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SS MPC1

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  • 1.
  • 2. 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
  • 3. The Impact of Obesity on the Local Community
    www.Choose-Health.org
  • 4. Understanding Low Glycemic Nutrition concepts will help us fight our common enemies…
    versus
  • 5. My personal story as well,… Me before…
    212 lbs
    05/29/2001
    200 lbs
    June 2009
    212
    162 lbs
    Sept 2009
    197 lbs
  • 6. Me 12 weeks later, and since…
    212 lbs
    05/29/2001
    200 lbs
    June 2009
    212
    162 lbs
    Sept 2009
    197 lbs
  • 7. 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
  • 8. My two KEY Individuals in Obesity, Insulin Resistance Low Glycemic NutritionResearch
    Dr. David Jenkins & Dr. David Ludwig
  • 9. David J.A. Jenkins, M.D., Ph.D., D.Sc. Developed the Concept of The Glycemic Index
  • 10. 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
  • 11. 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
  • 12. 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
  • 13. 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
  • 14. 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
  • 15. The#1 Health Threatfacing Savannah
    & Chatham County is Obesity
    Childhood and Adult Obesity are most commonly the result of Insulin Resistance
  • 16. 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
  • 17. 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
  • 18. 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
  • 19. 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
  • 20. 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
  • 21. Normal Blood Sugars
    &
    Low Insulin Need
  • 22. To Control Ongoing Blood Sugar Spikes
    Insulin Production Rises
    And Insulin
    Resistance
    Begins
  • 23. Insulin Resistance and Ongoing High Insulin Demand
    Eventually Exhaust the Pancreas
    Insulin Production Falls
    Fasting Sugar Elevates
    Type II Diabetes Results
  • 24. 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?
  • 25. 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
  • 26. 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
  • 27. 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
  • 28. 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
  • 29. 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
  • 30. 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
  • 31. 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”
  • 32. Simple Low-Glycemic Food Pyramid
    limit refined grains, breads, pasta and potatoes
    Lots of
    non-starchy vegetables
  • 33. 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
  • 34. 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
  • 35. 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
  • 36. 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…
  • 37. Significant Weight Loss
    220
    215
    210
    205
    200
    215
    Weight (lbs)
    205
    202
    Baseline
    Week 6
    Week 12
  • 38. Improved Total Cholesterol
    220
    210
    200
    190
    180
    170
    160
    206
    Total Cholesterol mg.dl
    180
    176
    Baseline
    Week 6
    Week 12
  • 39. 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
  • 40. Improved Triglycerides
    160
    140
    120
    100
    80
    141
    Triglycerides (mg/dl)
    111
    106
    Baseline
    Week 6
    Week 12
  • 41. Lower Systolic Blood Pressure
    135
    130
    125
    120
    115
    110
    131
    Systolic BP (mm Hg)
    123
    121
    Baseline
    Week 6
    Week 12
  • 42. Lower Diastolic Blood Pressure
    90
    85
    80
    75
    86
    Diastolic BP (mm Hg)
    83
    80
    Baseline
    Week 6
    Week 12
  • 43. Improved Insulin Sensitivity
    140
    130
    120
    110
    100
    90
    127
    121
    ISI Units
    111
    Baseline
    Week 6
    Week 12
  • 44. 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
  • 45.
  • 46. 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
  • 47. 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
  • 48. “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
  • 49. Physical Activity reduces Insulin Resistance and Obesity
    Civic leaders and planners should also encourage safe consistent moderate physical activity to promote community wellness
  • 50. 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