Re: DIABETES - PRICE OF PROGRESS
From: Dr. Andrew B. Chung, MD/PhD (nospam5_at_heartmdphd.com)
Date: 08/02/04
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Date: 2 Aug 2004 03:15:05 -0700
usenet@mantra.com (Dr. Jai Maharaj) wrote in message news:<sKK9X11hkvy0@Tn747b8nTUEYxT>...
> Diabetes: price of progress
>
> Changed lifestyle and food habits of a rural population
> have increased the incidence of diabetes three fold in 14
> years. First proof that lifestyle does not insulate the
> rural population.
>
> By R. Prasad
> The Hindu
> Thursday, July 15, 2004
>
> GIVE A villager a motorised transport, electricity, piped
> water supply, television, and food containing more of
> carbohydrate, protein and fat. "The chances are that the
> villager will invariably be afflicted with diabetes,"
> said, Dr. A. Ramachandran, Managing Director of the
> Chennai based M.V. Hospital for Diabetes. While progress
> is welcome, what comes with it unasked are the diseases
> of urbanised lifestyle. "The transition from a typical
> rural to urban lifestyle carries its own baggage of
> problems. Diabetes is one of them. It is a disease of
> progress," he explained.
>
> He should know better. A study of a rural area 40 kms
> from Chennai in 1989 showed the prevalence of diabetes
> hovering around 2.20 per cent. Typical of a rural area
> where manual labour, physical exercise and low
> fat/carbohydrate food ruled. The incidence has now shot
> up to 6.36 per cent when the disease prevalence was
> studied after a span of 14 years.The village is still
> typically rural but has all the fringes of an urbanised
> setting," he explained.
>
> The study proves conclusively what was widely believed.
> Changes in lifestyle and food habits have gone a long way
> in increasing the incidence level. For instance, women
> were found to confine themselves to household work and
> shun manual work that was very common 14 years ago.
> Similarly, food habits changed from ragi and vegetables
> to carbohydrate and fat filled food. Add to this, better
> facilities ? like motorised transport and piped water ?
> which mimic urban life. And the concoction has proved an
> ideal setting for diabetes prevalence to shoot up.
>
> "But even here the prevalence is a meagre 2.80 per cent
> in those who are still engaged in strenuous physical
> activity compared to 48.3 per cent living a near
> sedentary life," Dr. Ramachandran pointed out. Lack of
> physical exercise and consumption of fat filled food have
> had a telling effect on the Body Mass Index (BMI) of both
> the sexes. In the case of men, the BMI had increased from
> 17.60 to 20.70, waist girth from 71.4 to 79.9 in a span
> of 14 years.
>
> Though a BMI of 20.7 is much lower than the international
> cut off level of 25 to be labelled as obese, studies have
> conclusively proved that Indians with BMI of over 23 are
> obese. It has been conclusively proved that even small
> changes in the BMI could tilt the balance. "This is
> basically because we have higher upper-body adiposity
> even when we have lean body mass," Dr. Ramachandran
> explained.
>
> To the uninitiated, Indians have a high propensity to
> develop higher upper-body adiposity, particularly central
> obesity. And central obesity (in the form of huge paunch)
> is strongly associated with glucose intolerance than
> generalised obesity. For a given BMI, Indians have a
> higher degree of central adiposity. Blame it on central
> obesity, Indians are prone to become diabetic even when
> not obese in the literal sense.
>
> This predisposition to accumulate fat in the central
> region of the body (in the stomach region) is in the form
> of visceral fat. And visceral fat, in contrast to
> subcutaneous fat, does more damage as it leads to insulin
> resistance. In other words, it prevents the intake of
> glucose by the cells. "But we have found that
> subcutaneous fat is also responsible for developing
> insulin resistance," he clarified. The study involved
> studying the role of visceral and subcutaneous fat non-
> diabetics using CAT scans.
>
> According to Dr. Ramachandran, insulin resistance is a
> characteristic feature of Indians. And for any given BMI,
> Indians tend to have higher insulin levels, indicating
> the pronounced insulin resistance (peripheral). "Insulin
> resistance tends to worsen with small increase in weight
> and lack of physical activity," he elaborated.
>
> Studies done have conclusively shown that even
> individuals with ideal BMI tend to have body fat
> comparable to overweight westerners. The low muscle-mass
> and excess body fat contribute greatly to the propensity
> to develop diabetes. Hence any weight gain even within
> the ideal levels of body mass index can put the person at
> risk. The instance of villagers studied by Dr.
> Ramachandran who are well below 23 (BMI) is a classic
> example.
>
> There is a silver lining though. If an incremental
> increase in body weight tends to put the individual at
> risk (of developing diabetes), small loss in weight does
> wonders. It reduces the risk appreciably. It works both
> ways.
Enter the 2PD Approach:
http://www.heartmdphd.com/wtloss.asp
Would suggest you ask your doctor about this.
Related to the 2PD Approach:
http://www.heartmdphd.com/press.asp
Speaking of diabetes... here is a worthy diabetes charity:
http://makeashorterlink.com/?N2E9210F8
Please consider contributing as I have.
Remember that deeds and actions speak louder than words. Now the
truth about those who would oppose my posts will be revealed.
Servant to the humblest person in the universe,
Andrew
-- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867
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