• Young Women's Health & Insulin Resistance

    Before the joy of pregnancy and parenthood directs a women’s life, many young women worry about their weight. Since a pregnancy – specific definition of obesity has not been standardized, pregnant women are often considered obese or non-obese based on their pre-pregnancy body mass index (BMI).

    I had a patient who recently came to see me for weight loss prior to her wedding. She originally weighed 5 foot 9 inches and 207 pounds (BMI -30.6). Event though her concern is to lose weight so she can fit into her old clothes and wedding dress, she will also reduce her risk of developing insulin resistance, if she loses weight and follows a wellness program.

    Insulin is a hormone made in our bodies that helps keep our blood sugar normal . If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. Certain medical conditions such as being overweight, obese, or having an inflammatory condition called polycystic ovary syndrome (PCOS) or the metabolic syndrome can cause insulin resistance. PCOS has been associated with a miscarriage rate 20 to 40 percent higher than the baseline in the general obstetric population. PCOS is also associated with an increase in spontaneous preterm birth or cervical insufficiency.

    Obesity-associated insulin resistance is a major risk factor for type2 diabetes and heart disease. In the United States, approximately 6% of the adult population is diagnosed with insulin resistance. People with an excess collection of fat (adipose tissue) around their waistline (an “apple-shaped” distribution) are at greater risk for developing insulin resistance.

    So how do you know if you're at risk? if you have a waistline greater than 40 inches for men and 35 inches for women, according to the Journal of the American Medical Association, that's an indicator that you are carrying too much belly fat, even if you're a relatively healthy weight and generally in good health.

    Lifestyle changes including diet and exercise will lower your risk factors for insulin resistance and heart disease. You can help lower your insulin levels naturally by eating fewer starches and sugars, and more foods that are high in fiber and low in refined carbohydrates. Low glycemic foods, on the other hand, don’t raise your blood sugar or insulin levels as much as foods that are high in sugar or refined carbohydrates. Exercising is another way to improve your PCOS. Fitting in 60 minutes of exercise each day is recommended, but any amount of exercise you do will help manage your PCOS. Exercisedecreases insulin resistance.

      

    The American Diabetes Association suggests you limit your total daily fat intake to 20 to 30 percent of your total calories, keep saturated fat (animal fats, palm oils and processed snacks and desserts) to less than seven percent and try to eliminate harmful trans fats altogether. Your nutrition plan should contain lots of fresh vegetables and fruits, lean protein and complex carbohydrates such as beans, lentils and sprouted grains for energy and fiber. In addition, try cooking with olive, canola, peanut, safflower or sesame oils, as they contain monounsaturated fats, the “good fats” when used in moderation. You can also try healthy vegetable oils for cooking like coconut, sunflower, olive, avocado and grapeseed oils.

    Also the way you cook your foods can affect your chances of becoming diabetic, increase inflammation and accelerate premature aging. According to a recent study in Diabetolgia, foods cooked at low temperatures (stewed, steamed or poached) and avoiding foods that are cooked at high temperatures ( fried, baked or grilled), significantly improved insulin resistance and mildly reduced body weight.

    Finally, Thiazolidinediones (TZDs) represent a novel class of anti-diabetic agents that work by lowering your insulin resistance in people with obesity-associated type 2 diabetes (T2DM). TZD’s make your body produce new fat cells , and those cells allow insulin to do its job, which is to get sugar (glucose) into the cells and be used by our body for energy.. Examples of TZDs include Pioglitazone (Actos) and Rosiglitazone (Avandia).

     

     

    References:

     

    endocrineweb.com

     https://www.endocrineweb.com/conditions/type-2-diabetes/thiazolidinediones-tzds-or-glitazones-type-2-diabetes

     

    Genes and Development http://genesdev.cshlp.org/content/21/12/1443.full#sec-12

     

    Life Extension May/ June 2017

    Livestrong

    http://www.livestrong.com/article/173780-how-to-burn-visceral-fat/

    Pediatrics http://pediatrics.aappublications.org/content/pediatrics/early/2013/03/06/peds.2012-1421.full.pdf

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