Sleep is possibly the most overlooked aspect of successful weight loss. While there is a well known link between obesity and sleep, the actual role sleep plays in appetite regulation and glucose metabolism is often overlooked.

A recent study conducted by Uppsala University in Sweden found evidence that, “lack of sleep encourages the body to store more fat, altering the body’s metabolism.” The study demonstrated that even a small shift in an individual’s sleep schedule may have significant effects on metabolism leading to weight gain.

“Chronic sleep loss, social jet lag, and shift work—widespread in our modern 24/7 societies—are associated with an increased risk of numerous metabolic pathologies, including obesity, metabolic syndrome, and type 2 diabetes,” researchers explain in the new study. “Even minor weekly shifts in sleep timing, or as few as five consecutive nights of short sleep, have been associated with an increased risk of weight gain in healthy humans.”

In this study, fifteen volunteers were separated into two groups. One group received a normal night’s sleep and the other group had no sleep. Both groups gave samples of fat, muscle tissue, and blood. They were also asked to keep a food diary for the duration of the experiment. 

The most significant difference was in gene activity referred to as DNA methylation. This activity, “was linked to cells increasing their tendency to absorb lipids, boosting the body’s ability to store fats.” The participants who received no sleep also had a decreased ability to build or at least maintain muscle mass. Their bodies also experienced an increased state of inflammation and a higher risk for developing type 2 diabetes. 

To learn more: “Losing sleep can lead to more extra pounds”  ZME Science

South L.A. has been burdened with limited access to fresh and healthy foods for years. Hank’s Mini Market, a locally owned store originally opened in 1997, has decided  to introduce more wholesome and healthy foods to the area. The small corner store has partnered with Sweetgreen and California FreshWorks Fund to provide the community with  produce that is both fresh and affordable.

South Los Angeles, famous for the 1992 LA Riots, is often referred to as a food desert. The American Nutrition Association defines this as “a place where residents lack access to fresh fruit, vegetables, and other healthy whole foods. Food deserts generally occur in low-income areas where fast food is easier to find than an affordable grocery store.”

The hope for this grocery store’s transformation, is to allow the community to have access the healthy foods which will greatly impact their quality of life and reduce risk of diet-related diseases. The store is also providing a space for local art in hopes that it will help to build a sense of community.

The owner of the corner store states, “we should be able to shop locally, we should have nice spaces, we are deserving.” She is hoping that the transformation of her family-owned store will encourage others to demand more from their community and encourage change.

To read more about this topic, visit “Re-opened convenience store brings healthy options to South L.A.

Many popularized western diets promote a low-carb/high-protein diet for weight loss, however, recent studies show that a low-carb diet can actually increase your mortality risk. The study suggests that a low-carb diet can be just as detrimental to your long-term health as a high-carb diet. 

Multiple studies with over 400k participants, “suggest a U-shaped relationship between life expectancy and overall carbohydrate intake, in which lifespan is greatest among people with 50%-55% carbohydrate intake, a level that might be considered moderate in North America and Europe but low in other regions, such as Asia,” study authors wrote.

Despite many popularized diets such as the paleo or keto diet, substituting carbohydrates with animal-based protein actually increased mortality risks, study finds. When carbohydrates were replaced with plant-based protein (nuts, vegetables, whole-grain bread), mortality risks decreased. According the to the study, the popularity of the “low-carb” diet is mainly due to the short-term weight loss vs. long term health outcomes. 

We should still pay attention to what type of carbohydrates we are consuming, but skipping them all together for a long-term weight loss solution may not be the answer. Rather, according to this study, if you are looking to replace carbohydrates or cut back, choose plant protein over animal-based proteins to decrease your mortality risk and improve your outcomes!

To learn more – “Higher Mortality Risk Seen with Low Carb Diet” by MEDPAGE TODAY

“Insulin’s High Cost Leads To Lethal Rationing” – NPR

Such a tragic story of a young man’s life cut short because he couldn’t afford his insulin. Sign the ADA Petition to make insulin affordable.

We can make a difference starting today! 

Make Insulin Affordable – what you can do today

The Insulin Wars ( How insurance companies farm out their dirty work to doctors and patients) – The New York Times 

Providers often share nutrition recommendations with patients. In spite of best intentions, sometimes these recommendations may not match latest standards or reflect evidence based studies . A survey by the Nutrition and Lifestyle Working Group of the American College of Cardiology sought to understand just how much nutrition education physicians were actually receiving during medical school and throughout their careers.

The results of this survey concluded that while nearly 70% of physicians believed that nutrition education is vital in healing process, only 57% engaged in direct discussion with their patients. Almost 25% of physicians, “recall receiving no nutrition education in medical school” and 35% said their knowledge of nutrition, “often came from a single lecture.” In residency, a shocking 73% received no nutrition education whatsoever. With nutrition being a vital aspect of the healing process, it is hard to ensure you are receiving a complete treatment plan when physicians may not have the proper education to support their recommendations.  

For Diabetes Educators, this provides a wonderful opportunity to coach our referring providers on the latest nutrition guidelines. This can be accomplished by sending brief nutrition updates to providers, inviting guest speakers who have expertise on the latest nutrition guidelines and other strategies. Since we work in interdisciplinary teams, maintaining professional respect is an important aspect for long term collaboration and growth.

With the rise of CVD, Type 2 Diabetes, and other health conditions an intervention is required. “Improving education of physicians through more comprehensive nutrition training in medical schools and advanced postgraduate training is an essential step that can facilitate improvement.”

To learn more about the lack of nutrition education in our healthcare system, visit The Deficit of Nutrition Education of Physicians.

FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors 

The U.S. Food and Drug Administration (FDA) is warning that cases of a rare but serious infection of the genitals and area around the genitals have been reported with the class of type 2 diabetes medicines called (SGLT2) inhibitors. This serious rare infection, called necrotizing fasciitis of the perineum, is also referred to as Fournier’s gangrene.

Please let patient know about this new warning to be added to the prescribing information of all SGLT2 inhibitors.

Patients should seek medical attention immediately if they experience any symptoms of tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell. These symptoms can worsen quickly, so it is important to seek treatment right away.

Health care professionals should assess patients for Fournier’s gangrene if they present with the symptoms described above. If suspected, start treatment immediately with broad-spectrum antibiotics and surgical debridement if necessary. Discontinue the SGLT2 inhibitor, closely monitor blood glucose levels, and provide appropriate alternative therapy for glycemic control.

Fournier’s gangrene is an extremely rare but life-threatening bacterial infection of the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels of the perineum. The bacteria usually get into the body through a cut or break in the skin, where they quickly spread and destroy the tissue they infect. Having diabetes is a risk factor for developing Fournier’s gangrene; however, this condition is still rare among diabetic patients. Overall published literature about the occurrence of Fournier’s gangrene for men and women is very limited. Publications report that Fournier’s gangrene occurs in 1.6 out of 100,000 males annually in the U.S., and most frequently occurs in males 50-79 years (3.3 out of 100,000).^1-3 In our case series, however, we observed events in both women and men.

In the five years from March 2013 to May 2018, we identified 12 cases of Fournier’s gangrene in patients taking an SGLT2 inhibitor. This number includes only reports submitted to FDA* and found in the medical literature,^4-6 so there may be additional cases about which we are unaware. In 2017, an estimated 1.7 million patients received a dispensed prescription for an SGLT2 inhibitor from U.S. outpatient retail pharmacies.⁷ Although most cases of Fournier’s gangrene have previously been reported in men, our 12 cases included 7 men and 5 women. Fournier’s gangrene developed within several months of the patients starting an SGLT2 inhibitor and the drug was stopped in most cases. All 12 patients were hospitalized and required surgery. Some patients required multiple disfiguring surgeries, some developed complications, and one patient died. In comparison, only six cases of Fournier’s gangrene (all in men) were identified in review of other antidiabetic drug classes over a period of more than 30 years.

To help FDA track safety issues with medicines, we urge patients and health care professionals to report side effects involving SGLT2 inhibitors or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box.

For more information, please see the FDA Warning Post

Download our Diabetes Medication Pocket Cards

Humans are said to have five basic tastes: salty, sweet, bitter, sour, and the least known, umami. Umami is a Japanese word “used to express a delicious, savory meal.” Recent studies are beginning to show that healthy eating habits may be influenced by consuming savory foods.

Glutamate, a key component of Umami taste, is an amino acid that is commonly found in savory foods with higher protein values. Previous studies have shown that consuming glutamate via broth can decrease overall appetite and intake. This is especially helpful for individuals who struggle with overeating and weight gain. A study by the Journal of Neurophyschopharmacology found that the participants, “had more focused gazes during the meal and had more engagement of a brain area that is linked to successful self-regulation during food choice.”

Further research may help encourage and facilitate healthier eating patterns and reduce the amount of individuals at risk for developing type 2 diabetes and becoming obese.

To learn more about Umami and its prevalence in weight loss and appetite control, visit Savory Foods May Help Promote Healthy Eating.

“Children who drink fruit juice with breakfast are more likely to become overweight or obese.”

A recent study by the Medical University of Vienna reported that “children who had orange or apple juice with their breakfast were 50% more likely to be overweight.” On the alternative end, the children consuming water in the study decreased their risk for obesity by 40%. The study also evaluated the children’s overall eating habits and whether or not they skipped breakfast. The study found that the children who ate breakfast every morning were generally three pounds lighter than the children who skipped it all together.

The experts in the study recommended to look for fruit juices with lower added sugar and very simple ingredients. The increased risk of obesity is likely due to the the added sugars as well as the overall higher energy content. A small glass of freshly squeezed orange juice with no added sugar is a better, low-calorie option since it contains beneficial vitamins and minerals that are vital for children’s development. The fiber content in natural fruit juices is also beneficial for promoting good digestive health. Of course, enjoying the whole fruit is always the best option.

In summary, fruit juice does not necessarily need to be eliminated altogether.  Consider it a special treat. But better choices include eating the fruit instead or diluting the juice with 50% water (sparkly water works great) to decrease overall sugar and energy content.

To read more about this topic, visit Children who drink fruit juice with breakfast 50% more likely to be overweight.

Written by: Sofia Sepulveda