Hope For The Insulin Resistant

One-third of Americans are insulin resistant and most people don't even know it. If you're overweight, have high cholesterol and high blood pressure, there's a very good chance that you're one of them. The good news is that there is something you can do about it.

That was the conclusion of a panel of experts who met this week in Washington, D.C. The conference was sponsored jointly by the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) with participation from the American Medical Association and other organizations.

The condition, which is known as metabolic syndrome or "Syndrome X," was first identified by Stanford medical professor Gerald Reaven. It is associated with an increased risk of diabetes, heart problems and strokes.

Although I usually write about technology issues, the reason I'm tackling this subject is because I was part of Dr. Reaven's recent study to determine the effects of weight loss on Syndrome X.

Insulin resistance, according a statement on the Web site of the American Association of Clinical Endocrinologists, "is characterized by decreased tissue sensitivity to the action of insulin, leading to a compensatory increase in insulin secretion. Most people with insulin resistance are able to secrete enough insulin to maintain non-diabetic glucose levels. Some of these people will go on to develop overt type 2 diabetes. However, the majority, even if they do not develop diabetes, are still at significantly increased risk for heart attack, stroke and other diseases."

Insulin resistance is often associated with being overweight. Other risk factors include high blood pressure (greater than 130/85), high triglycerides (150 mg/dl or higher), high LDL cholesterol and low HDL cholesterol (less the 40 for men or less than 50 for women). Also at greater risk are men with a waist circumference over 40 inches, women with a waist circumference over 35 inches, those with a sedentary lifestyle and those over age 40. Non-caucasian ethnicities (Latino/Hispanic American, African American, Native American, Asian American and Pacific Islander) are at greater risk, too. The more risk factors you have, the greater the chance that you are insulin resistant.

The good news is that many people can go from being insulin resistant to "insulin sensitive" simply by loosing weight. I know, because in July of 2001, I was diagnosed with the syndrome by a team of Stanford doctors headed by Dr. Gerald Reaven and his collaborator, Tracey McLaughlin. Reaven and McLaughlin were both speakers at the recent Washington conference.

To confirm my diagnosis, the medical team administered a four-hour test called the Steady State Plasma Glucose Test. I scored 225, which put me in the 95th percentile for the syndrome. They then put me on a diet and when they retested me six months later, after a 30-pound weight loss, I no longer had the condition: I was insulin sensitive with an SSPG of 71 percent, the 20th percentile. Not everyone will have as dramatic a result, but just about everyone who is insulin resistant will benefit from a weight loss diet. Details about my diet and the study can be found in an extensive article I wrote that you'll find at www.pcanswer.com/fitness/weightloss.htm.

The most commonly used indicator of healthy weight is your Body Mass Index or BMI which can be calculated via an online BMI calculator (you'll find a link at www.larrysworld.com/fitness). A BMI of 25 or lower is considered healthy. Above 25 is overweight and above 30 is considered obese.

A weight loss of 5 to 10 percent combined with moderate physical activity can have an enormous impact, according to Dr. Reaven.

Dr. Reaven does not advocate a diet that is high in carbohydrates, but unlike Dr. Robert Atkins, he is also against a diet that is heavy in protein and saturated fat. For those who may be insulin resistant, he recommends a diet that is roughly 40 percent fat (with no more than 7 percent of your calories from saturated fat), 45 percent carbohydrates and 15 percent protein.

Thanks to the work of Dr. Reaven and his colleagues, we now have a better understanding of this syndrome that can lead to some pretty serious diseases. Being diagnosed with Syndrome X is the best thing that ever happened to me because it started me on a diet and a fitness program that's benefiting me in so many ways. But you don't need a team of Stanford experts to know if you're at risk. If you have any of the risk factors I discussed earlier, talk with your doctor and, if you are overweight or out of shape, consider this a wake up call. It may be all the incentive you need.

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By Larry Magid