Michele Helfgott, MD, FACOG

Transcription

1 Not for profit, all about you. Protecting Your Waistline: The Skinny on Vitamin D and the Insulin Connection Angela LaSalle, MD Medical Director Integrative Medicine and Parkview Women s Health Center Michele Helfgott, MD, FACOG Board certified OB/GYN 20 years experience Fellowship in Anti-Aging and Regenerative Medicine Committed to finding the root cause of disease, Dr. Helfgott treats issues associated with: Menopause, perimenopause, Autoimmune disease Gastrointestinal issues. Bio-identical hormone replacement Assists with nutritional counseling and exercise INTEGRATIVE MEDICINE. Not for focused profit, all for on you. Angela LaSalle MD 1

2 Workshop Goals Role of Vitamin D as a preventative strategy in the fight against obesity, diabetes and chronic disease. Understand screening tests for Vitamin D deficiency Risks and benefits of Vitamin D supplementation Role of insulin in obesity and diabetes Review basic recommendations to reduce insulin levels. Obesity: How Big is the Problem? Allen County 2004: 24.7% 2012: 33% Overweight is BMI > 25% Obesity is BMI > 30% Angela LaSalle MD 2

3 Diabetes: How Bad is the problem? The CDC estimates that by 2050, the incidence of Type 2 DM may be as high as 33% Vitamin D Deficiency: Who has it? 75% of Americans have low levels (Archives of Int. Med 3/09) 12.1% of infants and toddlers Higher incidence in dark skinned individuals: African Americans, Hispanics, Indian Angela LaSalle MD 3

4 Causes of Vitamin D deficiency Lack of sunlight Ethnicity Melanin in dark skin blocks light stimulation Aging Renal Disease Obesity Genetic Variance in Vitamin D receptors Common Denominator Insulin Angela LaSalle MD 4

5 How does Insulin Work? Angela LaSalle MD 5

6 Diabetes: What causes it? Type 2 diabetes is a miscommunication between multiple organs: Intestines Pancreas Liver Brain Cells It is not just a high blood sugar, but rather multiple biochemical abnormalities. Angela LaSalle MD 6

7 The results of insulin dysfunction It isn t just about the blood sugar. Higher insulin results in inflammation high blood pressure weight gain lipid disorders increase in risk of heart attack, stroke, cancer etc. Abdominal Fat is a biochemical problem! Role of Vitamin D in Insulin Release Key word is CALCIUM Vitamin D is responsible for the Calcium balance in the body. Release of Insulin requires the action of Calcium in the Beta Cell of the Pancreas. Action on other Vitamin D receptors in the cells of the body still under investigation. Angela LaSalle MD 7

8 Vitamin D Sources Fortified foods: most common ergocalciferol or vitamin D2 Vitamin D3 or Cholecalciferol is 66% better absorbed than D2 Angela LaSalle MD 8

9 Vitamin D Sources Sunlight is best source. UVB light nm Body makes 10,000 iu with min sunlight Toxicity from sun not possible After body makes 20,000 iu same light begins degradation of vitamin D Angela LaSalle MD 9

10 Symptoms of Deficiency Depression Fatigue Increased infections Muscle aches Loss of bone density Diseases with Vitamin D deficiency Rickets Osteomalacia, Osteopenia, Osteoporosis Psoriasis Peripheral Vascular Diease (80% may be deficient) Diabetes (both type 1 and type 2) Cancer Angela LaSalle MD 10

11 Diseases Under Investigation Multiple Sclerosis Rheumatoid Arthritis Parkinson s Alzheimer's Metabolic Functions of Vitamin D Affects insulin signaling Affects activation of enzymes Affects neurotransmitter production Affects function of macrophages Affects ability to fight infections Affects inflammatory cascades Affects cell growth Angela LaSalle MD 11

12 Vitamin D and Cancer 1000 IU (D3) decreased cancer: Colon by 50% Breast and ovarian by 30% Pancreatic by 43% Angela LaSalle MD 12

13 Medication Effects on Vitamin D Vitamin D Toxicity Signs consistent with high calcium levels Muscle Aches Loss of appetite, nausea Protein in urine Kidney stones Increased thirst and urination Angela LaSalle MD 13

14 Caveats Have Vitamin D levels checked Rule out magnesium deficiency Supplementation more than 1000iu daily should be followed by physician Monitor Vitamin D, parathyroid levels on therapy. Report any side effect of supplementation to physician. Recommendations to Reduce Insulin Angela LaSalle MD 14

15 Table Sugar Table Sugar Sugar: The Bitter Truth by Dr. Robert Lustig Pediatric Endocrinologist YouTube DVD: Sweet Suicide, A Documentary by Nancy Appleton, PhD Sweet Suicide is a 60-minute documentary produced in 2009 by Nancy Appleton, PhD, about the health dangers of sugar. Appleton is America's most well known anti-sugar expert and author of Lick the Sugar Habit, which is still selling strong after 30 years in print. Angela LaSalle MD 15

16 Sugar Makes Fat Study: Healthy med students were given a high fructose diet for 6 days Triglycerides doubled Free fatty acids in the blood doubled Insulin levels increased 5x more fat cells Sugar Makes You Old Sugar is implicated in all of the degenerative disease processes: Heart Disease Diabetes Auto Immune Disease Arthritis Cancer Impotence Hormone disruptions and. Wrinkles Angela LaSalle MD 16

17 Watch Your Fluids Recent studies have shown that drinking one soda a day increases your risk of heart disease by 20% Did you know that 4 grams of sugar equals approximately one teaspoon? Nutrition Label Coca Cola Angela LaSalle MD 17

18 Sober Thought Some brands of baby formula contain up to 43% corn syrup and 10.3% sucrose Coca Cola contains 10.5% sucrose Sweeteners Angela LaSalle MD 18

19 Nutrition Label Diet Nestea Diet Soda and Weight Gain University of Texas Health Science Center in San Antonio San Antonio Longitudinal Study of Aging (SALSA) 70% greater increase in waistline (9.5 yrs later) 2 or more sodas a day resulted in 500% more weight gain than non soda drinkers Results adjusted for diabetes status, physical activity and age. Angela LaSalle MD 19

20 Artificial Sweeteners Hundreds of times more sweet than sugar Body preps for sweets and releases excess insulin Blunts the neurotransmitters in brain that help you feel full Result is you feel less satisfied, take in more calories and the body stores more fat due to higher insulin levels. Implicated in inflammatory symptoms in some people Overhaul Your Fluids Eliminate all soda Look for any artificial sweeteners in your beverages Increase your water intake Limit coffee to no more than 2 cups a day Eliminate juices eat the fruit instead Angela LaSalle MD 20

21 Eliminate the Sweets Remember that flour also breaks down to sugar decrease the baked goods Try keeping a food diary to learn your habits Evaluate what you put in your beverages creamers, flavors and look for sugars and sweeteners. Start reading food labels for hidden sugars/sweeteners Remember 4 grams of sugar equals a teaspoon Balance any sugar intake with protein or fiber Increase Your Vegetables Good source of nutritients: antioxidants, phytonutrients, minerals Good source of fiber Helps hydration Good source of carbs without high insulin response Balance your plate with lean proteins (fish, chicken, lean cuts beef) Angela LaSalle MD 21

22 Exercise 30 minutes daily Decreases insulin resistance in skeletal muscle Decreases inflammation Rehearses the neurovascular connections of the body All disease preventative There is no substitute for the benefits of exercise! Talking Points with Your Doctor Ask for Testing: 25-OH Vitamin D Fasting Glucose < 95 is normal > 110, then glucose intolerant > 126 Diabetes Fasting Insulin Fasting Lipids Angela LaSalle MD 22

23 Talking Points with Your Doctor Measurements: Weight Blood Pressure BMI Waist to hip ratio 0.8 or below, is normal Supplementation and Monitoring Q & A Angela LaSalle MD 23

24 Angela LaSalle, MD Angela LaSalle is board certified in Family Medicine with a fellowshipinintegrativemedicine. She is a guest and keynote speaker on a variety of medical topics and women s health issues and provides interviews for radio and print media. A graduate of Indiana University School of Medicine, she received her fellowship in Integrative Medicine through the University of Arizona, a program founded by Andrew Weil, M.D. Her practice includes assessment of thyroid, adrenals, treatment of metabolic syndrome, bioidentical hormone replacement as well as comprehensive nutritional assessments. She provides integrative health care services for patients with thyroid, diabetes, metabolic and menopausal issues. A strong believer that inflammation is the underlying cause of many diseases, she also incorporates nutrition and stress management into her treatment arsenal. Dr. Angela LaSalle is Medical Director of Parkview Physician s Group Integrative Medicine clinical division and Medical Director of the Parkview Women's Health Center located at the new Parkview Regional Medical Center on its Parkview North Campus. Visit her web site: Angela LaSalle MD 24