Think Twice Before Eating White Rice?

Eating more white rice raised the risk for type 2 diabetes in a large clinical study, whereas eating more brown rice reduced the risk.

Type 2 diabetes is one of the fastest growing health problems in Americans of all ages. Being overweight or inactive increases your chances of developing the disease. Research suggests that eating more refined foods, including white bread and sugary foods, might also raise the risk.

The new study followed about 200,000 people for up to 22 years. The people who ate at least 5 weekly servings of white rice had a 17% higher risk than those who ate less than 1 serving per month.

On the other hand, people who ate at least 2 servings of brown rice a week had an 11% lower risk of developing type 2 diabetes than those who ate less than 1 serving a month.

“We believe replacing white rice and other refined grains with whole grains, including brown rice, would help lower the risk of type 2 diabetes,” says study co-author Dr. Qi Sun of Brigham and Women’s Hospital in Boston.

Healthy Body, Happy Heart

Improve Your Heart Health

Every moment of the day, your heart is pumping blood throughout your body. In silent moments, you can hear the thump-thump-thump of its demanding work. Do you take your heart for granted? Most of us will have heart trouble at some point in our lives. Heart disease is the number one killer of women and men in the United States. But you can take steps now to lower your risk.

“About 1 out of 3 people in America will die of heart disease,” says NIH heart disease expert Dr. David C. Goff, Jr. “And about 6 out of every 10 of us will have a major heart disease event before we die.”

Heart disease develops when the blood vessels supplying the heart become clogged with fatty deposits, or plaque. After the blood vessels narrow, blood flow to the heart is reduced. That means oxygen and nutrients can’t get to the heart as easily.

Eventually, an area of plaque can break open. This may cause a blood clot to form on the plaque’s surface. A blood clot can block blood flowing to the heart. That can cause a heart attack.

A heart attack happens when a vessel supplying the heart is blocked and the heart can’t get enough oxygen, which leads to death of heart muscle.

The three major risk factors for heart disease have been known since the 1960s: smoking, high blood pressure, and high cholesterol levels. These were identified in NIH’s Framingham Heart Study, a long-term study of people in Framingham, Massachusetts.

“If we could eliminate cigarette smoking, elevated blood pressure, and elevated cholesterol levels, we could eradicate about 9 out of 10 heart attacks in our country,” says Dr. Daniel Levy, a heart specialist at NIH who oversees the Framingham Heart Study currently.

The study has also uncovered other risk factors, including diabetes, obesity, and physical inactivity. Levy’s research team is now hunting for genes that may be risk factors for heart disease. By understanding the factors that play a role in heart disease, scientists hope to find new ways to prevent and treat it.

Get Tested

Early heart disease may not cause any symptoms. That’s why regular checkups with your doctor are so important.

“The sad truth is that the vast majority of us has heart disease and we don’t know it,” Goff says.

Blood pressure and cholesterol levels can provide early signs. “People should see their doctor, find out their cholesterol and blood pressure numbers, and if needed, take medication,” advises Goff.

There are many other tests to detect heart disease. An electro-cardiogram, also called an EKG or ECG, measures electrical activity in your heart. It can show how well your heart is working and pick up signs of a previous heart attack.

Another test called an echocardiogram uses sound waves to detect problems. It shows the size, shape, and structures of your heart. It can also measure blood flow through your heart.

Although early heart disease might not cause symptoms, advanced heart disease may cause chest pressure, shortness of breath, or fatigue. Some people may feel lightheaded, dizzy, or confused. Tell your doctor if you’re experiencing any symptoms.

Make Healthy Choices

Talk with your doctor about your risk of heart disease and what you can do to keep your heart healthy.

“The most important things for everyone to do to keep their heart healthy—to keep their entire body healthy—is to eat a healthy diet, get plenty of physical activity, maintain a lean body weight, and avoid smoking and exposure to secondhand smoke,” Goff says.

Following a heart-healthy eating plan is important for everyone. “When someone puts food on their plate, about half the plate should be fruits and vegetables. About a quarter of the plate should be whole grain. And about a quarter should be lean protein, like lean meat or seafood,” says Goff.

If you have high blood pressure, you may want to follow the DASH (Dietary Approaches to Stop Hypertension) diet. This diet emphasizes fruits, vegetables, whole-grain foods, and low-fat dairy products. To learn more about the diet, see www.nhlbi.nih.gov/health/health-topics/topics/dash.

Goff also advises, “Avoid foods that have a lot of salt in them. Salt is a major contributor to high blood pressure and risk of heart disease.”

Prevent Diabetes

Diabetes increases your chances of high blood pressure and high cholesterol. You’re also more likely to develop heart disease and have a heart attack.

“Having diabetes is almost like already having heart disease,” says Dr. Larissa Avilés-Santa, a diabetes and heart health expert at NIH. She oversees a large NIH study of heart disease risk factors among more than 16,000 Hispanic/Latino adults.

Avilés-Santa says that sometimes people think that they will develop diabetes and heart disease no matter what they do. But that’s not true. Even if you have a family history of these diseases, you can be the messenger of good health for your family, she says. You can help your family by inspiring healthy habits.

The best way to prevent diabetes is through diet and physical activity. “The evidence is outstanding that very modest changes in lifestyle could reduce the risk of developing diabetes much greater than medication,” Avilés-Santa says.

Get Help

For some people, having a heart attack is the first sign of heart disease. Pain or discomfort in your chest or upper body, a cold sweat, or shortness of breath are all signs of a heart attack.

If you feel any of these signs, get medical help right away. Acting fast can save your life and prevent permanent damage.

Heart disease and heart attacks are major risk factors for cardiac arrest, which is when the heart suddenly stops beating. Blood stops flowing to the brain and other parts of the body. If not treated within minutes, cardiac arrest can lead to death.

Heart disease and heart attacks can also make it harder for your heart’s electrical system to work. As a result, an irregular heartbeat, or arrhythmia, can occur. Your heart may beat too fast, too slow, or with an uneven rhythm. A dangerous arrhythmia can lead to cardiac arrest.

Regular checkups help ensure that a doctor will check your heart for problems. Heart disease and arrhythmias can be treated to lower the risk of cardiac arrest.

Be good to your heart. Don’t take it for granted. Get tested for heart disease, and follow your doctor’s suggestions. See the sidebar for questions you may want to ask your doctor.

Diabetes and Risk for Heart Disease and Stroke

Having type 2 diabetes increases the risk of cardiovascular events, like stroke or heart attack. For nearly a decade, NIH has supported a large clinical trial called the ACCORD study. It aimed to find ways to reduce the likelihood of cardiovascular events in adults with type 2 diabetes who are at especially high risk because of a previous heart attack, stroke or other reason.

One ACCORD trial involved more than 4,700 people who had diabetes and high blood pressure. They were asked to control their blood pressure with medications. Some were asked to target a standard blood pressure level, while others aimed for a lower level that’s considered normal in healthy people.

Lowering blood pressure to normal levels didn’t significantly reduce the risk of cardiovascular events overall. However, it did appear to reduce the likelihood of stroke.

Another report looked at 5,500 patients to evaluate a combination of 2 types of drugs that can reduce blood levels of fatty molecules called lipids. A statin medication alone proved as beneficial as a combination of a statin and a fibrate medication.

“Although our analysis suggests that certain patients may benefit from combination therapy, this study provides important information that should spare many people with diabetes unneeded therapy with fibrates,” says Dr. Henry Ginsberg of Columbia University, who led ACCORD’s lipid trial.

Are Proteins in Formula Linked to Type 1 Diabetes?

The study’s results don’t suggest any changes in guidelines for formula feeding to prevent type 1 diabetes. Purestock/Thinkstock

For decades, researchers have puzzled over why type 1 diabetes is becoming more common. Type 1 diabetes is a serious disease in which the body destroys the cells that make insulin. Insulin tells cells to take up sugar from your blood. People with type 1 diabetes need to take insulin every day to stay alive.

Researchers have wondered whether infant formula made from cow’s milk might cause children to develop type 1 diabetes. Studies suggested that early exposure to the complex proteins in cow’s milk might lead the body to mistakenly attack the cells that make insulin.

To test this idea, researchers used two formulas. One group of infants received a formula made from cow’s milk. The other received a formula made from cow’s milk that was processed to break complex proteins into small pieces. All the infants enrolled in the study had a genetic makeup that put them at higher risk of developing type 1 diabetes.

The mothers were encouraged to use the assigned formula whenever they didn’t breastfeed. The analysis included infants who were fed formula at least 60 days.

The results showed that the chance of developing type 1 diabetes by age 10 was the same for children in both groups. The complex proteins in cow’s milk did not raise the risk of developing type 1 diabetes.

“This once more shows us that there is no easy way to prevent type 1 diabetes,” says researcher Dr. Dorothy Becker at the University of Pittsburgh.

School Environment Affects Diabetes Risk

Healthier foods at school, longer and more intense physical activity and lessons in healthy lifestyles can reduce obesity and other risk factors for diabetes. These findings, from an NIH-funded study, suggest that school-based changes might help at-risk kids improve their health.

Nearly 1 in 5 school-age children in the U.S. is obese. This excess weight can lead to many health problems. The most serious is type 2 diabetes.

The new study was conducted at 42 middle schools where many students are minorities or from low-income families. Half the schools were randomly chosen to use the study’s “intervention” program: longer gym classes, more nutritious foods and education in healthy behaviors.

About 4,600 students were tracked from the beginning of 6th to the end of 8th grade. At the start, nearly half were overweight or obese. Many had other signs of high diabetes risk.

At the end of the study, kids who had been overweight or obese at the intervention schools had a 21% lower obesity rate than those at the comparison schools. Other diabetes risk factors, like larger waist size, also fell more at the intervention schools.

“The study shows that a school-based program can help lower obesity and certain risk factors for type 2 diabetes in youth at high risk for the disease,” says Dr. Griffin P. Rodgers, director of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.

School Guide Teaches ABCs of Diabetes

School-age children with diabetes face unique challenges. They may be vulnerable to serious swings in their blood glucose levels at any time. A newly updated booklet, “Helping the Student with Diabetes Succeed: A Guide for School Personnel,” can help. The guide offers suggestions for parents, teachers, principals and others to ensure the safety of these kids.

Diabetes is one of the most common long-term diseases in school-age children. It affects about 200,000 young people nationwide. Most students with diabetes must carefully monitor and control their blood glucose throughout the day. A severe drop in glucose levels can be life-threatening.

The guide urges parents to notify school officials that a child has diabetes. Parents are encouraged to partner with the child’s health care team to develop a diabetes medical management plan. The guide recommends that parents give permission for medical information to be shared by the school and health care team.

”Unfortunately, the need to manage diabetes doesn’t go away at school,” says Dr. Griffin P. Rodgers, director of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases. “The guide, quite literally, can be a lifesaver.”

To view, download or order a free copy of the guide, go to www.YourDiabetesInfo.org/schoolguide(link is external),

Breastfeeding May Help Health After Gestational Diabetes

A study suggests that breastfeeding may help women with a history of gestational diabetes from later developing type 2 diabetes.

About 5-9% of pregnant women nationwide develop high blood sugar levels even though they didn’t have diabetes before pregnancy. This condition, called gestational diabetes, raises a woman’s risk for type 2 diabetes later in life. Left untreated, type 2 diabetes can cause health problems such as heart disease, stroke, kidney disease, blindness, and amputation.

Past studies found that breastfeeding causes certain changes in the mother’s body that may help protect against type 2 diabetes. However, the connection hadn’t been proven, especially among women who’d had gestational diabetes. An NIH-funded research team at the Kaiser Permanente Division of Research set out to address the question.

The team enrolled more than 1,000 ethnically diverse women who were diagnosed with gestational diabetes. Their lactation intensity and duration were assessed by feeding diaries, in-person exams, phone calls, and questionnaires. Researchers tested blood sugar 6 to 9 weeks after delivery and then annually for 2 years.

During the 2-year follow-up, nearly 12% of the women developed type 2 diabetes. After accounting for differences in age and other risk factors, the researchers estimated that women who exclusively breastfed or mostly breastfed were about half as likely to develop type 2 diabetes as those who didn’t breastfeed.

How long women breastfed also affected their chance of developing type 2 diabetes. Breastfeeding for longer than 2 months lowered the risk of type 2 diabetes by almost half. Breastfeeding beyond 5 months lowered the risk by more than half.

“These findings highlight the importance of prioritizing breastfeeding education and support for women with gestational diabetes as part of early diabetes prevention efforts,” says study lead Dr. Erica P. Gunderson.

Five Lifestyle Factors Lower Diabetes Risk

A new study found that a combination of 5 healthy lifestyle factors may help reduce the chance of developing type 2 diabetes, even if family history puts you at risk for the disease.

People with diabetes have too high levels of glucose, a type of sugar, in their blood. Over time, high levels of glucose can lead to heart disease, stroke, blindness and other problems.

Several lifestyle factors can reduce your risk for type 2 diabetes, the most common form of the disease. A research team led by Dr. Jared Reis of NIH studied 5 factors:

• having a healthy diet,
• keeping an ideal body weight,
• being physically active,
• not smoking, and
• minimizing alcohol use.

The team used data collected in the mid-1990s from more than 200,000 older adults. They then looked to see who had developed diabetes over the next decade.

The analysis showed that the more healthy lifestyle factors adopted, the lower the risk for diabetes. Men with all 5 healthy lifestyle factors had a 72% lower risk for developing diabetes. Women had an 84% lower risk.

A family history of diabetes is strongly linked to type 2 diabetes. But these results show that you may still be able to prevent or delay the disease by leading a healthy lifestyle.

“Not being overweight or obese led to the greatest protection,” Reis says. “However, we found that overweight or obese adults with a greater number of the other healthy lifestyle factors had a lower risk of developing diabetes. This is good news because it suggests that overweight or obese adults can benefit by adopting other healthy lifestyle behaviors.”

Eye disease is one of the most common and debilitating complications of diabetes. NIH especially encourages people with diabetes to take steps to avoid vision loss by having the exam each year.

Diabetes is the leading cause of blindness in adults nationwide. An eye disorder known as diabetic retinopathy arises in about 40% of U.S. adults with diabetes. It occurs when blood vessels of the retina swell and leak fluid. In some cases, blood vessels become blocked and rupture, or new vessels grow on the retina, leading to permanent vision loss.

People with diabetes are also at risk for cataracts, which cause clouding of the eye lens, and glaucoma, which damages the optic nerve.

Comprehensive, dilated eye exams allow eye care professionals to monitor the eye, including the retina, for signs of disease. Diabetic retinopathy usually has no symptoms until vision loss occurs, but annual dilated eye exams can identify signs of it. In fact, about 90% of diabetes-related blindness is preventable through early detection, timely treatment and appropriate follow-up care.

Diabetes Increases in Children and Teens

The study found a rise in the rate of new cases of diabetes in youths under the age of 20.MarkHatfield/iStock/Thinkstock

A recent study found that rates of new cases of diabetes in children and teens rose during 2002 to 2012. The researchers reported increases in the rates of both type 1 and type 2 diabetes.

More than 29 million Americans are living with diabetes. People with diabetes have sugar (glucose) levels that are too high. Over time, high levels of blood glucose can cause many health problems.

In type 1 diabetes, the body does not produce insulin. People with type 1 diabetes need to take insulin every day to stay alive. Type 2 diabetes is caused when the body doesn’t make or use insulin well.

Researchers found that, for each year between 2002 and 2012, the rate of new cases of type 1 diabetes in youths under 20 rose by about 2%. The rate of new cases of type 2 diabetes in youths ages 10 to 19 increased by about 5%. Unlike type 1 diabetes, type 2 is seldom diagnosed in children younger than 10.

The researchers noted that rates of diabetes rose significantly in certain racial and ethnic groups. For type 1 diabetes, the rate of new cases increased in Hispanics, non-Hispanic blacks, and non-Hispanic whites. For type 2 diabetes, the rate of new cases rose in Hispanics, non-Hispanic blacks, Asian Americans/Pacific Islanders, and Native Americans.

The study also detected differences in the rates for male and female youths. For type 1 diabetes, the rate rose more in males. For type 2 diabetes, the rate increased more in females.

“The differences among racial and ethnic groups and between genders raise many questions,” says Dr. Barbara Linder, NIH’s senior advisor for childhood diabetes research. “We need to understand why the increase in rates of diabetes development varies so greatly and is so concentrated in specific racial and ethnic groups.”

NIH-funded studies are now examining what factors may increase the risk of diabetes.