Written by Cara Schrager, MPH, RD, CDCES
It is well known that smoking cigarettes causes a multitude of health problems including but not limited to cancer, heart disease, stroke, COPD and diabetes. Studies have shown that cigarette smokers are 30-40% more likely to develop type 2 diabetes than non-cigarette smokers (1). Those who have diabetes and smoke have an elevated risk of heart disease and stroke. Because smoking is a factor in increasing risk for diabetes complications, it is among one of the diabetes ABCs (A1C, Blood Pressure, Cholesterol, Stop Smoking) to prevent diabetes complications.
Nicotine is the chemical in tobacco that is highly addictive and leads to increased heart rate, blood pressure, narrowing of blood vessels, and hardening of arterial walls. Nicotine may impact blood sugar control by elevating blood glucose levels. Research found that nicotine may raise hemoglobin A1C (a 3 month average of blood glucose) up to 34% (2).
E-cigarettes and “vaping” have become very popular over the last decade, targeting young adults and youth. A 2022 study found that those who use cigarettes are 22% more likely to develop prediabetes based on self-report (3). Those who smoke regular cigarettes have a 40% chance of developing prediabetes.
E-cigarettes are often regarded as a healthier choice to regular cigarettes, however they still contain nicotine. Because nicotine raises blood glucose levels, it makes diabetes more difficult to manage. People with diabetes who smoke often need higher doses of insulin to manage their blood glucose levels to target range (3). A study in rats found that a specific diabetes associated gene plays a role in pathways for responsiveness to nicotine and insulin production, leading to higher blood glucose levels by way of the pancreas and increased consumption of nicotine (4).
Whether or not you have diabetes, vaping can increase your risk of developing the disease or make managing the disease more challenging. If you are looking for support to quit smoking check out these resources from the CDC and talk with your doctor about a plan that’s best for you.
What is Metabolic Syndrome?
You may have heard the name but there is often some confusion about what exactly is metabolic syndrome, in fact, keyword research shows over 74,000 Google searches for “metabolic syndrome” in just the past 24 hours. Also called syndrome x, metabolic syndrome is the name for a group of conditions that raise the risk of cardiovascular diseases and diabetes. When an individual has three of the five conditions a diagnosis of metabolic syndrome can be made. According to data from the National Health and Nutrition Examination Survey (NHANES) the prevalence of metabolic syndrome has been on the rise since the early 1990s and by 2012 it’s estimated that more than one-third of US adults met the diagnostic criteria.
The World Health Organization (WHO) defines Metabolic Syndrome diagnosis with any three of the following:
- High blood pressure ( systolic reading of 135 mm Hg over diastolic 85 mm Hg or greater)
- Impaired glucose tolerance (fasting blood glucose of 100 mg/dL or greater)
- High waist circumference (greater than 40 inches in men and 35 inches in women)
- High triglycerides (150 mg/dL or greater)
- Low HDL cholesterol (less than 40 mg/dL in men and 50 mg/dL in women)
3 Ways to Reduce Your Risk
Metabolic syndrome is treated by addressing the conditions that contribute to the diagnosis. Interventions with diet and lifestyle can often help to reverse the conditions that make up metabolic syndrome. For example, a weight loss of as little as 3% can lead to improvements in blood lipids and meeting minimum recommendations for daily exercise can help keep blood pressure in check. If you are looking to reduce your risk, try starting with the three tips below:
1. Know Your Numbers
Being an active participant in your healthcare and knowing where you stand can help you better understand your risk. Blood pressure, fasting glucose and blood lipids are tests that should be done each year at your annual check-up visit. Knowing where you stand now and watching the trends year after year can help you take action sooner if one area starts to creep up.
2. Don’t Ignore Your Weight
A prospective study published in the American Journal of Medicine in 2000 estimated that the average American gains and then maintains about a pound of weight annually. This may not seem clinically significant enough to warrant intervention at an annual check-up visit however year after year of gradual gains can become significant and contribute to the development of metabolic syndrome. Your weight may not fit perfectly within the BMI scale but knowing what’s a healthy range for you and watching your trends is important.
3. Strive For 150
Participating in some form of physical activity is well established in the research to have protective effects against the conditions that contribute to metabolic syndrome including lowering blood pressure, maintaining weight and reducing insulin resistance. Check in to see how close you are getting to meeting the minimum recommendations of 150 minutes of physical activity per week. Already there? See if you can reach 300 minutes a week for additional benefits. For more on the benefits of exercise check out my post on the 2018 Exercise Guidelines from the US Department of Health and Human Services.
Mediterranean-DASH Intervention for Neurodegenerative Delay
Are there choices that you could be making in your diet now that could slow cognitive decline and even reduce your risk of developing Alzheimer’s disease? A growing body of evidence is showing that this might be the case. Researchers from Rush University in Chicago created a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet resulting in the MIND diet or Mediterranean-DASH Intervention for Neurodegenerative Delay.
The study followed over 900 participants ages 58-98 for a period of 4.5 years and in that time researches saw a reduced risk of Alzheimer’s in 53% in those strictly following the diet. Not ready to commit? Even in those participants following the diet only moderately well had a 35% risk reduction.
What’s Included in the Diet?
The MIND diet identifies 15 main components: 10 brain-healthy foods to include and 5 foods to avoid. As you would expect being rooted in the Mediterranean and DASH diets, the MIND diet emphasizes plenty of vegetables, whole grains, and heart-healthy fats. It limits added sugars, refined flours, and saturated fats.
10 Brain-Healthy Foods:
- Leafy greens – 6 servings a week- With at least one additional serving of vegetables a day
- Berries- 2 servings a week
- Beans – 4 servings a week
- Nuts – 5 servings per week
- Whole grains – 3 servings a day
- Fish – once a week
- Poultry -twice a week
- Red wine- one glass a day
5 Foods to Avoid While Following the MIND Diet:
- Red meat – no more than 4 servings a week
- Butter – no more than 1 ½ teaspoons a day
- Pastries and sweets – no more than 5 servings a week
- Fried and fast foods – less than 1 serving a week
- Cheese – less than 1 serving a week
What Can You Do?
My take-home from this? Next time you are working on putting together your weekly shopping list think about these 15 foods. How often are you incorporating the “foods to avoid” and how often do you come close to meeting the recommendations for the “food to include”? If your ready to make some changes, start slow and focus on 1-2 things that you could add. Maybe picking up some frozen berries that you can work on adding to yogurt or oatmeal a couple of mornings a week. Or try my 3 bean turkey chili recipe for a serving of both beans and poultry. Starting slow and picking one or two things to focus on at a time can help ensure you keep up the habit long term and that is likely what is going to make the largest difference.