Diabesity – A Reversible Epidemic

Mark Hyman, MD  February 12, 2012

What life threatening, life sapping, energy robbing condition affects one in every two Americans (that is EVERY OTHER person) including 80% of those overweight and up to 40% of normal weight people?  What condition is responsible for more deaths from heart disease, cancer, high blood pressure, diabetes and dementia than anything else?  What condition also causes acne, infertility, sexual dysfunction and depression?

What condition accounts for more then 70% of our $2.4 trillion annual health care bill and will account for most of the $47 trillion we will spend globally over the next 20 years to deal with chronic disease?  What is responsible for nearly twice as many deaths every year as infectious disease, even in the developing world?

And what condition is not even diagnosed in over 90% of those who suffer from it?

What condition are doctors not trained or reimbursed to diagnose, treat or prevent, yet makes up the majority of health care visits and costs?

And what condition is nearly 100% preventable, treatable and reversible?

Diabesity.

It is the single biggest health challenge facing us individually, as a nation and as a global community.

Diabesity is the continuum of metabolic disturbances from mild blood sugar and insulin imbalances to pre-diabetes to full blown type 2 diabetes.  It occurs in about 40% of people of normal weight – these are the skinny fat people who look thin but are metabolically fat and have all the same risk factors for disease and death as those who are overweight.  And it occurs in 80% of overweight people.

Since it affects every other American, watch this video to see if you have it.

The solution is not coming from our health care system or doctors, not from our government, or from most corporations.  There are too many people vested in maintaining the status quo or worse profiting from making us fat and sick.  We need a solution.

That is why I wrote, The Blood Sugar Solution.  It has a bold central goal: to address and begin to reverse a global epidemic. It is a personal guide and plan, as well as a program for helping people get healthy together, based on functional medicine, and it is a blueprint for us to take back our health as a society.

Obesity, pre-diabetes and diabetes or what I call diabesity, which now affects one in two Americans arises out of existing social, economic and political conditions. In fact obesity and diabetes are social diseases and need a social cure and collective action on many levels to reverse the tide.

Over 10 years, these conditions will cost America over $3.5 trillion in direct costs, not including lost productivity and the costs in quality of life.  From 1983 to 2008, worldwide diabetes rates increased seven fold from 35 million to 240 million. In just 3 years from 2008 to 2011, the roll call for diabetes increased another 110 million.

Children less than 10 years old now get type 2 (or adult onset) diabetes, and have strokes and heart attacks by age 15 or 20.  One in three children born today will have diabetes unless we do something differently.

I wrote The Blood Sugar Solution to tackle this problem head on.

It is a personal plan that breaks through myths about obesity and diabetes that keep us sick and fat. And lays out the seven key steps to preventing, treating and reversing diabesity by dealing with the underlying causes. It is an eight-week plan that takes you through step by step how to reboot your metabolism, lose weight, reverse type 2 diabetes.

It is a plan for us to be more successful by working together to get healthy.  We do twice as well and lose twice as much weight when we get support from others in community. We are better together.

We recently did a “beta test” of this program with about 150 people. Their results were astounding:

• The group lost a total of 1,536 pounds in just eight weeks. That’s an average weight loss of over ten pounds per person!
• More than half the group lost more than ten pounds. Some lost as much as 28 pounds.
• Average waist size decreased by 1.5 inches, and some people lost so much of their waist that they had to go out and buy new clothes. One woman lost eight inches from her waist. Imagine, eight inches in eight weeks. No medication can help you do that.

But The Blood Sugar Solution is about far more than weight loss; it’s about taking back your health and your life. People who completed the program reported an average reduction of 14 points on their systolic blood pressure, their fatigue evaporated and they had more energy than they had felt in years, their joint and muscle pain vanished; the program improved their mood and sleep, eliminated their brain fog, and a provided a deep sense of well being. The Blood Sugar Solutiongave these people a new lease on life, here are a few of their stories.

The Blood Sugar Solution is a plan for each of us to take back our health as a society. Our health has been hijacked from us, taken from us slowly, quietly, over the past century. Our current food, social, family, school, work, faith-based, and community environments, health care institutions, and government policies make it hard for us to make healthy choices. We are presented with choices that foster bad habits. But together, getting and staying healthy is possible given the right information, tools, support, and collective action to take back our health.

Navigating the Terrain of Disease: Getting to the Root of the Problem

To effectively treat diabesity we must shift our focus away from the symptoms or risk factors of the disease and begin taking a hard look at the causes. All of our attention is on treatments that lower blood sugar (diabetes drugs and insulin), lower high blood pressure (anti-hypertensive drugs), improve cholesterol (statins), and thin the blood (aspirin). But we never ever ask the most important question:

Why is your blood sugar, blood pressure, or blood cholesterol too high and why is your blood too sticky and likely to clot?

Put another way: What are the root causes of diabesity?

Answering that question must be the focus of our diagnosis and treatment of the disease if we are going to solve this global epidemic.

The good news is that the answer is shockingly simple.

The Real Causes of Diabesity

The entire spectrum of diabesity including all of its complications—diabetes, elevated blood sugar, blood pressure, and cholesterol—are simply downstream symptoms that result from problems with diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities.

Those are the real causes of diabesity.

And the reason these dietary and lifestyle factors lead to diabesity is because they create a condition known as insulin resistance. Contrary to what most people think, type 2 diabetes is a disease of too much, not too little, insulin. Insulin is the real driver of problems with diabesity.

When your diet is full of empty calories and an abundance of quickly absorbed sugars, liquid calories,^[i] and carbohydrates (like bread, pasta, rice, and potatoes), your cells slowly become resistant to the effects of insulin and needs more and more to do the same job of keeping your blood sugar even. Thus you develop insulin resistance. A high insulin level is the first sign of a problem. The higher your insulin levels are, the worse your insulin resistance. Your body starts to age and deteriorate. In fact, insulin resistance is the single most important phenomenon that leads to rapid and premature aging and all its resultant diseases, including heart disease, stroke, dementia, and cancer.^[ii],[iii]

As your insulin levels increase it leads to an appetite that is out of control, increasing weight gain around the belly, more inflammation and oxidative stress, and myriad downstream effects including high blood pressure; high cholesterol; low HDL, high triglycerides;^[iv] weight gain around the middle; thickening of the blood; and increased risk of cancer, Alzheimer’s, and depression. These are all a result of insulin resistance and too much insulin. Elevated blood sugar is not the source of the problem.

And because insulin resistance (and diabesity) are a direct outcome of diet and lifestyle, the condition is 100 percent reversible in the vast majority of cases. Most people just need to eliminate the things that are sending their biology out of balance and include what’s needed to help the body rebalance itself. For most the interventions required are extremely simply and extraordinarily effective.

8 Steps to Reversing Diabesity

In my new book The Blood Sugar Solution I outline a comprehensive 8-week plan for overcoming diabesity in all its forms. Here is a sneak preview of the steps outlined in the book:

1. Get the right tests. Most doctors focus on fasting blood sugar. This is actually a poor indicator of diabesity. The best test to tease out the condition is an insulin response test where insulin levels are measured fasting and then 1 and 2 hours after a glucose drink. Demand this test from your doctor.
2. Get smart about nutrition. Despite the media hype and the seeming confusion amongst doctors, the basics of nutrition are extremely simply. Eliminate sugar and processed carbohydrates, include whole real foods like lean protein (chicken or fish), veggies, nuts, seeds, beans and whole grains.
3. Get the right supplements. There has recently been a frenzy of negative reports about supplements. Most of them are unfounded. Supplements are an essential part of treating diabesity. A good multivitamin, vitamin D, fish oil, and special blood sugar balancing nutrients like alpha lipoic acid, chromium polynicotinate, biotin, cinnamon, green tea catechins, and PGX (a super fiber) should also be included.
4. Get relaxed. Stress is a major unrecognized contributor to insulin resistance and blood sugar imbalance. Push your pause button every day with deep breathing, visualization, yoga, and other relaxation techniques.
5. Get moving. Aside from changing your diet, exercise is probably the single best medication for diabesity. Walk for at least 30 minutes every day. For some, 30-60 minutes of more vigorous aerobic exercise 4-6 times a week may be necessary.
6. Get clean and green. Environmental toxins also contribute to diabesity. Filter your water, look for green cleaning products, and avoid plastics when you can.
7. Get personal. While the steps above will address 80 percent of the problems with diabesity, some may need to take additional steps to optimize key areas of their biology. Remember, the medicine of the future is personal medicine. Seek out your own biological imbalances and look for ways to address them.
8. Get connected. Research is beginning to show that we get better more effectively when we get together. Invite your friends, families, and neighbors to change their diets and lifestyle along with you. Together we can all take back our health.

I hope that my book The Blood Sugar Solution will be the beginning of a larger transformation – for individuals, communities and for society.  In the book I outline all of the social, economic, biological, and medical underpinnings of this health epidemic and provide an 8-week, step-by-step system that will allow you to dig deep into your own biology and heal even the most severe cases of diabesity.

Get a book, get two and give one to someone you love  – you might be saving their life. When you purchase the book from this link you will automatically receive access to the following special bonuses:

• Special Report—Diabetes and Alzheimer’s: The Truth About “Type 3 Diabetes” and How You Can Avoid It.
• More Delicious Recipes: 15 Additional Ways to Make The Blood Sugar Solution as Tasty as It’s Healthy!
• Dr. Hyman’s UltraWellness Nutrition Coaching – FREE for 30 days!
• Hour 1 of The Blood Sugar Solution Workshop DVD

For more on diabesity, join us on www.drhyman.com

[i] Chen L, Appel LJ, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Mitchell D, Batch BC, Svetkey LP, Caballero B. Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. Am J Clin Nutr. 2009 May;89(5):1299-306.

[ii] Bhashyam S, Parikh P, Bolukoglu H, Shannon AH, Porter JH, Shen YT, Shannon RP. Aging is associated with myocardial insulin resistance and mitochondrial dysfunction. Am J Physiol Heart Circ Physiol. 2007 Nov;293(5):H3063-71.

[iii] Ryan AS. Insulin resistance with aging: effects of diet and exercise. Sports Med. 2000 Nov;30(5):327-46. Review.
[iv] Gaziano JM, Hennekens CH, O’Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation. 1997 Oct 21;96(8):2520-5.

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A session with Madhuji unlocks answers as he guides you in accessing your inner clarity and awareness. His ability to read your energy and provide Chakra, Karmic and Energy Healing brings release, strength and focus as you take a path towards higher consciousness and a permanent state of awakening. Life is a journey of discovery and growth. Make the most of yours. Experience the guiding power of love and acceptance with Madhuji.

Therapeutic chakra balancing is a comprehensive system of lifestyle yoga, meditation and healing. It consists of sessions that help develop wisdom to evaluate your energy, recognize where you are losing or receiving energy and how to access and balance your energies in a manner that supports your personal development, relax the mind, and improves your relationships. The result is a higher level of integration and a deeper connection with your inner self. It involves integration of chakra energy balancing, yogic healing and various other vibrational healing modalities to clean, balance and align your energy system. Madhuji has integrated these modalities of healing to take your consciousness to a new level resulting in optimal health and wellness of body, mind and spirit.

For more information on Madhuji and his practice, visit www.u5ji.com

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Get Re-Energized in Just 10 Days!

Every day, you are exposed to numerous chemicals that can affect the way that you feel:

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In his talk Lustig explains that all the reasons we think make us fat are just not true. No one chooses to be obese, especially children. It is not a matter of calories in and calories, not enough exercise, or just being lazy and gluttonous. It is a biochemical alteration that creates a toxic cycle of sugar, fat, more sugar, more fat. In fact, the metabolism of sugar is very similar to alcohol and can lead to fatty liver and hepatitis.

Bottom line: You can lose weight and control your appetite but you will never do it with the usual diet and exercise routine. You must get your sugar intake and your blood sugar hormones under control or you will continue to cycle and recycle the weight over and over.

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What is it?           

Polycystic ovary disease (also known as Polycystic Ovary Syndrome or PCOS) is defined as a condition in which there is an imbalance in female sex hormones. This can lead to a number of changes including abnormal and irregular menses, acne and infertility. The typical woman with PCOS is thought of as being overweight, with acne, excess body hair and other signs of androgen excess such as male pattern baldness and even clitoral enlargement. However, as so frequently occurs in medicine, there are many varying degrees of PCOS and a woman may have PCOS without expressing the above typical symptoms. Many women with infertility may have underlying PCOS. One of the main issues with PCOS is insulin resistance which leads to obesity, infertility, and contributes to acne. A woman may have completely normal testosterone levels but still have evidence of androgen excess because in PCOS the problem is not simply testosterone excess, but a hypersensitivity of the androgen receptor. The symptoms may begin as a teenager but is usually diagnosed in the 20s and 30s. The majority of women probably go undiagnosed unless they have the typical symptoms. Many women out there with irregular or even fairly normal periods may have a form of PCOS and be at risk for infertility, diabetes and endometrial and breast cancer (because of progesterone deficiency). Cystic ovaries are not essential to the diagnosis of PCOS.

Could you be at risk for PCOS?

The point of this post is that PCOS is much more prevalent than generally known and is frequently not diagnosed leaving these women at risk for the complications (infertility, diabetes, endometrial and breast cancer) associated with PCOS. Diagnosis can be made with hormonal evaluation, analysis of insulin resistance and risk for diabetes, and attention to the clinical symptoms.

How is PCOS treated?

Treatment consists of aggressive management of abnormal blood sugar through diet (mostly low glycemic, low carbohydrate, high protein), lifestyle (regular exercise and nutrient support to help decrease abdominal fat and increase muscle mass) and medication (metformin) if needed. Studies have shown that having a fasting blood glucose above 86 leads to increased risk for cardiovascular disease (CVD). It is well known that diabetics have an increased risk for CVD, cancer, accelerated aging and dementia. It is likely that fasting blood sugars between 90-100 (prediabetes) carry similar risk. Balancing the hormones can be done with bio identical hormones to correct for progesterone deficiency instead of using oral contraceptives (especially if pregnancy is desired) and is frequently much better tolerated.

If you think you might be at risk for PCOS, it might be a good idea to get screened by a physician knowledgeable in this area. In addition to routine lab tests such as lipids and thyroid function, lab tests should include fasting glucose, fasting insulin, FSH, LH, estradiol, progesterone and possibly vaginal ultrasound. A program of diet, lifestyle, medication, and hormone balancing should be the initial treatment. With commitment, many women with PCOS are able to get pregnant and manage their glucose issues to prevent the well know sequelae of pre-diabetes and diabetes.

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If you’ve been living on planet earth for the last 20-70 years, then you’ve been exposed to environmental toxins. We live in a modern age of convenience and abundance, fueled by technology and mass-production, and the by-products of these benefits are released into the air we breathe, the water we drink, and find their way, most certainly, into the food we eat.

There are basically three kinds of toxins:
• Environmental
• Lifestyle
• Internal

Environmental toxins include things like the air pollution from factories and auto exhaust, exposure to paint and household or industrial cleaning products, heavy metals, pesticides, herbicides and radiation. Lifestyle toxins are the result of the choices we make—they include anything you ingest intentionally—like nicotine, alcohol, caffeine, recreational, refined foods and sugars, prescription and over-the-counter drugs—and also unintentionally, artificial food additives like colorings, flavorings and preservatives, or meats from animals treated with hormones, antibiotics or artificial stabilizers. Don’t forget that your skin is like a giant sponge and everything you rub on it, bathe in, or wear contains potentials toxins. Internal toxins are the result of your body’s processes or imbalances: metabolic, hormonal, digestive, and emotional. Internal toxins include things like: bacteria, yeast, fungi, by-products of metabolism (carbon dioxide, ammonia, hormones), undigested food, and the biological by-products of stress or unresolved trauma.

Because exposure to all three kinds of toxins is ongoing, it’s important to understand that detoxification is not a one-time treatment. It is an ongoing program, a commitment, and a lifestyle choice. I generally recommend that people consider a program of detoxification twice a year.

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Vitamin D

Vitamin D is the new super-nutrient.  Studies have shown deficiencies across a broad spectrum of disease including breast, colon and other cancers, multiple sclerosis, osteoporosis, dementia, Parkinson’s, and many others.  The recommended daily allowance has been increased from 200 units to 800 units—and soon-to-be 1000 units—daily.  I have most of my patients on 2000 to 5000 units daily.  30 minutes a day of full-body sunshine can alleviate a vitamin D deficiency, but the sun doesn’t always shine, and our indoor lifestyle and regular use of sunscreen have led to widespread vitamin D deficiency.

Essential Fatty Acids (EFA)

Essential Fatty acids promote healthy cell membranes, which allows for the efficient exchange of nutrients, as well as the repair and growth of healthy tissue. An imbalance of Omega 3 and Omega 6 leads to an inflammatory state and poor cellular health. With the shift from grass fed to grain fed, our meat supply has become disproportionately low in Omega 3 and high in Omega 6 because agricultural feed—from cattle, chickens, and pigs to fish—primarily consists of corn. Cows have not evolved to eat corn; they have evolved to eat grass. In addition to fostering deadly bacteria like e. coli 157-H7, feeding corn to cattle has been shown to alter the normal ratio of omega 3 to omega 6 fatty acids in cattle’s systems, depleting the soothing Omega 3 in favor of Omega 6. Supplementing with a supplement called Y.E.S. Essential Fatty Acids provides the basic amino acids, linoleic and alpha linoleic, and provides the body with the basic building blocks it needs to correct an imbalance in EFA.

Minerals

Minerals are essential to normal and healthy cellular function and I recommend a multivitamin with a healthy mineral component. The liquid vitamins I generally recommend, Intramin or Intramax, are engineered to allow optimum absorption of essential minerals.    www.druckerlabs.com

B Vitamins

Because of compromised gastrointestinal function and the overuse of pharmaceuticals, many people poorly absorb B vitamins. B vitamins are absorbed as the body breaks down and absorbs proteins. We all need acid to break down protein, and many of us simply do not make enough of it (or are on an acid-reducing medication). Our stressful lives also contribute to a decline in B vitamins. Stress results in high cortisol levels and high cortisol levels result in increased utilization, and depletion, of B vitamins. These nutrients are essential for adequate neurological function including cognition, balance, and proprioception. Many pharmaceuticals, such as oral contraceptives and hormonal therapies, interfere with the absorption and function of B vitamins.

Multivitamins

A quality multivitamin can be a preventive measure to help you maintain your health, but a multivitamin alone—even a good one like Intramax—will not restore a lifetime of poor nutrition.

Probiotics

Healthy bacteria play an essential role in gut function. Again, our depleted diets and pharmaceutical onslaught, as well as chemical toxicities omnipresent in daily life, wreak havoc on the complex and delicate environment inside your body.  Eating yogurt can be helpful, but frequently a probiotic supplement is needed. Dr. Ohirra’s is available online, and at many health stores. A good probiotic has multiple strains of bacteria and adequate numbers to assure passage into the small intestine such as Xymogen’s ProBio Max DF or ProBio Max Daily DF.

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Below the list of foods are links to more information about the benefits of the nutrients they contain. Always remember that choosing organic is a key component of a healthy diet. A list of foods that are generally high-risk for pesticides and other toxins was compiled by the Environmental Working Group, which provides a Shopper’s Guide, identifying ‘The Dirty Dozen” (foods that are high-risk for numerous pesticides and should always be bought organic), and also ‘The Clean 15” (foods that tend to have a lower pesticide risk). The EWF website has a bounty of information about pollution in our air, water, and food supply.

Superfoods
Apples
Avocado
Beans
Blueberries
Broccoli
Cinnamon
Dark Chocolate
Extra Virgin Olive Oil
Garlic
Honey
Kiwi
Low Fat Yogurt
Oats
Onions
Oranges
Pomegranates
Pumpkin
Soy
Spinach
Tea
Tomatoes
Turkey
Walnuts
Wild Salmon

Super Nutrients
Ascorbic Acid
Calcium
Carotenoids
Fiber
Folate
Iron
Lutein
Magnesium
Manganese
Niacin
Omega 3 Fatty Acids
Polyphenols
Potassium
Protein
Riboflavin
Saponins
Selenium
Thiamin
Vitamin B6
Vitamin E
Zinc

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