Americans, and now the larger industrialized world, are getting fatter and suffering from it. Type II diabetes is rampant (the ADA stated in 2007 that 10-11% of adults 20 and over are affected), and inflammation caused by a “western lifestyle” has been linked to a diverse array of maladies that lie somewhere between autoimmunity and inappropriate inflammation. From heart disease to gout we now suspect faulty and personally neglected signaling pathways related to insulin. The events leading up to diabetes actually may cause the most damage.
According to an article published by the ADA there is good evidence for the existence of a syndrome linking increased levels of insulin to increased triglycerides and hypertension[1]. Most of the manifestations of this syndrome seem to relate to stress placed on muscle tissue in the presence of a high carbohydrate diet and lack of that fleeting pass-time, exercise. See, negative feedback is a wonderful thing, until you break a part of the cycle. In this case, muscle tissue fails to dispose of dietary blood glucose appropriately (or at least fails to do so in a timely manner) and the pancreas picks up the slack by stimulating the systemic uptake of glucose with insulin. You may have guessed by now that this creates a nasty little cycle, with the muscle becoming less stimulated and the pancreas secreting more insulin.
Unfortunately while the insulin-caused-insulin-resistance view of things supports the development of an insulin resistant state, it doesn't produce a culprit or even a biased, that-guy-looks -shady suspect for other inflammation-associated diseases. Diseases like stroke, certain cancers, asthma and others too numerous to list here, need another explanation. This is tricky, we can't point at something like peanuts and claim, “that causes inflammation.” The medical community tried that with the cholesterol hypothesis, and statin treatment; of which the most comprehensive studies are particularly lukewarm [2]. What we can point to, are the rise of the sedentary lifestyle and a trend towards highly processed foods as the norm. Facets of western culture that, if abandoned, might alleviate the suffering without significant medical intervention.
As far as the miracle of Bromelain discussed in “revisiting inflammation”, I would tend to be very skeptical of an enzyme based oral medication. Seeing as the enzyme is the meat tenderizer found at your local butcher, and your digestive tract releases a good deal of similar enzymes, it probably won't hurt[3]. Although the literature is still out on the actual medical benefits [4]. After the cholesterol/statin hullabaloo, I would expect the community to drag its feet regarding broad statements on the matter.
The sad part is that the CDC has reported a significant increase in the prevalence of type 2 diabetes in children and young adults under the age of 20 in the past 2 decades. Type 2 diabetes has been viewed in the past as a disease most commonly found in the middle-aged, as opposed to type 1 diabetes, or "juvenile diabetes"; now it sounds like we might have to modify the naming.
ReplyDeleteI agree a lot with what is said with this blog. I would be extremely skeptical if Insulin Resistance was a predisposition for a disease, or condition (other than Diabetes). As far as the sedentary lifestyle goes, I think the focus should really be on what do these fast foods (greasy foods, artificial foods) contain that help to introduce a contaminated states to our bodies.
ReplyDeleteIve heard of a situation where the frying oil from McDonalds is prohibited from the diets of those with stomach ulcers. It has something to do with the artificial components and/or carcinogens!
Glad you mentioned the type 1&2 distinction. But yes, it used to be easy to diagnose type 1 diabetes in children. Mostly because if they spilled glucose in their urine or had high blood glucose levels it was most likely due to the auto-immune destruction of islet cells. Now it's not so easy, many younger people come in with what appears to be a nasty mix of the two. Type 2 was unheard of in children and young adults until fairly recently. I can also think of several instances where adults might develop "juvenile-onset" diabetes as well.
ReplyDeleteI do think there is an increased risk of "some" disease states other than diabetes that correlate with a "weatern lifestyle". Increased levels of sugar in the blood damages the aterial walls, which in effect, will have the impact of increasing the chances of an individual developing hypertension, stroke and heart disease.
ReplyDeleteAubreyC595, I agree that we need to take a look at what we are ingesting via fast food chains. However, I also think that focusing on sedentary lifestyle is also super important i.e. the average person in Houston, TX walks less than 1 mile per week and they have one of the countries highest diabetes rates. obviously a direct correlation.
ReplyDeleteAubreyc595, what is really disappointing to me,personally, is that rather than diet and lifestyle changes, people would rather go under the knife.
ReplyDeleteIt's such a tough disease to figure out (type 2 diabetes)...there's a genetic component, but we don't know how large a role it plays...and then there's the environmental component (high fat, low fiber, low physical activity) that plays a large role.
ReplyDeleteMy former laboratory spent lots of time trying to "prove" that glucose (extra sugar in the blood) directly led to inflammation and we were unable to...it seems that (like most things in the body) it's more complicated...probably a mix between glucose, insulin, fatty acids and ???.
As Aubreyc595 stated, it is horribly sad how little people in Houston, TX move. I do think that the problem lies with people not eating correcting and not exercising. I wonder how much of a correlation there is between obesity/diabetes and welfare. There has been multiple times where I go into the grocery store to buy food and notice morbidly obese people buying Twinkies, chips, regular sodas, and other unhealthy items and pay with a food stamp card. We have neighbors who had family members come out here from New Orleans after Hurricane Katrina and all but one of the children (out of four) and the mother were diabetic and she had been on welfare almost her entire life. The family was very obese and when our neighbor made good, healthy meals, they refused to eat it. Our neighbor’s mom was a gourmet chief for Ronald Regan when he was governor of California, so if you don’t want to eat her food I don’t know what you would want to eat. In the South they do fry everything which is very unhealthy with the trans-fats and other free fatty acids because of this I often wonder if there would be some type of correlation. Do they feel that it is too much work or costs too much to buy healthy food verses just buying junk food? As Dr. Cohen stated there is a genetic component but I really wonder sometimes if environment alone could cause Diabetes 2 or if someone who is predisposed to having Diabetes 2 could beat the odds by eating a moderate diet and exercising. It is sad that people would rather have a dangerous surgery because they want a quick fix but it also could be because their insurance has to pay for it rather than them buying expensive healthy food. Another reason might be because if they don't lose the weight they could die very soon, while they could have avoided needing the surgery some people are at a point where it is necessary because without losing a great amount of weight quickly their life might end.
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