Atkins Diabetes Revolution (6 page)

I liked Dr. Atkins right away. He reminded me of the old-time GP I had as a child. He was solid and confident.“You’ve got a complex medical situation here,” he said, “and it could have been straightened out years
ago.” He asked me several questions, went through the eating plan with me, and told me I’d need to come to The Atkins Center once a month for follow-up. So for the next six months, I went every month—a big commitment when you have to drive three and a half hours to get there. Fortunately, my husband was willing to get up at six a.m. and drive with me each time.

When I first saw Dr. Atkins, my blood sugar level was 179, my cholesterol was 215, my triglycerides were 158, my HDL was 41 and my LDL was 142, and other lab results were also out of whack.As I’d suspected, my thyroid was not okay. Dr. Atkins took me off my medication and put me on natural alternatives. As of my last visit, my thyroid was normal, my cholesterol was down to 160, my blood sugar was within the normal range, and all of my other lab results had dropped from high-risk levels to within a normal range. My weight is 205 pounds—42 pounds less than I was—and I’m still losing about a quarter of a pound each week. I have lost 72 inches and am wearing a size 16 or 18. It’s a very slow process, but I have to look at the big picture. It’s not so much the change in my weight that matters, it’s the improvements in my blood sugar and my cholesterol. Recent labs measured a fasting blood sugar level of 96, cholesterol of 164, triglycerides of 72, HDL of 55, and LDL of 95. Dr. Atkins said that when I first came to him, I was three months away from a heart event.

Thanks to Atkins, I now exercise and can walk up and down the stairs of my house without becoming out of breath. Best of all, at age 57, I have a general, overall sense of well-being that I never had before. I also like what I see in the mirror. Recently, I was packing for a trip to Florida and I tried on a top that was a size 2X or something. I turned to my husband and said, “Look how big this is on me!” He smiled at me and said, “You just lit right up when you said that.” I’m going to save that top forever as a reminder to never go back to that size again.

Note: Your individual results may vary from those reported here.

Chapter 3

WEIGHING IN: THE NUMBER ONE RISK FACTOR

As we have stressed, the road to diabetes is a long one and at any point along the way, you can tip the balance back in your favor and stop the progression. That’s because you have a good deal of control over most of the risk factors for diabetes. The warning signs are there, if you have the knowledge and awareness to recognize them. In fact, if all this book does is help you notice these signs before you—or your doctor— would have otherwise, it will have been well worth the purchase price.

The number one risk factor for both men and women for developing diabetes is obesity, although you do not have to be overweight to become diabetic.
1
There is a clear relationship among weight gain,age, and the risk of developing Type 2 diabetes in women. The younger a woman is when she begins to gain weight, the higher her lifetime risk of getting diabetes. The good news is that studies show that over- weight women who slimmed down were able to lower their risk.
2

Research findings on men show the same trends.The long-running Health Professionals Study looked at the relationship between obesity and weight gain and Type 2 diabetes in more than 51,000 men, ages 40 to 75. Researchers found that men with a BMI of 35 or greater were42.1 times more likely to develop diabetes compared with men at their ideal weight with a BMI of 23 or less.
3

Preventing normal individuals in certain populations from becom ing overweight has also been shown to prevent diabetes.Maintaining a healthy weight would result in a 62 percent reduction in the incidence of Type 2 diabetes in Mexican Americans and a 74 percent reduction in non-Hispanic whites.
4
Genetics and other factors—which we’ll discuss later—can lead to Type 2 diabetes in people whose weight is within the normal range.

WHAT DOES OVERWEIGHT MEAN?

How heavy do you need to be to be at risk? That depends. The terms
normal weight, overweight,
and
obese
are really ways of describing weight ranges, not exact weights. That’s why the medical profession has stopped using the old weight-for-height charts to determine a person’s level of excess weight. The charts took a one-size-fits-all approach that defined the normal range too broadly and did not take body composition into consideration.

Since 1998,doctors have used the body-weight guidelines issued by the National Institutes of Health. These guidelines are based on body mass index (BMI). The BMI uses a mathematical formula to compare your height to your weight. (There’s a separate BMI formula for kids and teens,discussed in Chapter 24.) To find your BMI,use the table on pages 28–29.

According to the chart, a woman who is 64 inches tall (5 feet 4 inches) and weighs between 110 and 144.9 pounds is within the normal weight range for her height. As a general rule, however, you want your BMI to be in the 20 to 22 range—so in this case,she would ideally weigh between 116 and 128 pounds. The difference in pounds across BMI levels takes into account different builds and body types. If this same woman weighed between 145 and 173 pounds, she would be overweight; if she weighed 174 pounds or more, she would be obese. To qualify as morbidly obese, she would need to weigh more than 232 pounds. (The terms
extreme
and
morbid obesity
are used for people who are so overweight that their weight interferes with basic physical functions such as breathing.) The BMI chart lets you see quickly and accurately where you stand in weight range for your height. If you’re overweight or obese, it also gives you a good idea of what a healthier weight range would be for you.

WHAT YOUR BMI MEANS

Doctors use the BMI to classify an individual’s weight as follows:

Normal weight range: BMI of between 20 and 24.9

Overweight: BMI of between 25 and 29.9

Obese: BMI of 30 or more

Extremely or morbidly obese: BMI of 40 or more
5

Still, there are some limitations to the BMI chart. If you’re very muscular, your BMI might fall into the overweight category, even though you’re very fit and have a normal to low percentage of body fat. A more worrisome problem is that you might fall into the normal BMI weight range even though poor health has left you frail and you should actually weigh more. For those over 65, desirable BMI ranges are slightly higher.
6
However, the BMI is a pretty good indication how your weight compares with the normal range.

A more accurate way to figure out if you’re overweight is to ascertain your percentage of body fat. Body-fat measurement is not a standard test at a typical doctor’s office. It requires special equipment and it’s usually not an exact science. It’s most useful for tracking the trend of your weight, especially if you are exercising, to see if you are losing fat and gaining muscle.
7

DIABETES AND BMI

An individual’s risk of getting diabetes increases proportionally to the increase in his or her BMI.In the United States,two-thirds of the adult men and women diagnosed with diabetes have a BMI above 27.As you can see by the chart on pages 28–29, a BMI of 27 qualifies a person as overweight but not yet obese.
8
,
9

To use this chart, find your height in inches in the left-hand column, and then look

across to find your weight in pounds.The number at the top of the column is your body

mass index.

BODY MASS INDEX (BMI) TABLE

Source: Adapted from
Clinical Guidelines on the Identification, Evaluation, and Treatment of Over- weight and Obesity in Adults: The Evidence Report.

Dr.Atkins used to say that he rarely saw a patient with a BMI above 30 who wasn’t already well on the way to diabetes, or there already. One patient, Larry H., really stands out in that regard. Several years before he came to see Dr. Atkins, Larry was told by his doctor that he was borderline diabetic and put him on a variety of drugs. Larry, who was overweight, dutifully took the drugs but didn’t change his high- carb diet. When he arrived at the office, he had gained even more weight and his BMI was around 37. Dr. Atkins took one look at Larry and just knew he already had diabetes. His fasting blood sugar con- firmed his hunch—it came in at 201 mg/dL.

RESEARCH REPORT: WOMEN, WEIGHT GAIN, AND DIABETES

In an article published in 1995, researchers studied weight and weight gain among women as risk factors for developing Type 2 diabetes. They looked at more than 114,000 women, ages 30 to 55, who had taken part in the long-running Nurses’Health Study between 1976 and 1990.
10

Not surprisingly, the researchers found that among these women, body mass index was the dominant predictor of diabetes. The higher their BMI, the greater the risk. Even women who were at the high end of
normal
weight,with a BMI of 24,had an elevated risk.

The heavier a woman is, the greater her risk of diabetes, as shown in the following chart:

The researchers also looked at the women’s weight gain over the 14 years of the study. Compared with women whose weight stayed pretty much the same or went up by fewer than 11 pounds,women who experienced more weight gain had a greater risk of diabetes, as shown in the following chart:

Even among the women who fell into the normal BMI category, modest amounts of weight gain increased the risk of diabetes. The
women who started the study with BMIs between 22 and 25 and gained only 11 to 15 pounds (5 to 6.9 kg) over 14 years still had 1.6 times the risk of diabetes. In other words, even though at the end of the study period they were still within the guidelines for normal weight, the weight they did gain was enough to nearly double their risk of diabetes.
11

THE HEALTH RISKS OF BEING OVERWEIGHT

If you are carrying around extra pounds, you are tempting fate in more ways than one. Overall, being obese significantly increases your risk of developing the metabolic syndrome and all its potential complications. It is so important that you understand this condition that we have devoted an entire chapter to it. Without an understanding of the abnormal changes in your chemistry, it will be impossible for you to comprehend why controlling carbs is a key to prevention of diabetes. Being overweight also is implicated in gallbladder disease, a number of forms of cancer, osteoarthritis, asthma, sleep apnea, breathing difficulties, complications of pregnancy, polycystic ovary syndrome (PCOS), and increased surgical risk.
12