Hello, I'm Dr. Emerson
00:00:35.63\00:00:37.89
I am Medical Director at
Eden Valley Lifestyle Center
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I'd like to talk to you
today, again about obesity
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and weight control.
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Last session, you may recall
that we found that low-calorie
00:00:46.94\00:00:51.53
diets do not work
well for weight loss...
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They'll cause an initial drop
in weight, but then the body
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adapts to this stress
that it has been put under
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It responds by
lowering your metabolism,
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and making you feel
kind of miserable, weak...
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And when you then come
OFF of your low-calorie diet,
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the body says, "We better get
ready for the next starvation"
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So the way we'll get
ready for the next starvation is
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we'll keep the metabolism low,
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so we're
burning less calories...
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We'll keep the muscle mass low,
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so we'll have
less muscle to feed,
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and we'll keep the body
fat even higher, so we'll have
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more fat to feed less muscle.
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So that with repeated dieting,
we find that the weight actually
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slowly increases as the
metabolism slowly decreases
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and muscle mass drops.
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We found that the
Atkins Diet works also by
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calorie restriction, in a
sense that when people are
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restricted from carbohydrates
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Their actual calorie intake
and appetite is suppressed...
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they have no appetite for
the foods that are available
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They're only eating
about 66% of the calories that
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they would normally eat...
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and various studies
have actually shown that this
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is the reason for the initial
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weight loss in
the Atkins Program
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It is then followed
by a weight-rebound,
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and it's not tolerated well...
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And so when patients
come off of the program,
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the weight,
again, comes back up,
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just like in any
calorie-restricted diet
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Weight Watchers is another
program that many people are on
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This is
essentially a low-fat diet,
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and that's a step
in the right direction
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but it also restricts
calories, and is, therefore,
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prone to the same problems
that any low-calorie diet has
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when you come off of the problem
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In a study published in the
"Annals of Internal Medicine"
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in 2004, they did a
2-year randomized control study
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and they found that with
the Weight Watchers Program,
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the average weight loss,
after I believe it was 3 years,
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was only 6.4
pounds... 16% of them achieved
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and maintained a
weight loss of 10% or more
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The controls that were NOT
on the program only lost...
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well, 6% of
them lost 10% as well
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So, calorie intake isn't
really the answer to obesity.
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If calorie restriction
isn't the answer, what is?
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Well, what about activity?
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Is this the ultimate
solution to weight loss?
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And what we'll find will
present evidence to this effect
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that activity
can help weight loss,
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but only to a certain point.
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You'll find that if you can
get out of the inactive range
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into the active range,
there is a drop in weight;
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however, once
you're in the active range,
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further activity does not
drop the weight significantly.
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This was first
demonstrated in rats...
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in some rat experiments...
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they tested rats and they
found that rats put in a cage
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and exercised on a
treadmill had different weights
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based on their activity level.
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Some rats were not
allowed to exercise at all...
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Some rats were put at 20
minutes a day, 40 minutes a day,
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and then 60 minutes a day,
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and at those
levels, the weight dropped
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when they went from 0 to
20, to 40, to 60 minutes per day
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with the rats.
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But, once they
hit 60 minutes a day,
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further exercise
duration per day,
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from 1 hour to 2
hours, 3, 4, and 5...
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they found the weight plateaued.
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There was no
significant increase or decrease
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at that point, the
weight had stabilized.
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The only time the
weight started dropping AGAIN,
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was at about 5-1/2 hours
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...the weight again dropped,
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but this was because the rats
had gone into extreme fatigue
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They were falling
into the treadmill...
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They had no appetite.
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They were getting injuries.
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And, of course, we
want to avoid that range
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What they also
found was interesting...
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was that appetite dropped
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during their
increase in activity
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When they went from 0 to
20, to 40, to 60 minutes,
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the intake of calories actually
DROPPED until it hit, again,
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1 hour, and at 1
hour, the weight plateaued
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and further
exercise above 1 hour,
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the weight increased
again to match the increased
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demands they were putting
on the rats from activity.
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We're finding that the
initial drop in calorie intake
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was related mainly to
the decrease in weight,
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and the
decrease in surface area.
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They found that
with less surface area,
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the rats were
radiating less heat,
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and so, as the weight
dropped, they found that the
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calorie intake actually dropped,
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and the amount of calories
they were radiating dropped.
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So the appetite
dropped from 0 to 1 hour,
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and then once
the weight plateaued,
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the calorie intake was now
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proportional to
the activity level...
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and the appetite actually
helped control and maintain
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that stable weight.
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So there was really no problem
with the appetite mechanism
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with the rats.
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We're not rats, we're people...
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so, the same people that
tested the rats, then said...
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"Well, we need to
check this on people. "
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So they went to a mill in India,
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and they looked at
humans working in the mill
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...and they divided them
based on their activity level,
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according to the job they had.
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There were the
sedentary workers who were the
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stallholders, the supervisors,
and the type 1 clerks
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...then you went from
sedentary to light work
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and you found that
these were the clerks,
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the class 2 to 4
clerks, the mechanics
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Then they found
the medium workers...
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as the next
increase in activity level...
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These were the drivers,
the winders, the weavers,
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the baggers, the twisters
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Then they went to HEAVY work...
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These were the mill waste
carriers, the pilers, selectors
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Then they went to
VERY HEAVY WORK...
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the ashman, the
core men the blacksmiths,
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the cutters, the carriers...
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And what they found
is that as the activity,
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the daily activity level
increased, the weight dropped
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from an average
of 170 to about 115
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Now these were smaller-framed
people, and 115 was considered
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fairly normal weight for them
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At 115, the
weight then plateaued...
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and, as you went
from the moderate activity
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further on out, the
weight did NOT continue to drop,
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but it plateaued
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Calorie intake ALSO decreased.
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As the weight
dropped from 170 down to 115,
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the calorie intake dropped
from 350 calories per day
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to about 250 calories per
day until the weight plateaued
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Further increase in activity
now increased their appetite
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and their appetite
was now proportional to
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their activity level, and that's
what maintained their weight
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So the question then is...
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"How do we get
from the sedentary phase
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to the active phase?
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What works? What doesn't work?
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Well they looked at 34 subjects,
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and these were tested to find
out if activity could actually
00:08:54.18\00:09:00.08
help control their weight.
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And, they wanted to find
out which type of activity
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would control their
weight most effectively
00:09:05.31\00:09:09.30
These were people
who had previously
00:09:09.33\00:09:11.42
tried low-calorie
diets throughout their lives
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They had lost weight,
promptly regained it coming off
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the low-calorie diet.
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So they were asked to exercise
at least 30 minutes a day
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If they could
exercise 30 minutes a day,
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they qualified for the program.
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There was no
restriction on calories
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They were told to eat as much as
their appetite told them to eat
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Well, out of the 34 subjects,
5 couldn't do it because
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they couldn't devote enough
time required on a daily basis
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Six of them chose jogging...
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but 3 got
injuries from the jogging,
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and another 3 couldn't exercise
over the 30 minute time limit
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long enough to get a
significant change in the weight
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Three chose cycling, but
couldn't continue the cycling
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...the bicycling
long enough to control
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and affect their weight
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Three chose swimming, but
again, they couldn't tolerate
00:10:00.26\00:10:04.09
the swimming long
enough on a consistent basis
00:10:04.12\00:10:06.59
to affect their weight.
00:10:06.62\00:10:08.21
Eleven of them chose walking...
00:10:08.24\00:10:10.83
and ALL of these were successful
and all of them were able
00:10:10.86\00:10:13.79
to exceed 30 minutes
a day of daily walking
00:10:13.82\00:10:17.70
What they found, as they
charted the amount of minutes
00:10:17.73\00:10:20.82
per day that they walked,
versus their weight loss,
00:10:20.85\00:10:24.71
they found that, indeed,
weight loss was related to
00:10:24.74\00:10:28.55
the duration of walking
up to about 90 minutes a day
00:10:28.58\00:10:33.03
Weight loss going from
00:10:33.06\00:10:35.86
90 minutes to, say, 2 hours
a day... was not confirmed as
00:10:35.89\00:10:40.60
being beneficial
00:10:40.63\00:10:42.01
They weren't able
to test for that...
00:10:42.04\00:10:44.67
But, if you
plateaued at 60 minutes,
00:10:44.70\00:10:46.83
and you went
from 60 to 90 minutes,
00:10:46.84\00:10:48.35
there was again, another
weight loss that was documented.
00:10:48.38\00:10:51.80
Some contestants
found that when exercising,
00:10:51.81\00:10:59.31
if they got sick for 2
weeks, and their exercise
00:10:59.34\00:11:01.93
stopped for 2 weeks, their
weight would take a little blip
00:11:01.96\00:11:04.72
...go up a little bit
00:11:04.75\00:11:06.08
Once they got on
the program again,
00:11:06.09\00:11:08.42
the weight would
then normalize out
00:11:08.45\00:11:11.31
They found that
their skin fold thickness
00:11:11.34\00:11:14.74
which is a measure of body
fat decreased significantly
00:11:14.75\00:11:19.88
Skin fold thickness is
pretty easy to check...
00:11:19.91\00:11:21.74
They have little
calipers they would just squeeze
00:11:21.77\00:11:23.48
the skin and find out
how thick the skin was
00:11:23.51\00:11:26.73
and that was relating to
the amount of fat under the skin
00:11:26.77\00:11:30.85
So, if you're trying to
get out of the sedentary range,
00:11:32.17\00:11:36.78
into the
moderate activity range,
00:11:36.81\00:11:39.33
what you'd like to do is
choose an exercise that is easy,
00:11:39.36\00:11:44.29
and enjoyable.
00:11:44.32\00:11:46.82
The one that is found to
be most successful was walking
00:11:46.85\00:11:50.63
The daily amount of exercise
that you take should start
00:11:50.66\00:11:59.57
with something you can tolerate
00:11:59.60\00:12:02.54
What you could do is
start with 5, 10 minutes a day
00:12:02.57\00:12:07.14
Walk 5 minutes
OUT from your house,
00:12:07.15\00:12:09.08
turn around, come back, and
walk 5 minutes to your house
00:12:09.11\00:12:13.37
They found that weight
loss is proportional to duration
00:12:13.40\00:12:18.36
of exercise up to a point
00:12:18.39\00:12:21.24
Exercise is good in that
it eliminates fat, not muscle
00:12:21.27\00:12:25.99
You want to choose an exercise
that you can enjoy and tolerate
00:12:26.02\00:12:30.51
I have some friends that
seem to do well on a treadmill
00:12:30.54\00:12:35.52
I found treadmills to be
somewhat difficult because
00:12:35.55\00:12:38.55
they're somewhat
boring... you don't have any
00:12:38.58\00:12:40.44
change of scenery...
00:12:40.47\00:12:41.47
There's really no joy,
at least for me, in walking
00:12:41.50\00:12:46.30
I prefer the outdoor activities
where you can actually
00:12:46.33\00:12:49.51
get a change in scenery.
00:12:49.54\00:12:51.84
There are some
benefits in just walking
00:12:51.87\00:12:56.67
Now, what about a gym?
00:12:56.70\00:12:58.44
There are some benefits to gyms
00:12:58.47\00:13:01.21
They do have weight equipment
which can be beneficial
00:13:01.24\00:13:03.98
There are some
downsides, however...
00:13:04.01\00:13:06.20
There is a cost, but the
biggest thing I found was
00:13:06.23\00:13:09.31
that the time
involved in a gym...
00:13:09.34\00:13:11.24
When I tried a gym,
at one point in my life,
00:13:11.25\00:13:13.86
I found that I had to
get my clothes together,
00:13:13.89\00:13:16.83
get in the car,
drive to the gym...
00:13:16.86\00:13:19.03
which may take 1/2 an hour
00:13:19.06\00:13:20.24
When I got there,
I had to change...
00:13:20.27\00:13:22.39
do the 1/2 hour workout...
change, take a shower,
00:13:22.42\00:13:25.60
get dressed, drive home...
00:13:25.63\00:13:27.62
It may take me 2 hours, to
do a simple 30 minute workout
00:13:27.63\00:13:31.64
On the other hand, if
I come home from work,
00:13:31.67\00:13:34.78
in my work clothes, I can
put on some shoes, tennis shoes
00:13:34.81\00:13:39.03
I can either go for a
walk, I can go for a run...
00:13:39.06\00:13:41.96
I can go for a bicycle ride...
00:13:41.99\00:13:44.60
And when I come home,
I can change out of my
00:13:44.63\00:13:46.91
work clothes, take
a shower, my PJs on...
00:13:46.94\00:13:51.18
There's no extra
time out of my schedule,
00:13:51.21\00:13:55.17
and the only time,
really, spent for the exercise
00:13:55.20\00:13:59.28
is the actual exercise
time which is 30 to 45 minutes
00:13:59.31\00:14:05.52
Is exercise the
ultimate answer to obesity?
00:14:05.55\00:14:10.37
It is a help, but it's
actually not the ultimate answer
00:14:10.40\00:14:14.90
and it's not the reason
for the epidemic of obesity
00:14:14.93\00:14:18.46
that we see in America today
00:14:18.49\00:14:20.74
Dr. John McDougall
tells a story about a
00:14:20.77\00:14:28.48
private interview
with Carl Lewis...
00:14:28.51\00:14:30.93
They were actually being
interviewed on a talk show
00:14:30.96\00:14:33.78
and Carl Lewis is
the fastest man on earth!
00:14:33.81\00:14:37.23
He set the world
record in the 100 yard dash
00:14:37.26\00:14:40.91
And before they got on stage,
he shared with Dr. McDougall,
00:14:40.94\00:14:46.12
he said, you know, "I
have a problem with weight"
00:14:46.15\00:14:48.35
"If I eat too much, I
start gaining weight. "
00:14:48.38\00:14:51.43
And McDougall, kind of
tongue- in-cheek said...
00:14:51.46\00:14:53.35
Wow... you? Nobody
exercises more than you do!
00:14:53.38\00:14:55.94
You have a problem with
weight? He said... "Yes, I do. "
00:14:55.98\00:14:58.10
And then McDougall
said something very profound
00:14:58.13\00:15:00.12
He said, "Well, you
know, actually anybody on the
00:15:00.15\00:15:03.29
American diet will
have a problem with weight
00:15:03.32\00:15:06.79
no matter how
much they exercise. "
00:15:06.80\00:15:09.16
If you go on a plant-based
diet, you won't have a problem.
00:15:09.19\00:15:12.47
Well, a year later,
"Sports Magazine" interviewed
00:15:12.50\00:15:16.34
Carl Lewis, and he
indicated that he had changed
00:15:16.37\00:15:19.99
to a vegan diet, and he no
longer had an issue with weight
00:15:20.00\00:15:23.62
He could eat as
much as he wanted.
00:15:23.65\00:15:25.84
Also, his performance improved.
00:15:25.88\00:15:28.07
That's another
topic for another time.
00:15:28.10\00:15:29.93
So, if exercise isn't the
answer, what is the answer?
00:15:29.96\00:15:36.09
Well, we're going to find
that the answer is actually
00:15:36.12\00:15:38.54
found in the
insulin resistance syndrome
00:15:38.57\00:15:41.81
Now what is the
insulin resistance syndrome?
00:15:41.84\00:15:45.64
Well, as we mentioned on
other talks, it's a combination
00:15:45.67\00:15:50.25
of things that happens
when you have insulin resistance
00:15:50.26\00:15:54.60
Remember... insulin
resistance occurs when you
00:15:54.63\00:15:57.69
take in the animal products.
00:15:57.72\00:15:58.89
The way your body
is supposed to work...
00:15:58.93\00:16:00.26
You take in sugars or starches,
your blood sugar RISES,
00:16:00.29\00:16:03.23
the pancreas releases INSULIN,
which is a little key...
00:16:03.26\00:16:05.62
it goes to each of
the cells of your body,
00:16:05.65\00:16:07.79
it goes in the
keyhole, opens up the cell door
00:16:07.82\00:16:10.42
and allows sugar to leave
the blood and go in the cell,
00:16:10.45\00:16:13.31
and get burned, and that
brings your blood sugar down.
00:16:13.34\00:16:15.73
When you take the
animal products, those go in,
00:16:15.74\00:16:17.78
and they PLUG UP the KEYHOLES
00:16:17.81\00:16:21.93
Now when you eat sugars
or starches, the blood sugar
00:16:21.96\00:16:24.88
rises, insulin is released,
but it can't get in the keyhole
00:16:24.91\00:16:27.28
The doors stay shut,
and the blood sugars rise,
00:16:27.71\00:16:30.10
and that is the result
of insulin resistance...
00:16:30.13\00:16:32.96
and it can lead to DIABETES
00:16:32.99\00:16:35.60
But we're now finding that
this insulin resistance causes
00:16:35.63\00:16:38.37
other problems.
00:16:38.40\00:16:39.71
As we discussed earlier,
it causes high blood pressure,
00:16:39.72\00:16:42.13
it also causes
high blood sugars...
00:16:42.16\00:16:45.12
but it also causes obesity
00:16:45.15\00:16:47.89
And one of the criteria for the
insulin resistance syndrome is
00:16:47.92\00:16:51.99
...if your a man, if
your waist is over 40 inches,
00:16:52.02\00:16:54.98
or for a woman, if
it's over 35 inches
00:16:55.01\00:16:57.68
...those are 2 criteria
00:16:57.71\00:16:59.40
Insulin resistance also
includes high triglycerides...
00:16:59.43\00:17:01.88
that's the fat in
the blood, over 150
00:17:01.91\00:17:04.54
It includes a low HDL...
the HDL is the good cholesterol
00:17:04.57\00:17:08.50
in your blood.
00:17:08.53\00:17:10.06
If your a man, if it's below
40, or for a woman, below 50,
00:17:10.09\00:17:13.64
that's another criteria for
the insulin resistance syndrome
00:17:13.67\00:17:16.42
and if you have 3 out
of 5 of those symptoms,
00:17:16.45\00:17:19.29
you have the
insulin resistance syndrome
00:17:19.32\00:17:22.72
Well, the
question then follows...
00:17:22.75\00:17:24.86
What is it about the
insulin resistance syndrome that
00:17:24.87\00:17:28.36
causes weight gain?
00:17:28.39\00:17:31.51
Well what we find is that
when you have insulin resistance
00:17:31.54\00:17:36.76
the body starts to compensate
by releasing more insulin
00:17:36.77\00:17:44.33
What happens is
the pancreas says...
00:17:44.36\00:17:46.28
"You know, the normal 30 units
of insulin a day that used to
00:17:46.31\00:17:50.02
control the blood sugars,
is not working anymore. "
00:17:50.05\00:17:53.64
"Blood sugars are
rising because of this
00:17:53.67\00:17:55.83
insulin resistance...
What am I going to do?"
00:17:55.86\00:17:57.52
"I know what I'll do...
I'll just release more INSULIN"
00:17:57.55\00:18:01.49
So the pancreas
releases more insulin,
00:18:01.52\00:18:04.13
and now is able to
overcome the insulin resistance
00:18:04.16\00:18:07.28
...Maybe it has to
release 35 units a day,
00:18:07.31\00:18:10.88
40 units a day, whatever it
takes to keep the blood sugars
00:18:10.91\00:18:14.29
down!
00:18:14.32\00:18:16.32
This insulin resistance
is typically measureable
00:18:16.35\00:18:20.84
as many as 12 years
before the diagnosis of diabetes
00:18:20.87\00:18:25.33
As insulin resistance
increases over the years,
00:18:25.36\00:18:29.80
your body produces more
insulin and your insulin levels
00:18:29.83\00:18:34.02
slowly increase.
00:18:34.05\00:18:35.86
Is this a problem? Well, yes...
00:18:35.89\00:18:38.71
because insulin not only
drives sugar into the cells
00:18:38.74\00:18:42.69
to be burned, or stored
as glycogen in the liver,
00:18:42.72\00:18:45.58
it also drives fat into
the fat cells to be STORED
00:18:45.61\00:18:50.66
and it prevents
fat from being BURNED
00:18:50.69\00:18:53.31
So, as you are having increasing
insulin resistance over 12 years
00:18:53.34\00:18:57.41
...your insulin levels
RISE over those 12 years
00:18:57.44\00:19:00.69
and your body fat
increases over those 12 years...
00:19:00.72\00:19:04.54
until at the end of,
say, maybe 10-12 years,
00:19:04.57\00:19:06.87
the pancreas can no longer keep
up with the high insulin level
00:19:06.90\00:19:11.18
the high insulin resistance
you have at that point
00:19:11.21\00:19:13.87
and so now, the
pancreas can't keep up,
00:19:13.90\00:19:17.50
the fasting sugars start to rise
00:19:17.53\00:19:20.25
And then you see your
doctor, and the doctor says...
00:19:20.28\00:19:21.98
"Well, you have diabetes because
your blood sugars are high
00:19:22.01\00:19:26.32
and you are too heavy, and
that's causing your diabetes
00:19:26.35\00:19:35.91
Well... that's
not actually correct
00:19:35.94\00:19:37.97
What we find is that he
has obesity BECAUSE he has
00:19:38.00\00:19:42.65
the diabetes and
the insulin resistance,
00:19:42.66\00:19:44.92
and the increased
insulin levels causing that
00:19:44.95\00:19:47.69
fat storage in the body.
00:19:47.72\00:19:51.00
So these increased insulin
levels, cause increased weight
00:19:51.03\00:19:58.27
There was a man who
was diagnosed with diabetes
00:19:58.30\00:20:05.54
and his insulin resistance
had increased to the point
00:20:05.55\00:20:09.70
where we had to increase his
insulin levels, and I said...
00:20:09.71\00:20:13.76
"You know, we have to
increase your insulin dose"...
00:20:13.79\00:20:15.76
and he said, "OH!
Please don't do that...
00:20:15.79\00:20:17.26
don't do that... I
said, "Well, why not?"
00:20:17.30\00:20:18.67
He said, "Because my
weight is going to go UP!
00:20:18.70\00:20:22.27
He knows that once
you're diagnosed with diabetes,
00:20:22.30\00:20:24.83
and we start you on insulin
the more insulin we give you,
00:20:24.87\00:20:27.84
the higher your
blood sugar goes.
00:20:27.87\00:20:30.41
Now, when a person is typically
diagnosed with diabetes,
00:20:30.44\00:20:33.42
the first drugs that came
out on the market were the
00:20:33.45\00:20:36.15
sulfonylureas...
00:20:36.18\00:20:37.33
These are drugs which
stimulated the pancreas
00:20:37.36\00:20:40.68
to release more insulin
00:20:40.71\00:20:42.80
So we'd start a patient,
a newly diagnosed diabetic
00:20:42.83\00:20:45.04
on these sulfonylurea drugs...
00:20:45.07\00:20:47.01
It stimulated the pancreas
to release more insulin,
00:20:47.04\00:20:49.68
and that allowed the blood
sugars to be controlled again
00:20:49.71\00:20:53.45
BUT, at the expense
of higher insulin levels,
00:20:53.48\00:20:57.72
and the weight
would then increase.
00:20:57.75\00:21:00.58
A quote from one of
the medical journals talked
00:21:00.61\00:21:05.16
about diabetic drugs...
00:21:05.19\00:21:06.38
This was from an
up-to-date journal,
00:21:06.41\00:21:08.49
said... "Insulin
stimulates weight gain, and the
00:21:08.52\00:21:12.38
sulfonylureas that
increase insulin release,
00:21:12.41\00:21:16.13
ALSO increase weight!
00:21:16.14\00:21:19.53
Now today, there are some drugs
that do NOT increase weight
00:21:19.56\00:21:22.10
that are used for diabetes...
They have some pros and cons
00:21:22.13\00:21:25.77
which we can't discuss at this
time but there are other options
00:21:25.80\00:21:30.16
There was also a "United Kingdom
Prospective Diabetes Study"
00:21:30.19\00:21:35.25
The UK PDS that
reviewed 2,520 subjects
00:21:35.28\00:21:41.39
What they did was they tried
to control their blood sugars
00:21:41.42\00:21:43.69
4 different ways...
00:21:43.72\00:21:45.37
One with just a low-calorie diet
00:21:45.40\00:21:48.95
One was diabetic
pills; 2 types of pills which
00:21:48.96\00:21:53.20
increased insulin
release by the pancreas
00:21:53.23\00:21:55.87
And the last, was just
to use insulin injections
00:21:55.90\00:21:59.65
And what they did was,
they measured how much these
00:21:59.68\00:22:02.97
different approaches increased
insulin levels in the blood
00:22:02.98\00:22:07.33
They found that with
the low-calorie diet,
00:22:07.36\00:22:10.52
it really didn't affect
their insulin levels THAT much
00:22:10.55\00:22:13.92
and there was no
significant weight change
00:22:13.95\00:22:17.49
But the pills,
they found roughly...
00:22:17.52\00:22:19.71
the higher the insulin
level increase in the blood
00:22:19.74\00:22:24.37
from the medication,
the higher the weight gain
00:22:24.40\00:22:27.42
...That it was roughly
proportional to the level
00:22:27.45\00:22:31.31
of insulin increase in the blood
00:22:31.34\00:22:35.05
They did another test...
another large control trial
00:22:35.08\00:22:40.72
called... "The Diabetes
Control and Complications Trial"
00:22:40.75\00:22:43.32
and what they found in it
was that the weight gain effect
00:22:43.35\00:22:48.93
of insulin is dose-dependent
00:22:48.96\00:22:51.34
as illustrated in "The Diabetes
Control and Complications Trial"
00:22:51.37\00:22:55.54
where the mean increase
in weight was 5.1 kilograms
00:22:55.57\00:23:00.98
in the patients with the
intensive treatment group
00:23:01.01\00:23:03.59
In other words, they
took a group of patients,
00:23:03.62\00:23:05.54
they gave them LOTS of insulin
to get their blood sugars
00:23:05.57\00:23:07.97
very well controlled, and
they found that their weight
00:23:08.00\00:23:10.87
increased dramatically
00:23:10.90\00:23:13.48
In the other group, that
was controlled less intensely,
00:23:13.51\00:23:18.49
they used lower doses of
insulin, had higher blood sugars
00:23:18.52\00:23:21.54
but they found that the weight
increase was only 2.4 kilograms
00:23:21.55\00:23:26.30
...much less than those
with the intensive treatment
00:23:26.33\00:23:30.30
They also measured
A1c Well, what's A1c...
00:23:30.33\00:23:34.46
Well what happens when
you have high blood sugars
00:23:34.49\00:23:36.97
the sugars can
combine with the hemoglobin
00:23:36.98\00:23:40.42
and the percent of
hemoglobin that is in the blood
00:23:40.45\00:23:43.58
that is combined with sugars...
00:23:43.61\00:23:44.82
what they call the percent
A1c or the hemoglobin A1c
00:23:44.83\00:23:48.31
it's related to
your average blood sugars
00:23:48.34\00:23:51.38
over the last 3 months
00:23:51.41\00:23:53.40
And in this trial, the
better control they had,
00:23:53.44\00:23:57.86
the lower the A1c
levels they got...
00:23:57.89\00:24:01.36
the greater the weight gain
00:24:01.39\00:24:03.07
In other words, if they
were using lots of insulin
00:24:03.10\00:24:06.36
to get better
blood sugar control,
00:24:06.39\00:24:09.22
there was higher weight gain
00:24:09.25\00:24:11.85
In this trial, they found
something very significant
00:24:11.88\00:24:14.44
They found that
there was NO relationship
00:24:14.47\00:24:16.35
between calorie
intake, and weight gain
00:24:16.38\00:24:20.31
Those eating lots,
those eating little...
00:24:20.34\00:24:22.26
did not affect their weight
00:24:22.27\00:24:24.20
What did affect their
weight was their insulin levels
00:24:24.23\00:24:28.10
and how much
insulin they were getting.
00:24:28.13\00:24:30.60
There was also NO relationship
between EXERCISE in weight gain
00:24:30.63\00:24:35.24
in this study
00:24:35.27\00:24:36.68
They could be
exercising, or not exercising,
00:24:36.71\00:24:39.44
the weight was
more strongly controlled
00:24:39.47\00:24:44.21
by the insulin
that they were getting
00:24:44.25\00:24:47.95
It trumped the other
causes of weight problems.
00:24:47.99\00:24:52.65
Now, this puts us in somewhat
of a dilemma because physicians
00:24:52.66\00:24:57.79
now have a problem
00:24:57.82\00:24:59.72
Are we going to control their
blood sugar with more insulin?
00:24:59.75\00:25:02.62
Or are we going to try
to control their weight by
00:25:02.65\00:25:05.05
cutting back on the insulin?
00:25:05.08\00:25:07.27
And, it seems like
there's not a good solution,
00:25:07.30\00:25:11.15
but in fact, there
IS on a plant-based diet
00:25:11.18\00:25:14.57
you can actually
DECREASE your insulin-resistance
00:25:14.60\00:25:17.91
which would then
require less insulin...
00:25:17.94\00:25:21.90
which would then
help to drop your weight
00:25:21.93\00:25:24.66
And that is, indeed, what
we found to be most effective
00:25:24.69\00:25:28.18
is a plant-based diet to
decrease insulin resistance
00:25:28.21\00:25:31.43
and allow weight loss.
00:25:31.46\00:25:32.82
Our experience has
been, most people will lose
00:25:32.85\00:25:34.93
about 2 pounds a
week on a vegan-type diet
00:25:34.96\00:25:39.09
where you eliminate meat
products and dairy products,
00:25:39.12\00:25:41.25
the oils, and concentrate
on the fruits, nuts, grains,
00:25:41.28\00:25:45.83
vegetables and legumes.
00:25:45.86\00:25:49.29
Is insulin resistance prevalent
enough to account for the
00:25:49.32\00:25:54.35
diabetes epidemic
that we have in America?
00:25:54.38\00:25:57.54
As we mentioned in one
of our earlier talks...
00:25:57.57\00:26:00.45
diabetes increased 500%
00:26:00.48\00:26:04.09
in America in the span
of 36 years... it's epidemic
00:26:04.12\00:26:08.19
Americans, 1 out of 4 has
the insulin resistance syndrome
00:26:08.22\00:26:13.44
...30% of
overweight adolescents have the
00:26:13.47\00:26:16.14
insulin resistance syndrome
00:26:16.17\00:26:18.21
What this is
telling us is that... yes,
00:26:18.24\00:26:21.40
the insulin resistance syndrome
is certainly prevalent enough
00:26:21.43\00:26:26.33
to account for the
massive increase in obesity
00:26:26.36\00:26:30.74
that we have in America today.
00:26:30.77\00:26:33.02
So, what ARE the foods that
can decrease insulin resistance?
00:26:33.05\00:26:38.84
Monosaturated fats
can help decrease it.
00:26:38.87\00:26:42.68
The olive oil as
eaten in the olive...
00:26:42.71\00:26:45.44
Please get it in the
olive, that's the best place...
00:26:45.47\00:26:48.52
try to avoid the refined
oils That can be very helpful
00:26:48.55\00:26:52.04
Polyunsaturated
fats... found in safflower oil,
00:26:52.07\00:26:55.72
sunflower oil, corn, and
soybeans can also be helpful
00:26:55.75\00:26:59.46
But again, try to get the oils
in the plant in the natural form
00:26:59.47\00:27:04.94
For instance, to get 2
tablespoons of corn oil,
00:27:04.97\00:27:10.11
requires 14 ears of corn
00:27:10.14\00:27:13.37
Most of us don't eat
14 ears of corn at a time
00:27:13.38\00:27:17.01
We're not really designed to
get that much oil at one point
00:27:17.04\00:27:19.89
So, if you can eat the
oil IN the natural form,
00:27:19.92\00:27:24.25
you're going to
limit it naturally
00:27:24.28\00:27:27.19
Fiber can help
reduce insulin resistance
00:27:27.20\00:27:30.13
...Whole grains can also.
00:27:30.16\00:27:31.73
Remember, the foods that
increase insulin resistance,
00:27:31.76\00:27:34.21
is saturated fats, including
the flesh and the dairy,
00:27:34.24\00:27:36.94
trans fats from the
margarines, the shortenings
00:27:36.97\00:27:39.47
the fats from frying,
partially hydrogenated fats
00:27:39.50\00:27:42.64
in the trans fats...
00:27:42.65\00:27:44.13
If you can avoid these,
you can help reverse the
00:27:44.16\00:27:47.14
insulin resistance syndrome,
and your weight will come off
00:27:47.17\00:27:50.45
We're hoping that you can
try some of these approaches
00:27:50.48\00:27:55.49
monitor your weight,
and get the benefits that
00:27:55.52\00:27:59.75
God desires you to
have May God bless...
00:27:59.78\00:28:01.34
We look forward to seeing
you as we cover some last topics
00:28:02.25\00:28:05.67
in diabetes in our next talk
00:28:05.70\00:28:07.66