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Racial & Ethnic Minorities Carry Disproportionate Burden of Diabetes at Lower BMI

Being heavier for our stature (as measured by BMI) puts us at a higher risk of diabetes. In this study, researchers analyzed the prevalence of diabetes in nearly 5 million people. Hispanics, Asians, and Hawaiians/Pacific Islanders who were overweight had the same diabetes risk as whites, blacks, and Native Americans who were in the most obese tier (class 4 obesity). Further, they found that the link between BMI and diabetes is strongest in whites and lowest in blacks, indicating that other factors outside of overweight/obesity may increase diabetes risk in racial and ethnic minorities.
Diabetes Care.  2019 Sep 19. pii: dc190532. doi: 10.2337/dc19-0532. [Epub ahead of print] (Zhu Y et al.)

Acculturation from South Asian Lifestyle to Western Lifestyle Linked with Heart Disease Risk

Around the world, transitioning from a traditional diet with daily movement to a sedentary Western diet is linked with rising rates of chronic disease. In this study, researchers investigated the lifestyle factors that are associated with heart disease risk in South Asian adults. They found that moving from a traditional diet and lifestyle to one low in fruits and vegetables, low in physical activity, and high in alcohol and smoking is linked with a 2 to 3-fold higher risk of incident heart disease. “There’s a high recidivism in subjects who are placed on an eating plan different from their usual dietary patterns,” said Dr. Sikand, emphasizing the importance of culturally tailored diets. (Note that findings presented at meetings are considered preliminary until published in a peer-reviewed journal.)
Presentation at National Lipid Association Scientific Sessions. Miami, FL. May 16, 2019. (Sikand G)

Mediterranean Diet Linked with Lower Rates of Obesity; More Research Needed on Korean Diets and Obesity

The Mediterranean diet is a well-studied cultural model of healthy eating, but less is known about other dietary patterns around the world. In this article, researchers analyzed the relationship between obesity and traditional Mediterranean and Korean diets. The researchers found considerable evidence on the Mediterranean diet’s protective effect against obesity. However, there was no significant association between a traditional Korean diet (a higher carb, lower fat diet with rice, vegetables, fish, and moderate amounts of meat, as well as fermented foods) and obesity. The researchers note that more research is needed on traditional Korean diets and their impacts on health, and that the research could be improved with a standard way of measuring and defining Korean diets. The researchers also noted that many of the Korean diets included in this analysis had higher levels of sodium, and lower levels of fruit and dairy, suggesting that healthier alternatives to some Korean dietary patterns may have a more beneficial impact on health.
Journal of Obesity and Metabolic Syndrome. 2019 Mar;28(1):30-39. doi: 10.7570/jomes.2019.28.1.30. (Choi E et al.)

Replacing White Rice with Whole Grain Bread May Lower Diabetes Risk

White rice has displaced many traditional whole grains across Asia, so researchers wonder how white rice might relate to diabetes risk. In a study of 45,411 Chinese adults followed for 11 years, researchers found that replacing white rice with white bread and whole grain bread can reduce type 2 diabetes risk by 10% and 18% respectively, and that replacing white rice with noodles, red meat, or poultry might actually increase diabetes risk. Rice intake itself was not associated with higher type 2 diabetes. The authors conclude that “recommendations to reduce high white rice consumption in Asian populations for the prevention of [type 2 diabetes] may only be effective if substitute foods are considered carefully.”
European Journal of Nutrition. 2018 Dec 10. doi: 10.1007/s00394-018-1879-7. [Epub ahead of print] (Seah JYH et al.)

Plant-Based Korean Diet with Brown Rice Can Improve Blood Pressure and Blood Sugar in Hospitalized Patients

Many people are surprised at how effective lifestyle changes can be when it comes to managing chronic disease. In this study, 160 hospital patients in South Korea with high blood pressure changed their diet to eat a plant-based (vegan) diet based on brown rice at each meal, with lots of kimchi and pickled vegetables, fermented soy foods, and lots of other vegetables (both raw and cooked). They averaged about 1,700 calories per day and did not eat any refined grains or any noodles or breads, relying on brown rice as the staple. Their sodium intake was quite high, at 7,382mg per day. However, after about 2 weeks, 86% of the patients were able to stop taking their blood pressure and diabetes medications, and their reduced blood pressure levels remained stable even after stopping the medications. Similarly, HBA1C reduced from 7.6 to 7.2, indicating better blood sugar management. More research is needed to see if similar approaches might be effective in other populations.
Journal of Ethnic Foods. 2018 Nov 1. DOI: https://doi.org/10.1016/j.jef.2018.09.002 (Jung SJ et al.)

Strategies to Improve Sensory Qualities of Whole Wheat Asian Noodles

Noodles are a staple of Asian diets, yet many noodles on the market today are made with refined wheat flour, rather than whole grain flour. In this review, scientists share the best practices in making whole wheat Asian noodles (fresh, dried, and instant), and share where more research is needed. With the right techniques, replacing up to 20-72% of the refined white flour with whole wheat flour in Asian noodles can yield a high quality, more healthful product. Products with even higher quantities of whole grain can have even greater health impacts, although their quality may not be directly comparable. Selecting the right wheat variety for the recipe (such as a white whole wheat), milling to a finer particle size, adding complementary ingredients (such as tapioca or soy flour), or using ultrasound treatments to prolong shelf life, are all strategies that can be used to improve whole wheat Asian noodles.
Cereal Chemistry. 2018 Aug 23. doi: 10.1002/cche.10095 (Niu M et al.)

Whole Grain Recommendations Vary Throughout Southeast Asia

Whole grains are an important food group to help reduce the risk of diet-related disease, but many people fall short of recommendations. In this review, researchers analyzed studies on whole grain foods in Southeast Asia, as well as whole grain food labeling regulations and whole grain dietary guidelines. Most whole grain studies were related to food technology, rather than whole grain eating habits, though the authors did find research indicating that whole grain intake remains low across Southeast Asia. In the 10 member states of Southeast Asia, only 4 countries had suggestions for whole grain intake in their dietary guidelines: Indonesia, Malaysia, Singapore, and the Philippines. When it comes to food labeling, Indonesia and Singapore both require the percentage of whole grains to be listed in products labeled as “whole grain.” Indonesia also has a minimum requirement of 25% whole grain in “whole grain” labeled products, while Malaysia is currently drafting regulations regarding whole grain labeling. The authors conclude that “better understanding of the consumer base in the region is also likely to benefit public healthy messaging around increasing intake of whole grains at a population level and should also help in the development of innovative whole grain food products.”  
Nutrients. 2018 Jun 11;10(6). pii: E752. (Brownlee IA et al.)

Traditional Mediterranean and Japanese Diets Linked with Lower Risk of Death from Heart Disease

At first glance, Japanese and Mediterranean cuisines might seem worlds apart. However, the overall eating patterns share more similarities than one might think. Researchers analyzed the diets and long-term (50-year) data on death from heart disease in 12,763 men in the Seven Countries Study from the 1960s. The researchers noted a very similar eating pattern between the Mediterranean group and the Japanese group, with lots of seafood and vegetables, and low amounts of animal foods and animal fat. They also found that eating more vegetables and starch, and more closely following a “Mediterranean” diet (as the Mediterranean and Japanese groups did) were linked with significantly lower risks of death from heart disease. Sweets, animal foods, and hard fats (like butter or lard) were linked with increased risk.
European Journal of Clinical Nutrition. 2018 May 17. (Kromhout D et al.) [Epub ahead of print.]

Oat Noodles (Instead of Refined Noodles) Can Help Reduce Cholesterol, Blood Pressure

Refined wheat and rice noodles are common staple foods throughout Asia today, so replacing some of these foods with whole grain versions could go a long way in improving health. To test the impact, researchers randomly assigned 84 healthy adults (some with mildly high cholesterol) in Taiwan to an oat noodle group or a refined wheat noodle group, providing them with 100 grams (about 1 ½ cups cooked) of their respective noodles across 1 or 2 meals each day for 10 weeks. After the 10-week study, the oat group reduced their total cholesterol by 17% and LDL-c (“bad”) cholesterol by 19% compared with the wheat noodle group. The oat noodle group also significantly lowered their blood pressure by 7-11%, but the wheat noodle group did not. The benefits tended to be stronger in people who started the study with slightly high cholesterol, but the results were still statistically significant for the group as a whole.
Journal of Food and Drug Analysis. 2018 April. [Epub ahead of print.] (Liao MY et al.)

Common Healthy Eating Pattern Across Different Asian Ethnic Groups Linked with Better Cholesterol, BMI, Waist Size

Researchers analyzed the eating habits of 8,433 adults in Singapore who were of Chinese, Malay, and Indian ethnicity. Despite the wide variety in food preferences among these different ethnic groups, researchers were able to identify a common healthy eating pattern based on fruits, vegetables, dairy, wholegrain breads, breakfast cereals, unsaturated cooking oils; and low in fast food, sweetened beverages, meat, and flavored rice. Those most closely following the healthy eating pattern were more likely to have a lower BMI, smaller waist size, and lower levels of total cholesterol, LDL (“bad”) cholesterol, and triglycerides (another type of fat in the blood).
Journal of Nutrition. 2018 Apr 1;148(4):616-623. (Whitton C. et al.)

High Fiber Diet Promotes Select Gut Bacteria to Better Manage Diabetes

In line with many other countries, the usual care for patients with diabetes in China is education about balanced diets and blood sugar management strategies. In a small study, 43 patients with diabetes were randomly assigned to either these standard recommendations, or a high-fiber diet with whole grains and traditional Chinese medicinal foods. Both groups significantly improved their blood sugar (as measured by HbA1c) over the 12-week study, but significantly more people in the whole grain group (89% vs 50%) got their blood sugar to a well-managed level (HbA1c < 7%). To see how gut microbes might play a role, researchers also analyzed the gut bacteria of the participants. They found that the fiber from whole grains stimulated select bacteria to produce short chain fatty acids, which in turn, helped the body better manage blood sugar.
Science. 2018 March 9;6380(359):1151-1156. (Zhao L et al.)

Traditional Japanese Diets as a Cultural Model of Healthy Eating

Japan is famous for the long lifespan of its people, and the traditional diet is thought to play a role. In this review, researchers outline the healthful elements of traditional Japanese diets, including the variety of seasonal vegetables and seafood, umami flavors, cooking methods that incorporate water, modest portion sizes, and social and familial connections. They conclude that “Japanese traditional diet practices (Washoku), which prominently include the flavoring of foods with umami taste, can be characterized as a healthy diet in the same way that the DASH diet or the Mediterranean diet is so classified.”
Nutrients. 2018 Feb 3;10(2). pii: E173. (Gabriel AS et al.)

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