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Great Eat-spectations is my outlet for sharing recent news that sparks my interest (and hopefully yours), tasty recipes that I have tried, fun food facts, and fascinating articles for you to enjoy!

Saturday, December 31, 2011

Bitter Melon: Sweet Reward for Diabetes?

Bitter melon is a plant that grows in regions of Asia, South America, East Africa, and the Caribbean. The fruit has been used, by natives, throughout time as food and in medicine to treat diabetes, cancer, viral infections, and immune disorders. The active ingredients in bitter melon have been extensively studied for the fruit’s blood glucose lowering properties.

Currently, there are 150 million people with diabetes worldwide, and this figure is expected to increase to over 300 million by 2025. For many people living with diabetes is a constant struggle. Checking their blood glucose levels, watching what they eat and taking medications doesn’t always mean that their diabetes is under control. A national survey conducted in 2007 found that 17.7 percent of American adults had used dietary supplements, other than vitamins and minerals, in the past 12 months for a health condition. With 18.8 million people in the United States diagnosed with type-2 diabetes some may look to the Internet for information and stumble upon bitter melon.

What is the Consumer Finding?
Patients are more proactive about their health in this new age. Unfortunately there is just as much inaccurate, or unsubstantiated, medical information on the Internet as there is accurate information. Homeopathic websites refer to bitter melon as “a natural remedy for type-2 diabetes” and “an alternative to insulin” yet provide little evidence supporting these bold statements. Top selling herbal supplement brands have websites that market bitter melon in a number of ways that could seem appealing for diabetics who are struggle with their blood glucose control. Some statements include:
  • “Bitter Melon, also known as Bitter Gourd, has been traditionally used to regulate blood sugar levels within the normal limits. It contains Gurmarin, a polypeptide that has been shown in experimental studies to achieve its regulating effect by suppressing the neural response to sweet taste stimuli. Bitter Melon is also a natural source of Vitamin C.”
  • “Bitter Melon, also known as Bitter Gourd, has been used to support already normal blood sugar levels and has been shown in experimental studies to achieve a regulating effect by suppressing the neural response to sweet taste stimuli. (These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease)”
What Does the Research Show? 
Scientists in India began studying bitter melon’s effects on blood glucose in the 1950s, and their work has lead to other researcher’s interest in investigating the fruit’s potential for blood glucose management for those with diabetes. Throughout the past sixty years, studies reveal varying evidence to support the effectiveness of bitter melon for diabetes.

The largest study to evaluate the blood glucose-lowering effect of bitter melon was published in 1999 in the Bangladesh Medical Research Council Bulletin. The clinical trial examined the effect of the fruit on 100 patients with type-2 diabetes. The researchers recorded the patients’ blood glucose levels both without food intake for 12-24 hours and after taking 75g of glucose. They then administered a bitter melon pulp suspension to the diabetic patients and the results revealed a significant 14% reduction in fasting and post-meal serum glucose levels.

In another study researchers examined whether adding bitter melon capsules to the 40 participants existing medication could decrease their hemoglobin A1c levels by 1%. The results revealed only a 0.217% decline in the experimental group. The authors relied on the subjects to administer the supplements themselves and did not state the dosage used. The researchers stated that bitter melon’s effectiveness is undetermined.

A 2008 study, published in Chemistry and Biology, isolated four compounds in bitter melon that activate an enzyme that is responsible for regulating metabolism and transporting glucose from the blood into the cells. The researchers touted that isolating these compounds could lead to medications that someday could control obesity and type-2 diabetes.


Should You Recommend Bitter Melon to Patients? 
Personally, I would not recommend such a supplement to my patients. Not because there is limited scientific evidence on it, but because sometimes it has the potential to work too well. If taken incorrectly blood sugar can drop to unsafe levels. Often, in the case of supplements, dosage can be vague or worse—consumers can view it as safe at any dose because it is natural. The herbal supplement industry is loosely regulated and potency may differ between products.

One potential side effect is hypoglycemia, which can be fatal for diabetics. Hypoglycemia, a condition in which blood sugar drops too low, is the primary risk involved in taking bitter melon. If hypoglycemia is not treated quickly, the diabetic patient could fall into a coma that may result in death. 

With over 60 years of research bitter melon still lacks enough evidence for health care professionals to start recommending it for diabetes management. Many homeopathic websites justify the use of supplements by noting that several conventional medications used today came from natural substances. The difference is that conventional medications go through rigorous human testing before they hit the market. Make sure to always take in to consideration the cost, safety and effectiveness of supplements before recommending them to your patients.

Monday, December 26, 2011

Home-ish for the Holidays.

I realized, now that I am growing older, that controlling what you eat during the holidays gets harder and harder. Not because you have no self-control, although I am sure that is a part of the problem, but because someone else might be doing the cooking or you may be cooking for people that don't enjoy the same foods as you do.

I am spending my first holiday in Charlotte with my mother's side of the family. Not to bad mouth the area, but when I see macaroni and cheese listed as a vegetable side-dish on numerous restaurant menus I begin to doubt the food sanity of those around me. Since I will be helping to plan and cook the Christmas day menu I thought I should share with you how I intend to get in as many winter vegetables and whole grains so that even the kids will eat healthy.

The first challenge I faced wasn't even the people, it was where to find the healthy food. The local Walmart is where the majority of my family buys groceries, but their produce is often limited. So after traveling to three different supermarkets I was finally able to get all of the produce I needed for dinner.

The second challenge was to cut the sugar, salt and fat. Essentially, most recipes that I found I simply cut the sugar in half, eliminated adding salt by using pepper or spices instead, and used low-fat milk and half of the butter or oil. Cutting things out of recipes won't always work (especially with certain baked goods), but most of the time you can cut back on salt, sugar and fat without overly altering the taste. 

The third was to get everyone to try the food. (I avoided telling them that I had modified the recipes. Some may see this as unethical, but I think serving them the original recipes would be unethical).

My Christmas Day Menu
Hot Chocolate with Skim Milk
Baked Apples with Cinnamon
Roasted Butternut Squash with Beets and Parsnips
Winter Greens Salad with Balsamic and Dijon Dressing (Chicory, Radicchio, Escarole and Cabbage)
Pineapple Ham (Lean, Smoked, Shank Cut)
Smashed Potatoes (Reds with Skim Milk and a Little Butter)
Whole Wheat rolls

What was on your holiday menu?

Friday, December 23, 2011

StrongWomen Across America

For the past four months I have been working with StrongWomen Across America as part of a directed study at Tufts University. The StrongWomen Across America program is an evidence-based community exercise and nutrition program for midlife and older women. During the fall of 2011 the founder and director, Miriam Nelson, PhD, and the StrongWomen strength training program manager, Eleanor Heidkamp-Young, ACSM HFS, traveled from Kenai, Alaska to Brodheadsville, Pennsylvania visiting eight small towns to empower groups of women to make healthy changes for themselves and their communities.

I had the pleasure of helping out with the media, technology and communication aspects of the tour with the program coordinator, Allison Knott, RD. Allison and I spent many hours locked in an office editing photos, video and blog posts.

Check out our hard work and videos on the StrongWomen Across America blog and see what the StrongWomen Team and groups of women have to say.

Also, check out our podcast, an interview with Miriam and Eleanor about their 6,800 mile road trip, on Tufts University Friedman School of Nutrition Science and Policy Nutrition Talk Radio.

Enjoy!

Work, work, work.

Sorry about the four month delay on posts. I have gotten a bit distracted with some of my school projects, volunteer stuff and work. I promise that this week I will put something up relating to the holidays and then never leave you alone for such a long time again.