Insulin resistance, diabetes and high triglycerides

Type II diabetes -- formerly known as non-insulin dependent diabetes -- is caused by insufficient production of insulin in the pancreas or a resistance to the action of insulin in the body’s cells – especially in muscle, fat and liver cells. It is strongly associated with being overweight.

Insulin is a key hormone for glucose utilization; and the effectiveness of this hormone in the body relates to the conversion of carbohydrates and fats to energy-rich ATP.

Insulin resistance means, in its simplest sense, that the ability to utilize insulin and dispose of glucose in the liver, skeletal muscle, and other peripheral tissues is compromised. It is characterized by higher fasting and post-glucose loading insulin levels, and decreased responsiveness of tissue to the insulin driven clearance of the glucose from the bloodstream.

Insulin resistance is one of the driving forces behind elevated triglyceride levels.

A sedentary lifestyle and a diet rich in carbohydrates, sugars, and fats also promote insulin resistance. Moreover, the degree of insulin resistance increases with greater BMI (body mass index) and abdominal fat (i.e., big waists). Insulin resistance is associated with elevated lipids (LDL cholesterol and triglycerides) and may be a major contributor.

Insulin resistance leads to changes in the processing of sugar and fat in the liver, muscles and fat cells. The result of these changes is an increased uptake of triglyceride fat into liver cells. The triglycerides are absorbed from the diet as well as channeled from abdominal fat and peripheral muscles. These large quantities of triglyceride fat are then stored in tiny sacs inside the liver cells.

High levels of glucose can elevate blood insulin levels, causing insulin growth factors (IGFs) to increase (i.e. insulin resistance). This leads to oxidative stress and activates NF-κB, (a transcription protein) causing genetic instability and inflammation. Insulin resistance is an underlying cause of many of our modern health abnormalities and illnesses, including many forms of cancer and cardiovascular disease.

Glycation – is the name of a process in which glucose reacts with protein in an undesired way, resulting in sugar-damaged proteins (similar to browning food in the oven) called advanced glycation end products (AGE). These damaged proteins may lead to premature signs of aging (wrinkles and brown spots) and in the long run to damaging effects on most organ systems within the body. Glycation reactions are accelerated in the diabetic patient and contribute to the development of diabetic complications.

Leptin -- is a cellular signaling compound involved with weight gain. It is designed to replenish the body’s store of fat after a period of deprivation. Malfunctioning leptin causes major health problems. These include insulin resistance, high blood pressure, high cholesterol, diabetes, heart disease, increased risk for several forms of cancer, etc.

Leptin Resistance – is characterized by a decrease in beta cell response (release of fat for energy expenditure) and an increase in alpha II receptors and activation (fat storage). Leptin resistance is caused from overeating, eating too late at night, snacking between meals, lack of exercise, and stress and is the cause of yo-yo dieting.

Cigarette smoking increases insulin resistance, as does inactivity and obesity.

Pomegranates – The ellagic acid in pomegranates can reverse lung damage due to cigarette smoking.

Nutritional Solutions

Approximately 89% of the body’s insulin-mediated glucose uptake occurs in muscle and is enhanced by physical activity. Exercise along with proper diet is the best treatment we have. Exercise reduces insulin resistance by about 40%. In addition, exercise aids in weight loss, reduces blood pressure, and improves lipids.

Avoid - foods like doughnuts, sodas, French fries and chips. Avoid refined grains such as white breads, white rice and simple sugars as they have a high glycemic load and are rapidly metabolized to simple sugars, which are clearly associated with elevated triglyceride levels

Replace simple sugars, such as white sugar and fructose (high-fructose corn sweetener) with either tiny amounts of raw honey, maple syrup or molasses. Naturally occurring fructose in fruit is safe.

Coriander or Cilantro – has antioxidant ability and improves glucose and insulin utilization. Recent research has demonstrated the presence of antihyperglycaemic, insulin-releasing and insulin-like activity in Coriandrum sativum.

Grapefruit – may reduce insulin and increase metabolism, thereby increasing weight loss.

Eating a mixture of high quality proteins, unrefined carbohydrates, and unrefined fats at each meal will reduce the glycemic load. Eating foods rich in inulin, such as sunchokes, asparagus and burdock can be extremely beneficial in reducing insulin resistance.

The Mediterranean diet – Eat a diet that includes locally grown wild vegetables, as well as other common vegetables, such as cabbage, leafy and root vegetables, bitter greens including arugula, radicchio, endive, mushrooms, tomatoes and other fruiting vegetables, grapes, berries, fish, a moderate intake of hard cheeses, grains and extra-virgin olive oil. Several recent studies have shown that eating a Mediterranean diet decreases the absolute risk reduction of cardiovascular disease values more effectively than using statin drugs.

Dairy - Consume the equivalent of 1-2 cups of organic (from grass-fed animals) whole-milk dairy products, including goat or sheep, such as one and a half cups of yogurt and two ounces of cheese. Do not drink milk. Do not eat non-fat or even low-fat milk products. Eating low-fat milk products is associated with weight gain. A recent study linked low-fat diets with failure to thrive in children.

Researchers found that low-/nonfat milk was related to an increased risk of prostate cancer while whole milk was related to a decreased risk of prostate cancer. (Park et al, 2007)

Conjugated linolenic acid (CLA) – reduces leptin resistance and body fat in overweight people. CLA is found predominantly in “organic” fat from free-range grass-fed cows. CLA promotes weight loss while retaining lean muscle mass. It appears to improve insulin sensitivity and can be helpful for type II diabetics.

A recent study conducted by Ohio State University found that CLA supplementation significantly decreased women’s BMI and total body fat. Dr. Belury, the senior author of the study which is set for publication in the American Journal of Clinical Nutrition, believes adiponectin might have triggered the body’s ability to burn dietary fats.

Yogurt – Research reveals that yogurt may help turn up the body’s fat-burning ability, making it easier to lose fat while maintaining lean muscle.

Eggs – that come from chickens that are range free and that have eaten natural organic grains contain high amounts of lecithin. Lecithin is a phospholipid that emulsifies other fats and improves the liver’s ability to break down and absorb fat properly.

Butter – although a saturated fat, does not oxidize in the body nor generate free radical damage as hydrogenated polyunsaturated fats do. A survey of South Carolina adults found that men eating butter ran half the risk of developing heart disease as those using margarine. Saturated fats in moderation are acceptable with the most preferable sources being butter or ghee (clarified butter) and coconut oil.

The ingestion of rancid fats, refined sugars and refined starches will cause an over-oxidation of lipids, including cholesterol, and elevation of insulin levels. This will lead to serious damage of cardiac function and cause atherosclerosis. It is also damaging to the liver, spleen and other organs. Replacing fat with refined sugar and starch which is so common today, can cause hyper-insulinism, adrenal exhaustion and obesity. Eating a diet rich in refined sugars and refined starch has been shown to decrease “good” HDL cholesterol.

Herbal & Supplement Solutions

· Anti-Diabetic Herbs:

o Pterocarpus

o Alpha Lipoic Acid

o Resveratrol

o Holy Basil

o Ginseng

o Eleuthero Root

o Aralia Manchuria

o Rhaponticum carthamoides

o Rhodiola rosea

o Chromium

o Vanadium

· Herbs that Lower Triglycerides:

o Fenugreek seeds

o Hawthorne

o Siberian Pine seed oil

o Chromium

o Carnitine

· Pterocarpus extract – can reverse damaged pancreatic beta islet cells and actually repopulate the islets, resulting in an almost complete restoration of normal insulin secretion. Several mechanisms have been proposed to explain pterocarpus’ anti-diabetic effect, including the augmentation of glucose uptake through the modulation of many pathways, such as Glut-4, PPAR-gamma, and PI3 kinase. It lowers blood glucose and Hemoglobin A1C in diabetics. It also lowers blood lipids: triglycerides, total cholesterol, LDL and VLDL cholesterol.

· Fenugreek seeds – improve glycemic control and decreases insulin resistance in mild type II diabetic patients. There are also favorable effects on hypertriglyceridemia (high triglycerides). Fenugreek possesses insulintrophic and anti-diabetic properties and is anti-inflammatory, anti-ulcer and lipid-lowering. It can be used to assist people who have insulin resistance and elevated lipids.

· Alpha Lipoic Acid - has several beneficial effects on the whole body including the liver, eyes, brain, pancreas, kidneys and skin. Alpha lipoic acid helps break down sugars so that energy can be produced through cellular respiration. It is an extraordinarily broad-spectrum antioxidant able to quench a wide range of free radicals. Lipoic acid protects against and reduces glycation.

· Resveratrol – In one study rats receiving resveratrol had lower glucose levels, their hearts became healthier, as did their liver tissue. Other recent studies have found that resveratrol inhibits certain genes that become activated and induce obesity, diabetes, cancer and aging.

· Hawthorn extract – prevents elevation of plasma lipids, such as total cholesterol, triglycerides, and LDL and VLDL fraction. It also prevents the accumulation of cholesterol in the liver by enhancing cholesterol degradation to bile acids, promoting bile flow and suppressing cholesterol biosynthesis.

· Siberian Pine seed oil – lowers overall cholesterol, while increasing HDL and apolipoprotein (Apo) A-1 levels, the beneficial forms of cholesterol. In a separate study Siberian Pine seed oil was found to lower VLDL and LDL cholesterol, and in another study it lowered triglycerides.

· Holy Basil – has been shown in studies to reduce fasting blood glucose by 60% compared to 10% in controls after 13 weeks of extract administration. In another study it showed a dose-dependent hypoglycemic effect and prevented rise in plasma glucose in normal rats.

· Herbs such as Ginseng, both American and Asian, Eleuthero root and leaf, Aralia manchuria, Rhaponticum carthamoides and Rhodiola rosea have been shown to assist in glucose and insulin transport and utilization.

· Green Tea extract – reduces lipids and lipoproteins and possesses lipolytic activity.

· Cordyceps mushroom extract – improves glucose metabolism, is hypolipidemic and anti-atherosclerotic.

· Chromium – supplementation may improve insulin sensitivity at a dose of 200-1000 mcg/day. Chromium promotes better insulin utilization, which leads to an overall decrease in serum triglycerides and total cholesterol, while increasing “good” HDL levels and improving glucose tolerance. Chromium functions as a cofactor in all insulin-related activities.

· Magnesium – is necessary for the action of insulin and for the manufacture of insulin. Magnesium is found in most foods, especially dairy products, fish meat and seafood. Other rich food sources include apples, apricots, avocados, bananas, blackstrap molasses, green leafy vegetables, etc.

· L-glutamine – has come to be regarded as one of the most important amino acids when the body is subjected to such metabolic stress situations as trauma (including surgical trauma), cancer, sepsis and burns. Donald Yance has found glutamine supplementation helpful in maintaining energy levels and deterring excess sugar and carbohydrate cravings.

· Vanadium – has the ability to beneficially effect insulin activity in diabetics. Vanadium supplementation has shown in several studies to produce positive changes in glucose metabolism. Food sources for vanadium include shellfish, mushrooms, parsley, dill seed and black pepper.

· Carnitine – lowers triglyceride and cholesterol levels while increasing HDL (“good” cholesterol) levels. Carnitine can be manufactured by the body if sufficient amounts of iron, Vit B1, Vit. B6, lysine, methionine and Vit. C are available. It can also be obtained from food, primarily meats and other foods of animal origin.

· Vitamin E – contains tocotrienols which inhibit cancer and reduce LDL cholesterol. Sources of Vit. E include dark green leafy vegetables, legumes, nuts, seeds and whole grains.

· C-reactive protein (CRP) -- is a protein in the blood that signals acute inflammation. It is associated with inflammation related to insulin resistance. Levels should be below 0.8.

· A low glycemic load diet lowered C-reactive protein levels and raised DHEA levels. DHEA is believed to have an anti-tumor effect, as well as anti-inflammatory, antioxidant and anti-aging effects.

· There are six major pathways in which elevated glucose and insulin promote prostate and other cancers:

· Components of a modern-Western-style diet such as high consumption of red meat and foods that increase glycemic load are associated with a p53 disease pathway. (Cancer Epidemiol Biomarkers Prev. 2002 Jun;1 1(6):541-8) p53 is a transcription factor that controls the expression of genes – the protein products of which participate in complex signal transduction, and thus cell transformation. 50% of cancers have a mutation of this gene.

· Testosterone - Maintaining healthy testosterone levels may be an important treatment for heart disease. Testosterone also helps prevent diabetes, and may help treat diabetes. Rhaponticum carthamoides, pantocrin, Epimedium, Tribulus terrestris and Eurycoma longifolia jack are particularly effective for helping to raise testosterone levels.