Important findings about humanity’s past, about how we live and eat today, and even about how we typically treat type 2 diabetes — with medications that themselves induce weight gain — are providing clues that explain how the past two decades could see an explosion in overweight and obese Americans and skyrocketing cases of type 2 diabetes, which is usually closely tied to the problem.
Harvard’s extensive research on the subject weaves a story of ancient humans who were both extraordinarily active and able to easily gain weight in times of plenty. It illuminates how a modern diet rich in refined carbohydrates and heavy in red meat has preyed on Paleolithic instincts, creating an obese nation, a health crisis, and what one researcher describes as a hard-to-escape cycle of weight gain, insulin resistance, and weight-retaining diabetic medication, leading to more pounds.
“It’s not just a trap, it’s a trap and a downward spiral,” said Assistant Professor of Medicine Osama Hamdy, a physician at Harvard-affiliated Joslin Diabetes Center and director of a groundbreaking weight loss program being replicated at Joslin affiliates around the world.
Hamdy and hundreds of other Harvard investigators in recent decades have produced a dizzying array of findings on obesity and diabetes. Even a casual look at the years of research on the subject shows a slew of results on how lifestyle affects weight and how weight affects health. It shows new genes discovered, laser surgery to save diabetics’ eyesight, new diabetes drug candidates, and advances in using stem cells to replace the insulin-producing beta cells that diabetes destroys. Findings also illuminate humanity’s active, running past, to help us understand the problem’s roots.
Among seminal findings was the first study to document the extraordinarily tight connection between the two diseases. The work, by Walter Willett, the Harvard School of Public Health’s (HSPH) Stare Professor of Epidemiology and Nutrition, and by his colleagues showed that being even slightly overweight increased diabetes risk five times, and being seriously obese increased it 60 times. The study’s authors had to push just to get the results in print.
“We had a hard time getting the first paper published showing that even slight overweight greatly increased the risk of diabetes,” Willett said. “They didn’t believe it.”
They believe it now. Studies have shown that becoming overweight is a major risk factor in developing type 2 diabetes. Today, roughly 30 percent of overweight people have the disease, and 85 percent of diabetics are overweight.
Figures from the U.S. Centers for Disease Control and Prevention reveal that we live in a nation where skinny and normal-weight people are actually in the minority. A third of us are overweight, and another third are so overweight we’re obese. Government figures show obesity rates rising steadily from roughly 13 percent in the 1960s to 34 percent in 2007-2008, with numbers flattening out in recent years.
Diabetes cases have risen along with obesity, with prevalence doubling in the past 20 years. Today, 11 percent of adults over age 20 are diabetic, and HSPH Professor of Nutrition and Epidemiology Frank Hu said he expects the numbers to keep rising.
“We haven’t seen any sign of the epidemic slowing,” Hu said.
Not all diabetes cases are linked to weight. Genetics also comes into play. People with diabetic family members are at higher risk. For them, even five or six extra pounds can start a dangerous cycle leading to the disease, Hamdy said.
Unlike in type 1 diabetes, where the body directly attacks insulin-producing cells, in type 2 the body’s tissues gradually become less sensitive to insulin. This causes beta cells to work harder and eventually break down. Though not everyone with type 2 diabetes is overweight, it is type 2 — which accounts for roughly 90 percent of all diabetes cases — that has been linked to weight gain.
Both forms of the disease disrupt insulin flow. Cells have trouble getting the energy they need to function properly. Meanwhile, blood sugar rises. In untreated diabetes, high blood sugar can cause comas and death. Even when the disease is treated, poor sugar control can damage organs, causing complications. Less severe cases can be treated with medication, diet, and exercise, while more severe cases require insulin injections.
Diabetes is the nation’s seventh-leading cause of death and a prime cause of kidney failure, blindness, nontraumatic limb amputations, heart disease, and stroke. The government estimates that 26 million Americans had diabetes in 2010, costing $174 billion for direct and indirect costs. There were 1.9 million new adult cases diagnosed in 2010.
Read more at the Harvard Gazzette
CrossFit...I'm Interested And Nervous
Check for Paleo eBook