12-11-2003
Was Humanity's Rise to Prominence Fueled by Fish Oils? - 8:
What We All Need to Know About Diabetes 

Another Rude Awakening for Me
    Diabetes is a disease, isn't it? You either have it or you don't. And if you don't have it, it won't harm you.
    Wrong! Dead wrong, as in "What you don't know may kill you!"
    Major fluctuations in blood sugar levels caused by eating a baked potato or a quart of butter pecan ice cream (my own personal nemesis) elicit major outpourings of insulin. These high insulin levels can damage veins and arteries and bring on the other damage for which diabetes is justly famous, and you don't have to be a diabetic for this to happen!
    Diabetes has been treated as a specific disease in Western society, but I suspect that's going to change. Diabetes causes accelerated aging in many organs in the body, and aging is being linked, in part, to the processing of sugar in the mitochondria. Dr. Barry  Sear's and Dr. Nicholas Perricone's thesis is that one's vulnerability to degenerative diseases is linked to the pro-inflammatory properties of insulin (and indirectly, to the pro-inflammatory role of of the omega-6 fats, which are precursors to pro-inflammatory prostaglandins). The omega-3 fats are precursors to anti-inflammatory prostaglandins, and must be balanced against the pro-inflammatory tendencies of the omega-6 fats. Dr. Sears emphasizes that pro-inflammatory responses are vital to the body in, for example, fighting infections. Inflammatory cytokines are the body's weapons against foreign invaders, and inflammatory responses draw repair crews to the scene of a cut or other problem. However, these inflammatory responses carry a price tag in the form of collateral damage to tissue in the neighborhood of spot under repair. Also, especially later in life, when mutations occur in the cells of the body, immune cells can fail to recognize the tissues they're supposed to be defending, and can attack them. When this goes on year after year, it can lead to cancer, cardiovascular disease, arthritis, and perhaps Alzheimer's and Parkinson's diseases.
Insulin Control
    Type I diabetes typically occurs in childhood and stems from the pancreas' inability to manufacture insulin. For Type I diabetics, insulin must be externally supplied.
    Type II (adult-onset) diabetes is caused not by a lack of insulin, but by a growing insensitivity of the cells of the body to insulin  It is a normal concomitant of aging! Furthermore, the damage diabetes causes typically starts a couple of decades before diabetic symptoms, in the form of elevated fasting glucose blood levels,  first appear. Anyone familiar with the complications of diabetes knows about the cardiovascular problems it generates. It's considered to cause a form of accelerated aging.
    More than one strategy for extending the lives of roundworms and fruit flies involve manipulating insulin growth factor-1. My current understanding is that more and more, aging is being tied to the processing of glucose in the mitochondria. 
Dr. Roy Walford on Diabetes
    The gerontologists with whose publications I'm familiar seem generally in agreement that smooth control of blood sugar and of insulin levels is of importance in assuring a long and healthy life. In his book, "Beyond the 120-Year Diet", Roy Walford, M. D., Professor of Pathology at the UCLA Medical School, has this to say about diabetes:
    "The type-2, late-onset diabetes afflicts 5 percent of the U. S. population, including 5 million diagnosed and an estimated 2 million undiagnosed cases. The likelihood of developing diabetes doubles with each decade of life, going from 0.1 percent for people under 20 years old to about 15 percent for those over 60. The likelihood also doubles with every 20 percent gain in body weight above average. Even among the non-obese, it is much commoner in those who are now of average weight but were previously very lean. One person in 14 in the U. S. either has diabetes or will develop it.
    "Diabetes is the third leading cause of sickness and death in the United States if one includes its many complications: arteriosclerosis, cataracts, and nerve and kidney damage. Diabetics have five times the risk of a major heart attack. Diabetes is the leading cause of blindness in the developed nations of the world. Of the people with advanced kidney disease, 40 percent have diabetes.
    "Broadly speaking, diabetes is attributable to a failure of the body to appropriately metabolize glucose. The clinical picture, the phenotype, is a sort of end phenomenon. The underlying cause can be any of many genetic mutations. Disruption can occur anywhere in the long pathway from the synthesis and release of insulin to the complete oxidation of glucose by the target cells. There are many steps, involving many enzymes, and alterations in the code for any of these will cause diabetes. Altogether, the various disorders that yield the phenotype of diabetes constitute the largest group of genetic disorders found in humans. Both nuclear and mitochondrial mutations may yield the phenotype. Indeed, the number of mutations that may lead to diabetes exceeds 200. For their part, environmental factors---for example, obesity---have a strong influence on the development of the phenotype, which is diabetes.
    "Diabetes is of special interest to us because it shows many, albeit not all, of the features of accelerated aging. In this sense, it is unlike the diseases we've previously talked about, which occur more often in older people but are not necessarily associated with biomarker changes denoting accelerated age. A decline in immune function is seen in them earlier. Changes in their connective-tissue proteins (collagen) are characteristic of older persons. They lose gamma crystallin from the eye-lens proteins at an accelerated rate. And the number of times their connective tissue cells will divide is considerably curtailed, just as in aging.
    "Diabetics usually display high-blood cholesterol, a decrease in the beneficial arteriosclerosis-preventing HDL factors, and greater susceptibility to arteriosclerosis. Cataracts occur earlier than normal, as do heart disease, kidney damage, and nerve disorders. Many of these adverse effects are due to the fact that the diabetic's elevated blood sugar is itself damaging to cells. High concentrations are especially detrimental to those proteins that are slow to be replaced (low-turnover proteins):  those in the lens of the eye, the lining of blood vessels, and the insulating material around nerve cells. Exposed to glucose over a long period, proteins develop so=called "cross links," or Advanced Glycation End Products, and an insoluble brown pigment is formed. However, this is not the whole story about the toxicity glucose. Hyperglycemia also increases the levels of enzyme systems that cause damage to small- and large-caliber blood vessels and peripheral nerves.

    "Long-term animal studies show that high-Glycemic-Index foods increase fasting insulin levels and promote insulin resistance, more rapid weight gain, higher body fat levels, and increased triglycerides. Low-Glycemic-Index meals improve glucose and insulin metabolism and lead to lower glycosylated proteins, one form of Advanced Glycation End Product. (High monounsaturated fatty acids in diabetes... e. g., olive oil, nuts... in diabetes does not affect these glycosylated proteins.)
    "Responsible for the biological activity of the so-called glucose tolerance factor, or GTF, the trace mineral chromium may play a role in late onset diabetes. Glucose metabolism can be improved in the elderly not only by fiber but by the addition of a small quantity of organic chromium, or brewer's yeast, which contains GTF, to the diet, or even inorganic chromium. In one study, adding supplemental chromium to the diet of diabetics caused a drop in blood glucose levels and a significant rise in the anti-arteriosclerosis HDL factors in the blood.
"Avoid diabetes: Don't let yourself be or become above average weight. If you were lean when younger, stay lean when older; don't let your weight increase to average as you grow older because for you---if you were previously lean---that would be relative obesity. While late-life diabetes is partially hereditary, remember that weight gain will complete the equation and bring on the disease. Keep physically fit (see Chapter 8) and include enough of the proper kinds of fibers in your diet as well as at least RDA amounts of usable chromium. If you are genetically susceptible to developing this debilitating troublesome ultimately killer disease, you should certainly adopt the CRON (Caloric-Restricted, Optimal Nutrition) diet. It prevents the development of diabetes in genetically highly-at-risk mice, and may well do the same for you. Studies of long-term regimes of moderate calorie reduction in humans suggest that a CRON diet should improve the insulin response and control of blood sugar not only in diabetics but in the normal elderly."

    Barry Sears, Ph. D., considers blood sugar control to be a centerpiece of his Zone Diet books, and gives it equal billing with high-dose, long-chain, omega-3 fatty acids in his latest opus: "The Omega-3 Rx Zone: The Miracle of the New High-Dose Fish OIl".
    Nicholas Perricone, M. D., considers blood sugar control sufficiently important in his books to devote 15 pages in "The Perricone Prescription" to blood sugar control.
    And woe is me! I'm the guy who was skinny as a rail into his late twenties  (with a 29-inch waistline). I weighed 122 pounds in undergraduate school, and 130 pounds is probably my proper lean body weight. By that yardstick, I'm probably 15% overweight. Drat it!

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