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A New Idea for Me About Evolution: Body Weight, Insulin Resistance, and Fructose

July 28th, 2011

This paper is fascinating me right now despite being sidetracked yesterday. Dr. Richard Johnson of Denver Colorado is the presenter and researcher; he presented at the World Congress on Insulin Resistance, Diabetes, and Cardiovascular Disease in November 2010.

(This is one of what seems like an infinite number of instances wherein “diabetes” means type two diabetes, by my figuring.)

Full disclosure here: I’m not a scientist.  One of the reasons I’m not a scientist is that I have to read science terms very slowly and I’m not patient enough to do so.  So please remember I’m pointing to words, terms, and phrases in the online work itself rather than paraphrasing in large part because I’m not familiar enough with what I’m writing about.  (Not that that stops me from writing about it.) 

Johnson believes that “fructose may not be simply an energy source, but may have specific metabolic effects that may aid in increasing fat stores.”

He goes on to say that islet injury from fructose is in part mediated by urate, and uricase deficiency is a genetic mutation that may just have saved our ancestor’s lives. (I can’t fully explain how the islet injury occurs to begin with, or why.)

So, in a world where fruit and fruit sugar is a main source of energy, those with a uricase deficiency would have had a tough time of insulin management, which would today appear as insulin resistance (one of the hallmarks of type two diabetes).

Until  you consider Survival of the Fittest: those best able to survive periods of famine were those who had the genetic propensity to insulin resistance.

Why?

Because a body resistant to insulin makes more insulin to manage glucose in the blood.    It also in turn increases fat storage since that’s one of the functions insulin serves in our bodies.  More body weight (fat) means more insulin required, which means more insulin made, which starts the cycle all over again.

So those who carried extra body fat and body weight due to a uricase deficiency would have been those best equipped to survive a famine.

Wacky, isn’t it?

Our ancestor’s propensity to increase fructose consumption without proper genetic tools to manage that consumption helped them survive, and here we are in the twenty first century with insulin resistance and type two diabetes as one of the world’s most alarming health crises.

It’s important to keep in mind that the amount of fructose our ancestors consumed is NOWHERE NEAR the amount we consume today.  Johnson points out that in our lifetimes we have seen an incredible increase in the amount of sugar we consume compared to just three hundred years ago:
“…from a mean of 4 pounds of sugar intake per year in 1700 in the United Kingdom and United States, to greater than 150 pounds per year today….we found that 25% of the population was ingesting over 130 g of fructose per day, which equates to over 200 pounds of sugar per year …some individuals are ingesting more than 50 times the mean amount of sugar than was being ingested just 300 years ago.”

So while we owe our ancestors a debt of gratitude for surviving as well as they did, we need to make some changes in our own lives and in our own world so that our children and grandchildren and 10-times-great-grandchildren can thank us, too.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

Am I Simply Jaded?

July 22nd, 2011

I think it’s probably way past time for me to admit that I’m jaded when it comes to “the latest and greatest thing” for checking blood glucose levels.

Maybe it’s the companies trying to rekindle an excitement in me that never existed.

Maybe it’s my frustration at how much money must be pumped into research and development that I would rather see invested in people and families or even in tools that don’t exist for issues that I think do exist.

This one, in the July issue of Diabetes Forecast, discusses essentially a breathalyzer blood glucose glucometer thingamajig.  (Wow; I guess I must have added “thingamajig” to my computer’s dictionary since it flagged “glucometer” but not “thingamajig.” Awesome.) 

Scientists are trying to “develop a portable, lightweight, and inexpensive breath-testing device that could replace traditional blood glucose meters—and finger sticks.” (Forecast credits the April 2011 edition of the American Journal of Physicology-Endocrinology and Metabolism but I can’t find it in the Table of Contents over there.)

Just like the gluco watch I’ve never seen.

Or the iphone app that reads something like fluorocarbons injected under the skin.  (Shiver.)

Of particular interest in this one, they only tested normal and high blood glucose levels.  If only we had to concern ourselves with those, right?

Seriously: is checking blood glucose with a meter that much work for us that we need to invest millions in finding other solutions to accomplish the same thing?  I’m not saying my CGM isn’t fantastic, and I’m not saying that my meter isn’t a huge step up from urine checking.

I’m saying that people are working so hard to eliminate something that isn’t that big of a deal when it comes to my life with diabetes.

Don’t get me wrong: I think there is work to be done.  I think we need more and better tools when it comes to insulin and insulin delivery and our bodies’ metabolism.  I love the work people are doing on making low blood glucose levels a thing of the past through the use of service dogs.

What I can’t understand is why those people working with service dogs are doing so in nonprofit organizations and these scientists are probably making far more than minimum wage.

It gets to me.

Anyway, I’m not trying to complain.  But I am, and for that I apologize.  I’d love to leave you with a better thing to think about over the weekend.

So here you go, inspired by a Geico commercial I heard on the radio this morning (that I can no longer remember it was so long ago):

When cheese gets its picture taken, what does it say?

What hair color do they put on the drivers licenses of bald men?

Why are a wise man and a wise guy opposites?

If you’ve got any answers, I’d love to hear them!!

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Some Reasons Your Basal Rates Are What They Are (It’s Your Metabolism)

July 20th, 2011

I read this and appreciated how cut and dried it seemed.  At the end of the day, we are who we are.  Olympians, models, Jane and Joe.  It’s nice to see some of the reasons behind our pump basal rate requirements, and to recognize how big a factor weight training is as we age.

Reading this, it would seem that the only way we can alter much of our predestined fate is THROUGH EXERCISE.

Go figure.

So, rather than paraphrasing a straightforward article and making comments here and there like one of the old guys from the Muppets, I’m just going to copy and paste a Cathe Friedrich article below.  (Factoid of the day: those guys are named Statler and Waldorf, after two NYC hotels.)

But back to the show.  Here, now, are SIX FACTORS THAT AFFECT YOUR METABOLIC RATE by Cathe Friedrich!!!!

Do you wish you had a faster metabolism so you could eat more without gaining weight? Many people are convinced their metabolism is too slow, and it makes it harder for them to lose weight. Each person has a metabolic rate that’s affected by a number of factors. Some of these factors can be altered, while others can’t be so easily changed. Have you ever wondered what makes your metabolic rate fast or slow?

First, a definition. Metabolic rate is simply the amount of energy expended over a given period of time. This energy is released as heat. You can measure your metabolic rate at a single point in time using different methods, but the rate will vary throughout the day based on a variety of factors including activity level. Here are some factors that affect metabolism.

Factors That Determine Your Metabolic Rate

Race

According to a study published in Obesity Research, black women have a resting metabolic rate that’s about 5% slower than white women.

Gender

Men have a metabolic rate that’s 10 to 25% higher than women. This is at least partially due to greater muscle mass since muscle is more metabolically active than fat tissue. You can’t control your sex, but women can increase their lean body mass through exercise.

Age

Resting metabolic rate drops by as much as 2% each year after the age of 20. Both men and women also lose muscle mass as they age, which accounts for some of this decline. You can’t control the aging process, but you can do strength training to increase how much muscle you have.

Size

Larger people have higher metabolic rates because they have greater total mass. You can’t determine your height or the size of your frame, but you can alter your body composition and how much mass you carry to some degree through diet and exercise.

Genetics

Genetics play a role in determining metabolic rate too. Most people know someone who can eat anything they want without gaining a pound. Unfortunately, it catches up with them as they age, and their metabolism starts to slow down. Some people aren’t able to adapt to their changing metabolism and gain significant amounts of weight as they grow older. You’ve probably heard formerly thin people say, “I was as skinny as you
when I was younger.” They probably were.

Hormones

The primary hormone responsible for regulating metabolic rate is thyroid hormone, but sex hormones such as estrogen, progesterone and testosterone play a role too. This may be due to their effects on lean body mass. Most women experience a steeper decline in metabolic rate after menopause, but accelerated loss of muscle mass also contributes to this slow down. Growth hormone and other fat-burning hormones likely plays a role in regulating metabolism, and growth hormone levels decline with age.

Other Factors That Affect Your Metabolic Rate

Factors such as ambient temperature affect metabolic rate. Colder temperatures boost metabolic rate by causing shivering, which produces more heat. Turning down the temperature in your home can subtly boost your metabolism.

If you’re anxious or have a fever, you have a faster metabolic rate and produce more heat. Some medications can alter it too. Thyroid hormone, nicotine and caffeine raise it, and some medications such as anti-psychotic drugs lower metabolism.

High-intensity exercise that uses the anaerobic energy system such as heavy weight-lifting and sprinting boost metabolism for hours to days afterwards, and when you build lean body mass you burn more calories. Moderate-intensity endurance exercise has less of an effect on metabolic rate.

What and how you eat plays a role too. Restrict calories too much and your metabolism slows down to protect you against starvation.

What You Can Do to Boost Your Metabolism

Certain factors such as genetics, sex, race and age you can’t control. But you can boost your metabolism by doing high-intensity exercise and resistance training to increase lean body mass. If you restrict calories, never go below 1200 calories a day to avoid slowing down your metabolism. Focus on eating smaller meals more frequently that contain small amounts of lean protein. Drinking caffeinated beverages and green tea may also subtly increase metabolism.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

Do You Experience Illness or Wellness?

July 19th, 2011

A therapist asked me a few years ago how it felt to me that I had been ill for the majority of my life.

Um.

Well.

I wasn’t sure how to answer her.

(You should know that I do a very bad job of hiding my emotions off of my face.  If I don’t understand something, I won’t fake it.  You’ll know just by looking at my face.  Same thing if I think something is great, or gross, or whatever.  It is not an aspect of myself I find very useful, despite the fact I’m sure it’s pretty entertaining for others sometimes.)

Anyway, I can’t tell you what my expression was, but I can tell you my eyes squinted and I got a crease in my forehead.

I couldn’t believe anyone would consider me “ill” because I have type one diabetes.  It isn’t a way I think of myself!

I’m more of a wellness and fitness kind of gal.

Which is why this article caught my attention in such a special way.  Of
course, I applied it immediately to my own life and saw how true the message
felt.

Illness versus Wellness.  I versus We.

When I tried to live with my diabetes all alone, I sucked at it.  I was in denial, I was terrified, I was simultaneously blatantly rebelling and hiding from my disease and my physical reality.  It was awful.  Truly awful.

When I got myself to a supportive environment at the Diabetic Youth Foundation, my diabetes immediately shrank.  I could be ME when I was singing goofy songs about having a blood glucose of 64 or when I was sitting quietly with a blood glucose of 378 and people knew how that felt.  I could be ME when I taught teens how to make figurines of clay and filled big vats of RIT dye for tie dying day with families.

I found myself in a group.  ALL of me, because my diabetes was what got
me into that group.

Insulin may be the key that unlocks the doors to our cells so that our bodies can use the glucose we eat, but my disease is what unlocked the door to a new world for me.

A world where I wasn’t alone.  I could be WELL and not ill.  Because that’s what I wanted, and what I think we all deserve.

A world where wellness can be my priority, and sharing that through Diabetes Outside is what I want to do all day, every day.

It is what I think it’s all about.  Life, Diabetes, and everything in
between.  Together.

Won’t you join me?

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Monkey See, Monkey Do… Or Not (yes we’re the monkeys)

July 18th, 2011

I might have lost this bet.  I am rather surprised in some ways, but in other ways, it’s a no-brainer.

This study questioned general practitioners about their own activity levels and the activity levels they prescribe to their type 2 patients.

More confusingly, what they looked at was not the actual activity levels of the physicians, but rather the
physicians’ perceived barriers to physical activity.

I hope they didn’t word the questions in the same way. 

First off, they asked more than 600 physicians in France to complete the questionnaire; 574 declined to
participate.  Bummer for the researchers!  After all was said and done, 48 general physicians and 369 patients were included in the study.  So maybe this isn’t a great picture, but I think it does highlight on an important aspect of healthcare.  (This low return rate on the questionnaire is one of the things that surpised me.  It’s a shame because I’m pretty sure those physicians who do exercise returned their questionnaire.)

It matters to us patients how our healthcare professionals care for themselves.

The study found that the patients whose general physician didn’t think there were many hurdles with physical
activity in their own lives fared better when it came to the patient’s physical activity.

It makes sense: I think the average person would rather see a dentist who brushed their own teeth than one who didn’t.  We’d rather hire a plumber who had a toilet in their own house than one who used an outhouse.  (I could keep going but I won’t.  You’re welcome!)

So, it makes sense that if a general doctor tells a patient “exercise and be more active to help manage your diabetes” we at least on some levels will be more likely to follow that advice if the doctor exercises, too.

Maybe they can help their patients figure out how to beat some of the basic excuses when it comes to exercise
because they’ve had to figure out ways to make it work in their own lives.  Maybe it’s because a fit and active doctor
exudes good health and we as patients want to learn from and copy that good example.

But I don’t think it’s unrelated.  I don’t think patients who see fit general doctors aren’t paying attention.  I don’t
think patients who do need to exercise look at their unfit doctor and don’t see it as a “get out of jail free” card.  (Which is a categorical shame.)

We are all looking for ways to make exercise work for us and our bodies.  Especially
those of us living with diabetes.

If your doctor, be they a general practitioner or an endocrinologist, isn’t speaking to you about exercise, NOW is the time to ask:

WHY NOT?

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Is It All About Processing?

July 15th, 2011

Did you hear about the guy who lost 27 pounds in 8 weeks by eating the majority of his calories in the form of Ho Hos, Little Debbie cakes, and Twinkies?

Holy cow.

Somewhat reminiscent of the guy from SuperSize Me, this researcher wanted to prove that a calorie is a calorie, no matter what form it takes.

In fact he was correct: he lost the weight by cutting his normal 2,600 calories per day down to 1,800 calories per day.

It should seem like he lost some good health in there along the way!

Bless the researchers; someone else was trying to figure out what else mattered when it comes to processed food versus whole food.  THEY found some interesting things happening after each type of meal.

The study was conducted with the attention focused on the biological processes that occur in our bodies after we eat: the postprandial thermogenic response.  (My dad taught thermodynamics so I know that thermogenic has to do with the production of heat.  I tried Symlin for a few months so I know that postprandial means after eating.)

A calorie is in our world today a measurement we most commonly use to apply to food and exercise, but it comes from science and means, in thermodynamic terms, an amount of heat equal to 4.1840 joules.  (I have no recollection what that is or why it matters.  My last chemistry class was 18 years ago and I wasn’t very good at it at the time.)

ANYWAY, sorry for that tangent, but it matters for this study.  The researchers discovered that, 5-6 hours after the participants ate their cheese and bread sandwiches, the amount of heat/energy
produced was very different if the sandwiches were made of whole food or of processed food.

Fifty percent kind of different.

The average energy expenditure after the whole food meal was nearly 20% of the calories in the sandwich; the average for the processed food was 10.7%.

The wise researchers concluded that: “this reduction in daily energy expenditure has potential implications for diets comprised heavily of processed foods and their associations with obesity.”  I would say that potential implication is none other than that bugger Obesity.

It seems to me (an entirely unscientific person) that no matter what, food needs to be processed before our bodies can use it.  The potential outcome of that usage is calculated in terms of heat: the calorie.

I think we have outsourced those required processes to manufacturers instead of getting our food from farmers and processing it ourselves.

And look what has happened: rising obesity rates.

Think how fast that guy could have lost his 27 pounds if he had been
processing longer after he ate by eating whole food instead of processed snack cakes.

Yow.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, My Soapbox, Random Musings, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

Strengthening Your Self Control

July 13th, 2011

A little exercise can go a long way when it comes to resisting damaging behavior.

Take this study performed at the University of Exeter, England: 25 chocolate lovers were asked to avoid chocolate for three days prior to the mini stress test performed.  (I really hope they got paid for their participation!)

When the participants arrived at the lab, half of them were asked to walk briskly on a treadmill for 15 minutes while the other half simply waited for the tests to begin.

If abstaining from chocolate weren’t enough, the researchers then put all of the participants through a challenging mental test designed to stress them out.  (Sounds mean!) As if that weren’t enough, at
the end of the test another researcher walked into the room and lets you choose your favorite chocolate bar from the samples he carries.  Then you are asked to unwrap the chocolate BUT NOT EAT IT.

Yow.   How difficult do you imagine that was for the participants?!

The exercising participants showed a smaller increase in blood pressure during the mental tests and had a smaller increase in blood pressure when asked to unwrap but not eat the chocolate.

Researchers concluded that the 15 minutes of exercise helped the participants cope better with both challenges. 

(And it isn’t only chocolate: the same researchers have performed similar tests with smokers and on the subject of basic concentration in the face of distractions.)

It looks like the advice of “if you feel hungry, take a walk around the block” or “do 20 pushups” first before you reach for an unhealthy snack has some research to back it up!

If you are dealing with any number of temptations, use exercise to help you resist temptation and improve your self control!  Use your physiology to your advantage, and start to see exercise as a source of mental and physical strength!

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

Hanz and Franz vs. Harriet and Francine

July 11th, 2011

Do you remember these two guys from SNL in the early 90s?  They were SO FUN.  I just had a fun moment with my husband when I went to him and said “what were their names?” as I hunched forward, said “PUMP [clap] YOU UP!”  He said “Hanz and Franz” right away.

I guess we’ve been together a long time.

Anyway, I thought of these two and their stuffed sweatshirts as I thought about what to write about today.  I also thought about the roughly seven thousand and three conversations I have each year with women who say their husbands can lose weight just by thinking about it for an afternoon.

It begs the question: are men and women different when it comes to muscle mass?

The first and most obvious answer to that question is to say “yes” that men and women differ.  The various reasons for that number in the thousands; the critical differences when it comes to exercise are body size and composition.

When scientists look closer at muscle tissue itself, though, the differences between men and women do not exist! 

While men in general have more muscle MASS, the makeup and strength in muscle tissues of men and of women are equal. (Women’s values in muscle strength, pulmonary ventilation, and cardiac output are generally 60-75% of those values recorded in men due to the variances in body size, body composition, and levels of testosterone.)

So are there exercises that men should do and women shouldn’t do?  NOPE.

Are there “female” exercises and “male” exercises?  NOPE.

Is there a biological reason for “boy pushups” and “girl pushups”?  NOT ON MY WATCH.  EVER. (This is one of the very few things I will actually yell at you for saying during a workout.)

Seriously; your body isn’t as different from your brother or sister’s body as you may want to believe.  You can both train the same and both perform the same exercises and achieve most of the same results.  Sure, the improvements by the numbers will never be identical due to the basic differences above in size, composition, and testosterone, but that doesn’t mean you shouldn’t go after what you want.

Male or female, muscle is muscle.  Use it or lose it.

I vote “USE IT!”

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, My Soapbox, My Workouts, Random Musings, Uncategorized

Got a Spare $8,000?

July 7th, 2011

The George Washington University School of Public Health and Health Services’ Department of Health Policy released a study last year that reported the individual cost of obesity in the United States.

Not the cost in macroeconomic terms, the costs individuals pay for being obese.

Women pay an average of $4,879 and men pay $2,646 each year for obesity-related medical expenses and lost productivity.

Yikes.

Beyond that, the authors added in the value of each individual’s loss of life due to their obesity.  THAT took the toll up to $8,365 for women and $6,518 for men. Each year.

Yikes again.

We aren’t even counting what it costs to live with (presumably) type two diabetes.

Nor what the non-monetary costs are.

I suggest those non-monetary costs are much higher.

Do you travel less than you would if you weren’t concerned about fitting in a seat?  Do you attend fewer functions because you only have one or two “nice”outfits that fit?  Do you feel as though you can’t be yourself because you’re busy worrying about how big you are?

Do you think people aren’t your friend, don’t invite you to get-togethers, or talk behind your back about how much you weigh?  Do you take an awfully long time to climb a flight of stairs or walk to your destination?

If the answer is “yes” to any of these, I’m willing to bet you’d pay more than $8,000 to get it to stop.

_____

I’m not going to say that if I can do it, anyone can do it.  Anyone can do it regardless of my own success losing a lot of weight.

And it takes work, and not everyone is willing to work at it for as long as it takes.

But it IS possible, and you CAN do it.  But you absolutely must believe that you can; that’s I think where a lot of the trouble lies.  It isn’t about the monetary costs, and it isn’t about the non-monetary costs, and it isn’t about knowing or not knowing what to eat and not eat.  It isn’t about how long you’ll live or in what condition.

Most of it is about your belief in yourself. 

If you’ve got that, you can do anything.

So if you need to, take some time and have some honest conversations with yourself about what your body needs you to do.  Speak to your doctor, speak to me, speak with someone in your family, speak with a therapist.  Do what you need to do to get yourself to recognize your own needs and believe in yourself.

You (and your bank account) deserve it.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, My Soapbox, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

Amazing Benefits of Exercise

June 21st, 2011

You feel better when you exercise.  It helps you manage your diabetes.  It helps you lose weight or keep your weight in check.  It helps you fit in your clothes.  It helps your heart stay strong.  It helps your blood fat levels get to and stay in a healthy range.  It keeps your bones strong.  It helps you manage stress.

AND it helps you stay young.

I’m telling you, exercise is an amazing thing.

I think I blog more about cardiovascular exercise than I do resistance training, mainly because what I do for my cardio exercise is more interesting and exciting to write about.  (I mean, did you see yesterday’s blog?!)

When it comes to resistance exercise, however, I’m a huge fan and wish I were able to devote more time to it (marathons have taken precedence for the past two years).  Resistance training to help me stave off muscle loss as I age is crucial.  I also have one body so it’s hard to do everything I want to all the time. 

I’m sure you understand.

So you can imagine how fun it is for me to spread the word about TELOMERES. 

Telomeres are little pieces at the end of our cells’ DNA.  With every cell division, a tiny bit at the end of that telomere is lost. 

You can imagine how this story ends up.  If you can’t, look at your grandparents.

With every cell division snipping off a teensy piece of DNA, we are on a limited time budget.

The 2009 Nobel Prize in Medicine was awarded to three scientists whose work showed that telomeres are vital to protect our cells’ DNA.  Not only did their work show that the longer our telomeres the biologically younger we are, but they showed that the telomeres of middle-aged people who exercised regularly were only marginally shorter than those telomeres of people half their age who didn’t exercise regularly.

Gotta love scientific proof that regular exercise (and of course good sound nutrition) help our bodies significantly slow the aging process.

Just add it to the list of the amazing benefits of exercise.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?