CONTROLLING CARBS AND PREVENTING DISEASE

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CONTROLLING CARBS AND PREVENTING DISEASE

• Low carb, obesity, cardiovascular disease and
  diabetes
• Jacqueline A. Eberstein, R.N.

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Obesity

• 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.

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Obesity Trends Among U.S. AdultsBRFSS, 1990
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1991
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1995
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1997
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 2000
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 2001
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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BMI gt 30, or 30 lbs. overweight for 5'4"
person 2004                                     
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                        
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Important to remember

• Insulin- a hormone produced in the pancreas that
  carries sugar from the blood into the cells to be
  used for energy.
• Blood sugar- the amount of glucose in the blood
  stream at any given time. It is higher after
  eating.
• Insulin is a fat storage hormone.
• Glucagon- a hormone to counter the blood sugar
  lowering effects of insulin. In a properly
  functioning body insulin and glucagon are in
  balance.
• 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.

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Diabetes- a nutritional wear and tear disease

• 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.

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Risk factors for diabetes

• Obesity
• Diet
• Sedentary lifestyle
• Heredity
• Ethnicity
• History of gestational diabetes

• Metabolic syndrome
• Elevated blood sugar
• Abnormal lipids
• High blood pressure
• Advancing age

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Blood sugar by the numbers

• 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.

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Effects of high insulin

• 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

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Complications of diabetes

• Can begin about 10 years before the diagnosis is
  made-if its 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.

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Solution

• 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.

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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

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The Controlled Carb Advantage

• Physical improvements
• Improved lean body mass to fat mass ratio.
• Increased exercise capacity.
• Maintain weight loss w/o negative side
  effects.
• Prevents/ corrects hyperinsulin-related
  conditions
• Diabetes
• Hypertension
• Cardiac risk factors ( high triglycerides,
  low HDL, small dense LDL particles)

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ADA diet vs. controlling carbs in People with
Diabetes

• 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.
• 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.
• 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.

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Is a 60 carb, low fat diet working?

• 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.

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Research supports safety and efficacy of
controlling carbs

• There have been more than 60 published studies
  and papers focusing on the benefits of a
  controlled carb lifestyle.
• 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.
• Studies done by Duke, Harvard, University of Pa.,
  University of Conn., The American Heart
  Association, American Diabetes Association among
  others.