Health & Wellness: Obesity and Diabetes

From the Grace Church Health and Wellness Committee, October 2007

The themes for October are obesity and diabetes. Maintaining a sedentary lifestyle and failure to control food portion size are two key elements in the development of obesity and Type 2 diabetes (the most common form of diabetes). Your doctor is the best source of information about which form of diabetes you may be at risk for.

• Obesity: It is almost impossible to turn on the television or open a magazine or newspaper today and not be confronted by a drug, medical procedure or device targeted to fight obesity. But what is it? Simply put, obesity is an unhealthy level of body fat. Body mass index, or BMI, is a reliable measure of our body fat or our weight relative to our height and a useful tool in evaluating the extent to which we may be underweight, normal weight, overweight or obese. While generally reliable, the BMI has at least two limitations: (a) It may overestimate body fat in athletes and others who have a muscular build; and (b) It may underestimate body fat in older persons and others who have lost muscle mass. A number of adverse health conditions are contributed to by being overweight or obese including: diabetes, hypertension, and heart disease.

• Diabetes: Type 2 diabetes develops over time when either your body does not produce enough insulin in your blood or your cells ignore the insulin. The food we eat is broken down into glucose. Glucose is a simple sugar that is the main source of energy for our body's cells. Our cells cannot use glucose without insulin, a hormone produced by the pancreas. Insulin helps the cells take in glucose and convert it to energy. Being obese or overweight affects the way insulin works in your body. Extra fat tissue that is associated with obesity can make your body resistant to the action of insulin, but exercise helps insulin work well. As a result of this growing insulin resistance and increasing levels of glucose in the blood, your body begins overproducing insulin to regulate glucose levels. Over time your body can no longer keep these levels (insulin and glucose) in a normal range. Eventually this inability to achieve balance between insulin and glucose results in higher, unhealthy glucose levels, and ultimately leads to the development of Type 2 diabetes.

Connections: While obesity does increase the risk of developing diabetes, diabetes involves more than being obese. Only 5 – 10 percent of obese people are diabetic, and many diabetics are not obese. For most people, Type 2 diabetes is strongly associated with family history or genetics. Once diabetes has developed, weight loss can help but may not cure the diabetes. Finally, once developed, diabetes becomes a part of a larger group of health conditions referred to as the metabolic syndrome.

To summarize:

• Obesity is an unhealthy level of body fat and
• As a result of lifestyle choices and our family histories, more and more of us are developing Type 2 diabetes. Developing Type 2 diabetes does not happen suddenly, but rather is a result of a series of unhealthy changes in how our bodies process glucose (a simple sugar that is the main source of energy for our body's cells). Once developed, diabetes becomes a part of a larger group of health conditions referred to as the metabolic syndrome.

Your doctor is the best source of information about which medical conditions associated with metabolic syndrome you may be at risk for (e.g., heart disease, stroke, and Type 2 diabetes – all related to plaque buildups in artery walls).

• Metabolic Syndrome is defined by the National Cholesterol Education Program as the presence of any three of the following conditions: (a) excess fat around the waist, (b) high levels of triglycerides, (c) low levels of HDL, or "good," cholesterol, (d) high blood pressure (130/85 mm Hg or higher), or (e) high fasting blood glucose levels. All of these conditions put the heart at significant risk. Knowing your “numbers” (cholesterol, blood pressure and blood glucose), discussing them with your doctor, and taking appropriate actions are keys to preventing heart disease. The Centers for Disease Control and Prevention (CDC) reports that just 7 percent of patients with diabetes are getting all the medical treatments they need.

• Preventing or Delaying Diabetes: Type 2 diabetes develops when either the pancreas does not produce enough insulin or the cells ignore the insulin (insulin resistance). Being overweight and/or sedentary negatively affects the way insulin works in our bodies. Eventually the body’s inability to achieve balance between insulin and glucose results in higher, unhealthy glucose and insulin levels, and leads to the development of Type 2 diabetes.

• · Glucose levels change all of the time, in response to the amount and type of food we eat and the intensity and duration of our activities. Those of us with blood glucose levels that are consistently higher than normal but not yet in the diabetic range are often referred to as “pre-diabetic.” Pre-diabetics usually have no symptoms. Studies conducted by the National Institutes of Health indicate that pre-diabetes (insulin resistance) can, in some cases, be reversed and in other cases, delayed. Key action steps in reaching these goals include: (a) increasing physical activity (helping your muscle cells use blood glucose), (b) eating a low-fat, low-calorie diet, (c) achieving optimum weight, and (d) controlling blood pressure and cholesterol.

Should you have concerns or want additional information about the material presented above, please contact your local health care provider, public health department or someone on the Grace Church Health and Wellness Ministry Committee. This Committee is chaired by Mrs. Florence Poyer, R.N.

Prepared by: Walter S. Handy, Ph.D., Member, Grace Church Health and Wellness Ministry Committee