QUESTION - Is there any evidence that development of diabetes is influenced by either the composition of the diet or levels of physical activity, or by some combination of the two?
ANSWER - That hypothesis was first proposed by Hindu physicians in the 6th century A.D. They suggested that diet, described as "overindulgence in rich food," was related to the onset of diabetes. But the idea has never been confirmed.Studies have failed to find a consistent link between the composition of the diet and diabetes development. In part, this may be explained by the difficulty in obtaining accurate dietary information. Beyond that, unfortunately, many of the studies that have explored the question have failed to take into account the numerous other factors that could explain differences in incidence of diabetes between two populations or within subgroups of the same population.
When it comes to physical activity, the picture is really no less certain, although such a relationship is biologically plausible. It's clear that exercise can modify the body's short-term ability to handle glucose and blood sugar. But there is only sparse and inconsistent evidence that long-term lack of exercise increases the risk of adult-onset diabetes.
There are many reasons to argue both for a prudent diet - rich in complex carbohydrates, low in fat, salt and sugar - and for regular physical activity. But the question of whether both of these measures can help reduce the risk of adult-onset diabetes requires further research.
QUESTION - I suffer terribly from stomach gas shortly after I eat. Are there any dietary steps I can take to help control it?
ANSWER - There are three types of gases in the upper portion of the GI tract. Oxygen and nitrogen come from swallowed air, and carbon dioxide is produced by the interaction of acid and alkaline substances in the stomach. Several simple measures, targeted at reducing both the amount of gas consumed and the amount produced, can help relieve the discomfort associated with stomach gas.
The biggest culprits include large, calorie-laden meals, and fatty foods in particular, since they slow the rate at which foods leave the stomach. Carbonated beverages and chewing gum are also better set aside. Added to its long list of liabilities, smoking is linked to increased air swallowing and gas production. If you're experiencing symptoms commonly referred to as "heartburn," a few specific avoidances might help. Besides fatty foods, they include alcohol, chocolate and pepper.
You might also find some relief by modifying your eating behavior. If you tend to be a rapid eater, slow down. And while it's important to continue to drink plenty of fluids, limit the amount with which you wash down your food.
Medications are sometimes used to reduce carbon dioxide production, but this is something you should talk over with your doctor. In fact, if you have not done so recently, we strongly urge you to discuss with a physician the discomfort you are experiencing.
QUESTION - My daughter joined the high school swim team last semester. When I took her to the doctor, he discovered that she was anemic. I know that anemia is a common problem in women runners. Can the strenuous exercise cause her problem too?
ANSWER - A recently reported small study of swimmers suggests a more direct explanation for your daughter's anemia: low iron intake. Investigators could find no evidence of changes in blood profiles at the end of a season of competition, suggesting that the muscular exercise of swimming does no damage to red blood cells.
However, in that study, not one of the six women involved consumed even as much as 60 percent of the recommended dietary allowances. Some consumed considerably less. Assessment of the relationship between iron intake and menstrual losses in these women indicated that about half of them simply were not taking adequate amounts to offset their losses. Indeed, three other women who began the trial were dropped because their circulating iron levels were low enough that iron supplements were prescribed.
The reasons for the anemia commonly associated with distance running, especially among young women, are not well understood. However, the increased breakdown of red blood cells may be related to the mechanical trauma to the tiny blood vessels, or capillaries, in the feet.