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How we swamp our system with starch and sugars
(Avoiding diabetes, insulin resistance, obesity and damage to your blood vessels)
Glucose is a specific type of sugar that is
common in animals and plants. It’s what your brain needs for energy, and
your muscles use it too.
For your brain to work properly, you need to
have a precise amount of glucose in your blood – approximately one
teaspoon in total, which is really very little. After you eat or drink,
a sophisticated process stops your glucose level rising too high. Excess
glucose is taken into storage in your muscles or turned into fat. This
is controlled by a protein called insulin.
The modern diet can swamp this process. A single
can of fizzy drink often contains five teaspoons of glucose – that’s
five times the amount there should be in your blood. People these days also tend to eat
a lot of refined, starchy foods such as bread, potatoes and biscuits.
Starch is simply long chains of glucose, so these foods can release more
glucose than your body can cope with at one time.
High levels of blood glucose cause harm over time
Over the course of many years, high levels of
glucose in your blood can damage the lining of fine blood vessels –
especially those in your eyes and kidneys, potentially leading to visual
loss or kidney failure. Most of the glucose will be turned into body
fat, and too much fat is associated with a whole range of serious
diseases.
Fat stored around internal organs such as your
liver can be particularly harmful. Too much of this can lead to problems
with insulin, and that means glucose levels in the blood get out of
control. At worst, this can turn into diabetes, where insulin production
virtually stops. This is a dangerous condition.
Diabetes is on the rise
The number of people suffering from this form of
diabetes has been increasing dramatically over recent decades. Well over
two million people in the UK now have it, although many are not of aware
of this. It used to be rare in children, but it is becoming increasingly
common. This rise must be due to the changes in Western diet and
lifestyle.
It is likely that the high levels of sugar we consume have played a part. The sort of sugar we buy – and which is added by manufacturers to cooked and processed foods and drinks – is made not just of glucose, but also of a second type of sugar, fructose.
Fructose is not handled well by your body, and tends to turn into fat
stored around your internal organs – the dangerous type of fat. Sugar is
added to an amazing range of food, savoury as well as sweet. A single
can of fizzy drink may contain 5 teaspoons of fructose as well as the 5
of glucose.
Some of the things you can do
Be aware of the amount of sugar you are eating
and drinking, and cut back where you can.
Watch your waistline. A growing waistline may
mean you are storing dangerous fat around your internal organs. See our
body check page for details.
Instead of starchy foods such as bread and
potatoes, substitute some that release glucose more slowly, such as
beans, barley, oats and lightly cooked pasta.
Keep physically active, as this helps the
insulin system work more efficiently.
What the book covers
There is a lot more to this important subject than we’ve been able to summarise here. The book explains
why glucose is so important
how your body controls glucose levels
the various problems and conditions to watch out for, including pre-diabetes and insulin resistance which affect millions of people
ways to avoid these conditions, as well as diabetes itself
-
signs to look out for
what to do if you suspect you might have them
-
how high levels of glucose over many years can damage your blood vessels (especially in your eyes and kidneys)
plus much more about starch and sugar in your diet, and what is good and bad for your health.
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Selected references for the book
Incidence & overview
Zimmet P Alberti K. G. M. M ShawJ
Review Article. Global and societal
implications of the diabetes epidemic.
Nature 2001;414:782-
Glucose metabolism
Kelly TN et al
Systematic Review: Glucose Control and
Cardiovascular Disease in Type 2 Diabetes.
Ann Intern Med 2009;151:394-403
Hazards of fructose
Kimber L. Stanhope, et al
Consuming fructose-sweetened, not
glucose-sweetened, beverages increases visceral adiposity and lipids and
decreases insulin sensitivity in overweight/obese humans.
J Clin Invest. 2009;119:1322–1334
Bray GA
Fructose: pure, white, and deadly? Fructose,
by any other name, is a health hazard.
J Diabetes Sci Technol. 2010;4:1003-7.
Importance of Glycogen
Hers HG
The Control of Glycogen Metabolism in the
Liver
Annual Review of Biochemistry1976;45:167-190
Bergström J Hultman E
A Study of the Glycogen Metabolism during
Exercise in Man
Scand J Lab Clin Invest1967;19:218-228
Bollen M Keppens S Stalmans W
Specific features of glycogen metabolism in
the liver.
Biochem J. 1998;336:19–31.
Insulin metabolism and Type 2 diabetes
Weyer C et al
The natural history of insulin secretory
dysfunction and insulin resistance in the pathogenesis of type 2
diabetes mellitus
J Clin Invest. 1999;104:787–794
Hyperglycaemia damage
Brownlee M
The Pathobiology of Diabetic Complications: A
Unifying Mechanism
Diabetes 2005;54:1615-1625
Insulin resistance
DeFronzo RA Ferrannini E
Insulin resistance. A multifaceted syndrome
responsible for NIDDM, obesity, hypertension, dyslipidemia, and
atherosclerotic cardiovascular disease.
Diabetes Care March 1991;14:173-194
Kahn BB Flier JS
Obesity and insulin resistance
J Clin Invest. 2000;106:473–481
Pre-diabetes
Catherine C. Cowie et al
Full Accounting of Diabetes and Pre-Diabetes
in the U.S. Population in 1988–1994 and 2005–2006
Diabetes Care February 2009;32:287-294
http://www.pophealthmetrics.com/content/8/1/29
Boyle JP et al
Increasing pre-diabetes in US
Projection of the year 2050 burden of
diabetes in the US adult population: dynamic modeling of incidence,
mortality, and prediabetes prevalence
Population Health Metrics 2010;8:29
Reaven GM
Pathophysiology of insulin resistance in
human disease
Physiol Rev July 1995 vol. 75 no. 3 473-486
Complications of diabetes
Oxford Textbook of Medicine 5th
Edition OUP 2010
13.11.1 Diabetes – Chronic complications
http://otm.oxfordmedicine.com/cgi/content/essentials/med-9780199204854-chapter-131101
Treatment of diabetes
http://www.diabetes.org.uk/Guide-to-diabetes/Treatments/
Glycemic index COMMENT: Promissory Note Page
70 about GI. How much to go in here?
Access to the University of Sydney on
glycemic index and data-base of foods
Dairy produce and diabetes
Cho HK et al
Dairy Consumption and Risk of Type 2 Diabetes
Mellitus in Men. A Prospective Study
Arch intern med 2005; 165:997-1003
http://archinte.ama-assn.org/cgi/content/abstract/165/9/997
Liu S etal
A Prospective Study of Dairy Intake and the
Risk of Type 2 Diabetes in Women
Diabetes Care 2006;29:1579-1584
http://care.diabetesjournals.org/content/29/7/1579.short
Whole grain and diabetes
Fung TT et al
Whole-grain intake and the risk of type 2
diabetes: a prospective study in men
Am J Clin Nutr September 2002;76:535-540
http://www.ajcn.org/content/76/3/535.short
Sugar intake
Bowman SA et al
Effects of Fast-Food Consumption on Energy
Intake and Diet Quality Among Children in a National Household Survey
Pediatrics 2004;113:112 –118
Howard BV Wylie-Rosett J
Sugar and Cardiovascular Disease
A Statement for Healthcare Professionals From
the Committee on Nutrition of the Council on Nutrition, Physical
Activity, and Metabolism of the American Heart Association
Circulation. 2002; 106: 523-527
http://circ.ahajournals.org/content/106/4/523.extract