ONE IN THREE AMERICANS ARE

PRE-DIABETIC OR INSULIN RESISTANT!

According to the CDC, about 35% of all Americans are prediabetic! Let us look at the factors that contribute to the phenomenal rise of diabetes. While most Government Agencies will have you believe that it is the raise in obesity that is causing it, I will show you it is the raise in Insulin Resistance that is causing the obesity epidemic!

Also called metabolic syndrome, insulin resistance is common and accounts for many of the metabolic problems seen with weight gain. If you have some extra weight especially around your waist, you might be insulin resistant! An obesity medicine physician specializing in the medical management of obesity and insulin resistance might be able to help.

According to Dr. Prab R. Tumpati, MD, a practicing obesity medicine physician, and founder of W8MD Medical Weight Loss Centers of America, the current diet which is very high in refined carbohydrates contributes significantly to this phenomenon of insulin resistance. In order to understand this further, let us take a look at the actions of insulin.

What is Insulin?

Insulin is a hormone produced in the pancreas that helps control the blood sugars. It also controls many aspects of fat cell metabolism and is the principal anabolic hormone in adults, more important than even growth hormone for adults.

How do I know which foods are worse in requiring insulin?

Glycemic Index of foods is important because it determines how much insulin your body is going to need after the meal. The higher the Glycemic Load, the higher the Insulin Requirements. It is believed that eating high glycemic foods such as Bagels, Doughnuts, white breads, white rice, sweetened beverages etc., the body starts to go into Insulin

Resistance. The Insulin Resistance, in turn will lead to higher levels of Insulin circulating in the blood stream at baseline setting the stage for insulin resistance.

Anabolic Actions of Insulin

Since insulin is an anabolic(body building hormone), this can not only lead to weight gain, but also lead to central distribution of weight. Research has shown that central distribution of weight leads to increased risk of cardiovascular disease, diabetes and other health problems.

So, the current epidemic of metabolic syndrome, or insulin resistance is what contributes to weight gain, not the other way around, unlike what most Government agencies want to have your believe. This is because, more insulin resistant you are – more body building happens.

What is Insulin Resistance?

Insulin resistance is a condition in which the body produces insulin but does not use it properly. Insulin, a hormone made by the pancreas, helps the body use glucose for energy. Glucose is a form of sugar that is the body’s main source of energy.

The body’s digestive system breaks food down into glucose, which then travels in the bloodstream to cells throughout the body. Glucose in the blood is called blood glucose, also known as blood sugar. As the blood glucose level rises after a meal, the pancreas releases insulin to help cells take in and use the glucose.

When people are insulin resistant, their muscle, fat, and liver cells do not respond properly to insulin. As a result, their bodies need more insulin to help glucose enter cells. The pancreas tries to keep up with this increased demand for insulin by producing more. Eventually, the pancreas fails to keep up with the body’s need for insulin. Excess glucose builds up in the bloodstream, setting the stage for diabetes. Many people with insulin resistance have high levels of both glucose and insulin circulating in their blood at the same time. Insulin resistance increases the chance of developing type 2 diabetes and heart disease. Learning about insulin resistance is the first step toward making lifestyle changes that can help prevent diabetes and other health problems.

What causes insulin resistance?

It is believed that the sudden spikes and the crash of blood sugars that happens with high glycemic diets combined with lack of physical activity leads to insulin resistance as the body does not respond as well to insulin.

Compensation of the body to insulin resistance leads to weight gain!

In order to keep the blood sugar under control, the body compensates to insulin resistance by increasing the production of this anabolic hormone called Insulin. This compensation in turn leads to weight gain around the tummy, and upper part of the body, two areas of fat distribution know to increase cardiovascular disease.

This leads to excess weight around the waist, high blood pressure, and abnormal levels of cholesterol and triglycerides in the blood. Having several of these problems is called metabolic syndrome or insulin resistance syndrome, formerly called syndrome X.

How Do I Know If I have Insulin Resistance or Metabolic Syndrome?

Metablic Syndrome Metabolic syndrome, Syndrome X, or Dysmetabolic Syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. The cluster of conditions that are part of metabolic syndrome include: — increased blood pressure, a high blood sugar level, excess body fat around the waist or abnormal cholesterol levels. Some studies have shown the prevalence in the USA to be an estimated 1/3 of the population and prevalence increases with age. Find out if you might have metabolic syndrome using this W8MD tool!

W8MD Metabolic Syndrome Meter

(Based on the American Heart Association/Updated NCEP Criteria)

Is your waist circumference at the biggest point over 36 inches in women or 40 in men? * Yes No

Lipids: Do you have elevated triglycerides: Equal to or greater than 150 mg/dL (1.7 mmol/L) or on treatment for elevated triglycerides? Yes No

Lipids: Reduced HDL(good) cholesterol - <40 in men or <50 in women? Yes No

Fasting Blood Sugar: Equal to or greater than 100 mg/dL (5.6 mmol/L) or use of medication for hyperglycemia? Yes No

Blood Pressure: Equal to or greater than 130/85 mm Hg or use of medication for hypertension? Yes No

* Certain ethnicities such as Asians, or South East Asians meet lower

criteria

A score of 3 or More meets the criteria for Metabolic Syndrome!

If you answered yes to three or more of these questions, you have metabolic syndrome. It is a cluster of conditions caused by underlying insulin resistance and can be improved or reversed with proper treatment of the insulin resistance under careful monitoring and treatment of a bariatric physician trained in the metabolic aspects of Obesity. At W8MD Medical Weightloss Centers of America, we treat patients with metabolic syndrome and attempt to reverse the negative consequences of obesity.

What can I do to reduce my risk of diabetes?

� Get enough protein. If the body gets carbohydrates without enough protein, it goes into insulin resistance. Most people need about 30 grams of protein at each meal. One egg is about 7 grams. As we evolved as hunters and gatherers, we are designed to eat a non-grain based diet rich in protein, fruits, nuts and vegetables.

� Try to work more physical activity into your day. Both exercise and resistance training can help reduce your risk of diabetes, and also helps to control it once you have it.

� Eat more fiber. Fiber helps reduce your risk of diabetes by improving your blood sugar control. Try more fruits, vegetables, beans, whole grains, nuts, and seeds.

� Choose whole grains. When you do eat grains, look for the word "whole" in the ingredient list. Whole wheat, stone-ground whole wheat, brown rice, and oats are all whole-grain ingredients.

� Eat fewer simple carbohydrates. These foods, with high glycemic index, break down quickly in the body, and can lead to rapid fluctuations in blood sugar levels. Go easy on foods like white rice, white bread, white pasta, refined flours, candy,

fruit juice, soda pop, and baked goods made with white flour. The key is to understand glycemic Index of foods and focus on low glycemic foods.

� Get enough sleep. When you're sleep deprived, your body drives you to eat more simple carbohydrates. Get at least 7-8 hours a night.

� Get help from Obesity Medicine physicians. You probably tried them all and still cannot lose weight! You might want to get help from physicians trained in Obesity Medicine that can help deal with the complex issues leading to weight gain.

W8MD Glycemic Index Guide In general, you want to limit the high glycemic foods, have limited medium glycemic foods and have mostly low glycemic foods with adequate protein, fat, and other nutrients. Protein is generally low glycemic.

High GI foods = 70-100

Intermediate GI foods = 56-69

Low GI foods = 0-55

Glycemic Index of some common Foods Food Carbohydrates (gm) Glycemic Index Glucose has a GI value of 100 HIGH Baked potato, Russet, baked without fat ( 1 small potato, 5 oz.) 85 Waffles, Aunt Jemima (1 piece) 76 Gatorade (1 cup) 78 Grapenuts (approx. 1 cup, Kraft) 75 French Baguette

95 Bread, white (1 slice)

73 Bagel, (white, frozen)

72 Stuffing ( approx. 1 cup)

74 Graham wafers (approx. 1 cup) 74 Grape nuts (approx. 1 cup, Kraft) 75 Shredded wheat (1 oz. serving) 75 Total (1 oz. serving, General Mills) 76 Cream of Wheat (1 oz. serving, instant, Nabisco) 74 INTERMEDIATE Spaghetti, (plain, cooked, 3/4 cup)

61 Rice (brown, cooked, 3/4 cup)

60 Raisin bran (1 oz. serving, Kellogg's) 61

Oatmeal (1 cup) 66 Bran muffin (large) 60 Green pea soup (1 cup) 66 Ice cream, regular(1/2 cup) 61 Blueberry muffin (1) 59 Raisins (1/4 cup)

56 Power bar, chocolate 56 LOW Apple

34 Orange

42 Banana

52 Grapes (1 cup)

46 Carrot (raw, 1 medium) 47 Sweet corn (1/2 cup 54 Dried apricots (1/4 cup)

31 Peas (1/2 cup) 48

Bread 100% whole grain (1 slice) 51 Orange juice (3/4 cup, 6 oz.) 52 Fruit yogurt (reduced fat, 3/4 cup)

27 Tomato soup (1 cup) 38 *Skim milk (1 cup) 32 While Milk (1 cup) 27 Baked beans (1/2 cup)

48 Lentils (1/2 cup)

29 Kidney beans (1/2 cup)

28 Lima beans (1/2 cup, baby, frozen)

32 Garbanzo beans (1/2 cup)

28 *NB: Please note that whole milk has lower GI compared to skimmed or 2% milk

(Chart adapted from *The New Glucose Revolution)

Other Resources on Glycemic Index

1. The GI Diet Guide - A very useful and practical list of foods. A must visit link - www.The-GI-diet.org/lowgifoods/ - Very useful and practical!

2. University of Sidney's Glycemic Index Website - http://www.glycemicindex.com/

3. Comprehensive Glycemic index list spread sheet: for A comprehensive list of Glycemic Index, get the excel spread sheet here and look up the glycemic Index. Please note reduced fat milk has higher glycemic index compared to whole milk!

About W8MD Medical Weight Loss Centers

W8MD physicians have specialized obesity medicine training and are well versed with managing insulin resistance and other metabolic effects of weight. W8MD physicians can help you deal with insulin resistance, metabolic syndrome, prediabetes, diabetes, sleep apnea, fatty liver, polycystic ovaries, and other weight related problems.

Using evidence based, non-surgical weight loss measures such as 800 plus calorie Very Low Calorie (VLCD) diets, and 1000 plus calorie LCD diets, in combination with appropriate FDA approved weight loss medications such as Adipex/Phentermine, Topiramate, new weight loss medication, Qsymia, etc, exercise coaching, and intensive behaviour therapy for proper nutrition, and eating disorders, our W8MD Obesity Medicine Physicians can help you lose weight safely, and effectively using proven non surgical methods.

Call (800)W8MD-007 for more information or visit http://www.w8md.com for more information. We have offices in many states including Pennsylvania, New York, and Connecticut and most W8MD weight loss centers accept health insurance for the weight loss physician visits so you can lose weight with insurance.