Syndrome X Insulin Resistance

Metabolic SyndromeHealthy Wednesday Club

20th February, 2008with Richard Hill & Sue Davis

Uh-oh

Bad, Scary News

Sugar is an addiction like tobacco and alcohol

Obesity is now the main association with poor health (overtaking tobacco)

Teenagers have insulin resistance Half of children born this century will have

diabetes II by the age of 30

Insulin (from pancreas) helps glucose (broken down from carbohydrates) to enter the cell to give the cell energy Insulin does this by attaching to a receptor

on the outer wall of the cell

Insulin converts the excessGlucose into a starch –

glycogen for storage in the muscles

and liver for later use.

Normal

Insulin ResistanceToo much glucose, especially from refined carbohydrates

causes the pancreas to produce lots of insulinthe cells are overwhelmed and shut down receptors

Insulin can’t get the glucose out of the blood and into cellsso it turns the glucose into fat instead (triglycerides)

Visceral Fat

Professor Gerald Raven - 1988

Nutrition Inactivity Stress Smoking Sleep

DISEASE

Gastro-Int

Osteopathic

ReproductiveSensory

Metabolic

Dermatological.

PsychologicalPulmonary

Cancers

O B E S I T Y

Inflammatory cytokines, adipokines, myokines etc.

Low Grade Systemic Inflammation

InsulinResistance

Risk Factors

Lifestyle-Based Causes of Disease

More glucose from too much refined carbohydrate, too often

Pancreas produces more insulin to cope

High glucose AND high insulin

pre-diabetic syndrome

Pancreas finally gives up

Diabetes II – late onset diabetes

X. CENTRAL OBESITY:Defined according to ethnicity:

>94 for Europid men>80 for Europid women(10cm less for Asians/Indians etc)

XX. PLUS ANY TWO OF THE FOLLOWING:

A. Raised TG: (>1.7mmol/L)B. Decreased HDL:

(M<1.0 mmol/L; F<1.3 mmol/L)C. Raised Blood Pressure:

Systolic BP >130mmHGDiastolic BP >85mmHG

D. Raised Fasting Plasma Glucose:>5.6 mmol/L

IDF Criteria for Defining Metabolic Syndrome

Fatigue Agitated, jittery, moody,

headaches Intestinal bloating – gas Sleepiness Weight gain Depression

Also –

What to do

STOP THIS

DO THIS

EXERCISE

And do this

Healthy, low GI,whole foods

Glucaemic IndexGI is the effect that food has to raise blood glucose over 2 hours

GI3 tbsp glucose = 50 grams pure carbohydrate

= 200 gms of spagetti

= 5 oranges

Carbohydrates are how many calories food contains 1gm = 4 calories

1 tbsp honey = 17g carb (= 68 cals) - GI 58

½ cup Lima Beans = 17g carb (= 68 cals) - GI 32

Low GI – less than 55 Moderate GI – 56 to 70 High GI – greater than 70

On Packaging

www.glycemicindex.com

Vegetables - GI

High GI – potato, carrots, pumpkin, corn, sweet potato

High Carbs, Low GI – beetroot, peas Normal servings of carrots, pumpkin and

potatoes eaten with protein will lower GI effect

Bread – GI (per slice)

Low GI – Chapati (Indian bread made from chickpea flour) GI – 27

Pumpernickel GI – 52

Sourdough GI – 52

Stone ground GI – 53

Standard white GI - 70

Fruits GI

Low:

Grapefruit – 25

Cherries – 22

Apples - 38

Pears - 38

Dried apricots - 31

Med - High:

Oranges - 44

Grapes - 46

Mango - 55

Apricots - 57

Watermelon - 72

Gatorade (1 cup) - 78

Approx 3 cups per bottle

AND DO THIS

Good qualitySupplementsEspecially antioxidants

A meal replacement

program

That encourages

you eat

Medical Journal of AustraliaVolume 84 No 2 January 16, 2006

Professor Gary Eggar - SCU Are meal replacements and effective

clinical tool for weight loss? Clinical trials show partial meal

replacement products to be safe, acceptable and effective when used as part of an overall low energy diet.

Side effects of weight loss

Homocystine levels Oxidation – free radicals Energy loss Depression Medications – weight gain Starvation

AND THISRomance, Beauty and Joy

mind – body – soul connection

Nutrition Inactivity Stress Smoking Sleep

DISEASE

Gastro-Int

Osteopathic

ReproductiveSensory

Metabolic

Dermatological.

PsychologicalPulmonary

Cancers

O B E S I T Y

Inflammatory cytokines, adipokines, myokines etc.

Low Grade Systemic Inflammation

InsulinResistance

Risk Factors

Lifestyle-Based Causes of Disease

BiologicalPathology

EcologicalPathology

Risk factors/Markers

ProximalCauses

MedialCauses

DistalCauses

Dis-ease

IndustrializationPopulation growthEconomic Growth

-Diabetes-CVD-Cancers

-Climate change-Sea level rise-Extinctions

• Energy use• Over-production• Industrial waste (“Lifestyle”)

• Over-nutrition• Inactivity etc.

• Atmospheric pollution• Ocean acidity etc.

•‘Ecoflammation’• Carbon ‘resistance’• Global warming etc.

•‘Metaflammation’• Insulin resistance• Obesity etc.

• Energy use• Social pressure• Peer pressure (“Lifestyle”)

Individual

Global

‘Metaflammation’, ‘Ecoflammmation’, health & theenvironment

A Lifestyle Screening Questionnaire

(Adapted from: Goodyear-Smith et al. Lifestyle screening: development of an acceptable multi-item general practice tool. New Zealand Journal of Medicine, 2004:117(1205))

Please answer each of the following with a score from 1 to 5 based on the following scale:

Never/ Rarely Sometimes Often Very OftenDonÕt do 1 2 3 4 5

Score Would you like help with this

Yes No LaterDo you ever feel the need to cut down on your smoking? ___ ___ ___ ___Do you ever feel the need to cut down on your alcohol intake? ___ ___ ___ ___Do you ever feel the need to cut down on other drug use? ___ ___ ___ ___During the past month, have you often been bothered byfeeling down, depressed or hopeless? ___ ___ ___ ___During the past month, have you often been bothered by havinglittle interest or pleasure in doing things? ___ ___ ___ ___Have you been worrying a lot about everyday problems? ___ ___ ___ ___Do you spend most days being physically inactive? ___ ___ ___ ___Are you concerned about your current weight? ___ ___ ___ ___Are you unhappy with the quality of your sleep? ___ ___ ___ ___Do you eat less than about 3 serves of fruit and vegetables each day? ___ ___ ___ ___Do you suffer side-effects from any medications you take? ___ ___ ___ ___Do you have concerns about the state of your skin/hair? ___ ___ ___ ___Are you concerned in any way about your sexual performance? ___ ___ ___ ___Do your teeth/gums cause you any problems? ___ ___ ___ ___Do you regularly drink large amounts of soft drink or fruit juice? ___ ___ ___ ___

X. CENTRAL OBESITY:Defined according to ethnicity:

>94 for Europid men>80 for Europid women(10cm less for Asians/Indians etc)

XX. PLUS ANY TWO OF THE FOLLOWING:

A. Raised TG: (>1.7mmol/L)B. Decreased HDL:

(M<1.0 mmol/L; F<1.3 mmol/L)C. Raised Blood Pressure:

Systolic BP >130mmHGDiastolic BP >85mmHG

D. Raised Fasting Plasma Glucose:>5.6 mmol/L

IDF Criteria for Defining Metabolic Syndrome

Indicators of Insulin Resistance