How the USDA’s Failed Food Pyramid Contributed to I nsulin

Resistance and weight gain, metabolic syndrome and diabetes!

In May 2011, the USDA released a graphic called “My Plate” to help

people choose what foods to eat instead of the “Food Pyramid”. The

useless and misleading food pyramid, which has been confusing

consumers for over 25 years, has advocated a philosophy of eating

more grains and other less “fatty” foods. Food Pyramid failed to

differentiate simple versus complex sugars and placed undue

importance in promoting grain based products. How can the USDA, a

government body set up to promote agriculture and promote sale of

agricultural commodities

be also charged with

health

recommendations?

Unfortunately,

consuming a lot of the

grain based “simple

carbohydrates” such as

breads, potatoes, rice

etc. although low in fat,

are high in glycemic index and can lead to a phenomenon called

“Insulin Resistance”. Affecting up to one in every three Americans,

Insulin Resistance is very common and can lead to difficulty losing

weight, pre-diabetes, or type II diabetes, heart disease and other long

term health problems associated with obesity.

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. 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. Learning about insulin resistance is the first step toward making lifestyle changes that can help prevent diabetes and other health problems. An Obesity medicine physician well versed with medical management of Obesity and Insulin Resistance might be able to help!

Cause of Insulin Resistance

Scientists have identified specific genes that make people more likely to develop insulin resistance and diabetes. Excess weight and lack of physical activity also contribute to insulin resistance.

Many people with insulin resistance and high blood glucose have other conditions that increase the risk of developing type 2 diabetes and damage to the heart and blood vessels, also called cardiovascular disease. These conditions include having 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.

What Are The Effects Of Insulin Resistance

Insulin resistance can lead to many problems including weight gain, especially around the tummy due to the anabolic effects of Isulin. It also leads to metabolic syndrome as defined below, fatty liver, polycystic ovaries, acanthosis nigricans or dark patch around the neck, axilla, groin or other areas, skin tags, prediabetes, risk of elevated blood pressure, cardiovascular disease etc.

What Is Acanthosis Nigricans?

Insulin resistance and prediabetes usually have no symptoms. People may have one or both conditions for several years without noticing anything. People with a severe form of insulin resistance may have dark patches of skin, usually on the back of the neck. Sometimes people have a dark ring around their neck. Other possible sites for dark patches include elbows, knees, knuckles, and armpits. This condition is called acanthosis nigricans. What Is Metabolic Syndrome? Metabolic syndrome is defined as the presence of any three of the following conditions:

• waist measurement of 40 inches or more for men and 35 inches or more for women

• triglyceride levels of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride levels

• HDL, or “good,” cholesterol level below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL levels

• blood pressure levels of 130/85 or above, or taking medication for elevated blood pressure levels

• fasting blood glucose levels of 100 mg/dL or above, or taking medication for elevated blood glucose levels

What is prediabetes?

Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. This condition is sometimes called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or older—or 57 million people—had prediabetes in 2007.

People with prediabetes are at increased risk of developing type 2 diabetes, formerly called adult-onset diabetes or noninsulindependent diabetes. Type 2 diabetes is sometimes defined as the form of diabe-tes that develops when the body does not respond properly to insulin, as opposed to type 1 diabetes, in which the pancreas makes little or no insulin.

Studies have shown that most people with prediabetes develop type 2 diabetes within 10 years, unless they lose 5 to 7 percent of their body weight—about 10 to 15 pounds for someone who weighs 200 pounds—by making changes in their diet and level of physical activity. People with prediabetes also are at increased risk of developing cardiovascular disease.

How do you diagnose Insulin Resistance?

Health care providers use blood tests to determine whether a person has prediabetes but do not usually test for insulin resistance. Insulin resistance can be assessed by measuring the level of insulin in the blood. However, the test that most accurately measures insulin resistance, called the euglycemic clamp, is too costly and complicated to be used in most doctors’ offices. The clamp is a

research tool used by scientists to learn more about glucose metabolism. If tests indicate prediabetes or metabolic syndrome, insulin resistance most likely is present.

Diabetes and prediabetes can be detected with one o f the following tests: Fasting glucose test. This test measures blood glucose in people who have not eaten anything for at least 8 hours. This test is most reliable when done in the morning. Fasting glucose levels of 100 to 125 mg/dL are above normal but not high enough to be called diabetes. This condition is called prediabetes or IFG. People with IFG often have had insulin resistance for some time. They are much more likely to develop diabetes than people with normal blood glucose levels. Glucose tolerance test. This test measures blood glucose after people fast for at least 8 hours and 2 hours after they drink a sweet liquid provided by a doctor or laboratory. A blood glucose level between 140 and 199 mg/dL means glucose tolerance is not normal but is not high enough for a diagnosis of diabetes. This form of prediabetes is called IGT and, like IFG, it points toward a history of insulin resistance and a risk for developing diabetes. People whose test results indicate they have prediabetes should have their blood glucose levels checked again in 1 to 2 years. Why is it important to look at glycemic index of fo ods?

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. 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.

http://youtu.be/TjK8kR6ggbY

Tips for Avoiding Insulin Resistance

According to the American Diabetes Association, nearly two million new cases of diabetes were diagnosed in people aged 20 years and older in 2010. Since the grossly misleading food pyramid was introduced, the incidence of type 2 diabetes has gone up as much as 400 percent in the United States. Pre-diabetes, also called insulin resistance syndrome or metabolic syndrome, affects about a third of all Americans. 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.

W8MD physicians have specialized obesity medicine t raining and are well versed with managing insulin resistan ce and other metabolic effects of weight. W8MD physicians can he lp you lose weight safely, effectively using proven non surgica l methods.

Call (800)W8MD-007 for more information.

§ 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 compa red 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!

Summary Of Insulin Resistance

Insulin resistance is a condition in which the body’s cells do not use insulin properly. Insulin helps cells use blood glucose for energy. Insulin resistance increases the risk of developing prediabetes, type 2 diabetes, and cardiovascular disease. Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.

Causes of insulin resistance and prediabetes include genetic factors, excess weight, and lack of physical activity. Being physically active, making wise food choices, and reaching and maintaining a healthy weight can help prevent or reverse insulin resistance and prediabetes. How can W8MD Medical Weight Loss Centers Program Fo r Diabetes Prevention And Weight Loss Help?

W8MD Medical Weight Loss Program is a medical weight loss, metabolic syndrome management and sleep wellness program for people who are serious about losing weight and gaining control of their health. We understand that losing weight and keeping it off is a challenge for many people and a physician trained in the new field of Obesity Medicine can help. That is why we are committed to our proven approach to medical weight loss using evidence based non surgical methods. We want to give you all the tools you need to succeed in losing weight fast and safe in Greater Philadelphia, New York City and other places.

Author: Prab R. Tumpati, MD, Sleep and

Obesity Medicine

Medical Director, Sleep Medical Associates

and W8MD Medical Weight Loss Centers

of America located at 2003, Bath Avenue,

Brooklyn, NY 11214. Also have locations in

Philadelphia, Connecticut and other places.

Physicians interested in a low cost weight loss franchise to add a

W8MD Medical Weight Loss Program at their facility are also

welcome to contact us.

http://www.w8md.com