Nice preventing type 2 diabetes population and community interventions,m235i harman kardon,diabetes education resources for patients group,spw 3 in 1 jaar - Test Out

This Evidence Update relates to NICE guideline 35 on Preventing type 2 diabetes:  population and community-level interventions.
Search results were sifted to identify systematic reviews that are relevant to the remit of the guideline. Unsurprisingly, increasing the price of junk food reduces consumption.  Though maybe 99 bucks is a bit steep!
In terms of impact on current guidance, the most important findings were that raising the price of unhealthy foods reduces their consumption, and that subsidies for healthy foods increase their consumption. There’s good news here for diabetes prevention strategies, working with high risk populations, mass media campaigns and workplace health promotion schemes.
The systematic reviews generally reported substantial heterogeneity and many included both randomized and non-randomized studies. The quality of the individual studies was variable, and in some of the reviews, not assessed at all. Given the foregoing, and whilst this is the best evidence currently available, we would expect to see new evidence in future that changes our conclusions.
Horne M, Tierney S (2012) What are the barriers and facilitators to exercise and physical activity uptake and adherence among South Asian older adults: a systematic review of qualitative studies.
Osei-Assibey G, Boachie C (2011) Dietary interventions for weight loss and cardiovascular risk reduction in people of African ancestry (blacks): a systematic review. An R (2013) Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments.
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. Mass media, workplace and community interventions for diet and exercise can reduce risk factors for type 2 diabetes. In last century the infectious and communicable diseases were the enemy and killed thousand. However, in past few decades we are seeing the incidence of another group of diseases on sharp increase. NCDs are important from public health point of view because, they are becoming the leading cause of death all over the world. The World Health Organization (WHO) is the agency of the United Nations Organization (UNO) that acts as coordinating authority on international public health issues.
On June 10, 2013 on the occasion of opening the Global Conference on Health Promotion at Helsinki in Finland, she listed her grave concerns over NCDs hurting our health. Demography, ageing, rapid urbanization, globalization and adoption of unhealthy lifestyles in modern times have far reaching adverse effects.
In the beginning of 19th century, improvements in hygiene and living conditions brought about vast improvements in health status and life expectancy.
Today, getting people to lead healthy lifestyles and adopt healthy behaviors faces opposition from forces that are not so friendly.
Efforts to prevent non-communicable diseases go against the business interests of powerful economic operators. Today’s socioeconomic progress is creating the conditions that favor the rise of non-communicable diseases. Tactics also include gifts, grants, and contributions to worthy causes that cast these industries as respectable corporate citizens in the eyes of politicians and the public. The second is efforts by industry to shape the public health policies and strategies that affect their products. This deduction is what we see almost every day after following weight loss programs that fails so many times or the person puts on weight soon after losing some and slacks away.
This deduction is yet more important because the whole and plant based food prevents and even reverses many diseases.
Plant based whole food with no added oil seems to be the bottom line answer to good health and prevention of heart diseases and diabetes. Many complications of diabetes that we come across are severe and horrifying including blindness, heart diseases and amputations. Tasting sugar in urine: This may sound funny nut only a few centuries ago the treating physicians will hire services of “urine tasters”. Testing blood sugar level: Testing for blood sugar level started some decades ago but until about mid 1900s it was expensive and time consuming and would take many hours to know the results. Discovery of Insulin: Only a century ago, in 1910, with a diagnosis of diabetes type 2 at the age of 40, the patient would expect to live no more than ten years.
Preventing and conquering diabetes: It is now clear that in many cases overweight diabetic can conquer his diabetes and become a diet controlled diabetic without support of insulin or other blood sugar reducing medicines.
Better hopes for type 1 diabetes: Even type 1 diabetics can follow strict guidelines and enjoy a near normal life. There are many more such examples of type 1 and type 2 diabetics, who now live their lives “normally”. Prediabetes has come to be a recognized term in past two decades to describe a group of about 15% population who is more likely to develop frank diabetes. Here are some signals and warnings to identify those at risk of having prediabetes and are likely to develop type 2 diabetes. Those who developed diabetes while pregnant (gestational diabetes), or gave birth to a baby weighing 9 pounds or more. Those with impaired fasting sugar level or impaired glucose tolerance; your doctor will help you getting these tests done. Surprisingly it is not very difficult to delay the onset of diabetes once we identify those at risk. Lose some weight: Research shows that modest weight loss and regular physical activity can help prevent or delay type 2 diabetes by up to 58 percent in people with prediabetes. Activity: Everyone should get at least 150 minutes each week of physical activity or 20 minutes a day.
Lifestyle change programs: These are offered through the National Diabetes Prevention Program, which is led by CDC. Answer to the question if diabetes can be prevented or not can be best given like this; “Yes it seems prevention of diabetes should be possible in near future and this future may be fairly soon.
According to our present understanding about diabetes, there are some tested ways of life style changes, which if adopted, may delay onset of diabetes. Regular exercise of brisk walking, say about half an hour a day; overall activity for 150 minutes a day is recommended. With new understanding that we have acquired about the mechanism of onset of diabetes, it seems that prevention of diabetes is largely possible despite the risk factors that one may have due to reasons of heredity.
And the type of exercise you choose depends on your personal abilities and preferences, on your schedule, and on the facilities at your disposal.
The older we get, the more we need these supplementary activities. And as the years roll on, most of us will also benefit from some simple exercises to improve balance and prevent falling, a major health problem for seniors. Calories and energy for our daily needs: Let us first of all understand as to where do we get our daily energy from? In late 1970s, a disproportionately high numbers of young soldiers killed in action in Vietnam were found to have plaques in their coronary arteries. In the fast pace life of Western world, two persons in family needs to work to make two ends meet. OUR FIBER NEEDS: According to an Institute of Medicine (IOM) formula we should have 14 grams of fiber for every 1,000 calories.
However, American Dietetic Association, The American Heart Association and US Department of Agriculture recommend 25 to 30 g daily, varying according to age. Soluble fiber is found in beans, peas, lentils, oatmeal, oat bran, nuts, seeds, psyllium, apples, pears, strawberries, and blueberries. Insoluble fiber is found in whole grains, barley, couscous, brown rice, bulgur, wheat bran, nuts, seeds, carrots, cucumbers, zucchini, celery, green beans, dark leafy vegetables, raisins, nuts, grapes, and tomatoes. Calories from Carbs:  It is a fact that we get almost two thirds of our energy from carbs and that fiber despite being so important for the health of our GI system, does not provide much of energy, where does the carbs provide us so much energy? I have met many people confused over the terms carbohydrate and starch because they seem to mean different from different experts. Let us try to simplify this in an easy way and remove the confusion and misunderstanding about these terms.
Carbohydrates are a term used for three following groups of foods that are derived from plants. An important implication of sugars on our health and illness is the fact that sugars get quickly absorbed into blood spiking up the blood sugar level (BSL). Most important of all is that starchy food contains a lots of micronutrients, all vitamins and minerals in abundance. High starch sources: Staple diets like wheat, rice, corn, potatoes and beans legumes are full of starch.
I hope the concept about carbohydrate, sugars and cellulose that contains beneficial fiber is now clear.
Starch (carbohydrates) from grains and beans: These provide more than two third of our energy needs, even in diabetics.
Simple sugar (carbohydrates): These are table sugar, glucose and fructose in drinks from added sugar. Shortenings used in cooking and Partially Hydrogenated Vegetable Oils (PHVO), also called Vegetable Ghee (VG) in many countries, is a major source of Trans Fats (TFs). It seems that Food And Drug Administration (FDA) is now taking definitive action of banning them. At the end of 2013 FDA proposed to remove TFs from their GRAS (Generally Recognized As Safe) category list that is maintained and amended from 1958. It was a stormy evening, and the rain was pouring hard on the rooftops in Sunnyvale, Calif.
Indeed, the life of a person diagnosed with diabetes (and that of his family) can change in a blink of an eye.
Beyond my empathy to the personal suffering of people with diabetes, I'm also an entrepreneur whose personal commitment is to use technology to help people develop healthy habits and fight chronic illnesses.
The great news for people with pre-diabetes is that most of the experts agree that this condition is reversible with the right nutrition and sufficient levels of physical activity.
An orchestrated campaign by allied forces comprised of individual and institutional health care providers, corporations, consumers, restaurant chains, entrepreneurs, government, and food producers can really make a difference in the battle against diabetes. One key campaign initiative should be to educate patients on the importance of dealing with pre-diabetes early on. Develop custom wellness programs targeting pre-diabetics and offer incentives for successful completion of the program.

Some corporations already offer significant discounts on health care premiums for employees complying with certain corporate health program requirements, such as a health check, blood test, self-health assessment, and participation in a wellness program. Broader adoption across corporations and expanding the wellness programs to address the needs of pre-diabetics should help prevent Type 2 diabetes. The most important challenge for people diagnosed with pre-diabetes is to accept the fact that they need to change their lifestyle and act now. Spouses of pre-diabetics can play an instrumental role in helping their partners to take action at an early stage. Ensure that subsidies are aligned with healthier food choices to enable consumers to make healthier food choices at a lower cost. Offer a variety of healthier food choices, low in fat and carbs, for the pre-diabetic community. Tags: Balanced diet, Big Corporations, Big Sodas, CAD, DG WHO, Diabetes, Diabetes prevention, Dr. Its importance is not registering in minds of lot of people yet, but NCDs are going to large issue as we move in time. These are now largely controlled and the world is declared free from many of those diseases.
Hence, if a person is ready to simply change the life style, the disease is likely to be prevented or even reverted. Chan is extremely worried about the fact that the big corporations have a very strong influence over the policies of the government. Economic growth, modernization, and urbanization promote the spread of unhealthy lifestyles, which are responsible for high incidence of non-communicable diseases. They include front groups, lobbies and promises of self-regulation, lawsuits, and industry-funded research that confuse the evidence and keep the public in doubt. They include arguments that place the responsibility for harm to health on individuals, and portray government actions as interference in personal liberties and free choice. Governments introducing measures to protect the health of their citizens are being taken to court, and challenged in litigation. When industry is involved in policy-making, rest assured that the most effective control measures would be downplayed or left out entirely.
But as you may see from the full text of her speech, this is said by the DG of WHO, a United Nation’s body responsible for the health of the world citizens. This means that because the health is affected directly or indirectly by any and all policies of the government, the impact of any such new policy by the government must be reviewed to ascertain its effect on overall health of people. Campbell says in this article, “I have never been impressed with the ‘calories in-calories out’ proposition for explaining long-term body weight changes. It also simultaneously represses cancer development and reversing heart disease and type 2 diabetes. This is becoming more and more obvious as many more researchers and practitioners are undertaking to look into this deeper and finding this to be true. Unfortunately, these folks may have to exercise a little more or consume a little less than a non-obese person to get the same results. It seems that some of our genes prevent diseases and they are stimulated by plant chemicals.
It is a period in time wherein a person is likely to develop frank diabetes if proper precautions are not exercised.
Prediabetes is a period of time just before the person develops adult onset diabetes, called type 2 diabetes (T2D). However, many of our perspectives have changed with time to make us feel confident facing this disease.
The taster will literally taste urine to determine if it was sweet to pronounce the person suffering from diabetes. This requires the diabetic person to follow a few simple guidelines and change the life style conducive to reversal of diabetes. This certainly requires devoting extra time and effort to keep blood sugars in normal limits, keeping a good log and to consult experts early on if any complication is developing. The term is now in common use and helps to create a mindset that if we can identify those people at risk of developing diabetes, we can also help them to delay its onset for a few years. Such persons run higher risk for developing type 2 diabetes and other serious complications including heart disease, stroke, blindness and amputations. For the people at risk also it is fairly easy to help themselves with some disciplined living. Modest weight loss means 5% to 7% of body weight, which is 10 to 14 pounds for a 200-pound person. Trained lifestyle coaches lead classes to help participants improve their food choices, increase physical activity, and learn coping skills to maintain weight loss and healthy lifestyle changes.
Some universities have started programs for working on prevention of diabetes. First let us understand if diabetes can be prevented or not? By adopting measures that I will describe below, which are being recommended for preventing diabetes, the onset of my diabetes could have been delayed by, say 10 years. After taking anti diabetic medicine for few years I came across such publication that told me of a possibility of reversing diabetes.
This only requires adding a little exercise and activity, reducing a little weight and careful selection of what you eat. Their recommendations to  prevent diabetes are simple but yet found to be very effective in their studies.
You may look at the whole animal kingdom from fish to birds to reptiles to mammals, they are all actively using their bodies and body parts continually.
These may by walking, jogging, golfing, swimming, biking or even exercise while working from your chair. Dennis Burkitt, who passed away in 1993, (His major work is named after him as “Burkitt’s Lymphoma”). Burkitt and his contemporary Surgeon Cleave considered Fiber as a very important part of our food. So, for a person needing 2000 to 2,500 calories of energy will consume 28 to 35 grams a day.
Soluble fiber is associated with lowering LDL (bad) cholesterol, regulating blood sugar, and lowers risk of heart disease and type 2 diabetes. Grandma called it roughage, and one of the benefits of insoluble fiber is that it helps keep you regular, prevents constipation, and reduces the risk of diverticular disease. Starch (carbohydrates) from grains and beans: These provide most of our energy needs, even in diabetics. A very well known disaccharide that we use in our daily life is our table sugar or sucrose (one glucose and one fructose molecule), lactose (as we drink in milk) or maltose (obtained from softening of grains to derive malt from it). Hence person eating balanced plant based diet will have more than enough fats and protein both. Instead they have a lot of cellulose, which is not digestible by humans and hence not a large energy source but provider of a lot of fiber. Many food’s carbohydrates are refined, their cellulose is removed and hence mostly left as sugars without fiber.
Hence our effort should concentrate on eating good variety of starch, which contains a lot of fiber and also contains enough proteins and fats. We all need to understand how raw starch protect us from diabetes, obesity and coronary artery diseases.
There are lot of studies to justify conclusion that if we include more than 50 grams of fiber in our plant based diet, we may be able to prevent many modern diseases of our digestive tract including cancer.
Bottom line is that we obtain good energy from starch with the benefit of fiber for our digestive tract health. However, it is claimed that balanced plant based meal provides all proteins and fats along with required calories.
These get quickly absorbed, increase BSL and start chain reaction of insulin secretion and its sequelae. Margaret has just finished preparing a delicious dinner for her husband John and left it simmering on the stove. Diabetes is associated with an increased risk of a variety of health problems such as stroke, heart attack, and eye, skin and foot complications. One primary goal is to help our nation be healthier; another is to help reduce the financial burden of chronic illnesses on all of us.
Furthermore, expanding the focus of the allied forces beyond the Type 2 diabetes frontline into the pre-diabetes territory, as well as helping the entire consumer population to develop healthy habits, should make a tremendous difference over time. Using technology, including web and mobile apps, can help both educate and promote healthy living habits. Let us discuss different aspects of this serious challenge to human health in future caused by our modern ways of living and eating our food. We can deduce from the research and analysis that NCDs are mostly diseases of arising from our modern life style and pressures of time constraints causing us to accept fast foods, colas and sugars as major part of our food habits. With her vast experience in Public Health, she has identified NCDs having serious consequential importance. Such influence makes it difficult to abolish bad policies and in bringing in new policies that are health friendly.
This must be taken very seriously and should always be number one concern while formulating any policy. This is to prevent all un-intended adverse implications on health from any new policy right at its root. I dare say that though a balanced diet is the best to follow, but the diet slanted to be vegetarian or vegan is better because it will prevent diseases. Its reverse may also be true and that genes that are responsible for stimulations may also get blunted by some of our food contents and hence letting the disease take a foot hold.
That does not explain what happens to food in the body, and the conversion of food into the energy in the presence of so many hormones.
Campbell was one of the lead scientists in the 1980s by Cornell and Oxford Universities and the Chinese Academy of Preventive Medicine. Most important being that the patient himself can vigilantly watch his blood sugar levels and progress of diseases and hence be able to avoid complications of diabetes.
Such outlook has positively changed over last hundred years; today a diabetic person can live almost a normal life and longevity as non-diabetics, thanks to discovery of insulin in 1922.
It has become a great help in managing diabetes, because the blood sugar level at a particular point in time is only a snap shot of the level. From the same token a person with prediabetes, who is at risk of developing diabetes can delay the onset of diabetes and stay clear of complications.

Only a few simple measures to change their life style and outlook can make a huge difference. This means if I was taking few measures as recommended for prevention, I would have been diagnosed diabetic now and not 10 years ago.
Yet additional benefit was that I could also discontinue taking statin drugs for my high cholesterol and yet my cholesterol is also now within normal limits. Their Diabetes Prevention Program (DPP) was conducted in 27 health centers and was funded by National Institute of Health (NIH). Lot of research is underway and that coupled with new ways of diagnosis, like HbA1c results and the ease with which blood sugar results can be obtained, we will see further possibilities of prevention and better control of diabetes. Essence is to try and keep your muscles active and preferably get your heart to beat faster than at rest, somewhere within your range of about 80% of MHR allowed by your doctor. They both in the later part of last century believed that many diseases of our new civilization could be explained as consequences of eating refined carbohydrates. Ancel Keys of University of Minnesota provided ‘dishonest” results of six countries study blaming fats for heart diseases. These get quickly absorbed, increase BSL and start chain reaction of insulin secretion and its squeal. It is important that we understand the real meaning of these terms because all over the world the basic foods like wheat, rice, corn, potato and beans contain starch. It also increases the triglycerides levels and is the first step to our developing insulin resistance, and hence diabetes and obesity. They consider such fat content in plant based food is more than adequate for human requirements. Starchy food containing fiber will have a lower glycemic index and will raise the BSL slowly. Cows can digest cellulose from grass and termite can digest cellulose from wood, neither of which humans can digest because of absence of enzymes to do that.
Aside from energy, starch also provides us fiber that is important for our digestive health. If we were to fulfill our calorie (energy) requirements from green and leafy vegetables, we will need to eat them in large quantities, which is not practicable. Grapes and many fruits are sugars and hence carbohydrates but they are not a good source of starch. You may have noticed that if you chew a piece of bread in mouth for longer, it starts tasting sweet because more and more glucose units are broken from starch by the enzyme ptylin in our saliva. For example the refined wheat flour has no fiber left in it and is almost glucose, ready to be absorbed into blood by the action of saliva. We do not get any fiber from simple sugar at all though they are plant origin but they are processed to remove all fiber.
Because starch comes from plants, we need to stay on plant based vegetarian diet to stay healthy. This may only be understood by the fact that processed starch, which is essentially all glucose has immediate profound effect on BSL. This action alone reduced the intake of TFs in Americans to about one gram a day in 2012, down from 4.6 grams in 2006, because the food companies got the message of FDA thinking and scientific results. Food companies will then need to prove that TFs are safe to eat, which is almost impossible because the scientific literature overwhelmingly points to the contrary. It can be the result of insulin deficiency (Type 1 diabetes) or insensitivity to insulin action, aka insulin resistance (mostly seen in Type 2 diabetes). As such, I'm constantly searching for the most significant national health-related challenges to tackle, and diabetes definitely qualifies as a major challenge. Modern life styles have caused us to be more indoors, sedentary and much less active than our fore fathers.
These need serious attention of all concerned to ensure good health and longevity of our future generations. As we learned from experience with the tobacco industry, a powerful corporation can sell the public just about anything.
We should move to have every government in every country to adopt the same for better health promotion of their citizens. Colin Campbell published an article on Jan 14, 2015 captioned “Obesity Debate” in the Newsletter of Center for Nutrition Studies.
Of course, consuming excess calories for a period of time can increase body weight, as well as consuming less than needed calories can decrease body weight. And by virtue of the phytochemicals (chemical compounds that occur naturally in plants) in the plant based diets even revert those diseases that are present. Such thinking is the basis of many programs developed by NIH through many universities like Pittsburgh that are now popular and used for prevention of diabetes. This in turn will mean that ill effects of diabetes and its complications, instead of starting 10 years ago and causing many likely grave issues, would only start being potentially troublesome today, i.e.
The University of Pittsburgh found that diabetes could be prevented in 33% to 70% people with higher risk of diabetes by taking appropriate measure.
People exercise for one of five reasons: for work, for health, for recreation, for competition, or for their personal appearance. Examples will be to use staircase instead of elevators, have short walks every so often during the work day and park your cars as far as possible to steal some compulsory walks. However, it MUST be included in our diet to prevent many gut diseases including cancer of large intestine and heart disease to some extent. Despite the fact we get most of our calories (energy) from carbs, these carbs in fiber do not provide us much energy.
Our ancestors have used such starch as major ingredient of their diet for many thousands of years. If we were to all fulfill our calorie (energy) requirements from green and leafy vegetables, we will need to eat them in large quantities, which is not practicable. Hence all the subsequent chain of event will be slowed down and people eating starch (and not sugar) are less likely to develop diabetes, obesity and their complication including coronary artery disease. Though humans generally cannot digest cellulose, we require cellulose to derive fiber from it, which is an important ingredient in our diet to help us stay healthy. For example if you were to get all your energy from broccoli or cauliflower, perhaps you will need to eat them all day to make up your calorific needs. This causes a chain of events of increased insulin, triglycerides, insulin resistance, diabetes and obesity. So much so that The Institute of Medicine now says that there is no safe level for consumption of artificial TFs.
Recently, he had been constantly tired and complained of increased thirst and a frequent need to urinate. Persons with sedentary and inactive life and those consuming predominantly processed foods and tobacco are most prone to get these diseases. As the DG of WHO, she is the ultimate person responsible and in charge of the maintenance and promotion of our health. Similarly, regular exercise that increases calorie expenditure helps to decrease body weight.
Researchers recognized that such a group of people is in gray area between being diabetics and “normal”.
We can now diagnose diabetes more confidently and even measure blood sugar levels in few seconds with new gadgets.
With the help of insulin and blood sugar monitor he learnt to “normalize” his blood sugar levels, which lead to his living with type 1 diabetes and normal longevity.
University has since been able to develop training of Life Style Coach to instruct people to take appropriate measures to delay and prevent diabetes. Burkitt insists that most GI diseases and even heart diseases and gut cancers can be prevented by eating food with fiber (unprocessed).
Starch was the major source of their energy (calories) requirement to stay alive, progress and propagate. For example if you were to get all your energy from broccoli or cauliflower, perhaps you will need to eat them all day to fulfill your calorific needs. TF causes increase of LDL or bad cholesterol and help building the plaque in arterial wall. For example many cookies that contained a lot of TFs have reduced their TFs content and Oreo has announced to eliminate TFs completely. While waiting for her husband, Margaret decided to relax a bit on her favorite couch and started to doze off as if hypnotized by the harmonic rhythm of the raindrops drumming softly on the rooftop of their house. These people have an elevated blood sugar level and are more likely to develop Type 2 diabetes. But, except for a good physical activity program having varied health benefits, focusing solely on calories in-calories out is likely to lead only to a fleeting, un-sustained benefit (days, weeks, maybe a few months).
Such a group of people, almost waiting to develop diabetes is now identified as having Prediabetes.
He became MD at the age of 45 and taught complications of diabetes at Albert Einstein University until his retirement. Now, if my life span were going to be an average of, say 10 more years from now, I would face possibilities of complications for 10 years only and not for 20 years. So, it may be rightly claimed that my diabetes could be prevented for 10 years if I took right measures of life style changes. Most fiber is classified as soluble (meaning that it partially dissolves in water) or insoluble (meaning that it resists digestion and does not dissolve in water).
The soluble fiber helps in fermentation of food and transports the cholesterol out of our body.
The total annual cost of diagnosed diabetes in the United States is estimated by the ADA to reach $174 billion and includes direct medical costs and loss of productivity.
The time taken for this conversion varies on the quantity and strength of such enzymes present. The insoluble fiber increases the bulk of stool, forms the consistency of stool and help in continence.
He advocates normalizing of blood sugar to as low as 85mg% with strict diet control and appropriate dosage of insulin. The usually-stout John seemed to slouch now, as if an invisible burden was pressing on his shoulders.

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  1. KAMRAN_17

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  2. Inga

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