Low Carb Lung Doc
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Low Carb Lung Doc

What is metabolic syndrome?

Do I have it and can I make it go away? And does it impact my breathing?

Brief summary from the National Jewish Health Metabolic Health Virtual Support Group on March 9

Good morning, friends! I’m up this morning, fired up, and it’s time to get caught up on 2 support groups that we have held in the past two months. Recently, we launched a metabolic health support group at National Jewish Health, to discuss the impact of insulin resistance and metabolic syndrome on how we breathe, and ways to work toward improving metabolic health.

I want to give a huge shout-out to our support group organizer, Dthia Kalkwarf RN. She is a diabetes educator at National Jewish Health, and is passionate about helping people in the prevention and treatment of prediabetes and Type 2 diabetes.

Also off the bat, I want to let you know that this blog does not constitute medical advice and you should talk to your physician before making any substantial nutritional changes. Especially if you are on medications to lower your blood sugar, making changes without their input and adjustments could be life-threatening. Okay with that said, onto our summary…

In our first support group meeting, we went over an introduction to insulin resistance and metabolic syndrome.

What is metabolic syndrome? In our introduction we talked about the definition of metabolic syndrome. Metabolic syndrome is a group of conditions that predispose people to heart disease, diabetes, stroke, and other medical diseases (link to AHA website here). We discussed that the main driver of metabolic syndrome is the problem of insulin resistance.

Metabolic syndrome is a problem of lipid abnormalities, elevated glucose levels, and fat production and storage
Insulin resistance is the foundation of metabolic syndrome

We explained in very basic terms how our bodies process the energy that we take in. We eat something with sugar or starchy carbohydrates, our blood glucose rises, the pancreas secretes insulin, this signals to our body’s cells to take up energy, and this is transformed and stored in the liver and muscles as glycogen and in the fat cells as fat. This is (again basic) normal physiology.

The issue is that with our standard American Diet that is high in starchy carbohydrates, this process goes on overdrive. And eventually the body needs more and more insulin to bring down blood sugars. When this is no longer effective, a person develops prediabetes, and when it gets worse, type 2 diabetes. It is important to note that years before people get to overt prediabetes, there are often other markers of insulin resistance, like lipid abnormalities (high triglycerides, low HDL), abdominal obesity, or hypertension and other problems.

The Ominous Octet of Type 2 Diabetes shows all the organs affected by insulin resistance

When we look at the problems that come from insulin resistance and metabolic syndrome, there are several, and we use medications and treatments to treat each of these problems. We will prescribe blood pressure medications, statins or other lipid lowering medications, CPAP for obstructive sleep apnea, diabetes medications for diabetes, and so on and so forth. And while these medicines are important, our group also works to address the root cause, the insulin resistance itself, in the hopes that people will improve their metabolic health to put type 2 diabetes and prediabetes into remission, and be able to come off some of those medical therapies.

Do I have metabolic syndrome? There are tests that are performed to tell if you have metabolic syndrome (this is the topic of our April Support Group — summary coming soon). However if you have one or more of the medical conditions in the figure above (hypertension, or you are on blood pressure medications; cholesterol problems, or you are on a statin or other lipid lowering medicine; abdominal obesity; or the other conditions above such as fatty liver disease), you very well may have insulin resistance metabolic syndrome.

Can I make it go away? The good news is that yes, through shifting how we approach nutrition and other pillars of health, you can improve insulin resistance and metabolic syndrome. But as many people know, this is more difficult that the traditional advice we are given in the doctor’s office to “Eat Less and Exercise More,” which ascribes to the calories in, calories out (CICO) method of weight gain and loss. The reason it is a bit more complicated than that is because of the hormone, insulin. Jason Fung, in his book The Obesity Code, and on his website The Fasting Method, explains these concepts well. Essentially, obesity (and insulin resistance) is an issue of both calories as well as foods that activate insulin, which is a fat storage hormone. The way to lose weight or improve metabolic health, involves the types of food we eat, how much, and also when we eat. In order to lose fat mass, we need to eat healthy AND also reduce our own body’s insulin levels.

Comparing the calories in/calories out model of obesity to the hormonal hypothesis of obesity — From Jason Fung

How do we do that? There are several ways to do this. One way is by intermittent fasting. When we fast, our body lowers insulin (the signal to store fat) so that we can release fat from fat cells and convert it to energy. There are many ways to do intermittent fasting, but an easy way is by extending the fast by taking in no calories between dinner and lunch (skipping breakfast). You can find more information on The Fasting Method. We will also talk about this in a future support group and blog. Another way is by lowering the sugar and starchy carbohydrates that we take in to begin with. This can be by doing a method as simple as “No sugar, no grains,” as developed by trainer Vinnie Tortorich, who used this method for years to help ultraathletes get energy efficient and be able to utilize fat as well as get Hollywood stars in shape and lean for movies. We can even take this to more of an extreme by implementing a well-formulated ketogenic diet. One great way to do this is with a group called Virta Health, which provides medical supervision and coaching to anyone in the United States. We will talk more about these methods in future meetings and blog posts.

Obesity and Metabolic Syndrome affect how we breathe

Finally, does metabolic syndrome affect my breathing? The answer is YES. In a brief summary slide we discussed several cardiopulmonary conditions that may be fueled at least in part by insulin resistance and metabolic syndrome. It is for this reason that we are so keen on providing real coaching and strategies to address metabolic syndrome at our medical center and in our support group.

The way we approach this is by talking about the pillars of health with each and every patient we see. In addition to providing people with a diagnosis and medical treatment plan for their disease that is making them short of breath, we address sleep, nutrition, exercise, and mental health as well, to provide people with a complete prescription to help them breathe their best and live their best lives.

It is crucial to address the pillars of health when we take care of patients

Want to find out more about how you can improve your metabolic health? Feel free to sign up for our metabolic health support group mailing list at http://redcap.link/metabolichealthsignup or join us on the 2nd Wednesday of every month.

If you have prediabetes or type 2 diabetes, are able to come to Denver, and want to learn more about this patient-centered approach, you can call (303) 398–1355 and make an appointment in our Adult Diabetes Clinic.

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Patricia George

Patricia George

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Physician, athlete, and lover of the outdoors. Seeking to understand how we manifest our best selves. Inspired by hope. Opinions are my own.