The Silent Epidemic

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This year I will qualify for senior citizen discounts at the theater, which means I’m officially an old person. However, my goal is to stay mentally and physically young as long as possible. In order to do that, I’ve started researching information to help achieve optimal health and I recently found an interesting article about Kevin Patterson, a former CNMI physician, and his new book Consumption. Patterson stated that type 2 diabetes historically did not exist about 70 or 80 years ago. He believes the rise of obesity, especially the accumulation of abdominal fat, induces change in our receptors that cause them to be numb to the effects of insulin. The body compensates for this by having the pancreas secrete larger amounts of insulin to regulate the high blood sugar. The constant strain on the pancreas causes it to falter in the ability to secrete enough insulin and this is when diabetes develops.

Patterson believes that “the increase in abdominal fat has driven the epidemic of diabetes over the last 40 years in the developed world.” He continues, “I worked in Saipan, which is in the Marianas Island in the Pacific, and there, the dialysis population was increasing at about 18 percent a year, all as a consequence of diabetes and acculturation.

“When you look at the curves, it’s clear how unsustainable it is. In 20 or 30 years, everybody on the island will either be a dialysis patient or a dialysis nurse unless something fundamental is done about the rise in diabetes.”

This is not just a Saipan-thing because the 2011 National Diabetes Fact Sheet states that 8.3 percent, or 25.8 million of American adults already have diabetes. Seven million of them are undiagnosed, and even worse, it’s estimated that another 79 million have pre-diabetes. That means 33.8% of the U.S. population currently has diabetes or pre-diabetes! Diabetes underlies a host of other health issues such as heart disease and stroke, kidney disease, nervous system disease, blindness and amputations, and this silent epidemic contributed to a total of 231,404 deaths in 2007.

In reality, obesity has never been proven to be a causal factor of diabetes. There are plenty of trim people with diabetes, and there are a lot of obese people without it. It’s kind of like the chicken and the egg conundrum – does obesity cause insulin resistance and diabetes, like Dr. Patterson believes, or is it more likely that the insulin resistance behind type 2 diabetes causes obesity?

Here’s a scenario of what may likely be the behavior pattern underlying weight gain and type 2 diabetes: 1) Excess consumption of fast food and processed foods high in refined carbohydrates (sodas, sugar, candy, chips, breads, rice, pasta, etc.) elevate your blood sugar level, so 2) to lower your blood sugar level, the body releases insulin that transforms blood sugar into fats and stores them in your fat cells, 3) and as long as the pancreas produces insulin from a diet high in refined carbohydrates, fats will remain stored in cells; however 4) due to malnutrition your cells tell your body that you’re hungry which causes you to crave more carbs for quick energy, which 5) triggers more insulin to be released and causes more fat to get locked in your fat cells; 6) overwhelmed by the increasing production of insulin, the pancreas starts to fail, which results in the higher levels of blood sugar associated with type 2 diabetes, and then requires medication to lower the body’s glucose levels.

If the above pattern is correct, the simple five-step solution is to 1) stop eating and drinking insulin-provoking carbohydrates in order to 2) lower your blood sugar levels, which keeps insulin levels low, 3) so stored, nutrient-rich fatty acids can exit fat cells, 4) which is then metabolized as fuel, and 5) the out-of-balance hormones of the endocrine system begin to normalize themselves. The outcome of this is that you will start to lose weight and feel better.

Just changing your eating habits can make a difference, but when it’s combined with exercise to increase your metabolism the results are enhanced. You don’t necessarily need to eat less food, just eat less refined carbohydrates and more vegetables, fruits, and lean meats. Eat less processed and fast foods and more natural foods. If you only reduce your food intake, your body will sense the reduced calories and compensate by holding on to all the calories it can by turning down your basal metabolic rate, which is the rate that your body burns calories while you rest.

Drugs do help, but a large national study conducted with 3,234 volunteers at 27 sites around the U.S. found that small lifestyle changes are more successful at warding off diabetes than taking a drug. In the study, one group took a diabetes medicine called Metformin twice a day, a second group received placebo pills instead of Metformin, and the last group received intensive counseling from a dietitian and motivational coach to develop a plan to eat better and exercise more. The study found that the third group with the lifestyle changes were twice as effective as taking Metformin. It was also discovered that losing only 7 percent of their body weight (14 pounds for a 200 pound person) helped volunteers to cut their risk of diabetes by almost 60 percent.

In conclusion, the first step to better health is to watch what you put in your mouth. Reduce those insulin-triggering carbs and processed foods, and replace it with more natural fruits and vegetables. A lifestyle change doesn’t have to be drastic, but it does need to be consistent. Let’s show Dr. Patterson that our destiny is not to become an island full of dialysis patient, and that the only “curves” we should be watching on Saipan are those on the beach.