DEAR DR. BLONZ: I am 59 with no family history of diabetes, but was recently diagnosed as having Type 2. I know I have to lose some weight, but am curious about other steps to take. I read your bio online at blonz.com, and it states that you did some research on insulin and obesity. What exactly did you research, and what advice do you have about diabetes? -- F.S., Charlotte, North Carolina

DEAR F.S.: My doctoral research focused on the role of insulin in the development of obesity. I used an animal model that was genetically tweaked to get obese if fed a normal diet. As adults, these animals had an elevated insulin level (hyperinsulinemia) in addition to their obesity; I found that in this specialized animal model, the excess insulin preceded the obesity. Such research helps us better understand the relationships between obesity and insulin, and, by extension, diabetes -- but it won’t help us much in dealing with your particular situation.

During digestion, dietary carbohydrates tend to be broken down into their glucose building blocks. The glucose is then actively absorbed into the blood, at which point it is often referred to as “blood sugar.” Glucose, a key source of energy for the body, travels throughout the body via the blood. To release its energy, however, glucose needs to get into the cells where the work is done, and for this it requires insulin: the hormone produced and released by the pancreas as the blood glucose level rises. Once inside the cells, glucose can be used to provide energy for work, such as muscular efforts or cellular repair. When there is sufficient energy, the glucose gets changed into fat, the body’s most concentrated form of energy. It then gets put away in storage in the body’s fat cells.

Diabetes is present when there’s insufficient insulin to get excess glucose out of the blood and into the cells. Type 1 diabetes is when the pancreas is unable to produce the insulin. In such cases, replacement insulin needs to be provided from an external source, usually via injection. Insulin, a protein, can’t be taken orally because the digestive system would break it down before it could be absorbed. More common is Type 2 diabetes; this occurs when the pancreas is still able to produce and release insulin, but it’s unable to keep up with the demand, and the blood glucose level remains elevated. Treatments in such cases can include diet and lifestyle adjustments, or medications to stimulate the pancreas to release more insulin. Type 2 diabetes used to be known as “adult onset” diabetes because it was only seen in adults; not so anymore.

With weight gain, the fat cells increase in size, and enlarging fat cells are associated with a decreasing sensitivity to insulin. This “insulin resistance” means that the body needs more insulin to clear the same amount of glucose out of the blood. Obesity, in essence, overworks the pancreas, which is eventually unable to keep up. Between 80 and 90 percent of those with Type 2 diabetes are obese. This also helps explain why those with Type 2 diabetes often experience dramatic improvements when they lose a few excess pounds.

As there can be short- and long-term complications when one’s blood glucose remains elevated, the bottom line with any diabetic condition is to keep glucose within normal limits. Your task will be to get this done using diet, exercise, medications and/or insulin injections. I encourage you to speak with your family physician and a registered dietitian (R.D.). They can help you with mapping out strategies for weight loss and food selection. There is also a library of information at the American Diabetes Association (diabetes.org).

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR DR. BLONZ: I wanted some information on the advantages of liquid colloidal mineral supplements. My concerns are about the risk of osteoporosis, which runs in my family, and I would be happy to switch to a product that would be more effective in preventing it. These products are more expensive than the other minerals I take, but the expense would certainly be justified if the product has a higher level of absorption, as is claimed. Is there any substance to these claims? -- B.E., Hayward, California

DEAR B.F.: Colloidal mineral products are not new. There remains a lack of competent, reliable scientific evidence to support any claims that these types of dietary supplement products bring anything special to the table.

A colloid, or colloidal suspension, is a physical state in which solid particles are suspended in a medium, such as a liquid, in a way that the solids do not settle out. The source of colloidal mineral supplements is usually clay or humic shale deposits.

Mineral absorption takes place, for the most part, in the small intestine. Pills, tablets or capsules are designed to dissolve before they reach the absorptive surfaces of the small intestine. The key question is whether, all else being equal, the body will absorb more minerals in the form of a colloidal liquid than it will from a similar amount supplied as a standard pill, powder, tablet or capsule.

Think about what you would accept as proof. Would you want positive statements and testimonials from individuals who want to sell you their products? Or would you demand some form of solid science, such as the publication of unbiased research in a peer-reviewed journal? Hopefully you would opt for the latter. Unfortunately, there is no reliable published evidence to support claims of enhanced bioavailability from minerals in a colloidal form versus similar compounds in more standard supplement forms.

Minerals are all considered inorganic elements because, unlike protein, fat, carbohydrates and vitamins, they do not contain the element carbon. A unique thing about minerals is that they cannot be synthesized or changed by the body. Like vitamins, minerals are only needed in trace amounts, and they don’t provide any calories.

The minerals in our diet are distributed throughout the foods we eat. Calcium, for example, is found in dairy products, a number of green, leafy vegetables and some nuts; magnesium is present in nuts, bananas, legumes and whole grains; and zinc is present in meats, whole grains and seafood. The distribution of the various minerals among the different foods (the same theme holds true for vitamins) is the basis for the advice to focus on variety when it comes to food selection.

Finally, there are proven strategies to help combat the risk of osteoporosis. Check out the articles at tinyurl.com/yda34bj7 and tinyurl.com/yanjrxkc.

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR DR. BLONZ: What are your thoughts about drinking water, or another water-based liquid, in the 30 minutes after eating? In a course taught by a naturopath, it was explained that fluids could dilute or wash away digestive enzymes, limiting their efficiency by decreasing contact between the food and our digestive organs. How would this impact the otherwise healthful practices of having soup or a large salad (both mostly water) with a meal? -- S.T., Casa Grande, Arizona

DEAR S.T.: Mostly fiction here. The digestive enzymes’ primary activities do not take place until the food has left the stomach and begun to travel through the small intestines. Water tends to be rapidly absorbed. The “dilution of digestive enzymes” makes little sense, as enzymes attach themselves to specific parts of a specific food component. The issue here is the number of molecules of enzymes versus the number of molecules of their food-component target. Water is not a target for enzymatic action, so it has no major impact on this.

There might be some issue of water consumption and transient bloating, if excessive amounts of water are consumed while the food remains in the stomach. There also might be a problem for those with gastroesophageal reflux, as the extra volume in the stomach might encourage some sloshing up onto the esophagus while the stomach is doing its thing. Then there is the potential issue of aerophagia, the swallowing of air while one eats or drinks, which subsequently leads to belching -- often confused with indigestion.

Water and water-based foods are fine; in fact, they can contribute to satiety and decrease the total amount of calories consumed. A study in the June 2005 issue of Obesity Research looked at overweight women on a calorie-controlled weight-loss program. It was reported that having a soup with low energy-density at the start of a meal led to more weight loss than consuming the same number of calories in the form of a snack food with high energy-density.

An interesting study in the October 2004 Journal of the American Dietetic Association examined the impact of different types of salads. Researchers provided either no salad, a low energy-dense salad (0.33 kcal per gram), or a high energy-dense salad (1.33 kcal per gram) -- the difference coming from the addition of cheese or a rich salad dressing. These salads were served in either a small portion (150 grams) or a large portion (300 grams). After the mandatory salad course, the subjects consumed as much of the main course (pasta) as they desired. Those having the low energy-dense salad as their first course consumed fewer calories during the entire meal. The small serving of salad reduced energy intakes by 7 percent, and a large serving correlated with a mealtime energy reduction of 12 percent. Of interest, those who consumed a small portion of the high-energy dense salad ended up having 8 percent more calories during the meal, and those with the large portion of this salad had 17 percent more calories.

I shift things around a bit. Fresh greens are a part of my daily diet. My dinner strategy is to have set portions of the main course and any side dishes, and I then “fill up” on salad as my final course. Moving salads to the end of the meal has served me well over the years.

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.