By Mark William Lisky
U.S. health organizations are concerned that our country is in the middle of a diabetes epidemic. This epidemic, experts worry, is not only a health issue, it’s also an economic issue impacting our healthcare system. Exacerbating the diabetes epidemic is the rise of obesity. As levels of obesity increase, so do cases of diabetes. On an optimistic note, both these threats can be contained with a little knowledge, discipline and old-fashioned muscle power.
What is diabetes?
Diabetes is a group of disorders involving elevated blood sugar levels and insulin production. Insulin is a storage hormone vital to regulating cell metabolism. There are two main types of diabetes; Type 1 begins in childhood, accounts for 5 percent of all cases and requires treatments of insulin for life. To date, type 1 is not curable. Type 2 accounts for 90 to 95 percent of all cases, rarely requires insulin treatments and in many cases is preventable and reversible. It’s also the one triggered directly by obesity and physical inactivity.
Complications from type 2 can include coronary artery disease, kidney failure, erectile dysfunction, blindness and stroke. Once a disease of the middle-aged, type 2 is now a kid’s disease, caused mostly by increased rates of childhood obesity. Unfortunately, statistics show that overweight kids have a 70 percent chance of becoming obese adults. This chance increases to 80 percent if one or both parents are overweight or obese.
Type 2 diabetes and obesity
The importance of maintaining proper body weight to prevent type 2 has been noted by the Centers for Disease Control (CDC). Recently, the CDC has started the National Diabetes Prevention Program, which represents a network of lifestyle intervention programs for overweight, and obese people who are at high risk. These interventions include dietary changes, a target loss of 5 to 7 percent body weight and moderate physical activity for at least 150 minutes per week for the participants.
What causes obesity? Removing underlying medical disorders, obesity is eating more food than the body needs for healthy living. Excessive food is converted and stored in fat cells (adipose tissue) as non-essential body fat. Fat storage is under complete control of insulin. Studies show that overweight people who constantly eat large amounts of food with low nutritional value cause their insulin levels to remain in storage mode.
The more obese people get, the more their bodies becomes resistant to insulin. This causes an even a greater production of insulin. This cycle is called insulin resistance. Insulin resistance is recognized as the first step towards developing full-blown type 2 diabetes. The situation is worsened by physical inactivity.
The more obese people get, the more their bodies becomes resistant to insulin. This causes an even a greater production of insulin. This cycle is called insulin resistance. Insulin resistance is recognized as the first step towards developing full-blown type 2 diabetes. The situation is worsened by physical inactivity.
Which foods most affect insulin production and obesity? Over the last few decades, the public’s attention has focused on eating fats as the cause of obesity. However, data strongly suggests that table sugar, high fructose corn syrup, sugary drinks and white foods (bread, pasta and rice.) are the causes. This may account for why we have a fat-free-everything food culture, and yet obesity and diabetes cases have quadrupled over those decades.
According to Dr. Frank V. Porco, MD and Board Certified Fellow of the American College of Physicians, “The evidence now points to the cause of the obesity and diabetes epidemics in the United States as the direct result of the consumption of carbohydrate-rich food and its effect on insulin.” He added, “How much insulin your body produces is directly determined by how many carbohydrates (sugars) you eat, not by the amount of protein or fat. Once you restrict carbohydrates, you will get off the sugar highs and the sugar crashes that leave you fatigued and overweight.”
Why is it difficult to lose body fat? In a prevention program, weight loss means losing stored, nonessential body fat – not overall body mass. An adult doesn’t want to lose muscle mass, bone mass or any healthy cell mass. The problem with losing nonessential body fat is how fat cells react when you reduce them. They don’t want to be reduced. As fat cells get fatter, they reach set points. At these set points, large amounts of a circulating hormone called leptin are released. This tells the brain that the cells are fat and happy.
Leptin is a hormone that, among many functions, regulates hunger and feelings of fullness. As fat cells shrink via diet, leptin levels decrease. This signals the brain to increase hunger because the brain believes the body is starving. So appetite soars, binge eating starts and the 5 pounds of fat that were lost dieting are quickly regained. This is why crash fad diets don’t work.
In addition, when an obese person starts packing on more pounds, leptin levels can spike. Like insulin resistance, this may result in leptin resistance. If this occurs, it takes higher leptin levels to tell the brain that hunger has been satisfied. Consequently, it takes longer before a person feels full. So they keep eating. The good news is research has shown that high leptin levels and spikes are correctable through ‘proper’ dieting and exercise.
Diets: Counting calories may be unnecessary
What’s the best diet to prevent type 2 diabetes? If a person is at risk, successful dieting isn’t just losing 7 percent nonessential body fat. It’s keeping it off for good. Fat cells that were once fat want to be fat again. It’s a part of human evolution. For that reason, the challenge is finding a diet or a lifestyle that works for life.
There are countless diet programs. Most focus on counting and cutting calories by portion control. However for long-term success, counting calories may prove unnecessary. Research is showing that it’s not the amount of calories; it’s the kind. For example, some brands of fat free yogurts remove fat (that does not spike insulin) and replace it with sugars (that drives insulin levels crazy).
With this in mind, attention has been drawn to two diets. The first is the ‘Mediterranean’ diet. This diet is based on research from the ‘60s, focusing on the eating patterns of countries in the Mediterranean. This diet includes high intakes of fresh vegetables, nuts, olive oils, olives, fish, lamb, cheese and lots of wine with some complex breads. Studies show that this diet is very effective for weight loss. Also, this diet has been proven in research to improve the condition of patients with heart disease.
Second is the ‘Paleolithic’ diet. First proposed by Dr. S. Boyd Eaton M.D., this diet is based on what humans ate before the development of agriculture. Data for the diet was provided by research on modern-day hunter-gatherers. Many indigenous people have few, if any, modern medical disorders including diabetes, obesity or heart disease. The ratio between animal calories to plant calories in hunter-gatherer cultures is about 65 percent to 35 percent respectively. The Paleolithic diet emphasizes meats from grass-fed animals or wild game, free range poultry, seasonal fruits, raw nuts, raw seeds and lots of fresh leafy vegetables with no dairy.
Note that these diets are based on natural foods. One food group that’s not natural is trans-fats. These fats are manmade and should be removed from any diet. These diets also eliminate large intakes of high fructose corn syrup. Besides weight gain, data now shows that risk for cardiovascular disease is increased in people consuming 25 percent of their daily calories as fructose or high fructose corn syrup. An important point since 75 percent of all diabetics die from heart disease.
Both of these diets allow a person to eat as much as they want, but of foods that do not spike insulin. By eating until full, leptin levels and appetite may also be suppressed by the brain because it’s registering fullness, not starvation. Following a diet lifestyle that lowers insulin and leptin levels may allow an obese person to eventually reach and maintain a healthy weight body.
Keep moving
What exercise program is best for diabetes prevention? Quoting Dr. Ann Albright, director of the CDC’s Division of Diabetes Translation, “Physical activity is crucial to managing diabetes and reducing serious complications of the disease. Moderate intensity activities such as dancing or brisk walking, for just 150 minutes a week, can significantly improve the health of people with diabetes or at high risk for the disease.”
Along with walking, I believe a strength training program should be included. Strength training helps a person gain lean muscle mass, which is essential for proper metabolism. For a fitness program, people need to “keep it simple.” Go for energetic walks four or five times a week. Get to a gym and lift some weights at least two days a week. The key in using exercise for type 2 diabetes prevention or therapy is starting, being consistent and just keep moving.
Mark William Lisky is a fitness expert and professional speaker. He specializes in fitness for people over 50 and using exercise as preventive medicine. If you have any questions about fitness or you want to start an exercise program, drop in and talk to Mark. He has offices at the New Shrewsbury Racquet Club, Tinton Falls and Bio-Balance Fitness, Rumson or call (732) 933-9070: e-mail mlisky@liskyfitness.com)
