Did the failed food pyramid contribute to rise in obesity in America?
Posted by Prab R. Tumpati, MD, Medical Director
In May 2011, the USDA released a graphic called “My Plate” to help people choose what foods to eat instead of the “Food Pyramid”. The useless and misleading food pyramid, which has been confusing consumers for over 25 years, has advocated a philosophy of eating more grains and other less “fatty” foods. Food Pyramid failed to differentiate simple versus complex sugars and placed undue importance in promoting grain based products. How can the USDA, a government body set up to promote agriculture and promote sale of agricultural commodities be also charged with health recommendations?
Unfortunately, consuming a lot of the grain based “simple carbohydrates” such as breads, potatoes, rice etc. although low in fat, are high in glycemic index and can lead to a phenomenon called “Insulin Resistance”. Affecting up to one in every three Americans, Insulin Resistance is very common and can lead to difficulty losing weight, pre-diabetes, or type II diabetes, heart disease and other long term health problems associated with obesity.
What is Insulin Resistance?
Insulin resistance is a condition in which the body produces insulin but does not use it properly. Insulin, a hormone made by the pancreas, helps the body use glucose for energy. When people are insulin resistant, their muscle, fat, and liver cells do not respond properly to insulin. As a result, their bodies need more insulin 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 at the same time. Learning about insulin resistance is the first step toward making lifestyle changes that can help prevent diabetes and other health problems. An Obesity medicine physician well versed with medical management of Obesity and Insulin Resistance might be able to help!
Cause of Insulin Resistance
Scientists have identified specific genes that make people more likely to develop insulin resistance and diabetes. Excess weight and lack of physical activity also contribute to insulin resistance. Many people with insulin resistance and high blood glucose have other conditions that increase the risk of developing type 2 diabetes and damage to the heart and blood vessels, also called cardiovascular disease. These conditions include having excess weight around the waist, high blood pressure, and abnormal levels of cholesterol and triglycerides in the blood. Having several of these problems is called metabolic syndrome or insulin resistance syndrome, formerly called syndrome X.
What Are The Effects Of Insulin Resistance
Insulin resistance can lead to many problems including weight gain, especially around the tummy due to the anabolic effects of Isulin. It also leads to metabolic syndrome as defined below, fatty liver, polycystic ovaries, acanthosis nigricans or dark patch around the neck, axilla, groin or other areas, skin tags, prediabetes, risk of elevated blood pressure, cardiovascular disease etc.
What Is Acanthosis Nigricans?
What Is Metabolic Syndrome?
Metabolic syndrome is defined as the presence of any three of the following conditions:
- waist measurement of 40 inches or more for men and 35 inches or more for women
- triglyceride levels of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride levels
- HDL, or “good,” cholesterol level below 40 mg/dL for men and below 50 mg/dL 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 mg/dL or above, or taking medication for elevated blood glucose levels
What is prediabetes?
Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. This condition is sometimes called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or older—or 57 million people—had prediabetes in 2007.
People with prediabetes are at increased risk of developing type 2 diabetes, formerly called adult-onset diabetes or noninsulindependent diabetes. Type 2 diabetes is sometimes defined as the form of diabetes that develops when the body does not respond properly to insulin, as opposed to type 1 diabetes, in which the pancreas makes little or no insulin.
Studies have shown that most people with prediabetes develop type 2 diabetes within 10 years, unless they lose 5 to 7 percent of their body weight—about 10 to 15 pounds for someone who weighs 200 pounds—by making changes in their diet and level of physical activity. People with prediabetes also are at increased risk of developing cardiovascular disease.
How do you diagnose Insulin Resistance?
Health care providers use blood tests to determine whether a person has prediabetes but do not usually test for insulin resistance. Insulin resistance can be assessed by measuring the level of insulin in the blood. However, the test that most accurately measures insulin resistance, called the euglycemic clamp, is too costly and complicated to be used in most doctors’ offices. The clamp is a research tool used by scientists to learn more about glucose metabolism. If tests indicate prediabetes or metabolic syndrome, insulin resistance most likely is present.
Diabetes and prediabetes can be detected with one of the following tests:
Fasting glucose test. This test measures blood glucose in people who have not eaten anything for at least 8 hours. This test is most reliable when done in the morning. Fasting glucose levels of 100 to 125 mg/dL are above normal but not high enough to be called diabetes. This condition is called prediabetes or IFG. People with IFG often have had insulin resistance for some time. They are much more likely to develop diabetes than people with normal blood glucose levels.
Glucose tolerance test. This test measures blood glucose after people fast for at least 8 hours and 2 hours after they drink a sweet liquid provided by a doctor or laboratory. A blood glucose level between 140 and 199 mg/dL means glucose tolerance is not normal but is not high enough for a diagnosis of diabetes. This form of prediabetes is called IGT and, like IFG, it points toward a history of insulin resistance and a risk for developing diabetes.
People whose test results indicate they have prediabetes should have their blood glucose levels checked again in 1 to 2 years.
Why is it important to look at glycemic index of foods?
Glycemic Index of foods is important because it determines how much insulin your body is going to need after the meal. The higher the Glycemic Load, the higher the Insulin Requirements. It is believed that eating high glycemic foods such as Bagels, Doughnuts, white breads, white rice, sweetened beverages etc., the body starts to go into Insulin Resistance. The Insulin Resistance, in turn will lead to higher levels of Insulin circulating in the blood stream at baseline setting the stage for insulin resistance. Since insulin is an anabolic(body building hormone), this can not only lead to weight gain, but also lead to central distribution of weight. Research has shown that central distribution of weight leads to increased risk of cardiovascular disease, diabetes and other health problems.
Tips for Avoiding Insulin Resistance
According to the American Diabetes Association, nearly two million new cases of diabetes were diagnosed in people aged 20 years and older in 2010. Since the grossly misleading food pyramid was introduced, the incidence of type 2 diabetes has gone up as much as 400 percent in the United States. Pre-diabetes, also called insulin resistance syndrome or metabolic syndrome, affects about a third of all Americans. If you have some extra weight especially around your waist, you might be insulin resistant! An obesity medicine physician specializing in the medical management of obesity and insulin resistance might be able to help.
W8MD physicians have specialized obesity medicine training and are well versed with managing insulin resistance and other metabolic effects of weight. W8MD physicians can help you lose weight safely, effectively using proven non surgical methods. Call (800)W8MD-007 for more information.
§ Get enough protein. If the body gets carbohydrates without enough protein, it goes into insulin resistance. Most people need about 30 grams of protein at each meal. One egg is about 7 grams. As we evolved as hunters and gatherers, we are designed to eat a non-grain based diet rich in protein, fruits, nuts and vegetables.
§ Try to work more physical activity into your day. Both exercise and resistance training can help reduce your risk of diabetes, and also helps to control it once you have it.
§ Eat more fiber. Fiber helps reduce your risk of diabetes by improving your blood sugar control. Try more fruits, vegetables, beans, whole grains, nuts, and seeds.
§ Choose whole grains. When you do eat grains, look for the word “whole” in the ingredient list. Whole wheat, stone-ground whole wheat, brown rice, and oats are all whole-grain ingredients.
§ Eat fewer simple carbohydrates. These foods, with high glycemic index, break down quickly in the body, and can lead to rapid fluctuations in blood sugar levels. Go easy on foods like white rice, white bread, white pasta, refined flours, candy, fruit juice, soda pop, and baked goods made with white flour. The key is to understand glycemic Index of foods and focus on low glycemic foods.
§ Get enough sleep. When you’re sleep deprived, your body drives you to eat more simple carbohydrates. Get at least 7-8 hours a night.
§ Get help from Obesity Medicine physicians. You probably tried them all and still cannot lose weight! You might want to get help from physicians trained in Obesity Medicine that can help deal with the complex issues leading to weight gain.
- Is high glycemic food causing your weight gain? (freeweightlossdoctor.wordpress.com)
- The role of the failed food pyramid in causing Obesity And Insulin Resistance (freeweightlossdoctor.wordpress.com)
About Prab R. Tumpati, MD, Medical DirectorDr. Prab R. Tumpati, MD is a practicing Internal Medicine, Sleep and Obesity Medicine physician with offices in New York and Pennsylvania. Board certified in Sleep Medicine, Internal Medicine and board eligible in Obesity Medicine, Dr. Tumpati is experienced and well versed in the science and the arm of medicine. As the founder of W8MD Medical Weight Loss Centers of America, Dr. Tumpati brings his vision, and passion. Learn more at www.w8md.com
Posted on June 12, 2013, in Diet For Weight Loss, metabolic syndrome, Weight Loss Articles and tagged causes of obesity, causes of weight gain, diabetes causes, Diabetes mellitus type 2, failed food pyramid, food pyramid, Glycemic index, high glycemic foods, Impaired fasting glucose, Impaired glucose tolerance, Insulin resistance, Prediabetes, United States, USDA, Weight Loss Articles. Bookmark the permalink. Leave a comment.