Wednesday, November 11, 2009

November is National Diabetes Awareness Month

November is American Diabetes Awareness Month. According to the American Diabetes Association, “nearly 24 million children and adults
(7.8% of the population) in the United States (are) living with
diabetes, and an additional 57 million Americans (are) at risk.”
There are two major types of diabetes. Type I, also known as insulin dependent diabetes, occurs when the body does not produce insulin.
This type only affects 5-10% of the American population and results
from an auto-immune destruction of the insulin-producing cells in the pancreas. Type II diabetes, also known as insulin-independent diabetes or insulin-resistant diabetes, is a condition in which the body produces insulin but fails to use it properly. When the body becomes insensitive to the effects of insulin, a dangerous accumulation of sugar occurs in the blood leading to damage to small blood vessels and to organ dysfunction. Keeping a tighter lid on the
cookie jar may be a good start to reducing sugar consumption and the risk of developing diabetes.


What exactly is Diabetes?

When a person has diabetes it means that his or her body is not properly absorbing glucose, a type of simple sugar. Our cells need and utilize glucose for energy. Over time, however, too much glucose circulating in the blood can be toxic and lead to problems such as kidney failure, blindness, and loss of sensation. An easy way to understand the insulin-glucose connection is to think about the role of our mailman. The mailman carries and delivers our mail to our house every day, rain or shine. Insulin performs a role similar tothe mailman's because it carries and delivers glucose into our cells. When a person develops Type II diabetes, it is as if the mailman
is on strike and refuses to deliver the mail until more suitable conditions exist. When this happens, the mail just collects at the post office, we can't pay our bills, and we are left in a
financial crisis! If insulin doesn’t work, glucose accumulates in the blood and the body goes into a state of sugar turmoil. By maintaining a steady insulin-glucose balance, we can avoid these
insulin meltdowns and protect our body from experiencing toxic sugar overload. Choosing complex carbohydrates, eating smaller meals throughout the day, and watching proportion size are steps we can take to keep insulin and glucose in metabolic harmony.

Unfortunately, type II diabetes is not considered an adult disease anymore, and in fact, more and more older children and adolescents are being diagnosed. This is a very disturbing problem and reflects the obesity epidemic in our country. The good news is that eliminating excess weight, especially abdominal fat, decreases the risk of developing insulin resistance and the progression to Type II diabetes. Lifestyle therapies such as losing weight , engaging in
consistent moderate exercise and maintaining a healthy, low-fat diet filled with complex carbohydrates (whole grains and fiber rich foods) will set you on the right path toward good health. This Shabbos try snacking on sliced apples dipped in peanut butter, strawberries
drizzled with coconut flakes, or bananas sprinkled with ground flax seed. Make fruit snacks a fun dessert option by coming up with creative ways of dipping or adding toppings to them (minus chocolate and caramel sauces!). Also, this Shabbos take your children on a brisk
after-dinner/ after-lunch walk. This is a great time not only to lighten up after a full meal, but to provide an intimate time to engage in special parent-child moments. This can become a
unique Shabbos ritual shared and looked forward to each week. Play an active role in disease prevention and you will be providing one of the most important tools your child will carry throughout life – the recipe for good health.

Take a Bite Out of Your Apple Shape!

Being overweight is a very strong risk factor for the development of many chronic diseases such as diabetes, heart disease and certain forms of cancer. Assessment of body weight involves two key measures: body mass index and waist circumference. The body mass index or BMI is a calculation that was developed to determine the amount of body fat based on a person’s height and weight. Once calculated, a person may be defined as underweight if BMI <> 30). (Quickly calculate your BMI at http://www.nhlbisupport.com/bmi/). There are some limitations when calculating one’s BMI. First, athletes and others who have larger muscle mass may have an overestimated BMI because the weight of these individuals is disproportionate to their height due to the increased amount of muscle. The opposite is true of older individuals who have decreased muscle mass. These individuals may have an underestimated BMI and may have more total body fat then calculated. Because the body mass index calculation has its drawbacks, a more important tool in evaluating body weight is measuring the abdominal or waist circumference measurement (WCM). When measuring one’s waist circumference, you are essentially measuring abdominal fat, which is a stronger predictor of developing risk factors for heart disease and diabetes. It seems that the distribution of fat stores, especially abdominal fat, is more important in determining risk factors than the total amount of fat. In fact, it has been documented that individuals who suffer from diabetes or heart disease tend to have “apple-shaped” figures storing excess body fat around the abdomen. To measure your waist circumference, place a measuring tape snugly around your waistline right above your belly button. Waist measurements over 40 inches in men and over 35 inches in women are considered above normal. A cluster of risk factors has shown to promote the risk of developing Diabetes and Heart Disease and of all the risk factors, abdominal obesity has the strongest association with insulin resistance. In fact, the concept of a cluster of metabolic abnormalities, including abdominal obesity, hypertension, impaired fasting glucose, and hyperlipidemia (high blood lipid levels), leading to the development of insulin resistance, diabetes, and heart disease has been understood for the past sixty years and was originally referred to as Syndrome X or the Deadly Quartet. In 1998, the official name, Metabolic Syndrome was coined by the World Health Organization. The Mayo Clinic defines Metabolic Syndrome as “a cluster of conditions that occur together, increasing your risk of heart disease, stroke and diabetes.” In 2002, the American Association of Clinical Endocrinologists (AACE), designed the criteria for diagnosing Metabolic Syndrome involves having three of more of the following components:

Impaired fasting glucose (100 -126 mg/dl) or 2-h post oral glucose (≥ 140 mg/dl)

  • Blood pressure ≥ 130/85 mmHg
  • Abdominal obesity (waist circumference >102 cm (men) or 88 cm (women)
  • HDL-cholesterol <>
  • Body mass index ≥ 25 kg/m2
  • Other risk factors: family history of type 2 diabetes, hypertension or cardiovascular disease; PCOS, aging, physical inactivity, ethnic susceptibility to type 2 diabetes or cardiovascular disease

The good news is that most of the risk factors are modifiable and by managing your risk through lifestyle therapies, you may reduce the major risk factors for Diabetes and Heart Disease. Lifestyle interventions include weight loss, increased physical activity and healthy eating habits.

http://www.metabolic-syndrome-institute.org/news/2005/2005-05-19-document-view2.php

http://www.americanheart.org/presenter.jhtml?identifier=4756

http://www.thedoctorwillseeyounow.com/articles/nutrition/fatdistribution_1/#1