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Statins Increase Diabetes Risk

An editorial in today's New England Journal of Medicine shows that statins, taken to lower cholesterol and prevent heart attacks, increase risk for diabetes. (NEJM, April 25, 2012).

STATINS HELP TO PREVENT HEART ATTACKS. Heart attacks are the leading cause of illness and death in patients with type 2 diabetes. Statins lower cholesterol, and a reduction in the bad LDL Cholesterol of 1 Millimole per Liter (39 mg per deciliter) reduces risk of death of diabetics from any cause by nine percent and in those without diabetes by 13 percent.

STATINS INCREASE DIABETES: However, statins increased risk for diabetes by 25 percent in non-diabetics who had LDL cholesterol below 130 mg/Dl and C-Reactive Protein (a measure of inflammation) below 2 (N Engl J Med. 2008;359:2195-2207). A meta-analysis of six statin trials that included 57,593 participants revealed a 13 percent increase in the relative risk of new-onset diabetes (Diabetes Care 2009;32:1924-1929).

All statins appear to increase diabetes risk. The higher the dose, the more likely statins are to cause diabetes.

FDA RECOMMENDS CONTINUING STATINS: The US Food and Drug Administration (FDA) recently added information to statin labels that statins increase diabetes risk, but added that the "FDA continues to believe that the cardiovascular benefits of statins outweigh these small increased risks." The NEJM editorial concurs, stating that "The net cardiovascular benefit for people at high cardiovascular risk strongly favors statin use."

DO EVERYTHING TO PREVENT DIABETES: People who take statins to lower cholesterol should follow all of the rules to prevent diabetes:

1) Avoid overweight
2) Do not eat red meat
3) Do not take sugared drinks, including fruit juices, in any form, except during intense exercise
4) Avoid foods with added sugar
5) Avoid fried foods
6) Eat large amounts of fruits and vegetables
7) Grow muscle
8) Reduce body fat
9) Keep blood levels of vitamin D above 75 nmol/L
10) Exercise


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Caffeine and Sports Endurance

The best time to take caffeine to improve endurance is immediately before and during exercise (Journal of Strength and Conditioning Research/National Strength & Conditioning Association, April, 2012). Bicycle racers were given caffeine gum or a placebo two hours, one hour, or five minutes before racing in a time trial. They rode faster time trials only when they took the caffeine gum just before the time trial. They did not benefit from the caffeine taken one or two hours before the time trial.

CAFFEINE IMPROVES ENDURANCE ONLY WHEN TAKEN WITH SUGAR. Caffeine increases endurance by increasing the absorption of sugar from your intestines (Medicine & Science in Sports & Exercise, July 2010; and Journal of Applied Physiology, June 2006).

Another recent study shows that since caffeine increases endurance by increasing the absorption of sugar into the bloodstream, it must be taken with sugar to improve performance (Physiologie Appliquee, Nutrition et Metabolism, March 2012). This study was done on a time trial lasting less than a half hour.

The limiting factor to how fast you can move during a race is the amount of oxygen that you can take in and use. Since sugar requires less oxygen than fat to power your muscles, you want to get sugar into your muscles as quickly as possible. Anything that increases the amount of sugar that can be absorbed from your intestines into your bloodstream will help you ride or run faster and longer.

Caffeine helps athletes run faster short-distance races by causing the brain to send messages along nerves to cause a greater percentage of muscle fibers to contract at the same time.

HOW MUCH DO YOU NEED? Most research shows that it doesn't take much more than one or two soft drinks (30 to 60 mg caffeine) to increase endurance. Caffeine loses its beneficial effects with repeated exposure, so athletes who want to gain maximum advantage from caffeine during competition should avoid drinking caffeinated beverages when they are not competing.

HOW MUCH IS SAFE? Nobody really knows how much caffeine you can take without harming yourself. At rest, caffeine is a diuretic, but during exercise it does not increase urination. Caffeine is a potent stimulant that can cause irregular heartbeats and raise blood pressure in people who already have these conditions. It has not been shown to cause sustained high blood pressure.

HOW DO ENDURANCE ATHLETES GET THEIR CAFFEINE? A study from Griffith University in Queensland, Australia shows that 90 percent of triathletes used a caffeinated substance immediately prior to or throughout a competition (International Journal of Sport Nutrition and Exercise Metabolism, October 2006). They used cola drinks (78 percent), caffeinated gels (42 percent), coffee (37 percent), energy drinks (13 percent), and caffeine tablets (9 percent).

RESTRICT CAFFEINE WHEN NOT COMPETING: Since taking caffeine increases sugar absorption from the gut, taking it with carbohydrate-containing foods can double your rise in blood sugar (Journal of Caffeine Research, April 16, 2011). A high rise in blood sugar can cause cell damage. Taking caffeine can also raise blood pressure temporarily, but not permanently (Journal of Hypertension, May 2005).


High Blood Sugar Levels Increase Cancer Risk

High Blood Sugar Levels Increase Cancer Risk

Chinese authors followed almost 18,000 people, aged 35 and above, for five years and found that almost all risk factors for diabetes increased risk for cancer:
• Storing fat primarily in the belly
• high fasting blood sugar
• low HDL Cholesterol
• high triglycerides
• high blood pressure
(Chinese Medical Journal, April 22, 2012;125(3):481-5).

People with high blood sugar levels are at increased risk for cancers of the liver, gallbladder, respiratory tract, thyroid, rectum, pancreas, bladder, uterus, cervix and stomach; and for multiple myeloma (Public Library of Science Medicine, January 2010).

Other studies show that factors that increase the likelihood of having high blood sugar levels also increase risk for cancer:

• Diabetes
• Lack of exercise
• Obesity
• Abdominal obesity
• Eating saturated fats from animals (blocks insulin receptors)
• Lack of fruits and vegetables
• Lack of fiber

Read my report on "Blocking Glycolysis May Cure Cancer", for a detailed explanation of the link between high blood sugar and cancers:


Why Older Women Have a Difficult Time Finding Partners

Women live longer than men do, so the older they become, the fewer men are available, but times will change. By 2030, men will live as long as women do, predicts Professor Les Mayhew (City University's Cass Business School in London, published May 2012). In the last 20 years, male life expectancy after 30 has increased by six years. If it increases by the same amount in the next 20 years, men will live to an average of 87, the same as women.

• In 1965, the difference in longevity between men and women was at its highest (6 years) because almost 80 percent of men smoked. Since then, both men and women live longer, but the longevity rates for men are increasing faster primarily because men now smoke far less and women are smoking more. Since 1975, Lung cancer rates have halved in men and doubled in women.

• More men now work at office-based jobs, rather than in heavy industries such as coal mining.

• Heart attacks are three times more common in men than in women. Improvements in prevention and treatment are dramatically reducing the death rate from heart attacks.

• Traditionally, men take more risks than women do, and are more likely to die in sport and automobile accidents, but this may be changing.

• The rate of obesity in women is increasing more than in men. Obesity increases risk for premature death from diabetes, heart attacks, cancers and so forth.

• Both men and women are exposed to the latest news about the importance of exercising regularly and eating properly. The healthy-eating, healthy-living societies such as the Japanese live the longest. Professor Mayhew believes that men are catching up to women in the trend toward more healthful lifestyles.


Recipe of the Week:

Black Bean Gazpacho

You'll find lots of recipes and helpful tips in The Good Food Book
- it's FREE


April 29th, 2012
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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