20> At-risk 26% Diabetes 7% Balance 67% Diabetes and Accelerated Aging

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Madeline Lang
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1 Diabetes and Accelerated Aging There are twenty-one Million People have Diabetes. 90% of these are Type II Diabetics. Diabetes numbers get worse with Age. Of the people 65 and Older, 18% have Diabetes. Of this same age group, 40.8% have impaired glucose tolerance (borderline or pre-diabetes). Our population is Aging In 1986, 11% were over age 65 but by 2020, that number will double. U. S. Population with Diabetes Men Women U. S. Population with Diabetes At-risk 26% Diabetes by Age Diabetes 7% Balance 67% 20>

2 Prevalence in Men vs. Women Men Women Diabetes by Race/Ethnicity Prevalence Non-Hispanic Whites Non-Hispanic Blacks Hispanic/Latino Americans American Indian and Alaska Natives Cost of Healthcare One out of 7 healthcare dollars is spent on chronic complications of diabetes and the cost of diabetic care is 3.6 times higher than for non-diabetics..$105 billion or more for direct cost. Diabetes and Accelerated Aging Many signs and symptoms of diabetes also commonly occur with aging including: Cardiovascular ailments Cancer Vision Problems Impotence Hearing Loss Cognitive Impairment Skin Conditions Loss of elasticity and flexibility of skin and tissues

3 Diabetes and Accelerated Aging The fact that diabetes is a form of accelerated aging comes as a surprise to most people. The life expectancy for diabetics is 4 to 8 years less than non-diabetics. Both aging and diabetes contribute to biological processes that damage the body. Types of Diabetes Type I Insulin Dependent Type II Metabolic Syndrome Facts about Type I Insulin Dependent Early Onset Involves total loss of ability to produce insulin. Almost always requires Insulin Injections Approximately 10% of Diabetics are Type I Facts about Type II Metabolic Syndrome Later Onset Affected and Controlled by Diet in Some Cases Diet has Profound Effect on Type II Diabetes Insulin Resistance is the Cornerstone of Impaired Glucose Tolerance Intra-abdominal Fat is the Leading Contributor to Insulin Resistance Borderline or Pre-Diabetes In early stages of Type II diabetes the blood sugar levels after eating (postprandial) is the more important than fasting blood sugar. Increased Food Consumption In the past 30 years, food consumption has increased. Amount of protein remained constant Fat declined Carbohydrate consumption has increased

4 Insulin Blood glucose stimulates release of insulin Insulin transports blood sugar to cells Signals body to store fat Elevated Blood Sugar Levels One of the main causes of problems in diabetes is elevated blood sugars. Blood sugar sticks to proteins and fats in the body like a sweet glaze sticks to ham or roast. This process is called Glycation. Blood sugar sticks to proteins in red blood cells, nerves, kidneys, blood vessels, almost any place where there are proteins. Proteins then lose their natural ability to function when sugar sticks to them. With-in each cell there are proteins that carry on chemical processes that are responsible for energy production, as well as other things that makes us alive. Sugar sticking to these proteins slows down these life-giving processes. The more sugar that sticks, the less effective each cell becomes. Facts about Insulin Resistance Intra-abdominal fat (gut fat) is the leading contributor to insulin resistance The greater the insulin level, the more the body tends to store fat instead of burning it as fuel for energy When blood sugar goes up after a meal, our body responds by producing insulin to help clear the blood of this extra sugar Delaying the Onset of Diabetes The question is, What can be done to keep our blood sugar lower after we eat resulting in lower insulin levels which in turn reduces the amount of fat stored (especially around the waist) and also allows fat to be burned as fuel for long term energy between meals. Types of Food and how they impact blood sugar Fats, proteins and carbohydrates are the only kinds of foods we eat (Macronutrients) Carbohydrates are the only ones that increase blood sugar Intra-abdominal fat > Insulin Resistance -> Increased Blood Sugar -> Increased Insulin Levels -> Burn Less Fat -> Store More Fat (Gain Weight) All carbohydrates s are not created equal

5 Carbohydrates Some carbohydrates raise blood sugar levels very little while some raise them much more. Knowing which ones are acceptable and which ones are not is very valuable to those people who are interested in slowing the progression of diabetes. This approach to eating is important to all of us, non-diabetic as well as diabetic. Glycemic Index The Charts below compare some carbohydrates to blood sugar Glucose given value of 100 The higher the number the less you should consume Those below 45 should be substituted for those with higher numbers Some carbohydrates offer greater amounts of vitamins and nutrients than others Lower glycemic carbohydrates produce lower blood sugar levels. Lower blood sugar levels produce lower insulin levels. Lower insulin levels means there is less intra-abdominal fat stored. If insulin sensitivity is increased then more fat is burned. Vegetables Parsnips 97 All Lettuces <30 Baked Potato 85 Cauliflower <30 Pumpkin 75 Eggplant <30 Beets 64 Onions <30 Corn 55 Radishes <30 Sweet Potato 54 Yellow Squash <30 Yams 51 Water Chestnuts <30 Carrots 49 Sauerkraut <30 Green Beans 40 Tomatoes 15

6 Fruit Watermelon 72 Orange 44 Pineapple 66 Peach 42 Cantaloupe 65 Plum 39 Raisins 64 Apple 38 Mango 56 Pear 37 Banana 54 Apricots, dried 31 Kiwi 53 Grapefruit 25 Grapefruit Juice 48 Cherries 22 Grapes 46 Sweeteners Maltose 105 Glucose 100 Sucrose (table sugar) 64 High Fructose Corn Syrup 62 Honey 58 Fructose (fruit sugar) 22 Stevia 3

7 Dairy Products Tofutti 115 Ice Cream, full fat 61 Yogurt, sweetened 33 Skim Milk* 32 Soy Milk 30 Whole Milk 27 Yogurt, plain 14 Grains and Cereals French Bread 95 Wheat Bread, high fiber 68 Special K Cereal 54 Instant Rice 90 Stoned Wheat Thins 67 Oatmeal, slow cooking 49 Cornflakes 83 Grapenuts 67 Rye Kernel Bread 46 Pretzels 81 Couscous 65 Pita Bread, stone ground 45 White Bread 78 Hamburger Bun 61 All-Bran Cereal 42 Waffles 76 White Rice 58 Spaghetti, white 41 Cheerios 74 Pita Bread 57 Spaghetti, protein enriched27 Bagel 72 Muesli 56 Shredded Wheat 69 Brown Rice 55

8 Legumes Baked Beans, canned 48 Pinto Beans 39 Chickpeas 33 Black Beans 30 Kidney Beans 29 Lentils 29 Peas, dried 22 Soy Beans 18 Other Foods Dates 103 Pizza, cheese 60 Jelly Beans 80 Popcorn 55 Rice Cakes 77 Chocolate 49 Vanilla Wafers 77 Olives 18 French Fries 75 Nuts Graham Crackers 74

9 Most Common High Glycemic Offenders: Tips Alcohol Beer and drinks made with juice, soda, or sugar Candy All types Dried Fruits Except apricots Frozen Yogurt Pure sugar & carbs with no fat or protein to slow the rate of absorption Sugar-Sweetened Beverages Coke, Sprite, Snapple, bottled teas, spritzers Sugar In coffee, tea and on cereal Tubers & Roots Parsnips, potatoes, beets, etc. Watermelon Refined Foods Cereal, breads, cookies, rice/rice cakes, crackers Eat only those carbohydrates that are 45 or lower on the glycemic index Always eat carbohydrates s in combination with protein, fat or fiber in order to slow the rate of digestion and, therefore, the glycemic index of that carbohydrate. #1 choice = green #2 choice = blue #3 choice = turquoise #4 choice = pink DON T EAT WORSE THAN SUGAR = RED Glycation Glycation results in formation of glycotoxins. Glycotoxins are the contributing factor in diabetic complications. Browning of food from high heat produces glycotoxins. Therefore food preparation is also important in delaying onset of diabetes and aging

10 Glycation Examples Toasting Bread Grilling Lamb Chops Broiling Salmon Steaks Frying French Fries The browning of foods from high heat is a non-enzymatic reaction unlike the browning of a banana or other fruit from enzymes. Food Preparation Preparing foods at temperatures less than 250 degrees F avoids the formation of dietary glycotoxins. Such methods use liquids and slow cooking temperatures and include poaching, steaming, braising, stewing, and slow cooking (as in a Crockpot cooker). Tips for Eating Out No fast food! Call ahead and ask if the restaurant s chef can prepare using low-temperature cooking methods that use liquid, like braising, poaching, and stewing. Bring your own dressing or condiments. Start your meal with broth-based soup or a leafy green salad sprayed with olive oil and vinegar. Food Preparation Do s and Don ts DO: Marinate foods in liquids and seasonings: lemon juice, dry wine, broth, olive oil, cider vinegar. Feel free to add herbs and spices, including garlic, mustard, thyme, sage, tarragon, and others. DO: Eat foods prepared using low-heat cooking methods that employ water or liquid, like poaching, stewing, braising, boiling, steaming, slow-cooker cooking, and so on. Include a raw vegetable salad (and fruit) every day. AVOID: Broiling, frying, hot-oven roasting, grilling and barbecuing.

11 Summary Intra-abdominal fat is created through, Insulin Resistance which is a result of Increased Blood Sugar. Increased Insulin Levels allow for the body Burn Less Fat and Store More Fat (Gain Weight) In addition to reducing high glycemic carbohydrate intake food preparation is important Preparing foods at temperatures less than 250 degrees F avoids the formation of dietary glycotoxins. Such methods use liquids and slow cooking temperatures and include poaching, steaming, braising, stewing, and slow cooking (as in a Crockpot cooker). Educational materials disclaimer: The Diabetic Shoppe is pleased to provide you with educational materials. The staff of The Diabetic Shoppe has determined that the materials come from a reliable source. The information and opinions contained in the text are those of the authors and do not necessarily reflect those of The Diabetic Shoppe. This material does not replace the advice of your health care provider. Be sure to consult with your health care provider regarding your individual health care needs. The Diabetic Shoppe does not warrant or guarantee and expressly disclaims any and all responsibility or liability for the accuracy or completeness of any of the information.

Glycemic Load & Glycemic Index

Glycemic Load & Glycemic Index Load & Index When food is consumed it is converted to fuel for our bodies. One type of fuel is glucose and different foods impact blood glucose levels differently. A driver of this is the amount and type