SS MPC1

Sam Young, MD
Family Physician
Community Health Advocate
Former US Army Medical Corps Colonel
Born and raised in Savannah, Georgia
30 years of combined clinical experience in
Traditional & Complementary Medicine

The Impact of Obesity on the Local Community
www.Choose-Health.org

Understanding Low Glycemic Nutrition concepts will help us fight our common enemies…
versus

My personal story as well,… Me before…
212 lbs
05/29/2001
200 lbs
June 2009
212
162 lbs
Sept 2009
197 lbs

Me 12 weeks later, and since…
212 lbs
05/29/2001
200 lbs
June 2009
212
162 lbs
Sept 2009
197 lbs

My Four Objectives Today(using recent medical evidence)
1. Demonstrate Obesity as the Major Community Health Crisis
2. Identify the Primary Cause…. Insulin Resistance
Show how simple lifestyle changes can actually
Reverse Insulin Resistance and Obesity through
- Low Glycemic Food Choices
- Moderate Consistent Exercise
- Community Awareness
4. Relate these to The Metropolitan Planning Commission’s Strategic Plans, which will play an extremely critical role in our community’s success, …or failure

My two KEY Individuals in Obesity, Insulin Resistance Low Glycemic NutritionResearch
Dr. David Jenkins & Dr. David Ludwig

David J.A. Jenkins, M.D., Ph.D., D.Sc. Developed the Concept of The Glycemic Index

David Ludwig, MD, PhD
Pediatric Endocrinologist
International expert on Childhood Obesity
Principle Author of over 40 research studies on Adult and Childhood Obesity, Insulin Resistance, Chronic Disease, and Nutrition
Director, Optimal Weight for Life (OWL) Program at Children's Hospital Boston

Obesity, the #1 Health Threat in the USA
33% of US adults are obese, & another33% are overweight
By the year 2020
45% will be obese, & another >33% will be overweight

Recent CDC reports “Diabetes Belt” Tightens Around the South
The same CDC reportalso found higher levels of
Obesity in the South as well
March, 2011
American Journal of Preventive Medicine

Obesity dramatically increases risk of Diabetes,
Heart Disease, and many other Chronic Diseases
Obesity significantly decreases the length and quality of an individual’s life
andInsulin Resistanceleads to Obesity

33%of US children are either overweight or obese
This dramatically increases their lifelong risk of Diabetes, Heart Disease, and other Chronic Diseases
Despite living in the most developed nation on earth and for the first time in our history, the life expectancy of children in the USA today is less than it is for their parents
Insulin Resistancealso leads to Childhood Obesity

The#1 Health Threatfacing Savannah
& Chatham County is Obesity
Childhood and Adult Obesity are most commonly the result of Insulin Resistance

Insulin, a hormone made in the pancreas Lowers Blood Sugar
The “Insulin” Funnel
Think of insulin as a funnel to help move sugar from the blood into the cell

Some foods elevate the blood sugar slowly and gently
These are called Low Glycemic Foods
or “Real Foods”
Nuts, berries, vegetables, fruits, beans, whole grains

Th
and little insulin then required
to control the blood sugar
This is Desired and Good
Blood Glucose
meal
meal
Time
Low Glycemicfoods gently increase blood sugar levels

Some foods elevated blood sugar too fast and too high
High Glycemic Foods or Fake Foods*
Dr. Ludwig
*Highly processed foods made in factories, such as sweetened cereals, sugary drinks, chips, cookies, candy, white bread and fast food

High Blood Sugar
more insulin is required to lower the blood sugar,
which is bad because overtime, it leads to insulin resistance
Blood Glucose
meal
meal
Time
High Glycemic Foods Spike Blood Sugars
Stress Hormones released due to too much insulin release
Over Hungry

Normal Blood Sugars
&
Low Insulin Need

To Control Ongoing Blood Sugar Spikes
Insulin Production Rises
And Insulin
Resistance
Begins

Insulin Resistance and Ongoing High Insulin Demand
Eventually Exhaust the Pancreas
Insulin Production Falls
Fasting Sugar Elevates
Type II Diabetes Results

Carbohydrates
All carbohydrates are composed of sugars
Short chains of sugar, simple carbohydrates(glucose, sucrose, lactose and fructose)
were traditionally thought to be digested very quickly
Long chains of sugars called starches or complex carbohydrates
were thought to be digested more slowly than simple sugars
But is this actually True?

David J.A. Jenkins, M.D., Ph.D., D.Sc.
Dr. Jenkins began testing the actual effectsof carbohydrate containing foods on blood sugar and insulin levels in the 1970’s, and developed the concept of the Glycemic Index
Dr. Jenkins’ findings were reported in the
American Journal of Clinical Nutrition in 1981 1984, 1985, and 1987
As well as the NEJM 1989, Diabetes 1990, and British Medical Journal in 1998

The Glycemic Index
Dr. Jenkins measured the area under the blood sugar curve after Glucose was given.
He used Glucose as the standard and assigned it a Glycemic Index value of 100 units.
He then compared other carbohydrate foods to glucose’s Glycemic Index of 100 units.
Blood sugar curve for glucose
Area
under blood sugar curve
Test Food Given

Examples ofGlycemic Index (GI)
Low Glycemic Foods
High Glycemic Foods
GI
Apple 36
Low fat yogurt 31
Lentil beans 29
Chickpeas 28
Sweet Cherries 22
Black Beans 20
Peanut 14
Almonds 0
Avocado 0
GI
Baked Potato (no skin) 98
Instant White Rice 91
Corn Flakes 84
White Bagel 72
Jelly Beans 78
Pretzels 83
Table Sugar (sucrose) 61
Glucose 100

Spiking Blood Sugar Promotes Insulin Overproduction
Highly processedbreads, rices, cereals, and baked potatoes are high glycemic foods and spike blood sugarfasterthan table sugar
85 to 90% of the carbohydrates in the USA are highly processed and high-glycemic, and promote
overproduction of Insulin,
Insulin Resistance, and
Obesity

Insulin Resistance
Increases Risk for
Metabolic Syndrome
Pre - Diabetes
Heart Disease
Obesity
Stroke
Diabetes
Sleep Apnea
Premature death
Related Clinical Findings
Central Obesity
High Blood Pressure
Cholesterol Problems
High Blood Sugar
Trouble Losing Weight
Food Cravings

High Glycemic foods are everywhere
The major reason for skyrocketing rates of obesity is that we are surrounded by high glycemic foods
The fast food and beverage industries target children, and adults
If we were taken back to the 1960’s most obesity would disappear
Never before have so many kids been so heavy so early in life
Dr. David Ludwig

The Fake Food versus“Stone Age Food”Game
"Fake food is a concept that kids can get in a few minutes, and once they get it, it can guide them to make some dramatic changesin their eating habits“ Dr. David Ludwig
Write down foods normally eaten now
Circle foods not present in “Stone Age”
Call these “Fake Foods” (usually 70%)
Eat more “Stone Age Foods”

Simple Low-Glycemic Food Pyramid
limit refined grains, breads, pasta and potatoes
Lots of
non-starchy vegetables

Selecting Low Glycemic Foods
Typically whole foods, eaten in their natural state.
Examples include most fruits, non-starchy vegetables, beans, nuts, berries and whole grains.
Requires a commitment to simple lifestyle changes which are clearly supported by medical evidence

American Association of Endocrinologists
In response to obesity, metabolic syndrome and diabetes epidemics in the United States, the Fall 2008 AACE/ACE Consensus Report Recommended the First Step should be …..
Intensive Lifestyle Changes

Just How Effective is Lifestyle Change?VERY EFFECTIVE!!!
In this Clinical Study, Four Simple Lifestyle Changes were used for 12 weeks
August 2009
Holly R. Wyatt, MD
Center for Human Nutrition
University of Colorado

Obesity and Weight Management Journal
August 2009, pages 167-173, peer reviewed
Overweight Patients age 20-60 years
Pre-Diabetes, (Metabolic Syndrome)
Not on cholesterol or diabetes medications
12 week program
Low Glycemic Nutrition
2. A Moderate Exercise Program
3. High Quality Multiple Vitamins
4. Internet Coaching Program
The study results are shown next…

Significant Weight Loss
220
215
210
205
200
215
Weight (lbs)
205
202
Baseline
Week 6
Week 12

Improved Total Cholesterol
220
210
200
190
180
170
160
206
Total Cholesterol mg.dl
180
176
Baseline
Week 6
Week 12

Improved LDL Cholesterol
150.0
132.5
115.0
97.5
80.0
134
LDI Cholesterol mg.dl
114
111
Baseline
Week 6
Week 12

Improved Triglycerides
160
140
120
100
80
141
Triglycerides (mg/dl)
111
106
Baseline
Week 6
Week 12

Lower Systolic Blood Pressure
135
130
125
120
115
110
131
Systolic BP (mm Hg)
123
121
Baseline
Week 6
Week 12

Lower Diastolic Blood Pressure
90
85
80
75
86
Diastolic BP (mm Hg)
83
80
Baseline
Week 6
Week 12

Improved Insulin Sensitivity
140
130
120
110
100
90
127
121
ISI Units
111
Baseline
Week 6
Week 12

Reduced Insulin Levels
40.000
33.125
26.250
19.375
12.500
Blood Insulin (120 min)
34
Blood Insulin (mU/l)
23
19
Baseline
Week 6
Week 12

Savannah is a community committed to supporting healthy lifestyles
The Healthy Savannah Initiative is dedicated to making Savannah a healthier place to live by…
1. Promoting Health Awareness through Education
2. Increasing Access to Quality Nutrition
3. Encouraging Safe Consistent Physical Activity
And each of these three help reduce insulin resistance and obesity

Parental Lifestyle Modeling Critical
Families should rid their homes of most “fake foods” and increase “real foods”
Everybody in the family wins if the food environment at home is better
Adults should also be models for safe consistent moderate physical activity also known to prevent insulin resistance

“Community” Lifestyle Modeling also Critical to Combat Insulin Resistance and Obesity
Communities should significantly increase access to “real foods”
and help “Make the Healthy Choice the Easy Choice”
Everybodywins if the food environment in the community is better
GROUNDBREAKING FOR SAVANNAH’s SHUMAN MIDDLE SCHOOL GARDEN PROJECT
23 March 2011

Physical Activity reduces Insulin Resistance and Obesity
Civic leaders and planners should also encourage safe consistent moderate physical activity to promote community wellness

Overview of Key points
Insulin Resistance is a Major cause of Childhood and Adult Obesity
Insulin Resistance and Obesity can be PREVENTED and REVERSED through appropriate Lifestyle Changes
Civic leaders & planners are in a very unique positionto positively influence the health of entire communities for decades to come

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SS MPC1

by Sam Young, MD on Mar 23, 2011

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