Tissue Engineering

One of the most perplexing problems that diabetics face is weight loss. Many doctors insist it is a simple matter of consuming less calories than are burned. And, in a perfect world that works. But most diabetics will insist that there is more to it, because when they do the same things as non-diabetics, they get no results, while their non-diabetic friends drop pound after pound. Fad diets do not work, diet products do not work, even exercise shows little or no results. The struggling diabetics are right– there is more to it than just cutting calories.

Diabetes is caused by eating a bad diet, and a good diet is a key part of regaining control. But it is the bad diet that has placed a number of conditions in place that must be understood in order to win the fat war. There are a number of interrelated circumstances that contribute to making diabetic weight loss difficult. First, let’s look at how the problem originated, then we can investigate how that information can lead to reversing the problem.

Years of bad diet, containing fats, sweets, high glycemic index foods, prepared foods and dairy products caused inflammation. A complete detailed explanation of how inflammation caused diabetes can be found in the “Diabetics Handbook” (see below). The following will be a gross oversimplification, due to space limitations, but hopefully, it will demonstrate the important aspects of the problem. Pro-inflammatory substances (pro-oxidants) are normally used by the body to fight disease and infection (via the immune system). They play many important roles in the body including digestion, and even breathing. Normally, the body uses antioxidants to control these processes. However, years of bad diet, which is characteristically very low in antioxidants, causes an immune system to lose the ability to shut down. Consequently, the immune system begins to attack healthy cells causing serious damage. In type I diabetes, the beta cells (insulin producing cells) are destroyed. In type II diabetes many cells are damaged setting up a condition known as insulin resistance. Insulin resistance occurs when the body’s cells cannot properly communicate when using insulin to uptake and burn glucose.

When the body digests food, particularly carbohydrates, it is converted into glucose. Glucose is distributed throughout the body in the bloodstream by the liver. The liver will normally control fat levels. When very high levels of fat are in the bloodstream, due to diet, the liver cannot process it all. It begins to fill its cells with sacs of triglycerides (converted glucose for storage) and it places the excess in the adipose tissues (belly fat).

The brain, vital organs and muscle tissue rely on glucose which provides energy to function. As these organs use glucose, the liver will place more in the bloodstream to replace it. In a perfect world, the organs and tissues would use it efficiently, and hopefully in proportion to the amount produced by food. Insulin resistance reduces the amount of glucose that is absorbed and stored by the organs and muscle tissue. Add to that, the fact that most diabetics lead a sedentary lifestyle, meaning that they get minimal amounts of exercise resulting in much less glucose being burned.

When the body is impaired by insulin resistance (type II diabetes), the cells do not use as much glucose. The body senses that glucose levels are building up in the bloodstream, so it instructs the pancreas to release more insulin. The body now has high glucose levels and high insulin levels in the bloodstream. Insulin is a hormone that performs many functions, besides allowing cells to absorb glucose. Insulin will also attempt (vigorously) to remove excess glucose from the bloodstream by placing it in storage as fat. Once in storage, insulin will block the process of breaking fat down to remove it from storage. Many doctors say that the presence of high levels of insulin in the blood causes unnecessary water retention in the body, which is a factor in weight gain. This is a key aspect of beating diabetic obesity, which means that insulin regulation is very important. Insulin also acts on the brain. It promotes cravings that result in eating more and on the liver to manufacture more fat. The liver removes insulin from the bloodstream, but insulin causes fat to be deposited in the liver which, in turn, prevents the liver from removing insulin from the bloodstream. People with belly fat store too much fat in their livers (fatty liver disease – see below), which prevents the liver from removing insulin. consequently, insulin levels rise higher and higher, which can contribute to heart attacks and more abdominal obesity.

Also, fat in the abdominal area functions differently than fat elsewhere in the body, such as the hips. Blood flow from the belly fat goes directly to the liver. The blood flow from other fatty areas, such as the hips, goes into the body’s general circulation. Belly fat has an efficient blood supply and has as more receptors for cortisol (a stress hormone). Cortisol levels vary throughout the day, but will elevate and remain elevated if the body is under stress. High stress and high cortisol levels promote fat deposits in the belly area. It goes to the belly area because there are more cortisol receptors there. Chronically high cortisol levels kill neurons in the brain. They also interfere with neurotransmitters (such as dopamine and serotonin – the good mood neurotransmitters) which leads to depression and feeling more stressed. Depression is common in diabetics, which adds to the problem since depression causes a stress type reaction in the body. In other words, depression promotes the development of belly fat.

The fat that is stored in the adipose tissue (belly fat) is also a characteristic of diabetes. That means that diabetics are genetically prone to belly fat. Belly fat (central obesity) is associated with higher rates of cardiovascular disease, and several types of cancer as well. Heredity plays a role in overall body type (apple vs. a pear shape). Genetics accounts for 25-55 % of the tendency to develop the most serious diseases associated with abdominal fat, the remainder is lifestyle. As belly fat builds up, it does several things. First, it stops the production of the hormone leptin, which normally would curb appetite. Second, it causes insulin resistance to further increase, which has obvious consequences. The cells use less glucose, the body produces more insulin, and guess what… more fat goes into storage. Fat storage is the body’s way of following ancient mechanisms designed to protect the body during lean times. Cave men would sometimes go long periods of time between successful hunting campaigns. So the body learned to take advantage of good times to prepare for the bad times. The body converts glucose into glycogen and triglycerides which are very efficient methods of storing energy.

When the cells of the liver fill up with triglyceride fat sacs, the liver’s function is impaired. It cannot process fats efficiently. It quickly runs out of room to store more fat, and when the body’s tissues and organs are not using as much, the liver simply puts it all into storage as belly fat. The number of fat cells a person has is determined at birth. The numbers remain constant unless the fat cells become full. When they become full, the cells will divide creating new fat cells. The new cells will remain throughout the balance of the person’s life. However, a successful diet will reduce the size of the fat cells. Fat cells are fed by blood vessels in the belly area. Each fat cell is in contact with at least one capillary. The blood supply provides support for the metabolism. The blood flow will depend upon body weight and the overall nutritional state. The number of vessels will increase during fasting or high demand for glucose. Increased numbers of blood vessels can contribute to increasing blood pressure. The heart simply has to work harder to supply the additional vessels.

A liver that has many cells filled with triglyceride sacs is called a fatty liver NAFLD (nonalcoholic fatty liver disease). Any diabetic that has large amounts of belly fat likely has a fatty liver. Fatty liver develops early in the process because of high levels of triglycerides in the bloodstream. Diabetic fatty liver’s second stage is called NASH (nonalcoholic steatohepatitis), meaning that it is not caused by alcohol consumption (but similar), and it mimics damage caused by hepatitis diseases. Oxidation of cells begins to occur causing cell damage. The third stage is cirrhosis which is very serious and dangerous. The first stage of fatty liver is not particularly dangerous, and will go away with proper treatment. Fatty liver is difficult to diagnose. The only reliable test is to conduct a biopsy to determine how much fat is present and if any scarring is present. Biopsies are rarely conducted, because the medical industry cannot agree on how it should be interpreted. The symptoms of NAFLD are nondescript, non-existent or mimic symptoms of other diseases. Certain blood tests will display the presence of certain liver enzymes that are common in hepatitis, which would signify the presence of NASH. Fatty liver will seriously complicate the weight loss process.

Parasites will virtually stall weight loss efforts. Parasites are more common in diabetics than a non-diabetic person, due to their weakened state. Unfortunately, western medicine doctors have little training in recognizing the presence of parasites. Few people are trained in testing for them. Most common tests have a very low accuracy rate. Treating parasites with drugs is rarely effective because they have a very narrow range of effectiveness. There are over 100 common species found in humans and treatments are very specific to specie. Parasites escape diagnosis in as many as 70 chronic diseases, and are now believed to be instrumental in the development of many chronic diseases.

When parasites are present, patients will have virtually no success in losing weight. Reduced portion sizes, carbohydrate counting or elimination, or even vigorous exercise will not produce results. Parasites inflame the lining of the digestive tract, and slow nutrient absorption. They eventually spread to all areas of the body, including vital organs. They disrupt hormonal balance, blood sugar regulation and alter the metabolism. Parasites eat the nutrients ingested, or they eat the host. They leave the host with empty calories, which triggers cravings and over consumption of food (urges to pile it high on a plate). They virtually take over control of the body.

Parasites release toxins that overload the kidneys and liver. The weakened state leads to further reductions in metabolism. They hinder the maintenance of beneficial flora in the intestinal tract that can lead to over production of yeasts. Overdevelopment of yeasts lead to the development of allergies, gas and bloating. Their acids damage organs, breakdown muscle tissue and cause the central nervous system to become sluggish. The body will react to increased acid levels by producing fat cells to store the acid, thus removing it from the system. A lower metabolism encourages the production of fat cells.

The good news is, by now, the reasons for difficulty in losing weight are clearer. So how does one beat these powerful mechanisms? Start by getting rid of any parasites. The safe bet is to assume that they are present, because they probably are present. There is an extensive listing of symptoms, and how to cleanse the body of parasites in the “Diabetics Handbook”. Also read about glycemic index and load. Modify the diet to eat only low glycemic index foods. Stop eating any of the pro-oxidant foods, especially processed foods, which is basically anything in a box or can that has ingredients that you cannot pronounce, or it’s unknown as to why it is in there.

Then assume that you have a fatty liver, because you probably do to some extent. This is the tough part. The most success comes from combining a series of techniques. Fasting and exercise are effective to break the cycles and burn liver fat. But it must be done correctly. If liver and/or kidney damage is present a doctor should be consulted. An alternative to fasting is to start eating 6-8 very light, low glycemic index meals per day, instead of three large meals. That will reduce the glucose spikes that exacerbate the process.

Change the diet. Stop eating the pro-oxidant foods. Processed foods are poison to diabetics, which cannot be stressed enough! Processed flour is very bad for diabetics (actually for everybody). Sodas are high in pro-oxidants and phosphoric acid, drink green tea instead. However, be careful, some bottled green teas have additives in them, including phosphoric acid. Stop drinking coffee. Eat only very lean cuts of meat. Stop eating sweets, sugar substitutes and dairy products. Never cook food at high temperatures (over 400 degrees F) or microwave food. That means that grilling and broiling are out. Microwaves kill as much as 97% of the living nutrients in food. Steaming, stir frying in olive oil or boiling food is best. Diabetics should eat fruit if their system does not react to them (glucose spikes). Pineapple and bananas are very high in natural sugar. Eat low glycemic index foods only. Take a good quality multivitamin daily, such as Rejuvenage 40+, which is sold on the internet. If a multivitamin is being taken, compare the product label to the sample label posted on the internet. This particular multivitamin has the broadest coverage of nutrients found on the market. Eat lots of fiber, especially water-soluble fiber.

Glucose management can be improved if sodium levels are managed, and fiber levels are kept high. Sodium slows the insulin response, which means higher sodium levels can be an advantage for hypoglycemia. High sodium levels prevent a quick rise and fall in insulin levels, and subsequently reduce the blood sugar highs and lows commonly experienced with hypoglycemia. Sodium, along with ascorbic acid (vitamin C) and biotin are among the most important factors in reducing erratic glucose level changes; even between meals. Manganese, chromium and niacin/niacinamide control glucose response as well as the liver’s storage of glycogen. Potassium, vitamin B6, and vitamin C can both, help stabilize, or interfere with glucose management depending on whether a patient is prone to be hypoglycemic, or hyperglycemic. Lower amounts are recommended for patients that are prone to hypoglycemia, and higher amounts for patients that are prone to hyperglycemia. On the other hand, high amounts of potassium can reduce manganese and chromium. High amounts of vitamin C can lower manganese and stimulate insulin. Vitamin B6 stimulates magnesium and potassium, but lowers manganese. It can become complex. It should be noted that too much sodium in the diet is never a good thing.

Eliminate candies, honey, sodas of all types, donuts, cereals (especially sweetened), cakes and bakery goods, over ripe fruits, fruit juices (unless diluted), sugar (both brown and white), syrups (corn, maple and molasses), glucose, sucrose, fructose (of any variety), dextrose, maltose, or any substance ending in “ose”. Eliminate all artificial sweeteners except Stevia. Most of the bakery goods contain synthetic additives, along with processed flour, both of which are highly pro-oxidative.

It will be necessary to start exercising to maximize the burning of glucose in tissues. Power walking for approximately 45 minutes, preferably daily, will burn upwards of 300 calories each day. Exercising other major muscle groups is important. The fasting and exercise program should be alternated with non-fast and exercise programs (3-5 days each). Depending upon health conditions, choose between a water or a juice fast. The water fast is more aggressive. Don’t lose weight too fast. It can damage the liver. Most people lose 3-5 pounds after the first several days and an additional 3-5 pounds the next day, it will level off at a pound per day after the initial loss. It is customary to not lose weight during the non-fast phase. Then repeat the cycle. The “Diabetics Handbook” covers a variety of programs, the most aggressive being a 30 day fast, which will totally detox the entire body as well. It is known to release toxins present since birth. Fasting is safe, and very effective. Exercising a muscle does not get rid of fat over the specific muscles that are exercised. The only way to reduce a fat belly is to lose weight overall, and any type of exercise will help accomplish that. There’s a growing body of research showing that the fastest way to burn off belly fat is by a combination of weight training, aerobic exercise and modified diet. Bear in mind that increased muscle mass, from exercise, will increase body weight as fat is lost.

Physical activity is clearly beneficial for diabetics, including lowering blood glucose levels. However, physical activity can make levels go too low, causing hypoglycemia for up to 24 hours afterward. For those taking insulin, or one of the oral medications that increase insulin production, the breaking of routine (fasting) by having a snack, may be required if the glucose level goes below 100 mg/dL. Adjusting medication doses before physical activity can help avoid hypoglycemia. For some diabetics, it may be necessary to consult a doctor while on aggressive programs. A snack can prevent hypoglycemia, provided that it is a low glycemic index food. Extra blood glucose checks, especially 2 hours after strenuous exercise, may be advised. Place increased emphasis on maintaining blood sugar levels. Hold them as close to normal as possible. In type II diabetes that will reduce the amount of excess insulin in the bloodstream. If insulin-dependent, or type I diabetic, avoid taking more insulin than is required to maintain control. Many diabetics assume that more insulin than is needed is not necessarily a bad thing. This is a critical phase that requires lots of testing and focus. The combination of lower insulin, lower glucose levels and vigorous exercise will allow the body to quickly start burning the liver fat. It takes up to 12-16 hours for the body to start drawing fat from the liver. Exercise will increase the metabolism. However, understanding the metabolism will be helpful, because the metabolic rate will change throughout the process. Exercise reduces stress levels. If high stress is an issue, try stress reducing activities such as deep breathing or meditation. Be certain to take antioxidant supplements during the fasting process. Several recent studies show that omega-3 fats can reduce output of another stress hormone, epinephrine (aka adrenaline). Start taking 4000IU of fish oil twice daily. You cannot overdose on fish oil. The body will produce large amounts of free radicals, which will require large amounts of antioxidants to be controlled. Be certain that 100% of the daily requirements of vitamins and minerals is consumed.

In summary, modify the diet; learn what to eat and what not to eat; take a good quality multivitamin every day; get the glucose levels in tight control; manage the insulin levels; manage the sodium levels; exercise vigorously daily; manage stress; eliminate the possibility of parasite infestation; and consider fasting techniques. Learn as much as possible about diabetes, food, and how to cleanse and maintain all of the vital organs.

If this appears to be a lot of hard work, it is. But it is not unusual for diabetics, that have not had any dieting success at all, to lose 30 pounds the first month. The key to total diabetes control, and improved health, is to lose the belly fat. It is paramount. As the belly fat goes away, it will become increasingly easier to win the fat war. Blood sugar control will become easier, blood pressure, triglyceride and cholesterol levels will improve. Go to http://www.diabeticshandbook.com for a free daily nutrition log, which will make tracking nutrition easier.

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