CHOICE

SEE YOUR DOCTOR

Reference Riedl, David, and Gerhard Schüßler. “The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review.” Zeitschrift für Psychosomatische Medizin und Psychotherapie 63, no. 2 (2017): 131-150.

Research Summary Researchers from Medical University of Innsbruck, Austria systematically reviewed 17 controlled studies, and eight qualitative studies on the influence of the doctor-patient relationship and communication on health outcomes, retrieved by a search of the medical literature from 2000-2015. The statistical analysis showed that building a doctor-patient relationship had a positive effect on gathering health information and patient education in 60% of the studies. Communication skills showed improved results and enabled treatment-related emotions and behavior. Although more studies will be necessary, this systematic review revealed different domains of the doctor-patient relationship and communication positively influenced by different objectives (e.g. blood pressure) and subjective (e.g. pain scores) health outcomes.

GET EDUCATED

Reference Whitehead, Lisa C., Marie T. Crowe, Janet D. Carter, Virginia R. Maskill, Dave Carlyle, Carol Bugge, and Chris Frampton. “A nurse‐led education and cognitive behaviour therapy‐based intervention among adults with uncontrolled type 2 diabetes: A randomised controlled trial.” Journal of evaluation in clinical practice 23, no. 4 (2017): 821-829.

Research Summary Researchers from University of Otago, New Zealand, University of Stirling, United Kingdom, University of Canterbury, New Zealand, and Edith Cowan University, Australia studied the association of a nurse-led educational intervention, using education and acceptance and commitment therapy (ACT) and hemoglobin A1 in people with uncontrolled type II diabetes compared to usual diabetes care. Adults over the age of 18 years, with a confirmed diagnosis of type 2 diabetes and HbA_1c outside of the recommended range (4%-7%, 20-53 mmol/mol) for 12 months or more, were eligible to participate. Participants were randomized to either a nurse-led education intervention (34 people), a nurse-led education plus ACT intervention (39 people), or a usual care (45 people). Participants completed baseline data. A statistically significant reduction in HbA_1c in the education intervention group was found. At six months, HbA_1c was reduced in both intervention groups and the ACT group and it increased in the control group. A positive change in HbA_1c was noted in 50 participants overall. Twice as many participants (56%) in the intervention groups demonstrated an improvement as compared to the control group (24%).

Reference Chrvala, Carole A., Dawn Sherr, and Ruth D. Lipman. “Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control.” Patient education and counseling 99, no. 6 (2016): 926-943.

Research Summary Researchers from the American Association of Diabetes Educators systematically reviewed the effects of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. Data was collected to December 2013 for interventions which included elements to improve participants’ knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting. The results showed a 61.9% significant change in A1c levels, out of 118 unique intervention programs. The combination of group and individual engagement programs resulted in the largest decrease in A1c. In patients with persistently elevated glycemic values, a greater proportion of studies reported statistically significant reduction in A1c (83%).

Reference Hung, Jui-Yu, Pin-Fan Chen, Hanoch Livneh, Yi-Yu Chen, How-Ran Guo, and Tzung-Yi Tsai. “Long-term effectiveness of the Diabetes Conversation Map Program: A prepost education intervention study among type 2 diabetic patients in Taiwan.” Medicine 96, no. 36 (2017): e7912.

Research Summary Researchers from the United States and Taiwan examined the long-term effectiveness of the Diabetes Conversation Map (health education) Program (DCMP) among 95 type II diabetes hospitalized patients in Taiwan. In addition to routine care, the experiment group received seven sessions of DCMP delivered over two months, while the control group received only routine care during the same period. Validated questionnaire survey and medical records were reviewed at three time points (before DCMP, three days after DCMP, and three months after DCMP completion) to collect the effectiveness data. The results showed improvements in the body mass index, blood glucose, hemoglobin, self-monitoring of blood glucose, and diabetic health literacy in the DCMP group compared with control group. The positive effects were further maintained for three months after DCMP.

MANAGE STRESS

Reference Nyberg, Solja T., Eleonor I. Fransson, Katriina Heikkilä, Kirsi Ahola, Lars Alfredsson, Jakob B. Bjorner, Marianne Borritz et al. “Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women.” Diabetes care 37, no. 8 (2014): 2268-2275.

Research Summary Researchers from 29 institutions from United Kingdom, Sweden, Finland, Denmark, Germany, and France collaborated to study whether stress at work, defined as “job strain,” is associated with type II diabetes independent of lifestyle factors. Data was collected on 124,808 adults with diabetes from 13 European studies participating in the IPD-Work Consortium. Job strain was measured with baseline questionnaires. Type II diabetes at follow up was ascertained using national health registers, clinical screening, and self-report. Statistical analysis showed that job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits.

CHOOSE TO STOP 

Reference Pan, An, Yeli Wang, Mohammad Talaei, Frank B. Hu, and Tangchun Wu. “Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis.” The lancet Diabetes & endocrinology 3, no. 12 (2015): 958-967.

Research Summary Researchers from University of Science and Technology, China, Harvard T. H. Chan School of Public Health, United States, and National University of Singapore investigated the association between various smoking and the risk for developing type II diabetes. A systematic review was conducted and 88 prospective studies with 5,898,795 participants. The results showed that both active and passive smoking are associated with significantly increased risks of type 2 diabetes. The risk of diabetes is increased in new quitters, but decreases substantially as the time since quitting increases.

MONITOR YOUR NUMBERS

Reference Wagner, Julie, Stephen Armeli, Howard Tennen, Angela Bermudez-Millan, Howard Wolpert, and Rafael Pérez-Escamilla. “Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes.” Psychosomatic medicine 79, no. 7 (2017): 798-805.

Research Summary Researchers from Farleigh Dickinson University, and Yale University, United States examined the association between diabetes self-care behaviors and continuously monitored glucose in 50 participants with type II diabetes. The individuals wore a “blinded” continuous glucose monitor for seven days and responded two times per day to an automated phone survey regarding positive affect, negative affect, and self-care behaviors. Higher levels of negative affect were associated with higher glucose, greater percent hyperglycemia, and greater percentage of out-of-range glucose. Higher positive affect variability was related to lower percentage of hypoglycemia. Higher levels of self-care behaviors were related to lower glucose variability. Finally, higher self-care behavior variability was related to greater percentage of hyperglycemia and greater percentage of out-of-range glucose.

REST

TALK TO YOUR DOCTOR

Reference Strand, Linn Beate, Mercedes Carnethon, Mary Lou Biggs, Luc Djoussé, Robert C. Kaplan, David S. Siscovick, John A. Robbins et al. “Sleep disturbances and glucose metabolism in older adults: the cardiovascular health study.” Diabetes care 38, no. 11 (2015): 2050-2058.

Research Summary Multiple researchers from the United States and Norway examined the association of symptoms of sleep-apnea (disordered breathing), which was defined as loud snoring, episodes of stopped-breathing during sleep, daytime sleepiness, insomnia with glucose metabolism, and incident type 2 diabetes in older adults. Between 1989 and 1993, the Cardiovascular Health Study recruited 5,888 participants ≥65 years of age from four U.S. communities. Participants reported sleep apnea and insomnia symptoms yearly through 1989-1994. In 1989-1990, participants underwent an oral glucose tolerance test, from which insulin secretion and insulin sensitivity were estimated. Fasting glucose levels were measured in 1989-1990 and again in 1992-1993, 1994-1995, 1996-1997, and 1998-1999, and medication use was ascertained yearly. Observed apnea, snoring, and daytime sleepiness were associated with higher fasting glucose levels, higher two-hour glucose levels, lower insulin sensitivity, and higher insulin secretion. The risk of the development of type 2 diabetes was positively associated with observed apnea, snoring, and daytime sleepiness.  

EVALUATE YOUR SLEEP

Reference Buxton, Orfeu M., and Enrico Marcelli. “Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States.” Social science & medicine 71, no. 5 (2010): 1027-1036.

Research Summary Researchers from Harvard Medical School studied the association between short sleep (less than 7 hours) and long sleep (greater than 8 hours) and the risk for obesity, diabetes, hypertension, and cardiovascular disease. Data was analyzed from the 2004-2005 National Health Interview Survey of 56,507 observations on adults 18-85 years of age. The results classified at least 76% of adults on each of the outcomes studied and sleep duration was frequently more strongly associated with the risk for obesity, diabetes, hypertension, and cardiovascular disease that other variables (e.g. income, education, gender, age). The findings suggest a seven to eight-hour sleep duration directly and indirectly reduces chronic disease risk.

DEVELOP RESTFUL HABITS

Reference Yoda, Koichiro, Masaaki Inaba, Kae Hamamoto, Maki Yoda, Akihiro Tsuda, Katsuhito Mori, Yasuo Imanishi, Masanori Emoto, and Shinsuke Yamada. “Association between poor glycemic control, impaired sleep quality, and increased arterial thickening in type 2 diabetic patients.” PloS one 10, no. 4 (2015): e0122521.

Research Summary Researchers from Osaka City University Graduate School of Medicine, Japan examined the association between insomnia and both glycemic control and arteriosclerosis. A vascular laboratory was used to examine the impact of insomnia on 63 type II diabetes inpatients, not taking sleeping medications. The results showed that poor glycemic control was significantly associated with insomnia as represented by a decrease in rapid eye movement (REM) sleep which might be responsible for increased CA-IMT a relevant marker for arterial wall thickening.

Reference Mandel, Susan E., Beth A. Davis, and Michelle Secic. “Effects of music therapy and music-assisted relaxation and imagery on health-related outcomes in diabetes education: a feasibility study.” The diabetes educator 39, no. 4 (2013): 568-581.

Research Summary Researchers studied the association between the effects of music assisted relaxation and imagery administered via compact disc recording and no therapeutic intervention on the effects of music therapy (MT) facilitated by a board-certified music therapist, on selected health outcomes of patients enrolled in diabetes self-management education program. A three-group trial with 199 patients, 30-85 years old, with type 1, type 2, or prediabetes were employed. Patients were enrolled in a study from two hospital sites and randomly assigned to a no therapy group, the compact disc music experience, or the music therapy group. The music on CD included researcher-selected music and spoken suggestions, while music therapy included therapeutic experiences with personally preferred relaxing and energizing music. Outcome measures included blood pressure, glycosylated hemoglobin (A1C), body mass index (BMI), trait anxiety, state anxiety, and stress. Results showed significant improvement in the music therapy group from pre- to post-each session on all measured outcomes except blood pressure.

Reference Drake, Christopher, Timothy Roehrs, John Shambroom, and Thomas Roth. “Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed.” Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 9, no. 11 (2013): 1195.

Research Summary Researchers from Wayne State College of Medicine, United States compared the potential sleep disruptive effects of a 400-mg dose of caffeine administered at zero, three, and six hours prior to habitual bedtime relative to a placebo on self-reported sleep in the home. Sleep disturbance was also monitored objectively using a validated portable sleep monitor. The results demonstrated a moderate dose of caffeine at bedtime, three hours prior to bedtime, or six hours prior to bedtime each have significant effects on sleep disturbance relative to placebo group, which provides empirical support for sleep hygiene recommendations to refrain from substantial caffeine use for a minimum of six hours prior to bedtime.  

CREATE A GOOD SLEEP ENVIRONMENT

Reference Bano, Milena, Federica Chiaromanni, Michela Corrias, Matteo Turco, Michele De Rui, Piero Amodio, Carlo Merkel et al. “The influence of environmental factors on sleep quality in hospitalized medical patients.” Frontiers in neurology 5 (2014): 267.

Research Summary University of Padova, Italy and University of Fribourg, Switzerland assessed the sleep quality in 118 inpatients, in relation to environment factors and the switch to daylight-saving time. Between March and April 2013, 118 consecutive inpatients were screened. They slept in double or quadruple rooms, facing South/South-East, and were qualified as sleeping near/far from the window. They underwent daily sleep assessment by standard questionnaires. The degree of light was measured at each patient’s eye-level, four times per day. Noise level was measured at the same time each day. Information was recorded on room lighting, position of the rolling shutters and number/type of extra people in the room. The results showed a significant association between sleep quality and bed position to window light exposure. Noise levels were higher than recommended for care units but substantially comparable across times/room types, with 33% of the patients reporting one or more sleepless nights due to noise levels.  

TAKE A BREAK

Reference Hunter, Emily M., and Cindy Wu. “Give me a better break: Choosing workday break activities to maximize resource recovery.” Journal of Applied Psychology 101, no. 2 (2016): 302.

Research Summary Researchers from Baylor University, United States examined the association between workday break characteristics and well-being, in 95 employees, observed over five workdays. Results indicated that activities that were chosen by the employee, and earlier in the work shift related to more recovery following the break. In addition, break length interacted with the number of breaks per day such that longer breaks and frequent short breaks were associated with more recovery than infrequent short breaks.

Reference Kühnel, Jana, Hannes Zacher, Jessica De Bloom, and Ronald Bledow. “Take a break! Benefits of sleep and short breaks for daily work engagement.” European Journal of Work and Organizational Psychology 26, no. 4 (2017): 481-491.

Research Summary Multi-institutional researchers from Finland, Germany, and Singapore, investigated the benefits of a good night’s sleep and short work breaks for employees’ daily work engagement. It was hypothesized that sleep and self-initiated short breaks help restore energy which, in turn, enable employees to experience high work engagement. A daily diary study was conducted with 107 employees who provided data twice a day (before lunch and at the end of the working day) over five workdays (453 days in total). Statistical analysis showed that sleep quality and short breaks were beneficial for employees’ daily work engagement. After nights when employees slept better, they indicated higher work engagement during the day. Moreover, taking self-initiated short breaks from work in the afternoon boosted daily work engagement.

ENVIRONMENT

CLEAR THE AIR

Reference Jerrett, Michael, Robert Brook, Laura F. White, Richard T. Burnett, Jeffrey Yu, Jason Su, Edmund Seto et al. “Ambient ozone and incident diabetes: A prospective analysis in a large cohort of African American women.” Environment International 102 (2017): 42-47.

Research Summary Researchers from six United States universities investigated the association between ozone (an air pollutant) and type II diabetes in 45,231 African American women living in 56 metropolitan areas across the United States. Ozone levels were estimated using the U.S. EPA Models-3/Community Multiscale Air Quality (CMAQ) predictions fused with ground measurements at a resolution of 12 km for the years 2007-2008. Statistical analysis showed evidence of a positive association between ozone and diabetes in African American women.

Reference Wu, Hongyu, Kimberly A. Bertrand, Anna L. Choi, Frank B. Hu, Francine Laden, Philippe Grandjean, and Qi Sun. “Persistent organic pollutants and type 2 diabetes: a prospective analysis in the nurses’ health study and meta-analysis.” Environmental health perspectives 121, no. 2 (2013): 153.

Research Summary Researchers from Harvard School of Public Health, United States, and the University of Southern Denmark examined the relationship between four common air pollutants and the risk of type II diabetes. Plasma polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), and hexachlorobenzene (HCB) concentrations were measured in 1,095 women who were free of diabetes at blood draw in 1980-1990 and participated in the Nurses’ Health Study. They identified 48 incident type II diabetes cases through June 30, 2008. The results showed that plasma HCB concentration was positively associated with the risk of type II diabetes. Other pollutants were not significantly associated with diabetes.  

SOAK UP THE SUN

Reference Shore‐Lorenti, Catherine, Sharon L. Brennan, Kerrie M. Sanders, Rachel E. Neale, Robyn M. Lucas, and Peter R. Ebeling. “Shining the Light on Sunshine: a systematic review of the influence of sun exposure on type 2 diabetes mellitus‐related outcomes.” Clinical endocrinology 81, no. 6 (2014): 799-811.

Research Summary Researchers from four universities from Australia examined associations between sun exposure and type II diabetes and glucose metabolism. A best-evidence synthesis was then conducted using outcomes from analyses deemed to have high methodological quality. Ten eligible full-text articles were identified, yielding the best evidence analysis considered 11 outcomes that were grouped into six outcome types including fasting glucose, glucose tolerance, fasting insulin, insulin secretion, and insulin sensitivity. The results showed evidence to support a role of recreational sun exposure in reducing the odds of developing type II diabetes.  

FIND A QUIET PLACE

Reference Clark, Charlotte, Hind Sbihi, Lillian Tamburic, Michael Brauer, Lawrence D. Frank, and Hugh W. Davies. “Association of Long-Term Exposure to Transportation Noise and Traffic-Related Air Pollution with the Incidence of Diabetes: A Prospective Cohort Study.” Environmental Health Perspectives 87025 (2017): 1.

Research Summary Researchers from the University of London, United Kingdom and University of British Columbia, Canada studied the association between long-term residential traffic noise exposure and traffic-related air pollution on the incidence of diabetes on 380,738 residents of metropolitan Vancouver, Canada who were 45-85 years old with a four-year follow up (1999-2002). Annual average transportation noise (Lden), air pollution [black carbon, particulate matter with aerodynamic diameter <2.5μm (PM_2.5), nitrogen oxides], greenness [Normalized Difference Vegetation Index (NDVI)], and neighborhood walkability at each participant’s residence were modeled. Diabetes cases were identified using administrative health records. The results found a positive association between residential transportation noise and diabetes, adding to the growing body of evidence that noise pollution exposure may be independently linked to metabolic health and should be considered when developing public health interventions.  

CREATE AN OASIS

Reference Roster, Catherine A., Joseph R. Ferrari, and M. Peter Jurkat. “The dark side of home: Assessing possession ‘clutter’ on subjective well-being.” Journal of Environmental Psychology 46 (2016): 32-41.

Research Summary Researchers from University of New Mexico, and DePaul University, United States investigated the experienced quality of home when compromised by clutter, defined as an overabundance of possessions that collectively create chaotic and disorderly living spaces. An online survey was conducted with a population of U.S. and Canadian adults. Findings reveal that clutter had a negative impact on psychological experience of home and a sense of well-being. The authors concluded that these findings contribute to a broader understanding of how meanings of home are undermined by individuals’ clutter-making efforts.

SURROUND YOURSELF WITH GREEN

Reference Bjørnstad, Siv, Grete G. Patil, and Ruth K. Raanaas. “Nature contact and organizational support during office working hours: benefits relating to stress reduction, subjective health complaints, and sick leave.” Work 53, no. 1 (2016): 9-20.

Research Summary Researchers from University of Life Sciences, Norway studied whether nature contact at work was associated with employee’s health. Data were collected through a web-based, cross-sectional survey of 707 employees in seven public and private office workplaces in Norway. The results showed a greater amount of indoor nature contact at work was significantly associated with less job stress, fewer reported health complaints, and less absent days due to illness.

Reference Ngom, Roland, Pierre Gosselin, Claudia Blais, and Louis Rochette. “Type and proximity of green spaces are important for preventing cardiovascular morbidity and diabetes—A cross-sectional study for Quebec, Canada.” International journal of environmental research and public health 13, no. 4 (2016): 423.

Research Summary Researchers from Université Laval, Canada studied the role of the location of green spaces and the risk of cardiovascular diseases and diabetes. The authors measured the accessibility to various types of green spaces and used a validated survey disseminated in the Montreal and Quebec City metropolitan zones for the period 2006-2011. Statistical analysis was used to quantify the relationships between distances to specific types of green spaces and health outcomes (e.g. diabetes and hypertension). The results showed the most distant population had an 11% higher prevalence rate compared to the nearest, as well as higher diabetes risk than the nearest.

Reference Stigsdotter, Ulrika K., Ola Ekholm, Jasper Schipperijn, Mette Toftager, Finn Kamper-Jørgensen, and Thomas B. Randrup. “Health promoting outdoor environments-Associations between green space, and health, health-related quality of life and stress based on a Danish national representative survey.” Scandinavian Journal of Social Medicine 38, no. 4 (2010): 411-417.

Research Summary Researchers from University of Copenhagen, Denmark and University of Southern Denmark studied the associations between green space and health, health-related quality of life, and stress. Data was derived from the 2005 Danish Health Interview Survey and are based on a random sample of 21,832 adults. In addition, data was collected via face-to-face interviews followed by a self-administered questionnaire, including the SF-36, which measures eight dimensions of health and the Perceived Stress Scale, which measures self-reported stress. A total of 11,238 respondents completed the interview and returned the questionnaire. Statistical analysis was performed to investigate the association between distance to green space and self-perceived stress. The results showed that Danes living more than 0.62 miles away from the nearest green space reported poorer health and health-related quality of life, for example lower mean scores on all eight SF-36 dimensions of health than respondents living closer. Respondents living more than 0.62 miles away from a green space had greater changes of experiencing stress than did respondents living less than 1,000 feet from a green space. Respondents not reporting stress were more likely to visit a green space than are respondents reporting stress. Reasons for visiting green spaces differed significantly depending on whether or not respondents experienced stress. Respondents reporting stress were likely to use green spaces to reduce stress.

ACTIVITY

START WITH YOUR DOCTOR

Reference Riedl, David, and Gerhard Schüßler. “The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review.” Zeitschrift für Psychosomatische Medizin und Psychotherapie 63, no. 2 (2017): 131-150.

Research Summary Researchers from Medical University of Innsbruck, Austria systematically reviewed 17 controlled studies, and eight qualitative studies on the influence of the doctor-patient relationship and communication on health outcomes, retrieved by a search of the medical literature from 2000-2015. The statistical analysis showed that building a doctor-patient relationship had a positive effect on gathering health information and patient education in 60% of the studies. Communication skills showed improved results and enabled treatment-related emotions and behavior. Although more studies will be necessary, this systematic review revealed different domains of the doctor-patient relationship and communication positively influenced by different objectives (e.g. blood pressure) and subjective (e.g. pain scores) health outcomes. 

BREAK IT UP

Reference Dunstan, David W., Bronwyn A. Kingwell, Robyn Larsen, Genevieve N. Healy, Ester Cerin, Marc T. Hamilton, Jonathan E. Shaw et al. “Breaking up prolonged sitting reduces postprandial glucose and insulin responses.” Diabetes care 35, no. 5 (2012): 976-983.

Research Summary A study was conducted by 12 researchers from the United States, Australia, and China to examine the effects on after lunch and dinner glucose and insulin levels of uninterrupted sitting compared with sitting interrupted by brief bouts of light or moderate intensity walking. Overweight/obese adults (19), aged 45–65 years, were recruited for a randomized three-period, and three-treatment study: 1) uninterrupted sitting; 2) seated with two-minute bouts of light-intensity walking every 20 minutes; and 3) seated with two-minute bouts of moderate-intensity walking every 20 minutes. A standardized test drink was provided after an initial two-hour period of uninterrupted sitting. The results showed that interrupting sitting time with short bouts of light- or moderate-intensity walking lowers after lunch and dinner glucose and insulin levels in overweight/obese adults.

INCREASE THE INTENSITY

Reference Adams, O. Peter. “The impact of brief high-intensity exercise on blood glucose levels.” Diabetes, metabolic syndrome and obesity: targets and therapy 6 (2013): 113.

Research Summary A researcher from the University of the West Indies, Barbados systematically reviewed the effect of brief high-intensity exercise on blood glucose levels of people with and without diabetes. Data collected from six studies of people without diabetes requiring 7.5-20 minutes per week of high-intensity exercise (HIE) showed two weeks of sprint interval training increased insulin sensitivity up to three days post-intervention. Near maximal interval running (total exercise time 40 minutes per week) improved blood glucose levels to a similar extent as moderate level exercise for 150 minutes per week. The authors also reviewed eight studies of 63 people with type I and type II diabetes.  The results showed that blood glucose was generally higher during and up to two hours after HIE compared to the control group (nondiabetics). With type I diabetics, blood glucose decreased from midnight to 6 AM following HIE the previous morning. With type II diabetes, a single session improved postprandial BG for 24 hours, while a two-week program reduced the average blood glucose by 13% at 48 to 72 hours after exercise. In conclusion, very brief HIE improves blood glucose one to three-days post-exercise in both diabetics and non-diabetics.

Reference Liubaoerjijin, Yilina, Tasuku Terada, Kevin Fletcher, and Normand G. Boulé. “Effect of aerobic exercise intensity on glycemic control in type 2 diabetes: a meta-analysis of head-to-head randomized trials.” Acta diabetologica 53, no. 5 (2016): 769-781.

Research Summary Researchers from University of Alberta, Canada conducted a meta-analysis comparing different intensities of aerobic exercise with glycemic control in people with type II diabetes. Databases were searched up to January 2016 for studies that had exercise interventions lasting from 12 weeks to six months comparing two exercise interventions of different intensities from a total of eight studies, 235 participants. The prescribed exercise intensities varied among studies. Four studies utilized vigorous exercise intensities for short durations by performing interval training. The results showed overall, higher-intensity exercise (both interval training and higher-intensity continuous exercise) resulted in a greater reduction in HbA1c compared to lower-intensity exercise. Adherence to exercise and proportion of dropouts did not differ within trials. No adverse events were reported in these small trials with selected inclusion criteria.

ADD VARIETY—AND FUN

Reference Yang, Zuyao, Catherine A. Scott, Chen Mao, Jinling Tang, and Andrew J. Farmer. “Resistance exercise versus aerobic exercise for type 2 diabetes: a systematic review and meta-analysis.” Sports medicine 44, no. 4 (2014): 487-499.

Research Summary Researchers from the Chinese University of Hong Kong, China and University of Oxford, United Kingdom investigated whether resistance exercise is comparable to aerobic exercise in terms of effectiveness and safety in people with type 2 diabetes. The following criteria was used to select studies for inclusion in the review: (I) the study was a randomized clinical trial; (II) the participants were people 18 years or older with type 2 diabetes; (III) the trial compared resistance exercise with aerobic exercise for a duration of at least eight weeks, with pre-determined frequency, intensity, and duration; and (IV) the trial provided relevant data on at least one of the following: glycaemic control, blood lipids, body composition, blood pressure, fitness, health status, and adverse events. The results of the included 12 trials, with 626 participants, showed that following the exercise interventions, there was a non-significant difference in body mass index, peak oxygen consumption, and maximum heart rate per minute comparing aerobic and resistance exercise.

AIM FOR 150 MINUTES

Reference Umpierre, Daniel, Paula AB Ribeiro, Caroline K. Kramer, Cristiane B. Leitão, Alessandra TN Zucatti, Mirela J. Azevedo, Jorge L. Gross, Jorge P. Ribeiro, and Beatriz D. Schaan. “Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis.” Jama 305, no. 17 (2011): 1790-1799.

Research Summary Research Summary Researchers from the Federal University of Rio Grande do Sul, Brazil systematically reviewed the associations of structured exercise training regimens (aerobic, resistance, or both) and physical activity advice with or without dietary cointervention on chance in hemoglobin A_1c (in type 2 diabetes patients). Databases were searched from January 1980 through February 2011 and 47 articles with 8,538 patients with exercise interventions of at least 12 weeks duration and structured protocols were included. The results showed that the structured exercise training that consisted of aerobic exercise resistance training or both for more than 150 minutes were associated with HbA declines; and the greater HbA reduction was associated with 150 minutes of exercise or less per week.  

TRUST IN GOD

TALK TO GOD

Reference Baesler, E. James, and Kevin Ladd. “Exploring prayer contexts and health outcomes: From the chair to the pew.” Journal of Communication & Religion 32, no. 2 (2009).

Research Summary Researchers from Old Dominion University, United States studied the association between prayer, in interpersonal, small and large group contexts, and physical, psychological, and spiritual health. A sample of college and middle-aged adults (189) completed validated surveys. Statistical analysis revealed that prayer in all contexts predicted higher levels of spiritual health (having compassion, love, forgiveness, joy, and fulfillment). Large group prayer was the strongest predictor of mental health (handling stress well, relating well to others, and making positive choices).

GET CONNECTED WITH A CHURCH

Reference Aldwin, Carolyn M., Crystal L. Park, Yu-Jin Jeong, and Ritwik Nath. “Differing pathways between religiousness, spirituality, and health: A self-regulation perspective.” Psychology of Religion and Spirituality 6, no. 1 (2014): 9.

Research Summary Researchers from Oregon State University, University of Connecticut, and American University, studied the association between religiousness (e.g. church affiliation and service attendance) and self-regulation of health habits. Database searches were conducted to identify current models of religiousness and physical health, followed by a review of the literature that supports this model. The results showed that religiousness (individuals that had strong ties to a church and attended services weekly or more) was strongly associated with better health behavior habits, including less smoking and alcohol consumption and greater likelihood of medical screenings. Religious alienation had adverse effects on positive health behaviors and disease progression. 

HAVE FAITH

Reference Ellison, Christopher G., Matt Bradshaw, Kevin J. Flannelly, and Kathleen C. Galek. “Prayer, attachment to God, and symptoms of anxiety-related disorders among US adults.” Sociology of Religion 75, no. 2 (2014): 208-233.

Research Summary Researchers from the University of Texas at San Antonio, Baylor University, and United States examined the relationship between religion and mental health. This study adds to the literature in this area by addressing two main questions: (1) Is the frequency of prayer associated with symptoms of anxiety-related disorders among U.S. adults? (2) Is this association conditional on the nature of individuals’ attachment to God? We examine these questions using data from the 2010 Baylor Religion Survey (N = 1,511). Results reveal no meaningful associations between the frequency of prayer and anxiety symptoms. In contrast, anxious attachment to God is positively correlated with psychiatric symptoms, while secure attachment to God bears a modest inverse association with these outcomes (when anxious attachment is excluded from the model). Results also show that prayer is inversely associated with symptoms of anxiety-related disorders among individuals who have a secure attachment to God, but positively associated with these outcomes among those who have a more insecure or avoidant attachment to God. Several study limitations and promising directions for future research are discussed.

EXPECT GREAT THINGS

Reference Valtonen, Maarit, David E. Laaksonen, Tommi Tolmunen, Kristiina Nyyssönen, Heimo Viinamäki, Jussi Kauhanen, and Leo Niskanen. “Hopelessness—novel facet of the metabolic syndrome in men.” Scandinavian Journal of Social Medicine 36, no. 8 (2008): 795-802.

Research Summary Researchers from Kuopio University Hospital, Finland examined the association of hopelessness and metabolic syndrome (three or more risk factors for developing diabetes and/or heart disease), in a population-based medical study of 1,743 non-diabetic men aged 42, 48, 54, and 60 years old at baseline (1984-1989). Hopelessness was measured by one’s expectations about the future and reaching goals. Statistical analysis showed the prevalence of metabolic syndrome were more common in men with higher levels of hopelessness. Men in the highest category of hopelessness were more than two times more likely to develop metabolic syndrome than those scoring low in hopelessness.

FIND PURPOSE

Reference Hooker, Stephanie A., and Kevin S. Masters. “Purpose in life is associated with physical activity measured by accelerometer.” Journal of health psychology 21, no. 6 (2016): 962-971.

Research Summary Researchers from University of Minnesota, United States studied the association between purpose in life and the belief that one’s life is meaningful and greater engagement in physical activity. Community volunteers (104) measured purpose in life and wore accelerometers (measures physical activity) for three consecutive days. Results showed that purpose in life was positively associated with significantly more physical activity (both measured and self-reported). The authors concluded that individuals that have a sense of purpose in life are more likely to participate in moderate to vigorous activity.

Reference Boyle, Patricia A., Lisa L. Barnes, Aron S. Buchman, and David A. Bennett. “Purpose in life is associated with mortality among community-dwelling older persons.” Psychosomatic medicine 71, no. 5 (2009): 574.

Research Summary Researchers from Rush University Medical Center, United States assessed the association between purpose in life as an important determinant of reduced risk of death in community-dwelling elderly persons. Data was collected from 1,238 older persons without dementia from two longitudinal studies (Rush Memory and Aging Project and Minority Aging Research Study) with baseline evaluations of purpose in life and up to five years of follow up. Statistical analysis showed that high levels of purpose in life was associated with a 57% reduced risk of death from all medical conditions, compared to individuals with a low level of purpose in life. This risk reduction stayed the same even after adjusting for depression and chronic medical conditions.

INTERPERSONAL RELATIONSHIPS

INVEST IN RELATIONSHIPS

Reference Baek, Rachel N., Molly L. Tanenbaum, and Jeffrey S. Gonzalez. “Diabetes burden and diabetes distress: The buffering effect of social support.” Annals of Behavioral Medicine 48, no. 2 (2014): 145-155.

Research Summary Researchers from Yeshiva University and Albert Einstein College of Medicine, United States studied the association between social support and coping with diabetes in 119 participants (29% Latino, 61% Black, and 25% White). This study aimed to examine the moderating role of social support in the relationship between the burden of diabetes and diabetes distress. Statistical analysis evaluated the role of social support and relationships burden (indicated by required use of insulin, and the presence of complications) and distress. Results showed that Greater support satisfaction was significantly associated with lower distress after controlling for the burden of having diabetes. Support satisfaction and number of supports significantly moderated the relationship between diabetes burden and distress. Post hoc probing revealed a consistent pattern: Use of insulin was significantly associated with more diabetes distress at low levels of support but was not at high levels of support.

Reference Chang, Po-Ju, Linda Wray, and Yeqiang Lin. “Social relationships, leisure activity, and health in older adults.” Health Psychology 33, no. 6 (2014): 516.

Research Summary Researchers from California Polytechnic State University, United States used data from the 2006 and 2010 from the nationally representative U.S. Health and Retirement Study of 2,965 participants (50-96 years old) to determine if leisure activities was linked to perception of positive social relationships will improve health outcomes. The self-reported results came from interviews with all the participants. The results demonstrated that perceptions of positive social relationships were associated with greater involvement in leisure activities and greater involvement in leisure activities was associated with better health status in older age. Future studies aimed at increasing leisure activity may contribute to improved health outcomes in older adults.

INVOLVE YOUR FAMILY

Reference Hu, Jie, Debra C. Wallace, Thomas P. McCoy, and Karen A. Amirehsani. “A family-based diabetes intervention for Hispanic adults and their family members.” The Diabetes Educator 40, no. 1 (2014): 48-59.

Research Summary Researchers from University of North Carolina at Greensboro, United States studied the effects of a family based intervention program on diabetes self-management behaviors, A1c, other biomarkers, psychosocial factors, and health-related quality of life. Adult patients with diabetes (36) and family members (37) were recruited from a community clinic in rural central North Carolina. Patients and family members attended an eight-week culturally tailored diabetes educational program. Data was collected pre- and post-intervention for both patients and family members, with an additional data collection for patients one-month post-intervention. Results showed A1c decreased by 4.9% on average among patients from pre-intervention to one-month post-intervention. Patients showed significant improvements in systolic blood pressure, diabetes self-efficacy, diabetes knowledge, and physical and mental components of health-related quality of life. Higher levels of intake of healthy foods and performance of blood glucose tests and foot inspections were reported. Family members significantly lowered body mass index and improved diabetes knowledge from pre-intervention to immediately post-intervention.

GET SUPPORT

Reference Shaya, Fadia T., Viktor V. Chirikov, DeLeonardo Howard, Clyde Foster, Julian Costas, Soren Snitker, Jeffrey Frimpter, and Kathrin Kucharski. “Effect of social networks intervention in type 2 diabetes: a partial randomised study.” J Epidemiol Community Health 68, no. 4 (2014): 326-332.

Research Summary Researchers from University of Maryland School of Medicine and Pharmacy, United States assessed the effect of social networks (support groups) on the improvement of type II diabetes management. Patients (64) in the intervention group were asked to recruit peers, form small groups, and attend monthly diabetes education sessions, focused on peer support. Patients (70) in the control group were recruited individually to attend standard diabetes education sessions. The primary outcomes measures were changes in hemoglobin (A1c) and blood glucose. Secondary outcomes included blood pressure, weight, functional status, self-efficacy, perceived cohesion, social network connectedness and diabetes knowledge. Assessments were completed at three and six months of intervention. The results showed at six months from baseline, the support group network achieved a large reduction in hemoglobin A1c and blood glucose compared to the control group. The support group also had more favorable outcomes for weight, quality of life, self-efficacy, social network scores, and diabetes knowledge compared to the control group.

HELP YOUR COMMUNITY

Reference Koetsenruijter, Jan, Jan van Lieshout, Christos Lionis, Maria Carmen Portillo, Ivo Vassilev, Elka Todorova, Christina Foss et al. “Social support and health in diabetes patients: an observational study in six European countries in an era of austerity.” PloS one 10, no. 8 (2015): e0135079.

Research Summary Researchers from multiple institutions conducted an international study to examine the impact of different types of support (individual networks and community organizations) on health and health-related behaviors in patients with type II diabetes. This observational study used interviews and validated questionnaires from 1,692 type II diabetes patients from Bulgaria, Greece, Netherlands, Norway, Spain, and the United Kingdom. Outcomes were patient-reported health status, physical exercise, diet, and smoking. Results showed patients had an average of three support connections and 34.6% participated in community organizations. Large individual support networks were associated with worse physical and mental health and less physical activity. Participation in community organizations were consistently related to better physical and mental health status.

LOVE AN ANIMAL

Reference Ramírez, Mónica Teresa González, and René Landero Hernández. “Benefits of dog ownership: Comparative study of equivalent samples.” Journal of Veterinary Behavior: Clinical Applications and Research 9, no. 6 (2014): 311-315.

Research Summary Researchers from Universidad Autónoma de Nuevo León, Mexico studied the health benefits (perceived health, stress, life satisfaction, happiness, and psychosomatic symptoms, which are physical symptoms caused by mental factors) in dog owners and non-dog owners. The participant sample consisted of 602 individuals from Mexico aged ≥18 years (377 dog owners and 225 non-dog owners). These two groups were equivalent in age, gender, educational level, marital status, employment, parental status, and the presence of chronic illness. The results indicated that, compared to non-dog owners, the dog owners’ scores were significantly lower for psychosomatic symptoms and stress and were higher for general health, vitality, emotional role, absence of bodily pain, social functioning, and mental health. Individuals who perceive themselves to be healthier also reported owning a pet for the past five years.

OUTLOOK

FIND JOY

Reference Boehm, Julia K., Claudia Trudel-Fitzgerald, Mika Kivimaki, and Laura D. Kubzansky. “The prospective association between positive psychological well-being and diabetes.” Health Psychol 34, no. 10 (2015): 1013-1021.

Research Summary Researchers from Chapman University, Harvard School of Public Health, United States, and Laval University, Canada and University College London, United Kingdom, studied the protective association of well-being (happiness, joy, and contentment) and incident diabetes. At study baseline (1991-1994), 7,800 middle-aged British men and women without diabetes indicated their life satisfaction, emotional vitality, and optimism. Diabetes status was determined by self-reported physician diagnosis and oral glucose tolerance test (screen detection) at baseline and through 2002-2004. Incident diabetes was defined by physician-diagnosed and screen-detected cases combined and separately. At the end of the 13-year follow up, statistical analysis showed well-being was associated with up to a 15% decrease in incident diabetes. These findings suggest well-being may contribute to reducing risk of diabetes, although intervention studies are needed to confirm this.

Reference Ninomiya, Hiroyo, Naoto Katakami, Taka‐aki Matsuoka, Mitsuyoshi Takahara, Hitoshi Nishizawa, Norikazu Maeda, Michio Otsuki et al. “Association between poor psychosocial conditions and diabetic nephropathy in Japanese type 2 diabetes patients: A cross‐sectional study.” Journal of diabetes investigation 9, no. 1 (2018): 162-172.

Research Summary Researchers from Fukushima Medical University, Japan evaluated the association between psychosocial factors and diabetic nephropathy (DN), which is damage to kidneys, in patients with type II diabetes. To assess psychosocial condition, six indicators (happiness score, Life Orientation Test-revised score as an indicator of dispositional optimism (defined as happiness), laughter frequency, self-awareness of stress, social network, and social support) were assessed by a self-administered questionnaire, and associations between these psychosocial indicators and the presence of DN were examined. Statistical analysis of 123 patients with and without DN showed that a high score for happiness, less self-awareness of stress, high connection of social network and high social support were associated with a reduced risk of prevalence of DN. Similar results were observed even after adjustment for the following conventional risk factors of DN: age, sex, duration of diabetes, hemoglobin A1c, hypertension, dyslipidemia and current smoking. 

BE GENTLE WITH YOURSELF

Reference Epton, Tracy, Peter R. Harris, Rachel Kane, Guido M. van Koningsbruggen, and Paschal Sheeran. “The impact of self-affirmation on health-behavior change: a meta-analysis.” Health Psychology 34, no. 3 (2015): 187.

Research Summary Researchers from University of Manchester, United Kingdom, University of Sussex, United Kingdom, University of Sheffield, United Kingdom, VU University Amsterdam, Netherlands, and University of North Carolina at Chapel Hill, United States conducted a meta-analysis on the relationships between self-affirmation (reflection on important values, attributes, or social relationships) and readiness to make health behavior change. Medical literature was reviewed for three key points in the process of health behavior change: a) health risk information acceptance; b) intentions to change; and c) behavior change and 144 experimental studies met these outcomes. Statistical analysis showed that self-affirmation had a positive effect on receiving health risk information, setting the intention to change health behaviors, and making positive changes.

Reference Jessop, Donna C., Paul Sparks, Nicola Buckland, Peter R. Harris, and Sue Churchill. “Combining self-affirmation and implementation intentions: Evidence of detrimental effects on behavioral outcomes.” Annals of Behavioral Medicine 47, no. 2 (2014): 137-147.

Research Summary Researchers from University of Sussex and University of Chichester, United Kingdom studied the association between self-affirmation and healthy behaviour change. Participants from two studies, (study 1 had 120 participants, study 2 had 116 participants) were assigned to one of four situations: 1) self-affirmation; 2) no self-affirmation; 3) exercise implementation intention; and 4) no exercise implementation. Exercise behaviour was assessed one week after the intervention was complete. Results showed that only the group that completed self-affirmation significantly increased the amount they exercised during week following the intervention.

Reference Zessin, Ulli, Oliver Dickhäuser, and Sven Garbade. “The relationship between self‐compassion and well‐being: A meta‐analysis.” Applied Psychology: Health and Well‐Being 7, no. 3 (2015): 340-364.

Research Summary Research from University of Mannheim and SRH University Heidelberg, Germany explored the relationship between self-compassion (a positive and caring attitude of a person toward themselves in the face of failure and shortcoming) and mental and emotional well-being (a positive sense of well-being that enables an individual to be able to function in society and meet the demands of everyday life; people in good mental health can recover effectively from illness). The results showed a very strong relationship between self-compassion and mental and emotional well-being. The authors concluded the results of this study clearly highlight the importance of self-compassion for individuals’ well-being.

GET HELP

Reference Atlantis, Evan, Paul Fahey, and Jann Foster. “Collaborative care for comorbid depression and diabetes: a systematic review and meta-analysis.” BMJ open 4, no. 4 (2014): e004706.

Research Summary Researchers from University of Western Sydney and University of Adelaide, Australia systematically reviewed the effect of collaborative care (coordinated multidisciplinary model) on depression and glycemic control in over 3,000 adults with depression and diabetes, medical articles published before August 2013. Statistical analysis showed collaborative care significantly improved depression scores and HbA1c levels compared with the group that did not receive any care.

BE GRATEFUL

Reference Hill, Patrick L., Mathias Allemand, and Brent W. Roberts. “Examining the pathways between gratitude and self-rated physical health across adulthood.” Personality and individual differences 54, no. 1 (2013): 92-96.

Research Summary Researchers from University of Illinois at Urbana-Champaign, United States and University of Zurich, Switzerland examined whether dispositional gratitude (tendency to notice and appreciate the positive aspects of life) can predict physical health among 962 Swiss adults, and if so, whether this relationship occurs because grateful individuals lead healthier lives. The participants completed three validated survey instruments including The Gratitude Questionnaire (GQ-6), Short Form-12 Health Survey (SF-12), Big Five Inventory, and were interviewed about their health activities and use of healthcare services. Statistical analysis showed that dispositional gratitude was positively associated with self-reported physical health, and more grateful people had higher scores in psychological health, participated more in healthy activities, and were more willing to seek help for health concerns.

Reference Krause, Neal. “Religious involvement, gratitude, and change in depressive symptoms over time.” The International journal for the psychology of religion 19, no. 3 (2009): 155-172.

Research Summary A researcher from University of Michigan, United States evaluated three hypotheses in this study: 1) feelings of gratitude will offset the negative effects of chronic financial strain on depressive symptoms over time; 2) people who go to church more often will be more likely to feel grateful; and 3) predicts that individuals with a strong sense of God-mediated control will also feel more grateful. Data from a nationwide longitudinal study of 818 older adults (over 50 years old) were statistically analyzed. The results suggest that the effects of ongoing economic difficulty on depressive symptoms are especially pronounced for older people who are less grateful. But in contrast, persistent financial difficulties fail to exert a statistically significant effect on depressive symptoms over time for older individuals who are especially grateful. The results further reveal that more frequent church attendance and stronger God is in control beliefs are associated with positive changes in gratitude over time.

HAVE A LAUGH

Reference Hayashi, Kei, Ichiro Kawachi, Tetsuya Ohira, Katsunori Kondo, Kokoro Shirai, and Naoki Kondo. “Laughter and subjective health among community-dwelling older people in Japan: cross-sectional analysis of the Japan Gerontological Evaluation Study cohort data.” The Journal of nervous and mental disease 203, no. 12 (2015): 934.

Research Summary Researchers from University of Tokyo, Fukushima Medical University and University of the Ryukyus, Japan evaluated the association of laughter with self-rated health, depression, and psychosocial factors. Laughter was assessed from three perspectives: frequency, opportunities, and interpersonal interactions. Even after adjustment for depression, sociodemographic factors, and social participation, the prevalence of self-reported poor health among women who never or almost never laughed was 1.78 times higher when compared with those who reported laughing every day. Similar associations were observed among men. The mechanisms linking laughter and health warrant further study.

NUTRITION

EAT HEALTHY

Reference McDougall, John, Laurie E. Thomas, Craig McDougall, Gavin Moloney, Bradley Saul, John S. Finnell, Kelly Richardson, and Katelin Mae Petersen. “Effects of 7 days on an ad libitum low-fat vegan diet: the McDougall Program cohort.” Nutrition journal 13, no. 1 (2014): 99.

Research Summary Researchers McDougall’s Health and Medical Center, University of North Carolina, and AOMA Graduate School of Integrative Medicine, United States, studied the effects of eating a pure plant-based, low fat (less than 10% of calories), high carbohydrate (80% of calories), and moderate sodium diet for seven days on the biomarkers of cardiovascular disease and type 2 diabetes. Measurements of weight, blood pressure, blood sugar, and blood lipids and estimation of cardiovascular disease risk at baseline and day seven was taken from 1,615 participants in a 10-day residential dietary intervention program from 2002 to 2011. The average results were as follows: 1) weight loss of four pounds and 2) cholesterol decrease was 22 points, systolic BP decreased by 8 mm Hg and diastolic BP decreased by 4 mmHg. Blood glucose decrease by 5 mg/dl. Most hypertensive and antihyperglycemic medications were reduced or discontinued at baseline. For patients, whose risk of a cardiovascular event within 10 years was >7.5% at baseline, the risk dropped to 5.5% at day seven. The authors concluded that a low-fat, starch-based, vegan diet eaten ad libitum for seven-day results in significant favorable changes in commonly tested biomarkers that are used to predict future risks for cardiovascular and type 2 diabetes.

Reference Doostvandi, Tayebeh, Zahra Bahadoran, Hassan Mozaffari-Khosravi, Zhaleh Tahmasebinejad, Parvin Mirmiran, and Fereidoun Azizi. “The association of dietary patterns and the incidence of insulin resistance after a 3-year follow-up: Tehran lipid and glucose study.” Asia Pacific Journal of Clinical Nutrition (2013).

Research Summary Researchers as Shahid Sadoghi University of Medical Sciences, Iran studied the relationships between three major dietary patterns (Western, traditional, and healthy) and the risk of insulin resistance (IR) among an urban Iranian population. In this longitudinal study, 802 adult men and women were studied within the framework of Tehran Lipid and Glucose Study. Fasting serum insulin and glucose were measured at baseline and again after a three-year follow up. The usual dietary intakes were assessed using a validated 168 item semi-quantitative food frequency questionnaire and major dietary patterns were obtained. Statistical analysis showed that the healthy dietary pattern, loaded heavily on intake of vegetable oils, fresh and dried fruits, low-fat dairy, nuts and seeds, was accompanied with a reduced risk of insulin resistance by 81%. In the presence of all dietary pattern scores in statistical analysis showed, a 45% reduced risk of IR was observed per one-unit increase in healthy dietary pattern score. The authors concluded that these findings confirmed the protective effect of a plant-based, low-fat dietary pattern against the development of insulin resistance as a main risk factor of type 2 diabetes and metabolic disorders.

Reference Satija, Ambika, Shilpa N. Bhupathiraju, Eric B. Rimm, Donna Spiegelman, Stephanie E. Chiuve, Lea Borgi, Walter C. Willett, JoAnn E. Manson, Qi Sun, and Frank B. Hu. “Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies.” PLoS medicine 13, no. 6 (2016): e1002039.

Research Summary Researchers from Harvard T. H. Chan School of Public Health and Brigham and Women’s Hospital, United States examined the association of an overall plant-based diet and healthful and unhealthful versions of a plant-based diet. This study included 69,949 women from the Nurses’ Health Study (1984-2012), 90,239 women from the Nurses’ Health Study 2 (1991-2011), and 40,539 men from the Health Professionals Follow-Up Study (1986-2010), free of chronic diseases at baseline. Dietary data were collected every two to four years using a validated food frequency questionnaire. Using these data, we created an overall plant-based diet index, where plant foods received positive scores, while animal foods (animal fats, dairy, eggs, fish/seafood, poultry/red meat, miscellaneous animal-based foods) received reverse scores. We also created a healthful plant-based diet index, where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, sweets/desserts) and animal foods received reverse scores. Statistical analysis suggested that plant-based diets, especially when rich in high-quality plant foods, are associated with substantially lower risk of developing type 2 diabetes.

MAINTAIN A HEALTHY WEIGHT

Reference Raynor, Hollie A., Patricia G. Davidson, Heather Burns, Micki D. Hall Nadelson, Shelley Mesznik, Virginia Uhley, and Lisa Moloney. “Medical Nutrition Therapy and Weight Loss Questions for the Evidence Analysis Library Prevention of Type 2 Diabetes Project: Systematic Reviews.” Journal of the Academy of Nutrition and Dietetics 117, no. 10 (2017): 1578-1611.

Research Summary Researchers from six United States based universities studied the association between medical nutrition therapy, weight loss, and risk of developing type 2 diabetes. A systematic review collected data from 1995-2012, on participants aged 18 or older and meeting prediabetes or metabolic syndrome (three or more risk factors) diagnostic criteria. Two-hour after lunch and dinner blood glucose level, glycated hemoglobin level, albumin-to-creatinine ratio (metabolic syndrome samples only), fasting blood glucose level, high-density lipoprotein cholesterol level, systolic and diastolic blood pressure, triglyceride levels, urinary albumin excretion rate (metabolic syndrome samples only), waist circumference (WC), and waist-to-hip ratio were evaluated. Results showed for weight loss, 28 publications were identified including participants with prediabetes. A majority of publications reported significant improvements in glycemic control, triglyceride level, WC, and reduction in blood pressure. All significant risk factors in developing type II diabetes.

DRINK MOSTLY WATER

Reference Huang, Mengna, Abdullah Quddus, Lynda Stinson, James M. Shikany, Barbara V. Howard, Randa M. Kutob, Bing Lu, JoAnn E. Manson, and Charles B. Eaton. “Artificially sweetened beverages, sugar-sweetened beverages, plain water, and incident diabetes mellitus in postmenopausal women: the prospective Women’s Health Initiative observational study.” The American Journal of Clinical Nutrition 106, no. 2 (2017): 614-622.

Research Summary Researchers from Brown University, Harvard Medical School, University of Arizona College of Medicine, and University of Alabama at Birmingham, United States studied the association and consumption of sugar sweetened beverages (SSB), with an increased risk of diabetes mellitus (DM) and the benefits of replacing SSBs with artificially sweetened beverages or water. The national Women’s Health Initiative recruited a large population of post-menopausal women between 1993 and 1998. ASB, SSB, and water consumption was measured by lifestyle questionnaires, and DM was self-reported. The results showed that out of 64,850 women, the risk of developing DM was 43% for those who drank SSBs and 21% increased risk for those who drank ASBs) over an eight-year period. In addition, those who drank water saw a decreased risk. Further studies are suggested. 

KNOW WHAT TO AVOID

Reference Kim, Yoona, Jennifer B. Keogh, and Peter M. Clifton. “Consumption of red and processed meat and refined grains for 4weeks decreases insulin sensitivity in insulin-resistant adults: A randomized crossover study.” Metabolism 68 (2017): 173-183.

Research Summary Researchers from University of South Australia, Australia explored the association between a diet high in red and processed meat and refined grains (HMD), a diet high in whole grains, nuts, dairy, and legumes with no red meat (HWD and insulin sensitivity levels). Participants without diabetes [15 men and 34 women, age, 35.6±15.7 years, body mass index (BMI), 27±5.9kg/m²] underwent two four-week weight-stable dietary interventions. The participants were randomly assigned to one of the diet interventions. The insulin sensitivity index (ISI) was calculated from the last 30 minutes of a continuous low-dose insulin at the end of each diet. The results showed that a dietary pattern high in red and processed meat and refined grains decreased insulin sensitivity compared to a dietary pattern high in whole grains, nuts, dairy products, and legumes only in relatively insulin-resistant adults.

EAT BREAKFAST

Reference Nas, Alessa, Nora Mirza, Franziska Hägele, Julia Kahlhöfer, Judith Keller, Russell Rising, Thomas A. Kufer, and Anja Bosy-Westphal. “Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk.” The American Journal of Clinical Nutrition 105, no. 6 (2017): 1351-1361.

Research Summary Researchers from University of Hohenheim, Germany, investigated whether the timing of meal skipping impacts the risk of obesity and type II diabetes by affecting circadian regulation of energy balance, glucose metabolism, and after dinner inflammatory responses. In a randomized controlled trial, 17 participants underwent three 24-hour interventions, a breakfast skipping day (BSD) and a dinner skipping day (DSD) separated by a conventional three-meal-structure day (control). Energy and macronutrient balance was measured in a respiration chamber. After lunch and dinner glucose, insulin, and inflammatory responses in leukocytes as well as 24-hour glycemia and insulin secretion were analyzed. The results showed that compared with three meals/d, meal skipping increased energy expenditure. In contrast, higher after lunch and dinner insulin concentrations and increased fat oxidation with breakfast skipping suggest the development of metabolic inflexibility in response to prolonged fasting that may in the long-term lead to low-grade inflammation and impaired glucose control.