Study: Does eating white rice raise your risk of diabetes?

This article was originally posted in the Health and Family section of Time.com and is shared below in relation to a previous blog post about the diabetes epidemic in America.
 

When it comes to your risk of diabetes, a new study by Harvard researchers suggests that eating less white rice could make a difference.

Each additional daily serving of white rice, a staple of Asian diets, may increase the risk of Type 2 diabetes by 10%, according to the study, which analyzed the results of four previous studies involving 352,384 participants from four countries: China, Japan, U.S. and Australia. Those who ate the highest amounts of white rice had a 27% higher risk of diabetes than those who ate the least, and the risk was most pronounced in Asian people.

The studies followed people for anywhere from 4 to 22 years, tracking their food intake. All the participants were diabetes-free at the beginning of the study.

Why white rice may impact diabetes risk isn’t clear, but it may have to do with the food’s high score on the glycemic index (GI) — a measurement of how foods affect blood sugar levels — meaning that it can cause spikes in blood sugar. High GI ranking foods have previously been associated with increased risk of diabetes.

“White rice also lacks nutrients like fiber and magnesium,” says study author Qi Sun, a professor of medicine at the Harvard School of Public Health in Boston. “People with high white rice consumption lack these beneficial nutrients and Asian populations consume a lot of white rice. If you consume brown rice instead, you will get these nutrients. There are alternatives.”

But before you swear off white rice for good, the study authors and other nutrition experts caution that it’s not the only culprit in diabetes risk. Rather, a general decrease in physical activity and increase in food consumption may be responsible for the rise in obesity and insulin resistance in Asian countries.

“White rice has long been a part of Asian diets in which diabetes risk was very low,” Dr. David Katz, associate professor of public health at Yale University, told ABC News. “It is white rice plus aspects of modern living — including less physical work — that conspire to elevate the incidence of Type 2 diabetes.”

The authors agree, noting:

…[T]his transition may render Asian populations more susceptible to the adverse effects of high intakes of white rice, as well as other sources of refined carbohydrates such as pastries, white bread, and sugar sweetened beverages. In addition, the dose-response relations indicate that even for Western populations with typically low intake levels, relatively high white rice consumption may still modestly increase risk of diabetes.

Also, according to Sun, white rice is not the only red flag for a diabetes-prone diet. He recommends eating fewer refined carbs overall. “People should try to make a switch from eating refined carbs like white rice and white bread to eating more whole grains. This way, you consume more nutrients and fiber overall.”

For any healthful diet, moderation is key. “I’d tell [patients] what we know for sure,” Keith Ayoob, an associate professor in the department of pediatrics at the Albert Einstein College of Medicine in New York City, also told ABC News. “Take steps to keep from becoming overweight, make physical activity a real priority, include some protein and fiber in each meal and snack, and spread your calories throughout the day.”

The study was published online in the British Medical Journal.

10 Questions To Distinguish Real From Fake Science

This article was originally posted on Forbes and shared on this Mary Szela blog because it is important for consumers to distinguish between actual science and marketing schemes.

Pseudoscience is the shaky foundation of practices–often medically related–that lack a basis in evidence. It’s “fake” science dressed up, sometimes quite carefully, to look like the real thing. If you’re alive, you’ve encountered it, whether it was the guy at the mall trying to sell you Power Balance bracelets, the shampoo commercial promising you that “amino acids” will make your hair shiny, or the peddlers of “ natural remedies” or fad diet plans, who in a classic expansion of a basic tenet of advertising, make you think you have a problem so they can sell you something to solve it.

Pseudosciences are usually pretty easily identified by their emphasis on confirmation over refutation, on physically impossible claims, and on terms charged with emotion or false “sciencey-ness,” which is kind of like “truthiness” minus Stephen Colbert. Sometimes, what peddlers of pseudoscience say may have a kernel of real truth that makes it seem plausible. But even that kernel is typically at most a half truth, and often, it’s that other half they’re leaving out that makes what they’re selling pointless and ineffectual. But some are just nonsense out of the gate. I’d love to have some magic cream that would melt away fat or make wrinkles disappear, but how likely is it that such a thing would be available only via late-night commercials?

What science consumers need is a cheat sheet for people of sound mind to use when considering a product, book, therapy, or remedy. Below are the top-10 questions you should always ask yourself–and answer–before shelling out the benjamins for anything, whether it’s anti-aging cream, a diet fad program, books purporting to tell you secrets your doctor won’t, or jewelry items containing magnets:

1. What is the source? Is the person or entity making the claims someone with genuine expertise in what they’re claiming? Are they hawking on behalf of someone else? Are they part of a distributed marketing scam? Do they use, for example, a Website or magazine or newspaper ad that’s made to look sciencey or newsy when it’s really one giant advertisement meant to make you think it’s journalism?

2. What is the agenda? You must know this to consider any information in context. In a scientific paper, look at the funding sources. If you’re reading a non-scientific anything, remain extremely skeptical. What does the person or entity making the claim get out of it? Does it look like they’re telling you you have something wrong with you that you didn’t even realize existed…and then offering to sell you something to fix it? I’m reminded of the douche solution commercials of my youth in which a young woman confides in her mother that sometimes, she “just doesn’t feel fresh.” Suddenly, millions of women watching that commercial were mentally analyzing their level of freshness “down there” and pondering whether or not to purchase Summer’s Eve.

3. What kind of language does it use? Does it use emotion words or a lot of exclamation points or language that sounds highly technical (amino acids! enzymes! nucleic acids!) or jargon-y but that is really meaningless in the therapeutic or scientific sense? If you’re not sure, take a term and google it, or ask a scientist if you can find one. Sometimes, an amino acid is just an amino acid. Be on the lookout for sciencey-ness. As Albert Einstein once pointed out, if you can’t explain something simply, you don’t understand it well. If peddlers feel that they have to toss in a bunch of jargony science terms to make you think they’re the real thing, they probably don’t know what they’re talking about, either.

4. Does it involve testimonials? If all the person or entity making the claims has to offer is testimonials without any real evidence of effectiveness or need, be very, very suspicious. Anyone–anyone–can write a testimonial and put it on a Website. Example: ”I felt that I knew nothing about science until The Science Consumer blog came along! Now, my brain is packed with science facts, and I’m earning my PhD in aerospace engineering this year! If it could do it for me, The Science Consumer blog can do it for you, too! THANKS, SCIENCE CONSUMER BLOG! –xoxo, Julie C., North Carolina”

5. Are there claims of exclusivity? People have been practicing science and medicine for thousands of years. Millions of people are currently doing it. Typically, new findings arise out of existing knowledge and involve the contributions of many, many people. It’s quite rare–in fact, I can’t think of an example–that a new therapy or intervention is something completely novel without a solid existing scientific background to explain how it works, or that only one person figures it out. It certainly wouldn’t just suddenly appear one night on an infomercial. Also, watch for words like “proprietary” and “secret.” These terms signal that the intervention on offer has likely not been exposed to the light of scientific critique.

6. Is there mention of a conspiracy of any kind? Claims such as, “Doctors don’t want you to know” or “the government has been hiding this information for years,” are extremely dubious. Why wouldn’t the millions of doctors in the world want you to know about something that might improve your health? Doctors aren’t a monolithic entity in an enormous white coat making collective decisions about you any more than the government is some detached nonliving institution making robotic collective decisions. They’re all individuals, and in general, they do want you to know.

7. Does the claim involve multiple unassociated disorders? Does it involve assertions of widespread damage to many body systems (in the case of things like vaccines) or assertions of widespread therapeutic benefit to many body systems or a spectrum of unrelated disorders? Claims, for example, that a specific intervention will cure cancer, allergies, ADHD, and autism (and I am not making that up) are frankly irrational.

8. Is there a money trail or a passionate belief involved? The least likely candidates to benefit fiscally from conclusions about any health issue or intervention are the researchers in the trenches working on the underpinnings of disease (genes, environmental triggers, etc.), doing the basic science. The likeliest candidates to benefit are those who (1) have something patentable on their hands; (2) market “cures” or “therapies”; (3) write books or give paid talks or “consult”; or (4) work as “consultants” who “cure.” That’s not to say that people who benefit fiscally from research or drug development aren’t trustworthy. Should they do it for free? No. But it’s always, always important to follow the money. Another issue that’s arisen around pseudoscience is whether or not a bias of passionate belief is as powerful as fiscal motivation. If you have a bias detector, turn it on to full power when evaluating any scientific claim. If yours is faulty–which you might not realize because of bias–perhaps you can find someone in real life or online with a hypersensitive bias detector. Journalists, by nature of training and their work, often seem to operate theirs on full power.

9. Were real scientific processes involved? Evidence-based interventions generally go through many steps of a scientific process before they come into common use. Going through these steps includes performing basic research using tests in cells and in animals, clinical research with patients/volunteers in several heavily regulated phases, peer-review at each step of the way, and a trail of published research papers. Is there evidence that the product or intervention on offer has been tested scientifically, with results published in scientific journals? Or is it just sciencey-ness espoused by people without benefit of expert review of any kind?

10. Is there expertise? Finally, no matter how much you dislike “experts” or disbelieve the “establishment,” the fact remains that people who have an MD or a science PhD or both after their names have gone to school for 24 years or longer, receiving an in-depth, daily, hourly education in the issues they’re discussing. If they’re specialists in their fields, tack on about five more years. If they’re researchers in their fields, tack on more. They’re not universally blind or stupid or venal or uncaring or in it for the money; in fact, many of them are exactly the opposite. If they’re doing research, usually they’re not Rockefellers. Note that having “PhD” or even “MD” after a name or “Dr” before it doesn’t automatically mean that the degree or the honorific relates to expertise in the subject at hand. I have a PhD in biology. If I wrote a book about chemical engineering and slapped the term PhD on there, that still doesn’t make me an expert in chemical engineering. And I’m just one person with one expert voice in the things I do know well. I recommend listening to more than one expert voice.

There is nothing wrong with healthy skepticism, but there is also nothing wrong in acknowledging that a little knowledge can be a very dangerous thing, that there are really people out there whose in-depth educations and experience better qualify them to address certain issues. However, caveat emptor, as always. Given that even MDs and PhDs can be disposed to acquisitiveness just like those snake-oil salesmen, never forget to look for the money. Always, always follow the money.

There's an app for that: Mary Szela and iPhone prescriptions

As senior vice president of the Global Strategic Marketing and Services division, Mary Szela is central to the promotion of products at Abbott Laboratories. She strategizes sales plans and oversees execution for a range of pharmaceutical products.
 

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Few things have existed for as long as man; medicine is one of them. Throughout the centuries, diseases have become more resilient, but man has responded with vaccines and cures. With medicine’s current résumé, analysts would consider public confidence in the healthcare sector to have peaked— resigning to the system of consulting with doctors and taking their word as law. Technology, however, challenges this reliance.

Smartphones like Apple’s iPhone are thought to be "no work" and "all play" gadgets. The popularity of apps such as Instagram, Angry Birds, Fruit Ninja, and Temple Run do little to support otherwise. Even corporate executives, like Mary Szela, are seldom seen without the latest version of the device. As doctors are no exception to the fad, tech-savvy physicians now utilize the iPhone for professional functions.

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Several apps have been developed to aid practitioners in the healthcare industry. Tools like AirStrip OB and Dr. Rounds help nurses monitor a range of vital information remotely, allowing them to immediately detect any cause for concern. Consequently, apps are also being developed to empower patients. Surescripts and iPrescribe deliver "e-prescription" services, enabling users to conveniently purchase medication with an electronic doctor’s slip. Bolder applications now allow users to self-medicate, matching symptoms against possible diagnoses. Some go as far as suggesting the most suitable medication.

Arguably, technological innovation and medical advancement have worked in tandem for centuries. What is novel about iPhone applications is not that they assist doctors in making health care effective, but that they grant laypeople the power to prescribe.

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Price wars: Mary Szela on surviving in the age of generic equivalents

Produced in compliance with branded standards and made available at a fraction of the cost, generic drugs are quickly becoming the prescription of choice among Americans. Mary Szela, Senior Vice President of Global Strategic Marketing and Services at Abbott Pharmaceutical Products Group, has seen various medication through to the end of their life cycles, where some become pills distributed in packing labeled simply with a common ingredient.

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Over a hundred years ago, then-novice pharmaceutical companies began extensive research to determine the illnesses which needed a more consistently effective remedy. Working in collaboration with medical experts, biomedicine firms developed solutions for a range of ailments. As new diseases were discovered, medication was developed to eliminate their symptoms or manage their side effects. Each medical breakthrough or new drug formula was protected by a patent. The cost of all this research, testing, and development has resulted in the average price consumers pay for branded medication.

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Mary Szela values the investment a brand represents in the pharmaceutical industry. It is a testament to the development efforts made in producing the drug. In essence, consumers are not paying companies to continue providing the medication; they are actually paying the medicine makers back. However, patents only protect medication for a maximum of 20 years, and only in some cases do the makers renew the patent. When a pharmaceutical company opts not to renew a patent, they are essentially allowing the drug to be provided at a lower cost. It may seem like pharmaceutical companies are in competition with generic drug providers but, in fact, companies have already made a return on their investment by the time generic versions of their drug are made.

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Mary Szela: The value of pharmaceutical lifecycle management

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As pharmaceutical companies appear to have become even more challenging during the last decade, industry experts, such as Abbott’s Mary Szela, are likely pushing for the empowerment of lifecycle management as a significant part of overall business strategy.

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Lifecycle management (LCM) is defined as a set of optimization strategies aimed at maximizing the performance of brand assets. The discipline of LCM oversees a product’s market journey, including the speeding time to market, quality standards, and operating and production costs to enable a more sustainable value chain management. The LCM is also designed to fend off competitive market threats and to meet the industry’s revenue growth expectations. The whole spectrum of available LCM options is employed to address key challenges such as lower R&D efficiency, increasing development costs, safety concerns, and tougher business climate.

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Abbott executive Mary Szela would believe that companies applying the LCM discipline need to construct a comprehensive performance management system to determine how their LCM strategies fare in the pharmaceutical industry. Companies need to review their sustainability approaches such as innovation, choice influencing or the use of awareness campaigns, and choice editing or the removal of non-performing goods and services from the marketplace to ensure continuous improvement and above-average business performance.

Mary Szela is the Senior Vice President of the Global Strategic Marketing and Services department at Abbott Laboratories. Read more about her at MarySzela.Livejournal.com.

Death by remedies: Mary Szela on the reckless use of prescription drugs

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In The Imaginary Invalid, Moliere wrote, “nearly all men die of their remedies not of their diseases.” The pill paradox is among those challenging pharmaceutical issues which Mary Szela has likely examined as part of her critical role as Abbott’s Senior Vice President of Global Strategic Marketing and Services - Pharmaceutical Products Group.

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The recent marketing hype on pills, which are said to combat new age diseases linked to modern lifestyle, work, and social environments, has convinced people to believe that better health is within reach through chemistry. In effect, consumers are now pill-popping their way to better health as if taking painkillers and other medications is the only solution available. The pills premised on treating so-called health problems, which aren’t actually a matter of illnesses but of physical imperfections like wrinkles and cellulite, have sparked paranoia on the part of consumers, thereby increasing the likelihood for reckless use of drugs.

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Mary Szela isn’t at all supportive of any forms of sham in the pharmaceutical industry. In full compliance to Abbott’s culture of responsibility and corporate citizenship, she would rather aim for better holistic solutions for advancing health such as educating consumers about everything they need to know about drugs and diseases. An important insight to note is that many ailments labeled as pathological conditions cannot be regarded as true disorders, therefore making the use of pills as unnecessary.

Get to know more about Mary Szela at investing.businessweek.com.

The eyes and ears of society: Mary Szela ponders on consumer activism

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Pharmaceutical executives, like Mary Szela of Abbott, would likely perceive a partnership between consumer activists and marketers as a promising step toward a more responsible and socially conscious consumerism.

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Functioning as watchdogs, consumer activists observe unfair and unhealthy economic activities and make efforts to raise awareness intended for consumer protection. They aim to positively influence buying decision, to supplement government efforts, and to try to curb various trading malpractices by cooperating with market, judicial, and economic-oriented systems. As catalysts of change, they envision a society with an improved quality of life and without the clutter of irresponsible advertisement and marketing pursuits. With their range of extensive demands, consumer activists have become high-profile yet significant figures in this era of affluence and increasing consumerism.

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Socially aware corporate executives like Mary Szela respond to the call of activists by making public relations and social responsibility the core aspects of their business. These executives don’t wait for active consumers to articulate the flaws of their practices. They immediately scrutinize their actions and identify ways to improve their operations as a means to augment advocacy toward a more disciplined economy. They try harder to empower people to instigate changes in their own lives and contribute more for an improved quality of life.

Mary Szela is the SVP of Abbott’s Pharmaceutical Products Group. Learn more about her at Investing.Businessweek.com.