HeathWise March 2010
By Doctor Rik Heymans
Calle Angustias 24, NERJA
Telephone: 95 252 6775
Mobile : 619 50 21 51
Diabetes mellitus
About 246 million people worldwide suffer from diabetes mellitus, and it is expected that approximately 435 million patients will have this disease in the year 2030. It is one of the most common chronic diseases, and is in the news due to the dramatic increase over the past decades (a threefold increase these last thirty years). This increase is mainly due to changes in lifestyle, increasing prevalence of obesity, and the ageing of the population.
Diabetes is a major contributor to the development of cardiovascular disease. It is a metabolic syndrome; this means that an absolute or relative deficiency of Insulin causes a disturbance of the carbohydrate metabolism, which in its turn will disturb the protein, and fat metabolism.
Apart from the medical complications, there is also a financial aspect, in Europe the cost of treating diabetes and its complications swallows up approximately 10% of the health care budget, and this does not even take into account the personal financial loss due the illness.
The American Diabetes Association (ADA) and the WHO recommend a classification to define four subtypes of diabetes.
Type 1 is when there is an absolute Insulin deficiency, due to a dysfunction of the pancreas.
Type 2 is adult onset diabetes, and can be due to insulin resistance or insufficient production
Type 3 covers a wide range of specific types of diabetes, and Type 4 is pregnancy-related diabetes.
Type 1 diabetes - affects mainly young people, and there is a total lack of insulin. Without regular administration the patient will die. The family history is not as important here as with Type 2.
Type 2 diabetes - which is the most common type- starts at adult age. It affects about one out every fifty patients.
What are the Risk-factors for getting this type of diabetes?
- A family history of Type 2 diabetes
- Obesity.
- Physical inactivity
- Age above 45 years
- women who had early menopause, Type 4 diabetes, many children
- women who gave birth to large babies (more than 4.5 kg), they have a 30 times
higher risk
- Certain ethnic groups, like blacks, Indians, Spanish people.
Which diseases are increased in diabetes ?
- Liver and gallbladder cancer: risk x 4
- Osteoporosis especially in men the risk is raised
- Glaucoma and cataracts
- any infection is more likely to occur in diabetics, especially fungal infections
- Long term exposure to raised glucose levels can lead to blindness, renal failure.
- Cardiovascular complications are much more prevalent: strokes, heart failure,
impotence.
- Damage to the nervous system.
What are the signs of diabetes?
- excessive sweating, nausea, tiredness, hunger
- excessive thirst, fluid-intake and excessive urine production
- recurrent infections, especially on the skin
What to do if you are in a risk category, or if you present with early signs of diabetes?
- get checked regularly, a fasting blood sample is the easiest way to pick it up.
- lose weight, 10-15% loss brings you at about the same life expectancy level as
a healthy person
- get physically active: 45 minutes of exercise can reduce your risk with 25%!
- eat less fat and pure sugars; rather whole wheat etc.
- Vitamin and mineral supplements, especially Magnesium, vitamins E and B.
© Dr Rik HEYMANS.
Rik Heymans is a general medical practitioner in Nerja. He writes monthly for Streetwise on topics which a family doctor comes across regularly.
Health and fatness!!
by Paul Bateson
I don’t know about you but I get a little tired of continually seeing articles which state that latest research findings reveal that this or that will make you fat, thin, likely to have heart attack, improve circulation, give you diabetes, kill you!!!
Always there seems to be one type of food or another mentioned and advice is generally focused on not eating it rather than maybe eat what you like but EXERCISE!! It may seem simplistic but burn more calories than you consume and you will lose weight!! Give up smoking and you will be healthier. Problem is that if you enjoy a healthy lifestyle you don’t really need to worry about the articles whereas if you don’t live a healthy lifestyle you don’t read the articles anyway!
Many articles cover the problem of obesity which is on the increase. Eight percent of England’s adults were obese in 1980, but by last year that figure had risen to 23% and it is possible that soon the UK could overtake the USA, where an estimated one third of the population is obese.
So why is it on the increase? Why are 30% of children in Britain obese or overweight? Why is surgery seen as a once-and-for-all solution for 80% of cases?
It has got to be down to lifestyle, poor education and basic common sense. If your child is getting fat, you are probably fat, if your child has asthma and you enjoy a smoke or three then what do you expect... duh!!! Health warnings are printed on cigarette packets ...and ignored - so if health warnings were printed on all food containers, plates, cans, boxes, sweet wrappers it is a fair guess that they would also be ignored!
I now see that the British Heart Foundation (BHF) is making exercise sexy in a new campaign urging people over 50 in the UK to take part in physical activity for 30 minutes a day. Wonder if the Pope knows about this latest threat to celibacy? Calling it the ’30 a day’ campaign may not be the best idea either, smokers, who don’t read warnings, will probably think it means 30 cigarettess a day.
The BHF Director of Prevention and Care, Dr. Mike Knapton says, “It’s an alarming thought that inactivity kills someone in the UK every 15 minutes”, (whereas in the US it’s the Government condoned gun culture and in the Middle East it’s anyone who disagrees with anyone else)!!
Let’s face it, people can be their own worst enemy, if you enjoy doing something (or nothing) which is unhealthy it’s your funeral but maybe, after all the warnings are ignored and you require related medical treatment, perhaps you should pay for it ...now there’s a thought!!
Following on from the above I sometimes wonder what is really behind all the various health warnings. For example, I have just read an interesting article written by Chartered Herbalist, Bruce Burnett who says we can reap the joys of unfairly maligned saturated fats and live healthier. This would seem to conflict with every other statement offered to ‘Joe Public’ who in the end probably couldn’t care less.
I will give you the gist anyway; Mr. Burnett states that the tiresomely repeated, fallacious cliche that saturated fat is bad for you and causes heart disease is wrong! Especially for physically active people, (so it does mean doing some EXERCISE). Study after study proves this, in addition to simple historical evidence, but the advertising and lobbying power of the processed food and vegetable oil industries manages to win, over the facts, repeatedly.
An example given is that 100 years ago, per capita consumption of butter in the USA was 50 times what it is today. Heart disease was almost unknown. So why is it after a century of decreased consumption of butter and other saturated fats, along with a substantial increase in the consumption of margarine and other processed vegetable oils, we arrive at the fact that saturated fat is to blame for the increase in heart disease?
He also gives the results of a study which began in 1948 involving 6000 people who were split into two groups, one consumed little cholesterol and saturated fat and the other consumed large amounts. The groups were monitored every 5 years.
After 40 years it was found that the more saturated fat, cholesterol and calories one ate, the lower the person’s serum cholesterol and they also weighed the least and were the more physically active.
From an athletes point of view it has also been found that the traditional ‘carb-loading’ spaghetti dish before a race isn’t such a good idea as the carb-loaded runners have significantly less endurance than the ones who ‘fat-load’ before an event. I am pleased to see that as although I do like pasta I prefer it with the addition of a nice piece of pork or a steak.
The article sites numerous test results and basically those athletes trained on a high fat diet have healthier cholesterol profiles than when they eat the traditional low-fat, high-carbohydrate training diet and they do not gain weight or body fat.
Another observation was that on studying the dietary habits of indigenous peoples around the globe it was noted that groups that adhered to their native diets consisting largely of animal-based foods enjoyed robust health. Never once was a group encountered with an entirely vegetarian culture and heart disease and cancer were virtually non-existent.
Peoples who adopted the western diet of processed, sugar laden foods quickly fell victim to cardiovascular disease, cancers, arthritis, dental decay and many other ills of modern man.
In the summing up it appears that high cholesterol levels causing heart disease is a red herring, Western lifestyle and stress is the main problem, and the rise in obesity is related to the types of food we are now encouraged to eat by the food industry and consumer groups. People now eat a diet high in grain and inappropriate fats instead of natural animal fat, goose fat and natural vegetable fats such as olive, palm and coconut oils. The inappropriate fats are the highly processed polyunsaturated fats such as, soybean, canola and corn oils, which are ironically promoted as heart protective!
As the author of ‘Nourishing Traditions: The Cookbook that Challenges Political Correct Nutrition and the Diet Dictocrats’, Sally Fallon states, “Animal fats and cholesterol are not villains but vital factors in the diet, necessary for normal growth, proper function of the brain and nervous system, protection from disease and optimum energy levels’’.
Hopefully this article has been less confusing than the new food labelling system introduced by the UK’s Food Standard’s Agency which would have you believe that bananas and nuts are bad for you.
Bananas received a red light for sugar and nuts for fat as, unfortunately, the system makes no distinction between different types of fats and sugars, so even though there are natural fruit sugars in a banana and healthy monounsaturated and polyunsaturated fats in nuts, both get the red light label.
As a closing example of eating something you fancy and counteracting its effect with exercise lets try a nice serving of 600 calories worth of blackberry and apple crumble with custard… a big favourite of mine.
If you weighed 68kg you would need to run for 55 minutes at 10 minute mile pace or go rollerskating at 9mph for 1hour 34min or play football for 1 hour 13 minutes.
Main point is this, you can eat what you fancy but if you want to stay fit and healthy you must EXERCISE. BUT, If you do intend to start exercising and you have ‘let things slide a bit’, take advice, start slowly and maybe go for a medical first.
Paul Bateson, Team Axarsport s.l.
RunBikeHike, Sports Training/Holidays for Runners, Cyclists, Triathletes, Adventure Racers and Walkers. Trail Running Tours and Road Cycling Tours. Desert Runner Training Camps.
www.axarsport.com , www.trailrunspain.com and www.alandalus-ut.com
Cortijo Molino Vega 7, 18129 Santa Cruz del Comercio, Granada, Spain
