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Preventing Degenerative Disease- Diabetes - Identifying Diabetes - Syndrome X - Obesity -Treating Diabetes - Diet and Diabetes - Diabetes and Supplements - Low-Glycemic Meals

Meet Joe

Joe was forty one when he came into my office for a routine annual physicaI. He was feeling great and had absolutely no complaints. He just felt he needed a thorough checkup because he hadn't had a physical for several years. During the routine appointment, we drew some blood.

Because Joe felt so good. I was surprised and concerned when my lab technician showed me Joe's blood. It looked pink instead of' red. After the technician spun the blood in the centrifuge, the upper portion of the sample looked like cream (meaning it was loaded with fat). The lab report indicated that Joe's cholesterol was 250, his HDL cholesterol was 31, and his triglyceride level was abnormally high at 1208.

Triglyceride levels should be less than 150 and the triglyceride/HDL ratio should be less than 2. Joe's ratio was nearly 40! Although his f'asting blood sugar level was normal, it was soon obvious that Joe had developed Syndrome X--a precursor to diabetes mellitus.

Syndrome X: Is it Killing You?

Like Joe, most people have never heard of Syndrome X, but they certainly need to. Dr. Gerald Eleavens, a physician and professor at Stanford University, chose the term to describe a constellation of problems that have a common cause: insulin resistance. Through medical research, Dr. Reavens estimates that more than 80 million adult Americans have Syndrome X.3
Let's take a mornent to look at the cornmon cause of Syndrome X, the body's developed resistance against insulin.

What Is Insulin Resistance?

Americans are infatuated with a high-carbohydrate, low-fat diet, although in truth. most Americans eat a high-carbohydrate and high fat diet. Over the years our diet has taken its toll, and many of us have become less and less sensitive to our own insulin as a result. Insulin is basically a storage hormone that drives sugar into the cell to be utilized or stored as fat. The body desires to control our blood sugars. Therefore, when the body becomes less sensitive to its own insulin, it compensates by making more insulin. In other words our bodies respond to increasing blood sugar levels by forcing the beta cells of the pancreas to produce more insulin in order to control our blood sugars.

Individuals with insulin resistance need more and more insulin as the years go by to keep their blood sugars normal. Although these elevated insulin levels (hyperinsulinemia) are effective in controlling our blood sugars, they also may lead to some serious health problems. Below is a list of harmful effects elevated insulin levels cause These are the problems that constitute what Dr. Gerald Reavens has labeled Syndrome X:

o significant inflammation of the arteries, which can cause heart attack and stroke
o elevated blood pressure (hypertension)
o elevated triglycerides the other fat in the blood beside cholesterol
o lowered HDL (good) cholesterol
o increased LDL (bad) cholesterol
o increased tendency lo form blood clots
o development of significant "uncontrolled" weight gain-usually around the middle (called central obesity)

When all of the Syndrome X factors are combined. our risk of developing heart disease actually jumps twelve fold.4 Considering the fact the heart disease is the number-one killer in the industrialized world today, we cannot afford to disregard a growing risk of developing it!

After patients have had Syndrome X for several years (maybe even ten to twenty), the beta cells of the pancreas simply wear out and can no longer produce such high levels of insulin. At this point insulin levels begin to drop and blood sugars begin to rise.

At first only mild elevations of blood sugar may develop, which is known as glucose intolerance (or preclinical diabetes). More than 24 million people in the United States are at this stage of glucose intolerance.3 Then, usually within a year or two, if no change in lifestyle occurs, full-blown diabetes mellitus will develop. The aging of the arteries then accelerates even faster as blood sugars begin to steadily rise.

What Is the Cause of Insulin Resistance?

Several theories suggest reasons why we become less and less sensitive to our insulin over the years. But I truly believe insulin resistance is the result of the Western diet. Though we focus heavily on cutting back on fats, our love affair with carbohydrates continues. What many Americans don't fully realize is that carbohydrates are simply long chains of sugar that the body absorbs at various rates. Did you know white bread, white flour, pasta, rice, and potatoes release their sugars into the bloodstream even faster than table sugar? It's true. This is why such foods are called high-glycemic.

On the other hand foods such as green beans, brussels sprouts, tomatoes, apples, and oranges release their sugars into the bloodstream much more slowly and are therefore considered low-glycemic foods.

Our nation tends to eat far too many high-glycemic foods, which in turn causes blood sugars to rise very rapidly and stimulates the release of insulin. When our blood sugar drops, we feel hungry So we grab a snack or eat a big meal, and the whole process starts all over again. After a period of time, the release of insulin has been over stimulated so often that our bodies simply become less and less sensitive to it. In order for the body to control the blood sugar levels, the pancreas needs to put out higher levels of insulin. It is these elevated levels of insulin that cause the destructive metabolic changes associated with Syndrome X.

How Do You Know If You Have Syndrome X?

Most physicians do not routinely request blood insulin levels for their patients. But there is a simple (although indirect) way to see if you may be developing Syndrome X or insulin resistance. When your blood is tested you will routinely get a lipid profile, which includes the levels of total cholesterol HDL (good) cholesterol, the LDL (bad) cholesterol, and triglycerides (the other fat in the blood). Most everyone is familiar with the ratio you obtain by dividing the total cholesterol by the HDL cholesterol. But if you divide the triglyceride level by the HDL cholesterol, the ratio you get is an indication of whether you are developing the syndrome. If this ratio is greater than two, you may be starting to develop Syndrome X. Also, if you notice that your blood pressure or that your waistline is increasing, it is even more likely that you are developing a serious case of Syndrome X.

Here's an example of how to do this simple test. Let's say your triglyceride level is 210 and your HDL cholesterol level is 30. Dividing 210 by 30 equals a ratio of 7. Since this is definitely greater than a ratio of 2, you would conclude you have early signs of insulin resistance or Syndrome X.

As soon as a person begins developing insulin resistance, his physician should recommend and support lifestyle changes, because, as I pointed out earlier, this is when cardiovascular damage really begins. Therefore, physicians need to be readily aware of the early signs of developing insulin resistance via the triglycerides/HDL cholesterol ratio. Insulin resistance is totally reversible at this point. We must never be content to wait until a person becomes fully diabetic before treating him.

When a patient treats his insulin resistance with simple but effective lifestyle changes, not only does he prevent accelerated damage to the arteries, but he also avoids diabetes itself. This is true preventive medicine. A healthier lifestyle, not the drugs we prescribe, will make the difference.

Without question, I believe that doctors have over depended on medication to treat diabetes. Most physicians would agree that diet and exercise can help patients with diabetes, but we simply do not invest enough time in helping them understand that changing those very habits is the best offense against the devastating complications of the disease.

I realize it is much easier to write a prescription than to educate and motivate patients to make key changes in exercise and nutrition. But diabetes would be so much better controlled if we did not depend so heavily on meds. Even the representatives of the drug companies who visit my office agree that a high-fiber diet that includes low-glycemic foods is very effective. But they always maintain that patients usually will not make such changes in their diet and therefore must have medication.

This is not what I see. In my practice the majority of patients would rather make lifestyle changes than take more medication, though much depends on the doctor's attitude and approach. Consistently, when I take the time to explain all of this to patients and then ask them what they would like to do, more than 90 percent respond that they would rather try lifestyle adaptations first.

Joe can show us how this works.

Joe was very concerned about his lab results and so felt motivated to immediately change his lifestyle. We placed him on a modest exercise program, a low-glycemic diet, and a regimen of antioxidant and mineral supplementation. I repeated Joe's blood work twelve weeks later and documented amazing improvement: his cholesterol level dropped from 250 to 150, his HDL cholesterol increased 10 points to 41, and his triglyceride level plummeted from 1,208 to 102. His triglyceride/HDL ratio had decreased from 40 to 2.5. Joe accomplished all of this without any medication and within just twelve weeks. Both he and I were thrilled.

If you are in a health predicament like Joe's, you can achieve a similar outcome with the same commitment to lifestyle and eating adjustments. Syndrome X and its deadly ramifications can be beat..

"What Your Doctor Doesn't Know About Nutritional Medicine May Be Killing You."
Dr. Ray Strand http://www.raystrand.com/bookstore.asp