Why is 15% of the population so overweight that they have developed Type 2 diabetes? Why do I now see 4-5 wheelchairs brought onto commercial flights to help people off of the plane. People who are so overweight, and have lost so much muscle mass and strength that they can no longer even carry their own body weight to walk. Shocking, especially for people on their 60’s and 70’s. It does not make sense for it to be so easy and natural to gain weight. Or should it be?
Let’s go back 20-30 million years as human beings evolved. Food was scarce. It was almost always ”feast or famine.” If the hunters brought back a massive beast to eat, humans had only a few days to eat as much as they could and store all of the massive excess of calories as fat in order to fend off the starvation (famine) until the hunters brought back the next mastodon kill. There were no refrigerators or freezers to store the food for a few months to “level out” the eating opportunity. The food would spoil quickly and they did not eat it in a few days they could die of bacterial food poising. They had to eat a lot and quickly and store it as fat.
Those humans who made huge amounts of insulin (the key fat storing hormone) from their pancreas, and stored a lot of fat efficiently, would not die from starvation during the famine period. They lived to pass on their genetic tendency to make a lot of insulin, store fat and thus “survive.” Those who were less good at storing fat starved during the “famine” periods and did not pass on their genes.
So we are a species designed and genetically “selected” to make huge amounts of insulin in response to overeating. We have also, at some level been programmed to the have an ability to override satiety, and overeat massively. Thus, in a world of constant and cheap high caloric food, buffets, etc., humans, now face an obesity crisis. We need to better understand our metabolism, and understand that connecting our brains (satiety and hunger) to our mouth can allow us to control what drives obesity. If we do that we will have some hope to deal with this personal an societal healthcare crisis.
Brief Primer in Food Metabolism.
Glucose is a very simple sugar molecule (monosacharride). It is the basic unit of energy supply to cells in the human body. Glucose combined with oxygen allows your cells to make ATP (adenosine triphosphate). When the phosphate molecule of ATP is broken off in the cell, energy is released. It is this chain of glucose plus oxygen, creating ATP that creates energy from the burning of glucose, very much like gasoline used to fuel the internal combustion engine of a car. Much of this takes place in the mitochondria inside the cell.
Ultimately, all food, or stored fat, must be converted into glucose or its building blocks, in order to supply energy to our cells. When we eat, the food is absorbed in the small intestine. Very simple foods like table sugar (sucrose, a disaccharide) and simple processed starches are quickly converted to glucose and can quickly increase blood glucose levels. More complex carbohydrates, like the ones contained in most fresh fruits and vegetables are converted more slowly into glucose. Proteins take even more time and energy in the intestines and the liver to be converted into its component amino acids (protein building blocks). Amino acids can be converted into glucose, but usually only if other sources of glucose are not available. Thus, proteins take a relatively long time, through complex and energy consuming steps to be converted into glucose. Proteins and amino acids will also be used to build or re-build stressed muscle fibers when we stress our skeletal muscle, and may not be converted to glucose at all. This is important to remember when we talk about why eating protein is a key to muscle building and remodeling, and to losing weight. Atkins was right about protein.
How about fats in our diet? When we eat fatty foods it is really bad. Fats are absorbed rather quickly, converted to various fat molecules, like triglycerides, and then shipped off to organs, mainly fat cells (adipocytes) to be stored as fat. This process of rapid fat absorption and storage, and the conversion of glucose to fat is driven by the key hormone insulin, which is secreted by beta-cells in the pancreas.
Diabetes and Obesity: A Huge and Growing Problem
The obesity epidemic in America and other western cultures is perhaps the biggest healthcare crisis today. It is the predominant cause of the explosion in Type 2 (adult onset) diabetes. In a recent USA Today article, they note that 14% of Americans are diabetic. Even more frighteningly, experts predict that this may soar to close to 40% of the population by 2050!
Diabetes is the number one cause of kidney failure, adult blindness, limb amputation, and a huge contributor to coronary artery disease and stroke. It is an accelerator of atherosclerosis causing plaque buildup in our arteries throughout our body. The Center for Disease Control (CDC) estimates that diabetes currently costs the U.S. $174 billion per year, most of which is in direct healthcare costs. The cost, like the incidence, may nearly triple in the next 40 years to $500 billion per year if we do not stop this alarming explosion in obesity!
How do we become diabetic? Insulin is the bad actor! Rapid insulin release or insulin spikes occur in response to a significant and rapid increase in our blood glucose level. So, when we eat sweets (high sugar and processed carbohydrate content), or a huge meal of any type, our insulin levels rise quickly and dramatically. A high glucose level is the signal to our body that there is excessive food in our life. The message is, “Wow, food is plentiful, feast time, let’s store it as fat!” In very overweight adults who eat a lot, the pancreas works overtime and keeps producing a lot of insulin. This extra insulin in your blood will add to the problem, and make you even fatter. The body eventually makes fewer insulin receptors on the cell surface so we become “insulin resistant,” and glucose is not metabolized as quickly into glycogen and fat. Eventually we become so resistant to the effects of insulin that we cannot store the glucose in our body fast enough and our blood glucose levels are elevated, even when we are not eating! This is Type 2 diabetes.
This is not just a huge problem for society and our overburdened healthcare system. It is really harmful to you as an individual. Diabetes will triple the risk of heart attack and stroke, more than double the risk of developing kidney failure and blindness, triple the risk of developing peripheral neuropathy, and recently has been found to also nearly double the risk of developing Alzheimer’s dementia. The prognosis and effect on life expectancy from this condition is about the same as breast cancer or colon cancer. This is a disabling and deadly disease.
Here is the exciting news. Diabetes is nearly totally preventable and even curable! The main difference between Type 2 diabetes in an overweight adult and cancer is that you do not need surgery, radiation or chemotherapy to cure your “cancer” (i.e., the diabetes). If you lose 50-100 pounds, depending on how overweight you are you can prevent this condition. If you already have diabetes you can lose weight and cure your diabetes. Let’s think about this. If you had colon or breast cancer, and I told you that you could cure your cancer by losing 75 pounds, would you do it? I think we both know the answer. The cure is in your hands. You can prevent or cure your diabetes and live much longer.
Why Bother? I Am Not Diabetic. It Is Too Much Work, and What Are the Problems With Being Overweight?
There is no question. Humans are resistant to change. This is especially true if they do not see immediate positive reinforcement. It is always easier to just go back to your “usual” dietary and sedentary habits. Even though the behavioral changes outlined in Burn Calories While You Sleep are pretty simple and will work for just about everyone, this will not happen in thirty days. Be patient and know that if you follow the major key points in this program, week in and week out you will have a huge impact on your life. We are talking 20-50 years! You will be able to lose weight and achieve close to your ideal body weight, and without a huge time commitment. But why do it?
There are numerous and serious consequences to not doing this (i.e., staying 50-150 lbs. overweight). What will you gain by becoming fit and getting closer to your ideal body weight? A lot. You will have much more energy, stamina and physical strength. It will improve your mood (less depressed). You will reduce your blood pressure and possibly eliminate the need for blood pressure medications. You will substantially decrease your risk of a heart attack or stroke, and prevent the onset of Type 2 diabetes. You will reduce cancer risks. You will reduce the likelihood and/or delay severe osteoarthritis of your knees and hips that may eventually disable you or require hip or knee replacement. You will double or triple your muscle and core strength which will allow you to participate in an active life, including tennis, basketball, racket sports, biking, hiking, dancing, skiing, etc., well into your 70s. You will reduce the likelihood of a ruptured disc in your back. If you are a woman, and adopt this fitness routine you will slow or reverse osteoporosis. You will look better and be more attractive to your spouse, boyfriend or girlfriend. You will fit better in those horrible coach seats on airplanes. You can play touch football with the kids. You will look forward to wearing a bathing suit at the beach. You will have better (and probably more) sex! You will have enhanced self-esteem and self-confidence. You are more likely to get that job you interviewed for. You will (statistically) live five-to-ten years longer. These are some pretty compelling reasons to start today on a sensible and sustainable program to get fit and lose weight.