I have struggled with situational high blood pressure that can periodically become the status quo. I have always had high cholesterol, but I never considered type 2 diabetes because blood sugar isn’t something I struggle with. I assumed my blood pressure was due to stress and my cholesterol, hereditary. Never did I think any of my problems could be related to my eating or resulting weight.
My blood sugar has always been good, and my hemoglobin A1C hovers around the cutoff between healthy and pre-diabetes but usually on the lower side, so it’s never been an issue. I even had my insulin measured and it was 7.6μIU/mL, which was well within the reference range of 2.6-24.9μIU/mL (my feelings on reference ranges are something I really need to write about one day).
It wasn’t until recently, when I learned about someone who was on a long list of medication for blood pressure, cholesterol, and diabetes (my pharmacology course paid off), that I considered that weight could be related to all of these problems, and I was intrigued that someone struggle with all three. At this point, I had never heard the term “diabesity” and now it’s a word that haunts me because I feel like so many people are suffering from this and have no idea!
I quickly reconsidered my “good” 7.6μIU/mL fasting insulin result. I learned that the average insulin level in the US is around 8-9μIU/mL. When you consider the standard American diet (or aptly named, SAD), maybe I’m not doing as well as I think. I am not sure that I want to be close to “average” in anything that involves health or nutrition.
I came across a bargain basement copy of “The Blood Sugar Solution” by Dr. Mark Hyman at a bookstore, while on Christmas vacation. This may have been the best $5 I ever spent! I read it in a couple of days, watched an interview Dr. Hyman did, and then stumbled across books “The Obesity Code” and “The Complete Guide to Fasting” and blogs (https://idmprogram.com/blog/) by Dr. Jason Fung. These two medical doctors helped revolutionize my thinking regarding diabetes, insulin, weight, and overall health. I wish I knew then what I know now… and I wish I listened to my parents because they were onto something! Since you didn’t grow up with my parents, check out the references I listed, as they will do a much better job than I will at presenting the science and they also supplement everything they conclude with research articles, whereas I am going to make a lot of unsupported statements.
But, first, let me explain my mindset, the one thing I am competent to cover…
I attended high school in the early 1990s, and as a girl, was preoccupied with my weight. At this time, the traditional food guide pyramid was in full force, where fat was evil and sugar was of the gods. Fat and cholesterol from food were responsible for a myriad of health problems, including obesity and heart disease, and the only way to be healthy was to follow a low fat diet. I was a master of the low fat diet, but despite that, I was never satisfied with my weight.
My parents believed in Dr. Atkin’s approach to weight loss, but I feared nutritional fat so much, that I never understood how a low carbohydrate diet could encourage weight loss. I can hear my mother saying that healthy fat doesn’t make you fat and cholesterol doesn’t cause high cholesterol. She was wise beyond her years, or at least mine!
I counted calories like the best of them, being so vigilant that I was asked to beta test clinical tracking software because I was a super-user of the company’s personal version. Calories were king, and I lived by that magical formula – weight loss equals calories consumed minus calories burned. I exercised like crazy and found tons of ways to manipulate nutrition (all processed, of course) to eat all those “healthy” starches at the expense of fat. My weight never responded like I thought it should based upon the math, and I never understood why. Over the years, I’ve questioned what Dr. Fung termed (in his early material) the Calories Reduced as Primary (CraP) theory, which is the best acronym I have ever seen, but I never had a better idea to understand weight loss and weight gain.
I can’t help but remember a man that I knew around 15 years ago. He was one of those brutally honest types and told me whatever he was thinking. One day, he told me that he could never date a woman who ate food out of a box (meaning me and my love for processed food). I thought that was the strangest insult ever and never really considered it, but looking back, he was also so right!
I have since come to embrace that there are healthy fats, and that processed food is bad for you; I’ve read “Wheat Belly” (by Dr. William Davis) and researched organic foods, preservatives, plant-based diets, you name it; but, I don’t think I ever understood how detrimental the carbohydrate/processed food problem really is. I definitely never considered obesity was a hormone problem and insulin injections are the worst thing for people with type 2 diabetes.
Both Dr. Hyman and Dr. Fung do a great deal of describing that type 2 diabetes is more than a blood sugar problem; it’s an insulin resistance problem. I understood from my nutrition and biology courses that type 1 diabetics aren’t able to produce insulin and thus require insulin injections – that makes sense.
In type 2 diabetes, the body can produce insulin, but the insulin doesn’t work as well at allowing glucose to enter the cells, due to it becoming resistant, which causes a high blood sugar concentration. Diet changes are encouraged, but they generally involve more of a low-fat approach (although mainstream nutrition encourages whole grains these days, so that’s definitely a step in the right direction). The next intervention is medication, and eventually, as the type 2 diabetes progresses, insulin injections. Over time, more and more insulin is needed.
In my nutrition class, I learned about an eating disorder called diabulemia, which is where type 1 diabetics do not take their insulin as directed so that they lose weight. This was never stated explicitly in my class, but it only makes sense that insulin causes weight gain. How many skinny type 2 diabetics do you know? Me neither… The more insulin used, the heavier the patients. Insulin causes weight gain, so diabetes and obesity seem to be related!
What ended up happening for type 2 diabetes patients and pre-diabetes patients, is that low fat diet that was recommended to be healthy has actually increased health problems, such as obesity and type 2 diabetes. As the disease progresses, more and more insulin is required to bring blood sugar levels down to appropriate ranges, and this creates a downward spiral in terms of increased weight gain and poor health.
During this same time frame where obesity and type 2 diabetes levels has increased, wheat was genetically modified to reduce waste and now has a shorter stalk. That likely exacerbates the problem, since the timing correlates with the rise in obesity.
You can read all of the details in the references I provided.
The bottom line is this… Following the low fat, low cholesterol diet ignored the fact that the missing fat had to be up by something, which ended up being foods higher in sugar and processed carbohydrates. Our increased consumption of those “foods” is responsible for the metabolic problems we see today.
It may be counter-cultural, but I feel like I have to do my part to reverse the trend. For me, that means limiting carbohydrates and processed foods and focusing on a real food diet, which is based primarily upon healthy fats, protein and plant based foods. I may not be diabetic in the true since, but I feel like I can do better to be “below average” in insulin levels and I suspect that my blood pressure and cholesterol will also improve in the process.