Is Insulin Effecting Your Weight Loss and Your Health?

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1 Is Insulin Effecting Your Weight Loss and Your Health? Teressa Alexander, M.D., FACOG Women s Healthcare Associates

2 Obesity is Epidemic in the US 2/3rds of U.S. adults are overweight or obese Height Weight Range BMI Considered 124 lbs or less Below 18.5 Underweight 5' 9" 125 lbs to 168 lbs 18.5 to 24.9 Healthy weight 169 lbs to 202 lbs 25.0 to 29.9 Overweight 203 lbs or more 30 or higher Obese

3 Alarmingly, The Obesity Trend is Worsening No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

4 Over 50 Million Americans Have Metabolic Syndrome Defined as the presence of any three of the following conditions: waist measurement of 35 inches or more for women triglyceride levels of 150 or above, or taking medication for elevated triglyceride levels HDL, or good, cholesterol level below 50 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 or above, or taking medication for elevated blood glucose levels It places your risk of developing disease as EXTREMELY HIGH

5 The Bad News - Obesity Increases Your Likelihood of Disease People who are overweight or obese have a greater chance of developing: High blood pressure High cholesterol or other lipid disorders Type 2 diabetes Heart disease Stroke Certain cancers

6 Disease Risk Increases By Weight BMI Obesity Class Waist <35/ to Disease risk Waist >35/ to Disease risk Underweight < Normal Overweight Increased High Obesity I High Very High II Very High Very High Extreme Obesity 40 III Extremely High Extremely High

7 There is Good News A small weight loss (just 10% of your current weight) will help to lower your risk of developing those diseases

8 So How Does Insulin and Insulin Resistance Fit In? A hormone made by the pancreas Helps the body use glucose for energy Glucose in the blood is called blood glucose, also known as blood sugar As the blood glucose level rises after a meal, the pancreas releases insulin to help cells take in and use the glucose.

9 What is Insulin Resistance? A condition in which the body produces insulin but does not use it properly - muscle, fat, and liver cells do not receive this insulin.

10 A Vicious Cycle With resistance, more insulin is needed 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

11 What Causes Insulin Resistance? Specific genes have been isolated that make people more likely to develop insulin resistance and diabetes Poor diet, excess weight and lack of physical activity also contribute

12 The Fat-Burning Impact of Insulin Resistance Once your body releases insulin it immediately starts to inhibit your fat-burning hormone called hormone-sensitive lipase This hormone is responsible for releasing fat into your bloodstream to be utilized as fuel Once this enzyme is inhibited, your body is unable to burn fat and will then begin utilizing amino acids from your muscle and carbohydrates as fuel This will cause you to become hungry, which further feeds this vicious cycle. The key is to have LOW levels of insulin so your body can produce large amounts of hormone-sensitive lipase and burn fat

13 Other Effects of Insulin Resistance Insulin resistance increases the chance of developing: Type 2 diabetes Hormone abnormalities - PCOS Cardiovascular disease Abdominal Obesity High blood pressure Abnormal levels of cholesterol and triglycerides Metabolic Syndrome

14 Diabetes Type 1 - Where the pancreas makes little or no insulin because the body s immune system has attacked and destroyed the cells of the pancreas. Formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. Type 2 - Begins with insulin resistance, in time, however, the pancreas loses its ability to secrete enough insulin in response to meals. Formerly called adult-onset diabetes, is the most common form. People can develop type 2 diabetes at any age, even during childhood. Gestational Diabetes - Diabetes that first occurs during pregnancy and resolves with delivery but increases a woman chance of developing type 2 diabetes later in life.

15 PCOS Polycystic Ovarian Syndrome Most commonly related to ovulatory dysfunction as a result of adverse effects of elevated insulin levels on ovarian function Cause unknown may be some genetic component Seen across all races Affects 10% of all women Treatment addresses symptoms Symptoms Infertility Increased risk miscarriage 4-7x increase risk of heart disease Unwanted hair growth - face, chest, abdomen and feet Acne Elevated Blood Pressure Increased risk of Uterine Cancer Obesity

16 So What Are the Symptoms of Insulin Resistance? Usually have no symptoms Acanthosis nigricans - dark patches of skin, usually on the back of the neck, elbows, knees, knuckles, and armpits Abnormal periods Infertility Obesity

17 Diagnoses of Insulin Resistance Routine blood tests to determine whether a person is diabetic but do not usually test for insulin resistance Insulin resistance can be assessed by measuring the level of insulin in the blood Diabetes and pre-diabetes can be detected with one of the following tests: Fasting glucose test Glucose tolerance test

18 Treatment for Insulin Resistance Learning about insulin resistance is the first step toward making lifestyle changes that can help prevent diabetes and other health problems The first therapy should always be an intensive lifestyle modification program Weight loss and physical activity are much more effective than any medication at reducing diabetes risk. The American Diabetes Association recommends that Metformin is the only drug that should be considered for use in diabetes prevention. Metformin use was recommended only for very high-risk individuals who have BMI >35, Pre-diabetes, and < 60 years old.

19 Losing Weight Also Helps PCOS By losing weight, through diet and exercise, women affected by PCOS are more likely to have: Regular periods More ovulatory cycles Reduced hair growth Stabilized hormone levels Reduced risk of heart disease Weight loss will contribute to lowering insulin levels. Because high insulin levels has been found to contribute significantly to the many PCOS symptoms, reducing your insulin levels will have a direct improvement. Weight loss and regular exercise are now recommended as a first line treatment for PCOS. However, in some cases, drugs like Metformin may still be prescribed.

20 Is Insulin Effecting Your Weight Loss and Your Health? Rondi Stickney C.P.T, Master Trainer Founder of Ditch the Diet it s a Lifestyle

21 Diets Don t Work Individuals with the best results only lose 5 10% of their weight Over 2/3 gain ALL their weight back within 1 year 99% gain ALL their weight back within 2 years Going on a diet? Means eventually going OFF a diet a DIET IS NOT THE ANSWER

22 Low Carbohydrate vs. Conventional Diet The difference in weight loss was no longer significant at one year.

23 Glycemic Index How quickly a carbohydrate is absorbed by the body and raises our blood sugar (compared to controlled carbohydrate that is known, such as glucose) Bread, rice, cereal, white potatoes, spike sugar faster than as if eating table sugar Most critical time is immediately after a meal/snack when blood sugar rises too quickly, it can cause damage of the arteries, too much inflammation, and stimulates the production of too much insulin

24 Behavior Modification 3 Bad Behaviors It s a Lifestyle Change. First Bad Behavior: Portion Size. Large or too small. Typically palm size is a good measurement. Have a protein, vegetable, and a carbohydrate with meals. Try to eat 5-6 small meals. Drink Water! Second Bad Behavior: Bad choices of what we eat. Sweets, fried, processed or high-glycemic foods, etc. Third Bad Behavior: Late night snacking or having our last meal to late or that meal being too large. Eat at least 3 hrs before bed.

25 The Blood Sugar Roller Coaster Blood sugar control is necessary for the body to operate properly. If blood sugar is too high, as seen in diabetics, vision may be disturbed and we can t think as clearly as we should. If the blood sugar gets too low, we might actually get confused, have a seizure, or even go into a coma. The extreme rise and fall of one s blood sugar several times throughout the day, and the resultant over-stimulation of insulin, leads to the core of acquired insulin resistance. Control of Blood Sugar is the key to success.

26

27 Reversing Insulin Resistance Eat a healthy low glycemic diet that does not spike your blood sugar Develop modest exercise program Provide cells with cellular nutrition Employ relaxation (meditation or yoga)

28 Workouts help Reverse Insulin Resistance & Lower your risk of Breast Cancer By 28% Depression By 28% Heart Disease By 50% Colon Cancer By 40% Hip Fractures By 41%

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