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Glucomannan – A smart choice for blood sugar, appetite and weight management

Glucomannan flour has been used in China as a food source as well as a traditional medicine for many centuries (Liu, 2004), dating back as early as the time of the Western Han Dynasty (206 BC–08 AD).

A wide range of clinical studies (endorsed by the European Food Safety Authority) have demonstrated that supplementing the diet with konjac fibre significantly improves glycaemic control, lowers plasma cholesterol, and enhances bowel movement. There may also be beneficial appetite suppression associated.

Obesity is a global pandemic that is driving a surge in type 2 diabetes as well as a whole host of other obesity-related morbidities. Several groups of researchers have evaluated the safety and efficacy of konjac fibre use in weight loss in overweight and obese.

Konjac fibre has been proven to improve satiety by delaying gastric emptying caused by the mass effect of its gel-like & viscous nature. A study in 2015 reported that konjac fibre improved satiety by increasing the bulk effect of food & the time taken by the slow digestion of a konjac-containing meal, given konjac is not digestible itself; this in turn slows down the rate of any post-prandial glucose uptake, which would reduce the total glycaemic index of the meal, and subsequent insulin spike.

Another recent study evaluated the effects of konjac fibre on body weight and BMI in otherwise healthy obese children and adults. The authors concluded that the short-term use of konjac fibre would help to reduce body weight.

A study by Huang et al. investigated the effect of konjac fibre on blood glucose levels in patients with diabetes. Results show that both, fasting blood glucose and 2h post-prandial glucose level, were significantly reduced 7. Similar results were achieved by a study comparing the viscosity of a range of soluble fibres .

In summary, konjac fibre is an emerging alternative nutritional therapy for the treatment of type 2 diabetes, with clinical efficacy similar to lifestyle changes. The hypoglycaemic effects of the fibre have been attributed to the inhibition of carbohydrate absorption from the gut resulting in a decrease in the post-prandial insulin response. Not only does konjac fibre improve glycaemic control & insulin resistance, but it also reduces associated risk factors such as dyslipidaemia and hypertension

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Addressing Nutritional Gaps with Nutrient Supplementation

At PicPax our health professionals fully believe that a balanced and varied diet is the best source of essential nutrients, however, deficiencies occur throughout populations even where food supply is plentiful. The typical diets across the many and varied populations living in the UAE, bear little resemblance to what experts recommend for fruits and vegetables, wholegrains, good fats and portion size.

It is not uncommon for people to take multivitamins to fill nutritional gaps and with the idea that they may maintain and improve health. Multivitamins are usually well tolerated and it is unlikely that any major nutrient imbalance is likely.

Evidence, however, suggests that times of greater need occurs throughout the life cycle when the body requires more nutrients than the typical diet may provide, such as iron, calcium, zinc, vitamin D, folate and vitamin B12. Over the course of a lifetime, deficiencies in one or more nutrients may contribute to serious health issues.

Micronutrients are required for nearly all metabolic and developmental processes in the body and mostly met from the foods we consume. Some nutrients are not made in the body such as vitamins D, C and B12 as well as omega 3 fats and 9 amino acids. Anyone who eliminates certain foods such as dairy, fish, fruit and vegetables is at greater risk of having a nutrient deficiency. Eating patterns mainly based on high energy, low nutrient dense foods are often related disease which at certain stages in life, can have a big impact on short and long term health.

The food pyramid is still the best model for guiding people to make good food choices. It includes all five food groups:

  • Cereals and starchy vegetables/beans and pulses
  • Multi-coloured vegetables and fruits five plus a day
  • Animal and plant proteins
  • Dairy
  • Good fats

The confusion or lack of mindfulness of how much of these groups are being consumed are where energy levels can be out of balance. The elimination of any group can also open the door for nutrient deficiencies. A chat with a qualified nutritionist or dietitian is often well worth the time.

Even when a diet is well planned, it is not always possible for people to choose foods containing the recommended amounts of all essential micronutrients, and relatively minor nutrient shortfalls can lead to health problems. The role of multivitamins and targeted supplementation also needs to consider absorption and bioavailability of vitamins and minerals, as well as the effect of the balance of macronutrients – carbohydrate, protein and fat, on metabolism. Supplements cannot replace eating adequate amounts of a variety of foods, however, they may be particularly beneficial to people who have poor nutrition for a variety of reasons, including inadequate intake of foods from the food groups, advanced age or have specific health issues. When choosing supplements, consumers are advised to take a preparation that is tailored to their age, gender, risk factors and stage of life and wherever possible, supplementation should be selected on a nutritional assessment.

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Vitamin D Deficiency

Historically, humans were designed to synthesize vitamin D naturally obtained through the action of the sun. However, modern lifestyles, cultural habits and large numbers of populations living in the Northern Hemisphere, has proven inadequate. Although vitamin D is present to various amounts in food products (oily fish, egg yolk, fortified cereals and spreads, Shitake mushrooms, etc.), these food products are not usually preferred by children making it difficult to rely on sun and nutrition alone in order to obtain the recommended daily amounts.

Furthermore, the natural vitamin D production through exposure of the skin to sunlight is prevented in several high risk populations. People with darker pigmented skin need considerably more exposure to the sun to generate the same vitamin D amounts due to the presence of melanin, which acts as a natural sunscreen and deficiency/insufficiency was identified in populations who cover discretely for religious or cultural reasons.

Vitamin D is known to play a significant role in bone metabolism, muscle strength, musculoskeletal health, and is also related to a number of non-skeletal diseases. Its deficiency has been related to many health conditions including respiratory and other infections, asthma, atopic dermatitis and allergic disease, type 1 diabetes, inflammatory bowel, obesity and metabolic syndrome, autism and depression, and celiac disease, all having strong links with vitamin D insufficiency early in life.

The prevalence of vitamin D deficiency in adolescents in the UAE is very high, particularly in females, compared to their counterparts in other developed countries where vitamin D fortified foods are available, and people use vitamin D supplements. Although the UAE and other Gulf countries have a sunny environment, skin sun exposure is low, and therefore vitamin D deficiency remains one of the major public health problems.

We strongly support the recommendations published recently that encourage supplementation of vitamin D to special populations (pregnant and lactating women, infants, and high risk groups). We acknowledge the importance of international food fortification programs implemented to ensure nutritional sufficiency of vitamin D and calcium for the entire population.

Recommendations for boosting vitamin D levels:

Aim for fifteen minutes per day of midday sun

Try to take oily fish, egg yolks, fortified cereals, food products with Shiitake mushrooms and dairy products everyday

Supplement regularly with at least 400IU vitamin D3 for children and 1000IU – 2000IU for adults

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Supplement and Medicine Interactions

Supplementing with nutrients has become very common place and for the most part, should not become alternatives for medications, but an addition. Depending on where your condition lies as a health risk, supplements, diet and lifestyle changes can be a starting point but under the advice of a clinical nutritionist or dietitian. Interactions between medications, supplements and even some healthy foods do exist and yet many well-intentioned advice is given without an understanding that some dangerous interactions can occur. If you’re taking medication, always consult your pharmacist, dietitian or clinical nutritionist trained in this area or able to research any possible interactions. Here are five of the most important interactions to be aware of:

Grapefruit, grapefruit juice and grapefruit extract, are usually healthy antioxidants but well researched as blocking the enzymes required to metabolize some commonplace medicines. As a result, medication levels can build up and alter the dose being administered. This is particularly applicable to:

  • cholesterol-lowering medicines known as statins
  • blood-pressure lowering medicines known as calcium channel blockers
  • sertraline (an antidepressant)
  • carbamazepine (an anti-epileptic medicine)
  • most benzodiazepines (used for anxiety and insomnia)
  • cyclosporine (an immune suppressant)
  • sildenafil (erectile dysfunction medication)
  • saquinavir (antiretroviral HIV medication).

St John’s wort is an over the counter herb used for depression, and tends toward stimulating medications to work more quickly with the likelihood of the medication to be less effective over the day. When taken along with other anti-depressants, the side effects can worsen psychotic symptoms. It is also banned in some countries due to its interference of many serious health issues especially if medications are taken.

Garlic is another enzyme stimulator and may increase the effectiveness of warfarin and increase the chances of bruising and bleeding.

Ginkgo biloba used to improve age-related memory decline can increase the risk of spontaneous internal bleeding in people who take anticoagulants like warfarin, blood thinning medication like aspirin, or anti-inflammatory medicines like ibuprofen

Calcium can block the absorption from the intestine of two classes of antibiotics, tetracycline and quinolones. Calcium can reduce the absorption of thyroid medication. Separate calcium and thyroid medication doses by at least four hours.

Vitamin K is avoided when taking blood-thinning medications such as warfarin and may also diminish the effectiveness of some antibiotics such as tetracycline

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Glucosamine and Chondroitin with MSM

Glucosamine and chondroitin are among the most popular non-vitamin, non-mineral “specialty” supplements for improved cartilage/ joint health and inflammation. It has long been associated with MSM (methyl sulfonyl methane), a sulfur containing compound studied for its anti-inflammatory benefits and for reducing pain.  Sustainably sourced algae vegan Omega-3 oil and curcumin are added to further boost the anti- inflammatory response.

Glucosamine is a molecule that occurs naturally within the body, and works to lubricate the joints and reduce inflammation from wear and tear.

Glucosamine is a naturally occurring compound that is chemically classified as an amino sugar. Amino sugars are a glucose molecule with an amine group attached. Another common amino sugar is N-acetyl glucosamine which is essential for tissue maintenance in a similar way to glucosamine but aligned more with the gut membrane health.

Glucosamine is a building block for a variety of functional molecules in the body but is primarily recognized for developing and maintaining cartilage within your joints . It can be taken orally or topically as a gel or cream.

Glucosamine in nature is found in shellfish shells, animal bones and fungi and these are often the natural sources for supplements.

One high profile study (200 participants) linked glucosamine supplements to a 24 – 28% reduction in two critical inflammatory markers CRP and PGE after supplementation although not all inflammatory markers, indicating that it works well for certain bone and joint conditions, and not for others. The addition of chondroitin increased the reduction of inflammation to 36%.

Ultimately, more research is needed on glucosamine’s role in the reduction of inflammation.

Glucosamine Sulfate 2KCL

Glucosamine HCL

Methyl-Sulfonyl-Methane

Chondroitin Sulfate

Whole food formulas with an enzyme and mineral delivery system

This combination of amino acids has been specifically studied for their potential to treat symptoms and disease progression associated with osteoporosis, osteoarthritis and rheumatoid arthritis (RA).

There is a growing body of evidence that diet and nutrition play an important role in maintaining cartilage and soft tissue. Studies indicate that supplementing daily with glucosamine sulfate may offer effective, long-term treatment for osteoarthritis by slowing the progression of disease, delaying degeneration of the joint and reducing pain. It is not quite so clear if it is of benefit in RA although it may provide some pain relief.

The strongest evidence supports glucosamine sulfate use for long-term treatment of osteoarthritis symptoms, albeit it may not work for everyone. If you are considering Glucosamine and chondroitin, I would suggest you take it with MSM, omega-3 fish oil and curcumin and choose a quality supplementary source.

The typical glucosamine dosage is 1,200 – 1500mg per day of glucosamine and 1000mg chondroitin which you can take at once or in multiple smaller doses throughout the day with food.