5 Steps to prevent Heart Disease

Sunday, September 13, 2015

Paradigm shifts in Diabetes, Obesity, Hypertension and Cholesterol

Combination therapy is the key to treating:
Hypertension (Trial shows aggressive therapy better)
Cholesterol  (Multiplier effect on treating cholesterol)

Good review of paradigm shift in treating diabetes

link above to  Ralph A. DeFronzo, albarado@uthscsa.edu. article

Long ago I stopped using sulfonylureas.  Endocrinologists kept using them because the lowered HgA1c for five years.  But they cause weight gain and make problem worse. 

I use Actos (TZD) on myself.  Most young endocrinologists avoid this because of water retention and potential for possible heart failure.  Actos has been shown to regress plaque in carotids. 
I stopped Actos for a while because it is know to cause weight gain. I lost 10 lbs but my fasting glucose went up to 300.  I went back on Actos and gained back the 10 lbs and improved my glucose but not as good as before I stopped it. 
Actos increases the good peripheral fat?  Not metabolically toxic like the central visceral fat.  Dr. Vaselli said in April that the peripheral  fat can become metabolically toxic if weight continues to go up with excess calories. 
Presently I decreased my Actos from 45 to 30 mg as I want to get off of it to lower my weight.  Invokana has made a huge difference for me.  

Ralph A. DeFronzo lists diet and exercise as number 1 in the new paragdigm.
I have tried to keep exercise perscription simple.  
Walk 8 minutes after each meal or at least 20 minutes a day.  
Running is for athletes but as it turns out high rep (10) low weight resistance training is for everyone.  I would say this is new and important.   
I discovered my fasting glucose decreased with DAILY weight lifting on machines.  
link: “Obesity equates to myocyte-adipocyte insulin receptor imbalance”

As for diet,  there in no question in my mind that the only healthy diet for insulin resistance, pre-diabetes or diabetes is a low carbohydrate high fat diet. 
link: My LCHF diet core

Two critical areas of the shift of treatment is to:
1- treat Obesity with combination diet drugs, especially for reduced obese.
2- prevent obesity which is difficult since we don't really know what caused the obesity epidemic.  Could be bacteria or virus? 
I have no faith in the present programs of false hope of high carbohydrate diets and intense exercise(walking 5 miles). 
The Handbook of Obesity by Bray and Bouchard, chapter 5, Obesity and Evolution by Eaton and Lindeberg has the following on page 48:
"The need for personal and household hygiene was a concept as novel in the nineteenth century as is the need for physical activity and sensible nutrition in the twenty-first century.  The easily understood germ theory led to widespread changes in popular habits and behavior.  Consequently the incidence of infectious diseases began a downturn well before the introduction of antibiotics.  Evolutionary insight, together with appreciation of how obesity equates to myocyte-adipocyte insulin receptor imbalance,  may be capable of producing comparable benefits today.  This possibility has practical implications.  At present, methods for assessing human muscle mass are conspicuously lacking.  Developing an inexpensive, acceptably accurate measure of body muscle(and fat) proportions should become a technological goal."

I push Low Carb High Fat (LCHF) diet and 20 minutes walking and low impact weight lifting.  

I also call for the end of teaching the  false hope of high carbohydrate calorie restriction and intense exercise  with simple will power to do so.  Anyone who know the new science of obesity knows that once the plateau of weight loss is obtained the reduced obese regain most of their weight.  The 3500 calorie rule does not work.  These people especially need the diet drugs to maintain their weight loss.  

This is the new paradigm of treatment of Diabetes, Pre-diabetes and Insulin resistance.   

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