Saturday, September 10, 2016

New Oat Study

A short-interlude from potato-posts for breaking news on oats!

I've been seeing this study from China mentioned several times recently, so I thought I'd take a look at it. Short- and Long-Term Effects of Wholegrain Oat Intake on Weight Management and Glucolipid Metabolism in Overweight Type-2 Diabetics: A Randomized Control Trial (free full text).

Conclusions:

...short- and long-term oat intake had significant effects on controlling hyperglycemia, lowering blood lipid and reducing weight.



The Diet

Three meals a day, totaling 2275kcal (calories) for men and 1890 calories for women. The macro ratio of this diet was 60% carbs, 22% fat, 18% protein with 30g of fiber. Some participants ate a control diet with no oats, some ate a diet where a portion of the grains were replaced with 50g or 100g of oats (1/4 - 1/2 cup).

If any of you track your macros, you'll recognize this as a very low-fat diet.

The Study

298 overweight men and women with Type 2 Diabetes were chosen. They were kept in a hotel for 30 days and fed the various diets. Then they were released to the wild, with instructions to eat certain amounts (0, 50g or 100g) of oats for the next year. Blood labs were sampled throughout the period.

The test subjects were divided in four groups:
  • 59 people in "The Usual Care" group (eating whatever they wanted); 
  • 76 people in "The Healthy Diet" group, eating the low-fat control diet; 
  • 77 subjects in the 50g oat intervention; and 
  • 75 in the 100g oat intervention.
I'm ignoring the 30-day results. 30 days is too short too measure HbA1C and also too short for changes in gut bacteria. However, there were several improvements seen even at 30 days in the oat intervention groups. The more exciting changes were seen after one year.

Some results (from Table 4):
  • All groups lost weight (100g oats group lost the most).
  • All experienced a slight reduction in Body Mass Index (BMI).
  • All groups had decreases in Fasting Blood Glucose (100g oats had biggest reduction).
  • All groups had decreases in 2-hour post-prandial glucose readings (100g oats the most).
  • All groups had decreases in HbA1c (100g oats had the biggest decrease).
  • Most groups showed improvements in cholesterol, no change in triglycerides.


Some of the improvements seen were not drastic, but please consider that these are all overweight Type 2 Diabetics, I assume they are on medications, but this was not mentioned in the paper.

Take-home Message

If you have Type 2 Diabetes, adding a bowl of oatmeal to your daily routine should be quite helpful in maintaining long-term health, however, it will most likely not cure you. Similar for those with high cholesterol.

For everyone else...same thing. Oats have some amazing health properties, many come from the fiber known as β-glucan (beta-glucans). [See previous posts on oats].

If you are not a huge fan of oatmeal, oat bran is possibly even more effective as it has a higher percentage of  β-glucans.

I like to use oat bran in smoothies, and I always add a couple heaping spoonfuls to any regular oatmeal I prepare. When choosing your oat meal, I prefer the steel-cut, thick-cut, or groats. Please stay away from the oatmeal that comes pre-flavored in little packets. While more convenient, the quick, flavored oats are the least nutritious and have tons of additives and artificial flavors/colors. The ingredient list on your oatmeal should read: "Oats."

Thanks for reading.

Later!
Tim 

25 comments:

  1. Tim -

    I'm reading some mind-blowing books. The two books Influence and Pre-suasion by Robert Cialdini and Scott Adam's How to Fail at Amost Everything and Succeed.

    It's still early in my thinking process, but I think there might be additional benefit to your advice.

    Per Adams, dieting is hard. Especially, in my mind, a low fat diet. I go nuts in a few days without enough fat. Lowering cholesterol and improving blood sugars are not well-denied goals, and how to do so is ambiguous. Losing x pounds is a well-defined goal, but you get a reminder every day that you are a failure until you do. It defines you as a failure in your own mind, and that just sucks away the willpower.

    But now take adding a bowl of oatmeal every day. Every time you do, your a winner. You are a healthy eater because you eat healthy things, like oatmeal. Per Cialdini (and maybe Adams too because I haven't finished the book) this is going to prime you to make healthier food choices throughout the day. You want to stay consistent with this personal view. Bang! It's not only oatmeal but a mind hack.

    Here's a blog post by Adams.

    http://blog.dilbert.com/post/147238488266/the-persuasion-diet

    I find especially remarkable his statement that he eats what, when, and as much as he wants because he only wants healthy foods. That's what I experience. Maybe all the fiber I take is relevant mostly for the hypnotic effect! I'm ok with that. When I started this, I had given up all goals. Instead, I just decided to eat more vegetables and a little fiber every day. I redefined myself internally, which led to better choices.

    Oh, and the 50 g vs 100 g difference could be seen as a degree of commitment. A stronger benefit for a stronger commitment.

    Adams says no two systems will be the same. There are a bunch of us that would agree I think. For some, a good start might be a big bowl of oatmeal every day.

    ReplyDelete
    Replies
    1. I think the Chinese study used oat groats which are probably the best way to eat the oats. Oatmeal is steamed first and rollered and dried. So it's half cooked before you buy it. But even though Bob's Red Mill sells oat groats, I have not been able to find any here in the stores. There is one place that sells it downtown and hm, I think I'll order on line. Cooks up like rice but better.

      Delete
    2. I have been buying 15 lb bags of organic oat groats on Amazon and they are fantastic!

      Delete
  2. Now it's oats and potatoes for me, wonder what has happened to my Ketogenic diet that I recently thought made some sense.
    BTW Wilbur, above you referenced book by Robert Cialdini, there are so many with similar titles, which are you referring to, pls?

    ReplyDelete
    Replies
    1. The one I read is Influence:Science and Practice.

      https://www.amazon.com/Influence-Practice-Robert-B-Cialdini/dp/0205609996/ref=sr_1_2?ie=UTF8&qid=1473544241&sr=8-2&keywords=Influence

      I don't know how it differs from the less expensive one. It is oriented towards not being a victim of "compliance experts." I love that term. Pre-suasion is about ethically making a target more receptive to your pitch. It's powerful stuff. I've gotten my daughter to cheerfully clean her room, among other things, and gotten a big discount that I didn't even ask for. It's work for me as I usually go the opposite direction. I approached things completely wrong.

      Delete
    2. Wilbur!

      "I've gotten my daughter to cheerfully clean her room, among other things"

      Now you have my full attention. How?

      Delete
    3. All I said to her was, "Do a job that will make YOU proud."

      No threats. No promises. The two times I've said it, I've actually had to stop her because we ran out of time. Nothing we've said otherwise has ever worked like this.

      This works on my daughter because of her personality. Other kids might differ. When I mentioned what I'd said to my wife, she thought for a moment "that's brilliant!" It's the info in the books, not me.

      Some people are naturally good at this stuff. I'm not. But I'm trying.

      Delete
    4. That's awesome. Take up homeschooling. You're getting the knack for it! (Okay. I need XYZ to happen. How can I reach this child to get them to do XYZ, knowing their personality...)

      Delete
  3. Brewer's yeast is high in beta-glucans too. Don't know if it's the same type or not.

    ReplyDelete
  4. Brewer's yeast is high in beta-glucans too. Don't know if it's the same type or not.

    ReplyDelete
  5. This comment has been removed by the author.

    ReplyDelete
  6. Fungal/yeast beta-glucans are part of their cell walls and are inflammatory to the immune system. Bean glucans are storage polysaccharides and are not inflammatory. The fungal and bean glucans are very different in structure and are digested by different gut microbiota, so could also be considered as prebiotic fibers.

    ReplyDelete
    Replies
    1. That's a really interesting concept. I had not realized that all beta glucans were not created equal.

      Delete
    2. Art, so, edible mushrooms are inflammatory?

      Delete
  7. I could go into all of the gory biochemical detail, which is amazingly cool to me, but wall glucans and storage glucans are unrelated, except for the fact that they are made of long, branched chains of glucose. After all, starch, resistant starch, cellulose and other beta glucans are different polymers/polysaccharides of glucose, and they all have very different properties.

    Inflammation is both a tissue response, i.e. swelling, reddening, warmth and pain, and also a cellular reaction, i.e. turning on sixty genes under control of the NF-kB transcription factor. Adding fungal glucans to cells turns on NF-kB inflammation. Bean glucans do nothing.

    Fungal and bean glucans are also prebiotic fibers and are digested by gut flora. In the process of digestion, some glucan fragments will be exposed to the cells lining the intestines. I expect the fungal glucan fragments will turn on inflammation in some of the intestinal cells, but I expect that it is similar to the routine irritation of the intestines that occurs with wheat gluten fragments. Most people would probably not notice the irritation and it would just add onto the chronic low level inflammation that is common and provides a measure of protection against minor infections. It may shorten life and contribute to autoimmune diseases, but most people would not notice the impact.

    Fungal glucans may contribute to leaky gut, but leaky gut generally means that serum leaks out and very few molecules or bacteria go against the outward flow and reach the blood stream. The immune system is extraordinarily sensitive to bacterial and fungal wall materials, so even a few molecules may contribute to overall responses. So any symptoms from leaky gut reflect very tiny amounts actually coming out of the gut contents.

    ReplyDelete
    Replies
    1. Thank you for this information, Art. It is indeed cool! I wish I understood it better. Based on what you say, considering that I have a healthy gut, it might be a good idea - or a defensible idea - to add a small amount of various mushrooms on a regular basis? As I read things, it helps keep the immune system tuned and trained?

      Delete
  8. Related to inflammation, cholesterol and all that - my mom was recently diagnosed with heart disease, I'd like to help her prevent further damage or reverse damage if possible. Can anyone here recommend (a) reliable, evidence based books on cardio health? (a) a discussion forum where heart patients or people with genetic tendencies discuss protocols, supplements, etc? Thank you.

    ReplyDelete
    Replies
    1. Lynn -

      Sorry to hear about your mom. I know from experience that learning how to deal with CVD is overwhelming and confusing.

      I had symptoms of heart disease. My parents had it. I am now cured. No meds.

      I do not recommend any book. In fact, it is my opinion that trying to follow any particular diet will more likely impede progress.

      I started with vegetables and supplemental inulin. My goal was to feed the gut bacteria. I made sure that I got lots of different types of vegetables and fruits every day. But I think a critical feature is that I allowed myself to eat whatever I wanted otherwise (within reason, of course).

      For evidence on what to do, I did searches on PubMed and read the studies that came up. Search terms include

      Fiber cardiovascular disease
      Antioxidants cardiovascular disease
      Fiber cholesterol

      and so on.

      After a while, i converged on a diet that was at the time not like any I'd seen recommended. It certainly was not one anyone would naturally call heart healthy. My autoimmune issues began to disappear, including symptoms of CVD. It turns out, for example, that I cannot eat a low saturated fat diet. I think that trying to eat a low saturated fat diet before was a big part of my problem.

      Since then, I've learned about Terry Wahls' book. Her "basic" diet is very close to mine (although I put more emphasis on fiber) and she explains the evidence behind it. Her diet was developed for her MS, but she emphasizes that she believes (I do too) all autoimmune diseases, including CVD and MS, are different expressions of a common cause - a defective immune system.

      I'm not a doctor or a scientist. My only source of credibility is my recovery and perfect health. Take this as you will.

      I myself wish that I'd discovered what I know now before my mom died. She was miserable on a heart healthy diet, and it never helped her. I would have told her to eat lots of different types of vegetables (60 different types per week at least), asked her to supplement with inulin, and eat lots of high antioxidant fruits like berries, figs, apricots, prunes, etc. and then I would have told her to otherwise eat what she wants. Want a hamburger? Eat one. Want ice cream? Make SURE it is full-fat! Want nuts? Perfect! And maybe try to get a few more vegetables.

      My mom thought a salad was a vegetable. It's not for my purposes. It's a source of antioxidants, but not of fiber. Beets, carrots, potatoes, broccoli, onions, garlic, collard greens, leeks, celery, child peppers, turnips, beans, lentils, etc. are. Mushrooms count too!

      Good luck!

      Delete
    2. To clarify a little, I meant 60 different types of plant food, including vegetables, fruits, nuts, and seeds. Also spices, especially fresh ground. Try to eat some raw, especially root ones like carrots, beets, and radishes. Raw sauerkraut and its variations, raw pickles, etc.

      If your mom makes a habit of getting her big dose of vegetables first with every meal, she is guaranteed to eat less of anything she might eat that's "bad."

      My parents were always stressed about their diet. Their doctor told them they weren't being strict enough. They were strict. They allowed themselves a cheat meal every few weeks, and felt guilty (stress). Stress is bad too. It is my opinion that food should bring joy, not stress. Stress is bad for the heart too.

      Delete
    3. Lynn, if you haven't already, you may want to check out a couple of Sinatra's heart health books. He's an alternative-minded cardiologist (sounds like an oxymoron) and his books are widely available. I checked them out from the library. He doesn't talk about diet much, if I recall correctly, but has a lot about supplements he uses in his practice.

      I did not find alternative-oriented forums for heart health/heart disease. Maybe I could've looked more, but I looked around some when my husband was diagnosed with heart failure (not due to atherosclerosis/heart disease, so a smaller sub-category yet) and I was appalled at the "don't question your doctor" attitude I kept running into.

      Fwiw, I think my husband's overall health is significantly digestion-related. So if your mom's interested, I'd think a lot of what's discussed here would be helpful and relevant, though she may want to find an alternative-type healthcare provider to help with more specific help for her. I say that, but my husband and I are still on the DIY path for digestion/supplements/like that.

      Best wishes to you. It's quite the jolt, to be dealing with stuff like this.

      -Tanya

      Delete
    4. Wilbur,

      I am curious about you opinion on bread and grains. Do you eat bread and if so what kind?

      Teddy

      Delete
    5. Teddy -

      My opinion is that grains are fine for me today. But soon after I started and my gut began telling me what was good or bad, I could not eat any wheat. It all had a sharp, rancid odor that made it impossible to eat. After several months, I could eat bread made with regular flour, but nothing whole wheat. Anything whole wheat smelled rancid. After yet several more months and to date, I can eat any type of wheat. I have a psychological issue with store breads that have lots of unpronounceable ingredients, but I make my own or buy from good bakers.

      That said, in an average week I might have something like 1/3 lb (dry weight) pasta and one or two hot dog buns.

      I've grown to love collard greens, kale, raab, and brocollini as substitutes for pasta. I'm making red pasta sauce with ground goat and lots of extra garlic. The fam gets it on pasta; I'm putting mine on collard greens.

      Delete
    6. Wilbur,

      I wish my gut talked to me like that. I have long abandoned all packaged products unpronounceable and some pronounceable but suspicious ingredients but everything natural (vegetables, fruits, grains, fish, meat) smells and tastes great. I make sourdough bread or buy Ezekiel bread for my family but do not have any of it myself in case it is one of the culprits for my skin problem.
      I remember reading in one of your comments on FTA that Glucomannan made a big difference in your healing progress. Can you elaborate? I have read and tried so many things with little to no effect. I have my first box of Elixa in the fridge and waiting impatiently to start it in a few days (I need to go back to my normal life after the hurricane evacuaton.)

      Teddy

      Delete
    7. Teddy -

      I like glucomannan. I had hypoglycemia, and it went 100% away when I started taking it. The hypo was maybe 90% gone before it.

      I've been thinking about your wish. I've been reading a lot about persuasion, psychology, neurology, social psychology, moral psychology, negotiation, cognitive biases, and hypnosis. My reading in all of these disciplines suggests to me that there are, in a sense, two diets: one based on intuition (gut feelings) and one based on reason.

      The one based on gut feelings is unconscious. Probably it governs most of the time. It probably depends on the gut microbiome. When it decides to eat something and that something is eaten, the job of the conscious mind is to justify it. In its negative form, "I've been good today, so I deserve this piece of pie." Later, the conscious mind might regret the decision, but that's a different issue. At the moment, the job is justification.

      So when you wish that your gut talked to you - and you are not alone in saying this - it seems to mean really that your gut feelings do not coincide with your reasoning. Back before I started this, I thought saturated fat was bad. I avoided it. This was part of my diet determined by reasoning. But nearly every night, I'd have insane cravings for quesadillas with lots of cheese. This was part of my gut feeling diet. It's only after the fact that I realize I need saturated fats. After bringing them into my diet, I've had no quesadilla binges.

      The "you" below is not you you, but third person you.

      So, there are several issues. Is your gut healthy? Or is it demanding unhealthy things like refined sugar and processed food? If so, maybe fixing the gut is s priority. If it's demanding something healthy, then maybe it's trying to help you. And if you have intense cravings for foods that have X, can't stop eating foods that contain high amounts of X, but yet limit yourself on foods that contain X because you can't control yourself (or even find that supplements of X improve your health) - well, the message seems clear.

      Once I gave into my healthy craving and decided to trust my gut feeling diet, everything fell into place. There is no conflict. There is no guilt. The concept of a cheat day has no meaning. But the consequence is that I eat a diet at odds with what doctors think is healthy. It's my diet, determined by my gut. Apparently, gut microbiomes are like fingerprints - no two are the same. So maybe no diets should be the same.

      Delete
  9. Thank you all for the comments, following up. I've gotten her to start consuming more vegetables and oats and beginning to try other fbers. We have both found we are quite fond now of Asian greens - better than typical American diet greens. It's been driving me nuts that Grace Liu recommended a great forum for cardio patients and for the life of me I cannot find it now. I even sent her a message, but no reply. Assume she is busy. Thanks again.

    ReplyDelete