The Hemp Connection:
heart disease

I am so grateful I went to the educational meeting yesterday I almost didn't attend! For the majority of my career, the health benefits of vinegar is something that hasn't been taken seriously by colleagues in my profession. But when I saw the presenter for this topic was respected Arizona State University nutrition researcher Carol Johnston, I figured it was worth going to hear what she had to say.

Turns out, Dr. Johnston, a few years ago, while working on another project, quite by accident, found an obscure research article reporting that vinegar may be helpful in reducing insulin resistance. She decided to pick up on where the study left off, and what she has learned with her work has a lot of pertinence to PCOS.

One of the goals of better insulin function is to reduce a reading known as"postprandial blood glucose"…that is, the blood glucose reading you see after eating a meal. This reading can be important, because high numbers have been associated with heart disease as well as excessive baby weight gain in pregnancy (macrosomia). For those of you who experience the phenomenon of being hungry after eating a meal, part of the reason may be a high postprandial blood glucose.

Dr. Johnston's first study used nondiabetic subjects who were divided into two groups: insulin resistant and non-insulin resistant. None of these individuals were taking diabetes medications. If they were in the test group, they were asked to drink 20 grams of apple cider vinegar, wait 2 minutes, and then eat a (pretty high glycemic) test meal of a white bagel, butter, and orange juice. Both groups tried the vinegar and no vinegar protocols. Blood glucose 30 and 60 minutes later was measured.

They found that when vinegar was consumed before a meal, postprandial blood glucose was significantly reduced. Dr. Johnston proposes that vinegar actually may have activity similar to that of Precose or metformin. While she used apple cider vinegar in her studies, she shared that any vinegar will have the same effect. So whatever your preference, rice, balsamic, wine, or raspberry…get creative in the kitchen!

She also clarified that the difference between the action of cinnamon and vinegar is that cinnamon reduces fasting glucose and vinegar reduces postprandial glucose. So you can use both if you wish, they're not going to replace each others' benefit…they may actually complement each other.

It's important if you choose to try this, and you're on medication, to share this with your physician. The results may significantly affect the dose of medication you need. I can pretty much bet most physicians aren't informed about this, and since I was skeptical until yesterday myself, I'm providing all of the references used to write this article for anyone to download and share. The journals in which they were published are respected ones.

A really important caveat: you can overdo this advice. Large amounts of vinegar over time can cause low grade metabolic acidosis (Dr. Johnston studied this too, knowing the mentality of dieters and people desperate to get off of meds.), which is associated with osteoporosis. This acidosis can be prevented by making sure your diet has a good amount of high-potassium foods. Since those are notably fruits and vegetables, the obvious practical way to use this information is to eat a nice salad with each meal, topped with a vinaigrette dressing. Dr. Johnston recommends a ratio of 2 parts vinegar, 1 part oil, the reverse of what is traditionally used.

Keep in mind too, if you're planning to go to the health food store and buy the vinegar pills…they aren't going to work. Dr. Johnston did three separate studies with them (because she was so surprised they didn't work and she was so convinced they would), and did not get the same results the original vinegar produced.

We had the opportunity to try a new product by Bragg's, a line of vinegar beverages. inCYST intern Sarah Jones and I tried the apple-cinnamon and the concord grape-acai flavors. Both of us felt the drink was a little much to consume as packaged, but they would be fun to use in vinaigrettes, marinades, etc., in the kitchen. I'm going to try some recipes this weekend.

Keep in mind too, that any favorite foods made with vinegar will also be beneficial! Pickles, sauerkraut, Korean kimchi, there are many cultural favorites that can make this fun! Think of ways vinegar can be added to your own marinades and flip the oil to vinegar ratio.

If you're really adventurous, or just want a fun party gag, try these pickle pops we sampled yesterday! Sarah was not so keen on them but I'm German and found it pretty tasty. When I looked this up for you all,, I discovered there is even a jalapeno flavor. That's pushing it even for me, but hey, there's something for everyone.: )

Check back with us too if you're actually measuring your blood glucose after meals and let us know if this was helpful!

The cost of diabetes medications can exceed $6,000 per year, per person. And one of every 8 federal health care dollars, ($79.7 billion annually), is spent on diabetes care. Imagine what we could do to our personal budgets, not to mention that nagging national debt, if we all just walked into Costco and invested in an industrial-sized bottle of vinegar…

Ebihara K, Nakajima A. Effect of acetic acid and vinegar on blood glucose and insulin responses to orally administered sucrose and starch Agric Biol Chem 52: 1311-1312, 1988.

Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004: Jan 27(1); 281-2.

White AM, Johnston CS. Vinegar ingestion at bedtime moderates waking glucose concentrations in adults with well-controlled type 2 diabetes. Diabetes Care. 2007 Nov;30(11):2814-5.
Johnston CS, White AM, Kent SM. A preliminary evaluation of the safety and tolerance of medicinally ingested vinegar in individuals with type 2 diabetes. J Med Food. 2008 Mar;11(1):179-83.

Johnston CS, White AM, Kent SM. Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2009 May;84(2):e15-7.
Johnston CS, Steplewska I, Long CA, Harris LN, Ryals RH. Examination of the antiglycemic properties of vinegar in healthy adults. Ann Nutr Metab. 2010;56(1):74-9.

My blogger name is hormonewoman; I chose that for a reason. When hormones get out of balance, and out of balance is where they are when we don't take care of ourselves, that's when chronic diseases like PCOS become common…not to mention troublesome.

A relatively new hormone (well, it's been around as long as there have been humans but it's new as far as us scientists knowing it and understanding it) is adiponectin. This hormone helps to combat heart disease and diabetes. And it is apparently sensitive to the kinds of fats we choose to eat.

A population of mice was divided into four groups, each one receiving one of the four following fats: soybean oil, fish oil, coconut oil, or lard. Their biochemical response was measured after 2 days and 60 days on this diet. With every type of fat, except fish oil, adiponectin levels were reduced. Soybean oil and coconut oil produced the most significant reductions.

We're just not going to get around it, are we? Some kinds of fats just aren't health-friendly. Some food options, just need to be passed by.

Bueno AA, Oyama LM, de Oliveira C, Pisani LP, Ribeiro EB, Silveira VL, Oller do Nascimento CM. Effects of different fatty acids and dietary lipids on adiponectin gene expression in 3T3-L1 cells and C57BL/6J mice adipose tissue. Pflugers Arch. 2008 Jan;455(4):701-9. Epub 2007 Aug 24.

Thanks to all of you who wrote in response to the blog post on heart rate changes for women. When we get questions we know we're being read!

The most frequent question we got was whether or not the target heart rates would change depending on whether or not you are physically conditioned. The answer is no, and here is why.

Your heart is a muscle. Its job is to pump blood through your body. One of the reasons you should exercise is to make that muscle stronger. When your heart is strong, it can pump the same amount of blood with fewer beats. That is why, when you are in good physical shape, your resting heart rate usually drops…because your heart has become more efficient at doing its job.

Simply reducing your heart rate by one beat per minute saves you 525,600 heart beats per year!

Another really good sign that you're in good condition is that after you finish that exercise, your heart rate drops back to resting fairly quickly. In research times, you've improved your recovery rate. When you're out of shape and you start to exercise, you may find that you have an elevated heart rate long after your workout.

So if your heart is able to pump the same amount of blood with fewer beats when it is in good condition, it is going to be more difficult to get it to speed up its pace when you are exercising. The heart rate recommendations stay the same because your physical conditioning make it harder for you to stress your heart muscle.

One way you can challenge your heart is to switch out the kind of exercise you do, to use different muscle groups. Like your heart, other muscles can become accustomed to the workload and not have to work as hard to carry the same load.

The heart rate guidelines are a percentage of the maximum rate your heart rate should ever reach. So if you're having to work harder to max out your heart's capacity…you're in good shape.

The guidelines do NOT tell you what your maximum exercise rate should be. What they do indicate, is that if you are exceeding those guidelines, you're likely not burning fat and finding it harder to lose weight. You're also likely to be gaining weight in the form of muscle, glycogen, and water, to support that intensity of exercise.

You need to decide what your goal is. If you want to build muscle (and that's not a bad thing at all), then work out harder. If you want to burn fat, remember, more is not always better.

And keep that heart muscle pumping!

I've told many a client they're sick and they've been playing catch up since before they were even born. Others feel the same way, too…this was recently published in USA Today:

By Liz Szabo, USA TODAY
Keishawn Williams is already talking to her baby, although her child isn't due until November.

"What are you doing?" asks Williams, 22."Are you awake? Are you asleep? Why are you sitting on my bladder?"

Although Williams may not realize it, her body and baby are also conducting a separate, even more important conversation that may influence her child's health for the rest of its life. Although neither mother nor child is aware of this crucial dialogue, Williams' body already is telling her baby about what to expect from the world outside, says Mark Hanson, a professor at the University of Southampton in England.

And thanks to those biological signals, the choices that Williams makes today — by getting good prenatal care, eating nutrient-packed vegetables and avoiding alcohol, tobacco and caffeine — may help her baby long after birth, Hanson says. Research into the"developmental origins of adult disease" suggests that Williams' healthy living may help her child avoid problems such as cancer, heart disease, depression and diabetes not just in childhood, but 50 years from now.

Though adults still need to eat right and exercise, a growing number of studies now suggest the best time to fight the diseases of aging may be before babies are even born, says Peter Gluckman of the University of Auckland in New Zealand.

Williams' baby is still too young to kick, let alone ponder its future. But its body is already adapting and preparing for its specific environment, Gluckman says, by reading cues sent through Williams' blood and amniotic fluid.

"Every baby in fetal life is adjusting its pattern of development according to the world it predicts it will live in," he says.

Reading cues while in utero

During the crucial"window of opportunity" before birth and during infancy, environmental cues help"program" a person's DNA, says Alexander Jones of Great Ormond Street Hospital in London and the University College of London Institute for Child Health. This happens through a delicate interplay of genes and the environment called epigenetics, which can determine how a baby reacts for the rest of its life, Jones says.

Through epigenetics, chemical groups attach to DNA. Although they don't change the order of the genes, the chemical groups can switch those genes on or off, Jones says.

Many things, such as chemical contaminants, can cause epigenetic changes. So babies exposed in the womb to synthetic hormones may begin responding abnormally to the natural hormones later made by their own bodies, says Hugh Taylor of Yale University School of Medicine.

That's why, doctors believe, many babies exposed before birth to a drug called DES, or diethylstilbestrol, later developed rare cancers or fertility problems, Taylor says.

Doctors stopped prescribing DES, which had been used for decades to prevent miscarriages, in 1971. But Taylor and other scientists are concerned that"hormone-disrupting" chemicals, such as those used in pesticides and even common plastics, could cause similar problems.

Babies and children also can develop abnormal reactions to stress, says Jack Shonkoff of Harvard University, co-author of a June paper on early influences in health in The Journal of the American Medical Association.

In the short term, reacting to typical, everyday difficulties can help people develop a healthy response to stress.

But persistent,"toxic" stress — such as neglect or extreme poverty — may program a child's nervous system to be on perpetual high alert. Over time, this can damage the immune response and lead to chronic ailments, such as heart disease and depression, the study says.

Diet as a predictor

A pregnant woman's diet tells a fetus a lot about its future environment, including how much food will be available after birth, Jones says.

A baby conceived during a famine, for example, might learn to be"thrifty," hoarding every calorie and packing on fat rather than muscle, even at the expense of developing vital organs, such as the kidneys, liver and brain. Because of a lack of calories, the baby also may be born small.

In a famine, those early adjustments and predictions about the future could mean the difference between survival and starvation, Jones says.

But babies may run into trouble if the world doesn't match their predictions, Jones says.

A baby who has learned to hoard calories, for example, may grow up to be fat or diabetic once he or she finally gets enough to eat, Jones says. Doctors believe this occurs not just with babies whose mothers are starving, but with those who are malnourished because of a mother's medical problems, poor nutrition or exposure to tobacco smoke, which damages the placenta.

It's well known, Taylor says, that women who smoke are more likely to have low-birth-weight babies, who are in some ways"starved" for nutrients in the womb. Babies born too small are at risk for many immediate problems, such as underdeveloped lungs and bleeding in the brain.

If they survive, these youngsters also face long-term risks.

Studies show that small babies who gain weight rapidly in infancy or childhood — a sign that bodies are already making the most of every calorie — also have higher rates of adult heart disease and diabetes, Jones says.

Specialized X-rays have shown babies of young mothers with poor diets in India, for example, are born with extra belly fat, even though they seem to be a normal weight. Once these babies start getting an adequate diet, they are likely to put on weight, Gluckman says.

"Even by the time of birth, they're on a different pattern of development," Gluckman says.

Teaching future mothers

Adversity in early life can increase a child's risk of disease, but it doesn't seal his or her fate, Shonkoff says.

Although emotional abuse in childhood increases the risk of adult depression, for example, supportive relationships with adults can help children cope and recover, Shonkoff says.

Communities also can help, Gluckman says. By helping women such as Williams get good prenatal care and nutrition, for example, communities can reduce the number of fetuses who are malnourished and born small, Gluckman says. Babies who are born at normal weight are more likely to maintain that healthy weight.

Because half of pregnancies are unplanned, women need to learn about nutrition — and maintain healthy diets — long before they conceive, Gluckman says.

"We have got to give far greater focus to mothers, the women who are likely to become mothers and to the care of newborn children than we have in the past," Gluckman says.

Williams, who also has a 1-year-old son and 5-year-old daughter, says she's trying hard to give her children a bright future. She breast-fed both and now works as a breast-feeding peer counselor at the Family Health and Birth Center in Washington, D.C., where many patients are low-income or minority mothers.

The birth center also aims to help babies by getting their moms good prenatal care.

About 6% of black mothers who delivered at the birth center had low-birth-weight babies, compared with the citywide average of 14.2% for black mothers, says the center's Ruth Watson Lubic.

"Twentieth-century medicine dealt with child health and adult health separately," Shonkoff says."What 21st-century medicine is telling us is that if we want to change adult health, we have to look in babies, even before they're born."