Transcript CONTROLLING CARBS AND PREVENTING DISEASE

CONTROLLING CARBS AND
PREVENTING DISEASE
Low carb, obesity, cardiovascular
disease and diabetes
Jacqueline A. Eberstein, R.N.
Obesity
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Now effects all age groups
Is a global epidemic
Overweight is having a body mass index (BMI) between
25 and 29.9
Obesity is having a BMI of 30 or more.
Body Mass Index is a computation relating height with
weight. It is a useful guideline but can be inaccurate for
those with significant muscle mass.
To compute your BMI. Search BMI on the Internet and
enter your numbers.
Do not use adult BMI charts for ages 2 to 20.
Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
≥20
Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
≥20
Obesity Trends* Among U.S. Adults
BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
BMI > 30, or ~ 30 lbs. overweight for 5'4" person
2004
Important to remember
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Insulin- a hormone produced in the pancreas that carries
sugar from the blood into the cells to be used for energy.
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Blood sugar- the amount of glucose in the blood stream
at any given time. It is higher after eating.
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Insulin is a “fat storage hormone”.
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Glucagon- a hormone to counter the blood sugar
lowering effects of insulin. In a properly functioning body
insulin and glucagon are in balance.
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Insulin resistance- a consequence of heredity, excess
body fat, hormone changes and even some medications
that prevents our cells from using insulin to regulate
blood sugar effectively.
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The body attempts to keep the blood sugar
within a fairly narrow range- insulin/glucagon
balance.
Hyperinsulinism- an excess production of insulin.
Insulin in too large amounts over time damages
the body and leads to diabetes and heart
disease. High insulin levels can effect cancer
cells.
Metabolic syndrome is an insulin resistance
syndrome. It frequently leads to type 2 diabetes
and heart disease.
Diabetes- a nutritional wear and
tear disease
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Stage 1-insulin resistance of cells
Stage 2-insulin resistance with hyperinsulinism.
Stage 3-insulin resistance and reactive
hypoglycemia or unstable blood sugar.
Stage 4-insulin resistance, hyperinsulinism with
impaired glucose tolerance AKA prediabetes.
Stage 5- diabetes with high insulin resistance
and hyperinsulinism.
Stage 6-diabetes with low or virtually no insulin
production. Burnout of the islet cells of the
pancreas.
Risk factors for diabetes
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Obesity
Diet
Sedentary lifestyle
Heredity
Ethnicity
History of gestational
diabetes
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Metabolic syndrome
Elevated blood sugar
Abnormal lipids
High blood pressure
Advancing age
Blood sugar by the numbers
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Normal fasting blood sugar is generally 65 to
99mg/dL.
Impaired fasting blood sugar or prediabetes is
between 100 and 125 mg/dL.
Impaired glucose tolerance or prediabetes is a 2
hour blood sugar between 140 and 199 mg/dL.
Diabetes is a fasting blood sugar of 126 mg/dL
or greater on 2 readings: or 2 hours after food a
blood sugar reading of 200mg/dL or greater.
Effects of high insulin
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Increases deposition of excess body fat
Increases fat in the blood in the form of triglycerides
leading to heart disease.
Promotes the manufacture of LDL cholesterol by
stimulating the enzyme HMG-CoA reductase.
Causes an unstable blood sugar by depressing the
effects of glucagon.
Increases sodium retention and water retention leading
to edema and high blood pressure.
Depresses glucogen thus preventing fat burning.
Negatively effects other hormones such as those from
the adrenals and eicosanoids.
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Stimulates growth of smooth muscle cells
lining arteries.
Increases inflammatory markers leading to
CHD
Increases prothrombotic markers.
Promotes glucose and protein to fat storage.
Insulin-like growth factor may stimulate
cancer cells to grow.
Can increase breast cancer death rates.
PCOS/ infertility/ diabetes/ heart disease
Complications of diabetes
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Can begin about 10 years before the diagnosis
is made-if it’s made.
About 1/3 of diabetes cases are undiagnosed.
The body is damaged by glycation due to high
blood sugars.
Complications are caused by damage to all
blood vessels leading to heart disease, stroke,
blindness, kidney failure, painful neuropathy, and
amputations.
Direct and indirect costs from diabetes reached
132 billion dollars for 2002.
Solution
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Can control all but your genetics
Control your weight.
Rebalance your bodies’ hormones specifically
insulin to regulate blood sugar.
Dietary fat has a negligible effect on insulin.
Protein in excess can impact insulin and
glucose. Eat the right amount of protein.
Carbs are the main macronutrient that stimulates
insulin.
Control both the quantity and quality of carbs.
Exercise to improve insulin resistance.
Harvard Nurses Health Study
“Our findings suggest that a high intake of rapidly
digested and absorbed carbohydrate increases
the risk of CHD independent of conventional
coronary disease risk factors. These data add to
the concern that the current low-fat, high
carbohydrate diet recommended in the United
States may not be the optimal for the prevention
of CHD and could actually increase the risk in
individuals with high degrees of insulin
resistance and glucose intolerance.”
The American Journal of Clinical Nutrition, 2000
The Controlled Carb Advantage
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Physical improvements:
Improved lean body mass to fat mass ratio.
Increased exercise capacity.
Maintain weight loss w/o negative side effects.
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Prevents/ corrects hyperinsulin-related conditions:
Diabetes
Hypertension
Cardiac risk factors ( high triglycerides, low HDL,
small dense LDL particles)
ADA diet vs. controlling carbs in
People with Diabetes
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“ High carbohydrate intake is generally recommended,
resulting in suboptimal glycemic control and lipoprotein
profile, gradually increasing insulin and/or oral
hypoglycemic medication requirement and weight gain.
On the other hand, restriction of dietary carbohydrate is
associated with improvement in glycemic control and
other parameters of insulin resistance including body
mass and lipid profiles.”
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“…data demonstrates that the benefits of a low
carbohydrate diet on glycemic control are independent of
weight loss and are primarily due to carbohydrate
restriction.”
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“Emerging evidence suggests that low carb diets may
actually have beneficial effects on LDL cholesterol by
decreasing LDL particle concentration and increasing
LDL size to less atherogenic forms.”
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“A final irony is the report that physicians frequently
choose low carb diets for themselves while
recommending low fat for their patients.”
The Case for low carbohydrate diets in diabetes management, Dr., Samy
McFarlane, Nutrition and Metabolism, 2005.
Is a 60% carb, low fat diet working?
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A review of patients by the ADA published
in JAMA, January 2004 stated that only
30% of people with diabetes were
reaching treatment goals for blood sugar,
blood pressure and cholesterol. This
despite the use of a number of prescription
medications.
Research supports safety and
efficacy of controlling carbs
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There have been more than 60 published studies and papers
focusing on the benefits of a controlled carb lifestyle.
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Effective in weight loss and maintenance, seizures, PCOS,
metabolic syndrome, diabetes, GERD, lowering triglycerides,
increasing HDL, improving particle size of LDL, decreasing
inflammation markers (CRP), increasing insulin sensitivity and
other symptoms.
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Studies done by Duke, Harvard, University of Pa., University
of Conn., The American Heart Association, American Diabetes
Association among others.