Personal Health: News and Notes

A low-carb Mediterranean diet is better than a low-fat diet for newly diagnosed diabetics who are trying to get their blood sugar under control without medication, an Italian study has found.

The study followed 215 overweight diabetics from diagnosis until four years later. By then, diabetes drugs were needed by 44 percent of patients on the low-carb Mediterranean diet (less than half their daily calories were from carbohydrates), compared with 70 percent of patients on a low-fat diet (less than 30 percent of their calories were from fat).

One weakness of the study, led by the Second University of Naples, was that the researchers did not verify actual dietary intake - they just asked patients to report what they ate. Still, a low-carb Mediterranean diet can delay the need for diabetes drugs, concluded the study, published last week in the Annals of Internal Medicine.

- Marie McCullough

For certain medical conditions, small health clinics in drugstores and other retail outlets provide economical, good quality care, according to a study in the current issue of the Annals of Internal Medicine.

Researchers at the Rand Corp. and the University of Pittsburgh compared the cost and quality of care at so-called retail clinics, doctors' offices, urgent care clinics, and emergency rooms. The study analyzed just three areas: ear infections, sore throats, and urinary tract infections.

The 2,100 patients treated at retail clinics - 700 for each of the three conditions - were compared with people who sought care from the other types of providers.

Retail clinics cost an average of $110 per visit, while doctors' offices cost $166, urgent care centers charged $156, and hospital ERs charged $570. Quality indicators, such as appropriate use of antibiotics, were about the same regardless of the site.

The study was financed by the California HealthCare Foundation.
- Josh Goldstein

Doctors often recommend a high-fiber diet to keep the body's digestive plumbing working well. But when it comes to easing a condition called irritable bowel syndrome, all types of fiber may not be alike.

In a new study of 275 patients with that condition, daily consumption of a water-soluble fiber called psyllium was more helpful than bran (an insoluble fiber) or a placebo made with rice flour.

Psyllium, a plant grown mostly outside the United States, is contained in some cereals and fiber supplements. Patients were given 10 grams daily for 12 weeks. Those who took psyllium reported an average 90-point drop on a 500-point severity scale of symptoms such as abdominal pain and constipation. That compared with a 49-point drop for those on the placebo and a 58-point decline on bran. There was no difference in the patients' evaluations of quality of life, however.

Some previous evidence suggests that insoluble fiber may even worsen irritable bowel symptoms.

The study in bmj.com, the online edition of the British Medical Journal, was funded by the Netherlands Organisation for Health Research and Development. Irritable bowel syndrome is thought to affect 10 percent of the population.

- Tom Avril

Even without cutting back on doughnuts, a few good treadmill sessions can help obese teens stave off early symptoms of type 2 diabetes, according to a new study.

It was well known that changes in diet and exercise can often prevent type 2 diabetes, which is tied to obesity and is on the rise among adolescents. But no one had studied exercise alone, said lead researcher Agneta Sunehag of the Baylor College of Medicine.

So she and her colleagues recruited 14 normal teens and 15 obese teens and put them on treadmills, elliptical trainers or bicycles. The obese teens already showed signs of what's called insulin resistance - a condition in which the body makes enough insulin but cells don't react to it normally. That can lead to high blood sugar and eventually full-blown type 2 diabetes.

After 12 weeks on an exercise program, both the obese and normal teens improved their insulin sensitivity. They also improved cardiovascular fitness.

- Faye Flam