How to Overcome Your Predisposition to Weight Gain

Obesity is now an endemic problem and it needs to be considered a chronic disease. A big portion of the overweight population have an underlying metabolic disease or a genetic problem causing them to be overweight, however with the right food and exercise these conditions can be controlled.

Where you end up storing fat can also give you an indication of why you are storing fat. Typically if you store fat around your waist and abdomen that can indicate a metabolic problem, more commonly an insulin resistance problem or adrenal steroid excess. If you store fat around your hips and thighs then that is more commonly due to just extra weight but can be associated with liver or lymphatic issues.

It must be noted that if you are taking certain drugs that can influence weight gain. Some common drugs are:

– Corticosteroids used for inflammatory diseases
– Insulin & sulphonylureas for diabetes
– B-adrenergic blockers used for hypertension
– Sodium valproate for epilepsy
– Anti-depressive and anti-psychotics
– Lithium for bipolar
– Contraceptive pill
– Pizotifen for vasometric headache
– Cyproheptadine for allergy and hayfever

As obesity is becoming an epidemic problem its no wonder that more and more people are becoming sedentary. An increase in obesity means people are becoming less active. Exercise is important to keep the body well oiled. It burns calories, maintains a balanced appetite, keeps blood glucose levels balanced and increases your metabolism. Combining exercise with a good eating plan goes hand in hand. If you don’t exercise you will lose weight but it will be in the form of muscle instead of fat, so exercise increases your muscles and decreases your fat. Exercise also helps with heart disease, diabetes, and cancer. It will also help control stress, improve your circulation and strengthen your lungs and heart.

First let’s look at what is classed as an OK weight. There are different ways you can measure whether or not your weight is appropriate; one is the Body Mass Index (BMI).

BMI = weight (kg)/ height (m2)

For example if your weight was 60kg and your height 1.75 meters, that would be:

BMI = 60 / (1.75 x 1.75)
= 19.59

Therefore in the optimal range
Calculate your BMI!
The BMI rates indicate the following:

BMI of 18.5 to 25 – optimal weight
BMI of fewer than 18.5 – person is underweight
BMI of above 25 – person is overweight
BMI above 30 – person is obese
BMI above 40 – person is morbidly obese
BMI under 17.5 person has anorexia nervosa

Therefore to know if you are in the healthy range calculate your BMI, healthy tips on losing weight:

1. have small portion sizes
2. eat protein during the day
3. limit carbohydrates
4. eat good fat, cut out bad fat
5. drink plenty of water
6. fill up your plate with vegetables
7. reduce alcohol
8. get in resistance training
9. eat organic food
10. love your body the way it is

Manage Diabetes Effectively to Prevent Health Complications

The main theme during the management of diabetes is mostly to control blood sugar level. Management of diabetes requires awareness on part of patient. In order to lead a long and healthy life one has to keep his blood sugar level within his target range.

4 main methods to manage diabetes effectively are

a. Diet and lifestyle
b. Oral anti-diabetic drugs
c. Insulin
d. Other factors

About 50% of new cases can be controlled adequately by diet alone, 20-30% will need an oral anti-diabetic drug, and 20-30% will require insulin.

The ideal management for diabetes would allow the patient to lead a normal life, not only symptom free but in good health, to achieve a normal metabolic state and to escape long term complications.

Diet and lifestyle

Dietary management aims at –

1. Achieving good glycemic control
2. Assisting weight management
3. Reducing risk of micro vascular and macro vascular complications
4. Avoiding “atherogenic” diets
5. Assuring adequate nutritional intake
6. Avoiding hypoglycemia

Recommended composition of diet for people with diabetes –
% of energy intake
Carbohydrate – 45-60%
Sucrose – upto 10%
Total fat – less than 35%
N-6 polyunsaturated – less than 10%
Mono saturated – 10-20%
Saturated – less than 10%
Protein – 10-15%

Weight management is a key factor, as a high percentage of people with type 2 diabetes are overweight or obese and also many anti-diabetic medications and insulin encourage weight gain. Obesity, particularly abdominal obesity predicts insulin resistance and increased cardiovascular risk.

The importance of lifestyle changes such as taking regular exercise, observing a healthy diet and reducing alcohol consumption should not be under-estimated in improving glycemic control.

Oral anti-diabetic drugs

Varieties of drugs are quite effective in reducing hyperglycemia in patients with type 2 diabetes. Most of these drugs depend on supply of endogenous insulin.

Following are the groups of oral anti-diabetic drugs used –

a. Sulphonylureas
b. Biguanides
c. Alpha-glucosidase inhibitors
d. Thiazolidinediones
e. Meglitinides and amino acid derivatives
f. Incretin mimetics

Effects of hypoglycemic drugs –

a. Reduction of basal glycemia
b. Improvement in lipid profile
c. Increase body weight
d. Raised plasma insulin
e. Reduced post prandial glycemia

Insulin

Diabetic medications are designed to lower blood sugar level. Timing and size of dose have an important effect on effectiveness of these medications.

Many insulin preparations have been prepared to control diabetes. They are –

1. Rapidly acting e.g. lispro, aspart, glulisine.
2. Short acting e.g. soluble regular insulin.
3. Intermediately acting e.g. isophane, lente.
4. Long acting e.g. bovine ultralente.
5. Long acting insulin analogues e.g. glargine, detemir.

Other factors

Other factors include namely Alcohol, Salt and Diabetic foods and sweeteners. Alcohol consumption should be moderate unless there is a coexisting medical problem that requires abstinence.
Sodium intake should be no more than 6 g daily. In hypertensive patients it should not be more than 3 g daily.
Low calorie and sugar free drinks are very useful in diabetes.

Precautions to be taken –

1. Stick to your diabetes meal plan.
2. Exercise and weight management is necessary.
3. Co ordinate your meals and medication.
4. Be cautious with new medicines.

Diabetes Control With Diet and Hypoglycaemic Agents

Diabetes control can be achieved by employing a combination of diet and oral hypoglycaemic agents. Some forms of diabetes can be managed by changing diet and lifestyle, especially by improving exercise and shedding weight. Oral hypoglycaemic agents are drugs which are employed to help lower the elevated blood glucose level. These kinds of drugs may be employed in conjunction with diet to effectively control some forms of diabetes. A patient who has had diabetes for less than 5 years, who is older than 40 years and is not obese would benefit immensely from this type of treatment.

There are 2 types of oral hypoglycaemic agents: Sulphonylureas and the Biguanides. Examples of Sulphonylureas include Chlorpropamide (diabinese), Tolazamide (tolinase), Tolbutamide (orinase), etc. And an example of Biguanide is Phenformin. While the Sulphonylureas stimulate the pancreas to release insulin from its beta cells thereby helping to lower the blood sugar level, phenformin on the other hand inhibits glucose absorption from the intestine, increase peripheral utilization of glucose and decrease gluconeogenesis thereby promoting a reduction in blood glucose level. The level of sugar in the blood could remain abnormally high if nothing is done to utilize the peripheral glucose or to prevent its further production from the non-nitrogen portion of amino acids after deamination. This process is checked by oral hypoglycaemic agents which send a message to the liver and kidneys to reduce gluconeogenesis.

However, insulin is not contemplated for patients with non-insulin dependent diabetes mellitus since their pancreas is still producing insulin; all you need is something to make the insulin effective. Insulin can only be recommended for patients with insulin dependent diabetes mellitus and it is administered subcutaneously or intravenously to control the blood sugar. It is not given orally because it is destroyed by the enzyme proteinase. There are 3 classes of insulin which could be used by the patient and they include: The short-acting, intermediate-acting, and long-acting insulin.

Have it at the back of your mind that once you are diagnosed with non-insulin dependent diabetes mellitus you have two options – either to manage yourself by getting some facts about the kind of diet suitable for you and apply them, or add the oral drugs if the diet alone refuses to put it under proper control. The most important thing is that even before you are placed on certain drugs you already have adequate knowledge as to how they work and what you can do to get the best result using them.