Newsletter – December 2017

A Stroll After Supper Is Good Advice for Type 2 Diabetes Patients

Kristin Jenkins

Two new studies provide more evidence that exercise is critically important for both the prevention and management of type 2 diabetes.

In the first, researchers conclude that telling patients with type 2 diabetes to “Take a short walk right after meals” may be one of the best exercise prescriptions a clinician can give.

Results from the randomized crossover study show that postmeal blood glucose levels dropped 12%, on average, when patients with type 2 diabetes walked for 10 minutes after three daily meals compared with walking for 30 minutes at any time of day (P = .034).

Most of this effect came from a 22% glycemic drop in the 3-hour period following the after-dinner walk, particularly when the meal was carbohydrate-heavy, say Andrew N Reynolds, MD, from the University of Otago in Dunedin, New Zealand, and colleagues.

“The improvement was particularly striking after the evening meal when the most carbohydrate was consumed and sedentary behaviors were highest,” they say in their paper published October 17 in Diabetologia.

Since postprandial glycemia is an independent determinant of glycemic control as well as cardiovascular risk, the timing of physical activity may provide significant additional health benefits to patients with type 2 diabetes, Dr Reynolds and colleagues point out.

The findings also make a strong case for updating current guidelines, the researchers assert.

“The benefits relating to physical activity following meals suggest that current guidelines should be amended to specify postmeal activity, particularly when meals contain a substantial amount of carbohydrate.”

Current activity guidelines recommend that patients with type 2 diabetes get a minimum of 150 minutes of moderate physical activity each week, or about 30 minutes a day over 5 days. Daily exercise can be completed at one time or at different times throughout the day.

Postprandial physical activity may make it possible for patients to avoid an increased total insulin dose or additional mealtime insulin injections to lower glucose levels after eating, Dr Reynolds said in an interview.
Higher insulin doses might, in turn, be associated with weight gain in patients with type 2 diabetes, many of whom are already overweight or obese.

“What is surprising is how easily this advice can be communicated to patients with type 2 diabetes,” he told Medscape Medical News. ” ‘Go for a walk after your meals’ ” is a very clear message to deliver to your patients and then to follow up at each subsequent clinical visit.”

Since the prescribed level of activity was so modest (30 minutes total each day), the results may be applicable to a wide group of patients with type 2 diabetes mellitus, Dr Reynolds added.

The researchers are conducting follow-up research to identify factors that motivate or prevent people with type 2 diabetes from following a regular walking prescription, which they hope will be of use to physicians to help promote adherence to regular walking routines; they expect to publish this work soon, Dr Reynolds said.

More Exercise Always Better When It Comes to Preventing Diabetes

Results from the second study further inform when it comes to the dose-response relationship between exercise and the development of type 2 diabetes.

This was a meta-analysis of 23 cohort studies in 1.2 million nondiabetic individuals from the United States, Asia, Australia, and Europe, showing that those who achieved a 11.25 metabolic equivalent of task (MET) hours/week of moderate activity (the 150 minutes/week currently recommended) had a 26% reduction in the risk of developing type 2 diabetes.

Those whose physical activity reached 60 MET hours/week, however, reduced their risk of developing diabetes by an even greater amount, more than 50%, said lead author Andrea Smith, a PhD candidate in public health at the Health Behaviour Research Centre at University College London, United Kingdom, and colleagues.

The work is also published on October 17 in Diabetologia,

“Our study favors a ‘some is good but more is better’ guideline, in which specific targets are mainly used for a psychological effect,” say the researchers.

“There is no clear cutoff at which benefits are not achieved, and health benefits increase at activity levels well beyond current recommendations.”
Funding for the New Zealand study was provided by the University of Otago and the New Zealand Artificial Limb Service. Funding for the UK study was provided by the Centre for Diet and Activity Research (CEDAR). The authors from both studies disclosed no relevant financial relationships.

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Diabetologia. Published online October 17, 2016. Reynolds abstract, Smith abstract

Green tea extract may cause liver damage, Health Canada warns

By Dani-Elle Dubé National Online Journalist, Smart Living Global News

Health Canada is warning people of products that contain green tea extract.

Health Canada is strengthening its warning on green tea extract products – which are found in many over-the-counter weight-loss powders, pills and liquid supplements – over concerns of increased risk of liver damage.

According to Health Canada, there have been ongoing reports of serious liver injury worldwide, including a recent report in Canada. After conducting a review, the government body concluded that there may be a link between consuming green tea extract and “a risk of rare and unpredictable liver injury.”

Another recommendation is that these products only be used by adults. As well, product license holders of these natural health products that are intended for children will be required to either remove the ingredient entirely from the product or change their label to indicate that the product is for adult use only.

Green tea extract products are authorized for sale in Canada and are often used in weight loss and as a source of antioxidants – the main antioxidant being EGCG.

Green tea drinks or food products are different than extract products because they usually contain less EGCG, so consuming green tea in any form won’t cause harm, Health Canada explains. The extract, however, contains a higher concentrated amount of EGCG, which is what Health Canada believes is causing liver injuries.

There are currently over 2,500 licensed natural health products containing green tea extract as a medicinal ingredient in Canada, the Health Canada Safety Review says. Over 550 of these products come with a claim related to weight-loss management as well.

Health Canada says it will continue to monitor any safety information associated with green tea extract products and take “appropriate and timely action” if any other health risks are brought to light.

The American College of Gastroenterology also expressed their concerns over green tea extract in 2014.

A 2013 study out of Baylor College of Medicine also found a link between the extract and acute liver failure.

While the antioxidant EGCG is thought to be beneficial, too much of it may be what leads liver injuries, researchers say.

© 2017 Global News, a division of Corus Entertainment Inc.

Holiday Dinner Recipe

TURKEY

Ingredients 100g (3.5 oz.) turkey breast (skinless/boneless) Preparation Season – salt and pepper and herbs Bake in oven or fry in non-stick pan with PAM

STUFFING

Ingredients 2 slices of Betty Lite bread 100% whole wheat with pea hull fiber – cubed ½ oz. diced onion 1-2 tbsp. Campbell’s 25% less sodium Chicken broth Seasoning: savory, sage, salt, pepper (to taste)

CLOSEST THING TO MASH POTATOES

Ingredients 4 oz. cauliflower 1 tbsp. Beatrice fat free sour cream ½ tbsp. chopped fresh dill Preparation Steam cauliflower to tender crisp. Place cauliflower in blender and puree. Add Sour Cream and blend well. Just before serving mix with dill.

VEGETABLES

Ingredients UP TO 4 OZ OF THE FOLLOWING: Cabbage Salad OR Lettuce Salad OR Broccoli/ Green Beans Preparation Mix with 1 tbsp of Kraft Signature Calorie Wise Balsamic Vinaigrette.

GRAVY

Ingredients ½ cup Campbell’s 25% Less Sodium Chicken Broth. Preparation Reduce in the pan the Turkey was cooked in.

DESSERT

Baked Apples Ingredients 1 Medium apple (cored to ½ “from bottom of apple) ¼cup clear diet soda ½ package No Sugar Added Jell-O Preparation Mix Jell-O into soda to make syrup. Remove thin strip of peel around center of apple. Place apple upright in baking dish. Fill center with liquid. Cover and bake at 400 F until tender (25 to 30 minutes), or microwave covered for 3 to 5 minutes.

BEVERAGE PC Diet Cranberry Raspberry pop

Yields – 1 protein – 2 bread – 1 fruit – 1 vegetable – 2 Miscellaneous (Garnish) servings FOR ANY OCCASION

Food Bank Donation Drive

Bernstein Diet & Health Clinics is pleased to be participating in a food drive to help those in need. More families than ever are having a difficult time making ends meet, so we would like to draw upon the strength of our staff and patient networks to make a difference in our local communities. We will accept donations of all nutritious, non-perishable food items, but the following items are the most needed:
FOOD ITEMS Baby formula & food Beans & lentils Oatmeal Rice Canned fruits & vegetables Cereals Canned fish & meat Cans of soup or hearty stew Dried pasta & tomato sauce Macaroni & cheese Peanut butter Tetra Pak, canned or powdered milk Bottled, canned or Tetra Pak juice	HEALTH & PERSONAL CARE Deodorant Toothpaste and Toothbrushes Soap and Shampoo Feminine Products Baby Diapers
We are encouraging all of our patients to bring in a donation of any size at their next visit. All donations go directly to the food bank supporting people in your community who need help. We are looking forward to helping our food banks make this the most successful year ever! From everyone at Dr. Bernstein Diet & Health Clinics and your local food bank, Thank You

Our Clinics

We’re Hiring!

Clinic Support & Administration

We are always looking for skilled people to join our team. Opportunities exist for personal and professional growth, in one of our administration and support team positions. Your chance to make a contribution to our patients’ success range from entry level to management positions in areas such as: Finance; Human Resources; Contact Centre; Warehousing/Logistics; Operations & Nursing Support; & Information Technology.

Nurses & Medical Receptionists

Are you tired of working unstable shifts & weekends? Are you looking to improve the balance between your work and family life? If you answered YES then we have the opportunity for you! As part of our highly skilled team, you will be closely monitoring our patients’ health, educating them on proper nutrition and motivating them to achieve their goals and maintaining their healthy weight for the rest of their lives!

Physicians

Are you ready for a rewarding change of pace? With our dedicated and streamlined approach to patient care and clinic operations, the convenience of regular day-time working hours and attractive compensation, we present a significant lifestyle opportunity for today’s doctors. All while making a positive difference in so many of your patients’ lives.

For a list of current openings, and to apply online, visit https://www.drbdiet.com/careers/