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Breast cancer survivors more likely to develop diabetes, and should be screened more closely.
A large population study in Diabetologia shows that post-menopausal women who are breast cancer survivors are more likely to develop diabetes than women without breast cancer. Dr Lorraine Lipscombe and colleagues compared the incidence of diabetes among women aged 55 years or older with breast cancer, from 1996 to 2008, with that of age-matched women without breast cancer. They further explored this relationship based on whether the woman had undergone chemotherapy. They found that, of 24,976 breast cancer survivors and 124,880 controls, 9.7% developed diabetes over a mean follow-up of 5.8 years. The risk of diabetes among breast cancer survivors compared with women without breast cancer began to increase two years after diagnosis, with a 7% increased risk that rose to 21% after 10 years. Among those who received chemotherapy (4,404 patients) almost the opposite relationship was found: risk was highest in the first two years after diagnosis (a 24% increased risk compared with controls) and then declined to an 8% increased risk after 10 years.
Dr Lipscombe says: “It is possible that chemotherapy treatment may bring out diabetes earlier in susceptible women. Increased weight gain has been noted in the setting for adjuvant chemotherapy for breast cancer, which may be a factor in the increased risk of diabetes in women receiving treatment. Oestrogen suppression as a result of chemotherapy may also promote diabetes; however this may have been less of a factor in this study where most women were already post-menopausal.”
Other factors that may play a part for women with chemotherapy are the glucocorticoid drugs used to treat nausea in chemotherapy, known to cause spikes in blood sugar (acute hyperglycaemia), and the fact that women undergoing chemotherapy could be monitored more closely and thus are more likely to have diabetes detected.
Does Surviving Breast Cancer Lead to Obesity? In Journal of Cancer Survivorship, Rebecca Sedjo and colleagues report significant weight gain in 665 overweight and obese women within five years of surviving breast cancer that is influenced by a complex set of factors. Younger women and those with lower BMIs were more likely to gain significant amounts of weight over time. Women treated with selective estrogen-receptor modulators twice as likely to gain weight compared to women prescribed aromatase inhibitors. “Effective strategies to prevent this weight gain or provide obesity management strategies to breast cancer survivors are long overdue” says Prof Arya Sharma commenting on this research.
The sugar fructose not responsible for increase in non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease is the most common chronic liver disease in developed countries, affecting up to 30 per cent of people. Since the disease is closely linked to obesity and type 2 diabetes, there’s a growing debate in the medical community about whether diet plays a role in its development, specifically the consumption of fructose. A meta-analysis of all available human trials published in the European Journal of Clinical Nutrition says fructose in and of itself is not to blame for the increase in non-alcoholic fatty liver disease. But excess consumption of calories can contribute to the disease, regardless of whether those calories came from fructose or other carbohydrates, said the lead author, Dr. John Sievenpiper.
Photo: Hachette Australia, The Low GI Diet Cookbook
Dairy foods: Yoghurt may reduce diabetes risk.
Research scientists from the University of Cambridge report in Diabetologia the findings of their prospective study that higher consumption of low-fat fermented dairy products, which includes all yoghurt varieties and some low-fat, fermented soft cheeses (e.g. fromage frais and low-fat cottage cheese), reduced the relative risk of diabetes by 24 percent. (Their data was based on 7-day food diaries from the EPIC-Norfolk study.)
Yoghurt, when examined separately from the other low-fat fermented dairy products, was associated with a 28 percent reduced risk of developing diabetes. This risk reduction was observed among adults who consumed an average of four and a half standard 125g/4oz pots of yoghurt per week. While this type of study cannot prove that eating dairy products causes the reduced diabetes risk, dairy products do contain beneficial constituents such as vitamin D, calcium and magnesium. In addition, fermented dairy products may exert beneficial effects against diabetes through probiotic bacteria and a special form of vitamin K associated with fermentation.
Berribob Watson (Photo courtesy Skinnyfish)
Bush food: Australia’s bush potato. Bush potato (Ipomoea costata) belongs to the morning glory family and has a taste and texture similar to its sweet potato (I. batatas) cousin. It is rich in carbohydrate and fibre and is about one-third slower digesting than most regular potatoes (which are high GI) according to Prof. Jennie Brand-Miller’s 1987 study. A traditional staple for Australia’s Indigenous people, bush potatoes were much sought after (and they still are today). Harvesting the tubers in the wild is time-consuming due to the fact that they are about a metre or more underground, and it is virtually impossible for someone with an untrained eye to work out where to start digging for them. That’s why traditional know-how (and handing it on) is vital. In this short film produced by Skinnyfish, Berribob Watson talks about the importance of passing on his father’s knowledge to the next generation: how to hunt, how to make fire without matches, and how to find bush potatoes. You can watch it HERE.
Special Offer: Low GI Diet Shopper’s Guide 2014.
Australia/New Zealand edition. Includes the GI values for over 1,000 foods and pre-prepared meals. This eBook usually retails for AUD$9.99. You can buy a copy for AUD$4.99 until 12 April 2014 here:
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Cloudy with a chance of meatheads – Dr David Katz
When research should come with a warning label
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