Yesterday (8/1), was my birthday, and my vow for the next year (and beyond) is to keep myself as healthy and happy as possible-they go together, you know. I’m 58 and never thought of myself at that age, but it is upon me and I am going to make the best of it. I read somewhere that “it’s never too late to be the person you always wanted to be,” – I love that statement. I am going to do the best I can, this year and every year, to do what it takes to give myself the best shot at having the best possible chances of achieving health and happiness. But, enough about me. For now, I want to follow-up on the diabetes prevention from my last blog.

With type-2 diabetes, the problem begins with too little exercise (activity)  coupled with too much food.  What starts as a few inches around the midline  ends with bulging bellies and metabolic syndrome, sending our rates of diabetes skyward. What’s more alarming, is that 30 years ago, type-2 diabetes was non-existent in people under 35 years of age. It is now at 20% of the population! 20%! Let me say again, 20%! Unbelievable! The look into the future for this disease is bleak indeed. Diabetes is a leading contributor to heart disease, stroke, foot and leg amputations, neuropathy in the feet, hands, etc…., none of it very pretty. The sad thing is, it can be fixed!! How? Diet and exercise. Think about what you put in your mouth: anything you put in that long tube from your mouth to your rear end has a HUGE impact on your health. I blogged about diabetes a few days ago, but I wanted to follow-up on the subject today.

A few key explanations: Metabolic syndrome is the body’s inability to effectively process fats and sugars. Again, the central problem is that we eat too much and exercise too little. Metabolic syndrome raises our risk of type 2 diabetes and heart disease. One thing we do know: Belly fat generates factors that increase inflammation and the risk of heart disease and other issues. Fat cells (in the belly) also release factors that drive up blood pressure by reducing the ability of the blood vessels to relax; AND, fat cells release proteins that increase insulin resistance. Insulin is a hormone that allows blood sugar to be taken up from the bloodstream into muscle, where it’s burned for energy, and into fat, where it’s stored. Insulin resistance means that the insulin is less efficient at ‘delivering the goods’, so sugar levels rise in the blood. As a result, the pancreas works harder and harder to make more insulin to try to lower blood sugar levels. Over time, if you don’t lose weight and exercise, your insulin and sugar levels continue to climb until your blood sugar level is over 125, which means you have diabetes. Insulin also helps store free fatty acids in your fat cells. If your insulin is working, it’s going to keep fat in the cells until it’s needed for use as fuel for exercising muscles. BUT, if you have insulin resistance, the fat comes out of the fat cells and ends up in the liver, which repackages the fat cells as triglycerides. Triglycerides are the main fat in foods, and they’re also found in the bloodstream. Even though triglycerides are fats, diets high in carbohydrates, especially sugars that contain fructose-like agave nectar and high-fructose corn syrup, can raise triglycerides in the blood. Fructose was until recently, thought to be a healthier type of sugar, but it turns out that it is responsible for increased fat deposits in the deep belly, liver, and muscle. In a nutshell, increased abdominal (visceral) fat leads to diabetes type 2, in most people (unless you are very lucky with your genes). And, fat in the liver does more harm, leading to liver disease. Watch your sugar intake, especially fructose. Carbs like beans, brown rice, and vegetables are great, and can help counteract some of the damage done by simple sugars. Additionally, there is no substitute for the beneficial effects of exercise. I realize many people don’t like it, but, they’re going to like diabetes even more. Your choice.

There is an excellent article in the July/August edition of Nutrition Action Health Letter; a Q&A with Dr. Michael Miller. He is director of the Center for Preventative Cardiology and a professor of medicine, epidemiology, and public health at the University of Maryland School of Medicine.

Stay well, John R Blilie, M.S.