Newsletter #28

GOT THE RIGHT CARBS? by Linda A. Odum

PREVENT INSULIN RESISTANCE AND DIABETES

A condition that affects one in three Americans, insulin resistance syndrome (commonly

known as Syndrome X) can greatly increase a person's risk of developing Type II diabetes.

This syndrome can also lead to coronary heart disease and stroke.

WHAT IS INSULIN RESISTANCE?

Insulin is a hormone produced by beta cells in the pancreas. When you eat a meal, insulin is

released into the bloodstream to help the body use and store the glucose generated from food.

insulin resistance occurs when the body becomes less sensitive to the function of insulin,

causing it to compensate by producing even more of this hormone.

"You produce a lot of insulin, and over time that insulin becomes less and less effective,"

says Colette Heimowitz, director of education and research at Atkins Health and Medical

Information Services in New York. "The beta cells in the pancreas become desensitized

from so much blood glucose and insulin, until insulin becomes ineffective. It's like a machine

that's wearing down."

Though a small number of thin individuals have insulin resistance, the majority of sufferers

are overweight or obese. "When there is a large amount of body fat present, it inhibits the insulin

from working effectively and efficiently--and getting into the cells," says Melinda Maryniuk, Med,

RD, CDE, program manager at the Joslin Diabetes Center in Boston.

THE CARB CONNECTION

During the decades when a low-fat, high carbohydrate diet was recommended, not only was

there a marked increase in obesity in this country--but also an increase in the cases of Type II

diabetes. This suggests that the modern American diet of highly refined carbohydrates promotes

insulin resistance and obesity.

"Carbohydrates, unlike fat or protein require an insulin response," says Heimowitz. "When

you eat excessive carbohydrates, it raises the blood sugar too much. You produce a lot of insulin,

and over time that insulin becomes less and less effective. But if you control your carbohydrate

consumption, you control your insulin production."

Of course, not all carbohydrates are created equal. Complex carbohydrates (whole grains,

vegetables, fruits, nuts, and seeds) do not cause the excessive insulin reaction that refined carbo-

hydrates do.

One reason for this may be the increased amount of fiber found in complex carbs. "Fiber forms

a type of gummy mass that is more resistant to absorption in the gut," says Maryniuk. "Therefore,

fiber slows down the absorption of carbohydrates so they don't affect blood sugar as quickly."

"The more refined the carbohydrate, the bigger its impact on blood sugar," adds Heimowitz.

"whole-grain, high-fiber carbs release at a slower pace into the blood stream. When fat is

present, it retards the entry time even more. The best scenario is to eat very high fiber, complex

whole grains in their original form, not refined and processed, with some healthy fats like olive

oil or avocado or seeds and nuts."

LOWER YOUR RISK

How do you lower your risk of insulin resistance? The consensus is that simple lifestyle

changes--weight loss and exercise--are effective. "It's not a lot of weight that you have to lose,"

says Maryniuk. "The goal is a 5 to 7 percent weight loss from your starting point. If you weigh

160 pounds, you would only have to lose 8 to 11 pounds." A diabetes prevention study conducted

by the Joslin Diabetes Center found that people who lost that percentage of body weight and

exercised 150 minutes a week reduced their risk of diabetes by 58 percent.

Heimowitz recommends that individuals discover their critical carbohydrate tolerance level

by cutting back on carbohydrates and then reintroducing them slowly until weight loss is halted.

"Only introduce the most nutrient-dense carbohydrates, like seeds and nuts, whole grains, and

fruits and vegetables. Stay away from refined carbohydrates. Stay away from sugars. And make

sure you have plenty of healthy fats."

SUPPLEMENT SUPPORT

In addition, a number of supplements affect insulin response. Probably the best known is

chromium, which the body is unable to produce on its own. "In the late 1950's two German

scientists discovered that chromium is needed to make insulin work effectively," says Gary W.

Evans, PhD, a former research scientist in the field of human nutrition for the US Department of

Agriculture. "Insulin needs chromium. When chromium is sufficient in the body, insulin attaches

to the cells and the glucose keeps moving."

Since the best food sources for chromium are liver, kidney, and brewer's yeast, some individuals

choose to take chromium supplements, depending upon their health and glucose levels. To pre-

vent the onset of insulin resistance syndrome, 200 mcg of chromium daily should be enough.

If you are dealing with a related condition (obesity, diabetes, or high blood pressure, cholesterol,

or triglycerides, or if you have a family history of these conditions), try taking 400 to 800 mcg

chromium daily. (Individuals with diabetes may need blood sugar monitored when taking

chromium to determine the best dose.) Two or three smaller doses, divided during the day, often

help the body absorb chromium effectively.

Alpha lipoic acid (ALA) is another supplement important for anyone fighting insulin resistance.

It helps the body burn glucose, converting it to energy. ALA can decrease glucose and insulin

levels, thus reducing insulin resistance and improving insulin sensitivity. This antioxidant also

protects the body from free-radical damage. To prevent insulin resistance, take 50 mg daily as

part of a multivitamin supplement. If you are already insulin resistant, try 100 to 300 mg. Daily.

Vitamin C is another antioxidant found to reduce glucose levels and normalize insulin function

(1,000-2,000 mg daily in divided doses.) Vitamin E also helps manage glucose and insulin, plus

it reduces the risk of heart disease (400 IU daily). Along with chromium, zinc is another mineral

important in glucose regulation and insulin function (30 mg daily). Magnesium improves insulin

action as well as prevents hypertension (400 mg daily).

In addition, a number of herbs may help regulate insulin response. Milk Thistle (Silybum

marianum) improves glucose control, reducing insulin resistance (take 200 mg daily). Two

Ayurvedic remedies that appear promising:

• Fenugreek seed (Trigonella foenumgraecum), which helps reverse insulin resistance by

• Gurmar (Gymnema sylvestre), which improves glucose tolerance and insulin efficiency

(take 75 to 150 mg daily)

Finally, preliminary studies suggest that American ginseng (Panax quinquefolius L.) can reduce

Insulin resistance as well as control blood pressure and lipids. Larger studies are needed to

Understand its benefits fully.

The glycemic index (GI) developed in the 1980's compared the effect of different foods on blood

sugar levels 2 to 3 hours after consumption. However, recent research suggests that glycemic

load (GL), which combines the percentage of carbs in a food with its rating on the GI, may be a

better measurement. For example, nutrient-rich carrots score high on the GI but don't contain a

lot of carbohydrates per serving, so the GL is low. It would take eating a pound and a half of

carrots at one time to have a measurable effect on blood sugar.

Popcorn (air-popped) 5 g 0.79 4

Lentils 20g 0.41 8

Carrots 8 g 1.31 10

Wild rice 18g 0.78 14

Potato 37g 1.21 45

Grape-Nuts cereal 47g 0.96 45

SELECTED SOURCES

• "Clinical Endocrinologists Establish Strategies to Detect and Mangae the Insulin Resistance Syndrome,"
• "Use of Antioxidant Nutrients in the Prevention and Treatment of Type 2 Diabetes" by Rodney C. Ruhe, PhD
• "Konjac-Mannan and American Ginseng…Therapies for Type 2 Diabetes Mellitus" by Vladimir Vuksan, PhD
• "Potential Antioxidant Effects of Zinc and Chromium…Type 2 Diabetes Mellitus" by Richard A. Anderson
• Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance by Jack Challem;

Burt Berkson, MD, PhD; and Melissa Diane Smith

• "What if It's All Been a Big Fat Lie?" by Gary Taubes

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