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ONE IN FOUR AMERICANS HAS INSULIN RESISTANCE;
Hypoglycemia, Type II Diabetes, Heart Disease and Diet 

THE HIDDEN HEALTH PROBLEM
* Do you have trouble losing weight when that didn’t used to be a problem?
* Has your blood pressure, cholesterol and blood triglycerides started to creep up?
* Has that tummy started to expand despite no changes in your lifestyle, or even with reducing fat in your diet?
* Is there a growing tiredness and sluggishness?
* Are you having hypoglycemia (low blood sugar) symptoms before meals like mood swings, sweet and food cravings, nervousness, faintness or confusion?
* Did you suffer from gestational diabetes (diabetes during pregnancy)?
* Are you having increased problems with memory as you age?
* Have you and your peers started saying that old refrain “I guess I’m just getting older?” 

It is true that these problems can all be associated with growing older but they are not the result of being older; they are the result of losing health. If you have a poor lifestyle, as most Americans do, the accumulation of the resulting damage begins to be more noticeable in middle age. But the story is way more interesting than that. These problems mentioned above are just the early to middle stages of the process. Stay on the same path and things are likely to only get worse – increasing your risk for serious heart disease, stroke, diabetes, obesity, many other problems, and early death. 

What can be the common root of all these very different diseases? Contrary to what you might think it is not dietary fat, it is insulin resistance! But all is not doom and gloom. It is possible to reverse much of this. How, you ask? By changing your lifestyle. In some people’s cases it will be relatively minor changes. In others radical changes will be necessary at first and then later a more moderate lifestyle for maintenance. 

INSULIN RESISTANCE
Insulin resistance (IR) is when the body’s cells no longer respond as they should to insulin. The “end-stage” of this is type II diabetes (also called non-insulin dependent diabetes and used to be called adult onset). But damage is already occurring long before diabetes shows up. The intermediate stage of insulin resistance includes hypoglycemia, hypertension, cholesterol problems, heart disease, obesity and other health problems. The good news is that insulin resistance is reversible. But the cause must be addressed. So guess what the cause is? Sugar! Dietary simple sugars and other refined carbohydrates. 

American consumption of sugar has risen every year despite widespread health information on the negative affects of sugar and refined carbohydrates. America is now the fattest population in the world with an unheard of rate of childhood obesity. The insulin resistance that is the result of this sugar consumption is a large part of the explanation for the declining health and increasing obesity of Americans. It is estimated by medical researchers who work on IR that at least one in four Americans is now suffering from this syndrome, with a much higher percentage among the middle-aged. 

WHAT’S WORSE: SUGAR OR FAT?
As America has eaten more and more low-fat foods it has gotten fatter and fatter. Why? Because it has steadily increased the amount of simple and refined carbohydrates in its diet. To add insult to injury, America has gotten more and more sedentary. Weight gain is often described as the result of too many calories in vs. calories out. But it also makes a huge difference what the calories are from. Despite the popular emphasis on fat, sugar is the bigger problem. It does matter what kinds of fat, and too much can definitely be a problem, but the wrong carbohydrates are what leads to insulin resistance. 

This leads to a vicious cycle. Simple carbohydrates, like sugar, cause insulin resistance, which in turn causes obesity. But obesity by itself can aggravate insulin resistance. So more obesity results in more insulin resistance and, consequently, more obesity. So for many people eating fat is not the biggest reason why they are fat! It is the sugar and the other problem carbohydrates! 

CHILDREN’S NEW RISK
In addition, insulin resistance is no longer restricted to middle aged people; children are increasingly at risk for this and all of the problems associated with IR. Many overweight children are already insulin resistant. Type II diabetes (i.e., insulin resistant diabetes) used to be called adult onset diabetes. But now so many children and young adults get diagnosed with this kind of diabetes that it had to have a name change. 

THE MECHANISM
So lets look closer at the cause of this phenomena. A person’s blood sugar rises very quickly after the consumption of “high glycemic index foods” such as simple sugars (e.g., common table sugar, honey, fruit juice, etc.), refined carbohydrates (e.g., bread, white flour, pasta, etc.) and some kinds of starches (e.g., potatoes). The pancreas responds to the rapid rise in blood sugar by immediately pumping out insulin. The insulin connects with receptor sites on all of the body’s cell membranes telling the cells to take the sugar in and store it. Generally, the higher the glycemic index of the food, the more rapid the rise in blood sugar, and the more insulin produced. 

This isn’t a problem when this only happens occasionally, but if it is happening multiple times a day as is typical in the American diet, over time the cells begin to reduce the number of insulin receptor sites in response to the higher levels of blood insulin. So over long enough exposure the cells begin to get less responsive to the insulin, which leads to an upward spiral as the body produces more insulin to compensate. At this point the blood sugar levels are still being controlled. But at what cost? If the fasting blood sugar levels are measured they will be normal. But when the fasting insulin levels are measured, they will be starting to creep up. This growing imbalance is especially likely to happen if the person is sedentary. 

Unfortunately, few doctors are routinely measuring fasting insulin levels. And even if the fasting insulin levels are checked they may not be interpreted correctly. The medical researchers currently researching insulin resistance say that the standardized reference levels for “normal” amounts of blood insulin are set too high. It is now being suggested that anyone with a fasting blood insulin over 10 IU/ml is already insulin resistant.

MORE PROBLEMS WITH IR
Problems with fat metabolism begin to develop even in the early stages of insulin resistance. There is often a rise in total cholesterol, low-density lipoproteins (the bad cholesterol), small dense low-density lipoproteins (the really bad cholesterol) and blood triglycerides, and there is a decrease in high-density lipoproteins (the good cholesterol). In addition, chronically high insulin levels increase the damage to the arteries causing more atherosclerosis (i.e., hardening of the arteries), which leads to high blood pressure, heart disease and stroke. So not only does high insulin increase the bad cholesterol, it increases the damage to the arteries - a very deadly combination. 

In addition to the blood sugar diseases (hypoglycemia and diabetes), hypertension and heart disease, high levels of insulin can cause a wide range of other problems depending on the person’s susceptibility. It is not proven yet, but other problems that may be caused or aggravated by IR include polycystic ovarian syndrome; sleep apnea; adult acne; some kinds of cancer; increased inflammatory diseases like arthritis, fibromyalgia, irritable bowel syndrome, inflammatory bowel diseases; and the list seems to be growing as more research is done in this area. 

BEER BELLIES AND LOVE HANDLES -- OR THIN PEOPLE ARE NOT IMMUNE
Even people who appear normal weight can have insulin resistance. However, they often have the telltale abdominal weight gain. This would be the “beer” belly or pooch so often associated with middle age. (Beer and other alcoholic beverages can also aggravate IR.) This is not the same as the subcutaneous fat or “love” handles, but is the fat in the intra-abdominal cavity beneath the abdominal muscles. Research shows that insulin resistance and heart disease risk are very strongly associated with this visceral fat gain. In addition, regardless of their weight, anyone with abnormal cholesterol, triglycerides and blood pressure are likely suffering from the effects of IR. 

EXERCISE
Exercise is the great counterbalance for the over-consumption of high glycemic foods. The latest research on people who eat an average diet shows that in order to get the most health advantage you have to exercise vigorously for an hour a day. But how many people do this? While our ancestors did, not many people do today. The people who do this much exercise can get away with a lot more dietary indiscretions than the average American. For everyone else the more exercise the better, but a good diet becomes essential to good health. However, even heavy exercisers are known to get chronic health problems or die of heart attacks, so exercise is not the perfect antidote to a bad diet. 

OUR EXPERIENCE/CASES
We have found that placing IR patients on our healthy low-carbohydrate diet often leads to dramatic changes in a relatively short time. Within a few weeks almost everyone reports some improvements in energy, weight, cholesterol and blood triglycerides. Plus people report a significant decrease in their craving for sweets, making sticking to the diet relatively easy. Over the longer term hypoglycemia can be cured, fat metabolism can be normalized, hypertension can be helped, the risk factors for heart disease can be significantly reduced and type II diabetes can be controlled. No one can predict how many of your other health problems will improve with our Insulin Resistance Diet. Only trying it out will tell. 

Case example #1: In one male his blood triglycerides dropped by half and there was a significant decrease in the bad cholesterol in only three weeks. 

Case example #2: A female who exercised regularly and had a vegetarian diet that would usually be considered very healthy, was developing growing problems with low energy and had been slowly gaining weight year after year. She lost 10 pounds and had a dramatic improvement in energy in the few weeks on the diet and continues to lose weight, though at a much slower rate than initially (as would be expected). 

RISKS OF LOW-CARB DIETS
While in the short term any low-carb diet will help insulin resistance, many of the most popular low-carb diets may not be healthy over the long term. There are major health concerns with these popular low-carb diets that emphasize high amounts of protein and fat. The concerns include increased risk over time for kidney stones, osteoporosis, heart disease and colon cancer. These popular low-carb/high-protein diets are very acid and much evidence supports the idea that a more alkaline body is much healthier. CAUTION: No one with kidney disease should do any high-protein diet without first consulting with their physician. However, our IR diet does not carry any of these risks because it is a moderate-protein and moderate-fat diet. 

IMPORTANT INSULIN RESISTANCE LABORATORY VALUES
You probably have insulin resistance if:
·        The ratio of triglycerides to HDL is greater than or equal to 3.0 (trig/HDL=ratio)
·        Fasting blood insulin is over 10 IU/ml
You have type II diabetes if:
·        Fasting blood sugar is 126 mg/dl or higher (70-90 is optimal, 90-110 is at risk, 110-125 is pre-diabetes and represents significant IR)
·        Glycated hemoglobin (HbgAlc) is 7.0% or higher (HbgAlc is a measure of the average blood sugar over a 3 month period) (normal is 4 to 6)

WHAT TO DO
If you think IR could be a problem for you:
(a) Set up a naturopathic/nutritional consultation with us to get on a diet and program that will help you get back in control of your health;
(b) Attend a workshop that Dr. Bradley will be offering on IR (watch for announcements);
(c) Exercise regularly;
(d) If working on this problem on your own, going on a low-carb diet will be helpful, especially when exercise is increased with it. A low-carb diet is one that eliminates almost all sweets, sugars, refined carbohydrates, grains and grain products (i.e., bread, pasta, etc.) and starchy vegetables (i.e., potatoes); and/or
(e) When you need more dietary support than this webpage provides, the popular diet that is closest to this IR diet is The South Beach Diet by Arthur Agatston, M.D. This book and it companion cookbook provides good support. We also recommended reading The Paleo Diet by Loren Cordain, Ph.D. It gives a good background on the problems of the modern diet and the advantages of the Paleolithic diet. However, use our IR diet and this webpage as your main reference and refer to these books only for background and support.

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Copyright ă 2017 R. S. Bradley, N.D. All rights reserved. 

Heartland Naturopathic Clinic
5003 Burt Street
Omaha, NE 68132
(402) 391-6714