Sunday, March 01, 2009

Heart Disease- Part Two - Insulin Resistance


Last time I talked about the dangers of body fat, a belly that sticks out, becoming a diabetic, and diabetes in general. I thought I'd try to attempt to explain why this is the case. The above slide explains it on a very simple level, I'm guessing most of you have no idea what it means. HOWEVER, after reading this I'm hoping you well be able to understand this slide, and understand the dangers of insulin resistance. Maybe you won't be able to read it, but you'll know the story behind the slide.

Let me start by saying insulin resistance leads to type 2 diabetes. Many of you who have a belly, elevated blood pressure, and not a regular exerciser (Walk and hour a day and you're and exerciser) most likely have insulin resistance going on. You're headed toward type 2 diabetes that leads to so many other wonderful problems.

So what is insulin resistance? Let start by explaining normal metabolism. After you eat, in a response to your fed state, beta cells in your pancreas release insulin. This signals tissues that use glucose in your body (Fat tissue & Muscle tissue) to absorb glucose. Simple enough right? You eat, and your body recognizes you ate by the increase of glucose in your blood stream, it releases insulin (which is used to move glucose into muscle and fat tissue), and then your blood glucose levels drop to normal again.

In a person who is insulin resistant it requires more insulin than the normal person to get glucose into the muscle and fat tissue after you eat. Let's talk about why that might be.

We in our culture live in a constantly fed state. Our fat and muscle cells are constantly being forced to accept more than they have ability to accept. Part of this problem as well is that every time these cells touch insulin they get worn down a little, and it takes a little more insulin to get the job done. Remember that point last point. We'll talk about how to fix that later. Eventually it requires our pancreas to produce a lot more insulin than normal to get the job done after every time we eat because our tissues are constantly being hammered with more food/glucose than it can handle. This in turn leaves us with a higher blood glucose levels a lot of the time.

Side note- Remember, every time your get your blood labs done you're required to fast. Well this fasting can hide insulin resistance until BAM! Things are way out of control, and now your find out you're a type 2 diabetic. The problem is that it's difficult to get accurate readings on blood labs if you're not fasting.

So let's take the next step. Not only does fat tissue try to stop accepting glucose it also releases free fatty acid into the blood stream which is converted by the liver into triglycerides. So now we have an elevated trig level problem. Well I'm telling you right now it's a big, big problem. This increase in Trigs ruins, wrecks, and breaks normal lipid metabolism problems. Simply stated, it creates a horrible cholesterol problem that MOST doctors and many cardiologist don't take seriously. The reason why is because it's not just an LDL problem. LDL is commonly called "bad cholesterol." The problem is, that there is so much more to the story than just bad cholesterol.

So here is the next step, and I can't explain it completely and keep it simple, so I'm just going to keep it simple and leave out some detail. This increase in triglycerides does two things. One it effects your good cholesterol, and two it changes your bad cholesterol.

In regards to good cholesterol:
  1. One it lowers the total number of good cholesterol levels in your blood. That is bad, bad, bad, and many doctors won't treat this problem until it's way out of control. Even then, many doctors won't touch it at all because they aren't convinced it's a problem. TAKE MY WORD FOR IT! Low levels of good cholesterol is a very bad problem.
  2. It make the good cholesterol that you have less effective. That is bad new my friends. The good cholesterol is what keeps your arteries from building up plaque that narrows and hardens your arteries. It has been clearly demonstrated that even if you have very, very, low levels of bad cholesterol, if you have low good cholesterol your are at great risk of a heart attack or stroke.

So what is the other part of the problem of high triglyceride problem in regard to bad cholesterol:

  1. It makes your LDL "bad cholesterol" even more dangerous by shrinking them in size(smaller and more dense), and increasing the total amount of bad cholesterol particles in your blood stream. This is a big problem. I'm willing to bet none of you have ever had blood test that looks for this problem. The normal blood test that you have done by your doctor does not look for this problem at all. It looks at the total weight of cholesterol being carried by your bad cholesterol in your blood, and not the total number of bad particles. That's tough to explain without a slide and I can't find one.

However, even if you have never had a blood test that looks for small dense LDL particles, you can guess you have them by these signs. You have low HDL, and elevated triglycerides. If your have type 2 diabetes you have this problem, and if you have metabolic syndrome (

Here is another kicker, this elevation of fat floating around in your blood forces your body to eventually store it as fat someplace. Where? In the belly area. Yes, it is stored all over, but predominately in the belly area for some reason. We'll talk more about why this is a problem in another post.

So where the heck is the good news in all of this? This is completely reversible! How? Activity! Movement changes those muscle fibers and makes them hungry again. They stop being insulin resistant. THAT IS THE SECRET! You have to move amigos y Amiga's.

Now listen here, you may think you can trick your body. There are diets, like Atkins, that keep your insulin levels low. Therefore your body looks to your fats stores for those Trigs that they need for fuel, and bingo you start losing weight. However, in my little mind there is a problem with this. We all know people who have done these low insulin diets (self included, I generally live a South Beach diet), they lost the weight, then go off the diet and bam they gain 50 pounds in a month. I wondered why, and in my mind it is because they never changed their insulin resistant muscles tissue through exercise. So, when they went back to a "regular diet", with no activity, their muscle which never were fixed through exercise. So they continue to resist this increase of glucose, there is a Trig problem, and bam it's all stored as fat. The crazy part to me is how quickly it can happen if you're not exercising. If you're not moving, you leave the Atkins diet and eat some pizza, heck yes it was stored as fat. Yes that gain in weight on the scale is for real. If you're running, it doesn't happen. I know this from personal experience.

So as I read this I wonder how clear I made it. If there is a couple of key points I want you to remember it is this:

  • Constant eating of foods that are carb loaded eventually beats down your body, and your pancreas can't keep up with the demand of insulin over the course of years and then your pancreas shuts down.
  • Your doctor isn't going to tell you that your insulin resistant until you're a diabetic. A few will, but by far the majority won't.
  • This whole problem is completely reversible!
  • One of the ways to absolutely reverse this problem, and the best method by far is diet and exercise.

The moral to the story for me is this, you must start moving. That belly needs to be eliminated. Don't think for a second that just because you're thin you don't have to exercise. I'll make that case in a later post. Plenty of thin people die of heart disease.

Get your ipod and go for a one hour walk every day.

3 comments:

Ingrid said...

Sean,
I have never heard this all explained like this-- thank so much! Coming from one of those thin folks who is scared of dying young from (a nasty family history of) heart disease or cholesterol related problems, or yes, diabetes--- this all makes lovely lovely sense to me! I love to run-- and now you've given me that little "kick" that I need to get more motivated. I exercise way more than my parents ever did, but now I see that I really have to get serious about making tis a lifelong habit. Thanks for spelling it out chemically for me. This is the WHY that few doctors will ever take the time to explain, and you are right, they get crazy about treatment once you're sick, but prevention is not mentioned as much. Thanks again!

Maria said...

Great post! I hope everyone listens. I am a HUGE believer in exercise!! It is a must!! Choose something you love so you will actually do it. If you hate running, don't pretend you will, try walking, swimming, biking, dancing, whatever, JUST MOVE! My motto, eat less, move more!!

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