Monday, March 15, 2010

Inflammation: The Spark that Starts the Fire

Chronic inflammation is common among diabetics, but is usually a rather minor concern of mainstream medicine in addressing a long list of ailments associated with diabetes. Signs of low-grade systemic inflammation are very prevalent among people with metabolic syndrome, pre-diabetics and Type 2 diabetics according to H. Henry Dong of the University of Pittsburgh School of Medicine.

"But it's not yet clear if there is a cause-and-effect relationship between chronic exposure to low-grade inflammation and the onset of insulin resistance," he explained. "Other studies have shown that in patients who have inflammation and diabetes, insulin-sensitizing drugs seem to reduce inflammation while anti-inflammatory therapies improve sensitivity to insulin."

Current diabetic management therapies focus mainly on lowering high blood glucose levels with pharmaceuticals with lip service given to lifestyle interventions which may also improve obesity issues and unfavorable lipid profiles. But, have you ever discussed your C-reactive protein level (CRP) with your doctor? Rarely does diabetic treatment focus on lowering markers of inflammation.

We still need to remain vigilant in our daily discipline to maintain blood glucose levels, a healthy body weight, and a good lipid profile. In the long-term, however, achieving these objectives may be best accomplished by living an anti-inflammatory lifestyle to avoid the progression of diabete and diabetic complications. There are some very concrete things we can do which I hope to discuss in much more detail in future postings.

Eat anti-inflammatory food --

Simple carbohydrates are the most inflammatory thing we can put in our body. Sources of fructose are the worst. Many people also find that wheat and other grains are more inflammatory than other carb equivalents.

The oils and fats we eat can either fan the flames or squelch them. Saturated fats are now seen as fairly benign, but trans-fats are still the worst. The seismic shift in health science concerns "healthy" polyunsaturated fats. Now, we know that omega-6 polyunsaturated fats (n-6 PUFA) are extremely inflammatory, especially arachidonic acid found in animal protein. Omega-3 polyunsaturated fats (n-3 PUFA), on the other hand, are very anti-inflammatory, especially those found in animal protein like fish.

Plant foods can be a rich source of anti-inflammatory nutrients. The trick is to select those that have the best phyto-nutrients with the least carbohydrate (especially fructose) and the least omega-6 PUFA.

Exercise smart --

You need as much brain as body to achieve a critical balance of optimal duration, intensity and frequency without over-training. Now at middle-age, I find the balancing act gets more critical with age.

Optimizing the amount you eat and when you eat --

Many low carbers think calories don't count, but caloric restriction clearly improves markers of inflammation. The most dramatic way to lower inflammation as measured by CRP is to fast. Total fasting is not wise for any insulin dependent diabetic or anybody at risk of hypoglycemic episodes, but everybody benefits from giving their GI tract a break from eating and digesting ... if only avoiding between meal snacks.

Take supplements that work --

Supplements can be the realm of charlatans and weak science, but many really work. I join a growing number of scientists and medical professionals that have a near missionary zeal about Vitamin D3 to correct deficiencies (almost all diabetics who do not supplement are deficient) and fish oil to improve the balance of n-6:n-3 in the body. Many other supplements require poring over the latest sketchy research to make hard-headed decisions whether to use them.

Sleep well --

It's not as simple as eight hours. Attaining deep and restful sleep ... not too much, not too little ... can impact the markers of inflammation.

Avoid stress --

This is a very subjective area. What leads one person to blissful relaxation might drive another crazy, but controlling the stress response in your daily life greatly affects inflammation levels.

Think hard about drugs --

Drugs are the weapon of last resort in our battle with the D. Obviously, pharmaceuticals can have dramatic effects ... and sometimes unexpected side effects. The pharmaceutical industry has recognized the link between inflammation and blood glucose levels and is working hard to develop, patent and market new diabetic drugs that work by controlling inflammation.

Read, research and understand --

The buzz about inflammation and diabetes is a relative new phenomena. Stay abreast of the latest research. Join us in this discussion!

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