Obesity is an issue of health. Excess weight in terms of complementary medicine is seen as an excess condition of toxicity that needs to be eliminated. If you don't believe me carry around a ten-kilo bag of potatoes for a day and you will soon realise the strain this places on your heart.
Did you know that central obesity is as much linked to cardiovascular disease as cigarette smoking? However there is no add campaign telling us that fast food will lead to gangrene, although it can. Obesity is associated with complications in pregnancy, heart disease, late onset diabetes and certain cancers, in particular those related to oestrogen and the gastrointestinal tract.
Alarmingly I find that women of a healthy weight are now described as skinny and overweight women are accepted as the norm because they are the majority. People often have an excuse as to why they are overweight. Age, menopause, slow metabolism, child bearing, convenience and big bones, are some excuses people use. From a naturopathic perspective, there are legitimate reasons why people may gain weight that can be identified and addressed.
Why Diets Don't Work
- We feel deprived.
- Diets perpetuate an unhealthy obsession with food.
- We go on them to go off them. Why not just find a good one!
- Diets often provide inadequate nutrition.
- Diets treat the symptom and not the causes.
- Diets upset the bodies' metabolism, slowing down our Basal Metabolic Rate BMR.
- Diets don't address cravings.
- Diets don't work alone, often needed in combination with counselling and ongoing support networks.
Effective Weight Loss Measures
- You must sweat you must go hungry
- Have reasonable expectations i.e. 1kg /week.
- Include a realistic intake of energy.
- Ensure diet is nutritionally adequate.
- Reduce meal portions or have five small meals per day.
- Eat complex carbohydrates, nuts and seeds, legumes and grains and fat
- to give satiety.
- Eat food high in fibre to slow digestion and increase satiety.
- Relax, take a deep breath, and eat slowly.
- Select food low in saturated fats i.e. red meat, milk and cheese.
- Limit sugar, supermarket foods low in fat are high in sugar.
- Drink 6-8 glasses of room temperature water a day
- Exercise, exercise, exercise to increase your BMR. Buy that wet weather gear.
- Follow the rules of healthy eating for life and not a diet for weeks/months.
Naturopathic Causes Weight Gain and Obesity
- Excess calories consumption and deficient exercise
- Blood sugar imbalance AKA Insulin Resistance
- Functional hypothyroid AKA Low Basal Metabolic Rate
- Deficiency of good fats EFAs leading to decreased Thermogenesis
- Low stomach acid AKA Hypochlorydria
- Sluggish liver AKA fatty liver
Naturopathic Treatment Principles for Weight loss in Obesity
- Balance blood sugar and improve insulin sensitivity
- Boost the BMR
- Stimulate thermogenesis
- Increase stomach acid
- Improve liver function
Insulin Resistance and obesity
Insulin resistance (IR) is a physiological condition where the natural hormone, insulin, becomes less effective at lowering blood sugars leading to hyperglycaemia and resultant health problems. Certain cell types such as fat and muscle cells require insulin to absorb glucose. When these cells fail to respond adequately to circulating insulin, blood glucose levels rise. The liver helps regulate glucose levels by reducing its secretion of glucose in the presence of insulin. This normal reduction in the liver's glucose production may not occur in people with insulin resistance. See also Carahealth health articles, Insulin resistance.
Insulin resistance is often found in people with central obesity, hypertension, hyperglycaemia and dyslipidaemia involving elevated triglycerides, small dense low-density lipoprotein (sdLDL) particles, and decreased HDL cholesterol levels.
Causes of insulin resistance
There is clearly an inherited component but like with all genetic predispositions, our future is not necessarly writtem.
PCOS (polycystic ovary syndrome) as either causing it or being caused by it.
Excess sugar consumption causes Insulin Resistance
Insulin resistance has certainly risen in step with the increase in sugar consumption and the commercial usage of HFCS (high fructose corn syrup, currently the least expensive nutritive sweetener available).
Studies have linked insulin resistance to increased amounts of fructose (i.e. HFCS). Fructose causes changes in blood lipid profiles due to its effects on liver function.
High amounts of ordinary sucrose causes Insulin Resistance
High amounts of ordinary sucrose (i.e. table sugar) also has some causative effect on the development of insulin resistance (sucrose is 1/2 fructose).
Excessive refined High GI carbohydrate causes Insulin Resistance
Excessive refined High GI carbohydrate intake causes insulin resistance.
Excess insulin causes Insulin Resistance
Prolonged and repeated elevations of circulating insulin contribute to insulin resistance via down-regulation of insulin receptors or the GLUT4 (type four glucose receptors) on the cell's membrane. This leads to a greater need for insulin, which again leads to fewer glucose receptors. Exercise reverses this process, but if left unchecked, it can spiral into insulin resistance.
Inflammation causes Insulin Resistance
Inflammation is also implicated in causing insulin resistance. Studies have shown that insulin resistance do not develop under dietary conditions that normally produce it in the absence of inflammatory mediators such as interleukin 6 (IL6) and tumour necrosis factor TNFalpha).
Central obesity causes inflammation and thus insulin resistance
Central obesity is related to fat cells called visceral adipose cells. These fat cells produce significant amounts of proinflammatory cytokines such as tumour necrosis factor-alpha (TNF-a), and Interleukins-1 and -6, etc. Proinfammatory cytokines profoundly disrupt normal insulin action in fat and muscle cells, and may be a major factor in insulin resistance.
Central obesity is also related to an accumulation of fat in the liver, a condition known as nonalcoholic fatty liver disease (NAFLD). The result of NAFLD is an excessive release of free fatty acids into the bloodstream and an increase in hepatic glucose production, both of which have the effect of exacerbating insulin resistance and increasing the likelihood of type-2 diabetes.
Vitamin D deficiency causes Insulin Resistance
Vitamin D deficiency is also associated with insulin resistance.
Drugs causes insulin resistance
Certain drugs may also be associated with insulin resistance (e.g., glucocorticoids).
Magnesium Deficiency causes insulin resistance
Magnesium (Mg) is present in living cells and its plasma concentration is remarkably constant in healthy subjects. Magnesium levels are closely related to insulin. Poor intracellular Magnesium concentrations are found in noninsulin-dependent diabetes mellitus (NIDDM) and in hypertensive patients, By contrast, in NIDDM patients daily magnesium administration improves insulin sensitivity.
Excess consumption of bad fats causes Insulin Resistance
Some types of Monounsaturated fatty acids and saturated fats appear to promote insulin resistance, whereas some types of polyunsaturated fatty acids such as omega-3 can increase insulin sensitivity.
Herbal Medicine to imporve insulin sensitivity and balance blood sugar
Carahealth Blood Sugar contains Cinnamon (Cinnamonum zeylanicum), Gymnema (Gmynema sylvestra, Globe artichoke (Cynara scolymus), Nettle (Urtica dioica), Fenugreek (Trigonella foenum-graecum, Milk thistle (Silybum marinarum)and Bilberry (Vaccinium myrtillus).
Carahealth Blood Sugar contains hypoglycaemic herbs specifically formulated to prevent sharp rises in blood sugar and to lower blood sugar levels. The tincture also reduces cravings for sugar by blocking sugar receptors in the tongue. It is indicated for reactive hypoglycaemia (This results from initial high blood sugar and resultant pancreatic dumping of insulin), and can alleviate symptoms including hunger, shakiness, nervousness, sweating, dizziness or light-headedness, confusion, difficulty speaking, anxiety, weakness. As this tincture reduces balances blood sugar levels and cravings for carbohydrates, it is useful as part of a programme to promote weightloss.
Carahealth Blood Sugar is specific to treat and prevent insulin resistance, type 2 diabetes and is also useful to manage sugar levels in type 1 diabetes. The herbs potentiate the effect of prescribed insulin so that less insulin will be required under medical supervision. More broadly the tincture can treat Metabolic Syndrome, a condition associated with blood sugar imbalance, fasting hyperglycemia, diabetes mellitus type 2, insulin resistance, high blood pressure, central obesity, decreased HDL cholesterol and elevated triglycerides.
Cinnamon bark Cinnamonum zeylanicum
Cinnamon slows the rate at which the stomach empties after meals, reducing the rise in blood sugar after eating.. Cinnamon significantly improves insulin activity.
Gymnema / Gurmari Gmynema sylvestra
Gymnema is antidiabetic, antisweetener and anti-inflammatory. The herb has been shown to reduce blood sugar levels when used for an extended period of time. Additionally, Gymnema reduces cravings for sugar by blocking sugar receptors in the tongue, thus some use it to fight sugar cravings.
Globe artichoke Cynara scolymus
Globe artichoke is anticholesterolemic, antirheumatic, cholagogue, digestive, diuretic, hypoglycaemic and lithotropic. The globe artichoke has become important as a medicinal herb in recent years following the discovery of the bitter-tasting compound, cynarin which improves liver and gall bladder function, stimulates the secretion of digestive juices, especially bile, and lowers blood cholesterol levels.
Nettle leaf Urtica dioica
Nettles are rich in vitamins A, C, D, iron, potassium, manganese, and calcium and chlorophyll. Urtica has been shown experimentally to have both hypoglycaemic and hyperglycaemic properties, the hypoglycaemic component being 'urticin'. Nettle leaf extract contains active compounds that reduce TNF-α and other inflammatory cytokines associated with obesity.
Fenugreek seeds Trigonella foenum-graecum
Fenugreek is much used in herbal medicine, especially in North Africa, the Middle East and India. Research has shown that the seeds can inhibit cancer of the liver, lower blood cholesterol levels and improve insulin sensitivity.
Milk thistle Silybum marinarum
Milk thistle is the trophorestorative of the liver. Milk thistle is used to increase the secretion and flow of bile from the liver and gall bladder and contains constituents, which protect liver cells from chemical damage. As the liver breaks down glycogen into glucose between meals, taking a liver remedy is part of the naturopathic approach to balancing blood sugar. As milk thislte imorves bile flow from the liver, milk thistle treats a sluggish liver, fatty liver or non alcoholic fatty liver disease (NAFLD).
Bilberry Vaccinium myrtillus
Bilberry is a remedy for diabetes if taken for a prolonged period. The leaves contain glucoquinones, which reduce the levels of sugar in the blood. Bilberry will help prevent retinopathy.
Nutritional supplements to improve insulin sensitivity
Vitamin C improves insulin sensitivity
People with Type 1 diabetes (IDDM) and insulin resistance or Metabolic syndrome or pre-diabetes have low vitamin C levels. Vitamin C lowers sorbitol in diabetics. Sorbitol is a sugar that can accumulate and damage the eyes, nerves, and kidneys of diabetics. Vitamin C may improve insulin sensitivity and glucose tolerance in Type 2 diabetes (NIDDM).
The transport of vitamin C into cells is facilitated by insulin. It has been postulated that, due to impaired transport or dietary insufficiency, a relative vitamin C deficiency exists in the diabetic and that this may be responsible for the increased capillary permeability and other vascular disturbances seen in diabetics. Dosage is 1-3 grams per day of vitamin C in the form of calcium ascorbate or magnesium ascorbate.
Chromium improves insulin sensitivity via its role in Glucose Tolerance Factor GTF
Chromium supplements such as chromium picolinate have been shown to improve insulin sensitivity. As a key constituent of the 'glucose tolerance factor,' chromium is a critical nutrient to promtoe insulin sensitvity. Supplementation in the form of chromium picolinate (200 mcg 2 x daily) has been demonstrated to decrease fasting glucose levels, improve glucose tolerance, lower insulin levels and decrease total cholesterol and triglyceride levels, while increasing HDL-cholesterol levels. Exercise increases tissue chromium concentrations.
Magnesium improves insulin sensitivity
Magnesium levels are lowered in patients with insulin resistance. Scientists believe that a deficiency of magnesium interrupts insulin secretion in the pancreas and increases insulin resistance in the body's tissues. Supplementation with magnesium leads to improved insulin production in elderly people with Type 2 diabetes. Elders without diabetes may also produce more insulin as a result of magnesium supplements. Insulin requirements are lower in people with Type 1 diabetes who supplement with magnesium.
The therapeutic dose of magnesium in patients with insulin resistance is 300-400 mg of magnesium per day.
Zinc improves insulin sensitivity
Zinc is involved in virtually all aspects of insulin metabolism including synthesis, secretion and utilisation. Zinc also has a protective effect against beta cell destruction, and has well-known anti-viral effects. People with Type 2 diabetes (NIDDM) also have low zinc levels, caused by excess loss of zinc in their urine, which may impair immune function.
Zinc supplements lower blood sugar levels and iomporve insulin sensitivity. Take zinc with food to prevent stomach upset. If you take over 30 milligrams of zinc on a daily basis for more than one or two months, you should also take 1 to 2 milligrams of copper each day to maintain a proper mineral balance. Recommended dosage is 25mg once daily.
Dietary Advice to improve insulin sensitvity and treat Insulin Resistance
Research has shown the Maitake mushroom (Grifola frondosa) has a hypoglycemic effect, and may be beneficial for the management of diabetes. The reason Maitake lowers blood sugar is due to the fact the mushroom naturally acts as an alpha glucosidase inhibitor. Other mushrooms like Reishi, Agaricus blazei, Cordyceps lowers blood sugar levels.
Adopt a general anti-inflammatory diet to reduce IL6, IL1, TNF alpha & CRP as these are high in obesity
Mediterranean diet lower CRP, IL1 & IL6 (high in obesity)
Levels of C-reactive protein can be decreased by increasing consumption of fruits and vegetables. Sticking to a Mediterranean diet, high in fruits and vegetables and low in saturated fats, lowers levels of inflammation as reflected by lower levels of C-reactive protein, IL1 and IL6.
Foods high in fibre lower CRP, IL1 & IL6 (high in obesity)
In a study of 524 healthy adults, investigators found that those with the highest fibre intake had lower blood levels of C-reactive protein CRP than those who ate the least fibre. The findings support the general recommendation that adults get 20 to 35 grams of fibre per day in the form of fruits, vegetables, beans and whole grains. Both soluble and insoluble fibre lower CRP levels. Soluble fibre is found in oatmeal, beans, berries, apples, kidney beans, pinto beans, and black-eyed peas ect while whole grains and many vegetables are good sources of insoluble fibre.
Flavonoids lower C-reactive protein
Intake of dietary flavonoids is inversely associated with serum CRP concentrations in U.S. adults. Intake of flavonoid-rich foods reduces inflammation-mediated chronic diseases. Food sources of flavanoids include, tea, green tea, apples, apricots, blueberries, pears, raspberries, stra