Showing posts with label blood sugar. Show all posts
Showing posts with label blood sugar. Show all posts

Monday, December 27, 2010

"Let Food Be Thy Medicine"

Hippocrates is considered the father of modern medicine. One of his most famous quotes is “Let food be thy medicine, and medicine be thy food”. These words are often utilized for the eloquence with which they express the importance of our daily food choices. The relevance this phrase has is stronger than ever. Nutrition is an underlying theme for just about every health concern we may experience today. To address the underlying causes, we must consider the influence our diet has on our wellbeing. Today we will begin this journey by exploring blood sugar imbalances and the misconceptions that still prevail in our society regarding fats in foods.

When considering our food choices and the impact on our health, the first step relevant for today’s health concerns is to address blood sugar imbalances. Blood sugar imbalances are rampant in our culture. We tend to overly consume highly processed foods and grains, and simple sugars which contribute to an immediate jump in blood sugar levels due to their high glycemic index. The body responds by pumping out insulin from our pancreas to lower the level of sugar in our blood. Elevated blood sugars always cause an elevation in insulin levels. Insulin in our body conveys two primary messages. The first is that the blood sugar should be stored for later use in the form of fat depositions. Let me repeat this first point, elevated blood sugars and hence elevated insulin levels signal our body to store foods consumed as fat. The second is that insulin increases the levels of systemic inflammation in our body.

Day in and day out after the insulin assault on the unnecessarily high blood sugars, the blood sugar levels crash. This hypoglycemic state creates a sympathetic, or stress, response from the body. The adrenal glands release cortisol to help mobilize sugar from stores in the body. At this point the individual typically feels jittery, irritable, and quickly reaches for that sugary snack to get through to the next meal. This pattern causes the sugars to jump up again, insulin is released, and the entire process repeats itself. For most people eating the standard American diet (SAD) this happens every single day. Eventually the pancreas fatigues and can no longer release enough insulin to control the blood sugars and the patient is diagnosed as a diabetic. Simultaneously, the adrenals are exhausted and can no longer function in their full capacity. Our body’s hormone systems are affected by this constant stress and their functions are interrelated. Years of poor dietary choices often require an extensive amount of intervention to restore proper body function and balance.

Fats generally confound us more than any other aspect of nutrition. My 9 year old daughter helped me understand why when she said, “Dad, it’s a homonym. You know, a word that sounds the same but has different meanings.” She couldn’t be more correct. We use the word “fat” to describe lipids in foods and when referencing individuals that are overweight. Even though the low-fat dietary craze of the 80’s would have us believe that they are directly related, they most certainly are not. But the mis-information remains and people still worry that fats in foods will lead to becoming an overweight individual. The result for our lifestyle from this distorted view is that fats have been consistently removed from foods and replaced with sugars. The end product now has a higher glycemic index than the original food and the increased insulin levels to control the elevated blood sugar causes the body to store the food as fat. As we have pulled fat from foods, individuals have become more overweight and the incidence of diabetes and heart disease has continued to climb; yet we somehow continue to believe that fats in foods are detrimental to our health. They aren’t, with one exception.

Trans-fats, or hydrogenated oils, are pointless from a dietary standpoint. There is no need for us to consume them. Processed food manufactures continue to use them because they add stability and shelf life to their end products. They do this at the expense of our health. Trans-fat consumption is related to poor cholesterol levels and increased inflammation in the body, among other things. The only way to be certain that trans-fats are not in our food products is to read the full label. The imprudent business that continues to create these products have created a marketing ploy that will allow them to write largely on the front of a package that it contains “no trans-fats… per serving” as long as there is less that 0.5 grams of trans-fats per serving. The product itself certainly still has trans-fats in it, and so will we if we don’t read the ingredient list searching for the key words: hydrogenated, partially hydrogenated, or fully hydrogenated.

In general, foods are neither good nor bad for us. As we begin to change our relationship with foods and nutrition, it is vital to remember that the benefit or detriment to our health is primarily from the quantity and frequency with which we consume any particular food, not a quality inherent to the food itself. For example, we could consume too much water and actually die from an electrolyte imbalance. Our objective should be to strive for variation in our food regimen, focusing mostly on veggies and fruits coupled with protein sources to balance blood sugars. When ever possible and affordable, we should buy local and organic. By reducing our consumption of processed, high glycemic foods and avoiding trans-fats we will improve our daily energy with balanced blood sugars, decrease our systemic inflammation, and better help protect ourselves from the chronic lifestyle diseases that plague our culture.

Wednesday, August 4, 2010

Blood Sugar Screening - what the numbers don't say

I am fortunate to have the opportunity to work at multiple health fairs throughout the year in my surrounding community. I always enjoy meeting other healthcare providers and talking with the various employees and participants about their journey to health. It feels particularly good to reach so many individuals during a single day.
A couple weeks ago while spending the day at a health fair, I was concerned by something I overheard a employee say. I thought it would provide a useful and educational anecdote for people concerned about nutritional health.

The story happened something like this:
There was a nurse down at the other end of the room. She was doing finger sticks and checking employee's blood sugars as a basic diabetes screening. It was a simple test and most of the participants that weren't afraid of needles were having their numbers evaluated. A group of women, having just had their blood sugars checked, progressed across the room towards my table. While standing in front of me, a particular woman boasted of her food choices for the day: "Pancakes from McDonalds, hashbrowns, 2 soft drinks, and a cookie from the insurance table just across the way. Guess what? Her blood sugar was only 78." She smiled and gave herself a nod of approval at her excellent number.

In retrospect, I would have slowed my immediate response, but I was so upset by the inefficiency of this test in this particular moment that I jumped right in with an assessment of the situation. The woman was overweight and quite typically carrying the majority of her excess adipose tissue around her abdominal area. What I let her know, was that in order for her body to produce a blood sugar of 78 on this day following the food choices she had made, her pancreatic beta cells had to produce significantly more insulin than required had her food choices been different. Based on the blood sugar reading, it succeeded. But the extra insulin required to control the sugar spike from the foods consumed conveys a message to the body. The abundance of insulin tells the body, we have an excess of easy energy right now, the best thing to do is store it as fat for a later use. In addition to causing the body to store the consumed calories as fat, the insulin is also pro-inflammatory throughout the body. When this message and these signals are repeated day in and day out the end result is always the same => the individual is overweight and on the road to becoming a type II diabetic.
This is the risk with isolated screenings that do not consider the individual within the context of the big picture. Even though the number may look good today, the long term risks are compiling because the lifestyle factors are being neglected.