything goes at this meal.

The 28 Day Cleanse has been most helpful with clients who complain of fatigue, recurrent gastrointestinal problems (especially diarrhea), food intolerance or sensitivity, chemical or environmental sensitivities, chronic headache, and muscle or joint pain of unknown origin.

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Prostate Health

Here are 10 foods that can significantly cut a man’s risk of prostate cancer:

Tomatoes: Red tomatoes are a rich source of lycopene. Lycopene is a powerful antioxidant. Studies show that antioxidants protect against prostate cancer.

Green Tea: Study after study shows the benefit of drinking green tea for general good health. Green tea is protective against prostate cancer. Try to brew up at least two cups per day.

Cruciferous Vegetables: Broccoli, Brussel sprouts, & cauliflower help protect against prostate cancer. Others include kale, and mustard greens. Just three or more servings per week may reduce the risk of prostate cancer by 50 percent. Try to include at least one of these vege’s per day in your meals.

Garlic: Recent studies suggest it cuts the risk of prostate cancer tumors by over half. That’s possibly because it contains selenium. Selenium is an essential antioxidant that fights cancer and may cut prostate cancer risk by 50 percent.

Brazil Nuts: Another great source of selenium. A daily handful of Brazil nuts offers enough selenium to lower your risk by 50 percent.

Fish: Contains Omega 3 fatty acids, Vitamin E and selenium. These three taken together should be part of a prostate cancer prevention program. Best sources: Sardines, tuna, and salmon.

Flaxseeds: These are a rich source of vitamin E. Research conducted on mice shows that flaxseeds may slow the spread of prostate cancer. I like to put Flaxseeds in my protein shakes – UltraMeal powder by Metagenics or FitFood powder by Xymogen).

Pomegranate Juice: Pomegranate juice also slows the growth of prostate cancer, according to research on mice.

Scallions: One study showed that eating just a tenth of an ounce of scallions each day reduces the risk of prostate cancer by 70 percent.

Saw palmetto also boosts prostate health. Saw palmetto alleviates the symptoms of prostate gland enlargement. The herbal extract is the initial treatment for urinary tract problems in several European countries.

If you need added support and want to take a supplement in conjunction with a healthy diet, I recommend Prostate FLO by Xymogen (1-800-647-6100). This is a comprehensive prostate support formula. Its primary mode of action involves maintaining healthy testosterone metabolism.

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Daily Ginger Consumption Found To Ease Muscle Pain

For centuries, ginger root has been used as a folk remedy for a variety of ailments such as colds and upset stomachs. But now, researchers at the University of Georgia have found that daily ginger consumption also reduces muscle pain caused by exercise.

Ginger has been shown to exert anti-inflammatory effects and decrease pain. Cooking with ginger is one way to increase your intake. Another way to benefit from the pain-relieving effects is to make a shake with UltraInflamX 360.

UltraInflamX® Plus 360° is a medical food made by Metagenics formulated to provide specialized nutritional support—including reduced iso-alpha acids (RIAA, from hops), L-glutamine, and easily digestible rice protein. UltraInflamX includes ginger and rosemary. It also provides turmeric extract, which has been shown in research to inhibit the activities of a wide variety of enzymes, cytokines, eicosanoids, and reactive species implicated in pain and inflammation.

Another recommendation to help decrease pain is to increase EPA-DHA consumption (Omega 3 fish oils). I recommend EPA-DHA 720 by Metagneics.

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Triglycerides and heart disease link

Triglyerides are blood fats and are different from cholesterol. Cambridge University researchers looked at the role of triglycerides, which is produced in the liver and derived from foods such as meat and dairy products.

They did an analysis of 350,000 people from 101 previous studies and found those with higher levels of the blood fat were more likely to have heart disease.

The Lancet medical journal reported that the analysis centred on a specific gene which is known to influence the levels of triglycerides. Those with the variation in the gene which boosted triglyceride levels had an 18% greater risk of heart disease than those that did not.

The findings suggest the blood fat could be causing heart disease in some way. I’ve been saying for years that lowering triglyceride levels is more important than reducing cholesterol in reducing the risk of heart disease.

My advice is to make simple lifestyle changes; continue to eat a Paleo-Mediterranean diet; make the transition to a healthy, whole food diet; exercise; stop smoking; replace problem meals with a healthy protein shake (use UltraMeal Plus medical food from Metagenics). These are still the best ways to tackle your heart disease risk.

Most places you look these days are saying the TG/HDL ratio is the most important test of blood lipids, and should be under 2.0, or preferably under 1.0. Beyond that there is CRP, and a bunch of different, more expensive tests: http://www.bhlinc.com/clin_test.php http://www.atherotech.com/ http://www.atherotech.com/content/files/pdfs/vap_report_sample.pdf http://www.your-story.org/spectracell-laboratories-now-offers-hs-omega-3-indexr-161378/ http://www.spectracell.com/lpp

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Erectile Dysfunction

Erectile dysfunction is often a problem with circulation. Because it is an early indicator of problems with blood flow, the presence of erectile dysfunction may forewarn future cardiac problems.
Various herbs and nutrients have been studied. The Asian Journal of Andrology (2007; 9(2): 241-4) studied the effect of
Korean red ginseng in a double-blind, placebo-controlled study involving 60 subjects with erectile dysfunction. At the
end of the 12 week study, the group receiving 1000 mg of Korean Red Ginseng 3x per day had improvement of symptoms according to the five item version of the International Index of
Erectile Function (IIEF-5).

If ED is a concern for you, please feel free to discuss nutritional recommendations with me.

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Depression in Children Hepled With Fish Oils

A small, double-blind, placebo-controlled study, published in the American Journal of Psychiatry (2006; 163(6): 1098-100), looked at supplementation with omega-3 fatty acids and its
effect on childhood depression. The subjects of the study were 20 children between the ages of six and 12 suffering with depression. They were randomly assigned to receive either an omega-3 fatty acid supplement or a placebo. The children were evaluated using the Children’s Depression Rating Scale, the Children’s Depression Inventory and the Clinical Global Impression. Evaluations were taken at the beginning of the study and at weeks 2, 4, 8, 12 and 16. At the end of the study,
70% of the supplemented children showed at least a 50% reduction in depression scores.

I recommend EPA-DHA 720 from Metagenics or Xymogen’s Omega Pure 780EC. Both are tested to be free of dioxin and mercury. Quality is vital when choosing a fish oil product.

Omega 3 fish oils are part of a cardiovascular health program. Benefits include Blood Pressure; Lipids and Clotting; reducing inflammation of joints and skin; reducing back and neck pain;
support for mental health/behavior; support for the reduction of allergic-type response; glucose and insulin.

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