Feb 27, 2011

Diabetes: more influenced by diet or heredity?

I’ve spoken with many patients who worry about their health and that of their children because there seems to be a strong family history of type 2 diabetes, high blood pressure or even heart attacks. Their concerns are obvious but what can be done to prevent these illnesses from striking them or their children?

It’s the difference in your genetic coding that affects why you look so different from everyone else. Genetics affects your hair color, height, eye color, skin tone and even your metabolism.

The last several years have seen a constant flow of research investigation the how genetic differences among people seems to pre-dispose them to develop the diseases associated with insulin resistance. Your risk of developing these diseases (mainly diabetes, high blood pressure and heart attacks) is driven by an your particular consumption of carbohydrates as well as your unique genetic sensitivity to the toxic effects of carbohydrates.

Genetic differences among individuals are the reason why some families have a greater prevalence of diabetes, high blood pressure or heart disease than others in spite of eating similar types and quantities of food.

How Much Risk Comes From Genetics Versus Food?

Research suggests that an individual’s risk of developing diabetes is in part due to genetics and in part due to the food they eat. Studies suggest that about 50% of an individuals risk is due to genetics and 50% is due to the diet.

In other words, if you eat excess carbohydrates you still can develop diabetes even if noone in your family has previously been diagnosed with diabetes. The same hold true for high blood pressure as well as heart attacks.

Diabetes Risk =
Sensitivity to Carbs (50%) + Amount of Carbs in Diet (50%)

This is exactly what we have been seeing with the present diabetes epidemic. The incidence of type 2 diabetes has tripled since 1980 because of the continual increases in carbohydrate consumption by the U.S. population.

Presently, 1 in 10 adults over 21 have diabetes with the number expected to reach 1 in 3 in another 30-40 years. It is important to note that in spite of our genes playing a role in the development of diabetes, 90-95% of diabetes is preventable by changing what we eat and how much we exercise.

I believe that if anyone ate a diet high in processed carbohydrates for a few decades, they will eventually develop diabetes.

You Actually Have A Family History of Carbohydrate Sensitivity

We need to reframe the meaning of a family history of diabetes, high blood pressure or heart attacks. Although many members in your family may be developing these diseases, they are really suffering from a genetic sensitivity to the toxic effects of carbohydrates.

Diabetes, high blood pressure or heart attacks are simply the symptoms they are developing because of the primary underlying problem, carbohydrate sensitivity.

Excessive sensitivity to carbohydrates is the underlying mechanism that leads to a greater likelihood of developing insulin resistance and its associated illnesses of diabetes, high blood pressure and heart attacks.

Diseases Arising From Insulin Resistance

Type 2 Diabetes Mellitus
Hypertension (high blood pressure)
Coronary Artery Disease (cause of heart attacks)
Abnormal Triglycerides and Cholesterol
Sleep Apnea
Polycystic Ovarian Disease
Fatty Infiltration of the Liver

Carbohydrate sensitivity is also why some thin individuals who eat too many carbohydrates can develop insulin resistance and type 2 diabetes, high blood pressure or has a heart attack without becoming overweight. It’s not the weight that they have a problem with; it’s the toxic effects of the carbohydrates. Being overweight is an indicator that your probably eat a high proportion of carbohydrates.

On the other hand, some individuals who are overweight and eat the same or even more carbohydrates may not develop insulin resistance and these other conditions because they are less sensitive to carbohydrates.

History of Diabetes = History of Carbohydrate Sensitivity

Understanding genetics is the reason behind the difference in your family’s medical history is helpful but it can also make individuals feel helpless since you can’t change your genetic DNA.

The truth is that understanding that your family history of diabetes, high blood pressure or heart attacks represents a genetic sensitivity to carbohydrate toxicity can actually save your life.

Instead of feeling helpless against the contents of your DNA, you can take action by learning how to consistently reduce your carbohydrate intake in order to minimize the risk of developing these diseases altogether.

Remember, 90-95% of type 2 diabetes arises from your lifestyle choices. The same holds true for high blood pressure and heart attacks. They are all medical conditions that result from excess carbohydrate sensitivity.

A Plan To Prevent Diseases of Carbohydrate Toxicity

Instead of worrying about low fat diets, supplements of fish oil capsules, trying to eat more whole grains and exercising as a means to lose weight and become healthy, attack your family history carbohydrate sensitivity head on.

Start by reducing your carbohydrate intake to less than 100 grams per day.

Many patients will ask me, “What kind of carbohydrates are safe to eat?” Technically speaking, carbohydrates that still contain their fiber because they are still raw or not overly cooked (think fruits and vegetables), trigger less toxicity than carbohydrates that have no associated fiber.

But let me make this clear, if your goal is to eliminate insulin resistance, I believe you need to reduce all carbohydrates to less than 100 grams per day. Any carbohydrates in excessive amounts are dangerous to an individual with a family history of diabetes, high blood pressure or heart attacks (remember, think carbohydrate sensitivity).

You need to slash your carbohydrate consumption to prevent these diseases from occurring. Simply changing from low fiber to high fiber carbohydrates will lessen the intensity of insulin resistance; it won’t turn off the toxic effects of these carbohydrates completely unless you drop your total intake.

Technically speaking, whole grain breads and pasta and brown rice are ‘healthier’ than their highly processed versions but too many carbohydrates in an individual with excess sensitivity to carbohydrates is too many carbohydrates, period. When you are talking about the risk deadly diseases such as diabetes, high blood pressure or heart attacks, it doesn’t matter if the carbohydrates are whole grain or not.

The diseases you need to avoid are diabetes, high blood pressure or heart attacks. The problem is a genetic sensitivity to the toxic effects of carbohydrates. The solution is to reduce your carbohydrates to less than 100 grams per day.

A Lower Carbohydrate Lifestyle

Where to start with carbohydrate reduction? I tell people to try to eliminate all snacking. These generally are high carbohydrate foods. If there is undue craving for food between meals, make sure you eat low carbohydrate vegetables, meat or cheese – not carbohydrates. You may want to add a daily antacid such as Tums when feeling hungry between meals because excessive stomach acid accumulation can mimic your sense of hunger. I’ve discussed effect of Tums on your hunger here and here as well in my Science of Hunger Guide.

If you have an intense drive for sweets, soda or feel so fatigued you think you need an energy drink, you need to add salt to your diet for a while. Your symptoms are caused by poor brain blood pressure and improve with sweet tasting food or salt. You can read more about this in my article on “Lightheadedness and Fatigue” or this nice review about Orthostatic Hypotension.

Sweet sugary foods and drinks stimulate the brain and improve blood flow. Salt improves blood flow also but won’t contribute to your risk of developing diabetes, high blood pressure or heart attacks the way sugary carbohydrates will. This is the very same reason why women may crave pickles and ice cream during their pregnancy. They are simply stimulating their body to improve their blood flow to their brain.

For the first month or 2, you’ll want to add salt to your diet instead of eating sweets. Within a short time, your blood pressure regulatory mechanism will improve and you won’t need to add any extra salt. In spite of adding salt, you’ll be surprised how quickly your blood pressure starts normalizing.

What if 100 Grams Per Day is Still Too Much?

Now if after a few months your blood tests still show some predilection towards diabetes (elevated blood sugar or a hemoglobin A1C great than 5.6), elevated blood pressure (systolic blood pressure greater than 120 mmhg) or other evidence of insulin resistance (triglycerides greater than 150 or HDL cholesterol less than 50), you need to lower the level of carbohydrate intake even further.

I advise my patients to work towards limiting their intake to less than 50 grams per day as a next step. Usually this will completely reverse any laboratory evidence of diabetes, high blood pressure or insulin resistance and has a massive impact on reducing the risk of future heart attacks.

I like to reassure everyone that it is safe to eat little to no carbohydrates. Technically speaking, you don’t need to eat any carbohydrates what so ever. Your body can make all the carbohydrates required by converting the protein or fats that you consume into carbohydrates. The people who preach that you need to consume carbohydrates throughout the day are completely wrong to keep your blood sugar up are completely wrong.

Your Family History is a Warning, Be Grateful

Don’t feel bad about having a family history of diabetes, high blood pressure or heart attacks. View it as a fortunate warning. Many people are carrying the genetic seeds of their premature death and have not idea it exists and don’t have the opportunity to do anything about it.

Your family history indicates that excessive carbohydrates in your diet are as dangerous to your health as cigarettes. Fortunately it is easier to cut back on carbohydrates than to completely quit smoking. Start today, I promise your it will save your life.

(Dr. Nemechek)
Photo: Nutra Legacy.
Technorati tags: , , , , , , , , .
Blogalaxia tags: , , , , , , , , .

No comments: