Blood Glucose -- Know Your Number!

By James LaValle, RPh, ND, CCN

When it comes to blood sugar, the closer you can keep it to the normal range of 80 to 89 mg/dL the better. For years I have been warning that blood sugars even in the 90 to 100 range show that you are becoming insulin resistant and on your way to diabetes. A recent study done on 47,000 Kaiser Permanente patients validated this observation.

The study, published in the American Journal of Medicine found that blood sugar, blood glucose (BG) levels in the 95-99 range more than doubled a person's risk of becoming diabetic. In fact, for every point over 85 mg/dL the risk of becoming diabetic increased 6%, even when they controlled for other factors.¹

Accordingly, the study noted that there was more incidence of cardiovascular disease and hypertension in those with higher BG. Why is this research so important? It flies in the face of currently accepted medical guidelines that for years have used 100 as the magic number for diagnosing "pre-diabetes."

At LMI, I've been seeing red flags for years when patients come in with BG levels even in the 90's, because these levels are often accompanied by being somewhat overweight or over fat, having a thick waist, or the spare tire of dangerous belly fat. These are signs that the body can no longer efficiently process the sugars that come from complex carbohydrates in whole grains, starchy vegetables, fruits, and simple sugars.

In other words, they are signs of insulin resistance. Insulin is the "key" that unlocks the door to each cell in the body, letting glucose into the cell to be processed for energy. If the insulin key is faulty, the glucose remains in circulation, raising triglycerides, lowering HDL, and usually ending up at the waistline.

Anytime you see your doctor for a routine physical, fasting blood glucose is tested along with other blood labs. If your blood sugar comes in less than 100 mg/dL, you will likely get an "all clear," when it comes to diabetes risk. If you're overweight, have elevated blood pressure and are sedentary -- other risk factors for insulin resistance -- your doctor may suggest you lose a few pounds and add a few days of walking to your weekly routine.

But typically that won't happen unless your blood sugar levels come in greater than 100 mg/dL, but less than 126 mg/dL -- the pre-diabetes range -- then you will get a more stern warning regarding diet and exercise. However, it's not until your fasting blood sugar levels reach over 126 mg/dL that you are diagnosed with type II diabetes or non-insulin dependent diabetes.

By the time you get the "true diabetes" diagnosis -- your body is so insulin resistant that it may need much more than the "diabetic diet" and a walking routine to get your blood sugar levels under control. This is when you may need an oral hypoglycemic medicine, which comes with a nice little set of nutrient-depleting side effects.

Wouldn't it be nice if your doctor had warned you of your increased risk way before you even reached the 100 mark for blood glucose? For years, I have been warning my patients that a blood sugar of over 90 is a sign they are becoming insulin resistant. But because medical guidelines give an "all clear" at anything under 100, too many patients don't want to believe they could be at risk -- even with fasting BG's of 98 and showing every sign of insulin resistance.

At LMI, we go to work on the insulin resistance by giving our patients blood sugar support nutrients like chromium and having our dietitians provide instruction on a lower carb diet. Ironically, we sometimes receive calls from their primary care physicians questioning our course of action because they think these patients "are fine." But our philosophy is, don't wait to become diabetic -- take action well ahead of time.

Hopefully, the medical community's eyes will be opened with the newly published article in the American Journal of Medicine. This phenomenal research has hit the nail on the head and may finally spur new guidelines to be issued for the management of blood sugar.

Medical news can take a while to trickle down into actual practice, so in the meantime, you may need to become more proactive on your own. If your blood work reveals a high-normal fasting blood sugar level, cut down on carb-heavy sugars, starches, and fruits, up the organic vegetables and proteins, and get your body moving. You may be saving yourself from becoming a diabetes statistic.

Reference

1. Am J Med. 2008;121:519-524

[Ed. Note: James LaValle, R.Ph, ND, CCN, is the founding Director of the LaValle Metabolic Institute, one of the largest integrative medicine practices in the country. He was named as one of the 50 most influential pharmacists in the US by American Druggist magazine. Dr. LaValle is the author of more than a dozen books including the bestseller, Cracking the Metabolic Code: 9 Keys to Optimal Health.]

Cutting Edge Fitness: Weight Loss: Back to Basics By Carlo X. Alvarez

In past articles, I have written about high-intensity interval training and its benefits in prolonging the after-burn effect. This is the ability of the body to increase metabolic disturbances hours after your workout sessions. But in this article, I want to take a step back and make exercise recommendations for people that are overweight and can't handle the stress and anaerobic activity volume that comes with high-intensity metabolic training programs.

Exercise is crucial for long-term healthy weight loss. Regular cardiovascular workouts such as running, walking, and stair climbing burn calories, increase circulation, improve heart health, and increase endurance. Getting even a modest amount of exercise -- the equivalent of walking 30 to 45 minutes -- prevents weight gain and promotes positive changes in body composition.

The results of a new study support existing recommendations from the Centers for Disease Control and Prevention that adults get 30 minutes or more of moderate intensity physical activity on most, preferably all, days of the week.¹

Regular exercise not only burns calories, but builds lean muscle mass and raises resting metabolic rate, enabling you to burn even more calories. This is because muscle requires more energy than fat for maintenance. In fact, the most important reason for the high (and still rising) rate of obesity in the United States is because most people are not getting the amount of exercise their body needs.

When a person loses weight by severe calorie restriction, exercise increases energy expenditure and slows the rate of fat-free tissue loss that occurs. Exercise also helps maintain the resting metabolic rate, which contributes significantly to the daily caloric expenditure.

For weight loss, the basic guidelines to follow include calorie reduction, increased physical activity, and personal behavior modification that will improve eating and exercise habits.

For people that need to lose 10% of their body weight, the initial goal should be 1 to 2 lb per week over a 6-month period. A continued physical activity program will help to achieve that goal. Exercise appears to be the best predictor of long-term weight loss and its subsequent maintenance.

Reference

1. http://www.cdc.gov/nccdphp/dnpa/physical/everyone/recommendations/index.htm

[Ed. note: Carlo X. Alvarez is a noted authority in the customized fitness and sports performance field. He is recognized for his integrated and systematic approach to training, based on a foundation of safe and proven methodology that has direct and measurable benefits to performance.]

Nutrition & Health: Sugar, Carbs and Diabetes Risk By Laura LaValle, RD, LD

In medical circles, the idea that sugar increases the risk of diabetes is considered to be an old wives tale. However, recent studies bring not just sugar, but all high glycemic index (GI) and high glycemic load (GL) foods into question. Two studies from last year showed that women with the highest intakes of high carb-containing foods (high GI and high GL) had the greatest risk of becoming diabetic.

One studied looked at all high GI and GL foods and found the highest intakes of these foods were associated with the greatest risks of becoming diabetic. Sugary foods weren't evaluated separately, but just as part of the overall diet. While cereal is primarily a high GI food, this study showed that a diet high in cereal fiber lowered the risk of diabetes.¹ (This makes sense, because fiber slows the release of sugars into the blood stream.)

Another study of Chinese women found that those who ate the most rice had a 78% increased risk of diabetes compared to those who ate the least.²

Higher sugar intake leads to higher hemoglobin A1c levels (a measure of blood sugar levels over time) and is correlated with increased risk of heart disease.³ But interestingly, when sugar is evaluated separately from a person's total carb intake, the studies have not correlated it directly with diabetes.

But hold on -- because while sugar itself hasn't been directly linked to increased diabetes risk, sugar-sweetened beverages like soft drinks and fruit punch have been.⁴ They've also been linked with increased risk of becoming overweight or obese.⁵

We know that the more weight we gain, the more insulin resistant we start to become -- which does lead to diabetes. But we still can't say that high sugar intake increases risk of diabetes? At what point does this start to get ridiculous?

Here is what we know:

1. Higher intake of high GI and high GL foods increases risk of diabetes.
2. Higher intake of sugar-sweetened drinks increases risk of diabetes.
3. Higher intake of sugar increases risk of heart disease.

Whether the path is direct or not, I think it's plain to see that eating too much sugar -- or any high carb food or drink for that matter -- increases our risk of diabetes and heart disease.

If you need more reasons than that to reduce your sugar intake, you should also know that eating diets high in sugar has been linked with increased risk of gout,⁶ Alzheimer's disease,⁷ as well as cataracts⁸ and macular degeneration.

Enough said? I think so.

References

1. Krishnan S, et al. Arch Intern Med. 2007;167(21):2304-2309.
2. Villegas R, et al. Arch Intern Med. 2007;167(21):2310-2316.
3. Selvin E, et al. Arch Int Med 165:1910-1916.
4. Schulze M, et al. JAMA. 2004;292:927-934.
5. Reilly, J.J., et al. Br Med J 2005; 330: 1357; www.bmj.com.
6. Online first issue of the Br Med J, February 1, 2008.
7. http://www.mayoclinic.com/health/diabetes-and-alzheimers/AZ00050 accessed July 21st, 2008.
8. Mitchell P, et al. Am J Clin Nutr. 2007;85:1502-1508.

[Ed. Note: Laura B. LaValle, RD, LD is presently the director of dietetics nutrition at LaValle Metabolic Institute (formerly part of Living Longer Institute). She offers personal nutritional counseling at LMI for clients who need help with their diet in relation to illness or disease. Laura also provides educational services in the areas of health promotion, wellness, and disease prevention. To learn more click here.]

Healthy Recipes: Low Carb Huevos Rancheros with Poached Eggs By Laura LaValle, RD, LD

Huevos Rancheros (ranch-style eggs) is a Mexican breakfast classic that is both versatile and hearty. While it is often served on tostadas, tortillas, or English muffins, you can leave those behind by serving the eggs on top of the beans for a delicious lower carb version!

Serves: 4

Healing Nutrient Spotlight
Excellent source of vitamin A, vitamin C, vitamin K, iron, selenium
Good source of riboflavin, vitamin B-6, folate, calcium, iodine, manganese, molybdenum

Ingredients*
4 free-range organic chicken eggs
1 tsp. apple cider vinegar
4 cups water
1 T. coconut oil or grapeseed oil
2 cans of black beans, rinsed well and drained
1 medium onion, chopped
4 medium cloves garlic, minced
2 tsp. ground cumin
1 1/2 T. red chili powder (or to taste)
2 T. chopped fresh cilantro
sea salt and black pepper to taste
prepared salsa
2 cups shredded romaine lettuce
1 large avocado, cubed

*Select organic ingredients for optimum nutrition.

Preparation
Bring water and vinegar to a simmer in a shallow non-reactive skillet. Make sure there is enough water to cover eggs. Meanwhile, in a separate non-reactive skillet, heat oil over low to medium-low heat. Sauté onion for about 3 minutes. Add garlic, beans, red chili powder, and cumin. Cook bean mixture for about 10 minutes on low to medium low heat, stirring occasionally. Add cilantro, salt, and pepper. You may add a little water to the beans if they are too thick.

While the beans are cooking, poach eggs by carefully cracking them into the water so as to not break the yolks and cook them for about 5 minutes, just until the white is set and the yolks have filmed over. Remove with a slotted spoon, and place eggs over beans. Serve with salsa, shredded romaine lettuce, and avocado.

Nutrition
370 calories, 20 g total fat, 7 g saturated fat, 2 g monounsaturated fat,
2 g polyunsaturated fat, 210 mg cholesterol, 35 g carbohydrate, 16 g fiber,
3 g sugar, 18 g protein, 2200 IU vitamin A, .3 mg riboflavin, .2 mg vitamin B6,
65 mcg folate, 17 mg vitamin C, 25 mcg vitamin K, 110 mg calcium,
.4 mg manganese, 580 mg potassium, 12 mcg molybdenum, 5 mg iron,
16 mcg selenium, 650 mg sodium

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These articles appear courtesy of Early to Rise’s Total Health Breakthroughs [Issue 07-29-08] which offers alternative solutions for mind, body and soul. For a complimentary subscription, visit http://www.totalhealthbreakthroughs.com/