Posts

Calorie Restriction Extends Lifespan

calorie restrictionCalorie restriction (CR) in animals extends longevity by a considerable margin. Both primary and secondary aging processes are decelerated by limiting foods to those that are high in nutrients and relatively low in calories. Studies on humans are only now in progress, while those in animals have been unfolding for a few years. One of the boons of CR is a lowered core body temperature, which is that at which all physiological activity is most efficient. Not only this, but also fat reduction and consequent cardiac health can defer the foibles and imperfections of old age.

Studies at Washington University (St. Louis, MO) and the U. of California at San Francisco, sponsored in part by the Calorie Restriction Society, have found that” (calorie) restriction in animals seems to be the fountain of youth…” Studies on people may or may not yield the same results, primarily because free-living humans are not accepting of the same externally imposed restrictions as are endured by the animals. Human variables that need to be addressed include alterations in cognitions, behaviors, responses to stressors, and effects on other markers of health. However, humans have shown some of the same “…adaptations that are…involved in slowing primary aging in rats and mice.” Most notable here is a reduction in the inflammatory markers known as C-reactive protein and Tumor Necrosis Factor-alpha.

Primary aging is the gradual and inevitable process of physical deterioration that occurs throughout life.  You know, the aches and pains, the slowed movements, the loss of 20-20 vision, decreased resistance to infections, impaired hearing, and the rest of the baggage.  Secondary aging results from diseases and poor health practices (read lifestyle) that include smoking, torpor, booze and obesity, all of which can contribute to diseases in the first place.

Does CR work in people?  Yes, as long as it is reasonable…and that varies from person to person.  Decreasing calorie intake by only a few hundred can make a significant difference in health and longevity by reducing body fat, lowering blood pressure and cholesterol, and avoiding degenerative diseases, such as diabetes and heart disease.  Don’t forget about lowered body temperature, where the Washington University researchers learned that life expectancy was increased in animals. (Soare, 2011)  Of course, we can’t definitely tell how this affects people because we don’t know when each is programmed to die.  It is such, however, that family history of salubrious long life can be predictive of an individual’s longevity.

You might be interested to know that a nutritional supplement demonstrates an effect that mirrors calorie restriction.  We advise that you not yet jump for joy without the realization that this needs to be approached sensibly, which means being attentive to calorie intake. You can’t go wild on doughnuts, white flour bagels, ice cream and other culinary nonsense. You see, the mechanism behind calorie restriction’s success is not completely understood, but it is presumed that a protein called sirtuin is responsible for control of the aging process, and that CR directs the activity of sirtuin. Part of the aging procedure involves cellular stress, particularly in the mitochondria, the power plants of the cell that make energy. If we can slow down oxidation by ramping up the mitochondria’s defense mechanisms and simultaneously inhibiting the attack of reactive oxygen species, then we might be able to stave off the pangs of aging.  How do we do that without restriction of calories?  What supplement is held in such high regard? Resveratrol, the red wine polyphenol!

Independent of each other, Zoltan Ungvari (2009) and Thimmappa Anekonda (2006) discovered that resveratrol may have therapeutic value in the treatment of metabolic and neuronal diseases, based at least partially on the activity of sirtuin.  What is known about resveratrol’s mechanism of action is that it encourages the sirtuin homologue SIRT1 to ply its trade as a cellular regulator, where it slows down metabolism and any stimulatory reactions to environmental toxins, thus placing an organism into a defensive state so it can survive adverse circumstances.  Tobacco smoke-induced oxidative stress even becomes minimized.

We are individuals with different needs and responses to interventions, whether dietary or medical.  You will differ in your response to calorie restriction from your twin. You will differ in your response to resveratrol, if that is the route you choose.  But it seems more than likely you will experience a strengthened immune system, heightened energy, a healthier reproductive system, increased stamina…and looser trousers.

References

Exp Gerontol. 2007 Aug;42(8):709-12. Epub 2007 Mar 31.
Caloric restriction in humans.
Holloszy JO, Fontana L.

Toxicol Pathol. 2009;37(1):47-51. Epub 2008 Dec 15.
Caloric restriction and aging: studies in mice and monkeys.
Anderson RM, Shanmuganayagam D, Weindruch R.

Aging (Albany NY). 2011 Apr;3(4):374-9.
Long-term calorie restriction, but not endurance exercise, lowers core body temperature in humans.
Soare A, Cangemi R, Omodei D, Holloszy JO, Fontana L.

Free Radic Biol Med. 2011 Apr 22. [Epub ahead of print]
The controversial links among calorie restriction, SIRT1, and resveratrol.
Hu Y, Liu J, Wang J, Liu Q.

Am J Physiol Heart Circ Physiol. 2008 Jun;294(6):H2721-35. Epub 2008 Apr 18.
Vasoprotective effects of resveratrol and SIRT1: attenuation of cigarette smoke-induced oxidative stress and proinflammatory phenotypic alterations.
Csiszar A, Labinskyy N, Podlutsky A, Kaminski PM, Wolin MS, Zhang C, Mukhopadhyay P, Pacher P, Hu F, de Cabo R, Ballabh P, Ungvari Z.

Am J Physiol Heart Circ Physiol. 2009 Nov;297(5):H1876-81. Epub 2009 Sep 11.
Resveratrol attenuates mitochondrial oxidative stress in coronary arterial endothelial cells.
Ungvari Z, Labinskyy N, Mukhopadhyay P, Pinto JT, Bagi Z, Ballabh P, Zhang C, Pacher P, Csiszar A.

Brain Res Rev. 2006 Sep;52(2):316-26.
Resveratrol–a boon for treating Alzheimer’s disease?
Anekonda TS.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Do You Want What You Want When You Want It?

cravings2Is it O.K. to talk about addiction in the context of food consumption? Because some people believe that foods high in fats or carbohydrates might be addictive, does it mean that foods should be regarded in the same way as alcohol or cigarettes? Or is there confusion among the terms addiction, craving and eating disorders?

Addiction may be characterized by the compulsion to use a substance, by the uncontrolled consumption of that substance, and by the probability of withdrawal symptoms when access to it is denied or prevented. Binge eaters and those suffering from anorexia or bulimia may display such symptoms, suggesting similarities between the body’s reaction to drug use and compulsive eating. It’s been conjectured that common pathways in the brain are responsible for the pleasures obtained from food intake and drug use. In laboratory studies with rats, for example, it has been demonstrated that repeated, excessive intake of sugar can sensitize brain receptors to dopamine in a manner similar to that of illegal drugs. The dopamine transporter is an important site of action of cocaine and amphetamines, where the reward system gets fired up. So far, every kind of reward studied increases dopamine levels in the brain, all of which are amplified by drugs. Besides the reward system, there are other dopamine systems, including those that concern degenerative conditions such as Parkinson’s disease, and those that deal with chemical messenger activity (Basu, 2000) (Devoino, 1988).

Eating involves more than just the pleasure/reward system. Research has shown neurotransmitter variations to parallel the changes brought about by drugs and the intense desire to eat certain foods (Fallon, 2007). If food cravings are at all significant, it is because they play a role in overeating that may be driven by an increase in serotonin caused by carbohydrate ingestion (Young, 2007).

The criteria for addiction might possibly be met by the morbidly obese, especially if it is realized that even nonpalatable foods become desired and over consumed. In the obese, the number of dopamine receptors appears to be decreased in relation to their body mass indices, leading to overeating in an attempt to turn the reward switch on (Wang, 2001). Not until early in this century was there substantial interest in the functional neuroanatomy of food cravings. Magnetic resonance imaging (MRI) was used to track changes in the brain when thought patterns of test subjects were directed away from a monotonous diet of foods not craved toward a diet of favorite foods. It was discovered that the brain areas involved in drug cravings—the hippocampus, for example—also were stimulated by images of preferred foods, leading researchers to conclude a commonality between food and drug cravings (Pelchat, 2004)  The more intense the mental image, the more intense the desire (Tiggemann, 2005).

Could a nutrient deficiency trigger a food craving? Most of us can tell the difference between a real need for food and the psychological need prompted by the television. Once in a while, a nutrient deficit will cue a craving for a specific food…and it likely won’t go away or be satisfied by a glass of water.

Iron deficiency, often associated with anemia, might induce a condition known as pica, a centuries-old eating disorder satisfied by the ingestion of non-foods, such as dirt. Children, and even pregnant women, in poverty areas have been known to eat the paint from window sills to meet what was at one time an unidentified need. Other serious issues would then surface if the paint contained lead (Kettaneh, 2005). Though most of us would associate menses with iron deficiency as a result of blood flow, pica does not necessarily result. Craving for chocolate, however, does sometimes burgeon, as reported in a 1987 issue of the Journal of the American Dietetic Association (Tomelleri, 987). Giving chocolate the benefit of the doubt, it absolutely does have the fat, sweetness, texture and aroma that make it so appealing to one’s hedonistic side. It has culinary mouth, too, amiably accompanied by copper, magnesium, phosphorus, calcium, sodium and zinc, not to mention the fatty acids akin to the active ingredient in marijuana (Bruinsma, 1999). Admittedly, lots—and we mean lots—of people (of both genders) succumb willingly to the enticement of the chocolate siren, casting discretion to the wind and leaning on her mineral profile as an excuse to indulge.

Few people crave proteins and fats very often. Carbohydrates and sugars steal the show. To control sugar cravings, five minerals have been tagged as instrumental: chromium, magnesium, manganese, zinc and vanadium. Chromium stimulates insulin production and is vital for normal glucose utilization. It also works to metabolize other carbohydrates and fats. Magnesium is plentiful in the food chain, but not in humans, more than eighty percent of whom are deficient. It’s part of more than three hundred enzymes and helps to maintain tissue sensitivity to insulin. Low stores of manganese telegraph as reduced insulin activity and impaired glucose transport. Zinc influences carbohydrate metabolism by increasing insulin response and improving glucose tolerance. It affects basal metabolism rate and improves taste sensitivity. And vanadium mimics the activities of insulin, while inhibiting the storage of excess calories from carbohydrates as fat (Sandstead, 1997).

A study at Louisiana State found that chromium was able to regulate food intake in healthy overweight women who reported carbohydrate cravings (Anton, 2008), which is a common characteristic of those who suffer some forms of depression (Docherty, 2005). The magnesium in chocolate could explain why chocolate may be used as a form of self-medication in nutrient deficiency because, even though cravings may be episodic, they are real (Bruinsma, 1999). Does chocolate, then, satisfy magnesium deficit, or does magnesium satisfy chocolate deficit?

Food cravings are common, frequently for specific foods. Those for carbohydrates are postulated to arise from a physiological need to adjust neurotransmitters. However, sensory factors need to be considered. Whatever the cause might be, nutrient repletion seems to be the answer.

References

Anton SD, Morrison CD, Cefalu WT, Martin CK, Coulon S, Geiselman P, Han H, White CL, Williamson DA.
Effects of chromium picolinate on food intake and satiety.
Diabetes Technol Ther. 2008 Oct;10(5):405-12.

Basu S, Dasgupta PS.
Dopamine, a neurotransmitter, influences the immune system.
J Neuroimmunol. 2000 Jan 24;102(2):113-24.

Berridge KC, Robinson TE.
What is the role of dopamine in reward: hedonic impact, reward learning, or incentive salience?
Brain Res Brain Res Rev. 1998 Dec;28(3):309-69.

Bourre JM.
The role of nutritional factors on the structure and function of the brain: an update on dietary requirements
Rev Neurol (Paris). 2004 Sep;160(8-9):767-92.

Bourre JM.
Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients.
J Nutr Health Aging. 2006 Sep-Oct;10(5):377-85.

Bruinsma K, Taren DL
Chocolate: food or drug?
J Am Diet Assoc. 1999 Oct;99(10):1249-56.

Cefalu WT, Wang ZQ, Zhang XH, Baldor LC, Russell JC.
Oral chromium picolinate improves carbohydrate and lipid metabolism and enhances skeletal muscle Glut-4 translocation in obese, hyperinsulinemic (JCR-LA corpulent) rats.
J Nutr. 2002 Jun;132(6):1107-14.

Devoino L, Alperina E, Idova G.
Dopaminergic stimulation of the immune reaction: interaction of serotoninergic and dopaminergic systems in neuroimmunomodulation.
Int J Neurosci. 1988 Jun;40(3-4):271-88.

Docherty JP, Sack DA, Roffman M, Finch M, Komorowski JR.
A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving.
J Psychiatr Pract. 2005 Sep;11(5):302-14.

Fallon S, Shearman E, Sershen H, Lajtha A.
Food reward-induced neurotransmitter changes in cognitive brain regions.
Neurochem Res. 2007 Oct;32(10):1772-82. Epub 2007 Aug 25.

Harrison R, Rucklidge JJ, Blampied N.
Use of micronutrients attenuates cannabis and nicotine abuse as evidenced from a reversal design: a case study.
J Psychoactive Drugs. 2013 Apr-Jun;45(2):168-78.

Adrien Kettaneh, MD, Virginie Eclache, MD, Olivier Fain, MD, Christelle Sontag, MD, et al
Pica and food craving in patients with iron-deficiency anemia: A case-control study in France
The American Journal of Medicine (2005) 118, 185-188

Khan Y, Tisman G
Pica in iron deficiency: a case series.
J Med Case Reports 2010; 4:86

Macdiarmid JI, Hetherington MM.
Mood modulation by food: an exploration of affect and cravings in ‘chocolate addicts’.
Br J Clin Psychol. 1995 Feb;34 ( Pt 1):129-38.

Morabia A, Fabre J, Chee E, Zeger S, Orsat E, Robert A.
Diet and opiate addiction: a quantitative assessment of the diet of non-institutionalized opiate addicts.
Br J Addict. 1989 Feb;84(2):173-80.

Pelchat ML, Schaefer S.
Dietary monotony and food cravings in young and elderly adults.
Physiol Behav. 2000 Jan;68(3):353-9.

Pelchat ML, Johnson A, Chan R, Valdez J, Ragland JD.
Images of desire: food-craving activation during fMRI.
Neuroimage. 2004 Dec;23(4):1486-93.

Marcia Levin Pelchat
Food Addiction in Humans
J Nutr. 2009 Mar;139(3):620-2.

Sandstead HH, Alcock NW.
Zinc: an essential and unheralded nutrient.
J Lab Clin Med. 1997 Aug;130(2):116-8.

Tiggemann M, Kemps E.
The phenomenology of food cravings: the role of mental imagery.
Appetite. 2005 Dec;45(3):305-13.

Tomelleri R, Grunewald KK.
Menstrual cycle and food cravings in young college women.
J Am Diet Assoc. 1987 Mar;87(3):311-5.

Wang GJ, Volkow ND, Logan J, Pappas NR, Wong CT, Zhu W, Netusil N, Fowler JS.
Brain dopamine and obesity.
Lancet. 2001 Feb 3;357(9253):354-7.

Willner P, Benton D, Brown E, Cheeta S, Davies G, Morgan J, Morgan M.
“Depression” increases “craving” for sweet rewards in animal and human models of depression and craving.
Psychopharmacology (Berl). 1998 Apr;136(3):272-83.

Young SN.
How to increase serotonin in the human brain without drugs.
J Psychiatry Neurosci. 2007 Nov;32(6):394-9.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Holiday Indulgence

christmas-cookiesIt’s typical to drop your guard at holiday time.  Getting caught up in the festivities is probably the biggest excuse to overeat, the definition of which is relative. Generally, it refers to the consumption of an energy intake that is inappropriately large for the amount of energy burned.  Overeating has two categories, both being at least a little influenced by cultural and environmental factors. You can overeat on purpose because you think you’re truly hungry after being exposed to wonderful aromas or you can overeat inadvertently because you failed to pay attention to what and how much was on the plate. Food is more available now than it’s ever been, and marketers are likely to push cheap, energy-dense slop that’s high in fats and sugars, made with simple carbohydrates that’ll spike your insulin in a heartbeat, which can be interrupted if you’re not careful. Sedentary living is part of the total picture, too, as is eating too much of a specific dietary component, such as saturated and trans fats, and refined, simple carbohydrates.  Recently, attention has moved to the glycemic index, a topic to be addressed in a minute. If there are any barriers to changing prevalent overeating, look to corporate ignorance about the effects of energy-dense diets that induce passive, inadvertent overconsumption, to public ignorance about the profound effects of inactivity, and to commercial willfulness about portion sizes and energy density.

The glycemic index (GI) is a ranking of foods based on how they affect blood sugar levels in the two to three hours after eating.  Foods that break down quickly during digestion have the highest glycemic indices. Foods in the high GI category are mostly simple carbohydrates, those you would find in cakes and cookies, and other foods having refined flour, such as crackers and breads. Currently, glucose is used as the barometer, and is given an index rating of 100. White rice, watermelon, baked potatoes, and corn flakes are considered high GI foods. On the opposite side of the coin, most fruits and vegetables, legumes and whole grains, meat, eggs, and nuts are low GI foods. People who pay attention to GI are at reduced risk for Type 2 diabetes and coronary heart disease. (Temelkova-Kurktschiev. 2000)  (Balkau. 1998)

Using the GI, one may calculate glycemic load (GL) by combining the quality and quantity of carbohydrate. Right now it’s the best way to predict blood glucose values of different types and amounts of food.  There is a formula: GL= (GI x available carbohydrate in a food) ÷ 100
This is based on the premise that a high GI food eaten in small amounts would yield the same effect on blood sugar as a low GI food eaten in larger amounts.

Alcohol use or abuse is part of the holiday equation for many people. While it has been suggested that alcohol consumption may lower blood glucose (Salaspuro. 1977)  (Plougman. 2003), starch-based beverages, such as beer, may not, depending on the grain from which it is made. (Joffe. 1982)  A recent study in Boston examined the relationships of alcohol intake, carbohydrate quality (GI), quantity (GL), and incidence of Type 2 diabetes, and reported that alcohol consumption attenuates the concern, though volume is a factor. (Mekary. 2011)  There always has to be a “but,” right?  Here it is. There is a condition called “holiday heart syndrome,” which usually hits heavy drinkers, whether chronic or not. But it can also happen to people who drink very little, where heart rhythm disturbances appear seemingly out of nowhere. To a person with established heart disease, this can be a serious matter. (Menz. 1996) To a seasoned drinker, atrial fibrillation can scare him sober. (Greenspon. 1083)

A diet high in carbohydrates may cause elevated insulin concentrations that raise the risk for breast disease through the stimulation of insulin-like growth factor (IGF), which is part of a complex system that cells use to communicate with their environment. IGF plays a key role in the development of cancers (Figuero.1992) (Lajous. 2008), where it sends mitogenic signals to neoplastic cells and directs them to proliferate. (Friedrich. 2010)  Cows and humans share this hormone, and that makes dairy suspect, as well. Interest in GI and GL was piqued after their role in breast disease in the presence of IGF and elevated insulin levels was suggested.  Italian scientists found that total carbohydrate intake has little association with breast cancer risk, but that high glycemic index and high glycemic load do. (Sieri. 2007) Observational studies in Australia concur with their European counterparts, where investigators at the Human Nutrition Unit of the University of Sydney related low GI and low GL diets to reduced risk of certain chronic diseases, inferring that high postprandial glucose is a mechanism for the progression of disease. (Barclay. 2008)

Minimal carbohydrate consumption, or at least the consumption of complex, high-fiber carbohydrates, has a beneficial effect on health. These foods that take a long time to  digest become nutrition for the cells of the colon and create short-chain fatty acids that ferment to prevent colon diseases. In fact, they’re considered the primary prevention of colorectal cancer.  (Scheppach. 2001)  (Englyst. 2005)

So, then, how do you handle holiday eating? Focusing on the company instead of the food is the first step. When you eat, do it slowly while keeping serving size in check. You might even eat healthy stuff before you go to a party and only sample the less desirable victuals. High GI foods can stiffen arteries for a few hours after eating and render epithelial cells dysfunctional.  Not good.  (Greenfield. 2007)  Avoid the sugar; go for the shrimp.  (http://www.sciencedaily.com/releases/2009/06/090625133215.htm)

References

Balkau B, Shipley M, Jarrett RJ, Pyörälä K, Pyörälä M, Forhan A, Eschwège E.
High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men.
20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study. Diabetes Care. 1998 Mar;21(3):360-7.

Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, Brand-Miller JC.
Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies.
Am J Clin Nutr. 2008 Mar;87(3):627-37.

Barengolts E.
Vitamin D role and use in prediabetes.
Endocr Pract. 2010 May-Jun;16(3):476-85.

Englyst KN, Englyst HN.
Carbohydrate bioavailability.
Br J Nutr. 2005 Jul;94(1):1-11.

Figueroa JA, Yee D.
The insulin-like growth factor binding proteins (IGFBPs) in human breast cancer.
Breast Cancer Res Treat. 1992;22(1):81-90.

Friedrich RE, Hagel C, Bartel-Friedrich S.
Insulin-like growth factor-1 receptor (IGF-1R) in primary and metastatic undifferentiated carcinoma of the head and neck: a possible target of immunotherapy.
Anticancer Res. 2010 May;30(5):1641-3.

Greenfield JR, Samaras K, Chisholm DJ, Campbell LV.
Effect of postprandial insulinemia and insulin resistance on measurement of arterial stiffness (augmentation index).
Int J Cardiol. 2007 Jan 2;114(1):50-6.

Greenspon AJ, Schaal SF.
The “holiday heart”: electrophysiologic studies of alcohol effects in alcoholics.
Ann Intern Med. 1983 Feb;98(2):135-9.

Hofman A, Grobbee DE, Witteman JC.
Impaired fasting glucose is associated with increased arterial stiffness in elderly people without diabetes mellitus: the Rotterdam Study.
van Popele NM, Elizabeth Hak A, Mattace-Raso FU, Bots ML, van der Kuip DA, Reneman RS, Hoeks AP, J Am Geriatr Soc. 2006 Mar;54(3):397-404.

Joffe BI, Shires R, Lamprey JM, Baker SG, Seftel HC.
Effect of drinking bottled beer on plasma insulin and glucose responses in normal subjects.
S Afr Med J. 1982 Jul 17;62(3):95-7.

Lajous M, Boutron-Ruault MC, Fabre A, Clavel-Chapelon F, Romieu I.
Carbohydrate intake, glycemic index, glycemic load, and risk of postmenopausal breast cancer in a prospective study of French women.
Am J Clin Nutr. 2008 May;87(5):1384-91.

Mekary RA, Rimm EB, Giovannucci E, Stampfer MJ, Willett WC, Ludwig DS, Hu FB.
Joint association of glycemic load and alcohol intake with type 2 diabetes incidence in women.
Am J Clin Nutr. 2011 Dec;94(6):1525-32. Epub 2011 Nov 2.

Menz V, Grimm W, Hoffmann J, Maisch B
Alcohol and rhythm disturbance: the holiday heart syndrome.
Herz. 1996 Aug;21(4):227-31.

Nadimi H, Wesamaa H, Janket SJ, Bollu P, Meurman JH.
Are sugar-free confections really beneficial for dental health?
Br Dent J. 2011 Oct 7;211(7):E15.

Nazarian S, St Peter JV, Boston RC, Jones SA, Mariash CN.
Vitamin D3 supplementation improves insulin sensitivity in subjects with impaired fasting glucose.
Transl Res. 2011 Nov;158(5):276-81.

Plougmann S, Hejlesen O, Turner B, Kerr D, Cavan D.
The effect of alcohol on blood glucose in Type 1 diabetes–metabolic modelling and integration in a decision support system.
Int J Med Inform. 2003 Jul;70(2-3):337-44.

Prentice AM.
Overeating: the health risks.
Obes Res. 2001 Nov;9 Suppl 4:234S-238S.

Salaspuro MP, Pikkarainen P, Lindros K.
Ethanol-induced hypoglycaemia in man: its suppression by the alcohol dehydrogenase inhibitor 4-methylpyrazole.
Eur J Clin Invest. 1977 Dec;7(6):487-90.

Scheppach W, Luehrs H, Menzel T.
Beneficial health effects of low-digestible carbohydrate consumption.
Br J Nutr. 2001 Mar;85 Suppl 1:S23-30.

Sieri S, Pala V, Brighenti F, Pellegrini N, Muti P, Micheli A, Evangelista A, Grioni S, Contiero P, Berrino F, Krogh V.
Dietary glycemic index, glycemic load, and the risk of breast cancer in an Italian prospective cohort study.
Am J Clin Nutr. 2007 Oct;86(4):1160-6.

Temelkova-Kurktschiev TS, Koehler C, Henkel E, Leonhardt W, Fuecker K, Hanefeld M.
Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level.
Diabetes Care. 2000 Dec;23(12):1830-4.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.