LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

prediabetes

BLOOD PRESSURE USING MEDICATIONS – IS LOWER WORSE?

by

It is, of course, no big shocker that I am going to say that lifestyle is the only answer to safely lower blood pressure.  It should also be well known that the class of drugs known as beta blockers actually increase the risk of stroke and diabetes, and do not change the risk of dying.
 
The approach of blood pressure control with medication is lower is better.  But, as will anything using medication, when we begin to mess with our physiology, there is always a price to be paid.  This particular study looked at the benefits of lowering blood pressure below 130 systolic.  If you believe in mainstream medicine and that life is made better through chemistry, than this sounds like a reasonable goal.
 
However, while the risk of stroke was lowered by aggressive blood pressure lowering below 130, the risk of dangerous side effects went up 40%.  There was also no other benefit to the patient other than lowered stroke risk (in other words–a single intervention targeting only a single outcome-stroke, with absolutely no benefit to any other aspect of our health).
 
Contrast this to lowering blood pressure with lifestyle changes.  First, lifestyle will never bring you to a dangerously low blood pressure.  Dangerous side effects?  Only if you consider feeling better and looking better “dangerous.”  Single outcomes?  Lifestyle changes will cut across every other disease state in addition to lowering your risk of stroke.
 
Most case of high blood pressure stem from being prediabetic.  Manage the interplay between insulin and your cells with the right choices and you are well on your way to lowering your blood pressure.  That means exercise, more fruits / veggies, cut back on calories, increase intake of omega 3 fats while avoiding hydrogenated and reducing omega 6 and doing your best to avoid the toxic chemicals of the world we live in.
 

BEWARE THE NEW FANGLED DIABETIC DRUGS

by

Sit back for a brief primer on where the money is going for diabetic drug research.  Our small intestine has taste cells just like those of our tongue called “L” cells.  So when “sweet” crosses this cell in the small intestine, these taste cells release a compound called GLP-1 that does all kinds of wonderful things in regards to helping our bodies handle sugar.

Initial drug development was on synthetic GLP-1 (ours gets broken down in about 2 mins, so human GLP-1 can’t be used), but that proved tricky.  The next direction was to slow down the enzyme that breaks down our own GLP-1 so it will last longer than 2 minutes.  This involved slowing down the enzyme dipeptidyl peptidase IV (DPP4).

Thus was born one of the most massive push for drug development since the PPAR class of drugs (this class, by the way, which contained drugs like Avandia and troglitazone, are largely off the market because they proved to create much greater harm than good) over a decade ago.

Given the massive push, the heavy utilization and the continued reliance of drugs instead of lifestyle changes I would strongly suggest any diabetic sit on the sidelines for a few years and wait to see what happens with this class of drugs.  Almost without fail, when we move this fast in a brand new direction dealing with enzymes in the body we know little about, the results are disastrous.  Think Vioxx.

This particular study done in mice suggests the alterations in the levels of DPP4 may change the way our immune system responds, and this response can vary depending upon the immune status of the individual.  In other words, we really have no clue what a class of drugs that messes with DPP4 levels will do to our immune systems, but we’ve got some inklings that it does something.

As I said–best to sit on the sidelines for this one.  In the meantime, exercise, cut back on calories, drink more tea and coffee and absolutely get away from artificial sweeteners.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2011.03778.x/abstract

LOW SALT DIETS CONTRIBUTE TO DIABETES?

by

With research, we need to take everything with a grain of salt (so to speak…) and look at the big picture.  I have personally never been an advocate of steering patients towards a low salt diet.  As I’ve mentioned in prior posts, “low salt” is the low hanging fruit of lifestyle changes.  Very easy to change and no industry gets harmed too bad financially..it’s pretty easy to come out with a “low sodium” version of whatever crappy product was originally produced.

I personally think salt has been used as a surrogate for poor dietary choices.  Many unhealthy, processed foods are very high in sodium.  And, much like coffee use in the past, it was given a bad rap not because of its negative health effects, but rather by the behaviors associated with it.

Overall, a very small percentage of the population is salt sensitive.  Maybe 5%.  In these patients, lowering salt intake may bring down blood pressure a little.  Certainly not nearly as much as avoiding refined carbs and exercising.  But there is at least no harm in a low salt diet, right?

Not according to this study, which found an increase in insulin resistance (a very, very bad thing) in those consuming a low salt diet for 7 days.  What does this mean?  At the very least, it suggests that merely demonizing a single aspect of a dietary pattern (in this case salt), will never likely produce the intended outcome of the condition you were trying to impact.  In this case blood pressure.

The bottom line is that by consuming a diet as unprocessed as possible and using a wide variety of herbs and spices in your foods and using Celtic sea salt if you feel the need to salt your foods will have only positive effects on your long term health.

http://www.sciencedirect.com/science/article/pii/S002604951000329X

YOU KNOW YOUR CHOLESTEROL, BUT DO YOU KNOW THIS LEVEL?

by

In today’s health environment, thanks to aggressive marketing by the pharmaceutical companies promoting the near godlike power of the statins to lower levels, most everyone knows where their cholesterol sits.  The reality is that total cholesterol, as a risk factor for heart attacks and cardiovascular mortality, is just short of worthless.  The more important value, however, is not known by most people.

Triglycerides have long been known to be a major player in heart disease risk.  The relationship between triglycerides and HDL (“good”) cholesterol is a key factor to look at in evaluating your risk.  Ideally, a ratio of 2:1 or less is desirable.  There are only a handful of patients I have seen where the triglycerides are close to or even lower than the HDL levels.

There reason these levels are so important is that they are driven by our relationship between our insulin and our cells (i.e. prediabetes).  Since prediabetes and diabetes absolutely destroy our cardiovascular system you can see why this ratio is so important.

This particular study further reinforces this, finding that non-fasting levels of triglycerides were the strongest predictor of total mortality.  While non-fasting cholesterol levels were associated with risk of heart attack, the risks of high non-fasting triglycerides were much more severe.   Levels above 443 (normal fasting values should be well under 150) increased the risk of heart attack by 420% and risk of death overall by 50%.  THIS is why you need to know your numbers.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2010.02333.x/abstract

WANT A HEALTHY PREGNANCY? DO THIS FIRST…

by

This is not the first time I’ve mentioned just how critically important the in-utero environment is in programming that child’s health for the next FIFTY years.  If you want to ensure a healthy pregnancy and give your newborn baby the best odds to live a healthy life, you need to begin before pregnancy.

The studies confirming that preprogramming for obesity and diabetes begins in the womb continue to accrue.  This is little doubt left that this is true.  We no know that the second a woman is pregnant, her decisions affect her newborn’s health.  But what about decisions before pregnancy?

Turns out this is just as critically important.  Elevated cardiovascular risk, as evidence by elevated triglycerides (notice we did not say elevated total cholesterol), before conception led to a 60% higher risk of having a baby being born preterm.  Being born preterm increases that baby’s risk of obesity, heart disease and diabetes.  That baby, with elevated cardiovascular risk, will likely be raised by the mother who never learned to live for her genetics (as evidenced by the elevated triglycerides).

Here’s the rub.  The most common cause of infertility in the US today is polycystic ovarian syndrome (PCOS).  This IS insulin resistance.  It is a lifestyle problem.  Without fixing the prediabetic lifestyle, you will not fix the PCOS.  I have had too many patients over the years who spent tens of thousands of dollars, but no one ever addressed lifestyle, which is the key reason they need the fertility treatment!

By not fixing the lifestyle and forcing a woman’s body into pregnancy when it’s not ready, you are, without a doubt, increasing the risk that a successful pregnancy will put the newborn baby at increased risk for the rest of their lives for chronic diseases.  Seems like very short term thinking to just throw some Clomid at the problem..

http://www.sciencedirect.com/science/article/pii/S0002937811001797

HAVE SLEEP APNEA BUT HATE USING A CPAP?

by

There is nothing good about sleep apnea.  It deprives the brain of oxygen consistently through the night.  It stresses the body out and creates all the negative consequences of stress on the body.  It also keeps the body from settling into the deep sleep that our body needs to heal and recover from the day’s abuses.  Sleep apnea is strongly associated with heart disease.  It cannot be ignored.

Typically, the diagnosis is via a sleep study.  Once sleep apnea is identified, a CPAP machine is usually used to aid the patient in attaining deep sleep.  Unfortunately for many, the CPAP machine can be cumbersome, load or claustrophobia-generating.  Luckily, there are other answers.

First, if the primary apnea is obstructive in nature, you may be surprised that learning to circular breath can provide great relief.  There is an Australian musical instrument called a didgeridoo.  Learning to play this instrument can help with sleep apnea and snoring and has a handful of clinical studies to support this.

Far more scary is central sleep apnea.  This occurs because the brain’s respiratory center is affected by prediabetes, creating the apnea.  Sleep apnea will make prediabetes worse and prediabetes will make sleep apnea worse.  It produces a snowball effect.  It NEEDS to be managed.

Obviously, pulling away from a diabetic lifestyle will help with the sleep apnea.  This particular study supports this in finding that a very low calorie diet provided improvements in sleep apnea scores.  Half the patients in this study, one year later, were off of their CPAP machines.  THAT is powerful medicine.

http://www.bmj.com/content/342/bmj.d3017.abstract

UNDERSTANDING OUR MITOCHONDRIA

by

The mitochondria.  The “powerhouse of the cell.”  The little organelle that is believed to have originated outside of our cells since it carries its own DNA.  For me, thoughts and aspirations of improving the function of the mitochondria in our cells gives me warm and fuzzy feelings all the way to my core.  Unfortunately, for most of you, that warm and fuzzy feeling is a little more akin to nausea as suppressed memories of high school biology surface…

This organelle truly does hold to keep to longevity and health span.  It is the root of all evil that is chronic disease.  Even insulin resistance / prediabetes, as fundamental as it is to a huge list of chronic diseases, starts with mitochondrial dysfunction.

If I haven’t gotten your eyes glazed over just yet, let’s go a little deeper.  Every cell requires energy to survive and thrive.  At any given second, a BILLION reactions are occuring in our bodies.  Each requires energy in the form of ATP.  Some cells more than others.  Cells of the muscles, heart, liver, kidneys and brain may have thousands of mitochondria per cell.  The second our ability to generate energy falls, these organs begin to fail as well.

The goal of any lifestyle is to promote activities that support healthy mitochondrial function.  Calorie restriction without nutrient restriction is incredibly powerful.  With this approach, our cells have to use every scrap of glucose and every nutrient to function.  Our cells run a tighter ship, creating more efficient and greater numbers of mitochondria.  The opposite is true with too many calories–our cells get lazy and mitochondrial function tanks.

Other approaches to increase mitochondria function can include lots of phytonutrients in fruits, veggies and spices.  Exercise.  There are powerful supplements like resveratrol, ALA and CoQ10 support function.  There are some amazing supplements that can aid in this process.

Destruction of our mitochondria begins with excess calories, environmental toxins, smoking, stress, poor quality diets.

Combining protective aspects and avoiding negative aspects gives you the best possibility of extending lifespan AND healthspan.  Because who wants to live longer in a nursing home?

For those of you mesmerized by this topic, this article gives a very nice overview of the relationship of mitochondrial dysfunction and insulin resistance.

http://www.jci.org/articles/view/46405

INSULIN IS A DANGEROUS HORMONE?

by

We need to start this out with the understanding that nothing in our bodies are inherently “bad” or “good.”  They ALL serve a purpose.  Saying that we need to lower our “bad” (LDL) cholesterol is fine and dandy if down with lifestyle, but if done with medications can increase the risk for depression, Alzheimer’s and probably a bunch of other stuff we’re not aware of yet.

So what about insulin?  Far too many diabetics think they can eat stuff they shouldn’t and just increase the insulin they give themselves.  In the ACCORD trial, researchers tried to give diabetics more and more insulin with the single goal of lowering HbA1C levels as far as possible.

Insulin, when released by the pancreas and functioning in a healthy human, is absolutely essential for health.  The goal with insulin is to have it work as as efficiently as possible (called insulin sensitivity) so our body needs to release as little as possible.  There are few aspects of human physiology more important than making sure insulin and the cells of our body play well together.  The less insulin needed, the better the insulin plays with the target cell, the longer we will live.  It’s that simple.

So, whether we are pre-diabetic, Type 1 diabetic, Type 2 diabetic or any other type of human, a lifestyle that improves the relationship between the cell and insulin is integral to health.  That means exercise–both aerobic and strength training.  And just walking is NOT going to be enough, unless you’re over 80.  That means avoiding as many environmental chemicals as possible–things like BPA in plastic water bottles worsen insulin action.  Stress reduction–stress increases cortisol, which sucks muscles and turns them into sugar.  Lots of fruits and veggies and spices.  NEVER drink your calories.  Calorie restriction without nutrient restriction–do you REALLY need that whip cream on top of the venti mocha?  Increased intake of healthy fats–nuts, seeds, wild caught fish, omega-3 eggs, grass fed meets.

This particular study just drives home the importance of the relationship between insulin and longevity.  The SIRT1 family of genes is related to living longer.  This is pretty well established.  It’s why resveratrol in red wine and calorie restriction work so well.  So, activation of SIRT1 will lead to a longer lifespan.

This particular study found that insulin actually suppressed activation of SIRT1.  NOT a good thing.  Again–making insulin act efficiently in your body means you will need less of it.  It means that using more insulin in diabetics will kill you, as we indeed saw with the ACCORD trial, which was stopped because participants were dying at a faster rate with lower HbA1c from insulin use.  It means poor lifestyle choices will rob you of years of healthy living.  Period.

http://www.sciencedirect.com/science/article/pii/S0261561410002013