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What is Diabesity, and how to reverse it

Important Points:

  • Diabesity
  • Type 2 diabetes
  • Insulin resistance
  • Obesity
  • Sedentary lifestyle

What is Diabesity, and how to reverse it

If you are like most people you are probably thinking that I have confused diabetes for diabesity, or you are probably wondering whether I intended to say obesity. You are not so far away from the truth as diabesity is a modern disease that links obesity with type 2 diabetes. Diabesity should be a concern for people with normal blood sugars who may be accustomed to unhealthy eating and lifestyle patterns. It is unfortunate that much is not mentioned about diabesity which can predispose you to severe obesity, diabetes, and other fatal chronic conditions.

What Is Diabesity?

Diabesity is a sequence of events that starts with optimal blood sugar balance, to progressive insulin resistance, to being overweight, then becoming obese, and finally to full-blown Type-2 Diabetes. It comes in a spectrum that includes elevated blood sugar, elevated blood pressure, high cholesterol, and other health complications. These problems stem from diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities. A study published in NCBI in 2013 concluded that “(diabesity) makes a strong call for utilizing indigenous, low-cost means of enhancing healthy dietary and physical activity habits.” Diabesity can also be described as the coexistence of obesity and type 2 diabetes.

What Are The Triggers For Diabesity?

Diabesity occurs following the development of insulin resistance and obesity. When your diet is full of empty calories: quickly absorbed sugars, liquid calories (soda, juice, sports drinks), and refined carbohydrates, you are likely to develop a resistance to insulin. Insulin (produced by beta cells in the pancreas) is the hormone that is responsible for grabbing glucose out of the bloodstream and storing it in cells. This ensures that blood sugar levels remain stable in the blood. When the body starts ignoring the signal sent out by insulin we call this insulin resistance. Beta cells will keep releasing more and more insulin to try to remedy the situation, so a high insulin level is one of the first signs. Unfortunately, the higher your insulin levels are, the worse your insulin resistance becomes. High insulin levels will also cause a spike in appetite which leads to overeating. Very soon you develop weight gain around the belly, more inflammation, oxidative stress, and other effects such as high blood pressure, high cholesterol, low HDL, atherosclerosis, and increased risk of cancer, Alzheimer’s, and depression.

It is important to note here that the root cause of the problem is insulin resistance and not elevated blood sugar. Fortunately, insulin resistance can be reversed since it is strongly linked to poor diet and an unhealthy lifestyle.

Most people can save themselves from diabesity by eliminating the factors that are upending the balance of their biology and replacing them with what’s needed to help the body re-balance itself.

Diabesity and Genetics

Many people believe that insulin resistance and diabesity are genetic conditions that cannot be extraneously controlled. True enough, our genetic predisposition plays a role in the way we choose what to eat and how to live. It also plays a role in the development of insulin resistance. However, insulin resistance and diabesity are greatly influenced by diet and lifestyle, so controlling these factors can greatly minimize your chances of developing the conditions.

How To Reverse Diabesity

Before reversing diabesity, there are a few things you can do to keep safe. They include:

1.   Know the signs of insulin resistance.

One of the first tell-tale signs of insulin resistance is uncontrollable weight gain. You might also experience increased blood pressure and skin discoloration (acanthosis nigricans) on rare occasions. Unfortunately, insulin resistance may go unnoticed for years. Hence, you may be better off having some tests done.

2.  Get the right tests done

You should get tested if you have a positive family history of type 2 diabetes and are affected by a poor diet as well as a sedentary lifestyle. An insulin response test is the best test to tease out the condition.

If you have already been diagnosed with diabesity, here are three things you can do to start your reversal journey.

Make healthy diet choices

This may involve the input of your physician, nutritionist/ dietician, and yourself to come up with the right meal plan. A healthy diet will start with the elimination of sugary and processed foods. Opt for wholesome grains, fresh vegetables and fruits, nuts, white meat, and unsaturated fats instead. You can read more about this type of diet here. (hyperlink to foods that improve insulin sensitivity).

Get adequate rest

Stress is a major contributor to insulin resistance and blood sugar imbalance. Stress also contributes to making unhealthy food choices and overeating. You need to make a conscious effort to de-stress frequently by:

  • Sleeping for at least 7 hours daily
  • Practicing relaxation techniques such as yoga
  • Taking breaks in between work like every two hours
  • Taking sabbaticals and vacationing periodically

Quit a sedentary lifestyle

Modern jobs involve sitting at an office desk and hitting the keypad hours on end. In a world where work is compensated by the hour, it can be difficult to make time for exercise. However, when you consider the negative long-term effects of a sedentary lifestyle you will be forced to reconsider the value of the extra money. What is the point if it’s going to cost your health in the long run? Quitting a sedentary lifestyle involves making deliberate choices about exercise and fitness. This may mean walking at least 30 minutes every day or engaging in more vigorous aerobic exercise 4-6 times a week.

References

1.   Science Daily (2012): Genetic variant is linked to obesity and insulin resistance. Retrieved from https://www.sciencedaily.com/releases/2012/06/120626151107.htm

2.   NCBI (2011): Is fast food addictive? Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21999689

3.   NCBI (2013): Diabesity. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23905459

 

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What Exactly Is Insulin Resistance?

Important Points:

  • Insulin resistance
  • Insulin sensitivity
  • Unhealthy lifestyle
  • Glucose

What Exactly Is Insulin Resistance?

Insulin is a vital hormone that controls the levels of sugar in our bodies. In a nutshell, it removes excess glucose from the blood through a process known as glycogenesis.

However, problems with insulin are at the heart of many medical conditions. Insulin resistance occurs when your cells stop responding to insulin allowing sugar to build up in the bloodstream. About 100 million Americans are affected by insulin resistance. Fortunately, dietary and lifestyle changes can dramatically improve this condition.

This article explains all you need to know about insulin and insulin resistance.

What Is Insulin?

Insulin is a hormone that is produced by beta cells in the pancreas. Its main function is to regulate the amount of glucose circulating in your bloodstream, but it also affects fat and protein metabolism. When you eat a slice of bread, the carbohydrates are broken down into glucose and released into the bloodstream causing your blood sugar to rise. Consequently, your beta cells in your pancreas are stimulated to produce insulin. The insulin is released to your bloodstream where it removes the sugar and stores it in cells. This process reduces the blood sugar levels.

However, cells sometimes become less sensitive to insulin. When this happens, sugar begins to buildup in the bloodstream because the process of removing it is limited. Your pancreas senses an excess of blood sugar and produces even more insulin to lower the blood sugar levels. High insulin levels in your blood is called hyperinsulinemia.

Diabetes type 2 occurs when your cells become increasingly resistant to insulin, resulting in a rise in both insulin and blood sugar levels. If this persists for long, your beta cells may become damaged, leading to decreased insulin production.

Insulin resistance is the main cause of type 2 diabetes.

What About Insulin Sensitivity?

Insulin sensitivity is just the opposite of insulin resistance because insulin sensitivity is beneficial. When you have insulin resistance it also means that you have low insulin sensitivity.

What Causes Insulin Resistance?

Insulin resistance is caused by many factors. A number of studies have shown that high amounts of free fatty acids in your blood as a result of eating too many calories can cause insulin resistance. Being overweight or obese is also linked to insulin resistance as visceral fat that mostly accumulates around your waist can release free fatty acids into your blood and also trigger inflammation. However, even people with moderate weight can develop insulin resistance possibly due to genetic predisposition.

Other possible causes of insulin resistance include:

  • High sugar diet. Even artificial sugars have been linked to inflammation and insulin resistance.
  • Inactivity. Regular physical activity can reduce insulin resistance by stimulating weight loss.
  • Gut microbiota. A disruption in the bacterial environment of your digestive system can cause inflammation and insulin resistance.
  • Genetic factors: African American, Hispanic, and Asian peoples are at higher risk for insulin resistance.

What Are The Complications Of Insulin Resistance?

Insulin resistance is the precursor for diabetes type 2 and metabolic syndrome, a group of risk factors associated with type 2 diabetes and heart disease.

By the time a person is being diagnosed with diabetes type 2, they are likely to have developed chronic insulin resistance. It is estimated that by the time a diagnosis is made, 50% of insulin-producing cells may have lost function. This means that the person is not only resistant to insulin but they are also unable to produce adequate amounts of insulin.

Insulin resistance is also strongly associated with heart disease, which is the leading cause of death in the US. 

Other diseases linked to insulin resistance include:

  • Non-alcoholic fatty liver disease (NAFLD)
  • Cancer
  • Polycystic ovarian syndrome (PCOS)
  • Alzheimer’s disease

How to Reduce Insulin Resistance

Weight loss is one of the most effective ways of reducing insulin resistance. Making drastic dietary changes is also necessary so that you are consuming more of the beneficial foods and less of the harmful ones. Exercise also helps to shed off extra weight and maintain health. Lastly, doing away with harmful habits such as smoking and excessive drinking also plays a significant role.

  • Engage in regular exercise such as brisk walking or jogging for 30 minutes each day.
  • Lose belly fat
  • Stop smoking
  • Reduce intake of artificial sugar such as from artificially sweetened beverages
  • Increase intake of omega-3 fatty acids

For more on improving insulin sensitivity with dietary changes, read our previous article here.

The bottom line

Insulin resistance is responsible for a number of chronic health complications. Often it can go on undetected for a number of years without causing alarm. When insulin resistance is not detected early enough it is likely to wreck a person’s health. Fortunately, a number of things can be done to prevent or stop the progression of insulin resistance, and if insulin resistance can be prevented, we will definitely have millions of people living healthier, more fulfilled lives that are free of disease.

References

1.   NCBI (2005): Dose-response effect of elevated plasma free fatty acid on insulin signaling. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15919784

2.   CDC (2017): New CDC report: More than 100 million Americans have diabetes or prediabetes. Retrieved from https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html

3.   NCBI (2005): Dose-response effect of elevated plasma free fatty acid on insulin signaling. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15919784

4.   NCBI (2013): The Role of Gut Microbiota on Insulin Resistance. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705322/

 

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Unraveling the Metabolic Syndrome

Important Points:

  • Metabolic syndrome
  • Type 2 diabetes
  • Blood sugar
  • Insulin resistance

Unraveling the Metabolic Syndrome

Metabolic syndrome can be defined as a cluster of conditions that increase one’s risk for heart disease and type 2 diabetes. The cardinal signs involved include increased blood pressure, high blood sugar levels (insulin resistance), excess belly fat, high triglyceride levels, and low levels of good cholesterol (HDL). If you have at least three of them – you may already have the condition.

If you have any of the listed symptoms you should not panic as this is not a sure sign that you will develop heart disease or type 2 diabetes; however, it means that you should take caution because you are at a higher risk for developing either or both the diseases. Having more risk factors puts you at a greater risk as well.

Approximately 47 million Americans suffer from metabolic syndrome which translates to a staggering one in six people. There is a genetic link to this syndrome which mostly affects African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age. Fortunately, aggressive lifestyle changes can delay or even prevent serious health problems for those at risk of developing the disease.

What are the Symptoms of Metabolic Syndrome?

Metabolic syndrome is a cluster of conditions that indicate an underlying disease process. Some conditions including elevated triglycerides, high blood sugar, and high blood pressure need to be lab tested which makes it harder to pick up on the symptoms of the syndrome. Generally, a large or increasing waist circumference together with one or two other lab-tested signs may be an indication of the syndrome.

What are the Causes of Metabolic Syndrome?

Metabolic syndrome is closely linked to a sedentary lifestyle defined as sitting or lying down for long hours without expending much energy. When this is combined with an unhealthy diet such as eating processed foods packed with empty calories, chances of developing metabolic syndrome are increased.

Metabolic syndrome is also linked to insulin resistance. When a person has insulin resistance their cells don’t respond normally to the hormone insulin which removes sugar from the blood and stores it in cells. This leads to an increase in blood sugar levels.

Abdominal obesity, having extra fat around the waist, is another risk factor for metabolic syndrome. Lastly, hormonal imbalance and conditions including polycystic ovarian syndrome may also contribute to the development of the metabolic syndrome.

Age and ethnicity are other risk factors as risk increases with age and metabolic syndrome is seen more in certain ethnicities such as Hispanics in the US.

What are the Complications of Metabolic Syndrome?

Having metabolic syndrome can predispose you to the risk of developing:

  • Type 2 diabetes. One of the signs of Metabolic Syndrome is insulin resistance which is a precursor to type 2 diabetes.
  • Heart Disease. High levels of bad cholesterol and high blood pressure due to metabolic syndrome can lead to atherosclerosis. Many times, this eventually leads to heart disease and increased risk for stroke.

How is Metabolic Syndrome Diagnosed?

There are a few signs that may point towards metabolic syndrome. They include:

  • Having a large waist circumference measuring at least 89 centimeters for women and 102 centimeters for men.
  • Having high triglyceride above 150 milligrams per deciliter (mg/dL).
  • Low “good” (HDL) cholesterol levels below 40 mg/dL in men or below 50 mg/dL in women.
  • Having increased blood pressure of 130/85 millimeters of mercury (mm Hg) or higher.
  • Having high blood sugar of 100 mg/dL (5.6 mmol/L) or higher.

How Can You Prevent Metabolic Syndrome

Metabolic syndrome is largely a diet and lifestyle enhanced condition. Making the following lifestyle changes can prevent conditions that cause it:

Regular exercise

Health experts recommend exercising for at least 30 minutes each day. This may include brisk walking, aerobics, or slow jogging. If you are at high risk for heart disease you will need to consult with your physician before you can engage in strenuous physical activity.

Lose Weight

If you have extra weight around the mid-section it may be wise to shed it off. You can achieve this through targeted weight lifting and controlling your calorie intake. Losing 7 to 10 percent of your body weight can reduce insulin resistance and blood pressure and also decrease your risk of diabetes. Avoid embarking on weight loss crush programs as you are bound to rebound and gain more weight than you had previously. Instead, work on a program that allows you to lose weight gradually and sustainably.

Adopt a healthy diet plan

A healthy heart diet should be comprised of:

  • Vegetables
  • Fruits
  • Unsaturated fats
  • Whole grains rich in fiber
  • White meat

You should avoid or limit your intake of the following:

  • Sugar-sweetened beverages
  • Processed foods
  • Red meat
  • Excess alcohol
  • Excess salt
  • Trans fats and saturated fats

Reducing or manage stress

Stress is a big contributor to unhealthy lifestyle patterns. If you are at high risk for developing metabolic syndrome regular distressing may be necessary for you. Exercises such as meditation and yoga can be good ways to help you relax. Listening to classical music, taking up a hobby or traveling for leisure can also be of help. Ultimately, you will need to commit to a healthy lifestyle which will not only lower your risk for metabolic syndrome but also reduce your risk for other chronic conditions such as cancer and osteoporosis.

References

1.   Medscape (2019): Metabolic Syndrome: A Growing Clinical Challenge: Epidemiology. Retrieved from https://www.medscape.org/viewarticle/484166_2

2.   Heart.org: What is Metabolic Syndrome? Retrieved from https://www.heart.org/en/health-topics/metabolic-syndrome

3.   WebMD: What is Metabolic Syndrome? Retrieved from https://www.webmd.com/heart/metabolic-syndrome/metabolic-syndrome-what-is-it#

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The Carnivore Diet: 8 Reasons Why It Works

Important Points:

  • Carnivore Diet
  • Weight Loss
  • Insulin resistance
  • Blood glucose
  • Leaky Gut

 The Carnivore Diet: 8 Reasons Why It Works

The carnivore diet is considered a controversial diet by some, yet its followers expound the immense benefits it brings to their health and wellbeing. What about it makes it work? This article looks at its key components in an attempt to find out why it is effective where some other diets have failed.

What is the Carnivore Diet?

The Carnivore Diet is a restrictive diet that only includes meat, fish, and other animal foods like eggs and certain dairy products. In its strictest forms, it excludes all other foods, including fruits, vegetables, legumes, grains, nuts, and seeds.

Its proponents also recommend eliminating or limiting dairy intake to foods that are low in lactose — a sugar found in milk and dairy products — such as butter and hard cheeses.

The Carnivore Diet stems from the belief that human ancestral populations ate mostly meat and fish and that high-carb diets are to blame for today’s high rates of chronic disease.  Other popular low-carb diets, like the keto and paleo diets, limit but don’t exclude carb intake, but the Carnivore Diet aims for near zero carbs.

Top of Form

Bottom of Form

The Carnivore Diet has been touted to cure the incurable. Health sites like Meatheals.com, World Carnivore Tribe and ZeroCarb are overflowing with tens of thousands of people who have reversed serious health conditions.

It seems almost too good to be true, right?  We will delve into the reasons why the carnivore diet works so well. 

Why does the carnivore diet work?

1. The Carnivore Diet cuts out all added sugar

Sugar is one of the most controversial topics. To sum it up, sugar is bad for you. Here’s why:

  • It can stick to cholesterol particles in a process called glycation which can lead to atherosclerosis and type 2 diabetes.
  • It’s highly glycemic. Sugar spikes insulin and can lead to insulin resistance over time.
  • When metabolized, it produces AGEs which lead to aging, chronic disease and diabetes.
  • Glucose is oxidatively stressful, causes inflammation, and can produce reactive oxygen species. Oxidative stress plays a role in almost every disease.

In a study conducted, it was found that from consuming just 40 grams of added sugar, people had an increase in inflammation, insulin resistance and weight gain.

Glucose is also speculated to feed tumor growth. The Warburg Effect explains that cancer cells depend on glucose to grow. Very unlike normal cells, cancer cells cannot use Ketones.

While glucose is considered to be bad, fructose is considered to be even worse as it goes directly to the liver where it’s converted to fat. It is twenty times more likely to cause fatty liver than glucose alone.A fatty liver can lead directly to insulin resistance.

2. The Carnivore Diet can cure leaky gut

Leaky gut is a condition when the tight junctions of the small intestine open and allow proteins and toxins into the bloodstream.So far, the carnivore diet has been one of the few clinically shown ways to reverse intestinal permeability and the attendant consequences.

How does the carnivore diet cure leaky gut? Three main ways:

  • It reduces inflammation, which reverses gut microbiome imbalances
  • It is the most nutrient rich diet on earth, which heals the gut.
  • It removes foods that pry the tight junctions in the small intestine open like Lectins and Gluten

3. The Carnivore Diet eliminates refined carbohydrates

Carbohydrates are converted to glucose in your body (sugar). Here are some of the negative effects of consuming refined carbs:

  • Because all the fiber has been removed, refined carbs are digested very rapidly and cause major blood sugar spikes. This can lead to insulin resistance over time especially when consumed with fat.
  • Refined carbohydrates also damage the gut. Sugar and carbohydrates are fermented by the gut and colon which can exacerbate GI issues and lead to leaky gut. This is why a well-established treatment for IBS, recommends low carbohydrates to starve your bacteria.
  • Over time, refined carbohydrate consumption has been linked to inflammation and obesity.
  • Refined carbohydrates also increase blood triglyceride levels, which is a risk factor for Type 2 Diabetes and Heart Disease . Fat hanging out in your bloodstream is a sign that something is seriously off.

Eating refined carbs such as pasta are no different than eating straight sugar. Seven ounces of cooked spaghetti has the same amount of sugar as 4 12 oz cans of Pepsi.

4. The Carnivore Diet cuts out most carbohydrates

Carbohydrates range from simple sugars to complex carbohydrates. But even unrefined carbohydrates can be bad for you. Many forms of starch, for example, raise blood sugar as much as eating glucose.

Below are some reasons why cutting out all carbohydrates may be beneficial (yes, even the “healthy ones”):

  • High carbohydrate diets can lead to insulin resistance especially if combined with fat
  • Many whole grains are loaded with anti-nutrients, like lectins
  • Carbohydrates halt fat burning because of the insulin response; the more carbohydrates you eat the less body fat you burn.
  • Getting to < 50g a day allows you to burn fat and enter ketosis. Ketosis has a number of health benefits.
  • All carbohydrates break down into glucose, which can produce some of the negative effects mentioned above: AGEs, glycated LDL particles, insulin resistance, etc.
  • Carbohydrates and fiber are fermented by the gut, which can exacerbate gut issues like IBS

5. The Carnivore Diet is the very effective in reducing insulin resistance

Insulin resistance is related to almost every chronic disease. Though it might not cause all the conditions, its presence exacerbates them. Some of these conditions are: Heart disease, 62% higher cancer mortality, 160% higher gastrointestinal cancer mortality, prostate cancer, Alzheimer’s disease, aging, inflammation from elevated CRP and IL-6, and acne.

The good news is that you can reverse insulin resistance. The carnivore diet is the most effective way to reverse insulin resistance with these actions:

  • Cutting out the highly glycemic carbohydrates powers your body off of ketones and increases insulin sensitivity
  • Cutting out fructose increases insulin sensitivity
  • Certain plant antinutrients like lectins can bind to insulin receptors and make you more insulin resistant
  • Vegetable oils cause insulin resistance
  • Protein is satiating and high protein diets burn body fat, which reduces insulin resistance
  • People generally intermittent fast on the carnivore diet, which increases insulin sensitivity

If you want to live longer, you need to lower fasting insulin levels.

6. Carnivore Diet Increases Natural Saturated Fat Consumption

Despite the prevailing dogma, saturated fats are associated with longevity.

Saturated fats are highly beneficial to health. Your body cannot function without them. Diets high in natural saturated fats are associated with longevity. Hong Kong, for example, consumes more meat per capita than any other nation in the world, but they actually have the world’s longest life expectancy at 84.5 years.

Studies continue to debunk the myth that saturated fat causes heart disease. A review from 2014 looking at 76 studies, found no link at all between saturated fat and heart disease

7. Intermittent Fasting

Intermittent fasting isn’t a pivotal part of the carnivore diet. Nor is it prescribed. But people naturally tend to find themselves eating in a shorter window, which brings tremendous health benefits.

Intermittent fasting is restricting your feeding to a window less than or equal to 8 hours. This is a direct contradiction to what many American’s do today.

Fasting is extremely beneficial. It has been shown to:

  • Reduce inflammation 
  • Increase insulin sensitivity
  • Promote fat loss
  • Increase cognition, memory and focus
  • Increase autophagy, the natural cellular cleansing process
  • Increase BDNF, which upregulates neuronal creation and maintenance
  • Improve immune system
  • Starve bad gut bacteria
  • Improve autoimmune symptoms like RA and Crohn’s

8. The Carnivore Diet puts you into ketosis

Your body can use two types of fuels: glucose (from carbs) and ketones (from fat).

Everybody on the carnivore diet is in ketosis to some extent. When you stop fueling your brain and body with glucose, fat needs to take its place.

Here are some major benefits of going into ketosis:

  1. Upregulates FOXO genes which regulate oxidative stress and insulin sensitivity and influences longevity. 
  2. Ketones improve mood and have antidepressant like effects
  3. BHB reduces oxidative stress in the brain and may be beneficial in preventing neurodegenerative disease
  4. BHB lowers inflammation and blocks NLPR3 inflammasome
  5. Increases endogenous antioxidant production
  6. Ketones improve insulin sensitivity
  7. Increased fat loss while preserving lean muscle mass and performance
  8. Ketones can slow tumor growth by starving them of their preferred fuel, glucose, and lowering IGF-1

9. The Carnivore Diet is Simple

In the complexity of life, food doesn’t need to be complicated. The carnivore diet involves just eating meat, meat, and more meat. This makes it easier to stick to as there are no meal plans and measurements.

The Carnivore diet works…

If you have tried everything to in an attempt to stay in shape and manage any chronic conditions you might have, maybe it’s time you tried the carnivore diet. Its basic mechanisms make sense and are likely to cause some positive effects in your health. If you do have a chronic disease, like diabetes or heart disease, talk to your doctor before trying an extreme diet like this one. Do not follow the carnivore diet if you have any level of kidney disease.

References

  1. Healthline (2019): All You Need to Know About the Carnivore (All-Meat) Diet. Retrieved from

https://www.healthline.com/nutrition/carnivore-diet

  • Every day Health (2018):On the Carnivore Diet, People Are Eating Only Meat: Here’s What to Know. Retrieved from

https://www.everydayhealth.com/diet-nutrition/diet/carnivore-diet-benefits-risks-food-list-more/

  • Carnivore Aurelius (2019): 16 Reasons why the Carnivore Diet Works. Retrieved from
https://carnivoreaurelius.com/carnivore-diet/
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Reversing Diabetes: What Does and Doesn’t Work

Important Points:

  • Type 2 diabetes
  • Insulin resistance
  • Weight loss
  • Diabetes reversal
  • Diabetes remission

Reversing Diabetes: What Does and Doesn’t Work

About 30 million people in the US have diabetes, and of these, about 8 million don’t know that they have it. Early diagnosis of diabetes can help in the treatment and possible reversal of diabetes. But what is diabetes reversal?

Diabetes reversal is similar to long-term diabetes remission. It is not a definite cure for diabetes but a return to normal blood sugar levels without having to take diabetic medication hopefully for a number of years. This can be achieved through a number of factors which we shall discuss below. Before getting there, let’s shed some light on type 2 diabetes.

Diabetes type 2 Reversal

Type 2 Diabetes used to be a disease of the elderly, but with the adoption of a modern lifestyle, even young children are being plagued by this debilitating disease. Genetics and ethnicity play a role in the acquisition of type 2 diabetes, but diet and lifestyle factors are great contributors as well. By controlling the latter, a person predisposed to the disease is able to avoid it in some cases.

Type 2 Diabetes occurs when there is a gradual build-up of insulin resistance. Insulin is the hormone that removes sugar from the bloodstream and stores it in cells. Over time, a person becomes less sensitive to the effects of insulin leading to a buildup of sugar in the blood, beta cells are further stimulated to produce more and more insulin until eventually they are exhausted and depleted.

Reversal of type 2 diabetes targets the restoration of insulin sensitivity and in some cases the regeneration of beta cells such that a person with diabetes reversal should be able to maintain normal blood sugar levels without the use of diabetes medication. Research has shown that weight loss is one of the most effective approaches to achieving diabetes reversal.

Here are four ways to achieve healthy weight loss and diabetes reversal:

1.    Very Low-Calorie Diet

Several studies have looked at the effects of a very low-calorie diet on diabetes. In one study, two people followed a mostly liquid diet of 625-850 calories a day for 2-5 months, followed by a less restricted diet designed to help them keep off the weight they lost. Results showed that a low-calorie diet helps to reduce weight and improve insulin sensitivity. In another study, seven obese patients with type 2 diabetes were put on a very low-calorie diet of 900kcal and 115g of protein. This led to significant improvement in blood sugar control that was mainly attributed to improvements in insulin sensitivity.

Note that these types of diets are extreme. You have to work with a professional who will assess your fitness for undertaking such a drastic approach. Most people who have had success in reversing diabetes with this approach are those who have not had diabetes or a long time; to achieve this, it’s important to start the weight loss journey as soon as possible after you’re diagnosed.

2.    Exercise

Regular exercise is another way of improving diabetes but must be combined with diet and other measures in order to achieve diabetes reversal. Exercise needs commitment and dedication in order to bear fruit.

Regular exercise is associated with decreased demand for insulin as well as increased sensitivity to insulin. A 2015 study published showed that 67% of participants were able to achieve partial remission by taking part in a 6-month diet and exercise regimen. All the study participants were newly diagnosed with type 2 diabetes.

3.    Bariatric Surgery

Bariatric surgery helps one achieve weight loss by reducing their food intake. This, in the long run, has helped type 2 diabetes patients achieve reversal as evidenced by a 2010 study. A 2013 study reported that 24% of participants with type 2 diabetes achieved remission six years after receiving gastric bypass surgery. The study concluded that:

“Bariatric surgery can induce a significant and sustainable remission and improvement of Type 2 diabetes and other metabolic risk factors in severely obese patients. Surgical intervention within 5 years of diagnosis is associated with a high rate of long-term remission.”

Bariatric surgery is suitable only when your BMI is 35 or higher. It works best for people who’ve had diabetes for less than 5 years and are not on insulin. For newly diagnosed type 2 diabetics who are obese, this can be a suitable option to help them reverse diabetes.

4.    Intermittent Fasting

Intermittent means going without any food or drink with calories for a given amount of time. For example, you can restrict your eating to eight hours each day and you starve for the remaining sixteen hours. Caution: you need to consult with your doctor before embarking on a fast, even if it’s partial and for medical reasons.

A small study looked at three men between the ages of 40 and 67 who tried intermittent fasting for approximately 10 months. All were able to stop insulin treatment within a month of the study period. According to the author of the study Jason Fung, this showed that intermittent fasting could be effective in reversing type 2 diabetes. This result should only be used as anecdotal. Larger clinical trials need to be conducted to determine the clear effectiveness of this approach.

What Doesn’t Work?

There is a lot of hype when it comes to diabetes reversal. Shrewd businessmen have tried to exploit vulnerable patients by selling magic pills that they purport to cure diabetes. They come in all forms of preparations such as:

  • Over-the-counter pills
  • Herbs
  • Supplements
  • Alternative medicines
  • Homeopathic products
  • Prescription drugs

If you or a loved one is living with type 2 diabetes, it is important that you consult with your healthcare provider before embarking on any diabetes reversal program. As much as diabetes reversal is achievable, you need to be wary of greedy scammers eager to make a dishonest buck.

References

1.   Healthline: Type 2 Diabetes Statistics and Facts. Retrieved from https://www.healthline.com/health/type-2-diabetes/statistics#1

2.   NCBI (2019): Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/

3.   NCBI (1998): Early and long-term effects of acute caloric deprivation in obese diabetic patients. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/3291612

4.   Diabetes UK: Reversing Type 2 Diabetes. Retrieved from https://www.diabetes.co.uk/reversing-diabetes.html

5.   NCBI (2013): Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24018646

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Metabolic Inflammation: What is it?

Important Points:

  • Insulin resistance
  • Sugar
  • Type 2 Diabetes
  • Glucose

Metabolic Inflammation: What is it?

The modern diet contains a large amount of simple sugars. From bread, to donuts, to carbonated drinks, to chocolate, cookies and candy, everywhere you look, temptation abounds. The potential impact on health of diets rich in free sugars, particularly fructose, is of major concern. Does the sugar we take in have an impact on insulin resistance and obesity?

Sugar and Insulin resistance

Sugar has a bittersweet reputation when it comes to health. It occurs naturally in all foods that contain carbohydrates, such as fruits and vegetables, grains, and dairy. Consuming whole foods that contain natural sugar is safe. Plant foods also have high amounts of fiber, essential minerals, and antioxidants, and dairy foods contain protein and calcium.

Where does the problem with sugar come? – Added sugar, which is usually extracted or synthesized.

There is plenty of evidence to suggest that consuming too much sugar can have a negative effect on our metabolic health. Regular sugar consumption produces a constant release of the hormone insulin. Over a period of time, excess insulin can lead to serious problems, such as the synthesis of triglycerides, insulin resistance, fatty liver disease, type II diabetes, an increase in very low-density lipoprotein (the bad kind of cholesterol), and the accumulation of fat on all tissues.

Added sugar intake may contribute to and certainly does exacerbate insulin resistance. Added sugars cater to particularly energy-hungry but metabolically inefficient cells, including senescent cells, cancerous cells, and even quickly proliferating pathogenic bacteria in the gut.

There are several genetic and lifestyle factors that can contribute to how likely you are to develop insulin resistance. But even if you have a genetic risk, you can help yourself with regular exercise, a balanced diet, avoidance of added dietary sugars, healthy sleep patterns, and stress reduction activities.

 Risk factors for insulin resistance and prediabetes include:

  • Obesity
  • Aging
  • Physical inactivity
  • High cholesterol
  • High blood pressure
  • Sleep disorders or circadian rhythm disruption

It is said that one in three Americans—including half of those age 60 and older— have insulin resistance.

What exactly is Insulin Resistance?

Insulin resistance is when cells in your muscles, body fat, and liver start resisting or ignoring the signal of the hormone insulin when it signals to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates.

How does Insulin Resistance develop?

While genetics, aging, and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even not getting enough sleep.

As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas that are working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease. 

What are the Signs and Symptoms of Insulin Resistance?

Insulin resistance can be triggered by a combination of factors linked to weight, age, and genetics, being sedentary, and smoking.

– Polycystic ovary syndrome (PCOS): Insulin resistance can worsen the symptoms of PCOS, which can include irregular menstrual cycles, infertility, and periods that cause pain.

A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women, 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese or Japanese descent)increases the odds of insulin resistance and metabolic syndrome, a condition linked to insulin resistance.

Additional signs of metabolic syndrome. According to the National Institutes of Health, in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.

  • High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats. 
  • Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.   
  • High blood pressure. Readings of 130/85 mmHg or higher, or taking medication to control high blood pressure
  • High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

Acanthosis nigricans: This skin condition can develop in people with insulin resistance. It involves dark patches forming on the groin, armpits, and the back of the neck.

What health conditions are related to Insulin Resistance?

The most common health condition related to Insulin Resistance is prediabetes and the resultant Type 2 Diabetes. Insulin resistance also doubles your risk for heart attack and stroke and triples the odds that your heart attack or ‘brain attack’ will be deadly.
Insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate, and uterus.This is because the high insulin levels early in insulin resistance seem to fuel the growth of tumors and to suppress the body’s ability to protect itself by killing off malignant cells.

Furthermore, research has found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease.

Can you prevent or reverse insulin resistance?

The good news is that yes, insulin resistance can be prevented and also reversed in some cases. Here is what you can do:

  • Get recommended amounts of physical activity and structured exercise
  • Get adequate sleep
  • eat when the sun is up (we are more insulin resistant at night and after a night of poor sleep, due to disrupted circadian rhythms that help regulate our metabolic state)
  • Reduce stress and therefore stress-related inflammation
  • Maintain a healthy weight
  • Increase your plant fiber intake.

All the above can help improve your insulin sensitivity. It has been shown that combining changes to both diet and exercise has the most impact on insulin sensitivity.

In a fascinating University of New Mexico School of Medicine study, published in the International Journal of Obesity, overweight people who lost 10% of their weight through diet plus exercise saw insulin sensitivity improve by an impressive 80%. Those who lost the same amount of weight through diet alone got a 38% increase. And those who simply got more exercise, but didn’t lose much weight, saw almost no shift in their level of insulin resistance.

Intermittent fasting is another way in which you can reverse your insulin resistance. This is because it gives your body a break from insulin and glucose signaling pathways that promote cell proliferation and inflammation, and may help increase your insulin sensitivity.

What therefore is the relationship between sugar and Insulin Resistance?

There is an association between diets high in sugars (predominantly sucrose) and risk of disease, and experimental studies have shown that high intakes of fructose (over 100 g/d) can reduce insulin sensitivity. The mechanisms for such associations or effects have not been convincingly demonstrated.

References:

  1. NCBI (2016): A review of recent evidence relating to sugars, insulin resistance and diabetes. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/

  • Endocrineweb (2019): Insulin resistance causes and symptoms. Retrieved from

https://www.endocrineweb.com/conditions/type-2-diabetes/insulin-resistance-causes-symptoms

  • Medical News Today (2019):What to know about insulin resistance. Retrieved from

https://www.medicalnewstoday.com/articles/305567.php

  • The Sugar Movement (2016): Sugar vs Fat. Retrieved from

https://thatsugarmovement.com/sugar-vs-fat/

  • Harvard Health Publishing (2017):The sweet danger of sugar. Retrieved from

https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar

  • NCBI (2014): Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835728/

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Understanding the role metabolic inflammation plays in obesity and diabesity

Important Points:

  • Inflammation
  • Obesity
  • Diabesity
  • Insulin resistance
  • Adipose tissue

Understanding the role metabolic inflammation plays in obesity and diabesity

Obesity is a disease that has plagued the modern day man in recent time. Access to highly processed foods and decrease in physical activity are key contributors to this ailment. Researchers are hard at work looking into what other underlying factors lead to obesity, especially given its relationship with the onset of Type 2 Diabetes, Cardiovascular diseases, and liver disease. We will take an in-depth look at metabolic inflammation and its role in the onset of obesity. Let’s dive in.

1. What is Obesity?

Obesity is a state in which there is an over-accumulation of subcutaneous and/or abdominal fat (adipose tissue) characterized by a low grade chronic state of inflammation in which the level of pro inflammatory cytokines are increased.  This adipose tissue is no longer considered inert and mainly devoted to storing energy; it is emerging as an active tissue in the regulation of physiological and pathological processes including immunity and inflammation.

  Weight (Pounds) x 703       OR         Weight (Kilograms) 

 
Height (Inches) x Height (Inches)      Height (Meters) x Height (Meters)  

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, use one of these formulas:

BMI =  

BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity

For most people, BMI provides a reasonable estimate of body fat. Because BMI doesn’t directly measure body fat, some people such as muscular athletes may have a BMI in the obesity category even though they don’t have excess body fat.

2. What is Diabesity?

‘Diabesity’ is the term for diabetes occurring in the context of obesity. This form of obesity-dependent diabetes has emerged as a major public health problem in recent times. Though it is basically explained by insulin resistance and pancreatic beta cell dysfunction, new patterns have evolved to explain these modifications in the context of the modern rates of obesity and diabetes.

3. Is Obesity an Inflammatory Condition?

The connection between obesity and inflammation has been in debate in the recent past. Unbeknownst to many, the link between these conditions was made decades ago. Over a century ago, high doses of a class of anti-inflammatory compounds including aspirin (salicylates) were used to treat Type 2 diabetes. In some cases, the symptoms of diabetes totally disappeared. Unfortunately, this treatment was discontinued due to the serious side effects caused by the high doses of salicylates.

We will now look at the questions of our topic today in-depth; does obesity cause inflammation, or is inflammation caused by something secondary to obesity such as high blood sugar or triglycerides levels? How about diabesity? Does diabesity cause inflammation, or does inflammation cause diabesity? How and why does the body initiate an inflammatory response to diabesity? Let us tackle each item separately.

4. How Does Inflammation Cause Diabesity?

Listed are some lines of evidence that show inflammation directly causes obesity and diabesity.

  • The development of diabesity has been shown to follow inflammation. Raised levels of inflammatory cytokines predict impending weight gain. In a study, infusion of inflammatory cytokines into healthy, normal weight mice caused insulin resistance. This concept is also illustrated by the fact that people with other chronic inflammatory conditions are at higher risk of developing Type2 Diabetes; for example, about one-third of chronic Hepatitis C patients develop Type 2 diabetes, and those with rheumatoid arthritis are also at higher risk.
  • In obesity, inflammation has been noted to start in the fat cells themselves. As fat mass expands, inflammation increases. One explanation may be that dysfunction of the mitochondria (the “power plant” of our cells) caused by obesity puts increased stress on cellular function. Another mechanism may be oxidative stress. As more glucose is delivered to the fat cells, they produce an excess of reactive oxygen species (ROS) which in turn starts an inflammatory cascade within the cell.
  • Inflammation of the fat tissue causes insulin resistance, which is the primary feature of Type 2 diabetes. TNF-α, a cytokine (small protein) released during the inflammatory response and several other proteins involved with inflammation, such as MCP-1 and C-Reactive protein have been repeatedly shown to cause insulin resistance.
  • Inflammation of the brain (specifically the hypothalamus) causes leptin resistance, which often precedes and accompanies insulin resistance and Type 2 diabetes. Leptin is a hormone that regulates appetite and metabolism this through its effect on the hypothalamus. When the hypothalamus becomes resistant to leptin, glucose and fat metabolisms are impaired and weight gain and insulin resistance result.
  • When there is inflammation of the gut, there arises leptin and insulin resistance. This may occur via an increase in lipopolysaccharide (LPS), an endotoxin produced by Gram-negative bacteria in the gut. LPS has been shown to cause inflammation, insulin resistance in the liver, and weight gain.

5. How  does Diabesity Cause Inflammation?

In the past, fat was considered an inactive tissue with no biological action. It wasn’t considered for much other than storing energy. It has now emerged that fat tissue is a metabolically active endocrine organ that secretes hormones and inflammatory cytokines such as IL-6 and TNF-α. This metabolic activity of fat is the key to understanding its role in diabesity.

6. Why would obesity cause inflammation?

The first theory is that obesity-induced inflammation is a protective mechanism that prevents the body from losing mobility or fitness. Fat storage is an anabolic process, which means it builds up the organs and tissues. Inflammation, on the other hand, is a catabolic process which breaks down organs and tissues. It’s possible that the activation of catabolism via inflammation is the body’s attempt to keep weight within acceptable bounds. Evidence that experimentally induced local inflammation in fat tissue improves insulin resistance and causes weight loss supports this theory.

The second theory is that, obesity-induced inflammation is simply a malfunction that was never selected against in human evolution. Obesity and its related disorders have been extremely rare throughout human history, and have only become common in the past 40 years. The surplus of modern, processed foods that accompanies diabesity is also a relatively new phenomenon. It’s possible that the stresses of obesity are similar enough to the stresses of an infection that the body reacts to obesity in the same way it would to an infection: via inflammation. Supporting this theory is evidence that the same intracellular, inflammatory stress pathways are activated in both obesity and infection.

7. Tackling Inflammation in the control of diabesity

We can therefore conclude that inflammation is both the cause and the result of diabesity. Once obesity and/or insulin resistance have been established, each can further stimulate the production of inflammatory cytokines, forming a vicious cycle of inflammation and diabesity.  

Reduction of inflammation is a major key in preventing and treating diabesity. Focusing exclusively on regulating blood sugar and fat hormones without addressing other potential causes of inflammation is bound to produce inferior results.

 

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Metabolic inflammation as a cause of insulin resistance

Important Points:

Metabolic inflammation as a cause of insulin resistance

In previous articles, I have discussed the role of metabolic Inflammation in obesity and diabetes. Today, we will narrow down to the specifics of what insulin resistance is, its effects, and how metabolic inflammation increases the chances of one developing it.  

1. What is Insulin resistance?

Approximately 30% of Americans, and up to 50% in the 60 years and over bracket, have a silent blood sugar problem known as insulin resistance. It begins when cells in your muscles, body fat, and liver repel or ignore the signal sent out by the hormone insulin to take glucose from bloodstream into our cells for breakdown or storage. Glucose, commonly called blood sugar and is the body’s main source of fuel.

Insulin resistance increases the risk for prediabetes, Type 2 diabetes, and a host of other serious health problems, including heart attacks, strokes and cancer.

2. How does Insulin Resistance Develop?

Some factors that determine insulin resistance are aging and ethnicity, but the driving forces seems to be excess body weight, too much belly fat, a lack of exercise, smoking, and even sleep depravity.

As the insulin resistance develops, more insulin is produced by your body as it tries to fight back. After an accumulated period of time, several years even, the beta cells in your pancreas get worn out because of all the extra work and can no longer keep pace with the increased demand for insulin. Then – years after insulin resistance stealthily began – your blood sugar may spike and you may manifest prediabetes or type 2 diabetes. You are also at risk of developing non-alcoholic fatty liver disease (NAFLD), a condition that increases your risk for liver damage and heart disease.

3. What are the Signs and Symptoms of Insulin Resistance?

Insulin resistance does not always manifest to the naked eye but here are other possible signs that are visible:

  • A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women, 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese or Japanese descent) increases the odds of insulin resistance and metabolic syndrome, which is also linked to insulin resistance.
  • Additional signs of metabolic syndrome. According to the National Institutes of Health, in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.
  • High triglycerides. Levels of 150 or higher or taking medication to treat high levels of these blood fats.
  • Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men or taking medication to raise low high-density lipoprotein (HDL) levels.  
  • High blood pressure. Readings of 130/85 mmHg or higher or taking medication to control high blood pressure
  • High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
  • High fasting blood sugar or you’re on medicine to treat high blood sugar. Mildly high blood sugar may be an early sign of diabetes.
  • Dark skin patches. If insulin resistance is severe, you may have visible skin changes including patches of darkened skin on the back of your neck or on your elbows, knees, knuckles or armpits. This discoloration is called acanthosis nigricans.

4. Chronic low-grade inflammation and the development of insulin resistance

As early as 1950’s, a connection between inflammation and insulin resistance seemed to present especially in the obese, but the mechanics of the link were unknown. Recently, this has become clearer. Research has shown an association between the body activating signal pathways for inflammation over and over and a decrease in insulin sensitivity which is a rise in insulin resistance. Elevated levels of many inflammation signaling molecules (cytokines) and the inflammatory marker C-reactive protein (CRP) were found in those with insulin resistance and its symptoms, especially those that were obese.

5. What Health Conditions are Related to Insulin Resistance?

An estimated 87 million American adults have prediabetes; 30-50% will go on to develop full-blown type 2 diabetes., and up to 80% of people with type 2 diabetes have NAFLD. But those aren’t the only threats posed by insulin resistance.

Thanks to years of high insulin levels followed by an onslaught of cell-damaging high blood sugar, people with insulin resistance, prediabetes, and type 2 diabetes are at high risk for cardiovascular disease. Insulin resistance doubles your risk for heart attack and stroke and triples the odds that your heart attack or ‘brain attack’ will be deadly, according to the International Diabetes Federation.

Meanwhile, insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate and uterus. The connection: High insulin levels early in insulin resistance seem to fuel the growth of tumors and to suppress the body’s ability to protect itself by killing off malignant cells.

Research has also found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease

Research has also found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease.

6. Can understanding the causes of Insulin Resistance aid in future preventive approaches?

As obesity-associated chronic low-grade inflammation is responsible for the decrease of insulin sensitivity, so obesity is a major risk factor for insulin resistance and related diseases such as type 2 diabetes mellitus and metabolic syndromes. The state of low-grade inflammation is caused by over-nutrition which leads to lipid accumulation in adipocytes and interferes with insulin signaling and action. This interference only adds to the cascade of errors (pathogenesis) that leads to insulin resistance. It has been suggested that specific factors and signaling pathways are often correlated with each other; therefore, both the accumulation and the interference mentioned should be studied further to fully understand the connection between inflammation and insulin resistance.

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Insulin Resistance and Chronic Pain

Important Points:

  • Fibromyalgia
  • Chronic pain
  • hemoglobin A1c
  • insulin resistance

Insulin Resistance and Chronic Pain

An estimated 10 million adults in the United States live with fibromyalgia — a condition that causes pain throughout the body often to the point where it’s difficult to function. Could the key to understanding and treating fibromyalgia and other chronic pain involve insulin resistance? We will shed some light on current research on this topic.

So, what is Fibromyalgia?

Characterized by chronic and widespread pain, increased sensitivity to pain, and heightened feelings of fatigue, brain fog, etc., fibromyalgia remains poorly understood. The condition is also hard to diagnose, difficult to manage, and diminishes the quality of life for those struggling with it.  It is reported that there’s an estimated global prevalence of 2.7%, with females outnumbering males nearly three to one. In addition, a couple of studies have noted that fibromyalgia seems to be more prevalent among individuals with Type 2 diabetes (T2d) suggesting a link between the two conditions that is worthy of further study. While experts agree that genetics and environmental factors are at play with fibromyalgia, little is known regarding how and why the syndrome develops.

Diagnostic criteria for fibromyalgia comes from the American College of Rheumatology (ACR) guidelines. The Widespread Pain Index measures pain or tenderness felt in the week prior to the appointment in 19 different body regions. The Severity Scale is deduced by the patient’s reporting the severity of symptoms like fatigue and brain fog on a scale from 0 to 3. ACR guidelines combine these two measurements using a rating scale from 0 to 31, and according to them, a score of 13 or higher corresponds to a diagnosis of fibromyalgia.

The global economic impact of FM is enormous. In the United States alone, the healthcare cost is around $100 billion/year and is comparable to reports in European countries. Due to lower pain thresholds, patients with FM also have a higher incidence of symptomatic musculoskeletal and spinal disorders which in themselves contribute to the financial burden of managing this disorder.

Many hypotheses have been advanced to explain the extensive array of symptoms including inherited abnormalities, dysfunction of neurotransmitter pathways such as substance P, immune dysregulation, and several others. Unfortunately, none of these propositions has led to practical advances beyond symptomatic treatment. In fact, recent reviews of FM published in 2016 and 2017 have concluded that there have been no substantive advances in our understanding of this disease.

2.  What are the Similarities Between Fibromyalgia and Insulin Resistance?

Although more recent reviews of fibromyalgia research do not make mention of the purported link between the syndrome and insulin resistance or diabetes, the two conditions affect brain vasculature in strikingly similar ways.

According to Miguel Pappolla, MD, PhD, a professor of neurology at the University of Texas Medical Branch and medical director of St. Michael’s Pain and Spine Clinics in Houston, insulin resistance is known to impair brain microcirculation leading to slowed blood flow and oxygenation (hypo-perfusion) in certain brain regions. “What is very interesting,” he said, “is that patients with fibromyalgia also have hypo-perfusion in several brain areas.” The question remains, however, whether insulin resistance may be behind these similar decreases in blood flow experienced by those with fibromyalgia.

  • Research into these Similarities

To investigate this question, Dr. Pappolla led a retrospective, cross-sectional study, reviewing medical records from 23 patients (21 females, 2 males; 11 White, 8 Hispanic, 4 African American; ages 35 to 60) at St. Michael’s Pain and Spine Clinics.7 All 23 patients met the ACR criteria for diagnosis with fibromyalgia.

As a measure of insulin resistance, the team selected the hemoglobin A1c, in which values between 5.7 and 6.4 define prediabetes and values of 6.5 or more constitute diabetes. They compared the A1cs on record for the 23 patients with fibromyalgia to those of two separate control groups: the non-diabetic subset (1,350 people) from the Framingham Offspring Study characterized by normal glucose tolerance (FOS NGT) and the non-diabetic subset (1,592 people) from the National Health and Nutrition Examination Survey (NHANES).

When the investigators compared the A1c test results of the people with fibromyalgia with those of age-matched controls, they found that the former group had significantly higher levels of hemoglobin A1c than the latter indicating a measure of insulin resistance.

“[People with prediabetes] with slightly elevated A1c values carry a higher risk of developing central (brain) pain, a hallmark of fibromyalgia and other chronic pain disorders,” notes Dr. Pappolla, pointing out that this link between insulin resistance and fibromyalgia has been around for a long time. Surprisingly, this link went unnoticed. “Considering the extensive research on fibromyalgia, we were puzzled that prior studies had overlooked this simple connection,” the first author says.

“The main reason for this oversight is that about half of fibromyalgia patients have A1c values currently considered within the normal range. However, this is the first study to analyze these levels normalized for the person’s age, as optimal A1c levels do vary throughout life,” the researcher continues.

“Adjustment for the patients’ age was critical in highlighting the differences between patients and control subjects,” he explains.

As part of the study, the researchers administered metformin — a drug that people typically take to treat insulin resistance — to the participants with fibromyalgia and muscular or connective tissue pain.

Metformin successfully reduced pain in this cohort, prompting the researchers to suggest that this common drug could be a viable and less expensive treatment option for some people with this chronic pain condition.

“In the [U.S.] alone, the healthcare cost is around $100 billion [per] year; comparable to reports in European countries,” the researchers write in the study paper.

“Earlier studies discovered that insulin resistance causes dysfunction within the brain’s small blood vessels. Since this issue is also present in fibromyalgia, we investigated whether insulin resistance is the missing link in this disorder.”

First author Dr. Miguel Pappolla

“We showed that most — if not all — patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past 2 to 3 months,” Dr. Pappolla adds.

The A1c test is a blood test that allows doctors to measure a person’s blood sugar levels by looking at “hemoglobin A1c,” a blood cell protein that binds to the simple sugar glucose. Doctors use this test to diagnose prediabetes and type 2 diabetes

In order to supplement this finding, the evolution of the pain scores of patients with FM who had had their Insulin Resistance treated pharmacologically was also reviewed. This subgroup of patients reported dramatic improvements of their myofascial pain after treatment with metformin.

  • Do these findings offer hope for the future for Chronic Pain Treatment?

This evidence, although preliminary, suggests a pathogenetic relationship between Fibromyalgia and Insulin Resistance, which may lead to better treatment plans.  Along with this, Metformin, a drug commonly used to treat diabetes patients by targeting insulin resistance, has shown promise with treating pain from fibromyalgia; it may translate not only into a radical paradigm shift for the management of [fibromyalgia] but may also save billions of dollars to healthcare systems around the world.

That said more research is needed to better understand the link between insulin resistance and fibromyalgia and other types of chronic pain.

References:

  1. NCBI (2016): A Correlative Relationship Between Chronic Pain and Insulin Resistance in Zucker Fatty Rats: Role of Downregulation of Insulin Receptors. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/26705975

  • Science Daily (2019): Does insulin resistance cause fibromyalgia? Retrieved from

https://www.sciencedaily.com/releases/2019/05/190507145523.htm

  • MedicalNewsToday (2019):  Fibromyalgia: Is insulin resistance ‘the missing link?’ Retrieved from

https://www.medicalnewstoday.com/articles/325155.php#1

  • Plos One (2019): Is insulin resistance the cause of fibromyalgia? A preliminary report. Retrieved from

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216079

  • Practical Pain Management (2019): Fibromyalgia and Insulin Resistance: Correlational or Causal Relationship? Retrieved from

https://www.practicalpainmanagement.com/pain/myofascial/fibromyalgia-insulin-resistance-correlational-causal-relationship

  • Healthline (2019): Drug Used to Treat Diabetes May Be Effective Against Fibromyalgia. Retrieved from

https://www.healthline.com/health-news/does-insulin-resistance-cause-fibromyalgia

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Foods That Improve Insulin Sensitivity

Important Points:

  • Insulin sensitivity
  • Insulin resistance
  • Fiber
  • Processed foods

Foods That Improve Insulin Sensitivity

Insulin is an essential hormone responsible for regulating levels of blood sugar, and the bodies response to the release of insulin is called insulin sensitivity. When the sensitivity is high, the body will require a small amount of insulin to reduce blood sugar levels. When sensitivity is low, the body may fail to respond to even high levels of insulin, and this labeled as insulin resistance.

Insulin is made by beta cells in the pancreas. When the body’s cells are insulin resistant, they can’t use insulin effectively and the blood sugar level rises as it builds up in the blood. When your pancreas senses high blood sugar, it makes more insulin to overcome the resistance, but this may not improve the situation. Chronic insulin resistance, common in type 2 diabetes, may deplete beta cells in the pancreas. Prolonged high blood sugar can damage nerves and organs, so improving insulin sensitivity to reduce insulin resistance in imperative.

Here are 8 ways to improve insulin sensitivity.

1.   Eat More Soluble Fiber

Eating soluble fiber has many health benefits and has been linked to increased insulin sensitivity

There are two kinds of fiber: soluble and insoluble. Insoluble fiber helps in forming stool that can easily move through the bowels, while soluble fiber plays a huge role in promoting insulin sensitivity, as shown in a study published in NCBI. Another study showed that women who ate more soluble fiber had significantly lower levels of insulin resistance. Soluble fiber promotes the growth of friendly bacteria in your gut which has been linked to decreased insulin resistance.

Foods that are rich in soluble fiber include legumes, oatmeal, flaxseeds, Brussels sprouts, and fruits like oranges.

2.   Eat More Colorful Fruit and Vegetables

Colorful fruits and vegetables are rich in antioxidants which rid the body of free radicals causing harmful inflammation and insulin resistance.

3.   Use Herbs and Spices

A number of spices play a role in promoting insulin sensitivity. They include:

  • Fenugreek seeds have high soluble fiber content. A 2001 study concluded that “fenugreek seeds improves glycemic control and decreases insulin resistance in mild type-2 diabetic patients.”
  • Turmeric containsan active component called curcumin which has strong antioxidant and anti-inflammatory properties, both of which help to reduce insulin resistance.
  • Ginger contains acomponent called gingerol which increases sugar uptake and improves insulin sensitivity.
  • Cinnamon is known for its ability to reduce blood sugar and increase insulin sensitivity.

4.   Drink More Green Tea

Green tea is a choice drink for people with diabetes type 2. Green tea has been linked to increased insulin sensitivity and reduced blood sugar levels. Green tea also has antioxidants that help to fight off free radicals and many other health benefits.

5.   Try Apple Cider Vinegar

Vinegar, a key ingredient in apple cider vinegar, could help increase insulin sensitivity by reducing blood sugar and improving the effectiveness of insulin. Vinegar helps to slow gastric emptying hence allowing time for the body more time to absorb sugar. This gives insulin more time to act. Apple cider vinegar can be added to cold salads or drinks.

6.  Cut Down on Carbs

Carbs are the main stimulus behind high sugar levels and the production of insulin. Carbs release sugar into the bloodstream when they are broken down, and this sugar is an essential source of energy for the body. When the body breaks down carbs into glucose and releases it into the blood, the pancreas releases insulin to move the glucose from the blood into the cells. Consuming excessive carbs could cause insulin resistance because of the excess glucose from those carbs sparks an overproduction of insulin. Reducing your carbohydrate intake could increase insulin sensitivity. There is no need to eliminate carbs as that will cause other problems. Processed carbs that are likely to trigger insulin resistance include white rice, pasta, and white bread.

7.  Avoid Artificial Trans Fats

Trans fats are partially hydrogenated oils that are usually added to processed foods to help them keep for longer and to give them a better taste. Foods that typically contain artificial trans fats include cakes, cookies, pies, doughnuts, and fried fast foods. Artificial trans fats are typically found in more processed foods.  

Trans fats have been shown to cause inflammation and increase the risk of type 2 diabetes. The US Food and Drug Administration (FDA) declared trans fats unsafe to eat in 2018, however, this directive is yet to be implemented by manufacturers. It is up to you the consumer to scrutinize the ingredient list before buying any processed foods.

8.   Reduce Your Intake of Artificial Sugars

Artificial sugars are mostly found in processed foods, and they contain two main types of sugar: high-fructose corn syrup and table sugar known as sucrose. Fructose has been linked to insulin resistance even in people with no diabetes.

Can Supplements Help to Improve Insulin Sensitivity?

The idea of taking natural supplements is a controversial one and may require consultation with your physician. If you have been diagnosed with insulin resistance, you may benefit from taking supplements that increase insulin sensitivity. These include chromium, berberine, and magnesium supplements which are linked to increased insulin sensitivity. Another compound, Resveratrol, found in the skin of red grapes and other berries also appears to increase insulin sensitivity in people with type 2 diabetes.

Since supplements can interact with other medication, it is important to consult your doctor before you start taking them.

References

1.   NCBI (2011): Trans Fatty Acids Induce Vascular Inflammation and Reduce Vascular Nitric Oxide Production in Endothelial Cells. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247279/

2.   NCBI (2013): Adverse metabolic effects of dietary fructose: results from the recent epidemiological, clinical, and mechanistic studies. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23594708

3.   NCBI (2014): The impact of soluble dietary fiber on gastric emptying, postprandial blood glucose and insulin in patients with type 2 diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24901089

4.   NCBI (2013): The Role of Gut Microbiota on Insulin Resistance. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705322/

5.   NCBI (2001): Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11868855

6.   NCBI (2014): Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25168916